Practice innovation: the need for nimble data platforms to implement precision oncology care.

PubMed

Elfiky, Aymen; Zhang, Dongyang; Krishnan Nair, Hari K

2015-01-01

Given the drive toward personalized, value-based, and coordinated cancer care delivery, modern knowledge-based practice is being shaped within the context of an increasingly technology-driven healthcare landscape. The ultimate promise of 'precision medicine' is predicated on taking advantage of the range of new capabilities for integrating disease- and individual-specific data to define new taxonomies as part of a systems-based knowledge network. Specifically, with cancer being a constantly evolving complex disease process, proper care of an individual will require the ability to seamlessly integrate multi-dimensional 'omic' and clinical data. Importantly, however, the challenges of curating knowledge from multiple dynamic data sources and translating to practice at the point-of-care highlight parallel needs. As patients, caregivers, and their environments become more proactive in clinical care and management, practical success of precision medicine is equally dependent on the development of proper infrastructures for evolving data integration, platforms for knowledge representation in a clinically-relevant context, and implementation within a provider's work-life and workflow.

Ancient Dietary Wisdom for Tomorrow's Children.

ERIC Educational Resources Information Center

Fallon, Sally

1997-01-01

A review of Dr. Weston Price's work on the nutritional practices of "primitive" peoples and their subsequent levels of physical development shows that animal fats and cholesterol are not villains but vital factors in the diet, necessary for normal growth, proper functioning of the brain and nervous system, protection from disease, and…

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

ERIC Educational Resources Information Center

NELSON, GWEN

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

Performance Analysis of Saturated Induction Motors by Virtual Tests

ERIC Educational Resources Information Center

Ojaghi, M.; Faiz, J.; Kazemi, M.; Rezaei, M.

2012-01-01

Many undergraduate-level electrical machines textbooks give detailed treatments of the performance of induction motors. Students can deepen this understanding of motor performance by performing the appropriate practical work in laboratories or in simulation using proper software packages. This paper considers various common and less-common tests…

The proper contributions of social workers in health practice.

PubMed

Huntington, J

1986-01-01

Current and potential future contributions of social workers to health practice are considered at the three levels of direct service to patients, influence on the processes and procedures of the health setting and influence on its future planning and service development. The capacity of U.S.A. and U.K. social work to contribute at these levels is compared in the light of their contrasting relationships to the health system. U.S.A. social work in health care is practised as employees of the health setting or as private practitioners and contains the majority of U.S.A. social workers. It remains a specialism that sustains a major body of published work, commitment to knowledge-building, standard setting and performance review, and a psycho-social orientation shared by a growing number of medical and nursing professionals. Its approach to the health system is that of the pursuit of professional credibility in the secondary setting by adopting the professional-technical practice model of the clinician. U.K. social work since the early 1970s has been committed to generic education and practice and to the development of its own primary setting in social services departments which now employ almost all U.K. social workers. Area team social work in these departments, typified by statutory work with the most deprived sections of the population, has become the dominant culture of British social work, with implications for the occupational identity and career prospects of those social workers who are outposted or attached to health settings but no longer employed by them. British social work and its management now approach the health system from a position of organizational independence which should strengthen their capacity to influence the health system. The cultural differences between social work and medicine, however, are experienced more keenly than ever as many social workers adopt a socio-political practice model that is at odds with the professional-technical model of the clinician. Provision of social work services to the health system has become a questionable priority and raises the issue of whether much of what is now termed "health care' could more appropriately be termed "social care' and provided in a primary social work setting to which medicine and nursing would make their "proper contributions'.

Forum: Communication Activism Pedagogy. Expanding CAP's Interventionist Model and Developing Proper Learning Rubrics

ERIC Educational Resources Information Center

Del Gandio, Jason

2017-01-01

For Frey and Palmer (2014), communication activism pedagogy (CAP) "teaches students how to use their communication knowledge and resources (e.g., theories, research methods, pedagogies, and other practices) to work with community members to intervene into and reconstruct unjust discourses in more just ways." The author of this response…

What if the Spirit Does Not Move Me? A Personal Reconnaissance and Reconciliation

ERIC Educational Resources Information Center

Hoyt, Carlos A.

2008-01-01

The burgeoning recognition of the influence of religion and spirituality in personal, cultural, and political affairs has spurred discussions regarding the need for social work practice to be sensitive and responsive to the presence of spirituality in the lives of clients. However, though attending properly to clients' coping styles involving…

Knowledge of Good Blood Culture Sampling Practice among Healthcare Staffs in An Emergency Department - Are We Getting It Right?

PubMed

Chew, K S; Mohd Hashairi, F; Jusoh, A F; Aziz, A A; Nik Hisamuddin, N A R; Siti Asma, H

2013-08-01

Although a vital test, blood culture is often plagued with the problem of contamination and false results, especially in a chaotic emergency department setting. The objectives of this pilot study is to find out the level of understanding among healthcare staffs in emergency department, Hospital Universiti Sains Malaysia (HUSM) regarding good blood culture sampling practice. All healthcare staffs in emergency department, HUSM who consented to this study were given a set of selfadministered anonymous questionnaire to fill. More than half (53.1%) of the 64 participants are emergency medicine residents. Majority of them (75%) have been working in the emergency medicine, HUSM for more than 2 years. More than half of them were able to answer correctly the amount of blood volume needed for culture in adult and pediatric patients. When asked what are the factors required to improve the true yield as well as to reduce the risk of culture contamination, the four commonest answers given were observing proper aseptic technique during blood sampling, donning sterile glove, proper hand scrubbing as well as ensuring the sterility of the equipments. This study suggests that there is a lack of proper knowledge of good blood culture sampling practice among our healthcare staffs in emergency department.

Tuberculosis infection control practices and associated factors among health care workers in health centers of West Gojjam zone, Northwest Ethiopia: a cross-sectional study.

PubMed

Tamir, Kassahun; Wasie, Belaynew; Azage, Muluken

2016-08-08

Tuberculosis (TB) remains a major global health problem. The emerging epidemic of multi- and extensively drug-resistant (M/XDR) TB further imperils health workers, patients and public health. Health facilities with inadequate infection control are risky environments for the emergence and transmission of TB. There was no study that presented data on infection control practices of health care workers. This study aimed to assess tuberculosis infection control practices and associated factors among health care workers in West Gojjam Zone, Northwest Ethiopia. Institution based quantitative cross-sectional study triangulated with qualitative observation and key informant interview was conducted. Six hundred sixty two health care workers were selected by multistage random sampling method. Self-administered structured questionnaire was used to collect quantitative data. Observation checklists and key informant interview guides were used to collect qualitative data. Quantitative data were entered in to Epi Info version 3.5.3 and analyzed using SPSS version 20. Odds ratio with 95 % confidence interval was used to identify factors associated with TB infection control practice of health care workers. Qualitative data were translated, transcribed, analyzed and triangulated with the quantitative findings. The proportion of proper TB infection control (TBIC) practices was 38 %. Qualitative data showed that administrative, environmental and personal respiratory protection control measures were not practiced well. Knowledge on the presence of TBIC plan [AOR = 4.25, 95 % CI: 2.46 - 7.35], knowledge on the presence of national guideline [AOR = 8.95, 95 % CI: 4.35 - 18.40] and working department of the health care workers were independent predictors of TBIC practices. The proportion of proper TBIC practices of health care workers was low. TBIC practices were determined by knowing the presence of TBIC plan and national guideline and working department. Hence, supportive supervision and trainings should be given to health care workers who are working other than TB clinics to improve the knowledge of TBIC plan and guidelines. Health centers shall prepare TBIC plans and orient all health care workers.

Quality assurance and ergonomics in the mammography department.

PubMed

Reynolds, April

2014-01-01

Quality assurance (QA) in mammography is a system of checks that helps ensure the proper functioning of imaging equipment and processes. Ergonomics is a scientific approach to arranging the work environment to reduce the risk of work-related injuries while increasing staff productivity and job satisfaction. This article reviews both QA and ergonomics in mammography and explains how they work together to create a safe and healthy environment for radiologic technologists and their patients. QA and quality control requirements in mammography are discussed, along with ergonomic best practices in the mammography setting.

Aircraft Sheet Metal Practices; Sheet Metal Work 2: 9855.01.

ERIC Educational Resources Information Center

Dade County Public Schools, Miami, FL.

The course outline will serve as a guide to the 11th grade student interested in sheet metal occupations. Requiring 135 clock hours, the basic course covers orientation and techniques in aircraft sheet metal. Emphasis will be placed on the proper use of tools and machines, safety, fabrication methods, aircraft materials, basic layout, and special…

Guidelines for maintaining and managing the vaccine cold chain.

PubMed

2003-10-24

In February 2002, the Advisory Committee on Immunization Practices (ACIP) and American Academy of Family Physicians (AAFP) released their revised General Recommendations on Immunization, which included recommendations on the storage and handling of immunobiologics. Because of increased concern over the potential for errors with the vaccine cold chain (i.e., maintaining proper vaccine temperatures during storage and handling to preserve potency), this notice advises vaccine providers of the importance of proper cold chain management practices. This report describes proper storage units and storage temperatures, outlines appropriate temperature-monitoring practices, and recommends steps for evaluating a temperature-monitoring program. The success of efforts against vaccine-preventable diseases is attributable in part to proper storage and handling of vaccines. Exposure of vaccines to temperatures outside the recommended ranges can affect potency adversely, thereby reducing protection from vaccine-preventable diseases. Good practices to maintain proper vaccine storage and handling can ensure that the full benefit of immunization is realized.

Update on infection control challenges in special pediatric populations.

PubMed

Balkhy, Hanan H; Zingg, Walter

2014-08-01

Compared with adults, neonatal and pediatric populations are especially vulnerable patients who have specific diagnostic and therapeutic differences; therefore, the standard infection control practices designed for adults are sometimes not effective or need modifications to work. This review focuses on the recent literature addressing the challenges and successes in preventing healthcare-associated infections (HAIs) in children. Improving the implementation of pediatric versions of preventive bundles focusing on proper catheter insertion and maintenance, mainly as a part of a larger multimodal strategy, is effective in reducing the central-line-associated bloodstream infections in neonatal and pediatric populations including oncology patients. Appropriate feeding, antimicrobial stewardship, and infection control measures should be combined in reducing necrotizing enterocolitis in preterm neonates. Implementing a multimodal bundle strategy adapted for pediatric population is successful in preventing ventilator-associated pneumonia. Appropriate use of antimicrobial prophylaxis remains the cornerstone for preventing surgical-site infections irrespective of age, with few additional effective adjuvant preventive practices in specific pediatric patients. Several evidence-based practices are effective in reducing the incidence and the impact of HAIs in children; however, proper implementation remains a challenge. Additionally, several adult preventive practices are still unestablished in children and need further thorough examination.

Developing a Strong Direct Care Workforce.

PubMed

Stear, Lynda A

The aging population of the United States has led to a need for more direct care workers to provide personal care to older adults and disabled people in their homes. The U.S. Bureau of Labor Statistics predicts employment of paraprofessionals in home care will grow 49% between 2012 and 2022 as the baby boomer generation ages and requires more assistance in activities of daily living. The typical direct care worker is a female aged 25 to 54 years old, a demographic that is projected to remain flat in the coming years. Direct care workers typically are poorly paid for work that is labor-intensive and often work in less than optimal working conditions. It is important that agencies hiring direct care workers understand the challenges these workers face and institute sound hiring practices and provide proper training and ongoing supervision. It is possible to have a quality direct care team. Proper training, role modeling, and supervision will improve employee satisfaction, decrease turnover, and improve care outcomes for patients.

Student and Preceptor Advancement in a Dedicated Education Site: Innovation in Clinical Education for Advanced Practice Nurses.

PubMed

Hall, Katherine C; Diffenderfer, Sandy K; Stidham, April; Mullins, Christine M

2018-04-19

In the 1990s, dedicated education units transformed undergraduate preceptorships, but graduate preceptorships remain static. The dyadic nurse practitioner preceptorship model supports an environment where faculty, students, and preceptors may overlook nuances that affect the teaching-learning process. This article describes an innovative clinical education model, Student and Preceptor Advancement in a Dedicated Education Site, designed to improve preceptorships for advanced practice nurses. The focus is on adaptations made to facilitate use in advanced practice nursing programs.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Food safety

MedlinePlus

... conditions and practices that preserve the quality of food. These practices prevent contamination and foodborne illnesses. ... not handled properly. Improperly cooking, preparing, or storing ... Properly handling, storing, and preparing food greatly reduces ...

Understanding Marketing Strategies That Work in Adult Studies Programs in Faith-Based Higher Education Institutions

ERIC Educational Resources Information Center

Shores, Jonathan Eagle, Jr.

2017-01-01

Colleges and universities across the United States are turning to non-traditional programs to help keep revenue afloat as traditional-aged students drop in numbers. As colleges turn to this source of revenue, many are doing so without proper guidance or evaluation of recent, relevant research on best practices for how to evaluate marketing…

Radiological Worker II Training, Course 20301 (Live), Course 12909 (Test)

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

Harris, Jimmy D.

Radiological worker training is the basic building block for any additional radiological training you may receive. Upon completing radiological worker training, you will have the basic knowledge needed to work safely, using proper radiological practices, in areas where radiological hazards exist. You will also have a better understanding of the hazards and responsibilities associated with radiological work to help prevent the carelessness that can occur when working continually with or around radioactive material. This course does not qualify you for any specific radiological work. You may be required to take additional training at individual facilities to address facility- and job-specificmore » hazards and procedures.« less

Nonlinear Reduced-Order Simulation Using An Experimentally Guided Modal Basis

NASA Technical Reports Server (NTRS)

Rizzi, Stephen A.; Przekop, Adam

2012-01-01

A procedure is developed for using nonlinear experimental response data to guide the modal basis selection in a nonlinear reduced-order simulation. The procedure entails using nonlinear acceleration response data to first identify proper orthogonal modes. Special consideration is given to cases in which some of the desired response data is unavailable. Bases consisting of linear normal modes are then selected to best represent the experimentally determined transverse proper orthogonal modes and either experimentally determined inplane proper orthogonal modes or the special case of numerically computed in-plane companions. The bases are subsequently used in nonlinear modal reduction and dynamic response simulations. The experimental data used in this work is simulated to allow some practical considerations, such as the availability of in-plane response data and non-idealized test conditions, to be explored. Comparisons of the nonlinear reduced-order simulations are made with the surrogate experimental data to demonstrate the effectiveness of the approach.

The virtuous pathologist. An ethical basis for laboratory medicine.

PubMed

Stempsey, W E

1989-06-01

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

Establishing powder-handling workflow practices and standard operating procedures: compounding pharmacy and safety.

PubMed

Prince, Bryan; Lundevall, Jeremy

2014-01-01

This is an ongoing discussion and analysis of powder-handling safety in the compounding pharmacy laboratory that started in the November/December 2013 issue of the International Journal of Pharmaceutical Compounding. In the previous technical article, we established that most chemical powders handled during compounding procedures have an established occupational exposure limits and that powders are micronized during manipulation. All micronized powders handled on an open bench create health hazards to the technicians and create a potential for cross-contamination to the lab environment. Proper identification of the chemical hazard and established standard operating procedures in direct correlation to Good Lab Practices when working inside a powder hood will positively improve the compounding pharmacy's work environment.

Exploring varieties of knowledge in safe work practices - an ethnographic study of surgical teams

PubMed Central

2011-01-01

Background Within existing research in health and medicine, the nature of knowledge on how teams conduct safe work practices has yet to be properly explored. Methods We address this concern by exploring the varieties in which knowledge is expressed during interdisciplinary surgical operations. Specifically, the study was conducted in a surgical section of a Norwegian regional general hospital, between January and April of 2010, by means of an ethnographic design combining detailed non-participant observations, conversations and semi-structured interviews. Results Based on an analysis of the gathered data, we identify three particular themes in how knowledge is expressed by operating room personnel: (i) the ability and variety individuals demonstrate in handling multiple sources of information, before reaching a particular decision, (ii) the variety of ways awareness or anticipation of future events is expressed, and (iii) the different ways sudden and unexpected situations are handled by the individual team members. Conclusions We conclude that these facets of knowledge bring different insights into how safe work practices are achieved at an individual and team level in surgical operations, thus adding to the existing understanding of the nature of knowledge in safe work practices in surgical operations. Future research should focus on exploring and documenting the relationships between various elements of knowledge and safe work practices, in different surgical settings and countries. PMID:21914183

Behavioral Patterns in Special Education. Good Teaching Practices

PubMed Central

Rodríguez-Dorta, Manuela; Borges, África

2017-01-01

Providing quality education means to respond to the diversity in the classroom. The teacher is a key figure in responding to the various educational needs presented by students. Specifically, special education professionals are of great importance as they are the ones who lend their support to regular classroom teachers and offer specialized educational assistance to students who require it. Therefore, special education is different from what takes place in the regular classroom, demanding greater commitment by the teacher. There are certain behaviors, considered good teaching practices, which teachers have always been connected with to achieve good teaching and good learning. To ensure that these teachers are carrying out their educational work properly it is necessary to evaluate. This means having appropriate instruments. The Observational Protocol for Teaching Functions in Primary School and Special Education (PROFUNDO-EPE, v.3., in Spanish) allows to capture behaviors from these professionals and behavioral patterns that correspond to good teaching practices. This study evaluates the behavior of two special education teachers who work with students from different educational stages and educational needs. It reveals that the analyzed teachers adapt their behavior according the needs and characteristics of their students to the students responding more adequately to the needs presented by the students and showing good teaching practices. The patterns obtained indicate that they offer support, help and clear guidelines to perform the tasks. They motivate them toward learning by providing positive feedback and they check that students have properly assimilated the contents through questions or non-verbal supervision. Also, they provide a safe and reliable climate for learning. PMID:28512437

Behavioral Patterns in Special Education. Good Teaching Practices.

PubMed

Rodríguez-Dorta, Manuela; Borges, África

2017-01-01

Providing quality education means to respond to the diversity in the classroom. The teacher is a key figure in responding to the various educational needs presented by students. Specifically, special education professionals are of great importance as they are the ones who lend their support to regular classroom teachers and offer specialized educational assistance to students who require it. Therefore, special education is different from what takes place in the regular classroom, demanding greater commitment by the teacher. There are certain behaviors, considered good teaching practices, which teachers have always been connected with to achieve good teaching and good learning. To ensure that these teachers are carrying out their educational work properly it is necessary to evaluate. This means having appropriate instruments. The Observational Protocol for Teaching Functions in Primary School and Special Education (PROFUNDO-EPE, v.3., in Spanish) allows to capture behaviors from these professionals and behavioral patterns that correspond to good teaching practices. This study evaluates the behavior of two special education teachers who work with students from different educational stages and educational needs. It reveals that the analyzed teachers adapt their behavior according the needs and characteristics of their students to the students responding more adequately to the needs presented by the students and showing good teaching practices. The patterns obtained indicate that they offer support, help and clear guidelines to perform the tasks. They motivate them toward learning by providing positive feedback and they check that students have properly assimilated the contents through questions or non-verbal supervision. Also, they provide a safe and reliable climate for learning.

Range-Dependent Acoustic Propagation in Shallow Water with Elastic Bottom Effects

DTIC Science & Technology

2015-09-30

1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Range-Dependent Acoustic Propagation in Shallow Water ...theory is inadequate for properly describing loss in shallow water acoustic propagation. Finally there is range dependence, which can be significant in...work will lead to a practical method to investigate seismo- acoustic propagation in shallow - water environments, and allow us to compare and contrast

Apollo 11 impact on the occupational medicine program, NASA Manned Spacecraft Center

NASA Technical Reports Server (NTRS)

Wright, P. E.

1969-01-01

Requirements and development of standards for occupational medicine support of personnel in the Lunar Receiving Laboratory (LRL) are outlined. Considered are proper personnel performance and exclusion of people prone to develop a serious illness within the quarantine area. Occupational medicine report for the LRL consists of examination procedures covering laboratory work, periodic examinations, immunizations, health maintenance, preventive practices, medical standards, and waiver authority.

Clinical perspective: creating an effective practice peer review process-a primer.

PubMed

Gandhi, Manisha; Louis, Frances S; Wilson, Shae H; Clark, Steven L

2017-03-01

Peer review serves as an important adjunct to other hospital quality and safety programs. Despite its importance, the available literature contains virtually no guidance regarding the structure and function of effective peer review committees. This Clinical Perspective provides a summary of the purposes, structure, and functioning of effective peer review committees. We also discuss important legal considerations that are a necessary component of such processes. This discussion includes useful templates for case selection and review. Proper committee structure, membership, work flow, and leadership as well as close cooperation with the hospital medical executive committee and legal representatives are essential to any effective peer review process. A thoughtful, fair, systematic, and organized approach to creating a peer review process will lead to confidence in the committee by providers, hospital leadership, and patients. If properly constructed, such committees may also assist in monitoring and enforcing compliance with departmental protocols, thus reducing harm and promoting high-quality practice. Copyright © 2016 Elsevier Inc. All rights reserved.

Off-Loading Practices for the Wounded Foot: Concepts and Choices

PubMed Central

Mrdjenovich, Donald E.

2011-01-01

A wound practitioner’s best-laid plan of care and strategy for healing an ulcerated foot is doomed to fail without a properly conceived approach based on sound off-loading principles. Wound healing that has stalled despite best-practice techniques may require reevaluation of off-loading choices. This is particularly true in the patient with abnormal foot pathologies. Special considerations are certainly required with neuropathic ulcers; however, any wound on a weight-bearing surface of the foot requires proper off-loading. This discussion explores the basic biomechanical and pathomechanical concepts that modify and influence ambulation and gait patterns. Integration of these concepts into the choices for off-loading to deter pathologic influences will alert the reader of precautionary measures and other factors for consideration. The aim of this column is to provide both an adequate working knowledge of the available off-loading devices and the necessary tools and concepts needed to stimulate wise decision protocols for wound management and healing. PMID:24527154

Dual practice in the health sector: review of the evidence

PubMed Central

Ferrinho, Paulo; Van Lerberghe, Wim; Fronteira, Inês; Hipólito, Fátima; Biscaia, André

2004-01-01

This paper reports on income generation practices among civil servants in the health sector, with a particular emphasis on dual practice. It first approaches the subject of public–private overlap. Thereafter it focuses on coping strategies in general and then on dual practice in particular. To compensate for unrealistically low salaries, health workers rely on individual coping strategies. Many clinicians combine salaried, public-sector clinical work with a fee-for-service private clientele. This dual practice is often a means by which health workers try to meet their survival needs, reflecting the inability of health ministries to ensure adequate salaries and working conditions. Dual practice may be considered present in most countries, if not all. Nevertheless, there is surprisingly little hard evidence about the extent to which health workers resort to dual practice, about the balance of economic and other motives for doing so, or about the consequences for the proper use of the scarce public resources dedicated to health. In this paper dual practice is approached from six different perspectives: (1) conceptual, regarding what is meant by dual practice; (2) descriptive, trying to develop a typology of dual practices; (3) quantitative, trying to determine its prevalence; (4) impact on personal income, the health care system and health status; (5) qualitative, looking at the reasons why practitioners so frequently remain in public practice while also working in the private sector and at contextual, personal life, institutional and professional factors that make it easier or more difficult to have dual practices; and (6) possible interventions to deal with dual practice. PMID:15509305

[The application of radiological image in forensic medicine].

PubMed

Zhang, Ji-Zong; Che, Hong-Min; Xu, Li-Xiang

2006-04-01

Personal identification is an important work in forensic investigation included sex discrimination, age and stature estimation. Human identification depended on radiological image technique analysis is a practice and proper method in forensic science field. This paper intended to understand the advantage and defect by reviewed the employing of forensic radiology in forensic science field broadly and provide a reference to perfect the application of forensic radiology in forensic science field.

40 CFR 451.21 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2011 CFR

2011-07-01

... to shore, and properly dispose of all feed bags, packaging materials, waste rope and netting. (c... the pens through the use of active feed monitoring and management practices. These practices may... prevent discharge to waters of the U.S. (e) Materials storage. (1) Ensure proper storage of drugs...

40 CFR 451.21 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2010 CFR

2010-07-01

... to shore, and properly dispose of all feed bags, packaging materials, waste rope and netting. (c... the pens through the use of active feed monitoring and management practices. These practices may... prevent discharge to waters of the U.S. (e) Materials storage. (1) Ensure proper storage of drugs...

An evaluation of hospital hand hygiene practice and glove use in Hong Kong.

PubMed

Chau, Janita P-C; Thompson, David R; Twinn, Sheila; Lee, Diana T F; Pang, Sharon W M

2011-05-01

To identify omissions in hand hygiene practice and glove use among hospital workers in Hong Kong. Hospital-acquired infection is the commonest complication affecting hospitalised patients. Even though research evidence suggests that hand hygiene and proper glove use are the most important ways to prevent the spread of disease and infection, compliance with both are reported to be unacceptably low. An observational study of hospital workers in one acute and two convalescence and rehabilitation hospitals in Hong Kong was conducted. The participating clinical areas included the medical and surgical wards, accident and emergency department and intensive care unit. Hand hygiene practice and glove use amongst 206 hospital health and support workers, stratified according to years of working experience, were observed. The number of observed episodes for hand hygiene was 1037 and for glove use 304. Compliance with hand hygiene was 74.7% and with glove use 72.4%. In approximately two-third of episodes, participants washed their hands after each patient contact; though, 78.5% failed to rub their hands together vigorously for at least 15 seconds. The major break in compliance with glove use was failure to change gloves between procedures on the same patient. In 28.6% of observed glove use episodes, participants did not wear gloves during procedures that exposed them to blood, body fluids, excretion, non-intact skin or mucous membranes. Significant differences in performance scores on antiseptic hand rub were found between the two types of hospital and on glove use between the three groups of work experience: ≤ 5, 6-10, >10 years. Education and reinforcement of proper hand hygiene practice and glove use among hospital health and support workers is needed. © 2011 Blackwell Publishing Ltd.

Constructions of masculinity and femininity and sexual risk negotiation practices among women in urban Ghana.

PubMed

Fiaveh, Daniel Y; Izugbara, Chimaraoke O; Okyerefo, Michael P K; Reysoo, Fenneke; Fayorsey, Clara K

2015-01-01

Using qualitative data gathered through in-depth interviews with women in Accra, Ghana, this paper explores narratives of masculinity and femininity and sexual risk negotiation practices among women. While women framed 'proper' masculinity in terms of stereotypical reproductive norms, they also acknowledged the fluidity and multiplicity of masculinities. Femininity was more uniformly characterised in terms of physical attractiveness and beauty, responsibility and reproduction. These features, especially those related to adherence to morally and socially appropriate sexual norms (e.g., menstrual and bodily hygiene, unplanned pregnancy etc.), influenced women's approach to sexual negotiation. Work aiming to support women to negotiate sex safely needs to pay attention to their notions of gender and practices of sexual negotiation.

Staff Development Practices of Open and Distance Learning Institutions in Ghana: The Case of the Distance Education Programme of University of Education, Winneba, Ghana

ERIC Educational Resources Information Center

Owusu-Mensah, Francis; Anyan, Jerry Addison; Denkyi, Charles

2015-01-01

Staff development plays a crucial role in Open and Distance learning programmes because most of the staff working on these programmes are products of the conventional face to face system. Lack of proper training of staff in ODL can lead to high dropout rate among distance learners. The purpose of this study was to investigate staff development…

Proper laboratory notebook practices: protecting your intellectual property.

PubMed

Nickla, Jason T; Boehm, Matthew B

2011-03-01

A laboratory notebook contains a wealth of knowledge that can be critical for establishing evidence in support of intellectual property rights and for refuting claims of research misconduct. The proper type, organization, use, maintenance, and storage of laboratory notebooks should be a priority for everyone at research institutions. Failure to properly document research activities can lead to serious problems, including the loss of valuable patent rights. Consequences of improper laboratory notebook practices can be harsh; numerous examples are described in court cases and journal articles, indicating a need for research institutions to develop strict policies on the proper use and storage of research documentation.

Chemical Dependency and Nursing Students: A Complicated Process Calling for Nurse Educator Involvement.

PubMed

Dittman, Patricia W

2015-01-01

Chemical use and dependency is a prevalent problem in society and among the members of the nursing profession. Nursing students, as the novice representatives of the profession, may be particularly vulnerable to chemical use. Nursing leaders in both educational institutions and practice settings must recognize highly vulnerable individuals, which nursing activities are most vulnerable, and interventions to assist and support the vulnerable individual while assuring a safe practice environment. As nurses, it is our responsibility, both ethically and legally, to provide a safe working environment not only for our patients but also for ourselves by reporting the behaviors of nurses who may be impaired through the proper channels according to your state's Nurse Practice Act. Through a united approach, nurse leaders from both the academic and practice environments should provide a safe and effective rehabilitation approach.

Sound Assessment through Proper Policy

ERIC Educational Resources Information Center

Chappuis, Stephen J.

2007-01-01

Aligning a school board policy manual with the faculty handbook would be an excellent application of systems thinking in support of school district mission and goals. This article talks about changing sound assessment practice in accordance with the school's proper policy. One obstacle to changing assessment practice is the prevailing belief that…

Food Sanitation and Safety Self-Assessment Instrument for School Nutrition Programs.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento.

Like food-service establishments, child nutrition programs are responsible for preserving the quality and wholesomeness of food. Proper food-handling practices prevent contamination and job-related accidents. Application of the evaluation instrument presented in this document to individual programs helps to define proper practices, assess the…

Demonstration of a Graywater Management Project at a Community Level on the Island of Puerto Rico

EPA Science Inventory

Housing development practices in Puerto Rico, especially in rural areas, have often not considered the proper treatment and disposal of wastewater or the collection and treatment of stormwater. These practices have created a legacy of communities without proper sewage disposal in...

Compliance With Recommended Food Safety Practices in Television Cooking Shows.

PubMed

Cohen, Nancy L; Olson, Rita Brennan

Examine compliance with recommended food safety practices in television cooking shows. Using a tool based on the Massachusetts Food Establishment Inspection Report, raters examined 39 episodes from 10 television cooking shows. Chefs demonstrated conformance with good retail practices for proper use and storage of utensils in 78% of episodes; preventing contamination (62%), and fingernail care (82%). However, 50% to 88% of episodes were found to be out of compliance with other personal hygiene practices, proper use of gloves and barriers (85% to 100%), and maintaining proper time and temperature controls (93%). Over 90% failed to conform to recommendations regarding preventing contamination through wiping cloths and washing produce. In only 13% of episodes were food safety practices mentioned. There appears to be little attention to food safety during most cooking shows. Celebrity and competing chefs have the opportunity to model and teach good food safety practices for millions of viewers. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

16 CFR 23.15 - Misuse of the term “properly cut,” etc.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Misuse of the term âproperly cut,â etc. 23... FOR THE JEWELRY, PRECIOUS METALS, AND PEWTER INDUSTRIES § 23.15 Misuse of the term “properly cut,” etc. It is unfair or deceptive to use the terms “properly cut,” “proper cut,” “modern cut,” or any...

16 CFR 23.15 - Misuse of the term “properly cut,” etc.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Misuse of the term âproperly cut,â etc. 23... FOR THE JEWELRY, PRECIOUS METALS, AND PEWTER INDUSTRIES § 23.15 Misuse of the term “properly cut,” etc. It is unfair or deceptive to use the terms “properly cut,” “proper cut,” “modern cut,” or any...

[Midazolam sedation in the general dental practice].

PubMed

Bertens, J; Abraham-Inpijn, L; Meuwissen, P J

1994-03-01

The general dental practitioner is occasionally confronted with patients who, on the basis of psychological--and often somatic--criteria, are difficult to treat. Medicinal sedation in combination with anxiety reduction may be deemed appropriate for such patients. In the Netherlands inhalation sedation by means of a combination of oxygen and nitrous oxide is generally used. The limitations and disadvantages of this method have directed attention towards sedation by means of midazolam, a quick-acting benzodiazepine. In view of the complications which may accompany the administration of midazolam, the general practitioner working alone or in a group practice is advised against using midazolam sedation. Such use should be reserved for a dentist working in a hospital setting, who is able to consult with a physician regarding the advisability of administering midazolam. Even then, the safety of the patient requires that the practitioners have a proper insight into the physical state of the patient, work according to a protocol and in accordance with clearly defined responsibilities, and provide adequate accommodation during and after treatment.

Infant feeding practices of working mothers in an urban area.

PubMed

Thimmayamma, B V; Vidyavati, M; Belavady, B

1980-12-01

Information on infant feeding practices was collected from 410 educated, working mothers in a urban area. The mean duration for breast feeding was 4.1 months. Early introduction of supplements was the rule. About 61% of mothers used commercial baby foods, though with certain problems. More than 90% of mothers considered breast milk as the best food for infants. About 63% expressed a desire to have more knowledge on their responsibilities and infant care. Working mothers found it difficult to work outside their homes and at the same time care for their infants, because of several problems. They preferred joint families for better child care. The majority of women wanted well-maintained creches, an incease in number and duration of breaks for nursing their infants, and the option of part-time work to help them give proper care to the children. The problems with commercial baby food concerned the proportion of water to powder, which most mothers (62.1%) found too high for the infant to digest. Creche facilities near the place of work were available to 27.8% of mothers. Only 20% used them. 72% of mothers who had no creche facilities used relatives, neighbors, or servants.

Economic implications of cardiovascular disease management programs: moving beyond one-off experiments.

PubMed

Maru, Shoko; Byrnes, Joshua; Carrington, Melinda J; Stewart, Simon; Scuffham, Paul A

2015-01-01

Substantial variation in economic analyses of cardiovascular disease management programs hinders not only the proper assessment of cost-effectiveness but also the identification of heterogeneity of interest such as patient characteristics. The authors discuss the impact of reporting and methodological variation on the cost-effectiveness of cardiovascular disease management programs by introducing issues that could lead to different policy or clinical decisions, followed by the challenges associated with net intervention effects and generalizability. The authors conclude with practical suggestions to mitigate the identified issues. Improved transparency through standardized reporting practice is the first step to advance beyond one-off experiments (limited applicability outside the study itself). Transparent reporting is a prerequisite for rigorous cost-effectiveness analyses that provide unambiguous implications for practice: what type of program works for whom and how.

Enhancing work motivation for Japanese female nurses in small to medium-sized private hospitals by analyzing job satisfaction.

PubMed

Kudo, Yasushi; Kido, Shigeri; Shahzad, Machiko Taruzuka; Shida, Kyoko; Satoh, Toshihiko; Aizawa, Yoshiharu

2010-03-01

Proper work environments are important for nurses to feel motivated. We examined the associations between work motivation and job satisfaction among Japanese nurses to improve their motivation. In Japan, relatively small and medium-sized private hospitals play a central role in the healthcare industry. In the present study, the subjects were nurses working in 23 small and medium-sized private hospitals that had 65 to 326 beds. We analyzed 1,116 registered and licensed practical female nurses (average age, 38.3 years; standard deviation, 11.3 years). Many nurses with their specialized nursing skills dedicate themselves to patient care. However, many of these nurses may not be interested in contributing to their hospitals. Nurses may have different opinions regarding dedication to patient care and contribution to their hospitals. Therefore, concerning work motivation, we produced these two different items, "Nurses' dedication to patients" and "Nurses' contribution to their hospitals." We also produced our own original new job satisfaction questionnaire. We found 7 facets of job satisfaction: "Work as specialists," "Workplace safety," "Relationships with superiors," "Work-life balance," "Relationships among nurses," "Communications with physicians," and "Salary." Multiple linear regression analyses show that both "Nurses' dedication to patients" and "Nurses' contribution to their hospitals" were significantly associated with "Work as specialists." Nurses feel their jobs of protecting people's lives and health are valuable. They do not feel motivated only by money. They value the intrinsic nature of their jobs. Creating proper work environments is important for nurses to be able to work as specialists.

Financing and cash flow management for the medical group practice.

PubMed

Bert, Andrew J

2008-01-01

The expansion of a medical group practice and the addition of ancillary services require a substantial cash outlay. Obtaining proper financing to complete a successful expansion is a process that takes time, and there are critical steps that must be followed. The group's business objectives must be presented properly by developing a business plan detailing the practice and goals associated with the desired expansion. This article discusses some of the key elements that are essential in creating an overall effective business plan for the group medical practice.

From the EEL to the EGO: psychoanalysis and the remnants of Freud's early scientific practice.

PubMed

Wieser, Martin

2013-01-01

While numerous historiographical works have been written to shed light on Freud's early theoretical education in biology, physiology, and medicine and on the influence of that education on psychoanalysis, this paper approaches Freud's basic comprehension of science and methodology by focusing on his early research practice in physiology and neuranatomy. This practice, taking place in the specific context of Ernst Brücke's physiological laboratory in Vienna, was deeply concerned with problems of visuality and the revelation of hidden organic structures by use of proper preparation techniques and optical instruments. The paper explores the connection between such visualizing practices, shaped by a physiological context as they were, and Freud's later convictions of the scientific status of psychoanalysis and the function of its method as means to unveil the concealed structure of the "psychical apparatus". © 2013 Wiley Periodicals, Inc.

Implementing AORN recommended practices for sharps safety.

PubMed

Ford, Donna A

2014-01-01

Prevention of percutaneous sharps injuries in perioperative settings remains a challenge. Occupational transmission of bloodborne pathogens, not only from patients to health care providers but also from health care providers to patients, is a significant concern. Legislation and position statements geared toward ensuring the safety of patients and health care workers have not resulted in significantly reduced sharps injuries in perioperative settings. Awareness and understanding of the types of percutaneous injuries that occur in perioperative settings is fundamental to developing an effective sharps injury prevention program. The AORN "Recommended practices for sharps safety" clearly delineates evidence-based recommendations for sharps injury prevention. Perioperative RNs can lead efforts to change practice for the safety of patients and perioperative team members by promoting the elimination of sharps hazards; the use of engineering, work practice, and administrative controls; and the proper use of personal protective equipment, including double gloving. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Ergonomic applications to dental practice.

PubMed

Gupta, Shipra

2011-01-01

The term "work-related musculoskeletal disorders (WMSDs)," refers to musculoskeletal disorders to which the work environment contributes significantly, or to musculoskeletal disorders that are made worse or longer lasting by work conditions or workplace risk factors. In recent years, there has been an increase in reporting WMSDs for dental persons. Risk factors of WMSDs with specific reference to dentistry include - stress, poor flexibility, improper positioning, infrequent breaks, repetitive movements, weak postural muscles, prolonged awkward postures and improper adjustment of equipment. Ergonomics is the science of designing jobs, equipment and workplaces to fit workers. Proper ergonomic design is necessary to prevent repetitive strain injuries, which can develop over time and can lead to long-term disability. In this article, 20 strategies to prevent WMSDs in the dental operatory are discussed.

A Study on How to Breathe Properly When Practicing Tai Chi Chuan

ERIC Educational Resources Information Center

Yang, Hanchun

2011-01-01

When practicing Tai Chi Chuan, proper breath plays an important role in shaping Tai Chi Chuan's style and its fitness value. The paper aims to analyse the postures of Tai Chi Chuan and its breath characteristics. The paper also presents some new insights on how to co-ordinate breath with postures by case studies.

Calculating observables in inhomogeneous cosmologies. Part I: general framework

NASA Astrophysics Data System (ADS)

Hellaby, Charles; Walters, Anthony

2018-02-01

We lay out a general framework for calculating the variation of a set of cosmological observables, down the past null cone of an arbitrarily placed observer, in a given arbitrary inhomogeneous metric. The observables include redshift, proper motions, area distance and redshift-space density. Of particular interest are observables that are zero in the spherically symmetric case, such as proper motions. The algorithm is based on the null geodesic equation and the geodesic deviation equation, and it is tailored to creating a practical numerical implementation. The algorithm provides a method for tracking which light rays connect moving objects to the observer at successive times. Our algorithm is applied to the particular case of the Szekeres metric. A numerical implementation has been created and some results will be presented in a subsequent paper. Future work will explore the range of possibilities.

Transforming practice organizations to foster lifelong learning and commitment to medical professionalism.

PubMed

Frankford, D M; Patterson, M A; Konrad, T R

2000-07-01

Practice organizations will increasingly engage in activities that are the functional equivalents of continuing medical education. The authors maintain that if these activities are properly structured within practice organizations, they can become powerful engines of socialization to enhance physicians' lifelong learning and commitment to medical professionalism. They propose that this promise can be realized if new or reformed practice organizations combine education and service delivery and institutionalize processes of individual and collective reflection. The resulting "institutions of reflective practice" would be ones of collegial, experiential, reflective lifelong learning concerning the technical and normative aspects of medical work. They would extend recent methods of medical education such as problem-based learning into the practice setting and draw on extant methods used in complex organizations to maximize the advantages and minimize the disadvantages that practice organizations typically present for adult learning. As such, these institutions would balance the potentially conflicting organizational needs for, on the one hand, (1) self-direction, risk taking, and creativity; (2) specialization; and (3) collegiality; and, on the other hand, (4) organizational structure, (5) coordination of division of labor, and (6) hierarchy. Overall, this institutionalization of reflective practice would enrich practice with education and education with practice, and accomplish the ideals of what the authors call "responsive medical professionalism." The medical profession would both contribute and be responsive to social values, and medical work would be valued intrinsically and as central to practitioners' self-identity and as a contribution to the public good.

Risk-accepting personality and personal protective equipment use within the Agricultural Health Study.

PubMed

DellaValle, Curt T; Hoppin, Jane A; Hines, Cynthia J; Andreotti, Gabriella; Alavanja, Michael C R

2012-01-01

Pesticide exposures can be reduced by use of personal protective equipment as well as proper mixing and application practices. The authors examined the effects of risk-accepting personality on personal protective equipment (PPE) use and mixing and application practices among private pesticide applicators and their spouses within the Agricultural Health Study (AHS) in Iowa and North Carolina and commercial applicators in Iowa. The AHS follow-up questionnaire included four questions designed to assess attitudes toward risk. Analysis was limited to those who were currently working on a farm or registered as a commercial applicator and indicated current pesticide use (n=25,166). Respondents who answered three or more questions in the affirmative (private applicators: n=4160 [21%]; commercial applicators: n=199 [14%]; spouses: n=829 [23%]) were classified as having a risk-accepting personality. Logistic regression was used to evaluate specific work practices associated with risk-accepting attitudes. Among private applicators, the likelihood of using any PPE when mixing or loading pesticides was lower among risk-acceptors compared to risk-averse individuals (odds ratio [OR] = 0.72, 95% confidence interval [CI]: 0.65-0.79). A similar relationship was observed among commercial applicators (OR = 0.77, 95% CI: 0.34-1.77) but not among spouses (OR = 1.09, 95% CI: 0.90-1.33). Among private applicators, risk-acceptors were more likely than the risk-averse to apply pesticides within 50 feet of the home (OR = 1.21, 95% CI: 1.01-1.44), compared to further than ¼ mile. These findings suggest that the decisions to use personal protective equipment and properly handle/apply pesticides may be driven by risk-accepting personality traits.

Risk-Accepting Personality and Personal Protective Equipment Use within the Agricultural Health Study

PubMed Central

DellaValle, Curt T.; Hoppin, Jane A.; Hines, Cynthia J.; Andreotti, Gabriella; Alavanja, Michael C.R.

2012-01-01

Pesticide exposures can be reduced by use of personal protective equipment as well as proper mixing and application practices. We examined the effects of risk-accepting personality on personal protective equipment (PPE) use and mixing and application practices among private pesticide applicators and their spouses within the Agricultural Health Study (AHS) in Iowa and North Carolina and commercial applicators in Iowa. The AHS follow-up questionnaire included four questions designed to assess attitudes toward risk. Analysis was limited to those who were currently working on a farm or registered as a commercial applicator and indicated current pesticide use (n=25,166). Respondents who answered three or more questions in the affirmative (private applicators: n=4,160 (21%); commercial applicators: n=199 (14%); spouses: n=829 (23%)) were classified as having a risk-accepting personality. Logistic regression was used to evaluate specific work practices associated with risk-accepting attitudes. Among private applicators, the likelihood of using any PPE when mixing or loading pesticides was lower among risk-acceptors compared to risk-averse individuals (odds ratio (OR) = 0.72; 95% Confidence Interval (CI): 0.65 – 0.79). A similar relationship was observed among commercial applicators (OR = 0.77, 95% CI: 0.34 – 1.77) but not among spouses (OR = 1.09, 95% CI: 0.90 – 1.33). Among private applicators, risk-acceptors were more likely than the risk-averse to apply pesticides within 50 ft of the home (OR=1.21; 95% CI: 1.01 – 1.44), compared to further than ¼ mile. Our findings suggest that the decisions to use personal protective equipment and properly handle/apply pesticides may be driven by risk-accepting personality traits. PMID:22732067

Improving water, sanitation and hygiene in health-care facilities, Liberia.

PubMed

Abrampah, Nana Mensah; Montgomery, Maggie; Baller, April; Ndivo, Francis; Gasasira, Alex; Cooper, Catherine; Frescas, Ruben; Gordon, Bruce; Syed, Shamsuzzoha Babar

2017-07-01

The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities' preparedness and response to disease outbreaks and decreases the communities' trust in the health services provided. To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents. In Liberia, only 45% of 701 surveyed health-care facilities had an improved water source in 2015, and only 27% of these health-care facilities had proper disposal for infectious waste. Local ownership, through engagement of local health workers, was introduced to ensure development and refinement of the package. In-county collaborations between health-care facilities, along with multisectoral collaboration, informed national level direction, which led to increased focus on water and sanitation infrastructures and uptake of hygiene practices to improve the overall quality of service delivery. National level leadership was important to identify a vision and create an enabling environment for changing the perception of water, sanitation and hygiene in health-care provision. The involvement of health workers was central to address basic infrastructure and hygiene practices in health-care facilities and they also worked as stimulators for sustainable change. Further, developing a long-term implementation plan for national level initiatives is important to ensure sustainability.

Corrupt practices in chinese medical care: the root in public policies and a call for Confucian-market approach.

PubMed

Fan, Ruiping

2007-06-01

This paper argues that three salient corrupt practices that mark contemporary Chinese health care, namely the over-prescription of indicated drugs, the prescription of more expensive forms of medication and more expensive diagnostic work-ups than needed, and illegal cash payments to physicians-i.e., red packages-result not from the introduction of the market to China, but from two clusters of circumstances. First, there has been a loss of the Confucian appreciation of the proper role of financial reward for good health care. Second, misguided governmental policies have distorted the behavior of physicians and hospitals. The distorting policies include (1) setting very low salaries for physicians, (2) providing bonuses to physicians and profits to hospitals from the excessive prescription of drugs and the use of more expensive drugs and unnecessary expensive diagnostic procedures, and (3) prohibiting payments by patients to physicians for higher quality care. The latter problem is complicated by policies that do not allow the use of governmental insurance and funds from medical savings accounts in private hospitals as well as other policies that fail to create a level playing field for both private and government hospitals. The corrupt practices currently characterizing Chinese health care will require not only abolishing the distorting governmental policies but also drawing on Confucian moral resources to establish a rightly directed appreciation of the proper place of financial reward in the practice of medicine.

16 CFR 682.3 - Proper disposal of consumer information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF CONSUMER REPORT INFORMATION AND RECORDS § 682.3 Proper disposal of consumer information. (a) Standard. Any person who maintains or otherwise possesses consumer information for a business purpose must... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Proper disposal of consumer information. 682...

16 CFR 682.3 - Proper disposal of consumer information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Proper disposal of consumer information. 682... OF CONSUMER REPORT INFORMATION AND RECORDS § 682.3 Proper disposal of consumer information. (a) Standard. Any person who maintains or otherwise possesses consumer information for a business purpose must...

Maximizing the physical use of the office.

PubMed

Levin, Roger

2004-10-01

When referring to the physical plant in a dental practice, I am referring mainly to the use of dental chairs, because this is where dental practice production occurs. By maximizing the use of chairs or adding the necessary number of chairs to a practice, any office can grow and experience a proper patient flow. Since most offices have significantly high rates of no-shows, last-minute cancellations and overdue patients, the potential for growth is enormous. By using the schedule and chairs properly, the office has the opportunity to maximize production, create convenient appointments for patients and significantly increase practice profitability.

Gender difference in safe and unsafe practice of pesticide handling in tobacco farmers of malaysia.

PubMed

Bin Nordin, R; Araki, S; Sato, H; Yokoyama, K; Bin Wan Muda, W A; Win Kyi, D

2001-01-01

To identify gender difference in safe and unsafe practice of pesticide handling in tobacco farmers of Malaysia, we conducted a 20-item questionnaire interview on storage of pesticide (4 questions), mixing of pesticide (3 questions), use of personal protective equipment and clothing while spraying pesticide (7 questions), activities during and after spraying of pesticide (5 questions), and maintenance of pesticide sprayer (1 question) in 496 tobacco farmers (395 males and 101 females) in Bachok District, Kelantan, Malaysia. Duration of employment was significantly longer in females than those in males (p<0.001). In addition, proportion with no formal education in females was significantly higher than those in males (p<0.05). The following eight common factors were extracted from the 20 questionnaires by principal components factor analysis after varimax rotation in all farmers: (1) use of personal protective equipment, (2) unsafe work habit, (3) reading and following instructions on pesticide label, (4) security, storage and disposal of pesticide container, (5) safe work habit, (6) proper handling of pesticide and maintenance of pesticide sprayer, (7) use of personal protective clothing, and (8) safe handling of pesticide. Results of analysis of covariance for the eight factor scores of all male and female farmers, controlling for educational level and duration of employment, showed that: (1) factor scores for use of personal protective equipment (p<0.001), use of personal protective clothing (p<0.001) and safe work habit (p<0.001) in females were significantly lower than those in males; (2) conversely, factor scores for reading and following instruction on pesticide label (p<0.001) and proper handling of pesticide and maintenance of pesticide sprayer (p<0.01) in males were significantly lower than those in females; and (3) there were no significant differences in other three factor scores (p>0.05). We therefore conclude that: (1) for female tobacco farmers, choice of personal attire tend to result in lower scores on use of personal protective equipment and personal protective clothing while personal hygiene practices result in lower score on safe work habit; and, (2) for male tobacco farmers, the lower scores on reading and following instruction on pesticide label and mixing pesticide and maintenance of pesticide sprayer in good condition suggests that they were not primarily involved in these activities. It is postulated that these differences in safe and unsafe practices of pesticide handling across gender is related to the choice of personal attire, personal hygiene practices and division of labour within farming households which in turn is influenced by prevailing sociocultural norms in the community.

[Part-time medical specialist training; experiences with job-sharing for trainee internists].

PubMed

Bevers, K; Nauta, S; Stuyt, P M

2004-02-14

Due to various factors such as social changes, an increasing number of couples with two incomes, and a growing proportion of female doctors, there has been a growing demand for part-time work in recent years. This is also true for resident physicians. Objections such as a discontinuity in care and the decline in the quality of education frequently prevent resident physicians from working part-time. Over the past two years, the University Medical Centre Nijmegen, the Netherlands, has experimented with job-sharing on clinical wards for resident physicians in internal medicine. This approach works well in practice, as long as a number of conditions, including the proper transfer of medical information and good communication, are satisfied. Job-sharing is one means of satisfying the growing demand for part-time work among resident physicians and specialists.

Using Standardized Patients in Continuing Medical Education Courses on Proper Prescribing of Controlled Substances

ERIC Educational Resources Information Center

Swiggart, William H.; Ghulyan, Marine V.; Dewey, Charlene M.

2012-01-01

Controlled prescription drug (CPD) abuse is an increasing threat to patient safety and health care providers (HCPs) are not adequately prepared nor do they routinely employ proper screening techniques. Using standardized patients (SPs) as an instructional strategy, the trained physicians on proper prescribing practices and SBIRT (Screening, Brief…

16 CFR Figure 10 to Part 1633 - Jig for Setting Burners at Proper Distances From Mattress/Foundation

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Jig for Setting Burners at Proper Distances From Mattress/Foundation 10 Figure 10 to Part 1633 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FLAMMABLE FABRICS ACT REGULATIONS STANDARD FOR THE FLAMMABILITY (OPEN FLAME) OF MATTRESS SETS Pt.1633, Fig. 10 Figure 10 to Part 1633—Jig for...

16 CFR Figure 10 to Part 1633 - Jig for Setting Burners at Proper Distances From Mattress/Foundation

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Jig for Setting Burners at Proper Distances From Mattress/Foundation 10 Figure 10 to Part 1633 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FLAMMABLE FABRICS ACT REGULATIONS STANDARD FOR THE FLAMMABILITY (OPEN FLAME) OF MATTRESS SETS Pt.1633, Fig. 10 Figure 10 to Part 1633—Jig for...

16 CFR Figure 10 to Part 1633 - Jig for Setting Burners at Proper Distances From Mattress/Foundation

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Jig for Setting Burners at Proper Distances From Mattress/Foundation 10 Figure 10 to Part 1633 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FLAMMABLE FABRICS ACT REGULATIONS STANDARD FOR THE FLAMMABILITY (OPEN FLAME) OF MATTRESS SETS Pt.1633, Fig. 10 Figure 10 to Part 1633—Jig for...

16 CFR Figure 10 to Part 1633 - Jig for Setting Burners at Proper Distances From Mattress/Foundation

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Jig for Setting Burners at Proper Distances From Mattress/Foundation 10 Figure 10 to Part 1633 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FLAMMABLE FABRICS ACT REGULATIONS STANDARD FOR THE FLAMMABILITY (OPEN FLAME) OF MATTRESS SETS Pt. 1633, Fig. 10 Figure 10 to Part 1633—Jig for...

16 CFR Figure 10 to Part 1633 - Jig for Setting Burners at Proper Distances From Mattress/Foundation

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Jig for Setting Burners at Proper Distances From Mattress/Foundation 10 Figure 10 to Part 1633 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FLAMMABLE FABRICS ACT REGULATIONS STANDARD FOR THE FLAMMABILITY (OPEN FLAME) OF MATTRESS SETS Pt. 1633, Fig. 10 Figure 10 to Part 1633—Jig for...

Pre-return-to-work medical consultation for low back pain workers. Good practice recommendations based on systematic review and expert consensus.

PubMed

Petit, A; Rozenberg, S; Fassier, J B; Rousseau, S; Mairiaux, P; Roquelaure, Y

2015-10-01

The pre-return-to-work medical consultation during sick leave for low back pain (LBP) aims at assessing the worker's ability to resume working without risk for his/her health, and anticipating any difficulties inherent to returning to work and job retention. This article summarizes the good practices guidelines proposed by the French Society of Occupational Medicine (SFMT) and the French National Health Authority (HAS), and published in October 2013. Good practices guidelines developed by a multidisciplinary and independent task force (24 experts) and peer review committee (50 experts) based on a literature review from 1990 to 2012, according to the HAS methodology. According to the labour regulations, workers can request a medical consultation with their occupational physician at any time. The pre-return-to-work consultation precedes the effective return-to-work and can be requested by the employee regardless of their sick leave duration. It must be scheduled early enough to: (i) deliver reassuring information regarding risks to the lower back and managing LBP; (ii) evaluate prognostic factors of chronicity and prolonged disability in relations to LBP and its physical, social and occupational consequences in order to implement the necessary conditions for returning to work; (iii) support and promote staying at work by taking into account all medical, social and occupational aspects of the situation and ensure proper coordination between the different actors. A better understanding of the pre-return-to-work consultation would improve collaboration and coordination of actions to facilitate resuming work and job retention for patients with LBP. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

The ethics of forensic practice: reclaiming the wasteland.

PubMed

Morse, Stephen J

2008-01-01

After beginning with a warm appreciation of Alan Stone's scholarship and character, this article argues that Stone's woeful characterization of forensic practice as a wasteland that has no genuine ethical guide to practice and little to contribute is vastly overstated. It claims that the basis for useful ethical practice is rooted in a proper understanding of the law's folk psychological model of behavior and criteria. Then it suggests the proper bounds of forensic practice, including an aspirational list of do's and don'ts. The view presented is deflationary and cautious compared to what the law permits and most practitioners do, but it still leaves forensic practitioners with a wide and important role in the legal system.

Medical Information Exchange: Pattern of Global Mobile Messenger Usage among Otolaryngologists.

PubMed

Siegal, Gil; Dagan, Elad; Wolf, Michael; Duvdevani, Shay; Alon, Eran E

2016-11-01

Information technology has revolutionized health care. However, the development of dedicated mobile health software has been lagging, leading to the use of general mobile applications to fill in the void. The use of such applications has several legal, ethical, and regulatory implications. We examined the experience and practices governing the usage of a global mobile messenger application (WhatsApp) for mobile health purposes in a national cohort of practicing otolaryngologists in Israel, a known early adaptor information technology society. Cross-sectional data were collected from practicing otolaryngologists and otolaryngology residents via self-administered questionnaire. The questionnaire was composed of a demographic section, a section surveying the practices of mobile application use, mobile health application use, and knowledge regarding institutional policies governing the transmission of medical data. The sample included 22 otolaryngology residents and 47 practicing otolaryngologists. Of the physicians, 83% worked in academic centers, and 88% and 40% of the physicians who worked in a hospital setting or a community clinic used WhatsApp for medical use, respectively. Working with residents increased the medical usage of WhatsApp from 50% to 91% (P = .006). Finally, 72% were unfamiliar with any institutional policy regarding the transfer of medical information by personal smartphones. Mobile health is becoming an integral part of modern medical systems, improving accessibility, efficiency, and possibly quality of medical care. The need to incorporate personal mobile devices in the overall information technology standards, guidelines, and regulation is becoming more acute. Nonetheless, practices must be properly instituted to prevent unwanted consequences. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Applying mixed reality to simulate vulnerable populations for practicing clinical communication skills.

PubMed

Chuah, Joon Hao; Lok, Benjamin; Black, Erik

2013-04-01

Health sciences students often practice and are evaluated on interview and exam skills by working with standardized patients (people that role play having a disease or condition). However, standardized patients do not exist for certain vulnerable populations such as children and the intellectually disabled. As a result, students receive little to no exposure to vulnerable populations before becoming working professionals. To address this problem and thereby increase exposure to vulnerable populations, we propose using virtual humans to simulate members of vulnerable populations. We created a mixed reality pediatric patient that allowed students to practice pediatric developmental exams. Practicing several exams is necessary for students to understand how to properly interact with and correctly assess a variety of children. Practice also increases a student's confidence in performing the exam. Effective practice requires students to treat the virtual child realistically. Treating the child realistically might be affected by how the student and virtual child physically interact, so we created two object interaction interfaces - a natural interface and a mouse-based interface. We tested the complete mixed reality exam and also compared the two object interaction interfaces in a within-subjects user study with 22 participants. Our results showed that the participants accepted the virtual child as a child and treated it realistically. Participants also preferred the natural interface, but the interface did not affect how realistically participants treated the virtual child.

Practicing medicine in a new environment: what can we learn from the business managers?

PubMed

Frezza, Eldo Ermenegildo; Wachtel, Mitchell S

2006-01-01

Physicians, once only responsible for patient care, now are responsible for their organization's management. Although this paradigm shift occasioned much opposition, most aspects of this change are improving as the rules are reevaluated and reconsidered. Physician managers have difficult tasks for which medical school provides no preparation. Employees must be individually evaluated, so their unique talents can be properly exploited and appropriately compensated. Each person's weaknesses must be improved upon with delicacy, while his or her strengths are given greater and greater focus. This is especially true with regards to billing and coding because the financial health of all healthcare businesses requires organizational competence in this arena. It is vital to have an understanding of each staff member's skills, talents, and knowledge, and a proper deployment of each person into the appropriate job. The goal of any manager is a group of satisfied employees who enjoy their work and make appropriately recognized contributions.

Construction and Characterization of External Cavity Diode Lasers for Atomic Physics

PubMed Central

Hardman, Kyle S.; Bennetts, Shayne; Debs, John E.; Kuhn, Carlos C. N.; McDonald, Gordon D.; Robins, Nick

2014-01-01

Since their development in the late 1980s, cheap, reliable external cavity diode lasers (ECDLs) have replaced complex and expensive traditional dye and Titanium Sapphire lasers as the workhorse laser of atomic physics labs1,2. Their versatility and prolific use throughout atomic physics in applications such as absorption spectroscopy and laser cooling1,2 makes it imperative for incoming students to gain a firm practical understanding of these lasers. This publication builds upon the seminal work by Wieman3, updating components, and providing a video tutorial. The setup, frequency locking and performance characterization of an ECDL will be described. Discussion of component selection and proper mounting of both diodes and gratings, the factors affecting mode selection within the cavity, proper alignment for optimal external feedback, optics setup for coarse and fine frequency sensitive measurements, a brief overview of laser locking techniques, and laser linewidth measurements are included. PMID:24796259

Construction and characterization of external cavity diode lasers for atomic physics.

PubMed

Hardman, Kyle S; Bennetts, Shayne; Debs, John E; Kuhn, Carlos C N; McDonald, Gordon D; Robins, Nick

2014-04-24

Since their development in the late 1980s, cheap, reliable external cavity diode lasers (ECDLs) have replaced complex and expensive traditional dye and Titanium Sapphire lasers as the workhorse laser of atomic physics labs. Their versatility and prolific use throughout atomic physics in applications such as absorption spectroscopy and laser cooling makes it imperative for incoming students to gain a firm practical understanding of these lasers. This publication builds upon the seminal work by Wieman, updating components, and providing a video tutorial. The setup, frequency locking and performance characterization of an ECDL will be described. Discussion of component selection and proper mounting of both diodes and gratings, the factors affecting mode selection within the cavity, proper alignment for optimal external feedback, optics setup for coarse and fine frequency sensitive measurements, a brief overview of laser locking techniques, and laser linewidth measurements are included.

International survey for good practices in forecasting uncertainty assessment and communication

NASA Astrophysics Data System (ADS)

Berthet, Lionel; Piotte, Olivier

2014-05-01

Achieving technically sound flood forecasts is a crucial objective for forecasters but remains of poor use if the users do not understand properly their significance and do not use it properly in decision making. One usual way to precise the forecasts limitations is to communicate some information about their uncertainty. Uncertainty assessment and communication to stakeholders are thus important issues for operational flood forecasting services (FFS) but remain open fields for research. French FFS wants to publish graphical streamflow and level forecasts along with uncertainty assessment in near future on its website (available to the greater public). In order to choose the technical options best adapted to its operational context, it carried out a survey among more than 15 fellow institutions. Most of these are providing forecasts and warnings to civil protection officers while some were mostly working for hydroelectricity suppliers. A questionnaire has been prepared in order to standardize the analysis of the practices of the surveyed institutions. The survey was conducted by gathering information from technical reports or from the scientific literature, as well as 'interviews' driven by phone, email discussions or meetings. The questionnaire helped in the exploration of practices in uncertainty assessment, evaluation and communication. Attention was paid to the particular context within which every insitution works, in the analysis drawn from raw results. Results show that most services interviewed assess their forecasts uncertainty. However, practices can differ significantly from a country to another. Popular techniques are ensemble approaches. They allow to take into account several uncertainty sources. Statistical past forecasts analysis (such as the quantile regressions) are also commonly used. Contrary to what was expected, only few services emphasize the role of the forecaster (subjective assessment). Similar contrasts can be observed in uncertainty communication practices. Some countries are quite advanced in uncertainty communication to the general public whereas most of them restrain this communication to pre-defined stakeholders who have previously been sensitized or trained. Differents forms of communication were met during the survey, from written comments to complex graphics. No form could claim a clear leadership. This survey revealed useful to identify some difficulties in the design of the next French forecast uncertainty assessment and communication schemes.

Rotational Alignment Altered by Source Position Correlations

NASA Technical Reports Server (NTRS)

Jacobs, Chris S.; Heflin, M. B.; Lanyi, G. E.; Sovers, O. J.; Steppe, J. A.

2010-01-01

In the construction of modern Celestial Reference Frames (CRFs) the overall rotational alignment is only weakly constrained by the data. Therefore, common practice has been to apply a 3-dimensional No-Net-Rotation (NNR) constraint in order to align an under-construction frame to the ICRF. We present evidence that correlations amongst source position parameters must be accounted for in order to properly align a CRF at the 5-10 (mu)as level of uncertainty found in current work. Failure to do so creates errors at the 10-40 (mu)as level.

Restoring wisdom to the practice of psychiatry.

PubMed

Boyce, Philip

2006-03-01

While psychiatry is an exciting and rewarding discipline of medicine, the practice of psychiatry has become increasingly simplistic. This address seeks to identify some of the influences that underlie this phenomenon. The influences include an increased demand for services and pressure on beds, the sway of the pharmaceutical industry with a biological approach being promulgated, excessive managerial constraints with an emphasis on efficiency versus effectiveness, and the acceptance of DSM diagnostic categories of uncertain validity. I argue that we need to rediscover a more wise approach to psychiatric practice. We have to insist upon changes to our training such that trainees are encouraged to get to know their patients and understand them from a biopsychosocial perspective. As a profession, we have to insist on proper care for our patients and work with managers and bureaucrats to ensure that the management of our patients is centred on quality of care and effectiveness over and above efficiency.

Improving water, sanitation and hygiene in health-care facilities, Liberia

PubMed Central

Montgomery, Maggie; Baller, April; Ndivo, Francis; Gasasira, Alex; Cooper, Catherine; Frescas, Ruben; Gordon, Bruce; Syed, Shamsuzzoha Babar

2017-01-01

Abstract Problem The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities’ preparedness and response to disease outbreaks and decreases the communities’ trust in the health services provided. Approach To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents. Local setting In Liberia, only 45% of 701 surveyed health-care facilities had an improved water source in 2015, and only 27% of these health-care facilities had proper disposal for infectious waste. Relevant changes Local ownership, through engagement of local health workers, was introduced to ensure development and refinement of the package. In-county collaborations between health-care facilities, along with multisectoral collaboration, informed national level direction, which led to increased focus on water and sanitation infrastructures and uptake of hygiene practices to improve the overall quality of service delivery. Lessons learnt National level leadership was important to identify a vision and create an enabling environment for changing the perception of water, sanitation and hygiene in health-care provision. The involvement of health workers was central to address basic infrastructure and hygiene practices in health-care facilities and they also worked as stimulators for sustainable change. Further, developing a long-term implementation plan for national level initiatives is important to ensure sustainability. PMID:28670017

There Is No Place Like Home: Imitation and the Politics of Recognition in Bolivian Obstetric Care.

PubMed

Morales, Gabriela Elisa

2018-01-17

This article examines how efforts to "culturally adapt" birthing spaces in a rural Bolivian hospital are generating debates among doctors about what constitutes proper obstetric care. Working at the intersection of national and transnational projects, NGOs in Bolivia have remade the birthing rooms of some public health institutions to look more like a home, with the goal of making indigenous women feel more comfortable and encouraging them to come to the clinic to give birth. Yet narratives of transformation also obscure ongoing conditions of racial and gendered inequality in health services. I demonstrate how doctors' use of culturally adapted technologies enacts shifting affective relations-warm, cold, gentle, harsh-that draws on preoccupations with indigenous culture as a threat to maternal and infant life. In tracing practices of care, I argue that culturally adapted birthing in many ways extends historically rooted practices of doing biomedical work on indigenous bodies. © 2018 by the American Anthropological Association.

Nurses' attitudes towards end-of-life decisions in medical practice: a nationwide study in Flanders, Belgium.

PubMed

Inghelbrecht, E; Bilsen, J; Mortier, F; Deliens, L

2009-10-01

We investigated on a nationwide level the attitudes of nurses towards end-of-life decisions (ELDs) that may hasten death and towards their role in those decisions. We took a representative random sample of 6000 nurses in Flanders, Belgium. Response rate was 62.5%. Most nurses agreed with the practice of withholding/withdrawing potentially life-prolonging treatments (93%), with decisions to alleviate symptoms with possible life-shortening side effects (96%) and with the practice of euthanasia (92%). Their support for the different decisions existed regardless of whether they had cared for terminally ill patients or not. Most nurses also thought that they have an important role to play especially in the ELD-making process. Nurses' views on their proper role in the administration of drugs in euthanasia and continuous deep sedation showed a large dispersal. Overall, nurses' work setting determines their opinions on nurses' role in ELDs. In conclusion, nurses accept a wide variety of ELDs being practiced with terminally ill patients.

Communication Patterns in Preschool Education Institutions – Practical Examples

PubMed Central

Radic-Hozo, Endica

2014-01-01

Introduction: Proper communication in pre-school institutions for education is undeniable importance to the development of the child, as evidenced by numerous studies. After the child's birth follows the most complex phase in its early phases - preschool education. Only high-quality, synergistic relationship triad: parent-child-educator and the modern postulates of preschool child education, warrants successful preschool child education. Methods and materials: Description, with examples from daily practice in a large institution for preschool education, marked were the critical points on the complex way in child education, many pitfalls encountered by both parents and educators. Considered are the errors in communication with the proposed solution to avoid the same in practice. Conclusion: Proper, daily communication in the preschool institution for education, within a relationship between parent-child-educator, mutual consultation, respect, acceptance, facilitation, resulting in successful common goal - the proper education and socialization of children in institutions for preschool education. PMID:25568636

Condom Use Among Female Sex Workers in China: Role of Gatekeepers

PubMed Central

YANG, HONGMEI; LI, XIAOMING; STANTON, BONITA; FANG, XIAOYI; ZHAO, RAN; DONG, BAIQING; LIU, WEI; LIANG, SHAOLING; ZHOU, YUEJIAO; HONG, YAN

2007-01-01

Objective The objective of this study was to assess the potential role of gatekeepers of establishments in promoting condom use among female sex workers (FSWs) in China. Goals The goals of this study were to explore FSWs’ perceptions of gatekeeper attitudes and support for condom use, and to assess their association with FSWs’ practice, communication, intention, proper use, knowledge of correct use, and perceptions related to condom use. Study The authors conducted a cross-sectional study among 454 establishment-based FSWs in one Chinese county. Results Perceived gatekeeper support for condom use was low among FSWs. Perceived support was positively associated with condom use communication with sexual partners, condom use frequency and intention, but not associated with proper condom use among FSWs. Perceived support was significantly associated with most condom use-related perceptions (e.g., self-efficacy of condom use, barriers to condom use, and perceived peer condom use) among FSWs. Conclusions Healthcare professionals should work with gatekeepers to create a supportive local environment for condom use in sex work establishments. Gatekeepers need to clearly articulate their support for condom use to the FSWs. Training and skill acquisition regarding correct use of condoms among FSWs will be necessary. PMID:16118607

A social work plan to promote HIV testing: A social marketing approach.

PubMed

Morgan-Siebe, J P

2017-03-01

Many people living with human immunodeficiency virus (HIV) do not know that they are infected. It is important for infected persons to get tested for HIV in order to be diagnosed and medically treated. HIV has no known cure, but it can be controlled and sometimes prevented with proper medical care. The social work profession has ideal positioning to be extraordinarily helpful in work that promotes HIV testing, leading to reducing then eliminating new HIV diagnoses. Social marketing interventions, along with audience segmenting are explained. Specific attention is given to two separate subjects-minority health disparities and impulsive and/or sensation seeking sex practices-to showcase the versatility of social marketing in the promotion of HIV testing. Further ideas about how social workers can participate in these interprofessional social marketing campaigns are provided.

Mobile retroreflectivity best practices handbook.

DOT National Transportation Integrated Search

2009-07-01

This handbook documents best practices related to proper use of the mobile retroreflectometer, sampling of : sites for data collection, and handling of mobile retroreflectivity data. The best practices described in this : handbook are derived from th...

A Proposed Collaborative Framework for Prefabricated Housing Construction Using RFID Technology

NASA Astrophysics Data System (ADS)

Charnwasununth, Phatsaphan; Yabuki, Nobuyoshi; Tongthong, Tanit

Despite the popularity of prefabricated housing construction in Thailand and many other countries, due to the lack of collaboration in current practice, undesired low productivity and a number of mistakes are identified. This research proposes a framework to raise the collaborative level for improving productivity and reducing mistake occurrences at sites. In this framework, RFID system bridges the gap between the real situation and the design, and the proposed system can cope with the unexpected construction conditions by generating proper alternatives. This system is composed of PDAs, RFID readers, laptop PCs, and a desktop PC. Six main modules and a database system are implemented in laptop PCs for recording actual site conditions, generating working alternatives, providing related information, and evaluating the work.

Practice, awareness and opinion of pharmacists toward disposal of unwanted medications in Kuwait

PubMed Central

Abahussain, Eman; Waheedi, Mohammad; Koshy, Samuel

2012-01-01

Background The disposal of unwanted medications has been a concern in many countries, as pharmaceutical waste enters the ecosystem, ultimately having an effect on human health and environment. Earlier studies in Kuwait found that the method of disposal by the public was by disposing in the garbage or by flushing down the drain. In accordance with patient preference and environment safety, it would be appropriate to use local government pharmacies as collection points for proper disposal. Objective To determine the practice of pharmacists, working in government healthcare sectors, with regard to disposal of returned unwanted medications by the public. This study also aims to assess pharmacists’ awareness toward the impact of improper disposal on the environment and to investigate whether pharmacists agree to have their pharmacies as collection points for future take-back programs. Method A random sample of 144 pharmacists from the six main governmental hospitals and 12 specialized polyclinics in Kuwait, completed a self-administered questionnaire about their practice of disposal, awareness and opinion on using pharmacies as collection points for proper disposal of UMs. Data were analyzed using descriptive statistics. Results A total of 144 pharmacists completed the survey. Throwing UMs in the trash was the main method of disposal by majority of the respondents (73%). Only 23 pharmacists disposed UMs according to the guidelines of Ministry of Health, Kuwait (MOH). However, about 82% are aware that improper disposal causes damage to the environment and 97% agree that it is their responsibility to protect the environment. About 86–88% of the pharmacists agree to have government hospital pharmacies and polyclinics as collection points for future take-back programs. Conclusion Even though the current practice of disposal by majority of pharmacists is inappropriate, they are aware of the damage and acknowledge their responsibilities toward environment protection. Concerned authorities should monitor and implement proper disposal guidelines in all pharmacies. Majority of pharmacists support the idea of having the government pharmacies as collection points for safe disposal of UMs in Kuwait. PMID:23960793

"A Thousand Names They Called Him" Naming and Proper Names in the Work of S. Y. Agnon

ERIC Educational Resources Information Center

Hadad, Shira

2012-01-01

This dissertation offers a study of proper names and naming as a conceptual and thematic anchor in the work of S.Y. Agnon. Proper names, I argue, constitute an underexplored and highly fruitful prism through which to read literature, and specifically Agnon's fiction. My study consists of a series of readings in several of Agnon's major…

Investigating solid waste production and associated management practices in private dental units

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

Kontogianni, S.; Xirogiannopoulou, A.; Karagiannidis, A.

In the municipality of Thessaloniki in 2006 mercury-bearing dental wastes were not managed properly by 80% of dentists and metal-bearing waste was handled in accordance with internationally established best management practices by less than 50% of dentists. Those results were documented through a biennial field-based research study that took place in private dental units within the Thessaloniki Urban Area. For quantifying the waste produced, structured questionnaires were used and interviews with dentists were performed. In the present work, results of this survey are presented; critical parameters and factors affecting the quantity and quality of the dental waste stream are reportedmore » together with the analysis and classification of dominant conditions and needs of the dental sector in the waste management field.« less

Gender Difference in Safe and Unsafe Practice of Pesticide Handling in Tobacco Farmers of Malaysia

PubMed Central

BIN NORDIN, Rusli; ARAKI, Shunichi; SATO, Hajime; YOKOYAMA, Kazuhito; BIN WAN MUDA, Wan Abdul Manan; WIN KYI, Daw

2001-01-01

To identify gender difference in safe and unsafe practice of pesticide handling in tobacco farmers of Malaysia, we conducted a 20-item questionnaire interview on storage of pesticide (4 questions), mixing of pesticide (3 questions), use of personal protective equipment and clothing while spraying pesticide (7 questions), activities during and after spraying of pesticide (5 questions), and maintenance of pesticide sprayer (1 question) in 496 tobacco farmers (395 males and 101 females) in Bachok District, Kelantan, Malaysia. Duration of employment was significantly longer in females than those in males (p<0.001). In addition, proportion with no formal education in females was significantly higher than those in males (p<0.05). The following eight common factors were extracted from the 20 questionnaires by principal components factor analysis after varimax rotation in all farmers: (1) use of personal protective equipment, (2) unsafe work habit, (3) reading and following instructions on pesticide label, (4) security, storage and disposal of pesticide container, (5) safe work habit, (6) proper handling of pesticide and maintenance of pesticide sprayer, (7) use of personal protective clothing, and (8) safe handling of pesticide. Results of analysis of covariance for the eight factor scores of all male and female farmers, controlling for educational level and duration of employment, showed that: (1) factor scores for use of personal protective equipment (p<0.001), use of personal protective clothing (p<0.001) and safe work habit (p<0.001) in females were significantly lower than those in males; (2) conversely, factor scores for reading and following instruction on pesticide label (p<0.001) and proper handling of pesticide and maintenance of pesticide sprayer (p<0.01) in males were significantly lower than those in females; and (3) there were no significant differences in other three factor scores (p>0.05). We therefore conclude that: (1) for female tobacco farmers, choice of personal attire tend to result in lower scores on use of personal protective equipment and personal protective clothing while personal hygiene practices result in lower score on safe work habit; and, (2) for male tobacco farmers, the lower scores on reading and following instruction on pesticide label and mixing pesticide and maintenance of pesticide sprayer in good condition suggests that they were not primarily involved in these activities. It is postulated that these differences in safe and unsafe practices of pesticide handling across gender is related to the choice of personal attire, personal hygiene practices and division of labour within farming households which in turn is influenced by prevailing sociocultural norms in the community. PMID:22973149

Telehealth physician oversight over direct to consumer testing: doctors working with patients towards patient empowerment.

PubMed

Chung, Rick

2012-06-01

Patient empowerment has increased the demand for direct to consumer (DTC) laboratory testing. Multiple professional societies and advocacy groups have raised concerns over how DTC laboratory testing is being offered to consumers without proper physician oversight. Physician telehealth services can properly oversee DTC laboratory testing in a safe and medically sound manner. Using telehealth protocols and standards established by professional health organizations and state regulators, physician telehealth oversight in DTC laboratory test ordering can be effective to increase patient access to healthcare services. With proper physician oversight in test interpretation, post-test counseling, and information collaboration, DTC laboratory testing can remain a reliable and convenient option for consumers. Working within the channel of distribution of most DTC laboratory testing, physician telehealth services can properly oversee DTC laboratory testing in a safe and medically sound manner to ensure that proper test interpretation, counseling, and information collaboration are achieved. Physician telehealth services can properly oversee DTC laboratory testing to ensure that proper test interpretation, counseling, and information collaboration are achieved.

Dermatology practice management enhancement: implications for dermatology in the age of managed care.

PubMed

Nestor, M S

2000-09-01

Health care delivery in the United States has changed dramatically during the past 10 years. Dermatologists are faced with challenging changes in the way they learn new skills, practice, and provide dermatologic care. Dermatologists can survive and flourish in this environment if they learn proper management and enhancement skills. These skills include proper coding and documentation, regulatory compliance, and new levels of practice effectiveness and efficiency. Dermatologists can offer also the benefit of cosmetic procedures and ethical office-based dispensing to their patients. Greater future unification of this specialty will allow dermatology to flourish and show its need, efficiency, and cost-effectiveness.

A quantitative risk-assessment system (QR-AS) evaluating operation safety of Organic Rankine Cycle using flammable mixture working fluid.

PubMed

Tian, Hua; Wang, Xueying; Shu, Gequn; Wu, Mingqiang; Yan, Nanhua; Ma, Xiaonan

2017-09-15

Mixture of hydrocarbon and carbon dioxide shows excellent cycle performance in Organic Rankine Cycle (ORC) used for engine waste heat recovery, but the unavoidable leakage in practical application is a threat for safety due to its flammability. In this work, a quantitative risk assessment system (QR-AS) is established aiming at providing a general method of risk assessment for flammable working fluid leakage. The QR-AS covers three main aspects: analysis of concentration distribution based on CFD simulations, explosive risk assessment based on the TNT equivalent method and risk mitigation based on evaluation results. A typical case of propane/carbon dioxide mixture leaking from ORC is investigated to illustrate the application of QR-AS. According to the assessment results, proper ventilation speed, safe mixture ratio and location of gas-detecting devices have been proposed to guarantee the security in case of leakage. The results revealed that this presented QR-AS was reliable for the practical application and the evaluation results could provide valuable guidance for the design of mitigation measures to improve the safe performance of ORC system. Copyright © 2017 Elsevier B.V. All rights reserved.

Rules of good practice in the care of laboratory animals used in biomedical research.

PubMed

Valanzano, Angelina

2004-01-01

In recent years, the use of laboratory animals has decreased as a result of the adoption of alternative methods such as in vitro experiments and simulation studies. Nonetheless, animal models continue to be necessary in many fields of biomedical research, giving rise to ethical issues regarding the treatment of these animals. In the present work, a general overview of the rules of good practise in caring for laboratory animals is provided, focussing on housing conditions and the proper means of handling animals, including the importance of the relationship or "bond" between the researcher and the animal.

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

Xu, Xingchen; Peng, Xuan; Sumption, Michael

The internal oxidation technique can generate ZrO2 nano particles in Nb3Sn strands, which markedly refine the Nb3Sn grain size and boost the high-field critical current density (Jc). This article summarizes recent efforts on implementing this technique in practical Nb3Sn wires and adding Ti as a dopant. It is demonstrated that this technique can be readily incorporated into the present Nb3Sn conductor manufacturing technology. Powder-in-tube (PIT) strands with fine subelements (~25 µm) based on this technique were successfully fabricated, and proper heat treatments for oxygen transfer were explored. Future work for producing strands ready for applications is proposed.

Risk of Potential Exposure Incident in Non-healthcare Workers in Contact with Infectious and Municipal Waste

PubMed Central

Kanisek, Sanja; Gmajnić, Rudika; Barać, Ivana

2018-01-01

Abstract Introduction The proper classification of sharp and infectious waste in situ by the healthcare workers is an important measure of prevention of sharps and other exposure incidents in non-healthcare workers, who handle such waste. The aim was to examine the practice of classifying sharp and infectious waste in family and dental practices. Methods An analysis of 50 bags of infectious and 50 bags of municipal waste from five family and five dental practices for five days in October 2016 at the Health centre Osijek. Results Healthcare workers in 70% of the practices deposited sharps in infectious waste. In 56% of infectious waste bags, sharp object were found. More risky bags of infectious waste were produced by family practices (64%), but with no significant differences in relation to dental practices (48%), (P=0.143). Disposing of infectious into municipal waste was the case in 90% of the practitioners, where in 60% of municipal waste bags, infectious waste was disposed. Dental practices produced more risky bags of municipal waste (76%) in relation to family practices (44%), but with no significant difference (P=0.714). Conclusions The results of this research point to importance of performing audits of proper disposal of sharps and infectious waste to reduce the risks of injury to non-healthcare workers who come into contact with the said waste. Given results could be used for framing written protocols of proper disposal of sharps and infectious waste that should be visibly available in family and dental practices and for education of healthcare workers. PMID:29651317

Sample survey methods as a quality assurance tool in a general practice immunisation audit.

PubMed

Cullen, R

1994-04-27

In a multidoctor family practice there are often just too many sets of patients records to make it practical to repeat an audit by census of even an age band of the practice on a regular basis. This paper attempts to demonstrate how sample survey methodology can be incorporated into the quality assurance cycle. A simple random sample (with replacement) of 120 from 580 children with permanent records who were aged between 6 weeks and 2 years old from an Auckland general practice was performed, with sample size selected to give a predetermined precision. The survey was then repeated after 4 weeks. Both surveys were able to be completed within the course of a normal working day. An unexpectedly low level of under 2 years olds that were recorded as not overdue for any immunisations was found (22.5%) with only a modest improvement after a standard telephone/letter catch up campaign. Seventy-two percent of the sample held a group one community services card. The advantages of properly conducted sample surveys in producing useful estimates of known precision without disrupting office routines excessively were demonstrated. Through some attention to methodology, the trauma of a practice census can be avoided.

Methodology of Dynamic Monitoring of Structures in the Vicinity of Hydrotechnical Works - Selected Case Studies

NASA Astrophysics Data System (ADS)

Wyjadłowski, Marek

2017-12-01

The constant development of geotechnical technologies imposes the necessity of monitoring techniques to provide a proper quality and the safe execution of geotechnical works. Several monitoring methods enable the preliminary design of work process and current control of hydrotechnical works (pile driving, sheet piling, ground improvement methods). Wave parameter measurements and/or continuous histogram recording of shocks and vibrations and its dynamic impact on engineering structures in the close vicinity of the building site enable the modification of the technology parameters, such as vibrator frequency or hammer drop height. Many examples of practical applications have already been published and provide a basis for the formulation of guidelines, for work on the following sites. In the current work the author's experience gained during sheet piling works for the reconstruction of City Channel in Wrocław (Poland) was presented. The examples chosen describe ways of proceedings in the case of new and old residential buildings where the concrete or masonry walls were exposed to vibrations and in the case of the hydrotechnical structures (sluices, bridges).

Addressing Authorship Issues Prospectively: A Heuristic Approach.

PubMed

Roberts, Laura Weiss

2017-02-01

Collaborative writing in academic medicine gives rise to more richly informed scholarship, and yet challenging ethical issues surrounding authorship are commonly encountered. International guidelines on authorship help clarify whether individuals who have contributed to a completed scholarly work have been correctly included as authors, but these guidelines do not facilitate intentional and proactive authorship planning or decisions regarding authorship order.In this Commentary, the author presents a heuristic approach to help collaborators clarify, anticipate, and resolve practical and ethically important authorship issues as they engage in the process of developing manuscripts. As this approach illustrates, assignment of authorship should balance work effort and professional responsibility, reflecting the effort and intellectual contribution and the public accountability of the individuals who participate in the work. Using a heuristic approach for managing authorship issues prospectively can foster an ethical, collaborative writing process in which individuals are properly recognized for their contributions.

Asteroid families in the Cybele and Hungaria groups

NASA Astrophysics Data System (ADS)

Vinogradova, T.; Shor, V.

2014-07-01

Asteroid families are fragments of some disrupted parent bodies. Planetary perturbations force the primarily close orbits to evolve. One of the main features of the orbit evolution is the long-period variation of the osculating elements, such as the inclination and eccentricity. Proper elements are computed by elimination of short- and long-period perturbations, and, practically, they do not change with time. Therefore, proper elements are important for family-identification procedures. The techniques of proper-element computation have improved over time. More and more accurate dynamical theories are developed. Contrastingly, in this work, an empirical method is proposed for proper-element calculations. The long-term variations of osculating elements manifest themselves very clearly in the distributions of pairs: inclination and longitude of ascending node; eccentricity and longitude of perihelion in the corresponding planes. Both of these dependencies have a nearly sinusoidal form for most asteroid orbits with regular motion of node and perihelion. If these angular parameters librate, then the sinusoids transform to some closed curve. Hence, it is possible to obtain forced elements, as parameters of curves specified above. The proper elements can be calculated by an elimination of the forced ones. The method allows to obtain the proper elements in any region, if there is a sufficient number of asteroids. This fact and the simplicity of the calculations are advantages of the empirical method. The derived proper elements include the short-period perturbations, but their accuracy is sufficient to search for asteroid families. The special techniques have been developed for the identification of the families, but over a long time large discrepancies took place between the lists of families derived by different authors. As late as 1980, a list of 30 reliable families was formed. And now the list by D. Nesvorny includes about 80 robust families. To date, only two families have been found in the most outer part of the main asteroid belt or the Cybele group: Sylvia and Ulla. And the Hungaria group in the most inner part of the belt has always been considered as one family. In this work, the proper elements were calculated by the empirical method for all multi-opposition asteroids in these two zones. As the source of the initial osculating elements, the MPC catalogue (version Feb. 2014) was used. Due to the large set of proper elements used in our work, the families are apparent more clearly. An approach similar to the hierarchical clustering method (HCM) was used for the identification of the families. As a result, five additional families have been found in the Cybele region, associated with (121) Hermione, (643) Scheherezade, (1028) Lydina, (3141) Buchar, and (522) Helga. The small Helga family, including 15 members, is the family in the main belt (3.6--3.7 au) most distant from the Sun. Due to the isolation of this family, its identification is very reliable. As to the Hungaria region, two low-density families have been found additionally: (1453) Fennia and (3854) George. They have inclinations slightly greater than that of the Hungaria family (from 24 to 26 degrees). In contradiction to the predominant C-type of the Hungaria family asteroids, the taxonomy of these families is represented mainly by the S and L types. Most likely, these families are two parts of a single ancient family.

Coherent field propagation between tilted planes.

PubMed

Stock, Johannes; Worku, Norman Girma; Gross, Herbert

2017-10-01

Propagating electromagnetic light fields between nonparallel planes is of special importance, e.g., within the design of novel computer-generated holograms or the simulation of optical systems. In contrast to the extensively discussed evaluation between parallel planes, the diffraction-based propagation of light onto a tilted plane is more burdensome, since discrete fast Fourier transforms cannot be applied directly. In this work, we propose a quasi-fast algorithm (O(N 3  log N)) that deals with this problem. Based on a proper decomposition into three rotations, the vectorial field distribution is calculated on a tilted plane using the spectrum of plane waves. The algorithm works on equidistant grids, so neither nonuniform Fourier transforms nor an explicit complex interpolation is necessary. The proposed algorithm is discussed in detail and applied to several examples of practical interest.

The psychologist who is not a psychologist: a deconstructive reading of Wolfgang Giegerich's idea of psychology proper.

PubMed

Marlan, Stanton

2016-04-01

This paper represents an archetypal and deconstructive reading of the work of Wolfgang Giegerich. In an attempt to extend and philosophically develop Jung's late-life view of the objective psyche, Giegerich, via Hegel, defines psychology proper as fundamentally separate from the everyday person and the 'human, all-too-human' aspects of the soul. It is argued that, in so doing, Giegerich removes the human person from being the primary focus of his psychology and creates instead a hierarchy of ideas and values privileging syntax over semantics, the logical over the empirical, and thinking over imagination. This bypasses the emotionality of the everyday person/patient and also renders psychology proper unable to address the day-to-day practice of the analyst. Giegerich attempts to rectify this problem by re-incorporating what he had previously rejected, making his theory more complex than is apparent in his binary oppositions. In the end, however, it remains a question to what extent Giegerich is successful in avoiding a binary scission (Saban 2015) or a tendency to regularly de-emphasize the human aspect of the soul (Hoedl 2015) in his need to continue to heroically push off from the ego seeking total freedom from neurosis and from our humanity. © 2016, The Society of Analytical Psychology.

Occupational health and safety issues in the informal economic segment of Pakistan: a survey of construction sites.

PubMed

Ahmed, Ishfaq; Shaukat, Muhammad Zeeshan; Usman, Ahmad; Nawaz, Muhammad Musarrat; Nazir, Mian Sajid

2018-06-01

This research covers the current status of occupational health and safety (OHS)-related practices in the informal construction segment of Pakistan. Data were collected, through interviews, from 316 construction sites employing 3577 workers. The results of the study reveal that both employers and workers lack knowledge of OHS laws/standards and no practices of this nature are enacted at these construction sites. Alarmingly, work-related accidents, whenever they happen, are not given due attention and there is no formal injury-report system. The informal construction industry employs a huge portion of the informal workforce, and lack of OHS happens at tremendous human cost. These research findings may thus play their role in strengthening the case for reforms in the sector. This study, if properly utilized, may also enable employers of the sector by increasing their knowledge about OHS practices and, as a result, trying to offer safer environments for their workers.

Communities of practice as a professional and organizational development strategy in local public health organizations in Quebec, Canada: an evaluation model.

PubMed

Richard, Lucie; Chiocchio, François; Essiembre, Hélène; Tremblay, Marie-Claude; Lamy, Geneviève; Champagne, François; Beaudet, Nicole

2014-02-01

Communities of practice (CoPs) are among the professional development strategies most widely used in such fields as management and education. Though the approach has elicited keen interest, knowledge pertaining to its conceptual underpinnings is still limited, thus hindering proper assessment of CoPs' effects and the processes generating the latter. To address this shortcoming, this paper presents a conceptual model that was developed to evaluate an initiative based on a CoP strategy: Health Promotion Laboratories are a professional development intervention that was implemented in local public health organizations in Montreal (Quebec, Canada). The model is based on latest theories on work-group effectiveness and organizational learning and can be usefully adopted by evaluators who are increasingly called upon to illuminate decision-making about CoPs. Ultimately, validation of this conceptual model will help advance knowledge and practice pertaining to CoPs as well as professional and organizational development strategies in public health. Copyright © 2014 Longwoods Publishing.

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.

Visual bottle inspection performance in highly paced belt-conveyor systems.

PubMed

Saito, M; Tanaka, T

1977-12-01

The relation between visual work performance and a few variables with immediate effects, i.e, lighting, work speed, work spell, etc. was studied. At the same time, some physiological and behavioral variations obtained in the study were also discussed. Through experiments and surveys, the optimum conditions were found for each variable. Work performance, however, is affected in such a subtle, interactive and dynamic manner that the working conditions are to be adjusted by taking into account not only these variables having immediate effects but also those indirectly relating ones meeting real needs in the practical working fields. Improvement of some physical working conditions, such as lighting, produces only a transitory increase of performance which is very unstable unless other determinants of performance are simultaneously managed in a proper manner. The same applied to arrangement of the optimum work speed and work spell for highly paced visual inspection, variations in rejection rate and in physiological functions interacting with individual and other determinants. In order to maximize understanding of the integrated and synthesized manner of determinants, it is emphasized that work performance must be pursued in a considerably comprehensive framework from a long-term perspective.

Ill-placed democracy: ethics consultations and the moral status of voting.

PubMed

Fiester, Autumn M

2011-01-01

As groups around the country begin to craft standards for clinical ethics consultations, one focus of that work is the proper procedure for conducting ethics consults. From a recent empirical look into the workings of ethics consult services (ECSs), one worrisome finding is that some ECSs rely on a committee vote when making a recommendation. This article examines the practice of voting and its moral standing as a procedural strategy for arriving at a clinical ethics recommendation. I focus here on the type of clinical ethics conflicts that are most likely to lead an ECS to vote, namely, conflicts involving ethical uncertainty--or, in the Greek, aporia. I argue that in cases of aporia, voting on an ethics conflict is not a morally justifiable procedure. Then on the same grounds that I use to show that voting is ethically problematic, I raise broader concerns about the common practice of making recommendations by other procedures. In contrast to the standard approach of adjudicating between moral claims, I argue that ECSs can best resolve aporetic conflict through the process of clinical ethics mediation.

Evaluation of participatory training in managing mental health for supervisory employees in the financial industry.

PubMed

Yoshikawa, Toru; Ogami, Ayumi; Muto, Takashi

2013-12-01

Industry-specific primary prevention measures for promoting mental health of workers were undertaken in 2008 and 2009 as a result of participatory training involving 130 supervisory employees in workplaces of the financial industry. These measures included the following five points suggested to be effective in the industry: 1) proper opportunities for training and career building, 2) control of work time and improving work organization, 3) standardization of tasks, 4) job rotation for sharing work responsibilities, and 5) increasing communication and mutual support. A post-training follow-up survey revealed that participatory, action-oriented training facilitated sharing of feasible measures and mutual support, leading to the development of measures easily introduced and established at each workplace. We concluded that mutually supportive group work of teams composed of members who held similar duty positions and were engaged in similar operations, using the Mental Health Action Checklist as a guiding tool, was effective for realizing implementation of optimally practical and specific measures.

R.S.V.P. Teacher-Coordinator Handbook.

ERIC Educational Resources Information Center

1983

Alaska Teacher-Coordinators in the Rural Student Vocational Program (RSVP) should be familiar with activities necessary to insure proper selection of students and proper and meaningful work placement. In RSVP, students from outlying high schools travel to Anchorage, Fairbanks, or Juneau to participate in 2 weeks of work experience with cooperating…

29 CFR 1926.952 - Mechanical equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of each shift during which the equipment is to be used to determine that the brakes and operating systems are in proper working condition. (3) No employer shall use any motor vehicle equipment having an... certified for work on the proper voltage, mechanical equipment shall not be operated closer to any energized...

29 CFR 1926.952 - Mechanical equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... of each shift during which the equipment is to be used to determine that the brakes and operating systems are in proper working condition. (3) No employer shall use any motor vehicle equipment having an... certified for work on the proper voltage, mechanical equipment shall not be operated closer to any energized...

Cytomegalovirus (CMV) and Pregnancy

MedlinePlus

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

A Flight Training Simulator for Instructing the Helicopter Autorotation Maneuver (Enhanced Version)

NASA Technical Reports Server (NTRS)

Rogers, Steven P.; Asbury, Charles N.

2000-01-01

Autorotation is a maneuver that permits a safe helicopter landing when the engine loses power. A catastrophe may occur if the pilot's control inputs are incorrect, insufficient, excessive, or poorly timed. Due to the danger involved, full-touchdown autorotations are very rarely practiced. Because in-flight autorotation training is risky, time-consuming, and expensive, the objective of the project was to develop the first helicopter flight simulator expressly designed to train students in this critical maneuver. A central feature of the project was the inclusion of an enhanced version of the Pilot-Rotorcraft Intelligent Symbology Management Simulator (PRISMS), a virtual-reality system developed by Anacapa Sciences and Thought Wave. A task analysis was performed to identify the procedural steps in the autorotation, to inventory the information needed to support student task performance, to identify typical errors, and to structure the simulator's practice environment. The system provides immediate knowledge of results, extensive practice of perceptual-motor skills, part-task training, and augmented cueing in a realistic cockpit environment. Additional work, described in this report, extended the capabilities of the simulator in three areas: 1. Incorporation of visual training aids to assist the student in learning the proper appearance of the visual scene when the maneuver is being properly performed; 2. Introduction of the requirement to land at a particular spot, as opposed to the wide, flat open field initially used, and development of appropriate metrics of success; and 3. Inclusion of wind speed and wind direction settings (and random variability settings) to add a more realistic challenge in "hitting the spot."

7 CFR 407.16 - Group risk plan for soybean.

Code of Federal Regulations, 2012 CFR

2012-01-01

... calculate indemnities. Planted acreage. Land in which the soybean seed has been placed by a machine... properly prepared for the planting method and production practice. Land on which seed is initially spread... accepted application; (b) Properly planted and reported by the acreage reporting date; (c) Planted with the...

7 CFR 407.17 - Group risk plan for wheat.

Code of Federal Regulations, 2011 CFR

2011-01-01

... calculate indemnities. Planted acreage. Land in which the wheat seed has been planted by a machine... properly prepared for the planting method and production practice. Land on which seed is initially spread... accepted application; (b) Properly planted and reported by the acreage reporting date; (c) Planted with the...

7 CFR 407.16 - Group risk plan for soybean.

Code of Federal Regulations, 2011 CFR

2011-01-01

... calculate indemnities. Planted acreage. Land in which the soybean seed has been placed by a machine... properly prepared for the planting method and production practice. Land on which seed is initially spread... accepted application; (b) Properly planted and reported by the acreage reporting date; (c) Planted with the...

7 CFR 407.17 - Group risk plan for wheat.

Code of Federal Regulations, 2012 CFR

2012-01-01

... calculate indemnities. Planted acreage. Land in which the wheat seed has been planted by a machine... properly prepared for the planting method and production practice. Land on which seed is initially spread... accepted application; (b) Properly planted and reported by the acreage reporting date; (c) Planted with the...

Toothbrushing: Do It Daily.

ERIC Educational Resources Information Center

Texas Child Care, 1993

1993-01-01

Offers a practical guide for promoting daily toothbrushing in young children. Discusses the importance of proper dental care, explains the causes of tooth decay, describes proper dental care for infants and young children, recommends materials and teaching methods, and discusses visits to the dentist and the benefits of fluoride for dental health.…

Behavior Modification Revisited: Practical Application for the Reading Teacher.

ERIC Educational Resources Information Center

Lang, Deborah Odom; Lang, William Steve

An informal study examined the impact of a simple behavior modification procedure on the reading habits of second and fifth grade students. Behavior modification theory was pared down to two rules ("reinforce proper behavior" and "reinforce anything close to proper behavior") so that no additional burdens would be placed on…

The Feminization of Teaching and the Practice of Teaching: Threat or Opportunity?

ERIC Educational Resources Information Center

Griffiths, Morwenna

2006-01-01

In this essay, Morwenna Griffiths considers the effect of feminization on the practices of education. She outlines a feminist theory of practice that draws critically on theories of embodiment, diversity, and structures of power to show that any practice is properly seen as fluid, leaky, and viscous. Examining different and competing…

Neuroscience and Values: A Case Study Illustrating Developments in Policy, Training and Research in the UK and Internationally**

PubMed Central

Fulford, K. W. M

2011-01-01

In the current climate of dramatic advances in the neurosciences, it has been widely assumed that the diagnosis of mental disorder is a matter exclusively for value-free science. Starting from a detailed case history, this paper describes how, to the contrary, values come into the diagnosis of mental disorders, directly through the criteria at the heart of psychiatry’s most scientifically grounded classification, the American Psychiatric Association’s DSM (Diagnostic and Statistical Manual). Various possible interpretations of the prominence of values in psychiatric diagnosis are outlined. Drawing on work in the Oxford analytic tradition of philosophy, it is shown that, properly understood, the prominence of psychiatric diagnostic values reflects the necessary engagement of psychiatry with the diversity of individual human values. This interpretation opens up psychiatric diagnostic assessment to the resources of a new skills-based approach to working with complex and conflicting values (also derived from analytic philosophy) called ‘values-based practice.’ Developments in values-based practice in training, policy and research in mental health are briefly outlined. The paper concludes with an indication of how the integration of values-based with evidence-based approaches provides the basis for psychiatric practice in the twenty-first century that is both science-based and person-centred. PMID:21694963

Guidelines for Mountain Stream Relocations in North Carolina

DOT National Transportation Integrated Search

1979-03-01

Relocations of North Carolina's mountain trout streams traditionally have been : a routine practice during road construction. This practice has been extremely : destructive to the state's fishery, wildlife and recreational sources, because proper env...

Self-Care Practices among Diabetes Patients in Addis Ababa: A Qualitative Study

PubMed Central

Tewahido, Dagmawit; Berhane, Yemane

2017-01-01

Background Self-care practices that include self-monitoring of blood sugar level, diet management, physical exercise, adherence to medications, and foot care are the cornerstones of diabetes management. However, very little is known about self-care in developing countries where the prevalence of diabetes is increasing. Objective The objective of this study was to describe self-care practices among individuals with type II diabetes in Addis Ababa, Ethiopia. Methods A qualitative method was used to gather data from type II diabetes patients. Patients were recruited from the outpatient diabetes clinics of two public hospitals in Addis Ababa. Data were collected using a semi structured interview guide. A thematic analysis approach was used to process the data. Results Overall self-care practices were not adequate. Most patients reported irregular self-monitoring of blood sugar. Dietary and physical exercise recommendations were inadequately practiced by most of the participants. Most patients better adhered to medication prescriptions. Patients generally lack proper information/knowledge regarding the importance of self-care and how it should be implemented. Based on reported behavior we identified three main categories of patients; which are those ‘endeavor to be compliant’, ‘confused’ and ‘negligent’. Conclusion Diabetes patients largely depend on prescribed medications to control their blood sugar level. The importance of proper self-care practices for effective management of diabetes is not adequately emphasized in diabetes care centers and patients lack sufficient knowledge for proper self-care. PMID:28045992

Teaching Fair Use with Astronomy Imagery

NASA Astrophysics Data System (ADS)

Wilson, Teresa

2016-01-01

Plagiarism among students is most common because of a misunderstanding of copyright and fair use. Images and text are frequently used without proper credit to the original author, and works are frequently acknowledged improperly. For example, space imagery is often used in posters, presentations, on the web, on Facebook, and even in the classrooms, but often are not properly cited. A lesson plan on fair use is presented, outlining what constitutes fair use and how to properly acknowledge the work done by artists and authors everywhere, with examples drawn from the Astronomy Picture of the Day (APOD).

75 FR 76067 - Agency Information Collection Activities: Requests for Comments; Clearance of Renewed Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-07

... qualified persons, and at proper intervals. This work is done by certified mechanics, repair stations, and... qualified persons, and at proper intervals. This work is done by certified mechanics, repair stations, and... for flight. Respondents: An estimated 87,769 certified mechanics, repair stations, and air carriers...

Influence of job demands and job control on work-life balance among Taiwanese nurses.

PubMed

Ng, Lee-Peng; Chen, I-Chi; Ng, Hui-Fuang; Lin, Bo-Yen; Kuar, Lok-Sin

2017-09-01

This study investigated the extent to which the job demands and job control of nurses were related to their work-life balance. The inability to achieve work-life balance is one of the major reasons for the declining retention rate among nurses. Job demands and job control are two major work domain factors that can have a significant influence on the work-life balance of nurses. The study measured the job demands, job control and work-life balance of 2040 nurses in eight private hospitals in Taiwan in 2013. Job demands and job control significantly predicted all the dimensions of work-life balance. Job demands increased the level of work-life imbalance among nurses. While job control showed positive effects on work/personal life enhancement, it was found to increase both work interference with personal life and personal life interference with work. Reducing the level of job demands (particularly for psychological demands) between family and career development and maintaining a proper level of job control are essential to the work-life balance of nurses. Flexible work practices and team-based management could be considered by nursing management to lessen job demand pressure and to facilitate job engagement and participation among nurses, thus promoting a better balance between work and personal life. © 2017 John Wiley & Sons Ltd.

Back to basics: hand hygiene and surgical hand antisepsis.

PubMed

Spruce, Lisa

2013-11-01

Health care-associated infections (HAIs) are a significant issue in the United States and throughout the world, but following proper hand hygiene practices is the most effective and least expensive way to prevent HAIs. Hand hygiene is inexpensive and protects patients and health care personnel alike. The four general types of hand hygiene that should be performed in the perioperative environment are washing hands that are visibly soiled, hand hygiene using alcohol-based products, surgical hand scrubs, and surgical hand scrubs using an alcohol-based surgical hand rub product. Barriers to proper hand hygiene may include not thinking about it, forgetting, skin irritation, a lack of role models, or a lack of a safety culture. One strategy for improving hand hygiene practices is monitoring hand hygiene as part of a quality improvement project, but the most important aspect for perioperative team members is to set an example for other team members by following proper hand hygiene practices and reminding each other to perform hand hygiene. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Waste management in small hospitals: trouble for environment.

PubMed

Pant, Deepak

2012-07-01

Small hospitals are the grassroots for the big hospital structures, so proper waste management practices require to be initiated from there. Small hospitals contribute a lot in the health care facilities, but due to their poor waste management practices, they pose serious biomedical waste pollution. A survey was conducted with 13 focus questions collected from the 100 hospital present in Dehradun. Greater value of per day per bed waste was found among the small hospitals (178 g compared with 114 g in big hospitals), indicating unskilled waste management practices. Small hospitals do not follow the proper way for taking care of segregation of waste generated in the hospital, and most biomedical wastes were collected without segregation into infectious and noninfectious categories.

The application of participatory ergonomics in a healthcare setting in Hong Kong.

PubMed

Lee, Edwin W C; Fok, Joan P C; Lam, Augustine T; Law, Rainbow K Y; Szeto, Grace P Y; Li, Philip P K

2014-01-01

Work-related musculoskeletal disorders (WRMDs) are recognized as a major source of significant pain and disability in the healthcare sector. However, they are preventable if appropriate surveillance and intervention programs are implemented. The purpose of this paper is to describe the holistic ergonomic approach that was used to address the multifactorial problems encountered by healthcare workers in their daily work. Using participatory ergonomics, healthcare workers in this study teamed up with management and staff with expertise in ergonomic analysis, design, and implementation of remedies. Selected participatory ergonomic intervention programs targeted at an organizational level are elaborated. Interventions included pre-work stretching, workplace surveillance at a psychiatric department, on-site ergonomic teaching for community nurses, and display screen equipment consultancy. Changes in workplace design, equipment re-arrangement, awareness of proper posture, and adoption of good work practices all play important roles in reducing musculoskeletal disorders among healthcare workers. Prompt occupational medicine and rehabilitation services were also provided to complement the work disability prevention process. The impact of the various intervention programs on staff health, costs and productivity of the organization are simultaneously discussed.

Unproven diagnostic procedures in IgE-mediated allergic diseases.

PubMed

Niggemann, B; Grüber, C

2004-08-01

A considerable body of literature on therapeutic aspects of complementary and alternative medicine has been published in recent years, but little is known on diagnostic procedures. This short review lists complementary and alternative diagnostic procedures for the diagnosis of allergic diseases and presents an assessment of their usefulness for the daily practice. The review of the literature revealed that neither the determination of specific immunoglobulin G-antibodies in serum, the hair-analysis, the cytotoxic test, kinesiology, iridology, or electrodermal testing represent useful tests for the daily practice. To date, no complementary or alternative diagnostic procedure can be recommended as a meaningful element in the diagnostic work-up of allergic diseases. This is especially true for food allergy: properly performed oral food challenges still represent the gold standard for implementing specific diets in food allergic individuals. Ineffective diagnostic approaches may be costly for the consumer and delay appropriate therapy.

Specifications of a continual reassessment method design for phase I trials of combined drugs†

PubMed Central

Wages, Nolan A.; Conaway, Mark R.

2013-01-01

In studies of combinations of agents in phase I oncology trials, the dose–toxicity relationship may not be monotone for all combinations, in which case the toxicity probabilities follow a partial order. The continual reassessment method for partial orders (PO-CRM) is a design for phase I trials of combinations that leans upon identifying possible complete orders associated with the partial order. This article addresses some practical design considerations not previously undertaken when describing the PO-CRM. We describe an approach in choosing a proper subset of possible orderings, formulated according to the known toxicity relationships within a matrix of combination therapies. Other design issues, such as working model selection and stopping rules, are also discussed. We demonstrate the practical ability of PO-CRM as a phase I design for combinations through its use in a recent trial designed at the University of Virginia Cancer Center. PMID:23729323

Seven surefire ways to start a nonphysician practitioner off right.

PubMed

Toth, Cheryl

2014-01-01

With the proper planning and preparation, nonphysician practitioners (NPPs) can improve physician productivity and increase patient access to the practice. A thorough training and orientation program is vital to optimizing the effectiveness and retention of an NPP. An organized approach to understanding payer reimbursement guidelines will ensure that his or her services are documented and billed correctly, and paid appropriately. And proper communication and marketing will go a long way toward building the NPP's patient base. This article offers seven proven ideas for getting an NPP off to a great start in any physician practice.

Orthopaedic Surgeons as Clinical Leaders in the National Health Service, United Kingdom (NHS UK): Can the World Learn From Us?

PubMed

Javed, Mustafa; Moulder, Elizabeth; Mohsen, Amr

2015-07-01

This article outlines some of the key concepts in leadership (both styles and theories) to provide a platform for further learning and to help the modern day orthopaedic surgeons to apply these concepts to their current practice. It is focused on two major aspects: management of medical organizations and effective twenty-first century care by surgeons through proper leadership guide and aimed in improving patient care outcomes. Practicing proper leadership skills based on evidence resulted in effective management of organization. Thus achieving patient's satisfaction.

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.

Psychometric Properties of a 36-Item Version of the “Stress Management Competency Indicator Tool”

PubMed Central

Toderi, Stefano; Sarchielli, Guido

2016-01-01

The development of supervisors’ behaviours has been proposed as an innovative approach for the reduction of employees’ work stress. The UK Health and Safety Executive (HSE) developed the “Stress Management Competency Indicator Tool” (SMCIT), designed to be used within a learning and development intervention. However, its psychometric properties have never been evaluated, and the length of the questionnaire (66 items) limits its practical applicability. We developed a brief 36-item version of the questionnaire, assessed its psychometric properties and studied the relationship with the employees’ psychosocial work environment. 353 employees filled in the brief SMCIT and the “Stress Management Indicator Tool”. The latter is a self-report questionnaire developed by the UK HSE, measuring workers’ perceptions of seven dimensions of the psychosocial work environment that if not properly managed can lead to harm. Data were analysed with structural equation modelling and multiple regressions. The results confirmed the factorial structure of the brief SMCIT questionnaire and mainly supported the convergent validity and internal consistency of the scales. Furthermore, with few exceptions, the relations hypothesized between supervisors’ competencies and the psychosocial work environment were confirmed, supporting the criterion validity of the revised questionnaire and the UK HSE framework. We conclude that the brief 36-item version of the SMCIT represents an important step toward the development of interventions directed at supervisors and we discuss the practical implications for work stress prevention. PMID:27827940

"Borrowing" Activities from Another Culture: A Native American's Perspective.

ERIC Educational Resources Information Center

Oles, Gordon W. A.

1992-01-01

Criticizes the practice in adventure education of using Native American rituals and practices without the proper cultural context. Suggests that western society uses rites and ceremonies initiated in its own culture for experiential education. (KS)

WATER, DRINKING

EPA Science Inventory

The primary object of the microbiology of drinking water is to prevent waterborne disease. A drinking-water system can minimize waterborne disease by employing proper treatment and cntrol practices, and by monitoring the effectiveness of these practices. Here, these issues are ad...

Efficient preloading of the ventricles by a properly timed atrial contraction underlies stroke work improvement in the acute response to cardiac resynchronization therapy

PubMed Central

Hu, Yuxuan; Gurev, Viatcheslav; Constantino, Jason; Trayanova, Natalia

2013-01-01

Background The acute response to cardiac resynchronization therapy (CRT) has been shown to be due to three mechanisms: resynchronization of ventricular contraction, efficient preloading of the ventricles by a properly timed atrial contraction, and mitral regurgitation reduction. However, the contribution of each of the three mechanisms to the acute response of CRT, specifically stroke work improvement, has not been quantified. Objective The goal of this study was to use an MRI-based anatomically accurate 3D model of failing canine ventricular electromechanics to quantify the contribution of each of the three mechanisms to stroke work improvement and identify the predominant mechanisms. Methods An MRI-based electromechanical model of the failing canine ventricles assembled previously by our group was further developed and modified. Three different protocols were used to dissect the contribution of each of the three mechanisms to stroke work improvement. Results Resynchronization of ventricular contraction did not lead to significant stroke work improvement. Efficient preloading of the ventricles by a properly timed atrial contraction was the predominant mechanism underlying stroke work improvement. Stroke work improvement peaked at an intermediate AV delay, as it allowed ventricular filling by atrial contraction to occur at a low diastolic LV pressure but also provided adequate time for ventricular filling before ventricular contraction. Diminution of mitral regurgitation by CRT led to stroke work worsening instead of improvement. Conclusion Efficient preloading of the ventricles by a properly timed atrial contraction is responsible for significant stroke work improvement in the acute CRT response. PMID:23928177

What are the qualities of dilemmas experienced when prescribing opioids in general practice?

PubMed

Bendtsen, P; Hensing, G; Ebeling, C; Schedin, A

1999-07-01

The decision process preceding prescribing analgesics is complex and the physician is often struggling to balance several disparate considerations in order to work out what is rational. Several factors--medical, intellectual, emotional and logistic--influence the decision whether or not to prescribe, and the decision itself influences how the physicians feel about themselves. In this study the 'critical incident technique' was used for exploring the qualities of dilemmas among general physicians prior to prescribing analgesics to patients in primary health care. The study displayed two main types of problems in connection with prescription of opioids. The first main problem was a concern about abuse and addiction with no proper indication for the drug. The second main type of problem was related to the appropriateness of the drug, although the indication as such might be correct, i.e. acute or chronic pain. An important consequence of the dilemmas experienced influenced the physicians' self-esteem negatively, including failures in the patient-physician relationship. This results in emotional strain and is often experienced as a personal defeat. Only a few physicians denied prescription despite the experience of a dilemma, which might indicate an ambivalence or lack of knowledge among physicians with regard to proper indications for opioid prescription. However, it may also suggest that physicians need more training in saying no, or skills in deciding proper indications for opioids, which needs to be addressed during educational programmes.

Breast tumor malignancy modelling using evolutionary neural logic networks.

PubMed

Tsakonas, Athanasios; Dounias, Georgios; Panagi, Georgia; Panourgias, Evangelia

2006-01-01

The present work proposes a computer assisted methodology for the effective modelling of the diagnostic decision for breast tumor malignancy. The suggested approach is based on innovative hybrid computational intelligence algorithms properly applied in related cytological data contained in past medical records. The experimental data used in this study were gathered in the early 1990s in the University of Wisconsin, based in post diagnostic cytological observations performed by expert medical staff. Data were properly encoded in a computer database and accordingly, various alternative modelling techniques were applied on them, in an attempt to form diagnostic models. Previous methods included standard optimisation techniques, as well as artificial intelligence approaches, in a way that a variety of related publications exists in modern literature on the subject. In this report, a hybrid computational intelligence approach is suggested, which effectively combines modern mathematical logic principles, neural computation and genetic programming in an effective manner. The approach proves promising either in terms of diagnostic accuracy and generalization capabilities, or in terms of comprehensibility and practical importance for the related medical staff.

Sweet cherries from farm to table: A review.

PubMed

Habib, Muzammil; Bhat, Mudassir; Dar, B N; Wani, Ali Abas

2017-05-24

In order to enable long-distance transportation and ensure that the fruit presents the requisite quality on arrival at markets, the cherry industry for direct consumption needs to prolong post-harvest shelf life. Sweet cherries are highly perishable, non-climacteric fruits with shelf life of 7-14 days in cold storage. Their shelf life is shortened by loss of firmness, color and flavor, stem discoloration, desiccation and mould growth. Various factors such as harvest time, proper handling and cooling practices and above all packaging, greatly influence the shelf life of cherries. One of the areas of research that has shown promise, and had success, is modified atmosphere packaging (MAP). It is one of the fastest growing packaging technologies and has many advantages for different food products. Properly designed modified atmosphere packs can be exploited to lower respiration rates and thus ripening of fruits which results in least changes in physiochemical parameters of sweet cherries during postharvest storage. This paper intended to review a broad spectrum of studies dealt with the use of MAP for preservation of sweet cherries cultivars with an interest for future research work.

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

Alnajjar, Mikhail S.; Quigley, David; Kuntamukkula, Murty

Due to the inherent nature of pyrophoric substances to ignite spontaneously upon exposure to air, special precautions must be taken to ensure their safe handling and use. Pyrophoric gases (such as diborane, dichloroborane, phosphine, etc.) are typically the easiest class of pyrophoric substances to handle since the gas can be plumbed directly to the application and used remotely. Pyrophoric solids and liquids, however, require the user to physically manipulate them when transferring them from one container to another. Failure to follow proper safety precautions could result in serious injury or unintended consequences to laboratory personnel.12 Because of this danger, pyrophoricsmore » should be handled only by experienced personnel. Users with limited experience must be trained on how to handle pyrophoric reagents and consult with a knowledgeable staff member prior to performing the experimental task. The purpose of this article is three fold: 1) to provide guidelines and general safety precautions to avoid accidents, 2) describe proper techniques on how to successfully handle, store, and dispose of pyrophoric liquids and solids, and 3) illustrate best practices for working with this class of reactants in a laboratory environment.« less

A qualitative study of perceived risk for HIV transmission among police officers in Dar es Salaam, Tanzania

PubMed Central

2013-01-01

Background Understanding people’s views about HIV transmission by investigating a specific population may help to design effective HIV prevention strategies. In addition, knowing the inherent sexual practices of such a population, as well as the risky circumstances that may facilitate HIV transmission, is crucial for the said strategies to become effective. In this article, we report how police officers in Dar es Salaam, Tanzania, perceived the problem of HIV and AIDS in their local context, particularly in relation to unsafe sexual practices. The study was done with the view to recommending ways by which HIV transmission could be minimised within the police force. Methods The study was conducted among members of the police force in Dar es Salaam, Tanzania. Eight focus group discussions (FGDs) were conducted, with a total of 66 participants who were mixed in terms of age, gender, and marital status. Some of these were caregivers to patients with AIDS. Data were analysed using the interpretive description approach. Results The participants believed that both individual sexual behaviour and work-related circumstances were sources of HIV infection. They also admitted that they were being tempted to engage in risky sexual practices because of the institutional rules that prohibit officers from getting married during their training and for three years after. Nevertheless, as members of the Police Force, they stressed the fact that the risky sexual behaviour that exposes them to HIV is not limited to the force; it is rather a common problem that is faced by the general population. However, they complained, the nature of their job exposes them to road accident victims, subjecting them further to possible infection, especially when they have to handle these road accident casualties without proper protective gear. Conclusion Individual sexual behaviour and job-related circumstances are worth investigating if proper advice is to be given to the police regarding HIV prevention strategies. In order to improve the lives of these police officers, there is a need to review the existing institutional rules and practices to accommodate individual sexual needs. In addition, improving their working environment may minimize the risk of HIV transmission from handling casualties in emergency situations. PMID:23984994

Effectiveness and costs of a vocational advice service to improve work outcomes in patients with musculoskeletal pain in primary care: a cluster randomised trial (SWAP trial ISRCTN 52269669).

PubMed

Wynne-Jones, Gwenllian; Artus, Majid; Bishop, Annette; Lawton, Sarah A; Lewis, Martyn; Jowett, Sue; Kigozi, Jesse; Main, Chris; Sowden, Gail; Wathall, Simon; Burton, A Kim; van der Windt, Danielle A; Hay, Elaine M; Foster, Nadine E

2017-10-30

Musculoskeletal pain is a common cause of work absence, and early intervention is advocated to prevent the adverse health and economic consequences of longer-term absence. This cluster randomised controlled trial investigated the effect of introducing a vocational advice service into primary care to provide occupational support. Six general practices were randomised; patients were eligible if they were consulting their general practitioner with musculoskeletal pain and were employed and struggling at work or absent from work <6 months. Practices in the intervention arm could refer patients to a vocational advisor embedded within the practice providing a case-managed stepwise intervention addressing obstacles to working. The primary outcome was number of days off work, over 4 months. Participants in the intervention arm (n = 158) had fewer days work absence compared with the control arm (n = 180) (mean 9.3 [SD 21·7] vs 14·4 [SD 27·7]) days, incidence rate ratio 0·51 (95% confidence interval 0·26, 0·99), P = 0·048). The net societal benefit of the intervention compared with best care was £733: £748 gain (work absence) vs £15 loss (health care costs). The addition of a vocational advice service to best current primary care for patients consulting with musculoskeletal pain led to reduced absence and cost savings for society. If a similar early intervention to the one tested in this trial was implemented widely, it could potentially reduce days absent over 12 months by 16%, equating to an overall societal cost saving of approximately £500 million (US $6 billion) and requiring an investment of only £10 million.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

Civil Forensic Psychiatry - part 3: practical aspects of managing a medico-legal practice.

PubMed

Samuels, Anthony H

2018-06-01

This is the third in a series of papers on Civil Forensic Psychiatry and provides practical advice for forensic psychiatrists, general psychiatrists and trainees who are expanding or contemplating a medico-legal aspect to their practice. Attention to the practice setting, office layout, recording of information, management of documentation, screening of briefs and proper timetabling can improve safety, quality, reliability and workload manageability.

PRACTICE TEACHING--MODELS AND MODULES.

ERIC Educational Resources Information Center

MACKEY, WILLIAM F.

THE PURPOSE OF THIS DOCUMENT IS TO DISCUSS THE PROBLEMS INVOLVED IN THE OBSERVATION, PRACTICE, AND CRITICISM PHASES OF PRACTICE TEACHING IN THE LANGUAGE TEACHER TRAINING PROGRAM, AND TO GIVE AN ACCOUNT OF THE PROPER USE OF VIDEOTAPE IN THE MORE EFFICIENT AND LESS TIME-CONSUMING PERFORMANCE OF THESE ACTIVITIES. AFTER PINPOINTING THE PROBLEM OF…

Prick test: evolution towards automated reading.

PubMed

Justo, X; Díaz, I; Gil, J J; Gastaminza, G

2016-08-01

The prick test is one of the most common medical methods for diagnosing allergies, and it has been carried out in a similar and laborious manner over many decades. In an attempt to standardize the reading of the test, many researchers have tried to automate the process of measuring the allergic reactions found by developing systems and algorithms based on multiple technologies. This work reviews the techniques for automatic wheal measurement with the aim of pointing out their advantages and disadvantages and the progress in the field. Furthermore, it provides a classification scheme for the different technologies applied. The works discussed herein provide evidence that significant challenges still exist for the development of an automatic wheal measurement system that not only helps allergists in their medical practice but also allows for the standardization of the reading and data exchange. As such, the aim of the work was to serve as guideline for the development of a proper and feasible system. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Acoustic conditions in open plan office - Application of technical measures in a typical room].

PubMed

Mikulski, Witold

2018-03-09

Noise in open plan offices should not exceed acceptable levels for the hearing protection. Its major negative effects on employees are nuisance and impediment in execution of work. Specific technical solutions should be introduced to provide proper acoustic conditions for work performance. Acoustic evaluation of a typical open plan office was presented in the article published in "Medycyna Pracy" 5/2016. None of the rooms meets all the criteria, therefore, in this article one of the rooms was chosen to apply different technical solutions to check the possibility of reaching proper acoustic conditions. Acoustic effectiveness of those solutions was verified by means of digital simulation. The model was checked by comparing the results of measurements and calculations before using simulation. The analyzis revealed that open plan offices supplemented with signals for masking speech signals can meet all the required criteria. It is relatively easy to reach proper reverberation time (i.e., sound absorption). It is more difficult to reach proper values of evaluation parameters determined from A-weighted sound pressure level (SPLA) of speech. The most difficult is to provide proper values of evaluation parameters determined from speech transmission index (STI). Finally, it is necessary (besides acoustic treatment) to use devices for speech masking. The study proved that it is technically possible to reach proper acoustic condition. Main causes of employees complaints in open plan office are inadequate acoustic work conditions. Therefore, it is necessary to apply specific technical solutions - not only sound absorbing suspended ceiling and high acoustic barriers, but also devices for speech masking. Med Pr 2018;69(2):153-165. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Introduction to clinical pathology: A brief course of laboratory medicine in the field for medical students.

PubMed

Omidifar, Navid; Keshtkari, Ali; Dehghani, Mohammadreza; Shokripour, Mansoureh

2017-01-01

Teaching of clinical pathology to medical students has been ignored in many countries such as Iran. We aim to introduce a practical brief course and its proper timing. Three groups of medical students from consecutive years of entrance passed a 1.5 working day practical course on the field. Their level of knowledge was assessed by pre- and post-tests. Their idea and satisfaction were gathered by questionnaires. Knowledge of students became significantly higher after the course. Their satisfaction was high. Students in later year of education got significantly higher marks. Most of the students wished such a course should be away from basic sciences period and as near as possible to internship. Due to overloaded curriculum of general medicine in Iran, we decided to run a brief practical course of laboratory medicine education for medical students. Although the course was practical, the knowledge of students became higher. Students with more clinical experience and knowledge absorbed more. Being actively involved in the classes lit the enthusiasm of students and made them satisfied with the course. It seemed that the course should be placed in later years of clinical training to get the best uptake and results.

U.S. Department of Energy's site screening, site selection, and initial characterization for storage of CO2 in deep geological formations

USGS Publications Warehouse

Rodosta, T.D.; Litynski, J.T.; Plasynski, S.I.; Hickman, S.; Frailey, S.; Myer, L.

2011-01-01

The U.S. Department of Energy (DOE) is the lead Federal agency for the development and deployment of carbon sequestration technologies. As part of its mission to facilitate technology transfer and develop guidelines from lessons learned, DOE is developing a series of best practice manuals (BPMs) for carbon capture and storage (CCS). The "Site Screening, Site Selection, and Initial Characterization for Storage of CO2 in Deep Geological Formations" BPM is a compilation of best practices and includes flowchart diagrams illustrating the general decision making process for Site Screening, Site Selection, and Initial Characterization. The BPM integrates the knowledge gained from various programmatic efforts, with particular emphasis on the Characterization Phase through pilot-scale CO2 injection testing of the Validation Phase of the Regional Carbon Sequestration Partnership (RCSP) Initiative. Key geologic and surface elements that suitable candidate storage sites should possess are identified, along with example Site Screening, Site Selection, and Initial Characterization protocols for large-scale geologic storage projects located across diverse geologic and regional settings. This manual has been written as a working document, establishing a framework and methodology for proper site selection for CO2 geologic storage. This will be useful for future CO2 emitters, transporters, and storage providers. It will also be of use in informing local, regional, state, and national governmental agencies of best practices in proper sequestration site selection. Furthermore, it will educate the inquisitive general public on options and processes for geologic CO2 storage. In addition to providing best practices, the manual presents a geologic storage resource and capacity classification system. The system provides a "standard" to communicate storage and capacity estimates, uncertainty and project development risk, data guidelines and analyses for adequate site characterization, and guidelines for reporting estimates within the classification based on each project's status. 

Model-guided fieldwork: practical guidelines for multidisciplinary research on wildlife ecological and epidemiological dynamics

PubMed Central

Restif, Olivier; Hayman, David T S; Pulliam, Juliet R C; Plowright, Raina K; George, Dylan B; Luis, Angela D; Cunningham, Andrew A; Bowen, Richard A; Fooks, Anthony R; O'Shea, Thomas J; Wood, James L N; Webb, Colleen T

2012-01-01

Infectious disease ecology has recently raised its public profile beyond the scientific community due to the major threats that wildlife infections pose to biological conservation, animal welfare, human health and food security. As we start unravelling the full extent of emerging infectious diseases, there is an urgent need to facilitate multidisciplinary research in this area. Even though research in ecology has always had a strong theoretical component, cultural and technical hurdles often hamper direct collaboration between theoreticians and empiricists. Building upon our collective experience of multidisciplinary research and teaching in this area, we propose practical guidelines to help with effective integration among mathematical modelling, fieldwork and laboratory work. Modelling tools can be used at all steps of a field-based research programme, from the formulation of working hypotheses to field study design and data analysis. We illustrate our model-guided fieldwork framework with two case studies we have been conducting on wildlife infectious diseases: plague transmission in prairie dogs and lyssavirus dynamics in American and African bats. These demonstrate that mechanistic models, if properly integrated in research programmes, can provide a framework for holistic approaches to complex biological systems. PMID:22809422

Helping the auto repair industry manage hazardous wastes: an education project in King County, Washington.

PubMed

McKenrick, Laurence L; Ii, Keiko; Lawrence, Bill; Kaufmann, Michael; Marshall, Mark

2003-11-01

From January 1, 2000, to August 31, 2001, a team of environmental health specialists from Public Health-Seattle & King County, a partner in King County's Local Hazardous Waste Management Program, made educational visits to 981 automotive repair shops. The purpose was to give the auto repair industry technical assistance on hazardous waste management without using enforcement action. Through site inspections and interviews, the environmental health staff gathered information on the types and amounts of conditionally exempt small-quantity generator (CESQG) hazardous wastes and how they were handled. Proper methods of hazardous waste management, storage, and disposal were discussed with shop personnel. The environmental health staff measured the impact of these educational visits by noting changes made between the initial and follow-up visits. This report focuses on nine major waste streams identified in the auto repair industry. Of the 981 shops visited, 497 were already practicing proper hazardous waste management and disposal. The remaining 484 shops exhibited 741 discrepancies from proper practice. Environmental health staff visited these shops again within six months of the initial visit to assess changes in their practices. The educational visits and technical assistance produced a 76 percent correction of all the discrepancies noted.

Solvent selection in ultrasonic-assisted emulsification microextraction: Comparison between high- and low-density solvents by means of novel type of extraction vessel.

PubMed

Nojavan, Saeed; Gorji, Tayebeh; Davarani, Saied Saeed Hosseiny; Morteza-Najarian, Amin

2014-08-01

There are numerous published reports about dispersive liquid phase microextraction of the wide range of substances, however, till now no broadly accepted systematic and purpose oriented selection of extraction solvent has been proposed. Most works deal with the optimization of available solvents without adequate pre-consideration of properness. In this study, it is tried to compare the performances of low- and high-density solvents at the same conditions by means of novel type of extraction vessel with head and bottom conical shape. Extraction efficiencies of seven basic pharmaceutical compounds using eighteen common organic solvents were studied in this work. It was much easier to work with high-density solvents and they mostly showed better performances. This work shows that although exact predicting the performance of the solvents is multifaceted case but the pre-consideration of initial selection of solvents with attention to the physiochemical properties of the desired analytes is feasible and promising. Finally, the practicality of the method for extraction from urine and plasma samples was investigated. Copyright © 2014 Elsevier B.V. All rights reserved.

Knee ultrasound from research to real practice: a systematic literature review of adult knee ultrasound assessment feasibility studies.

PubMed

Peltea, Alexandra; Berghea, Florian; Gudu, Tania; Ionescu, Ruxandra

2016-12-05

To identify and analyse existing data regarding knee ultrasound (US) feasibility in clinical practice. Material and methods: A systematic literature review was performed using the terms: ("knee") AND ("ultrasound" OR "ultrasonography") AND ("feasibility" OR "pilot" OR "proof of concept"). Feasibility studies regarding knee US or US aided maneuver involving knee joint, published during 2005-2015, were selected and evaluated against a complex framework constructed around mandatory key areas for feasibility studies: acceptability, demand, implementation, practicality, adaptation, integration and expansion. One hundred and fifty-nine publications were identified, of which 9 were included in the final analysis: 6 dealt with the development and implementation of novel US scores, while the rest focused on implementing MSUS in clinical practice, evaluating the usefulness of articular cartilage US assessment and the feasibility of sonography for intra-articular knee injections, respectively. Six studies quantified feasibility as time spent for the evaluation, with only two addressing areassuch as acceptability, implementation and practicality, although none of these systematically assessed all feasibility domains. Knee US feasibility is still poorly addressed; the time required for US assessment is the main area addressed. This information gap should be properly addressed in future works, in order to ensure the right place for this technique.

Solid waste production and its management in dental clinics in Gorgan, northern Iran.

PubMed

Nabizadeh, R; Faraji, H; Mohammadi, A A

2014-10-01

Waste produced in dental clinics has been the topic of investigations for many years. These waste materials have important health impacts and are hazardous to humans and the environment. To investigating solid waste production and its management in dental clinics in Gorgan, northern Iran. In this cross-sectional study, 45 of 143 public dental practices and 5 of 25 private dental practices were selected and studied. From each clinic, 3 samples were taken and analyzed at the end of successive working days (Tuesday and Wednesday). Samples were manually sorted into 50 components. The measured components were then classified on the basis of their characteristics, hazard potentials, and WHO classification. The total annual amount of dental waste produced in public and private dental practices in Gorgan was 12 015.1 and 3135.0 kg, respectively. Production percentages of infectious, domestic, chemical and pharmaceutical, and toxic waste in public dental practices were 38.4%, 33.7%, 6.6%, and 0.6%, respectively. The percentages for private practices were 8.7%, 10.6%, 1.1%, and 0.1%, respectively. Dental waste management in Gorgan is inadequate; dental waste is not properly segregated, collected, and disposed, as demanded by the WHO. Employees in dentist offices must be trained in correct handling of waste products and the associated risks.

Patient or customer?

PubMed

Parker, J M

1999-01-01

This paper investigates caring in practice within the context of the global imperative of increasing rationalisation of care based on an economic ethic. The notion of the global marketplace has spread to the domain of health services, so that 'health' has come to be seen as a commodity, with the body as its site, and the 'patient' a customer; clinicians work to construct standard pathways through the healthcare supermarket. The challenge for nurses is to work within but also to challenge and resist the reductionist impetus of economically based and commercially driven approaches to health care. They must retain the sense of the value of the wholeness of the person, the deeply personal and profoundly significant professional-recipient relationship, and find ways of demonstrating their capacity to deliver high-quality care in a cost-effective way. Proper and appropriate accountability is a key strategy to maintaining quality nursing as a significant aspect of care. The expansion of the role of the advanced practice nurse is very useful in providing holistic and cost-effective care, though there are currently limitations to scope of practice that need to be removed. The metaphor of the marketplace, underpinned by powerful global economic forces, can draw us into unthinking compliance with its imperatives--but other metaphors are available. Metaphor and creativity are linked, and we need to consider how the creative use of language can facilitate the emergence of new ways of understanding in health care.

Development Module (Lab Report) As a Media of Learning in Vocational Education Viewed by Gender

NASA Astrophysics Data System (ADS)

Muslim, Supari; Suprianto, Bambang; Putra Gitama, Nahindi

2018-04-01

Module as a media of learning and training, which especially the students studying in institutions offering education at undergraduate and associate levels can employ as a PLC (Programmable Logic Controller) controlled simulator of the logic gate, timer and counter. During industrial manufacturing processes, has been actualized through this work, for the purpose of training qualified technical personnel needed by companies, who are specialized in control and electro mechanics. It was found that, students are very happy learning to use the module so with very significant contributes to a large extent to the training process in favor of faculty members, who are to train personnel for the sector, and in favor of students, who should be able to acquire proper education. Working on the training tool allows students to acquire knowledge and practical skills and then make use of those skills for troubleshooting and control of machinery.

[The occupational physician and communication to workers].

PubMed

Perbellini, L; di Leo, E; Goio, I

2010-01-01

Communication ability is essential for the Physician to the proper management of ambulatory activity and corporate training. The aim of this work is describe the communication strategies to be adopted in everyday healthcare practice. When the occupational physician relates with an employee his message must act both verbal both non-verbal. The medical history should be collected carefully and during the physical examination is important to put the employee at ease by adopting a discreet and attentive attitude. The clinical findings and the capacity to work with any limitations will be discussed at the end of health surveillance using understandable terminology to the worker. During the training-information process is important to define the primary objectives, organize the program and bring the display materials. The worker should be actively involved and encouraged to learn throughout the course information. In the text will also be shown the main aspects of information on line.

Nurses and Health-Promoting Behaviors: Knowledge May Not Translate Into Self-Care

PubMed Central

Ross, Alyson; Bevans, Margaret; Brooks, Alyssa T.; Gibbons, Susanne; Wallen, Gwenyth R.

2017-01-01

Nurses are knowledgeable regarding the importance of health-promoting activities such as healthy eating, physical activity, stress management, sleep hygiene, and maintaining healthy relationships. However, this knowledge may not translate into nurses’ own self-care. Nurses may not follow recommended guidelines for physical activity and proper nutrition. Long hours, work overload, and shift work associated with nursing practice can be stressful and contribute to job dissatisfaction, burnout, and health consequences such as obesity and sleep disturbances. The purpose of this article is to provide an overview of research examining nurses’ participation in health-promoting behaviors, including intrinsic and extrinsic factors that may influence nurses’ participation in these activities. This article also provides recommendations for perioperative nurse leaders regarding strategies to incorporate into the nursing workplace to improve the health of the staff nurses by increasing health-promoting behaviors. PMID:28241948

Generalizing Landauer's principle

NASA Astrophysics Data System (ADS)

Maroney, O. J. E.

2009-03-01

In a recent paper [Stud. Hist. Philos. Mod. Phys. 36, 355 (2005)] it is argued that to properly understand the thermodynamics of Landauer’s principle it is necessary to extend the concept of logical operations to include indeterministic operations. Here we examine the thermodynamics of such operations in more detail, extending the work of Landauer to include indeterministic operations and to include logical states with variable entropies, temperatures, and mean energies. We derive the most general statement of Landauer’s principle and prove its universality, extending considerably the validity of previous proofs. This confirms conjectures made that all logical operations may, in principle, be performed in a thermodynamically reversible fashion, although logically irreversible operations would require special, practically rather difficult, conditions to do so. We demonstrate a physical process that can perform any computation without work requirements or heat exchange with the environment. Many widespread statements of Landauer’s principle are shown to be special cases of our generalized principle.

Health hazards of ceramic artists.

PubMed

Dorevitch, S; Babin, A

2001-01-01

Ceramic artists can be exposed to many hazards including metals (such as lead), fibrogenic dusts (such as silica), heat, repetitive motion, radiation, and toxic emissions from kilns. The health risks of these exposures have not been well characterized among artists, although limited information is available from commercial potteries. Adverse health effects may be prevented by using less hazardous materials (such as lead-free glazes), improved ventilation, and proper work practices. Special precautions must be in place if children have access to the ceramics studio. The use of glazed ceramic dishes can be a risk for lead toxicity. Food should not be stored in glazed ceramics, and pregnant women should avoid daily use of ceramic mugs for drinking hot beverages.

The relationship between European paediatricians and commerce: ethical principles in paediatrics working group recommendations. Confederation of European Societies of Paediatrics (CESP).

PubMed

Chambers, T L

2000-01-01

It is important that doctors have an ethically proper relationship with commercial interests. The relationship between paediatricians, paediatric societies and industry is probably healthy. To further the interests of patients it is important that it remains so. This mentionship would be undermined if: there was a perceived conflict of interests between paediatricians, their patients and industry; paediatricians were seen to endorse companies whose marketing and other practices were unethical. It will be enhanced if: paediatricians did not receive individual gain from industry; industrial support for educational and research activities, whether to individuals or institutions, is open, proportionate and accountable.

Russian nursing in the Crimean war.

PubMed

Sorokina, T S

1995-01-01

Although the practice of military medicine and surgery goes back to antiquity, the British date the proper care of the wounded from the arrival of Florence Nightingale at Scutari in Turkey on 4 November 1854. The 140th anniversary of her work in that winter of the Crimean war is being celebrated by an exhibition at the Florence Nightingale Museum, 2 Lambeth Palace Road SE1 7EW, from 1 December 1994 till 30 April 1995. For the first time in this country it will tell a little of the other side of the story--the exploits of Russian nurses in caring for the casualties from both sides in the conflict--which is the subject of this article.

Malaysia’s First Transplanted Case of Chronic Granulomatous Disease: The Journey of Overcoming Obstacles

PubMed Central

Ismail, Intan Hakimah; Jamli, Faizah Mohamed; Othman, Ida Shahnaz; Noh, Lokman Mohd; Abdul Latiff, Amir Hamzah

2016-01-01

The awareness of primary immunodeficiency (PID) in Malaysia is still not forthcoming. Certain practical issues such as lack of clinical immunologists and specialized laboratory diagnostic facilities remain to be addressed. However, great efforts taken by passionate clinicians and scientists in the immunology networking have ascertained some prevalence. Despite the limitation, all suspected cases of PID are being properly investigated and competently managed. In this case report we highlighted the obstacles we faced in managing PID patients, particularly preparing for bone marrow transplant. This is the first transplanted case of chronic granulomatous disease in Malaysia, which emphasizes the importance of collaborative work to ensure further morbidities or mortalities are prevented. PMID:27417247

Malaysia's First Transplanted Case of Chronic Granulomatous Disease: The Journey of Overcoming Obstacles.

PubMed

Ismail, Intan Hakimah; Jamli, Faizah Mohamed; Othman, Ida Shahnaz; Noh, Lokman Mohd; Abdul Latiff, Amir Hamzah

2016-05-17

The awareness of primary immunodeficiency (PID) in Malaysia is still not forthcoming. Certain practical issues such as lack of clinical immunologists and specialized laboratory diagnostic facilities remain to be addressed. However, great efforts taken by passionate clinicians and scientists in the immunology networking have ascertained some prevalence. Despite the limitation, all suspected cases of PID are being properly investigated and competently managed. In this case report we highlighted the obstacles we faced in managing PID patients, particularly preparing for bone marrow transplant. This is the first transplanted case of chronic granulomatous disease in Malaysia, which emphasizes the importance of collaborative work to ensure further morbidities or mortalities are prevented.

Firefighter safety: rampant unsafe practices as documented in mainstream media.

PubMed

Kahn, Steven A; Woods, Jason; Sipes, Jan C; Toscano, Nicole; Bell, Derek E

2014-01-01

More than 30,000 firefighters are injured on the fireground each year. Literature suggests that injury often occurs when protective gear is not used properly. According to firefighters, failure to correctly wear protective equipment occurs for several reasons: (1) gear not used because of haste, (2) cumbersome gear can sometimes interfere with performance, and (3) cultural factors. The purpose of this study is to quantify improper gear and tactic use in a publicly available, online video repository in order to better understand unsafe firefighting. This was an Institutional Review Board-exempt study of public video records. A search for "fire fighting videos" was conducted at YouTube (www.youtube.com). The first 50 videos that contained volunteer or career firefighters at work fighting fires were selected evaluated for appropriate use of personal protective equipment and for safe behavior. The videos were evaluated by two highly experienced professional firefighters. Of the 50 videos reviewed, 25 (50%) demonstrated violations of firefighting safety principles. Of the unsafe videos, 21 (42%) displayed firefighters improperly using gear, while the other 4 (8%) were related to unsound tactics. The most common problem was failure to wear or properly secure a self-contained breathing apparatus when appropriate (14 videos or 28%). The second most common failure was lack of helmet, hood, or approved gloves (11 videos or 22%). In conclusion, firefighting as documented on YouTube is often unsafe because of failure to properly use personal protective equipment. Half of the videos reviewed contained unsafe practices. With such a shockingly high rate of unsafe firefighting, the profession is in need of additional education and reform. In response to this epidemic, a multidisciplinary educational program has been developed to improve firefighter awareness of gear limitations and burn injury risk. Effectiveness of educational programs should be documented in additional prospective studies.

Access to Safe Water and Personal Hygiene Practices in the Kulandia Refugee Camp (Jerusalem).

PubMed

Issa, Mohamad; McHenry, Michael; Issa, Abdul Aziz; Blackwood, R Alexander

2015-12-22

Diarrheal illness, frequently associated with fecal-oral transmission, is one of the leading causes of death worldwide. It is commonly preventable through the implementation of safe water practices. This experiment concerns how to best implement safe water practices in a quasi-permanent refugee camp setting with limited ability for structural changes. Specifically, we explore how health promotion activities that help identify target groups for hygiene interventions can play a role in disease prevention. An anonymous survey was conducted at the United Nations Relief and Works Agency Health Clinic in the Kulandia refugee camp to assess the safe water and personal hygiene practices. Demographic and social characteristics, accessible water and personal hygiene characteristics, and gastrointestinal (GI) burden for individuals and their households were assessed. A total of 96 individuals were enrolled; 62 females and 34 males. Approximately 58% of the sample had soap available and washed hands before and after eating and when preparing food. Piped water was the main source of drinking water (62%), while 31% of our sample utilized tanker-trucks. 93% of participants had access to toilet facilities, with 86% of these facilities being private households. 55% practice extra water hygiene measures on their household drinking water source. 51.3% considered vendor cleanliness when they were buying food. 51% had received formal health education. 68.8% had been taught by their parents, but only 55.2% were teaching their children and 15.6% had consistent access to a health professional for hygiene inquiries. Individual variables and hygiene practices associated with lower rates of diarrheal illnesses included having water piped into the home, proper hand washing, adequate soap availability, proper consideration of vendor cleanliness, higher income, levels of education, health hygiene education, and having access to healthcare professions to discuss hygiene related matters. This is the first study to assess the water and personal hygiene practices at the Kulandia refugee ramp. This study demonstrates that hygiene education and better practices are closely associated with the rate at which individuals and households suffer from diarrheal illnesses within the Kulandia refugee camp. There are significant hygiene deficits in the camp, which likely result from a lack of formal hygiene education and a lack of awareness concerning the connection between diarrheal illness and hygiene. With respect to practices, our results elucidate several areas where basic, communal programming - including lessons on appropriate hand washing and food preparation - will likely improve hygiene practices and decrease overall GI burden.

Practical and effective rehabilitation of rangelands: lessons learned

USDA-ARS?s Scientific Manuscript database

Disturbed rangelands present significant challenges to land managers and private land owners. Controversy exists on the approach as to how to restore or rehabilitate these degraded rangelands. The proper use of plant materials and aggressive weed control practices can significantly increase the succ...

16 CFR 1061.11 - Incomplete or insufficient applications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Incomplete or insufficient applications. 1061.11 Section 1061.11 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL APPLICATIONS... staff believes that additional information is necessary or useful for a proper evaluation of the...

Computation of Asteroid Proper Elements: Recent Advances

NASA Astrophysics Data System (ADS)

Knežević, Z.

2017-12-01

The recent advances in computation of asteroid proper elements are briefly reviewed. Although not representing real breakthroughs in computation and stability assessment of proper elements, these advances can still be considered as important improvements offering solutions to some practical problems encountered in the past. The problem of getting unrealistic values of perihelion frequency for very low eccentricity orbits is solved by computing frequencies using the frequency-modified Fourier transform. The synthetic resonant proper elements adjusted to a given secular resonance helped to prove the existence of Astraea asteroid family. The preliminary assessment of stability with time of proper elements computed by means of the analytical theory provides a good indication of their poorer performance with respect to their synthetic counterparts, and advocates in favor of ceasing their regular maintenance; the final decision should, however, be taken on the basis of more comprehensive and reliable direct estimate of their individual and sample average deviations from constancy.

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

Walters, Douglas B.; Ho, Pauline; Hardesty, Jasper

Many chemicals that are frequently used in laboratories and industries can be harmful if not handled properly. Chemical safety best practices are designed to protect people from accidentally being exposed to hazardous chemicals. On the other hand, chemical security best practices are designed to protect people from someone deliberately exposing others to hazardous chemicals. Finally, many chemical safety best practices overlap with chemical security best practices, but there are important differences, as will be discussed in this paper.

Making sense of self-care practices at the intersection of severe mental illness and physical health-An Australian study.

PubMed

Ehrlich, Carolyn; Chester, Polly; Kisely, Steve; Crompton, David; Kendall, Elizabeth

2018-01-01

The poor physical health of people who experience severe mental illness (SMI) is an important public health issue that has been acknowledged, yet not properly addressed. People who live with SMI perform a myriad of complex tasks in order to take care of their physical health, while receiving unpredictable levels of support and assistance from health professionals. In this qualitative study, we aimed to uncover the kinds of work people with SMI do in order to look after their physical health. In a metropolitan area in Queensland, Australia, 32 people with lived experience of SMI participated in semi-structured, face-to-face interviews. Data were digitally recorded, transcribed verbatim and open coded. They were then themed using a constant comparative process. We found that people with SMI were engaged in a "rhythm of life with illness" that consisted of relatively short, acute and chaotic cycles of mental and physical illness, accompanied by much longer mental and physical illness recovery cycles. Participants engaged in three specific types of health-related work to manage these cycles: discovery work (and the associated role of the health professional); sense-making work to meaningfully interpret health and illness; and embedding work to become engaged self-managers of illness and producers of health. We discuss how varying levels of support from health professionals impact consumers' self-management of their physical and mental health; how health professionals influence consumers' experience of treatment burden; and implications for practice. © 2017 John Wiley & Sons Ltd.

"The Jackson Table Is a Pain in the…": A Qualitative Study of Providers' Perception Toward a Spinal Surgery Table.

PubMed

Asiedu, Gladys B; Lowndes, Bethany R; Huddleston, Paul M; Hallbeck, Susan

2016-01-07

The aim of this study was to define health care providers' perceptions toward prone patient positioning for spine surgery using the Jackson Table, which has not been hitherto explored. We analyzed open-ended questionnaire data and interviews conducted with the spine surgical team regarding the current process of spinal positioning/repositioning using the Jackson Table. Participants were asked to provide an open-ended explanation as to whether they think the current process of spinal positioning/repositioning is safe for the staff or patients. Follow-up qualitative interviews were conducted with 11 of the participants to gain an in-depth understanding of the challenges and safety issues related to prone patient positioning. Data analysis resulted in 6 main categories: general challenges with patient positioning, role-specific challenges, challenges with the Jackson Table and the "sandwich" mechanism, safety concerns for patients, safety concerns for the medical staff, and recommendations for best practices. This study is relevant to everyday practice for spinal surgical team members and advances our understanding of how surgical teams qualitatively view the current process of patient positioning for spinal surgery. Providers recommended best practices for using the Jackson Table, which can be achieved through standardized practice for transfer of patients, educational tools, and checklists for equipment before patient transfer and positioning. This research has identified several important practice opportunities for improving provider and patient safety in spine surgery.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.

Infection control in South African oral hygiene practice.

PubMed

de Kock, K; van Wyk, C W

2001-12-01

The aim was to gain information about the practice of infection control in oral hygiene practice. A questionnaire based on OSHA and CDC guidelines was submitted to oral hygienists who attended a refresher course followed by a second posted questionnaire seeking information about hand hygiene practice. The questions were directed to observance of personal protection by oral hygienists and the application of procedures required for infection control in the surgery. 87.5% wore face masks but the proper use of facial protection, overcoats and disposable overcoats was reported by fewer than 50%. A total of 97% wore gloves and 88% changed gloves between patients. Skin reactions to gloves were reported by 26%. Only 7% had not been vaccinated against hepatitis B. The correct procedures for sterilising equipment and instruments were carried out by fewer than 50%, and 57% of participants wanted an improvement of infection control arrangements in their workplace. It is concluded that a need exists for proper practice of infection control by oral hygienists which can be remedied by interceptive and preventive education and peer pressure.

The Boston Safe Shops Project--preliminary findings of a case study in applying the 10 essential services of public health to building environmental health capacity.

PubMed

Shoemaker, Paul A; Skogstrom, Tiffany; Shea, John; Bethune, Leon

2007-01-01

Boston's more than 500 automotive shops, located primarily in low-income communities of color, are a source both of well-paying jobs and of potential hazardous exposures to employees and residents. The Safe Shops Project works to reduce occupational and environmental health hazards without having to close these businesses. Combining inspections, in-shop trainings, outreach, and technical/financial assistance, it brings shops into compliance with laws and promotes use of safer practices and alternative products. After 18 months, 254 workers at 61 of 124 participating shops had received training. Surveys showed improved worker knowledge: Pre-training, 24.2 percent of the worker survey respondents stated that they knew what an MSDS was, and post-training, 75 percent stated that they knew. The surveys also found improvement in work practices: Pre-training, 48 percent of workers indicated that they used safety goggles in their work, while post-training, 70 percent indicated proper use of safety goggles. The results also showed shops investing in capital improvements such as replacement of PCE-based brake cleaners with aqueous cleaners. The Safe Shops Project has a successfully modeled application of the 10-essential-services framework to the building of public health capacity and community collaboration, and this model can be adapted to other locations and industries.

Manual of praying mantis morphology, nomenclature, and practices (Insecta, Mantodea)

PubMed Central

Brannoch, Sydney K.; Wieland, Frank; Rivera, Julio; Klass, Klaus-Dieter; Olivier Béthoux; Svenson, Gavin J.

2017-01-01

Abstract This study provides a comprehensive review of historical morphological nomenclature used for praying mantis (Mantodea) morphology, which includes citations, original use, and assignment of homology. All referenced structures across historical works correspond to a proposed standard term for use in all subsequent works pertaining to praying mantis morphology and systematics. The new standards are presented with a verbal description in a glossary as well as indicated on illustrations and images. In the vast majority of cases, originally used terms were adopted as the new standard. In addition, historical morphological topographical homology conjectures are considered with discussion on modern interpretations. A new standardized formulation to present foreleg femoral and tibial spines is proposed for clarity based on previous works. In addition, descriptions for methods of collection, curation, genital complex dissection, and labeling are provided to aid in the proper preservation and storage of specimens for longevity and ease of study. Due to the lack of consistent linear morphometric measurement practices in the literature, we have proposed a series of measurements for taxonomic and morphological research. These measurements are presented with figures to provide visual aids with homologous landmarks to ensure compatibility and comparability across the Order. Finally, our proposed method of pinning mantises is presented with a photographical example as well as a video tutorial available at http://mantodearesearch.com. PMID:29200926

Precision agriculture in large-scale mechanized farming

USDA-ARS?s Scientific Manuscript database

Precision agriculture involves a great deal of technologies and requires additional investments of money and time, but it can be practiced at different levels depending on the specific field and crop conditions and the resources and technology services available to the farmer. If practiced properly,...

Information Practice and Malpractice. . .Do We Need Malpractice Insurance?

ERIC Educational Resources Information Center

Mintz, Anne P.

1984-01-01

Relates interview responses of seven information brokers on proper practice of information and extent of malpractice (e.g., industrial espionage, breaches of client or source confidentiality). Types of protection against malpractice--contracts, good educational background for entry-level positions, continuing education, personal values,…

Integrated Pest Management of Poplar Species

Treesearch

T. H. Filer; J. D. Solomon; D. T. Cooper; M. Hubbes

1979-01-01

Proper site selection, good site preparation, correct planting practices, and 1st-year cultivation directly and indirectly affect survival rate of trees. Losses from canker fungi are minimized by cultural practices that increase tree vigor--poor tree vigor means more cankers per acre and greater mortality.

The first step in infection control is hand hygiene.

PubMed

Canham, Leslie

2011-01-01

A dental health care worker (DHCW) has an obligation to prevent the spread of health care associated infections. Adhering to proper hand hygiene procedures, selecting appropriate hand hygiene products and the use of gloves are all important elements of infection control. The CDC Guidelines for Hand Hygiene state that improved hand hygiene practices can reduce transmission of pathogenic microorganisms to patients and personnel in health care settings. DHCWs must also protect themselves by recognizing pitfalls such as irritants or allergies that may pose obstacles to proper hand hygiene. Occupational irritants and allergies can be caused by frequent hand washing, exposure to hand hygiene products, exposure to chemicals and shear forces associated with wearing or removing gloves. Since the primary defense against infection and transmission of pathogens is healthy, unbroken skin, DHCWs must take steps to ensure that their skin remains healthy and intact. These steps include evaluating different types of hand hygiene products, lotions and gloves for the best compatibility. If the DHCW sees a breakdown of his or her skin barrier, steps should be taken to determine the cause and remedy. Remedies can include the use of alcohol-based hand sanitizers containing emollients and moisturizers and regular use of a medical grade hand lotion. The bottom line: healthy skin protects you at work and at home. Selection and use of appropriate hand hygiene products, including moisturizers, are an essential part ofa dental office infection control program. My coworker lost the use of her thumb for several months due to complications of a staph infection. She was unable to work and found even simple tasks such as closing a button hard to do. Think of how difficult your work would be if something happened to your hands. Injury, irritation or allergies could alter your ability to work or even perform routine tasks. Our hands provide us with the ability to work in clinical dentistry. It makes good sense to protect your hands, your most valuable tools.

Evaluation of non-selective refocusing pulses for 7 T MRI

PubMed Central

Moore, Jay; Jankiewicz, Marcin; Anderson, Adam W.; Gore, John C.

2011-01-01

There is a continuing need for improved RF pulses that achieve proper refocusing in the context of ultra-high field (≥ 7 T) human MRI. Simple block or sinc pulses are highly susceptible to RF field inhomogeneities, and adiabatic pulses are generally considered too SAR intensive for practical use at 7 T. The performance of the array of pulses falling between these extremes, however, has not been systematically evaluated. The aim of this work was to compare the performances of 21 non-selective refocusing pulses spanning a range of durations and SAR levels. The evaluation was based upon simulations and both phantom and in vivo human brain experiments conducted at 7 T. Tested refocusing designs included block, composite block, BIR-4, hyperbolic secant, and numerically optimized composite waveforms. These pulses were divided into three SAR classes and two duration categories, and, based on signal gain in a 3-D spin echo sequence, practical recommendations on usage are made within each category. All evaluated pulses were found to produce greater volume-averaged signals relative to a 180° block pulse. Although signal gains often come with the price of increased SAR or duration, some pulses were found to result in significant signal enhancement while also adhering to practical constraints. This work demonstrates the signal gains and losses realizable with single-channel refocusing pulse designs and should assist in the selection of suitable refocusing pulses for practical 3-D spin-echo imaging at 7 T. It further establishes a reference against which future pulses and multi-channel designs can be compared. PMID:22177384

Lacuna in the Practice of In-Loco-Parentis in Nigerian Schools: The Pot Calling the Kettle Black

ERIC Educational Resources Information Center

Igbinedion, Doye Angela; Nwogu, Uzoma Jonah; Abraham, Nath M.

2016-01-01

The principle of in-loco-parentis allows the teachers to assume the responsibilities of a parent in discharging their duties in school. Based on this same principle, parents also have the right to sue teachers, school management, or the government for negligence, recklessness and other practices which do not depict the proper practice of…

Exposure control practices for administering nitrous oxide: A survey of dentists, dental hygienists, and dental assistants.

PubMed

Boiano, James M; Steege, Andrea L; Sweeney, Marie H

2017-06-01

Engineering, administrative, and work practice controls have been recommended for many years to minimize exposure to nitrous oxide during dental procedures. To better understand the extent to which these exposure controls are used, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted among members of professional practice organizations representing dentists, dental hygienists and dental assistants. The anonymous, modular, web-based survey was completed by 284 dental professionals in private practice who administered nitrous oxide to adult and/or pediatric patients in the seven days prior to the survey. Use of primary engineering controls (i.e., nasal scavenging mask and/or local exhaust ventilation (LEV) near the patient's mouth) was nearly universal, reported by 93% and 96% of respondents who administered to adult (A) and pediatric (P) patients, respectively. However, adherence to other recommended precautionary practices were lacking to varying degrees, and were essentially no different among those administering nitrous oxide to adult or pediatric patients. Examples of work practices which increase exposure risk, expressed as percent of respondents, included: not checking nitrous oxide equipment for leaks (41% A; 48% P); starting nitrous oxide gas flow before delivery mask or airway mask was applied to patient (13% A; 12% P); and not turning off nitrous oxide gas flow before turning off oxygen flow to the patient (8% A; 7% P). Absence of standard procedures to minimize worker exposure to nitrous oxide (13% of all respondents) and not being trained on safe handling and administration of nitrous oxide (3%) were examples of breaches of administrative controls which may also increase exposure risk. Successful management of nitrous oxide emissions should include properly fitted nasal scavenging masks, supplemental LEV (when nitrous oxide levels cannot be adequately controlled using nasal masks alone), adequate general ventilation, regular inspection of nitrous oxide delivery and scavenging equipment for leaks, availability of standard procedures to minimize exposure, periodic training, ambient air and exposure monitoring, and medical surveillance.

How applicable is uneven-age management in northern forest types?

Treesearch

Stanley M. Filip

1977-01-01

For the proper application and practice of uneven-age management, one must consider residual stocking, maximum tree-size objective, and diameter distribution. All three components are described, and it is shown how they fit into a practical package for application in a timber tract.

Development of Communities of Practice in School Library Education

ERIC Educational Resources Information Center

Burns, Elizabeth A.; Howard, Jody K.; Kimmel, Sue C.

2016-01-01

To properly prepare pre-service school librarians, school library educators in online courses must provide opportunities for collaborative engagement. This collaborative education should also recognize the pedagogical benefit of the organic formation of communities of practice that develop within areas outside of curriculum content. This…

Multicultural Counseling Schools: A Practical Handbook.

ERIC Educational Resources Information Center

Pedersen, Paul B.; Carey, John C.

The second edition of "Multicultural Counseling in Schools" documents the tremendous change and improvement that is evident in the theory and practice of multicultural school counseling. Consistent with the new directions of the American School Counselor Association, this edition reflects cutting-edge thinking about the proper role and…

[Analysis of women nutritional status during pregnancy--a survey].

PubMed

Selwet, Monika; Machura, Mariola; Sipiński, Adam; Kuna, Anna; Kazimierczak, Małgorzata

2004-01-01

The proper diet is one of the most important factor during pregnancy. The general knowledge about proper nourishment during pregnancy allows the women to avoid quantitative and qualitative nourishment mistakes. Because of this--the salubrious education in this aspect is very important. The aim of the study is to analyze the proper nourishment during pregnancy particularly in professionally active women and those who don't work during pregnancy.

Role Conflict, Role Ambiguity, and Role Strain in United States Air Force Chief Nurse Administrators.

DTIC Science & Technology

1987-01-01

exercise practices (Veninga 1962). Positive Co’ Mdchasms Coping mechanisms of a positive sort that favor eustressful outcomes are direct actions to deal...resistance through proper diet, exercise , sleep, and relaxation. Cognitive restructuring is another direct strategy used to consciously change the...developing social support, implementing relaxation techniques, meditating, along with proper diet. sleep, and exercise are all positive ways to cope with

An internal morality of nursing: what it can and cannot do.

PubMed

Newham, Roger A

2013-04-01

It has been claimed that there are certain acts that nurses as people practising nursing (nurses qua nurses) must never do because they are nurses and this is regardless of what the same agent (when not acting in the role of a nurse) should do; that certain actions are not part of proper nursing practice. The concept of an internal morality has been discussed in relation to medicine and has been used to ground the actions proper to medicine in a realist tradition. Although the concept of an internal morality of nursing is not explicitly mentioned in the literature the underpinning ideas about the proper practice of nursing based on philosophical realism I argue equate with it and a discussion of the method of an internal morality can help to understand how arguments against euthanasia (amongst other acts) related to the profession of nursing are far from clear. Ultimately, although the idea of particular acts proper to nurses qua nurses is not clear, the concept of an internal morality can help to get practitioners to see how the profession is tightly linked to moral actions, even so the hard problems in bioethics such as the morality of euthanasia remain hard for all and the easy ones easy for all. © 2013 Blackwell Publishing Ltd.

Lick Northern Proper Motion Program: NPM2

NASA Astrophysics Data System (ADS)

Jones, B. F.; Hanson, R. B.; Klemola, A. R.

2000-05-01

The Lick Northern Proper Motion (NPM) program is nearing completion after a half-century of work. Two-epoch photography began in 1947 and was completed in 1988. Measurements and reductions for proper motions, positions, and two-color photometry in the sky outside the Milky Way (``NPM1'') began in 1975 and were completed in 1992. The Lick NPM1 Catalog, containing 149,000 stars, was distributed in 1993. Work on the Milky Way sky (``NPM2'') comprising some 300,000 stars, began in 1996, and plate measurements were finished in 1999. The NPM program will be completed with the publication of the Lick NPM2 Catalog in 2003. The NPM program will provide absolute proper motions, measured on an inertial system defined by some 50,000 faint galaxies, for over 400,000 stars from 9 < B < 18, covering the northern two-thirds of the sky. Included in the NPM catalogs are many stars of astrophysical interest, anonymous stars for galactic studies, and stars from positional catalogues and proper motion surveys. Current work at Lick encompasses data reductions and star identifications for NPM2. Procedures are based on NPM1, with appropriate modifications. Reference galaxies are not available in the Milky Way sky, so the Hipparcos Catalogue is used to link the NPM2 proper motions to the inertial system defined by NPM1. The large number of stars in NPM2 reflects the higher density of stars near the Galactic plane and toward the Galactic center. The NPM catalogs will have lasting value as a unique database for future studies in galactic structure, stellar kinematics, and astrometry. As we produce NPM2, we are also applying the NPM data to several outstanding problems in these research fields. We would like to thank Dave Monet and the USNO for measuring the NPM2 plates. We thank the National Science Foundation for its continued support of the NPM program. The work reported here was supported by NSF grant AST 9530632.

Trench Safety–Using a Qualitative Approach to Understand Barriers and Develop Strategies to Improve Trenching Practices

PubMed Central

FLYNN, MICHAEL A.; SAMPSON, JULIE M.

2015-01-01

Despite efforts to ensure workplace safety and health, injuries and fatalities related to trenching and excavation remain alarmingly high in the construction industry. Because properly installed trenching protective systems can potentially reduce the significant number of trenching fatalities, there is clearly a need to identify the barriers to the use of these systems and to develop strategies to ensure these systems are utilized consistently. The current study reports on the results of focus groups with construction workers and safety management personnel to better understand these barriers and to identify solutions. The results suggest several factors, from poor planning to pressures from experienced workers and supervisors, which present barriers to safe trenching practices. Based on the results, it is recommended that safety trainings incorporate unique messages for new workers, experienced workers and management in an effort to motivate each group to work safely as well as provide them with solutions to overcome the identified barriers. PMID:26550006

Features and perspectives of automatized construction crane-manipulators

NASA Astrophysics Data System (ADS)

Stepanov, Mikhail A.; Ilukhin, Peter A.

2018-03-01

Modern construction industry still has a high percentage of manual labor, and the greatest prospects of improving the construction process are lying in the field of automatization. In this article automatized construction manipulator-cranes are being studied in order to achieve the most rational design scheme. This is done through formulating a list of general conditions necessary for such cranes and a set of specialized kinematical conditions. A variety of kinematical schemes is evaluated via these conditions, and some are taken for further dynamical analisys. The comparative dynamical analisys of taken schemes was made and the most rational scheme was defined. Therefore a basis for a more complex and practical research of manipulator-cranes design is given and ways to implement them on practical level can now be calculated properly. Also, the perspectives of implementation of automated control systems and informational networks on construction sites in order to boost the quality of construction works, safety of labour and ecological safety are shown.

[Challenges in the implementation of clinical practice guidelines in major public health institutions in Mexico: A multiple case study].

PubMed

Gutiérrez-Alba, Gaudencio; González-Block, Miguel Ángel; Reyes-Morales, Hortensia

2015-01-01

To identify, prioritize and relate barriers and facilitators in the implementation of Clinical Practice Guidelines (GPC, in Spanish). We used qualitative methods to study and compare the introduction of GPC across the domains of the consolidated research implementation framework in hospitals of the three main public institutions in a state of Mexico. Authorities and hospital staff were interviewed using a semi-structured questionnaire. The main barriers to implementation are the absence of standards, training, resources and incentives. The most important implementation facilitators are the characteristics of the GPC, which are perceived as properly designed and with simple language as well as with capacity to improve the work environment. The barriers to implementation must be solved to achieve the goal of standardizing the healthcare process across the sector; the positive perception of the GPC should promote the continuous actualization of the evidence and a sectoral view from their development stage to ensure adoption in the heterogeneous environments that characterize health institutions.

Using Debate in EFL Classes

ERIC Educational Resources Information Center

Alasmari, Ali; Ahmed, Sayed Salahuddin

2013-01-01

The countries that use English as a foreign language need effective activities which propel students to practice skills of the language properly inside as well as outside classrooms. Debating is a practice that inspires learners to open their mouth, get into discussion, defend their own positions, place counter arguments and also conduct research…

Collaborative Learning in Higher Education: Lecturers' Practices and Beliefs

ERIC Educational Resources Information Center

De Hei, Miranda Suzanna Angelique; Strijbos, Jan-Willem; Sjoer, Ellen; Admiraal, Wilfried

2015-01-01

Collaborative learning can, if designed and implemented properly, contribute to student learning outcomes and prepare them for teamwork. However, the design and implementation of collaborative learning in practice depend on beliefs of lecturers about teaching and learning in general, and collaborative learning in particular. One hundred and…

Healthier Cleaning & Maintenance: Practices and Products for Schools.

ERIC Educational Resources Information Center

New York State Association for Superintendents of School Buildings and Grounds, Albany.

This paper helps all those concerned with keeping schools clean and properly maintained in adopting healthier cleaning and maintenance practices and promoting the purchase and use of environmentally preferable products which perform well and are cost effective. It explains how children are exposed to toxic chemicals in school cleaning and…

Vegetation management practices: Past and present

Treesearch

Peter F. Ffolliott; Gerald J. Gottfried; William H. Kruse

2003-01-01

Improving management practices have been at the core of most research conducted in the semidesert grass-shrub vegetation on the Santa Rita Experimental Range. Much of this research has been directed to sustaining forage resources through proper livestock grazing and controlling the invasion of competing woody plants, primarily mesquite. Both research orientations...

The carcinogenicity of chromium

PubMed Central

Norseth, Tor

1981-01-01

The carcinogenicity of chromium compounds is reviewed with specific attention to the gaps in knowledge for risk estimation and research needs. The most important problems at present are whether trivalent chromium compounds cause cancer, and whether there is a difference in cancer causing effects between the soluble and the slightly soluble hexavalent compounds in the practical exposure situation. Dose estimates for risk estimation based on epidemiological investigations are also lacking. Present evidence indicates that the trivalent chromium compounds do not cause cancer although high concentrations in some in vitro systems have shown genetic toxicity. Hexavalent chromium compounds cause cancer in humans, in experimental animals and exert genetic toxicity in bacteria and in mammalian cells in vitro. Epidemiological evidence and animal experiments indicate that the slightly soluble hexavalent salts are the most potent carcinogens, but proper identification and characterization of exposure patterns in epidemiological work are lacking. Workers also tend to have mixed exposures. Soluble and slightly soluble salts are equally potent genotoxic agents in vitro. Further work for establishing dose estimates for risk evaluation in epidemiological work is important. In vitro systems should be applied for further identification of the mechanism of the carcinogenic effects, and animal experiments are urgent for comparison of the carcinogenic potency of the different hexavalent salts. Hexavalent chromium salts must be regarded as established carcinogens, and proper action should be taken in all industries with regard to such exposure. At present the carcinogenic risk to the general population caused by chromium compounds seems to be negligible, chromium in cigarettes, however, is an uncertainty in this respect. The amount of chromium and the type of chromium compounds inhaled from cigarettes is not known. PMID:7023928

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.

Ethical issues in health workforce development.

PubMed Central

Cash, Richard

2005-01-01

Increasing the numbers of health workers and improving their skills requires that countries confront a number of ethical dilemmas. The ethical considerations in answering five important questions on enabling health workers to deal appropriately with the circumstances in which they must work are described. These include the problems of the standards of training and practice required in countries with differing levels of socioeconomic development and different priority diseases; how a society can be assured that health practitioners are properly trained; how a health system can support its workers; diversion of health workers and training institutions; and the teaching of ethical principles to student health workers. The ethics of setting standards for the skills and care provided by traditional health-care practitioners are also discussed. PMID:15868019

Economic implications of sleep disorders.

PubMed

Skaer, Tracy L; Sclar, David A

2010-01-01

Sleep disorders such as insomnia, obstructive sleep apnoea (OSA), excessive daytime sleepiness (EDS) and fatigue, sleep deprivation and restless legs syndrome (RLS) are increasingly seen in clinical practice. Sleep is considered vital for preserving daytime cognitive function and physiological well-being. Sleep insufficiency may have deleterious effects on work-life balance, overall health and safety. The consequential economic burden at both the individual and societal levels is significant. Moreover, sleep disorders are commonly associated with other major medical problems such as chronic pain, cardiovascular disease, mental illness, dementias, gastrointestinal disorders and diabetes mellitus. Thus, in order to properly care for patients presenting with sleep-related morbidity, and to reduce the consequential economic burden, accurate screening efforts and efficacious/cost-effective treatments need to be developed and employed.

Study of major factors developed among young swimmers during the practice session and competition causing interference of their performances.

PubMed

Das, Pradip Kumar; Panja, Debjit

2013-12-01

Swimming is a mass-oriented, well organised and health directed sport which helps to acquire good health for the participants. In our country it is started mostly in the 8-9 years of age and when compared to developed countries the children start the practices around the 3-6 years of age. In swimming like other sports, injury can happen particularly during practice and events competition. The different types of injuries like shoulder joint injury, knee joint injury, red eyes, ear-nose infections, muscle cramps, etc, so happened during swimming practice and swimming competition, affect the performances of the swimmers on many different levels, in both training and in swim meets. This is an ongoing problem for many swimmers, moreover swimming is an intense workout, so it's important to make sure for getting adequate nutrition throughout the day. Proper nutrition and dieting play a large role in optimising swimming performance. A poor diet has a negative effect on athletic performance, as it is also evident in this study where most of the swimmers are suffering from nutritional anaemia as detected by the low level of haemoglobin in their blood and so today the study work has obviously thrown some light on this aspect to highlight the problems and their solutions.

Thinking outside the box in clinical practice.

PubMed

Williams, Andrew N

2017-12-01

During difficult times we forget that as healthcare practitioners we are immensely privileged. We have a job, with regular work and generally don't have to worry about putting food on our families' table. But from a humanities perspective, we also have front row seats on the drama of life and no two days can be the same. Yet as we struggle to master our profession, the day to day realities of the job itself struggles to master us. If we become 'too hard' we may be fully competent yet fail to discharge our duties properly; however, should we become 'too soft', we may find ourselves not being able to discharge those duties at all. Striking that 'happy' balance is a decision we each make for ourselves every day during our decades of practice. For me, it has been necessary from the outset to include medical humanities within the clinico-medical perspective of daily practice. My definition of Medical Humanities will not only include medical history but also, stories, films and plays. This article relates some practices which I have found useful. © 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.

Advocating to Protect Our Nurses: Addressing Unethical Recruitment of Foreign-Educated Nurses.

PubMed

Shaffer, Franklin; Bakhshi, Mukul; Jacobs, Arielle

Advocacy in the nursing sector is often about advocating for patients. However, nurses have begun to put more effort into protecting their rights as workers. Advocacy on behalf of foreign-educated nurses has been a critical component of this advocacy. While foreign-educated nurses can make our nursing workforce stronger, this can only happen if they are well-treated and well-trained. Organizations across diverse missions and perspectives have come together to promote fair treatment of foreign-educated nurses, which ultimately ensures that all nurses are working as effectively as possible and that patients receive proper care. The Alliance for Ethical International Recruitment Practices' Health Care Code for Ethical Recruitment and Employment Practices represents a bottom-up agreement on which market practices constitute ethical recruitment. From a top-down level, the World Health Organization's Code of Global Practice establishes obligations and reporting requirements for member states that commit to ensuring ethical recruitment. This combination of efforts, bolstered by strong advocacy, is gaining traction as nursing migration grows at the global level. The collaboration across diverse stakeholder groups and the combination of legal, voluntary, and global efforts to promote the rights of foreign-educated nurses provides a model to apply for advocacy in different areas.

Introduction to clinical pathology: A brief course of laboratory medicine in the field for medical students

PubMed Central

Omidifar, Navid; Keshtkari, Ali; Dehghani, Mohammadreza; Shokripour, Mansoureh

2017-01-01

OBJECTIVES: Teaching of clinical pathology to medical students has been ignored in many countries such as Iran. We aim to introduce a practical brief course and its proper timing. MATERIALS AND METHODS: Three groups of medical students from consecutive years of entrance passed a 1.5 working day practical course on the field. Their level of knowledge was assessed by pre- and post-tests. Their idea and satisfaction were gathered by questionnaires. RESULTS: Knowledge of students became significantly higher after the course. Their satisfaction was high. Students in later year of education got significantly higher marks. Most of the students wished such a course should be away from basic sciences period and as near as possible to internship. DISCUSSION: Due to overloaded curriculum of general medicine in Iran, we decided to run a brief practical course of laboratory medicine education for medical students. Although the course was practical, the knowledge of students became higher. Students with more clinical experience and knowledge absorbed more. Being actively involved in the classes lit the enthusiasm of students and made them satisfied with the course. It seemed that the course should be placed in later years of clinical training to get the best uptake and results. PMID:29114552

The relationship between long working hours and depression among first-year residents in Japan.

PubMed

Ogawa, Ryoko; Seo, Emiko; Maeno, Takami; Ito, Makoto; Sanuki, Masaru; Maeno, Tetsuhiro

2018-03-27

In Japan, some residents develop mental health problems. In previous studies, it was reported that long working hours might be a cause of stress reaction such as depression. There were some reports that compared residents with 80 or more working hours with those with less than 80 working hours. However, many residents are practically detained for extra-long time, designated as 100 h or more per week, for medical practice, training, self-study, etc. There have been few reports on extra-long hours of work. This study evaluated the working environment and the amount of stress experienced by first-year residents, and examined the relationship between long working hours and depression, especially in the group of extra-long working hours. The study included 1241 first-year residents employed at 250 training hospitals in 2011. A self-report questionnaire was administered at the beginning of the residency and 3 months later to collect data on demographics, depressive symptoms, and training conditions (e.g., duration of work, sleep, disposable time, and night shift). Depressive symptoms were rated using the Center for Epidemiologic Studies Depression Scale. The mean duration of work per week was 79.4 h, with 97 residents (7.8%) working 100 h or more. At 3 months, clinically significant depressive symptoms were reported by 45.5% of residents working 100 or more h per week, which proportion was significantly greater than that for respondents working less than 60 h (P < 0.001). Multivariate logistic regression analysis showed that a working week of 80 to 99.9 h was associated with a 2.83 fold higher risk and 100 h or more was associated with a 6.96-fold higher risk of developing depressive symptoms compared with a working week of less than 60 h. Working excessively long hours was significantly associated with development of depressive symptoms. Proper management of resident physicians' working hours is critical to maintaining their physical and mental health and to improve the quality of care they provide.

Methodology of selecting dozers for lignite open pit mines in Serbia

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

Stojanovic, D.; Ignjatovic, D.; Kovacevic, S.

1996-12-31

Apart from the main production processes (coal and overburden mining, rail conveyors transportation and storage of excavated masses) performed by great-capacity mechanization at open pit mines, numerous and different auxiliary works, that often have crucial influence on both the work efficiency of main equipment and the maintenance of optimum technical conditions of machines and plants covering technological system of open pit, are present. Successful realization of work indispensably requires a proper and adequate selection of auxiliary machines according to their type quantity, capacity, power etc. thus highly respecting specific conditions existing at each and every open pit mine. A dozermore » is certainly the most important and representative auxiliary machine at single open pit mine. It is widely used in numerous works that, in fact, are preconditions for successful work of the main mechanization and consequently the very selection of a dozer ranges among the most important operations when selecting mechanization. This paper presents the methodology of dozers selection when lignite open pit mines are concerned. A mathematical model defining the volume of work required for dozers to perform at open pit mines and consequently the number of necessary dozers was designed. The model underwent testing in practice at big open pit mines and can be used in design of future open pits mines.« less

Technicians and Shop Owners

EPA Pesticide Factsheets

Overview page provides information for shops and technicians that repair or service motor vehicle air-conditioning systems, including information on proper training, approved equipment, and regulatory practices.

Prevention of injuries at work: the role of the occupational physician.

PubMed

Porru, Stefano; Placidi, Donatella; Carta, Angela; Alessio, Lorenzo

2006-03-01

To highlight the role of occupational physician (OP) in occupational injuries (OI) prevention and management. To suggest an approach beyond traditional focus on descriptive epidemiology, engineering interventions, administrative aspects of OI prevention. To promote a person- and enterprise-tailored approach, entailing greater attention to human factors and to practical problems of the specific workplace, with a call to a leading role played by OP. Analysis of the literature on the broader topic of OI prevention revealed thousands of publications; however, only a handful of them mention or describe the participation of OP in OI prevention. While recognizing that literature search is not the proper and only way to appreciate the current role of OP in this field, therefore, it seems necessary to call OP to a stronger effort in prevention and management of OI, through the context of a comprehensive intervention in cooperation with managers, supervisors, safety personnel and workers, focusing on specific needs of each enterprise. The following areas of OP intervention were examined: risk assessment, health surveillance, management, scientific research and health education. Within each of these topics, possible contributions, methodologies, instruments available for the OP were discussed, taking into account the relevant literature. Pathways for practical applications were illustrated, e.g., OI data generation and analyses, predictors of OI, fitness for work, case management, team work, educational issues, first aid, suggestion for OP contribution in specific research questions. OI continue to take a remarkable toll from individuals and society. New multidisciplinary interventions are needed to prevent OI. Focused activities at the single worksite with a central role from OP are definite options. OP is an effective interface between workforce and management and may offer, through a proactive approach, valuable practical and cultural contributions, while respecting technical and ethical guidelines of occupational health professionals.

European consensus conference on faecal microbiota transplantation in clinical practice

PubMed Central

Cammarota, Giovanni; Ianiro, Gianluca; Tilg, Herbert; Rajilić-Stojanović, Mirjana; Kump, Patrizia; Satokari, Reetta; Sokol, Harry; Arkkila, Perttu; Pintus, Cristina; Hart, Ailsa; Segal, Jonathan; Aloi, Marina; Masucci, Luca; Molinaro, Antonio; Scaldaferri, Franco; Gasbarrini, Giovanni; Lopez-Sanroman, Antonio; Link, Alexander; de Groot, Pieter; de Vos, Willem M; Högenauer, Christoph; Malfertheiner, Peter; Mattila, Eero; Milosavljević, Tomica; Nieuwdorp, Max; Sanguinetti, Maurizio; Simren, Magnus; Gasbarrini, Antonio

2017-01-01

Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance. In view of this, an evidence-based recommendation is needed to drive the practical implementation of FMT. In this European Consensus Conference, 28 experts from 10 countries collaborated, in separate working groups and through an evidence-based process, to provide statements on the following key issues: FMT indications; donor selection; preparation of faecal material; clinical management and faecal delivery and basic requirements for implementing an FMT centre. Statements developed by each working group were evaluated and voted by all members, first through an electronic Delphi process, and then in a plenary consensus conference. The recommendations were released according to best available evidence, in order to act as guidance for physicians who plan to implement FMT, aiming at supporting the broad availability of the procedure, discussing other issues relevant to FMT and promoting future clinical research in the area of gut microbiota manipulation. This consensus report strongly recommends the implementation of FMT centres for the treatment of C. difficile infection as well as traces the guidelines of technicality, regulatory, administrative and laboratory requirements. PMID:28087657

SIAMOC position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an Italian consensus conference.

PubMed

Benedetti, Maria Grazia; Beghi, Ettore; De Tanti, Antonio; Cappozzo, Aurelio; Basaglia, Nino; Cutti, Andrea Giovanni; Cereatti, Andrea; Stagni, Rita; Verdini, Federica; Manca, Mario; Fantozzi, Silvia; Mazzà, Claudia; Camomilla, Valentina; Campanini, Isabella; Castagna, Anna; Cavazzuti, Lorenzo; Del Maestro, Martina; Croce, Ugo Della; Gasperi, Marco; Leo, Tommaso; Marchi, Pia; Petrarca, Maurizio; Piccinini, Luigi; Rabuffetti, Marco; Ravaschio, Andrea; Sawacha, Zimi; Spolaor, Fabiola; Tesio, Luigi; Vannozzi, Giuseppe; Visintin, Isabella; Ferrarin, Maurizio

2017-10-01

Gait analysis is recognized as a useful assessment tool in the field of human movement research. However, doubts remain on its real effectiveness as a clinical tool, i.e. on its capability to change the diagnostic-therapeutic practice. In particular, the conditions in which evidence of a favorable cost-benefit ratio is found and the methodology for properly conducting and interpreting the exam are not identified clearly. To provide guidelines for the use of Gait Analysis in the context of rehabilitation medicine, SIAMOC (the Italian Society of Clinical Movement Analysis) promoted a National Consensus Conference which was held in Bologna on September 14th, 2013. The resulting recommendations were the result of a three-stage process entailing i) the preparation of working documents on specific open issues, ii) the holding of the consensus meeting, and iii) the drafting of consensus statements by an external Jury. The statements were formulated based on scientific evidence or experts' opinion, when the quality/quantity of the relevant literature was deemed insufficient. The aim of this work is to disseminate the consensus statements. These are divided into 13 questions grouped in three areas of interest: 1) General requirements and management, 2) Methodological and instrumental issues, and 3) Scientific evidence and clinical appropriateness. SIAMOC hopes that this document will contribute to improve clinical practice and help promoting further research in the field. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Safety, security and dual-use chemicals

DOE PAGES

Walters, Douglas B.; Ho, Pauline; Hardesty, Jasper

2014-12-18

Many chemicals that are frequently used in laboratories and industries can be harmful if not handled properly. Chemical safety best practices are designed to protect people from accidentally being exposed to hazardous chemicals. On the other hand, chemical security best practices are designed to protect people from someone deliberately exposing others to hazardous chemicals. Finally, many chemical safety best practices overlap with chemical security best practices, but there are important differences, as will be discussed in this paper.

Staff Perception on Biomedical or Health Care Waste Management: A Qualitative Study in a Rural Tertiary Care Hospital in India

PubMed Central

Joshi, Rita; Shah, Harshada; Sharma, Megha; Pathak, Ashish; Macaden, Ragini; Stålsby Lundborg, Cecilia

2015-01-01

Background Health care or biomedical waste, if not managed properly, can be of high risk to the hospital staff, the patients, the community, public health and the environment, especially in low and middle income settings where proper disposal norms are often not followed. Our aim was to explore perceptions of staff of an Indian rural tertiary care teaching hospital on hospital waste management. Method A qualitative study was conducted using 10 focus group discussions (FGDs), with different professional groups, cleaning staff, nurses, medical students, doctors and administrators. The FGD guide included the following topics: (i) role of Health Care Waste Management (HCWM) in prevention of health care associated infections, (ii) awareness of and views about HCWM-related guidelines/legislation, (iii) current HCWM practices, (iv) perception and preparedness related to improvements of the current practices, and (v) proper implementation of the available guidelines/legislation. The FGDs were recorded, transcribed verbatim, translated to English (when conducted in Hindi) and analysed using content analysis. Results Two themes were identified: Theme (A), ‘Challenges in integration of HCWM in organizational practice,’ with the categories (I) Awareness and views about HCWM, (II) Organizational practices regarding HCWM, and (III) Challenges in Implementation of HCWM; and Theme (B), ‘Interventions to improve HCWM,’ with three categories, (I) Educational and motivational interventions, (II) Organizational culture change, and (III) Policy-related interventions. Conclusion A gap between knowledge and actual practice regarding HCWM was highlighted in the perception of the hospital staff. The participants suggested organizational changes, training and monitoring to address this. The information generated is relevant not merely to the microsystem studied but to other institutions in similar settings. PMID:26023783

Good practices in managing work-related indoor air problems: a psychosocial perspective.

PubMed

Lahtinen, Marjaana; Huuhtanen, Pekka; Vähämäki, Kari; Kähkönen, Erkki; Mussalo-Rauhamaa, Helena; Reijula, Kari

2004-07-01

Indoor air problems at workplaces are often exceedingly complex. Technical questions are interrelated with the dynamics of the work community, and the cooperation and interaction skills of the parties involved in the problem solving process are also put to the test. The objective of our study was to analyze the process of managing and solving indoor air problems from a psychosocial perspective. This collective case study was based on data from questionnaires, interviews and various documentary materials. Technical inspections of the buildings and indoor air measurements were also carried out. The following four factors best differentiated successful cases from impeded cases: extensive multiprofessional collaboration and participative action, systematic action and perseverance, investment in information and communication, and process thinking and learning. The study also proposed a theoretical model for the role of the psychosocial work environment in indoor air problems. The expertise related to social and human aspects of problem solving plays a significant role in solving indoor air problems. Failures to properly handle these aspects may lead to resources being wasted and result in a problematic situation becoming stagnant or worse. Copyright 2004 Wiley-Liss, Inc.

Reversible calcium alloying enables a practical room-temperature rechargeable calcium-ion battery with a high discharge voltage

NASA Astrophysics Data System (ADS)

Wang, Meng; Jiang, Chunlei; Zhang, Songquan; Song, Xiaohe; Tang, Yongbing; Cheng, Hui-Ming

2018-06-01

Calcium-ion batteries (CIBs) are attractive candidates for energy storage because Ca2+ has low polarization and a reduction potential (-2.87 V versus standard hydrogen electrode, SHE) close to that of Li+ (-3.04 V versus SHE), promising a wide voltage window for a full battery. However, their development is limited by difficulties such as the lack of proper cathode/anode materials for reversible Ca2+ intercalation/de-intercalation, low working voltages (<2 V), low cycling stability, and especially poor room-temperature performance. Here, we report a CIB that can work stably at room temperature in a new cell configuration using graphite as the cathode and tin foils as the anode as well as the current collector. This CIB operates on a highly reversible electrochemical reaction that combines hexafluorophosphate intercalation/de-intercalation at the cathode and a Ca-involved alloying/de-alloying reaction at the anode. An optimized CIB exhibits a working voltage of up to 4.45 V with capacity retention of 95% after 350 cycles.

Using Action Research to prevent work-related illness among rubber farmers in Northeastern Thailand.

PubMed

Sena, Wijitra; Nilvarangkul, Kessarawan; Saranrittichai, Kesinee; Smith, John F; Phajan, Teerasak; Seetangkham, Sansanee

2018-06-10

This research aimed to enhance self-care among rubber farmers for preventing work-related illness. The project used Action Research's four phase iterative process: fact-finding to understand the problems, action planning, action plan implementation, and evaluation and reflection on action plan impacts. Sixty-six participants (46 rubber farmers and 20 community stakeholders) were purposively recruited from two villages in the top 10 rubber producing provinces in Northeastern Thailand. Demographic and work-related illness data were collected in face-to-face structured interviews, Focus group interviews and participant observations were used to collect data in each project phase. Night group meetings were held throughout the research phases. The intervention included training workshops and establishing a community health education team for ongoing farmer support. Results showed improved farmer self-care behaviors and establishment of a community health education team to encourage farmers to care for themselves properly. Community nurses, other health personnel, and the Thai government can build on initiatives like this to strengthen occupational health and safety practices and services policy for rubber farmers. © 2018 Wiley Periodicals, Inc.

Best practices to reduce the accident rate hotel

NASA Astrophysics Data System (ADS)

García Revilla, M. R.; Kahale Carrillo, D. T.

2014-10-01

Examining the available databases and existing tourism organizations can conclude that appear studies on accidents and their relationship with other variables. But in our case we want to assess this relationship in the performance of the hotel in relation to lower the accident rate. The Industrial Safety studies analyzing this accident causes (why they happen), their sources (committed activities), their agents (participants work means), its type (how the events occur or develop), all in order to develop prevention. In our case, as accidents happen because people commit wrongful acts or because the equipment, tools, machinery or workplaces are not in proper conditions, the preventive point of view we analyze through the incidence of workplace accidents hotel subsector. The crash occurs because there is a risk, so that adequate control of it would avoid despite individual factors. Absenteeism or absence from work was taken into account first by Dubois in 1977, as he realized the time lost in the nineteenth century due to the long working hours, which included the holidays. Motivation and job satisfaction were the elements that have been most important in the phenomenon of social psychology.

Proper Exercise and Nutrition kit: use of obesity screening and assessment tools with underserved populations.

PubMed

Kopp, Mary K; Hornberger, Cynthia

2008-02-01

Additional efforts are needed to assist public health, school, and clinic-based pediatric nurses in identifying the prevalence of obesity among Kansas Medicaid-eligible children, 21 years or younger. A Proper Exercise and Nutrition (PEN) tool kit was mailed to 500 public health nurses who performed KAN Be Healthy (KBH) assessments. KBH nurses were provided an expanded training curriculum on growth, nutrition, and obesity along with appropriate screening tools. Nurses were surveyed about their current assessment practices and general knowledge of obese clients. After the PEN tool kit distribution, nurses reported an increased use of screening tools and standardized referral parameters. This program intervention was successful in changing nursing practice, resulting in evidence-based understanding of obesity screening and assessment.

An empirical evaluation of software quality assurance practices and challenges in a developing country: a comparison of Nigeria and Turkey.

PubMed

Sowunmi, Olaperi Yeside; Misra, Sanjay; Fernandez-Sanz, Luis; Crawford, Broderick; Soto, Ricardo

2016-01-01

The importance of quality assurance in the software development process cannot be overemphasized because its adoption results in high reliability and easy maintenance of the software system and other software products. Software quality assurance includes different activities such as quality control, quality management, quality standards, quality planning, process standardization and improvement amongst others. The aim of this work is to further investigate the software quality assurance practices of practitioners in Nigeria. While our previous work covered areas on quality planning, adherence to standardized processes and the inherent challenges, this work has been extended to include quality control, software process improvement and international quality standard organization membership. It also makes comparison based on a similar study carried out in Turkey. The goal is to generate more robust findings that can properly support decision making by the software community. The qualitative research approach, specifically, the use of questionnaire research instruments was applied to acquire data from software practitioners. In addition to the previous results, it was observed that quality assurance practices are quite neglected and this can be the cause of low patronage. Moreover, software practitioners are neither aware of international standards organizations or the required process improvement techniques; as such their claimed standards are not aligned to those of accredited bodies, and are only limited to their local experience and knowledge, which makes it questionable. The comparison with Turkey also yielded similar findings, making the results typical of developing countries. The research instrument used was tested for internal consistency using the Cronbach's alpha, and it was proved reliable. For the software industry in developing countries to grow strong and be a viable source of external revenue, software assurance practices have to be taken seriously because its effect is evident in the final product. Moreover, quality frameworks and tools which require minimum time and cost are highly needed in these countries.

The Mediating Effect of Kaizen between Total Quality Management (TQM) and Business Performance

NASA Astrophysics Data System (ADS)

Shan, Ang Wei; Fauzi Ahmad, Mohd; Hisyamudin Muhd Nor, Nik

2016-11-01

Every customer preference is different but yet important. The global market is shifting rapidly, organizations are needed to continuously identify new opportunity to obtain competitive advantages. Literature suggested that manufacturing companies are needed to differentiate themselves through emphasize on quality and continuous improvement in product and services as a crucial part to secure and success in the future. The Total Quality Management (TQM) practices has developed a strong bearing on growth and competitiveness in market. Therefore, a proper continuous improvement (Kaizen) practice is needed to eliminate waste and value added in production to remain competitiveness and retained the potential customer. However, based on the previous study it had indicated an inconsistent result between TQM and BP. Besides that, researcher also less emphasized on mediator in previous work. Therefore, the purpose of this paper is to recommend the relationship between TQM and business performance with a mediator's effect of Kaizen. This proposed model attempt to create knowledge to both academician and company players to acquire a better understanding among the TQM and Kaizen practices. Consequently, the Structural Equation Modelling (SEM) techniques is applying to identify and evaluate the relationship among TQM, Kaizen, and business performance in developing a new TQM model.

Re-orienting discussions of scientific explanation: A functional perspective.

PubMed

Woody, Andrea I

2015-08-01

Philosophy of science offers a rich lineage of analysis concerning the nature of scientific explanation, but the vast majority of this work, aiming to provide an analysis of the relation that binds a given explanans to its corresponding explanandum, presumes the proper analytic focus rests at the level of individual explanations. There are, however, other questions we could ask about explanation in science, such as: What role(s) does explanatory practice play in science? Shifting focus away from explanations, as achievements, toward explaining, as a coordinated activity of communities, the functional perspective aims to reveal how the practice of explanatory discourse functions within scientific communities given their more comprehensive aims and practices. In this paper, I outline the functional perspective, argue that taking the functional perspective can reveal important methodological roles for explanation in science, and consequently, that beginning here provides resources for developing more adequate responses to traditional concerns. In particular, through an examination of the ideal gas law, I emphasize the normative status of explanations within scientific communities and discuss how such status underwrites a compelling rationale for explanatory power as a theoretical virtue. Copyright © 2015 Elsevier Ltd. All rights reserved.

Ultrasonic Method for Deployment Mechanism Bolt Element Preload Verification

NASA Technical Reports Server (NTRS)

Johnson, Eric C.; Kim, Yong M.; Morris, Fred A.; Mitchell, Joel; Pan, Robert B.

2014-01-01

Deployment mechanisms play a pivotal role in mission success. These mechanisms often incorporate bolt elements for which a preload within a specified range is essential for proper operation. A common practice is to torque these bolt elements to a specified value during installation. The resulting preload, however, can vary significantly with applied torque for a number of reasons. The goal of this effort was to investigate ultrasonic methods as an alternative for bolt preload verification in such deployment mechanisms. A family of non-explosive release mechanisms widely used by satellite manufacturers was chosen for the work. A willing contractor permitted measurements on a sampling of bolt elements for these release mechanisms that were installed by a technician following a standard practice. A variation of approximately 50% (+/- 25%) in the resultant preloads was observed. An alternative ultrasonic method to set the preloads was then developed and calibration data was accumulated. The method was demonstrated on bolt elements installed in a fixture instrumented with a calibrated load cell and designed to mimic production practice. The ultrasonic method yielded results within +/- 3% of the load cell reading. The contractor has since adopted the alternative method for its future production. Introduction

The impact of medical tourism and the code of medical ethics on advertisement in Nigeria

PubMed Central

Makinde, Olusesan Ayodeji; Brown, Brandon; Olaleye, Olalekan

2014-01-01

Advances in management of clinical conditions are being made in several resource poor countries including Nigeria. Yet, the code of medical ethics which bars physician and health practices from advertising the kind of services they render deters these practices. This is worsened by the incursion of medical tourism facilitators (MTF) who continue to market healthcare services across countries over the internet and social media thereby raising ethical questions. A significant review of the advertisement ban in the code of ethics is long overdue. Limited knowledge about advances in medical practice among physicians and the populace, the growing medical tourism industry and its attendant effects, and the possibility of driving brain gain provide evidence to repeal the code. Ethical issues, resistance to change and elitist ideas are mitigating factors working in the opposite direction. The repeal of the code of medical ethics against advertising will undoubtedly favor health facilities in the country that currently cannot advertise the kind of services they render. A repeal or review of this code of medical ethics is necessary with properly laid down guidelines on how advertisements can be and cannot be done. PMID:25722776

[The shutdown point and the output volume limit (OVL) in the present situation of healthcare in Hungary (or a little economics for practicing physicians)].

PubMed

Gresz, Miklós

2008-09-07

In the present situation of health care, financing has become so complicated that the treating doctor has to know not only his profession but also has to consider the different regulations, laws and book of rules. The work of the physician cannot be carried out only through the fact that he is a master of his art, that is healing. All healing practice, diagnostic abilities, intuition, empathy and other things are in vain: if he is not familiar with the basics of financing he can lead his institution to insolvency. This article tries to give a view of a small part of financing, the output volume limit (OVL) from another aspect. According to the basics of economy and general rules of leadership it tries to show up the practical difficulties of the output volume limit. The study enlightens that by defining the output volume limit one has to consider the shutdown point of the hospital and knowing this, the actual output volume limit should be defined in the way that it does not make the proper activity of the hospital completely impossible.

The impact of medical tourism and the code of medical ethics on advertisement in Nigeria.

PubMed

Makinde, Olusesan Ayodeji; Brown, Brandon; Olaleye, Olalekan

2014-01-01

Advances in management of clinical conditions are being made in several resource poor countries including Nigeria. Yet, the code of medical ethics which bars physician and health practices from advertising the kind of services they render deters these practices. This is worsened by the incursion of medical tourism facilitators (MTF) who continue to market healthcare services across countries over the internet and social media thereby raising ethical questions. A significant review of the advertisement ban in the code of ethics is long overdue. Limited knowledge about advances in medical practice among physicians and the populace, the growing medical tourism industry and its attendant effects, and the possibility of driving brain gain provide evidence to repeal the code. Ethical issues, resistance to change and elitist ideas are mitigating factors working in the opposite direction. The repeal of the code of medical ethics against advertising will undoubtedly favor health facilities in the country that currently cannot advertise the kind of services they render. A repeal or review of this code of medical ethics is necessary with properly laid down guidelines on how advertisements can be and cannot be done.

Is the value of Community Healthcare Agents in Brazil's Family Health Strategy receiving full recognition?

PubMed

Guanaes-Lorenzi, Carla; Pinheiro, Ricardo Lana

2016-08-01

This paper discusses meanings produced by Community Healthcare Agents (ACSs) on whether or not they feel that ACSs in Brazil's Family Health Strategy are receiving the recognition they deserve, considering their work with social networks. Discussion groups with 28 agents of six Health Units were held, sound-recorded and transcribed. Qualitative analysis of the material enables us to identify, in the discursive practices of ACSs, a tension on whether proper value is attributed to their work, or not. There was attribution of value when they talk of their activity in close proximity with the community, and their potential for construction of human connections; but there was non-attribution of value when they talk of the system's macro-structural aspects, such as low salaries, and low recognition of their function, in comparison to higher-level professionals. We conclude that the view of their work - still involving fragmented work processes, and expectation by the population that they will be able to provide immediate solutions to demands - might be preventing them from taking on board a more wide-ranging concept of primary healthcare, as a structuring and communication agent of the Healthcare Network, and as an organizing agent of Brazil's Unified Health System.

Correalism and Equipoise: Kiesler and Giedion on the sustainable

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

Braham, W.W.

1997-12-31

This paper inquires about standards for the sustainable that are not strictly bound to the principles of conservation or scarcity. In particular, two earlier contributions to this discussion offer alternate views of sustainability: the architect Frederick Kiesler and the critic-historian Siegfried Giedion both explored the human and social consequences of technological constructions. Their work participates in the long, nineteenth- and twentieth-century discourse about mechanization, that examined the many consequences of industrialization. In a sequence of published and unpublished works in the 1930`s Kieler evolved a theory about the relationship between buildings and nature that he called Correalism. While at themore » end Mechanization Takes Command of 1948, Giedion examined the loss of public and regenerative bathing habits and the rise of the private, forms of cleansing still largely practiced today. He concluded that work with a plea for a dynamic balance that he called Equipoise. Both works develop from ideas of interconnection that he now associates with systems theory and which are properly integral to modern ecology. Their critical questions revolve around the social dimensions of everyday constructions like buildings and bathtubs. The distinction between instrumental criteria and social ones is everywhere present in modern environmentalism, which can be traced to fundamental concerns about either resource use or about health. These two issues are wholly intertwined in most environmental practices, but the assumptions on which they rest are themselves historically changeable. The complex interaction between measurable environmental features and human concerns or desires is the subject of Kiesler`s Correalism.« less

Correlates of domestic waste management and related health outcomes in Sunyani, Ghana: a protocol towards enhancing policy.

PubMed

Addo, Henry O; Dun-Dery, Elvis J; Afoakwa, Eugenia; Elizabeth, Addai; Ellen, Amposah; Rebecca, Mwinfaug

2017-07-03

Domestic waste generation has contributed significantly to hampering national waste management efforts. It poses serious threat to national development and requires proper treatment and management within and outside households. The problem of improper waste management has always been a challenge in Ghana, compelling several national surveys to report on the practice of waste management. However, little is known about how much waste is generated and managed within households and there is a serious dearth of information for national policy and planning. This paper seeks to document the handling and practice of waste management, including collection, storage, transportation and disposal along with the types and amount of waste generated by Households and their related health outcome. The study was a descriptive cross-sectional study and used a multi-stage sampling technique to sample 700 households. The study was planned and implemented from January to May 2015. It involved the use of structured questionnaires in the data collection over the period. Factors such as demographic characteristics, amount of waste generated, types of waste bins used within households, waste recycling, cost of disposing waste, and distance to dumpsite were all assessed. The paper shows that each surveyed household generated 0.002 t of waste per day, of which 29% are both organic and inorganic. Though more than half of the respondents (53.6%) had positive attitude towards waste management, only 29.1% practiced waste management. The study reveals that there is no proper management of domestic waste except in few households that segregate waste. The study identified several elements as determinants of waste management practice. Female respondents were less likely to practice waste management (AOR 0.45; 95% Cl 0.29, 0.79), household size also determined respondents practice (AOR 0.26; Cl 0.09, 0.77). Practice of recycling (AOR 0.03; Cl 0.02, 0.08), distance to dumpsite (AOR 0.45; Cl 0.20, 0.99), were all significant predictors of waste management practice. Cholera which is a hygiene related disease was three times more likely to determine households' waste management practice (AOR 3.22; Cl 1.33, 7.84). Considering the low waste management practice among households, there is the need for improved policy and enhanced education on proper waste management practice among households.

Bladder Control and Nerve Disease

MedlinePlus

... VUR) The Urinary Tract & How It Works Bladder Control Problems & Nerve Disease For the urinary system to ... the bladder do not work properly. What bladder control problems does nerve damage cause? Nerves that work ...

Effects of forest harvest on biogeochemical processes in the Caspar Creek watershed

Treesearch

Randy A. Dahlgren

1998-01-01

Water quality and long-term sustainability are major components addressed within the ecosystem approach to forest management. Forest harvest practices are often implicated as having adverse impacts on sensitive aquatic communities and on the long-term sustainability of forest ecosystems. While careless harvest practices can certainly cause adverse impacts, proper...

31 CFR 10.5 - Application for enrollment as an enrolled agent or enrolled retirement plan agent.

Code of Federal Regulations, 2011 CFR

2011-07-01

... enrollment. (d) Temporary recognition. On receipt of a properly executed application, the Director of the Office of Professional Responsibility may grant the applicant temporary recognition to practice pending a determination as to whether enrollment to practice should be granted. Temporary recognition will be granted only...

31 CFR 10.5 - Application for enrollment as an enrolled agent or enrolled retirement plan agent.

Code of Federal Regulations, 2010 CFR

2010-07-01

... his or her application for enrollment. (d) Temporary recognition. On receipt of a properly executed... recognition to practice pending a determination as to whether enrollment to practice should be granted. Temporary recognition will be granted only in unusual circumstances and it will not be granted, in any...

Infection control practices for dental radiography.

PubMed

Palenik, Charles John

2004-06-01

Infection control for dental radiography employs the same materials, processes, and techniques used in the operatory, yet unless proper procedures are established and followed, there is a definite potential for cross-contamination to clinical area surfaces and DHCP. In general, the aseptic practices used are relatively simple and inexpensive, yet they require complete application in every situation.

Prevention of catheter-related blood stream infection.

PubMed

Byrnes, Matthew C; Coopersmith, Craig M

2007-08-01

Catheter-related blood stream infections are a morbid complication of central venous catheters. This review will highlight a comprehensive approach demonstrated to prevent catheter-related blood stream infections. Elements of prevention important to inserting a central venous catheter include proper hand hygiene, use of full barrier precautions, appropriate skin preparation with 2% chlorhexidine, and using the subclavian vein as the preferred anatomic site. Rigorous attention needs to be given to dressing care, and there should be daily assessment of the need for central venous catheters, with prompt removal as soon as is practicable. Healthcare workers should be educated routinely on methods to prevent catheter-related blood stream infections. If rates remain higher than benchmark levels despite proper bedside practice, antiseptic or antibiotic-impregnated catheters can also prevent infections effectively. A recent program utilizing these practices in 103 ICUs in Michigan resulted in a 66% decrease in infection rates. There is increasing recognition that a comprehensive strategy to prevent catheter-related blood stream infections can prevent most infections, if not all. This suggests that thousands of infections can potentially be averted if the simple practices outlined herein are followed.

Early workplace dialogue in physiotherapy practice improved work ability at 1-year follow-up-WorkUp, a randomised controlled trial in primary care.

PubMed

Sennehed, Charlotte P; Holmberg, Sara; Axén, Iben; Stigmar, Kjerstin; Forsbrand, Malin; Petersson, Ingemar F; Grahn, Birgitta

2018-03-15

Workplace involvement in rehabilitation for patients with musculoskeletal pain may improve work ability. Convergence Dialogue Meeting (CDM) is a model aimed at helping the patient, the care giver, and the employer to support work ability and return-to-work. Our aim was to study the effect on work ability when adding a workplace dialogue according to CDM in physiotherapy practice for patients with pain in ordinary primary care. We conducted a prospective pairwise cluster randomised controlled trial (ClinicalTrials.gov ID: NCT02609750) in primary care involving 20 primary care rehabilitation units with 1-year follow-up. Adult patients with acute/subacute neck and back pain, worked ≥4 weeks past year and not currently on sick leave or no more than 60 days of sick leave and considered at-risk of sick leave were included (n = 352). All patients received structured physiotherapy and the intervention was the addition of CDM, delivered by the treating physiotherapist. The main confirmatory outcome, work ability (defined as working at least 4 consecutive weeks at follow-up), was assessed by a weekly short text message question on number of sick leave days past week. Work ability was reached by significantly more patients in the intervention group (108/127, 85%) compared with the reference group (127/171, 74%) (P = 0.02). The intervention increased the odds of having work ability at 1-year follow-up, also after adjustment for baseline health-related quality of life (odds ratio 1.85, confidence interval 1.01-3.38). We conclude that an early workplace dialogue in addition to structured physiotherapy improved work ability significantly.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

An Evidence-Based Multidisciplinary Practice Guideline to Reduce the Workload due to Lifting for Preventing Work-Related Low Back Pain

PubMed Central

2014-01-01

We developed an evidence-based practice guideline to support occupational safety and health (OSH) professionals in assessing the risk due to lifting and in selecting effective preventive measures for low back pain (LBP) in the Netherlands. The guideline was developed at the request of the Dutch government by a project team of experts and OSH professionals in lifting and work-related LBP. The recommendations for risk assessment were based on the quality of instruments to assess the risk on LBP due to lifting. Recommendations for interventions were based on a systematic review of the effects of worker- and work directed interventions to reduce back load due to lifting. The quality of the evidence was rated as strong (A), moderate (B), limited (C) or based on consensus (D). Finally, eight experts and twenty-four OSH professionals commented on and evaluated the content and the feasibility of the preliminary guideline. For risk assessment we recommend loads heavier than 25 kg always to be considered a risk for LBP while loads less than 3 kg do not pose a risk. For loads between 3–25 kg, risk assessment shall be performed using the Manual handling Assessment Charts (MAC)-Tool or National Institute for Occupational Safety and Health (NIOSH) lifting equation. Effective work oriented interventions are patient lifting devices (Level A) and lifting devices for goods (Level C), optimizing working height (Level A) and reducing load mass (Level C). Ineffective work oriented preventive measures are regulations to ban lifting without proper alternatives (Level D). We do not recommend worker-oriented interventions but consider personal lift assist devices as promising (Level C). Ineffective worker-oriented preventive measures are training in lifting technique (Level A), use of back-belts (Level A) and pre-employment medical examinations (Level A). This multidisciplinary evidence-based practice guideline gives clear criteria whether an employee is at risk for LBP while lifting and provides an easy-reference for (in)effective risk reduction measures based on scientific evidence, experience, and consensus among OSH experts and practitioners. PMID:24999432

An Evidence-Based Multidisciplinary Practice Guideline to Reduce the Workload due to Lifting for Preventing Work-Related Low Back Pain.

PubMed

Kuijer, P Paul Fm; Verbeek, Jos Ham; Visser, Bart; Elders, Leo Am; Van Roden, Nico; Van den Wittenboer, Marion Er; Lebbink, Marian; Burdorf, Alex; Hulshof, Carel Tj

2014-01-01

We developed an evidence-based practice guideline to support occupational safety and health (OSH) professionals in assessing the risk due to lifting and in selecting effective preventive measures for low back pain (LBP) in the Netherlands. The guideline was developed at the request of the Dutch government by a project team of experts and OSH professionals in lifting and work-related LBP. The recommendations for risk assessment were based on the quality of instruments to assess the risk on LBP due to lifting. Recommendations for interventions were based on a systematic review of the effects of worker- and work directed interventions to reduce back load due to lifting. The quality of the evidence was rated as strong (A), moderate (B), limited (C) or based on consensus (D). Finally, eight experts and twenty-four OSH professionals commented on and evaluated the content and the feasibility of the preliminary guideline. For risk assessment we recommend loads heavier than 25 kg always to be considered a risk for LBP while loads less than 3 kg do not pose a risk. For loads between 3-25 kg, risk assessment shall be performed using the Manual handling Assessment Charts (MAC)-Tool or National Institute for Occupational Safety and Health (NIOSH) lifting equation. Effective work oriented interventions are patient lifting devices (Level A) and lifting devices for goods (Level C), optimizing working height (Level A) and reducing load mass (Level C). Ineffective work oriented preventive measures are regulations to ban lifting without proper alternatives (Level D). We do not recommend worker-oriented interventions but consider personal lift assist devices as promising (Level C). Ineffective worker-oriented preventive measures are training in lifting technique (Level A), use of back-belts (Level A) and pre-employment medical examinations (Level A). This multidisciplinary evidence-based practice guideline gives clear criteria whether an employee is at risk for LBP while lifting and provides an easy-reference for (in)effective risk reduction measures based on scientific evidence, experience, and consensus among OSH experts and practitioners.

"Are We hurting ourselves?" What is the prevalence of back pain in anesthesia providers?

PubMed

Anson, Jonathan A; Mets, Elbert J; Vaida, Sonia J; King, Tonya S; Ochoa, Tim; Gordin, Vitaly

2016-11-01

Back injuries are a highly reported category of occupational injury in the health care setting. The daily clinical activities of an anesthesia provider, including lifting, pushing stretchers, transferring patients, and bending for procedures, are risk factors for developing low back pain. The purpose of this study is to investigate the prevalence of work related low back pain in anesthesia providers. We conducted a cross-sectional survey study of anesthesia providers at an academic institution. The target population included all 141 clinical anesthesia providers employed by the Penn State Milton S. Hershey Medical Center Department of Anesthesia. A survey study was conducted using the Oswestry Disability Index (ODI), a validated scoring system for low back pain. Additional questions related to the daily activities of clinical anesthesia practice were also asked. The survey instrument underwent pretesting and clinical sensibility testing to ensure validity and consistent interpretation. The primary self-reported measures were the prevalence of low back pain in anesthesia providers and an assessment of disability based on the ODI. Secondary functional measures included the impact of low back pain on work flow. Nearly half (46.6%) of respondents suffer from low back pain attributed to clinical practice. In this subset of respondents, 70.1% reported not having back pain prior to their anesthesia training. Of those with low back pain, 44% alter their work flow, and 9.8% reported missing at least one day of work. Six providers (5.3%) required surgical intervention. Using the ODI score interpretation guidelines, 46% of respondents had a "mild disability" and 2% had a "moderate disability." Respondents reporting feeling "burned out" from their job had a significantly higher average ODI score compared to those who did not (6.8 vs 3.3, respectively; P=.01). Nearly half of all anesthesia providers sampled suffer from low back pain subjectively attributed to their clinical practice. This leads to changes in work flow and missed days of work. The results of this study suggest a deficiency in the effectiveness of anesthesia training programs in teaching proper techniques to prevent musculoskeletal injuries. Copyright © 2016 Elsevier Inc. All rights reserved.

[Tool of nutrition education for allergic to egg and cow's milk protein in pediatric age].

PubMed

San Mauro Martín, Ismael

2014-05-01

Food allergy affects a large part of the population and their numbers are increasing. Although the knowing of this pathology is growing, allergic patients have really difficulties to lead a normal life, especially with food. Until now,this group hadn t practical tools that would help them in the development of a balanced daily diet, as there are for the general population in the form of pyramids and dietary guidelines . This work has covered this need for two of the most prevalent allergies in early life. gather information on the allergy of cow's milk protein and egg, to design a food pyramid for these patients, based on the consensus, recommendations and scientific guidance. After confirming the absence of a similar work, food pyramids allergy to egg and cow's milk protein, adapted to each, and a joint pyramid is designed to both allergies. Besides basic recommendations for healthy eating were included in general and in particular individuals, with special interest for the collective (food hygiene, food additives, cosmetics, medicines, etc). Due to the importance of nutrition in childhood and acquires the underlying difficulties this group, to properly plan the diet is very important as it can prevent accidents and long-term nutritional deficiencies. Therefore provide graphical tools and practices to this goal, is importance for population and medical and scientific community, and is the result of this work. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Knowledge, attitudes and practices (KAP) of hygiene among school children in Angolela, Ethiopia.

PubMed

Vivas, A P; Gelaye, B; Aboset, N; Kumie, A; Berhane, Y; Williams, M A

2010-06-01

Poor hygiene practices and inadequate sanitary conditions play major roles in the increased burden of communicable diseases within developing countries. This study evaluated the KAP of hygiene among rural school children in Ethiopia and assessed the extent to which proper knowledge of hygiene was associated with personal hygiene characteristics. This cross-sectional study was comprised of 669 students who were interviewed by trained staff Participants were in grades 1-6 at Angolela Primary School, located in rural Ethiopia. Data consisted of hygiene and hand washing practices, knowledge about sanitation, personal hygiene characteristics, and presence of gastrointestinal parasitic infection. Results. Approximately 52% of students were classified as having adequate knowledge of proper hygiene. Most students reported hand washing before meals (99.0%), but only 36.2% reported using soap. Although 76.7% of students reported that washing hands after defecation was important, only 14.8% reported actually following this practice. Students with adequate knowledge of proper hygiene were more likely to have clean clothes (AOR 1.62, CI 1.14-2.29) and to have a lower risk of parasitic infection (AOR 0.78, CI 0.56-1.09) although statistical significance was not achieved for the latter Study findings underscore the need for more hand washing and hygiene education in schools; and provide objective evidence that may guide the development of comprehensive health and hygiene intervention programs in rural Ethiopian schools. Successful implementation of these programs is likely to substantially attenuate the transmissible disease burden borne by school children in rural settings.

Tax-exempt bonds and sponsored research.

PubMed

Ballard, Frederic L

2003-01-01

"Sponsored research," wherein a business corporation or the government pays a portion of the cost of research activities carried out by a university or hospital, is increasingly important both for state institutions and for Section 510(c)(3) organizations. Sponsored research arrangements that are not properly structured can jeopardize the status of tax-exempt bonds issued to finance the facility at which the sponsored research occurs. While these rules have been difficult to apply in practice, properly structured agreements can provide funding for research without undue risk. This Article discusses the multiple pieces of guidance put forth by the Internal Revenue Service to clarify the many issues and tiers of analysis necessary to ensure a properly-structured sponsored research agreement.

On the systematics in apparent proper motions of radio sources observed by VLBI

NASA Astrophysics Data System (ADS)

Raposo-Pulido, V.; Lambert, S.; Capitaine, N.; Nilsson, T.; Heinkelmann, R.; Schuh, H.

2015-08-01

For about twenty years, several authors have been investigating the systematics in the apparent proper motions of radio source positions. In some cases, the theoretical work developed (Pyne et al., 1996) could not be assessed due to the few number of VLBI observations. In other cases, the effects attributed to apparent proper motion could not be related successfully because there were no significant evidences from a statistical point of view (MacMillan, 2005). In this work we provide considerations about the estimation of the coefficients of spherical harmonics, based on a three-step procedure used by Titov et al. (2011) and Titov and Lambert (2013). The early stage of this work has been to compare step by step the computations and estimation processes between the Calc/Solve (http://gemini.gsfc.nasa.gov/solve/) and VieVS software (Böhm et al., 2012). To achieve this, the results were analyzed and compared with the previous study done by Titov and Lambert (2013).

Basics of Biosafety

NASA Technical Reports Server (NTRS)

Wong, Willy

2009-01-01

This slide presentation reviews the basics of biosafety and the importance of assuring proper biosafety practices. The objectives of the presentation are to review regulations about biosafety, and the different biosafety levels; the biosafety facilities at Johnson Space Center; the usage and maintenance of the biosafety cabinet, the proper methods to handle biologically hazardous materials upon exposure, and the methods of cleanup in the event of a spill, and the training requirements that are mandated for personnel handling biologically hazardous materials.

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

NASA Astrophysics Data System (ADS)

Dobos, P.; Tamás, P.; Illés, B.

2016-11-01

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

(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare.

PubMed

Mannion, Russell; Exworthy, Mark

2017-03-28

Recent years have witnessed a parallel and seemingly contradictory trend towards both the standardization and the customization of healthcare and medical treatment. Here, we explore what is meant by 'standardization' and 'customization' in healthcare settings and explore the implications of these changes for healthcare delivery. We frame the paradox of these divergent and opposing factors in terms of institutional logics - the socially constructed rules, practices and beliefs which perpetuate institutional behaviour. As the tension between standardization and customization is fast becoming a critical fault-line within many health systems, there remains an urgent need for more sustained work exploring how these competing logics are articulated, adapted, resisted and co-exist on the front line of care delivery. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Domestic abuse as a transgressive practice: understanding nurses' responses through the lens of abjection.

PubMed

Bradbury-Jones, Caroline; Taylor, Julie

2013-10-01

Domestic abuse is a worldwide public health issue with long-term health and social consequences. Nurses play a key role in recognizing and responding to domestic abuse. Yet there is considerable evidence that their responses are often inappropriate and unhelpful, such as trivializing or ignoring the abuse. Empirical studies have identified several reasons why nurses' responses are sometimes wanting. These include organizational constraints, e.g. lack of time and privacy; and interpersonal factors such as fear of offending women and lack of confidence. We propose, however, that these factors present only a partial explanation. Drawing on the work of Julia Kristeva, we suggest that alternative understandings may be derived through applying the concept of abjection. Abjection is a psychological defence against any threat (the abject) to the clean and proper self that results in rejection of the abject. Using examples from our own domestic abuse research, we contend that exposure of nurses to the horror of domestic abuse evokes a state of abjection. Domestic abuse (the abject) transgresses established social boundaries of clean and proper. Thus when exposed to patients' and clients' experiences of it, some nurses subconsciously reject domestic abuse as a possibility (abjection). They do this to protect themselves from the horror of the act, but in so doing, render themselves unable to formulate appropriate responses. Rather than understanding the practice of some nurses as wilfully neglectful or ignorant, we argue that through a state of abjection, they are powerless to act. This does not refute existing evidence about nurses' responses to domestic abuse. Rather, as a relatively unknown concept in nursing, abjection provides an additional explanatory layer that accounts for why some nurses respond the way they do. Crucially, it elucidates the need for nurses to be supported emotionally when faced with the transgressive practice of abuse. © 2013 John Wiley & Sons Ltd.

Modeling the behavior of human body tissues on penetration

NASA Astrophysics Data System (ADS)

Conci, A.; Brazil, A. L.; Popovici, D.; Jiga, G.; Lebon, F.

2018-02-01

Several procedures in medicine (such as anesthesia, injections, biopsies and percutaneous treatments) involve a needle insertion. Such procedures operate without vision of the internal involved areas. Physicians and anesthetists rely on manual (force and tactile) feedback to guide their movements, so a number of medical practice is strongly based on manual skill. In order to be expert in the execution of such procedures the medical students must practice a number of times, but before practice in a real patient they must be trained in some place and a virtual environment, using Virtual Reality (VR) or Augmented Reality (AR) is the best possible solution for such training. In a virtual environment the success of user practices is improved by the addition of force output using haptic device to improve the manual sensations in the interactions between user and computer. Haptic devices enable simulate the physical restriction of the diverse tissues and force reactions to movements of operator hands. The trainees can effectively "feel" the reactions to theirs movements and receive immediate feedback from the actions executed by them in the implemented environment. However, in order to implement such systems, the tissue reaction to penetration and cutting must be modeled. A proper model must emulate the physical sensations of the needle action in the skin, fat, muscle, and so one, as if it really done in a patient that is as they are holding a real needle and feeling each tissue resistance when inserting it through the body. For example an average force value for human skin puncture is 6.0 N, it is 2.0 N for subcutaneous fat tissue and 4.4 N for muscles: this difference of sensations to penetration of each layers trespassed by the needle makes possible to suppose the correct position inside the body. This work presents a model for tissues before and after the cutting that with proper assumptions of proprieties can model any part of human body. It was based on experiments and used in embryonic system for epidural anesthesia having good evaluation as presented in the last section "Preliminary Results".

Fitness for work in health care workers from the prospective of ethics, science and good practices.

PubMed

Alessio, L; Arici, Cecilia; Franco, G

2012-01-01

Fitness for work (FFW) is the final task of both risk assessment and health surveillance, aimed at protecting workers' health and working capacity. There are numerous specific concerns regarding health care workers. In particular: i) the frequent difficulty in determining at pre-employment/pre-placement examinations the specific task that the individual worker will perform; ii) the prevalence of female workers and the contemporary presence of numerous occupational risk factors that are a potential cause of harmful effects on women's reproductive health; iii) the progressive aging of the staff especially nurses; iv) the risk to third parties, with particular reference to the issues of biological risk and substance abuse, also in relation to shift work, fatigue and occupational stress; v) the increasing number of immigrant workers among support staff In such cases the occupational physician, respecting both ethical principles and regulations and with an appropriate balance between scientific evidence and the precautionary principle, should express a FFW judgment that allows both the adaptation of work to the worker and vice versa, as recommended by the World Health Organization (WHO) and the International Commission on Occupational Health (ICOH). Proper FFW judgment also permits the expected benefits to be achieved, not only for the workers but also for employers, companies and society.

Auto-Mechanics Course. Bilingual Vocational Instructional Materials.

ERIC Educational Resources Information Center

Lopez-Cox, Guadalupe

This auto-mechanics course, one of a series of bilingual English-Spanish vocational education courses, is designed to introduce the basic skills that an automotive mechanics student should know. It is geared to teach the student basic manipulative skills, safety judgments, proper work habits, desirable attitudes, and proper behavior for initial…

Breathing Easy

EPA Pesticide Factsheets

This fact sheet provides practical information and guidance to auto refinish shops on proper ventilation of paint mixing rooms, including ventilation system basics and diagrams, risk reduction ideas, common mistakes, tips, and design considerations.

Best Practices for Managing Medical Equipment and Supplies Stored in a Vehicle.

PubMed

McGoldrick, Mary

2015-01-01

Home care clinicians often have to transport supplies to patients' homes, and remove and transport items from the home after care is provided. This article will provide guidelines and best practices for the proper methods of managing and storing infection prevention and control supplies and regulated medical waste in a home care clinician's personal vehicle.

Teaching and Our "Deepest Motivations": Beginning with "I-Thou"

ERIC Educational Resources Information Center

Whale, Mark

2012-01-01

"Why is the practice of teaching worth putting at the centre of one's life?" Chris Higgins believes that this question must be properly addressed if people who become teachers are to become themselves--are to discover a way of simultaneously practicing their profession and "flourishing" as human beings. In this essay, the author aims to give an…

Student Interns Share the Spirit of Science | Poster

Cancer.gov

They came for a science lesson. They left with more. The new Werner H. Kirsten student interns filed into the auditorium in Building 549 to expand their knowledge of fundamental laboratory practices, as part of the Science Skills Boot Camp. A panel of presenters instructed the attendees on skills such as reading scientific papers effectively, practicing proper research ethics,

The Reliability and User-Feasibility of Materials and Procedures for Monitoring the Implementation Integrity of a Reading Intervention

ERIC Educational Resources Information Center

Begeny, John C.; Easton, Julia E.; Upright, James J.; Tunstall, Kali R.; Ehrenbock, Cassia A.

2014-01-01

Within the realm of school-based interventions, implementation integrity is important for practical, legal, and ethical purposes. Unfortunately, evidence suggests that proper monitoring of implementation integrity is often absent from both research and practice. School psychology practitioners and researchers have reported that a major barrier to…

33 CFR 150.607 - What are the general safe working requirements?

Code of Federal Regulations, 2011 CFR

2011-07-01

... subchapter. (b) All machinery and equipment must be maintained in proper working order or removed. Personal Protective Equipment ... Workplace Conditions § 150.607 What are the general safe working requirements? (a) All equipment, including...

33 CFR 150.607 - What are the general safe working requirements?

Code of Federal Regulations, 2010 CFR

2010-07-01

... subchapter. (b) All machinery and equipment must be maintained in proper working order or removed. Personal Protective Equipment ... Workplace Conditions § 150.607 What are the general safe working requirements? (a) All equipment, including...

Modified stretched exponential model of computer system resources management limitations-The case of cache memory

NASA Astrophysics Data System (ADS)

Strzałka, Dominik; Dymora, Paweł; Mazurek, Mirosław

2018-02-01

In this paper we present some preliminary results in the field of computer systems management with relation to Tsallis thermostatistics and the ubiquitous problem of hardware limited resources. In the case of systems with non-deterministic behaviour, management of their resources is a key point that guarantees theirs acceptable performance and proper working. This is very wide problem that stands for many challenges in financial, transport, water and food, health, etc. areas. We focus on computer systems with attention paid to cache memory and propose to use an analytical model that is able to connect non-extensive entropy formalism, long-range dependencies, management of system resources and queuing theory. Obtained analytical results are related to the practical experiment showing interesting and valuable results.

A flexible ultrasound transducer array with micro-machined bulk PZT.

PubMed

Wang, Zhe; Xue, Qing-Tang; Chen, Yuan-Quan; Shu, Yi; Tian, He; Yang, Yi; Xie, Dan; Luo, Jian-Wen; Ren, Tian-Ling

2015-01-23

This paper proposes a novel flexible piezoelectric micro-machined ultrasound transducer, which is based on PZT and a polyimide substrate. The transducer is made on the polyimide substrate and packaged with medical polydimethylsiloxane. Instead of etching the PZT ceramic, this paper proposes a method of putting diced PZT blocks into holes on the polyimide which are pre-etched. The device works in d31 mode and the electromechanical coupling factor is 22.25%. Its flexibility, good conformal contacting with skin surfaces and proper resonant frequency make the device suitable for heart imaging. The flexible packaging ultrasound transducer also has a good waterproof performance after hundreds of ultrasonic electric tests in water. It is a promising ultrasound transducer and will be an effective supplementary ultrasound imaging method in the practical applications.

77 FR 52372 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... stolen securities. Reporting to the central database also allows reporting institutions to gain access to... proper performance of the functions of the agency, including whether the information shall have practical...

How Can the Science Community Support Reality Based Policies to Reducing the Escalating Toll of Natural Hazards?

NASA Astrophysics Data System (ADS)

Thomas, E. A.

2012-12-01

Worldwide, the toll of disaster damage caused by foreseeable natural hazards is growing, despite the fact that science is increasingly able to quantify the risk and foresee the likely location of natural events (NCDC 2012; NHC 2010). Those events can cause disastrous consequences if human built infrastructure is not properly designed for both the current state and future events (IBHS, 2012). Our existing approaches are not working at reducing the mounting toll of disasters which follow foreseeable natural events. Rather, even if the climate were not changing, current land use decisions coupled with development, engineering, design, and construction practices are significantly contributing to further increasing an unsustainable toll from disasters (Pielke, Gratz et al. 2007). Safe and proper construction practices developed to reduce flood losses (e.g. Design for Flooding, Watson, Adams et al., 2010) are all too often thought of as a zero sum situation where the community wins and the developer loses. In reality, the United States and the rest of the world often can find win-win solutions based on sound economics, law, ethics, and environmental sustainability that will benefit communities, developers, and natural hazard risk mitigation practitioners. While such solutions are being implemented in a fragmentary manner throughout the United States, communities implementing these solutions are increasingly working together in peer networks, such as the Natural Hazard Mitigation Association (NHMA)'s Resilient Neighbors Network. Examples include the Urban Drainage and Flood Control District that covers the metropolitan Denver area and recent work in Tulsa, Oklahoma. This presentation will set forth the scientific, ethical, and legal basis of higher development standards which, when combined with good negotiations techniques, can significantly decrease the terrible misery from wildfires, tornadoes, floods, and other natural disasters. Communities clearly have the legal right to implement safe design standards (Thomas, Riley Medlock 2008); yet all too often do not (NOAA, 2010). The required negotiations techniques must include outreach even to those who believe the topics of climate change and sustainability are some sort of plot against property rights and the free enterprise system. The presentation will also challenge the scientific community to support reasoned efforts to better prepare society for the even greater challenges posed by climate variability, uncertainty, and change: to work with practitioners who seek to build a safe and sustainable future to identify gaps in scientific knowledge and help develop workable solutions at the local level. Edward A. Thomas Esq. President Natural Hazard Mitigation Association

Cellulitis

MedlinePlus

... original pen marking) Your immune system is not working well (due to cancer, HIV) You have an ... chronic disease or your immune system is not working properly. People with fungal infections of the feet ...

PK-12 Public Educational Facilities Master Plan Evaluation Guide

ERIC Educational Resources Information Center

21st Century School Fund, 2011

2011-01-01

Proper planning of school facilities is critical for all school districts no matter how large or small, whether major construction is in the works or the district is managing enrollment declines. When school districts properly plan for their school facilities they have better schools, more public use and higher value for public spending. This…

Construction Trade Course. Bilingual Vocational Instructional Materials.

ERIC Educational Resources Information Center

Lopez-Cox, Guadalupe

This building trades course, one of a series of bilingual English-Spanish vocational education courses, is designed to introduce the basic skills that a student must know in the construction field. It is geared to teach the student basic manipulative skills, safety judgments, proper work habits, desirable attitudes, and proper behavior for initial…

Dental care knowledge and practice of a group of health workers in benin city, Nigeria.

PubMed

Amuh, Vo; Okojie, Oh; Ehizele, Ao

2014-09-01

The correlation between knowledge of dental care knowledge and its practice varies among the different health professionals. The aim of the following study is to assess the knowledge and practice of health workers in a private medical health facility on dental care. A descriptive cross-sectional study was carried out on the health workers in Faith Medical Center, Benin City, Nigeria. A self-administered questionnaire, containing 31 open and closed questions was used for data collection to assess their knowledge and practice of dental care. The data was analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0 (Chicago, IL, USA) and WIN PEPI software version 11.15. None of the respondents had a poor knowledge of dental care, but majority had poor practice. The pattern of distribution of knowledge and practice of dental care observed in this study was not significantly affected by age, gender, occupation and working experience. The entire respondents knew that bleeding from the gum is not normal and 96.2% (75/78) gave correct causes of bleeding gums. Majority 88.5% (69/78) also knew that tooth decay is not normal, but fewer 66.6% (52/78) knew the correct causes of tooth decay. Only 37.2% (29/75) of the respondents took correct action after experiencing a toothache (i.e., consulting a dentist for proper management) and majority 80.8% (63/78) and 76.1% (60/78) still make use of toothpicks, which is considered as potentially harmful and frequently consume cariogenic diet respectively. There is a good knowledge of dental care, but poor oral health practices among the studied health workers. Oral health education to correct their improper practices is therefore highly advocated.

49 CFR 229.211 - Processing of petitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Docket Management System and posted on its Web site at http://www.regulations.gov. (3) In the event FRA..., FRA will consider proper documentation of competent engineering analysis, or practical demonstrations...

49 CFR 229.211 - Processing of petitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Docket Management System and posted on its Web site at http://www.regulations.gov. (3) In the event FRA..., FRA will consider proper documentation of competent engineering analysis, or practical demonstrations...

77 FR 20638 - Ashish Macwan: Debarment Order

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... Manufacturing Practices; violating Standards of Procedure by failing to properly investigate, log, and archive... inaccurate data and records to obtain FDA approval to market new product lines. In furtherance of the...

Waiving Deductibles and Copays: No Good Deed Goes Unpunished.

PubMed

Sacopulos, Michael J

2015-01-01

In an age of high deductibles, many surgical candidates are requesting that practices reduce or waive the self-pay portion of the professional fee. These requests come with a risk to the practice. Third-party payer agreements often prohibit discounting of fees to patients. Claiming breach of contract and interference with actuarial calculations, some third-party payers have sued practices for waiving fees owed by their insureds. Only by having the proper policies in place may a practice safely engage in fee reductions for patients insured by an entity with whom the practice has a contractual relationship.

Simulation-Based Mastery Learning with Deliberate Practice Improves Clinical Performance in Spinal Anesthesia

PubMed Central

Udani, Ankeet D.; Macario, Alex; Tanaka, Maria A.; Tanaka, Pedro P.

2014-01-01

Introduction. Properly performing a subarachnoid block (SAB) is a competency expected of anesthesiology residents. We aimed to determine if adding simulation-based deliberate practice to a base curriculum improved performance of a SAB. Methods. 21 anesthesia residents were enrolled. After baseline assessment of SAB on a task-trainer, all residents participated in a base curriculum. Residents were then randomized so that half received additional deliberate practice including repetition and expert-guided, real-time feedback. All residents were then retested for technique. SABs on all residents' next three patients were evaluated in the operating room (OR). Results. Before completing the base curriculum, the control group completed 81% of a 16-item performance checklist on the task-trainer and this increased to 91% after finishing the base curriculum (P < 0.02). The intervention group also increased the percentage of checklist tasks properly completed from 73% to 98%, which was a greater increase than observed in the control group (P < 0.03). The OR time required to perform SAB was not different between groups. Conclusions. The base curriculum significantly improved resident SAB performance. Deliberate practice training added a significant, independent, incremental benefit. The clinical impact of the deliberate practice intervention in the OR on patient care is unclear. PMID:25157263

Simulation-based mastery learning with deliberate practice improves clinical performance in spinal anesthesia.

PubMed

Udani, Ankeet D; Macario, Alex; Nandagopal, Kiruthiga; Tanaka, Maria A; Tanaka, Pedro P

2014-01-01

Introduction. Properly performing a subarachnoid block (SAB) is a competency expected of anesthesiology residents. We aimed to determine if adding simulation-based deliberate practice to a base curriculum improved performance of a SAB. Methods. 21 anesthesia residents were enrolled. After baseline assessment of SAB on a task-trainer, all residents participated in a base curriculum. Residents were then randomized so that half received additional deliberate practice including repetition and expert-guided, real-time feedback. All residents were then retested for technique. SABs on all residents' next three patients were evaluated in the operating room (OR). Results. Before completing the base curriculum, the control group completed 81% of a 16-item performance checklist on the task-trainer and this increased to 91% after finishing the base curriculum (P < 0.02). The intervention group also increased the percentage of checklist tasks properly completed from 73% to 98%, which was a greater increase than observed in the control group (P < 0.03). The OR time required to perform SAB was not different between groups. Conclusions. The base curriculum significantly improved resident SAB performance. Deliberate practice training added a significant, independent, incremental benefit. The clinical impact of the deliberate practice intervention in the OR on patient care is unclear.

Development of reference practices for the calibration and validation of atmospheric composition satellites

NASA Astrophysics Data System (ADS)

Lambert, Jean-Christopher; Bojkov, Bojan

The Committee on Earth Observation Satellites (CEOS)/Working Group on Calibration and Validation (WGCV) is developing a global data quality strategy for the Global Earth Obser-vation System of Systems (GEOSS). In this context, CEOS WGCV elaborated the GEOSS Quality Assurance framework for Earth Observation (QA4EO, http://qa4eo.org). QA4EO en-compasses a documentary framework and a set of ten guidelines, which describe the top-level approach of QA activities and key requirements that drive the QA process. QA4EO is appli-cable virtually to all Earth Observation data. Calibration and validation activities are a cornerstone of the GEOSS data quality strategy. Proper uncertainty assessment of the satellite measurements and their derived data products is essential, and needs to be continuously monitored and traceable to standards. As a practical application of QA4EO, CEOS WGCV has undertaken to establish a set of best practices, methodologies and guidelines for satellite calibration and validation. The present paper reviews current developments of best practices and guidelines for the vali-dation of atmospheric composition satellites. Aimed as a community effort, the approach is to start with current practices that could be improved with time. The present review addresses current validation capabilities, achievements, caveats, harmonization efforts, and challenges. Terminologies and general principles of validation are reminded. Going beyond elementary def-initions of validation like the assessment of uncertainties, the specific GEOSS context requires considering also the validation of individual service components and against user requirements.

The prevalence of occupational health-related problems in dentistry: A review of the literature.

PubMed

Moodley, Rajeshree; Naidoo, Saloshni; Wyk, Jacqueline van

2018-03-27

The study was conducted to report on the scope and prevalence of occupational health related-problems experienced by dentists, dental therapists, and oral hygienists in their practice of dentistry. Professional practice and dental training have many risk factors, and the dental team should be able to recognize these factors to protect themselves. The prevalence of conditions related to the musculoskeletal system, stress, percutaneous injuries, ears, and eyes are of concern. The dental team should also not forget hepatitis B, hepatitis C, and HIV as risks in practice. Dental practitioners should protect themselves by self-recognizing risk factors and by maintaining proper working conditions. The study targeted all empirical research, case studies, and systematic literature reviews written in English. All articles selected were subjected to a data analysis process. Data were captured on an Excel spreadsheet and reported in a comprehensive table. The literature addressing occupational health among dental practitioners included mainly cross-sectional studies and review papers (2001-2016). Forty-nine studies were included in the review. Musculoskeletal disorders remain the most researched occupational health-related problems in dentistry. Eye protection compliance was low among practitioners. Percutaneous injuries especially among young dentists and students were still a concern. Occupational health-related problems are still prevalent in current dentistry practice, despite changes in equipment and surgery design. The reported prevalence of occupational related-health problems and other findings of investigative studies highlight the need for continuous professional education and a need to improve clinical practice aspects of dentistry curricula.

Good Practices in Free-energy Calculations

NASA Technical Reports Server (NTRS)

Pohorille, Andrew; Jarzynski, Christopher; Chipot, Christopher

2013-01-01

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

Screening women for intimate partner violence: Creating proper practice habits.

PubMed

Knox, Beth

2018-05-17

Intimate partner violence continues to be a challenge for advanced practice registered nurses to address and manage in their daily practice. This article reviews current healthcare concerns in heterosexual, bisexual, transgender, and lesbian women, and explores screening guidelines and resources for developing successful screening habits. Additionally, the article discusses how the Transtheoretical Model and Stages of Change offers insight into the behavior of women who experience intimate partner violence and provides safety strategies for these women.

Rapid Response Teams: Is it Time to Reframe the Questions of Rapid Response Team Measurement?

PubMed

Salvatierra, Gail G; Bindler, Ruth C; Daratha, Kenn B

2016-11-01

The purpose of this article is to present an overview of rapid response team (RRT) history in the United States, provide a review of prior RRT effectiveness research, and propose the reframing of four new questions of RRT measurement that are designed to better understand RRTs in the context of contemporary nursing practice as well as patient outcomes. RRTs were adopted in the United States because of their intuitive appeal, and despite a lack of evidence for their effectiveness. Subsequent studies used mortality and cardiac arrest rates to measure whether or not RRTs "work." Few studies have thoroughly examined the effect of RRTs on nurses and on nursing practice. An extensive literature review provided the background. Suppositions and four critical, unanswered questions arising from the literature are suggested. The results of RRT effectiveness, which have focused on patient-oriented outcomes, have been ambiguous, contradictory, and difficult to interpret. Additionally, they have not taken into account the multiple ways in which these teams have impacted nurses and nursing practice as well as patient outcomes. What happens in terms of RRT process and utilization is likely to have a major impact on nurses and nursing care on general medical and surgical wards. What that impact will be depends on what we can learn from measuring with an expanded yardstick, in order to answer the question, "Do RRTs work?" Evidence for the benefits of RRTs depends on proper framing of questions relating to their effectiveness, including the multiple ways RRTs contribute to nursing efficacy. © 2016 Sigma Theta Tau International.

Changing Clinical Practice: Evaluation of Implementing Recommendations for Opportunistic Salpingectomy in British Columbia and Ontario.

PubMed

Lander, Bryn; Wilcox, Elizabeth; McAlpine, Jessica N; Finlayson, Sarah J; Huntsman, David G; Miller, Dianne; Hanley, Gillian E

2018-05-11

The aim of the study was to explore the factors that contributed to the adoption of opportunistic salpingectomies (removal of fallopian at the time of hysterectomy or in lieu of tubal ligation) by gynecologic surgeons in British Columbia (where a knowledge translation initiative took place) and in Ontario (a comparator where no knowledge translation initiative took place). We aimed to understand why the knowledge translation initiative undertaken by OVCARE in British Columbia resulted in such a dramatic uptake in opportunistic salpingectomy. We undertook a qualitative evaluation of clinicians' decisions about whether or not they should adopt the practice of opportunistic salpingectomy based on interviews with gynecologic surgeons in British Columbia and Ontario (n = 28). The analysis draws from the Consolidated Framework for Implementation Research. Regional cohesion combined with practice change information exposure and thought leader support were important in explaining differences in adoption levels between participants. The British Columbian knowledge translation campaign was successful because provincial thought leaders exposed gynecologic surgeons to recommendations through multiple sources within a highly socially cohesive environment wherein clinicians felt pressure to adopt the recommendations. In both provinces, high adopters often believed that the workload and surgical risk associated with the adoption was low and the potential benefit-because of limited ovarian cancer detection and treatment options-was high. This research points to the important role that local professional networks can play in encouraging clinicians to change their practice by creating a cohesive regional environment where clinicians are repeatedly exposed to important information and supported in their practice change by local thought leaders.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Research in action: using positive deviance to improve quality of health care

PubMed Central

Bradley, Elizabeth H; Curry, Leslie A; Ramanadhan, Shoba; Rowe, Laura; Nembhard, Ingrid M; Krumholz, Harlan M

2009-01-01

Background Despite decades of efforts to improve quality of health care, poor performance persists in many aspects of care. Less than 1% of the enormous national investment in medical research is focused on improving health care delivery. Furthermore, when effective innovations in clinical care are discovered, uptake of these innovations is often delayed and incomplete. In this paper, we build on the established principle of 'positive deviance' to propose an approach to identifying practices that improve health care quality. Methods We synthesize existing literature on positive deviance, describe major alternative approaches, propose benefits and limitations of a positive deviance approach for research directed toward improving quality of health care, and describe an application of this approach in improving hospital care for patients with acute myocardial infarction. Results The positive deviance approach, as adapted for use in health care, presumes that the knowledge about 'what works' is available in existing organizations that demonstrate consistently exceptional performance. Steps in this approach: identify 'positive deviants,' i.e., organizations that consistently demonstrate exceptionally high performance in the area of interest (e.g., proper medication use, timeliness of care); study the organizations in-depth using qualitative methods to generate hypotheses about practices that allow organizations to achieve top performance; test hypotheses statistically in larger, representative samples of organizations; and work in partnership with key stakeholders, including potential adopters, to disseminate the evidence about newly characterized best practices. The approach is particularly appropriate in situations where organizations can be ranked reliably based on valid performance measures, where there is substantial natural variation in performance within an industry, when openness about practices to achieve exceptional performance exists, and where there is an engaged constituency to promote uptake of discovered practices. Conclusion The identification and examination of health care organizations that demonstrate positive deviance provides an opportunity to characterize and disseminate strategies for improving quality. PMID:19426507

Current practices in the diagnosis and management of gestational diabetes mellitus in India (WINGS-5)

PubMed Central

Mahalakshmi, Manni Mohanraj; Bhavadharini, Balaji; Maheswari, Kumar; Anjana, Ranjit Mohan; Jebarani, Saravanan; Ninov, Lyudmil; Kayal, Arivudainambi; Malanda, Belma; Belton, Anne; Uma, Ram; Mohan, Viswanathan; Unnikrishnan, Ranjit

2016-01-01

Aim: To obtain information on existing practices in the diagnosis and management of gestational diabetes mellitus (GDM) among physicians/diabetologists/endocrinologists and obstetricians/gynecologists (OB/GYNs) in India. Methods: Details regarding diagnostic criteria used, screening methods, management strategies, and the postpartum follow-up of GDM were obtained from physicians/diabetologists/endocrinologists and OB/GYNs across 24 states of India using online/in-person surveys using a structured questionnaire. Results: A total of 3841 doctors participated in the survey of whom 68.6% worked in private clinics. Majority of OB/GYNs (84.9%) preferred universal screening for GDM, and screening in the first trimester was performed by 67% of them. Among the OB/GYNs, 600 (36.7%) reported using the nonfasting 2 h criteria for diagnosing GDM whereas 560 (29.4%) of the diabetologists/endocrinologists reported using the same. However, further questioning on the type of blood sample collected and the glucose load used revealed that, in reality, only 208 (12.7%) and 72 (3.8%), respectively, used these criteria properly. The survey also revealed that the International Association of Diabetes and Pregnancy Study Groups criteria was followed properly by 299 (18.3%) of OB/GYNs and 376 (19.7%) of physicians/diabetologists/endocrinologists. Postpartum oral glucose tolerance testing was advised by 56% of diabetologists and 71.6% of OB/GYNs. Conclusion: More than half of the physicians/diabetologists/endocrinologists and OB/GYNs in India do not follow any of the recommended guidelines for the diagnosis of GDM. This emphasizes the need for increased awareness about screening and diagnosis of GDM both among physicians/diabetologists/endocrinologists and OB/GYNs in India. PMID:27186555

Barriers to nutritional care for the undernourished hospitalised elderly: perspectives of nurses.

PubMed

Eide, Helene Dahl; Halvorsen, Kristin; Almendingen, Kari

2015-03-01

To identify what nurses experience as barriers to ensuring adequate nutritional care for the undernourished hospitalized elderly. Undernutrition occurs frequently among the hospitalised elderly and can result in a variety of negative consequences if not treated. Nevertheless, undernutrition is often unrecognised and undertreated. Nurses have a great responsibility for nutritional care, as this is part of the patient's basic needs. Exploring nurses' experiences of preventing and treating undernourishment among older patients in hospitals is therefore highly relevant. A focus group study was employed based on a hermeneutic phenomenological methodological approach. Four focus group interviews with totally 16 nurses working in one large university hospital in Norway were conducted in spring 2012. The nurses were recruited from seven somatic wards, all with a high proportion of older (≥70 years) inpatients. The data were analysed in the three interpretative contexts: self-understanding, a critical common-sense understanding and a theoretical understanding. We identified five themes that reflect barriers the nurses experience in relation to ensuring adequate nutritional care for the undernourished elderly: loneliness in nutritional care, a need for competence in nutritional care, low flexibility in food service practices, system failure in nutritional care and nutritional care is being ignored. The results imply that nutritional care at the university hospital has its limits within the hospital structure and organisation, but also regarding the nurses' competence. Moreover, the barriers revealed that the undernourished elderly are not identified and treated properly as stipulated in the recommendations in the national guidelines on the prevention and treatment of undernutrition. The barriers revealed in this study are valuable when considering improvements to nutritional care practices on hospital wards to enable undernourished older inpatients to be identified and treated properly. © 2014 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Closing the Mathematical Achievement Gap Through the Heart To the Brain: A Case Study of Urban High School Mathematics Teachers' Perceptions of How Their Emotional Intelligence Facilitates Instruction and Learning in the Classroom

NASA Astrophysics Data System (ADS)

Fang, Chung-Chieh

The purpose of this qualitative case study was to examine urban high school mathematics teachers' perceptions of how they manage their own and their students' emotional intelligence (EI) to facilitate instruction and learning; their reports of how they handle their emotions as urban mathematics teachers; and their reports of how they manage the emotions of their students. The study focused on the voices of sixteen urban mathematics teachers and was undertaken in reaction to the significant mathematics achievement gap between urban students and their suburban counterparts. The conceptual framework undergirding the study was synthesized work by Daniel Goleman, (1995) and Mayer and Salovey (1997); categorizing emotional intelligence in emotional selfawareness, managing emotions, harnessing emotions, empathy, and handling relationships. Research questions addressing each category were created and from these categories an interview guide was developed. Data gathered during individual teacher interviews was transcribed and sorted into emergent categories using open coding. The findings were organized and presented according to the study's research questions. Urban math teachers reported passion for their students, their feelings affect teaching and learning, and that humor is an important tool in mediating emotions. The study concludes with multiple recommendations for further research and practices. Future studies should compare teachers assuming paternal vs. mentor role when dealing with their students. The study can evaluate if either role has a significant impact in student teacher relationships. A recommendation for practice is for teachers to have professional development experiences focusing on the proper use of humor in the classroom. Humor used properly promotes a positive classroom environment. This is a skill that would be especially beneficial to urban teachers.

Pharmacological management of anticancer agent extravasation: A single institutional guideline.

PubMed

Kimmel, Jaime; Fleming, Patrick; Cuellar, Sandra; Anderson, Jennifer; Haaf, Christina Mactal

2018-03-01

Although the risk of extravasation of a chemotherapy (anticancer) medication is low, the complications associated with these events can have a significant impact on morbidity and health care costs. Institutions that administer anticancer agents should ideally have a current guideline on the proper management of the inadvertent administration of these toxic medications into tissues surrounding blood vessels. It is imperative that the health care team involved in administering drugs used to treat cancer be educated on the risk factors, preventative strategies and treatment of anticancer extravasations, as well as practice safe and proper administration techniques. Anticancer agents are generally divided into classes based on their ability to cause tissue damage. The review of current published guidelines and available literature reveals a lack of consensus on how these medications should be classified. In addition, many recently approved drugs for the treatment of cancer may lack data to support their classification and management of extravasation events. The treatment of the majority of extravasations of anticancer agents involves nonpharmacological measures, potentially in the ambulatory care setting. Antidotes are available for the extravasation of a minority of vesicant agents in order to mitigate tissue damage. Due to the limited data and lack of consensus in published guidelines, a working group was established to put forth an institutional guideline on the management of anticancer extravasations.

Technological processes of grating light valve as diffractive spatial light modulator in laser phototypesetting system

NASA Astrophysics Data System (ADS)

Zhang, Wei; Geng, Yu; Hou, Changlun; Yang, Guoguang; Bai, Jian

2008-11-01

Grating Light Valve (GLV) is a kind of optics device based on Micro-Opto-Electro-Mechanical System (MOEMS) technology, utilizing diffraction principle to switch, attenuate and modulate light. In this paper, traditional GLV device's structure and its working principle are illuminated, and a kind of modified GLV structure is presented, with details introduction of the fabrication technology. The GLV structure includes single crystal silicon substrate, silicon dioxide isolating layer, aluminum layer of fixed ribbons and silicon nitride of movable ribbons. In the fabrication, lots of techniques are adopted, such as low-pressure chemical vapor deposition (LPCVD), photolithography, etching and evaporation. During the fabrication processes, Photolithography is a fundamental and fatal technology, which determines etching result and GLV quality. Some methods are proposed through repeated experiments, to improve etching result greatly and guide the practical application. This kind of GLV device can be made both small and inexpensively, and has been tested to show proper range of actuation under DC bias, with good performance. The GLV device also has merits such as low cost, simple technology, high fill ratio and low driving voltage. It can properly be well used and match the demands of high light power needed in laser phototypesetting system, as a high-speed, high-resolution light modulator.

Proper joint analysis of summary association statistics requires the adjustment of heterogeneity in SNP coverage pattern.

PubMed

Zhang, Han; Wheeler, William; Song, Lei; Yu, Kai

2017-07-07

As meta-analysis results published by consortia of genome-wide association studies (GWASs) become increasingly available, many association summary statistics-based multi-locus tests have been developed to jointly evaluate multiple single-nucleotide polymorphisms (SNPs) to reveal novel genetic architectures of various complex traits. The validity of these approaches relies on the accurate estimate of z-score correlations at considered SNPs, which in turn requires knowledge on the set of SNPs assessed by each study participating in the meta-analysis. However, this exact SNP coverage information is usually unavailable from the meta-analysis results published by GWAS consortia. In the absence of the coverage information, researchers typically estimate the z-score correlations by making oversimplified coverage assumptions. We show through real studies that such a practice can generate highly inflated type I errors, and we demonstrate the proper way to incorporate correct coverage information into multi-locus analyses. We advocate that consortia should make SNP coverage information available when posting their meta-analysis results, and that investigators who develop analytic tools for joint analyses based on summary data should pay attention to the variation in SNP coverage and adjust for it appropriately. Published by Oxford University Press 2017. This work is written by US Government employees and is in the public domain in the US.

21 CFR 1316.59 - Submission and receipt of evidence.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FUNCTIONS, PRACTICES, AND PROCEDURES Administrative Hearings § 1316.59 Submission and receipt of evidence... the witness is properly qualified. (c) The authenticity of all documents submitted in advance shall be...

Say No to Raw Dough!

MedlinePlus

... Follow safe food handling practices when you are baking and cooking with flour and other raw ingredients: ... the recipe or package directions for cooking or baking at the proper temperature and for the specified ...

49 CFR 392.64 - Riding within closed commercial motor vehicles without proper exits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (Continued) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS DRIVING OF COMMERCIAL MOTOR VEHICLES Prohibited Practices § 392.64 Riding within...

Globalization, decision making and taboo in nursing.

PubMed

Keighley, T

2012-06-01

This paper is a reflection on the representation of nurses and their practice at a global level. In considering the International Council of Nurses (ICN) conference in Malta (2011), it is clear that certain assumptions have been made about nurses and their practice which assume that globalization is under way for the whole of the profession and that the assumptions can be applied equally around the world. These assumptions appear in many ways to be implicit rather than explicit. The implicitness of the assumptions is examined against the particular decision-making processes adopted by the ICN. An attempt is then made to identify another base for the ongoing global work of the ICN. This involves the exploration of taboo (that which is forbidden because it is either holy or unclean) as a way of examining why nursing is not properly valued, despite years of international representation. The paper concludes with some thoughts on how such a new approach interfaces with the possibilities held out by new information technologies. © 2011 The Author. International Nursing Review © 2011 International Council of Nurses.

A new experimental community pharmacy internship module for undergraduate pharmacy students in western Nepal: overview and reflections.

PubMed

Timsina, Sangita; K C, Bhuvan; Adhikari, Dristi; Alrasheedy, Alian A; Mohamed Ibrahim, Mohamed Izham; Kaundinnyayana, Atisammodavardhana

2017-01-01

Community pharmacies in Nepal and other South Asian countries are in a mediocre state due to poor regulation and the fact that many pharmacies are run by people with insufficient training in dispensing. This has led to the inappropriate use of medicines. The problems due to poor regulation and the mediocre state of community pharmacies in South Asia encompass both academia and clinical practice. In this paper, a 2-week community pharmacy internship programme completed by 2 graduating pharmacy students of Pokhara University (a Nepalese public university) at Sankalpa Pharmacy, Pokhara, Nepal is illustrated. During the internship, they were systematically trained on store management, pharmaceutical care, counselling skills, the use of medical devices, pharmaceutical business plans, medicine information sources, and adverse drug reaction reporting. An orientation, observations and hands-on training, case presentation, discussion, and feedback from 2 senior pharmacists were used as the training method. A proper community pharmacy internship format, good pharmacy practice standards, and a better work environment for pharmacists may improve the quality of community pharmacies.

Immunonutrition in septic patients: a philosophical view of the current situation.

PubMed

Bertolini, Guido; Luciani, Davide; Biolo, Gianni

2007-02-01

Two different ways of thinking pervaded the history of science: rationalism and empiricism. In theory, these two paradigms are not necessarily in conflict. In practice, there has always been tension between them. The coming of evidence-based medicine put empiricism in a privileged position, but empiricism without a rationalistic guide could even be usefulness. The aim of this work is to present the tension between the rational reasons to administer immunonutrients to patients with sepsis and the controversial empirical evidence stemming from clinical trials. We reviewed the literature on immunonutrition in sepsis from the rationalist and the empiricist perspectives. The large body of evidence for positive effects of immunonutrients in experimental models and the contradictory results from clinical trials make the discussion on immunonutrition in sepsis a typical example where the conflict between rationalism and empiricism hampered the advancement of knowledge and the implementation of new effective therapies into clinical practice. Future research projects involving immunonutrients should be based on robust knowledge of basic mechanisms of action to be properly addressed in clinical trials.

PubMed Central

Côté, L.; Clavet, D.; St-Hilaire, S.; Vaillancourt, C.; Blondeau, F.; Martineau, B.

1999-01-01

PROBLEM ADDRESSED: In addition to clinical instruction, residents need "people" skills that will enable them to deal with all sorts of patients in difficult clinical situations. We planned a series of 12 seminars to teach these skills to first-year residents. OBJECTIVES OF PROGRAM: To ask relevant questions typical of the patient-centred approach; with empathy and respect, to encourage patients to express their emotions; to become more aware of one's own emotions and reactions in one's work as a physician; to negotiate with patients, taking into account both the patient's agenda and one's own. MAIN COMPONENTS OF PROGRAM: Clinical problems drawn from a list of situations likely to involve difficult contact with patients were used to achieve program objectives. Various teaching methods (discussion, brief presentation, practical demonstration, role play) were used during the four stages of skills development: information, demonstration, practice, and feedback. Various tools were used to test the program. CONCLUSION: Proper planning requires ongoing exploration of objectives, content, teaching methods, and evaluation. This discussion of the teaching principles applied in planning our seminars might inspire others to develop similar programs. PMID:10349069

A new experimental community pharmacy internship module for undergraduate pharmacy students in western Nepal: overview and reflections

PubMed Central

2017-01-01

Community pharmacies in Nepal and other South Asian countries are in a mediocre state due to poor regulation and the fact that many pharmacies are run by people with insufficient training in dispensing. This has led to the inappropriate use of medicines. The problems due to poor regulation and the mediocre state of community pharmacies in South Asia encompass both academia and clinical practice. In this paper, a 2-week community pharmacy internship programme completed by 2 graduating pharmacy students of Pokhara University (a Nepalese public university) at Sankalpa Pharmacy, Pokhara, Nepal is illustrated. During the internship, they were systematically trained on store management, pharmaceutical care, counselling skills, the use of medical devices, pharmaceutical business plans, medicine information sources, and adverse drug reaction reporting. An orientation, observations and hands-on training, case presentation, discussion, and feedback from 2 senior pharmacists were used as the training method. A proper community pharmacy internship format, good pharmacy practice standards, and a better work environment for pharmacists may improve the quality of community pharmacies. PMID:28811395

Proper Plugin Protocols

DTIC Science & Technology

2011-12-28

specify collaboration constraints that occur in Java and XML frameworks and that the collaboration constraints from these frameworks matter in practice. (a...programming language boundaries, and Chapter 6 and Appendix A demonstrate that Fusion can specify constraints across both Java and XML in practice. (c...designed JUnit, Josh Bloch designed Java Collec- tions, and Krzysztof Cwalina designed the .NET Framework APIs. While all of these frameworks are very

Harnessing Sparse and Low-Dimensional Structures for Robust Clustering of Imagery Data

ERIC Educational Resources Information Center

Rao, Shankar Ramamohan

2009-01-01

We propose a robust framework for clustering data. In practice, data obtained from real measurement devices can be incomplete, corrupted by gross errors, or not correspond to any assumed model. We show that, by properly harnessing the intrinsic low-dimensional structure of the data, these kinds of practical problems can be dealt with in a uniform…

Reconceptualizing Language Ownership. A Case Study of Language Practices and Attitudes among Students at the University of KwaZulu-Natal

ERIC Educational Resources Information Center

Parmegiani, Andrea

2010-01-01

The notion that language is not simply a politically neutral medium of communication, but a social practice that determines power relations and shapes subjectivity has become widely accepted in critical language and literacy studies. Within any socio-linguistic community, certain ways of using language are considered "proper,"…

Forensic Metrology: Its Importance and Evolution in the United States

NASA Astrophysics Data System (ADS)

Vosk, JD Ted

2016-11-01

Forensic measurements play a significant role in the U.S. criminal justice system. Guilt or innocence, or the severity of a sentence, may depend upon the results of such measurements. Until recently, however, forensic disciplines were largely unaware of the field of metrology. Accordingly, proper measurement practices were often, and widely, neglected. These include failure to adopt proper calibration techniques, establish the traceability of results and determine measurement uncertainty. These failures undermine confidence in verdicts based upon forensic measurements. Over the past decade, though, the forensic sciences have been introduced to metrology and its principles leading to more reliable measurement practices. The impetus for this change was driven by many forces. Pressure came initially from criminal defense lawyers challenging metrologically unsound practices and results relied upon by government prosecutions. Litigation in the State of Washington led this movement spurring action by attorneys in other jurisdictions and eventually reform in the measurement practices of forensic labs around the country. Since then, the greater scientific community, other forensic scientists and even prosecutors have joined the fight. This paper describes the fight to improve the quality of justice by the application of metrological principles and the evolution of the field of forensic metrology.

Balancing health care evidence and art to meet clinical needs: policymakers' perspectives.

PubMed

Parker, Louise E; Ritchie, Mona J; Kirchner, Joann E; Owen, Richard R

2009-12-01

Rationale, aims and objectives Although many believe that evidence-based practice (EBP) has great potential, critics have identified limitations including a focus on randomized clinical trial (RCT) evidence to the exclusion of other evidence types and a disregard for the art of medicine. Others have argued, however, that proper application of EBP involves reasoned consideration of a wide variety of information; thus, the dichotomy between medical science and art may be false. We explore the views of executive-level policymakers from the Veterans Health Administration, a leader in the EBP movement, regarding what constitutes evidence and the relative importance of evidence versus practical needs when determining clinical policy. Method We conducted 26 semi-structured qualitative interviews and performed a content analysis. Results Although informants generally believed in the value of EBP and the role of RCTs within it, they also valued other types of evidence. Further, they had concerns that were sometimes antithetical with strict adherence to an evidence-based approach. These included practical concerns, fit with organizational values and with local circumstances, resources, political pressures and patient needs. They were especially concerned about how to address medical conditions that affect many individuals or high-risk populations that have no evidence-based treatment. Conclusion When possible, health care practice should be evidence-based. When this is not possible, health care providers must turn to the art of medicine by using consensus-based best practices. Further, it is important for policymakers and researchers to work in concert to develop EBPs that are practical and meet needs.

Prescription errors in the National Health Services, time to change practice.

PubMed

Hamid, Tahir; Harper, Luke; Rose, Samman; Petkar, Sanjive; Fienman, Richard; Athar, Syed M; Cushley, Michael

2016-02-01

Medication error is a major source of iatrogenic illness. Error in prescription is the most common form of avoidable medication error. We present our study, performed at two, UK, National Health Services Hospitals. The prescription practice of junior doctor's working on general medical and surgical wards in National Health Service District General and University Teaching Hospitals in the UK was reviewed. Practice was assessed against standard hospital prescription charts, developed in accordance with local pharmacy guidance. A total of 407 prescription charts were reviewed in both initial audit and re-audit one year later. In the District General Hospital, documentation of allergy, weight and capital-letter prescription was achieved in 31, 5 and 40% of charts, respectively. Forty-nine per cent of discontinued prescriptions were properly deleted and signed for. In re-audit significant improvement was noted in documentation of the patient's name 100%, gender 54%, allergy status 51% and use of generic drug name 71%. Similarly, in the University Teaching Hospital, 82, 63 and 65% compliance was achieved in documentation of age, generic drug name prescription and capital-letter prescription, respectively. Prescription practice was reassessed one year later after recommendations and changes in the prescription practice, leading to significant improvement in documentation of unit number, generic drug name prescription, insulin prescription and documentation of the patient's ward. Prescription error remains an important, modifiable form of medical error, which may be rectified by introducing multidisciplinary assessment of practice, nationwide standardised prescription charts and revision of current prescribing clinical training. © The Author(s) 2016.

Work stress prevention needs of employees and supervisors.

PubMed

Havermans, Bo M; Brouwers, Evelien P M; Hoek, Rianne J A; Anema, Johannes R; van der Beek, Allard J; Boot, Cécile R L

2018-05-21

Work stress prevention can reduce health risks for individuals, as well as organisational and societal costs. The success of work stress interventions depends on proper implementation. Failure to take into account the needs of employees and supervisors can hinder intervention implementation. This study aimed to explore employee and supervisor needs regarding organisational work stress prevention. Semi-structured telephone interviews were conducted with employees (n = 7) and supervisors (n = 8) from different sectors, such as the finance, health care, and services industry. The interviews focused on respondents' needs regarding the prevention of work stress within an organisational setting. Performing thematic analysis, topics and themes were extracted from the verbatim transcribed interviews using Atlas.ti. Both employees and supervisors reported a need for: 1) communication about work stress, 2) attention for determinants of work stress, 3) supportive circumstances (prerequisites) for work stress prevention, 4) involvement of various stakeholders in work stress prevention, and 5) availability of work stress prevention measures. Both employees and supervisors expressed the need for supervisors to communicate about work stress. Employees and supervisors reported similar psychosocial work factors that should be targeted for prevention (e.g., social support and autonomy). There was greater variety in the sub-themes within communication about work stress and supportive circumstances for work stress prevention in supervisor responses, and greater variety in the sub-themes within availability of work stress prevention measures in employee responses. Both employees and supervisors were explicit about who should take part in communication about work stress, what prerequisites for work stress prevention should exist, and which stakeholders should be involved. These results can inform work stress prevention practice, supporting selection and implementation of interventions. This study was registered in the Netherlands National Trial Register, trial code: NTR5527 .

A framework provided an outline toward the proper evaluation of potential screening strategies.

PubMed

Adriaensen, Wim J; Matheï, Cathy; Buntinx, Frank J; Arbyn, Marc

2013-06-01

Screening tests are often introduced into clinical practice without proper evaluation, despite the increasing awareness that screening is a double-edged sword that can lead to either net benefits or harms. Our objective was to develop a comprehensive framework for the evaluation of new screening strategies. Elaborating on the existing concepts proposed by experts, a stepwise framework is proposed to evaluate whether a potential screening test can be introduced as a screening strategy into clinical practice. The principle of screening strategy evaluation is illustrated for cervical cancer, which is a template for screening because of the existence of an easily detectable and treatable precursor lesion. The evaluation procedure consists of six consecutive steps. In steps 1-4, the technical accuracy, place of the test in the screening pathway, diagnostic accuracy, and longitudinal sensitivity and specificity of the screening test are assessed. In steps 5 and 6, the impact of the screening strategy on the patient and population levels, respectively, is evaluated. The framework incorporates a harm and benefit trade-off and cost-effectiveness analysis. Our framework provides an outline toward the proper evaluation of potential screening strategies before considering implementation. Copyright © 2013 Elsevier Inc. All rights reserved.

The 5S lean method as a tool of industrial management performances

NASA Astrophysics Data System (ADS)

Filip, F. C.; Marascu-Klein, V.

2015-11-01

Implementing the 5S (seiri, seiton, seiso, seiketsu, and shitsuke) method is carried out through a significant study whose purpose to analyse and deployment the management performance in order to emphasize the problems and working mistakes, reducing waste (stationary and waiting times), flow transparency, storage areas by properly marking and labelling, establishing standards work (everyone knows exactly where are the necessary things), safety and ergonomic working places (the health of all employees). The study describes the impact of the 5S lean method implemented to storing, cleaning, developing and sustaining a production working place from an industrial company. In order to check and sustain the 5S process, it is needed to use an internal audit, called “5S audit”. Implementing the 5S methodology requires organization and safety of the working process, properly marking and labelling of the working place, and audits to establish the work in progress and to maintain the improved activities.

40 CFR 82.34 - Prohibitions and required practices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... promulgated under § 82.32(e)(2) of this subpart B; or (ii) (A) Recovered using approved refrigerant recycling... MVAC or MVAC-like appliance, properly using approved refrigerant recycling equipment in accordance with...

40 CFR 82.34 - Prohibitions and required practices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... promulgated under § 82.32(e)(2) of this subpart B; or (ii) (A) Recovered using approved refrigerant recycling... MVAC or MVAC-like appliance, properly using approved refrigerant recycling equipment in accordance with...

40 CFR 82.34 - Prohibitions and required practices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... promulgated under § 82.32(e)(2) of this subpart B; or (ii) (A) Recovered using approved refrigerant recycling... MVAC or MVAC-like appliance, properly using approved refrigerant recycling equipment in accordance with...

40 CFR 82.34 - Prohibitions and required practices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... promulgated under § 82.32(e)(2) of this subpart B; or (ii) (A) Recovered using approved refrigerant recycling... MVAC or MVAC-like appliance, properly using approved refrigerant recycling equipment in accordance with...

40 CFR 82.34 - Prohibitions and required practices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... promulgated under § 82.32(e)(2) of this subpart B; or (ii) (A) Recovered using approved refrigerant recycling... MVAC or MVAC-like appliance, properly using approved refrigerant recycling equipment in accordance with...

Evaluation of a Training Program to Reduce Stressful Trunk Postures in the Nursing Professions: A Pilot Study.

PubMed

Kozak, Agnessa; Freitag, Sonja; Nienhaus, Albert

2017-01-01

The aim of this pilot study was to evaluate metrologically the effectiveness of a training program on the reduction of stressful trunk postures in geriatric nursing professions. A training program, consisting of instruction on body postures in nursing, practical ergonomic work methods at the bedside or in the bathroom, reorganization of work equipment, and physical exercises, was conducted in 12 wards of 6 nursing homes in Germany. The Computer-Assisted Recording and Long-Term Analysis of Musculoskeletal Loads (CUELA) measurement system was used to evaluate all movements and trunk postures adopted during work before and 6 months after the training program. In total, 23 shifts were measured. All measurements were supported by video recordings. A specific software program (WIDAAN 2.75) was used to synchronize the measurement data and video footage. The median proportion of time spent in sagittal inclinations at an angle of >20° was significantly reduced (by 29%) 6 months after the intervention [from 35.4% interquartile range (27.6-43.1) to 25.3% (20.7-34.1); P < 0.001]. Very pronounced inclinations exceeding 60° [2.5% (1.1-4.6) to 1.0% (0.8-1.7); P = 0.002] and static inclinations of over 20° for >4 s [4.4% (3.0-6.7) to 3.6% (2.5-4.5); P < 0.001] were significantly reduced, by 60% and 22%, respectively. Video analysis showed that in 49% of care situations, ergonomic measures were implemented properly, either at the bedside or in the bathroom. Stressful trunk postures could be significantly reduced by raising awareness of the physical strains that frequently occur during a shift, by changes in work practices and by redesigning the work environment. Workplace interventions aimed at preventing or reducing low back pain in nursing personnel would probably benefit from sensitizing employees to their postures during work. © The Author 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Impact of role-, job- and organizational characteristics on Nursing Unit Managers' work related stress and well-being.

PubMed

Van Bogaert, Peter; Adriaenssens, Jef; Dilles, Tinne; Martens, Daisy; Van Rompaey, Bart; Timmermans, Olaf

2014-11-01

To study the impact of role, job- and organizational characteristics on nurse managers' work related stress and well-being such as feelings of emotional exhaustion, work engagement, job satisfaction and turnover intention. Various studies investigated role-, job- and organizational characteristics influencing nurse-related work environments. Research on nurse managers' related work environments define influencing factors, but, a clear understanding of the impact of nurse-managers' work-environment characteristics on their work related stress and well-being is limited. A cross-sectional design with a survey. A cross-sectional survey (N = 365) was carried out between December 2011-March 2012. The questionnaire was based on various validated measurement instruments identified by expert meetings (e.g. staff nurses, nurse managers and executives and physicians). Hierarchical regression analyses were performed using emotional exhaustion, work engagement, job satisfaction and turnover intentions as outcome variables. Study results showed one out of six nursing unit managers have high to very high feelings of emotional exhaustion and two out of three respondents have high to very high work engagement. Hierarchical regression models showed that role conflict and role meaningfulness were strong predictors of nursing unit managers' work related stress and well-being, alongside with job- and organizational characteristics. Several risk factors and stimulating factors influencing nurse unit managers' work related stress and well-being were identified. Further challenges will be to develop proper interventions and strategies to support nursing unit managers and their team in daily practice to deliver the best and safest patient care. © 2014 John Wiley & Sons Ltd.

Work-related musculoskeletal disorders among dental professionals in Saudi Arabia

PubMed Central

Alghadir, Ahmad; Zafar, Hamayun; Iqbal, Zaheen A.

2015-01-01

[Purpose] Musculoskeletal disorders are common causes of work-related disability in different professions involving the frequent practice of lifting, stooping, twisting, prolonged sitting, or standing. The dental profession is one such profession. Our aim was to determine the prevalence of work-related musculoskeletal disorders among dental professionals in Saudi Arabia, the factors associated with them, and their consequences and to propose preventive measures for them. [Subjects and Methods] A self-administered online questionnaire was sent to 225 members of the Saudi Dental Association. It included questions on demographic and professional characteristics, general medical history, and history of work-related musculoskeletal disorders before and after joining the dental profession. [Results] The questionnaire was completed by 65% of the respondents. Among them 85% reported that they had developed some pain due to work after joining the dental profession, and 42% reported that they were suffering pain at the time of the survey. Besides lower back, shoulder, and neck regions, the hands, upper back, and other regions like the elbows, buttocks, thighs, leg, and feet were areas in which they pain. [Conclusion] The prevalence of work-related musculoskeletal disorders among dental professionals in Saudi Arabia is high, affecting their daily activities, sometimes even forcing them to change their work setting. Age, gender, specialty of work, work setting, number of contact hours with patients, etc., were all found to be related to their work-related pain. We need to emphasize the role of ergonomics, counseling, proper techniques of patient handling, etc., during the training of dental professionals so that they can work efficiently. PMID:25995567

29 CFR 778.318 - Productive and nonproductive hours of work.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Special Problems Effect of Failure to Count Or Pay for Certain Working Hours § 778.318 Productive and... Act; such nonproductive working hours must be counted and paid for. (b) Compensation payable for... which such nonproductive hours are properly counted as working time but no special hourly rate is...

Architectures for paediatric palliative care: how to improve quality of life and environmental well-being.

PubMed

Gola, Marco; Francalanza, Paolo Carlo; Galloni, Giulio; Pagella, Bianca; Capolongo, Stefano

2016-01-01

The influence of the environment on wellness, not only for patients themselves but for all care-givers as well, refers to the humanisation principles of spaces of care. Commencing with an analysis of existing paediatric hospices, the paper examines design suggestions for prosthetic environments, considered as a fundamental component in the healing process. A prosthetic environment can be created only through a specific knowledge of the real needs of users. Therefore, some scholars have conducted research work for defining the best practices for healing environments, supported by an assessment and comparison of case studies. The methodology is based on two phases: the first is based on interviews with experts in hospice design and management and the second, through the application of a questionnaire to several users. Discussion and Results. The output of the work is the achievement of a logical, sequential and participatory broad-spectrum process in the design of health facilities in order to cause a sustainable awareness in paediatric hospices. Starting from the research work, it is necessary to define a scientific method for implementing knowledge on health, psychological, perceptual and behavioural needs to contribute towards proper planning for meeting the real requirements of users.

Preliminary model and validation of molten carbonate fuel cell kinetics under sulphur poisoning

NASA Astrophysics Data System (ADS)

Audasso, E.; Nam, S.; Arato, E.; Bosio, B.

2017-06-01

MCFC represents an effective technology to deal with CO2 capture and relative applications. If used for these purposes, due to the working conditions and the possible feeding, MCFC must cope with a different number of poisoning gases such as sulphur compounds. In literature, different works deal with the development of kinetic models to describe MCFC performance to help both industrial applications and laboratory simulations. However, in literature attempts to realize a proper model able to consider the effects of poisoning compounds are scarce. The first aim of the present work is to provide a semi-empirical kinetic formulation capable to take into account the effects that sulphur compounds (in particular SO2) have on the MCFC performance. The second aim is to provide a practical example of how to effectively include the poisoning effects in kinetic models to simulate fuel cells performances. To test the reliability of the proposed approach, the obtained formulation is implemented in the kinetic core of the SIMFC (SIMulation of Fuel Cells) code, an MCFC 3D model realized by the Process Engineering Research Team (PERT) of the University of Genova. Validation is performed through data collected at the Korea Institute of Science and Technology in Seoul.

Infection control in design and construction work.

PubMed

Collinge, William H

2015-01-01

To clarify how infection control requirements are represented, communicated, and understood in work interactions through the medical facility construction project life cycle. To assist project participants with effective infection control management by highlighting the nature of such requirements and presenting recommendations to aid practice. A 4-year study regarding client requirement representation and use on National Health Service construction projects in the United Kingdom provided empirical evidence of infection control requirement communication and understanding through design and construction work interactions. An analysis of construction project resources (e.g., infection control regulations and room data sheets) was combined with semi-structured interviews with hospital client employees and design and construction professionals to provide valuable insights into the management of infection control issues. Infection control requirements are representationally indistinct but also omnipresent through all phases of the construction project life cycle: Failure to recognize their nature, relevance, and significance can result in delays, stoppages, and redesign work. Construction project resources (e.g., regulatory guidance and room data sheets) can mask or obscure the meaning of infection control issues. A preemptive identification of issues combined with knowledge sharing activities among project stakeholders can enable infection control requirements to be properly understood and addressed. Such initiatives should also reference existing infection control regulatory guidance and advice. © The Author(s) 2015.

Legal changes necessitate proactive management of Musculoskeletal Disorders: the role of electrodiagnostic functional assessment Soft Tissue Management program.

PubMed

Cusimano-Reaston, MaryRose; Carney, Brendan

2011-01-01

Musculoskeletal Disorders (MSD) often classified as sprains and strains to the low back, neck, shoulder or knee are the leading cost drivers in the workers compensation system. In 2009, soft tissue muscle injuries accounted for 40% of total injury cases requiring days away from work. The demand on U.S. employers to comply with all applicable mandates has exponentially increased as the regulatory landscape grows more complex evidenced by recent legislation from Equal Employment Opportunity Commission (EEOC), American With Disability Act 2.0 and Center for Medicare and Medicaid Services (CMS) Mandatory Reporting Act. Employers should revisit their return to work policies and engage in the interactive process to stay in compliance and avoid legal quagmire. EFA Soft Tissue Management (STM) is a comprehensive and compliant risk management program for objective diagnosis of work-related injuries that directs timely and proper allocation of resources to optimize injured worker (IW) outcomes. This bookend solution comparing pre- and post-loss data is a best practice to accurately determine between compensable acute workplace injury and exacerbation of a preexisting injury from chronic unrelated conditions. The EFA is an evidenced-based objective tool to assist in measuring functional status of the IW and make return to work determinations.

The German medical dissertation--time to change?

PubMed

Diez, C; Arkenau, C; Meyer-Wentrup, F

2000-08-01

German medical students must conduct a research project and write a dissertation in order to receive the title "Doctor." However, the dissertation is not required to graduate, enter a residency, or practice medicine. About 90% of practicing physicians hold the title "Doctor"; a career in academic medicine almost always requires it. Although no convincing evidence supports the usefulness of the dissertation, many regard its completion as important to maintaining a high level of scientific competence and patient care. In recent years, the number of successfully completed dissertations has declined. Lack of time during medical school, the perceived irrelevance of the dissertation to medical practice, and the poor design of many projects may be at least part of the problem. There is also increasing evidence that conducting research frequently delays graduation and may affect clinical skills because students working on projects attend fewer classes, ward rounds, and clinical tutorials and do not spent sufficient time preparing for examinations. The scientific value of students' research has also been criticized; critics point out that students do not have enough time or experience to critically analyze methods and data, and they often are not properly supervised. European unification will probably lead to standardized requirements for medical education and research. The authors hope this will eliminate the dissertation requirement in Germany.

Breastfeeding and Weaning: Practices in Urban Slums of Southern Punjab, Pakistan

PubMed Central

Ahmed, Khalil; Khalid, Zainab; Khurshid, Mehvish; Ishtiaq, Rizwan

2018-01-01

Objective Proper breastfeeding and weaning practices are effective ways of reducing childhood morbidity and mortality. This study aimed to find out breastfeeding and weaning practices among infants of six months to one year in urban slums of Bahawalpur city. By evaluating the knowledge and attitude of lactating mothers regarding their child feeding habits, modifications and specific interventions can be implemented to improve the breastfeeding and weaning practices of the area. Methods A cross-sectional descriptive study was carried out in the Shahdrah slums of Bahawalpur City after getting approval from the institutional review board of Quaid-e-Azam Medical College, Bahawalpur. The survey was conducted from April 10, 2017 to May 30, 2017. One hundred mothers of infants aging six months to one year of age were interviewed. Mothers filled a customized questionnaire, consisting of questions about logistic variables, breastfeeding, and weaning. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 22.0 (IBM Corp. Armonk, NY, USA). Results The mean age of the women was 24+2 years. It was found that 74% (n=74) of the mothers had one to three children, 85% (n=85) of the mothers were breastfeeding their infants at the time of the study, 40% (n=40) of the mothers were illiterate, 16% (n=16) of the mothers had secondary education, and 87% (n=87) of the mothers were nonworking women. Out of 85 women who were breastfeeding, 95% (n=80) of the women were 18-23 years of age. We found that 57% (n=57) of the infants were six to nine months old and the remaining 43% (n=43) were up to 12 months of age. Regarding the initiation of breastfeeding, 60% of the females started soon after delivery, and 32% started within two to seven days. We found that 70% (9/13) of the working women and 87.4% (76/87) of the non-working women were breastfeeding. The study found that 92.3% (12/13) of the working women and 88.5% (77/87) of the non-working women were weaning. Conclusion A majority of the mothers were breastfeeding and weaning their babies. The factors documented were young age, low parity, no working status, and nuclear families. The commonly used feeding materials were cereals, banana, rice, and bread. No side effects of weaning were observed. Weaning was associated by late age, parity, non-working status, educational status of father, and nuclear families. PMID:29662728

40 CFR 133.105 - Treatment equivalent to secondary treatment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... through proper operation and maintenance of the treatment works, based on an analysis of the past... treatment works, considering the design capability of the treatment process and geographical and climatic...

Broadening the Cloaking Bandwidth with Non-Foster Metasurfaces

NASA Astrophysics Data System (ADS)

Chen, Pai-Yen; Argyropoulos, Christos; Alù, Andrea

2013-12-01

We introduce the concept and practical design of broadband, ultrathin cloaks based on non-Foster, negatively capacitive metasurfaces. By using properly tailored, active frequency-selective screens conformal to an object, within the realm of a practical realization, we show that it is possible to drastically reduce the scattering over a wide frequency range in the microwave regime, orders of magnitude broader than any available passive cloaking technology. The proposed active cloak may impact not only invisibility and camouflaging, but also practical antenna and sensing applications.

Advancing Long Tail Data Capture and Access Through Trusted, Community-Driven Data Services at the IEDA Data Facility

NASA Astrophysics Data System (ADS)

Lehnert, K. A.; Carbotte, S. M.; Ferrini, V.; Hsu, L.; Arko, R. A.; Walker, J. D.; O'hara, S. H.

2012-12-01

Substantial volumes of data in the Earth Sciences are collected in small- to medium-size projects by individual investigators or small research teams, known as the 'Long Tail' of science. Traditionally, these data have largely stayed 'in the dark', i.e. they have not been properly archived, and have therefore been inaccessible and underutilized. The primary reason has been the lack of appropriate infrastructure, from adequate repositories to resources and support for investigators to properly manage their data, to community standards and best practices. Lack of credit for data management and for the data themselves has contributed to the reluctance of investigators to share their data. IEDA (Integrated Earth Data Applications), a NSF-funded data facility for solid earth geoscience data, has developed a comprehensive suite of data services that are designed to address the concerns and needs of investigators. IEDA's data publication service registers datasets with DOI and ensures their proper citation and attribution. IEDA is working with publishers on advanced linkages between datasets in the IEDA repository and scientific online articles to facilitate access to the data, enhance their visibility, and augment their use and citation. IEDA's investigator support ranges from individual support for data management to tools, tutorials, and virtual or face-to-face workshops that guide and assist investigators with data management planning, data submission, and data documentation. A critical aspect of IEDA's concept has been the disciplinary expertise within the team and its strong liaison with the science community, as well as a community-based governance. These have been fundamental to gain the trust and support of the community that have lead to significantly improved data preservation and access in the communities served by IEDA.

Effectiveness of GNSS disposal strategies

NASA Astrophysics Data System (ADS)

Alessi, E. M.; Rossi, A.; Valsecchi, G. B.; Anselmo, L.; Pardini, C.; Colombo, C.; Lewis, H. G.; Daquin, J.; Deleflie, F.; Vasile, M.; Zuiani, F.; Merz, K.

2014-06-01

The management of the Global Navigation Satellite Systems (GNSS) and of the Medium Earth Orbit (MEO) region as a whole is a subject that cannot be deferred, due to the growing exploitation and launch rate in that orbital regime. The advent of the European Galileo and the Chinese Beidou constellations significantly added complexity to the system and calls for an adequate global view on the four constellations present in operation. The operation procedures, including maintenance and disposal practices, of the constellations currently deployed were analyzed in order to asses a proper reference simulation scenario. The complex dynamics of the MEO region with all the geopotential and lunisolar resonances was studied to better identify the proper end-of-life orbit for every proposed strategy, taking into account and, whenever possible, exploiting the orbital dynamics in this peculiar region of space. The possibility to exploit low thrust propulsion or non gravitational perturbations with passive de-orbiting devices (and a combination of the two) was analyzed, in view of possible applications in the design of the future generations of the constellations satellites. Several upgrades in the long-term evolution software SDM and DAMAGE were undertaken to properly handle the constellation simulations in every aspect from constellation maintenance to orbital dynamics. A thorough approach considering the full time evolving covariance matrix associated with every object was implemented in SDM to compute the collision risk and associated maneuver rate for the constellation satellites. Once the software upgrades will be completed, the effectiveness of the different disposal strategies will be analyzed in terms of residual collision risk and avoidance maneuvers rate. This work was performed under the ESA/GSP Contract no. 4000107201/12/F/MOS.

78 FR 57421 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-18

... information collection is necessary for the proper performance of the functions of the agency, including... benefits are payable to qualified female employees if they are unable to work, or if working would be...

Chemical Safety Alert: Catastrophic Failure of Storage Tanks

EPA Pesticide Factsheets

Aboveground, atmospheric storage tanks can fail when flammable vapors in the tank explode and break either the shell-to-bottom or side seam, resulting in hazardous release accidents. Proper maintenance practices can help prevent accidents.

Library Professionalism and the Democratic Way.

ERIC Educational Resources Information Center

Meyer, Richard W.

1980-01-01

Advocates pursuit of service to the public rather than autonomy of practice as the proper professional goal of librarians. This article explores the tensions between professional attributes and the bureaucratic demands of the organizational environment. (Author/RAA)

Analysis of United States Air Forces Central Government Purchase Card Reachback Viability

DTIC Science & Technology

2011-12-01

Phase 1: Mobilization and Initial Deployment ................................38  2.  Phase 2: Joint Reception , Staging, Onward Movement, and...the theory into practice. By creating a test cell, efficiencies, best practices, proper funding, and appropriate manning can be analyzed. Second... Reception , Staging, Onward Movement, and Integration Phase 2 (better known as the buildup phase) is characterized by the reception and bed-down of the

Logos: the emblem in the marketing wars.

PubMed

Chan, S D

1994-07-01

The logo is a powerful marketing tool. It is a condensed form of communication for a selected niche in a mass audience. Effective logo design principles include considerations of art design, visual perception, memory retention, and succinct nonverbal communication. Design principles for logos for dental practices are presented. Dental practices may realize significant advantages if logos are properly conceived and executed and are creatively implemented.

Tracking data in the office environment.

PubMed

Erickson, Ty B

2010-09-01

Data tracking in the office setting focuses on a narrow spectrum of the entire patient safety arena; however, when properly executed, data tracking increases staff members' awareness of the importance of patient safety. Data tracking is also a high-volume event and thereby continues to loop back on the consciousness of providers in all aspects of their practice. Improvement in date tracking will improve the collateral areas of patient safety such as proper medication usage, legibility of written communication, effective delegation of patient safety initiatives, and a collegial effort at developing teams for safety design processes.

The proper care and feeding of administrators. How to bridge individual performance and organizational effectiveness? Start by caring for your professional self.

PubMed

Pope, Christina

2004-09-01

As many medical practice administrators focus on the proper care and feeding of their organizations, they've developed the same ailment as other "caregivers"--they tend to their own professional development and needs as an afterthought. But as any self-preserving caregiver can tell you, nurturing yourself actually helps those you serve. How should administrators balance and respond to their own goals and preferences and their organization's needs--while anticipating changes in the broader environment?

Health hazard evaluation report HETA 80-008-1546, BASF Wyandotte Corporation, Rensselaer, New York

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

Gordon, J.E.; Taylor, P.; Hearn, S.

A health hazard evaluation at BASF Wyandotte Corporation (SIC-2810, SIC-2820, SIC-2880, SIC-2870), Rensselaer, New York was conducted. The evaluation was requested by a union representative because of adverse pregnancy outcomes among workers involved in the manufacture of 3,5-dinitro-N-4N-4-dipropylsulfanilamide (19044883) (oryzalin). All persons employed from January 1, 1972 through December 31, 1980 were identified from company records. Birth, fetal, and death records were obtained from the State of New York. The authors conclude that workers who were involved in manufacturing oryzalin sired offspring having an unusual cluster of birth defects, especially those of the heart. Whether these were the result ofmore » occupational exposure cannot be decisively determined. Implementing proper engineering and work practice controls is recommended.« less

ISS Benefits for Humanity: Train Like an Astronaut

NASA Image and Video Library

2015-01-29

Published on Jan 29, 2015 Developed in cooperation with NASA scientists and fitness professionals working directly with astronauts, the Train Like an Astronaut program is an exciting and engaging way to get the children of today up and moving. The project uses the excitement of exploration to challenge students to set physical fitness and research goals, practice physical fitness activities, and research proper nutrition, enabling each child to become our next generation of fit explorers! The International Space Station is a blueprint for global cooperation and scientific advancements, a destination for a growing commercial marketplace in low-Earth orbit and a test bed for demonstrating new technologies. The space station is the springboard to NASA’s next great leap in exploration, including future missions to an asteroid and Mars. For more information: http://go.nasa.gov/1zhkuW9

The opto-mechanical design process: from vision to reality

NASA Astrophysics Data System (ADS)

Kvamme, E. Todd; Stubbs, David M.; Jacoby, Michael S.

2017-08-01

The design process for an opto-mechanical sub-system is discussed from requirements development through test. The process begins with a proper mission understanding and the development of requirements for the system. Preliminary design activities are then discussed with iterative analysis and design work being shared between the design, thermal, and structural engineering personnel. Readiness for preliminary review and the path to a final design review are considered. The value of prototyping and risk mitigation testing is examined with a focus on when it makes sense to execute a prototype test program. System level margin is discussed in general terms, and the practice of trading margin in one area of performance to meet another area is reviewed. Requirements verification and validation is briefly considered. Testing and its relationship to requirements verification concludes the design process.

Efficient management of high level XMM-Newton science data products

NASA Astrophysics Data System (ADS)

Zolotukhin, Ivan

2015-12-01

Like it is the case for many large projects, XMM-Newton data have been used by the community to produce many valuable higher level data products. However, even after 15 years of the successful mission operation, the potential of these data is not yet fully uncovered, mostly due to the logistical and data management issues. We present a web application, http://xmm-catalog.irap.omp.eu, to highlight an idea that existing public high level data collections generate significant added research value when organized and exposed properly. Several application features such as access to the all-time XMM-Newton photon database and online fitting of extracted sources spectra were never available before. In this talk we share best practices we worked out during the development of this website and discuss their potential use for other large projects generating astrophysical data.

Current biomedical waste management practices and cross-infection control procedures of dentists in India.

PubMed

Singh, Balendra Pratap; Khan, Suleman A; Agrawal, Neeraj; Siddharth, Ramashanker; Kumar, Lakshya

2012-06-01

To investigate the knowledge, attitudes and behaviour of dentists working in dental clinics and dental hospitals regarding biomedical waste management and cross-infection control. A national survey was conducted. Self-administered questionnaires were sent to 800 dentists across India. A total of 494 dentists responded, giving a response rate of 61.8%. Of these, 228 of 323 (70.6%) general dentists reported using boiling water as a sterilising medium and 339 (68.6%) dentists reported disposing of hazardous waste such as syringes, blades and ampoules in dustbins and emptying these into municipal corporation bins. Dentists should undergo continuing education programmes on biomedical waste management and infection control guidelines. Greater cooperation between dental clinics and hospitals and pollution control boards is needed to ensure the proper handling and disposal of biomedical waste. © 2012 FDI World Dental Federation.

Food safety knowledge, attitudes and practices of institutional food-handlers in Ghana.

PubMed

Akabanda, Fortune; Hlortsi, Eli Hope; Owusu-Kwarteng, James

2017-01-06

In large scale cooking, food is handled by many individuals, thereby increasing the chances of food contamination due to improper handling. Deliberate or accidental contamination of food during large scale production might endanger the health of consumers, and have very expensive repercussions on a country. The purpose of this study was to evaluate the food safety knowledge, attitudes, and practices among institutional food- handlers in Ghana. The study was conducted using a descriptive, cross-sectional survey of 29 institutions by conducting face to face interview and administration of questionnaire to two hundred and thirty-five (235) institutional food-handlers. The questionnaire was peer-reviewed and pilot tested in three institutions in the Upper East Region of Ghana, before the final version was distributed to food-handlers. The questionnaire was structured into five distinctive parts to collect information on (i) demographic characteristics, (ii) employees' work satisfaction, (iii) knowledge on food safety, (iv) attitudes towards food safety and (v) food hygiene practices. Majority of the food-handlers were between 41-50 years (39.1%). Female respondents were (76.6%). In our study, the food-handlers were knowledgeable about hygienic practices, cleaning and sanitation procedures. Almost all of the food-handlers were aware of the critical role of general sanitary practices in the work place, such as hand washing (98.7% correct answers), using gloves (77.9%), proper cleaning of the instruments/utensils (86.4%) and detergent use (72.8%). On disease transmission, the results indicates that 76.2% of the food- handlers did not know that Salmonella is a food borne pathogens and 70.6% did not know that hepatitis A is a food borne pathogen. However, 81.7% handlers agreed that typhoid fever is transmitted by food and 87.7% agreed that bloody diarrhea is transmitted by food. Logistic regression analysis testing four models showed statistically significant differences (p < 0.05), for models in which the explanatory variable was the level of education. In generally, the institutional food-handlers have satisfactory knowledge in food safety but this does not translate into strict hygienic practices during processing and handling food products.

Evidence-based communications strategies: NWPERLC response to training on effectively reaching limited English-speaking (LEP) populations in emergencies.

PubMed

DʼAmbrosio, Luann; Huang, Claire E; Sheng Kwan-Gett, Tao

2014-01-01

Identifying and overcoming barriers to effective emergency preparedness and response is one of the objectives for the Centers for Disease Control and Prevention's network of 14 Preparedness and Emergency Response Learning Centers (PERLCs) and 9 Preparedness and Response Research Centers (PERRCs). This report describes how a PERLC and a PERRC colocated at the Northwest Center for Public Health Practice responded to Los Angeles County Department of Public Health's (DPH's) request to improve emergency communications with limited English-proficient (LEP) populations. Activities included an assessment of training needs of the DPH preparedness workforce, a training series on social media and community engagement, and a toolkit of evidence-based findings to improve LEP populations' emergency communications and community resilience. Most respondents to the training needs assessment considered themselves essential personnel during an emergency and stated that they have received proper training. Respondents would like to receive further emergency preparedness training, including additional clarity on their role during an emergency. The majority of participants rated the training series as excellent/very good and agreed that they will be able to apply the course content to their work. The percentage of participants who reported confidence in their knowledge and skills related to each course learning objective increased from the precourse survey to the postcourse survey. This article discusses how the colocation of PERRC and PERLC offers efficiencies and expertise to accomplish multicomponent evidence-based requests. The ability to translate research findings quickly into evidence-based training and best practice resources is a strategic benefit to public health practice agencies working on emergency preparedness. LA County DPH was able to use knowledge and lessons learned gained from this work to design and prioritize education and training offerings to improve the capacity to effectively engage and communicate with LEP communities before and during public health emergencies.

Commissioning medical education: principles for best practice.

PubMed

Walsh, Kieran

2016-04-01

We need to ensure that we get value for money for our investments in medical education. Commissioning is one method of ensuring that we get value. However, like any other tool, it needs to be used properly.

Network system effects of mileage fee.

DOT National Transportation Integrated Search

2015-08-01

This project presents a comprehensive investigation about the network effects of MF to facilitate the : developments of proper MF policies. After a practice scan and a review of the recent literature on MF, a multi-class mathematical programming with...

Food allergy: practical approach on education and accidental exposure prevention.

PubMed

Pádua, I; Moreira, A; Moreira, P; Barros, R

2016-09-01

Food allergies are a growing problem and currently the primary treatment of food allergy is avoidance of culprit foods. However, given the lack of information and education and also the ubiquitous nature of allergens, accidental exposures to food allergens are not uncommon. The fear of potential fatal reactions and the need of a proper avoidance leads in most of the cases to the limitation of leisure and social activities. This review aims to be a practical approach on education and accidental exposure prevention regarding activities like shopping, eating out, and travelling. The recommendations are focused especially on proper reading of food labels and the management of the disease, namely in restaurants and airplanes, concerning cross-contact and communication with other stakeholders. The implementation of effective tools is essential to manage food allergy outside home, avoid serious allergic reactions and minimize the disease's impact on individuals' quality of life.

Interiors, intentions, and the "spirituality" of Islamic ritual practice.

PubMed

Powers, Paul R

2004-01-01

The Arabic term niyya (intention) is prominent in texts of Islamic ritual law. Muslim jurists require niyya in the "heart" during such ritual duties as prayer, fasting, and pilgrimage. Western scholars often treat niyya as a "spiritual" component of Islamic ritual. Muslim jurists, however, consistently treat niyya as a formal, taxonomic matter, a mental focus that makes a given act into the specific named duty required by religious law. Although the effort to thrust niyya into a "spiritual" role is meant to defend Islam from charges of "empty ritualism," it subtly reinforces the characterization of Islam as rigidly legalistic. Much scholarship on niyya belies the scholars' own definition of "proper religion" centered on an inner, individual, nonmaterial dimension of the self. Instead of trying to wash away the formalism of niyya, I argue that scholars ought to recognize that such embodied practices are properly religious rather than spiritually defective.

Judicial virtues and decision-making in the VCAT Guardianship List.

PubMed

Polkinghorn, Richard

2014-06-01

The contemporary legal theory of virtue jurisprudence provides great insight into the proper practice of Australian tribunal members and the desired operation of tribunals. Virtue jurisprudence identifies the attributes of "good" tribunal members and provides guidance on how legal disputes should be decided. This article focuses on the fundamental virtues relevant to tribunal practice in the Guardianship List of the Victorian Civil and Administrative Tribunal. The special features of this tribunal jurisdiction, particularly the disadvantaged nature of its primary client group, require tribunal members to undertake a fact-finding, inquisitorial role, as well as a support and advisory role. Decision-makers must also become conversant with expert evidence and the process of testing expert evidence; they cannot simply defer to the expert on issues of decision-making capacity. This analysis considers the fundamental breaches of human rights that occur when tribunal members fail to execute this multilevel task properly.

Estimation variance bounds of importance sampling simulations in digital communication systems

NASA Technical Reports Server (NTRS)

Lu, D.; Yao, K.

1991-01-01

In practical applications of importance sampling (IS) simulation, two basic problems are encountered, that of determining the estimation variance and that of evaluating the proper IS parameters needed in the simulations. The authors derive new upper and lower bounds on the estimation variance which are applicable to IS techniques. The upper bound is simple to evaluate and may be minimized by the proper selection of the IS parameter. Thus, lower and upper bounds on the improvement ratio of various IS techniques relative to the direct Monte Carlo simulation are also available. These bounds are shown to be useful and computationally simple to obtain. Based on the proposed technique, one can readily find practical suboptimum IS parameters. Numerical results indicate that these bounding techniques are useful for IS simulations of linear and nonlinear communication systems with intersymbol interference in which bit error rate and IS estimation variances cannot be obtained readily using prior techniques.

Medical deontology, meetings, journals, candidacy for higher posts and how to better enjoy life.

PubMed

Grammaticos, Philip C

2014-01-01

Unfortunately, today few physicians care about medical deontology and medical ethics, that is how to behave and respect others when exercising our medical profession. Some of us may not show the care and kindness we should show towards our students or the due respect to our senior colleagues. Occasionally, when examining our patients we may not pay the proper attention to their problems, being tired from work overload. Another issue of deontology is medical meetings. Do they offer us enough knowledge or mainly pleasure? Is our curriculum vitae comprised by useful to society and to medicine original or confirmatory research work? Few examples to illustrate what the situation is at present are included in this paper. Our financial success in practice should not compete with the "old" Hippocratic oath and ideals. The pursuit of happiness in our life is not achieved through untruthfulness, dishonesty or only high financial status. "The Lancet"mentioned long ago (1969; September 27; 681-4) a phrase by John Keats: "Truth is beauty‥this only exists on Earth and this is what we need to know".

Solvent containing processes and work practices: environmental observations

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

Kalliokoski, P.

1986-01-01

Even though there has been a shift toward water-based or fully solid systems, organic solvents still comprise a significant occupational health hazard. Fortunately, exposure levels can nowadays be effectively controlled by proper enclosures and ventilation in most remaining applications of organic solvents, and, generally taken, the development of occupational health conditions has been favorable on the workplaces using organic solvents. When as many as 24.2% of the 2639 solvent measurements carried out by the Institute of Occupational Health in Finland exceeded the occupational health standards between 1971 and 1976, such non-compliance levels were detected only in 3.0% of the 2823more » samples taken between 1977 and 1980. The persons dealing with occupational health problems in workplaces should also be aware of the possible existence of solvent misuse. This may not develop into the level of solvent sniffing, but into a milder addiction. The workers adopt working habits that cause unnecessary exposure. Repeatedly found exceptionally high concentration levels in biological exposure tests are an indication of a possible abuse. 25 references.« less

Teacher Research Experiences: Impacting and Benefiting Teacher Professional Development and School-wide Practices (Invited)

NASA Astrophysics Data System (ADS)

Manning, C. B.

2013-12-01

Providing authentic research opportunities is a potent form of professional development that significantly impacts teaching practices. The University of Rhode Island's ARMADA Project (2003-2010) was funded by the National Science Foundation to create opportunities for teachers to work with marine science researchers and implement best-practices in their classrooms. In early 2009, I participated in a 6-week research experience that has changed how I teach and how I learn. On board the R/V Knorr, I worked as a sedimentologist with an international crew who used geophysics, geochemistry, microbiology and geology to understand the controls on and distribution of subseafloor microbial life in the equatorial Pacific. This experience has affected my educational practices in two ways: (1) motivating me to fill gaps in my own understanding of natural chemical processes, and (2) prioritizing authentic research opportunities for all students at my school. My participation in the ARMADA project underscored the importance of an interdisciplinary approach to research. The team of scientists exposed me to a variety of topics. Biochemistry and the role of redox reactions in biological systems were relatively new to me. Scientists encouraged me to dig deeper into the chemical systems that we were researching. Through self-study and coursework focusing on biogeochemical cycles, deriving energy through chemical processes, and atmospheric chemistry, I have learned much of the chemistry that I am now expected to teach in my courses. I continue to seek out opportunities to learn more and am currently volunteering at geochemistry laboratories at the USGS. My ARMADA research experience depended on teamwork. I learned that while the dynamics of research teams can be simplified if the teams are carefully designed, it is important that students need to learn to work with a variety of people in different situations. Therefore, in my courses, students work in different teams to design and conduct research projects. Currently, I work with other science teachers creating student-driven research opportunities that involve designing and carrying out experiments, reading scientific literature, and evaluating evidence. Depending on the grade level, students also work across disciplines with teachers in English, Math, and Social Studies to develop research projects, report on results and evaluate the work of other student groups. My ARMADA experience emphasized the importance of ensuring that students understand and implement proper protocols, value academic integrity, and civic responsibility. In our program, students learn valuable teamwork and leadership skills, build on experiences from one year to the next, and develop a sense of pride in their own learning endeavors. While we do not expect every student to pursue a STEM career, we do expect our students to think critically, solve problems in a logical manner, and invest in their own creativity.

On the road

MedlinePlus

... alert and aware of their surroundings. Keep your car in good working order You may think of a car as simply a way to get from Point A to Point B, but cars need regular care to work properly. Make sure ...

33 CFR 150.607 - What are the general safe working requirements?

Code of Federal Regulations, 2012 CFR

2012-07-01

... machinery, cranes, derricks, portable power tools, and, most importantly, safety gear must be used in a safe... subchapter. (b) All machinery and equipment must be maintained in proper working order or removed. Personal...

33 CFR 150.607 - What are the general safe working requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... machinery, cranes, derricks, portable power tools, and, most importantly, safety gear must be used in a safe... subchapter. (b) All machinery and equipment must be maintained in proper working order or removed. Personal...

33 CFR 150.607 - What are the general safe working requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... machinery, cranes, derricks, portable power tools, and, most importantly, safety gear must be used in a safe... subchapter. (b) All machinery and equipment must be maintained in proper working order or removed. Personal...

The prevalence of occupational health-related problems in dentistry: A review of the literature

PubMed Central

Naidoo, Saloshni; van Wyk, Jacqueline

2017-01-01

The study was conducted to report on the scope and prevalence of occupational health related-problems experienced by dentists, dental therapists, and oral hygienists in their practice of dentistry. Background: Professional practice and dental training have many risk factors, and the dental team should be able to recognize these factors to protect themselves. The prevalence of conditions related to the musculoskeletal system, stress, percutaneous injuries, ears, and eyes are of concern. The dental team should also not forget hepatitis B, hepatitis C, and HIV as risks in practice. Dental practitioners should protect themselves by self-recognizing risk factors and by maintaining proper working conditions. Methods: The study targeted all empirical research, case studies, and systematic literature reviews written in English. All articles selected were subjected to a data analysis process. Data were captured on an Excel spreadsheet and reported in a comprehensive table. Results: The literature addressing occupational health among dental practitioners included mainly cross-sectional studies and review papers (2001-2016). Forty-nine studies were included in the review. Musculoskeletal disorders remain the most researched occupational health-related problems in dentistry. Eye protection compliance was low among practitioners. Percutaneous injuries especially among young dentists and students were still a concern. Conclusion: Occupational health-related problems are still prevalent in current dentistry practice, despite changes in equipment and surgery design. The reported prevalence of occupational related-health problems and other findings of investigative studies highlight the need for continuous professional education and a need to improve clinical practice aspects of dentistry curricula. PMID:29213011

[System of biometric identification: by the way of control].

PubMed

Simões, José Augusto

2011-01-01

The ethics and morals make the line between lawful to unlawful, the right and wrong, acceptable from the unacceptable. Furthermore the purpose of ethics in the field of profesional practice is, in particular the application of moral standards based on honesty, courtesy and honour. But they are not the only ones. Confidentiality should be the first of duties the professional has no right to disclose information that was only reported in their work and because it was necessary to run it. This requirement aims to protect the recipient of the service and avoid damage to society. The professional should also encourage members of his team, because solidarity is a very effective way to improve the intellectual and moral qualities of work partners and ensure their involvement. When you have an honest professional conduct within and outside of professional practice, you attract confidence and prestige, which is an incentive to drive, with safety, the proper course of his career. The purpose of the biometric control based on the need to expedite the fulfilment of a goal whose integration is recognized by law under the control of the employer's: the setting of working hours, monitoring the attendance and registration of working time. This record is also the accounting and control of additional work. To consider the biometric control as an appropriate mean to ensure a «legitimate purpose», the Law 67/98 requires the National Commission for Data Protection, in each case, to ascertain whether the prevailing interests the rights and freedoms guarantees data subjects on the interest for the treatment of data relied upon by the employer. This procedure seems to be the best fit to the principle of proportionality and therefore the processing of data should be refused where it appears unjustified, inappropriate and excessive, or when, by their lack of reliability, it undermines the purpose of determining it.

Oral hygiene teaching in clinical activities at the Department of Dentistry of Dakar (Senegal).

PubMed

Massamba, Diouf; Adama, Faye; Daouda, Faye; Daouda, Cissé; Lo Cheikh, M M

2010-06-01

The aim of this study was to assess the attitudes and practices of students related to oral hygiene teaching by mean of a questionnaire submitted to patients attending the clinics of the Department of Dentistry of Dakar. A KPC study (Knowledge, Practices and Coverage) focusing on dental students was conducted and consists on a interview of 295 patients. The socio-demographic and brushing method variables involved the patients. While those related to attitudes and practices regarding oral hygiene teaching concerned only students. The tests at the univariate and multivariate analysis by logistic regression were significant when P < 0.05. The study population consisted of 48.5% of men, 76.6% were adults. 32.9% of patients came from the Conservative Dentistry and Endodontic (CDE) clinic and 5.4% of them from Orthodontic clinic. For 52.2% of patients, no prophylactic measure was laid and the link with the proper brushing technique of patients was significant (OR = 4.4). Using supports at time of oral hygiene teaching was respected for 17.4% of cases. It was associated with proper brushing technique even after adjustment. The attitudes and practices of students in Dentistry Department of Dakar in relation to oral hygiene teaching deserves more vigilant in watching over the prophylactic care and using supports during oral hygiene teaching.

European consensus conference on faecal microbiota transplantation in clinical practice.

PubMed

Cammarota, Giovanni; Ianiro, Gianluca; Tilg, Herbert; Rajilić-Stojanović, Mirjana; Kump, Patrizia; Satokari, Reetta; Sokol, Harry; Arkkila, Perttu; Pintus, Cristina; Hart, Ailsa; Segal, Jonathan; Aloi, Marina; Masucci, Luca; Molinaro, Antonio; Scaldaferri, Franco; Gasbarrini, Giovanni; Lopez-Sanroman, Antonio; Link, Alexander; de Groot, Pieter; de Vos, Willem M; Högenauer, Christoph; Malfertheiner, Peter; Mattila, Eero; Milosavljević, Tomica; Nieuwdorp, Max; Sanguinetti, Maurizio; Simren, Magnus; Gasbarrini, Antonio

2017-04-01

Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance. In view of this, an evidence-based recommendation is needed to drive the practical implementation of FMT. In this European Consensus Conference, 28 experts from 10 countries collaborated, in separate working groups and through an evidence-based process, to provide statements on the following key issues: FMT indications; donor selection; preparation of faecal material; clinical management and faecal delivery and basic requirements for implementing an FMT centre. Statements developed by each working group were evaluated and voted by all members, first through an electronic Delphi process, and then in a plenary consensus conference. The recommendations were released according to best available evidence, in order to act as guidance for physicians who plan to implement FMT, aiming at supporting the broad availability of the procedure, discussing other issues relevant to FMT and promoting future clinical research in the area of gut microbiota manipulation. This consensus report strongly recommends the implementation of FMT centres for the treatment of C. difficile infection as well as traces the guidelines of technicality, regulatory, administrative and laboratory requirements. 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/.

Design and analysis of group-randomized trials in cancer: A review of current practices.

PubMed

Murray, David M; Pals, Sherri L; George, Stephanie M; Kuzmichev, Andrey; Lai, Gabriel Y; Lee, Jocelyn A; Myles, Ranell L; Nelson, Shakira M

2018-06-01

The purpose of this paper is to summarize current practices for the design and analysis of group-randomized trials involving cancer-related risk factors or outcomes and to offer recommendations to improve future trials. We searched for group-randomized trials involving cancer-related risk factors or outcomes that were published or online in peer-reviewed journals in 2011-15. During 2016-17, in Bethesda MD, we reviewed 123 articles from 76 journals to characterize their design and their methods for sample size estimation and data analysis. Only 66 (53.7%) of the articles reported appropriate methods for sample size estimation. Only 63 (51.2%) reported exclusively appropriate methods for analysis. These findings suggest that many investigators do not adequately attend to the methodological challenges inherent in group-randomized trials. These practices can lead to underpowered studies, to an inflated type 1 error rate, and to inferences that mislead readers. Investigators should work with biostatisticians or other methodologists familiar with these issues. Funders and editors should ensure careful methodological review of applications and manuscripts. Reviewers should ensure that studies are properly planned and analyzed. These steps are needed to improve the rigor and reproducibility of group-randomized trials. The Office of Disease Prevention (ODP) at the National Institutes of Health (NIH) has taken several steps to address these issues. ODP offers an online course on the design and analysis of group-randomized trials. ODP is working to increase the number of methodologists who serve on grant review panels. ODP has developed standard language for the Application Guide and the Review Criteria to draw investigators' attention to these issues. Finally, ODP has created a new Research Methods Resources website to help investigators, reviewers, and NIH staff better understand these issues. Published by Elsevier Inc.

Ethics and transparent risk communication start with proper risk assessment methodologies

NASA Astrophysics Data System (ADS)

Oboni, Franco; Oboni, Cesar

2014-05-01

We will use throught this paper a "dialogue" between two professionals. One is aware of the misleading character of many risk assessments and wants to foster better approaches. A discomforting set of statements sets the background of the "story": public reactions to risk assessments are generally negative, the developer find it difficult to understand the reasons for general public negative reactions, many projects get often rejected without valid reasons by the public, anywhere in the world. Common practice approaches in Risk Assessment are discussed from the angle of public rejection, taking into account various studies that explicitly expose common practices limitations and voids. The hiatus between rational and well-balanced risk assessments and common practices is explored. Finally solutions to overcome the limitations of common practices and deliver to the public more realistic risk assessment on which to build a widespread consensus are reviewed. The paper conclusions relate to the need of: properly communicating risk throughout the life of a project, from cradle to grave, avoiding conflict of interest, having estimates that are understandable to foster good understanding of what a risk assessment can bring to better Human existence, in an ethical and fair way. The paper delivers a list of possible remedies and shows that "Common Practices" do not equate to "Best Practices": common practices are not to be proposed/used any longer if we want to avoid public distrust and misrepresentations. Many of the "modern" issues ranging from public distrust to insurance denial could be relieved or mitigated ahead of time if misrepresentation was kept at bay using five simple rules. Common practice Risk Assessments, especially those developed under conflict of interest situations, generally misrepresent risks and fail to give the "big picture", hence do not help taking valid decision and are prone to generating/fostering public distrust.

30 CFR 57.11027 - Scaffolds and working platforms.

Code of Federal Regulations, 2010 CFR

2010-07-01

... condition. Floorboards shall be laid properly and the scaffolds and working platform shall not be overloaded... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Scaffolds and working platforms. 57.11027 Section 57.11027 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND...

Fee-for-service as a business model of growing importance: the academic biobank experience.

PubMed

McDonald, Sandra A; Sommerkamp, Kara; Egan-Palmer, Maureen; Kharasch, Karen; Holtschlag, Victoria

2012-10-01

Biorepositories offer tremendous scientific value to a wide variety of customer groups (academic, commercial, industrial) in their ability to deliver a centralized, standardized service model, encompassing both biospecimen storage and related laboratory services. Generally, the scientific expertise and economies of scale that are offered in centralized, properly resourced research biobanks has yielded value that has been well-recognized by universities, pharmaceutical companies, and other sponsoring institutions. However, like many facets of the economy, biobanks have been under increasing cost pressure in recent years. This has been a particular problem in the academic arena, where direct support from grant sources (both governmental and philanthropic) typically now is more difficult to secure, or provides reduced financial support, relative to previous years. One way to address this challenge is to establish or enhance a well-defined fee-for-service model which is properly calibrated to cover operational costs while still offering competitive value to users. In this model, customers are never charged for the biospecimens themselves, but rather for the laboratory services associated with them. Good communication practices, proper assessment of value, implementation of best practices, and a sound business plan are all needed for this initiative to succeed. Here we summarize our experiences at Washington University School of Medicine in the expectation they will be useful to others.

Ensuring a Safe Technological Revolution

DTIC Science & Technology

2016-12-01

Defense AT&L: November-December 2016 14 Ensuring a Safe Technological Revolution William E. Frazier, Ph.D. n Elizabeth L. McMichael n Jennifer...for 5 years, working on nonferrous welding and AM and has an M.S. in Mechanical Engineering from the University of Maryland, Baltimore County. I n...has acceptable proper- ties. A “certified” part can perform properly in its operating environment . The conventional qualification/certification

Initiation of traditional birth attendants and their traditional and spiritual practices during pregnancy and childbirth in Ghana.

PubMed

Aziato, Lydia; Omenyo, Cephas N

2018-03-07

Prior to the advent of modern obstetric services, traditional birth attendants (TBAs) have rendered services to pregnant women and women in labour for a long time. Although it is anticipated that women in contemporary societies will give birth in hospitals and clinics, some women still patronize the services of TBAs. The study therefore sought to gain an in-depth understanding of the initiation of TBAs and their traditional and spiritual practices employed during pregnancy and childbirth in Ghana. The design was an exploratory qualitative one using in-depth individual interviews. Data saturation was reached with 16 participants who were all of Christian faith. Interviews were conducted with a semi-structured interview guide, audiotaped and transcribed verbatim. Content analysis was employed to generate findings. The findings showed that TBAs were initiated through apprenticeship from family members who were TBAs and other non-family TBAs as well as through dreams and revelations. They practice using both spiritual and physical methods and their work was founded on spiritual directions, use of spiritual artefacts, herbs and physical examination. TBAs delay cutting of the cord and disposal of the placenta was associated with beliefs which indicated that when not properly disposed, it will have negative consequences on the child during adulthood. Although, TBAs like maternal health professionals operate to improve maternal health care, some of their spiritual practices and beliefs may pose threats to their clients. Nonetheless, with appropriate initiation and training, they can become useful.

[Airborne asbestos fibers: law references, TLV, considerations].

PubMed

Massola, A

2003-01-01

The ACGIH proposal of 0.1 fibers/liter as TLV for airborne asbestos fibers isn't a properly parameter, because it is applicable in work environments and the Italian legislation has forbidden every work which employs asbestos from 1993 [Law 257/92 and Min.Dec. 6/9/94]. Actually in Italy the application of a TLV is only referred to two analytical results: A) 20 ff/liter by CPOM analysis, B) 2 ff/liter by SEM analysis. We think that a CPOM 4-5 ff/liter is a no trespassing limit and over this concentration alarm may be notified. Waste disposal of asbestos materials must be properly disposed in a restricted area.

Osteodistraction With Dental Implant-Borne Devices for Bone Regeneration in Atrophied Premaxilla.

PubMed

Carlino, Francesco; Villani, Gian Piero; Berti, Andrea; Pantaleo, Giuseppe; Cortese, Antonio; Claudio, Pier Paolo

2016-11-01

Aim of this work is to present the evolution of an innovative technique for tooth/implant supported bone distraction, leading to proper oral rehabilitation in patients with atrophic alveolar bone, even when a complete premaxilla expansion is needed, or in patients in whom implants were already present, but inserted in wrong position.Distraction osteogenesis was selected because of its moderate invasiveness, the few surgical steps needed, and the proper cost/benefits balance. This procedure is particularly suited for young patients with remarkable aesthetic demands related to active social and working life, as for elderly patients expecting lower surgical stress and risks.

Visualizing time: how linguistic metaphors are incorporated into displaying instruments in the process of interpreting time-varying signals

NASA Astrophysics Data System (ADS)

Garcia-Belmonte, Germà

2017-06-01

Spatial visualization is a well-established topic of education research that has allowed improving science and engineering students' skills on spatial relations. Connections have been established between visualization as a comprehension tool and instruction in several scientific fields. Learning about dynamic processes mainly relies upon static spatial representations or images. Visualization of time is inherently problematic because time can be conceptualized in terms of two opposite conceptual metaphors based on spatial relations as inferred from conventional linguistic patterns. The situation is particularly demanding when time-varying signals are recorded using displaying electronic instruments, and the image should be properly interpreted. This work deals with the interplay between linguistic metaphors, visual thinking and scientific instrument mediation in the process of interpreting time-varying signals displayed by electronic instruments. The analysis draws on a simplified version of a communication system as example of practical signal recording and image visualization in a physics and engineering laboratory experience. Instrumentation delivers meaningful signal representations because it is designed to incorporate a specific and culturally favored time view. It is suggested that difficulties in interpreting time-varying signals are linked with the existing dual perception of conflicting time metaphors. The activation of specific space-time conceptual mapping might allow for a proper signal interpretation. Instruments play then a central role as visualization mediators by yielding an image that matches specific perception abilities and practical purposes. Here I have identified two ways of understanding time as used in different trajectories through which students are located. Interestingly specific displaying instruments belonging to different cultural traditions incorporate contrasting time views. One of them sees time in terms of a dynamic metaphor consisting of a static observer looking at passing events. This is a general and widespread practice common in the contemporary mass culture, which lies behind the process of making sense to moving images usually visualized by means of movie shots. In contrast scientific culture favored another way of time conceptualization (static time metaphor) that historically fostered the construction of graphs and the incorporation of time-dependent functions, as represented on the Cartesian plane, into displaying instruments. Both types of cultures, scientific and mass, are considered highly technological in the sense that complex instruments, apparatus or machines participate in their visual practices.

75 FR 34684 - Notice of Request for Extension of a Currently Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

... information is necessary for the proper performance of the functions of RBS, including whether the information will have practical utility; (b) the accuracy of the RBS' estimate of the burden of the proposed...

278. Photocopied July 1978. NOTICE TO MINE EMPLOYEES, CITIZENS AND ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

278. Photocopied July 1978. NOTICE TO MINE EMPLOYEES, CITIZENS AND NON-CITIZENS, ADVISING THEM OF ACCEPTABLE BEHAVIOR AND PROPER SHOP PRACTICES DURING WARTIME. WRITTEN IN SIX LANGUAGES. C. 1918. - Quincy Mining Company, Hancock, Houghton County, MI

Prevention in practice – a summary.

PubMed Central

2015-01-01

Background This paper is a summary document of the Prevention in Practice Conference and Special Supplement of BMC Oral Health. It represents the consensus view of the presenters and captures the questions, comments and suggestions of the assembled audience. Methods Using the prepared manuscripts for the conference, collected materials from scribes during the conference and additional resources collated in advance of the meeting, authors agreed on the summary document. Results The Prevention in Practice conference aimed to collate information about which diseases could be prevented in practice, how diseases could be identified early enough to facilitate prevention, what evidence based therapies and treatments were available and how, given the collective evidence, could these be introduced in general dental practice within different reimbursement models. Conclusions While examples of best practice were provided from both social care and insurance models it was clear that further work was required on both provider and payer side to ensure that evidence based prevention was both implemented properly but also reimbursed sufficiently. It is clear that savings can be made but these must not be overstated and that the use of effective skill mix would be key to realizing efficiencies. The evidence base for prevention of caries and periodontal disease has been available for many years, as have the tools and techniques to detect, diagnose and stage the diseases appropriately. Dentistry finds itself in a enviable position with respect to its ability to prevent, arrest and reverse much of the burden of disease, however, it is clear that the infrastructure within primary care must be changed, and practitioners and their teams appropriately supported to deliver this paradigm shift from a surgical to a medical model. PMID:26391906

Clinical and diagnostic aspects of lymphedema.

PubMed

Keo, Hong H; Gretener, Silvia B; Staub, Daniel

2017-07-01

Lymphedema is a chronic, progressive, and common but often unrecognized condition. The diagnosis of lymphatic disease on clinical grounds alone remains a challenge. Without proper diagnosis, therapy is often delayed, allowing disease progression. There is a need for a practical diagnostic algorithm and its imaging technique to guide clinical decision-making. The aim of this topical review is to provide a practical approach for assessing patients with suspected lymphedema and to give a critical appraisal of currently available imaging modalities that are applied in clinical practice to diagnose and map lymphatic disease.

Implementing AORN recommended practices for minimally invasive surgery: part I.

PubMed

Morton, Paula J

2012-09-01

This article focuses on the patient safety aspects of the revised AORN "Recommended practices for minimally invasive surgery" (MIS). Key considerations include ensuring proper fluid management practices, assessing patients for risk factors related to MIS, implementing precautions for electrosurgery, planning for risks related to MIS, and assessing patients postoperatively for potential complications related to MIS. Collaboration and collegiality among members of the surgical team are essential for ensuring all pertinent aspects of care are recognized and considered. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

APIC position paper: safe injection, infusion, and medication vial practices in health care.

PubMed

Dolan, Susan A; Felizardo, Gwenda; Barnes, Sue; Cox, Tracy R; Patrick, Marcia; Ward, Katherine S; Arias, Kathleen Meehan

2010-04-01

Outbreaks involving the transmission of bloodborne pathogens or other microbial pathogens to patients in various types of health care settings due to unsafe injection, infusion, and medication vial practices are unacceptable. Each of the outbreaks could have been prevented by the use of proper aseptic technique in conjunction with basic infection prevention practices for handling parenteral medications, administration of injections, and procurement and sampling of blood. This document provides practice guidance for health care facilities on essential safe injection, infusion, and vial practices that should be consistently implemented in such settings. 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Forum for Injection Technique and Therapy Expert Recommendations, India: The Indian Recommendations for Best Practice in Insulin Injection Technique, 2017

PubMed Central

Tandon, Nikhil; Kalra, Sanjay; Balhara, Yatan Pal Singh; Baruah, Manash P.; Chadha, Manoj; Chandalia, Hemraj B.; Prasanna Kumar, K. M.; Madhu, S. V.; Mithal, Ambrish; Sahay, Rakesh; Shukla, Rishi; Sundaram, Annamalai; Unnikrishnan, Ambika G.; Saboo, Banshi; Gupta, Vandita; Chowdhury, Subhankar; Kesavadev, Jothydev; Wangnoo, Subhash K.

2017-01-01

Health-care professionals in India frequently manage injection or infusion therapies in persons with diabetes (PWD). Patients taking insulin should know the importance of proper needle size, correct injection process, complication avoidance, and all other aspects of injection technique from the first visit onward. To assist health-care practitioners in their clinical practice, Forum for Injection Technique and Therapy Expert Recommendations, India, has updated the practical advice and made it more comprehensive evidence-based best practice information. Adherence to these updated recommendations, learning, and translating them into clinical practice should lead to effective therapies, improved outcomes, and lower costs for PWD. PMID:28670547

78 FR 52564 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Survey of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-23

... primary indicator of national progress in providing every working man and woman safe and healthful working...: Evaluate whether the proposed collection of information is necessary for the proper performance of the...

Low-order modelling of shallow water equations for sensitivity analysis using proper orthogonal decomposition

NASA Astrophysics Data System (ADS)

Zokagoa, Jean-Marie; Soulaïmani, Azzeddine

2012-06-01

This article presents a reduced-order model (ROM) of the shallow water equations (SWEs) for use in sensitivity analyses and Monte-Carlo type applications. Since, in the real world, some of the physical parameters and initial conditions embedded in free-surface flow problems are difficult to calibrate accurately in practice, the results from numerical hydraulic models are almost always corrupted with uncertainties. The main objective of this work is to derive a ROM that ensures appreciable accuracy and a considerable acceleration in the calculations so that it can be used as a surrogate model for stochastic and sensitivity analyses in real free-surface flow problems. The ROM is derived using the proper orthogonal decomposition (POD) method coupled with Galerkin projections of the SWEs, which are discretised through a finite-volume method. The main difficulty of deriving an efficient ROM is the treatment of the nonlinearities involved in SWEs. Suitable approximations that provide rapid online computations of the nonlinear terms are proposed. The proposed ROM is applied to the simulation of hypothetical flood flows in the Bordeaux breakwater, a portion of the 'Rivière des Prairies' located near Laval (a suburb of Montreal, Quebec). A series of sensitivity analyses are performed by varying the Manning roughness coefficient and the inflow discharge. The results are satisfactorily compared to those obtained by the full-order finite volume model.

Determining bonding, thickness, and density via thermal wave impedance NDE

NASA Technical Reports Server (NTRS)

Green, D. R.

1985-01-01

Bonding, density, and thickness of coatings have a vital effect on their performance in many applications. Pioneering development work on thermal wave nondestructive evaluation (NDE) methods during the past 25 years has resulted in an array of useful techniques for performing bonding, density, and thickness measurements in a practical shop environment. The most useful thermal wave methods for this purpose are based on thermal wave surface impedance measurement or scanning. A pulse of heat from either a thermal transducer or a hot gas pulse is projected onto the surface, and the resulting temperature response is analyzed to unfold the bonding, density, and thickness of the coating. An advanced emissivity independent infrared method was applied to detect the temperature response. These methods were recently completely computerized and can automatically provide information on coating quality in near real-time using the proper equipment. Complex shapes such as turbine blades can be scanned. Microscopic inhomogeneities such as microstructural differences and small, normal, isolated voids do not cause problems but are seen as slight differences in the bulk thermal properties. Test objects with rough surfaces can be effectively nondestructively evaluated using proper thermal surface impedance methods. Some of the basic principles involved, as well as metallographic results illustrating the ability of the thermal wave surface impedance method to detect natural nonbonds under a two-layer thermally sprayed coating, will be presented.

Inhaler technique: facts and fantasies. A view from the Aerosol Drug Management Improvement Team (ADMIT).

PubMed

Levy, Mark L; Dekhuijzen, P N R; Barnes, P J; Broeders, M; Corrigan, C J; Chawes, B L; Corbetta, L; Dubus, J C; Hausen, Th; Lavorini, F; Roche, N; Sanchis, J; Usmani, Omar S; Viejo, J; Vincken, W; Voshaar, Th; Crompton, G K; Pedersen, Soren

2016-04-21

Health professionals tasked with advising patients with asthma and chronic obstructive pulmonary disease (COPD) how to use inhaler devices properly and what to do about unwanted effects will be aware of a variety of commonly held precepts. The evidence for many of these is, however, lacking or old and therefore in need of re-examination. Few would disagree that facilitating and encouraging regular and proper use of inhaler devices for the treatment of asthma and COPD is critical for successful outcomes. It seems logical that the abandonment of unnecessary or ill-founded practices forms an integral part of this process: the use of inhalers is bewildering enough, particularly with regular introduction of new drugs, devices and ancillary equipment, without unnecessary and pointless adages. We review the evidence, or lack thereof, underlying ten items of inhaler 'lore' commonly passed on by health professionals to each other and thence to patients. The exercise is intended as a pragmatic, evidence-informed review by a group of clinicians with appropriate experience. It is not intended to be an exhaustive review of the literature; rather, we aim to stimulate debate, and to encourage researchers to challenge some of these ideas and to provide new, updated evidence on which to base relevant, meaningful advice in the future. The discussion on each item is followed by a formal, expert opinion by members of the ADMIT Working Group.

An adaptive model order reduction by proper snapshot selection for nonlinear dynamical problems

NASA Astrophysics Data System (ADS)

Nigro, P. S. B.; Anndif, M.; Teixeira, Y.; Pimenta, P. M.; Wriggers, P.

2016-04-01

Model Order Reduction (MOR) methods are employed in many fields of Engineering in order to reduce the processing time of complex computational simulations. A usual approach to achieve this is the application of Galerkin projection to generate representative subspaces (reduced spaces). However, when strong nonlinearities in a dynamical system are present and this technique is employed several times along the simulation, it can be very inefficient. This work proposes a new adaptive strategy, which ensures low computational cost and small error to deal with this problem. This work also presents a new method to select snapshots named Proper Snapshot Selection (PSS). The objective of the PSS is to obtain a good balance between accuracy and computational cost by improving the adaptive strategy through a better snapshot selection in real time (online analysis). With this method, it is possible a substantial reduction of the subspace, keeping the quality of the model without the use of the Proper Orthogonal Decomposition (POD).

Methane Leakage from Natural Gas Systems: Comparisons, Communication, and Policy Relevance (Invited)

NASA Astrophysics Data System (ADS)

Weber, C.; Clavin, C.; Mueller, K. L.

2013-12-01

Increases in domestic natural gas production from shale gas and tight oil resources have ignited a scientific and policy debate about the climate implications of increasing levels of natural gas utilization on a national and global scale. The debate has primarily centered on characterizing the life-cycle greenhouse gas emissions associated with natural gas electricity generation or transportation. As such, there has been significant recent attention to estimating upstream methane and CO2 emissions from natural gas production, processing, transmission, and distribution using either bottom-up inventory or top-down atmospheric methods ranging from regional to global scales. Due to the general scarcity of measured data, the highly variable production practices of the oil & gas industry, and the different geological conditions under which the industry operates, determining methane emissions (sometimes calculated as a 'leakage rate') and overall climate impact over a policy-relevant spatial and temporal scale has been highly challenging. This unsettled state of the science exists as energy and climate policy decisions are being made in tandem with scientific knowledge generation, while at the same time production practices continue to change in a quickly innovating industry. This research critically reviews the work to date on quantifying methane leakage and life-cycle greenhouse gas implications of unconventional onshore oil & gas compared to other fuels such as coal. We take the perspective of a national-level U.S. decision-maker and ask how different methods (inventories, device-level measurements, regional and national inversions) can contribute to the information needed to make informed energy and climate policy decision regarding unconventional resources. Different methods have different strengths, weaknesses, and uncertainties, and such differences must be accounted for properly to ensure usefulness. We find that most work to date has suffered from one or more of several flaws that decrease the policy applicability of scientific results. These include inconsistent metric definitions (particularly related to the 'methane leakage' metric), inconsistent comparisons between studies with different scopes and temporal and spatial boundaries, and a failure to properly distinguish between emissions associated with oil, gas, and other co-products. We conclude that in order for policy decisions to be made in the needed timeframe given the current speed of development, scientists from different communities must work together to develop common strategies for communicating results and interpreting differences between highly different methods. This represents a significant challenge but one that is imperative for atmospheric scientists, engineers, and policy analysts to jointly solve in order to better inform national energy policy needs.

Hierarchical hybrid control of manipulators: Artificial intelligence in large scale integrated circuits

NASA Technical Reports Server (NTRS)

Greene, P. H.

1972-01-01

Both in practical engineering and in control of muscular systems, low level subsystems automatically provide crude approximations to the proper response. Through low level tuning of these approximations, the proper response variant can emerge from standardized high level commands. Such systems are expressly suited to emerging large scale integrated circuit technology. A computer, using symbolic descriptions of subsystem responses, can select and shape responses of low level digital or analog microcircuits. A mathematical theory that reveals significant informational units in this style of control and software for realizing such information structures are formulated.

Asteroid proper elements and secular resonances

NASA Technical Reports Server (NTRS)

Knezevic, Zoran; Milani, Andrea

1992-01-01

In a series of papers (e.g., Knezevic, 1991; Milani and Knezevic, 1990; 1991) we reported on the progress we were making in computing asteroid proper elements, both as regards their accuracy and long-term stability. Additionally, we reported on the efficiency and 'intelligence' of our software. At the same time, we studied the associated problems of resonance effects, and we introduced the new class of 'nonlinear' secular resonances; we determined the locations of these secular resonances in proper-element phase space and analyzed their impact on the asteroid family classification. Here we would like to summarize the current status of our work and possible further developments.

Pros and cons of practice-owned and office-based ambulatory surgery centers.

PubMed

Bert, J M

2000-01-01

A detailed feasibility analysis is imperative to ensure the success of a practice-owned ASC. Analysis of the payer mix and the market relating to surgical volume that can be performed at the ASC is imperative. If overbuilding, overequipping, and overstaffing are avoided and the group has adequate volume that can be managed at the ASC, the facility should be a success. Building a practice-owned ASC without an accurate and detailed financial feasibility and payer study can place the endeavor at risk. A well-planned, economically constructed and properly managed ASC will result in an efficient and successful ancillary service for the orthopedic group practice.

ABCs of Being Smart… P Is for Productivity

ERIC Educational Resources Information Center

Foster, Joanne

2014-01-01

In this article, the author presents pointers for--and perspectives on--pathways to productivity. The following pathways are presented and described: (1) Planning and Preparation; (2) Proper Programming; (3) Play; (4) Pay Attention; (5) Possible Problems; and (6) Practice and Persistence.

40 CFR 792.35 - Quality assurance unit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... from approved protocols or standard operating procedures were made without proper authorization and... standard operating procedures, and that the reported results accurately reflect the raw data of the study... ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 792.35 Quality...

40 CFR 792.35 - Quality assurance unit.

Code of Federal Regulations, 2011 CFR

2011-07-01

... from approved protocols or standard operating procedures were made without proper authorization and... standard operating procedures, and that the reported results accurately reflect the raw data of the study... ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 792.35 Quality...

40 CFR 792.35 - Quality assurance unit.

Code of Federal Regulations, 2012 CFR

2012-07-01

... from approved protocols or standard operating procedures were made without proper authorization and... standard operating procedures, and that the reported results accurately reflect the raw data of the study... ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 792.35 Quality...

40 CFR 792.35 - Quality assurance unit.

Code of Federal Regulations, 2014 CFR

2014-07-01

... from approved protocols or standard operating procedures were made without proper authorization and... standard operating procedures, and that the reported results accurately reflect the raw data of the study... ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 792.35 Quality...

40 CFR 792.35 - Quality assurance unit.

Code of Federal Regulations, 2013 CFR

2013-07-01

... from approved protocols or standard operating procedures were made without proper authorization and... standard operating procedures, and that the reported results accurately reflect the raw data of the study... ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 792.35 Quality...

Differential Decomposition of Bacterial and Viral Fecal Indicators in Common Human Pollution Types

EPA Science Inventory

Understanding the decomposition of microorganisms associated with different human fecal pollution types is necessary for proper implementation of many water qualitymanagement practices, as well as predicting associated public health risks. Here, thedecomposition of select cultiva...

47 CFR 1.1415 - Other orders.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Other orders. 1.1415 Section 1.1415 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Pole Attachment Complaint... as will best conduce to the proper dispatch of business and the ends of justice. ...

Practices in security and confidentiality of HIV/AIDS patients' information: A national survey among staff at HIV outpatient clinics in Vietnam.

PubMed

Khac Hai, Nguyen; Lawpoolsri, Saranath; Jittamala, Podjanee; Thi Thu Huong, Phan; Kaewkungwal, Jaranit

2017-01-01

Breach of confidentiality or invasion of privacy from the collection and use of medical records, particularly those of patients with HIV/AIDS or other diseases sensitive to stigmatization, should be prevented by all related stakeholders in healthcare settings. The main focus of this study was to assess practices regarding security and confidentiality of HIV-related information among staff at HIV outpatient clinics (HIV-OPCs) in Vietnam. A descriptive cross-sectional study was conducted at all 312 HIV-OPCs across the country using an online survey technique. In general, the staff practices for securing and protecting patient information were at acceptable levels. Most staff had proper measures and practices for maintaining data security; however, the protection of patient confidentiality, particularly for data access, sharing, and transfer still required improvement. Most HIV-OPC staff had good or moderate knowledge and positive perceptions towards security and confidentiality issues. Staff who were not trained in the practice of security measures differed significantly from those who were trained (OR: 3.74; 95%CI: 1.44-9.67); staff needing improved knowledge levels differed significantly from those with good (OR: 5.20; 95%CI: 2.39-11.32) and moderate knowledge levels (OR: 5.10; 95%CI: 2.36-11.00); and staff needing improved perception levels differed significantly from those with good (i.e., with 100% proper practices) and moderate perception levels (OR: 5.67; 95%CI: 2.93-10.95). Staff who were not trained in the protection of data confidentiality differed significantly from those who were trained (OR: 2.18; 95%CI: 1.29-3.65). Training is an important factor to help raise the levels of proper practices regarding confidentiality and security, to improve knowledge and raise awareness about change among staff. The operation and management of HIV treatment and care in Vietnam are currently transitioning from separate healthcare clinics (HIV-OPC) into units integrated into general hospitals/healthcare facilities. The findings of this study highlight topics that could be used for improving management and operation of information system and revising guidelines and regulations on protection measures/strategies for data security and confidentiality of HIV/AIDS patients by Vietnam health authorities or other countries facing similar situations. Secure infrastructure and secure measures for data access and use are very important, worthwhile investments. The provision of continuous training and active enforcement and monitoring of the practices of healthcare personnel might lead to an improved understanding and acknowledegement of the importance of national policies/guidelines regarding HIV-related patient information.

The ABC's required for establishing a practical computerized plant engineering management data base system

NASA Technical Reports Server (NTRS)

Maiocco, F. R.; Hume, J. P.

1976-01-01

A system's approach is outlined in the paper to assist facility and Plant Engineers improve their organization's data management system. The six basic steps identified may appear somewhat simple; however, adequate planning, proper resources, and the involvement of management will determine the success of a computerized facility management data base. Helpful suggestions are noted throughout the paper to insure the development of a practical computerized data management system.

The Nexus between Instructional Supervision, Supervisors' and Teachers': The Practical Paradox and Its Effect on Quality Education a Case of Woliat Zone Administration Elementary and Secondary Schools (1-8)

ERIC Educational Resources Information Center

Dea, Mulatu

2016-01-01

Even though the new instructional supervision practices materialized in the schools level, teachers were not properly supported well, so that the students achievements was decreasing in national exams than before as the regional grade report documents revealed and quality is deteriorating from time to times. Hence, the main objective of this study…

The medical content of English almanacs 1640-1700.

PubMed

Curth, Louise Hill

2005-07-01

There has been a great deal of recent interest in popular health care in early modern England, resulting in studies on a range of topics from practitioners through remedial treatment. Over the past decade, the history of books has also attracted growing interest. This is particularly true for the seventeenth century, a period marked by a dramatic rise in all types of printed works. The 1640s are especially significant in the evolution of printed vernacular medical publications, which continued to flourish during the rest of the century. While recent studies on popular medical books have contributed greatly to our understanding of contemporary medical beliefs and practices, they have failed to properly recognize the effect that almanacs had on early modern medicine. Although their primary function was not to disseminate medical information, most provided a great deal of medical information. Furthermore, these cheap, annual publications targeted and were read by a wide cross-section of the public, making them the first true form of British mass media. This article is based on the content of 1,392 almanacs printed between 1640 and 1700, which may make it the largest comparative study of the medical content of any early modern printed works. The project has resulted in two major findings. First of all, almanacs played a major part in the dissemination, continuing popularity, and longevity of traditional astrological and Galenic beliefs and practices. Secondly, at the same time, almanacs played an important early role in the growth of medical materialism in Britain.

Use cases and DEMO: aligning functional features of ICT-infrastructure to business processes.

PubMed

Maij, E; Toussaint, P J; Kalshoven, M; Poerschke, M; Zwetsloot-Schonk, J H M

2002-11-12

The proper alignment of functional features of the ICT-infrastructure to business processes is a major challenge in health care organisations. This alignment takes into account that the organisational structure not only shapes the ICT-infrastructure, but that the inverse also holds. To solve the alignment problem, relevant features of the ICT-infrastructure should be derived from the organisational structure and the influence of this envisaged ICT to the work practices should be pointed out. The objective of our study was to develop a method to solve this alignment problem. In a previous study we demonstrated the appropriateness of the business process modelling methodology Dynamic Essential Modelling of Organizations (DEMO). A proven and widely used modelling language for expressing functional features is Unified Modelling Language (UML). In the context of a specific case study at the University Medical Centre Utrecht in the Netherlands we investigated if the combined use of DEMO and UML could solve the alignment problem. The study demonstrated that the DEMO models were suited as a starting point in deriving system functionality by using the use case concept of UML. Further, the case study demonstrated that in using this approach for the alignment problem, insight is gained into the mutual influence of ICT-infrastructure and organisation structure: (a) specification of independent, re-usable components-as a set of related functionalities-is realised, and (b) a helpful representation of the current and future work practice is provided for in relation to the envisaged ICT support.

IMPROVED WELL PLUGGING EQUIPMENT AND WASTE MANGEMENT TECHNIQUES EXCEED ALARA GOALS AT THE OAK RIDGE NATIONAL LABORATORY

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

Whiteside, R.; Pawlowicz, R.; Whitehead, L.

2002-02-25

In 2000, Bechtel Jacobs Company LLC (BJC) contracted Tetra Tech NUS, Inc. (TtNUS) and their sub-contractor, Texas World Operations, Inc. (TWO), to plug and abandon (P&A) 111 wells located in the Melton Valley area of Oak Ridge National Laboratory (ORNL). One hundred and seven of those wells were used to monitor fluid movement and subsurface containment of the low level radioactive liquid waste/grout slurry that was injected into the Pumpkin Valley Shale Formation, underlying ORNL. Four wells were used as hydrofracture injection wells to emplace the waste in the shale formation. Although the practice of hydrofracturing was and is consideredmore » by many to pose no threat to human health or the environment, the practice was halted in 1982 after the Federal Underground Injection Control regulations were enacted by United States Environmental Protection Agency (USEPA) making it necessary to properly close the wells. The work is being performed for the United States Department of Energy Oak Ridge Operations (DOE ORO). The project team is using the philosophy of minimum waste generation and the principles of ALARA (As Low As Reasonably Achievable) as key project goals to minimize personnel and equipment exposure, waste generation, and project costs. Achievement of these goals was demonstrated by the introduction of several new pieces of custom designed well plugging and abandonment equipment that were tested and used effectively during field operations. Highlights of the work performed and the equipment used are presented.« less

Naval Sea Systems Command Did Not Properly Apply Guidance Regarding Contracting Officers Representatives

DTIC Science & Technology

2016-03-18

Contract _______________________________ 10 PCO and ACO Did Not Ensure Appointment of COR ________________________________________ 12 NAVSEA Did Not Properly...sample was selected, NAVSEA had issued work for 36 availabilities on the contract—obligating $102.5M. { The procuring contracting officer ( PCO ) at...Responsibilities,” Section 1.602-2, “Responsibilities,” May 29, 2014. 3 The contracting officers for the contract reviewed are the PCO at NAVSEA

Retail Deli Slicer Inspection Practices: An EHS-Net Study.

PubMed

Lipcsei, Lauren E; Brown, Laura G; Hoover, E Rickamer; Faw, Brenda V; Hedeen, Nicole; Matis, Bailey; Nicholas, David; Ripley, Danny

2018-05-01

The Centers for Disease Control and Prevention (CDC) estimates that 3,000 people die in the United States each year from foodborne illness, and Listeria monocytogenes causes the third highest number of deaths. Risk assessment data indicate that L. monocytogenes contamination of particularly delicatessen meats sliced at retail is a significant contributor to human listeriosis. Mechanical deli slicers are a major source of L. monocytogenes cross-contamination and growth. In an attempt to prevent pathogen cross-contamination and growth, the U.S. Food and Drug Administration (FDA) created guidance to promote good slicer cleaning and inspection practices. The CDC's Environmental Health Specialists Network conducted a study to learn more about retail deli practices concerning these prevention strategies. The present article includes data from this study on the frequency with which retail delis met the FDA recommendation that slicers should be inspected each time they are properly cleaned (defined as disassembling, cleaning, and sanitizing the slicer every 4 h). Data from food worker interviews in 197 randomly selected delis indicate that only 26.9% of workers ( n = 53) cleaned and inspected their slicers at this frequency. Chain delis and delis that serve more than 300 customers on their busiest day were more likely to have properly cleaned and inspected slicers. Data also were collected on the frequency with which delis met the FDA Food Code provision that slicers should be undamaged. Data from observations of 685 slicers in 298 delis indicate that only 37.9% of delis ( n = 113) had slicers that were undamaged. Chain delis and delis that provide worker training were more likely to have slicers with no damage. To improve slicer practices, food safety programs and the retail food industry may wish to focus on worker training and to focus interventions on independent and smaller delis, given that these delis were less likely to properly inspect their slicers and to have undamaged slicers.

Perception of ethical misconduct by neuropsychology professionals in Spain.

PubMed

Olabarrieta-Landa, Laiene; Romero, Alfonso Caracuel; Panyavin, Ivan; Arango-Lasprilla, Juan Carlos

2017-01-01

To examine the prevalence of perceived ethical misconduct in clinical practice, teaching, and research in the field of neuropsychology in Spain. Two hundred and fifteen self-identified mental health professionals who engage in neuropsychology practice in Spain completed an online survey from July to December of 2013. In the ethics section of the survey, participants were asked to identify if neuropsychologists they know who work in their country engaged in specific kinds of ethical misconduct. 41% reported receiving formal training in professional ethics. The clinical findings are as follows. The highest rate of perceived misconduct was found in the area of professional training and expertise, with an average of 40.7%, followed by research/publications (25.6%), clinical care (23.9%), and professional relationships (8.8%). Specifically, regarding training, over half of respondents (56.7%) know professionals who claim themselves to be neuropsychologists, even though they lack proper training or expertise and 46.0% know professionals in the field who do not have adequate training for experience to be working in the field. Regarding research/publications, 41.9% of respondents know professionals who appear as authors on publications where they have not made a significant contribution. Regarding clinical care, over one third of respondents endorse knowing professionals who (1) provide results of neuropsychological evaluations in such a way that patients or other professionals are not likely to understand (37.2%) and (2) do not have the skills or training to work with patients who are culturally different from them (34.9%). Less than half of survey respondents reported receiving ethics training. It is possible that introducing more or improved ethics courses into pre-graduate and/or graduate school curriculums, and/or requiring continuing ethics education certification may reduce perceived ethical misconduct among neuropsychological professionals in Spain.

Health Care Transition in Young Adults With Type 1 Diabetes: Perspectives of Adult Endocrinologists in the U.S.

PubMed

Garvey, Katharine C; Telo, Gabriela H; Needleman, Joseph S; Forbes, Peter; Finkelstein, Jonathan A; Laffel, Lori M

2016-02-01

Young adults with type 1 diabetes transitioning from pediatric to adult care are at risk for adverse outcomes. Our objective was to describe experiences, resources, and barriers reported by a national sample of adult endocrinologists receiving and caring for young adults with type 1 diabetes. We fielded an electronic survey to adult endocrinologists with a valid e-mail address identified through the American Medical Association Physician Masterfile. We received responses from 536 of 4,214 endocrinologists (response rate 13%); 418 surveys met the eligibility criteria. Respondents (57% male, 79% Caucasian) represented 47 states; 64% had been practicing >10 years and 42% worked at an academic center. Only 36% of respondents reported often/always reviewing pediatric records and 11% reported receiving summaries for transitioning young adults with type 1 diabetes, although >70% felt that these activities were important for patient care. While most respondents reported easy access to diabetes educators (94%) and dietitians (95%), fewer (42%) reported access to mental health professionals, especially in nonacademic settings. Controlling for practice setting and experience, endocrinologists without easy access to mental health professionals were more likely to report barriers to diabetes management for young adults with depression (odds ratio [OR] 5.3; 95% CI 3.4, 8.2), substance abuse (OR 3.5; 95% CI 2.2, 5.6), and eating disorders (OR 2.5; 95% CI 1.6, 3.8). Our findings underscore the need for enhanced information transfer between pediatric and adult providers and increased mental health referral access for young adults with diabetes post-transition. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Aspects of operational radiation protection during dismantling of nuclear facilities relevant for the estimation of internal doses.

PubMed

Labarta, T

2007-01-01

Operational radiation protection of workers during the dismantling of nuclear facilities is based on the same radiation protection principles as that applied in its exploitation period with the objective of ensuring proper implementation of the as-low-as-reasonably-achievable (ALARA) principle. These principles are: prior determination of the nature and magnitude of radiological risk; classification of workplaces and workers depending on the risks; implementation of control measures; monitoring of zones and working conditions, including, if necessary, individual monitoring. From the experiences and the lessons learned during the dismantling processes carried out in Spain, several important aspects in the practical implementation of these principles that directly influence and ensure an adequate prevention of exposures and the estimation of internal doses are pointed out, with special emphasis on the estimation of internal doses due to transuranic intakes.

A PRIM approach to predictive-signature development for patient stratification

PubMed Central

Chen, Gong; Zhong, Hua; Belousov, Anton; Devanarayan, Viswanath

2015-01-01

Patients often respond differently to a treatment because of individual heterogeneity. Failures of clinical trials can be substantially reduced if, prior to an investigational treatment, patients are stratified into responders and nonresponders based on biological or demographic characteristics. These characteristics are captured by a predictive signature. In this paper, we propose a procedure to search for predictive signatures based on the approach of patient rule induction method. Specifically, we discuss selection of a proper objective function for the search, present its algorithm, and describe a resampling scheme that can enhance search performance. Through simulations, we characterize conditions under which the procedure works well. To demonstrate practical uses of the procedure, we apply it to two real-world data sets. We also compare the results with those obtained from a recent regression-based approach, Adaptive Index Models, and discuss their respective advantages. In this study, we focus on oncology applications with survival responses. PMID:25345685

Modeling scintillator and WLS fiber signals for fast Monte Carlo simulations

NASA Astrophysics Data System (ADS)

Sánchez, F. A.; Medina-Tanco, G.

2010-08-01

In this work we present a fast, robust and flexible procedure to simulate electronic signals of scintillator units: plastic scintillator material embedded with a wavelength shifter optical fiber coupled to a photo-multiplier tube which, in turn, is plugged to a front-end electronic board. The simple rationale behind the simulation chain allows to adapt the procedure to a broad range of detectors based on that kind of units. We show that, in order to produce realistic results, the simulation parameters can be properly calibrated against laboratory measurements and used thereafter as input of the simulations. Simulated signals of atmospheric background cosmic ray muons are presented and their main features analyzed and validated using actual measured data. Conversely, for any given practical application, the present simulation scheme can be used to find an adequate combination of photo-multiplier tube and optical fiber at the prototyping stage.

Factors Affecting Medical Service Quality.

PubMed

Mosadeghrad, Ali Mohammad

2014-02-01

A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians. Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Individual, organizational and environmental factors enhance or inhibit the quality of medical services. Quality of medical services depends on the personal factors of the physician and patient, and factors pertaining to the healthcare setting and the broader environment. Differences in internal and external factors such as availability of resources, patient cooperation and collaboration among providers affect the quality of medical services and patient outcomes. Supportive leadership, proper planning, education and training and effective management of resources and processes improve the quality of medical services. This article contributes to healthcare theory and practice by developing a conceptual framework for understanding factors that influence medical services quality.

Network meta-analysis: an introduction for clinicians.

PubMed

Rouse, Benjamin; Chaimani, Anna; Li, Tianjing

2017-02-01

Network meta-analysis is a technique for comparing multiple treatments simultaneously in a single analysis by combining direct and indirect evidence within a network of randomized controlled trials. Network meta-analysis may assist assessing the comparative effectiveness of different treatments regularly used in clinical practice and, therefore, has become attractive among clinicians. However, if proper caution is not taken in conducting and interpreting network meta-analysis, inferences might be biased. The aim of this paper is to illustrate the process of network meta-analysis with the aid of a working example on first-line medical treatment for primary open-angle glaucoma. We discuss the key assumption of network meta-analysis, as well as the unique considerations for developing appropriate research questions, conducting the literature search, abstracting data, performing qualitative and quantitative synthesis, presenting results, drawing conclusions, and reporting the findings in a network meta-analysis.

Chemical dependency: an occupational hazard in the field of anaesthesia.

PubMed

Ismail, Samina

2010-10-01

The medical personnel are vulnerable to substance abuse and dependence due to ready access to substance of abuse. Addiction is considered as an occupational hazard for those involved in the practice of anaesthesia for the same reason. Substance abuse is defined as a psychosocial biogenetic disease, which results from dynamic interplay between a susceptible host and favourable environment. According to the 5th and the last National Survey on Drug Abuse (NSDA) in 1993 by Pakistan Narcotic Control, there are nearly three million drug dependants in Pakistan, but no data is available to determine the prevalence among medical or anaesthesia personnel. In order to handle the rising trend of chemical abuse, we need to have more surveys and studies on this subject, written policy and educational programme in postgraduate training with proper control and frequent checking of narcotic dispensing. Reporting of drug abuse and rehabilitation of affected doctors are areas which need to be worked upon.

[Physical projects atelier: strategy for physical resources administration learning on nursing].

PubMed

Draganov, Patricia Bover; Sanna, Maria Cristina

2011-09-01

The success of learning involves adequate strategies. Those inspired on andragogy, which is the science of teaching adults, seem to be ideal for the nursing undergraduate subject "projects", with a focus on the administration of physical resources for nursing. This study reports teaching strategies that try to estimulate the acquisition of competences that make the nurse capable of a dialogue on projects with a multiprofessional team. The strategy involved a workshop composed by four stages: reading of projects, health assistance institute (HAI) attributions, notions on physical scaling strategies and development of a glossary. The strategy, proposed by a graduate student in the subject "Strategies to the teaching of Administration", was tested through practical application, evaluated and approved by graduate students and teachers. The conditions for its implementation are working with few students, availability of proper classrooms and equipment, and partnership with HAIs.

IMMIGRATION ENFORCEMENT AND MIXED-STATUS FAMILIES: THE EFFECTS OF RISK OF DEPORTATION ON MEDICAID USE

PubMed Central

Vargas, Edward D.

2015-01-01

As Congress priorities the immigration debate on increased border security, the fate of an estimated 11 million undocumented citizens remains uncertain. Stuck in between partisan politics and practical solutions are mixed-status families in which some members of the family are U.S. citizens while other members are in the country without proper authorization. This paper, examines the relationship between risk of deportation and Medicaid use drawing from a nationally sample of mothers from the Fragile Families and Child Wellbeing Survey. These data are then merged with data from the U.S. Citizenship and Immigration Services to create a contextual risk of deportation measure. Findings suggest that an increase in risk of deportation is associated with a decrease in Medicaid use. The implications of this work have tremendous impacts for health service providers and policy makers interested in preventing and reducing health disparities in complex family structures. PMID:26435562

History of neurologic examination books

PubMed Central

2015-01-01

The objective of this study was to create an annotated list of textbooks dedicated to teaching the neurologic examination. Monographs focused primarily on the complete neurologic examination published prior to 1960 were reviewed. This analysis was limited to books with the word “examination” in the title, with exceptions for the texts of Robert Wartenberg and Gordon Holmes. Ten manuals met the criteria. Works dedicated primarily to the neurologic examination without a major emphasis on disease description or treatment first appeared in the early 1900s. Georg Monrad-Krohn's “Blue Book of Neurology” (“Blue Bible”) was the earliest success. These treatises served the important purpose of educating trainees on proper neurologic examination technique. They could make a reputation and be profitable for the author (Monrad-Krohn), highlight how neurology was practiced at individual institutions (McKendree, Denny-Brown, Holmes, DeJong, Mayo Clinic authors), and honor retiring mentors (Mayo Clinic authors). PMID:25829645

Elective induction of labor: part 2.

PubMed

Crosby, Warren

2008-12-01

The elective induction of labor has become commonplace, and many are concerned that the practice introduces risks for the woman and the fetus that would not be incurred if labor had been allowed to begin spontaneously. This second paper of a two-part communication reviews the risks and benefits of the elective induction of labor, and concludes that the risks of the induction of labor are few when the patient is properly screened medically and appropriately informed. The principal worry is a doubled risk of Cesarean delivery among primigravidas (not multiparas) in whom labor is electively induced. The benefits of selecting the date of delivery are powerful incentives for busy working women. But the benefits are primarily social, and add to the convenience of both the patient and her doctor. The risks, however, are medical, and are not confined to the pregnancy at risk. Appropriately informed consent is the key to balance the risks and benefits.

Mediation in the Belgian health care sector: analysis of a particular issue--the material scope of application of mediation.

PubMed

Derèse, Marie-Noëlle

2011-06-01

In this paper, the material scope of application of mediation regulated in the Belgian Act of August 22nd, 2002 on Patient's Rights will be discussed in detail. In accordance with this Act, a mediator only has the competence to handle patients' complaints concerning the medical and care aspects of patients' rights, such as complaints relating to informed consent, access to medical files, etc. In practice, it has been observed that issues relating to administrative matters also give rise to complaints and that some patients do not know with whom they should lodge such complaints. Some clarification is necessary for a clear and proper complaints procedure that works. One possible solution is the creation of a single institution that would be in charge of handling both kinds of complaints. Such a solution has to be enacted in accordance with Belgian federalism.

Optimizing noise control strategy in a forging workshop.

PubMed

Razavi, Hamideh; Ramazanifar, Ehsan; Bagherzadeh, Jalal

2014-01-01

In this paper, a computer program based on a genetic algorithm is developed to find an economic solution for noise control in a forging workshop. Initially, input data, including characteristics of sound sources, human exposure, abatement techniques, and production plans are inserted into the model. Using sound pressure levels at working locations, the operators who are at higher risk are identified and picked out for the next step. The program is devised in MATLAB such that the parameters can be easily defined and changed for comparison. The final results are structured into 4 sections that specify an appropriate abatement method for each operator and machine, minimum allowance time for high-risk operators, required damping material for enclosures, and minimum total cost of these treatments. The validity of input data in addition to proper settings in the optimization model ensures the final solution is practical and economically reasonable.

Automatic exposure control for space sequential camera

NASA Technical Reports Server (NTRS)

Mcatee, G. E., Jr.; Stoap, L. J.; Solheim, C. D.; Sharpsteen, J. T.

1975-01-01

The final report for the automatic exposure control study for space sequential cameras, for the NASA Johnson Space Center is presented. The material is shown in the same sequence that the work was performed. The purpose of the automatic exposure control is to automatically control the lens iris as well as the camera shutter so that the subject is properly exposed on the film. A study of design approaches is presented. Analysis of the light range of the spectrum covered indicates that the practical range would be from approximately 20 to 6,000 foot-lamberts, or about nine f-stops. Observation of film available from space flights shows that optimum scene illumination is apparently not present in vehicle interior photography as well as in vehicle-to-vehicle situations. The evaluation test procedure for a breadboard, and the results, which provided information for the design of a brassboard are given.

Typhoid fever in Fiji: a reversible plague?

PubMed

Thompson, Corinne N; Kama, Mike; Acharya, Shrish; Bera, Una; Clemens, John; Crump, John A; Dawainavesi, Aggie; Dougan, Gordon; Edmunds, W John; Fox, Kimberley; Jenkins, Kylie; Khan, M Imran; Koroivueta, Josefa; Levine, Myron M; Martin, Laura B; Nilles, Eric; Pitzer, Virginia E; Singh, Shalini; Raiwalu, Ratu Vereniki; Baker, Stephen; Mulholland, Kim

2014-10-01

The country of Fiji, with a population of approximately 870 000 people, faces a growing burden of several communicable diseases including the bacterial infection typhoid fever. Surveillance data suggest that typhoid has become increasingly common in rural areas of Fiji and is more frequent amongst young adults. Transmission of the organisms that cause typhoid is facilitated by faecal contamination of food or water and may be influenced by local behavioural practices in Fiji. The Fijian Ministry of Health, with support from Australian Aid, hosted a meeting in August 2012 to develop comprehensive control and prevention strategies for typhoid fever in Fiji. International and local specialists were invited to share relevant data and discuss typhoid control options. The resultant recommendations focused on generating a clearer sense of the epidemiology of typhoid in Fiji and exploring the contribution of potential transmission pathways. Additionally, the panel suggested steps such as ensuring that recommended ciprofloxacin doses are appropriate to reduce the potential for relapse and reinfection in clinical cases, encouraging proper hand hygiene of food and drink handlers, working with water and sanitation agencies to review current sanitation practices and considering a vaccination policy targeting epidemiologically relevant populations. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

Accelerated Testing Methodology Developed for Determining the Slow Crack Growth of Advanced Ceramics

NASA Technical Reports Server (NTRS)

Choi, Sung R.; Gyekenyesi, John P.

1998-01-01

Constant stress-rate ("dynamic fatigue") testing has been used for several decades to characterize the slow crack growth behavior of glass and structural ceramics at both ambient and elevated temperatures. The advantage of such testing over other methods lies in its simplicity: strengths are measured in a routine manner at four or more stress rates by applying a constant displacement or loading rate. The slow crack growth parameters required for component design can be estimated from a relationship between strength and stress rate. With the proper use of preloading in constant stress-rate testing, test time can be reduced appreciably. If a preload corresponding to 50 percent of the strength is applied to the specimen prior to testing, 50 percent of the test time can be saved as long as the applied preload does not change the strength. In fact, it has been a common, empirical practice in the strength testing of ceramics or optical fibers to apply some preloading (<40 percent). The purpose of this work at the NASA Lewis Research Center is to study the effect of preloading on measured strength in order to add a theoretical foundation to the empirical practice.

Typhoid fever in Fiji: a reversible plague?

PubMed Central

Thompson, Corinne N; Kama, Mike; Acharya, Shrish; Bera, Una; Clemens, John; Crump, John A; Dawainavesi, Aggie; Dougan, Gordon; Edmunds, W John; Fox, Kimberley; Jenkins, Kylie; Khan, M Imran; Koroivueta, Josefa; Levine, Myron M; Martin, Laura B; Nilles, Eric; Pitzer, Virginia E; Singh, Shalini; Raiwalu, Ratu Vereniki; Baker, Stephen; Mulholland, Kim

2014-01-01

The country of Fiji, with a population of approximately 870 000 people, faces a growing burden of several communicable diseases including the bacterial infection typhoid fever. Surveillance data suggest that typhoid has become increasingly common in rural areas of Fiji and is more frequent amongst young adults. Transmission of the organisms that cause typhoid is facilitated by faecal contamination of food or water and may be influenced by local behavioural practices in Fiji. The Fijian Ministry of Health, with support from Australian Aid, hosted a meeting in August 2012 to develop comprehensive control and prevention strategies for typhoid fever in Fiji. International and local specialists were invited to share relevant data and discuss typhoid control options. The resultant recommendations focused on generating a clearer sense of the epidemiology of typhoid in Fiji and exploring the contribution of potential transmission pathways. Additionally, the panel suggested steps such as ensuring that recommended ciprofloxacin doses are appropriate to reduce the potential for relapse and reinfection in clinical cases, encouraging proper hand hygiene of food and drink handlers, working with water and sanitation agencies to review current sanitation practices and considering a vaccination policy targeting epidemiologically relevant populations. PMID:25066005

Foodservice employees benefit from interventions targeting barriers to food safety.

PubMed

York, Valerie K; Brannon, Laura A; Shanklin, Carol W; Roberts, Kevin R; Howells, Amber D; Barrett, Elizabeth B

2009-09-01

The number of foodborne illnesses traced to improper food handling in restaurants indicates a need for research to improve food safety in these establishments. Therefore, this 2-year longitudinal study investigated the effectiveness of traditional ServSafe (National Restaurant Association Educational Foundation, Chicago, IL) food-safety training and a Theory of Planned Behavior intervention program targeting employees' perceived barriers and attitudes toward important food-safety behaviors. The effectiveness of the training and intervention was measured by knowledge scores and observed behavioral compliance rates related to food-safety practices. Employees were observed for handwashing, thermometer usage, and proper handling of work surfaces at baseline, after receiving ServSafe training, and again after exposure to the intervention targeting barriers and negative attitudes about food-safety practices. Repeated-measures analyses of variance indicated training improved handwashing knowledge, but the intervention was necessary to improve overall behavioral compliance and handwashing compliance. Results suggest that registered dietitians; dietetic technicians, registered; and foodservice managers should implement a combination of training and intervention to improve knowledge and compliance with food-safety behaviors, rather than relying on training alone. Challenges encountered while conducting this research are discussed, and recommendations are provided for researchers interested in conducting this type of research in the future.

Helminth ova control in wastewater and sludge for advanced and conventional sanitation.

PubMed

Jiménez, B; Maya, C; Galván, M

2007-01-01

Worldwide, the most important reuse of wastewater, in volume, is agricultural irrigation. Therefore, there is a need to properly treat wastewater for such purpose, considering the removal of pathogens while leaving suitable amounts of nutrients and other compounds to increase productivity. Helminth ova are one of the main targeted pathogens in the new guidelines for water reuse in agriculture and aquaculture issued in 2006 by the World Health Organization. However, relatively little research has been done recently on how to remove and inactivate helminth ova from wastewater and sludge and recommendations given several decades ago are still used, but when put into practice, particularly in developing countries, produce unsatisfactory results. One problem is that these criteria were developed using inaccurate analytical techniques and the other is the large number and variety of helminth ova species found in wastewater and sludge from the developing world. In fact, the few technological options to remove and inactivate helminth ova come from research performed using wastewater and sludge with low helminth ova content, and refer almost only to Ascaris (one type of helminth). This paper summarises recent research work and results from practical experience concerning helminth ova control for advanced and conventional sanitation.

Practices of pharmaceutical waste generation and discarding in households across Portugal.

PubMed

Dias-Ferreira, Celia; Valente, Susana; Vaz, João

2016-10-01

This work is the first nationwide study in Portugal on pharmaceutical waste generated at households, exploring people's attitudes and risk perception. The waste audit was carried out from September to November 2014, targeting pharmaceutical products kept by a sample of families (n = 244). This campaign was an assignment of VALORMED, the non-profit association that manages waste and packaging from expired and unused pharmaceutical products collected by the pharmacies. On average, each household kept at home 1097 g of pharmaceutical products, of which 20% were in use, 72% were not in use, and 8% were mostly expired products ready to discard. Face-to-face interviews with householders showed that 69% of the respondents claimed returning pharmaceutical waste to the local pharmacy. However, this figure is overrated, probably owing to a possible 'good answer' effect. The barriers identified to proper disposal were mainly established routines and lack of close disposal points. This study also provides an insight into the Portuguese awareness and daily practices concerning pharmaceutical waste, which is the cornerstone of any future strategy to reduce the release of active pharmaceutical ingredients into ecosystems. © The Author(s) 2016.

A systematic review of psychometric testing of instruments that measure intention to work with older people.

PubMed

Che, Chong Chin; Hairi, Noran Naqiah; Chong, Mei Chan

2017-09-01

To review systematically the psychometric properties of instruments used to measure intention to work with older people. Nursing students are part of the future healthcare workforce; thus, being aware of their intention to work with older people would give valuable insights to nursing education and practice. Despite a plethora of research on measuring intention to work with older people, a valid and reliable instrument has not been identified. A systematic literature review of evidence and psychometric properties. Eight database searches were conducted between 2006 - 2016. English articles were selected based on inclusion and exclusion criteria. The COSMIN checklist was used to assess instruments reporting a psychometric evaluation of validity and reliability. Of 41 studies identified for full text review, 36 met the inclusion criteria. Seven different types of instruments were identified for psychometric evaluation. Measures of reliability were reported in eight papers and validity in five papers. Evidence for each measurement property was limited, with each instrument demonstrating a lack of information on measurement properties. Based on the COSMIN checklist, the overall quality of the psychometric properties was rated as poor to good. No single instrument was found to be optimal for use. Studies of high methodological quality are needed to properly assess the measurement properties of the instruments that are currently available. Until such studies are available, we recommend using existing instruments with caution. © 2017 John Wiley & Sons Ltd.

Virtual Environments for Visualizing Structural Health Monitoring Sensor Networks, Data, and Metadata.

PubMed

Napolitano, Rebecca; Blyth, Anna; Glisic, Branko

2018-01-16

Visualization of sensor networks, data, and metadata is becoming one of the most pivotal aspects of the structural health monitoring (SHM) process. Without the ability to communicate efficiently and effectively between disparate groups working on a project, an SHM system can be underused, misunderstood, or even abandoned. For this reason, this work seeks to evaluate visualization techniques in the field, identify flaws in current practices, and devise a new method for visualizing and accessing SHM data and metadata in 3D. More precisely, the work presented here reflects a method and digital workflow for integrating SHM sensor networks, data, and metadata into a virtual reality environment by combining spherical imaging and informational modeling. Both intuitive and interactive, this method fosters communication on a project enabling diverse practitioners of SHM to efficiently consult and use the sensor networks, data, and metadata. The method is presented through its implementation on a case study, Streicker Bridge at Princeton University campus. To illustrate the efficiency of the new method, the time and data file size were compared to other potential methods used for visualizing and accessing SHM sensor networks, data, and metadata in 3D. Additionally, feedback from civil engineering students familiar with SHM is used for validation. Recommendations on how different groups working together on an SHM project can create SHM virtual environment and convey data to proper audiences, are also included.

Virtual Environments for Visualizing Structural Health Monitoring Sensor Networks, Data, and Metadata

PubMed Central

Napolitano, Rebecca; Blyth, Anna; Glisic, Branko

2018-01-01

Visualization of sensor networks, data, and metadata is becoming one of the most pivotal aspects of the structural health monitoring (SHM) process. Without the ability to communicate efficiently and effectively between disparate groups working on a project, an SHM system can be underused, misunderstood, or even abandoned. For this reason, this work seeks to evaluate visualization techniques in the field, identify flaws in current practices, and devise a new method for visualizing and accessing SHM data and metadata in 3D. More precisely, the work presented here reflects a method and digital workflow for integrating SHM sensor networks, data, and metadata into a virtual reality environment by combining spherical imaging and informational modeling. Both intuitive and interactive, this method fosters communication on a project enabling diverse practitioners of SHM to efficiently consult and use the sensor networks, data, and metadata. The method is presented through its implementation on a case study, Streicker Bridge at Princeton University campus. To illustrate the efficiency of the new method, the time and data file size were compared to other potential methods used for visualizing and accessing SHM sensor networks, data, and metadata in 3D. Additionally, feedback from civil engineering students familiar with SHM is used for validation. Recommendations on how different groups working together on an SHM project can create SHM virtual environment and convey data to proper audiences, are also included. PMID:29337877

Models, validation, and applied geochemistry: Issues in science, communication, and philosophy

USGS Publications Warehouse

Nordstrom, D. Kirk

2012-01-01

Models have become so fashionable that many scientists and engineers cannot imagine working without them. The predominant use of computer codes to execute model calculations has blurred the distinction between code and model. The recent controversy regarding model validation has brought into question what we mean by a ‘model’ and by ‘validation.’ It has become apparent that the usual meaning of validation may be common in engineering practice and seems useful in legal practice but it is contrary to scientific practice and brings into question our understanding of science and how it can best be applied to such problems as hazardous waste characterization, remediation, and aqueous geochemistry in general. This review summarizes arguments against using the phrase model validation and examines efforts to validate models for high-level radioactive waste management and for permitting and monitoring open-pit mines. Part of the controversy comes from a misunderstanding of ‘prediction’ and the need to distinguish logical from temporal prediction. Another problem stems from the difference in the engineering approach contrasted with the scientific approach. The reductionist influence on the way we approach environmental investigations also limits our ability to model the interconnected nature of reality. Guidelines are proposed to improve our perceptions and proper utilization of models. Use of the word ‘validation’ is strongly discouraged when discussing model reliability.

Human-computer interaction reflected in the design of user interfaces for general practitioners.

PubMed

Stoicu-Tivadar, Lacramioara; Stoicu-Tivadar, Vasile

2006-01-01

To address the problem of properly built health information systems in general practice as an important issue for their approval and use in clinical practice. We present how a national general practitioner (GP) network was built, put in practice and several results of its activity seen from the clinician's and the software application team's points of view. We used a multi-level incremental development appropriate for the conditions of the required information system. After the development of the first version of the software components (based on rapid prototyping) of the sentinel network, a questionnaire addressed the needs and improvements required by the health professionals. Based on the answers, the functionality of the system and the interface were improved regarding the real needs expressed by the end-users. The network is functional and the collected data from the network are being processed using statistical methods. The academic software team developed a GP application that is well received by the GPs in the network, as resulted from the survey and discussions during the training period. As an added confirmation, several GPs outside the network enrolled after seeing the software at work. Another confirmation that we did a good job was that after the final presentation of the results of the project a representative from the Romanian Society for Cardiology expressed the wish of this society to access the data yielded by the network.

A new practice-driven approach to develop software in a cyber-physical system environment

NASA Astrophysics Data System (ADS)

Jiang, Yiping; Chen, C. L. Philip; Duan, Junwei

2016-02-01

Cyber-physical system (CPS) is an emerging area, which cannot work efficiently without proper software handling of the data and business logic. Software and middleware is the soul of the CPS. The software development of CPS is a critical issue because of its complicity in a large scale realistic system. Furthermore, object-oriented approach (OOA) is often used to develop CPS software, which needs some improvements according to the characteristics of CPS. To develop software in a CPS environment, a new systematic approach is proposed in this paper. It comes from practice, and has been evolved from software companies. It consists of (A) Requirement analysis in event-oriented way, (B) architecture design in data-oriented way, (C) detailed design and coding in object-oriented way and (D) testing in event-oriented way. It is a new approach based on OOA; the difference when compared with OOA is that the proposed approach has different emphases and measures in every stage. It is more accord with the characteristics of event-driven CPS. In CPS software development, one should focus on the events more than the functions or objects. A case study of a smart home system is designed to reveal the effectiveness of the approach. It shows that the approach is also easy to be operated in the practice owing to some simplifications. The running result illustrates the validity of this approach.

Maternal–Child Microbiome: Specimen Collection, Storage and Implications for Research and Practice

PubMed Central

Jordan, Sheila; Baker, Brenda; Dunn, Alexis; Edwards, Sara; Ferranti, Erin; Mutic, Abby D.; Yang, Irene; Rodriguez, Jeannie

2017-01-01

Background The maternal microbiome is a key contributor to the development and outcomes of pregnancy and the health status of both mother and infant. Significant advances are occurring in the science of the maternal and child microbiome and hold promise in improving outcomes related to pregnancy complications, child development, and chronic health conditions of mother and child. Objectives The purpose of the paper is to review site-specific considerations in the collection and storage of maternal and child microbiome samples and its implications for nursing research and practice. Approach Microbiome sampling protocols were reviewed and synthesized. Precautions across sampling protocols were also noted. Results Oral, vaginal, gut, placental, and breastmilk are viable sources for sampling the maternal and/or child microbiome. Prior to sampling special considerations need to be addressed related to various factors including current medications, health status, and hygiene practices. Proper storage of samples will avoid degradation of cellular and DNA structures vital for analysis. Discussion Changes in the microbiome throughout the perinatal, postpartum and childhood periods are dramatic and significant to outcomes of the pregnancy and the long-term health of mother and child. Proper sampling techniques are required to produce reliable results from which evidence-based practice recommendations will be built. Ethical and practical issues surrounding study design and protocol development must also be considered when researching vulnerable groups such as pregnant women and infants. Nurses hold the responsibility to both perform the research and to translate findings from microbiome investigations for clinical use. PMID:28252577

Evaluation of knowledge, practices, and possible barriers among healthcare providers regarding medical waste management in Dhaka, Bangladesh.

PubMed

Sarker, Mohammad Abul Bashar; Harun-Or-Rashid, Md; Hirosawa, Tomoya; Abdul Hai, Md Shaheen Bin; Siddique, Md Ruhul Furkan; Sakamoto, Junichi; Hamajima, Nobuyuki

2014-12-09

Improper handling of medical wastes, which is common in Bangladesh, could adversely affect the hospital environment and community at large, and poses a serious threat to public health. We aimed to assess the knowledge and practices regarding medical waste management (MWM) among healthcare providers (HCPs) and to identify possible barriers related to it. A cross-sectional study was carried out during June to September, 2012 including 1 tertiary, 3 secondary, and 3 primary level hospitals in Dhaka division, Bangladesh through 2-stage cluster sampling. Data were collected from 625 HCPs, including 245 medical doctors, 220 nurses, 44 technologists, and 116 cleaning staff who were directly involved in MWM using a self-administered (researcher-administered for cleaning staff), semi-structured questionnaire. Nearly one-third of medical doctors and nurses and two-thirds of technologists and cleaning staff had inadequate knowledge, and about half of medical doctors (44.0%) and cleaning staff (56.0%) had poor practices. HCPs without prior training on MWM were more likely to have poor practices compared to those who had training. Lack of personal protective equipment, equipment for final disposal, MWM-related staff, proper policy/guideline, and lack of incinerator were identified as the top 5 barriers. Strengthening and expansion of ongoing educational programs/training is necessary to improve knowledge and practices regarding MWM. The government should take necessary steps and provide financial support to eliminate the possible barriers related to proper MWM.

Evidence of African-American women's frustrations with chronic recurrent bacterial vaginosis.

PubMed

Payne, Sandra C; Cromer, Pamela R; Stanek, Michele K; Palmer, Allyson A

2010-02-01

The purpose of this study was to explore the impact of recurrent bacterial vaginosis (BV) and its treatment on quality of life (QOL), acceptance of current treatment options, and psychosocial issues related to lifestyle practices associated with BV. Qualitative and quantitative data were obtained from 23 African American women with recurrent BV. Participants completed a short survey, developed by the researchers based on a prior study which examined factors associated with recurrent BV, and a one-on-one interview assessing the impact of BV, current treatment modalities, and lifestyle practices related to recurrent BV. Emerging themes suggest that recurrent BV is associated with psychosocial issues that are currently not addressed in a typical office visit. Reported feelings of shame and embarrassment often cause women to engage in hypervigilant routines of hygiene that negatively impact their professional, personal, and intimate relationships, significantly affecting their QOL. Without proper education, advice, and support, BV is perpetuated by lifestyle practices leading to recurrent infection and associated symptoms. With proper guidance, it is expected that women with recurrent BV will see an improvement in their QOL, with fewer complications from BV infection, and healthy relationships with intimate partners, family, and friends.

Time in rituals of Javanese-Saivism as preserved in Bali

NASA Astrophysics Data System (ADS)

Suamba, I. B. P.; Mudana, I. G.

2018-01-01

Religion in practice is often associated with ritual in its various modes. Ritual can only be practised after proper time has been set up in advanced. This paper attempts to study times as a system in rituals of Javanse-Saivism tradition as practised in Bali. Library research was conducted to get required data through observing a number of texts belong to Wariga literature. It is found that there is a system of times known as Saka-Bali as applied in calendar system combining Indian solar-lunar system with local Javanese Wuku system. The combination of two systems cause the system becomes complex since the days are not only divided into 12 months in a year and pananggal and panglong of both full moon and new moon in a month, but also into wewaran, ingkel, dauh, etc. in a six month period. The concept “alah dening” shows gradual importance from solar-lunar to wewaran divisions of days, and the method applied in determining proper times. In practice, solar-lunar system is more dominant than the other; however both are complementary in practice. Time is equated with the Ultimate Reality, and hence it is eternal.

The importance of human resources management in health care: a global context.

PubMed

Kabene, Stefane M; Orchard, Carole; Howard, John M; Soriano, Mark A; Leduc, Raymond

2006-07-27

This paper addresses the health care system from a global perspective and the importance of human resources management (HRM) in improving overall patient health outcomes and delivery of health care services. We explored the published literature and collected data through secondary sources. Various key success factors emerge that clearly affect health care practices and human resources management. This paper will reveal how human resources management is essential to any health care system and how it can improve health care models. Challenges in the health care systems in Canada, the United States of America and various developing countries are examined, with suggestions for ways to overcome these problems through the proper implementation of human resources management practices. Comparing and contrasting selected countries allowed a deeper understanding of the practical and crucial role of human resources management in health care. Proper management of human resources is critical in providing a high quality of health care. A refocus on human resources management in health care and more research are needed to develop new policies. Effective human resources management strategies are greatly needed to achieve better outcomes from and access to health care around the world.

The importance of human resources management in health care: a global context

PubMed Central

Kabene, Stefane M; Orchard, Carole; Howard, John M; Soriano, Mark A; Leduc, Raymond

2006-01-01

Background This paper addresses the health care system from a global perspective and the importance of human resources management (HRM) in improving overall patient health outcomes and delivery of health care services. Methods We explored the published literature and collected data through secondary sources. Results Various key success factors emerge that clearly affect health care practices and human resources management. This paper will reveal how human resources management is essential to any health care system and how it can improve health care models. Challenges in the health care systems in Canada, the United States of America and various developing countries are examined, with suggestions for ways to overcome these problems through the proper implementation of human resources management practices. Comparing and contrasting selected countries allowed a deeper understanding of the practical and crucial role of human resources management in health care. Conclusion Proper management of human resources is critical in providing a high quality of health care. A refocus on human resources management in health care and more research are needed to develop new policies. Effective human resources management strategies are greatly needed to achieve better outcomes from and access to health care around the world. PMID:16872531

21 CFR 225.30 - Equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Construction and Maintenance of Facilities and Equipment § 225.30 Equipment. (a) Equipment which is designed to perform its intended function and is properly installed and used is essential to the manufacture of medicated feeds. Such equipment permits...

7 CFR 51.1901 - U.S. Grade A.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... the contents of the container. (See § 51.1903.) (a) Incident to proper grading and handling, except...

7 CFR 51.1902 - U.S. Grade B.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... of the contents of the container. (See § 51.1903.) (a) Incident to proper grading and handling...

Improvements in powered air purifying respirator protection in an ABSL-3E facility

USDA-ARS?s Scientific Manuscript database

The study of and experimentation with zoonotic pathogens such as highly pathogenic avian influenza (HPAI) requires risk mitigation strategies including laboratory engineering controls and safety equipment, personal protective equipment (PPE), and proper practices and techniques. Incidences of potent...

9 CFR 3.75 - Housing facilities, general.

Code of Federal Regulations, 2010 CFR

2010-01-01

... requirements differ, as do their social and environmental requirements. As a result, the conditions appropriate... for proper husbandry practices and research needs. Housing facilities other than those maintained by research facilities and Federal research facilities must be physically separated from any other businesses...

40 CFR 63.562 - Standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... barrels per day; and (C) For 1997, 1,445,000 barrels per day. (ii) Maximum extent practicable means that... (thermocouples, pressure transducers, continuous emissions monitors (CEMS), etc.) variances. (i) The plan shall... monitoring equipment functions properly and variances of the control equipment and monitoring equipment are...

Characterization of low temperature creep properties of crack sealants using bending beam rehometry.

DOT National Transportation Integrated Search

2009-11-01

Crack sealing has been widely used as a routine preventative maintenance practice. Given its proper installation, crack sealants can extend : pavement service life by three to five years. However, current specifications for the selection of crack sea...

Characterization of low temperature mechanical properties of crack sealants utilizing direct tension test.

DOT National Transportation Integrated Search

2008-11-01

Crack sealing has been widely used as a routine preventative maintenance practice. Given its proper : installation, crack sealants can extend pavement service life by three to five years. However, current : specifications for the selection of crack s...

40 CFR 160.35 - Quality assurance unit.

Code of Federal Regulations, 2012 CFR

2012-07-01

... standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating... LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.35 Quality assurance unit. (a) A testing...

40 CFR 160.35 - Quality assurance unit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating... LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.35 Quality assurance unit. (a) A testing...

40 CFR 160.35 - Quality assurance unit.

Code of Federal Regulations, 2014 CFR

2014-07-01

... standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating... LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.35 Quality assurance unit. (a) A testing...

40 CFR 160.35 - Quality assurance unit.

Code of Federal Regulations, 2013 CFR

2013-07-01

... standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating... LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.35 Quality assurance unit. (a) A testing...

40 CFR 160.35 - Quality assurance unit.

Code of Federal Regulations, 2011 CFR

2011-07-01

... standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating... LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.35 Quality assurance unit. (a) A testing...

45 CFR 81.112 - Improper conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PRACTICE AND PROCEDURE FOR HEARINGS... communications media, by paid advertisement or otherwise, designed to influence the judgment of any officer... person to solicit communications to any such officer, or his decisional staff, other than proper...

7 CFR 160.35 - Illegible inspection marks.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) NAVAL STORES REGULATIONS AND... the proper grade or identity of the rosin. No fee will be charged for this service, but the cost of...

7 CFR 1951.885 - Loan classifications.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 14 2011-01-01 2011-01-01 false Loan classifications. 1951.885 Section 1951.885 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS... obtain proper documentation or any other deviations from prudent lending practices. Adverse trends in the...

7 CFR 1951.885 - Loan classifications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Loan classifications. 1951.885 Section 1951.885 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS... obtain proper documentation or any other deviations from prudent lending practices. Adverse trends in the...

[Practical guideline for the management of adverse events associated with BCG installations].

PubMed

Rodríguez, Fernando; Palou, Juan; Martínez, R; Rodríguez, O; Rosales, A; Huguet, Jorge; Villavicencio, Humberto

2008-06-01

Morbidity secondary to intravesical Bacillus Calmette-Guèrin (BCG) may present both locally and systemically. Most patients suffer a self-limited irritative voiding syndrome. Often, there are not unified criteria for the management of BCG side effects. After treating more than 500 patients with BCG we developed a practical guideline for the management of its morbidity. We present clearly and schematically the practice guideline we follow in our Center when the patient presents symptoms and morbidity secondary to BCG intravesical installations. We analyze and describe, following the literature and our own experience, the management of adverse events experienced by patients treated with intravesical BCG, since the initial implementation of the protocol for its indication in patients with high risk non-muscle invasive bladder tumors and/or CIS. Irritative voiding symptoms are among the most frequent symptoms, generally self-limited; but if they persist (> 48 hours) will have the urologist treat them depending on intensity and duration. Macroscopic hematuria is not unfrequent and diminishes with an expectant approach and water intake. But, it may also be a urinary tract infection or residual tumor. A febrile syndrome, if present, is usually self-limited to the first 24-48 hours and below 38.5 degrees C without general status affectation. In cases of persistence and/or sepsis, tuberculostatic treatment and/or corticoids should be started. Other clinical pictures may appear, such as orchyoepididymitis, arthritis, etc. Proper diagnosis and treatment of adverse events after BCG therapy are basic to allow intravesical immunotherapy be properly prescribed and managed by urologists, enabling a proper treatment of patients and avoiding the possibility of more severe complications.

Occupational health and safety in small animal veterinary practice: Part I--nonparasitic zoonotic diseases.

PubMed

Weese, J S; Peregrine, A S; Armstrong, J

2002-08-01

Zoonotic diseases are an ever-present concern in small animal veterinary practice and are often overlooked. A variety of nonparasitic zoonotic diseases may be encountered in small animal practice, including cat scratch disease (bartonellosis), cat bite abscesses, rabies, leptospirosis, methicillin-resistant Staphylococcus aureus, Clostridium difficile-associated diarrhea, salmonellosis, avian chlamydiosis, campylobacteriosis, dermatophytosis, and blastomycosis. These may cause human disease ranging from mild and self-limiting to fatal. The risk of development of a zoonotic disease can be lessened by early recognition of infected animals, proper animal handling, basic biosecurity precautions, and, most importantly, personal hygiene.

Polish Listening SPAN: A New Tool for Measuring Verbal Working Memory

ERIC Educational Resources Information Center

Zychowicz, Katarzyna; Biedron, Adriana; Pawlak, Miroslaw

2017-01-01

Individual differences in second language acquisition (SLA) encompass differences in working memory capacity, which is believed to be one of the most crucial factors influencing language learning. However, in Poland research on the role of working memory in SLA is scarce due to a lack of proper Polish instruments for measuring this construct. The…

Work-Ready Testing: Education and Employability in Neoliberal Times

ERIC Educational Resources Information Center

Lakes, Richard

2011-01-01

Work-ready is used to measure employability levels among the working classes. This is the neoliberal era of human capital accounting, and global business pins its profits and losses on worker knowledge and job skills. Employers do not believe that school-based curriculums are capable of properly preparing future workers; and the paper diploma is…

21 CFR 225.65 - Equipment cleanout procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Product Quality Control § 225.65 Equipment cleanout procedures. (a) Adequate cleanout procedures for all equipment used in the manufacture... sequential production of feeds. (2) If flushing is utilized, the flush material shall be properly identified...

21 CFR 211.68 - Automatic, mechanical, and electronic equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS... satisfactorily, may be used in the manufacture, processing, packing, and holding of a drug product. If such... designed to assure proper performance. Written records of those calibration checks and inspections shall be...

7 CFR 51.1901 - U.S. Grade A.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... representative in size and quality of the contents of the container. (See § 51.1903.) (a) Incident to proper...

Prepubescent Strength Training Gains Support.

ERIC Educational Resources Information Center

Duda, Marty

1986-01-01

Recent studies have stimulated greater support for prepubescent weight training. There seems to be general agreement that strength and weight training, when practiced under properly controlled conditions, is safe and efficacious for prepubescents. Weight lifting is not supported. Recommendations for weight training are made, and reservations are…

78 FR 69838 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-21

... public information collection and seeks public comment on the provisions thereof. Comments are invited on: (a) Whether the proposed collection of information is necessary for the proper performance of the functions of the agency, including whether the information shall have practical utility; (b) the accuracy of...

Practical Applications of Data Processing to School Purchasing.

ERIC Educational Resources Information Center

California Association of School Business Officials, San Diego. Imperial Section.

Electronic data processing provides a fast and accurate system for handling large volumes of routine data. If properly employed, computers can perform myriad functions for purchasing operations, including purchase order writing; equipment inventory control; vendor inventory; and equipment acquisition, transfer, and retirement. The advantages of…

Differential Decay of Bacterial and Viral Fecal Indicators in Common Human Pollution Sources

EPA Science Inventory

Understanding the decomposition of different human fecal pollution sources is necessary for proper implementation of many water quality management practices, as well as predicting associated public health risks. Here, the decay of select cultivated and molecular indicators of fe...

Management practices affect soil nutrients and bacterial populations in backgrounding beef feedlot

USDA-ARS?s Scientific Manuscript database

Contaminants associated with manure in animal production sites are of significant concern. Unless properly managed, high soil nutrient concentrations in feedlots can deteriorate soil and water quality. This three year study tested a nutrient management strategy with three sequentially imposed manage...

Effective Classroom Discipline: Advice for Educators.

ERIC Educational Resources Information Center

Fuhr, Don

1993-01-01

The need for properly administered classroom discipline is manifested by misbehaving students desiring structure that reveals the importance of managing time, distinguishes between right and wrong, and supports the notion of perseverance. Top performers in administration and teaching understand and practice effective discipline by reinforcing and…

Rain garden guidelines for southwest Ohio

EPA Science Inventory

Rain gardens are a unique and practical landscape feature that can enhance the beauty of home gardens. When properly installed, they are one method of limiting the negative effects of rainfall runoff in urban areas. Indeed, rain gardens turn a "negative" into a "positive" by capt...

Fee-For-Service as a Business Model of Growing Importance: The Academic Biobank Experience

PubMed Central

Sommerkamp, Kara; Egan-Palmer, Maureen; Kharasch, Karen; Holtschlag, Victoria

2012-01-01

Biorepositories offer tremendous scientific value to a wide variety of customer groups (academic, commercial, industrial) in their ability to deliver a centralized, standardized service model, encompassing both biospecimen storage and related laboratory services. Generally, the scientific expertise and economies of scale that are offered in centralized, properly resourced research biobanks has yielded value that has been well-recognized by universities, pharmaceutical companies, and other sponsoring institutions. However, like many facets of the economy, biobanks have been under increasing cost pressure in recent years. This has been a particular problem in the academic arena, where direct support from grant sources (both governmental and philanthropic) typically now is more difficult to secure, or provides reduced financial support, relative to previous years. One way to address this challenge is to establish or enhance a well-defined fee-for-service model which is properly calibrated to cover operational costs while still offering competitive value to users. In this model, customers are never charged for the biospecimens themselves, but rather for the laboratory services associated with them. Good communication practices, proper assessment of value, implementation of best practices, and a sound business plan are all needed for this initiative to succeed. Here we summarize our experiences at Washington University School of Medicine in the expectation they will be useful to others. PMID:23386922

Sedation and monitoring for gastrointestinal endoscopy

PubMed Central

Amornyotin, Somchai

2013-01-01

The safe sedation of patients for diagnostic or therapeutic procedures requires a combination of properly trained physicians and suitable facilities. Additionally, appropriate selection and preparation of patients, suitable sedative technique, application of drugs, adequate monitoring, and proper recovery of patients is essential. The goal of procedural sedation is the safe and effective control of pain and anxiety as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation practices for gastrointestinal endoscopy (GIE) vary widely. The majority of GIE patients are ambulatory cases. Most of this procedure requires a short time. So, short acting, rapid onset drugs with little adverse effects and improved safety profiles are commonly used. The present review focuses on commonly used regimens and monitoring practices in GIE sedation. This article is to discuss the decision making process used to determine appropriate pre-sedation assessment, monitoring, drug selection, dose of sedative agents, sedation endpoint and post-sedation care. It also reviews the current status of sedation and monitoring for GIE procedures in Thailand. PMID:23424050

On long-time instabilities in staggered finite difference simulations of the seismic acoustic wave equations on discontinuous grids

NASA Astrophysics Data System (ADS)

Gao, Longfei; Ketcheson, David; Keyes, David

2018-02-01

We consider the long-time instability issue associated with finite difference simulation of seismic acoustic wave equations on discontinuous grids. This issue is exhibited by a prototype algebraic problem abstracted from practical application settings. Analysis of this algebraic problem leads to better understanding of the cause of the instability and provides guidance for its treatment. Specifically, we use the concept of discrete energy to derive the proper solution transfer operators and design an effective way to damp the unstable solution modes. Our investigation shows that the interpolation operators need to be matched with their companion restriction operators in order to properly couple the coarse and fine grids. Moreover, to provide effective damping, specially designed diffusive terms are introduced to the equations at designated locations and discretized with specially designed schemes. These techniques are applied to simulations in practical settings and are shown to lead to superior results in terms of both stability and accuracy.

FHWA Field Manual for Bridge Painting Inspection

DOT National Transportation Integrated Search

1997-10-01

This manual is a model to be followed by bridge paint inspectors on how to perform inspection duties properly. Given that most of today's bridge-paint work is being done on existing steel, this manual is geared toward people working in the field on e...

The compleat lawyer--medical law as practical reasoning: doctrine, empiricism, and engagement.

PubMed

Montgomery, Jonathan

2012-01-01

Margot Brazier has modelled the relationship between legal scholarship and health care practice--an evidence-based approach to doing good in the real world through the application of the discipline of law. No ivory tower academic, but a good citizen. This paper explores the expression of her comprehensive contribution in an academic paper and a policy review. She has shown how law needs to take into account the realities of the clinic when considering the plausibility of various claims for the doctrine of informed consent. She has also demonstrated how discipline could be brought to bear on policy-making, where in the Surrogacy Review she prioritised empirical evidence over preconceptions: evidence-based policy not policy-based evidence as modern consultation documents too often elicit. Margot Brazier has also provided a role model for academic lawyers' contribution to the public good; not only through ensuring the proper administration of the law (as chair of the Animal Procedures Committee for the Home Office), but also in shaping a cathartic response to public concerns as Chair of the Retained Organ Commission. She did not set out to establish a grand theory of medical law, but rather has built an approach that has enriched its practice and has had a lasting impact on those working in the field. In her hands, law is a tool for improving the practice of health care. Efficient practice precedes the theory of it; methodologies presuppose the application of the methods, of the critical investigation of which they are the products. It was because Aristotle found himself and others reasoning now intelligently and now stupidly and it was because Izaak Walton found himself and others angling sometimes effectively and sometimes ineffectively that both were able to give their pupils the maxims and prescriptions of their arts.

How to Sustain Change and Support Continuous Quality Improvement

PubMed Central

McQuillan, Rory; Harel, Ziv; Weizman, Adam V.; Thomas, Alison; Nesrallah, Gihad; Bell, Chaim M.; Chan, Christopher T.; Chertow, Glenn M.

2016-01-01

To achieve sustainable change, quality improvement initiatives must become the new way of working rather than something added on to routine clinical care. However, most organizational change is not maintained. In this next article in this Moving Points in Nephrology feature on quality improvement, we provide health care professionals with strategies to sustain and support quality improvement. Threats to sustainability may be identified both at the beginning of a project and when it is ready for implementation. The National Health Service Sustainability Model is reviewed as one example to help identify issues that affect long-term success of quality improvement projects. Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles. Process control and performance boards are methods to communicate improvement results to staff and leadership. Standard work is a written or visual outline of current best practices for a task and provides a framework to ensure that changes that have improved patient care are consistently and reliably applied to every patient encounter. Improvement huddles are short, regular meetings among staff to anticipate problems, review performance, and support a culture of improvement. Many of these tools rely on principles of visual management, which are systems transparent and simple so that every staff member can rapidly distinguish normal from abnormal working conditions. Even when quality improvement methods are properly applied, the success of a project still depends on contextual factors. Context refers to aspects of the local setting in which the project operates. Context affects resources, leadership support, data infrastructure, team motivation, and team performance. For these reasons, the same project may thrive in a supportive context and fail in a different context. To demonstrate the practical applications of these quality improvement principles, these principles are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). PMID:27016498

An Overview of Total Quality Management (TQM) practice in Construction Sector

NASA Astrophysics Data System (ADS)

Likita, A. J.; Zainun, N. Y.; Rahman, I. Abdul; Awal, A. S. M. Abdul; Alias, A. R.; Rahman, M. Q. Abdul; Ghazali, F. E. Mohamed

2018-04-01

In construction sector TQM can be termed as a philosophy which guides construction professionals on the proper execution of construction projects in terms of quality. The aim of this paper is to discuss on quality management practice in construction sector. This paper evaluated five previous researches and the findings were discussed to find a conclusion of TQM practise in construction sector. The study found that TQM had been successfully practice in construction sector at Saudi Arabia, India, US and South Africa. Application of Artificial Neural Network (ANN) help to improve the implementation of TQM in construction sector. In conclusion, quality management practices will give better control of processes in construction sector.

[Practical skills of harmonic scalpel in laparoscopic gastrointestinal surgery].

PubMed

Li, Guo-xin

2013-10-01

Harmonic scalpel, one of the most commonly used energy tools, have been recognized as an important revolutionary development in surgical device. Due to its convenience in cutting, coagulating, and dissecting harmonic scalpel has been increasingly used to performed surgery by more and more surgeons. In gastrointestinal surgeries, however, many manipulationssuch as dissecting soft connective tissues off the stomach or colon, isolating and cutting particular vessels, would require proper techniques in handling harmonic scalpels. Thus, based on our experiences of using harmonic scalpel in laparoscopic gastrointestinal surgeries, we summarized a "nine-word tactics", which may be helpful for beginners to use harmonic scalpels in a proper and efficient manner.

[Collaborative projects with academia for regulatory science studies on biomarkers].

PubMed

Saito, Yoshiro; Nakamura, Ryosuke; Maekawa, Keiko

2014-01-01

Biomarkers are useful tools to be utilized as indicators/predictors of disease severity and drug responsiveness/safety, and thus are expected to promote efficient drug development and to accelerate proper use of approved drugs. Many academic achievements have been reported, but only a small number of biomarkers are used in clinical trials and drug treatments. Regulatory sciences on biomarkers for their secure development and proper qualification are necessary to facilitate their practical application. We started to collaborate with Tohoku University and Nagoya City University for sample quality, biomarker identification, evaluation of their usage, and making guidances. In this short review, scheme and progress of these projects are introduced.

Incorporating diagnosis and treatment of hyperhidrosis into clinical practice.

PubMed

Pariser, David M

2014-10-01

Proper billing and coding are essential to document the diagnosis of hyperhidrosis and to assure proper reimbursement for treatment. Providers should become familiar with the payment policies of local health plans to streamline the preauthorization process that is often needed for many treatments commonly used for hyperhidrosis. Having a preprinted letter of medical necessity and patient intake forms that record the necessary historical information about the disease, previous treatments, and other pertinent information will help increase the speed of the office flow. This article presents algorithms for treatment of the various forms of primary focal hyperhidrosis. Copyright © 2014 Elsevier Inc. All rights reserved.

Determinants of cord care practices among mothers in Benin City, Edo State, Nigeria.

PubMed

Abhulimhen-Iyoha, B I; Ibadin, M O

2012-01-01

Mothers care for their infants' umbilical cord stump in various ways. Different cord care practices have been documented; some are beneficial while others are harmful. Who and what influence the cord care practiced by mothers have, however, not been fully explored particularly in the study locale. The objective of this study was to determine the factors that influence cord care practices among mothers in Benin City. The study subjects included 497 mothers who brought their babies to Well Baby/Immunization Clinic at the University of Benin Teaching Hospital (UBTH), Benin City, Edo State, between July and August 2009. A structured questionnaire served as an instrument to extract information on their biodata and possible determinants of cord care practices. Significantly older women (P=0.023), educated mothers (P=0.029), and those who had male babies (P=0.013) practiced beneficial cord stump care practices. Beneficial cord care practice increased with increasing maternal educational status. The best predictors of beneficial cord care practices are maternal level of education (P=0.029) and infant's sex (P=0.013). The use of harmful cord care practices was more common among mothers who delivered outside the Teaching hospitals. Most (71.2%) of the mothers were aware of hygienic/beneficial cord care. The choices of cord care methods eventually practiced by mothers were influenced mainly by the disposition of nurses (51.3%), participants' mothers (32.0%), and their mothers-in-law (5.8%). There was no significant relationship between cord care practice on one hand and maternal parity, tribe, and socioeconomic classes on the other. The need for female education is again emphasized. The current findings strongly justify the need for public enlightenment programs, using the mass media and health talks in health facilities, targeting not only women of reproductive age but also secondary audience like their mothers, mothers-in-law, nurses, and attendants at health facilities. Proper hygiene including proper hand washing techniques while caring for newborns along with vaccination of infants and their mothers will help prevent infections including tetanus while prompt health-seeking behavior is advised to improve outcome should such infections occur.

[Controversies over the surgical placebo: legal issues and the ethical debate].

PubMed

Hervé, C; Moutel, G; Meningaud, J P; Wolf, M; Lopes, M

2000-06-17

The debate on controlled surgery trials has had some rather "sensational" repercussions, enlivening the placebo issue. In France, there is a consensus on the ethical conditions necessary for proper protection of individual persons. This consensus has taken on a legal form with the promulgation of the Huriet law. For this reason, all studies and research protocols in medicine and surgery are examined by ethics committees (CCPPRB) who assess the inclusion conditions within the framework of biomedical research and in compliance with the concept that individual participants must be give proper protection. These committees are faced with increasingly complex situations, particularly concerning the pertinence of information give to the participant and the modalities of consent. In France, standard measures were established after a parliamentary debate issuing from a wider public debate. The issue has become a social transaction between biomedical research professionals and the society in general. The international debate over the surgery placebo is an interesting illustration of how mediation institutions, working along the principles of ethical committees, play a key role in social awareness of the ethical issues involved before an innovating practice is initiated. But how legitimate are sensational pieces published in the media, which as is clearly demonstrated with the debate over the surgical placebo, are almost always individual points of view? Shouldn't the debate take into account the contributions of ethical committees which integrate representatives of the social community as well as the importance of a legal framework for individual protection as proposed by the French law? Shouldn't personal points of view be counterbalanced by regularly expressed ethical committee opinions formed after appropriate ethics-oriented discussion going beyond the simple question of "should we do it", a question often dismissed by extreme theoretical arguments that leave unanswered the practical question of "how should we do it"?

Proper alignment of the microscope.

PubMed

Rottenfusser, Rudi

2013-01-01

The light microscope is merely the first element of an imaging system in a research facility. Such a system may include high-speed and/or high-resolution image acquisition capabilities, confocal technologies, and super-resolution methods of various types. Yet more than ever, the proverb "garbage in-garbage out" remains a fact. Image manipulations may be used to conceal a suboptimal microscope setup, but an artifact-free image can only be obtained when the microscope is optimally aligned, both mechanically and optically. Something else is often overlooked in the quest to get the best image out of the microscope: Proper sample preparation! The microscope optics can only do its job when its design criteria are matched to the specimen or vice versa. The specimen itself, the mounting medium, the cover slip, and the type of immersion medium (if applicable) are all part of the total optical makeup. To get the best results out of a microscope, understanding the functions of all of its variable components is important. Only then one knows how to optimize these components for the intended application. Different approaches might be chosen to discuss all of the microscope's components. We decided to follow the light path which starts with the light source and ends at the camera or the eyepieces. To add more transparency to this sequence, the section up to the microscope stage was called the "Illuminating Section", to be followed by the "Imaging Section" which starts with the microscope objective. After understanding the various components, we can start "working with the microscope." To get the best resolution and contrast from the microscope, the practice of "Koehler Illumination" should be understood and followed by every serious microscopist. Step-by-step instructions as well as illustrations of the beam path in an upright and inverted microscope are included in this chapter. A few practical considerations are listed in Section 3. Copyright © 2013 Elsevier Inc. All rights reserved.

Act No. 8/1988 on infractions and sanctions in the social order, 7 April 1988.

PubMed

1988-01-01

This Act sets forth infractions and sanctions with respect to labor and social security. Among other things, it classifies the following as very serious offenses: 1) unilateral decisions of employers involving discrimination, either favorable or adverse, in the matter of compensation, hours, training, promotion, and other labor conditions with respect to sex and kinship with other workers; and 2) establishment of conditions through advertising, offers of work, or any other means that constitute discrimination, either favorable or adverse, with respect to access to employment for reasons of sex or kinship with other workers. The following persons will also be considered to have committed very serious infractions: 1) employers who use foreign workers without having first obtained the proper work permit or its renewal; they will incur an infraction for each foreign worker so employed; 2) foreigners who exercise in Spain any lucrative, labor, or professional activity for themselves without having obtained the proper permit or renewed it; and 3) real or legal persons who promote, facilitate, or protect the work of foreigners in Spain without the proper work permit. The Act sets penalties for these infractions ranging from 500,001 pesetas to 15,000,000 pesetas depending on attenuating or aggravating circumstances. In addition, employers committing these infractions are 1) automatically to lose benefits derived from employment programs from the time the infraction was committed and 2) to be excluded from access to such benefits for a maximum period of one year. full text

[Burnout : illness or symptom?].

PubMed

Kapfhammer, H P

2012-11-01

Burnout is primarily conceptualized by work psychology. It describes symptoms resulting from a long-standing, finally derailing adjustment to work-related stressors. Burnout is not a proper diagnosis according to traditional classification systems. However, ICD-10 considers burnout as a significant factor representing major personal problems that have impact on health status and illness behaviour. Burnout may be considered either as a transitional or persisting adjustment reaction to work-related stress, a condition of increased risk regarding to serious mental illnesses and physical diseases, or an integral syndrome of these various conditions. The core symptom of exhaustion or persisting tiredness must be carefully assessed in respect of depressive, anxiety and somatoform disorders from the perspective of psychiatric differential diagnosis. In most cases of a serious burnout the diagnosis of major depression can be established and should lead to proper psychotherapeutic and/or pharmacological treatments. Any aetiopathogenetic evaluation may be favourably done within a multifactorial biopsychosocial model. Consequences for medical care will be described.

Benefits of a Dedicated Breastfeeding Facility and Support Program for Exclusive Breastfeeding among Workers in Indonesia.

PubMed

Basrowi, Ray W; Sulistomo, Astrid B; Adi, Nuri Purwito; Vandenplas, Yvan

2015-06-01

A mother's working environment is believed to be a major determinant of exclusive breastfeeding (EBF) practice. We aimed to define the influence of a facility dedicated to breastfeeding and a breastfeeding support program at the workplace on breastfeeding practice. A cross-sectional study was performed in five workplaces. The inclusion criteria were female workers whose last child was between 6 and 36 months old. Observational data were obtained and a questionnaire was filled out. The World Health Organization definition for EBF was used. Data from 186 subjects (74 office workers and 112 factory workers) were collected. Just over half (52%) of the mothers were between 20 and 46 years old, 75.3% had graduated from high school and university, 12.9% had more than two children and 36.0% owned a house. The prevalence of EBF during the last 6 months was 32.3%. A proper dedicated breastfeeding facility was available for 21.5% of the mothers, but only 7.5% had been in contact with a breastfeeding support program. The presence of a dedicated breastfeeding facility increased EBF practice almost threefold, by an odds ratio (OR) of 2.74 and a 95% confidence interval (CI) of 1.34-5.64 (p<0.05). Knowledge of the breastfeeding support program increased EBF practice by almost six times (OR, 5.93; 95% CI, 1.78-19.79) (p<0.05). Our findings suggest that Governments should make it obligatory for employers to offer a breastfeeding support program and a dedicated breastfeeding facility at the workplace as these simple measures significantly increase EBF.

Varying influences of motivation factors on employees' likelihood to perform safe food handling practices because of demographic differences.

PubMed

Ellis, Jason D; Arendt, Susan W; Strohbehn, Catherine H; Meyer, Janell; Paez, Paola

2010-11-01

Food safety training has been the primary avenue for ensuring food workers are performing proper food handling practices and thus, serving safe food. Yet, knowledge of safe food handling practices does not necessarily result in actual performance of these practices. This research identified participating food service employees' level of agreement with four factors of motivation (internal motivations, communication, reward-punishment, and resources) and determined if respondents with different demographic characteristics reported different motivating factors. Data were collected from 311 food service employees who did not have any supervisory responsibilities. Intrinsic motivation agreement scores were consistently the highest of all four motivational factors evaluated and did not differ across any of the demographic characteristics considered. In contrast, motivation agreement scores for communication, reward-punishment, and resources did differ based on respondents' gender, age, place of employment, job status, food service experience, completion of food handler course, or possession of a food safety certification. In general, respondents agreed that these motivation factors influenced their likelihood to perform various safe food handling procedures. This research begins to illustrate how employees' demographic characteristics influence their responses to various motivators, helping to clarify the complex situation of ensuring safe food in retail establishments. Future research into why employee willingness to perform varies more for extrinsic motivation than for intrinsic motivation could assist food service managers in structuring employee development programs and the work environment, in a manner that aids in improving external motivation (communication, reward-punishment, and resources) and capitalizing on internal motivation.

Litigations and the Obstetrician in Clinical Practice

PubMed Central

Adinma, JIB

2016-01-01

The expectation of obstetrics is a perfect outcome. Obstetrics malpractice can cause morbidity and mortality that may engender litigation. Globally, increasing trend to litigation in obstetrics practice has resulted in high indemnity cost to the obstetrician with consequent frustration and overall danger to the future of obstetrics practice. The objective was to review litigations and the Obstetrician in Clinical Practice, highlighting medical ethics, federation of gynecology and obstetrics (FIGO’s) ethical responsibility guideline on women's sexual and reproductive health and right; examine the relationship between medical ethics and medical laws; X-ray medical negligence and litigable obstetrics malpractices; and make recommendation towards the improvement of obstetrics practices to avert misconduct that would lead to litigation. Review involves a literature search on the internet in relevant journals, textbooks, and monographs. Knowledge and application of medical ethics are important to the obstetricians to avert medical negligence that will lead to litigation. A medical negligence can occur in any of the three triads of medicare viz: Diagnosis, advice/counseling, and treatment. Lawsuits in obstetrics generally center on errors of omission or commission especially in relation to the failure to perform caesarean section or to perform the operation early enough. Fear of litigation, high indemnity cost, and long working hours are among the main reasons given by obstetricians for ceasing obstetrics practice. Increasing global trend in litigation with high indemnity cost to the obstetrician is likely to jeopardize the future of obstetrics care especially in countries without medical insurance coverage for health practitioners. Litigation in obstetrics can be prevented through the Obstetrician's mindfulness of its possibility; acquainting themselves of the medical laws and guidelines related to their practice; ensuring adequate communication with, and consent of patients during treatment together with proper and correct documentation of cases. The supervision of resident-in-training, development and implementation of obstetrics protocol, and continuing medical education of obstetricians are also important factors to the prevention of litigation in obstetrics. PMID:27213088

7 CFR Exhibit A to Subpart Jj of... - Agreement Form

Code of Federal Regulations, 2010 CFR

2010-01-01

..., as required, the time worked by and work accomplishments of Agency employees. (e) Consult with the... conflicts of interest of Agency employees. (f) Reimburse Agency employees for proper and reasonable travel... with Administration travel regulations. (g) Consider Agency employees to be Federal employees for the...

Coaching Athletics: A Tort Just Waiting for a Judgment?

ERIC Educational Resources Information Center

Clear, Delbert K.; Bagley, Martha

1982-01-01

Discusses school boards' potential tort liability for sports injuries arising from coaches' lack of knowledge of how to prevent or treat injuries. Argues for board policies requiring that coaches be trained in handling injuries, that their skills be upgraded, and that proper practices be followed. (RW)

Antimicrobial Drugs

PubMed Central

Becker, Daniel E.

2013-01-01

Antibiotics play a vital role in dental practice for managing orofacial infections. They are used to manage existing infection and they are also used as prophylaxis for certain medical conditions and surgical procedures. This article will review pharmacological and therapeutic considerations for the proper use of these agents for dental infections. PMID:24010989

BEHAVIORAL TECHNOLOGY AND MANPOWER DEVELOPMENT.

ERIC Educational Resources Information Center

COOK, DONALD A.; MECHNER, FRANCIS

A BRIEF HISTORIC SURVEY WHICH PLACES PROGRAMED INSTRUCTION IN THE PROPER PERSPECTIVE RELATIVE TO BEHAVIORAL TECHNOLOGY AS A WHOLE IS PRESENTED. BEHAVIORAL TECHNOLOGY IS THE APPLICATION OF LEARNING THEORY TO PRACTICAL PROBLEMS OF TRAINING AND EDUCATION. THE APPLICATION OF BEHAVIORAL TECHNOLOGY TO THE TEACHING OF CERTAIN VERBAL AND INTELLECTUAL…

42 CFR 416.42 - Condition for coverage-Surgical services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... accordance with approved policies and procedures of the ASC. (a) Standard: Anesthetic risk and evaluation. (1) A physician must examine the patient immediately before surgery to evaluate the risk of anesthesia... applicable State health and safety laws, standards of practice, and ASC policy, for proper anesthesia...

42 CFR 416.42 - Condition for coverage-Surgical services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... accordance with approved policies and procedures of the ASC. (a) Standard: Anesthetic risk and evaluation. (1) A physician must examine the patient immediately before surgery to evaluate the risk of anesthesia... applicable State health and safety laws, standards of practice, and ASC policy, for proper anesthesia...