Shanghai: Front-Runner of Community-Based Eldercare in China.

PubMed

Chen, Lin; Han, Wen-Jui

2016-01-01

Facing dramatic growth in its elderly population, Shanghai, China's economic center, has strategically exercised decentralized policy-making power to develop community-based service centers for the elderly. A growing number of elders have been using such services, particular dining services, since 2007. We discuss the evolution in community-based eldercare services in Shanghai, using dining services as an example. We also compare these service centers in Shanghai to multipurpose senior centers in the United States to offer policy recommendations for Shanghai and China's growing eldercare industry. Tailored policy recommendations are discussed.

Operating Policies and Procedures of Computer Data-Base Systems.

ERIC Educational Resources Information Center

Anderson, David O.

Speaking on the operating policies and procedures of computer data bases containing information on students, the author divides his remarks into three parts: content decisions, data base security, and user access. He offers nine recommended practices that should increase the data base's usefulness to the user community: (1) the cost of developing…

Improving the recommender algorithms with the detected communities in bipartite networks

NASA Astrophysics Data System (ADS)

Zhang, Peng; Wang, Duo; Xiao, Jinghua

2017-04-01

Recommender system offers a powerful tool to make information overload problem well solved and thus gains wide concerns of scholars and engineers. A key challenge is how to make recommendations more accurate and personalized. We notice that community structures widely exist in many real networks, which could significantly affect the recommendation results. By incorporating the information of detected communities in the recommendation algorithms, an improved recommendation approach for the networks with communities is proposed. The approach is examined in both artificial and real networks, the results show that the improvement on accuracy and diversity can be 20% and 7%, respectively. This reveals that it is beneficial to classify the nodes based on the inherent properties in recommender systems.

Systemic Therapy in Men With Metastatic Castration-Resistant Prostate Cancer: American Society of Clinical Oncology and Cancer Care Ontario Clinical Practice Guideline

PubMed Central

Basch, Ethan; Loblaw, D. Andrew; Oliver, Thomas K.; Carducci, Michael; Chen, Ronald C.; Frame, James N.; Garrels, Kristina; Hotte, Sebastien; Kattan, Michael W.; Raghavan, Derek; Saad, Fred; Taplin, Mary-Ellen; Walker-Dilks, Cindy; Williams, James; Winquist, Eric; Bennett, Charles L.; Wootton, Ted; Rumble, R. Bryan; Dusetzina, Stacie B.; Virgo, Katherine S.

2014-01-01

Purpose To provide treatment recommendations for men with metastatic castration-resistant prostate cancer (CRPC). Methods The American Society of Clinical Oncology and Cancer Care Ontario convened an expert panel to develop evidence-based recommendations informed by a systematic review of the literature. Results When added to androgen deprivation, therapies demonstrating improved survival, improved quality of life (QOL), and favorable benefit-harm balance include abiraterone acetate/prednisone, enzalutamide, and radium-223 (223Ra; for men with predominantly bone metastases). Improved survival and QOL with moderate toxicity risk are associated with docetaxel/prednisone. For asymptomatic/minimally symptomatic men, improved survival with unclear QOL impact and low toxicity are associated with sipuleucel-T. For men who previously received docetaxel, improved survival, unclear QOL impact, and moderate to high toxicity risk are associated with cabazitaxel/prednisone. Modest QOL benefit (without survival benefit) and high toxicity risk are associated with mitoxantrone/prednisone after docetaxel. No benefit and excess toxicity are observed with bevacizumab, estramustine, and sunitinib. Recommendations Continue androgen deprivation (pharmaceutical or surgical) indefinitely. Abiraterone acetate/prednisone, enzalutamide, or 223Ra should be offered; docetaxel/prednisone should also be offered, accompanied by discussion of toxicity risk. Sipuleucel-T may be offered to asymptomatic/minimally symptomatic men. For men who have experienced progression with docetaxel, cabazitaxel may be offered, accompanied by discussion of toxicity risk. Mitoxantrone may be offered, accompanied by discussion of limited clinical benefit and toxicity risk. Ketoconazole or antiandrogens (eg, bicalutamide, flutamide, nilutamide) may be offered, accompanied by discussion of limited known clinical benefit. Bevacizumab, estramustine, and sunitinib should not be offered. There is insufficient evidence to evaluate optimal sequences or combinations of therapies. Palliative care should be offered to all patients. PMID:25199761

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

PubMed

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

2004-10-01

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

A Cognitive-Behavioral Approach to Chronic Pain Management.

ERIC Educational Resources Information Center

Grant, Lynda D.; Haverkamp, Beth E.

1995-01-01

Provides counselors with an introduction to the role of psychosocial processes in the experience of pain and offers assessment and intervention recommendations based on a cognitive-behavioral therapy approach to pain management. (JPS)

World Health Organization recommendations are often strong based on low confidence in effect estimates.

PubMed

Alexander, Paul E; Bero, Lisa; Montori, Victor M; Brito, Juan Pablo; Stoltzfus, Rebecca; Djulbegovic, Benjamin; Neumann, Ignacio; Rave, Supriya; Guyatt, Gordon

2014-06-01

Expert guideline panelists are sometimes reluctant to offer weak/conditional/contingent recommendations. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance warns against strong recommendations when confidence in effect estimates is low or very low, suggesting that such recommendations may seldom be justified. We aim to characterize the classification of strength of recommendations and confidence in estimates in World Health Organization (WHO) guidelines that used the GRADE approach and graded both strength and confidence (GRADEd). We reviewed all WHO guidelines (January 2007 to December 2012), identified those that were GRADEd, and, in these, examined the classifications of strong and weak and associated confidence in estimates (high, moderate, low, and very low). We identified 116 WHO guidelines in which 43 (37%) were GRADEd and had 456 recommendations, of which 289 (63.4%) were strong and 167 (36.6%) were conditional/weak. Of the 289 strong recommendations, 95 (33.0%) were based on evidence warranting low confidence in estimates and 65 (22.5%) on evidence warranting very low confidence in estimates (55.5% strong recommendations overall based on low or very low confidence in estimates). Strong recommendations based on low or very low confidence estimates are very frequently made in WHO guidelines. Further study to determine the reasons for such high uncertainty recommendations is warranted. Copyright © 2014 Elsevier Inc. All rights reserved.

Recreation-Based Camps for Military Children: Past, Present, and Future

ERIC Educational Resources Information Center

Griffiths, Haley K.; Townsend, Jasmine A.

2018-01-01

This article discusses current literature and recommendations for future recreation-based camps for military children aged 7 to 17. Since the beginning of the Global War on Terrorism, the amount of government and community-based programs offered for military families over the past 15 years has significantly increased. This article gives a brief…

Discovering Their Needs: Southern Rural Women of East India.

PubMed

Wilson-Anderson, Kaye; Lee, Holly; Pinnock, Jessi; Sybrandt, Anne; White, Alissa

2016-01-01

This qualitative, descriptive, phenomenological study explored how southern, rural women in India (N = 14) view health, how they learned about health, and what health education they desired. Health education classes were offered, based on participants' responses. Recommendations are offered for a best practice model that could potentially enhance the efforts of non-Indian nurses desiring to assist impoverished women and families in India.

17 CFR 229.1012 - (Item 1012) The solicitation or recommendation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... offer or is unable to take a position with respect to the tender offer. (b) Reasons. State the reasons... recommendation, state whether the filing person is advising holders of the subject securities to accept or reject the tender offer or to take other action with respect to the tender offer and, if so, describe the...

The Endocrine Society guidelines: when the confidence cart goes before the evidence horse.

PubMed

Brito, Juan P; Domecq, Juan P; Murad, Mohammed H; Guyatt, Gordon H; Montori, Victor M

2013-08-01

In 2005, the Endocrine Society (TES) adopted the GRADE system of developing clinical practice guidelines. Grading of Recommendations, Assessment, Development, and Evaluation working group guidance suggests that strong recommendations based on low or very low (L/VL) confidence may often be inappropriate, and has offered a taxonomy of paradigmatic situations in which strong recommendations based on L/VL confidence estimates may be appropriate. We sought to characterize strong recommendations of TES based on L/VL confidence evidence. We identified all strong recommendations based on L/VL confidence evidence published in TES guidelines between 2005 and 2011. We identified those consistent with one of the paradigmatic situations in the taxonomy. Two hundred six of 357 (58%) of the recommendations of TES were strong; of these, 121 (59%) were based on L/VL confidence evidence. Of these 121, 35 (29%) were consistent with one of the paradigmatic situations. The most common situation (13, 11%) was of a strong recommendation against the intervention because of low confidence evidence for benefit and high confidence evidence for harm. The remaining 86 (71%) comprised 43 (36%) "best practice" statements for which sensible alternatives do not exist; 5 (4%) in which recommendations were for "additional research"; 5 (4%) in which greater confidence in the estimates was warranted; and 33 (27%) for which we could not find a compelling explanation for the incongruence. Guideline panels should beware of formulating strong recommendations when confidence in estimates is low. Our taxonomy when such recommendations are appropriate may be helpful.

EEG Based Analysis of Cognitive Load Enhance Instructional Analysis

ERIC Educational Resources Information Center

Dan, Alex; Reiner, Miriam

2017-01-01

One of the recommended approaches in instructional design methods is to optimize the value of working memory capacity and avoid cognitive overload. Educational neuroscience offers novel processes and methodologies to analyze cognitive load based on physiological measures. Observing psychophysiological changes when they occur in response to the…

Challenges and Opportunities for Learning Biology in Distance-Based Settings

ERIC Educational Resources Information Center

Hallyburton, Chad L.; Lunsford, Eddie

2013-01-01

The history of learning biology through distance education is documented. A review of terminology and unique problems associated with biology instruction is presented. Using published research and their own teaching experience, the authors present recommendations and best practices for managing biology in distance-based formats. They offer ideas…

Conceptual design study. Science and Applications Space Platform (SASP). Final briefing

NASA Technical Reports Server (NTRS)

1980-01-01

The modularity, shape, and size of the recommended platform concept offers a low investment, early option to demonstrate the system; flexibility to conservative growth; adaptability to great variety of multi or dedicated payload groups; and good dispersion and viewing freedom for payloads. Platform configuration effectively supports 80 to 85% of the NASA/OSS and OSTA payloads. The subsystem approaches recommended are based on cost effective distribution of functions.

Training Research: Practical Recommendations for Maximum Impact

PubMed Central

Beidas, Rinad S.; Koerner, Kelly; Weingardt, Kenneth R.; Kendall, Philip C.

2011-01-01

This review offers practical recommendations regarding research on training in evidence-based practices for mental health and substance abuse treatment. When designing training research, we recommend: (a) aligning with the larger dissemination and implementation literature to consider contextual variables and clearly defining terminology, (b) critically examining the implicit assumptions underlying the stage model of psychotherapy development, (c) incorporating research methods from other disciplines that embrace the principles of formative evaluation and iterative review, and (d) thinking about how technology can be used to take training to scale throughout all stages of a training research project. An example demonstrates the implementation of these recommendations. PMID:21380792

Department of Defense meteorological and environmental inputs to aviation systems

NASA Technical Reports Server (NTRS)

Try, P. D.

1983-01-01

Recommendations based on need, cost, and achievement of flight safety are offered, and the re-evaluation of weather parameters needed for safe landing operations that lead to reliable and consistent automated observation capabilities are considered.

Neonatal physical therapy. Part II: Practice frameworks and evidence-based practice guidelines.

PubMed

Sweeney, Jane K; Heriza, Carolyn B; Blanchard, Yvette; Dusing, Stacey C

2010-01-01

(1) To outline frameworks for neonatal physical therapy based on 3 theoretical models, (2) to describe emerging literature supporting neonatal physical therapy practice, and (3) to identify evidence-based practice recommendations. Three models are presented as a framework for neonatal practice: (1) dynamic systems theory including synactive theory and the theory of neuronal group selection, (2) the International Classification of Functioning, Disability and Health, and (3) family-centered care. Literature is summarized to support neonatal physical therapists in the areas of examination, developmental care, intervention, and parent education. Practice recommendations are offered with levels of evidence identified. Neonatal physical therapy practice has a theoretical and evidence-based structure, and evidence is emerging for selected clinical procedures. Continued research to expand the science of neonatal physical therapy is critical to elevate the evidence and support practice recommendations.

Virginia method for the design of dense-graded emulsion mixes.

DOT National Transportation Integrated Search

1982-01-01

An investigation into the Illinois method for the design of dense-graded emulsion base mixes had resulted in a report offering several modifications to that procedure. The Bituminous Research Advisory Committee then recommended that the Illinois meth...

International Human Resource Management Education: A Survey of HR Professionals, Suggestions for Skill Dissemination.

ERIC Educational Resources Information Center

Barclay, Lizabeth A.; Wagner-Marsh, Fraya; Loewe, G. Michael

2002-01-01

Surveyed a human resource professional association about training and interest in international human resources management. Based on results, offers recommendations for expanding coverage of this topic in credit and non-credit courses. (EV)

Development of sensors for ceramic components in advanced propulsion systems: Survey and evaluation of measurement techniques for temperature, strain and heat flux for ceramic components in advanced propulsion systems

NASA Technical Reports Server (NTRS)

Atkinson, W. H.; Cyr, M. A.; Strange, R. R.

1988-01-01

The report presents the final results of Tasks 1 and 2, Development of Sensors for Ceramic Components in Advanced Propulsion Systems (NASA program NAS3-25141). During Task 1, an extensive survey was conducted of sensor concepts which have the potential for measuring surface temperature, strain and heat flux on ceramic components for advanced propulsion systems. Each sensor concept was analyzed and evaluated under Task 2; sensor concepts were then recommended for further development. For temperature measurement, both pyrometry and thermographic phosphors are recommended for measurements up to and beyond the melting point of ceramic materials. For lower temperature test programs, the thin-film techniques offer advantages in the installation of temperature sensors. Optical strain measurement techniques are recommended because they offer the possibility of being useful at very high temperature levels. Techniques for the measurement of heat flux are recommended for development based on both a surface mounted sensor and the measurement of the temperature differential across a portion of a ceramic component or metallic substrate.

Comprehension Instruction: Research-Based Best Practices. Solving Problems in the Teaching of Literacy. Second Edition

ERIC Educational Resources Information Center

Block, Cathy Collins, Ed.; Parris, Sheri R., Ed.

2008-01-01

Now in a substantially revised and updated second edition, this comprehensive professional resource and text is based on cutting-edge research. In each chapter, leading scholars provide an overview of a particular aspect of comprehension, offer best-practice instructional guidelines and policy recommendations, present key research questions still…

Grading NASA's Solar System Exploration Program: A Midterm Report

NASA Technical Reports Server (NTRS)

2008-01-01

The Committee on Assessing the Solar System Exploration Program has reviewed NASA's progress to date in implementing the recommendations made in the National Research Council's (NRC's) solar system exploration decadal survey covering the period 2003-2013, New Frontiers in the Solar System, and in its Mars Architecture report, Assessment of NASA s Mars Architecture 2007-2016. The committee assessed NASA's progress with respect to each individual recommendation in these two reports, assigning an academic-style grade, explaining the rationale for the grade and trend, and offering recommendations for improvement. The committee generally sought to develop recommendations in cases where it determined that the grade, the trend, or both were worrisome and that the achievement of a decadal survey recommendation would require some kind of corrective action on NASA's part. This usually meant that the committee sought to offer a recommendation when the grade was a "C" or lower. However, the committee did offer recommendations in connection with some higher grades when it believed that minor corrective action was possible and desirable. More importantly, the committee did not offer recommendations for some of the activities given lower grades, particularly in the enabling technologies area (Chapter 6), because the committee determined that only the restoration of funding and the development of a strategic technology development program would solve these problems.

Summary of evidence-based guideline: Complementary and alternative medicine in multiple sclerosis

PubMed Central

Yadav, Vijayshree; Bever, Christopher; Bowen, James; Bowling, Allen; Weinstock-Guttman, Bianca; Cameron, Michelle; Bourdette, Dennis; Gronseth, Gary S.; Narayanaswami, Pushpa

2014-01-01

Objective: To develop evidence-based recommendations for complementary and alternative medicine (CAM) in multiple sclerosis (MS). Methods: We searched the literature (1970–March 2011; March 2011−September 2013 MEDLINE search), classified articles, and linked recommendations to evidence. Results and recommendations: Clinicians might offer oral cannabis extract for spasticity symptoms and pain (excluding central neuropathic pain) (Level A). Clinicians might offer tetrahydrocannabinol for spasticity symptoms and pain (excluding central neuropathic pain) (Level B). Clinicians should counsel patients that these agents are probably ineffective for objective spasticity (short-term)/tremor (Level B) and possibly effective for spasticity and pain (long-term) (Level C). Clinicians might offer Sativex oromucosal cannabinoid spray (nabiximols) for spasticity symptoms, pain, and urinary frequency (Level B). Clinicians should counsel patients that these agents are probably ineffective for objective spasticity/urinary incontinence (Level B). Clinicians might choose not to offer these agents for tremor (Level C). Clinicians might counsel patients that magnetic therapy is probably effective for fatigue and probably ineffective for depression (Level B); fish oil is probably ineffective for relapses, disability, fatigue, MRI lesions, and quality of life (QOL) (Level B); ginkgo biloba is ineffective for cognition (Level A) and possibly effective for fatigue (Level C); reflexology is possibly effective for paresthesia (Level C); Cari Loder regimen is possibly ineffective for disability, symptoms, depression, and fatigue (Level C); and bee sting therapy is possibly ineffective for relapses, disability, fatigue, lesion burden/volume, and health-related QOL (Level C). Cannabinoids may cause adverse effects. Clinicians should exercise caution regarding standardized vs nonstandardized cannabis extracts and overall CAM quality control/nonregulation. Safety/efficacy of other CAM/CAM interaction with MS disease-modifying therapies is unknown. PMID:24663230

Tribal recommendations for designing culturally appropriate technology-based sexual health interventions targeting Native youth in the Pacific Northwest.

PubMed

Craig Rushing, Stephanie; Stephens, David

2012-01-01

Media technologies, including the Internet, cell phones, and video games, offer new avenues to reach Native youth on sensitive health topics. Project Red Talon, a sexually transmitted disease (STD)/HIV prevention project that serves the 43 federally recognized tribes in Oregon, Washington, and Idaho, used community-based participatory research methods in partnership with the Northwest tribes to review existing technology-based interventions and generate recommendations for designing interventions that reflect the culture, needs, and organizational capacities of participating tribes and Native youth. These findings are now being used to guide the development of technology-based health interventions targeting American Indian/Alaska Native teens and young adults.

Ignoring the Market.

ERIC Educational Resources Information Center

Chubb, John E.

2003-01-01

Argues that market-driven education (charter schools, vouchers) is the most effective, albeit overlooked, reform strategy since publication of "A Nation at Risk." Describes corresponding growth of for-profit school management. Offers several recommendations to improve effectiveness of market-based reforms, such as state' continuing…

Do Sweat the Small Stuff: Stemming School Violence.

ERIC Educational Resources Information Center

Willert, H. Jennette

2002-01-01

Reports high school students' views on school violence based on interviews with 11 students in a focus group. For example, schools fail to educate students about violence prevention. Offers four recommendations to improve school climate and safety. (Contains 16 references.) (PKP)

Integration of tobacco cessation services into multidisciplinary lung cancer care: rationale, state of the art, and future directions

PubMed Central

Warren, Graham W.

2015-01-01

Tobacco use is the largest risk factor for lung cancer and many lung cancer patients still smoke at the time of diagnosis. Although clinical practice guidelines recommend that all patients receive evidence-based tobacco treatment, implementation of these services in oncology practices is inconsistent and inadequate. Multidisciplinary lung cancer treatment programs offer an ideal environment to optimally deliver effective smoking cessation services. This article reviews best practice recommendations and current status of tobacco treatment for oncology patients, and provides recommendations to optimize delivery of tobacco treatment in multidisciplinary practice. PMID:26380175

Do physicians' attitudes toward implantable cardioverter defibrillator therapy vary by patient age, gender, or race?

PubMed

Al-Khatib, Sana M; Sanders, Gillian D; O'Brien, Sean M; Matlock, Daniel; Zimmer, Louise O; Masoudi, Frederick A; Peterson, Eric

2011-01-01

Implantable cardioverter defibrillator (ICD) therapy improves survival of patients with systolic heart failure. We assessed whether physicians' recommendation for ICD therapy varies as a function of patient age, gender, race, and physician's specialty. We surveyed a random sample (n = 9969) of U.S. physicians who are active members of the American College of Cardiology (ACC). We asked participants about their likelihood to recommend ICD therapy in 4 clinical scenarios that randomly varied patient age, gender, race, and ICD indication (guideline Class I, Class IIa, Class III, and Class I in a noncompliant patient). Responses were received from 1210 physicians (response rate 12%), of whom 1127 met the study inclusion criteria. Responders and nonresponders had similar demographics. In responding to hypothetical clinical scenarios, physicians were less likely to recommend an ICD to older patients (≥80 vs 50 years) (P < 0.01) but were unaffected by gender or race for all class indications. Compared with non-electrophysiologists (EPs), EPs were significantly more likely to recommend an ICD for a Class I indication (92.4% vs 81.4%; P < 0.01), but they were not more likely to offer an ICD for a Class III indication (0.4% vs 0.6%; P = 0.95). Based on survey responses, physicians were equally willing to offer an ICD to men and women and to whites and blacks, but were less likely to offer an ICD to an older patient even when indicated by practice guidelines. Electrophysiologists (EPs) more often adhered to practice guideline recommendations on ICD therapy compared with non-EPs. ©2011, Wiley Periodicals, Inc.

Finding Your Literature Match - A Physics Literature Recommender System

NASA Astrophysics Data System (ADS)

Henneken, Edwin; Kurtz, Michael

2010-03-01

A recommender system is a filtering algorithm that helps you find the right match by offering suggestions based on your choices and information you have provided. A latent factor model is a successful approach. Here an item is characterized by a vector describing to what extent a product is described by each of N categories, and a person is characterized by an ``interest'' vector, based on explicit or implicit feedback by this user. The recommender system assigns ratings to new items and suggests items this user might be interested in. Here we present results of a recommender system designed to find recent literature of interest to people working in the field of solid state physics. Since we do not have explicit feedback, our user vector consists of (implicit) ``usage.'' Using a system of N keywords we construct normalized keyword vectors for articles based on the keywords of that article and its bibliography. The normalized ``interest'' vector is created by calculating the normalized frequency of keyword occurrence in the papers cited by the papers read.

An evaluation of the guidelines of the Society of Obstetricians and Gynaecologists of Canada.

PubMed

Ghui, Roslyn; Bansal, Jassimran Kaur; McLaughlin, Catarina; Kotaska, Andrew; Lokugamage, Amali

2016-07-01

Clinical practice guidelines hope to offer unbiased, evidence-based guidance for clinicians. This paper examines levels of evidence contained within the guidelines of the Society of Obstetricians and Gynaecologists of Canada and compares classification of the recommendation (CoR) A/B/C/D/E/L (derived from evidence and consensus) versus quality of evidence assessment (QoEA) I-III. 1250 recommendations were analysed and 43% of recommendations were graded as "good" evidence, the highest grade of CoR, while just 24.6% of recommendations were based on the highest level of QoEA (level I). The paper discusses possible reasons for this discrepancy. The authors hope that this analysis promotes greater transparency in evidence-based medicine ultimately leading to using the best quality of evidence available yet taking into account any areas of scientific uncertainty. This will enhance respectful care of patients, while taking into account their autonomy and furthering the cause of patient centre care.

Do we need personalized recommendations for infants at risk of developing disease?

PubMed

Hernell, Olle; West, Christina

2008-01-01

Current nutrition recommendations, directed towards populations, are based on estimated average nutrient requirements for a target population and intend to meet the needs of most individuals within that population. They also aim at preventing common diseases such as obesity, diabetes and cardiovascular disease. For infants with specific genetic polymorphisms, e.g. some inborn errors of metabolism, adherence to current recommendations will cause disease symptoms and they need personalized nutrition recommendations. Some other monogenic polymorphisms, e.g. adult hypolactasia, are common but with varying prevalence between ethnic groups and within populations. Ages at onset as well as the degree of the resulting lactose intolerance also vary, making population-based as well as personalized recommendations difficult. The tolerable intake is best set by each individual based on symptoms. For polygenetic diseases such as celiac disease, type-1 diabetes and allergic disease, current knowledge is insufficient to suggest personalized recommendations aiming at primary prevention for all high-risk infants, although it may be justified to provide such recommendations on an individual level should the parents ask for them. New technologies such as nutrigenetics and nutrigenomics are promising tools with which current nutrition recommendations can possibly be refined and the potential of individualized nutrition be explored. It seems likely that in the future it will be possible to offer more subgroups within a population personalized recommendations.

Organ donor management: Eight common recommendations and actions that deserve reflection.

PubMed

Chamorro-Jambrina, C; Muñoz-Ramírez, M R; Martínez-Melgar, J L; Pérez-Cornejo, M S

2017-12-01

Despite major advances in our understanding of the physiopathology of brain death (BD), there are important controversies as to which protocol is the most appropriate for organ donor management. Many recent reviews on this subject offer recommendations that are sometimes contradictory and in some cases are not applied to other critically ill patients. This article offers a review of the publications (many of them recent) with an impact upon these controversial measures and which can help to confirm, refute or open new areas of research into the most appropriate measures for the management of organ donors in BD, and which should contribute to discard certain established recommendations based on preconceived ideas, that lead to actions lacking a physiopathological basis. Aspects such as catecholamine storm management, use of vasoactive drugs, hemodynamic objectives and monitoring, assessment of the heart for donation, and general care of the donor in BD are reviewed. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women: A Clinical Practice Guideline Update From the American College of Physicians.

PubMed

Qaseem, Amir; Forciea, Mary Ann; McLean, Robert M; Denberg, Thomas D

2017-06-06

This guideline updates the 2008 American College of Physicians (ACP) recommendations on treatment of low bone density and osteoporosis to prevent fractures in men and women. This guideline is endorsed by the American Academy of Family Physicians. The ACP Clinical Guidelines Committee based these recommendations on a systematic review of randomized controlled trials; systematic reviews; large observational studies (for adverse events); and case reports (for rare events) that were published between 2 January 2005 and 3 June 2011. The review was updated to July 2016 by using a machine-learning method, and a limited update to October 2016 was done. Clinical outcomes evaluated were fractures and adverse events. This guideline focuses on the comparative benefits and risks of short- and long-term pharmacologic treatments for low bone density, including pharmaceutical prescriptions, calcium, vitamin D, and estrogen. Evidence was graded according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. The target audience for this guideline includes all clinicians. The target patient population includes men and women with low bone density and osteoporosis. ACP recommends that clinicians offer pharmacologic treatment with alendronate, risedronate, zoledronic acid, or denosumab to reduce the risk for hip and vertebral fractures in women who have known osteoporosis. (Grade: strong recommendation; high-quality evidence). ACP recommends that clinicians treat osteoporotic women with pharmacologic therapy for 5 years. (Grade: weak recommendation; low-quality evidence). ACP recommends that clinicians offer pharmacologic treatment with bisphosphonates to reduce the risk for vertebral fracture in men who have clinically recognized osteoporosis. (Grade: weak recommendation; low-quality evidence). ACP recommends against bone density monitoring during the 5-year pharmacologic treatment period for osteoporosis in women. (Grade: weak recommendation; low-quality evidence). ACP recommends against using menopausal estrogen therapy or menopausal estrogen plus progestogen therapy or raloxifene for the treatment of osteoporosis in women. (Grade: strong recommendation; moderate-quality evidence). ACP recommends that clinicians should make the decision whether to treat osteopenic women 65 years of age or older who are at a high risk for fracture based on a discussion of patient preferences, fracture risk profile, and benefits, harms, and costs of medications. (Grade: weak recommendation; low-quality evidence).

Tribal Recommendations for Designing Culturally Appropriate Technology-Based Sexual Health Interventions Targeting Native Youth in the Pacific Northwest

ERIC Educational Resources Information Center

Rushing, Stephanie Craig; Stephens, David

2012-01-01

Media technologies, including the Internet, cell phones, and video games, offer new avenues to reach Native youth on sensitive health topics. Project Red Talon, a sexually transmitted disease (STD)/HIV prevention project that serves the 43 federally recognized tribes in Oregon, Washington, and Idaho, used community-based participatory research…

Technology, recommendation and design: on being a 'paternalistic' philosopher.

PubMed

Wong, Pak-Hang

2013-03-01

Philosophers have talked to each other about moral issues concerning technology, but few of them have talked about issues of technology and the good life, and even fewer have talked about technology and the good life with the public in the form of recommendation. In effect, recommendations for various technologies are often left to technologists and gurus. Given the potential benefits of informing the public on their impacts on the good life, however, this is a curious state of affairs. In the present paper, I will examine why philosophers are seemingly reluctant to offer recommendations to the public. While there are many reasons for philosophers to refrain from offering recommendations, I shall focus on a specific normative reason. More specifically, it appears that, according to a particular definition, offering recommendations can be viewed as paternalistic, and therefore is prima facie wrong to do so. I will provide an argument to show that the worry about paternalism is unfounded, because a form of paternalism engendered by technology is inevitable. Given the inevitability of paternalism, I note that philosophers should accept the duty to offer recommendations to the public. I will then briefly turn to design ethics, which has reconceptualised the role of philosophers and, in my mind, fitted well with the inevitability of paternalism. Finally, I shall argue that design ethics has to be supplemented by the practice of recommendation if it is to sustain its objective.

Knowledge translation: an overview and recommendations in relation to the Fourth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia

PubMed Central

2013-01-01

The growing population of persons with dementia in Canada and the provision of quality care for this population is an issue that no healthcare authority will escape. Physicians often view dementia as a difficult and time-consuming condition to diagnose and manage. Current evidence must be effectively transformed into usable recommendations for physicians; however, we know that use of evidence-based practice recommendations is a challenge in all realms of medical care, and failure to utilize these leads to less than optimal care for patients. Despite this expanding need for readily available resources, knowledge translation (KT) is often seen as a daunting, if not confusing, undertaking for researchers. Here we offer a brief introduction to the processes around KT, including terms and definitions, and outline some common KT frameworks including the knowledge to action cycle, the Promoting Action on Research Implementation in Health Services framework and the Consolidated Framework for Implementation Research. We also outline practical steps for planning and executing a KT strategy particularly around the implementation of recommendations for practice, and offer recommendations for KT planning in relation to the Fourth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia. PMID:24565407

Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer.

PubMed

Rex, Douglas K; Boland, C Richard; Dominitz, Jason A; Giardiello, Francis M; Johnson, David A; Kaltenbach, Tonya; Levin, Theodore R; Lieberman, David; Robertson, Douglas J

2017-07-01

This document updates the colorectal cancer (CRC) screening recommendations of the U.S. Multi-Society Task Force of Colorectal Cancer (MSTF), which represents the American College of Gastroenterology, the American Gastroenterological Association, and The American Society for Gastrointestinal Endoscopy. CRC screening tests are ranked in 3 tiers based on performance features, costs, and practical considerations. The first-tier tests are colonoscopy every 10 years and annual fecal immunochemical test (FIT). Colonoscopy and FIT are recommended as the cornerstones of screening regardless of how screening is offered. Thus, in a sequential approach based on colonoscopy offered first, FIT should be offered to patients who decline colonoscopy. Colonoscopy and FIT are recommended as tests of choice when multiple options are presented as alternatives. A risk-stratified approach is also appropriate, with FIT screening in populations with an estimated low prevalence of advanced neoplasia and colonoscopy screening in high prevalence populations. The second-tier tests include CT colonography every 5 years, the FIT-fecal DNA test every 3 years, and flexible sigmoidoscopy every 5 to 10 years. These tests are appropriate screening tests, but each has disadvantages relative to the tier 1 tests. Because of limited evidence and current obstacles to use, capsule colonoscopy every 5 years is a third-tier test. We suggest that the Septin9 serum assay (Epigenomics, Seattle, Wash) not be used for screening. Screening should begin at age 50 years in average-risk persons, except in African Americans in whom limited evidence supports screening at 45 years. CRC incidence is rising in persons under age 50, and thorough diagnostic evaluation of young persons with suspected colorectal bleeding is recommended. Discontinuation of screening should be considered when persons up to date with screening, who have prior negative screening (particularly colonoscopy), reach age 75 or have <10 years of life expectancy. Persons without prior screening should be considered for screening up to age 85, depending on age and comorbidities. Persons with a family history of CRC or a documented advanced adenoma in a first-degree relative age <60 years or 2 first-degree relatives with these findings at any age are recommended to undergo screening by colonoscopy every 5 years, beginning 10 years before the age at diagnosis of the youngest affected relative or age 40, whichever is earlier. Persons with a single first-degree relative diagnosed at ≥60 years with CRC or an advanced adenoma can be offered average-risk screening options beginning at age 40 years.

Deprescribing benzodiazepine receptor agonists: Evidence-based clinical practice guideline.

PubMed

Pottie, Kevin; Thompson, Wade; Davies, Simon; Grenier, Jean; Sadowski, Cheryl A; Welch, Vivian; Holbrook, Anne; Boyd, Cynthia; Swenson, Robert; Ma, Andy; Farrell, Barbara

2018-05-01

To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper and stop benzodiazepine receptor agonists (BZRAs); to focus on the highest level of evidence available and seek input from primary care professionals in the guideline development, review, and endorsement processes. The overall team comprised 8 clinicians (1 family physician, 2 psychiatrists, 1 clinical psychologist, 1 clinical pharmacologist, 2 clinical pharmacists, and 1 geriatrician) and a methodologist; members disclosed conflicts of interest. For guideline development, a systematic process was used, including the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Evidence was generated by conducting a systematic review of BZRA deprescribing trials for insomnia, as well as performing a review of reviews of the harms of continued BZRA use and narrative syntheses of patient preferences and resource implications. This evidence and GRADE quality of evidence ratings were used to generate recommendations. The team refined guideline content and recommendations through consensus and synthesized clinical considerations to address front-line clinician questions. The draft guideline was reviewed by clinicians and stakeholders. We recommend that deprescribing (tapering slowly) of BZRAs be offered to elderly adults (≥ 65 years) who take BZRAs, regardless of duration of use, and suggest that deprescribing (tapering slowly) be offered to adults aged 18 to 64 who have used BZRAs for more than 4 weeks. These recommendations apply to patients who use BZRAs to treat insomnia on its own (primary insomnia) or comorbid insomnia where potential underlying comorbidities are effectively managed. This guideline does not apply to those with other sleep disorders or untreated anxiety, depression, or other physical or mental health conditions that might be causing or aggravating insomnia. Benzodiazepine receptor agonists are associated with harms, and therapeutic effects might be short term. Tapering BZRAs improves cessation rates compared with usual care without serious harms. Patients might be more amenable to deprescribing conversations if they understand the rationale (potential for harm), are involved in developing the tapering plan, and are offered behavioural advice. This guideline provides recommendations for making decisions about when and how to reduce and stop BZRAs. Recommendations are meant to assist with, not dictate, decision making in conjunction with patients. Copyright© the College of Family Physicians of Canada.

Teaching the Virtues.

ERIC Educational Resources Information Center

Sommers, Christina Hoff

1993-01-01

Recommends an approach to the teaching of ethics from the perspective of the philosophy of virtue that begins with the work of the ancient Greek philosopher, Aristotle. Offers guidance on how to prepare and teach such a course based on the author's and other teachers' experiences in the classroom. (JB)

A crisis in critical thinking.

PubMed

del Bueno, Dorothy

2005-01-01

Aggregate results for competency assessment of new registered nurses using the Performance Based Development System indicate that most new graduates do not meet expectations for entry-level clinical judgment ability.This article discusses implications for nursing education and offers recommendations for developing clinical judgment in nursing students.

Integrating Positive Psychology Techniques into Rehabilitation Counselor Education

ERIC Educational Resources Information Center

Chapin, Martha H.; Boykin, Rebecca B.

2010-01-01

Positive psychology offers rehabilitation counselor educators a framework to help students evaluate their own competencies and understand the value of a strengths-based approach to rehabilitation counseling. This article reviews several positive psychology techniques and discusses recommended uses as well as their effectiveness. Positive…

Warrior culture, spirituality, and prayer.

PubMed

Malmin, Mark

2013-09-01

Research has shown an increase in suicides by military veterans and law enforcement officers in the United States. Etiologic research elucidates warrior culture and subculture as contributing factors of this pathology. This paper examines the idiosyncratic nature and influence of warrior culture and subculture and offers recommendations to promote culture change. Faith-based spirituality and prayer are examined as adjunct modalities for stress management and emotional healing. Further research is recommended to assess the associated hidden cost factors and long-term financial impact of warrior culture on society.

A longitudinal evaluation of a project-based learning initiative in an engineering undergraduate programme

NASA Astrophysics Data System (ADS)

Hall, Wayne; Palmer, Stuart; Bennett, Mitchell

2012-05-01

Project-based learning (PBL) is a well-known student-centred methodology for engineering design education. The methodology claims to offer a number of educational benefits. This paper evaluates the student perceptions of the initial and second offering of a first-year design unit at Griffith University in Australia. It builds on an earlier evaluation conducted after the initial offering of the unit. It considers the implementation of the recommended changes. Evaluations of the two offerings reveal that students (in both the initial and second offering) generally enjoyed the experience, but that the second offering was found to be a significantly more enjoyable learning experience. Students in the second offering also reported a significantly better understanding of what they needed to do for the design projects and where to find the requisite information. The oral presentation aspect of the initial and second offerings received the lowest satisfaction rating. The inclusion (and delivery) of the computer-aided drawing component of the unit is seen as a positive aspect by some students, but many others comment on it negatively. The best aspects of the PBL unit and those aspects needing further improvement were similar to the findings of other investigations documented in the literature.

Women's experiences of developing musculoskeletal diseases: employment challenges and policy recommendations.

PubMed

Crooks, Valorie A

2007-07-30

To answer three specific questions: (i) How do women experience the workplace after the onset of a musculoskeletal disease; (ii) What employment policy and programme suggestions can they offer for ways to better support chronically ill women in their abilities to maintain workforce participation; and (iii) How are these women's employment policy and programme recommendations informed by their own lived experiences and desires? In-depth interviews were conducted with 18 women who had developed musculoskeletal diseases while involved in the labour market. Data were coded and analysed thematically. Participants identified three common workplace barriers experienced and three types of workplace accommodations commonly requested. They offered four specific employment policy and programme recommendations for ways to better support women who develop musculoskeletal diseases in maintaining labour market participation. It is found that their employment policy and programme recommendations are informed by their own experiences in the workplace and desires for being supported in maintaining involvement in paid labour. Creating employment programmes and policies that support chronically ill women in their attempts to remain involved in the workforce based on how much paid labour they are able to perform and where they are best able to work is of the utmost importance.

Assessing the Use of Media Reporting Recommendations by the World Health Organization in Suicide News Published in the Most Influential Media Sources in China, 2003-2015.

PubMed

Chu, Xin; Zhang, Xingyi; Cheng, Peixia; Schwebel, David C; Hu, Guoqing

2018-03-05

Public media reports about suicide are likely to influence the population's suicidal attempts and completed suicides. Irresponsible reports might trigger copycat suicidal behaviors, while responsible reports may help reduce suicide rates. The World Health Organization (WHO) released recommendations to encourage responsible suicide reports in 2008. However, little is known about whether these recommendations are reflected in the suicide news for most countries, including China. In this study, we assessed the responsibility of suicide stories published in the most influential newspaper and Internet media sources in China from 2003 to 2015, using the media reporting recommendations by the World Health Organization (WHO). In total, 3965 and 1836 eligible stories from newspaper and Internet-based media, respectively, were included in the study. Newspapers and Internet-based media performed similarly in applying WHO recommendations to report suicide news. Three recommendations were applied in over 88% of suicide stories. However, four recommendations were seldom applied, including offering information about where to seek help and linking the suicide event to mental disorders. Government and the journalism industry should work together to improve media reporting of news about suicide in China.

Teaching Math to Young Children. Educator's Practice Guide. What Works Clearinghouse. NCEE 2014-4005

ERIC Educational Resources Information Center

Frye, Douglas; Baroody, Arthur J.; Burchinal, Margaret; Carver, Sharon M.; Jordan, Nancy C.; McDowell, Judy

2013-01-01

The goal of this practice guide is to offer educators specific, evidence-based recommendations that address the challenge of teaching early math to children ages 3 to 6. The guide provides practical, clear information on critical topics related to teaching early math and is based on the best available evidence as judged by the authors. The guide…

Differentiated Instruction for K-8 Math and Science: Activities and Lesson Plans

ERIC Educational Resources Information Center

Hamm, Mary; Adams, Dennis

2008-01-01

This book offers practical recommendations to reach every student in a K-8 classroom. Research-based and written in a teacher-friendly style, it will help teachers with classroom organization and lesson planning in math and science. Included are math and science games, activities, ideas, and lesson plans based on the math and science standards.…

Consumers of Mental Health Services.

ERIC Educational Resources Information Center

Roy, Alec

2001-01-01

Risk factors for suicide include psychiatric disorders, social factors, psychological factors, and biologic and genetic factors. Important knowledge about why people commit suicide has been obtained from 20 psychological autopsy studies of suicide victims carried out over the past 40 years. Based upon these studies, recommendations are offered for…

Ideas for Inclusion: The School Administrator's Guide.

ERIC Educational Resources Information Center

Beninghof, Anne M.; Singer, Anne Louise T.

This book for school administrators offers methods for effecting changes in school culture and practices so that inclusion of students with all kinds of disabilities is successful. The recommendations are based on such principles as the following: professionals must collaborate to serve students with disabilities appropriately; students are…

A Consumer Perspective of Handgun Control in the U.S.

ERIC Educational Resources Information Center

Hill, Ronald Paul

1994-01-01

Examines the public policy issue of handgun control from a consumer perspective. Summarizes and analyzes research that investigates attitudes toward and use of handguns. Offers recommendations that are consumer based and attempt to balance the needs of gun owners with the interests of society. (JOW)

Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments.

PubMed

Bakker, David; Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

2016-03-01

The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems.

Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments

PubMed Central

Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

2016-01-01

Background The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. Objective To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. Methods A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Results Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Conclusions Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems. PMID:26932350

A philosophical argument against evidence-based policy.

PubMed

Anjum, Rani Lill; Mumford, Stephen D

2017-10-01

Evidence-based medicine has two components. The methodological or ontological component consists of randomized controlled trials and their systematic review. This makes use of a difference-making conception of cause. But there is also a policy component that makes a recommendation for uniform intervention, based on the evidence from randomized controlled trials. The policy side of evidence-based medicine is basically a form of rule utilitarianism. But it is then subject to an objection from Smart that rule utilitarianism inevitably collapses. If one assumes (1) you should recommend the intervention that has brought most benefit (the core of evidence-based policy making), (2) individual variation (acknowledged by use of randomization) and (3) no intervention benefits all (contingent but true), then the objection can be brought to bear. A utility maximizer should always ignore the rule in an individual case where greater benefit can be secured through doing so. In the medical case, this would mean that a clinician who knows that a patient would not benefit from the recommended intervention has good reason to ignore the recommendation. This is indeed the feeling of many clinicians who would like to offer other interventions but for an aversion to breaking clinical guidelines. © 2016 John Wiley & Sons, Ltd.

Rebuilding the Marriage during Recovery from Compulsive Sexual Behavior.

ERIC Educational Resources Information Center

Schneider, Jennifer P.

1989-01-01

Defines sexual addiction and describes its effects on individual and his/her primary relationship. Addresses problems of recognizing sexual compulsivity and offers suggestions for treatment which include use of both dyadic and group therapy. Recommends attendance at self-help groups based on Alcoholics Anonymous model. (Author/CM)

Federal Information Resources Management: New Challenges for the Nineties.

ERIC Educational Resources Information Center

Ryan, Joe; And Others

1994-01-01

Identifies critical success factors that federal information resources management (IRM) must address, offers recommendations for how best to meet these challenges, and describes opportunities based on discussions with senior IRM leaders. A brief history of federal IRM, beginning with the Commission on Federal Paperwork in 1974, is provided.…

A Character Education Research Perspective for the 21st Century

ERIC Educational Resources Information Center

Davidson, Matthew

2014-01-01

The Institute for Excellence and Ethics (IEE) is a nonprofit organization dedicated to the development and dissemination of research-based tools and strategies for building intentional cultures of excellence and ethics in education, athletics, home, and workplace settings. The following five emphases and recommended actions are offered are…

Soft Paths: How To Enjoy the Wilderness without Harming It.

ERIC Educational Resources Information Center

Hampton, Bruce; Cole, David

This outdoor-education book describes methods of hiking and camping that minimize the human impact upon the natural environment. Each chapter offers the rationale behind recommended practices, based on the best scientific research on recreational impact. The first chapter, "The Case for Minimum Impact," describes increasing tourist use…

75 FR 21630 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-26

... participate in the second phase. Quantitative surveys will be administered by computers and personal... administer a survey, conduct interviews and offer HIV rapid testing in Black Men who have sex with Men (BMSM...-minute eligibility screening interview. The baseline computer-based survey will take 45 minutes. The...

75 FR 64317 - Advisory Committee on Interdisciplinary, Community-Based Linkages; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Service Administration Advisory... Secretary of the Department of Health and Human Services (the Secretary) and Congress, focusing on a... efforts, and offer recommendations for improvement of these training programs for the Secretary and the...

Critique of a practice-based pilot study in chiropractic practices in Western Australia.

PubMed

Amorin-Woods, Lyndon G; Parkin-Smith, Gregory F; Nedkoff, Lee; Fisher, Colleen

2016-01-01

Practice-based data collection can offer insight into the nature of chiropractic practice and contribute to resolving the conundrum of the chiropractic profession's role in contemporary healthcare, subsequently informing care service policy. However, there is little formal data available about chiropractic practice to inform decision-makers about the nature and role of chiropractic within the context of a modern multidisciplinary healthcare context in Australia, particularly at a local and regional level. This was a mixed-methods data transformation model (qualitative to quantitative) pilot study the purpose of which was to provide a critique of the research design and collect data from a selected sample of chiropractic practices in Western Australia, with a view to offer recommendations related to the design, feasibility and implementation of a future confirmatory study. A narrative critique of the research methods of this pilot study is offered in this paper covering: (a) practice and patient recruitment, (b) enrollment of patients, (c) data collection methods, (d) acceptability of the study methods, (e) sample size calculations, and (f) design critique. The result of this critique provides a sensible sample size estimate and recommendations as to the design and implementation of a future confirmatory study. Furthermore, we believe that a confirmatory study is not only feasible, but indeed necessary, with a view to offer meaningful insight into chiropractic practice in Western Australia. ACTRN12616000434493 Australian New Zealand Clinical Trials Registry (ANZCTR). Registered 5 April 2016. First participant enrolled 01 July 2014, retrospectively registered.

78 FR 19329 - Request for Information (RFI): Reducing Investigator's Administrative Workload for Federally...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-29

... most to their administrative workload and to offer recommendations for reducing that workload. Members... offer recommendations to reduce unnecessary and redundant administrative requirements. Background Over... an awardee's available research time, a figure widely cited in numerous articles and reports. To help...

Lessons Learned from Undergraduate Students in Designing a Science-Based Course in Bioethics

PubMed Central

Loike, John D.; Rush, Brittany S.; Schweber, Adam; Fischbach, Ruth L.

2013-01-01

Columbia University offers two innovative undergraduate science-based bioethics courses for student majoring in biosciences and pre–health studies. The goals of these courses are to introduce future scientists and healthcare professionals to the ethical questions they will confront in their professional lives, thus enabling them to strategically address these bioethical dilemmas. These courses incorporate innovative pedagogical methods, case studies, and class discussions to stimulate the students to think creatively about bioethical issues emerging from new biotechnologies. At the end of each course, each student is required to submit a one-page strategy detailing how he or she would resolve a bioethical dilemma. Based on our experience in teaching these courses and on a qualitative analysis of the students’ reflections, we offer recommendations for creating an undergraduate science-based course in bioethics. General recommendations include: 1) integrating the science of emerging biotechnologies, their ethical ramifications, and contemporary bioethical theories into interactive class sessions; 2) structuring discussion-based classes to stimulate students to consider the impact of their moral intuitions when grappling with bioethical issues; and 3) using specific actual and futuristic case studies to highlight bioethical issues and to help develop creative problem-solving skills. Such a course sparks students’ interests in both science and ethics and helps them analyze bioethical challenges arising from emerging biotechnologies. PMID:24297296

Recommendations to enhance constructivist-based learning in Interprofessional Education using video-based self-assessment

PubMed Central

Dahmen, Uta; Schulze, Christine; Schindler, Claudia; Wick, Katharina; Schwartze, Dominique; Veit, Andrea; Smolenski, Ulrich

2016-01-01

Introduction: Interprofessional collaboration is crucial to the optimization of patient care. Aim: This paper aims to provide recommendations for implementing an innovative constructivist educational concept with the core element of video-based self-assessment. Methodology: A course for students in medicine, physiotherapy, and nursing was developed through interprofessional, cross-institutional collaboration. The course consisted of drawing on prior knowledge about the work done by each professional group in regard to a specific clinical scenario and an interprofessional treatment situation, filming a role play of this treatment situation, and a structured self-assessment of the role play. We evaluated the preparation and implementation of the three courses conducted thus far. Concrete recommendations for implementation were made based on evaluation sheets (students), open discussions (tutors, instructors, institutions) and recorded meeting minutes (project managers, project participants). Results: Basic recommendations for implementation include: selecting appropriate criteria for self-assessment and a simulated situation that offers members of each professional group an equal opportunity to act in the role play. In terms of administrative implementation we recommend early coordination among the professions and educational institutions regarding the target groups, scheduling and attendance policy to ensure participant recruitment across all professions. Procedural planning should include developing teaching materials, such as the case vignette and treatment scenario, and providing technical equipment that can be operated intuitively in order to ensure efficient recording. Conclusion: These recommendations serve as an aid for implementing an innovative constructivist educational concept with video-based self-assessment at its core. PMID:27280144

Towards Competence-Based Learning Design Driven Remote and Virtual Labs Recommendations for Science Teachers

ERIC Educational Resources Information Center

Zervas, Panagiotis; Sergis, Stylianos; Sampson, Demetrios G.; Fyskilis, Stefanos

2015-01-01

Remote and virtual labs (RVLs) are widely used by science education teachers in their daily teaching practice. This has led to a plethora of RVLs that are offered with or without cost. In order to organise them and facilitate their search and findability, several RVL web-based repositories have been operated. As a result, a key open challenge is…

Aiming Instruments On The Space Station

NASA Technical Reports Server (NTRS)

Estus, Jay M.; Laskin, Robert; Lin, Yu-Hwan

1989-01-01

Report discusses capabilities and requirements for aiming scientific instruments carried aboard proposed Space Station. Addresses two issues: whether system envisioned for pointing instruments at celestial targets offers sufficiently low jitter, high accuracy, and high stability to meet scientific requirements; whether it can do so even in presence of many vibrations and other disturbances on Space Station. Salient conclusion of study, recommendation to develop pointing-actuator system including mechanical/fluid base isolator underneath reactionaless gimbal subsystem. This kind of system offers greatest promise of high performance, cost-effectiveness, and modularity for job at hand.

SYNAISTHISI: an IoT-powered smart visitor management and cognitive recommendations system

NASA Astrophysics Data System (ADS)

Thanos, Giorgos Konstandinos; Karafylli, Christina; Karafylli, Maria; Zacharakis, Dimitris; Papadimitriou, Apostolis; Dimitros, Kostantinos; Kanellopoulou, Konstantina; Kyriazanos, Dimitris M.; Thomopoulos, Stelios C. A.

2016-05-01

Location-based and navigation services are really needed to help visitors and audience of big events, complex buildings, shopping malls, airports and large companies. However, the lack of GPS and proper mapping indoors usually renders location-based applications and services useless or simply not applicable in such environments. SYNAISTHISI introduces a mobile application for smartphones which offers navigation capabilities outside and inside buildings and through multiple floor levels. The application comes together with a suite of helpful services, including personalized recommendations, visit/event management and a helpful search functionality in order to navigate to a specific location, event or person. As the user finds his way towards his destination, NFC-enabled checkpoints and bluetooth beacons assist him, while offering re-routing, check-in/out capabilities and useful information about ongoing meetings and nearby events. The application is supported by a back-end GIS system which can provide a broad and clear view to event organizers, campus managers and field personnel for purposes of event logistics, safety and security. SYNAISTHISI system comes with plenty competitive advantages including (a) Seamless Navigation as users move between outdoor and indoor areas and different floor levels by using innovative routing algorithms, (b) connection to and powered by IoT platform, for localization and real-time information feedback, (c) dynamic personalized recommendations based on user profile, location and real-time information provided by the IoT platform and (d) Indoor localization without the need for expensive infrastructure and installations.

Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer.

PubMed

Rex, Douglas K; Boland, C Richard; Dominitz, Jason A; Giardiello, Francis M; Johnson, David A; Kaltenbach, Tonya; Levin, Theodore R; Lieberman, David; Robertson, Douglas J

2017-07-01

This document updates the colorectal cancer (CRC) screening recommendations of the U.S. Multi-Society Task Force of Colorectal Cancer (MSTF), which represents the American College of Gastroenterology, the American Gastroenterological Association, and The American Society for Gastrointestinal Endoscopy. CRC screening tests are ranked in 3 tiers based on performance features, costs, and practical considerations. The first-tier tests are colonoscopy every 10 years and annual fecal immunochemical test (FIT). Colonoscopy and FIT are recommended as the cornerstones of screening regardless of how screening is offered. Thus, in a sequential approach based on colonoscopy offered first, FIT should be offered to patients who decline colonoscopy. Colonoscopy and FIT are recommended as tests of choice when multiple options are presented as alternatives. A risk-stratified approach is also appropriate, with FIT screening in populations with an estimated low prevalence of advanced neoplasia and colonoscopy screening in high prevalence populations. The second-tier tests include CT colonography every 5 years, the FIT-fecal DNA test every 3 years, and flexible sigmoidoscopy every 5 to 10 years. These tests are appropriate screening tests, but each has disadvantages relative to the tier 1 tests. Because of limited evidence and current obstacles to use, capsule colonoscopy every 5 years is a third-tier test. We suggest that the Septin9 serum assay (Epigenomics, Seattle, Wash) not be used for screening. Screening should begin at age 50 years in average-risk persons, except in African Americans in whom limited evidence supports screening at 45 years. CRC incidence is rising in persons under age 50, and thorough diagnostic evaluation of young persons with suspected colorectal bleeding is recommended. Discontinuation of screening should be considered when persons up to date with screening, who have prior negative screening (particularly colonoscopy), reach age 75 or have <10 years of life expectancy. Persons without prior screening should be considered for screening up to age 85, depending on age and comorbidities. Persons with a family history of CRC or a documented advanced adenoma in a first-degree relative age <60 years or 2 first-degree relatives with these findings at any age are recommended to undergo screening by colonoscopy every 5 years, beginning 10 years before the age at diagnosis of the youngest affected relative or age 40, whichever is earlier. Persons with a single first-degree relative diagnosed at ≥60 years with CRC or an advanced adenoma can be offered average-risk screening options beginning at age 40 years. Copyright © 2017 AGA Institute, American College of Gastroenterology, and the American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Knowledge and attitude of pregnant women toward flu vaccination: a cross-sectional survey.

PubMed

Maurici, Massimo; Dugo, Valentina; Zaratti, Laura; Paulon, Luca; Pellegrini, Maria Grazia; Baiocco, Elisa; Rizzo, Giuseppe; Franco, Elisabetta

2016-10-01

The study was conducted to explore the knowledge of pregnant women about influenza, influenza vaccine during pregnancy and the attitudes regarding immunization. A questionnaire based on the model proposed by Yudin in 2009 was translated, adapted and administered to 309 pregnant women in the third trimester of pregnancy between October 1 and December 1, 2013 at San Giovanni Calibita Fatebenefratelli hospital of Rome (Italy). Most of the interviewed women (68.9%) answered that influenza is highly contagious, 34.6% of them believed that pregnant women have the same risk of complications as non-pregnant women. Only 5.8% were aware that the vaccine is recommended for women in the second and third trimester of pregnancy and only 14.2% of women answered that the vaccine is safe during pregnancy. Only 3/309 women reported recommendation and offer of vaccination during current pregnancy, but none of them was vaccinated. Overall, knowledge regarding influenza, implications during pregnancy and influenza vaccine was poor among pregnant women. In Italy, the National Vaccine Prevention Plan 2012-2014 recommends influenza vaccine during pregnancy, but only 18/309 were aware of this recommendation. These results suggest that in order to increase influenza vaccine acceptance it is necessary to improve pregnant women knowledge about influenza and to offer education to healthcare providers.

Community Pharmacists' Views and Practices Regarding Natural Health Products Sold in Community Pharmacies.

PubMed

Ogbogu, Ubaka; Necyk, Candace

Reports of regulatory and evidentiary gaps have raised concerns about the marketing and use of natural health products (NHPs). The majority of NHPs offered for sale are purchased at a community pharmacy and pharmacists are "front-line" health professionals involved in the marketing and provision of NHPs. To date, the involvement of pharmacists in pharmacy care involving NHPs and the degree to which concerns over the safety, efficacy, marketing and regulation of NHPs are addressed in pharmacy care in Canada have not been studied. Using Qualtrics, a web-based data collection and analysis software, and a study instrument made up of fifteen (15) open-ended, closed and rating scale questions, we surveyed the attitudes and practices of 403 community pharmacists in the Canadian province of Alberta regarding NHPs offered for sale in community pharmacies. The majority of pharmacists surveyed (276; 68%) recommend NHPs to clients sometimes to very often. Vitamin D, calcium, multivitamins, prenatal vitamins, probiotics and fish oil and omega-3 fatty acids were the most frequently recommended NHPs. The most common indications for which NHPs are recommended include bone and musculoskeletal disorders, maintenance of general health, gastrointestinal disorders and pregnancy. Review articles published in the Pharmacist's Letter and Canadian Pharmacists Journal were the primary basis for recommending NHPs. The majority of pharmacists surveyed (339; 84%) recommend the use of NHPs concurrently with conventional drugs, while a significant number and proportion (125; 31%) recommend alternative use. Pharmacists in the study overwhelmingly reported providing counselling on NHPs to clients based on information obtained mainly from the Natural Medicines Comprehensive Database. The study findings indicate a high prevalence of pharmacy care relating to NHPs among study participants. Although pharmacists' practices around NHPs are consistent with the existing licensing framework, we found some involvement in problematic practices that necessitate further research and potential policy scrutiny. The study also uncovered patterns of recommendations, including sources relied on in recommending NHPs and in providing counselling to patients, that raise concerns about the quality and credibility of NHP-related care provided to pharmacy patrons.

[Psychological intervention after trauma--does it work?].

PubMed

Smedsrud, Marit Kristine; Hem, Erlend; Ekeberg, Øivind

2005-06-30

A Cochrane review from 1998 concluded that single-session intervention does not prevent the onset of post-traumatic stress disorder. This led to a debate about what is the best, if any, psychological treatment after traumas. In consequence, some clinicians have become doubtful about as how to deal with traumatized patients. We present three examples in order to illustrate situations in which psychological intervention is useful. The conclusions in the Cochrane review are well documented. However, insufficient correspondence between the traumas and the intervention offered gave us cause to question the clinical importance of existing studies. Future studies of psychological intervention after traumas should use an individualized design in which the intervention is in proportion to the trauma. Based on knowledge not given by randomized controlled studies, we recommend clinicians to offer psychological help to those exposed to traumatic incidents. Most people need adequate information after traumas. For those who develop health problems, intervention until recovery is recommended.

Role of social support, hardiness, and acculturation as predictors of mental health among international students of Asian Indian origin.

PubMed

Atri, Ashutosh; Sharma, Manoj; Cottrell, Randall

This study determined the role of social support, hardiness, and acculturation as predictors of mental health among international Asian Indian students enrolled at two large public universities in Ohio. A sample of 185 students completed a 75-item online instrument assessing their social support levels, acculturation, hardiness, and their mental health. Regression analyses were conducted to test for variance in mental health attributable to each of the three independent variables. The final regression model revealed that the belonging aspect of social support, acculturation and prejudice of acculturation scale, and commitment and control of hardiness were all predictive of mental health (R2 = 0.523). Recommendations have been offered to develop interventions that will help strengthen the social support, hardiness, and acculturation of international students and help improve their mental health. Recommendations for development of future Web-based studies also are offered.

Raptor nesting near oil and gas development: an overview of key findings and implications for management based on four reports by HawkWatch International

USGS Publications Warehouse

Fuller, Mark R.

2013-01-01

juniper vegetation communities in the Piceance Basin of Colorado, described basic vegetation and landscape characteristics of nests, and offered recommendations about surveying for accipiter hawks in pinyon–juniper landscapes. Please read the HWI reports for details.

Protecting residences from wildfires: a guide for homeowners, lawmakers, and planners

Treesearch

Howard E. Moore

1981-01-01

This guide, based on a literature review and personal contacts, offers recommendations and standards for procedures in reducing losses of residences from wildfires. Possible solutions to the problem of fire protection are discussed in the broad areas of land-use planning and zoning, property development, structural design and construction, landscaping, accessories,...

Missouri Extension Study Commission. Report to the Governor and General Assembly.

ERIC Educational Resources Information Center

Missouri State Extension Study Commission, Jefferson City.

A report on the Missouri Extension Study Commission's (a blue ribbon commission) review of the scope, organization, management, and funding of extension activities conducted by Missouri colleges and universities is presented. Based on information obtained from public hearings and studies, 10 general recommendations are offered that pertain to:…

Internet resources for psychiatry and neuropsychiatry

PubMed Central

Stone, J; Sharpe, M

2003-01-01

Some of the most useful internet resources relevant to psychiatry and neuropsychiatry are summarised. Web sites recommended for professionals and patients are detailed, including where to find evidence based psychiatry, psychiatry news, and professional organisations. Some thoughts on "cyberchondria" and the opportunities that the internet offers for illness transmission are also considered. PMID:12486258

Vocabulary Acquisition: Curricular and Instructional Implications for Diverse Learners. Technical Report No. 14.

ERIC Educational Resources Information Center

Baker, Scott K.; And Others

A curricular and instructional framework for increasing the vocabulary skills of diverse learners is described. Areas of convergence in research literature on vocabulary learning and diverse learners are noted, and two recommendations based on these areas of convergence are offered: interventions to address the vocabulary delays of diverse…

Sources for Developing a Theory of Visual Literacy.

ERIC Educational Resources Information Center

Hortin, John A.

Organized as a bibliographic essay, this paper examines the many sources available for developing a theory of visual literacy. Several definitions are offered in order to clarify the meaning of the term "visual literacy" so that meaningful research can be conducted on the topic. Based on the review of resources, three recommendations are offered…

Literacy Coaches' Perceptions of a Formative Fluency Assessment in Urban Elementary Schools

ERIC Educational Resources Information Center

Ellison, Marclette

2013-01-01

In "Reading First" schools throughout the United States, literacy coaches administer the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) as the sole measure of fluency and then offer instructional recommendations for students with reading difficulties based on those results. However, critics of DIBELS question its accuracy for…

Presymptomatic ALS genetic counseling and testing

PubMed Central

Stanislaw, Christine; Reyes, Eliana; Hussain, Sumaira; Cooley, Anne; Fernandez, Maria Catalina; Dauphin, Danielle D.; Michon, Sara-Claude; Andersen, Peter M.; Wuu, Joanne

2016-01-01

Remarkable advances in our understanding of the genetic contributions to amyotrophic lateral sclerosis (ALS) have sparked discussion and debate about whether clinical genetic testing should routinely be offered to patients with ALS. A related, but distinct, question is whether presymptomatic genetic testing should be offered to family members who may be at risk for developing ALS. Existing guidelines for presymptomatic counseling and testing are mostly based on small number of individuals, clinical judgment, and experience from other neurodegenerative disorders. Over the course of the last 8 years, we have provided testing and 317 genetic counseling sessions (including predecision, pretest, posttest, and ad hoc counseling) to 161 first-degree family members participating in the Pre-Symptomatic Familial ALS Study (Pre-fALS), as well as testing and 75 posttest counseling sessions to 63 individuals with familial ALS. Based on this experience, and the real-world challenges we have had to overcome in the process, we recommend an updated set of guidelines for providing presymptomatic genetic counseling and testing to people at high genetic risk for developing ALS. These recommendations are especially timely and relevant given the growing interest in studying presymptomatic ALS. PMID:27194384

[Guidelines in RA treatment: concepts on safety and recommendations using anti-TNF-alpha inhibitors. Grupo de Estudio de Nuevas Terapias de Enfermedades reumáticas (GENTE)].

PubMed

Díaz-Jouanen, Efraín; Abud-Mendoza, Carlos; Garza-Elizondo, Mario Alberto; Medrano-Ramírez, Gabriel; Burgos-Vargas, Rubén; Orozco-Alcalá, José Javier; Pacheco-Tena, César Francisco; Pineda, Carlos; Pozos-Espíndola, Juan Carlos; Ramos-Niembro, Francisco; Robles-San-Román, Manuel; Santana-Sahagún, Jesús Ernesto

2009-01-01

Recommendations for the use of Disease-Modifying Antirheumatic Drugs (DMARD) with both conventional and biological agents in Rheumatoid Arthritis (RA) must be based on their safety profile, adverse effects, risks, and advantages. With the purpose of presenting the most updated information about the safety of tumor necrosis factor alpha (TNFalpha) antagonists, in this article we summarize the literature published during the last three years about this sort of biological agents in specific clinical situations, such as risk of developing infections, cancer, cardiovascular diseases, and autoimmunity; as well as their administration to patients who will undergo surgical procedures, pregnant and/or breast-feeding women, and patients who need immunizations. Likewise, in this analysis we offer specific recommendations, based on evidence, for the best anti-TNF-alfa management.

Clinical factors associated with rape victims' ability to testify in court: a records-based study of final psychiatric recommendation to court.

PubMed

Phaswana, T D; Van der Westhuizen, D; Krüger, C

2013-09-01

A rape victim may encounter professionals in both the health and the legal systems. Unanswered questions remain about clinical factors associated with a rape victim's ability to testify in court, and the quality of care offered to rape victims. The objectives of this study were thus to determine the clinical factors that are associated with a rape victim's ability to testify in court, as well as to undertake a preliminary exploration of the referral system between the court and the mental health services. A retrospective study was conducted of rape victims referred by the court (n=70) to be assessed psycho-legally by psychiatrists. Rape victims who were recommended as able and those recommended as unable to testify in court were compared with regard to their clinical characteristics. Thirty-seven (53.6%) victims were recommended as able to testify and 32 (46.4%) victims as unable to testify in court. Victims from rural areas and victims with severe mental retardation were statistically significantly more often found to be unable to testify in court. Almost half (49.2%) of the victims were referred by court for first assessment within six months of being raped. Most (63.5%) victims were assessed for the first time within one month of being referred. The decision about a victim's ability to testify should not be based solely on the two statistically significant variables but, rather, individualised. Optimal mental health and legal services should be offered to rape victims. Further studies are required in assessing the collaboration between the health and legal systems.

An assessment of preventive care offered to orthodontic patients by oral health therapists in NSW Australia.

PubMed

Masoe, Angela V; Blinkhorn, Anthony S; Taylor, Jane; Blinkhorn, Fiona A

2015-08-01

The aim of this study was to record preventive oral health care planned by dental therapists and oral health therapists (therapists) for patients with poor oral hygiene undergoing orthodontic treatment. A cross-sectional survey, using a clinical vignette of a patient with poor oral hygiene undergoing therapy with a fixed appliance, was undertaken to record the preventive care offered to this individual by therapists working across 15 Local Health Districts (LHDs). This orthodontic vignette was inserted between two dental caries-related vignettes. Data were coded and descriptive statistics were used to report the findings. One-hundred and seventeen therapists returned questionnaires (giving a response rate of 64.6%), of whom 82.0% (n = 95) completed the orthodontic vignette. Adopting motivational interviewing techniques to facilitate communication with the patient and their parent was recommended by 88.4% (n = 84) respondents, 98.0% (n = 93) offered oral-hygiene instruction, 70.5% (n = 67) recorded plaque levels and used disclosing solution and 60.0% (n = 57) offered dietary advice. Products recommended for use at home included fluoride toothpaste [1,450 ppm F (80.0%; n = 76) and 5,000 ppm F (59.0%; n = 24)] and casein phosphopeptide amorphous phosphates plus fluoride (CPP-ACPF) paste (33.3%; n = 32). Less than 20% offered fissure sealants. Preventive advice and care was offered inconsistently by therapists in this study. To ensure that all therapists adopt a scientifically based approach to prevention, LHD clinical directors should implement continuous professional education programmes for therapists to improve patient's health outcomes. © 2015 FDI World Dental Federation.

UpToDate adherence to GRADE criteria for strong recommendations: an analytical survey

PubMed Central

Merglen, Arnaud; Heen, Anja Fog; Kristiansen, Annette; Neumann, Ignacio; Brito, Juan P; Brignardello-Petersen, Romina; Alexander, Paul E; Rind, David M; Vandvik, Per O; Guyatt, Gordon H

2017-01-01

Introduction UpToDate is widely used by clinicians worldwide and includes more than 9400 recommendations that apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. GRADE guidance warns against strong recommendations when certainty of the evidence is low or very low (discordant recommendations) but has identified five paradigmatic situations in which discordant recommendations may be justified. Objectives Our objective was to document the strength of recommendations in UpToDate and assess the frequency and appropriateness of discordant recommendations. Design Analytical survey of all recommendations in UpToDate. Methods We identified all GRADE recommendations in UpToDate and examined their strength (strong or weak) and certainty of the evidence (high, moderate or low certainty). We identified all discordant recommendations as of January 2015, and pairs of reviewers independently classified them either into one of the five appropriate paradigms or into one of three categories inconsistent with GRADE guidance, based on the evidence presented in UpToDate. Results UpToDate included 9451 GRADE recommendations, of which 6501 (68.8%) were formulated as weak recommendations and 2950 (31.2%) as strong. Among the strong, 844 (28.6%) were based on high certainty in effect estimates, 1740 (59.0%) on moderate certainty and 366 (12.4%) on low certainty. Of the 349 discordant recommendations 204 (58.5%) were judged appropriately (consistent with one of the five paradigms); we classified 47 (13.5%) as good practice statements; 38 (10.9%) misclassified the evidence as low certainty when it was at least moderate and 60 (17.2%) warranted a weak rather than a strong recommendation. Conclusion The proportion of discordant recommendations in UpToDate is small (3.7% of all recommendations) and the proportion that is truly problematic (strong recommendations that would best have been weak) is very small (0.6%). Clinicians should nevertheless be cautious and look for clear explanations—in UpToDate and elsewhere—when guidelines offer strong recommendations based on low certainty evidence. PMID:29150475

Study Partners Recommendation for xMOOCs Learners

PubMed Central

Xu, Bin; Yang, Dan

2015-01-01

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

Computer Networking for Collegial Exchange among Teachers: A Summary of Findings and Recommendations. Technical Report.

ERIC Educational Resources Information Center

West, Mary Maxwell; McSwiney, Eileen

Asynchronous computer-based conferencing offers several unique capabilities as a medium. Participants can read and write messages at whatever time is convenient for them, groups can interact even though participants are geographically separated, and messages are available to readers almost instantly. Because the medium has served for over a decade…

Comparisons of High School Graduation Rates of Students with Disabilities and Their Peers in Twelve Southern States

ERIC Educational Resources Information Center

Smith, Theodore Scott; Manuel, Nancy; Stokes, Billy R.

2012-01-01

This study compared differences in diploma and graduation dropout rates among students with and without disabilities, analyzed differences in various graduation-types by disabilities, and offered recommendations to improve graduation rates through evidence-based practices. The geographic catchment area of this study was limited to twelve Southern…

Complexity of Choice: Teachers' and Students' Experiences Implementing a Choice-Based Comprehensive School Health Model

ERIC Educational Resources Information Center

Sulz, Lauren; Gibbons, Sandra; Naylor, Patti-Jean; Wharf Higgins, Joan

2016-01-01

Background: Comprehensive School Health models offer a promising strategy to elicit changes in student health behaviours. To maximise the effect of such models, the active involvement of teachers and students in the change process is recommended. Objective: The goal of this project was to gain insight into the experiences and motivations of…

Materials thermal and thermoradiative properties/characterization technology

NASA Technical Reports Server (NTRS)

Dewitt, D. P.; Ho, C. Y.

1989-01-01

Reliable properties data on well characterized materials are necessary for design of experiments and interpretation of experimental results. The activities of CINDAS to provide data bases and predict properties are discussed. An understanding of emissivity behavior is important in order to select appropriate methods for non-contact temperature determination. Related technical issues are identified and recommendations are offered.

Proposals for Standardizing and Improving the Policy of Adding Points on the Entrance Exam

ERIC Educational Resources Information Center

Yuhong, Deng

2013-01-01

This article reviews policies for adding points on the College Entrance Examination. It analyzes the rationales and specific implementation strategies of various policies for adding points on the entrance exam, as well as their advantages and pitfalls. Based on these observations and analysis, the author also offers policy recommendations on the…

Role of Radio and TV Programmes in Distance and Open Learning System: A Case of Bangladesh Open University.

ERIC Educational Resources Information Center

Karim, Salma; Kama, Mustafa Azad; Islam, Md. Mayenul

2001-01-01

Examines the role and effectiveness of radio and television programs in distance and open learning systems based on a survey of students at Bangladesh Open University. Offers recommendations for improvements, including extending the time span, ensuring the quality of presentations, teacher involvement, and audio and video cassette…

Dissemination of evidence-based cancer control interventions among Catholic faith-based organizations: results from the CRUZA randomized trial.

PubMed

Allen, Jennifer D; Torres, Maria Idalí; Tom, Laura S; Leyva, Bryan; Galeas, Ana V; Ospino, Hosffman

2016-05-18

The CRUZA randomized trial tested the efficacy of an organizational-level intervention to increase the capacity of Catholic faith-based organizations (FBOs) serving Latinos to implement evidence-based strategies (EBS) for cancer control. Thirty-one Catholic parishes were enrolled. Twenty were randomized to a "capacity enhancement" (CE) intervention and 11 to a "standard dissemination" (SD) condition. Each received a Program Implementation Manual and Toolkit of materials culturally adapted for FBOs with Latino audiences for five types of EBS recommended by the US Preventive Services Community Guide. CE parishes were offered a menu of capacity-building activities over a 3-month period, while SD parishes were provided a one-time consultation by an Intervention Specialist. Baseline and follow-up surveys compared the number and types of EBS offered. At baseline, only one parish had offered any cancer-related program in the prior year, yet a third (36 %) had offered some other type of health program or service. At post-intervention follow-up, all parishes offered a greater number of EBS. The only statistically significant difference between CE and SD groups was the number of parishes offering small media interventions (90 % in CE, 64 % in SD; p < 0.05). All parishes increased the number of cancer control activities offered to their members. These findings suggest that Catholic parishes may already have capacity to implement EBS if they are appropriately adapted and packaged and may only require low levels of support to carry out programming. Further research is needed to examine the extent to which program offerings continued after the period of grant funding. Clinicaltrials.gov NCT01740219 .

Persuasion and types of enticements offered by pharmaceutical companies to Gold Coast general practitioners in an attempt to encourage a health website recommendation.

PubMed

Usher, Wayne; Skinner, James

2010-01-01

This study was undertaken to determine if pharmaceutical companies persuade and offer enticements to Gold Coast (Queensland, Australia) general practitioners (GPs), in an attempt to encourage them to recommend health websites to the health consumer. A survey instrument consisting of seven single response questions was mailed to 250 (61%) out of 410 GPs. Questions were designed to measure the percentages (%) and proportions associated with levels of persuasion and types of enticements pharmaceutical companies are offering GPs, in an attempt to encourage them to recommend health websites to the health consumer. The survey instrument allowed participants to indicate their (1) gender, (2) age and (3) years of experience (less experienced or= 10 years). One hundred and eight (43%) of the 250 GPs returned a completed survey. The return rate for male GPs was 72 (40%) and for female GPs, it was 36 (33%). Sixty-eight (63%) GPs indicated that they actively recommend health websites to their patients [male GPs--48 (71%), female GPs--20 (29%)]. This study highlights that female GPs (80%), those aged between 31 and 40 (77%) and GPs with < 10 years experience (72%) were more frequently targeted by pharmaceutical companies. This study reports that pharmaceutical companies are offering various types of enticements in an attempt to persuade Gold Coast GPs to recommend specific health websites to the health consumer. Further research should explore if similar levels of persuasion and types of enticements are being offered to GPs across Australia.

Redefining Security. A Report by the Joint Security Commission

DTIC Science & Technology

1994-02-28

security policies. This report offers recommendations on developing new strategies for achieving security within our infor-mation systems, including...better, and we outline methods of improving government and industry personnel security poli- cies. We offer recommendations on developing new strategies ... strategies , sufficient funding, and management attention if our comput- ers and networks are to protect the confidentiality, integrity, and availability of

Examining the front lines of local environmental public health practice: a Maryland case study.

PubMed

Resnick, Beth; Zablotsky, Joanna; Nachman, Keeve; Burke, Thomas

2008-01-01

Local environmental public health (EPH) is the foundation of a nation's environmental protection infrastructure. With increasing pressure to demonstrate the ability of EPH activities to effectively protect health, the Johns Hopkins Center for Excellence in EPH Practice, as part of the Centers for Disease Control and Prevention's (CDC's) EPH capacity-building effort, developed the Profile of Maryland Environmental Public Health Practice. This profile offers an examination of front-line local EPH strengths, needs, challenges, and provides recommendations to strengthen the EPH infrastructure. A multistep process was conducted, including site visits to all of Maryland's 24 local EPH agencies and a questionnaire addressing administrative structure, communication, funding, workforce, crisis management, technology, and legal authority, completed by local EPH directors. The Maryland Profile revealed a dedicated and responsive workforce limited by a neglected, fragmented, and underfunded EPH infrastructure. Recommendations regarding leadership, workforce, training, technology, communication, and legal authority are offered. This research has implications for the national EPH infrastructure. Recommendations offered are consistent with the CDC's findings in A National Strategy to Revitalize Environmental Public Health Services. These findings and recommendations offer opportunities to facilitate the advancement of an EPH system to better protect the nation's health.

Influences of different dietary contents of macrominerals on the availability of trace elements in horses.

PubMed

Neustädter, L-T; Kamphues, J; Ratert, C

2018-04-01

In this study, influences of a reduced macromineral intake on the trace element metabolism in horses at maintenance were investigated. Background of this study is the revised recommendation on the macromineral supply for horses (GfE ). Balance studies on three adult pony geldings with body weights of 405 / 348 / 384 kg were performed to obtain data on apparent digestibility (aD), retention and serum concentrations of different trace elements (Cu, Zn, Se) at different dietary macromineral levels. A mineral supplement or a complementary feed-with a reduced macromineral content-was added to a hay-based diet (daily 5.5 kg hay per animal, split in three servings a day), beside distilled water was offered. The diets were offered one after the other in a way that all ponies had the same sequence of treatments. The native macromineral contents of the daily offered amount of hay already surpassed the new recommendations whereas dietary trace elements needed to be supplemented. There were no statistically significant differences (p ≤ .05) concerning the aD of copper, zinc and selenium comparing the diets with and without macromineral supplementation. Serum levels of these three trace elements were not affected by the different macromineral content of the diet. Results of this study, based on a 22-day feeding period for each treatment, indicate that a macromineral supplementation of a hay-based diet for adult horses at maintenance was not necessary. However, no negative effects of added macrominerals on the trace element metabolism occurred in this study. © 2017 Blackwell Verlag GmbH.

Owner observations regarding cat scratching behavior: an internet-based survey.

PubMed

Wilson, Colleen; Bain, Melissa; DePorter, Theresa; Beck, Alexandra; Grassi, Vanessa; Landsberg, Gary

2016-10-01

This study was performed to examine aspects of the cat, environment and scratching post that might influence scratching behavior, in an effort to determine how inappropriate scratching behavior might be refocused on acceptable targets. An internet survey, posted on several public websites, gathered details about scratching behavior, as described by owners in their home environments, from 4331 respondents over a 4 month period. Responses from 39 different countries were analyzed, mostly from the USA, Canada and the UK. Owners offered traditionally recommended scratching substrates including rope, cardboard, carpet and wood. Rope was most frequently used when offered, although carpet was offered most commonly. Most owners provided at least one scratching post; cats scratched the preferred substrate more often when the post was a simple upright type or a cat tree with two or more levels and at least 3 ft high. Narrower posts (base width ⩽3 ft) were used more often than wider posts (base width ⩾5 ft). Intact or neutered cats (males and females) were as likely to scratch inappropriately, and inappropriate scratching decreased with age. Geriatric cats between the ages of 10 and 14 years preferred carpet substrate most frequently; all other ages preferred rope first. Inappropriate scratching decreased as the different types/styles of posts increased in the home. Inappropriate scratching did not increase if the number of cats or dogs increased in the household. Declawed cats were preventatively declawed most often to prevent household item destruction. Although cats can have individual preferences, our data provide a starting point for veterinarians recommending scratching posts to clients. © The Author(s) 2015.

[A survey on the sodium content of customers' orderings at three restaurants in Beijing].

PubMed

Zhao, Nanxi; Liang, Baojing; He, Pingping; Li, Liming; Lyu, Jun

2014-04-01

To survey the mean sodium content of menu offering and customers' orderings on sodium when eating out. All weights of ingredients of menu offerings at three Chinese restaurants with Wenzhou, Shandong, and Yunnan cuisine, in Beijing, were collected and their sodium values were estimated based on data from the Chinese Food Composition. All records from customers' orders were collected in a certain period of time from year 2011 to 2013. The mean sodium content of ordering per person and the proportion of all orders exceeding the recommended daily sodium limit that applicable to most native Chinese, were estimated. Of all the menu offerings, hot dishes (1 728.6 mg; P25, P75: 1 198.7, 2 482.8) and soup dishes (2 101.5 mg; P25, P75: 1 467.8, 2 291.2) had the highest sodium contents, followed by cold dressed dishes (790.7 mg; P25, P75: 128.1, 1 472.9) staple foods (802.9 mg; P25, P75: 115.1, 1 563.2) while the beverages having the lowest sodium contents (17.0 mg; P25, P 75: 2.0, 19.5) (P < 0.05). Meat dishes (1 796.3 mg; P25, P75: 1 303.9, 2 670.3) contained more sodium than vegetable dishes (1 105.5 mg; P25, P75: 423.6, 1 628.6) (P < 0.001). The median sodium contents in per person orderings were 2 325.6 mg (P25, P75:1 700.7, 3 213.8) for lunch and 2 542.5 mg (P25, P75: 1 857.5, 3 498.1) for dinner. Current dietary guideline recommended for Chinese adults was: in general, the amount of consumption should not exceed 2 400 mg of sodium per day. Based on the recommended optimal daily calories intake ratio as 3:4:3 for breakfast, lunch, and dinner, we would suggest that the sodium intake should follow the amount as 960 mg for lunch and 720 mg for dinner. Our data indicated that 97.5% of the ordered meals appeared that they were over the recommended sodium limit and 76.5% of the tables showed two times more than the limit of recommendation. Soup and hot dishes provided at these three restaurants contained more sodium contents. People ordered dishes at restaurants would contain more sodium than the recommended Chinese daily sodium intake.

The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline.

PubMed

Chaves, Nadia J; Paxton, Georgia A; Biggs, Beverley-Ann; Thambiran, Aesen; Gardiner, Joanne; Williams, Jan; Smith, Mitchell M; Davis, Joshua S

2017-04-17

In 2009, the Australasian Society of Infectious Diseases published guidelines on the post-arrival health assessment of recently arrived refugees. Since then, the number of refugees and asylum seekers reaching Australia has increased substantially (17 555 refugees in 2015-16) and the countries of origin have changed. These groups are likely to have had poor access to health care pre-arrival and, consequently, are at risk of a range of chronic and infectious diseases. We established an advisory group that included infectious diseases physicians, general practitioners, public health specialists, paediatricians and refugee health nurses to update the 2009 guidelines.Main recommendations: All people from refugee-like backgrounds, including children, should be offered a tailored comprehensive health assessment and management plan, ideally within 1 month of arrival in Australia. This can be offered at any time if initial contact with a GP or clinic is delayed. Recommended screening depends on history, examination and previous investigations, and is tailored based on age, gender, countries of origin and transit and risk profile. The full version of the guidelines is available at http://www.asid.net.au/documents/item/1225.Changes in management as a result of this guideline: These guidelines apply to all people from refugee-like backgrounds, including asylum seekers. They provide more information about non-communicable diseases and consider Asia and the Middle East as regions of origin as well as Africa. Key changes include an emphasis on person-centred care; risk-based rather than universal screening for hepatitis C virus, malaria, schistosomiasis and sexually transmissible infections; updated immunisation guidelines; and new recommendations for other problems, such as nutritional deficiencies, women's health and mental health.

Integration of health technology assessment recommendations into organizational and clinical practice: A case study in Catalonia.

PubMed

Gagnon, Marie-Pierre; Sánchez, Emília; Pons, Joan M V

2006-01-01

Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy makers. This research sought to understand factors affecting the uptake of HTA recommendations to support decision making with respect to the introduction of three health technologies. Using a multidimensional framework, based upon a combination of theoretical models, a case study was conducted. A total of twenty-eight semistructured interviews were done with physicians from fifteen hospitals and other stakeholders in Catalonia. Interview content was analyzed iteratively and classified according to theoretical dimensions and contextual factors. At the sociopolitical level, factors related to the organization and financing of the health system were found to affect the utilization of HTA recommendations. At the healthcare organization level, existing collaborations between the hospital and the HTA agency favored the integration of recommendations into practices. Formalism in the organization also influenced the utilization of HTA recommendations. At the professional level, the high degree of autonomy of specialists, the importance of peers and collegial control, and the definition of professional roles and responsibilities influenced physicians' willingness to integrate HTA recommendations into their practice. This study offers a comprehensive framework to understand the complex dynamics that affect adoption of health technologies in organizational and professional practices. The findings suggest some avenues to promote the integration of HTA recommendations into practices and, thus, increase the utilization of scientific evidence to support decision making in health care.

Data You May Like: A Recommender System for Research Data Discovery

NASA Astrophysics Data System (ADS)

Devaraju, A.; Davy, R.; Hogan, D.

2016-12-01

Various data portals been developed to facilitate access to research datasets from different sources. For example, the Data Publisher for Earth & Environmental Science (PANGAEA), the Registry of Research Data Repositories (re3data.org), and the National Geoscience Data Centre (NGDC). Due to data quantity and heterogeneity, finding relevant datasets on these portals may be difficult and tedious. Keyword searches based on specific metadata elements or multi-key indexes may return irrelevant results. Faceted searches may be unsatisfactory and time consuming, especially when facet values are exhaustive. We need a much more intelligent way to complement existing searching mechanisms in order to enhance user experiences of the data portals. We developed a recommender system that helps users to find the most relevant research datasets on the CSIRO's Data Access Portal (DAP). The system is based on content-based filtering. We computed the similarity of datasets based on data attributes (e.g., descriptions, fields of research, location, contributors, and provenance) and inference from transaction logs (e.g., the relations among datasets and between queries and datasets). We improved the recommendation quality by assigning weights to data similarities. The weight values are drawn from a survey involving data users. The recommender results for a given dataset are accessible programmatically via a web service. Taking both data attributes and user actions into account, the recommender system will make it easier for researchers to find and reuse data offered through the data portal.

Undergraduate Education in Cancer in the European Region. Report on a UICC/WHO Meeting (Geneva, Switzerland, April 6-8, 1981).

ERIC Educational Resources Information Center

World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

The progress of undergraduate education in cancer in European countries was assessed, and recommendations were offered for further development according to the EURO program. Based on a survey of undergraduate education in medical schools of the European region, the following areas were evaluated: goals and objectives of teaching, tasks a general…

An Assessment of the Army Officer Education System From an Adult Learning Perspective

DTIC Science & Technology

2005-05-26

learning 2 Brockett, Ralph, and Roger Hiemstra. "Bridging the Theory -Practice Gap in Self-Directed... Learning ." In Self-Directed Learning : From Theory to Practice, edited by S. Brookfield. New Directions for Continuing Education No. 25. (San...offers conclusions and recommendations about the Army Officer Education System based on analysis from adult learning theory . Statement of the

Foundational Skills to Support Reading for Understanding in Kindergarten through 3rd Grade. Educator's Practice Guide. NCEE 2016-4008

ERIC Educational Resources Information Center

Foorman, Barbara; Beyler, Nicholas; Borradaile, Kelley; Coyne, Michael; Denton, Carolyn A.; Dimino, Joseph; Furgeson, Joshua; Hayes, Lynda; Henke, Juliette; Justice, Laura; Keating, Betsy; Lewis, Warnick; Sattar, Samina; Streke, Andrei; Wagner, Richard; Wissel, Sarah

2016-01-01

The goal of this practice guide is to offer educators specific, evidence-based recommendations for teaching foundational reading skills to students in kindergarten through 3rd grade. This guide is a companion to the existing practice guide, "Improving Reading Comprehension in Kindergarten Through 3rd Grade", and as a set, these guides…

Preventing Dropout in Secondary Schools. Educator's Practice Guide. What Works Clearinghouse. NCEE 2017-4028

ERIC Educational Resources Information Center

Rumberger, Russell W.; Addis, Howard; Allensworth, Elaine; Balfanz, Robert; Bruch, Julie; Dillon, Erin; Duardo, Debra; Dynarski, Mark; Furgeson, Joshua; Jayanthi, Madhavi; Newman-Gonchar, Rebecca; Place, Kate; Tuttle, Christina

2017-01-01

The goal of this practice guide is to offer educators specific, evidence-based recommendations that address the challenges of preventing dropout in secondary schools. This guide synthesizes the best publicly available research and shares practices that are supported by evidence. It is intended to be practical and easy for teachers and school…

The Use of Certified Mail in Mail Surveys. Research Memorandum No. 73-25.

ERIC Educational Resources Information Center

Echternacht, Gary J.; McCaffrey, Patty J.

The cost effectiveness of using certified mail as a device to raise response rates in mail surveys is investigated. Of the three optional services offered by the Post Office when sending certified mail, the base certified rate was recommended, since the Post Office often failed to perform the more expensive services. A sample of 120 students from…

L'alphabetisation et les femmes francophones: Guide a l'intention des formatrices (Literacy Education and Francophone Women: Guide for Teachers).

ERIC Educational Resources Information Center

Brown, Johanne, Ed.; And Others

This guide, written in French and designed for literacy teachers, offers suggestions for providing appropriate literacy education for Canadian francophone women. It recommends an approach that is based on learner needs, is holistic, and focuses on the student as the principal agent of her own education. A discussion of instructional management…

Summary of evidence-based guideline: complementary and alternative medicine in multiple sclerosis: report of the guideline development subcommittee of the American Academy of Neurology.

PubMed

Yadav, Vijayshree; Bever, Christopher; Bowen, James; Bowling, Allen; Weinstock-Guttman, Bianca; Cameron, Michelle; Bourdette, Dennis; Gronseth, Gary S; Narayanaswami, Pushpa

2014-03-25

To develop evidence-based recommendations for complementary and alternative medicine (CAM) in multiple sclerosis (MS). We searched the literature (1970-March 2011; March 2011-September 2013 MEDLINE search), classified articles, and linked recommendations to evidence. Clinicians might offer oral cannabis extract for spasticity symptoms and pain (excluding central neuropathic pain) (Level A). Clinicians might offer tetrahydrocannabinol for spasticity symptoms and pain (excluding central neuropathic pain) (Level B). Clinicians should counsel patients that these agents are probably ineffective for objective spasticity (short-term)/tremor (Level B) and possibly effective for spasticity and pain (long-term) (Level C). Clinicians might offer Sativex oromucosal cannabinoid spray (nabiximols) for spasticity symptoms, pain, and urinary frequency (Level B). Clinicians should counsel patients that these agents are probably ineffective for objective spasticity/urinary incontinence (Level B). Clinicians might choose not to offer these agents for tremor (Level C). Clinicians might counsel patients that magnetic therapy is probably effective for fatigue and probably ineffective for depression (Level B); fish oil is probably ineffective for relapses, disability, fatigue, MRI lesions, and quality of life (QOL) (Level B); ginkgo biloba is ineffective for cognition (Level A) and possibly effective for fatigue (Level C); reflexology is possibly effective for paresthesia (Level C); Cari Loder regimen is possibly ineffective for disability, symptoms, depression, and fatigue (Level C); and bee sting therapy is possibly ineffective for relapses, disability, fatigue, lesion burden/volume, and health-related QOL (Level C). Cannabinoids may cause adverse effects. Clinicians should exercise caution regarding standardized vs nonstandardized cannabis extracts and overall CAM quality control/nonregulation. Safety/efficacy of other CAM/CAM interaction with MS disease-modifying therapies is unknown.

Digital case-based learning system in school.

PubMed

Gu, Peipei; Guo, Jiayang

2017-01-01

With the continuing growth of multi-media learning resources, it is important to offer methods helping learners to explore and acquire relevant learning information effectively. As services that organize multi-media learning materials together to support programming learning, the digital case-based learning system is needed. In order to create a case-oriented e-learning system, this paper concentrates on the digital case study of multi-media resources and learning processes with an integrated framework. An integration of multi-media resources, testing and learning strategies recommendation as the learning unit is proposed in the digital case-based learning framework. The learning mechanism of learning guidance, multi-media materials learning and testing feedback is supported in our project. An improved personalized genetic algorithm which incorporates preference information and usage degree into the crossover and mutation process is proposed to assemble the personalized test sheet for each learner. A learning strategies recommendation solution is proposed to recommend learning strategies for learners to help them to learn. The experiments are conducted to prove that the proposed approaches are capable of constructing personalized sheets and the effectiveness of the framework.

Digital case-based learning system in school

PubMed Central

Gu, Peipei

2017-01-01

With the continuing growth of multi-media learning resources, it is important to offer methods helping learners to explore and acquire relevant learning information effectively. As services that organize multi-media learning materials together to support programming learning, the digital case-based learning system is needed. In order to create a case-oriented e-learning system, this paper concentrates on the digital case study of multi-media resources and learning processes with an integrated framework. An integration of multi-media resources, testing and learning strategies recommendation as the learning unit is proposed in the digital case-based learning framework. The learning mechanism of learning guidance, multi-media materials learning and testing feedback is supported in our project. An improved personalized genetic algorithm which incorporates preference information and usage degree into the crossover and mutation process is proposed to assemble the personalized test sheet for each learner. A learning strategies recommendation solution is proposed to recommend learning strategies for learners to help them to learn. The experiments are conducted to prove that the proposed approaches are capable of constructing personalized sheets and the effectiveness of the framework. PMID:29107965

Current perspectives on recommendations for BRCA genetic testing in ovarian cancer patients.

PubMed

Vergote, Ignace; Banerjee, Susana; Gerdes, Anne-Marie; van Asperen, Christi; Marth, Christian; Vaz, Fatima; Ray-Coquard, Isabelle; Stoppa-Lyonnet, Dominique; Gonzalez-Martin, Antonio; Sehouli, Jalid; Colombo, Nicoletta

2016-12-01

Traditionally, BRCA genetic testing has been undertaken to identify patients and family members at future risk of developing cancer and patients have been referred for testing based on family history. However, the now recognised risk of ovarian cancer (OC) patients, even those with no known family history, harbouring a mutation in BRCA1/2, together with the first poly adenosine diphosphate ribose polymerase inhibitor (PARPi; olaparib [Lynparza]) being licenced for the treatment of BRCA-mutated OC, has led to reconsideration of referral criteria for OC patients. Provided here is a review of the existing data and guidelines in the European Union, relating to recommendations, as well as considerations, for the referral of OC patients for BRCA genetic testing. Based on this review of newly updated guidance and up-to-date evidence, the following is recommended: all patients with invasive epithelial OC (excluding borderline or mucinous), including those with fallopian tube and peritoneal cancers, should be considered as candidates for referral for BRCA genetic testing, irrespective of age; genetic testing should ideally be offered at diagnosis, although patients can be referred at any stage; retrospective testing should be offered to patients in long-term follow-up because of the implications for family members and individual future breast cancer risk; and germline BRCA testing of a blood/saliva sample should initially be conducted and, if negative, tumour tissue should be tested (to identify non-germline [somatic] BRCA PARPi therapy candidates). Copyright © 2016 Elsevier Ltd. All rights reserved.

Clinical practice guideline: Allergic rhinitis.

PubMed

Seidman, Michael D; Gurgel, Richard K; Lin, Sandra Y; Schwartz, Seth R; Baroody, Fuad M; Bonner, James R; Dawson, Douglas E; Dykewicz, Mark S; Hackell, Jesse M; Han, Joseph K; Ishman, Stacey L; Krouse, Helene J; Malekzadeh, Sonya; Mims, James Whit W; Omole, Folashade S; Reddy, William D; Wallace, Dana V; Walsh, Sandra A; Warren, Barbara E; Wilson, Meghan N; Nnacheta, Lorraine C

2015-02-01

Allergic rhinitis (AR) is one of the most common diseases affecting adults. It is the most common chronic disease in children in the United States today and the fifth most common chronic disease in the United States overall. AR is estimated to affect nearly 1 in every 6 Americans and generates $2 to $5 billion in direct health expenditures annually. It can impair quality of life and, through loss of work and school attendance, is responsible for as much as $2 to $4 billion in lost productivity annually. Not surprisingly, myriad diagnostic tests and treatments are used in managing this disorder, yet there is considerable variation in their use. This clinical practice guideline was undertaken to optimize the care of patients with AR by addressing quality improvement opportunities through an evaluation of the available evidence and an assessment of the harm-benefit balance of various diagnostic and management options. The primary purpose of this guideline is to address quality improvement opportunities for all clinicians, in any setting, who are likely to manage patients with AR as well as to optimize patient care, promote effective diagnosis and therapy, and reduce harmful or unnecessary variations in care. The guideline is intended to be applicable for both pediatric and adult patients with AR. Children under the age of 2 years were excluded from the clinical practice guideline because rhinitis in this population may be different than in older patients and is not informed by the same evidence base. The guideline is intended to focus on a limited number of quality improvement opportunities deemed most important by the working group and is not intended to be a comprehensive reference for diagnosing and managing AR. The recommendations outlined in the guideline are not intended to represent the standard of care for patient management, nor are the recommendations intended to limit treatment or care provided to individual patients. The development group made a strong recommendation that clinicians recommend intranasal steroids for patients with a clinical diagnosis of AR whose symptoms affect their quality of life. The development group also made a strong recommendation that clinicians recommend oral second-generation/less sedating antihistamines for patients with AR and primary complaints of sneezing and itching. The panel made the following recommendations: (1) Clinicians should make the clinical diagnosis of AR when patients present with a history and physical examination consistent with an allergic cause and 1 or more of the following symptoms: nasal congestion, runny nose, itchy nose, or sneezing. Findings of AR consistent with an allergic cause include, but are not limited to, clear rhinorrhea, nasal congestion, pale discoloration of the nasal mucosa, and red and watery eyes. (2) Clinicians should perform and interpret, or refer to a clinician who can perform and interpret, specific IgE (skin or blood) allergy testing for patients with a clinical diagnosis of AR who do not respond to empiric treatment, or when the diagnosis is uncertain, or when knowledge of the specific causative allergen is needed to target therapy. (3) Clinicians should assess patients with a clinical diagnosis of AR for, and document in the medical record, the presence of associated conditions such as asthma, atopic dermatitis, sleep-disordered breathing, conjunctivitis, rhinosinusitis, and otitis media. (4) Clinicians should offer, or refer to a clinician who can offer, immunotherapy (sublingual or subcutaneous) for patients with AR who have inadequate response to symptoms with pharmacologic therapy with or without environmental controls. The panel recommended against (1) clinicians routinely performing sinonasal imaging in patients presenting with symptoms consistent with a diagnosis of AR and (2) clinicians offering oral leukotriene receptor antagonists as primary therapy for patients with AR. The panel group made the following options: (1) Clinicians may advise avoidance of known allergens or may advise environmental controls (ie, removal of pets; the use of air filtration systems, bed covers, and acaricides [chemical agents formulated to kill dust mites]) in patients with AR who have identified allergens that correlate with clinical symptoms. (2) Clinicians may offer intranasal antihistamines for patients with seasonal, perennial, or episodic AR. (3) Clinicians may offer combination pharmacologic therapy in patients with AR who have inadequate response to pharmacologic monotherapy. (4) Clinicians may offer, or refer to a surgeon who can offer, inferior turbinate reduction in patients with AR with nasal airway obstruction and enlarged inferior turbinates who have failed medical management. (5) Clinicians may offer acupuncture, or refer to a clinician who can offer acupuncture, for patients with AR who are interested in nonpharmacologic therapy. The development group provided no recommendation regarding the use of herbal therapy for patients with AR. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Guide to the Evaluation of Educational Experiences in the Armed Services. The 1978 Guide. 3: Coast Guard, Marine Corps, Navy.

ERIC Educational Resources Information Center

American Council on Education, Washington, DC. Office on Educational Credit.

Postsecondary educational credit recommendations for formal courses offered by the Coast Guard, the Marine Corps, the Navy, and the Department of Defense are provided in this third of a three-volume set. (Other volumes cover courses offered by the Army and by the Air Force. See note.) Also included are credit recommendations for Navy general rates…

Comparison of the Treatment Guidelines for Actinic Keratosis: A Critical Appraisal and Review.

PubMed

Fleming, Patrick; Zhou, Stephanie; Bobotsis, Robert; Lynde, Charles

There are currently several reputable guidelines on the treatment of actinic keratosis (AK) from groups in Canada, the United Kingdom, and Europe. These recommendations, based on evidence or expert consensus, offer clinicians a variety of treatment options for the different clinical presentations of AKs. Although the guidelines are similar in some regards, variations exist in treatment options, duration, and strength of recommendation. Some guidelines also lack input on specific therapies and certain types of AK, such as hypertrophic or thin presentations. The purpose of this article is to review and compare guidelines published by Canadian, UK, and European groups for the management of AKs in patients.

State recommendations on approaches to LANDSAT

NASA Technical Reports Server (NTRS)

Bay, S. M.; Wubker, P.

1977-01-01

The feasibility of continuing the LANDSAT program is contingent upon the success of the technology transfer process to state and local governments. The focus of these concerns can be generally expressed in terms of these issue areas: (1) user needs, in terms of awareness, technical capabilities, and training; (2) product availability and pricing; and (3) roles and communication links, in terms of federal and state governments, the private sector, and the universities. The perspective of the states on these issues are classified. Where possible, alternative strategies for accomplishing the satellite technology transfer for effective state implementation are suggested. Those suggestions are based on the recommendations offered by the state and local user community.

Psychological interventions in obsessive compulsive disorder.

PubMed

Gellatly, Judith; Molloy, Christine

2014-08-26

Obsessive compulsive disorder (OCD) is a common mental health problem associated with poor quality of life, impaired functioning and increased risk of suicide. Improvement is unlikely and symptoms will remain chronic unless adequate treatment is provided. National Institute for Health and Care Excellence (2006a) guidelines on the management of OCD, recommend the use of psychological treatments that are based on cognitive behavioural therapy (CBT). Brief treatment forms of CBT are recommended initially and more intensive forms are offered when health gain is not apparent. While the presentation of OCD can be complex, nurses can assist in the recognition and treatment of OCD through additional training or current skills.

Internet-Based Delphi Research: Case Based Discussion

PubMed Central

Donohoe, Holly M.; Stellefson, Michael L.

2013-01-01

The interactive capacity of the Internet offers benefits that are intimately linked with contemporary research innovation in the natural resource and environmental studies domains. However, e-research methodologies, such as the e-Delphi technique, have yet to undergo critical review. This study advances methodological discourse on the e-Delphi technique by critically assessing an e-Delphi case study. The analysis suggests that the benefits of using e-Delphi are noteworthy but the authors acknowledge that researchers are likely to face challenges that could potentially compromise research validity and reliability. To ensure that these issues are sufficiently considered when planning and designing an e-Delphi, important facets of the technique are discussed and recommendations are offered to help the environmental researcher avoid potential pitfalls associated with coordinating e-Delphi research. PMID:23288149

A study of concept-based similarity approaches for recommending program examples

NASA Astrophysics Data System (ADS)

Hosseini, Roya; Brusilovsky, Peter

2017-07-01

This paper investigates a range of concept-based example recommendation approaches that we developed to provide example-based problem-solving support in the domain of programming. The goal of these approaches is to offer students a set of most relevant remedial examples when they have trouble solving a code comprehension problem where students examine a program code to determine its output or the final value of a variable. In this paper, we use the ideas of semantic-level similarity-based linking developed in the area of intelligent hypertext to generate examples for the given problem. To determine the best-performing approach, we explored two groups of similarity approaches for selecting examples: non-structural approaches focusing on examples that are similar to the problem in terms of concept coverage and structural approaches focusing on examples that are similar to the problem by the structure of the content. We also explored the value of personalized example recommendation based on student's knowledge levels and learning goal of the exercise. The paper presents concept-based similarity approaches that we developed, explains the data collection studies and reports the result of comparative analysis. The results of our analysis showed better ranking performance of the personalized structural variant of cosine similarity approach.

Clinical use of sensory gardens and outdoor environments in norwegian nursing homes: a cross-sectional e-mail survey.

PubMed

Gonzalez, Marianne Thorsen; Kirkevold, Marit

2015-01-01

Gardens and outdoor environments offer multiple therapeutic possibilities for the residents in nursing homes. Web-based questionnaires were sent to 488 nursing home leaders and 121 leaders responded. The clinical impressions of the leaders and staff regarding the benefits of sensory gardens (SGs) to the residents were consistent with previous research. SGs facilitated taking residents outdoors, offered convenient topics for communication and facilitated social privacy for relatives. For improved clinical use of SGs and outdoor environments, systematic assessment of residents' interests, performance and experiences when outdoors, implementation of seasonal clinical programmes and educational programmes for leaders and staff are recommended.

Building Computer-Based Experiments in Psychology without Programming Skills.

PubMed

Ruisoto, Pablo; Bellido, Alberto; Ruiz, Javier; Juanes, Juan A

2016-06-01

Research in Psychology usually requires to build and run experiments. However, although this task has required scripting, recent computer tools based on graphical interfaces offer new opportunities in this field for researchers with non-programming skills. The purpose of this study is to illustrate and provide a comparative overview of two of the main free open source "point and click" software packages for building and running experiments in Psychology: PsychoPy and OpenSesame. Recommendations for their potential use are further discussed.

Improving Access and Systems of Care for Evidence-Based Childhood Obesity Treatment: Conference Key Findings and Next Steps

PubMed Central

Wilfley, Denise E.; Staiano, Amanda E.; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G.; Dietz, William H.; Cook, Stephen

2017-01-01

Objectives To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e. clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 hours over 6–12 months to improve weight status) and to expand payment for these services. Methods In July 2015, forty-three cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Results Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multi-disciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g. >25 hours) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Conclusion Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale-up training to ensure quality of care. PMID:27925451

Improving access and systems of care for evidence-based childhood obesity treatment: Conference key findings and next steps.

PubMed

Wilfley, Denise E; Staiano, Amanda E; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G; Dietz, William H; Cook, Stephen

2017-01-01

To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e., clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 h over 6 to 12 months to improve weight status) and to expand payment for these services. In July 2015, 43 cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multidisciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g., >25 h) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale up training to ensure quality of care. © 2016 The Obesity Society.

[Interdisciplinary AWMF guideline for the treatment of primary antibody deficiencies].

PubMed

Krudewig, J; Baumann, U; Bernuth von, H; Borte, M; Burkhard-Meier, U; Dueckers, G; Foerster-Waldl, E; Franke, K; Habermehl, P; Hönig, M; Kern, W; Kösters, K; Kugel, K; Lehrnbecher, T; Liese, J; Marks, R; Müller, G A; Müller, R; Nadal, D; Peter, H-H; Pfeiffer-Kascha, D; Schneider, M; Sitter, H; Späth, P; Wahn, V; Welte, T; Niehues, T

2012-10-01

Currently, management of antibody deficient patients differs significantly among caregivers. Evidence and consensus based (S3) guidelines for the treatment of primary antibody deficiencies were developed to improve the management of these patients. Based on a thorough analysis of current evidence (systematic literature search in PubMed; deadline November 2011) 14 recommendations were finalized during a consensus meeting in Frankfurt in November 2011 using structured consensus methods (nominal group technique). Experts were nominated by their scientific societies/patient initiatives (Tab. 1). The guidelines focus on indication, practical issues and monitoring of immunoglobulin replacement therapy as well as on different routes of administration. Furthermore recommendations regarding supportive measures such as antiinfective therapy, vaccinations and physiotherapy are given. Combining literature evidence and experience of caregivers within this evidence and consensus based guidelines offers the chance to improve the quality of care for anti-body deficient patients. © Georg Thieme Verlag KG Stuttgart · New York.

A community-based approach to trials of aerobic exercise in aging and Alzheimer’s disease

PubMed Central

Vidoni, Eric D.; Van Sciver, Angela; Johnson, David K.; He, Jinghua; Honea, Robyn; Haines, Brian; Goodwin, Jami; Laubinger, M. Pat; Anderson, Heather S.; Kluding, Patricia M.; Donnelly, Joseph E.; Billinger, Sandra A.; Burns, Jeffrey M.

2012-01-01

The benefits of exercise for aging have received considerable attention in both the popular and academic press. The putative benefits of exercise for maximizing cognitive function and supporting brain health have great potential for combating Alzheimer’s disease (AD). Aerobic exercise offers a low-cost, low-risk intervention that is widely available and may have disease modifying effects. Demonstrating aerobic exercise alters the AD process would have enormous public health implications. The purpose of this paper is to a report the protocol of a current, community-based pilot study of aerobic exercise for AD to guide future investigation. This manuscript provides 1) an overview of possible benefits of exercise in those with dementia, 2) a rationale and recommendations for implementation of a community-based approach, 3) recommendation for implementation of similar study protocols, 4) unique challenges in conducting an exercise trial in AD. PMID:22903151

Recommendations for Promoting E-learning in Higher Education Institutions: A Case Study of Iran

ERIC Educational Resources Information Center

Hanafizadeh, Payam; Khodabakhshi, Mohsen; Hanafizadeh, Mohammad Reza

2011-01-01

This paper intends to offer recommendations for promoting e-learning in higher education institutions in developing countries in general, and in Iran in particular. For this, 279 recommendations were extracted through the investigation of 11 countries and 5 regions. Using content analysis, 23 recommendations were selected and then categorized into…

Stability analysis of multipoint tool equipped with metal cutting ceramics

NASA Astrophysics Data System (ADS)

Maksarov, V. V.; Khalimonenko, A. D.; Matrenichev, K. G.

2017-10-01

The article highlights the issues of determining the stability of the cutting process by a multipoint cutting tool equipped with cutting ceramics. There were some recommendations offered on the choice of parameters of replaceable cutting ceramic plates for milling based of the conducted researches. Ceramic plates for milling are proposed to be selected on the basis of value of their electrical volume resistivity.

Ages & Stages Questionnaires[R], Third Edition (ASQ-3[TM]): A Parent-Completed Child-Monitoring System

ERIC Educational Resources Information Center

Squires, Jane; Bricker, Diane

2009-01-01

Now enhanced and updated based on extensive user feedback and a new, unparalleled research sample of more than 12,000 children, ASQ-3 is the most accurate, cost-effective, and parent-friendly way to identify children from one month to 5 1/2 years with developmental delays. ASQ-3 offers more than any other screening system: (1) Recommended by the…

Minnehaha Creek Watershed SWMM5 Model Data Analysis and Future Recommendations

DTIC Science & Technology

2013-07-01

comprehensive inventory of data inconsistencies without a source data inventory. To solve this problem, MCWD needs to develop a detailed, georeferenced, GIS...LMCW models, USACE recommends that MCWD keep the SWMM5 models separated instead of combining them into one comprehensive SWMM5 model for the entire...SWMM5 geometry. SWMM5 offers three routing methods: steady flow, kinematic wave, and dynamic wave. Each method offers advantages and disadvantages and

Opportunities for extracurricular physical activity in North Carolina middle schools.

PubMed

Edwards, Michael B; Kanters, Michael A; Bocarro, Jason N

2011-07-01

This study's purpose was to assess the opportunities for North Carolina adolescents to be physically active in extracurricular middle school environments and to compare opportunities across community types. Data were analyzed based on the results of an electronic questionnaire distributed to a sample of 431 schools with a response rate of 75.4% (N = 325). Nearly all schools offered interscholastic sports while fewer than half offered intramurals or noncompetitive activities to students. "Open gym" was offered at only 35% of schools, while 24% of schools offered extracurricular activities to students with disabilities. Overall, 43.4% of schools offered special transportation to students who participated in some extracurricular physical activities. Schools in rural areas generally offered fewer programs and had fewer supports than schools located in more urbanized areas. Over two-thirds of rural schools offered no extracurricular programs other than interscholastic sports. Schools can be important settings for physical activity. North Carolina's middle schools and its rural schools in particular, are falling short in efforts to provide extracurricular physical activity programming recommended by researchers and policy groups. Lower accessibility to extracurricular physical activities may partially contribute to higher levels of physical inactivity found in the state.

Moving research tools into practice: the successes and challenges in promoting uptake of classification tools.

PubMed

Cunningham, Barbara Jane; Hidecker, Mary Jo Cooley; Thomas-Stonell, Nancy; Rosenbaum, Peter

2018-05-01

In this paper, we present our experiences - both successes and challenges - in implementing evidence-based classification tools into clinical practice. We also make recommendations for others wanting to promote the uptake and application of new research-based assessment tools. We first describe classification systems and the benefits of using them in both research and practice. We then present a theoretical framework from Implementation Science to report strategies we have used to implement two research-based classification tools into practice. We also illustrate some of the challenges we have encountered by reporting results from an online survey investigating 58 Speech-language Pathologists' knowledge and use of the Communication Function Classification System (CFCS), a new tool to classify children's functional communication skills. We offer recommendations for researchers wanting to promote the uptake of new tools in clinical practice. Specifically, we identify structural, organizational, innovation, practitioner, and patient-related factors that we recommend researchers address in the design of implementation interventions. Roles and responsibilities of both researchers and clinicians in making implementations science a success are presented. Implications for rehabilitation Promoting uptake of new and evidence-based tools into clinical practice is challenging. Implementation science can help researchers to close the knowledge-to-practice gap. Using concrete examples, we discuss our experiences in implementing evidence-based classification tools into practice within a theoretical framework. Recommendations are provided for researchers wanting to implement new tools in clinical practice. Implications for researchers and clinicians are presented.

Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations.

PubMed

Döring, Nora; Mayer, Susanne; Rasmussen, Finn; Sonntag, Diana

2016-09-13

Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention.

Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations

PubMed Central

Döring, Nora; Mayer, Susanne; Rasmussen, Finn; Sonntag, Diana

2016-01-01

Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention. PMID:27649218

Brownfields Green Avenue Sites: Technical Memorandum - Conceptual Design for Sustainable Redevelopment

EPA Pesticide Factsheets

This technical memorandum briefly describes the site and proposed conceptual site plan, indicates conceptual design considerations, specifies recommended green and sustainable features, and offers other recommendations

Global Consensus Recommendations on Prevention and Management of Nutritional Rickets.

PubMed

Munns, Craig F; Shaw, Nick; Kiely, Mairead; Specker, Bonny L; Thacher, Tom D; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary; Högler, Wolfgang

2016-02-01

Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required.

Teen Pregnancy Prevention Program Recommendations from Urban and Reservation Northern Plains American Indian Community Members.

PubMed

McMahon, Tracey R; Hanson, Jessica D; Griese, Emily R; Kenyon, DenYelle Baete

2015-07-03

Despite declines over the past few decades, the United States has one of the highest rates of teen pregnancy compared to other industrialized nations. American Indian youth have experienced higher rates of teen pregnancy compared to the overall population for decades. Although it's known that community and cultural adaptation enhance program effectiveness, few teen pregnancy prevention programs have published on recommendations for adapting these programs to address the specific needs of Northern Plains American Indian youth. We employed a mixed-methods analysis of 24 focus groups and 20 interviews with a combined total of 185 urban and reservation-based American Indian youth and elders, local health care providers, and local school personnel to detail recommendations for the cultural adaptation, content, and implementation of a teen pregnancy prevention program specific to this population. Gender differences and urban /reservation site differences in the types of recommendations offered and the potential reasons for these differences are discussed.

Recommendations

ERIC Educational Resources Information Center

Brazelton, G. Blue; Renn, Kristen A.; Stewart, Dafina-Lazarus

2015-01-01

In this chapter, the editors provide a summary of the information shared in this sourcebook about the success of students who have minoritized identities of sexuality or gender and offer recommendations for policy, practice, and further research.

Recommendations of the National Advisory Council on Migrant Health, 1993.

ERIC Educational Resources Information Center

National Migrant Resource Program, Inc., Austin, TX.

The 1993 recommendations to the Secretary of Health and Human Services on migrant health emphasize that all available federal and state public service programs be mobilized to also serve farmworkers, and that coordination of efforts among federal agencies and departments take place. The following recommendations offer approaches to secure…

Vocational Training and Placement of the Severely Handicapped: Research and Development Recommendations.

ERIC Educational Resources Information Center

Cook, Paul F.; Dahl, Peter R.

The monograph synthesizes findings of the Vocational Training and Placement of the Severely Handicapped Project (VOTAP) and offers recommendations for further research and development. Chapter 1 presents the theoretical model that describes the dimensions upon which the task of developing research and development recommendations could be…

Beta blockers in patients with end-stage renal disease-Evidence-based recommendations.

PubMed

Weir, Matthew A; Herzog, Charles A

2018-05-01

For patients who require hemodialysis, beta blockers offer a simultaneous opportunity and challenge in the treatment of cardiovascular disease. Beta blockers are well supported by data from nondialysis populations and directly mitigate the sympathetic overactivity that links chronic kidney disease with cardiovascular sequelae. However, the evidence supporting their use in patients receiving hemodialysis is sparse and the heterogeneity of the beta blocker class makes it difficult to prescribe these medications with confidence. Despite these limitations, both trial and observational data exist that can help guide the use of these medications. In this review, we outline the reasons to consider beta blockers for patients receiving hemodialysis, discuss the barriers to their use, and provide specific evidence-based recommendations for beta blocker use in patients with heart failure, hypertension, ischemic heart disease and arrhythmia. © 2018 Wiley Periodicals, Inc.

GENESIS 2: Advanced lunar outpost

NASA Technical Reports Server (NTRS)

Moore, Gary T.

1991-01-01

Advanced, second-generation lunar habitats for astronauts and mission specialists working on the Moon are investigated. The work was based on design constraints set forth in previous publications. Design recommendations are based on environmental response to the lunar environment, habitability, safety, near-term technology, replaceability and modularity, and suitability for NASA lunar research missions in the early 21st century. Scientists, engineers, and architects from NASA/JSC, Wisconsin aeronautical industry, and area universities gave technical input and offered critiques at design reviews throughout the process. The recommended design uses a lunar lava tube, with construction using a combination of Space Station Freedom-derived modules and lightweight Kevlar-laminate inflatables. The outpost includes research laboratories and biotron, crew quarters and support facility, mission control, health maintenance facility, and related areas for functional and psychological requirements. Furniture, specialized equipment, and lighting are included in the design analysis.

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

PubMed

Grunebaum, Lisa Danielle; Reiter, David

2006-01-01

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

Evidence-based recommendations for cancer fatigue, anorexia, depression, and dyspnea.

PubMed

Dy, Sydney M; Lorenz, Karl A; Naeim, Arash; Sanati, Homayoon; Walling, Anne; Asch, Steven M

2008-08-10

PURPOSE The experience of patients with cancer often involves symptoms of fatigue, anorexia, depression, and dyspnea. METHODS We developed a set of standards through an iterative process of structured literature review and development and refinement of topic areas and standards and subjected recommendations to rating by a multidisciplinary expert panel. Results For fatigue, providers should screen patients at the initial visit, for newly identified advanced cancer, and at chemotherapy visits; assess for depression and insomnia in newly identified fatigue; and follow up after treatment for fatigue or a secondary cause. For anorexia, providers should screen at the initial visit for cancer affecting the oropharynx or gastrointestinal tract or advanced cancer, evaluate for associated symptoms, treat underlying causes, provide nutritional counseling for patients undergoing treatment that may affect nutritional intake, and follow up patients given appetite stimulants. For depression, providers should screen newly diagnosed patients, those started on chemotherapy or radiotherapy, those with newly identified advanced disease, and those expressing a desire for hastened death; document a treatment plan in diagnosed patients; and follow up response after treatment. For general dyspnea, providers should evaluate for causes of new or worsening dyspnea, treat or symptomatically manage underlying causes, follow up to evaluate treatment effectiveness, and offer opioids in advanced cancer when other treatments are unsuccessful. For dyspnea and malignant pleural effusions, providers should offer thoracentesis, follow up after thoracentesis, and offer pleurodesis or a drainage procedure for patients with reaccumulation and dyspnea. CONCLUSION These standards provide a framework for evidence-based screening, assessment, treatment, and follow-up for cancer-associated symptoms.

The clinical content of preconception care: reproductive history.

PubMed

Stubblefield, Phillip G; Coonrod, Dean V; Reddy, Uma M; Sayegh, Raja; Nicholson, Wanda; Rychlik, Daniel F; Jack, Brian W

2008-12-01

A history of previous birth of a low birthweight infant, previous cesarean sections, multiple previous spontaneous abortions, prior stillbirth, or uterine anomaly identifies women at increased risk for recurrent abortion, preterm birth, or stillbirth. We review the evidence for the potential benefit of reproductive history in identifying strategies for evaluation and treatment to prevent recurrent adverse pregnancy outcome. We offer evidence-based recommendations for management of women with these histories.

Aquinas on Inclusion: Using the Good Doctor and Catholic Social Teaching to Build a Moral Case for Inclusion in Catholic Schools for Children with Special Needs

ERIC Educational Resources Information Center

Carlson, Mary

2014-01-01

This article discusses the present status of students with disabilities in Catholic schools. It then builds the case, based upon the teachings of St. Thomas Aquinas and Catholic Social Teaching, that Catholic Schools, to remain true to Church teachings, must offer special educational services. The article concludes with recommendations for…

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

Nadel, S.; Elliott, R.N.; Shepard, M.

This updated and revised book, based on the best-selling first edition, will address how motors and motor systems can achieve greater efficiency through efficient motors, motor management, optimized controls, improved component sizing and repair, better transmission hardware, and comprehensive monitoring and maintenance. In language understandable to non-engineers, this second edition will provide an overview of existing motor stock, chronicle experience with drive power programs and policies, and offer recommendations for future efforts to increase motor system efficiency.

Neurogenic bowel dysfunction: Clinical management recommendations of the Neurologic Incontinence Committee of the Fifth International Consultation on Incontinence 2013.

PubMed

Cotterill, Nikki; Madersbacher, Helmut; Wyndaele, Jean J; Apostolidis, Apostolos; Drake, Marcus J; Gajewski, Jerzy; Heesakkers, John; Panicker, Jalesh; Radziszewski, Piotr; Sakakibara, Ryuji; Sievert, Karl-Dietrich; Hamid, Rizwan; Kessler, Thomas M; Emmanuel, Anton

2018-01-01

Evidence-based guidelines for the management of neurological disease and lower bowel dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance. To update clinical management of neurogenic bowel dysfunction from the recommendations of the 4th ICI, 2009. A series of evidence reviews and updates were performed by members of the working group. The resulting guidelines were presented at the 2012 meeting of the European Association of Urology for consultation, and modifications applied to deliver evidence based conclusions and recommendations for the scientific report of the 5th edition of the ICI in 2013. The current review is a synthesis of the conclusions and recommendations, including the algorithms for initial and specialized management of neurogenic bowel dysfunction. The pathophysiology is described in terms of spinal cord injury, multiple sclerosis, and Parkinson's disease. Assessment requires detailed history and clinical assessment, general investigations, and specialized testing, if required. Treatment primarily focuses on optimizing stool consistency and regulating bowel evacuation to improve quality of life. Symptom management covers conservative and interventional measures to promote good habits and assist stool evacuation, along with prevention of incontinence. Education is essential to achieving optimal bowel management. The review offers a pragmatic approach to management in the context of complex pathophysiology and varied evidence base. © 2017 Wiley Periodicals, Inc.

Neurogenic lower urinary tract dysfunction: Clinical management recommendations of the Neurologic Incontinence committee of the fifth International Consultation on Incontinence 2013.

PubMed

Drake, Marcus John; Apostolidis, Apostolos; Cocci, Andrea; Emmanuel, Anton; Gajewski, Jerzy B; Harrison, Simon C W; Heesakkers, John P F A; Lemack, Gary E; Madersbacher, Helmut; Panicker, Jalesh N; Radziszewski, Piotr; Sakakibara, Ryuji; Wyndaele, Jean Jacques

2016-08-01

Evidence-based guidelines for the management of neurological disease and lower urinary tract dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance. To update clinical management of neurogenic bladder dysfunction from the recommendations of the fourth ICI, 2009. A series of evidence reviews and updates were performed by members of the working group. The resulting guidelines were presented at the 2012 meeting of the European Association of Urology for consultation, and consequently amended to deliver evidence-based conclusions and recommendations in 2013. The current review is a synthesis of the conclusions and recommendations, including the algorithms for initial and specialized management of neurogenic lower urinary tract dysfunction. The pathophysiology is categorized according to the nature of onset of neurological disease and the part(s) of the nervous system affected. Assessment requires clinical evaluation, general investigations, and specialized testing. Treatment primarily focuses on ensuring safety of the patient and optimizing quality of life. Symptom management covers conservative and interventional measures to aid urine storage and bladder emptying, along with containment of incontinence. A multidisciplinary approach to management is essential. The review offers a pragmatic review of management in the context of complex pathophysiology and varied evidence base. Neurourol. Urodynam. 35:657-665, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Formative Evaluation of the Behavior Change Components within a Colorado Weatherization Assistance Program

NASA Astrophysics Data System (ADS)

Sandoval, Perla K.

A formative evaluation of behavior change elements of an ongoing Weatherization Assistance Program (WAP) offered by the Energy Resource Center (E.R.C.) in Denver, CO was conducted. The WAP as administered by the E.R.C. in Colorado saves residents an average 15% of energy consumption (E.R.C., 2015). However, research suggests that adding behavioral components to WAPs could increase energy savings to 21-26% (Gregory, 1992; APPRAISE, 2002). The goal of this evaluation is to provide recommendations to E.R.C. for program changes using Community Based Social Marketing (CBSM) and Theory of Planned Behavior. The CBSM Step 1- Step 3 is the focus of this formative evaluation. This program evaluation has four components: 1) review of written materials, 2) interviews with staff, 3) surveys mailed to E.R.C. clients and 4) in-home observations conducted with E.R.C. clients. Results of this formative evaluation has 3 sections of behaviors recommended for future intervention high priority, mid priority, and low priority recommendations based on CBSM penetration, probability, and impact factors. Behaviors that are listed as high priority for E.R.C. Behavioral intervention are cold water washing, hang drying, setting back thermostats, and window coverings. Overall increase in staff engagement is also recommended to be pursued. Each staff level is also given recommendations on how to engage in behavior change interventions.

Ada training evaluation and recommendations from the Gamma Ray Observatory Ada Development Team

NASA Technical Reports Server (NTRS)

1985-01-01

The Ada training experiences of the Gamma Ray Observatory Ada development team are related, and recommendations are made concerning future Ada training for software developers. Training methods are evaluated, deficiencies in the training program are noted, and a recommended approach, including course outline, time allocation, and reference materials, is offered.

John Dewey's Report of 1924 and his Recommendations on the Turkish Educational System Revisited.

ERIC Educational Resources Information Center

Turan, Selahattin

2000-01-01

Explains that in 1924, John Dewey went to Turkey in order to observe and analyze the educational system and offer restructuring recommendations. Aims to reevaluate the significance of Dewey's visit to Turkey, his recommendations, and his report on the Turkish educational system. Analyses his 30 page report. (CMK)

What we have learnt (so far) about deliberative dialogue for evidence-based policymaking in West Africa

PubMed Central

Dagenais, Christian

2017-01-01

Policy decisions do not always take into account research results, and there is still little research being conducted on interventions that promote their use, particularly in Africa. To promote the use of research evidence in Africa, deliberative dialogue workshops are increasingly recommended as a means to establish evidence-informed dialogue among multiple stakeholders engaged in policy decision-making. In this paper, we reflect on our experiences of conducting national workshops in six African countries, and we propose operational recommendations for those wishing to organise deliberative dialogue. Our reflective and cross-sectional analysis of six national deliberative dialogue workshops in which we participated shows there are many specific challenges that should be taken into account when organising such encounters. In conclusion, we offer operational recommendations, drawn from our experience, to guide the preparation and conduct of deliberative workshops. PMID:29259821

Organizing Books and Authors by Multilayer SOM.

PubMed

Zhang, Haijun; Chow, Tommy W S; Wu, Q M Jonathan

2016-12-01

This paper introduces a new framework for the organization of electronic books (e-books) and their corresponding authors using a multilayer self-organizing map (MLSOM). An author is modeled by a rich tree-structured representation, and an MLSOM-based system is used as an efficient solution to the organizational problem of structured data. The tree-structured representation formulates author features in a hierarchy of author biography, books, pages, and paragraphs. To efficiently tackle the tree-structured representation, we used an MLSOM algorithm that serves as a clustering technique to handle e-books and their corresponding authors. A book and author recommender system is then implemented using the proposed framework. The effectiveness of our approach was examined in a large-scale data set containing 3868 authors along with the 10500 e-books that they wrote. We also provided visualization results of MLSOM for revealing the relevance patterns hidden from presented author clusters. The experimental results corroborate that the proposed method outperforms other content-based models (e.g., rate adapting poisson, latent Dirichlet allocation, probabilistic latent semantic indexing, and so on) and offers a promising solution to book recommendation, author recommendation, and visualization.

A knowledge-based system with learning for computer communication network design

NASA Technical Reports Server (NTRS)

Pierre, Samuel; Hoang, Hai Hoc; Tropper-Hausen, Evelyne

1990-01-01

Computer communication network design is well-known as complex and hard. For that reason, the most effective methods used to solve it are heuristic. Weaknesses of these techniques are listed and a new approach based on artificial intelligence for solving this problem is presented. This approach is particularly recommended for large packet switched communication networks, in the sense that it permits a high degree of reliability and offers a very flexible environment dealing with many relevant design parameters such as link cost, link capacity, and message delay.

Automated software development workstation

NASA Technical Reports Server (NTRS)

1986-01-01

Engineering software development was automated using an expert system (rule-based) approach. The use of this technology offers benefits not available from current software development and maintenance methodologies. A workstation was built with a library or program data base with methods for browsing the designs stored; a system for graphical specification of designs including a capability for hierarchical refinement and definition in a graphical design system; and an automated code generation capability in FORTRAN. The workstation was then used in a demonstration with examples from an attitude control subsystem design for the space station. Documentation and recommendations are presented.

Strategies To Empower Communities To Reduce Health Disparities.

PubMed

Thompson, Beti; Molina, Yamile; Viswanath, Kasisomayajula; Warnecke, Richard; Prelip, Michael L

2016-08-01

Community-based participatory research is a promising approach to reducing health disparities. It empowers individuals and communities to become the major players in solving their own health problems. We discuss the use of community-based participatory research and other strategies to enhance empowerment. We also discuss projects from the Centers for Population Health and Health Disparities that have empowered communities to achieve positive health outcomes aimed at reducing disparities. We offer recommendations to policy makers for involving residents in efforts to achieve health equity. Project HOPE—The People-to-People Health Foundation, Inc.

[Organ transplants for HIV-infected patients--time for reevaluation?].

PubMed

Katzenstein, Terese L

2005-11-14

With the improvement in antiretroviral therapy, comorbidity is increasingly a cause of morbidity among HIV-infected patients. In the United States and several European countries, kidney and liver transplantations have been performed on selected HIV-infected patients. The short-term results have been comparable to those among HIV-negative recipients. Based on these results, it is recommended that kidney and liver transplants be offered to Danish HIV patients based on the same criteria as those that apply for non-HIV-infected patients with end-stage kidney or liver disease.

Community pharmacists’ services for women during pregnancy and breast feeding in Kuwait: a cross-sectional study

PubMed Central

Albassam, Abdullah

2018-01-01

Objectives This study was designed to identify the services provided by community pharmacists in Kuwait and their views regarding self-care in pregnancy and lactation. In addition, it determined the pharmacists’ recommendations for treatment of pregnancy-related and breast feeding-related ailments. Design Cross-sectional questionnaire-based survey. Setting Community pharmacies in Kuwait. Participants 207 pharmacies were randomly selected from the Ministry of Health database. One registered pharmacist was approached from each pharmacy. One hundred and ninety-two (92.8%) pharmacists agreed to participate and completed a self-administered questionnaire. Outcomes The proportions of pharmacists offering particular advice for health conditions in pregnancy and lactation, pharmacists’ recommendations for common and specific ailments during pregnancy and breast feeding, and pharmacists’ views about self-care in pregnancy and breast feeding. Results The top services provided to pregnant and lactating women were recommending vitamins and food supplements (89.8%) and contraception advice (83.4%), respectively. More than half of participants indicated that they would recommend medications for headache, constipation, cough, runny nose, sore throat, nausea/vomiting, indigestion, sore or cracked nipple and insufficient milk. Diarrhoea, haemorrhoids, insomnia, varicose vein, swelling of the feet and legs, vaginal itching, back pain, fever, mastitis and engorgement were frequently referred to the physician. Recommendations on medication use were occasionally inappropriate in terms of unneeded drug therapy, off-label use and safety. In relation to offering advice and solving medication and health problems of pregnant and lactating women, more than half of pharmacists indicated that they have sufficient knowledge (61.5%; 50.5%) and confidence (58.3%; 53.1%), respectively. Most of the respondents (88.5%) agreed that a continuing education programme on this topic would be of value for their practice. Conclusion The present findings show that respondents had different recommendations for treatment of pregnancy-related and lactation-related ailments; and also highlight the need for interventions, including continuing professional development and revision of the undergraduate pharmacy curriculum. PMID:29306891

Teaching topography-based and selection-based verbal behavior to developmentally disabled individuals: Some considerations

PubMed Central

Shafer, Esther

1993-01-01

Augmentative and alternative communication systems are widely recommended for nonvocal developmentally disabled individuals, with selection-based systems becoming increasingly popular. However, theoretical and experimental evidence suggests that topography-based communication systems are easier to learn. This paper discusses research relevant to the ease of acquisition of topography-based and selection-based systems. Additionally, current practices for choosing and designing communication systems are reviewed in order to investigate the extent to which links have been made with available theoretical and experimental knowledge. A stimulus equivalence model is proposed as a clearer direction for practitioners to follow when planning a communication training program. Suggestions for future research are also offered. PMID:22477085

Adolescent bariatric surgery: a systematic review of recommendation documents.

PubMed

Childerhose, Janet E; Alsamawi, Amal; Mehta, Tanvi; Smith, Judith E; Woolford, Susan; Tarini, Beth A

2017-10-01

Bariatric surgery has been performed on adolescents since the 1970s, but little is known about the guidance offered to providers in recommendation documents published in the United States. A systematic review was conducted to generate a complete record of all US recommendation documents and describe variability across the documents. This study had 3 aims: to identify the developers, examine selection criteria, and document reasons why developers have recommended this intervention for adolescents. Four databases (MEDLINE, National Guidelines Clearinghouse, Trip, and Embase) ertr searched, followed by a hand search. Documents were eligible for inclusion if they satisfied 5 criteria: written in the English language; developed and published by a US organization; comprised a clinical practice guideline, position statement, or consensus statement; offered a minimum 1-sentence recommendation on bariatric surgery for the treatment of obesity or related co-morbidities; and offered a minimum 1-sentence recommendation on bariatric surgery for children, adolescents, or both. No date limits were applied. Sixteen recommendation documents published between 1991 and 2013 met our inclusion criteria: 10 clinical practice guidelines, 4 position statements, and 2 consensus statements. Nine were produced by medical organizations, 3 by surgical organizations, and 4 by public health/governmental bodies. One document recommended against bariatric surgery for minors, and 15 endorsed the intervention for this population. Body mass index (a measure of obesity calculated by dividing weight in kilograms by the square of height in meters) thresholds were the selection criteria most often provided. Minimum age varied widely. Of the 15 endorsing documents, 10 provided a reason for performing bariatric surgery on minors, most often to treat obesity-related co-morbidities that threaten the health of the adolescent. We make 3 suggestions to improve the quality of future recommendation documents. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Recommendations for the return of research results to study participants and guardians: a report from the Children's Oncology Group.

PubMed

Fernandez, Conrad V; Ruccione, Kathleen; Wells, Robert J; Long, Jay B; Pelletier, Wendy; Hooke, Mary C; Pentz, Rebecca D; Noll, Robert B; Baker, Justin N; O'Leary, Maura; Reaman, Gregory; Adamson, Peter C; Joffe, Steven

2012-12-20

The Children's Oncology Group (COG) strongly supports the widely recognized principle that research participants should be offered a summary of study results. The mechanism by which to do so in a cooperative research group setting has not been previously described. On the basis of a review of the available empirical and theoretic literature and on iterative, multidisciplinary discussion, a COG Return of Results Task Force (RRTF) offered detailed recommendations for the return of results to research study participants. The RRTF established guidelines for the notification of research participants and/or their parents/guardians about the availability of research results, a mechanism for and timing of sharing results via registration on the COG public Web site, the scope of the research to be shared, the target audience, and a process for creating and vetting lay summaries of study results. The RRTF recognized the challenges in adequately conveying complex scientific results to audiences with varying levels of health literacy and recommended that particularly sensitive or complex results be returned using direct personal contact. The RRTF also recommended evaluation of the cost, effectiveness, and impact of sharing results. These recommendations provide a framework for the offering and returning of results to participants. They can be used by individual investigators, multi-investigator research collaboratives, and large cooperative groups.

Recommendations for the Return of Research Results to Study Participants and Guardians: A Report From the Children's Oncology Group

PubMed Central

Fernandez, Conrad V.; Ruccione, Kathleen; Wells, Robert J.; Long, Jay B.; Pelletier, Wendy; Hooke, Mary C.; Pentz, Rebecca D.; Noll, Robert B.; Baker, Justin N.; O'Leary, Maura; Reaman, Gregory; Adamson, Peter C.; Joffe, Steven

2012-01-01

Purpose The Children's Oncology Group (COG) strongly supports the widely recognized principle that research participants should be offered a summary of study results. The mechanism by which to do so in a cooperative research group setting has not been previously described. Methods On the basis of a review of the available empirical and theoretic literature and on iterative, multidisciplinary discussion, a COG Return of Results Task Force (RRTF) offered detailed recommendations for the return of results to research study participants. Results The RRTF established guidelines for the notification of research participants and/or their parents/guardians about the availability of research results, a mechanism for and timing of sharing results via registration on the COG public Web site, the scope of the research to be shared, the target audience, and a process for creating and vetting lay summaries of study results. The RRTF recognized the challenges in adequately conveying complex scientific results to audiences with varying levels of health literacy and recommended that particularly sensitive or complex results be returned using direct personal contact. The RRTF also recommended evaluation of the cost, effectiveness, and impact of sharing results. Conclusion These recommendations provide a framework for the offering and returning of results to participants. They can be used by individual investigators, multi-investigator research collaboratives, and large cooperative groups. PMID:23109703

The Report of the 2016-2017 Advocacy Standing Committee.

PubMed

Jordan, Ronald P; Bratberg, Jeffrey; Congdon, Heather B; Cross, L Brian; Hill, Lucas G; Marrs, Joel C; McBane, Sarah; Lang, William G; Ekoma, Jeffrey O

2017-10-01

Based on the growing importance of community engagement and the recognition of its importance by the American Association of Colleges of Pharmacy (AACP), the committee offers several examples of community engagement activities for consideration and replication by our academy and beyond. These activities, including those of winning institutions of the Lawrence J. Weaver Transformational Community Engagement Award, can be mapped to the core components of community engagement presented in Table 1. The committee, using an implementation readiness framework, provides the reader with insight into the challenges that may impact successful community engagement and encourages our academy to continue its work to support faculty capacity in this area. Toward that end, the committee offers a policy statement that encourages schools and colleges of pharmacy to have an office or designate a faculty member whose focus is specifically on community engagement. The committee also offers a recommendation that the core components be included in the criteria for the Weaver Award.

Nutritional levels of diets fed to captive Amazon parrots: does mixing seed, produce, and pellets provide a healthy diet?

PubMed

Brightsmith, Donald J

2012-09-01

Poor nutrition is a serious problem in captive psittacine birds. Seed-based diets are known to contain excess fat, low calcium:phosphorus ratios, and other nutrient deficiencies, whereas many consider nutritionally superior, formulated diets to be monotonous. As a result, many bird owners feed a mixture of seed, produce, and formulated diet. However, the nutritional contents of such mixed diets have rarely been evaluated. In this study, we describe the nutrient contents of diets consumed by 7 adult (>6 years old), captive Amazon parrots offered produce (50% fresh weight), formulated diet (25%), and seed (25%). Diets consumed were deficient in calcium, sodium, and iron and contained more than the recommended amount of fat. In addition, the birds chose foods that exacerbated these imbalances. Birds offered low-seed diets (60% pellet, 22% produce, 18% seed, wet weight) consumed diets with more fat than recommended but acceptable levels of calcium and all other nutrients measured, as well as acceptable calcium:phosphorus ratios. This suggests that small quantities of seeds may not result in nutritionally imbalanced diets. Birds fed 75% formulated diet and 25% produce consumed diets within the recommendations for nearly all measured nutrients, demonstrating that owners of psittacine birds should be encouraged to supplement manufactured diets with low energy-density, fresh produce items to provide stimulation and foraging opportunities without fear of causing major nutritional imbalances.

Findings from Existing Data on the Department of Defense Industrial Base

DTIC Science & Technology

2014-01-01

the federal government. Leading purchasing textbooks recommend that buyers purchase no more than 30 percent of any sup- plier’s entire capacity, with...percentage of average total revenue FSRS and FPDS data can offer information on supplier dependency (Chart 22). Lead- ing purchasing textbooks (e.g...more contracts become subject to FSRS, may show a different level of sup- plier dependency. Industry Subaward Data 33 24RAND 150,000100,00050,000 90

Le contexte du materiel pedagogique dans l'anglais de specialite. Etude sur les themes tires de l'environnement (The Context of Instructional Materials for ESP. A Study of Themes Drawn from the Environment).

ERIC Educational Resources Information Center

Williams, Ray

1981-01-01

Challenges the idea that ESP courses should be based strictly on instructional materials taken from the relevant professional context. Accordingly recommends a multidisciplinary themes approach as illustrated in the detailed description of the methods and materials used in a course offered by the University of Aston (Birmingham). Societe Nouvelle…

Developing genomic knowledge bases and databases to support clinical management: current perspectives.

PubMed

Huser, Vojtech; Sincan, Murat; Cimino, James J

2014-01-01

Personalized medicine, the ability to tailor diagnostic and treatment decisions for individual patients, is seen as the evolution of modern medicine. We characterize here the informatics resources available today or envisioned in the near future that can support clinical interpretation of genomic test results. We assume a clinical sequencing scenario (germline whole-exome sequencing) in which a clinical specialist, such as an endocrinologist, needs to tailor patient management decisions within his or her specialty (targeted findings) but relies on a genetic counselor to interpret off-target incidental findings. We characterize the genomic input data and list various types of knowledge bases that provide genomic knowledge for generating clinical decision support. We highlight the need for patient-level databases with detailed lifelong phenotype content in addition to genotype data and provide a list of recommendations for personalized medicine knowledge bases and databases. We conclude that no single knowledge base can currently support all aspects of personalized recommendations and that consolidation of several current resources into larger, more dynamic and collaborative knowledge bases may offer a future path forward.

Developing genomic knowledge bases and databases to support clinical management: current perspectives

PubMed Central

Huser, Vojtech; Sincan, Murat; Cimino, James J

2014-01-01

Personalized medicine, the ability to tailor diagnostic and treatment decisions for individual patients, is seen as the evolution of modern medicine. We characterize here the informatics resources available today or envisioned in the near future that can support clinical interpretation of genomic test results. We assume a clinical sequencing scenario (germline whole-exome sequencing) in which a clinical specialist, such as an endocrinologist, needs to tailor patient management decisions within his or her specialty (targeted findings) but relies on a genetic counselor to interpret off-target incidental findings. We characterize the genomic input data and list various types of knowledge bases that provide genomic knowledge for generating clinical decision support. We highlight the need for patient-level databases with detailed lifelong phenotype content in addition to genotype data and provide a list of recommendations for personalized medicine knowledge bases and databases. We conclude that no single knowledge base can currently support all aspects of personalized recommendations and that consolidation of several current resources into larger, more dynamic and collaborative knowledge bases may offer a future path forward. PMID:25276091

Inquiries into Malaysia's socio-technical disasters: recommendations and lessons learnt.

PubMed

Said, Aini Mat; Ahmadun, Fakhru'l-Razi; Abdul Kadir, Razali; Daud, Mohamed

2009-04-01

Most democratic countries hold inquiries into disasters. One of their key functions is to establish the cause of an event and to learn lessons in order to prevent a recurrence. In addition, they offer an opportunity for communal catharsis, permitting the public to vent anger, distress and frustration and to exert pressure for policy changes. Malaysia has experienced six landmark socio-technical disasters since 1968, which resulted in the proposal or amendment of various safety/emergency acts and regulations. The authors used a grounded theory approach utilising a constant comparative method to analyse the recommendations made by the inquiries into these events. Data indicate that social and technical recommendations comprise 85 and 15 per cent, respectively, of the total recommendations made by the inquiry committees. This paper offers suggestions for improving the management of inquiry tribunals, as they will remain a valuable source of information for society and corporations to learn from past incidents.

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.

Global Consensus Recommendations on Prevention and Management of Nutritional Rickets.

PubMed

Munns, Craig F; Shaw, Nick; Kiely, Mairead; Specker, Bonny L; Thacher, Tom D; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary; Högler, Wolfgang

2016-01-01

Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describes the strength of the recommendation and the quality of supporting evidence. Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required. © 2016 S. Karger AG, Basel and The Endocrine Society.

African American community leaders' policy recommendations for reducing racial disparities in HIV infection, treatment, and care: results from a community-based participatory research project in Philadelphia, Pennsylvania.

PubMed

Nunn, Amy; Sanders, Julia; Carson, Lee; Thomas, Gladys; Cornwall, Alexandra; Towey, Caitlin; Lee, Hwajin; Tasco, Marian; Shabazz-El, Waheedah; Yolken, Annajane; Smith, Tyrone; Bell, Gary; Feller, Sophie; Smith, Erin; James, George; Shelton Dunston, Brenda; Green, Derek

2015-01-01

African Americans account for 45% of new HIV infections in the United States. Little empirical research investigates African American community leaders' normative recommendations for addressing these disparities. Philadelphia's HIV infection rate is 5 times the national average, nearly 70% of new infections are among African Americans, and 2% of African Americans in Philadelphia are living with HIV/AIDS. Using a community-based participatory research approach, we convened focus groups among 52 African American community leaders from diverse backgrounds to solicit normative recommendations for reducing Philadelphia's racial disparities in HIV infection. Leaders recommended that (a) Philadelphia's city government should raise awareness about HIV/AIDS with media campaigns featuring local leaders, (b) local HIV-prevention interventions should address social and structural factors influencing HIV risks rather than focus exclusively on mode of HIV transmission, (c) resources should be distributed to the most heavily affected neighborhoods of Philadelphia, and (d) faith institutions should play a critical role in HIV testing, treatment, and prevention efforts. We developed a policy memo highlighting these normative recommendations for how to enhance local HIV prevention policy. This policy memo led to Philadelphia City Council hearings about HIV/AIDS in October 2010 and subsequently informed local HIV/AIDS prevention policy and development of local HIV prevention interventions. This community-based participatory research case study offers important lessons for effectively engaging community leaders in research to promote HIV/AIDS policy change. © 2014 Society for Public Health Education.

Global Consensus Recommendations on Prevention and Management of Nutritional Rickets

PubMed Central

Munns, Craig F.; Shaw, Nick; Kiely, Mairead; Specker, Bonny L.; Thacher, Tom D.; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M. Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A.; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M.; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary

2016-01-01

Background: Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. Evidence: A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Process: Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. Results: This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Conclusion: Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required. PMID:26745253

Managing Advanced HIV Disease in a Public Health Approach

PubMed Central

Ford, Nathan; Meintjes, Graeme; Calmy, Alexandra; Bygrave, Helen; Migone, Chantal; Vitoria, Marco; Penazzato, Martina; Vojnov, Lara; Doherty, Meg; Asero, Patricia; Bologna, Rosa; Chakroun, Mohamed; Chambal, Lucia; Chiller, Tom; Conradie, Francesca; Eholie, Serge; Frigati, Lisa; Gibb, Diana; Goemaere, Eric; Govender, Nelesh; Grant, Alison; Kumarasamy, Nagalingeswaran; Lalloo, David; Le, Thuy; Letang, Emilio; Mbori-Ngacha, Dorothy; Mfinanga, Sayoki; Nacher, Mathieu; Ribakare, Muhayimpundu; Siegfried, Nandi; Sikwese, Kenly; Tun, Nini; Vidal, Jose E

2018-01-01

Abstract In 2017, the World Health Organization (WHO) published guidelines for the management of advanced human immunodeficiency virus (HIV) disease within a public health approach. Recent data suggest that more than a third of people starting antiretroviral therapy (ART) do so with advanced HIV disease, and an increasing number of patients re-present to care at an advanced stage of HIV disease following a period of disengagement from care. These guidelines recommend a standardized package of care for adults, adolescents, and children, based on the leading causes of morbidity and mortality: tuberculosis, severe bacterial infections, cryptococcal meningitis, toxoplasmosis, and Pneumocystis jirovecii pneumonia. A package of targeted interventions to reduce mortality and morbidity was recommended, based on results of 2 recent randomized trials that both showed a mortality reduction associated with delivery of a simplified intervention package. Taking these results and existing recommendations into consideration, WHO recommends that a package of care be offered to those presenting with advanced HIV disease; depending on age and CD4 cell count, the package may include opportunistic infection screening and prophylaxis, including fluconazole preemptive therapy for those who are cryptococcal antigen positive and without evidence of meningitis. Rapid ART initiation and intensified adherence interventions should also be proposed to everyone presenting with advanced HIV disease. PMID:29514232

Managing Advanced HIV Disease in a Public Health Approach.

PubMed

Ford, Nathan; Meintjes, Graeme; Calmy, Alexandra; Bygrave, Helen; Migone, Chantal; Vitoria, Marco; Penazzato, Martina; Vojnov, Lara; Doherty, Meg

2018-03-04

In 2017, the World Health Organization (WHO) published guidelines for the management of advanced human immunodeficiency virus (HIV) disease within a public health approach. Recent data suggest that more than a third of people starting antiretroviral therapy (ART) do so with advanced HIV disease, and an increasing number of patients re-present to care at an advanced stage of HIV disease following a period of disengagement from care. These guidelines recommend a standardized package of care for adults, adolescents, and children, based on the leading causes of morbidity and mortality: tuberculosis, severe bacterial infections, cryptococcal meningitis, toxoplasmosis, and Pneumocystis jirovecii pneumonia. A package of targeted interventions to reduce mortality and morbidity was recommended, based on results of 2 recent randomized trials that both showed a mortality reduction associated with delivery of a simplified intervention package. Taking these results and existing recommendations into consideration, WHO recommends that a package of care be offered to those presenting with advanced HIV disease; depending on age and CD4 cell count, the package may include opportunistic infection screening and prophylaxis, including fluconazole preemptive therapy for those who are cryptococcal antigen positive and without evidence of meningitis. Rapid ART initiation and intensified adherence interventions should also be proposed to everyone presenting with advanced HIV disease.

Leaders by example: Best practices and advice on establishing a state-of-the art surgical simulation center that optimizes available resources.

PubMed

Gardner, A K; Ritter, E M; Dunkin, B J; Smink, D S; Lau, J N; Paige, J T; Phitayakorn, R; Acton, R D; Stefanidis, D; Gee, D W

2018-02-01

The role of simulation-based education continues to expand exponentially. To excel in this environment as a surgical simulation leader requires unique knowledge, skills, and abilities that are different from those used in traditional clinically-based education. Leaders in surgical simulation were invited to participate as discussants in a pre-conference course offered by the Association for Surgical Education. Highlights from their discussions were recorded. Recommendations were provided on topics such as building a simulation team, preparing for accreditation requirements, what to ask for during early stages of development, identifying tools and resources needed to meet educational goals, expanding surgical simulation programming, and building educational curricula. These recommendations provide new leaders in simulation with a unique combination of up-to-date best practices in simulation-based education, as well as valuable advice gained from lessons learned from the personal experiences of national leaders in the field of surgical simulation and education. Copyright © 2017 Elsevier Inc. All rights reserved.

Early life programming as a target for prevention of child and adolescent mental disorders

PubMed Central

2014-01-01

This paper concerns future policy development and programs of research for the prevention of mental disorders based on research emerging from fetal and early life programming. The current review offers an overview of findings on pregnancy exposures such as maternal mental health, lifestyle factors, and potential teratogenic and neurotoxic exposures on child outcomes. Outcomes of interest are common child and adolescent mental disorders including hyperactive, behavioral and emotional disorders. This literature suggests that the preconception and perinatal periods offer important opportunities for the prevention of deleterious fetal exposures. As such, the perinatal period is a critical period where future mental health prevention efforts should be focused and prevention models developed. Interventions grounded in evidence-based recommendations for the perinatal period could take the form of public health, universal and more targeted interventions. If successful, such interventions are likely to have lifelong effects on (mental) health. PMID:24559477

Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, Seth; Mangione, Carol M; Pignone, Michael; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2018-04-24

Falls are the leading cause of injury-related morbidity and mortality among older adults in the United States. In 2014, 28.7% of community-dwelling adults 65 years or older reported falling, resulting in 29 million falls (37.5% of which needed medical treatment or restricted activity for a day or longer) and an estimated 33 000 deaths in 2015. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on the prevention of falls in community-dwelling older adults. The USPSTF reviewed the evidence on the effectiveness and harms of primary care-relevant interventions to prevent falls and fall-related morbidity and mortality in community-dwelling older adults 65 years or older who are not known to have osteoporosis or vitamin D deficiency. The USPSTF found adequate evidence that exercise interventions have a moderate benefit in preventing falls in older adults at increased risk for falls and that multifactorial interventions have a small benefit. The USPSTF found adequate evidence that vitamin D supplementation has no benefit in preventing falls in older adults. The USPSTF found adequate evidence to bound the harms of exercise and multifactorial interventions as no greater than small. The USPSTF found adequate evidence that the overall harms of vitamin D supplementation are small to moderate. The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. (B recommendation) The USPSTF recommends that clinicians selectively offer multifactorial interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the patient's values and preferences. (C recommendation) The USPSTF recommends against vitamin D supplementation to prevent falls in community-dwelling adults 65 years or older. (D recommendation) These recommendations apply to community-dwelling adults who are not known to have osteoporosis or vitamin D deficiency.

Brownfields Waterfront Sustainability Pilot, Allentown PA: Technical Memorandum on Conceptual Design Using Low Impact Development

EPA Pesticide Factsheets

This technical memorandum briefly describes the site and the master plan, indicates design constraints considered, specifies recommended LID stormwater techniques and features for sustainable redevelopment of the site, and offers other recommendations.

“Let Me Help You Help Me”: Church-based HIV Prevention for Young Black Men who have Sex with Men

PubMed Central

Powell, Terrinieka W.; Herbert, Ann; Ritchwood, Tiarney D.; Latkin, Carl A.

2016-01-01

The goal of this study was to identify strategies that could yield more inclusive church-based HIV prevention efforts. In-depth interviews were conducted with 30 young Black men who have sex with men (YBMSM) living in Baltimore, Maryland. The sample had an equal number of regular and infrequent church attendees. Nearly one-fourth of the sample was HIV-positive. Interviews were transcribed verbatim and analyzed inductively using a qualitative content analytic approach. Two main recommendations emerged for churches to offer more inclusive HIV prevention efforts: (1) reduce homosexuality stigma by increasing interpersonal and institutional acceptance, and (2) address the sexual health needs of all congregants by offering universal and targeted sexual health promotion. Thus, results support a tiered approached to providing more inclusive church-based HIV prevention efforts. We conclude that Black churches can be a critical access point for HIV prevention among YBMSM and represent an important setting to intervene. PMID:27244189

D-WISE: Diabetes Web-Centric Information and Support Environment: conceptual specification and proposed evaluation.

PubMed

Abidi, Samina; Vallis, Michael; Raza Abidi, Syed Sibte; Piccinini-Vallis, Helena; Imran, Syed Ali

2014-06-01

To develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management. The above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management. We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision support services that use logic-based reasoning algorithms to utilize the knowledge encoded within the diabetes management ontology to assist physicians by recommending patient-specific diabetes-management interventions and behaviour-change strategies; C) a mobile diabetes self-management application to engage and educate diabetes patients to self-manage their condition in a home-based setting while working in concert with their family physicians. We have been successful in creating and conducting a usability assessment of the physician decision support tool. These results will be published once the patient self- management application has been evaluated. D-WISE will be evaluated through pilot studies measuring 1) the usability of the e-Health interventions; and 2) the impact of the interventions on patients' behaviour changes and diabetes control. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

A CLINICIAN'S GUIDE TO X-LINKED HYPOPHOSPHATEMIA

PubMed Central

Carpenter, Thomas O.; Imel, Erik A.; Holm, Ingrid A.; Jan de Beur, Suzanne M.; Insogna, Karl L.

2011-01-01

X-linked hypophosphatemia (XLH) is the prototypic disorder of renal phosphate wasting, and the most common form of heritable rickets. Physicians, patients, and XLH support groups have all expressed concerns about the dearth of information about this disease and the lack of treatment guidelines which frequently lead to missed diagnoses or mismanagement. This perspective addresses the recommendation by conferees for the dissemination of concise and accessible treatment guidelines for clinicians arising from the “Advances in Rare Bone Diseases Scientific Conference,” held at the National Institutes of Health in October 2008. We briefly review the clinical and pathophysiologic features of the disorder, and offer this guide in response to the conference recommendation, base on our collective accumulated experience in the management of this complex disorder. PMID:21538511

Norms in Conflict: Statecraft, Preventive Force, and Counter Proliferation

DTIC Science & Technology

2016-12-01

power. Finally, the ethical character of norms offers a framework for the attacking state to justify its actions to the international community ...national identity, sanctions, and ethics play in counter-proliferation strategies. Finally, it concludes by offering policy recommendations for...role that national identity, sanctions, and ethics play in counter-proliferation strategies. Finally, it concludes by offering policy

Dental fluorosis in the primary dentition and intake of manufactured soy-based foods with fluoride.

PubMed

de Carvalho, Cristiane Alves Paz; Zanlorenzi Nicodemo, César Augusto; Ferreira Mercadante, Daniela Cristiane; de Carvalho, Fábio Silva; Buzalaf, Marília Afonso Rabelo; de Carvalho Sales-Peres, Sílvia Helena

2013-06-01

To identify manufactured soy-based products more recommended by pediatricians and nutritionists; to determine fluoride concentrations in these products; to evaluate children concerning fluorosis in primary teeth and its association with the consumption of soy-based products. Pediatricians and Nutritionists answered a questionnaire about soy-based products they most recommended to children. Fluoride concentrations of the 10 products more cited were analyzed with the ion-specific electrode. Dental fluorosis exams were performed in 315 4-6-year-old children. Dean's Index was used to assess fluorosis. Among the children examined, 26 had lactose intolerance. Their parents answered a questionnaire about children's and family's profile, besides permitting the identification of soy-based products use. Chi-squared and Multivariable Logistic Regression tests were used (p < 0.05). Fluoride content in the analyzed products ranged from 0.03 to 0.50 μg F(-)/mL. Dental fluorosis was detected in 11% of the children, with very mild and mild degrees. Dental fluorosis in primary teeth was associated with lactose intolerance (p < 0.05), but there was no significant association with the use of manufactured soy-based products. Isolated consumption of soy-based products recommended by health professionals to children do not offer risk of dental fluorosis in primary teeth, which had a low prevalence and severity. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Israeli nurses' attitudes to the holistic approach to health and their use of complementary and alternative therapies.

PubMed

Orkaby, Brurya; Greenberger, Chaya

2015-03-01

To examine nurses' attitudes to holistic and biomedical approaches to health care and the correlation between the two and to explore the extent of recommending and using complementary and alternative medicine (CAM) by nurses and its correlation with attitudes toward the holistic approach to care. In this cross-sectional correlational study, a structured questionnaire was completed anonymously by 213 Israeli hospital-based nurses from various departments. Nurses perceived both approaches as critical to optimal health care: a positive correlation emerged of attitudes to the two approaches. Nurses recommended and used CAM extensively; most therapies were recommended and/or used by 70% or more of the respondents. Nurses with more positive attitudes toward holistic care tended to recommend and use CAM to a greater extent. Biomedical and holistic approaches are perceived by nurses to coexist within nursing professional boundaries and form a broad basis for optimal health care. Nurses' attitudes to the holistic approach appear to promote recommendation and/or use of CAM in practice. More training in CAM should be offered in nursing educational frameworks and research should continue to establish evidence for CAM's effectiveness. © The Author(s) 2014.

The confusing world of dietary sugars: definitions, intakes, food sources and international dietary recommendations.

PubMed

Hess, Jennifer; Latulippe, Marie E; Ayoob, Keith; Slavin, Joanne

2012-05-01

Government and health organizations worldwide have issued dietary guidelines for sugars. These guidelines vary considerably in the recommended or suggested intakes and the types of sugars specified. Despite access to the same published literature, recommendations vary greatly and create confusion for nutrition practitioners who offer dietary guidance. Some of the confusion in this field is linked to differences in definitions for sugar and methods to measure total sugars. Additionally, although dietary guidance typically recommends foods high in sugar, fruits and dairy products, other advice suggests strict limits on intake of "added sugar". Added sugar cannot be analytically determined and must be calculated so nutrient databases generally contain values for total sugar and do not differentiate between sugars naturally occurring in foods and those added in processing. This review defines sugars, provides the sugar content of major food sources, summarizes health concerns about dietary sugars, and compiles dietary guidelines for sugars issued by various organizations. Dietary recommendations from various health organizations are based on different means of assessment, and thus vary considerably. In general, the use of added sugars is cautioned, especially when it contributes to calories in excess of needs for an individual.

The use of chaperones for intimate examinations: the patient perspective based on an anonymous questionnaire.

PubMed

Osmond, Mark K; Copas, Andrew J; Newey, Charlotte; Edwards, Simon G; Jungmann, Eva; Mercey, Danielle

2007-10-01

The objective of the study was to identify genitourinary (GU) medicine patients' opinions concerning the offer and provision of chaperones and to audit adherence to clinic policy. An anonymous questionnaire was completed by patients after their examination in two GU medicine clinics in central and north London. In total, 750 patients were given questionnaires, of which 627 (84%) were completed and returned. Less than half (45%) reported that they had been offered a chaperone. There was an association between patient gender/orientation and examiner gender/role for both offer and acceptance. Those likely to be offered (75%, 18/24) and accept (93%, 14/15) were women being examined by a man. Those least likely to be offered (27%, 32/120) or accept (3%, 1/31) were men who have sex with men. The offer of a chaperone was significantly greater for younger patients and those from Asian or black ethnic groups. Acceptance was highest among Asian patients. Most patients (88%, 530/602) did not want a chaperone for future examinations. Our conclusion was that most patients do not want a chaperone in the GU medicine clinic. Those who do would prefer for one to be offered, rather than for it to be routine. This supports the recommendation that all patients should be offered a chaperone for intimate examinations.

Leveraging cues from person-generated health data for peer matching in online communities

PubMed Central

Hartzler, Andrea L; Taylor, Megan N; Park, Albert; Griffiths, Troy; Backonja, Uba; McDonald, David W; Wahbeh, Sam; Brown, Cory; Pratt, Wanda

2016-01-01

Objective Online health communities offer a diverse peer support base, yet users can struggle to identify suitable peer mentors as these communities grow. To facilitate mentoring connections, we designed a peer-matching system that automatically profiles and recommends peer mentors to mentees based on person-generated health data (PGHD). This study examined the profile characteristics that mentees value when choosing a peer mentor. Materials and Methods Through a mixed-methods user study, in which cancer patients and caregivers evaluated peer mentor recommendations, we examined the relative importance of four possible profile elements: health interests, language style, demographics, and sample posts. Playing the role of mentees, the study participants ranked mentors, then rated both the likelihood that they would hypothetically contact each mentor and the helpfulness of each profile element in helping the make that decision. We analyzed the participants’ ratings with linear regression and qualitatively analyzed participants’ feedback for emerging themes about choosing mentors and improving profile design. Results Of the four profile elements, only sample posts were a significant predictor for the likelihood of a mentee contacting a mentor. Communication cues embedded in posts were critical for helping the participants choose a compatible mentor. Qualitative themes offer insight into the interpersonal characteristics that mentees sought in peer mentors, including being knowledgeable, sociable, and articulate. Additionally, the participants emphasized the need for streamlined profiles that minimize the time required to choose a mentor. Conclusion Peer-matching systems in online health communities offer a promising approach for leveraging PGHD to connect patients. Our findings point to interpersonal communication cues embedded in PGHD that could prove critical for building mentoring relationships among the growing membership of online health communities. PMID:26911825

Decision tool for clients with medical issues: a framework for identifying driving risk and potential to return to driving.

PubMed

Dickerson, Anne E; Bédard, Michel

2014-04-01

This paper offers occupational therapy generalists and specialists a new framework by which to consider clinical evaluation data and an older adult's driving risk and potential to resume this previously learned skill. Based on Michon's model describing the hierarchy of driving levels, clinical questions identify the factors that may affect a client's fitness to drive. The first part is intended to support clinical judgment of whether a client needs a driving evaluation by a driver rehabilitation specialist. The second part offers a framework to organize clinical data that are already known and determine what other evaluation information is justified and necessary to make a driving recommendation. Methods and rational for use are discussed.

A technology-based patient and family engagement consult service for the pediatric hospital setting.

PubMed

Jackson, Gretchen P; Robinson, Jamie R; Ingram, Ebone; Masterman, Mary; Ivory, Catherine; Holloway, Diane; Anders, Shilo; Cronin, Robert M

2018-02-01

The Vanderbilt Children's Hospital launched an innovative Technology-Based Patient and Family Engagement Consult Service in 2014. This paper describes our initial experience with this service, characterizes health-related needs of families of hospitalized children, and details the technologies recommended to promote engagement and meet needs. We retrospectively reviewed consult service documentation for patient characteristics, health-related needs, and consultation team recommendations. Needs were categorized using a consumer health needs taxonomy. Recommendations were classified by technology type. Twenty-two consultations were conducted with families of patients ranging in age from newborn to 15 years, most with new diagnoses or chronic illnesses. The consultation team identified 99 health-related needs (4.5 per consultation) and made 166 recommendations (7.5 per consultation, 1.7 per need). Need categories included 38 informational needs, 26 medical needs, 23 logistical needs, and 12 social needs. The most common recommendations were websites (50, 30%) and mobile applications (30, 18%). The most frequent recommendations by need category were websites for informational needs (39, 50%), mobile applications for medical needs (15, 40%), patient portals for logistical needs (12, 44%), and disease-specific support groups for social needs (19, 56%). Families of hospitalized pediatric patients have a variety of health-related needs, many of which could be addressed by technology recommendations from an engagement consult service. This service is the first of its kind, offering a potentially generalizable and scalable approach to assessing health-related needs, meeting them with technologies, and promoting patient and family engagement in the inpatient setting. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Standard operating procedures for vascular surgery in erectile dysfunction: revascularization and venous procedures.

PubMed

Sohn, Michael; Hatzinger, Martin; Goldstein, Irwin; Krishnamurti, Sudhakar

2013-01-01

The impact of penile blood supply on erectile function was recognized some 500 years ago. At the turn of the 20th century first results of penile venous ligation were published and in 1973 the first surgical attempts to restore penile arterial inflow were undertaken. Numerous techniques were published in the meantime, but inclusion criteria, patient selection, and success evaluation differed extremely between study groups. To develop evidence-based standard operating procedures (SOPs) for vascular surgery in erectile dysfunction, based on recent state of the art consensus reports and recently published articles in peer-reviewed journals. Based on the recent publication of the consensus process during the 2009 International Consultation on Sexual Medicine in Paris, recommendations are derived for diagnosis and surgical treatment of vascular erectile dysfunction. In addition several recent publications in this field not mentioned in the consensus statements are included in the discussion. The Oxford system of evidence-based review was systematically applied. Due to the generally low level of evidence in this field expert opinions were accepted, if published after a well-defined consensus process in peer-reviewed journals. Referring to penile revascularization it may be concluded, that in the face of missing randomized trials, only recommendations grade D may be given: this kind of surgery may be offered to men less than 55 years, who are nonsmokers, nondiabetic, and demonstrate isolated arterial stenoses in the absence of generalized vascular disease. The evidence level for recommendations concerning penile venous ligations may be even lower. Too many unsolved controversies exist and universal diagnostic criteria for patient selection as well as operative technique selection have not been unequivocally established. This kind of surgery is still considered investigational but may be offered in special situations on an individualized basis in an investigational or research setting after obtaining written consent, using both pre- and postoperatively validated measuring instruments of success evaluation. SOPs for penile revascularization procedures can be developed, concerning a highly selected patient group with isolated arterial stenoses. Based on the available data it is not yet possible to define SOPs for surgical treatment of corporal veno-occlusive dysfunction. © 2012 International Society for Sexual Medicine.

17 CFR 230.418 - Supplemental information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... offer or similar transaction, any feasibility studies, management analyses, fairness opinions or similar....405), of the securities being registered except for: (i) Reports solely comprised of recommendations to buy, sell or hold the securities of the registrant, unless such recommendations have changed...

Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years or older - United States, 2014.

PubMed

Bridges, Carolyn B; Coyne-Beasley, Tamera

2014-02-07

Vaccines are recommended for adults on the basis of their age, prior vaccinations, health conditions, lifestyle, occupation, and travel. Reasons for current low levels of vaccination coverage for adult vaccines are multifactorial and include limited awareness among the public about vaccines for adults and gaps in incorporation of regular assessments of vaccine needs and vaccination into routine medical care. Updated standards for immunization of adults were approved by the National Vaccine Advisory Committee (NVAC) in September 2013. These standards acknowledge the current low levels of vaccination coverage among adults and the role that all health-care providers, including those who do not offer all recommended adult vaccines in their practices, have in ensuring that their patients are up-to-date on recommended vaccines. NVAC recommends that providers assess vaccination needs for their patients at each visit, recommend needed vaccines, and then, ideally, offer the vaccine or, if the provider does not stock the needed vaccines, refer the patient to a provider who does vaccinate. Vaccinating providers should also ensure that patients and their referring health-care providers have documentation of the vaccination.

Health and wellness programming in faith-based organizations: a description of a nationwide sample.

PubMed

Bopp, Melissa; Fallon, Elizabeth A

2013-01-01

Most of the U.S. population is affiliated with faith-based organizations (FBOs) and regularly attends services. Health and wellness activities (HWA) delivered through FBOs have great potential for reach, but the number of FBOs offering health programs and the characteristics of these programs are currently unknown. The purpose of this study was to better understand rates, characteristics, and factors influencing faith-based HWA across the United States. Faith leaders (N = 844) completed an online survey assessing faith leader demographics and health, FBO demographics (e.g., denomination, size, location, diversity), and details of HWA within their FBO. Respondents were primarily White (93%), male (72%), middle-aged (53.2 ± 12.1 years), and affiliated with Methodist (42.5%) or Lutheran (20.2%) denominations. Although most faith leaders report meeting physical activity recommendations (56.5%), most were overweight/obese (77.4%), did not meet fruit and vegetable recommendations (65.9%), and had been diagnosed with 1.25 ± 1.36 chronic diseases. Respondents reported offering 4.8 ± 3 HWA within their FBO over the past 12 months. Most common HWA included clubs/teams related to physical activity (54.8%), individual-level health counseling (54%), and providing health/wellness pamphlets. Leaders cited a lack of lay leadership (48.1%) and financial resources for staff time (47.8%) as the most common barriers to HWA. An increase in interest/awareness in health topics from FBO members was the most common facilitator for HWA (66.5%). Although faith-based HWA are prevalent nationally, types of HWA and the factors influencing HWA are dependent on FBO characteristics. Future faith-based interventions should consider existing capabilities and moderating factors for HWA.

From National Defense Stockpile (NDS) to Strategic Materials Security Program (SMSP): Evidence and Analytic Support. Volume 1

DTIC Science & Technology

2010-05-01

textiles include “soft” body armor; spall liners for combat vehicles; flame protection garments; and protective braided sleeves for hoses and cable...summarizes the results of an Interim Base Case analysis of those materials as well. Chapter Four offers IDA’s initial ideas regarding opportunities that...process in the requirements analysis process by which the department determines the NDS goals, or stockpile requirements, it will recommend to the

Implementing universal HIV treatment in a high HIV prevalence and rural South African setting – Field experiences and recommendations of health care providers

PubMed Central

Gumede, Dumile; Boyer, Sylvie; Pillay, Deenan; Dabis, François; Seeley, Janet; Orne-Gliemann, Joanna

2017-01-01

Background We aimed to describe the field experiences and recommendations of clinic-based health care providers (HCP) regarding the implementation of universal antiretroviral therapy (ART) in rural KwaZulu-Natal, South Africa. Methods In Hlabisa sub-district, the local HIV programme of the Department of Health (DoH) is decentralized in 18 clinics, where ART was offered at a CD4 count ≤500 cells/μL from January 2015 to September 2016. Within the ANRS 12249 TasP trial, implemented in part of the sub-district, universal ART (no eligibility criteria) was offered in 11 mobile clinics between March 2012 and June 2016. A cross-sectional qualitative survey was conducted in April–July 2016 among clinic-based nurses and counsellors providing HIV care in the DoH and TasP trial clinics. In total, 13 individual interviews and two focus groups discussions (including 6 and 7 participants) were conducted, audio-recorded, transcribed, and thematically analyzed. Results All HCPs reported an overall good experience of delivering ART early in the course of HIV infection, with most patients willing to initiate ART before being symptomatic. Yet, HCPs underlined that not feeling sick could challenge early ART initiation and adherence, and thus highlighted the need to take time for counselling as an important component to achieve universal ART. HCPs also foresaw logistical challenges of universal ART, and were especially concerned about increasing workload and ART shortage. HCPs finally recommended the need to strengthen the existing model of care to facilitate access to ART, e.g., community-based and integrated HIV services. Conclusions The provision of universal ART is feasible and acceptable according to HCPs in this rural South-African area. However their experiences suggest that universal ART, and more generally the 90-90-90 UNAIDS targets, will be difficult to achieve without the implementation of new models of health service delivery. PMID:29155832

Implementing universal HIV treatment in a high HIV prevalence and rural South African setting - Field experiences and recommendations of health care providers.

PubMed

Plazy, Melanie; Perriat, Delphine; Gumede, Dumile; Boyer, Sylvie; Pillay, Deenan; Dabis, François; Seeley, Janet; Orne-Gliemann, Joanna

2017-01-01

We aimed to describe the field experiences and recommendations of clinic-based health care providers (HCP) regarding the implementation of universal antiretroviral therapy (ART) in rural KwaZulu-Natal, South Africa. In Hlabisa sub-district, the local HIV programme of the Department of Health (DoH) is decentralized in 18 clinics, where ART was offered at a CD4 count ≤500 cells/μL from January 2015 to September 2016. Within the ANRS 12249 TasP trial, implemented in part of the sub-district, universal ART (no eligibility criteria) was offered in 11 mobile clinics between March 2012 and June 2016. A cross-sectional qualitative survey was conducted in April-July 2016 among clinic-based nurses and counsellors providing HIV care in the DoH and TasP trial clinics. In total, 13 individual interviews and two focus groups discussions (including 6 and 7 participants) were conducted, audio-recorded, transcribed, and thematically analyzed. All HCPs reported an overall good experience of delivering ART early in the course of HIV infection, with most patients willing to initiate ART before being symptomatic. Yet, HCPs underlined that not feeling sick could challenge early ART initiation and adherence, and thus highlighted the need to take time for counselling as an important component to achieve universal ART. HCPs also foresaw logistical challenges of universal ART, and were especially concerned about increasing workload and ART shortage. HCPs finally recommended the need to strengthen the existing model of care to facilitate access to ART, e.g., community-based and integrated HIV services. The provision of universal ART is feasible and acceptable according to HCPs in this rural South-African area. However their experiences suggest that universal ART, and more generally the 90-90-90 UNAIDS targets, will be difficult to achieve without the implementation of new models of health service delivery.

Clinical trials needed to evaluate compression therapy in breast cancer related lymphedema (BCRL). Proposals from an expert group.

PubMed

Partsch, H; Stout, N; Forner-Cordero, I; Flour, M; Moffatt, C; Szuba, A; Milic, D; Szolnoky, G; Brorson, H; Abel, M; Schuren, J; Schingale, F; Vignes, S; Piller, N; Döller, W

2010-10-01

A mainstay of lymphedema management involves the use of compression therapy. Compression therapy application is variable at different levels of disease severity. Evidence is scant to direct clinicians in best practice regarding compression therapy use. Further, compression clinical trials are fragmented and poorly extrapolable to the greater population. An ideal construct for conducting clinical trials in regards to compression therapy will promote parallel global initiatives based on a standard research agenda. The purpose of this article is to review current evidence in practice regarding compression therapy for BCRL management and based on this evidence, offer an expert consensus recommendation for a research agenda and prescriptive trials. Recommendations herein focus solely on compression interventions. This document represents the proceedings of a session organized by the International Compression Club (ICC) in June 2009 in Ponzano (Veneto, Italy). The purpose of the meeting was to enable a group of experts to discuss the existing evidence for compression treatment in breast cancer related lymphedema (BCRL) concentrating on areas where randomized controlled trials (RCTs) are lacking. The current body of research suggests efficacy of compression interventions in the treatment and management of lymphedema. However, studies to date have failed to adequately address various forms of compression therapy and their optimal application in BCRL. We offer recommendations for standardized compression research trials for prophylaxis of arm lymphedema and for the management of chronic BCRL. Suggestions are also made regarding; inclusion and exclusion criteria, measurement methodology and additional variables of interest for researchers to capture. This document should inform future research trials in compression therapy and serve as a guide to clinical researchers, industry researchers and lymphologists regarding the strengths, weaknesses and shortcomings of the current literature. By providing this construct for research trials, the authors aim to support evidence-based therapy interventions, promote a cohesive, standardized and informative body of literature to enhance clinical outcomes, improve the quality of future research trials, inform industry innovation and guide policy related to BCRL.

Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations.

PubMed

Pastore, Robert L; Brooks, Judith T; Carbone, John W

2015-06-01

Recent research suggests that traditional grain-based heart-healthy diet recommendations, which replace dietary saturated fat with carbohydrate and reduce total fat intake, may result in unfavorable plasma lipid ratios, with reduced high-density lipoprotein (HDL) and an elevation of low-density lipoprotein (LDL) and triacylglycerols (TG). The current study tested the hypothesis that a grain-free Paleolithic diet would induce weight loss and improve plasma total cholesterol, HDL, LDL, and TG concentrations in nondiabetic adults with hyperlipidemia to a greater extent than a grain-based heart-healthy diet, based on the recommendations of the American Heart Association. Twenty volunteers (10 male and 10 female) aged 40 to 62 years were selected based on diagnosis of hypercholesterolemia. Volunteers were not taking any cholesterol-lowering medications and adhered to a traditional heart-healthy diet for 4 months, followed by a Paleolithic diet for 4 months. Regression analysis was used to determine whether change in body weight contributed to observed changes in plasma lipid concentrations. Differences in dietary intakes and plasma lipid measures were assessed using repeated-measures analysis of variance. Four months of Paleolithic nutrition significantly lowered (P < .001) mean total cholesterol, LDL, and TG and increased (P < .001) HDL, independent of changes in body weight, relative to both baseline and the traditional heart-healthy diet. Paleolithic nutrition offers promising potential for nutritional management of hyperlipidemia in adults whose lipid profiles have not improved after following more traditional heart-healthy dietary recommendations. Copyright © 2015 Elsevier Inc. All rights reserved.

Guidelines for Retrofitting Bleachers.

ERIC Educational Resources Information Center

Consumer Product Safety Commission, Washington, DC.

This brochure offers guidance on bleacher retrofitting to prevent falls, and suggests follow-up inspections and maintenance practices. Bleacher styles are described along with descriptions of bleacher-associated deaths, injuries, and hazards. Retrofitting recommendations are offered for guardrails and openings followed by retrofit strategies and…

World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia - a short version for primary care.

PubMed

Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas; Lieberman, Jeffrey; Glenthøj, Birte; Gattaz, Wagner F; Thibaut, Florence; Möller, Hans-Jürgen

2017-06-01

Schizophrenia is a severe mental disorder and many patients are treated in primary care settings. Apart from the pharmacological management of disease-associated symptoms, the detection and treatment of side effects is of the utmost importance in clinical practice. The purpose of this publication is to offer relevant evidence-based recommendations for the biological treatment of schizophrenia in primary care. This publication is a short and practice-oriented summary of Parts I-III of the World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia. The recommendations were developed by the authors and consented by a task force of international experts. Guideline recommendations are based on randomized-controlled trials and supplemented with non-randomized trials and meta-analyses where necessary. Antipsychotics of different chemical classes are the first-line pharmacological treatments for schizophrenia. Specific circumstances (e.g., suicidality, depression, substance dependence) may need additional treatment options. The pharmacological and non-pharmacological management of side effects is of crucial importance for the long-term treatment in all settings of the healthcare system. This summary of the three available evidence-based guidelines has the potential to support clinical decisions and can improve treatment of schizophrenia in primary care settings.

Integrating Palliative Care Into Comprehensive Cancer Centers: Consensus-Based Development of Best Practice Recommendations

PubMed Central

Stiel, Stephanie; Simon, Steffen T.; Schmitz, Andrea; van Oorschot, Birgitt; Stachura, Peter; Ostgathe, Christoph

2016-01-01

Background. International associations admit that specialized palliative care (SPC) is an obvious component of excellent cancer care. Nevertheless, gaps in integration at the international level have been identified. Recommendations for integrating SPC in clinical care, research, and education are needed, which are subject of the present study. Materials and Methods. A Delphi study, with three written Delphi rounds, including a face-to-face-meeting with a multiprofessional expert panel (n = 52) working in SPC in 15 German Comprehensive Cancer Centers (CCCs) funded by the German Cancer Aid was initiated. Initial recommendations are built on evidence-based literature. Consensus was defined in advance with ≥80% agreement based on the question of whether each recommendation was unambiguously formulated, relevant, and realizable for a CCC. Results. A total of 38 experts (73.1%) from 15 CCCs performed all three Delphi rounds. Consensus was achieved for 29 of 30 recommendations. High agreement related to having an organizationally and spatially independent palliative care unit (≥6 beds), a mobile multiprofessional SPC team, and cooperation with community-based SPC. Until round 3, an ongoing discussion was registered on hospice volunteers, a chair of palliative care, education in SPC among staff in emergency departments, and integration of SPC in decision-making processes such as tumor boards or consultation hours. Integration of SPC in decision-making processes was not consented by a low-rated feasibility (76.3%) due to staff shortage. Conclusion. Recommendations should be considered when developing standards for cancer center of excellence in Germany. Definition and implementation of indicators of integration of SPC in CCCs and evaluation of its effectiveness are current and future challenges. Implications for Practice: General and specialized palliative care (SPC) is an integral part of comprehensive cancer care. However, significant diversity concerning the design of SPC in the German Comprehensive Cancer Center (CCC) Network led to the establishment of consensual best practice recommendations for integration of SPC into the clinical structures, processes, research, and education throughout the CCC network. The recommendations contribute to a greater awareness relating to the strategic direction and development of SPC in CCCs. The access to information about SPC and access to offers regarding SPC shall be facilitated by implementing the recommendations in the course of treatment of patients with cancer. PMID:27440065

Frequency of whole breast radiation therapy after intraoperative radiation therapy due to criteria identified by lumpectomy.

PubMed

Mellon, Eric A; Orman, Amber; Joya, Luis E; Montejo, Michael E; Laronga, Christine; Hoover, Susan J; Lee, M Catherine; Khakpour, Nazanin; Kubal, Pamela F; Diaz, Roberto

For selected early breast cancers, intraoperative radiation therapy (IORT) at the time of lumpectomy can be an efficient alternative to fractionated whole breast radiation therapy (WBRT). However, some patients are later recommended WBRT after IORT due to surgical pathologic findings. To understand risk factor identification rates triggering WBRT recommendation, we analyzed adverse prognostic features based on multiple international criteria for suitability for accelerated partial breast irradiation. We performed a single-institution retrospective review of all 200 nonrecurrent invasive breast carcinomas that received IORT in 20 Gy to the tumor cavity using a 50 kV photon applicator between January 2011 and December 2015. IORT eligibility was based on the 2009 accelerated partial breast irradiation Consensus Statement from the American Society for Radiation Oncology (ASTRO). IORT was offered as the sole radiation modality to patients meeting 0-1 "cautionary" and no "unsuitable" criteria before lumpectomy. WBRT was recommended after IORT when 2+ cautionary and/or 1+ unsuitable criteria were met after accounting for resection pathology. We recalculated WBRT recommendation rates using initial and reresection margins for ASTRO consensus, Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology recommendations, and TARGeted Intraoperative radioTherapy vs. Postoperative Radiotherapy trial "prepathology" stratum protocol. Depending on the selection criteria chosen, rates of WBRT recommendation can vary from 4.5% to 33%. WBRT recommendation rates of 30-33% after lumpectomy and IORT are observed when the WBRT indication is a single ASTRO cautionary/unsuitable, Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology intermediate/high-risk criterion, or TARGeted Intraoperative radioTherapy vs. postoperative radiotherapy trial protocol recommendation. Alternatively, allowing for re-excision to clear margins and accepting one ASTRO cautionary factor lowered the rate of WBRT recommendation to 9.5%. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Investigating Barriers in HIV-Testing Oncology Patients: The IBITOP Study, Phase I.

PubMed

Merz, Laurent; Zimmermann, Stefan; Peters, Solange; Cavassini, Matthias; Darling, Katharine E A

2016-10-01

Although the prevalence of non-AIDS-defining cancers (non-ADCs) among people living with HIV is rising, we observed HIV testing rates below 5% at our oncology center, against a regional HIV prevalence of 0.2%-0.4%. We performed the Investigating Barriers in HIV-Testing Oncology Patients (IBITOP) study among oncology physicians and patients. Between July 1 and October 31, 2013, patients of unknown HIV status newly diagnosed with solid-organ non-ADCs referred to Lausanne University Hospital Oncology Service, Switzerland, were offered free HIV testing as part of their oncology work-up. The primary endpoints were (a) physician willingness to offer and patient acceptance of HIV testing and (b) physicians' reasons for not offering testing. Of 239 patients of unknown HIV status with a new non-ADC diagnosis, 43 (18%) were offered HIV testing, of whom 4 declined (acceptance rate: 39 of 43; 91%). Except for 21 patients tested prior to oncology consultation, 175 patients (of 239; 73%) were not offered testing. Testing rate declined among patients who were >70 years old (12% versus 30%; p = .04); no non-European patients were tested. Physicians gave reasons for not testing in 16% of cases, the main reason being patient follow-up elsewhere (10 patients; 5.7%). HIV testing during the IBITOP study increased the HIV testing rate to 18%. Although the IBITOP study increased HIV testing rates, most patients were not tested. Testing was low or nonexistent among individuals at risk of late HIV presentation (older patients and migrants). Barriers to testing appear to be physician-led, because patient acceptance of testing offered was very high (91%). In November 2013, the Swiss HIV testing recommendations were updated to propose testing in cancer patients. Phase II of the IBITOP study is examining the effect of these recommendations on HIV testing rates and focusing on physician-led testing barriers. Patients of unknown HIV status newly diagnosed with solid-organ non-AIDS-defining cancers were offered free HIV testing. Physician and patient barriers to HIV testing were examined. Most patients (82%) were not offered testing, and testing of individuals at risk of late HIV presentation (older patients and migrants) was low or nonexistent. Conversely, patient acceptance of testing offered was very high (91%), suggesting that testing barriers in this setting are physician-led. Since this study, the Swiss HIV testing recommendations now advise testing cancer patients before chemotherapy. Phase II of the Investigating Barriers in HIV-Testing Oncology Patients study is examining the effect of these recommendations on testing rates and physician barriers. ©AlphaMed Press.

17 CFR 240.14d-9 - Recommendation or solicitation by the subject company and others.

Code of Federal Regulations, 2011 CFR

2011-04-01

... to such tender offer and (ii) the reason(s) for the position taken by the subject company with... holders to defer making a determination whether to accept or reject such tender offer until they have been... communication by a person described in paragraph (e) of this section with respect to a tender offer will not be...

Fuzzy Behavior-Based Navigation for Planetary

NASA Technical Reports Server (NTRS)

Tunstel, Edward; Danny, Harrison; Lippincott, Tanya; Jamshidi, Mo

1997-01-01

Adaptive behavioral capabilities are necessary for robust rover navigation in unstructured and partially-mapped environments. A control approach is described which exploits the approximate reasoning capability of fuzzy logic to produce adaptive motion behavior. In particular, a behavior-based architecture for hierarchical fuzzy control of microrovers is presented. Its structure is described, as well as mechanisms of control decision-making which give rise to adaptive behavior. Control decisions for local navigation result from a consensus of recommendations offered only by behaviors that are applicable to current situations. Simulation predicts the navigation performance on a microrover in simplified Mars-analog terrain.

Pruritus Ani

PubMed Central

Siddiqi, S; Vijay, V; Ward, M; Mahendran, R; Warren, S

2008-01-01

INTRODUCTION Pruritus ani is a common condition with many causes, predominately anorectal pathology. There are some new insights and therapies, but the most recommendations are based on low-level evidence. PATIENTS AND METHODS A literature search was carried out using Medline and the internet with the keywords ‘pruritus ani’ from 1950 to 2007. RESULTS A review of the evidence is presented and a management plan based on the elimination of irritants and scratching, general control measures and active treatment measures is offered. CONCLUSIONS Treatment of primary and secondary pruritus ani has a good prospect of regression of symptoms and skin changes. PMID:18765023

Competencies for public health finance: an initial assessment and recommendations.

PubMed

Gillespie, Kathleen N; Kurz, Richard S; McBride, Timothy; Schmitz, Homer H

2004-01-01

The purpose of the study in this article was to identify The needs of public health managers with regard to public health finance. A survey of public health practitioners regarding competencies was conducted and a review of course offerings in finance among schools of public health was performed. Most public health practitioners surveyed believe that a broad array of management competencies are required to administer the finances of a public health facility or department. Respondents added 35 competencies to those initially given to them for review. Most added competencies that were more specific than the original competencies or could be viewed as subpoints of the original competencies. Many schools offered no courses specifically addressing public health care finance, with a few offering at most only one public health finance course. All schools offered at least one corporate finance course, and the majority offered two or more courses. We conclude with a number of recommendations for education and competency development, suggesting several next steps that can advance the field of public health's understanding of what managers need to master in public health finance to effectively function as public health managers.

Purchasing oncology services. Kerr L. White Institute/American Cancer Society Task Force on Purchasing Oncology Services.

PubMed

Cangialose, C B; Blair, A E; Borchardt, J S; Ades, T B; Bennett, C L; Dickersin, K; Gesme, D H; Henderson, I C; McGinnis, L S; Mooney, K; Mortenson, L E; Sperduto, P; Winkenwerder, W; Ballard, D J

2000-06-15

A multidisciplinary panel representing various stakeholders in the health care delivery and oncology services marketplace was convened to develop specific criteria for healthcare purchasers to consider when evaluating the structures and processes of health plans. These rank ordered criteria also can be used by oncologic service providers and health plan designers as a yardstick for the services they offer. A multidisciplinary 31-member Task Force was assembled by the Kerr L. White Institute and the American Cancer Society in March 1997. Task Force members were selected for their ability to offer expert insight as purchasers, suppliers, policymakers, consumers, or stakeholders in the health care marketplace. A preference-weighted majority voting rule was used to identify the three most important recommendations of the 10 that were generated through a modified Delphi technique. To test the practicality of the top three recommendations, leaders of large managed care organizations (MCOs) were surveyed; the results of this survey then were compared with the results of the Task Force survey. The three most important recommendations from the Task Force were that health plans provide access to: 1) comprehensive cancer care, 2) preventive and screening services, and 3) second opinions and treatment options supported by scientific evidence. The difference between the responses of the Task Force and the MCOs was that MCOs placed the highest importance on evidence-based decision-making, with their next three rankings coinciding with those identified by the Task Force. The value of these summary recommendations will be realized through their use by both purchasers and suppliers to influence the structure and content of the delivery of oncologic services.

Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation

PubMed Central

Sung, Lillian; Robinson, Paula; Treister, Nathaniel; Baggott, Tina; Gibson, Paul; Tissing, Wim; Wiernikowski, John; Brinklow, Jennifer; Dupuis, L Lee

2017-01-01

Purpose To develop an evidence-based clinical practice guideline for the prevention of oral mucositis in children (0–18 years) receiving treatment for cancer or undergoing haematopoietic stem cell transplantation (HSCT). Methods The Mucositis Prevention Guideline Development Group was interdisciplinary and included internationally recognised experts in paediatric mucositis. For the evidence review, we included randomised controlled trials (RCTs) conducted in either children or adults evaluating the following interventions selected according to prespecified criteria: cryotherapy, low level light therapy (LLLT) and keratinocyte growth factor (KGF). We also examined RCTs of any intervention conducted in children. For all systematic reviews, we synthesised the occurrence of severe oral mucositis. The Grades of Recommendation, Assessment, Development and Evaluation approach was used to describe quality of evidence and strength of recommendations. Results We suggest cryotherapy or LLLT may be offered to cooperative children receiving chemotherapy or HSCT conditioning with regimens associated with a high rate of mucositis. We also suggest KGF may be offered to children receiving HSCT conditioning with regimens associated with a high rate of severe mucositis. However, KGF use merits caution as there is a lack of efficacy and toxicity data in children, and a lack of long-term follow-up data in paediatric cancers. No other interventions were recommended for oral mucositis prevention in children. Conclusions All three specific interventions evaluated in this clinical practice guideline were associated with a weak recommendation for use. There may be important organisational and cost barriers to the adoption of LLLT and KGF. Considerations for implementation and key research gaps are highlighted. PMID:25818385

Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation.

PubMed

Sung, Lillian; Robinson, Paula; Treister, Nathaniel; Baggott, Tina; Gibson, Paul; Tissing, Wim; Wiernikowski, John; Brinklow, Jennifer; Dupuis, L Lee

2017-03-01

To develop an evidence-based clinical practice guideline for the prevention of oral mucositis in children (0-18 years) receiving treatment for cancer or undergoing haematopoietic stem cell transplantation (HSCT). The Mucositis Prevention Guideline Development Group was interdisciplinary and included internationally recognised experts in paediatric mucositis. For the evidence review, we included randomised controlled trials (RCTs) conducted in either children or adults evaluating the following interventions selected according to prespecified criteria: cryotherapy, low level light therapy (LLLT) and keratinocyte growth factor (KGF). We also examined RCTs of any intervention conducted in children. For all systematic reviews, we synthesised the occurrence of severe oral mucositis. The Grades of Recommendation, Assessment, Development and Evaluation approach was used to describe quality of evidence and strength of recommendations. We suggest cryotherapy or LLLT may be offered to cooperative children receiving chemotherapy or HSCT conditioning with regimens associated with a high rate of mucositis. We also suggest KGF may be offered to children receiving HSCT conditioning with regimens associated with a high rate of severe mucositis. However, KGF use merits caution as there is a lack of efficacy and toxicity data in children, and a lack of long-term follow-up data in paediatric cancers. No other interventions were recommended for oral mucositis prevention in children. All three specific interventions evaluated in this clinical practice guideline were associated with a weak recommendation for use. There may be important organisational and cost barriers to the adoption of LLLT and KGF. Considerations for implementation and key research gaps are highlighted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Assessment of short reports using a human rights-based approach to tobacco control to the Commitee on Economics, Cultural and Social Rights.

PubMed

Dresler, Carolyn; Henry, Kirsten; Loftus, John; Lando, Harry

2017-07-28

The health impact of tobacco use remains a major global public health concern and a human rights issue. The Human Rights and Tobacco Control Network (HRTCN) was established to increase the visibility of tobacco as a human rights issue. HRTCN submitted short reports to the UN Committee on Economic Social and Cultural Rights evaluating individual nations' tobacco control policies and offering recommendations. HRTCN reviewed Concluding Observations documents for nations for which the HRTCN submitted reports. If tobacco was mentioned in the Concluding Observations through acknowledging the Framework Convention on Tobacco Control ratification, policy changes or discussing tobacco in the recommendations, this was scored as a positive finding. HRTCN also reviewed Concluding Observations for nations for which HRTCN did not submit reports as a comparison. Thirty-eight HRTCN reports were submitted and tobacco was mentioned in Concluding Observations for 11 nations for a rate of 28.9%. In a comparison set of Concluding Observations (n=59), 7% had comments or recommendations relative to tobacco. This was not a controlled study and the 28.9% 'success rate' for impacting the Concluding Observations, although encouraging, is less than optimal-and leaves room for improvement. The higher rate of tobacco mentions for the cases where the HRTCN short reports were submitted provides preliminary indications that the short reports may have potential to increase the state focus on tobacco control. Future work will seek to improve the design and scope of the reports, and the specificity of the background information and recommendations offered. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Enabling Open Research Data Discovery through a Recommender System

NASA Astrophysics Data System (ADS)

Devaraju, Anusuriya; Jayasinghe, Gaya; Klump, Jens; Hogan, Dominic

2017-04-01

Government agencies, universities, research and nonprofit organizations are increasingly publishing their datasets to promote transparency, induce new research and generate economic value through the development of new products or services. The datasets may be downloaded from various data portals (data repositories) which are general or domain-specific. The Registry of Research Data Repository (re3data.org) lists more than 2500 such data repositories from around the globe. Data portals allow keyword search and faceted navigation to facilitate discovery of research datasets. However, the volume and variety of datasets have made finding relevant datasets more difficult. Common dataset search mechanisms may be time consuming, may produce irrelevant results and are primarily suitable for users who are familiar with the general structure and contents of the respective database. Therefore, we need new approaches to support research data discovery. Recommender systems offer new possibilities for users to find datasets that are relevant to their research interests. This study presents a recommender system developed for the CSIRO Data Access Portal (DAP, http://data.csiro.au). The datasets hosted on the portal are diverse, published by researchers from 13 business units in the organisation. The goal of the study is not to replace the current search mechanisms on the data portal, but rather to extend the data discovery through an exploratory search, in this case by building a recommender system. We adopted a hybrid recommendation approach, comprising content-based filtering and item-item collaborative filtering. The content-based filtering computes similarities between datasets based on metadata such as title, keywords, descriptions, fields of research, location, contributors, etc. The collaborative filtering utilizes user search behaviour and download patterns derived from the server logs to determine similar datasets. Similarities above are then combined with different degrees of importance (weights) to determine the overall data similarity. We determined the similarity weights based on a survey involving 150 users of the portal. The recommender results for a given dataset are accessible programmatically via a RESTful web service. An offline evaluation involving data users demonstrates the ability of the recommender system to discover relevant and 'novel' datasets.

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…

Experiential learning and andragogy--negotiated learning in nurse education: a critical appraisal.

PubMed

Burnard, P

1989-10-01

Andragogy and experiential learning have frequently been cited as recommended approaches to aspects of nurse education. This paper offers a critical appraisal of the two approaches and offers suggestions as to how a negotiated nursing curriculum may be developed.

Making it work: health care provider perspectives on strategies to increase colorectal cancer screening in federally qualified health centers.

PubMed

Gwede, Clement K; Davis, Stacy N; Quinn, Gwendolyn P; Koskan, Alexis M; Ealey, Jamila; Abdulla, Rania; Vadaparampil, Susan T; Elliott, Gloria; Lopez, Diana; Shibata, David; Roetzheim, Richard G; Meade, Cathy D

2013-12-01

Colorectal cancer screening (CRCS) rates are low among men and women who seek health care at federally qualified health centers (FQHCs). This study explores health care providers' perspectives about their patient's motivators and impediments to CRCS and receptivity to preparatory education. A mixed methods design consisting of in-depth interviews, focus groups, and a short survey is used in this study. The participants of this study are 17 health care providers practicing in FQHCs in the Tampa Bay area. Test-specific patient impediments and motivations were identified including fear of abnormal findings, importance of offering less invasive fecal occult blood tests, and need for patient-centered test-specific educational materials in clinics. Opportunities to improve provider practices were identified including providers' reliance on patients' report of symptoms as a cue to recommend CRCS and overemphasis of clinic-based guaiac stool tests. This study adds to the literature on CRCS test-specific motivators and impediments. Providers offered unique approaches for motivating patients to follow through with recommended CRCS and were receptive to in-clinic patient education. Findings readily inform the design of educational materials and interventions to increase CRCS in FQHCs.

Environmental flow assessments for transformed estuaries

NASA Astrophysics Data System (ADS)

Sun, Tao; Zhang, Heyue; Yang, Zhifeng; Yang, Wei

2015-01-01

Here, we propose an approach to environmental flow assessment that considers spatial pattern variations in potential habitats affected by river discharges and tidal currents in estuaries. The approach comprises four steps: identifying and simulating the distributions of critical environmental factors for habitats of typical species in an estuary; mapping of suitable habitats based on spatial distributions of the Habitat Suitability Index (HSI) and adopting the habitat aggregation index to understand fragmentation of potential suitable habitats; defining variations in water requirements for a certain species using trade-off analysis for different protection objectives; and recommending environmental flows in the estuary considering the compatibility and conflict of freshwater requirements for different species. This approach was tested using a case study in the Yellow River Estuary. Recommended environmental flows were determined by incorporating the requirements of four types of species into the assessments. Greater variability in freshwater inflows could be incorporated into the recommended environmental flows considering the adaptation of potential suitable habitats with variations in the flow regime. Environmental flow allocations should be conducted in conjunction with land use conflict management in estuaries. Based on the results presented here, the proposed approach offers flexible assessment of environmental flow for aquatic ecosystems that may be subject to future change.

Physical activity and training in sarcoidosis: review and experience-based recommendations.

PubMed

Strookappe, Bert; Saketkoo, Lesley Ann; Elfferich, Marjon; Holland, Anne; De Vries, Jolanda; Knevel, Ton; Drent, Marjolein

2016-10-01

Sarcoidosis is a multisystemic inflammatory disorder with a great variety of symptoms, including fatigue, dyspnea, pain, reduced exercise tolerance and muscle strength. Physical training has the potential to improve exercise capacity and muscle strength, and reduce fatigue. The aim of this review and survey was to present information about the role of physical training in sarcoidosis and offer practical guidelines. A systematic literature review guided an international consensus effort among sarcoidosis experts to establish practice-basic recommendations for the implementation of exercise as treatment for patients with various manifestations of sarcoidosis. International sarcoidosis experts suggested considering physical training in symptomatic patients with sarcoidosis. Expert commentary: There is promising evidence of a positive effect of physical training. Recommendations were based on available data and expert consensus. However, the heterogeneity of these patients will require modification and program adjustment of the standard rehabilitation format for e.g. COPD or interstitial lung diseases. An optimal training program (types of exercise, intensities, frequency, duration) still needs to be defined to optimize training adjustments, especially reduction of fatigue. Further randomized controlled trials are needed to consolidate these findings and optimize the comprehensive care of sarcoidosis patients.

Prescribed Travel Schedules for Fatigue Management

NASA Technical Reports Server (NTRS)

Whitmire, Alexandra; Johnston, Smith; Lockley, Steven

2011-01-01

The NASA Fatigue Management Team is developing recommendations for managing fatigue during travel and for shift work operations, as Clinical Practice Guidelines for the Management of Circadian Desynchrony in ISS Operations. The Guidelines provide the International Space Station (ISS ) flight surgeons and other operational clinicians with evidence-based recommendations for mitigating fatigue and other factors related to sleep loss and circadian desynchronization. As much international travel is involved both before and after flight, the guidelines provide recommendations for: pre-flight training, in-flight operations, and post-flight rehabilitation. The objective of is to standardize the process by which care is provided to crewmembers, ground controllers, and other support personnel such as trainers, when overseas travel or schedule shifting is required. Proper scheduling of countermeasures - light, darkness, melatonin, diet, exercise, and medications - is the cornerstone for facilitating circadian adaptation, improving sleep, enhancing alertness, and optimizing performance. The Guidelines provide, among other things, prescribed travel schedules that outline the specific implementation of these mitigation strategies. Each travel schedule offers evidence based protocols for properly using the NASA identified countermeasures for fatigue. This presentation will describe the travel implementation schedules and how these can be used to alleviate the effects of jet lag and/or schedule shifts.

[Psychocardiology: clinically relevant recommendations regarding selected cardiovascular diseases].

PubMed

Albus, C; Ladwig, K-H; Herrmann-Lingen, C

2014-03-01

Psychosocial risk factors (work stress, low socioeconomic status, impaired social support, anger, anxiety and depression), certain personality traits (e.g. hostility) and post-traumatic stress disorders may negatively influence the incidence and course of multiple cardiovascular disease conditions. Systematic screening for these factors may help to adequately assess the psychosocial risk pattern of a given patient and may also contribute to the treatment of these patients. Recommendations for treatment are based on current guidelines. The physician-patient interaction should basically follow the principle of a patient centered communication and should gender and age specific aspects into consideration. Integrated biopsychosocial care is an effective, low threshold option to treat psycho-social risk factors and should be offered on a regular basis. Patients with high blood pressure may profit from relaxation programs and biofeedback procedures (however with moderate success). An individually adjusted multimodal treatment strategy should be offered to patients with coronary heart disease, heart failure and after heart surgery. It may incorporate educational tools, exercise therapy, motivational modules, relaxation and stress management programs. In case of affective comorbidity, psychotherapy may be indicated. Anti-depressant pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs) in the first line should only be offered to patients with at least moderate severe depressive episodes. Psychotherapy and SSRIs, particularly sertraline, have been proven to be safe and effective with regard to improvements of the patient's quality of life. A prognostic benefit has not been clearly proven so far. Patients with an implanted cardioverter/defibrillator (ICD) should receive psychosocial support on a regular basis. Concomitant psychotherapy and/or psychopharmacotherapy (SSRIs) should be offered in case of a severe mental comorbidity. Generally, tricyclic antidepressants should be avoided in cardiac patients because of adverse side effects. © Georg Thieme Verlag KG Stuttgart · New York.

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

PubMed

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

2015-06-01

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

Management of Adults With Acute Migraine in the Emergency Department: The American Headache Society Evidence Assessment of Parenteral Pharmacotherapies.

PubMed

Orr, Serena L; Friedman, Benjamin W; Christie, Suzanne; Minen, Mia T; Bamford, Cynthia; Kelley, Nancy E; Tepper, Deborah

2016-06-01

To provide evidence-based treatment recommendations for adults with acute migraine who require treatment with injectable medication in an emergency department (ED). We addressed two clinically relevant questions: (1) Which injectable medications should be considered first-line treatment for adults who present to an ED with acute migraine? (2) Do parenteral corticosteroids prevent recurrence of migraine in adults discharged from an ED? The American Headache Society convened an expert panel of authors who defined a search strategy and then performed a search of Medline, Embase, the Cochrane database and clinical trial registries from inception through 2015. Identified articles were rated using the American Academy of Neurology's risk of bias tool. For each medication, the expert panel determined likelihood of efficacy. Recommendations were created accounting for efficacy, adverse events, availability of alternate therapies, and principles of medication action. The search identified 68 unique randomized controlled trials utilizing 28 injectable medications. Of these, 19 were rated class 1 (low risk of bias), 21 were rated class 2 (higher risk of bias), and 28 were rated class 3 (highest risk of bias). Metoclopramide, prochlorperazine, and sumatriptan each had multiple class 1 studies supporting acute efficacy, as did dexamethasone for prevention of headache recurrence. All other medications had lower levels of evidence. Intravenous metoclopramide and prochlorperazine, and subcutaneous sumatriptan should be offered to eligible adults who present to an ED with acute migraine (Should offer-Level B). Dexamethasone should be offered to these patients to prevent recurrence of headache (Should offer-Level B). Because of lack of evidence demonstrating efficacy and concern about sub-acute or long-term sequelae, injectable morphine and hydromorphone are best avoided as first-line therapy (May avoid-Level C). © 2016 American Headache Society.

Factors affecting Polish nurses' willingness to recommend the hospital as a place of care.

PubMed

Kózka, Maria; Brzostek, Tomasz; Cisek, Maria; Brzyski, Piotr; Przewoźniak, Lucyna; Gabryś, Teresa; Ogarek, Maria; Gajda, Krzysztof; Ksykiewicz-Dorota, Anna

Nurses constitute the major professional group offering constant hospital patients' care. Willingness to recommend their hospital reflects confidence in the offered care, satisfaction and identification with the work place. The aim of the present study has been to investigate which elements of hospital environment and nurse personal related factors predict recommendation of the hospital as a place of care by employed nurses. Cross-sectional, correlation study was, based on 1723 self-reported, anonymous questionnaires of nurses working in 30 acute hospitals. Data was analyzed using the logistic regression model, with general estimation equations. About 25% of nurses were unwilling to recommend their hospital as the place of care. The odds ratio (OR) of the lack of willingness to recommend the hospital was related to assessment of patients' safety (OR = 0.28, 95% confidence interval (CI): 0.18-0.46, p = 0.00), decrease in the quality of patient care during the preceding year (OR = 0.62, 95% CI: 0.41-0.93, p = 0.02), overall work conditions (OR = 0.35, 95% CI: 0.22-0.57, p = 0.00), weak cooperation between nurses and physicians (OR = 0.37, 95% CI: 0.25-0.54, p = 0.00), poor work schedule flexibility (OR = 0.74, 95% CI: 0.55- 0.99, p = 0.04) and educational opportunities (OR = 0.71, 95% CI: 0.54-0.95, p = 0.02) and the level of nurses depersonalization (OR = 1.78, 95% CI: 1.18-1.68, p = 0.00). The hospital manager should consider strategies which improve patients' safety and the staff working conditions. Thanks to that they will also achieve better and more competitive image of the hospital in the local community. Med Pr 2016;67(4):447-454. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Online availability and safety of drugs in shortage: a descriptive study of internet vendor characteristics.

PubMed

Liang, Bryan A; Mackey, Tim K

2012-02-09

Unprecedented drug shortages announced by the US Food and Drug Administration (FDA) have severely affected therapeutic access, patient safety, and public health. With continued shortages, patients may seek drugs online. To assess the prevalence of online marketing for current FDA shortage drugs and potential patient safety risks. We performed a descriptive study of the prevalence of online marketing for shortage drugs-that is, offers for sale of each drug, including characteristics of online drug sellers and intermediary sites marketing these drugs. Of the 72 FDA shortage-listed drugs, 68 (94%) were offered for sale online. We found 291 offers for these drugs, the vast majority (n = 207, 71.1%) by online drug sellers selling direct to consumers. Intermediary sites included data aggregators (n = 22, 8%), forum links (n = 23, 8%), and personal page data links (n = 34, 12%), as well as Flickr social media links (n = 5, 2%), all advertising drugs without a prescription. Of the 91 online drug sellers identified, 31 (34%) had more than 1 shortage drug offered for sale, representing most (n = 148, 71%) of all online drug seller sales offers. The majority of these online drug sellers (n = 21, 68%) were on the National Association of Boards of Pharmacy (NABP) Not Recommended Sites list. Finally, for shortage drugs with an online drug seller (n = 58, 85%), 53 (91%) had at least one site on the Not Recommended list and 21 (36%) had only sites on the Not Recommended list. FDA shortage drugs are widely marketed over the Internet. Suspect online drug sellers and intermediaries dominate these sales offers. As a critical risk management issue, patients, providers, and policymakers should be extremely cautious in procuring shortage drugs through Internet sourcing.

Online Availability and Safety of Drugs in Shortage: A Descriptive Study of Internet Vendor Characteristics

PubMed Central

Mackey, Tim K

2012-01-01

Background Unprecedented drug shortages announced by the US Food and Drug Administration (FDA) have severely affected therapeutic access, patient safety, and public health. With continued shortages, patients may seek drugs online. Objective To assess the prevalence of online marketing for current FDA shortage drugs and potential patient safety risks. Methods We performed a descriptive study of the prevalence of online marketing for shortage drugs—that is, offers for sale of each drug, including characteristics of online drug sellers and intermediary sites marketing these drugs. Results Of the 72 FDA shortage-listed drugs, 68 (94%) were offered for sale online. We found 291 offers for these drugs, the vast majority (n = 207, 71.1%) by online drug sellers selling direct to consumers. Intermediary sites included data aggregators (n = 22, 8%), forum links (n = 23, 8%), and personal page data links (n = 34, 12%), as well as Flickr social media links (n = 5, 2%), all advertising drugs without a prescription. Of the 91 online drug sellers identified, 31 (34%) had more than 1 shortage drug offered for sale, representing most (n = 148, 71%) of all online drug seller sales offers. The majority of these online drug sellers (n = 21, 68%) were on the National Association of Boards of Pharmacy (NABP) Not Recommended Sites list. Finally, for shortage drugs with an online drug seller (n = 58, 85%), 53 (91%) had at least one site on the Not Recommended list and 21 (36%) had only sites on the Not Recommended list. Conclusions FDA shortage drugs are widely marketed over the Internet. Suspect online drug sellers and intermediaries dominate these sales offers. As a critical risk management issue, patients, providers, and policymakers should be extremely cautious in procuring shortage drugs through Internet sourcing. PMID:22321731

Campus Administrator and Student Perspectives for Improving Transfer Policy and Practice

ERIC Educational Resources Information Center

Fann, Amy

2013-01-01

This chapter offers a set of recommendations for two-year and four-year institutions related to the evaluation and implementation of transfer policy and practice. These recommendations were drawn from a major study to investigate the perspectives of students, staff, and administrators.

2015 UK national guideline for the management of infection with Chlamydia trachomatis.

PubMed

Nwokolo, Nneka C; Dragovic, Bojana; Patel, Sheel; Tong, C Y William; Barker, Gary; Radcliffe, Keith

2016-03-01

This guideline offers recommendations on the diagnostic tests, treatment regimens and health promotion principles needed for the effective management of Chlamydia trachomatis genital infection. It covers the management of the initial presentation, as well the prevention of transmission and future infection. The guideline is aimed at individuals aged 16 years and older presenting to healthcare professionals working in departments offering Level 3 care in sexually transmitted infections management within the UK. However, the principles of the recommendations should be adopted across all levels, using local care pathways where appropriate. © The Author(s) 2016.

Recommendations for research design of telehealth studies.

PubMed

Chumbler, Neale R; Kobb, Rita; Brennan, David M; Rabinowitz, Terry

2008-11-01

Properly designed randomized controlled trials (RCTs) are the gold standard to use when examining the effectiveness of telehealth interventions on clinical outcomes. Some published telehealth studies have employed well-designed RCTs. However, such methods are not always feasible and practical in particular settings. This white paper addresses not only the need for properly designed RCTs, but also offers alternative research designs, such as quasi-experimental designs, and statistical techniques that can be employed to rigorously assess the effectiveness of telehealth studies. This paper further offers design and measurement recommendations aimed at and relevant to administrative decision-makers, policymakers, and practicing clinicians.

Metastatic Pancreatic Cancer: ASCO Clinical Practice Guideline Update.

PubMed

Sohal, Davendra P S; Kennedy, Erin B; Khorana, Alok; Copur, Mehmet S; Crane, Christopher H; Garrido-Laguna, Ignacio; Krishnamurthi, Smitha; Moravek, Cassadie; O'Reilly, Eileen M; Philip, Philip A; Ramanathan, Ramesh K; Ruggiero, Joseph T; Shah, Manish A; Urba, Susan; Uronis, Hope E; Lau, Michelle W; Laheru, Daniel

2018-05-23

Purpose In 2016, ASCO published a guideline to assist in clinical decision making in metastatic pancreatic cancer for initial assessment after diagnosis, first- and second-line treatment options, palliative and supportive care, and follow-up. The purpose of this update is to incorporate new evidence related to second-line therapy for patients who have experienced disease progression or intolerable toxicity during first-line therapy. Methods ASCO convened an Expert Panel to conduct a systematic review of the literature on second-line therapy published between June 2015 and January 2018. Recommendations on other topics covered in the 2016 Metastatic Pancreatic Cancer Guideline were endorsed by the Expert Panel. Results Two new studies were found that met the inclusion criteria. Recommendations For second-line therapy, gemcitabine plus nanoparticle albumin-bound paclitaxel should be offered to patients with first-line treatment with FOLFIRINOX (leucovorin, fluorouracil, irinotecan, and oxaliplatin), an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 to 1, and a favorable comorbidity profile; fluorouracil plus nanoliposomal irinotecan can be offered to patients with first-line treatment with gemcitabine plus NAB-paclitaxel, an ECOG PS of 0 to 1, and a favorable comorbidity profile; fluorouracil plus irinotecan or fluorouracil plus oxaliplatin may be offered when there is a lack of availability of fluorouracil plus nanoliposomal irinotecan; gemcitabine or fluorouracil should be offered to patients with either an ECOG PS of 2 or a comorbidity profile that precludes other regimens. Testing select patients for mismatch repair deficiency or microsatellite instability is recommended, and pembrolizumab is recommended for patients with mismatch repair deficiency or high microsatellite instability tumors. Endorsed recommendations from the 2016 version of this guideline for computed tomography, baseline performance status and comorbidity profile, defining goals of care, first-line therapy, and palliative care are also contained within the full guideline text. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines .

Recommendations for Culturally Sensitive Research Methods

ERIC Educational Resources Information Center

Awad, Germine H.; Patall, Erika A.; Rackley, Kadie R.; Reilly, Erin D.

2016-01-01

As the US continues to diversify, methods for accurately assessing human behavior must evolve. This paper offers multicultural research considerations at several stages of the research process for psychological research and consultation. Implications regarding the comparative research framework are discussed and suggestions are offered on how to…

Comments on settling chamber design for quiet, blowdown wind tunnels

NASA Technical Reports Server (NTRS)

Beckwith, I. E.

1981-01-01

Transfer of an existing continous circuit supersonic wind tunnel to Langley and its operation there as a blowdown tunnel is planned. Flow disturbance requirements in the supply section and methods for reducing the high level broad band acoustic disturbances present in typical blowdown tunnels are reviewed. Based on recent data and the analysis of two blowdown facilities at Langley, methods for reducing the total turbulence levels in the settling chamber, including both acoustic and vorticity modes, to less than one percent are recommended. The pertinent design details of the damping screens and honeycomb and the recommended minimum pressure drop across the porous components providing the required two orders of magnitude attenuation of acoustic noise levels are given. A suggestion for the support structure of these high pressure drop porous components is offered.

Functional requirements for the man-vehicle systems research facility. [identifying and correcting human errors during flight simulation

NASA Technical Reports Server (NTRS)

Clement, W. F.; Allen, R. W.; Heffley, R. K.; Jewell, W. F.; Jex, H. R.; Mcruer, D. T.; Schulman, T. M.; Stapleford, R. L.

1980-01-01

The NASA Ames Research Center proposed a man-vehicle systems research facility to support flight simulation studies which are needed for identifying and correcting the sources of human error associated with current and future air carrier operations. The organization of research facility is reviewed and functional requirements and related priorities for the facility are recommended based on a review of potentially critical operational scenarios. Requirements are included for the experimenter's simulation control and data acquisition functions, as well as for the visual field, motion, sound, computation, crew station, and intercommunications subsystems. The related issues of functional fidelity and level of simulation are addressed, and specific criteria for quantitative assessment of various aspects of fidelity are offered. Recommendations for facility integration, checkout, and staffing are included.

Does integration matter? A holistic model for building community resilience in Pakistan.

PubMed

Kanta Kafle, Shesh

2017-01-01

This paper analyses an integrated communitybased risk reduction model adopted by the Pakistan Red Crescent. The paper analyses the model's constructs and definitions, and provides a conceptual framework and a set of practical recommendations for building community resilience. The study uses the process of outcome-based resilience index to assess the effectiveness of the approach. The results indicate that the integrated programming approach is an effective way to build community resilience as it offers a number of tangible and longlasting benefits, including effective and efficient service delivery, local ownership, sustainability of results, and improved local resilience with respect to the shock and stress associated with disaster. The paper also outlines a set of recommendations for the effective and efficient use of the model for building community resilience in Pakistan.

Systematic review of recent dementia practice guidelines.

PubMed

Ngo, Jennifer; Holroyd-Leduc, Jayna M

2015-01-01

dementia is a highly prevalent acquired cognitive disorder that interferes with activities of daily living, relationships and quality of life. Recognition and effective management strategies are necessary to provide comprehensive care for these patients and their families. High-quality clinical practice guidelines can improve the quality and consistency of care in all aspects of dementia diagnosis and management by clarifying interventions supported by sound evidence and by alerting clinicians to interventions without proven benefit. we aimed to offer a synthesis of existing practice recommendations for the diagnosis and management of dementia, based upon moderate-to-high quality dementia guidelines. we performed a systematic search in EMBASE and MEDLINE as well as the grey literature for guidelines produced between 2008 and 2013. thirty-nine retrieved practice guidelines were included for quality appraisal by the Appraisal of Guidelines Research and Evaluation II (AGREE-II) tool, performed by two independent reviewers. From the 12 moderate-to-high quality guidelines included, specific practice recommendations for the diagnosis and/or management of any aspect of dementia were extracted for comparison based upon the level of evidence and strength of recommendation. there was a general agreement between guidelines for many practice recommendations. However, direct comparisons between guidelines were challenging due to variations in grading schemes. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Family Policy: Recommendations for State Action.

ERIC Educational Resources Information Center

Romig, Candace L., Ed.

This publication on family policy reviews federal and state policies and offers recommendations for state action. Initial discussion covers changes in the American family, demographics, and the economy. Issues of family maintenance considered include: family welfare policy and welfare reform; child abuse and neglect; alternatives to out-of-home…

Training Guidelines for Healthy School Meals for Food Service Professionals.

ERIC Educational Resources Information Center

Food and Consumer Service (USDA), Washington, DC.

These guidelines offer recommended topic areas and content for training local-level food service personnel. The recommended topic areas for training school food service directors/supervisors and food service managers are nutrition requirements, menu planning for school meals, procurement, financial management, marketing, food production, program…

Occupational Interests and Mentally Retarded People: Review and Recommendations.

ERIC Educational Resources Information Center

Stodden, Robert A.; And Others

1979-01-01

The article reviews several studies regarding the choice of occupational interests for the mentally retarded adolescent. Several concerns about current evaluation practices are discussed. Recommendations are offered for a client centered, developmental model, making the evaluation of occupational interests a viable part of the client's…

Lessons Learned From Dissemination of Evidence-Based Interventions for HIV Prevention.

PubMed

Collins, Charles B; Sapiano, Tobey N

2016-10-01

In 1999, IOM issued a report that recommended that the Centers for Disease Control and Prevention should disseminate evidence-based HIV prevention interventions (EBIs) to be implemented by health departments, community-based organizations, drug treatment centers, and clinics. Based on these recommendations, the Diffusion of Effective Behavioral Interventions Project was initiated in 2000 and began disseminating interventions into public health practice. For 15 years, the Centers for Disease Control and Prevention has disseminated 29 EBIs to more than 11,300 agencies. Lessons were identified during the 15 years of implementation regarding successful methods of dissemination of EBIs. Lessons around selecting interventions for dissemination, developing a dissemination infrastructure including a resource website (https://effectiveinterventions.cdc.gov), and engagement with stakeholders are discussed. A continuous development approach ensured that intervention implementation materials, instructions, and technical assistance were all tailored to the needs of end users, focus populations, and agency capacities. Six follow-up studies demonstrated that adopters of EBIs were able to obtain comparable outcomes to those of the original efficacy research. The Diffusion of Effective Behavioral Interventions Project may offer guidance for other large, national, evidence-based public health dissemination projects. Published by Elsevier Inc.

Office-based anesthesia: new frontiers, better outcomes, and emphasis on safety.

PubMed

Desai, Meena S

2008-12-01

Office-based anesthesia has grown and continues to grow very rapidly in the ever-changing medical environment. The demand of patients, surgeons and the evolving economic environment has set off a dynamic growth explosion. This explosion has created aggressive and tumultuous enhancements, some of which have been adapted well and some of which have led to disastrous results. As we institute rules and regulations to govern this 'wild west' of anesthesia, the landscape is set with some new guidelines that continue to evolve.Practice recommendations have been outlined for fire safety especially on patient fires. Closed claim studies offer valuable recommendations for MAC claims in the office based setting. Anesthesia Patient Safety Foundation and the ASA have outlined valuable information regarding the nonsilencing of equipment alarms.New equipment enhancements have generated successful mobile general anesthesia platforms. Finally, as we forge ahead we must construct measurements of our safety and success as outcome parameters are developed. The review of recent literature and technological advances has provided some valuable lessons in the evolution of patient safety and office based technology for the surgical office-based environment. As this specialty grows, measures of its outcome parameters will allow a gauge of performance.

[Education, advanced and further training in the field "psychology in rehabilitation"].

PubMed

Bengel, J; Gall, H; Grande, G; Küch, D; Mittag, O; Schmucker, D; Spijkers, W; Arling, V; Jahed, J; Lutze, B; Morfeld, M

2014-04-01

The commission for vocational training, training and further education of the German Society of Rehabilitation Science tends to discuss and to give recommendations for various professions in rehabilitation. The working group, which is led by J. Bengel/Freiburg and M. Morfeld/Magdeburg-Stendal created an inventory of Rehabilitation Psychology. The training programs for Rehabilitation Psychology at universities and universities of applied science in Germany are based on a job profile of psychologists in medical and vocational rehabilitation. The different universities have diverse priorities focusing on Rehabilitation Psychology. The offer changes because of the adaption of requirements and implementation of Bologna Reform. The training and further education offers are specific and available for large indication areas. Finally outstanding issues and problems are pointed out. © Georg Thieme Verlag KG Stuttgart · New York.

Initiating undergraduate medical students into communities of research practise: what do supervisors recommend?

PubMed Central

2010-01-01

Background Much has been written in the educational literature on the value of communities of practise in enhancing student learning. Here, we take the experience of senior undergraduate medical students involved in short-term research as a member of a team as a paradigm for learning in a community of practise. Based on feedback from experienced supervisors, we offer recommendations for initiating students into the research culture of their team. In so doing, we endeavour to create a bridge between theory and practise through disseminating advice on good supervisory practise, where the supervisor is perceived as an educator responsible for designing the research process to optimize student learning. Methods Using the questionnaire design tool SurveyMonkey and comprehensive lists of contact details of staff who had supervised research projects at the University of Edinburgh during 1995 - 2008, current and previous supervisors were invited to recommend procedures which they had found successful in initiating students into the research culture of a team. Text responses were then coded in the form of derivative recommendations and categorized under general themes and sub-themes. Results Using the chi-square tests of linear trend and association, evidence was found for a positive trend towards more experienced supervisors offering responses (χ2 = 16.833, p < 0.0005, n = 215) while there was a lack of evidence of bias in the gender distribution of respondents (χ2 = 0.482, p = 0.487, n = 203), respectively. A total of 126 codes were extracted from the text responses of 65 respondents. These codes were simplified to form a complete list of 52 recommendations, which were in turn categorized under seven derivative overarching themes, the most highly represented themes being Connecting the student with others and Cultivating self-efficacy in research competence. Conclusions Through the design of a coding frame for supervisor responses, a wealth of ideas has been captured to make communities of research practise effective mediums for undergraduate student learning. The majority of these recommendations are underpinned by educational theory and have the potential to take the learner beyond the stage of initiation to that of integration within their community of research practise. PMID:21092088

Community pharmacists' services for women during pregnancy and breast feeding in Kuwait: a cross-sectional study.

PubMed

Albassam, Abdullah; Awad, Abdelmoneim

2018-01-05

This study was designed to identify the services provided by community pharmacists in Kuwait and their views regarding self-care in pregnancy and lactation. In addition, it determined the pharmacists' recommendations for treatment of pregnancy-related and breast feeding-related ailments. Cross-sectional questionnaire-based survey. Community pharmacies in Kuwait. 207 pharmacies were randomly selected from the Ministry of Health database. One registered pharmacist was approached from each pharmacy. One hundred and ninety-two (92.8%) pharmacists agreed to participate and completed a self-administered questionnaire. The proportions of pharmacists offering particular advice for health conditions in pregnancy and lactation, pharmacists' recommendations for common and specific ailments during pregnancy and breast feeding, and pharmacists' views about self-care in pregnancy and breast feeding. The top services provided to pregnant and lactating women were recommending vitamins and food supplements (89.8%) and contraception advice (83.4%), respectively. More than half of participants indicated that they would recommend medications for headache, constipation, cough, runny nose, sore throat, nausea/vomiting, indigestion, sore or cracked nipple and insufficient milk. Diarrhoea, haemorrhoids, insomnia, varicose vein, swelling of the feet and legs, vaginal itching, back pain, fever, mastitis and engorgement were frequently referred to the physician. Recommendations on medication use were occasionally inappropriate in terms of unneeded drug therapy, off-label use and safety. In relation to offering advice and solving medication and health problems of pregnant and lactating women, more than half of pharmacists indicated that they have sufficient knowledge (61.5%; 50.5%) and confidence (58.3%; 53.1%), respectively. Most of the respondents (88.5%) agreed that a continuing education programme on this topic would be of value for their practice. The present findings show that respondents had different recommendations for treatment of pregnancy-related and lactation-related ailments; and also highlight the need for interventions, including continuing professional development and revision of the undergraduate pharmacy curriculum. © 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.

18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging.

PubMed

Caresia Aroztegui, Ana Paula; García Vicente, Ana María; Alvarez Ruiz, Soledad; Delgado Bolton, Roberto Carlos; Orcajo Rincon, Javier; Garcia Garzon, Jose Ramon; de Arcocha Torres, Maria; Garcia-Velloso, Maria Jose

2017-10-01

Current guidelines do not systematically recommend 18F-FDG PET/CT for breast cancer staging; and the recommendations and level of evidence supporting its use in different groups of patients vary among guidelines. This review summarizes the evidence about the role of 18F-FDG PET/CT in breast cancer staging and the therapeutic and prognostic impact accumulated in the last decade. Other related aspects, such as the association of metabolic information with biology and prognosis are considered and evidence-based recommendations for the use of 18F-FDG PET/CT in breast cancer staging are offered. We systematically searched MEDLINE for articles reporting studies with at least 30 patients related to clinical questions following the Problem/Population, Intervention, Comparison, and Outcome framework. We critically reviewed the selected articles and elaborated evidence tables structuring the summarized information into methodology, results, and limitations. The level of evidence and the grades of recommendation for the use of 18F-FDG PET/CT in different contexts are summarized. Level III evidence supports the use of 18F-FDG PET/CT for initial staging in patients with recently diagnosed breast cancer; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a weak recommendation in this population. In patients with locally advanced breast cancer, level II evidence supports the use of 18F-FDG PET/CT for initial staging; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a strong recommendation in this population. In patients with recently diagnosed breast cancer, the metabolic information from baseline 18F-FDG PET/CT is associated with tumor biology and has prognostic implications, supported by level II evidence. In conclusion, 18F-FDG PET/CT is not recommended for staging all patients with early breast cancer, although evidence of improved regional and systemic staging supports its use in locally advanced breast cancer. Baseline tumor glycolytic activity is associated with tumor biology and prognosis.

Looking Backwards--Looking Forward. Volume V: July, 1989-June, 1990. A Collection of Essays: Recommendations Related to Education in General and Vocational-Technical Education in Particular.

ERIC Educational Resources Information Center

North Carolina State Advisory Council on Vocational Education, Raleigh.

This is the fifth of five volumes of essays in the form of recommendations for the improvement of programs, services, and activities offered through vocational-technical education in North Carolina. The volume explains the rationale for and comments on 15 recommendations prepared by the State Advisory Council on Vocational Education for fiscal…

The Report of the 2016-2017 Advocacy Standing Committee

PubMed Central

Jordan, Ronald P.; Bratberg, Jeffrey; Congdon, Heather B.; Cross, L. Brian; Hill, Lucas G.; Marrs, Joel C.; McBane, Sarah; Lang, William G.; Ekoma, Jeffrey O.

2017-01-01

EXECUTIVE SUMMARY Based on the growing importance of community engagement and the recognition of its importance by the American Association of Colleges of Pharmacy (AACP), the committee offers several examples of community engagement activities for consideration and replication by our academy and beyond. These activities, including those of winning institutions of the Lawrence J. Weaver Transformational Community Engagement Award, can be mapped to the core components of community engagement presented in Table 1. The committee, using an implementation readiness framework, provides the reader with insight into the challenges that may impact successful community engagement and encourages our academy to continue its work to support faculty capacity in this area. Toward that end, the committee offers a policy statement that encourages schools and colleges of pharmacy to have an office or designate a faculty member whose focus is specifically on community engagement. The committee also offers a recommendation that the core components be included in the criteria for the Weaver Award. PMID:29200458

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…

Interoperability of Electronic Health Records: A Physician-Driven Redesign.

PubMed

Miller, Holly; Johns, Lucy

2018-01-01

PURPOSE: Electronic health records (EHRs), now used by hundreds of thousands of providers and encouraged by federal policy, have the potential to improve quality and decrease costs in health care. But interoperability, although technically feasible among different EHR systems, is the weak link in the chain of logic. Interoperability is inhibited by poor understanding, by suboptimal implementation, and at times by a disinclination to dilute market share or patient base on the part of vendors or providers, respectively. The intent of this project has been to develop a series of practicable recommendations that, if followed by EHR vendors and users, can promote and enhance interoperability, helping EHRs reach their potential. METHODOLOGY: A group of 11 physicians, one nurse, and one health policy consultant, practicing from California to Massachusetts, has developed a document titled "Feature and Function Recommendations To Optimize Clinician Usability of Direct Interoperability To Enhance Patient Care" that offers recommendations from the clinician point of view. This report introduces some of these recommendations and suggests their implications for policy and the "virtualization" of EHRs. CONCLUSION: Widespread adoption of even a few of these recommendations by designers and vendors would enable a major advance toward the "Triple Aim" of improving the patient experience, improving the health of populations, and reducing per capita costs.

Workplace availability, risk group and perceived barriers predictive of 2016-17 influenza vaccine uptake in the United States: A cross-sectional study.

PubMed

Luz, Paula M; Johnson, Riley E; Brown, Heidi E

2017-10-13

Seasonal influenza, though mostly self-limited in the healthy adult, may lead to severe disease and/or complications in subpopulations. Annual influenza vaccination is available in many countries with coverage goals rarely being met. We conducted a cross-sectional study of influenza vaccine uptake and explored socio-demographic, economic, and psychological factors that explained vaccine uptake. The survey was administered via Amazon Mechanical Turk (MTurk) to United States residents in January 2017, using the Qualtrics platform. Using principal axis factor analysis, we reduced the 25 items theory-based psychological determinants into the primary constructs they measure if/when internal consistency was sufficient (Cronbach's alpha >0.60). Logistic regression models were used to quantify the association of socio-demographic, economic, and psychological factors with reported vaccine behavior in the 2016-17 flu season. 1007 participants completed the survey, sex distribution was even, 67% had 25-44years of age, and 61% annual household income of $30-99 thousand United States dollars. About 25% had the flu shot offered at their workplace and 20% reported belonging to a group for whom the flu shot is recommended. Vaccine uptake was 31.5%. Eight predictors remained in the final adjusted model (R 2 =0.489), having the vaccine offered at the workplace, belonging to a group for whom the vaccine is recommended, and higher perceived barriers were the strongest predictors of vaccine uptake, increasing (and decreasing in the case of barriers) the odds by >3-fold. Additionally, higher household income, higher perceived susceptibility and higher perceived benefits also independently predicted vaccine uptake. We found evidence that perceived barriers significantly impaired vaccine uptake to the same extent that having the vaccine offered at the workplace or belonging to a group for whom the vaccine is recommended facilitated uptake. Ideally, a better understanding of drivers of vaccine hesitancy will result in improved interventions to increase vaccine uptake. Copyright © 2017 Elsevier Ltd. All rights reserved.

Spinal Manipulative Therapy and Other Conservative Treatments for Low Back Pain: A Guideline From the Canadian Chiropractic Guideline Initiative.

PubMed

Bussières, André E; Stewart, Gregory; Al-Zoubi, Fadi; Decina, Philip; Descarreaux, Martin; Haskett, Danielle; Hincapié, Cesar; Pagé, Isabelle; Passmore, Steven; Srbely, John; Stupar, Maja; Weisberg, Joel; Ornelas, Joseph

2018-05-01

The objective of this study was to develop a clinical practice guideline on the management of acute and chronic low back pain (LBP) in adults. The aim was to develop a guideline to provide best practice recommendations on the initial assessment and monitoring of people with low back pain and address the use of spinal manipulation therapy (SMT) compared with other commonly used conservative treatments. The topic areas were chosen based on an Agency for Healthcare Research and Quality comparative effectiveness review, specific to spinal manipulation as a nonpharmacological intervention. The panel updated the search strategies in Medline. We assessed admissible systematic reviews and randomized controlled trials for each question using A Measurement Tool to Assess Systematic Reviews and Cochrane Back Review Group criteria. Evidence profiles were used to summarize judgments of the evidence quality and link recommendations to the supporting evidence. Using the Evidence to Decision Framework, the guideline panel determined the certainty of evidence and strength of the recommendations. Consensus was achieved using a modified Delphi technique. The guideline was peer reviewed by an 8-member multidisciplinary external committee. For patients with acute (0-3 months) back pain, we suggest offering advice (posture, staying active), reassurance, education and self-management strategies in addition to SMT, usual medical care when deemed beneficial, or a combination of SMT and usual medical care to improve pain and disability. For patients with chronic (>3 months) back pain, we suggest offering advice and education, SMT or SMT as part of a multimodal therapy (exercise, myofascial therapy or usual medical care when deemed beneficial). For patients with chronic back-related leg pain, we suggest offering advice and education along with SMT and home exercise (positioning and stabilization exercises). A multimodal approach including SMT, other commonly used active interventions, self-management advice, and exercise is an effective treatment strategy for acute and chronic back pain, with or without leg pain. Copyright © 2018. Published by Elsevier Inc.

Nursing recruitment: relationship between perceived employer image and nursing employees' recommendations.

PubMed

Van Hoye, Greet

2008-08-01

This paper is a report of a study to examine the relationship between nursing employees' perceptions of instrumental and symbolic dimensions of employer image on the one hand and their intentions to recommend their organization as an employer and their willingness to testify in their organization's recruitment materials on the other. Previous research suggests that word-of-mouth recommendations by current nursing employees can enhance healthcare organizations' attractiveness as an employer for potential applicants. However, it is not known what motivates employees to provide positive word-of-mouth comments and to endorse their employer in recruitment testimonials. The instrumental-symbolic framework was applied to identify relevant dimensions of perceived employer image that might relate to employee recommendations. A questionnaire was administered in 2006 to 106 nurses and nursing aides from four non-profit nursing homes in Belgium. The response rate was 55%. Overall, nursing employees were more willing to recommend their nursing home to others than to testify in recruitment materials. Both instrumental and symbolic employer image dimensions predicted nursing employees' recommendation intentions. Conversely, willingness to testify was only predicted by symbolic image dimensions. Specifically, the more the nursing employees perceived that their nursing home offers task diversity, offers the possibility to help people and is prestigious, the more they intended to recommend their organization to others. The more they perceived their nursing home as competent, the higher were their recommendation intentions and their willingness to testify in recruitment communication. To increase nursing employees' willingness to recommend their employer to potential applicants, organizations should enhance their perceived employer image.

Recommendations to Revise the Regulation of Private Post-Secondary Institutions

ERIC Educational Resources Information Center

Roedler, George; Grimes, Tricia

2006-01-01

The purpose of this report is to summarize the Minnesota Office of Higher Education's work to develop recommendations to revise the regulation of private post-secondary institutions in Minnesota and public postsecondary institutions located outside of Minnesota that offer instruction to residents in Minnesota pursuant to Minnesota Statutes Chapter…

Recommendations for Improving the Career Opportunities of Teachers in the Charlotte-Mecklenburg Schools: A Constructive Alternative to Merit Pay.

ERIC Educational Resources Information Center

Schlechty, Phillip; And Others

1984-01-01

Offers recommendations for developing a system of teacher staffing and evaluation that would improve teacher performance and the state of education in general. Discusses incentive and reward systems, performance evaluation, career advancement and enrichment, and other issues. (KH)

Context-Aware Recommender Systems for Learning: A Survey and Future Challenges

ERIC Educational Resources Information Center

Verbert, K.; Manouselis, N.; Ochoa, X.; Wolpers, M.; Drachsler, H.; Bosnic, I.; Duval, E.

2012-01-01

Recommender systems have been researched extensively by the Technology Enhanced Learning (TEL) community during the last decade. By identifying suitable resources from a potentially overwhelming variety of choices, such systems offer a promising approach to facilitate both learning and teaching tasks. As learning is taking place in extremely…

Undergraduate Instruction in Empirical Research Methods in Communication: Assessment and Recommendations

ERIC Educational Resources Information Center

Parks, Malcolm R.; Faw, Meara; Goldsmith, Daena

2011-01-01

This study assesses the current state of undergraduate instruction in empirical research methods in communication and offers recommendations for enhancing such instruction. Responses to an online questionnaire were received from 149 communication-related programs at four-year colleges and universities. Just over 85% of responding programs offered…

Technical Communication in the International Workplace: Some Implications for Curriculum Development.

ERIC Educational Resources Information Center

Barclay, Rebecca O.; And Others

1991-01-01

Reports survey results of U.S. and European aerospace engineers concerning the kinds of communication products they actually use, the kinds they produce, and recommendations they would offer designers of academic courses. Recommends relevant faculty work and educational background, advisory boards, professional contacts, research, and feedback as…

Determining the anaerobic threshold in postpolio syndrome: comparison with current guidelines for training intensity prescription.

PubMed

Voorn, Eric L; Gerrits, Karin H; Koopman, Fieke S; Nollet, Frans; Beelen, Anita

2014-05-01

To determine whether the anaerobic threshold (AT) can be identified in individuals with postpolio syndrome (PPS) using submaximal incremental exercise testing, and to compare current guidelines for intensity prescription in PPS with the AT. Cohort study. Research laboratory. Individuals with PPS (N=82). Not applicable. Power output, gas exchange variables, heart rate, and rating of perceived exertion (RPE) were measured in an incremental submaximal cycle ergometry test. Two independent observers identified the AT. Comparison of current guidelines for training intensity prescription in PPS (40%-60% heart rate reserve [HRR] or RPE of 12) with the AT was based on correlations between recommended heart rate and the heart rate at the AT. In addition, we determined the proportion of individuals that would have been recommended to train at an intensity corresponding to their AT. The AT was identified in 63 (77%) of the participants. Pearson correlation coefficients between the recommended heart rate and the heart rate at the AT were lower in cases of 40% HRR (r=.56) and 60% HRR (r=.50) than in cases of prescription based on the RPE (r=.86). Based on the RPE, 55% of the individuals would have been recommended to train at an intensity corresponding to their AT. This proportion was higher compared with 40% HRR (41%) or 60% HRR (18%) as criterion. The AT can be identified in most individuals with PPS offering an individualized target for aerobic training. If the AT cannot be identified (eg, because gas analysis equipment is not available), intensity prescription can best be based on the RPE. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Current information technology needs of small to medium sized apparel manufacturers and contractors

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

Wimple, C., LLNL

1998-04-01

This report documents recent efforts of the American Textile Partnership (AMTEX{sup TM}) Demand Activated Manufacturing Architecture (DAMA) Project to identify opportunities for cost effective enhanced information technology use by small to medium sized apparel manufacturers and contractors. Background on the AMTEX/DAMA project and objectives for the specific DAMA Small and Medium Enterprise (SME) effort are discussed in this section. The approach used to gather information about current opportunities or needs is outlined in Section 2 Approach, and relevant findings are identified and a brief analysis of the information gathered is presented in Section 3 Findings. Recommendations based on the analysis,more » are offered in Section 4 Recommendations, and plans are suggested for DAMA follow-on in Section 5 Future Plans. Trip reports for each of the companies visited are contained in Appendix E - Company Trip Reports. These individual reports contain the data upon which the analysis presented in Section 3 Findings is based.« less

Nonsurgical Medical Penile Girth Augmentation: Experience-Based Recommendations.

PubMed

Oates, Jayson; Sharp, Gemma

2017-10-01

Penile augmentation is increasingly sought by men who are dissatisfied with the size and/or appearance of their penis. However, augmentation procedures are still considered to be highly controversial with no standardized recommendations reported in the medical literature and limited outcome data. Nevertheless, these procedures continue to be performed in increasing numbers in private settings. Therefore, there is a need for safe, effective, and minimally invasive procedures to be developed, evaluated, and reported in the research literature. In this article, we focus particularly on girth enhancement procedures rather than lengthening procedures as penile girth appears to be particularly important for sexual satisfaction. We discuss the advantages and disadvantages of the common techniques to date, with a focus on the minimally invasive injectable girth augmentation techniques. Based on considerable operative experience, we offer our own suggestions for patient screening, technique selection, and perioperative care. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association.

PubMed

Van Horn, Linda; Carson, Jo Ann S; Appel, Lawrence J; Burke, Lora E; Economos, Christina; Karmally, Wahida; Lancaster, Kristie; Lichtenstein, Alice H; Johnson, Rachel K; Thomas, Randal J; Vos, Miriam; Wylie-Rosett, Judith; Kris-Etherton, Penny

2016-11-29

In 2013, the American Heart Association and American College of Cardiology published the "Guideline on Lifestyle Management to Reduce Cardiovascular Risk," which was based on a systematic review originally initiated by the National Heart, Lung, and Blood Institute. The guideline supports the American Heart Association's 2020 Strategic Impact Goals for cardiovascular health promotion and disease reduction by providing more specific details for adopting evidence-based diet and lifestyle behaviors to achieve those goals. In addition, the 2015-2020 Dietary Guidelines for Americans issued updated evidence relevant to reducing cardiovascular risk and provided additional recommendations for adopting healthy diet and lifestyle approaches. This scientific statement, intended for healthcare providers, summarizes relevant scientific and translational evidence and offers practical tips, tools, and dietary approaches to help patients/clients adapt these guidelines according to their sociocultural, economic, and taste preferences. © 2016 American Heart Association, Inc.

E-therapy for mental health problems: a systematic review.

PubMed

Postel, Marloes G; de Haan, Hein A; De Jong, Cor A J

2008-09-01

The widespread availability of the Internet offers opportunities for improving access to therapy for people with mental health problems. There is a seemingly infinite supply of Internet-based interventions available on the World Wide Web. The aim of the present study is to systematically assess the methodological quality of randomized controlled trials (RCTs) concerning e-therapy for mental health problems. Two reviewers independently assessed the methodological quality of the RCTs, based on a list of criteria for the methodological quality assessment as recommended by the Cochrane Back Review Group. The search yielded 14 papers that reported RCTs concerning e-therapy for mental-health problems. The methodological quality of studies included in this review was generally low. It is concluded that e-therapy may turn out to be an appropriate therapeutic entity, but the evidence needs to be more convincing. Recommendations are made concerning the method of reporting RCTs and the need to add some content items to an e-therapy study.

Clearing Hurdles: The Challenges of Implementation of Mental Health Evidence-Based Practices in Under-resourced Schools.

PubMed

Eiraldi, Ricardo; Wolk, Courtney Benjamin; Locke, Jill; Beidas, Rinad

Schools have become the main provider of services to children with mental health needs. Although there is substantial literature on barriers to implementation of evidence-based practices (EBPs) in under-resourced school districts, less has been written on how to overcome those barriers. Providing mental health services in the school setting presents a tremendous opportunity to increase access to quality mental health care for underserved youth. This review provides a brief overview of the barriers to successful implementation and sustainment of EBPs in under-resourced public schools and provides recommendations for overcoming them. The discussion is organized around an established conceptual framework adapted for the delivery of services in under-resourced schools that focuses on interdependent factors that exist at the individual-, team, school-, and macro-levels. This manuscript explores some recommendations and strategies for effectively addressing challenges related to implementation of EBPs. Research ideas are offered to bridge the research-to-practice gap that impacts many under-resourced public school districts.

Clearing Hurdles: The Challenges of Implementation of Mental Health Evidence-Based Practices in Under-resourced Schools

PubMed Central

Eiraldi, Ricardo; Wolk, Courtney Benjamin; Locke, Jill; Beidas, Rinad

2015-01-01

Schools have become the main provider of services to children with mental health needs. Although there is substantial literature on barriers to implementation of evidence-based practices (EBPs) in under-resourced school districts, less has been written on how to overcome those barriers. Providing mental health services in the school setting presents a tremendous opportunity to increase access to quality mental health care for underserved youth. This review provides a brief overview of the barriers to successful implementation and sustainment of EBPs in under-resourced public schools and provides recommendations for overcoming them. The discussion is organized around an established conceptual framework adapted for the delivery of services in under-resourced schools that focuses on interdependent factors that exist at the individual-, team, school-, and macro-levels. This manuscript explores some recommendations and strategies for effectively addressing challenges related to implementation of EBPs. Research ideas are offered to bridge the research-to-practice gap that impacts many under-resourced public school districts. PMID:26336512

[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.

Cultivating a Cross-Cultural Disposition

DTIC Science & Technology

2007-06-15

OF ADAPTATION PROCESS ........................................................................................70 REFERENCE LIST...and the use of distance learning media echo recommendations offered by one of the article’s cited military sources, retired Major General Robert H...leaving one to his or her personal definition. Those that do offer conceptualization of culture often equate it to group level cognitive processes , an

Training and Development through Adult Learning Theory.

ERIC Educational Resources Information Center

Swagar, Colleen

This report analyzes the employee training program at the Outdoor Program Centre (OPC) of the University of Calgary and offers recommendations that may be of benefit to other outdoor recreation centers. The OPC offers products and services such as facility access, equipment rentals, instructional and recreational programs, and repair services for…

Investigating Barriers in HIV-Testing Oncology Patients: The IBITOP Study, Phase I

PubMed Central

Merz, Laurent; Zimmermann, Stefan; Peters, Solange; Cavassini, Matthias

2016-01-01

Background. Although the prevalence of non-AIDS-defining cancers (non-ADCs) among people living with HIV is rising, we observed HIV testing rates below 5% at our oncology center, against a regional HIV prevalence of 0.2%–0.4%. We performed the Investigating Barriers in HIV-Testing Oncology Patients (IBITOP) study among oncology physicians and patients. Methods. Between July 1 and October 31, 2013, patients of unknown HIV status newly diagnosed with solid-organ non-ADCs referred to Lausanne University Hospital Oncology Service, Switzerland, were offered free HIV testing as part of their oncology work-up. The primary endpoints were (a) physician willingness to offer and patient acceptance of HIV testing and (b) physicians’ reasons for not offering testing. Results. Of 239 patients of unknown HIV status with a new non-ADC diagnosis, 43 (18%) were offered HIV testing, of whom 4 declined (acceptance rate: 39 of 43; 91%). Except for 21 patients tested prior to oncology consultation, 175 patients (of 239; 73%) were not offered testing. Testing rate declined among patients who were >70 years old (12% versus 30%; p = .04); no non-European patients were tested. Physicians gave reasons for not testing in 16% of cases, the main reason being patient follow-up elsewhere (10 patients; 5.7%). HIV testing during the IBITOP study increased the HIV testing rate to 18%. Conclusion. Although the IBITOP study increased HIV testing rates, most patients were not tested. Testing was low or nonexistent among individuals at risk of late HIV presentation (older patients and migrants). Barriers to testing appear to be physician-led, because patient acceptance of testing offered was very high (91%). In November 2013, the Swiss HIV testing recommendations were updated to propose testing in cancer patients. Phase II of the IBITOP study is examining the effect of these recommendations on HIV testing rates and focusing on physician-led testing barriers. Implications for Practice: Patients of unknown HIV status newly diagnosed with solid-organ non-AIDS-defining cancers were offered free HIV testing. Physician and patient barriers to HIV testing were examined. Most patients (82%) were not offered testing, and testing of individuals at risk of late HIV presentation (older patients and migrants) was low or nonexistent. Conversely, patient acceptance of testing offered was very high (91%), suggesting that testing barriers in this setting are physician-led. Since this study, the Swiss HIV testing recommendations now advise testing cancer patients before chemotherapy. Phase II of the Investigating Barriers in HIV-Testing Oncology Patients study is examining the effect of these recommendations on testing rates and physician barriers. PMID:27440062

Medical education practice-based research networks: Facilitating collaborative research.

PubMed

Schwartz, Alan; Young, Robin; Hicks, Patricia J

2016-01-01

Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging. In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN). We searched for extant networks through peer-reviewed literature and the world-wide web. We identified 15 research networks in medical education founded since 2002 with membership ranging from 8 to 120 programs. Most focus on graduate medical education in primary care or emergency medicine specialties. We offer four recommendations for the further development and spread of medical education research networks: increasing faculty development, obtaining central resources, studying networks themselves, and developing networks of networks.

Medical education practice-based research networks: Facilitating collaborative research

PubMed Central

Schwartz, Alan; Young, Robin; Hicks, Patricia J.; APPD LEARN, For

2016-01-01

Abstract Background: Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging. Aims: In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN). Methods: We searched for extant networks through peer-reviewed literature and the world-wide web. Results: We identified 15 research networks in medical education founded since 2002 with membership ranging from 8 to 120 programs. Most focus on graduate medical education in primary care or emergency medicine specialties. Conclusions: We offer four recommendations for the further development and spread of medical education research networks: increasing faculty development, obtaining central resources, studying networks themselves, and developing networks of networks. PMID:25319404

Conducting Meta-Analyses Based on p Values

PubMed Central

van Aert, Robbie C. M.; Wicherts, Jelte M.; van Assen, Marcel A. L. M.

2016-01-01

Because of overwhelming evidence of publication bias in psychology, techniques to correct meta-analytic estimates for such bias are greatly needed. The methodology on which the p-uniform and p-curve methods are based has great promise for providing accurate meta-analytic estimates in the presence of publication bias. However, in this article, we show that in some situations, p-curve behaves erratically, whereas p-uniform may yield implausible estimates of negative effect size. Moreover, we show that (and explain why) p-curve and p-uniform result in overestimation of effect size under moderate-to-large heterogeneity and may yield unpredictable bias when researchers employ p-hacking. We offer hands-on recommendations on applying and interpreting results of meta-analyses in general and p-uniform and p-curve in particular. Both methods as well as traditional methods are applied to a meta-analysis on the effect of weight on judgments of importance. We offer guidance for applying p-uniform or p-curve using R and a user-friendly web application for applying p-uniform. PMID:27694466

To treat or not to treat: On what should surgical therapy be based?

PubMed

Jones, James W; McCullough, Laurence B

2015-12-01

Dr C. Autious has just returned from the most prestigious vascular surgery meeting in America. At the meeting, one of the most prominent complex aneurysm surgeons arose to discuss a paper concerning a procedure he had developed and popularized over the last decade. Dr L. Uminous stunned the audience with his declaration that he no longer recommends that his namesake procedure be performed. Instead, he proclaimed that a new, radically different procedure be adopted immediately. He showed slides detailing the novel proposal but did not give data concerning results obtained. The recommended procedure is technically possible but seems to require a different skill set. Dr Autious has a patient scheduled for elective surgery that he had planned to use the Uminous procedure to treat. What should he do? A. Do the recommended procedure as best you can. B. Refer the patient to Dr Uminous. C. Offer the recommended procedure with full disclosure. D. Give full disclosure and let the patient decide which procedure to use. E. Put the procedure on hold until more information becomes available. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Study on Personalized Recommendation Model of Internet Advertisement

NASA Astrophysics Data System (ADS)

Zhou, Ning; Chen, Yongyue; Zhang, Huiping

With the rapid development of E-Commerce, the audiences put forward higher requirements on personalized Internet advertisement than before. The main function of Personalized Advertising System is to provide the most suitable advertisements for anonymous users on Web sites. The paper offers a personalized Internet advertisement recommendation model. By mining the audiences' historical and current behavior, and the advertisers' and publisher's web site content, etc, the system can recommend appropriate advertisements to corresponding audiences.

Human Papillomavirus Vaccine Uptake in Adolescent Boys: An Evidence Review.

PubMed

Voss, Danielle S; Wofford, Linda G

2016-10-01

Despite evidence-based guidelines recommending routine vaccination against human papillomavirus (HPV) for adolescent boys, ages 11-12 years, vaccine uptake among this population remains low. To examine reasons for low HPV quadrivalent vaccine uptake and methods available to increase vaccine uptake among adolescent males, ages 11-12 years. Of 341 identified studies, 30 were included from three databases. The 30 studies were grouped into six categories: population-specific, problem-specific, educational interventions, theory-specific, political implications, and foundational guidelines and Websites. Among eight studies, low vaccine uptake was attributed to lack of parental, adolescent, and physician knowledge of HPV4 vaccine availability and recommendations. HPV4 vaccine educational interventions for parents and adolescents were the most effective for promoting vaccine uptake. Theory applications and gain-framed messages were shown to be effective for assessing HPV vaccine attitudes and perceptions. Political implication studies reveal the need for political and financial measures to encourage HPV vaccine acceptability among the population. To promote HPV vaccine uptake among adolescent males, providers must remain current with HPV vaccine recommendations and offer parental and adolescent HPV education focusing on benefits of vaccine acceptance and risks of vaccine refusal. The results of this review inform our understanding of effective educational strategies to positively impact HPV vaccine uptake in adolescent males. Based on this review, clinicians can employ several evidence-based educational strategies to facilitate HPV vaccine uptake. © 2016 Sigma Theta Tau International.

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

PubMed

Cooperberg, Matthew R

2017-09-01

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

Advancing Evidence-Based Assessment in School Mental Health: Key Priorities for an Applied Research Agenda.

PubMed

Arora, Prerna G; Connors, Elizabeth H; George, Melissa W; Lyon, Aaron R; Wolk, Courtney B; Weist, Mark D

2016-12-01

Evidence-based assessment (EBA) is a critically important aspect of delivering high-quality, school-based mental health care for youth. However, research in this area is limited and additional applied research on how best to support the implementation of EBA in school mental health (SMH) is needed. Accordingly, this manuscript seeks to facilitate the advancement of research on EBA in SMH by reviewing relevant literature on EBA implementation in schools and providing recommendations for key research priorities. Given the limited number of published studies available, findings from child and adolescent mental health and implementation science research are also included to inform a robust and comprehensive research agenda on this topic. Based on this literature review, five priorities for research on EBA in SMH are outlined: (1) effective identification of assessment targets, (2) appropriate selection of assessment measures, (3) investigation of organizational readiness for EBA, (4) study of implementation support for EBA, and (5) promotion of EBA data integration and use. Each priority area includes recommended directions for future research. A comprehensive and robust research agenda is warranted to build the science and practice of implementing EBA in SMH. Specific directions for this agenda are offered.

API consensus guidelines for use of antiretroviral therapy in adults (API-ART guidelines). Endorsed by the AIDS Society of India.

PubMed

Gupta, S B; Pujari, S N; Joshi, S R; Patel, A K

2006-01-01

With rational use of antiretroviral therapy (ART), human immunodeficiency virus (HIV) infection has been transformed into a chronic manageable illness like diabetes and hypertension. These guidelines provide information on state of art, evidence based approach for use of ART in Indian context. When to initiate ART? Antiretroviral therapy is indicated for all symptomatic HIV infected persons regardless of CD4 counts and plasma viral load (PVL) levels. In asymptomatic patients, ART should be offered when the CD4 counts < 200/mm3 and should be considered in patients with CD4 counts between 200-250/mm3. Therapy is not recommended for patients with CD4 count more than 350/ mm3. Involvement of patient in all treatment decisions and assessing readiness is critical before initiating ART. What to start with? A non-nucleoside reverse transcriptase inhibitor (NNRTI) based regimen is recommended for antiretroviral naïve patients. The choice between nevirapine and efavirenz is based on differences in adverse events profiles; cost and availability of convenient fixed dose combinations and need for concomitant use of rifampicin. A backbone of 2-nucleoside reverse transcriptase inhibitors (NRTIs) is combined with the NNRTI. Various combinations and ART strategies not to be used in clinical practice has been enlisted. How to follow up? Recommendations have been made for baseline evaluation and monitoring of patients on ART. These include guidelines on laboratory and clinical evaluation. A plasma viral load at 6 months after initiation of first-line ART is strongly recommended. Yearly estimation of lipid profile has been recommended. How to identify and manage ART failure? The guidelines recognize the issue of identifying ART failure late if only CD4 counts are used for monitoring. In the absence of resistance testing various second-line regimens have been enlisted. A boosted protease inhibitor based regimen is recommended in this situation to be combined with 2-NRTIs. Special situations Recommendations have been made for use of ART in HIV-TB, HIV-HBV, and HIV-HCV co-infected patients. In patients with active TB and a CD4 count < 200/mm3, initiation of ART is recommended as soon as the anti-TB treatment is tolerated. Efavirenz is the only ARV drug, which can be safely used with rifampicin. In pregnancy use of single dose nevirapine for reducing risk of mother to child transmission of HIV is not recommended, because of the risk of development of resistance. For post-exposure prophylaxis taking ART treatment history of the source patient is crucial in designing an effective regimen.

Understanding customer reactions to brokered ultimatums: applying negotiation and justice theory.

PubMed

Humphrey, Stephen E; Ellis, Aleksander P J; Conlon, Donald E; Tinsley, Catherine H

2004-06-01

There has been little research examining customer reactions to brokered ultimatum game (BUG) contexts (i.e. exchanges in which 1 party offers an ultimatum price for a resource through an intermediary, and the ultimatum offer is accepted or rejected by the other party). In this study, the authors incorporated rational decision-making theory and justice theory to examine how customers' bids, recommendations, and repatronage behavior are affected by characteristics of BUG contexts (changing from an ultimatum to negotiation transaction, response timeliness, and offer acceptance or rejection). Results indicated that customers attempt to be economically efficient with their bidding behavior. However, negotiation structures, long waits for a response, and rejected bids create injustice perceptions (particularly informational and distributive injustice), negatively influencing customers' recommendations to others and their repatronage. The authors then discuss the practical and theoretical implications of their results. (c) 2004 APA

Data Recommender: An Alternative Way to Discover Open Scientific Datasets

NASA Astrophysics Data System (ADS)

Klump, J. F.; Devaraju, A.; Williams, G.; Hogan, D.; Davy, R.; Page, J.; Singh, D.; Peterson, N.

2017-12-01

Over the past few years, institutions and government agencies have adopted policies to openly release their data, which has resulted in huge amounts of open data becoming available on the web. When trying to discover the data, users face two challenges: an overload of choice and the limitations of the existing data search tools. On the one hand, there are too many datasets to choose from, and therefore, users need to spend considerable effort to find the datasets most relevant to their research. On the other hand, data portals commonly offer keyword and faceted search, which depend fully on the user queries to search and rank relevant datasets. Consequently, keyword and faceted search may return loosely related or irrelevant results, although the results may contain the same query. They may also return highly specific results that depend more on how well metadata was authored. They do not account well for variance in metadata due to variance in author styles and preferences. The top-ranked results may also come from the same data collection, and users are unlikely to discover new and interesting datasets. These search modes mainly suits users who can express their information needs in terms of the structure and terminology of the data portals, but may pose a challenge otherwise. The above challenges reflect that we need a solution that delivers the most relevant (i.e., similar and serendipitous) datasets to users, beyond the existing search functionalities on the portals. A recommender system is an information filtering system that presents users with relevant and interesting contents based on users' context and preferences. Delivering data recommendations to users can make data discovery easier, and as a result may enhance user engagement with the portal. We developed a hybrid data recommendation approach for the CSIRO Data Access Portal. The approach leverages existing recommendation techniques (e.g., content-based filtering and item co-occurrence) to produce similar and serendipitous data recommendations. It measures the relevance between datasets based on their properties, and search and download patterns. We evaluated the recommendation approach in a user study, and the obtained user judgments revealed the ability of the approach to accurately quantify the relevance of the datasets.

Consensus of recommendations guiding comparative effectiveness research methods.

PubMed

Morton, Jacob B; McConeghy, Robert; Heinrich, Kirstin; Gatto, Nicolle M; Caffrey, Aisling R

2016-12-01

Because of an increasing demand for quality comparative effectiveness research (CER), methods guidance documents have been published, such as those from the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI). Our objective was to identify CER methods guidance documents and compare them to produce a summary of important recommendations which could serve as a consensus of CER method recommendations. We conducted a systematic literature review to identify CER methods guidance documents published through 2014. Identified documents were analyzed for methods guidance recommendations. Individual recommendations were categorized to determine the degree of overlap. We identified nine methods guidance documents, which contained a total of 312 recommendations, 97% of which were present in two or more documents. All nine documents recommended transparency and adaptation for relevant stakeholders in the interpretation and dissemination of results. Other frequently shared CER methods recommendations included: study design and operational definitions should be developed a priori and allow for replication (n = 8 documents); focus on areas with gaps in current clinical knowledge that are relevant to decision-makers (n = 7); validity of measures, instruments, and data should be assessed and discussed (n = 7); outcomes, including benefits and harms, should be clinically meaningful, and objectively measured (n = 7). Assessment for and strategies to minimize bias (n = 6 documents), confounding (n = 6), and heterogeneity (n = 4) were also commonly shared recommendations between documents. We offer a field-consensus guide based on nine CER methods guidance documents that will aid researchers in designing CER studies and applying CER methods. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Regression-based statistical mediation and moderation analysis in clinical research: Observations, recommendations, and implementation.

PubMed

Hayes, Andrew F; Rockwood, Nicholas J

2017-11-01

There have been numerous treatments in the clinical research literature about various design, analysis, and interpretation considerations when testing hypotheses about mechanisms and contingencies of effects, popularly known as mediation and moderation analysis. In this paper we address the practice of mediation and moderation analysis using linear regression in the pages of Behaviour Research and Therapy and offer some observations and recommendations, debunk some popular myths, describe some new advances, and provide an example of mediation, moderation, and their integration as conditional process analysis using the PROCESS macro for SPSS and SAS. Our goal is to nudge clinical researchers away from historically significant but increasingly old school approaches toward modifications, revisions, and extensions that characterize more modern thinking about the analysis of the mechanisms and contingencies of effects. Copyright © 2016 Elsevier Ltd. All rights reserved.

[From Evidence to Health Policy Making: Pre-Exposure Prophylaxis for HIV Prevention].

PubMed

Ko, Nai-Ying

2016-12-01

Pre-exposure prophylaxis (PrEP), in combination with traditional prevention strategies (such as condom use, voluntary HIV counseling and testing, and treatment for sexually transmitted infections), has been shown to effectively prevent HIV infection. As of September 2015, the World Health Organization recommends that people at substantial risk of HIV infection should be offered PrEP as an additional prevention choice, as part of comprehensive prevention. This article introduces how to apply a systematic review using the methodology of Grading of Recommendations Assessment, Development and Evaluation (GRADE) to write clinical guidelines. With support from the Taiwan Centers for Disease Control, the Taiwan AIDS Society published clinical guidelines for oral pre-exposure prophylaxis in Taiwan. Nurses are responsible to apply evidence-based knowledge and to use their professional influence to shape health policies related to HIV prevention.

Pharmacogenetics-based personalized therapy: Levels of evidence and recommendations from the French Network of Pharmacogenetics (RNPGx).

PubMed

Picard, Nicolas; Boyer, Jean-Christophe; Etienne-Grimaldi, Marie-Christine; Barin-Le Guellec, Chantal; Thomas, Fabienne; Loriot, Marie-Anne

2017-04-01

More than 50 laboratories offer pharmacogenetic testing in France. These tests are restricted to a limited number of indications: prevention of serious adverse drug reactions; choice of most appropriate therapeutic option; dose adjustment for a specific drug. A very small proportion of these tests are mentioned in drug information labeling and the data provided (if any) are generally insufficient to ascertain whether a test is required and if it is useful. This article discusses the rationale for evaluating the performance and clinical usefulness of pharmacogenetics and provides, on behalf of the French national network of pharmacogenetics (RNPGx), three levels of recommendation for testing: essential, advisable, and possibly helpful. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

Terrorism's Psychologic Effects and Their Implications for Primary Care Policy, Research, and Education

PubMed Central

Eisenman, David P; Stein, Bradley D; Tanielian, Terri L; Pincus, Harold Alan

2005-01-01

This paper examines primary care physicians' (PCP) roles in helping the nation prepare for, respond to, and recover from the psychologic consequences of chemical, biologic, radiologic, or nuclear (CBRN) terrorism. First, we discuss the psychologic consequences of a CBRN attack and PCPs' roles in responding to these consequences. Second, we analyze these roles in light of the known barriers to delivering high-quality, primary care–based, mental health care. Third, we offer recommendations for mitigating these barriers and preparing PCPs to respond to the psychosocial consequences of a CBRN weapon. Importantly, our recommendations provide dual-use benefits to PCPs faced with the daily concerns of primary care mental health, including improved linkages and electronic connectivity with mental health, information technology, and decision support for providers, and needed education and research. PMID:16050892

Association of American Universities Policy Recommendations for President-Elect Obama

ERIC Educational Resources Information Center

Association of American Universities, 2008

2008-01-01

In this document, the Association of American Universities offers a series of research and technology policy recommendations that would help our nation to continue its global pre-eminence in science and high technology, improve the quality of life and national security of our citizens, and speed our nation's economic recovery. After policy…

Guidelines and Strategies for Cross-Cultural Counseling with Korean American Clients

ERIC Educational Resources Information Center

Kim, Yea Sun Eum

2005-01-01

The 3 major topics discussed begin with a recommendation of family counseling as the primary therapeutic modality for Korean Americans. Second, the article recommends various culturally congruent joining strategies, presented in 5 general groups. The 3rd major section of the article offers the cross-cultural counselor strategies for therapeutic…

What Experiences Do Expository Books on Recommended Book Lists Offer to K-2 Students?

ERIC Educational Resources Information Center

Kletzien, Sharon B.; Dreher, Mariam Jean

2017-01-01

Teachers can use expository texts to teach academic vocabulary, content knowledge, text structure, and text features. National associations' recommended book lists are often used to identify books for classrooms. Previously we identified expository texts on these lists from 2001-2002 and 2011-2012. The current study explored instructional…

Report of the Task Force on De-Regulation Initiatives.

ERIC Educational Resources Information Center

Fishbein, Estelle A.; Blumer, Dennis H.

In response to a request by the Presidential Task Force on Regulatory Relief, this report offers specific recommendations for reform of federal regulations. A cover letter explains the constraints imposed by the recommended format: that the report is unable to address adequately the area of federal regulatory activity generating the most adverse…

Redefining Teacher Pensions: Strategically Defined Benefits for New Teachers and Fiscal Sustainability for All

ERIC Educational Resources Information Center

Miller, Raegen T.

2011-01-01

This paper offers three constructive recommendations that apply specifically to public school teachers, the largest group of state and local government employees, and one of special importance to the long-term economic competitiveness of the country. The recommendations embrace and protect existing defined-benefit pension plans, which are under…

Economic Evaluation of Adolescent Addiction Programs: Methodological Challenges and Recommendations

PubMed Central

Homer, Jenny F.; Drummond, Michael F.; French, Michael T.

2008-01-01

This paper identifies and describes several methodological challenges encountered in economic evaluations of substance abuse interventions for adolescents. Topics include study design, the choice of perspective, the estimation of costs and outcomes, and the generalizability of results. Recommendations are offered for confronting these challenges using examples from adolescent addiction research. PMID:19027640

Video Games: Research, Ratings, Recommendations. ERIC Digest.

ERIC Educational Resources Information Center

Cesarone, Bernard

This Digest reviews research on the demographics and effects of video game playing, discusses game rating systems, and offers recommendations for parents. The Digest begins by discussing research on the time children spend playing electronic games, which shows that younger children's game playing at home (90% of fourth-graders played at least one…

Why adjuvant chemotherapy for stage III colon cancer was not given: Reasons for non-recommendation by clinicians or patient refusal.

PubMed

Gilbar, Peter; Lee, Andrew; Pokharel, Khageshwor

2017-03-01

Aim The aim of our study was to evaluate stage III colon cancer patients discussed at a multidisciplinary team meeting to identify reasons for clinicians not recommending adjuvant chemotherapy and reasons for patients declining recommended chemotherapy. Methods A retrospective, single institution Australian study was conducted on all surgically managed stage III colon cancer patients diagnosed at the regional cancer centre at Toowoomba Hospital between July 2010 and December 2014. Reasons why adjuvant chemotherapy was not recommended by the multidisciplinary team or following referral to a medical oncologist and patients' reasons for refusing chemotherapy despite medical oncology recommendation were determined. Results One hundred and nine patients were suitable for evaluation. Overall, 72 (66.1%) received adjuvant chemotherapy. Chemotherapy was not recommended in 25 (23.4%) of patients, with the majority (68%) having more than one cited reason. Multiple comorbidities and advanced age were the most common reasons for non-recommendation ( p < 0.01). Age alone was not a reason for not recommending chemotherapy. Twelve (11%) patients declined offered chemotherapy. The reasons for refusal were not detailed in the majority of patient charts (63.6%). Travel distance was not a factor in accepting or refusing chemotherapy. Conclusion Discussion at a multidisciplinary team meeting facilitates the identification of patients unsuitable for adjuvant treatment. The reasons for declining offered chemotherapy need to be assessed fully to ensure that patients' treatment preferences are balanced against the proven benefits of chemotherapy. Attendance at a regional cancer centre provides the opportunity for high standard care in the management of stage III colon cancer.

Marker-based quantitative genetics in the wild?: the heritability and genetic correlation of chemical defenses in eucalyptus.

PubMed

Andrew, R L; Peakall, R; Wallis, I R; Wood, J T; Knight, E J; Foley, W J

2005-12-01

Marker-based methods for estimating heritability and genetic correlation in the wild have attracted interest because traditional methods may be impractical or introduce bias via G x E effects, mating system variation, and sampling effects. However, they have not been widely used, especially in plants. A regression-based approach, which uses a continuous measure of genetic relatedness, promises to be particularly appropriate for use in plants with mixed-mating systems and overlapping generations. Using this method, we found significant narrow-sense heritability of foliar defense chemicals in a natural population of Eucalyptus melliodora. We also demonstrated a genetic basis for the phenotypic correlation underlying an ecological example of conditioned flavor aversion involving different biosynthetic pathways. Our results revealed that heritability estimates depend on the spatial scale of the analysis in a way that offers insight into the distribution of genetic and environmental variance. This study is the first to successfully use a marker-based method to measure quantitative genetic parameters in a tree. We suggest that this method will prove to be a useful tool in other studies and offer some recommendations for future applications of the method.

General Education Today. A Critical Analysis of Controversies, Practices, and Reforms.

ERIC Educational Resources Information Center

Gaff, Jerry G.

The range of controversies and changes emerging from the current revival of general education are examined, and many ideas, examples, and recommendations for achieving realistic and successful curricular reform are offered. Instead of either offering an apology for general education or advocating any particular approach, the book draws on solid…

Links to Learning: Recommended Websites for Your World History Class

ERIC Educational Resources Information Center

Wangerin, Laura

2012-01-01

Technology offers three major benefits to world history teachers: an online supply of supplemental resources; access to creative tools; and the opportunity for students to collaborate. These three positive contributions vary in the degree of involvement they require of students. Supplemental resources offer or display information, but often lack a…

Neurovestibular Considerations for Sub-Orbital Space Flight: A Framework for Future Investigation

PubMed Central

Karmali, Faisal; Shelhamer, Mark

2013-01-01

Commercial sub-orbital operators will soon offer the excitement of traveling to space to thousands of people. Based on previous experience in space flight and parabolic flight, sensorimotor disruptions in eye movements, postural stability, and motor coordination are likely in these travelers. Here we propose a framework for developing strategies to overcome these sensorimotor disruptions. We delineate how approaches should differ from those applied to orbital flight and between sub-orbital passengers and pilots based on differing frequency of flights and mission objectives. Sensorimotor adaptation is one strategy for overcoming disruptions; an important question is whether it occurs quickly enough to be of use during periods of reduced and enhanced gravity lasting less than five minutes. Data are presented showing that sensorimotor adaptation of the pitch vestibulo-ocular reflex during parabolic flight takes a few consecutive days of flying to overcome an initial disruption. We conclude with recommendations for operators and researchers to improve safety and comfort during sub-orbital operations. We recommend using parabolic flight as a tool for pre-adapting sub-orbital passengers, along with further research into the required quantity and timing of these pre-adaptation flights and the tasks conducted during these flights. Likewise, for sub-orbital pilots, we recommend emphasizing recency of experience. PMID:20555165

Soil DNA metabarcoding and high-throughput sequencing as a forensic tool: considerations, potential limitations and recommendations.

PubMed

Young, J M; Austin, J J; Weyrich, L S

2017-02-01

Analysis of physical evidence is typically a deciding factor in forensic casework by establishing what transpired at a scene or who was involved. Forensic geoscience is an emerging multi-disciplinary science that can offer significant benefits to forensic investigations. Soil is a powerful, nearly 'ideal' contact trace evidence, as it is highly individualistic, easy to characterise, has a high transfer and retention probability, and is often overlooked in attempts to conceal evidence. However, many real-life cases encounter close proximity soil samples or soils with low inorganic content, which cannot be easily discriminated based on current physical and chemical analysis techniques. The capability to improve forensic soil discrimination, and identify key indicator taxa from soil using the organic fraction is currently lacking. The development of new DNA sequencing technologies offers the ability to generate detailed genetic profiles from soils and enhance current forensic soil analyses. Here, we discuss the use of DNA metabarcoding combined with high-throughput sequencing (HTS) technology to distinguish between soils from different locations in a forensic context. Specifically, we provide recommendations for best practice, outline the potential limitations encountered in a forensic context and describe the future directions required to integrate soil DNA analysis into casework. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Social work and end-of-life decisions: self-determination and the common good.

PubMed

Wesley, C A

1996-05-01

Client self-determination is the key element of NASW's policy statement about social work intervention in end-of-life decisions. However, both self-determination and the common good must be respected in social work practice and policy regarding end-of-life decisions. This article discusses self-determination in end-of-life decision making, ethical decision making and the NASW Code of Ethics, and professional ethics based on a balanced view of both self-determination and the common good. Recommendations for professional practice and social policy are offered.

Scientific Reporting: Raising the Standards.

PubMed

McLeroy, Kenneth R; Garney, Whitney; Mayo-Wilson, Evan; Grant, Sean

2016-10-01

This article is based on a presentation that was made at the 2014 annual meeting of the editorial board of Health Education & Behavior. The article addresses critical issues related to standards of scientific reporting in journals, including concerns about external and internal validity and reporting bias. It reviews current reporting guidelines, effects of adopting guidelines, and offers suggestions for improving reporting. The evidence about the effects of guideline adoption and implementation is briefly reviewed. Recommendations for adoption and implementation of appropriate guidelines, including considerations for journals, are provided. © 2016 Society for Public Health Education.

Utility of the Electrocardiogram in Drug Overdose and Poisoning: Theoretical Considerations and Clinical Implications

PubMed Central

Yates, Christopher; Manini, Alex F

2012-01-01

The ECG is a rapidly available clinical tool that can help clinicians manage poisoned patients. Specific myocardial effects of cardiotoxic drugs have well-described electrocardiographic manifestations. In the practice of clinical toxicology, classic ECG changes may hint at blockade of ion channels, alterations of adrenergic tone, or dysfunctional metabolic activity of the myocardium. This review will offer a structured approach to ECG interpretation in poisoned patients with a focus on clinical implications and ECG-based management recommendations in the initial evaluation of patients with acute cardiotoxicity. PMID:22708912

Determinants of health: a progressive political platform.

PubMed

Terris, M

1994-01-01

This paper is based on the statement in the Ottawa Charter for Health Promotion that "The fundamental conditions and resources for health are peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice and equity. Improvement in health requires a secure foundation in these basic prerequisites." It attempts to formulate a progressive political platform for a number of these prerequisites, offering a series of recommendations regarding education, employment, income, and housing, and urging that the proposed programs be funded by progressive taxation and major reductions in the military budget.

Guidelines - A Primer for Communicating Effectively with NABIR Stakeholders

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

Weber, James R.; Schell, Charlotte J.; Marino, T

2004-02-10

This version of the communication primer comprises two interlocking parts: Pat 1, a practical section, intended to prepare you for public interactions, and Part 2, a theoretical section that provides social and technical bases for the practices recommended in Part 1. The mutual support of practice and theory is very familiar in science and clearly requires a willingness to observe and revise our prior assumptions--in this document, we invoke both. We hope that is offering will represent a step both towards improving practice and maturing the theory of practical science communication.

Parent ADHD and Evidence-Based Treatment for Their Children: Review and Directions for Future Research

PubMed Central

Woods, Kelsey E.; Strickland, Jennifer; Stein, Mark A.

2017-01-01

One fourth to one half of parents of children with attention-deficit/hyperactivity disorder (ADHD) have ADHD themselves, complicating delivery of evidence-based child behavioral and pharmacological treatments. In this article, we review the literature examining the relation between parent ADHD and outcomes following behavioral and pharmacological treatments for their children with ADHD. We also review research that has incorporated treatment of parent ADHD (either alone or in combination with child treatment) with the goal of improving parenting and child outcomes. Finally, we offer recommendations for future research on the relation between parent ADHD and evidence-based treatment outcomes for their children, with the purpose of advancing the science and informing clinical care of these families. PMID:28025755

Leveraging cues from person-generated health data for peer matching in online communities.

PubMed

Hartzler, Andrea L; Taylor, Megan N; Park, Albert; Griffiths, Troy; Backonja, Uba; McDonald, David W; Wahbeh, Sam; Brown, Cory; Pratt, Wanda

2016-05-01

Online health communities offer a diverse peer support base, yet users can struggle to identify suitable peer mentors as these communities grow. To facilitate mentoring connections, we designed a peer-matching system that automatically profiles and recommends peer mentors to mentees based on person-generated health data (PGHD). This study examined the profile characteristics that mentees value when choosing a peer mentor. Through a mixed-methods user study, in which cancer patients and caregivers evaluated peer mentor recommendations, we examined the relative importance of four possible profile elements: health interests, language style, demographics, and sample posts. Playing the role of mentees, the study participants ranked mentors, then rated both the likelihood that they would hypothetically contact each mentor and the helpfulness of each profile element in helping the make that decision. We analyzed the participants' ratings with linear regression and qualitatively analyzed participants' feedback for emerging themes about choosing mentors and improving profile design. Of the four profile elements, only sample posts were a significant predictor for the likelihood of a mentee contacting a mentor. Communication cues embedded in posts were critical for helping the participants choose a compatible mentor. Qualitative themes offer insight into the interpersonal characteristics that mentees sought in peer mentors, including being knowledgeable, sociable, and articulate. Additionally, the participants emphasized the need for streamlined profiles that minimize the time required to choose a mentor. Peer-matching systems in online health communities offer a promising approach for leveraging PGHD to connect patients. Our findings point to interpersonal communication cues embedded in PGHD that could prove critical for building mentoring relationships among the growing membership of online health communities. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Canadian clinical practice guidelines for acute and chronic rhinosinusitis

PubMed Central

2011-01-01

This document provides healthcare practitioners with information regarding the management of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS) to enable them to better meet the needs of this patient population. These guidelines describe controversies in the management of acute bacterial rhinosinusitis (ABRS) and include recommendations that take into account changes in the bacteriologic landscape. Recent guidelines in ABRS have been released by American and European groups as recently as 2007, but these are either limited in their coverage of the subject of CRS, do not follow an evidence-based strategy, or omit relevant stakeholders in guidelines development, and do not address the particulars of the Canadian healthcare environment. Advances in understanding the pathophysiology of CRS, along with the development of appropriate therapeutic strategies, have improved outcomes for patients with CRS. CRS now affects large numbers of patients globally and primary care practitioners are confronted by this disease on a daily basis. Although initially considered a chronic bacterial infection, CRS is now recognized as having multiple distinct components (eg, infection, inflammation), which have led to changes in therapeutic approaches (eg, increased use of corticosteroids). The role of bacteria in the persistence of chronic infections, and the roles of surgical and medical management are evolving. Although evidence is limited, guidance for managing patients with CRS would help practitioners less experienced in this area offer rational care. It is no longer reasonable to manage CRS as a prolonged version of ARS, but rather, specific therapeutic strategies adapted to pathogenesis must be developed and diffused. Guidelines must take into account all available evidence and incorporate these in an unbiased fashion into management recommendations based on the quality of evidence, therapeutic benefit, and risks incurred. This document is focused on readability rather than completeness, yet covers relevant information, offers summaries of areas where considerable evidence exists, and provides recommendations with an assessment of strength of the evidence base and degree of endorsement by the multidisciplinary expert group preparing the document. These guidelines have been copublished in both Allergy, Asthma & Clinical Immunology and the Journal of Otolaryngology-Head and Neck Surgery. PMID:21310056

The relationship between qualified personnel and self-reported implementation of recommended physical education practices and programs in U.S. schools.

PubMed

Davis, Kristen S; Burgeson, Charlene R; Brener, Nancy D; McManus, Tim; Wechsler, Howell

2005-06-01

The authors analyzed data from the School Health Policies and Programs Study 2000 to assess the associations between the presence of a district physical education coordinator and district-level physical education policies and practices recommended by federal government agencies and national organizations. The authors also examined the relationship between teacher qualifications and staff development related to physical education and self-reported implementation of recommended teachingpractices. District-level data were collected by self-administered mail questionnaires from a nationally representative sample of school districts. Classroom-level data were collected by computer-assisted personal interviews with teachers of randomly selected classes in elementary schools and randomly selected required physical education courses in middle/junior high and senior high schools. Nearly two thirds (62.2%) of districts had a physical education coordinator, and those were generally more likely than other districts to report having policies and practices that corresponded with national recommendations for high-quality physical education programs. More than two thirds of teachers (66.9%) met the criteria for teacher qualifications based on their education and certification. These teachers were more likely than others to report use of certain recommended physical education teaching practices. Teachers who participated in staff development also were more likely to use recommended teaching practices in their classrooms. Using a district physical education coordinator and teachers with appropriate qualifications as well as offering staff development opportunities on physical education may enhance school physical education programs.

A Process Evaluation of Project Developmental Continuity, Interim Report VI: Recommendations for Continuing the Impact Study.

ERIC Educational Resources Information Center

Granville, Arthur; And Others

This interim report re-examines data on instrument suitability, comparability of groups, and adequacy of sample size in Year III of the process evaluation of Project Developmental Continuity (PDC) and offers preliminary recommendations concerning the feasibility of continuing the impact study. PDC is a Head Start demonstration program aimed at…

Recommendations to the Illinois General Assembly on Zoning for Community Residences.

ERIC Educational Resources Information Center

Illinois Planning Council on Developmental Disabilities, Springfield.

The Illinois General Assembly enacted the Community Residence Location Planning Act (CRLPA) to provide assistance to the state's 110 home rule municipalities to help bring their zoning ordinances into compliance with 1988 amendments to the U.S. Fair Housing Act. This report presents the results of this effort and offers recommendations to the…

The Effect of Team Pentathlon on Ten- to Eleven-Year-Old Childrens' Engagement in Physical Activity

ERIC Educational Resources Information Center

Michaud, Valerie; Nadeau, Luc; Martel, Denis; Gagnon, Jocelyn; Godbout, Paul

2012-01-01

Background: To promote regular physical activity (PA) among children and adolescents, authors recommend that physical education (PE) teachers offer their students programmes that would allow them to be physically active outside PE classes. However, such programmes are rarely rigorously assessed and it is recommended that further studies be…

Agenda. Recommendations for National Action in Higher Education. The 96th Congress. A Joint Statement.

ERIC Educational Resources Information Center

National Association of State Universities and Land Grant Colleges, Washington, DC.

Recommendations for national action in higher education are offered by the National Association of State Universities and Land-Grant Colleges and the American Association of State Colleges and Universities. The joint policy statement focuses on issues that the federal government needs to consider including: how to broaden educational opportunity…

17 CFR 275.206(4)-1 - Advertisements by investment advisers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of each such recommendation (e.g., whether to buy, sell or hold), the market price at that time, the price at which the recommendation was to be acted upon, and the market price of each such security as of... graph, chart, formula or other device being offered will assist any person in making his own decisions...

Classroom-tested Recommendations for Teaching Problem Solving within a Traditional College Course: Genetics.

ERIC Educational Resources Information Center

Smith, Mike U.

Both teachers and students alike acknowledge that genetics and genetics problem-solving are extremely difficult to learn and to teach. Therefore, a number of recommendations for teaching college genetics are offered. Although few of these ideas have as yet been tested in controlled experiments, they are supported by research and experience and may…

Indian Nations At Risk, Summary of Issues & Recommendations from Regional Hearings, July-October 1990.

ERIC Educational Resources Information Center

Department of Education, Washington, DC. Indian Nations At Risk Task Force.

The Indian Nations At Risk Task Force held seven regional hearings during 1990 on issues in American Indian education. This document contains detailed reports of the seven hearings, individual summaries of each hearing, and an overall summary of issues and recommendations offered in the field of American Indian education. Major areas of concern…

Disallowing Recommendations for Practice and Policy: A Proposal that Is Both Too Much and Too Little

ERIC Educational Resources Information Center

Harris, Karen R.

2013-01-01

Robinson et al. ("Educ Psychol Rev" 25(2):291-302, 2013) offer a thoughtful and powerful argument for a policy change for primary educational research journals. This policy change would "disallow recommendations for practice" (p. 10) in primary educational research journals. They provided compelling examples of works in which…

Juegos de videos: Investigacion, puntajes y recomendaciones (Video Games: Research, Ratings and Recommendations). ERIC Digest.

ERIC Educational Resources Information Center

Cesarone, Bernard

This Spanish-language digest reviews research on the demographics and effects of video game playing, discusses game rating systems, and offers recommendations for parents. The digest begins by discussing research on the time children spend playing electronic games, which shows that younger children's game playing at home (90% of fourth-graders…

Recommendations for the detection and therapeutic management of cognitive impairment in multiple sclerosis.

PubMed

Bensa, C; Bodiguel, E; Brassat, D; Laplaud, D; Magy, L; Ouallet, J-C; Zephir, H; De Seze, J; Blanc, F

2012-11-01

The aim of the Multiple Sclerosis Think Tank (Groupe de réflexion sur la sclérose en plaques [GRESEP]) is to prescribe recommendations following a systematic literature search and using a Rand Corporation and California University (RAND/UCLA) appropriateness derived method, in response to practical questions that are raised in the management of patients with multiple sclerosis (MS). The topics of this working program were chosen because they were not addressed in the French recommendations and because of the few data in the literature that enabled practices to be based on validated data. Following the theme on useful serum testing with suspected multiple sclerosis, the subjects of the present work concern the detection and management of cognitive impairment in the beginning stages of the disease course. Two clinical questions were asked: which complementary exams (besides physical examination and neuropsychological tests) would help in the screening of cognitive impairment at the beginning of the disease? What care management should the person with MS and cognitive impairment be offered (treatments and neurocognitive rehabilitation)? The recommendations are the result of a consensus amongst a working group, a rating group and a reading group comprised of hospital neurologists involved in the management of patients with multiple sclerosis. Each recommendation is presented with the degree of consensus that it was accorded. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Mandatory and recommended vaccination in the EU, Iceland and Norway: results of the VENICE 2010 survey on the ways of implementing national vaccination programmes.

PubMed

Haverkate, M; D'Ancona, F; Giambi, C; Johansen, K; Lopalco, P L; Cozza, V; Appelgren, E

2012-05-31

This report provides an updated overview of recommended and mandatory vaccinations in the European Union (EU), Iceland and Norway, considering the differences in vaccine programme implementation between countries. In 2010, the Vaccine European New Integrated Collaboration Effort (VENICE) network, conducted a survey among the VENICE project gatekeepers to learn more about how national vaccination programmes are implemented, whether recommended or mandatory. Information was collected from all 27 EU Member States, Iceland and Norway. In total 15 countries do not have any mandatory vaccinations; the remaining 14 have at least one mandatory vaccination included in their programme. Vaccination against polio is mandatory for both children and adults in 12 countries; diphtheria and tetanus vaccination in 11 countries and hepatitis B vaccination in 10 countries. For eight of the 15 vaccines considered, some countries have a mixed strategy of recommended and mandatory vaccinations. Mandatory vaccination may be considered as a way of improving compliance to vaccination programmes. However, compliance with many programmes in Europe is high, using only recommendations. More information about the diversity in vaccine offer at European level may help countries to adapt vaccination strategies based on the experience of other countries. However, any proposal on vaccine strategies should be developed taking into consideration the local context habits.

Ethics of reproductive technology: AFS recommendations, dissent.

PubMed

McCormick, R A

1987-03-01

The Ethics Committee of the American Fertility Society recently released its report, "Ethical Considerations of the New Reproductive Technologies." The report examines general ethical, legal, and biological aspects of and makes ethical recommendations on procreative technologies, from standard in vitro fertilization, through all its possible variations and accompaniments, including donor gametes and preembryos, surrogate mothers, and cryopreservation. The judgment of ethical acceptability of third-party involvement in reproductive technology is the report's weakest aspect. The potential impact of such participation was not sufficiently weighed because of primacy given to a single value: the provision of a baby to an individual couple, or even an individual, who could not otherwise have one. A dissent to the report is based on two analyses: Third-party involvement itself violates the marriage covenant, independent of any potential damaging effects or benefits, and relaxation of marital exclusivity could harm the marriage (and marriage in general) and the prospective child. The committee also failed to resolve the problem of preembryo status. Instead, it recommended that local programs offering reproductive assistance draw up their own policies.

Importance of characteristics and modalities of physical activity and exercise in defining the benefits to cardiovascular health within the general population: recommendations from the EACPR (Part I).

PubMed

Vanhees, L; De Sutter, J; GeladaS, N; Doyle, F; Prescott, E; Cornelissen, V; Kouidi, E; Dugmore, D; Vanuzzo, D; Börjesson, M; Doherty, P

2012-08-01

Over the last decades, more and more evidence is accumulated that physical activity (PA) and exercise interventions are essential components in primary and secondary prevention for cardiovascular disease. However, it is less clear whether and which type of PA and exercise intervention (aerobic exercise, dynamic resistive exercise, or both) or characteristic of exercise (frequency, intensity, time or duration, and volume) would yield more benefit in achieving cardiovascular health. The present paper, as the first of a series of three, will make specific recommendations on the importance of these characteristics for cardiovascular health in the population at large. The guidance offered in this series of papers is aimed at medical doctors, health practitioners, kinesiologists, physiotherapists and exercise physiologists, politicians, public health policy makers, and the individual member of the public. Based on previous and the current literature, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding type, volume, and intensity of PA and exercise.

Cardiovascular emergency preparedness in recreation facilities at major US universities: college fitness center emergency readiness.

PubMed

Herbert, William G; Herbert, David L; McInnis, Kyle J; Ribisl, Paul M; Franklin, Barry A; Callahan, Mandy; Hood, Aaron W

2007-01-01

Recent American Heart Association/American College of Sports Medicine (AHA/ACSM) guidelines advocate preparticipation screening, planning, and rehearsal for emergencies and automated external defibrillators in all health/fitness facilities. The authors evaluated adherence to these recommendations at 158 recreational service departments in major US universities (51% response rate for 313 institutions queried). Many made their facilities available to unaffiliated residents, with 39% offering programs for those with special medical conditions. Only 18% performed universal preparticipation screening. Twenty-seven percent reported having 1 or more exercise-related instances of cardiac arrest or sudden cardiac death within the past 5 years. Seventy-three percent had an automated external defibrillator, but only 6% reported using it in an emergency. Almost all had written emergency plans, but only 50% posted their plans, and only 27% performed the recommended quarterly emergency drills. The authors' findings suggest low awareness of and adherence to the AHA/ACSM recommendations for identifying individuals at risk for exercise-related cardiovascular complications and for handling such emergencies in university-based fitness facilities. (

Chlamydia screening interventions from community pharmacies: a systematic review.

PubMed

Gudka, Sajni; Afuwape, Folasade E; Wong, Bessie; Yow, Xuan Li; Anderson, Claire; Clifford, Rhonda M

2013-07-01

Chlamydia (Chlamydia trachomatis) is the most commonly notified sexually transmissible infection in Australia. Increasing the number of people aged 16-25 years being tested for chlamydia has become a key objective. The strategy recommends that chlamydia screening sites should be easy to access. Community pharmacies are conveniently located and easily accessible. This review aimed to determine the different types of pharmacy-based chlamydia screening interventions, describe their uptake rates, and understand issues around the acceptability of and barriers to testing. Seven electronic databases were searched for peer-reviewed articles published up to 30 October 2011 for studies that reported chlamydia screening interventions from community pharmacies, or had qualitative evidence on acceptability or barriers linked with interventions. Of the 163 publications identified, 12 met the inclusion criteria. Nine reported chlamydia screening interventions in a pharmacy setting, whereas three focussed on perspectives on chlamydia screening. Pharmacists could offer a chlamydia test to consumers attending the pharmacy for a sexual health-related consultation, or consumers could request a chlamydia test as part of a population-based intervention. Participating consumers said pharmacies were accessible and convenient, and pharmacists were competent when offering a chlamydia test. Pharmacists reported selectively offering tests to women they thought would be most at risk, undermining the principles of opportunistic interventions. Chlamydia screening from community pharmacies is feasible, and can provide an accessible, convenient venue to get a test. Professional implementation support, alongside resources, education and training programs, and incentives may overcome the issue of pharmacists selectively offering the test.

Anatomy and Pathophysiology of Spinal Cord Injury Associated With Regional Anesthesia and Pain Medicine: 2015 Update.

PubMed

Neal, Joseph M; Kopp, Sandra L; Pasternak, Jeffrey J; Lanier, William L; Rathmell, James P

2015-01-01

In March 2012, the American Society of Regional Anesthesia and Pain Medicine convened its second Practice Advisory on Neurological Complications in Regional Anesthesia and Pain Medicine. This update is based on the proceedings of that conference and relevant information published since its conclusion. This article updates previously described information on the pathophysiology of spinal cord injury and adds new material on spinal stenosis, blood pressure control during neuraxial blockade, neuraxial injury subsequent to transforaminal procedures, cauda equina syndrome/local anesthetic neurotoxicity/arachnoiditis, and performing regional anesthetic or pain medicine procedures in patients concomitantly receiving general anesthesia or deep sedation. Recommendations are based on extensive review of research on humans or employing animal models, case reports, pathophysiology research, and expert opinion. The pathophysiology of spinal cord injury associated with regional anesthetic techniques is reviewed in depth, including that related to mechanical trauma from direct needle/catheter injury or mass lesions, spinal cord ischemia or vascular injury from direct needle/catheter trauma, and neurotoxicity from local anesthetics, adjuvants, or antiseptics. Specific recommendations are offered that may reduce the likelihood of spinal cord injury associated with regional anesthetic or interventional pain medicine techniques. The practice advisory's recommendations may, in select cases, reduce the likelihood of injury. However, many of the described injuries are neither predictable nor preventable based on our current state of knowledge. Since publication of initial recommendations in 2008, new information has enhanced our understanding of 5 specific entities: spinal stenosis, blood pressure control during neuraxial anesthesia, neuraxial injury subsequent to transforaminal techniques, cauda equina syndrome/local anesthetic neurotoxicity/arachnoiditis, and performing regional anesthetic or pain procedures in patients concomitantly receiving general anesthesia or deep sedation.

A Review of Propulsion Industrial Base Studies and an Introduction to the National Institute of Rocket Propulsion Systems

NASA Technical Reports Server (NTRS)

Doreswamy, Rajiv; Fry, Emma K.

2012-01-01

Over the past decade there have been over 40 studies that have examined the state of the industrial base and infrastructure that supports propulsion systems development in the United States. This paper offers a comprehensive, systematic review of these studies and develops conclusions and recommendations in the areas of budget, policy, sustainment, infrastructure, workforce retention and development and mission/vision and policy. The National Institute for Rocket Propulsion System (NIRPS) is a coordinated, national organization that is responding to the key issues highlighted in these studies. The paper outlines the case for NIRPS and the specific actions that the Institute is taking to address these issues.

Artemisinin-based combination therapy in the treatment of uncomplicated malaria: review of recent regulatory experience at the European Medicines Agency

PubMed Central

Pelfrene, Eric; Pinheiro, Marie-Hélène; Cavaleri, Marco

2015-01-01

Malaria remains a major public health challenge with almost half of the world's population exposed to the risk of contracting the illness. Prompt, effective and well tolerated treatment remains one of the cornerstones in the disease management, with artemisinin-based combination therapy the recommended option for non-severe malaria in endemic areas with predominant Plasmodium falciparum infections. Recent experience has been obtained at the European Medicines Agency with regulatory approval of two such antimalarial fixed combination products. For these cases, two different regulatory pathways were applied. As such, the present contribution describes this experience, emphasising main differences and applicability offered by these regulatory choices. PMID:25855638

Drug offence sentencing practices in the United States of America.

PubMed

Weissman, J C

1984-01-01

The United States criminal justice system, in response to a variety of risks, makes available a range of options to help control drug offenders. Pre-arrest diversion, pre-trial diversion, pre-trial release, probation, split sentencing, warn release, incarceration and parole release are alternative dispositions involving a graduated scale of punishment, incarceration, specific deterrence and rehabilitation. New drug offence sentencing policies are emerging within the criminal justice system. Traditional values of rehabilitation are currently less favoured and contemporary doctrines advocate sentencing based on principles of uniformity and retribution. Drug law sentencing practices are a principal concern of this article and the major policy themes are systematically reviewed. Diversion, criminal responsibility, selective incapacitation, trafficking, and cocaine abuse are examined. Guidelines for policy development are recommended and the analysis covers the related concepts of sentencing ideology, decriminalization, and determinate sentencing models. Specific recommendations are offered for revision of drug offence sentencing policies to incorporate the emerging penal values.

Principles of chronic venous access: recommendations based on the Roswell Park experience.

PubMed

Sabel, M S; Smith, J L

1997-11-01

At Roswell Park Cancer Institute, we have seen a dramatic increase in the need for long-term venous access. Chronic venous catheters are an indispensible part of the treatment provided to oncology patients. Cancer patients are often at higher risk for complications secondary to their underlying disease and treatments. These risks may be minimized by paying close attention to several important aspects of central line placement. These include matching individual patient needs with the access device most suited to those needs, a thorough preoperative assessment, and the safest and most appropriate operative approach for placement. Likewise, the prompt recognition and treatment of complications when they do occur is crucial to the care of these patients. In order to optimize the care of patients with long-term venous access devices, we have reviewed our experience of over 700 vascular access consultations and offer the following recommendations.

Threading Together Patient Expertise

PubMed Central

Civan, Andrea; Pratt, Wanda

2007-01-01

Patients are valuable sources of expertise for other patients in similar situations, but little is understood about the nature of this expertise. To address this knowledge gap, we investigated informational support as a mechanism for peers to help one another learn to cope with the breast cancer experience. We analyzed the types of problems discussed and recommendations offered by correspondents in three online breast cancer communities. Informational support was prevalent and directed towards problems in which correspondents were planning for future events or coping with emergent situations. Peers shared a wealth of patient expertise, including action strategies, recommended knowledge, suggested approaches, and information resources for dealing with problems. Our results highlight how peers are helping one another to learn. These findings bring insight to new support we could provide to patients for developing and sharing patient expertise, such as problem-based information organization and functionality for collaborative problem solving. PMID:18693814

Engaging Girls in STEM: How to Plan or Revamp Your EPO Resources or Activities to be More Effective for Girls

NASA Technical Reports Server (NTRS)

Bleacher, Lora V.; Peterson, Karen A.; Sharma, Mangala; Smith, Denise

2012-01-01

This two-hour workshop, which was held as a follow-on to the plenary session "Engaging Girls in STEM: A Discussion of Foundational and Current Research on What Works," offered research-based insights, resources, and tips to help participants plan or revamp programs and resources aimed at encouraging girls in science. Led by Karen Peterson, PI for the National Girls Collaborative Project,1 the workshop included: a brief discussion about effective strategies recommended for encouraging girls in STEM; hands-on experience, where participants-availing of the expert's guidance-applied the recommended strategies to alter or tailor an existing or planned program/resource to be more girl-friendly; and a sharing out, where the participants reflected on the results of the hands-on exercise and developed action items to continue carrying out the girl-friendly best practices in science, technology, engineering, and math education and public outreach.

Chemotherapy extravasations: prevention, identification, management, and documentation.

PubMed

Gonzalez, Tulia

2013-02-01

The nurses' role in safe and effective practice of chemotherapy administration is paramount. The purpose of this article is to present nurses administering chemotherapy with evidence-based information useful in eliminating or reducing the severity of an injury from a chemotherapy extravasation. Nurse education is essential to prevent, recognize, manage, and document chemotherapy extravasations. The classification of the cytotoxic drug and its mechanism of action is useful when selecting the IV access device and also will direct the nurse's intervention to manage the injury. The Oncology Nursing Society's Chemotherapy and Biotherapy Guidelines and Recommendations for Practice and the drug manufacturer are the best sources offering pharmacologic and nonpharmacologic recommendations. The nurse's best ally in the prevention, prompt recognition, and management of an extravasation is the educated patient. Documenting chemotherapy extravasation is another important step to guide the treatment plan; therefore, the document must provide complete details and the extent of the event.

Perceived discontinuities and continuities in transdisciplinary scientific working groups.

PubMed

Crowston, Kevin; Specht, Alison; Hoover, Carol; Chudoba, Katherine M; Watson-Manheim, Mary Beth

2015-11-15

We examine the DataONE (Data Observation Network for Earth) project, a transdisciplinary organization tasked with creating a cyberinfrastructure platform to ensure preservation of and access to environmental science and biological science data. Its objective was a difficult one to achieve, requiring innovative solutions. The DataONE project used a working group structure to organize its members. We use organizational discontinuity theory as our lens to understand the factors associated with success in such projects. Based on quantitative and qualitative data collected from DataONE members, we offer recommendations for the use of working groups in transdisciplinary synthesis. Recommendations include welcome diverse opinions and world views, establish shared communication practices, schedule periodic synchronous face-to-face meetings, and ensure the active participation of bridge builders or knowledge brokers such as librarians who know how to ask questions about disciplines not their own. Copyright © 2015 Elsevier B.V. All rights reserved.

TANF policy: past, present, and future directions.

PubMed

Washington, Gregory; Sullivan, Michael; Washington, Edwina Thomas

2006-01-01

The purpose of this article is to offer a brief and concise history of relevant public welfare policies for a discussion of the effects of public welfare reform, and how it impacts families in ways not comprehensively understood. Social scientists' concerns about the potential for the families to be thrust into an "extreme poverty" status due to the forced workforce participation requirement and expiration of time limited benefits is discussed. A second concern regarding a "one size fits all" approach to work requirements for TANF recipients being unrealistic and insensitive is also discussed. The authors recommend a comprehensive multi-system analysis to determine the impact of welfare reform. There is also a recommendation that the workforce requirements should correlate to an assessment score based on the ability of welfare recipients to function in identified areas. Implications of maintaining a welfare reform policy status quo are identified.

Toward Defining, Measuring, and Evaluating LGBT Cultural Competence for Psychologists

PubMed Central

Boroughs, Michael S.; Andres Bedoya, C.; O'Cleirigh, Conall; Safren, Steven A.

2015-01-01

A central part of providing evidence-based practice is appropriate cultural competence to facilitate psychological assessment and intervention with diverse clients. At a minimum, cultural competence with lesbian, gay, bisexual, and transgender (LGBT) people involves adequate scientific and supervised practical training, with increasing depth and complexity across training levels. In order to further this goal, we offer 28 recommendations of minimum standards moving toward ideal training for LGBT-specific cultural competence. We review and synthesize the relevant literature to achieve and assess competence across the various levels of training (doctoral, internship, post-doctoral, and beyond) in order to guide the field towards best practices. These recommendations are aligned with educational and practice guidelines set forth by the field and informed by other allied professions in order to provide a roadmap for programs, faculty, and trainees in improving the training of psychologists to work with LGBT individuals. PMID:26279609

Aetiological diagnosis of child deafness: CODEPEH recommendations.

PubMed

Núñez-Batalla, Faustino; Jáudenes-Casaubón, Carmen; Sequí-Canet, Jose Miguel; Vivanco-Allende, Ana; Zubicaray-Ugarteche, Jose; Cabanillas-Farpón, Rubén

Important progress in the fields of molecular genetics (principally) and diagnostic imaging, together with the lack of a consensus protocol for guiding the diagnostic process after confirming deafness by neonatal screening, have led to this new work document drafted by the Spanish Commission for the Early Detection of Child Deafness (Spanish acronym: CODEPEH). This 2015 Recommendations Document, which is based on the most recent scientific evidence, provides guidance to professionals to support them in making decisions regarding aetiological diagnosis. Such diagnosis should be performed without delay and without impeding early intervention. Early identification of the causes of deafness offers many advantages: it prevents unnecessary trouble for the families, reduces health system expenses caused by performing different tests, and provides prognostic information that may guide therapeutic actions. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

The agency problem and medical acting: an example of applying economic theory to medical ethics.

PubMed

Langer, Andreas; Schröder-Bäck, Peter; Brink, Alexander; Eurich, Johannes

2009-03-01

In this article, the authors attempt to build a bridge between economic theory and medical ethics to offer a new perspective to tackle ethical challenges in the physician-patient encounter. They apply elements of new institutional economics to the ethically relevant dimensions of the physician-patient relationship in a descriptive heuristic sense. The principal-agent theory can be used to analytically grasp existing action problems in the physician-patient relationship and as a basis for shaping recommendations at the institutional level. Furthermore, the patients' increased self-determination and modern opportunities for the medical laity to inform themselves lead to a less asymmetrical distribution of information between physician and patient and therefore require new interaction models. Based on the analysis presented here, the authors recommend that, apart from the physician's necessary individual ethics, greater consideration should be given to approaches of institutional ethics and hence to incentive systems within medical ethics.

[Comprehensive quality management in hospitals--experience and recommendations].

PubMed

Schubert, H J

1999-03-01

Total quality management concepts, increasingly being introduced into hospitals, offer opportunities for integrative leadership concepts because of their multidimensional character viewed from the aspects of results and from the standpoint of organisational design. Customized for leadership and organisation of hospitals in Germany, questions of introduction strategies as well as recommendations for the integration of total quality understanding into the daily practice of management and employees are discussed. The active support of top and middle management and a combination of radical change in selected problem areas and continual incremental improvements on a broad base have been proven as significant factors for the success in the introductory phase. For a lasting integration of the principles of a comprehensive quality management concept in a hospital, it will be necessary to carry out regularly relevant measurements of success. The results become an important part of agreements with management.

Recommendations for palliative and bereavement care in the NICU: a family-centered integrative approach.

PubMed

Kenner, C; Press, J; Ryan, D

2015-12-01

Technological advances have increased our ability to detect a life-threatening, life-limiting or lethal problem early in pregnancy, leaving parents months to anticipate a death or a prematurely born infant. Babies can also be born with unanticipated problems that could lead to death. In either scenario, perinatal palliative care should be offered as a strategy for family support. Since the preponderance of professional training focuses on saving lives, many health professionals are uncomfortable with palliative care. This article's purpose is to define best practices for the provision of family-centered perinatal and neonatal palliative care and provision of support to bereaved families experiencing anticipated and unanticipated life-limiting conditions or death of their infant. An overview of core concepts and values is presented, followed by intervention strategies to promote an integrated family-centered approach to palliative and bereavement care. The concluding section presents evidence-based recommendations.

Lessons Learned from the Evolution of an Academic Community Partnership: Creating "Patient Voices".

PubMed

Chambers, Meghan K; Ireland, Anna; D'Aniello, Rona; Lipnicki, Stephanie; Glick, Myron; Tumiel-Berhalter, Laurene

2015-01-01

Long-term partners received federal funding to develop the Patient Voices Network, a partnership of safety-net family practices and their patients to develop health improvement strategies. The scope and structure of the newly funded grant presented unexpected challenges that threatened the future of the partnership.Purpose of Article: To present a case study of the evolution of an existing partnership and offer lessons learned along with recommendations for future partnerships. Federal funding formalized the partnership in a way that required looking at it through a new lens. Leadership, programmatic, personnel, and financial challenges emerged. Short-term and long-term strategies were applied to address evolving needs. This case study demonstrates how federal funding raises the bar for academic-community partnerships and how challenges can be worked through, particularly if the partnership embraces the key principles of community-based participatory research (CBPR). Recommendations have been applied successfully to future initiatives.

OFT, VBP: QED?

PubMed

Claxton, Karl

2007-06-01

The report by the Office of Fair Trading (OFT) on the UK pharmaceutical price regulation scheme (PPRS) recommends the reform of the current scheme, which is a combination of profit and price controls, to one where price is based on the health benefits offered by a pharmaceutical. On closer examination some of the more commonly expressed concerns about these proposals do not seem to be well founded. In principle, the OFT's recommendations may contribute to allocative and dynamic efficiency in the NHS. However, there are some dangers and the details of how it will be implemented are crucial. For example, value-based pricing with an inappropriate threshold for cost-effectiveness, or an inappropriate pricing structure, could lead to technologies being adopted at prices where their benefits, in terms of health outcome, do not offset the health displaced elsewhere in the NHS, a situation in which the NHS is damaged rather than improved by innovation. A failure to account for uncertainty and the value of evidence in negotiating prices and coverage could also undermine the evidence base for future NHS practice. Whatever view is taken, the OFT report will inevitably shape the scope of future policy debates about value, guidance, price and innovation.

[Schools meals in French secondary state schools: compliance to national recommendations and schools catering patterns].

PubMed

Bertin, M; Lafay, L; Calamassi-Tran, G; Volatier, J-L; Dubuisson, C

2011-02-01

Recent reports on the lack of nutritional quality of meals served in schools have led public authorities to draft, in 1999, recommendations for restoring a balanced food supply. Following the survey carried out by the French food safety Agency in 2005-2006, which highlighted gaps in the implementation of these recommendations, a law passed in July 2010 plans to make these recommendations mandatory, as their 2007 revised version. Thus, the objective of this study was to assess initial school compliance with regard to this last revised version of the recommendations and to identify school patterns through their catering management and implication in a dietary project. Seven hundred and seven secondary state schools were questioned (570 were administrated by the Ministry of Education and 137 by the Ministry of Agriculture) on their catering practices. Twenty consecutive menus from each school were also analyzed with a specific coding system to establish its nutritional composition for comparison with the 2007 recommendations. On average, schools complied with half of the recommendations. Good compliance was observed with the 2007 recommendations concerning fried products, starchy foods, fruits, and dairy products whereas very few schools were in compliance with recommendations concerning fish, cheeses and sweetened desserts containing less than 15 % fat and more than 20 g of sugar per portion. Furthermore, compliance with recommendations was significantly better for lunch meals, and even better for agricultural establishments. A 5-component meal was also associated with greater compliance with the recommendations. In addition, four school patterns were identified based on catering management practices. The first two categories of establishments had knowledge of the recommendations but exhibited different levels of application. The last two types of establishments had no knowledge of the recommendations and differed in their catering management practices. Compliance with recommendations was contrasted, with high adequacy for some guidelines and low for others. Nevertheless, application of the current guidelines and real implication of the school in a dietary project did improve the dietary offer in such schools. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Clinical Practice Guideline Focused Update.

PubMed

Denduluri, Neelima; Chavez-MacGregor, Mariana; Telli, Melinda L; Eisen, Andrea; Graff, Stephanie L; Hassett, Michael J; Holloway, Jamie N; Hurria, Arti; King, Tari A; Lyman, Gary H; Partridge, Ann H; Somerfield, Mark R; Trudeau, Maureen E; Wolff, Antonio C; Giordano, Sharon H

2018-05-22

Purpose To update key recommendations of the ASCO guideline adaptation of the Cancer Care Ontario guideline on the selection of optimal adjuvant chemotherapy regimens for early breast cancer and adjuvant targeted therapy for breast cancer. Methods An Expert Panel conducted targeted systematic literature reviews guided by a signals approach to identify new, potentially practice-changing data that might translate to revised practice recommendations. Results The Expert Panel reviewed phase III trials that evaluated adjuvant capecitabine after completion of standard preoperative anthracycline- and taxane-based combination chemotherapy by patients with early-stage breast cancer HER2-negative breast cancer with residual invasive disease at surgery; the addition of 1 year of adjuvant pertuzumab to combination chemotherapy and trastuzumab for patients with early-stage, HER2-positive breast cancer; and the use of neratinib as extended adjuvant therapy for patients after combination chemotherapy and trastuzumab-based adjuvant therapy with early-stage, HER2-positive breast cancer. Recommendations Patients with early-stage HER2-negative breast cancer with pathologic, invasive residual disease at surgery following standard anthracycline- and taxane-based preoperative therapy may be offered up to six to eight cycles of adjuvant capecitabine. Clinicians may add 1 year of adjuvant pertuzumab to trastuzumab-based combination chemotherapy in patients with high-risk, early-stage, HER2-positive breast cancer. Clinicians may use extended adjuvant therapy with neratinib to follow trastuzumab in patients with early-stage, HER2-positive breast cancer. Neratinib causes substantial diarrhea, and diarrhea prophylaxis must be used. Additional information can be found at www.asco.org/breast-cancer-guidelines .

Symptoms, Diagnosis, and Treatment of Cow's Milk Allergy.

PubMed

Vandenplas, Yvan; Marchand, Johan; Meyns, Lien

2015-01-01

The diagnosis and management of cow's milk allergy (CMA) is a topic of debate because there are no specific symptoms and reliable diagnostic tests. Literature was searched using databases to find original papers and reviews on this topic. A "challenge test" is still recommended as the most specific and sensitive diagnostic test, although a positive challenge test does not proof the involvement of the immune system. Only in the rare case of anaphylaxis, the challenge tests is not recommended. The Cow's Milk Symptom Score (CoMiSS) is an awareness tool for health care professionals to better recognize symptoms caused by the ingestion of cow's milk, but still needs validation. Today, the recommended diagnostic approach consists of an elimination diet with an extensive cow's milk based hydrolysate, followed by a challenge test. Amino acid based formula is reserved for the severe cases. Rice hydrolysates are gaining popularity, because they have been shown to be effective, have a better acceptability, and to be cheaper than the extensive cow's milk based hydrolysates. Soy infant formula may offer an additional alternative option as reviews concluded that about 10-15% of infants allergic to cow's milk will also react to soy. Gastro-intestinal microbiota manipulation may be of additional benefit in the treatment of CMA. The development of rice hydrolysates challenge the use of Today, extensive cow's milk based extensive hydrolysates remain the first option for the majority of patients and amino acid formula for the most severe cases. Rice hydrolysates and soy infant formula are considered as second choice options.

Engaging youth in research planning, design and execution: Practical recommendations for researchers.

PubMed

Hawke, Lisa D; Relihan, Jacqueline; Miller, Joshua; McCann, Emma; Rong, Jessica; Darnay, Karleigh; Docherty, Samantha; Chaim, Gloria; Henderson, Joanna L

2018-06-01

Engaging youth as partners in academic research projects offers many benefits for the youth and the research team. However, it is not always clear to researchers how to engage youth effectively to optimize the experience and maximize the impact. This article provides practical recommendations to help researchers engage youth in meaningful ways in academic research, from initial planning to project completion. These general recommendations can be applied to all types of research methodologies, from community action-based research to highly technical designs. Youth can and do provide valuable input into academic research projects when their contributions are authentically valued, their roles are clearly defined, communication is clear, and their needs are taken into account. Researchers should be aware of the risk of tokenizing the youth they engage and work proactively to take their feedback into account in a genuine way. Some adaptations to regular research procedures are recommended to improve the success of the youth engagement initiative. By following these guidelines, academic researchers can make youth engagement a key tenet of their youth-oriented research initiatives, increasing the feasibility, youth-friendliness and ecological validity of their work and ultimately improve the value and impact of the results their research produces. © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.

New guidelines for topical NSAIDs in the osteoarthritis treatment paradigm.

PubMed

Altman, Roy D

2010-12-01

Osteoarthritis (OA), the most common form of arthritis, often affects hands, hips, and knees and involves an estimated 26.9 million US adults. Women have a higher prevalence of OA, and the risk of developing OA increases with age, obesity, and joint malalignment. OA typically presents with pain and reduced function. Therapeutic programs are often multimodal and must take into account pharmaceutical toxicities and patient comorbidities. For example, nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with cardiovascular, gastrointestinal, and renal adverse events. Topical NSAIDs offer efficacy with reduced systemic drug exposure. This is a review of current guideline recommendations regarding the use of topical NSAIDs in OA of the hand and knee. Articles were identified by PubMed search (January 1, 2000 to May 21, 2010). Several current guidelines for management of OA recommend topical NSAIDs, indicating them as a safe and effective treatment. One guideline recommends that topical NSAIDs be considered as first-line pharmacologic therapy. A US guideline for knee OA recommends topical NSAIDs in older patients and in patients with increased gastrointestinal risk. The consensus across US and European OA guidelines is that topical NSAIDs are a safe and effective treatment for OA. Because the research base on topical NSAIDs for OA is small, guidelines will continue to evolve.

Adherence to nutritional recommendations in vending machines at secondary schools in Madrid (Spain), 2014-2015.

PubMed

Monroy-Parada, Doris Xiomara; Jácome-González, María Luisa; Moya-Geromini, María Ángeles; Rodríguez-Artalejo, Fernando; Royo-Bordonada, Miguel Ángel

2017-07-13

To describe the nutritional content of products offered in food and drink vending machines at secondary schools in the Madrid Autonomous Community (Spain), and to evaluate these items' adherence to the nutritional recommendations of the National Health System Consensus Document on School Food. Cross-sectional study of a sample of 330 secondary schools in Madrid across the period 2014-2015. Secondary school vending machines were identified by telephone interview. The products offered in a representative sample of six machines were identified by inspection in situ, and their nutritional composition was obtained from the labelling. A total of 94.5% of the 55 products on offer failed to comply with at least one nutritional criterion of the Consensus Document on School Food. The recommendation relating to sugar content registered the highest level of non-compliance, with 52.7% of products, followed by the recommendations relating to energy (47.3%) and fats (45.5%). The mean number of unmet criteria was 2.2, with this figure being higher in foods than in drinks (2.8 versus 1; p <0.01). Almost all the products on display in secondary school vending machines in Madrid were in breach of the Consensus Document on School Food, mainly due to an excess of calories, sugars and fats. Compulsory nutritional criteria and a procedure for monitoring adherence should be established, specifying those responsible for performing this task and the corrective measures to be applied in the event of non-compliance. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Una Nacion En Peligro: La Necesidad Imperiosa de Reformar La Ensenanza. (A Nation at Risk: The Imperative for Educational Reform).

ERIC Educational Resources Information Center

National Commission on Excellence in Education (ED), Washington, DC.

This report: (1) investigates the declining state of the educational system in America, as measured by high school student performance in the United States and other countries; (2) identifies specific problem areas; and (3) offers multiple recommendations for improvement. The five major recommendations arrived at appear, respectively, under the…

The procurement of cells for the derivation of human embryonic stem cell lines for therapeutic use: recommendations for good practice.

PubMed

Murdoch, Alison; Braude, Peter; Courtney, Aidan; Brison, Daniel; Hunt, Charles; Lawford-Davies, James; Moore, Harry; Stacey, Glyn; Sethe, Sebastian

2012-03-01

The donation of human embryos for the derivation of embryonic stem cell lines that may be used in the development of therapeutic products raises more complex ethical, practical and regulatory problems than the donation of embryos for non-clinical research. This review considers these issues and offers recommendations for good practice.

A Digest of Reports of the Carnegie Commission on Higher Education. With an Index to Recommendations and Suggested Assignments of Responsibility for Action.

ERIC Educational Resources Information Center

Carnegie Commission on Higher Education , Berkeley, CA.

In 21 reports issued over the span of almost six years, the Carnegie Commission on Higher Education has made available a massive resource of information for policymakers in colleges and universities, government agencies, and philanthropic and business organizations. The Commission has also offered nearly 300 individual recommendations for…

Reaching Out to Youth: A Report of the Commission on the Mental Health of Adolescents and Young Adults.

ERIC Educational Resources Information Center

Texas Univ., Austin. Hogg Foundation for Mental Health.

This report offers task force recommendations to provide greater support and understanding for adolescents and young adults. The Commission report and recommendations focus on the issues of teenage pregnancy, drug and alcohol abuse, juvenile delinquency, dropping out of school, and suicide. Part 1, "Growing Up in Texas," begins with an…

Keeping Score: Direct Student Lending. An Evaluation Prepared for the Iowa College Student Aid Commission and the Iowa Student Loan Liquidity Corporation.

ERIC Educational Resources Information Center

Chance, William

This paper provides recommendations for the development, implementation, and evaluation of a demonstration program designed to assess direct lending as a replacement for the current federal student loan program. It offers a list of principles which the demonstration project should address. Recommendations include: (1) maintenance of student…

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

ERIC Educational Resources Information Center

Universities UK, 2011

2011-01-01

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

The Gender Equity Movement in Women's Sports: A Literature Review and Recommendations.

ERIC Educational Resources Information Center

Karr-Kidwell, PJ; Sorenson, Karen

This paper provides a review of the literature published between 1973 and 1993 related to the gender equity movement on varsity and collegiate levels of women's sports, and offers recommendations for women's sports into the 21st century. The paper focuses on the equity movement in the 20th century, including a historical perspective of women in…

Secondary Statistical Modeling with the National Assessment of Adult Literacy: Implications for the Design of the Background Questionnaire. Working Paper Series.

ERIC Educational Resources Information Center

Kaplan, David

This paper offers recommendations to the National Center for Education Statistics (NCES) on the development of the background questionnaire for the National Assessment of Adult Literacy (NAAL). The recommendations are from the viewpoint of a researcher interested in applying sophisticated statistical models to address important issues in adult…

The Psychology of Working Theory.

PubMed

Duffy, Ryan D; Blustein, David L; Diemer, Matthew A; Autin, Kelsey L

2016-03-01

In the current article, we build on research from vocational psychology, multicultural psychology, intersectionality, and the sociology of work to construct an empirically testable Psychology of Working Theory (PWT). Our central aim is to explain the work experiences of all individuals, but particularly people near or in poverty, people who face discrimination and marginalization in their lives, and people facing challenging work-based transitions for which contextual factors are often the primary drivers of the ability to secure decent work. The concept of decent work is defined and positioned as the central variable within the theory. A series of propositions is offered concerning (a) contextual predictors of securing decent work, (b) psychological and economic mediators and moderators of these relations, and (c) outcomes of securing decent work. Recommendations are suggested for researchers seeking to use the theory and practical implications are offered concerning counseling, advocacy, and public policy. (c) 2016 APA, all rights reserved).

A social-ecological systems approach for environmental management.

PubMed

Virapongse, Arika; Brooks, Samantha; Metcalf, Elizabeth Covelli; Zedalis, Morgan; Gosz, Jim; Kliskey, Andrew; Alessa, Lilian

2016-08-01

Urgent environmental issues are testing the limits of current management approaches and pushing demand for innovative approaches that integrate across traditional disciplinary boundaries. Practitioners, scholars, and policy-makers alike call for increased integration of natural and social sciences to develop new approaches that address the range of ecological and societal impacts of modern environmental issues. From a theoretical perspective, social-ecological systems (SES) science offers a compelling approach for improved environmental management through the application of transdisciplinary and resilience concepts. A framework for translating SES theory into practice, however, is lacking. In this paper, we define the key components of an SES-based environmental management approach. We offer recommendations for integrating an SES approach into existing environmental management practices. Results presented are useful for management professionals that seek to employ an SES environmental management approach and scholars aiming to advance the theoretical foundations of SES science for practical application. Published by Elsevier Ltd.

Violence and abuse against people with disabilities: A comparison of the approaches of the European Court of Human Rights and the United Nations Committee on the Rights of Persons with Disabilities.

PubMed

Lewis, Oliver; Campbell, Ann

This paper explores how, and how effectively, two systems of international law have addressed exploitation, violence and abuse of people with mental disabilities. The two international systems reviewed were the Council of Europe's European Court of Human Rights and the United Nations Committee on the Rights of Persons with Disabilities. The two issues dealt with are (a) forced institutionalisation and denial of community-based services and (b) medically-sanctioned treatment as abuse or violence. The paper offers a comparative analysis of the way in which the two bodies have dealt with exploitation, violence and abuse of people with disabilities, and offers recommendations as to how the two bodies could adjust their approaches to come into closer alignment. Copyright © 2017. Published by Elsevier Ltd.

The changing landscape of biosimilars in rheumatology

PubMed Central

Dörner, Thomas; Strand, Vibeke; Cornes, Paul; Gonçalves, João; Gulácsi, László; Kvien, Tore K; Tanaka, Yoshiya; Burmester, Gerd R

2016-01-01

Biosimilars remain a hot topic in rheumatology, and some physicians are cautious about their application in the real world. With many products coming to market and a wealth of guidelines and recommendations concerning their use, there is a need to understand the changing landscape and the real clinical and health-economic potential offered by these agents. Notably, rheumatologists will be at the forefront of the use of biosimilar monoclonal antibodies/soluble receptors. Biosimilars offer cost savings and health gains for our patients and will play an important role in treating rheumatic diseases. We hope that these lower costs will compensate for inequities in access to therapy based on economic differences across countries. Since approved biosimilars have already demonstrated highly similar efficacy, it will be most important to establish pharmacovigilance databases across countries that are adequate to monitor long-term safety after marketing approval. PMID:26964144

The law of incidental findings in human subjects research: establishing researchers' duties.

PubMed

Wolf, Susan M; Paradise, Jordan; Caga-anan, Charlisse

2008-01-01

Research technologies can now produce so much information that there is significant potential for incidental findings (IFs). These are findings generated in research that are beyond the aims of the study. Current law and federal regulations offer no direct guidance on how to deal with IFs in research, nor is there adequate professional or institutional guidance. We advocate a defined set of researcher duties based on law and ethics and recommend a pathway to be followed in handling IFs in research. This article traces the underlying ethical and legal theories supporting researcher duties to manage IFs, including duties to develop a plan for management in the research protocol, to discuss the possibility of and management plan for IFs in the informed consent process, and to address, evaluate, and ultimately offer to disclose IFs of potential clinical or reproductive significance to research participants when they arise.

[School meals: state of the art and recommendations].

PubMed

Aranceta Bartrina, J; Pérez Rodrigo, C; Dalmau Serra, J; Gil Hernández, A; Lama More, R; Martín Mateos, M A; Martínez Suárez, V; Pavón Belinchón, P; Suárez Cortina, L

2008-07-01

School meals contribute substantially to overall energy and nutrient intake adequacy of children, but also play an important role in the development of child food habits and the socialisation process. Evidence shows that school based environmental actions, which include changes in school meals and school food policies related to increased availability and access to healthy foods and drinks while in the school are effective to foster healthy eating practices among children. A growing number of children engage in school meals. Available information to date shows that the quality of the food on offer is not always consistent with dietary guidelines. Vegetables and fish are served less often than desirable and excess added fats are used in food preparations. Norms and regulations are very detailed regarding food safety issues and administrative management of the service, including subcontracting of catering providers and care staff. Nutrition and health promotion issues should also be included in regulations by means of nutrition recommendations for school meals along with information on food based dietary guidelines and portion sizes. School meals should be part of the educational project using a whole school approach.

Instrumentation issues in implementation science.

PubMed

Martinez, Ruben G; Lewis, Cara C; Weiner, Bryan J

2014-09-04

Like many new fields, implementation science has become vulnerable to instrumentation issues that potentially threaten the strength of the developing knowledge base. For instance, many implementation studies report findings based on instruments that do not have established psychometric properties. This article aims to review six pressing instrumentation issues, discuss the impact of these issues on the field, and provide practical recommendations. This debate centers on the impact of the following instrumentation issues: use of frameworks, theories, and models; role of psychometric properties; use of 'home-grown' and adapted instruments; choosing the most appropriate evaluation method and approach; practicality; and need for decision-making tools. Practical recommendations include: use of consensus definitions for key implementation constructs; reporting standards (e.g., regarding psychometrics, instrument adaptation); when to use multiple forms of observation and mixed methods; and accessing instrument repositories and decision aid tools. This debate provides an overview of six key instrumentation issues and offers several courses of action to limit the impact of these issues on the field. With careful attention to these issues, the field of implementation science can potentially move forward at the rapid pace that is respectfully demanded by community stakeholders.

PubMed

Ströhle, Alexander; Löser, Christian; Behrendt, Isabel; Leitzmann, Claus; Hahn, Andreas

2018-02-01

Alternative diets (AD) differ from the current common mixed diet; AD are recommended as a permanent diet. These diets are based on ethical, philosophical and health promoting principles and lead to very different recommendations for food selection. Even within a particular AD there is usually a broad spectrum of versions, so that a general evaluation is only possible to a limited extent. This is also true for single AD. Vegetarian diets and partly paleo-diets have been investigated to a reasonable extent. Plant based diets are appropriate as permanent diets and offer health benefits as compared with currently practiced diets (risk reduction of cancers by 10-18% and of heart diseases by 30%; favorable effect on blood pressure and lipid profile; no risk reduction on cancer and total mortality). Vegan diets have to be critically assessed: they are linked to an increased risk of deficits for single nutrients (vitamin B 12 , iodine and as the case may be. calcium and long chain omega-3 fatty acids), if suitable supplements or fortified foods are not consumed. © Georg Thieme Verlag KG Stuttgart · New York.

Computer-assisted generation of individual training concepts for advanced education in manufacturing metrology

NASA Astrophysics Data System (ADS)

Werner, Teresa; Weckenmann, Albert

2010-05-01

Due to increasing requirements on the accuracy and reproducibility of measurement results together with a rapid development of novel technologies for the execution of measurements, there is a high demand for adequately qualified metrologists. Accordingly, a variety of training offers are provided by machine manufacturers, universities and other institutions. Yet, for an interested learner it is very difficult to define an optimal training schedule for his/her individual demands. Therefore, a computer-based assistance tool is developed to support a demand-responsive scheduling of training. Based on the difference between the actual and intended competence profile and under consideration of amending requirements, an optimally customized qualification concept is derived. For this, available training offers are categorized according to different dimensions: regarding contents of the course, but also intended target groups, focus of the imparted competences, implemented methods of learning and teaching, expected constraints for learning and necessary preknowledge. After completing a course, the achieved competences and the transferability of gathered knowledge are evaluated. Based on the results, recommendations for amending measures of learning are provided. Thus, a customized qualification for manufacturing metrology is facilitated, adapted to the specific needs and constraints of each individual learner.

Guidelines for the development of social marketing programmes for sun protection among adolescents and young adults.

PubMed

Johnson, K M; Jones, S C; Iverson, D

2009-09-01

To formulate 'best practice' guidelines for social marketing programmes for adolescents' and young adults' sun protection. A Delphi consensus process. Eleven experts in sun protection and social marketing participated in a Delphi consensus process, where they were asked to provide up to 10 key points, based on their knowledge and practical experience, which they felt were most important in developing social marketing interventions for the primary prevention of skin cancer among adolescents and young adults. After reaching consensus, the evidence base for each guideline was determined and graded via the Scottish Intercollegiate Guideline Network grading system. Participants were then asked to indicate how strongly they rated the finalized 15 recommendations based on all aspects relating to their knowledge and practical opinion, as well as the research evidence, on a visual analogue scale. The resultant 15 guidelines offer general principles for sun protection interventions utilizing a social marketing approach. This method of guideline development brought the expertise of practitioners to the forefront of guideline development, whilst still utilizing established methods of evidence confirmation. It thus offers a useful method for guideline development in a public health context.

Asthma patient education opportunities in predominantly minority urban communities.

PubMed

Zayas, Luis E; McLean, Don

2007-12-01

Disenfranchised ethnic minority communities in the urban United States experience a high burden of asthma. Conventional office-based patient education often is insufficient to promote proper asthma management and coping practices responsive to minority patients' environments. This paper explores existing and alternative asthma information and education sources in three urban minority communities in western New York State to help design other practical educational interventions. Four focus groups (n = 59) and four town hall meetings (n = 109) were conducted in one Hispanic and two black communities. Focus groups included adult asthmatics or caretakers of asthmatics, and town meetings were open to all residents. A critical theory perspective informed the study. Asthma information and education sources, perceptions of asthma and ways of coping were elicited through semi-structured interviews. Data analysis followed a theory-driven immersion-crystallization approach. Several asthma education and information resources from the health care system, media, public institutions and communities were identified. Intervention recommendations highlighted asthma workshops that recognize participants as teachers and learners, offer social support, promote advocacy, are culturally appropriate and community-based and include health care professionals. Community-based, group health education couched on people's experiences and societal conditions offers unique opportunities for patient asthma care empowerment in minority urban communities.

Examining preferences for website support to parents of adolescents with diabetes.

PubMed

Nicholas, David B; Gutwin, Carl; Paterson, Barbara

2013-01-01

Diabetes can be stressful as parents seek optimal outcomes for their adolescent with type 1 diabetes. This study examined parents' interest and perspectives related to online diabetes resources. Based on a qualitative description approach, 14 qualitative group interviews were conducted with (i) parents of adolescents with diabetes (n = 29), and (ii) pediatric health care providers (n = 31). Participants were recruited, through a purposive sampling approach, at pediatric centers in three Canadian cities. Qualitative data were subjected to thematic analysis comprising data coding, categorization, and ultimate theme generation. Participants described parental care for adolescents with diabetes as complex and reflective of difficult and nuanced tasks. They recommended the development of a comprehensive parent-based information and support website, and identified crucial elements of the website. Overarching themes comprised the following: complex parenting processes in diabetes care, parents' need for information and support, challenges and benefits of online support, key elements of an online resource, and caution regarding online resources. Based on these findings, website information and support emerged as a viable and desired resource for augmenting pediatric care within clinical settings. Caution was also offered in addressing potential challenges inherent in online support. Findings offer guidance for online support to parents.

Integrating Information Extraction Agents into a Tourism Recommender System

NASA Astrophysics Data System (ADS)

Esparcia, Sergio; Sánchez-Anguix, Víctor; Argente, Estefanía; García-Fornes, Ana; Julián, Vicente

Recommender systems face some problems. On the one hand information needs to be maintained updated, which can result in a costly task if it is not performed automatically. On the other hand, it may be interesting to include third party services in the recommendation since they improve its quality. In this paper, we present an add-on for the Social-Net Tourism Recommender System that uses information extraction and natural language processing techniques in order to automatically extract and classify information from the Web. Its goal is to maintain the system updated and obtain information about third party services that are not offered by service providers inside the system.

Panacea, a semantic-enabled drug recommendations discovery framework.

PubMed

Doulaverakis, Charalampos; Nikolaidis, George; Kleontas, Athanasios; Kompatsiaris, Ioannis

2014-03-06

Personalized drug prescription can be benefited from the use of intelligent information management and sharing. International standard classifications and terminologies have been developed in order to provide unique and unambiguous information representation. Such standards can be used as the basis of automated decision support systems for providing drug-drug and drug-disease interaction discovery. Additionally, Semantic Web technologies have been proposed in earlier works, in order to support such systems. The paper presents Panacea, a semantic framework capable of offering drug-drug and drug-diseases interaction discovery. For enabling this kind of service, medical information and terminology had to be translated to ontological terms and be appropriately coupled with medical knowledge of the field. International standard classifications and terminologies, provide the backbone of the common representation of medical data while the medical knowledge of drug interactions is represented by a rule base which makes use of the aforementioned standards. Representation is based on a lightweight ontology. A layered reasoning approach is implemented where at the first layer ontological inference is used in order to discover underlying knowledge, while at the second layer a two-step rule selection strategy is followed resulting in a computationally efficient reasoning approach. Details of the system architecture are presented while also giving an outline of the difficulties that had to be overcome. Panacea is evaluated both in terms of quality of recommendations against real clinical data and performance. The quality recommendation gave useful insights regarding requirements for real world deployment and revealed several parameters that affected the recommendation results. Performance-wise, Panacea is compared to a previous published work by the authors, a service for drug recommendations named GalenOWL, and presents their differences in modeling and approach to the problem, while also pinpointing the advantages of Panacea. Overall, the paper presents a framework for providing an efficient drug recommendations service where Semantic Web technologies are coupled with traditional business rule engines.

Future Research Directions for the Field of E/BD: Standing on the Shoulders of Giants

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Jolivette, Kristine; Conroy, Maureen; Nelson, C. Michael; Benner, Gregory J.

2011-01-01

The origins and evolution of the field of emotional/behavioral disorders (E/BD) provide a context for offering suggestions for advancing the field. Building from this historical past and the research of others in the field, four broad recommendations which focus on academic and social needs of students with E/BD are offered: (a) ensuring high…

Considerations and Recommendations for Implementing a Dual-Enrollment Program: Bridging the Gap between High School and College Level Science

ERIC Educational Resources Information Center

Lukes, Laura A.

2014-01-01

Dual-enrollment (DE) science courses offer a way to strengthen the science, technology, engineering, and mathematics pipeline between high school and college. These courses offer high school students the opportunity to experience college science in a more supported environment, allowing them to adjust to the different academic and social demands…

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

Bluestein, J.; Horgan, S.; Eldridge, M. M.

Relatively small projects for generating electrical power at or near the point of use--distributed generation (DG)--offer unique opportunities for enhancing the U.S. electric system. This report finds that current air quality regulatory practices are inappropriately inhibiting the development of DG through a failure to recognize the environmental benefits offered by DG or by imposing requirements designed for larger systems that are not appropriate to DG systems. The report recommends that air quality regulation be made more efficient and appropriate for DG by establishing national standards for DG equipment. This report also recommends that DG projects be evaluated on a''net'' emissionsmore » basis by being given credit for any emission sources that they displace. Air quality regulation should also recognize the benefits of combined heat and power (CHP).« less

Can we HIIT cancer if we attack inflammation?

PubMed

Papadopoulos, Efthymios; Santa Mina, Daniel

2018-01-01

Physical exercise offers numerous health-related benefits to individuals with cancer. Epidemiologic research has primarily been concerned with conventional exercise training that aligns with the recommendations of 150 min of moderate to vigorous physical activity per week. These recommendations are safe and effective at improving physical and psychosocial outcomes. Given the extensive evidence for generalized physical activity, researchers have begun to explore novel training regimens that may provide additional health benefits and/or improved adherence. Specifically, exercise at higher intensities may offer more or different benefits than conventional training approaches with potentially profound effects on the tumor microenvironment. This commentary focuses on the physiological effects of high-intensity interval training, also known as "HIIT," and its potential antineoplastic properties.

Developing an effective breast cancer vaccine.

PubMed

Soliman, Hatem

2010-07-01

Harnessing the immune response in treating breast cancer would potentially offer a less toxic, more targeted approach to eradicating residual disease. Breast cancer vaccines are being developed to effectively train cytotoxic T cells to recognize and kill transformed cells while sparing normal ones. However, achieving this goal has been problematic due to the ability of established cancers to suppress and evade the immune response. A review of the literature on vaccines and breast cancer treatment was conducted, specifically addressing strategies currently available, as well as appropriate settings, paradigms for vaccine development and response monitoring, and challenges with immunosuppression. Multiple issues need to be addressed in order to optimize the benefits offered by breast cancer vaccines. Primary issues include the following: (1) cancer vaccines will likely work better in a minimal residual disease state, (2) clinical trial design for immunotherapy should incorporate recommendations from expert groups such as the Cancer Vaccine Working Group and use standardized immune response measurements, (3) the presently available cancer vaccine approaches, including dendritic cell-based, tumor-associated antigen peptide-based, and whole cell-based, have various pros and cons, (4) to date, no one approach has been shown to be superior to another, and (5) vaccines will need to be combined with immunoregulatory agents to overcome tumor-related immunosuppression. Combining a properly optimized cancer vaccine with novel immunomodulating agents that overcome tumor-related immunosuppression in a well-designed clinical trial offers the best hope for developing an effective breast cancer vaccine strategy.

A Survey of Cost Estimating Methodologies for Distributed Spacecraft Missions

NASA Technical Reports Server (NTRS)

Foreman, Veronica; Le Moigne, Jacqueline; de Weck, Oliver

2016-01-01

Satellite constellations present unique capabilities and opportunities to Earth orbiting and near-Earth scientific and communications missions, but also present new challenges to cost estimators. An effective and adaptive cost model is essential to successful mission design and implementation, and as Distributed Spacecraft Missions (DSM) become more common, cost estimating tools must become more representative of these types of designs. Existing cost models often focus on a single spacecraft and require extensive design knowledge to produce high fidelity estimates. Previous research has examined the shortcomings of existing cost practices as they pertain to the early stages of mission formulation, for both individual satellites and small satellite constellations. Recommendations have been made for how to improve the cost models for individual satellites one-at-a-time, but much of the complexity in constellation and DSM cost modeling arises from constellation systems level considerations that have not yet been examined. This paper constitutes a survey of the current state-of-the-art in cost estimating techniques with recommendations for improvements to increase the fidelity of future constellation cost estimates. To enable our investigation, we have developed a cost estimating tool for constellation missions. The development of this tool has revealed three high-priority weaknesses within existing parametric cost estimating capabilities as they pertain to DSM architectures: design iteration, integration and test, and mission operations. Within this paper we offer illustrative examples of these discrepancies and make preliminary recommendations for addressing them. DSM and satellite constellation missions are shifting the paradigm of space-based remote sensing, showing promise in the realms of Earth science, planetary observation, and various heliophysical applications. To fully reap the benefits of DSM technology, accurate and relevant cost estimating capabilities must exist; this paper offers insights critical to the future development and implementation of DSM cost estimating tools.

A Survey of Cost Estimating Methodologies for Distributed Spacecraft Missions

NASA Technical Reports Server (NTRS)

Foreman, Veronica L.; Le Moigne, Jacqueline; de Weck, Oliver

2016-01-01

Satellite constellations present unique capabilities and opportunities to Earth orbiting and near-Earth scientific and communications missions, but also present new challenges to cost estimators. An effective and adaptive cost model is essential to successful mission design and implementation, and as Distributed Spacecraft Missions (DSM) become more common, cost estimating tools must become more representative of these types of designs. Existing cost models often focus on a single spacecraft and require extensive design knowledge to produce high fidelity estimates. Previous research has examined the limitations of existing cost practices as they pertain to the early stages of mission formulation, for both individual satellites and small satellite constellations. Recommendations have been made for how to improve the cost models for individual satellites one-at-a-time, but much of the complexity in constellation and DSM cost modeling arises from constellation systems level considerations that have not yet been examined. This paper constitutes a survey of the current state-of-theart in cost estimating techniques with recommendations for improvements to increase the fidelity of future constellation cost estimates. To enable our investigation, we have developed a cost estimating tool for constellation missions. The development of this tool has revealed three high-priority shortcomings within existing parametric cost estimating capabilities as they pertain to DSM architectures: design iteration, integration and test, and mission operations. Within this paper we offer illustrative examples of these discrepancies and make preliminary recommendations for addressing them. DSM and satellite constellation missions are shifting the paradigm of space-based remote sensing, showing promise in the realms of Earth science, planetary observation, and various heliophysical applications. To fully reap the benefits of DSM technology, accurate and relevant cost estimating capabilities must exist; this paper offers insights critical to the future development and implementation of DSM cost estimating tools.

[WHO Framework Convention on Tobacco Control: adherence and establishment in Latin America].

PubMed

Portes, Leonardo Henriques; Machado, Cristiani Vieira

2015-11-01

To draw an overview of the adherence of countries around the world to the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) and to describe the establishment of WHO FCTC recommended measures in Latin American countries. This descriptive study was based on analysis of documents and secondary data to determine the status of countries from the six WHO regions regarding adherence to the FCTC. After that, the establishment of recommended measures until the year 2012 was mapped in all States Parties and particularly in 12 Latin American States Parties. Finally, the degree to which FCTC measures had been established in Brazil, Chile, Colombia, Mexico, and Venezuela was assessed (incipient, intermediate, or advanced). This step took into consideration the measures covered by four domains - reduction in the demand for tobacco, reduction in the offer of tobacco, reduction in damage to the environment and to the health of people caused by tobacco, and support for quitting the use of tobacco. Until August 2015, 180 countries had joined as States Parties to the FCTC. Considering the 126 countries that submitted global progress reports in the 2012 cycle, the most prevalent measures adopted referred to the protection against exposure to tobacco smoke (83.0% for all countries and 100% for the group of Latin American countries). Among the five countries selected for detailed analysis, the measures referring to the reduction of demand and offer of tobacco were the most frequent. Measures focused on reducing environmental damage were rare. Brazil and Mexico had the most advanced FCTC status among the studied countries. Latin America presented a high proportion of States Parties with established FCTC recommended measures. The heterogeneity of the FCTC status in the five selected countries suggests that the implementation of tobacco control policies depends on specific aspects of each country.

Androgen deprivation therapy for prostate cancer: recommendations to improve patient and partner quality of life.

PubMed

Elliott, Stacy; Latini, David M; Walker, Lauren M; Wassersug, Richard; Robinson, John W

2010-09-01

Because of improved prostate cancer detection, more patients begin androgen deprivation therapy (ADT) earlier and remain on it longer than before. Patients now may be androgen deprived for over a decade, even when they are otherwise free of cancer symptoms. An ADT Survivorship Working Group was formed to develop and evaluate interventions to limit the physiological and emotional trauma patients and their partners experience from this treatment. The multidisciplinary Working Group met for 2 days to define the challenges couples face when patients commence ADT. A writing sub-group was formed. It compiled the meeting's proceedings, reviewed the literature and, in consultation with the other members of the working group, wrote the manuscript. Expert opinion of the side effects of ADT that affect the quality of life (QOL) of patients and their partners and the recommendations for managing ADT to optimize QOL were based on the best available literature, clinical experience, and widespread internal discussions among Working Group members. Side effects identified as particularly challenging include: (i) body feminization; (ii) changes in sexual performance; (iii) relationship changes; (iv) cognitive and affective symptoms; and (v) fatigue, sleep disturbance, and depression. Recommendations for managing ADT include providing information about ADT side effects before administration of ADT, and, where appropriate, providing referrals for psychosocial support. Sexual rehabilitation principles for persons with chronic illness may prove useful. Psychological interventions for sexual sequelae need to be offered and individualized to patients, regardless of their age or partnership. Support should also be offered to partners. Our hope is that this plan will serve as a guide for optimizing how ADT is carried out and improve the lives of androgen-deprived men and their intimate partners. © 2010 International Society for Sexual Medicine.

Toward a sustainable biomedical research enterprise: Finding consensus and implementing recommendations

PubMed Central

Pickett, Christopher L.; Corb, Benjamin W.; Matthews, C. Robert; Sundquist, Wesley I.; Berg, Jeremy M.

2015-01-01

The US research enterprise is under significant strain due to stagnant funding, an expanding workforce, and complex regulations that increase costs and slow the pace of research. In response, a number of groups have analyzed the problems and offered recommendations for resolving these issues. However, many of these recommendations lacked follow-up implementation, allowing the damage of stagnant funding and outdated policies to persist. Here, we analyze nine reports published since the beginning of 2012 and consolidate over 250 suggestions into eight consensus recommendations made by the majority of the reports. We then propose how to implement these consensus recommendations, and we identify critical issues, such as improving workforce diversity and stakeholder interactions, on which the community has yet to achieve consensus. PMID:26195768

European guideline for the diagnosis and treatment of insomnia.

PubMed

Riemann, Dieter; Baglioni, Chiara; Bassetti, Claudio; Bjorvatn, Bjørn; Dolenc Groselj, Leja; Ellis, Jason G; Espie, Colin A; Garcia-Borreguero, Diego; Gjerstad, Michaela; Gonçalves, Marta; Hertenstein, Elisabeth; Jansson-Fröjmark, Markus; Jennum, Poul J; Leger, Damien; Nissen, Christoph; Parrino, Liborio; Paunio, Tiina; Pevernagie, Dirk; Verbraecken, Johan; Weeß, Hans-Günter; Wichniak, Adam; Zavalko, Irina; Arnardottir, Erna S; Deleanu, Oana-Claudia; Strazisar, Barbara; Zoetmulder, Marielle; Spiegelhalder, Kai

2017-12-01

This European guideline for the diagnosis and treatment of insomnia was developed by a task force of the European Sleep Research Society, with the aim of providing clinical recommendations for the management of adult patients with insomnia. The guideline is based on a systematic review of relevant meta-analyses published till June 2016. The target audience for this guideline includes all clinicians involved in the management of insomnia, and the target patient population includes adults with chronic insomnia disorder. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to grade the evidence and guide recommendations. The diagnostic procedure for insomnia, and its co-morbidities, should include a clinical interview consisting of a sleep history (sleep habits, sleep environment, work schedules, circadian factors), the use of sleep questionnaires and sleep diaries, questions about somatic and mental health, a physical examination and additional measures if indicated (i.e. blood tests, electrocardiogram, electroencephalogram; strong recommendation, moderate- to high-quality evidence). Polysomnography can be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders), in treatment-resistant insomnia, for professional at-risk populations and when substantial sleep state misperception is suspected (strong recommendation, high-quality evidence). Cognitive behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (strong recommendation, high-quality evidence). A pharmacological intervention can be offered if cognitive behavioural therapy for insomnia is not sufficiently effective or not available. Benzodiazepines, benzodiazepine receptor agonists and some antidepressants are effective in the short-term treatment of insomnia (≤4 weeks; weak recommendation, moderate-quality evidence). Antihistamines, antipsychotics, melatonin and phytotherapeutics are not recommended for insomnia treatment (strong to weak recommendations, low- to very-low-quality evidence). Light therapy and exercise need to be further evaluated to judge their usefulness in the treatment of insomnia (weak recommendation, low-quality evidence). Complementary and alternative treatments (e.g. homeopathy, acupuncture) are not recommended for insomnia treatment (weak recommendation, very-low-quality evidence). © 2017 European Sleep Research Society.

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

Stakeholder consultation insights on the future of genomics at the clinical-public health interface.

PubMed

Modell, Stephen M; Kardia, Sharon L R; Citrin, Toby

2014-05-01

In summer 2011, the Centers for Disease Control and Prevention Office of Public Health Genomics conducted a stakeholder consultation, administered by the University of Michigan Center for Public Health and Community Genomics, and Genetic Alliance, to recommend priorities for public health genomics from 2012 through 2017. Sixty-two responses from health professionals, administrators, and members of the public were pooled with 2 sets of key informant interviews and 3 discussion groups. NVivo 9 and manual methods were used to organize themes. This review offers an interim analysis of progress with respect to the final recommendations, which demonstrated a strong interest in moving genomic discoveries toward implementation and comparative effectiveness (T3/T4) translational research. A translational research continuum exists with familial breast and ovarian cancer at one end and prostate cancer at the other. Cascade screening for inherited arrhythmia syndromes and hypercholesterolemia lags stakeholder recommendations in the United States but not in Europe; implementation of health service-based screening for Lynch syndrome, and integration into electronic health information systems, is on pace with the recommended timeline. A number of options exist to address deficits in the funding of translational research, particularly for oncogenomic gene expression profiling. The goal of personalized risk assessment necessitates both research progress (eg, in whole genome sequencing, as well as provider education in the differentiation of low- vs high-risk status. The public health approach supports an emphasis on genetic test validation while endorsing clinical translation research inclusion of an environmental and population-based perspective. Copyright © 2014 Mosby, Inc. All rights reserved.

International Myeloma Working Group Recommendations for the Treatment of Multiple Myeloma–Related Bone Disease

PubMed Central

Terpos, Evangelos; Morgan, Gareth; Dimopoulos, Meletios A.; Drake, Matthew T.; Lentzsch, Suzanne; Raje, Noopur; Sezer, Orhan; García-Sanz, Ramón; Shimizu, Kazuyuki; Turesson, Ingemar; Reiman, Tony; Jurczyszyn, Artur; Merlini, Giampaolo; Spencer, Andrew; Leleu, Xavier; Cavo, Michele; Munshi, Nikhil; Rajkumar, S. Vincent; Durie, Brian G.M.; Roodman, G. David

2013-01-01

Purpose The aim of the International Myeloma Working Group was to develop practice recommendations for the management of multiple myeloma (MM) –related bone disease. Methodology An interdisciplinary panel of clinical experts on MM and myeloma bone disease developed recommendations based on published data through August 2012. Expert consensus was used to propose additional recommendations in situations where there were insufficient published data. Levels of evidence and grades of recommendations were assigned and approved by panel members. Recommendations Bisphosphonates (BPs) should be considered in all patients with MM receiving first-line antimyeloma therapy, regardless of presence of osteolytic bone lesions on conventional radiography. However, it is unknown if BPs offer any advantage in patients with no bone disease assessed by magnetic resonance imaging or positron emission tomography/computed tomography. Intravenous (IV) zoledronic acid (ZOL) or pamidronate (PAM) is recommended for preventing skeletal-related events in patients with MM. ZOL is preferred over oral clodronate in newly diagnosed patients with MM because of its potential antimyeloma effects and survival benefits. BPs should be administered every 3 to 4 weeks IV during initial therapy. ZOL or PAM should be continued in patients with active disease and should be resumed after disease relapse, if discontinued in patients achieving complete or very good partial response. BPs are well tolerated, but preventive strategies must be instituted to avoid renal toxicity or osteonecrosis of the jaw. Kyphoplasty should be considered for symptomatic vertebral compression fractures. Low-dose radiation therapy can be used for palliation of uncontrolled pain, impending pathologic fracture, or spinal cord compression. Orthopedic consultation should be sought for long-bone fractures, spinal cord compression, and vertebral column instability. PMID:23690408

Expanding the recommendations for annual influenza vaccination to school-age children in the United States.

PubMed

Fiore, Anthony E; Epperson, Scott; Perrotta, Dennis; Bernstein, Henry; Neuzil, Kathleen

2012-03-01

Despite long-standing recommendations to vaccinate children who have underlying chronic medical conditions or who are contacts of high-risk persons, vaccination coverage among school-age children remains low. Community studies have indicated that school-age children have the highest incidence of influenza and are an important source of amplifying and sustaining community transmission that affects all age groups. A consultation to discuss the advantages and disadvantages of a universal recommendation for annual influenza vaccination of all children age ≥6 months was held in Atlanta, Georgia, in September 2007. Consultants provided summaries of current data on vaccine effectiveness, safety, supply, successful program implementation, and economics studies and discussed challenges associated with continuing a risk- and contact-based vaccination strategy compared with a universal vaccination recommendation. Consultants noted that school-age children had a substantial illness burden caused by influenza, that vaccine was safe and effective for children aged 6 months through 18 years, and that evidence suggested that vaccinating school-age children would provide benefits to both the vaccinated children and their unvaccinated household and community contacts. However, implementation of an annual recommendation for all school-age children would pose major challenges to parents, medical providers and health care systems. Alternative vaccination venues were needed, and of these school-located vaccination programs might offer the most promise as an alternative vaccination site for school-age children. Expansion of recommendations to include all school-age children will require additional development of an infrastructure to support implementation and methods to adequately evaluate impact.

All-terrain vehicle dealership point-of-sale child safety compliance in Illinois.

PubMed

Hafner, John W; Getz, Marjorie A; Begley, Brandon

2012-08-01

In 2008, an estimated 37,700 children younger than 16 were treated in US emergency departments for nonfatal all-terrain vehicle (ATV) injuries. This study identifies safety guidelines and recommendations dealers convey to consumers at the point of sale. A telephone survey of all 2004 licensed motorcycle dealers in Illinois was conducted. Trained investigators, using aliases and posing as a parent of a 13-year-old teenager, spoke with dealership personnel. Investigators indicated they wished to purchase an ATV with the dealership, but had no knowledge of ATV use or safety issues. The telephone call's true purpose was concealed during the survey. Specific responses from the salesperson, models and brands of ATVs, price quotes, engine sizes, and safety information/recommendations were recorded in a written survey instrument. One hundred twenty-seven ATV dealers completed the survey. A salesperson most often fielded the telephone interview (124/127). Telephone interviews by male investigators were longer than those by female interviewers (5 minutes 37 seconds vs 3 minutes 51 seconds; P = 0.001). Dealers recommended Consumer Product Safety Commission-based child-size ATVs (<90 mL engine size) during 75% of the calls. Nearly all dealers recommended helmet use (108/127), and few (3/127) labeled the vehicles as "safe." Most dealers (83.5%) recommended some form of rider training, with half (49.6%) offered point-of-purchase training. All-terrain vehicle dealers in Illinois recommend child-size vehicles, safety training, and helmet use for the majority of telephone inquiries. Injury prevention efforts targeting ATV dealers may be less needed than those using other populations.

Physicians' health habits are associated with lifestyle counseling for hypertensive patients.

PubMed

Hung, Olivia Y; Keenan, Nora L; Fang, Jing

2013-02-01

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) recommended lifestyle interventions, either with or without pharmacologic treatment, for all patients with high blood pressure. The objective of this study is to determine the association of physicians' personal habits with their attitudes and behaviors regarding JNC VII lifestyle modification guidelines. One thousand primary care physicians completed DocStyles 2010, a voluntary web-based survey designed to provide insight into physician attitudes and behaviors regarding various health issues. The respondents' average age was 45.3 years, and 68% were male. In regards to physician behavior, 4.0% smoked at least once a week, 38.6% ate ≥5 cups of fruits and/or vegetables ≥5 days/week, and 27.4% exercised ≥5 days/week. When asked about specific types of advice offered to their hypertensive patients, physicians reported recommending that their patients eat a healthy diet (92.2%), or cut down on salt (96.1%), or attain or maintain a healthy weight (94.8%), or limit the use of alcohol (75.4%), or be physically active (94.4%). Collectively, 66.5% made all 5 lifestyle modification recommendations. Nonsmoking physicians were more likely to recommend each lifestyle intervention to their hypertensive patients. Those who exercised at least 1 day per week were more likely to recommend limiting alcohol use. The probability of recommending all 5 JNC VII interventions was greater for physicians who were nonsmoking and who exercised at least 1 day a week.

Phytochemicals to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field.

PubMed

Teo, Lynn; Crawford, Cindy; Snow, James; Deuster, Patricia A; Bingham, John J; Gallon, Matthew D; O'Connell, Meghan L; Chittum, Holly K; Arzola, Sonya M; Berry, Kevin

2017-06-01

Optimizing cognitive performance and preventing cognitive impairments that result from exposure to high-stress situations are important to ensure mission-readiness for military personnel. This systematic review assesses the quality of the evidence for plant-based foods and beverages, or their phytochemical constituents, across various outcomes related to cognitive function in healthy adult populations to develop research recommendations for the military. PubMed, CINAHL, Embase, PsycInfo, and the Cochrane Library were searched. Peer-reviewed randomized controlled trials published in the English language were eligible. Twenty-five trials were included and assessed for methodological quality, and descriptive data were extracted. The acceptable (n = 16) to high-quality (n = 4) studies produced either no statistically significant effect or mixed results for enhancing cognitive function. The evidence suggested that healthy populations do not experience significant changes in cognitive performance when consuming soy- and non-soy-sourced isoflavones or cocoa. Heterogeneity among other interventions precluded reaching formal conclusions surrounding the evidence. Research recommendations are offered, including conducting more studies on the effect of plant-based interventions on populations reflective of military populations when exposed to military-like situations. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Visualization and recommendation of large image collections toward effective sensemaking

NASA Astrophysics Data System (ADS)

Gu, Yi; Wang, Chaoli; Nemiroff, Robert; Kao, David; Parra, Denis

2016-03-01

In our daily lives, images are among the most commonly found data which we need to handle. We present iGraph, a graph-based approach for visual analytics of large image collections and their associated text information. Given such a collection, we compute the similarity between images, the distance between texts, and the connection between image and text to construct iGraph, a compound graph representation which encodes the underlying relationships among these images and texts. To enable effective visual navigation and comprehension of iGraph with tens of thousands of nodes and hundreds of millions of edges, we present a progressive solution that offers collection overview, node comparison, and visual recommendation. Our solution not only allows users to explore the entire collection with representative images and keywords but also supports detailed comparison for understanding and intuitive guidance for navigation. The visual exploration of iGraph is further enhanced with the implementation of bubble sets to highlight group memberships of nodes, suggestion of abnormal keywords or time periods based on text outlier detection, and comparison of four different recommendation solutions. For performance speedup, multiple graphics processing units and central processing units are utilized for processing and visualization in parallel. We experiment with two image collections and leverage a cluster driving a display wall of nearly 50 million pixels. We show the effectiveness of our approach by demonstrating experimental results and conducting a user study.

Understanding barriers to preventive health actions for occupational noise-induced hearing loss.

PubMed

Patel, D S; Witte, K; Zuckerman, C; Murray-Johnson, L; Orrego, V; Maxfield, A M; Meadows-Hogan, S; Tisdale, J; Thimons, E D

2001-01-01

A theoretically based formative evaluation was conducted with coal miners in the Appalachian Mountains who were at high risk for noise-induced hearing loss (NIHL). The results of four focus groups indicate that despite high levels of knowledge, strong perceived severity of negative consequences, and strong perceived susceptibility to hearing loss, two main categories of barriers (environmental and individual) keep coal miners from using their hearing protection devices (HPD). Further analysis suggests that the environmental factors, rather than individual variables, more strongly influence decisions against protective actions. Recommendations and practical implications are offered.

A commentary on the status of the behavioral approach in the healthcare marketplace.

PubMed

Moss, G R

1993-12-01

Clinically applied behavioral technology (e.g., integrated, systems-based hospital programs) and specific behavior therapies (e.g., systematic desensitization) have a long record of documented and powerful efficacy yet have failed to penetrate successfully the healthcare marketplace and to receive adequate public recognition. Many behavioral techniques are utilized widely without acknowledgement of their true origins. The current position of the behavioral approach in the healthcare marketplace is examined, and factors making for resistance to its acceptance are identified. Recommendations are offered for the more effective promotion of behavioral methods and services.

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

NASA Technical Reports Server (NTRS)

Wood, Richard M.

2002-01-01

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

Using alfalfa leaf meal as a supplement in late-gestation beef heifer and nursing beef calf diets.

PubMed

Zehnder, C M; Maddock, T D; DiCostanzo, A; Miller, L R; Hall, J M; Lamb, G C

2010-06-01

Two experiments were conducted to investigate using alfalfa leaf meal (ALM; 22% CP, DM basis) in beef cattle diets. In Exp. 1, a total of 24 late-gestation Angus heifers (initial BW 470 +/- 9 kg) were blocked by BW, calving date, and BCS to 1 of 4 dietary treatments in a randomized complete block design. All heifers were offered a basal hay diet (7.4% CP and 67.6% NDF, DM basis). Treatments were arranged as a 2 x 2 factorial consisting of CP supplied at 100 or 112.5% of the recommended daily intake using either soybean meal (SBM) or ALM as the supplemental protein source. Treatments were fed for an average of 100 d before calving. Total DMI was unaffected by supplemental protein source, although heifers consumed more (P < 0.001) ALM supplement than SBM supplement at the expense of hay and corn. Feeding 112.5% of recommended CP to heifers increased precalving rate of BW gain (P = 0.004) and DM digestibility (P = 0.003). Protein source did not affect DM digestibility (P = 0.17). Neither supplemental protein source nor protein amount affected changes in BCS or calving traits. In Exp. 2, replicates of treatments were conducted over 2 consecutive years at 2 locations in northern Minnesota to determine the effects of including ALM in creep-fed supplements on nursing calf performance, supplement BW gain efficiency (GF; BW gain over control/supplement intake), and cow performance. Treatments were control (no supplement), ALM supplement (58% ALM, as-fed basis), or a wheat middling- and soybean hull-based supplement (MIDD). Milk intake (estimated by the weigh-suckle-weigh technique) was similar among treatments. Creep-fed calves had greater (P < 0.001) ADG than control calves, whereas calves offered MIDD tended to have greater ADG (P = 0.05) than those offered ALM (1.38 vs. 1.30 kg/d, respectively). Calves offered MIDD had greater (P < 0.001) creep feed DMI than those offered ALM (2.6 vs. 1.3 kg/d, respectively). A year x treatment interaction was noted for GF (P = 0.02). In yr 1, GF for calves offered ALM was greater (P = 0.006) than GF for calves offered MIDD, but in yr 2, there were no differences. Alfalfa leaf meal may substitute for SBM in beef heifer wintering diets and conventional creep feed ingredients. When included in creep feed diets, ALM can result in slightly less ADG and less DMI, but supplement conversion efficiency may be increased.

The Master Plan for Florida Postsecondary Education. Supplement Number 3: Disabled Student Access to Postsecondary Education. Report and Recommendations of the Postsecondary Education Planning Commission.

ERIC Educational Resources Information Center

Florida State Postsecondary Education Commission, Tallahassee.

This third supplement to the Florida master plan for postsecondary education considers resources and barriers to education for disabled students and offers 21 recommendations. To provide a foundation to discuss the needs of disabled students, characteristics of the following major functional impairments are described: hearing impairment, learning…

Efforts to Bridge the Gap between Research and Practice in Social Work: Precedents and Prospects: Keynote Address at the Bridging the Gap Symposium

ERIC Educational Resources Information Center

Rubin, Allen

2015-01-01

This keynote address discusses previous and ongoing efforts to reduce the persistent gap between research and practice in social work and offers recommendations for further bridging that gap. Key among those recommendations is the need to conduct descriptive outcome studies of efforts to adapt research-supported interventions in everyday practice…

Meteorological support for space operations: Review and recommendations

NASA Technical Reports Server (NTRS)

1988-01-01

The current meteorological support provided to NASA by NOAA, Air Weather Service, and other contractors is reviewed and suggestions are offered for its improvement. These recommendations include improvement in NASA's internal management organizational structure that would accommodate continued improvement in operational weather support, installation of new observing systems, improvement in analysis and forecasting procedures, and the establishment of an Applied Research and Forecasting Facility.

[Chronic heart failure and depression].

PubMed

Herrmann-Lingen, C

2018-05-01

Depression is a frequent comorbidity in chronic heart failure. It can be triggered by the experience of suffering from heart disease, but it can also play a causal role in accelerated development and poor prognosis of heart failure. The aim of this study was to investigate the interrelationships between heart failure and depression and the psychophysiological and behavioral mechanisms involved in this association. The effects of comorbid depression on quality of life in patients with heart failure were also examined and therapeutic options reviewed. A narrative review of the literature was undertaken. Several psychophysiological and behavioral mechanisms have been identified as mediators of the association between depression and heart failure and the adverse prognostic effects of this comorbidity. Comorbid depression leads to substantial reductions in health-related quality of life. These effects are only incompletely antagonized by exercise training and cognitive behavioral therapy. No specific effect of antidepressant medication has been demonstrated as yet in patients with heart failure. While current guidelines recommend the identification and treatment of depressive comorbidity in patients with heart failure, the available evidence provides no convincing rationale for specific treatment recommendations beyond the guideline-based treatment of heart failure itself, lifestyle interventions and patient-centered medical care. If available, psychotherapy should be offered, ideally cognitive behavioral therapy. For patients that do not improve sufficiently under outpatient treatment, the German health care system offers dedicated psychocardiological inpatient treatment programs.

Consuming sustainable seafood: guidelines, recommendations and realities.

PubMed

Farmery, Anna K; O'Kane, Gabrielle; McManus, Alexandra; Green, Bridget S

2018-06-01

Encouraging people to eat more seafood can offer a direct, cost-effective way of improving overall health outcomes. However, dietary recommendations to increase seafood consumption have been criticised following concern over the capacity of the seafood industry to meet increased demand, while maintaining sustainable fish stocks. The current research sought to investigate Australian accredited practising dietitians' (APD) and public health nutritionists' (PHN) views on seafood sustainability and their dietary recommendations, to identify ways to better align nutrition and sustainability goals. A self-administered online questionnaire exploring seafood consumption advice, perceptions of seafood sustainability and information sources of APD and PHN. Qualitative and quantitative data were collected via open and closed questions. Quantitative data were analysed with χ 2 tests and reported using descriptive statistics. Content analysis was used for qualitative data. Australia. APD and PHN were targeted to participate; the sample includes respondents from urban and regional areas throughout Australia. Results indicate confusion around the concept of seafood sustainability and where to obtain information, which may limit health professionals' ability to recommend the best types of seafood to maximise health and sustainability outcomes. Respondents demonstrated limited understanding of seafood sustainability, with 7·5 % (n 6/80) satisfied with their level of understanding. Nutrition and sustainability goals can be better aligned by increasing awareness on seafood that is healthy and sustainable. For health professionals to confidently make recommendations, or identify trade-offs, more evidence-based information needs to be made accessible through forums such as dietetic organisations, industry groups and nutrition programmes.

Prevention and treatment of low back pain: evidence, challenges, and promising directions.

PubMed

Foster, Nadine E; Anema, Johannes R; Cherkin, Dan; Chou, Roger; Cohen, Steven P; Gross, Douglas P; Ferreira, Paulo H; Fritz, Julie M; Koes, Bart W; Peul, Wilco; Turner, Judith A; Maher, Chris G

2018-06-09

Many clinical practice guidelines recommend similar approaches for the assessment and management of low back pain. Recommendations include use of a biopsychosocial framework to guide management with initial non-pharmacological treatment, including education that supports self-management and resumption of normal activities and exercise, and psychological programmes for those with persistent symptoms. Guidelines recommend prudent use of medication, imaging, and surgery. The recommendations are based on trials almost exclusively from high-income countries, focused mainly on treatments rather than on prevention, with limited data for cost-effectiveness. However, globally, gaps between evidence and practice exist, with limited use of recommended first-line treatments and inappropriately high use of imaging, rest, opioids, spinal injections, and surgery. Doing more of the same will not reduce back-related disability or its long-term consequences. The advances with the greatest potential are arguably those that align practice with the evidence, reduce the focus on spinal abnormalities, and ensure promotion of activity and function, including work participation. We have identified effective, promising, or emerging solutions that could offer new directions, but that need greater attention and further research to determine if they are appropriate for large-scale implementation. These potential solutions include focused strategies to implement best practice, the redesign of clinical pathways, integrated health and occupational interventions to reduce work disability, changes in compensation and disability claims policies, and public health and prevention strategies. Copyright © 2018 Elsevier Ltd. All rights reserved.

Guide to the Evaluation of Educational Experiences in the Armed Services. The 1978 Guide. 1: Air Force.

ERIC Educational Resources Information Center

American Council on Education, Washington, DC. Office on Educational Credit.

Postsecondary educational credit recommendations for formal courses offered by the Air Force and the Department of Defense are provided in this first of a three-volume guide. (Other volumes cover courses offered by the Army and by the Coast Guard, Marine Corps, and Navy. See note.) Following brief sections on use of the guide, the formal course…

An Investigation of the Products and Impact of Graduate Student SoTL Programs: Observations and Recommendations from a Single Institution

ERIC Educational Resources Information Center

Chick, Nancy L.; Brame, Cynthia

2015-01-01

This study offers an investigation of three graduate-level SoTL programs offered since 2007 at a mid-size, highly selective, private, research-intensive university in the southeastern United States. We identify patterns in these early experiences with the scholarship of teaching and learning, specifically the choices made while carrying out their…

An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE)

PubMed Central

Althof, Stanley E; McMahon, Chris G; Waldinger, Marcel D; Serefoglu, Ege Can; Shindel, Alan W; Adaikan, P Ganesan; Becher, Edgardo; Dean, John; Giuliano, Francois; Hellstrom, Wayne JG; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

2014-01-01

Introduction In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient and partner, assessment, and pharmacological, psychological, and combined treatments. It concluded by recognizing the continually evolving nature of clinical research and recommended a subsequent guideline review and revision every fourth year. Consistent with that recommendation, the ISSM organized a second multidisciplinary panel of experts in April 2013, which met for 2 days in Bangalore, India. This manuscript updates the previous guidelines and reports on the recommendations of the panel of experts. Aim The aim of this study was to develop clearly worded, practical, evidenced-based recommendations for the diagnosis and treatment of PE for family practice clinicians as well as sexual medicine experts. Method A comprehensive literature review was performed. Results This article contains the report of the second ISSM PE Guidelines Committee. It offers a new unified definition of PE and updates the previous treatment recommendations. Brief assessment procedures are delineated, and validated diagnostic and treatment questionnaires are reviewed. Finally, the best practices treatment recommendations are presented to guide clinicians, both familiar and unfamiliar with PE, in facilitating treatment of their patients. Conclusion Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual dysfunction. We again recommend that these guidelines be reevaluated and updated by the ISSM in 4 years. Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, Becher E, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE). Sex Med 2014;2:60–90. PMID:25356302

AAPT Lab Recommendations: Past, Present, and Future

NASA Astrophysics Data System (ADS)

Kozminski, Joseph

The ``AAPT Recommendations for the Undergraduate Physics Laboratory Curriculum'' was endorsed by the American Association of Physics Teachers Executive Board in November 2014. This set of curriculum recommendations focuses on developing skills and competencies that will prepare students for research in graduate school and for jobs in the STEM sector, education, and many other employment sectors. The recommendations can be used to guide changes in laboratory curricula, to assess department laboratory curricula during program reviews, and to educate university officials about the importance of laboratory experiences. The recommendations offer many potential opportunities for collaboration between physics education researchers and laboratory instructors in studying skill development in the lab and how various elements of the laboratory curriculum can best be assessed. There are also discussions underway to create an online resource for laboratory instructors to share implementation ideas and resources. This presentation provides an overview of these recommendations and their development, how the recommendations are currently being used, and opportunities for expanded use of the recommendations going forward.

Assessment and management of anxiety disorders in children and adolescents

PubMed Central

Creswell, Cathy; Waite, Polly; Cooper, Peter J

2014-01-01

Anxiety disorders in childhood and adolescence are extremely common and are often associated with lifelong psychiatric disturbance. Consistent with DSM-5 and the extant literature, this review concerns the assessment and treatment of specific phobias, separation anxiety disorder, generalised anxiety disorder, social anxiety disorder, panic disorder and agoraphobia. Evidence-based psychological treatments (cognitive behaviour therapy; CBT) for these disorders have been developed and investigated, and in recent years promising low-intensity versions of CBT interventions have been proposed that offer a means to increase access to evidence-based treatments. There is some evidence of effectiveness of pharmacological treatments for anxiety disorders in children and young people, however, routine prescription is not recommended due to concerns about potential harm. PMID:24636957

Assessment and management of anxiety disorders in children and adolescents.

PubMed

Creswell, Cathy; Waite, Polly; Cooper, Peter J

2014-07-01

Anxiety disorders in childhood and adolescence are extremely common and are often associated with lifelong psychiatric disturbance. Consistent with DSM-5 and the extant literature, this review concerns the assessment and treatment of specific phobias, separation anxiety disorder, generalised anxiety disorder, social anxiety disorder, panic disorder and agoraphobia. Evidence-based psychological treatments (cognitive behaviour therapy; CBT) for these disorders have been developed and investigated, and in recent years promising low-intensity versions of CBT interventions have been proposed that offer a means to increase access to evidence-based treatments. There is some evidence of effectiveness of pharmacological treatments for anxiety disorders in children and young people, however, routine prescription is not recommended due to concerns about potential harm.

Interpersonal psychotherapy for depressed adolescents (IPT-A).

PubMed

Brunstein-Klomek, Anat; Zalsman, Gil; Mufson, Laura

2007-01-01

Recently the Food and Drug Administration (FDA) published a black box warning on the use of serotonin receptor reuptake inhibitors for adolescent depression. This situation makes the non-pharmacological therapeutic alternatives more relevant than ever before. The aim of this review is to introduce the theoretical formulation, practical application and efficacy studies of Interpersonal Psychotherapy for depressed adolescents (IPT-A). A review is offered of published papers in peer-reviewed journals, books and edited chapters using Medline and PsychInfo publications between 1966 and February 2005. IPT-A is an evidence-based psychotherapy for depressed adolescents in both hospital-based and community outpatient settings. IPT-A is a brief and efficient therapy for adolescent depression. Training programs for child psychologists and psychiatrists are recommended.

Staff immunisation: policy and practice in child care.

PubMed

Spokes, Paula J; Ferson, Mark J; Ressler, Kelly-Anne

2011-08-01

The aims of this study were to determine the level of knowledge among child-care centre directors regarding the National Health and Medical Research Council (NHMRC) recommendations for the immunisation of child-care workers, the extent to which this knowledge was translated into practice and any organisational barriers to the development and implementation of staff immunisation policy. A cross-sectional survey, conducted in August 2006, in which a postal questionnaire was sent to a random sample of 784 NSW child-care centres. Centre directors were asked to complete the questionnaire on immunisation knowledge, policy and practice for the centre. A multivariate logistic-regression model was used to identify factors independently associated with centres with an immunisation policy for staff and centres that offered to pay all or part of the cost of vaccination of staff. Directors from 437 centres participated in the study for a response rate of 56%. Of these, 49% were aware of the NHMRC recommendations, and 57% had a staff immunisation policy in place. In the logistic regression model, centres with a written immunisation policy for staff were more likely to be aware of the NHMRC guidelines and offer long day care services. Centres that offered to pay all or part of the cost of immunisation for staff were more likely to be aware of the NHMRC guidelines, offer other child-care services and not operate for profit. Barriers to staff immunisation were related to the implementation of policy and included cost, time and access to information. The level of awareness of specific staff immunisation recommendations was relatively low. The transition of knowledge to policy was encouraging, although implementation of policies requires further commitment. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Interpersonal Relationship Skills--Key to Effective Middle School Leadership.

ERIC Educational Resources Information Center

Meyer, Calvin F.; VanHoose, John J.

1981-01-01

Reports the findings of a study comparing the perceptions of principals and teachers toward the performance of instructional leaders. Offers recommendations for improving the principal's effectiveness. (WD)

Sudden Infant Death Syndrome: Facts for Caregivers.

ERIC Educational Resources Information Center

Texas Child Care, 2000

2000-01-01

Presents risk factors and prevention measures related to Sudden Infant Death Syndrome. Offers infant sleep recommendations and five discussion questions to test knowledge of Sudden Infant Death Syndrome. (DLH)

Business travelers: vaccination considerations for this population.

PubMed

Chen, Lin H; Leder, Karin; Wilson, Mary E

2013-04-01

Illness in business travelers is associated with reduced productivity on the part of the employee as well as the employer. Immunizations offer a reliable method of preventing infectious diseases for international business travelers. The authors review the travel patterns of business travelers, available data on illnesses they encounter, their potential travel-associated risks for vaccine-preventable diseases and recommendations on immunizations for this population. Routine vaccines (e.g., measles, tetanus and influenza) should be reviewed to assure that they provide current coverage. The combined hepatitis A and hepatitis B vaccine with a rapid schedule offers options for those with time constraints. Other vaccine recommendations for business travelers need to focus on their destinations and activities and underlying health, taking into account the concept of cumulative risk for those with frequent travel, multiple trips or long stays.

Toward the adoption of complexity science in health care: implications for risk-taking and decision-making activities.

PubMed

Perez, Bianca; Liberman, Aaron

2011-01-01

This article explores the issues of risk taking and decision making in health care. An analysis of various sociocultural and psychological influences is provided for understanding of the dominant mind set in this industry. In tandem with this analysis, the evolution of system theories is described so as to promote understanding of the relative merits of the mechanistic and complexity philosophies. These philosophies are at odds with each other, conceptually and practically speaking; however, it seems that the complexity approach offers more promising strategies for the growth and development of health care. Recommendations for improving employee competencies and the organizational structure and culture in health care are offered in light of this analysis. These recommendations are relevant to activities that are clinical and administrative in nature.

Physical activity guides for Canadians: messaging strategies, realistic expectations for change, and evaluation.

PubMed

Brawley, Lawrence R; Latimer, Amy E

2007-01-01

Physical activity guidelines offer evidence-based behavioural benchmarks that relate to reduced risk of morbidity and mortality if people adhere to them. Essentially, the guidelines tell people what to do, but not why and how they should do it. Thus, to motivate adherence, messages that translate guidelines should convey not only how much physical activity one should attempt and why it is recommended, but also how to achieve such a recommendation. Canada's physical activity guides exemplify how guidelines can be translated. This paper (i) provides a brief overview of the challenges encountered in creating the existing guides and (ii) highlights important practical issues and empirical evidence that should be considered in the future when translating guidelines into messages and disseminating these messages. We draw on the successes of past efforts to translate the goals of physical activity guidelines and on recent literature on messages and media campaigns to make recommendations. Information to motivate people to move toward the goals in physical activity guidelines should be translated into a set of messages that are informative, thought provoking, and persuasive. These messages should be disseminated to the public via a multi-phase social-marketing campaign that is carefully planned and thoroughly evaluated.

Dietary Sodium and Blood Pressure: How Low Should We Go?

PubMed

Van Horn, Linda

2015-01-01

Sodium intake in the United States exceeds recommended amounts across all age, gender and ethnic groups. National dietary guidelines advocate reduced intake by at least 1,000mg per day or more, but whether there is population-wide benefit from further reductions to levels of 1500mg per day remains controversial. A brief review of current evidence-based dietary guidelines is provided and key prospective, randomized studies that report dietary and urinary sodium data are summarized. Dietary sources of sodium and eating patterns that offer nutritiously sound approaches to nutrient dense, reduced sodium intake are compared. No studies suggest that high sodium intake at the levels of the population's current diet is optimal. On the contrary, national and international evidence and systematic reviews consistently recommend reducing sodium intake overall, generally by 1000mg/day. Recommendations to reduce intakes to 2400mg/d are generally accepted as beneficial. Whether further reductions to 1500mg/d are useful, feasible and safe among specific subgroups in the population who are at increased risk of hypertension or stroke remains controversial and requires individualized consideration by patients and their health care providers. Copyright © 2015 Elsevier Inc. All rights reserved.

What to Build for Middle-Agers to Come? Attractive and Necessary Functions of Exercise-Promotion Mobile Phone Apps: A Cross-Sectional Study

PubMed Central

Chien, Yu-Tai; Chen, Yu-Jen; Hsiung, Hsiao-Fang; Chen, Hsiao-Jung; Hsieh, Meng-Hua; Wu, Wen-Jie

2017-01-01

Background Physical activity is important for middle-agers to maintain health both in middle age and in old age. Although thousands of exercise-promotion mobile phone apps are available for download, current literature offers little understanding regarding which design features can enhance middle-aged adults’ quality perception toward exercise-promotion apps and which factor may influence such perception. Objectives The aims of this study were to understand (1) which design features of exercise-promotion apps can enhance quality perception of middle-agers, (2) whether their needs are matched by current functions offered in app stores, and (3) whether physical activity (PA) and mobile phone self-efficacy (MPSE) influence quality perception. Methods A total of 105 middle-agers participated and filled out three scales: the International Physical Activity Questionnaire (IPAQ), the MPSE scale, and the need for design features questionnaire. The design features were developed based on the Coventry, Aberdeen, and London—Refined (CALO-RE) taxonomy. Following the Kano quality model, the need for design features questionnaire asked participants to classify design features into five categories: attractive, one-dimensional, must-be, indifferent, and reverse. The quality categorization was conducted based on a voting approach and the categorization results were compared with the findings of a prevalence study to realize whether needs match current availability. In total, 52 multinomial logistic regression models were analyzed to evaluate the effects of PA level and MPSE on quality perception of design features. Results The Kano analysis on the total sample revealed that visual demonstration of exercise instructions is the only attractive design feature, whereas the other 51 design features were perceived with indifference. Although examining quality perception by PA level, 21 features are recommended to low level, 6 features to medium level, but none to high-level PA. In contrast, high-level MPSE is recommended with 14 design features, medium level with 6 features, whereas low-level participants are recommended with 1 feature. The analysis suggests that the implementation of demanded features could be low, as the average prevalence of demanded design features is 20% (4.3/21). Surprisingly, social comparison and social support, most implemented features in current apps, were categorized into the indifferent category. The magnitude of effect is larger for MPSE because it effects quality perception of more design features than PA. Delving into the 52 regression models revealed that high MPSE more likely induces attractive or one- dimensional categorization, suggesting the importance of technological self-efficacy on eHealth care promotion. Conclusions This study is the first to propose middle-agers’ needs in relation to mobile phone exercise-promotion. In addition to the tailor-made recommendations, suggestions are offered to app designers to enhance the performance of persuasive features. An interesting finding on change of quality perception attributed to MPSE is proposed as future research. PMID:28546140

Intergenerational communication in the classroom: recommendations for successful teacher-student relationships.

PubMed

Gibson, Sandra E

2009-01-01

Intergenerational communication between teacher and student is especially important today, because of the gaps of time and understanding that exist among four active generations--Traditionalist, Baby Boomers, Generation X, and Millennials. Faculty have opportunities to be successful by learning the values, learning styles, past generational experiences, and current expectations of today's highly technologically competent students. Recommendations are offered for communication strategies in schools of nursing.

The Plan of Action for Children: A Task Force Report. Prepared for the Colman Fund for the Well-Being of Children and Youth.

ERIC Educational Resources Information Center

Chicago Community Trust, IL.

Addressed to policymakers and to all the citizens of Illinois, this report of the Plan of Action for Children Task Force offers 81 recommendations for addressing the serious problems faced by children residing in the state. Taken together, the recommendations lead to six conclusions: (1) focus on prevention; (2) commit resources to strengthen…

Do Technological and Course-Related Variables Impact Undergraduates' Perceived Favorability and Willingness to Recommend Online/Hybrid Business Courses?

ERIC Educational Resources Information Center

Blau, Gary; Drennan, Rob B., Jr.; Karnik, Satyajit; Kapanjie, Darin

2017-01-01

Lower teaching evaluations can affect students' willingness to recommend an online course. To maintain online course quality, it is important to keep the "integrity" of a course, that is, offer to the extent possible, the same content and learning outcomes in an online course as the face-to-face (F2F) equivalent. This study explored the…

Participation in recreation and sports for persons with spinal cord injury: review and recommendations.

PubMed

Slater, Daniel; Meade, Michelle A

2004-01-01

Recreation and sports following Spinal Cord Injury (SCI) are beneficial, but under-studied, aspects of community integration. Previous studies have shown that sports and recreation can offer numerous physiological and psychological benefits to those who participate. This manuscript critically reviews available literature focused upon participation in recreation and sports among persons with SCI. Issues of participation, technology and safety are discussed and recommendations are provided.

Impact of school health management committees on health services delivery in Ghana: A national level assessment.

PubMed

Bowman, Angela S; Owusu, Andrew; Trueblood, Amber B; Bosumtwi-Sam, Cynthia

2018-05-07

To examine the prevalence, determinants, and impact of local school health management committees on implementation of minimum-recommended school health services delivery among basic and secondary schools in Ghana. National level cross-sectional data from the first-ever assessment of Ghana Global-School Health Policies and Practices Survey was utilized. Complex sample analyses were used to quantify school-level implementation of recommended minimum package for health services delivery. Of 307 schools, 98% were basic and government run, and 33% offered at least half of the recommended health service delivery areas measured. Schools with a school health management committee (53%) were 4.8 (95% CI = 3.23-5.18) times as likely to offer at least 50% of the minimum health services package than schools that did not. There is significant deficit concerning delivery of school health services in schools across Ghana. However, school health management committees positively impact implementation of health service delivery. School health management committees provide a significant impact on delivery of school health services; thus, it is recommended that policy makers and programmers place greater emphasis on the value and need for these advisory boards in all Ghanaian schools. Copyright © 2018 John Wiley & Sons, Ltd.

How many steps/day are enough? For adults.

PubMed

Tudor-Locke, Catrine; Craig, Cora L; Brown, Wendy J; Clemes, Stacy A; De Cocker, Katrien; Giles-Corti, Billie; Hatano, Yoshiro; Inoue, Shigeru; Matsudo, Sandra M; Mutrie, Nanette; Oppert, Jean-Michel; Rowe, David A; Schmidt, Michael D; Schofield, Grant M; Spence, John C; Teixeira, Pedro J; Tully, Mark A; Blair, Steven N

2011-07-28

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions or translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognize that "some physical activity is better than none" while maintaining a focus on time spent in moderate-to-vigorous physical activity (MVPA). Thus, the purpose of this review was to update our existing knowledge of "How many steps/day are enough?", and to inform step-based recommendations consistent with current physical activity guidelines. Normative data indicate that healthy adults typically take between 4,000 and 18,000 steps/day, and that 10,000 steps/day is reasonable for this population, although there are notable "low active populations." Interventions demonstrate incremental increases on the order of 2,000-2,500 steps/day. The results of seven different controlled studies demonstrate that there is a strong relationship between cadence and intensity. Further, despite some inter-individual variation, 100 steps/minute represents a reasonable floor value indicative of moderate intensity walking. Multiplying this cadence by 30 minutes (i.e., typical of a daily recommendation) produces a minimum of 3,000 steps that is best used as a heuristic (i.e., guiding) value, but these steps must be taken over and above habitual activity levels to be a true expression of free-living steps/day that also includes recommendations for minimal amounts of time in MVPA. Computed steps/day translations of time in MVPA that also include estimates of habitual activity levels equate to 7,100 to 11,000 steps/day. A direct estimate of minimal amounts of MVPA accumulated in the course of objectively monitored free-living behaviour is 7,000-8,000 steps/day. A scale that spans a wide range of incremental increases in steps/day and is congruent with public health recognition that "some physical activity is better than none," yet still incorporates step-based translations of recommended amounts of time in MVPA may be useful in research and practice. The full range of users (researchers to practitioners to the general public) of objective monitoring instruments that provide step-based outputs require good reference data and evidence-based recommendations to be able to design effective health messages congruent with public health physical activity guidelines, guide behaviour change, and ultimately measure, track, and interpret steps/day.

How many steps/day are enough? for adults

PubMed Central

2011-01-01

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions or translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognize that "some physical activity is better than none" while maintaining a focus on time spent in moderate-to-vigorous physical activity (MVPA). Thus, the purpose of this review was to update our existing knowledge of "How many steps/day are enough?", and to inform step-based recommendations consistent with current physical activity guidelines. Normative data indicate that healthy adults typically take between 4,000 and 18,000 steps/day, and that 10,000 steps/day is reasonable for this population, although there are notable "low active populations." Interventions demonstrate incremental increases on the order of 2,000-2,500 steps/day. The results of seven different controlled studies demonstrate that there is a strong relationship between cadence and intensity. Further, despite some inter-individual variation, 100 steps/minute represents a reasonable floor value indicative of moderate intensity walking. Multiplying this cadence by 30 minutes (i.e., typical of a daily recommendation) produces a minimum of 3,000 steps that is best used as a heuristic (i.e., guiding) value, but these steps must be taken over and above habitual activity levels to be a true expression of free-living steps/day that also includes recommendations for minimal amounts of time in MVPA. Computed steps/day translations of time in MVPA that also include estimates of habitual activity levels equate to 7,100 to 11,000 steps/day. A direct estimate of minimal amounts of MVPA accumulated in the course of objectively monitored free-living behaviour is 7,000-8,000 steps/day. A scale that spans a wide range of incremental increases in steps/day and is congruent with public health recognition that "some physical activity is better than none," yet still incorporates step-based translations of recommended amounts of time in MVPA may be useful in research and practice. The full range of users (researchers to practitioners to the general public) of objective monitoring instruments that provide step-based outputs require good reference data and evidence-based recommendations to be able to design effective health messages congruent with public health physical activity guidelines, guide behaviour change, and ultimately measure, track, and interpret steps/day. PMID:21798015

A Symphony of Software.

ERIC Educational Resources Information Center

Currents, 2002

2002-01-01

Offers a descriptive table of databases that help higher education institutions orchestrate advancement operations. Information includes vendor, contact, software, price, database engine/server platform, recommended reporting tools, record capacity, and client type. (EV)

Presenting Papers at ABCA Conferences: Opinions and Recommendations.

ERIC Educational Resources Information Center

Mier, Denise; Myers, Robert

1981-01-01

Offers guidelines for preparing and presenting papers at American Business Communication Association (ABCA) conferences. Topics covered include: (1) types of delivery, (2) extemporaneous speaking, and (3) manuscript speaking. (FL)

Daily menus can result in suboptimal nutrient intakes, especially calcium, of adolescents living in dormitories.

PubMed

Kresić, Greta; Simundić, Borislav; Mandić, Milena L; Kendel, Gordana; Zezelj, Sandra Pavicić

2008-03-01

The aims of this study were to evaluate daily menus in Croatian dormitories and to assess the overall intake of dairy products among resident adolescents. For this purpose, 168 daily menus were chosen for nutritional evaluation by random sampling. In addition, 227 adolescents (133 girls and 94 boys) participated in a questionnaire focused on food intake in addition to the meals supplied in dormitories with the aim to assess the amount and the type of dairy products consumed. The results showed that only 35% of the daily menus were nutritionally balanced. Most of the menus provided an excess of energy, protein, carbohydrate, saturated fat, phosphorus, riboflavin, and vitamin A. The levels of calcium and magnesium in the menus were suboptimal. The menus offered to adolescents provided approximately 2 servings of dairy products per day. Milk was the most often supplied dairy product (1.1 servings per day), whereas yogurt had the lowest frequency of serving (0.2 servings per day). The most preferred dairy-based snack for both sexes was milk. Dairy-based snacks provided about 1 serving per day for both sexes and contributed to about 30% of the recommended dietary allowances for calcium. Adolescents who regularly consumed dairy-based snacks meet the recommendations (3.2 servings of dairy products per day and about 98% recommended dietary allowances for calcium). We conclude that the institutional menu planning should be improved because the intake of dairy snacks will continue to be a problem for achieving a healthy diet in adolescences.

Routinely collected English birth data sets: comparisons and recommendations for reproductive epidemiology.

PubMed

Ghosh, Rebecca E; Ashworth, Danielle C; Hansell, Anna L; Garwood, Kevin; Elliott, Paul; Toledano, Mireille B

2016-09-01

In England there are four national routinely collected data sets on births: Office for National Statistics (ONS) births based on birth registrations; Hospital Episode Statistics (HES) deliveries (mothers' information); HES births (babies' information); and NHS Numbers for Babies (NN4B) based on ONS births plus gestational age and ethnicity information. This study describes and compares these data, with the aim of recommending the most appropriate data set(s) for use in epidemiological research and surveillance. We assessed the completeness and quality of the data sets in relation to use in epidemiological research and surveillance and produced detailed descriptive statistics on common reproductive outcomes for each data set including temporal and spatial trends. ONS births is a high quality complete data set but lacks interpretive and clinical information. HES deliveries showed good agreement with ONS births but HES births showed larger amounts of missing or unavailable data. Both HES data sets had improved quality from 2003 onwards, but showed some local spatial variability. NN4B showed excellent agreement with ONS and HES deliveries for the years available (2006-2010). Annual number of births increased by 17.6% comparing 2002 with 2010 (ONS births). Approximately 6% of births were of low birth weight (2.6% term low birth weight) and 0.5% were stillbirths. Routinely collected data on births provide a valuable resource for researchers. ONS and NN4B offer the most complete and accurate record of births. Where more detailed clinical information is required, HES deliveries offers a high quality data set that captures the majority of English births. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Treatment of fibromyalgia at the Maharishi Ayurveda Health Centre in Norway II--a 24-month follow-up pilot study.

PubMed

Rasmussen, Lars Bjørn; Mikkelsen, Knut; Haugen, Margaretha; Pripp, Are H; Fields, Jeremy Z; Førre, Øystein T

2012-05-01

Treatments offered at the Maharishi Ayurveda Health Centre in Norway are based on Maharishi Vedic Medicine (MVM). MVM is a consciousness-based revival by Maharishi Mahesh Yogi, the founder of the Transcendental Meditation (TM) program of the ancient Ayurvedic medicine tradition in India. To extend from 6 to 24 months, a pilot study of the effects of the treatment program at the Health Centre on fibromyalgia. Retesting 2 years after a clinical trial. In this intention to treat study, 31 women with a diagnosis of fibromyalgia received an individually tailored program of (1) physiological purification therapy (Maharishi Panchakarma) and (2) Ayurvedic recommendations regarding daily routine and diet including a novel approach to food intolerance. Five subjects chose to learn TM for stress reduction, pain management and personal development. All were recommended Ayurvedic herbal products for follow-up treatment. A modified Fibromyalgia Impact Questionnaire (FIQ) that included seven dimensions. Scores at 24 months follow-up were compared with pre-treatment scores. At 24-months follow-up, there were significant reductions (26% to 44%) in six of the seven fibromyalgia dimensions: impairment of working ability, pain, tiredness, morning tiredness, stiffness and anxiety. The 7th, depression, decreased 32% (borderline significant). At 24 months, the four subjects who continued practising TM, had almost no symptoms and significantly lower FIQ change scores (-92% to 97%) than the non-meditators on all outcomes. This pilot study suggests that the treatments and health promotion programs offered at the Maharishi Ayurveda Health Centre in Norway lead to long-term reductions in symptoms of fibromyalgia, which is considered a treatment-resistant condition, and further studies are warranted.

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.

Psychological and interpersonal dimensions of sexual function and dysfunction.

PubMed

Althof, Stanley E; Leiblum, Sandra R; Chevret-Measson, Marie; Hartmann, Uwe; Levine, Stephen B; McCabe, Marita; Plaut, Michael; Rodrigues, Oswaldo; Wylie, Kevan

2005-11-01

There are limited outcome data on the efficacy of psychological interventions for male and female sexual dysfunction and the role of innovative combined treatment paradigms. To highlight the salient psychological and interpersonal issues contributing to sexual health and dysfunction; to offer a four-tiered paradigm for understanding the evolution and maintenance of sexual symptoms; and to offer recommendations for clinical management and research. An International Consultation assembled over 200 multidisciplinary experts from 60 countries into 17 committees. The recommendations of committee members represent state-of-the-art knowledge and opinions of experts from five continents were developed in a process over a 2-year period. Concerning the Psychological and Interpersonal Committee of Sexual Function and Dysfunction, there were nine experts from five countries. Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. Medical and psychological therapies for sexual dysfunctions should address the intricate biopsychosocial influences of the patient, the partner, and the couple. The biopsychosocial model provides a compelling reason for skepticism that any single intervention (i.e., a phosphodiesterase type 5 inhibitor, supraphysiological doses of a hormone, processing of childhood victimization, marital therapy, pharmacotherapy of depression, etc.) will be sufficient for most patients or couples experiencing sexual dysfunction. There is need for collaboration between healthcare practitioners from different disciplines in evaluation, treatment, and education issues surrounding sexual dysfunction. In many cases, neither psychotherapy alone nor medical intervention alone is sufficient for the lasting resolution of sexual problems. Assessment of male, female, and couples' sexual dysfunction should ideally include inquiry about: predisposing, precipitating, maintaining, and contextual factors. Treatment of lifelong and/or chronic dysfunction will be different from acquired or recent dysfunction. Research is needed to identify efficacious combined and/or integrated treatments for sexual dysfunction.

The role of objective personality inventories in suicide risk assessment: an evaluation and proposal.

PubMed

Johnson, W B; Lall, R; Bongar, B; Nordlund, M D

1999-01-01

Objective personality assessment instruments offer a comparatively underutilized source of clinical data in attempts to evaluate and predict risk for suicide. In contrast to focal suicide risk measures, global personality inventories may be useful in identification of long-standing styles that predispose persons to eventual suicidal behavior. This article reviews the empirical literature regarding the efficacy of established personality inventories in predicting suicidality. The authors offer several recommendations for future research with these measures and conclude that such objective personality instruments offer only marginal utility as sources of clinical information in comprehensive suicide risk evaluations. Personality inventories may offer greatest utility in long-term assessment of suicide risk.

[Reason for dietary salt reduction and potential effect on population health--WHO recommendation].

PubMed

Kaić-Rak, Antoinette; Pucarin-Cvetković, Jasna; Heim, Inge; Skupnjak, Berislav

2010-05-01

It is well known that reduction of salt results in lowering blood pressure and cardiovascular incidents. Daily salt is double the recommended daily quantity and mainly comes from processed food. The assessment of daily salt intake for Croatia is 12 g/day (WHO recommendation is <5 g/day). The main source of sodium is processed food and food prepared in restaurants (77%), natural content of sodium in food (12%), added salt at table (6%) and prepared meals at home (5%). Reduction of salt by 50% would save nearly 180,000 lives per year in Europe. It is necessary to establish better collaboration with food manufacturers in order to reduce the content of salt in processed food and to achieve appropriate salt intake per day in accordance with the WHO recommendation. Further, it is necessary to encourage food manufacturers to produce food and meals with low or reduced salt content (shops, catering, changes in recipes, offer salt substitutions). This kind of collaboration is based on bilateral interests that can result in positive health effects. One of the most important public health tasks is to educate consumers and to give them choice when buying food. This can be achieved by effective campaigns and social marketing, by ensuring a declaration of salt content on the product, or specially designed signs for food products with low or reduced salt content.

Recommendations for participation in competitive sport and leisure-time physical activity in individuals with cardiomyopathies, myocarditis and pericarditis.

PubMed

Pelliccia, Antonio; Corrado, Domenico; Bjørnstad, Hans Halvor; Panhuyzen-Goedkoop, Nicole; Urhausen, Axel; Carre, Francois; Anastasakis, Aris; Vanhees, Luc; Arbustini, Eloisa; Priori, Silvia

2006-12-01

Several relatively uncommon, but important cardiovascular diseases are associated with increased risk for acute cardiac events during exercise (including sudden death), such as hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), arrhythmogenic right ventricular cardiomyopathy (ARVC) and myo-pericarditis. Practising cardiologists are frequently asked to advise on exercise programmes and sport participation in young individuals with these cardiovascular diseases. Indeed, many asymptomatic (or mildly symptomatic) patients with cardiomyopathies aspire to a physically active lifestyle to take advantage of the many documented benefits of exercise. While recommendations dictating the participation in competitive sport for athletes with cardiomyopathies and myo-pericarditis have recently been published as a consensus document of the European Society of Cardiology, no European guidelines have addressed the possible participation of patients with cardiomyopathies in recreational and amateur sport activities. The present document is intended to offer a comprehensive overview to practising cardiologists and sport physicians of the recommendations governing safe participation in different types of competitive sport, as well as the participation in a variety of recreational physical activities and amateur sports in individuals with cardiomyopathies and myo-pericarditis. These recommendations, based largely on the experience and insights of the expert panel appointed by the European Society of Cardiology, include the most up-to-date information concerning regular exercise and sports activity in patients with cardiomyopathies and myo-pericarditis.

Initiating decision-making in neurology consultations: 'recommending' versus 'option-listing' and the implications for medical authority.

PubMed

Toerien, Merran; Shaw, Rebecca; Reuber, Markus

2013-07-01

This article compares two practices for initiating treatment decision-making, evident in audio-recorded consultations between a neurologist and 13 patients in two hospital clinics in the UK. We call these 'recommending' and 'option-listing'. The former entails making a proposal to do something; the latter entails the construction of a list of options. Using conversation analysis (CA), we illustrate each, showing that the distinction between these two practices matters to participants. Our analysis centres on two distinctions between the practices: epistemic differences and differences in the slots each creates for the patient's response. Considering the implications of our findings for understanding medical authority, we argue that option-listing - relative to recommending - is a practice whereby clinicians work to relinquish a little of their authority. This article contributes, then, to a growing body of CA work that offers a more nuanced, tempered account of medical authority than is typically portrayed in the sociological literature. We argue that future CA studies should map out the range of ways - in addition to recommending - in which treatment decision-making is initiated by clinicians. This will allow for further evidence-based contributions to debates on the related concepts of patient participation, choice, shared decision-making and medical authority. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Clinical trials recruitment planning: A proposed framework from the Clinical Trials Transformation Initiative.

PubMed

Huang, Grant D; Bull, Jonca; Johnston McKee, Kelly; Mahon, Elizabeth; Harper, Beth; Roberts, Jamie N

2018-03-01

Patient recruitment is widely recognized as a key determinant of success for clinical trials. Yet a substantial number of trials fail to reach recruitment goals-a situation that has important scientific, financial, ethical, and policy implications. Further, there are important effects on stakeholders who directly contribute to the trial including investigators, sponsors, and study participants. Despite efforts over multiple decades to identify and address barriers, recruitment challenges persist. To advance a more comprehensive approach to trial recruitment, the Clinical Trials Transformation Initiative (CTTI) convened a project team to examine the challenges and to issue actionable, evidence-based recommendations for improving recruitment planning that extend beyond common study-specific strategies. We describe our multi-stakeholder effort to develop a framework that delineates three areas essential to strategic recruitment planning efforts: (1) trial design and protocol development, (2) trial feasibility and site selection, and (3) communication. Our recommendations propose an upstream approach to recruitment planning that has the potential to produce greater impact and reduce downstream barriers. Additionally, we offer tools to help facilitate adoption of the recommendations. We hope that our framework and recommendations will serve as a guide for initial efforts in clinical trial recruitment planning irrespective of disease or intervention focus, provide a common basis for discussions in this area and generate targets for further analysis and continual improvement. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Identifying domestic and international sex-trafficking victims during human service provision.

PubMed

Macy, Rebecca J; Graham, Laurie M

2012-04-01

Children, youth, and adults of both genders are sex trafficked into and throughout the United States every day. Regrettably, little attention has been given to how human service providers might identify the sex-trafficking victims they are likely to encounter. To address this knowledge gap, the authors review 20 documents with the aim of detecting and synthesizing service identification recommendations in the scientific literature, government reports, and documents produced by organizations working with sex-trafficking victims. The review shows consensus regarding identification recommendations, including (a) trafficking indicators, (b) victim interaction strategies, (c) immediate response strategies, and (d) child-specific information. The review also shows consensus regarding screening questions that are important for service providers to use in identifying sex-trafficking victims. These questions relate to the victims' safety, employment, living environment, and travel and immigration status in addition to specific questions used with children and youth. The review results offer human service providers a preliminary set of screening strategies and questions that can be used to identify sex-trafficking victims in the context of human services. Building on the review findings, the authors offer policy and research recommendations.

Laser-powered MHD generators for space application

NASA Technical Reports Server (NTRS)

Jalufka, N. W.

1986-01-01

Magnetohydrodynamic (MHD) energy conversion systems of the pulsed laser-supported detonation (LSD) wave, plasma MHD, and liquid-metal MHD (LMMHD) types are assessed for their potential as space-based laser-to-electrical power converters. These systems offer several advantages as energy converters relative to the present chemical, nuclear, and solar devices, including high conversion efficiency, simple design, high-temperature operation, high power density, and high reliability. Of these systems, the Brayton cycle liquid-metal MHD system appears to be the most attractive. The LMMHD technology base is well established for terrestrial applications, particularly with regard to the generator, mixer, and other system components. However, further research is required to extend this technology base to space applications and to establish the technology required to couple the laser energy into the system most efficiently. Continued research on each of the three system types is recommended.

Rethinking Intelligence Quotient Exclusion Criteria Practices in the Study of Attention Deficit Hyperactivity Disorder

PubMed Central

Mackenzie, Genevieve B.; Wonders, Elif

2016-01-01

Attention deficit hyperactivity disorder (ADHD) is associated with lower than average intelligence quotient (IQ) scores. However, research done on this disorder often excludes participants based on lower than average IQ’s (i.e., between 70 and 85). The purpose of this paper is to alert researchers to the consequences of excluding participants based on IQ’s within this range and to highlight the importance of providing a clear rationale when choosing to exclude participants based on IQ. Next, we offer recommendations for researching ADHD and their relative benefits and drawbacks of these approaches. Overall this paper emphasizes that including participants who have lower than average IQ in research on ADHD may promote a more realistic understanding of the condition and in turn improve our ability to treat it. PMID:27303350

Design Options for a Desktop Publishing Course.

ERIC Educational Resources Information Center

Mayer, Kenneth R.; Nelson, Sandra J.

1992-01-01

Offers recommendations for development of an undergraduate desktop publishing course. Discusses scholastic level and prerequisites, purpose and objectives, instructional resources and methodology, assignments and evaluation, and a general course outline. (SR)

Investigating the impact of the properties of pilot points on calibration of groundwater models: case study of a karst catchment in Rote Island, Indonesia

NASA Astrophysics Data System (ADS)

Klaas, Dua K. S. Y.; Imteaz, Monzur Alam

2017-09-01

A robust configuration of pilot points in the parameterisation step of a model is crucial to accurately obtain a satisfactory model performance. However, the recommendations provided by the majority of recent researchers on pilot-point use are considered somewhat impractical. In this study, a practical approach is proposed for using pilot-point properties (i.e. number, distance and distribution method) in the calibration step of a groundwater model. For the first time, the relative distance-area ratio ( d/ A) and head-zonation-based (HZB) method are introduced, to assign pilot points into the model domain by incorporating a user-friendly zone ratio. This study provides some insights into the trade-off between maximising and restricting the number of pilot points, and offers a relative basis for selecting the pilot-point properties and distribution method in the development of a physically based groundwater model. The grid-based (GB) method is found to perform comparably better than the HZB method in terms of model performance and computational time. When using the GB method, this study recommends a distance-area ratio of 0.05, a distance-x-grid length ratio ( d/ X grid) of 0.10, and a distance-y-grid length ratio ( d/ Y grid) of 0.20.

Faith-Based Organizations and Veteran Reintegration: Enriching the Web of Support.

PubMed

Werber, Laura; Derose, Kathryn Pitkin; Rudnick, Mollie; Harrell, Margaret C; Naranjo, Diana

2015-11-30

Faith-based organizations (FBOs) are an important community-based resource for veterans as they readjust to civilian life. Through interviews with both national-level and smaller, local FBOs, the authors sought to understand better the current and potential roles for FBOs in veteran reintegration. Interviewees suggested that veterans may look to FBOs for support because they offer privacy and confidentiality, two features that may be especially critical when a potential stigma is involved. Some FBOs have also developed a reputation as safe places for veterans, providing supportive, judgment-free environments. FBOs not only help veterans with spiritual matters but address diverse areas of veteran health and wellness, including vocation, education, financial and legal stability, shelter, access to goods and services, mental health, access to health care, physical health, family, and social networks. In some cases, the support is offered to veterans directly; in other instances, the support is indirect, via training individuals to help veterans or educating the public about them. In the process of providing support, FBOs interact with varied organizations, including government entities, private nonprofits, and one another, for training, outreach, referrals, information exchange, obtaining donations, and collaboration. Yet challenges exist, including insufficient connections with chaplains working in different settings and others in the web of support, resource and capacity constraints, lack of awareness of experience with veterans, issues related to religious philosophy or orientation, and characteristics of veterans themselves. To move forward, the authors offer recommendations for policymakers, organizations that interact with FBOs, and FBOs themselves to help FBOs engage fully in the web of reintegration support.

Patient perspectives about bariatric surgery unveil experiences, education, satisfaction, and recommendations for improvement.

PubMed

Groller, Karen D; Teel, Cynthia; Stegenga, Kristin H; El Chaar, Maher

2018-02-17

Following bariatric surgery, up to 35% of patients struggle with strict regimens and experience weight recidivism within 2 years [1-5]. Accredited weight management centers (WMC) must provide educational programs and support patients in lifestyle changes before and after surgery. Educational programs, however, may not be evidence-based or patient-centered and may vary in curriculum, approach, and educator type [6]. To obtain patient descriptions about the weight loss surgery (WLS) experience, including education, satisfaction, and recommendations for improvement. Participants were recruited from a university hospital-based WMC in Pennsylvania. This qualitative descriptive study used purposive sampling and inductive content analysis. A NEW ME-VERSION 2.0, encompassed themes from semistructured interviews with 11 participants (36% male). Theme 1: Programming and Tools, explained how individuals undergoing WLS found support through educational programming. Theme 2: Updates and Upgrades, identified issues surrounding quality of life and challenges before and after surgery. Theme 3: Lessons Learned and Future Considerations, identified satisfaction levels and recommendations for improving the WLS experience. Participants reported positive experiences, acknowledging educational programs and extensive WMC resources, yet also offered recommendations for improving educational programming. Patient narratives provided evidence about the WLS experience. Achievement of weight goals, adherence to rules, and improved health status contributed to perceptions of WLS success. Participants encouraged educators to identify expected outcomes of educational programming, monitor holistic transformations, foster peer support, and use technology in WMC programming. Results also validated the need for the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program's education requirement (standard 5.1). Future educational research could help develop best practices in WLS patient education and assess associations between education and clinical outcomes. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Hanford Spent Nuclear Fuel Project recommended path forward

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

Fulton, J.C.

The Spent Nuclear Fuel Project (the Project), in conjunction with the U.S. Department of Energy-commissioned Independent Technical Assessment (ITA) team, has developed engineered alternatives for expedited removal of spent nuclear fuel, including sludge, from the K Basins at Hanford. These alternatives, along with a foreign processing alternative offered by British Nuclear Fuels Limited (BNFL), were extensively reviewed and evaluated. Based on these evaluations, a Westinghouse Hanford Company (WHC) Recommended Path Forward for K Basins spent nuclear fuel has been developed and is presented in Volume I of this document. The recommendation constitutes an aggressive series of projects to construct andmore » operate systems and facilities to safely retrieve, package, transport, process, and store K Basins fuel and sludge. The overall processing and storage scheme is based on the ITA team`s proposed passivation and vault storage process. A dual purpose staging and vault storage facility provides an innovative feature which allows accelerated removal of fuel and sludge from the basins and minimizes programmatic risks beyond any of the originally proposed alternatives. The projects fit within a regulatory and National Environmental Policy Act (NEPA) overlay which mandates a two-phased approach to construction and operation of the needed facilities. The two-phase strategy packages and moves K Basins fuel and sludge to a newly constructed Staging and Storage Facility by the year 2000 where it is staged for processing. When an adjoining facility is constructed, the fuel is cycled through a stabilization process and returned to the Staging and Storage Facility for dry interim (40-year) storage. The estimated total expenditure for this Recommended Path Forward, including necessary new construction, operations, and deactivation of Project facilities through 2012, is approximately $1,150 million (unescalated).« less

International short-term medical missions: a systematic review of recommended practices.

PubMed

Roche, Stephanie D; Ketheeswaran, Pavinarmatha; Wirtz, Veronika J

2017-01-01

To identify practices for conducting international short-term medical missions (STMMs) recommended in the literature and examine how these link STMMs to recipient countries' existing health systems. Systematic review of PubMed-indexed articles on STMMs and their bibliographies using preferred reporting items for systematic reviews and meta-analyses guidelines. Recommendations were organized using the World Health Organization Health Systems Framework. In 92 publications, 67 % offered at least one recommendation that would link STMMs to the recipient country's health system. Among these recommendations, most focused on service delivery and few on health financing and governance. There is a lack of consensus around a proper standard of care, patient selection, and trip duration. Comprehensive global standards are needed for STMM work to ensure that services are beneficial both to patients and to the broader healthcare systems of recipient countries. By providing an overview of the current recommendations and important gaps where practice recommendations are needed, this study can provide relevant input into the development of global standards for STMMs.

A multi-method review of home-based chemotherapy.

PubMed

Evans, J M; Qiu, M; MacKinnon, M; Green, E; Peterson, K; Kaizer, L

2016-09-01

This study summarises research- and practice-based evidence on home-based chemotherapy, and explores existing delivery models. A three-pronged investigation was conducted consisting of a literature review and synthesis of 54 papers, a review of seven home-based chemotherapy programmes spanning four countries, and two case studies within the Canadian province of Ontario. The results support the provision of home-based chemotherapy as a safe and patient-centred alternative to hospital- and outpatient-based service. This paper consolidates information on home-based chemotherapy programmes including services and drugs offered, patient eligibility criteria, patient views and experiences, delivery structures and processes, and common challenges. Fourteen recommendations are also provided for improving the delivery of chemotherapy in patients' homes by prioritising patient-centredness, provider training and teamwork, safety and quality of care, and programme management. The results of this study can be used to inform the development of an evidence-informed model for the delivery of chemotherapy and related care, such as symptom management, in patients' homes. © 2015 John Wiley & Sons Ltd.

Accounting principles, reporting rules, and payment practices.

PubMed

Kovener, R R

1979-12-01

Misconceptions concerning the distinction between accounting principles, reporting rules, and payment practices and how they interrelate can lessen the effectiveness of hospital financial managers in these areas/clarification and recommendations are offered.

Types of Faculty Scholars in Community Colleges

ERIC Educational Resources Information Center

Park, Toby J.; Braxton, John M.; Lyken-Segosebe, Dawn

2015-01-01

This chapter describes three empirically derived types of faculty scholars in community colleges: Immersed Scholars, Scholars of Dissemination, and Scholars of Pedagogical Knowledge. This chapter discusses these types and offers a recommendation.

Latino Male Ethnic Subgroups: Patterns in College Enrollment and Degree Completion

ERIC Educational Resources Information Center

Ponjuan, Luis; Palomin, Leticia; Calise, Angela

2015-01-01

This chapter examines Latino male ethnic subgroups and their college enrollment and degree completion patterns. The chapter also offers recommendations to improve Latino male ethnic subgroups' educational achievement.

Dinosaurs, Dinosaur Eggs, and Probability.

ERIC Educational Resources Information Center

Teppo, Anne R.; Hodgson, Ted

2001-01-01

Outlines several recommendations for teaching probability in the secondary school. Offers an activity that employs simulation by hand and using a programmable calculator in which geometry, analytical geometry, and discrete mathematics are explored. (KHR)

Canadian guidelines for acute bacterial rhinosinusitis

PubMed Central

Kaplan, Alan

2014-01-01

Objective To provide a clinical summary of the Canadian clinical practice guidelines for acute bacterial rhinosinusitis (ABRS) that includes relevant considerations for family physicians. Quality of evidence Guideline authors performed a systematic literature search and drafted recommendations. Recommendations received both strength of evidence and strength of recommendation ratings. Input from external content experts was sought, as was endorsement from Canadian medical societies (Association of Medical Microbiology and Infectious Disease Canada, Canadian Society of Allergy and Clinical Immunology, Canadian Society of Otolaryngology—Head and Neck Surgery, Canadian Association of Emergency Physicians, and the Family Physicians Airways Group of Canada). Main message Diagnosis of ABRS is based on the presence of specific symptoms and their duration; imaging or culture are not needed in uncomplicated cases. Treatment is dependent on symptom severity, with intranasal corticosteroids (INCSs) recommended as monotherapy for mild and moderate cases, although the benefit might be modest. Use of INCSs plus antibiotics is reserved for patients who fail to respond to INCSs after 72 hours, and for initial treatment of patients with severe symptoms. Antibiotic selection must account for the suspected pathogen, the risk of resistance, comorbid conditions, and local antimicrobial resistance trends. Adjunct therapies such as nasal saline irrigation are recommended. Failure to respond to treatment, recurrent episodes, and signs of complications should prompt referral to an otolaryngologist. The guidelines address situations unique to the Canadian health care environment, including actions to take during prolonged wait periods for specialist referral or imaging. Conclusion The Canadian guidelines provide up-to-date recommendations for diagnosis and treatment of ABRS that reflect an evolving understanding of the disease. In addition, the guidelines offer useful tools to help clinicians discern viral from bacterial episodes, as well as optimally manage their patients with ABRS. PMID:24627376

The case for workforce development in social marketing.

PubMed

Pounds, Lea

2016-01-01

The Centers for Disease Control and Prevention, Association of Schools and Programs of Public Health, and the Council on Linkages Between Academia and Public Health Practice have emphasized the increasing need to train the public health workforce in social marketing. With only 21 U.S. academic institutions offering course work in social marketing and only four institutions offering degrees in social marketing there is a gap between what academic institutions are offering and these recommendations (Kelly, 2013 ). The successful application of social marketing in public health practice relies on academic institutions creating and promoting social marketing-related programs.

Transformation in Teaching-Learning: Emerging Possibilities with Interprofessional Education.

PubMed

Yancey, Nan Russell; Cahill, Susan; McDowell, Michael

2018-04-01

As the global community continues to face increasing mobility, rising healthcare costs, and decreasing or inaccessible healthcare resources, healthcare providers must be able to work together effectively in addressing the needs of progressively older and diverse persons and populations. In this column, the notion of interprofessional education (IPE) is explored and a model proposed for implementation in an institution offering graduate programs in nursing and occupational therapy. While the proposed model was developed for two disciplinary programs in a specific institution, the recommendations offered may easily be adapted for use in academic institutions offering varied and unique healthcare professional programs.

Framework for the design and delivery of organized physical activity sessions for children and adolescents: rationale and description of the 'SAAFE' teaching principles.

PubMed

Lubans, David R; Lonsdale, Chris; Cohen, Kristen; Eather, Narelle; Beauchamp, Mark R; Morgan, Philip J; Sylvester, Benjamin D; Smith, Jordan J

2017-02-23

The economic burden of inactivity is substantial, with conservative estimates suggesting the global cost to health care systems is more than US$50 billion. School-based programs, including physical education and school sport, have been recommended as important components of a multi-sector, multi-system approach to address physical inactivity. Additionally, community sporting clubs and after-school programs (ASPs) offer further opportunities for young people to be physically active outside of school. Despite demonstrating promise, current evidence suggests school-based physical activity programs, community sporting clubs and ASPs are not achieving their full potential. For example, physical activity levels in physical education (PE) and ASP sessions are typically much lower than recommended. For these sessions to have the strongest effects on young people's physical activity levels and their on-going physical literacy, they need to improve in quality and should be highly active and engaging. This paper presents the Supportive, Active, Autonomous, Fair, Enjoyable (SAAFE) principles, which represent an evidence-based framework designed to guide the planning, delivery and evaluation of organized physical activity sessions in school, community sport and ASPs. In this paper we provide a narrative and integrative review of the conceptual and empirical bases that underpin this framework and highlight implications for knowledge translation and application.

Staff Report on the Guaranteed Student Loan Program, Belmont Task Force Recommendations. Prepared for the Subcommittee on Postsecondary Education of the Committee on Education and Labor.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and Labor.

Recommendations of the Belmont Task Force concerning the problem of student loan defaults are offered to the U.S. House of Representatives. The task force concludes that the purpose of the Guaranteed Student Loan (GSL) program has changed significantly in the last decade. While originally established as a loan of convenience for middle-income…

GRADE: Assessing the quality of evidence in environmental and occupational health.

PubMed

Morgan, Rebecca L; Thayer, Kristina A; Bero, Lisa; Bruce, Nigel; Falck-Ytter, Yngve; Ghersi, Davina; Guyatt, Gordon; Hooijmans, Carlijn; Langendam, Miranda; Mandrioli, Daniele; Mustafa, Reem A; Rehfuess, Eva A; Rooney, Andrew A; Shea, Beverley; Silbergeld, Ellen K; Sutton, Patrice; Wolfe, Mary S; Woodruff, Tracey J; Verbeek, Jos H; Holloway, Alison C; Santesso, Nancy; Schünemann, Holger J

2016-01-01

There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modeling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are to provide an overview of GRADE, discuss GRADE's applicability to environmental health, and identify priority areas for method assessment and development. Copyright © 2016 Elsevier Ltd. All rights reserved.

Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline.

PubMed

Brahmer, Julie R; Lacchetti, Christina; Schneider, Bryan J; Atkins, Michael B; Brassil, Kelly J; Caterino, Jeffrey M; Chau, Ian; Ernstoff, Marc S; Gardner, Jennifer M; Ginex, Pamela; Hallmeyer, Sigrun; Holter Chakrabarty, Jennifer; Leighl, Natasha B; Mammen, Jennifer S; McDermott, David F; Naing, Aung; Nastoupil, Loretta J; Phillips, Tanyanika; Porter, Laura D; Puzanov, Igor; Reichner, Cristina A; Santomasso, Bianca D; Seigel, Carole; Spira, Alexander; Suarez-Almazor, Maria E; Wang, Yinghong; Weber, Jeffrey S; Wolchok, Jedd D; Thompson, John A

2018-06-10

Purpose To increase awareness, outline strategies, and offer guidance on the recommended management of immune-related adverse events in patients treated with immune checkpoint inhibitor (ICPi) therapy. Methods A multidisciplinary, multi-organizational panel of experts in medical oncology, dermatology, gastroenterology, rheumatology, pulmonology, endocrinology, urology, neurology, hematology, emergency medicine, nursing, trialist, and advocacy was convened to develop the clinical practice guideline. Guideline development involved a systematic review of the literature and an informal consensus process. The systematic review focused on guidelines, systematic reviews and meta-analyses, randomized controlled trials, and case series published from 2000 through 2017. Results The systematic review identified 204 eligible publications. Much of the evidence consisted of systematic reviews of observational data, consensus guidelines, case series, and case reports. Due to the paucity of high-quality evidence on management of immune-related adverse events, recommendations are based on expert consensus. Recommendations Recommendations for specific organ system-based toxicity diagnosis and management are presented. While management varies according to organ system affected, in general, ICPi therapy should be continued with close monitoring for grade 1 toxicities, with the exception of some neurologic, hematologic, and cardiac toxicities. ICPi therapy may be suspended for most grade 2 toxicities, with consideration of resuming when symptoms revert to grade 1 or less. Corticosteroids may be administered. Grade 3 toxicities generally warrant suspension of ICPis and the initiation of high-dose corticosteroids (prednisone 1 to 2 mg/kg/d or methylprednisolone 1 to 2 mg/kg/d). Corticosteroids should be tapered over the course of at least 4 to 6 weeks. Some refractory cases may require infliximab or other immunosuppressive therapy. In general, permanent discontinuation of ICPis is recommended with grade 4 toxicities, with the exception of endocrinopathies that have been controlled by hormone replacement. Additional information is available at www.asco.org/supportive-care-guidelines and www.asco.org/guidelineswiki .

GRADE: Assessing the quality of evidence in environmental and occupational health

PubMed Central

Morgan, Rebecca L; Thayer, Kristina A; Bero, Lisa; Bruce, Nigel; Falck-Ytter, Yngve; Ghersi, Davina; Guyatt, Gordon; Hooijmans, Carlijn; Langendam, Miranda; Mandrioli, Daniele; Mustafa, Reem A.; Rehfuess, Eva A; Rooney, Andrew A; Shea, Beverley; Silbergeld, Ellen K; Sutton, Patrice; Wolfe, Mary; Woodruff, Tracey J; Verbeek, Jos H; Holloway, Alison C.; Santesso, Nancy; Schünemann, Holger J

2016-01-01

There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modelling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are to provide an overview of GRADE, discuss GRADE’s applicability to environmental health, and identify priority areas for method assessment and development. PMID:26827182

Nordic guidelines for neuraxial blocks in disturbed haemostasis from the Scandinavian Society of Anaesthesiology and Intensive Care Medicine.

PubMed

Breivik, H; Bang, U; Jalonen, J; Vigfússon, G; Alahuhta, S; Lagerkranser, M

2010-01-01

Central neuraxial blocks (CNBs) for surgery and analgesia are an important part of anaesthesia practice in the Nordic countries. More active thromboprophylaxis with potent antihaemostatic drugs has increased the risk of bleeding into the spinal canal. National guidelines for minimizing this risk in patients who benefit from such blocks vary in their recommendations for safe practice. The Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) appointed a task force of experts to establish a Nordic consensus on recommendations for best clinical practice in providing effective and safe CNBs in patients with an increased risk of bleeding. We performed a literature search and expert evaluation of evidence for (1) the possible benefits of CNBs on the outcome of anaesthesia and surgery, for (2) risks of spinal bleeding from hereditary and acquired bleeding disorders and antihaemostatic drugs used in surgical patients for thromboprophylaxis, for (3) risk evaluation in published case reports, and for (4) recommendations in published national guidelines. Proposals from the taskforce were available for feedback on the SSAI web-page during the summer of 2008. Neuraxial blocks can improve comfort and reduce morbidity (strong evidence) and mortality (moderate evidence) after surgical procedures. Haemostatic disorders, antihaemostatic drugs, anatomical abnormalities of the spine and spinal blood vessels, elderly patients, and renal and hepatic impairment are risk factors for spinal bleeding (strong evidence). Published national guidelines are mainly based on experts' opinions (weak evidence). The task force reached a consensus on Nordic guidelines, mainly based on our experts' opinions, but we acknowledge different practices in heparinization during vascular surgery and peri-operative administration of non-steroidal anti-inflammatory drugs during neuraxial blocks. Experts from the five Nordic countries offer consensus recommendations for safe clinical practice of neuraxial blocks and how to minimize the risks of serious complications from spinal bleeding. A brief version of the recommendations is available on http://www.ssai.info.

Linking the Medical and Educational Home to Support Children With Autism Spectrum Disorder: Practice Recommendations.

PubMed

Shahidullah, Jeffrey D; Azad, Gazi; Mezher, Katherine R; McClain, Maryellen Brunson; McIntyre, Laura Lee

2018-05-01

Children with autism spectrum disorder (ASD) present with complex medical problems that are often exacerbated by a range of other intellectual and psychiatric comorbidities. These children receive care for their physical and mental health from a range of providers within numerous child-serving systems, including their primary care clinic, school, and the home and community. Given the longitudinal nature in which care is provided for this chronic disorder, it is particularly necessary for services and providers to coordinate their care to ensure optimal efficiency and effectiveness. There are 2 primary venues that serve as a "home" for coordination of service provision for children with ASD and their families-the "medical home" and the "educational home." Unfortunately, these venues often function independently from the other. Furthermore, there are limited guidelines demonstrating methods through which pediatricians and other primary care providers (PCPs) can coordinate care with schools and school-based providers. The purpose of this article is 2-fold: (1) we highlight the provision of evidence-based care within the medical home and educational home and (2) we offer practice recommendations for PCPs in integrating these systems to optimally address the complex medical, intellectual, and psychiatric symptomology affected by autism.

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

Promote Breastfeeding in the Outpatient Setting: It's Easy!

PubMed

Sriraman, Natasha K

2017-12-01

The numerous benefits for both mother and baby of breastfeeding are evidence-based and well-defined. Breastmilk is the physiologic norm for infant nutrition, offering multiple health benefits and protections for mothers and babies. Although major medical and health organizations, which represent the health of women and children, such as the American Academy of Pediatrics (AAP), American College of Obstetrics and Gynecology (ACOG), American Academy of Family Practice (AAFP), Centers for Disease Control (CDC), UNICEF, the World Health Organization (WHO) and the National Public Health Service (NPHS), all recommend exclusive breastfeeding, few women meet the recommended goals for duration and exclusivity, despite high initiation rates. This article will discuss the barriers women face when breastfeeding. Strategies will be discussed on how physicians and health care providers can assist and advocate for their mothers while helping to improve the health of women and children. Physicians/pediatricians can support women and design interventions that can help patients' mothers overcome these challenges. Copyright © 2016 Mosby, Inc. All rights reserved.

Corporate funding and conflicts of interest: a primer for psychologists.

PubMed

Pachter, Wendy S; Fox, Ronald E; Zimbardo, Philip; Antonuccio, David O

2007-12-01

A presidential task force on external funding was established by the American Psychological Association (APA) in 2003 to review APA policies, procedures, and practices regarding the acceptance of funding and support from private corporations for educational and training programs; continuing education offerings; research projects; publications; advertising; scientific and professional meetings and conferences; and consulting, practice, and advocacy relationships. This article, based on the Executive Summary of the APA Task Force on External Funding Final Report, presents the findings and unanimous recommendations of the task force in the areas of association income, annual convention, research and journals, continuing education, education, practice, and conflicts of interest and ethics. The task force concluded that it is important for both APA and individual psychologists to become familiar with the challenges that corporate funding can pose to their integrity. The nature and extent of those challenges led the task force to recommend that APA develop explicit policies, educational materials, and continuing education programs to preserve the independence of psychological science, practice, and education. (Copyright) 2007 APA.

The Role of Therapist Training in the Implementation of Psychosocial Treatments: A Review and Critique with Recommendations

PubMed Central

Herschell, Amy D.; Kolko, David J.; Baumann, Barbara L.; Davis, Abigail C.

2010-01-01

Evidence-based treatments (EBT) are underutilized in community settings, where consumers are often seen for treatment. Underutilization of EBTs may be related to a lack of empirically informed and supported training strategies. The goals of this review are to understand the state of the literature for training therapists in psychotherapy skills and to offer recommendations to improve research in this area. Results of this review of 55 studies evaluating six training methods indicate that multi-component trainings have been studied most often and have most consistently demonstrated positive training outcomes relative to other training methods. Studies evaluating utility of reading, self-directed trainings, and workshops have documented that these methods do not routinely produce positive outcomes. Workshop follow-ups help to sustain outcomes. Little is known about the impact of train-the-trainer methods. Methodological flaws and factors that may influence training outcome and future directions are also reviewed. PMID:20304542

Forensic issues in medical evaluation: competency and end-of-life issues.

PubMed

Soliman, Sherif; Hall, Ryan C W

2015-01-01

Decision-making capacity is a common reason for psychiatric consultation that is likely to become more common as the population ages. Capacity assessments are frequently compromised by misconceptions, such as the belief that incapacity is permanent or that patients with dementia categorically lack capacity. This chapter will review the conceptual framework of decision-making capacity and discuss its application to medical decision-making. We will review selected developments in capacity assessment and recommend an approach to assessing decision-making capacity. We will discuss the unique challenges posed by end-of-life care, including determining capacity, identifying surrogate decision-makers, and working with surrogate decision-makers. We will discuss clinical and legal approaches to incapacity, including advance directives, surrogate decision-makers, and guardians. We will discuss the legal standards based on which surrogates make medical decisions and outline options for resolving disagreements between clinical staff and surrogate decision-makers. We will offer recommendations for approaching decision-making capacity assessments. © 2015 S. Karger AG, Basel.

[Pulse oximetry screening of critical congenital heart defects in the neonatal period. The Spanish National Neonatal Society recommendation].

PubMed

Sánchez Luna, Manuel; Pérez Muñuzuri, Alejandro; Sanz López, Ester; Leante Castellanos, José Luis; Benavente Fernández, Isabel; Ruiz Campillo, César W; Sánchez Redondo, M Dolores; Vento Torres, Máximo; Rite Gracia, Segundo

2018-02-01

Due to its severity, as well as the consequences of a late diagnosis, critical congenital heart defects (CCHD) represent a challenging situation, making an early diagnosis necessary and ideally before symptoms appear when circulatory collapse or death of the newborn can occur. Due to this, a prenatal and very early postnatal diagnosis is very important. Prenatal ultrasound screening and physical examination of the newborn can miss a considerable number of CCHD cases. Pulse oximetry screening has been demonstrated to be an effective, non-invasive, inexpensive, and well accepted tool in the early diagnosis of CCHD. The Spanish National Society of Neonatology, through its Standards Committee, and based on the current evidence, recommend the implementation of pulse oximetry screening of CCHD in Spain, and then to offer the best therapy possible to these newborn infants. Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

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

PubMed

Picouto, María Dolores; Braquehais, María Dolores

2013-01-01

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

2010 ACVIM Small Animal Consensus Statement on Leptospirosis: Diagnosis, Epidemiology, Treatment, and Prevention

PubMed Central

Sykes, JE; Hartmann, K; Lunn, KF; Moore, GE; Stoddard, RA; Goldstein, RE

2011-01-01

This report offers a consensus opinion on the diagnosis, epidemiology, treatment, and prevention of leptospirosis in dogs, an important zoonosis. Clinical signs of leptospirosis in dogs relate to development of renal disease, hepatic disease, uveitis, and pulmonary hemorrhage. Disease may follow periods of high rainfall, and can occur in dogs roaming in proximity to water sources, farm animals, or wildlife, or dogs residing in suburban environments. Diagnosis is based on acute and convalescent phase antibody titers by the microscopic agglutination test (MAT), with or without use of polymerase chain reaction assays. There is considerable interlaboratory variation in MAT results, and the MAT does not accurately predict the infecting serogroup. The recommended treatment for optimal clearance of the organism from renal tubules is doxycycline, 5 mg/kg PO q12h, for 14 days. Annual vaccination can prevent leptospirosis caused by serovars included in the vaccine and is recommended for dogs at risk of infection. PMID:21155890

Evaluation of psychology practitioner competence in clinical supervision.

PubMed

Gonsalvez, Craig J; Crowe, Trevor P

2014-01-01

There is a growing consensus favouring the development, advancement, and implementation of a competency-based approach for psychology training and supervision. There is wide recognition that skills, attitude-values, and relationship competencies are as critical to a psychologist's competence as are knowledge capabilities, and that these key competencies are best measured during placements, leaving the clinical supervisor in an unparalleled position of advantage to provide formative and summative evaluations on the supervisee's progression towards competence. Paradoxically, a compelling body of literature from across disciplines indicates that supervisor ratings of broad domains of competence are systematically compromised by biases, including leniency error and halo effect. The current paper highlights key issues affecting summative competency evaluations by supervisors: what competencies should be evaluated, who should conduct the evaluation, how (tools) and when evaluations should be conducted, and process variables that affect evaluation. The article concludes by providing research recommendations to underpin and promote future progress and by offering practice recommendations to facilitate a more credible and meaningful evaluation of competence and competencies.

Use of Portal Monitors for Detection of Technogenic Radioactive Sources in Scrap Metal

NASA Astrophysics Data System (ADS)

Solovev, D. B.; Merkusheva, A. E.

2017-11-01

The article considers the features of organization of scrap-metal primary radiation control on the specialized enterprises engaging in its deep processing and storage at using by primary technical equipment - radiation portal monitors. The issue of this direction relevance, validity of radiation control implementation with the use of radiation portal monitors, physical and organizational bases of radiation control are considered in detail. The emphasis is put on the considerable increase in the number of technogenic radioactive sources detected in scrap-metal that results in the entering into exploitation of radioactive metallic structures as different building wares. One of reasons of such increase of the number of technogenic radioactive sources getting for processing with scrap-metal is the absence of any recommendations on the radiation portal monitors exploitation. The practical division of the article offers to recommendation on tuning of the modes of work of radiation portal monitors depending on influence the weather factor thus allowing to considerably increase the percent of technogenic radioactive sources detection.

Benefits and Limitations of Macrotextured Breast Implants and Consensus Recommendations for Optimizing Their Effectiveness.

PubMed

Maxwell, G Patrick; Scheflan, Michael; Spear, Scott; Nava, Maurizio B; Hedén, Per

2014-08-01

Implant texture is an important factor influencing implant selection for breast augmentation. Natrelle Biocell implants are characterized by macrotextured shell surfaces containing irregularly arranged concavities with large open-pore diameters and depths. These properties facilitate adhesion of the implant to the surrounding tissue, thereby promoting implant immobilization. Relative to implants with other surfaces, macrotextured implants offer low rates of capsular contracture; low rates of malposition, rotation, and rippling; and high rates of patient satisfaction. However, macrotextured implants are associated with a slightly higher risk of double capsule and late seroma. The surgeon can minimize these risks with straightforward techniques that encourage tissue adhesion. This report presents experience-based recommendations to optimize the effectiveness of Biocell anatomic implants. The authors discuss the application of best practices to all aspects of the breast implantation process, from implant selection and surgical planning to operative technique and postoperative management. LEVEL OF EVIDENCE 3. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.

Provision of foot health services for people with rheumatoid arthritis in New South Wales: a web-based survey of local podiatrists

PubMed Central

2013-01-01

Background It is unclear if podiatric foot care for people with rheumatoid arthritis (RA) in New South Wales (NSW) meets current clinical recommendations. The objective of this study was to survey podiatrists’ perceptions of the nature of podiatric foot care provision for people who have RA in NSW. Methods An anonymous, cross-sectional survey with a web-based questionnaire was conducted. The survey questionnaire was developed according to clinical experience and current foot care recommendations. State registered podiatrists practising in the state of NSW were invited to participate. The survey link was distributed initially via email to members of the Australian Podiatry Association (NSW), and distributed further through snowballing techniques using professional networks. Data was analysed to assess significant associations between adherence to clinical practice guidelines, and private/public podiatry practices. Results 86 podiatrists participated in the survey (78% from private practice, 22% from public practice). Respondents largely did not adhere to formal guidelines to manage their patients (88%). Only one respondent offered a dedicated service for patients with RA. Respondents indicated that the primary mode of accessing podiatry was by self-referral (68%). Significant variation was observed regarding access to disease and foot specific assessments and treatment strategies. Assessment methods such as administration of patient reported outcome measures, vascular and neurological assessments were not conducted by all respondents. Similarly, routine foot care strategies such as prescription of foot orthoses, foot health advice and footwear were not employed by all respondents. Conclusions The results identified issues in foot care provision which should be explored through further research. Foot care provision in NSW does not appear to meet the current recommended standards for the management of foot problems in people who have RA. Improvements to foot care could be undertaken in terms of providing better access to examination techniques and treatment strategies that are recommended by evidence based treatment paradigms. PMID:23972081

The Global Spine Care Initiative: applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities.

PubMed

Chou, Roger; Côté, Pierre; Randhawa, Kristi; Torres, Paola; Yu, Hainan; Nordin, Margareta; Hurwitz, Eric L; Haldeman, Scott; Cedraschi, Christine

2018-02-19

The purpose of this review was to develop recommendations for the management of spinal disorders in low-income communities, with a focus on non-invasive pharmacological and non-pharmacological therapies for non-specific low back and neck pain. We synthesized two evidence-based clinical practice guidelines for the management of low back and neck pain. Our recommendations considered benefits, harms, quality of evidence, and costs, with attention to feasibility in medically underserved areas and low- and middle-income countries. Clinicians should provide education and reassurance, advise patients to remain active, and provide information about self-care options. For acute low back and neck pain without serious pathology, primary conservative treatment options are exercise, manual therapy, superficial heat, and nonsteroidal anti-inflammatory drugs (NSAIDs). For patients with chronic low back and neck pain without serious pathology, primary treatment options are exercise, yoga, cognitive behavioral therapies, acupuncture, biofeedback, progressive relaxation, massage, manual therapy, interdisciplinary rehabilitation, NSAIDs, acetaminophen, and antidepressants. For patients with spinal pain with radiculopathy, clinicians may consider exercise, spinal manipulation, or NSAIDs; use of other interventions requires extrapolation from evidence regarding effectiveness for non-radicular spinal pain. Clinicians should not offer treatments that are not effective, including benzodiazepines, botulinum toxin injection, systemic corticosteroids, cervical collar, electrical muscle stimulation, short-wave diathermy, transcutaneous electrical nerve stimulation, and traction. Guidelines developed for high-income settings were adapted to inform a care pathway and model of care for medically underserved areas and low- and middle-income countries by considering factors such as costs and feasibility, in addition to benefits, harms, and the quality of underlying evidence. The selection of recommended conservative treatments must be finalized through discussion with the involved community and based on a biopsychosocial approach. Decision determinants for selecting recommended treatments include costs, availability of interventions, and cultural and patient preferences. These slides can be retrieved under Electronic Supplementary Material.

Status of wildland fire prevention evaluation in the United States.

Treesearch

Larry Doolittle; Linda R. Donoghue

1991-01-01

Presents findings of an assessment of the evaluation of wildland prevention efforts by all U.S. Wildland fire management agencies, and offers recommendations for improvements in prevention valuation techniques and procedures.

Managing Impression Formation in Computer-Mediated Communication.

ERIC Educational Resources Information Center

Liu, Yuliang; Ginther, Dean

2001-01-01

Offers suggestions for online instructors regarding verbal and nonverbal impression management. The recommendations should facilitate computer mediated teacher-student or manager-client interactions and help develop constructive relationships that promote learning and productivity. (EV)

American Association of Neuromuscular & Electrodiagnostic Medicine

MedlinePlus

... on diagnostic approaches to neuromuscular diseases. We recommend Principles of Clinical Electromyography Case Studies. Learn more Enhance ... offers your company the chance to meet its marketing objectives through participation at the AANEM Annual Meeting ...

Exploring Veteran Success through State-Level Administrative Data Sets

ERIC Educational Resources Information Center

Massa, Tod; Gogia, Laura

2017-01-01

This chapter describes the benefits and challenges of state-level longitudinal data collection on student veterans and offers recommendations for optimizing collection and reporting for the advocacy of student veteran success.

Governance in a Union Environment

ERIC Educational Resources Information Center

Garfield, Timothy K.

2008-01-01

The presence of a faculty union in a community college has a significant impact on its governance. This chapter offers recommendations for dealing with the challenges presented by collective bargaining in the postsecondary education environment.

Influence of institutional culture and policies on do-not-resuscitate decision making at the end of life.

PubMed

Dzeng, Elizabeth; Colaianni, Alessandra; Roland, Martin; Chander, Geetanjali; Smith, Thomas J; Kelly, Michael P; Barclay, Stephen; Levine, David

2015-05-01

Controversy exists regarding whether the decision to pursue a do-not-resuscitate (DNR) order should be grounded in an ethic of patient autonomy or in the obligation to act in the patient's best interest (beneficence). To explore how physicians' approaches to DNR decision making at the end of life are shaped by institutional cultures and policies surrounding patient autonomy. We performed semistructured in-depth qualitative interviews of 58 internal medicine physicians from 4 academic medical centers (3 in the United States and 1 in the United Kingdom) by years of experience and medical subspecialty from March 7, 2013, through January 8, 2014. Hospitals were selected based on expected differences in hospital culture and variations in hospital policies regarding prioritization of autonomy vs best interest. This study identified the key influences of institutional culture and policies on physicians' attitudes toward patient autonomy in DNR decision making at the end of life. A hospital's prioritization of autonomy vs best interest as reflected in institutional culture and policy appeared to influence the way that physician trainees conceptualized patient autonomy. This finding may have influenced the degree of choice and recommendations physician trainees were willing to offer regarding DNR decision making. Trainees at hospitals where policies and culture prioritized autonomy-focused approaches appeared to have an unreflective deference to autonomy and felt compelled to offer the choice of resuscitation neutrally in all situations regardless of whether they believed resuscitation to be clinically appropriate. In contrast, trainees at hospitals where policies and culture prioritized best-interest-focused approaches appeared to be more comfortable recommending against resuscitation in situations where survival was unlikely. Experienced physicians at all sites similarly did not exclusively allow their actions to be defined by policies and institutional culture and were willing to make recommendations against resuscitation if they believed it would be futile. Institutional cultures and policies might influence how physician trainees develop their professional attitudes toward autonomy and their willingness to make recommendations regarding the decision to implement a DNR order. A singular focus on autonomy might inadvertently undermine patient care by depriving patients and surrogates of the professional guidance needed to make critical end of life decisions.

Promoting health and safety virtually: key recommendations for occupational health nurses.

PubMed

Wolf, Debra M; Anton, Bonnie B; Wenskovitch, John

2014-07-01

Nurses' use of the Internet and social media has surfaced as a critical concern requiring further exploration and consideration by all health care organizations and nursing associations. In an attempt to support this need, the American Nurses Association (2011) published six principles of social networking that offered guidance and direction for nurses. In addition, the National Council of State Boards of Nursing (2011) published a nurse's guide to using social media. Surfing the Internet and using social media for professional and personal needs is extremely common among nurses. What is concerning is when nurses do not separate their professional and personal presence in the virtual world. This article presents an Institutional Review Board-approved pilot survey that explored nurses' use of social media personally and professionally and offers recommendations specifically directed to the occupational health nurse. Copyright 2014, SLACK Incorporated.

Recommended Strain Gage Application Procedures for Various Langley Research Center Balances and Test Articles

NASA Technical Reports Server (NTRS)

Moore, Thomas C., Sr.

1997-01-01

The NASA Langley Research Center uses more than 10000 strain gages per year in supporting its various research programs. The character of the testing at LaRC is such that the types of strain gage installations, the materials they are applied to, and the test environments encountered, require many varied approaches for installing strain gages. These installations must be accomplished in the most technically discerning and appropriate manner. This technical memorandum is offered as an assisting guide in helping the strain gage user to determine the appropriate approach for a given strain gage application requirement. Specifically, this document offers detailed recommendations for strain gaging the following: LaRC-Designed balances, LARC custom transducers, certain composite materials and alloys, high-temperature test articles, and selected non-typical or unique materials or test conditions.

Deception in research: distinctions and solutions from the perspective of utilitarianism.

PubMed

Pittenger, David J

2002-01-01

The use of deception in psychological research continues to be a controversial topic. Using Rawls's explication of utilitarianism, I attempt to demonstrate how professional organizations, such as the American Psychological Association, can provide more specific standards that determine the permissibility of deception in research. Specifically, I argue that researchers should examine the costs and benefits of creating and applying specific rules governing deception. To that end, I offer 3 recommendations. First, that researchers who use deception provide detailed accounts of the procedures they used to minimize the harm created by deception in their research reports. Second, that the American Psychological Association offer a definition of deception that describes techniques commonly used in research. Finally, I recommend that the informed consent procedure be revised to indicate that the researcher may use deception as part of the study.

Strategies for waste management in small and medium towns of developing countries: a case study of India.

PubMed

Sundaravadivel, M; Vigneswaran, S

2003-01-01

This paper evaluates the issues of waste management in small and medium towns (SMTs) (with population in the range of 10,000-100,000) of India, and identifies the need for a multi-disciplinary approach encompassing technological, economic and financial aspects of the issues to effect improvements. A comprehensive set of cross-disciplinary strategies is suggested to improve the prevailing conditions with environmentally appropriate, economically efficient and financially self-sustaining waste management services. Based on a case study of four SMTs in the State of Tamil Nadu in India, this paper evaluates the application of the suggested strategies and offers policy recommendations.

Exercise program for children and adolescents with leukemia and lymphoma during treatment: A comprehensive review.

PubMed

Zucchetti, Giulia; Rossi, Francesca; Chamorro Vina, Carolina; Bertorello, Nicoletta; Fagioli, Franca

2018-05-01

An exercise program (EP) during cancer treatment seems to be a valid strategy against physiological and quality-of-life impairments, but scientific evidence of benefits among pediatric patients is still limited. This review summarizes the literature focused on randomized controlled trials of EP offered to patients during leukemia and lymphoma treatment. Studies published up to June 2017 were selected from multiple databases and assessed by three independent reviewers for methodological validity. The review identified eight studies, but several types of bias have to be avoided to provide evidence-based recommendations accessible to patients, families, and professionals. © 2018 Wiley Periodicals, Inc.

[Management of lice infestations, recommendations for 2012].

PubMed

Maillard, Alexia; Trellu, Laurence Toutous; Eicher, Nicole; Michaud, Mélanie; Laffitte, Emmanuel

2012-04-04

Pediculosis is the most frequent and contagious ectoparasitic infestation in human, particularly in children from 3 to 8 years of age. Epidemics are observed from time to time, in schools or in adults in prisons. Even though benign, these infections remain unpleasant and can have an important psyco-social impact. Since a few years, caregivers have to face increasing problems while treating lice: appearance of insecticide resistances, lindane's withdrawal from the market and the marketing of new products which are not always well evaluated. This article offers first recalls about pediculoses and then a sum up of the different available treatments with an evidence based management strategy.

Children who witness violence: what services do they need to heal?

PubMed

Willis, Danny; Hawkins, Joellen W; Pearce, Carole W; Phalen, Jaime; Keet, Meredith; Singer, Cristen

2010-09-01

Children are witnesses to violence far too often in their daily lives. To elicit information on the needs of children and adolescents living in the United States who have witnessed violence in their homes, neighborhoods, or communities, we held focus groups with mothers who have survived interpersonal violence and whose family included child witnesses to violence (CWV), professionals who work with families affected by violence, and with adolescents who have witnessed violence. Based on four separate focus group discussions held in Massachusetts, involving a total of 45 participants, recommendations for screening, programming, and the development of healing interventions are offered to mental health professionals.

Electronic Design Automation: Integrating the Design and Manufacturing Functions

NASA Technical Reports Server (NTRS)

Bachnak, Rafic; Salkowski, Charles

1997-01-01

As the complexity of electronic systems grows, the traditional design practice, a sequential process, is replaced by concurrent design methodologies. A major advantage of concurrent design is that the feedback from software and manufacturing engineers can be easily incorporated into the design. The implementation of concurrent engineering methodologies is greatly facilitated by employing the latest Electronic Design Automation (EDA) tools. These tools offer integrated simulation of the electrical, mechanical, and manufacturing functions and support virtual prototyping, rapid prototyping, and hardware-software co-design. This report presents recommendations for enhancing the electronic design and manufacturing capabilities and procedures at JSC based on a concurrent design methodology that employs EDA tools.

REVIEW OF Education and Training for Officers (RETO). Volume 3. The Data Base

DTIC Science & Technology

1978-06-30

tactics, and strategies. ( 7 ) Explain how military forces...are developed, sustained, and employed in both peace and war. G-4 3. RECOMMENDATIONS. None...0 000 J ~w 0aa - In I In ccil cc C9 __1 (A 0 z -- 0 10 x-A 0 100- #,A .a U 0 W 0 0 Ve (A ; A4-4 0: .5. I % ccU. 0 4- ) Ia.01 -) If La. 0o AS a 1.G- 7 ...offer to the Army, as ground warfare moves into a more highly technological era, and Army officers are increasingly "manning the equipment" as compared o

[Endocrinology, what's new in 2016].

PubMed

Mavromati, Maria; Philippe, Jacques

2017-01-11

The European Society of Endocrinology has published this year a series of guidelines for hypoparathyroidism, the management of adrenal incidentalomas as well as for the long-term follow-up of patients operated on for a phaeochromocytoma/paraganglioma (PPGL). For hypoparathyroidism, guidelines insist on screening for chronic complications and monitoring treatment with calcium and vitamin D; the use of recombinant PTH may provide new opportunities for the future. Concerning adrenal incidentalomas, the panel of the guidelines primarily recommends non contrast CT for the evaluation of the risk of malignancy. Patients operated on for a PPGL, should be offered an individualized follow-up plan based on assessment of their risk of tumor recurrence.

Parent-Infant Skin-to-Skin Contact Following Birth: History, Benefits, and Challenges.

PubMed

Hubbard, Jessie Marie; Gattman, Kindsey Rae

2017-03-01

It is a practice with strong roots in nature and has a significant influence on health outcomes, particularly for at-risk newborns in low-resource settings. In this comprehensive review, benefits of SSC for newborns, mothers, and fathers after vaginal and cesarean births are discussed as well as the benefits of SSC observed for infants in the NICU. Barriers to SSC practice implementation are discussed, and proposed solutions and recommendations are offered. By understanding the many benefits of SSC and strategies for implementation, health care providers can best support and promote this high-quality, evidence-based practice with mothers, newborns, and their families.

Enhancing marketing recruitment strategies: administrator tenure and nursing expenditures.

PubMed

Gunby, Norris White

2005-01-01

When recruiting nurses, long-term care facilities require an ability to identify salient organizational characteristics that are attractive to potential nursing services candidates vis-à-vis their competitors. The findings of this study suggest that information on administrative tenure can be utilized to attract applicants by appealing to criteria within their high-involvement job search activities. High-involvement applicants proactively seek recruitment content that provides essential job attributes that match their needs and skills and are more apt to be a higher quality candidate. Based upon the study's findings, managers are offered marketing strategy recommendations for tailoring recruiting messages that appeal to high-involvement job seekers.