Effect of polymyxin resistance (pmr) on biofilm formation of Cronobacter sakazakii.

PubMed

Bao, Xuerui; Jia, Xiangyin; Chen, Lequn; Peters, Brian M; Lin, Chii-Wann; Chen, Dingqiang; Li, Lin; Li, Bing; Li, Yanyan; Xu, Zhenbo; Shirtliff, Mark E

2017-05-01

Cronobacter sakazakii (C.sakazakii) has been identified as a wide-spread conditioned pathogen associated with series of serious illnesses, such as neonatal meningitis, enterocolitis, bacteremia or sepsis. As food safety is concerned, microbial biofilm has been considered to be a potential source of food contamination. The current study aims to investigate the ability of biofilm formation of two C. sakazakii strains (wild type BAA 894 and pmrA mutant). Crystal violet (CV), XTT (2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino carbonyl)-2H-(tetrazolium hydroxide)] assays, and scanning electron microscopy (SEM) are performed on different time points during biofilm formation of C. sakazakii strains. Furthermore, RNA-seq strategy is utilized and the transcriptome data is analyzed to study the expression of genes related to biofilm formation along with whole genome sequencing. For biomass, in the first 24 h, pmrA mutant produced approximately 5 times than wildtype. However, the wild type exhibited more biomass than pmrA mutant during the post maturation stage (7-14 d). In addition, the wildtype showed higher viability than pmrA mutant during the whole biofilm formation. This study represents the first evidence on the biofilm formation of C. sakazakii pmrA mutant, which may further aid in the prevention and control for the food contamination caused by C. sakazakii. Copyright © 2016 Elsevier Ltd. All rights reserved.

Structural derivation of lipid A from Cronobacter sakazakii using tandem mass spectrometry.

PubMed

Li, Yanyan; Yoon, Sung Hwan; Wang, Xiaoyuan; Ernst, Robert K; Goodlett, David R

2016-10-30

Cronobacter sakazakii is a Gram-negative opportunistic pathogen that can cause necrotizing enterocolitis, bacteremia, and meningitis. Lipid A, the glycolipid membrane anchor of lipopolysaccharide (LPS), is a potential virulence factor for C. sakazakii. Given the potential importance of this molecule in infection and virulence, structural characterization of lipid A was carried out. The structural characterization of lipid A extracted from C. sakazakii was performed using electrospray ionization and collision-induced dissociation in a linear ion trap mass spectrometer. Specifically, for detailed structural characterization, hierarchical tandem mass spectrometry was performed on the dominant ions present in the precursor ion mass spectra. By comparing the C. sakazakii fragmentation pathways to those of the known structure of E. coli lipid A, a structure of C. sakazakii lipid A was derived. The precursor ion at m/z 1796 from C. sakazakii is produced from a lipid A molecule where the acyl chains between the 2'b (C14) and 3'b (C12) positions are reversed as compared to E. coli lipid A. Additionally, the precursor ion at m/z 1824 from C. sakazakii corresponds to an E. coli structure with the same acyl chain at the 2'b position (C14), but a longer acyl chain (C14) at the 3'b position versus m/z 1796. Two lipid A structures were derived for the C. sakazakii ions at m/z 1796 and 1824. They differed in composition at the 2'b and 3'b acyl chain substituents, which may be a result of differences in substrate specificity of the two lipid A acyl chain transferases: LpxL and LpxM. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Thymoquinone Inhibits Virulence Related Traits of Cronobacter sakazakii ATCC 29544 and Has Anti-biofilm Formation Potential.

PubMed

Shi, Chao; Yan, Chunhong; Sui, Yue; Sun, Yi; Guo, Du; Chen, Yifei; Jin, Tong; Peng, Xiaoli; Ma, Linlin; Xia, Xiaodong

2017-01-01

The aim of this study was to determine whether thymoquinone, the principal active ingredient in the volatile oil of Nigella sativa seeds, could suppress certain virulence traits of Cronobacter sakazakii ATCC 29544 which contribute to infection. Sub-inhibitory concentrations of thymoquinone significantly decreased motility, quorum sensing, and endotoxin production of C. sakazakii ATCC 29544 and biofilm formation of C. sakazakii 7-17. Thymoquinone substantially reduced the adhesion and invasion of C. sakazakii ATCC 29544 to HT-29 cells and decreased the number of intracellular bacterial cells within the RAW 264.7 macrophage cells. Thymoquinone also repressed the transcription of sixteen genes involved in the virulence. These findings suggest that thymoquinone could attenuated virulence-related traits of C. sakazakii ATCC 29544, and its effects on other C. sakazakii strains and in vivo C. sakazakii infection need further investigation.

Thymoquinone Inhibits Virulence Related Traits of Cronobacter sakazakii ATCC 29544 and Has Anti-biofilm Formation Potential

PubMed Central

Shi, Chao; Yan, Chunhong; Sui, Yue; Sun, Yi; Guo, Du; Chen, Yifei; Jin, Tong; Peng, Xiaoli; Ma, Linlin; Xia, Xiaodong

2017-01-01

The aim of this study was to determine whether thymoquinone, the principal active ingredient in the volatile oil of Nigella sativa seeds, could suppress certain virulence traits of Cronobacter sakazakii ATCC 29544 which contribute to infection. Sub-inhibitory concentrations of thymoquinone significantly decreased motility, quorum sensing, and endotoxin production of C. sakazakii ATCC 29544 and biofilm formation of C. sakazakii 7-17. Thymoquinone substantially reduced the adhesion and invasion of C. sakazakii ATCC 29544 to HT-29 cells and decreased the number of intracellular bacterial cells within the RAW 264.7 macrophage cells. Thymoquinone also repressed the transcription of sixteen genes involved in the virulence. These findings suggest that thymoquinone could attenuated virulence-related traits of C. sakazakii ATCC 29544, and its effects on other C. sakazakii strains and in vivo C. sakazakii infection need further investigation. PMID:29234307

Comparison of Chromogenic Selective Media for the Detection of Cronobacter spp. (Enterobacter sakazakii).

PubMed

Teramura, Hajime; Fukuda, Noriko; Okada, Yumiko; Ogihara, Hirokazu

2018-01-01

　The four types of chromogenic selective media that are commercially available in Japan were compared for establishing a Japanese standard method for detecting Cronobacter spp. based on ISO/TS 22964:2006. When assessed using 9 standard Cronobacter spp. strains and 29 non-Cronobacter strains, Enterobacter sakazakii isolation agar, Chromocult TM Enterobacter sakazakii agar, CHROMagar TM E. sakazakii, and XM-sakazakii agar demonstrated excellent inclusivity and exclusivity. Using the ISO/TS 22964:2006 method, the recovered numbers of 38 Cronobacter spp. strains, including 29 C. sakazakii isolates obtained from each medium, were equivalent, indicating that there was no significant difference (p > 0.05) among the four types of chromogenic selective media. Thus, we demonstrated that these four chromogenic selective media are suitable alternatives when using the standard method for detecting Cronobacter spp. in Japan, based on the ISO/TS 22964:2006.

Inhibition of Cronobacter sakazakii by Lactobacillus acidophilus n.v. Er2 317/402.

PubMed

Charchoghlyan, Haykuhi; Kwon, Heejun; Hwang, Dong-Ju; Lee, Jong Suk; Lee, Junsoo; Kim, Myunghee

2016-10-31

Lactobacillus acidophilus n.v. Er2 317/402 strain Narine is known as a health beneficial functional probiotic culture and supplementary source of nutrition for newborns. In this study, in vitro antimicrobial activities of Narine-lyophilized (Narine-L), Narine-heat treated (Narine-HT), and Narine crude cell-free extract (Narine-CCFE) were evaluated against pathogen Cronobacter sakazakii ( C. sakazakii ) in agar as well as in a reconstituted powdered infant formula (RPIF) model. Inhibition zones of 30 mg Narine-L and Narine-HT were both 150 U, whereas inhibition zone of 30 mg Narine-CCFE was 200 U. Narine-L (1 g) and Narine-HT (1 g) were added to 10 mL of artificially contaminated RPIF, respectively, containing 100 μL of C. sakazakii (1.62×10 8 colony forming unit (CFU)/mL). After treatment with Narine-L and Narine-HT for 3 h and 6 h at 37℃, less than ≤107 CFU/mL of C. sakazakii was detected in RPIF. Without Narine-L and Narine-HT treatment, the population of C. sakazakii increased up to 5.36×10 9 CFU/mL after 6 h. Examination by transmission electron microscopy confirmed C. sakazakii cells were damaged by Narine-CCFE. Thus, employing Narine culture as a natural and safe bio-preservative may protect infants from C. sakazakii .

Microarray-based Comparative Genomic Indexing of the Cronobacter genus (Enterobacter sakazakii)

USDA-ARS?s Scientific Manuscript database

Cronobacter is a recently defined genus synonymous with Enterobacter sakazakii. This new genus currently comprises 6 genomospecies. To extend our understanding of the genetic relationship between Cronobacter sakazakii BAA-894 and the other species of this genus, microarray-based comparative genomi...

Meningoencephalitis and Compartmentalization of the Cerebral Ventricles Caused by Enterobacter sakazakii

PubMed Central

Kleiman, Martin B.; Allen, Stephen D.; Neal, Patricia; Reynolds, Janet

1981-01-01

A necrotizing meningoencephalitis complicated by ventricular compartmentalization and abscess formation caused by Enterobacter sakazakii in a previously healthy 5-week-old female is described. A detailed description of the isolate is presented. This communication firmly establishes the pathogenicity of E. sakazakii. PMID:7287892

Insights into virulence factors determining the pathogenicity of Cronobacter sakazakii.

PubMed

Singh, Niharika; Goel, Gunjan; Raghav, Mamta

2015-01-01

Cronobacter sakazakii is an opportunistic pathogen associated with outbreaks of life-threatening necrotizing enterocolitis, meningitis and sepsis in neonates and infants. The pathogen possesses an array of virulence factors which aid in tissue adhesion, invasion and host cell injury. Although the identification and validation of C. sakazakii virulence factors has been hindered by availability of suitable neonatal animal model, various studies has reported outer membrane protein A (ompA) as a potential virulence marker. Various other plasmid associated genes such as filamentous hemagglutinin (fhaBC), Cronobacter plasminogen activator (cpa) and genes responsible for iron acquisition (eitCBAD and iucABD/iutA) have been reported in different strains of C. sakazakii. Besides these proposed virulence factors, several biophysical growth factors such as formation of biofilms and resistance to various environmental stresses also contributes to the pathogenic potential of this pathogen. This review provides an update on virulence determinants associated with the pathogenesis of C. sakazakii. The potential reservoirs of the pathogen, mode of transmission and epidemiology are also discussed.

Insights into virulence factors determining the pathogenicity of Cronobacter sakazakii

PubMed Central

Singh, Niharika; Goel, Gunjan; Raghav, Mamta

2015-01-01

Cronobacter sakazakii is an opportunistic pathogen associated with outbreaks of life-threatening necrotizing enterocolitis, meningitis and sepsis in neonates and infants. The pathogen possesses an array of virulence factors which aid in tissue adhesion, invasion and host cell injury. Although the identification and validation of C. sakazakii virulence factors has been hindered by availability of suitable neonatal animal model, various studies has reported outer membrane protein A (ompA) as a potential virulence marker. Various other plasmid associated genes such as filamentous hemagglutinin (fhaBC), Cronobacter plasminogen activator (cpa) and genes responsible for iron acquisition (eitCBAD and iucABD/iutA) have been reported in different strains of C. sakazakii. Besides these proposed virulence factors, several biophysical growth factors such as formation of biofilms and resistance to various environmental stresses also contributes to the pathogenic potential of this pathogen. This review provides an update on virulence determinants associated with the pathogenesis of C. sakazakii. The potential reservoirs of the pathogen, mode of transmission and epidemiology are also discussed. PMID:25950947

Examine the Correlation between Heat Shock Protein IbpA and Heat Tolerance in Cronobacter sakazakii.

PubMed

Zhao, Zhi Jing; Wang, Bin; Yuan, Jing; Liang, Hao Yu; Dong, Si Guo; Zeng, Ming

2017-08-01

We used a proteomic approach to identify IbpA in Cronobacter sakazakii (C. sakazaki), which is related to heat tolerance in this strain. The abundance of IbpA in C. sakazakii strains strongly increased after heat shock. C. sakazakii CMCC 45402 ibpA deletion mutants were successfully constructed. The C. sakazakii CMCC 45402 ΔibpA and wild-type strains could not be distinguished based on colony morphology on LB agar plates or biochemical assays. The growth of the C. sakazakii CMCC 45402 ΔibpA mutant in heat shock conditions was indistinguishable from that of the isogenic wild-type, but showed greater heat resistance than E. coli O157:H7 strain CMCC 44828. This study suggests that the absence of a single ibpA gene has no obvious effect on the phenotype or heat resistance of the strain C. sakazakii CMCC 45402. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

[The role of science in policy making--EuSANH-ISA project, framework for science advice for health].

PubMed

Cianciara, Dorota; Piotrowicz, Maria; Bielska-Lasota, Magdalena; Wysocki, Mirosław J

2012-01-01

Governments and other authorities (including MPs) should be well informed on issues of science and technology. This is particularly important in the era of evidence-based practice. This implies the need to get expert advice. The process by which scientific knowledge is transmitted, along with proposals how to solve the problem, is called science advice. The main aim of the article is to discuss the issue of science advice--definitions, interaction between science and policymaking, and its position in contemporary policies. The second aim is to present European Science Advisory Network for Health (EuSANH), EuSANH-ISA project, and framework for science advice for health which was developed by participants. Furthermore, the role of civil society in decision-making process and science advice is also discussed. Interaction between scientists and policy-makers are described in terms of science-push approach (technocratic model), policy-pull (decisionistic) and simultaneous push-pull approach (pragmatic). The position of science advice is described in historical perspective from the 50s, especially in the last two decades. Description relies to USA, Canada and UK. Principles of scientific advice to government (Government Office for Science, UK) are quoted. Some important documents related to science advice in EU and UN are mentioned. EuSANH network is described as well as EuSANH-ISA project, with its objectives and outcomes. According to findings of this project, the process of science advice for health should follow some steps: framing the issue to be covered; planning entire process leading to the conclusion; drafting the report; reviewing the report and revision; publishing report and assessing the impact on policy.

Nonthermal Inactivation of Cronobacter sakazakii in Infant Formula Milk: A Review.

PubMed

Pina-Pérez, M C; Rodrigo, D; Martínez, A

2016-07-26

Up-to-date, nonthermal technologies and combinations of them, in accordance with the "hurdle technology" concept, are being applied by different research groups in response to calls by the International Food and Human Health Organizations (ESPGHAN, 2004; FAO/WHO, 2006, 2008) for alternatives to thermal control of Cronobacter sakazakii in reconstituted powdered infant formula milk. This review highlights (i) current knowledge on the application of nonthermal technologies to control C. sakazakii in infant formula milk and (ii) the importance of the application of nonthermal technologies for the control of C. sakazakii as part of the development of strategies in the context of improving food safety and quality of this product.

Inhibition of quorum-sensing-mediated biofilm formation in Cronobacter sakazakii strains.

PubMed

Singh, Niharika; Patil, Amrita; Prabhune, Asmita; Goel, Gunjan

2016-09-01

The present study investigated plant extracts for their anti-quorum-sensing (QS) potential to inhibit the biofilm formation in Cronobacter sakazakii strains. The bioassay based on loss of pigment production by Chromobacterium violaceum 026 and Agrobacterium tumefaciens NTL4(pZLR4) was used for initial screening of the extracts. Further, the effect of extracts on the inhibition of QS-mediated biofilm in C. sakazakii isolates was evaluated using standard crystal violet assay. The effect on biofilm texture was studied using SYTO9 staining and light and scanning electron microscopy. Among the tested extracts, Piper nigrum and Cinnamomum verum at 100 ppm resulted in 78 and 68 % reduction in the production of violacein as well as blue-green colour in both biosensor strains. A higher inhibitory activity (>50 %) on biofilm formation in C. sakazakii was observed for Pip. nigrum and Cin. verum, whereas the other extracts possessed moderate (25-50 %) and minimal (<25 %) inhibitory activities. Further, the fluorescent and scanning electron microscopic images indicated a major disruption in the architecture of biofilms of tested strains by Pip. nigrum. This study points to the possibility of using Pip. nigrum and Cin. verum as inhibitor of QS-mediated biofilm formation by C. sakazakii that could be further explored for novel bioactive molecules to limit the emerging infections of C. sakazakii.

Immunoproteomic identification of immunogenic proteins in Cronobacter sakazakii strain BAA-894.

PubMed

Wang, Jian; Du, Xin-Jun; Lu, Xiao-Nan; Wang, Shuo

2013-03-01

Cronobacter spp. are emerging opportunistic pathogens. Cronobacter sakazakii is considered as the predominant species in all infections. So far, our understanding of the species' immunogens and potential virulence factors of Cronobacter spp. remains limited. In this study, an immunoproteomic approach was used to investigate soluble and insoluble proteins from the genome-sequenced strain C. sakazakii ATCC BAA-894. Proteins were separated using two-dimensional electrophoresis, detected by Western blotting with polyclonal antibodies of C. sakazakii BAA-894, and identified using tandem mass spectrometry (MALDI-MS and MALDI-MS/MS, MS/MSMS). A total of 11 immunoreactive proteins were initially identified in C. sakazakii BAA-894, including two outer membrane proteins, four periplasmic proteins, and five cytoplasmic proteins. In silico functional analysis of the 11 identified proteins indicated three proteins that were initially described as immunogens of pathogenic bacteria. For the remaining eight proteins, one protein was categorized as a potential virulence factor involved in protection against reactive oxygen species, and seven proteins were considered to play potential roles in adhesion, invasion, and biofilm formation. To our knowledge, this is the first time that immunogenic proteins of C. sakazakii BAA-894 have been identified as immunogens and potential virulence factors by an immunoproteomics approach. Future studies should investigate the roles of these proteins in bacterial pathogenesis and modulation of host immune responses during infection to identify their potential as molecular therapeutic targets.

Characterization of outer membrane vesicles from a neonatal meningitic strain of Cronobacter sakazakii.

PubMed

Alzahrani, Hayat; Winter, Jody; Boocock, David; De Girolamo, Luigi; Forsythe, Stephen J

2015-06-01

Cronobacter sakazakii is associated with severe and often fatal cases of infant meningitis and necrotizing enterocolitis. The form of meningitis differs from that due to Neisseria meningitidis and Streptococcus spp., in that it is highly invasive and destructive towards human brain cells. However, there is relatively little understanding of the cytopathogenic interaction of C. sakazakii with host cells which results in stimulation of an inflammatory immune response. The production of Cronobacter outer membrane vesicles (OMV) and their potential pathogenic functions have not yet been elucidated. This study is the first to show that C. sakazakii produce OMV, which may play a role in the activation of cytopathogenic and host cell responses on human intestinal epithelial cells. Cronobacter sakazakii strain 767 was used which had been isolated from a fatal outbreak of neonatal meningitis and necrotizing enterocolitis. Cronobacter sakazakii OMV were internalized by Caco-2 cells, increased cell proliferation and stimulated the host's innate proinflammatory response without inducing overt toxicity. A total of 18 OMV-associated proteins were identified by mass spectrometry and their potential pathogenicity roles were evaluated. Collectively, these data indicate that C. sakazakii OMV could play a role in pathogenesis by delivering bacterial toxins into host epithelial cells, driving proliferative and proinflammatory responses. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Heat Tolerances of Salmonella, Cronobacter sakazakii, and Pediococcus acidilactici Inoculated into Galactooligosaccharide.

PubMed

Bang, Jihyun; Choi, Moonkak; Jeong, Haeseok; Lee, Sangseob; Kim, Yoonbin; Ryu, Jee-Hoon; Kim, Hoikyung

2017-07-01

Food-grade galactooligosaccharide (GOS) with low water activity (a w of ca. 0.7) is used as an ingredient in various foods. We evaluated heat tolerances of Salmonella, Cronobacter sakazakii, and Pediococcus acidilactici at temperatures (70 to 85°C) used during the saturation process of GOS by comparing decimal reduction time (D-values) and thermal resistance constants (z-values). To determine the D- and z-values, GOS containing Salmonella (5.1 to 5.8 log CFU/g) or C. sakazakii (5.3 to 5.9 log CFU/g) was heat treated at 70, 77.5, or 85°C for up to 40, 25, or 15 s, respectively, and GOS containing P. acidilactici (6.1 to 6.5 log CFU/g) was heat treated at 70, 77.5, or 85°C for up to 150, 75, or 40 s, respectively. The D-values were calculated using a linear model for heating time versus microbial population for each bacterium. When the D-values for Salmonella, C. sakazakii, and P. acidilactici in GOS were compared, the thermal resistance of all bacteria decreased as the temperature increased. Among the three bacteria, P. acidilactici had higher D-values than did Salmonella and C. sakazakii. The z-values of Salmonella, C. sakazakii, and P. acidilactici were 30.10, 33.18, and 13.04°C, respectively. Overall order of thermal resistance was P. acidilactici > Salmonella ≈ C. sakazakii. These results will be useful for selecting appropriate heat treatment conditions for the decontamination of pathogenic microorganisms during GOS manufacturing.

Inactivation of Enterobacter sakazakii of dehydrated infant formula by gamma-irradiation

NASA Astrophysics Data System (ADS)

Lee, Ju-Woon; Oh, Sang-Hee; Byun, Eui-Baek; Kim, Jae-Hun; Kim, Jang-Ho; Woon, Jae-Ho; Byun, Myung-Woo

2007-11-01

Enterobacter sakazakii has been implicated as a causal organism in a severe form of neonatal meningitis, with reported mortality rates of 20%. The population at greatest risk is immunocompromised infants of any age. Dried infant formula has been identified as a potential source of the organism in both outbreaks and sporadic cases. The objective of this study was to investigate theirradiation effect of the inactivation on E. sakazakii (ATCC 29544) of a dehydrated infant formula. The D10-values were 0.22-0.27 and 0.76 kGy for broth and dehydrated infant formula, respectively. The irradiation at 5.0 kGy was able to completely eliminate the E. sakazakii inoculated at 8.0 to 9.0 log CFU g -1 onto a dehydrated infant formula. There was no regrowth for all samples during the time they were stored at 10 °C for 6 h after rehydration. The present results indicated that a gamma-irradiation could potentially be used to inactivate E. sakazakii in a dehydrated powdered infant formula.

Cronobacter sakazakii in foods and factors affecting its survival, growth, and inactivation

USDA-ARS?s Scientific Manuscript database

Cronobacter sakazakii has been isolated from a wide range of environmental sources and from several foods of animal and plant origin. While infections caused by C. sakazakii have predominantly involved neonates and infants, its presence on or in foods other than powdered infant formula raises conce...

Prevalence, Molecular Characterization, and Antibiotic Susceptibility of Cronobacter sakazakii Isolates from Powdered Infant Formula Collected from Chinese Retail Markets

PubMed Central

Fei, Peng; Jiang, Yichao; Jiang, Yan; Yuan, Xiujuan; Yang, Tongxiang; Chen, Junliang; Wang, Ziyuan; Kang, Huaibin; Forsythe, Stephen J.

2017-01-01

Cronobacter sakazakii is an opportunistic pathogen that causes severe infections in neonates and infants through contaminated powdered infant formula (PIF). Therefore, the aim of this study was a large-scale study on determine the prevalence, molecular characterization and antibiotic susceptibility of C. sakazakii isolates from PIF purchased from Chinese retail markets. Two thousand and twenty PIF samples were collected from different institutions. Fifty-six C. sakazakii strains were isolated, and identified using fusA sequencing analysis, giving a contamination rate of 2.8%. Multilocus sequence typing (MLST) was more discriminatory than other genotyping methods. The C. sakazakii isolates were divided into 14 sequence types (STs) by MLST, compared with only seven clusters by ompA and rpoB sequence analysis, and four C. sakazakii serotypes by PCR-based O-antigen serotyping. C. sakazakii ST4 (19/56, 33.9%), ST1 (12/56, 21.4%), and ST64 (11/56, 16.1%) were the dominant sequence types isolated. C. sakazakii serotype O2 (34/56, 60.7%) was the primary serotype, along with ompA6 and rpoB1 as the main allele profiles, respectively. Antibiotic susceptibility testing indicated that all C. sakazakii isolates were susceptible to ampicillin-sulbactam, cefotaxime, ciprofloxacin, meropenem, tetracycline, piperacillin-tazobactam, and trimethoprim-sulfamethoxazole. The majority of C. sakazakii strains were susceptible to chloramphenicol and gentamicin (87.5 and 92.9%, respectively). In contrast, 55.4% C. sakazakii strains were resistant to cephalothin. In conclusion, this large-scale study revealed the prevalence and characteristics of C. sakazakii from PIF in Chinese retail markets, demonstrating a potential risk for neonates and infants, and provide a guided to effective control the contamination of C. sakazakii in production process. PMID:29089940

Genomic dissection of the 1994 Cronobacter sakazakii outbreak in a French neonatal intensive care unit.

PubMed

Masood, Naqash; Moore, Karen; Farbos, Audrey; Paszkiewicz, Konrad; Dickins, Ben; McNally, Alan; Forsythe, Stephen

2015-10-05

Cronobacter sakazakii is a member of the genus Cronobacter that has frequently been isolated from powdered infant formula (PIF) and linked with rare but fatal neonatal infections such as meningitis and necrotising enterocolitis. The Cronobacter MLST scheme has reported over 400 sequence types and 42 clonal complexes; however C. sakazakii clonal complex 4 (CC4) has been linked strongly with neonatal infections, especially meningitis. There have been a number of reported Cronobacter outbreaks over the last three decades. The largest outbreak of C. sakazakii was in a neonatal intensive care unit (NICU) in France (1994) that lasted over 3 months and claimed the lives of three neonates. The present study used whole genome sequencing data of 26 isolates obtained from this outbreak to reveal their relatedness. This study is first of its kind to use whole genome sequencing data to analyse a Cronobacter outbreak. Whole genome sequencing data was generated for 26 C. sakazakii isolates on the Illumina MiSeq platform. The whole genome phylogeny was determined using Mugsy and RaxML. SNP calls were determined using SMALT and SAMtools, and filtered using VCFtools. The whole genome phylogeny suggested 3 distant clusters of C. sakazakii isolates were associated with the outbreak. SNP typing and phylogeny indicate the source of the C. sakazakii could have been from extrinsic contamination of reconstituted infant formula from the NICU environment and personnel. This pool of strains would have contributed to the prolonged duration of the outbreak, which was up to 3 months. Furthermore 3 neonates were co-infected with C. sakazakii from two different genotype clusters. The genomic investigation revealed the outbreak consisted of an heterogeneous population of C. sakazakii isolates. The source of the outbreak was not identified, but probably was due to environmental and personnel reservoirs resulting in extrinsic contamination of the neonatal feeds. It also indicated that C. sakazakii

Duplex Real-Time PCR Method for the Differentiation of Cronobacter sakazakii and Cronobacter malonaticus.

PubMed

Li, Xiaofang; Cui, Jinghua; Du, Xiaoli; Cui, Zhigang; Huang, Yibing; Kan, Biao

2017-01-01

Cronobacter sakazakii and Cronobacter malonaticus are the most common species of Cronobacter , so it is necessary to detect the two species as soon as possible in surveillance programs. We developed a real-time PCR method for identifying C. sakazakii and C. malonaticus from the genus Cronobacter . In this study, the two pairs of primers and probes were designed, targeting 16S rRNA and fusA, respectively. The specificity of the real-time PCR assay was validated with 112 strains of Cronobacter , including 56 C. sakazakii , 32 C. malonaticus , 16 Cronobacter dublinensis , 6 Cronobacter turicensis , and 2 Cronobacter muytjensii . The results showed that C. sakazakii and C. malonaticus were all correctly identified, consistent with the results of another method by analyzing the clustering of the fusA sequence. The detection limit for pure culture was 10 2 CFU/ml and 10 3 CFU/g for artificially contaminated rehydrated powdered infant formula. Therefore, the developed real-time PCR was a rapid, sensitive, and reliable method for the identification of C. sakazakii and C. malonaticus .

Efficiency of bacteriophage therapy against Cronobacter sakazakii in Galleria mellonella (greater wax moth) larvae.

PubMed

Abbasifar, Reza; Kropinski, Andrew M; Sabour, Parviz M; Chambers, James R; MacKinnon, Joanne; Malig, Thomas; Griffiths, Mansel W

2014-09-01

Cronobacter sakazakii, an opportunistic pathogen found in milk-based powdered infant formulae, has been linked to meningitis in infants, with high fatality rates. A set of phages from various environments were purified and tested in vitro against strains of C. sakazakii. Based on host range and lytic activity, the T4-like phage vB_CsaM_GAP161, which belongs to the family Myoviridae, was selected for evaluation of its efficacy against C. sakazakii. Galleria mellonella larvae were used as a whole-animal model for pre-clinical testing of phage efficiency. Twenty-one Cronobacter strains were evaluated for lethality in G. mellonella larvae. Different strains of C. sakazakii caused 0 to 98% mortality. C. sakazakii 3253, with an LD50 dose of ~2.0×10(5) CFU/larva (24 h, 37 °C) was selected for this study. Larvae infected with a dose of 5×LD50 were treated with phage GAP161 (MOI=8) at various time intervals. The mortality rates were as high as 100% in the groups injected with bacteria only, compared to 16.6% in the group infected with bacteria and treated with phage. Phage GAP161 showed the best protective activity against C. sakazakii when the larvae were treated prior to or immediately after infection. The results obtained with heat-inactivated phage proved that the survival of the larvae is not due to host immune stimulation. These results suggest that phage GAP161 is potentially a useful control agent against C. sakazakii. In addition, G. mellonella may be a useful whole-animal model for pre-screening phages for efficacy and safety prior to clinical evaluation in mammalian models.

Comparative proteomic analysis of Cronobacter sakazakii by iTRAQ provides insights into response to desiccation.

PubMed

Hu, Shuangfang; Yu, Yigang; Wu, Xinwei; Xia, Xingzhou; Xiao, Xinglong; Wu, Hui

2017-10-01

Cronobacter sakazakii is a foodborne pathogen throughout the world and survives extremely desiccation stress. However, the molecular basis involved in desiccation resistance of C. sakazakii is still unknown. In this study, the potential desiccation resistance factors of C. sakazakii ATCC 29544 were determined using iTRAQ-based quantitative proteomic analysis. A total of 2775 proteins were identified by iTRAQ, of which 233 showed a different protein expression between control group and desiccation stress group. Among these 233 proteins identified as desiccation resistance proteins, there were 146 proteins downregulated and 87 proteins upregulated. According to the comprehensive proteome coverage analysis, C. sakazakii increased its resistance to desiccation by reducing the gene involved with unnecessary survival functions such as those used for virulence, adhesion, invasion and flagella assembly, while increasing gene expression of genes used in withstanding osmotic stress such as those genes involved in trehalose and betaine uptake. However, the mechanism involved in amino acid metabolism in an osmotic stress response, including the producing of γ-aminobutyric acid in C. sakazakii is still uncertain. This is the first report to determine the potential desiccation resistant factors of C. sakazakii at the proteomic levels. Copyright © 2017. Published by Elsevier Ltd.

Identification of potential virulence factors of Cronobacter sakazakii isolates by comparative proteomic analysis.

PubMed

Ye, Yingwang; Li, Hui; Ling, Na; Han, Yongjia; Wu, Qingping; Xu, Xiaoke; Jiao, Rui; Gao, Jina

2016-01-18

Cronobacter is a group of important foodborne pathogens associated with neonatal meningitis, septicemia, and necrotizing enterocolitis. Among Cronobacter species, Cronobacter sakazakii is the most common species in terms of isolation frequency. However, the molecular basis involved in virulence differences among C. sakazakii isolates is still unknown. In this study, based on the determination of virulence differences of C. sakazakii G362 (virulent isolate) and L3101 (attenuated isolate) through intraperitoneal injection, histopathologic analysis (small intestine, kidney, and liver) further confirmed virulence differences. Thereafter, the potential virulence factors were determined using two-dimensional electrophoresis (2-DE) coupled with MALDI/TOP/TOF mass spectrometry. Among a total of 36 protein spots showing differential expression (fold change>1.2), we identified 31 different proteins, of which the expression abundance of 22 was increased in G362. These up-regulated proteins in G362 mainly contained DNA starvation/stationary phase protection protein Dps, OmpA, LuxS, ATP-dependent Clp protease ClpC, and ABC transporter substrate-binding proteins, which might be involved in virulence of C. sakazakii. This is the first report to determine the potential virulence factors of C. sakazakii isolates at the proteomic levels. Copyright © 2015 Elsevier B.V. All rights reserved.

Cellulose as an extracellular matrix component present in Enterobacter sakazakii biofilms.

PubMed

Grimm, Maya; Stephan, Roger; Iversen, Carol; Manzardo, Giuseppe G G; Rattei, Thomas; Riedel, Kathrin; Ruepp, Andreas; Frishman, Dmitrij; Lehner, Angelika

2008-01-01

Cellulose was identified and characterized as an extracellular matrix component present in the biofilm of an Enterobacter sakazakii clinical isolate grown in nutrient-deficient (M9) medium. Using a bacterial artificial cloning approach in Escherichia coli and subsequent screening of transformants for fluorescence on calcofluor plates, nine genes organized in two operons were identified as putatively responsible for the biosynthesis of cellulose. In addition to the genes already described for cellulose production, two more genes were identified, putatively transcribed together with the genes from the first operon. Putative cellulose in E. sakazakii ES5 biofilm grown on glass coverslips was visualized by calcofluor staining and confocal fluorescence laser scanning microscopy. For the first time, the presence of cellulose in biofilms produced by E. sakazakii was confirmed by methylation analysis.

Growth Inhibition of Cronobacter sakazakii in Experimentally Contaminated Powdered Infant Formula by Kefir Supernatant.

PubMed

Kim, Dong-Hyeon; Chon, Jung-Whan; Kang, Il-Byeong; Kim, Hyunsook; Kim, Hong-Seok; Song, Kwang-Young; Seo, Kun-Ho

2015-09-01

Kefir is a type of fermented milk containing lactic and acetic acid bacteria and yeast. In this study, we evaluated the antimicrobial activity of kefir supernatant against Cronobacter sakazakii in powdered infant formula (PIF). In a spot-on-lawn test, the growth of 20 C. sakazakii strains, including 10 clinical and 10 food isolates, was completely inhibited in the presence of kefir supernatant. Significant differences in the diameters of inhibition zones were observed upon treatment with kefir compared with the results for Lactobacillus kefiri and Candida kefyr culture supernatants or solutions of lactic and acetic acid and ethyl alcohol in the agar well diffusion test (P < 0.05). The addition of 100 μl of kefir supernatant to 1 ml of nutrient broth completely inhibited the growth of C. sakazakii, as evaluated by spectrophotometry. The antimicrobial activity of kefir supernatant in experimentally contaminated PIF was also tested; we found no viable C. sakazakii cells remaining in PIF rehydrated with 30% kefir supernatant solution for 1 h, demonstrating that the antimicrobial activity of kefir supernatant against C. sakazakii could be applied in real food samples.

Genome Sequence of Cronobacter sakazakii BAA-894 and Comparative Genomic Hybridization Analysis with Other Cronobacter Species

PubMed Central

Kucerova, Eva; Clifton, Sandra W.; Xia, Xiao-Qin; Long, Fred; Porwollik, Steffen; Fulton, Lucinda; Fronick, Catrina; Minx, Patrick; Kyung, Kim; Warren, Wesley; Fulton, Robert; Feng, Dongyan; Wollam, Aye; Shah, Neha; Bhonagiri, Veena; Nash, William E.; Hallsworth-Pepin, Kymberlie; Wilson, Richard K.

2010-01-01

Background The genus Cronobacter (formerly called Enterobacter sakazakii) is composed of five species; C. sakazakii, C. malonaticus, C. turicensis, C. muytjensii, and C. dublinensis. The genus includes opportunistic human pathogens, and the first three species have been associated with neonatal infections. The most severe diseases are caused in neonates and include fatal necrotizing enterocolitis and meningitis. The genetic basis of the diversity within the genus is unknown, and few virulence traits have been identified. Methodology/Principal Findings We report here the first sequence of a member of this genus, C. sakazakii strain BAA-894. The genome of Cronobacter sakazakii strain BAA-894 comprises a 4.4 Mb chromosome (57% GC content) and two plasmids; 31 kb (51% GC) and 131 kb (56% GC). The genome was used to construct a 387,000 probe oligonucleotide tiling DNA microarray covering the whole genome. Comparative genomic hybridization (CGH) was undertaken on five other C. sakazakii strains, and representatives of the four other Cronobacter species. Among 4,382 annotated genes inspected in this study, about 55% of genes were common to all C. sakazakii strains and 43% were common to all Cronobacter strains, with 10–17% absence of genes. Conclusions/Significance CGH highlighted 15 clusters of genes in C. sakazakii BAA-894 that were divergent or absent in more than half of the tested strains; six of these are of probable prophage origin. Putative virulence factors were identified in these prophage and in other variable regions. A number of genes unique to Cronobacter species associated with neonatal infections (C. sakazakii, C. malonaticus and C. turicensis) were identified. These included a copper and silver resistance system known to be linked to invasion of the blood-brain barrier by neonatal meningitic strains of Escherichia coli. In addition, genes encoding for multidrug efflux pumps and adhesins were identified that were unique to C. sakazakii strains from

Cronobacter sakazakii bacteremia in a heart transplant patient with polycystic kidney disease.

PubMed

Tamigniau, A; Vanhaecke, J; Saegeman, V

2015-12-01

Infections with Cronobacter sakazakii are mainly described among neonates and infants, with contaminated powdered infant formulas most often incriminated as the cause. We describe here a case of C. sakazakii bacteremia secondary to a suspected cyst infection in a heart-and-kidney transplant patient with polycystic kidney disease. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Genetic Characterization of Cronobacter sakazakii Recovered from the Environmental Surveillance Samples During a Sporadic Case Investigation of Foodborne Illness.

PubMed

Sulaiman, Irshad M; Jacobs, Emily; Segars, Katharine; Simpson, Steven; Kerdahi, Khalil

2016-08-01

Cronobacter sakazakii is an opportunistic human-pathogenic bacterium known to cause acute meningitis and necrotizing enterocolitis in neonates and immunocompromised individuals. This human-pathogenic microorganism has been isolated from a variety of food and environmental samples, and has been also linked to foodborne outbreaks associated with powdered infant formula (PIF). The U.S. Food and Drug Administration have a policy of zero tolerance of these organisms in PIF. Thus, this agency utilizes the presence of these microorganisms as one of the criteria in implementing regulatory actions and assessing adulteration of food products of public health importance. In this study, we recovered two isolates of Cronobacter from the 91 environmental swab samples during an investigation of sporadic case of foodborne illness following conventional microbiological protocols. The isolated typical colonies were identified using VITEK2 and real-time PCR protocols. The recovered Cronobacter isolates were then characterized for species identification by sequencing the 16S rRNA locus. Further, multilocus sequence typing (MLST) was accomplished characterizing seven known C. sakazakii-specific MLST loci (atpD, fusA, glnS, gltB, gyrB, infB, and pps). Results of this study confirmed all of the recovered Cronobacter isolates from the environmental swab samples to be C. sakazakii. The MLST profile matched with the published profile of the complex 31 of C. sakazakii. Thus, rRNA and 7-loci MLST-based sequencing protocols are robust techniques for rapid detection and differentiation of Cronobacter species, and these molecular diagnostic tools can be used in implementing successful surveillance program and in the control and prevention of foodborne illness.

Inactivation of Cronobacter sakazakii in reconstituted infant formula by combination of thymoquinone and mild heat.

PubMed

Shi, C; Jia, Z; Chen, Y; Yang, M; Liu, X; Sun, Y; Zheng, Z; Zhang, X; Song, K; Cui, L; Baloch, A B; Xia, X

2015-12-01

The objective of this study was to determine the combined effect of thymoquinone (TQ) and mild heat on Cronobacter sakazakii in reconstituted infant formula. Reconstituted infant formula samples inoculated with a mixture of four C. sakazakii strains (approx. 6·5 log CFU ml(-1) ) were prepared with various concentrations of TQ (0, 5, 10, 20 and 30 mmol l(-1) ) and were heated to 45, 50 and 55°C for 0, 10, 20, 30, 60 and 120 min, and the surviving populations of C. sakazakii at each sampling time were enumerated. To elucidate the mode of action of TQ, membrane integrity and changes in cell morphology were examined by LIVE/DEAD(®) BacLight(™) bacterial viability kit and field emission scanning electron microscope respectively. TQ at 30 mmol l(-1) reduced the pathogen to undetectable level in between 60 and 120 min at 45°C, 60 min at 50°C and 10 min at 55°C respectively. Our results demonstrated that the combined treatments significantly reduced (P < 0·05) the population of C. sakazakii, compared to the control. Cronobacter sakazakii numbers were reduced much more rapidly with higher temperatures and increased concentrations of TQ. And combined treatment inactivated pathogen partly by causing cell membrane disruption. These findings suggested that TQ, together with mild heat, may have potential application in infant formula to control C. sakazakii before consumption and therefore is a possible way to prevent infections associated with C. sakazakii in infant formula. © 2015 The Society for Applied Microbiology.

Detection of Cronobacter sakazakii in powdered infant formula using an immunoliposome-based immunomagnetic concentration and separation assay

PubMed Central

Shukla, Shruti; Lee, Gibaek; Song, Xinjie; Park, Jung Hyun; Cho, Hyunjeong; Lee, Eun Ju; Kim, Myunghee

2016-01-01

This study aimed to optimize the applicability of an immunoliposome-based immunomagnetic concentration and separation assay to facilitate rapid detection of Cronobacter sakazakii in powdered infant formula (PIF). To determine the detection limit, specificity, and pre-enrichment incubation time (0, 4, 6, and 8 h), assay tests were performed with different cell numbers of C. sakazakii (2 × 100 and 2 × 101 CFU/ml) inoculated in 10 g of PIF. The assay was able to detect as few as 2 cells of C. sakazakii/10 g of PIF sample after 6 h of pre-enrichment incubation with an assay time of 2 h 30 min. The assay was assessed for cross-reactivity with other bacterial strains and exhibited strong specificity to C. sakazakii. Moreover, the assay method was applied to the detection of C. sakazakii in PIF without pre-enrichment steps, and the results were compared with INC-ELISA and RT-PCR. The developed method was able to detect C. sakazakii in spiked PIF without pre-enrichment, whereas INC-ELISA failed to detect C. sakazakii. In addition, when compared with the results obtained with RT-PCR, our developed assay required lesser detection time. The developed assay was also not susceptible to any effect of the food matrix or background contaminant microflora. PMID:27721500

Profiling of Virulence Determinants in Cronobacter sakazakii Isolates from Different Plant and Environmental Commodities.

PubMed

Singh, Niharika; Raghav, Mamta; Narula, Shifa; Tandon, Simran; Goel, Gunjan

2017-05-01

Cronobacter sakazakii is an emerging pathogen causing meningitis, sepsis and necrotizing enterocolitis in neonates and immune-compromised adults. The present study describes the profiling of different virulence factors associated with C. sakazakii isolates derived from plant-based materials and environmental samples (soil, water, and vacuum dust). All the isolates exhibited β-hemolysis and chitinase activity, and were able to utilize inositol. Among the nine virulence-associated genes, hly gene coding for hemolysin was detected in all the isolates followed by ompA (outer membrane protein); however, plasmid-borne genes were detected at a level of 60% for both cpa (cronobacter plasminogen activator) and eitA (Ferric ion transporter protein) gene, respectively. Furthermore, the isolate C. sakazakii N81 showed cytotoxicity for Caco-2 cells. The presence of the virulence determinants investigated in this study indicates the pathogenic potential of C. sakazakii with their plausible connection with clinical manifestations.

Plasmid-Encoded MCP Is Involved in Virulence, Motility, and Biofilm Formation of Cronobacter sakazakii ATCC 29544

PubMed Central

Choi, Younho; Kim, Seongok; Hwang, Hyelyeon; Kim, Kwang-Pyo; Kang, Dong-Hyun

2014-01-01

The aim of this study was to elucidate the function of the plasmid-borne mcp (methyl-accepting chemotaxis protein) gene, which plays pleiotropic roles in Cronobacter sakazakii ATCC 29544. By searching for virulence factors using a random transposon insertion mutant library, we identified and sequenced a new plasmid, pCSA2, in C. sakazakii ATCC 29544. An in silico analysis of pCSA2 revealed that it included six putative open reading frames, and one of them was mcp. The mcp mutant was defective for invasion into and adhesion to epithelial cells, and the virulence of the mcp mutant was attenuated in rat pups. In addition, we demonstrated that putative MCP regulates the motility of C. sakazakii, and the expression of the flagellar genes was enhanced in the absence of a functional mcp gene. Furthermore, a lack of the mcp gene also impaired the ability of C. sakazakii to form a biofilm. Our results demonstrate a regulatory role for MCP in diverse biological processes, including the virulence of C. sakazakii ATCC 29544. To the best of our knowledge, this study is the first to elucidate a potential function of a plasmid-encoded MCP homolog in the C. sakazakii sequence type 8 (ST8) lineage. PMID:25332122

Plasmid-encoded MCP is involved in virulence, motility, and biofilm formation of Cronobacter sakazakii ATCC 29544.

PubMed

Choi, Younho; Kim, Seongok; Hwang, Hyelyeon; Kim, Kwang-Pyo; Kang, Dong-Hyun; Ryu, Sangryeol

2015-01-01

The aim of this study was to elucidate the function of the plasmid-borne mcp (methyl-accepting chemotaxis protein) gene, which plays pleiotropic roles in Cronobacter sakazakii ATCC 29544. By searching for virulence factors using a random transposon insertion mutant library, we identified and sequenced a new plasmid, pCSA2, in C. sakazakii ATCC 29544. An in silico analysis of pCSA2 revealed that it included six putative open reading frames, and one of them was mcp. The mcp mutant was defective for invasion into and adhesion to epithelial cells, and the virulence of the mcp mutant was attenuated in rat pups. In addition, we demonstrated that putative MCP regulates the motility of C. sakazakii, and the expression of the flagellar genes was enhanced in the absence of a functional mcp gene. Furthermore, a lack of the mcp gene also impaired the ability of C. sakazakii to form a biofilm. Our results demonstrate a regulatory role for MCP in diverse biological processes, including the virulence of C. sakazakii ATCC 29544. To the best of our knowledge, this study is the first to elucidate a potential function of a plasmid-encoded MCP homolog in the C. sakazakii sequence type 8 (ST8) lineage. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Prevalence and Characterization of Cronobacter sakazakii in Retail Milk-Based Infant and Baby Foods in Shaanxi, China.

PubMed

Li, Zhen; Ge, Wupeng; Li, Keting; Gan, Jing; Zhang, Yifan; Zhang, Qiang; Luo, Rong; Chen, Limin; Liang, Yi; Wang, Qianning; Xi, Meili; Xia, Xiaodong; Wang, Xin; Yang, Baowei

2016-04-01

Cronobacter sakazakii (formerly Enterobacter sakazakii) is an opportunistic pathogen that causes meningitis, sepsis, and necrotizing enterocolitis in neonates and infants through consumption of contaminated milk-based foods. In this study, the prevalence of C. sakazakii in 705 retail milk-based infant and baby food samples was investigated in 12 cities in Shaanxi, China, in 2010 and 2012. One hundred and nineteen samples (16.9%) were C. sakazakii positive. The isolates were further characterized for antimicrobial susceptibility to 14 antibiotics, pulsed-field gel electrophoresis profiles, and presence of the virulence genes. Samples of brand W, Y, A, and G in 2010 and 2012 were C. sakazakii positive. All isolates recovered in 2010 and 2012 were susceptible to levofloxacin and cefoperazone. In 2012, no isolate was resistant to gentamicin, cefoxitin, chloramphenicol, gatifloxacin, ciprofloxacin, and ceftriaxone. Antibiotic resistance of the isolates was most commonly found to rifampicin, amoxicillin-clavulanic acid, streptomycin, tetracycline, and ampicillin in both 2010 and 2012, except to trimethoprim/sulfamethoxazole in 2012. Pulsed-field gel electrophoresis profiles indicated that C. sakazakii isolates were genotypically diverse, although these isolates were prevalent in infant and baby foods with the same brand. A total of 34 virulence gene profiles of the C. sakazakii isolates in 2010 and 2012 were detected. Isolates that co-carried hly-ompX-eitCBAD-iucABCD/iutA genes in 2012 were significantly (p < 0.05) more prevalent than those in 2010. The results added new epidemiological evidence for the widespread occurrence of C. sakazakii in retail milk-based infant and baby foods and this should be an indicator of potential health risk for consumers.

CRISPR-cas loci profiling of Cronobacter sakazakii pathovars.

PubMed

Ogrodzki, Pauline; Forsythe, Stephen James

2016-12-01

Cronobacter sakazakii sequence types 1, 4, 8 and 12 are associated with outbreaks of neonatal meningitis and necrotizing enterocolitis infections. However clonality results in strains which are indistinguishable using conventional methods. This study investigated the use of clustered regularly interspaced short palindromic repeats (CRISPR)-cas loci profiling for epidemiological investigations. Seventy whole genomes of C. sakazakii strains from four clonal complexes which were widely distributed temporally, geographically and origin of source were profiled. All strains encoded the same type I-E subtype CRISPR-cas system with a total of 12 different CRISPR spacer arrays. This study demonstrated the greater discriminatory power of CRISPR spacer array profiling compared with multilocus sequence typing, which will be of use in source attribution during Cronobacter outbreak investigations.

A phosphoethanolamine transferase specific for the 4'-phosphate residue of Cronobacter sakazakii lipid A.

PubMed

Liu, L; Li, Y; Wang, X; Guo, W

2016-11-01

Investigate how Cronobacter sakazakii modify their lipid A structure to avoid recognition by the host immune cells. Lipid A modification was observed in C. sakazakii BAA894 grown at pH 5·0 but not pH 7·0. Overexpression of C. sakazakii gene ESA_RS09200 in Escherichia coli W3110 caused a phosphoethanolamine (PEA) modification of lipid A; when ESA_RS09200 was deleted in C. sakazakii BAA894, this lipid A modification disappeared. Lipid A modification was observed in BAA894 grown at pH 5·0 when the 1- phosphate residue of lipid A was removed, but disappeared when the 4'- phosphate residue of lipid A was removed. When ESA_RS16430, the orthologous gene of E. coli pmrA, was deleted in C. sakazakii BAA894, this PEA modification of lipid A was still observed, suggesting that this modification was not regulated by the PmrA-PmrB system. Compared to the wild-type BAA894, ESA_RS09200 deletion mutant showed decreased resistance to cationic antimicrobial peptides (CAMP), increased recognition by TLR4/MD2, decreased ability to invade and persist in mammalian cells. ESA_RS09200 in C. sakazakii BAA894 encodes a PEA transferase that specifically adds a PEA to the 4'-phosphate residue of lipid A, but not regulated by the PmrA-PmrB system. PEA modification of lipid A reduces recognition and killing by the host innate immune system. This study showed that modification of the lipid A moiety of C. sakazakii with PEA increased resistance to CAMP and recognition of the immune response although signalling of TLR4/MD2 cascade, suggesting that the organism could not successfully evade the host innate immune system without the transference of PEA to its lipid A moiety. © 2016 The Society for Applied Microbiology.

Electrochemical coupled immunosensing platform based on graphene oxide/gold nanocomposite for sensitive detection of Cronobacter sakazakii in powdered infant formula.

PubMed

Shukla, Shruti; Haldorai, Yuvaraj; Bajpai, Vivek K; Rengaraj, Arunkumar; Hwang, Seung Kyu; Song, Xinjie; Kim, Myunghee; Huh, Yun Suk; Han, Young-Kyu

2018-06-30

A sensitive electrochemical immunosensing platform for the detection of Cronobacter sakazakii was developed using a graphene oxide/gold (GO/Au) composite. Transmission electron microscopy showed that the Au nanoparticles, with an average size of < 30 nm, were well dispersed on the GO surface. For the detection of C. sakazakii, a polyclonal anti-C. sakazakii antibody (IgG) was covalently immobilized to the Au nanoparticles on the surface of the GO/Au composite coated glassy carbon electrode (GCE). The electrochemical sensing performance of immunofunctionalized GCE was characterized by cyclic voltammetry and differential pulse voltammetry. Under optimized conditions, in pure culture there was a linear relationship between electrical signal and C. sakazakii levels over the range 2.0 × 10 2 -2.0 × 10 7 cfu/mL (R 2 = 0.999), with a detection limit of 2.0 × 10 1 cfu/mL. The total analytical time was 15 min per sample. The C. sakazakii electrochemical immunosensing assay was able to successfully detect 2.0 × 10 1 cfu/mL of C. sakazakii in artificially contaminated powdered infant formula without any enrichment or pre-enrichment steps. Furthermore, the recovery rates of the C. sakazakii electrochemical immunosensing assay following spiking of powdered infant formula with different concentrations of C. sakazakii (cfu/mL) were 82.58% at 2.0 × 10 1 cfu/mL, 84.86% at 2.0 × 10 2 cfu/mL, and 95.40% at 2.0 × 10 3 cfu/mL. The C. sakazakii electrochemical immunosensing assay had good selectivity, reproducibility, and reactivity compared with other Cronobacter spp. and/or pathogens belonging to other genera, indicating its significant potential in the clinical diagnosis of C. sakazakii. Copyright © 2018 Elsevier B.V. All rights reserved.

Antimicrobial activity of syringic acid against Cronobacter sakazakii and its effect on cell membrane.

PubMed

Shi, Chao; Sun, Yi; Zheng, Zhiwei; Zhang, Xiaorong; Song, Kaikuo; Jia, Zhenyu; Chen, Yifei; Yang, Miaochun; Liu, Xin; Dong, Rui; Xia, Xiaodong

2016-04-15

Syringic acid (SA) has been reported to exhibit antibacterial ability against various microorganisms, but little work has been done on its effect on Cronobacter sakazakii. In this study, minimum inhibitory concentrations (MICs) of SA against various C. sakazakii strains were determined. Moreover, changes in intracellular ATP concentration, intracellular pH (pHin), membrane potential and membrane integrity were measured to evaluate the influence of SA on cell membrane. Finally, field emission scanning electron microscope (FESEM) was used to assess the morphological changes of bacterial cells caused by SA. It was shown that the MICs of SA against all tested C. sakazakii strains were 5mg/mL. SA retarded bacterial growth, and caused cell membrane dysfunction, which was evidenced by intracellular ATP concentration decrease, pHin reduction, cell membrane hyperpolarization and changes in cellular morphology. These findings indicated that SA has potential to be developed as a natural preservative to control C. sakazakii in foods associated with this pathogen and prevent related infections. Copyright © 2015 Elsevier Ltd. All rights reserved.

Short communication: Effects of high-pressure processing on the inactivity of Cronobacter sakazakii in whole milk and skim milk samples.

PubMed

Jiao, Rui; Gao, Jina; Li, Yinxiang; Zhang, Xiyan; Zhang, Maofeng; Ye, Yingwang; Wu, Qingping; Fan, Hongying

2016-10-01

Powdered infant formula is considered as the main transmission vehicle for Cronobacter sakazakii infections including meningitis, septicemia, and necrotizing enterocolitis. The effects of high-pressure processing treatment on inactivation of C. sakazakii ranging from 100 to 400 MPa for 3.0, 5.0, and 7.0 min in whole milk and skim milk were studied. Significant differences in inactivation of C. sakazakii were observed in milk samples under different pressures for 3 to 7 min compared with untreated samples, and C. sakazakii was not detected after 400 MPa for 3 min. The lethality rates of C. sakazakii cells in whole and skim milk with an initial level of 10(4) cfu/mL after 100 and 200 MPa treatments were not significantly different, but relatively higher lethality rates were found in whole milk after 300 MPa treatment than in skim milk. Finally, the scanning electron micrographs indicated that cellular envelope and intracellular damage of C. sakazakii cells were apparent after 300 and 400 MPa for 5.0 min compared with the untreated cells, and a progressive increase of injured cells with increased pressure treatment was found. It was concluded that C. sakazakii was sensitive to high-pressure processing treatment and that high-pressure processing treatment with 400 MPa for 3.0 min can be used to control C. sakazakii contamination in milk samples. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Monitoring ultraviolet (UV) radiation inactivation of Cronobacter sakazakii in dry infant formula using Fourier transform infrared spectroscopy.

PubMed

Liu, Qian; Lu, Xiaonan; Swanson, Barry G; Rasco, Barbara A; Kang, Dong-Hyun

2012-01-01

Cronobacter sakazakii is an opportunistic pathogen associated with dry infant formula presenting a high risk to low birth weight neonates. The inactivation of C. sakazakii in dry infant formula by ultraviolet (UV) radiation alone and combined with hot water treatment at temperatures of 55, 60, and 65 °C were applied in this study. UV radiation with doses in a range from 12.1 ± 0.30 kJ/m² to 72.8 ± 1.83 kJ/m² at room temperature demonstrated significant inactivation of C. sakazakii in dry infant formula (P < 0.05). UV radiation combining 60 °C hot water treatment increased inactivation of C. sakazakii cells significantly (P < 0.05) in reconstituted infant formula. Significant effects of UV radiation on C. sakazakii inactivation kinetics (D value) were not observed in infant formula reconstituted in 55 and 65 °C water (P > 0.05). The inactivation mechanism was investigated using vibrational spectroscopy. Infrared spectroscopy detected significant stretching mode changes of macromolecules on the basis of spectral features, such as DNA, proteins, and lipids. Minor changes on cell membrane composition of C. sakazakii under UV radiation could be accurately and correctly monitored by infrared spectroscopy coupled with 2nd derivative transformation and principal component analysis. © 2011 Institute of Food Technologists®

Reassessment of Cronobacter spp. originally isolated as Enterobacter sakazakii from infant food.

PubMed

Akineden, Ömer; Heinrich, Vanessa; Gross, Madeleine; Usleber, Ewald

2017-08-01

Cronobacter spp. cause infant disease, several cases have been associated with powdered infant formulae (PIF). In the early 2000s, contamination of German PIF with these opportunistic pathogens was quite common. Before 2008, all isolates Cronobacter spp. had been classified as Enterobacter sakazakii, therefore little is known about species diversity within such isolates. Genetic, serologic, and biochemical traits of 80 Cronobacter isolates, originally obtained 2003-2006 within infant food surveys in Germany, were reassessed in this study. By sequencing of the fusA gene, all isolates were unambiguously assigned to two species, C. sakazakii (n = 73) and C. malonaticus (n = 7). PCR serotyping identified five C. sakazakii serotypes and two C. malonaticus serotypes, biochemical profiling yielded five biogroups. PFGE analysis also showed high heterogeneity in both species. Multilocus sequence typing of 26 selected isolates yielded 16 different sequence types (ST), including C. sakazakii ST 1 (n = 6) and the highly virulent ST 4 (n = 2). The results suggest that just two, but highly heterogeneous species were responsible for the Cronobacter contamination problem which challenged the German PIF industry in the beginning of this century. This fact may have influenced the success of efforts to identify and eliminate sources of contamination. Copyright © 2017 Elsevier Ltd. All rights reserved.

Inactivation of Enterobacter sakazakii, Bacillus cereus, and Salmonella typhimurium in powdered weaning food by electron-beam irradiation

NASA Astrophysics Data System (ADS)

Hong, Yun-Hee; Park, Ji-Yong; Park, Jong-Hyun; Chung, Myong-Soo; Kwon, Ki-Sung; Chung, Kyungsook; Won, Misun; Song, Kyung-Bin

2008-09-01

Inactivation of Enterobacter sakazakii, Bacillus cereus, and Salmonella typhimurium were evaluated in powdered weaning food using electron-beam irradiation. E. sakazakii, B. cereus, and S. typhimurium were eliminated by irradiation at 16, 8, and 8 kGy, respectively. The D10-vlaues of E. sakazakii, B. cereus, and S. typhimurium inoculated on powdered weaning food were 4.83, 1.22, and 0.98 kGy, respectively. The results suggest that electron-beam irradiation should inhibit the growth of pathogenic bacteria on baby food without impairing qualities.

A Newly Isolated Bacteriophage, PBES 02, Infecting Cronobacter sakazakii.

PubMed

Lee, Hyung Ju; Kim, Wan Il; Kwon, Young Chan; Cha, Kyung Eun; Kim, Minjin; Myung, Heejoon

2016-09-28

A novel bacteriophage, PBES 02, infecting Cronobacter sakazakii was isolated and characterized. It has a spherical head of 90 nm in diameter and a tail of 130 nm in length, and belongs to Myoviridae as observed under a transmission electron microscope. The major virion protein appears to be 38 kilodaltons (kDa) in size. The latent period of PBES 02 is 30 min and the burst size is 250. Infectivity of the phage remained intact after exposure to temperatures ranging from 4°C to 55°C for 1 h. It was also stable after exposure to pHs ranging from 6 to 10 for 1 h. The phage effectively removed contaminating Cronobacter sakazakii from broth infant formula. PBES 02 has a double-stranded DNA genome of 149,732 bases. Its GC ratio is 50.7%. Sequence analysis revealed that PBES 02 has 299 open reading frames (ORFs) and 14 tRNA genes. Thirty-nine ORFs were annotated, including 24 related to replication and regulation functions, 10 related to structural proteins, and 5 related to DNA packaging. The genome of PBES 02 is closely related to that of two other C. sakazakii phages, CR3 and CR8. Comparison of DNA sequences of genes encoding the major capsid protein revealed a wide geographical distribution of related phages over Asia, Europe, and America.

Inactivation of Nondesiccated and Desiccated Cronobacter sakazakii in Reconstituted Infant Formula by Combination of Citral and Mild Heat.

PubMed

Shi, Chao; Jia, Zhenyu; Sun, Yi; Chen, Yifei; Guo, Du; Liu, Zhiyuan; Wen, Qiwu; Guo, Xiao; Ma, Linlin; Yang, Baowei; Baloch, Allah Bux; Xia, Xiaodong

2017-07-01

The objective of this study was to evaluate the combined effect of citral plus mild heat on nondesiccated and desiccated Cronobacter sakazakii in reconstituted infant formula. Various concentrations of citral (0, 0.3, 0.6, and 0.9%) combined with various temperatures (25, 45, 50, and 55°C) were applied to nondesiccated and desiccated cocktails of three C. sakazakii strains (approximately 6.0 log CFU mL -1 ) in reconstituted infant formula, and the bacterial populations were assayed periodically. The combined treatments had marked antimicrobial effects on C. sakazakii compared with the control. Desiccated cells were more susceptible to citral than were nondesiccated cells in reconstituted infant formula. These findings suggest there is a potential application of citral in combination with mild heat to control C. sakazakii during preparation of reconstituted infant formula.

Rapid inactivation of Cronobacter sakazakii on copper alloys following periods of desiccation stress.

PubMed

Elguindi, Jutta; Alwathnani, Hend A; Rensing, Christopher

2012-04-01

Cronobacter spp. have been identified as the causative agent in meningitis and necrotizing enterocolitis in premature infants which can be linked to the bacterium's desiccation resistance and persistence in powdered infant formula. In this study we examined the efficacy of copper cast alloys in contact killing of Cronobacter sakazakii following periods of desiccation stress. Cronobacter sakazakii cells suspended in Tryptic Soy Broth (TSB) were killed within 10 min while kept moist on 99.9% copper alloys and within 1 min of drying on 99.9% copper alloys. Survival times were unchanged after cells suspended in TSB were desiccated for 33 days. Cronobacter sakazakii cells suspended in infant formula were killed within 30 min under moist conditions and within 3 min of drying on 99.9% copper alloys. However, when desiccated in infant formula for 45 days, survival times decreased to 10 and 1 min in moist and dry conditions, respectively. In contrast, no decrease in viable cells was noted on stainless steel surfaces under the experimental conditions employed in this study. Cronobacter sakazakii was rapidly killed on copper alloys under all testing conditions of this study indicating that desiccation and copper ion resistance do not prolong survival. These results could have important implications for the utilization of copper in the production and storage of powdered infant formula.

Short communication: Effects of vacuum freeze-drying on inactivation of Cronobacter sakazakii ATCC29544 in liquid media with different initial inoculum levels.

PubMed

Jiao, Rui; Gao, Jina; Zhang, Xiyan; Zhang, Maofeng; Chen, Jiren; Wu, Qingping; Zhang, Jumei; Ye, Yingwang

2017-03-01

Vacuum freeze-drying is an important food-processing technology for valid retention of nutrients and bioactive compounds. Cronobacter sakazakii has been reported to be associated with severe infections in neonates through consumption of contaminated powdered infant formula. In this study, effects of vacuum freeze-drying treatment for 12, 24, and 36 h on inactivation of C. sakazakii with different initial inoculum levels in sterile water, tryptic soy broth (TSB), skim milk, and whole milk were determined. Results indicated that the lethality rate of C. sakazakii in each sample increased with the extension of vacuum freeze-drying time. With initial inoculum levels of 10 2 and 10 3 cfu/mL, the survival of C. sakazakii in different liquid media was significantly affected by vacuum freeze-drying for 12, 24, and 36 h. In addition, the lethality rates of C. sakazakii in whole milk, skim milk, and TSB was significantly reduced compared with those in sterile water. Furthermore, whole milk showed the strongest protective role for C. sakazakii cells, followed by skim milk and TSB medium. Using the scanning electron microscope, the intracellular damage and obvious distortion of C. sakazakii cells were observed after vacuum freeze-drying for 24 and 36 h compared with the untreated sample, and the injured cells increased with the extension of vacuum-drying time. We concluded that inactivation of vacuum freeze-drying on C. sakazakii cells is related to the food matrix, and a combination with other methods for inactivating C. sakazakii is required for ensuring microbial safety of powdered infant formula. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Virulent and pathogenic features on the Cronobacter sakazakii polymyxin resistant pmr mutant strain s-3.

PubMed

Bao, Xuerui; Yang, Ling; Chen, Lequn; Li, Bing; Li, Lin; Li, Yanyan; Xu, Zhenbo

2017-09-01

Cronobacter sakazakii is a well-known opportunistic pathogen responsible for necrotizing enterocolitis, meningitis and septicaemia in the premature, immunocompromised infants and neonates. This pathogen possesses various virulence factors and regulatory systems, and pmrA/pmrB regulatory system has been identified in a variety of bacterial species. The current study aims to investigate role of pmrA gene in the pathogenicity and virulence characteristics of Cronobacter sakazakii using whole genome sequencing and RNA-seq. Results demonstrated that the absence of pmrA has the potential to affect Cronobacter sakazakii on its pathogenicity, virulence and resistance abilities by regulating expression of numerous related genes, including CusB, CusC, CusR and ESA_pESA3p05434. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multiplexed Lateral Flow Test for Detection and Differentiation of Cronobacter sakazakii Serotypes O1 and O2

PubMed Central

Scharinger, Eva J.; Dietrich, Richard; Wittwer, Tobias; Märtlbauer, Erwin; Schauer, Kristina

2017-01-01

The ubiquitous and opportunistic pathogen Cronobacter sakazakii is responsible for severe meningitis, sepsis, and necrotizing enterocolitis in neonates and infants associated with ingestion of contaminated powdered infant formula (PIF). The current ISO method for isolation and detection of Cronobacter spp. is laborious, time-consuming and expensive. In this study, a multiplexed lateral flow test strip was developed to rapidly detect and simultaneously serotype O1 and O2 C. sakazakii serotypes. The assay is based on two monoclonal antibodies (MAb) that specifically bind to the lipopolysaccharides (LPS) of these pathogens. The test strip provides results very quickly; C. sakazakii could be detected in pure culture within 15 min with a sensitivity of 107 CFU/ml. After non-selective enrichment for 18 h as low as one Cronobacter cell per g PIF could be detected. Moreover, the established lateral flow assay (LFA) offers excellent specificity showing no cross-reactivity with other C. sakazakii serotypes, Cronobacter species or Enterobacteriaceae tested. These characteristics, together with several advantages such as speed, simplicity in performance, low analysis cost, and no requirement of specialized skills or sophisticated equipment make the developed multiplexed LFA suitable for reliable detection and serotyping of C. sakazakii serotypes O1 and O2. PMID:28979257

Multiplexed Lateral Flow Test for Detection and Differentiation of Cronobacter sakazakii Serotypes O1 and O2.

PubMed

Scharinger, Eva J; Dietrich, Richard; Wittwer, Tobias; Märtlbauer, Erwin; Schauer, Kristina

2017-01-01

The ubiquitous and opportunistic pathogen Cronobacter sakazakii is responsible for severe meningitis, sepsis, and necrotizing enterocolitis in neonates and infants associated with ingestion of contaminated powdered infant formula (PIF). The current ISO method for isolation and detection of Cronobacter spp. is laborious, time-consuming and expensive. In this study, a multiplexed lateral flow test strip was developed to rapidly detect and simultaneously serotype O1 and O2 C. sakazakii serotypes. The assay is based on two monoclonal antibodies (MAb) that specifically bind to the lipopolysaccharides (LPS) of these pathogens. The test strip provides results very quickly; C. sakazakii could be detected in pure culture within 15 min with a sensitivity of 10 7 CFU/ml. After non-selective enrichment for 18 h as low as one Cronobacter cell per g PIF could be detected. Moreover, the established lateral flow assay (LFA) offers excellent specificity showing no cross-reactivity with other C. sakazakii serotypes, Cronobacter species or Enterobacteriaceae tested. These characteristics, together with several advantages such as speed, simplicity in performance, low analysis cost, and no requirement of specialized skills or sophisticated equipment make the developed multiplexed LFA suitable for reliable detection and serotyping of C. sakazakii serotypes O1 and O2.

Functional Screening of the Cronobacter sakazakii BAA-894 Genome reveals a role for ProP (ESA_02131) in carnitine uptake.

PubMed

Feeney, Audrey; Sleator, Roy D

2015-01-01

Cronobacter sakazakii is a neonatal pathogen responsible for up to 80% of fatalities in infected infants. Low birth weight infants and neonates infected with C. sakazakii suffer necrotizing enterocolitis, bacteraemia and meningitis. The mode of transmission most often associated with infection is powdered infant formula (PIF) which, with an aw of ∼0.2, is too low to allow most microorganisms to persist. Survival of C. sakazakii in environments subject to extreme hyperosmotic stress has previously been attributed to the uptake of compatible solutes including proline and betaine. Herein, we report the construction and screening of a C. sakazakii genome bank and the identification of ProP (ESA_02131) as a carnitine uptake system.

Mining for sensitive and reliable species-specific primers for PCR for detection of Cronobacter sakazakii by a bioinformatics approach.

PubMed

Qiming, Chen; Tingting, Tao; Xiaomei, Bie; Yingjian, Lu; Fengxia, Lu; Ligong, Zhai; Zhaoxin, Lu

2015-08-01

Although several studies have reported PCR assays for distinguishing Cronobacter sakazakii from other species in the genus, reports regarding assay sensitivity and specificity, as well as applications for food testing, are lacking. Hence, the objective of this study was to develop a sensitive and reliable PCR-based method for detection of C. sakazakii by screening for specific target genes. The genome sequence of C. sakazakii in the GenBank database was compared with that of other organisms using BLAST. Thirty-eight DNA fragments unique to C. sakazakii were identified, and primers targeting these sequences were designed. Finally, 3 primer sets (CS14, CS21, and CS38) were found to be specific for C. sakazakii by PCR verification. The detection limit of PCR assays using the 3 pairs of primers was 1.35 pg/μL, 135 fg/μL, and 135 fg/μL, respectively, for genomic DNA, and 5.5×10(5), 5.5×10(3), 5.5×10(3) cfu/mL, respectively, using pure cultures of the bacteria, compared with 13.5 pg/μLand 5.5×10(5) cfu/mLfor primer set SpeCronsaka, which has been previously described. Cronobacter sakazakii were detected in artificially contaminated powdered infant formula (PIF) by PCR using primer sets CS21 and CS38 after 8h of enrichment. The detection limit was 5.5×10(-1) cfu/10g of PIF. Thus, the PCR assay can be used for rapid and sensitive detection of C. sakazakii in PIF. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Survival and growth of Enterobacter sakazakii in infant cereal as affected by composition, reconstitution liquid, and storage temperature.

PubMed

Lin, Li-Chun; Beuchat, Larry R

2007-06-01

Invasive infections caused by Enterobacter sakazakii have occurred predominantly in low-birth-weight neonates and infants younger than 2 months of age. However, infections have also occurred in healthy infants up to 8 months of age and in immunocompromised children up to 4 years of age. The ability of E. sakazakii to survive and grow in infant cereals as affected by composition of the cereal, composition of the reconstitution liquid, and temperature is unknown. A study was done to determine the survival and growth characteristics of E. sakazakii initially at populations of 0.005 and 0.52 CFU/ml of infant rice cereal, oatmeal cereal, or rice with mixed fruit cereal reconstituted with water, milk, or apple juice. Reconstituted cereals were stored at 4, 12, 21, and 30 degrees C, and populations were monitored for up to 72 h. Growth did not occur in reconstituted cereals stored at 4 degrees C or in cereals reconstituted with apple juice and stored at 12 degrees C. Populations (> or =1 CFU/ml) were detected in cereals reconstituted with water or milk and stored at 12, 21, and 30 degres C for 24, 8, and 4 h, respectively. The composition of infant cereals did not markedly affect the survival or growth of E. sakazakii in reconstituted cereals. Populations of E. sakazakii in reconstituted cereal decreased with increases in populations of mesophilic aerobic microflora up to 8 to 9 log CFU/ml, which was concurrent with decreases in pH. E. sakazakii, initially at 2.62 log CFU/ml of rice cereal reconstituted with apple juice (pH 4.32), survived at 40C for at least 14 days. The pathogen grew at 21 and 30 degrees C within 2 days and then decreased to undetectable levels (<1 CFU/10 ml) in cereal stored at 21 degrees C for 5 days or 30'C for 4 days. Initially, at 7.32 log CFU/ml, E. sakazakii was detected in rice cereal stored at 4 degrees C for 50 days. It is recommended that reconstituted infant cereals stored at 21 or 30 degrees C be discarded within 4 h after preparation or

Cronobacter sakazakii Infection from Expressed Breast Milk, Australia

PubMed Central

McMullan, Rowena; Menon, Vidthiya; Jensen, Slade O.; van Hal, Sebastiaan J.; Davis, Rebecca

2018-01-01

Cronobacter sakazakii neonatal infections are often epidemiologically linked to the consumption of contaminated powdered infant formula. We describe a case resulting from consumption of contaminated expressed breast milk, as confirmed by whole-genome sequencing. This case highlights potential risks associated with storage and acquisition of expressed breast milk. PMID:29350166

Cpa, the outer membrane protease of Cronobacter sakazakii, activates plasminogen and mediates resistance to serum bactericidal activity.

PubMed

Franco, A A; Kothary, M H; Gopinath, G; Jarvis, K G; Grim, C J; Hu, L; Datta, A R; McCardell, B A; Tall, B D

2011-04-01

Cronobacter spp. are emerging neonatal pathogens in humans, associated with outbreaks of meningitis and sepsis. To cause disease, they must survive in blood and invade the central nervous system by penetrating the blood-brain barrier. C. sakazakii BAA-894 possesses an ~131-kb plasmid (pESA3) that encodes an outer membrane protease (Cpa) that has significant identity to proteins that belong to the Pla subfamily of omptins. Members of this subfamily of proteins degrade a number of serum proteins, including circulating complement, providing protection from the complement-dependent serum killing. Moreover, proteins of the Pla subfamily can cause uncontrolled plasmin activity by converting plasminogen to plasmin and inactivating the plasmin inhibitor α2-antiplasmin (α2-AP). These reactions enhance the spread and invasion of bacteria in the host. In this study, we found that an isogenic cpa mutant showed reduced resistance to serum in comparison to its parent C. sakazakii BAA-894 strain. Overexpression of Cpa in C. sakazakii or Escherichia coli DH5α showed that Cpa proteolytically cleaved complement components C3, C3a, and C4b. Furthermore, a strain of C. sakazakii overexpressing Cpa caused a rapid activation of plasminogen and inactivation of α2-AP. These results strongly suggest that Cpa may be an important virulence factor involved in serum resistance, as well as in the spread and invasion of C. sakazakii.

Genotyping and Source Tracking of Cronobacter sakazakii and C. malonaticus Isolates from Powdered Infant Formula and an Infant Formula Production Factory in China

PubMed Central

Fei, Peng; Man, Chaoxin; Lou, Binbin; Forsythe, Stephen J.; Chai, Yunlei; Li, Ran; Niu, Jieting

2015-01-01

Cronobacter spp. (formerly defined as Enterobacter sakazakii) are opportunistic bacterial pathogens of both infants and adults. In this study, we analyzed 70 Cronobacter isolates from powdered infant formula (PIF) and an infant formula production facility in China to determine possible contamination routes. The strains were profiled by multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), PCR-based O-antigen serotyping, and ompA and rpoB sequence analyses. The isolates were primarily Cronobacter sakazakii (66/70) or Cronobacter malonaticus (4/70). The strains were divided into 38 pulsotypes (PTs) using PFGE and 19 sequence types (STs) by MLST. In contrast, rpoB and ompA sequence analyses divided the strains into 10 overlapping clusters each. PCR serotyping of the 66 C. sakazakii and 4 C. malonaticus strains resulted in the identification of four C. sakazakii serotypes (O1, O2, O4, and O7) and a single C. malonaticus serotype, O2. The dominant C. sakazakii sequence types from PIF and an infant formula production factory in China were C. sakazakii clonal complex 4 (CC4) (n = 19), ST1 (n = 14), and ST64 (n = 11). C. sakazakii CC4 is a clonal lineage strongly associated with neonatal meningitis. In the process of manufacturing PIF, the spray-drying, fluidized-bed-drying, and packing areas were the main areas with Cronobacter contamination. C. sakazakii strains with the same pulsotypes (PT3 and PT2) and sequence types (ST1 and ST64) were isolated both from processing equipment and from the PIF finished product. PMID:26048942

Evaluation of an automated repetitive sequence-based PCR system for subtyping Enterobacter sakazakii.

PubMed

Healy, B; Mullane, N; Collin, V; Mailler, S; Iversen, C; Chatellier, S; Storrs, M; Fanning, S

2008-07-01

Enterobacter sakazakii is regarded as a ubiquitous organism that can be isolated from a wide range of foods and environments. Infection in at-risk infants has been epidemiologically linked to the consumption of contaminated powdered infant formula. Preventing the dissemination of this pathogen in a powdered infant formula manufacturing facility is an important step in ensuring consumer confidence in a given brand together with the protection of the health status of a vulnerable population. In this study we report the application of a repetitive sequence-based PCR typing method to subtype a previously well-characterized collection of E. sakazakii isolates of diverse origin. While both methods successfully discriminated between the collection of isolates, repetitive sequence-based PCR identified 65 types, whereas pulsed-field gel electrophoresis identified 110 types showing > or =95% similarity. The method was quick and easy to perform, and our data demonstrated the utility and value of this approach to monitor in-process contamination, which could potentially contribute to a reduction in the transmission of E. sakazakii.

Use of novel species-specific PCR primers targeted to DNA gyrase subunit B (gyrB) gene for species identification of the Cronobacter sakazakii and Cronobacter dublinensis.

PubMed

Huang, Chien-Hsun; Chang, Mu-Tzu; Huang, Lina

2013-02-01

Cronobacter sakazakii and its phylogenetically closest species are considered to be an opportunistic pathogens associated with food-borne disease in neonates and infants. Neither phenotypic nor genotypic (16S ribosomal DNA sequence analysis) techniques can provide sufficient resolutions for accurately and rapidly identification of these species. The objective of this study was to develop species-specific PCR based on the gyrB gene sequence for direct species identification of the C. sakazakii and Cronobacter dublinensis within the C. sakazakii group. Two pair of species-specific primers were designed and used to specifically identify C. sakazakii and C. dublinensis, but none of the other C. sakazakii group strains. Our data indicate that the novel species-specific primers could be used to rapidly and accurately identify the species of C. sakazakii and C. dublinensis from C. sakazakii group by the PCR based assays. Copyright © 2012 Elsevier Ltd. All rights reserved.

A Novel Bacteriophage Targeting Cronobacter sakazakii Is a Potential Biocontrol Agent in Foods

PubMed Central

Lee, Ju-Hoon; Bai, Jaewoo; Shin, Hakdong; Kim, Yeran; Park, Bookyung; Heu, Sunggi

2015-01-01

Cronobacter sakazakii is an important pathogen that causes high mortality in infants. Due to its occasional antibiotic resistance, a bacteriophage approach might be an alternative effective method for the control of this pathogen. To develop a novel biocontrol agent using bacteriophages, the C. sakazakii-infecting phage CR5 was newly isolated and characterized. Interestingly, this phage exhibited efficient and relatively durable host lysis activity. In addition, a specific gene knockout study and subsequent complementation experiment revealed that this phage infected the host strain using the bacterial flagella. The complete genome sequence analysis of phage CR5 showed that its genome contains 223,989 bp of DNA, including 231 predicted open reading frames (ORFs), and it has a G+C content of 50.06%. The annotated ORFs were classified into six functional groups (structure, packaging, host lysis, DNA manipulation, transcription, and additional functions); no gene was found to be related to virulence or toxin or lysogen formation, but >80% of the predicted ORFs are unknown. In addition, a phage proteomic analysis using SDS-PAGE and matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) revealed that seven phage structural proteins are indeed present, supporting the ORF predictions. To verify the potential of this phage as a biocontrol agent against C. sakazakii, it was added to infant formula milk contaminated with a C. sakazakii clinical isolate or food isolate, revealing complete growth inhibition of the isolates by the addition of phage CR5 when the multiplicity of infection (MOI) was 105. PMID:26497465

Cpa, the Outer Membrane Protease of Cronobacter sakazakii, Activates Plasminogen and Mediates Resistance to Serum Bactericidal Activity▿

PubMed Central

Franco, A. A.; Kothary, M. H.; Gopinath, G.; Jarvis, K. G.; Grim, C. J.; Hu, L.; Datta, A. R.; McCardell, B. A.; Tall, B. D.

2011-01-01

Cronobacter spp. are emerging neonatal pathogens in humans, associated with outbreaks of meningitis and sepsis. To cause disease, they must survive in blood and invade the central nervous system by penetrating the blood-brain barrier. C. sakazakii BAA-894 possesses an ∼131-kb plasmid (pESA3) that encodes an outer membrane protease (Cpa) that has significant identity to proteins that belong to the Pla subfamily of omptins. Members of this subfamily of proteins degrade a number of serum proteins, including circulating complement, providing protection from the complement-dependent serum killing. Moreover, proteins of the Pla subfamily can cause uncontrolled plasmin activity by converting plasminogen to plasmin and inactivating the plasmin inhibitor α2-antiplasmin (α2-AP). These reactions enhance the spread and invasion of bacteria in the host. In this study, we found that an isogenic cpa mutant showed reduced resistance to serum in comparison to its parent C. sakazakii BAA-894 strain. Overexpression of Cpa in C. sakazakii or Escherichia coli DH5α showed that Cpa proteolytically cleaved complement components C3, C3a, and C4b. Furthermore, a strain of C. sakazakii overexpressing Cpa caused a rapid activation of plasminogen and inactivation of α2-AP. These results strongly suggest that Cpa may be an important virulence factor involved in serum resistance, as well as in the spread and invasion of C. sakazakii. PMID:21245266

Genotyping and Source Tracking of Cronobacter sakazakii and C. malonaticus Isolates from Powdered Infant Formula and an Infant Formula Production Factory in China.

PubMed

Fei, Peng; Man, Chaoxin; Lou, Binbin; Forsythe, Stephen J; Chai, Yunlei; Li, Ran; Niu, Jieting; Jiang, Yujun

2015-08-15

Cronobacter spp. (formerly defined as Enterobacter sakazakii) are opportunistic bacterial pathogens of both infants and adults. In this study, we analyzed 70 Cronobacter isolates from powdered infant formula (PIF) and an infant formula production facility in China to determine possible contamination routes. The strains were profiled by multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), PCR-based O-antigen serotyping, and ompA and rpoB sequence analyses. The isolates were primarily Cronobacter sakazakii (66/70) or Cronobacter malonaticus (4/70). The strains were divided into 38 pulsotypes (PTs) using PFGE and 19 sequence types (STs) by MLST. In contrast, rpoB and ompA sequence analyses divided the strains into 10 overlapping clusters each. PCR serotyping of the 66 C. sakazakii and 4 C. malonaticus strains resulted in the identification of four C. sakazakii serotypes (O1, O2, O4, and O7) and a single C. malonaticus serotype, O2. The dominant C. sakazakii sequence types from PIF and an infant formula production factory in China were C. sakazakii clonal complex 4 (CC4) (n = 19), ST1 (n = 14), and ST64 (n = 11). C. sakazakii CC4 is a clonal lineage strongly associated with neonatal meningitis. In the process of manufacturing PIF, the spray-drying, fluidized-bed-drying, and packing areas were the main areas with Cronobacter contamination. C. sakazakii strains with the same pulsotypes (PT3 and PT2) and sequence types (ST1 and ST64) were isolated both from processing equipment and from the PIF finished product. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Application of pulsed-field gel electrophoresis to characterise and trace the prevalence of Enterobacter sakazakii in an infant formula processing facility.

PubMed

Mullane, N R; Whyte, P; Wall, P G; Quinn, T; Fanning, S

2007-05-01

Enterobacter sakazakii (E. sakazakii) contamination of powdered infant formula (PIF) and its processing environment was monitored between April 2005 and March 2006. The purpose of the monitoring programme was to locate points of contamination, investigate clonal persistence, and identify possible dissemination routes along the processing chain. A total of 80 E. sakazakii isolates were recovered from the manufacturing facility. The overall frequency of isolation of E. sakazakii in intermediate and final product was 2.5%, while specific locations in the processing environment were contaminated at frequencies up to 31%. All E. sakazakii isolates were characterised by pulsed-field gel electrophoresis (PFGE). XbaI macrorestriction digests yielded 19 unique pulse-types that could be grouped into 6 clusters of between 5 and 32 isolates. The formation of large clusters was consistent with the presence of a number of clones in the manufacturing environment. While the majority of isolates were of environmental origin (72.5%), no cluster was confined to one specific location and indistinguishable PFGE profiles were generated from isolates cultured from the manufacturing environment, sampling points along the processing chain and from intermediate and final product. These findings suggest that the manufacturing environment serves as a key route for sporadic contamination of PIF. These data will support the development of efficient intervention measures contributing to the reduction of E. sakazakii in the PIF processing chain.

International Life Science Institute North America Cronobacter (Formerly Enterobacter sakazakii) isolate set.

PubMed

Ivy, Reid A; Farber, Jeffrey M; Pagotto, Franco; Wiedmann, Martin

2013-01-01

Foodborne pathogen isolate collections are important for the development of detection methods, for validation of intervention strategies, and to develop an understanding of pathogenesis and virulence. We have assembled a publicly available Cronobacter (formerly Enterobacter sakazakii) isolate set that consists of (i) 25 Cronobacter sakazakii isolates, (ii) two Cronobacter malonaticus isolates, (iii) one Cronobacter muytjensii isolate, which displays some atypical phenotypic characteristics, biochemical profiles, and colony color on selected differential media, and (iv) two nonclinical Enterobacter asburiae isolates, which show some phenotypic characteristics similar to those of Cronobacter spp. The set consists of human (n = 10), food (n = 11), and environmental (n = 9) isolates. Analysis of partial 16S rDNA sequence and seven-gene multilocus sequence typing data allowed for reliable identification of these isolates to species and identification of 14 isolates as sequence type 4, which had previously been shown to be the most common C. sakazakii sequence type associated with neonatal meningitis. Phenotypic characterization was carried out with API 20E and API 32E test strips and streaking on two selective chromogenic agars; isolates were also assessed for sorbitol fermentation and growth at 45°C. Although these strategies typically produced the same classification as sequence-based strategies, based on a panel of four biochemical tests, one C. sakazakii isolate yielded inconclusive data and one was classified as C. malonaticus. EcoRI automated ribotyping and pulsed-field gel electrophoresis (PFGE) with XbaI separated the set into 23 unique ribotypes and 30 unique PFGE types, respectively, indicating subtype diversity within the set. Subtype and source data for the collection are publicly available in the PathogenTracker database (www. pathogentracker. net), which allows for continuous updating of information on the set, including links to publications that include

Gold nanoparticle-based enhanced lateral flow immunoassay for detection of Cronobacter sakazakii in powdered infant formula.

PubMed

Pan, Ruili; Jiang, Yujun; Sun, Luhong; Wang, Rui; Zhuang, Kejin; Zhao, Yueming; Wang, Hui; Ali, Md Aslam; Xu, Honghua; Man, Chaoxin

2018-05-01

Cronobacter sakazakii is an opportunistic foodborne pathogen that can infect newborns through powdered infant formula (PIF). In this study, we developed a novel enhanced lateral flow immunoassay (LFA) with enhanced sensitivity for detection of C. sakazakii in PIF by the naked eye. The proposed strategy for signal enhancement of the traditional LFA used concentrated gold nanoparticles (AuNP) as the enhancer to conjugate with capture antibodies, which could increase the immobilized capture antibodies concentration at the detection zone to improve capture efficiency. Besides, the detection signal was further amplified by accumulated AuNP as the C. sakazakii labeled with AuNP probes was captured by antibodies conjugated with enhancer at the test line. We also studied the effect of different concentrations of capture antibodies and concentrated AuNP on detection performance, and found that 2.2 mg/mL of capture antibodies and 0.06 nM concentrated AuNP were the optimal combination that could avoid a false-positive signal and maximally amplify the detection signal of the enhanced LFA. Using this strategy, the detection sensitivity of the enhanced LFA was 10 3 cfu/mL and improved 100-fold compared with traditional LFA. The strip was highly specific to C. sakazakii, and the time for detection of C. sakazakii in PIF was shortened by 3 h. In summary, the enhanced LFA developed by the addition of concentrated AuNP as the enhancer can be used as a sensitive, rapid, visual qualitative and point-of-care test method for detecting target analytes. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Inhibition of Cronobacter sakazakii Adhesion to Caco-2 Cells by Commercial Dairy Powders and Raw Buttermilk.

PubMed

Ripollés, Daniel; Harouna, Saidou; Parrón, José A; Arenales, Irene; Calvo, Miguel; Pérez, María D; Sánchez, Lourdes

2017-02-08

Cronobacter sakazakii is a foodborne pathogen that has been associated with severe infections, mainly in neonates. The binding of this bacterium to host cell surfaces represents the first step in the pathogenesis of disease. An ELISA-based assay has been developed using a polyclonal antiserum against C. sakazakii to determine its adhesion to Caco-2 cells. The antiserum used recognized many of the outer membrane proteins of C. sakazakii. A positive correlation was found between the absorbance values obtained by ELISA and the number of bacteria adhered to cells determined by plate counting. The inhibitory effect on bacterial adhesion to cells observed with some dairy products was concentration-dependent. Commercial buttermilk caused the maximal reduction of the adhesion percentage (33.0 ± 5.07) at the highest concentration assayed (20 mg/mL), followed by butter serum (31.9 ± 5.36), skim milk (30.4 ± 5.07), and raw buttermilk (25.6 ± 3.80). In some cases, significant differences (p < 0.05) were found in the inhibition exerted by the different products evaluated. The results obtained in this study demonstrate that dairy products contain some components with the ability to inhibit the adhesion of C. sakazakii to Caco-2 cells.

Outer membrane defect and stronger biofilm formation caused by inactivation of a gene encoding for heptosyltransferase I in Cronobacter sakazakii ATCC BAA-894.

PubMed

Wang, L; Hu, X; Tao, G; Wang, X

2012-05-01

To investigate the role of lipopolysaccharide (LPS) structure in the stability of outer membrane and the ability of biofilm formation in Cronobacter sakazakii. A C. sakazakii mutant strain LWW02 was constructed by inactivating the gene ESA_04107 encoding for heptosyltransferase I. LPS were purified from LWW02, and changes in their structure were confirmed by thin-layer chromatography and electrospray ionization mass spectrometry. Comparing with the wild-type strain BAA-894, slower growth, higher membrane permeability, higher surface hydrophobicity, stronger ability of autoaggregation and biofilm formation were observed for the mutant strain LWW02. The gene ESA_04107 encodes heptosyltransferase I in C. sakazakii ATCC BAA-894. The cleavage of LPS in C. sakazakii could cause its outer membrane defects and increase its ability to form biofilms. The study is important for understanding the pathogenic mechanism and efficient control of C. sakazakii. © 2012 The Authors. Journal of Applied Microbiology © 2012 The Society for Applied Microbiology.

Antibacterial activities of plant-derived compounds and essential oils toward Cronobacter sakazakii and Cronobacter malonaticus.

PubMed

Fraňková, Adéla; Marounek, Milan; Mozrová, Věra; Weber, Jaroslav; Klouček, Pavel; Lukešová, Daniela

2014-10-01

Cronobacter sakazakii and C. malonaticus are opportunistic pathogens that cause infections in children and immunocompromised adults. In the present study, the antibacterial activity of 19 plant-derived compounds, 5 essential oils, and an extract of propolis were assessed against C. sakazakii and C. malonaticus. The effects of most of these antimicrobials have not been reported previously. Both strains were susceptible to thymol, carvacrol, thymoquinone, p-cymene, linalool, camphor, citral, eugenol, and trans-cinnamaldehyde as well as cinnamon, lemongrass, oregano, clove, and laurel essential oils; their minimum inhibitory concentrations varied between 0.1 and 2.0 mg/mL. As an alternative treatment method, vapors of the volatiles were tested as an indirect treatment. Vapors of trans-cinnamaldehyde, eugenol, oregano, and cinnamon essential oils inhibited both tested strains, while vapors of linalool were only active against C. sakazakii. To our knowledge, this study is the first time that the inhibitory activity of the vapors of these compounds and essential oils has been reported against Cronobacter spp.

[Isolation and identification of Cronobacter (Enterobacter sakazakii) strains from food].

PubMed

Dong, Xiaohui; Li, Chengsi; Wu, Qingping; Zhang, Jumei; Mo, Shuping; Guo, Weipeng; Yang, Xiaojuan; Xu, Xiaoke

2013-05-04

This study aimed to detect and quantify Cronobacter in 300 powdered milk samples and 50 non-powdered milk samples. Totally, 24 Cronobacter (formerly Enterobacter sakazakii) strains isolated from powdered milk and other foods were identified and confirmed. Cronobacter strains were detected quantitatively using most probable number (MPN) method and molecular detection method. We identified 24 Cronobacter strains using biochemical patterns, including indole production and dulcitol, malonate, melezitose, turanose, and myo-Inositol utilization. Of the 24 strains, their 16S rRNA genes were sequenced, and constructed phylogenetic tree by N-J (Neighbour-Joining) with the 16S rRNA gene sequences of 17 identified Cronobacter strains and 10 non-Cronobacter strains. Quantitative detection showed that Cronobacter strains were detected in 23 out of 350 samples yielding 6.6% detection rate. Twenty-four Cronobacter strains were isolated from 23 samples and the Cronobacter was more than 100 MPN/100g in 4 samples out of 23 samples. The 24 Cronobacter spp. isolates strains were identified and confirmed, including 19 Cronobacter sakazakii strains, 2 C. malonaticus strains, 2 C. dubliensis subsp. lactaridi strains, and 1 C. muytjensii strain. The combination of molecular detection method and most probable number (MPN) method could be suitable for the detection of Cronobacter in powdered milk, with low rate of contamination and high demand of quantitative detection. 24 isolated strains were confirmed and identified by biochemical patterns and molecular technology, and C. sakazakii could be the dominant species. The problem of Cronobacter in powdered milk should be a hidden danger to nurseling, and should catch the government and consumer's attention.

Inhibition of Cronobacter sakazakii by heat labile bacteriocins produced by probiotic LAB isolated from healthy infants.

PubMed

Awaisheh, Saddam S; Al-Nabulsi, Anas A; Osaili, Tareq M; Ibrahim, Salam; Holley, Richard

2013-09-01

Cronobacter sakazakii is an opportunistic pathogen that can cause bacteremia, meningitis, and necrotizing enterocolitis, most often in neonates with case-fatality rates that may reach 80%. The antimicrobial activity of lactic acid bacteria against a wide range of foodborne pathogens is well-established in different types of food products. The objective of the current study was to investigate the antibacterial activity of Lactobacillus acidophilus and L. casei isolated from feces of healthy infants against different strains of C. sakazakii in agar and a rehydrated infant milk formula (RIMF) model. The inhibition zones of C. sakazakii around L. acidophilus or L. casei ranged from 22 to 32 mm on eMan Rogosa Sharpe (MRS) agar under aerobic conditions, while a slight reduction in antibacterial activity was noted on modified MRS (0.2% glucose) under anaerobic conditions. It was observed that pH-neutralized cell-free supernatant (CFS) of L. acidophilus or L. casei was inhibitory against tested C. sakazakii strains. The inhibition zones of neutralized CFS were lower than the antibacterial activities of live cultures. The antibacterial activity of CFS was abolished when CFS from L. acidophilus or L. casei was heated at 60 or 80 °C for either 10 min or 2 h, or treated with trypsin or pepsin. This was considered strong evidence that the inhibition was due to the production of bacteriocins by L. casei and L. acidophilus. Both the CFS and active growing cells of L. casei and L. acidophilus were able to reduce the viability of C. sakazakii in the RIMF model. The results may extend the use of natural antimicrobials instead of conventional preservation methods to improve the safety of RIMF. © 2013 Institute of Food Technologists®

Transcriptome analysis of Cronobacter sakazakii ATCC BAA-894 after interaction with human intestinal epithelial cell line HCT-8.

PubMed

Jing, Chun-e; Du, Xin-jun; Li, Ping; Wang, Shuo

2016-01-01

Cronobacter spp. are opportunistic pathogens that are responsible for infections including severe meningitis, septicemia, and necrotizing enterocolitis in neonates and infants. To date, questions still remain regarding the mechanisms of pathogenicity and virulence determinants for each bacterial strain. In this study, we established an in vitro model for Cronobacter sakazakii ATCC BAA-894 infection of HCT-8 human colorectal epithelial cells. The transcriptome profile of C. sakazakii ATCC BAA-894 after interaction with HCT-8 cells was determined using high-throughput whole-transcriptome sequencing (RNA sequencing (RNA-seq)). Gene expression profiles indicated that 139 genes were upregulated and 72 genes were downregulated in the adherent C. sakazakii ATCC BAA-894 strain on HCT-8 cells compared to the cultured bacteria in the cell-free medium. Expressions of some flagella genes and virulence factors involved in adherence were upregulated. High osmolarity and osmotic stress-associated genes were highly upregulated, as well as genes responsible for the synthesis of lipopolysaccharides and outer membrane proteins, iron acquisition systems, and glycerol and glycerophospholipid metabolism. In sum, our study provides further insight into the mechanisms underlying C. sakazakii pathogenesis in the human gastrointestinal tract.

Simultaneous Rapid Detection and Serotyping of Cronobacter sakazakii Serotypes O1, O2, and O3 by Using Specific Monoclonal Antibodies

PubMed Central

Scharinger, Eva J.; Dietrich, Richard; Kleinsteuber, Ina; Märtlbauer, Erwin

2016-01-01

Cronobacter sakazakii is a foodborne pathogen associated with rare but often lethal infections in neonates. Powdered infant formula (PIF) represents the most frequent source of infection. Out of the identified serotypes (O1 to O7), O1, O2, and O3 are often isolated from clinical and PIF samples. Serotype-specific monoclonal antibodies (MAbs) suitable for application in enzyme immunoassays (EIAs) for the rapid detection of C. sakazakii have not yet been developed. In this study, we created specific MAbs with the ability to bind to C. sakazakii of serotypes O1, O2, and O3. Characterization by indirect EIAs, immunofluorescence, motility assays, and immunoblotting identified lipopolysaccharide (LPS) and exopolysaccharide (EPS) as the antigenic determinants of the MAbs. The established sandwich EIAs were highly sensitive and were able to detect between 2 × 103 and 9 × 106 CFU/ml. Inclusivity tests confirmed that 93% of serotype O1 strains, 100% of O2 strains, and 87% of O3 strains were detected at low cell counts. No cross-reactivity with >100 strains of Cronobacter spp. and other Enterobacteriaceae was observed, except for that with C. sakazakii serotype O3 and Cronobacter muytjensii serotype O1. Moreover, the sandwich EIAs detected C. sakazakii in PIF samples artificially contaminated with 1 to 10 bacterial cells per 10 g of sample after 15 h of preenrichment. The use of these serotype-specific MAbs not only allows the reliable detection of C. sakazakii strains but also enables simultaneous serotyping in a simple sandwich EIA method. PMID:26850303

Sub-lethal heat treatment affects the tolerance of Cronobacter sakazakii BCRC 13988 to various organic acids, simulated gastric juice and bile solution.

PubMed

Hsiao, Wan-Ling; Ho, Wei-Li; Chou, Cheng-Chun

2010-12-15

Cronobacter spp., formerly Enterobacter sakazakii, are considered emerging opportunistic pathogens and the etiological agent of life-threatening bacterial infections in infants. In the present study, C. sakazakii BCRC 13988 was first subjected to sub-lethal heat treatment at 47°C for 15min. Survival rates of the heat-shocked and non-shocked C. sakazakii cells in phosphate buffer solution (PBS, pH 4.0) containing organic acids (e.g. acetic, propionic, citric, lactic or tartaric acid), simulated gastric juice (pH 2.0-4.0), and bile solution (0.5 and 2.0%) were examined. Results revealed that sub-lethal heat treatment enhanced the test organism's tolerance to organic acids, although the extent of increased acid tolerance varied with the organic acid examined. Compared with the control cells, heat-shocked C. sakazakii cells after 120-min of exposure, exhibited the largest increase in tolerance in the lactic acid-containing PBS. Furthermore, although heat shock did not affect the behavior of C. sakazakii in bile solution, it increased the test organism's survival when exposed to simulated gastric juice with a pH of 3.0-4.0. Copyright © 2010. Published by Elsevier B.V.

Growth and survival of Enterobacter sakazakii in human breast milk with and without fortifiers as compared to powdered infant formula.

PubMed

Lenati, Raquel F; O'Connor, Deborah L; Hébert, Karine C; Farber, Jeffrey M; Pagotto, Franco J

2008-02-29

Enterobacter sakazakii infections often involve debilitated neonates consuming contaminated reconstituted powdered infant formula. There is the possibility that expressed human breast milk can become contaminated with E. sakazakii in the hospital or home setting and through the use of contaminated breast milk fortifiers. In addition, although breast milk has been shown to have some antimicrobial effects, this has not been extensively researched in regards to E. sakazakii. Thus, we examined the survival and growth of 9 strains of E. sakazakii in breast milk, human breast milk with fortifiers and powdered infant formula at 10, 23 and 37 degrees C. The average generation times for clinical, food and environmental isolates in breast milk were 0.94+/-0.04, 0.75+/-0.04 and 0.84+/-0.04 h at 23 degrees C; and 0.51+/-0.03, 0.33+/-0.03 and 0.42+/-0.03 h at 37 degrees C, respectively. E. sakazakii was able to survive up to 12 days in breast milk with fortifiers at 10 degrees C. However, its average generation times among replicates and isolate sources ranged from 11.97+/-3.82 to 27.08+/-4.54 h in breast milk at 10 degrees C. Interestingly, average generation times in breast milk with fortifiers at 23 degrees C (0.83+/-0.05, 0.93+/-0.06 and 0.96+/-0.06 h) and 37 degrees C (0.41+/-0.04, 0.51+/-0.05 and 0.54+/-0.05 h) were longer than in powdered infant formula and breast milk at the same temperatures, indicating that human breast milk fortifiers may have an inhibitory effect on the growth of E. sakazakii. However, the intrinsically ascribed antimicrobial properties of breast milk do not appear to inhibit the growth of this foodborne pathogen in-vitro.

Simultaneous Rapid Detection and Serotyping of Cronobacter sakazakii Serotypes O1, O2, and O3 by Using Specific Monoclonal Antibodies.

PubMed

Scharinger, Eva J; Dietrich, Richard; Kleinsteuber, Ina; Märtlbauer, Erwin; Schauer, Kristina

2016-04-01

Cronobacter sakazakii is a foodborne pathogen associated with rare but often lethal infections in neonates. Powdered infant formula (PIF) represents the most frequent source of infection. Out of the identified serotypes (O1 to O7), O1, O2, and O3 are often isolated from clinical and PIF samples. Serotype-specific monoclonal antibodies (MAbs) suitable for application in enzyme immunoassays (EIAs) for the rapid detection of C. sakazakii have not yet been developed. In this study, we created specific MAbs with the ability to bind toC. sakazakii of serotypes O1, O2, and O3. Characterization by indirect EIAs, immunofluorescence, motility assays, and immunoblotting identified lipopolysaccharide (LPS) and exopolysaccharide (EPS) as the antigenic determinants of the MAbs. The established sandwich EIAs were highly sensitive and were able to detect between 2 × 10(3)and 9 × 10(6)CFU/ml. Inclusivity tests confirmed that 93% of serotype O1 strains, 100% of O2 strains, and 87% of O3 strains were detected at low cell counts. No cross-reactivity with >100 strains of Cronobacter spp. and other Enterobacter iaceae was observed, except for that with C. sakazakii serotype O3 and Cronobacter muytjensii serotype O1. Moreover, the sandwich EIAs detected C. sakazakii in PIF samples artificially contaminated with 1 to 10 bacterial cells per 10 g of sample after 15 h of preenrichment. The use of these serotype-specific MAbs not only allows the reliable detection of C. sakazakii strains but also enables simultaneous serotyping in a simple sandwich EIA method. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Complete genome sequence and phenotype microarray analysis of Cronobacter sakazakii SP291: a persistent isolate cultured from a powdered infant formula production facility.

PubMed

Yan, Qiongqiong; Power, Karen A; Cooney, Shane; Fox, Edward; Gopinath, Gopal R; Grim, Christopher J; Tall, Ben D; McCusker, Matthew P; Fanning, Séamus

2013-01-01

Outbreaks of human infection linked to the powdered infant formula (PIF) food chain and associated with the bacterium Cronobacter, are of concern to public health. These bacteria are regarded as opportunistic pathogens linked to life-threatening infections predominantly in neonates, with an under developed immune system. Monitoring the microbiological ecology of PIF production sites is an important step in attempting to limit the risk of contamination in the finished food product. Cronobacter species, like other microorganisms can adapt to the production environment. These organisms are known for their desiccation tolerance, a phenotype that can aid their survival in the production site and PIF itself. In evaluating the genome data currently available for Cronobacter species, no sequence information has been published describing a Cronobacter sakazakii isolate found to persist in a PIF production facility. Here we report on the complete genome sequence of one such isolate, Cronobacter sakazakii SP291 along with its phenotypic characteristics. The genome of C. sakazakii SP291 consists of a 4.3-Mb chromosome (56.9% GC) and three plasmids, denoted as pSP291-1, [118.1-kb (57.2% GC)], pSP291-2, [52.1-kb (49.2% GC)], and pSP291-3, [4.4-kb (54.0% GC)]. When C. sakazakii SP291 was compared to the reference C. sakazakii ATCC BAA-894, which is also of PIF origin, the annotated genome data identified two interesting functional categories, comprising of genes related to the bacterial stress response and resistance to antimicrobial and toxic compounds. Using a phenotypic microarray (PM), we provided a full metabolic profile comparing C. sakazakii SP291 and the previously sequenced C. sakazakii ATCC BAA-894. These data extend our understanding of the genome of this important neonatal pathogen and provides further insights into the genotypes associated with features that can contribute to its persistence in the PIF environment.

Rapid detection of Cronobacter sakazakii by real-time PCR based on the cgcA gene and TaqMan probe with internal amplification control.

PubMed

Hu, Shuangfang; Yu, Yigang; Li, Rong; Wu, Xinwei; Xiao, Xinglong; Wu, Hui

2016-03-01

Cronobacter sakazakii is a severe virulent strain that is frequently detected in powdered infant formula (PIF). Therefore, it is necessary to develop a fast and specific detection method. The specificity of our newly developed quantitative real-time PCR (qRT-PCR) was validated with DNA from 46 strains. Among them, 12 C. sakazakii strains were correctly amplified, whereas no positive florescent signal was observed from 34 nontarget controls. The detection limit of C. sakazakii was about 110 CFU/mL in broth and 1100 CFU/g in PIF. After enrichment in buffered peptone water for 6 h, our developed qRT-PCR assay could reliably detect C. sakazakii when the inoculation level was as low as 2 CFU/25 g (0.08 CFU/g) in PIF. The growth of C. sakazakii could be inhibited by the presence of Lactobacillus pentosus and Bacillus cereus, which used a longer enrichment period before the isolation was accomplished. However, at 5 and 50 CFU/25 g inoculation levels of C. sakazakii in the presence of 4 × 10(6) CFU L. pentosus/25 g or of 2 × 10(4) CFU B. cereus/25 g, the qRT-PCR assay could detect the presence of Cronobacter even though these artificially spiked samples were negative in culture. Therefore, our results indicated that the qRT-PCR assay could detect samples containing inhibitors and could avoid false negatives by using an internal amplification control.

Antibiotic and Desiccation Resistance of Cronobacter sakazakii and C. malonaticus Isolates from Powdered Infant Formula and Processing Environments

PubMed Central

Fei, Peng; Jiang, Yujun; Feng, Jing; Forsythe, Stephen J.; Li, Ran; Zhou, Yanhong; Man, Chaoxin

2017-01-01

This study evaluated the antimicrobial and desiccation resistance of Cronobacter sakazakii and Cronobacter malonaticus isolates from powdered infant formula and processing environments. The antimicrobial susceptibility tests showed that the 70 Cronobacter strains, representing 19 sequence types, were susceptible to the most of the antibiotics except for amoxicillin-clavulanate, ampicillin, and cefazolin. Furthermore, the growth of six C. sakazakii and two C. malonaticus strains from different sequence types (STs) in hyperosmotic media was measured. The growth of the two C. sakazakii strains (CE1 and CE13) from the neonatal pathovars ST4 and ST8, were significantly higher (p < 0.05) than that of other strains. C. malonaticus strain CM35 (ST201) was the slowest grower in all strains, and most could not grow in more than 8% NaCl solution. Also the survival of these strains under desiccation conditions was followed for 1 year. The viable count of Cronobacter spp. under desiccation conditions was reduced on average by 3.02 log cycles during 1 year, with CE13 (ST8) being the most desiccation resistant strain. These results will improve our understanding of the persistence of the two closely related species C. sakazakii and C. malonaticus which are of concern for neonatal and adult health. PMID:28303125

Carriage of Cronobacter sakazakii in the very preterm infant gut.

PubMed

Chandrasekaran, Sukantha; Burnham, Carey-Ann D; Warner, Barbara B; Tarr, Phillip I; Wylie, Todd N

2018-01-31

Cronobacter sakazakii causes severe neonatal infections, but we know little about gut carriage of this pathogen in very low birthweight infants. We sequenced 16S rRNA genes from 2,304 stools from 121 children at St. Louis Children's Hospital whose birthweight was ≤1,500 grams, attempted to isolate C. sakazakii from 157 of these stools, genome sequenced the recovered isolates, and sought correlations between indices of Cronobacter excretion, host characteristics and unit formula use. Of these 2,304 stools, 1,271 (55.2%) contained Cronobacter rRNA gene sequences. The median (interquartile range) per-subject percent of specimens with at least one Cronobacter sequence and the median per-subject read density were 57.1 (25.5-87.3) and 0.07 (0.01-0.67), respectively. There was no variation according to commercially prepared liquid versus powdered formula use in the NICU, or the day-of-life that specimens were produced. However, the proportion of specimens containing >4.0% of reads mapping to Cronobacter fell from 4.3% to 0.9% after powdered infant formula was discontinued (P<0.0001). We isolated sequence type (ST) 4 C. sakazakii from multiple specimens from two subjects; one also harbored ST233. The sequenced ST4 isolates from the two subjects had >99.9% sequence identity in the ~93% of best-match reference genome that they contained, and shared multiple virulence loci. Very low birthweight infants excrete putatively pathogenic Cronobacter. High-density Cronobacter sequence samples were more common during the use of powdered infant formula. Better understanding of the ecology of Cronobacter in infant guts will inform future prevention and control strategies. © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Rapid Detection of Enterobacter Sakazakii in milk Powder using amino modified chitosan immunomagnetic beads.

PubMed

Zhu, Yinglian; Wang, Dongfeng

2016-12-01

Chitosan immunomagnetic beads (CIBs) were first prepared through converting hydroxyl groups of natural polymer material-chitosan into amino groups using epichlorohydrin and ethylenediamine as modification agent and then coupling with polyclonal antibodies of Enterobacter sakazakii using glutaraldehyde as cross-linking agent. The beads before coupling with antibodies were characterized by magnetic property measurement, FTIR, SEM and XRD technologies. In the assay a natural polysaccharide-chitosan, which has good biological and chemical properties such as non-toxicity, biocompatibility and high chemical reactivity was first used for synthesis of immunomagnetic beads. The detection method first established in this paper that combined the beads with chromogenic medium together to rapid detect E. sakazakii in milk powder could greatly improve the detection specificity and working efficiency. The beads exhibited a maximum capturing capacity of 1×10 6 cfu/g with the detection sensitivity of 4cfu/g. The results demonstrate that the assay is a straightforward, specific and sensitive alternative for rapid detection of E.sakazakii in food matrix. The total analysis time was as little as about 25h, which greatly shorten the detection time. The method can provides new ideas not only to preparation technique of immunomagnetic beads but to imunne detection technique in food safety. Copyright © 2016 Elsevier B.V. All rights reserved.

Hfq plays important roles in virulence and stress adaptation in Cronobacter sakazakii ATCC 29544.

PubMed

Kim, Seongok; Hwang, Hyelyeon; Kim, Kwang-Pyo; Yoon, Hyunjin; Kang, Dong-Hyun; Ryu, Sangryeol

2015-05-01

Cronobacter spp. are opportunistic pathogens that cause neonatal meningitis and sepsis with high mortality in neonates. Despite the peril associated with Cronobacter infection, the mechanisms of pathogenesis are still being unraveled. Hfq, which is known as an RNA chaperone, participates in the interaction with bacterial small RNAs (sRNAs) to regulate posttranscriptionally the expression of various genes. Recent studies have demonstrated that Hfq contributes to the pathogenesis of numerous species of bacteria, and its roles are varied between bacterial species. Here, we tried to elucidate the role of Hfq in C. sakazakii virulence. In the absence of hfq, C. sakazakii was highly attenuated in dissemination in vivo, showed defects in invasion (3-fold) into animal cells and survival (10(3)-fold) within host cells, and exhibited low resistance to hydrogen peroxide (10(2)-fold). Remarkably, the loss of hfq led to hypermotility on soft agar, which is contrary to what has been observed in other pathogenic bacteria. The hyperflagellated bacteria were likely to be attributable to the increased transcription of genes associated with flagellar biosynthesis in a strain lacking hfq. Together, these data strongly suggest that hfq plays important roles in the virulence of C. sakazakii by participating in the regulation of multiple genes. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

hfq Plays Important Roles in Virulence and Stress Adaptation in Cronobacter sakazakii ATCC 29544

PubMed Central

Kim, Seongok; Hwang, Hyelyeon; Kim, Kwang-Pyo; Yoon, Hyunjin; Kang, Dong-Hyun

2015-01-01

Cronobacter spp. are opportunistic pathogens that cause neonatal meningitis and sepsis with high mortality in neonates. Despite the peril associated with Cronobacter infection, the mechanisms of pathogenesis are still being unraveled. Hfq, which is known as an RNA chaperone, participates in the interaction with bacterial small RNAs (sRNAs) to regulate posttranscriptionally the expression of various genes. Recent studies have demonstrated that Hfq contributes to the pathogenesis of numerous species of bacteria, and its roles are varied between bacterial species. Here, we tried to elucidate the role of Hfq in C. sakazakii virulence. In the absence of hfq, C. sakazakii was highly attenuated in dissemination in vivo, showed defects in invasion (3-fold) into animal cells and survival (103-fold) within host cells, and exhibited low resistance to hydrogen peroxide (102-fold). Remarkably, the loss of hfq led to hypermotility on soft agar, which is contrary to what has been observed in other pathogenic bacteria. The hyperflagellated bacteria were likely to be attributable to the increased transcription of genes associated with flagellar biosynthesis in a strain lacking hfq. Together, these data strongly suggest that hfq plays important roles in the virulence of C. sakazakii by participating in the regulation of multiple genes. PMID:25754196

A Negative Regulator of Cellulose Biosynthesis, bcsR, Affects Biofilm Formation, and Adhesion/Invasion Ability of Cronobacter sakazakii.

PubMed

Gao, Jian-Xin; Li, Ping; Du, Xin-Jun; Han, Zhong-Hui; Xue, Rui; Liang, Bin; Wang, Shuo

2017-01-01

Cronobacter sakazakii is an important foodborne pathogen that causes neonatal meningitis and sepsis, with high mortality in neonates. However, very little information is available regarding the pathogenesis of C. sakazakii at the genetic level. In our previous study, a cellulose biosynthesis-related gene ( bcsR ) was shown to be involved in C. sakazakii adhesion/invasion into epithelial cells. In this study, the detailed functions of this gene were investigated using a gene knockout technique. A bcsR knockout mutant (Δ bcsR ) of C. sakazakii ATCC BAA-894 showed decreased adhesion/invasion (3.9-fold) in human epithelial cell line HCT-8. Biofilm formation by the mutant was reduced to 50% of that exhibited by the wild-type (WT) strain. Raman spectrometry was used to detect variations in biofilm components caused by bcsR knockout, and certain components, including carotenoids, fatty acids, and amides, were significantly reduced. However, another biofilm component, cellulose, was increased in Δ bcsR , suggesting that bcsR negatively affects cellulose biosynthesis. This result was also verified via RT-PCR, which demonstrated up-regulation of five crucial cellulose synthesis genes ( bcsA, B, C, E, Q ) in Δ bcsR . Furthermore, the expression of other virulence or biofilm-related genes, including flagellar assembly genes ( fliA, C, D ) and toxicity-related genes ( ompA, ompX, hfq ), was studied. The expression of fliC and ompA in the Δ bcsR mutant was found to be remarkably reduced compared with that in the wild-type and the others were also affected excepted ompX . In summary, bcsR is a negative regulator of cellulose biosynthesis but positively regulates biofilm formation and the adhesion/invasion ability of C. sakazakii .

Complete genome sequence and phenotype microarray analysis of Cronobacter sakazakii SP291: a persistent isolate cultured from a powdered infant formula production facility

PubMed Central

Yan, Qiongqiong; Power, Karen A.; Cooney, Shane; Fox, Edward; Gopinath, Gopal R.; Grim, Christopher J.; Tall, Ben D.; McCusker, Matthew P.; Fanning, Séamus

2013-01-01

Outbreaks of human infection linked to the powdered infant formula (PIF) food chain and associated with the bacterium Cronobacter, are of concern to public health. These bacteria are regarded as opportunistic pathogens linked to life-threatening infections predominantly in neonates, with an under developed immune system. Monitoring the microbiological ecology of PIF production sites is an important step in attempting to limit the risk of contamination in the finished food product. Cronobacter species, like other microorganisms can adapt to the production environment. These organisms are known for their desiccation tolerance, a phenotype that can aid their survival in the production site and PIF itself. In evaluating the genome data currently available for Cronobacter species, no sequence information has been published describing a Cronobacter sakazakii isolate found to persist in a PIF production facility. Here we report on the complete genome sequence of one such isolate, Cronobacter sakazakii SP291 along with its phenotypic characteristics. The genome of C. sakazakii SP291 consists of a 4.3-Mb chromosome (56.9% GC) and three plasmids, denoted as pSP291-1, [118.1-kb (57.2% GC)], pSP291-2, [52.1-kb (49.2% GC)], and pSP291-3, [4.4-kb (54.0% GC)]. When C. sakazakii SP291 was compared to the reference C. sakazakii ATCC BAA-894, which is also of PIF origin, the annotated genome data identified two interesting functional categories, comprising of genes related to the bacterial stress response and resistance to antimicrobial and toxic compounds. Using a phenotypic microarray (PM), we provided a full metabolic profile comparing C. sakazakii SP291 and the previously sequenced C. sakazakii ATCC BAA-894. These data extend our understanding of the genome of this important neonatal pathogen and provides further insights into the genotypes associated with features that can contribute to its persistence in the PIF environment. PMID:24032028

Diverse profiles of N-acyl-homoserine lactones in biofilm forming strains of Cronobacter sakazakii.

PubMed

Singh, Niharika; Patil, Amrita; Prabhune, Asmita A; Raghav, Mamta; Goel, Gunjan

2017-04-03

The present study investigates the role of quorum sensing (QS) molecules expressed by C. sakazakii in biofilm formation and extracellular polysaccharide expression. The QS signaling was detected using Chromobacterium violaceum 026 and Agrobacterium tumefaciens NTL4(pZLR4) based bioassay. Long chain N-acyl-homoserine lactones (AHLs) with C6- C18 chain length were identified using High Performance Liquid Chromatography and Liquid Chromatography-High Resolution Mass Spectrometry. A higher Specific Biofilm Formation (SBF) index (p < 0.05) with the presence of genes associated with cellulose biosynthesis (bcsA, bcsC and bcsG) was observed in the strains. AHLs and their mechanisms can serve as novel targets for developing technologies to eradicate and prevent biofilm formation by C. sakazakii.

Analysis on pathogenic and virulent characteristics of the Cronobacter sakazakii strain BAA-894 by whole genome sequencing and its demonstration in basic biology science.

PubMed

Bao, Xuerui; Yang, Ling; Chen, Lequn; Li, Bing; Li, Lin; Li, Yanyan; Xu, Zhenbo

2017-08-01

Cronobacter sakazakii is an opportunistic pathogen responsible for necrotizing enterocolitis, meningitis and septicaemia especially to infant and neonate, with high lethality ranging in 40%-80%. This strain is able to survive in infant milk formula and possesses capability of pathogenicity and virulence, biofilm formation, and high resistance to elevated osmotic, low pH, heat, oxidation, and desiccasion. This study is aims to investigate the molecular characteristics of Cronobacter sakazakii BAA 894, including mechanisms of its invasion and adherence, biofilm formation, unusual resistance to environmental stress employing whole genome sequencing and comparative genomics. Results in this study suggest that numerous genes and pathways, such as LysM, Cyx system, luxS, vancomycin resistance pathway, insulin resistance pathway, and sod encoding superoxide dismutase for the survival of C. sakazakii in macrophages, contribute to pathogenicity and resistance to stressful environment of C. sakazakii BAA 894. Copyright © 2017. Published by Elsevier Ltd.

The Glutaredoxin Gene, grxB, Affects Acid Tolerance, Surface Hydrophobicity, Auto-Aggregation, and Biofilm Formation in Cronobacter sakazakii.

PubMed

Ling, Na; Zhang, Jumei; Li, Chengsi; Zeng, Haiyan; He, Wenjing; Ye, Yingwang; Wu, Qingping

2018-01-01

Cronobacter species are foodborne pathogens that can cause neonatal meningitis, necrotizing enterocolitis, and sepsis; they have unusual abilities to survive in environmental stresses such as acid stress. However, the factors involved in acid stress responses and biofilm formation in Cronobacter species are poorly understood. In this study, we investigated the role of grxB on cellular morphology, acid tolerance, surface hydrophobicity, auto-aggregation (AAg), motility, and biofilm formation in Cronobacter sakazakii . The deletion of grxB decreased resistance to acid stresses, and notably led to weaker surface hydrophobicity, AAg, and biofilm formation under normal and acid stress conditions, compared with those of the wild type strain; however, motility was unaffected. Therefore, grxB appears to contribute to the survival of C. sakazakii in acid stresses and biofilm formation. This is the first report to provide valuable evidence for the role of grxB in acid stress responses and biofilm formation in C. sakazakii.

More Effective VET and Lifelong Learning Policies: Awareness Raising, Analysis and Advice--Cedefop's Achievements in 2012 and Plans for 2013. Briefing Note

ERIC Educational Resources Information Center

Cedefop - European Centre for the Development of Vocational Training, 2013

2013-01-01

Reform of vocational education and training (VET) in Europe is complex, especially at a time of economic crisis. Cedefop raises awareness and provides analysis and advice to policy-makers at European level and in Member States to help them decide on policies and actions. Cedefop's work supports the European policy agenda for VET and lifelong…

Identification of Natural Animicrobial Substances in Red Muscadine Juice against Cranonbacter sakazakii

USDA-ARS?s Scientific Manuscript database

Muscadine grape (Vitis rotundifolia Michx.) juice with natural organic, phenolic acids and polyphenol compounds identified in red muscadine juice (‘Noble’) were tested against Cronobacter sakazakii. Commercial baby juices with high polyphenol content (176.7~347.7 mg/mL), showed poor antimicrobial a...

Identification of Natural Antimicrobial Substances in Red Muscadine Juice against Enterobacter sakazakii

USDA-ARS?s Scientific Manuscript database

Red muscadine (Vitis rotundifolia Michx.) juices with natural organic, phenolic acids and polyphenol compounds were tested against Cronobacter sakazakii. The concentration of total phenolic compounds of commercial baby juices ranged from 176.7 to 347.7 mg/mL. Commercial baby juices showed poor antim...

Decreasing Enterobacter sakazakii (Cronobacter spp.) food contamination level with bacteriophages: prospects and problems

PubMed Central

Zuber, Sophie; Boissin‐Delaporte, Catherine; Michot, Lise; Iversen, Carol; Diep, Benjamin; Brüssow, Harald; Breeuwer, Pieter

2008-01-01

Summary Enterobacter sakazakii (Cronobacter spp.) is an opportunistic pathogen, which can cause rare, but life‐threatening infections in neonates and infants through feeding of a contaminated milk formula. We isolated 67 phages from environmental samples and tested their lytic host range on a representative collection of 40 E. sakazakii strains. A cocktail of five phages prevented the outgrowth of 35 out of 40 test strains in artificially contaminated infant formula. Two E. sakazakii phages represented prolate head Myoviridae. Molecular tests identified them as close relatives of Escherichia coli phage T4. The remaining three phages represented isometric head Myoviridae with large genome size of 140 and 200 kb, respectively, which belonged to two different DNA hybridization groups. A high dose of 108 pfu ml−1 of phage could effectively sterilize a broth contaminated with both high and low pathogen counts (106 and 102 cfu ml−1). In contrast, broth inoculated with 104 phage and 102 bacteria per ml first showed normal bacterial growth until reaching a cell titre of 105 cfu ml−1. Only when crossing this threshold, phage replication started, but it could not reduce the contamination level below 100 cfu ml−1. Phages could be produced with titres of 1010 pfu ml−1 in broth culture, but they were not stable upon freeze‐drying. Addition of trehalose or milk formula stabilized the phage preparation, which then showed excellent storage stability even at elevated temperature. PMID:21261874

Investigating the biocontrol and anti-biofilm potential of a three phage cocktail against Cronobacter sakazakii in different brands of infant formula.

PubMed

Endersen, Lorraine; Buttimer, Colin; Nevin, Eoghan; Coffey, Aidan; Neve, Horst; Oliveira, Hugo; Lavigne, Rob; O'Mahony, Jim

2017-07-17

In recent years, the microbiological safety of powdered infant formula has gained increasing attention due to the identification of contaminating C. sakazakii and its epidemiological link with life-threatening neonatal infections. Current intervention strategies have fallen short of ensuring the production of infant formula that is free from C. sakazakii. In this study, we describe the isolation and characterisation of three bacteriophages (phages) and their application as a phage cocktail to inhibit the growth of C. sakazakii in different brands of infant formula, while also assessing the phages ability to prevent biofilm formation. All three phages, isolated from slurry, possess a relatively broad host range, verified by their ability to infect across genera and species. When all three phages were combined and used as part of a phage cocktail, 73% coverage was obtained across all Cronobacter strains tested. Optimum thermo-tolerance and pH stability were determined between 4°C-37°C, and pH6-8, respectively, well within the normal range of application of infant formula. Genome sequencing and analysis revealed all the phages to be free from lysogenic properties, a trait which renders each favourable for phage therapy applications. As such, the combined-phage preparation (3×10 8 pfu/mL) was found to possess a strong bactericidal effect on C. sakazakii/C. sakazakii LUX cells (≤10 4 cfu/mL), resulting in a significant reduction in cell numbers, to below the limit of detection (<10cfu/mL). This was observed following a 20h challenge in different brands of infant formula, where samples in the absence of the phage cocktail reached concentrations of ~10 9 cfu/mL. The phage cocktail also demonstrated promise in preventing the establishment of biofilm, as biofilm formation could not be detected for up to 48h post treatment. These results highlight the potential application of this phage preparation for biocontrol of C. sakazakii contamination in reconstituted infant

An Advice Mechanism for Heterogeneous Robot Teams

NASA Astrophysics Data System (ADS)

Daniluk, Steven

The use of reinforcement learning for robot teams has enabled complex tasks to be performed, but at the cost of requiring a large amount of exploration. Exchanging information between robots in the form of advice is one method to accelerate performance improvements. This thesis presents an advice mechanism for robot teams that utilizes advice from heterogeneous advisers via a method guaranteeing convergence to an optimal policy. The presented mechanism has the capability to use multiple advisers at each time step, and decide when advice should be requested and accepted, such that the use of advice decreases over time. Additionally, collective collaborative, and cooperative behavioural algorithms are integrated into a robot team architecture, to create a new framework that provides fault tolerance and modularity for robot teams.

Growth kinetics and model comparison of cronobacter sakazakii in reconstituted powdered infant formula

USDA-ARS?s Scientific Manuscript database

Cronobacter sakazakii is a life-threatening bacterium, primarily implicated in illnesses associated with the consumption of powdered infant formula (PIF). It can cause rare but invasive infections, leading to sepsis, meningitis, or necrotizing enterocolitis in infants fed with contaminated PIF. Th...

Putative Inv Is Essential for Basolateral Invasion of Caco-2 Cells and Acts Synergistically with OmpA To Affect In Vitro and In Vivo Virulence of Cronobacter sakazakii ATCC 29544

PubMed Central

Chandrapala, Dilini; Kim, Kyumson; Choi, Younho; Senevirathne, Amal; Kang, Dong-Hyun; Ryu, Sangryeol

2014-01-01

Cronobacter sakazakii is an opportunistic pathogen that causes neonatal meningitis and necrotizing enterocolitis. Its interaction with intestinal epithelium is important in the pathogenesis of enteric infections. In this study, we investigated the involvement of the inv gene in the virulence of C. sakazakii ATCC 29544 in vitro and in vivo. Sequence analysis of C. sakazakii ATCC 29544 inv revealed that it is different from other C. sakazakii isolates. In various cell culture models, an Δinv deletion mutant showed significantly lowered invasion efficiency, which was restored upon genetic complementation. Studying invasion potentials using tight-junction-disrupted Caco-2 cells suggested that the inv gene product mediates basolateral invasion of C. sakazakii ATCC 29544. In addition, comparison of invasion potentials of double mutant (ΔompA Δinv) and single mutants (ΔompA and Δinv) provided evidence for an additive effect of the two putative outer membrane proteins. Finally, the importance of inv and the additive effect of putative Inv and OmpA were also proven in an in vivo rat pup model. This report is the first to demonstrate two proteins working synergistically in vitro, as well as in vivo in C. sakazakii pathogenesis. PMID:24549330

Putative Inv is essential for basolateral invasion of Caco-2 cells and acts synergistically with OmpA to affect in vitro and in vivo virulence of Cronobacter sakazakii ATCC 29544.

PubMed

Chandrapala, Dilini; Kim, Kyumson; Choi, Younho; Senevirathne, Amal; Kang, Dong-Hyun; Ryu, Sangryeol; Kim, Kwang-Pyo

2014-05-01

Cronobacter sakazakii is an opportunistic pathogen that causes neonatal meningitis and necrotizing enterocolitis. Its interaction with intestinal epithelium is important in the pathogenesis of enteric infections. In this study, we investigated the involvement of the inv gene in the virulence of C. sakazakii ATCC 29544 in vitro and in vivo. Sequence analysis of C. sakazakii ATCC 29544 inv revealed that it is different from other C. sakazakii isolates. In various cell culture models, an Δinv deletion mutant showed significantly lowered invasion efficiency, which was restored upon genetic complementation. Studying invasion potentials using tight-junction-disrupted Caco-2 cells suggested that the inv gene product mediates basolateral invasion of C. sakazakii ATCC 29544. In addition, comparison of invasion potentials of double mutant (ΔompA Δinv) and single mutants (ΔompA and Δinv) provided evidence for an additive effect of the two putative outer membrane proteins. Finally, the importance of inv and the additive effect of putative Inv and OmpA were also proven in an in vivo rat pup model. This report is the first to demonstrate two proteins working synergistically in vitro, as well as in vivo in C. sakazakii pathogenesis.

Thermal resistance of Cronobacter sakazakii isolated from baby food ingredients of dairy origin

USDA-ARS?s Scientific Manuscript database

Milk and whey powders are commonly used ingredients in powdered infant formula (PIF) and follow-up formula (FUF). In this study, Cronobacter sakazakii and Cronobacter dublinensis both of dairy origin and a reference strain, Cronobacter muytjensii ATCC 51329, were investigated for thermal inactivatio...

No Effect of Writing Advice on Reading Comprehension

ERIC Educational Resources Information Center

Balling, Laura Winther

2018-01-01

This article considers text comprehension through the integrated perspectives of language processing research and practical writing advice as expressed in writing guides and language policies. Such guides for instance include advice to use active constructions instead of passives and sentences instead of nominalizations. These recommended and…

Validation of radio-frequency dielectric heating system for destruction of Cronobacter sakazakii and Salmonella species in nonfat dry milk.

PubMed

Michael, M; Phebus, R K; Thippareddi, H; Subbiah, J; Birla, S L; Schmidt, K A

2014-12-01

Cronobacter sakazakii and Salmonella species have been associated with human illnesses from consumption of contaminated nonfat dry milk (NDM), a key ingredient in powdered infant formula and many other foods. Cronobacter sakazakii and Salmonella spp. can survive the spray-drying process if milk is contaminated after pasteurization, and the dried product can be contaminated from environmental sources. Compared with conventional heating, radio-frequency dielectric heating (RFDH) is a faster and more uniform process for heating low-moisture foods. The objective of this study was to design an RFDH process to achieve target destruction (log reductions) of C. sakazakii and Salmonella spp. The thermal destruction (decimal reduction time; D-value) of C. sakazakii and Salmonella spp. in NDM (high-heat, HH; and low-heat, LH) was determined at 75, 80, 85, or 90 °C using a thermal-death-time (TDT) disk method, and the z-values (the temperature increase required to obtain a decimal reduction of the D-value) were calculated. Time and temperature requirements to achieve specific destruction of the pathogens were calculated from the thermal destruction parameters, and the efficacy of the RFDH process was validated by heating NDM using RFDH to achieve the target temperatures and holding the product in a convection oven for the required period. Linear regression was used to determine the D-values and z-values. The D-values of C. sakazakii in HH- and LH-NDM were 24.86 and 23.0 min at 75 °C, 13.75 and 7.52 min at 80 °C, 8.0 and 6.03 min at 85 °C, and 5.57 and 5.37 min at 90 °C, respectively. The D-values of Salmonella spp. in HH- and LH-NDM were 23.02 and 24.94 min at 75 °C, 10.45 and 12.54 min at 80 °C, 8.63 and 8.68 min at 85 °C, and 5.82 and 4.55 min at 90 °C, respectively. The predicted and observed destruction of C. sakazakii and Salmonella spp. were in agreement, indicating that the behavior of the organisms was similar regardless of the heating system (conventional vs

Learners Need Face-to-Face Advice

ERIC Educational Resources Information Center

Sedgmore, Lynne

2012-01-01

In January the 157 Group launched a policy paper making the case for professional careers guidance. With the launch of the National Careers Service in April, information, advice and guidance is a hot topic within the education and skills sector and one that is regularly debated. The combination of policy changes, including the introduction of…

Drying parameters greatly affect the destruction of Cronobacter sakazakii and Salmonella Typhimurium in standard buffer and milk.

PubMed

Lang, Emilie; Iaconelli, Cyril; Zoz, Fiona; Guyot, Stéphane; Alvarez-Martin, Pablo; Beney, Laurent; Perrier-Cornet, Jean-Marie; Gervais, Patrick

2017-04-01

Salmonella Typhimurium and Cronobacter sakazakii are two foodborne pathogens involved in neonatal infections from milk powder and infant formula. Their ability to survive in low-moisture food and during processing from the decontamination to the dried state is a major issue in food protection. In this work, we studied the effects of the drying process on Salmonella Typhimurium and Cronobacter sakazakii, with the aim of identifying the drying parameters that could promote greater inactivation of these two foodborne pathogens. These two bacteria were dried under different atmospheric relative humidities in milk and phosphate-buffered saline, and the delays in growth recovery and cultivability were followed. We found that water activity was related to microorganism resistance. C. sakazakii was more resistant to drying than was S. Typhimurium, and milk increased the cultivability and recovery of these two species. High drying rates and low final water activity levels (0.11-0.58) had a strong negative effect on the growth recovery and cultivability of these species. In conclusion, we suggest that effective use of drying processes may provide a complementary tool for food decontamination and food safety during the production of low-moisture foods. Copyright © 2016 Elsevier Ltd. All rights reserved.

Structural studies of O-polysaccharide isolated from Cronobacter sakazakii Sequence Type 12 from a case of neonatal necrotizing enterocolitis.

PubMed

Marszewska, Kinga; Czerwicka, Małgorzata; Forsythe, Stephen J; Ossowska, Karolina; Dziadziuszko, Halina; Kaczyński, Zbigniew

2015-04-30

The O-polysaccharide (OPS) of Cronobacter sakazakii NTU 696 (Sequence Type 12) from a case of neonatal necrotizing enterocolitis was isolated from the polysaccharide fraction obtained after lipopolysaccharide (LPS) hydrolysis. Purified OPS was analyzed by NMR spectroscopy ((1)H, COSY, TOCSY, NOESY, HSQC, HSQC-TOCSY and HMBC experiments) and chemical methods. Obtained monosaccharide derivatives analyzed by gas chromatography and gas chromatography-mass spectrometry allowed the identification of six sugar components. Performed experiments enabled to establish a structure of the OPS repeating unit of C. sakazakii NTU 696, as: [structure: see text]. Copyright © 2015 Elsevier Ltd. All rights reserved.

Survival and growth of Cronobacter sakazakii on fresh-cut fruit and the effect of UV-C illumination and electrolyzed water in the reduction of its population.

PubMed

Santo, David; Graça, Ana; Nunes, Carla; Quintas, Célia

2016-08-16

Cronobacter sakazakii, found in foods such as powdered infant formula and plant origin ready-to-eat food, is an opportunistic pathogen to infants, neonates and vulnerable adults. The objective of this study was to monitor the growth of C. sakazakii in fresh-cut 'Royal gala' apple, 'Rocha' pear, and 'Piel de sapo' melon, and the effect of UV-C illumination, acidic electrolyzed water (AEW) and neutral electrolyzed water (NEW) in the reduction of its population. Fresh-cut fruits were inoculated and incubated at different temperatures during 10days while monitoring C. sakazakii. The inhibitory activity of different doses of UV-C (0-10kJ.m(2)), electrolyzed water and sodium hypochlorite (SH) (100ppm chlorine) was evaluated on the fruits inoculated with C. sakazakii. The bacterium showed a significant growth in the fruits at 12 and 20°C, but did not grow at 4°C, despite having survived for 10days. At 8°C, adaptation phases of 0.6-3.9days were estimated in the fruits before exponential growth. The UV-C 7.5 and 10kJ/m(2) produced greater C. sakazakii population decreases (2-2.4logcfu/g) than AEW (1.3-1.8logcfu/g), NEW (1-1.2logcfu/g) and SH (0.8-1.4logcfu/g). The UV-C decontamination system and refrigeration at 4°C, may contribute to the product's safety and quality. The results help better understand the behavior of C. sakazakii on fresh-cut fruit alerting producers of the necessity to respect the high hygienic practices, adequate refrigerating temperature maintenance and caution with the tendency to prolong the validity of this kind of ready-to-eat food. Copyright © 2016 Elsevier B.V. All rights reserved.

Conditioned medium from Bifidobacteria infantis protects against Cronobacter sakazakii-induced intestinal inflammation in newborn mice

PubMed Central

Weng, Meiqian; Ganguli, Kriston; Zhu, Weishu; Shi, Hai Ning

2014-01-01

Necrotizing enterocolitis (NEC) is associated with a high morbidity and mortality in very low birth weight infants. Several hypotheses regarding the pathogenesis of NEC have been proposed but to date no effective treatment is available. Previous studies suggest that probiotic supplementation is protective. We recently reported that probiotic (Bifidobacterium infantis) conditioned medium (PCM) has an anti-inflammatory effect in cultured fetal human intestinal cells (H4) and fetal intestine explants. In this study, we tested in vivo whether PCM protects neonatal mice from developing intestinal inflammation induced by exposure to Cronobacter sakazakii (C. sakazakii), an opportunistic pathogen associated with NEC. We found that infected neonatal mice had a significantly lower body weight than control groups. Infection led to ileal tissue damage including villous rupture, disruption of epithelial cell alignment, intestinal inflammation, apoptotic cell loss, and decreased mucus production. Pretreatment with PCM prevented infection caused decrease in body weight, attenuated enterocyte apoptotic cell death, mitigated reduced mucin production, and maintained ileal structure. Infected ileum expressed reduced levels of IκBα, which could be restored upon pretreatment with PCM. We also observed a nuclear translocation of NF-κB p65 in H4 cells exposed to C. sakazakii, which was prevented in PCM-pretreated cells. Finally, treatment of neonatal mice with PCM prior to infection sustained the capacity of ileal epithelial proliferation. This study suggests that an active component(s) released into the culture medium by B. infantis may prevent ileal damage by a pathogen linked to NEC. PMID:24627567

Fate of Enterobacter sakazakii attached to or in biofilms on stainless steel upon exposure to various temperatures or relative humidities.

PubMed

Kim, Hoikyung; Bang, Jihyun; Beuchat, Larry R; Ryu, Jee-Hoon

2008-05-01

Survival of Enterobacter sakazakii dried on the surface of stainless steel and exposed to 43% relative humidity, as affected by temperature, was studied. Populations of E. sakazakii (7.4 to 8.6 log CFU per coupon) on coupons dried for 2 h at 22 degrees C decreased significantly (P < or = 0.05) at 4, 25, and 37 degrees C within 10, 3, and 1 day(s), respectively, but the pathogen remained viable for up to 60 days. At a given storage temperature and time, reductions were significantly greater when cells had been suspended in water rather than in infant formula before drying. Formation of biofilm by E. sakazakii on stainless steel immersed in M9 medium, which contains minimal concentrations of nutrients, and infant formula at 25 degrees C and subsequent survival of cells at 25 degrees C as affected by exposure to 23, 43, 68, 85, and 100% relative humidity were investigated. Some of the cells in these biofilms survived under all test relative humidities for up to 42 days. The overall order of survival as affected by relative humidity was 100 > 23 = 43 = 68 > 85% relative humidity, regardless of the medium in which the biofilm was formed. Reduction in viability of cells was significantly greater in biofilm that had formed in M9 medium than in biofilm formed in infant formula. Results indicate that infant formula provides protection for attached cells, as well as cells in biofilm, against lethality on exposure to desiccation. These results are useful when predicting the survival characteristics of E. sakazakii on stainless steel surfaces in processing and preparation kitchen environments.

Cronobacter sakazakii: stress survival and virulence potential in an opportunistic foodborne pathogen.

PubMed

Feeney, Audrey; Kropp, Kai A; O'Connor, Roxana; Sleator, Roy D

2014-01-01

A characteristic feature of the opportunistic foodborne pathogen Cronobacter sakazakii is its ability to survive in extremely arid environments, such as powdered infant formula, making it a dangerous opportunistic pathogen of individuals of all age groups, especially infants and neonates. Herein, we provide a brief overview of the pathogen; clinical manifestations, environmental reservoirs and our current understanding of stress response mechanisms and virulence factors which allow it to cause disease.

Cronobacter sakazakii: stress survival and virulence potential in an opportunistic foodborne pathogen

PubMed Central

Feeney, Audrey; Kropp, Kai A; O’Connor, Roxana; Sleator, Roy D

2014-01-01

A characteristic feature of the opportunistic foodborne pathogen Cronobacter sakazakii is its ability to survive in extremely arid environments, such as powdered infant formula, making it a dangerous opportunistic pathogen of individuals of all age groups, especially infants and neonates. Herein, we provide a brief overview of the pathogen; clinical manifestations, environmental reservoirs and our current understanding of stress response mechanisms and virulence factors which allow it to cause disease. PMID:25562731

Genomic characterization of malonate positive Cronobacter sakazakii serotype O:2, sequence type 64 strains, isolated from clinical, food, and environment samples.

PubMed

Gopinath, Gopal R; Chase, Hannah R; Gangiredla, Jayanthi; Eshwar, Athmanya; Jang, Hyein; Patel, Isha; Negrete, Flavia; Finkelstein, Samantha; Park, Eunbi; Chung, TaeJung; Yoo, YeonJoo; Woo, JungHa; Lee, YouYoung; Park, Jihyeon; Choi, Hyerim; Jeong, Seungeun; Jun, Soyoung; Kim, Mijeong; Lee, Chaeyoon; Jeong, HyeJin; Fanning, Séamus; Stephan, Roger; Iversen, Carol; Reich, Felix; Klein, Günter; Lehner, Angelika; Tall, Ben D

2018-01-01

Malonate utilization, an important differential trait, well recognized as being possessed by six of the seven Cronobacter species is thought to be largely absent in Cronobacter sakazakii (Csak). The current study provides experimental evidence that confirms the presence of a malonate utilization operon in 24 strains of sequence type (ST) 64, obtained from Europe, Middle East, China, and USA; it offers explanations regarding the genomic diversity and phylogenetic relatedness among these strains, and that of other C. sakazakii strains. In this study, the presence of a malonate utilization operon in these strains was initially identified by DNA microarray analysis (MA) out of a pool of 347 strains obtained from various surveillance studies involving clinical, spices, milk powder sources and powdered infant formula production facilities in Ireland and Germany, and dried dairy powder manufacturing facilities in the USA. All ST64 C. sakazakii strains tested could utilize malonate. Zebrafish embryo infection studies showed that C. sakazakii ST64 strains are as virulent as other Cronobacter species. Parallel whole genome sequencing (WGS) and MA showed that the strains phylogenetically grouped as a separate clade among the Csak species cluster. Additionally, these strains possessed the Csak O:2 serotype. The nine-gene, ~ 7.7 kbp malonate utilization operon was located in these strains between two conserved flanking genes, gyrB and katG. Plasmidotyping results showed that these strains possessed the virulence plasmid pESA3, but in contrast to the USA ST64 Csak strains, ST64 Csak strains isolated from sources in Europe and the Middle East, did not possess the type six secretion system effector vgrG gene. Until this investigation, the presence of malonate-positive Csak strains, which are associated with foods and clinical cases, was under appreciated. If this trait was used solely to identify Cronobacter strains, many strains would likely be misidentified. Parallel WGS and

Emergence of Colistin Resistance Gene mcr-1 in Cronobacter sakazakii Producing NDM-9 and in Escherichia coli from the Same Animal.

PubMed

Liu, Bao-Tao; Song, Feng-Jing; Zou, Ming; Hao, Zhi-Hui; Shan, Hu

2017-02-01

We report the presence of mcr-1 in Escherichia coli and carbapenem-resistant Cronobacter sakazakii from the same diseased chicken. The mcr-1 gene linked with ISApl1 was located on two different IncI2 plasmids, including one multidrug plasmid in E. coli, whereas fosA3-bla NDM-9 was on an IncB/O plasmid in C. sakazakii The development of the fosA3-bla NDM-9 resistance region was mediated by IS26 The colocation of mcr-1 or bla NDM-9 with other resistance genes will accelerate the dissemination of the two genes. Copyright © 2017 American Society for Microbiology.

Attachment of and biofilm formation by Enterobacter sakazakii on stainless steel and enteral feeding tubes.

PubMed

Kim, Hoikyung; Ryu, Jee-Hoon; Beuchat, Larry R

2006-09-01

Enterobacter sakazakii has been reported to form biofilms, but environmental conditions affecting attachment to and biofilm formation on abiotic surfaces have not been described. We did a study to determine the effects of temperature and nutrient availability on attachment and biofilm formation by E. sakazakii on stainless steel and enteral feeding tubes. Five strains grown to stationary phase in tryptic soy broth (TSB), infant formula broth (IFB), or lettuce juice broth (LJB) at 12 and 25 degrees C were examined for the extent to which they attach to these materials. Higher populations attached at 25 degrees C than at 12 degrees C. Stainless steel coupons and enteral feeding tubes were immersed for 24 h at 4 degrees C in phosphate-buffered saline suspensions (7 log CFU/ml) to facilitate the attachment of 5.33 to 5.51 and 5.03 to 5.12 log CFU/cm(2), respectively, before they were immersed in TSB, IFB, or LJB, followed by incubation at 12 or 25 degrees C for up to 10 days. Biofilms were not produced at 12 degrees C. The number of cells of test strains increased by 1.42 to 1.67 log CFU/cm(2) and 1.16 to 1.31 log CFU/cm(2) in biofilms formed on stainless steel and feeding tubes, respectively, immersed in IFB at 25 degrees C; biofilms were not formed on TSB and LJB at 25 degrees C, indicating that nutrient availability plays a major role in processes leading to biofilm formation on the surfaces of these inert materials. These observations emphasize the importance of temperature control in reconstituted infant formula preparation and storage areas in preventing attachment and biofilm formation by E. sakazakii.

Identification of genes involved in serum tolerance in the clinical strain Cronobacter sakazakii ES5.

PubMed

Schwizer, Sarah; Tasara, Taurai; Zurfluh, Katrin; Stephan, Roger; Lehner, Angelika

2013-02-15

Cronobacter spp. are opportunistic pathogens that can cause septicemia and infections of the central nervous system primarily in premature, low-birth weight and/or immune-compromised neonates. Serum resistance is a crucial virulence factor for the development of systemic infections, including bacteremia. It was the aim of the current study to identify genes involved in serum tolerance in a selected Cronobacter sakazakii strain of clinical origin. Screening of 2749 random transposon knock out mutants of a C. sakazakii ES 5 library for modified serum tolerance (compared to wild type) revealed 10 mutants showing significantly increased/reduced resistance to serum killing. Identification of the affected sites in mutants displaying reduced serum resistance revealed genes encoding for surface and membrane proteins as well as regulatory elements or chaperones. By this approach, the involvement of the yet undescribed Wzy_C superfamily domain containing coding region in serum tolerance was observed and experimentally confirmed. Additionally, knock out mutants with enhanced serum tolerance were observed. Examination of respective transposon insertion loci revealed regulatory (repressor) elements, coding regions for chaperones and efflux systems as well as the coding region for the protein YbaJ. Real time expression analysis experiments revealed, that knock out of the gene for this protein negatively affects the expression of the fimA gene, which is a key structural component of the formation of fimbriae. Fimbriae are structures of high immunogenic potential and it is likely that absence/truncation of the ybaJ gene resulted in a non-fimbriated phenotype accounting for the enhanced survival of this mutant in human serum. By using a transposon knock out approach we were able to identify genes involved in both increased and reduced serum tolerance in Cronobacter sakazakii ES5. This study reveals first insights in the complex nature of serum tolerance of Cronobacter spp.

Endangered Mangroves in Segara Anakan, Indonesia: Effective and Failed Problem-Solving Policy Advice.

PubMed

Dharmawan, Budi; Böcher, Michael; Krott, Max

2017-09-01

The success of scientific knowledge transfer depends on if the decision maker can transform the scientific advice into a policy that can be accepted by all involved actors. We use a science-policy interactions model called research-integration-utilization to observe the process of scientific knowledge transfer in the case of endangered mangroves in Segara Anakan, Indonesia. Scientific knowledge is produced within the scientific system (research), science-based solutions to problems are practically utilized by political actors (utilization), and important links between research and utilization must be made (integration). We looked for empirical evidence to test hypotheses about the research-integration-utilization model based on document analysis and expert interviews. Our study finds that the failures in knowledge transfer are caused by the inappropriate use of scientific findings. The district government is expected by presidential decree to only used scientifically sound recommendations as a prerequisite for designing the regulation. However, the district government prefers to implement their own solutions because they believe that they understand the solutions better than the researcher. In the process of integration, the researcher cannot be involved, since the selection of scientific recommendations here fully depends on the interests of the district government as the powerful ally.

Endangered Mangroves in Segara Anakan, Indonesia: Effective and Failed Problem-Solving Policy Advice

NASA Astrophysics Data System (ADS)

Dharmawan, Budi; Böcher, Michael; Krott, Max

2017-09-01

The success of scientific knowledge transfer depends on if the decision maker can transform the scientific advice into a policy that can be accepted by all involved actors. We use a science-policy interactions model called research-integration-utilization to observe the process of scientific knowledge transfer in the case of endangered mangroves in Segara Anakan, Indonesia. Scientific knowledge is produced within the scientific system (research), science-based solutions to problems are practically utilized by political actors (utilization), and important links between research and utilization must be made (integration). We looked for empirical evidence to test hypotheses about the research-integration-utilization model based on document analysis and expert interviews. Our study finds that the failures in knowledge transfer are caused by the inappropriate use of scientific findings. The district government is expected by presidential decree to only used scientifically sound recommendations as a prerequisite for designing the regulation. However, the district government prefers to implement their own solutions because they believe that they understand the solutions better than the researcher. In the process of integration, the researcher cannot be involved, since the selection of scientific recommendations here fully depends on the interests of the district government as the powerful ally.

The potential of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry for the identification of biogroups of Cronobacter sakazakii.

PubMed

Karamonová, Ludmila; Junková, Petra; Mihalová, Denisa; Javůrková, Barbora; Fukal, Ladislav; Rauch, Pavel; Blažková, Martina

2013-02-15

The bacterial genus Cronobacter was established quite recently, in 2008. Therefore, its systematic classification is still in progress as well as the risk assessment of Cronobacter strains. The possibility of rapid identification within the biogroup level has an essential epidemiological significance. We examined the potential of mass spectrometry to accomplish this task on species Cronobacter sakazakii comprising eight different biogroups. Members of all Cronobacter sakazakii biogroups were characterized by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) using intact cells. Analyses were performed on a Biflex IV MALDI-TOF mass spectrometer in the range of 2000 to 20 000 Da in linear mode with an accelerated voltage of 19 kV. Optimal conditions for a proper identification of biogroups, such as suitable cultivation media or growth time of bacteria, were investigated. The biomarker patterns characterizing each of the Cronobacter sakazakii biogroups were obtained. The established identification protocol was applied to ten previously non-identified strains and their biogroups were successfully determined. The presented work is the first report of successful and rapid bacterial biogroup taxonomy classification using MALDI-TOF-MS that could substitute demanding biochemical testing. Copyright © 2012 John Wiley & Sons, Ltd.

Comparative proteomic analysis of Cronobacter sakazakii isolates with different virulences.

PubMed

Du, Xin-jun; Han, Ran; Li, Ping; Wang, Shuo

2015-10-14

Cronobacter is a genus of widespread, opportunistic, foodborne pathogens that can result in serious illnesses in at-risk infants because of their immature immunity and high dependence on powdered formula, which is one of the foods most often contaminated by this pathogen. However, limited information is available regarding the pathogenesis and the specific virulence factors of this species. In this study, the virulences of 42 Cronobacter sakazakii isolates were analyzed by infecting neonatal SD rats. A comparison of the typing patterns of the isolates enabled groups with close relationships but that exhibited distinct pathogenesis to be identified. Among these groups, 2 strains belonging to the same group but showing distinct virulences were selected, and 2-DE was applied to identify differentially expressed proteins, focusing on virulence-related proteins. A total of 111 protein spots were identified using matrix-assisted laser desorption/ionization time-of-flight tandem mass spectrometry (MALDI-TOF/TOF-MS), and 89 were successfully identified. Further analysis suggested that at least 11 of these proteins may be involved in the pathogenesis of this pathogen. Real-time PCR was carried out to further confirm the differential expression pattern of the genes, and the results indicated that the mRNA expression levels were consistent with the protein expression levels. The virulence factors and pathogenesis of Cronobacter are largely unknown. In combination with animal toxicological experiments and subtyping results of C. sakazakii, comparative proteomics analysis was performed to comprehensively evaluate the differentially expressed proteins of two isolates that exhibited distinct virulence but were closely related. These procedures made it possible to identify the virulence-related of factors of Cronobacter. Among the 89 total identified proteins, at least 11 show virulence-related potential. This work provides comprehensive candidates for the further investigation of

Good Advice

ERIC Educational Resources Information Center

Dryden, Lisa S.

2005-01-01

Letter writing in a "Dear Abby" format can encourage your reluctant writers to dig deeper into books by dispensing advice to troubled characters When this author's triplet daughters were in the fifth grade and wrote the advice column for their school newspaper, she discovered giving advice can motivate reluctant writers. This realization prompted …

Presence of AmpC beta-lactamases, CSA-1, CSA-2, CMA-1, and CMA-2 conferring an unusual resistance phenotype in Cronobacter sakazakii and Cronobacter malonaticus.

PubMed

Müller, Andrea; Hächler, Herbert; Stephan, Roger; Lehner, Angelika

2014-08-01

Here we describe the presence of two very similar but unusual variants of AmpC cephalosporinase in each Cronobacter sakazakii and C. malonaticus isolates conferring resistance exclusively to first generation cephalosporins. During a survey on the antibiotic resistance patterns of C. sakazakii and C. malonaticus strains isolated from a milk powder production facility, originally two different phenotypes regarding the susceptibility/resistance for the two beta-lactam antibiotics ampicillin (amp) and cephalothin (ceph) were observed: (i) isolates being susceptible for both antibiotics (amp(S)/ceph(S)), and (ii) strains exhibiting susceptibility to ampicillin but resistance to cephalothin (amp(S)/ceph(R)). The latter phenotype (amp(S)/ceph(R)) was observed in the majority of the environmental strains from the facility. Analysis of whole genome sequences of C. sakazakii revealed a gene putatively coding for an AmpC beta-lactamase. Consequently, the ampC genes from both species and both phenotypes were subjected to a cloning approach. Surprisingly, when expressed in Escherichia coli, all transformants exhibited the amp(S)/ceph(R) phenotype regardless of (i) the phenotypic backgrounds or (ii) the AmpC amino acid sequences of the original strains from which the clones were derived. The novel AmpC beta-lactamases were designated CSA-1 and CSA-2 (from C. sakazakii) and CMA-1 and CMA-2 (from C. malonaticus). The observed variations in the minimum inhibitory concentration (MIC) levels for cephalothin (wt compared to transformants) suggest that this feature is a target of a yet unknown regulatory mechanism present in the natural Cronobacter background but absent in the neutral E. coli host.

Cronobacter, the emergent bacterial pathogen Enterobacter sakazakii comes of age; MLST and whole genome sequence analysis.

PubMed

Forsythe, Stephen J; Dickins, Benjamin; Jolley, Keith A

2014-12-16

Following the association of Cronobacter spp. to several publicized fatal outbreaks in neonatal intensive care units of meningitis and necrotising enterocolitis, the World Health Organization (WHO) in 2004 requested the establishment of a molecular typing scheme to enable the international control of the organism. This paper presents the application of Next Generation Sequencing (NGS) to Cronobacter which has led to the establishment of the Cronobacter PubMLST genome and sequence definition database (http://pubmlst.org/cronobacter/) containing over 1000 isolates with metadata along with the recognition of specific clonal lineages linked to neonatal meningitis and adult infections Whole genome sequencing and multilocus sequence typing (MLST) has supports the formal recognition of the genus Cronobacter composed of seven species to replace the former single species Enterobacter sakazakii. Applying the 7-loci MLST scheme to 1007 strains revealed 298 definable sequence types, yet only C. sakazakii clonal complex 4 (CC4) was principally associated with neonatal meningitis. This clonal lineage has been confirmed using ribosomal-MLST (51-loci) and whole genome-MLST (1865 loci) to analyse 107 whole genomes via the Cronobacter PubMLST database. This database has enabled the retrospective analysis of historic cases and outbreaks following re-identification of those strains. The Cronobacter PubMLST database offers a central, open access, reliable sequence-based repository for researchers. It has the capacity to create new analysis schemes 'on the fly', and to integrate metadata (source, geographic distribution, clinical presentation). It is also expandable and adaptable to changes in taxonomy, and able to support the development of reliable detection methods of use to industry and regulatory authorities. Therefore it meets the WHO (2004) request for the establishment of a typing scheme for this emergent bacterial pathogen. Whole genome sequencing has additionally shown a range

Whole-Genome Sequences of Cronobacter sakazakii Isolates Obtained from Foods of Plant Origin and Dried-Food Manufacturing Environments.

PubMed

Jang, Hyein; Addy, Nicole; Ewing, Laura; Jean-Gilles Beaubrun, Junia; Lee, YouYoung; Woo, JungHa; Negrete, Flavia; Finkelstein, Samantha; Tall, Ben D; Lehner, Angelika; Eshwar, Athmanya; Gopinath, Gopal R

2018-04-12

Here, we present draft genome sequences of 29 Cronobacter sakazakii isolates obtained from foods of plant origin and dried-food manufacturing facilities. Assemblies and annotations resulted in genome sizes ranging from 4.3 to 4.5 Mb and 3,977 to 4,256 gene-coding sequences with G+C contents of ∼57.0%.

Use of enhanced nisin derivatives in combination with food-grade oils or citric acid to control Cronobacter sakazakii and Escherichia coli O157:H7.

PubMed

Campion, Alicia; Morrissey, Ruth; Field, Des; Cotter, Paul D; Hill, Colin; Ross, R Paul

2017-08-01

Cronobacter sakazakii and Escherichia coli O157:H7 are well known food-borne pathogens that can cause severe disease. The identification of new alternatives to heating to control these pathogens in foods, while reducing the impact on organoleptic properties and nutritional value, is highly desirable. In this study, nisin and its bioengineered variants, nisin V and nisin S29A, are used alone, or in combination with plant essential oils (thymol, carvacrol and trans-cinnamaldehyde) or citric acid, with a view to controlling C. sakazakii and E. coli O157:H7 in laboratory-based assays and model food systems. The use of nisin variants (30 μM) with low concentrations of thymol (0.015%), carvacrol (0.03%) and trans-cinnamaldehyde (0.035%) resulted in extended lag phases of growth compared to those for corresponding nisin A-essential oil combinations. Furthermore, nisin variants (60 μM) used in combination with carvacrol (0.03%) significantly reduced viable counts of E. coli O157:H7 (3-log) and C. sakazakii (4-log) compared to nisin A-carvacrol treatment. Importantly, this increased effectiveness translated into food. More specifically, sub-inhibitory concentrations of nisin variants and carvacrol caused complete inactivation of E. coli O157:H7 in apple juice within 3 h at room temperature compared to that of the equivalent nisin A combination. Furthermore, combinations of commercial Nisaplin and the food additive citric acid reduced C. sakazakii numbers markedly in infant formula within the same 3 h period. These results highlight the potential benefits of combining nisin and variants thereof with carvacrol and/or citric acid for the inhibition of Gram negative food-borne pathogens. Copyright © 2017 Elsevier Ltd. All rights reserved.

Whole-Genome Sequences of Cronobacter sakazakii Isolates Obtained from Foods of Plant Origin and Dried-Food Manufacturing Environments

PubMed Central

Addy, Nicole; Ewing, Laura; Jean-Gilles Beaubrun, Junia; Lee, YouYoung; Woo, JungHa; Negrete, Flavia; Finkelstein, Samantha; Tall, Ben D.; Lehner, Angelika; Eshwar, Athmanya; Gopinath, Gopal R.

2018-01-01

ABSTRACT Here, we present draft genome sequences of 29 Cronobacter sakazakii isolates obtained from foods of plant origin and dried-food manufacturing facilities. Assemblies and annotations resulted in genome sizes ranging from 4.3 to 4.5 Mb and 3,977 to 4,256 gene-coding sequences with G+C contents of ∼57.0%. PMID:29650569

Here's Advice on Cutting Staff (From Those Who've Done It).

ERIC Educational Resources Information Center

Hill, T. Susan

1982-01-01

Using the experiences of individual school districts, such as the Yonkers (New York) Public Schools, the author provides advice on how a board should carry out a reduction in force (RIF). She stresses the need to develop a written RIF policy and recommends involving staff and the community in the policy development process. Issues the policy…

Short communication: Roles of outer membrane protein W (OmpW) on survival and biofilm formation of Cronobacter sakazakii under neomycin sulfate stress.

PubMed

Ye, Yingwang; Ling, Na; Gao, Jina; Zhang, Maofeng; Zhang, Xiyan; Tong, Liaowang; Ou, Dexin; Wang, Yaping; Zhang, Jumei; Wu, Qingping

2018-04-01

Cronobacter sakazakii is associated with severe infections including sepsis, neonatal meningitis, and necrotizing enterocolitis. Antibiotic resistance in Cronobacter species has been documented in recent years, but the genes involved in resistance in Cronobacter strains are poorly understood. In this study, we determined the role of outer membrane protein W (OmpW) on survival rates, morphologic changes, and biofilm formation between wild type (WT) and an OmpW mutant strain (ΔOmpW) under neomycin sulfate stress. Results indicated that the survival rates of ΔOmpW were significantly reduced after half minimum inhibitory concentration (½ MIC) treatment compared with the WT strain. Filamentation of C. sakazakii cells was observed after ½ MIC treatment in WT and ΔOmpW, and morphologic injury, including cell disruption and leakage of cells, was more predominant in ΔOmpW. Under ½ MIC stress, the biofilms of WT and ΔOmpW were significantly decreased, but decreasing rates of biofilm formation in mutant strain were more predominant compared with WT strain. This is the first report to determine the role of OmpW on survival, morphological changes, and biofilm formation in C. sakazakii under neomycin sulfate stress. The findings indicated that OmpW contributed to survival and reduction of morphological injury under neomycin sulfate stress. In addition, enhancing biofilm formation in ΔOmpW may be an alternative advantage for adaptation to neomycin sulfate stress. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Escherichia coli and Cronobacter sakazakii in 'Tommy Atkins' minimally processed mangos: Survival, growth and effect of UV-C and electrolyzed water.

PubMed

Santo, David; Graça, Ana; Nunes, Carla; Quintas, Célia

2018-04-01

These studies were aimed at assessing the growing capacity of Escherichia coli and Cronobacter sakazakii and the effectiveness of Ultraviolet-C (UV-C) radiation, acidic electrolyzed (AEW) and neutral electrolyzed (NEW) waters in the inhibition of these bacteria on minimally processed 'Tommy Atkins' mangoes (MPM). The fruits were contaminated by dip inoculation and kept 10 days at 4, 8, 12 and 20 °C while enumerating bacteria. Contaminated mangoes were disinfected using UV-C (2.5, 5, 7.5 and 10 kJ/m 2 ), AEW, NEW and sodium hypochlorite (SH) and the microorganisms were monitored. None of the enterobacteria grew at 4, 8 and 12 °C regardless of having persisted during the 10-day period. At 20 °C, E. coli and C. sakazakii grew, after adaption phases of 48 h and 24 h, to values of 8.7 and 8.5 log cfu/g at day eight, respectively. E. coli showed the highest reduction counts on the MPM washed with NEW and SH (2.2 log cfu/g). UV-C was more effective in reducing C. sakazakii (2.4-2.6 log cfu/g), when compared to AEW, NEW and SH (1.2-1.8 log cfu/g). The efficacy of decontamination technologies depends on microorganisms, highlighting the importance of preventing contamination at the primary production and of combining different methods to increase the safety of fresh-cut fruits. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is Some Provider Advice on Smoking Cessation Better Than No Advice? An Instrumental Variable Analysis of the 2001 National Health Interview Survey

PubMed Central

Bao, Yuhua; Duan, Naihua; Fox, Sarah A

2006-01-01

Research Objective To estimate the effect of provider advice in routine clinical contacts on patient smoking cessation outcome. Data Source The Sample Adult File from the 2001 National Health Interview Survey. We focus on adult patients who were either current smokers or quit during the last 12 months and had some contact with the health care providers or facilities they most often went to for acute or preventive care. Study Design We estimate a joint model of self-reported smoking cessation and ever receiving advice to quit during medical visits in the past 12 months. Because providers are more likely to advise heavier smokers and/or patients already diagnosed with smoking-related conditions, we use provider advice for diet/nutrition and for physical activity reported by the same patient as instrumental variables for smoking cessation advice to mitigate the selection bias. We conduct additional analyses to examine the robustness of our estimate against the various scenarios by which the exclusion restriction of the instrumental variables may fail. Principal Findings Provider advice doubles the chances of success in (self-reported) smoking cessation by their patients. The probability of quitting by the end of the 12-month reference period increased from 6.9 to 14.7 percent, an effect that is of both statistical (p<.001) and clinical significance. Conclusions Provider advice delivered in routine practice settings has a substantial effect on the success rate of smoking cessation among smoking patients. Providing advice consistently to all smoking patients, compared with routine care, is more effective than doubling the federal excise tax and, in the longer run, likely to outperform some of the other tobacco control policies such as banning smoking in private workplaces. PMID:17116112

Effect of heat shock on the fatty acid and protein profiles of Cronobacter sakazakii BCRC 13988 as well as its growth and survival in the presence of various carbon, nitrogen sources and disinfectants.

PubMed

Li, Po-Ting; Hsiao, Wan-Ling; Yu, Roch-Chui; Chou, Cheng-Chun

2013-12-01

In the present study, Cronobacter sakazakii, a foodborne pathogen, was first subjected to heat shock at 47 °C for 15 min. Effect of heat shock on the fatty acid and protein profiles, carbon and nitrogen source requirements as well as the susceptibilities of C. sakazakii to Clidox-S, a chlorine-containing disinfectant and Quatricide, a quaternary ammonium compound were investigated. Results revealed that heat shock increased the proportion of myristic acid (14:0), palmitic acid (16:0) and the ratio of saturated fatty acid to unsaturated fatty acid, while reducing the proportion of palmitoleic acid (16:1) and cis-vacceric acid (18:1). In addition, eleven proteins showed enhanced expression, while one protein showed decreased expression in the heat-shocked compared to the non-heat-shocked cells. Non-heat-shocked cells in the medium supplemented with beef extract exhibited the highest maximum population. On the contrary, the highest maximum population of heat-shocked C. sakazakii was noted in the medium having either tryptone or yeast extract as the nitrogen source. Among the various carbon sources examined, the growth of the test organism, regardless of heat shock, was greatest in the medium having glucose as the carbon source. Furthermore, heat shock enhanced the resistance of C. sakazakii to Clidox-S or Quatricide. Copyright © 2013 Elsevier Ltd. All rights reserved.

Protein sequences insight into heavy metal tolerance in Cronobacter sakazakii BAA-894 encoded by plasmid pESA3.

PubMed

Chaturvedi, Navaneet; Kajsik, Michal; Forsythe, Stephen; Pandey, Paras Nath

2015-12-01

The recently annotated genome of the bacterium Cronobacter sakazakii BAA-894 suggests that the organism has the ability to bind heavy metals. This study demonstrates heavy metal tolerance in C. sakazakii, in which proteins with the heavy metal interaction were recognized by computational and experimental study. As the result, approximately one-fourth of proteins encoded on the plasmid pESA3 are proposed to have potential interaction with heavy metals. Interaction between heavy metals and predicted proteins was further corroborated using protein crystal structures from protein data bank database and comparison of metal-binding ligands. In addition, a phylogenetic study was undertaken for the toxic heavy metals, arsenic, cadmium, lead and mercury, which generated relatedness clustering for lead, cadmium and arsenic. Laboratory studies confirmed the organism's tolerance to tellurite, copper and silver. These experimental and computational study data extend our understanding of the genes encoding for proteins of this important neonatal pathogen and provide further insights into the genotypes associated with features that can contribute to its persistence in the environment. The information will be of value for future environmental protection from heavy toxic metals.

Comparison of desiccation tolerance among Listeria monocytogenes, Escherichia coli O157:H7, Salmonella enterica, and Cronobacter sakazakii in powdered infant formula.

PubMed

Koseki, Shigenobu; Nakamura, Nobutaka; Shiina, Takeo

2015-01-01

Bacterial pathogens such as Listeria monocytogenes, Escherichia coli O157:H7, Salmonella enterica, and Cronobacter sakazakii have demonstrated long-term survival in/on dry or low-water activity (aw) foods. However, there have been few comparative studies on the desiccation tolerance among these bacterial pathogens separately in a same food matrix. In the present study, the survival kinetics of the four bacterial pathogens separately inoculated onto powdered infant formula as a model low-aw food was compared during storage at 5, 22, and 35°C. No significant differences in the survival kinetics between E. coli O157:H7 and L. monocytogenes were observed. Salmonella showed significantly higher desiccation tolerance than these pathogens, and C. sakazakii demonstrated significantly higher desiccation tolerance than all other three bacteria studied. Thus, the desiccation tolerance was represented as C. sakazakii > Salmonella > E. coli O157:H7 = L. monocytogenes. The survival kinetics of each bacterium was mathematically analyzed, and the observed kinetics was successfully described using the Weibull model. To evaluate the variability of the inactivation kinetics of the tested bacterial pathogens, the Monte Carlo simulation was performed using assumed probability distribution of the estimated fitted parameters. The simulation results showed that the storage temperature significantly influenced survival of each bacterium under the dry environment, where the bacterial inactivation became faster with increasing storage temperature. Furthermore, the fitted rate and shape parameters of the Weibull model were successfully modelled as a function of temperature. The numerical simulation of the bacterial inactivation was realized using the functions of the parameters under arbitrary fluctuating temperature conditions.

Influence of sweet whey protein concentrate and its hydrolysates on host-pathogen interactions in the emerging foodborne pathogen Cronobacter sakazakii.

PubMed

McEvoy, K; Hayes, J; Kealey, C; Brady, D

2016-09-01

Antimicrobial resistance poses a significant global healthcare predicament. An attractive approach to the dilemma of drug-resistant bacteria is the development and use of agents that interfere with the ability of pathogens to adhere to human tissue. The influence of sweet whey protein concentrate (SWPC), and selected hydrolysates of this material, on host-pathogen interactions of Cronobacter sakazakii (ATCC 29544) was investigated. CaCo-2 cell line was selected as a suitable model for the human intestinal epithelium. Cronobacter sakazakiiATCC 29544 was identified as the strain with the highest adhesion efficiency. SWPC reduced its association by 80% (P < 0·01), invasion 35% (P < 0·01), and translocation >95% (P < 0·001). SWPC enzymatically modified with lipase, trypsin and pepsin had variable effects on these behaviours with the most significant effect exhibited with the lipase treatment. SWPC produced an almost total inhibition of translocation of C. sakazakii across a CaCo-2 cell monolayer. Lipase and pepsin treated SWPC also reduced translocation by 75% and 90% respectively. However, trypsin treatment nullified the effect SWPC had on translocation. The presence of viable bacterial cells and SWPC both increased expression of IL-8 following Cronobacter invasion into CaCo-2 cells. Factors governing adherence, invasion and translocation of Cronobacter spp. to human intestinal cells are multi-factorial and digested milk products exhibit varying effects dependant on their enzyme modification and protein lipid content. These findings contribute to our, as yet, incomplete understanding of Cronobacter pathogenesis, and suggest that SWPC in whole and enzymatically hydrolysed forms, may provide a cost-effective source of bioactive materials with inhibitory effects on bacterial virulence. © 2016 The Society for Applied Microbiology.

Development of Multiplex Real-time PCR with Internal Amplification Control for Simultaneous Detection of Salmonella and Cronobacter sakazakii in Powdered Infant Formula.

USDA-ARS?s Scientific Manuscript database

Contamination of powdered infant formula (PIF) by the bacteria Cronobacter sakazakii and Salmonella enterica was deemed a matter of great concern by the World Health Organization and the Food and Agriculture Organization of the United Nations in 2004. Therefore, we developed a rapid and sensitive m...

Millennials at Work: The Advice of Great Leaders

DTIC Science & Technology

2015-04-01

Millennials at Work The Advice of Great Leaders Carol Axten Axten has more than 30 years of experience in Defense Department engineering, program...management, and policy development. She has graduate degrees in business , engineering, international relations, and national security resource strategy...million members of the millennial generation will enter the workforce and by 2030 will make up 75 percent of all working professionals. As managers in the

Instructional Advice, Time Advice and Learning Questions in Computer Simulations

ERIC Educational Resources Information Center

Rey, Gunter Daniel

2010-01-01

Undergraduate students (N = 97) used an introductory text and a computer simulation to learn fundamental concepts about statistical analyses (e.g., analysis of variance, regression analysis and General Linear Model). Each learner was randomly assigned to one cell of a 2 (with or without instructional advice) x 2 (with or without time advice) x 2…

The Straightforwardness of Advice: Advice-Giving in Interactions Between Swedish District Nurses and Patients.

ERIC Educational Resources Information Center

Leppanen, Vesa

1998-01-01

A study examined advice-giving interactions between Swedish district nurses and patients, comparing these sequences with parallel interactions between British health visitors and first-time mothers in previous research. Analysis focused on how advice-giving is organized in the settings, including how advice is initiated and designed, its…

Capsular profiling of the Cronobacter genus and the association of specific Cronobacter sakazakii and C. malonaticus capsule types with neonatal meningitis and necrotizing enterocolitis.

PubMed

Ogrodzki, P; Forsythe, S

2015-10-08

Cronobacter sakazakii and C. malonaticus can cause serious diseases especially in infants where they are associated with rare but fatal neonatal infections such as meningitis and necrotising enterocolitis. This study used 104 whole genome sequenced strains, covering all seven species in the genus, to analyse capsule associated clusters of genes involved in the biosynthesis of the O-antigen, colanic acid, bacterial cellulose, enterobacterial common antigen (ECA), and a previously uncharacterised K-antigen. Phylogeny of the gnd and galF genes flanking the O-antigen region enabled the defining of 38 subgroups which are potential serotypes. Two variants of the colanic acid synthesis gene cluster (CA1 and CA2) were found which differed with the absence of galE in CA2. Cellulose (bcs genes) were present in all species, but were absent in C. sakazakii sequence type (ST) 13 and clonal complex (CC) 100 strains. The ECA locus was found in all strains. The K-antigen capsular polysaccharide Region 1 (kpsEDCS) and Region 3 (kpsMT) genes were found in all Cronobacter strains. The highly variable Region 2 genes were assigned to 2 homology groups (K1 and K2). C. sakazakii and C. malonaticus isolates with capsular type [K2:CA2:Cell(+)] were associated with neonatal meningitis and necrotizing enterocolitis. Other capsular types were less associated with clinical infections. This study proposes a new capsular typing scheme which identifies a possible important virulence trait associated with severe neonatal infections. The various capsular polysaccharide structures warrant further investigation as they could be relevant to macrophage survival, desiccation resistance, environmental survival, and biofilm formation in the hospital environment, including neonatal enteral feeding tubes.

Efficacy of the thin agar layer method for the recovery of stressed Cronobacter spp. (Enterobacter sakazakii).

PubMed

Osaili, Tareq M; Al-Nabulsi, Anas A; Shaker, Reyad R; Al-Holy, Murad M; Al-Haddaq, Mohammed S; Olaimat, Amin N; Ayyash, Mutamed M; Al Ta'ani, Mahmoud K; Forsythe, Stephen J

2010-10-01

Cronobacter spp. (Enterobacter sakazakii) are emerging opportunistic pathogens for all age groups, and are of particular concern when it comes to infants. Prior to contaminating food, the organism may be exposed to a variety of stresses, leading to a generation of sublethally injured cells that may not be detected by selective media unless a protracted recovery period is included in the isolation procedure. This study evaluated the efficacy of the thin agar layer (TAL) method for the recovery of Cronobacter cells that had been exposed to various stress conditions. Five strains of C. sakazakii and C. muytjensii were exposed to starvation, heat, cold, acid, alkaline, chlorine, or ethanol, with or without further exposure to desiccation stress. The recovery of the stressed cells was determined on tryptone soy agar (TSA; nonselective control medium), violet red bile glucose agar (VRBGA; selective agar), Druggan-Forsythe-Iversen (DFI; selective agar), and TAL media (viz., VRBGA overlaid with TSA, and DFI overlaid with TSA). Regardless of stress type, there were no significant differences among the recoveries of stressed desiccated Cronobacter spp. cultures on TSA, DFI+TSA, and VRBGA+TSA, but there was significantly less recovery on VRBGA. The recovery of prestressed desiccated Cronobacter spp. on DFI+TSA was similar to that on TSA, whereas the recovery on VRBGA+TSA was lower. DFI+TSA performed better than VRBGA+TSA did in differentiating Cronobacter spp. within mixed bacterial cultures. The results of this study suggest the use of the TAL method DFI+TSA as an improved method for the direct recovery of stressed Cronobacter spp.

Research in geosciences policy

NASA Technical Reports Server (NTRS)

Brunner, Ronald D.

1992-01-01

The general task was to look beyond the adverse physical impacts and to defining the policy problem. In order for policy actions to be effective, they must address the right policy problems, which will be different from and broader than the physical problems. We will work on defining the policy problems with a view to indicating how practical solutions might be implemented. In particular, public officials need advice on what should be said, and done, and for what purposes. That advice needs to be based on systematic analysis of: (1) the scholarly literature in the social sciences, and related disciplines; (2) the charging content of the policy debate at the center of attention; and (3) how citizens perceive and understand issues related to global change. We will conduct this analysis. Chapter 1 and 2 each reports work on defining the policy problem and analyzing the scholarly literature. Chapters 3 and 4, respectively, address the policy debate and citizen viewpoints in issues related to global change.

Cronobacter sakazakii DNA Detection in Cerebrospinal Fluid of a Patient with Amyotrophic Lateral Sclerosis Mimic Syndrome

PubMed Central

Piombo, Marianna; Chiarello, Daniela; Corbetto, Marzia; Di Pino, Giovanni; Dicuonzo, Giordano; Angeletti, Silvia; Riva, Elisabetta; De Florio, Lucia; Capone, Fioravante; Di Lazzaro, Vincenzo

2015-01-01

A 45-year-old male noticed progressive weakness of the right lower limb with gait disturbance. Over the following months, motor deficits worsened, spreading to the right upper limb. Electromyography showed active denervation in the upper and lower limb muscles. A diagnosis of amyotrophic lateral sclerosis (ALS) was made. About 2 years after symptom onset, gradual improvement occurred. Cerebrospinal fluid analysis performed about 3 years after the beginning of symptoms identified Cronobacter sakazakii. Since no other possible causes were identified, we suggest that an almost completely reversible ALS-like syndrome had been triggered by Cronobacter infection in our immunocompetent patient. PMID:26955334

Nutrition Advice and Recipes

MedlinePlus

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Ingested Salmonella enterica, Cronobacter sakazakii, Escherichia coli O157:H7, and Listeria monocytogenes: transmission dynamics from adult house flies to their eggs and first filial (F1) generation adults.

PubMed

Pava-Ripoll, Monica; Pearson, Rachel E Goeriz; Miller, Amy K; Tall, Ben D; Keys, Christine E; Ziobro, George C

2015-07-31

The mechanical transmission of pathogenic bacteria by synanthropic filth flies is widely recognized. While many studies report the fate and the temporospatial distribution of ingested foodborne bacteria by filth flies, there is little evidence about the transmission dynamics of ingested foodborne bacteria by adult house flies (Musca domestica) to their progeny. In this study, we fed parental house fly adults with food contaminated with low, medium, and high concentrations of Salmonella enterica, Cronobacter sakazakii, Escherichia coli O157:H7, and Listeria monocytogenes and evaluated the probability of transmission of these pathogens to house fly eggs and the surface and the alimentary canal of their first filial (F1) generation adults. All foodborne pathogens were present in samples containing pooled house fly eggs. The probability of transmission was higher after parental house flies ingested food containing medium bacterial loads. Cronobacter sakazakii was 16, 6, and 3 times more likely to be transmitted to house fly eggs than S. enterica, E. coli O157:H7, and L. monocytogenes, respectively. Only S. enterica and C. sakazakii were transmitted to F1 generation adults and their presence was 2.4 times more likely on their body surfaces than in their alimentary canals. The highest probabilities of finding S. enterica (60 %) and C. sakazakii (28 %) on newly emerged F1 adults were observed after parental house flies ingested food containing medium and high levels of these pathogens, respectively. Our study demonstrates that adult house flies that fed from food contaminated with various levels of foodborne bacteria were able to transmit those pathogens to their eggs and some were further transmitted to newly emerged F1 generation adults, enhancing the vector potential of these insects. Understanding the type of associations that synanthropic filth flies establish with foodborne pathogens will help to elucidate transmission mechanisms and possible ways to mitigate the

16 CFR 1.3 - Advice.

Code of Federal Regulations, 2011 CFR

2011-01-01

... views. (b) Any advice given by the Commission is without prejudice to the right of the Commission to... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Advice. 1.3 Section 1.3 Commercial Practices... Guidance Advisory Opinions § 1.3 Advice. (a) On the basis of the materials submitted, as well as any other...

16 CFR 1.3 - Advice.

Code of Federal Regulations, 2010 CFR

2010-01-01

... views. (b) Any advice given by the Commission is without prejudice to the right of the Commission to... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Advice. 1.3 Section 1.3 Commercial Practices... Guidance Advisory Opinions § 1.3 Advice. (a) On the basis of the materials submitted, as well as any other...

A new application of a sodium deoxycholate-propidium monoazide-quantitative PCR assay for rapid and sensitive detection of viable Cronobacter sakazakii in powdered infant formula.

PubMed

Zhou, Baoqing; Chen, Bolu; Wu, Xin; Li, Fan; Yu, Pei; Aguilar, Zoraida P; Wei, Hua; Xu, Hengyi

2016-12-01

A rapid, reliable, and sensitive method for the detection of Cronobacter sakazakii, a common foodborne pathogen that may cause serious neonatal disease, has been developed. In this study, a rapid real-time quantitative PCR (qPCR) assay combined with sodium deoxycholate (SD) and propidium monoazide (PMA) was developed to detect C. sakazakii contamination in powdered infant formula (PIF). This method could eliminate the interference from dead or injured bacteria. Optimization studies indicated that SD and PMA at 0.08% (wt/vol) and 5µg/mL, respectively, were the most appropriate. In addition, qPCR, PMA-qPCR, SD-PMA-qPCR, and plate count assays were used to account for the number of viable bacteria in cell suspensions that were exposed to a 55°C water bath at different length of time. As a result, the viable number by PMA-qPCR showed significantly higher than of the number from SD-PMA-qPCR or plate counts. The number of viable bacteria was consistent between SD-PMA-qPCR and traditional plate counts, which indicated that SD treatment could eliminate the interference from dead or injured cells. Using the optimized parameters, the limit of detection with the SD-PMA-qPCR assay was 3.3×10 2 cfu/mL and 4.4×10 2 cfu/g in pure culture and in spiked PIF, respectively. A similar detection limit of 5.6×10 2 cfu/g was obtained in the presence of the Staphylococcus aureus (10 7 cfu/mL). The combined SD-PMA-qPCR assay holds promise for the rapid detection of viable C. sakazakii in PIF. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

International Air Transport Policy

NASA Technical Reports Server (NTRS)

Butler, C.

1972-01-01

The actions of the Civil Aviation Board in providing assistance and advice to the State Department regarding international air transport policy are discussed. The policies and guidelines of the Civil Aviation Board are defined. The relationship with the policies of the Executive Branch of the Government and the interpretations of the Department of Transportation are reported.

The Normative Context of Advice as Social Support.

ERIC Educational Resources Information Center

Goldsmith, Daena J.; Fitch, Kristine

1997-01-01

Documents the multiple goals and implications of advice among white, middle-class, college students. Identifies three dilemmas of seeking, receiving, and giving advice: (1) advice may be seen as helpful or as "butting-in"; (2) advice may be experienced as honest or supportive; and (3) seeking and taking advice may enact respect and…

Travel health advice: benefits, compliance, and outcome.

PubMed

Angelin, Martin; Evengård, Birgitta; Palmgren, Helena

2014-06-01

Travel health advice is an important and difficult part of a pre-travel consultation. The aim of this study was to determine whether the travel health advice given is followed by the traveller and whether it affects disease and injury experienced during travel. A prospective survey study was carried out from October 2009 to April 2012 at the Travel Medicine Clinic of the Department of Infectious Diseases, Umeå University Hospital, Umeå, Sweden. The Travel Medicine Clinic in Umeå is the largest travel clinic in northern Sweden. We included 1277 individuals in the study; 1059 (83%) responded to the post-travel questionnaire. Most visitors (88%) remembered having received travel health advice; among these, 95% found some of the health advice useful. Two-thirds (67%) claimed to have followed the advice, but fell ill during travel to the same extent as those who did not. Younger travellers (< 31 y) found our travel health advice less beneficial, were less compliant with the advice, took more risks during travel, and fell ill during travel to a greater extent than older travellers. Helping travellers stay healthy during travel is the main goal of travel medicine. Younger travellers are a risk group for illness during travel and there is a need to find new methods to help them avoid illness. Travellers find travel health advice useful, but it does not protect them from travel-related illness. Factors not easily influenced by the traveller play a role, but a comprehensive analysis of the benefits of travel health advice is needed.

5 CFR 2638.502 - Recommendations and advice.

Code of Federal Regulations, 2010 CFR

2010-01-01

... recommendation may be made or the advice given either orally or in writing. In addition, the Director shall... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Recommendations and advice. 2638.502... Cases Involving Individual Executive Agency Employees § 2638.502 Recommendations and advice. The...

5 CFR 2638.502 - Recommendations and advice.

Code of Federal Regulations, 2011 CFR

2011-01-01

... recommendation may be made or the advice given either orally or in writing. In addition, the Director shall... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Recommendations and advice. 2638.502... Cases Involving Individual Executive Agency Employees § 2638.502 Recommendations and advice. The...

16 CFR 1.1 - Policy.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Policy. 1.1 Section 1.1 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Industry Guidance Advisory Opinions § 1.1 Policy. (a) Any person, partnership, or corporation may request advice...

The View from Schools on Provision of Careers Information, Advice and Guidance in STEM Subjects

ERIC Educational Resources Information Center

Collinson, Gill

2014-01-01

This article explores the recent history of careers information, advice and guidance (IAG) and how it has been shaped by successive government policies and initiatives. It looks at the impact of these initiatives, particularly how they have influenced students' attitudes to STEM related careers. It also looks at recommendations for implementing…

32 CFR 776.10 - Informal ethics advice.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Informal ethics advice. 776.10 Section 776.10... § 776.10 Informal ethics advice. (a) Advisors. Covered attorneys may seek informal ethics advice either... of Director, JA Division, HQMC; and (5) Head, Standards of Conduct/Government Ethics Branch...

32 CFR 776.10 - Informal ethics advice.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Informal ethics advice. 776.10 Section 776.10... § 776.10 Informal ethics advice. (a) Advisors. Covered attorneys may seek informal ethics advice either... of Director, JA Division, HQMC; and (5) Head, Standards of Conduct/Government Ethics Branch...

32 CFR 776.10 - Informal ethics advice.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Informal ethics advice. 776.10 Section 776.10... § 776.10 Informal ethics advice. (a) Advisors. Covered attorneys may seek informal ethics advice either... of Director, JA Division, HQMC; and (5) Head, Standards of Conduct/Government Ethics Branch...

32 CFR 776.10 - Informal ethics advice.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Informal ethics advice. 776.10 Section 776.10... § 776.10 Informal ethics advice. (a) Advisors. Covered attorneys may seek informal ethics advice either... of Director, JA Division, HQMC; and (5) Head, Standards of Conduct/Government Ethics Branch...

32 CFR 776.10 - Informal ethics advice.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Informal ethics advice. 776.10 Section 776.10... § 776.10 Informal ethics advice. (a) Advisors. Covered attorneys may seek informal ethics advice either... of Director, JA Division, HQMC; and (5) Head, Standards of Conduct/Government Ethics Branch...

16 CFR 1.1 - Policy.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Policy. 1.1 Section 1.1 Commercial Practices... Guidance Advisory Opinions § 1.1 Policy. (a) Any person, partnership, or corporation may request advice... Commission's views, where practicable, under the following circumstances. (1) The matter involves a...

16 CFR 1.1 - Policy.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Policy. 1.1 Section 1.1 Commercial Practices... Guidance Advisory Opinions § 1.1 Policy. (a) Any person, partnership, or corporation may request advice... Commission's views, where practicable, under the following circumstances. (1) The matter involves a...

16 CFR 1.1 - Policy.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Policy. 1.1 Section 1.1 Commercial Practices... Guidance Advisory Opinions § 1.1 Policy. (a) Any person, partnership, or corporation may request advice... Commission's views, where practicable, under the following circumstances. (1) The matter involves a...

16 CFR 1.1 - Policy.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Policy. 1.1 Section 1.1 Commercial Practices... Guidance Advisory Opinions § 1.1 Policy. (a) Any person, partnership, or corporation may request advice... Commission's views, where practicable, under the following circumstances. (1) The matter involves a...

Nutrition and sustainability: an emerging food policy discourse.

PubMed

Lang, Tim; Barling, David

2013-02-01

It is well known that food has a considerable environmental impact. Less attention has been given to mapping and analysing the emergence of policy responses. This paper contributes to that process. It summarises emerging policy development on nutrition and sustainability, and explores difficulties in their integration. The paper describes some policy thinking at national, European and international levels of governance. It points to the existence of particular policy hotspots such as meat and dairy, sustainable diets and waste. Understanding the environmental impact of food systems challenges nutrition science to draw upon traditions of thinking which have recently been fragmented. These perspectives (life sciences, social and environmental) are all required if policy engagement and clarification is to occur. Sustainability issues offer opportunities for nutrition science and scientists to play a more central role in the policy analysis of future food systems. The task of revising current nutrition policy advice to become sustainable diet advice needs to begin at national and international levels.

Investigating the Responses of Cronobacter sakazakii to Garlic-Drived Organosulfur Compounds: a Systematic Study of Pathogenic-Bacterium Injury by Use of High-Throughput Whole-Transcriptome Sequencing and Confocal Micro-Raman Spectroscopy

PubMed Central

Feng, Shaolong; Eucker, Tyson P.; Holly, Mayumi K.; Konkel, Michael E.

2014-01-01

We present the results of a study using high-throughput whole-transcriptome sequencing (RNA-seq) and vibrational spectroscopy to characterize and fingerprint pathogenic-bacterium injury under conditions of unfavorable stress. Two garlic-derived organosulfur compounds were found to be highly effective antimicrobial compounds against Cronobacter sakazakii, a leading pathogen associated with invasive infection of infants and causing meningitis, necrotizing entercolitis, and bacteremia. RNA-seq shows changes in gene expression patterns and transcriptomic response, while confocal micro-Raman spectroscopy characterizes macromolecular changes in the bacterial cell resulting from this chemical stress. RNA-seq analyses showed that the bacterial response to ajoene differed from the response to diallyl sulfide. Specifically, ajoene caused downregulation of motility-related genes, while diallyl sulfide treatment caused an increased expression of cell wall synthesis genes. Confocal micro-Raman spectroscopy revealed that the two compounds appear to have the same phase I antimicrobial mechanism of binding to thiol-containing proteins/enzymes in bacterial cells generating a disulfide stretching band but different phase II antimicrobial mechanisms, showing alterations in the secondary structures of proteins in two different ways. Diallyl sulfide primarily altered the α-helix and β-sheet, as reflected in changes in amide I, while ajoene altered the structures containing phenylalanine and tyrosine. Bayesian probability analysis validated the ability of principal component analysis to differentiate treated and control C. sakazakii cells. Scanning electron microscopy confirmed cell injury, showing significant morphological variations in cells following treatments by these two compounds. Findings from this study aid in the development of effective intervention strategies to reduce the risk of C. sakazakii contamination in the food production environment and on food contact surfaces

Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature

PubMed Central

Schaafsma, Frederieke; Verbeek, Jos; Hulshof, Carel; van Dijk, Frank

2005-01-01

Background Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM) promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based practice and EBM we compared professional advice on occupational health topics with best evidence from the literature. Methods We asked 14 occupational physicians to consult their usual information sources on 12 pre-conceived occupational health problems. The problems were presented in the form of case vignettes which contained sufficient clinical information to be used by the occupational physicians for the consultation of their experts. We had searched the literature for the best available evidence on the 12 problems, which made it possible to answer the clinical questions with a clear yes or no. Results The cases could be used by the occupational physicians as arising from their own practice. All together the occupational physicians consulted 75 different experts. Almost half of the consulted experts were near colleagues, 10% were industrial hygienists, 8% medical specialists and the rest had a varied background. Fifty three percent (95% confidence interval 42% to 65%) of all professional advice was not in line with the research literature. In 18 cases (24%) professional advice explicitly referred to up-to-date research literature as their used source. These cases were substantially less incorrect (17%) than advice that had not mentioned the literature as a source (65%) (difference 48%, 95% Confidence Interval from 27% to 69%). Conclusion Advice that occupational physicians routinely get in their daily practice differs substantially from best evidence from the literature. Occupational physicians who ask professional advice should always ask about the evidence of this advice. PMID:16131405

21 CFR 14.174 - Advice and recommendations in writing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... § 14.174 Advice and recommendations in writing. Advice and recommendations given by a committee on a... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Advice and recommendations in writing. 14.174... of the advice and recommendations of the committee. ...

21 CFR 14.174 - Advice and recommendations in writing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... § 14.174 Advice and recommendations in writing. Advice and recommendations given by a committee on a... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Advice and recommendations in writing. 14.174... of the advice and recommendations of the committee. ...

Disentangling the Effects of Advisor Consensus and Advice Proximity

ERIC Educational Resources Information Center

Wanzel, Stella K.; Schultze, Thomas; Schulz-Hardt, Stefan

2017-01-01

When advice comes from interdependent sources (e.g., from advisors who use the same database), less information should be gained as compared to independent advice. On the other hand, since individuals strive for consistency, they should be more confident in consistent compared to conflicting advice, and interdependent advice should be more…

Clinician advice to quit smoking among seniors.

PubMed

Shadel, William G; Elliott, Marc N; Haas, Ann C; Haviland, Amelia M; Orr, Nate; Farmer, Melissa M; Ma, Sai; Weech-Maldonado, Robert; Farley, Donna O; Cleary, Paul D

2015-01-01

Little smoking research in the past 20years includes persons 50 and older; herein we describe patterns of clinician cessation advice to US seniors, including variation by Medicare beneficiary characteristics. In 2012-4, we analyzed 2010 Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data from Medicare beneficiaries over age 64 (n=346,674). We estimated smoking rates and the proportion of smokers whose clinicians encouraged cessation. 12% of male and 8% of female respondents aged 65 and older smoke. The rate decreases with age (14% of 65-69, 3% of 85+) and education (12-15% with no high school degree, 5-6% with BA+). Rates are highest among American Indian/Alaskan Native (16%), multiracial (14%), and African-American (13%) seniors, and in the Southeast (14%). Only 51% of smokers say they receive cessation advice "always" or "usually" at doctor visits, with advice more often given to the young, those in low-smoking regions, Asians, and women. For all results cited p<0.05. Smoking cessation advice to seniors is variable. Providers may focus on groups or areas in which smoking is less common or when they are most comfortable giving advice. More consistent interventions are needed, including cessation advice from clinicians. Copyright © 2014 Elsevier Inc. All rights reserved.

Biochemical and molecular characterization of Cronobacter spp. (formerly Enterobacter sakazakii) isolated from foods.

PubMed

Turcovský, Imrich; Kuniková, Kristína; Drahovská, Hana; Kaclíková, Eva

2011-02-01

The aim of this study was to identify and characterize Cronobacter spp. isolated from a range of foods. A total of 71 Cronobacter strains were isolated from 602 foods in our laboratory. The highest contamination was observed in foods of plant origin, e.g. spices, teas, chocolate, nuts, pastries and vegetables. On the basis of genus and species identification performed using genus-specific PCR, 16S rRNA sequencing and AFLP genotyping, most of the strains belonged to Cronobacter sakazakii. Biochemical profiling by the tests included in API 20E, complemented with relevant additional tests, classified the strains into 13 biogroups. AFLP genotyping facilitated discrimination of six main groups at the 70% similarity level and strain grouping correlated clearly with species identification. Our results indicate that molecular typing by AFLP may be applied as a useful tool not only for direct comparison of Cronobacter isolates, providing traceability, but also for the reliable species classification. Moreover, tracing of these bacteria in a wider variety of foods should be important to enhance the knowledge of their transmission.

A Collaborative Approach to Bridging the Research-Policy Gap through the Development of Policy Advice Software

ERIC Educational Resources Information Center

Milne, Barry John; Lay-Yee, Roy; McLay, Jessica; Tobias, Martin; Tuohy, Pat; Armstrong, Ann; Lynn, Robert; Pearson, Janet; Mannion, Oliver; Davis, Peter

2014-01-01

We have developed a software-based tool to support a dynamic micro-simulation model of life-course development (to age 13) as an aid to policy makers assessing the impact of policies affecting children. We demonstrate how this approach bridges the research-policy gap by creating: (1) an easy transfer of evidence in a form that policymakers can use…

Which patients receive advice on diet and exercise? Do certain characteristics affect whether they receive such advice?

PubMed

Sinclair, Jennifer; Lawson, Beverley; Burge, Fred

2008-03-01

To examine whether patients' characteristics, familiarity with the clinic, or perspectives on the quality of their care predict whether they receive advice from physicians regarding diet and exercise. Secondary data analysis of responses to the Primary Care Practice Survey. Capital District Health Authority in Nova Scotia. Residents of the Capital District Health Authority 18 years old and older (N = 1562). Percentage of patients who reported frequently receiving advice from their family physicians regarding diet and exercise. Almost 38% of respondents reported frequently receiving advice from their physicians on diet. Those more likely to receive advice on diet were male (adjusted odds ratio [AOR] 1.6, 95% confidence interval [CI] 1.2 to 2.1), were 35 to 54 years old (compared with those aged 18 to 34) (AOR 1.5, 95% CI 1.1 to 2.2), had more chronic illnesses (AOR 1.3, 95% CI 1.2 to 1.6), had good relationships with their health care providers (AOR 2.3, 95% CI 1.8 to 3.1), or reported higher scores on an enablement scale (AOR 2.2, 95% CI 1.6 to 3.1). Respondents who reported their health status as excellent were less likely to receive advice on diet (AOR 0.5, 95% CI 0.3 to 0.9). About 42% of respondents reported frequently receiving advice on exercise. Men (AOR 1.7, 95% CI 1.3 to 2.2), those older than 35 years (AOR 1.7, 95% CI 1.2 to 2.4 for those aged 35 to 54; AOR 1.6, 95% CI 1.1 to 2.3 for those 55 and older), those rating their health as good (AOR 1.6, 95% CI 1.1 to 2.4), those with more chronic illnesses (AOR 1.3, 95% CI 1.1 to 1.5), and those reporting higher scores on communication (AOR 3.2, 95% CI 2.3 to 4.4) and enablement (AOR 1.8, 95% CI 1.3 to 2.4) scales were more likely to receive advice on exercise. Strategies to increase the number of patients who receive advice on diet and exercise would likely include enhancing communication between patients and their physicians, improving relationships between patients and their physicians, and improving

The best advice I ever got.

PubMed

Wademan, Daisy

2005-01-01

A young manager faces an impasse in his career. He goes to see his mentor at the company, who closes the office door, offers the young man a chair, recounts a few war stories, and serves up a few specific pointers about the problem at hand. Then, just as the young manager is getting up to leave, the elder executive adds one small kernel of avuncular wisdom--which the junior manager carries with him through the rest of his career. Such is the nature of business advice. Or is it? The six essays in this article suggest otherwise. Few of the leaders who tell their stories here got their best advice in stereotypical form, as an aphorism or a platitude. For Ogilvy & Mather chief Shelly Lazarus, profound insight came from a remark aimed at relieving the tension of the moment. For Novartis CEO Daniel Vasella, it was an apt comment, made on a snowy day, back when he was a medical resident. For publishing magnate Earl Graves and Starwood Hotels' Barry Sternlicht, advice they received about trust from early bosses took on ever deeper and more practical meaning as their careers progressed. For Goldman Sachs chairman Henry Paulson, Jr., it was as much his father's example as it was a specific piece of advice his father handed down to him. And fashion designer Liz Lange rejects the very notion that there's inherent wisdom in accepting other people's advice. As these stories demonstrate, people find wisdom when they least expect to, and they never really know what piece of advice will transcend the moment, profoundly affecting how they later make decisions, evaluate people, and examine--and reexamine--their own actions.

5 CFR 2635.107 - Ethics advice.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Ethics advice. 2635.107 Section 2635.107 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.107 Ethics advice. (a) As required by §§ 2638.201...

5 CFR 2635.107 - Ethics advice.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Ethics advice. 2635.107 Section 2635.107 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.107 Ethics advice. (a) As required by §§ 2638.201...

5 CFR 2635.107 - Ethics advice.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Ethics advice. 2635.107 Section 2635.107 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.107 Ethics advice. (a) As required by §§ 2638.201...

5 CFR 2635.107 - Ethics advice.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Ethics advice. 2635.107 Section 2635.107 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.107 Ethics advice. (a) As required by §§ 2638.201...

5 CFR 2635.107 - Ethics advice.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Ethics advice. 2635.107 Section 2635.107 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.107 Ethics advice. (a) As required by §§ 2638.201...

29 CFR 1912.36 - Advice of advisory committees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... members of an advisory committee shall not be a reason for not giving advice to the Assistant Secretary... 29 Labor 7 2010-07-01 2010-07-01 false Advice of advisory committees. 1912.36 Section 1912.36... Advice of advisory committees. (a) Approval by a majority of all members of an advisory committee is...

29 CFR 1912.36 - Advice of advisory committees.

Code of Federal Regulations, 2011 CFR

2011-07-01

... members of an advisory committee shall not be a reason for not giving advice to the Assistant Secretary... 29 Labor 7 2011-07-01 2011-07-01 false Advice of advisory committees. 1912.36 Section 1912.36... Advice of advisory committees. (a) Approval by a majority of all members of an advisory committee is...

29 CFR 1912a.5 - Advice and recommendations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) NATIONAL ADVISORY COMMITTEE ON OCCUPATIONAL SAFETY AND HEALTH § 1912a.5 Advice and recommendations. Any advice or recommendations of the Committee shall be given or made with approval of a majority... 29 Labor 7 2011-07-01 2011-07-01 false Advice and recommendations. 1912a.5 Section 1912a.5 Labor...

29 CFR 1912a.5 - Advice and recommendations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) NATIONAL ADVISORY COMMITTEE ON OCCUPATIONAL SAFETY AND HEALTH § 1912a.5 Advice and recommendations. Any advice or recommendations of the Committee shall be given or made with approval of a majority... 29 Labor 7 2010-07-01 2010-07-01 false Advice and recommendations. 1912a.5 Section 1912a.5 Labor...

Improving driving advice provided to cardiology patients on discharge.

PubMed

Vusirikala, Amoolya; Backhouse, Mark; Schimansky, Sarah

2018-01-01

Certain cardiac conditions can limit patients' ability to drive. It remains the doctors' responsibility to advise patients of any driving restrictions and is particularly important after certain diagnoses or procedures. We identified that the quality of documented advice was variable and frequently no written driving advice was recorded on discharge. It was apparent that there was a lack of awareness and knowledge of the current Driving and Vehicle Licensing Agency (DVLA) guidance among junior doctors. We therefore designed a quality improvement project using Plan-Do-Study-Act (PDSA) methodology to improve the provision of driving advice on discharge from a cardiology ward by focusing on staff education. After collecting baseline data, we created a template with cardiology-specific DVLA advice. During the second PDSA cycle, we improved the electronic template and also introduced a hard copy on the ward. During the third PDSA cycle, we incorporated information on DVLA guidance in the specialty induction session. We also evaluated junior doctors' confidence of providing driving advice before and after this intervention. Baseline measurements showed that 10% (9/92) of all discharge summaries included driving advice. This improved to 49% (34/69) after the third PDSA cycle. Importantly, after receiving information on driving advice in the induction, junior doctors felt more confident in providing driving advice to cardiology patients on discharge. In conclusion, the provision of driving advice on discharge is an important element of patient safety. However, clinicians' knowledge and awareness of current DVLA guidance is often limited. We demonstrated a significant increase in the provision of driving advice by introducing a standardised template.

Stepwise Advice Negotiation in Writing Center Peer Tutoring

ERIC Educational Resources Information Center

Park, Innhwa

2014-01-01

While the delivery and reception of advice is a practice integral to a wide range of settings, little attention has been given to the detailed practices of advice resistance and how it leads to advice negotiation. Based on 7 hours of videotaped tutoring interactions among 6 tutors and 11 tutees, this conversation analytic study examines the…

Improving driving advice provided to cardiology patients on discharge

PubMed Central

Vusirikala, Amoolya; Backhouse, Mark; Schimansky, Sarah

2018-01-01

Certain cardiac conditions can limit patients’ ability to drive. It remains the doctors' responsibility to advise patients of any driving restrictions and is particularly important after certain diagnoses or procedures. We identified that the quality of documented advice was variable and frequently no written driving advice was recorded on discharge. It was apparent that there was a lack of awareness and knowledge of the current Driving and Vehicle Licensing Agency (DVLA) guidance among junior doctors. We therefore designed a quality improvement project using Plan–Do–Study–Act (PDSA) methodology to improve the provision of driving advice on discharge from a cardiology ward by focusing on staff education. After collecting baseline data, we created a template with cardiology-specific DVLA advice. During the second PDSA cycle, we improved the electronic template and also introduced a hard copy on the ward. During the third PDSA cycle, we incorporated information on DVLA guidance in the specialty induction session. We also evaluated junior doctors’ confidence of providing driving advice before and after this intervention. Baseline measurements showed that 10% (9/92) of all discharge summaries included driving advice. This improved to 49% (34/69) after the third PDSA cycle. Importantly, after receiving information on driving advice in the induction, junior doctors felt more confident in providing driving advice to cardiology patients on discharge. In conclusion, the provision of driving advice on discharge is an important element of patient safety. However, clinicians’ knowledge and awareness of current DVLA guidance is often limited. We demonstrated a significant increase in the provision of driving advice by introducing a standardised template. PMID:29610769

78 FR 74129 - National Advisory Council for Environmental Policy and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-10

... for Environmental Policy and Technology AGENCY: Environmental Protection Agency (EPA). ACTION: Notice... Environmental Policy and Technology (NACEPT). NACEPT provides advice to the EPA Administrator on a broad range of environmental policy, technology, and management issues. NACEPT members represent academia...

76 FR 37112 - National Advisory Council for Environmental Policy and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

... advice to the EPA Administrator on a broad range of environmental policy, technology, and management... Second Advice Letter on EPA Workforce Planning: Leadership Capabilities and Culture for ``One EPA'' and..., [email protected] , (202) 564-5320, U.S. EPA, Office of Federal Advisory Committee Management and...

75 FR 25240 - National Advisory Council for Environmental Policy and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... ENVIRONMENTAL PROTECTION AGENCY National Advisory Council for Environmental Policy and Technology... for Environmental Policy and Technology (NACEPT). NACEPT provides advice to the EPA Administrator on a broad range of environmental policy, technology, and management issues. NACEPT is a committee of...

19 CFR 177.11 - Requests for advice by field offices.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Requests for advice by field offices. 177.11... advice by field offices. (a) Generally. Advice or guidance as to the interpretation or proper application... prospective, current, or completed. Advice as to the proper application of the Customs and related laws to a...

19 CFR 177.11 - Requests for advice by field offices.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Requests for advice by field offices. 177.11... advice by field offices. (a) Generally. Advice or guidance as to the interpretation or proper application... prospective, current, or completed. Advice as to the proper application of the Customs and related laws to a...

76 FR 24481 - National Advisory Council for Environmental Policy and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-02

...: Under the Federal Advisory Committee Act, Public Law 92463, EPA gives notice of a public meeting of the National Advisory Council for Environmental Policy and Technology (NACEPT). NACEPT provides advice to the... tribal governments. The purpose of this meeting is to: (1) Discuss NACEPT's second advice letter on EPA...

Provider smoking cessation advice among California Asian-American smokers.

PubMed

Tong, Elisa K; Tang, Hao; Chen, Moon S; McPhee, Stephen J

2011-01-01

To determine proportions of provider advice to quit smoking for Asian-American smokers and to describe factors that may affect the provision of such advice. Secondary data analysis of population-based survey. California. Current smokers from the California Tobacco Use Surveys for Chinese-Americans (n = 2117, participation rate = 52%), Korean-Americans (n = 2545, participation rate = 48%), and Vietnamese-Americans (n = 2179, participation rate = 63.5%). Sociodemographics including insurance status, smoking frequency, provider visit in past year, and provider advice to quit. Multivariate logistic regression models examined dependent outcomes of (1) provider visit in past year and (2) provider advice to quit. Less than a third (30.5%) of smokers in our study reported both seeing a provider (50.8%) and then receiving advice to quit (60.1%). Factors associated with provider visits included being female, being 45 years or older, having health insurance, and being Vietnamese. Among smokers who saw a provider, factors associated with provider advice to quit included having health insurance and being a daily smoker. Asian-American smokers reported low proportions of provider advice to quit in the past year, largely because only half of smokers saw a provider. Providers who see such smokers may need greater awareness that several effective cessation treatments do not require health insurance, and that intermittent smokers need advice to quit.

Detection of Cronobacter spp. (formerly Enterobacter sakazakii) from medicinal plants and spices in Syria.

PubMed

Belal, Mouhammad; Al-Mariri, Ayman; Hallab, Lila; Hamad, Ibtesam

2013-02-15

Cronobacter spp. (formerly Enterobacter sakazakii) is an emerging food-borne pathogen that causes severe meningitis, sepsis, and necrotizing enterocolitis in neonates and infants. These infections have been reported from different parts of the world. The epidemiology and reservoir of Cronobacter spp. are still unknown, and most strains have been isolated from clinical specimens and from a variety of foods, including cheese, meat, milk, vegetables, grains, spices, and herbs. Our study aimed to detect and isolate Cronobacter spp. from different Syrian samples of spices, medicinal herbs and liquorices, depending on the pigment production and biochemical profile of isolates and PCR technique. This PCR method, which provides a powerful tool for rapid, specific, and sensitive detection of Cronobacter spp., is considered a reliable alternative to traditional bacteriological methods. This study revealed that the percentage of Cronobacter spp. was 94%, 52%, and 32% in liquorice, spices and medicinal herbs, respectively. In addition, it assured that the optimal enhancing growth temperature was 44°C, and optimal enhancing growth pH was 5.

Structural and genetic relationships of closely related O-antigens of Cronobacter spp. and Escherichia coli: C. sakazakii G2594 (serotype O4)/E. coli O103 and C. malonaticus G3864 (serotype O1)/E. coli O29.

PubMed

Shashkov, Alexander S; Wang, Min; Turdymuratov, Eldar M; Hu, Shaohui; Arbatsky, Nikolay P; Guo, Xi; Wang, Lei; Knirel, Yuriy A

2015-03-02

O-Antigen (O-polysaccharide) variation is the basis for bacterial serotyping and is important in bacterial virulence and niche adaptation. In this work, we present structural and genetic evidences for close relationships between the O-antigens of the Cronobacter spp. and Escherichia coli. Cronobacter sakazakii G2594 (serotype O4) and Cronobacter malonaticus G3864 (serotype O1) are structurally related to those of E. coli O103 and O29, respectively, and some other members of the Enterobacteriaceae family differing in the patterns of lateral glucosylation (C. sakazakii G2594) or O-acetylation (C. malonaticus G3864). The O-antigen gene clusters of the corresponding Cronobacter and E. coli strains contain the same genes with high-level similarity, and the structural differences within both O-antigen pairs were suggested to be due to modification genes carried by prophages. Copyright © 2014 Elsevier Ltd. All rights reserved.

31 CFR 10.37 - Requirements for other written advice.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Revenue Service § 10.37 Requirements for other written advice. (a) Requirements. A practitioner must not give written advice (including electronic communications) concerning one or more Federal tax issues if... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Requirements for other written advice...

31 CFR 10.37 - Requirements for other written advice.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Revenue Service § 10.37 Requirements for other written advice. (a) Requirements. A practitioner must not give written advice (including electronic communications) concerning one or more Federal tax issues if... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Requirements for other written advice...

76 FR 1431 - National Advisory Council for Environmental Policy and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-10

...: Under the Federal Advisory Committee Act, Public Law 92463, EPA gives notice of a public meeting of the National Advisory Council for Environmental Policy and Technology (NACEPT). NACEPT provides advice to the...'s request for advice on workforce issues the Agency is facing and how EPA can best address the needs...

75 FR 38810 - National Advisory Council for Environmental Policy and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

...: Under the Federal Advisory Committee Act, Public Law 92463, EPA gives notice of a public teleconference... advice to the EPA Administrator on a broad range of environmental policy, technology, and management... developing to respond to EPA's request for advice on workforce issues the Agency is facing and how EPA can...

75 FR 52941 - National Advisory Council for Environmental Policy and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-30

...: Under the Federal Advisory Committee Act, Public Law 92463, EPA gives notice of a public meeting of the National Advisory Council for Environmental Policy and Technology (NACEPT). NACEPT provides advice to the...'s request for advice on workforce issues the Agency is facing and how EPA can best address the needs...

Ancient advice for modern mariners

NASA Astrophysics Data System (ADS)

Brooks, David A.

Some unusual preparations may be advised for persons anticipating voyages in sailing research vessels. For example, cooking facilities on sailing ships tend to be of modest means, and a scientist embarking on such a vessel may wonder whether he should bring his own essential provisions. Casting about for ideas, I happened on some relevant advice from Benjamin Franklin, who was seldom reluctant to sermonize on matters at hand. In spite of his numerous Atlantic crossings, Franklin was humble about offering advice to mariners, who he realized were generally suspicious of landlubbers.

Preconception lifestyle advice for people with subfertility.

PubMed

Anderson, Kirsty; Norman, Robert J; Middleton, Philippa

2010-04-14

Infertility is a prevalent problem and has significant consequences for individuals, families and the wider community. People's chance of having a healthy, live birth may be impacted upon by factors such as weight, diet, smoking, other substance abuse, environmental pollutants, infections, medical conditions, medications and family medical history. However, there is no current guideline about what preconception advice should be offered to people presenting for infertility treatment. It is important to determine what preconception advice should be given about these types of factors to such people in order to help them to make positive changes and hopefully improve their chances of conception and delivering a healthy, live baby. To assess the effects of preconception advice on the chances of a live birth for people who perceive that they may be infertile and are investigating the possibility of medical treatment to address subfertility. All published and unpublished randomised controlled trials addressing preconception advice to influence lifestyle factors in people who perceived that they may be infertile and investigated the possibility of medical treatment to address subfertility were sought from the Cochrane Menstrual Disorders and Subfertility Review Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library, MEDLINE, PubMed, EMBASE, PsycINFO, AMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), LILACS, trial registers for ongoing and registered trials, citation indexes, ISI Web of Knowledge, Clinical Study Results database, OpenSIGLE database, China National Knowledge Infrastructure (CNKI) Periodical Index and Google (inception to 5 October 2009). Only randomised controlled trials (RCTs), including cluster-randomised (group-randomised) trials, that considered preconception advice given to individuals who perceived that they may be infertile and were investigating the possibility of medical treatment

Content and Style of Advice in Iran and Canada

ERIC Educational Resources Information Center

Tavakoli, Mahin

2013-01-01

The content and nature of nonprofessional advice in Iran, a hierarchical and collectivist culture, was compared to the same type of advice in Canada, an egalitarian and individualist culture. A researcher developed a questionnaire that consisted of 10 letters, each describing a writer's problem and asking for advice. The responses of participants…

PISA Data: Raising Concerns with Its Use in Policy Settings

ERIC Educational Resources Information Center

Gillis, Shelley; Polesel, John; Wu, Margaret

2016-01-01

This article considers the role played by policy makers, government organisations, and research institutes (sometimes labelled "think tanks") in the analysis, use and reporting of PISA data for the purposes of policy advice and advocacy. It draws on the ideas of Rizvi and Lingard (Globalizing Education Policy, 2010), Bogdandy and…

ADVICE--Educational System for Teaching Database Courses

ERIC Educational Resources Information Center

Cvetanovic, M.; Radivojevic, Z.; Blagojevic, V.; Bojovic, M.

2011-01-01

This paper presents a Web-based educational system, ADVICE, that helps students to bridge the gap between database management system (DBMS) theory and practice. The usage of ADVICE is presented through a set of laboratory exercises developed to teach students conceptual and logical modeling, SQL, formal query languages, and normalization. While…

Young Children's Trust in Overtly Misleading Advice

ERIC Educational Resources Information Center

Heyman, Gail D.; Sritanyaratana, Lalida; Vanderbilt, Kimberly E.

2013-01-01

The ability of 3- and 4-year-old children to disregard advice from an overtly misleading informant was investigated across five studies (total "n" =212). Previous studies have documented limitations in young children's ability to reject misleading advice. This study was designed to test the hypothesis that these limitations are primarily…

Sustainable diet policy development: implications of multi-criteria and other approaches, 2008-2017.

PubMed

Lang, Tim; Mason, Pamela

2017-12-04

The objective of the present paper is to draw lessons from policy development on sustainable diets. It considers the emergence of sustainable diets as a policy issue and reviews the environmental challenge to nutrition science as to what a 'good' diet is for contemporary policy. It explores the variations in how sustainable diets have been approached by policy-makers. The paper considers how international United Nations and European Union (EU) policy engagement now centres on the 2015 Sustainable Development Goals and Paris Climate Change Accord, which require changes across food systems. The paper outlines national sustainable diet policy in various countries: Australia, Brazil, France, the Netherlands, Qatar, Sweden, UK and USA. While no overarching common framework for sustainable diets has appeared, a policy typology of lessons for sustainable diets is proposed, differentiating (a) orientation and focus, (b) engagement styles and (c) modes of leadership. The paper considers the particularly tortuous rise and fall of UK governmental interest in sustainable diet advice. Initial engagement in the 2000s turned to disengagement in the 2010s, yet some advice has emerged. The 2016 referendum to leave the EU has created a new period of policy uncertainty for the UK food system. This might marginalise attempts to generate sustainable diet advice, but could also be an opportunity for sustainable diets to be a goal for a sustainable UK food system. The role of nutritionists and other food science professions will be significant in this period of policy flux.

19 CFR 111.39 - Advice to client.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Advice to client. 111.39 Section 111.39 Customs... CUSTOMS BROKERS Duties and Responsibilities of Customs Brokers § 111.39 Advice to client. (a) Withheld or false information. A broker must not withhold information relative to any customs business from a client...

Advice-Implicative Interrogatives: Building "Client-Centered" Support in a Children's Helpline

ERIC Educational Resources Information Center

Butler, Carly W.; Potter, Jonathan; Danby, Susan; Emmison, Michael; Hepburn, Alexa

2010-01-01

Interactional research on advice giving has described advice as normative and asymmetric. In this paper we examine how these dimensions of advice are softened by counselors on a helpline for children and young people through the use of questions. Through what we term "advice-implicative interrogatives," counselors ask clients about the…

Consumer satisfaction with telehealth advice-nursing.

PubMed

Chang, B L; Mayo, A; Omery, A

2001-01-01

An increase in interest in the establishment of telephone advice services has resulted in the proliferation of call centers. Despite their wide usage, research for the most part has not addressed the quality of care in relation to consumer satisfaction. This paper examines consumer outcomes of satisfaction, and follow-up with recommendations, within a framework of the nursing process and its associated components of assessment (including problem identification), care planning, intervention, and evaluation. The data for the study were obtained from seven after-hours call centers operating under the auspices of health maintenance organizations, preferred provider organizations, and private insurance companies. A sample of 157 non-redundant telephone calls from adults with medical-surgical problems were audiotaped with providers' and callers' consent. Sociodemographic information of the advice nurses, and chief complaints of the callers were obtained. The quality of nursing of the audiotaped calls was rated through an implicit review method by registered nurse raters using an advice nurse structured implicit review (AN-SIR) form developed for the study. Follow-up information was obtained through telephone calls to ascertain the consumers' perceptions of satisfaction, helpfulness, and follow-through with recommendations. Results indicated that consumers calling with a variety of general complaints contacted 32 nurses in advice nurse call centers. The quality of nursing process was found to be the best in the area of intervention. Evaluation was also well above the midpoint on a transformed scale of zero to 100. Assessment, although slightly above midpoint, was the lowest of the three components of the nursing process examined. Consumer satisfaction was high with 95.4 percent of the consumers rating the calls as completely or at least somewhat satisfied, and 93.2 percent, stating the advice was very or somewhat helpful. Exploratory regression analysis showed that the

Western Australian women's perceptions of conflicting advice around breast feeding.

PubMed

Hauck, Yvonne L; Graham-Smith, Catherine; McInerney, Justine; Kay, Sue

2011-10-01

to explore women's perceptions of conflicting advice around breast feeding from formal support networks, specifically health professionals involved in postnatal support. a qualitative exploratory design was employed using the critical incident technique. Data were obtained from 62 Western Australian women who responded to an invitation to share incidents of receiving conflicting advice. Women who had breast fed a child within the past 12 months shared their experience through a telephone interview (n = 50) or completing a brief questionnaire (n = 12) addressing the following questions: Describe a situation in detail where you felt you received conflicting advice about breast feeding from a health professional. How did this situation affect you and/or your breast feeding? a modified constant comparison method was used to analyse the critical incidents revealing commonalities under who offered conflicting advice; what contributed to advice being perceived as conflicting; topic areas more inclined to being regarded as conflicting; what protected against advice being perceived as conflicting; the consequences of receiving conflicting advice; and strategies that women used to manage these incidents. advice that was viewed as conflicting extended beyond the provision of information that was inconsistent or directly contradictory, and included issues around information overload and disparities between the mother's and health professional's expectations. The manner of presenting information or advice, the skills of using effective communication, demonstration of a caring attitude with an empathic approach and focusing upon the woman as an individual were seen to be important to minimise these incidents. Attention to women's perceptions and the consequences of conflicting advice must be addressed, otherwise the credibility and confidence in health professionals' knowledge and ability to support breast feeding is questioned, resulting in a valuable support network being

Making a Difference: Lessons Learned, Advice Given

ERIC Educational Resources Information Center

Kramer, Gary L.

2011-01-01

When it comes to giving advice, the author agrees with colleagues who have stated that although they might give advice to aspiring professionals, it would be better yet if they would write or apply it to themselves! So within that context, the author, like his colleagues, does not claim to possess superior wisdom in student services. Rather, he…

Power in telephone-advice nursing.

PubMed

Leppänen, Vesa

2010-03-01

Power is a central aspect of nursing, especially in telephone-advice nursing, where nurses assess callers' medical problems and decide what measures that need to be taken. This article presents a framework for understanding how power operates in social interaction between nurses and callers in telephone-advice nursing in primary care in Sweden. Power is analysed as the result of nurses and callers being oriented to five social structures that are relevant to their actions in this context, namely the organization of telephone-advice nursing, the social stock of medical knowledge, the professional division of labour between nurses and doctors, structures of social interaction and structures of emotions. While structural constraints govern some actions to a high degree, calls take place in an organizational free room that give nurses more leeway for acting more creatively. The discussion focuses on the introduction of new technologies of control, for instance computerized decision support systems and audio recording of calls, and on how they reduce the free room. Empirical data consist of 276 audio-recorded telephone calls to 13 nurses at six primary-care centres and of qualitative interviews with 18 nurses.

Advice for windpower users

NASA Astrophysics Data System (ADS)

Stephenson, W.

1982-01-01

Advice for private users of windpower energy is given. Type of energy needed; amount of energy expected from windpower systems; cost effectiveness; autonomous operation versus connection to the national grid; and high and low speed systems are discussed.

Testing an Integrated Model of Advice Giving in Supportive Interactions

ERIC Educational Resources Information Center

Feng, Bo

2009-01-01

Viewing supportive communication as a multistage process, the present study proposed and tested an integrated model of advice giving, which specifies three sequential moves in supportive interactions involving advice: emotional support, problem inquiry and analysis, and advice. Seven hundred and fifty-two participants read and responded to a…

77 FR 39705 - National Advisory Council for Environmental Policy and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

... and Technology AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of Advisory Committee... meeting of the National Advisory Council for Environmental Policy and Technology (NACEPT). NACEPT provides advice to the EPA Administrator on a broad range of environmental policy, technology, and management...

Which patients receive advice on diet and exercise?

PubMed Central

Sinclair, Jennifer; Lawson, Beverley; Burge, Fred

2008-01-01

OBJECTIVE To examine whether patients’ characteristics, familiarity with the clinic, or perspectives on the quality of their care predict whether they receive advice from physicians regarding diet and exercise. DESIGN Secondary data analysis of responses to the Primary Care Practice Survey. SETTING Capital District Health Authority in Nova Scotia. PARTICIPANTS Residents of the Capital District Health Authority 18 years old and older (N = 1562). MAIN OUTCOME MEASURES Percentage of patients who reported frequently receiving advice from their family physicians regarding diet and exercise. RESULTS Almost 38% of respondents reported frequently receiving advice from their physicians on diet. Those more likely to receive advice on diet were male (adjusted odds ratio [AOR] 1.6, 95% confidence interval [CI] 1.2 to 2.1), were 35 to 54 years old (compared with those aged 18to 34) (AOR 1.5, 95% CI 1.1 to 2.2), had more chronic illnesses (AOR 1.3, 95% CI 1.2 to 1.6), had good relationships with their health care providers (AOR 2.3, 95% CI 1.8 to 3.1), or reported higher scores on an enablement scale (AOR 2.2, 95% CI 1.6 to 3.1). Respondents who reported their health status as excellent were less likely toreceive advice on diet (AOR 0.5, 95% CI 0.3 to 0.9). About 42% of respondents reported frequently receiving advice on exercise. Men (AOR 1.7, 95% CI 1.3 to 2.2), those older than 35 years (AOR 1.7, 95% CI 1.2 to 2.4 for those aged 35 to 54; AOR 1.6, 95% CI 1.1 to 2.3 for those 55 and older), those rating their health as good (AOR 1.6, 95% CI 1.1 to 2.4), those with more chronic illnesses (AOR 1.3, 95% CI 1.1 to 1.5), and those reporting higher scores on communication (AOR 3.2, 95% CI 2.3 to 4.4) and enablement (AOR 1.8, 95% CI 1.3 to 2.4) scales were more likely to receive advice on exercise. CONCLUSION Strategies to increase the number of patients who receive advice on diet and exercise would likely include enhancing communication between patients andtheir physicians

Advice to young behavioral and cognitive scientists.

PubMed

Weisman, Ronald G

2008-02-01

Modeled on Medawar's Advice to a Young Scientist [Medawar, P.B., 1979. Advice to a Young Scientist. Basic Books, New York], this article provides advice to behavioral and cognitive scientists. An important guiding principle is that the study of comparative cognition and behavior are natural sciences tasked with explaining nature. The author advises young scientists to begin with a natural phenomenon and then bring it into the laboratory, rather than beginning in the laboratory and hoping for an application in nature. He suggests collaboration as a way to include research outside the scientist's normal competence. He then discusses several guides to good science. These guides include Tinbergen's [Tinbergen, N., 1963. On aims and methods of ethology. Zeitschrift für Tierpsychologie, 20, 410-433. This journal was renamed Ethology in 1986. Also reprinted in Anim. Biol. 55, 297-321, 2005] four "why" questions, Platt's [Platt, J.R., 1964. Strong inference. Science 146, 347-353, (http://weber.ucsd.edu/~jmoore/courses/Platt1964.pdf)] notion of strong inference using multiple alternative hypotheses, and the idea that positive controls help scientists to follow Popper's [Popper, K.R., 1959. The Logic of Scientific Discovery. Basic Books, New York, p. 41] advice about disproving hypotheses. The author also recommends Strunk and White's [Strunk, W., White, E.B., 1979. The Elements of Style, third ed. Macmillan, New York] rules for sound writing, and he provides his personal advice on how to use the anticipation of peer review to improve research and how to decode editors' and reviewers' comments about submitted articles.

28 CFR 0.75 - Policy functions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Department defense mobilization and contingency planning. (q) Review legislation for potential impact on the... Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Justice Management... Management Division and shall provide advice relating to basic Department policy for budget and financial...

28 CFR 0.75 - Policy functions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Department defense mobilization and contingency planning. (q) Review legislation for potential impact on the... Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Justice Management... Management Division and shall provide advice relating to basic Department policy for budget and financial...

14 CFR 1209.305 - Legal advice and assistance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Legal advice and assistance. 1209.305 Section 1209.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION BOARDS AND COMMITTEES Contract Adjustment Board § 1209.305 Legal advice and assistance. The General Counsel of NASA shall provide...

14 CFR 1209.305 - Legal advice and assistance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Legal advice and assistance. 1209.305 Section 1209.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION BOARDS AND COMMITTEES Contract Adjustment Board § 1209.305 Legal advice and assistance. The General Counsel of NASA shall provide...

14 CFR 1209.305 - Legal advice and assistance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Legal advice and assistance. 1209.305 Section 1209.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION BOARDS AND COMMITTEES Contract Adjustment Board § 1209.305 Legal advice and assistance. The General Counsel of NASA shall provide...

29 CFR 1912a.5 - Advice and recommendations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 7 2013-07-01 2013-07-01 false Advice and recommendations. 1912a.5 Section 1912a.5 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) NATIONAL ADVISORY COMMITTEE ON OCCUPATIONAL SAFETY AND HEALTH § 1912a.5 Advice and...

29 CFR 1912a.5 - Advice and recommendations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 7 2014-07-01 2014-07-01 false Advice and recommendations. 1912a.5 Section 1912a.5 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) NATIONAL ADVISORY COMMITTEE ON OCCUPATIONAL SAFETY AND HEALTH § 1912a.5 Advice and...

Marriage Advice for Parents of Children With Special Needs

MedlinePlus

... Staying Safe Videos for Educators Search English Español Marriage Advice for Parents of Children With Special Needs KidsHealth / For Parents / Marriage Advice for Parents of Children With Special Needs ...

Student giving health advice to family and friends.

PubMed

Tso, Simon; Yousuf, Asim

2016-06-01

This study explored graduate-entry medical students' experiences of health-advice requests from their family and friends. This was a descriptive thematic analysis study involving a convenience sample of medical students from the University of Warwick 4-year MB ChB graduate-entry medicine programme. Each participating student attended a one-to-one semi-structured interview. Audio recordings of the interviews were transcribed verbatim and analysed thematically. Data saturation of the main themes was achieved following 14 interviews. Of the 14 students, eight (57%) were males and six (43%) were females. Students were asked to advise on a range of human and veterinary health issues. They were prepared to offer advice on health issues that they felt competent to manage: for example, first-aid scenarios that a 'reasonable layperson' or a first-aider would be able to help with. The nature of health advice given by students became increasingly complex as they progressed through their degree programme; however, they generally refrained from giving advice on complex health issues and chose to refer the individual to seek help from competent professionals instead. Previous research highlighted inappropriate advice could delay individuals seeking help from competent professionals, resulting in adverse clinical outcomes; however, we recommend that students should not be discouraged to act as good Samaritans. Instead, educators could help them to explore the professionalism and ethical issues raised by these requests, and the practical ways of handling these requests sensitively through discussion of case scenarios with acceptable and inappropriate behaviours. This study explored graduate-entry medical students' experiences of health-advice requests from their family and friends. © 2015 John Wiley & Sons Ltd.

A phenomenologic investigation of pediatric residents' experiences being parented and giving parenting advice.

PubMed

Bax, A C; Shawler, P M; Blackmon, D L; DeGrace, E W; Wolraich, M L

2016-09-01

Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The primary purpose of this study was to examine pediatric residents' self-reported experiences giving parenting advice and explore the relationship between parenting advice given and types of parenting residents received as children. Thirteen OUHSC pediatric residents were individually interviewed to examine experiences being parented and giving parenting advice. Phenomenological methods were used to explicate themes and secondary analyses explored relationships of findings based upon Baumrind's parenting styles (authoritative, authoritarian, permissive). While childhood experiences were not specifically correlated to the parenting advice style of pediatric residents interviewed, virtually all reported relying upon childhood experiences to generate their advice. Those describing authoritative parents reported giving more authoritative advice while others reported more variable advice. Core interview themes related to residents' parenting advice included anxiety about not being a parent, varying advice based on families' needs, and emphasis of positive interactions and consistency. Themes related to how residents were parented included discipline being a learning process for their parents and recalling that their parents always had expectations, yet always loved them. Pediatric residents interviewed reported giving family centered parenting advice with elements of positive interactions and consistency, but interviews highlighted many areas of apprehension residents have around giving parenting advice. Our study suggests that pediatric residents may benefit from more general educational opportunities to develop the content of their parenting advice, including reflecting on any impact from their own upbringing.

77 FR 2719 - National Advisory Council for Environmental Policy and Technology; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-19

... and Technology; Meeting AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of Advisory... a public meeting of the National Advisory Council for Environmental Policy and Technology (NACEPT). NACEPT provides advice to the EPA Administrator on a broad range of environmental policy, technology...

22 CFR 8.2 - Policy.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Policy. 8.2 Section 8.2 Foreign Relations... solely for advisory functions and any decision taken pursuant to the advice or recommendation of an... advisory committees will be open to the public unless there is a compelling reason which requires...

Fusion policy advisory committee named

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

Not Available

Department of Energy Secretary James Watkins has announced the formation of new Fusion Policy Advisory Committee which will recommend a policy for conducting DOE's fusion energy research program. Issues that will be considered by the committee include the balance of research activities within the programs, the timing of experiments to test the burning of plasma fuel, the International Thermonuclear Experimental Reactor, and the development of laser technologies, DOE said. Watkins said that he would be entirely open to the committee's advice.

The Perceived Impact of Agricultural Advice in Ethiopia

ERIC Educational Resources Information Center

Hamilton, Alexander; Hudson, John

2017-01-01

Purpose: We examine the impact of advice given by extension agents to Ethiopian farmers, as perceived by the farmers themselves. Design/methodology/approach: Using survey data from 2014, we analyze the perceived impact of advice on farmers' incomes and crop yields. We use a bootstrapped instrumental variable (IV) estimator and the conditional…

Expert Financial Advice Neurobiologically “Offloads” Financial Decision-Making under Risk

PubMed Central

Engelmann, Jan B.; Capra, C. Monica; Noussair, Charles; Berns, Gregory S.

2009-01-01

Background Financial advice from experts is commonly sought during times of uncertainty. While the field of neuroeconomics has made considerable progress in understanding the neurobiological basis of risky decision-making, the neural mechanisms through which external information, such as advice, is integrated during decision-making are poorly understood. In the current experiment, we investigated the neurobiological basis of the influence of expert advice on financial decisions under risk. Methodology/Principal Findings While undergoing fMRI scanning, participants made a series of financial choices between a certain payment and a lottery. Choices were made in two conditions: 1) advice from a financial expert about which choice to make was displayed (MES condition); and 2) no advice was displayed (NOM condition). Behavioral results showed a significant effect of expert advice. Specifically, probability weighting functions changed in the direction of the expert's advice. This was paralleled by neural activation patterns. Brain activations showing significant correlations with valuation (parametric modulation by value of lottery/sure win) were obtained in the absence of the expert's advice (NOM) in intraparietal sulcus, posterior cingulate cortex, cuneus, precuneus, inferior frontal gyrus and middle temporal gyrus. Notably, no significant correlations with value were obtained in the presence of advice (MES). These findings were corroborated by region of interest analyses. Neural equivalents of probability weighting functions showed significant flattening in the MES compared to the NOM condition in regions associated with probability weighting, including anterior cingulate cortex, dorsolateral PFC, thalamus, medial occipital gyrus and anterior insula. Finally, during the MES condition, significant activations in temporoparietal junction and medial PFC were obtained. Conclusions/Significance These results support the hypothesis that one effect of expert advice is to �

A Better Prescription: Advice for a National Strategy on Pharmaceutical Policy in Canada

PubMed Central

Gagnon, Marc-André; Mintzes, Barbara; Lexchin, Joel

2016-01-01

Canada needs a national strategy to fulfill its obligation to ensure universal access to necessary healthcare, including prescription drugs. A 2004 attempt at a national strategy for pharmaceutical policy failed because it lacked clear vision, logical planning and commitment from federal and provincial governments. The result of uncoordinated pharmaceutical policies in Canada has been more than a decade of poor system performance. In this essay, we present a framework for a renewed national strategy for pharmaceutical policy. Building on published research and international frameworks, we propose that pharmaceutical policies of federal, provincial and territorial governments be coordinated around a core health-focused goal. We strongly suggest policy actions be taken on four core objectives that are necessary to support the overarching health goal. If implemented, the proposed strategy would offer clear benefits to all Canadians who use medicines, federal and provincial governments and to the economy as a whole. We therefore argue that political leadership is now needed to articulate and implement such a plan on behalf of Canadians. PMID:27585023

A Better Prescription: Advice for a National Strategy on Pharmaceutical Policy in Canada.

PubMed

Morgan, Steven G; Gagnon, Marc-André; Mintzes, Barbara; Lexchin, Joel

2016-08-01

Canada needs a national strategy to fulfill its obligation to ensure universal access to necessary healthcare, including prescription drugs. A 2004 attempt at a national strategy for pharmaceutical policy failed because it lacked clear vision, logical planning and commitment from federal and provincial governments. The result of uncoordinated pharmaceutical policies in Canada has been more than a decade of poor system performance. In this essay, we present a framework for a renewed national strategy for pharmaceutical policy. Building on published research and international frameworks, we propose that pharmaceutical policies of federal, provincial and territorial governments be coordinated around a core health-focused goal. We strongly suggest policy actions be taken on four core objectives that are necessary to support the overarching health goal. If implemented, the proposed strategy would offer clear benefits to all Canadians who use medicines, federal and provincial governments and to the economy as a whole. We therefore argue that political leadership is now needed to articulate and implement such a plan on behalf of Canadians. Copyright © 2016 Longwoods Publishing.

5 CFR 2634.402 - Special notice for advice-and-consent nominees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... trust after the Senate has given its advice and consent to a nomination. ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Special notice for advice-and-consent... § 2634.402 Special notice for advice-and-consent nominees. (a) In general. In any case in which the...

5 CFR 2634.402 - Special notice for advice-and-consent nominees.

Code of Federal Regulations, 2011 CFR

2011-01-01

... trust after the Senate has given its advice and consent to a nomination. ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Special notice for advice-and-consent... § 2634.402 Special notice for advice-and-consent nominees. (a) In general. In any case in which the...

Why people seek advice from community pharmacies about skin problems.

PubMed

Tucker, Rod; Stewart, Derek

2015-04-01

The objective of this study was to explore the reasons why patients with undiagnosed skin problems seek advice at pharmacies. Semi-structured telephone interviews were conducted with patients presenting at pharmacies requesting advice for their own (or their child's) undiagnosed skin problem. Twenty-five patients were interviewed. Key themes around choice of pharmacy were convenience of professional advice, triage to general practitioner (GP) care if warranted, inaccessibility of GP care and perceived non-serious nature of the condition. Interviewees also described high levels of trust in their pharmacists. Few concerns were noted, but those that were centred on lack of privacy and the potential for misdiagnosis. Almost all participants felt positive about their pharmacy care and would re-visit for future skin problems. Patients with undiagnosed skin problems seek advice from pharmacies for reasons of professional advice, accessibility, familiarity and trust and because they perceive their conditions as non-serious. © 2014 Royal Pharmaceutical Society.

Isolation of Enterobacter sakazakii from ass' milk in Sicily: case report, safety and legal issues.

PubMed

Conte, F; Passantino, A

2008-07-01

Enterobacter sakazakii (Es) infections are likely to involve newborns and infants, causing meningitis and necrotizing enterocolitis and sepsis. Contamination of infant formulae milk during factory production or bottle preparation is implicated. Es has been isolated from environmental sources and from food other than infant formula and milk powder, but why it is associated only with the consumption of infant formulae, is unclear. According to Regulation (EC) No. 2073/2005 on the microbiological criteria for foodstuffs, Es is considered a microorganisms of greatest concern in infant formulae and follow-on formulae. Es is included between "safety criteria". The isolation of two strains of Es from 50 samples of ass' milk in Sicily is described. The antibiotic resistance profile of the isolates revealed a multiple resistance profile, including fluoroquinolones, commonly used to treat the infections. The authors underline the importance of survey because in Italy ass' milk is considered one of the solutions for infants suffering from hypersensitivity to milk protein of some animal species. There is scarce information about the ecology and the uncertainty concerning the source of infection in the children and adults; the authors are concerned that ass' milk could become a high-risk food.

Lifestyle advice for Korean Americans and native Koreans with hypertension.

PubMed

Kim, Mi Ja; Lee, Suk Jeong; Ahn, Yang-Heui; Lee, Hyeonkyeong

2011-03-01

This paper is a report of a comparison of advice on lifestyle given by healthcare providers and subsequent action by recipients between Korean Americans and native Koreans with hypertension. High blood pressure is controllable by having a healthy lifestyle, such as weight control, dietary change, exercise, low-sodium diet, alcohol restriction and smoking cessation, and by taking medication. Healthcare providers play an important role in teaching individuals with hypertension on healthy lifestyles. This descriptive comparative study was conducted with a convenience sample of 100 Korean Americans and 100 native Koreans with hypertension. They were interviewed between May 2003 and June 2004 on the advice they received from healthcare providers on lifestyle and their subsequent action in terms of taking medication, weight control, dietary change, exercise, low-sodium diet, smoking cessation, alcohol restriction and tension reduction. Nutrient profiles were examined using the 24-hour dietary recall method. Korean Americans received advice on lifestyle less than did native Koreans, but more Korean Americans followed healthy lifestyle advice on dietary change and exercise than did native Koreans (P<0.001). Weight control was the least adhered to behaviour among the Korean Americans, although almost two-thirds of them were overweight or obese. Both groups exceeded the Dietary Reference Intakes of sodium, but perceived their sodium consumption as low. Native Korean participants need to pay closer attention to carrying out the advice, whereas healthcare providers to Korean Americans need to give more advice on culturally acceptable healthy lifestyles, particularly on dietary changes and weight control. Both groups need to monitor their sodium intake more realistically. It is not only advice from healthcare providers that is integral to control of hypertension, but also that patients should follow that advice. © 2010 Blackwell Publishing Ltd.

Financial Advice: Who Pays

ERIC Educational Resources Information Center

Finke, Michael S.; Huston, Sandra J.; Winchester, Danielle D.

2011-01-01

Using a cost-benefit framework for financial planning services and proprietary data collected in the summer of 2008, the client characteristics that are associated with the likelihood of paying for professional financial advice, as well as the type of financial services purchased, are identified. Results indicate that respondents who pay for…

State Share of Instruction Funding to Ohio Public Community Colleges: A Policy Analysis

ERIC Educational Resources Information Center

Johnson, Betsy

2012-01-01

This study investigated various state policies to determine their impact on the state share of instruction (SSI) funding to community colleges in the state of Ohio. To complete the policy analysis, the researcher utilized three policy analysis tools, defined by Gill and Saunders (2010) as iterative processes, intuition and judgment, and advice and…

43 CFR 2203.5 - Action on advice of the Attorney General.

Code of Federal Regulations, 2011 CFR

2011-10-01

... record of decision on the proposed exchange, discuss the consideration given any advice received from the... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Action on advice of the Attorney General... PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.5 Action on advice of the Attorney General...

DOE/EERE conflict-of-interest policy and form

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

None, None

2009-01-18

Conflict of interest policy and agreement recognize that 1) expert reviewers of in-progress programs do not make funding decisions, and 2) programs must often balanced perceived conflict of interest & need expert advice from small community of experts.

5 CFR 1304.4607 - Advice to former Government employees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Advice to former Government employees. 1304.4607 Section 1304.4607 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES POST EMPLOYMENT CONFLICT OF INTEREST § 1304.4607 Advice to former Government employees. The Office...

Factors affecting the acceptance of expert advice.

PubMed

Van Swol, Lyn M; Sniezek, Janet A

2005-09-01

This paper expands research on the judge advisor system (JAS) by examining advice utilization and trust. Experiment 1 examined five factors that could increase utilization of expert advice: judge's trust in the advisor, advisor confidence, advisor accuracy, judge's prior relationship with the advisor, and judge's power to set payment to the advisor. While judge's trust and advisor confidence correlated with the judge matching the advisor's advice, a stepwise regression found that of the five variables, advisor confidence was the only significant predictor of the judge matching the advisor. Experiment 2 examined trust without the role assignment to judge or advisor. While trust expressed in partner was not higher for the judge than the advisor in Experiment 1, in Experiment 2 trust in partner expressed by the low-expertise dyad member was higher than trust expressed by the high-expertise dyad member. Results from the two experiments are discussed in the context of Sniezek and Van Swol (2001).

The implementation of ergonomics advice and the stage of change approach.

PubMed

Rothmore, Paul; Aylward, Paul; Karnon, Jonathan

2015-11-01

This paper investigates the implementation of injury prevention advice tailored according to the Stage of Change (SOC) approach. The managers of 25 workgroups, drawn from medium to large companies across a wide range of occupational sectors were allocated to receive either standard ergonomics advice or ergonomics advice tailored according to the workgroup SOC. Twelve months after the advice was provided, semi-structured interviews were conducted with each manager. In a multivariate model, managers who had received tailored advice were found to have implemented significantly more of the recommended changes (IRR = 1.68, 95% CI 1.07-2.63) and more "additional" changes (IRR = 1.90, 95% CI 1.12-3.20). Qualitative analysis identified that the key barriers and facilitators to the implementation of changes were largely related to worker resistance to change and the attitudes of senior managers towards health and safety. The findings from this study suggest that the implementation of ergonomics recommendations may be improved by the tailoring of advice according to SOC principles. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Drinking policies and exercise-associated hyponatraemia: is anyone still promoting overdrinking?

PubMed

Beltrami, F G; Hew-Butler, T; Noakes, T D

2008-10-01

The purpose of this review is to describe the evolution of hydration research and advice on drinking during exercise from published scientific papers, books and non-scientific material (advertisements and magazine contents) and detail how erroneous advice is likely propagated throughout the global sports medicine community. Hydration advice from sports-linked entities, the scientific community, exercise physiology textbooks and non-scientific sources was analysed historically and compared with the most recent scientific evidence. Drinking policies during exercise have changed substantially throughout history. Since the mid-1990s, however, there has been an increase in the promotion of overdrinking by athletes. While the scientific community is slowly moving away from "blanket" hydration advice in which one form of advice fits all and towards more modest, individualised, hydration guidelines in which thirst is recognised as the best physiological indicator of each subject's fluid needs during exercise, marketing departments of the global sports drink industry continue to promote overdrinking.

Trust in Sources of Advice about Infant Care Practices: The SAFE Study.

PubMed

Hwang, Sunah S; Rybin, Denis V; Heeren, Timothy C; Colson, Eve R; Corwin, Michael J

2016-09-01

Objectives (1) Determine the prevalence of maternal trust in advice sources on infant care practices; (2) Investigate the association of maternal and infant characteristics with trust in advice sources on infant care practices. Methods Using probability sampling methods, we recruited mothers from 32 U.S. maternity hospitals with oversampling of Black and Hispanic women resulting in a nationally representative sample of mothers of infants aged 2-6 months. Survey questions assessed maternal trust in advice sources (physicians, nurses, family, friends, and media) regarding infant care practices including infant sleep practices (sleep position, bed sharing, and pacifier use), feeding, and vaccination. Weighted frequencies of maternal trust in advice sources were calculated to obtain prevalence estimates. Multivariable logistic regression was used to assess the association of maternal and infant characteristics with maternal trust in advice sources. Results Mothers had the greatest trust in doctors for advice on all infant care practices (56-89 %), while trust was lowest for friends (13-22 %) and the media (10-14 %). In the adjusted analyses, there were significant associations of maternal race/ethnicity, education, and age with trust in advice sources. Conclusions for Practice Maternal trust in advice about infant care practices varied significantly by source. A better understanding of which advice sources are most trusted by mothers, as well as the factors associated with maternal trust, may guide the development of more effective strategies to improve adherence to health promoting infant care practices.

29 CFR 1400.735-3 - Advice and counseling service.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 4 2012-07-01 2012-07-01 false Advice and counseling service. 1400.735-3 Section 1400.735-3 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE STANDARDS OF CONDUCT, RESPONSIBILITIES, AND DISCIPLINE General § 1400.735-3 Advice and counseling service...

29 CFR 1400.735-3 - Advice and counseling service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Advice and counseling service. 1400.735-3 Section 1400.735-3 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE STANDARDS OF CONDUCT, RESPONSIBILITIES, AND DISCIPLINE General § 1400.735-3 Advice and counseling service...

29 CFR 1400.735-3 - Advice and counseling service.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 4 2013-07-01 2013-07-01 false Advice and counseling service. 1400.735-3 Section 1400.735-3 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE STANDARDS OF CONDUCT, RESPONSIBILITIES, AND DISCIPLINE General § 1400.735-3 Advice and counseling service...

29 CFR 1400.735-3 - Advice and counseling service.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 4 2014-07-01 2014-07-01 false Advice and counseling service. 1400.735-3 Section 1400.735-3 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE STANDARDS OF CONDUCT, RESPONSIBILITIES, AND DISCIPLINE General § 1400.735-3 Advice and counseling service...

29 CFR 1400.735-3 - Advice and counseling service.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 4 2011-07-01 2011-07-01 false Advice and counseling service. 1400.735-3 Section 1400.735-3 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE STANDARDS OF CONDUCT, RESPONSIBILITIES, AND DISCIPLINE General § 1400.735-3 Advice and counseling service...

How does cot death prevention advice influence parents' behaviour?

PubMed

Miller, L H; Fraser, A; Moy, R

2008-09-01

To explore parents' understanding of the recommended cot death prevention strategies, and to discuss what they are doing in practice. If there is a difference between knowledge and implementation measures, possible reasons for this will be considered. A qualitative study using thematic analysis, aimed at finding out attitudes and opinions of parents about cot death prevention measures. Twelve participants were interviewed from two disadvantaged communities in south Birmingham. Parents found that much of the cot death prevention advice they were provided with was conflicting and caused confusion. As such, many parents chose to follow advice from non-healthcare sources. Some parents were carrying out preventative measures but were not aware of the reason for doing it. Many felt they did not receive enough advice relating to cot death prevention. Cot death health promotion advice appears to be inadequate among patients from a deprived socioeconomic background. Some of these issues could be resolved with increased training addressing these matters.

Aspects of Recipient Design in Expert Advice-giving on Call-in Radio.

ERIC Educational Resources Information Center

Hutchby, Ian

1995-01-01

Investigates the management of expertise in advice-giving in the calls to a radio advice line. Analyzes how the expert's talk handles the tension between the personal and public dimensions of advice-giving in such a public forum. (HB)

Advice Taking from Humans and Machines: An fMRI and Effective Connectivity Study.

PubMed

Goodyear, Kimberly; Parasuraman, Raja; Chernyak, Sergey; Madhavan, Poornima; Deshpande, Gopikrishna; Krueger, Frank

2016-01-01

With new technological advances, advice can come from different sources such as machines or humans, but how individuals respond to such advice and the neural correlates involved need to be better understood. We combined functional MRI and multivariate Granger causality analysis with an X-ray luggage-screening task to investigate the neural basis and corresponding effective connectivity involved with advice utilization from agents framed as experts. Participants were asked to accept or reject good or bad advice from a human or machine agent with low reliability (high false alarm rate). We showed that unreliable advice decreased performance overall and participants interacting with the human agent had a greater depreciation of advice utilization during bad advice compared to the machine agent. These differences in advice utilization can be perceivably due to reevaluation of expectations arising from association of dispositional credibility for each agent. We demonstrated that differences in advice utilization engaged brain regions that may be associated with evaluation of personal characteristics and traits (precuneus, posterior cingulate cortex, temporoparietal junction) and interoception (posterior insula). We found that the right posterior insula and left precuneus were the drivers of the advice utilization network that were reciprocally connected to each other and also projected to all other regions. Our behavioral and neuroimaging results have significant implications for society because of progressions in technology and increased interactions with machines.

Advice Taking from Humans and Machines: An fMRI and Effective Connectivity Study

PubMed Central

Goodyear, Kimberly; Parasuraman, Raja; Chernyak, Sergey; Madhavan, Poornima; Deshpande, Gopikrishna; Krueger, Frank

2016-01-01

With new technological advances, advice can come from different sources such as machines or humans, but how individuals respond to such advice and the neural correlates involved need to be better understood. We combined functional MRI and multivariate Granger causality analysis with an X-ray luggage-screening task to investigate the neural basis and corresponding effective connectivity involved with advice utilization from agents framed as experts. Participants were asked to accept or reject good or bad advice from a human or machine agent with low reliability (high false alarm rate). We showed that unreliable advice decreased performance overall and participants interacting with the human agent had a greater depreciation of advice utilization during bad advice compared to the machine agent. These differences in advice utilization can be perceivably due to reevaluation of expectations arising from association of dispositional credibility for each agent. We demonstrated that differences in advice utilization engaged brain regions that may be associated with evaluation of personal characteristics and traits (precuneus, posterior cingulate cortex, temporoparietal junction) and interoception (posterior insula). We found that the right posterior insula and left precuneus were the drivers of the advice utilization network that were reciprocally connected to each other and also projected to all other regions. Our behavioral and neuroimaging results have significant implications for society because of progressions in technology and increased interactions with machines. PMID:27867351

Patient characteristics associated with receipt of lifestyle behavior advice.

PubMed

Corsino, Leonor; Svetkey, Laura P; Ayotte, Brian J; Bosworth, Hayden B

2009-01-01

Lifestyle behaviors such as reducing weight if overweight or obese, reducing salt intake, exercising, reducing alcohol intake, quitting smoking, and eating a healthy diet are related to the prevention and control of chronic diseases. However the amount of lifestyle advice provided by clinicians has been declining over the last decade. In 2002, a telephone survey was conducted to assess the quality of preventive care offered by health care providers. The study was a cross-sectional observational study of a randomly selected sample of 516 diverse individuals in Durham County, North Carolina. Information regarding age, sex, race, education, health conditions, and self-reported receipt of lifestyle advice was examined in the study. The odds of receiving advice to engage in preventive lifestyle behaviors were significantly higher for those with a pre-existing diagnosis of diabetes or hypertension and for participants reporting poor health status. For example, the odds of receiving advice to control or lose weight was 8.32 (95% CI, 2.65, 26.75) among individuals reporting a diagnosis of diabetes. Similarly, the odds of reporting "receiving advice to reduce salt intake" was 6.97 (95% CI, 3.74, 13.00) among subjects reporting a diagnosis of hypertension. The results are from a cross-sectional study of a sample of individuals in only one county. Additionally, the results are based on patient self-reported information, which could be subject to recall and social desirability bias. Patients with identified health problems were more likely than others to report being advised to adopt healthy lifestyle recommendations. Future research should examine methods to encourage health care providers to offer lifestyle advice to those without pre-existing illness.

16 CFR 1.72 - Examination, counseling and staff advice.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Examination, counseling and staff advice. 1... and staff advice. The Commission maintains a staff to carry out on-the-scene examination of records... counseling. Requests for staff interpretation of the Fair Credit Reporting Act should be directed to the...

16 CFR 1.72 - Examination, counseling and staff advice.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Examination, counseling and staff advice. 1... and staff advice. The Commission maintains a staff to carry out on-the-scene examination of records... counseling. Requests for staff interpretation of the Fair Credit Reporting Act should be directed to the...

16 CFR 1.72 - Examination, counseling and staff advice.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Examination, counseling and staff advice. 1... and staff advice. The Commission maintains a staff to carry out on-the-scene examination of records... counseling. Requests for staff interpretation of the Fair Credit Reporting Act should be directed to the...

16 CFR 1.72 - Examination, counseling and staff advice.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Examination, counseling and staff advice. 1... and staff advice. The Commission maintains a staff to carry out on-the-scene examination of records... counseling. Requests for staff interpretation of the Fair Credit Reporting Act should be directed to the...

16 CFR 1.72 - Examination, counseling and staff advice.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Examination, counseling and staff advice. 1... and staff advice. The Commission maintains a staff to carry out on-the-scene examination of records... counseling. Requests for staff interpretation of the Fair Credit Reporting Act should be directed to the...

75 FR 16894 - Advisory Committee on International Economic Policy; Notice of Open Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

....S. Government in a solely advisory capacity, and provides advice concerning issues and challenges in... DEPARTMENT OF STATE [Public Notice 6910] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2 p...

Racial disparities in reported prenatal care advice from health care providers.

PubMed Central

Kogan, M D; Kotelchuck, M; Alexander, G R; Johnson, W E

1994-01-01

OBJECTIVES. The relationship between certain maternal behaviors and adverse pregnancy outcomes has been well documented. One method to alter these behaviors is through the advice of women's health care providers. Advice from providers may be particularly important in minority populations, who have higher rates of infant mortality and prematurity. This study examines racial disparities according to women's self-report of advice received from health care providers during pregnancy in four areas: tobacco use, alcohol consumption, drug use, and breast-feeding. METHODS. Health care providers' advice to 8310 White non-Hispanic and Black women was obtained from the National Maternal and Infant Health Survey. RESULTS. After controlling for sociodemographic, utilization, and medical factors, Black women were more likely to report not receiving advice from their prenatal care providers about smoking cessation and alcohol use. The difference between Blacks and Whites also approached significance for breast-feeding. No overall difference was noted in advice regarding cessation of drug use, although there was a significant interaction between race and marital status. CONCLUSIONS. These data suggest that Black women may be at greater risk for not receiving information that could reduce their chances of having an adverse pregnancy outcome. PMID:8279618

14 CFR § 1209.305 - Legal advice and assistance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Legal advice and assistance. § 1209.305 Section § 1209.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION BOARDS AND COMMITTEES Contract Adjustment Board § 1209.305 Legal advice and assistance. The General Counsel of NASA...

Dietary advice interventions in pregnancy for preventing gestational diabetes mellitus.

PubMed

Tieu, Joanna; Shepherd, Emily; Middleton, Philippa; Crowther, Caroline A

2017-01-03

Gestational diabetes mellitus (GDM) is a form of diabetes occurring during pregnancy which can result in short- and long-term adverse outcomes for women and babies. With an increasing prevalence worldwide, there is a need to assess strategies, including dietary advice interventions, that might prevent GDM. To assess the effects of dietary advice interventions for preventing GDM and associated adverse health outcomes for women and their babies. We searched Cochrane Pregnancy and Childbirth's Trials Register (3 January 2016) and reference lists of retrieved studies. Randomised controlled trials (RCTs) and quasi-RCTs assessing the effects of dietary advice interventions compared with no intervention (standard care), or to different dietary advice interventions. Cluster-RCTs were eligible for inclusion but none were identified. Two review authors independently assessed study eligibility, extracted data and assessed the risk of bias of the included studies. Data were checked for accuracy. The quality of the evidence was assessed using the GRADE approach. We included 11 trials involving 2786 women and their babies, with an overall unclear to moderate risk of bias. Six trials compared dietary advice interventions with standard care; four compared low glycaemic index (GI) with moderate- to high-GI dietary advice; one compared specific (high-fibre focused) with standard dietary advice. Dietary advice interventions versus standard care (six trials) Considering primary outcomes, a trend towards a reduction in GDM was observed for women receiving dietary advice compared with standard care (average risk ratio (RR) 0.60, 95% confidence interval (CI) 0.35 to 1.04; five trials, 1279 women; Tau² = 0.20; I² = 56%; P = 0.07; GRADE: very low-quality evidence); subgroup analysis suggested a greater treatment effect for overweight and obese women receiving dietary advice. While no clear difference was observed for pre-eclampsia (RR 0.61, 95% CI 0.25 to 1.46; two trials, 282 women

Behavior Modification of Studying Through Study Skills Advice and Self-Control Procedures

ERIC Educational Resources Information Center

Richards, C. Steven

1975-01-01

Investigates the efficacy of two behavioral self-control procedures as additions to the typical treatment for college students' study behavior--study skills advice. Predicted self-monitoring would be an effective treatment addition to study skills advice and study skills advice would be superior to the control groups. Results supported…

Building and Strengthening Policy Research Capacity: Key Issues in Canadian Higher Education

ERIC Educational Resources Information Center

Jones, Glen A.

2014-01-01

Given the importance of higher education in social and economic development, governments need to build a strong higher education data and policy research infrastructure to support informed decision-making, provide policy advice, and offer a critical assessment of key trends and issues. The author discusses the decline of higher education policy…

[Pre travel advice - a study among Swiss general practitioners].

PubMed

Walz, Alexander; Tschudi, Peter; Badertscher, Nina; Hatz, Christoph

2013-06-01

Up to 65 % of travellers seek pre-travel advice at their general practitioner. Professionals should inform about the most common and most dangerous health threats, requiring up-to-date knowledge about epidemiology of respective disorders. The aim of the present study was to investigate the content of pre-travel advice given by general practitioners in order to provide them with better expert support from travel medicine specialists. One third of them perform pre-travel advice weekly, and some two thirds do so at least monthly. The most frequently discussed topics are malaria, immunisation, insect bite prevention and travellers' diarrhoea. Less than half of the advice sessions included talking about the risk of accidents. Apart from the need for yellow fever vaccination, referral to travel medicine experts was highest for immunocompromised and pregnant travellers, and for trips to "high risk" countries. A considerable number of practitioners do not comply with the Swiss recommendations, continuously updated in the Bulletin of the Federal Office of Public Health, possibly because only 21 % consult them at regular intervals.

31 CFR 248.3 - Advice of nonreceipt or loss.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Advice of nonreceipt or loss. 248.3... § 248.3 Advice of nonreceipt or loss. The payee or owner of a depositary check which is not received, or..., giving information as to the circumstances of the loss, theft or destruction of the check and whether it...

31 CFR 245.4 - Advice of nonreceipt or loss.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Advice of nonreceipt or loss. 245.4... § 245.4 Advice of nonreceipt or loss. (a) In the event of the nonreceipt, loss or destruction of a check... of such check, describing the check, stating the purpose for which it was issued and giving, if...

31 CFR 245.4 - Advice of nonreceipt or loss.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Advice of nonreceipt or loss. 245.4... § 245.4 Advice of nonreceipt or loss. (a) In the event of the nonreceipt, loss or destruction of a check... of such check, describing the check, stating the purpose for which it was issued and giving, if...

31 CFR 248.3 - Advice of nonreceipt or loss.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Advice of nonreceipt or loss. 248.3... § 248.3 Advice of nonreceipt or loss. The payee or owner of a depositary check which is not received, or..., giving information as to the circumstances of the loss, theft or destruction of the check and whether it...

5 CFR 2641.105 - Advice.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS POST-EMPLOYMENT CONFLICT OF INTEREST RESTRICTIONS General Provisions § 2641.105 Advice. (a) Agency ethics officials.Current or former employees or... designated agency ethics official or another agency ethics official. The agency in which an individual...

Nutrigenomics-based personalised nutritional advice: in search of a business model?

PubMed

Ronteltap, Amber; van Trijp, Hans; Berezowska, Aleksandra; Goossens, Jo

2013-03-01

Nutritional advice has mainly focused on population-level recommendations. Recent developments in nutrition, communication, and marketing sciences have enabled potential deviations from this dominant business model in the direction of personalisation of nutrition advice. Such personalisation efforts can take on many forms, but these have in common that they can only be effective if they are supported by a viable business model. The present paper takes an inventory of approaches to personalised nutrition currently available in the market place as its starting point to arrive at an identification of their underlying business models. This analysis is presented as a unifying framework against which the potential of nutrigenomics-based personalised advice can be assessed. It has uncovered nine archetypical approaches to personalised nutrition advice in terms of their dominant underlying business models. Differentiating features among such business models are the type of information that is used as a basis for personalisation, the definition of the target group, the communication channels that are being adopted, and the partnerships that are built as a part of the business model. Future research should explore the consumer responses to the diversity of "archetypical" business models for personalised nutrition advice as a source of market information on which the delivery of nutrigenomics-based personalised nutrition advice may further build.

A parent advice package for family shopping trips: development and evaluation1

PubMed Central

Clark, Hewitt B.; Greene, Brandon F.; Macrae, John W.; McNees, M. Patrick; Davis, Jerry L.; Risley, Todd R.

1977-01-01

This article reports on the primary steps in the development of parent advice for popular dissemination: (a) developing advice for one specific problem situation, family shopping trips; (b) testing the advice program for benefit to children and convenience to adults; and (c) packaging the advice so it can be used successfully by interested parents. Systematic observation of 12 families using the written advice package on shopping trips revealed its effectiveness in reducing child disruptions and increasing positive interactions between parents and children. These findings, along with interview information from families, showed that the package is usable, effective, and popular with both parents and children, and thus is ready for dissemination to a wide audience of parents—a step that in itself should involve research and evaluation. PMID:16795570

Regulatory Scientific Advice on Non-Inferiority Drug Trials

PubMed Central

Knol, Mirjam J.; Klungel, Olaf H.; Gispen-De Wied, Christine C.; de Boer, Antonius; Hoes, Arno W.; Leufkens, Hubert G.; Mantel-Teeuwisse, Aukje K.

2013-01-01

The active-controlled trial with a non-inferiority design has gained popularity in recent years. However, non-inferiority trials present some methodological challenges, especially in determining the non-inferiority margin. Regulatory guidelines provide some general statements on how a non-inferiority trial should be conducted. Moreover, in a scientific advice procedure, regulators give companies the opportunity to discuss critical trial issues prior to the start of the trial. The aim of this study was to identify potential issues that may benefit from more explicit guidance by regulators. To achieve this, we collected and analyzed questions about non-inferiority trials posed by applicants for scientific advice in Europe in 2008 and 2009, as well as the responses given by the European Medicines Agency (EMA). In our analysis we included 156 final letters of advice from 2008 and 2009, addressed to 94 different applicants (manufacturers). Our analysis yielded two major findings: (1) applicants frequently asked questions ‘whether’ and ‘how’ to conduct a non-inferiority trial, 26% and 74%, respectively, and (2) the EMA regulators seem mainly concerned about the choice of the non-inferiority margin in non-inferiority trials (36% of total regulatory answers). In 40% of the answers, the EMA recommended using a stricter margin, and in 10% of the answers regarding non-inferiority margins, the EMA questioned the justification of the proposed non-inferiority margin. We conclude that there are still difficulties in selecting the appropriate methodology for non-inferiority trials. Straightforward and harmonized guidance regarding non-inferiority trials is required, for example on whether it is necessary to conduct such a trial and how the non-inferiority margin is determined. It is unlikely that regulatory guidelines can cover all therapeutic areas; therefore, in some cases regulatory scientific advice may be used as an opportunity for tailored advice. PMID:24040346

Health Professional Advice and Adult Action to Reduce Sodium Intake.

PubMed

Jackson, Sandra L; Coleman King, Sallyann M; Park, Soyoun; Fang, Jing; Odom, Erika C; Cogswell, Mary E

2016-01-01

Excessive sodium intake is a key modifiable risk factor for hypertension and cardiovascular disease. Although 95% of U.S. adults exceed intake recommendations, knowledge is limited regarding whether doctor or health professional advice motivates patients to reduce intake. Our objectives were to describe the prevalence and determinants of taking action to reduce sodium, and to test whether receiving advice was associated with action. Analyses, conducted in 2014, used data from the 2013 Behavioral Risk Factor Surveillance System, a state-based telephone survey representative of non-institutionalized adults. Respondents (n=173,778) from 26 states, the District of Columbia, and Puerto Rico used the new optional sodium module. We estimated prevalence ratios (PRs) based on average marginal predictions, accounting for the complex survey design. Fifty-three percent of adults reported taking action to reduce sodium intake. Prevalence of action was highest among adults who received advice (83%), followed by adults taking antihypertensive medications, adults with diabetes, adults with kidney disease, or adults with a history of cardiovascular disease (range, 73%-75%), and lowest among adults aged 18-24 years (29%). Overall, 23% of adults reported receiving advice to reduce sodium intake. Receiving advice was associated with taking action (prevalence ratio=1.59; 95% CI=1.56, 1.61), independent of sociodemographic and health characteristics, although some disparities were observed across race/ethnicity and BMI categories. Our results suggest that more than half of U.S. adults in 26 states and two territories are taking action to reduce sodium intake, and doctor or health professional advice is strongly associated with action. Published by Elsevier Inc.

Relationships between physician advice and tobacco and alcohol use during pregnancy.

PubMed

Jones-Webb, R; McKiver, M; Pirie, P; Miner, K

1999-04-01

We sought to examine relationships between physician advice and use of tobacco and alcohol during pregnancy among 683 women in the upper Midwest. Data on risk of substance use during pregnancy were analyzed using logistic regression analysis. A higher proportion of women used tobacco (34%) than alcohol (25%) during their most recent pregnancy. Women who received advice from a physician to abstain from alcohol reported a lower risk of smoking and drinking during pregnancy than women who did not receive such advice. Risk of smoking and drinking during pregnancy was also common among women who reported early onset of alcohol use. Results suggest that physician advice regarding alcohol use during pregnancy is protective against maternal smoking and drinking during pregnancy.

Low Income Women and Physician Breastfeeding Advice: A Regional Assessment

ERIC Educational Resources Information Center

Stolzer, J; Zeece, Pauline

2006-01-01

Objectives: The aims of the pilot study presented here were to determine whether low income women were receiving compendious breastfeeding advice from their attending physicians. Design: This study assessed low income women's reports of physician breastfeeding advice using a newly designed Likert scaled survey based on the American Surgeon…

Family planning advice and postpartum contraceptive use among low-income women in Mexico.

PubMed

Barber, Sarah L

2007-03-01

In Mexico, family planning advice has been incorporated into the clinical guidelines for prenatal care. However, the relationship between women's receipt of family planning advice during prenatal care and subsequent contraceptive use has not been evaluated. Data were collected in 2003 and 2004 in 17 Mexican states from 2,238 urban low-income women postpartum. Participating women reported on prenatal services received and contraceptive use. Logistic and multinomial logistic regression models evaluated whether receiving family planning advice during prenatal care predicted current contraceptive use, after quality of care in the community, service utilization, delivery characteristics, household socioeconomic characteristics, and maternal and infant characteristics were controlled for. Overall, 47% of women used a modern contraceptive method. Women who received family planning advice during prenatal care were more likely to use a contraceptive than were those who did not receive such advice (odds ratio, 2.2). Women who received family planning advice had a higher probability of using condoms (relative risk ratio, 2.3) and IUDs (5.2), and of undergoing sterilization (1.4), than of using no method. Integrating family planning advice into prenatal care may be an important strategy for reaching women when their demand for contraception is high.

More Than Maintenance: Sustaining Improvement Efforts over the Long Run. Policy Brief

ERIC Educational Resources Information Center

Jerald, Craig

2005-01-01

This is the last in a series of four policy briefs to be published by The Center for Comprehensive School Reform and Improvement in 2005. The briefs are intended to provide fresh insights and useful advice to policymakers and school assistance providers. The first part of this policy brief breaks down the process of sustaining improvement and…

Sociality Mental Modes Modulate the Processing of Advice-Giving: An Event-Related Potentials Study

PubMed Central

Li, Jin; Zhan, Youlong; Fan, Wei; Liu, Lei; Li, Mei; Sun, Yu; Zhong, Yiping

2018-01-01

People have different motivations to get along with others in different sociality mental modes (i.e., communal mode and market mode), which might affect social decision-making. The present study examined how these two types of sociality mental modes affect the processing of advice-giving using the event-related potentials (ERPs). After primed with the communal mode and market mode, participants were instructed to decide whether or not give an advice (profitable or damnous) to a stranger without any feedback. The behavioral results showed that participants preferred to give the profitable advice to the stranger more slowly compared with the damnous advice, but this difference was only observed in the market mode condition. The ERP results indicated that participants demonstrated more negative N1 amplitude for the damnous advice compared with the profitable advice, and larger P300 was elicited in the market mode relative to both the communal mode and the control group. More importantly, participants in the market mode demonstrated larger P300 for the profitable advice than the damnous advice, whereas this difference was not observed at the communal mode and the control group. These findings are consistent with the dual-process system during decision-making and suggest that market mode may lead to deliberate calculation for costs and benefits when giving the profitable advice to others. PMID:29467689

Health reform requires policy capacity

PubMed Central

Forest, Pierre-Gerlier; Denis, Jean-Louis; Brown, Lawrence D.; Helms, David

2015-01-01

Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility. PMID:25905476

Cancer Battles and the Sleep of Reason policy and science need not be related.

PubMed

Bennett, David

2003-01-01

Cancer Battles and the Sleep of Reason is an inquiry into the role of scientific experts in environmental health policy-making. The article first establishes two propositions: that there is no necessary relationship between science and environmental health policy; and that risk assessment is not the only science of environmental health. It then asks the question: why should policy-makers consult the scientific experts? If experts are to be consulted, there will have to be some way of grading experts as to the quality of their advice and their usefulness to policy-makers. A mode of grading experts is provided in Environmental Cancer--A Political Disease? by S. Robert Lichter and Stanley Rothman. But the arguments in this book are shown to be worthless; the book fails to address the underlying issue of why the experts should be consulted at all. The article concludes that experts are to be consulted whenever policy-makers consider their advice to be essential or useful. There is nothing in the scientific disciplines that entrenches them in the policymaking process; the opinions of scientific experts have no special place in environmental health policy.

"What Advice Would You Give to Students Starting Your Course?"

ERIC Educational Resources Information Center

Meedin, Aneeqa

2007-01-01

In this essay, the author, a Biomedical Sciences student at the University of Sheffield, presents an atypical way of addressing the question "What advice would you give to students starting your course?" by transcribing the much-evoked and revered Ten Commandments, the original guide to life, into advice for new and bewildered Biomedical…

Listen to Your Heart? Calling and Receptivity to Career Advice

ERIC Educational Resources Information Center

Dobrow, Shoshana R.; Tosti-Kharas, Jennifer

2012-01-01

This study explores calling in the context of career decision making. Specifically, the authors examine receptivity to advice that discourages individuals from pursuing a professional path in their calling's domain. The authors hypothesize that people with a strong calling will be more likely to ignore negative career advice. In Study 1, a…

A quantitative analysis of the quality and content of the health advice in popular Australian magazines.

PubMed

Wilson, Amanda; Smith, David; Peel, Roseanne; Robertson, Jane; Kypri, Kypros

2017-06-01

To examine how health advice is provided in popular magazines and the quality of that advice. A prospective quantitative analysis of the quality of health advice provided in Australian magazines between July and December 2011 was conducted. A rating instrument was adapted from the Media Doctor Australia rating tool used to assess quality of health news reporting. Criteria included: recommends seeing a doctor; advice based on reliable evidence; advice clear and easily applied; benefits presented meaningfully; potential harms mentioned; evidence of disease mongering; availability and cost of treatments; obvious advertising; vested interest, and anecdotal evidence. 163 health advice articles were rated showing a wide variation in the quality of advice presented between magazines. Magazines with 'health' in the title, rated most poorly with only 36% (26/73) of these articles presenting clear and meaningful advice and 52% (38/73) giving advice based on reliable evidence. Australian magazines, especially those with health in the title, generally presented poor quality, unreliable health advice. Teen magazine Dolly provided the highest quality advice. Consumers need to be aware of this when making health choices. © 2016 Public Health Association of Australia.

General physical health advice for people with serious mental illness.

PubMed

Tosh, Graeme; Clifton, Andrew V; Xia, Jun; White, Margueritte M

2014-03-28

There is currently much focus on provision of general physical health advice to people with serious mental illness and there has been increasing pressure for services to take responsibility for providing this. To review the effects of general physical healthcare advice for people with serious mental illness. We searched the Cochrane Schizophrenia Group's Trials Register (last update search October 2012) which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO and registries of Clinical Trials. There is no language, date, document type, or publication status limitations for inclusion of records in the register. All randomised clinical trials focusing on general physical health advice for people with serious mental illness.. We extracted data independently. For binary outcomes, we calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data, we estimated the mean difference (MD) between groups and its 95% CI. We employed a fixed-effect model for analyses. We assessed risk of bias for included studies and created 'Summary of findings' tables using GRADE. Seven studies are now included in this review. For the comparison of physical healthcare advice versus standard care we identified six studies (total n = 964) of limited quality. For measures of quality of life one trial found no difference (n = 54, 1 RCT, MD Lehman scale 0.20, CI -0.47 to 0.87, very low quality of evidence) but another two did for the Quality of Life Medical Outcomes Scale - mental component (n = 487, 2 RCTs, MD 3.70, CI 1.76 to 5.64). There was no difference between groups for the outcome of death (n = 487, 2 RCTs, RR 0.98, CI 0.27 to 3.56, low quality of evidence). For service use two studies presented favourable results for health advice, uptake of ill-health prevention services was significantly greater in the advice group (n = 363, 1 RCT, MD 36.90, CI 33.07 to 40.73) and service use: one or more primary

Giving and Receiving Advice in Computer-Mediated Peer Response Activities

ERIC Educational Resources Information Center

Tsai, Mei-Hsing; Kinginger, Celeste

2015-01-01

In synchronous computer-mediated contexts, peer-to-peer interaction at the microlevel has received little scrutiny. In applying a conversation analysis approach, this study scrutinizes the precise nature of peer-to-peer advice giving and receiving. In this process, an advice giver can be viewed at certain moments as more competent to evaluate a…

For the sake of whom: conversation analysis of advice giving in offender counseling.

PubMed

Jing-ying, Guo

2013-08-01

Regarded as beneficial and preferable to the clients, advice delivery has been an integral part of counseling; however, there are controversies over the suitability of giving advice in counseling services, including counseling conducted in the context of prisons. Based on conversation analysis, this article tries to explore when and how police counselors in two Chinese prisons give advice and how inmate clients respond to and seek advice in offender counseling. It is found that advice delivery, supposed to be for the inmate clients' sake, only serves a phatic function in the context of prisons in which security is a priority, and transforming inmates into law-abiding citizen is the overall goal of prison rehabilitation and correction. Hence, offender counselors, intending to alleviate depression and anxiety in inmate clients, are caught in a dilemma.

Lifestyle advice and lifestyle change: to what degree does lifestyle advice of healthcare professionals reach the population, focusing on gender, age and education?

PubMed

Brobeck, Elisabeth; Bergh, Håkan; Odencrants, Sigrid; Hildingh, Cathrine

2015-03-01

Health promotion practice in health care has a high priority in the endeavour to achieve equal opportunities for health and diversity in health among the population. The purpose of the study was to investigate whether there is any connection between the lifestyle advice given by healthcare professionals and the lifestyle change of the population, focusing on age, gender and education level. The study is based on the data from a national population survey in Sweden in which 52 595 patients who had attended health care were interviewed by phone. The participants were asked whether healthcare professionals had raised the subject of lifestyle during the visit and whether the advice they gave had contributed to a lifestyle change. The results indicated that lifestyle issues were raised with 32.2% of those who attended health care, particularly among men, younger patients and those with a high education level. When lifestyle issues were raised, the advice contributed to 39.2% of patients making a lifestyle change, to a higher extent among men, older patients and those with a low education level. The study shows that lifestyle advice given by healthcare professionals, during both emergency and outpatient healthcare visits, is an important contributor to patients' lifestyle change. © 2014 Nordic College of Caring Science.

Using Advice from Multiple Sources to Revise and Improve Judgments

ERIC Educational Resources Information Center

Yaniv, Ilan; Milyavsky, Maxim

2007-01-01

How might people revise their opinions on the basis of multiple pieces of advice? What sort of gains could be obtained from rules for using advice? In the present studies judges first provided their initial estimates for a series of questions; next they were presented with several (2, 4, or 8) opinions from an ecological pool of advisory estimates…

29 CFR 2550.408g-1 - Investment advice-participants and beneficiaries.

Code of Federal Regulations, 2012 CFR

2012-07-01

...)(A) Any investment advice is based on generally accepted investment theories that take into account... theories that take into account additional considerations; (B) Any investment advice takes into account... to— (A) Apply generally accepted investment theories that take into account the historic risks and...

29 CFR 2550.408g-1 - Investment advice-participants and beneficiaries.

Code of Federal Regulations, 2013 CFR

2013-07-01

...)(A) Any investment advice is based on generally accepted investment theories that take into account... theories that take into account additional considerations; (B) Any investment advice takes into account... to— (A) Apply generally accepted investment theories that take into account the historic risks and...

29 CFR 2550.408g-1 - Investment advice-participants and beneficiaries.

Code of Federal Regulations, 2014 CFR

2014-07-01

...)(A) Any investment advice is based on generally accepted investment theories that take into account... theories that take into account additional considerations; (B) Any investment advice takes into account... to— (A) Apply generally accepted investment theories that take into account the historic risks and...

Watchful Waiting for Cases of Pediatric Otitis Media: Modeling Parental Response to Physician Advice.

PubMed

MacGeorge, Erina L; Smith, Rachel A; Caldes, Emily P; Hackman, Nicole M

2016-08-01

Watchful waiting (WW) can reduce unnecessary antibiotic use in the treatment of pediatric otitis media (ear infection), but its utility is impaired by underutilization and noncompliance. Guided by advice response theory, the current study proposes advantage and capacity as factors that predict how caregivers evaluate and respond affectively to WW. Parents (N = 373) of at least 1 child age 5 years or younger completed questionnaires that assessed responses to hypothetical WW advice for their youngest child. Perceptions of advantage from WW and the capacity to monitor and manage symptoms predicted advice quality, physician trust, and future compliance both directly and indirectly through negative affect. The findings suggest the elaboration of advice response theory to include more aspects of advice content evaluation (e.g., advantage) and the influence of negative affect. The study also provides practical guidance for physicians seeking to improve caregiver reception of WW advice.

[Life style advice provided by primary health care to prevent cardiovascular diseases].

PubMed

Meland, E; Ellekjaer, H; Gjelsvik, B; Kimsås, A; Holmen, J; Hetlevik, I

2000-09-20

The Working Group on Hypertension of the Norwegian College of General Practitioners reports in this paper on the documentation on behavioural advice in the prevention of cardiovascular disease. Emphasis is given to hypertension. The recommendations are mainly based on updated metaanalyses and randomised controlled trials. Hypertension is treated to prevent cardiovascular disease; that is why we put emphasis on documentation with significant end points. The validity of the documentation for general practice is assessed. We have also assessed whether certain methods or theories for behavioural change could be helpful to the general practitioner. The value of advice against smoking, dietary advice (increased intake of grain products, vegetables, fruit, poultry and fish), and advice about exercise are well documented and applicable in general practice. Respect for the patient's autonomy and interest in the patients and their health-related habits seem to be important factors for improving doctor's chances of influencing patient behaviour. The value of life-style advice is well documented and should play an important role in clinical strategies to prevent cardiovascular disease in high-risk patients.

It is important that they care - older persons' experiences of telephone advice nursing.

PubMed

Holmström, Inger K; Nokkoudenmäki, Mai-Britt; Zukancic, Selma; Sundler, Annelie J

2016-06-01

The aim of the study was to explore older persons' experiences of telephone advice nursing at primary healthcare centres. Telephone advice nursing is expanding worldwide, and the older population is increasing. Little is known about older persons' experiences of telephone advice nursing provided by primary healthcare. This study has a descriptive design with a qualitative inductive approach. Data were collected via interviews with a purposive sample of 10 older persons in 2014. The data were analysed using qualitative content analysis. The older persons' experiences were described in two themes: the patient-friendly aspects of telephone advice nursing and the patient-unfriendly aspects of telephone advice nursing. The themes can be understood as two sides of the same coin; the differences point to both the advantages and disadvantages of the service and are further illuminated through seven subthemes. This study contributes to increased awareness of the advantages and disadvantages of the telephone advice nursing system as experienced by older persons. To be the focus of attention during calls was highlighted as important; and clear communication was deemed crucial. When the communication between the nurse and the older persons was perceived as good and the perspective of the caller was the focus, an experience of safety and satisfaction was described. Older persons had great confidence in the telephone nurses' competence and perceived their ability to access the service as mostly good, even if it was sometimes difficult to use the service. The communicative competence of telephone nurses is essential when providing telephone advice nursing to older persons. In addition, a person-centred approach is important to provide optimal care in telephone advice nursing. © 2016 John Wiley & Sons Ltd.

Parents’ professional sources of advice regarding child discipline and their use of corporal punishment

PubMed Central

Taylor, Catherine A.; Moeller, William; Hamvas, Lauren; Rice, Janet C.

2014-01-01

Parents (n=500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents that sought advice from religious leaders (vs. pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported they were more likely to follow the advice of pediatricians than any other professional; however, Black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents. PMID:23185082

Parents' professional sources of advice regarding child discipline and their use of corporal punishment.

PubMed

Taylor, Catherine A; Moeller, William; Hamvas, Lauren; Rice, Janet C

2013-02-01

Parents (n = 500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of the parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents who sought advice from religious leaders (vs pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported that they were more likely to follow the advice of pediatricians than any other professional; however, black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents.

Advice on drug safety in pregnancy: are there differences between commonly used sources of information?

PubMed

Frost Widnes, Sofia K; Schjøtt, Jan

2008-01-01

Safety regarding use in pregnancy is not established for many drugs. Inconsistencies between sources providing drug information can give rise to confusion with possible therapeutic consequences. Therefore, it is important to measure clinically important differences between drug information sources. The objective of this study was to compare two easily accessible Norwegian sources providing advice on drug safety in pregnancy - the product monographs in the Felleskatalog (FK), published by the pharmaceutical companies, and the five regional Drug Information Centres (DICs) in Norway - in addition to assessing the frequency of questions regarding drug safety in pregnancy made to the DICs according to the Anatomical Therapeutic Chemical (ATC) classification system. Advice on drug use in pregnancy provided by the DICs in 2003 and 2005 were compared with advice in the product monographs for the respective drugs in the FK. Comparison of advice was based on categorization to one of four categories: can be used, benefit-risk assessment, should not be used, or no available information. A total of 443 drug advice were categorized. Seven out of ten of drugs frequently enquired about, according to the ATC system, were drugs acting on the nervous system (group N). For 208 (47%) of the drugs, advice differed between the DICs and FK. Advice from the FK was significantly (p < 0.01) more restrictive than advice from the DICs. There were no differences in the level of consistency of advice between drugs that were newly introduced and those that had been on the market for a longer time, advice regarding use of drugs in the first trimester and advice regarding use of drugs in the second or third trimester, or between advice provided during 2003 and during 2005. The results of this study show considerable differences between two Norwegian sources providing advice on the use of drugs in pregnancy. Based on the knowledge that healthcare providers choose sources of information in a random

General physical health advice for people with serious mental illness.

PubMed

Tosh, Graeme; Clifton, Andrew; Bachner, Mick

2011-02-16

There is currently much focus on provision of general physical health advice to people with serious mental illness and there has been increasing pressure for services to take responsibility for providing this. To assess the effects of general physical health advice as a means of reducing morbidity, mortality and improving or maintaining quality of life in people with serious mental illness. We searched the Cochrane Schizophrenia Group Trials Register (November 2009) which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. All randomised clinical trials focusing on general physical health advice. We extracted data independently. For binary outcomes we calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data we estimated mean difference (MD) between groups and its 95% CI. We employed a random-effects model for analyses. For the comparison of physical healthcare advice versus standard care we identified five studies (total n = 884) of limited quality. For measures of quality of life one trial found no difference (n = 54, 1 RCT, MD Lehman scale 0.00 CI -0.67 to 0.67) but another did (n = 407, 1 RCT, MD Quality of Life Medical Outcomes Scale - mental component 3.7 CI 1.7 to 5.6). There was no difference between groups for the outcome of death (n = 407, 1 RCT, RR 1.3 CI 0.3 to 6.0), for the outcome of uptake of ill-health prevention services, one study found percentages significantly greater in the advice group (n = 363, 1 RCT, MD 36.9 CI 33.1 to 40.7). Economic data were equivocal. Attrition was large (> 30%) but similar for both groups (n = 884, 5 RCTs, RR 1.18 CI 0.97 to 1.43). Comparisons of one type of physical healthcare advice with another were grossly underpowered and equivocal. General physical health could lead to people with serious mental illness accessing more health services which, in turn, could mean they see longer term benefits such as reduced mortality or morbidity. On the

Determinants of physical activity frequency and provider advice during pregnancy.

PubMed

Santo, Eilann C; Forbes, Peter W; Oken, Emily; Belfort, Mandy B

2017-09-05

Our aims were to (1) describe the frequency of physical activity and prenatal healthcare provider advice about physical activity during pregnancy and (2) examine determinants and correlates of 3rd trimester physical activity and receipt of physical activity advice. We analyzed data from the 2008 Pregnancy Risk Assessment Monitoring System. We studied 2669 women from North Carolina and Colorado with data on physical activity frequency in the 3 months prior to pregnancy and during the 3rd trimester and 1584 women from Oklahoma with data on provider advice regarding physical activity during pregnancy. Respondents reported physical activity, defined as 30 min or more of exercise/physical activity (excluding vocationally related activity), in in these categories: <1 day/week, 1-4 days/week, and ≥5 days/week. We defined adherence to American College of Obstetrics & Gynecology (ACOG) criteria as physical activity ≥5 days/week in the 3rd trimester. We performed logistic regression analyses weighted for sampling and adjusted for socio-demographic factors. Forty-two percent of women in North Carolina and Colorado reported 3rd trimester physical activity <1 day/week, 42% 1-4 days/week, 9% ≥5 days/week; 7% reported being told not to exercise. Seventy-two percent of women in Oklahoma reported receiving physical activity advice from a prenatal care provider. Low activity frequency (<1 day/week) prior to pregnancy was strongly associated with low likelihood of ACOG guideline adherence in the 3rd trimester (aOR 0.10, 95% CU 0.04, 0.30 vs. 1-4 days/week). Underweight women were more likely to adhere to ACOG guidelines than normal weight women (aOR 2.27, 95% CI 1.36, 3.79). Overweight women were more likely to receive physical activity advice (aOR 2.9, 95% CI 1.3, 6.3 vs. normal weight), but obese women were not (aOR 0.65, 95% CI 0.4, 1.2). Few women meet ACOG guideline criteria for physical activity during pregnancy. Improving physical activity and weight status

Analysis of free online physician advice services.

PubMed

Cohen, Raphael; Elhadad, Michael; Birk, Ohad

2013-01-01

Online Consumer Health websites are a major source of information for patients worldwide. We focus on another modality, online physician advice. We aim to evaluate and compare the freely available online expert physicians' advice in different countries, its scope and the type of content provided. Using automated methods for information retrieval and analysis, we compared consumer health portals from the US, Canada, the UK and Israel (WebMD,NetDoctor,AskTheDoctor and BeOK). The evaluated content was generated between 2002 and 2011. We analyzed the different sites, looking at the distribution of questions in the various health topics, answer lengths and content type. Answers could be categorized into longer broad-educational answers versus shorter patient-specific ones, with different physicians having personal preferences as to answer type. The Israeli website BeOK, providing 10 times the number of answers than in the other three health portals, supplied answers that are shorter on average than in the other websites. Response times in these sites may be rapid with 32% of the WebMD answers and 64% of the BeOK answers provided in less than 24 hours. The voluntary contribution model used by BeOK and WebMD enables generation of large numbers of physician expert answers at low cost, providing 50,000 and 3,500 answers per year, respectively. Unlike health information in online databases or advice and support in patient-forums, online physician advice provides qualified specialists' responses directly relevant to the questions asked. Our analysis showed that high numbers of expert answers could be generated in a timely fashion using a voluntary model. The length of answers varied significantly between the internet sites. Longer answers were associated with educational content while short answers were associated with patient-specific content. Standard site-specific guidelines for expert answers will allow for more desirable content (educational content) or better throughput

43 CFR 2203.5 - Action on advice of the Attorney General.

Code of Federal Regulations, 2013 CFR

2013-10-01

... PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.5 Action on advice of the Attorney General... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Action on advice of the Attorney General. 2203.5 Section 2203.5 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF...

43 CFR 2203.5 - Action on advice of the Attorney General.

Code of Federal Regulations, 2012 CFR

2012-10-01

... PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.5 Action on advice of the Attorney General... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Action on advice of the Attorney General. 2203.5 Section 2203.5 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF...

43 CFR 2203.5 - Action on advice of the Attorney General.

Code of Federal Regulations, 2014 CFR

2014-10-01

... PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.5 Action on advice of the Attorney General... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Action on advice of the Attorney General. 2203.5 Section 2203.5 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF...

45 CFR 73.735-805 - Advice and guidance on conflicts matters.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Advice and guidance on conflicts matters. 73.735... STANDARDS OF CONDUCT Financial Interest § 73.735-805 Advice and guidance on conflicts matters. (a) Whenever... should include a description of: (1) The activity, relationship, or interest giving rise to the question...

45 CFR 73.735-805 - Advice and guidance on conflicts matters.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Advice and guidance on conflicts matters. 73.735... STANDARDS OF CONDUCT Financial Interest § 73.735-805 Advice and guidance on conflicts matters. (a) Whenever... should include a description of: (1) The activity, relationship, or interest giving rise to the question...

Advice as a smoking cessation strategy: a systematic review and implications for physical therapists.

PubMed

Bodner, Michael E; Dean, Elizabeth

2009-07-01

Although identified as a clinical priority, smoking cessation has been addressed minimally in the literature in the context of physical therapy practice. Smoking cessation advice delivered by a health professional can help smokers quit. The salient components of such advice however warranted elucidation to enable physical therapists to integrate this clinical competence into their practices. Therefore, we conducted a systematic review to elucidate the effectiveness of advice by a health professional and its components to optimize smoking cessation instituted in the context of physical therapy practice. Thirty source articles were identified. A random-effects model meta-analysis was used to assess the effectiveness of the advice parameters. Risk ratios (RRs) were used to estimate pooled treatment effects. RRs for brief, intermediate, and intensive advice were 1.74 (95% CI=1.37, 2.22), 1.71 (95% CI=1.39, 2.09), and 1.60 (95% CI=1.13, 2.27), respectively. Self-help materials, follow-up, and interventions based on psychological or motivational frameworks were particularly effective components of intermediate and intensive advice interventions. Advice can be readily integrated into physical therapy practice and used to initiate or support ongoing smoking cessation in clients irrespective of reason for referral. Incorporating smoking cessation as a physical therapy goal is consistent with the contemporary definition of the profession and the mandates of physical therapy professional associations to promote health and wellness, including smoking cessation for both primary health benefit and to minimize secondary effects (e.g., delayed healing and recovery, and medical and surgical complications). Thus, advice is an evidence-based strategy to effect smoking cessation that can be exploited in physical therapy practice. Further research to refine how best to assess smokers and, in turn, individualize brief smoking cessation advice could augment positive smoking cessation

Reasons for discharges against medical advice: a qualitative study.

PubMed

Onukwugha, Eberechukwu; Saunders, Elijah; Mullins, C Daniel; Pradel, Françoise G; Zuckerman, Marni; Weir, Matthew R

2010-10-01

There is limited information in the literature about reasons for discharges against medical advice (DAMA) as supplied by patients and providers. Information about the reasons for DAMA is necessary for identifying workable strategies to reduce the likelihood and health consequences of DAMA. The objective of this study is to identify the reasons for DAMA based on patient and multicategory provider focus-group interviews (FGIs). Patients who discharged against medical advice between 2006 and 2008 from a large, academic medical centre along with hospital providers reporting contact with patients who left against medical advice were recruited. Three patient-only groups, one physician-only group and one nurse/social worker group were held. Focus-group interviews were transcribed, and a thematic analysis was performed to identify themes within and across groups. Participants discussed the reasons for patient DAMA and identified potential solutions. Eighteen patients, five physicians, six nurses and four social workers participated in the FGIs. Seven themes emerged across the separate patient, doctor, nurse/social worker FGIs of reasons why patients leave against medical advice: (1) drug addiction, (2) pain management, (3) external obligations, (4) wait time, (5) doctor's bedside manner, (6) teaching hospital setting and (7) communication. Solutions to tackle DAMA identified by participants revolved mainly around enhanced communication and provider education. In a large, academic medical centre, the authors find some differences and many similarities across patients and providers in identifying the causes of and solutions to DAMA, many of which relate to communication.

Variability in Cell Response of Cronobacter sakazakii after Mild-Heat Treatments and Its Impact on Food Safety

PubMed Central

Parra-Flores, Julio; Juneja, Vijay; Garcia de Fernando, Gonzalo; Aguirre, Juan

2016-01-01

Cronobacter spp. have been responsible for severe infections in infants associated with consumption of powdered infant formula and follow-up formulae. Despite several risk assessments described in published studies, few approaches have considered the tremendous variability in cell response that small micropopulations or single cells can have in infant formula during storage, preparation or post process/preparation before the feeding of infants. Stochastic approaches can better describe microbial single cell response than deterministic models as we prove in this study. A large variability of lag phase was observed in single cell and micropopulations of ≤50 cells. This variability increased as the heat shock increased and growth temperature decreased. Obviously, variability of growth of individual Cronobacter sakazakii cell is affected by inoculum size, growth temperature and the probability of cells able to grow at the conditions imposed by the experimental conditions should be taken into account, especially when errors in bottle-preparation practices, such as improper holding temperatures, or manipulation, may lead to growth of the pathogen to a critical cell level. The mean probability of illness from initial inoculum size of 1 cell was below 0.2 in all the cases and for inoculum size of 50 cells the mean probability of illness, in most of the cases, was above 0.7. PMID:27148223

Advice given by community members to pregnant women: a mixed methods study.

PubMed

Verma, Bianca A; Nichols, Lauren P; Plegue, Melissa A; Moniz, Michelle H; Rai, Manisha; Chang, Tammy

2016-11-09

Smoking and excess weight gain during pregnancy have been shown to have serious health consequences for both mothers and their infants. Advice from friends and family on these topics influences pregnant women's behaviors. The purpose of our study was to compare the advice that community members give pregnant women about smoking versus the advice they give about pregnancy weight gain. A survey was sent via text messaging to adults in a diverse, low-income primary care clinic in 2015. Respondents were asked what advice (if any) they have given pregnant women about smoking or gestational weight gain and their comfort-level discussing the topics. Descriptive statistics were used to characterize the sample population and to determine response rates. Open-ended responses were analyzed qualitatively using grounded theory analysis with an overall convergent parallel mixed methods design. Respondents (n = 370) were 77 % female, 40 % black, and 25 % reported education of high school or less. More respondents had spoken to pregnant women about smoking (40 %, n = 147) than weight gain (20 %, n = 73). Among individuals who had not discussed either topic (n = 181), more reported discomfort in talking about weight gain (65 %) compared to smoking (34 %; p < 0.0001). Advice about smoking during pregnancy (n = 148) was frequently negative, recommending abstinence and identifying smoking as harmful for baby and/or mother. Advice about weight gain in pregnancy (n = 74) revealed a breadth of messages, from reassurance about all weight gain ("Eat away" or "It's ok if you are gaining weight"), to specific warnings against excess weight gain ("Too much was dangerous for her and the baby."). Many community members give advice to pregnant women. Their advice reveals varied perspectives on the effects of pregnancy weight gain. Compared to a nearly ubiquitous understanding of the harms of smoking during pregnancy, community members demonstrated less

Internet provision of tailored advice on falls prevention activities for older people: a randomized controlled evaluation.

PubMed

Yardley, Lucy; Nyman, Samuel R

2007-06-01

Falls are very common in older persons and can result in substantial disability and distress. By undertaking strength and balance training (SBT) exercises, older people can reduce their risk of falling. The Internet offers a potentially cost-effective means of disseminating information about SBT to older people and their carers. A particular advantage of using the Internet for this purpose is that the advice given can be 'tailored' to the needs of the individual. This study used a randomized controlled design to evaluate an interactive web-based program that tailored advice about undertaking SBT activities. The participants were 280 people with an age range of 65-97 years recruited by advertising the website by email and the Internet. Those randomized to the tailored advice were presented with advice tailored to their personal self-rated balance capabilities, health problems and activity preferences. Those in the control group were presented with all the advice from which the tailored advice was selected. After reading the advice, those in the tailored advice group (n = 144) had more positive attitudes (p < 0.01) than those in the control group (n = 136), reporting greater perceived relevance of the SBT activities, greater confidence in the ability to carry them out, and hence stronger intentions to undertake the activities. This study provides an initial indication that an interactive website might offer a cost-effective way to provide personalized advice to some older people. Further research is required to determine whether website-based advice on falls prevention changes behavior as well as intentions and whether the advice needs to be supplemented by other forms of support.

Kosmo's Farewell Advice

NASA Technical Reports Server (NTRS)

Kosmo, Joe; Ross, Amy

2012-01-01

Joe Kosmo shared some final words and advice for his teammates in the Spacesuit and Crew Survival Systems Branch (EC5) and the Crew and Thermal Systems Division (CTSD (EC)) upon his retirement. He knew nothing about spacesuits when he started working for NASA in 1961, but neither did anyone else. He summed up the best lessons learned during his 50 years of developing U.S. spacesuits and encouraged the next generation s space industry workers to challenge what they hear and decide what is right. Topics include and oral history of early NASA manned flights by Richard S. Johnston, U.S. human spaceflight chronology, a history of advanced EVA project funding, and a discussion of NASA's innovative spirit.

Empowering Girls through Sport? Sports Advice Books for Young Female Readers

ERIC Educational Resources Information Center

Heinecken, Dawn

2016-01-01

Advice books by female athletes are among the top selling sports books for young readers in the US. Though they have received little attention to date, sports advice books are important to examine because of how they function as a form of conduct manual instructing girls in specific understandings of female identity. Implying that girls face…

The UNCCD Science-Policy Interface (SPI) - Exploring the sustainable land management nexus among the Rio Conventions

NASA Astrophysics Data System (ADS)

Safriel, Uriel; Akhtar-Schuster, Mariam; Abraham, Elena Maria; Cowie, Annette; Daradur, Mihail; de Vente, Joris; Dema Dorji, Karma; Kust, German; Metternicht, Graciela; Orr, Barron; Pietragalla, Vanina

2015-04-01

At its 11th meeting in Windhoek/Namibia, in September 2013, the United Nations Convention to Combat Desertification (UNCCD) Conference of the Parties (COP) decided to establish a Science-Policy Interface (SPI)* (decision 23/COP.11). The goal of the SPI is to facilitate a two-way dialogue between scientists and policy makers in order to ensure the delivery of policy-relevant information, knowledge and advice on desertification/land degradation and drought (DLDD). The SPI established several initial objectives, including working with the scientific community to bring to the UNCCD and the other Rio conventions (climate change and biodiversity) the scientific evidence for the contribution of sustainable land use and management to climate change adaptation/mitigation and to safeguarding biodiversity and ecosystem services. *For more on the SPI see: http://www.unccd.int/en/programmes/Science/International-Scientific-Advice/Pages/SPI.aspx?HighlightID=282

Association of gestational weight gain expectations with advice on actual weight gain

USDA-ARS?s Scientific Manuscript database

To examine pregnant women's gestational weight gain expectations/advice from various sources (i.e., self, family/friends, physician) and the impact of these sources of expectations/advice on actual measured gestational weight gain. Pregnant women (n=230, 87.4% Caucasian, second pregnancy) in a cohor...

A qualitative study exploring midwives' perceptions and knowledge of maternal obesity: Reflecting on their experiences of providing healthy eating and weight management advice to pregnant women.

PubMed

McCann, Mary T; Newson, Lisa; Burden, Catriona; Rooney, Jane S; Charnley, Margaret S; Abayomi, Julie C

2018-04-01

Midwives are responsible for providing advice regarding the complex issues of healthy eating and weight management during pregnancy. This study utilised an inductive data-driven thematic approach in order to determine midwives' perceptions, knowledge, and experiences of providing healthy eating and weight management advice to pregnant women. Semistructured interviews with 17 midwives were transcribed verbatim and data subjected to thematic analysis. The findings offer insight into the challenges facing midwives in their role trying to promote healthy eating and appropriate weight management to pregnant women. Three core themes were identified: (a) "If they eat healthily it will bring their weight down": Midwives Misunderstood; (b) "I don't think we are experienced enough": Midwives Lack Resources and Expertise; and (c) "BMI of 32 wouldn't bother me": Midwives Normalised Obesity. The midwives recognised the importance of providing healthy eating advice to pregnant women and the health risks associated with poor diet and obesity. However, they reported the normalisation of obesity in pregnant women and suggested that this, together with their high workload and lack of expertise, explained the reasons why systematic advice was not in standard antenatal care. In addition, the current lack of UK clinical guidance, and thus, possibly lack of clinical leadership are also preventing delivery of tailored advice. Implementation literature on understanding the barriers to optimal health care delivery and informing clinical practice through research evidence needs to be further investigated in this field. This study has recommendations for policy makers, commissioners, service providers, and midwives. © 2017 John Wiley & Sons Ltd.

Reinforcement learning agents providing advice in complex video games

NASA Astrophysics Data System (ADS)

Taylor, Matthew E.; Carboni, Nicholas; Fachantidis, Anestis; Vlahavas, Ioannis; Torrey, Lisa

2014-01-01

This article introduces a teacher-student framework for reinforcement learning, synthesising and extending material that appeared in conference proceedings [Torrey, L., & Taylor, M. E. (2013)]. Teaching on a budget: Agents advising agents in reinforcement learning. {Proceedings of the international conference on autonomous agents and multiagent systems}] and in a non-archival workshop paper [Carboni, N., &Taylor, M. E. (2013, May)]. Preliminary results for 1 vs. 1 tactics in StarCraft. {Proceedings of the adaptive and learning agents workshop (at AAMAS-13)}]. In this framework, a teacher agent instructs a student agent by suggesting actions the student should take as it learns. However, the teacher may only give such advice a limited number of times. We present several novel algorithms that teachers can use to budget their advice effectively, and we evaluate them in two complex video games: StarCraft and Pac-Man. Our results show that the same amount of advice, given at different moments, can have different effects on student learning, and that teachers can significantly affect student learning even when students use different learning methods and state representations.

A survey of exercise advice and recommendations in United Kingdom paediatric cardiac clinics.

PubMed

Williams, Craig A; Gowing, Lucy; Horn, Richard; Stuart, Alan Graham

2017-07-01

Physical activity and exercise have important health benefits for children and adolescents with CHD. The objective of this study was to survey the provision of advice and recommendations in United Kingdom paediatric CHD clinics. A three-page questionnaire was sent out to paediatric cardiac consultants in the United Kingdom, paediatric consultants with expertise in cardiology, and nursing staff (Paediatricians with Expertise in Cardiology Special Interest Group), as well as all members of the British Congenital Cardiovascular Association. The aim of this questionnaire was to determine the extent and scope of current information provision and to assess the importance that clinicians place on this advice. There were 68 responses in total, and the data showed that, of these, 24 (36%) clinicians had never provided paediatric CHD patients with written advice about exercise. Only 27 (39%) clinicians provided physical activity advice at every appointment. Lack of time during consultation (n=39, 56.9%), lack of training (n=38, 55.2%), and uncertainty about appropriate recommendations (n=38, 55.2%) were identified as the main factors preventing clinicians from providing patients with advice about physical activity. Although healthcare providers consider physical activity to be very important, the provision of clear, specific advice and recommendations is underutilised; therefore, more education and provision of resources to support the promotion of exercise need to be provided to clinicians and their support teams.

Maternal perceptions of advice on sleep in young children: How, what, and when?

PubMed

Hatton, Rosalind E M; Gardani, Maria

2018-05-01

Parental knowledge on sleep hygiene in children may be a contributing factor for sleep difficulties in preschoolers. As sleep is crucial for healthy development, it is important to understand how parental knowledge can be improved. The aim of this qualitative study was to develop an understanding of advice available in the United Kingdom (UK) on sleep in young children. This study employed constructivist grounded theory methodology. Participants were recruited via social media and a previously constructed participant database. Interviews were audio-recorded, transcribed, and analysed. Fourteen mothers were interviewed independently, whilst one mother was interviewed together with her husband. Themes relating to how UK mothers wish advice on sleep to be formulated, what they believe it should include and when they would like to receive it, were identified from the data. Specifically, this study suggests that UK mothers value experience and thus recommends that advice be made through collaboration projects involving both professionals and parents. It also suggests that advice should be readily available and given to expecting parents prior to the arrival of their baby as well as at regular follow-ups. In addition, the participating mothers wanted advice to be balanced and non-judgemental. This study looks at the views of mainly White British mothers currently residing within the United Kingdom. Thus, it may not represent the views of everyone in the United Kingdom. Nevertheless, it still makes important recommendations for practice. For example, relationships between health professionals and parents need to be improved and information on different sleeping practices widely dispersed. Statement of contribution What is already known on this subject? Poor sleep is common in young children. Young children's sleep quality can be affected by parental behaviours. Parents lack knowledge of sleep in young children. What does this study add? According to this study: It would

[Pharmaceutical advice concerning different pharmaceutical dosage forms].

PubMed

Szakonyi, Gergely; Zelkó, Romána

2010-01-01

The present paper summarizes the commonly applied types of drug uptake and the pharmacists' advice concerning a certain dosage form. The manuscript also deals with the modified release dosage forms and their abbreviations in the name of the marketing authorized products.

Reasons for discharges against medical advice: a qualitative study

PubMed Central

Onukwugha, Eberechukwu; Saunders, Elijah; Mullins, C. Daniel; Pradel, Françoise G.; Zuckerman, Marni; Weir, Matthew R.

2013-01-01

Background There is limited information in the literature about reasons for discharges against medical advice (DAMA) as supplied by patients and providers. Information about the reasons for DAMA is necessary for identifying workable strategies to reduce the likelihood and health consequences of DAMA. The objective of this study is to identify the reasons for DAMA based on patient and multi-category provider focus group interviews (FGIs). Methods Patients who discharged against medical advice between 2006 and 2008 from a large, academic medical center along with hospital providers reporting contact with patients who left against medical advice were recruited. Three patient-only groups, one physician-only group, and one nurse/social worker group were held. Focus group interviews were transcribed and a thematic analysis was performed to identify themes within and across groups. Participants discussed the reasons for patient DAMA and identified potential solutions. Results Eighteen patients, 5 physicians, 6 nurses and 4 social workers participated in the FGIs. Seven themes emerged across the separate patient, doctor, nurse/social worker group FGIs of reasons why patients leave against medical advice: 1) drug addiction, 2) pain management, 3) external obligations, 4) wait time, 5) doctor’s bedside manner, 6) teaching hospital setting, and 7) communication. Solutions to tackle DAMA identified by participants revolve mainly around enhanced communication and provider education. Conclusions In a large, academic medical center we find some differences and many similarities across patients and providers in identifying the causes of and solutions to DAMA, many of which relate to communication. PMID:20538627

Advice to stay active as a single treatment for low back pain and sciatica.

PubMed

Hilde, G; Hagen, K B; Jamtvedt, G; Winnem, M

2002-01-01

Low back pain is one of the most common conditions managed in primary care. Restricted activity, rest, and symptomatic analgesics are the most commonly prescribed treatment for low back pain and sciatica. To assess the effects of advice to stay active as single treatment for patients with low back pain. Computerised searches in MEDLINE, EMBASE, Sport, The Cochrane Controlled Trials Register, Musculoskeletal Group's Trials Register and Scisearch, and scanning of reference lists from relevant articles were undertaken. Relevant studies were also traced by contacting authors. Date of the most recent searches: December 1998. We included all randomised trials or quasi-randomised trials where the study population consisted of adult patients with low back pain or sciatica, in which one comparison group was advised to stay active. The main outcomes of interest were pain, functional status, recovery and return to work. Two reviewers independently selected trials for inclusion, assessed the validity of included trials and extracted data. Investigators were contacted to collect missing data or for clarification when needed. Four trials, with a total of 491 patients, were included. Advice to stay active was compared to advice to rest in bed in all trials. Two trials were assessed to have low risk of bias and two to have moderate to high risk of bias. The results were heterogeneous. Results from one high quality trial of patients with acute simple LBP found small differences in functional status [Weighted Mean Difference (on a 0-100 scale) 6.0 (95% CI: 1.5, 10.5)] and length of sick leave [WMD 3.4 days (95% CI: 1.6, 5.2)] in favour of staying active compared to advice to stay in bed for two days. The other high quality trial compared advice to stay active with advice to rest in bed for 14 days for patients with sciatic syndrome, and found no differences between the groups. One of the high quality trials also compared advice to stay active with exercises for patients with acute

4 CFR 28.8 - Informal procedural advice.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 4 Accounts 1 2010-01-01 2010-01-01 false Informal procedural advice. 28.8 Section 28.8 Accounts GOVERNMENT ACCOUNTABILITY OFFICE GENERAL PROCEDURES GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL APPEALS BOARD; PROCEDURES APPLICABLE TO CLAIMS CONCERNING EMPLOYMENT PRACTICES AT THE GOVERNMENT ACCOUNTABILITY OFFICE...

Dietary advice for muscularity, leanness and weight control in Men's Health magazine: a content analysis.

PubMed

Cook, Toni M; Russell, Jean M; Barker, Margo E

2014-10-11

The dietary content of advice in men's lifestyle magazines has not been closely scrutinised. We carried out an analysis of such content in all 2009 issues (n = 11) of Men's Health (MH) focusing on muscularity, leanness and weight control. Promotion of a mesomorphic body image underpinned advice to affect muscle building and control weight. Diet advice was underpinned by a strong pseudo-scientific discourse, with citation of expert sources widely used to legitimise the information. Frequently multiple dietary components were advocated within one article e.g. fat, omega-3 fatty acids, thiamine, zinc and high-glycaemic index foods. Furthermore advice would cover numerous nutritional effects, e.g. strengthening bones, reducing stress and boosting testosterone, with little contextualisation. The emphasis on attainment of a mesomorphic body image permitted promotion of slimming diets.Advice to increase calorie and protein intake to augment muscle mass was frequent (183 and 262 references, respectively). Such an anabolic diet was advised in various ways, including consumption of traditional protein foods (217 references) and sports foods (107 references), thereby replicating muscle magazines' support for nutritional supplements. Although advice to increase consumption of red meat was common (52 references), fish and non-flesh sources of protein (eggs, nuts & pulses, and soy products) together exceeded red meat in number of recommendations (206 references). Advice widely asserted micronutrients and phytochemicals from plant food (161 references) as being important in muscle building. This emphasis diverges from stereotypical gender-based food consumption patterns.Dietary advice for control of body weight largely replicated that of muscularity, with strong endorsement to consume fruits and vegetables (59 references), diets rich in nuts and pulses and fish (66 references), as well as specific micronutrients and phytochemicals (62 references). Notably there was emphasis on

Physicians’ duty to recontact and update genetic advice

PubMed Central

Stevens, Yvonne A; Senner, Grant D; Marchant, Gary E

2017-01-01

This perspective addresses whether physicians have a duty to recontact former or current patients to update clinical advice based on newly discovered genomic information. Genetic information is unique compared with other medical data in that the underlying data do not appreciably change during the patients’ lifetime, but the clinical significance of that information will continue to evolve. Based on relevant case law and guidelines, there is no general, established legal duty for physicians to affirmatively recontact former or current patients to update clinical advice based on newly discovered genetic information. However, integration of genomics into clinical practice is advancing quickly, and there may be limited, specific situations where a physician may have a duty to provide updated genetic information. PMID:29158769

Reinventing Your Board: A Step-by-Step Guide to Implementing Policy Governance. The Jossey-Bass Nonprofit and Public Management Series.

ERIC Educational Resources Information Center

Carver, John; Carver, Miriam Mayhew

This guide provides practical advice regarding implementation of the Policy Governance model for school boards. Chapter 1, "Setting the Stage," explores questions commonly raised by boards prior to implementation of the Policy Governance model. Chapter 2, "The Theoretical Foundation," reviews the key theoretical principles of…

77 FR 3475 - National Advisory Council for Environmental Policy and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-24

... advice to the EPA Administrator on a broad range of environmental policy, technology, and management...) leadership development and organizational transformation at EPA. A copy of the agenda for the meeting will be... , (202) 564-2432, U.S. EPA, Office of Federal Advisory Committee Management and Outreach (1601M), 1200...

Cronobacter species (formerly known as Enterobacter sakazakii) in powdered infant formula: a review of our current understanding of the biology of this bacterium.

PubMed

Yan, Q Q; Condell, O; Power, K; Butler, F; Tall, B D; Fanning, S

2012-07-01

Cronobacter species (formerly known as Enterobacter sakazakii) are opportunistic pathogens that can cause necrotizing enterocolitis, bacteraemia and meningitis, predominantly in neonates. Infection in these vulnerable infants has been linked to the consumption of contaminated powdered infant formula (PIF). Considerable research has been undertaken on this organism in the past number of years which has enhanced our understanding of this neonatal pathogen leading to improvements in its control within the PIF production environment. The taxonomy of the organism resulted in the recognition of a new genus, Cronobacter, which consists of seven species. This paper presents an up-to-date review of our current knowledge of Cronobacter species. Taxonomy, genome sequencing, current detection protocols and epidemiology are all discussed. In addition, consideration is given to the control of this organism in the manufacturing environment, as a first step towards reducing the occurrence of this pathogen in PIF. © 2012 The Authors. Journal of Applied Microbiology © 2012 The Society for Applied Microbiology.

Daughter-initiated health advice to mothers: perceptions of African–American and Latina daughters

PubMed Central

Mosavel, M.; Thomas, T.

2009-01-01

The prevailing paradigm of health exchange within the family is for health advice to flow from parent to child. Consistent with this pattern of exchange, most research has focused on the one-directional influence of the parent on the child and there is thus an absence of literature that explores the ability of adolescents to influence their parents’ health behaviors. This qualitative study addressed this gap by exploring the feasibility of daughters providing health advice to their mothers. Twelve focus groups were conducted with 78 African–American and Latina daughters between the ages of 12 and 17 from low-income neighborhoods in a Mid-Western city in the United States. This study utilized a grounded theory approach to examine the focus group data. The findings indicate that many daughters report that they are already giving their mothers a wide spectrum of advice, including health advice. Differences were found in the reported willingness of African–American daughters when compared to Latina daughters to provide their mothers with specific cancer advice. These data suggest that some of these daughters have the potential to be valuable health education conveyers in the family. PMID:19339373

Integrating advice and experience: learning and decision making with social and nonsocial cues.

PubMed

Collins, Elizabeth C; Percy, Elise J; Smith, Eliot R; Kruschke, John K

2011-06-01

When making decisions, people typically gather information from both social and nonsocial sources, such as advice from others and direct experience. This research adapted a cognitive learning paradigm to examine the process by which people learn what sources of information are credible. When participants relied on advice alone to make decisions, their learning of source reliability proceeded in a manner analogous to traditional cue learning processes and replicated the established learning phenomena. However, when advice and nonsocial cues were encountered together as an established phenomenon, blocking (ignoring redundant information) did not occur. Our results suggest that extant cognitive learning models can accommodate either advice or nonsocial cues in isolation. However, the combination of advice and nonsocial cues (a context more typically encountered in daily life) leads to different patterns of learning, in which mutually supportive information from different types of sources is not regarded as redundant and may be particularly compelling. For these situations, cognitive learning models still constitute a promising explanatory tool but one that must be expanded. As such, these findings have important implications for social psychological theory and for cognitive models of learning. 2011 APA, all rights reserved

Following celebrities’ medical advice: meta-narrative analysis

PubMed Central

Tan, Charlie

2013-01-01

Objective To synthesise what is known about how celebrities influence people’s decisions on health. Design Meta-narrative analysis of economics, marketing, psychology, and sociology literatures. Data sources Systematic searches of electronic databases: BusinessSource Complete (1886-), Communication & Mass Media Complete (1915-), Humanities Abstracts (1984-), ProQuest Political Science (1985-), PsycINFO (1806-), PubMed (1966-), and Sociology Abstracts (1952-). Inclusion criteria Studies discussing mechanisms of celebrities’ influence on people in any context. Results Economics literature shows that celebrity endorsements act as signals of credibility that differentiate products or ideas from competitors and can catalyse herd behaviour. Marketing studies show that celebrities transfer their desirable attributes to products and use their success to boost their perceived credibility. Psychology shows that people are classically conditioned to react positively to the advice of celebrities, experience cognitive dissonance if they do not, and are influenced by congruencies with their self conceptions. Sociology helps explain the spread of celebrity medical advice as a contagion that diffuses through social networks and people’s desire to acquire celebrities’ social capital. Conclusions The influence of celebrity status is a deeply rooted process that can be harnessed for good or abused for harm. A better understanding of celebrity can empower health professionals to take this phenomenon seriously and use patient encounters to educate the public about sources of health information and their trustworthiness. Public health authorities can use these insights to implement regulations and restrictions on celebrity endorsements and design counter marketing initiatives—perhaps even partnering with celebrities—to discredit bogus medical advice while promoting evidence based practices.

Evidence-based first aid advice for paediatric burns in the United Kingdom.

PubMed

Varley, Alice; Sarginson, Julia; Young, Amber

2016-05-01

Burn and scald injuries are common in children. First aid advice for paediatric burns is offered by a range of health organisations and charities in the UK. Despite this, children still present to emergency departments and burn services having received little or inadequate first aid. A survey was undertaken regarding the content and consistency of the advice given by a cross-section of UK health organisations involved in first aid prevention and education. The advice was subsequently examined to determine if it was evidence-based. Our study has demonstrated inconsistencies in the content of the first aid advice provided by the 21 organisations included in the study. Seventy-one percent of the information was only available online. The temperature, method and duration of cooling varied substantially, as did the advice recommended for the removal of clothing and jewellery and methods for covering the burn immediately after injury. Results from the literature review concluded the following based on available evidence; cool the burn with running tap water for 20min, remove clothing and jewellery and cover the burn with cling film or a clean non-adhesive dressing. This study highlights the lack of consistency between first aid guidance provided by health organisations and charities in the UK. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Peer Tutoring in a Graduate Writing Centre: Identity, Expertise, and Advice Resisting

ERIC Educational Resources Information Center

Waring, Hansun Zhang

2005-01-01

Compared to research on the giving of advice (e.g. Hutchby 1995), relatively less work has been conducted on the receiving or resisting of advice, where the interactionally problematic nature of advising is crystallized (e.g. Heritage and Sefi 1992). Moreover, the notion of advising in education settings has predominantly concerned procedural…

Impact of weight-related advice from healthcare professionals on body mass index of patients in the USA.

PubMed

Yang, H-Y; Chen, H-J; Hsu, Y-J; Cheskin, L J; Wang, Y

2018-06-01

Healthcare professionals (HCPs) can help promote healthy eating and active living in patients. This study assessed the effects of weight-related advice from HCPs on change in body mass index (BMI) of patients in the USA. A 1-year follow-up study of 20,002 adults who participated in a nationally representative survey between 2004 and 2008. Using the 2004-2008 Medical Expenditure Panel Survey data, 1-year BMI and weight status changes were compared between patients who did and did not report receiving advice on exercise or on restricted intake of fat and cholesterol from their HCPs. Patients who received weight-related advice had a greater increase in BMI compared with those who did not receive weight-related advice. Stratified by the baseline weight status of patients (i.e. normal weight, overweight or obese), adverse direction of BMI change was only significantly associated with advice on exercise. Patients who received advice to exercise more were more likely to move to a higher weight status than remaining at the same weight status, compared with patients who did not receive advice to exercise more. This study did not find that weight-related advice from HCPs had a positive impact on BMI loss in patients. On the contrary, patients who reported receiving weight-related advice from HCPs had worse weight outcomes 1 year later than patients who did not report receiving weight-related advice. Further research is warranted to elucidate the role of weight-related advice from HCPs on lifestyle change and obesity prevention and control. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Inequalities in advice provided by public health workers to women during antenatal sessions in rural India.

PubMed

Singh, Abhishek; Pallikadavath, Saseendran; Ram, Faujdar; Ogollah, Reuben

2012-01-01

Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India. The District Level Household Survey (2007-08) was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%-72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice. A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver appropriate and recommended advice to all clients, irrespective of

The financial crisis and global health: the International Monetary Fund's (IMF) policy response.

PubMed

Ruckert, Arne; Labonté, Ronald

2013-09-01

In this article, we interrogate the policy response of the International Monetary Fund (IMF) to the global financial crisis, and discuss the likely global health implications, especially in low-income countries. In doing so, we ask if the IMF has meaningfully loosened its fiscal deficit targets in light of the economic challenges posed by the financial crisis and adjusted its macro-economic policy advice to this new reality; or has the rhetoric of counter-cyclical spending failed to translate into additional fiscal space for IMF loan-recipient countries, with negative health consequences? To answer these questions, we assess several post-crisis IMF lending agreements with countries requiring financial assistance, and draw upon recent academic studies and civil society reports examining policy conditionalities still being prescribed by the IMF. We also reference recent studies examining the health impacts of these conditionalities. We demonstrate that while the IMF has been somewhat more flexible in its crisis response than in previous episodes of financial upheaval, there has been no meaningful rethinking in the application of dominant neoliberal macro-economic policies. After showing some flexibility in the initial crisis response, the IMF is pushing for excessive contraction in most low and middle-income countries. We conclude that there remains a wide gap between the rhetoric and the reality of the IMF's policy and programming advice, with negative implications for global health.

Health behaviour advice from health professionals to Canadian adults with hypertension: results from a national survey.

PubMed

Walker, Robin L; Gee, Marianne E; Bancej, Christina; Nolan, Robert P; Kaczorowski, Janusz; Joffres, Michel; Bienek, Asako; Gwadry-Sridhar, Femida; Campbell, Norman R C

2011-01-01

Health professionals play an important role in providing health information to patients. The objectives of this study were to examine the type of advice that Canadians with hypertension recall receiving from health professionals to manage their condition, and to assess if there is an association between health behaviour advice provided by health professionals and self-reported engagement in health behaviour modification. Respondents of the 2009 Survey on Living with Chronic Diseases in Canada (N = 6142) were asked about sociodemographic characteristics, health care utilization, and health behaviour modification to control hypertension. Association between receipt of advice from health professional and ever engaging, continuing to engage, and not engaging in health behaviour modification was quantified by prevalence rate ratios. Most participants (90.9%; 95% confidence interval [CI], 89.6-92.2) reported that the health professional most responsible for treating their high blood pressure was their general practitioner. Approximately 9% reported that they had not received or do not recall receiving any advice for blood pressure control. The most commonly reported advice received from a health professional was to participate in physical activity or exercise (70.0%). Respondents who had received advice on health behaviour change to manage their high blood pressure were more likely to report engaging in the behaviour compared with those who did not receive such advice. Many Canadians with hypertension receive health behaviour change advice from their health professionals. Receiving this advice was associated with a greater likelihood of attempting health behaviour change and attempting to sustain that change. Copyright © 2011 Canadian Cardiovascular Society. All rights reserved.

77 FR 48169 - The Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 1...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-13

... Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 1; The Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 2 AGENCY: United States... Technology Agreement: Advice and Information on the Proposed Expansion: Part 1, and investigation No. 332-536...

"I Don't Know Where to Find the Careers Adviser … He Has Disappeared": The Impact of Changes to Careers Advice on 14-16 Year Olds in University Technical Colleges and Schools

ERIC Educational Resources Information Center

Acquah, Daniel K.; Limmer, Hayley; Malpass, Debra

2017-01-01

Recent policies in England have enacted significant changes to careers information advice and guidance (CIAG) and work-related learning (WRL). This paper offers insight into these changes from the perspective of young people studying engineering at University Technical Colleges (UTCs) as well as "comprehensive" schools. Face-to-face CIAG…

7 CFR 1450.5 - Performance based on advice or action of USDA.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Performance based on advice or action of USDA. 1450.5... (BCAP) Common Provisions § 1450.5 Performance based on advice or action of USDA. (a) The provisions of... representative of USDA apply to this part, and may be considered as a basis to provide relief to persons subject...

7 CFR 12.11 - Action based upon advice or action of USDA.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 1 2014-01-01 2014-01-01 false Action based upon advice or action of USDA. 12.11... CONSERVATION General Provisions § 12.11 Action based upon advice or action of USDA. The provisions of part 718... it is determined by the appropriate USDA agency that the action of a person which would form the...

7 CFR 12.11 - Action based upon advice or action of USDA.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 1 2011-01-01 2011-01-01 false Action based upon advice or action of USDA. 12.11... CONSERVATION General Provisions § 12.11 Action based upon advice or action of USDA. The provisions of part 718... it is determined by the appropriate USDA agency that the action of a person which would form the...

7 CFR 1450.5 - Performance based on advice or action of USDA.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Performance based on advice or action of USDA. 1450.5... (BCAP) Common Provisions § 1450.5 Performance based on advice or action of USDA. (a) The provisions of... representative of USDA apply to this part, and may be considered as a basis to provide relief to persons subject...

7 CFR 12.11 - Action based upon advice or action of USDA.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 1 2012-01-01 2012-01-01 false Action based upon advice or action of USDA. 12.11... CONSERVATION General Provisions § 12.11 Action based upon advice or action of USDA. The provisions of part 718... it is determined by the appropriate USDA agency that the action of a person which would form the...

7 CFR 1450.5 - Performance based on advice or action of USDA.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Performance based on advice or action of USDA. 1450.5... (BCAP) Common Provisions § 1450.5 Performance based on advice or action of USDA. (a) The provisions of... representative of USDA applies to this part, and may be considered as a basis to provide relief to persons...

7 CFR 1450.5 - Performance based on advice or action of USDA.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Performance based on advice or action of USDA. 1450.5... (BCAP) Common Provisions § 1450.5 Performance based on advice or action of USDA. (a) The provisions of... representative of USDA apply to this part, and may be considered as a basis to provide relief to persons subject...

7 CFR 12.11 - Action based upon advice or action of USDA.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Action based upon advice or action of USDA. 12.11... CONSERVATION General Provisions § 12.11 Action based upon advice or action of USDA. The provisions of part 718... it is determined by the appropriate USDA agency that the action of a person which would form the...

7 CFR 12.11 - Action based upon advice or action of USDA.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 1 2013-01-01 2013-01-01 false Action based upon advice or action of USDA. 12.11... CONSERVATION General Provisions § 12.11 Action based upon advice or action of USDA. The provisions of part 718... it is determined by the appropriate USDA agency that the action of a person which would form the...

Evaluation of a telephone advice nurse in a nursing faculty managed pediatric community clinic.

PubMed

Beaulieu, Richard; Humphreys, Janice

2008-01-01

Nurse-managed health centers face increasing obstacles to financial viability. Efficient use of clinic resources and timely and appropriate patient care are necessary for sustainability. A registered nurse with adequate education and support can provide high-quality triage and advice in community-based practice sites. The purpose of this program evaluation was to examine the effect of a telephone advice nurse service on parent/caregiver satisfaction and access to care. A quasi-experimental separate pre-post sample design study investigated parent/caregiver satisfaction with a telephone advice nurse in an urban pediatric nurse-managed health center. The clinic medical information system was used to retrieve client visit data prior to the service and in the first year of the program. Statistically significant differences were found on two items from the satisfaction with the advice nurse survey: the reason for calling (P < .05), and the importance of being involved in decision making (P < .05). A telephone advice nurse may increase both parent/caregiver and provider satisfaction and access to care.

Advice networks in teams: the role of transformational leadership and members' core self-evaluations.

PubMed

Zhang, Zhen; Peterson, Suzanne J

2011-09-01

This article examines the team-level factors promoting advice exchange networks in teams. Drawing upon theory and research on transformational leadership, team diversity, and social networks, we hypothesized that transformational leadership positively influences advice network density in teams and that advice network density serves as a mediating mechanism linking transformational leadership to team performance. We further hypothesized a 3-way interaction in which members' mean core self-evaluation (CSE) and diversity in CSE jointly moderate the transformational leadership-advice network density relationship, such that the relationship is positive and stronger for teams with low diversity in CSE and high mean CSE. In addition, we expected that advice network centralization attenuates the positive influence of network density on team performance. Results based on multisource data from 79 business unit management teams showed support for these hypotheses. The results highlight the pivotal role played by transformational leadership and team members' CSEs in enhancing team social networks and, ultimately, team effectiveness. PsycINFO Database Record (c) 2011 APA, all rights reserved

Advice for acute low back pain: a comparison of what research supports and what guidelines recommend.

PubMed

Stevens, Matthew L; Lin, Chung-Wei C; de Carvalho, Flavia A; Phan, Kevin; Koes, Bart; Maher, Chris G

2017-10-01

Advice is widely considered an effective treatment for acute low back pain (LBP); however, details on what and how to deliver this intervention is less clear. We assessed and compared clinical trials that test advice for acute LBP with practice guidelines for their completeness of reporting and concordance on the content, method of delivery, and treatment regimen of advice interventions. Systematic review. Advice randomized controlled trials were identified through a systematic search. Guidelines were taken from recent overviews of guidelines for LBP. Completeness of reporting was assessed using the Template for Intervention Description and Replication checklist. Thematic analysis was used to characterize advice interventions into topics across the aspects of content, method of delivery, and regimen. Concordance between clinical trials and guidelines was assessed by comparing the number of trials that found a statistically significant treatment effect for an intervention that included a specific advice topic with the number of guidelines recommending that topic. The median (interquartile range) completeness of reporting for clinical trials and guidelines was 8 (7-9) and 3 (2-4) out of nine items on the Template for Intervention Description and Replication checklist, respectively. Guideline recommendations were discordant with clinical trials for 50% of the advice topics identified. Completeness of reporting was less than ideal for randomized controlled trials and extremely poor for guidelines. The recommendations made in guidelines of advice for acute LBP were often not concordant with the results of clinical trials. Taken together, these findings mean that the potential clinical value of advice interventions for patients with acute LBP is probably not being realized. Copyright © 2017 Elsevier Inc. All rights reserved.

Communication of Science Advice to Government.

PubMed

Hutchings, Jeffrey A; Stenseth, Nils Chr

2016-01-01

There are various ways to construct good processes for soliciting and understanding science. Our critique of advisory models finds that a well-supported chief science advisor (CSA) best ensures the provision of deliberative, informal, and emergency advice to government. Alternatively, bias, increasingly manifest as science-based advocacy, can hinder communication, diminish credibility, and distort scientific evidence. Copyright © 2015 Elsevier Ltd. All rights reserved.

WITHDRAWN: Advice to stay active as a single treatment for low-back pain and sciatica.

PubMed

Hilde, G; Hagen, K B; Jamtvedt, G; Winnem, M

2007-07-18

Low back pain is one of the most common conditions managed in primary care. Restricted activity, rest, and symptomatic analgesics are the most commonly prescribed treatment for low back pain and sciatica. To assess the effects of advice to stay active as single treatment for patients with low back pain. Computerised searches in MEDLINE, EMBASE, Sport, The Cochrane Controlled Trials Register, Musculoskeletal Group's Trials Register and Scisearch, and scanning of reference lists from relevant articles were undertaken. Relevant studies were also traced by contacting authors. Date of the most recent searches: December 1998. We included all randomised trials or quasi-randomised trials where the study population consisted of adult patients with low back pain or sciatica, in which one comparison group was advised to stay active. The main outcomes of interest were pain, functional status, recovery and return to work. Two reviewers independently selected trials for inclusion, assessed the validity of included trials and extracted data. Investigators were contacted to collect missing data or for clarification when needed. Four trials, with a total of 491 patients, were included. Advice to stay active was compared to advice to rest in bed in all trials. Two trials were assessed to have low risk of bias and two to have moderate to high risk of bias. The results were heterogeneous. Results from one high quality trial of patients with acute simple LBP found small differences in functional status [Weighted Mean Difference (on a 0-100 scale) 6.0 (95% CI: 1.5, 10.5)] and length of sick leave [WMD 3.4 days (95% CI: 1.6, 5.2)] in favour of staying active compared to advice to stay in bed for two days. The other high quality trial compared advice to stay active with advice to rest in bed for 14 days for patients with sciatic syndrome, and found no differences between the groups. One of the high quality trials also compared advice to stay active with exercises for patients with acute

Improving tsunami resiliency: California's Tsunami Policy Working Group

USGS Publications Warehouse

Real, Charles R.; Johnson, Laurie; Jones, Lucile M.; Ross, Stephanie L.; Kontar, Y.A.; Santiago-Fandiño, V.; Takahashi, T.

2014-01-01

California has established a Tsunami Policy Working Group to facilitate development of policy recommendations for tsunami hazard mitigation. The Tsunami Policy Working Group brings together government and industry specialists from diverse fields including tsunami, seismic, and flood hazards, local and regional planning, structural engineering, natural hazard policy, and coastal engineering. The group is acting on findings from two parallel efforts: The USGS SAFRR Tsunami Scenario project, a comprehensive impact analysis of a large credible tsunami originating from an M 9.1 earthquake in the Aleutian Islands Subduction Zone striking California’s coastline, and the State’s Tsunami Preparedness and Hazard Mitigation Program. The unique dual-track approach provides a comprehensive assessment of vulnerability and risk within which the policy group can identify gaps and issues in current tsunami hazard mitigation and risk reduction, make recommendations that will help eliminate these impediments, and provide advice that will assist development and implementation of effective tsunami hazard risk communication products to improve community resiliency.

Decision Making and Confidence Given Uncertain Advice

ERIC Educational Resources Information Center

Lee, Michael D.; Dry, Matthew J.

2006-01-01

We study human decision making in a simple forced-choice task that manipulates the frequency and accuracy of available information. Empirically, we find that people make decisions consistent with the advice provided, but that their subjective confidence in their decisions shows 2 interesting properties. First, people's confidence does not depend…

Enacting Effective Climate Policy Advice: Institutional Strategies to Foster Saliency, Credibility and Legitimacy

ERIC Educational Resources Information Center

Bauer, Anja; Pregernig, Michael; Reinecke, Sabine

2016-01-01

This article asks how scientific advisory institutions (SAIs) in climate policy strive towards effectiveness. Our analysis is grounded on the assumption that effectiveness is not passively experienced but is deliberately enacted by SAIs. We draw on a widely used set of criteria, namely saliency, credibility and legitimacy (SCL). Based on an…

Whose Expertise?: An Analysis of Advice Giving in Early Childhood Parent-Teacher Conferences

ERIC Educational Resources Information Center

Cheatham, Gregory A.; Ostrosky, Michaelene M.

2011-01-01

Early childhood and early childhood special education programs have a focus on parent-educator partnerships. Parent-teacher conferences are a context for these partnerships, and advice giving is one type of exchange occurring within conferences. Parent-teacher conference advice was investigated through participant interviews and the methodology of…

The information filter: how dentists use diet diary information to give patients clear and simple advice.

PubMed

Arheiam, Arheiam; Brown, Stephen L; Higham, Susan M; Albadri, Sondos; Harris, Rebecca V

2016-12-01

Diet diaries are recommended for dentists to monitor children's sugar consumption. Diaries provide multifaceted dietary information, but patients respond better to simpler advice. We explore how dentists integrate information from diet diaries to deliver useable advice to patients. As part of a questionnaire study of general dental practitioners (GDPs) in Northwest England, we asked dentists to specify the advice they would give a hypothetical patient based upon a diet diary case vignette. A sequential mixed method approach was used for data analysis: an initial inductive content analysis (ICA) to develop coding system to capture the complexity of dietary assessment and delivered advice. Using these codes, a quantitative analysis was conducted to examine correspondences between identified dietary problems and advice given. From these correspondences, we inferred how dentists reduced problems to give simple advice. A total of 229 dentists' responses were analysed. ICA on 40 questionnaires identified two distinctive approaches of developing diet advice: a summative (summary of issues into an all-encompassing message) and a selective approach (selection of a main message approach). In the quantitative analysis of all responses, raw frequencies indicated that dentists saw more problems than they advised on and provided highly specific advice on a restricted number of problems (e.g. not eating sugars before bedtime 50.7% or harmful items 42.4%, rather than simply reducing the amount of sugar 9.2%). Binary logistic regression models indicate that dentists provided specific advice that was tailored to the key problems that they identified. Dentists provided specific recommendations to address what they felt were key problems, whilst not intervening to address other problems that they may have felt less pressing. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

National Vaccine Policy: ethical equity issues.

PubMed

Jayakrishnan, T

2013-01-01

The ministry of health and family welfare published the national vaccination policy in April 2011. The policy document drew severe criticism from several public health experts. A review of the print and web-based literature on the national vaccine policy was done and the issues of ethics and equity involved in introducing new vaccines under the Universal Immunisation Programme (UIP) were studied. The average coverage of the UIP vaccines at the national level is below 50%. Despite this, the policy document did not state any concrete strategy for increasing the coverage. The main stumbling block for evidence-based vaccine policy in India is the lack of reliable epidemiological data, which makes it difficult for the National Technical Advisory Group on Immunisation to offer sound technical advice to the government. No attempts have been made to prioritise diseases or the selection of vaccines. The policy suggests the introduction of the following vaccines in the UIP: Haemophilus influenzae type b, pneumococcal vaccine, rotavirus vaccines and human papillomavirus (HPV). This selection is on the grounds of the vaccines' availability, not on the basis of epidemiological evidence or proven cost-effectiveness. This is a critical review of the current vaccination policy and the move to include the rotavirus and HPV vaccines in the UIP.

Quality of Extension Advice: A Gendered Case Study from Ghana and Sri Lanka

ERIC Educational Resources Information Center

Lamontagne-Godwin, Julien; Williams, Frances; Bandara, Willoru Mudiyansele Palitha Thilakasiri; Appiah-Kubi, Ziporah

2017-01-01

Purpose: Women farmers have less access to extension services than male farmers, even though they make up almost half of the global agricultural workforce. Gender-focused international development programmes have focused on how ensuring women receive better access to advice. However, the quality of the technical advice and the service women…

Experience of dietary advice among Pakistani-born persons with type 2 diabetes in Oslo.

PubMed

Fagerli, Rønnaug Aa; Lien, Marianne E; Wandel, Margareta

2005-12-01

Experience and implementation of dietary advice are influenced by various factors including ethnic, cultural and religious background. The aim is to explore how ethnic minority persons with diabetes experience dietary advice given by Norwegian health-workers, which strategies they have in response to the advice and how they explain their actions. In-depth interviews were performed with 15 Pakistani-born persons with type 2 diabetes living in Oslo. The analyses are based on the principles of Giorgi's interpretation of phenomenology. The participants expressed great concern to follow the advice. However, narratives about constraints were numerous. These concerned different life-situational factors, but more importantly they were related to communication problems arising from discontinuities between universalising medical knowledge and lay knowledge, as well as between different types of culturally defined lay knowledge. As a consequence, advice was generally experienced as inadequately based on the participant's food-cultural background, leaving the person with diabetes to do the translation between different levels of knowledge. In general health-workers would benefit from expanding their knowledge of the many positive aspects of their patients' cultural background, and apply their knowledge thereafter, whether it concerns (food)-culture or the impact of religion in everyday life.

National and Governmental Advisory Committee Advice Letters for 2014

EPA Pesticide Factsheets

Advice Letters produced for and/or by the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation

National and Governmental Advisory Committee Advice Letters for 2015

EPA Pesticide Factsheets

Advice Letters produced for and/or by the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation

Advising Beef-Cattle Farmers: Problem-Finding Rather than Problem-Solving. Characterization of Advice Practices in Creuse

ERIC Educational Resources Information Center

Magne, Marie-Angelina; Ingrand, Stephane

2004-01-01

French farms have to adapt quickly in an economic and social context that is in profound change. For this, advice procedures must themselves be reconsidered. The aim of this work was to characterize the advice practices in beef-cattle systems in Creuse and define farmers' and advisers' requirements according to future methods of providing advice.…

Differential neurobiological effects of expert advice on risky choice in adolescents and adults.

PubMed

Engelmann, Jan B; Moore, Sara; Monica Capra, C; Berns, Gregory S

2012-06-01

We investigated behavioral and neurobiological mechanisms by which risk-averse advice, provided by an expert, affected risky decisions across three developmental groups [early adolescents (12-14 years), late adolescents (15-17 years), adults (18+ years)]. Using cumulative prospect theory, we modeled choice behavior during a risky-choice task. Results indicate that advice had a significantly greater impact on risky choice in both adolescent groups than in adults. Using functional magnetic resonance imaging, we investigated the neural correlates of this behavioral effect. Developmental effects on correlations between brain activity and valuation parameters were obtained in regions that can be classified into (i) cognitive control regions, such as dorsolateral prefrontal cortex (DLPFC) and ventrolateral PFC; (ii) social cognition regions, such as posterior temporoparietal junction; and (iii) reward-related regions, such as ventromedial PFC (vmPFC) and ventral striatum. Within these regions, differential effects of advice on neural correlates of valuation were observed across development. Specifically, advice increased the correlation strength between brain activity and parameters reflective of safe choice options in adolescent DLPFC and decreased correlation strength between activity and parameters reflective of risky choice options in adult vmPFC. Taken together, results indicate that, across development, distinct brain systems involved in cognitive control and valuation mediate the risk-reducing effect of advice during decision making under risk via specific enhancements and reductions of the correlation strength between brain activity and valuation parameters.

Knowledge, attitudes, and practices of US practitioners who provide pre-travel advice.

PubMed

Kogelman, Laura; Barnett, Elizabeth D; Chen, Lin H; Quinn, Emily; Yanni, Emad; Wilson, Mary E; Benoit, Christine; Karchmer, Adolf W; Ooi, Winnie W; Jentes, Emily S; Hamer, Davidson H

2014-01-01

As international travel increases, many health care professionals are being asked to provide pre-travel advice. We designed an anonymous web-based survey to assess the extent to which primary care providers (PCPs) provide travel medicine advice and how their understanding and delivery of itinerary-specific advice and management compare with that of travel medicine specialists. We surveyed randomly selected US PCPs registered in the Pri-Med Institute (now pmiCME) database and US travel medicine specialists from the International Society of Travel Medicine (ISTM), American Society of Tropical Medicine and Hygiene (ASTMH), and Centers for Disease Control and Prevention (CDC) yellow fever (YF) vaccine provider mailing lists. SAS software (SAS Institute, Cary, NC, USA) was used for all analyses. Of 14,932 e-mails sent to valid e-mail addresses, 902 yielded complete or partially completed surveys (6.0% response rate). Eighty percent of respondents personally provided pre-travel advice (95% of travel medicine specialists versus 73% of PCPs). About two thirds of PCPs (68%) providing pre-travel consultations saw <50 travelers per year whereas 30% of travel medicine specialists saw <50 travelers per year. More travel medicine specialists (59%) than PCPs (18%) saw >500 travelers per year. Familiarity with travel-specific vaccines (YF, Japanese encephalitis) and provision of written educational materials increased as volume of travelers increased. Familiarity with antimalarial side effects and malaria resistance patterns, and knowledge scores based on brief pre-travel scenarios were higher in travel medicine specialists, ASTMH or ISTM certificate holders, and respondents who saw more pre-travel patients. Many PCP survey participants provided pre-travel advice, but most saw few travelers. Volume of travelers and holding an ASTMH or ISTM certificate had the greatest influence on knowledge of travel medicine and provision of appropriate advice and recommendations. Creating easily

31 CFR 10.37 - Requirements for written advice.

Code of Federal Regulations, 2014 CFR

2014-07-01

...' professional knowledge on Federal tax matters are not considered written advice on a Federal tax matter for... representations, statements, findings, or agreements (including projections, financial forecasts, or appraisals... on representations, statements, findings, or agreements is unreasonable if the practitioner knows or...

National and Governmental Advisory Committee Advice Letters for 2016

EPA Pesticide Factsheets

Advice Letters and produced by the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation, and EPA responses

45 CFR 162.1602 - Standards for health care payment and remittance advice transaction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Standards for health care payment and remittance advice transaction. 162.1602 Section 162.1602 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Care Payment and Remittance Advice § 162.1602 Standards for...

45 CFR 162.1602 - Standards for health care payment and remittance advice transaction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Standards for health care payment and remittance advice transaction. 162.1602 Section 162.1602 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Health Care Payment and Remittance Advice § 162.1602 Standards for...

39 CFR 762.41 - Advice of non-receipt or loss, destruction, or mutilation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Advice of non-receipt or loss, destruction, or..., Mutilated, and Defaced Disbursement Postal Money Orders § 762.41 Advice of non-receipt or loss, destruction... purpose for which it was issued, giving, if possible, its date, number, and amount, and requesting that...

39 CFR 762.41 - Advice of non-receipt or loss, destruction, or mutilation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Advice of non-receipt or loss, destruction, or..., Mutilated, and Defaced Disbursement Postal Money Orders § 762.41 Advice of non-receipt or loss, destruction... purpose for which it was issued, giving, if possible, its date, number, and amount, and requesting that...

Development and usability of a computer-tailored pedometer-based physical activity advice for breast cancer survivors.

PubMed

De Cocker, K; Charlier, C; Van Hoof, E; Pauwels, E; Lechner, L; Bourgois, J; Spittaels, H; Vandelanotte, C; De Bourdeaudhuij, I

2015-09-01

This observational study aimed to adapt a computer-tailored step advice for the general population into a feasible advice for breast cancer survivors and to test its usability. First, several adaptations were made to the original design (adding cancer-related physical activity (PA) barriers and beliefs, and self-management strategies to improve survivors' personal control). Second, the adapted advice was evaluated in two phases: (1) a usability testing in healthy women (n = 3) and survivors (n = 6); and (2) a process evaluation during 3 weeks in breast cancer survivors (n = 8). Preliminary usability testing revealed no problems during logging-in; however, three survivors misinterpreted some questions. After refining the questionnaire and advice, survivors evaluated the advice as interesting, attractive to read, comprehensible and credible. Inactive survivors found the advice novel, but too long. The process evaluation indicated that the majority of the women (n = 5/8) reported increased steps. Monitoring step counts by using a pedometer was perceived as an important motivator to be more active. To conclude, this study provides initial support for the usability and acceptability of a computer-tailored pedometer-based PA advice for breast cancer survivors. After testing efficacy and effectiveness of this intervention, this tool can broaden the reach of PA promotion in breast cancer survivors. © 2014 John Wiley & Sons Ltd.

The pattern of clinical advice sought by general practitioners from a medical consultant in clinical biochemistry.

PubMed Central

Bhatnagar, D

1997-01-01

Clinical biochemistry departments can be a valuable source of clinical advice for further investigations and the need for referral to specialist clinics. This paper outlines the pattern of clinical advice sought by general practitioners in a district hospital setting, and addresses some of the issues regarding seeking such advice and the implications for continuing medical education and training. PMID:9196966

The President’s Office of Science and Technology Policy: Issues for Congress

DTIC Science & Technology

2009-02-06

History of Science and...committees, even though the office provides advice and assistance to the White House.2 This report will provide an overview of the history of science and...with the OSTP Director as a co-chair.6 4 Jeffrey K. Stine, A History of Science Policy

Grolar Bears, Social Class, and Policy Relevance: Extraordinary Agendas for the Emerging 21st Century

PubMed Central

Fiske, Susan T.

2016-01-01

This Agenda article first considers whether social psychology is in the best or worst of times and suggests that we are instead in extraordinary times, given exciting agendas and potential policy relevance, if we are careful. The article illustrates with two current research agendas—the hybrid vigor of multiple categories and the psychology of social class—that could inform policy. The essay then reflects on how we know when our work is indeed ready for the public arena. Regarding hybrids: World immigration, social media, and global businesses are increasing. How will this complicate people’s stereotypes of each other? One agenda could build on the existing social and behavioral science of people as social hybrids, emerging with a framework to synthesize existing work and guide future research that better reflects our changing world. Policy implications already emerge from our current knowledge of hybrids. Regarding the social psychology of social class: We do not know enough yet to give advice, except to suggest questioning some common stereotypes, e.g., about the economic behavior of lower-income people. Before the budding social psychology of class can be ready for policy export, the research results need replication, validation, and generality. Overall, principles of exportable policy insights include peer-reviewed standards, honest brokering, nonpartisan advice, and respectful, trustworthy communication. Social psychology can take advantage of its extraordinary times to be innovative and useful. PMID:27397941

Changes in Patient-Reported Alcohol-Related Advice Following Veterans Health Administration Implementation of Brief Alcohol Interventions.

PubMed

Chavez, Laura J; Williams, Emily C; Lapham, Gwen T; Rubinsky, Anna D; Kivlahan, Daniel R; Bradley, Katharine A

2016-05-01

Brief alcohol interventions are recommended for primary care patients who screen positive for alcohol misuse, but implementation is challenging. The U.S. Veterans Health Administration (Veterans Affairs [VA]) implemented brief interventions for patients with alcohol misuse in 2008, and rates of brief interventions documented in the electronic medical record increased from 24% to 78% (2008-2011). This study examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. This retrospective cross-sectional study included VA outpatient respondents to the VA's Survey of Healthcare Experiences of Patients (SHEP; 2007-2011) who reported past-year alcohol use and answered a question about alcohol-related advice. Alcohol-related advice was defined as a report of past-year advice from a VA clinician to abstain from or reduce drinking. The adjusted prevalence of alcoholrelated advice among patients who screened positive for alcohol misuse (SHEP AUDIT-C ≥ 5) was estimated for each year. Among patients with alcohol misuse (n = 61,843), the adjusted prevalence of alcohol-related advice increased from 40.4% (95% CI [39.3%, 41.5%]) in 2007 to 55.5% (95% CI [53.3%, 57.8%]) in 2011. Rates of alcoholrelated advice increased significantly each year except the last. The VA's efforts to implement brief interventions were associated with increased patient-reported alcohol-related advice over time, with a majority of patients with alcohol misuse reporting its receipt. Other systems considering similar approaches to implementation may benefit from collecting patient-reported measures of brief interventions for an additional perspective on implementation.

Scientific Integrity Policy Creation and Implementation.

NASA Astrophysics Data System (ADS)

Koizumi, K.

2017-12-01

Ensuring the integrity of science was a priority for the Obama Administration. In March 2009, President Obama issued a Presidential Memorandum that recognized the need for the public to be able to trust the science and scientific process informing public policy decisions. In 2010, the White House Office of Science and Technology Policy (OSTP) issued a Memorandum providing guidelines for Federal departments and agencies to follow in developing scientific integrity policies. This Memorandum describes minimum standards for: (1) strengthening the foundations of scientific integrity in government, including by shielding scientific data and analysis from inappropriate political influence; (2) improving public communication about science and technology by promoting openness and transparency; (3) enhancing the ability of Federal Advisory Committees to provide independent scientific advice; and (4) supporting the professional development of government scientists and engineers. The Memorandum called upon the heads of departments and agencies to develop scientific integrity policies that meet these requirements. At the end of the Obama Administration, 24 Federal departments and agencies had developed and implemented scientific integrity policies consistent with the OSTP guidelines. This year, there are significant questions as to the Trump Administration's commitment to these scientific integrity policies and interest in the Congress in codifying these policies in law. The session will provide an update on the status of agency scientific integrity policies and legislation.

Weight Advice Associated With Male Firefighter Weight Perception and Behavior

PubMed Central

Brown, Austin L.; Poston, Walker S.C.; Jahnke, Sara A.; Haddock, C. Keith; Luo, Sheng; Delclos, George L.; Day, R. Sue

2016-01-01

Introduction The high prevalence of overweight and obesity threatens the health and safety of the fire service. Healthcare professionals may play an important role in helping firefighters achieve a healthy weight by providing weight loss counseling to at-risk firefighters. This study characterizes the impact of healthcare professional weight loss advice on firefighter weight perceptions and weight loss behaviors among overweight and obese male firefighters. Methods A national sample of 763 overweight and obese male firefighters who recalled visiting a healthcare provider in the past 12 months reported information regarding healthcare visits, weight perceptions, current weight loss behaviors, and other covariates in 2011–2012. Analyzed in 2013, four unique multilevel logistic regression models estimated the association between healthcare professional weight loss advice and the outcomes of firefighter-reported weight perceptions, intentions to lose weight, reduced caloric intake, and increased physical activity. Results Healthcare professional weight loss advice was significantly associated with self-perception as overweight (OR=4.78, 95% CI=2.16, 10.57) and attempted weight loss (OR=2.06, 95% CI=1.25, 3.38), but not significantly associated with reduced caloric intake (OR=1.26, 95% CI=0.82, 1.95) and increased physical activity (OR=1.51, 95% CI=0.89, 2.61), after adjusting for confounders. Conclusions Healthcare professional weight loss advice appears to increase the accuracy of firefighter weight perceptions, promote weight loss attempts, and may encourage dieting and physical activity behaviors among overweight firefighters. Healthcare providers should acknowledge their ability to influence the health behaviors of overweight and obese patients and make efforts to increase the quality and frequency of weight loss recommendations for all firefighters. PMID:26141913

An fMRI and effective connectivity study investigating miss errors during advice utilization from human and machine agents.

PubMed

Goodyear, Kimberly; Parasuraman, Raja; Chernyak, Sergey; de Visser, Ewart; Madhavan, Poornima; Deshpande, Gopikrishna; Krueger, Frank

2017-10-01

As society becomes more reliant on machines and automation, understanding how people utilize advice is a necessary endeavor. Our objective was to reveal the underlying neural associations during advice utilization from expert human and machine agents with fMRI and multivariate Granger causality analysis. During an X-ray luggage-screening task, participants accepted or rejected good or bad advice from either the human or machine agent framed as experts with manipulated reliability (high miss rate). We showed that the machine-agent group decreased their advice utilization compared to the human-agent group and these differences in behaviors during advice utilization could be accounted for by high expectations of reliable advice and changes in attention allocation due to miss errors. Brain areas involved with the salience and mentalizing networks, as well as sensory processing involved with attention, were recruited during the task and the advice utilization network consisted of attentional modulation of sensory information with the lingual gyrus as the driver during the decision phase and the fusiform gyrus as the driver during the feedback phase. Our findings expand on the existing literature by showing that misses degrade advice utilization, which is represented in a neural network involving salience detection and self-processing with perceptual integration.

[Scientific advice by the national and European approval authorities concerning advanced therapy medicinal products].

PubMed

Jost, Nils; Schüssler-Lenz, Martina; Ziegele, Bettina; Reinhardt, Jens

2015-11-01

The aim of scientific advice is to support pharmaceutical developers in regulatory and scientific questions, thus facilitating the development of safe and efficacious new medicinal products. Recent years have shown that the development of advanced therapy medicinal products (ATMPs) in particular needs a high degree of regulatory support. On one hand, this is related to the complexity and heterogeneity of this group of medicinal products and on the other hand due to the fact that mainly academic research institutions and small- and medium-sized enterprises (SMEs) are developing ATMPs. These often have limited regulatory experience and resources. In 2009 the Paul-Ehrlich-Institut (PEI) initiated the Innovation Office as a contact point for applicants developing ATMPs. The mandate of the Innovation Office is to provide support on regulatory questions and to coordinate national scientific advice meetings concerning ATMPs for every phase in drug development and especially with view to the preparation of clinical trial applications. On the European level, the Scientific Advice Working Party (SAWP) of the Committee for Medicinal Products for Human Use (CHMP) of the European Medicinal Agency (EMA) offers scientific advice. This article describes the concepts of national and EMA scientific advice concerning ATMPs and summarizes the experience of the last six years.

A policy for science.

PubMed

Lauer, Michael S

2012-06-12

Policy and science often interact. Typically, we think of policymakers looking to scientists for advice on issues informed by science. We may appreciate less the opposite look: where people outside science inform policies that affect the conduct of science. In clinical medicine, we are forced to make decisions about practices for which there is insufficient, inadequate evidence to know whether they improve clinical outcomes, yet the health care system may not be structured to rapidly generate needed evidence. For example, when the Centers for Medicare and Medicaid Services noted insufficient evidence to support routine use of computed tomography angiography and they called for a national commitment to completion of randomized trials, their call ran into substantial opposition. I use the computed tomography angiography story to illustrate how we might consider a "policy for science" in which stakeholders would band together to identify evidence gaps and to use their influence to promote the efficient design, implementation, and completion of high-quality randomized trials. Such a policy for science could create a culture that incentivizes and invigorates the rapid generation of evidence, ultimately engaging all clinicians, all patients, and indeed all stakeholders into the scientific enterprise. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Why do women not adhere to advice on maternal referral in rural Tanzania? Narratives of women and their family members.

PubMed

Pembe, Andrea B; Mbekenga, Columba K; Olsson, Pia; Darj, Elisabeth

2017-01-01

In most low-income countries, many women with high-risk pregnancies and complications do not reach the referral hospitals despite the provision of referral advice. To explore how antenatal maternal referral advice is understood and handled in a rural Tanzanian community. Individual in-depth interviews were conducted with six women who did not go to hospital and 13 people who were involved in the referral advice. Narrative analysis was used to describe and create meanings out of the decision-making process. In all interviews, not following the referral advice was greatly influenced by close family members. Three main traits of how referral advice was understood emerged: convinced referral is not necessary, accepting referral advice but delayed by others, and passive and moving with the wind. The main reasons given for declining the referral advice included discrediting midwives' advice, citing previous successful deliveries despite referral advice; being afraid of undergoing surgery; lack of support for care of siblings at home; and high costs incurred during referral. Declining maternal referral advice centred around the pregnant women's position and their dependence on the family members around them, with a decreased ability to show autonomy. If they were socially and economically empowered, women could positively influence decision making during maternal referrals.

Deterring Violent Extremism in America by Utilizing Good Counter-Radicalization Practices from Abroad: A Policy Perspective

DTIC Science & Technology

2017-03-01

offering rehabilitation programs to former extremists. This thesis provides a way ahead for American policy makers by sharing good practices in each of...and offering training to prevent terrorism from when individuals are young. Understanding that humans are fallible, American policy makers and...in the United Kingdom that provided trained Islamic scholars to offer advice about the true teaching of Islam.102 The hotline “El-Hatef el- Islami’s

Optimal climate change: economics and climate science policy histories (from heuristic to normative).

PubMed

Randalls, Samuel

2011-01-01

Historical accounts of climate change science and policy have reflected rather infrequently upon the debates, discussions, and policy advice proffered by economists in the 1980s. While there are many forms of economic analysis, this article focuses upon cost-benefit analysis, especially as adopted in the work of William Nordhaus. The article addresses the way in which climate change economics subtly altered debates about climate policy from the late 1970s through the 1990s. These debates are often technical and complex, but the argument in this article is that the development of a philosophy of climate change as an issue for cost-benefit analysis has had consequences for how climate policy is made today.

77 FR 47880 - U.S.-Trans-Pacific Partnership Free Trade Agreement Including Canada and Mexico: Advice on the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

....S.-Trans-Pacific Partnership Free Trade Agreement Including Malaysia: Advice on Probable Economic... Partnership Free Trade Agreement Including Canada and Mexico: Advice on the Probable Economic Effect of... Mexico: Advice on the Probable Economic Effect of Providing Duty-Free Treatment for Imports. DATES...

The Use of Living Organisms in Schools: Advice and Support from Science Inspectors.

ERIC Educational Resources Information Center

Lock, Roger

1996-01-01

Focuses on the advice and support from science inspectors or advisers with respect to the use of living organisms in schools. Reports that advice, support, and encouragement in the use of living organisms in teaching was widely available at the time of this study and schools have a great deal to lose from the shrinkage in the advisory service.…

76 FR 66135 - Investment Advice-Participants and Beneficiaries

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-25

... ``computer model'' requirement (requiring use of a certified computer model). Both types of arrangements also... that use fee-leveling] or paragraph (b)(4) [describing investment advice arrangements that use computer...-leveling and computer modeling provisions of the final rule. We note that, as also reflected in paragraph...

Exposing the impact of Citizens Advice Bureau services on health: a realist evaluation protocol.

PubMed

Forster, N; Dalkin, S M; Lhussier, M; Hodgson, P; Carr, S M

2016-01-20

Welfare advice services can be used to address health inequalities, for example, through Citizens Advice Bureau (CAB). Recent reviews highlight evidence for the impact of advice services in improving people's financial position and improving mental health and well-being, daily living and social relationships. There is also some evidence for the impact of advice services in increasing accessibility of health services, and reducing general practitioner appointments and prescriptions. However, direct evidence for the impact of advice services on lifestyle behaviour and physical health is currently much less well established. There is a need for greater empirical testing of theories around the specific mechanisms through which advice services and associated financial or non-financial benefits may generate health improvements. A realist evaluation will be conducted, operationalised in 5 phases: building the explanatory framework; refining the explanatory framework; testing the explanatory framework through empirical data (mixed methods); development of a bespoke data recording template to capture longer term impact; and verification of findings with a range of CAB services. This research will therefore aim to build, refine and test an explanatory framework about how CAB services can be optimally implemented to achieve health improvement. The study was approved by the ethics committee at Northumbria University, UK. Project-related ethical issues are described and quality control aspects of the study are considered. A stakeholder mapping exercise will inform the dissemination of results in order to ensure all relevant institutions and organisations are targeted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Weight Advice Associated With Male Firefighter Weight Perception and Behavior.

PubMed

Brown, Austin L; Poston, Walker S C; Jahnke, Sara A; Haddock, C Keith; Luo, Sheng; Delclos, George L; Day, R Sue

2015-10-01

The high prevalence of overweight and obesity threatens the health and safety of the fire service. Healthcare professionals may play an important role in helping firefighters achieve a healthy weight by providing weight loss counseling to at-risk firefighters. This study characterizes the impact of healthcare professional weight loss advice on firefighter weight perceptions and weight loss behaviors among overweight and obese male firefighters. A national sample of 763 overweight and obese male firefighters who recalled visiting a healthcare provider in the past 12 months reported information regarding healthcare visits, weight perceptions, current weight loss behaviors, and other covariates in 2011-2012. Analyzed in 2013, four unique multilevel logistic regression models estimated the association between healthcare professional weight loss advice and the outcomes of firefighter-reported weight perceptions, intentions to lose weight, reduced caloric intake, and increased physical activity. Healthcare professional weight loss advice was significantly associated with self-perception as overweight (OR=4.78, 95% CI=2.16, 10.57) and attempted weight loss (OR=2.06, 95% CI=1.25, 3.38), but not significantly associated with reduced caloric intake (OR=1.26, 95% CI=0.82, 1.95) and increased physical activity (OR=1.51, 95% CI=0.89, 2.61), after adjusting for confounders. Healthcare professional weight loss advice appears to increase the accuracy of firefighter weight perceptions, promote weight loss attempts, and may encourage dieting and physical activity behaviors among overweight firefighters. Healthcare providers should acknowledge their ability to influence the health behaviors of overweight and obese patients and make efforts to increase the quality and frequency of weight loss recommendations for all firefighters. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

7 CFR 1468.33 - Performance based upon advice or action of representatives of CCC.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Performance based upon advice or action of representatives of CCC. 1468.33 Section 1468.33 Agriculture Regulations of the Department of Agriculture... representatives of CCC. If a participant relied upon the advice or action of any authorized representative of CCC...

7 CFR 1468.33 - Performance based upon advice or action of representatives of CCC.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Performance based upon advice or action of representatives of CCC. 1468.33 Section 1468.33 Agriculture Regulations of the Department of Agriculture... representatives of CCC. If a participant relied upon the advice or action of any authorized representative of CCC...

7 CFR 1468.33 - Performance based upon advice or action of representatives of CCC.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Performance based upon advice or action of representatives of CCC. 1468.33 Section 1468.33 Agriculture Regulations of the Department of Agriculture... representatives of CCC. If a participant relied upon the advice or action of any authorized representative of CCC...

7 CFR 1468.33 - Performance based upon advice or action of representatives of CCC.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Performance based upon advice or action of representatives of CCC. 1468.33 Section 1468.33 Agriculture Regulations of the Department of Agriculture... representatives of CCC. If a participant relied upon the advice or action of any authorized representative of CCC...

7 CFR 1468.33 - Performance based upon advice or action of representatives of CCC.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Performance based upon advice or action of representatives of CCC. 1468.33 Section 1468.33 Agriculture Regulations of the Department of Agriculture... representatives of CCC. If a participant relied upon the advice or action of any authorized representative of CCC...

Discharge Against Medical Advice in the Pediatric Wards in Boo-ali Sina Hospital, Sari, Iran 2010.

PubMed

Mohseni Saravi, Benyamin; Reza Zadeh, Esmaeil; Siamian, Hasan; Yahghoobian, Mahboobeh

2013-12-01

Since children neither comprehended nor contribute to the decision, discharge against medical advice is a challenge of health care systems in the world. Therefore, the current study was designed to determine the rate and causes of discharge against medical advice. This descriptive cross-sectional study was done by reviewing the medical records by census method. Data was analyzed using SPSS software and x(2) statistics was used to determine the relationship between variables. The value of P<0.05 was considered significant. Rate of discharged against medical advice was 108 (2.2%). Mean of age and length of stay were 2.8±4 (SD).3 years old and 3.7±5.4 (SD) days, respectively. Totally, 95 patients (88.7%) had health insurance and 65 (60.2%) patients lived in urban areas. History of psychiatric disease and addiction in 22 (20.6%) of the parents were negative. In addition, 100 (92.3%) patients admitted for medical treatment and the others for surgery. The relationship of the signatory with patients (72.3%) was father. Of 108 patients discharged against medical advice, 20 (12%) were readmitted. The relationship between the day of discharge and discharge against medical advice was significant (ρ =0/03). Rate of discharge against medical advice in Boo-ali hospital is the same as the other studies in the same range. The form which is used for this purpose did not have suitable data elements about description of consequence of such discharge, and it has not shown the real causes of discharge against medical advice.

Physician Advice for e-Cigarette Use.

PubMed

Kollath-Cattano, Christy; Thrasher, James F; Osman, Amira; Andrews, Jeannette O; Strayer, Scott M

To determine characteristics of smokers discussing e-cigarette use with their physician and receiving recommendations from their physician to use e-cigarettes for smoking cessation. US adult smokers who had visited a physician in the previous 12 months (n = 2671) were surveyed. Logistic generalized estimating equation models were used to assess the characteristics of smokers who (1) talked to a physician about e-cigarettes, and (2) received physician advice to use e-cigarettes for smoking cessation. 15% (n = 406) of smokers who visited a physician talked with their physician about e-cigarettes. Among those asked whether their physician recommend e-cigarettes for smoking cessation (n = 257), 61% responded affirmatively. Current e-cigarette users were more likely to talk to their physicians about e-cigarettes (nondaily users vs never users: OR, 2.70; 95% CI, 1.79-4.05; daily users vs never users: OR, 4.29; 95% CI, 2.34-7.84) and have their physician recommend e-cigarettes for smoking cessation (daily users vs never users: OR, 9.40; 95% CI, 2.54-34.71). The majority of smokers who talk to their physician about e-cigarettes report that they received advice to use e-cigarettes to quit smoking, despite limited evidence for their efficacy. More studies are needed to better understand e-cigarette recommendations in clinical settings. © Copyright 2016 by the American Board of Family Medicine.

Patients discharged against medical advice from a psychiatric hospital in Iran: a prospective study.

PubMed

Sheikhmoonesi, Fatemeh; Khademloo, Mohammad; Pazhuheshgar, Samaneh

2014-03-30

Self- discharged patients are at high risk for readmission and ultimately higher cost for care.We intended to find the proportion of patients who leave hospital against medical advice and explore some of their characteristics. This prospective study of discharge against medical advice was conducted in psychiatric wards of Zare hospital in Iran, 2011. A psychologist recorded some information on a checklist based on the documented information about the patient who wanted to leave against medical advice. The psychologist interviewed these patients and recorded the reasons for discharge against medical advice. Descriptive statistics were calculated for the variables. The rate of premature discharge was 34.4%. Compared to patients with regular discharges, patients with premature discharge were significantly more likely to be male, self-employed, to have co morbid substance abuse and first admission and positive family history of psychiatric disorder. Disappearance of symptoms was the most frequent reason for premature discharge. The 34.4% rate of premature discharge observed in our study is higher than rate reported in other studies. One possible explanation is our teaching hospital serves a low-income urban area and most patients had low socioeconomic status. Further studies are needed to compare teaching and non-teaching hospital about the rate of premature discharge and the reasons of patients who want to leave against medical advice.

Developing leaflets to give dental health advice to Aboriginal families with young children.

PubMed

Blinkhorn, Fiona; Wallace, Janet; Smith, Leanne; Blinkhorn, Anthony S

2014-08-01

Dental caries (decay) is a serious problem for young Aboriginal children, causing pain and stress. Treatment often involves extraction of teeth under a general anaesthetic. However, dental caries can be prevented by reducing the frequency of sugar consumption and brushing teeth twice a day with fluoride toothpaste. Such straightforward advice could be given to families by Aboriginal Health Workers who are trusted by their communities and have an existing advisory role. This paper reports on the development of dental health advice leaflets for use in Aboriginal communities. An Aboriginal reference panel was recruited to comment on dental health advice leaflets prepared by an Aboriginal graphic designer. The panel was asked to consider the design, cultural appropriateness and practicality of the leaflets. Comments were collected through email and face-to-face discussions, which were collated and the leaflets altered accordingly. The advice from the panel resulted in greater use of pictures. For example large green ticks and red crosses highlighted healthy and unhealthy behaviours, respectively. The tooth brushing leaflet was amended to emphasise the safe storage of toothpaste in order to keep it out of reach of young children. The panel stated that all leaflets should incorporate the Aboriginal flag, and proposed that fridge magnets might be beneficial as all family members would benefit from seeing the messages every day. The consultation process refined dental advice leaflets to reflect the views of an Aboriginal Reference Panel, in terms of design, cultural competence and practicality. © 2014 FDI World Dental Federation.

Critiquing: A Different Approach to Expert Computer Advice in Medicine

PubMed Central

Miller, Perry L.

1984-01-01

The traditional approach to computer-based advice in medicine has been to design systems which simulate a physician's decision process. This paper describes a different approach to computer advice in medicine: a critiquing approach. A critiquing system first asks how the physician is planning to manage his patient and then critiques that plan, discussing the advantages and disadvantages of the proposed approach, compared to other approaches which might be reasonable or preferred. Several critiquing systems are currently in different stages of implementation. The paper describes these systems and discusses the characteristics which make each domain suitable for critiquing. The critiquing approach may prove especially well-suited in domains where decisions involve a great deal of subjective judgement.

The Back 2 Activity Trial: education and advice versus education and advice plus a structured walking programme for chronic low back pain

PubMed Central

2010-01-01

Background Current evidence supports the use of exercise-based treatment for chronic low back pain that encourages the patient to assume an active role in their recovery. Walking has been shown it to be an acceptable type of exercise with a low risk of injury. However, it is not known whether structured physical activity programmes are any more effective than giving advice to remain active. Methods/Design The proposed study will test the feasibility of using a pedometer-driven walking programme, as an adjunct to a standard education and advice session in participants with chronic low back pain. Fifty adult participants will be recruited via a number of different sources. Baseline outcome measures including self reported function; objective physical activity levels; fear-avoidance beliefs and health-related quality of life will be recorded. Eligible participants will be randomly allocated under strict, double blind conditions to one of two treatments groups. Participants in group A will receive a single education and advice session with a physiotherapist based on the content of the 'Back Book'. Participants in group B will receive the same education and advice session. In addition, they will also receive a graded pedometer-driven walking programme prescribed by the physiotherapist. Follow up outcomes will be recorded by the same researcher, who will remain blinded to group allocation, at eight weeks and six months post randomisation. A qualitative exploration of participants' perception of walking will also be examined by use of focus groups at the end of the intervention. As a feasibility study, treatment effects will be represented by point estimates and confidence intervals. The assessment of participant satisfaction will be tabulated, as will adherence levels and any recorded difficulties or adverse events experienced by the participants or therapists. This information will be used to modify the planned interventions to be used in a larger randomised controlled

Evaluating Health Advice in a Web 2.0 Environment: The Impact of Multiple User-Generated Factors on HIV Advice Perceptions.

PubMed

Walther, Joseph B; Jang, Jeong-Woo; Hanna Edwards, Ashley A

2018-01-01

Unlike traditional media, social media systems often present information of different types from different kinds of contributors within a single message pane, a juxtaposition of potential influences that challenges traditional health communication processing. One type of social media system, question-and-answer advice systems, provides peers' answers to health-related questions, which yet other peers read and rate. Responses may appear good or bad, responders may claim expertise, and others' aggregated evaluations of an answer's usefulness may affect readers' judgments. An experiment explored how answer feasibility, expertise claims, and user-generated ratings affected readers' assessments of advice about anonymous HIV testing. Results extend the heuristic-systematic model of persuasion (Chaiken, 1980) and warranting theory (Walther & Parks, 2002). Information that is generally associated with both systematic and heuristic processes influenced readers' evaluations. Moreover, content-level cues affected judgments about message sources unexpectedly. When conflicting cues were present, cues with greater warranting value (consensus user-generated ratings) had greater influence on outcomes than less warranted cues (self-promoted expertise). Findings present a challenge to health professionals' concerns about the reliability of online health information systems.

Virtual patients: practical advice for clinical authors using Labyrinth.

PubMed

Begg, Michael

2010-09-01

Labyrinth is a tool originally developed in the University of Edinburgh's Learning Technology Section for authoring and delivering branching case scenarios. The scenarios can incorporate game-informed elements such as scoring, randomising, avatars and counters. Labyrinth has grown more popular internationally since a version of the build was made available on the open source network Source Forge. This paper offers help and advice for clinical educators interested in creating cases. Labyrinth is increasingly recognised as a tool offering great potential for delivering cases that promote rich, situated learning opportunities for learners. There are, however, significant challenges to generating such cases, not least of which is the challenge for potential authors in approaching the process of constructing narrative-rich, context-sensitive cases in an unfamiliar authoring environment. This paper offers a brief overview of the principles informing Labyrinth cases (game-informed learning), and offers some practical advice to better prepare educators with little or no prior experience. Labyrinth has continued to grow and develop, from its roots as a research and development environment to one that is optimised for use by non-technical clinical educators. The process becomes increasingly iterative and better informed as the teaching community push the software further. The positive implications of providing practical advice and concept insight to new case authors is that it ideally leads to a broader base of users who will inform future iterations of the software. © Blackwell Publishing Ltd 2010.

Advice offered by practitioners of complementary/ alternative medicine: an important ethical issue.

PubMed

Ernst, E

2009-12-01

The current popularity of complementary/alternative medicine (CAM) generates many challenges to medical ethics. The one discussed here is the advice offered by CAM practitioners. Using selected examples, the author tries to demonstrate that some of the advice issued through the popular media or provided by acupuncturists, chiropractors, herbalists, homeopaths, pharmacists, and doctors is misleading or dangerous. This, the author argues, can impinge on the main principle of medical ethics: beneficence, nonmaleficence, and autonomy. We should work toward correcting this deplorable situation.

Effects of yoga, strength training and advice on back pain: a randomized controlled trial.

PubMed

Brämberg, Elisabeth Björk; Bergström, Gunnar; Jensen, Irene; Hagberg, Jan; Kwak, Lydia

2017-03-29

Among the working population, non-specific low-back pain and neck pain are one of the most common reasons for sickness absenteeism. The aim was to evaluate the effects of an early intervention of yoga - compared with strength training or evidence-based advice - on sickness absenteeism, sickness presenteeism, back and neck pain and disability among a working population. A randomized controlled trial was conducted on 159 participants with predominantly (90%) chronic back and neck pain. After screening, the participants were randomized to kundalini yoga, strength training or evidence-based advice. Primary outcome was sickness absenteeism. Secondary outcomes were sickness presenteeism, back and neck pain and disability. Self-reported questionnaires and SMS text messages were completed at baseline, 6 weeks, 6 and 12 months. The results did not indicate that kundalini yoga and strength training had any statistically significant effects on the primary outcome compared with evidence-based advice. An interaction effect was found between adherence to recommendations and sickness absenteeism, indicating larger significant effects among the adherers to kundalini yoga versus evidence-based advice: RR = 0.47 (CI 0.30; 0.74, p = 0.001), strength training versus evidence-based advice: RR = 0.60 (CI 0.38; 0.96, p = 0.032). Some significant differences were also found for the secondary outcomes to the advantage of kundalini yoga and strength training. Guided exercise in the forms of kundalini yoga or strength training does not reduce sickness absenteeism more than evidence-based advice alone. However, secondary analyses reveal that among those who pursue kundalini yoga or strength training at least two times a week, a significantly reduction in sickness absenteeism was found. Methods to increase adherence to treatment recommendations should be further developed and applied in exercise interventions. Clinicaltrials.gov NCT01653782, date of registration: June, 28

The effect of pre-travel advice on sexual risk behavior abroad: a systematic review.

PubMed

Croughs, Mieke; Remmen, Roy; Van den Ende, Jef

2014-01-01

Travelers often have casual sex abroad and the risk of acquiring a sexually transmitted infection (STI) associated with casual travel sex is considered to be threefold higher compared to the risk of casual sex in the home country. Consequently, international guidelines recommend including STI advice in the pre-travel consultation. We performed a systematic review on the effect of a pre-travel STI intervention on sexual risk behavior abroad. In September 2012, a systematic analysis and meta-analysis of peer reviewed literature were performed on the relation between pre-travel STI advice for travelers and sexual risk behavior abroad. Primary outcome measure consisted of the number of travelers with a new sexual partner abroad; secondary outcome measure entailed the proportion of consistent condom use. Six studies were identified for inclusion in the review, of which three clinical trials on the effect of a motivational intervention compared to standard pre-travel STI advice qualified for the meta-analysis. Two of these trials were performed in US marines deployed abroad and one in visitors of a travel clinic. The extensive motivational training program of the marines led to a reduction in sexual risk behavior, while the brief motivational intervention in the travel clinic was not superior to standard advice. The meta-analysis established no overall effect on risk behavior abroad. No clinical trials on the effect of a standard pre-travel STI discussion were found, but a cohort study reported that no relation was found between the recall of a nonstructured pre-travel STI discussion and sexual risk behavior, while the recall of reading the STI information appeared to be related to more consistent condom use. Motivational pre-travel STI intervention was not found to be superior to standard STI advice, while no clinical trials on the effect of standard pre-travel STI advice were found. © 2013 International Society of Travel Medicine.

Survey of Australian practitioners' provision of healthy lifestyle advice to clients who are obese.

PubMed

Ashby, Samantha; James, Carole; Plotnikoff, Ronald; Collins, Clare; Guest, Maya; Kable, Ashley; Snodgrass, Suzanne

2012-06-01

Obesity is a global issue, with healthcare practitioners increasingly involved in clinical interactions with people who are overweight or obese. These interactions are opportunities to provide evidence-based healthy lifestyle advice, and impact on public health. This study used a cross-sectional survey of Australian healthcare practitioners to investigate what influenced the provision of healthy lifestyle advice to obese and overweight clients. A modified theory of planned behavior was used to explore knowledge translation processes. Knowledge translation was linked to three factors: (i) a healthcare practitioner's education and confidence in the currency of their knowledge; (ii) personal characteristics - whether they accepted that providing this advice was within their domain of practice; and (iii) the existence of organizational support structures, such as access to education, and best practice guidelines. To fulfill the potential role healthcare practitioners can play in the provision of evidence-based health promotion advice requires organizations to provide access to practice guidelines and to instill a belief in their workforce that this is a shared professional domain. © 2012 Blackwell Publishing Asia Pty Ltd.

"Advice to Writers": Students Discuss the Craft of Writing.

ERIC Educational Resources Information Center

Aversa, Nicholas J.; Tritt, Michael

1988-01-01

Asserts that the "Advice to Writers" project, encouraging students to articulate what they do when they write and to share those perceptions with fellow student writers, is an effective way for students to reflect on the writing process. (MM)

Parents’ Primary Professional Sources of Parenting Advice Moderate Predictors of Parental Attitudes toward Corporal Punishment

PubMed Central

Taylor, Catherine A.; McKasson, Sarah; Hoy, Guenevere; DeJong, William

2016-01-01

Despite the risk it poses to children’s mental and physical health, approval and use of corporal punishment (CP) remains high in the United States. Informed by the Theory of Planned Behavior, we examined potential predictors of attitudes supportive of CP while assessing the moderating effects of parents’ (N=500) chosen primary professional source of advice regarding child discipline: pediatricians (47.8%), religious leaders (20.8%), mental health professionals (MHPs) (n=18.4%), or other identified professionals (13.0%). We conducted a random-digit-dial telephone survey among parents ages 18 and over within New Orleans, LA. The main outcome measure was derived from the Attitudes Toward Spanking scale (ATS). The main “predictors” were: perceived injunctive norms (i.e., perceived approval of CP by professionals; and by family and friends), perceived descriptive norms of family and friends regarding CP, and expected outcomes of CP use. We used multivariate OLS models to regress ATS scores on the predictor variables for each subset of parents based on their chosen professional source of advice. Perceived approval of CP by professionals was the strongest predictor of parental attitudes supportive of CP, except for those seeking advice from MHPs. Perceived injunctive and descriptive norms of family and friends were important, but only for those seeking advice from pediatricians or religious leaders. Positive expected outcomes of CP mattered, but only for those seeking advice from religious leaders or MHPs. In conclusion, the strength and relevance of variables predicting attitudes toward CP varied according to the professional from which the parent was most likely to seek advice. PMID:28529440

Parents' Primary Professional Sources of Parenting Advice Moderate Predictors of Parental Attitudes toward Corporal Punishment.

PubMed

Taylor, Catherine A; McKasson, Sarah; Hoy, Guenevere; DeJong, William

2017-02-01

Despite the risk it poses to children's mental and physical health, approval and use of corporal punishment (CP) remains high in the United States. Informed by the Theory of Planned Behavior, we examined potential predictors of attitudes supportive of CP while assessing the moderating effects of parents' (N=500) chosen primary professional source of advice regarding child discipline: pediatricians (47.8%), religious leaders (20.8%), mental health professionals (MHPs) (n=18.4%), or other identified professionals (13.0%). We conducted a random-digit-dial telephone survey among parents ages 18 and over within New Orleans, LA. The main outcome measure was derived from the Attitudes Toward Spanking scale (ATS). The main "predictors" were: perceived injunctive norms (i.e., perceived approval of CP by professionals; and by family and friends), perceived descriptive norms of family and friends regarding CP, and expected outcomes of CP use. We used multivariate OLS models to regress ATS scores on the predictor variables for each subset of parents based on their chosen professional source of advice. Perceived approval of CP by professionals was the strongest predictor of parental attitudes supportive of CP, except for those seeking advice from MHPs. Perceived injunctive and descriptive norms of family and friends were important, but only for those seeking advice from pediatricians or religious leaders. Positive expected outcomes of CP mattered, but only for those seeking advice from religious leaders or MHPs. In conclusion, the strength and relevance of variables predicting attitudes toward CP varied according to the professional from which the parent was most likely to seek advice.

The role of time and risk preferences in adherence to physician advice on health behavior change.

PubMed

van der Pol, Marjon; Hennessy, Deirdre; Manns, Braden

2017-04-01

Changing physical activity and dietary behavior in chronic disease patients is associated with significant health benefits but is difficult to achieve. An often-used strategy is for the physician or other health professional to encourage behavior changes by providing advice on the health consequences of such behaviors. However, adherence to advice on health behavior change varies across individuals. This paper uses data from a population-based cross-sectional survey of 1849 individuals with chronic disease to explore whether differences in individuals' time and risk preferences can help explain differences in adherence. Health behaviors are viewed as investments in health capital within the Grossman model. Physician advice plays a role in the model in that it improves the understanding of the future health consequences of investments. It can be hypothesized that the effect of advice on health behavior will depend on an individuals' time and risk preference. Within the survey, which measured a variety of health-related behaviors and outcomes, including receipt and compliance with advice on dietary and physical activity changes, time preferences were measured using financial planning horizon, and risk preferences were measured through a commonly used question which asked respondents to indicate their willingness to take risks on a ten-point scale. Results suggest that time preferences play a role in adherence to physical activity advice. While time preferences also play a role in adherence to dietary advice, this effect is only apparent for males. Risk preferences do not seem to be associated with adherence. The results suggest that increasing the salience of more immediate benefits of health behavior change may improve adherence.

The Public Services Job Hunt: Observations and Advice

ERIC Educational Resources Information Center

Saunders, Laura

2014-01-01

The library science job market is competitive, and library and information science (LIS) students and new graduates often have questions and concerns about how to engage in a successful job hunt. Based on research with employers and interactions with students and alumni, the author offers advice for job-seekers looking for public services…

Women and Heart Disease: Sharing Advice from the Heart

MedlinePlus

... page please turn JavaScript on. Feature: Women and Heart Disease Sharing Advice From The Heart Past Issues / Spring 2016 Table of Contents This ... inspired you to get involved in the American Heart Association's Go Red For Women movement and Red ...

Altitude-Related Illness: Advice to Travellers

PubMed Central

Crutcher, Rodney A.

1990-01-01

Altitude-related medical problems have received much attention in the recent medical literature. Family physicians must be knowledgeable about these problems so that they can give appropriate advice to travellers. The author, a practising family physician, discusses issues arising from both the modest cabin altitudes experienced in modern-day air travel and the greater altitudes experienced by skiers and trekkers, pilots and mountaineers, and lowland adventurers of all sorts. He reviews the process of acclimatization to altitude and the four principal forms of altitude illness. PMID:21233912

A self-help book is better than sleep hygiene advice for insomnia: a randomized controlled comparative study.

PubMed

Bjorvatn, Bjørn; Fiske, Eldbjørg; Pallesen, Ståle

2011-12-01

The objective was to compare the effects of two types of written material for insomnia in a randomized trial with follow-up after three months. Insomniacs were recruited through newspaper advertisements to a web-based survey with validated questionnaires about sleep, anxiety, depression, and use of sleep medications. A self-help book focusing on cognitive behavioral therapy for insomnia was compared to standard sleep hygiene advice; 77 and 78 participants were randomized to self-help book or sleep hygiene advice, respectively. The response rate was 81.9%. The self-help book gave significantly better scores on the sleep questionnaires compared to sleep hygiene advice. The proportion using sleep medications was reduced in the self-help book group, whereas it was increased in the sleep hygiene group. Compared to pre-treatment, the self-help book improved scores on the sleep (effect sizes 0.61-0.62) and depression (effect size 0.18) scales, whereas the sleep hygiene advice improved scores on some sleep scales (effect sizes 0.24-0.28), but worsened another (effect size -0.36). In addition, sleep hygiene advice increased the number of days per week where they took sleep medications (effect size -0.50). To conclude, in this randomized controlled trial, the self-help book improved sleep and reduced the proportion using sleep medications compared to sleep hygiene advice. The self-help book is an efficient low-threshold intervention, which is cheap and easily available for patients suffering from insomnia. Sleep hygiene advice also improved sleep at follow-up, but increased sleep medication use. Thus, caution is warranted when sleep hygiene advice are given as a single treatment. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

Ostracism Reduces Reliance on Poor Advice from Others during Decision Making.

PubMed

Byrne, Kaileigh A; Tibbett, Thomas P; Laserna, Lauren N; Carter-Sowell, Adrienne R; Worthy, Darrell A

2016-10-01

Decision-making is rarely context-free, and often both social information and non-social information are weighed into one's decisions. Incorporating information into a decision can be influenced by previous experiences. Ostracism has extensive effects, including taxing cognitive resources and increasing social monitoring. In decision-making situations, individuals are often faced with both objective and social information and must choose which information to include or filter out. How will ostracism affect the reliance on objective and social information during decision-making? Participants ( N =245) in Experiment 1 were randomly assigned to be included or ostracized in a standardized, group task. They then performed a dynamic decision-making task that involved the presentation of either non-social (i.e. biased reward feedback) or social (i.e., poor advice from a previous participant) misleading information. In Experiment 2, participants ( N =105) completed either the ostracism non-social condition or social misleading information condition with explicit instructions stating that the advice given was from an individual who did not partake in the group task. Ostracized individuals relied more on non-social misleading information and performed worse than included individuals. However, ostracized individuals discounted misleading social information and outperformed included individuals. Results of Experiment 2 replicated the findings of Experiment 1. Across two experiments, ostracized individuals were more critical of advice from others, both individuals who may have ostracized them and unrelated individuals. In other words, compared to included individuals, ostracized individuals underweighted advice from another individual, but overweighted non-social information during decision-making. We conclude that when deceptive objective information is present, ostracism results in disadvantageous decision-making.

Ostracism Reduces Reliance on Poor Advice from Others during Decision Making

PubMed Central

Byrne, Kaileigh A.; Tibbett, Thomas P.; Laserna, Lauren N.; Carter-Sowell, Adrienne R.; Worthy, Darrell A.

2016-01-01

Decision-making is rarely context-free, and often both social information and non-social information are weighed into one’s decisions. Incorporating information into a decision can be influenced by previous experiences. Ostracism has extensive effects, including taxing cognitive resources and increasing social monitoring. In decision-making situations, individuals are often faced with both objective and social information and must choose which information to include or filter out. How will ostracism affect the reliance on objective and social information during decision-making? Participants (N=245) in Experiment 1 were randomly assigned to be included or ostracized in a standardized, group task. They then performed a dynamic decision-making task that involved the presentation of either non-social (i.e. biased reward feedback) or social (i.e., poor advice from a previous participant) misleading information. In Experiment 2, participants (N=105) completed either the ostracism non-social condition or social misleading information condition with explicit instructions stating that the advice given was from an individual who did not partake in the group task. Ostracized individuals relied more on non-social misleading information and performed worse than included individuals. However, ostracized individuals discounted misleading social information and outperformed included individuals. Results of Experiment 2 replicated the findings of Experiment 1. Across two experiments, ostracized individuals were more critical of advice from others, both individuals who may have ostracized them and unrelated individuals. In other words, compared to included individuals, ostracized individuals underweighted advice from another individual, but overweighted non-social information during decision-making. We conclude that when deceptive objective information is present, ostracism results in disadvantageous decision-making. PMID:28469290

Time Advice and Learning Questions in Computer Simulations

ERIC Educational Resources Information Center

Rey, Gunter Daniel

2011-01-01

Students (N = 101) used an introductory text and a computer simulation to learn fundamental concepts about statistical analyses (e.g., analysis of variance, regression analysis and General Linear Model). Each learner was randomly assigned to one cell of a 2 (with or without time advice) x 3 (with learning questions and corrective feedback, with…

Beliefs about radiation: scientists, the public and public policy.

PubMed

Jenkins-Smith, Hank C; Silva, Carol L; Murray, Christopher

2009-11-01

Human behavioral responses to potential hazards are mediated by the beliefs held about those hazards. This holds whether the "behavior" under consideration is the provision of advice about the hazard, statements of support for policies that address the hazard, or personal behaviors in response to the hazard. This paper focuses on beliefs about radiation and the implications of those beliefs for views about radiation protection by both scientists and members of the U.S. public. We use data from a large sample of scientists, collected in 2002, and a series of surveys of the U.S. public collected in 2007. Among scientists, we focus on how beliefs about radiation are related to policy prescriptions for radiation protection. Among members of the lay public the focus shifts to the relationship between beliefs about radiation risks and policy preferences for nuclear energy and nuclear waste policy options. The importance of the differences and similarities in the patterns of beliefs of scientists and the lay public are discussed.

Pragmatic Variations in Giving Advice in L2 by Malaysian Postgraduate Students: The Situational Effects

ERIC Educational Resources Information Center

Farashaiyan, Atieh; Muthusamy, Paramasivam

2016-01-01

The present study attempted to describe the giving advice strategies utilized by Malaysian postgraduate students in confronting different situations. In addition, it examined the effects of the situational factors of social distance, power, and imposition on the students' choice of giving advice strategies. Another objective was to categorize the…

The Readability of Electronic Cigarette Health Information and Advice: A Quantitative Analysis of Web-Based Information.

PubMed

Park, Albert; Zhu, Shu-Hong; Conway, Mike

2017-01-06

The popularity and use of electronic cigarettes (e-cigarettes) has increased across all demographic groups in recent years. However, little is currently known about the readability of health information and advice aimed at the general public regarding the use of e-cigarettes. The objective of our study was to examine the readability of publicly available health information as well as advice on e-cigarettes. We compared information and advice available from US government agencies, nongovernment organizations, English speaking government agencies outside the United States, and for-profit entities. A systematic search for health information and advice on e-cigarettes was conducted using search engines. We manually verified search results and converted to plain text for analysis. We then assessed readability of the collected documents using 4 readability metrics followed by pairwise comparisons of groups with adjustment for multiple comparisons. A total of 54 documents were collected for this study. All 4 readability metrics indicate that all information and advice on e-cigarette use is written at a level higher than that recommended for the general public by National Institutes of Health (NIH) communication guidelines. However, health information and advice written by for-profit entities, many of which were promoting e-cigarettes, were significantly easier to read. A substantial proportion of potential and current e-cigarette users are likely to have difficulty in fully comprehending Web-based health information regarding e-cigarettes, potentially hindering effective health-seeking behaviors. To comply with NIH communication guidelines, government entities and nongovernment organizations would benefit from improving the readability of e-cigarettes information and advice. ©Albert Park, Shu-Hong Zhu, Mike Conway. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 06.01.2017.

3D Visualization as a Communicative Aid in Pharmaceutical Advice-Giving over Distance

PubMed Central

Dahlbäck, Nils; Petersson, Göran Ingemar

2011-01-01

Background Medication misuse results in considerable problems for both patient and society. It is a complex problem with many contributing factors, including timely access to product information. Objective To investigate the value of 3-dimensional (3D) visualization paired with video conferencing as a tool for pharmaceutical advice over distance in terms of accessibility and ease of use for the advice seeker. Methods We created a Web-based communication service called AssistancePlus that allows an advisor to demonstrate the physical handling of a complex pharmaceutical product to an advice seeker with the aid of 3D visualization and audio/video conferencing. AssistancePlus was tested in 2 separate user studies performed in a usability lab, under realistic settings and emulating a real usage situation. In the first study, 10 pharmacy students were assisted by 2 advisors from the Swedish National Co-operation of Pharmacies’ call centre on the use of an asthma inhaler. The student-advisor interview sessions were filmed on video to qualitatively explore their experience of giving and receiving advice with the aid of 3D visualization. In the second study, 3 advisors from the same call centre instructed 23 participants recruited from the general public on the use of 2 products: (1) an insulin injection pen, and (2) a growth hormone injection syringe. First, participants received advice on one product in an audio-recorded telephone call and for the other product in a video-recorded AssistancePlus session (product order balanced). In conjunction with the AssistancePlus session, participants answered a questionnaire regarding accessibility, perceived expressiveness, and general usefulness of 3D visualization for advice-giving over distance compared with the telephone and were given a short interview focusing on their experience of the 3D features. Results In both studies, participants found the AssistancePlus service helpful in providing clear and exact instructions. In

Lifestyle advice with or without pelvic floor muscle training for pelvic organ prolapse: a randomized controlled trial.

PubMed

Due, Ulla; Brostrøm, Søren; Lose, Gunnar

2016-04-01

We evaluated the effect of adding pelvic floor muscle training (PFMT) to a structured lifestyle advice program. This was a single-blinded randomized trial of women with symptomatic pelvic organ prolapse (POP) stage ≥ II. Participants were randomized to a structured lifestyle advice program with or without PFMT. Both groups received similar lifestyle advice in six separate group sessions. The combined group performed group PFMT after an individual assessment. Primary outcome was a global improvement scale at six-month follow-up. Secondary outcomes were the global scale and objective POP at three-month follow-up, symptoms and quality of life including sexuality, at three and six-month follow-up. A clinically relevant change of symptoms was defined as ≥ 15 %. We included 109 women. Eighty-nine women (82 %) completed three months follow-up; 85 (78 %) completed six-month follow-up. At both follow-ups, significantly more women in the combined group reported improvement in the global scale. At the three-month follow-up, the combined group only had significant improvement of POP symptoms while only the lifestyle advice group had significant improvement of quality of life. Change in objective POP and sexuality was nonsignificant. The symptom score improved 17 % in the combined group and 14 % in the lifestyle advice group (P = 0.57). Significantly more women in the lifestyle advice group had sought further treatment at the six-month follow-up. Adding PFMT to a structured lifestyle advice program gave superior results in a global scale and for POP symptoms. Overall effect of either intervention barely reached clinical relevance.

An Evaluation of an Occupational Health Advice Service

ERIC Educational Resources Information Center

Shearn, P.; Ford, Norma J.; Murphy, R. G.

2010-01-01

Objective: The objective of this article is to identify the profile of service users of an occupational health (OH) support service and establish areas of need, and to gather client feedback on the experience of participating in the support service and perceived outcomes and the impact of the advice received. Design and Setting: We carried out…

Lay Evaluation of Financial Experts: The Action Advice Effect and Confirmation Bias.

PubMed

Zaleskiewicz, Tomasz; Gasiorowska, Agata; Stasiuk, Katarzyna; Maksymiuk, Renata; Bar-Tal, Yoram

2016-01-01

The goal of this experimental project was to investigate lay peoples' perceptions of epistemic authority (EA) in the field of finance. EA is defined as the extent to which a source of information is treated as evidence for judgments independently of its objective expertise and based on subjective beliefs. Previous research suggested that EA evaluations are biased and that lay people tend to ascribe higher EA to experts who advise action (in the case of medical experts) or confirm clients' expectations (in the case of politicians). However, there has been no research into biases in lay evaluations of financial experts and this project is aimed to fill this gap. Experiment 1 showed that lay people tended to ascribe greater authority to financial consultants who gave more active advice to clients considering taking out a mortgage. Experiment 2 confirmed the action advice effect found in Experiment 1. However, the outcomes of Experiments 2 and - particularly - 3 suggested that this bias might also be due to clients' desire to confirm their own opinions. Experiment 2 showed that the action advice effect was moderated by clients' own opinions on taking loans. Lay people ascribed the greatest EA to the advisor in the scenario in which he advised taking action and where this coincided with the client's positive opinion on the advisability of taking out a loan. In Experiment 3 only participants with a positive opinion on the financial product ascribed greater authority to experts who recommended it; participants whose opinion was negative tended to rate consultants who advised rejecting the product more highly. To conclude, these three experiments revealed that lay people ascribe higher EA to financial consultants who advise action rather than maintenance of the status quo , but this effect is limited by confirmation bias: when the client's a priori opinion is salient, greater authority is ascribed to experts whose advice confirms it. In this sense, results presented in the

Lay Evaluation of Financial Experts: The Action Advice Effect and Confirmation Bias

PubMed Central

Zaleskiewicz, Tomasz; Gasiorowska, Agata; Stasiuk, Katarzyna; Maksymiuk, Renata; Bar-Tal, Yoram

2016-01-01

The goal of this experimental project was to investigate lay peoples’ perceptions of epistemic authority (EA) in the field of finance. EA is defined as the extent to which a source of information is treated as evidence for judgments independently of its objective expertise and based on subjective beliefs. Previous research suggested that EA evaluations are biased and that lay people tend to ascribe higher EA to experts who advise action (in the case of medical experts) or confirm clients’ expectations (in the case of politicians). However, there has been no research into biases in lay evaluations of financial experts and this project is aimed to fill this gap. Experiment 1 showed that lay people tended to ascribe greater authority to financial consultants who gave more active advice to clients considering taking out a mortgage. Experiment 2 confirmed the action advice effect found in Experiment 1. However, the outcomes of Experiments 2 and – particularly – 3 suggested that this bias might also be due to clients’ desire to confirm their own opinions. Experiment 2 showed that the action advice effect was moderated by clients’ own opinions on taking loans. Lay people ascribed the greatest EA to the advisor in the scenario in which he advised taking action and where this coincided with the client’s positive opinion on the advisability of taking out a loan. In Experiment 3 only participants with a positive opinion on the financial product ascribed greater authority to experts who recommended it; participants whose opinion was negative tended to rate consultants who advised rejecting the product more highly. To conclude, these three experiments revealed that lay people ascribe higher EA to financial consultants who advise action rather than maintenance of the status quo, but this effect is limited by confirmation bias: when the client’s a priori opinion is salient, greater authority is ascribed to experts whose advice confirms it. In this sense, results

An Expert's Advice: What To Do If You Have Psoriasis

MedlinePlus

... on. Feature: Living with Psoriasis An Expert's Advice: What To Do If You Have Psoriasis Past Issues / ... the Dermatology Foundation, and the American Skin Association. What is psoriasis? Psoriasis is a chronic (long-term) ...

Who Is and Who Is Not Willing to Use Online Employer-Provided Retirement Investment Advice

ERIC Educational Resources Information Center

Joo, So-Hyun; Grable, John E.; Choe, Hyuncha

2007-01-01

This study used classification tree analysis to examine who is and who is not willing to use online employer-provided retirement investment advice. Using data from the Retirement Confidence Survey (Employee Benefit Research Institute, 2004), the study focused on who was more likely to use online retirement investment advice when it was available…

'How to stop a nosebleed': an assessment of the quality of epistaxis treatment advice on YouTube.

PubMed

Haymes, A T; Harries, V

2016-08-01

Video hosting websites are increasingly being used to disseminate health education messages. This study aimed to assess the quality of advice contained within YouTube videos on the conservative management of epistaxis. YouTube.com was searched using the phrase 'how to stop a nosebleed'. The first 50 videos were screened. Objective advice scores and subjective production quality scores were attributed by independent raters. Forty-five videos were analysed. The mean advice score was 2.0 out of 8 and the mean production quality score was 1.6 out of 3. There were no correlations between a video's advice score and its search results rank (ρ = -0.28, p = 0.068), its view count (ρ = 0.20, p = 0.19) or its number of 'likes' (ρ = 0.21, p = 0.18). The quality of information on conservative epistaxis management within YouTube videos is extremely variable. A high search rank is no indication of video quality. Many videos proffer inappropriate and dangerous 'alternative' advice. We do not recommend YouTube as a source for patient information.

Nutrition and the brain: what advice should we give?

PubMed

Cooper, James K

2014-09-01

The knowledge base of nutrition and the brain is steadily expanding. Much of the research is aimed at ways to protect the brain from damage. In adults, the major causes of brain damage are aging and dementia. The most prominent dementia, and the condition that grabs the most public attention, is Alzheimer's disease. The assumption in the field is that possibly some change in nutrition could protect the brain and prevent, delay, or minimize Alzheimer's disease damage. Presented here is a framework for understanding the implications of this research. There is a gap between publishing research results and change in public nutrition behavior. Several influencing elements intervene. These include regulatory agencies and all the organizations and people who advise the public, all with their own perspectives. In considering what advice to give, advisors may consider effectiveness, research model, persuasiveness, and risks, among other factors. Advice about nutrition and Alzheimer's disease today requires several caveats. Copyright © 2014 Elsevier Inc. All rights reserved.

Protecting Against Influenza (Flu): Advice for Caregivers of Young Children

MedlinePlus

... Protecting Against Influenza (Flu): Advice for Caregivers of Young Children Language: English (US) Español Recommend on Facebook ... on How to Prevent Flu for Caregivers of Young Children 1. Take Time to Get a Vaccine ...

Assessment of producers' response to Salmonella biosecurity issues and uptake of advice on laying hen farms in England and Wales.

PubMed

Gosling, R J; Martelli, F; Wintrip, A; Sayers, A R; Wheeler, K; Davies, R H

2014-01-01

High standards of biosecurity are known to reduce the risk of disease outbreaks; however, uptake of advice and implementation of biosecurity measures are dependent on many factors. This study assessed the uptake of targeted biosecurity advice by 60 laying hen farms provided during biosecurity audit visits. Advice was provided as bullet point cards focusing on specific areas identified as benefitting from improvement. These covered site entrance, site tidiness, vaccination, boot hygiene, hand hygiene, house tidiness, rodent control, fly control, red mite control and cleaning and disinfection between flocks. Background knowledge of Salmonella and biosecurity and farmers' willingness and intent to implement additional measures were assessed. About 50% of the principal decision-makers had basic background knowledge of Salmonella, with 22% considered well informed; almost all agreed that biosecurity could impact on Salmonella control and many appeared willing to implement additional biosecurity measures. Sixty-three per cent of study farms were categorised using the Defra Farmer Segmentation Model as Modern Family Businesses (MFBs), with 7-11% of farms being categorised as Custodian, Lifestyle Choice, Pragmatist or Challenged Enterprise; however, categorisation, did not determine uptake of advice. The most frequently used advice cards were boot hygiene, red mite control, hand hygiene, site entrance and cleaning and disinfection; uptake of advice ranged from 54 to 80% depending on the advice card. Uptake of advice by the farmers was encouraging, especially considering it was being provided by people other than their usual source of biosecurity information. Those who did not implement the recommended measures cited cost, difficulty of enforcement and practicality as the main reasons. However, the positive uptake of advice and implementation of recommended measures by many farmers demonstrates that targeted advice, discussed face to face with farmers, on a small number of

[Demand for environmental medical advice at public health offices: experiences in the district aachen public health office].

PubMed

Wiesmüller, G A; Etschenberg, W; Koch, T; Konteye, C; Zahmel, J

2002-03-01

Since November, 1999 environmental medical advice is offered to interested citizens in the Aachen district at the District Aachen Public Health Office in cooperation with the outpatient unit of environmental medicine (UEM) of the Institute of Hygiene and Environmental Medicine of the University Hospital at Aachen, Germany. Advisory cases are documented in a data bank of Microsoft(R) Access 97. Until now, all advisory cases between November, 1999 and March, 2001 have been descriptively analysed. In this period, 34 personal and two telephonic advices were performed. The frequency of advisory activities is in the lower rang of published experiences in environmental medicine. Age distribution, more frequent advice utilization by women than by men and predominance of unspecific health disorders are comparable with published environmental medical experiences. However, in respect of suspected exposures, unspecific indoor-related environmental factors are predominant. In the past this was true for wood preservatives. Judgement about possible relationships between suspected environmental factors and health disorders or diseases was positive among 11.8 % of the persons seeking advice. This percentage is higher than published experiences which mostly show values below 10 %. It must be considered that this judgement depends primarily on the physician. Other reasons may be the too small number of advice seeking persons and selective influences. Furthermore, a definite judgement can be made only after environmental medical diagnostics (biological monitoring, local inspection, ambient monitoring) and differential diagnostics. Conspicuously, 76.5 % of the advisory cases had no contact to environmental medicine prior to the environmental medical advice at the Aachen District Public Health Office. This points to an information deficit about possibilities to clarify questions concerning environmental medicine in the population. In this context a regional guide on environmental

How do stroke survivors and their carers use practitioners' advice on secondary prevention medications? Qualitative study of an online forum.

PubMed

Izuka, Nkeonye J; Alexander, Matthew A W; Balasooriya-Smeekens, Chantal; Mant, Jonathan; De Simoni, Anna

2017-09-01

Secondary prevention medications reduce risk of stroke recurrence, yet many people do not receive recommended treatment, nor take medications optimally. Exploring how patients report making use of practitioners' advice on secondary prevention medicines on an online forum and what feedback was received from other participants. Thematic analysis of the archive of Talkstroke (2004-2011), UK. Posts including any secondary prevention medication terms, General Practitioner (GP) and their replies were identified. Fifity participants talked about practitioners' advice on secondary prevention medications in 43 discussion threads. Patients consulted practitioners for reassurance and dealing with side effects. Practitioners' advice varied from altering to maintaining current treatment. Three main themes emerged from the use of practitioners' advice: patients following advice (reassured, happy when side effects made tolerable, or still retaining anxiety about treatment); patients not following advice (admitting adherence on-off or stopping medications as side effects still not tolerable); asking other participants for feedback on advice received. Practitioners' advice was disregarded mainly when related to dealing with statin side effects, after one or two consultations. Themes for feedback involved sharing experience, directing back to practitioners, or to external evidence. Side effects of secondary prevention medications and statins in particular, cause anxiety and resentment in some patients, and their concerns are not always addressed by practitioners. Practitioners could consider more proactive strategies to manage such side effects. Forum feedback was appropriate and supportive of the practitioners' advice received. Our findings from peer-to-peer online conversations confirm and widen previous research. © The Author 2017. Published by Oxford University Press.

Advice for prevention from HIV-positive African-American women: 'My story is not just a story'.

PubMed

Robillard, Alyssa; Padi, Akhila; Lewis, Kaleea; Julious, Carmen; Troutman, Jamie

2017-05-01

Large disparities in HIV incidence, prevalence and mortality exist for African-American women, especially in the southern region of the USA. Based on the culture-centric health promotion model, HIV-positive African American women can use their stories to support primary prevention. The purpose of this study was to document advice from HIV-positive African-American women (n = 25) to young African-American women, as described in their own cultural narratives collected through qualitative interviews. Content analysis of women's advice identified five common themes revolving broadly around: (1) advice for prevention, (2) support systems for prevention, (3) education, (4) empowerment/self-care and (5) potential barriers to prevention. Advice reflected recommendations based on personal experience and highlighted social determinants linked to HIV, such as stigma, access to education and healthcare, social support, and gender and power dynamics. Women also offered advice for coping with an HIV-positive diagnosis. Communication with parents, family and friends regarding education and social support emerged as an important interpersonal factor for participants, as were interactions with sexual/romantic partners. Stigma, at the community level, was consistently discussed as a hindrance to prevention. Narratives of HIV-positive women as community health agents of change can enhance the effectiveness of HIV prevention interventions for young US African-American women.

Compliance hotlines: practical advice for implementing a reporting mechanism.

PubMed

Pastin, M J

1999-01-01

No element of a corporate compliance program in healthcare facilities generates more controversy than the hotline established for employees who wish to raise a concern. Healthcare organizations are adopting hotlines but with reluctance, mainly because of limited staff available to answer calls and because of limited support from upper management. Those that have committed to the hotline will tell you they can't imagine not having it. Running a good hotline means first answering such questions as whether it will be answered in-house, outsourced or handled through a combination of both means. The best organizations treat the hotline as a resource for employees, managers and physicians. If employees receive advice about policies over the hotline, however, it must be answered in-house. If multiple call answers are used, a secure file-sharing system, either paper or online, must be in use to track caller concerns. Most calls are routine, but one where the caller is reporting a serious infraction can save an organization millions of dollars by forestalling a false claim or allowing for voluntary resolution of a problem. If your company has run a hotline unsuccessfully and earned a poor reputation with employees, outsourcing may be the best option. A hotline that is not supported by management may prove to be an insurmountable problem for anyone who attempts to operate it. Your approach to hotline call intake will set the tone for your compliance program.

CVMP advice on injection-site fibrosarcomas in cats.

PubMed

2003-03-29

In response to increasing concern, the Committee for Veterinary Medicinal Products (CVMP) has produced this advisory notice for veterinary surgeons on the development in cats of fibrosarcomas at sites of administration of veterinary medicinal products. The advice relates principally, but not exclusively, to the subcutaneous injection of vaccines. The issue is of relevance only to cats and no extrapolation should be made to other species or to man. At the current state of knowledge, it is not possible to provide specific advice on the risk that any product, or any type of product, might represent in terms of inducing a fibrosarcoma at the site of administration. However, following the precautionary principle, the CVMP considers that information on this issue should be made available to veterinary surgeons in order that they can have an informed discussion with owners of the benefits and risks of therapeutic interventions in cats, particularly in relation to vaccination and re-vaccination. The CVMP wishes to emphasise that modern vaccines continue to represent the only safe and effective means of protecting cats against serious infectious diseases and this should be taken fully into account in any discussion between veterinary surgeons and owners of cats.

Who Do Hospital Physicians and Nurses Go to for Advice About Medications? A Social Network Analysis and Examination of Prescribing Error Rates.

PubMed

Creswick, Nerida; Westbrook, Johanna Irene

2015-09-01

To measure the weekly medication advice-seeking networks of hospital staff, to compare patterns across professional groups, and to examine these in the context of prescribing error rates. A social network analysis was conducted. All 101 staff in 2 wards in a large, academic teaching hospital in Sydney, Australia, were surveyed (response rate, 90%) using a detailed social network questionnaire. The extent of weekly medication advice seeking was measured by density of connections, proportion of reciprocal relationships by reciprocity, number of colleagues to whom each person provided advice by in-degree, and perceptions of amount and impact of advice seeking between physicians and nurses. Data on prescribing error rates from the 2 wards were compared. Weekly medication advice-seeking networks were sparse (density: 7% ward A and 12% ward B). Information sharing across professional groups was modest, and rates of reciprocation of advice were low (9% ward A, 14% ward B). Pharmacists provided advice to most people, and junior physicians also played central roles. Senior physicians provided medication advice to few people. Many staff perceived that physicians rarely sought advice from nurses when prescribing, but almost all believed that an increase in communication between physicians and nurses about medications would improve patient safety. The medication networks in ward B had higher measures for density, reciprocation, and fewer senior physicians who were isolates. Ward B had a significantly lower rate of both procedural and clinical prescribing errors than ward A (0.63 clinical prescribing errors per admission [95%CI, 0.47-0.79] versus 1.81/ admission [95%CI, 1.49-2.13]). Medication advice-seeking networks among staff on hospital wards are limited. Hubs of advice provision include pharmacists, junior physicians, and senior nurses. Senior physicians are poorly integrated into medication advice networks. Strategies to improve the advice-giving networks between senior

Library Students Are "Breaking Good" with Saul Goodman's Advice

ERIC Educational Resources Information Center

Turkewitz, Deborah

2014-01-01

Graduate students are taking big steps and stretching themselves, whether returning to school midpoint in their lives, taking classes on unfamiliar topics, or starting internships and trying to put theory into practice. Who better to offer advice to these graduate students than America's favorite hilarious, morally ambiguous, ambulance-chasing,…

Sense about Sex: Media, Sex Advice, Education and Learning

ERIC Educational Resources Information Center

Attwood, Feona; Barker, Meg John; Boynton, Petra; Hancock, Justin

2015-01-01

The media are widely acknowledged as important in sex and relationship education, but they are usually associated with "bad" effects on young people in contrast to the "good" knowledge represented by more informational and educational formats. In this paper we look at sex advice giving in newspapers, magazines and television in…

18 CFR 388.104 - Informal advice from Commission staff.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Commission staff. 388.104 Section 388.104 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Commission staff. (a) The Commission staff provides informal advice and assistance to the general public and... expressed by the staff do not represent the official views of the Commission, but are designed to aid the...

18 CFR 388.104 - Informal advice from Commission staff.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Commission staff. 388.104 Section 388.104 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Commission staff. (a) The Commission staff provides informal advice and assistance to the general public and... expressed by the staff do not represent the official views of the Commission, but are designed to aid the...

18 CFR 388.104 - Informal advice from Commission staff.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Commission staff. 388.104 Section 388.104 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Commission staff. (a) The Commission staff provides informal advice and assistance to the general public and... expressed by the staff do not represent the official views of the Commission, but are designed to aid the...

18 CFR 388.104 - Informal advice from Commission staff.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Commission staff. 388.104 Section 388.104 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Commission staff. (a) The Commission staff provides informal advice and assistance to the general public and... expressed by the staff do not represent the official views of the Commission, but are designed to aid the...

18 CFR 388.104 - Informal advice from Commission staff.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Commission staff. 388.104 Section 388.104 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Commission staff. (a) The Commission staff provides informal advice and assistance to the general public and... expressed by the staff do not represent the official views of the Commission, but are designed to aid the...

Advice to White Allies: Insights from Faculty of Color

ERIC Educational Resources Information Center

Boutte, Gloria S.; Jackson, Tambra O.

2014-01-01

This article interweaves discussions of successes and tensions surrounding cross-racial collaborative social justice efforts in teacher education. It addresses frustrations that often occur for faculty of Color when working with White allies in P-12 settings and schools of education at Predominantly White Institutions. Advice is offered with the…

Scotland's Centre of Expertise for Waters - helping address Scotland's water policy challenges

NASA Astrophysics Data System (ADS)

MacDonald, Jannette; Morris, Sue; Hastings, Emily; Ferrier, Bob

2014-05-01

CREW connects water research and policy in Scotland. We deliver easily accessible research and expert opinion to support Scottish Government and its delivery partners in the development and implementation of water policy in Scotland. The main policy areas include the Water Framework Directive, Flooding Directive, and Scotland's Hydro Nation Strategy with links to cross cutting policies such as those relating to agriculture and climate change. CREW is unique in its demand-driven and free service for policy makers and practitioners, managing the engagement between scientists, policy makers and practitioners to work effectively across this interface. CREW aims are to; • deliver timely and accurate advice • coordinate and fund research, analysis and interpretation • stimulate innovative and proactive thinking • develop and implement a programme of knowledge exchange • develop the networks and skills of researchers, policy makers and practitioners to make best use of available science leading to improved environmental, social and economic outcomes for all CREW is a partnership between the James Hutton Institute and Scottish Universities, funded by the Scottish Government. http://www.crew.ac.uk/home

Lifestyle advice provision to teenage and young adult cancer patients: the perspective of health professionals in the UK.

PubMed

Pugh, Gemma; Hough, Rachael; Gravestock, Helen; Williams, Kate; Fisher, Abigail

2017-12-01

Health professionals are an important source of information for teenage and young adult (TYA) cancer patients. However, little is known about health professionals' provision of lifestyle advice to young people with cancer who are in their care. An online survey was distributed to health professionals within the UK who identified themselves as working with TYA cancer patients. Health professional awareness of lifestyle guidance, provision of lifestyle advice to young people and views on lifestyle information format and delivery were explored. Ninety-five health professionals (44% nurses; 28% allied health professionals; 17% physicians) completed the survey. The majority (72%) of respondents were aware of some lifestyle guidance for cancer patients. However, less than half of TYA health professionals (46%) were able to successfully recall the source of the guidelines and less than a third reported proving specific advice to the majority of their patients on weight management, smoking, alcohol consumption and sun safety. Many health professionals (38%) felt that they were not the right person to provide advice and cited lack of resources as a key barrier to advice provision. The majority (95%) reported being interested in a resource containing relevant lifestyle information that could be given to young people with cancer. TYA health professionals' awareness of lifestyle guidance and provision of advice regarding health behaviour is sub-optimal. Clear and comprehensive guidance written specifically for TYA health professionals could overcome the reported barriers and improve professionals' confidence in addressing and providing advice on lifestyle to young people with cancer.

Early scientific advice obtained simultaneously from regulators and payers: findings from a pilot study in Australia.

PubMed

Wonder, Michael; Backhouse, Martin E; Hornby, Edward

2013-01-01

There is scope for better interaction between regulators, payers/HTA agencies, and medicines developers in their common objective of getting new medicines to patients. This paper reports on a tripartite early scientific advice pilot conducted by a pharmaceutical company (developer), the Therapeutic Goods Administration (TGA: regulator) and the Pharmaceutical Benefit Advisory Committee (PBAC) Secretariat (HTA agency) in Australia. The objective was to explore the practicality, feasibility, and sustainability of means of obtaining simultaneous scientific advice from both a regulatory and reimbursement perspective. Advice was sought for two development compounds in different disease areas. The focus was on matters of common interest to the TGA and the PBAC (i.e. the clinical evidence). Briefing books were prepared by the developer and supplied eight weeks prior to the meeting and only verbal advice was provided. The pilot meeting took place in 2009. Each session lasted for approximately two hours and was structured around the questions in the briefing books. The representatives from the TGA and PBAC Secretariat provided well-informed, considered and careful advice for both compounds, which was predominantly actionable and practical. The sessions proved highly informative and permitted better alignment of the possible positioning of new medicines with the clinical evidence that regulators and HTA agencies might subsequently require for favorable assessment. The process provided early and clear signals to inform major development investments and the probability of successful market access. A number of challenges need to be addressed before tripartite scientific advice can be provided on continual basis. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

[Social counseling in outpatient cancer counseling centers : Offers and use by advice-seekers].

PubMed

Ernst, Jochen; Mehnert, Anja; Weis, Joachim; Faust, Tanja; Giesler, Jürgen M; Roick, Julia

2016-11-01

Outpatient psychosocial cancer care has gained importance in recent years and psychosocial counselling services (PCS) offer a broad spectrum of counselling interventions. Yet there is no published research on PCS legal counselling services. This study investigated the range of issues addressed by legal counselling and their relationship with characteristics of advice seekers and counsellors. We analyzed the records of 21 PCS funded by the German Cancer Aid (DKH) including 5203 advice seekers (80 % patients, 20 % others including friends and family; age ∅ 54 years; 24 % male) in 20,947 counselling sessions. We calculated descriptive statistics and binary logistic regression analyses (legal counselling: yes/no). Fifty-five percent of counselling seekers received legal counselling and 28 % approached the PCS exclusively for legal counselling. The proportion of people seeking legal advice ranged from 15 to 87 % between counselling centers. The most common topics during legal counselling were medical rehabilitation programs (57 %) and disability law (43 %). Counselling occurred in a single session in 68 % of cases and was mostly sought by older and unemployed persons with a recent diagnosis. Legal counselling made up 18 % of counselling time. Legal advice was mostly given by social workers (71 %). Legal counselling is a major part of psychosocial care services. Our results reveal large differences between counselling centers. Further research on quality of care and efficacy of legal counseling is needed.

Sickness certification for common mental disorders and GP return-to-work advice.

PubMed

Gabbay, Mark; Shiels, Chris; Hillage, Jim

2016-09-01

Aim To report the types and duration of sickness certification for different common mental disorders (CMDs) and the prevalence of GP advice aimed at returning the patient to work. In the United Kingdom, common mental health problems, such and depression and stress, have become the main reasons for patients requesting a sickness certificate to abstain from usual employment. Increasing attention is being paid to mental health and its impact on employability and work capacity in all parts of the welfare system. However, relatively little is known about the extent to which different mental health diagnoses impact upon sickness certification outcomes, and how the GP has used the new fit note (introduced in 2010) to support a return to work for patients with mental health diagnoses. Sickness certification data was collected from 68 UK-based general practices for a period of 12 months. Findings The study found a large part of all sickness absence certified by GPs was due to CMDs (29% of all sickness absence episodes). Females, younger patients and those living in deprived areas were more likely to receive a fit note for a CMD (compared with one for a physical health problem). The highest proportion of CMD fit notes were issued for 'stress'. However, sickness certification for depression contributed nearly half of all weeks certified for mental health problems. Only 7% of CMD fit notes included any 'may be fit' advice from the GP, with type of advice varying by mental health diagnostic category. Patients living in the most socially deprived neighbourhoods were less likely to receive 'may be fit' advice on their CMD fit notes.

45 CFR 162.1602 - Standards for health care electronic funds transfers (EFT) and remittance advice transaction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Technical Report Type 3—Health Care Claim Payment/Advice (835), April 2006, ASC X12N/005010X221... for Electronic Data Interchange Technical Report Type 3, “Health Care Claim Payment/Advice (835... same transmission, the ASC X12 Standards for Electronic Data Interchange Technical Report Type 3...

45 CFR 162.1602 - Standards for health care electronic funds transfers (EFT) and remittance advice transaction.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Technical Report Type 3—Health Care Claim Payment/Advice (835), April 2006, ASC X12N/005010X221... for Electronic Data Interchange Technical Report Type 3, “Health Care Claim Payment/Advice (835... same transmission, the ASC X12 Standards for Electronic Data Interchange Technical Report Type 3...

45 CFR 162.1602 - Standards for health care electronic funds transfers (EFT) and remittance advice transaction.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Technical Report Type 3—Health Care Claim Payment/Advice (835), April 2006, ASC X12N/005010X221... for Electronic Data Interchange Technical Report Type 3, “Health Care Claim Payment/Advice (835... same transmission, the ASC X12 Standards for Electronic Data Interchange Technical Report Type 3...

Do Students Listen to Advice from Their Experienced Peers?

ERIC Educational Resources Information Center

Finck, Joseph E.; DeLine, Amy D.

2008-01-01

Smith and Peterson (2007) recognize the impact between students seeking out advice and that student's academic performance. And Sallee and Tierney (2007) considered the ways in which students' peer networks facilitate or inhibit access to academic resources. In this paper the authors look at the students who receive suggestions from the previous…

A perspective on physiological studies supporting the provision of scientific advice for the management of Fraser River sockeye salmon (Oncorhynchus nerka)

PubMed Central

Patterson, David A.; Cooke, Steven J.; Hinch, Scott G.; Robinson, Kendra A.; Young, Nathan; Farrell, Anthony P.; Miller, Kristina M.

2016-01-01

The inability of physiologists to effect change in fisheries management has been the source of frustration for many decades. Close collaboration between fisheries managers and researchers has afforded our interdisciplinary team an unusual opportunity to evaluate the emerging impact that physiology can have in providing relevant and credible scientific advice to assist in management decisions. We categorize the quality of scientific advice given to management into five levels based on the type of scientific activity and resulting advice (notions, observations, descriptions, predictions and prescriptions). We argue that, ideally, both managers and researchers have concomitant but separate responsibilities for increasing the level of scientific advice provided. The responsibility of managers involves clear communication of management objectives to researchers, including exact descriptions of knowledge needs and researchable problems. The role of the researcher is to provide scientific advice based on the current state of scientific information and the level of integration with management. The examples of scientific advice discussed herein relate to physiological research on the impact of high discharge and water temperature, pathogens, sex and fisheries interactions on in-river migration success of adult Fraser River sockeye salmon (Oncorhynchus nerka) and the increased understanding and quality of scientific advice that emerges. We submit that success in increasing the quality of scientific advice is a function of political motivation linked to funding, legal clarity in management objectives, collaborative structures in government and academia, personal relationships, access to interdisciplinary experts and scientific peer acceptance. The major challenges with advancing scientific advice include uncertainty in results, lack of integration with management needs and institutional caution in adopting new research. We hope that conservation physiologists can learn from

A perspective on physiological studies supporting the provision of scientific advice for the management of Fraser River sockeye salmon (Oncorhynchus nerka).

PubMed

Patterson, David A; Cooke, Steven J; Hinch, Scott G; Robinson, Kendra A; Young, Nathan; Farrell, Anthony P; Miller, Kristina M

2016-01-01

The inability of physiologists to effect change in fisheries management has been the source of frustration for many decades. Close collaboration between fisheries managers and researchers has afforded our interdisciplinary team an unusual opportunity to evaluate the emerging impact that physiology can have in providing relevant and credible scientific advice to assist in management decisions. We categorize the quality of scientific advice given to management into five levels based on the type of scientific activity and resulting advice (notions, observations, descriptions, predictions and prescriptions). We argue that, ideally, both managers and researchers have concomitant but separate responsibilities for increasing the level of scientific advice provided. The responsibility of managers involves clear communication of management objectives to researchers, including exact descriptions of knowledge needs and researchable problems. The role of the researcher is to provide scientific advice based on the current state of scientific information and the level of integration with management. The examples of scientific advice discussed herein relate to physiological research on the impact of high discharge and water temperature, pathogens, sex and fisheries interactions on in-river migration success of adult Fraser River sockeye salmon ( Oncorhynchus nerka ) and the increased understanding and quality of scientific advice that emerges. We submit that success in increasing the quality of scientific advice is a function of political motivation linked to funding, legal clarity in management objectives, collaborative structures in government and academia, personal relationships, access to interdisciplinary experts and scientific peer acceptance. The major challenges with advancing scientific advice include uncertainty in results, lack of integration with management needs and institutional caution in adopting new research. We hope that conservation physiologists can learn from

Effectiveness of web-based tailored smoking cessation advice reports (iQuit): a randomized trial.

PubMed

Mason, Dan; Gilbert, Hazel; Sutton, Stephen

2012-12-01

To determine whether web-based tailored cessation advice, based on social cognitive theory and the perspectives on change model, was more effective in aiding a quit attempt than broadly similar web-based advice that was not tailored. Participants were allocated randomly to one of two groups, to receive either a cessation advice report and progress report that were tailored to individual-level characteristics or a cessation advice report that presented standardized (non-tailored) content. Tailoring was based on smoking-related beliefs, personal characteristics and smoking patterns, self-efficacy and outcome expectations. Participant enrolment and baseline assessments were conducted remotely online via the study website, with the advice reports presented by the same website. Participants (n = 1758) were visitors to the QUIT website who were based in the United Kingdom, aged 18 years or over and who smoked cigarettes or hand-rolled tobacco. Follow-up assessments were made at 6 months by telephone interview. The primary outcome measure was self-reported 3 months prolonged abstinence, and secondary outcomes were 1 month prolonged abstinence, 7-day and 24-hour point prevalence abstinence. The intervention group did not differ from the control group on the primary outcome (9.1% versus 9.3%; odds ratio = 1.02 95% confidence interval 0.73-1.42) or on any of the secondary outcomes. Intervention participants gave more positive evaluations of the materials than control participants. A web-based intervention that tailored content according to smoking-related beliefs, personal characteristics and smoking patterns, self-efficacy and outcome expectations, was not more effective than web-based materials presenting broadly similar non-tailored information. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

A survey of footwear advice, beliefs and wear habits in people with knee osteoarthritis.

PubMed

Paterson, Kade L; Wrigley, Tim V; Bennell, Kim L; Hinman, Rana S

2014-01-01

Expert opinion recommends cushioned and supportive footwear for people with knee osteoarthritis (OA). However, little is known about the footwear advice people receive from healthcare professionals, or the beliefs and footwear habits of people with knee OA. This study aimed to determine i) what types of shoes people are advised to wear for their knee OA and by whom; ii) establish which types of shoes people with knee OA believe are best for managing their knee OA symptoms and (iii) which shoes they wear most often. 204 people with symptomatic knee OA completed an online survey. The survey comprised 14 questions asking what footwear advice people had received for their knee OA and who they received it from, individual beliefs about optimal footwear styles for their knee OA symptoms and the types of footwear usually worn. Only one third (n = 69, 34%) of participants reported receiving footwear advice for their knee OA, and this was most frequently received from a podiatrist (n = 47, 68%). The most common advice was to wear sturdy/supportive shoes (n = 96, 47%) or shoes with arch supports (n = 84, 41%). These were also amongst the shoe styles that participants believed were best for their knee OA (n = 157 (77%) and n = 138 (68%) respectively). The type of shoes most frequently worn were athletic (n = 131, 64%) and sturdy/supportive shoes (n = 116, 57%). Most people with knee OA who completed our survey had not received advice about footwear for their knee OA symptoms. Our participants typically believed that sturdy/supportive shoes were best for their knee OA and this shoe style was most frequently worn, which is reflective of expert opinion. Future research is needed to confirm whether sturdy/supportive shoes are indeed optimal for managing symptoms of knee OA.

Advice to Stay Active or Structured Exercise in the Management of Sciatica: A Systematic Review and Meta-analysis.

PubMed

Fernandez, Matt; Hartvigsen, Jan; Ferreira, Manuela L; Refshauge, Kathryn M; Machado, Aryane F; Lemes, Ítalo R; Maher, Chris G; Ferreira, Paulo H

2015-09-15

A systematic review and meta-analysis. To evaluate the evidence on comparative effectiveness of advice to stay active versus supervised structured exercise in the management of sciatica. Conservative management of sciatica usually includes interventions to promote physical activity in the form of advice to stay active or exercise, but there has been no systematic review directly comparing the effectiveness of these 2 approaches. Data Sources included MEDLINE, CINAHL, EMBASE, and PEDro databases. Studies were randomized controlled trials comparing advice with exercise. Two independent reviewers extracted data and assessed methodological quality using the PEDro scale. Pain and disability data were extracted for all time points and converted to a common 0 to 100 scale. Data were pooled with a random effects model for short, intermediate, and long-term follow-ups. The GRADE approach was used to summarize the strength of evidence. Five trials were included in the meta-analysis, which showed a significant, although small effect favoring exercise over advice for reducing leg pain intensity in the short term (weighted mean difference: 11.43 [95% confidence interval, 0.71-22.16]) but no difference for disability (weighted mean difference: 1.45 [95% confidence interval, -2.86 to 5.76]). Furthermore, there was no difference at intermediate and long-term follow-ups between advice and exercise for patient-relevant outcomes. There is low-quality evidence (GRADE) that exercise provides small, superior effects compared with advice to stay active on leg pain in the short term for patients experiencing sciatica. However, there is moderate-quality evidence showing no difference between advice to stay active and exercise on leg pain and disability status in people with sciatica in the long term. 1.

Caught in the middle? How women deal with conflicting pregnancy-advice from health professionals and their social networks.

PubMed

Schölmerich, Vera L N; Ghorashi, Halleh; Denktaş, Semiha; Groenewegen, Peter

2016-04-01

to investigate how pregnant women deal with conflicting advice from their social networks and their caregivers and how this influenced their pregnancy-related behaviours. a qualitative study based on face-to-face interviews and focus-groups. We applied an inductive analysis technique closely following the 'Gioia method'. impoverished neighbourhoods in Rotterdam, the Netherlands. 40 women who were pregnant, or had given birth within the last 12 months. 12 women were Native Dutch, 16 had a Moroccan background, and 12 had a Turkish background. all women faced a misalignment of advice by health professionals and social networks. For the native Dutch respondents, this misalignment did not seem to present a challenge. They had a strongly articulated preference for the advice of health professionals, and did not fear any social consequences for openly following their advice. For the women with a Turkish/Moroccan background, however, this discrepancy in advice presented a dilemma. Following one piece of advice seemed to exclude also following the other one, which would possibly entail social consequences. These women employed one of the three strategies to deal with this dilemma: a) avoiding the dilemma (secretly not following the advice of one side), b) embracing the dilemma (combining conflicting advice), and c) resolving the dilemma (communicating between both sides). we argue that the currently popular interventions geared towards increasing the health literacy of non-Western ethnic minority pregnant women and improving communication between ethnic minority clients and caregivers are not sufficient, and might even exacerbate the dilemma some pregnant women face. As an alternative, we recommend involving not only caregivers but also women's social network in intervention efforts. Interventions could aim to increase the negotiation capacity of the target group, but also to increase the health literacy of the members of their social network to enable the circulation of

Recall of discharge advice given to patients with minor head injury presenting to a Singapore emergency department.

PubMed

Heng, K W J; Tham, K Y; How, K Y; Foo, J S; Lau, Y H; Li, A Y K

2007-12-01

Most patients presenting to the emergency department (ED) with minor head injury (HI) can be discharged, provided a caregiver is present and careful discharge instructions are given. The study ED uses an advice leaflet with verbal reinforcement to patients and caregivers detailing post-discharge instructions and warning symptoms of worsening HI. We aim to evaluate local patients' and caregivers' compliance to discharge instructions and their ability to recall HI advice. A prospective study was conducted in an adult ED between April 10, 2006 and May 1, 2006. All patients with minor HI discharged from the ED or its 24-hour observation ward were included in the study. A telephone survey was conducted within 48 hours of discharge using a standardised questionnaire. During the study period, 292 patients had HI, of which 182 were eligible for the study. 71 were uncontactable and one refused to participate, leaving 110 patients in the study. Patients' age ranged between 7 and 109 years (median 41 years). 100 confirmed receiving HI advice (57 percent received by patients, 26 percent caregivers, 16 percent both patients and caregivers). 29 percent of respondents reported non-compliance to discharge advice. Mean HI-symptom recall score was 1.9 (SD 1.6) (total 9 symptoms). 30 percent cited other symptoms not part of the HI advice, which they believed necessitated a return to the ED. Recall scores were not statistically different, regardless of mode of instruction (verbal or printed) or the recipient (patient, caregiver or both). Our study raises concerns about the reliability of discharge advice for minor HI patients.

75 FR 65031 - U.S.-Trans-Pacific Partnership Free Trade Agreement Including Malaysia: Advice on the Probable...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-21

... Partnership Free Trade Agreement Including Malaysia: Advice on the Probable Economic Effect of Providing Duty...-2104-027, U.S.-Trans-Pacific Partnership Free Trade Agreement Including Malaysia: Advice on the Probable Economic Effect of Providing Duty-Free Treatment for Imports. DATES: November 10, 2010: Deadline...

Advice on Writing a Scientific Paper

NASA Astrophysics Data System (ADS)

Sterken, C.

2006-04-01

What makes one author a good communicator and another a poor one? What turns out one manuscript a swift editorial task, and another an editorial nightmare? Based on direct experience from the manuscripts of the lectures and papers presented during this school, advice is given on what to do and on what to avoid when writing a scientific paper. Some feedback recommendation is also provided on how to prepare manuscripts, handle copyright and permissions to reproduce, how to anticipate plagiarism, how to deal with editors and referees, and how to avoid common errors. A few illustrations of English grammar and style for the foreign author are given.

12 CFR 563g.15 - Requests for interpretive advice or waiver.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., Corporate and Securities Division; (b) The provisions of this part to which the request relates, the... SECURITIES OFFERINGS § 563g.15 Requests for interpretive advice or waiver. Any requests to the Office for...

12 CFR 563g.15 - Requests for interpretive advice or waiver.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., Corporate and Securities Division; (b) The provisions of this part to which the request relates, the... SECURITIES OFFERINGS § 563g.15 Requests for interpretive advice or waiver. Any requests to the Office for...

12 CFR 563g.15 - Requests for interpretive advice or waiver.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., Corporate and Securities Division; (b) The provisions of this part to which the request relates, the... SECURITIES OFFERINGS § 563g.15 Requests for interpretive advice or waiver. Any requests to the Office for...

12 CFR 563g.15 - Requests for interpretive advice or waiver.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., Corporate and Securities Division; (b) The provisions of this part to which the request relates, the... SECURITIES OFFERINGS § 563g.15 Requests for interpretive advice or waiver. Any requests to the Office for...

12 CFR 563g.15 - Requests for interpretive advice or waiver.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., Corporate and Securities Division; (b) The provisions of this part to which the request relates, the... SECURITIES OFFERINGS § 563g.15 Requests for interpretive advice or waiver. Any requests to the Office for...

Promoting Access to Quality Child Care: Critical Steps in Conducting Market Rate Surveys and Establishing Rate Policies.

ERIC Educational Resources Information Center

Stoney, Louise

This report is designed to help policymakers, child care providers, and advocates establish child care rate support policies that support high quality in the context of government-subsidized, privately-provided child care. It also provides advice on the development and interpretation of market rate surveys of local child care fees. Part 1…

The role of cystovaginoscopy and hygienic advice in girls referred for symptoms of vulvovaginitis.

PubMed

Ram, Ashok Daya; Hurst, Katherine Victoria; Steinbrecher, Henrik

2012-05-01

Vulvovaginitis is a common presenting symptom referred to a paediatric urology clinic. Some of these patients undergo diagnostic cystovaginoscopy to determine whether there is any underlying anatomical cause for the persistent infection. However, in the majority of the patients, no underlying abnormality is found and they are given hygienic advice and prescribed bio yoghurt postoperatively. This study examines the outcome in these patients after hygienic advice is given: determining whether cystovaginoscopy was really necessary and whether it changed the management of vulvovaginitis.

78 FR 23954 - U.S.-EU Transatlantic Trade and Investment Partnership Agreement: Advice on the Probable Economic...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-23

... Transatlantic Trade and Investment Partnership Agreement: Advice on the Probable Economic Effect of Providing... on the Probable Economic Effect of Providing Duty-Free Treatment for Imports. DATES: May 16, 2013... its advice as to the probable economic effect of providing duty-free treatment for imports of products...

Pre‐operative oral nutritional supplementation with dietary advice versus dietary advice alone in weight‐losing patients with colorectal cancer: single‐blind randomized controlled trial

PubMed Central

Gibson, Debra J.; Lal, Simon; Hill, James; Pilling, Mark; Soop, Mattias; Ramesh, Aswatha; Todd, Chris

2017-01-01

Abstract Background Pre‐operative weight loss has been consistently associated with increased post‐operative morbidity. The study aims to determine if pre‐operative oral nutritional supplements (ONSs) with dietary advice reduce post‐operative complications. Methods Single‐blinded randomized controlled trial. People with colorectal cancer scheduled for surgery with pre‐operative weight loss >1 kg/3–6 months were randomized by using stratified blocks (1:1 ratio) in six hospitals (1 November 2013–28 February 2015). Intervention group was given 250 mL/day ONS (10.1 KJ and 0.096 g protein per mL) and dietary advice. Control group received dietary advice alone. Oral nutritional supplements were administered from diagnosis to the day preceding surgery. Research team was masked to group allocation. Primary outcome was patients with one or more surgical site infection (SSI) or chest infection; secondary outcomes included percentage weight loss, total complications, and body composition measurements. Intention‐to‐treat analysis was performed with both unadjusted and adjusted analyses. A sample size of 88 was required. Results Of 101 participants, (55 ONS, 46 controls) 97 had surgery. In intention‐to‐treat analysis, there were 21/45 (47%) patients with an infection—either an SSI or chest infection in the control group vs. 17/55 (30%) in the ONS group. The odds ratio of a patient incurring either an SSI or chest infection was 0.532 (P = 0.135 confidence interval 0.232 to 1.218) in the unadjusted analysis and when adjusted for random differences at baseline (age, gender, percentage weight loss, and cancer staging) was 0.341 (P = 0.031, confidence interval 0.128 to 0.909). Pre‐operative percentage weight loss at the first time point after randomization was 4.1% [interquartile range (IQR) 1.7–7.0] in ONS group vs. 6.7% (IQR 2.6–10.8) in controls (Mann–Whitney U P = 0.021) and post‐operatively was 7.4% (IQR 4.3–10.0) in

A Survey of Sun Protection Policy and Education in Secondary Schools

PubMed Central