Sample records for offers specific recommendations

  1. 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.

  2. 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.

  3. 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.

  4. 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…

  5. 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…

  6. Recommendations from Friends Anytime and Anywhere: Toward a Model of Contextual Offer and Consumption Values

    PubMed Central

    Shen, Xiao-Liang; Wang, Nan

    2013-01-01

    Abstract The ubiquity and portability of mobile devices provide additional opportunities for information retrieval. People can easily access mobile applications anytime and anywhere when they need to acquire specific context-aware recommendations (contextual offer) from their friends. This study, thus, represents an initial attempt to understand users' acceptance of a mobile-based social reviews platform, where recommendations from friends can be obtained with mobile devices. Based on the consumption value theory, a theoretical model is proposed and empirically examined using survey data from 218 mobile users. The findings demonstrate that contextual offers based on users' profiles, access time, and geographic positions significantly predict their value perceptions (utilitarian, hedonic, and social), which, in turn, affect their intention to use a mobile social reviews platform. This study is also believed to provide some useful insights to both research and practice. PMID:23530548

  7. Recommendations and offers for adult influenza vaccination, 2011-2012 season, United States.

    PubMed

    Benedict, Katharine M; Santibanez, Tammy A; Black, Carla L; Ding, Helen; Graitcer, Samuel B; Bridges, Carolyn B; Kennedy, Erin D

    2017-03-01

    Provider recommendations and offers for influenza vaccination improve adult influenza vaccination coverage. Analysis was performed to describe receipt of influenza vaccination recommendations and offers among adults who visited a healthcare provider (HCP) during the 2011-2012 influenza season and describe differences between those receiving and not receiving recommendations and offers for influenza vaccination. Associations between influenza vaccination and receipt of recommendations and offers were examined. Respondents to a random digit dial telephone survey who had visited a HCP since July 1, 2011 were asked if they had received a recommendation for influenza vaccination. Those receiving a recommendation were asked if they received an offer for vaccination. Participants were characterized by demographic and access to health care variables. Logistic regression was used to examine the relationships between participant characteristics and recommendation alone, between participant characteristics and recommendation and offer, and between influenza vaccination and recommendation and offer. Of those who reported visiting a HCP, 43.8% reported receiving a recommendation for influenza vaccination. Of those who reported receiving a recommendation, 76.6% reported receiving an offer for influenza vaccination. Persons with high-risk conditions and persons over 65 years were more likely to receive recommendations for influenza vaccination when compared to those without high-risk conditions and 18-49 year olds, respectively. Those reporting receipt of a recommendation and offer for influenza vaccination were 1.76 times more likely and those reporting receipt of a recommendation but no offer were 1.72 times more likely to report being vaccinated for influenza controlling for all patient characteristics. Less than half of respondents reported receipt of recommendations and offers of influenza vaccination during the 2011-2012 influenza season and disparities exist between groups. All healthcare providers seeing adults should recommend or offer influenza vaccination for all patients at every visit during the influenza season. Copyright © 2016. Published by Elsevier Ltd.

  8. Recommendations and offers for adult influenza vaccination, 2011–2012 season, United States

    PubMed Central

    Benedict, Katharine M.; Santibanez, Tammy A.; Black, Carla L.; Ding, Helen; Graitcer, Samuel B.; Bridges, Carolyn B.; Kennedy, Erin D.

    2017-01-01

    Background Provider recommendations and offers for influenza vaccination improve adult influenza vaccination coverage. Analysis was performed to describe receipt of influenza vaccination recommendations and offers among adults who visited a healthcare provider (HCP) during the 2011–2012 influenza season and describe differences between those receiving and not receiving recommendations and offers for influenza vaccination. Associations between influenza vaccination and receipt of recommendations and offers were examined. Methods Respondents to a random digit dial telephone survey who had visited a HCP since July 1, 2011 were asked if they had received a recommendation for influenza vaccination. Those receiving a recommendation were asked if they received an offer for vaccination. Participants were characterized by demographic and access to health care variables. Logistic regression was used to examine the relationships between participant characteristics and recommendation alone, between participant characteristics and recommendation and offer, and between influenza vaccination and recommendation and offer. Results Of those who reported visiting a HCP, 43.8% reported receiving a recommendation for influenza vaccination. Of those who reported receiving a recommendation, 76.6% reported receiving an offer for influenza vaccination. Persons with high-risk conditions and persons over 65 years were more likely to receive recommendations for influenza vaccination when compared to those without high-risk conditions and 18–49 year olds, respectively. Those reporting receipt of a recommendation and offer for influenza vaccination were 1.76 times more likely and those reporting receipt of a recommendation but no offer were 1.72 times more likely to report being vaccinated for influenza controlling for all patient characteristics. Conclusions Less than half of respondents reported receipt of recommendations and offers of influenza vaccination during the 2011–2012 influenza season and disparities exist between groups. All healthcare providers seeing adults should recommend or offer influenza vaccination for all patients at every visit during the influenza season. PMID:27137099

  9. 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.

  10. 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…

  11. 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.

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

    PubMed

    Reid, Helen; Bahar, Ron J

    2006-03-01

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

  13. The Victor-Bostrom Fund Report: Food and Population. Report No. 19, Summer-Fall 1974.

    ERIC Educational Resources Information Center

    Victor-Bostrom Fund Committee, Washington, DC.

    Eleven articles comprise this document which presents commentaries on nutrition, population, and environmental education. The articles deal specifically with the crises of a rapidly growing world population, a worsening world food situation, and an energy crisis. A number of specific recommendations, both national and international, are offered to…

  14. Diagnosing Dyslexia. A Guide to the Assessment of Adults with Specific Learning Difficulties.

    ERIC Educational Resources Information Center

    Klein, Cynthia

    This book offers tutors in adult, further, and higher education materials for diagnosing students with specific learning disabilities (dyslexia). It provides information for setting up an appropriate individualized teaching program and making recommendations for supporting such students. Materials and methods can be used with students from basic…

  15. Rejecting the Null: Research and Social Justice Means Asking Different Questions

    ERIC Educational Resources Information Center

    Chapman, Stephanie; Schwartz, Jonathan P.

    2012-01-01

    The focus of this article is on the specific ethical issues related to social justice research and the practical implications of engaging in social justice research, including the potential impact of research results on practice, policy, and advocacy at the local and national level. Specific recommendations are offered, including identifying…

  16. Purdue Plane Structures Analyzer II : a computerized wood engineering system

    Treesearch

    S. K. Suddarth; R. W. Wolfe

    1984-01-01

    The Purdue Plane Structures Analyzer (PPSA) is a computer program developed specifically for the analysis of wood structures. It uses recognized analysis procedures, in conjunction with recommendations of the 1982 National Design Specification for Wood Construction, to determine stresses and deflections of wood trusses and frames. The program offers several options for...

  17. 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.

  18. 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…

  19. Coronary heart disease in women: highlights of the past 2 years--stepping stones, milestones and obstructing boulders.

    PubMed

    Wenger, Nanette K

    2006-04-01

    Emerging data continue to highlight important sex-based differences in coronary heart disease (CHD) prevention and diagnostic testing, in the management of acute coronary syndromes and in the outcomes of CHD therapies. Evidence-based guidelines have been developed that offer specific recommendations for clinicians and information for women. These guidelines are buttressed by results that have become available from randomized, controlled clinical trials in women, and data from CHD registries and clinical trials involving both sexes but including adequate numbers of women to enable the reporting of sex-specific results. Underuse of guideline-based preventive and therapeutic strategies for women probably contributes to their less favorable CHD outcomes. Adherence to recommendations offers the promise of improving the heart health of women. In this article, I summarize new information to guide the preventive, diagnostic and therapeutic management of CHD in women.

  20. Disciplining Handicapped Students.

    ERIC Educational Resources Information Center

    Hockstaff, Jim

    1983-01-01

    After a review of the legal foundations of school governance and specific protection offered handicapped students by federal legislation, this report focuses on Oregon regulations and practices and outlines recommendations for appropriate disciplinary procedures for students categorized as handicapped. Since the Education for All Handicapped…

  1. 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.

  2. Juvenile Justice, Mental Health, and the Transition to Adulthood: A Review of Service System Involvement and Unmet Needs in the U.S

    PubMed Central

    Zajac, Kristyn; Sheidow, Ashli J.; Davis, Maryann

    2015-01-01

    Although adolescents are the primary focus of juvenile justice, a significant number of young people involved with this system are considered transition age youth (i.e., 16–25 years of age). The aim of this review is to summarize the specific needs of transition age youth with mental health conditions involved with the juvenile justice system, identify the multiple service systems relevant to this group, and offer recommendations for policies and practice. A comprehensive search strategy was used to identify and synthesize the literature. Findings highlight the paucity of research specific to transition age youth. Thus, we also summarized relevant research on justice-involved adolescents, with a focus evaluating its potential relevance in the context of the unique milestones of the transition age, including finishing one’s education, setting and working towards vocational goals, and transitioning from ones’ family of origin to more independent living situations. Existing programs and initiatives relevant to transition age youth with mental health conditions are highlighted, and nine specific recommendations for policy and practice are offered. PMID:26273119

  3. Juvenile Justice, Mental Health, and the Transition to Adulthood: A Review of Service System Involvement and Unmet Needs in the U.S.

    PubMed

    Zajac, Kristyn; Sheidow, Ashli J; Davis, Maryann

    2015-09-01

    Although adolescents are the primary focus of juvenile justice, a significant number of young people involved with this system are considered transition age youth (i.e., 16-25 years of age). The aim of this review is to summarize the specific needs of transition age youth with mental health conditions involved with the juvenile justice system, identify the multiple service systems relevant to this group, and offer recommendations for policies and practice. A comprehensive search strategy was used to identify and synthesize the literature. Findings highlight the paucity of research specific to transition age youth. Thus, we also summarized relevant research on justice-involved adolescents, with a focus evaluating its potential relevance in the context of the unique milestones of the transition age, including finishing one's education, setting and working towards vocational goals, and transitioning from ones' family of origin to more independent living situations. Existing programs and initiatives relevant to transition age youth with mental health conditions are highlighted, and nine specific recommendations for policy and practice are offered.

  4. Technology's Impact on Library Interior Planning.

    ERIC Educational Resources Information Center

    Michaels, David Leroy

    1987-01-01

    Discusses issues to be considered in planning a library that will anticipate the needs of the future. Power and telecommunications capacity are stressed, and a checklist of items requiring specific writing services is included. Recommendations for workstation design and structural elements are offered. (MES)

  5. Curriculum Guidelines for Microscopic Anatomy.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1993

    1993-01-01

    The American Association of Dental Schools' guidelines for curricula in microscopic anatomy offer an overview of the histology curriculum, note primary educational goals, outline specific content for general and oral histology, suggest prerequisites, and make recommendations for sequencing. Appropriate faculty and facilities are also suggested.…

  6. Thinking about Thinking.

    ERIC Educational Resources Information Center

    Gough, Deborah

    1991-01-01

    This document summarizes five studies that offer insight into the nature of higher-order thinking skills and the most effective methods for teaching them to students. The reviews outline the conclusions, definitions, recommendations, specific methods of teaching, instructional strategies, and programs detailed in the documents themselves.…

  7. Post-Secondary Education in Manitoba: Doing Things Differently.

    ERIC Educational Resources Information Center

    Manitoba Dept. of Education and Training, Winnipeg.

    This report examined the state of postsecondary education in Manitoba and offers recommendations for the improvement of university governance, scholarship, financial management, public accountability, accessibility, aboriginal peoples, and institutional linkage. It specifically examined the operation of the University of Manitoba, the University…

  8. 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.

  9. The Screening and Diagnosis of Autistic Spectrum Disorders.

    ERIC Educational Resources Information Center

    Filipek, Pauline A.; Accardo, Pasquale J.; Baranek, Grace T.; Cook, Edwin H., Jr.; Dawson, Geraldine; Gordon, Barry; Gravel, Judith S.; Johnson, Chris P.; Kallen, Ronald J.; Levy, Susan E.; Minshew, Nancy J.; Prizant, Barry M.; Rapin, Isabelle; Rogers, Sally J.; Stone, Wendy L.; Teplin, Stuart; Tuchman, Roberto F.; Volkmar, Fred R.

    1999-01-01

    This paper presents detailed recommendations for diagnosis of autism established by a multidisciplinary panel of the Child Neurology Society and the American Academy of Neurology. The paper offers dual-level (general development and specific symptoms) guidelines for diagnosis of autistic disorder, Asperger disorder, childhood disintegrative…

  10. 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.

  11. Teaching communication with ethnic minority patients: ten recommendations.

    PubMed

    Seeleman, Conny; Selleger, Veronica; Essink-Bot, Marie-Louise; Bonke, Benno

    2011-01-01

    Culturally competent communication is indispensable for medical practice in an ethnically diverse society. This article offers recommendations to teach such communication skills based on the experiences of members of a Dutch NMVO Special Interest Group on 'Diversity'. A questionnaire with three open-ended questions on recommendations for training in culturally competent communication was sent to all members (n = 35). Returned questionnaires (n = 23) were analysed qualitatively with a thematic coding framework based on educational themes emerging from the data. All students need to be educated in culturally competent communication. Teachers should stimulate awareness of personal biases and an open attitude. Teach the three core communication skills, listening, exploring and checking, and offer practice with a professional interpreter. Knowledge content should focus on mechanisms relevant to various ethnic groups. Offer students a variety of experiences in a safe environment. All involved should be aware that stereotyping is a pitfall. Training in communication skills for consultation with ethnic minority patients cannot be separated from teaching issues of awareness and knowledge. The shared views on the content of these communication trainings are in line with general patient-centred approaches. The development of proper training in this field demands specific efforts of those involved.

  12. The Teacher/Scientist: From Trainer to Educator.

    ERIC Educational Resources Information Center

    Ellerbrock, Michael J.

    Problems and issues in U.S. undergraduate education are identified, and 10 recommendations for improvement are offered. Specific reference is made to agriculture faculty. Problems and issues include: current emphasis on academic specialization rather than the development of integrated, holistic students; the purpose of a liberal education versus…

  13. Accounting guidelines for HMOs: issues and practices.

    PubMed

    Ingram, R W; Robbins, W A

    1987-03-01

    HMOs are fast becoming an important part of the healthcare industry today. Unfortunately, specific accounting guidelines have not yet been established for them. This concern has led the AICPA to describe and offer recommendations concerning preferred accounting techniques for HMOs. This article looks at the issues raised by the AICPA and how current HMO financial officers feel about the practices that are recommended. It is suggested that the organization, taxability, and other attributes of an HMO must be clearly understood before strict accounting guidelines are imposed.

  14. Interdependent and Relational Tendencies among Asian Clients: Infusing Collectivistic Strategies into Counselling

    ERIC Educational Resources Information Center

    Kuo, Ben C. H.

    2004-01-01

    This article uses the case of Asians to highlight the collectivistic elements inherent in Asian help-seeking patterns, problem-solving styles, and stress-coping responses. It then offers recommendations for specific counseling strategies that complement Asians' collectivistic orientation. It should be noted that although generalized observations…

  15. Complex Variables throughout the Curriculum

    ERIC Educational Resources Information Center

    D'Angelo, John P.

    2017-01-01

    We offer many specific detailed examples, several of which are new, that instructors can use (in lecture or as student projects) to revitalize the role of complex variables throughout the curriculum. We conclude with three primary recommendations: revise the syllabus of Calculus II to allow early introductions of complex numbers and linear…

  16. Selected Issues in Mathematics Education.

    ERIC Educational Resources Information Center

    Lindquist, Mary Montgomery, Ed.

    This document examines specifically relevant issues and offers useful guidance in making decisions for elementary and secondary school mathematics education in the 1980's. The expertise of 19 authors is reflected in 14 chapters that provide an overview of mathematics today and recommendations for the future. The individual chapters are titled: (1)…

  17. Professional Boundaries in the Era of the Internet

    ERIC Educational Resources Information Center

    Gabbard, Glen O.; Kassaw, Kristin A.; Perez-Garcia, Gonzalo

    2011-01-01

    Objective: The era of the Internet presents new dilemmas in educating psychiatrists about professional boundaries. The objective of this overview is to clarify those dilemmas and offer recommendations for dealing with them. Method: The characteristics of social networking sites, blogs, and search engines are reviewed with a specific focus on their…

  18. Standardization in Andean Languages.

    ERIC Educational Resources Information Center

    Cerron-Palomino, Rodolfo

    1992-01-01

    This paper discusses current efforts to standardize the two major Andean languages: Quechua and Aymara. The difficulties in gaining consensus on standardizing phonology, grammar, and lexicon are highlighted. Specific recommendations are offered on how to deal with neologisms, and a proposal is made for the creation of a pan-Andean entity to…

  19. Teaching Methodologies and Course Contents in International Finance.

    ERIC Educational Resources Information Center

    Garg, Ramesh C.

    A guide to designing a course in international finance and multinational corporations is presented. It offers a rationale for such a course, discusses its primary goals, suggests two possible course orientations (professional or theoretical) and desirable or necessary prerequisites, and recommends specific course content areas and subareas. Types…

  20. Course Objectives: Electronic Fundamentals, EL16.

    ERIC Educational Resources Information Center

    Wilson, David H.

    The general objective, recommended text, and specific objectives of a course titled "Electronic Fundamentals," as offered at St. Lawrence College of Applied Arts and Technology, are provided. The general objective of the course is "to acquire an understanding of diodes, transistors, and tubes, and so be able to analyze the operation…

  1. Systematic Research and Evaluation in a Rural Pennsylvania School District.

    ERIC Educational Resources Information Center

    Leopold, Greg; And Others

    This report summarizes the evaluation of a rural school district in Pennsylvania and offers recommendations reflecting the district's goals for school improvement and construction. Specifically, the objectives of the study were to identify curricular needs of the district and individual schools; review and assess district facilities with respect…

  2. 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.

  3. 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.

  4. 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.

  5. [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.

  6. Modernization of Russian Higher Education: Exploring Paths of Influence

    ERIC Educational Resources Information Center

    Gounko, Tatiana; Smale, William

    2007-01-01

    This article discusses the changes in Russian higher education policies and the role of international organizations--the World Bank and OECD--in promoting education reforms in this country. General and specific recommendations offered by the World Bank and the OECD expert teams to improve Russian higher education are analysed to determine if any…

  7. U.S. Interests and the Global Environment. Occasional Paper 35.

    ERIC Educational Resources Information Center

    Caldwell, Lynton K.

    This essay presents an argument for policies responsive to global environmental needs by examining the causes and consequences of six critical environmental issues, and then offering specific U.S. policy recommendations. Following an explanation of the global nature of environmental problems, a summary of the salient facts regarding the following…

  8. Nurturing the Parent Teacher Alliance: A Guide to Forming A Facilitative Relationship.

    ERIC Educational Resources Information Center

    Howe, Frank; Simmons, Betty Jo

    This booklet provides guidelines to help teachers better understand the importance of forming alliances with the primary caregivers (birth parents, adoptive parents, step parents, foster parents, or guardians) of the children whom they teach. Specific recommendations are offered concerning the following factors: conferences in the home, in school,…

  9. Vocational Career Guide for Connecticut. Revised Edition--1975.

    ERIC Educational Resources Information Center

    University Research Inst. of Connecticut, Inc., Wallingford.

    A guide to career training programs below the baccalaureate level in Connecticut was compiled from a survey of all schools offering identifiable programs of formal education for careers. Intended as a tool to assist students and guidance counselors in learning about the schools and programs, the guide does not recommend any specific schools or…

  10. Reworking Industrial Models, Exploring Contemporary Ideas, and Fostering Teacher Leadership

    ERIC Educational Resources Information Center

    Steel, Christopher; Craig, Elizabeth

    2006-01-01

    If the culture of teaching is to change from one of isolation and professional limitations to one of collaboration and empowerment, administrators must change how they view and interact with teachers. Mr. Steel and Ms. Craig offer specific recommendations for how school leaders can support and facilitate teachers' growth. (Contains 9 endnotes.)

  11. 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.

  12. 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.

  13. [Results of a study of the diagnostic qualities of brucellosis and tularemic antigenic erythrocytic diagnostica].

    PubMed

    Tsybin, B P; Taran, I F; Tinker, A I

    1975-09-01

    The authors elaborated methods of preparation of brucella and tularemia antigenic erythrocytic diagnostic agents which were characterized as highly specific, specific and stable preparations in mass examination of humans and animals at various stages of the vaccinal and infectous processes. The simplicity of obtaining specific antigens intended for the sensitization of formalinized erythrocytes and stability of the results of results of reproduction of the methods of preparation of the antigenic erythrocytic diagnostic agents offered a possibility of recommending the mentioned methods of industrial preparation of the diagnostic agents.

  14. How to Sustain Interprofessional Learning and Practice: Messages for Higher Education and Health and Social Care Management

    ERIC Educational Resources Information Center

    Meads, Geoffrey; Jones, Isabel; Harrison, Rachel; Forman, Dawn; Turner, Warren

    2009-01-01

    The principal aim of this article is to promote the more effective integration of interprofessional learning with practice developments in health and social care. Ten specific recommendations are offered for the successful management of recent central policies for collaboration at the interface of the higher education and service sectors.…

  15. 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…

  16. The Emotionally-Handicapped Child: Altering Home, School, and Social Environments as the Key to Prevention and Cure.

    ERIC Educational Resources Information Center

    Jones, Vern

    The author examines the causes of behavioral disorders that stem from conditions existing in the home, school, and society, and offers specific recommendations for institutional changes which would reduce the number of behaviorally disordered children. Factors noted to be significantly related to emotional difficulties include divorce; the…

  17. The Crucial Role of Hispanic-Serving Institutions in the Education of Latino/a Youth

    ERIC Educational Resources Information Center

    Arciniega, Tomas A.

    2012-01-01

    This article offers an analysis of policy issues and recommendations regarding the specific mission of Hispanic-Serving Institutions (HSIs) in the United States. Through anecdotes and a brief historical outline, I urge readers not to forget the rich historical activist legacy of early Latino leaders who worked to ensure the inclusion of Hispanics…

  18. Arm position during ambulatory blood pressure monitoring: a review of the evidence and clinical guidelines.

    PubMed

    Byrd, James B; Brook, Robert D

    2014-03-01

    Ambulatory blood pressure monitoring (ABPM) offers advantages over clinic blood pressure measurement. Supporting the arm at the level of the right atrium has long been standard in clinic blood pressure measurement. In contrast, there is no consensus regarding arm position in the guidelines addressing ABPM. Research studies have used a variety of arm positions during ABPM. Discussed in this review are the merits of ABPM and a review of the several arm positions recommended in ABPM guidelines, suggested by cuff manufacturers, and used in research studies. To address this lack of standardization, a rationale for a clinically reasonable arm position during ABPM is offered. Specifically, the authors recommend advising the patient to keep the arm still and relaxed straight down at the side of the body when the cuff is going to inflate, when safe to do so. ©2014 Wiley Periodicals, Inc.

  19. 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.

  20. 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...

  1. The performance of adobe and other thermal mass materials in residential buildings

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

    Robertson, D.

    1986-01-01

    This paper reviews the history and current status of thermal mass research, and national, state, and local codes with respect to thermal mass; and offers specific recommendations on how best to use thermal mass for energy efficiency and comfort. Much of the material comes directly from the Southwest Thermal Mass Study (SWTMS), an experimental research study on the thermal performance of adobe conducted at Tesuque Pueblo, New Mexico, in the early 1980s. The focus is primarily on residential construction, although the theory and most of the recommendations apply to small commercial buildings as well.

  2. Summer Workshop on Near-Earth Resources

    NASA Technical Reports Server (NTRS)

    Arnold, J. R. (Editor); Duke, M. B. (Editor)

    1978-01-01

    The possible large scale use of extraterrestrial resources was addressed, either to construct structures in space or to return to Earth as supplements for terrestrial resources. To that end, various specific recommendations were made by the participants in the summer study on near-Earth resources, held at La Jolla, California, 6 to 13 August, 1977. The Moon and Earth-approaching asteroids were considered. Summaries are included of what is known about their compositions and what needs to be learned, along with recommendations for missions designed to provide the needed data. Tentative schedules for these projects are also offered.

  3. Flexible Applications of the Coping Cat Program for Anxious Youth1

    PubMed Central

    Beidas, Rinad S.; Benjamin, Courtney L.; Puleo, Connor M.; Edmunds, Julie M.; Kendall, Philip C.

    2010-01-01

    The current article offers suggestions for ways to adapt empirically supported treatments (ESTs). A specific manualized EST (Coping Cat; Kendall & Hedtke, 2006a) is used to illustrate the concept of “flexibility within fidelity” (Kendall & Beidas, 2007; Kendall, Gosch, Furr, & Sood, 2008). Flexibility within fidelity stresses the importance of using ESTs while considering and taking into account individual client presentations. In this discussion, recommendations are offered for the use of the Coping Cat with younger youth, adolescents, and youth with secondary comorbidities (i.e., social skills deficits, inattentive symptoms, and depressive symptoms). PMID:20936081

  4. Demographic Profile and Needs Assessment of Single Parents and Homemakers in New Jersey Vocational Education Programs 1990-1991.

    ERIC Educational Resources Information Center

    Montclair State Coll., Upper Montclair, NJ. Life Skills Center.

    A 5-year (1986-91) follow-up needs assessment was conducted to evaluate current single parent and displaced homemaker programs in New Jersey. Suggestions were offered to help them continue effectively helping the changing target population attain long-term economic self-sufficiency. Recommendations made in response to specific findings included…

  5. 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…

  6. Effects of landscape position and season of burn on fire temperature in Southern Ohio's mixed oak forests

    Treesearch

    Doug J. Schwemlein; Roger A. Williams

    2007-01-01

    The use of fire to maintain and restore oak (Quercus spp.) ecosystems is becoming an increasingly accepted silvicultural tool; however, specific management recommendations have been slow to develop as past studies have shown mixed results. By examining fire temperature in response to landscape position and season of burn, we attempted to offer...

  7. 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…

  8. 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…

  9. Career Education at O.S.S.D. A Study of Needs and Plan of Action for Career Education at Oregon State School for the Deaf.

    ERIC Educational Resources Information Center

    McKinlay, Bruce; And Others

    Recognizing a need for improvement in their vocational education offerings, the administration of the program for the deaf appointed a study team representing backgrounds including education of the deaf, manpower research, public administration, and occupational analysis. This report presents their specific analysis and recommendations for a…

  10. 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.

  11. Weight bias in graduate school admissions.

    PubMed

    Burmeister, Jacob M; Kiefner, Allison E; Carels, Robert A; Musher-Eizenman, Dara R

    2013-05-01

    Whether weight bias occurs in the graduate school admissions process is explored here. Specifically, we examined whether body mass index (BMI) was related to letter of recommendation quality and the number of admissions offers applicants received after attending in-person interviews. Participants were 97 applicants to a psychology graduate program at a large university in the United States. They reported height, weight, and information about their applications to psychology graduate programs. Participants' letters of recommendation were coded for positive and negative statements as well as overall quality. Higher BMI significantly predicted fewer post-interview offers of admission into psychology graduate programs. Results also suggest this relationship is stronger for female applicants. BMI was not related to overall quality or the number of stereotypically weight-related adjectives in letters of recommendation. Surprisingly, higher BMI was related to more positive adjectives in letters. The first evidence that individuals interviewing applicants to graduate programs may systematically favor thinner applicants is provided here. A conscious or unconscious bias against applicants with extra body weight is a plausible explanation. Stereotype threat and social identity threat are also discussed as explanations for the relationship between BMI and interview success. Copyright © 2012 The Obesity Society.

  12. External Funding for Community College Courses and Programs. Report and Recommendations of the Florida Postsecondary Education Planning Commission. Report 3.

    ERIC Educational Resources Information Center

    Florida State Postsecondary Education Planning Commission, Tallahassee.

    This study was prepared in response to Specific Appropriation 577A of the 1991 General Appropriations Act, Chapter 91-193, Laws of Florida, by the Florida Postsecondary Education Planning Commission, of community college programs and courses offered in academic year 1990-91 to obtain an overview of the types of course funding arrangements which…

  13. Aquatic Environment, Housing, and Management in the Eighth Edition of the Guide for the Care and Use of Laboratory Animals: Additional Considerations and Recommendations

    PubMed Central

    Mason, Timothy J; Matthews, Monte

    2012-01-01

    The eighth edition of the Guide for the Care and Use of Laboratory Animals recognizes the widespread use of aquatic and semiaquatic research animals by including, among other references, an entire section on aquatic animals in its chapter on environment, housing, and management. Recognizing the large number of aquatic and semiaquatic species used in research and the inherent diversity in animal needs, the Guide refers the reader to texts and journal reviews for specific recommendations and suggests consultations with persons experienced in caring for aquatic species. Here we present considerations that may add to the basic information presented in the Guide and offer some recommendations that may be useful for aquatic animal model caregivers and researchers. PMID:22776190

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

    PubMed

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

    2017-11-01

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

  15. 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.

  16. 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).

  17. Preschool Multiple-Breath Washout Testing. An Official American Thoracic Society Technical Statement.

    PubMed

    Robinson, Paul D; Latzin, Philipp; Ramsey, Kathryn A; Stanojevic, Sanja; Aurora, Paul; Davis, Stephanie D; Gappa, Monika; Hall, Graham L; Horsley, Alex; Jensen, Renee; Lum, Sooky; Milla, Carlos; Nielsen, Kim G; Pittman, Jessica E; Rosenfeld, Margaret; Singer, Florian; Subbarao, Padmaja; Gustafsson, Per M; Ratjen, Felix

    2018-03-01

    Obstructive airway disease is nonuniformly distributed throughout the bronchial tree, although the extent to which this occurs can vary among conditions. The multiple-breath washout (MBW) test offers important insights into pediatric lung disease, not available through spirometry or resistance measurements. The European Respiratory Society/American Thoracic Society inert gas washout consensus statement led to the emergence of validated commercial equipment for the age group 6 years and above; specific recommendations for preschool children were beyond the scope of the document. Subsequently, the focus has shifted to MBW applications within preschool subjects (aged 2-6 yr), where a "window of opportunity" exists for early diagnosis of obstructive lung disease and intervention. This preschool-specific technical standards document was developed by an international group of experts, with expertise in both custom-built and commercial MBW equipment. A comprehensive review of published evidence was performed. Recommendations were devised across areas that place specific age-related demands on MBW systems. Citing evidence where available in the literature, recommendations are made regarding procedures that should be used to achieve robust MBW results in the preschool age range. The present work also highlights the important unanswered questions that need to be addressed in future work. Consensus recommendations are outlined to direct interested groups of manufacturers, researchers, and clinicians in preschool device design, test performance, and data analysis for the MBW technique.

  18. Extending WS-Agreement with Multi-round Negotiation Capability

    NASA Astrophysics Data System (ADS)

    Rumpl, Angela; Wäldrich, Oliver; Ziegler, Wolfgang

    The WS-Agreement specification of the Open Grid Forum defines a language and a protocol for advertising the capabilities of service providers and creating agreements based on templates, and for monitoring agreement compliance at runtime. While the specification, which currently is in the process of transition from a proposed recommendation of the Open Grid Forum to a full recommendation, has been widely used after the initial publication in May 2007, it became obvious that the missing possibility to negotiate an agreement rather than just accepting an offer is limiting or inhibiting the use of WS-Agreement for a number of use-cases. Therefore, the Grid Resource Allocation Agreement Working Group of the Open Grid Forum started in 2008 to prepare an extension of WS-Agreement that adds negotiation capabilities without changing the current specification in a way, which leads to an incompatible new version of WS-Agreement. In this paper we present the results of this process with an updated version of the specification in mind and the first implementation in the European project SmartLM.

  19. 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.

  20. A service brokering and recommendation mechanism for better selecting cloud services.

    PubMed

    Gui, Zhipeng; Yang, Chaowei; Xia, Jizhe; Huang, Qunying; Liu, Kai; Li, Zhenlong; Yu, Manzhu; Sun, Min; Zhou, Nanyin; Jin, Baoxuan

    2014-01-01

    Cloud computing is becoming the new generation computing infrastructure, and many cloud vendors provide different types of cloud services. How to choose the best cloud services for specific applications is very challenging. Addressing this challenge requires balancing multiple factors, such as business demands, technologies, policies and preferences in addition to the computing requirements. This paper recommends a mechanism for selecting the best public cloud service at the levels of Infrastructure as a Service (IaaS) and Platform as a Service (PaaS). A systematic framework and associated workflow include cloud service filtration, solution generation, evaluation, and selection of public cloud services. Specifically, we propose the following: a hierarchical information model for integrating heterogeneous cloud information from different providers and a corresponding cloud information collecting mechanism; a cloud service classification model for categorizing and filtering cloud services and an application requirement schema for providing rules for creating application-specific configuration solutions; and a preference-aware solution evaluation mode for evaluating and recommending solutions according to the preferences of application providers. To test the proposed framework and methodologies, a cloud service advisory tool prototype was developed after which relevant experiments were conducted. The results show that the proposed system collects/updates/records the cloud information from multiple mainstream public cloud services in real-time, generates feasible cloud configuration solutions according to user specifications and acceptable cost predication, assesses solutions from multiple aspects (e.g., computing capability, potential cost and Service Level Agreement, SLA) and offers rational recommendations based on user preferences and practical cloud provisioning; and visually presents and compares solutions through an interactive web Graphical User Interface (GUI).

  1. Low Thrust Orbital Maneuvers Using Ion Propulsion

    NASA Astrophysics Data System (ADS)

    Ramesh, Eric

    2011-10-01

    Low-thrust maneuver options, such as electric propulsion, offer specific challenges within mission-level Modeling, Simulation, and Analysis (MS&A) tools. This project seeks to transition techniques for simulating low-thrust maneuvers from detailed engineering level simulations such as AGI's Satellite ToolKit (STK) Astrogator to mission level simulations such as the System Effectiveness Analysis Simulation (SEAS). Our project goals are as follows: A) Assess different low-thrust options to achieve various orbital changes; B) Compare such approaches to more conventional, high-thrust profiles; C) Compare computational cost and accuracy of various approaches to calculate and simulate low-thrust maneuvers; D) Recommend methods for implementing low-thrust maneuvers in high-level mission simulations; E) prototype recommended solutions.

  2. Considerations for ceramic inlays in posterior teeth: a review

    PubMed Central

    Hopp, Christa D; Land, Martin F

    2013-01-01

    This review of ceramic inlays in posterior teeth includes a review of the history of ceramic restorations, followed by common indications and contraindications for their use. A discussion on the potential for tooth wear is followed by a review of recommended preparation design considerations, fabrication methods, and material choices. Despite the improved materials available for fabrication of porcelain inlays, fracture remains a primary mode of inlay failure. Therefore, a brief discussion on strengthening methods for ceramics is included. The review concludes with a section on luting considerations, and offers the clinician specific recommendations for luting procedures. In conclusion, inlay success rates and longevity, as reported in the literature, are summarized. PMID:23750101

  3. Mammography Patient Information at Hospital Websites: Most Neither Comprehensible Nor Guideline Supported.

    PubMed

    Sadigh, Gelareh; Singh, Kush; Gilbert, Kirven; Khan, Ramsha; Duszak, Abigail M; Duszak, Richard

    2016-11-01

    Ongoing controversy regarding screening mammography guidelines has created confusion for many patients. Given recommendations that patient educational material be prepared at or below the 7th grade reading level of average Americans, the purpose of this study was to assess the readability of online mammography information offered by hospitals nationwide. During 2015, online mammography patient educational materials were identified for all Medicare-recognized hospitals nationwide for which screening mammography metrics were publicly available. Patient educational materials were assessed using six validated readability score algorithms. All references to official screening guidelines were captured. Of 4105 hospitals nationwide, 3252 had websites and confirmable screening mammography services. Of those, 1753 (54%) offered mammography information material online. Only 919 (28%) referenced any professional society guidelines. After excluding information not formatted in HTML and shorter than 100 words (to improve algorithm reliability), 1524 hospital mammography webpages were assessed for grade level scores. Nationally, the mean of each readability score for all hospitals varied between the 10th and 14th grade levels, all higher than the recommended 7th grade level (p < 0.001). At the individual hospital level, only 14 hospitals (0.4%) had mean scores at or below the 7th grade level. Of U.S. hospitals that offer screening mammography and have websites, only 54% provide online mammography educational material. Of those, only 0.4% present information at a reading level comprehensible to average Americans, and only 28% offer specific information to help patients reconcile conflicting guidelines. Health systems offering mammography should strive to better meet women's health information and literacy needs.

  4. Patient Satisfaction Measurement in Occupational and Environmental Medicine Practice.

    PubMed

    Drury, David L; Adamo, Philip; Cloeren, Marianne; Hegmann, Kurt T; Martin, Douglas W; Levine, Michael J; Olson, Shawn M; Pransky, Glenn S; Tacci, James A; Thiese, Matthew

    2018-05-01

    : High patient satisfaction is a desirable goal in medical care. Patient satisfaction measures are increasingly used to evaluate and improve quality in all types of medical practices. However, the unique aspects of occupational and environmental medicine (OEM) practice require development of OEM-specific measures and thoughtful interpretation of results. The American College of Occupational and Environmental Medicine has developed and recommends a set of specific questions to measure patient satisfaction in OEM, designed to meet anticipated regulatory requirements, facilitate quality improvement of participating OEM practices, facilitate case-management review, and offer fair and accurate assessment of OEM physicians.

  5. Providing Adequate Services for the Deaf and Hard of Hearing Population in the Commonwealth [of Kentucky]: A Strategic and Long Range Plan. A Task Force Report to the Governor and the Legislative Commission.

    ERIC Educational Resources Information Center

    Boyd, Barbara; Harker, Heather; Scoggins, Bobbie Beth

    This report to the Kentucky State Legislature and Governor on the needs of the state's hearing impaired population was developed with information from 40 state agencies, 25 consumer organizations, and 135 deaf and hard of hearing individuals. Fifteen recommendations are offered with specific suggestions for required funding and possible funding…

  6. Therapy students' recommendations of physical activity for managing persistent low back pain in older adults.

    PubMed

    Ryan, Cormac G; Schofield, Patricia; Martin, Denis J

    2013-07-01

    Negative views of older adults can lead to suboptimal care. For older adults with persistent low back pain (LBP), promotion of physical activity by health care professionals is important. Health care professionals' views of older adults are influenced by their training. This study aimed to compare recommendations for physical activity for managing persistent LBP offered by students in physiotherapy and occupational therapy to an older person vs. a younger person. In a cross-sectional online survey, participants (N = 77) randomly received a vignette of either a 40-yr-old or 70-yr-old patient with persistent LBP. Other than age, the vignettes were identical. There was no difference between the younger and older vignettes in the likelihood of participants making overall appropriate physical activity recommendations--63% vs. 59%, OR (95% CI) = 1.19 (0.48-2.99), p = .71--although there was a trend toward age bias on recommendations specific to daily activity. Postqualification education may be where ageist views need to be addressed.

  7. Expert panel consensus recommendations for home blood pressure monitoring in Asia: the Hope Asia Network.

    PubMed

    Park, Sungha; Buranakitjaroen, Peera; Chen, Chen-Huan; Chia, Yook-Chin; Divinagracia, Romeo; Hoshide, Satoshi; Shin, Jinho; Siddique, Saulat; Sison, Jorge; Soenarta, Arieska Ann; Sogunuru, Guru Prasad; Tay, Jam Chin; Turana, Yuda; Wang, Ji-Guang; Zhang, Yuqing; Kario, Kazuomi

    2018-04-01

    Hypertension is the leading cause of mortality throughout Asia. Home blood pressure monitoring has the potential to improve hypertension control and is a useful adjunct to conventional office blood pressure measurements due to its diagnostic accuracy and prognostic value in predicting cardiovascular outcomes. At present, there are no region-specific guidelines addressing the use of home blood pressure monitoring in Asia. Therefore, an expert panel was convened to address the use of home blood pressure monitoring and develop key recommendations to help guide clinical practice throughout the Asia region. The resulting recommendations support the use of home blood pressure monitoring with a validated device as an accurate adjunct for diagnosing hypertension and predicting cardiovascular outcome. Diagnosis and treatment of hypertension should still be guided by conventional office/clinic blood pressure measurements. The expert panel encourages the incorporation of home blood pressure monitoring into local clinical guidelines and offers practical recommendations to ensure continuity of care where a validated home blood pressure device is not available.

  8. Development of clinical recommendations for progressive return to activity after military mild traumatic brain injury: guidance for rehabilitation providers.

    PubMed

    McCulloch, Karen L; Goldman, Sarah; Lowe, Lynn; Radomski, Mary Vining; Reynolds, John; Shapiro, Rita; West, Therese A

    2015-01-01

    Previously published mild traumatic brain injury (mTBI) management guidelines provide very general recommendations to return individuals with mTBI to activity. This lack of specific guidance creates variation in military rehabilitation. The Office of the Army Surgeon General in collaboration with the Defense and Veterans Brain Injury Center, a component center of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, convened an expert working group to review the existing literature and propose clinical recommendations that standardize rehabilitation activity progression following mTBI. A Progressive Activity Working Group consisted of 11 Department of Defense representatives across all service branches, 7 Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury representatives, and 8 academic/research/civilian experts with experience assessing and treating individuals with mTBI for return to activity. An expert working group meeting included the Progressive Activity Working Group and 15 additional subject matter experts. In February 2012, the Progressive Activity Working Group was established to determine the need and purpose of the rehabilitation recommendations. Following literature review, a table was created on the basis of the progression from the Zurich consensus statement on concussion in sport. Issues were identified for discussion with a meeting of the larger expert group during a July 2012 conference. Following development of rehabilitation guidance, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury coordinated a similar process for military primary care providers. End products for rehabilitation and primary care providers include specific recommendations for return to activity after concussion. A 6-stage progression specifies activities in physical, cognitive, and balance/vestibular domains and allows for resumption of activity for those with low-level or preinjury symptom complaints. The clinical recommendations for progressive return to activity represent an important effort to standardize activity progression across functional domains and offer providers duty-specific activities to incorporate into intervention. Recommendations were released in January 2014.

  9. 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...

  10. 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

  11. Sexual Harassment in Academic Medicine: Persistence, Non-Reporting, and Institutional Response.

    PubMed

    Wear, Delese; Aultman, Julie

    2005-12-01

    Sexual harassment occurs with regularity during medical training, and it remains largely unreported. This study is one institution's attempt to understand how third and fourth-year medical students perceive and experience sexual harassment, what they believe about reporting sexual harassment, and how they believe it might be eradicated from the educational environment. We used a qualitative research method for our investigation, which would generate more specific language to use in a larger empirical study involving larger numbers of our students. We conducted five focus groups with 24 students, which yielded five categories of response obtained through a close, line-byline reading of transcribed audiotapes. In addition, we offer four recommendations to medical education researchers, deans of medical schools, and medical school accrediting bodies that may reduce the incidence of sexual harassment of medical students. While we do not make the case that the observations, explanations, and recommendations of these 24 students reflect the opinions of all medical students here or elsewhere, we do propose that they are a snapshot of one medical school's gender climate and offer a valuable foundation for further inquiry.

  12. 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.

  13. 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.

  14. [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.

  15. A Service Brokering and Recommendation Mechanism for Better Selecting Cloud Services

    PubMed Central

    Gui, Zhipeng; Yang, Chaowei; Xia, Jizhe; Huang, Qunying; Liu, Kai; Li, Zhenlong; Yu, Manzhu; Sun, Min; Zhou, Nanyin; Jin, Baoxuan

    2014-01-01

    Cloud computing is becoming the new generation computing infrastructure, and many cloud vendors provide different types of cloud services. How to choose the best cloud services for specific applications is very challenging. Addressing this challenge requires balancing multiple factors, such as business demands, technologies, policies and preferences in addition to the computing requirements. This paper recommends a mechanism for selecting the best public cloud service at the levels of Infrastructure as a Service (IaaS) and Platform as a Service (PaaS). A systematic framework and associated workflow include cloud service filtration, solution generation, evaluation, and selection of public cloud services. Specifically, we propose the following: a hierarchical information model for integrating heterogeneous cloud information from different providers and a corresponding cloud information collecting mechanism; a cloud service classification model for categorizing and filtering cloud services and an application requirement schema for providing rules for creating application-specific configuration solutions; and a preference-aware solution evaluation mode for evaluating and recommending solutions according to the preferences of application providers. To test the proposed framework and methodologies, a cloud service advisory tool prototype was developed after which relevant experiments were conducted. The results show that the proposed system collects/updates/records the cloud information from multiple mainstream public cloud services in real-time, generates feasible cloud configuration solutions according to user specifications and acceptable cost predication, assesses solutions from multiple aspects (e.g., computing capability, potential cost and Service Level Agreement, SLA) and offers rational recommendations based on user preferences and practical cloud provisioning; and visually presents and compares solutions through an interactive web Graphical User Interface (GUI). PMID:25170937

  16. Depression and Anxiety During Pregnancy: Evaluating the Literature in Support of Clinical Risk-Benefit Decision-Making.

    PubMed

    Dalke, Katharine Baratz; Wenzel, Amy; Kim, Deborah R

    2016-06-01

    Depression and anxiety during pregnancy are common, and patients and providers are faced with complex decisions regarding various treatment modalities. A structured discussion of the risks and benefits of options with the patient and her support team is recommended to facilitate the decision-making process. This clinically focused review, with emphasis on the last 3 years of published study data, evaluates the major risk categories of medication treatments, namely pregnancy loss, physical malformations, growth impairment, behavioral teratogenicity, and neonatal toxicity. Nonpharmacological treatment options, including neuromodulation and psychotherapy, are also briefly reviewed. Specific recommendations, drawn from the literature and the authors' clinical experience, are also offered to help guide the clinician in decision-making.

  17. 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.

  18. Management of relapsed multiple myeloma: recommendations of the International Myeloma Working Group.

    PubMed

    Laubach, J; Garderet, L; Mahindra, A; Gahrton, G; Caers, J; Sezer, O; Voorhees, P; Leleu, X; Johnsen, H E; Streetly, M; Jurczyszyn, A; Ludwig, H; Mellqvist, U-H; Chng, W-J; Pilarski, L; Einsele, H; Hou, J; Turesson, I; Zamagni, E; Chim, C S; Mazumder, A; Westin, J; Lu, J; Reiman, T; Kristinsson, S; Joshua, D; Roussel, M; O'Gorman, P; Terpos, E; McCarthy, P; Dimopoulos, M; Moreau, P; Orlowski, R Z; Miguel, J S; Anderson, K C; Palumbo, A; Kumar, S; Rajkumar, V; Durie, B; Richardson, P G

    2016-05-01

    The prognosis for patients multiple myeloma (MM) has improved substantially over the past decade with the development of new, more effective chemotherapeutic agents and regimens that possess a high level of anti-tumor activity. In spite of this important progress, however, nearly all MM patients ultimately relapse, even those who experience a complete response to initial therapy. Management of relapsed MM thus represents a vital aspect of the overall care for patients with MM and a critical area of ongoing scientific and clinical research. This comprehensive manuscript from the International Myeloma Working Group provides detailed recommendations on management of relapsed disease, with sections dedicated to diagnostic evaluation, determinants of therapy, and general approach to patients with specific disease characteristics. In addition, the manuscript provides a summary of evidence from clinical trials that have significantly impacted the field, including those evaluating conventional dose therapies, as well as both autologous and allogeneic stem cell transplantation. Specific recommendations are offered for management of first and second relapse, relapsed and refractory disease, and both autologous and allogeneic transplant. Finally, perspective is provided regarding new agents and promising directions in management of relapsed MM.

  19. [Nutrition counseling in tumor cachexia so patients will eat better].

    PubMed

    Krumwiede, K H

    2003-03-13

    With the aim of preventing, or at least limiting, malnutrition in patients suffering from cancer, they should receive appropriate nutritional advice before, during and after treatment. Such problems as loss of appetite, nausea, gustatory disturbances, dry mouth, etc., may be ameliorated by specific counseling. Enteral liquid diets and commercially available baby food products offer a good alternative to normal diet, or may be used to supplement it. Such supplements as vitamin and/or mineral tablets, and vegetable and fruit concentrates should only be used selectively and for well-founded indications. The metabolic situation in cachectic patients is not particularly amenable to oral nutritional measures. A fat-rich diet is recommended. The administration of pharmacological doses of omega-3 fatty acids may offer some benefit.

  20. 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.

  1. 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

  2. Vaccine recommendations for children and youth for the 2014/2015 influenza season.

    PubMed

    Moore, Dorothy L

    2014-10-01

    The Canadian Paediatric Society continues to encourage annual influenza vaccination for ALL children and youth ≥6 months of age. Recommendations from the National Advisory Committee on Immunization for the 2014/2015 influenza season include some important changes: Influenza vaccination is recommended for ALL individuals ≥6 months of age, with particular focus on those at high risk of influenza-related complications and their close contacts. Definitions of high-risk conditions and close contacts have not changed from those of 2013/2014.The preference for intranasal, live attenuated influenza vaccine (LAIV) over trivalent inactivated influenza vaccines for healthy children is restricted to individuals two to six years of age. There is insufficient evidence to recommend LAIV over trivalent inactivated influenza vaccines in older children or in children with chronic health conditions; either vaccine may be used unless there are specific contraindications.Quadrivalent influenza vaccines are expected to be available for the 2014/2015 season and may be used interchangeably with trivalent vaccines. They may offer improved protection.Trivalent or quadrivalent inactivated vaccines may be used in individuals with egg allergy; LAIV has not yet been evaluated in this population and is not recommended at this time.

  3. 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.

  4. Systemic Therapy for Stage IV Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update.

    PubMed

    Hanna, Nasser; Johnson, David; Temin, Sarah; Baker, Sherman; Brahmer, Julie; Ellis, Peter M; Giaccone, Giuseppe; Hesketh, Paul J; Jaiyesimi, Ishmael; Leighl, Natasha B; Riely, Gregory J; Schiller, Joan H; Schneider, Bryan J; Smith, Thomas J; Tashbar, Joan; Biermann, William A; Masters, Gregory

    2017-10-20

    Purpose Provide evidence-based recommendations updating the 2015 ASCO guideline on systemic therapy for patients with stage IV non-small-cell lung cancer (NSCLC). Methods The ASCO NSCLC Expert Panel made recommendations based on a systematic review of randomized controlled trials from February 2014 to December 2016 plus the Cancer Care Ontario Program in Evidence-Based Care's update of a previous ASCO search. Results This guideline update reflects changes in evidence since the previous guideline update. Fourteen randomized controlled trials provide the evidence base; earlier phase trials also informed recommendation development. Recommendations New or revised recommendations include the following. Regarding first-line treatment for patients with non-squamous cell carcinoma or squamous cell carcinoma (without positive markers, eg, EGFR/ALK /ROS1), if the patient has high programmed death ligand 1 (PD-L1) expression, pembrolizumab should be used alone; if the patient has low PD-L1 expression, clinicians should offer standard chemotherapy. All other clinical scenarios follow 2015 recommendations. Regarding second-line treatment in patients who received first-line chemotherapy, without prior immune checkpoint therapy, if NSCLC tumor is positive for PD-L1 expression, clinicians should use single-agent nivolumab, pembrolizumab, or atezolizumab; if tumor has negative or unknown PD-L1 expression, clinicians should use nivolumab or atezolizumab. All immune checkpoint therapy is recommended alone plus in the absence of contraindications. For patients who received a prior first-line immune checkpoint inhibitor, clinicians should offer standard chemotherapy. For patients who cannot receive immune checkpoint inhibitor after chemotherapy, docetaxel is recommended; in patients with nonsquamous NSCLC, pemetrexed is recommended. In patients with a sensitizing EGFR mutation, disease progression after first-line epidermal growth factor receptor tyrosine kinase inhibitor therapy, and T790M mutation, osimertinib is recommended; if NSCLC lacks the T790M mutation, then chemotherapy is recommended. Patients with ROS1 gene rearrangement without prior crizotinib may be offered crizotinib, or if they previously received crizotinib, they may be offered chemotherapy.

  5. Aspects of deceased organ donation in paediatrics.

    PubMed

    Brierley, J; Hasan, A

    2012-01-01

    Organ transplantation offers children in acute or chronic severe organ failure similar opportunities to adults. However, while the number who might benefit is relatively low, significantly fewer cadaveric donors exist for any given child compared with an adult. Incompatible organ size and relatively low donation rates mean that despite living parental donation and innovations to reduce donated organ size, children die before organs become available. The severity of the UK situation is compounded by restrictions on paediatric living donation, uncertainties over the application of brain death criteria, and ethical concerns about the use of donation after circulatory death. The UK Department of Health's Organ Donation Task Force suggested the means by which the adult donor pool might be increased, recommending that outstanding ethical and legal issues be resolved, but made no specific recommendations about children.

  6. 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.

  7. Internet Presentation of Departments of Pediatric Surgery in Germany and Their Compliance with Recommended Criteria for Promoting Services and Offering Professional Information for Patients.

    PubMed

    Farhat, Naim; Zoeller, Christoph; Petersen, Claus; Ure, Benno

    2016-08-01

    Introduction The presentation of health institutions in the internet is highly variable concerning marketing features and medical information. We aimed to investigate the structure and the kind of information provided on the Web sites of all departments of pediatric surgery in Germany. Furthermore, we aimed to identify the degree to which these Web sites comply with internet marketing recommendations for generating business. Method The Web sites of all pediatric surgery units referred to as departments on the official Web site of the German Society of Pediatric Surgery (GSPS) were assessed. The search engine Google was used by entering the terms "pediatric surgery" and the name of the city. Besides general data eight content characteristics focusing on ranking, accessibility, use of social media, multilingual sites, navigation options, selected images, contact details, and medical information were evaluated according to published recommendations. Results A total of 85 departments of pediatric surgery were included. On Google search results 44 (52%) ranked number one and 34 (40%) of the department's homepages were accessible directly through the homepage link of the GSPS. A link to own digital and/or social media was offered on 11 (13%) homepages. Nine sites were multilingual. The most common navigation bar item was clinical services on 74 (87%) homepages. Overall, 76 (89%) departments presented their doctors and 17 (20%) presented other staff members with images of doctors on 53 (62%) and contact data access from the homepage on 68 (80%) Web sites. On 25 (29%) Web sites information on the medical conditions treated were presented, on 17 (20%) details of treating concepts, and on 4 (5%) numbers of patients with specific conditions treated in the own department per year. Conclusion We conclude that numerous of the investigated online presentations do not comply with recommended criteria for offering professional information for patients and for promoting services. Only less than one-third of the departments of pediatric surgery in Germany offer information about the medical conditions they treat. Features, which may influence the decision of patients and parents such as ranking, accessibility, use of social media, multilingual sites, navigation options, selected images, and contact information were differently lacking on many Web sites. Georg Thieme Verlag KG Stuttgart · New York.

  8. 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

  9. 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.

  10. Reduction in Thyroid Nodule Biopsies and Improved Accuracy with American College of Radiology Thyroid Imaging Reporting and Data System.

    PubMed

    Hoang, Jenny K; Middleton, William D; Farjat, Alfredo E; Langer, Jill E; Reading, Carl C; Teefey, Sharlene A; Abinanti, Nicole; Boschini, Fernando J; Bronner, Abraham J; Dahiya, Nirvikar; Hertzberg, Barbara S; Newman, Justin R; Scanga, Daniel; Vogler, Robert C; Tessler, Franklin N

    2018-04-01

    Purpose To compare the biopsy rate and diagnostic accuracy before and after applying the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) criteria for thyroid nodule evaluation. Materials and Methods In this retrospective study, eight radiologists with 3-32 years experience in thyroid ultrasonography (US) reviewed US features of 100 thyroid nodules that were cytologically proven, pathologically proven, or both in December 2016. The radiologists evaluated nodule features in five US categories and provided biopsy recommendations based on their own practice patterns without knowledge of ACR TI-RADS criteria. Another three expert radiologists served as the reference standard readers for the imaging findings. ACR TI-RADS criteria were retrospectively applied to the features assigned by the eight radiologists to produce biopsy recommendations. Comparison was made for biopsy rate, sensitivity, specificity, and accuracy. Results Fifteen of the 100 nodules (15%) were malignant. The mean number of nodules recommended for biopsy by the eight radiologists was 80 ± 16 (standard deviation) (range, 38-95 nodules) based on their own practice patterns and 57 ± 11 (range, 37-73 nodules) with retrospective application of ACR TI-RADS criteria. Without ACR TI-RADS criteria, readers had an overall sensitivity, specificity, and accuracy of 95% (95% confidence interval [CI]: 83%, 99%), 20% (95% CI: 16%, 25%), and 28% (95% CI: 21%, 37%), respectively. After applying ACR TI-RADS criteria, overall sensitivity, specificity, and accuracy were 92% (95% CI: 68%, 98%), 44% (95% CI: 33%, 56%), and 52% (95% CI: 40%, 63%), respectively. Although fewer malignancies were recommended for biopsy with ACR TI-RADS criteria, the majority met the criteria for follow-up US, with only three of 120 (2.5%) malignancy encounters requiring no follow-up or biopsy. Expert consensus recommended biopsy in 55 of 100 nodules with ACR TI-RADS criteria. Their sensitivity, specificity, and accuracy were 87% (95% CI: 48%, 98%), 51% (95% CI: 40%, 62%), and 56% (95% CI: 46%, 66%), respectively. Conclusion ACR TI-RADS criteria offer a meaningful reduction in the number of thyroid nodules recommended for biopsy and significantly improve the accuracy of recommendations for nodule management. © RSNA, 2018 Online supplemental material is available for this article.

  11. 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.

  12. 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

  13. [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.

  14. Comparison of avian biochemical test results with Abaxis VetScan and Hitachi 911 analyzers.

    PubMed

    Greenacre, Cheryl B; Flatland, Bente; Souza, Marcy J; Fry, Michael M

    2008-12-01

    To compare results of clinical biochemical analysis using an Abaxis VetScan bench-top analyzer with reagents specifically marketed for avian use and a Hitachi 911 analyzer, plasma (both methods) and whole blood (VetScan method) samples from 20 clinically healthy Hispaniolan Amazon parrots (Amazona ventralis) were analyzed. Correlation between methods was very high (r = 0.9-1.0) for aspartate aminotransferase (AST), calcium, glucose, and uric acid; high (r = 0.7-0.89) for creatine kinase (CK), phosphorus, potassium, and total protein; moderate (r = 0.5-0.69) for globulin; and low (r = 0.3-0.49) for albumin and sodium. VetScan analyzer results for globulin, sodium, and uric acid had a constant negative bias (values below those from the Hitachi method). Based on difference plot analysis, results for AST, calcium, CK, and glucose are comparable. Because 16 of 20 values fell below the lower detection limit of the VetScan analyzer, bile acid data were excluded from analysis. By using a relatively small sample size (0.1 ml whole blood or plasma), the VetScan analyzer offers rapid in-house results, compact size, and ease of operation. For 4 of the most clinically relevant biochemical analytes used in avian medicine (AST, calcium, CK, glucose), it offers reliable values. For an additional 4 analytes (phosphorous, potassium, total protein, uric acid), establishing analyzer-specific reference intervals is recommended. Neither the VetScan nor the Hitachi method is recommended to assess albumin and globulin concentrations.

  15. Measure Guideline: Optimizing the Configuration of Flexible Duct Junction Boxes

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

    Beach, R.; Burdick, A.

    2014-03-01

    This measure guideline offers additional recommendations to heating, ventilation, and air conditioning (HVAC) system designers for optimizing flexible duct, constant-volume HVAC systems using junction boxes within Air Conditioning Contractors of America (ACCA) Manual D guidance. IBACOS used computational fluid dynamics software to explore and develop guidance to better control the airflow effects of factors that may impact pressure losses within junction boxes among various design configurations. These recommendations can help to ensure that a system aligns more closely with the design and the occupants' comfort expectations. Specifically, the recommendations described herein show how to configure a rectangular box with fourmore » outlets, a triangular box with three outlets, metal wyes with two outlets, and multiple configurations for more than four outlets. Designers of HVAC systems, contractors who are fabricating junction boxes on site, and anyone using the ACCA Manual D process for sizing duct runs will find this measure guideline invaluable for more accurately minimizing pressure losses when using junction boxes with flexible ducts.« less

  16. Improving Human Resources for Health means Retaining Health-Workers: Application of the WHO-Recommendations for the Retention of Health-Workers in Rural Northern-Nigeria.

    PubMed

    Afenyadu, Godwin Y; Adegoke, Adetoro A; Findley, Sally

    2017-01-01

    Nigeria is one of 57 countries with critical shortage of health workers (HWs). Strategies to increase and equitably distribute HWs are critical to the achievement of Health Millennium/Sustainable Development Goals. We describe how three Northern Nigeria states adapted World Health Organisation (WHO)-recommended incentives to attract, recruit, and retain midwives. Secondary analysis of data from two surveys assessing midwife motivation, retention, and attrition in Northern Nigeria; and expert consultations. Midwives highlighted financial and non-financial incentives as key factors in their decisions to renew their contracts. Their perspectives informed the consensus positions of health managers, policymakers and heads of institutions, and led to the adaptation of the WHO recommendations into appropriate state-specific incentive packages. The feedback from midwives combined with an expert consultation approach allowed stakeholders to consider and use available evidence to select appropriate incentive packages that offer the greatest potential for helping to address inadequate numbers of rural midwives.

  17. Are professional psychology training programs willing the future to economic illiterates?: a clarion call for pedagogical action.

    PubMed

    Friedberg, Robert D

    2016-10-01

    The behavioral health care environment in the United States is changing and many experts expect seismic shifts in access, accountability and reimbursement policies. Students in professional psychology training programs will be called upon to administer, manage, supervise and deliver clinically sound as well as cost effective services. While in general, traditional professional psychology training curricula prepare students well for clinical challenges, most students enter the profession naïve to the economic, financial and business enterprise crucibles in the behavioral health care marketplace. This article examines the problem of such naiveté and offers several recommendations for improving graduate students' economic literacy. Moreover, the article argues that increased business and economic acumen may serve to close the research-practice gap in professional psychology. The article reviews literature pertinent to training psychologists and highlights pedagogical gaps. Several recommendations for curricular development are offered. Specifically, adding courses in health care economics and basic business principles is suggested. Integrating cost-effectiveness analyses across all course content is proposed. The article also emphasizes both didactic and experiential learning opportunities. Course work should be augmented with training opportunities at the practicum, internship, and post-doctoral fellowship level.

  18. [Diagnosis and surgical management in gastrointestinal neuroendocrine tumors].

    PubMed

    Tomulescu, V; Stănciulea, O; Dima, S; Herlea, V; Stoica Mustafa, E; Dumitraşcu, T; Pechianu, C; Popescu, I

    2011-01-01

    Neuroendocrine tumors, known as carcinoid tumors constitute a heterogeneous group of neoplasms that present many clinical challenges. They secrete peptides and neuroamines that cause specific clinical syndromes. Assessment of specific or general tumors markers offers high sensitivity in establishing the diagnosis and they also have prognostic significance. Management strategies include curative surgery, whenever possible-that can be rarely achieved, palliative surgery, chemotherapy, radiologic therapy, such as radiofrequency ablation and chemoembolisations and somatostatin analogues therapy in order to control the symptoms. The aim of this paper is to review recent publications in this field and to give recommendations that take into account current advances in order to facilitate improvement in management and outcome.

  19. Debriefing and accountability in deceptive research.

    PubMed

    Miller, Franklin G; Gluck, John P; Wendler, David

    2008-09-01

    Debriefing is a standard ethical requirement for human research involving the use of deception. Little systematic attention, however, has been devoted to explaining the ethical significance of debriefing and the specific ethical functions that it serves. In this article, we develop an account of debriefing as a tool of moral accountability for the prima facie wrong of deception. Specifically, we contend that debriefing should include a responsibility to promote transparency by explaining the deception and its rationale, to provide an apology to subjects for infringing the principle of respect for persons, and to offer subjects an opportunity to withdraw their data. We also present recommendations concerning the discussion of deception in scientific articles reporting the results of research using deception.

  20. Peridigm summary report : lessons learned in development with agile components.

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

    Salinger, Andrew Gerhard; Mitchell, John Anthony; Littlewood, David John

    2011-09-01

    This report details efforts to deploy Agile Components for rapid development of a peridynamics code, Peridigm. The goal of Agile Components is to enable the efficient development of production-quality software by providing a well-defined, unifying interface to a powerful set of component-based software. Specifically, Agile Components facilitate interoperability among packages within the Trilinos Project, including data management, time integration, uncertainty quantification, and optimization. Development of the Peridigm code served as a testbed for Agile Components and resulted in a number of recommendations for future development. Agile Components successfully enabled rapid integration of Trilinos packages into Peridigm. A cost of thismore » approach, however, was a set of restrictions on Peridigm's architecture which impacted the ability to track history-dependent material data, dynamically modify the model discretization, and interject user-defined routines into the time integration algorithm. These restrictions resulted in modifications to the Agile Components approach, as implemented in Peridigm, and in a set of recommendations for future Agile Components development. Specific recommendations include improved handling of material states, a more flexible flow control model, and improved documentation. A demonstration mini-application, SimpleODE, was developed at the onset of this project and is offered as a potential supplement to Agile Components documentation.« less

  1. 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

  2. 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.

  3. 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

  4. 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/.

  5. 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.

  6. Designing a Method with Physician Participation to Assess and Improve Quality of Healthcare in Otolaryngology.

    PubMed

    Arce, José M; Martín Cleary, Catalina; Cenjor, Carlos; Ramos, Ángel; Ortiz, Alberto

    2017-04-01

    Patient choice of healthcare centers to be treated for specific diseases is compromised by the low accessibility of understandable information. Physicians are rarely involved in healthcare quality assessment, despite their potentially valuable input. The purpose of this study was to develop a methodology for evaluating the quality of care that specifically incorporates advice from medical specialists and provides accessible information for patients in search of high-quality healthcare. A pilot Delphi study was conducted among 28 Spanish otolaryngology experts, seeking their opinion on the quality-of-care indicators and on their ability to recommend the most suitable department for the treatment of specific otolaryngologic diseases. The average acceptance rate was 91.9% for quality-of-care indicator and 96.5% for the resources needed for improving the quality of care. Furthermore, 93% experts reported that patients frequently ask for physician advice on which center provides better care for a specific disease, 92.6% experts believe they could recommend the best centers for specific otolaryngologic diseases, and 80% experts agreed that expert opinion on the quality of care offered by different centers would be a valuable addition to quality-of-care assessment. The incorporation of physician advice into healthcare quality assessment may improve the usefulness of healthcare quality indicators for patients. Assessment tools incorporating physician advice should be developed and validated.

  7. Recommendation 87/567/EEC on vocational training for women, 24 November 1987.

    PubMed

    1987-01-01

    This document contains the text of a 1987 Recommendation of the Commission of the European Communities on vocational training for women. Article 1 recommends that Member States adopt a policy to encourage participation of women in training schemes, especially those relevant to occupations of the future and in areas where women are under-represented. Article 2 recommends that Member States: 1) integrate training for women within a broad framework of cooperation between all parties involved; 2) staff such services with personnel trained to deal with the specific problems faced by women; 3) promote outreach activities on the part of such services; 4) provide more decentralized and widely distributed educational and training facilities; 5) promote images of women engaged in nontraditional activities; 6) encourage female participation in higher education, especially in technological areas; 7) encourage female participation in nontraditional apprenticeships; 8) encourage female entrepreneurs by offering appropriate training; 9) develop measures to promote participation of women in continuous training activities; 10) provide underprivileged women and women returning to work with specific courses designed to meet their needs; 11) provide flexible child care arrangements and financial incentives for women to participate in training activities; 12) recognize skills acquired in running a household and looking after a family; and 13) monitor the progress of women taking part in training schemes. Member States are to inform the Commission of their activities in these areas within three years to enable the Commission to create a report on such measures.

  8. Cryopreservation of MHC multimers: Recommendations for quality assurance in detection of antigen specific T cells.

    PubMed

    Hadrup, Sine Reker; Maurer, Dominik; Laske, Karoline; Frøsig, Thomas Mørch; Andersen, Sofie Ramskov; Britten, Cedrik M; van der Burg, Sjoerd H; Walter, Steffen; Gouttefangeas, Cécile

    2015-01-01

    Fluorescence-labeled peptide-MHC class I multimers serve as ideal tools for the detection of antigen-specific T cells by flow cytometry, enabling functional and phenotypical characterization of specific T cells at the single cell level. While this technique offers a number of unique advantages, MHC multimer reagents can be difficult to handle in terms of stability and quality assurance. The stability of a given fluorescence-labeled MHC multimer complex depends on both the stability of the peptide-MHC complex itself and the stability of the fluorochrome. Consequently, stability is difficult to predict and long-term storage is generally not recommended. We investigated here the possibility of cryopreserving MHC multimers, both in-house produced and commercially available, using a wide range of peptide-MHC class I multimers comprising virus and cancer-associated epitopes of different affinities presented by various HLA-class I molecules. Cryopreservation of MHC multimers was feasible for at least 6 months, when they were dissolved in buffer containing 5-16% glycerol (v/v) and 0.5% serum albumin (w/v). The addition of cryoprotectants was tolerated across three different T-cell staining protocols for all fluorescence labels tested (PE, APC, PE-Cy7 and Quantum dots). We propose cryopreservation as an easily implementable method for stable storage of MHC multimers and recommend the use of cryopreservation in long-term immunomonitoring projects, thereby eliminating the variability introduced by different batches and inconsistent stability. © 2014 International Society for Advancement of Cytometry.

  9. Cryopreservation of MHC Multimers: Recommendations for Quality Assurance in Detection of Antigen Specific T Cells

    PubMed Central

    Hadrup, Sine Reker; Maurer, Dominik; Laske, Karoline; Frøsig, Thomas Mørch; Andersen, Sofie Ramskov; Britten, Cedrik M; van der Burg, Sjoerd H; Walter, Steffen; Gouttefangeas, Cécile

    2015-01-01

    Fluorescence-labeled peptide-MHC class I multimers serve as ideal tools for the detection of antigen-specific T cells by flow cytometry, enabling functional and phenotypical characterization of specific T cells at the single cell level. While this technique offers a number of unique advantages, MHC multimer reagents can be difficult to handle in terms of stability and quality assurance. The stability of a given fluorescence-labeled MHC multimer complex depends on both the stability of the peptide-MHC complex itself and the stability of the fluorochrome. Consequently, stability is difficult to predict and long-term storage is generally not recommended. We investigated here the possibility of cryopreserving MHC multimers, both in-house produced and commercially available, using a wide range of peptide-MHC class I multimers comprising virus and cancer-associated epitopes of different affinities presented by various HLA-class I molecules. Cryopreservation of MHC multimers was feasible for at least 6 months, when they were dissolved in buffer containing 5–16% glycerol (v/v) and 0.5% serum albumin (w/v). The addition of cryoprotectants was tolerated across three different T-cell staining protocols for all fluorescence labels tested (PE, APC, PE-Cy7 and Quantum dots). We propose cryopreservation as an easily implementable method for stable storage of MHC multimers and recommend the use of cryopreservation in long-term immunomonitoring projects, thereby eliminating the variability introduced by different batches and inconsistent stability. © 2014 International Society for Advancement of Cytometry PMID:25297339

  10. 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.

  11. [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.

  12. 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.

  13. 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

  14. Contract law for physicians. The basics.

    PubMed

    Eelkema, R

    1989-02-01

    As part of the Minnesota Medical Association's ongoing contract review process, this article provides information to help educate physicians about the major managed care contracts being offered to them. The information provided is not intended to, nor should it be a substitute for legal advice pertaining to an individual's practice and specific contracts with third parties. The MMA will not be making recommendations regarding the merits of any particular contract. A decision to enter into a contract rests with the physician and his or her clinic in consultation with private legal counsel.

  15. Strengthening senior tax credit programs in Massachusetts.

    PubMed

    Kiesel, Kristin

    2002-01-01

    In the last decade, property taxes have increased, creating a financial burden on senior homeowners. In Massachusetts, senior property tax credit programs have arisen to address this problem, as well as to provide cost-effective volunteer assistance for municipal departments, offer seniors meaningful work that otherwise would not have been attempted, and foster involvement in municipal government among seniors. The success of the programs in retaining senior homeowners in the community remains to be evaluated. Program specifics are detailed, policy options are considered, and recommendations are made to strengthen existing programs and assist replication.

  16. 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…

  17. European Psychiatric Association Guidance on psychotherapy in chronic depression across Europe.

    PubMed

    Jobst, A; Brakemeier, E-L; Buchheim, A; Caspar, F; Cuijpers, P; Ebmeier, K P; Falkai, P; Jan van der Gaag, R; Gaebel, W; Herpertz, S; Kurimay, T; Sabaß, L; Schnell, K; Schramm, E; Torrent, C; Wasserman, D; Wiersma, J; Padberg, F

    2016-03-01

    Patients with chronic depression (CD) by definition respond less well to standard forms of psychotherapy and are more likely to be high utilizers of psychiatric resources. Therefore, the aim of this guidance paper is to provide a comprehensive overview of current psychotherapy for CD. The evidence of efficacy is critically reviewed and recommendations for clinical applications and research are given. We performed a systematic literature search to identify studies on psychotherapy in CD, evaluated the retrieved documents and developed evidence tables and recommendations through a consensus process among experts and stakeholders. We developed 5 recommendations which may help providers to select psychotherapeutic treatment options for this patient group. The EPA considers both psychotherapy and pharmacotherapy to be effective in CD and recommends both approaches. The best effect is achieved by combined treatment with psychotherapy and pharmacotherapy, which should therefore be the treatment of choice. The EPA recommends psychotherapy with an interpersonal focus (e.g. the Cognitive Behavioural Analysis System of Psychotherapy [CBASP]) for the treatment of CD and a personalized approach based on the patient's preferences. The DSM-5 nomenclature of persistent depressive disorder (PDD), which includes CD subtypes, has been an important step towards a more differentiated treatment and understanding of these complex affective disorders. Apart from dysthymia, ICD-10 still does not provide a separate entity for a chronic course of depression. The differences between patients with acute episodic depression and those with CD need to be considered in the planning of treatment. Specific psychotherapeutic treatment options are recommended for patients with CD. Patients with chronic forms of depression should be offered tailored psychotherapeutic treatments that address their specific needs and deficits. Combination treatment with psychotherapy and pharmacotherapy is the first-line treatment recommended for CD. More research is needed to develop more effective treatments for CD, especially in the longer term, and to identify which patients benefit from which treatment algorithm. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Mobile phone and my health

    NASA Astrophysics Data System (ADS)

    Surducan, Aneta; Dabala, Dana; Neamtu, Camelia; Surducan, Vasile; Surducan, Emanoil

    2013-11-01

    The interaction of the microwave radiation emitted by mobile phones with the user's body is analyzed from the International Commission on Non-Ionizing Radiation Protection (ICNIRP) recommendations perspective as a correlation between the specific absorption ratio (SAR) of the mobile phone and the call duration. The relative position of the cell phone to the user's body, the dielectric properties of the exposed body parts, the SAR value and the call duration are considered in the local body temperature rise due to the microwave heating effect. The recommended local temperature rise limit in the human body is evaluated according to standards. The aim of this study is to disseminate information to young people, especially high school students, about the microwave thermal effects on the human body, to make them aware of the environmental electromagnetic pollution and to offer them a simple method of biological self protection.

  19. 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.

  20. 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.

  1. Assessing the consequences of unrealistic optimism: Challenges and recommendations.

    PubMed

    Shepperd, James A; Pogge, Gabrielle; Howell, Jennifer L

    2017-04-01

    Of the hundreds of studies published on unrealistic optimism (i.e., expecting a better personal future than is reasonably likely), most have focused on demonstrating the phenomenon, examining boundary conditions, or documenting causes. Few studies have examined the consequences of unrealistic optimism. In this article, we provide an overview of the measurement of unrealistic optimism, review possible consequences, and identify numerous challenges confronting investigators attempting to understand the consequences. Assessing the consequences of unrealistic optimism is tricky, and ultimately probably impossible when researchers assess unrealistic optimism at the group level (which reveals if a group of people is displaying unrealistic optimism on average) rather than the individual level (which reveals whether a specific individual displays unrealistic optimism). We offer recommendations to researchers who wish to examine the consequences of unrealistic optimism. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Co-morbidities in severe asthma: Clinical impact and management.

    PubMed

    Porsbjerg, Celeste; Menzies-Gow, Andrew

    2017-05-01

    Patients with severe asthma represent a minority of the total asthma population, but carry a majority of the morbidity and healthcare costs. Achieving better asthma control in this group of patients is therefore of key importance. Systematic assessment of patients with possible severe asthma to identify treatment barriers and triggers of asthma symptoms, including co-morbidities, improves asthma control and reduces healthcare costs and is recommended by international guidelines on management of severe asthma. This review provides the clinician with an overview of the prevalence and clinical impact of the most common co-morbidities in severe asthma, including chronic rhinosinusitis, nasal polyposis, allergic rhinitis, dysfunctional breathing, vocal cord dysfunction, anxiety and depression, obesity, obstructive sleep apnoea syndrome (OSAS), gastroesophageal reflux disease (GERD), bronchiectasis, allergic bronchopulmonary aspergillosis (ABPA) and eosinophilic granulomatous with polyangiitis (EGPA). Furthermore, the review offers a summary of recommended diagnostic and management approaches for each co-morbidity. Finally, the review links co-morbid conditions to specific phenotypes of severe asthma, in order to guide the clinician on which co-morbidities to look for in specific patients. © 2017 Asian Pacific Society of Respirology.

  3. Whole dietary patterns to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field.

    PubMed

    Teo, Lynn; Crawford, Cindy; Yehuda, Rachel; Jaghab, Danny; Bingham, John J; Gallon, Matthew D; O'Connell, Meghan L; Chittum, Holly K; Arzola, Sonya M; Berry, Kevin

    2017-06-01

    Optimizing cognitive performance, particularly during times of high stress, is a prerequisite to mission-readiness among military personnel. It has been of interest to determine whether such performance could be enhanced through diet. This systematic review assesses the quality of the evidence for whole dietary patterns 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. Fifteen included trials were assessed for methodological quality, and descriptive data were extracted. Of the 6 acceptable-quality studies, 1 demonstrated statistically nonsignificant results, whereas the other 5 showed conflicting results across the cognitive outcomes assessed. Due to the heterogeneity across the included studies, no recommendations could be reached concerning whether certain whole dietary patterns have an effect on cognitive outcomes in healthy populations. Specific recommendations for future research are offered. © 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.

  4. UV tanning advertisements in high school newspapers.

    PubMed

    Freeman, Scott; Francis, Shayla; Lundahl, Kristy; Bowland, Terri; Dellavalle, Robert P

    2006-04-01

    To examine the increasing use of UV tanning parlors by adolescents, despite the World Health Organization recommendation that no one under the age of 18 years use UV tanning devices. We examined tanning advertisements in a sample of public high school newspapers published between 2001 and 2005 in 3 Colorado counties encompassing the Denver metropolitan area. Tanning advertisements appeared in newspapers from 11 (48%) of 23 schools. Newspaper issues (N = 131) contained 40 advertisements placed by 18 tanning parlors. Advertisements commonly offered discounts (19 of 40) including unlimited tanning offers (15 of 40). Thirteen advertisements featured non-UV tanning treatments, and 2 advertisements mentioned parental consent or accompaniment for UV tanning. UV radiation, a classified carcinogen, is commonly and specifically marketed to adolescents through high school newspaper advertising. Public health skin cancer prevention policies should include the prohibition of UV tanning advertising to minors.

  5. Bowel Ultrasonography in the Management of Crohn's Disease. A Review with Recommendations of an International Panel of Experts.

    PubMed

    Calabrese, Emma; Maaser, Christian; Zorzi, Francesca; Kannengiesser, Klaus; Hanauer, Stephen B; Bruining, David H; Iacucci, Marietta; Maconi, Giovanni; Novak, Kerri L; Panaccione, Remo; Strobel, Deike; Wilson, Stephanie R; Watanabe, Mamoru; Pallone, Francesco; Ghosh, Subrata

    2016-05-01

    Bowel ultrasonography (US) is considered a useful technique for assessing mural inflammation and complications in Crohn's disease (CD). The aim of this review is to appraise the evidence on the accuracy of bowel US for CD. In addition, we aim to provide recommendations for its optimal use. Publications were identified by literature search from 1992 to 2014 and selected based on predefined criteria: 15 or more patients; bowel US for diagnosing CD, complications, postoperative recurrence, activity; adequate reference standards; prospective study design; data reported to allow calculation of sensitivity, specificity, agreement, or correlation values; articles published in English. The search yielded 655 articles, of which 63 were found to be eligible and retrieved as full-text articles for analysis. Bowel US showed 79.7% sensitivity and 96.7% specificity for the diagnosis of suspected CD, and 89% sensitivity and 94.3% specificity for initial assessment in established patients with CD. Bowel US identified ileal CD with 92.7% sensitivity, 88.2% specificity, and colon CD with 81.8% sensitivity, 95.3% specificity, with lower accuracy for detecting proximal lesions. The oral contrast agent improves the sensitivity and specificity in determining CD lesions and in assessing sites and extent. Bowel US is a tool for evaluation of CD lesions in terms of complications, postoperative recurrence, and monitoring response to medical therapy; it reliably detects postoperative recurrence and complications, as well as offers the possibility of monitoring disease progression.

  6. 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…

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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…

  13. 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…

  14. Utility-Based Link Recommendation in Social Networks

    ERIC Educational Resources Information Center

    Li, Zhepeng

    2013-01-01

    Link recommendation, which suggests links to connect currently unlinked users, is a key functionality offered by major online social networking platforms. Salient examples of link recommendation include "people you may know"' on Facebook and "who to follow" on Twitter. A social networking platform has two types of stakeholder:…

  15. 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.

  16. 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

  17. "One for Sorrow, Two for Joy?": American embryo transfer guideline recommendations, practices, and outcomes for gestational surrogate patients.

    PubMed

    White, Pamela M

    2017-04-01

    In January 2016, Melissa Cook, a California gestational surrogate experiencing a multiple-birth pregnancy following the in vitro fertilization (IVF) transfer of three embryos comprised of donor eggs and sperm provided by the intended father, went to the media when the intended father requested that she undergo a fetal reduction because twins were less expensive to raise than triplets. Much of the legal interest in this case to date has centered on the enforceability of surrogacy contracts. However, the Cook case also raises troubling issues about fertility treatment practices involving gestational surrogates, twin preference, and third-party reproduction medical decision-making. This paper focuses on multiple-embryo transfers in the context of US surrogacy arrangements. Offering an original analysis of data obtained from the US national-assisted reproduction registry, it examines single- and multiple-embryo transfer trends over a 12-year period (2003 to 2014). Findings reveal that recommended guidelines were followed in fewer than 42% of the cases in 2014. The paper argues that ensuring equitable medical treatment for all recipients of IVF requires the adoption of treatment guidelines tailored to, and offering protections for, specific patient groups, and that, once in place, guidelines must be robustly implemented.

  18. Intraoperative radiation therapy using mobile electron linear accelerators: report of AAPM Radiation Therapy Committee Task Group No. 72.

    PubMed

    Beddar, A Sam; Biggs, Peter J; Chang, Sha; Ezzell, Gary A; Faddegon, Bruce A; Hensley, Frank W; Mills, Michael D

    2006-05-01

    Intraoperative radiation therapy (IORT) has been customarily performed either in a shielded operating suite located in the operating room (OR) or in a shielded treatment room located within the Department of Radiation Oncology. In both cases, this cancer treatment modality uses stationary linear accelerators. With the development of new technology, mobile linear accelerators have recently become available for IORT. Mobility offers flexibility in treatment location and is leading to a renewed interest in IORT. These mobile accelerator units, which can be transported any day of use to almost any location within a hospital setting, are assembled in a nondedicated environment and used to deliver IORT. Numerous aspects of the design of these new units differ from that of conventional linear accelerators. The scope of this Task Group (TG-72) will focus on items that particularly apply to mobile IORT electron systems. More specifically, the charges to this Task Group are to (i) identify the key differences between stationary and mobile electron linear accelerators used for IORT, (ii) describe and recommend the implementation of an IORT program within the OR environment, (iii) present and discuss radiation protection issues and consequences of working within a nondedicated radiotherapy environment, (iv) describe and recommend the acceptance and machine commissioning of items that are specific to mobile electron linear accelerators, and (v) design and recommend an efficient quality assurance program for mobile systems.

  19. Diagnosis of deep endometriosis: clinical examination, ultrasonography, magnetic resonance imaging, and other techniques.

    PubMed

    Bazot, Marc; Daraï, Emile

    2017-12-01

    The aim of the present review was to evaluate the contribution of clinical examination and imaging techniques, mainly transvaginal sonography and magnetic resonance imaging (MRI) to diagnose deep infiltrating (DE) locations using prisma statement recommendations. Clinical examination has a relative low sensitivity and specificity to diagnose DE. Independently of DE locations, for all transvaginal sonography techniques a pooled sensitivity and specificity of 79% and 94% are observed approaching criteria for a triage test. Whatever the protocol and MRI devices, the pooled sensitivity and specificity for pelvic endometriosis diagnosis were 94% and 77%, respectively. For rectosigmoid endometriosis, pooled sensitivity and specificity of MRI were 92% and 96%, respectively fulfilling criteria of replacement test. In conclusion, advances in imaging techniques offer high sensitivity and specificity to diagnose DE with at least triage value and for rectosigmoid endometriosis replacement value imposing a revision of the concept of laparoscopy as the gold standard. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. Approaches to the diagnosis and management of occupational asthma amongst UK respiratory physicians.

    PubMed

    Barber, C M; Naylor, S; Bradshaw, L M; Francis, M; Harris-Roberts, J; Rawbone, R; Curran, A D; Fishwick, D

    2007-09-01

    This study aimed to assess the approach to the diagnosis and management of occupational asthma amongst general (non-specialist) respiratory consultants in the UK. A random sample of 100 UK general respiratory physicians were invited to participate, and asked to provide information on their diagnostic approach to a case scenario of a patient with possible occupational asthma relating to flour exposure. Participation rates were 42% for the main part of the study. Less than half of consultants specifically reported they would ask whether symptoms improved away from work, and just over a third mentioned examining the patient. All of those interviewed recommended a chest X-ray, and 98% simple spirometry. Eighty-six per cent suggested measurement of serial peak flows, recorded for between 2 and 8 weeks, with measurements taken half-twelve hourly. Less than half advocated a specific flour allergy test, and almost one-quarter (23%) would not perform any immunological test at all. Once a diagnosis of occupational asthma was confirmed, less than two-thirds of those interviewed commented they would recommend some form of exposure reduction, and only 28% specifically stated they would offer compensation advice. The diagnosis of occupational asthma by general respiratory physicians within the UK lacks standardisation, and in some cases falls short of evidence-based best practise.

  1. Recommendations from Transgender Healthcare Consumers in Rural Areas

    PubMed Central

    Knutson, Douglas; Martyr, Meredith A.; Mitchell, Travis A.; Arthur, Tori; Koch, Julie M.

    2018-01-01

    Abstract Purpose: Scholars indicate that rates of mental and physical health issues (e.g., substance use, anxiety, depression) may be much higher among transgender individuals relative to the general population. This disparity may be even greater for transgender individuals in rural areas. Clinical researchers suggest using affirmative therapeutic approaches and interventions to address the health concerns of transgender individuals, specifically to connect individuals with the transgender community. However, little is known about the content of information that is shared in transgender communities in rural areas. Method: For this qualitative study, researchers asked transgender individuals in rural areas (n=10) what recommendations they would offer to other transgender individuals in rural areas regarding healthcare access. Results: Results were organized into four domains: Access care, Quality control, Difficulties, and Mentorship. Within these domains, we identified 11 sub-domains: Get physical healthcare, Get mental healthcare, Provider search, Provider vetting, Treatment verification, It will be difficult, Know who you are, Believe in yourself, Move, Connect to community, and Other. Conclusions: We discuss implications of our findings for healthcare provision in rural areas, and we provide recommendations for future research.

  2. A Retrospective Management Perspective on Nearly 20 Years of the Savannah River Site Citizen Advisory Board - 13078

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

    Belencan, Helen L.; Guevara, Karen C.; Spears, Terrel J.

    2013-07-01

    The Department of Energy, Office of Environmental Management (DOE EM) program has invested in site specific advisory boards since 1994. These boards have served as a portal to the communities surrounding the DOE sites, provided a key avenue for public involvement, and have actively engaged in providing input and feedback that has informed clean up and priority decisions made by EM. Although the EM program has made considerable progress in completing its mission, work will continue for decades, including work at the Savannah River Site (SRS). It is reasonable to assume the advisory boards will continue in their role providingmore » input and feedback to EM. The SRS Citizen Advisory Board (CAB) formed in 1994 and has issued 298 recommendations through September 2012. Although the effectiveness of the board is not measured by the number of recommendations issued, the recommendations themselves serve to illustrate the areas in which the CAB is particularly interested, and offer insight to the overall effectiveness of the CAB as a means for public participation in the EM decision making process. (authors)« less

  3. 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.

  4. Treatment Issues for Aboriginal Mothers with Substance Use Problems and Their Children

    PubMed Central

    Niccols, Allison; Dell, Colleen Anne; Clarke, Sharon

    2014-01-01

    In many cultures, approximately one third of people with drug dependence are women of child-bearing age. Substance use among pregnant and parenting women is a major public health concern. Aboriginal people have some of the highest rates of substance abuse in Canada, increasing concern for detrimental health impacts, including those for women and their children. For many women, substance abuse offers a means of coping with trauma, such as childhood abuse, partner violence, and, for Aboriginal women, the intergenerational effects of colonization. In this paper, we review treatment issues for Aboriginal mothers with substance use problems and their children. We discuss gender-specific issues in substance abuse, the need for women-specific treatment, the impact of substance abuse on children and parenting, the additional risks for Aboriginal women and children, and the need for integrated programs (those that integrate pregnancy-, parenting-, and child-related services with women-specific addiction treatment). We describe New Choices as an example of an integrated program, review research on existing treatment for Aboriginal mothers with substance use issues, and describe Sheway as a promising integrated program for Aboriginal women with substance abuse issues and their young children. There are few treatment programs specifically for Aboriginal mothers with substance use issues and their children and very little research on their effectiveness. Based on our review of existing evidence, we offer recommendations for future research and practice. PMID:24976814

  5. Optimizing Telehealth Strategies for Subspecialty Care: Recommendations from Rural Pediatricians

    PubMed Central

    Demirci, Jill R.; Bogen, Debra L.; Mehrotra, Ateev; Miller, Elizabeth

    2015-01-01

    Abstract Background: Telehealth offers strategies to improve access to subspecialty care for children in rural communities. Rural pediatrician experiences and preferences regarding the use of these telehealth strategies for children's subspecialty care needs are not known. We elicited rural pediatrician experiences and preferences regarding different pediatric subspecialty telehealth strategies. Materials and Methods: Seventeen semistructured telephone interviews were conducted with rural pediatricians from 17 states within the United States. Interviewees were recruited by e-mails to a pediatric rural health listserv and to rural pediatricians identified through snowball sampling. Themes were identified through thematic analysis of interview transcripts. Institutional Review Board approval was obtained. Results: Rural pediatricians identified several telehealth strategies to improve access to subspecialty care, including physician access hotlines, remote electronic medical record access, electronic messaging systems, live video telemedicine, and telehealth triage systems. Rural pediatricians provided recommendations for optimizing the utility of each of these strategies based on their experiences with different systems. Rural pediatricians preferred specific telehealth strategies for specific clinical contexts, resulting in a proposed framework describing the complementary role of different telehealth strategies for pediatric subspecialty care. Finally, rural pediatricians identified additional benefits associated with the use of telehealth strategies and described a desire for telehealth systems that enhanced (rather than replaced) personal relationships between rural pediatricians and subspecialists. Conclusions: Rural pediatricians described complementary roles for different subspecialty care telehealth strategies. Additionally, rural pediatricians provided recommendations for optimizing individual telehealth strategies. Input from rural pediatricians will be crucial for optimizing specific telehealth strategies and designing effective telehealth systems. PMID:25919585

  6. 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

  7. Mobile phone and my health

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

    Surducan, Aneta; Dabala, Dana; Neamtu, Camelia, E-mail: emanoil.surducan@itim-cj.ro

    The interaction of the microwave radiation emitted by mobile phones with the user's body is analyzed from the International Commission on Non-Ionizing Radiation Protection (ICNIRP) recommendations perspective as a correlation between the specific absorption ratio (SAR) of the mobile phone and the call duration. The relative position of the cell phone to the user's body, the dielectric properties of the exposed body parts, the SAR value and the call duration are considered in the local body temperature rise due to the microwave heating effect. The recommended local temperature rise limit in the human body is evaluated according to standards. Themore » aim of this study is to disseminate information to young people, especially high school students, about the microwave thermal effects on the human body, to make them aware of the environmental electromagnetic pollution and to offer them a simple method of biological self protection.« less

  8. Commercial Sexual Exploitation of Children and State Child Welfare Systems.

    PubMed

    Bounds, Dawn; Julion, Wrenetha A; Delaney, Kathleen R

    2015-01-01

    In several states, commercial sexual exploitation of children (CSEC) is now a reportable child abuse offense. Illinois has taken the lead in tackling the issue and the Illinois experience illuminates valuable lessons. This article delineates the protection, practice, and policy implications that evolve when CSEC falls under a state child welfare system. The specific aims are to (a) discuss CSEC, its victims, risks, harms, and challenges inherent in providing effective care; (b) use Illinois as an exemplar to explicate the consequences and implementation challenges of establishing a state reporting system that frames CSEC as a child welfare issue; (c) recommend strategies for developing effective state reporting models, and (d) demonstrate how nurses are well poised to advocate for victims of human trafficking on both state and national levels. Recommendations for improving the identification of CSEC victims and overcoming challenges to state implementation are offered. © The Author(s) 2015.

  9. 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

  10. 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.

  11. A guide to processing bat acoustic data for the North American Bat Monitoring Program (NABat)

    USGS Publications Warehouse

    Reichert, Brian; Lausen, Cori; Loeb, Susan; Weller, Ted; Allen, Ryan; Britzke, Eric; Hohoff, Tara; Siemers, Jeremy; Burkholder, Braden; Herzog, Carl; Verant, Michelle

    2018-06-14

    The North American Bat Monitoring Program (NABat) aims to improve the state of conservation science for all species of bats shared by the United States, Canada, and Mexico. To accomplish this goal, NABat offers guidance and standardized protocols for acoustic monitoring of bats. In this document, “A Guide to Processing Bat Acoustic Data for the North American Bat Monitoring Program (NABat),” we provide general recommendations and specific workflows for the process of identifying bat species from acoustic files recorded using the NABat stationary point and mobile transect acoustic monitoring protocols.

  12. Books for siblings of children having illness or disability.

    PubMed

    Ahmann, E

    1997-01-01

    A child's disability or acute or chronic illness has an effect on all family members, including siblings of the affected child. Children's books, fiction and non-fiction, can be used to support siblings by providing information, addressing feelings, offering insight, assuring the child that others have had similar problems, and facilitating coping. Nurses can introduce children and their families to useful books by having books or book covers on display that the child can choose from; providing families with lists of books; and/or assessing the child's needs, interests and reading level, and recommending a specific title.

  13. Wanted: entrepreneurs in occupational therapy.

    PubMed

    Anderson, Kristin M; Nelson, David L

    2011-01-01

    The American Occupational Therapy Association (AOTA) has challenged occupational therapy practitioners to advance the profession so that we may become more "powerful" and "widely recognized" by the year 2017 (AOTA, 2007a). To fully achieve this vision, this article argues that the profession should encourage occupational therapy entrepreneurship. As Herz, Bondoc, Richmond, Richman, and Kroll (2005, p.2) stated, "Entrepreneurship may provide us with the means to achieve the outcomes we need to succeed in the current health care environment." This article also argues the urgency of seizing the many opportunities that entrepreneurship offers and recommends specific actions to be taken by AOTA and by therapists.

  14. Structural and cultural barriers to the adoption of smoking cessation services in addiction treatment organizations.

    PubMed

    Knudsen, Hannah K; Studts, Jamie L; Boyd, Sara; Roman, Paul M

    2010-07-01

    Few studies have examined associations between the availability of smoking cessation services in addiction treatment organizations and specific cultural, staffing, and resource barriers. Telephone interviews were conducted with administrators of 897 addiction treatment organizations in the United States. These data revealed that few programs had adopted the full bundle of five recommended tobacco-related intake procedures, and that less than half of programs offered any smoking cessation services. Barriers to adoption of the intake bundle and availability of services included organizational culture and low levels of staff skills. Adoption of cessation services was associated with center type, location in a hospital setting, levels of care, and organizational size. Although a substantial proportion of organizations offer smoking cessation services, expansion of these services and greater adoption of tobacco-related intake procedures are needed to address the needs of nicotine-dependent individuals in addiction treatment.

  15. Application of adult attachment theory to group member transference and the group therapy process.

    PubMed

    Markin, Rayna D; Marmarosh, Cheri

    2010-03-01

    Although clinical researchers have applied attachment theory to client conceptualization and treatment in individual therapy, few researchers have applied this theory to group therapy. The purpose of this article is to begin to apply theory and research on adult dyadic and group attachment styles to our understanding of group dynamics and processes in adult therapy groups. In particular, we set forth theoretical propositions on how group members' attachment styles affect relationships within the group. Specifically, this article offers some predictions on how identifying group member dyadic and group attachment styles could help leaders predict member transference within the therapy group. Implications of group member attachment for the selection and composition of a group and the different group stages are discussed. Recommendations for group clinicians and researchers are offered. PsycINFO Database Record (c) 2010 APA, all rights reserved

  16. Addressing therapeutic boundaries in social networking.

    PubMed

    Ginory, Almari; Sabatier, Laura Mayol; Eth, Spencer

    2012-01-01

    Facebook is the leading social networking website, with over 500 million users. Prior studies have shown an increasing number of housestaff accessing the site. While Facebook can be used to foster camaraderie, it can also create difficulties in the doctor-patient relationship, especially when boundaries are crossed. This study explored the prevalence of such boundary crossings and offers recommendations for training. An anonymous voluntary survey regarding Facebook use was distributed to current psychiatry residents through the American Psychiatric Association (APA) listserv. Of the 182 respondents, 95.7% had current Facebook profiles, and 9.7% had received friend requests from patients. In addition, 18.7% admitted to viewing patient profiles on Facebook. There is a substantial utilization of Facebook among psychiatric residents as compared with prior studies. Specific guidance regarding social media websites and the potential for ethical difficulties should be offered to trainees. © 2012 Guilford Publications, Inc.

  17. 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

  18. 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.

  19. 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)

  20. Specific yield: compilation of specific yields for various materials

    USGS Publications Warehouse

    Johnson, A.I.

    1967-01-01

    Specific yield is defined as the ratio of (1) the volume of water that a saturated rock or soil will yield by gravity to (2) the total volume of the rock or soft. Specific yield is usually expressed as a percentage. The value is not definitive, because the quantity of water that will drain by gravity depends on variables such as duration of drainage, temperature, mineral composition of the water, and various physical characteristics of the rock or soil under consideration. Values of specific yields nevertheless offer a convenient means by which hydrologists can estimate the water-yielding capacities of earth materials and, as such, are very useful in hydrologic studies. The present report consists mostly of direct or modified quotations from many selected reports that present and evaluate methods for determining specific yield, limitations of those methods, and results of the determinations made on a wide variety of rock and soil materials. Although no particular values are recommended in this report, a table summarizes values of specific yield, and their averages, determined for 10 rock textures. The following is an abstract of the table. [Table

  1. Automated detection using natural language processing of radiologists recommendations for additional imaging of incidental findings.

    PubMed

    Dutta, Sayon; Long, William J; Brown, David F M; Reisner, Andrew T

    2013-08-01

    As use of radiology studies increases, there is a concurrent increase in incidental findings (eg, lung nodules) for which the radiologist issues recommendations for additional imaging for follow-up. Busy emergency physicians may be challenged to carefully communicate recommendations for additional imaging not relevant to the patient's primary evaluation. The emergence of electronic health records and natural language processing algorithms may help address this quality gap. We seek to describe recommendations for additional imaging from our institution and develop and validate an automated natural language processing algorithm to reliably identify recommendations for additional imaging. We developed a natural language processing algorithm to detect recommendations for additional imaging, using 3 iterative cycles of training and validation. The third cycle used 3,235 radiology reports (1,600 for algorithm training and 1,635 for validation) of discharged emergency department (ED) patients from which we determined the incidence of discharge-relevant recommendations for additional imaging and the frequency of appropriate discharge documentation. The test characteristics of the 3 natural language processing algorithm iterations were compared, using blinded chart review as the criterion standard. Discharge-relevant recommendations for additional imaging were found in 4.5% (95% confidence interval [CI] 3.5% to 5.5%) of ED radiology reports, but 51% (95% CI 43% to 59%) of discharge instructions failed to note those findings. The final natural language processing algorithm had 89% (95% CI 82% to 94%) sensitivity and 98% (95% CI 97% to 98%) specificity for detecting recommendations for additional imaging. For discharge-relevant recommendations for additional imaging, sensitivity improved to 97% (95% CI 89% to 100%). Recommendations for additional imaging are common, and failure to document relevant recommendations for additional imaging in ED discharge instructions occurs frequently. The natural language processing algorithm's performance improved with each iteration and offers a promising error-prevention tool. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  2. 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.

  3. 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.

  4. 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

  5. Modeling conflict : research methods, quantitative modeling, and lessons learned.

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

    Rexroth, Paul E.; Malczynski, Leonard A.; Hendrickson, Gerald A.

    2004-09-01

    This study investigates the factors that lead countries into conflict. Specifically, political, social and economic factors may offer insight as to how prone a country (or set of countries) may be for inter-country or intra-country conflict. Largely methodological in scope, this study examines the literature for quantitative models that address or attempt to model conflict both in the past, and for future insight. The analysis concentrates specifically on the system dynamics paradigm, not the political science mainstream approaches of econometrics and game theory. The application of this paradigm builds upon the most sophisticated attempt at modeling conflict as a resultmore » of system level interactions. This study presents the modeling efforts built on limited data and working literature paradigms, and recommendations for future attempts at modeling conflict.« less

  6. Incidental genetic findings in randomized clinical trials: recommendations from the Genomics and Randomized Trials Network (GARNET)

    PubMed Central

    2013-01-01

    Recommendations and guidance on how to handle the return of genetic results to patients have offered limited insight into how to approach incidental genetic findings in the context of clinical trials. This paper provides the Genomics and Randomized Trials Network (GARNET) recommendations on incidental genetic findings in the context of clinical trials, and discusses the ethical and practical issues considered in formulating our recommendations. There are arguments in support of as well as against returning incidental genetic findings in clinical trials. For instance, reporting incidental findings in clinical trials may improve the investigator-participant relationship and the satisfaction of participation, but it may also blur the line between clinical care and research. The issues of whether and how to return incidental genetic findings, including the costs of doing so, should be considered when developing clinical trial protocols. Once decided, plans related to sharing individual results from the aim(s) of the trial, as well as incidental findings, should be discussed explicitly in the consent form. Institutional Review Boards (IRBs) and other study-specific governing bodies should be part of the decision as to if, when, and how to return incidental findings, including when plans in this regard are being reconsidered. PMID:23363732

  7. 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.

  8. Reference centres for adults with rare and complex cancers - Policy recommendations to improve the organisation of care in Belgium.

    PubMed

    Stordeur, S; Vrijens, F; Leroy, R

    2016-02-01

    Rare and/or complex cancers call for a very specific expertise and adequate infrastructure. In Belgium, every hospital with a programme in oncology can deliver care for adults with rare and/or complex cancer types, without having demonstrated a specific know-how to adequately manage these patients. Therefore, the Minister of Health ordered a scenario for the organisation of care for adults with rare and/or complex cancers, taking into account the current Belgian situation and relevant foreign experience. Combined methods were used in this study: a literature review, the consultation of stakeholders, in depth discussions in 14 multidisciplinary groups leading to concrete proposals for several rare/complex cancers and the consultation of a panel of expert pathologists. The core recommendation is the set-up of shared care networks around reference centres, with multidisciplinary teams of recognised expertise in specific rare/complex cancers. The definition of minimum caseloads for hospitals and medical specialists, the evaluation of the quality of care, a model of diagnostic confirmation and the set-up of a national portal website which provides information on rare and/or complex cancers and reference centres are highly recommended. It is no longer practicable, efficient or ethical that every hospital or every practitioner continues to offer care for every rare/complex cancer. Improving the quality of rare/complex cancer care requires to concentrate expertise and sophisticated infrastructure in reference centres. Furthermore, the formation of networks between reference centres and peripheral centres will allow a delivery of care combining expertise and proximity. The next step is the translation of the recommendations into policy decisions. It is very well realised that this will take some courage and that a certain degree of resistance will have to be surmounted, but eventually, the best interest of the patient should prevail. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.

    PubMed

    Nowakowski, Alexandra C H; Carretta, Henry J; Dudley, Julie K; Forrest, Jamie R; Folsom, Abbey N

    2016-01-01

    To assess gaps in emergency department (ED) asthma management at Florida hospitals. Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement. Emergency departments at 10 large hospitals in the state of Florida. Clinical care providers and health administrators from participating hospitals. Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts. Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up. Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.

  10. The promises and limitations of female-initiated methods of HIV/STI protection.

    PubMed

    Mantell, Joanne E; Dworkin, Shari L; Exner, Theresa M; Hoffman, Susie; Smit, Jenni A; Susser, Ida

    2006-10-01

    New methods are now available, and others are being developed, that could enable women to take the initiative in preventing sexually transmitted infections. However, attempts to capitalize on "female-controlled" preventive methods thus far have met with limited success. Female-initiated methods were introduced to intervene in the state of gender relations and assist women who are disempowered vis-à-vis their male partners. Paradoxically, however, we underscore that it is the very structure of regional and local gender relations that shapes the acceptability (or lack of acceptability) of these methods. This paper specifically addresses how the structure of gender relations-for better and for worse-shapes the promises and limitations of widespread use and acceptance of female-initiated methods. We draw on examples from around the world to underscore how the regional specificities of gender (in)equality shape the acceptance, negotiation, and use of these methods. Simultaneously, we demonstrate how the introduction and sustained use of methods are shaped by gender relations and offer possibilities for reinforcing or challenging their current state. Based on our analyses, we offer key policy and programmatic recommendations to increase promotion and effective use of women-initiated HIV/STI protection methods for both women and men.

  11. 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.

  12. Do countries rely on the World Health Organization for translating research findings into clinical guidelines? A case study.

    PubMed

    Noor, Ramadhani A; Geldsetzer, Pascal; Bärnighausen, Till; Fawzi, Wafaie

    2016-10-06

    The World Health Organization's (WHO) antiretroviral therapy (ART) guidelines have generally been adopted rapidly and with high fidelity by countries in sub-Saharan Africa. Thus far, however, WHO has not published specific guidance on nutritional care and support for (non-pregnant) adults living with HIV despite a solid evidence base for some interventions. This offers an opportunity for a case study on whether national clinical guidelines in sub-Saharan Africa provide concrete recommendations in the face of limited guidance by WHO. This study, therefore, aims to determine if national HIV treatment guidelines in sub-Saharan Africa contain specific guidance on nutritional care and support for non-pregnant adults living with HIV. We identified the most recent national HIV treatment guidelines in sub-Saharan African countries with English as an official language. Using pre-specified criteria, we determined for each guideline whether it provides guidance to clinicians on each of five components of nutritional care and support for adults living with HIV: assessment of nutritional status, dietary counseling, micronutrient supplementation, ready-to-use therapeutic or supplementary foods, and food subsidies. We found that national HIV treatment guidelines in sub-Saharan Africa generally do not contain concrete recommendations on nutritional care and support for non-pregnant adults living with HIV. Given that decisions on nutritional care and support are inevitably being made at the clinician-patient level, and that clinicians have a relative disadvantage in systematically identifying, summarizing, and weighing up research evidence compared to WHO and national governments, there is a need for more specific clinical guidance. In our view, such guidance should at a minimum recommend daily micronutrient supplements for adults living with HIV who are in pre-ART stages, regular dietary counseling, periodic assessment of anthropometric status, and additional nutritional management of undernourished patients. More broadly, our findings suggest that countries in sub-Saharan Africa look to WHO for guidance in translating evidence into clinical guidelines. It is, thus, likely that the development of concrete recommendations by WHO on nutritional interventions for people living with HIV would lead to more specific guidelines at the country-level and, ultimately, better clinical decisions and treatment outcomes.

  13. 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

  14. 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.

  15. Challenging Obesity: Patient, Provider, and Expert Perspectives on the Roles of Available and Emerging Nonsurgical Therapies

    PubMed Central

    Apovian, Caroline M.; Garvey, W. Timothy; Ryan, Donna H.

    2015-01-01

    Objective Adult obesity is recognized as a chronic disease. According to principles of chronic disease management, healthcare professionals should work collaboratively with patients to determine appropriate therapeutic strategies that address overweight and obesity, specifically considering a patient’s disease status in addition to their individual needs, preferences, and attitudes regarding treatment. A central role and responsibility of healthcare professionals in this process is to inform and educate patients about their treatment options. Although current recommendations for the management of adult obesity provide general guidance regarding safe and proper implementation of lifestyle, pharmacological, and surgical interventions, healthcare professionals need awareness of specific evidence-based information that supports individualized clinical application of these therapies. More specifically, healthcare professionals should be up-to-date on approaches that promote successful lifestyle management and be knowledgeable about newer weight loss pharmacotherapies, so they can offer patients with obesity a wide range of options to personalize their treatment. Accordingly, this educational activity has been developed to provide participants with the latest information on treatment recommendations and therapeutic advances in lifestyle intervention and pharmacotherapy for adult obesity management. Design and Methods This supplement is based on the content presented at a live CME symposium held in conjunction with ObesityWeek 2014. Results This supplement provides an expert summary of current treatment recommendations and recent advances in nonsurgical therapies for the management of adult obesity. Patient and provider perspectives on obesity management are highlighted in embedded video clips available via QR codes, and new evidence will be applied using clinically relevant case studies. Conclusions This supplement provides a topical update of obesity management, including clinical practice examples, for healthcare professionals who treat or provide care for adults with obesity. PMID:26154880

  16. Guidelines for the selection of chemical-protective clothing. Volume 2. Technical and reference manual. (3rd Edition). Report for January 1985-March 1987

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

    Schwope, A.D.; Costas, P.P.; Jackson, J.O.

    1987-02-01

    A variety of protective-clothing items are commercially available for emergency response and other applications where chemical hazards may be encountered. Data and information for selecting chemical-protective clothing is either not available or is inconsistant from source to source. In 1983, the U.S. Environmental Protection Agency sponsored the development of chemical-protective clothing selection guidelines to assist their own Office of Health and Safety in providing guidance to personnel, primarily EPA employees and contractors, working on hazardous-waste sites. These guidelines allowed a user to select an appropriate protective material for a specific chemical, select a clothing item (glove, suit, etc.), and thenmore » determine which manufacturers offered the clothing item in the recommended material. The U.S, Coast Guard Office of Research and Development and the EPA have supplemented these guidelines with additional data on material chemical resistance, material physical properties, clothing design features, and specific-vendor products. A chapter has been added for selecting chemical-protective suits. These guidelines contain data for over 750 chemicals and 700 clothing products. Volume I provides performance information and recommendations for selecting different types of protective clothing. Volume II contains a detailed technical discussion, and the data on which Volume I recommendations are based. The U.S. Coast Guard intends to use these guidelines for protective-clothing selection by its National Strike Force and Marine Safety Offices.« less

  17. Optimization of exposure index values for the antero-posterior pelvis and antero-posterior knee examination

    NASA Astrophysics Data System (ADS)

    Butler, M. L.; Rainford, L.; Last, J.; Brennan, P. C.

    2009-02-01

    Introduction The American Association of Medical Physicists is currently standardizing the exposure index (EI) value. Recent studies have questioned whether the EI value offered by manufacturers is optimal. This current work establishes optimum EIs for the antero-posterior (AP) projections of a pelvis and knee on a Carestream Health (Kodak) CR system and compares these with manufacturers recommended EI values from a patient dose and image quality perspective. Methodology Human cadavers were used to produce images of clinically relevant standards. Several exposures were taken to achieve various EI values and corresponding entrance surface doses (ESD) were measured using thermoluminescent dosimeters. Image quality was assessed by 5 experienced clinicians using anatomical criteria judged against a reference image. Visualization of image specific common abnormalities was also analyzed to establish diagnostic efficacy. Results A rise in ESD for both examinations, consistent with increasing EI was shown. Anatomic image quality was deemed to be acceptable at an EI of 1560 for the AP pelvis and 1590 for the AP knee. From manufacturers recommended values, a significant reduction in ESD (p=0.02) of 38% and 33% for the pelvis and knee respectively was noted. Initial pathological analysis suggests that diagnostic efficacy at lower EI values may be projection-specific. Conclusion The data in this study emphasize the need for clinical centres to consider establishing their own EI guidelines, and not necessarily relying on manufacturers recommendations. Normal and abnormal images must be used in this process.

  18. 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...

  19. [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.

  20. What do Internet-based alcohol treatment websites offer?

    PubMed

    Toll, Benjamin A; Sobell, Linda C; D'Arienzo, Justin; Sobell, Mark B; Eickleberry-Goldsmith, Lori; Toll, Heather J

    2003-12-01

    The Internet was searched for websites that advertised or provided treatment or help for alcohol problems. Websites were evaluated for the types of treatment offered and whether the treatment had an empirical basis. While a wide range of treatments were advertised, very few websites offered online services. In addition, very few sites provided or advertised alcohol treatment programs that were empirically based. Recommendations for future Internet-based health care and treatment are offered.

  1. 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.

  2. [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.

  3. 75 FR 33311 - Guidance for Industry on Bioequivalence Recommendations for Specific Products; Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-11

    ... available recommendations on how to design product- specific bioequivalence (BE) studies to support... meaningful opportunity for the public to consider and comment on product-specific BE study recommendations... available recommendations on how to design product-specific BE studies to support ANDAs. Under this process...

  4. Multifamily group treatment for veterans with traumatic brain injury: what is the value to participants?

    PubMed

    Straits-Troster, Kristy; Gierisch, Jennifer M; Strauss, Jennifer L; Dyck, Dennis G; Dixon, Lisa B; Norell, Diane; Perlick, Deborah A

    2013-06-01

    This study evaluated the feasibility, acceptability, and helpfulness of implementation of multifamily group treatment for traumatic brain injury (TBI) among veterans who sustained a TBI during the wars in Iraq and Afghanistan and their families or caregivers. Veterans and their family members who participated in an open clinical trial (August 2010-March 2011) of multifamily psychoeducation for TBI at two Veterans Affairs medical centers were invited to one of three focus groups. Participants were asked about problems experienced before and during the intervention, aspects of treatment that were helpful, and improvements that would facilitate effective implementation of multifamily group treatment for TBI. Postintervention focus group transcripts were analyzed by utilizing qualitative content analysis. Participants included eight veterans with TBI and eight family members. Five themes emerged: exploring common struggles and reducing isolation, building skills to cope with TBI and related problems, restoring relationships through communication and understanding, increasing understanding of the interconnection between TBI and posttraumatic stress disorder, and improving the multifamily group experience and increasing treatment engagement of veterans and families. Veterans and family members found multifamily group treatment for TBI highly acceptable and offered recommendations to improve and increase access to the program. The results supported the feasibility and acceptability of multifamily group treatment for TBI. Specific recommendations to improve this psychoeducational intervention and its implementation are offered.

  5. 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.

  6. 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.

  7. 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…

  8. Design of a real-time and continua-based framework for care guideline recommendations.

    PubMed

    Lin, Yu-Feng; Shie, Hsin-Han; Yang, Yi-Ching; Tseng, Vincent S

    2014-04-16

    Telehealth is an important issue in the medical and healthcare domains. Although a number of systems have been developed to meet the demands of emerging telehealth services, the following problems still remain to be addressed: (1) most systems do not monitor/predict the vital signs states so that they are able to send alarms to caregivers in real-time; (2) most systems do not focus on reducing the amount of work that caregivers need to do, and provide patients with remote care; and (3) most systems do not recommend guidelines for caregivers. This study thus proposes a framework for a real-time and Continua-based Care Guideline Recommendation System (Cagurs) which utilizes mobile device platforms to provide caregivers of chronic patients with real-time care guideline recommendations, and that enables vital signs data to be transmitted between different devices automatically, using the Continua standard. Moreover, the proposed system adopts the episode mining approach to monitor/predict anomalous conditions of patients, and then offers related recommended care guidelines to caregivers so that they can offer preventive care in a timely manner.

  9. Design of a Real-Time and Continua-Based Framework for Care Guideline Recommendations

    PubMed Central

    Lin, Yu-Feng; Shie, Hsin-Han; Yang, Yi-Ching; Tseng, Vincent S.

    2014-01-01

    Telehealth is an important issue in the medical and healthcare domains. Although a number of systems have been developed to meet the demands of emerging telehealth services, the following problems still remain to be addressed: (1) most systems do not monitor/predict the vital signs states so that they are able to send alarms to caregivers in real-time; (2) most systems do not focus on reducing the amount of work that caregivers need to do, and provide patients with remote care; and (3) most systems do not recommend guidelines for caregivers. This study thus proposes a framework for a real-time and Continua-based Care Guideline Recommendation System (Cagurs) which utilizes mobile device platforms to provide caregivers of chronic patients with real-time care guideline recommendations, and that enables vital signs data to be transmitted between different devices automatically, using the Continua standard. Moreover, the proposed system adopts the episode mining approach to monitor/predict anomalous conditions of patients, and then offers related recommended care guidelines to caregivers so that they can offer preventive care in a timely manner. PMID:24743843

  10. Using client feedback in psychotherapy from an interpersonal process perspective.

    PubMed

    Reese, Robert J; Slone, Norah C; Miserocchi, Kristin M

    2013-09-01

    The process of monitoring treatment outcome, also known as "client feedback," is increasingly becoming a recommended practice for psychotherapy. One concern, however, is how to integrate such a process into the work that psychotherapists typically do. Three clinical examples are presented, illustrating how a client feedback system can be used in conjunction with a specific theoretical framework, interpersonal process therapy (Teyber, 2006). The examples highlight that client feedback not only can be of minimal disruption to the psychotherapy process, but may also offer the potential to augment a clinician's approach to helping. Theoretical and research support are provided for each example. 2013 APA, all rights reserved

  11. NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 25: The impact of language and culture on technical communication in Japan

    NASA Technical Reports Server (NTRS)

    Kohl, John R.; Barclay, Rebecca O.; Pinelli, Thomas E.; Keene, Michael L.; Kennedy, John M.

    1993-01-01

    One of the most significant developments in the field of technical communication during the 1980's and 1990's has been a growing interest in international technical communication, including technical communication in Japan. This article provides insights into aspects of the Japanese language and culture that affect Japanese technical communication practices. These insights are then used to interpret and report the results of a survey of Japanese aerospace engineers and scientists concerning the kinds of communication products they produce, the kinds they use, and the specific recommendation they would offer to designers of academic programs in technical communication.

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

    PubMed

    Sperber, M N

    1992-01-01

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

  13. NASA/DoD Aerospace Knowledge Diffusion Research Project. XXV - The impact of language and culture on technical communication in Japan

    NASA Technical Reports Server (NTRS)

    Kohl, John R.; Barclay, Rebecca O.; Pinelli, Thomas E.; Keene, Michael L.; Kennedy, John M.

    1993-01-01

    One of the most significant developments in the field of technical communication during the 1980s and 1990s has been a growing interest in international technical communication, including technical communication in Japan. This article provides insights into aspects of the Japanese language and culture that affect Japanese technical communication practices. The authors then use these insights to interpret and report the results of a survey of Japanese aerospace engineers and scientists concerning the kinds of communication products they produce, the kinds they use, and the specific recommendations they would offer to designers of academic programs in technical communication.

  14. Composite material application for liquid rocket engines

    NASA Technical Reports Server (NTRS)

    Heubner, S. W.

    1982-01-01

    With increasing emphasis on improving engine thrust-to-weight ratios to provide improved payload capabilities, weight reductions achievable by the use of composites have become attractive. Of primary significance is the weight reduction offered by composites, although high temperature properties and cost reduction were also considered. The potential for application of composites to components of Earth-to-orbit hydrocarbon engines and orbit-to-orbit LOX/H2 engines was assessed. The components most likely to benefit from the application of composites were identified, as were the critical technology areas where developed would be required. Recommendations were made and a program outlined for the design, fabrication, and demonstration of specific engine components.

  15. Formation of power management strategy at the industrial enterprises

    NASA Astrophysics Data System (ADS)

    Akimova, Elena

    2017-10-01

    The article is dedicated to energy efficiency problems. The main recommendations about the development of the system of strategic power management at the industrial enterprise offered in the research include a number of the principles, aimed at the increase of the importance of human resources in information-and-analytical and innovative functions of power management. According to the results of the current situation analyses, the author suggests using some specific indicators of human resources, as they can contribute to the energy efficiency formation. The system of standardization is considered to be the basis for the implementation of strategic power management at the enterprises.

  16. Financial Issues and Adult Immunization: Medicare Coverage and the Affordable Care Act

    PubMed Central

    Hurley, Laura P.; Lindley, Megan C.; Allison, Mandy A.; Crane, Lori A.; Brtnikova, Michaela; Beaty, Brenda L.; Snow, Megan; Bridges, Carolyn B.; Kempe, Allison

    2017-01-01

    Background Financial barriers to adult vaccination are poorly understood. Our objectives were to assess among general internists (GIM) and family physicians (FP) shortly after Affordable Care Act (ACA) implementation: 1) proportion of adult patients deferring or refusing vaccines because of cost and frequency of physicians not recommending vaccines for financial reasons; 2) satisfaction with reimbursement for vaccine purchase and administration by payer type; 3) knowledge of Medicare coverage of vaccines; and 4) awareness of vaccine-specific provisions of the ACA. Methods We administered an Internet and mail survey from June to October 2013 to national networks of 438 GIMs and 401 FPs. Results Response rates were 72% (317/438) for GIM and 59% (236/401) for FP. Among physicians who routinely recommended vaccines, up to 24% of GIM and 30% of FP reported adult patients defer or refuse certain vaccines for financial reasons most of the time. Physicians reported not recommending vaccines because they thought the patient’s insurance would not cover it (35%) or the patient could be vaccinated more affordably elsewhere (38%). Among physicians who saw patients with this insurance, dissatisfaction (‘very dissatisfied’) was highest for payments received from Medicaid (16 % vaccine purchase, 14 % vaccine administration) and Medicare Part B (11 % vaccine purchase, 11 % vaccine administration). Depending on the vaccine, 36–71% reported not knowing how Medicare covered the vaccine. Thirty-seven percent were ‘not at all aware’ and 19% were ‘a little aware’ of vaccine-specific provisions of the ACA. Conclusions Patients are refusing and physicians are not recommending adult vaccinations for financial reasons. Increased knowledge of private and public insurance coverage for adult vaccinations might position physicians to be more likely to recommend vaccines and better enable them to refer patients to other vaccine providers when a particular vaccine or vaccines are not offered in the practice. PMID:28024954

  17. 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

  18. 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.

  19. 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...

  20. Safe Sleep Infant Care Practices Reported by Mothers of Twins.

    PubMed

    Damato, Elizabeth G; Haas, Madeline C; Czeck, Pamela; Dowling, Donna A; Barsman, Sarah Gutin

    2016-12-01

    The high prevalence of prematurity and low birth-weight places twin infants at increased risk for sudden unexpected infant death (SUID) and/or sudden infant death syndrome (SIDS). Risk for these SUID and SIDS is affected by a combination of nonmodifiable intrinsic risk factors and modifiable extrinsic stressors including infant care practices related to sleep. Although adherence to the full scope of American Academy of Pediatrics (AAP) 2011 recommendations is intended to decrease risk, these recommendations are aimed at singleton infants and may require tailoring for families with multiple infants. The study describes infant care practices reported by mothers of twins in the first 6 months postpartum. Mothers caring for twin infants (N = 35) were surveyed online both longitudinally (at 2, 8, 16, and 24 weeks after infant hospital discharge) and cross-sectionally. AAP recommendations (2011) guided survey content. The degree of adherence to AAP recommendations varied over time. For example, mothers of twins reported 100% adherence to placing twins supine for sleep initially, but many reported putting babies on their stomachs for naps as twins became older. Sharing a parent's bedroom decreased over time as did frequency of crib sharing. Fewer than half of mothers offered a pacifier most or all of the time for sleep. Opportunities exist for development of an educational program geared specifically for postpartum parents of twins. Barriers affecting adherence to AAP recommendations and effectiveness of educational programs addressing needs of this unique population need further exploration.

  1. 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.

  2. Revisiting Information Technology tools serving authorship and editorship: a case-guided tutorial to statistical analysis and plagiarism detection

    PubMed Central

    Bamidis, P D; Lithari, C; Konstantinidis, S T

    2010-01-01

    With the number of scientific papers published in journals, conference proceedings, and international literature ever increasing, authors and reviewers are not only facilitated with an abundance of information, but unfortunately continuously confronted with risks associated with the erroneous copy of another's material. In parallel, Information Communication Technology (ICT) tools provide to researchers novel and continuously more effective ways to analyze and present their work. Software tools regarding statistical analysis offer scientists the chance to validate their work and enhance the quality of published papers. Moreover, from the reviewers and the editor's perspective, it is now possible to ensure the (text-content) originality of a scientific article with automated software tools for plagiarism detection. In this paper, we provide a step-bystep demonstration of two categories of tools, namely, statistical analysis and plagiarism detection. The aim is not to come up with a specific tool recommendation, but rather to provide useful guidelines on the proper use and efficiency of either category of tools. In the context of this special issue, this paper offers a useful tutorial to specific problems concerned with scientific writing and review discourse. A specific neuroscience experimental case example is utilized to illustrate the young researcher's statistical analysis burden, while a test scenario is purpose-built using open access journal articles to exemplify the use and comparative outputs of seven plagiarism detection software pieces. PMID:21487489

  3. Revisiting Information Technology tools serving authorship and editorship: a case-guided tutorial to statistical analysis and plagiarism detection.

    PubMed

    Bamidis, P D; Lithari, C; Konstantinidis, S T

    2010-12-01

    With the number of scientific papers published in journals, conference proceedings, and international literature ever increasing, authors and reviewers are not only facilitated with an abundance of information, but unfortunately continuously confronted with risks associated with the erroneous copy of another's material. In parallel, Information Communication Technology (ICT) tools provide to researchers novel and continuously more effective ways to analyze and present their work. Software tools regarding statistical analysis offer scientists the chance to validate their work and enhance the quality of published papers. Moreover, from the reviewers and the editor's perspective, it is now possible to ensure the (text-content) originality of a scientific article with automated software tools for plagiarism detection. In this paper, we provide a step-bystep demonstration of two categories of tools, namely, statistical analysis and plagiarism detection. The aim is not to come up with a specific tool recommendation, but rather to provide useful guidelines on the proper use and efficiency of either category of tools. In the context of this special issue, this paper offers a useful tutorial to specific problems concerned with scientific writing and review discourse. A specific neuroscience experimental case example is utilized to illustrate the young researcher's statistical analysis burden, while a test scenario is purpose-built using open access journal articles to exemplify the use and comparative outputs of seven plagiarism detection software pieces.

  4. 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.

  5. Stimulating high impact HIV-related cardiovascular research: recommendations from a multidisciplinary NHLBI Working Group on HIV-related heart, lung, and blood disease.

    PubMed

    Shah, Monica R; Cook, Nakela; Wong, Renee; Hsue, Priscilla; Ridker, Paul; Currier, Judith; Shurin, Susan

    2015-02-24

    The clinical challenges confronting patients with human immunodeficiency virus (HIV) have shifted from acquired immunodeficiency syndrome (AIDS)-related illnesses to chronic diseases, such as coronary artery disease, chronic lung disease, and chronic anemia. With the growing burden of HIV-related heart, lung, and blood (HLB) disease, the National Heart, Lung, and Blood Institute (NHLBI) recognizes it must stimulate and support HIV-related HLB research. Because HIV offers a natural, accelerated model of common pathological processes, such as inflammation, HIV-related HLB research may yield important breakthroughs for all patients with HLB disease. This paper summarizes the cardiovascular recommendations of an NHLBI Working Group, Advancing HIV/AIDS Research in Heart, Lung, and Blood Diseases, charged with identifying scientific priorities in HIV-related HLB disease and developing recommendations to promote multidisciplinary collaboration among HIV and HLB investigators. The working group included multidisciplinary sessions, as well as HLB breakout sessions for discussion of disease-specific issues, with common themes about scientific priorities and strategies to stimulate HLB research emerging in all 3 groups. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. 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…

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. C style guide

    NASA Technical Reports Server (NTRS)

    Doland, Jerry; Valett, Jon

    1994-01-01

    This document discusses recommended practices and style for programmers using the C language in the Flight Dynamics Division environment. Guidelines are based on generally recommended software engineering techniques, industry resources, and local convention. The Guide offers preferred solutions to common C programming issues and illustrates through examples of C Code.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. 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 .

  20. Primary prevention of type 2 diabetes: integrative public health and primary care opportunities, challenges and strategies

    PubMed Central

    Green, Lawrence W; Brancati, Frederick L; Albright, Ann

    2012-01-01

    Type 2 diabetes imposes a large and growing burden on the public’s health. This burden, combined with the growing evidence for primary prevention from randomized controlled trials of structured lifestyle programs leads to recommendations to include caloric reduction, increased physical activity and specific assistance to patients in problem solving to achieve modest weight loss as well as pharmacotherapy. These recommendations demand exploration of new ways to implement such primary prevention strategies through more integrated community organization, medical practice and policy. The US experience with control of tobacco use and high blood pressure offers valuable lessons for policy, such as taxation on products, and for practice in a variety of settings, such as coordination of referrals for lifestyle supports. We acknowledge also some notable exceptions to their generalizability. This paper presents possible actions proposed by an expert panel, summarized in Table 1 as recommendations for immediate action, strategic action and research. The collaboration of primary care and public health systems will be required to make many of these recommendations a reality. This paper also provides information on the progress made in recent years by the Division of Diabetes Translation at the US Centers for Disease Control and Prevention (CDC) to implement or facilitate such integration of primary care and public health for primary prevention. PMID:22399542

  1. 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.

  2. 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.

  3. 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…

  4. Clinical Neuropsychology in Integrated Rehabilitation Care Teams.

    PubMed

    Johnson-Greene, Doug

    2018-05-01

    Neuropsychologists have been an integral part of rehabilitation-oriented integrated care teams for some time and they provide care that is complimentary to other specialties, such as rehabilitation psychologists. Neuropsychologists are more likely than other specialties to offer objective cognitive data that includes consideration of emotional and behavioral features when assessing patients who have known or suspected brain injury or illness. Objective cognitive data is then often used for treatment and discharge planning as well as anticipating safety issues and impairment of functional skills. Unlike a consultative model, neuropsychologists in rehabilitation must work as part of a team of rehabilitation professionals and understand the contributions each specialty offers patients. This paper will highlight a number of issues pertaining to the practice of neuropsychology in rehabilitation settings including: (i) essential skills and duties, (ii) reimbursement, (iii) practice specifics, (iv) types of recommendations, (v) communication issues, (vi) impact of neuropsychological services, (vii) role satisfaction; (viii) advice for early career neuropsychologists, and (ix) a sample report.

  5. Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program

    PubMed Central

    Meagher, Karen M.

    2016-01-01

    Public health policy works best when grounded in firm public health standards of evidence and widely shared social values. In this article, we argue for incorporating a specific method of ethical deliberation—deliberative public bioethics—into public health. We describe how deliberative public bioethics is a method of engagement that can be helpful in public health. Although medical, research, and public health ethics can be considered some of what bioethics addresses, deliberative public bioethics offers both a how and where. Using the Human Genome Project Ethical, Legal, and Social Implications program as an example of effective incorporation of deliberative processes to integrate ethics into public health policy, we examine how deliberative public bioethics can integrate both public health and bioethics perspectives into three areas of public health practice: research, education, and health policy. We then offer recommendations for future collaborations that integrate deliberative methods into public health policy and practice. PMID:26843669

  6. Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program.

    PubMed

    Meagher, Karen M; Lee, Lisa M

    2016-01-01

    Public health policy works best when grounded in firm public health standards of evidence and widely shared social values. In this article, we argue for incorporating a specific method of ethical deliberation--deliberative public bioethics--into public health. We describe how deliberative public bioethics is a method of engagement that can be helpful in public health. Although medical, research, and public health ethics can be considered some of what bioethics addresses, deliberative public bioethics offers both a how and where. Using the Human Genome Project Ethical, Legal, and Social Implications program as an example of effective incorporation of deliberative processes to integrate ethics into public health policy, we examine how deliberative public bioethics can integrate both public health and bioethics perspectives into three areas of public health practice: research, education, and health policy. We then offer recommendations for future collaborations that integrate deliberative methods into public health policy and practice.

  7. Putting food on the public health table: Making food security relevant to regional health authorities.

    PubMed

    Rideout, Karen; Seed, Barbara; Ostry, Aleck

    2006-01-01

    Food security is emerging as an increasingly important public health issue. The purpose of this paper is to describe a conceptual model and five classes of food security indicators for regional health authorities (RHAs): direct, indirect, consequence, process, and supra-regional. The model was developed after a review of the food security literature and interviews with British Columbia community nutritionists and public health officials. We offer this conceptual model as a practical tool to help RHAs develop a comprehensive framework and use specific indicators, in conjunction with public health nutritionists and other community stakeholders. We recommend using all five classes of indicator together to ensure a complete assessment of the full breadth of food security. This model will be useful for Canadian health authorities wishing to take a holistic community-based approach to public health nutrition to develop more effective policies and programs to maximize food security. The model and indicators offer a rational process that could be useful for collaborative multi-stakeholder initiatives to improve food security.

  8. 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…

  9. 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…

  10. 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…

  11. 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.

  12. 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…

  13. 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…

  14. A historical examination of the Budin-Pinard phantom: what can contemporary obstetrics education learn from simulators of the past?

    PubMed

    Owen, Harry; Pelosi, Marco A

    2013-05-01

    In the 19th and early 20th centuries, obstetric simulators were widely used in medical schools to teach patient assessment skills and to allow students to learn and practice management of a wide range of conditions. Several types of simulators were manufactured, but one, known as the Budin-Pinard phantom, was specifically identified and recommended by J. Whitridge Williams of Johns Hopkins University in a paper he presented to the June 1898 meeting of the Association of American Medical Colleges. Obstetrics simulation became less popular as more women were encouraged to deliver in hospitals, providing trainees the opportunity to learn from actual patients. Today, though, simulation is undergoing a renaissance in obstetrics as a tool to improve learning and patient safety. In light of this shift, the authors examine the origins of simulation in obstetrics training, and specifically why Williams recommended the Budin-Pinard simulator in particular. They investigate the context of simulation in U.S. and Canadian obstetrics training generally up to the early 20th century and provide details about the Budin-Pinard simulator. Finally, the authors offer a discussion of how the Budin-Pinard simulator shaped obstetrics training in the 19th and early 20th centuries and how it can contribute to modern medical education.

  15. Should the Gross Motor Function Classification System be used for children who do not have cerebral palsy?

    PubMed

    Towns, Megan; Rosenbaum, Peter; Palisano, Robert; Wright, F Virginia

    2018-02-01

    This literature review addressed four questions. (1) In which populations other than cerebral palsy (CP) has the Gross Motor Function Classification System (GMFCS) been applied? (2) In what types of study, and why was it used? (3) How was it modified to facilitate these applications? (4) What justifications and evidence of psychometric adequacy were used to support its application? A search of PubMed, MEDLINE, and Embase databases (January 1997 to April 2017) using the terms: 'GMFCS' OR 'Gross Motor Function Classification System' yielded 2499 articles. 118 met inclusion criteria and reported children/adults with 133 health conditions/clinical descriptions other than CP. Three broad GMFCS applications were observed: as a categorization tool, independent variable, or outcome measure. While the GMFCS is widely used for children with health conditions/clinical description other than CP, researchers rarely provided adequate justification for these uses. We offer recommendations for development/validation of other condition-specific classification systems and discuss the potential need for a generic gross motor function classification system. The Gross Motor Function Classification System should not be used outside cerebral palsy or as an outcome measure. The authors provide recommendations for development and validation of condition-specific or generic classification systems. © 2017 Mac Keith Press.

  16. The hospital component of general practice vocational training--the Irish experience.

    PubMed

    Murphy, A W

    1992-12-01

    All second and third year general practice vocational trainees in the Irish Republic in 1991 were invited to complete a questionnaire concerning the hospital component of their training. The questionnaire was based on specific recommendations published by the I.C.G.P. regarding hospital training posts. Replies were received from 39 trainees constituting 70% of the total number of eligible trainees. In general, hospital posts were perceived to be of relevance and to offer adequate exposure to outpatient management and to the development of useful practical skills. More than 70% of the trainees were free to attend at least 75% of the study release course. Everyone entitled to study leave for examination purposes obtained it. However, 95% of trainees found their hospital teachers unfamiliar with the aims and objectives of Vocational Training. Two-thirds of trainees received less than two hours a week of formal or informal teaching. More than two-thirds did not participate in an introductory general practice period and less than a quarter had their individual needs assessed early on. Substantial realisation of the guidelines issued by the ICGP has been achieved. Further work is necessary in the areas of individual needs assessment, relevant structured teaching and general practice liaison. Three specific recommendations are made to achieve these aims.

  17. 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…

  18. 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)

  19. 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…

  20. 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…

  1. 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…

  2. Concluding Comments and Recommendations

    ERIC Educational Resources Information Center

    Carson, Russell L.; Landers, Rian Q.; Blankenship, Bonnie Tjeerdsma

    2010-01-01

    Using the expertise from the academy interest areas of the National Association for Sport and Physical Education, the 2010 All-Academy Symposium and this feature set out to discern the promises and pitfalls of youth sport specialization. This final article offers a few conclusions and recommendations based on the multidisciplinary perspectives and…

  3. 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

  4. Improving the use of research evidence in guideline development: 12. Incorporating considerations of equity.

    PubMed

    Oxman, Andrew D; Schünemann, Holger J; Fretheim, Atle

    2006-12-05

    The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 12th of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this. We reviewed the literature on incorporating considerations of equity in guidelines and recommendations. We searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments. We found few directly relevant empirical methodological studies. These answers are based largely on logical arguments. When and how should inequities be addressed in systematic reviews that are used as background documents for recommendations? The following question should routinely be considered: Are there plausible reasons for anticipating differential relative effects across disadvantaged and advantaged populations? If there are plausible reasons for anticipating differential effects, additional evidence should be included in a review to inform judgments about the likelihood of differential effects. What questions about equity should routinely be addressed by those making recommendations on behalf of WHO? The following additional questions should routinely be considered: How likely is it that the results of available research are applicable to disadvantaged populations and settings? How likely are differences in baseline risk that would result in differential absolute effects across disadvantaged and advantaged populations? How likely is it that there are important differences in trade-offs between the expected benefits and harms across disadvantaged and advantaged populations? Are there different implications for disadvantaged and advantaged populations, or implications for addressing inequities? What context specific information is needed to inform adaptation and decision making in a specific setting with regard to impacts on equity? Those making recommendations on behalf of WHO should routinely consider and offer advice about the importance of the following types of context specific data that might be needed to inform adaptation and decision making in a specific setting: Effect modifiers for disadvantaged populations and for the likelihood of differential effects. Baseline risk in relationship to social and economic status. Utilization and access to care in relationship to social and economic status. Costs in relationship to social and economic status. Ethics and laws that may impact on strategies for addressing inequities. Availability of resources to address inequities. What implementation strategies are likely be needed to ensure that recommendations are implemented equitably? Organisational changes are likely to be important to address inequities. While it may only be possible to consider these in relationship to specific settings, consideration should be given to how best to provide support for identifying and addressing needs for organisational changes. In countries with pervasive inequities institutional, cultural and political changes may first be needed. Appropriate indicators of social and economic status should be used to monitor the effects of implementing recommendations on disadvantaged populations and on changes in social and economic status.

  5. Interdisciplinary consensus document for the treatment of fibromyalgia.

    PubMed

    de Miquel, C Alegre; Campayo, J García; Flórez, M Tomás; Arguelles, J M Gómez; Tarrio, E Blanco; Montoya, M Gobbo; Martin, Á Pérez; Salio, A Martínez; Fuentes, J Vidal; Alberch, E Altarriba; de la Cámara, A Gómez

    2010-01-01

    Backgrounds. The elevated prevalence and enormous clinical and social impact of fibromyalgia, together with the complexity of its treatment, require action consensuses that guide health care professionals. Although there are some similar documents in our language, most have been made from the perspective of a single discipline.Objective. To develop a consensus on the treatment of fibromyalgia made by selected representatives and supported by the principal medical associations that intervene in its treatment (rheumatology, neurology, psychiatry,rehabilitation and family medicine) and representatives of the associations of patients. On the other hand, understanding the disease not as a homogenous disorders but also as the sum of different clinical subtypes,having specific symptomatic characteristics and different therapeutic needs is stressed. This approach represented a need perceived by the clinicians and a novelty regarding previous consensuses.Methods. The different clinical classifications proposed in fibromyalgia and the scientific evidence of the treatments used in this disease were reviewed. For the selection of the classification used and performance of the therapeutic recommendations, some of the usual techniques to obtain the consensus (nominal group and brainstorming) were used.Conclusion. The classification of Giesecke of fibromyalgia into 3 subgroups seems to have the greatest scientific evidence and the most useful for the clinician. The guide offers a series of general recommendations for all the patients with fibromyalgia. However, in addition, for each subgroup, there are a series of specific pharmacological and psychological-type recommendations and those of modification of the environment, which will make it possible to have a personalized approach to the patient with fibromyalgia in accordance with their individual clinical characteristics (pain, catastrophizing levels, etc.).

  6. Management of treatment-related toxicities in advanced medullary thyroid cancer.

    PubMed

    Brose, Marcia S; Bible, Keith C; Chow, Laura Q M; Gilbert, Jill; Grande, Carolyn; Worden, Francis; Haddad, Robert

    2018-05-01

    Progress in the treatment of advanced medullary thyroid cancer (MTC) has resulted from the approval of 2 drugs within the past 5 years, vandetanib and cabozantinib. These multikinase inhibitors (MKIs) possess overlapping specificities for multiple kinase targets implicated in the progression of MTC. Both drugs are associated with toxicities, including hypertension, hemorrhage/perforation, diarrhea and other gastrointestinal events, several dermatologic events, and hypothyroidism. In addition, vandetanib is uniquely associated with QTc prolongation through interaction with myocardial potassium channels, and cabozantinib is uniquely associated with hand-foot skin reaction. Treatment-related toxicities occur frequently and can be severe or life-threatening, and patients undergoing long-term treatment will likely experience adverse events (AEs). Here we offer specific practical recommendations for managing AEs commonly occurring with vandetanib and cabozantinib. The recommended approach relies on early recognition and palliation of symptoms, dose interruption, and dose reduction as necessary in order for the patient to maintain the highest tolerable dose for as long as possible and optimal quality of life. Treatment guidelines do not specify a recommended sequence for treating with vandetanib and cabozantinib; however, most patients will receive both drugs during their lifetime. The choice for first-line therapy is individualized after a risk-benefit assessment and depends on physician preference and patient-related factors, such as comorbid conditions. Because most generalist practices may not be familiar with the intricacies of agents such as vandetanib and cabozantinib, we commend that patients with advanced MTC be managed and treated by a thyroid cancer specialist with coordination of care within a multidisciplinary team. Copyright © 2018. Published by Elsevier Ltd.

  7. 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.

  8. Novel therapeutic approaches: Rett syndrome and human induced pluripotent stem cell technology

    PubMed Central

    Gomathi, Mohan

    2017-01-01

    Recent advances in induced pluripotent stem cell (iPSC) technology target screening and discovering of therapeutic agents for the possible cure of human diseases. Human induced pluripotent stem cells (hiPSC) are the right kind of platform for testing potency of specific active compounds. Ayurveda, the Indian traditional system of medicine developed between 2,500 and 500 BC, is a science involving the intelligent formulations of herbs and minerals. It can serve as a “goldmine” for novel neuroprotective agents used for centuries to treat neurological disorders. This review discusses limitations in screening drugs for neurological disorders and the advantages offered by hiPSC integrated with Indian traditional system of medicine. We begin by describing the current state of hiPSC technology in research on Rett syndrome (RTT) followed by the current controversies in RTT research combined with the emergence of patient-specific hiPSC that indicate an urgent need for researchers to understand the etiology and drug mechanism. We conclude by offering recommendations to reinforce the screening of active compounds present in the ayurvedic medicines using the human induced pluripotent neural model system for research involving drug discovery for RTT. This integrative approach will fill the current knowledge gap in the traditional medicines and drug discovery. PMID:28447035

  9. Wildfire and invasive species in the west: challenges that hinder current and future management and protection of the sagebrush-steppe ecosystem: a Gap Report

    USGS Publications Warehouse

    Mayer, Kenneth F.; Anderson, Pete; Chambers, Jeanne; Boyd, Chad; Christiansen, Tom; Davis, Dawn; Espinosa, Shawn; Havlina, Doug; Ielmini, Michael; Kemner, Don; Kurth, Laurie; Maestas, Jeremy; Mealor, Brian; Milesneck, Ted; Niell, Lara; Pellant, Mike; Pyke, David A.; Tague, Joe; Vernon, Jason

    2013-01-01

    The WG will continue to meet on a regular basis to further develop and expand this list of gaps. Additionally, the WG will offer specific options to address the identified gaps. However, the WG recommends that the FWS, possibly through the State/Federal (Western Governors Association) Sage Grouse Task Force or the National Sage-grouse Executive Oversight Committee, establish a Subcommittee to specifically review this Gap Report and develop a multi-agency approach on how to address each gap. The WG will continue to endeavor to establish a priority list and identify the “low hanging fruit” that can be addressed in the short-term to affect the listing decision. Additionally, the WG will propose a longer-term strategy. However, to successfully establish such a strategy it will take buy-in and commitment at the highest levels in federal and state governments. In an effort to provide managers an opportunity to address the most important issues this coming fiscal year, we offer the following top 5 gaps. Beyond these top 5, the WG has identified 17 additional gaps that should be evaluated by both federal and state agencies as a means to help better manage the wildfire/invasive threat in the west.

  10. The promises and limitations of female-initiated methods of HIV/STI protection

    PubMed Central

    Mantell, Joanne E.; Dworkin, Shari L.; Exner, Theresa M.; Hoffman, Susie; Smit, Jenni A.; Susser, Ida

    2014-01-01

    New methods are now available, and others are being developed, that could enable women to take the initiative in preventing sexually transmitted infections. However, attempts to capitalize on “female-controlled” preventive methods thus far have met with limited success. Female-initiated methods were introduced to intervene in the state of gender relations and assist women who are disempowered vis-à-vis their male partners. Paradoxically, however, we underscore that it is the very structure of regional and local gender relations that shapes the acceptability (or lack of acceptability) of these methods. This paper specifically addresses how the structure of gender relations—for better and for worse—shapes the promises and limitations of widespread use and acceptance of female-initiated methods. We draw on examples from around the world to underscore how the regional specificities of gender (in)equality shape the acceptance, negotiation, and use of these methods. Simultaneously, we demonstrate how the introduction and sustained use of methods are shaped by gender relations and offer possibilities for reinforcing or challenging their current state. Based on our analyses, we offer key policy and programmatic recommendations to increase promotion and effective use of women-initiated HIV/STI protection methods for both women and men. PMID:16814912

  11. Criteria for use of composite end points for competing risks-a systematic survey of the literature with recommendations.

    PubMed

    Manja, Veena; AlBashir, Siwar; Guyatt, Gordon

    2017-02-01

    Composite end points are frequently used in reports of clinical trials. One rationale for the use of composite end points is to account for competing risks. In the presence of competing risks, the event rate of a specific event depends on the rates of other competing events. One proposed solution is to include all important competing events in one composite end point. Clinical trialists require guidance regarding when this approach is appropriate. To identify publications describing criteria for use of composite end points for competing risk and to offer guidance regarding when a composite end point is appropriate on the basis of competing risks. We searched MEDLINE, CINAHL, EMBASE, The Cochrane's Central & Systematic Review databases including the Health Technology Assessment database, and the Cochrane's Methodology register from inception to April 2015, and candidate textbooks, to identify all articles providing guidance on this issue. Eligible publications explicitly addressed the issue of a composite outcome to address competing risks. Two reviewers independently screened the titles and abstracts for full-text review; independently reviewed full-text publications; and abstracted specific criteria authors offered for use of composite end points to address competing risks. Of 63,645 titles and abstracts, 166 proved potentially relevant of which 43 publications were included in the final review. Most publications note competing risks as a reason for using composite end points without further elaboration. None of the articles or textbook chapters provide specific criteria for use of composite end points for competing risk. Some advocate using composite end points to avoid bias due to competing risks and others suggest that composite end points seldom or never be used for this purpose. We recommend using composite end points for competing risks only if the competing risk is plausible and if it occurs with sufficiently high frequency to influence the interpretation of the effect of intervention on the end point of interest. These criteria will seldom be met. Review of heart failure trials published in the New England Journal of Medicine revealed that many of them use the composite end point of death or hospitalization; none of the trials, however, satisfied our criteria. The existing literature fails to provide clear guidance regarding use of composite end point for competing risks. We recommend using composite end points for competing risks only if the competing risk is plausible and if it occurs sufficiently often. Published by Elsevier Inc.

  12. 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

  13. 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…

  14. 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

  15. Process quality of decision-making in multidisciplinary cancer team meetings: a structured observational study.

    PubMed

    Hahlweg, Pola; Didi, Sarah; Kriston, Levente; Härter, Martin; Nestoriuc, Yvonne; Scholl, Isabelle

    2017-11-17

    The quality of decision-making in multidisciplinary team meetings (MDTMs) depends on the quality of information presented and the quality of team processes. Few studies have examined these factors using a standardized approach. The aim of this study was to objectively document the processes involved in decision-making in MDTMs, document the outcomes in terms of whether a treatment recommendation was given (none vs. singular vs. multiple), and to identify factors related to type of treatment recommendation. An adaptation of the observer rating scale Multidisciplinary Tumor Board Metric for the Observation of Decision-Making (MDT-MODe) was used to assess the quality of the presented information and team processes in MDTMs. Data was analyzed using descriptive statistics and mixed logistic regression analysis. N = 249 cases were observed in N = 29 MDTMs. While cancer-specific medical information was judged to be of high quality, psychosocial information and information regarding patient views were considered to be of low quality. In 25% of the cases no, in 64% one, and in 10% more than one treatment recommendations were given (1% missing data). Giving no treatment recommendation was associated with duration of case discussion, duration of the MDTM session, quality of case history, quality of radiological information, and specialization of the MDTM. Higher levels of medical and treatment uncertainty during discussions were found to be associated with a higher probability for more than one treatment recommendation. The quality of different aspects of information was observed to differ greatly. In general, we did not find MDTMs to be in line with the principles of patient-centered care. Recommendation outcome varied substantially between different specializations of MDTMs. The quality of certain information was associated with the recommendation outcome. Uncertainty during discussions was related to more than one recommendation being considered. Time constraints were found to play an important role. Some of those aspects seem modifiable, which offers possibilities for the reorganization of MDTMs.

  16. ISY Mission to Planet Earth Conference: A planning meeting for the International Space Year

    NASA Technical Reports Server (NTRS)

    Meyerson, Harvey

    1991-01-01

    A major theme was the opportunity offered by the International Space Year (ISY) to initiate a long-term program of Earth observation mission coordination and worldwide data standardization. The challenge is immense and extremely time critical. A recommendation was made to inventory the capabilities of Earth observing spacecraft scheduled during the next decade. The ISY effort to strengthen coordination and standardization should emphasize global issues, and also regional initiatives of particular relevance to developing nations. The concepts of a Global Information System Test (GIST) was accepted and applied to specific issues of immediate concern. The importance of ISY Earth observation initiatives extending beyond research to include immediate and direct applications for social and economic development was stressed. Several specific Mission to Planet Earth proposals were developed during the Conference. A mechanism was set up for coordinating participation of the national space agencies or equivalent bodies.

  17. Goal setting: an integral component of effective diabetes care.

    PubMed

    Miller, Carla K; Bauman, Jennifer

    2014-08-01

    Goal setting is a widely used behavior change tool in diabetes education and training. Prior research found specific relatively difficult but attainable goals set within a specific timeframe improved performance in sports and at the workplace. However, the impact of goal setting in diabetes self-care has not received extensive attention. This review examined the mechanisms underlying behavioral change according to goal setting theory and evaluated the impact of goal setting in diabetes intervention studies. Eight studies were identified, which incorporated goal setting as the primary strategy to promote behavioral change in individual, group-based, and primary care settings among patients with type 2 diabetes. Improvements in diabetes-related self-efficacy, dietary intake, physical activity, and A1c were observed in some but not all studies. More systematic research is needed to determine the conditions and behaviors for which goal setting is most effective. Initial recommendations for using goal setting in diabetes patient encounters are offered.

  18. Adherence to the cancer prevention recommendations of the World Cancer Research Fund/American Institute for Cancer Research and mortality: a census-linked cohort.

    PubMed

    Lohse, Tina; Faeh, David; Bopp, Matthias; Rohrmann, Sabine

    2016-09-01

    Modifiable lifestyle factors linked to cancer offer great potential for prevention. Previous studies suggest an association between adherence to recommendations on healthy lifestyle and cancer mortality. The aim of this study was to examine whether adherence to the cancer prevention recommendations of the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) is associated with reduced all-cause, total cancer, and specific cancer type mortality. We built a lifestyle score that included 3 categories, based on the recommendations of the WCRF/AICR. Applying Cox regression models, we investigated the association with all-cause, total cancer, and specific cancer type mortality; in addition, we included cardiovascular disease (CVD) mortality. We used census- and death registry-linked survey data allowing a mortality follow-up for ≤32 y. Our analysis included 16,722 participants. Information on lifestyle score components and confounders was collected at baseline. Over a mean follow-up of 21.7 y, 3730 deaths were observed (1332 cancer deaths). Comparing best with poorest category of the lifestyle score showed an inverse association with all-cause (HR: 0.82; 95% CI: 0.75, 0.89) and total cancer (men only, HR: 0.69; 95% CI: 0.57, 0.84) mortality. We estimated that ∼13% of premature cancer deaths in men would have been preventable if lifestyle score levels had been high. Inverse associations were observed for lung, upper aerodigestive tract, stomach, and prostate cancer mortality [men and women combined, HR: 0.72; 95% CI: 0.51, 0.99; HR: 0.49; 95% CI: 0.26, 0.92; HR: 0.34; 95% CI: 0.14, 0.83; HR: 0.48; 95% CI: 0.28, 0.82 (men only), respectively]. CVD mortality was not associated with the lifestyle score (men and women combined, HR: 0.96; 95% CI: 0.82, 1.13). Our results support the importance of adhering to recommendations for a healthy lifestyle with regard to all-cause and cancer mortality. To reduce the burden of cancer in the population, preventive measures should stress the potential of low-risk health behavior patterns rather than of specific risk factors only. © 2016 American Society for Nutrition.

  19. 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.

  20. 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.

  1. Diagnostic Dilemmas and Cultural Diversity in Emergency Rooms

    PubMed Central

    Weaver, Charlotte; Sklar, David

    1980-01-01

    Language and cultural beliefs play an extremely important role in the interaction between patients from diverse cultural groups and physicians. Especially in emergency rooms, there are many dangers in missed communications. A patient from a foreign culture, especially one who does not speak English, often expresses symptoms in ways that are unfamiliar to many American physicians. Specific areas of cultural vulnerability can be identified for the major ethnic groups in the United States as they interact with the scientific medical system. A short review of folk medical beliefs and recommendations for improving diagnostic accuracy and treatment may assist emergency room staffs in offering care that is culturally acceptable to patients of diverse ethnic backgrounds. PMID:7347053

  2. Caregivers as money managers for adults with severe mental illness: how treatment providers can help.

    PubMed

    Elbogen, Eric B; Wilder, Christine; Swartz, Marvin S; Swanson, Jeffrey W

    2008-01-01

    To review the prevalence, benefits, and problems associated with families who, either informally or formally as representative payees, manage money for adults with severe mental illness. Based on empirical research and clinical cases, suggestions are offered for minimizing downsides and capitalizing upon benefits of family money management. The findings and case vignettes demonstrate four specific strategies for treatment providers: facilitating collaboration, increasing knowledge about disability funds, improving money-management skills, and developing plans for financial decision-making. By following these recommendations and becoming aware of whether their clients had family money managers, clinicians can promote independent functioning and family support for a substantial number of people with severe mental illness.

  3. Representations of Patients' Experiences of Autonomy in Graphic Medicine.

    PubMed

    Tschaepe, Mark

    2018-02-01

    I advocate using graphic medicine in introductory medical ethics courses to help trainees learn about patients' experiences of autonomy. Graphic narratives about this content offer trainees opportunities to gain insights into making diagnoses and recommending treatments. Graphic medicine can also illuminate aspects of patients' experiences of autonomy differently than other genres. Specifically, comics allow readers to consider visual and text-based representations of a patient's actions, speech, thoughts, and emotions. Here, I use Ellen Forney's Marbles: Mania, Depression, Michelangelo, and Me: A Graphic Memoir and Peter Dunlap-Shohl's My Degeneration: A Journey Through Parkinson's as two examples that can serve as pedagogical resources. © 2018 American Medical Association. All Rights Reserved.

  4. Delaware Technical & Community College's response to the critical shortage of Delaware secondary science teachers

    NASA Astrophysics Data System (ADS)

    Campbell, Nancy S.

    This executive position paper examines the critical shortage of Delaware high school science teachers and Delaware Technical & Community College's possible role in addressing this shortage. A concise analysis of economic and political implications of the science teacher shortage is presented. The following topics were researched and evaluated: the specific science teacher needs for Delaware school districts; the science teacher education program offerings at Delaware universities and colleges; the Alternative Route to Teacher Certification (ARTC); and the state of Delaware's scholarship response to the need. Recommendations for Delaware Tech's role include the development and implementation of two new Associate of Arts of Teaching programs in physics secondary science education and chemistry secondary science education.

  5. Black Male Mental Health and the Black Church: Advancing a Collaborative Partnership and Research Agenda.

    PubMed

    Robinson, Michael A; Jones-Eversley, Sharon; Moore, Sharon E; Ravenell, Joseph; Adedoyin, A Christson

    2018-06-01

    This article explores the role the Black Church could play in facilitating spiritually sensitive, culturally relevant and gender-specific services to address the mental health and well-being of Black males. The help-seeking behaviors of Black men are examined as the authors offer two theories: the body, mind, spirit, environment, social, transcendent, and health, illness, men, and masculinities that may assist the Black Church in functioning as an effective support networks for healthy Black male mental health. Next, the authors discuss implications for practice, research, and education, and lastly, eight recommendations for Black Church leadership, social workers, and mental health professionals are also discussed.

  6. 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.

  7. Recommendations for peer-to-peer support for NICU parents

    PubMed Central

    Hall, S L; Ryan, D J; Beatty, J; Grubbs, L

    2015-01-01

    Peer-to-peer support provided by ‘veteran' neonatal intensive care unit (NICU) parents to those with current NICU babies is a legitimate and unique form of support that can complement or supplement, but not replace, services provided by professional NICU staff. Peer support can be delivered through hospital- or community-based programs that offer one-to-one in-person or telephone matches, or support groups that meet in-person or via the Internet. Issues in program development, volunteer training and program operation are discussed. Recommendations for offering peer support to all NICU parents as an integral component of family-centered care and comprehensive family support are presented. PMID:26597805

  8. [The acceptability of the NICE recommendations for schizophrenia in the Italian Departments of Mental Health. The SIEP-DIRECT'S Project on the discrepancy between routine practice and evidence].

    PubMed

    Semisa, Domenico; Lasalvia, Antonio; Miceli, Maurizio; Dall'Agnola, Rosa Bruna; Pucci, Cristina; Bissoli, Sarah; Visani, Enrico; Pismataro, Carmine Pasquale; Vanetti, Michele; Pioli, Rosaria; Ruggeri, Mirella; Lora, Antonio

    2008-01-01

    This paper aims at presenting the most significant results emerging from the work carried out by the focus groups of the multi-centre Project SIEP-DIRECT'S. The Project is aimed at assessing the existing discrepancies between the evidence-based NICE guidelines for schizophrenia and the usual practices of care given by Italian mental health services. Each focus group was requested to give an evaluation on: (a) appropriateness of the English NICE guidelines in the context of the Italian mental health services; (b) clarity and usefulness of the 103 indicators developed on the basis of the NICE recommendations to measure their level of application within the services. In each of the 19 mental health departments or psychiatric services participating in the Project there were organized "multidisciplinary" focus groups and "specialistic" focus groups. The former included, amongst others, professional operators of the mental health services, patients, their relatives, representatives of patient organizations and general practitioners. They examined the recommendations and indicators upon which the participants could express their opinion or judgment based on their knowledge, experience or information in their possession. The latter group, composed only of psychiatrists, examined the recommendations and indicators relative to pharmacological treatments that regarded the specific competences of their professional category. Most NICE recommendations seemed appropriate to the working context of the Italian services. However, some perplexity emerged as regards specific organizational models of the services, such as the specific services for psychotic onsets or the assertive outreach teams, which were believed not to be strictly pertinent to the traditional organization of mental health care in our Country. There were also some criticisms regarding the cognitive-behavioural treatments which the NICE Guidelines recommend as the principle psychotherapeutic option for patients with schizophrenia, since in many Italian services, when the use of psychological interventions are needed, the tendency is to prefer interventions based on psychodynamic theories. The SIEP indicators were generally held to be clear and acceptable. In the view of the focus groups, the NICE guidelines are on the whole useful and suitable for orientating the services in the choice of more efficacious practices in the treatment of patients with schizophrenia. Moreover, the results obtained legitimate the use of the set of SIEP indicators for the evaluation of good practices and the quality of care offered by Italian services. Finally, the use of focus groups delines to a different context as well as the verification of the comprehensibility and applicability of SIEP indicators.

  9. The Biosynthesis of Unusual Floral Volatiles and Blends Involved in Orchid Pollination by Deception: Current Progress and Future Prospects.

    PubMed

    Wong, Darren C J; Pichersky, Eran; Peakall, Rod

    2017-01-01

    Flowers have evolved diverse strategies to attract animal pollinators, with visual and olfactory floral cues often crucial for pollinator attraction. While most plants provide reward (e.g., nectar, pollen) in return for the service of pollination, 1000s of plant species, particularly in the orchid family, offer no apparent reward. Instead, they exploit their often specific pollinators (one or few) by mimicking signals of female insects, food source, and oviposition sites, among others. A full understanding of how these deceptive pollination strategies evolve and persist remains an open question. Nonetheless, there is growing evidence that unique blends that often contain unusual compounds in floral volatile constituents are often employed to secure pollination by deception. Thus, the ability of plants to rapidly evolve new pathways for synthesizing floral volatiles may hold the key to the widespread evolution of deceptive pollination. Yet, until now the biosynthesis of these volatile compounds has been largely neglected. While elucidating the biosynthesis in non-model systems is challenging, nonetheless, these cases may also offer untapped potential for biosynthetic breakthroughs given that some of the compounds can be exclusive or dominant components of the floral scent and production is often tissue-specific. In this perspective article, we first highlight the chemical diversity underpinning some of the more widespread deceptive orchid pollination strategies. Next, we explore the potential metabolic pathways and biosynthetic steps that might be involved. Finally, we offer recommendations to accelerate the discovery of the biochemical pathways in these challenging but intriguing systems.

  10. Training the next generation of global health experts: experiences and recommendations from Pacific Rim universities.

    PubMed

    Withers, Mellissa; Press, David; Wipfli, Heather; McCool, Judith; Chan, Chang-Chuan; Jimba, Masamine; Tremewan, Christopher; Samet, Jonathan

    2016-06-23

    Finding solutions to global health problems will require a highly-trained, inter-disciplinary workforce. Global health education and research can potentially have long-range impact in addressing the global burden of disease and protecting and improving the health of the global population. We conducted an online survey of twelve higher education institutions in the Pacific Rim that spanned the period 2005-2011. Program administrators provided data on program concentrations, student enrollment and student funding opportunities for 41 public health programs, including those specific to global health. The Master of Public Health (MPH) was the most common degree offered. A growing demand for global health education was evident. Enrollment in global health programs increased over three-fold between 2005-2011. Very few institutions had specific global health programs or offered training to undergraduates. Funding for student scholarships was also lacking. The growing demand for global health education suggests that universities in the Pacific Rim should increase educational and training opportunities in this field. Schools of medicine may not be fully equipped to teach global health-related courses and to mentor students who are interested in global health. Increasing the number of dedicated global health research and training institutions in the Pacific Rim can contribute to building capacity in the region. Faculty from different departments and disciplines should be engaged to provide multi-disciplinary global health educational opportunities for undergraduate and graduate students. New, innovative ways to collaborate in education, such as distance education, can also help universities offer a wider range of global health-related courses. Additional funding of global health is also required.

  11. The WHO 2016 verbal autopsy instrument: An international standard suitable for automated analysis by InterVA, InSilicoVA, and Tariff 2.0

    PubMed Central

    Chandramohan, Daniel; Clark, Samuel J.; Jakob, Robert; Leitao, Jordana; Rao, Chalapati; Riley, Ian; Setel, Philip W.

    2018-01-01

    Background Verbal autopsy (VA) is a practical method for determining probable causes of death at the population level in places where systems for medical certification of cause of death are weak. VA methods suitable for use in routine settings, such as civil registration and vital statistics (CRVS) systems, have developed rapidly in the last decade. These developments have been part of a growing global momentum to strengthen CRVS systems in low-income countries. With this momentum have come pressure for continued research and development of VA methods and the need for a single standard VA instrument on which multiple automated diagnostic methods can be developed. Methods and findings In 2016, partners harmonized a WHO VA standard instrument that fully incorporates the indicators necessary to run currently available automated diagnostic algorithms. The WHO 2016 VA instrument, together with validated approaches to analyzing VA data, offers countries solutions to improving information about patterns of cause-specific mortality. This VA instrument offers the opportunity to harmonize the automated diagnostic algorithms in the future. Conclusions Despite all improvements in design and technology, VA is only recommended where medical certification of cause of death is not possible. The method can nevertheless provide sufficient information to guide public health priorities in communities in which physician certification of deaths is largely unavailable. The WHO 2016 VA instrument, together with validated approaches to analyzing VA data, offers countries solutions to improving information about patterns of cause-specific mortality. PMID:29320495

  12. The Biosynthesis of Unusual Floral Volatiles and Blends Involved in Orchid Pollination by Deception: Current Progress and Future Prospects

    PubMed Central

    Wong, Darren C. J.; Pichersky, Eran; Peakall, Rod

    2017-01-01

    Flowers have evolved diverse strategies to attract animal pollinators, with visual and olfactory floral cues often crucial for pollinator attraction. While most plants provide reward (e.g., nectar, pollen) in return for the service of pollination, 1000s of plant species, particularly in the orchid family, offer no apparent reward. Instead, they exploit their often specific pollinators (one or few) by mimicking signals of female insects, food source, and oviposition sites, among others. A full understanding of how these deceptive pollination strategies evolve and persist remains an open question. Nonetheless, there is growing evidence that unique blends that often contain unusual compounds in floral volatile constituents are often employed to secure pollination by deception. Thus, the ability of plants to rapidly evolve new pathways for synthesizing floral volatiles may hold the key to the widespread evolution of deceptive pollination. Yet, until now the biosynthesis of these volatile compounds has been largely neglected. While elucidating the biosynthesis in non-model systems is challenging, nonetheless, these cases may also offer untapped potential for biosynthetic breakthroughs given that some of the compounds can be exclusive or dominant components of the floral scent and production is often tissue-specific. In this perspective article, we first highlight the chemical diversity underpinning some of the more widespread deceptive orchid pollination strategies. Next, we explore the potential metabolic pathways and biosynthetic steps that might be involved. Finally, we offer recommendations to accelerate the discovery of the biochemical pathways in these challenging but intriguing systems. PMID:29181016

  13. 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

  14. 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…

  15. 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…

  16. 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…

  17. Twelve Recommendations for Strengthening Mathematics and Science Programs Serving a Diverse Population

    ERIC Educational Resources Information Center

    Kaser, Joyce S.

    2010-01-01

    Based on the data gathered and the interviews with administrators, the author makes the following suggestions. These twelve recommendations are targeted primarily toward educators wanting to strengthen their own mathematics and science offerings, possibly by establishing a school-within-a school or launching a charter school. The recommendations…

  18. To Strengthen Quality in Higher Education. Summary Recommendations of the National Commission on Higher Education Issues.

    ERIC Educational Resources Information Center

    National Commission in Higher Education Issues, Washington, DC.

    Recommendations for improving educational quality and strengthening public confidence in American higher education are offered, based on the deliberations of the National Commission on Higher Education, which existed for 1 year and held four meetings. Areas of concern include: setting priorities for the institution and strengthening administrative…

  19. 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

  20. A Review of the Literature on Online Developmental Mathematics: Research-Based Recommendations for Practice

    ERIC Educational Resources Information Center

    Coleman, Sandra Lee; Skidmore, Susan Troncoso; Martirosyan, Nara M.

    2017-01-01

    In this review of literature, the efficacy of online instruction for developmental mathematics students was explored. Current peer-reviewed articles, representing research from community college settings and written between 1996 and 2015, were reviewed. Based on those studies, several recommendations are offered regarding the online delivery of…

  1. 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…

  2. "What Works": Recommendations on Improving Academic Experiences and Outcomes for Black Males

    ERIC Educational Resources Information Center

    Howard, Tyrone C.; Douglas, Ty-Ron, M. O.; Warren, Chezare A.

    2016-01-01

    This brief presents the most significant recommendations based on a review of key findings from research presented in this special issue. The authors offer what they believe to be the most important considerations of what works for improving Black male school achievement in the domains of research, practice, and policy.

  3. 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.

  4. 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.

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

    PubMed

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

    2017-02-01

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

  6. Measure Guideline: Optimizing the Configuration of Flexible Duct Junction Boxes

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

    Beach, R.; Burdick, A.

    2014-03-01

    This measure guideline offers additional recommendations to heating, ventilation, and air conditioning (HVAC) system designers for optimizing flexible duct, constant-volume HVAC systems using junction boxes within Air Conditioning Contractors of America (ACCA) Manual D guidance (Rutkowski, H. Manual D -- Residential Duct Systems, 3rd edition, Version 1.00. Arlington, VA: Air Conditioning Contractors of America, 2009.). IBACOS used computational fluid dynamics software to explore and develop guidance to better control the airflow effects of factors that may impact pressure losses within junction boxes among various design configurations (Beach, R., Prahl, D., and Lange, R. CFD Analysis of Flexible Duct Junction Boxmore » Design. Golden, CO: National Renewable Energy Laboratory, submitted for publication 2013). These recommendations can help to ensure that a system aligns more closely with the design and the occupants' comfort expectations. Specifically, the recommendations described herein show how to configure a rectangular box with four outlets, a triangular box with three outlets, metal wyes with two outlets, and multiple configurations for more than four outlets. Designers of HVAC systems, contractors who are fabricating junction boxes on site, and anyone using the ACCA Manual D process for sizing duct runs will find this measure guideline invaluable for more accurately minimizing pressure losses when using junction boxes with flexible ducts.« less

  7. 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.

  8. Treating Nicotine Dependence and Preventing Smoking Relapse in Cancer Patients

    PubMed Central

    Chang, Eun Hae Estelle; Braith, Andrew; Hitsman, Brian; Schnoll, Robert A.

    2017-01-01

    Introduction Despite the well-documented harmful effects of smoking, many cancer patients continue to smoke. Smoking cessation is critical to address in this population given the associated increase in treatment toxicity, risk of second primary tumors, decrease in treatment response and higher disease-specific and all-cause mortality with continued smoking following a cancer diagnosis. This review seeks to summarize the latest recommendations and guidelines on smoking cessation treatment for patients diagnosed with cancer, and the evidence behind those recommendations. Areas covered We reviewed the latest evidence for smoking cessation treatments for cancer patients and the clinical guidelines and recommendation available for oncologists and health care providers. The unique aspects of nicotine dependence among patients diagnosed with cancer, and key challenges and barriers that cancer survivors and health care providers experience when considering smoking cessation treatments, and available clinical resources, are also discussed. Lastly, the authors summarize future directions in the field of smoking cessation treatment for cancer patients. Expert commentary While there are areas of improvement in research of smoking cessation treatment for cancer patients, critical under-explored areas remain. Nonetheless, providers should adhere to the NCCN guidelines and offer a brief counseling intervention to motivate patients to quit smoking when appropriate resources are not available. PMID:28808692

  9. 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…

  10. 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…

  11. Managed Retreat in New York after Sandy: Incentivizing Participation in High-Cost Areas

    NASA Astrophysics Data System (ADS)

    McDonnell, S.; Ghorbani, P.; Wolf, C.; Stovall, G.

    2017-12-01

    Extreme weather events may potentially displace millions of people worldwide by 2100 (Nicholls et al., 2011). In the US, flood-prone areas are still attractive to many residents (Dyckman, St. John, & London, 2014), and the most common policies such as zoning or subsidized flood insurance continue to incentivize more development (Mechler & Bouwer, 2015). An increasingly popular alternative for mitigating flood damage is managed retreat, which consists of buying out properties in hazardous areas and relocating the owners elsewhere. We explore New York State's buyout program—a $680 million program administered under its Community Development Block Grant-Disaster Recovery (CDBG-DR) allocation—in the aftermath of Superstorm Sandy. Buyouts in New York tend to be costlier because of higher housing prices and density (Lincoln Institute, 2016), and potential participants may face challenges finding comparable housing within their communities. Since buyout offers are based on property values, homeowners with lower net property values may have less incentive to participate. We ask what neighborhood, household, and property characteristics affect the likelihood of participating in the buyout program. Specifically, are lower property values a disincentive to participation? We use binomial and multinomial logistic regression analyses to estimate the likelihood of participation for a sample of 2,062 properties invited to the program. Our main predictor compares the net offer amount against the local median housing value, controlling for an array of household and neighborhood characteristics. We find that relative property values are inversely correlated with participation, more visibly pronounced in areas with larger gaps between applicants' property values and local home values. While CDBG-DR is specifically geared towards lower-income families and neighborhoods, our findings imply that its existing structure may hinder engagement of these target groups in high-cost areas. To attract them, we recommend an incentive structure that rewards clustered participation compared to individual properties. We also recommend that additional incentive be provided to help lower-income applicants stay close to their original neighborhoods.

  12. Commentary: Recommendations and remaining questions for health care leadership training programs.

    PubMed

    Stoller, James K

    2013-01-01

    Effective leadership is critical for optimizing cost, access, and quality in health care. Creating a pipeline of effective health care leaders requires developing leadership competencies that differ from the usual criteria of clinical and scientific excellence by which physicians have traditionally been promoted to leadership positions. Specific competencies that differentiate effective leaders from average leaders, especially emotional intelligence and its component abilities, are essential for effective leadership.Adopting a long-standing practice from successful corporations, some health care institutions, medical societies, and business schools now offer leadership programs that address these differentiating leadership competencies. The author draws on experience with such programs through the Cleveland Clinic Academy to provide recommendations for health care leadership training and to identify unanswered questions about such programs.The author recommends that such training should be broadly available to all health care leadership communities (i.e., nurses, administrators, and physicians). A progressive curriculum, starting with foundational concepts and extending to coaching and feedback opportunities through experiential learning, recognizes the challenge of becoming an effective leader and the long time line needed to do so. Linking leadership courses to continuing medical education and to graduate credit opportunities is appealing to participants. Other recommendations focus on the importance of current leaders' involvement in nominating emerging leaders for participation, embedding leadership development discussions in faculty's professional reviews, and blending discussion of frameworks and theory with practical, experiential lessons. The author identifies questions about the benefits of formal health care leadership training that remain to be answered.

  13. 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.

  14. Evidence-based guideline summary: Evaluation, diagnosis, and management of facioscapulohumeral muscular dystrophy

    PubMed Central

    Tawil, Rabi; Kissel, John T.; Heatwole, Chad; Pandya, Shree; Gronseth, Gary; Benatar, Michael

    2015-01-01

    Objective: To develop recommendations for the evaluation, diagnosis, prognostication, and treatment of facioscapulohumeral muscular dystrophy (FSHD) from a systematic review and analysis of the evidence. Methods: Relevant articles were analyzed in accordance with the American Academy of Neurology classification of evidence schemes for diagnostic, prognostic, and treatment studies. Recommendations were linked to the strength of the evidence and other factors. Results and recommendations: Available genetic testing for FSHD type 1 is highly sensitive and specific. Although respiratory insufficiency occurs rarely in FSHD, patients with severe FSHD should have routine pulmonary function testing. Routine cardiac screening is not necessary in patients with FSHD without cardiac symptoms. Symptomatic retinal vascular disease is very rare in FSHD. Exudative retinopathy, however, is potentially preventable, and patients with large deletions should be screened through dilated indirect ophthalmoscopy. The prevalence of clinically relevant hearing loss is not clear. In clinical practice, patients with childhood-onset FSHD may have significant hearing loss. Because undetected hearing loss may impair language development, screening through audiometry is recommended for such patients. Musculoskeletal pain is common in FSHD and treating physicians should routinely inquire about pain. There is at present no effective pharmacologic intervention in FSHD. Available studies suggest that scapular fixation is safe and effective. Surgical scapular fixation might be cautiously offered to selected patients. Aerobic exercise in FSHD appears to be safe and potentially beneficial. On the basis of the evidence, patients with FSHD might be encouraged to engage in low-intensity aerobic exercises. PMID:26215877

  15. Do patient race and sex change surgeon recommendations for TKA?

    PubMed

    Dy, Christopher J; Lyman, Stephen; Boutin-Foster, Carla; Felix, Karla; Kang, Yoon; Parks, Michael L

    2015-02-01

    Prior investigations have suggested that physician-related factors may contribute to differential use of TKA among women and ethnic minorities. We sought to evaluate the effect of surgeon bias on recommendations for TKA. Using an experimental approach with standardized patient scenarios, we sought to evaluate surgeon recommendations regarding TKA, specifically to determine whether recommendations for TKA are influenced by (1) patient race, and (2) patient sex. We developed four computerized scenarios for all combinations of race (white or black) and sex (male or female) for otherwise similar patients with end-stage knee osteoarthritis. Patients gave an orthopaedic history of 2 years worsening pain with decreased functional status and failure of oral antiinflammatory medications and corticosteroid intraarticular injections. Orthopaedic surgeons attending the 2012 annual meetings of the New York State Society of Orthopaedic Surgeons and American Association of Hip and Knee Surgeons were recruited for the study. Surgeons passing an open recruitment table at each meeting were asked to participate. Of the 1111 surgeons in attendance at either meeting, 113 (10.2%) participated in the study. All participants viewed the "control" patient's story (white male) and were randomized to view one of the three "experimental" scenarios (white female, black male, black female). After viewing each scenario, the participants were anonymously asked whether they would recommend TKA. An a priori power analysis showed that 112 participants were needed to detect a 15% difference in the likelihood of recommending surgery for white versus nonwhite patients in the test scenarios evaluated with 90% power at a level of significance of 0.05. Of the 39 surgeons who viewed the white male plus black female scenario, there were 33 (85%) concordant responses (TKA offered to both patients) and six discordant responses (TKA offered to only one of the patients), with no effect of patient race and sex (p = 0.99). Of the 37 surgeons who viewed the white male plus black male scenario, there were 33 (89%) concordant responses and four discordant responses, with no effect of patient race (p = 0.32). Of the 37 surgeons who viewed the white male plus white female scenario, there were 30 (77%) concordant responses and seven discordant responses, with no effect of patient sex (p = 0.71). After orthopaedic surgeons viewed video scenarios of patients with end-stage knee osteoarthritis, patient race and sex were not associated with a different likelihood of a surgical recommendation. Our findings support the notion that patient race and sex may be less influential on decision making when there are strong clinical data to support a decision. Physician bias may have a greater effect on decision making in situations where the indications for surgery are less clear.

  16. 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

  17. Physiotherapy and cardiac rhythm devices: a review of the current scope of practice.

    PubMed

    Digby, Geneviève C; Daubney, Marguerite E; Baggs, Jim; Campbell, Debra; Simpson, Christopher S; Redfearn, Damian P; Brennan, F James; Abdollah, Hoshiar; Baranchuk, Adrian

    2009-07-01

    Several case reports have demonstrated negative interactions between various physiotherapy modalities and cardiac rhythm devices (CRD). Fear of these potential interactions may lead to suboptimal utilization of physiotherapy treatments in CRD patients. No prior review of available guidelines, or management strategies, on the interaction between physiotherapy modalities and CRD patients has been reported. To review existing guidelines regarding the use of physiotherapy modalities in patients with pacemakers and/or implantable cardioverter-defibrillators (ICDs). To retrospectively analyse CRD patient encounters at a local physiotherapy facility during a period of 2 years. A review of the literature regarding the potential interactions between physiotherapy modalities and CRDs was performed. Next, a 2 year retrospective analysis of patient encounters at a physiotherapy facility was conducted. In addition, seven international physiotherapy societies and four CRD manufacturers were surveyed with respect to recommendations regarding physiotherapy treatments in device patients. The local physiotherapy facility treated 25 patients with CRD (22 pacemaker and 3 ICD patients) for a total of 230 visits (9.2 visits/patient). Five patients received transcutaneous electrical nerve stimulation (TENS) and all 25 were administered additional treatment in the form of ultrasound (15), acupuncture (19), Laser (7), traction/manual therapy (12), exercise (8), education (18), taping (5), and/or moist heat (5). No complications occurred. Meanwhile, international societies and device manufacturers offered few specific or consistent recommendations. There are no specific international policies regarding the administration of physiotherapy modalities in CRD patients and, thus, there are no specific guidelines to be implemented at the local level. Review of the literature and of recommendations from CRD manufacturers suggests that TENS, Diathermy, and Interferential Electrical Current Therapy are best avoided in patients with CRDs. However, there is no consensus and it may be possible to safely deliver these modalities in a proper setting with device and patient monitoring. Although further research is required in this regard, active collaboration between physiotherapists and CRD clinic physicians should allow for the safe application of most physiotherapy modalities.

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. 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...

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 77 FR 56851 - Draft and Revised Draft Guidances for Industry Describing Product-Specific Bioequivalence...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-14

    ... Bioequivalence Recommendations; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY... draft product-specific bioequivalence (BE) recommendations. The recommendations provide product-specific guidance on the design of BE studies to support abbreviated new drug applications (ANDAs). In the Federal...

  8. Impact of Gender-Specific Human Papillomavirus Vaccine Recommendations on Uptake of Other Adolescent Vaccines: Analysis of the NIS-Teen (2008-2012).

    PubMed

    Bednarczyk, Robert A; Orenstein, Walter A; Omer, Saad B

    In the United States, human papillomavirus vaccination was routinely recommended for adolescent females in 2006 and provisionally recommended for adolescent males in 2009. We evaluated the hypothesis that gender-specific human papillomavirus vaccination recommendations would impact gender-specific uptake of other vaccines using National Immunization Survey-Teen public use data sets (2008-2012). Female adolescents had higher coverage than males of at least 1 other adolescent vaccine in 2008 (3.0% higher) and 2009 (4.3% higher). Gender differences abated in 2010, 2011, and 2012 (0.2%, 0.9%, and 0.4%, respectively). To evaluate unintended consequences of gender-based recommendations, countries with female-only human papillomavirus vaccination recommendations should evaluate gender-specific uptake of other adolescent vaccines.

  9. Developing dimensions for a multicomponent multidisciplinary approach to obesity management: a qualitative study.

    PubMed

    Cochrane, Anita J; Dick, Bob; King, Neil A; Hills, Andrew P; Kavanagh, David J

    2017-10-16

    There have been consistent recommendations for multicomponent and multidisciplinary approaches for obesity management. However, there is no clear agreement on the components, disciplines or processes to be considered within such an approach. In this study, we explored multicomponent and multidisciplinary approaches through an examination of knowledge, skills, beliefs, and recommendations of stakeholders involved in obesity management. These stakeholders included researchers, practitioners, educators, and patients. We used qualitative action research methods, including convergent interviewing and observation, to assist the process of inquiry. The consensus was that a multicomponent and multidisciplinary approach should be based on four central meta-components (patient, practitioner, process, and environmental factors), and specific components of these factors were identified. Psychologists, dieticians, exercise physiologists and general practitioners were nominated as key practitioners to be included. A complex condition like obesity requires that multiple components be addressed, and that both patients and multiple disciplines are involved in developing solutions. Implementing cycles of continuous improvement to deal with complexity, instead of trying to control for it, offers an effective way to deal with complex, changing multisystem problems like obesity.

  10. Financial remuneration for clinical and behavioral research participation: ethical and practical considerations.

    PubMed

    Permuth-Wey, Jennifer; Borenstein, Amy R

    2009-04-01

    Although the practice of providing payment to clinical research participants has been ongoing for more than a century, it remains an ethically controversial topic among members of the research community. The aims of this commentary are to summarize ethical and practical considerations regarding financial remuneration of research participants and to make recommendations for researchers contemplating this practice. A PubMed search was conducted to explore the ethical implications surrounding financial remuneration and review the body of empiric data on this topic. Financial remuneration is perceived to be ethically acceptable by many researchers and research participants and can be helpful in the recruitment process. It is recommended that when investigators are contemplating whether to offer payment to research participants, they should consider the nature of the study and the potential benefits and risks to the participants, institutional or organizational guidelines, and cultural and societal norms specific to the population being studied. Financial remuneration has the ability to serve as a sign of appreciation for the contributions of research participants and a way to facilitate clinical and behavioral research.

  11. Stakeholders' Recommendations to Improve Patient-centered "LGBTQ" Primary Care in Rural and Multicultural Practices.

    PubMed

    Kano, Miria; Silva-Bañuelos, Alma Rosa; Sturm, Robert; Willging, Cathleen E

    2016-01-01

    Individuals among gender/sexual minorities share experiences of stigma and discrimination, yet have distinctive health care needs influenced by ethnic/racial minority and rural realities. We collected qualitative data from lesbian/gay/bisexual/transgender (LGBT) and queer persons across the largely rural, multicultural state of New Mexico, particularly those from understudied ethnic groups, regarding factors facilitating or impeding patient-centered primary care. The themes identified formed the basis for a statewide summit on LGBT health care guidelines and strategies for decreasing treatment gaps. Three to 15 individuals, ages 18 to 75 years, volunteered for 1 of 4 town hall dialogues (n = 32), and 175 people took part in the summit. Participants acknowledged health care gaps pertinent to LGBT youth, elders, American Indians, and Latinos/Latinas, expressing specific concern for rural residents. This preliminary research emphasizes the need to improve primary care practices that treat rural and ethnic-minority LGBT people and offers patient-driven recommendations to enhance care delivery while clinic-level transformations are implemented. © Copyright 2016 by the American Board of Family Medicine.

  12. Preparing strategic information management plans for hospitals: a practical guideline SIM plans for hospitals: a guideline.

    PubMed

    Brigl, B; Ammenwerth, E; Dujat, C; Gräber, S; Grosse, A; Häber, A; Jostes, C; Winter, A

    2005-01-01

    Systematic information management in hospitals demands for a strategic information management plan (SIM plan). As preparing a SIM plan is a considerable challenge we provide a practical guideline that is directly applicable when a SIM plan is going to be prepared. The guideline recommends a detailed structure of a SIM plan and gives advice about its content and the preparation process. It may be used as template, which can be adapted to the individual demands of any hospital. The guideline was used in several hospitals preparing a SIM plan. Experiences showed that the SIM plans could be prepared very efficiently and timely using the guideline, that the proposed SIM plan structure suited well, that the guideline offers enough flexibility to meet the requirements of the individual hospitals and that the specific recommendations of the guideline were very helpful. Nevertheless, we must strive for a more comprehensive theory of strategic information management planning which -- in the sense of enterprise architecture planning -- represents the intrinsic correlations of the different parts of a SIM plan to a greater extent.

  13. Responsive Feeding: Implications for Policy and Program Implementation12

    PubMed Central

    Engle, Patrice L.; Pelto, Gretel H.

    2011-01-01

    In this article, we examine responsive feeding as a nutrition intervention, with an emphasis on the development and incorporation of responsive feeding into policies and programs over the last 2 decades and recommendations for increasing the effectiveness of responsive feeding interventions. A review of policy documents from international agencies and high-income countries reveals that responsive feeding has been incorporated into nutrition policies. Official guidelines from international agencies, nongovernmental organizations, and professional organizations often include best practice recommendations for responsive feeding. Four potential explanations are offered for the rapid development of policies related to responsive feeding that have occurred despite the relatively recent recognition that responsive feeding plays a critical role in child nutrition and growth and the paucity of effectiveness trials to determine strategies to promote responsive feeding. Looking to the future, 3 issues related to program implementation are highlighted: 1) improving intervention specificity relative to responsive feeding; 2) developing protocols that facilitate efficient adaptation of generic guidelines to national contexts and local conditions; and 3) development of program support materials, including training, monitoring, and operational evaluation. PMID:21270361

  14. Psycho-educational strategies to promote fluid adherence in adult hemodialysis patients: a review of intervention studies.

    PubMed

    Welch, Janet L; Thomas-Hawkins, Charlotte

    2005-07-01

    We reviewed psycho-educational intervention studies that were designed to reduce interdialytic weight gain (IDWG) in adult hemodialysis patients. Our goals were to critique research methods, describe the effectiveness of tested interventions, and make recommendations for future research. Medline, PsychInfo, and the Cumulative Index to Nursing and Applied Health (CINAHL) databases were searched to identify empirical work. Each study was evaluated in terms of sample, design, theoretical framework, intervention delivery, and outcome. Nine studies were reviewed. Self-monitoring appears to be a promising strategy to be considered to reduce IDWG. Theory was not usually used to guide interventions, designs generally had control groups, interventions were delivered individually, more than one intervention was delivered at a time, the duration of the intervention varied greatly, there was no long-term follow-up, IDWG was the only outcome, and IDWG was operationalized in different ways. Theoretical models and methodological rigor are needed to guide future research. Specific recommendations on design, measurement, and conceptual issues are offered to enhance the effectiveness of future research.

  15. Professional e-mail communication among health care providers: proposing evidence-based guidelines.

    PubMed

    Malka, S Terez; Kessler, Chad S; Abraham, John; Emmet, Thomas W; Wilbur, Lee

    2015-01-01

    E-mail is now a primary method of correspondence in health care, and proficiency with professional e-mail use is a vital skill for physicians. Fundamentals of e-mail courtesy can be derived from lay literature, but there is a dearth of scientific literature that addresses the use of e-mail between physicians. E-mail communication between providers is generally more familiar and casual than other professional interactions, which can promote unprofessional behavior or misunderstanding. Not only e-mail content but also wording, format, and tone may influence clinical recommendations and perceptions of the e-mail sender. In addition, there are serious legal and ethical implications when unprofessional or unsecured e-mails related to patient-identifying information are exchanged or included within an electronic medical record. The authors believe that the appropriate use of e-mail is a vital skill for physicians, with serious legal and ethical ramifications and the potential to affect professional development and patient care. In this article, the authors analyze a comprehensive literature search, explore several facets of e-mail use between physicians, and offer specific recommendations for professional e-mail use.

  16. College health professionals and academic librarians: collaboration for student health.

    PubMed

    Hallyburton, Ann; Kolenbrander, Nancy; Robertson, Carolyn

    2008-01-01

    College health professionals must find new ways of educating students on finding and evaluating consumer health information, specifically in the online environment. Librarians are trained as information professionals; however, librarians at general academic libraries are not taking a lead role in providing consumer health information. The authors' purpose in this research was to determine the health information resource needs of college and university students and provide a model for collaboration between college health professionals and academic librarians. The authors compared data from a national survey on college health (N = 54,111) with their own results from a survey of general academic librarians (N = 17) to create recommendations for synching students' reported health information needs with librarians' resources. Although the Internet was students' second most-often consulted health information source, they ranked the believability of online health information above only television. In the librarian survey, although 12 respondents indicated that health information provision is a library's responsibility, the majority (n = 11) believed their library's consumer health outreach to be passive. The authors offer recommendations for partnerships between college healthcare professionals and academic librarians to better provide this information to students.

  17. Development and validation of a paediatric long-bone fracture classification. A prospective multicentre study in 13 European paediatric trauma centres

    PubMed Central

    2011-01-01

    Background The aim of this study was to develop a child-specific classification system for long bone fractures and to examine its reliability and validity on the basis of a prospective multicentre study. Methods Using the sequentially developed classification system, three samples of between 30 and 185 paediatric limb fractures from a pool of 2308 fractures documented in two multicenter studies were analysed in a blinded fashion by eight orthopaedic surgeons, on a total of 5 occasions. Intra- and interobserver reliability and accuracy were calculated. Results The reliability improved with successive simplification of the classification. The final version resulted in an overall interobserver agreement of κ = 0.71 with no significant difference between experienced and less experienced raters. Conclusions In conclusion, the evaluation of the newly proposed classification system resulted in a reliable and routinely applicable system, for which training in its proper use may further improve the reliability. It can be recommended as a useful tool for clinical practice and offers the option for developing treatment recommendations and outcome predictions in the future. PMID:21548939

  18. 78 FR 20925 - Draft and Revised Draft Guidances for Industry Describing Product-Specific Bioequivalence...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-08

    ... Recommendations; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and...-specific bioequivalence (BE) recommendations. The recommendations provide product-specific guidance on the design of BE studies to support abbreviated new drug applications (ANDAs). In the Federal Register of...

  19. 77 FR 35688 - Draft and Revised Draft Guidances for Industry Describing Product-Specific Bioequivalence...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-14

    ... Recommendations; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and...-specific bioequivalence (BE) recommendations. The recommendations provide product-specific guidance on the design of BE studies to support abbreviated new drug applications (ANDAs). In the Federal Register of...

  20. 77 FR 16842 - Draft and Revised Draft Guidances for Industry Describing Product-Specific Bioequivalence...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-22

    ... Recommendations; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and...-specific bioequivalence (BE) recommendations. The recommendations provide product-specific guidance on the design of BE studies to support abbreviated new drug applications (ANDAs). In the Federal Register of...

  1. The state of the art in evaluating the performance of assistant and associate deans as seen by deans and assistant and associate deans.

    PubMed

    Dunning, David G; Durham, Timothy M; Aksu, Mert N; Lange, Brian M

    2008-04-01

    This study explores the little-understood process of evaluating the performance of assistant and associate deans at dental colleges in the United States and Canada. Specifically, this research aimed to identify the methods, processes, and outcomes related to the performance appraisals of assistant/associate deans. Both deans and assistant/associate deans were surveyed. Forty-four of sixty-six deans (66.7 percent) and 227 of 315 assistant/associate deans (72.1 percent) completed surveys with both close-ended and open-ended questions. In addition, ten individuals from each group were interviewed. Results indicate that 75-89 percent of assistant/associate deans are formally evaluated, although as many as 27 percent may lack formal job descriptions. Some recommended best practices for performance appraisal are being used in a majority of colleges. Examples of these best practices are having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for assistant/associate deans. Still, there is much room to improve appraisals by incorporating other recommended practices. Relatively high levels of overall satisfaction were reported by both assistant/associate deans and deans for the process and outcomes of appraisals. Assistant/associate deans rated the value of appraisals to overall development lower than did deans. Qualitative data revealed definite opinions about what constitutes effective and ineffective appraisals, including the use of goal-setting, timeliness, and necessary commitment. Several critical issues related to the results are discussed: differences in perspectives on performance reviews, the importance of informal feedback and job descriptions, the influence of an assistant/associate deans' lack of tenure, and the length of service of deans. Lastly, recommendations for enhancing performance evaluations are offered.

  2. Process evaluation of the Regional Biomass Energy Program

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

    Wilson, C.R.; Brown, M.A.; Perlack, R.D.

    1994-03-01

    The U.S. Department of Energy (DOE) established the Regional Biomass Energy Program (RBEP) in 1983 to increase the production and use of biomass energy resources. Through the creation of five regional program (the Great Lakes, Northeast, Pacific Northwest, Southeast, and West), the RBEP focuses on regionally specific needs and opportunities. In 1992, Oak Ridge National (ORNL) conducted a process evaluation of the RBEP Program designed to document and explain the development of the goals and strategies of the five regional programs; describe the economic and market context surrounding commercialization of bioenergy systems; assess the criteria used to select projects; describemore » experiences with cost sharing; identify program accomplishments in the transfer of information and technology; and offer recommendations for program improvement.« less

  3. Gender and care: access to HIV testing, care, and treatment.

    PubMed

    Remien, Robert H; Chowdhury, Jenifar; Mokhbat, Jacques E; Soliman, Cherif; Adawy, Maha El; El-Sadr, Wafaa

    2009-07-01

    HIV transmission and occurrence of AIDS in the Middle East and North Africa region (MENA) is increasing, while access to ART in the region lags behind most low to middle-income countries. Like in other parts of the world, there is a growing feminization of the epidemic, and men and women each confront unique barriers to adequate HIV prevention and treatment services, while sharing some common obstacles as well. This paper focuses on important gender dimensions of access to HIV testing, care and treatment in the MENA region, including issues related to stigma, religion and morality, gender power imbalances, work status, and migration. Culturally specific policy and programmatic recommendations for improving HIV prevention and treatment in the MENA region are offered.

  4. The ethical commitments of academic faculty in psychiatric education.

    PubMed

    Green, Stephen A

    2006-01-01

    This article explores the commitment of faculty to ethics training in psychiatric education. Although psychiatry has insufficiently addressed the profession's need for ethics training in education, program directors acknowledge its critical importance, and its positive impact has been demonstrated. Additionally, residents often seek ethics training as part of their instruction. The author suggests that academic faculty could respond to the profession's inadequate treatment of ethics training by helping trainees develop moral agency--the ability to recognize, assess, and respond to ethical dilemmas; decide what constitutes right or wrong care; and act accordingly. The author also describes how this objective could be met by promoting professionalism and offering didactic instruction that address substantive and process issues regarding psychiatric care. Specific recommendations are provided.

  5. EMPOWER--pathways for supporting the self-management of diabetes patients.

    PubMed

    Plößnig, Manuela; Kabak, Yildiray; Lamprinos, Ilias; Pabst, Alexander; Hildebrand, Claudia; Mantwill, Sarah

    2015-01-01

    Diabetes is a serious world-wide medical challenge and there is a recognised need for improved diabetes care outcomes. This paper describes results of the EMPOWER project, to foster the self-management of diabetes patients by integration of existing and new services offered to patients after having been diagnosed with diabetes. The Self-Management Pathway described in this paper helps patients in the specification of personalized activities based on medical recommendations and personal goals, as well as self-monitoring of the results. The whole process is supported by innovative ICT services that motivate patients to change their lifestyle and adhere to defined medication and activity plans. We describe the approach and present the findings of the validation phase in Germany and Turkey.

  6. Illustrative case studies in the return of exome and genome sequencing results

    PubMed Central

    Amendola, Laura M; Lautenbach, Denise; Scollon, Sarah; Bernhardt, Barbara; Biswas, Sawona; East, Kelly; Everett, Jessica; Gilmore, Marian J; Himes, Patricia; Raymond, Victoria M; Wynn, Julia; Hart, Ragan; Jarvik, Gail P

    2015-01-01

    Whole genome and exome sequencing tests are increasingly being ordered in clinical practice, creating a need for research exploring the return of results from these tests. A goal of the Clinical Sequencing and Exploratory Research (CSER) consortium is to gain experience with this process to develop best practice recommendations for offering exome and genome testing and returning results. Genetic counselors in the CSER consortium have an integral role in the return of results from these genomic sequencing tests and have gained valuable insight. We present seven emerging themes related to return of exome and genome sequencing results accompanied by case descriptions illustrating important lessons learned, counseling challenges specific to these tests and considerations for future research and practice. PMID:26478737

  7. [Effective Presentations in Medicine. The Art of Communication and Transmission: Ten Recommendations].

    PubMed

    Morales, Álvaro J Ruiz

    2012-01-01

    To communicate effectively during a lecture or presentation it is necessary to follow simple rules, including the preparation of the conference with the audience in mind and with the definition of a specific message to leave the audience. The public's attention should be quickly captured and all subsequent actions should aim to keep it. The text must be accurate and sizes easily visible, the slides should provide good contrast with solid and simple backgrounds and should avoid excessive animations. At the close of the conference, the conclusions and question session offers the invaluable opportunity to reinforce the desired message. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  8. Building Employer Capacity to Support Meaningful Employment for Persons with Developmental Disabilities: A Grounded Theory Study of Employment Support Perspectives.

    PubMed

    Rashid, Marghalara; Hodgetts, Sandra; Nicholas, David

    2017-11-01

    To explore strategies to build employer capacity to support people with DD in meaningful employment from perspective of employment support workers. A grounded theory study was conducted with 34 employment support individuals. A theoretical sampling approach was used to identify and recruit participants from multiple sites in Ontario and Alberta. Three main themes, with seven sub-themes, emerged: (1) experiences of supporting employment finding for people with DD, (2) institutional influences on employee experiences, and (3) attitudes, assumptions and stigma. Several recommendations related to building employer capacity were offered. Our findings provide insight on specific elements and strategies that can support building employer capacity for persons with DD.

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

    PubMed

    Anderson, Lori S; Enge, Karmin J

    2012-10-01

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

  10. Theological reflections on violence and abuse.

    PubMed

    Nienhuis, Nancy Eileen

    2005-01-01

    This article examines the contemporary problem of intimate violence and sexual assault within a larger theoretical and theological context. It does so by tracing two trajectories in theological thinking: first, that suffering is sent from God and requires obedience; and, second, that the roles of men and women are not only specific and hierarchical but must remain so lest society risk moral chaos. It argues that many messages from traditional Christian theology continue to haunt abused women in such a way as to at times facilitate domestic violence. It offers suggestions for transforming common theological interpretations in ways that are empowering for battered women. These recommendations include attempts to emphasize resources within a tradition that may help transform unjust power relations like those in abusive relationships.

  11. 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

  12. 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.

  13. Management of chronic spontaneous urticaria in routine clinical practice: A Delphi-method questionnaire among specialists to test agreement with current European guidelines statements.

    PubMed

    Giménez-Arnau, A; Ferrer, M; Bartra, J; Jáuregui, I; Labrador-Horrillo, M; Frutos, J Ortiz de; Silvestre, J F; Sastre, J; Velasco, M; Valero, A

    Chronic spontaneous urticaria (CSU) is a frequent clinical entity that often presents a diagnostic and therapeutic challenge. To explore the degree of agreement that exists among the experts caring for patients with CSU diagnosis, evaluation, and management. An online survey was conducted to explore the opinions of experts in CSU, address controversial issues, and provide recommendations regarding its definition, natural history, diagnosis, and treatment. A modified Delphi method was used for the consensus. The questionnaire was answered by 68 experts (dermatologists, allergologists, and primary care physicians). A consensus was reached on 54 of the 65 items posed (96.4%). The experts concluded that CSU is a difficult-to-control disease of unpredictable evolution. Diagnostic tests should be limited and based on clinical history and should not be indiscriminate. Autoinflammatory syndromes and urticarial vasculitis must be ruled out in the differential diagnosis. A cutaneous biopsy is only recommended when wheals last more than 24h, to rule out urticarial vasculitis. The use of specific scales to assess the severity of the disease and the quality of life is recommended. In patients with severe and resistant CSU, second-generation H1-antihistamines could be used at doses up to four times the standard dose before giving second-line treatments. Omalizumab is a safe and effective treatment for CSU that is refractory to H1-antihistamines treatment. In general, diagnosis and treatment recommendations given for adults could be extrapolated to children. This work offers consensus recommendations that may be useful in the management of CSU. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  14. Characterization of Vaccination Policies for Attendance and Employment at Day/Summer Camps in New York State.

    PubMed

    Prescott, William A; Violanti, Kelsey C; Fusco, Nicholas M

    2018-01-01

    New York state requires day/summer camps to keep immunization records for all enrolled campers and strongly recommends requiring vaccination for all campers and staff. The objective of this study was to characterize immunization requirements/recommendations for children/adolescents enrolled in and staff employed at day/summer camps in New York state. An electronic hyperlink to a 9-question survey instrument was distributed via e-mail to 178 day/summer camps located in New York state cities with a population size greater than 100 000 people. A follow-up telephone survey was offered to nonresponders. The survey instrument included questions pertaining to vaccination documentation policies for campers/staff and the specific vaccines that the camp required/recommended. Fisher's exact and Chi-square tests were used to analyze categorical data. Sixty-five day/summer camps responded to the survey (36.5% response rate): 48 (73.8%) and 23 (41.8%) camps indicated having a policy/procedure for documenting vaccinations for campers and staff, respectively. Camps that had a policy/procedure for campers were more likely to have a policy/procedure for staff ( P = .0007). Age-appropriate vaccinations that were required/recommended for campers by at least 80% of camps included: measles, mumps, and rubella (MMR), diphtheria, tetanus, and pertussis (DTaP), hepatitis B, inactivated/oral poliovirus (IPV/OPV), Haemophilus influenzae type b (Hib), and varicella. Age-appropriate vaccinations that were required/recommended for staff by at least 80% of camps included: DTaP, hepatitis B, IPV/OPV, MMR, meningococcus, varicella, Hib, and tetanus, diphtheria, and pertussis (Tdap). Vaccination policies at day/summer camps in New York state appear to be suboptimal. Educational outreach may encourage camps to strengthen their immunization policies, which may reduce the transmission of vaccine-preventable diseases.

  15. From Guide to Practice: Improving Your After School Science Program to Increase Student Academic Achievement

    NASA Astrophysics Data System (ADS)

    Taylor, J.

    2013-12-01

    Numerous science organizations, such as NASA, offer educational outreach activities geared towards after school. For some programs, the primary goal is to grow students' love of science. For others, the programs are also intended to increase academic achievement. For those programs looking to support student learning in out-of-school time environments, aligning the program with learning during the classroom day can be a challenge. The Institute for Education Sciences, What Works Clearinghouse, put together a 'Practice Guide' for maximizing learning time beyond the regular school day. These practice guides provide concrete recommendations for educators supported by research. While this guide is not specific to any content or subject-area, the recommendations provided align very well with science education. After school science is often viewed as a fun, dynamic environment for students. Indeed, one of the recommendations to ensure time is structured according to students' needs is to provide relevant and interesting experiences. Given that our after school programs provide such creative environments for students, what other components are needed to promote increased academic achievement? The recommendations provided to academic achievement, include: 1. Align Instruction, 2. Maximize Attendance and Participation, 3. Adapt Instruction, 4. Provide Engaging Experiences, and 5. Evaluate Program. In this session we will examine these five recommendations presented in the Practice Guide, discuss how these strategies align with science programs, and examine what questions each program should address in order to provide experiences that lend themselves to maximizing instruction. Roadblocks and solutions for overcoming challenges in each of the five areas will be presented. Jessica Taylor will present this research based on her role as an author on the Practice Guide, 'Improving Academic Achievement in Out-of-School Time' and her experience working in various informal science programs for NASA.

  16. Analysing the consumer behaviour and the influence of brand loyalty in purchasing sportswear products

    NASA Astrophysics Data System (ADS)

    Erdumlu, N.; Saricam, C.; Tufekyapan, M.; Cetinkaya, M.; Donmez, AC

    2017-10-01

    Brand loyalty is an important term that defines the relationship between customer and it is important for the retailers to have a large loyal customer base. Specifically, sportswear products seem to be one of the most convenient apparel product categories to develop loyalty for the consumers. In this study, it was aimed to analyse the profile of sportswear consumers and their loyalty towards the leading sportswear retailers in Turkey. For this aim, a survey was conducted among 190 participants aged between 18 and 40, and the socio-demographic characteristics of the consumers were explored. The results revealed that more than half of the participants (54.74%) identified themselves as loyal customers in terms of sportswear products. The loyal consumers stated that they would continue to buy from these brands in the future and recommend to others. Expressing the reason for loyalty, the majority of the participant related their loyalty to the satisfying products offered by this brand. However, the participants seem likely to switch to the other brands if the other brands offer attractive promotions.

  17. Evidence-informed recommendations for rehabilitation with older adults living with HIV: a knowledge synthesis

    PubMed Central

    O'Brien, Kelly K; Solomon, Patricia; Trentham, Barry; MacLachlan, Duncan; MacDermid, Joy; Tynan, Anne-Marie; Baxter, Larry; Casey, Alan; Chegwidden, William; Robinson, Greg; Tran, Todd; Wu, Janet; Zack, Elisse

    2014-01-01

    Objective Our aim was to develop evidence-informed recommendations for rehabilitation with older adults living with HIV. Design We conducted a knowledge synthesis, combining research evidence specific to HIV, rehabilitation and ageing, with evidence on rehabilitation interventions for common comorbidities experienced by older adults with HIV. Methods We included highly relevant HIV-specific research addressing rehabilitation and ageing (stream A) and high-quality evidence on the effectiveness of rehabilitation interventions for common comorbidities experienced by older adults ageing with HIV (stream B). We extracted and synthesised relevant data from the evidence to draft evidence-informed recommendations for rehabilitation. Draft recommendations were refined based on people living with HIV (PLHIV) and clinician experience, values and preferences, reviewed by an interprofessional team for Grading of Recommendations Assessment, Development, and Evaluation (GRADE) (quality) rating and revision and then circulated to PLHIV and clinicians for external endorsement and final refinement. We then devised overarching recommendations to broadly guide rehabilitation with older adults living with HIV. Results This synthesis yielded 8 overarching and 52 specific recommendations. Thirty-six specific recommendations were derived from 108 moderate-level or high-level research articles (meta-analyses and systematic reviews) that described the effectiveness of rehabilitation interventions for comorbidities that may be experienced by older adults with HIV. Recommendations addressed rehabilitation interventions across eight health conditions: bone and joint disorders, cancer, stroke, cardiovascular disease, mental health challenges, cognitive impairments, chronic obstructive pulmonary disease and diabetes. Sixteen specific recommendations were derived from 42 research articles specific to rehabilitation with older adults with HIV. The quality of evidence from which these recommendations were derived was either low or very low, consisting primarily of narrative reviews or descriptive studies with small sample sizes. Recommendations addressed approaches to rehabilitation assessment and interventions, and contextual factors to consider for rehabilitation with older adults living with HIV. Conclusions These evidence-informed recommendations provide a guide for rehabilitation with older adults living with HIV. PMID:24833687

  18. 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.

  19. Applying the Social Ecological Model and Theory of Self-Efficacy in the Worksite Heart Health Improvement Project-PLUS.

    PubMed

    Doran, Kelly; Resnick, Barbara; Kim, Natalie; Lynn, Donna; McCormick, Tyrell

    2017-02-01

    Long-term care (LTC) employees are at high risk for cardiovascular disease. Despite the documented benefits of worksite health promotion (WHP) programs for employees and employers and the potential benefits to residents in LTC facilities, LTC employees are rarely offered WHP programs. The purpose of the intervention described in this article is to reduce cardiovascular disease risk factors among LTC workers using a physical activity, nutrition, and stress management WHP implemented during paid work time with 98 LTC staff members. This article describes a 9-month physical activity, nutrition, and stress management WHP intervention delivered during paid work time to reduce the cardiovascular disease risk of employees working in LTC. The intervention is rooted in the social ecological model and social cognitive theory. The intervention is based on formative research and evidence-based practice recommendations and is specifically designed to reduce barriers to intervention participation (e.g., inconsistent break times and unpredictable resident care needs) and enhance motivators to program participation (e.g., enhanced social support). The intervention is ongoing, but measures are described. As more employers offer WHP programs, it is important that programs are tailored to meet specific employee groups and work environments. This article operationalizes a WHP research protocol with LTC employees that can be applied to reduce cardiovascular disease risk in LTC employees or similar employee groups in similar work environments.

  20. Pathways into homelessness among post-9/11-era veterans.

    PubMed

    Metraux, Stephen; Cusack, Meagan; Byrne, Thomas H; Hunt-Johnson, Nora; True, Gala

    2017-05-01

    Despite the scale of veteran homelessness and government-community initiatives to end homelessness among veterans, few studies have featured individual veteran accounts of experiencing homelessness. Here we track veterans' trajectories from military service to homelessness through qualitative, semistructured interviews with 17 post-9/11-era veterans. Our objective was to examine how veterans become homeless-including the role of military and postmilitary experiences-and how they negotiate and attempt to resolve episodes of homelessness. We identify and report results in 5 key thematic areas: transitioning from military service to civilian life, relationships and employment, mental and behavioral health, lifetime poverty and adverse events, and use of veteran-specific services. We found that veterans predominantly see their homelessness as rooted in nonmilitary, situational factors such as unemployment and the breakup of relationships, despite very tangible ties between homelessness and combat sequelae that manifest themselves in clinical diagnoses such as posttraumatic stress disorder. Furthermore, although assistance provided by the U.S. Department of Veterans Affairs (VA) and community-based organizations offer a powerful means for getting veterans rehoused, veterans also recount numerous difficulties in accessing and obtaining VA services and assistance. Based on this, we offer specific recommendations for more systematic and efficient measures to help engage veterans with VA services that can prevent or attenuate their homelessness. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. 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.

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 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…

  8. Recruitment of minority students to U.S. epidemiology degree programs. The American College of Epidemiology Committee on Minority Affairs.

    PubMed

    St George, D M; Schoenbach, V J; Reynolds, G H; Nwangwu, J; Adams-Campbell, L

    1997-05-01

    African-, Hispanic-, and Native Americans are underrepresented in the field of epidemiology including degree programs. As part of the assessment component of its mandate, the American College of Epidemiology Committee on Minority Affairs conducted a survey of minority recruitment activities of U.S. epidemiology degree programs. The survey, containing questions related to marketing activities, institution infrastructure, financial support, academic offerings, and receptive/supportive environment, was mailed to all programs identified in Episource as offering epidemiology degrees. Separate responses were requested concerning activities at the department and school levels. Fifty-two completed questionnaires were received (response rate of 79%). All but two institutions had at least one activity conducted by either the department or the school. However, all activities were more common at the school- than at the department-level. Indeed, some activities [a written minority student recruitment plan (6% of departments and 52% of schools), personnel with minority recruitment responsibilities (4% of departments and 73% of schools)] were almost exclusively school-sponsored. Although marketing-type activities were the most common minority recruitment tool used by departments, only 21% made visits to minority schools, 17% visited other colleges specifically to recruit minorities, and 12% produced materials targeted to ethnic/racial minorities. Six percent of the departments and 19% of the schools offered financial support (grants, fellowships, scholarships) to almost all underrepresented minority students. Even though individual epidemiology degree programs may not see a need for general recruitment activities in order to maintain the size of their applicant pool, minority-specific recruitment activities should be undertaken to enhance and diversify that pool. We recommend that epidemiology departments develop, adopt, and implement comprehensive written plans for the recruitment of underrepresented minority students into their programs.

  9. Using simulation to study difficult clinical issues: prenatal counseling at the threshold of viability across American and Dutch cultures.

    PubMed

    Geurtzen, Rosa; Hogeveen, Marije; Rajani, Anand K; Chitkara, Ritu; Antonius, Timothy; van Heijst, Arno; Draaisma, Jos; Halamek, Louis P

    2014-06-01

    Prenatal counseling at the threshold of viability is a challenging yet critically important activity, and care guidelines differ across cultures. Studying how this task is performed in the actual clinical environment is extremely difficult. In this pilot study, we used simulation as a methodology with 2 aims as follows: first, to explore the use of simulation incorporating a standardized pregnant patient as an investigative methodology and, second, to determine similarities and differences in content and style of prenatal counseling between American and Dutch neonatologists. We compared counseling practice between 11 American and 11 Dutch neonatologists, using a simulation-based investigative methodology. All subjects performed prenatal counseling with a simulated pregnant patient carrying a fetus at the limits of viability. The following elements of scenario design were standardized across all scenarios: layout of the physical environment, details of the maternal and fetal histories, questions and responses of the standardized pregnant patient, and the time allowed for consultation. American subjects typically presented several treatment options without bias, whereas Dutch subjects were more likely to explicitly advise a specific course of treatment (emphasis on partial life support). American subjects offered comfort care more frequently than the Dutch subjects and also discussed options for maximal life support more often than their Dutch colleagues. Simulation is a useful research methodology for studying activities difficult to assess in the actual clinical environment such as prenatal counseling at the limits of viability. Dutch subjects were more directive in their approach than their American counterparts, offering fewer options for care and advocating for less invasive interventions. American subjects were more likely to offer a wider range of therapeutic options without providing a recommendation for any specific option.

  10. 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.

  11. Recommendation Method for Build-to-Order Products Considering Substitutability of Specifications and Stock Consumption Balance of Components

    NASA Astrophysics Data System (ADS)

    Shimoda, Atsushi; Kosugi, Hidenori; Karino, Takafumi; Komoda, Norihisa

    This study focuses on a stock reduction method for build-to-order (BTO) products to flow surplus parts out to the market using sale by recommendation. A sale by recommendation is repeated in an each business negotiation using a recommended configuration selected from the inventory of parts to minimize the stock deficiency or excess at the end of a certain period of the production plan. The method is based on the potential of a customer specification to be replaced by an alternative one if the alternative one is close to the initial customer specification. A recommendation method is proposed that decides the recommended product configuration by balancing the part consumption so that the alternative specification of the configuration is close enough to the initial customer specification for substitutability. The method was evaluated by a simulation using real BTO manufacturing data and the result demonstrates that the unbalance of the consumption of parts inventory is improved.

  12. Guidelines on Diabetic Eye Care: The International Council of Ophthalmology Recommendations for Screening, Follow-up, Referral, and Treatment Based on Resource Settings.

    PubMed

    Wong, Tien Y; Sun, Jennifer; Kawasaki, Ryo; Ruamviboonsuk, Paisan; Gupta, Neeru; Lansingh, Van Charles; Maia, Mauricio; Mathenge, Wanjiku; Moreker, Sunil; Muqit, Mahi M K; Resnikoff, Serge; Verdaguer, Juan; Zhao, Peiquan; Ferris, Frederick; Aiello, Lloyd P; Taylor, Hugh R

    2018-05-24

    Diabetes mellitus (DM) is a global epidemic and affects populations in both developing and developed countries, with differing health care and resource levels. Diabetic retinopathy (DR) is a major complication of DM and a leading cause of vision loss in working middle-aged adults. Vision loss from DR can be prevented with broad-level public health strategies, but these need to be tailored to a country's and population's resource setting. Designing DR screening programs, with appropriate and timely referral to facilities with trained eye care professionals, and using cost-effective treatment for vision-threatening levels of DR can prevent vision loss. The International Council of Ophthalmology Guidelines for Diabetic Eye Care 2017 summarize and offer a comprehensive guide for DR screening, referral and follow-up schedules for DR, and appropriate management of vision-threatening DR, including diabetic macular edema (DME) and proliferative DR, for countries with high- and low- or intermediate-resource settings. The guidelines include updated evidence on screening and referral criteria, the minimum requirements for a screening vision and retinal examination, follow-up care, and management of DR and DME, including laser photocoagulation and appropriate use of intravitreal anti-vascular endothelial growth factor inhibitors and, in specific situations, intravitreal corticosteroids. Recommendations for management of DR in patients during pregnancy and with concomitant cataract also are included. The guidelines offer suggestions for monitoring outcomes and indicators of success at a population level. Copyright © 2018 American Academy of Ophthalmology. All rights reserved.

  13. Immunization Strategies Targeting Newly Arrived Migrants in Non-EU Countries of the Mediterranean Basin and Black Sea

    PubMed Central

    Giambi, Cristina; Del Manso, Martina; Dente, Maria Grazia; Napoli, Christian; Montaño-Remacha, Carmen; Riccardo, Flavia; Declich, Silvia

    2017-01-01

    Background: The World Health Organization recommends that host countries ensure appropriate vaccinations to refugees, asylum seekers and migrants. However, information on vaccination strategies targeting migrants in host countries is limited. Methods: In 2015–2016 we carried out a survey among national experts from governmental bodies of 15 non-EU countries of the Mediterranean and Black Sea in order to document and share national vaccination strategies targeting newly arrived migrants. Results: Four countries reported having regulations/procedures supporting the immunization of migrants at national level, one at sub-national level and three only targeting specific population groups. Eight countries offer migrant children all the vaccinations included in their national immunization schedule; three provide only selected vaccinations, mainly measles and polio vaccines. Ten and eight countries also offer selected vaccinations to adolescents and adults respectively. Eight countries provide vaccinations at the community level; seven give priority vaccines in holding centres or at entry sites. Data on administered vaccines are recorded in immunization registries in nine countries. Conclusions: Although differing among countries, indications for immunizing migrants are in place in most of them. However, we cannot infer from our findings whether those strategies are currently functioning and whether barriers to their implementation are being faced. Further studies focusing on these aspects are needed to develop concrete and targeted recommendations for action. Since migrants are moving across countries, development of on-line registries and cooperation between countries could allow keeping track of administered vaccines in order to appropriately plan immunization series and avoid unnecessary vaccinations. PMID:28441361

  14. Immunization Strategies Targeting Newly Arrived Migrants in Non-EU Countries of the Mediterranean Basin and Black Sea.

    PubMed

    Giambi, Cristina; Del Manso, Martina; Dente, Maria Grazia; Napoli, Christian; Montaño-Remacha, Carmen; Riccardo, Flavia; Declich, Silvia; Network For The Control Of Cross-Border Health Threats In The Mediterranean Basin And Black Sea For The ProVacMed Project

    2017-04-25

    Background : The World Health Organization recommends that host countries ensure appropriate vaccinations to refugees, asylum seekers and migrants. However, information on vaccination strategies targeting migrants in host countries is limited. Methods : In 2015-2016 we carried out a survey among national experts from governmental bodies of 15 non-EU countries of the Mediterranean and Black Sea in order to document and share national vaccination strategies targeting newly arrived migrants. Results : Four countries reported having regulations/procedures supporting the immunization of migrants at national level, one at sub-national level and three only targeting specific population groups. Eight countries offer migrant children all the vaccinations included in their national immunization schedule; three provide only selected vaccinations, mainly measles and polio vaccines. Ten and eight countries also offer selected vaccinations to adolescents and adults respectively. Eight countries provide vaccinations at the community level; seven give priority vaccines in holding centres or at entry sites. Data on administered vaccines are recorded in immunization registries in nine countries. Conclusions : Although differing among countries, indications for immunizing migrants are in place in most of them. However, we cannot infer from our findings whether those strategies are currently functioning and whether barriers to their implementation are being faced. Further studies focusing on these aspects are needed to develop concrete and targeted recommendations for action. Since migrants are moving across countries, development of on-line registries and cooperation between countries could allow keeping track of administered vaccines in order to appropriately plan immunization series and avoid unnecessary vaccinations.

  15. An evaluation of physical activity training in Australian medical school curricula.

    PubMed

    Strong, Abigail; Stoutenberg, Mark; Hobson-Powell, Anita; Hargreaves, Mark; Beeler, Halle; Stamatakis, Emmanuel

    2017-06-01

    To evaluate the current level of physical activity (PA) training provided to Australian medical students. Individual interviews were completed via phone interview or online survey from June-October 2015. Program leaders from Australian medical schools, who were knowledgeable about their curriculum content, were invited to participate in the study. The number of programs, hours of PA training instruction, institutional attitude towards offering PA, barriers experienced, and content areas in which PA training was offered, were explored. Seventeen of the 19 (89%) Australian medical schools participated in the study. Among the responding schools, 15 (88.2%) reported providing specific PA training to medical students. Thirteen of these 15 schools (86.7%) taught the national aerobic guidelines while only seven (46.7%) taught the national strength training recommendations. Four, five, and six year programs reported providing an average of 6.6, 5.0, and 12.3h of PA training, respectively, across their entire curriculum. Only 42.9% of the schools that had PA training reported that it was sufficient for their medical students. Nearly half (41.2%) of the respondents reported no barriers to implementing PA training into their medical curricula. Most Australian medical schools reported including some PA training in their medical curriculum. Key topics, such as the national strength recommendations, however, were not taught by most schools. Given the importance of PA for the prevention and treatment of numerous mental and physical health outcomes, it is unlikely that the attention it currently receives adequately prepares medical students to treat patients. Copyright © 2016. Published by Elsevier Ltd.

  16. Understanding the Barriers to Accessing Symptom-Specific Cognitive Behavior Therapy (CBT) for Distressing Voices: Reflecting on and Extending the Lessons Learnt From the CBT for Psychosis Literature

    PubMed Central

    Hazell, Cassie M.; Greenwood, Kathryn; Fielding-Smith, Sarah; Rammou, Aikaterini; Bogen-Johnston, Leanne; Berry, Clio; Jones, Anna-Marie; Hayward, Mark

    2018-01-01

    The experience of hearing voices (‘auditory hallucinations’) can cause significant distress and disruption to quality of life for people with a psychosis diagnosis. Psychological therapy in the form of cognitive behavior therapy (CBT) for psychosis is recommended for the treatment of positive symptoms, including distressing voices, but is rarely available to patients in the United Kingdom. CBT for psychosis has recently evolved with the development of symptom-specific therapies that focus upon only one symptom of psychosis at a time. Preliminary findings from randomized controlled trials suggest that these symptom-specific therapies can be more effective for distressing voices than the use of broad CBT protocols, and have the potential to target voices trans-diagnostically. Whilst this literature is evolving, consideration must be given to the potential for a symptom-specific approach to overcome some of the barriers to delivery of evidence-based psychological therapies within clinical services. These barriers are discussed in relation to the United Kingdom mental health services, and we offer suggestions for future research to enhance our understanding of these barriers.

  17. Understanding the Barriers to Accessing Symptom-Specific Cognitive Behavior Therapy (CBT) for Distressing Voices: Reflecting on and Extending the Lessons Learnt From the CBT for Psychosis Literature.

    PubMed

    Hazell, Cassie M; Greenwood, Kathryn; Fielding-Smith, Sarah; Rammou, Aikaterini; Bogen-Johnston, Leanne; Berry, Clio; Jones, Anna-Marie; Hayward, Mark

    2018-01-01

    The experience of hearing voices ('auditory hallucinations') can cause significant distress and disruption to quality of life for people with a psychosis diagnosis. Psychological therapy in the form of cognitive behavior therapy (CBT) for psychosis is recommended for the treatment of positive symptoms, including distressing voices, but is rarely available to patients in the United Kingdom. CBT for psychosis has recently evolved with the development of symptom-specific therapies that focus upon only one symptom of psychosis at a time. Preliminary findings from randomized controlled trials suggest that these symptom-specific therapies can be more effective for distressing voices than the use of broad CBT protocols, and have the potential to target voices trans-diagnostically. Whilst this literature is evolving, consideration must be given to the potential for a symptom-specific approach to overcome some of the barriers to delivery of evidence-based psychological therapies within clinical services. These barriers are discussed in relation to the United Kingdom mental health services, and we offer suggestions for future research to enhance our understanding of these barriers.

  18. Psychotherapy for Bipolar Disorder in Adults: A Review of the Evidence

    PubMed Central

    Swartz, Holly A.; Swanson, Joshua

    2015-01-01

    Although pharmacotherapy is the mainstay of treatment for bipolar disorder, medication offers only partial relief for patients. Treatment with pharmacologic interventions alone is associated with disappointingly low rates of remission, high rates of recurrence, residual symptoms, and psychosocial impairment. Bipolar-specific therapy is increasingly recommended as an essential component of illness management. This review summarizes the available data on psychotherapy for adults with bipolar disorder. We conducted a search of the literature for outcome studies published between 1995 and 2013 and identified 35 reports of 28 randomized controlled trials testing individual or group psychosocial interventions for adults with bipolar disorder. These reports include systematic trials investigating the efficacy and effectiveness of individual psychoeducation, group psychoeducation, individual cognitive-behavioral therapy, group cognitive-behavioral therapy, family therapy, interpersonal and social rhythm therapy, and integrated care management. The evidence demonstrates that bipolar disorder-specific psychotherapies, when added to medication for the treatment of bipolar disorder, consistently show advantages over medication alone on measures of symptom burden and risk of relapse. Whether delivered in a group or individual format, those who receive bipolar disorder-specific psychotherapy fare better than those who do not. Psychotherapeutic strategies common to most bipolar disorder-specific interventions are identified. PMID:26279641

  19. 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

  20. 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.

  1. 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…

  2. 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…

  3. 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

  4. 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

  5. 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).

  6. 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.

  7. Omega-3 polyunsaturated fatty acids to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field.

    PubMed

    Teo, Lynn; Crawford, Cindy; Yehuda, Rachel; Jaghab, Danny; Bingham, John J; Chittum, Holly K; Gallon, Matthew D; O'Connell, Meghan L; Arzola, Sonya M; Berry, Kevin

    2017-06-01

    There has been interest in identifying whether nutrients might help optimize cognitive performance, especially for the military tasked with ensuring mission-readiness. This systematic review assesses the quality of the evidence for n-3 polyunsaturated fatty acids (PUFAs) across various outcomes related to cognitive function in healthy adult populations in order to develop research recommendations concerning n-3 PUFAs for mission-readiness. PubMed, CINAHL, Embase, PsycInfo, and the Cochrane Library were searched. Peer-reviewed randomized controlled trials published in the English language were eligible. Thirteen included trials were assessed for methodological quality, and descriptive data were extracted. Of the acceptable-quality (n = 8) and high-quality (n = 1) studies, 2 produced no statistically significant results, 5 produced mixed results, and 2 did not report between-group results. Results indicate that ingestion of n-3 PUFAs does not significantly alter cognitive performance in cognitively healthy persons. Studies exposing subjects to adverse circumstances that would be most relevant for drawing conclusions specifically for the military population are lacking. Several research recommendations are offered to enhance understanding of the role of fatty acids on cognitive functioning. © 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.

  8. Development of practice guidelines for psychological interventions in the rehabilitation of patients with oncological disease (breast, prostate, or colorectal cancer): Methods and results.

    PubMed

    Reese, Christina; Weis, Joachim; Schmucker, Dieter; Mittag, Oskar

    2017-10-01

    The goal of this project was to develop evidence- and consensus-based practice guidelines for psychological interventions in the rehabilitation of patients with oncological disease (breast, prostate, or colorectal cancer). First of all, we conducted a literature search and survey of all oncological rehabilitation centers in Germany (N = 145) to obtain a thorough perspective of the recent evidence, guidelines, the structural framework, and practice of psychological services in oncological rehabilitation. Next, an expert workshop was held with national experts from scientific departments, clinicians from rehabilitation centers, and patients. In this workshop, we drafted and agreed upon an initial version of the practice guidelines. Afterwards, the practice guidelines were sent to all head physicians and senior psychologists at oncological rehabilitation centers in Germany for approval (N = 280 questionnaires). In addition, key recommendations were discussed with a group of rehabilitation patients. Finally, the practice guidelines were revised by the expert panel and made available online to the public. The practice guidelines have been widely accepted by both the expert panel and the surveyed clinicians and patients. They include recommendations for psycho-oncological interventions that should be offered to all rehabilitation patients with breast, prostate, or colorectal cancer. They also comprise recommendations for specific problem areas concerning psychological functions, body functions, and environmental and personal factors. The practice guidelines provide detailed recommendations for high-quality psychosocial care in an oncological rehabilitation context. It is their aim to guide the multidisciplinary team, especially psychologists and physicians, in their daily practice. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Outcomes of androgen replacement therapy in adult male hypogonadism: recommendations from the Italian society of endocrinology.

    PubMed

    Isidori, A M; Balercia, G; Calogero, A E; Corona, G; Ferlin, A; Francavilla, S; Santi, D; Maggi, M

    2015-01-01

    We developed clinical practice guidelines to assess the individual risk-benefit profile of androgen replacement therapy in adult male hypogonadism (HG), defined by the presence of specific signs and symptoms and serum testosterone (T) below 12 nmol/L. The task force consisted of eight clinicians experienced in treating HG, selected by the Italian Society of Endocrinology (SIE). The authors received no corporate funding or remuneration. Consensus was guided by a systematic review of controlled trials conducted on men with a mean T < 12 nmol/L and by interactive discussions. The guidelines were reviewed and sequentially approved by the SIE Guidelines Commission and Executive Committee. We recommend T supplementation (TS) for adult men with severely reduced T levels (T < 8 nmol/L) to improve body composition and sexual function. We suggest that TS be offered to subjects with T < 12 nmol/L to improve glycaemic control, lipid profile, sexual function, bone mineral density, muscle mass and depressive symptoms, once major contraindications have been ruled out. We suggest that lifestyle changes and other available interventions (e.g. for erectile dysfunction) be suggested prior to TS. We suggest that TS should be combined with currently available treatments for individuals at high risk for complications, such as those with osteoporosis and/or metabolic disorders. We recommend against using TS to improve cardiac outcome and limited mobility. We recommend against using TS in men with prostate cancer, unstable cardiovascular conditions or elevated haematocrit. The task force places a high value on the timely treatment of younger and middle-aged subjects to prevent the long-term consequences of hypoandrogenism.

  10. Teaching internet use to adult learners: The LANL experience

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

    Smith, S.; Comstock, D.

    The Research library at Los Alamos National Laboratory has been teaching an Internet class to adult learners since May 1994. The class is a team effort, combining lecture/demo with hands-on practice using Gopher and the World Wide Web. What started out as a small short-term project has become a weekly class available to any Lab employee or associate. More than 250 people have been taught to find basic reference materials and to navigate the Internet on the Gopher and World Wide Web. The class is one of the first classes offered by the Research Library to be filled every month,more » and one Laboratory group has recommended that their staff attend this class in preparation for more advanced Internet and HTML classes as part of their group training. The success of this class spurred development by the Research Library of more specific subject classes using Internet resources, specifically business and general science resources.« less

  11. The State and Future of the Primary Care Behavioral Health Model of Service Delivery Workforce.

    PubMed

    Serrano, Neftali; Cordes, Colleen; Cubic, Barbara; Daub, Suzanne

    2018-06-01

    The growth of the Primary Care Behavioral Health model (PCBH) nationally has highlighted and created a workforce development challenge given that most mental health professionals are not trained for primary care specialization. This work provides a review of the current efforts to retrain mental health professionals to fulfill roles as Behavioral Health Consultants (BHCs) including certificate programs, technical assistance programs, literature and on-the-job training, as well as detail the future needs of the workforce if the model is to sustainably proliferate. Eight recommendations are offered including: (1) the development of an interprofessional certification body for PCBH training criteria, (2) integration of PCBH model specific curricula in graduate studies, (3) integration of program development skill building in curricula, (4) efforts to develop faculty for PCBH model awareness, (5) intentional efforts to draw students to graduate programs for PCBH model training, (6) a national employment clearinghouse, (7) efforts to coalesce current knowledge around the provision of technical assistance to sites, and (8) workforce specific research efforts.

  12. Do perceived cues, benefits, and barriers to physical activity differ between male and female adolescents?

    PubMed

    Tergerson, Jennifer L; King, Keith A

    2002-11-01

    A four-page survey was administered to 535 adolescents at two single-sex (one male, one female) high schools in Cincinnati, Ohio, to examine whether perceptions of physical activity differed by gender. More specifically, the survey assessed perceived cues, benefits, and barriers to exercising. Results indicated that the most helpful cue to physical activity for both female and male students was "having a friend to exercise with." The most commonly reported benefit of exercising among females was "to stay in shape," whereas the most commonly reported benefit to exercising among males was "to become strong." Among females, the most common barrier to exercising was "having no time to exercise," whereas males were most likely to report "wanting to do other things with my time." Multivariate analyses of covariance revealed that perceived cues, benefits, and barriers to physical activity differed significantly based on gender. Recommendations on specific strategies to increasing male and female adolescent physical activity levels are offered.

  13. The Economic Costs of Substance Abuse Treatment: Updated Estimates and Cost Bands for Program Assessment and Reimbursement

    PubMed Central

    French, Michael T.; Popovici, Ioana; Tapsell, Lauren

    2008-01-01

    Federal, State, and local government agencies require current and accurate cost information for publicly funded substance abuse treatment programs to guide program assessments and reimbursement decisions. The Center for Substance Abuse Treatment (CSAT) published a list of modality-specific cost bands for this purpose in 2002. However, the upper and lower values in these ranges are so wide that they offer little practical guidance for funding agencies. Thus, the dual purpose of this investigation was to assemble the most current and comprehensive set of economic cost estimates from the readily-available literature and then use these estimates to develop updated modality-specific cost bands for more reasonable reimbursement policies. Although cost estimates were scant for some modalities, the recommended cost bands are based on the best available economic research, and we believe these new ranges will be more useful and pertinent for all stakeholders of publicly-funded substance abuse treatment. PMID:18294803

  14. Using a Cultural and RDoC Framework to Conceptualize Anxiety in Asian Americans

    PubMed Central

    Liu, Huiting; Lieberman, Lynne; Stevens, Elizabeth; Auerbach, Randy P.; Shankman, Stewart A.

    2016-01-01

    Asian Americans are one of the fastest growing minority group in the United States; however, mental health within this population segment, particularly anxiety disorders, remains significantly understudied. Both the heterogeneity within the Asian American population, along with the multidimensional nature of anxiety, contribute to difficulties in understanding anxiety in this population. The present paper will review two sources of heterogeneity within anxiety in Asian Americans: (1) cultural variables and (2) mechanisms or components of anxiety. Specifically, we will examine four cultural variables most commonly found in research related to anxiety in Asian Americans: acculturation, affect valuation, loss of face, and individualism-collectivism. We will also discuss ways to parse anxiety through a Research Domain Criteria (RDoC) framework, specifically focusing on sensitivity to acute and potential threat, constructs within the Negative Valence System. We also present previously unpublished preliminary data to illustrate one way of examining ethnic differences in anxiety using an RDoC framework. Finally, this paper offers recommendations for future work in this area. PMID:27659553

  15. Asking the difficult questions: message strategies used by organ procurement coordinators in requesting familial consent to organ donation.

    PubMed

    Anker, Ashley E; Feeley, Thomas Hugh

    2011-07-01

    The present study provides an in-depth examination of the messages used by organ procurement coordinators (OPCs) in shaping familial requests for organ donation. OPCs (N = 102), recruited from a national sample of 16 organ procurement organizations, participated in a structured interview designed to uncover the communication strategies used in obtaining familial consent for donation. Analysis of interviews indicates OPCs' messages cover 4 domain areas. Specifically, OPCs report use of messages intended to (a) provide education, (b) discuss the benefits to donation, (c) learn about potential donor families, and (d) persuade families to engage in donation. Within the 4 domain areas, OPCs report use of 15 specific messages (e.g., "positively framing the donor," "social proof," "discuss the benefit of donation to grieving") in requesting consent. The present study provides a detailed examination of strategies and offers recommendations for using message strategies to explore the effectiveness of the consent process from the perspective of OPCs in approaching donor families.

  16. Cyber Vulnerabilities Within Critical Infrastructure: The Flaws of Industrial Control Systems in the Oil and Gas Industry

    NASA Astrophysics Data System (ADS)

    Alpi, Danielle Marie

    The 16 sectors of critical infrastructure in the US are susceptible to cyber-attacks. Potential attacks come from internal and external threats. These attacks target the industrial control systems (ICS) of companies within critical infrastructure. Weakness in the energy sector's ICS, specifically the oil and gas industry, can result in economic and ecological disaster. The purpose of this study was to establish means for oil companies to identify and stop cyber-attacks specifically APT threats. This research reviewed current cyber vulnerabilities and ways in which a cyber-attack may be deterred. This research found that there are insecure devices within ICS that are not regularly updated. Therefore, security issues have amassed. Safety procedures and training thereof are often neglected. Jurisdiction is unclear in regard to critical infrastructure. The recommendations this research offers are further examination of information sharing methods, development of analytic platforms, and better methods for the implementation of defense-in-depth security measures.

  17. Using a cultural and RDoC framework to conceptualize anxiety in Asian Americans.

    PubMed

    Liu, Huiting; Lieberman, Lynne; Stevens, Elizabeth S; Auerbach, Randy P; Shankman, Stewart A

    2017-05-01

    Asian Americans are one of the fastest growing minority groups in the United States; however, mental health within this population segment, particularly anxiety disorders, remains significantly understudied. Both the heterogeneity within the Asian American population and the multidimensional nature of anxiety contribute to difficulties in understanding anxiety in this population. The present paper reviewed two sources of heterogeneity within anxiety in Asian Americans: (1) cultural variables and (2) mechanisms or components of anxiety. Specifically, we examined four cultural variables most commonly found in research related to anxiety in Asian Americans: acculturation, loss of face, affect valuation, and individualism-collectivism. We also discussed ways to parse anxiety through a Research Domain Criteria (RDoC) framework, specifically focusing on sensitivity to acute and potential threat, constructs within the Negative Valence System. Previously unpublished preliminary data were presented to illustrate one way of examining ethnic differences in anxiety using an RDoC framework. Finally, this paper offered recommendations for future work in this area. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. 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…

  19. 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…

  20. 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.

  1. Physical activity, sedentary behaviour and sleep in COPD guidelines: A systematic review.

    PubMed

    Lewthwaite, Hayley; Effing, Tanja W; Olds, Timothy; Williams, Marie T

    2017-08-01

    Physical activity, sedentary and sleep behaviours have strong associations with health. This systematic review aimed to identify how clinical practice guidelines (CPGs) for the management of chronic obstructive pulmonary disease (COPD) report specific recommendations and strategies for these movement behaviours. A systematic search of databases (Medline, Scopus, CiNAHL, EMbase, Clinical Guideline), reference lists and websites identified current versions of CPGs published since 2005. Specific recommendations and strategies concerning physical activity, sedentary behaviour and sleep were extracted verbatim. The proportions of CPGs providing specific recommendations and strategies were reported. From 2370 citations identified, 35 CPGs were eligible for inclusion. Of these, 21 (60%) provided specific recommendations for physical activity, while none provided specific recommendations for sedentary behaviour or sleep. The most commonly suggested strategies to improve movement behaviours were encouragement from a healthcare provider (physical activity n = 20; sedentary behaviour n = 2) and referral for a diagnostic sleep study (sleep n = 4). Since optimal physical activity, sedentary behaviour and sleep durations and patterns are likely to be associated with mitigating the effects of COPD, as well as with general health and well-being, there is a need for further COPD-specific research, consensus and incorporation of recommendations and strategies into CPGs.

  2. 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.

  3. 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…

  4. 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.

  5. 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.

  6. Cervical cancer screening among women who attend sexually transmitted diseases (STD) clinics: background paper for 2010 STD Treatment Guidelines.

    PubMed

    Datta, S Deblina; Saraiya, Mona

    2011-12-01

    In April 2008, experts reviewed updates on sexually transmitted disease (STD) prevention and treatment in preparation for the revision of the Centers for Disease Control and Prevention (CDC) STD Treatment Guidelines. This included a review of cervical cancer screening in the STD clinical setting. Key questions were identified with assistance from an expert panel. Reviews of the literature were conducted using the PubMed computerized database and shared with the panel. Updated information was incorporated in the 2010 CDC STD Treatment Guidelines. We recommend that STD clinics offering cervical screening services screen and treat women according to guidelines by the American College of Obstetrics and Gynecology, the American Cancer Society, the US Preventive Services Task Force, and the American Society for Colposcopists and Cervical Pathologists. New to the 2010 guidelines are higher age for initiating cervical screening (age ≥ 21 years) and less frequent intervals of screening (at least every 3 years). New recommendations include new technologies, such as liquid-based cytology and high-risk human papillomavirus (HPV) DNA tests. Liquid-based technologies are not recommended over conventional testing. HPV DNA tests are recommended as adjunct tests and with new indications for use in cervical screening and management. Stronger recommendations were issued for STD clinics offering cervical screening services to have protocols in place for follow-up of test results and referral (eg, colposcopy). Important additions to the 2010 STD Treatment Guidelines include information on updated algorithms for screening and management of women and recommendations for use of liquid-based cytology and high-risk HPV testing.

  7. Recommendations for the use of medications with continuous enteral nutrition.

    PubMed

    Wohlt, Paul D; Zheng, Lan; Gunderson, Shelly; Balzar, Sarah A; Johnson, Benjamin D; Fish, Jeffrey T

    2009-08-15

    Recommendations for the use of medications with continuous enteral nutrition are provided. A literature review was conducted to identify primary literature reporting medication interactions with continuous enteral nutrition. For medications without supporting literature, manufacturers were contacted for information. Package inserts for specific medications were also investigated for any information to help guide recommendations. If no specific recommendations were made by the pharmaceutical manufacturer or the package insert concerning administration of products with continuous enteral nutrition, a tertiary database was consulted. Recommendations were generated by a consensus of clinicians for those medications that lacked specific recommendations in the primary literature or from the pharmaceutical manufacturer. Documentation of medication interactions with continuous enteral nutrition and food was then collated along with specific recommendations on how to administer the medication with regard to continuous enteral nutrition. Recommendations were classified as strong (grade 1) or weak (grade 2). The quality of evidence was classified as high (grade A), moderate (grade B), or low (grade C). Forty-six medications commonly given to hospitalized patients were evaluated. Twenty-four medications had recommendations based on available data, and the remaining 22 medications had recommendations based on a consensus of clinicians. There was a lack of published data regarding drug-nutrient interactions for a majority of the drugs commonly administered to patients receiving continuous enteral nutrition. Clinicians should recognize potential drug-nutrient interactions and use available evidence to optimize patients' drug therapy.

  8. Genotypic, Phenotypic and Clinical Validation of GeneXpert in Extra-Pulmonary and Pulmonary Tuberculosis in India

    PubMed Central

    Singh, Urvashi B.; Pandey, Pooja; Mehta, Girija; Bhatnagar, Anuj K.; Mohan, Anant; Goyal, Vinay; Ahuja, Vineet; Ramachandran, Ranjani; Sachdeva, Kuldeep S.; Samantaray, Jyotish C.

    2016-01-01

    Background Newer molecular diagnostics have brought paradigm shift in early diagnosis of tuberculosis [TB]. WHO recommended use of GeneXpert MTB/RIF [Xpert] for Extra-pulmonary [EP] TB; critics have since questioned its efficiency. Methods The present study was designed to assess the performance of GeneXpert in 761 extra-pulmonary and 384 pulmonary specimens from patients clinically suspected of TB and compare with Phenotypic, Genotypic and Composite reference standards [CRS]. Results Comparison of GeneXpert results to CRS, demonstrated sensitivity of 100% and 90.68%, specificity of 100% and 99.62% for pulmonary and extra-pulmonary samples. On comparison with culture, sensitivity for Rifampicin [Rif] resistance detection was 87.5% and 81.82% respectively, while specificity was 100% for both pulmonary and extra-pulmonary TB. On comparison to sequencing of rpoB gene [Rif resistance determining region, RRDR], sensitivity was respectively 93.33% and 90% while specificity was 100% in both pulmonary and extra-pulmonary TB. GeneXpert assay missed 533CCG mutation in one sputum and dual mutation [517 & 519] in one pus sample, detected by sequencing. Sequencing picked dual mutation [529, 530] in a sputum sample sensitive to Rif, demonstrating, not all RRDR mutations lead to resistance. Conclusions Current study reports observations in a patient care setting in a high burden region, from a large collection of pulmonary and extra-pulmonary samples and puts to rest questions regarding sensitivity, specificity, detection of infrequent mutations and mutations responsible for low-level Rif resistance by GeneXpert. Improvements in the assay could offer further improvement in sensitivity of detection in different patient samples; nevertheless it may be difficult to improve sensitivity of Rif resistance detection if only one gene is targeted. Assay specificity was high both for TB detection and Rif resistance detection. Despite a few misses, the assay offers major boost to early diagnosis of TB and MDR-TB, in difficult to diagnose pauci-bacillary TB. PMID:26894283

  9. Effectiveness of a tailored intervention to improve cardiovascular risk management in primary care: study protocol for a randomised controlled trial.

    PubMed

    Huntink, Elke; Heijmans, Naomi; Wensing, Michel; van Lieshout, Jan

    2013-12-17

    Cardiovascular disease (CVD) is an important worldwide cause of mortality. In The Netherlands, CVD is the leading cause of death for women and the second cause of death for men. Recommendations for diagnosis and treatment of CVD are not well implemented in primary care. In this study, we aim to examine the effectiveness of a tailored implementation program targeted at practice nurses to improve healthcare for patients with (high risk for) CVD. A two-arm cluster randomized trial is planned. We offer practice nurses a tailored program to improve adherence to six specific recommendations related to blood pressure and cholesterol target values, risk profiling and lifestyle advice. Practice nurses are offered training and feedback on their motivational interviewing technique and an e-learning program on cardiovascular risk management (CVRM). They are also advised to screen for the presence and severity of depressive symptoms in patients. We also advise practice nurses to use selected E-health options (selected websites and Twitter-consult) in patients without symptoms of depression. Patients with mild depressive symptoms are referred to a physical exercise group. We recommend referring patients with major depressive symptoms for assessment and treatment of depressive symptoms if appropriate before starting CVRM. Data from 900 patients at high risk of CVD or with established CVD will be collected in 30 general practices in several geographical areas in The Netherlands. The primary outcome measure is performance of practice nurses in CVRM and reflects application of recommendations for personalized counselling and education of CVRM patients. Patients' health-related lifestyles (physical exercise, diet and smoking status) will be measured with validated questionnaires and medical record audit will be performed to document estimated CVD risk. Additionally, we will survey and interview participating healthcare professionals for exploration of processes of change. The control practices will provide usual care. Tailored interventions can improve healthcare. An understanding of the methods to reach the improved healthcare can be improved. This research contributes a share of it. Identification of the determinants of practice and developing implementation interventions were two steps which were completed. The subsequent step was implementation of the tailored intervention program. Name trial register: Nederlands trial register. Web address of trial register: http://www.trialregister.nl. Data of registration: 11 July 2013. Number of registration: NTR4069.

  10. 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

  11. 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)

  12. 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)

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

    PubMed

    McCourt, Alexander D; Vernick, Jon S

    2018-01-01

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

  14. Civil Rights Laws as Tools to Advance Health in the Twenty-First Century.

    PubMed

    McGowan, Angela K; Lee, Mary M; Meneses, Cristina M; Perkins, Jane; Youdelman, Mara

    2016-01-01

    To improve health in the twenty-first century, to promote both access to and quality of health care services and delivery, and to address significant health disparities, legal and policy approaches, specifically those focused on civil rights, could be used more intentionally and strategically. This review describes how civil rights laws, and their implementation and enforcement, help to encourage health in the United States, and it provides examples for peers around the world. The review uses a broad lens to define health for both classes of individuals and their communities--places where people live, learn, work, and play. Suggestions are offered for improving health and equity broadly, especially within societal groups and marginalized populations. These recommendations include multisectorial approaches that focus on the social determinants of health.

  15. Adolescent Experiences with the Vaginal Ring

    PubMed Central

    Epstein, Laura B.; Sokal-Gutierrez, Karen; Ivey, Susan L.; Raine, Tina; Auerswald, Colette

    2011-01-01

    Purpose To understand racial/ethnic minority adolescent females’ experiences with the vaginal ring. Methods We conducted in-depth interviews with a clinic-based sample of 32 young women aged 15–24 years who had used the vaginal ring. Results Qualitative analysis using grounded theory revealed that adolescents undergo a multi-stage process when trying the ring and adopting ring use. These stages include hearing about the ring, initial reactions, first experiences with insertion and removal, and first sexual experiences. Adolescents subsequently enter an assessment and adjustment stage in which they decide whether to adopt or discontinue ring use. Ultimately they share their experiences with friends. Conclusions The model developed provides a context within which providers may advise adolescents as they begin use of the ring. Some specific recommendations are offered. PMID:18565439

  16. Role transition from caregiver to case manager--Part II.

    PubMed

    Schmitt, Nancy

    2006-01-01

    This two-part article explores the process of role transition as it pertains to nurses moving from roles of caregivers to roles of case managers. Part 1 of the article presented a theoretical model that demonstrated the interplay of significant factors in the process of role transition and discussed how this model could be used to examine nurses' experience of this transition. Part 2 presents findings from a qualitative study involving interview and focus group data contributed by nurses who have made the transition from caregiver to case manager. Data point to specific tensions experienced by these nurses, which are associated with time-task orientation, interactions and relationships, business culture and objectives, and self-image and professional identity. Recommendations for preparing and supporting nurses through this role are also offered.

  17. Monte Carlo simulation: Its status and future

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

    Murtha, J.A.

    1997-04-01

    Monte Carlo simulation is a statistics-based analysis tool that yields probability-vs.-value relationships for key parameters, including oil and gas reserves, capital exposure, and various economic yardsticks, such as net present value (NPV) and return on investment (ROI). Monte Carlo simulation is a part of risk analysis and is sometimes performed in conjunction with or as an alternative to decision [tree] analysis. The objectives are (1) to define Monte Carlo simulation in a more general context of risk and decision analysis; (2) to provide some specific applications, which can be interrelated; (3) to respond to some of the criticisms; (4) tomore » offer some cautions about abuses of the method and recommend how to avoid the pitfalls; and (5) to predict what the future has in store.« less

  18. The value of health screening in music schools and conservatoires.

    PubMed

    Clark, Terry; Williamon, Aaron; Redding, Emma

    2013-04-01

    Interest in musicians' health and well-being is growing, reflected by increasing numbers of investigations into the physicality and psychology of musical performance. Within sport and dance, screening and profiling programmes, especially of the musculoskeletal system, have furthered understanding on not only physical and psychological capabilities and demands but also musculoskeletal injury mechanisms and susceptibility. This article engages with questions relating to the development and delivery of musician-specific health screening programmes. Effective screening can offer a variety of benefits for musicians, providing informed recommendations for sustaining performance-related fitness across educational and professional contexts. Employing an interdisciplinary approach when developing screening programmes is essential, as is the ecological appropriateness of the measures used. The implications inherent in delivering and sustaining successful screening programmes in schools and conservatoires are discussed.

  19. Effective Interpersonal Communication: A Practical Guide to Improve Your Life.

    PubMed

    Vertino, Kathleen A

    2014-09-30

    Use of effective interpersonal communication strategies by nurses in both personal and professional settings, may reduce stress, promote wellness, and therefore, improve overall quality of life. This article briefly explores the concept of interpersonal communication as it relates to Maslow's hierarchy of human needs; describes personal variables and the interaction of internal and external variables that can impact communication; and discusses possible causes and consequences of ineffective communication. Drawing on both the literature and experiences as a longtime provider of care in the mental health field, the author offers multiple practical strategies, with specific examples of possible responses for effective communication. Recommendations in this article are intended for nurses to consider as they seek healthy communication strategies that may be useful in both their personal and professional lives.

  20. LED Surgical Task Lighting Scoping Study: A Hospital Energy Alliance Project

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

    Tuenge, Jason R.

    Tungsten-halogen (halogen) lamps have traditionally been used to light surgical tasks in hospitals, even though they are in many respects ill-suited to the application due to the large percentage of radiant energy outside the visible spectrum and issues with color rendering/quality. Light-emitting diode (LED) technology offers potential for adjustable color and improved color rendition/quality, while simultaneously reducing side-effects from non-visible radiant energy. It also has the potential for significant energy savings, although this is a fairly narrow application in the larger commercial building energy use sector. Based on analysis of available products and Hospital Energy Alliance member interest, it ismore » recommended that a product specification and field measurement procedure be developed for implementation in demonstration projects.« less

  1. 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.

  2. 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.

  3. Are nutrition messages lost in transmission? Assessing the quality and consistency of diabetes guideline recommendations on the delivery of nutrition therapy.

    PubMed

    Hale, Kelli; Capra, Sandra; Bauer, Judy

    2016-12-01

    To provide an overview of (1) the consistency of Type 2 Diabetes Clinical Practice Guidelines recommendations on the delivery of nutrition therapy and (2) Clinical Practice Guideline quality. Large international clinical practice guideline repositories, diabetes organisation websites, and electronic databases (Pubmed, Scopus), were searched to identify Clinical Practice Guidelines for adults with type 2 diabetes published 2005 to August 2014. Recommendations on the delivery of nutrition therapy were extracted and inductive content analysis was used to analyse consistency. Two researchers independently assessed guideline quality using the AGREE II tool. Nine topics were identified from the recommendations. Overall the consistency of the recommendations was related to guideline type. Compared with nutrition-specific guidelines, the broad ones had a broader focus and included more patient-focused recommendations. The ten Clinical Practice Guidelines assessed included six broad guidelines and four nutrition specific guidelines. Based on AGREE II analysis, the broad guidelines were higher quality than nutrition-specific ones. Broad Clinical Practice Guidelines were higher quality and included more patient-focused recommendations than nutrition-specific ones. Our findings suggest a need for nutrition-specific guidelines to be modified to include greater patient-focus, or for practitioners delivering nutrition therapy to adopt broad Clinical Practice Guidelines. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. 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.

  5. 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…

  6. 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…

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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)

  13. 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)

  14. 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.

  15. Physical activity, sedentary behaviour and sleep in COPD guidelines: A systematic review

    PubMed Central

    Effing, Tanja W; Olds, Timothy; Williams, Marie T

    2017-01-01

    Objectives: Physical activity, sedentary and sleep behaviours have strong associations with health. This systematic review aimed to identify how clinical practice guidelines (CPGs) for the management of chronic obstructive pulmonary disease (COPD) report specific recommendations and strategies for these movement behaviours. Methods: A systematic search of databases (Medline, Scopus, CiNAHL, EMbase, Clinical Guideline), reference lists and websites identified current versions of CPGs published since 2005. Specific recommendations and strategies concerning physical activity, sedentary behaviour and sleep were extracted verbatim. The proportions of CPGs providing specific recommendations and strategies were reported. Results: From 2370 citations identified, 35 CPGs were eligible for inclusion. Of these, 21 (60%) provided specific recommendations for physical activity, while none provided specific recommendations for sedentary behaviour or sleep. The most commonly suggested strategies to improve movement behaviours were encouragement from a healthcare provider (physical activity n = 20; sedentary behaviour n = 2) and referral for a diagnostic sleep study (sleep n = 4). Conclusion: Since optimal physical activity, sedentary behaviour and sleep durations and patterns are likely to be associated with mitigating the effects of COPD, as well as with general health and well-being, there is a need for further COPD-specific research, consensus and incorporation of recommendations and strategies into CPGs. PMID:28774202

  16. Report of the Task Force on SSC Magnet System Test Site

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

    NONE

    1984-10-01

    The Task Force on SSC Magnet Systems test Site was appointed by Maury Tigner, Director of the SSC, Phase 1 in August 1984. In brief, the charge asked the Task Force to make a critical evaluation of potential test sites for a major SSC magnet System Test Facility (STF) with regard to: (1) availability of the needed space, utilities, staff and other requirements on the desired time scale; and (2) the cost of preparing the sites for the tests and for operating the facilities during the test period. The charge further suggests that, by virtue of existing facilities and availabilitymore » of experienced staff, BNL and FNAL are the two best candidate sites and that is therefore appears appropriate to restrict the considerations of the Task Force to these sites. During the subsequent deliberations of the Task Force, no new facts were revealed that altered the assumptions of the charge in this regard. The charge does not ask for a specific site recommendation for the STF. Indeed, an agreement on such a recommendation would be difficult to achieve considering the composition of the Task Force, wherein a large fraction of the membership is drawn from the two contending laboratories. Instead, we have attempted to describe the purpose of the facility, outline a productive test program, list the major facilities required, carefully review the laboratories` responses to the facility requirements, and make objective comparisons of the specific features and capabilities offered.« less

  17. Interprofessional communication between community pharmacists and general practitioners: a qualitative study.

    PubMed

    Weissenborn, Marina; Haefeli, Walter E; Peters-Klimm, Frank; Seidling, Hanna M

    2017-06-01

    Background While collaboration between community pharmacists (CPs) and general practitioners (GPs) is essential to provide comprehensive patient care, their communication often is scarce and hampered by multiple barriers. Objective We aimed to assess both professions' perceptions of interprofessional communication with regard to content and methods of communication as a basis to subsequently develop best-practice recommendations for information exchange. Setting Ambulatory care setting in Germany. Method CPs and GPs shared their experience in focus groups and in-depth interviews which were conducted using a semi-structured interview guideline. Transcribed recordings were assessed using qualitative content analysis according to Mayring. Main outcome measure Specification of existing barriers, CPs'/GPs' general perceptions of interprofessional communication and similarities and differences regarding prioritization of specific information items and how to best communicate with each other. Results Four focus groups and fourteen interviews were conducted. Seven internal (e.g. professions were not personally known to one another) and nine external barriers (e.g. mutual accessibility) were identified. Ten organizational, eight medication-related, and four patient-related information items were identified requiring interprofessional communication. Their relevance varied between the professions, e.g. CPs rated organizational issues higher than GPs. Both professions indicated communication via phone to be the most frequently used method of communication. Conclusion CPs and GPs opinions often differ. However, communication between CPs and GPs is perceived as crucial suggesting that a future concept has to offer standardized recommendations, while leaving CPs and GPs room to adjust it to their individual needs.

  18. 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

  19. 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

    PubMed Central

    2012-01-01

    Background The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), that produced its first Guidelines in 2005, felt the need to revise them and increase their scientific quality. The aim is to offer to all professionals and their patients an evidence-based updated review of the actual evidence on conservative treatment of idiopathic scoliosis (CTIS). Methods All types of professionals (specialty physicians, and allied health professionals) engaged in CTIS have been involved together with a methodologist and a patient representative. A review of all the relevant literature and of the existing Guidelines have been performed. Documents, recommendations, and practical approach flow charts have been developed according to a Delphi procedure. A methodological and practical review has been made, and a final Consensus Session was held during the 2011 Barcelona SOSORT Meeting. Results The contents of the document are: methodology; generalities on idiopathic scoliosis; approach to CTIS in different patients, with practical flow-charts; literature review and recommendations on assessment, bracing, physiotherapy, Physiotherapeutic Specific Exercises (PSE) and other CTIS. Sixty-five recommendations have been given, divided in the following topics: Bracing (20 recommendations), PSE to prevent scoliosis progression during growth (8), PSE during brace treatment and surgical therapy (5), Other conservative treatments (3), Respiratory function and exercises (3), Sports activities (6), Assessment (20). No recommendations reached a Strength of Evidence level I; 2 were level II; 7 level III; and 20 level IV; through the Consensus procedure 26 reached level V and 10 level VI. The Strength of Recommendations was Grade A for 13, B for 49 and C for 3; none had grade D. Conclusion These Guidelines have been a big effort of SOSORT to paint the actual situation of CTIS, starting from the evidence, and filling all the gray areas using a scientific method. According to results, it is possible to understand the lack of research in general on CTIS. SOSORT invites researchers to join, and clinicians to develop good research strategies to allow in the future to support or refute these recommendations according to new and stronger evidence. PMID:22264320

  20. 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.

  1. 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.

  2. 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)

  3. Comparison of 2 recommendations for adjusting the working height in milking parlors.

    PubMed

    Jakob, Martina C; Liebers, Falk

    2017-08-01

    Milking cows is one of the major labor inputs on dairy farms. Modern parlors allow upright working positions, but pain and disorders among parlor workers are still very prevalent. The platform height in the parlors is important for the body posture of the workers. Based on a large set of data containing parlor-specific measures, anthropometrics, and bovimetrics, a simulation of 2 recommendations published in the literature was carried out. This article presents and discusses the results of 2 formulas for determining the appropriate pit depth. The shoulder and body height of the worker and the distance between the udder and the floor influence the adjustment of the pit depth. If work at shoulder level is favored, autotandem parlors offer the most suitable pit depths, whereas side-by-side parlors are too deep in all cases. Due to the variation in anthropometrics and bovimetrics, a good parlor design can reduce the extent of unfavorable body postures, but more technical measures are necessary to completely eliminate them. Actions that reduce the workload and the prevalence of musculoskeletal pain and disorders should be considered. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  4. An assessment of the status and trends in satellite communications 1986-2000: An information document prepared for the Communications Subcommittee of the Space Applications Advisory Committee

    NASA Technical Reports Server (NTRS)

    Poley, W. A.; Stevens, G. H.; Stevenson, S. M.; Lekan, J.; Arth, C. H.; Hollansworth, J. E.; Miller, E. F.

    1986-01-01

    This is a response to a Space Applications Advisory Committee (SAAC) request for information about the status and trends in satellite communications, to be used to support efforts to conceive and recommend long range goals for NASA communications activities. Included in this document are assessments of: (1) the outlook for satellite communications, including current applications, potential future applications, and impact of the changing environment such as optical fiber networks, the Integrated Services Digital Network (ISDN) standard, and the rapidly growing market for Very Small Aperture Terminals (VSAT); (2) the restrictions imposed by our limited spectrum resource; and (3) technology needs indicated by future trends. Potential future systems discussed include: large powerful satellites for providing personal communications; VSAT compatible satellites with onboard switching and having voice capability; large satellites which offer a pervasive T1 network service (primarily for video-phone); and large geostationary communications facilities which support common use by several carriers. Also, discussion is included of NASA particular needs and possible future systems. Based on the mentioned system concepts, specific technology recommendations are provided for the time frames of now - 1993, 1994 - 2000, and 2000 - 2010.

  5. A qualitative study of young people's perspectives on receiving psychiatric services via televideo.

    PubMed

    Boydell, Katherine M; Volpe, Tiziana; Pignatiello, Antonio

    2010-02-01

    It is critical to consult young people about their experiences. This study addresses the paucity of research on the perspective of young people in general, and in paediatric telepsychiatry specifically. The goal is to understand the experience of young people receiving telepsychiatry. Interpretive interactionism (Denzin, 1989) was used to interview 30 young people; immediately following the consultation and four to six weeks later. Analysis occurred via a series of steps in keeping with the interpretive interactionist framework. Four themes arose repeatedly: the encounter with the psychiatrist and experience of having others in the room; the helpfulness of the session; a sense of personal choice during the consultation; and, the technology. Participants highlighted the importance of their relationship with the psychiatrist. Participant's narratives were replete with examples of ways that they actively took responsibility and exerted control within the session itself. Young people have a significant role to play in their own care. It is critical that telepsychiatry recommendations be explained and opportunities for young people to express their concerns and discuss alternatives are provided. Further efforts to include young people may include ensuring offering alternate treatments and/or negotiated when recommended treatments are unacceptable and/or resisted.

  6. Testosterone therapy in men with prostate cancer: literature review, clinical experience, and recommendations

    PubMed Central

    Morgentaler, Abraham; Conners III, William P

    2015-01-01

    For several decades any diagnosis of prostate cancer (PCa) has been considered an absolute contraindication to the use of testosterone (T) therapy in men. Yet this prohibition against T therapy has undergone recent re-examination with refinement of our understanding of the biology of androgens and PCa, and increased appreciation of the benefits of T therapy. A reassuringly low rate of negative outcomes has been reported with T therapy after radical prostatectomy (RP), radiation treatments, and in men on active surveillance. Although the number of these published reports are few and the total number of treated men is low, these experiences do provide a basis for consideration of T therapy in selected men with PCa. For clinicians considering offering this treatment, we recommend first selecting patients with low grade cancers and undetectable prostate-specific antigen following RP. Further research is required to define the safety of T therapy in men with PCa. However, many patients symptomatic from T deficiency are willing to accept the potential risk of PCa progression or recurrence in return for the opportunity to live a fuller and happier life with T therapy. PMID:25652633

  7. 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.

  8. Adoption of the HPV vaccine: a case study of three emerging countries.

    PubMed

    Caro Martínez, Araceli; Espín Balbino, Jaime; Lemgruber, Alexandre; Martín Ruiz, Eva; Olry de Labry Lima, Antonio; García-Mochón, Leticia; Lessa, Fernanda

    2017-05-01

    The human papillomavirus (HPV) vaccine has recently attracted considerable attention in emerging countries, due to its potential to reduce the impact of HPV-related diseases. This case study sheds new light about the variety of HTA arrangements, methods and processes involved in the adoption and use of HPV vaccines in a selected sample of central, eastern and southern Europe and Latin America and the Caribbean, all of them emerging in the use of HTA. A multi-country case study was designed. Mixed methods, document review, semi-structured surveys and personal communication with experts, were used for data collection and triangulation. This study shows that common elements of good practice exist in the processes and methods used, with all countries arriving at the same appraisal recommendations. However, the influence of socio-politico-economic factors appears to be determinant on the final decisions and restrictions to access made. This case study intends to draw useful lessons for policymakers in emerging settings interested in the adoption of the HPV vaccine supported by evidence-informed processes, such as those offered by institutionalized HTA. Future studies are also recommended to elucidate the specific roles that social values and uncertainties play in vaccine decision-making across different societies.

  9. Living Donor Kidney Transplantation: Overcoming Disparities in Live Kidney Donation in the US—Recommendations from a Consensus Conference

    PubMed Central

    Rodrigue, James R.; Kazley, Abby Swanson; Mandelbrot, Didier A.; Hays, Rebecca; LaPointe Rudow, Dianne

    2015-01-01

    Despite its superior outcomes relative to chronic dialysis and deceased donor kidney transplantation, live donor kidney transplantation (LDKT) is less likely to occur in minorities, older adults, and poor patients than in those who are white, younger, and have higher household income. In addition, there is considerable geographic variability in LDKT rates. Concomitantly, in recent years, the rate of living kidney donation (LKD) has stopped increasing and is declining, after decades of consistent growth. Particularly noteworthy is the decline in LKD among black, younger, male, and lower-income adults. The Live Donor Community of Practice within the American Society of Transplantation, with financial support from 10 other organizations, held a Consensus Conference on Best Practices in Live Kidney Donation in June 2014. The purpose of this meeting was to identify LKD best practices and knowledge gaps that might influence LDKT, with a focus on patient and donor education, evaluation efficiencies, disparities, and systemic barriers to LKD. In this article, we discuss trends in LDKT/LKD and emerging novel strategies for attenuating disparities, and we offer specific recommendations for future clinical practice, education, research, and policy from the Consensus Conference Workgroup focused on disparities. PMID:25883072

  10. Pogo suppression on space shuttle - early studies

    NASA Technical Reports Server (NTRS)

    Rubin, S.; Wagner, R. G.; Payne, J. G.

    1973-01-01

    Preliminary studies for pogo prevention on the shuttle vehicle are reported. The importance of the effect of oscillatory outflow from a hydroelastic tank is displayed in terms of excitation of normal modes for a structure containing that tank assuming its outlet is closed. Evaluation of an approximate propulsion frequency response at undamped feedline resonance reveals the conditions for which the contribution of tank outflow is destabilizing and also provides a criterion for identifying those structural modes which are of potential significance for system stability. Various finite-element and normal-mode models for hydraulic feedlines are evaluated relative to accuracy of admittances of a long line. A procedure is recommended for modeling a feed system to minimize the required number of second-order equations. Specific recommendations are made for the analytical estimation of pump cavitation compliance and a first estimate for the shuttle pumps is given. Weakness in past practices of pump testing are identified and a new three-phase program is proposed. Finally results of numerical studies on the early vehicle configuration are presented. It is concluded that an accumulator between the boost and main pump offers promise of higher effectiveness than one at the engine inlet.

  11. Research and development needs in the Department of Energy. Interim report

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

    Not Available

    1980-09-05

    In April 1980, the Deputy Secretary requested that the Board participate in the Department's review of the technology base component of DOE's R and D programs and that the Board address the following broad concerns: (1) The adequacy of the research underpinning for technology development programs; (2) Possible gaps or duplications of effort; (3) The balance among research performers (universities, laboratories, industry); (4) Significant R and D opportunities that DOE's programs may be missing. The Board offered the following recommendations to the Secretary: (1) Place greater research emphasis on environmental and health issues to ensure the success of the nationalmore » synfuels program. (2) Provide more research in energy use and productivity projects. (3) Increase the level of effort in basic research. (4) Place higher priority for high-level radioactive waste disposal R and D. (5) Evaluate the various energy technology options on a common comparison basis to clearly identify the costs, benefits and risks of each option. (6) Develop more effective DOE procurement practices. Additional recommendations were directed to the Under Secretary and Assistant Secretaries of Energy reviewing specific issues in conservation, fossil, nuclear and solar energy, resource applications, environment, and energy research.« less

  12. Unreliable Yet Still Replicable: A Comment on LeBel and Paunonen (2011)

    PubMed Central

    De Schryver, Maarten; Hughes, Sean; Rosseel, Yves; De Houwer, Jan

    2016-01-01

    Lebel and Paunonen (2011) highlight that despite their importance and popularity in both theoretical and applied research, many implicit measures continue to be plagued by a persistent and troublesome issue—low reliability. In their paper, they offer a conceptual analysis of the relationship between reliability, power and replicability, and then provide a series of recommendations for researchers interested in using implicit measures in an experimental setting. At the core of their account is the idea that reliability can be equated with statistical power, such that “lower levels of reliability are associated with decreasing probabilities of detecting a statistically significant effect, given one exists in the population” (p. 573). They also take the additional step of equating reliability and replicability. In our commentary, we draw attention to the fact that there is no direct, fixed or one-to-one relation between reliability and power or replicability. More specifically, we argue that when adopting an experimental (rather than a correlational) approach, researchers strive to minimize inter-individual variation, which has a direct impact on sample based reliability estimates. We evaluate the strengths and weaknesses of the LeBel and Paunonen's recommendations and refine them where appropriate. PMID:26793150

  13. Why do children decide not to participate in clinical research: a quantitative and qualitative study.

    PubMed

    Hein, Irma M; Troost, Pieter W; de Vries, Martine C; Knibbe, Catherijne A J; van Goudoever, Johannes B; Lindauer, Ramón J L

    2015-07-01

    More pediatric drug trials are needed, but although specific pediatric regulations warrant safety, recruitment of children for these trials remains one of the main difficulties. Therefore, we investigated potential determining factors of nonparticipation in clinical research, in order to optimize research participation of children by recommending improved recruitment strategies. Between 1 January 2012 and 1 January 2014, we performed a prospective study among161 pediatric patients, aged 6 to 18 y, who were eligible for clinical research. We quantitatively analyzed the association of potential explanatory variables (e.g., age, cognitive development, experience, ethnicity) with nonparticipation and qualitatively analyzed interviews on reasons for nonparticipation. Sixty percent of the children did not participate in the research project on offer (39% decided not to participate, 21% were indecisive). Lower age, less disease experience, and less complex research with lower risk were predictive for not participating. Time constraint and extra burden were expressed as decisive reasons for not participating. Strategies to optimize research participation should be aimed at younger children and their families, who are logistically challenged and unfamiliar with health care and research. Recommendations include informing pediatric patients and their families of the value of research; minimizing logistic burdens; and improving accessibility.

  14. LPA or GeneXpert in the diagnosis of multidrug-resistant tuberculosis.

    PubMed

    Mindru, Roxana; Spinu, Victor; Popescu, Oana

    2016-01-01

    Facing a constant increase of multidrug-resistant tuberculosis (MDR-TB), there is large need for routine use of new diagnostic tests, based on molecular techniques that allow both a rapid diagnosis for TB complex and rapid identification of resistance mutations. The resistances are due to genetic factors: accumulation of changes within the genome structure, acquisition or loss of genes, spontaneous mutations in chromosomal genes, and changes that induce selection of resistant strains during a suboptimal treatment. The bacteriology laboratory plays a crucial role in the making of the diagnosis, monitoring and preventing TB transmission. World Health Organization offers consistent recommendations in favour of use of Xpert MTB/RIF, GeneXpert platform, as initial diagnostic test in adults and children suspected of TB, because it can simultaneously determine the presence of Mycobacterium tuberculosis and the Rifampicin resistance, which is a surrogate marker of MDR strains. The very high sensibility and specificity, also in the smear negative samples, as well as the short time needed for the results, make Xpert MTB/RIF a valuable tool in the fight against TB. Other recommended tests are: LPA, which identifies M. Tuberculosis complex, the Rifancim and Isoniazid resistance; MTBDR plus or, for second line anti-TB drugs, the MTBDRsl.

  15. The Unintended Consequences of Social Media in Healthcare: New Problems and New Solutions.

    PubMed

    Hors-Fraile, S; Atique, S; Mayer, M A; Denecke, K; Merolli, M; Househ, M

    2016-11-10

    Social media is increasingly being used in conjunction with health information technology (health IT). The objective of this paper is to identify some of the undesirable outcomes that arise from this integration and to suggest solutions to these problems. After a discussion with experts to elicit the topics that should be included in the survey, we performed a narrative review based on recent literature and interviewed multidisciplinary experts from different areas. In each case, we identified and analyzed the unintended effects of social media in health IT. Each analyzed topic provided a different set of unintended consequences. Most relevant consequences include lack of privacy with ethical and legal issues, patient confusion in disease management, poor information accuracy in crowdsourcing, unclear responsibilities, misleading and biased information in the prevention and detection of epidemics, and demotivation in gamified health solutions with social components. Using social media in healthcare offers several benefits, but it is not exempt of potential problems, and not all of these problems have clear solutions. We recommend careful design of digital systems in order to minimize patient's feelings of demotivation and frustration and we recommend following specific guidelines that should be created by all stakeholders in the healthcare ecosystem.

  16. Top-selling childbirth advice books: a discourse analysis.

    PubMed

    Kennedy, Holly Powell; Nardini, Katrina; McLeod-Waldo, Rebecca; Ennis, Linda

    2009-12-01

    Recent evidence suggests that one-third of women receive information about pregnancy and childbirth through books. Messages about what characteristics are normal (or expected) in childbirth are disseminated in a variety of ways, including popular childbirth education books, but little study of them has been conducted. The purpose of this investigation is to address that gap by examining the discussions about childbirth in the 10 top-selling books in the United States. Discourse analysis (relating to the public, personal, and political discussions about a specific phenomenon) was used to study 10 best-selling United States childbirth advice books marketed to childbearing women during the first week of November 2007. Book styles ranged from clinical descriptions of pregnancy and birth primarily offering reassurance, self-help information, and danger signs to more folksy and humorous commentaries. Presentation of scientific evidence to support recommendations was uneven and at times inaccurate. Five focal areas of discourse included body image, labor and birth, pain, power and control, and life preparation for motherhood. Top-selling books shine an interesting light on the current state of United States maternity practices. Women and health professionals should assess them carefully and engage with each other about their recommendations and implications for childbirth.

  17. Community engagement for paediatric MDR-TB clinical trials: principles to support ethical trial implementation.

    PubMed

    Hoddinott, G; Staples, S; Brown, R; Simwinga, M; Mubekapi-Musadaidzwa, C; Hesseling, A C; Hendricks, G; De Koker, P; McKenna, L

    2018-05-01

    The paediatric tuberculosis (TB) prevention and treatment landscape is moving into a new and exciting era, with knowledge from clinical trials offering real benefit to children. Community engagement is key to optimising the success of these trials. However, the clinical profile, epidemiology and social perceptions for paediatric multidrug-resistant TB (MDR-TB) complicate the operationalisation of this community engagement. We reflect on a diversity of recent experiences attempting to implement this type of research and the community engagement around it. We describe four recommendations and argue that these should guide the implementation of the community engagement agenda in the new landscape of paediatric MDR-TB clinical trials. Specifically, we argue for 1) dynamic, long-term continuity in community engagement platforms; 2) tiers of TB and research literacy; 3) multiple separate and joint platforms for holding 'stakes'; and 4) addressing the social/structural implications of family participation. We conclude that community-level stakeholders, such as health workers, parents and children, are willing to collaborate in paediatric MDR-TB clinical trials. Using these recommendations, there is considerable opportunity for effective community engagement in this new era of paediatric MDR-TB research.

  18. Understanding variations in secondary findings reporting practices across U.S. genome sequencing laboratories.

    PubMed

    Ackerman, Sara L; Koenig, Barbara A

    2018-01-01

    Increasingly used for clinical purposes, genome and exome sequencing can generate clinically relevant information that is not directly related to the reason for testing (incidental or secondary findings). Debates about the ethical implications of secondary findings were sparked by the American College of Medical Genetics (ACMG) 2013 policy statement, which recommended that laboratories report pathogenic alterations in 56 genes. Although wide variation in laboratories' secondary findings policies has been reported, little is known about its causes. We interviewed 18 laboratory directors and genetic counselors at 10 U.S. laboratories to investigate the motivations and interests shaping secondary findings reporting policies for clinical exome sequencing. Analysis of interview transcripts and laboratory documents was informed by sociological theories of standardization. Laboratories varied widely in terms of the types of secondary findings reported, consent-form language, and choices offered to patients. In explaining their adaptation of the ACMG report, our participants weighed genetic information's clinical, moral, professional, and commercial value in an attempt to maximize benefits for patients and families, minimize the costs of sequencing and analysis, adhere to professional norms, attract customers, and contend with the uncertain clinical implications of much of the genetic information generated. Nearly all laboratories in our study voluntarily adopted ACMG's recommendations, but their actual practices varied considerably and were informed by laboratory-specific judgments about clinical utility and patient benefit. Our findings offer a compelling example of standardization as a complex process that rarely leads simply to uniformity of practice. As laboratories take on a more prominent role in decisions about the return of genetic information, strategies are needed to inform patients, families, and clinicians about the differences between laboratories' practices and ensure that the consent process prompts a discussion of the value of additional genetic information for patients and their families.

  19. Case reports to suggest an algorithm for management of total fertilisation failure prior to use of donor gametes.

    PubMed

    Nicopoullos, James D M; Whitney, E; Wells, V; Batha, S; Faris, R; Abdalla, H

    2015-11-01

    Total fertilisation failure (TFF), even with intracytoplasmic sperm injection (ICSI), occurs in approximately 3 % of cycles, can be recurrent and the exact cause is difficult to elucidate. Differentiation between oocyte and sperm-related cause of TFF is possible using mouse oocyte-activation techniques, but is not an option within most clinical settings. Therefore, the management of these couples is clinically driven, and the endpoint, if recurrent, is often the use of donor gametes. However, with the invariable lack of a definitive cause of TFF, any decision between the use of donor sperm or oocytes remains an emotive one. We present two case reports demonstrating the importance of appropriate investigation, activation techniques (mechanical and chemical) and clinical management options to develop a clinical algorithm prior to the use of donor gametes. This study is composed of two case reports of assisted reproduction investigation and treatment within an assisted conception unit for couples with recurrent total fertilisation failure. Using appropriate investigation (endocrine, urological and embryological) and treatments (ICSI, IMSI, oocyte-activation techniques), a fertilisation rate of 48 % was achieved in two cycles in couples following a total of nine previous cycles (and 200 previously collected eggs) with TFF. Oocyte activation requires the triggering of intracellular calcium oscillations by the release of a sperm-specific factor (phospholipase C zeta (PLCζ)) into the oocyte cytoplasm. Although, PLCζ deficiencies have been demonstrated as putative causes of failed activation, impaired oocyte responsiveness may also be a factor. The use of donor gametes is often recommended and is often the required endpoint of treatment. However, these reports outline a clinical algorithm that potentially offers success without donation, and also offers a systematic approach to help decide whether donor oocytes or sperm should be recommended.

  20. 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.

  1. Nutraceutical approaches to metabolic syndrome.

    PubMed

    Sirtori, Cesare R; Pavanello, Chiara; Calabresi, Laura; Ruscica, Massimiliano

    2017-12-01

    Metabolic Syndrome (MetS), affecting at least 30% of adults in the Western World, is characterized by three out of five variables, from high triglycerides, to elevated waist circumference and blood pressure. MetS is not characterized by elevated cholesterolemia, but is rather the consequence of a complex interaction of factors generally leading to increased insulin resistance. Drug treatments are of difficult handling, whereas well-characterized nutraceuticals may offer an effective alternative. Among these, functional foods, e.g. plant proteins, have been shown to improve insulin resistance and reduce triglyceride secretion. Pro- and pre-biotics, that are able to modify intestinal microbiome, reduce absorption of specific nutrients and improve the metabolic handling of energy-rich foods. Finally, specific nutraceuticals have proven to be of benefit, in particular, red-yeast rice, berberine, curcumin as well as vitamin D. All these can improve lipid handling by the liver as well as ameliorate insulin resistance. While lifestyle approaches, such as with the Mediterranean diet, may prove to be too complex for the single patient, better knowledge of selected nutraceuticals and more appropriate formulations leading to improved bioavailability will certainly widen the use of these agents, already in large use for the management of these very frequent patient groups. Key messages Functional foods, e.g. plant proteins, improve insulin resistance. Pro- and pre-biotics improve the metabolic handling of energy-rich foods. Nutraceutical can offer a significant help in handling MetS patients being part of lifestyle recommendations.

  2. What do clinicians want? Interest in integrative health services at a North Carolina academic medical center

    PubMed Central

    Kemper, Kathi J; Dirkse, Deborah; Eadie, Dee; Pennington, Melissa

    2007-01-01

    Background Use of complementary medicine is common, consumer driven and usually outpatient focused. We wished to determine interest among the medical staff at a North Carolina academic medical center in integrating diverse therapies and services into comprehensive care. Methods We conducted a cross sectional on-line survey of physicians, nurse practitioners and physician assistants at a tertiary care medical center in 2006. The survey contained questions on referrals and recommendations in the past year and interest in therapies or services if they were to be provided at the medical center in the future. Results Responses were received from 173 clinicians in 26 different departments, programs and centers. There was strong interest in offering several specific therapies: therapeutic exercise (77%), expert consultation about herbs and dietary supplements (69%), and massage (66%); there was even stronger interest in offering comprehensive treatment programs such as multidisciplinary pain management (84%), comprehensive nutritional assessment and advice (84%), obesity/healthy lifestyle promotion (80%), fit for life (exercise and lifestyle program, 76%), diabetes healthy lifestyle promotion (73%); and comprehensive psychological services for stress management, including hypnosis and biofeedback (73%). Conclusion There is strong interest among medical staff at an academic health center in comprehensive, integrated services for pain, obesity, and diabetes and in specific services in fitness, nutrition and stress management. Future studies will need to assess the cost-effectiveness of such services, as well as their financial sustainability and impact on patient satisfaction, health and quality of life. PMID:17291340

  3. 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.

  4. Integrated software system for improving medical equipment management.

    PubMed

    Bliznakov, Z; Pappous, G; Bliznakova, K; Pallikarakis, N

    2003-01-01

    The evolution of biomedical technology has led to an extraordinary use of medical devices in health care delivery. During the last decade, clinical engineering departments (CEDs) turned toward computerization and application of specific software systems for medical equipment management in order to improve their services and monitor outcomes. Recently, much emphasis has been given to patient safety. Through its Medical Device Directives, the European Union has required all member nations to use a vigilance system to prevent the reoccurrence of adverse events that could lead to injuries or death of patients or personnel as a result of equipment malfunction or improper use. The World Health Organization also has made this issue a high priority and has prepared a number of actions and recommendations. In the present workplace, a new integrated, Windows-oriented system is proposed, addressing all tasks of CEDs but also offering a global approach to their management needs, including vigilance. The system architecture is based on a star model, consisting of a central core module and peripheral units. Its development has been based on the integration of 3 software modules, each one addressing specific predefined tasks. The main features of this system include equipment acquisition and replacement management, inventory archiving and monitoring, follow up on scheduled maintenance, corrective maintenance, user training, data analysis, and reports. It also incorporates vigilance monitoring and information exchange for adverse events, together with a specific application for quality-control procedures. The system offers clinical engineers the ability to monitor and evaluate the quality and cost-effectiveness of the service provided by means of quality and cost indicators. Particular emphasis has been placed on the use of harmonized standards with regard to medical device nomenclature and classification. The system's practical applications have been demonstrated through a pilot evaluation trial.

  5. 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.

  6. 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.

  7. 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.

  8. 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)

  9. 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.

  10. 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.

  11. Direct and indirect effectiveness of influenza vaccination delivered to children at school preceding an epidemic caused by 3 new influenza virus variants.

    PubMed

    Glezen, W Paul; Gaglani, Manjusha J; Kozinetz, Claudia A; Piedra, Pedro A

    2010-12-01

    Influenza is an uncontrolled epidemic disease that is vaccine preventable. New recommendations for universal immunization present a challenge to the implementation of vaccine delivery. This field trial examines the effectiveness of school-based clinics for vaccine delivery before an epidemic caused by 3 new influenza virus variants not contained in the vaccine. Live attenuated influenza vaccine (LAIV) was offered to eligible children in elementary schools of eastern Bell County, Texas. Age-specific rates of medically attended acute respiratory illness for health plan members at the intervention site were compared with those for members at comparison sites during the epidemic, defined by viral surveillance at all sites. Almost 48% of children in elementary schools were vaccinated. Significant herd protection attributed to LAIV was detected for all age groups except 12-17-year-old students, who were not offered free vaccine. Approximately 2500 medical encounters were prevented at the intervention site. Inactivated vaccine provided marginal protection against the epidemic viruses. LAIV delivered to elementary-school children before an epidemic caused by 3 new variant influenza viruses generated significant cross-protection for the recipients and indirect (herd) protection for the community.

  12. Management of inflammatory bowel disease-related anemia and iron deficiency with specific reference to the role of intravenous iron in current practice.

    PubMed

    Stein, Jürgen; Aksan, Ayşegül; Farrag, Karima; Dignass, Axel; Radeke, Heinfried H

    2017-11-01

    Anemia is a common extraintestinal manifestation in patients with inflammatory bowel disease, impacting disease prognosis, morbidity, hospitalization rates and time lost from work. While iron deficiency anemia and anemia of chronic inflammation predominate, combinations of hematimetric and biochemical markers facilitate the diagnosis and targeted therapy of other etiologies according to their underlying pathophysiological causes. Intravenous iron replacement is currently recommended in IBD patients with moderate to severe anemia or intolerance to oral iron. Areas covered: This review examines the impact, pathophysiology and diagnostics of iron deficiency and anemia, compares the characteristics and safety profiles of available oral and intravenous iron preparations, and highlights issues which require consideration in decision making for therapy administration and monitoring. Expert opinion: Modern intravenous iron formulations have been shown to be safe and effective in IBD patients, allowing rapid anemia correction and repletion of iron stores. While traditional oral iron preparations are associated with increased inflammation, negative effects on the microbiome, and poor tolerance and compliance, first clinical trial data indicate that newer oral compounds such as ferric maltol and sucrosomial iron offer improved tolerability and may thus offer a viable alternative for the future.

  13. Designing and Interpreting Limiting Dilution Assays: General Principles and Applications to the Latent Reservoir for Human Immunodeficiency Virus-1.

    PubMed

    Rosenbloom, Daniel I S; Elliott, Oliver; Hill, Alison L; Henrich, Timothy J; Siliciano, Janet M; Siliciano, Robert F

    2015-12-01

    Limiting dilution assays are widely used in infectious disease research. These assays are crucial for current human immunodeficiency virus (HIV)-1 cure research in particular. In this study, we offer new tools to help investigators design and analyze dilution assays based on their specific research needs. Limiting dilution assays are commonly used to measure the extent of infection, and in the context of HIV they represent an essential tool for studying latency and potential curative strategies. Yet standard assay designs may not discern whether an intervention reduces an already miniscule latent infection. This review addresses challenges arising in this setting and in the general use of dilution assays. We illustrate the major statistical method for estimating frequency of infectious units from assay results, and we offer an online tool for computing this estimate. We recommend a procedure for customizing assay design to achieve desired sensitivity and precision goals, subject to experimental constraints. We consider experiments in which no viral outgrowth is observed and explain how using alternatives to viral outgrowth may make measurement of HIV latency more efficient. Finally, we discuss how biological complications, such as probabilistic growth of small infections, alter interpretations of experimental results.

  14. The importance of health belief models in determining self-care behaviour in diabetes.

    PubMed

    Harvey, J N; Lawson, V L

    2009-01-01

    Patients' self-care behaviours have a major role in diabetes management. Diabetes education provides the required knowledge, but despite this, self-care is often suboptimal. The degree to which patients follow advice as regards the various self-care behaviours is determined by their health beliefs (Illness Representations or Personal Models) of diabetes. Psychometric studies have tried to categorize and measure the beliefs about illness that influence patients to adhere to treatment recommendations in diabetes. Various models have been proposed to explain the relationship between beliefs and behaviour. Leventhal's Self-Regulatory Model, which takes account of the emotional as well as the objective rational response to illness, currently seems to offer the best system for identifying the determinants of patient self-care behaviour. A review of interventions indicates those based on psychological theory offer professionals the best chance of maximizing their patients' contribution to diabetes self-management and achieving improved outcomes, both glycaemic and psychosocial. Studies designed specifically to modify illness representations are now being undertaken. This brief review aims to summarize developments in this area of psychological theory over the last 20 years and the implications for promoting better self-care behaviour in diabetes.

  15. 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.

  16. 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…

  17. Twelve tips for overnight teaching.

    PubMed

    Richards, Jeremy B; Wilcox, Susan R; Roberts, David H; Schwartzstein, Richard M

    2014-03-01

    The European Working Time Directive and the United States' duty hour restrictions have changed resident physicians' schedules, specifically increasing overnight shifts and decreasing overall time spent in the hospital. As residents' perception of night shifts is that they have little educational value, efforts to improve educational opportunities and night attending teaching are desirable. However, resources about and recommendations for best practices for overnight teaching by faculty are scarce. To provide 12 tips to highlight strategies intended to optimize attending physicians' overnight teaching skills and strategies. The tips provided are based on our experiences and reflections as in-house faculty supervising residents working overnight, by our experience and group discussions as medical educators, and the available literature. The 12 tips presented offer specific strategies to optimize attending physicians' overnight teaching for resident physicians, specifically highlighting the unique logistics, pedagogy and follow-up of overnight teaching. Preparation for teaching is important in any environment, but understanding the unique timing and circumstances associated with overnight teaching is vital to ensure that overnight teaching is effective. Acknowledging and addressing the physical and cognitive obstacles associated with overnight teaching and learning is necessary to maximize the educational value of overnight teaching.

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

    Peck, T; Sparkman, D; Storch, N

    ''The LLNL Site-Specific Advanced Simulation and Computing (ASCI) Software Quality Engineering Recommended Practices VI.I'' document describes a set of recommended software quality engineering (SQE) practices for ASCI code projects at Lawrence Livermore National Laboratory (LLNL). In this context, SQE is defined as the process of building quality into software products by applying the appropriate guiding principles and management practices. Continual code improvement and ongoing process improvement are expected benefits. Certain practices are recommended, although projects may select the specific activities they wish to improve, and the appropriate time lines for such actions. Additionally, projects can rely on the guidance ofmore » this document when generating ASCI Verification and Validation (VSrV) deliverables. ASCI program managers will gather information about their software engineering practices and improvement. This information can be shared to leverage the best SQE practices among development organizations. It will further be used to ensure the currency and vitality of the recommended practices. This Overview is intended to provide basic information to the LLNL ASCI software management and development staff from the ''LLNL Site-Specific ASCI Software Quality Engineering Recommended Practices VI.I'' document. Additionally the Overview provides steps to using the ''LLNL Site-Specific ASCI Software Quality Engineering Recommended Practices VI.I'' document. For definitions of terminology and acronyms, refer to the Glossary and Acronyms sections in the ''LLNL Site-Specific ASCI Software Quality Engineering Recommended Practices VI.I''.« less

  19. 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.

  20. 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)

  1. 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)

  2. 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 ...

  3. 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.

  4. 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.

  5. Recommendations for intra-abdominal infections consensus report

    PubMed Central

    Avkan-Oğuz, Vildan; Baykam, Nurcan; Sökmen, Selman; Güner, Rahmet; Agalar, Fatih; Alp, Emine; Doğrul, Ahmet; Turhan, Özge; Ağalar, Canan; Kurtaran, Behice; Geçim, İbrahim Ethem; Özaras, Reşat; Yılmaz, Gürdal; Akbulut, Ayhan; Koksal, İftihar

    2016-01-01

    Guidelines include the recommendations of experts from various specialties within a topic in consideration of data specific to each country. However, to date there has not been a guideline standardizing the nomenclature and offering recommendations for intra-abdominal infections (IAIs) in Turkey. This is mainly due to the paucity of laboratory studies regarding the clinical diagnosis and treatment of IAIs or the sensitivity of microorganisms isolated from patients with IAIs. However, due to the diversification of host characteristics and advancements in technological treatment methods, it has become imperative to ‘speak a common language’. For this purpose May 2015, a group of 15 experts in intra-abdominal infections, under the leadership of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey (EKMUD) and with representatives from the Turkish Surgical Association, Turkish Society of Colon and Rectal Surgery, Hernia Society, Turkish Society of Hepato-pancreato-biliary Surgery, and the Turkish Society of Hospital Infections and Control, was formed to analyze relevant studies in the literature. Ultimately, the suggestions for adults found in this consensus report were developed using available data from Turkey, referring predominantly to the 2010 guidelines for diagnosing and managing complicated IAIs in adults and children by the Infectious Diseases Society of America (IDSA) and the Surgical Infection Society. The recommendations are presented in two sections, from the initial diagnostic evaluation of patients to the treatment approach for IAI. This Consensus Report was presented at the EKMUD 2016 Congress in Antalya and was subsequently opened for suggestions on the official websites of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey and Turkish Surgical Association for one month. The manuscript was revised according to the feedback received. PMID:28149134

  6. Wellness programs: a remedy for reducing healthcare costs.

    PubMed

    Kocakulah, Mehmet C; Joseforsky, Holly

    2002-01-01

    Offering wellness programs has become a popular method for preserving the health of employees in the hope of generating lower healthcare expenses and, in turn, higher profits. This article offers a cost/benefits analysis of providing wellness programs, to determine whether such programs could add value to a company. Recommendations follow for how to implement a successful wellness program with minimal initial costs should an analysis find that wellness initiatives would prove beneficial.

  7. Productive work groups in complex hospital units. Proposed contributions of the nurse executive.

    PubMed

    Sheafor, M

    1991-05-01

    The Fiedler and Garcia cognitive resources contingency model of leadership offers a new approach for nurse executives to influence the productivity of work groups led by nurse managers. The author offers recommendations toward achieving the relatively stress-free environment for nurse managers specified by the model using Schmeiding's application of Orlando's communication theory to nursing administration. Suggestions for incorporating these insights into graduate education for nursing administration follow.

  8. What do we think we are doing? How might a clinical information network be promoting implementation of recommended paediatric care practices in Kenyan hospitals?

    PubMed

    English, Mike; Ayieko, Philip; Nyamai, Rachel; Were, Fred; Githanga, David; Irimu, Grace

    2017-02-02

    The creation of a clinical network was proposed as a means to promote implementation of a set of recommended clinical practices targeting inpatient paediatric care in Kenya. The rationale for selecting a network as a strategy has been previously described. Here, we aim to describe network activities actually conducted over its first 2.5 years, deconstruct its implementation into specific components and provide our 'insider' interpretation of how the network is functioning as an intervention. We articulate key activities that together have constituted network processes over 2.5 years and then utilise a recently published typology of implementation components to give greater granularity to this description from the perspective of those delivering the intervention. Using the Behaviour Change Wheel we then suggest how the network may operate to achieve change and offer examples of change before making an effort to synthesise our understanding in the form of a realist context-mechanism-outcome configuration. We suggest our network is likely to comprise 22 from a total of 73 identifiable intervention components, of which 12 and 10 we consider major and minor components, respectively. At the policy level, we employed clinical guidelines, marketing and communication strategies with intervention characteristics operating through incentivisation, persuasion, education, enablement, modelling and environmental restructuring. These might influence behaviours by enhancing psychological capability, creating social opportunity and increasing motivation largely through a reflective pathway. We previously proposed a clinical network as a solution to challenges implementing recommended practices in Kenyan hospitals based on our understanding of theory and context. Here, we report how we have enacted what was proposed and use a recent typology to deconstruct the intervention into its elements and articulate how we think the network may produce change. We offer a more generalised statement of our theory of change in a context-mechanism-outcome configuration. We hope this will complement a planned independent evaluation of 'how things work', will help others interpret results of change reported more formally in the future and encourage others to consider further examination of networks as means to scale up improvement practices in health in lower income countries.

  9. On Establishing Big Data Wave Breakwaters with Analytics (Invited)

    NASA Astrophysics Data System (ADS)

    Riedel, M.

    2013-12-01

    The Research Data Alliance Big Data Analytics (RDA-BDA) Interest Group seeks to develop community based recommendations on feasible data analytics approaches to address scientific community needs of utilizing large quantities of data. RDA-BDA seeks to analyze different scientific domain applications and their potential use of various big data analytics techniques. A systematic classification of feasible combinations of analysis algorithms, analytical tools, data and resource characteristics and scientific queries will be covered in these recommendations. These combinations are complex since a wide variety of different data analysis algorithms exist (e.g. specific algorithms using GPUs of analyzing brain images) that need to work together with multiple analytical tools reaching from simple (iterative) map-reduce methods (e.g. with Apache Hadoop or Twister) to sophisticated higher level frameworks that leverage machine learning algorithms (e.g. Apache Mahout). These computational analysis techniques are often augmented with visual analytics techniques (e.g. computational steering on large-scale high performance computing platforms) to put the human judgement into the analysis loop or new approaches with databases that are designed to support new forms of unstructured or semi-structured data as opposed to the rather tradtional structural databases (e.g. relational databases). More recently, data analysis and underpinned analytics frameworks also have to consider energy footprints of underlying resources. To sum up, the aim of this talk is to provide pieces of information to understand big data analytics in the context of science and engineering using the aforementioned classification as the lighthouse and as the frame of reference for a systematic approach. This talk will provide insights about big data analytics methods in context of science within varios communities and offers different views of how approaches of correlation and causality offer complementary methods to advance in science and engineering today. The RDA Big Data Analytics Group seeks to understand what approaches are not only technically feasible, but also scientifically feasible. The lighthouse Goal of the RDA Big Data Analytics Group is a classification of clever combinations of various Technologies and scientific applications in order to provide clear recommendations to the scientific community what approaches are technicalla and scientifically feasible.

  10. 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

  11. How to Design Tobacco Prevention and Control Games for Youth and Adolescents: A Qualitative Analysis of Expert Interviews.

    PubMed

    Hall, Amanda K; Mercado, Rebeccah; Anderson-Lewis, Charkarra; Darville, Gabrielle; Bernhardt, Jay M

    2015-12-01

    Games for health, including digital videogames and gaming-based approaches, are increasingly being used in health promotion research and practice. Recently published research has shown that videogames have significant potential to promote healthy behaviors among youth and adolescents. Yet, there is a lack of available evidence-based resources to guide practitioners on the integration of games into tobacco prevention and smoking cessation interventions. To address this gap, expert researchers and game developers were interviewed to further define games for health, explore the current research, and provide recommendations for developing, evaluating, and promoting effective anti-tobacco games. Nationally recognized experts on game development, games for health, tobacco, and health behavior were asked to participate. A qualitative analysis of 25 in-depth individual interviews using a constant comparative approach for emerging themes was conducted. Main themes that emerged from the data analysis included the following: (1) the current state of games for health research to facilitate health behavior change, (2) strategies for how to develop and evaluate games for quality and impact, and (3) recommendations for how to effectively design tobacco prevention and smoking cessation educational videogames that engage youth and adolescents. The synthesized findings identified through these expert interviews offer stakeholders strategies for how to incorporate games for health within their current and future work. Specific recommendations are presented for developers and researchers to consider when developing and evaluating videogames for tobacco prevention and smoking cessation targeted at youth and adolescents.

  12. 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.

  13. Rationalizing antibiotic use to limit antibiotic resistance in India+

    PubMed Central

    2011-01-01

    Antibiotic resistance, a global concern, is particularly pressing in developing nations, including India, where the burden of infectious disease is high and healthcare spending is low. The Global Antibiotic Resistance Partnership (GARP) was established to develop actionable policy recommendations specifically relevant to low- and middle-income countries where suboptimal access to antibiotics - not a major concern in high-income countries - is possibly as severe a problem as is the spread of resistant organisms. This report summarizes the situation as it is known regarding antibiotic use and growing resistance in India and recommends short and long term actions. Recommendations aim at (i) reducing the need for antibiotics; (ii) lowering resistance-enhancing drug pressure through improved antibiotic targeting, and (iii) eliminating antibiotic use for growth promotion in agriculture. The highest priority needs to be given to (i) national surveillance of antibiotic resistance and antibiotic use - better information to underpin decisions on standard treatment guidelines, education and other actions, as well as to monitor changes over time; (ii) increasing the use of diagnostic tests, which necessitates behavioural changes and improvements in microbiology laboratory capacity; (iii) setting up and/or strengthening infection control committees in hospitals; and (iv) restricting the use of antibiotics for non-therapeutic uses in agriculture. These interventions should help to reduce the spread of antibiotic resistance, improve public health directly, benefit the populace and reduce pressure on the healthcare system. Finally, increasing the types and coverage of childhood vaccines offered by the government would reduce the disease burden enormously and spare antibiotics. PMID:21985810

  14. Recommendations for age-appropriate education of children and adolescents with diabetes and their parents in the European Union.

    PubMed

    Martin, Delphine; Lange, Karin; Sima, Alexandra; Kownatka, Dagmar; Skovlund, Søren; Danne, Thomas; Robert, Jean-Jacques

    2012-09-01

    Education is the keystone of diabetes care, and structured self-management education is the key to a successful outcome. Existing guidelines provide comprehensive guidance on the various aspects of education and offer general and organizational principles of education, detailed curricula at different ages and stages of diabetes, and recommendations on models, methods, and tools to attain educative objectives. The International Society for Pediatric and Adolescent Diabetes guidelines give the most elaborate and detailed descriptions and recommendations on the practice of education, which other national guidelines address on specific aspects of education and care. The aim of the work package on education developed by Better Control in Paediatric and Adolescent Diabetes in the European Union: Working to Create Centers of Reference (SWEET) project was not to generate new guidelines but to evaluate how the existing guidelines were implemented in some pediatric diabetes reference centers. The SWEET members have completed a questionnaire that elaborates on the many aspects of delivery of education. This survey highlights a profound diversity of practices across centers in Europe, in terms of organization as well as the practices and the content of initial and continuing education. A toolbox is being developed within SWEET to facilitate exchanges on all aspects of education and to establish a process of validation of materials, tools, written structured age-adjusted programs, and evaluation procedures for the education of children and adolescents with diabetes. © 2012 John Wiley & Sons A/S.

  15. Development and validation of measures to assess prevention and control of AMR in hospitals.

    PubMed

    Flanagan, Mindy; Ramanujam, Rangaraj; Sutherland, Jason; Vaughn, Thomas; Diekema, Daniel; Doebbeling, Bradley N

    2007-06-01

    The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. To develop and validate a measurement scale for assessing hospitals' efforts to implement recommended AMR prevention and control measures. Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. : Four hundred forty-eight infection control professionals participated (67% response rate). Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. "Derivation" and "validation" samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.

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

    PubMed

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

    2017-04-01

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

  17. National Athletic Trainers' Association Position Statement: Preventing, Detecting, and Managing Disordered Eating in Athletes

    PubMed Central

    Bonci, Christine M; Bonci, Leslie J; Granger, Lorita R; Johnson, Craig L; Malina, Robert M; Milne, Leslie W; Ryan, Randa R; Vanderbunt, Erin M

    2008-01-01

    Objective: To present recommendations for the prevention, detection, and comprehensive management of disordered eating (DE) in athletes. Background: Athletes with DE rarely self-report their symptoms. They tend to deny the condition and are often resistant to referral and treatment. Thus, screenings and interventions must be handled skillfully by knowledgeable professionals to obtain desired outcomes. Certified athletic trainers have the capacity and responsibility to play active roles as integral members of the health care team. Their frequent daily interactions with athletes help to facilitate the level of medical surveillance necessary for early detection, timely referrals, treatment follow-through, and compliance. Recommendations: These recommendations are intended to provide certified athletic trainers and others participating in the health maintenance and performance enhancement of athletes with specific knowledge and problem-solving skills to better prevent, detect, and manage DE. The individual biological, psychological, sociocultural, and familial factors for each athlete with DE result in widely different responses to intervention strategies, challenging the best that athletics programs have to offer in terms of resources and expertise. The complexity, time intensiveness, and expense of managing DE necessitate an interdisciplinary approach representing medicine, nutrition, mental health, athletic training, and athletics administration in order to facilitate early detection and treatment, make it easier for symptomatic athletes to ask for help, enhance the potential for full recovery, and satisfy medicolegal requirements. Of equal importance is establishing educational initiatives for preventing DE. PMID:18335017

  18. Recommendations for the Design and Analysis of Treatment Trials for Alcohol Use Disorders

    PubMed Central

    Witkiewitz, Katie; Finney, John W.; Harris, Alex H.S; Kivlahan, Daniel R.; Kranzler, Henry R.

    2015-01-01

    Background Over the past 60 years the view that “alcoholism” is a disease for which the only acceptable goal of treatment is abstinence has given way to the recognition that alcohol use disorders (AUDs) occur on a continuum of severity, for which a variety of treatment options are appropriate. However, because the available treatments for AUDs are not effective for everyone, more research is needed to develop novel and more efficacious treatments to address the range of AUD severity in diverse populations. Here we offer recommendations for the design and analysis of alcohol treatment trials, with a specific focus on the careful conduct of randomized clinical trials of medications and non-pharmacological interventions for AUDs. Methods Narrative review of the quality of published clinical trials and recommendations for the optimal design and analysis of treatment trials for AUDs. Results Despite considerable improvements in the design of alcohol clinical trials over the past two decades, many studies of AUD treatments have used faulty design features and statistical methods that are known to produce biased estimates of treatment efficacy. Conclusions The published statistical and methodological literatures provide clear guidance on methods to improve clinical trial design and analysis. Consistent use of state-of-the-art design features and analytic approaches will enhance the internal and external validity of treatment trials for AUDs across the spectrum of severity. The ultimate result of this attention to methodological rigor is that better treatment options will be identified for patients with an AUD. PMID:26250333

  19. The omni-relevance of surgery: how medical specialization shapes orthopedic surgeons' treatment recommendations.

    PubMed

    Hudak, Pamela L; Clark, Shannon J; Raymond, Geoffrey

    2013-01-01

    This article examines treatment recommendations in orthopedic surgery consultations and shows how surgery is treated as "omni-relevant" within this activity, providing a context within which the broad range of treatment recommendations proposed by surgeons is offered. Using conversation analysis to analyse audiotaped encounters between orthopedic surgeons and patients, we highlight how surgeons treat surgery as having a special, privileged status relative to other treatment options by (1) invoking surgery (whether or not it is actually being recommended) and (2) presenting surgery as the "last best resort" (in relation to which other treatment options are calibrated, described and considered). This privileged status surfaces in the design and delivery of recommendations as a clear asymmetry: Recommendations for surgery are proposed early, in relatively simple and unmitigated form. In contrast, recommendations not for surgery tend to be delayed and involve significantly more interactional work in their delivery. Possible implications of these findings, including how surgeons' structuring of recommendations may shape patient expectations (whether for surgery or some alternative), and potentially influence the distribution of orthopedic surgery procedures arising from these consultations, are considered.

  20. Application of Recommended Design Practices for Conceptual Nuclear Fusion Space Propulsion Systems

    NASA Technical Reports Server (NTRS)

    Williams, Craig H.

    2004-01-01

    An AIAA Special Project Report was recently produced by AIAA's Nuclear and Future Flight Propulsion Technical Committee and is currently in peer review. The Report provides recommended design practices for conceptual engineering studies of nuclear fusion space propulsion systems. Discussion and recommendations are made on key topics including design reference missions, degree of technological extrapolation and concomitant risk, thoroughness in calculating mass properties (nominal mass properties, weight-growth contingency and propellant margins, and specific impulse), and thoroughness in calculating power generation and usage (power-flow, power contingencies, specific power). The report represents a general consensus of the nuclear fusion space propulsion system conceptual design community and proposes 15 recommendations. This paper expands on the Report by providing specific examples illustrating how to apply each of the recommendations.

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