recommendations include creating: Topics by Science.gov

Sample records for recommendations include creating

Creating a State-Wide Virtual Health Library: The Michigan Experience.

ERIC Educational Resources Information Center

Brenneise, Harvey

The AccessMichigan Electronic Community Health Information Initiative (AMECHII) is a response to a recommendation of the Michigan Information Technology Commission Report recommending improved access to high-quality health care information for all Michigan stakeholders. This project is multi-type, including public, general academic, academic…
2014 Update of the Canadian Rheumatology Association/spondyloarthritis research consortium of Canada treatment recommendations for the management of spondyloarthritis. Part I: principles of the management of spondyloarthritis in Canada.

PubMed

Rohekar, Sherry; Chan, Jon; Tse, Shirley M L; Haroon, Nigil; Chandran, Vinod; Bessette, Louis; Mosher, Dianne; Flanagan, Cathy; Keen, Kevin J; Adams, Karen; Mallinson, Michael; Thorne, Carter; Rahman, Proton; Gladman, Dafna D; Inman, Robert D

2015-04-01

The Canadian Rheumatology Association (CRA) and the Spondyloarthritis Research Consortium of Canada (SPARCC) have collaborated to update the recommendations for the management of spondyloarthritis (SpA). A working group was assembled and consisted of the SPARCC executive committee, rheumatologist leaders from SPARCC collaborating sites, Canadian rheumatologists from across the country with an interest in SpA (both academic and community), a rheumatology trainee with an interest in SpA, an epidemiologist/health services researcher, a member of the CRA executive, a member of the CRA therapeutics committee, and a patient representative from the Canadian Spondylitis Association. An extensive review was conducted of literature published from 2007 to 2014 involving the management of SpA. The working group created draft recommendations using multiple rounds of Web-based surveys and an in-person conference. A survey was sent to the membership of the CRA to obtain an extended review that was used to finalize the recommendations. Guidelines for the management of SpA were created. Part I focuses on the principles of management of SpA in Canada and includes 6 general management principles, 5 ethical considerations, target groups for treatment recommendations, 2 wait time recommendations, and recommendations for disease monitoring. Also included are 6 modifications for application to juvenile SpA. These recommendations were developed based on current literature and applied to a Canadian healthcare context. It is hoped that the implementation of these recommendations will promote best practices in the treatment of SpA.
Le conte: Mille et une facons de dire... (The Story: A Thousand and One Ways to Say...).

ERIC Educational Resources Information Center

Cazaux, Henri

1996-01-01

A teacher/storyteller recommends story creation by students to encourage creativity and pleasure in developing language skills. Suggested exercises include combining random nouns (e.g., "le fer et le bois") and creating a proverb about them, creating a story using names of consumer products, and developing a story using only body-language idioms…
Experiences From Creating the Guide to the Systems Engineering Body of Knowledge (SEBoK) v. 1.0

DTIC Science & Technology

2013-03-01

00-00-2013 to 00-00-2013 4. TITLE AND SUBTITLE Experiences From Creating the Guide to the Systems Engineering Body of Knowledge (SEBoK) v. 1.0 5a...external sources, was not easy to achieve. SE Literature: The most comprehensive source of SE knowledge today is the Systems Engineering Handbook [3...recommended for further reading - SEBoK v. 1.0 includes 224 primary references; and (3) Additional references include other related literature that are good
Education for Rural Practice: A Saga of Pipelines and Plumbers. Commentary.

ERIC Educational Resources Information Center

Norris, Thomas E.

2000-01-01

Current efforts to address the severe and worsening shortage of rural physicians include attracting and preparing rural students for medical school, enhancing medical school curricula, and placing and retaining rural physicians. Recommendations include creating incentives for successful rural training programs, encouraging innovation in rural…
A systematic review and quality appraisal of international guidelines for early breast cancer systemic therapy: Are recommendations sensitive to different global resources?

PubMed

Gandhi, S; Verma, S; Ethier, J-L; Simmons, C; Burnett, H; Alibhai, S M H

2015-08-01

The breast cancer incidence in low and middle income countries (LMCs) is increasing globally, and patient outcomes are generally worse in these nations compared to high income countries (HICs). This is partly due to resource constraints associated with implementing recommended breast cancer therapies. Clinical practice guideline (CPG) adherence can improve breast cancer outcomes, however, many CPGs are created in HICs, and include costly recommendations that may not be feasible in LMCs. In addition, the quality of CPGs can be variable. The aim of this study was to perform a systematic review of CPGs on early breast cancer systemic therapy with potential international impact, to evaluate their content, quality, and resource sensitivity. A MEDLINE and gray literature search was completed for English language CPGs published between 2005 and 2010, and then updated to July 2014. Extracted guidelines were evaluated using the AGREE 2 instrument. Guidelines were specifically analyzed for resource sensitivity. Most of the extracted CPGs had similar recommendations with regards to systemic therapy. However, only one, the Breast Health Global Initiative, made recommendations with consideration of different global resources. Overall, the CPGs were of variable quality, and most scored poorly in the quality domain evaluating implementation barriers such as resources. Published CPGs for early breast cancer are created in HICs, have similar recommendations, and are generally resource-insensitive. Given the visibility and influence of these CPGs on LMCs, efforts to create higher quality, resource-sensitive guidelines with less redundancy are needed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Developing a proactive research agenda to advance nail salon worker health, safety, and rights.

PubMed

Quach, Thu; Liou, Julia; Fu, Lisa; Mendiratta, Anuja; Tong, My; Reynolds, Peggy

2012-01-01

Nail salons represent a burgeoning industry with Vietnamese immigrant workers making up the majority. Workers routinely handle cosmetic products containing hazardous compounds, with implications for their health. This paper describes how a collaborative of multiple organizations and community members collectively developed a proactive research agenda for salon worker health, safety, and rights during a pivotal multistakeholder convening, and advanced on such recommendations, including creating groundbreaking policy changes. Key recommendations included (1) creating a multidisciplinary research advisory committee, (2) conducting research on workplace exposures and long-term health impacts, (3) advocating for better governmental oversight of product manufacturers, and (4) identifying safer product alternatives via green chemistry, albeit with cost considerations to salon businesses. The participation of diverse stakeholders in the discussions allowed for cross-dialogue on a complex issue, helped to align different stakeholders as allies, and identified critical resources to addressing research gaps.
Recommendations for design, construction, and maintenance of bridge approach slabs.

DOT National Transportation Integrated Search

2012-09-01

Settlement and heave related movements of bridge approach slabs relative to bridge decks create a bump in : the roadway. Several problems arise from these bumps, which include poor riding conditions, potential : vehicle damage, loss of vehicle contro...
What's New in Software? Videocassettes for Parenting.

ERIC Educational Resources Information Center

Hedley, Carolyn N.

1989-01-01

Videocassettes useful in creating educational environments in the home are described, focusing specifically on the areas of parenting and living skills, literature for the primary and intermediate grades, and social studies. A list of 66 recommended videocassettes is included. (JDD)
Investigating country-specific music preferences and music recommendation algorithms with the LFM-1b dataset.

PubMed

Schedl, Markus

2017-01-01

Recently, the LFM-1b dataset has been proposed to foster research and evaluation in music retrieval and music recommender systems, Schedl (Proceedings of the ACM International Conference on Multimedia Retrieval (ICMR). New York, 2016). It contains more than one billion music listening events created by more than 120,000 users of Last.fm. Each listening event is characterized by artist, album, and track name, and further includes a timestamp. Basic demographic information and a selection of more elaborate listener-specific descriptors are included as well, for anonymized users. In this article, we reveal information about LFM-1b's acquisition and content and we compare it to existing datasets. We furthermore provide an extensive statistical analysis of the dataset, including basic properties of the item sets, demographic coverage, distribution of listening events (e.g., over artists and users), and aspects related to music preference and consumption behavior (e.g., temporal features and mainstreaminess of listeners). Exploiting country information of users and genre tags of artists, we also create taste profiles for populations and determine similar and dissimilar countries in terms of their populations' music preferences. Finally, we illustrate the dataset's usage in a simple artist recommendation task, whose results are intended to serve as baseline against which more elaborate techniques can be assessed.
Integrating complexity of social systems in natural hazards planning: An example from Caracas, Venezuela

NASA Astrophysics Data System (ADS)

Vranes, Kevin; Czuchlewski, Kristina R.

In December 1999, days of heavy rain on steep slopes north of Caracas, Venezuela triggered massive mud and debris flows, killing tens of thousands. Partly in response to this disaster, a multidisciplinary team of urban planners and Earth scientists from Columbia University recently developed a framework plan for building disaster resilience into the Venezuelan capital region. After assessing the complex intersection of urban geography with severe seismic and hydrologic hazards, substantial recommendations were made to local and regional authorities on future hazards mitigation.Areas found most at risk in the Caracas region include the transportation and utility infrastructure and the friable building stock of squatter settlements. Recognizing realistic economic and socio-political constraints on implementing change, a prioritized list of goals and activities was constructed, and recommendations made along various time scales. Immediate disaster-avoidance goals (to be completed within 1 to 5 years) include strengthening critical infrastructure nodes, housing stock, and emergency services. More intermediate goals (5 to 10 years) focus on upgrading fragile housing units, creating detailed hazard maps across the city, and incorporating disaster education into cultural activities. Recommended activities for the long term (beyond 10 years) include creating a fully redundant transportation and water delivery network, establishing legitimate land title for squatters, and re-locating critical facilities currently in high-risk areas.
An Expertise Recommender using Web Mining

NASA Technical Reports Server (NTRS)

Joshi, Anupam; Chandrasekaran, Purnima; ShuYang, Michelle; Ramakrishnan, Ramya

2001-01-01

This report explored techniques to mine web pages of scientists to extract information regarding their expertise, build expertise chains and referral webs, and semi automatically combine this information with directory information services to create a recommender system that permits query by expertise. The approach included experimenting with existing techniques that have been reported in research literature in recent past , and adapted them as needed. In addition, software tools were developed to capture and use this information.
A Prototype Indicators System for U.S. Climate Changes, Impacts, Vulnerabilities, and Responses

NASA Astrophysics Data System (ADS)

Kenney, M. A.; Janetos, A.; Gerst, M.; Lloyd, A.; Wolfinger, J. F.; Reyes, J. J.; Anderson, S. M.; Pouyat, R. V.

2015-12-01

Indicators are observations or calculations that are used to systematically report or forecast social and biophysical conditions over time. When the purpose of indicators is to, in part, provide complex scientific information that is understood by non-scientists and included in decision processes, the choice of indicators requires a structured process that includes co-production among a range of actors, including scientists, decision-makers, and a range of stakeholders. Here we describe recommendations on a vision and a prototype created for an indicators system, we term the National Climate Indicators System (NCIS). The goal of the NCIS is to create a system of physical, natural, and societal indicators to communicate and inform decisions about climate changes, impacts, vulnerabilities, and responses. The process of generating the indicator system involved input from over 200 subject-matter experts. Organized into 13 teams, experts created conceptual models of their respective sectors to generate an initial recommended set of indicators. A subset of indicators, which could be immediately implemented, were prototyped for the U.S. Global Change Research Program (USGCRP) a Federal program that coordinates and supports integration of global change research across the government. USGCRP reviewed the recommendations (Kenney et al., 2014) and prototypes provided by the scientific experts, and recently launched 14 indicators as proof-of-concept in support of a sustained National Climate Assessment and to solicit feedback from the users. Social science research is currently being undertaken in order to evaluate how well the prototype indicators communicate science to non-scientists, the usability of indicator system portal by scientists and decision-makers, and the development of information visualization guidelines to improve visual communication effectiveness. The goal of such efforts would be to provide input into the development of a more comprehensive USGCRP indicator set, building on recommendations from Kenney et al. (2014), and improve our understanding of the comprehension and use of indicators by non-scientists.
Assessment of DoD Enterprise Resource Planning Business Systems

DTIC Science & Technology

2011-02-01

activities, and processes to the organizational units that execute them • Architecture standards, such as application of the BPMN • Recommended...Recommendation: • Create and use style guides for the development of BPMN based process models. The style guide would probably include specifications such as...o All processes must have ‘entry points’ or ‘triggers’ in the form of BPMN Events o All processes must have ‘outcomes’ also in the form of BPMN
Tailored Educational Approaches for Consumer Health: A Model to Address Health Promotion in an Era of Personalized Medicine.

PubMed

Cohn, Wendy F; Lyman, Jason; Broshek, Donna K; Guterbock, Thomas M; Hartman, David; Kinzie, Mable; Mick, David; Pannone, Aaron; Sturz, Vanessa; Schubart, Jane; Garson, Arthur T

2018-01-01

To develop a model, based on market segmentation, to improve the quality and efficiency of health promotion materials and programs. Market segmentation to create segments (groups) based on a cross-sectional questionnaire measuring individual characteristics and preferences for health information. Educational and delivery recommendations developed for each group. General population of adults in Virginia. Random sample of 1201 Virginia residents. Respondents are representative of the general population with the exception of older age. Multiple factors known to impact health promotion including health status, health system utilization, health literacy, Internet use, learning styles, and preferences. Cluster analysis and discriminate analysis to create and validate segments. Common sized means to compare factors across segments. Developed educational and delivery recommendations matched to the 8 distinct segments. For example, the "health challenged and hard to reach" are older, lower literacy, and not likely to seek out health information. Their educational and delivery recommendations include a sixth-grade reading level, delivery through a provider, and using a "push" strategy. This model addresses a need to improve the efficiency and quality of health promotion efforts in an era of personalized medicine. It demonstrates that there are distinct groups with clearly defined educational and delivery recommendations. Health promotion professionals can consider Tailored Educational Approaches for Consumer Health to develop and deliver tailored materials to encourage behavior change.
Adaptation of the World Health Organization's Selected Practice Recommendations for Contraceptive Use for the United States.

PubMed

Curtis, Kathryn M; Tepper, Naomi K; Jamieson, Denise J; Marchbanks, Polly A

2013-05-01

The Centers for Disease Control and Prevention (CDC) recently adapted global guidance on contraceptive use from the World Health Organization (WHO) to create the US Selected Practice Recommendations for Contraceptive Use (US SPR). The WHO guidance includes evidence-based recommendations on common, yet sometimes complex, contraceptive management questions. We determined the need and scope for the adaptation, conducted 30 systematic reviews of the scientific evidence and convened a meeting of health care professionals to discuss translation of the evidence into recommendations. The US SPR provides recommendations on contraceptive management issues such as how to initiate contraceptive methods, what regular follow-up is needed, and how to address problems, including missed pills and side effects such as unscheduled bleeding. The US SPR is intended to serve as a source of clinical guidance for providers in assisting women and men to initiate and successfully use contraception to prevent unintended pregnancy. Published by Elsevier Inc.
Implementing AORN Recommended Practices for Laser Safety.

PubMed

Castelluccio, Donna

2012-05-01

Lasers used in the OR pose many risks to both patients and personnel. AORN's "Recommended practices for laser safety in perioperative practice settings" identifies the potential hazards associated with laser use, such as eye damage and fire- and smoke-related injuries. The practice recommendations are intended to be used as a guide for establishing best practices in the workplace and to give perioperative nurses strategies for implementing the recommended safety measures. A laser safety program should include measures to control access to laser use areas; protect staff members and patients from exposure to the laser beam; provide staff members and patients with the appropriate safety eyewear for use in the laser use area; and protect staff members and patients from surgical smoke, electrical, and fire hazards. Measures such as using a safety checklist or creating a laser cart can help perioperative nurses successfully incorporate the practice recommendations. Patient scenarios are included as examples of how to use the document in real-life situations. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Metal Detectors.

ERIC Educational Resources Information Center

Harrington-Lueker, Donna

1992-01-01

Schools that count on metal detectors to stem the flow of weapons into the schools create a false sense of security. Recommendations include investing in personnel rather than hardware, cultivating the confidence of law-abiding students, and enforcing discipline. Metal detectors can be quite effective at afterschool events. (MLF)
Towards a dynamic social-network-based approach for service composition in the Internet of Things

NASA Astrophysics Data System (ADS)

Xu, Wen; Hu, Zheng; Gong, Tao; Zhao, Zhengzheng

2011-12-01

The User-Generated Service (UGS) concept allows end-users to create their own services as well as to share and manage the lifecycles of these services. The current development of the Internet-of-Things (IoT) has brought new challenges to the UGS area. Creating smart services in the IoT environment requires a dynamic social network that considers the relationship between people and things. In this paper, we consider the know-how required to best organize exchanges between users and things to enhance service composition. By surveying relevant aspects including service composition technology, social networks and a recommendation system, we present the first concept of our framework to provide recommendations for a dynamic social network-based means to organize UGSs in the IoT.
Technology support of the handover: promoting observability, flexibility and efficiency.

PubMed

Patterson, Emily S

2012-12-01

Efforts to standardise data elements and increase the comprehensiveness of information included in patient handovers have produced a growing interest in augmenting the verbal exchange of information with written communications conducted through health information technology (HIT). The aim of this perspective is to offer recommendations to optimise technology support of handovers, based on a review of the relevant scientific literature. Review of the literature on human factors and the study of communication produced three recommendations. The first entails making available "shared knowledge" relevant to the handover and subsequent clinical management with intended and unintended recipients. The second is to create a flexible narrative structure (unstructured text fields) for human-human communications facilitated by technology. The third recommendation is to avoid reliance on real-time data entry during busy periods. Implementing these recommendations is anticipated to increase the observability (the ability to readily determine current status), flexibility, and efficiency of HIT-supported patient handovers. Anticipated benefits of technology-supported handovers include reducing reliance on human memory, increasing the efficiency and structure of the verbal exchange, avoiding readbacks of numeric data, and aiding clinical management following the handover. In cases when verbal handovers are delayed, do not occur, or involve members of the health care team without first-hand access to critical information, making 'common ground' observable for all recipients, creating a flexible narrative structure for communication and avoiding reliance on real-time data entry during the busiest times has implications for HIT design and day to day data entry and management operations. Benefits include increased observability, flexibility, and efficiency of HIT-supported patient handovers.

Partnerships for better mental health worldwide: WPA recommendations on best practices in working with service users and family carers

PubMed Central

WALLCRAFT, JAN; AMERING, MICHAELA; FREIDIN, JULIAN; DAVAR, BHARGAVI; FROGGATT, DIANE; JAFRI, HUSSAIN; JAVED, AFZAL; KATONTOKA, SYLVESTER; RAJA, SHOBA; RATAEMANE, SOLOMON; STEFFEN, SIGRID; TYANO, SAM; UNDERHILL, CHRISTPHER; WAHLBERG, HENRIK; WARNER, RICHARD; HERRMAN, HELEN

2011-01-01

WPA President M. Maj established the Task Force on Best Practice in Working with Service Users and Carers in 2008, chaired by H. Herrman. The Task Force had the remit to create recommendations for the international mental health community on how to develop successful partnership working. The work began with a review of literature on service user and carer involvement and partnership. This set out a range of considerations for good practice, including choice of appropriate terminology, clarifying the partnership process and identifying and reducing barriers to partnership working. Based on the literature review and on the shared knowledge in the Task Force, a set of ten recommendations for good practice was developed. These recommendations were the basis for a worldwide consultation of stakeholders with expertise as service users, families and carers, and the WPA Board and Council. The results showed a strong consensus across the international mental health community on the ten recommendations, with the strongest agreement coming from service users and carers. This general consensus gives a basis for Task Force plans to seek support for activities to promote shared work worldwide to identify best practice examples and create a resource to assist others to begin successful collaboration. PMID:21991284
Total, Added, and Free Sugars: Are Restrictive Guidelines Science-Based or Achievable?

PubMed Central

Erickson, Jennifer; Slavin, Joanne

2015-01-01

Sugar consumption, especially added sugars, is under attack. Various government and health authorities have suggested new sugar recommendations and guidelines as low as 5% of total calories from free sugars. Definitions for total sugars, free sugars, and added sugars are not standardized, nor are there accepted nutrient databases for this information. Our objective was to measure total sugars and added sugars in sample meal plans created by the United States Department of Agriculture (USDA) and the Academy of Nutrition and Dietetics (AND). Utilizing the Nutrition Data System for Research (NDSR) nutritional database, results found that plans created by the USDA and AND averaged 5.1% and 3.1% calories from added sugar, 8.7% and 3.1% from free sugar, and 23.3% and 21.1% as total sugars respectively. Compliance with proposed added sugar recommendations would require strict dietary compliance and may not be sustainable for many Americans. Without an accepted definition and equation for calculating added sugar, added sugar recommendations are arbitrary and may reduce intakes of nutrient-rich, recommended foods, such as yogurt, whole grains, and tart fruits including cranberries, cherries, and grapefruit. Added sugars are one part of excess calorie intake; however, compliance with low added sugar recommendations may not be achievable for the general public. PMID:25884659
Total, added, and free sugars: are restrictive guidelines science-based or achievable?

PubMed

Erickson, Jennifer; Slavin, Joanne

2015-04-15

Sugar consumption, especially added sugars, is under attack. Various government and health authorities have suggested new sugar recommendations and guidelines as low as 5% of total calories from free sugars. Definitions for total sugars, free sugars, and added sugars are not standardized, nor are there accepted nutrient databases for this information. Our objective was to measure total sugars and added sugars in sample meal plans created by the United States Department of Agriculture (USDA) and the Academy of Nutrition and Dietetics (AND). Utilizing the Nutrition Data System for Research (NDSR) nutritional database, results found that plans created by the USDA and AND averaged 5.1% and 3.1% calories from added sugar, 8.7% and 3.1% from free sugar, and 23.3% and 21.1% as total sugars respectively. Compliance with proposed added sugar recommendations would require strict dietary compliance and may not be sustainable for many Americans. Without an accepted definition and equation for calculating added sugar, added sugar recommendations are arbitrary and may reduce intakes of nutrient-rich, recommended foods, such as yogurt, whole grains, and tart fruits including cranberries, cherries, and grapefruit. Added sugars are one part of excess calorie intake; however, compliance with low added sugar recommendations may not be achievable for the general public.
Which Online Resources Are Right for Your Collection?

ERIC Educational Resources Information Center

Pearlmutter, Jane

1999-01-01

Discusses important considerations for library media specialists creating a virtual-resources-collection policy, including selecting the right resources, navigating licensing fees, and free, searchable online sources. A sidebar lists resources for evaluating Web sites and places that lead to recommended sites for students. (AEF)
Fiber Optics: Deregulate and Deploy.

ERIC Educational Resources Information Center

Suwinski, Jan H.

1993-01-01

Describes fiber optic technology, explains its use in education and commercial settings, and recommends regulations and legislation that will speed its use to create broadband information networks. Topics discussed include distance learning; interactive video; costs; and the roles of policy makers, lawmakers, public advocacy groups, and consumers.…
Designing Playgrounds for Children of All Abilities.

ERIC Educational Resources Information Center

Goltsman, Susan

1997-01-01

Provides performance criteria for creating accessibility for and integration of children of all abilities within school playgrounds. Included are recommendations for accessible route designs; play equipment; sand and water play; gathering places and outdoor classrooms; entrances and signage; and fences, enclosures, and barriers. Proposed changes…
Using a trauma-informed policy approach to create a resilient urban food system.

PubMed

Hecht, Amelie A; Biehl, Erin; Buzogany, Sarah; Neff, Roni A

2018-07-01

Food insecurity is associated with toxic stress and adverse long-term physical and mental health outcomes. It can be experienced chronically and also triggered or exacerbated by natural and human-made hazards that destabilize the food system. The Baltimore Food System Resilience Advisory Report was created to strengthen the resilience of the city's food system and improve short- and long-term food security. Recognizing food insecurity as a form of trauma, the report was developed using the principles of trauma-informed social policy. In the present paper, we examine how the report applied trauma-informed principles to policy development, discuss the challenges and benefits of using a trauma-informed approach, and provide recommendations for others seeking to create trauma-informed food policy. Report recommendations were developed based on: semi-structured interviews with food system stakeholders; input from community members at outreach events; a literature review; Geographic Information System mapping; and other analyses. The present paper explores findings from the stakeholder interviews. Baltimore, Maryland, USA. Baltimore food system stakeholders stratified by two informant categories: organizations focused on promoting food access (n 13) and community leaders (n 12). Stakeholder interviews informed the recommendations included in the report and supported the idea that chronic and acute food insecurity are experienced as trauma in the Baltimore community. Applying a trauma-informed approach to the development of the Baltimore Food System Resilience Advisory Report contributed to policy recommendations that were community-informed and designed to lessen the traumatic impact of food insecurity.
The Texas Children's Hospital immunization forecaster: conceptualization to implementation.

PubMed

Cunningham, Rachel M; Sahni, Leila C; Kerr, G Brady; King, Laura L; Bunker, Nathan A; Boom, Julie A

2014-12-01

Immunization forecasting systems evaluate patient vaccination histories and recommend the dates and vaccines that should be administered. We described the conceptualization, development, implementation, and distribution of a novel immunization forecaster, the Texas Children's Hospital (TCH) Forecaster. In 2007, TCH convened an internal expert team that included a pediatrician, immunization nurse, software engineer, and immunization subject matter experts to develop the TCH Forecaster. Our team developed the design of the model, wrote the software, populated the Excel tables, integrated the software, and tested the Forecaster. We created a table of rules that contained each vaccine's recommendations, minimum ages and intervals, and contraindications, which served as the basis for the TCH Forecaster. We created 15 vaccine tables that incorporated 79 unique dose states and 84 vaccine types to operationalize the entire United States recommended immunization schedule. The TCH Forecaster was implemented throughout the TCH system, the Indian Health Service, and the Virginia Department of Health. The TCH Forecast Tester is currently being used nationally. Immunization forecasting systems might positively affect adherence to vaccine recommendations. Efforts to support health care provider utilization of immunization forecasting systems and to evaluate their impact on patient care are needed.
Using Alice 2.0 to Design Games for People with Stroke.

PubMed

Proffitt, Rachel; Kelleher, Caitlin; Baum, M Carolyn; Engsberg, Jack

2012-08-01

Computer and videogames are gaining in popularity as rehabilitation tools. Unfortunately, most systems still require extensive programming/engineering knowledge to create, something that therapists, as novice programmers, do not possess. There is software designed to allow novice programmers to create storyboard and games through simple drag-and-drop formats; however, the applications for therapeutic game development have not been studied. The purpose of this study was to have an occupational therapy (OT) student with no prior computer programming experience learn how to create computer games for persons with stroke using Alice 2.0, a drag-and-drop editor, designed by Carnegie Mellon University (Pittsburgh, PA). The OT student learned how to use Alice 2.0 through a textbook, tutorials, and assistance from computer science students. She kept a journal of her process, detailing her successes and challenges. The OT student created three games for people with stroke using Alice 2.0. She found that although there were many supports in Alice for creating stories, it lacked critical pieces necessary for game design. Her recommendations for a future programming environment for therapists were that it (1) be efficient, (2) include basic game design pieces so therapists do not have to create them, (3) provide technical support, and (4) be simple. With the incorporation of these recommendations, a future programming environment for therapists will be an effective tool for therapeutic game development.
Meeting the Preteen Vaccine Law: A Pilot Program in Urban Middle Schools.

ERIC Educational Resources Information Center

Boyer-Chuanroong, Lynda; Deaver, Paul

2000-01-01

Describes the efforts, outcomes, and recommendations from an urban California school district's pilot program for vaccinating preteens in two diverse urban middle schools. Barriers and strategies included staff inexperience, educating students, informing parents, tracking vaccinations, coping with language diversity, and creating individualized…
Collection Development Policies in Community College Libraries.

ERIC Educational Resources Information Center

Mesling, Chris Fowler

2003-01-01

Emphasizes the need for collection development policy in community college academic libraries. Highlights areas of resource sharing, community analysis, and collection assessment. Also provides an overview of how to create a collection for development policy, and recommends books on writing such policy. Includes model policy statements. (NB)
Texas Sustainable School Design Guideline.

ERIC Educational Resources Information Center

Nicklas, Michael; Bailey, Gary; Padia, Harshad D.; Malin, Nadav

This guide offers a detailed listing of the key practices and technologies that can help create a sustainable school. The document includes hundreds of cost-effective recommendations that can improve the energy performance and environmental quality of school designs. Each design and construction phase is addressed, from site selection through…
Food, Energy, and The Environment: Alternatives for Creating New Lifestyles.

ERIC Educational Resources Information Center

Sorrells, Nancy R.; Pimentel, David

1981-01-01

Provides background information on the interdependency of agriculture and ecological and social systems. Discusses in detail: (1) fossil energy and food production; (2) energy-intensive agriculture and environmental pollution; and (3) methods for developing alternatives. Includes recommendations to conserve fossil energy used in current food…
Development of clinical recommendations for progressive return to activity after military mild traumatic brain injury: guidance for rehabilitation providers.

PubMed

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

2015-01-01

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

PubMed

Cerri, Karin H; Knapp, Martin; Fernandez, Jose-Luis

2014-09-01

The College Voor Zorgverzekeringen (CVZ) provides guidance to the Dutch healthcare system on funding and use of new pharmaceutical technologies. This study examined the impact of evidence, process and context factors on CVZ decisions in 2004-2009. A data set of CVZ decisions pertaining to pharmaceutical technologies was created, including 29 variables extracted from published information. A three-category outcome variable was used, defined as the decision to 'recommend', 'restrict' or 'not recommend' a technology. Technologies included in list 1A/1B or on the expensive drug list were considered recommended; those included in list 2 or for which patient co-payment is required were considered restricted; technologies not included on any reimbursement list were classified as 'not recommended'. Using multinomial logistic regression, the relative contribution of explanatory variables on CVZ decisions was assessed. In all, 244 technology appraisals (256 technologies) were analysed, with 51%, of technologies recommended, 33% restricted and 16% not recommended by CVZ for funding. The multinomial model showed significant associations (p ≤ 0.10) between CVZ outcome and several variables, including: (1) use of an active comparator and demonstration of statistical superiority of the primary endpoint in clinical trials, (2) pharmaceutical budget impact associated with introduction of the technology, (3) therapeutic indication and (4) prevalence of the target population. Results confirm the value of a comprehensive and multivariate approach to understanding CVZ decision-making.
Implementing AORN recommended practices for transfer of patient care information.

PubMed

Seifert, Patricia C

2012-11-01

The Joint Commission estimates that 80% of serious medical errors are associated with miscommunication during patient transfers. Patient transfers may occur between a wide array of settings: between physicians' offices or preoperative areas and traditional ORs or ambulatory settings, between emergency departments or interventional suites and the OR, and between other areas where the exchange of patient information occurs. AORN's "Recommended practices for transfer of patient care information" serves as a guide for establishing achievable practices that promote a safe level of care during perioperative patient transfers. Strategies for the successful implementation of the recommended practices include promoting teamwork, including with the patient and the patient's family members; developing effective communication skills; documenting processes; creating and adhering to policies and procedures; and establishing quality management programs. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Considerations Taken in Developing the Frequency Assignment Guidelines for Communications in the Mars Region Provided in SFCG Recommendation 22-1, (SFCG Action Item No. 23/10)

NASA Technical Reports Server (NTRS)

Wang, Charles C.; Peng, Ted; Sue, Miles K.

2004-01-01

In the 23'd Annual SFCG meeting in San Diego, CA, the SFCG created SFCG Action Item No. 23/10 to provide a readable summary of the work done by the Mars Interim Working Group (MIWG). The SFCG created the MIWG to develop a frequency plan for future Mars missions. The working group has produced a number of documents resulting in a recommendation, SFCG Rec 22-1 [1], titled Frequency Assignment Guidelines for Communications in Mars Region, including a frequency plan for the Mars Region. This document is prepared in response to the SFCG Action Item to provide an overview of the considerations taken when selecting the frequencies and to point out where detailed information of the considerations can be found.
School Readiness Report Card

ERIC Educational Resources Information Center

Chase, Richard; Egbert, Andi; Valorose, Jennifer

2011-01-01

The Early Childhood Advisory Council (ECAC) in Minnesota makes recommendations to the Governor and Legislature, and is responsible for fulfilling the duties required by federal and state statutes. The Council was created in 2008 by the Governor's Executive Order 08-14. The ECAC consists of 18 members, including the State Director of the Head Start…
Strategies for Implementing a Tobacco-Free Campus Policy

ERIC Educational Resources Information Center

Glassman, Tavis J.; Reindl, Diana M.; Whewell, Aubrey T.

2011-01-01

This report examines the rationale for creating a tobacco-free campus to utilize in passing antitobacco policies, and recommendations for overcoming barriers. As with any type of advocacy effort, a variety of impediments exist, including lack of administrative and staff support, absence of student involvement, and sparse resources. A variety of…
Ask a Futurist. Peace [and] Robots.

ERIC Educational Resources Information Center

Joseph, Earl C.

A futurist addresses two questions concerning world peace and the implications of using robots. In the section on peace (part 1), recommendations for world peace include: (1) implementing peace education as a mandatory part of education; (2) establishing a Department of Peace in each country to create a societal infrastructure for implementing…

What Makes the Weather?

ERIC Educational Resources Information Center

NatureScope, 1985

1985-01-01

Provides (1) background information showing how the sun, earth, air, and water work together to create weather; (2) six activities on this topic; and (3) a ready-to-copy coloring page on the water cycle. Each activity includes an objective, list of materials needed, recommended age level(s), subject area(s), and instructional strategies. (JN)
Factors Affecting the Formation of Food Preferences in Preschool Children.

ERIC Educational Resources Information Center

Alles-White, Monica L.; Welch, Patricia

1985-01-01

Identifies and discusses factors that affect the development of food preferences in preschool children, including familiarity, age, parents, peers, teachers, and programs designed to influence food habits. Makes recommendations to preschool and day care programs for creating an atmosphere conducive to trying new foods. (Author/DST)
Eleven Ways to Stamp Out the Potential for Sexual Harassment.

ERIC Educational Resources Information Center

Decker, Robert H.

1988-01-01

Reviews the 1980 Equal Employment Opportunity Commission guidelines defining sexual harassment as a form of sex discrimination. Advises 11 steps, including creating clear-cut policies and guidelines to help school officials deal with the problem. Insets offer policy "pointers" and several recommendations for staff members desiring to counter…
The Development of Best Practice Recommendations to Support the Hiring, Recruitment, and Advancement of Women Physicians in Emergency Medicine.

PubMed

Choo, Esther K; Kass, Dara; Westergaard, Mary; Watts, Susan H; Berwald, Nicole; Regan, Linda; Promes, Susan B; Clem, Kathleen J; Schneider, Sandra M; Kuhn, Gloria J; Abbuhl, Stephanie; Nobay, Flavia

2016-11-01

Women in medicine continue to experience disparities in earnings, promotion, and leadership roles. There are few guidelines in place defining organization-level factors that promote a supportive workplace environment beneficial to women in emergency medicine (EM). We assembled a working group with the goal of developing specific and feasible recommendations to support women's professional development in both community and academic EM settings. We formed a working group from the leadership of two EM women's organizations, the Academy of Women in Academic Emergency Medicine (AWAEM) and the American Association of Women Emergency Physicians (AAWEP). Through a literature search and discussion, working group members identified four domains where organizational policies and practices supportive of women were needed: 1) global approaches to supporting the recruitment, retention, and advancement of women in EM; 2) recruitment, hiring, and compensation of women emergency physicians; 3) supporting development and advancement of women in EM; and 4) physician health and wellness (in the context of pregnancy, childbirth, and maternity leave). Within each of these domains, the working group created an initial set of specific recommendations. The working group then recruited a stakeholder group of EM physician leaders across the country, selecting for diversity in practice setting, geographic location, age, race, and gender. Stakeholders were asked to score and provide feedback on each of the recommendations. Specific recommendations were retained by the working group if they achieved high rates of approval from the stakeholder group for importance and perceived feasibility. Those with >80% agreement on importance and >50% agreement on feasibility were retained. Finally, recommendations were posted in an open online forum (blog) and invited public commentary. An initial set of 29 potential recommendations was created by the working group. After stakeholder voting and feedback, 16 final recommendations were retained. Recommendations were refined through qualitative comments from stakeholders and blog respondents. Using a consensus building process that included male and female stakeholders from both academic and community EM settings, we developed recommendations for organizations to implement to create a workplace environment supportive of women in EM that were perceived as acceptable and feasible. This process may serve as a model for other medical specialties to establish clear, discrete organization-level practices aimed at supporting women physicians. © 2016 by the Society for Academic Emergency Medicine.
Spanish adaptation of the recommendations for the appropriate use of social networks in urology of the European Association of Urology.

PubMed

Rodríguez-Socarrás, M E; Gómez-Rivas, J; Álvarez-Maestro, M; Tortolero, L; Ribal, M J; Garcia Sanz, M; Roupret, M

2016-09-01

To adapt to Spanish the recommendations for the appropriate use of social media (SoMe) in the urological setting prepared by the European Association of Urology (EAU). The use of SoMe has become fairly popular in the international urological community. Due to the nature of the medical content shared among healthcare professionals through SoMe, however, there is the risk of medical and legal problems. For this reason, various international urological associations such as the American Urological Association, the British Association of Urological Surgeons and EAU have published their recommendations for the appropriate use of social media. Efforts have been made to adapt and summarise the recommendations of the EAU in Spanish and to publish them in Actas Urológicas Españolas (@actasurologicas), the official journal of the Spanish Urological Association (@InfoAEU) and the American Confederation of Urology (@CAU_URO). SoMe include well-known platforms such as Twitter, Facebook and YouTube, which have undoubtedly changed the way in which people communicate and interact. SoMe offer clear advantages for communicating between professionals, working in teams, disseminating knowledge and creating professional profiles and are increasingly used by patients and healthcare practitioners. The introduction of SoMe in the urological community has started a revolution in how scientific articles are shared, how people participate in congresses and how international urological associations communicate with their followers. However, SoMe is generally an open public setting, with potential risks for confidentiality and the doctor-patient relationship due to the nature of the shared information. The present recommendations include tools for creating professional profiles, protecting confidentiality and creating honest and responsible content. SoMe represents a fascinating area for the communication and dissemination of knowledge, with considerable applicability in health care and the urological community. New efforts are being directed to extend the use of social media in the urological community, measuring its actual academic impact and standardising the language employed. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.
Utilizing Linked Open Data Sources for Automatic Generation of Semantic Metadata

NASA Astrophysics Data System (ADS)

Nummiaho, Antti; Vainikainen, Sari; Melin, Magnus

In this paper we present an application that can be used to automatically generate semantic metadata for tags given as simple keywords. The application that we have implemented in Java programming language creates the semantic metadata by linking the tags to concepts in different semantic knowledge bases (CrunchBase, DBpedia, Freebase, KOKO, Opencyc, Umbel and/or WordNet). The steps that our application takes in doing so include detecting possible languages, finding spelling suggestions and finding meanings from amongst the proper nouns and common nouns separately. Currently, our application supports English, Finnish and Swedish words, but other languages could be included easily if the required lexical tools (spellcheckers, etc.) are available. The created semantic metadata can be of great use in, e.g., finding and combining similar contents, creating recommendations and targeting advertisements.
Educational Decentralization and Behavior Change Needs in Indonesia. Working Paper.

ERIC Educational Resources Information Center

Cohen, Joseph

This working paper examines behavior change as a key element in creating an enabling environment to sustain educational reform in Indonesia. It recommends elevating the importance of a formalized behavior change framework and methodology so that future plans for educational reform in Indonesia will include social marketing as a planned…
Creating a cryobank for germplasm of fruit and berry crops: methodological recommendations

USDA-ARS?s Scientific Manuscript database

Plant genetic resources are a national treasure in each country. They serve as a basis for developing new and improving existing varieties of plants. In Kazakhstan, a wide selection of cultivated and wild forms grow unique fruit and berry crops, including apple (Malus sieversii (Ledeb.) M. Roem., Ma...
Don't Fight the Man Who Buys His Ink by the Barrel.

ERIC Educational Resources Information Center

Akers, James T.

Positive school-media relations are essential if schools are to expect an "understanding press" during crucial periods. Recommendations for developing and maintaining such relations fall into 10 areas, including school boards' establishing a firm media relations policy, appointing a board spokesman, creating a "game plan" for media dealings, and…
The Faculty Liaison as Research Coordinator: A Growing Need for the Academic Community.

ERIC Educational Resources Information Center

Grochmal, Helen M.

This paper recommends the creation of a position of research coordinator by expanding the role of faculty liaison within colleges and universities to help bring services generally provided by special libraries to academic researchers. Reasons given for academic institutions to create such a position include the practicability of applying new…
The FACET Report. Toward 2001: An Odyssey of Excellence.

ERIC Educational Resources Information Center

Saint Petersburg Junior Coll., FL.

In 1989, the Focus on Access, Community, and Excellence in Teaching (FACET) Commission was created at St. Petersburg Junior College (SPJC) to develop recommendations to guide the college into the 21st century. The Commission's work plan included the definition of SPJC's educational standards; open hearings to solicit ideas from students, faculty,…
Assessment and Accommodations for English Language Learners: Issues and Recommendations. CRESST Policy Brief 4, Summer 2001.

ERIC Educational Resources Information Center

Abedi, Jamal

This policy brief addresses the inclusion of English language learners (ELLs) in large-scale assessments and ELL assessment accommodations. The inclusion of ELL students creates specific accountability policy challenges. States differ in the students they include and their inclusion policies and accommodation practices, and, at present, inclusion…
Drilling deeper into the core: an analysis of journal evaluation methodologies used to create the "Basic List of Veterinary Medical Serials," third edition.

PubMed

Ugaz, Ana G

2011-04-01

The paper analyzes the journal evaluation criteria used to create the third edition of a core list of veterinary serials to determine the impact of each criterion on the final composition of the list in order to assess the value of using multiple criteria in creating a core list. Three additional lists were generated from criteria that were previously combined to prepare the third edition of the "Basic List of Veterinary Medical Serials": a list based on journal recommendations from veterinary specialty organizations, another list based on journals selected by veterinary librarians, and a list based on both indexing coverage and scholarly rank. The top fifteen journals in each of the three lists were then compared to reveal potential biases. Subject representation on the full lists generated by each of these methods was also compared. The list based on journal recommendations from veterinary specialty organizations exhibited a focus on clinically relevant titles. The list based on veterinary librarian recommendations resulted in the broadest subject coverage. The list based on indexing and scholarly rank, while emphasizing research titles, produced the largest number of unique titles. A combination approach that includes objective evaluation measures and practical input, whether from librarians or discipline experts, can improve coverage and can result in a list that balances research-based with clinical practice journals.
Mixed reaction to science department proposal

NASA Astrophysics Data System (ADS)

The recommendation last month by a presidential commission that a federal Department of Science and Technology be created to encompass “major civilian research and development (R&D) agencies” has elicited a mixed reaction from members of the geophysical sciences community.The Commission on Industrial Competitiveness, created by President Ronald Reagan in June 1983 to study ways to strengthen the ability of the United States to compete in a global marketplace, recommended establishment of a Cabinet-level science department “to promote national interest in and policies for research and technological innovation.” The commission, chaired by John A. Young, president of the Hewlett-Packard Company, was composed primarily of presidents and chief executive officers of major technology corporations but also included members of academia and government. Creation of a federal science and technology 'department is one of many suggestions contained in the commission's final report, Global Competition: The New Reality.
Recommendations to Sustain the Academic Mission Ecosystem at U.S. Medical Schools.

PubMed

Kerschner, Joseph E; Hedges, Jerris R; Antman, Karen; Abraham, Edward; Colón Negrón, Edgar; Jameson, J Larry

2018-07-01

Academic medical center (AMC) faculty, administrators, and leaders have the critical tasks of teaching and training the next generation of health care providers and biomedical researchers, as well as generating new knowledge that improves the health of all. In the United States, medical schools and their affiliated hospitals train remarkably high-quality physicians and scientists, and the research conducted at these institutions results in advances in health. To that end, AMCs have become essential engines for driving better health in the United States and the rest of the world; they also have become essential engines driving the economies of their respective communities and regions. The education and research missions, however, require subsidization because tuition and extramural grant funding do not cover the costs of these endeavors. This subsidization largely has come from revenues generated by AMCs' clinical endeavors. The viability of this cross-subsidization, however, is increasingly threatened in the current clinical environment. The authors of this Perspective discuss these issues in depth and provide some concrete recommendations to address these challenges. They hope to stimulate discussion and, ultimately, ensure the financial viability of U.S. AMCs-a national resource of utmost importance. Recommendations to sustain research include creating strategic biomedical research plans, developing a defined and sustained model to support National Institutes of Health funding that keeps pace with inflation, and evolving funding mechanisms. Recommendations to sustain medical education include limiting student debt, creating more cost-effective curricula, and ensuring that clinical training opportunities that meet national standards are available to students.
Growing Wikipedia Across Languages via Recommendation.

PubMed

Wulczyn, Ellery; West, Robert; Zia, Leila; Leskovec, Jure

2016-04-01

The different Wikipedia language editions vary dramatically in how comprehensive they are. As a result, most language editions contain only a small fraction of the sum of information that exists across all Wikipedias. In this paper, we present an approach to filling gaps in article coverage across different Wikipedia editions. Our main contribution is an end-to-end system for recommending articles for creation that exist in one language but are missing in another. The system involves identifying missing articles, ranking the missing articles according to their importance, and recommending important missing articles to editors based on their interests. We empirically validate our models in a controlled experiment involving 12,000 French Wikipedia editors. We find that personalizing recommendations increases editor engagement by a factor of two. Moreover, recommending articles increases their chance of being created by a factor of 3.2. Finally, articles created as a result of our recommendations are of comparable quality to organically created articles. Overall, our system leads to more engaged editors and faster growth of Wikipedia with no effect on its quality.
Growing Wikipedia Across Languages via Recommendation

PubMed Central

Wulczyn, Ellery; West, Robert; Zia, Leila; Leskovec, Jure

2016-01-01

The different Wikipedia language editions vary dramatically in how comprehensive they are. As a result, most language editions contain only a small fraction of the sum of information that exists across all Wikipedias. In this paper, we present an approach to filling gaps in article coverage across different Wikipedia editions. Our main contribution is an end-to-end system for recommending articles for creation that exist in one language but are missing in another. The system involves identifying missing articles, ranking the missing articles according to their importance, and recommending important missing articles to editors based on their interests. We empirically validate our models in a controlled experiment involving 12,000 French Wikipedia editors. We find that personalizing recommendations increases editor engagement by a factor of two. Moreover, recommending articles increases their chance of being created by a factor of 3.2. Finally, articles created as a result of our recommendations are of comparable quality to organically created articles. Overall, our system leads to more engaged editors and faster growth of Wikipedia with no effect on its quality. PMID:27819073
Research Gaps in Wilderness Medicine.

PubMed

Tritz, Daniel; Dormire, Kody; Brachtenbach, Travis; Gordon, Joshua; Sanders, Donald; Gearheart, David; Crawford, Julia; Vassar, Matt

2018-05-18

Wilderness medicine involves the treatment of individuals in remote, austere environments. Given the high potential for injuries as well as the unique treatment modalities required in wilderness medicine, evidence-based clinical practice guidelines are necessary to provide optimal care. In this study, we identify evidence gaps from low-quality recommendations in wilderness medicine clinical practice guidelines and identify new/ongoing research addressing them. We included relevant clinical practice guidelines from the Wilderness Medical Society and obtained all 1C or 2C level recommendations. Patient/Problem/Population, intervention, comparison, outcome (PICO) questions were created to address each recommendation. Using 24 search strings, we extracted titles, clinical trial registry number, and recruitment status for 8899 articles. We categorized the articles by trial design to infer the effect they may have on future recommendations. Twelve clinical practice guidelines met inclusion criteria. From these we located 275 low-quality recommendations and used them to create 275 PICO questions. Thirty-three articles were relevant to the PICO questions. Heat-related illness had the highest number of relevant articles (n=9), but acute pain and altitude sickness had the most randomized clinical trials (n=6). Overall, few studies were being conducted to address research gaps in wilderness medicine. Heat-related illness had the most new or ongoing research, whereas no studies were being conducted to address gaps in eye injuries, basic wound management, or spine immobilization. Animals, cadavers, and mannequin research are useful in cases in which human evidence is difficult to obtain. Establishing research priorities is recommended for addressing research gaps identified by guideline panels. Copyright © 2018 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
Software Engineering Laboratory Series: Proceedings of the Twentieth Annual Software Engineering Workshop

NASA Technical Reports Server (NTRS)

1995-01-01

The Software Engineering Laboratory (SEL) is an organization sponsored by NASA/GSFC and created to investigate the effectiveness of software engineering technologies when applied to the development of application software. The activities, findings, and recommendations of the SEL are recorded in the Software Engineering Laboratory Series, a continuing series of reports that includes this document.
3 CFR 13517 - Executive Order 13517 of October 30, 2009. Amendments to Executive Orders 13183 and 13494

Code of Federal Regulations, 2010 CFR

2010-01-01

... initiatives that benefit Puerto Rico; provide advice and recommendations to the President and the Congress on..., or concerning the manner of exercising, the right to organize and bargain collectively), including.... 31.205-21.” Sec. 3. This order is not intended to, and does not, create any right or benefit...

Software Engineering Laboratory Series: Collected Software Engineering Papers. Volume 15

NASA Technical Reports Server (NTRS)

1997-01-01

The Software Engineering Laboratory (SEL) is an organization sponsored by NASA/GSFC and created to investigate the effectiveness of software engineering technologies when applied to the development of application software. The activities, findings, and recommendations of the SEL are recorded in the Software Engineering Laboratory Series, a continuing series of reports that includes this document.
Software Engineering Laboratory Series: Collected Software Engineering Papers. Volume 14

NASA Technical Reports Server (NTRS)

1996-01-01

The Software Engineering Laboratory (SEL) is an organization sponsored by NASA/GSFC and created to investigate the effectiveness of software engineering technologies when applied to the development of application software. The activities, findings, and recommendations of the SEL are recorded in the Software Engineering Laboratory Series, a continuing series of reports that includes this document.
Software Engineering Laboratory Series: Collected Software Engineering Papers. Volume 13

NASA Technical Reports Server (NTRS)

1995-01-01

The Software Engineering Laboratory (SEL) is an organization sponsored by NASA/GSFC and created to investigate the effectiveness of software engineering technologies when applied to the development of application software. The activities, findings, and recommendations of the SEL are recorded in the Software Engineering Laboratory Series, a continuing series of reports that includes this document.
Assessment and recommendations for two sites with active and potential aquaculture production in Rift Valley and Coast Provinces, Kenya

USDA-ARS?s Scientific Manuscript database

Kenya has a long history of local fish consumption. The population in the Lake Victoria area (Rift Valley Province) Northwest of Nairobi and coastal communities (Coast Province) have historically included fish in their diet. Migration from villages to urban areas and increasing commerce has created ...
Ethnic Heritage Studies Program: Assessment of the First Year, July 1, 1974-June 30, 1975.

ERIC Educational Resources Information Center

National Education Association, Washington, DC.

The report explains how the federal Ethnic Heritage Studies Program was created, gives an overview of the 1974 program, and makes recommendations for future development of the program. Summaries of the 1974 projects, bibliographies of replicable materials produced by the projects, and ethnic and regional indexes are included. The overview…
Some developing concepts of engineering education

NASA Technical Reports Server (NTRS)

Perkins, C. D.

1975-01-01

An analysis of the circumstances which have created a shortage of aeronautical engineering undergraduate students in the universities is presented. Suggestions for motivating students to enter aeronautical engineering are examined. The support of the aeronautical industry for graduate education funding is recommended. Examples of actions taken by governmental agencies to promote increased interest in aeronautical engineering are included.
Altered Mental Status: Current Evidence-based Recommendations for Prehospital Care.

PubMed

Sanello, Ashley; Gausche-Hill, Marianne; Mulkerin, William; Sporer, Karl A; Brown, John F; Koenig, Kristi L; Rudnick, Eric M; Salvucci, Angelo A; Gilbert, Gregory H

2018-05-01

In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the AMS protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were patient assessment, point-of-care tests, supplemental oxygen, use of standardized scoring, evaluating for causes of AMS, blood glucose evaluation, toxicological treatment, and pediatric evaluation and management. Protocols across 33 EMS agencies in California varied widely. All protocols call for a blood glucose check, 21 (64%) suggest treating adults at <60mg/dL, and half allow for the use of dextrose 10%. All the protocols recommend naloxone for signs of opioid overdose, but only 13 (39%) give specific parameters. Half the agencies (52%) recommend considering other toxicological causes of AMS, often by using the mnemonic AEIOU TIPS. Eight (24%) recommend a 12-lead electrocardiogram; others simply suggest cardiac monitoring. Fourteen (42%) advise supplemental oxygen as needed; only seven (21%) give specific parameters. In terms of considering various etiologies of AMS, 25 (76%) give instructions to consider trauma, 20 (61%) to consider stroke, and 18 (55%) to consider seizure. Twenty-three (70%) of the agencies have separate pediatric AMS protocols; others include pediatric considerations within the adult protocol. Protocols for patients with AMS vary widely across the State of California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols.
Recommendations for Laboratory Containment and Management of Gene Drive Systems in Arthropods.

PubMed

Benedict, Mark Q; Burt, Austin; Capurro, Margareth L; De Barro, Paul; Handler, Alfred M; Hayes, Keith R; Marshall, John M; Tabachnick, Walter J; Adelman, Zach N

2018-01-01

Versatile molecular tools for creating driving transgenes and other invasive genetic factors present regulatory, ethical, and environmental challenges that should be addressed to ensure their safe use. In this article, we discuss driving transgenes and invasive genetic factors that can potentially spread after their introduction into a small proportion of individuals in a population. The potential of invasive genetic factors to increase their number in natural populations presents challenges that require additional safety measures not provided by previous recommendations regarding accidental release of arthropods. In addition to providing physical containment, invasive genetic factors require greater attention to strain management, including their distribution and identity confirmation. In this study, we focus on insects containing such factors with recommendations for investigators who are creating them, institutional biosafety committees charged with ensuring safety, funding agencies providing support, those managing insectaries handling these materials who are responsible for containment, and other persons who will be receiving insects-transgenic or not-from these facilities. We give specific examples of efforts to modify mosquitoes for mosquito-borne disease control, but similar considerations are relevant to other arthropods that are important to human health, the environment, and agriculture.
Recommendations for Laboratory Containment and Management of Gene Drive Systems in Arthropods

PubMed Central

Burt, Austin; Capurro, Margareth L.; De Barro, Paul; Handler, Alfred M.; Hayes, Keith R.; Marshall, John M.; Tabachnick, Walter J.; Adelman, Zach N.

2018-01-01

Abstract Versatile molecular tools for creating driving transgenes and other invasive genetic factors present regulatory, ethical, and environmental challenges that should be addressed to ensure their safe use. In this article, we discuss driving transgenes and invasive genetic factors that can potentially spread after their introduction into a small proportion of individuals in a population. The potential of invasive genetic factors to increase their number in natural populations presents challenges that require additional safety measures not provided by previous recommendations regarding accidental release of arthropods. In addition to providing physical containment, invasive genetic factors require greater attention to strain management, including their distribution and identity confirmation. In this study, we focus on insects containing such factors with recommendations for investigators who are creating them, institutional biosafety committees charged with ensuring safety, funding agencies providing support, those managing insectaries handling these materials who are responsible for containment, and other persons who will be receiving insects—transgenic or not—from these facilities. We give specific examples of efforts to modify mosquitoes for mosquito-borne disease control, but similar considerations are relevant to other arthropods that are important to human health, the environment, and agriculture. PMID:29040058
The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo.

PubMed

Mohammad, Tasneem F; Al-Jamal, Mohammed; Hamzavi, Iltefat H; Harris, John E; Leone, Giovanni; Cabrera, Raúl; Lim, Henry W; Pandya, Amit G; Esmat, Samia M

2017-05-01

Treatment of vitiligo with narrowband ultraviolet B light (NBUVB) is an important component of the current standard of care. However, there are no consistent guidelines regarding the dosing and administration of NBUVB in vitiligo, reflected by varied treatment practices around the world. To create phototherapy recommendations to facilitate clinical management and identify areas requiring future research. The Vitiligo Working Group (VWG) Phototherapy Committee addressed 19 questions regarding the administration of phototherapy over 3 conference calls. Members of the Photomedicine Society and a group of phototherapy experts were surveyed regarding their phototherapy practices. Based on comparison and analysis of survey results, expert opinion, and discussion held during conference calls, expert recommendations for the administration of NBUVB phototherapy in vitiligo were created. There were several areas that required further research before final recommendations could be made. In addition, no standardized methodology was used during literature review and to assess the strength of evidence during the development of these recommendations. This set of expert recommendations by the VWG is based on the prescribing practices of phototherapy experts from around the world to create a unified, broadly applicable set of recommendations on the use of NBUVB in vitiligo. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Quality and Variability of Online Available Physical Therapy Protocols From Academic Orthopaedic Surgery Programs for Anterior Cruciate Ligament Reconstruction.

PubMed

Makhni, Eric C; Crump, Erica K; Steinhaus, Michael E; Verma, Nikhil N; Ahmad, Christopher S; Cole, Brian J; Bach, Bernard R

2016-08-01

To assess the quality and variability found across anterior cruciate ligament (ACL) rehabilitation protocols published online by academic orthopaedic programs. Web-based ACL physical therapy protocols from United States academic orthopaedic programs available online were included for review. Main exclusion criteria included concomitant meniscus repair, protocols aimed at pediatric patients, and failure to provide time points for the commencement or recommended completion of any protocol components. A comprehensive, custom scoring rubric was created that was used to assess each protocol for the presence or absence of various rehabilitation components, as well as when those activities were allowed to be initiated in each protocol. Forty-two protocols were included for review from 155 U.S. academic orthopaedic programs. Only 13 protocols (31%) recommended a prehabilitation program. Five protocols (12%) recommended continuous passive motion postoperatively. Eleven protocols (26%) recommended routine partial or non-weight bearing immediately postoperatively. Ten protocols (24%) mentioned utilization of a secondary/functional brace. There was considerable variation in range of desired full-weight-bearing initiation (9 weeks), as well as in the types of strength and proprioception exercises specifically recommended. Only 8 different protocols (19%) recommended return to sport after achieving certain strength and activity criteria. Many ACL rehabilitation protocols recommend treatment modalities not supported by current reports. Moreover, high variability in the composition and time ranges of rehabilitation components may lead to confusion among patients and therapists. Level II. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Guidelines for the Pharmacotherapy of Schizophrenia in Adults.

PubMed

Remington, Gary; Addington, Donald; Honer, William; Ismail, Zahinoor; Raedler, Thomas; Teehan, Michael

2017-09-01

The present guidelines address the pharmacotherapy of schizophrenia in adults across different stages, phases, and symptom domains. Guidelines were developed using the ADAPTE process, which takes advantage of existing guidelines. Six guidelines were identified for adaptation, with recommendations extracted from each. For those specific to the pharmacotherapy of schizophrenia in adults, a working group selected between guidelines and recommendations to create an adapted guideline. Recommendations can be categorized into 6 areas that include 1) first-episode schizophrenia, 2) acute exacerbation, 3) relapse prevention and maintenance treatment, 4) treatment-resistant schizophrenia, 5) clozapine-resistant schizophrenia, and 6) specific symptom domains. For each category, recommendations are made based on the available evidence, which is discussed and linked to other established guidelines. In most cases, evidence-based recommendations are made that can be used to guide current clinical treatment and decision making. Notably, however, there is a paucity of established evidence to guide treatment decision making in the case of clozapine-resistant schizophrenia, a subsample that represents a sizable proportion of those with schizophrenia.
Childhood Obesity Task Forces Established by State Legislatures, 2001-2010

PubMed Central

Kim, Sonia A.; Sherry, Bettylou; Blanck, Heidi M.

2013-01-01

Introduction States and communities are considering policy and environmental strategies, including enacting legislation, to reduce and prevent childhood obesity. One legislative approach has been to create task forces to understand key issues and develop a course of action. The goal of this study was to describe state-level, childhood obesity task forces in the United States created by legislation from 2001 through 2010. Methods We used the Center for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity database to identify state-level childhood obesity task forces created through legislation from 2001 through 2010. Results We identified 21 states that had enacted legislation creating childhood obesity task forces of which 6 had created more than one task force. Most task forces were charged with both gathering and reviewing information and making recommendations for obesity-prevention actions in the state. Most legislation required that task forces include representation from the state legislature, state agencies, community organizations, and community members. Conclusion Evaluation of the effectiveness of obesity-prevention task forces and the primary components that contribute to their success may help to determine the advantages of the use of such strategies in obesity prevention. PMID:23987250
ECLSS Integration Analysis: Advanced ECLSS Subsystem and Instrumentation Technology Study for the Space Exploration Initiative

NASA Technical Reports Server (NTRS)

1990-01-01

In his July 1989 space policy speech, President Bush proposed a long range continuing commitment to space exploration and development. Included in his goals were the establishment of permanent lunar and Mars habitats and the development of extended duration space transportation. In both cases, a major issue is the availability of qualified sensor technologies for use in real-time monitoring and control of integrated physical/chemical/biological (p/c/b) Environmental Control and Life Support Systems (ECLSS). The purpose of this study is to determine the most promising instrumentation technologies for future ECLSS applications. The study approach is as follows: 1. Precursor ECLSS Subsystem Technology Trade Study - A database of existing and advanced Atmosphere Revitalization (AR) and Water Recovery and Management (WRM) ECLSS subsystem technologies was created. A trade study was performed to recommend AR and WRM subsystem technologies for future lunar and Mars mission scenarios. The purpose of this trade study was to begin defining future ECLSS instrumentation requirements as a precursor to determining the instrumentation technologies that will be applicable to future ECLS systems. 2. Instrumentation Survey - An instrumentation database of Chemical, Microbial, Conductivity, Humidity, Flowrate, Pressure, and Temperature sensors was created. Each page of the sensor database report contains information for one type of sensor, including a description of the operating principles, specifications, and the reference(s) from which the information was obtained. This section includes a cursory look at the history of instrumentation on U.S. spacecraft. 3. Results and Recommendations - Instrumentation technologies were recommended for further research and optimization based on a consideration of both of the above sections. A sensor or monitor technology was recommended based on its applicability to future ECLS systems, as defined by the ECLSS Trade Study (1), and on whether its characteristics were considered favorable relative to similar instrumentation technologies (competitors), as determined from the Instrumentation Survey (2). The instrumentation technologies recommended by this study show considerable potential for development and promise significant returns if research efforts are invested.
Reading Clinic. A New Use for Dr. Seuss: Rhymes Help Children Learn About Words.

ERIC Educational Resources Information Center

Cunningham, Patricia

1998-01-01

This activity for K-3 students helps them learn to decode and spell words using rhyme, noting that hearing and creating rhyme helps children hear similarities among words. Books with the Dr. Seuss imprint are recommended because they appeal to children. A sample poem entitled March, by Solveig Paulson Russell, is included on a reproducible sheet.…
Death on Campuses: Common Postvention Strategies in Higher Education

ERIC Educational Resources Information Center

Streufert, Billie J.

2004-01-01

The purpose of this article is to expand on E. S. Zinner's (1985a) postvention recommendations and, given R. L. Wrenn's (1991a) conclusion that 62% of institutions have not created a postvention plan, describe how to develop a death response team (DRT) to deal with campus fatalities. The basic components of a DRT that are examined include the…
Software Engineering Laboratory Series: Proceedings of the Twenty-First Annual Software Engineering Workshop

NASA Technical Reports Server (NTRS)

1996-01-01

The Software Engineering Laboratory (SEL) is an organization sponsored by NASA/GSFC and created to investigate the effectiveness of software engineering technologies when applied to the development of application software. The activities, findings, and recommendations of the SEL are recorded in the Software Engineering Laboratory Series, a continuing series of reports that includes this document.
Software Engineering Laboratory Series: Proceedings of the Twenty-Second Annual Software Engineering Workshop

NASA Technical Reports Server (NTRS)

1997-01-01

The Software Engineering Laboratory (SEL) is an organization sponsored by NASA/GSFC and created to investigate the effectiveness of software engineering technologies when applied to the development of application software. The activities, findings, and recommendations of the SEL are recorded in the Software Engineering Laboratory Series, a continuing series of reports that includes this document.
Management of Side Effects of Novel Therapies for Multiple Myeloma: Consensus Statements Developed by the International Myeloma Foundation’s Nurse Leadership Board

PubMed Central

Bertolotti, Page; Bilotti, Elizabeth; Colson, Kathleen; Curran, Kathleen; Doss, Deborah; Faiman, Beth; Gavino, Maria; Jenkins, Bonnie; Lilleby, Kathy; Love, Ginger; Mangan, Patricia A.; McCullagh, Emily; Miceli, Teresa; Miller, Kena; Rogers, Kathryn; Rome, Sandra; Sandifer, Stacey; Smith, Lisa C.; Tariman, Joseph D.; Westphal, Jeanne

2014-01-01

Nurses play an essential role in managing the care of patients with multiple myeloma, who require education and support to receive and adhere to optimal therapy. The International Myeloma Foundation created a Nurse Leadership Board comprised of oncology nurses from leading cancer centers and community practices. An assessment survey identified the need for specific recommendations for managing key side effects of novel antimyeloma agents. Myelosuppression, thromboembolic events, peripheral neuropathy, steroid toxicities, and gastrointestinal side effects were selected for the first consensus statements. The board developed recommendations for healthcare providers in any medical setting, including grading of side-effect toxicity and strategies for managing the side effects in general, with specific recommendations pertaining to the novel agents. PMID:18490252
Stormwater Volume Control to Prevent Increases in Lake Flooding and Dam Failure Risk

NASA Astrophysics Data System (ADS)

Potter, K. W.

2017-12-01

Urban expansion is not often considered a major factor contributing to dam failure. But if urbanization occurs without mitigation of the hydrologic impacts, the risk of dam failure will increase. Of particular concern are increases in the volume of storm runoff resulting from increases in the extent of impervious surfaces. Storm runoff volumes are not regulated for much the U.S, and where they are, the required control is commonly less than 100%. Unmitigated increases in runoff volume due to urbanization can pose a risk to dams. A recent technical advisory committee of Dane County has recommended that the county require 100% control of stormwater volumes for new developments. The primary motivation was to prevent increases in the water levels in the Yahara Lakes, slowly draining lakes that are highly sensitive to runoff volume. The recommendations included the use of "volume trading" to achieve efficient compliance. Such recommendations should be considered for other slowly draining lakes, including those created by artificial structures.

Common Data Elements for Clinical Research in Friedreich Ataxia

PubMed Central

Lynch, David R.; Pandolfo, Massimo; Schulz, Jorg B.; Perlman, Susan; Delatycki, Martin B.; Payne, R. Mark; Shaddy, Robert; Fischbeck, Kenneth H.; Farmer, Jennifer; Kantor, Paul; Raman, Subha V.; Hunegs, Lisa; Odenkirchen, Joanne; Miller, Kristy; Kaufmann, Petra

2012-01-01

Background To reduce study start-up time, increase data sharing, and assist investigators conducting clinical studies, the National Institute of Neurological Disorders and Stroke embarked on an initiative to create common data elements for neuroscience clinical research. The Common Data Element Team developed general common data elements which are commonly collected in clinical studies regardless of therapeutic area, such as demographics. In the present project, we applied such approaches to data collection in Friedreich ataxia, a neurological disorder that involves multiple organ systems. Methods To develop Friedreich’s ataxia common data elements, Friedreich’s ataxia experts formed a working group and subgroups to define elements in: Ataxia and Performance Measures; Biomarkers; Cardiac and Other Clinical Outcomes; and Demographics, Laboratory Tests and Medical History. The basic development process included: Identification of international experts in Friedreich’s ataxia clinical research; Meeting via teleconference to develop a draft of standardized common data elements recommendations; Vetting of recommendations across the subgroups; Dissemination of recommendations to the research community for public comment. Results The full recommendations were published online in September 2011 at http://www.commondataelements.ninds.nih.gov/FA.aspx. The Subgroups’ recommendations are classified as core, supplemental or exploratory. Template case report forms were created for many of the core tests. Conclusions The present set of data elements should ideally lead to decreased initiation time for clinical research studies and greater ability to compare and analyze data across studies. Their incorporation into new and ongoing studies will be assessed in an ongoing fashion to define their utility in Friedreich’s ataxia. PMID:23239403
Recommendations for patient engagement in patient-oriented emergency medicine research.

PubMed

Archambault, Patrick M; McGavin, Colleen; Dainty, Katie N; McLeod, Shelley L; Vaillancourt, Christian; Lee, Jacques S; Perry, Jeffrey J; Gauvin, François-Pierre; Boivin, Antoine

2018-05-01

To make pragmatic recommendations on best practices for the engagement of patients in emergency medicine (EM) research. We created a panel of expert Canadian EM researchers, physicians, and a patient partner to develop our recommendations. We used mixed methods consisting of 1) a literature review; 2) a survey of Canadian EM researchers; 3) qualitative interviews with key informants; and 4) feedback during the 2017 Canadian Association of Emergency Physicians (CAEP) Academic Symposium. We synthesized our literature review into categories including identification and engagement, patients' roles, perceived benefits, harms, and barriers to patient engagement; 40/75 (53% response rate) invited researchers completed our survey. Among respondents, 58% had engaged patients in research, and 83% intended to engage patients in future research. However, 95% stated that they need further guidance to engage patients. Our qualitative interviews revealed barriers to patient engagement, including the need for training and patient partner recruitment.Our panel recommends 1) an overarching positive recommendation to support patient engagement in EM research; 2) seven policy-level recommendations for CAEP to support the creation of a national patient council, to develop, adopt and adapt training material, guidelines, and tools for patient engagement, and to support increased patient engagement in EM research; and 3) nine pragmatic recommendations about engaging patients in the preparatory, execution, and translational phases of EM research. Patient engagement can improve EM research by helping researchers select meaningful outcomes, increase social acceptability of studies, and design knowledge translation strategies that target patients' needs.
Many Ingredients, One Sublime Dish: The Recipe for the Passage of Illinois HB5412 Into Law.

PubMed

Baté-Ambrus, Venoncia M; Castillo, Amparo; Martinez, Erica; Campbell, Jamie; Boughton-Price, Leticia; Gutierrez Kapheim, Melissa; Arrom, José O; Hernandez, Wandy; Waddy, Jeffery; Castillo, Sheila; Schaps, Margie; Williams, Yolonda

2015-01-01

This article contextualizes the need for Illinois House Bill 5412 (HB5412), which calls for the establishment of a state board to create recommendations for the community health worker (CHW) field in Illinois, including a scope of practice, core competencies, training and certification standards, and sustainable funding and reimbursement mechanisms. Multisectorial partnerships and their outputs, coupled with frontline CHW interventions, created a synergistic climate conducive to the passing of this historic CHW legislation. This article provides a timeline and recipe for legislative success as described through processes and activities collaboratively undertaken, concentrating on a 5-year period (2009-2014).
The Inclusion of Students with BESD in Mainstream Schools: Teachers' Experiences of and Recommendations for Creating a Successful Inclusive Environment

ERIC Educational Resources Information Center

Goodman, R. L.; Burton, D. M.

2010-01-01

Since the election of the Labour government in 1997, England has seen policy changes leading to increased rights for students with special educational needs (SEN), including those with behavioural, emotional and social difficulties (BESD), to be educated in mainstream schools. The present paper reports on the findings of a small-scale study…
Recommendations from Inclusive Astronomy: Position Papers for The Decadal Survey

NASA Astrophysics Data System (ADS)

Coble, Kimberly A.; Inclusive Astronomy 2015 organizers

2018-06-01

In June 2015, 160 astronomers, sociologists, policy makers, and community leaders convened the first Inclusive Astronomy meeting at Vanderbilt University. The conference had a theme of intersectionality and was structured around four broad areas: (1) Eliminating Barriers to Access, (2) Creating Inclusive Environments, (3) Establishing a Community of Inclusive Practice, and (4) Policy, Power, and Leadership. From that meeting came the Nashville Recommendations, a road map for equity and inclusion in astronomy. At 41 pages long, the document is rich in topics for position papers relevant to the state of the profession section of the upcoming Decadal Survey. In this talk we will describe plans for position papers based on the recommendations relevant to various stake holders in the astronomical community, including funding agencies, professional societies, academic institutions, and other organizations. Feedback from Society members attending this session is encouraged.
Good Practices for Real-World Data Studies of Treatment and/or Comparative Effectiveness: Recommendations from the Joint ISPOR-ISPE Special Task Force on Real-World Evidence in Health Care Decision Making.

PubMed

Berger, Marc L; Sox, Harold; Willke, Richard J; Brixner, Diana L; Eichler, Hans-Georg; Goettsch, Wim; Madigan, David; Makady, Amr; Schneeweiss, Sebastian; Tarricone, Rosanna; Wang, Shirley V; Watkins, John; Mullins, C Daniel

2017-09-01

Real-world evidence (RWE) includes data from retrospective or prospective observational studies and observational registries and provides insights beyond those addressed by randomized controlled trials. RWE studies aim to improve health care decision making. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and the International Society for Pharmacoepidemiology (ISPE) created a task force to make recommendations regarding good procedural practices that would enhance decision makers' confidence in evidence derived from RWD studies. Peer review by ISPOR/ISPE members and task force participants provided a consensus-building iterative process for the topics and framing of recommendations. The ISPOR/ISPE Task Force recommendations cover seven topics such as study registration, replicability, and stakeholder involvement in RWE studies. These recommendations, in concert with earlier recommendations about study methodology, provide a trustworthy foundation for the expanded use of RWE in health care decision making. The focus of these recommendations is good procedural practices for studies that test a specific hypothesis in a specific population. We recognize that some of the recommendations in this report may not be widely adopted without appropriate incentives from decision makers, journal editors, and other key stakeholders. Copyright © 2017. Published by Elsevier Inc.
Altered Mental Status: Current Evidence-based Recommendations for Prehospital Care

PubMed Central

Sanello, Ashley; Mulkerin, William; Sporer, Karl A.; Brown, John F.; Koenig, Kristi L.; Rudnick, Eric M.; Salvucci, Angelo A.; Gilbert, Gregory H.

2018-01-01

Introduction In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. Methods We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the AMS protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were patient assessment, point-of-care tests, supplemental oxygen, use of standardized scoring, evaluating for causes of AMS, blood glucose evaluation, toxicological treatment, and pediatric evaluation and management. Results Protocols across 33 EMS agencies in California varied widely. All protocols call for a blood glucose check, 21 (64%) suggest treating adults at <60mg/dL, and half allow for the use of dextrose 10%. All the protocols recommend naloxone for signs of opioid overdose, but only 13 (39%) give specific parameters. Half the agencies (52%) recommend considering other toxicological causes of AMS, often by using the mnemonic AEIOU TIPS. Eight (24%) recommend a 12-lead electrocardiogram; others simply suggest cardiac monitoring. Fourteen (42%) advise supplemental oxygen as needed; only seven (21%) give specific parameters. In terms of considering various etiologies of AMS, 25 (76%) give instructions to consider trauma, 20 (61%) to consider stroke, and 18 (55%) to consider seizure. Twenty-three (70%) of the agencies have separate pediatric AMS protocols; others include pediatric considerations within the adult protocol. Conclusion Protocols for patients with AMS vary widely across the State of California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols. PMID:29760852
Development of Design Guidance for K-12 Schools: From 30% to 50% Energy Savings

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

Pless, S.; Torcellini, P.; Long, N.

2008-01-01

This paper describes the development of energy efficiency recommendations for achieving 30% whole-building energy savings in K-12 Schools over levels achieved by following the ANSI/ASHRAE/IESNA Standard 90.1, Energy Standard for Buildings Except Low-Rise Residential Buildings (1999 and 2004 versions). Exhaustive simulations were run to create packages of energy design solutions available over a wide range of K-12 schools and climates. These design recommendations look at building envelope, fenestration, lighting systems (including electrical lights and daylighting), HVAC systems, building automation and controls, outside air treatment, and service water heating. We document and discuss the energy modeling performed to demonstrate that themore » recommendations will result in at least 30% energy savings over ASHRAE 90.1-1999 and ASHRAE 90.1-2004. Recommendations are evaluated based on the availability of daylighting for the school and by the type of HVAC system. Compared to the ASHRAE 90.1-1999 baseline, the recommendations result in more than 30% savings in all climate zones for both daylit and nondaylit elementary, middle, and high schools with a range of HVAC system types. These recommendations have been included in the Advanced Energy Design Guide for K-12 School Buildings. Compared to the more stringent ASHRAE 90.1-2004 baseline, the recommendations result in more than 30% savings in all climate zones, for only the daylit elementary, middle, and high schools, with a range of HVAC system types. To inform the future development of recommendations for higher level of energy savings, we analyzed a subset of recommendations to understand which energy efficiency technologies would be needed to achieve 50% energy savings.« less
Guidelines for the Pharmacotherapy of Schizophrenia in Adults

PubMed Central

Addington, Donald; Honer, William; Ismail, Zahinoor; Raedler, Thomas; Teehan, Michael

2017-01-01

Objective: The present guidelines address the pharmacotherapy of schizophrenia in adults across different stages, phases, and symptom domains. Method: Guidelines were developed using the ADAPTE process, which takes advantage of existing guidelines. Six guidelines were identified for adaptation, with recommendations extracted from each. For those specific to the pharmacotherapy of schizophrenia in adults, a working group selected between guidelines and recommendations to create an adapted guideline. Results: Recommendations can be categorized into 6 areas that include 1) first-episode schizophrenia, 2) acute exacerbation, 3) relapse prevention and maintenance treatment, 4) treatment-resistant schizophrenia, 5) clozapine-resistant schizophrenia, and 6) specific symptom domains. For each category, recommendations are made based on the available evidence, which is discussed and linked to other established guidelines. Conclusions: In most cases, evidence-based recommendations are made that can be used to guide current clinical treatment and decision making. Notably, however, there is a paucity of established evidence to guide treatment decision making in the case of clozapine-resistant schizophrenia, a subsample that represents a sizable proportion of those with schizophrenia. PMID:28703015
The Global Engagement in Care Convening: Recommended Actions to Improve Health Outcomes for People Living With HIV.

PubMed

Maulsby, C; Valdiserri, R O; Kim, J J; Mahon, N; Flynn, A; Eriksson, E; Jain, K M; Enobun, Blessing; Holtgrave, D R

2016-10-01

The National HIV AIDS Strategy (NHAS) calls for a more coordinated response to the HIV epidemic. The Global Engagement in Care Convening created a forum for domestic and international experts to identify best practices in HIV care. This manuscript summarizes the meeting discussions and recommendations from meeting notes and an audio recording of the meeting. Recommendations include: further standardization of performance goals and performance measures; additional research; a more robust system to support competing needs of clients receiving services; electronic information exchanges for HIV-related data; an expansion of the role of other health professionals to extend the capacity of physicians and other members of the care team; and revisions to current financing systems to increase reimbursement for and access to services that promote linkage to and retention in HIV care. The recommendations provide a unique example of "reverse technical assistance" and will inform U.S. program development, research, and policy.
On the Effect of Group Structures on Ranking Strategies in Folksonomies

NASA Astrophysics Data System (ADS)

Abel, Fabian; Henze, Nicola; Krause, Daniel; Kriesell, Matthias

Folksonomies have shown interesting potential for improving information discovery and exploration. Recent folksonomy systems explore the use of tag assignments, which combine Web resources with annotations (tags), and the users that have created the annotations. This article investigates on the effect of grouping resources in folksonomies, i.e. creating sets of resources, and using this additional structure for the tasks of search & ranking, and for tag recommendations. We propose several group-sensitive extensions of graph-based search and recommendation algorithms, and compare them with non group-sensitive versions. Our experiments show that the quality of search result ranking can be significantly improved by introducing and exploiting the grouping of resources (one-tailed t-Test, level of significance α=0.05). Furthermore, tag recommendations profit from the group context, and it is possible to make very good recommendations even for untagged resources- which currently known tag recommendation algorithms cannot fulfill.
Making Sense of Federal Employment and Training Policy for Youth and Adults. Volume II: Expert Recommendations To Create a Comprehensive and Unified System.

ERIC Educational Resources Information Center

Moore, Kristina M., Ed.; And Others

This document contains 27 essays and 5 policy statements regarding creation of a comprehensive and unified federal employment and training policy for youth and adults. The following essays are included: "In Search of the American Way" (Wills); "Rethink the Demand Side" (Smith); "The Federal Government as a Change Agent" (Nathan); "Making Sense of…
Evidence-Based Management Guidelines on Peyronie's Disease.

PubMed

Chung, Eric; Ralph, David; Kagioglu, Ates; Garaffa, Guilio; Shamsodini, Ahmed; Bivalacqua, Trinity; Glina, Sidney; Hakim, Lawrence; Sadeghi-Nejad, Hossein; Broderick, Gregory

2016-06-01

Despite recent advances in our knowledge and treatment strategies in Peyronie's Disease (PD), much remained unknown about this disease. To provide a clinical framework and key guideline statements to assist clinicians in an evidence-based management of PD. A systematic literature search was conducted to identify published literature relevant to PD. The search included all relevant articles published up to June 2015, including preclinical studies and published guidelines. References used in the text were assessed according to their level of evidence, and guideline recommendations were graded based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence. Owing to the paucity of larger series and randomized placebo-controlled trials with regard to surgical intervention, guideline statements are provided as clinical principle or expert opinion. This literature was discussed at a panel meeting, and selected articles with the highest evidence available were used to create consensus guideline statements for the Fourth International Consultation on Sexual Medicine guidelines on PD. In addition to existing Third International Consultation on Sexual Medicine guidelines on PD, seven new summary recommendations were created. A greater understanding of the scientific basis of PD is greatly needed to address our understanding of the pathophysiology, clinical epidemiology, psychosocial, and diagnostic assessment as well as treatment strategies. Copyright © 2016 International Society for Sexual Medicine. All rights reserved.
Working With LGBT Baby Boomers and Older Adults: Factors That Signal a Welcoming Service Environment.

PubMed

Croghan, Catherine F; Moone, Rajean P; Olson, Andrea M

2015-01-01

Many providers recognize the importance of creating culturally competent services for lesbian, gay, bisexual, and transgender (LGBT) older adults. Although multiple resources list steps to make professional practices more LGBT-welcoming, these resources provide no empirical data to support their recommendations. LGBT older adults (N = 327) were asked to describe what signals that a provider is LGBT-welcoming. Six of the top 10 signals related to provider behavior and suggest the importance of staff training; the balance included display of signage and rainbow flags, use of inclusive language on forms and the presence of LGBT-identified staff. Results provide evidence-based recommendations for working with LGBT older adults.
Marine Corps Energy: Instilling an Ethos of Energy Efficiency

DTIC Science & Technology

2012-03-20

promulgate this vision and strategy. Of course, as Kotter warns, the vision is never really in threat of being over-communicated. The Marine Corps always...the stages of creating major change John Kotter recommends in Leading Change to determine whether those actions are sufficient to bring about the...Corps against the stages of creating major change John Kotter recommends in Leading Change to determine whether those actions are sufficient to bring
CAEP 2014 Academic Symposium: "How to make research succeed in your emergency department: How to develop and train career researchers in emergency medicine".

PubMed

Perry, Jeffrey J; Snider, Carolyn E; Artz, Jennifer D; Stiell, Ian G; Shaeri, Sedigheh; McLeod, Shelley; Le Sage, Natalie; Hohl, Corinne; Calder, Lisa A; Vaillancourt, Christian; Holroyd, Brian; Hollander, Judd E; Morrison, Laurie J

2015-05-01

We sought to 1) identify best practices for training and mentoring clinician researchers, 2) characterize facilitators and barriers for Canadian emergency medicine researchers, and 3) develop pragmatic recommendations to improve and standardize emergency medicine postgraduate research training programs to build research capacity. We performed a systematic review of MEDLINE and Embase using search terms relevant to emergency medicine research fellowship/graduate training. We conducted an email survey of all Canadian emergency physician researchers. The Society for Academic Emergency Medicine (SAEM) research fellowship program was analysed, and other similar international programs were sought. An expert panel reviewed these data and presented recommendations at the Canadian Association of Emergency Physicians (CAEP) 2014 Academic Symposium. We refined our recommendations based on feedback received. Of 1,246 potentially relevant citations, we included 10 articles. We identified five key themes: 1) creating training opportunities; 2) ensuring adequate protected time; 3) salary support; 4) infrastructure; and 5) mentorship. Our survey achieved a 72% (67/93) response rate. From these responses, 42 (63%) consider themselves clinical researchers (i.e., spend a significant proportion of their career conducting research). The single largest constraint to conducting research was funding. Factors felt to be positive contributors to a clinical research career included salary support, research training (including an advanced graduate degree), mentorship, and infrastructure. The SAEM research fellowship was the only emergency medicine research fellowship program identified. This 2-year program requires approval of both the teaching centre and each applying fellow. This program requires training in 15 core competencies, manuscript preparation, and submission of a large grant to a national peer-review funding organization. We recommend that the CAEP Academic Section create a process to endorse research fellowship/graduate training programs. These programs should include two phases: Phase I: Research fellowship/graduate training would include an advanced research university degree and 15 core learning areas. Phase II: research consolidation involves a further 1-3 years with an emphasis on mentorship and scholarship production. It is anticipated that clinician scientists completing Phase I and Phase II training at a CAEP Academic Section-endorsed site(s) will be independent researchers with a higher likelihood of securing external peer-reviewed funding and be able to have a meaningful external impact in emergency medicine research.
Chapter 6. Protection of patients and staff during a pandemic. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Taylor, Bruce L; Montgomery, Hugh E; Rhodes, Andrew; Sprung, Charles L

2010-04-01

To provide recommendations and standard operating procedures (SOPs) for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on protection of patients and staff. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including protection of patients and staff. Key recommendations include: (1) prepare infection control and occupational health policies for clinical risks relating to potential disease transmission; (2) decrease clinical risks and provide adequate facilities through advanced planning to maximise capacity by increasing essential equipment, drugs, supplies and encouraging staff availability; (3) create robust systems to maintain staff confidence and safety by minimising non-clinical risks and maintaining or escalating essential services; (4) prepare formal reassurance plans for legal protection; (5) provide assistance to staff working outside their normal domains. Judicious planning and adoption of protocols for protection of patients and staff are necessary to optimise outcomes during a pandemic.
Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments.

PubMed

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

2016-03-01

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

PubMed Central

Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

2016-01-01

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

NASA Technical Reports Server (NTRS)

Lawless, James G.; Mann, Lisa J.

1991-01-01

Since its inception three years ago, the Land Processes Aircraft Science Management Operations Working Group (MOWG) provided recommendations on the optimal use of the Agency's aircraft in support of the Land Processes Science Program. Recommendations covered topics such as aircraft and sensor usage, development of long-range plans, Multisensor Airborne Campaigns (MAC), program balance, aircraft sensor databases, new technology and sensor development, and increased University scientist participation in the program. Impacts of these recommendations improved the efficiency of various procedures including the flight request process, tracking of flight hours, and aircraft usage. The group also created a bibliography focused on publications produced by Land Processes scientists from the use of the aircraft program, surveyed NASA funded PI's on their participation in the aircraft program, and developed a planning template for multi-sensor airborne campaigns. Benefits from these activities are summarized.

Wheelchair transportation safety on school buses: stakeholder recommendations for priority issues and actions.

PubMed

Buning, Mary Ellen; Karg, Patricia E

2011-01-01

This paper presents results from and provides discussion of a state-of-the-science workshop in which highly informed stakeholders in wheelchair transportation safety for students on school buses were participants. The Nominal Group Technique was used to create a process in which the main issues preventing safe transportation of wheelchair-seated students and key strategies to overcome these issues were identified and ranked. These results, along with a synthesis of group discussion and recommendations for action, are presented along with consideration of current policies, regulations, and political realities. Critical safety shortcomings exist in this highly specialized enterprise that varies from state to state. Recommended strategies include implementing wheelchair requirements in federal transportation safety standards, creation of a clearinghouse for wheelchair transportation best practices and education, creation of national standards for training, practices, and monitoring, and increased "buy-in" to voluntary wheelchair standards by wheelchair manufacturers.
Synthetic biology: navigating the challenges ahead.

PubMed

Bhutkar, Arjun

2005-01-01

The emerging field of synthetic biology is broadly defined as the area of intersection of biology and engineering that focuses on the modification or creation of novel biological systems that do not have a counterpart in nature. Potential applications of this technology range from creating systems for environmental cleanup tasks, for medical diagnosis and treatment, to economical generation of hydrogen fuel. This technology is in tis nascent state and there are a number of concerns surrounding its potential applications and the nature of research being performed. With the potential to create hitherto unknown "living organisms", it raises a number of challenges along different dimensions. This article reviews the current state of the technology and analyzes synthetic biology using different lenses: patentability, ethics, and regulation. It proposes a classification system for the products of synthetic biology and provides recommendations in each of the above areas (patentability, ethics, and regulation) in the context of this classification system. These recommendations include an improved framework for patentability testing, ethical principles to guide work in this area, a controlled approval process, and reference frameworks for regulation.
Using Qualitative Methods to Create a Home Health Web Application User Interface for Patients with Low Computer Proficiency.

PubMed

Baier, Rosa R; Cooper, Emily; Wysocki, Andrea; Gravenstein, Stefan; Clark, Melissa

2015-01-01

Despite the investment in public reporting for a number of healthcare settings, evidence indicates that consumers do not routinely use available data to select providers. This suggests that existing reports do not adequately incorporate recommendations for consumer-facing reports or web applications. Healthcentric Advisors and Brown University undertook a multi-phased approach to create a consumer-facing home health web application in Rhode Island. This included reviewing the evidence base review to identify design recommendations and then creating a paper prototype and wireframe. We performed qualitative research to iteratively test our proposed user interface with two user groups, home health consumers and hospital case managers, refining our design to create the final web application. To test our prototype, we conducted two focus groups, with a total of 13 consumers, and 28 case manager interviews. Both user groups responded favorably to the prototype, with the majority commenting that they felt this type of tool would be useful. Case managers suggested revisions to ensure the application conformed to laws requiring Medicare patients to have the freedom to choose among providers and could be incorporated into hospital workflow. After incorporating changes and creating the wireframe, we conducted usability testing interviews with 14 home health consumers and six hospital case managers. We found that consumers needed prompting to navigate through the wireframe; they demonstrated confusion through both their words and body language. As a result, we modified the web application's sequence, navigation, and function to provide additional instructions and prompts. Although we designed our web application for low literacy and low health literacy, using recommendations from the evidence base, we overestimated the extent to which older adults were familiar with using computers. Some of our key learnings and recommendations run counter to general web design principles, leading us to believe that such guidelines need to be adapted for this user group. As web applications proliferate, it is important to ensure those who are most vulnerable-who have the least knowledge and the lowest literacy, health literacy, and computer proficiency-can access, understand, and use them. In order for the investment in public reporting to produce value, consumer-facing web applications need to be designed to address end users' unique strengths and limitations. Our findings may help others to build consumer-facing tools or technology targeted to a predominantly older population. We encourage others designing consumer-facing web technologies to critically evaluate their assumptions about user interface design, particularly if they are designing tools for older adults, and to test products with their end users.
Going the extra mile - creating a co-operative model for supporting patient and public involvement in research.

PubMed

Horobin, Adele

2016-01-01

In 2014, the Chief Medical Officer and Director General of Research and Development commissioned a review of patient and public involvement in the National Institute for Health Research. The report on this review, entitled 'Going the Extra Mile' was published in March, 2015. It described the bold goal of expecting all people using health and social care, and increasing numbers of the public, to be aware of and choosing to be involved in research. This requires more effort to build public awareness of research and better support for the public and researchers to do patient and public involvement in research. The author has created a new way of providing support for patient and public involvement based on co-operation between organisations. Termed 'share-banking', this model pools limited resources across organisations to deliver a regional programme of support activities for patient and public involvement over the long term. This includes helping organisations to share and learn from each other to avoid 're-inventing wheels' (where separate organisations each develop the same thing from the beginning). The 'Going the Extra Mile' report recommends that local organisations should work together to deliver public involvement activities across a region. 'Share-banking' should help fulfil this recommendation. The 'Going the Extra Mile' final report opened with the ambition to increase the public's awareness, participation and involvement in research. It stated the need for public and researchers to be better supported to do public involvement. A new co-operative model, termed 'share-banking', has been developed whereby organisations pool limited resources to create and sustain support for patient and public involvement in research. This should fulfil the 'Going the Extra Mile' report's recommendation to take a collaborative, cross-organisational and regional approach to public involvement.
LH2 fuel tank design for SSTO

NASA Technical Reports Server (NTRS)

Wright, Geoff

1994-01-01

This report will discuss the design of a liquid hydrogen fuel tank constructed from composite materials. The focus of this report is to recommend a design for a fuel tank which will be able to withstand all static and dynamic forces during manned flight. Areas of study for the design include material selection, material structural analysis, heat transfer, thermal expansion, and liquid hydrogen diffusion. A structural analysis FORTRAN program was developed for analyzing the buckling and yield characteristics of the tank. A thermal analysis Excel spreadsheet was created to determine a specific material thickness which will minimize heat transfer through the wall of the tank. The total mass of the tank was determined by the combination of both structural and thermal analyses. The report concludes with the recommendation of a layered material tank construction. The designed system will include exterior insulation, combination of metal and organize composite matrices and honeycomb.
Good practices for real-world data studies of treatment and/or comparative effectiveness: Recommendations from the joint ISPOR-ISPE Special Task Force on real-world evidence in health care decision making.

PubMed

Berger, Marc L; Sox, Harold; Willke, Richard J; Brixner, Diana L; Eichler, Hans-Georg; Goettsch, Wim; Madigan, David; Makady, Amr; Schneeweiss, Sebastian; Tarricone, Rosanna; Wang, Shirley V; Watkins, John; Daniel Mullins, C

2017-09-01

Real-world evidence (RWE) includes data from retrospective or prospective observational studies and observational registries and provides insights beyond those addressed by randomized controlled trials. RWE studies aim to improve health care decision making. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and the International Society for Pharmacoepidemiology (ISPE) created a task force to make recommendations regarding good procedural practices that would enhance decision makers' confidence in evidence derived from RWD studies. Peer review by ISPOR/ISPE members and task force participants provided a consensus-building iterative process for the topics and framing of recommendations. The ISPOR/ISPE Task Force recommendations cover seven topics such as study registration, replicability, and stakeholder involvement in RWE studies. These recommendations, in concert with earlier recommendations about study methodology, provide a trustworthy foundation for the expanded use of RWE in health care decision making. The focus of these recommendations is good procedural practices for studies that test a specific hypothesis in a specific population. We recognize that some of the recommendations in this report may not be widely adopted without appropriate incentives from decision makers, journal editors, and other key stakeholders. © 2017 The Authors. Pharmacoepidemiology & Drug Safety published by John Wiley & Sons Ltd.
Defense Health Care: Department of Defense Needs a Strategic Approach to Contracting for Health Care Professionals

DTIC Science & Technology

2013-05-01

DOD identify, develop, and implement joint medical personnel standards for shared services .22 While DOD concurred with our recommendation, as of...a defense health agency in part to assume the responsibility for creating and managing shared services , and leave the military chain of command...intact with the military departments in control of their military treatment facilities. This option would include a shared services concept to
Proof-of-Concept of a Revolutionary Cooling Shirt with a Thermal Manikin

DTIC Science & Technology

2013-09-01

involving high levels of physical activity or exposure to high temperature environments including military, fire protection, and sports . Battlefield...spandex. Pockets of the same material were created to fully encapsulate the lightweight cryotherapy pad. The cooling medium is flame resistant to 815°C...effect on the manikin. Per manufacturer recommendation, the cryotherapy pads were stored in a refrigerator at 10°C to obtain a maximum effect. New pads
Creating and connecting recommended practices for reproducible research through collaborative culture and consensus in the Research Data Alliance

NASA Astrophysics Data System (ADS)

Parsons, M. A.; Yarmey, L.; Dillo, I.

2017-12-01

Data are the foundation of a robust, efficient, and reproducible scientific enterprise. The Research Data Alliance (RDA) is a community-driven, action-oriented, virtual organization committed to enabling open sharing and reuse of data by building social and technical bridges. The international RDA community includes almost 6000 members bringing diverse perspectives, domain knowledge, and expertise to a common table for identification of common challenges and holistic solutions. RDA members work together to identify common interests and form exploratory Interest Groups and outcome-oriented Working Groups. Participants exchange knowledge, share discoveries, discuss barriers and potential solutions, articulate policies, and align standards to enhance and facilitate global data sharing within and across domains and communities. With activities defined and led by members, RDA groups have organically been addressing issues across the full research cycle with community-ratified Recommendations and other outputs that begin to create the components of a global, data-sharing infrastructure. This paper examines how multiple RDA Recommendations can be implemented together to improve data and information discoverability, accessibility, and interconnection by both people and machines. For instance, the Persistent Identifier Types can support moving data across platforms through the Data Description Registry Interoperability framework following the RDA/WDS Publishing Data Workflows model. The Scholix initiative connects scholarly literature and data across numerous stakeholders can draw on the Practical Policy best practices for machine-actionable data policies. Where appropriate, we use a case study approach built around several flagship data sets from the Deep Carbon Observatory to examine how multiple RDA Recommendations can be implemented in actual practice.
Recommendations and guidelines on shoreline development and hazards to navigation.

DOT National Transportation Integrated Search

2010-12-01

This guidebook addresses recommendations regarding encroachment into the Gulf Coast : Intracoastal Waterway (GIWW). Encroachment of hazards to navigation creates operational : inefficiencies that impede commerce. The shippers who rely on the waterway...
Creating adaptive web recommendation system based on user behavior

NASA Astrophysics Data System (ADS)

Walek, Bogdan

2018-01-01

The paper proposes adaptive web recommendation system based on user behavior. The proposed system uses expert system to evaluating and recommending suitable items of content. Relevant items are subsequently evaluated and filtered based on history of visited items and user´s preferred categories of items. Main parts of the proposed system are presented and described. The proposed recommendation system is verified on specific example.
Creating Safe Spaces for Music Learning

ERIC Educational Resources Information Center

Hendricks, Karin S.; Smith, Tawnya D.; Stanuch, Jennifer

2014-01-01

This article offers a practical model for fostering emotionally safe learning environments that instill in music students a positive sense of self-belief, freedom, and purpose. The authors examine the implications for music educators of creating effective learning environments and present recommendations for creating a safe space for learning,…
"We talk of AIDS because we love life": a stakeholder assessment of HIV/AIDS organizations in Buenos Aires, Argentina.

PubMed

Spaulding, Alicen B; Brieger, William R

This stakeholder assessment of HIV/AIDS service providing institutions in Argentina offers insights into the HIV/AIDS crisis in Spanish-speaking Latin America from an institutional level and makes recommendations for strengthening the work and functioning of these institutions. This stakeholder assessment was conducted to determine how HIV/AIDS prevention and management in Argentina affects and is affected by relevant HIV/AIDS institutions. Semi-structured qualitative interviews were conducted with 13 key leaders of organizations working in HIV/AIDS prevention in Buenos Aires including non-governmental, governmental, and academic institutions. Analyses of interviewee comments are presented according to four major themes: network connections, program resources, perceptions of success, and challenges. Key findings include the need for strengthening formal networks, increasing the involvement of other non-AIDS related social institutions in promoting HIV prevention, finding more sustainable funding options, working more effectively with the public sector to create policies and regulations favorable to the HIV/AIDS field, and addressing the lack of perceived susceptibility to HIV/AIDS in Argentine culture. From leaders' comments, recommendations are made for strengthening the HIV/AIDS network among key institutions including adapting the UNAIDS "Three Ones" principal to create one crosssector office responsible for coordinating HIV/AIDS work, formalizing agreements with institutions outside of Buenos Aires, increasing the role of schools in HIV/AIDS awareness, and designing programs that address lack of perceived susceptibility to HIV/AIDS among Argentines.
76 FR 9541 - Saguache County Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-18

... Committee Act. The purpose is to review and recommend project proposals to be funded with Title II money... projects; (2) Review, evaluate and recommend project proposals to be funded with Title II money; (3) Create...
A decentralized and onsite wastewater management course: bringing together global concerns and practical pedagogy.

PubMed

Gaulke, L S; Borgford-Parnell, J L; Stensel, H D

2008-01-01

This paper reports on the design, implementation, and results of a course focused on decentralized and onsite wastewater treatment in global contexts. Problem-based learning was the primary pedagogical method, with which students tackled real-world problems and designed systems to meet the needs of diverse populations. Both learning and course evaluations demonstrated that the course was successful in fulfilling learning objectives, increasing student design skills, and raising awareness of global applications. Based on this experience a list of recommendations was created for co-developing and team-teaching multidisciplinary design courses. These recommendations include ideas for aligning student and teacher goals, overcoming barriers to effective group-work, and imbedding continuous course assessments. Copyright IWA Publishing 2008.
Implementation Research to Address the United States Health Disadvantage: Report of a National Heart, Lung, and Blood Institute Workshop.

PubMed

Engelgau, Michael M; Narayan, K M Venkat; Ezzati, Majid; Salicrup, Luis A; Belis, Deshiree; Aron, Laudan Y; Beaglehole, Robert; Beaudet, Alain; Briss, Peter A; Chambers, David A; Devaux, Marion; Fiscella, Kevin; Gottlieb, Michael; Hakkinen, Unto; Henderson, Rain; Hennis, Anselm J; Hochman, Judith S; Jan, Stephen; Koroshetz, Walter J; Mackenbach, Johan P; Marmot, M G; Martikainen, Pekka; McClellan, Mark; Meyers, David; Parsons, Polly E; Rehnberg, Clas; Sanghavi, Darshak; Sidney, Stephen; Siega-Riz, Anna Maria; Straus, Sharon; Woolf, Steven H; Constant, Stephanie; Creazzo, Tony L; de Jesus, Janet M; Gavini, Nara; Lerner, Norma B; Mishoe, Helena O; Nelson, Cheryl; Peprah, Emmanuel; Punturieri, Antonello; Sampson, Uchechukwu; Tracy, Rachael L; Mensah, George A

2018-04-28

Four decades ago, U.S. life expectancy was within the same range as other high-income peer countries. However, during the past decades, the United States has fared worse in many key health domains resulting in shorter life expectancy and poorer health-a health disadvantage. The National Heart, Lung, and Blood Institute convened a panel of national and international health experts and stakeholders for a Think Tank meeting to explore the U.S. health disadvantage and to seek specific recommendations for implementation research opportunities for heart, lung, blood, and sleep disorders. Recommendations for National Heart, Lung, and Blood Institute consideration were made in several areas including understanding the drivers of the disadvantage, identifying potential solutions, creating strategic partnerships with common goals, and finally enhancing and fostering a research workforce for implementation research. Key recommendations included exploring why the United States is doing better for health indicators in a few areas compared with peer countries; targeting populations across the entire socioeconomic spectrum with interventions at all levels in order to prevent missing a substantial proportion of the disadvantage; assuring partnership have high-level goals that can create systemic change through collective impact; and finally, increasing opportunities for implementation research training to meet the current needs. Connecting with the research community at large and building on ongoing research efforts will be an important strategy. Broad partnerships and collaboration across the social, political, economic, and private sectors and all civil society will be critical-not only for implementation research but also for implementing the findings to have the desired population impact. Developing the relevant knowledge to tackle the U.S. health disadvantage is the necessary first step to improve U.S. health outcomes. Published by Elsevier B.V.
Recommendations for pharmacological clinical trials in children with functional constipation: The Rome foundation pediatric subcommittee on clinical trials.

PubMed

Koppen, I J N; Saps, M; Lavigne, J V; Nurko, S; Taminiau, J A J M; Di Lorenzo, C; Benninga, M A

2018-04-01

Evidence for the efficacy of commonly used drugs in the treatment of childhood functional constipation (FC) is scarce, studies are often of low quality and study designs are heterogeneous. Thus, recommendations for the design of clinical trials in childhood FC are needed. Members of the Rome Foundation and a member of the Pediatric Committee of the European Medicines Agency formed a committee to create recommendations for the design of clinical trials in children with FC. This committee recommends conducting randomized, double-blind, placebo-controlled, parallel-group clinical trials to assess the efficacy of new drugs for the treatment of childhood FC. Pediatric study participants should be included based on fulfilling the Rome IV criteria for FC. A treatment free run-in period for baseline assessment is recommended. The trial duration should be at least 8 weeks. Treatment success is defined as no longer meeting the Rome IV criteria for FC. Stool consistency should be reported based on the Bristol Stool Scale. Endpoints of drug efficacy need to be tailored to the developmental age of the patient population. © 2018 John Wiley & Sons Ltd.
Between Discomfort and Comfort: Towards Language That Creates Space for Social Change

ERIC Educational Resources Information Center

Schultz, Christie

2017-01-01

This paper examines the potential of the term "settler ally" to create productive discomfort alongside productive comfort, thereby creating space for positive social change. The setting in which the term is examined is Canada--Alberta in particular--following the release of the recommendations of the Truth and Reconciliation Commission…
Reply to "transforming oncology care": advancing value, accessing innovation.

PubMed

Paradis, Rebecca

2015-09-01

Alternative payment models in oncology are already successfully standardizing care, curbing costs, and improving the patient experience. Yet, it is unclear whether decision makers are adequately considering patient access to innovation when creating these models, which could have severe consequences for a robust innovation ecosystem and the lives of afflicted patients. The suggested chart includes recommendations on: Allowing for the adoption of new, promising therapies; Promoting the measurement of patient-centered outcomes; and Providing support for personalized medicine.
Plain Language Summary: Earwax (Cerumen Impaction)

PubMed

Krouse, Helene J; Magit, Anthony E; O'Connor, Sarah; Schwarz, Seth R; Walsh, Sandra A

2017-01-01

This plain language summary serves as an overview in explaining earwax (cerumen). The summary applies to patients older than 6 months with a clinical diagnosis of earwax impaction and is based on the 2017 update of the Clinical Practice Guideline: Earwax (Cerumen Impaction). The evidence-based guideline includes research that supports diagnosis and treatment of earwax impaction. The guideline was developed to improve care by health care providers for managing earwax impaction by creating clear recommendations to use in medical practice.

Recommender systems in knowledge-mining

NASA Astrophysics Data System (ADS)

Volna, Eva

2017-07-01

The subject of the paper is to analyse the possibilities of application of recommender systems in the field of data mining. The work focuses on three basic types of recommender systems (collaborative, content-based and hybrid). The goal of the article is to evaluate which of these three concepts of recommender systems provides forecast with the lowest error rate in the domain of recommending movies. This target is fulfilled by the practical part of the work - at first, the own recommender system was designed and created, capable of obtaining movies recommendation from the database based on the user's preferences. Next, we verified experimentally which recommender system produces more accurate results.
Quality of Web-Based Educational Interventions for Clinicians on Human Papillomavirus Vaccine: Content and Usability Assessment

PubMed Central

Bishop, James M; McDonald, Skye L; Kahn, Jessica A; Kreps, Gary L

2018-01-01

Background Human papillomavirus (HPV) vaccination rates fall far short of Healthy People 2020 objectives. A leading reason is that clinicians do not recommend the vaccine consistently and strongly to girls and boys in the age group recommended for vaccination. Although Web-based HPV vaccine educational interventions for clinicians have been created to promote vaccination recommendations, rigorous evaluations of these interventions have not been conducted. Such evaluations are important to maximize the efficacy of educational interventions in promoting clinician recommendations for HPV vaccination. Objective The objectives of our study were (1) to expand previous research by systematically identifying HPV vaccine Web-based educational interventions developed for clinicians and (2) to evaluate the quality of these Web-based educational interventions as defined by access, content, design, user evaluation, interactivity, and use of theory or models to create the interventions. Methods Current HPV vaccine Web-based educational interventions were identified from general search engines (ie, Google), continuing medical education search engines, health department websites, and professional organization websites. Web-based educational interventions were included if they were created for clinicians (defined as individuals qualified to deliver health care services, such as physicians, clinical nurses, and school nurses, to patients aged 9 to 26 years), delivered information about the HPV vaccine and how to increase vaccination rates, and provided continuing education credits. The interventions’ content and usability were analyzed using 6 key indicators: access, content, design, evaluation, interactivity, and use of theory or models. Results A total of 21 interventions were identified, out of which 7 (33%) were webinars, 7 (33%) were videos or lectures, and 7 (33%) were other (eg, text articles, website modules). Of the 21 interventions, 17 (81%) identified the purpose of the intervention, 12 (57%) provided the date that the information had been updated (7 of these were updated within the last 6 months), 14 (67%) provided the participants with the opportunity to provide feedback on the intervention, and 5 (24%) provided an interactive component. None of the educational interventions explicitly stated that a theory or model was used to develop the intervention. Conclusions This analysis demonstrates that a substantial proportion of Web-based HPV vaccine educational interventions has not been developed using established health education and design principles. Interventions designed using these principles may increase strong and consistent HPV vaccination recommendations by clinicians. PMID:29453187
Announcing a Community Effort to Create an Information Model for Research Software Archives

NASA Astrophysics Data System (ADS)

Million, C.; Brazier, A.; King, T.; Hayes, A.

2018-04-01

An effort has started to create recommendations and standards for the archiving of planetary science research software. The primary goal is to define an information model that is consistent with OAIS standards.
Construction of a Clinical Decision Support System for Undergoing Surgery Based on Domain Ontology and Rules Reasoning

PubMed Central

Bau, Cho-Tsan; Huang, Chung-Yi

2014-01-01

Abstract Objective: To construct a clinical decision support system (CDSS) for undergoing surgery based on domain ontology and rules reasoning in the setting of hospitalized diabetic patients. Materials and Methods: The ontology was created with a modified ontology development method, including specification and conceptualization, formalization, implementation, and evaluation and maintenance. The Protégé–Web Ontology Language editor was used to implement the ontology. Embedded clinical knowledge was elicited to complement the domain ontology with formal concept analysis. The decision rules were translated into JENA format, which JENA can use to infer recommendations based on patient clinical situations. Results: The ontology includes 31 classes and 13 properties, plus 38 JENA rules that were built to generate recommendations. The evaluation studies confirmed the correctness of the ontology, acceptance of recommendations, satisfaction with the system, and usefulness of the ontology for glycemic management of diabetic patients undergoing surgery, especially for domain experts. Conclusions: The contribution of this research is to set up an evidence-based hybrid ontology and an evaluation method for CDSS. The system can help clinicians to achieve inpatient glycemic control in diabetic patients undergoing surgery while avoiding hypoglycemia. PMID:24730353
Commercially sexually exploited youths' health care experiences, barriers, and recommendations: A qualitative analysis.

PubMed

Ijadi-Maghsoodi, Roya; Bath, Eraka; Cook, Mekeila; Textor, Lauren; Barnert, Elizabeth

2018-02-01

The current study sought to understand commercially sexually exploited (CSE) youths' health care experiences, barriers to care, and recommendations for improving health care services. We conducted focus groups (N=5) with 18 CSE youth from February 2015 through May 2016 at two group homes serving CSE youth in Southern California. We performed thematic content analysis to identify emergent themes about CSE youths' perspectives on health care. Youth described facilitators to care, including availability of services such as screening for sexually transmitted infections, knowledge about sexual health, and a strong motivation to stay healthy. Barriers included feeling judged, concerns about confidentiality, fear, perceived low quality of services, and self-reliance. Overall, youth emphasized self-reliance and "street smarts" for survival and de-emphasized "victimhood," which shaped their interactions with health care, and recommended that health providers develop increased understanding of CSE youth. Our findings suggest that providers and community agencies can play an essential role in raising awareness of the needs of CSE youth and meet their health needs through creating a non-judgmental environment in health care settings that validates the experiences of these youth. Published by Elsevier Ltd.
Construction of a clinical decision support system for undergoing surgery based on domain ontology and rules reasoning.

PubMed

Bau, Cho-Tsan; Chen, Rung-Ching; Huang, Chung-Yi

2014-05-01

To construct a clinical decision support system (CDSS) for undergoing surgery based on domain ontology and rules reasoning in the setting of hospitalized diabetic patients. The ontology was created with a modified ontology development method, including specification and conceptualization, formalization, implementation, and evaluation and maintenance. The Protégé-Web Ontology Language editor was used to implement the ontology. Embedded clinical knowledge was elicited to complement the domain ontology with formal concept analysis. The decision rules were translated into JENA format, which JENA can use to infer recommendations based on patient clinical situations. The ontology includes 31 classes and 13 properties, plus 38 JENA rules that were built to generate recommendations. The evaluation studies confirmed the correctness of the ontology, acceptance of recommendations, satisfaction with the system, and usefulness of the ontology for glycemic management of diabetic patients undergoing surgery, especially for domain experts. The contribution of this research is to set up an evidence-based hybrid ontology and an evaluation method for CDSS. The system can help clinicians to achieve inpatient glycemic control in diabetic patients undergoing surgery while avoiding hypoglycemia.
Family environment and pediatric overweight: what is a parent to do?

PubMed

Ritchie, Lorrene D; Welk, Greg; Styne, Dennis; Gerstein, Dana E; Crawford, Patricia B

2005-05-01

Although the causes of pediatric overweight are many and the levels of intervention required to prevent overweight in children extend from the child's immediate environment to the larger societal level, one critical intervention target is the parent. Scientific evidence points to specific dietary and physical activity/inactivity behaviors that families can adopt to encourage healthful weight status. Dietary recommendations include providing children with ample access to nutrient-dense foods and beverages and high-fiber foods, both at meals and snack times, reducing children's access to high-calorie, nutrient-poor beverages and foods both when eating at home and at restaurants, avoiding excessive food restriction or use of food as a reward, and encouraging children to eat breakfast on a daily basis. Physical activity recommendations include providing opportunities and encouragement for children to be physically active while reducing children's television and video game time. Parental modeling of healthful eating and physical activity practices is recommended to reinforce these patterns in youth. Dietetics professionals, physicians, and other health care professionals can assist parents in their efforts to prevent pediatric overweight by providing information and supporting these key behaviors, while working to create environments that support healthful lifestyle changes.
Canadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death-Summary Report.

PubMed

Weiss, Matthew J; Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, Sonny; Sivarajan, V Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D

2017-11-01

Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation after circulatory determination of death, 7) cardiac and innovative pediatric donation after circulatory determination of death, and 8) implementation. For brevity, 48 Good Practice Statement and truncated justification are included in this summary report. The remaining recommendations, detailed methodology, full Grading of Recommendations Assessment, Development, and Evaluation tables, and expanded justifications are available in the full text report. This process showed that rigorous, transparent clinical practice guideline development is possible in the domain of pediatric deceased donation. Application of these recommendations will increase access to pediatric donation after circulatory determination of death across Canada and may serve as a model for future clinical practice guideline development in deceased donation.
Learning Materials Recommendation Using Good Learners' Ratings and Content-Based Filtering

ERIC Educational Resources Information Center

Ghauth, Khairil Imran; Abdullah, Nor Aniza

2010-01-01

The enormity of the amount of learning materials in e-learning has led to the difficulty of locating suitable learning materials for a particular learning topic, creating the need for recommendation tools within a learning context. In this paper, we aim to address this need by proposing a novel e-learning recommender system framework that is based…
Ground Water Sample Preservation at In-Situ Chemical Oxidation Sites – Recommended Guidelines

EPA Pesticide Factsheets

This issue paper describes the recommended processes for sampling at in Situ Chemical Oxidation sites. Care must be taken because the oxidizing chemicals used for the remediation process can create an erroneously low sampling result.
Recommendations for involving the family in developmental care of the NICU baby

PubMed Central

Craig, J W; Glick, C; Phillips, R; Hall, S L; Smith, J; Browne, J

2015-01-01

Family involvement is a key to realize the potential for long-lasting positive effects on physical, cognitive and psychosocial development of all babies, including those in the neonatal intensive care unit (NICU). Family-centered developmental care (FCDC) recognizes the family as vital members of the NICU health-care team. As such, families are integrated into decision-making processes and are collaborators in their baby's care. Through standardized use of FCDC principles in the NICU, a foundation is constructed to enhance the family's lifelong relationship with their child and optimize development of the baby. Recommendations are made for supporting parental roles as caregivers of their babies in the NICU, supporting NICU staff participation in FCDC and creating NICU policies that support this type of care. These recommendations are designed to meet the basic human needs of all babies, the special needs of hospitalized babies and the needs of families who are coping with the crisis of having a baby in the NICU. PMID:26597804
NASA's Space Shuttle Columbia: Synopsis of the Report of the Columbia Accident Investigation Board

NASA Technical Reports Server (NTRS)

Smith, Marcia S.

2003-01-01

NASA's space shuttle Columbia broke apart on February 1, 2003 as it returned to Earth from a 16-day science mission. All seven astronauts aboard were killed. NASA created the Columbia Accident Investigation Board (CAIB), chaired by Adm. (Ret.) Harold Gehman, to investigate the accident. The Board released its report (available at [http://www.caib.us]) on August 26, 2003, concluding that the tragedy was caused by technical and organizational failures. The CAIB report included 29 recommendations, 15 of which the Board specified must be completed before the shuttle returns to flight status. This report provides a brief synopsis of the Board's conclusions, recommendations, and observations. Further information on Columbia and issues for Congress are available in CRS Report RS21408. This report will not be updated.
Building energy analysis tool

DOEpatents

Brackney, Larry; Parker, Andrew; Long, Nicholas; Metzger, Ian; Dean, Jesse; Lisell, Lars

2016-04-12

A building energy analysis system includes a building component library configured to store a plurality of building components, a modeling tool configured to access the building component library and create a building model of a building under analysis using building spatial data and using selected building components of the plurality of building components stored in the building component library, a building analysis engine configured to operate the building model and generate a baseline energy model of the building under analysis and further configured to apply one or more energy conservation measures to the baseline energy model in order to generate one or more corresponding optimized energy models, and a recommendation tool configured to assess the one or more optimized energy models against the baseline energy model and generate recommendations for substitute building components or modifications.
U.S. National Security Interests in Africa and the Future Global War on Terrorism (GWOT): A Proposal to Create an African Regional Combatant Command and a Regional African Special Operations Command

DTIC Science & Technology

2005-09-01

distributed. The final recommendations concluded that the geographical boundaries of USPACOM would include the entire Indian Ocean to the east coast of...strategically be located within the sub-region of West Africa or East Africa. 15. NUMBER OF PAGES 94 14. SUBJECT TERMS US National Interests...should strategically be located within the sub-region of West Africa or East Africa. vi THIS PAGE
Session 1.5: health policy and coordination: a critical review of experiences.

PubMed

Procacci, Pasqualino; Doran, Rodger; Chunkath, Sheela Rani; Garfield, Richard; Briceno, Salvano; Fric, Anton

2005-01-01

This is a summary of the presentations and discussion of Session 1.5 on Health Policy and Coordination: A Critical Review of Experiences during the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to health policy and coordination as pertain to the responses to the damage created by the Tsunami. Key questions were answered in this session, and recommendations were made.
Society for Neuroscience in Anesthesiology and Critical Care Expert consensus statement: anesthetic management of endovascular treatment for acute ischemic stroke*: endorsed by the Society of NeuroInterventional Surgery and the Neurocritical Care Society.

PubMed

Talke, Pekka O; Sharma, Deepak; Heyer, Eric J; Bergese, Sergio D; Blackham, Kristine A; Stevens, Robert D

2014-04-01

Literature on the anesthetic management of endovascular treatment of acute ischemic stroke (AIS) is limited. Anesthetic management during these procedures is still mostly dependent on individual or institutional preferences. Thus, the Society of Neuroscience in Anesthesiology and Critical Care (SNACC) created a task force to provide expert consensus recommendations on anesthetic management of endovascular treatment of AIS. The task force conducted a systematic literature review (up to August 2012). Because of the limited number of research articles relating to this subject, the task force solicited opinions from experts in this area. The task force created a draft consensus statement based on the available data. Classes of recommendations and levels of evidence were assigned to articles specifically addressing anesthetic management during endovascular treatment of stroke using the standard American Heart Association evidence rating scheme. The draft consensus statement was reviewed by the Task Force, SNACC Executive Committee and representatives of Society of NeuroInterventional Surgery (SNIS) and Neurocritical Care Society (NCS) reaching consensus on the final document. For this consensus statement the anesthetic management of endovascular treatment of AIS was subdivided into 12 topics. Each topic includes a summary of available data followed by recommendations. This consensus statement is intended for use by individuals involved in the care of patients with acute ischemic stroke, such as anesthesiologists, interventional neuroradiologists, neurologists, neurointensivists, and neurosurgeons.
Republished: Society for Neuroscience in Anesthesiology and Critical Care expert consensus statement: Anesthetic management of endovascular treatment for acute ischemic stroke.

PubMed

Talke, Pekka O; Sharma, Deepak; Heyer, Eric J; Bergese, Sergio D; Blackham, Kristine A; Stevens, Robert D

2014-08-01

Literature on the anesthetic management of endovascular treatment of acute ischemic stroke (AIS) is limited. Anesthetic management during these procedures is still mostly dependent on individual or institutional preferences. Thus, the Society of Neuroscience in Anesthesiology and Critical Care (SNACC) created a task force to provide expert consensus recommendations on anesthetic management of endovascular treatment of AIS. The task force conducted a systematic literature review (up to August 2012). Because of the limited number of research articles relating to this subject, the task force solicited opinions from experts in this area. The task force created a draft consensus statement based on the available data. Classes of recommendations and levels of evidence were assigned to articles specifically addressing anesthetic management during endovascular treatment of stroke using the standard American Heart Association evidence rating scheme. The draft consensus statement was reviewed by the Task Force, SNACC Executive Committee and representatives of Society of NeuroInterventional Surgery (SNIS) and Neurocritical Care Society (NCS) reaching consensus on the final document. For this consensus statement the anesthetic management of endovascular treatment of AIS was subdivided into 12 topics. Each topic includes a summary of available data followed by recommendations. This consensus statement is intended for use by individuals involved in the care of patients with acute ischemic stroke, such as anesthesiologists, interventional neuroradiologists, neurologists, neurointensivists and neurosurgeons. © 2014 American Heart Association, Inc.
Providers' perceptions of spinal cord injury pressure ulcer guidelines.

PubMed

Thomason, Susan S; Evitt, Celinda P; Harrow, Jeffrey J; Love, Linda; Moore, D Helen; Mullins, Maria A; Powell-Cope, Gail; Nelson, Audrey L

2007-01-01

Pressure ulcers are a serious complication for people with spinal cord injury (SCI). The Consortium for Spinal Cord Medicine (CSCM) published clinical practice guidelines (CPGs) that provided guidance for pressure ulcer prevention and treatment after SCI. The aim of this study was to assess providers' perceptions for each of the 32 CPG recommendations regarding their agreement with CPGs, degree of CPG implementation, and CPG implementation barriers and facilitators. This descriptive mixed-methods study included both qualitative (focus groups) and quantitative (survey) data collection approaches. The sample (n = 60) included 24 physicians and 36 nurses who attended the 2004 annual national conferences of the American Paraplegia Society or American Association of Spinal Cord Injury Nurses. This sample drew from two sources: a purposive sample from a list of preregistered participants and a convenience sample of conference attendee volunteers. We analyzed quantitative data using descriptive statistics and qualitative data using a coding scheme to capture barriers and facilitators. The focus groups agreed unanimously on the substance of 6 of the 32 recommendations. Nurse and physician focus groups disagreed on the degree of CGP implementation at their sites, with nurses as a group perceiving less progress in implementation of the guideline recommendations. The focus groups identified only one recommendation, complications of surgery, as being fully implemented at their sites. Categories of barriers and facilitators for implementation of CPGs that emerged from the qualitative analysis included (a) characteristics of CPGs: need for research/evidence, (b) characteristics of CPGs: complexity of design and wording, (c) organizational factors, (d) lack of knowledge, and (e) lack of resources. Although generally SCI physicians and nurses agreed with the CPG recommendations as written, they did not feel these recommendations were fully implemented in their respective clinical settings. The focus groups identified multiple barriers to the implementation of the CPGs and suggested several facilitators/solutions to improve implementation of these guidelines in SCI. Participants identified organizational factors and the lack of knowledge as the most substantial systems/issues that created barriers to CPG implementation.
Spinal fusion surgery: From relief to insecurity.

PubMed

Damsgaard, Janne B; Jørgensen, Lene B; Norlyk, Annelise; Birkelund, Regner

2017-02-01

During their decision-making process patients perceive surgery as a voluntary yet necessary choice. Surgery initiates hope for a life with less pain but also creates a feeling of existential insecurity in terms of fear, isolation and uncertainty. The aim of this study was to explore how patients experience their situation from the point of making the decision to undergo spinal fusion surgery to living their everyday life after surgery. A phenomenological-hermeneutic study design was applied based on the French philosopher Paul Ricoeur's theory of interpretation. Data were collected through observations and semi-structured interviews. The recommendation and decision to undergo spinal fusion surgery felt like a turning point for the patients and brought hope of regaining their normal lives, of being a more resourceful parent, partner, friend and colleague with no or less pain. Thus, deciding to undergo surgery created a brief feeling of relief. However, life with back pain had changed the patients' understanding of themselves. Consequently, some patients postoperatively experienced insecurity and a weakened self-image with difficulties creating meaning in their lives. Being recommended and undergoing spinal fusion surgery initiates hope for a life with less pain and altered life conditions. At the same time, paradoxically, this creates a feeling of existential insecurity in terms of facing the surgery and the future to come. It is, therefore, important to recognise and include the patients' everyday life experiences concerning how they give (or may not give) meaning to their illness, i.e. their understanding of how it is affecting them. These aspects are essential for the patients' definition and re-definition of themselves and thus crucial to draw upon in the relationship and communication between patient and healthcare professional. Copyright © 2016 Elsevier Ltd. All rights reserved.
Data Communities are Stronger Together: RDA and the broader landscape

NASA Astrophysics Data System (ADS)

Yarmey, L.

2016-12-01

The Research Data Alliance (RDA) is a community-driven, action-oriented, virtual organization committed to enabling open sharing of data by building social and technical bridges. The international RDA community includes over 4000 members, each bringing diverse perspectives, domains, and expertise. RDA members work together to identify common interests and form exploratory Interest Groups and outcome-oriented Working Groups. Participants exchange knowledge, share discoveries, discuss barriers and potential solutions, articulate policies, and align standards to enhance and facilitate global data sharing within and across domains and communities. RDA is an organization of action. 18 months after the 2013 RDA launch, the first Working Groups had already produced a series of well-defined, endorsed, and adopted Recommendations publically available for wider integration. The adopted and endorsed RDA Recommendations at time of writing include Persistent Identifier Information Types, Foundational Terminology query tool, Machine Actionable Policy Templates, and Data Type Model and Registry. Other Recommendations, including bibliometrics, metadata standards, and repository audit and certification are currently under community review on their way to endorsement. The number of RDA Working Groups and resulting Recommendations is expected to increase over time. RDA members are individuals and organizations who subscribe to RDA's Guiding Principles including Openness, Consensus, and Balance. In most (if not all) cases, RDA members also participate in other communities and/or partnerships. This raises important considerations for RDA in terms of scope, sustainability, realistic volunteer engagement, facilitation, and coordinated partnerships across the data landscape. By identifying common interests and maintaining ongoing partnerships and collaboration, individuals and data communities alike can increase our collective ability to create and maintain critical, integrated, and usable data infrastructure.

Assessment of the status of resources for essential trauma care in Hanoi and Khanh Hoa, Vietnam.

PubMed

Son, Nguyen Thai; Thu, Nguyen Hoai; Tu, Nguyen Thi Hong; Mock, Charles

2007-09-01

The World Health Organization and the International Association for Trauma Surgery and Intensive Care have published the Guidelines for Essential Trauma Care. This provides recommendations for the human and physical resources needed to provide an adequate, essential level of trauma care services in countries at all economic levels worldwide. We sought to use this set of recommendations as a basis to assess the trauma care capabilities in two locations in Vietnam and thus to identify affordable and sustainable methods to strengthen trauma care nationwide. A needs assessment tool was created that incorporated the recommendations of the Guidelines. This was used to conduct in-depth, onsite evaluations of 11 health care facilities in Hanoi and Khanh Hoa Province, including commune health stations, district hospitals, provincial hospitals, and a central hospital. Resources for trauma care were mostly adequate at provincial and central hospitals. There were several deficiencies at the district hospitals and especially at commune health stations. These included low level of trauma related training and shortages of supplies and equipment. In many cases these shortages were of low-cost items. However, in general, capabilities had improved compared with prior evaluations. This study has identified several low-cost ways in which to strengthen trauma care in Vietnam. These include greater use of continuing education courses for trauma care and more attention to trauma related curriculum in schools of medicine and nursing. These also include defining and assuring the availability of a core set of essential trauma related equipment and supplies. A policy recommendation that follows from the above findings is the need for programs to strengthen the organization and planning for trauma care.
Creating A Choral Sound.

ERIC Educational Resources Information Center

Leenman, Tracy E.

1996-01-01

Covers a variety of strategies for creating a unique and identifiable choral sound. Provides specific instructions for developing singing in unison and recommends a standing arrangement of soprano, alto, tenor, and bass quartets. Provides other tips for instrumentation, sight reading, and quality rehearsal time. (MJP)
Generalization across Domains: The Relating-Forming-Extending Generalization Framework

ERIC Educational Resources Information Center

Ellis, Amy; Tillema, Erik; Lockwood, Elise; Moore, Kevin

2017-01-01

Generalization is a critical aspect of doing mathematics, with policy makers recommending that it be a central component of mathematics instruction at all levels. This recommendation poses serious challenges, however, given researchers consistently identifying students' difficulties in creating and expressing normative mathematical…
Ethical guidelines in pandemic influenza: recommendations of the Ethics Subcommittee of the Advisory Committee of the Director, Centers for Disease Control and Prevention.

PubMed

Kinlaw, Kathy; Barrett, Drue H; Levine, Robert J

2009-12-01

Because of the importance of including ethical considerations in planning efforts for pandemic influenza, in February 2005 the Centers for Disease Control and Prevention requested that the Ethics Subcommittee of the Advisory Committee to the Director develop guidance that would serve as a foundation for decision making in preparing for and responding to pandemic influenza. Specifically, the ethics subcommittee was asked to make recommendations regarding ethical considerations relevant to decision making about vaccine and antiviral drug distribution prioritization and development of interventions that would limit individual freedom and create social distancing. The ethics subcommittee identified a number of general ethical considerations including identification of clear goals for pandemic planning, responsibility to maximize preparedness, transparency and public engagement, sound science, commitment to the global community, balancing individual liberty and community interests, diversity in ethical decision making, and commitment to justice. These general ethical considerations are applied to the issues of vaccine and antiviral drug distribution and use of community mitigation interventions.
Interagency Task Forces: The Right Tools for the Job

DTIC Science & Technology

2011-01-01

shortcomings. This analysis discusses four organizational reform models and recommends the interagency task force ( IATF ) as the preferred structure...model.64 Still others recommend creating and deploying ad hoc IATFs for crisis operations. These interagency task forces would be task- organized to...forces assigned for planning, exercises, and mission execution.65 A 2005 article in Policy Review recommended developing IATFs as needed for specific
Methodology for AACT evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning.

PubMed

Gosselin, Sophie; Morris, Martin; Miller-Nesbitt, Andrea; Hoffman, Robert S; Hayes, Bryan D; Turgeon, Alexis F; Gilfix, Brian M; Grunbaum, Ami M; Bania, Theodore C; Thomas, Simon H L; Morais, José A; Graudins, Andis; Bailey, Benoit; Mégarbane, Bruno; Calello, Diane P; Levine, Michael; Stellpflug, Samuel J; Hoegberg, Lotte C G; Chuang, Ryan; Stork, Christine; Bhalla, Ashish; Rollins, Carol J; Lavergne, Valéry

2015-07-01

Intravenous lipid emulsion (ILE) therapy is a novel treatment that was discovered in the last decade. Despite unclear understanding of its mechanisms of action, numerous and diverse publications attested to its clinical use. However, current evidence supporting its use is unclear and recommendations are inconsistent. To assist clinicians in decision-making, the American Academy of Clinical Toxicology created a workgroup composed of international experts from various clinical specialties, which includes representatives of major clinical toxicology associations. Rigorous methodology using the Appraisal of Guidelines for Research and Evaluation or AGREE II instrument was developed to provide a framework for the systematic reviews for this project and to formulate evidence-based recommendations on the use of ILE in poisoning. Systematic reviews on the efficacy of ILE in local anesthetic toxicity and non-local anesthetic poisonings as well as adverse effects of ILE are planned. A comprehensive review of lipid analytical interferences and a survey of ILE costs will be developed. The evidence will be appraised using the GRADE system. A thorough and transparent process for consensus statements will be performed to provide recommendations, using a modified Delphi method with two rounds of voting. This process will allow for the production of useful practice recommendations for this therapy.
78 FR 60861 - Native American Tribal Insignia Database

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-02

... Database ACTION: Proposed collection; comment request. SUMMARY: The United States Patent and Trademark... the report was that the USPTO create and maintain an accurate and comprehensive database containing... this recommendation, the Senate Committee on Appropriations directed the USPTO to create this database...
Extracorporeal treatment for theophylline poisoning: systematic review and recommendations from the EXTRIP workgroup.

PubMed

Ghannoum, Marc; Wiegand, Timothy J; Liu, Kathleen D; Calello, Diane P; Godin, Melanie; Lavergne, Valery; Gosselin, Sophie; Nolin, Thomas D; Hoffman, Robert S

2015-05-01

The Extracorporeal Treatments in Poisoning workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments (ECTRs) in poisoning. Here, the workgroup presents its systematic review and recommendations for theophylline. After a systematic review of the literature, a subgroup reviewed articles, extracted data, summarized findings, and proposed structured voting statements following a pre-determined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and the RAND/UCLA Appropriateness Method was used to quantify disagreement. Anonymous votes were compiled, returned, and discussed. A second vote determined the final recommendations. 141 articles were included: 6 in vitro studies, 4 animal studies, 101 case reports/case series, 7 descriptive cohorts, 4 observational studies, and 19 pharmacokinetic studies, yielding a low-to-very-low quality of evidence for all recommendations. Data on 143 patients were reviewed, including 10 deaths. The workgroup concluded that theophylline is dialyzable (level of evidence = A) and made the following recommendations: ECTR is recommended in severe theophylline poisoning (1C). Specific recommendations for ECTR include a theophylline concentration [theophylline] > 100 mg/L (555 μmol/L) in acute exposure (1C), the presence of seizures (1D), life-threatening dysrhythmias (1D) or shock (1D), a rising [theophylline] despite optimal therapy (1D), and clinical deterioration despite optimal care (1D). In chronic poisoning, ECTR is suggested if [theophylline] > 60 mg/L (333 μmol/L) (2D) or if the [theophylline] > 50 mg/L (278 μmol/L) and the patient is either less than 6 months of age or older than 60 years of age (2D). ECTR is also suggested if gastrointestinal decontamination cannot be administered (2D). ECTR should be continued until clinical improvement is apparent or the [theophylline] is < 15 mg/L (83 μmol/L) (1D). Following the cessation of ECTR, patients should be closely monitored. Intermittent hemodialysis is the preferred method of ECTR (1C). If intermittent hemodialysis is unavailable, hemoperfusion (1C) or continuous renal replacement therapies may be considered (3D). Exchange transfusion is an adequate alternative to hemodialysis in neonates (2D). Multi-dose activated charcoal should be continued during ECTR (1D). Theophylline poisoning is amenable to ECTRs. The workgroup recommended extracorporeal removal in the case of severe theophylline poisoning.
Creating reporting and learning cultures in health-care organizations.

PubMed

Jeffs, Lianne; Law, Madelyn; Baker, G Ross

2007-03-01

Patient safety has emerged as an important issue in Canadian health care, as reflected in the Canadian Council on Health Services Accreditation's patient/client safety goals. Achieving these goals calls for concerted efforts within health-care organizations. To assist nurse leaders in their efforts in developing a culture of safety that is receptive to reporting and learning from adverse events and near misses, the authors explore the challenges and provide four recommendations for action. By enacting these recommendations, nurse leaders can support the analysis and actions necessary to identify improvements that will create safer health-care environments.
Creating Space for Children's Literature

ERIC Educational Resources Information Center

Serafini, Frank

2011-01-01

As teachers struggle to balance the needs of their students with the requirements of commercial reading materials, educators need to consider how teachers will create space for children's literature in today's classrooms. In this article, 10 practical recommendations for incorporating children's literature in the reading instructional framework…
Select Committee on Public Education. Recommendations.

ERIC Educational Resources Information Center

Texas State Legislature, Austin. Select Committee on Public Education.

Texas' Select Committee on Public Education, created in 1983 by resolution of the Texas Legislature, was directed "to study the issues and continuing concerns relating to public education in Texas, particularly school finance and each of its components." The committee's recommendations, presented in this report, are intended to provide…
Ways of thinking about and teaching ethical problem solving: microethics and macroethics in engineering.

PubMed

Herkert, Joseph R

2005-07-01

Engineering ethics entails three frames of reference: individual, professional, and social. "Microethics" considers individuals and internal relations of the engineering profession; "macroethics" applies to the collective social responsibility of the profession and to societal decisions about technology. Most research and teaching in engineering ethics, including online resources, has had a "micro" focus. Mechanisms for incorporating macroethical perspectives include: integrating engineering ethics and science, technology and society (STS); closer integration of engineering ethics and computer ethics; and consideration of the influence of professional engineering societies and corporate social responsibility programs on ethical engineering practice. Integrating macroethical issues and concerns in engineering ethics involves broadening the context of ethical problem solving. This in turn implies: developing courses emphasizing both micro and macro perspectives, providing faculty development that includes training in both STS and practical ethics; and revision of curriculum materials, including online resources. Multidisciplinary collaboration is recommended 1) to create online case studies emphasizing ethical decision making in individual, professional, and societal contexts; 2) to leverage existing online computer ethics resources with relevance to engineering education and practice; and 3) to create transparent linkages between public policy positions advocated by professional societies and codes of ethics.
Patient Safety Culture: A Review of the Nursing Home Literature and Recommendations for Practice

PubMed Central

Bonner, Alice F.; Castle, Nicholas G.; Perera, Subashan; Handler, Steven M.

2010-01-01

Patient safety culture (PSC) is a critical factor in creating high-reliability health-care organizations. Most PSC research studies to date have been conducted in acute care settings; however, nursing home studies have recently begun to appear in the literature. Nursing homes differ from hospitals in a number of ways, including the population they serve, the medical model of care, and having the vast majority of direct care provided by non-licensed certified nursing assistants. Research has shown that nursing home PSC differs in important ways from PSC in acute care institutions. Recent PSC studies conducted in nursing homes and related quality and safety research can guide recommendations for nursing homes wishing to evaluate their own PSC. Relationships between PSC measurement, quality improvement, and workforce issues are potentially important and may influence clinical outcomes. PMID:21701601
Online and in-person networking among women in the Earth Sciences Women's Network at www.ESWNonline.org

NASA Astrophysics Data System (ADS)

Kontak, R.; Adams, A. S.; De Boer, A. M.; Hastings, M. G.; Holloway, T.; Marin-Spiotta, E.; Steiner, A. L.; Wiedinmyer, C.

2012-12-01

The Earth Science Women's Network is an international peer-mentoring network of women in the Earth Sciences, many of whom are in the early stages of their careers. Membership is free and has grown through "word of mouth," and includes upper-level undergraduates, graduate students, professionals in a range of environmental fields, scientists working in public and private institutions. Our mission is to promote career development, build community, provide informal mentoring and support, and facilitate professional collaborations. Since 2002 we have accomplished this trough online networking, including over email and a listserv, on facebook, in-person networking events, and professional development workshops. Now in our 10th year, ESWN is debuting a new web-center that creates an online space exclusively for women in any discipline of the Earth (including planetary) sciences. ESWN members can connect and create an online community of support and encouragement for themselves as women in a demanding career. Many women in Earth Science fields feel isolated and are often the only woman in their department or work environments. ESWN is a place to meet others, discuss issues faced in creating work-life balance and professional success and share best practices through peer mentoring. Now on ESWN's new web-center, members can create and personalize their profiles and search for others in their field, nearby, or with similar interests. Online discussions in the members-only area can also be searched. Members can create groups for discussion or collaboration, with document sharing and password protection. Publicly, we can share gained knowledge with a broader audience, like lessons learned at our professional development workshops and collected recommendations from members. The new web center allows for more connectivity among other online platforms used by our members, including linked-in, facebook, and twitter. Built in Wordpress with a Buddpress members-only section, the new ESWN website is supported by AGU and a NSF ADVANCE grant.;
Linking Course Web Sites to Library Collections and Services

ERIC Educational Resources Information Center

Rieger, Oya Y.; Horne, Angela K.; Revels, Ira

2004-01-01

A five-month research study at Cornell University Library (CUL) confirmed the strategic importance of a library presence in faculty-created course Web sites. It sparked specific recommendations to support the seamless integration of the CUL digital library within the virtual learning environments created by faculty.
Adoption: Overview and Major Recommendations.

ERIC Educational Resources Information Center

Schulman, Irving; Behrman, Richard E.

1993-01-01

Examines a number of facets of adoption in the United States and recommends that the federal government create an adoption data collection system; states implement a uniform adoption law; and the adoption process be more open, both for adoptees and prospective adoptive parents. Also discusses the adoption of children with special needs, and…
Blender Bikes: Blending Nutrition and Physical Activity

ERIC Educational Resources Information Center

Ferrari, Theresa M.; Smathers, Carol A.

2018-01-01

Many Americans do not meet the recommendations for diet and physical activity. A blender bike can be an effective tool when coupled with hands-on activities that reinforce health recommendations. We created "Blending Nutrition and Physical Activity: An Activity Guide for Use with Blender Bikes" to use when incorporating a blender bike…
Developing Jobs and Neighborhoods through Small Business Growth: Recommendations for Action.

ERIC Educational Resources Information Center

Holzman, Michael S.

Research was conducted to define methods for creating jobs for urban youth through small business expansion, particularly in Chicago. This report presents recommendations derived from the research. The first section suggests ways of increasing the effectiveness of Chicago's small business/neighborhood economic development efforts. The second…
Assessing Strength of Evidence of Appropriate Use Criteria for Diagnostic Imaging Examinations.

PubMed

Lacson, Ronilda; Raja, Ali S; Osterbur, David; Ip, Ivan; Schneider, Louise; Bain, Paul; Mita, Carol; Whelan, Julia; Silveira, Patricia; Dement, David; Khorasani, Ramin

2016-05-01

For health information technology tools to fully inform evidence-based decisions, recommendations must be reliably assessed for quality and strength of evidence. We aimed to create an annotation framework for grading recommendations regarding appropriate use of diagnostic imaging examinations. The annotation framework was created by an expert panel (clinicians in three medical specialties, medical librarians, and biomedical scientists) who developed a process for achieving consensus in assessing recommendations, and evaluated by measuring agreement in grading the strength of evidence for 120 empirically selected recommendations using the Oxford Levels of Evidence. Eighty-two percent of recommendations were assigned to Level 5 (expert opinion). Inter-annotator agreement was 0.70 on initial grading (κ = 0.35, 95% CI, 0.23-0.48). After systematic discussion utilizing the annotation framework, agreement increased significantly to 0.97 (κ = 0.88, 95% CI, 0.77-0.99). A novel annotation framework was effective for grading the strength of evidence supporting appropriate use criteria for diagnostic imaging exams. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Treating pain on skin graft donor sites: Review and clinical recommendations.

PubMed

Sinha, Sarthak; Schreiner, Amanda J; Biernaskie, Jeff; Nickerson, Duncan; Gabriel, Vincent A

2017-11-01

Split-thickness skin grafting is the most common reconstructive procedure in managing burn injuries. Harvesting split-thickness skin creates a new partial thickness wound referred to as the donor site. Pain at the donor site is reported to be one of the most distressing symptoms during the early postoperative period. Here, we (a) identify strategies for managing donor site pain, (b) assess the quality of individual studies, and (c) formulate evidence-based recommendations based on the amount and consistency of evidence. Our analysis revealed five distinct approaches to minimize donor site pain. These include: continuous subcutaneous local anesthetic infusion (three studies), subcutaneous anesthetic injection (five studies), topical agents (six studies), nonpharmacological interventions (three studies), and wound dressings (18 studies). Available randomized control trials typically evaluated pain on standardized scales (i.e. Visual Analog Scale, Numerical Rating Scale), and compared the experimental group with standard care. Recommended treatments include: (a) subcutaneous anesthetic injection of adrenaline-lidocaine; (b) ice application; (c) topical agents, such as lidocaine and bupivacaine; and (d) hydrocolloid- and polyurethane-based wound dressings accompanied with fibrin sealant. Methodologically sound randomized control trials examining the efficacy of modified tumescent solution, ropivacaine, plasma therapy, noncontact ultrasound, and morphine gels are lacking and should be a priority for future research.

Participatory Research Challenges in Drug Abuse Studies Among Transnational Mexican Migrants

PubMed Central

Garcia, Victor; Gonzalez, Laura

2011-01-01

Participatory research is essential in public health studies, but using this methodology to examine sensitive public health problems among vulnerable populations is a challenge. We share some of our trials and tribulations in attempting to use participatory research in our substance abuse studies among transnational Mexican migrants in southeastern Pennsylvania. Major challenges did not permit partnerships across the community in all phases of research, including the dissemination of findings. Especially difficult was including transnational migrants and nearby relatives as partners in the research, similar to partnerships created with others in the community. The sensitive nature of our research and associated human subject concerns did not permit a more participatory methodology. Another problem involved partnerships with members of the larger community, given the apathy and ambivalence towards drug use by transnational migrants. Finally, collaborating with community stakeholders to develop and implement research-based recommendations was also problematic. As we learned, there are more to generating substance abuse recommendations in partnership with stakeholders than simply working together on recommendations, which also require an effective implementation strategy. Based on these experiences, we elaborate useful suggestions in development and application of local-level programs aimed at curtailing substance abuse among transnational migrant workers while they are at their work sites in Pennsylvania. PMID:22003376
Coteaching in physical education: a strategy for inclusive practice.

PubMed

Grenier, Michelle A

2011-04-01

Qualitative research methods were used to explore the factors that informed general and adapted physical education teachers' coteaching practices within an inclusive high school physical education program. Two physical education teachers and one adapted physical education teacher were observed over a 16-week period. Interviews, field notes, and documents were collected and a constant comparative approach was used in the analysis that adopted a social model framework. Primary themes included community as the cornerstone for student learning, core values of trust and respect, and creating a natural support structure. Coteaching practices existed because of the shared values of teaching, learning, and the belief that all students should be included. Recommendations include shifting orientations within professional preparation programs to account for the social model of disability.
Quality of Web-Based Educational Interventions for Clinicians on Human Papillomavirus Vaccine: Content and Usability Assessment.

PubMed

Rosen, Brittany L; Bishop, James M; McDonald, Skye L; Kahn, Jessica A; Kreps, Gary L

2018-02-16

Human papillomavirus (HPV) vaccination rates fall far short of Healthy People 2020 objectives. A leading reason is that clinicians do not recommend the vaccine consistently and strongly to girls and boys in the age group recommended for vaccination. Although Web-based HPV vaccine educational interventions for clinicians have been created to promote vaccination recommendations, rigorous evaluations of these interventions have not been conducted. Such evaluations are important to maximize the efficacy of educational interventions in promoting clinician recommendations for HPV vaccination. The objectives of our study were (1) to expand previous research by systematically identifying HPV vaccine Web-based educational interventions developed for clinicians and (2) to evaluate the quality of these Web-based educational interventions as defined by access, content, design, user evaluation, interactivity, and use of theory or models to create the interventions. Current HPV vaccine Web-based educational interventions were identified from general search engines (ie, Google), continuing medical education search engines, health department websites, and professional organization websites. Web-based educational interventions were included if they were created for clinicians (defined as individuals qualified to deliver health care services, such as physicians, clinical nurses, and school nurses, to patients aged 9 to 26 years), delivered information about the HPV vaccine and how to increase vaccination rates, and provided continuing education credits. The interventions' content and usability were analyzed using 6 key indicators: access, content, design, evaluation, interactivity, and use of theory or models. A total of 21 interventions were identified, out of which 7 (33%) were webinars, 7 (33%) were videos or lectures, and 7 (33%) were other (eg, text articles, website modules). Of the 21 interventions, 17 (81%) identified the purpose of the intervention, 12 (57%) provided the date that the information had been updated (7 of these were updated within the last 6 months), 14 (67%) provided the participants with the opportunity to provide feedback on the intervention, and 5 (24%) provided an interactive component. None of the educational interventions explicitly stated that a theory or model was used to develop the intervention. This analysis demonstrates that a substantial proportion of Web-based HPV vaccine educational interventions has not been developed using established health education and design principles. Interventions designed using these principles may increase strong and consistent HPV vaccination recommendations by clinicians. ©Brittany L Rosen, James M Bishop, Skye L McDonald, Jessica A Kahn, Gary L Kreps. Originally published in JMIR Cancer (http://cancer.jmir.org), 16.02.2018.
The American Society for Radiation Oncology's 2015 Core Physics Curriculum for Radiation Oncology Residents

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

Burmeister, Jay, E-mail: burmeist@karmanos.org; Chen, Zhe; Chetty, Indrin J.

Purpose: The American Society for Radiation Oncology (ASTRO) Physics Core Curriculum Subcommittee (PCCSC) has updated the recommended physics curriculum for radiation oncology resident education to improve consistency in teaching, intensity, and subject matter. Methods and Materials: The ASTRO PCCSC is composed of physicists and physicians involved in radiation oncology residency education. The PCCSC updated existing sections within the curriculum, created new sections, and attempted to provide additional clinical context to the curricular material through creation of practical clinical experiences. Finally, we reviewed the American Board of Radiology (ABR) blueprint of examination topics for correlation with this curriculum. Results: The newmore » curriculum represents 56 hours of resident physics didactic education, including a 4-hour initial orientation. The committee recommends completion of this curriculum at least twice to assure both timely presentation of material and re-emphasis after clinical experience. In addition, practical clinical physics and treatment planning modules were created as a supplement to the didactic training. Major changes to the curriculum include addition of Fundamental Physics, Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy, and Safety and Incidents sections, and elimination of the Radiopharmaceutical Physics and Dosimetry and Hyperthermia sections. Simulation and Treatment Verification and optional Research and Development in Radiation Oncology sections were also added. A feedback loop was established with the ABR to help assure that the physics component of the ABR radiation oncology initial certification examination remains consistent with this curriculum. Conclusions: The ASTRO physics core curriculum for radiation oncology residents has been updated in an effort to identify the most important physics topics for preparing residents for careers in radiation oncology, to reflect changes in technology and practice since the publication of previous recommended curricula, and to provide practical training modules in clinical radiation oncology physics and treatment planning. The PCCSC is committed to keeping the curriculum current and consistent with the ABR examination blueprint.« less
The American Society for Radiation Oncology's 2015 Core Physics Curriculum for Radiation Oncology Residents.

PubMed

Burmeister, Jay; Chen, Zhe; Chetty, Indrin J; Dieterich, Sonja; Doemer, Anthony; Dominello, Michael M; Howell, Rebecca M; McDermott, Patrick; Nalichowski, Adrian; Prisciandaro, Joann; Ritter, Tim; Smith, Chadd; Schreiber, Eric; Shafman, Timothy; Sutlief, Steven; Xiao, Ying

2016-07-15

The American Society for Radiation Oncology (ASTRO) Physics Core Curriculum Subcommittee (PCCSC) has updated the recommended physics curriculum for radiation oncology resident education to improve consistency in teaching, intensity, and subject matter. The ASTRO PCCSC is composed of physicists and physicians involved in radiation oncology residency education. The PCCSC updated existing sections within the curriculum, created new sections, and attempted to provide additional clinical context to the curricular material through creation of practical clinical experiences. Finally, we reviewed the American Board of Radiology (ABR) blueprint of examination topics for correlation with this curriculum. The new curriculum represents 56 hours of resident physics didactic education, including a 4-hour initial orientation. The committee recommends completion of this curriculum at least twice to assure both timely presentation of material and re-emphasis after clinical experience. In addition, practical clinical physics and treatment planning modules were created as a supplement to the didactic training. Major changes to the curriculum include addition of Fundamental Physics, Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy, and Safety and Incidents sections, and elimination of the Radiopharmaceutical Physics and Dosimetry and Hyperthermia sections. Simulation and Treatment Verification and optional Research and Development in Radiation Oncology sections were also added. A feedback loop was established with the ABR to help assure that the physics component of the ABR radiation oncology initial certification examination remains consistent with this curriculum. The ASTRO physics core curriculum for radiation oncology residents has been updated in an effort to identify the most important physics topics for preparing residents for careers in radiation oncology, to reflect changes in technology and practice since the publication of previous recommended curricula, and to provide practical training modules in clinical radiation oncology physics and treatment planning. The PCCSC is committed to keeping the curriculum current and consistent with the ABR examination blueprint. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Brazilian recommendations of mechanical ventilation 2013. Part 2

PubMed Central

2014-01-01

Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in São Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document. PMID:25410835
Brazilian recommendations of mechanical ventilation 2013. Part I

PubMed Central

Barbas, Carmen Sílvia Valente; Ísola, Alexandre Marini; Farias, Augusto Manoel de Carvalho; Cavalcanti, Alexandre Biasi; Gama, Ana Maria Casati; Duarte, Antonio Carlos Magalhães; Vianna, Arthur; Serpa, Ary; Bravim, Bruno de Arruda; Pinheiro, Bruno do Valle; Mazza, Bruno Franco; de Carvalho, Carlos Roberto Ribeiro; Toufen, Carlos; David, Cid Marcos Nascimento; Taniguchi, Corine; Mazza, Débora Dutra da Silveira; Dragosavac, Desanka; Toledo, Diogo Oliveira; Costa, Eduardo Leite; Caser, Eliana Bernardete; Silva, Eliezer; Amorim, Fabio Ferreira; Saddy, Felipe; Galas, Filomena Regina Barbosa Gomes; Silva, Gisele Sampaio; de Matos, Gustavo Faissol Janot; Emmerich, João Claudio; Valiatti, Jorge Luis dos Santos; Teles, José Mario Meira; Victorino, Josué Almeida; Ferreira, Juliana Carvalho; Prodomo, Luciana Passuello do Vale; Hajjar, Ludhmila Abrahão; Martins, Luiz Cláudio; Malbouisson, Luiz Marcelo Sá; Vargas, Mara Ambrosina de Oliveira; Reis, Marco Antonio Soares; Amato, Marcelo Brito Passos; Holanda, Marcelo Alcântara; Park, Marcelo; Jacomelli, Marcia; Tavares, Marcos; Damasceno, Marta Cristina Paulette; Assunção, Murillo Santucci César; Damasceno, Moyzes Pinto Coelho Duarte; Youssef, Nazah Cherif Mohamad; Teixeira, Paulo José Zimmermann; Caruso, Pedro; Duarte, Péricles Almeida Delfino; Messeder, Octavio; Eid, Raquel Caserta; Rodrigues, Ricardo Goulart; de Jesus, Rodrigo Francisco; Kairalla, Ronaldo Adib; Justino, Sandra; Nemer, Sérgio Nogueira; Romero, Simone Barbosa; Amado, Verônica Moreira

2014-01-01

Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in São Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document. PMID:25028944
Brazilian recommendations of mechanical ventilation 2013. Part 2

PubMed Central

Barbas, Carmen Sílvia Valente; Ísola, Alexandre Marini; Farias, Augusto Manoel de Carvalho; Cavalcanti, Alexandre Biasi; Gama, Ana Maria Casati; Duarte, Antonio Carlos Magalhães; Vianna, Arthur; Serpa Neto, Ary; Bravim, Bruno de Arruda; Pinheiro, Bruno do Valle; Mazza, Bruno Franco; de Carvalho, Carlos Roberto Ribeiro; Toufen Júnior, Carlos; David, Cid Marcos Nascimento; Taniguchi, Corine; Mazza, Débora Dutra da Silveira; Dragosavac, Desanka; Toledo, Diogo Oliveira; Costa, Eduardo Leite; Caser, Eliana Bernadete; Silva, Eliezer; Amorim, Fabio Ferreira; Saddy, Felipe; Galas, Filomena Regina Barbosa Gomes; Silva, Gisele Sampaio; de Matos, Gustavo Faissol Janot; Emmerich, João Claudio; Valiatti, Jorge Luis dos Santos; Teles, José Mario Meira; Victorino, Josué Almeida; Ferreira, Juliana Carvalho; Prodomo, Luciana Passuello do Vale; Hajjar, Ludhmila Abrahão; Martins, Luiz Claudio; Malbouisson, Luis Marcelo Sá; Vargas, Mara Ambrosina de Oliveira; Reis, Marco Antonio Soares; Amato, Marcelo Brito Passos; Holanda, Marcelo Alcântara; Park, Marcelo; Jacomelli, Marcia; Tavares, Marcos; Damasceno, Marta Cristina Paulette; Assunção, Murillo Santucci César; Damasceno, Moyzes Pinto Coelho Duarte; Youssef, Nazah Cherif Mohamed; Teixeira, Paulo José Zimmermann; Caruso, Pedro; Duarte, Péricles Almeida Delfino; Messeder, Octavio; Eid, Raquel Caserta; Rodrigues, Ricardo Goulart; de Jesus, Rodrigo Francisco; Kairalla, Ronaldo Adib; Justino, Sandra; Nemer, Sergio Nogueira; Romero, Simone Barbosa; Amado, Verônica Moreira

2014-01-01

Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in São Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document. PMID:25295817
Diverticular disease: guidelines of the german society for gastroenterology, digestive and metabolic diseases and the german society for general and visceral surgery.

PubMed

Kruis, Wolfgang; Germer, Christoph-Thomas; Leifeld, Ludger

2014-01-01

Diverticular disease is one of the most common disorders of the gastrointestinal tract. 28-45% of the population develop colonic diverticula, while about 25% suffer symptoms and about 5% complications. To create formal guidelines for diagnosis and management. Six working groups with 44 participants analyzed key questions in subject areas assigned to them. Following a systematic literature search, 451 publications were included. Consensus was obtained by agreement within the working groups, two Delphi processes and a guideline conference. Targeted management of diverticular disease requires a classificatory diagnosis. A new classification was created. In addition to the clinical examination, intestinal ultrasound or computed tomography is the determining factor. Interval colonoscopy is recommended to exclude comorbidities. A low-fiber diet, obesity, lack of exercise, smoking and immunosuppression have an adverse impact on diverticulosis. This can lead to diverticulitis. Antibiotics are no longer recommended in uncomplicated diverticulitis if no risk factors such as immunosuppression are present. If close monitoring is ensured, uncomplicated diverticulitis can be treated on an outpatient basis. Complicated diverticulitis should be treated in hospital, involving broad-spectrum antibiotic therapy, where necessary abscess drainage, and surgery, if possible laparoscopically. In the case of chronic relapsing diverticulitis, the risk of perforation decreases with each episode, so that surgery is no longer recommended after the second episode but only following individual assessment. New findings on diverticular disease call into question the overuse of antibiotics and excessive indications for surgery. Targeted treatment requires a precise diagnosis and intensive interdisciplinary cooperation. © 2014 S. Karger AG, Basel.
Brazilian recommendations of mechanical ventilation 2013. Part I

PubMed Central

2014-01-01

Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in São Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document. PMID:25210957
Reviewing the definition of crisis in dementia care

PubMed Central

2013-01-01

Background Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice. Methods We systematically searched for articles containing definitions of crisis in the context of dementia care. We created an operational framework of crisis based on retrieved definitions. Recommendations to address crisis situations were reviewed and classified according to care settings. Results Abstracts and titles of 1,113 articles, screened from PubMed and EMBASE, were narrowed down to 27 articles. After review, crisis in dementia was defined as a process where a stressor causes an imbalance requiring an immediate decision to be made which leads to a desired outcome and therefore a resolution of the crisis. If the crisis is not resolved, the cycle continues. Recommendations for resolving crisis involving persons with dementia and their caregivers include awareness therapy after diagnosis and increased contact with general practitioners, case manager consultations, caregiver support and education. Furthermore, nursing home staff should be attuned to the environmental, physical and psychological needs of persons with dementia. Conclusions This is the first article to review the definition of crisis in the context of dementia care. A review of the literature indicated that the definition of a crisis is idiosyncratic. Therefore, it is difficult to prevent or plan for all crises. We used an operational framework to compile types of crisis stressors and recommendations from the crisis literature based on three different perspectives; the person with the dementia, the caregiver and the healthcare providers. PMID:23374634
Reviewing the definition of crisis in dementia care.

PubMed

MacNeil Vroomen, Janet; Bosmans, Judith E; van Hout, Hein P J; de Rooij, Sophia E

2013-02-01

Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice. We systematically searched for articles containing definitions of crisis in the context of dementia care. We created an operational framework of crisis based on retrieved definitions. Recommendations to address crisis situations were reviewed and classified according to care settings. Abstracts and titles of 1,113 articles, screened from PubMed and EMBASE, were narrowed down to 27 articles. After review, crisis in dementia was defined as a process where a stressor causes an imbalance requiring an immediate decision to be made which leads to a desired outcome and therefore a resolution of the crisis. If the crisis is not resolved, the cycle continues. Recommendations for resolving crisis involving persons with dementia and their caregivers include awareness therapy after diagnosis and increased contact with general practitioners, case manager consultations, caregiver support and education. Furthermore, nursing home staff should be attuned to the environmental, physical and psychological needs of persons with dementia. This is the first article to review the definition of crisis in the context of dementia care. A review of the literature indicated that the definition of a crisis is idiosyncratic. Therefore, it is difficult to prevent or plan for all crises. We used an operational framework to compile types of crisis stressors and recommendations from the crisis literature based on three different perspectives; the person with the dementia, the caregiver and the healthcare providers.
Children's Media Culture in the New Millennium: Mapping the Digital Landscape.

ERIC Educational Resources Information Center

Montgomery, Kathryn C.

2000-01-01

Describes technological, demographic, and market forces shaping the new digital media culture and the various Web sites being created for children and teens, explaining how heavily-promoted commercial sites overshadow educational sites. Discusses efforts to create safe Internet zones for children. Recommends actions to promote development of a…
Wetland mitigation banking for the oil and gas industry: Assessment, conclusions, and recommendations

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

Wilkey, P.L.; Sundell, R.C.; Bailey, K.A.

1994-01-01

Wetland mitigation banks are already in existence in the United States, and the number is increasing. To date, most of these banks have been created and operated for mitigation of impacts arising from highway or commercial development and have not been associated with the oil and gas industry. Argonne National Laboratory evaluated the positive and negative aspects of wetland mitigation banking for the oil and gas industry by examining banks already created for other uses by federal, state, and private entities. Specific issues addressed in this study include (1) the economic, ecological, and technical effectiveness of existing banks; (2) themore » changing nature of local, state, and federal jurisdiction; and (3) the unique regulatory and jurisdictional problems affecting bank developments associated with the oil and gas industry.« less
Plain Language Summary: Evaluation of the Neck Mass in Adults.

PubMed

Pynnonen, Melissa A; Colandrea, Maria; Finestone, Sandra A; O'Connor, Sarah S

2017-09-01

This plain language summary serves as an overview in explaining the evaluation of the neck mass in adults. The summary applies to patients aged ≥18 years and is based on the 2017 "Clinical Practice Guideline: Evaluation of the Neck Mass in Adults." The evidence-based guideline includes research to support more effective evaluation and diagnosis of the neck mass in adults. The guideline was developed as a quality improvement opportunity for evaluation of the neck mass by creating clear recommendations to use in medical practice.
Canadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death—Summary Report*

PubMed Central

Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, ; Sonny; Sivarajan, V. Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A.; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D.

2017-01-01

Objectives: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. Methods: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. Results: We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation after circulatory determination of death, 7) cardiac and innovative pediatric donation after circulatory determination of death, and 8) implementation. For brevity, 48 Good Practice Statement and truncated justification are included in this summary report. The remaining recommendations, detailed methodology, full Grading of Recommendations Assessment, Development, and Evaluation tables, and expanded justifications are available in the full text report. Conclusions: This process showed that rigorous, transparent clinical practice guideline development is possible in the domain of pediatric deceased donation. Application of these recommendations will increase access to pediatric donation after circulatory determination of death across Canada and may serve as a model for future clinical practice guideline development in deceased donation. PMID:28925929
Using holistic interpretive synthesis to create practice-relevant guidance for person-centred fundamental care delivered by nurses.

PubMed

Feo, Rebecca; Conroy, Tiffany; Marshall, Rhianon J; Rasmussen, Philippa; Wiechula, Richard; Kitson, Alison L

2017-04-01

Nursing policy and healthcare reform are focusing on two, interconnected areas: person-centred care and fundamental care. Each initiative emphasises a positive nurse-patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse-patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice-relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse-patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse-patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person-centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. © 2016 John Wiley & Sons Ltd.
Critical care medicine training and certification for emergency physicians.

PubMed

Huang, David T; Osborn, Tiffany M; Gunnerson, Kyle J; Gunn, Scott R; Trzeciak, Stephen; Kimball, Edward; Fink, Mitchell P; Angus, Derek C; Dellinger, R Phillip; Rivers, Emanuel P

2005-09-01

Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivists. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine and critical care medicine. Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivists. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine (EM) and critical care medicine (CCM). Critical care is a continuum that includes prehospital, emergency department (ED), and intensive care unit (ICU) care teams. Both EM and CCM require expertise in treating life-threatening acute illness, with many critically ill patients often presenting first to the ED. Increased patient volumes and acuity have resulted in longer ED lengths of stay and more critical care delivery in the ED. However, the majority of CCM fellowships do not accept EM residents, and those who successfully complete a fellowship do not have access to a U.S. certification exam in CCM. Despite these barriers, interest in CCM training among EM physicians is increasing. Dual EM/CCM-trained physicians not only will help alleviate the intensivist shortage but also will strengthen critical care delivery in the ED and facilitate coordination at the ED-ICU interface. We therefore propose that all accreditation bodies work cooperatively to create a route to CCM certification for emergency physicians who complete a critical care fellowship.
Comparative hydraulics of two fishery research circular tanks and recommendations for control of experimental bias

USGS Publications Warehouse

Odeh, M.; Schrock, R.M.; Gannam, A.

2003-01-01

Hydraulic characteristics inside two research circular tanks (1.5-m and 1.2-m diameter) with the same volume of water were studied to understand how they might affect experimental bias by influencing the behavior and development of juvenile fish. Water velocities inside each tank were documented extensively and flow behavior studied. Surface inflow to the 1.5-m tank created a highly turbulent and aerated surface, and produced unevenly distributed velocities within the tank. A low-flow velocity, or "dead" zone, persisted just upstream of the surface inflow. A single submerged nozzle in the 1.2-m tank created uniform flow and did not cause undue turbulence or introduce air. Flow behavior in the 1.5-m tank is believed to have negatively affected the feeding behavior and physiological development of a group of juvenile fall chinook salmon, Oncorhynchus tshawytscha. A new inflow nozzle design provided comparable flow behavior regardless of tank size and water depth. Maintaining similar hydraulic conditions inside tanks used for various biological purposes, including fish research, would minimize experimental bias caused by differences in flow behavior. Other sources of experimental bias are discussed and recommendations given for reporting and control of experimental conditions in fishery research tank experiments.
Notes from the field: the economic value chain in disease management organizations.

PubMed

Fetterolf, Donald

2006-12-01

The disease management (DM) "value chain" is composed of a linear series of steps that include operational milestones in the development of knowledge, each stage evolving from the preceding one. As an adaptation of Michael Porter's "value chain" model, the process flow in DM moves along the following path: (1) data/information technology, (2) information generation, (3) analysis, (4) assessment/recommendations, (5) actionable customer plan, and (6) program assessment/reassessment. Each of these stages is managed as a major line of product operations within a DM company or health plan. Metrics around each of the key production variables create benchmark milestones, ongoing management insight into program effectiveness, and potential drivers for activity-based cost accounting pricing models. The value chain process must remain robust from early entry of data and information into the system, through the final presentation and recommendations for our clients if the program is to be effective. For individuals involved in the evaluation or review of DM programs, this framework is an excellent method to visualize the key components and sequence in the process. The value chain model is an excellent way to establish the value of a formal DM program and to create a consultancy relationship with a client involved in purchasing these complex services.

Clinical practice guideline for the prevention, early detection, diagnosis, management and follow up of type 2 diabetes mellitus in adults.

PubMed

Aschner, Pablo M; Muñoz, Oscar Mauricio; Girón, Diana; García, Olga Milena; Fernández-Ávila, Daniel Gerardo; Casas, Luz Ángela; Bohórquez, Luisa Fernanda; Arango T, Clara María; Carvajal, Liliana; Ramírez, Doris Amanda; Sarmiento, Juan Guillermo; Colon, Cristian Alejandro; Correa G, Néstor Fabián; Alarcón R, Pilar; Bustamante S, Álvaro Andrés

2016-06-30

In Colombia, diabetes mellitus is a public health program for those responsible for creating and implementing strategies for prevention, diagnosis, treatment, and follow-up that are applicable at all care levels, with the objective of establishing early and sustained control of diabetes. A clinical practice guide has been developed following the broad outline of the methodological guide from the Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations taken into account in formulating them. In general terms, what is proposed here is a screening process using the Finnish Diabetes Risk Score questionnaire adapted to the Colombian population, which enables early diagnosis of the illness, and an algorithm for determining initial treatment that can be generalized to most patients with diabetes mellitus type 2 and that is simple to apply in a primary care context. In addition, several recommendations have been made to scale up pharmacological treatment in those patients that do not achieve the objectives or fail to maintain them during initial treatment. These recommendations also take into account the evolution of weight and the individualization of glycemic control goals for special populations. Finally, recommendations have been made for opportune detection of micro- and macrovascular complications of diabetes.
Clinical practice guideline for the prevention, early detection, diagnosis, management and follow up of type 2 diabetes mellitus in adults

PubMed Central

Muñoz, Oscar Mauricio; Girón, Diana; García, Olga Milena; Fernández-Ávila, Daniel Gerardo; Casas, Luz Ángela; Bohórquez, Luisa Fernanda; Arango T, Clara María; Carvajal, Liliana; Ramírez, Doris Amanda; Sarmiento, Juan Guillermo; Colon, Cristian Alejandro; Correa G, Néstor Fabián; Alarcón R, Pilar; Bustamante S, Álvaro Andrés

2016-01-01

In Colombia, diabetes mellitus is a public health program for those responsible for creating and implementing strategies for prevention, diagnosis, treatment, and follow-up that are applicable at all care levels, with the objective of establishing early and sustained control of diabetes. A clinical practice guide has been developed following the broad outline of the methodological guide from the Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations taken into account in formulating them. In general terms, what is proposed here is a screening process using the Finnish Diabetes Risk Score questionnaire adapted to the Colombian population, which enables early diagnosis of the illness, and an algorithm for determining initial treatment that can be generalized to most patients with diabetes mellitus type 2 and that is simple to apply in a primary care context. In addition, several recommendations have been made to scale up pharmacological treatment in those patients that do not achieve the objectives or fail to maintain them during initial treatment. These recommendations also take into account the evolution of weight and the individualization of glycemic control goals for special populations. Finally, recommendations have been made for opportune detection of micro- and macrovascular complications of diabetes. PMID:27546934
Surgical management of pancreatic necrosis: A practice management guideline from the Eastern Association for the Surgery of Trauma.

PubMed

Mowery, Nathan T; Bruns, Brandon R; MacNew, Heather G; Agarwal, Suresh; Enniss, Toby M; Khan, Mansoor; Guo, Weidun Alan; Cannon, Jeremy W; Lissauer, Matthew E; Duane, Therese M; Hildreth, Amy N; Pappas, Peter A; Gries, Lynn M; Kaiser, Meghann; Robinson, Bryce R H

2017-08-01

Pancreatic or peripancreatic tissue necrosis confers substantial morbidity and mortality. New modalities have created a wide variation in approaches and timing of interventions for necrotizing pancreatitis. As acute care surgery evolves, its practitioners are increasingly being called upon to manage these complex patients. A systematic review of the MEDLINE database using PubMed was performed. English language articles regarding pancreatic necrosis from 1980 to 2014 were included. Letters to the editor, case reports, book chapters, and review articles were excluded. Topics of investigation included operative timing, the use of adjuvant therapy and the type of operative repair. Grading of Recommendations, Assessment, Development and Evaluations methodology was applied to question development, outcome prioritization, evidence quality assessments, and recommendation creation. Eighty-eight studies were included and underwent full review. Increasing the time to surgical intervention had an improved outcome in each of the periods evaluated (72 hours, 12-14 days, 30 days) with a significant improvement in outcomes if surgery was delayed 30 days. The use of percutaneous and endoscopic procedures was shown to postpone surgery and potentially be definitive. The use of minimally invasive surgery for debridement and drainage has been shown to be safe and associated with reduced morbidity and mortality. Acute Care Surgeons are uniquely trained to care for those with pancreatic necrosis due their training in critical care and complex surgery with ongoing shock. In adult patients with pancreatic necrosis, we recommend that pancreatic necrosectomy be delayed until at least day 12. During the first 30 days of symptoms with infected necrotic collections, we conditionally recommend surgical debridement only if the patients fail to improve after radiologic or endoscopic drainage. Finally, even with documented infected necrosis, we recommend that patients undergo a step-up approach to surgical intervention as the preferred surgical approach. Systematic review/guideline, level III.
Recommendations for safety planning, data collection, evaluation and reporting during drug, biologic and vaccine development: a report of the safety planning, evaluation, and reporting team.

PubMed

Crowe, Brenda J; Xia, H Amy; Berlin, Jesse A; Watson, Douglas J; Shi, Hongliang; Lin, Stephen L; Kuebler, Juergen; Schriver, Robert C; Santanello, Nancy C; Rochester, George; Porter, Jane B; Oster, Manfred; Mehrotra, Devan V; Li, Zhengqing; King, Eileen C; Harpur, Ernest S; Hall, David B

2009-10-01

The Safety Planning, Evaluation and Reporting Team (SPERT) was formed in 2006 by the Pharmaceutical Research and Manufacturers of America. SPERT's goal was to propose a pharmaceutical industry standard for safety planning, data collection, evaluation, and reporting, beginning with planning first-in-human studies and continuing through the planning of the post-product-approval period. SPERT's recommendations are based on our review of relevant literature and on consensus reached in our discussions. An important recommendation is that sponsors create a Program Safety Analysis Plan early in development. We also give recommendations for the planning of repeated, cumulative meta-analyses of the safety data obtained from the studies conducted within the development program. These include clear definitions of adverse events of special interest and standardization of many aspects of data collection and study design. We describe a 3-tier system for signal detection and analysis of adverse events and highlight proposals for reducing "false positive" safety findings. We recommend that sponsors review the aggregated safety data on a regular and ongoing basis throughout the development program, rather than waiting until the time of submission. We recognize that there may be other valid approaches. The proactive approach we advocate has the potential to benefit patients and health care providers by providing more comprehensive safety information at the time of new product marketing and beyond.
Five key recommendations for the implementation of Hospital Electronic Prescribing and Medicines Administration systems in Scotland.

PubMed

Cresswell, Kathrin; Slee, Ann; Sheikh, Aziz

2017-01-24

NHS Scotland is about to embark on the implementation of Hospital Electronic Prescribing and Medicines Administration (HEPMA) systems. There are a number of risks associated with such ventures, thus drawing on existing experiences from other settings is crucial in informing deployment.Drawing on our previous and ongoing work in English settings as well as the international literature, we reflect on key lessons that NHS Scotland may wish to consider in going forward. These deliberations include recommendations surrounding key aspects of deployment strategy surrounding: 1) the way central coordination should be conceptualised, 2) how flexibility in can be ensured, 3) paying attention to optimising systems from the outset, 4) how expertise should be developed and centrally shared, and 5) ways in which learning from experience can be maximised.Our five recommendations will, we hope, provide a starting point for the strategic deliberations of policy makers. Throughout this journey, it is important to view the deployment of HEPMA as part of a wider strategic goal of creating integrated digital infrastructures across Scotland.
Recommended industry best management practices for the prevention of Phytophthora ramorum introduction in nursery operations

Treesearch

Karen Suslow

2008-01-01

The following industry recommended best management practices (BMPs), designed for growers and/or interstate shippers of host and associated host plants of Phytophthora ramorum, consists of biosecurity guidelines created by and for nursery growers in order to reduce the risks associated with P. ramorum. The control of P....
Creating Safer Campuses through Implementation of Threat-Assessment Teams: Are They Enough?

ERIC Educational Resources Information Center

Toppe, Michele L.

2017-01-01

According to higher education policy experts, "Campus threat assessment is not merely a recommendation, but an emerging standard of care." However, despite evidence of the emergence of this standard and the consistency of recommendations that comport with those made by the Virginia Tech Review Panel, college campuses continue to vary…
Recommendations for Benchmarking Web Site Usage among Academic Libraries.

ERIC Educational Resources Information Center

Hightower, Christy; Sih, Julie; Tilghman, Adam

1998-01-01

To help library directors and Web developers create a benchmarking program to compare statistics of academic Web sites, the authors analyzed the Web server log files of 14 university science and engineering libraries. Recommends a centralized voluntary reporting structure coordinated by the Association of Research Libraries (ARL) and a method for…
Virtual goods recommendations in virtual worlds.

PubMed

Chen, Kuan-Yu; Liao, Hsiu-Yu; Chen, Jyun-Hung; Liu, Duen-Ren

2015-01-01

Virtual worlds (VWs) are computer-simulated environments which allow users to create their own virtual character as an avatar. With the rapidly growing user volume in VWs, platform providers launch virtual goods in haste and stampede users to increase sales revenue. However, the rapidity of development incurs virtual unrelated items which will be difficult to remarket. It not only wastes virtual global companies' intelligence resources, but also makes it difficult for users to find suitable virtual goods fit for their virtual home in daily virtual life. In the VWs, users decorate their houses, visit others' homes, create families, host parties, and so forth. Users establish their social life circles through these activities. This research proposes a novel virtual goods recommendation method based on these social interactions. The contact strength and contact influence result from interactions with social neighbors and influence users' buying intention. Our research highlights the importance of social interactions in virtual goods recommendation. The experiment's data were retrieved from an online VW platform, and the results show that the proposed method, considering social interactions and social life circle, has better performance than existing recommendation methods.
Virtual Goods Recommendations in Virtual Worlds

PubMed Central

Chen, Kuan-Yu; Liao, Hsiu-Yu; Chen, Jyun-Hung; Liu, Duen-Ren

2015-01-01

Virtual worlds (VWs) are computer-simulated environments which allow users to create their own virtual character as an avatar. With the rapidly growing user volume in VWs, platform providers launch virtual goods in haste and stampede users to increase sales revenue. However, the rapidity of development incurs virtual unrelated items which will be difficult to remarket. It not only wastes virtual global companies' intelligence resources, but also makes it difficult for users to find suitable virtual goods fit for their virtual home in daily virtual life. In the VWs, users decorate their houses, visit others' homes, create families, host parties, and so forth. Users establish their social life circles through these activities. This research proposes a novel virtual goods recommendation method based on these social interactions. The contact strength and contact influence result from interactions with social neighbors and influence users' buying intention. Our research highlights the importance of social interactions in virtual goods recommendation. The experiment's data were retrieved from an online VW platform, and the results show that the proposed method, considering social interactions and social life circle, has better performance than existing recommendation methods. PMID:25834837
CAEP 2015 Academic Symposium: Current State and Recommendations to Achieve Adequate and Sustainable Funding for Emergency Medicine Academic Units.

PubMed

Lang, Eddy S; Artz, Jennifer D; Wilkie, Ryan D; Stiell, Ian G; Topping, Claude; Belanger, François P; Afilalo, Marc; Renouf, Tia; Crocco, Anthony; Wyatt, Kelly; Christenson, Jim

2016-05-01

To describe the current state of academic emergency medicine (EM) funding in Canada and develop recommendations to grow and establish sustainable funding. A panel of eight leaders from different EM academic units was assembled. Using mixed methods (including a literature review, sharing of professional experiences, a survey of current EM academic heads, and data previously collected from an environmental scan), 10 recommendations were drafted and presented at an academic symposium. Attendee feedback was incorporated, and the second set of draft recommendations was further distributed to the Canadian Association Emergency Physicians (CAEP) Academic Section for additional comments before being finalized. Recommendations were developed around the funding challenges identified and solutions developed by academic EM university-based units across Canada. A strategic plan was seen as integral to achieving strong funding of an EM unit, especially when it aligned with departmental and institutional priorities. A business plan, although occasionally overlooked, was deemed an important component for planning and sustaining the academic mission. A number of recommendations surrounding philanthropy consisted of creating partnerships with existing foundations and engaging multiple stakeholders and communities. Synergy between academic and clinical EM departments was also viewed as an opportunity to ensure integration of common missions. Education and networking for current and future leaders were also viewed as invaluable to ensure that opportunities are optimized through strong leadership development and shared experiences to further the EM academic missions across the country. These recommendations were designed to improve the financial circumstances for many Canadian EM units. There is a considerable wealth of resources that can contribute to financial stability for an academic unit, and an annual networking meeting and continuing education on these issues will facilitate more rapid implementation of these recommendations.
A comparison of the treatment recommendations for neurogenic lower urinary tract dysfunction in the national institute for health and care excellence, European Association of Urology and international consultations on incontinence guidelines.

PubMed

Jaggi, Ashley; Drake, Marcus; Siddiqui, Emad; Fatoye, Francis

2018-04-17

Healthcare guidelines are an important vehicle in establishing up-to-date evidence based medicine (EBM) in clinical practice. Due to varying development processes, clinical guidelines created by different institutions can often contain contrasting recommendations. This can have implications for optimal and standardized patient care across management settings. The similarities and differences of treatment recommendations made in the National Institute for Health and Care Excellence (NICE), The European Association of Urology (EAU), and the International Consultation on Continence (ICI) guidelines for neurogenic lower urinary tract dysfunction (NLUTD) were assessed. The guidelines generally agree on their approach to conservative management, including behavioral therapies, and catheterization techniques. There was discrepancy on the benefit of using an alpha blocker in NLUTD and bladder outlet obstruction (BOO) and administering Botulinum toxin A (Onabotulinum-A) in NLUTD. The highest degree of divergence was seen in recommendations for surgical treatments, where the EAU made gender-specific recommendations, and gave continent urinary diversion higher preference than given in the NICE and ICI guidelines. In the absence of high-quality clinical evidence, many of the recommendations made across all three guidelines are based on expert opinion. NICE, the EAU and ICI have similarities but they place differing emphasis on costs and expert opinion, which translated in notably different recommendations. It is evident that increased research efforts, possibly in the form of prospective registries, pragmatic trials, and resource utilization studies are necessary to improve the underlying evidence base for NLUTD, and subsequently the strength and concordance of recommendations across guidelines. © 2018 Wiley Periodicals, Inc.
Vaccinations in women.

PubMed

Sprabery, L R

2001-06-01

Obstetricians/gynecologists who deliver primary care have an opportunity to enhance the preventive care of their patients. At the first visit with each patient, the vaccination history should be taken. Systems should be developed to remind the physician and office staff of the need for influenza and pneumococcal vaccination, including prompts for patients. One should create or use forms already developed by the CDC to record vaccination data in the patient chart. Additional information is available on the Web at www.cdc.gov/nip provided by the National Immunization Program. The Facts and Comparisons section has a Web site with links to other sources: www.immunofacts.com. All current recommendations of the ACIP are included in the reference list.
Exercise interventions for patients with pediatric cancer during inpatient acute care: A systematic review of literature.

PubMed

Rustler, Vanessa; Hagerty, Meaghan; Daeggelmann, Julia; Marjerrison, Stacey; Bloch, Wilhelm; Baumann, Freerk T

2017-11-01

Physical inactivity has been shown to exacerbate negative side effects experienced by pediatric patients undergoing cancer therapy. Exercise interventions are being created in response. This review summarizes current exercise intervention data in the inpatient pediatric oncology setting. Two independent reviewers collected literature from three databases, and analyzed data following the PRISMA statement for systematic reviews and meta-analyses. Ten studies were included, representing 204 patients. Good adherence, positive trends in health status, and no adverse events were noted. Common strategies included individual, supervised, combination training with adaptability to meet fluctuating patient abilities. We recommend that general physical activity programming be offered to pediatric oncology inpatients. © 2017 Wiley Periodicals, Inc.
Dental management for head and neck cancer patients undergoing radiation therapy: comprehensive patient based planning--a case report.

PubMed

Higham, Paola; Quek, Samuel; Cohen, Harold V

2009-01-01

Medical management of the head and neck cancer patient (HNCP) most often will include radiation therapy to the head and neck region. HNCPs with malignant disease require judicious dental treatment planning prior to radiation therapy (RT) and/or chemotherapy. RT can result in a multitude of adverse effects, both reversible and irreversible. We report a case of a patient with squamous cell carcinoma of the throat above the larynx (supraglottic), who did not adhere to dental treatment recommendations for both pre- and post radiation dental management. The focus of this case report is to create awareness within the clinician that, in addition to evaluating the patient for the disease related issues that may affect the oral cavity and dentition, a total management plan should include factors beyond the structural oral problems related to the cancer. Final treatment plans for the HNCP should include medical assessment of past dental history, oral hygiene, potential compliance, or lack of, to dental care recommendations, the emotional state of the patient, socio-economic status of the patient (lifestyle, cost of care), future quality of life, the medical and/or life prognosis of the patient.
Recommendations Service for Chronic Disease Patient in Multimodel Sensors Home Environment

PubMed Central

Hussain, Maqbool; Ali, Taqdir; Khan, Wajahat Ali; Afzal, Muhammad; Latif, Khalid

2015-01-01

Abstract With advanced technologies in hand, there exist potential applications and services built around monitoring activities of daily living (ADL) of elderly people at nursing homes. Most of the elderly people in these facilities are suffering from different chronic diseases such as dementia. Existing technologies are mainly focusing on non-medication interventions and monitoring of ADL for addressing loss of autonomy or well-being. Monitoring and managing ADL related to cognitive behaviors for non-medication intervention are very effective in improving dementia patients' conditions. However, cognitive functions of patients can be improved if appropriate recommendations of medications are delivered at a particular time. Previously we developed the Secured Wireless Sensor Network Integrated Cloud Computing for Ubiquitous-Life Care (SC3). SC3 services were limited to monitoring ADL of elderly people with Alzheimer's disease and providing non-medication recommendations to the patient. In this article, we propose a system called the Smart Clinical Decision Support System (CDSS) as an integral part of the SC3 platform. Using the Smart CDSS, patients are provided with access to medication recommendations of expert physicians. Physicians are provided with an interface to create clinical knowledge for medication recommendations and to observe the patient's condition. The clinical knowledge created by physicians as the knowledge base of the Smart CDSS produces recommendations to the caregiver for medications based on each patient's symptoms. PMID:25559934
Recommendations service for chronic disease patient in multimodel sensors home environment.

PubMed

Hussain, Maqbool; Ali, Taqdir; Khan, Wajahat Ali; Afzal, Muhammad; Lee, Sungyoung; Latif, Khalid

2015-03-01

With advanced technologies in hand, there exist potential applications and services built around monitoring activities of daily living (ADL) of elderly people at nursing homes. Most of the elderly people in these facilities are suffering from different chronic diseases such as dementia. Existing technologies are mainly focusing on non-medication interventions and monitoring of ADL for addressing loss of autonomy or well-being. Monitoring and managing ADL related to cognitive behaviors for non-medication intervention are very effective in improving dementia patients' conditions. However, cognitive functions of patients can be improved if appropriate recommendations of medications are delivered at a particular time. Previously we developed the Secured Wireless Sensor Network Integrated Cloud Computing for Ubiquitous-Life Care (SC(3)). SC(3) services were limited to monitoring ADL of elderly people with Alzheimer's disease and providing non-medication recommendations to the patient. In this article, we propose a system called the Smart Clinical Decision Support System (CDSS) as an integral part of the SC(3) platform. Using the Smart CDSS, patients are provided with access to medication recommendations of expert physicians. Physicians are provided with an interface to create clinical knowledge for medication recommendations and to observe the patient's condition. The clinical knowledge created by physicians as the knowledge base of the Smart CDSS produces recommendations to the caregiver for medications based on each patient's symptoms.
Developing a virtual community for health sciences library book selection: Doody's Core Titles.

PubMed

Shedlock, James; Walton, Linda J

2006-01-01

The purpose of this article is to describe Doody's Core Titles in the Health Sciences as a new selection guide and a virtual community based on an effective use of online systems and to describe its potential impact on library collection development. The setting is the availability of health sciences selection guides. Participants include Doody Enterprise staff, Doody's Library Board of Advisors, content specialists, and library selectors. Resources include the online system used to create Doody's Core Titles along with references to complementary databases. Doody's Core Titles is described and discussed in relation to the literature of selection guides, especially in comparison to the Brandon/Hill selected lists that were published from 1965 to 2003. Doody's Core Titles seeks to fill the vacuum created when the Brandon/Hill lists ceased publication. Doody's Core Titles is a unique selection guide based on its method of creating an online community of experts to identify and score a core list of titles in 119 health sciences specialties and disciplines. The result is a new selection guide, now available annually, that will aid health sciences librarians in identifying core titles for local collections. Doody's Core Titles organizes the evaluation of core titles that are identified and recommended by content specialists associated with Doody's Book Review Service and library selectors. A scoring mechanism is used to create the selection of core titles, similar to the star rating system employed in other Doody Enterprise products and services.
Creating More Credible and Persuasive Recommender Systems: The Influence of Source Characteristics on Recommender System Evaluations

NASA Astrophysics Data System (ADS)

Yoo, Kyung-Hyan; Gretzel, Ulrike

Whether users are likely to accept the recommendations provided by a recommender system is of utmost importance to system designers and the marketers who implement them. By conceptualizing the advice seeking and giving relationship as a fundamentally social process, important avenues for understanding the persuasiveness of recommender systems open up. Specifically, research regarding the influence of source characteristics, which is abundant in the context of humanhuman relationships, can provide an important framework for identifying potential influence factors. This chapter reviews the existing literature on source characteristics in the context of human-human, human-computer, and human-recommender system interactions. It concludes that many social cues that have been identified as influential in other contexts have yet to be implemented and tested with respect to recommender systems. Implications for recommender system research and design are discussed.
An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications.

PubMed

Dweik, Raed A; Boggs, Peter B; Erzurum, Serpil C; Irvin, Charles G; Leigh, Margaret W; Lundberg, Jon O; Olin, Anna-Carin; Plummer, Alan L; Taylor, D Robin

2011-09-01

Measurement of fractional nitric oxide (NO) concentration in exhaled breath (Fe(NO)) is a quantitative, noninvasive, simple, and safe method of measuring airway inflammation that provides a complementary tool to other ways of assessing airways disease, including asthma. While Fe(NO) measurement has been standardized, there is currently no reference guideline for practicing health care providers to guide them in the appropriate use and interpretation of Fe(NO) in clinical practice. To develop evidence-based guidelines for the interpretation of Fe(NO) measurements that incorporate evidence that has accumulated over the past decade. We created a multidisciplinary committee with expertise in the clinical care, clinical science, or basic science of airway disease and/or NO. The committee identified important clinical questions, synthesized the evidence, and formulated recommendations. Recommendations were developed using pragmatic systematic reviews of the literature and the GRADE approach. The evidence related to the use of Fe(NO) measurements is reviewed and clinical practice recommendations are provided. In the setting of chronic inflammatory airway disease including asthma, conventional tests such as FEV(1) reversibility or provocation tests are only indirectly associated with airway inflammation. Fe(NO) offers added advantages for patient care including, but not limited to (1) detecting of eosinophilic airway inflammation, (2) determining the likelihood of corticosteroid responsiveness, (3) monitoring of airway inflammation to determine the potential need for corticosteroid, and (4) unmasking of otherwise unsuspected nonadherence to corticosteroid therapy.

An Official ATS Clinical Practice Guideline: Interpretation of Exhaled Nitric Oxide Levels (FeNO) for Clinical Applications

PubMed Central

Dweik, Raed A.; Boggs, Peter B.; Erzurum, Serpil C.; Irvin, Charles G.; Leigh, Margaret W.; Lundberg, Jon O.; Olin, Anna-Carin; Plummer, Alan L.; Taylor, D. Robin

2011-01-01

Background: Measurement of fractional nitric oxide (NO) concentration in exhaled breath (FeNO) is a quantitative, noninvasive, simple, and safe method of measuring airway inflammation that provides a complementary tool to other ways of assessing airways disease, including asthma. While FeNO measurement has been standardized, there is currently no reference guideline for practicing health care providers to guide them in the appropriate use and interpretation of FeNO in clinical practice. Purpose: To develop evidence-based guidelines for the interpretation of FeNO measurements that incorporate evidence that has accumulated over the past decade. Methods: We created a multidisciplinary committee with expertise in the clinical care, clinical science, or basic science of airway disease and/or NO. The committee identified important clinical questions, synthesized the evidence, and formulated recommendations. Recommendations were developed using pragmatic systematic reviews of the literature and the GRADE approach. Results: The evidence related to the use of FeNO measurements is reviewed and clinical practice recommendations are provided. Conclusions: In the setting of chronic inflammatory airway disease including asthma, conventional tests such as FEV1 reversibility or provocation tests are only indirectly associated with airway inflammation. FeNO offers added advantages for patient care including, but not limited to (1) detecting of eosinophilic airway inflammation, (2) determining the likelihood of corticosteroid responsiveness, (3) monitoring of airway inflammation to determine the potential need for corticosteroid, and (4) unmasking of otherwise unsuspected nonadherence to corticosteroid therapy. PMID:21885636
Readability of "Dear Patient" device advisory notification letters created by a device manufacturer.

PubMed

Mueller, Luke A; Sharma, Arjun; Ottenberg, Abigale L; Mueller, Paul S

2013-04-01

In 2006, the Heart Rhythm Society (HRS) recommended that cardiovascular implantable electronic device (CIED) manufacturers use advisory notification letters to communicate with affected patients. To evaluate the readability of the HRS sample "patient device advisory notification" letter and those created by 1 CIED manufacturer. The HRS sample letter and 25 Boston Scientific Corporation letters dated from 2005 through 2011 were evaluated by using 6 readability tests. Readability (Flesch-Kincaid score) of the HRS sample letter was grade level 12.5, and median readability of the device manufacturer letters was grade level 12.8 (range 10.8-18.9). Similar results were obtained by using other readability scales. No letters had readability scores at the National Work Group on Literacy and Health's recommended reading level-fifth grade; the letters' readability exceeded this recommended level by an average of 7.7 grades (95% confidence interval 6.9-8.5; P<.001). Likewise, no letters had readability scores at the average reading level of US adults-eighth grade; the letters' readability exceeded this level by an average of 4.7 grades (95% confidence interval 3.9-5.5; P< .001). The readability of the HRS sample letter and those created by a CIED manufacturer significantly exceeded the recommended and average US adults' reading skill levels. Such letters are unlikely to be informative to many patients. CIED manufacturers should ensure that advisory letters are comprehensible to most affected patients. Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Undergraduate Research Engagement at Major US Research Universities. Research & Occasional Paper Series: CSHE.14.13

ERIC Educational Resources Information Center

Douglass, John Aubrey; Zhao, Chun-Mei

2013-01-01

Bolstered by the recommendations of the 1998 Boyer Report, US federal agencies have put significant resources into promoting opportunities for undergraduates to engage in research. American universities and colleges have been creating support programs and curricular opportunities intended to create a "culture of undergraduate research."…
Student Adoption & Development of Digital Learning Media: Action Research and Recommended Practices

ERIC Educational Resources Information Center

Tabor, Sharon W.; Minch, Robert P.

2013-01-01

Digital technologies offer many opportunities for creating engaging course content. In this study we captured student perceptions and adoption choices related to creating and using digital media as learning tools. Podcasts, video and other media were integrated in a variety of contexts and tasks in two undergraduate information technology (IT)…
Recommendations from the Field: Creating an LGBTQ Learning Community

ERIC Educational Resources Information Center

Jaekel, Kathryn S.

2015-01-01

This article details the creation of a lesbian, gay, bisexual, transgender, and queer (LGBTQ) learning community. Created because of research that indicates chilly campus climates (Rankin, 2005), as well as particular needs of LGBTQ students in the classroom, this learning community focused upon LGBTQ topics in and out of the classroom. While…
Integrating Community with Collections in Educational Digital Libraries

ERIC Educational Resources Information Center

Akbar, Monika

2013-01-01

Some classes of Internet users have specific information needs and specialized information-seeking behaviors. For example, educators who are designing a course might create a syllabus, recommend books, create lecture slides, and use tools as lecture aid. All of these resources are available online, but are scattered across a large number of…
10 Ways to Promote a Culture of Literacy

ERIC Educational Resources Information Center

Gilmore, Barry

2017-01-01

Barry Gilmore, a principal at Hutchinson School in Memphis, Tennessee, has set out to create a culture of literacy at his school. In this article, he outlines 10 steps for fostering such an environment. Among other recommendations: publicly celebrate reading, create channels for booksharing, read and write across content areas, value disciplinary…
The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016).

PubMed

Nishida, Osamu; Ogura, Hiroshi; Egi, Moritoki; Fujishima, Seitaro; Hayashi, Yoshiro; Iba, Toshiaki; Imaizumi, Hitoshi; Inoue, Shigeaki; Kakihana, Yasuyuki; Kotani, Joji; Kushimoto, Shigeki; Masuda, Yoshiki; Matsuda, Naoyuki; Matsushima, Asako; Nakada, Taka-Aki; Nakagawa, Satoshi; Nunomiya, Shin; Sadahiro, Tomohito; Shime, Nobuaki; Yatabe, Tomoaki; Hara, Yoshitaka; Hayashida, Kei; Kondo, Yutaka; Sumi, Yuka; Yasuda, Hideto; Aoyama, Kazuyoshi; Azuhata, Takeo; Doi, Kent; Doi, Matsuyuki; Fujimura, Naoyuki; Fuke, Ryota; Fukuda, Tatsuma; Goto, Koji; Hasegawa, Ryuichi; Hashimoto, Satoru; Hatakeyama, Junji; Hayakawa, Mineji; Hifumi, Toru; Higashibeppu, Naoki; Hirai, Katsuki; Hirose, Tomoya; Ide, Kentaro; Kaizuka, Yasuo; Kan'o, Tomomichi; Kawasaki, Tatsuya; Kuroda, Hiromitsu; Matsuda, Akihisa; Matsumoto, Shotaro; Nagae, Masaharu; Onodera, Mutsuo; Ohnuma, Tetsu; Oshima, Kiyohiro; Saito, Nobuyuki; Sakamoto, So; Sakuraya, Masaaki; Sasano, Mikio; Sato, Norio; Sawamura, Atsushi; Shimizu, Kentaro; Shirai, Kunihiro; Takei, Tetsuhiro; Takeuchi, Muneyuki; Takimoto, Kohei; Taniguchi, Takumi; Tatsumi, Hiroomi; Tsuruta, Ryosuke; Yama, Naoya; Yamakawa, Kazuma; Yamashita, Chizuru; Yamashita, Kazuto; Yoshida, Takeshi; Tanaka, Hiroshi; Oda, Shigeto

2018-01-01

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. Members of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two-thirds (>66.6%) majority vote of each of the 19 committee members. A total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J-SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta-analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs. Based on the evidence gathered, we were able to formulate Japanese-specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non-specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.
Measurement Tools for Integrated Worker Health Protection and Promotion: Lessons Learned From the SafeWell Project.

PubMed

Pronk, Nicolaas P; McLellan, Deborah L; McGrail, Michael P; Olson, Shawn M; McKinney, Zeke J; Katz, Jeffrey N; Wagner, Gregory R; Sorensen, Glorian

2016-07-01

To describe (a) a conceptual approach, (b) measurement tools and data collection processes, (c) characteristics of an integrated feedback report and action plan, and (d) experiences of three companies with an integrated measurement approach to worker safety and health. Three companies implemented measurement tools designed to create an integrated view of health protection and promotion based on organizational- and individual-level assessments. Feedback and recommended actions were presented following assessments at baseline and 1-year follow-up. Measurement processes included group dialogue sessions, walk-through, online surveys, and focus groups. The approach and measurement tools generated actionable recommendations and documented changes in the physical (eg, safety hazards) and psychosocial (eg, health and safety culture) work environment between baseline and 1-year follow-up. The measurement tools studied were feasible, acceptable, and meaningful to companies in the SafeWell study.
Anatomical terminology and nomenclature: past, present and highlights.

PubMed

Kachlik, David; Baca, Vaclav; Bozdechova, Ivana; Cech, Pavel; Musil, Vladimir

2008-08-01

The anatomical terminology is a base for medical communication. It is elaborated into a nomenclature in Latin. Its history goes back to 1895, when the first Latin anatomical nomenclature was published as Basiliensia Nomina Anatomica. It was followed by seven revisions (Jenaiensia Nomina Anatomica 1935, Parisiensia Nomina Anatomica 1955, Nomina Anatomica 2nd to 6th edition 1960-1989). The last revision, Terminologia Anatomica, (TA) created by the Federative Committee on Anatomical Terminology and approved by the International Federation of Associations of Anatomists, was published in 1998. Apart from the official Latin anatomical terminology, it includes a list of recommended English equivalents. In this article, major changes and pitfalls of the nomenclature are discussed, as well as the clinical anatomy terms. The last revision (TA) is highly recommended to the attention of not only teachers, students and researchers, but also to clinicians, doctors, translators, editors and publishers to be followed in their activities.
Towards a Collaborative Filtering Approach to Medication Reconciliation

PubMed Central

Hasan, Sharique; Duncan, George T.; Neill, Daniel B.; Padman, Rema

2008-01-01

A physician’s prescribing decisions depend on knowledge of the patient’s medication list. This knowledge is often incomplete, and errors or omissions could result in adverse outcomes. To address this problem, the Joint Commission recommends medication reconciliation for creating a more accurate list of a patient’s medications. In this paper, we develop techniques for automatic detection of omissions in medication lists, identifying drugs that the patient may be taking but are not on the patient’s medication list. Our key insight is that this problem is analogous to the collaborative filtering framework increasingly used by online retailers to recommend relevant products to customers. The collaborative filtering approach enables a variety of solution techniques, including nearest neighbor and co-occurrence approaches. We evaluate the effectiveness of these approaches using medication data from a long-term care center in the Eastern US. Preliminary results suggest that this framework may become a valuable tool for medication reconciliation. PMID:18998834
Towards a collaborative filtering approach to medication reconciliation.

PubMed

Hasan, Sharique; Duncan, George T; Neill, Daniel B; Padman, Rema

2008-11-06

A physicians prescribing decisions depend on knowledge of the patients medication list. This knowledge is often incomplete, and errors or omissions could result in adverse outcomes. To address this problem, the Joint Commission recommends medication reconciliation for creating a more accurate list of a patients medications. In this paper, we develop techniques for automatic detection of omissions in medication lists, identifying drugs that the patient may be taking but are not on the patients medication list. Our key insight is that this problem is analogous to the collaborative filtering framework increasingly used by online retailers to recommend relevant products to customers. The collaborative filtering approach enables a variety of solution techniques, including nearest neighbor and co-occurrence approaches. We evaluate the effectiveness of these approaches using medication data from a long-term care center in the Eastern US. Preliminary results suggest that this framework may become a valuable tool for medication reconciliation.
Perceived discontinuities and continuities in transdisciplinary scientific working groups.

PubMed

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

2015-11-15

We examine the DataONE (Data Observation Network for Earth) project, a transdisciplinary organization tasked with creating a cyberinfrastructure platform to ensure preservation of and access to environmental science and biological science data. Its objective was a difficult one to achieve, requiring innovative solutions. The DataONE project used a working group structure to organize its members. We use organizational discontinuity theory as our lens to understand the factors associated with success in such projects. Based on quantitative and qualitative data collected from DataONE members, we offer recommendations for the use of working groups in transdisciplinary synthesis. Recommendations include welcome diverse opinions and world views, establish shared communication practices, schedule periodic synchronous face-to-face meetings, and ensure the active participation of bridge builders or knowledge brokers such as librarians who know how to ask questions about disciplines not their own. Copyright © 2015 Elsevier B.V. All rights reserved.
Technical Support Document: Development of the Advanced Energy Design Guide for Large Hospitals - 50% Energy Savings

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

Bonnema, E.; Leach, M.; Pless, S.

2013-06-01

This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Large Hospitals: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-LH) ASHRAE et al. (2011b). The AEDG-LH is intended to provide recommendations for achieving 50% whole-building energy savings in large hospitals over levels achieved by following Standard 90.1-2004. The AEDG-LH was created for a 'standard' mid- to large-size hospital, typically at least 100,000 ft2, but the strategies apply to all sizes and classifications of new construction hospital buildings. Its primary focus is new construction, but recommendations may be applicablemore » to facilities undergoing total renovation, and in part to many other hospital renovation, addition, remodeling, and modernization projects (including changes to one or more systems in existing buildings).« less
Syrian Refugee Women’s Health in Lebanon, Turkey, and Jordan and Recommendations for Improved Practice

PubMed Central

Samari, Goleen

2017-01-01

Since 2011, an estimated nine million Syrian refugees have fled to neighboring countries, and over four million have fled to neighboring countries of Lebanon, Turkey, and Jordan. Seventy five percent of Syrian refugees are women and children. In times of conflict, women’s health disproportionately suffers. Based on an assessment of academic literature and international policy and development reports, this study explores the vulnerabilities of Syrian women and girls in Lebanon, Turkey, and Jordan, and how these countries approach Syrian refugee women’s health care. In all settings, sexual and gender-based violence, reduced use of modern contraceptives, menstrual irregularity, unplanned pregnancies, preterm birth, and infant morbidity are ongoing issues. Recommendations for improved practice include taking a multilevel approach to eliminate social and service delivery barriers that prevent access to care, conducting thorough needs assessments, and creating policy and programmatic solutions that establish long term care for Syrian refugee women. PMID:29051840
Resources and rewards for clerkship directors: how surgery compares.

PubMed

Ephgrave, Kimberly; Ferguson, Kristi; Shaaban, Aimen; Hoshi, Hisakazu

2010-01-01

Clerkship directors (CDs) are key educators and active clinicians. In 2003, the Alliance for Clinical Education published standards for CD resources and responsibilities, but how reality compares is unknown. Representatives from each core clinical disciplines' CD organizations created an electronic survey that CDs received in 2006-2007. More than 500 CDs responded, including 71 surgeons. Surgeons reported spending approximately 27% of professional time on education. Most have codirectors, so total CD effort approximates the greater than 50% Alliance for Clinical Education guidelines. No disciplines' CDs have more than one support staff as recommended. Surgeons have the least clinic time, but the most inpatient weeks and many publications. Surgery CD concerns are curricula and simulation; few believe being a CD impairs academic advancement and more than 95% believe it enhances work satisfaction. Surgery CDs are clinically active and academically productive. Although few surgery CDs have the recommended support staff, more than 95% report being a CD enhances work satisfaction.
Canadian Association of Gastroenterology policy on the application for, and implementation of, clinical practice guidelines

PubMed Central

Singh, Harminder; Leontiadis, Grigorios I; Hookey, Lawrence; Enns, Robert; Bistritz, Lana; Rioux, Louis-Charles; Hope, Louise; Sinclair, Paul

2014-01-01

An important mandate of the Canadian Association of Gastroenterology (CAG), as documented in the Association’s governance policies, is to optimize the care of patients with digestive disorders. Clinical practice guidelines are one means of achieving this goal. The benefits of timely, high-quality and evidenced-based recommendations include: Enhancing the professional development of clinical members through education and dissemination of synthesized clinical research;Improving patient care provided by members by providing focus on quality and evidence;Creating legislative environments that favour effective clinical practice;Enhancing the clinical care provided to patients with digestive disease by nongastroenterologists; andIdentifying areas that require further information or research to improve clinical care.The present document provides the foundation required to ensure that clinical practice guidelines produced by the CAG are necessary, appropriate, credible and applicable. These recommendations should be adhered to as closely as possible to obtain CAG endorsement. PMID:25314352
Canadian Association of Gastroenterology policy on the application for, and implementation of, clinical practice guidelines.

PubMed

Singh, Harminder; Leontiadis, Grigorios I; Hookey, Lawrence; Enns, Robert; Bistritz, Lana; Rioux, Louis-Charles; Hope, Louise; Sinclair, Paul

2014-10-01

An important mandate of the Canadian Association of Gastroenterology (CAG), as documented in the Association's governance policies, is to optimize the care of patients with digestive disorders. Clinical practice guidelines are one means of achieving this goal. The benefits of timely, high-quality and evidenced-based recommendations include: Enhancing the professional development of clinical members through education and dissemination of synthesized clinical research; Improving patient care provided by members by providing focus on quality and evidence; Creating legislative environments that favour effective clinical practice; Enhancing the clinical care provided to patients with digestive disease by nongastroenterologists; and Identifying areas that require further information or research to improve clinical care. The present document provides the foundation required to ensure that clinical practice guidelines produced by the CAG are necessary, appropriate, credible and applicable. These recommendations should be adhered to as closely as possible to obtain CAG endorsement.
Can ASCII data files be standardized for Earth Science?

NASA Astrophysics Data System (ADS)

Evans, K. D.; Chen, G.; Wilson, A.; Law, E.; Olding, S. W.; Krotkov, N. A.; Conover, H.

2015-12-01

NASA's Earth Science Data Systems Working Groups (ESDSWG) was created over 10 years ago. The role of the ESDSWG is to make recommendations relevant to NASA's Earth science data systems from user experiences. Each group works independently focusing on a unique topic. Participation in ESDSWG groups comes from a variety of NASA-funded science and technology projects, such as MEaSUREs, NASA information technology experts, affiliated contractor, staff and other interested community members from academia and industry. Recommendations from the ESDSWG groups will enhance NASA's efforts to develop long term data products. Each year, the ESDSWG has a face-to-face meeting to discuss recommendations and future efforts. Last year's (2014) ASCII for Science Data Working Group (ASCII WG) completed its goals and made recommendations on a minimum set of information that is needed to make ASCII files at least human readable and usable for the foreseeable future. The 2014 ASCII WG created a table of ASCII files and their components as a means for understanding what kind of ASCII formats exist and what components they have in common. Using this table and adding information from other ASCII file formats, we will discuss the advantages and disadvantages of a standardized format. For instance, Space Geodesy scientists have been using the same RINEX/SINEX ASCII format for decades. Astronomers mostly archive their data in the FITS format. Yet Earth scientists seem to have a slew of ASCII formats, such as ICARTT, netCDF (an ASCII dump) and the IceBridge ASCII format. The 2015 Working Group is focusing on promoting extendibility and machine readability of ASCII data. Questions have been posed, including, Can we have a standardized ASCII file format? Can it be machine-readable and simultaneously human-readable? We will present a summary of the current used ASCII formats in terms of advantages and shortcomings, as well as potential improvements.
Re-examining the Evidence in Radiation Dermatitis Management Literature: An Overview and a Critical Appraisal of Systematic Reviews

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

Chan, Raymond Javan, E-mail: email.rchan@gmail.com; School of Nursing and Midwifery, University of Queensland, and Research Centre for Clinical and Community Practice Innovation, Griffith University; Larsen, Emily

2012-11-01

Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for 'assessment of multiple systematic reviews'). Results: Of 1837 potential titles, 6 SRs were included. A numbermore » of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.« less

Recommendations concerning satellite-acquired earth resource data: 1982 report of the Data Management Subcommittee of the GEOSAT Committee, Incorporated

NASA Technical Reports Server (NTRS)

1982-01-01

End user concerns about the content and accessibility of libraries of remote sensing data in general are addressed. Recommendations pertaining to the United States' satellite remote sensing programs urge: (1) the continuation of the NASA/EROS Data Center program to convert pre-1979 scenes to computer readable tapes and create a historical archive of this valuable data; (2) improving the EROS archive by adding geologically interesting scenes, data from other agencies (including previously classified data), and by adopting a policy to retire data from the archive; (3) establishing a computer data base inquiry system that includes remote sensing data from all publically available sources; (4) capability for prepurchase review and evaluation; (5) a flexible price structure; and (6) adoption of standard digital data products format. Information about LANDSAT 4, the status of worldwide LANDSAT receiving stations, future non-U.S. remote sensing satellites, a list of sources for LANDSAT data, and the results of a survey of GEOSAT members' remote sensing data processing systems are also considered.
Dynamics of resilience of wheat to drought in Australia from 1991-2010.

PubMed

Huai, Jianjun

2017-08-25

Although enhancing resilience is a well-recognized adaptation to climate change, little research has been undertaken on the dynamics of resilience. This occurs because complex relationships exist between adaptive capacity and resilience, and some issues also create challenges related to the construction, operation, and application of resilience. This study identified the dynamics of temporal, spatial changes of resilience found in a sample of wheat-drought resilience in Australia's wheat-sheep production zone during 1991-2010. I estimated resilience using principal component analysis, mapped resilience and its components, distinguished resilient and sensitive regions, and provided recommendations related to improving resilience. I frame that resilience is composed of social resilience including on- and off-site adaptive capacity as well as biophysical resilience including resistance and absorption. I found that resilience and its components have different temporal trends, spatial shifts and growth ratios in each region during different years, which results from complicated interactions, such as complementation and substitution among its components. In wheat-sheep zones, I recommend that identifying regional bottlenecks, science-policy engagement, and managing resilience components are the priorities for improving resilience.
Revisioning a clinical nurse specialist curriculum in 3 specialty tracks.

PubMed

Arslanian-Engoren, Cynthia; Sullivan, Barbara-Jean; Struble, Laura

2011-01-01

The objective of the present study was to revise 3 clinical nurse specialist (CNS) educational tracks with current National Association of Clinical Nurse Specialist core competencies and educational expectations. National curricula recommendations include core competencies by the 3 spheres of influence. Advanced practice registered nurses consensus model educational requirements include a minimum of 500 faculty-supervised clinical hours; separate graduate courses in pharmacology, pathophysiology, and advanced physical assessment; and content in differential diagnosis disease management, decision making, and role preparation. This educational initiative was designed to (1) align with core competencies and advanced practice registered nurse consensus model recommendations, (2) create an innovative learning environment, (3) meet the needs of diverse student populations, (4) align with emerging doctor of nursing practice programs, (5) create a high-efficiency and high-quality environment to manage human and fiscal resources, and (6) reduce duplication of efforts. Courses were revised that did not meet current CNS educational preparation expectations. A total of 11 didactic and clinical sequences courses were developed for the 3 tracks to (1) ensure minimum numbers of clinical hours; (2) expand content on health promotion and risk reduction, advanced practice nurse role, and the healthcare delivery system; (3) consolidate clinical courses; and (4) resequence foundational content before beginning clinical courses. Revisioning a CNS curriculum in 3 specialty tracks is challenging but doable using innovative and creative approaches. The innovative process used to revise our CNS curriculum will assist nurse educators faced with similar program delivery challenges to meet future directions for educating CNS students in advanced nursing practice. Copyright © 2011 Lippincott Williams & Wilkins.
Assessment and management of nutrition and growth in Rett syndrome

PubMed Central

Leonard, Helen; Ravikumara, Madhur; Baikie, Gordon; Naseem, Nusrat; Ellaway, Carolyn; Percy, Alan; Abraham, Suzanne; Geerts, Suzanne; Lane, Jane; Jones, Mary; Bathgate, Katherine; Downs, Jenny

2014-01-01

Objectives We developed recommendations for the clinical management of poor growth and weight gain in Rett syndrome through evidence review and the consensus of an expert panel of clinicians. Methods Initial draft recommendations were created based upon literature review and 34 open-ended questions where the literature was lacking. Statements and questions were made available to an international, multi-disciplinary panel of clinicians in an online format and a Microsoft Word formatted version of the draft via email. Input was sought using a 2-stage modified Delphi process to reach consensus agreement. Items included clinical assessment of growth, anthropometry, feeding difficulties and management to increase caloric intake, decrease feeding difficulties and consideration of gastrostomy. Results Agreement was achieved on 101/112 statements. A comprehensive approach to the management of poor growth in Rett syndrome is recommended that takes into account factors such as feeding difficulties and nutritional needs. A BMI of approximately the 25th centile can be considered as a reasonable target in clinical practice. Gastrostomy is indicated for very poor growth, if there is risk of aspiration and if feeding times are prolonged. Conclusions These evidence- and consensus-based recommendations have the potential to improve care of nutrition and growth in a rare condition and stimulate research to improve the current limited evidence base. PMID:24084372
World Health Organization Guidelines for treatment of cervical intraepithelial neoplasia 2-3 and screen-and-treat strategies to prevent cervical cancer.

PubMed

Santesso, Nancy; Mustafa, Reem A; Schünemann, Holger J; Arbyn, Marc; Blumenthal, Paul D; Cain, Joanna; Chirenje, Michael; Denny, Lynette; De Vuyst, Hugo; Eckert, Linda O'Neal; Forhan, Sara E; Franco, Eduardo L; Gage, Julia C; Garcia, Francisco; Herrero, Rolando; Jeronimo, José; Lu, Enriquito R; Luciani, Silvana; Quek, Swee Chong; Sankaranarayanan, Rengaswamy; Tsu, Vivien; Broutet, Nathalie

2016-03-01

It is estimated that 1%-2% of women develop cervical intraepithelial neoplasia grade 2-3 (CIN 2-3) annually worldwide. The prevalence among women living with HIV is higher, at 10%. If left untreated, CIN 2-3 can progress to cervical cancer. WHO has previously published guidelines for strategies to screen and treat precancerous cervical lesions and for treatment of histologically confirmed CIN 2-3. Guidelines were developed using the WHO Handbook for Guideline Development and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. A multidisciplinary guideline panel was created. Systematic reviews of randomized controlled trials and observational studies were conducted. Evidence tables and Evidence to Recommendations Tables were prepared and presented to the panel. There are nine recommendations for screen-and-treat strategies to prevent cervical cancer, including the HPV test, cytology, and visual inspection with acetic acid. There are seven for treatment of CIN with cryotherapy, loop electrosurgical excision procedure, and cold knife conization. Recommendations have been produced on the basis of the best available evidence. However, high-quality evidence was not available. Such evidence is needed, in particular for screen-and-treat strategies that are relevant to low- and middle-income countries. Copyright © 2015. Published by Elsevier Ireland Ltd.
World Health Organization Guidelines: Use of cryotherapy for cervical intraepithelial neoplasia.

PubMed

Santesso, Nancy; Schünemann, Holger; Blumenthal, Paul; De Vuyst, Hugo; Gage, Julia; Garcia, Francisco; Jeronimo, Jose; Lu, Ricky; Luciani, Silvana; Quek, Swee C; Awad, Tahany; Broutet, Nathalie

2012-08-01

In 2008, cervical cancer was responsible for 275000 deaths, of which approximately 88% occurred in low- and middle-income countries. In 2009, the World Health Organization (WHO) committed to updating recommendations for use of cryotherapy for cervical intraepithelial neoplasia (CIN). We followed the WHO Handbook for Guidelines Development to develop present guidelines. An expert panel was established, which included clinicians, researchers, program directors, and methodologists. An independent group conducted systematic reviews and produced evidence summaries following the GRADE approach. GRADE evidence profiles were created for 16 key questions about the effects of cryotherapy in the presence of histologically confirmed CIN compared with no treatment and with loop electrosurgical excision procedure, as well as the use of different cryotherapy techniques. We identified a small number of randomized controlled trials or independently controlled observational studies. Surrogate outcomes were reported when evidence about outcomes critical to decision making were not available. The panel made 14 recommendations and documented factors that determined the strength and direction of the recommendations in decision tables. The present document summarizes new evidence-based WHO recommendations about the use of cryotherapy in women with histologically confirmed CIN for low-, middle-, and high-income countries. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Winds of War: Enhancing Civilian and Military Partnerships to Assure Readiness: White Paper.

PubMed

Schwab, C William

2015-08-01

This White Paper summarizes the state of readiness of combat surgeons and provides action recommendations that address the problems of how to train, sustain, and retain them for future armed conflicts. As the basis for the 2014 Scudder Oration, I explored how to secure an improved partnership between military and civilian surgery, which would optimize learning platforms and embed military trauma personnel at America's academic medical universities for trauma combat casualty care (TCCC). To craft and validate these recommendations, I conducted an integrative and iterative process of literature reviews, interviews of military and civilian leaders, and a survey of military-affiliated surgeons. The recommended action points advance the training of combat surgeons and their trauma teams by creating an expanded network of TCCC training sites and sourcing the cadre of combat-seasoned surgeons currently populating our civilian and military teaching hospitals and universities. The recommendation for the establishment of a TCCC readiness center or command within the Medical Health System of the Department of Defense includes a military and civilian advisory board, with the reformation of a think tank of content experts to address high-level solutions for military medicine, readiness, and TCCC. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
The Arizona Riparian Area Advisory Committee: An experience in defining desired conditions

Treesearch

K. E. Randall

1996-01-01

Created in 1992 by the Arizona Legislature, the Riparian Area Advisory Committee (RAAC) developed recommendations for protecting, maintaining, and restoring riparian areas in Arizona. These recommendations were submitted to the Legislature and to the Governor after concluding a two year period of study and discussion. The RAAC, consisting of 34 members broadly...
Virginia Tech Weighs Hundreds of Recommendations and Acts on Some

ERIC Educational Resources Information Center

Fischer, Karin

2008-01-01

Three reports on last April's shootings left Virginia Tech under a mountain of recommendations--roughly 400 in all. So far the university has dealt with some of the most significant ones. Virginia Tech established an emergency-notification system, created a team to assess at-risk students and employees, and hired additional police officers and…
Ten recommendations for software engineering in research.

PubMed

Hastings, Janna; Haug, Kenneth; Steinbeck, Christoph

2014-01-01

Research in the context of data-driven science requires a backbone of well-written software, but scientific researchers are typically not trained at length in software engineering, the principles for creating better software products. To address this gap, in particular for young researchers new to programming, we give ten recommendations to ensure the usability, sustainability and practicality of research software.
The Potential Effects of the Defense Business Board Military Compensation Task Group’s 2011 Recommendations on Active-Duty Service Member Retirement

DTIC Science & Technology

2012-12-01

system be implemented. In this study, we created a mathematical model to simulate accumulated savings under the proposed defined...retirement system be implemented. In this study, we created a mathematical model to simulate accumulated savings under the proposed defined...lumbering recovery, it has reemerged as a potential austerity measure within the U.S. government. B. METHODOLOGY We created a mathematical model of
SU-F-P-05: Initial Experience with an Independent Certification Program for Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

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

Solberg, T; Robar, J; Gevaert, T

Purpose: The ASTRO document “Safety is no accident: A FRAMEWORK FOR QUALITY RADIATION ONCOLOGY AND CARE” recommends external reviews of specialized modalities. The purpose of this presentation is to describe the implementation of such a program for Stereotactic Radiosurgery (SRS) and Stereotactic Body radiation Therapy (SBRT). Methods: The margin of error for SRS and SBRT delivery is significantly smaller than that of conventional radiotherapy and therefore requires special attention and diligence. The Novalis Certified program was created to fill an unmet need for specialized SRS / SBRT credentialing. A standards document was drafted by a panel of experts from severalmore » disciplines, including medical physics, radiation oncology and neurosurgery. The document, based on national and international standards, covers requirements in program structure, personnel, training, clinical application, technology, quality management, and patient and equipment QA. The credentialing process was modeled after existing certification programs and includes an institution-generated self-study, extensive document review and an onsite audit. Reviewers generate a descriptive report, which is reviewed by a multidisciplinary expert panel. Outcomes of the review may include mandatory requirements and optional recommendations. Results: 15 institutions have received Novalis Certification, including 3 in the US, 7 in Europe, 4 in Australia and 1 in Asia. 87 other centers are at various stages of the process. Nine reviews have resulted in mandatory requirements, however all of these were addressed within three months of the audit report. All reviews have produced specific recommendations ranging from programmatic to technical in nature. Institutions felt that the credentialing process addressed a critical need and was highly valuable to the institution. Conclusion: Novalis Certification is a unique peer review program assessing safety and quality in SRS and SBRT, while recognizing international practice standards. The approach is capable of highlighting outstanding requirements and providing recommendations to enhance both new and established programs. Timothy Solberg is co-owner of Global Radiosurgery services, LLC.« less
The Rules of Engagement: CTTI Recommendations for Successful Collaborations Between Sponsors and Patient Groups Around Clinical Trials.

PubMed

Bloom, Diane; Beetsch, Joel; Harker, Matthew; Hesterlee, Sharon; Moreira, Paulo; Patrick-Lake, Bray; Selig, Wendy; Sherman, Jeffrey; Smith, Sophia K; Valentine, James E; Roberts, Jamie N

2018-03-01

To identify the elements necessary for successful collaboration between patient groups and academic and industry sponsors of clinical trials, in order to develop recommendations for best practices for effective patient group engagement. In-depth interviews, informed by a previously reported survey, were conducted to identify the fundamentals of successful patient group engagement. Thirty-two respondents from 3 sectors participated: patient groups, academic researchers, and industry. The findings were presented to a multistakeholder group of experts in January 2015. The expert group came to consensus on a set of actionable recommendations for best practices for patient groups and research sponsors. Interview respondents acknowledged that not all patient groups are created equal in terms of what they can contribute to a clinical trial. The most important elements for effective patient group engagement include establishing meaningful partnerships, demonstrating mutual benefits, and collaborating as partners from the planning stage forward. Although there is a growing appreciation by sponsors about the benefits of patient group engagement, there remains some resistance and some uncertainty about how best to engage. Barriers include mismatched expectations and a perception that patient groups lack scientific sophistication and that "wishful thinking" may cloud their recommendations. Patient groups are developing diverse skillsets and acquiring assets to leverage in order to become collaborators with industry and academia on clinical trials. Growing numbers of research sponsors across the clinical trials enterprise are recognizing the benefits of continuous and meaningful patient group engagement, but there are still mindsets to change, and stakeholders need further guidance on operationalizing a new model of clinical trial conduct.
Manikin families representing obese airline passengers in the US.

PubMed

Park, Hanjun; Park, Woojin; Kim, Yongkang

2014-01-01

Aircraft passenger spaces designed without proper anthropometric analyses can create serious problems for obese passengers, including: possible denial of boarding, excessive body pressures and contact stresses, postural fixity and related health hazards, and increased risks of emergency evacuation failure. In order to help address the obese passenger's accommodation issues, this study developed male and female manikin families that represent obese US airline passengers. Anthropometric data of obese individuals obtained from the CAESAR anthropometric database were analyzed through PCA-based factor analyses. For each gender, a 99% enclosure cuboid was constructed, and a small set of manikins was defined on the basis of each enclosure cuboid. Digital human models (articulated human figures) representing the manikins were created using a human CAD software program. The manikin families were utilized to develop design recommendations for selected aircraft seat dimensions. The manikin families presented in this study would greatly facilitate anthropometrically accommodating large airline passengers.
A Thematic Analysis of Self-described Authentic Leadership Behaviors Among Experienced Nurse Executives.

PubMed

Alexander, Catherine; Lopez, Ruth Palan

2018-01-01

The aim of this study is to understand the behaviors experienced nurse executives use to create healthy work environments (HWEs). The constructs of authentic leadership formed the conceptual framework for the study. The American Association of Critical-Care Nurses recommends authentic leadership as the preferred style of leadership for creating and sustaining HWEs. Behaviors associated with authentic leadership in nursing are not well understood. A purposive sample of 17 experienced nurse executives were recruited from across the United States for this qualitative study. Thematic analysis was used to analyze the in-depth, semistructured interviews. Four constructs of authentic leaders were supported and suggest unique applications of each including self-awareness (a private and professional self), balanced processing (open hearted), transparency (limiting exposure), and moral leadership (nursing compass). Authentic leadership may provide a sound foundation to support nursing leadership practices; however, its application to the discipline requires additional investigation.
From bedside to classroom: the nurse educator transition model.

PubMed

Schoening, Anne M

2013-01-01

The purpose of this qualitative study was to generate a theoretical model that describes the social process that occurs during the role transition from nurse to nurse educator. Recruitment and retention of qualified nurse educators is essential in order to remedy the current staff nurse and faculty shortage in the United States, yet nursing schools face many challenges in this area. This grounded theory study utilized purposive, theoretical sampling to identify 20 nurse educators teaching in baccalaureate nursing programs in the Midwest. The Nurse Educator Transition (NET) model was created from these data.This model identifies four phases in the role transition from nurse to nurse educator: a) the Anticipatory/Expectation Phase, b) the Disorientation Phase, c) the Information-Seeking Phase, and d) the Identity Formation Phase. Recommendations include integrating formal pedagogical education into nursing graduate programs and creating evidence-based orientation and mentoring programs for novice nurse faculty.
Serious science games, social selves and complex nature of possible selves

NASA Astrophysics Data System (ADS)

Khan, Mubina Schroeder

2012-12-01

Margaret Beier, Leslie Miller, and Shu Wang's paper, Science games and the development of possible selves examines the effects of game-playing in a serious scientific game on science possible selves identity creation, utilizing a possible selves identification instrument they created. This paper continues the discussion that Beier and colleagues start in the paper by calling into question both the idea that a predictive model of science career choice can be attained by serious science game-playing and the nature of the instrument created and used by Beier and her colleagues to identify participants' creation of science possible selves. Recommendations include incorporating the idea of possible selves as being complex, dynamic and intertwined with self-concept in interpreting their findings and casting a wider net to capture the phenomena of their participants' identities and experiences by potentially making use of possible selves identification methodologies from the career training arena.
Design of a digital and self-reported food frequency questionnaire to estimate food consumption in adolescents and young adults: birth cohorts at Pelotas, Rio Grande do Sul, Brazil.

PubMed

Schneider, Bruna Celestino; Motta, Janaína Vieira Dos Santos; Muniz, Ludmila Correa; Bielemann, Renata Moraes; Madruga, Samanta Winck; Orlandi, Silvana Paiva; Gigante, Denise Petrucci; Assunção, Maria Cecília Formoso

2016-01-01

Methodological paper aiming to describe the development of a digital and self-reported food frequency questionnaire (FFQ), created to the 1982 and 1993 Pelotas Birth Cohorts. The instrument was created based on FFQs previously applied to subjects belonging to both cohorts in the 2004 and 2008 follow-ups. The FFQ was developed including 88 foods and/or meals where frequencies were clustered from a minimum of never or once/month to a maximum of greater than or equal to 5 times/day. The closed options related to portions were based on a 24-hour recall previously asked to a subsample from the 1993 cohort. Three options for portions were created: equal to, less than or greater than. Equal to portion was described based on the 50 percentile of each food consumed reported in a 24-hour recall. Photographs of portions related to the 50 percentile for each food were also included in the software. This digital FFQ included food and meals based on the needs of current researches. The layout of the software was attractive to the staff members as well as to the cohort members. The responding time was 12 minutes and the software allowed several individuals to use it at the same time. Moreover, this instrument dismissed interviewers and double data entry. It is recommended the use of the same strategy in other studies, adapted to different contexts and situations.
Nursing management and organizational ethics in the intensive care unit.

PubMed

Wlody, Ginger Schafer

2007-02-01

This article describes organizational ethics issues involved in nursing management of an intensive care unit. The intensive care team and medical center management have the dual responsibility to create an ethical environment in which to provide optimum patient care. Addressing organizational ethics is key to creating that ethical environment in the intensive care unit. During the past 15-20 yrs, increasing costs in health care, competitive markets, the effect of high technology, and global business changes have set the stage for business and healthcare organizational conflicts that affect the ethical environment. Studies show that critical care nurses experience moral distress and are affected by the ethical climate of both the intensive care unit and the larger organization. Thus, nursing moral distress may result in problems related to recruitment and retention of staff. Other issues with organizational ethics ramifications that may occur in the intensive care unit include patient safety issues (including those related to disruptive behavior), intensive care unit leadership style, research ethics, allocation of resources, triage, and other economic issues. Current organizational ethics conflicts are discussed, a professional practice model is described, and multidisciplinary recommendations are put forth.
Creating New Strategies to Enhance Postpartum Health and Wellness.

PubMed

Cornell, Andria; McCoy, Carolyn; Stampfel, Caroline; Bonzon, Erin; Verbiest, Sarah

2016-11-01

Over the past 5 years there have been a number of new initiatives focused on improving birth outcomes and reducing infant mortality, including a renewed focus on the complex interactions between motherhood and infancy that influence lifelong health trajectories. Beginning in 2012, the Association of Maternal & Child Health Programs (AMCHP) facilitated a series of meetings to enhance coordination across initiatives. Emerging from these conversations was a shared desire across stakeholders to reimagine the postpartum visit and improve postpartum care and wellness. AMCHP convened a Postpartum Think-Tank Meeting in 2014 to map the system of postpartum care and identify levers for its transformation. The meeting findings are presented in an infographic which frames the challenges and proposed solutions from the woman's perspective. The infographic describes maternal issues and concerns along with a concise summary of the recommended solutions. Strategies include creating integrated services and seamless care transitions from preconception through postpartum and well-baby; business, community, and government support, including paid parental leave, health insurance and spaces for new parents to meet each other; and mother-centered care, including quality visits on her schedule with complete and culturally appropriate information. These solutions catalyze a postpartum system of care that supports women, children, and families by infusing new ideas and capitalizing on existing opportunities and resources.

Parameters of care for craniosynostosis.

PubMed

McCarthy, Joseph G; Warren, Stephen M; Bernstein, Joseph; Burnett, Whitney; Cunningham, Michael L; Edmond, Jane C; Figueroa, Alvaro A; Kapp-Simon, Kathleen A; Labow, Brian I; Peterson-Falzone, Sally J; Proctor, Mark R; Rubin, Marcie S; Sze, Raymond W; Yemen, Terrance A

2012-01-01

A multidisciplinary meeting was held from March 4 to 6, 2010, in Atlanta, Georgia, entitled "Craniosynostosis: Developing Parameters for Diagnosis, Treatment, and Management." The goal of this meeting was to create parameters of care for individuals with craniosynostosis. Fifty-two conference attendees represented a broad range of expertise, including anesthesiology, craniofacial surgery, dentistry, genetics, hand surgery, neurosurgery, nursing, ophthalmology, oral and maxillofacial surgery, orthodontics, otolaryngology, pediatrics, psychology, public health, radiology, and speech-language pathology. These attendees also represented 16 professional societies and peer-reviewed journals. The current state of knowledge related to each discipline was reviewed. Based on areas of expertise, four breakout groups were created to reach a consensus and draft specialty-specific parameters of care based on the literature or, in the absence of literature, broad clinical experience. In an iterative manner, the specialty-specific draft recommendations were presented to all conference attendees. Participants discussed the recommendations in multidisciplinary groups to facilitate exchange and consensus across disciplines. After the conference, a pediatric intensivist and social worker reviewed the recommendations. Consensus was reached among the 52 conference attendees and two post hoc reviewers. Longitudinal parameters of care were developed for the diagnosis, treatment, and management of craniosynostosis in each of the 18 specialty areas of care from prenatal evaluation to adulthood. To our knowledge, this is the first multidisciplinary effort to develop parameters of care for craniosynostosis. These parameters were designed to help facilitate the development of educational programs for the patient, families, and health-care professionals; stimulate the creation of a national database and registry to promote research, especially in the area of outcome studies; improve credentialing of interdisciplinary craniofacial clinical teams; and improve the availability of health insurance coverage for all individuals with craniosynostosis.
A System for Anesthesia Drug Administration Using Barcode Technology: The Codonics Safe Label System and Smart Anesthesia Manager.

PubMed

Jelacic, Srdjan; Bowdle, Andrew; Nair, Bala G; Kusulos, Dolly; Bower, Lynnette; Togashi, Kei

2015-08-01

Many anesthetic drug errors result from vial or syringe swaps. Scanning the barcodes on vials before drug preparation, creating syringe labels that include barcodes, and scanning the syringe label barcodes before drug administration may help to prevent errors. In contrast, making syringe labels by hand that comply with the recommendations of regulatory agencies and standards-setting bodies is tedious and time consuming. A computerized system that uses vial barcodes and generates barcoded syringe labels could address both safety issues and labeling recommendations. We measured compliance of syringe labels in multiple operating rooms (ORs) with the recommendations of regulatory agencies and standards-setting bodies before and after the introduction of the Codonics Safe Label System (SLS). The Codonics SLS was then combined with Smart Anesthesia Manager software to create an anesthesia barcode drug administration system, which allowed us to measure the rate of scanning syringe label barcodes at the time of drug administration in 2 cardiothoracic ORs before and after introducing a coffee card incentive. Twelve attending cardiothoracic anesthesiologists and the OR satellite pharmacy participated. The use of the Codonics SLS drug labeling system resulted in >75% compliant syringe labels (95% confidence interval, 75%-98%). All syringe labels made using the Codonics SLS system were compliant. The average rate of scanning barcodes on syringe labels using Smart Anesthesia Manager was 25% (730 of 2976) over 13 weeks but increased to 58% (956 of 1645) over 8 weeks after introduction of a simple (coffee card) incentive (P < 0.001). An anesthesia barcode drug administration system resulted in a moderate rate of scanning syringe label barcodes at the time of drug administration. Further, adaptation of the system will be required to achieve a higher utilization rate.
Recommended Approaches for Pharmacokinetic Natural Product-Drug Interaction Research: a NaPDI Center Commentary.

PubMed

Paine, Mary F; Shen, Danny D; McCune, Jeannine S

2018-05-07

Sales of botanical dietary supplements and other purported medicinal natural products (NPs) have escalated over the past ~25 years, increasing the potential for NPs to precipitate clinically significant pharmacokinetic interactions with United States Food and Drug Administration (FDA)-approved medications (NP-drug interactions or NPDIs). Published NPDI studies to date often lack consistency in design, implementation, and documentation, which present difficulties in assessing the clinical significance of the results. Common hurdles include large variability in the admixture composition of phytoconstituents between and within batches of a given NP, limited knowledge on the pharmacokinetics of precipitant NP constituents, and use of animal and/or in vitro models which, in some cases, are not mechanistically appropriate for extrapolation to humans. The National Center for Complementary and Integrative Health has created a Center of Excellence for Natural Product-Drug Interaction (NaPDI Center) to address these unmet research needs. The NaPDI Center has two overarching goals: 1) develop Recommended Approaches to guide researchers in the proper conduct of NPDI studies, which will evolve over time concurrent with emerging technologies and new research data; and 2) apply the Recommended Approaches in evaluating four model NPs as precipitants of NPDIs with clinically relevant object drugs. The major objectives of this commentary are to 1) explain the rationale for creating the NaPDI Center; 2) describe the Decision Trees developed by the NaPDI Center to enhance the planning, rigor, and consistency of NPDI studies; and 3) provide a framework for communicating results to the multidisciplinary scientists interested in the NaPDI Center&rsquo's Interaction Projects. The American Society for Pharmacology and Experimental Therapeutics.
Ottawa panel evidence-based clinical practice guidelines for therapeutic exercises and manual therapy in the management of osteoarthritis.

PubMed

2005-09-01

Osteoarthritis (OA) affects a large and growing proportion of the population. The purpose of this project was to create guidelines for the use of therapeutic exercises and manual therapy in the management of adult patients (>18 years of age) with a diagnosis of OA. All stages of the disease were included in the analysis, and studies of patients who had recent surgery or other rheumatologic, musculoskeletal, or spinal problems or of subjects without known pathology or impairments were excluded. The Ottawa Methods Group used Cochrane Collaboration methods to find and synthesize evidence from comparative controlled trials and then asked stakeholder groups to nominate representatives to serve on a panel of experts. The Ottawa Panel agreed on criteria for grading the strength of the recommendations and their supporting evidence. Of the 609 potential articles on therapeutic exercises for OA that were identified, 113 were considered potentially relevant, and 26 randomized controlled trials and controlled clinical trials were ultimately used. Sixteen positive recommendations of clinical benefit were developed for therapeutic exercises, especially strengthening exercises and general physical activity, particularly for the management of pain and improvement of functional status. Manual therapy combined with exercises also is recommended in the management of patients with OA. The Ottawa Panel recommends the use of therapeutic exercises alone, or combined with manual therapy, for managing patients with OA. There were a total of 16 positive recommendations: 13 grade A and 3 grade C+. The Ottawa Panel recommends the use of therapeutic exercises because of the strong evidence (grades A, B, and C+) in the literature.
Care for the Health Care Provider.

PubMed

Kunin, Sharon Brown; Kanze, David Mitchell

2016-03-01

Pretravel care for the health care provider begins with an inventory, including the destination, length of stay, logistical arrangements, type of lodging, food and water supply, team members, personal medical needs, and the needs of the community to be treated. This inventory should be created and processed well in advance of the planned medical excursion. The key thing to remember in one's planning is to be a health care provider during one's global health care travel and not to become a patient oneself. This article will help demonstrate the medical requirements and recommendations for such planning. Copyright © 2016 Elsevier Inc. All rights reserved.
Proceedings of the 19th Annual Software Engineering Workshop

NASA Technical Reports Server (NTRS)

1994-01-01

The Software Engineering Laboratory (SEL) is an organization sponsored by NASA/GSFC and created to investigate the effectiveness of software engineering technologies when applied to the development of applications software. The goals of the SEL are: (1) to understand the software development process in the GSFC environment; (2) to measure the effects of various methodologies, tools, and models on this process; and (3) to identify and then to apply successful development practices. The activities, findings, and recommendations of the SEL are recorded in the Software Engineering Laboratory Series, a continuing series of reports that include this document.
Screening youth for suicide risk in medical settings: time to ask questions.

PubMed

Horowitz, Lisa M; Bridge, Jeffrey A; Pao, Maryland; Boudreaux, Edwin D

2014-09-01

This paper focuses on the National Action Alliance for Suicide Prevention's Research Prioritization Task Force's Aspirational Goal 2 (screening for suicide risk) as it pertains specifically to children, adolescents, and young adults. Two assumptions are forwarded: (1) strategies for screening youth for suicide risk need to be tailored developmentally; and (2) we must use instruments that were created and tested specifically for suicide risk detection and developed specifically for youth. Recommendations for shifting the current paradigm include universal suicide screening for youth in medical settings with validated instruments. Published by Elsevier Inc.
What Constitutes Terrorist Network Resiliency?

DTIC Science & Technology

2011-05-31

organizations like al Qaeda. One of the main deficiencies with international law is with the Financial Action Task Force ( FATF ) which had been...2005). The FATF identified 40 recommendations to be implemented to counter money laundering activities. However, no formal binding convention or...treaty was created therefore consistent implementation of the FATF recommendations did not occur thus leaving loop holes in international law for
Using Collaborative Filtering to Support College Students' Use of Online Forum for English Learning

ERIC Educational Resources Information Center

Wang, Pei-Yu; Yang, Hui-Chun

2012-01-01

This study examined the impact of collaborative filtering (the so-called recommender) on college students' use of an online forum for English learning. The forum was created with an open-source software, Drupal, and its extended recommender module. This study was guided by three main questions: 1) Is there any difference in online behaviors…
Awarding Dollars Based on Student Need: A Recommendation to Implement Weighted Student Funding in Georgia

ERIC Educational Resources Information Center

Education Resource Strategies, 2014

2014-01-01

As the state of Georgia considers revising its K-12 funding formula, Education Resource Strategies (ERS) recommends the state implement a weighted student-funding formula (WSF) system in order to create resource use flexibility for districts and to remove the marginal inequity found in its current funding system. Additionally, such a change would…
Total physical activity volume, physical activity intensity, and metabolic syndrome: 1999-2004 National Health and Nutrition Examination Survey.

PubMed

Churilla, James R; Fitzhugh, Eugene C

2012-02-01

This study examined the association of total physical activity volume (TPAV) and physical activity (PA) from three domains [leisure-time physical activity (LTPA), domestic, transportation] with metabolic syndrome. We also investigated the relationship between LTPA intensity and metabolic syndrome risk. Sample included adults who participated in the 1999-2004 National Health and Nutrition Examination Survey. Physical activity measures were created for TPAV, LTPA, domestic PA, and transportational PA. For each, a six-level measure based upon no PA (level 1) and quintiles (levels 2-6) of metabolic equivalents (MET)·min·wk(-1) was created. A three-level variable associated with the current Department of Health and Human Services (DHHS) PA recommendation was also created. SAS and SUDAAN were used for the statistical analysis. Adults reporting the greatest volume of TPAV and LTPA were found to be 36% [odds ratio (OR) 0.64; 95% confidence interval (CI) 0.49-0.83] and 42% (OR 0.58; 95% CI 0.43-0.77), respectively, less likely to have metabolic syndrome. Domestic and transportational PA provided no specific level of protection from metabolic syndrome. Those reporting a TPAV that met the DHHS PA recommendation were found to be 33% (OR 0.67; 95%; CI 0.55-0.83) less likely to have metabolic syndrome compared to their sedentary counterparts. Adults reporting engaging in only vigorous-intensity LTPA were found to be 37% (OR 0.63; 95 CI 0.42-0.96) to 56% (OR 0.44; 95% CI 0.29-0.67) less likely to have metabolic syndrome. Volume, intensity, and domain of PA may all play important roles in reducing the prevalence and risk of metabolic syndrome.
Extracorporeal treatment for carbamazepine poisoning: Systematic review and recommendations from the EXTRIP workgroup

PubMed Central

Ghannoum, Marc; Yates, Christopher; Galvao, Tais F.; Sowinski, Kevin M.; Vo, Thi Hai Vân; Coogan, Andrew; Gosselin, Sophie; Lavergne, Valery; Nolin, Thomas D.; Hoffman, Robert S.

2014-01-01

Abstract Context. The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was created to provide evidence and consensus-based recommendations on the use of extracorporeal treatments (ECTRs) in poisoning. Objectives. To perform a systematic review and provide clinical recommendations for ECTR in carbamazepine poisoning. Methods. After a systematic literature search, the subgroup extracted the data and summarized the findings following a pre-determined format. The entire workgroup voted via a two-round modified Delphi method to reach a consensus on voting statements, using a RAND/UCLA Appropriateness Method to quantify disagreement. Anonymous votes were compiled, returned, and discussed in person. A second vote determined the final recommendations. Results. Seventy-four articles met inclusion criteria. Articles included case reports, case series, descriptive cohorts, pharmacokinetic studies, and in-vitro studies; two poor-quality observational studies were identified, yielding a very low quality of evidence for all recommendations. Data on 173 patients, including 6 fatalities, were reviewed. The workgroup concluded that carbamazepine is moderately dialyzable and made the following recommendations: ECTR is suggested in severe carbamazepine poisoning (2D). ECTR is recommended if multiple seizures occur and are refractory to treatment (1D), or if life-threatening dysrhythmias occur (1D). ECTR is suggested if prolonged coma or respiratory depression requiring mechanical ventilation are present (2D) or if significant toxicity persists, particularly when carbamazepine concentrations rise or remain elevated, despite using multiple-dose activated charcoal (MDAC) and supportive measures (2D). ECTR should be continued until clinical improvement is apparent (1D) or the serum carbamazepine concentration is below 10 mg/L (42 the μ in μmol/L looks weird.) (2D). Intermittent hemodialysis is the preferred ECTR (1D), but both intermittent hemoperfusion (1D) or continuous renal replacement therapies (3D) are alternatives if hemodialysis is not available. MDAC therapy should be continued during ECTR (1D). Conclusion. Despite the low quality of the available clinical evidence and the high protein binding capacity of carbamazepine, the workgroup suggested extracorporeal removal in cases of severe carbamazepine poisoning. PMID:25355482
Obama Administration Announces Ocean Policy

NASA Astrophysics Data System (ADS)

Showstack, Randy

2010-08-01

With the U.S. Interagency Ocean Policy Task Force final report in hand, U.S. president Barack Obama issued an executive order on 19 July largely adopting its recommendations. These include establishing a National Policy for the Stewardship of the Ocean, Coasts, and Great Lakes; creating a National Ocean Council, which will hold its first meeting later this summer; strengthening the ocean governance structure; and providing for the development of coastal and marine spatial plans. The task force report indicates that U.S. ocean policy includes protecting, maintaining, and restoring ocean, coastal, and Great Lakes ecosystems and resources; increasing scientific understanding and using the best available science and knowledge to inform decisions about them; and improving the understanding and awareness of changing environmental conditions.
NHF-McMaster Guideline on Care Models for Haemophilia Management.

PubMed

Pai, M; Key, N S; Skinner, M; Curtis, R; Feinstein, M; Kessler, C; Lane, S J; Makris, M; Riker, E; Santesso, N; Soucie, J M; Yeung, C H T; Iorio, A; Schünemann, H J

2016-07-01

This guideline was developed to identify evidence-based best practices in haemophilia care delivery, and discuss the range of care providers and services that are most important to optimize outcomes for persons with haemophilia (PWH) across the United States. The guideline was developed following specific methods described in detail in this supplement and based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluation approach). Direct evidence from published literature and the haemophilia community, as well as indirect evidence from other chronic diseases, were reviewed, synthesized and applied to create evidence-based recommendations. The Guideline panel suggests that the integrated care model be used over non-integrated care models for PWH (conditional recommendation, moderate certainty in the evidence). For PWH with inhibitors and those at high risk for inhibitor development, the same recommendation was graded as strong, with moderate certainty in the evidence. The panel suggests that a haematologist, a specialized haemophilia nurse, a physical therapist, a social worker and round-the-clock access to a specialized coagulation laboratory be part of the integrated care team, over an integrated care team that does not include all of these components (conditional recommendation, very low certainty in the evidence). Based on available evidence, the integrated model of care in its current structure, is suggested for optimal care of PWH. There is a need for further appropriately designed studies that address unanswered questions about specific outcomes and the optimal structure of the integrated care delivery model in haemophilia. © 2016 John Wiley & Sons Ltd.
ASCCP Colposcopy Standards: How Do We Perform Colposcopy? Implications for Establishing Standards.

PubMed

Waxman, Alan G; Conageski, Christine; Silver, Michelle I; Tedeschi, Candice; Stier, Elizabeth A; Apgar, Barbara; Huh, Warner K; Wentzensen, Nicolas; Massad, L Stewart; Khan, Michelle J; Mayeaux, Edward J; Einstein, Mark H; Schiffman, Mark H; Guido, Richard S

2017-10-01

The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. Working group 3 defined colposcopy procedure guidelines for minimum and comprehensive colposcopy practice and evaluated the use of colposcopy adjuncts. The working group performed a systematic literature review to identify best practices in colposcopy methodology and to evaluate the use of available colposcopy adjuncts. The literature provided little evidence to support specific elements of the procedure. The working group, therefore, implemented a national survey of current and recent ASCCP members to evaluate common elements of the colposcopy examination. The findings of this survey were modified by expert consensus from the ASCCP Colposcopy Standards Committee members to create guidelines for performing colposcopy. The draft recommendations were posted online for public comment and presented at an open session of the International Federation for Cervical Pathology and Colposcopy 2017 World Congress for further comment. All comments were considered in the development of final recommendations. Minimum and comprehensive colposcopy practice guidelines were developed. These guidelines represent recommended practice in all parts of the examination including the following: precolposcopy evaluation, performing the procedure, documentation of findings, biopsy practice, and postprocedure follow-up. These guidelines are intended to serve as a guide to standardize colposcopy across the United States.
Evidence-informed recommendations for constructing and disseminating messages supplementing the new Canadian Physical Activity Guidelines

PubMed Central

2013-01-01

Background Few validated guidelines exist for developing messages in health promotion practice. In clinical practice, the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) Instrument is the international gold standard for guideline assessment, development, and reporting. In a case study format, this paper describes the application of the AGREE II principles to guide the development of health promotion guidelines for constructing messages to supplement the new Canadian Physical Activity Guidelines (CPAG) released in 2011. Methods The AGREE II items were modified to suit the objectives of developing messages that (1) clarify key components of the new CPAG and (2) motivate Canadians to meet the CPAG. The adapted AGREE II Instrument was used as a systematic guide for the recommendation development process. Over a two-day meeting, five workgroups (one for each CPAG – child, youth, adult, older adult – and one overarching group) of five to six experts (including behavior change, messaging, and exercise physiology researchers, key stakeholders, and end users) reviewed and discussed evidence for creating and targeting messages to supplement the new CPAG. Recommendations were summarized and reviewed by workgroup experts. The recommendations were pilot tested among end users and then finalized by the workgroup. Results The AGREE II was a useful tool in guiding the development of evidence-based specific recommendations for constructing and disseminating messages that supplement and increase awareness of the new CPAG (child, youth, adults, and older adults). The process also led to the development of sample messages and provision of a rationale alongside the recommendations. Conclusions To our knowledge, these are the first set of evidence-informed recommendations for constructing and disseminating messages supplementing physical activity guidelines. This project also represents the first application of international standards for guideline development (i.e., AGREE II) to the creation of practical recommendations specifically aimed to inform health promotion and public health practice. The messaging recommendations have the potential to increase the public health impact of evidence-based guidelines. PMID:23634998
Developing a virtual community for health sciences library book selection: Doody's Core Titles

PubMed Central

Shedlock, James; Walton, Linda J.

2006-01-01

Purpose: The purpose of this article is to describe Doody's Core Titles in the Health Sciences as a new selection guide and a virtual community based on an effective use of online systems and to describe its potential impact on library collection development. Setting/Participants/Resources: The setting is the availability of health sciences selection guides. Participants include Doody Enterprise staff, Doody's Library Board of Advisors, content specialists, and library selectors. Resources include the online system used to create Doody's Core Titles along with references to complementary databases. Brief Description: Doody's Core Titles is described and discussed in relation to the literature of selection guides, especially in comparison to the Brandon/Hill selected lists that were published from 1965 to 2003. Doody's Core Titles seeks to fill the vacuum created when the Brandon/Hill lists ceased publication. Doody's Core Titles is a unique selection guide based on its method of creating an online community of experts to identify and score a core list of titles in 119 health sciences specialties and disciplines. Results/Outcome: The result is a new selection guide, now available annually, that will aid health sciences librarians in identifying core titles for local collections. Evaluation Method: Doody's Core Titles organizes the evaluation of core titles that are identified and recommended by content specialists associated with Doody's Book Review Service and library selectors. A scoring mechanism is used to create the selection of core titles, similar to the star rating system employed in other Doody Enterprise products and services. PMID:16404471
A Primer on Autonomous Aerial Vehicle Design

PubMed Central

Coppejans, Hugo H. G.; Myburgh, Herman C.

2015-01-01

There is a large amount of research currently being done on autonomous micro-aerial vehicles (MAV), such as quadrotor helicopters or quadcopters. The ability to create a working autonomous MAV depends mainly on integrating a simultaneous localization and mapping (SLAM) solution with the rest of the system. This paper provides an introduction for creating an autonomous MAV for enclosed environments, aimed at students and professionals alike. The standard autonomous system and MAV automation are discussed, while we focus on the core concepts of SLAM systems and trajectory planning algorithms. The advantages and disadvantages of using remote processing are evaluated, and recommendations are made regarding the viability of on-board processing. Recommendations are made regarding best practices to serve as a guideline for aspirant MAV designers. PMID:26633410
A Primer on Autonomous Aerial Vehicle Design.

PubMed

Coppejans, Hugo H G; Myburgh, Herman C

2015-12-02

There is a large amount of research currently being done on autonomous micro-aerial vehicles (MAV), such as quadrotor helicopters or quadcopters. The ability to create a working autonomous MAV depends mainly on integrating a simultaneous localization and mapping (SLAM) solution with the rest of the system. This paper provides an introduction for creating an autonomous MAV for enclosed environments, aimed at students and professionals alike. The standard autonomous system and MAV automation are discussed, while we focus on the core concepts of SLAM systems and trajectory planning algorithms. The advantages and disadvantages of using remote processing are evaluated, and recommendations are made regarding the viability of on-board processing. Recommendations are made regarding best practices to serve as a guideline for aspirant MAV designers.
The practices, challenges and recommendations of South African audiologists regarding managing children with auditory processing disorders

PubMed Central

Govender, Samantha; Khan, Nasim

2016-01-01

Audiologists managing children with auditory processing disorders (APD) encounter challenges that include conflicting definitions, several classification profiles, problems with differential diagnosis and a lack of standardised guidelines. The heterogeneity of the disorder and its concomitant childhood disorders makes diagnosis difficult. Linguistic and cultural issues are additional challenges faced by South African audiologists. The study aimed to describe the practices, challenges and recommendations of South African audiologists managing children with APD. A quantitative, non-experimental descriptive survey was used to obtain data from 156 audiologists registered with the Health Professions of South Africa. Findings revealed that 67% screened for APD, 42% assessed while 43% provided intervention. A variety of screening and assessment procedures were being administered, with no standard test battery identified. A range of intervention strategies being used are discussed. When the relationship between the number of years of experience and the audiologists’ level of preparedness to practice in the field of APD was compared, a statistically significant difference (p = 0.049) was seen in that participants with more than 10 years of experience were more prepared to practice in this area. Those participants having qualified as speech-language therapists and audiologists were significantly more prepared (p = 0.03) to practice than the audiologists who comprised the sample. Challenges experienced by the participants included the lack of linguistically and culturally appropriate screening and assessment tools and limited normative data. Recommendations included reviewing the undergraduate audiology training programmes, reinstituting the South African APD Taskforce, developing linguistically and culturally appropriate normative data, creating awareness among educators and involving them in the multidisciplinary team. PMID:27380913

Regenerative Medicine: Creating the Future for Military Medicine

DTIC Science & Technology

2009-08-01

research institutes, and/or small/large businesses by identifying and facilitating appropriate partnerships as well as recommending more targeted...cells without the need for prolonged culture periods to expand the cell populations. In addition, the researchers have found a method that will induce...Regenerative Medicine CREATING THE FUTURE FOR MILITARY MEDICINE U.S. ARMY MEDICAL RESEARCH & MATERIEL COMMAND (USAMRMC) TELEMEDICINE & ADVANCED
Grand Challenges in Clinical Decision Support v10

PubMed Central

Sittig, Dean F.; Wright, Adam; Osheroff, Jerome A.; Middleton, Blackford; Teich, Jonathan M.; Ash, Joan S.; Campbell, Emily; Bates, David W.

2008-01-01

There is a pressing need for high-quality, effective means of designing, developing, presenting, implementing, evaluating, and maintaining all types of clinical decision support capabilities for clinicians, patients and consumers. Using an iterative, consensus-building process we identified a rank-ordered list of the top 10 grand challenges in clinical decision support. This list was created to educate and inspire researchers, developers, funders, and policy-makers. The list of challenges in order of importance that they be solved if patients and organizations are to begin realizing the fullest benefits possible of these systems consists of: Improve the human-computer interface; Disseminate best practices in CDS design, development, and implementation; Summarize patient-level information; Prioritize and filter recommendations to the user; Create an architecture for sharing executable CDS modules and services; Combine recommendations for patients with co-morbidities; Prioritize CDS content development and implementation; Create internet-accessible clinical decision support repositories; Use freetext information to drive clinical decision support; Mine large clinical databases to create new CDS. Identification of solutions to these challenges is critical if clinical decision support is to achieve its potential and improve the quality, safety and efficiency of healthcare. PMID:18029232
f-treeGC: a questionnaire-based family tree-creation software for genetic counseling and genome cohort studies.

PubMed

Tokutomi, Tomoharu; Fukushima, Akimune; Yamamoto, Kayono; Bansho, Yasushi; Hachiya, Tsuyoshi; Shimizu, Atsushi

2017-07-14

The Tohoku Medical Megabank project aims to create a next-generation personalized healthcare system by conducting large-scale genome-cohort studies involving three generations of local residents in the areas affected by the Great East Japan Earthquake. We collected medical and genomic information for developing a biobank to be used for this healthcare system. We designed a questionnaire-based pedigree-creation software program named "f-treeGC," which enables even less experienced medical practitioners to accurately and rapidly collect family health history and create pedigree charts. f-treeGC may be run on Adobe AIR. Pedigree charts are created in the following manner: 1) At system startup, the client is prompted to provide required information on the presence or absence of children; f-treeGC is capable of creating a pedigree up to three generations. 2) An interviewer fills out a multiple-choice questionnaire on genealogical information. 3) The information requested includes name, age, gender, general status, infertility status, pregnancy status, fetal status, and physical features or health conditions of individuals over three generations. In addition, information regarding the client and the proband, and birth order information, including multiple gestation, custody, multiple individuals, donor or surrogate, adoption, and consanguinity may be included. 4) f-treeGC shows only marriages between first cousins via the overlay function. 5) f-treeGC automatically creates a pedigree chart, and the chart-creation process is visible for inspection on the screen in real time. 6) The genealogical data may be saved as a file in the original format. The created/modified date and time may be changed as required, and the file may be password-protected and/or saved in read-only format. To enable sorting or searching from the database, the file name automatically contains the terms typed into the entry fields, including physical features or health conditions, by default. 7) Alternatively, family histories are collected using a completed foldable interview paper sheet named "f-sheet", which is identical to the questionnaire in f-treeGC. We developed a questionnaire-based family tree-creation software, named f-treeGC, which is fully compliant with international recommendations for standardized human pedigree nomenclature. The present software simplifies the process of collecting family histories and pedigrees, and has a variety of uses, from genome cohort studies or primary care to genetic counseling.
Planning for chronic disease medications in disaster: perspectives from patients, physicians, pharmacists, and insurers.

PubMed

Carameli, Kelley A; Eisenman, David P; Blevins, Joy; d'Angona, Brian; Glik, Deborah C

2013-06-01

Recent US disasters highlight the current imbalance between the high proportion of chronically ill Americans who depend on prescription medications and their lack of medication reserves for disaster preparedness. We examined barriers that Los Angeles County residents with chronic illness experience within the prescription drug procurement system to achieve recommended medication reserves. A mixed methods design included evaluation of insurance pharmacy benefits, focus group interviews with patients, and key informant interviews with physicians, pharmacists, and insurers. Most prescriptions are dispensed as 30-day units through retail pharmacies with refills available after 75% of use, leaving a monthly medication reserve of 7 days. For patients to acquire 14- to 30-day disaster medication reserves, health professionals interviewed supported 60- to 100-day dispensing units. Barriers included restrictive insurance benefits, patients' resistance to mail order, and higher copay-ments. Physicians, pharmacists, and insurers also varied widely in their preparedness planning and collective mutual-aid plans, and most believed pharmacists had the primary responsibility for patients' medication continuity during a disaster. To strengthen prescription drug continuity in disasters, recommendations include the following: (1) creating flexible drug-dispensing policies to help patients build reserves, (2) training professionals to inform patients about disaster planning, and (3) building collaborative partnerships among system stakeholders.
Preparing for Euro 2012: developing a hazard risk assessment.

PubMed

Wong, Evan G; Razek, Tarek; Luhovy, Artem; Mogilevkina, Irina; Prudnikov, Yuriy; Klimovitskiy, Fedor; Yutovets, Yuriy; Khwaja, Kosar A; Deckelbaum, Dan L

2015-04-01

Risk assessment is a vital step in the disaster-preparedness continuum as it is the foundation of subsequent phases, including mitigation, response, and recovery. To develop a risk assessment tool geared specifically towards the Union of European Football Associations (UEFA) Euro 2012. In partnership with the Donetsk National Medical University, Donetsk Research and Development Institute of Traumatology and Orthopedics, Donetsk Regional Public Health Administration, and the Ministry of Emergency of Ukraine, a table-based tool was created, which, based on historical evidence, identifies relevant potential threats, evaluates their impacts and likelihoods on graded scales based on previous available data, identifies potential mitigating shortcomings, and recommends further mitigation measures. This risk assessment tool has been applied in the vulnerability-assessment-phase of the UEFA Euro 2012. Twenty-three sub-types of potential hazards were identified and analyzed. Ten specific hazards were recognized as likely to very likely to occur, including natural disasters, bombing and blast events, road traffic collisions, and disorderly conduct. Preventative measures, such as increased stadium security and zero tolerance for impaired driving, were recommended. Mitigating factors were suggested, including clear, incident-specific preparedness plans and enhanced inter-agency communication. This hazard risk assessment tool is a simple aid in vulnerability assessment, essential for disaster preparedness and response, and may be applied broadly to future international events.
Create an Adventure Challenge: Using Recess Time to Supplement Physical Activity during the School Day

ERIC Educational Resources Information Center

DiGiacinto, Kacey Lynn; Jones, Emily

2010-01-01

NASPE recommends children ages 5-12 accumulate at least 60 minutes of moderate to vigorous physical activity each day of the week. With the growing occurrence of obesity in the United States, it is clear that too many of America's youth are not meeting the recommended amount of daily physical activity. Given that America's youth are having…
A Collaborative Location Based Travel Recommendation System through Enhanced Rating Prediction for the Group of Users.

PubMed

Ravi, Logesh; Vairavasundaram, Subramaniyaswamy

2016-01-01

Rapid growth of web and its applications has created a colossal importance for recommender systems. Being applied in various domains, recommender systems were designed to generate suggestions such as items or services based on user interests. Basically, recommender systems experience many issues which reflects dwindled effectiveness. Integrating powerful data management techniques to recommender systems can address such issues and the recommendations quality can be increased significantly. Recent research on recommender systems reveals an idea of utilizing social network data to enhance traditional recommender system with better prediction and improved accuracy. This paper expresses views on social network data based recommender systems by considering usage of various recommendation algorithms, functionalities of systems, different types of interfaces, filtering techniques, and artificial intelligence techniques. After examining the depths of objectives, methodologies, and data sources of the existing models, the paper helps anyone interested in the development of travel recommendation systems and facilitates future research direction. We have also proposed a location recommendation system based on social pertinent trust walker (SPTW) and compared the results with the existing baseline random walk models. Later, we have enhanced the SPTW model for group of users recommendations. The results obtained from the experiments have been presented.
Science for Society Workshop Summary Report

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

Wolfe, Amy K; Bjornstad, David J; Lenhardt, W Christopher

Science for Society, a workshop held at the Oak Ridge National Laboratory (ORNL) on September 27, 20111, explored ways to move Laboratory science toward use. It sought actionable recommendations. Thus the workshop focused on: (1) current practices that promote and inhibit the translation of science into use, (2) principles that could lead to improving ORNL's translational knowledge and technology transfer efforts, and (3) specific recommendations for making these principles operational. This highly interactive workshop struck a positive chord with participants, a group of 26 ORNL staff members from diverse arenas of science and technology (S and T), technology transfer, andmore » external laboratory relations, who represented all levels of science, technology, and management. Recognizing that the transformation of fundamental principles into operational practices often follows a jagged path, the workshop sought to identify key choices that could lead to a smoother journey along this path, as well as choices that created roadblocks and bottlenecks. The workshop emphasized a portion of this pathway, largely excluding the marketplace. Participants noted that research translation includes linkages between fundamental and applied research and development (R and D), and is not restricted to uptake by manufacturers, consumers, or end users. Three crosscutting ideas encapsulate workshop participants observations: (1) ORNL should take more action to usher the translation of its S and T products toward use, so as to make a positive national and global impact and to enhance its own competitiveness in the future; (2) ORNL (and external entities such as DOE and Congress) conveys inconsistent messages with regard to the importance of research translation and application, which (a) creates confusion, (b) poses disincentives to pursue research translation, (c) imposes barriers that inhibit cross-fertilization and collaboration, and (d) diminishes the effectiveness of both the science mission and the translation of that science for use; and (3) ORNL should design its commitments and actions for helping move science from the Laboratory toward use to align with one another and should integrate them into its institutional culture in such a way as to elevate research translation and application to coequal status with scientific excellence. Participants made several actionable recommendations for enhancing research translation at ORNL, some of which were particular to specific S and T domains. Among the recommendations that participants agreed apply Lab-wide are to: align metrics and incentives with research translation goals; manage risks and conflicts of interest instead of avoiding them; and create programs (e.g., entrepreneurial leave) that promote interactions between key ORNL staff and industry in ways that complement careers at ORNL.« less
Cannabis Users' Recommended Warnings for Packages of Legally Sold Cannabis: An Australia-Centered Study

PubMed Central

Malouff, John M.; Johnson, Caitlin E.; Rooke, Sally E.

2016-01-01

Abstract Introduction: Although cannabis use creates health risks, governments have recently been legalizing either medical use or leisure use. These governments can mandate health warnings on cannabis packages. Prior research examined recommended warnings of cannabis experts. The aim of this study was to obtain suggested cannabis health and safety warnings from cannabis users. Methods: We used a media release, Facebook postings, and announcements in university classes to seek individuals who had used cannabis at least once according to their own report. Using online data collection software that keeps participants anonymous, we asked the individuals to suggest a warning that governments could mandate on cannabis packages. Results: In total, 288 users suggested warnings. Categorizing the warnings into content categories led to six warning topics: (1) risk of harm to mental health and psychological functioning; (2) risk of operating machinery while under the influence; (3) short-term physical side effects; (4) responsible use; (5) long-term negative physical effects; and (6) dependence, addiction, or abuse. The user-suggested warnings overlapped with six expert-recommended warnings identified in prior survey research and included two content areas that did not feature in expert-recommended warnings: short-term physical side effects and the importance of responsible use. Conclusions: The results are consistent with prior findings that some youths perceive cannabis use as potentially harmful. The current findings provide possible new content for warnings on cannabis packages. PMID:28861495
In the face of contradictory evidence: report of the Dietary Guidelines for Americans Committee.

PubMed

Hite, Adele H; Feinman, Richard David; Guzman, Gabriel E; Satin, Morton; Schoenfeld, Pamela A; Wood, Richard J

2010-10-01

Concerns that were raised with the first dietary recommendations 30 y ago have yet to be adequately addressed. The initial Dietary Goals for Americans (1977) proposed increases in carbohydrate intake and decreases in fat, saturated fat, cholesterol, and salt consumption that are carried further in the 2010 Dietary Guidelines Advisory Committee (DGAC) Report. Important aspects of these recommendations remain unproven, yet a dietary shift in this direction has already taken place even as overweight/obesity and diabetes have increased. Although appealing to an evidence-based methodology, the DGAC Report demonstrates several critical weaknesses, including use of an incomplete body of relevant science; inaccurately representing, interpreting, or summarizing the literature; and drawing conclusions and/or making recommendations that do not reflect the limitations or controversies in the science. An objective assessment of evidence in the DGAC Report does not suggest a conclusive proscription against low-carbohydrate diets. The DGAC Report does not provide sufficient evidence to conclude that increases in whole grain and fiber and decreases in dietary saturated fat, salt, and animal protein will lead to positive health outcomes. Lack of supporting evidence limits the value of the proposed recommendations as guidance for consumers or as the basis for public health policy. It is time to reexamine how US dietary guidelines are created and ask whether the current process is still appropriate for our needs. Copyright © 2010 Elsevier Inc. All rights reserved.
Cannabis Users' Recommended Warnings for Packages of Legally Sold Cannabis: An Australia-Centered Study.

PubMed

Malouff, John M; Johnson, Caitlin E; Rooke, Sally E

2016-01-01

Introduction: Although cannabis use creates health risks, governments have recently been legalizing either medical use or leisure use. These governments can mandate health warnings on cannabis packages. Prior research examined recommended warnings of cannabis experts. The aim of this study was to obtain suggested cannabis health and safety warnings from cannabis users. Methods: We used a media release, Facebook postings, and announcements in university classes to seek individuals who had used cannabis at least once according to their own report. Using online data collection software that keeps participants anonymous, we asked the individuals to suggest a warning that governments could mandate on cannabis packages. Results: In total, 288 users suggested warnings. Categorizing the warnings into content categories led to six warning topics: (1) risk of harm to mental health and psychological functioning; (2) risk of operating machinery while under the influence; (3) short-term physical side effects; (4) responsible use; (5) long-term negative physical effects; and (6) dependence, addiction, or abuse. The user-suggested warnings overlapped with six expert-recommended warnings identified in prior survey research and included two content areas that did not feature in expert-recommended warnings: short-term physical side effects and the importance of responsible use. Conclusions: The results are consistent with prior findings that some youths perceive cannabis use as potentially harmful. The current findings provide possible new content for warnings on cannabis packages.
AAPT Lab Recommendations: Past, Present, and Future

NASA Astrophysics Data System (ADS)

Kozminski, Joseph

The ``AAPT Recommendations for the Undergraduate Physics Laboratory Curriculum'' was endorsed by the American Association of Physics Teachers Executive Board in November 2014. This set of curriculum recommendations focuses on developing skills and competencies that will prepare students for research in graduate school and for jobs in the STEM sector, education, and many other employment sectors. The recommendations can be used to guide changes in laboratory curricula, to assess department laboratory curricula during program reviews, and to educate university officials about the importance of laboratory experiences. The recommendations offer many potential opportunities for collaboration between physics education researchers and laboratory instructors in studying skill development in the lab and how various elements of the laboratory curriculum can best be assessed. There are also discussions underway to create an online resource for laboratory instructors to share implementation ideas and resources. This presentation provides an overview of these recommendations and their development, how the recommendations are currently being used, and opportunities for expanded use of the recommendations going forward.
Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 3: Endoscopic computer-assisted electromagnetic navigation and ultrasonography as technical adjuvants for shunt placement.

PubMed

Flannery, Ann Marie; Duhaime, Ann-Christine; Tamber, Mandeep S; Kemp, Joanna

2014-11-01

This systematic review was undertaken to answer the following question: Do technical adjuvants such as ventricular endoscopic placement, computer-assisted electromagnetic guidance, or ultrasound guidance improve ventricular shunt function and survival? The US National Library of Medicine PubMed/MEDLINE database and the Cochrane Database of Systematic Reviews were queried using MeSH headings and key words specifically chosen to identify published articles detailing the use of cerebrospinal fluid shunts for the treatment of pediatric hydrocephalus. Articles meeting specific criteria that had been delineated a priori were then examined, and data were abstracted and compiled in evidentiary tables. These data were then analyzed by the Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force to consider evidence-based treatment recommendations. The search yielded 163 abstracts, which were screened for potential relevance to the application of technical adjuvants in shunt placement. Fourteen articles were selected for full-text review. One additional article was selected during a review of literature citations. Eight of these articles were included in the final recommendations concerning the use of endoscopy, ultrasonography, and electromagnetic image guidance during shunt placement, whereas the remaining articles were excluded due to poor evidence or lack of relevance. The evidence included 1 Class I, 1 Class II, and 6 Class III papers. An evidentiary table of relevant articles was created. CONCLUSIONS/RECOMMENDATION: There is insufficient evidence to recommend the use of endoscopic guidance for routine ventricular catheter placement. Level I, high degree of clinical certainty. The routine use of ultrasound-assisted catheter placement is an option. Level III, unclear clinical certainty. The routine use of computer-assisted electromagnetic (EM) navigation is an option. Level III, unclear clinical certainty.
Insufficient access to harm reduction measures in prisons in 5 countries (PRIDE Europe): a shared European public health concern.

PubMed

Michel, Laurent; Lions, Caroline; Van Malderen, Sara; Schiltz, Julie; Vanderplasschen, Wouter; Holm, Karina; Kolind, Torsten; Nava, Felice; Weltzien, Nadja; Moser, Andrea; Jauffret-Roustide, Marie; Maguet, Olivier; Carrieri, Patrizia M; Brentari, Cinzia; Stöver, Heino

2015-10-27

Prisoners constitute a high-risk population, particularly for infectious diseases. The aim of this study was to estimate the level of infectious risk in the prisons of five different European countries by measuring to what extent the prison system adheres to WHO/UNODC recommendations. Following the methodology used in a previous French survey, a postal/electronic questionnaire was sent to all prisons in Austria, Belgium, Denmark and Italy to collect data on the availability of several recommended HIV-HCV prevention interventions and HBV vaccination for prisoners. A score was built to compare adherence to WHO/UNODC recommendations (considered a proxy of environmental infectious risk) in those 4 countries. It ranged from 0 (no adherence) to 12 (full adherence). A second score (0 to 9) was built to include data from a previous French survey, thereby creating a 5-country comparison. A majority of prisons answered in Austria (100 %), France (66 %) and Denmark (58 %), half in Belgium (50 %) and few in Italy (17 %), representing 100, 74, 89, 47 and 23 % coverage of the prison populations, respectively. Availability of prevention measures was low, with median adherence scores ranging from 3.5 to 4.5 at the national level. These results were confirmed when using the second score which included France in the inter-country comparison. Overall, the adherence score was inversely associated with prison overpopulation rates (p = 0.08). Using a score of adherence to WHO/UNODC recommendations, the estimated environmental infectious risk remains extremely high in the prisons of the 5 European countries assessed. Public health strategies should be adjusted to comply with the principle of equivalence of care and prevention with the general community.
A decision support tool for identifying abuse of controlled substances by ForwardHealth Medicaid members.

PubMed

Mailloux, Allan T; Cummings, Stephen W; Mugdh, Mrinal

2010-01-01

Our objective was to use Wisconsin's Medicaid Evaluation and Decision Support (MEDS) data warehouse to develop and validate a decision support tool (DST) that (1) identifies Wisconsin Medicaid fee-for-service recipients who are abusing controlled substances, (2) effectively replicates clinical pharmacist recommendations for interventions intended to curb abuse of physician and pharmacy services, and (3) automates data extraction, profile generation and tracking of recommendations and interventions. From pharmacist manual reviews of medication profiles, seven measures of overutilization of controlled substances were developed, including (1-2) 6-month and 2-month "shopping" scores, (3-4) 6-month and 2-month forgery scores, (5) duplicate/same day prescriptions, (6) count of controlled substance claims, and the (7) shopping 6-month score for the individual therapeutic class with the highest score. The pattern analysis logic for the measures was encoded into SQL and applied to the medication profiles of 190 recipients who had already undergone manual review. The scores for each measure and numbers of providers were analyzed by exhaustive chi-squared automatic interaction detection (CHAID) to determine significant thresholds and combinations of predictors of pharmacist recommendations, resulting in a decision tree to classify recipients by pharmacist recommendations. The overall correct classification rate of the decision tree was 95.3%, with a 2.4% false positive rate and 4.0% false negative rate for lock-in versus prescriber-alert letter recommendations. Measures used by the decision tree include the 2-month and 6-month shopping scores, and the number of pharmacies and prescribers. The number of pharmacies was the best predictor of abuse of controlled substances. When a Medicaid recipient receives prescriptions for controlled substances at 8 or more pharmacies, the likelihood of a lock-in recommendation is 90%. The availability of the Wisconsin MEDS data warehouse has enabled development and application of a decision tree for detecting recipient fraud and abuse of controlled substance medications. Using standard pharmacy claims data, the decision tree effectively replicates pharmacist manual review recommendations. The DST has automated extraction and evaluation of pharmacy claims data for creating recommendations for guiding pharmacists in the selection of profiles for manual review. The DST is now the primary method used by the Wisconsin Medicaid program to detect fraud and abuse of physician and pharmacy services committed by recipients.
Neuromodulators for Functional Gastrointestinal Disorders (Disorders of Gut-Brain Interaction): A Rome Foundation Working Team Report.

PubMed

Drossman, Douglas A; Tack, Jan; Ford, Alexander C; Szigethy, Eva; Törnblom, Hans; Van Oudenhove, Lukas

2018-03-01

Central neuromodulators (antidepressants, antipsychotics, and other central nervous system-targeted medications) are increasingly used for treatment of functional gastrointestinal disorders (FGIDs), now recognized as disorders of gut-brain interaction. However, the available evidence and guidance for the use of central neuromodulators in these conditions is scanty and incomplete. In this Rome Foundation Working Team report, a multidisciplinary team summarized available research evidence and clinical experience to provide guidance and treatment recommendations. The working team summarized the literature on the pharmacology of central neuromodulators and their effects on gastrointestinal sensorimotor function and conducted an evidence-based review on their use for treating FGID syndromes. Because of the paucity of data for FGIDs, we included data for non-gastrointestinal painful disorders and specific symptoms of pain, nausea, and vomiting. This information was combined into a final document comprising a synthesis of available evidence and recommendations for clinical use guided by the research and clinical experience of the experts on the committee. The evidence-based review on neuromodulators in FGID, restricted by the limited available controlled trials, was integrated with open-label studies and case series, along with the experience of experts to create recommendations using a consensus (Delphi) approach. Due to the diversity of conditions and complexity of treatment options, specific recommendations were generated for different FGIDs. However, some general recommendations include: (1) low to modest dosages of tricyclic antidepressants provide the most convincing evidence of benefit for treating chronic gastrointestinal pain and painful FGIDs and serotonin noradrenergic reuptake inhibitors can also be recommended, though further studies are needed; (2) augmentation, that is, adding a second treatment (adding quetiapine, aripiprazole, buspirone α2δ ligand agents) is recommended when a single medication is unsuccessful or produces side effects at higher dosages; (3) treatment should be continued for 6-12 months to potentially prevent relapse; and (4) implementation of successful treatment requires effective communication skills to improve patient acceptance and adherence, and to optimize the patient-provider relationship. Based on systematic and selectively focused review and the consensus of a multidisciplinary panel, we have provided summary information and guidelines for the use of central neuromodulators in the treatment of chronic gastrointestinal symptoms and FGIDs. Further studies are needed to confirm and refine these recommendations. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.
Health professionals' experience of teamwork education in acute hospital settings: a systematic review of qualitative literature.

PubMed

Eddy, Kylie; Jordan, Zoe; Stephenson, Matthew

2016-04-01

Teamwork is seen as an important element of patient care in acute hospital settings. The complexity of the journey of care for patients highlights the need for health professionals to collaborate and communicate clearly with each other. Health organizations in western countries are committed to improving patient safety through education of staff and teamwork education programs have been integral to this focus. There are no current systematic reviews of the experience of health professionals who participate in teamwork education in acute hospital settings. The objective of this systematic review was to search for the best available evidence on the experiences of health professionals who participate in teamwork education in acute hospital settings. This review considered studies reporting on experiences of registered health professionals who work in acute hospitals. This included medical, nursing and midwifery and allied health professionals. The focus of the meta-synthesis was the experiences and reflections of health professionals who were involved in teamwork education in acute hospital settings. The geographical context for this review was acute hospitals in rural or metropolitan settings in Australia and overseas countries. The review focused on the experiences of health professionals who work in acute hospitals and participated in teamwork education programs. This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.In the absence of research studies, other text such as opinion papers, discussion papers and reports were considered. Studies published in English and from 1990 to 2013 were included in this review. The literature search for relevant papers occurred between 13 September and 26 October 2013. A three-step search strategy was utilized in this review. The databases searched were PubMed, CINAHL, Embase and Scopus. The standardized critical appraisal tool the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) was used to assess the methodological quality of included papers. Data that included statements and text of interest was extracted from papers included in the study using the standardized data extraction tool from JBI-QARI. Qualitative research findings were pooled using JBI-QARI. This involved the aggregation and synthesis of findings to generate a set of statements that represented that aggregation. In total, 116 papers were selected for analysis of full text, 11 papers were selected for critical appraisal and seven papers were selected for data synthesis. This resulted in 44 findings. The findings were assigned to 16 categories based on identified similarities across the papers. The categories were integrated into six meta-syntheses. These were: Meta-synthesis One: It is important to recognize that organizational culture and expectations have an impact on health professionals' participation and experience of teamwork education. Meta-synthesis Two: Understanding how successful teams function is central to the development of teamwork education programs and the experience of participants. Meta-synthesis Three: A health professional's experience of teamwork education will be influenced by his/her starting point of learning. Meta-synthesis Four: Participants highly value teamwork education programs that are implemented by facilitators who create practical authentic learning opportunities and foster reflection and debriefing for participants. Meta-synthesis Five: High fidelity simulation used with specific communication strategies provides a powerful learning opportunity for health professions to practice teamwork skills. Meta-synthesis Six: Participants have increased confidence and are motivated to apply their newly learnt teamwork skills into their daily practice. The review identified qualitative evidence that can guide organizations and education facilitators in the development and implementation of teamwork education in acute hospital settings. Although the quality of the specific teamwork education programs was an important factor, there were a number of issues that also impacted on the experiences of health professionals who participated in teamwork education programs. These included the context that the program was delivered in, the diversity of health care teams, starting points of individual learners, the type of tools utilized in education programs, the levels of confidence and motivation of learners post training and the opportunity to transfer into practice new learning. Drawing from the synthesized findings of the review, recommendations for practice have been devised in order to guide the development and implementation of teamwork education in acute hospital settings and to improve the experience of participating health professionals. The Joanna Briggs Institute utilizes Grades of Recommendation to rate a health management strategy in terms of its desirable effects, evidence of adequate quality supporting its use, benefits of use, and the inclusion of patient experience, values and preferences. A strong recommendation has a Grade A and a weak recommendation has a Grade B. The FAME (Feasibility, Appropriateness, Meaningfulness and Effectiveness) scale was used to inform the strength of the following six recommendations for practice from the review: RECOMMENDATION ONE: All members of a team should be encouraged by their organization/managers to participate in teamwork education programs in order to foster a positive culture of learning and teamwork within the team.JBI Recommendation: Grade A. This recommendation is appropriate and applicable to all health professionals in acute hospital settings, is associated with positive experiences for participants of teamwork education programs and has a beneficial effect on participants. Facilitators of teamwork education programs should understand how successful teams function and consider these factors when planning or delivering training.JBI Recommendation: Grade A. This recommendation is associated with positive experiences for participants and creates a beneficial effect to the quality of a teamwork education program. Facilitators of teamwork education programs need to explore participant learning needs and their prior experiences of working in teams before implementing teamwork education programs.JBI Recommendation: Grade A. This recommendation creates a beneficial effect to the participants of teamwork education programs and to the quality of education provided by facilitators. Facilitators of teamwork education programs should provide learning opportunities that are practical, authentic to participants and foster constructive debriefing and reflection.JBI Recommendation: Grade A. This recommendation is applicable to all health professionals and circumstances in which teamwork education occurs, is associated with positive experiences and has a beneficial effect on participants. High fidelity simulation should be considered in acute hospitals for the training of teamwork skills in addition to clinical skills. Scenarios provide realistic opportunities for participants to practice communication strategies that enhance teamwork.JBI Recommendation: Grade A. This recommendation is applicable to all health professionals and circumstances in which teamwork education occurs and has a beneficial effect on participants of education programs. Team managers should harness the new confidence and motivation of staff around teamwork skills following participation in teamwork education programs and ensure that there are opportunities in the workplace to apply new skills and knowledge into daily practice.JBI Recommendation: Grade A. This recommendation is applicable to all health professionals and circumstances in which teamwork education occurs, is adaptable to a variety of circumstances and has a beneficial effect on health professional's daily practice of teamwork skills. In order to strengthen the evidence base about teamwork education in acute hospital settings there needs to be quantitative and qualitative research into:How organizations that have successfully embedded a culture of collaboration and safety in health teams have planned, implemented and evaluated teamwork education programs in acute hospital settings?What are the characteristics of teams that have led to successful participation in teamwork education and positive outcomes for team performance?What are the experiences, training and support provided to education facilitators who successfully implement teamwork education programs in acute hospitals?
Recommendations for elaboration, transcultural adaptation and validation process of tests in Speech, Hearing and Language Pathology.

PubMed

Pernambuco, Leandro; Espelt, Albert; Magalhães, Hipólito Virgílio; Lima, Kenio Costa de

2017-06-08

to present a guide with recommendations for translation, adaptation, elaboration and process of validation of tests in Speech and Language Pathology. the recommendations were based on international guidelines with a focus on the elaboration, translation, cross-cultural adaptation and validation process of tests. the recommendations were grouped into two Charts, one of them with procedures for translation and transcultural adaptation and the other for obtaining evidence of validity, reliability and measures of accuracy of the tests. a guide with norms for the organization and systematization of the process of elaboration, translation, cross-cultural adaptation and validation process of tests in Speech and Language Pathology was created.
Common data elements collected among universities for sport-related concussion studies.

PubMed

Yang, Jingzhen; Peek-Asa, Corinne; Noble, James M; Torner, James; Schmidt, Paul; Cooper, Martha L

2018-02-12

Universities are increasingly implementing programs to effectively respond to and manage sport-related concussions (SRCs). One such effort is to develop common data elements (CDEs) and standardize data collection methods. The objectives of this study were to describe CDEs currently collected by Big Ten and Ivy League universities for SRC studies, and to compare the data collected with the core CDEs recommended by the National Institute of Neurological Disorders and Stroke (NINDS). We conducted an anonymous cross-sectional online survey among medical staff at the 14 Big Ten and 8 Ivy League universities (one per university) between September and October 2015. The survey instrument, including 9 questions corresponding to the concussion data collected before, during, and after a concussion, was developed and pilot-tested before field use. We analyzed patterns of the concussion CDEs being collected, including when, what, and how the data were collected and stored, and compared them with the NINDS' recommended core CDEs. A total of 19 out of 22 universities were included, with 13 from Big Ten and 6 from Ivy-League universities. All 19 participating universities currently collected concussion data with athletes before, during, and after a concussion. Great similarities in data collection were observed at baseline and acutely post-concussion across participating universities. All 19 universities collected at least one of the ten recommended acute symptoms checklists, and 18 universities collected one of the four recommended core neuropsychological function cognitive measures. However, CDEs in the sub-acute and chronic timeframes were limited, with only 9 (47%) universities collecting post-concussion short to long term outcome data. While over 60% of universities collected and stored concussion data electronically, only 17% to 42% of data collected were readily available for research. Significant inter-institutional similarities in acute concussion CDEs were found. Further efforts should focus on collecting sub-acute and chronic timeframe core CDEs and creating data access protocols to facilitate evidence-based concussion prevention and treatment for all collegiate athletes.
Discussing State-of-the-Art Spatial Visualization Techniques Applicable for the Epidemiological Surveillance Data on the Example of Campylobacter spp. in Raw Chicken Meat.

PubMed

Plaza-Rodríguez, C; Appel, B; Kaesbohrer, A; Filter, M

2016-08-01

Within the European activities for the 'Monitoring and Collection of Information on Zoonoses', annually EFSA publishes a European report, including information related to the prevalence of Campylobacter spp. in Germany. Spatial epidemiology becomes here a fundamental tool for the generation of these reports, including the representation of prevalence as an essential element. Until now, choropleth maps are the default visualization technique applied in epidemiological monitoring and surveillance reports made by EFSA and German authorities. However, due to its limitations, it seems to be reasonable to explore alternative chart type. Four maps including choropleth, cartogram, graduated symbols and dot-density maps were created to visualize real-world sample data on the prevalence of Campylobacter spp. in raw chicken meat samples in Germany in 2011. In addition, adjacent and coincident maps were created to visualize also the associated uncertainty. As an outcome, we found that there is not a single data visualization technique that encompasses all the necessary features to visualize prevalence data alone or prevalence data together with their associated uncertainty. All the visualization techniques contemplated in this study demonstrated to have both advantages and disadvantages. To determine which visualization technique should be used for future reports, we recommend to create a dialogue between end-users and epidemiologists on the basis of sample data and charts. The final decision should also consider the knowledge and experience of end-users as well as the specific objective to be achieved with the charts. © 2015 The Authors. Zoonoses and Public Health Published by Blackwell Verlag GmbH.

High Standards and High Graduation Rates: Moving forward on a Dual Agenda in Massachusetts. Recommendations and Action Steps for Education Policymakers

ERIC Educational Resources Information Center

Jobs for the Future, 2007

2007-01-01

To create an education pipeline capable of moving all students through to an advanced level of skills and credentials and connecting young adults to the well-paying jobs being created in Massachusetts, two challenges deserve the special and immediate attention of state leaders: (1) Substantially increasing the percentage of the state's low-income,…
Creating E-Commerce Start-Ups with Information Systems Students: Lessons Learned from New Venture Successes and Failures

ERIC Educational Resources Information Center

Abrahams, Alan

2010-01-01

In this paper, we review a variety of e-commerce startups created by senior information systems students, under the author's guidance, over a number of years at multiple universities. We compare the characteristics of the start-ups and comment on various factors which appear to have contributed to their success or failure. Our recommendations are…
TH-A-204-00: Key Dosimetry Data - Impact of New ICRU Recommendations

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

NONE

The ICRU is currently finalizing a report on key data for radiation dosimetry. This multi-year review has resulted in a number of recommendations regarding “fundamental” data that are used in dosimetry related to radiation therapy. This educational session will explain the background for the ICRU committee’s work, the content and conclusions of the report and the impact on outputs, including NIST primary standards, ADCL calibration coefficients and clinical reference dosimetry. Parameters and beam modalities potentially affected by this report include: The mean excitation energy, I, for graphite, air, and water, The average energy required to create an ion pair inmore » dry air (commonly referred to as W/e), The uncertainty in the determination of air kerma in kV xrays The absolute value of Co-60 and Cs-137 primary standards and the dissemination of calibration coefficients, The determination of air kerma strength for Ir-192 HDR brachytherapy sources Ion chamber kQ factors for linac MV beams Ion chamber kQ factors for proton beams. The changes in reference dosimetry that would result from adoption of the ICRU recommendations are of the order of 0.5% to 1%, an effect that will not impact clinical dose delivery but will be detectable in the clinical setting. This session will also outline how worldwide metrology is coordinated through the Convention of the Meter and therefore how the international dosimetry community will proceed with adopting these recommendations so that uniformity from country to country in reference dosimetry is maintained. Timelines and communications methods will also be discussed to ensure that users, such as clinical medical physicists, are not surprised when their chamber’s calibration coefficient apparently changes. Learning Objectives: Understand the background for the ICRU committee’s work on key dosimetry data. Understand the proposed changes to key data and the impacts on reference dosimetry. Understand the methodology and timeline for adoption of the ICRU recommendations.« less
Obtaining consumer perspectives using a citizens' jury: does the current country of origin labelling in Australia allow for informed food choices?

PubMed

Withall, Elizabeth; Wilson, Annabelle M; Henderson, Julie; Tonkin, Emma; Coveney, John; Meyer, Samantha B; Clark, Jacinta; McCullum, Dean; Ankeny, Rachel; Ward, Paul R

2016-12-09

Contemporary food systems are vast and complex, creating greater distance between consumers and their food. Consequently, consumers are required to put faith in a system of which they have limited knowledge or control. Country of origin labelling (CoOL) is one mechanism that theoretically enables consumer knowledge of provenance of food products. However, this labelling system has recently come under Australian Government review and recommendations for improvements have been proposed. Consumer engagement in this process has been limited. Therefore this study sought to obtain further consumer opinion on the issue of CoOL and to identify the extent to which Australian consumers agree with Australian Government recommendations for improvements. A citizens' jury was conducted with a sample of 14 South Australian consumers to explore their perceptions on whether the CoOL system allows them to make informed food choices, as well as what changes (if any) need to be made to enable informed food choices (recommendations). Overall, jurors' perception of usefulness of CoOL, including its ability to enable consumers to make informed food choices, fluctuated throughout the Citizens' Jury. Initially, the majority of the jurors indicated that the labels allowed informed food choice, however by the end of the session the majority disagreed with this statement. Inconsistencies within jurors' opinions were observed, particularly following delivery of information from expert witnesses and jury deliberation. Jurors provided recommendations for changes to be made to CoOL, which were similar to those provided in the Australian Government inquiry. Consumers in this study engaged with the topical issue of CoOL and provided their opinions. Overall, consumers do not think that the current CoOL system in Australia enables consumers to make informed choices. Recommendations for changes, including increasing the size of the label and the label's font, and standardising its position, were made.
Progress Report on the Airborne Metadata and Time Series Working Groups of the 2016 ESDSWG

NASA Astrophysics Data System (ADS)

Evans, K. D.; Northup, E. A.; Chen, G.; Conover, H.; Ames, D. P.; Teng, W. L.; Olding, S. W.; Krotkov, N. A.

2016-12-01

NASA's Earth Science Data Systems Working Groups (ESDSWG) was created over 10 years ago. The role of the ESDSWG is to make recommendations relevant to NASA's Earth science data systems from users' experiences. Each group works independently focusing on a unique topic. Participation in ESDSWG groups comes from a variety of NASA-funded science and technology projects, including MEaSUREs and ROSS. Participants include NASA information technology experts, affiliated contractor staff and other interested community members from academia and industry. Recommendations from the ESDSWG groups will enhance NASA's efforts to develop long term data products. The Airborne Metadata Working Group is evaluating the suitability of the current Common Metadata Repository (CMR) and Unified Metadata Model (UMM) for airborne data sets and to develop new recommendations as necessary. The overarching goal is to enhance the usability, interoperability, discovery and distribution of airborne observational data sets. This will be done by assessing the suitability (gaps) of the current UMM model for airborne data using lessons learned from current and past field campaigns, listening to user needs and community recommendations and assessing the suitability of ISO metadata and other standards to fill the gaps. The Time Series Working Group (TSWG) is a continuation of the 2015 Time Series/WaterML2 Working Group. The TSWG is using a case study-driven approach to test the new Open Geospatial Consortium (OGC) TimeseriesML standard to determine any deficiencies with respect to its ability to fully describe and encode NASA earth observation-derived time series data. To do this, the time series working group is engaging with the OGC TimeseriesML Standards Working Group (SWG) regarding unsatisfied needs and possible solutions. The effort will end with the drafting of an OGC Engineering Report based on the use cases and interactions with the OGC TimeseriesML SWG. Progress towards finalizing recommendations will be presented at the meeting.
Development of tuberculosis infection control guidelines in a pediatric HIV clinic in sub-Saharan Africa.

PubMed

Carlucci, J G; Jin, L; Sanders, J E; Mohapi, E Q; Mandalakas, A M

2015-03-21

A well-established pediatric human immunodeficiency virus (HIV) clinic in Lesotho with initial infection control (IC) measures prioritizing blood-borne disease. In line with international recommendations, services have been expanded to include the management of patients with tuberculosis (TB). The creation of comprehensive IC guidelines with an emphasis on TB has become a priority. To provide a model for developing and implementing IC guidelines in ambulatory care facilities in limited-resource settings with high HIV and TB prevalence. Activities: An IC plan that includes guidance covering both general IC measures and TB-specific guidelines was created by integrating local and international recommendations and emphasizing the importance of administrative measures, environmental controls, and disease-specific precautions. An interdisciplinary committee was established to oversee its implementation, monitoring, and evaluation. Development and implementation of IC guidelines in resource-limited settings are feasible and should be a priority in high HIV and TB prevalence areas. Education should be the cornerstone of such endeavors. Many interventions can be implemented with minimal expertise and material resources. Administrative support and institutional investment are essential to the sustainability of an effective IC program.
Customizing for clients: developing a library liaison program from need to plan.

PubMed

Tennant, M R; Butson, L C; Rezeau, M E; Tucker, P J; Boyle, M E; Clayton, G

2001-01-01

Building on the experiences of librarian representatives to curriculum committees in the colleges of dentistry, medicine, and nursing, the Health Science Center Libraries (HSCL) Strategic Plan recommended the formation of a Library Liaison Work Group to create a formal Library Liaison Program to serve the six Health Science Center (HSC) colleges and several affiliated centers and institutes. The work group's charge was to define the purpose and scope of the program, identify models of best practice, and recommend activities for liaisons. The work group gathered background information, performed an environmental scan, and developed a philosophy statement, a program of liaison activities focusing on seven primary areas, and a forum for liaison communication. Hallmarks of the plan included intensive subject specialization (beyond collection development), extensive communication with users, and personal information services. Specialization was expected to promote competence, communication, confidence, comfort, and customization. Development of the program required close coordination with other strategic plan implementation teams, including teams for collection development, education, and marketing. This paper discusses the HSCL's planning process and the resulting Library Liaison Program. Although focusing on an academic health center, the planning process and liaison model may be applied to any library serving diverse, subject-specific user populations.
Customizing for clients: developing a library liaison program from need to plan*

PubMed Central

Tennant, Michele R.; Butson, Linda C.; Rezeau, Michelle E.; Tucker, Prudence J.; Boyle, Marian E.; Clayton, Greg

2001-01-01

Building on the experiences of librarian representatives to curriculum committees in the colleges of dentistry, medicine, and nursing, the Health Science Center Libraries (HSCL) Strategic Plan recommended the formation of a Library Liaison Work Group to create a formal Library Liaison Program to serve the six Health Science Center (HSC) colleges and several affiliated centers and institutes. The work group's charge was to define the purpose and scope of the program, identify models of best practice, and recommend activities for liaisons. The work group gathered background information, performed an environmental scan, and developed a philosophy statement, a program of liaison activities focusing on seven |primary areas, and a forum for liaison communication. Hallmarks of the plan included intensive subject specialization (beyond collection development), extensive communication with users, and personal information services. Specialization was expected to promote competence, communication, confidence, comfort, and customization. Development of the program required close coordination with other strategic plan implementation teams, including teams for collection development, education, and marketing. This paper discusses the HSCL's planning process and the resulting Library Liaison Program. Although focusing on an academic health center, the planning process and liaison model may be applied to any library serving diverse, subject-specific user populations. PMID:11209807
Planning a multilevel intervention to prevent hearing loss among farmworkers and managers: a systematic approach.

PubMed

Fernandez, M E; Bartholomew, L K; Alterman, T

2009-01-01

Noise-induced hearing loss (NIHL) is the second most prevalent self-reported occupational illness or injury in the U.S., and agricultural workers experience high rates of hearing loss. This article uses Intervention Mapping (IM), a systematic approach to intervention development, to make recommendations for a program to improve hearing loss protection among farmworkers and managers. Final recommendations, based on previous work in the literature on hearing loss prevention, qualitative formative research, and theoretical considerations, include a specification of a multilevel theory- and evidence-based hearing protection program for farmworkers and farm managers. Twelve performance objectives (e.g., "monitor hearing and hearing loss with regular hearing testing") are specified and crossed with six relevant determinants (knowledge and behavioral capability; perceived exposure and susceptibility and noise annoyance; outcome expectations; barriers; social influence; skills and self-efficacy) to create a highly detailed matrix of change objectives for farmworkers and for their managers. These change objectives are then grouped into five categories: two for both farmworkers and their managers (noticing exposures, taking action) and three only for the latter (surveying and planning, implementation and evaluation, and communication). Theoretical methods and practical strategies, including program materials and activities, are then delineated.
The Unintended Consequences of Social Media in Healthcare: New Problems and New Solutions.

PubMed

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

2016-11-10

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

PubMed

Blanco Souza, Túlio Armanini; Colomé, Letícia Marques; Bender, Eduardo André; Lemperle, Gottfriede

2018-06-05

Considering that aesthetic benefits can be obtained with the use of permanent filling materials, this work focuses on the development of a consensus regarding the facial and corporal use of polymethylmethacrylate (PMMA) filler in Brazil. A questionnaire regarding PMMA treatment, which included items on the main indication, application site, volume of product applied, criteria for selection of the material, complications, contraindications, and individual professional experience, was distributed to the Expert Group members. In addition, the responses were summarized, constituting the starting point for the debate regarding the use of PMMA-based fillers on The First Brazilian PMMA Symposium to create a guideline to be followed in PMMA facial and corporal treatments. This survey involved 87,371 cases. PMMA treatment is recommended for restorative and aesthetic purposes in facial and corporal cases, particularly for facial balance. PMMA 30% filler is recommended in specific facial sites (nose, mentum, mandible angle, zygomatic arc, and malar). PMMA filler is contraindicated in other sites (lips) regardless of concentration. With regard to facial treatment, the juxtaperiostal is the application plane most recommended. For PMMA corporal application, intramuscular is the application plane most indicated, while intradermal and justadermal planes are contraindicated. The submuscular plane application is relative to PMMA filler concentration. The experts also inquired regarding the amount of PMMA recommended in each corporal site (50 mL in the calf, 100-150 mL in the gluteal region). These recommendations provide a guideline for physicians, supporting them to perform safe and efficacious treatment with PMMA fillers. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .
WISE recommendations to ensure the safety of injections in diabetes.

PubMed

Strauss, K

2012-01-01

Injections and fingersticks administered to patients with diabetes in health care settings present a risk of blood exposure to the injector as well as other workers in potential contact with sharps. Such exposures could lead to transmission of bloodborne pathogens such as hepatitis and HIV. A recent EU Directive requires that where such risks have been identified, processes and devices must be put in place to reduce or eliminate the risk. The aim of this paper is to provide formal guidelines on the application of this Directive to diabetes care settings. These evidence-based recommendations were written and vetted by a large group of international safety experts. A systematic literature search was conducted for all peer-reviewed studies and publications which bear on sharps safety in diabetes. Initially a group of experts reviewed this literature and drafted the recommendations. These were then presented for review, debate and revision to 57 experts from 14 countries at the WISE workshop in October, 2011. After the WISE meeting, the revised Recommendations were circulated electronically to attendees on three occasions, each time in a new iteration with revisions. Each recommendation was graded by the weight it should have in daily practice and by its degree of support in the medical literature. The topics covered include Risks of Sharps Injury and Muco-cutaneous Exposure, The EU Directive, Device Implications, Injection Technique Implications, Education and Training (Creating a "Safety Culture"), Value, Awareness and Responsibility. These safety recommendations provide practical guidance and fill an important gap in diabetes management. If followed, they should help ensure safe, effective and largely injury-free injections and fingersticks. They will serve as the roadmap for applying the new EU Directive to diabetes care. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Reliability and validity of the instrument used in BRFSS to assess physical activity.

PubMed

Yore, Michelle M; Ham, Sandra A; Ainsworth, Barbara E; Kruger, Judy; Reis, Jared P; Kohl, Harold W; Macera, Caroline A

2007-08-01

State-level statistics of adherence to the physical activity objectives in Healthy People 2010 are derived from the Behavioral Risk Factor Surveillance System (BRFSS) data. BRFSS physical activity questions were updated in 2001 to include domains of leisure time, household, and transportation-related activity of moderate- and vigorous intensity, and walking questions. This article reports the reliability and validity of these questions. The BRFSS Physical Activity Study (BPAS) was conducted from September 2000 to May 2001 in Columbia, SC. Sixty participants were followed for 22 d; they answered the physical activity questions three times via telephone, wore a pedometer and accelerometer, and completed a daily physical activity log for 1 wk. Measures for moderate, vigorous, recommended (i.e., met the criteria for moderate or vigorous), and strengthening activities were created according to Healthy People 2010 operational definitions. Reliability and validity were assessed using Cohen's kappa (kappa) and Pearson correlation coefficients. Seventy-three percent of participants met the recommended activity criteria compared with 45% in the total U.S. population. Test-retest reliability (kappa) was 0.35-0.53 for moderate activity, 0.80-0.86 for vigorous activity, 0.67-0.84 for recommended activity, and 0.85-0.92 for strengthening. Validity (kappa) of the survey (using the accelerometer as the standard) was 0.17-0.22 for recommended activity. Validity (kappa) of the survey (using the physical activity log as the standard) was 0.40-0.52 for recommended activity. The validity and reliability of the BRFSS physical activity questions suggests that this instrument can classify groups of adults into the levels of recommended and vigorous activity as defined by Healthy People 2010. Repeated administration of these questions over time will help to identify trends in physical activity.
Incentives to create and sustain healthy behaviors: technology solutions and research needs.

PubMed

Teyhen, Deydre S; Aldag, Matt; Centola, Damon; Edinborough, Elton; Ghannadian, Jason D; Haught, Andrea; Jackson, Theresa; Kinn, Julie; Kunkler, Kevin J; Levine, Betty; Martindale, Valerie E; Neal, David; Snyder, Leslie B; Styn, Mindi A; Thorndike, Frances; Trabosh, Valerie; Parramore, David J

2014-12-01

Health-related technology, its relevance, and its availability are rapidly evolving. Technology offers great potential to minimize and/or mitigate barriers associated with achieving optimal health, performance, and readiness. In support of the U.S. Army Surgeon General's vision for a "System for Health" and its Performance Triad initiative, the U.S. Army Telemedicine and Advanced Technology Research Center hosted a workshop in April 2013 titled "Incentives to Create and Sustain Change for Health." Members of government and academia participated to identify and define the opportunities, gain clarity in leading practices and research gaps, and articulate the characteristics of future technology solutions to create and sustain real change in the health of individuals, the Army, and the nation. The key factors discussed included (1) public health messaging, (2) changing health habits and the environmental influence on health, (3) goal setting and tracking, (4) the role of incentives in behavior change intervention, and (5) the role of peer and social networks in change. This report summarizes the recommendations on how technology solutions could be employed to leverage evidence-based best practices and identifies gaps in research where further investigation is needed. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Spinal Stenosis

MedlinePlus

... Overview Spinal stenosis is a narrowing of the spaces within your spine, which can put pressure on ... stenosis, doctors may recommend surgery to create additional space for the spinal cord or nerves. Types of ...
Innovative Ideas for Coordinating International Space Activities: International Center for Space Medicine, International Space Authority, and other Global Youth Space Initiatives

NASA Astrophysics Data System (ADS)

Marshall, W.

2002-01-01

The Space Generation Forum SGF, at UNISPACE-III, as one of its ten formal recommendations to the United Nations in 1999, put forward the suggestion that the an international space authority should be created. Other recommendations were the establishment of an International Center for Space Medicine, creation of a global space exploration and development program, establishment of a global space (Nobel) prize, and a global space library. These projects are being further developed at the Space Generation Summit (SGS), an event at World Space Congress (WSC) which shall unite international students and young professionals to develop a youth vision and strategy for the peaceful uses of space. SGS, endorsed by the United Nations, will take place from October 11- 13th, during which the 200 delegates will discuss ongoing youth space activities, particularly those stemming from the UNISPACE-III/SGF and taken forward by the Space Generation Advisory Council. Delegates will address a variety of topics with the goal of devising new recommendations according to the theme, 'Accelerating Our Pace in Space'. The material presented here and in other technical sessions throughout WSC includes the findings of these discussions. In this paper, we present the International Space Authority idea together with recommendations on how that might be taken forward. The purpose of such an organization would be to allow: 1. Oversight and enforcement for the balanced regulation of multiple interests in space 2. Access for all peoples to the material benefits and knowledge and understanding enabled by the exploration and 3. Pooling of national and industry resources for the creation of space infrastructure, missions and enterprises for Operating principles: 1. The ISA regulatory regime would encourage commercialization and the harnessing of competitive market 2. Consistent with its charter to ensure access to all peoples, all UN member states and appropriate NGOs would 3. Close coordination with appropriate industry-based bodies, e.g. the SGF-recommended International Space The Association for the Development of Aerospace Medicine was established in 1999 as a first step towards creating an International Center for Space Medicine. In this paper, we present this and other work of the SGS delegates relating to new international coordination concepts, such as the Global Education Curriculum and the global space prize.
Internal Medicine Hospitalists' Perceived Barriers and Recommendations for Optimizing Secondary Prevention of Osteoporotic Hip Fractures.

PubMed

Tan, Eng Keong; Loh, Kah Poh; Goff, Sarah L

2017-12-01

Osteoporosis is a major public health concern affecting an estimated 10 million people in the United States. To the best of our knowledge, no qualitative study has explored barriers perceived by medicine hospitalists to secondary prevention of osteoporotic hip fractures. We aimed to describe these perceived barriers and recommendations regarding how to optimize secondary prevention of osteoporotic hip fracture. In-depth, semistructured interviews were performed with 15 internal medicine hospitalists in a tertiary-care referral medical center. The interviews were analyzed with directed content analysis. Internal medicine hospitalists consider secondary osteoporotic hip fracture prevention as the responsibility of outpatient physicians. Identified barriers were stratified based on themes including physicians' perception, patients' characteristics, risks and benefits of osteoporosis treatment, healthcare delivery system, and patient care transition from the inpatient to the outpatient setting. Some of the recommendations include building an integrated system that involves a multidisciplinary team such as the fracture liaison service, initiating a change to the hospital policy to facilitate inpatient care and management of osteoporosis, and creating a smooth patient care transition to the outpatient setting. Our study highlighted how internal medicine hospitalists perceive their role in the secondary prevention of osteoporotic hip fractures and what they perceive as barriers to initiating preventive measures in the hospital. Inconsistency in patient care transition and the fragmented nature of the existing healthcare system were identified as major barriers. A fracture liaison service could remove some of these barriers.
Unhealthy Landscapes: Policy Recommendations on Land Use Change and Infectious Disease Emergence

PubMed Central

Patz, Jonathan A.; Daszak, Peter; Tabor, Gary M.; Aguirre, A. Alonso; Pearl, Mary; Epstein, Jon; Wolfe, Nathan D.; Kilpatrick, A. Marm; Foufopoulos, Johannes; Molyneux, David; Bradley, David J.

2004-01-01

Anthropogenic land use changes drive a range of infectious disease outbreaks and emergence events and modify the transmission of endemic infections. These drivers include agricultural encroachment, deforestation, road construction, dam building, irrigation, wetland modification, mining, the concentration or expansion of urban environments, coastal zone degradation, and other activities. These changes in turn cause a cascade of factors that exacerbate infectious disease emergence, such as forest fragmentation, disease introduction, pollution, poverty, and human migration. The Working Group on Land Use Change and Disease Emergence grew out of a special colloquium that convened international experts in infectious diseases, ecology, and environmental health to assess the current state of knowledge and to develop recommendations for addressing these environmental health challenges. The group established a systems model approach and priority lists of infectious diseases affected by ecologic degradation. Policy-relevant levels of the model include specific health risk factors, landscape or habitat change, and institutional (economic and behavioral) levels. The group recommended creating Centers of Excellence in Ecology and Health Research and Training, based at regional universities and/or research institutes with close links to the surrounding communities. The centers’ objectives would be 3-fold: a) to provide information to local communities about the links between environmental change and public health; b) to facilitate fully interdisciplinary research from a variety of natural, social, and health sciences and train professionals who can conduct interdisciplinary research; and c) to engage in science-based communication and assessment for policy making toward sustainable health and ecosystems. PMID:15238283
Information Filtering via Heterogeneous Diffusion in Online Bipartite Networks

PubMed Central

Zhang, Fu-Guo; Zeng, An

2015-01-01

The rapid expansion of Internet brings us overwhelming online information, which is impossible for an individual to go through all of it. Therefore, recommender systems were created to help people dig through this abundance of information. In networks composed by users and objects, recommender algorithms based on diffusion have been proven to be one of the best performing methods. Previous works considered the diffusion process from user to object, and from object to user to be equivalent. We show in this work that it is not the case and we improve the quality of the recommendation by taking into account the asymmetrical nature of this process. We apply this idea to modify the state-of-the-art recommendation methods. The simulation results show that the new methods can outperform these existing methods in both recommendation accuracy and diversity. Finally, this modification is checked to be able to improve the recommendation in a realistic case. PMID:26125631
Intrapersonal, Behavioral, and Environmental Factors Associated With Meeting Recommended Physical Activity Among Rural Latino Youth

PubMed Central

Perry, Cynthia K.; Saelens, Brian E.; Thompson, Beti

2013-01-01

This study aimed to identify intrapersonal, behavioral, and environmental factors associated with engaging in recommended levels of physical activity among rural Latino middle school youth. Data were from an anonymous survey of 773 Latino youth (51% female) about level of and barriers and motivators to physical activity, risk behaviors, and park use. Logistic regression models identified factors correlated with meeting recommended levels of physical activity (5 days or more 360 min/day). Thirty-four percent of girls and 41% of boys reported meeting this physical activity recommendation. Participation in an organized after school activity (p < .001) and in physical education (PE) classes 5 days a week (p < .001) were strongly associated with meeting recommended physical activity level. Making PE available 5 days a week and creating opportunities for organized after school physical activity programs may increase the number of rural Latino middle school youth who meet recommended physical activity level. PMID:22109778

Intrapersonal, behavioral, and environmental factors associated with meeting recommended physical activity among rural Latino youth.

PubMed

Perry, Cynthia K; Saelens, Brian E; Thompson, Beti

2011-11-01

This study aimed to identify intrapersonal, behavioral, and environmental factors associated with engaging in recommended levels of physical activity among rural Latino middle school youth. Data were from an anonymous survey of 773 Latino youth (51% female) about level of and barriers and motivators to physical activity, risk behaviors, and park use. Logistic regression models identified factors correlated with meeting recommended levels of physical activity (5 days or more 3 60 min/day). Thirty-four percent of girls and 41% of boys reported meeting this physical activity recommendation. Participation in an organized after school activity (p < .001) and in physical education (PE) classes 5 days a week (p < .001) were strongly associated with meeting recommended physical activity level. Making PE available 5 days a week and creating opportunities for organized after school physical activity programs may increase the number of rural Latino middle school youth who meet recommended physical activity level.
Information Filtering via Heterogeneous Diffusion in Online Bipartite Networks.

PubMed

Zhang, Fu-Guo; Zeng, An

2015-01-01

The rapid expansion of Internet brings us overwhelming online information, which is impossible for an individual to go through all of it. Therefore, recommender systems were created to help people dig through this abundance of information. In networks composed by users and objects, recommender algorithms based on diffusion have been proven to be one of the best performing methods. Previous works considered the diffusion process from user to object, and from object to user to be equivalent. We show in this work that it is not the case and we improve the quality of the recommendation by taking into account the asymmetrical nature of this process. We apply this idea to modify the state-of-the-art recommendation methods. The simulation results show that the new methods can outperform these existing methods in both recommendation accuracy and diversity. Finally, this modification is checked to be able to improve the recommendation in a realistic case.
An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy.

PubMed

Kreiner, D Scott; Hwang, Steven W; Easa, John E; Resnick, Daniel K; Baisden, Jamie L; Bess, Shay; Cho, Charles H; DePalma, Michael J; Dougherty, Paul; Fernand, Robert; Ghiselli, Gary; Hanna, Amgad S; Lamer, Tim; Lisi, Anthony J; Mazanec, Daniel J; Meagher, Richard J; Nucci, Robert C; Patel, Rakesh D; Sembrano, Jonathan N; Sharma, Anil K; Summers, Jeffrey T; Taleghani, Christopher K; Tontz, William L; Toton, John F

2014-01-01

The objective of the North American Spine Society's (NASS) Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy is to provide evidence-based recommendations to address key clinical questions surrounding the diagnosis and treatment of lumbar disc herniation with radiculopathy. The guideline is intended to reflect contemporary treatment concepts for symptomatic lumbar disc herniation with radiculopathy as reflected in the highest quality clinical literature available on this subject as of July 2011. The goals of the guideline recommendations are to assist in delivering optimum efficacious treatment and functional recovery from this spinal disorder. To provide an evidence-based educational tool to assist spine specialists in the diagnosis and treatment of lumbar disc herniation with radiculopathy. Systematic review and evidence-based clinical guideline. This guideline is a product of the Lumbar Disc Herniation with Radiculopathy Work Group of NASS' Evidence-Based Guideline Development Committee. The work group consisted of multidisciplinary spine care specialists trained in the principles of evidence-based analysis. A literature search addressing each question and using a specific search protocol was performed on English-language references found in Medline, Embase (Drugs and Pharmacology), and four additional evidence-based databases to identify articles. The relevant literature was then independently rated using the NASS-adopted standardized levels of evidence. An evidentiary table was created for each of the questions. Final recommendations to answer each clinical question were developed via work group discussion, and grades were assigned to the recommendations using standardized grades of recommendation. In the absence of Level I to IV evidence, work group consensus statements have been developed using a modified nominal group technique, and these statements are clearly identified as such in the guideline. Twenty-nine clinical questions were formulated and addressed, and the answers are summarized in this article. The respective recommendations were graded by strength of the supporting literature, which was stratified by levels of evidence. The clinical guideline has been created using the techniques of evidence-based medicine and best available evidence to aid practitioners in the care of patients with symptomatic lumbar disc herniation with radiculopathy. The entire guideline document, including the evidentiary tables, suggestions for future research, and all the references, is available electronically on the NASS Web site at http://www.spine.org/Pages/PracticePolicy/ClinicalCare/ClinicalGuidlines/Default.aspx and will remain updated on a timely schedule. Copyright © 2014 Elsevier Inc. All rights reserved.
Aviation Medical Examiner 2012 Feedback Survey: Content Analysis of Recommendations

DTIC Science & Technology

2013-06-01

not for the purpose of comparison but due to different operational conditions. Results provide a programmatic view of AME-recommended improvements...type of AME, not for purposes of comparison, but due to different operational conditions. Two AME groups were created--a domestic group and a combined...were distinct differences between the groups (Table 22), which likely reflects differences in levels of experience with the various systems /tools
CNS role evolution.

PubMed

Payne, J L; Baumgartner, R G

1996-01-01

THE CNS ROLE has been actualized in a variety of ways. Flexibility-inherent in the role-and the revolution in health care consciousness tend to place the CNS at risk for criticism regarding value to the organization. At Vanderbilt University Medical Center, a CNS task force evaluated the current reality of CNS practice and recommended role changes to include the financial analysis of patient care. After incorporating a financial perspective into our present practice, we have embarked on an interesting journey of post-Master's degree study, that of the tertiary care nurse practitioner. This practice option could elevated the clinical and financial aspects of providing cost-effective health care to a more autonomous role form; however, the transition has been challenging. Since 1990, the American Nurses Association has recommended that nursing school curricula change to meet the needs of the health care environment and provide increased career flexibility through creating one advanced degree incorporating both CNS and NP functions. Swiftly moving past differences and toward similarities will bridge the gap for advanced practice nurses in the future.
Aluminum Data Measurements and Evaluation for Criticality Safety Applications

NASA Astrophysics Data System (ADS)

Leal, L. C.; Guber, K. H.; Spencer, R. R.; Derrien, H.; Wright, R. Q.

2002-12-01

The Defense Nuclear Facility Safety Board (DNFSB) Recommendation 93-2 motivated the US Department of Energy (DOE) to develop a comprehensive criticality safety program to maintain and to predict the criticality of systems throughout the DOE complex. To implement the response to the DNFSB Recommendation 93-2, a Nuclear Criticality Safety Program (NCSP) was created including the following tasks: Critical Experiments, Criticality Benchmarks, Training, Analytical Methods, and Nuclear Data. The Nuclear Data portion of the NCSP consists of a variety of differential measurements performed at the Oak Ridge Electron Linear Accelerator (ORELA) at the Oak Ridge National Laboratory (ORNL), data analysis and evaluation using the generalized least-squares fitting code SAMMY in the resolved, unresolved, and high energy ranges, and the development and benchmark testing of complete evaluations for a nuclide for inclusion into the Evaluated Nuclear Data File (ENDF/B). This paper outlines the work performed at ORNL to measure, evaluate, and test the nuclear data for aluminum for applications in criticality safety problems.
Assessing lung function and respiratory health in schoolchildren as a means to improve local environmental conditions.

PubMed

Hutter, Hans-Peter; Borsoi, Livia; Wallner, Peter; Moshammer, Hanns; Kundi, Michael

2009-07-01

In response to the World Health Organization Children's Environment and Health Action Plan for Europe (CEHAPE), a town near Vienna initiated a health survey of schoolchildren. To create recommendations for the community's decision makers, the health survey tried to identify the environmental factors influencing the respiratory health of children. The survey consisted of a questionnaire and spirometry. For 186 of 207 children of first and second grade, parents consented to include their children and answered a questionnaire. Spirometry was performed in 177 children. Results of lung function testing revealed that lung function was significantly reduced in children with visible mould infestation at home and living on a street with frequent lorry traffic. Larger family size and living in a rural area had positive effects on lung function. Our study provides an example for a feasible strategy to provide local decision makers with recommendations based on scientific evidence and actual observations and to help them implement measures in accordance with CEHAPE.
Implementing Physical Activity Recommendations in a Tri-ethnic Rural Community through a Community-University Partnership

PubMed Central

Davis, Sally M.; Cruz, Theresa; Hess, Julia Meredith; Kozoll, Richard; Page-Reeves, Janet

2016-01-01

Background A tri-ethnic rural community with limited resources and a university Prevention Research Center developed a partnership to promote evidence-based physical activity. Objective The purpose of this study was to investigate how a community-university partnership can disseminate and implement The Community Guide’s recommendations for increasing physical activity and create a model for other under-resourced communities experiencing high rates of chronic disease. Methods Qualitative data collected through 47 semi-structured interviews, meeting minutes, and local newspaper articles were coded for themes and analyzed for patterns across the data. Results Implementation resulted in the creation of new paths and trails, increased walkability throughout the community, local park enhancements, and a community-wide campaign. Lessons learned included the importance of community-defined goals and outcomes, leadership, volunteerism, mutually beneficial goals, synergy, and having non-traditional partners. Conclusion This research provides a community-university partnership model for implementing evidence-based strategies to increase physical activity in rural communities. PMID:28736407
Evaluation of Chemical Coating Processes for AXAF

NASA Technical Reports Server (NTRS)

Engelhaupt, Darell; Ramsey, Brian; Mendrek, Mitchell

1998-01-01

The need existed at MSFC for the development and fabrication of radioisotope calibration sources of cadmium 109 and iron 55 isotopes. This was in urgent response to the AXA-F program. Several issues persisted in creating manufacturing difficulties for the supplier. In order to meet the MSFC requirements very stringent control needed to be maintained for the coating quality, specific activity and thickness. Due to the difficulties in providing the precisely controlled devices for testing, the delivery of the sources was seriously delayed. It became imperative that these fabrication issues be resolved to avoid further delays in this AXA-F observatory key component. The objectives are: 1) Research and provide expert advice on coating materials and procedures. 2) Research and recommend solutions to problems that have been experienced with the coating process. 3) Provide recommendations on the selection and preparation of substrates. 4) Provide consultation on the actual coating process including the results of the qualification and acceptance test programs. 5) Perform independent tests at UAH or MSFC as necessary.
Pediatricians Transitioning Practices, Youth With Special Health Care Needs in New York State.

PubMed

Davidson, Lynn F; Chhabra, Rosy; Cohen, Hillel W; Lechuga, Claudia; Diaz, Patricia; Racine, Andrew

2015-10-01

To assess current practices of New York State pediatricians as they transition youth with special health care needs to adult-oriented medical care. A survey of New York State pediatricians included 6 critical steps from 2002 consensus statement, 11 essential steps adapted from recent literature, and questions targeting age of starting transition and availability of transition policy. Of 181 respondents, only 11% have a transition policy. Most assist patients in transition process; identify an adult provider (92%); and create portable medical summary (57%). Only 3% start planning process at recommended age. No respondents are compliant with all 6 critical steps; subspecialists were more likely to report compliance to more than 4 steps. Participating pediatricians are making gains, yet effort is needed, to incorporate the essential steps into practice for transitioning youth with special health care needs. Recognition of barriers, use of electronic tools, and clarifying subspecialist's approach, may improve compliance with transition recommendations. © The Author(s) 2015.
A review of obesity-themed policy briefs.

PubMed

Dodson, Elizabeth A; Eyler, Amy A; Chalifour, Stephanie; Wintrode, Christopher G

2012-09-01

Policy approaches are one of the most promising population-based means of addressing the epidemic of obesity in the U.S., especially as they create supportive environments for healthy living. Policy briefs can be an effective means of disseminating research information to inform obesity prevention efforts; however, they are often ineffective because of length, density, and inaccessibility. The purposes of this project were to identify a collection of obesity-related policy briefs, analyze the content, and make recommendations for model policy briefs. In 2010, online searching strategies were developed with criteria that included a primary topical focus on obesity, written between 2000 and 2010, targeting any population age group, including a policy-change message, and being readily available online. The research team developed a coding tool and used it to analyze briefs. A subsample of the briefs was used for further analysis on dissemination. Analyses were conducted on 100 briefs. Most (72%) were developed between 2005 and 2010; the average length was five pages. The majority had no tables, few figures, and only 36% included photos. The average reading level was high. A lack of monitoring or evaluating dissemination efforts prevailed. Policy briefs represent an effective, often-preferred, potent tool for public health practitioners and researchers to communicate information to policymakers. Recommendations include presenting information clearly, using a concise format, including design elements, noting reference and contact information, employing active and targeted dissemination efforts, and conducting evaluation. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Report for Task 8.4: Development of Control Room Layout Recommendations

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

McDonald, Robert

Idaho National Laboratory (INL) has contracted Institutt for Energiteknikk (IFE) to support in the development of an end state vision for the US Nuclear industry and in particular for a utility that is currently moving forward with a control room modernization project. This support includes the development of an Overview display and technical support in conducting an operational study. Development of operational scenarios to be conducted using a full scope simulator at the INL HSSL. Additionally IFE will use the CREATE modelling tool to provide 3-D views of the potential and possible end state view after the completion of digitalmore » upgrade project.« less
Strategic management of technostress. The chaining of Prometheus.

PubMed

Caro, D H; Sethi, A S

1985-12-01

The article proposes the concept of technostress and makes a strong recommendation for conducting research based on key researchable hypotheses. A conceptual framework of technostress is suggested to provide some focus to future research. A number of technostress management strategies are put forward, including strategic technological planning, organization culture development, technostress monitoring systems, and technouser self-development programs. The management of technostress is compared to the chaining of Prometheus, which, left uncontrolled, can create havoc in an organization. The authors believe that organizations have a responsibility to introduce, diffuse, and manage computer technology in such a way that it is congruent with the principles of sound, supportive, and humanistic management.
Impact of Ada and object-oriented design in the flight dynamics division at Goddard Space Flight Center

NASA Technical Reports Server (NTRS)

Waligora, Sharon; Bailey, John; Stark, Mike

1995-01-01

The Software Engineering Laboratory (SEL) is an organization sponsored by NASA/GSFC and created to investigate the effectiveness of software engineering technologies when applied to the development of applications software. The goals of the SEL are (1) to understand the software development process in the GSFC environment; (2) to measure the effects of various methodologies, tools, and models on this process; and (3) to identify and then to apply successful development practices. The activities, findings, and recommendations of the SEL are recorded in the Software Engineering Laboratory Series, a continuing series of reports that includes this document.
Pitfalls With the New American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy.

PubMed

Pauli, Jaimey M; Repke, John T

2017-03-01

The American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy was created to evaluate the existing literature, develop practice guidelines, and identify areas for future research focus. Several issues were identified that may not have been initially obvious during the process of developing this document, including limited practical use, a lack of high quality literature, conflicting recommendations, a potential for high resource utilization, need for continually updated information, and little headway in research that is clinically useful. The purpose of this review was to make suggestions to improving these guidelines' overall usefulness and consistency for the busy clinician.
Impact of the Minimum Wage on Compression.

ERIC Educational Resources Information Center

Wolfe, Michael N.; Candland, Charles W.

1979-01-01

Assesses the impact of increases in the minimum wage on salary schedules, provides guidelines for creating a philosophy to deal with the impact, and outlines options and presents recommendations. (IRT)
Protecting the world against meningitis: new recommendations from the CDC's advisory committee on immunization practices.

PubMed

Cyrus, Scott S

2011-10-01

Meningococcal meningitis is a rare but often fatal disease. Throughout adolescence, the incidence of meningococcal meningitis increases, reaching a peak among individuals between the ages of 16 and 21 years. Vaccines are available to combat this deadly disease. Recently, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices updated its recommendations on meningitis vaccination to improve outcomes and to prevent this disease in adolescents and other vulnerable populations, such as adults traveling internationally to epidemic areas. Improved meningitis vaccines and revised vaccination recommendations will help to create a healthier world.
Integrating nurse researchers in clinical practice - a challenging, but necessary task for nurse leaders.

PubMed

Hølge-Hazelton, Bibi; Kjerholt, Mette; Berthelsen, Connie Bøttcher; Thomsen, Thora Grothe

2016-05-01

To create awareness among nurse leaders, of what they may need to consider, when integrating nurse researchers as advanced nurse practitioners (ANP) at PhD-level among their staff. In a time of transition nurse leaders may be challenged by the change towards evidence-based clinical nursing, including integrating nurse researchers in ANP positions. A collective case study including three ANPs took place at a large regional hospital in Denmark. The cases were first analysed by focusing on the generic features, functions and skills of ANPs, and second by focusing on the approaches to evidence-based practice seen in the cases. Regardless of same position, formal level of research expertise and overall responsibility, different approaches related to each ANPs professional profile, interest, academic ambitions and personality were seen. Nurse leaders must ensure a process where the content and expectations of the particular role are mutually clarified and adjusted to the individual ANP and to the specific context, in order to create a harmonious match. In order to clarify expectations regarding the inclusion of nurse researchers as ANPs at PhD level, the paper provides firm recommendations that may guide the process. © 2015 John Wiley & Sons Ltd.
Evidenced-Based Guidelines on the Treatment of Fibromyalgia Patients: Are They Consistent and If Not, Why Not? Have Effective Psychological Treatments Been Overlooked?

PubMed

Thieme, Kati; Mathys, Marc; Turk, Dennis C

2017-07-01

We compared the recommendations and methodology of several recent evidence-based guidelines for the management of patients with fibromyalgia published by professional organizations: 1) American Pain Society (APS; 2005), 2) Association of the Scientific Medical Societies in Germany (AWMF; 2012), 3) Canadian Pain Society (CPS; 2013; also used in the United Kingdom), and 4) European League Against Rheumatism (EULAR; 2016). Each guideline used systematic reviews and meta-analyses as highest level of evidence; APS, CPS, and AWMF also included individual randomized clinical trials. The APS, CPS, and AWMF assigned the highest ranking of recommendation to aerobic exercise, cognitive-behavioral therapy, amitriptyline, and multicomponent treatment. In contrast, the most recent EULAR guidelines assign the highest level of recommendation to exercise, contrary to the 2008 EULAR guidelines, which recommended pharmacotherapy. Although there was some consistency for pharmacological treatment recommendations among the 4 guidelines, APS, CPS, and AWMF guidelines gave the higher ranking to cognitive-behavioral therapy and multicomponent treatments. The inconsistencies across guidelines can be attributed to the criteria used for study inclusion, outcome measures used, weighting systems, and composition of the review panels. A guideline consensus is needed to harmonize the discrepancies. This article presents an overview and highlights the inconsistencies of 4 recent clinical practice guidelines for treatment of fibromyalgia patients related to study inclusion criteria, outcome measures used, ranking system used, and composition of the review panels. The discrepancies suggest a need to create a guideline consensus to synthesize guidelines. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.
The understandings and meanings eight seventh and eighth grade Latinas gave to science

NASA Astrophysics Data System (ADS)

Parker, Carolyn Ann

My study examined the experiences of eight seventh and eighth grade girls of Central American descent, in and out of the science classroom. The study was interpretive in design and explored the question, "How did the eight participants understand and make meaning of science?" Guided by a sociocultural perspective and a socially critical stance, I explored issues of educational access, particularly to science, mediated by the relationships and experiences formed by families, peers, science classrooms, schools, and society. Data sources included monthly individual interviews, regular focus group meetings, school observations, and interviews with teachers and family members. Findings include the importance of school science experiences that emphasize hands-on activities and the study of topics relevant to students' everyday lives. School influences that I discuss include English-as-a-Second Language learning, English language ability and its effect on classroom interactions, ability grouping, standardized testing, and teachers' instructional practices. Out-of-school influences I examine include the national science education reform movement, familial expectations, and society and the media's portrayal of science and the scientist. The implications and recommendations of the study are particularly germane to practice. Recommendations for the science classroom include a continued emphasis on hands-on science experiences that incorporate high academic expectations for all students, including second-language learners. Moreover, curriculum should be connected and relevant to students' everyday experiences. Recommendations for outside-the-science classroom include a thoughtful examination of the educational environment created by a school's tracking policy and continued support of meaningful professional development experiences for teachers. Future research and the subsequent development of theory should include a further analysis of the influence of gender, ethnicity, science, and recently immigrated students. A study of the influence of English-language ability on students' educational experiences would be especially informative. Studies like this can assist the science education community to implement gender and culturally-equitable curricula, instructional materials, and assessment strategies that could better meet the needs of students who have historically been underrepresented in the discipline, including, but not limited to, second-language learners and recent immigrants to the United States.

An evidence-based clinical guideline for the use of antithrombotic therapies in spine surgery.

PubMed

Bono, Christopher M; Watters, William C; Heggeness, Michael H; Resnick, Daniel K; Shaffer, William O; Baisden, Jamie; Ben-Galim, Peleg; Easa, John E; Fernand, Robert; Lamer, Tim; Matz, Paul G; Mendel, Richard C; Patel, Rajeev K; Reitman, Charles A; Toton, John F

2009-12-01

The objective of the North American Spine Society (NASS) Evidence-Based Clinical Guideline on antithrombotic therapies in spine surgery was to provide evidence-based recommendations to address key clinical questions surrounding the use of antithrombotic therapies in spine surgery. The guideline is intended to address these questions based on the highest quality clinical literature available on this subject as of February 2008. The goal of the guideline recommendations was to assist in delivering optimum, efficacious treatment with the goal of preventing thromboembolic events. To provide an evidence-based, educational tool to assist spine surgeons in minimizing the risk of deep venous thrombosis (DVT) and pulmonary embolism (PE). Systematic review and evidence-based clinical guideline. This report is from the Antithrombotic Therapies Work Group of the NASS Evidence-Based Guideline Development Committee. The work group was composed of multidisciplinary spine care specialists, all of whom were trained in the principles of evidence-based analysis. Each member of the group was involved in formatting a series of clinical questions to be addressed by the group. The final questions agreed on by the group are the subject of this report. A literature search addressing each question and using a specific search protocol was performed on English language references found in MEDLINE, EMBASE (Drugs and Pharmacology), and four additional, evidence-based databases. The relevant literature was then independently rated by at least three reviewers using the NASS-adopted standardized levels of evidence. An evidentiary table was created for each of the questions. Final grades of recommendation for the answers to each clinical question were arrived at via Web casts among members of the work group using standardized grades of recommendation. When Level I to IV evidence was insufficient to support a recommendation to answer a specific clinical question, expert consensus was arrived at by the work group through the modified nominal group technique and is clearly identified as such in the guideline. Fourteen clinical questions were formulated, addressing issues of incidence of DVT and PE in spine surgery and recommendations regarding utilization of mechanical prophylaxis and chemoprophylaxis in spine surgery. The answers to these 14 clinical questions are summarized in this article. The respective recommendations were graded by the strength of the supporting literature that was stratified by levels of evidence. A clinical guideline addressing the use of antithrombotic therapies in spine surgery has been created using the techniques of evidence-based medicine and using the best available evidence as a tool to assist spine surgeons in minimizing the risk of DVT and PE. The entire guideline document, including the evidentiary tables, suggestions for future research, and all references, is available electronically at the NASS Web site (www.spine.org) and will remain updated on a timely schedule.
Quality improvement to guide the new health system.

PubMed

Merry, M D

2001-03-01

While there are many areas, such as intensive care treatment and pain management, where great gains in quality improvement can be made, the greatest strides will come as the leaders and trustees in health care organizations begin to create "the industrial revolution" in their organizations by creating cultures of quality. Stephen Shortell recommends the following list of things board members can do to improve quality in their organizations.
Enhancing RN-to-BSN students' information literacy skills through the use of instructional technology.

PubMed

Schutt, Michelle A; Hightower, Barbara

2009-02-01

The American Association of Colleges of Nursing advocates that professional nurses have the information literacy skills essential for evidence-based practice. As nursing schools embrace evidence-based models to prepare students for nursing careers, faculty can collaborate with librarians to create engaging learning activities focused on the development of information literacy skills. Instructional technology tools such as course management systems, virtual classrooms, and online tutorials provide opportunities to reach students outside the traditional campus classroom. This article discusses the collaborative process between faculty and a library instruction coordinator and strategies used to create literacy learning activities focused on the development of basic database search skills for a Computers in Nursing course. The activities and an online tutorial were included in a library database module incorporated into WebCT. In addition, synchronous classroom meeting software was used by the librarian to reach students in the distance learning environment. Recommendations for module modifications and faculty, librarian, and student evaluations are offered.
A Collaborative Location Based Travel Recommendation System through Enhanced Rating Prediction for the Group of Users

PubMed Central

Ravi, Logesh; Vairavasundaram, Subramaniyaswamy

2016-01-01

Rapid growth of web and its applications has created a colossal importance for recommender systems. Being applied in various domains, recommender systems were designed to generate suggestions such as items or services based on user interests. Basically, recommender systems experience many issues which reflects dwindled effectiveness. Integrating powerful data management techniques to recommender systems can address such issues and the recommendations quality can be increased significantly. Recent research on recommender systems reveals an idea of utilizing social network data to enhance traditional recommender system with better prediction and improved accuracy. This paper expresses views on social network data based recommender systems by considering usage of various recommendation algorithms, functionalities of systems, different types of interfaces, filtering techniques, and artificial intelligence techniques. After examining the depths of objectives, methodologies, and data sources of the existing models, the paper helps anyone interested in the development of travel recommendation systems and facilitates future research direction. We have also proposed a location recommendation system based on social pertinent trust walker (SPTW) and compared the results with the existing baseline random walk models. Later, we have enhanced the SPTW model for group of users recommendations. The results obtained from the experiments have been presented. PMID:27069468
Conflicts of Interest in Clinical Guidelines: Update of U.S. Preventive Services Task Force Policies and Procedures.

PubMed

Ngo-Metzger, Quyen; Moyer, Virginia; Grossman, David; Ebell, Mark; Woo, Meghan; Miller, Therese; Brummer, Tana; Chowdhury, Joya; Kato, Elisabeth; Siu, Albert; Phillips, William; Davidson, Karina; Phipps, Maureen; Bibbins-Domingo, Kirsten

2018-01-01

The U.S. Preventive Services Task Force (USPSTF) provides independent, objective, and scientifically rigorous recommendations for clinical preventive services. A primary concern is to avoid even the appearance of members having special interests that might influence their ability to judge evidence and formulate unbiased recommendations. The conflicts of interest policy for the USPSTF is described, as is the formal process by which best practices were incorporated to update the policy. The USPSTF performed a literature review, conducted key informant interviews, and reviewed conflicts of interest policies of ten similar organizations. Important findings included transparency and public accessibility; full disclosure of financial relationships; disclosure of non-financial relationships (that create the potential for bias and compromise a member's objective judgment); disclosure of family members' conflicts of interests; and establishment of appropriate reporting periods. Controversies in best practices include the threshold of financial disclosures, ease of access to conflicts of interest policies and declarations, vague definition of non-financial biases, and request for family members' conflicts of interests (particularly those that are non-financial in nature). The USPSTF conflicts of interest policy includes disclosures for immediate family members, a clear non-financial conflicts of interest definition, long look-back period and application of the policy to prospective members. Conflicts of interest is solicited from all members every 4 months, formally reviewed, adjudicated, and made publicly available. The USPSTF conflicts of interest policy is publicly available as part of the USPSTF Procedure Manual. A continuous improvement process can be applied to conflicts of interest policies to enhance public trust in members of panels, such as the USPSTF, that produce clinical guidelines and recommendations. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder.

PubMed

Yatham, Lakshmi N; Kennedy, Sidney H; Parikh, Sagar V; Schaffer, Ayal; Bond, David J; Frey, Benicio N; Sharma, Verinder; Goldstein, Benjamin I; Rej, Soham; Beaulieu, Serge; Alda, Martin; MacQueen, Glenda; Milev, Roumen V; Ravindran, Arun; O'Donovan, Claire; McIntosh, Diane; Lam, Raymond W; Vazquez, Gustavo; Kapczinski, Flavio; McIntyre, Roger S; Kozicky, Jan; Kanba, Shigenobu; Lafer, Beny; Suppes, Trisha; Calabrese, Joseph R; Vieta, Eduard; Malhi, Gin; Post, Robert M; Berk, Michael

2018-03-01

The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third- line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment-emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second- line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence-based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first-line treatments for acute mania. First-line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first-line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Creating a segregated medical profession: African American physicians and organized medicine, 1846-1910.

PubMed

Baker, Robert B; Washington, Harriet A; Olakanmi, Ololade; Savitt, Todd L; Jacobs, Elizabeth A; Hoover, Eddie; Wynia, Matthew K; Blanchard, Janice; Boulware, L Ebony; Braddock, Clarence; Corbie-Smith, Giselle; Crawley, LaVera; LaVeist, Thomas A; Maxey, Randall; Mills, Charles; Moseley, Kathryn L; Williams, David R

2009-06-01

An independent panel of experts, convened by the American Medical Association (AMA) Institute for Ethics, analyzed the roots of the racial divide within American medical organizations. In this, the first of a 2-part report, we describe 2 watershed moments that helped institutionalize the racial divide. The first occurred in the 1870s, when 2 medical societies from Washington, DC, sent rival delegations to the AMA's national meetings: an all-white delegation from a medical society that the US courts and Congress had formally censured for discriminating against black physicians; and an integrated delegation from a medical society led by physicians from Howard University. Through parliamentary maneuvers and variable enforcement of credentialing standards, the integrated delegation was twice excluded from the AMA's meetings, while the all-white society's delegations were admitted. AMA leaders then voted to devolve the power to select delegates to state societies, thereby accepting segregation in constituent societies and forcing African American physicians to create their own, separate organizations. A second watershed involved AMA-promoted educational reforms, including the 1910 Flexner report. Straightforwardly applied, the report's population-based criterion for determining the need for phySicians would have recommended increased training of African American physicians to serve the approximately 9 million African Americans in the segregated south. Instead, the report recommended closing all but 2 African American medical schools, helping to cement in place an African American educational system that was separate, unequal, and destined to be insufficient to the needs of African Americans nationwide.
Implementation science in low-resource settings: using the interactive systems framework to improve hand hygiene in a tertiary hospital in Ghana.

PubMed

Kallam, Brianne; Pettitt-Schieber, Christie; Owen, Medge; Agyare Asante, Rebecca; Darko, Elizabeth; Ramaswamy, Rohit

2018-05-19

Low-resource clinical settings often face obstacles that challenge the implementation of recommended evidence-based practices (EBPs). Implementation science approaches are useful in identifying barriers and developing strategies to address them. Ridge Regional Hospital (RRH), a tertiary referral hospital in Accra, Ghana experienced a spike in rates of neonatal sepsis and launched a quality improvement (QI) initiative that identified poor adherence to hand hygiene in the neonatal intensive care unit as a potential source of infections. A multi-modal change package of World Health Organization-recommended solutions was created to address this issue. To ensure that the outputs of the QI effort were adopted within the organization, leaders at RRH and Kybele, Inc. used an implementation science framework called the 'Interactive Systems Framework for Dissemination and Implementation' (ISF) to create a package of locally acceptable implementation strategies. The ISF has never been used before to guide implementation in low-resource settings. Hand hygiene compliance rose from 67% to 92% overall, including a 36% increase during the night shifts-a group of healthcare workers with typically very low levels of compliance. The drastic improvement in adherence to hand hygiene suggests the potential value of the joint use of QI and implementation science to promote the creation and application of contextually appropriate EBPs in low-resource settings. Our results also suggest that using an implementation framework such as the ISF could rapidly increase the uptake of other evidence-based interventions in low-resource settings.
Evacuation Simulation in Kalayaan Residence Hall, up Diliman Using Gama Simulation Software

NASA Astrophysics Data System (ADS)

Claridades, A. R. C.; Villanueva, J. K. S.; Macatulad, E. G.

2016-09-01

Agent-Based Modeling (ABM) has recently been adopted in some studies for the modelling of events as a dynamic system given a set of events and parameters. In principle, ABM employs individual agents with assigned attributes and behaviors and simulates their behavior around their environment and interaction with other agents. This can be a useful tool in both micro and macroscale-applications. In this study, a model initially created and applied to an academic building was implemented in a dormitory. In particular, this research integrates three-dimensional Geographic Information System (GIS) with GAMA as the multi-agent based evacuation simulation and is implemented in Kalayaan Residence Hall. A three-dimensional GIS model is created based on the floor plans and demographic data of the dorm, including respective pathways as networks, rooms, floors, exits and appropriate attributes. This model is then re-implemented in GAMA. Different states of the agents and their effect on their evacuation time were then observed. GAMA simulation with varying path width was also implemented. It has been found out that compared to their original states, panic, eating and studying will hasten evacuation, and on the other hand, sleeping and being on the bathrooms will be impedances. It is also concluded that evacuation time will be halved when path widths are doubled, however it is recommended for further studies for pathways to be modeled as spaces instead of lines. A more scientific basis for predicting agent behavior in these states is also recommended for more realistic results.
Recommended minimal emergency equipment and resources for schools: national consensus group report.

PubMed

Bobo, Nichole; Hallenbeck, Paula; Robinson, Judith

2003-06-01

Providing an environment that is responsive to emergency health needs of students is essential to creating a safe setting for children in schools. The question of what minimal essential emergency equipment and resources should be available in schools brings with it many and varied opinions, issues, and concerns. Through funding from the Emergency Medical Services for Children (EMSC), the National Association of School Nurses (NASN) was charged with the task of convening a consensus group to formulate a recommended list of minimal essential emergency equipment and resources that should be present in all schools. This article provides an overview of the issues surrounding minimal emergency equipment needs for schools, presents recommended minimal emergency equipment and resources, and recommendations for further actions.
2006 AAHA canine vaccine guidelines.

PubMed

Paul, Michael A; Carmichael, Leland E; Childers, Henry; Cotter, Susan; Davidson, Autumn; Ford, Richard; Hurley, Kate F; Roth, James A; Schultz, Ronald D; Thacker, Eileen; Welborn, Link

2006-01-01

In 2005, AAHA's Canine Vaccine Task Force met to reexamine and revise guidelines on the use of vaccines in dogs. The results of the Task Force's work are summarized and tabulated in this article and are published in their entirety on the AAHA website (www.aahanet.org). The 2006 AAHA Canine Vaccine Guidelines contain information on new technological developments in vaccines, an introduction to conditionally licensed vaccines, and detailed recommendations on the use of available vaccines. Perhaps the most noteworthy addition to the guidelines is a separate set of recommendations created for shelter facilities. Vaccines are classified as core (universally recommended), noncore (optional), or not recommended. The Task Force recognizes that vaccination decisions must always be made on an individual basis, based on risk and lifestyle factors.
Mystery Boxes, X Rays, and Radiology.

ERIC Educational Resources Information Center

Thomson, Norman

2000-01-01

Indicates the difficulties of teaching concepts beyond light and color and creating memorable learning experiences. Recommends sequential activities using the mystery box approach to explain how scientists and doctors use photon applications. (YDS)
Erosion Control and Environment Restoration Plan Development, Matagorda County, Texas. Phase 2. Preliminary Design

DTIC Science & Technology

2013-08-01

recommended groin system. ......................... 37 Figure 23. H1% and Hs at the groin toe as a function of storm surge...phases of work. Keep in mind, the recommended groin system design will advance the shoreline; however, without dune and vegetation management, it...will not create a wider dry beach. Since the existing beach is presumably in equili- brium, the dune and vegetation will advance with the shoreline
STS/SCA/AmSECT Clinical Practice Guidelines: Anticoagulation during Cardiopulmonary Bypass.

PubMed

Shore-Lesserson, Linda; Baker, Robert A; Ferraris, Victor; Greilich, Philip E; Fitzgerald, David; Roman, Philip; Hammon, John

2018-03-01

Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, the Society of Thoracic Surgeons (STS), the Society of Cardiovascular Anesthesiologists (SCA), and the American Society of Extracorporeal Technology (AmSECT) developed an Evidence Based Workgroup. This was a group of interdisciplinary professionals gathered together to summarize the evidence and create practice recommendations for various aspects of CPB. To date, anticoagulation practices in CPB have not been standardized in accordance with the evidence base. This clinical practice guideline was written with the intent to fill the evidence gap and to establish best practices in anticoagulation for CPB using the available evidence. To identify relevant evidence a systematic review was outlined and literature searches were conducted in PubMed® using standardized MeSH terms from the National Library of Medicine list of search terms. Search dates were inclusive of January 2000 to December 2015. The search yielded 833 abstracts which were reviewed by two independent reviewers. Once accepted into the full manuscript review stage, two members of the writing group evaluated each of 286 full papers for inclusion eligibility into the guideline document. Ninety-six manuscripts were included in the final review. In addition, 17 manuscripts published prior to 2000 were included to provide method, context, or additional supporting evidence for the recommendations as these papers were considered sentinel publications. Members of the writing group wrote and developed recommendations based on review of the articles obtained and achieved more than two thirds agreement on each recommendation. The quality of information for a given recommendation allowed assessment of the level of evidence as recommended by the AHA/ACCF Task Force on Practice Guidelines. Recommendations were written in the three following areas 1) Heparin dosing and monitoring for initiation and maintenance of CPB, 2) Heparin contraindications and heparin alternatives, 3) Reversal of anticoagulation during cardiac operations. It is hoped that this guideline will serve as a resource and will stimulate investigators to conduct more research and expand upon the evidence base on the topic of anticoagulation for CPB.
Deception in research: distinctions and solutions from the perspective of utilitarianism.

PubMed

Pittenger, David J

2002-01-01

The use of deception in psychological research continues to be a controversial topic. Using Rawls's explication of utilitarianism, I attempt to demonstrate how professional organizations, such as the American Psychological Association, can provide more specific standards that determine the permissibility of deception in research. Specifically, I argue that researchers should examine the costs and benefits of creating and applying specific rules governing deception. To that end, I offer 3 recommendations. First, that researchers who use deception provide detailed accounts of the procedures they used to minimize the harm created by deception in their research reports. Second, that the American Psychological Association offer a definition of deception that describes techniques commonly used in research. Finally, I recommend that the informed consent procedure be revised to indicate that the researcher may use deception as part of the study.
We Made Your Bed, Why Won’t You Lie in It? Food Availability and Disease May Affect Reproductive Output of Reintroduced Frogs

PubMed Central

Valdez, Jose; Stockwell, Michelle; Fardell, Loren; Clulow, Simon; Clulow, John; Mahony, Michael

2016-01-01

Mitigation to offset the impacts of land development is becoming increasingly common, with reintroductions and created habitat programs used as key actions. However, numerous reviews cite high rates of poor success from these programs, and a need for improved monitoring and scientific testing to evaluate outcomes and improve management actions. We conducted extensive monitoring of a released population of endangered green and golden bell frogs, Litoria aurea, within a created habitat, as well as complementary surveys of a surrounding wild population. We then compared differences between the created habitat and natural ponds where extant frogs either bred or didn’t breed in order to determine factors that contributed to the breeding failure within the created habitat. We evaluated differences of L. aurea abundance, abundance of other fauna, vegetation, water quality, habitat structure, invasive fish, and disease between the three pond types (created habitat, breeding ponds, non-breeding ponds). We discovered that vegetation and invertebrate diversity were low within the created habitat, potentially reducing energy and nutritional resources required for breeding. Also, a greater proportion of frogs in the created habitat were carrying the chytrid fungal pathogen, Batrachochytrium dendrobatidis, compared to the wild populations. In addition to causing the potentially fatal disease, chytridiomycosis, this pathogen has been shown to reduce reproductive functioning in male L. aurea, and subsequently may have reduced reproductive activities in the created habitat. Conspecific attraction, pond hydrology, and aquatic vegetation may also have had some influence on breeding behaviours, whilst the presence of the invasive mosquitofish, Gambusia holbrooki, and heterospecific tadpoles were unlikely to have deterred L. aurea from breeding within the created habitat. Through the use of scientific testing and monitoring, this study is able to make recommendations for future amphibian breed and release programs, and suggests planting a diversity of plant species to attract invertebrates, creating some permanent ponds, connecting habitat with existing populations, trialling artificial mating calls, and following recommendations to reduce the prevalence of disease within the population. PMID:27463095
In-flight cardiac arrest and in-flight cardiopulmonary resuscitation during commercial air travel: consensus statement and supplementary treatment guideline from the German Society of Aerospace Medicine (DGLRM).

PubMed

Hinkelbein, Jochen; Böhm, Lennert; Braunecker, Stefan; Genzwürker, Harald V; Kalina, Steffen; Cirillo, Fabrizio; Komorowski, Matthieu; Hohn, Andreas; Siedenburg, Jörg; Bernhard, Michael; Janicke, Ilse; Adler, Christoph; Jansen, Stefanie; Glaser, Eckard; Krawczyk, Pawel; Miesen, Mirko; Andres, Janusz; De Robertis, Edoardo; Neuhaus, Christopher

2018-05-05

By the end of the year 2016, approximately 3 billion people worldwide travelled by commercial air transport. Between 1 out of 14,000 and 1 out of 50,000 passengers will experience acute medical problems/emergencies during a flight (i.e., in-flight medical emergency). Cardiac arrest accounts for 0.3% of all in-flight medical emergencies. So far, no specific guideline exists for the management and treatment of in-flight cardiac arrest (IFCA). A task force with clinical and investigational expertise in aviation, aviation medicine, and emergency medicine was created to develop a consensus based on scientific evidence and compiled a guideline for the management and treatment of in-flight cardiac arrests. Using the GRADE, RAND, and DELPHI methods, a systematic literature search was performed in PubMed. Specific recommendations have been developed for the treatment of IFCA. A total of 29 specific recommendations for the treatment and management of in-flight cardiac arrests were generated. The main recommendations included emergency equipments as well as communication of the emergency. Training of the crew is of utmost importance, and should ideally have a focus on CPR in aircraft. The decision for a diversion should be considered very carefully.
Prevention for those who can pay: insurance reimbursement of genetic-based preventive interventions in the liminal state between health and disease

PubMed Central

Prince, Anya E.R.

2015-01-01

Clinical use of genetic testing to predict adult onset conditions allows individuals to minimize or circumvent disease when preventive medical interventions are available. Recent policy recommendations and changes expand patient access to information about asymptomatic genetic conditions and create mechanisms for expanded insurance coverage for genetic tests. The American College of Medical Genetics and Genomics (ACMG) recommends that laboratories provide incidental findings of medically actionable genetic variants after whole genome sequencing. The Patient Protection and Affordable Care Act (ACA) established mechanisms to mandate coverage for genetic tests, such as BRCA. The ACA and ACMG, however, do not address insurance coverage for preventive interventions. These policies equate access to testing as access to prevention, without exploring the accessibility and affordability of interventions. In reality, insurance coverage for preventive interventions in asymptomatic adults is variable given the US health insurance system's focus on treatment. Health disparities will be exacerbated if only privileged segments of society can access preventive interventions, such as prophylactic surgeries, screenings, or medication. To ensure equitable access to interventions, federal or state legislatures should mandate insurance coverage for both predictive genetic testing and recommended follow-up interventions included in a list established by an expert panel or regulatory body. PMID:26339500
Community Healthcare and Technology to Enhance Communication in Pediatric Obesity Care: Expert Exchange Workgroup's Views.

PubMed

Siegel, Robert M; Haemer, Matthew; Kharofa, Roohi Y; Christison, Amy L; Hampl, Sarah E; Tinajero-Deck, Lydia; Lockhart, Mary Kate; Reich, Sarah; Pont, Stephen J; Stratbucker, William; Robinson, Thomas N; Shaffer, Laura A; Woolford, Susan J

2018-06-07

Childhood obesity continues to be a critical healthcare issue and a paradigm of a pervasive chronic disease affecting even our youngest children. When considered within the context of the socioecological model, the factors that influence weight status, including the social determinants of health, limit the impact of multidisciplinary care that occurs solely within the medical setting. Coordinated care that incorporates communication between the healthcare and community sectors is necessary to more effectively prevent and treat obesity. In this article, the Expert Exchange authors, with input from providers convened at an international pediatric meeting, provide recommendations to address this critical issue. These recommendations draw upon examples from the management of other chronic conditions that might be applied to the treatment of obesity, such as the use of care plans and health assessment forms to allow weight management specialists and community personnel (e.g., school counselors) to communicate about treatment recommendations and responses. To facilitate communication across the healthcare and community sectors, practical considerations regarding the development and/or evaluation of communication tools are presented. In addition, the use of technology to enhance healthcare-community communication is explored as a means to decrease the barriers to collaboration and to create a web of connection between the community and healthcare providers that promote wellness and a healthy weight status.
Report of the SSME assessment team

NASA Technical Reports Server (NTRS)

1993-01-01

In response to a request from the House of Representatives Committee on Science, Space, and Technology in its Report No. 102-500 of April 22, 1992, the Aerospace Safety Advisory Panel (ASAP) created an ad hoc task force to conduct a thorough assessment of the Space Shuttle Main Engine (SSME). The membership was drawn mostly from organizations other than ASAP, and this report represents the views of that task force. Its task was to assess the risk that the SSME poses to the safe operation of the Space Shuttle, to identify and evaluate improvements to the engine that would reduce the risk, and to recommend a set of priorities for the implementation of these improvements. The SSME Assessment Team, as it opted to call itself, convened in mid-1992 and, subsequently, met with and gathered information from all the principal organizations involved in the SSME program. These included the Rocketdyne Division of Rockwell International, the Marshall Space Flight Center of NASA, and the Pratt & Whitney Division of United Technologies Corporation. The information in this report reflects the program status as of October 1992. From the information received, the Team formed its conclusions and recommendations. Changes in the program status have, of course, occurred since that time; however, they did not affect the Team's conclusions and recommendations.

Prevention for those who can pay: insurance reimbursement of genetic-based preventive interventions in the liminal state between health and disease.

PubMed

Prince, Anya E R

2015-07-01

Clinical use of genetic testing to predict adult onset conditions allows individuals to minimize or circumvent disease when preventive medical interventions are available. Recent policy recommendations and changes expand patient access to information about asymptomatic genetic conditions and create mechanisms for expanded insurance coverage for genetic tests. The American College of Medical Genetics and Genomics (ACMG) recommends that laboratories provide incidental findings of medically actionable genetic variants after whole genome sequencing. The Patient Protection and Affordable Care Act (ACA) established mechanisms to mandate coverage for genetic tests, such as BRCA. The ACA and ACMG, however, do not address insurance coverage for preventive interventions. These policies equate access to testing as access to prevention, without exploring the accessibility and affordability of interventions. In reality, insurance coverage for preventive interventions in asymptomatic adults is variable given the US health insurance system's focus on treatment. Health disparities will be exacerbated if only privileged segments of society can access preventive interventions, such as prophylactic surgeries, screenings, or medication. To ensure equitable access to interventions, federal or state legislatures should mandate insurance coverage for both predictive genetic testing and recommended follow-up interventions included in a list established by an expert panel or regulatory body.
Outcomes in pediatric neurology: a review of conceptual issues and recommendationsThe 2010 Ronnie Mac Keith Lecture.

PubMed

Ronen, Gabriel M; Fayed, Nora; Rosenbaum, Peter L

2011-04-01

This paper discusses how to evaluate whether, and in what ways, treatments affect the lives of children with neurological conditions and their families. We argue that professionals should incorporate perspectives from patients and families to help them make decisions about what 'outcomes' are important, and we discuss how those outcomes might be assessed. A case vignette illustrates the differences and complementarity between the perspectives of clinicians and those of children and their parents. We recommend methods for expanding the range of relevant health outcomes in child neurology to include those that reflect the ways patients and families view their conditions and our interventions. We explore the added value of a 'non-categorical' approach to the choice of outcomes. The International Classification of Functioning, Disability and Health is a useful biopsychosocial framework to 'rule in' relevant aspects of child and family issues to create a dynamic system of possible influences on outcomes. We examine the meaning of 'health', 'health-related quality of life', and 'quality of life' as related but conceptually distinct outcomes. Specific issues are discussed about the construction, validation, and appraisal of outcome measures, as well as practical recommendations on how to select outcome measures in the clinical setting and research. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.
Accessing sexual and reproductive health care and information: Perspectives and recommendations from young Asian American women.

PubMed

Frost, Madeline; Cares, Alexa; Gelman, Katie; Beam, Rita

2016-12-01

Understanding the influence of culture on how sexual and reproductive health is perceived and addressed in Asian American communities is important for the effective provision of care and health information. This study aimed to explore how and when sexual and reproductive health information is shared within Asian American families and communities, barriers and facilitators to accessing sexual and reproductive health care and information for young Asian American women, and their recommendations to improve access. Qualitative data were collected through six focus groups conducted with a total of 33 young Asian American women. The majority of participants reported that stigma created a barrier to discussing these topics within their families and communities, and discussed ways in which they confidentially seek out care and information. Responses varied with respect to participants' preferred means of increasing access to care and information; some recommended strategies that would increase communication about these issues in their families and communities, while others expressed a desire to maintain confidentiality. These findings suggest that diversified strategies are needed to connect Asian American women with sexual and reproductive health care and information in order to meet their varied preferences, including strategies that are community-driven and culturally appropriate. Copyright © 2016 Elsevier B.V. All rights reserved.
Effectiveness guidance document (EGD) for Chinese medicine trials: a consensus document

PubMed Central

2014-01-01

Background There is a need for more Comparative Effectiveness Research (CER) on Chinese medicine (CM) to inform clinical and policy decision-making. This document aims to provide consensus advice for the design of CER trials on CM for researchers. It broadly aims to ensure more adequate design and optimal use of resources in generating evidence for CM to inform stakeholder decision-making. Methods The Effectiveness Guidance Document (EGD) development was based on multiple consensus procedures (survey, written Delphi rounds, interactive consensus workshop, international expert review). To balance aspects of internal and external validity, multiple stakeholders, including patients, clinicians, researchers and payers were involved in creating this document. Results Recommendations were developed for “using available data” and “future clinical studies”. The recommendations for future trials focus on randomized trials and cover the following areas: designing CER studies, treatments, expertise and setting, outcomes, study design and statistical analyses, economic evaluation, and publication. Conclusion The present EGD provides the first systematic methodological guidance for future CER trials on CM and can be applied to single or multi-component treatments. While CONSORT statements provide guidelines for reporting studies, EGDs provide recommendations for the design of future studies and can contribute to a more strategic use of limited research resources, as well as greater consistency in trial design. PMID:24885146
The Use of a Reciprocating Handpiece to Create a Glide Path in Curved Canals: Comparison with Manual Glide Path Preparation

DTIC Science & Technology

2016-06-01

instruments into the root canal system, manufacturers recommend creating a glide path to reduce the risk of instrument fracture due to taper lock . This...Results The two groups had almost identical mean and standard...The groups had identical median values of 85 seconds, and there was no significant difference between the groups (Mann-Whitney U test; p=0.15; two
Developing guidelines in low-income and middle-income countries: lessons from Kenya

PubMed Central

English, Mike; Irimu, Grace; Nyamai, Rachel; Were, Fred; Garner, Paul; Opiyo, Newton

2017-01-01

There are few examples of sustained nationally organised, evidence-informed clinical guidelines development processes in Sub-Saharan Africa. We describe the evolution of efforts from 2005 to 2015 to support evidence-informed decision making to guide admission hospital care practices in Kenya. The approach to conduct reviews, present evidence, and structure and promote transparency of consensus-based procedures for making recommendations improved over four distinct rounds of policy making. Efforts to engage important voices extended from government and academia initially to include multiple professional associations, regulators and practitioners. More than 100 people have been engaged in the decision-making process; an increasing number outside the research team has contributed to the conduct of systematic reviews, and 31 clinical policy recommendations has been developed. Recommendations were incorporated into clinical guideline booklets that have been widely disseminated with a popular knowledge and skills training course. Both helped translate evidence into practice. We contend that these efforts have helped improve the use of evidence to inform policy. The systematic reviews, Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approaches and evidence to decision-making process are well understood by clinicians, and the process has helped create a broad community engaged in evidence translation together with a social or professional norm to use evidence in paediatric care in Kenya. Specific sustained efforts should be made to support capacity and evidence-based decision making in other African settings and clinical disciplines. PMID:28584069
Enhancement of the Earth Science and Remote Sensing Group's Website and Related Projects

NASA Technical Reports Server (NTRS)

Coffin, Ashley; Vanderbloemen, Lisa

2014-01-01

The major problem addressed throughout the term was the need to update the group's current website, as it was outdated and required streamlining and modernization. The old Gateway to Astronaut Photography of the Earth website had multiple components, many of which involved searches through expansive databases. The amount of work required to update the website was large and due to a desired release date, assistance was needed to help build new pages and to transfer old information. Additionally, one of the tools listed on the website called Image Detective had been underutilized in the past. It was important to address why the public was not using the tool and how it could potentially become more of a resource for the team. In order to help with updating the website, it was necessary to first learn HTML. After assisting with small edits, I began creating new pages. I utilized the "view page source" and "developer" tools in the internet browser to observe how other websites created their features and to test changes without editing the code. I then edited the code to create an interactive feature on the new page. For the Image Detective Page I began an evaluation of the current page. I also asked my fellow interns and friends at my University to offer their input. I took all of the opinions into account and wrote up a document regarding my recommendations. The recommendations will be considered as I help to improve the Image Detective page for the updated website. In addition to the website, other projects included the need for additional, and updated image collections, along with various project requests. The image collections have been used by educators in the classroom and the impact crater collection was highly requested. The glaciers collection focused mostly on South American glaciers and needed to include more of the earth's many glaciers. The collections had not been updated or created due to the fact that related imagery had not been catalogued. The process of cataloging involves identifying the center point location of the image and feature identification. Other project needs included collecting night images of India in for publishing. Again, many of the images were not catalogued and the database was lacking in night time imagery for that region. The last project was to calculate the size of mega fans in South Africa. Calculating the fan sizes involved several steps. To expedite the study, calculations needed to be made after the base maps had been created. Using data files that included an outline of the mega fans on a topographic map, I opened the file in Photoshop, determined the number of pixels within the outlined area, created a one degree squared box, determined the pixels within the box, converted the pixels within the box to kilometers, and then calculated the fan size using this information. Overall, the internship has been a learning experience for me. I have learned how to use new programs and I developed new skills. These These skills can help me as I enter into the next phase of my career. Learning Photoshop and HTML in addition to coding in Dreamweaver are highly sought after skills that are used in a variety of fields. Additionally, the exposure to different aspects of the team and working with different people helped me to gain a broader set of skills and allowed me to work with people with different experiences. The various projects I have worked on this summer have directly benefitted the team whether it was completing projects they did not have the time to do, or by helping the team reach deadlines sooner. The new website will be the best place to see all of my work as it will include the newly designed pages and will feature my updates to collections.
Policies for biosimilar uptake in Europe: An overview

PubMed Central

Vulto, Arnold G.; Huys, Isabelle; Dylst, Pieter; Godman, Brian; Keuerleber, Simon; Claus, Barbara; Dimitrova, Maria; Petrova, Guenka; Sović-Brkičić, Ljiljana; Slabý, Juraj; Šebesta, Robin; Laius, Ott; Karr, Allan; Beck, Morgane; Martikainen, Jaana E.; Selke, Gisbert W.; Spillane, Susan; McCullagh, Laura; Trifirò, Gianluca; Vella Bonanno, Patricia; Mack, Asbjørn; Fogele, Antra; Viksna, Anita; Władysiuk, Magdalena; Mota-Filipe, Helder; Meshkov, Dmitry; Kalaba, Marija; Mencej Bedrač, Simona; Fürst, Jurij; Zara, Corrine; Skiöld, Peter; Magnússon, Einar; Simoens, Steven

2017-01-01

Background Across European countries, differences exist in biosimilar policies, leading to variations in uptake of biosimilars and divergences in savings all over Europe. Objectives The aim of this article is to provide an overview of different initiatives and policies that may influence the uptake of biosimilars in different European countries. Recommendations will be formulated on how to create sustainable uptake. Methods An overview of policies on biosimilars was obtained via a questionnaire, supplemented with relevant articles. Topics were organized in five themes: availability, pricing, reimbursement, demand-side policies, and recommendations to enhance uptake. Results In all countries studied, biological medicines are available. Restrictions are mainly dependent on local organization of the healthcare system. Countries are willing to include biosimilars for reimbursement, but for commercial reasons they are not always marketed. In two thirds of countries, originator and biosimilar products may be subjected to internal reference pricing systems. Few countries have implemented specific incentives targeting physicians. Several countries are implementing pharmacist substitution; however, the scope and rules governing such substitution tend to vary between these countries. Reported educational policies tend to target primarily physicians, whereas fewer initiatives were reported for patients. Recommendations as proposed by the different country experts ranged from the need for information and communication on biosimilars to competitive pricing, more support for switching and guidance on substitution. Conclusions Most countries have put in place specific supply-side policies for promoting access to biosimilars. To supplement these measures, we propose that investments should be made to clearly communicate on biosimilars and educate stakeholders. Especially physicians need to be informed on the entry and use of biosimilars in order to create trust. When physicians are well-informed on the treatment options, further incentives should be offered to prescribe biosimilars. Gainsharing can be used as an incentive to prescribe, dispense or use biosimilars. This approach, in combination with binding quota, may support a sustainable biosimilar market. PMID:29284064
Atopic dermatitis guideline. Position paper from the Latin American Society of Allergy, Asthma and Immunology.

PubMed

Sánchez, Jorge; Páez, Bruno; Macías, A; Olmos, C; de Falco, A

2014-01-01

As in other regions, the incidence of atopic dermatitis in Latin America has been increasing in recent years. Although there are several clinical guidelines, many of their recommendations cannot be universal since they depend on the characteristics of each region. Thus, we decided to create a consensus guideline on atopic dermatitis applicable in Latin America and other tropical regions, taking into account socio-economic, geographical, cultural and health care system characteristics. The Latin American Society of Allergy Asthma and Immunology (SLAAI) conducted a systematic search for articles related to the pathophysiology, diagnosis and treatment of dermatitis using various electronic resources such as Google, Pubmed, EMBASE (Ovid) and Cochrane data base. We have also looked for all published articles in Latin America on the subject using LILACS (Latin American and Caribbean Literature on Health Sciences) database. Each section was reviewed by at least two members of the committee, and the final version was subsequently approved by all of them, using the Delphi methodology for consensus building. Afterward, the final document was shared for external evaluation with physicians, specialists (allergists, dermatologists and pediatricians), patients and academic institutions such as universities and scientific societies related to the topic. All recommendations made by these groups were taken into account for the final drafting of the document. There are few original studies conducted in Latin America about dermatitis; however, we were able to create a practical guideline for Latin America taking into account the particularities of the region. Moreover, the integral management was highlighted including many of the recommendations from different participants in the health care of this disease (patients, families, primary care physicians and specialists). This practical guide presents a concise approach to the diagnosis and management of atopic dermatitis that can be helpful for medical staff, patients and their families in Latin America.
Loyalty and positive word-of-mouth: patients and hospital personnel as advocates of a customer-centric health care organization.

PubMed

Ferguson, Ronald J; Paulin, Michele; Leiriao, Elizabeth

2006-01-01

The ability to attract and retain loyal customers depends on the successful implementation of a customer-centric strategy. Customer loyalty is an attitude about an organization and its' services that is manifested by intentions and behaviors of re-patronization and recommendation. In the context of many medical services, loyalty through repeat patronization is not pertinent, whereas loyalty through positive word-of mouth (WOM) recommendation can be a powerful marketing tool. The Shouldice Hospital, a well-known institution for the surgical correction of hernias, instituted a marketing plan to develop a stable base of patients by creating positive WOM advocacy. This study focused on the consequences of both hernia patient overall satisfaction (and overall service quality) and hospital personnel satisfaction on the level of positive WOM advocacy. Using a commitment ladder of positive WOM advocacy, respondents were divided into three categories described as passive supporters, active advocates and ambassador advocates. Patient assessments of overall satisfaction and service quality were significantly related to these progressive levels of WOM for recommending the hospital to potential patients. Similarly, the satisfaction of the hospital employees was also significantly related to these progressive levels of positive WOM about recommending the hospital to potential patients and to potential employees. High levels of satisfaction are required to create true ambassadors of a service organization.
The Basics of Braces

MedlinePlus

... that attaches to the back teeth, providing stronger force to move the teeth. The orthodontist also might recommend that your child have one or more teeth removed to create more space in his or her mouth. Once the braces ...
75 FR 57437 - Saguache County Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-21

... Committee Act. The purpose is to review and recommend project proposals to be funded with Title II money... money; (4) Create a timeline to receive and review new project proposals and schedule the next meeting...
Brownfields Langdale Mill Project: Technical Memo on Creating Inventory of Materials that can be Reused or Recycled

EPA Pesticide Factsheets

This technical memorandum presents the sustainability pilot activities, a summary of inventory results, and other observations and recommendations for sustainable redevelopment identified during the pilot activities.
Commercial Building Energy Saver, Web App

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

Hong, Tianzhen; Piette, Mary; Lee, Sang Hoon

The CBES App is a web-based toolkit for use by small businesses and building owners and operators of small and medium size commercial buildings to perform energy benchmarking and retrofit analysis for buildings. The CBES App analyzes the energy performance of user's building for pre-and posto-retrofit, in conjunction with user's input data, to identify recommended retrofit measures, energy savings and economic analysis for the selected measures. The CBES App provides energy benchmarking, including getting an EnergyStar score using EnergyStar API and benchmarking against California peer buildings using the EnergyIQ API. The retrofit analysis includes a preliminary analysis by looking upmore » retrofit measures from a pre-simulated database DEEP, and a detailed analysis creating and running EnergyPlus models to calculate energy savings of retrofit measures. The CBES App builds upon the LBNL CBES API.« less
Machine learning algorithms for the creation of clinical healthcare enterprise systems

NASA Astrophysics Data System (ADS)

Mandal, Indrajit

2017-10-01

Clinical recommender systems are increasingly becoming popular for improving modern healthcare systems. Enterprise systems are persuasively used for creating effective nurse care plans to provide nurse training, clinical recommendations and clinical quality control. A novel design of a reliable clinical recommender system based on multiple classifier system (MCS) is implemented. A hybrid machine learning (ML) ensemble based on random subspace method and random forest is presented. The performance accuracy and robustness of proposed enterprise architecture are quantitatively estimated to be above 99% and 97%, respectively (above 95% confidence interval). The study then extends to experimental analysis of the clinical recommender system with respect to the noisy data environment. The ranking of items in nurse care plan is demonstrated using machine learning algorithms (MLAs) to overcome the drawback of the traditional association rule method. The promising experimental results are compared against the sate-of-the-art approaches to highlight the advancement in recommendation technology. The proposed recommender system is experimentally validated using five benchmark clinical data to reinforce the research findings.
[Recommendations for assessing the hyponutrition risk in hospitalised patients].

PubMed

Ulibarri, J I; Burgos, R; Lobo, G; Martínez, M A; Planas, M; Pérez de la Cruz, A; Villalobos, J L

2009-01-01

Given the frequency and clinical, social, and economic implications of hospital hyponutrition and the usual lack of sensibility before this problem from health care professionals, it seemed appropriate to create a working group within the Spanish Society of Parenteral and Enteral Nutrition (SENPE), which will lead to consensus recommendations on hyponutrition assessment among hospitalised patients. At a first stage, it seemed interesting to elaborate some recommendations on early and regular detection of hyponutrition among patients admitted to our hospitals. After carefully reviewing the screening methods published, the group considers that using screening methods should be recommended according to the possibilities at each centre in order to detect those patients that will further need a more complete evaluation of their nutritional status and, in case of necessary, to establish a nutritional action plan.
Learning material recommendation based on case-based reasoning similarity scores

NASA Astrophysics Data System (ADS)

Masood, Mona; Mokmin, Nur Azlina Mohamed

2017-10-01

A personalized learning material recommendation is important in any Intelligent Tutoring System (ITS). Case-based Reasoning (CBR) is an Artificial Intelligent Algorithm that has been widely used in the development of ITS applications. This study has developed an ITS application that applied the CBR algorithm in the development process. The application has the ability to recommend the most suitable learning material to the specific student based on information in the student profile. In order to test the ability of the application in recommending learning material, two versions of the application were created. The first version displayed the most suitable learning material and the second version displayed the least preferable learning material. The results show the application has successfully assigned the students to the most suitable learning material.
SEA Change: Bringing together Science, Engineering and the Arts at the University of Florida

NASA Astrophysics Data System (ADS)

Perfit, M. R.; Mertz, M. S.; Lavelli, L.

2014-12-01

A group of interested and multifaceted faculty, administrators and students created the Science, Engineering, Arts Committee (SEA Change) two years ago at the University of Florida (UF). Recognizing that innovative ideas arise from the convergence of divergent thinkers, the committee seeks to bring together faculty in Science, Engineering, the Arts and others across campus to develop and disseminate innovative ideas for research, teaching and service that will enhance the campus intellectual environment. We meet regularly throughout the year as faculty with graduate and undergraduate students to catalyze ideas that could lead to collaborative or interdisciplinary projects and make recommendations to support innovative, critical and creative work. As an example, the Department of Geological Sciences and the School of Art and Art History collaborated on a competition among UF undergraduate painting students to create artistic works that related to geoscience. Each student gathered information from Geological Sciences faculty members to use for inspiration in creating paintings along with site-specific proposals to compete for a commission. The winning work was three-story high painting representing rock strata and the Florida environment entitled "Prairie Horizontals" that is now installed in the Geoscience building entrance atrium. Two smaller paintings of the second place winner, depicting geologists in the field were also purchased and displayed in a main hallway. Other activities supported by SEA Change have included a collaborative work of UF engineering and dance professors who partnered for the Creative Storytelling and Choreography Lab, to introduce basic storytelling tools to engineering students. A campus-wide gathering of UF faculty and graduate students titled Creative Practices: The Art & Science of Discovery featured guest speakers Steven Tepper, Victoria Vesna and Benjamin Knapp in spring 2014. The Committee plans to develop and foster ideas that will lead to more collaborative or interdisciplinary projects and make recommendations to the administration to support a creative environment across disciplines on UF campus.
Chapter 3. Coordination and collaboration with interface units. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Joynt, Gavin M; Loo, Shi; Taylor, Bruce L; Margalit, Gila; Christian, Michael D; Sandrock, Christian; Danis, Marion; Leoniv, Yuval; Sprung, Charles L

2010-04-01

To provide recommendations and standard operating procedures (SOPs) for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on enhancing coordination and collaboration between the ICU and other key stakeholders. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including coordination and collaboration. Key recommendations include: (1) establish an Incident Management System with Emergency Executive Control Groups at facility, local, regional/state or national levels to exercise authority and direction over resource use and communications; (2) develop a system of communication, coordination and collaboration between the ICU and key interface departments within the hospital; (3) identify key functions or processes requiring coordination and collaboration, the most important of these being manpower and resources utilization (surge capacity) and re-allocation of personnel, equipment and physical space; (4) develop processes to allow smooth inter-departmental patient transfers; (5) creating systems and guidelines is not sufficient, it is important to: (a) identify the roles and responsibilities of key individuals necessary for the implementation of the guidelines; (b) ensure that these individuals are adequately trained and prepared to perform their roles; (c) ensure adequate equipment to allow key coordination and collaboration activities; (d) ensure an adequate physical environment to allow staff to properly implement guidelines; (6) trigger events for determining a crisis should be defined. Judicious planning and adoption of protocols for coordination and collaboration with interface units are necessary to optimize outcomes during a pandemic.
The Rules of Engagement

PubMed Central

Bloom, Diane; Beetsch, Joel; Harker, Matthew; Hesterlee, Sharon; Moreira, Paulo; Patrick-Lake, Bray; Selig, Wendy; Sherman, Jeffrey; Smith, Sophia K.; Valentine, James E.; Roberts, Jamie N.

2017-01-01

Objective: To identify the elements necessary for successful collaboration between patient groups and academic and industry sponsors of clinical trials, in order to develop recommendations for best practices for effective patient group engagement. Methods: In-depth interviews, informed by a previously reported survey, were conducted to identify the fundamentals of successful patient group engagement. Thirty-two respondents from 3 sectors participated: patient groups, academic researchers, and industry. The findings were presented to a multistakeholder group of experts in January 2015. The expert group came to consensus on a set of actionable recommendations for best practices for patient groups and research sponsors. Results: Interview respondents acknowledged that not all patient groups are created equal in terms of what they can contribute to a clinical trial. The most important elements for effective patient group engagement include establishing meaningful partnerships, demonstrating mutual benefits, and collaborating as partners from the planning stage forward. Although there is a growing appreciation by sponsors about the benefits of patient group engagement, there remains some resistance and some uncertainty about how best to engage. Barriers include mismatched expectations and a perception that patient groups lack scientific sophistication and that “wishful thinking” may cloud their recommendations. Conclusions: Patient groups are developing diverse skillsets and acquiring assets to leverage in order to become collaborators with industry and academia on clinical trials. Growing numbers of research sponsors across the clinical trials enterprise are recognizing the benefits of continuous and meaningful patient group engagement, but there are still mindsets to change, and stakeholders need further guidance on operationalizing a new model of clinical trial conduct. PMID:29714514

Transformational leadership: What every nursing dean should know.

PubMed

Giddens, Jean

Transformational leadership (TFL) has become a predominant leadership style practiced by leaders across many industries and disciplines, including nursing. As a component of the Full Range Leadership Model proposed by Bass (1985), TFL is characterized by the ability to stimulate, inspire, and motivate followers. Transformational leaders focus on building relationships with people and creating change by emphasizing values. Most TFL literature in nursing focuses on clinical practice with very little representation from academic nursing leadership. This article describes TFL, presents general findings from the literature, discusses this leadership style in the context of academic nursing leadership, makes recommendations for professional development of this leadership approach and offers suggests for future inquiry. Copyright © 2017 Elsevier Inc. All rights reserved.
Cervical cancer biopsy reporting: a review.

PubMed

Reyes, Maria Carolina; Cooper, Kumarasen

2014-01-01

The terminology for reporting human papillomavirus-associated squamous lesions in the cervix, both in tissue samples and cytology specimens, has suffered from many changes throughout the last years creating confusion in interpreting cervical biopsy and cytology reports by clinicians. This review presents a summary and discussion of the current terminology for reporting results of cervical biopsies and cytology with emphasis in the lower anogenital squamous terminology consensus recommendations for tissue specimens and the 2001 Bethesda Workshop for reporting cytology results. Microscopic features of cervical lesions in tissue samples and cytology specimens are presented. Biomarkers, including p16 and Ki-67, are discussed and how they can help the pathologist when dealing with difficult cases.
Panel 2.17: private commercial sector partnerships for health action in crises.

PubMed

Sundnes, Knut Ole; Sannerkvist, Milan; Hedger, Philip; Woodworth, Brent; Hyre, Anne; Cuddyre, Terrence; Waldman, Ronald

2005-01-01

This is a summary of the presentations and discussion of Panel 2.17, Private Commercial Sector Partnerships for Health Action in Crises of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to private sector partnerships for health action in crises as pertain to the responses to the damage created by the Tsunami. It is presented in the following sections: (1) key questions; (2) issues and challenges; (3) lessons learned; (4) what was done well?; (5) what could have been done better?; and (6) conclusions and recommendations.
The Oklahoma Attorney General's Task Force report on the State of End-of-Life Health Care, 2005.

PubMed

Edmondson, W A Drew

2005-05-01

This article includes the recommendations submitted by the 15 members of the Oklahoma Attorney General's Task Force in their Report on the State of End-of-Life Health Care. The task force was created on April 21, 2004, and their report was accepted by Attorney General W.A. Drew Edmondson at a press conference April 11, 2005. It has been forwarded to members of the Oklahoma Legislature, relevant state agencies and organizations with an invitation to join with members of the task force to continue efforts to improve end-of-life care for Oklahomans. Copies of the report are available upon request to the Office of Attorney General.
Earth scientists list top priorities for space missions

NASA Astrophysics Data System (ADS)

Voosen, Paul

2018-01-01

Earth scientists hope a new priority setting effort will help them make the most of NASA's limited budget for satellite missions that watch over the planet. The so-called decadal survey, issued in January by the National Academies of Sciences, Engineering, and Medicine, laid out the community's consensus wish list, ranging from cloud monitoring to multiwavelength imaging—and recommends a strong dose of competition to keep costs down. The report prioritizes five observations for launch, including hyperspectral imaging, clouds, atmospheric particles, and missions to chart gravity variations and tiny crustal movements. It also advocates creating a new line of $350 million missions targeting seven observations, with competitions to choose three for flight in the next 10 years.
Research of cement mixtures with additions of industrial by-products

NASA Astrophysics Data System (ADS)

Papesch, R.; Klus, L.; Svoboda, J.; Zajac, R.

2017-10-01

The main goal of the article is the comparison of the possible use of secondary energy products. Used fly ashes, respectively steel dusts in cement mixes derive from production in Moravian-Silesian Region. The research focused on their influence on the chemical and physico-mechanical characteristics of the fresh and solid mixture. The aim was to find suitable formulations for grouting works, highway construction possibly rehabilitation of underground cavities created by mining activities. The introduction is mentioned the history of waste utilization up to current use as a product and the overall state of the problem. The conclusion is an evaluation of possible use in practice, including recommendations to carry out further tests.
The Earth Resources Laboratory Applications Software (ELAS) in university research and education: An operator oriented geobased information system

NASA Technical Reports Server (NTRS)

Coker, B. L.; Kind, T. C.; Smith, W. F., Jr.; Weber, N. V.

1981-01-01

Created for analyzing and processing digital data such as that collected by multispectral scanners or digitized from maps, ELAS is designed for ease of user operation and includes its own FORTRAN operating monitor and an expandable set of application modules which are FORTRAN overlays. On those machines that do not support FORTRAN overlaying, the modules exist as subprograms. The subsystem can be implemented on most 16-bit or 32-bit machines and is capable of, but not limited to, operating on low-cost minicomputer systems. The recommended hardware configuration for ELAS and a representative listing of some operating and application modules are presented.
Public-Private Partnership: Joint recommendations to improve downloads of large Earth observation data

NASA Astrophysics Data System (ADS)

Ramachandran, R.; Murphy, K. J.; Baynes, K.; Lynnes, C.

2016-12-01

With the volume of Earth observation data expanding rapidly, cloud computing is quickly changing the way Earth observation data is processed, analyzed, and visualized. The cloud infrastructure provides the flexibility to scale up to large volumes of data and handle high velocity data streams efficiently. Having freely available Earth observation data collocated on a cloud infrastructure creates opportunities for innovation and value-added data re-use in ways unforeseen by the original data provider. These innovations spur new industries and applications and spawn new scientific pathways that were previously limited due to data volume and computational infrastructure issues. NASA, in collaboration with Amazon, Google, and Microsoft, have jointly developed a set of recommendations to enable efficient transfer of Earth observation data from existing data systems to a cloud computing infrastructure. The purpose of these recommendations is to provide guidelines against which all data providers can evaluate existing data systems and be used to improve any issues uncovered to enable efficient search, access, and use of large volumes of data. Additionally, these guidelines ensure that all cloud providers utilize a common methodology for bulk-downloading data from data providers thus preventing the data providers from building custom capabilities to meet the needs of individual cloud providers. The intent is to share these recommendations with other Federal agencies and organizations that serve Earth observation to enable efficient search, access, and use of large volumes of data. Additionally, the adoption of these recommendations will benefit data users interested in moving large volumes of data from data systems to any other location. These data users include the cloud providers, cloud users such as scientists, and other users working in a high performance computing environment who need to move large volumes of data.
DNA Commission of the International Society for Forensic Genetics: Recommendations on the validation of software programs performing biostatistical calculations for forensic genetics applications.

PubMed

Coble, M D; Buckleton, J; Butler, J M; Egeland, T; Fimmers, R; Gill, P; Gusmão, L; Guttman, B; Krawczak, M; Morling, N; Parson, W; Pinto, N; Schneider, P M; Sherry, S T; Willuweit, S; Prinz, M

2016-11-01

The use of biostatistical software programs to assist in data interpretation and calculate likelihood ratios is essential to forensic geneticists and part of the daily case work flow for both kinship and DNA identification laboratories. Previous recommendations issued by the DNA Commission of the International Society for Forensic Genetics (ISFG) covered the application of bio-statistical evaluations for STR typing results in identification and kinship cases, and this is now being expanded to provide best practices regarding validation and verification of the software required for these calculations. With larger multiplexes, more complex mixtures, and increasing requests for extended family testing, laboratories are relying more than ever on specific software solutions and sufficient validation, training and extensive documentation are of upmost importance. Here, we present recommendations for the minimum requirements to validate bio-statistical software to be used in forensic genetics. We distinguish between developmental validation and the responsibilities of the software developer or provider, and the internal validation studies to be performed by the end user. Recommendations for the software provider address, for example, the documentation of the underlying models used by the software, validation data expectations, version control, implementation and training support, as well as continuity and user notifications. For the internal validations the recommendations include: creating a validation plan, requirements for the range of samples to be tested, Standard Operating Procedure development, and internal laboratory training and education. To ensure that all laboratories have access to a wide range of samples for validation and training purposes the ISFG DNA commission encourages collaborative studies and public repositories of STR typing results. Published by Elsevier Ireland Ltd.
MANAGEMENT OF DIABETES DURING AIR TRAVEL: A SYSTEMATIC LITERATURE REVIEW OF CURRENT RECOMMENDATIONS AND THEIR SUPPORTING EVIDENCE.

PubMed

Pavela, James; Suresh, Rahul; Blue, Rebecca S; Mathers, Charles H; Belalcazar, L Maria

2018-02-01

Individuals with diabetes are increasingly seeking pretravel advice, but updated professional recommendations remain scant. We performed a systematic review on diabetes management during air travel to summarize current recommendations, assess supporting evidence, and identify areas of future research. A systematic review of the English literature on diabetes management during air travel was undertaken utilizing PubMed and MEDLINE. Publications regarding general travel advice; adjustment of insulin and noninsulin therapies; and the use of insulin pumps, glucometers and subcutaneous glucose sensors at altitude were included. Gathered information was used to create an updated summary of glucose-lowering medication adjustment during air travel. Sixty-one publications were identified, most providing expert opinion and few offering primary data (47 expert opinion, 2 observational studies, 2 case reports, 10 device studies). General travel advice was uniform, with increasing attention to preflight security. Indications for oral antihyperglycemic therapy adjustments varied. There were few recommendations on contemporary agents and on nonhypoglycemic adverse events. There was little consensus on insulin adjustment protocols, many antedating current insulin formulations. Most publications advocated adjusting insulin pump time settings after arrival; however, there was disagreement on timing and rate adjustments. Glucometers and subcutaneous glucose sensors were reported to be less accurate at altitude, but not to an extent that would preclude their clinical use. Recommendations for diabetes management during air travel vary significantly and are mostly based on expert opinion. Data from systematic investigation on glucose-lowering medication adjustment protocols may support the development of a future consensus statement. CSII = continuous subcutaneous insulin infusion (device) DPP-4 = dipeptidyl peptidase 4 EGA = error grid analysis GDH = glucose dehydrogenase GOX = glucose oxidase GLP1 = glucagon-like peptide-1 NPH = neutral protamine Hagedorn SGLT2 = sodium-glucose cotransporter-2.
The Unintended Consequences of Social Media in Healthcare: New Problems and New Solutions

PubMed Central

Atique, S.; Mayer, M. A.; Denecke, K.; Merolli, M.; Househ, M.

2016-01-01

Summary Objectives Social media is increasingly being used in conjunction with health information technology (health IT). The objective of this paper is to identify some of the undesirable outcomes that arise from this integration and to suggest solutions to these problems. Methodology After a discussion with experts to elicit the topics that should be included in the survey, we performed a narrative review based on recent literature and interviewed multidisciplinary experts from different areas. In each case, we identified and analyzed the unintended effects of social media in health IT. Results Each analyzed topic provided a different set of unintended consequences. Most relevant consequences include lack of privacy with ethical and legal issues, patient confusion in disease management, poor information accuracy in crowdsourcing, unclear responsibilities, misleading and biased information in the prevention and detection of epidemics, and demotivation in gamified health solutions with social components. Conclusions Using social media in healthcare offers several benefits, but it is not exempt of potential problems, and not all of these problems have clear solutions. We recommend careful design of digital systems in order to minimize patient’s feelings of demotivation and frustration and we recommend following specific guidelines that should be created by all stakeholders in the healthcare ecosystem. PMID:27830230
Accumulating Data to Optimally Predict Obesity Treatment (ADOPT): Recommendations from the Biological Domain.

PubMed

Rosenbaum, Michael; Agurs-Collins, Tanya; Bray, Molly S; Hall, Kevin D; Hopkins, Mark; Laughlin, Maren; MacLean, Paul S; Maruvada, Padma; Savage, Cary R; Small, Dana M; Stoeckel, Luke

2018-04-01

The responses to behavioral, pharmacological, or surgical obesity treatments are highly individualized. The Accumulating Data to Optimally Predict obesity Treatment (ADOPT) project provides a framework for how obesity researchers, working collectively, can generate the evidence base needed to guide the development of tailored, and potentially more effective, strategies for obesity treatment. The objective of the ADOPT biological domain subgroup is to create a list of high-priority biological measures for weight-loss studies that will advance the understanding of individual variability in response to adult obesity treatments. This list includes measures of body composition, energy homeostasis (energy intake and output), brain structure and function, and biomarkers, as well as biobanking procedures, which could feasibly be included in most, if not all, studies of obesity treatment. The recommended high-priority measures are selected to balance needs for sensitivity, specificity, and/or comprehensiveness with feasibility to achieve a commonality of usage and increase the breadth and impact of obesity research. The accumulation of data on key biological factors, along with behavioral, psychosocial, and environmental factors, can generate a more precise description of the interplay and synergy among them and their impact on treatment responses, which can ultimately inform the design and delivery of effective, tailored obesity treatments. © 2018 The Obesity Society.
Proposed declassification of disease categories related to sexual orientation in the International Statistical Classification of Diseases and Related Health Problems (ICD-11).

PubMed

Cochran, Susan D; Drescher, Jack; Kismödi, Eszter; Giami, Alain; García-Moreno, Claudia; Atalla, Elham; Marais, Adele; Vieira, Elisabeth Meloni; Reed, Geoffrey M

2014-09-01

The World Health Organization is developing the 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), planned for publication in 2017. The Working Group on the Classification of Sexual Disorders and Sexual Health was charged with reviewing and making recommendations on disease categories related to sexuality in the chapter on mental and behavioural disorders in the 10th revision (ICD-10), published in 1990. This chapter includes categories for diagnoses based primarily on sexual orientation even though ICD-10 states that sexual orientation alone is not a disorder. This article reviews the scientific evidence and clinical rationale for continuing to include these categories in the ICD. A review of the evidence published since 1990 found little scientific interest in these categories. In addition, the Working Group found no evidence that they are clinically useful: they neither contribute to health service delivery or treatment selection nor provide essential information for public health surveillance. Moreover, use of these categories may create unnecessary harm by delaying accurate diagnosis and treatment. The Working Group recommends that these categories be deleted entirely from ICD-11. Health concerns related to sexual orientation can be better addressed using other ICD categories.
Legal perspectives on cross-border reproductive care.

PubMed

Crockin, Susan L

2011-12-01

Global cross-border reproductive care (CBRC), and the challenges accompanying it, are here to stay. A recent issue of this journal devoted to CBRC provides an extraordinary array of insights into multiple facets, with a focus on the legal dimensions of practices by restrictive countries such as Turkey and Italy. The articles identify restrictive laws that challenge and create vulnerabilities for both citizens and providers involved in CBRC, and call instead for more modest and nuanced legislation and the closing paper presents a thoughtful and ambitious outline for a future research agenda. This commentary reflects on the implications of these legal dimensions, including their applicability to countries with more permissive CBRC policies, discusses three specific examples of legal concerns that have arisen in the USA and identifies numerous legal issues meriting future study. Together with the nuanced, more modest legislation recommended for restrictive countries, consistent legal and judicial principles for CBRC in permissive countries would respect varying perspectives on family building while attempting to address a central legal concern of CBRC, the protection of families, third-parties and providers. Any future agenda should include research and recommendations on the legal dimensions of CBRC in both restrictive and permissive countries. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
A systematic review of psychosocial interventions for adult refugees and asylum seekers.

PubMed

Tribe, Rachel H; Sendt, Kyra-Verena; Tracy, Derek K

2017-05-09

Europe is in the midst of the largest refugee migration since the Second World War; there is an urgent need to provide an updated systematic review of the current best evidence for managing mental distress in refugee populations. The aim of this review is to provide an exhaustive summary of the current literature on psychosocial interventions, both trauma- and non-trauma-focused, for refugee populations experiencing post-traumatic stress disorder (PTSD), depressive or anxiety symptoms. To produce recommendations for future research and current clinical practice. Searches were conducted in PubMed, PsychINFO (Hosted by Ovid), PILOTS and Social Services Abstracts; 5305 articles were screened and 40 were included. This review found medium to high quality evidence supporting the use of narrative exposure therapy (NET). A lack of culturally adapted treatments was apparent and there was less evidence to support standard cognitive behavioural therapy (CBT), Eye Movement Desensitisation and Reprocessing (EMDR) and multidisciplinary treatments. NET produced positive outcomes in refugees from a diverse range of backgrounds and trauma types. There is a general dearth of research in all intervention types: further research should include more "real-world" multidisciplinary interventions that better model clinical practice. Recommendations for evaluating local need, and creating a culturally sensitive workforce are discussed.
Proposed declassification of disease categories related to sexual orientation in the International Statistical Classification of Diseases and Related Health Problems (ICD-11)

PubMed Central

Drescher, Jack; Kismödi, Eszter; Giami, Alain; García-Moreno, Claudia; Atalla, Elham; Marais, Adele; Vieira, Elisabeth Meloni; Reed, Geoffrey M

2014-01-01

Abstract The World Health Organization is developing the 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), planned for publication in 2017. The Working Group on the Classification of Sexual Disorders and Sexual Health was charged with reviewing and making recommendations on disease categories related to sexuality in the chapter on mental and behavioural disorders in the 10th revision (ICD-10), published in 1990. This chapter includes categories for diagnoses based primarily on sexual orientation even though ICD-10 states that sexual orientation alone is not a disorder. This article reviews the scientific evidence and clinical rationale for continuing to include these categories in the ICD. A review of the evidence published since 1990 found little scientific interest in these categories. In addition, the Working Group found no evidence that they are clinically useful: they neither contribute to health service delivery or treatment selection nor provide essential information for public health surveillance. Moreover, use of these categories may create unnecessary harm by delaying accurate diagnosis and treatment. The Working Group recommends that these categories be deleted entirely from ICD-11. Health concerns related to sexual orientation can be better addressed using other ICD categories. PMID:25378758
Caring for inpatient boarders in the emergency department: improving safety and patient and staff satisfaction.

PubMed

Bornemann-Shepherd, Melanie; Le-Lazar, Jamie; Makic, Mary Beth Flynn; DeVine, Deborah; McDevitt, Kelly; Paul, Marcee

2015-01-01

Hospital capacity constraints lead to large numbers of inpatients being held for extended periods in the emergency department. This creates concerns with safety, quality of care, and dissatisfaction of patients and staff. The aim of this quality-improvement project was to improve satisfaction and processes in which nurses provided care to inpatient boarders held in the emergency department. A quality-improvement project framework that included the use of a questionnaire was used to ascertain employee and patient dissatisfaction and identify opportunities for improvement. A task force was created to develop action plans related to holding and caring for inpatients in the emergency department. A questionnaire was sent to nursing staff in spring 2012, and responses from the questionnaire identified improvements that could be implemented to improve care for inpatient boarders. Situation-background-assessment-recommendation (SBAR) communications and direct observations were also used to identify specific improvements. Post-questionnaire results indicated improved satisfaction for both staff and patients. It was recognized early that the ED inpatient area would benefit from the supervision of an inpatient director, managers, and staff. Outcomes showed that creating an inpatient unit within the emergency department had a positive effect on staff and patient satisfaction. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
Utilizing a Pediatric Disaster Coalition Model to Increase Pediatric Critical Care Surge Capacity in New York City.

PubMed

Frogel, Michael; Flamm, Avram; Sagy, Mayer; Uraneck, Katharine; Conway, Edward; Ushay, Michael; Greenwald, Bruce M; Pierre, Louisdon; Shah, Vikas; Gaffoor, Mohamed; Cooper, Arthur; Foltin, George

2017-08-01

A mass casualty event can result in an overwhelming number of critically injured pediatric victims that exceeds the available capacity of pediatric critical care (PCC) units, both locally and regionally. To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) was established. The PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from 18 of 25 major NYC PCC-capable hospitals. A PCC surge committee created recommendations for making additional PCC beds available with an emphasis on space, staff, stuff (equipment), and systems. The PDC assisted 15 hospitals in creating PCC surge plans by utilizing template plans and site visits. These plans created an additional 153 potential PCC surge beds. Seven hospitals tested their plans through drills. The purpose of this article was to demonstrate the need for planning for disasters involving children and to provide a stepwise, replicable model for establishing a PDC, with one of its primary goals focused on facilitating PCC surge planning. The process we describe for developing a PDC can be replicated to communities of any size, setting, or location. We offer our model as an example for other cities. (Disaster Med Public Health Preparedness. 2017;11:473-478).
Comparing the reported burn conditions for different severity burns in porcine models: a systematic review.

PubMed

Andrews, Christine J; Cuttle, Leila

2017-12-01

There are many porcine burn models that create burns using different materials (e.g. metal, water) and different burn conditions (e.g. temperature and duration of exposure). This review aims to determine whether a pooled analysis of these studies can provide insight into the burn materials and conditions required to create burns of a specific severity. A systematic review of 42 porcine burn studies describing the depth of burn injury with histological evaluation is presented. Inclusion criteria included thermal burns, burns created with a novel method or material, histological evaluation within 7 days post-burn and method for depth of injury assessment specified. Conditions causing deep dermal scald burns compared to contact burns of equivalent severity were disparate, with lower temperatures and shorter durations reported for scald burns (83°C for 14 seconds) compared to contact burns (111°C for 23 seconds). A valuable archive of the different mechanisms and materials used for porcine burn models is presented to aid design and optimisation of future models. Significantly, this review demonstrates the effect of the mechanism of injury on burn severity and that caution is recommended when burn conditions established by porcine contact burn models are used by regulators to guide scald burn prevention strategies. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Becoming an Adult in a Community of Faith

ERIC Educational Resources Information Center

Frye, Steven B.

2014-01-01

This chapter describes developmental needs of emerging young adults and how they are often met, or not met, in faith communities. The author offers recommendations for creating better connections with today's emerging young adults.

Surface mine impoundments as wildlife and fish habitat

Treesearch

Mark A. Rumble

1989-01-01

Unreclaimed surface mine impoundments provide poor fish and wildlife habitat. Recommendations given here for reclaiming "prelaw" impoundments and creating new impoundments could provide valuable fish and wildlife habitat if incorporated into existing laws and mine plans.
Improving the Spiritual Dimension of Whole Person Care: Reaching National and International Consensus

PubMed Central

Vitillo, Robert; Hull, Sharon K.; Reller, Nancy

2014-01-01

Abstract Two conferences, Creating More Compassionate Systems of Care (November 2012) and On Improving the Spiritual Dimension of Whole Person Care: The Transformational Role of Compassion, Love and Forgiveness in Health Care (January 2013), were convened with the goals of reaching consensus on approaches to the integration of spirituality into health care structures at all levels and development of strategies to create more compassionate systems of care. The conferences built on the work of a 2009 consensus conference, Improving the Quality of Spiritual Care as a Dimension of Palliative Care. Conference organizers in 2012 and 2013 aimed to identify consensus-derived care standards and recommendations for implementing them by building and expanding on the 2009 conference model of interprofessional spiritual care and its recommendations for palliative care. The 2013 conference built on the 2012 conference to produce a set of standards and recommended strategies for integrating spiritual care across the entire health care continuum, not just palliative care. Deliberations were based on evidence that spiritual care is a fundamental component of high-quality compassionate health care and it is most effective when it is recognized and reflected in the attitudes and actions of both patients and health care providers. PMID:24842136
Research of Adhesion Bonds Between Gas-Thermal Coating and Pre-Modified Base

NASA Astrophysics Data System (ADS)

Kovalevskaya, Z.; Zaitsev, K.; Klimenov, V.

2016-08-01

Nature of adhesive bonds between gas-thermal nickel alloy coating and carbon steel base was examined using laser profilometry, optical metallography, transmission and scanning electron microscopy. The steel surface was plastically pre-deformed by an ultrasonic tool. Proved that ultrasound pre-treatment modifies the steel surface. Increase of dislocation density and formation of sub micro-structure are base elements of surface modification. While using high-speed gas-flame, plasma and detonation modes of coatings, surface activation occurs and durable adhesion is formed. Ultrasonic pre-treatment of base material is effective when sprayed particles and base material interact through physical-chemical bond formation. Before applying high-speed gas flame and plasma sprayed coatings, authors recommend ultrasonic pretreatment, which creates periodic wavy topography with a stroke of 250 microns on the steel surface. Before applying detonation sprayed coatings, authors recommend ultrasound pretreatment that create modified surface with a uniform micro-topography.
Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review

PubMed Central

Brand, Sarah L.; Thompson Coon, Jo; Fleming, Lora E.; Carroll, Lauren; Bethel, Alison; Wyatt, Katrina

2017-01-01

Background Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and “burnout” at work than staff in other sectors. There is a growing call for the ‘triple aim’ of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom’s (UK) Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff. Objectives This systematic review aims to identify whole-system healthy workplace interventions in healthcare settings that incorporate (combinations of) these recommendations and determine whether they improve staff health and wellbeing. Methods A comprehensive and systematic search of medical, education, exercise science, and social science databases was undertaken. Studies were included if they reported the results of interventions that included all healthcare staff within a healthcare setting (e.g. whole hospital; whole unit, e.g. ward) in collective activities to improve physical or mental health or promote healthy behaviours. Results Eleven studies were identified which incorporated at least one of the whole-system recommendations. Interventions that incorporated recommendations to address local need and engage the whole workforce fell in to four broad types: 1) pre-determined (one-size-fits-all) and no choice of activities (two studies); or 2) pre-determined and some choice of activities (one study); 3) A wide choice of a range of activities and some adaptation to local needs (five studies); or, 3) a participatory approach to creating programmes responsive and adaptive to local staff needs that have extensive choice of activities to participate in (three studies). Only five of the interventions included substantial involvement and engagement of leadership and efforts aimed at up-skilling the leadership of staff to support staff health and wellbeing. Incorporation of more of the recommendations did not appear to be related to effectiveness. The heterogeneity of study designs, populations and outcomes excluded a meta-analysis. All studies were deemed by their authors to be at least partly effective. Two studies reported statistically significant improvement in objectively measured physical health (BMI) and eight in subjective mental health. Six studies reported statistically significant positive changes in subjectively assessed health behaviours. Conclusions This systematic review identified 11 studies which incorporate at least one of the Boorman recommendations and provides evidence that whole-system healthy workplace interventions can improve health and wellbeing and promote healthier behaviours in healthcare staff. PMID:29200422
Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review.

PubMed

Brand, Sarah L; Thompson Coon, Jo; Fleming, Lora E; Carroll, Lauren; Bethel, Alison; Wyatt, Katrina

2017-01-01

Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and "burnout" at work than staff in other sectors. There is a growing call for the 'triple aim' of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom's (UK) Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff. This systematic review aims to identify whole-system healthy workplace interventions in healthcare settings that incorporate (combinations of) these recommendations and determine whether they improve staff health and wellbeing. A comprehensive and systematic search of medical, education, exercise science, and social science databases was undertaken. Studies were included if they reported the results of interventions that included all healthcare staff within a healthcare setting (e.g. whole hospital; whole unit, e.g. ward) in collective activities to improve physical or mental health or promote healthy behaviours. Eleven studies were identified which incorporated at least one of the whole-system recommendations. Interventions that incorporated recommendations to address local need and engage the whole workforce fell in to four broad types: 1) pre-determined (one-size-fits-all) and no choice of activities (two studies); or 2) pre-determined and some choice of activities (one study); 3) A wide choice of a range of activities and some adaptation to local needs (five studies); or, 3) a participatory approach to creating programmes responsive and adaptive to local staff needs that have extensive choice of activities to participate in (three studies). Only five of the interventions included substantial involvement and engagement of leadership and efforts aimed at up-skilling the leadership of staff to support staff health and wellbeing. Incorporation of more of the recommendations did not appear to be related to effectiveness. The heterogeneity of study designs, populations and outcomes excluded a meta-analysis. All studies were deemed by their authors to be at least partly effective. Two studies reported statistically significant improvement in objectively measured physical health (BMI) and eight in subjective mental health. Six studies reported statistically significant positive changes in subjectively assessed health behaviours. This systematic review identified 11 studies which incorporate at least one of the Boorman recommendations and provides evidence that whole-system healthy workplace interventions can improve health and wellbeing and promote healthier behaviours in healthcare staff.
Ottawa Panel evidence-based clinical practice guidelines for the management of osteoarthritis in adults who are obese or overweight.

PubMed

Brosseau, Lucie; Wells, George A; Tugwell, Peter; Egan, Mary; Dubouloz, Claire-Jehanne; Casimiro, Lynn; Bugnariu, Nicoleta; Welch, Vivian A; De Angelis, Gino; Francoeur, Lilliane; Milne, Sarah; Loew, Laurianne; McEwan, Jessica; Messier, Steven P; Doucet, Eric; Kenny, Glen P; Prud'homme, Denis; Lineker, Sydney; Bell, Mary; Poitras, Stéphane; Li, Jing Xian; Finestone, Hillel M; Laferrière, Lucie; Haines-Wangda, Angela; Russell-Doreleyers, Marion; Lambert, Kim; Marshall, Alison D; Cartizzone, Margot; Teav, Adam

2011-06-01

The objective of this review was to construct an updated evidence-based clinical practice guideline on the use of physical activity and diet for the management of osteoarthritis (OA) in adults (>18 years of age) who are obese or overweight (body mass index ≥25 kg/m(2)). Articles were extracted from the following databases: MEDLINE, EMBASE (Current Contents), SPORTDiscus, SUM, Scopus, CINAHL, AMED, BIOMED, PubMed, ERIC, the Cochrane Controlled Trials, and PEDro. The Ottawa Panel and research assistance team strictly applied the inclusion and exclusion criteria from previous Ottawa Panel publications. An a priori literature search was conducted for articles related to obesity and OA of the lower extremities that were published from January 1, 1966, to November 30, 2010. Inclusion criteria and the methods to grade the recommendations were created by the Ottawa Panel. were graded based on the strength of evidence (A, B, C, C+, D, D+, or D-) as well as experimental design (I for randomized controlled trials and II for nonrandomized studies). In agreement with previous Ottawa Panel methods, Cochrane Collaboration methods were utilized for statistical analysis. Clinical significance was established by an improvement of ≥15% in the experimental group compared with the control group. There were a total of 79 recommendations from 9 articles. From these recommendations, there were 36 positive recommendations: 21 grade A and 15 grade C+. There were no grade B recommendations, and all recommendations were of clinical benefit. Further research is needed, as more than half of the trials were of low methodological quality. This review suggests that physical activity and diet programs are beneficial, specifically for pain relief (9 grade A recommendations) and improved functional status (6 grade A and 7 grade C+ recommendations), for adults with OA who are obese or overweight. The Ottawa Panel was able to demonstrate that when comparing physical activity alone, diet alone, physical activity combined with diet, and control groups, the intervention including physical activity and diet produced the most beneficial results.
MicroRNA based Pan-Cancer Diagnosis and Treatment Recommendation.

PubMed

Cheerla, Nikhil; Gevaert, Olivier

2017-01-13

The current state-of-the-art in cancer diagnosis and treatment is not ideal; diagnostic tests are accurate but invasive, and treatments are "one-size fits-all" instead of being personalized. Recently, miRNA's have garnered significant attention as cancer biomarkers, owing to their ease of access (circulating miRNA in the blood) and stability. There have been many studies showing the effectiveness of miRNA data in diagnosing specific cancer types, but few studies explore the role of miRNA in predicting treatment outcome. Here we go a step further, using tissue miRNA and clinical data across 21 cancers from the 'The Cancer Genome Atlas' (TCGA) database. We use machine learning techniques to create an accurate pan-cancer diagnosis system, and a prediction model for treatment outcomes. Finally, using these models, we create a web-based tool that diagnoses cancer and recommends the best treatment options. We achieved 97.2% accuracy for classification using a support vector machine classifier with radial basis. The accuracies improved to 99.9-100% when climbing up the embryonic tree and classifying cancers at different stages. We define the accuracy as the ratio of the total number of instances correctly classified to the total instances. The classifier also performed well, achieving greater than 80% sensitivity for many cancer types on independent validation datasets. Many miRNAs selected by our feature selection algorithm had strong previous associations to various cancers and tumor progression. Then, using miRNA, clinical and treatment data and encoding it in a machine-learning readable format, we built a prognosis predictor model to predict the outcome of treatment with 85% accuracy. We used this model to create a tool that recommends personalized treatment regimens. Both the diagnosis and prognosis model, incorporating semi-supervised learning techniques to improve their accuracies with repeated use, were uploaded online for easy access. Our research is a step towards the final goal of diagnosing cancer and predicting treatment recommendations using non-invasive blood tests.
Survivorship: Screening for Cancer and Treatment Effects, Version 2.2014

PubMed Central

Denlinger, Crystal S.; Ligibel, Jennifer A.; Are, Madhuri; Baker, K. Scott; Demark-Wahnefried, Wendy; Dizon, Don; Friedman, Debra L.; Goldman, Mindy; Jones, Lee; King, Allison; Ku, Grace H.; Kvale, Elizabeth; Langbaum, Terry S.; Leonardi-Warren, Kristin; McCabe, Mary S.; Melisko, Michelle; Montoya, Jose G.; Mooney, Kathi; Morgan, Mary Ann; Moslehi, Javid J.; O’Connor, Tracey; Overholser, Linda; Paskett, Electra D.; Peppercorn, Jeffrey; Raza, Muhammad; Rodriguez, M. Alma; Syrjala, Karen L.; Urba, Susan G; Wakabayashi, Mark T.; Zee, Phyllis; McMillian, Nicole; Freedman-Cass, Deborah

2015-01-01

The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for common physical and psychosocial consequences of cancer and cancer treatment. This portion of the guidelines describes recommendations regarding screening for the effects of cancer and its treatment. The panel created a sample screening tool, specifically for use in combination with the NCCN Guidelines for Survivorship, to guide providers to topics that require more in-depth assessment. Effective screening and assessment can help providers deliver necessary and comprehensive survivorship care. PMID:25361799
Initial Testing for the Recommendation of Improved Gas Metal Arc Welding Procedures for HY-80 Steel Plate Butt Joints at Norfolk Naval Shipyard

DTIC Science & Technology

2015-12-01

is unlimited 12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) Hull cut welding proficiency is an essential skill maintained by personnel...at naval shipyards. This thesis explores arc weld theory to develop ideal submarine hull butt joint designs and recommends preliminary testing to...shipboard hull welding applications, theoretically. Butt joint samples were created using HY-80 steel plate so that the following comparisons could
Guidelines for the management of neuroendocrine tumours by the Brazilian gastrointestinal tumour group

PubMed Central

Riechelmann, Rachel P; Weschenfelder, Rui F; Costa, Frederico P; Andrade, Aline Chaves; Osvaldt, Alessandro Bersch; Quidute, Ana Rosa P; dos Santos, Allan; Hoff, Ana Amélia O; Gumz, Brenda; Buchpiguel, Carlos; Vilhena Pereira, Bruno S; Lourenço Junior, Delmar Muniz; da Rocha Filho, Duilio Reis; Fonseca, Eduardo Antunes; Riello Mello, Eduardo Linhares; Makdissi, Fabio Ferrari; Waechter, Fabio Luiz; Carnevale, Francisco Cesar; Coura-Filho, George B; de Paulo, Gustavo Andrade; Girotto, Gustavo Colagiovanni; Neto, João Evangelista Bezerra; Glasberg, João; Casali-da-Rocha, Jose Claudio; Rego, Juliana Florinda M; de Meirelles, Luciana Rodrigues; Hajjar, Ludhmila; Menezes, Marcos; Bronstein, Marcello D; Sapienza, Marcelo Tatit; Fragoso, Maria Candida Barisson Villares; Pereira, Maria Adelaide Albergaria; Barros, Milton; Forones, Nora Manoukian; do Amaral, Paulo Cezar Galvão; de Medeiros, Raphael Salles Scortegagna; Araujo, Raphael L C; Bezerra, Regis Otaviano França; Peixoto, Renata D’Alpino; Aguiar, Samuel; Ribeiro, Ulysses; Pfiffer, Tulio; Hoff, Paulo M; Coutinho, Anelisa K

2017-01-01

Neuroendocrine tumours are a heterogeneous group of diseases with a significant variety of diagnostic tests and treatment modalities. Guidelines were developed by North American and European groups to recommend their best management. However, local particularities and relativisms found worldwide led us to create Brazilian guidelines. Our consensus considered the best feasible strategies in an environment involving more limited resources. We believe that our recommendations may be extended to other countries with similar economic standards. PMID:28194228
Technique to Avoid Hemodialysis Catheter in Patients with Failing Aneurysmal Arteriovenous Fistula by Creating a Concomitant New Arteriovenous Fistula.

PubMed

Lara, Kelly A; Chua, Rochelle Anne; Vo, Trung D

2018-05-01

Autogenous arteriovenous fistula (AVF) is the primary recommended access for hemodialysis. Long-term use will not uncommonly result in AVF aneurysmal degeneration. Aneurysm-associated complications encompass pain, skin ulceration, infection, thrombosis, cannulation difficulties, and life-threatening bleeding. Various methods to repair aneurysmal AVFs have been described. However, there may be circumstances when this is not possible and require insertion of a temporary hemodialysis catheter (HDC) until a new arteriovenous access is created. We describe a case series of creating a new simultaneous AVF while continuing to use the primary failing aneurysmal AVF to avoid placement of an HDC. Once the new AVF becomes operational, the primary aneurysmal AVF can be abandoned. Six patients underwent simultaneous new AVF creation, 4 ipsilateral, and 2 contralateral. None of the patients developed symptomatic steal syndrome or congestive heart failure. Five of 6 patients had successful usage of the new AVF, and subsequently underwent ligation and excision of the aneurysmal AVF, thus avoiding a temporary HDC. Close monitoring for skin compromise and bleeding in the aneurysmal AVF is recommended while the new AVF matures. Copyright © 2018 Elsevier Inc. All rights reserved.
Development of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) for migrants to Western societies: an international Delphi consensus process.

PubMed

Gagnon, Anita J; DeBruyn, Rebecca; Essén, Birgitta; Gissler, Mika; Heaman, Maureen; Jeambey, Zeinab; Korfker, Dineke; McCourt, Christine; Roth, Carolyn; Zeitlin, Jennifer; Small, Rhonda

2014-06-10

Through the World Health Assembly Resolution, 'Health of Migrants', the international community has identified migrant health as a priority. Recommendations for general hospital care for international migrants in receiving-countries have been put forward by the Migrant Friendly Hospital Initiative; adaptations of these recommendations specific to maternity care have yet to be elucidated and validated. We aimed to develop a questionnaire measuring migrant-friendly maternity care (MFMC) which could be used in a range of maternity care settings and countries. This study was conducted in four stages. First, questions related to migrant friendly maternity care were identified from existing questionnaires including the Migrant Friendliness Quality Questionnaire, developed in Europe to capture recommended general hospital care for migrants, and the Mothers In a New Country (MINC) Questionnaire, developed in Australia and revised for use in Canada to capture the maternity care experiences of migrant women, and combined to create an initial MFMC questionnaire. Second, a Delphi consensus process in three rounds with a panel of 89 experts in perinatal health and migration from 17 countries was undertaken to identify priority themes and questions as well as to clarify wording and format. Third, the draft questionnaire was translated from English to French and Spanish and back-translated and subsequently culturally validated (assessed for cultural appropriateness) by migrant women. Fourth, the questionnaire was piloted with migrant women who had recently given birth in Montreal, Canada. A 112-item questionnaire on maternity care from pregnancy, through labour and birth, to postpartum care, and including items on maternal socio-demographic, migration and obstetrical characteristics, and perceptions of care, has been created--the Migrant Friendly Maternity Care Questionnaire (MFMCQ)--in three languages (English, French and Spanish). It is completed in 45 minutes via interview administration several months post-birth. A 4-stage process of questionnaire development with international experts in migrant reproductive health and research resulted in the MFMCQ, a questionnaire measuring key aspects of migrant-sensitive maternity care. The MFMCQ is available for further translation and use to examine and compare care and perceptions of care within and across countries, and by key socio-demographic, migration, and obstetrical characteristics of migrant women.
Development of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) for migrants to Western societies: an international Delphi consensus process

PubMed Central

2014-01-01

Background Through the World Health Assembly Resolution, ‘Health of Migrants’, the international community has identified migrant health as a priority. Recommendations for general hospital care for international migrants in receiving-countries have been put forward by the Migrant Friendly Hospital Initiative; adaptations of these recommendations specific to maternity care have yet to be elucidated and validated. We aimed to develop a questionnaire measuring migrant-friendly maternity care (MFMC) which could be used in a range of maternity care settings and countries. Methods This study was conducted in four stages. First, questions related to migrant friendly maternity care were identified from existing questionnaires including the Migrant Friendliness Quality Questionnaire, developed in Europe to capture recommended general hospital care for migrants, and the Mothers In a New Country (MINC) Questionnaire, developed in Australia and revised for use in Canada to capture the maternity care experiences of migrant women, and combined to create an initial MFMC questionnaire. Second, a Delphi consensus process in three rounds with a panel of 89 experts in perinatal health and migration from 17 countries was undertaken to identify priority themes and questions as well as to clarify wording and format. Third, the draft questionnaire was translated from English to French and Spanish and back-translated and subsequently culturally validated (assessed for cultural appropriateness) by migrant women. Fourth, the questionnaire was piloted with migrant women who had recently given birth in Montreal, Canada. Results A 112-item questionnaire on maternity care from pregnancy, through labour and birth, to postpartum care, and including items on maternal socio-demographic, migration and obstetrical characteristics, and perceptions of care, has been created - the Migrant Friendly Maternity Care Questionnaire (MFMCQ) – in three languages (English, French and Spanish). It is completed in 45 minutes via interview administration several months post-birth. Conclusions A 4-stage process of questionnaire development with international experts in migrant reproductive health and research resulted in the MFMCQ, a questionnaire measuring key aspects of migrant-sensitive maternity care. The MFMCQ is available for further translation and use to examine and compare care and perceptions of care within and across countries, and by key socio-demographic, migration, and obstetrical characteristics of migrant women. PMID:24916892
Academic Medical Centers Forming Accountable Care Organizations and Partnering With Community Providers: The Experience of the Johns Hopkins Medicine Alliance for Patients.

PubMed

Berkowitz, Scott A; Ishii, Lisa; Schulz, John; Poffenroth, Matt

2016-03-01

Academic medical centers (AMCs)--which include teaching hospital(s) and additional care delivery entities--that form accountable care organizations (ACOs) must decide whether to partner with other provider entities, such as community practices. Indeed, 67% (33/49) of AMC ACOs through the Medicare Shared Savings Program through 2014 are believed to include an outside community practice. There are opportunities for both the AMC and the community partners in pursuing such relationships, including possible alignment around shared goals and adding ACO beneficiaries. To create the Johns Hopkins Medicine Alliance for Patients (JMAP), in January 2014, Johns Hopkins Medicine chose to partner with two community primary care groups and one cardiology practice to support clinical integration while adding approximately 60 providers and 5,000 Medicare beneficiaries. The principal initial interventions within JMAP included care coordination for high-risk beneficiaries and later, in 2014, generating dashboards of ACO quality measures to facilitate quality improvement and early efforts at incorporating clinical pathways and Choosing Wisely recommendations. Additional interventions began in 2015.The principal initial challenges JMAP faced were data integration, generation of quality measure reports among disparate electronic medical records, receiving and then analyzing claims data, and seeking to achieve provider engagement; all these affected timely deployment of the early interventions. JMAP also created three regional advisory councils as a forum promoting engagement of local leadership. Network strategies among AMCs, including adding community practices in a nonemployment model, will continue to require thoughtful strategic planning and a keen understanding of local context.
Barriers to appropriate care for mothers and infants during the perinatal period in rural Afghanistan: A qualitative assessment

PubMed Central

Newbrander, William; Natiq, Kayhan; Shahim, Shafiqullah; Hamid, Najibullah; Skena, Naomi Brill

2013-01-01

This study, conducted in five rural districts in Afghanistan, used qualitative methods to explore traditional practices of women, families and communities related to maternal and newborn care, and sociocultural and health system issues that create access barriers. The traditional practices discussed include delayed bathing of mothers and delayed breastfeeding of infants, seclusion of women after childbirth, restricted maternal diet, and use of traditional home remedies and self-medication instead of care in health facilities to treat maternal and newborn conditions. This study also looked at community support structures, transportation and care-seeking behaviour for maternal and newborn problems which create access barriers. Sociocultural barriers to better maternal-newborn health include shame about utilisation of maternal and neonatal services, women's inability to seek care without being accompanied by a male relative, and care-seeking from mullahs for serious health concerns. This study also found a high level of post-partum depression. Targeted and more effective behaviour-change communication programmes are needed. This study presents a set of behaviour-change messages to reduce maternal and newborn mortality associated with births occurring at home in rural communities. This study recommends using religious leaders, trained health workers, family health action groups and radio to disseminate these messages. PMID:24003851
Defining competition in markets: why and how?

PubMed Central

Bernstein, A B; Gauthier, A K

1998-01-01

OBJECTIVE: To examine the variety of perspectives from which to study the measurement of competition in the healthcare marketplace. Based on a meeting held by The Robert Wood Johnson Foundation in 1996, the authors discuss the complications inherent in the way markets and products are defined by key stakeholders, including economists, policymakers, federal antitrust officials, purchasers, and the competitors themselves. CONCLUSION: The consensus among those who study this issue is that the way competitors, markets, and geographic areas are currently defined, and the ways of measuring competition, are inadequate, due mainly to the fact that both the measures and the definitions have been constructed from very limited data. Confounding this is the fact that analyses of competition are undertaken for such a wide variety of uses and that creating one database to solve the problems mentioned can be extremely daunting. RECOMMENDATIONS: Future research should examine ways to develop better definitions of the new healthcare structures that are competing with each other and ways to create measures of competition that include these new structures. To remedy gaps in the ability to measure competition, the field might also benefit from a public use data file, similar to the Area Resource File (ARF), that would contain HMO data according to geographic area, as well as provider data, employer data, payer data, and sociodemographic data. PMID:9865227
Systematic review of health branding: growth of a promising practice.

PubMed

Evans, W Douglas; Blitstein, Jonathan; Vallone, Donna; Post, Samantha; Nielsen, Wendy

2015-03-01

Brands are marketing tools that create mental representations in the minds of consumers about products, services, and organizations. Brands create schema that help consumers decide whether to initiate or continue use of a product or service. Health branding determines behavioral choice by building consumer relationships and identification with health behaviors and their benefits. Health branding can be measured by the associations individuals form with health behaviors. In 2008, Evans and colleagues systematically reviewed the literature on health brands, reported on branded health messages and campaigns worldwide, and examined specific branding strategies in multiple subject areas. This paper extends that review. We replicated the comprehensive online literature search strategy from 2008. We screened a total of 311 articles and included 130 for full-text review. This included both articles from the 2008 review and new articles. After excluding those new articles that did not meet full-text inclusion criteria, we reviewed 69 in total. Of these, 32 were new articles since the 2008 review. Branded health campaigns cover most major domains of public health and appear worldwide. Since 2008, we observed improvement in evaluation, application of theory, and description of campaign strategies in published work. We recommend enhanced education of public health practitioners and researchers on the use and evaluation of branding.
Measuring social science concepts in pharmacy education research: From definition to item analysis of self-report instruments.

PubMed

Cor, M Ken

Interpreting results from quantitative research can be difficult when measures of concepts are constructed poorly, something that can limit measurement validity. Social science steps for defining concepts, guidelines for limiting construct-irrelevant variance when writing self-report questions, and techniques for conducting basic item analysis are reviewed to inform the design of instruments to measure social science concepts in pharmacy education research. Based on a review of the literature, four main recommendations emerge: These include: (1) employ a systematic process of conceptualization to derive nominal definitions; (2) write exact and detailed operational definitions for each concept, (3) when creating self-report questionnaires, write statements and select scales to avoid introducing construct-irrelevant variance (CIV); and (4) use basic item analysis results to inform instrument revision. Employing recommendations that emerge from this review will strengthen arguments to support measurement validity which in turn will support the defensibility of study finding interpretations. An example from pharmacy education research is used to contextualize the concepts introduced. Copyright © 2017 Elsevier Inc. All rights reserved.
Autism Spectrum Disorder: Primary Care Principles.

PubMed

Sanchack, Kristian E; Thomas, Craig A

2016-12-15

Autism spectrum disorder is characterized by difficulty with social communication and restricted, repetitive patterns of behavior, interest, or activities. The Diagnostic and Statistical Manual of Mental Disorders, 5th ed., created an umbrella diagnosis that includes several previously separate conditions: autistic disorder, Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. There is insufficient evidence to recommend screening for autism spectrum disorder in children 18 to 30 months of age in whom the disorder is not suspected; however, there is a growing body of evidence that early intensive behavioral intervention based on applied behavior analysis improves cognitive ability, language, and adaptive skills. Therefore, early identification of autism spectrum disorder is important, and experts recommend the use of a validated screening tool at 18- and 24-month well-child visits. Medications can be used as adjunctive treatment for maladaptive behaviors and comorbid psychiatric conditions, but there is no single medical therapy that is effective for all symptoms of autism spectrum disorder. Prognosis is heavily affected by the severity of diagnosis and the presence of intellectual disability. Children with optimal outcomes receive earlier, more intensive behavioral interventions and less pharmacologic treatment.
Cumulative biological impacts of The Geysers geothermal development

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

Brownell, J.A.

1981-10-01

The cumulative nature of current and potential future biological impacts from full geothermal development in the steam-dominated portion of The Geysers-Calistoga KGRA are identified by the California Energy Commission staff. Vegetation, wildlife, and aquatic resources information have been reviewed and evaluated. Impacts and their significance are discussed and staff recommendations presented. Development of 3000 MW of electrical energy will result in direct vegetation losses of 2790 acres, based on an estimate of 11.5% loss per lease-hold of 0.93 acres/MW. If unmitigated, losses will be greater. Indirect vegetation losses and damage occur from steam emissions which contain elements (particularly boron) toxicmore » to vegetation. Other potential impacts include chronic low-level boron exposure, acid rain, local climate modification, and mechanical damage. A potential exists for significant reduction and changes in wildlife from direct habitat loss and development influences. Highly erosive soils create the potential for significant reduction of aquatic resources, particularly game fish. Toxic spills have caused some temporary losses of aquatic species. Staff recommends monitoring and implementation of mitigation measures at all geothermal development stages.« less

Managing Incidental Pancreatic Cysts.

PubMed

Phan, Jennifer; Raman Muthusamy, V

2018-06-09

The goal of this review is to critically analyze the current literature regarding the management of incidental pancreatic cysts. Given their increased rates of detection due to the frequent use of cross-sectional imaging, correctly identifying the subset of high risk lesions that are appropriate for surgical resection is critical. However, the existing consensus and societal guidelines discussed in this review lack high quality data to create evidence-based recommendations, making achieving this important aim challenging. Several recent studies have focused on the natural history of pancreatic cysts and defining the role of endoscopic ultrasound, which remains unclear. EUS-guided diagnostic tools include molecular analysis of obtained fluid; EUS-guided FNA, FNB, and intracystic forceps biopsy of the cyst wall; and confocal endomicroscopy. While their precise role in diagnosing pancreatic cystic neoplasms remains to be defined, they represent promising innovations that may play a future role in cyst assessment and management. Large, long-term, prospective studies of incidentally identified pancreatic cysts are essential to fully understand their natural history and potential for neoplastic progression. Given the absence of such data at present, an individualized patient approach is recommended.
A no-fault compensation system for medical injury is long overdue.

PubMed

Weisbrot, David; Breen, Kerry J

2012-09-03

The 2011 report of the Productivity Commission (PC) recommended the establishment of a no-fault national injury insurance scheme limited to "catastrophic" injury, including medical injury. The report is welcome, but represents a missed opportunity to establish simultaneously a much-needed no-fault scheme for all medical injuries. The existing indemnity scheme based on negligence remains a slow, costly, inefficient, ill targeted and stress-creating system. A fault-based negligence scheme cannot deter non-intentional errors and does little to identify or prevent systems failures. In addition, it discourages reporting, and thus is antithetical to the modern focus on universal patient safety. A no-fault scheme has the potential to be fairer, quicker and no more costly, and to contribute to patient safety. No-fault schemes have been in place in at least six developed countries for many years. This extensive experience in comparable countries should be examined to assist Australia to design an effective, comprehensive system. Before implementing the recommendations of the PC, the federal government should ask the Commission to study and promptly report on an ancillary no-fault scheme that covers all medical injury.
Lesbian, Gay, and Heterosexual Adoptive Parents' Experiences in Preschool Environments

PubMed Central

Goldberg, Abbie E.

2014-01-01

Little research has examined the school experiences of lesbian/gay (LG) parent families or adoptive parent families. The current exploratory study examined the experiences of 79 lesbian, 75 gay male, and 112 heterosexual adoptive parents of preschool-age children with respect to their (a) level of disclosure regarding their LG parent and adoptive family status at their children's schools; (b) perceived challenges in navigating the preschool environment and advocating on behalf of their children and families; and (c) recommendations to teachers and schools about how to create affirming school environments with respect to family structure, adoption, and race/ethnicity. Findings revealed that the majority of parents were open about their LG and adoptive family status, and had not encountered challenges related to family diversity. Those parents who did experience challenges tended to describe implicit forms of marginalization, such as insensitive language and school assignments. Recommendations for teachers included discussing and reading books about diverse families, tailoring assignments to meet the needs of diverse families, and offering school community-building activities and events to help bridge differences across families. PMID:25414543
Lesbian, Gay, and Heterosexual Adoptive Parents' Experiences in Preschool Environments.

PubMed

Goldberg, Abbie E

2014-01-01

Little research has examined the school experiences of lesbian/gay (LG) parent families or adoptive parent families. The current exploratory study examined the experiences of 79 lesbian, 75 gay male, and 112 heterosexual adoptive parents of preschool-age children with respect to their (a) level of disclosure regarding their LG parent and adoptive family status at their children's schools; (b) perceived challenges in navigating the preschool environment and advocating on behalf of their children and families; and (c) recommendations to teachers and schools about how to create affirming school environments with respect to family structure, adoption, and race/ethnicity. Findings revealed that the majority of parents were open about their LG and adoptive family status, and had not encountered challenges related to family diversity. Those parents who did experience challenges tended to describe implicit forms of marginalization, such as insensitive language and school assignments. Recommendations for teachers included discussing and reading books about diverse families, tailoring assignments to meet the needs of diverse families, and offering school community-building activities and events to help bridge differences across families.
[Attention deficit hyperactivity disorder].

PubMed

Cunill, Ruth; Castells, Xavier

2015-04-20

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders and can persist into the adulthood. ADHD has important social, academic and occupational consequences. ADHD diagnosis is based on the fulfillment of several clinical criteria, which can vary depending on the diagnostic system used. The clinical presentation can show great between-patient variability and it has been related to a dysfunction in the fronto-striatal and meso-limbic circuits. Recent investigations support a model in which multiple genetic and environmental factors interact to create a neurobiological susceptibility to develop the disorder. However, no clear causal association has yet been identified. Although multimodal treatment including both pharmacological and psychosocial interventions is usually recommended, no convincing evidence exists to support this recommendation. Pharmacological treatment has fundamentally shown to improve ADHD symptoms in the short term, while efficacy data for psychosocial interventions are scarce and inconsistent. Yet, drug treatment is increasingly popular and the last 2 decades have witnessed a sharp increase in the prescription of anti-ADHD medications coinciding with the marketing of new drugs to treat ADHD. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Broad and Inconsistent Muscle Food Classification Is Problematic for Dietary Guidance in the U.S.

PubMed Central

O’Connor, Lauren E.; Campbell, Wayne W.; Woerner, Dale R.; Belk, Keith E.

2017-01-01

Dietary recommendations regarding consumption of muscle foods, such as red meat, processed meat, poultry or fish, largely rely on current dietary intake assessment methods. This narrative review summarizes how U.S. intake values for various types of muscle foods are grouped and estimated via methods that include: (1) food frequency questionnaires; (2) food disappearance data from the U.S. Department of Agriculture Economic Research Service; and (3) dietary recall information from the National Health and Nutrition Examination Survey data. These reported methods inconsistently classify muscle foods into groups, such as those previously listed, which creates discrepancies in estimated intakes. Researchers who classify muscle foods into these groups do not consistently considered nutrient content, in turn leading to implications of scientific conclusions and dietary recommendations. Consequentially, these factors demonstrate a need for a more universal muscle food classification system. Further specification to this system would improve accuracy and precision in which researchers can classify muscle foods in nutrition research. Future multidisciplinary collaboration is needed to develop a new classification system via systematic review protocol of current literature. PMID:28926963
Evaluation of Factors that Influence Residential Solar Panel Installations

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

Morton, April M.; Omitaomu, Olufemi A.; Kotikot, Susan M.

Though rooftop photovoltaic (PV) systems are the fastest growing source of distributed generation, detailed information about where they are located and who their owners are is often known only to installers and utility companies. This lack of detailed information is a barrier to policy and financial assessment of solar energy generation and use. To bridge the described data gap, Oak Ridge National Laboratory (ORNL) was sponsored by the Department of Energy (DOE) Office of Energy Policy and Systems Analysis (EPSA) to create an automated approach for detecting and characterizing buildings with installed solar panels using high-resolution overhead imagery. Additionally, ORNLmore » was tasked with using machine learning techniques to classify parcels on which solar panels were automatically detected in the Washington, DC, and Boston areas as commercial or residential, and then providing a list of recommended variables and modeling techniques that could be combined with these results to identify attributes that motivate the installation of residential solar panels. This technical report describes the methodology, results, and recommendations in greater detail, including lessons learned and future work.« less
Online faculty development for creating E-learning materials.

PubMed

Niebuhr, Virginia; Niebuhr, Bruce; Trumble, Julie; Urbani, Mary Jo

2014-01-01

Faculty who want to develop e-learning materials face pedagogical challenges of transforming instruction for the online environment, especially as many have never experienced online learning themselves. They face technical challenges of learning new software and time challenges of not all being able to be in the same place at the same time to learn these new skills. The objective of the Any Day Any Place Teaching (ADAPT) faculty development program was to create an online experience in which faculty could learn to produce e-learning materials. The ADAPT curriculum included units on instructional design, copyright principles and peer review, all for the online environment, and units on specific software tools. Participants experienced asynchronous and synchronous methods, including a learning management system, PC-based videoconferencing, online discussions, desktop sharing, an online toolbox and optional face-to-face labs. Project outcomes were e-learning materials developed and participants' evaluations of the experience. Likert scale responses for five instructional units (quantitative) were analyzed for distance from neutral using one-sample t-tests. Interview data (qualitative) were analyzed with assurance of data trustworthiness and thematic analysis techniques. Participants were 27 interprofessional faculty. They evaluated the program instruction as easy to access, engaging and logically presented. They reported increased confidence in new skills and increased awareness of copyright issues, yet continued to have time management challenges and remained uncomfortable about peer review. They produced 22 new instructional materials. Online faculty development methods are helpful for faculty learning to create e-learning materials. Recommendations are made to increase the success of such a faculty development program.
75 FR 64985 - Upper Rio Grande Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-21

... money. DATES: The meeting will be held on November 8, 2010, and will begin at 10 a.m. ADDRESSES: The... and recommend project proposals to be funded with Title II money; (3) Create a timeline to receive and...
PATHOGEN EQUIVALENCY COMMITTEE (PEC)

EPA Science Inventory

The U.S. Environmental Protection Agency created the PEC in 1985 to make recommendations to EPA and State managers on the equivalency of unproven sewage sludge disinfection technologies/processes to either a Process to Significantly Reduce Pathogens (PSRP) or a Process to Further...
SmartPark Technology Demonstration Project, Phase II: Final Report : Technology Brief

DOT National Transportation Integrated Search

2018-05-01

In 2000, the National Transportation Safety Board recommended that the Federal Motor Carrier Safety Administration (FMCSA) create a guide to inform truck drivers about locations and availability of parking. In 2002, the Federal Highway Administration...
"Since I have my case manager, I am back to life" case management in Croatia.

PubMed

Gruber, Ema N; Ivezić-Strkalj, Sladana; Agius, Mark; Martić-Biocina, Sanja

2008-03-01

The authors present a case report of a patient who was treated by a case manager, a member of a Croatian Community Mental Health (CMH) Team, following the recommendations of WHO 2004 as well as the IRIS guidelines and the Basic Standards for Management of Patients with Serious Mental Illness in the Community (Agius 2005) and using the elements of Clinical case management (Muser 1998), Assertive community treatment model (Burns 1995, Scott 1995, Wolfsan 1990), the personal strength model (Rapp 1988) and Rehabilitation model (Anthony 1993). In order to emphasize the importance of the therapist-patient relationship in the treatment of chronic schizophrenic patients (Ivezic 2001) and creating the group atmosphere a Croatian model of case management is created where the patient's needs and risks are assessed by a multidisciplinary team which also conducts the recommended psychosocial interventions plan. The majority of interventions are conducted in groups. The case manager develops a confident relationship with a patient, nourishes the positive transference and aids the delivery of the treatment. The main goals of the interventions are empowerment of the patient, improvement of his abilities and decreasing of disabilities. The case manager also carries out a full assessment of the needs of the patient's family so that the family or carers are also included in the treatment or support if necessary (Gruber 2006). A case report of a patient and the work of her case manager as well as the case manager's diary (Gruber 2007) and the Croatian model of case management is presented in this article.
Literature review of visual representation of the results of benefit-risk assessments of medicinal products.

PubMed

Hallgreen, Christine E; Mt-Isa, Shahrul; Lieftucht, Alfons; Phillips, Lawrence D; Hughes, Diana; Talbot, Susan; Asiimwe, Alex; Downey, Gerald; Genov, Georgy; Hermann, Richard; Noel, Rebecca; Peters, Ruth; Micaleff, Alain; Tzoulaki, Ioanna; Ashby, Deborah

2016-03-01

The PROTECT Benefit-Risk group is dedicated to research in methods for continuous benefit-risk monitoring of medicines, including the presentation of the results, with a particular emphasis on graphical methods. A comprehensive review was performed to identify visuals used for medical risk and benefit-risk communication. The identified visual displays were grouped into visual types, and each visual type was appraised based on five criteria: intended audience, intended message, knowledge required to understand the visual, unintentional messages that may be derived from the visual and missing information that may be needed to understand the visual. Sixty-six examples of visual formats were identified from the literature and classified into 14 visual types. We found that there is not one single visual format that is consistently superior to others for the communication of benefit-risk information. In addition, we found that most of the drawbacks found in the visual formats could be considered general to visual communication, although some appear more relevant to specific formats and should be considered when creating visuals for different audiences depending on the exact message to be communicated. We have arrived at recommendations for the use of visual displays for benefit-risk communication. The recommendation refers to the creation of visuals. We outline four criteria to determine audience-visual compatibility and consider these to be a key task in creating any visual. Next we propose specific visual formats of interest, to be explored further for their ability to address nine different types of benefit-risk analysis information. Copyright © 2015 John Wiley & Sons, Ltd.
TH-A-204-01: Part I - Key Data for Ionizing-Radiation Dosimetry

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

Seltzer, S.

The ICRU is currently finalizing a report on key data for radiation dosimetry. This multi-year review has resulted in a number of recommendations regarding “fundamental” data that are used in dosimetry related to radiation therapy. This educational session will explain the background for the ICRU committee’s work, the content and conclusions of the report and the impact on outputs, including NIST primary standards, ADCL calibration coefficients and clinical reference dosimetry. Parameters and beam modalities potentially affected by this report include: The mean excitation energy, I, for graphite, air, and water, The average energy required to create an ion pair inmore » dry air (commonly referred to as W/e), The uncertainty in the determination of air kerma in kV x-rays The absolute value of Co-60 and Cs-137 primary standards and the dissemination of calibration coefficients, The determination of air kerma strength for Ir-192 HDR brachytherapy sources Ion chamber kQ factors for linac MV beams Ion chamber kQ factors for proton beams. The changes in reference dosimetry that would result from adoption of the ICRU recommendations are of the order of 0.5% to 1%, an effect that will not impact clinical dose delivery but will be detectable in the clinical setting. This session will also outline how worldwide metrology is coordinated through the Convention of the Meter and therefore how the international dosimetry community will proceed with adopting these recommendations so that uniformity from country to country in reference dosimetry is maintained. Timelines and communications methods will also be discussed to ensure that users, such as clinical medical physicists, are not surprised when their chamber’s calibration coefficient apparently changes. Learning Objectives: Understand the background for the ICRU committee’s work on key dosimetry data. Understand the proposed changes to key data and the impacts on reference dosimetry. Understand the methodology and timeline for adoption of the ICRU recommendations.« less
TH-A-204-02: Part II - Worldwide Radiation Metrology

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

McEwen, M.

The ICRU is currently finalizing a report on key data for radiation dosimetry. This multi-year review has resulted in a number of recommendations regarding “fundamental” data that are used in dosimetry related to radiation therapy. This educational session will explain the background for the ICRU committee’s work, the content and conclusions of the report and the impact on outputs, including NIST primary standards, ADCL calibration coefficients and clinical reference dosimetry. Parameters and beam modalities potentially affected by this report include: The mean excitation energy, I, for graphite, air, and water, The average energy required to create an ion pair inmore » dry air (commonly referred to as W/e), The uncertainty in the determination of air kerma in kV x-rays The absolute value of Co-60 and Cs-137 primary standards and the dissemination of calibration coefficients, The determination of air kerma strength for Ir-192 HDR brachytherapy sources Ion chamber kQ factors for linac MV beams Ion chamber kQ factors for proton beams. The changes in reference dosimetry that would result from adoption of the ICRU recommendations are of the order of 0.5% to 1%, an effect that will not impact clinical dose delivery but will be detectable in the clinical setting. This session will also outline how worldwide metrology is coordinated through the Convention of the Meter and therefore how the international dosimetry community will proceed with adopting these recommendations so that uniformity from country to country in reference dosimetry is maintained. Timelines and communications methods will also be discussed to ensure that users, such as clinical medical physicists, are not surprised when their chamber’s calibration coefficient apparently changes. Learning Objectives: Understand the background for the ICRU committee’s work on key dosimetry data. Understand the proposed changes to key data and the impacts on reference dosimetry. Understand the methodology and timeline for adoption of the ICRU recommendations.« less
Introducing students to patient safety through an online interprofessional course.

PubMed

Blue, Amy V; Charles, Laurine; Howell, David; Koutalos, Yiannis; Mitcham, Maralynne; Nappi, Jean; Zoller, James

2010-01-01

Interprofessional education (IPE) is increasingly called upon to improve health care systems and patient safety. Our institution is engaged in a campus-wide IPE initiative. As a component of this initiative, a required online interprofessional patient-safety-focused course for a large group (300) of first-year medical, dental, and nursing students was developed and implemented. We describe our efforts with developing the course, including the use of constructivist and adult learning theories and IPE competencies to structure students' learning in a meaningful fashion. The course was conducted online to address obstacles of academic calendars and provide flexibility for faculty participation. Students worked in small groups online with a faculty facilitator. Thematic modules were created with associated objectives, online learning materials, and assignments. Students posted completed assignments online and responded to group members' assignments for purposes of group discussion. Students worked in interprofessional groups on a project requiring them to complete a root cause analysis and develop recommendations based on a fictional sentinel event case. Through project work, students applied concepts learned in the course related to improving patient safety and demonstrated interprofessional collaboration skills. Projects were presented during a final in-class session. Student course evaluation results suggest that learning objectives and content goals were achieved. Faculty course evaluation results indicate that the course was perceived to be a worthwhile learning experience for students. We offer the following recommendations to others interested in developing an in-depth interprofessional learning experience for a large group of learners: 1) consider a hybrid format (inclusion of some face-to-face sessions), 2) address IPE and broader curricular needs, 3) create interactive opportunities for shared learning and working together, 4) provide support to faculty facilitators, and 5) recognize your learners' educational level. The course has expanded to include students from additional programs for the current academic year.
Introducing students to patient safety through an online interprofessional course

PubMed Central

Blue, Amy V; Charles, Laurine; Howell, David; Koutalos, Yiannis; Mitcham, Maralynne; Nappi, Jean; Zoller, James

2010-01-01

Interprofessional education (IPE) is increasingly called upon to improve health care systems and patient safety. Our institution is engaged in a campus-wide IPE initiative. As a component of this initiative, a required online interprofessional patient-safety-focused course for a large group (300) of first-year medical, dental, and nursing students was developed and implemented. We describe our efforts with developing the course, including the use of constructivist and adult learning theories and IPE competencies to structure students’ learning in a meaningful fashion. The course was conducted online to address obstacles of academic calendars and provide flexibility for faculty participation. Students worked in small groups online with a faculty facilitator. Thematic modules were created with associated objectives, online learning materials, and assignments. Students posted completed assignments online and responded to group members’ assignments for purposes of group discussion. Students worked in interprofessional groups on a project requiring them to complete a root cause analysis and develop recommendations based on a fictional sentinel event case. Through project work, students applied concepts learned in the course related to improving patient safety and demonstrated interprofessional collaboration skills. Projects were presented during a final in-class session. Student course evaluation results suggest that learning objectives and content goals were achieved. Faculty course evaluation results indicate that the course was perceived to be a worthwhile learning experience for students. We offer the following recommendations to others interested in developing an in-depth interprofessional learning experience for a large group of learners: 1) consider a hybrid format (inclusion of some face-to-face sessions), 2) address IPE and broader curricular needs, 3) create interactive opportunities for shared learning and working together, 4) provide support to faculty facilitators, and 5) recognize your learners’ educational level. The course has expanded to include students from additional programs for the current academic year. PMID:23745069
Occupational exposures to respirable crystalline silica during hydraulic fracturing.

PubMed

Esswein, Eric J; Breitenstein, Michael; Snawder, John; Kiefer, Max; Sieber, W Karl

2013-01-01

This report describes a previously uncharacterized occupational health hazard: work crew exposures to respirable crystalline silica during hydraulic fracturing. Hydraulic fracturing involves high pressure injection of large volumes of water and sand, and smaller quantities of well treatment chemicals, into a gas or oil well to fracture shale or other rock formations, allowing more efficient recovery of hydrocarbons from a petroleum-bearing reservoir. Crystalline silica ("frac sand") is commonly used as a proppant to hold open cracks and fissures created by hydraulic pressure. Each stage of the process requires hundreds of thousands of pounds of quartz-containing sand; millions of pounds may be needed for all zones of a well. Mechanical handling of frac sand creates respirable crystalline silica dust, a potential exposure hazard for workers. Researchers at the National Institute for Occupational Safety and Health collected 111 personal breathing zone samples at 11 sites in five states to evaluate worker exposures to respirable crystalline silica during hydraulic fracturing. At each of the 11 sites, full-shift samples exceeded occupational health criteria (e.g., the Occupational Safety and Health Administration calculated permissible exposure limit, the NIOSH recommended exposure limit, or the ACGIH threshold limit value), in some cases, by 10 or more times the occupational health criteria. Based on these evaluations, an occupational health hazard was determined to exist for workplace exposures to crystalline silica. Seven points of dust generation were identified, including sand handling machinery and dust generated from the work site itself. Recommendations to control exposures include product substitution (when feasible), engineering controls or modifications to sand handling machinery, administrative controls, and use of personal protective equipment. To our knowledge, this represents the first systematic study of work crew exposures to crystalline silica during hydraulic fracturing. Companies that conduct hydraulic fracturing using silica sand should evaluate their operations to determine the potential for worker exposure to respirable crystalline silica and implement controls as necessary to protect workers.
[Preventing dependency in the elderly].

PubMed

Gómez Pavón, J; Martín Lesende, I; Baztán Cortés, J J; Regato Pajares, P; Formiga Pérez, F; Segura Benedito, A; Abizanda Soler, P; de Pedro Cuesta, J

2008-01-01

Dependency, i.e. the need to depend on another person to perform activities of daily living, is the main concern and cause of suffering and poor quality of life in the elderly. The prevalence of dependency increases with age and is related to the presence of prior disease and fragility. Dependency is associated with increased morbidity, mortality and institutionalization, as well as with greater health and social resource utilization, all of which increases health costs. To create a consensus document on the main health recommendations for the prevention of dependency in the elderly, based on the scientific evidence available to date, with the collaboration of scientific societies and public health administrations (the Spanish Ministry of Health, Autonomous Communities and Cities). a) a preliminary consensus document was drafted by an expert group composed of representatives of various scientific societies and health administrations. This document was based on a review of the recommendations and guidelines published by the main organizations involved in health promotion and the prevention of disease, functional deterioration and dependency in the elderly; b) the consensus document was reviewed by the remaining experts assigned by the scientific societies and central and autonomous administrations; c) the final document was approved after a session in which the text was discussed and reviewed by all the experts participating in the working group (including the academic committee); d) the document was presented and discussed in the First National Conference on Prevention and Health Promotion in Clinical Practice in Spain. All participating experts signed a conflicts of interest statement. The document provides recommendations, with their grades of evidence, grouped in the following three categories: a) health promotion and disease prevention, with specific preventive activities for the elderly, including prevention of geriatric syndromes; b) prevention of functional deterioration, with clinical recommendations that can be applied in primary and specialized care; c) prevention of iatrogeny (drug prescription, inappropriate use of diagnostic and therapeutic modalities and healthcare). These recommendations were tailored to the characteristics of the older person (OP), categorized in five groups: healthy OP, OP with chronic disease, fragile or at risk OP, dependent OP, and OP at the end of life. These recommendations should be implemented by public health administrations to improve strategies for the prevention of dependency in the elderly in the xxi century.
A Mobile App Development Guideline for Hospital Settings: Maximizing the Use of and Minimizing the Security Risks of "Bring Your Own Devices" Policies

PubMed Central

Pelletier, Alexandra; Sunthara, Gajen; Gujral, Nitin; Mittal, Vandna; Bourgeois, Fabienne C

2016-01-01

Background Hospitals today are introducing new mobile apps to improve patient care and workflow processes. Mobile device adoption by hospitals fits with present day technology behavior; however, requires a deeper look into hospital device policies and the impact on patients, staff, and technology development. Should hospitals spend thousands to millions of dollars to equip all personnel with a mobile device that is only used in a hospital environment? Allowing health care professionals to use personal mobile devices at work, known as bring-your-own-device (BYOD), has the potential to support both the hospital and its employees to deliver effective and efficient care. Objective The objectives of this research were to create a mobile app development guideline for a BYOD hospital environment, apply the guideline to the development of an in-house mobile app called TaskList, pilot the TaskList app within Boston Children’s Hospital (BCH), and refine the guideline based on the app pilot. TaskList is an Apple operating system (iOS)-based app designed for medical residents to monitor, create, capture, and share daily collaborative tasks associated with patients. Methods To create the BYOD guidelines, we developed TaskList that required the use of mobile devices among medical resident. The TaskList app was designed in four phases: (1) mobile app guideline development, (2) requirements gathering and developing of TaskList fitting the guideline, (3) deployment of TaskList using BYOD with end-users, and (4) refinement of the guideline based on the TaskList pilot. Phase 1 included understanding the existing hospital BYOD policies and conducting Web searches to find best practices in software development for a BYOD environment. Phase 1 also included gathering subject matter input from the Information Services Department (ISD) at BCH. Phase 2 involved the collaboration between the Innovation Acceleration Program at BCH, the ISD Department and the TaskList Clinical team in understanding what features should be built into the app. Phase 3 involved deployment of TaskList on a clinical floor at BCH. Lastly, Phase 4 gathered the lessons learned from the pilot to refine the guideline. Results Fourteen practical recommendations were identified to create the BCH Mobile Application Development Guideline to safeguard custom applications in hospital BYOD settings. The recommendations were grouped into four categories: (1) authentication and authorization, (2) data management, (3) safeguarding app environment, and (4) remote enforcement. Following the guideline, the TaskList app was developed and then was piloted with an inpatient ward team. Conclusions The Mobile Application Development guideline was created and used in the development of TaskList. The guideline is intended for use by developers when addressing integration with hospital information systems, deploying apps in BYOD health care settings, and meeting compliance standards, such as Health Insurance Portability and Accountability Act (HIPAA) regulations. PMID:27169345

A Mobile App Development Guideline for Hospital Settings: Maximizing the Use of and Minimizing the Security Risks of "Bring Your Own Devices" Policies.

PubMed

Al Ayubi, Soleh U; Pelletier, Alexandra; Sunthara, Gajen; Gujral, Nitin; Mittal, Vandna; Bourgeois, Fabienne C

2016-05-11

Hospitals today are introducing new mobile apps to improve patient care and workflow processes. Mobile device adoption by hospitals fits with present day technology behavior; however, requires a deeper look into hospital device policies and the impact on patients, staff, and technology development. Should hospitals spend thousands to millions of dollars to equip all personnel with a mobile device that is only used in a hospital environment? Allowing health care professionals to use personal mobile devices at work, known as bring-your-own-device (BYOD), has the potential to support both the hospital and its employees to deliver effective and efficient care. The objectives of this research were to create a mobile app development guideline for a BYOD hospital environment, apply the guideline to the development of an in-house mobile app called TaskList, pilot the TaskList app within Boston Children's Hospital (BCH), and refine the guideline based on the app pilot. TaskList is an Apple operating system (iOS)-based app designed for medical residents to monitor, create, capture, and share daily collaborative tasks associated with patients. To create the BYOD guidelines, we developed TaskList that required the use of mobile devices among medical resident. The TaskList app was designed in four phases: (1) mobile app guideline development, (2) requirements gathering and developing of TaskList fitting the guideline, (3) deployment of TaskList using BYOD with end-users, and (4) refinement of the guideline based on the TaskList pilot. Phase 1 included understanding the existing hospital BYOD policies and conducting Web searches to find best practices in software development for a BYOD environment. Phase 1 also included gathering subject matter input from the Information Services Department (ISD) at BCH. Phase 2 involved the collaboration between the Innovation Acceleration Program at BCH, the ISD Department and the TaskList Clinical team in understanding what features should be built into the app. Phase 3 involved deployment of TaskList on a clinical floor at BCH. Lastly, Phase 4 gathered the lessons learned from the pilot to refine the guideline. Fourteen practical recommendations were identified to create the BCH Mobile Application Development Guideline to safeguard custom applications in hospital BYOD settings. The recommendations were grouped into four categories: (1) authentication and authorization, (2) data management, (3) safeguarding app environment, and (4) remote enforcement. Following the guideline, the TaskList app was developed and then was piloted with an inpatient ward team. The Mobile Application Development guideline was created and used in the development of TaskList. The guideline is intended for use by developers when addressing integration with hospital information systems, deploying apps in BYOD health care settings, and meeting compliance standards, such as Health Insurance Portability and Accountability Act (HIPAA) regulations.
Soft Regulation with Crowd Recommendation: Coordinating Self-Interested Agents in Sociotechnical Systems under Imperfect Information.

PubMed

Luo, Yu; Iyengar, Garud; Venkatasubramanian, Venkat

2016-01-01

Regulating emerging industries is challenging, even controversial at times. Under-regulation can result in safety threats to plant personnel, surrounding communities, and the environment. Over-regulation may hinder innovation, progress, and economic growth. Since one typically has limited understanding of, and experience with, the novel technology in practice, it is difficult to accomplish a properly balanced regulation. In this work, we propose a control and coordination policy called soft regulation that attempts to strike the right balance and create a collective learning environment. In soft regulation mechanism, individual agents can accept, reject, or partially accept the regulator's recommendation. This non-intrusive coordination does not interrupt normal operations. The extent to which an agent accepts the recommendation is mediated by a confidence level (from 0 to 100%). Among all possible recommendation methods, we investigate two in particular: the best recommendation wherein the regulator is completely informed and the crowd recommendation wherein the regulator collects the crowd's average and recommends that value. We show by analysis and simulations that soft regulation with crowd recommendation performs well. It converges to optimum, and is as good as the best recommendation for a wide range of confidence levels. This work sheds a new theoretical perspective on the concept of the wisdom of crowds.
Soft Regulation with Crowd Recommendation: Coordinating Self-Interested Agents in Sociotechnical Systems under Imperfect Information

PubMed Central

2016-01-01

Regulating emerging industries is challenging, even controversial at times. Under-regulation can result in safety threats to plant personnel, surrounding communities, and the environment. Over-regulation may hinder innovation, progress, and economic growth. Since one typically has limited understanding of, and experience with, the novel technology in practice, it is difficult to accomplish a properly balanced regulation. In this work, we propose a control and coordination policy called soft regulation that attempts to strike the right balance and create a collective learning environment. In soft regulation mechanism, individual agents can accept, reject, or partially accept the regulator’s recommendation. This non-intrusive coordination does not interrupt normal operations. The extent to which an agent accepts the recommendation is mediated by a confidence level (from 0 to 100%). Among all possible recommendation methods, we investigate two in particular: the best recommendation wherein the regulator is completely informed and the crowd recommendation wherein the regulator collects the crowd’s average and recommends that value. We show by analysis and simulations that soft regulation with crowd recommendation performs well. It converges to optimum, and is as good as the best recommendation for a wide range of confidence levels. This work sheds a new theoretical perspective on the concept of the wisdom of crowds. PMID:26977699
A critical appraisal of guidelines for electronic communication between patients and clinicians: the need to modernize current recommendations.

PubMed

Lee, Joy L; Matthias, Marianne S; Menachemi, Nir; Frankel, Richard M; Weiner, Michael

2018-04-01

Patient-provider electronic communication has proliferated in recent years, yet there is a dearth of published research either leading to, or including, recommendations that improve clinical care and prevent unintended negative consequences. We critically appraise published guidelines and suggest an agenda for future work in this area. To understand how existing guidelines align with current practice, evidence, and technology. We performed a narrative review of provider-targeted guidelines for electronic communication between patients and providers, searching Ovid MEDLINE, Embase, and PubMed databases using relevant terms. We limited the search to articles published in English, and manually searched the citations of relevant articles. For each article, we identified and evaluated the suggested practices. Across 11 identified guidelines, the primary focus was on technical and administrative concerns, rather than on relational communication. Some of the security practices recommended by the guidelines are no longer needed because of shifts in technology. It is unclear the extent to which the recommendations that are still relevant are being followed. Moreover, there is no guideline-cited evidence of the effectiveness of the practices that have been proposed. Our analysis revealed major weaknesses in current guidelines for electronic communication between patients and providers: the guidelines appear to be based on minimal evidence and offer little guidance on how best to use electronic tools to communicate effectively. Further work is needed to systematically evaluate and identify effective practices, create a framework to evaluate quality of communication, and assess the relationship between electronic communication and quality of care.
Recommendations for Modeling Disaster Responses in Public Health and Medicine: A Position Paper of The Society for Medical Decision Making

PubMed Central

Brandeau, Margaret L.; McCoy, Jessica H.; Hupert, Nathaniel; Holty, Jon-Erik; Bravata, Dena M.

2013-01-01

Purpose Mathematical and simulation models are increasingly used to plan for and evaluate health sector responses to disasters, yet no clear consensus exists regarding best practices for the design, conduct, and reporting of such models. We examined a large selection of published health sector disaster response models to generate a set of best practice guidelines for such models. Methods We reviewed a spectrum of published disaster response models addressing public health or healthcare delivery, focusing in particular on the type of disaster and response decisions considered, decision makers targeted, choice of outcomes evaluated, modeling methodology, and reporting format. We developed initial recommendations for best practices for creating and reporting such models and refined these guidelines after soliciting feedback from response modeling experts and from members of the Society for Medical Decision Making. Results We propose six recommendations for model construction and reporting, inspired by the most exemplary models: Health sector disaster response models should address real-world problems; be designed for maximum usability by response planners; strike the appropriate balance between simplicity and complexity; include appropriate outcomes, which extend beyond those considered in traditional cost-effectiveness analyses; and be designed to evaluate the many uncertainties inherent in disaster response. Finally, good model reporting is particularly critical for disaster response models. Conclusions Quantitative models are critical tools for planning effective health sector responses to disasters. The recommendations we propose can increase the applicability and interpretability of future models, thereby improving strategic, tactical, and operational aspects of preparedness planning and response. PMID:19605887
An Analysis of Adolescent Content in South Africa's Contraception Policy Using a Human Rights Framework.

PubMed

Hoopes, Andrea J; Chandra-Mouli, Venkatraman; Steyn, Petrus; Shilubane, Tlangelani; Pleaner, Melanie

2015-12-01

To evaluate whether the updated South African national contraception policy and guidelines adequately address the needs of adolescents. We used the World Health Organization (WHO) guidance and recommendations on ensuring human rights in the provision of contraceptive information and services as an analytic framework. We assessed the South African policy in relation to each WHO summary recommendation. Specifically, we determined where normative guidance pertaining to adolescents is present and whether it is adequate, normative guidance pertaining to all populations but not specifically adolescents is present, or normative guidance for that recommendation is missing from the policy. We developed an analytic table to discuss with coauthors and draw conclusions. We found specific guidance for adolescents relating to 6/9 WHO summary recommendations and 11/24 subrecommendations. Adolescents are highlighted throughout the policy as being at risk for discrimination or coercion, and laws protecting the rights of adolescents are cited. Confidentiality of services for young people is emphasized, and youth-friendly services are described as a key element of service delivery. Areas to strengthen include the need for normative guidance ensuring both availability of contraceptive information and services for young people and adolescent participation in development of community programs and services. South Africa's contraception policy and guidelines are comprehensive and forward looking. Nevertheless, there are gaps that may leave adolescents vulnerable to discrimination and coercion and create barriers to accessing contraceptive services. These findings provide insight for the revision and development of adolescent health policies in South Africa and other settings. Copyright © 2015. Published by Elsevier Inc.
A service brokering and recommendation mechanism for better selecting cloud services.

PubMed

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

2014-01-01

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

PubMed

Rattan, Rishi; Joseph, D'Andrea K; Dente, Christopher J; Klein, Eric N; Kimbrough, Mary K; Nguyen, Jonathan; Simmons, Jon D; O'Keeffe, Terence; Crandall, Marie

2018-06-01

Despite increasing usage since their introduction, there exist no evidence-based guidelines on all-terrain vehicles (ATVs) and injury prevention. While the power and speed of these vehicles has increased over time, advancements in ATV safety have been rare. A priori questions about ATV injury pattern and the effect of helmet and safety equipment use and legislation mandating use were developed. A query of MEDLINE, PubMed, Cochrane Library, and Embase for all-terrain vehicle injury was performed. Letters to the editor, case reports, book chapters, and review articles were excluded. Grading of Recommendations Assessment, Development, and Evaluation methodology was used to perform a systematic review and create recommendations. Twenty-eight studies were included. Helmet use reduced traumatic brain injury (TBI). However, studies examining whether legislation mandating helmet use reduced TBI had mixed results. When ATV safety legislation was enforced, overall injury rates and mortality decreased. However, enforcement varied widely and lack of enforcement led to decreased compliance with legislation and mixed results. There was not enough evidence to determine the effectiveness of non-helmet-protective equipment. Helmet use when riding an ATV reduced the rate of TBI. ATV safety legislation, when enforced, also reduced morbidity and mortality. Compliance with laws is often low, however, possibly due to poor enforcement. We recommend helmet use when riding on an ATV to reduce TBI. We conditionally recommend implementing ATV safety legislation as a means to reduce ATV injuries, noting that enforcement must go hand in hand with enactment to ensure compliance.
Recommendations for modeling disaster responses in public health and medicine: a position paper of the society for medical decision making.

PubMed

Brandeau, Margaret L; McCoy, Jessica H; Hupert, Nathaniel; Holty, Jon-Erik; Bravata, Dena M

2009-01-01

Mathematical and simulation models are increasingly used to plan for and evaluate health sector responses to disasters, yet no clear consensus exists regarding best practices for the design, conduct, and reporting of such models. The authors examined a large selection of published health sector disaster response models to generate a set of best practice guidelines for such models. . The authors reviewed a spectrum of published disaster response models addressing public health or health care delivery, focusing in particular on the type of disaster and response decisions considered, decision makers targeted, choice of outcomes evaluated, modeling methodology, and reporting format. They developed initial recommendations for best practices for creating and reporting such models and refined these guidelines after soliciting feedback from response modeling experts and from members of the Society for Medical Decision Making. . The authors propose 6 recommendations for model construction and reporting, inspired by the most exemplary models: health sector disaster response models should address real-world problems, be designed for maximum usability by response planners, strike the appropriate balance between simplicity and complexity, include appropriate outcomes that extend beyond those considered in traditional cost-effectiveness analyses, and be designed to evaluate the many uncertainties inherent in disaster response. Finally, good model reporting is particularly critical for disaster response models. . Quantitative models are critical tools for planning effective health sector responses to disasters. The proposed recommendations can increase the applicability and interpretability of future models, thereby improving strategic, tactical, and operational aspects of preparedness planning and response.
Less is (sometimes) more in cognitive engineering: the role of automation technology in improving patient safety

PubMed Central

Vicente, K

2003-01-01

   There is a tendency to assume that medical error can be stamped out by automation. Technology may improve patient safety, but cognitive engineering research findings in several complex safety critical systems, including both aviation and health care, show that more is not always better. Less sophisticated technological systems can sometimes lead to better performance than more sophisticated systems. This "less is more" effect arises because safety critical systems are open systems where unanticipated events are bound to occur. In these contexts, decision support provided by a technological aid will be less than perfect because there will always be situations that the technology cannot accommodate. Designing sophisticated automation that suggests an uncertain course of action seems to encourage people to accept the imperfect advice, even though information to decide independently on a better course of action is available. It may be preferable to create more modest designs that merely provide feedback about the current state of affairs or that critique human generated solutions than to rush to automate by creating sophisticated technological systems that recommend (fallible) courses of action. PMID:12897363
Beyond the "Code": A Guide to the Description and Documentation of Biodiversity in Ciliated Protists (Alveolata, Ciliophora).

PubMed

Warren, Alan; Patterson, David J; Dunthorn, Micah; Clamp, John C; Achilles-Day, Undine E M; Aescht, Erna; Al-Farraj, Saleh A; Al-Quraishy, Saleh; Al-Rasheid, Khaled; Carr, Martin; Day, John G; Dellinger, Marc; El-Serehy, Hamed A; Fan, Yangbo; Gao, Feng; Gao, Shan; Gong, Jun; Gupta, Renu; Hu, Xiaozhong; Kamra, Komal; Langlois, Gaytha; Lin, Xiaofeng; Lipscomb, Diana; Lobban, Christopher S; Luporini, Pierangelo; Lynn, Denis H; Ma, Honggang; Macek, Miroslav; Mackenzie-Dodds, Jacqueline; Makhija, Seema; Mansergh, Robert I; Martín-Cereceda, Mercedes; McMiller, Nettie; Montagnes, David J S; Nikolaeva, Svetlana; Ong'ondo, Geoffrey Odhiambo; Pérez-Uz, Blanca; Purushothaman, Jasmine; Quintela-Alonso, Pablo; Rotterová, Johana; Santoferrara, Luciana; Shao, Chen; Shen, Zhuo; Shi, Xinlu; Song, Weibo; Stoeck, Thorsten; La Terza, Antonietta; Vallesi, Adriana; Wang, Mei; Weisse, Thomas; Wiackowski, Krzysztof; Wu, Lei; Xu, Kuidong; Yi, Zhenzhen; Zufall, Rebecca; Agatha, Sabine

2017-07-01

Recent advances in molecular technology have revolutionized research on all aspects of the biology of organisms, including ciliates, and created unprecedented opportunities for pursuing a more integrative approach to investigations of biodiversity. However, this goal is complicated by large gaps and inconsistencies that still exist in the foundation of basic information about biodiversity of ciliates. The present paper reviews issues relating to the taxonomy of ciliates and presents specific recommendations for best practice in the observation and documentation of their biodiversity. This effort stems from a workshop that explored ways to implement six Grand Challenges proposed by the International Research Coordination Network for Biodiversity of Ciliates (IRCN-BC). As part of its commitment to strengthening the knowledge base that supports research on biodiversity of ciliates, the IRCN-BC proposes to populate The Ciliate Guide, an online database, with biodiversity-related data and metadata to create a resource that will facilitate accurate taxonomic identifications and promote sharing of data. © 2017 The Authors Journal of Eukaryotic Microbiology published by Wiley Periodicals, Inc. on behalf of International Society of Protistologists.
Dealing with the long-term social implications of research.

PubMed

Fleischman, Alan; Levine, Carol; Eckenwiler, Lisa; Grady, Christine; Hammerschmidt, Dale E; Sugarman, Jeremy

2011-05-01

Biomedical and behavioral research may affect strongly held social values and thereby create significant controversy over whether such research should be permitted in the first place. Institutional review boards (IRBs) responsible for protecting the rights and welfare of participants in research are sometimes faced with review of protocols that have significant implications for social policy and the potential for negative social consequences. Although IRB members often raise concerns about potential long-term social implications in protocol review, federal regulations strongly discourage IRBs from considering them in their decisions. Yet IRBs often do consider the social implications of research protocols and sometimes create significant delays in initiating or even prevent such research. The social implications of research are important topics for public scrutiny and professional discussion. This article examines the reasons that the federal regulations preclude IRBs from assessing the social risks of research, and examines alternative approaches that have been used with varying success by national advisory groups to provide such guidance. The article concludes with recommendations for characteristics of a national advisory group that could successfully fulfill this need, including sustainability, independence, diverse and relevant expertise, and public transparency.
Systems Modeling for Crew Core Body Temperature Prediction Postlanding

NASA Technical Reports Server (NTRS)

Cross, Cynthia; Ochoa, Dustin

2010-01-01

The Orion Crew Exploration Vehicle, NASA s latest crewed spacecraft project, presents many challenges to its designers including ensuring crew survivability during nominal and off nominal landing conditions. With a nominal water landing planned off the coast of San Clemente, California, off nominal water landings could range from the far North Atlantic Ocean to the middle of the equatorial Pacific Ocean. For all of these conditions, the vehicle must provide sufficient life support resources to ensure that the crew member s core body temperatures are maintained at a safe level prior to crew rescue. This paper will examine the natural environments, environments created inside the cabin and constraints associated with post landing operations that affect the temperature of the crew member. Models of the capsule and the crew members are examined and analysis results are compared to the requirement for safe human exposure. Further, recommendations for updated modeling techniques and operational limits are included.
An Analysis of Physician Assistant LibGuides: A Tool for Collection Development.

PubMed

Johnson, Catherine V; Johnson, Scott Y

2017-01-01

The Physician Assistant (PA) specialty encompasses many subject areas and requires many types of library resources. An analysis of PA LibGuides was performed to determine most frequently recommended resources. A sample of LibGuides from U.S. institutions accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) was included in this study. Resources presented on guides were tabulated and organized by resource type. Databases and point-of-care tools were the types of resources listed by the most LibGuides. There were over 1,000 books listed on the 45 guides, including over 600 unique books listed. There were fewer journals listed, only 163. Overall, while the 45 LibGuides evaluated list many unique resources in each category, a librarian can create an accepted list of the most frequently listed resources from the data gathered.
An integrative conceptual framework of disability. New directions for research.

PubMed

Tate, Denise G; Pledger, Constance

2003-04-01

Advances in research on disability and rehabilitation are essential to creating equal opportunity, economic self-sufficiency, and full participation for persons with disabilities. Historically, such initiatives have focused on separate and specific areas, including neuroscience, molecular biology and genetics, gerontology, engineering and physical sciences, and social and behavioral sciences. Research on persons with disabilities should examine the broader context and trends of society that affect the total environment of persons with disabilities. This article examines the various disability paradigms across time, assessing the relative contribution of the socioecological perspective in guiding research designed to improve the lives of persons with disabilities. The authors recommend new research directions that include a focus on life span issues, biomedicine, biotechnology, the efficacy and effectiveness of current interventions, an emphasis on consumer-driven investigations within a socioecological perspective of disability, and the implications for research and practice.
Interdisciplinary Guidelines for Care of Women Presenting to the Emergency Department With Pregnancy Loss.

PubMed

Catlin, Anita

In April 2016, the National Perinatal Association and Kaiser Permanente Northern California Nursing Research Community Benefits Grant sponsored an interdisciplinary summit to explore the needs of women who present with actual or potential pregnancy loss to the emergency department (ED). Thirty-two experts in the field of pregnancy loss, 17 of whom represented their professional organizations, participated. These experts, which included nurses, physicians, social workers, counselors, authors, and parents, worked together to create guidelines for care of women with a pregnancy loss in the ED. Recommendations for ED healthcare providers are included. Emergency department personnel agreed that improvements in care could be offered and were willing to endorse education for their staff. The guidelines delineate how to better provide physical, emotional, and bereavement support at any stage of gestational loss. Administrative support for policies in the ED is essential to ensure the delivery of family-centered, culturally sensitive practices when a pregnancy ends.
Proceedings of second Indian GAME conference, Mumbai, February, 2016.

PubMed

Srivastava, Vaibhav; Stevenson, Robin; Sanghvi, Shwetal

2016-01-01

The second Indian Global Alliance for Medical Education (GAME) conference on continuing medical education-continuing professional development (CME-CPD) was held in Mumbai in February 2016. The main aim of the meeting was to create a blueprint for further development of CME in India based on best practices from around the world. To that end, delegates had been invited from the USA, the UK and Australasia, who engaged in productive discussions with the major stakeholders of the CME community in India. The latter included clinicians, medical communications representatives and delegates from the pharmaceutical industry. The mandatory CME system already established in Maharashtra was described as an example, which could be exported to other states. The various types of accreditation were discussed, including provider and activity accreditation along with hybrid systems. Recommendations for future development were proposed from workshops comprising clinicians, industry representatives and medical communications agencies.
Intentional Interprofessional Experiential Education.

PubMed

Grice, Gloria R; Thomason, Angela R; Meny, Lisa M; Pinelli, Nicole R; Martello, Jay L; Zorek, Joseph A

2018-04-01

The experiential component of a doctor of pharmacy curricula is an ideal, yet underutilized vehicle to advance interprofessional education (IPE) initiatives. To date, most experiential-based IPE initiatives occur in a naturally occurring, non-deliberate fashion. The American Association of Colleges of Pharmacy (AACP) Experiential Education Section formed the Task Force on Intentional Interprofessional Education in Experiential Education in academic year 2015-2016 to explore the issue. This commentary describes the work of the task force, including the following elements: defining intentional interprofessional experiential education as "the explicit effort by preceptors and practice sites to create/foster educational opportunities or activities designed specifically to achieve interprofessional educational competencies;" conducting a systematic literature review to identify examples of intentional interprofessional experiential education in the published literature; surveying faculty with oversight of experiential education programs and preceptors within those programs; and generating recommendations to stakeholders including AACP, pharmacy schools, and experiential education administrators.
Sibling rivalry and the new baby: anticipatory guidance and management strategies.

PubMed

Sawicki, J A

1997-01-01

Sibling rivalry can be found in many families and frequently creates a stressful and challenging situation for parents. The arrival of a new baby often causes older siblings to feel displaced, frustrated, angry, and even unloved. Age, gender, personality and temperament, and parental behavior are factors that appear to influence the degree to which sibling rivalry occurs. Common reactions of older siblings to the birth of a new baby include aggression toward the newborn, behavioral regression, and attention seeking behavior, as well as independence and maturity. Anticipatory guidance is recommended to help parents adequately prepare their older child for the arrival of a new sibling. Strategies for managing sibling rivalry include open parent-child communication, equal treatment of siblings, non-intervention in sibling conflicts, distraction, and separation. Parents can minimize feelings of jealousy between siblings by providing a supportive, nurturing environment that allows each child to feel secure and loved.
Successful public-private partnerships: The NYPD shield model.

PubMed

Amadeo, Vincent; Iannone, Stephen

2017-12-01

This article will identify the challenges that post 9/11 law enforcement faces regarding privatepublic partnerships and describe in detail the NYPD Shield programme, created to combat those challenges. Recommendations made by the 911 Commission included the incorporation of the private sector into future homeland security strategies. One such strategy is NYPD Shield. This programme is a nationally recognized award-winning public-private partnership dedicated to providing counterterrorism training and information sharing with government agencies, non-government organizations, private businesses, and the community. Information is shared through several platforms that include a dedicated website, instruction of counterterrorism training curricula, e-mail alerts, intelligence assessments and the hosting of quarterly conferences. This article also details how the NYPD Shield is providing its successful template to other law enforcement agencies enabling them to initiate similar programmes in their respective jurisdictions, and in doing so joining a National Shield Network.

The psychological contract: enhancing productivity and its implications for long-term care.

PubMed

Flannery, Raymond B

2002-01-01

When hired, a new employee is usually given a job description and an explanation of benefits. In addition, the employee will also have a psychological contract with the organization. This contract, often unstated, reflects the main source of the employee's motivation to work hard. This is true of all groups of employees, including long-term care staff. Common examples of psychological contracts for long-term care administrative staff include autonomy, social acceptance, and being in the forefront of cutting-edge research. An awareness of these psychological contracts can result in better "fits" between employee aspirations and relevant long-term care organization tasks so that productivity is enhanced. This article outlines the steps necessary to create these good fits in ways that benefit both the organization and its employees. These recommendations are of particular relevance to administrators and supervisors in long-term carefacilities.
Methods for estimating bicycling and walking in Washington state.

DOT National Transportation Integrated Search

2014-05-01

This report presents the work performed in the first and second phases in the process of creating a method to : calculate Bicycle and Pedestrian Miles Traveled (BMT/PMT) for the state of Washington. First, we recommend : improvements to the existing ...
Recommendations for design, construction, and maintenance of bridge approach slabs : synthesis report.

DOT National Transportation Integrated Search

2009-04-01

Bridge approaches provide smooth and safe transition of vehicles from highway pavements to bridge : structures. However, settlement of the bridge approach slab relative to bridge decks usually creates a : bump in the roadway. The bump causes inconven...
Brownfields Allen-Morrison Project: Technical Memorandum on Creating Inventory of Materials that can be Reused or Recycled through Deconstruction

EPA Pesticide Factsheets

This technical memorandum presents sustainability pilot activities, a summary of inventory results, and other observations and recommendations for sustainable redevelopment identified during the pilot activities at the brownfields projects.
Insights on the Budget Process. Professional Notes.

ERIC Educational Resources Information Center

Vaughan, Susan

1996-01-01

Maintains that music educators need to become familiar with the budget process in order to act as advocates for their program. Offers several suggestions designed to increase the probability of program requests appropriation. Recommends creating a business plan and encouraging partnerships. (MJP)
Creating a community of practice for blueberries

USDA-ARS?s Scientific Manuscript database

The “All about Blueberries” Community of Practice is adapting the best existing extension publications and developing new research-based extension recommendations related to blueberry 20 production and consumption. Our primary goal is to increase blueberry productivity and consumption of blueberries...
Establishing the Research Agenda for Increasing the Representation of Women in Engineering and Computing

PubMed Central

Buse, Kathleen; Hill, Catherine; Benson, Kathleen

2017-01-01

While there is an extensive body of research on gender equity in engineering and computing, there have been few efforts to glean insight from a dialog among experts. To encourage collaboration and to develop a shared vision of the future research agenda, a 2 day workshop of 50 scholars who work on the topic of gender in engineering and computing was held at a rural conference center. The structure of the conference and the location allowed for time to reflect, dialog, and to craft an innovative research agenda aimed at increasing the representation of women in engineering and computing. This paper has been written by the conference organizers and details the ideas and recommendations from the scholars. The result is an innovative, collaborative approach to future research that focuses on identifying effective interventions. The new approach includes the creation of partnerships with stakeholders including businesses, government agencies, non-profits and academic institutions to allow a broader voice in setting research priorities. Researchers recommend incorporating multiple disciplines and methodologies, while expanding the use of data analytics, merging and mining existing databases and creating new datasets. The future research agenda is detailed and includes studies focused on socio-cultural interventions particularly on career choice, within undergraduate and graduate programs, and for women in professional careers. The outcome is a vision for future research that can be shared with researchers, practitioners and other stakeholders that will lead to gender equity in the engineering and computing professions. PMID:28469591
Establishing the Research Agenda for Increasing the Representation of Women in Engineering and Computing.

PubMed

Buse, Kathleen; Hill, Catherine; Benson, Kathleen

2017-01-01

While there is an extensive body of research on gender equity in engineering and computing, there have been few efforts to glean insight from a dialog among experts. To encourage collaboration and to develop a shared vision of the future research agenda, a 2 day workshop of 50 scholars who work on the topic of gender in engineering and computing was held at a rural conference center. The structure of the conference and the location allowed for time to reflect, dialog, and to craft an innovative research agenda aimed at increasing the representation of women in engineering and computing. This paper has been written by the conference organizers and details the ideas and recommendations from the scholars. The result is an innovative, collaborative approach to future research that focuses on identifying effective interventions. The new approach includes the creation of partnerships with stakeholders including businesses, government agencies, non-profits and academic institutions to allow a broader voice in setting research priorities. Researchers recommend incorporating multiple disciplines and methodologies, while expanding the use of data analytics, merging and mining existing databases and creating new datasets. The future research agenda is detailed and includes studies focused on socio-cultural interventions particularly on career choice, within undergraduate and graduate programs, and for women in professional careers. The outcome is a vision for future research that can be shared with researchers, practitioners and other stakeholders that will lead to gender equity in the engineering and computing professions.
Creating the Future of Evidence-Based Nutrition Recommendations: Case Studies from Lipid Research123

PubMed Central

Dwyer, Johanna T; Rubin, Kristin H; Psota, Tricia L; Liska, DeAnn J; Montain, Scott J

2016-01-01

Strategic translational research is designed to address research gaps that answer specific guidance questions. It provides translational value with respect to nutrition guidance and regulatory and public policy. The relevance and the quality of evidence both matter in translational research. For example, design decisions regarding population, intervention, comparator, and outcome criteria affect whether or not high-quality studies are considered relevant to specific guidance questions and are therefore included as evidence within the context of systematic review frameworks used by authoritative food and health organizations. The process used in systematic reviews, developed by the USDA for its Nutrition Evidence Library, is described. An eating pattern and cardiovascular disease (CVD) evidence review is provided as an example, and factors that differentiated the studies considered relevant and included in that evidence base from those that were excluded are noted. Case studies on ω-3 (n–3) fatty acids (FAs) and industrial trans-FAs illustrate key factors vital to relevance and translational impact, including choice of a relevant population (e.g., healthy, at risk, or diseased subjects; general population or high-performance soldiers); dose and form of the intervention (e.g., food or supplement); use of relevant comparators (e.g., technically feasible and realistic); and measures for both exposure and outcomes (e.g., inflammatory markers or CVD endpoints). Specific recommendations are provided to help increase the impact of nutrition research on future dietary guidance, policy, and regulatory issues, particularly in the area of lipids. PMID:27422509
A review of national television PSA campaigns for preventing alcohol-impaired driving, 1987-1992.

PubMed

DeJong, W; Atkin, C K

1995-01-01

We present a content analysis of 137 public service announcements (PSAs) focused on alcohol-impaired driving that aired nationally on U.S. television between 1987 and 1992. Our findings include the following: 1) Most PSAs were intended to reach an undifferentiated general audience, not necessarily those who are at greatest risk for driving after drinking. 2) Most PSAs were designed to create awareness of the problem of alcohol-impaired driving or to promote individual behavior change. 3) More PSAs were developed on the use of designated drivers than on any other subject. 4) About two-thirds of the PSAs included one or more celebrities who speak directly to the audience. Past media campaigns have tended to ignore the fact that people's behavior is profoundly shaped by their environment, which in turn is shaped by public policy. We recommend that future mass media campaigns against alcohol-impaired driving focus on building support for changes in institutional structures, public policy or law that will motivate, support, and sustain the efforts of individuals to alter their behavior. Television PSAs can play an important but somewhat limited role in support of this effort. Greater emphasis will need to be given instead to media advocacy strategies, including paid radio advertising. We further recommend that the principal organizations concerned about alcohol-impaired driving share their plans and develop a common communications strategy that will advance the public policy agenda proposed by the Surgeon General's Workshop on Drunk Driving.
USING CFD TO ANALYZE NUCLEAR SYSTEMS BEHAVIOR: DEFINING THE VALIDATION REQUIREMENTS

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

Richard Schultz

2012-09-01

A recommended protocol to formulate numeric tool specifications and validation needs in concert with practices accepted by regulatory agencies for advanced reactors is described. The protocol is based on the plant type and perceived transient and accident envelopes that translates to boundary conditions for a process that gives the: (a) key phenomena and figures-of-merit which must be analyzed to ensure that the advanced plant can be licensed, (b) specification of the numeric tool capabilities necessary to perform the required analyses—including bounding calculational uncertainties, and (c) specification of the validation matrices and experiments--including the desired validation data. The result of applyingmore » the process enables a complete program to be defined, including costs, for creating and benchmarking transient and accident analysis methods for advanced reactors. By following a process that is in concert with regulatory agency licensing requirements from the start to finish, based on historical acceptance of past licensing submittals, the methods derived and validated have a high probability of regulatory agency acceptance.« less
Updated US Department of Agriculture Food Patterns meet goals of the 2010 dietary guidelines.

PubMed

Britten, Patricia; Cleveland, Linda E; Koegel, Kristin L; Kuczynski, Kevin J; Nickols-Richardson, Sharon M

2012-10-01

The US Department of Agriculture Food Patterns were updated for the 2010 Dietary Guidelines for Americans to meet new nutrition goals and incorporate results of food pattern modeling requested by the Dietary Guidelines Advisory Committee. The purpose of this article is to describe the process used and changes in the updated patterns. Changes include renaming the Meat and Beans and Milk Groups to the Protein Foods and Dairy Groups, respectively, to be more encompassing of foods in each. Vegetable subgroups now provide more achievable intake recommendations. Calcium-fortified soymilk is now included in the Dairy Group because of its similarity to foods in that group. Increased amounts of seafoods are recommended in the Protein Foods Group, balanced by decreased amounts of meat and poultry. A limit on calories from solid fats and added sugars is included, replacing the previous discretionary calorie allowance and emphasizing the need to choose nutrient-dense forms of foods. Lacto-ovo vegetarian and vegan patterns that meet nutrition goals were created by making substitutions in the Protein Foods Group, and for vegan patterns, in the Dairy Group. Patterns identify food choices that meet nutritional needs within energy allowances and encourage choosing a variety of foods. They rely on foods in nutrient-dense forms, including a limited amount of calories from solid fats and added sugars. The Food Patterns provide a useful template for educating consumers about healthful food choices while highlighting a large gap between choices many Americans make and healthy eating patterns. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
[The relevance of the International Committee of Medical Journal Editors (ICMJE) for medical publishing and research].

PubMed

Reyes, Humberto B

2014-01-01

The International Committee of Medical Journal Editors is a leading independent institution providing guidance for the report of biomedical research and health related topics in medical journals. Established in 1978, it is currently constituted by editors of fourteen general medical journals from different countries, plus one representative for the US National Library of Medicine and one representative for the World Association of Biomedical Journal Editors. Since 1978 the Committee provides a document, originally named "Uniform Requirements…", "to help authors, editors, and others involved in peer review and biomedical publishing create and distribute accurate, clear, unbiased medical journal articles". This document has been updated several times and the last version was released in August 2013, now renamed "Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals", available in www.icmje.org and citable as "ICMJE Recommendations". A vast proportion of medical journals, worldwide, have adopted these recommendations as rules. The ICMJE discusses and provides guidance on several relevant aspects including criteria on authorship, peer review, scientific misconduct, conflicts of interest, clinical trials registration, good editorial practices, the relations between editors and journal owners, the protection of individuals subject to medical research, the solvency of electronic publications, among others. The 2013 ICMJE Annual Meeting took place in Santiago, Chile, in November 4 and 5. The photograph shows attendants to the final session.
Systematic review of guidelines for management of intermediate hepatocellular carcinoma using the Appraisal of Guidelines Research and Evaluation II instrument.

PubMed

Holvoet, Tom; Raevens, Sarah; Vandewynckel, Yves-Paul; Van Biesen, Wim; Geboes, Karen; Van Vlierberghe, Hans

2015-10-01

Hepatocellular carcinoma is the second leading cause of cancer-related mortality worldwide. Multiple guidelines have been developed to assist clinicians in its management. We aimed to explore methodological quality of these guidelines focusing on treatment of intermediate hepatocellular carcinoma by transarterial chemoembolization. A systematic search was performed for Clinical Practice Guidelines and Consensus statements for hepatocellular carcinoma management. Guideline quality was appraised using the Appraisal of Guidelines Research and Evaluation II instrument, which rates guideline development processes across 6 domains: 'Scope and purpose', 'Stakeholder involvement', 'Rigour of development', 'Clarity of presentation', 'Applicability' and 'Editorial independence'. Thematic analysis of guidelines was performed to map differences in recommendations. Quality of 21 included guidelines varied widely, but was overall poor with only one guideline passing the 50% mark on all domains. Key recommendations as (contra)indications and technical aspects were inconsistent between guidelines. Aspects on side effects and health economics were mainly neglected. Methodological quality of guidelines on transarterial chemoembolization in hepatocellular carcinoma management is poor. This results in important discrepancies between guideline recommendations, creating confusion in clinical practice. Incorporation of the Appraisal of Guidelines Research and Evaluation II instrument in guideline development may improve quality of future guidelines by increasing focus on methodological aspects. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines-Anticoagulation During Cardiopulmonary Bypass.

PubMed

Shore-Lesserson, Linda; Baker, Robert A; Ferraris, Victor A; Greilich, Philip E; Fitzgerald, David; Roman, Philip; Hammon, John W

2018-02-01

Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup. This was a group of interdisciplinary professionals gathered to summarize the evidence and create practice recommendations for various aspects of CPB. To date, anticoagulation practices in CPB have not been standardized in accordance with the evidence base. This clinical practice guideline was written with the intent to fill the evidence gap and to establish best practices in anticoagulation therapy for CPB using the available evidence. To identify relevant evidence, a systematic review was outlined and literature searches were conducted in PubMed using standardized medical subject heading (MeSH) terms from the National Library of Medicine list of search terms. Search dates were inclusive of January 2000 to December 2015. The search yielded 833 abstracts, which were reviewed by two independent reviewers. Once accepted into the full manuscript review stage, two members of the writing group evaluated each of 286 full papers for inclusion eligibility into the guideline document. Ninety-six manuscripts were included in the final review. In addition, 17 manuscripts published before 2000 were included to provide method, context, or additional supporting evidence for the recommendations as these papers were considered sentinel publications. Members of the writing group wrote and developed recommendations based on review of the articles obtained and achieved more than two thirds agreement on each recommendation. The quality of information for a given recommendation allowed assessment of the level of evidence as recommended by the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Recommendations were written in the three following areas: (1) heparin dosing and monitoring for initiation and maintenance of CPB; (2) heparin contraindications and heparin alternatives; and (3) reversal of anticoagulation during cardiac operations. It is hoped that this guideline will serve as a resource and will stimulate investigators to conduct more research and to expand on the evidence base on the topic of anticoagulation therapy for CPB.
Panel 2.18: logistics, information technology (IT), and telecommunications in crisis management.

PubMed

De Silva, Terrence; Chikersal, Jyotsna; Snoad, Nigel; Woodworth, Brent; Ghaly, Cherif; Catterall, Martin

2005-01-01

This is a summary of the presentations and discussion of Panel 2.18, Logistics, Information Technology, and Telecommunications in Crisis Management of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to logistics, information technology (IT), and crisis communication pertaining to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) issues; (2) lessons learned; (3) what was done well; (4) what could have been done better; and (5) conclusions and recommendations. Each major section is presented in four sub-sections: (1) needs assessments; (2) coordination; (3) filling the gaps; and (4) capacity building.
Moving mountains together: strategic community leadership and systems change.

PubMed

Nissen, Laura Burney; Merrigan, Daniel M; Kraft, M Katherine

2005-01-01

Traditional leadership practice frameworks to guide systems change often fall short in today's practice environment. Reclaiming Futures is a national initiative to create an integrated, comprehensive, seamless system of care for teens with substance abuse problems involved in juvenile justice. It uses leadership and systems reform strategies to improve public health institutions. The premise is that interruption of the destructive cycle of drugs and delinquency can only be attained through the cultivation of shared strategic leadership. This article presents the limitations of traditional practice frameworks of leadership, describes the theory of this new approach to leadership development, and clarifies collaborative leadership and system change. The article includes an example of the framework in action, a discussion of lessons learned, and recommendations for community leadership development initiatives.
Validating Retinal Fundus Image Analysis Algorithms: Issues and a Proposal

PubMed Central

Trucco, Emanuele; Ruggeri, Alfredo; Karnowski, Thomas; Giancardo, Luca; Chaum, Edward; Hubschman, Jean Pierre; al-Diri, Bashir; Cheung, Carol Y.; Wong, Damon; Abràmoff, Michael; Lim, Gilbert; Kumar, Dinesh; Burlina, Philippe; Bressler, Neil M.; Jelinek, Herbert F.; Meriaudeau, Fabrice; Quellec, Gwénolé; MacGillivray, Tom; Dhillon, Bal

2013-01-01

This paper concerns the validation of automatic retinal image analysis (ARIA) algorithms. For reasons of space and consistency, we concentrate on the validation of algorithms processing color fundus camera images, currently the largest section of the ARIA literature. We sketch the context (imaging instruments and target tasks) of ARIA validation, summarizing the main image analysis and validation techniques. We then present a list of recommendations focusing on the creation of large repositories of test data created by international consortia, easily accessible via moderated Web sites, including multicenter annotations by multiple experts, specific to clinical tasks, and capable of running submitted software automatically on the data stored, with clear and widely agreed-on performance criteria, to provide a fair comparison. PMID:23794433
Sexual assault support services and community systems: understanding critical issues and needs in the LGBTQ community.

PubMed

Todahl, Jeffrey L; Linville, Deanna; Bustin, Amy; Wheeler, Jenna; Gau, Jeff

2009-08-01

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals encounter social conditions that create important considerations for LGBTQ sexual assault victims. This exploratory, mixed-methods study examines the relationship between community attitudes toward LGBTQ persons and associated community responses to LGBTQ sexual assault victims. An online and paper-and-pencil survey (n = 130) and four focus group interviews (n = 14) are analyzed using frequency distributions and grounded theory methods. The central theme that emerged in focus group interviews, titled "low community awareness and support for sexual violence in the LGBTQ community," was corroborated by survey participants. Participants' views of unique considerations for LGBTQ sexual assault victims are presented, including causal factors, consequences, and recommended strategies.
A Whooping Cough Education Module for WIC Clients in Utah.

PubMed

Luthy, Karlen E; Anderson, Alicia; Macintosh, Janelle; Beckstrand, Renea L; Eden, Lacey M; Amy, Ryan; Macintosh, Christopher I

Clients in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are required to complete education modules quarterly to maintain eligibility. The purposes of this project were to: (1) create a whooping cough vaccination education module for WIC clients; (2) evaluate baseline perceptions of WIC clients on the whooping cough vaccine and disease; and (3) evaluate whooping cough knowledge following completion of the module. A decline in vaccination rates among infants and children using WIC services was reported by a local WIC program director who requested whooping cough vaccination education materials. This quality improvement project included development of a whooping cough education module and evaluation of learning. Learning was evaluated using a pre- and posttest design. Client feedback was solicited via open-ended questions. Quantitative analysis was performed on visual analog-type questions with paired t-tests and a Cohen's d. Content analysis was conducted on open-ended items. The module was designed by a team of vaccination experts and included general definitions, signs and symptoms during the three stages of disease, recommendations to prevent whooping cough, and vaccination recommendations. Learning of users of the module was then evaluated. After using the module, clients indicated they were significantly more likely to vaccinate themselves and their child against whooping cough, and to recommend the vaccination to their family members. The greatest concern of participants about whooping cough was how it affected infants. Participants reported they learned new information on disease seriousness, recognition of symptoms, and treatment options but still requested additional information on the whooping cough disease and vaccine. A whooping cough education module is an effective strategy to improve whooping cough knowledge and promote the whooping cough vaccine.

Microbiologic Analysis of Complicated and Uncomplicated Acute Appendicitis.

PubMed

García-Marín, Andrés; Pérez-López, Mercedes; Martínez-Guerrero, Elena; Rodríguez-Cazalla, Lorena; Compañ-Rosique, Antonio

2018-01-01

Microbiologic studies suggest that complicated (CAA) and uncomplicated (UAA) acute appendicitis are different entities. Routine peritoneal fluid cultures continue to be controversially related to a low positive rate, found mainly in UAA; to isolation of typical micro-organisms with expected susceptibilities; and to a community-acquired intra-abdominal infection. The aim of this study was to describe microbiologic isolates in CAA and UAA and the usefulness of peritoneal fluid cultures to determine the susceptibilities to our antibiotic therapy guidelines. This study was a retrospective review of a prospective database collected at University San Juan Hospital (Spain) between June 2014 and June 2017. Complicated acute appendicitis was defined as gangrenous or perforated, whereas UAA was defined as phegmonous or suppurative. Our antibiotic recommendations are amoxicillin-clavulanic acid and in patients with β-lactam allergies, metronidazole plus aztreonam, and an aminoglycoside (gentamicin or tobramycin). Microbiologic cultures were performed in 264 patients, 157 with a CAA and 107 with a UAA. The positive culture rate was significantly higher in CAA (59%) than in UAA (24.3%). Gram-positive cocci (51.6% CAA; 23.1% UAA), including Streptococcus constellatus (29% CAA; 3.8% UAA), and anaerobes (67.7% CAA; 42.3% UAA) were significantly more common in CAA. The rates of antibiotic resistance were amoxicillin-clavulanic acid 14% (17.2% CAA; 3.8% UAA), gentamicin or tobramycin 8.4% (9.7% CAA; 3.8% UAA), ciprofloxacin 5.9% (6.5% CAA; 3.8% UAA), and ertapenem 10.9% (14% CAA; 0 UAA). The culture-positive rate was higher in CAA, with different isolates and susceptibilities than in UAA, identifying a higher frequency of gram-positive cocci (including S. constellatus) and anaerobes. We recommend obtaining peritoneal fluid cultures in CAA, which frequently will lead to a change in the antimicrobial drug therapy guidelines, creating specific recommendations in AA.
Recommendations for physical and occupational therapy practice from the perspective of clients undergoing therapy for breast cancer-related impairments.

PubMed

Lattanzi, Jill B; Giuliano, Susan; Meehan, Caitlin; Sander, Beth; Wootten, Rachel; Zimmerman, Amanda

2010-01-01

Evidence points to the efficacy of physical and occupational therapy intervention for the management of impairments and functional limitations related to the treatment of breast cancer. However, few studies give voice to the women participating in the physical rehabilitation programs intended to ameliorate their deficits. The purpose of this qualitative investigation was to explore the experience of physical rehabilitation as well as to identify recommendations for physical and occupational therapy practice from the perspective of the client undergoing therapy for breast cancer-related impairments. A phenomenological design was chosen and included a purposive sample of women (n = 10) undergoing physical rehabilitation for impairments related to breast cancer treatment. Data included semistructured interviews and artifact examination. Ten semistructured interviews were conducted at a setting of the participants' choice. Data collection continued until saturation was reached. Data analysis was cyclical and ongoing and involved all six researchers in analyzing and triangulating all pieces of data. Member checks and a peer review were conducted to confirm relevance and validity. Five themes emerged: 1) challenges with obtaining referrals, 2) challenges with patient education, 3) improvements in functional impairments, 4) emotional support, and 5) benefits of a specialized clinic environment. Consideration of the five themes led to four recommendations for physical and occupational therapist practice from the perspective of the client: 1) advocate for presurgical therapy consultations, 2) be competent in the management of all impairments and functional limitations associated with breast cancer treatment, 3) be aware of the emotional support the therapist has the capacity to provide or not provide, and 4) as much as possible, create an inviting, nonclinical environment.
Reference Value Advisor: a new freeware set of macroinstructions to calculate reference intervals with Microsoft Excel.

PubMed

Geffré, Anne; Concordet, Didier; Braun, Jean-Pierre; Trumel, Catherine

2011-03-01

International recommendations for determination of reference intervals have been recently updated, especially for small reference sample groups, and use of the robust method and Box-Cox transformation is now recommended. Unfortunately, these methods are not included in most software programs used for data analysis by clinical laboratories. We have created a set of macroinstructions, named Reference Value Advisor, for use in Microsoft Excel to calculate reference limits applying different methods. For any series of data, Reference Value Advisor calculates reference limits (with 90% confidence intervals [CI]) using a nonparametric method when n≥40 and by parametric and robust methods from native and Box-Cox transformed values; tests normality of distributions using the Anderson-Darling test and outliers using Tukey and Dixon-Reed tests; displays the distribution of values in dot plots and histograms and constructs Q-Q plots for visual inspection of normality; and provides minimal guidelines in the form of comments based on international recommendations. The critical steps in determination of reference intervals are correct selection of as many reference individuals as possible and analysis of specimens in controlled preanalytical and analytical conditions. Computing tools cannot compensate for flaws in selection and size of the reference sample group and handling and analysis of samples. However, if those steps are performed properly, Reference Value Advisor, available as freeware at http://www.biostat.envt.fr/spip/spip.php?article63, permits rapid assessment and comparison of results calculated using different methods, including currently unavailable methods. This allows for selection of the most appropriate method, especially as the program provides the CI of limits. It should be useful in veterinary clinical pathology when only small reference sample groups are available. ©2011 American Society for Veterinary Clinical Pathology.
Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society.

PubMed

Wild, Robert A; Carmina, Enrico; Diamanti-Kandarakis, Evanthia; Dokras, Anuja; Escobar-Morreale, Hector F; Futterweit, Walter; Lobo, Rogerio; Norman, Robert J; Talbott, Evelyn; Dumesic, Daniel A

2010-05-01

Women with polycystic ovary syndrome (PCOS) often have cardiovascular disease (CVD) risk factors. The Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society created a panel to provide evidence-based reviews of studies assessing PCOS-CVD risk relationships and to develop guidelines for preventing CVD. An expert panel in PCOS and CVD reviewed literature and presented recommendations. Only studies comparing PCOS with control patients were included. All electronic databases were searched; reviews included individual studies/databases, systematic reviews, abstracts, and expert data. Articles were excluded if other hyperandrogenic disorders were not excluded, PCOS diagnosis was unclear, controls were not described, or methodology precluded evaluation. Inclusion/exclusion criteria were confirmed by at least two reviewers and arbitrated by a third. Systematic reviews of CVD risk factors were compiled and submitted for approval to the AE-PCOS Society Board. Women with PCOS with obesity, cigarette smoking, dyslipidemia, hypertension, impaired glucose tolerance, and subclinical vascular disease are at risk, whereas those with metabolic syndrome and/or type 2 diabetes mellitus are at high risk for CVD. Body mass index, waist circumference, serum lipid/glucose, and blood pressure determinations are recommended for all women with PCOS, as is oral glucose tolerance testing in those with obesity, advanced age, personal history of gestational diabetes, or family history of type 2 diabetes mellitus. Mood disorder assessment is suggested in all PCOS patients. Lifestyle management is recommended for primary CVD prevention, targeting low-density and non-high-density lipoprotein cholesterol and adding insulin-sensitizing and other drugs if dyslipidemia or other risk factors persist.
Examining influences on speaking up among critical care healthcare providers in the United Arab Emirates.

PubMed

Edrees, Hanan H; Ismail, Mohd Nasir Mohd; Kelly, Bernadette; Goeschel, Christine A; Berenholtz, Sean M; Pronovost, Peter J; Al Obaidli, Ali Abdul Kareem; Weaver, Sallie J

2017-11-01

Assess perceived barriers to speaking up and to provide recommendations for reducing barriers to reporting adverse events and near misses. A six-item survey was administered to critical care providers in 19 Intensive Care Units in Abu Dhabi as part of an organizational safety and quality improvement effort. Questions elicited perspectives about influences on reporting, perceived barriers and recommendations for conveying patient safety as an organizational priority. Qualitative thematic analyses were conducted for open-ended questions. A total of 1171 participants were invited to complete the survey and 639 responded (response rate = 54.6%). Compared to other stakeholders (e.g. the media, public), a larger proportion of respondents 'agreed/strongly agreed' that corporate health system leadership and the health regulatory authority encouraged and supported error reporting (83%; 75%), and had the most influence on their decisions to report (81%; 74%). 29.5% of respondents cited fear of repercussion as a barrier, and 21.3% of respondents indicated no barriers to reporting. Barriers included perceptions of a culture of blame and issues with reporting procedures. Recommendations to establish patient safety as an organizational priority included creating supportive environments to discuss errors, hiring staff to advocate for patient safety, and implementing policies to standardize clinical practices and streamline reporting procedures. Influences on reporting perceived by providers in the UAE were similar to those in the US and other countries. These findings highlight the roles of corporate leadership and regulators in developing non-punitive environments where reporting is a valuable and safe activity. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
Male Reproductive Health After Childhood, Adolescent, and Young Adult Cancers: A Report From the Children's Oncology Group

PubMed Central

Kenney, Lisa B.; Cohen, Laurie E.; Shnorhavorian, Margarett; Metzger, Monika L.; Lockart, Barbara; Hijiya, Nobuko; Duffey-Lind, Eileen; Constine, Louis; Green, Daniel; Meacham, Lillian

2012-01-01

The majority of children, adolescents, and young adults diagnosed with cancer will become long-term survivors. Although cancer therapy is associated with many adverse effects, one of the primary concerns of young male cancer survivors is reproductive health. Future fertility is often the focus of concern; however, it must be recognized that all aspects of male health, including pubertal development, testosterone production, and sexual function, can be impaired by cancer therapy. Although pretreatment strategies to preserve reproductive health have been beneficial to some male patients, many survivors remain at risk for long-term reproductive complications. Understanding risk factors and monitoring the reproductive health of young male survivors are important aspects of follow-up care. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) were created by the COG to provide recommendations for follow-up care of survivors at risk for long-term complications. The male health task force of the COG-LTFU Guidelines, composed of pediatric oncologists, endocrinologists, nurse practitioners, a urologist, and a radiation oncologist, is responsible for updating the COG-LTFU Guidelines every 2 years based on literature review and expert consensus. This review summarizes current task force recommendations for the assessment and management of male reproductive complications after treatment for childhood, adolescent, and young adult cancers. Issues related to male health that are being investigated, but currently not included in the COG-LTFU Guidelines, are also discussed. Ongoing investigation will inform future COG-LTFU Guideline recommendations for follow-up care to improve health and quality of life for male survivors. PMID:22649147
Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report.

PubMed

Turner, Gill; Clegg, Andrew

2014-11-01

Older people are majority users of health and social care services in the UK and internationally. Many older people who access these services have frailty, which is a state of vulnerability to adverse outcomes. The existing health care response to frailty is mainly secondary care-based and reactive to the acute health crises of falls, delirium and immobility. A more proactive, integrated, person-centred and community-based response to frailty is required. The British Geriatrics Society Fit for Frailty guideline is consensus best practice guidance for the management of frailty in community and outpatient settings. The BGS recommends that all encounters between health and social care staff and older people in community and outpatient settings should include an assessment for frailty. A gait speed <0.8m/s; a timed-up-and-go test >10s; and a score of ≥3 on the PRISMA 7 questionnaire can indicate frailty. The common clinical presentations of frailty (falls, delirium, sudden immobility) can also be used to indicate the possible presence of frailty. The BGS recommends an holistic medical review based on the principles of comprehensive geriatric assessment (CGA) for all older people identified with frailty. This will: diagnose medical illnesses to optimise treatment; apply evidence-based medication review checklists (e.g. STOPP/START criteria); include discussion with older people and carers to define the impact of illness; work with the older person to create an individualised care and support plan. The BGS does not recommend population screening for frailty using currently available instruments. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Late Effects Surveillance Recommendations among Survivors of Childhood Hematopoietic Cell Transplantation: A Children’s Oncology Group Report

PubMed Central

Chow, Eric J.; Anderson, Lynnette; Baker, K. Scott; Bhatia, Smita; Guilcher, Gregory M.T.; Huang, Jennifer T.; Pelletier, Wendy; Perkins, Joanna L.; Rivard, Linda S.; Schechter, Tal; Shah, Ami Jayant; Wilson, Karla Dee; Wong, Kenneth; Grewal, Satkiran; Armenian, Saro; Meacham, Lillian R.; Mulrooney, Daniel A.; Castellino, Sharon M.

2016-01-01

Hematopoietic cell transplantation (HCT) is an important curative treatment for children with high-risk hematologic malignancies and solid tumors, and increasingly, non-malignant diseases. Given improvements in care, there is a growing number of long-term survivors of pediatric HCT. Compared with non-transplanted childhood cancer survivors, HCT survivors have been shown to have a substantially increased burden of serious chronic conditions and impairments involving virtually every organ system and overall quality of life. This likely reflects the joint contributions of pre-transplant treatment exposures and organ dysfunction, the transplant conditioning regimen, and any post-transplant graft versus host disease (GVHD). In response, the Children’s Oncology Group (COG) has created Long-Term Follow-Up Guidelines (www.survivorshipguidelines.org) for survivors of childhood, adolescent, and young adult cancer, including those treated with HCT. Guidelines taskforces, consisting of HCT specialists, other pediatric oncologists, radiation oncologists, organ-specific subspecialists, nurses, social workers, other healthcare professionals, and patient advocates have systematically reviewed the literature with regards to late effects after childhood cancer and HCT since 2002, with the most recent review completed in 2013. For the most recent review cycle, over 800 articles from the medical literature relevant to childhood cancer and HCT survivorship were reviewed, including 586 original research articles. Provided here-in is an organ system-based overview that emphasizes the most relevant COG recommendations (with accompanying evidence grade) for the long-term follow-up care of childhood HCT survivors (regardless of current age) based on a rigorous review of the available evidence. These recommendations cover both autologous and allogeneic HCT survivors, those transplanted for non-malignant diseases, and those with a history of chronic GVHD. PMID:26802323
Of Rat Time and Terminators.

ERIC Educational Resources Information Center

Barnhizer, David

1995-01-01

The situation created by a glut of lawyers in the profession is examined, particularly heightened competition and need for technical legal skills. Eight recommendations are made concerning the financing of legal education, curriculum design, field experience program changes, and expansion of access to legal services. (MSE)
Public Playground Safety: Paradigm or Paradox.

ERIC Educational Resources Information Center

Kutska, Ken

1994-01-01

Despite abundant information on playground safety, National Recreation and Parks Association members still search for ways to handle playground problems. Since each playground is unique, there is no simple answer. The paper makes recommendations on how to begin and create a playground safety plan. (SM)
Commission on the Future of Howard Community College, Progress Report 2000.

ERIC Educational Resources Information Center

Howard Community Coll., Columbia, MD. Office of Planning and Evaluation.

Presents the Commission on the Future of Howard Community College's (HCC) (Maryland) progress report 2000. Section 1, "Creating a World Class Learning Organization," presents strategic process and tactical action recommendations. Section 2, "Collaboration with Other Educational Organizations," discusses curricular and…
Creating a culture of innovation in nursing education through shared vision, leadership, interdisciplinary partnerships, and positive deviance.

PubMed

Melnyk, Bernadette Mazurek; Davidson, Sandra

2009-01-01

Although innovation is typically viewed by healthcare and academic institutions, business leaders, entrepreneurs, and private corporations as necessary for continuous improvement, high-quality care, and scientific advancement, barriers in creating and sustaining innovative academic environments abound and require effective leadership to overcome them. Therefore, the purpose of this article is to describe the major barriers and facilitators to innovation in colleges of nursing and healthcare professions along with recommendations for creating a culture of innovation in these academic environments. In addition, key strategies for educational innovation are discussed. Innovations launched by the Arizona State University College of Nursing & Healthcare Innovation are highlighted to provide examples of how a college that established innovation as a top priority in 2005 in its strategic plan created an innovative culture that has led to several successful outcomes.
Guidelines and Recommendations for Developing Interactive eHealth Apps for Complex Messaging in Health Promotion.

PubMed

Heffernan, Kayla Joanne; Chang, Shanton; Maclean, Skye Tamara; Callegari, Emma Teresa; Garland, Suzanne Marie; Reavley, Nicola Jane; Varigos, George Andrew; Wark, John Dennis

2016-02-09

The now ubiquitous catchphrase, "There's an app for that," rings true owing to the growing number of mobile phone apps. In excess of 97,000 eHealth apps are available in major app stores. Yet the effectiveness of these apps varies greatly. While a minority of apps are developed grounded in theory and in conjunction with health care experts, the vast majority are not. This is concerning given the Hippocratic notion of "do no harm." There is currently no unified formal theory for developing interactive eHealth apps, and development is especially difficult when complex messaging is required, such as in health promotion and prevention. This paper aims to provide insight into the creation of interactive eHealth apps for complex messaging, by leveraging the Safe-D case study, which involved complex messaging required to guide safe but sufficient UV exposure for vitamin D synthesis in users. We aim to create recommendations for developing interactive eHealth apps for complex messages based on the lessons learned during Safe-D app development. For this case study we developed an Apple and Android app, both named Safe-D, to safely improve vitamin D status in young women through encouraging safe ultraviolet radiation exposure. The app was developed through participatory action research involving medical and human computer interaction researchers, subject matter expert clinicians, external developers, and target users. The recommendations for development were created from analysis of the development process. By working with clinicians and implementing disparate design examples from the literature, we developed the Safe-D app. From this development process, recommendations for developing interactive eHealth apps for complex messaging were created: (1) involve a multidisciplinary team in the development process, (2) manage complex messages to engage users, and (3) design for interactivity (tailor recommendations, remove barriers to use, design for simplicity). This research has provided principles for developing interactive eHealth apps for complex messaging as guidelines by aggregating existing design concepts and expanding these concepts and new learnings from our development process. A set of guidelines to develop interactive eHealth apps generally, and specifically those for complex messaging, was previously missing from the literature; this research has contributed these principles. Safe-D delivers complex messaging simply, to aid education, and explicitly, considering user safety.
Guidelines and Recommendations for Developing Interactive eHealth Apps for Complex Messaging in Health Promotion

PubMed Central

Heffernan, Kayla Joanne; Maclean, Skye Tamara; Callegari, Emma Teresa; Garland, Suzanne Marie; Reavley, Nicola Jane; Varigos, George Andrew; Wark, John Dennis

2016-01-01

Background The now ubiquitous catchphrase, “There’s an app for that,” rings true owing to the growing number of mobile phone apps. In excess of 97,000 eHealth apps are available in major app stores. Yet the effectiveness of these apps varies greatly. While a minority of apps are developed grounded in theory and in conjunction with health care experts, the vast majority are not. This is concerning given the Hippocratic notion of “do no harm.” There is currently no unified formal theory for developing interactive eHealth apps, and development is especially difficult when complex messaging is required, such as in health promotion and prevention. Objective This paper aims to provide insight into the creation of interactive eHealth apps for complex messaging, by leveraging the Safe-D case study, which involved complex messaging required to guide safe but sufficient UV exposure for vitamin D synthesis in users. We aim to create recommendations for developing interactive eHealth apps for complex messages based on the lessons learned during Safe-D app development. Methods For this case study we developed an Apple and Android app, both named Safe-D, to safely improve vitamin D status in young women through encouraging safe ultraviolet radiation exposure. The app was developed through participatory action research involving medical and human computer interaction researchers, subject matter expert clinicians, external developers, and target users. The recommendations for development were created from analysis of the development process. Results By working with clinicians and implementing disparate design examples from the literature, we developed the Safe-D app. From this development process, recommendations for developing interactive eHealth apps for complex messaging were created: (1) involve a multidisciplinary team in the development process, (2) manage complex messages to engage users, and (3) design for interactivity (tailor recommendations, remove barriers to use, design for simplicity). Conclusions This research has provided principles for developing interactive eHealth apps for complex messaging as guidelines by aggregating existing design concepts and expanding these concepts and new learnings from our development process. A set of guidelines to develop interactive eHealth apps generally, and specifically those for complex messaging, was previously missing from the literature; this research has contributed these principles. Safe-D delivers complex messaging simply, to aid education, and explicitly, considering user safety. PMID:26860623
A strategy for providing electronic library services to members of the AGATE Consortium

NASA Technical Reports Server (NTRS)

Thompson, J. Garth

1995-01-01

In November, 1992, NASA Administrator Daniel Goldin established a Task Force to evaluate conditions which have lead to the precipitous decline of the US General Aviation System and to recommend actions needed to re-establish US leadership in General Aviation. The Task Force Report and a report by Dr. Bruce J. Holmes, Manager of the General Aviation/Commuter Office at NASA Langley Research Center provided the directions for the formation of the Advanced General Aviation Transport Experiments (AGATE), a consortium of government, industry and university committed to the revitalization of the US General Aviation Industry. One of the recommendations of the Task Force Report was that 'a central repository of information should be created to disseminate NASA research as well as other domestic and foreign aeronautical research that has been accomplished, is ongoing or is planned... A user friendly environment should be created.' This paper describes technical and logistic issues and recommends a plan for providing technical information to members of the AGATE Consortium. It is recommended that the General Aviation office establish and maintain an electronic literature page on the AGATE server. This page should provide a user friendly interface to existing technical report and index servers identified in the report and listed in the Recommendations section. A page should also be provided which gives links to Web resources. A list of specific resources is provided in the Recommendations section. Links should also be provided to a page with tips on searching, a form to provide for feedback and suggestions from users for other resources. Finally, a page should be maintained which provides pointers to other resources like the LaRCsim workstation simulation software which is avail from LaRC at no cost. The developments of the Web is very dynamic. These developments should be monitored regularly by the GA staff and links to additional resources should be provided on the server as they become available. An recommendation to NASA Headquarters should be made to establish a logically central access to all of the NASA Technical Libraries, to make these resources available both to all NASA employees and to the AGATE Consortium.
Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study

PubMed Central

Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard

2017-01-01

Background: Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. Aim: To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. Design: Semi-structured in-depth qualitative interviews analysed using thematic analysis. Setting/participants: In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer (n = 21), non-cancer (n = 16) and both a cancer and a non-cancer conditions (n = 3). Results: In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals’ preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. Conclusion: Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people. PMID:28502218
Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study.

PubMed

Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard

2018-01-01

Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. Semi-structured in-depth qualitative interviews analysed using thematic analysis. In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer ( n = 21), non-cancer ( n = 16) and both a cancer and a non-cancer conditions ( n = 3). In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals' preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people.
Starlink Document Styles

NASA Astrophysics Data System (ADS)

Lawden, M. D.

This document describes the various styles which are recommended for Starlink documents. It also explains how to use the templates which are provided by Starlink to help authors create documents in a standard style. This paper is concerned mainly with conveying the ``look and feel" of the various styles of Starlink document rather than describing the technical details of how to produce them. Other Starlink papers give recommendations for the detailed aspects of document production, design, layout, and typography. The only style that is likely to be used by most Starlink authors is the Standard style.
DOE Office of Scientific and Technical Information (OSTI.GOV)

Srivastava, Viraj; Makhmalbaf, Atefe; Parker, Graham B.

The research reported is part of a collaborative with Honeywell, Inc. to bring novel home energy management concepts and technologies to reduce energy consumption, reduce peak electricity demand, integrate renewable energy and storage technology, and change homeowner behavior to manage and consume less energy. The objective of the collaborative is to create a Context-Aware Smart Home Energy Manager (CASHEM) that dynamically schedules major home appliances according to conditions and homeowner convenience of service (CoS) preferences, monitors and analyzes energy consumption of appliances, recommends further energy saving actions, and engages/motivates the homeowner to adopt those recommendations.
"European Resuscitation Council 2015 burn 1st Aid recommendations-concerns and issues for first responders".

PubMed

Goodwin, Nicholas S

2016-08-01

As the lead author of a recently published systematic review on hydrogel burn dressings in pre-hospital, I was alarmed to read the claim by the authors to the effect no one method of burn wound cooling was superior to any other; "There is no evidence to recommend a specific temperature or method of cooling". The reputation and prominence of the ERC within the circle of resuscitation councils now delving into 1st Aid recommendations leads to the conclusion that misguided recommendations may cause confusion amongst first responders, may falsely misdirect 1st Aid providers to unsupported practices or alternatively create a window of opportunity for marketers or sellers of alternative burn 1st Aid technologies to make unsupported claims in respect of comparable efficacy of their own product versus "traditional" methods. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Chew on This: Not All First Finger Foods Are Created Equal.

PubMed

Awadalla, Nicol; Pham, Tammy; Milanaik, Ruth

2017-10-01

The American Academy of Pediatrics (AAP) recommends when to start first finger foods (FFFs) and what types of foods to start with, but it is unclear whether products marketed as FFF comply with these recommendations. We evaluated FFF products for compliance with AAP recommendations and product safety using 41 adult product testers, who were asked to dissolve each product in their mouth. Product characteristics, comments pertaining to product safety, and time to dissolve each product were recorded. Only 2 products met all AAP criteria, and safety concerns were raised for an additional 2 products. One product showed a large change in dissolvability after being left out of original packaging. Consumers should not assume that products marketed for infant/toddler consumption comply with AAP recommendations. Also, products left out of original packaging may change consistency, presenting a choking hazard. Additional research is warranted to guide the development of regulations surrounding labeling and marketing of these foods.
The Skills, Competences, and Attitude toward Information and Communications Technology Recommender System: an online support program for teachers with personalized recommendations

NASA Astrophysics Data System (ADS)

Revilla Muñoz, Olga; Alpiste Penalba, Francisco; Fernández Sánchez, Joaquín

2016-01-01

Teachers deal with Information and Communications Technology (ICT) every day and they often have to solve problems by themselves. To help them in coping with this issue, an online support program has been created, where teachers can pose their problems on ICT and they can receive solutions from other teachers. A Recommender System has been defined and implemented into the support program to suggest to each teacher the most suitable solution based on her Skills, Competences, and Attitude toward ICT (SCAT-ICT). The support program has initially been populated with 70 problems from 86 teachers. 30 teachers grouped these problems into six categories with the card-sorting technique. Real solutions to these problems have been proposed by 25 trained teachers. Finally, 17 teachers evaluated the usability of the support program and the Recommender System, where results showed a high score on the standardized System Usability Scale.
Sustainable diets for the future: Can we contribute to reducing greenhouse gas emissions by eating a healthy diet?

PubMed

Macdiarmid, Jennie I; Kyle, Janet; Horgan, Graham W; Loe, Jennifer; Fyfe, Claire; Johnstone, Alexandra; McNeill, Geraldine

2012-09-01

Food systems account for 18-20% of UK annual greenhouse gas emissions (GHGEs). Recommendations for improving food choices to reduce GHGEs must be balanced against dietary requirements for health. We assessed whether a reduction in GHGEs can be achieved while meeting dietary requirements for health. A database was created that linked nutrient composition and GHGE data for 82 food groups. Linear programming was used iteratively to produce a diet that met the dietary requirements of an adult woman (19-50 y old) while minimizing GHGEs. Acceptability constraints were added to the model to include foods commonly consumed in the United Kingdom in sensible quantities. A sample menu was created to ensure that the quantities and types of food generated from the model could be combined into a realistic 7-d diet. Reductions in GHGEs of the diets were set against 1990 emission values. The first model, without any acceptability constraints, produced a 90% reduction in GHGEs but included only 7 food items, all in unrealistic quantities. The addition of acceptability constraints gave a more realistic diet with 52 foods but reduced GHGEs by a lesser amount of 36%. This diet included meat products but in smaller amounts than in the current diet. The retail cost of the diet was comparable to the average UK expenditure on food. A sustainable diet that meets dietary requirements for health with lower GHGEs can be achieved without eliminating meat or dairy products or increasing the cost to the consumer.
Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on women in academic emergency medicine.

PubMed

Kuhn, Gloria J; Abbuhl, Stephanie B; Clem, Kathleen J

2008-08-01

The Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to "Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine." To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.
Optimising physical activity engagement during youth sport: a self-determination theory approach.

PubMed

Fenton, Sally A M; Duda, Joan L; Barrett, Timothy

2016-10-01

Research suggests participation in youth sport does not guarantee physical activity (PA) guidelines are met. Studies indicate few children achieve recommended levels of moderate-to-vigorous physical activity (MVPA) during their youth sport involvement, and habitual levels of MVPA are below the recommended 60 min per day. Informed by self-determination theory, this study examined whether the coach-created social environment and related player motivation predict variability in objectively measured MVPA within the youth sport setting. Seventy three male youth sport footballers (Mean age = 11.66 ± 1.62) completed a multisection questionnaire assessing their perceptions of the social environment created in youth sport (autonomy supportive and controlling) and motivation towards their football participation (autonomous and controlled). Intensity of PA during youth sport was measured using accelerometers (GT3X, ActiGraph). Results supported a model in which perceptions of autonomy support significantly and positively predicted autonomous motivation towards football, which in turn significantly and positively predicted youth sport MVPA (% time). A significant indirect effect was observed for perceptions of autonomy support on youth sport %MVPA via autonomous motivation. Results have implications for optimising MVPA engagement during youth sport and increasing daily MVPA towards recommended and health-enhancing levels on youth sport days.
The Haiti Medical Education Project: development and analysis of a competency based continuing medical education course in Haiti through distance learning.

PubMed

Battat, Robert; Jhonson, Marc; Wiseblatt, Lorne; Renard, Cruff; Habib, Laura; Normil, Manouchka; Remillard, Brian; Brewer, Timothy F; Sacajiu, Galit

2016-10-19

Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti. Real time lectures from local and international institutions were teleconferenced to physicians in remote Haitian sites using VidyoConferencing™ technology. With American Academy of Family Physicians (AAFP) and College of Family Physicians Canada (CFPC) guidelines as references, a competency-derived syllabus was created for a Haitian continuing medical education program. The resulting educational goals were reviewed by a committee of Haitian and North American physician/medical education practitioners to reflect local needs. All authors reviewed lectures and then conferred to establish agreement on competencies presented for each lecture. Sixty-seven lectures were delivered. Human immunodeficiency virus/Acquired Immunodeficiency Syndrome, ophthalmologic, infectious diseases, renal and endocrine competencies were well-represented, with more than 50 % of the joint AAFP and CFPC recommended competencies outlined. Areas under-represented included allergy and immunology, cardiology, surgery, pain management, gastroenterology, neurology, pulmonology, men's health and rheumatology; these topics accounted for less than 25 % of AAFP/CFPC recommended competencies. Areas not covered included geriatrics, nutrition, occupational health and women's health. Within practice-based lectures, only disaster medicine, health promotion and information management were included, but only partially covered. We identified teaching goals covered and competencies that were missing from a CME program for rural Haitian physicians. We aim to use this analysis to provide a competency-based CME lecture series that proportionally meets local needs while following recommendations of recognized national family medicine organizations.
The Physician Recommendation Coding System (PhyReCS): A Reliable and Valid Method to Quantify the Strength of Physician Recommendations During Clinical Encounters

PubMed Central

Scherr, Karen A.; Fagerlin, Angela; Williamson, Lillie D.; Davis, J. Kelly; Fridman, Ilona; Atyeo, Natalie; Ubel, Peter A.

2016-01-01

Background Physicians’ recommendations affect patients’ treatment choices. However, most research relies on physicians’ or patients’ retrospective reports of recommendations, which offer a limited perspective and have limitations such as recall bias. Objective To develop a reliable and valid method to measure the strength of physician recommendations using direct observation of clinical encounters. Methods Clinical encounters (n = 257) were recorded as part of a larger study of prostate cancer decision making. We used an iterative process to create the 5-point Physician Recommendation Coding System (PhyReCS). To determine reliability, research assistants double-coded 50 transcripts. To establish content validity, we used one-way ANOVAs to determine whether relative treatment recommendation scores differed as a function of which treatment patients received. To establish concurrent validity, we examined whether patients’ perceived treatment recommendations matched our coded recommendations. Results The PhyReCS was highly reliable (Krippendorf’s alpha =. 89, 95% CI [.86, .91]). The average relative treatment recommendation score for each treatment was higher for individuals who received that particular treatment. For example, the average relative surgery recommendation score was higher for individuals who received surgery versus radiation (mean difference = .98, SE = .18, p < .001) or active surveillance (mean difference = 1.10, SE = .14, p < .001). Patients’ perceived recommendations matched coded recommendations 81% of the time. Conclusion The PhyReCS is a reliable and valid way to capture the strength of physician recommendations. We believe that the PhyReCS would be helpful for other researchers who wish to study physician recommendations, an important part of patient decision making. PMID:27343015
The Physician Recommendation Coding System (PhyReCS): A Reliable and Valid Method to Quantify the Strength of Physician Recommendations During Clinical Encounters.

PubMed

Scherr, Karen A; Fagerlin, Angela; Williamson, Lillie D; Davis, J Kelly; Fridman, Ilona; Atyeo, Natalie; Ubel, Peter A

2017-01-01

Physicians' recommendations affect patients' treatment choices. However, most research relies on physicians' or patients' retrospective reports of recommendations, which offer a limited perspective and have limitations such as recall bias. To develop a reliable and valid method to measure the strength of physician recommendations using direct observation of clinical encounters. Clinical encounters (n = 257) were recorded as part of a larger study of prostate cancer decision making. We used an iterative process to create the 5-point Physician Recommendation Coding System (PhyReCS). To determine reliability, research assistants double-coded 50 transcripts. To establish content validity, we used 1-way analyses of variance to determine whether relative treatment recommendation scores differed as a function of which treatment patients received. To establish concurrent validity, we examined whether patients' perceived treatment recommendations matched our coded recommendations. The PhyReCS was highly reliable (Krippendorf's alpha = 0.89, 95% CI [0.86, 0.91]). The average relative treatment recommendation score for each treatment was higher for individuals who received that particular treatment. For example, the average relative surgery recommendation score was higher for individuals who received surgery versus radiation (mean difference = 0.98, SE = 0.18, P < 0.001) or active surveillance (mean difference = 1.10, SE = 0.14, P < 0.001). Patients' perceived recommendations matched coded recommendations 81% of the time. The PhyReCS is a reliable and valid way to capture the strength of physician recommendations. We believe that the PhyReCS would be helpful for other researchers who wish to study physician recommendations, an important part of patient decision making. © The Author(s) 2016.
Translating Evidence to Facilitate Shared Decision Making: Development and Usability of a Consult Decision Aid Prototype.

PubMed

Stacey, Dawn; Légaré, France; Lyddiatt, Anne; Giguere, Anik M C; Yoganathan, Manosila; Saarimaki, Anton; Pardo, Jordi Pardo; Rader, Tamara; Tugwell, Peter

2016-12-01

The purpose of this study was to translate evidence from Cochrane Reviews into a format that can be used to facilitate shared decision making during the consultation, namely patient decision aids. A systematic development process (a) established a stakeholder committee; (b) developed a prototype according to the International Patient Decision Aid Standards; (c) applied the prototype to a Cochrane Review and used an interview-guided survey to evaluate acceptability/usability; (d) created 12 consult decision aids; and (e) used a Delphi process to reach consensus on considerations for creating a consult decision aid. The 1-page prototype includes (a) a title specifying the decision; (b) information on the health condition, options, benefits/harms with probabilities; (c) an explicit values clarification exercise; and (d) questions to screen for decisional conflict. Hyperlinks provide additional information on definitions, probabilities presented graphically, and references. Fourteen Cochrane Consumer Network members and Cochrane Editorial Unit staff participated. Thirteen reported that it would help patient/clinician discussions and were willing to use and/or recommend it. Seven indicated the right amount of information, six not enough, and one too much. Changes to the prototype were more links to definitions, more white space, and details on GRADE evidence ratings. Creating 12 consult decision aids took about 4 h each. We identified ten considerations when selecting Cochrane Reviews for creating consult decision aids. Using a systematic process, we developed a consult decision aid prototype to be populated with evidence from Cochrane Reviews. It was acceptable and easy to apply. Future studies will evaluate implementation of consult decision aids.
3D printing to simulate laparoscopic choledochal surgery.

PubMed

Burdall, Oliver C; Makin, Erica; Davenport, Mark; Ade-Ajayi, Niyi

2016-05-01

Laparoscopic simulation has transformed skills acquisition for many procedures. However, realistic nonbiological simulators for complex reconstructive surgery are rare. Life-like tactile feedback is particularly difficult to reproduce. Technological innovations may contribute novel solutions to these shortages. We describe a hybrid model, harnessing 3D technology to simulate laparoscopic choledochal surgery for the first time. Digital hepatic anatomy images and standard laparoscopic trainer dimensions were employed to create an entry level laparoscopic choledochal surgery model. The information was fed into a 3D systems project 660pro with visijet pxl core powder to create a free standing liver mold. This included a cuboid portal in which to slot disposable hybrid components representing hepatic and pancreatic ducts and choledochal cyst. The mold was used to create soft silicone replicas with T28 resin and T5 fast catalyst. The model was assessed at a national pediatric surgery training day. The 10 delegates that trialed the simulation felt that the tactile likeness was good (5.6/10±1.71, 10=like the real thing), was not too complex (6.2/10±1.35; where 1=too simple, 10=too complicated), and generally very useful (7.36/10±1.57, 10=invaluable). 100% stated that they felt they could reproduce this in their own centers, and 100% would recommend this simulation to colleagues. Though this first phase choledochal cyst excision simulation requires further development, 3D printing provides a useful means of creating specific and detailed simulations for rare and complex operations with huge potential for development. Copyright © 2016. Published by Elsevier Inc.
Using smart card technology to monitor the eating habits of children in a school cafeteria: 2. The nutrient contents of all meals chosen by a group of 8- to 11-year-old boys over 78 days.

PubMed

Lambert, N; Plumb, J; Looise, B; Johnson, I T; Harvey, I; Wheeler, C; Robinson, M; Rolfe, P

2005-08-01

The aim of the study was to test the abilities of the newly created smart card system to track the nutrient contents of foods chosen over several months by individual diners in a school cafeteria. From the food choice and composition of food data sets, an Access database was created encompassing 30 diners (aged 8-11 years), 78 days and eight nutrients. Data were available for a total of 1909 meals. Based upon population mean values the cohort were clearly choosing meals containing higher than the recommended maximum amounts for sugar and lower than the recommended minimum amounts of fibre, iron and vitamin A. Protein and vitamin C contents of meals chosen were well above minimum requirements. Over the 1909 meals, nutrient requirements were met 41% of the time. The system created was very effective at continually monitoring food choices of individual diners over limitless time. The data generated raised questions on the common practice of presenting nutrient intakes as population mean values calculated over a few days. The impact of heavily fortified foods on such studies in general is discussed.
Diagnosis, natural history, and management in vascular Ehlers-Danlos syndrome.

PubMed

Byers, Peter H; Belmont, John; Black, James; De Backer, Julie; Frank, Michael; Jeunemaitre, Xavier; Johnson, Diana; Pepin, Melanie; Robert, Leema; Sanders, Lynn; Wheeldon, Nigel

2017-03-01

Vascular Ehlers Danlos syndrome (vEDS) is an uncommon genetic disorders characterized by arterial aneurysm, dissection and rupture, bowel rupture, and rupture of the gravid uterus. The frequency is estimated as 1/50,000-1/200,000 and results from pathogenic variants in COL3A1, which encodes the chains of type III procollagen, a major protein in vessel walls and hollow organs. Initial diagnosis depends on the recognitions of clinical features, including family history. Management is complex and requires multiple specialists who can respond to and manage the major complications. A summary of recommendations for management include: Identify causative variants in COL3A1 prior to application of diagnosis, modulate life style to minimize injury, risk of vessel/organ rupture, identify and create care team, provide individual plans for emergency care ("vascular EDS passport") with diagnosis and management plan for use when traveling, centralize management at centers of excellence (experience) when feasible, maintain blood pressure in the normal range and treat hypertension aggressively, surveillance of vascular tree by doppler ultrasound, CTA (low radiation alternatives) or MRA if feasible on an annual basis. These recommendations represent a consensus of an international group of specialists with a broad aggregate experience in the care of individuals with vascular EDS that will need to be assessed on a regular basis as new information develops. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Nutrition considerations for open-water swimming.

PubMed

Shaw, Gregory; Koivisto, Anu; Gerrard, David; Burke, Louise M

2014-08-01

Open-water swimming (OWS) is a rapidly developing discipline. Events of 5-25 km are featured at FINA World Championships, and the international circuit includes races of 5-88 km. The Olympic OWS event, introduced in 2008, is contested over 10 km. Differing venues present changing environmental conditions, including water and ambient temperatures, humidity, solar radiation, and unpredictable tides. Furthermore, the duration of most OWS events (1-6 hr) creates unique physiological challenges to thermoregulation, hydration status, and muscle fuel stores. Current nutrition recommendations for open-water training and competition are either an extension of recommendations from pool swimming or are extrapolated from other athletic populations with similar physiological requirements. Competition nutrition should focus on optimizing prerace hydration and glycogen stores. Although swimmers should rely on self-supplied fuel and fluid sources for shorter events, for races of 10 km or greater, fluid and fuel replacement can occur from feeding pontoons when tactically appropriate. Over the longer races, feeding pontoons should be used to achieve desirable targets of up to 90 g/ hr of carbohydrates from multitransportable sources. Exposure to variable water and ambient temperatures will play a significant role in determining race nutrition strategies. For example, in extreme environments, thermoregulation may be assisted by manipulating the temperature of the ingested fluids. Swimmers are encouraged to work with nutrition experts to develop effective and efficient strategies that enhance performance through appropriate in-competition nutrition.
Tobacco industry tactics for resisting public policy on health.

PubMed Central

Saloojee, Y.; Dagli, E.

2000-01-01

The tactics used by the tobacco industry to resist government regulation of its products include conducting public relations campaigns, buying scientific and other expertise to create controversy about established facts, funding political parties, hiring lobbyists to influence policy, using front groups and allied industries to oppose tobacco control measures, pre-empting strong legislation by pressing for the adoption of voluntary codes or weaker laws, and corrupting public officials. Formerly secret internal tobacco industry documents provide evidence of a 50-year conspiracy to "resist smoking restrictions, restore smoker confidence and preserve product liability defence". The documents reveal industry-wide collusion on legal, political and socially important issues to the tobacco industry and clearly demonstrate that the industry is not disposed to act ethically or responsibly. Societal action is therefore required to ensure that the public health takes precedence over corporate profits. Recommendations for reducing the political influence of the tobacco industry include the following. Every tobacco company in every market should publicly disclose what it knew about the addictiveness and harm caused by tobacco, when it obtained this information, and what it did about it. The industry should be required to guarantee internationally recognized basic consumer rights to its customers. Trade associations and other industry groupings established to deceive the public should be disbanded. These recommendations should be incorporated into WHO's Framework Convention on Tobacco Control. PMID:10994263
Cannabis Guidelines .

PubMed

Kennedy Sheldon, Lisa

2017-08-01

Cannabis has been used for centuries in the treatment of medical conditions. Cannabis has been recommended for appetite, anxiety, depression, sleep, and migraines. However, the stigma associated with cannabis as a recreational drug has created challenges to the legitimacy and social acceptance of cannabis for medical purposes in the United States.
Sodium content in US packaged foods 2009

USDA-ARS?s Scientific Manuscript database

In 2010, the Institute of Medicine recommended food manufacturers reduce the amount of sodium in their products. Monitoring sodium in packaged foods is necessary to evaluate the impact of these efforts. Using commercially available data from Nielsen and Gladson, we created a database with sales and...
Improving Indicators of Child Well-Being

ERIC Educational Resources Information Center

Stagner, Matthew; Goerge, Robert; Ballard, Pete

2009-01-01

This report makes a number of recommendations on new directions for the development of child well-being indicators. For developmental transitions throughout early childhood, the authors call for standardizing birth records across states, collecting additional data at immunization visits, and creating common assessments at kindergarten entry. For…
Childhood Obesity Demands New Approaches.

ERIC Educational Resources Information Center

Satter, Ellyn

1991-01-01

Health professionals suggest creating achievable goals in childhood obesity. The article recommends correcting factors that distort normal growth and providing positive eating and exercise management to slow weight gain. Rather than trying for weight loss, children must learn positive lifelong eating and exercise patterns and attitudes toward self…
76 FR 60500 - Request for Information: Announcement of Carcinogen and Recommended Exposure Limit (REL) Policy...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... answers to 5 questions. NIOSH has also created a new NIOSH Cancer and RELs Policy Web Topic Page [see http... be available on the NIOSH Web page at http://www.cdc.gov/niosh/docket , and comments will be...
Somalia's Reconstruction: An Opportunity to Create a Responsive Information Infrastructure.

ERIC Educational Resources Information Center

Abdulla, Ali D.

1996-01-01

Argues that the development of an effective information infrastructure would contribute to Somalia's economic and social renewal. Outlines the attributes of such an infrastructure and makes specific recommendations to future Somali development planners and international donors supporting information development activities. (Author/PEN)

Some links on this page may take you to non-federal websites. Their policies may differ from this site.