WorldWideScience

Sample records for administration evidence supporting

  1. Case and Administrative Support Tools

    Data.gov (United States)

    U.S. Environmental Protection Agency — Case and Administrative Support Tools (CAST) is the secure portion of the Office of General Counsel (OGC) Dashboard business process automation tool used to help...

  2. Case and Administrative Support Tools

    Science.gov (United States)

    Case and Administrative Support Tools (CAST) is the secure portion of the Office of General Counsel (OGC) Dashboard business process automation tool used to help reduce office administrative labor costs while increasing employee effectiveness. CAST supports business functions which rely on and store Privacy Act sensitive data (PII). Specific business processes included in CAST (and respective PII) are: -Civil Rights Cast Tracking (name, partial medical history, summary of case, and case correspondance). -Employment Law Case Tracking (name, summary of case). -Federal Tort Claims Act Incident Tracking (name, summary of incidents). -Ethics Program Support Tools and Tracking (name, partial financial history). -Summer Honors Application Tracking (name, home address, telephone number, employment history). -Workforce Flexibility Initiative Support Tools (name, alternative workplace phone number). -Resource and Personnel Management Support Tools (name, partial employment and financial history).

  3. Effective Administrative Support for Able Teachers.

    Science.gov (United States)

    Willing, Delight C.

    1979-01-01

    The continuing education administrator should provide support that will enable teachers to perform effectively. By using Herzberg's motivation-hygiene theory as a framework, the administrator can develop a positive working environment and seek ways of providing motivation to the teacher. (SK)

  4. Database Support for Research in Public Administration

    Science.gov (United States)

    Tucker, James Cory

    2005-01-01

    This study examines the extent to which databases support student and faculty research in the area of public administration. A list of journals in public administration, public policy, political science, public budgeting and finance, and other related areas was compared to the journal content list of six business databases. These databases…

  5. Supporting institutional development in land administration

    DEFF Research Database (Denmark)

    Enemark, Stig

    2006-01-01

    Land management is the process by which the resources of land are put into good effect. Land management encompasses all activities associated with the management of land and natural resources that are required to achieve sustainable development. Land Administration Systems are institutional......, the national capacity to manage land rights, restrictions and responsibilities is not well developed in terms of mature institutions and the necessary human resources and skills. The paper examines the capacity building concept and underpins the need for institutional development to facilitate the design...... and implementation of efficient Land Administration Models and to support good governance. The paper identifies the role of FIG in this regard. This includes support for professional, institutional and global development in surveying and land management, and aims to facilitate the creation of sustainable...

  6. Faculty: Thy Administrator's Keeper? Some Evidence

    Science.gov (United States)

    Cunningham, Brendan M.

    2009-01-01

    Colleges and universities face a principal-agent problem. There are information asymmetries over the actions chosen by administrators. Because non-profit constraints limit the financial stake of trustees there may be insufficient monitoring of administrators and, consequentially, shirking. It is conceivable that faculty will serve as "delegated…

  7. Ethics in Public Administration: Evidence from Slovenia

    Directory of Open Access Journals (Sweden)

    Zlatko NEDELKO

    2013-12-01

    Full Text Available The main purpose of this paper is to examine how employees’ personal ethics, expressed through their personal values and attitudes toward social and environmental issues, are associated with the ethics of organizations in public administration. The authors introduce their own theoretical model that examines the relations between employees’ personal ethics – expressed through employees’ personal values and attitudes toward natural and social environments – and the ethics of public administration. The reported study examined these relations and tested a proposed model based on the answers of 212 employees from public administration organizations in Slovenia. Employees’ attitudes toward natural and social environments and the ethics of their organizations were measured using a questionnaire designed to measure aspects of ethics whereas personal values were measured using the Schwartz value survey. The results demonstrated that employees’ self-enhancing values significantly influence their attitudes toward the natural environment. Employees’ self-transcendence and self-enhancement values significantly influence their attitudes toward the social environment and the ethics of organizations. In addition, research results about the mediation effect of employees’ attitudes toward natural and social environments on the association between the employees’ personal values and their perception of the ethics of public administration organizations reveals that employees’ social attitudes have a significant impact on the ethics of public administration while the impact of self-transcending and self-enhancing values becomes insignificant. Based on results of testing our model we can conclude that the employee’s attitudes toward to the social environment represent a significantly more powerful predictor of ethics in public administration organizations than the employees’ personal values. These results present a solid basis for further

  8. Ethics in Public Administration: Evidence from Slovenia

    OpenAIRE

    Zlatko NEDELKO; Vojko POTOCAN

    2013-01-01

    The main purpose of this paper is to examine how employees’ personal ethics, expressed through their personal values and attitudes toward social and environmental issues, are associated with the ethics of organizations in public administration. The authors introduce their own theoretical model that examines the relations between employees’ personal ethics – expressed through employees’ personal values and attitudes toward natural and social environments – and the ethics of public administrati...

  9. 12 CFR 793.4 - Administrative claims; evidence and information to be submitted.

    Science.gov (United States)

    2010-01-01

    ... evidence or information which may have a bearing on the responsibility of the United States for the death... GOVERNMENT Procedures § 793.4 Administrative claims; evidence and information to be submitted. (a) Death. In support of a claim based on death, the claimant may be required to submit the following evidence or...

  10. Perceptions of Administrative and Supervisory Support in Public Child Welfare

    Directory of Open Access Journals (Sweden)

    Tonya M. Westbrook

    2012-06-01

    Full Text Available Using the Child Welfare Organizational Culture Inventory (CWOCI in a public child welfare agency, perceptions of administrative and supervisory support held by employees with social work degrees (BSW and MSW were compared to perceptions of administrative and supervisory support held by employees without social work degrees. Child welfare employees with social work degrees reported lower administrative and supervisory support than employees without social work degrees. Implications for social work educators, public child welfare administrators and supervisors, and future research are presented.

  11. Promoting energy efficiency: supporting Public Administration and Local Bodies

    International Nuclear Information System (INIS)

    Fasano, G.; Manila, E.

    2008-01-01

    ENEAS's institutional tasks include technical and scientific support to Public Administration and Local Bodies in the field of energy. Recently such a role has been strengthened by setting up the Agency for Energy Efficiency which ENEA is responsible for [it

  12. Nurses' clinical reasoning practices that support safe medication administration: An integrative review of the literature.

    Science.gov (United States)

    Rohde, Emily; Domm, Elizabeth

    2018-02-01

    To review the current literature about nurses' clinical reasoning practices that support safe medication administration. The literature about medication administration frequently focuses on avoiding medication errors. Nurses' clinical reasoning used during medication administration to maintain medication safety receives less attention in the literature. As healthcare professionals, nurses work closely with patients, assessing and intervening to promote mediation safety prior to, during and after medication administration. They also provide discharge teaching about using medication safely. Nurses' clinical reasoning and practices that support medication safety are often invisible when the focus is medication errors avoidance. An integrative literature review was guided by Whittemore and Knafl's (Journal of Advanced Nursing, 5, 2005 and 546) five-stage review of the 11 articles that met review criteria. This review is modelled after Gaffney et al.'s (Journal of Clinical Nursing, 25, 2016 and 906) integrative review on medical error recovery. Health databases were accessed and systematically searched for research reporting nurses' clinical reasoning practices that supported safe medication administration. The level and quality of evidence of the included research articles were assessed using The Johns Hopkins Nursing Evidence-Based Practice Rating Scale©. Nurses have a central role in safe medication administration, including but not limited to risk awareness about the potential for medication errors. Nurses assess patients and their medication and use knowledge and clinical reasoning to administer medication safely. Results indicated nurses' use of clinical reasoning to maintain safe medication administration was inadequately articulated in 10 of 11 studies reviewed. Nurses are primarily responsible for safe medication administration. Nurses draw from their foundational knowledge of patient conditions and organisational processes and use clinical reasoning that

  13. Current evidence supporting "letrozole" for ovulation induction

    Directory of Open Access Journals (Sweden)

    Sujata Kar

    2013-01-01

    Full Text Available Aromatase inhibitor "letrozole" was first introduced as a potential ovulation induction (OI drug almost a decade back. Large number of studies has been published using letrozole for OI: In polycystic ovary syndrome (PCOS women, clomiphene citrate (CC resistant women, for intrauterine insemination and also in various protocols of mild stimulation for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI. Letrozole appears to be a good option, with its oral route of administration, cost, shorter half-life and negligible side effects. However, the verdict on efficacy and safety of letrozole is still uncertain. This review explores the current scientific data supporting letrozole for OI.

  14. Web-Based Administrative Supports for University Students.

    Science.gov (United States)

    McClelland, Robert J.

    2001-01-01

    Evaluates development and effectiveness of a Web-based administration support for business students at Liverpool John Moores University. Considers whether the strategic planning and individual school developments have influenced the development and usefulness of the campus-wide information system. Discusses action research findings on student…

  15. Teachers' Perceptions of Administrative Support and Antecedents of Turnover

    Science.gov (United States)

    Russell, Elizabeth Morgan; Williams, Sue W.; Gleason-Gomez, Cheryl

    2010-01-01

    The purpose of this pilot study was to determine the degree to which teachers' age, perceptions of fair pay, receipt of employer-sponsored health insurance, and administrative support, as operationalized by the Competing Values Framework, predicted antecedents of turnover. Teachers' thoughts of leaving their current job and commitment to a center…

  16. Administrative support of novice science teachers: A multiple case study

    Science.gov (United States)

    Iacuone, Leann

    Novice science teachers leave the confines of colleges and universities to embark on a new adventure in education where they aim to influence young minds, make a difference in the world, and share their love for their content. They have learned their pedagogical skills with the support and assistance of fellow classmates, a supporting professor, and a cooperating teacher. These teachers enter their new place of employment and are met with many unexpected challenges, such as a lack of resources, no one to ask questions of, and a busy staff with already established relationships, causing them to feel an overall lack of support and resulting in many new teachers rethinking their career choice and leaving the field of education within 5 years of entering. This multiple-case study investigated the administrative support 4 novice science teachers received during an academic year and the novice teachers' perceptions of the support they received to answer the following research question: How do novice science teachers who have consistent interactions with administrators develop during their first year? To answer this question, semistructured interviews, reflection journals, observations, resumes, long-range plans, and student discipline referrals were collected. The findings from this study show novice science teachers who had incidents occur in the classroom requiring administrative assistance and guidance felt more confident in enforcing their classroom management policies and procedures as the year progressed to change student behavior. The novice science teachers perceived administrators who provided resources including technology, office supplies, science supplies, and the guidance of a mentor as supportive. Novice science teachers who engaged in dialogue after administrative observations, were provided the opportunity to attend professional development outside the district, and had a mentor who taught the same discipline made more changes to their instructional

  17. New evidence: data documenting parental support for earlier sexuality education.

    Science.gov (United States)

    Barr, Elissa M; Moore, Michele J; Johnson, Tammie; Forrest, Jamie; Jordan, Melissa

    2014-01-01

    Numerous studies document support for sexuality education to be taught in high school, and often, in middle school. However, little research has been conducted addressing support for sexuality education in elementary schools. As part of the state Behavioral Risk Factor Surveillance System (BRFSS) Survey administration, the Florida Department of Health conducted the Florida Child Health Survey (FCHS) by calling back parents who had children in their home and who agreed to participate (N = 1715). Most parents supported the following sexuality education topics being taught specifically in elementary school: communication skills (89%), human anatomy/reproductive information (65%), abstinence (61%), human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) (53%), and gender/sexual orientation issues (52%). Support was even greater in middle school (62-91%) and high school (72-91%) for these topics and for birth control and condom education. Most parents supported comprehensive sexuality education (40.4%), followed by abstinence-plus (36.4%) and abstinence-only (23.2%). Chi-square results showed significant differences in the type of sexuality education supported by almost all parent demographic variables analyzed including sex, race, marital status, and education. Results add substantial support for age-appropriate school-based sexuality education starting at the elementary school level, the new National Sexuality Education Standards, and funding to support evidence-based abstinence-plus or comprehensive sexuality education. © 2013, American School Health Association.

  18. Supporting Capacity Development for Sustainable Land Administration Infrastructures

    DEFF Research Database (Denmark)

    Enemark, Stig

    2005-01-01

    and for identifying an adequate response to these needs at societal, organisational and individual levels. The paper examines the capacity building concept and underpins the need for institutional development to facilitate the design and implementation of efficient Land Administration Models and to support good......Land management is the process by which the resources of land are put into good effect. Land management encompasses all activities associated with the management of land and natural resources that are required to achieve sustainable development. Land Administration Systems are institutional......, the national capacity to manage land rights, restrictions and responsibilities is not well developed in terms of mature institutions and the necessary human resources and skills. In this regard, the capacity building concept offers some guidance for analysing and assessing the capacity needs...

  19. Cooptation of Peer Support Staff: Quantitative Evidence

    Directory of Open Access Journals (Sweden)

    Anthony J. Alberta

    2014-03-01

    Full Text Available Objective In 2007, the Centers for Medicare and Medicaid Services (CMS sent a letter to state Medicaid directors outlining requirements for implementing peer-based recovery support services (P-BRSS as a Medicaid-funded service. Since then, 30 states have implemented these services. Although the literature describing implementation of P-BRSS has identified the cooptation of peer support staff (PSS as a barrier to the effective provision of P-BRSS, the evidence for it remains anecdotal. This study attempts to determine if the context of employment in either a treatment organization or peer organization affected cooptation. Methods We conducted a survey of PSS in the fall of 2013. In all, 92 of the 181 respondents were working as PSS at the time, 53 in treatment organizations. Chi-square analysis was used to determine if the context of employment had an effect on the cooptation of peer staff. Results Peer staff working in treatment organizations reported that they were supervised by treatment staff and participated in employment-related training to improve their skills at providing treatment services more frequently than their counterparts in peer organizations. Peer staff working in treatment organizations also participated in training and education to prepare for employment as treatment professionals more frequently than peer staff working in peer organizations. Conclusions and Implications for Practice Peer staff members working in treatment organizations are subject to processes of acculturation into professional cultures that peer staff working in peer organizations are not. Effective implementation of P-BRSS should include specific efforts to minimize the cooptation of peer staff.

  20. Cynicism as mediating variable between leadership support and emotional burnout : Administrative support staff in Turkish universities

    NARCIS (Netherlands)

    Akbaş, Türkmen Taşer; Durak, İbrahim; Çetin, Aysun; Karkin, N.

    2018-01-01

    Studies in management and organization scholarship prefer to focus on personnel who constitute the core in institutions having bilateral employee status, academicians in the case of our research. Yet, organizational issues pertaining to administrative employees, as support personnel, seem

  1. Current Evidence Supporting Obstetric Fistula Prevention Strategies ...

    African Journals Online (AJOL)

    Evidences from the articles were linked to prevention strategies retrieved from grey literature. The strategies were classified using an innovative target-focused method. Gaps in the literature show the need for fistula prevention research to aim at systematically measuring incidence and prevalence of the disease, identify the ...

  2. 40 CFR 1620.5 - Administrative claim; evidence and information to be submitted.

    Science.gov (United States)

    2010-07-01

    ... INVESTIGATION BOARD ADMINISTRATIVE CLAIMS ARISING UNDER THE FEDERAL TORT CLAIMS ACT § 1620.5 Administrative... before and after the alleged negligence or wrongful act or omission. (6) Any other evidence or...

  3. New Evidence: Data Documenting Parental Support for Earlier Sexuality Education

    Science.gov (United States)

    Barr, Elissa M.; Moore, Michele J.; Johnson, Tammie; Forrest, Jamie; Jordan, Melissa

    2014-01-01

    Background: Numerous studies document support for sexuality education to be taught in high school, and often, in middle school. However, little research has been conducted addressing support for sexuality education in elementary schools. Methods: As part of the state Behavioral Risk Factor Surveillance System (BRFSS) Survey administration, the…

  4. Plan selection in Medicare Part D: Evidence from administrative data

    Science.gov (United States)

    Heiss, Florian; Leive, Adam; McFadden, Daniel; Winter, Joachim

    2014-01-01

    We study the Medicare Part D prescription drug insurance program as a bellwether for designs of private, non-mandatory health insurance markets, focusing on the ability of consumers to evaluate and optimize their choices of plans. Our analysis of administrative data on medical claims in Medicare Part D suggests that fewer than 25 percent of individuals enroll in plans that are ex ante as good as the least cost plan specified by the Plan Finder tool made available to seniors by the Medicare administration, and that consumers on average have expected excess spending of about $300 per year, or about 15 percent of expected total out-of-pocket cost for drugs and Part D insurance. These numbers are hard to reconcile with decision costs alone; it appears that unless a sizeable fraction of consumers place large values on plan features other than cost, they are not optimizing effectively. PMID:24308882

  5. DECENTRALIZATION, ELIGIBILITY OF AUTHORITIES AND CONSULTATION OF CITIZENS - EVIDENCE OF THE OCCURRENCE OF AUTONOMY IN LOCAL PUBLIC ADMINISTRATION MANAGEMENT

    Directory of Open Access Journals (Sweden)

    ZAHARIA PETRONELA

    2013-04-01

    Full Text Available Being important for the proper functioning of the management activity conducted at the local public administration level, local autonomy cannot occur without the support coming from other rules of organization and functioning of local administrative system. From this perspective, in this paper we propose to analyze the content of decentralization, eligibility of authorities and consultation of citizens in solving local problems, in order to highlight how each of these principles demonstrates the efficiency of autonomy. Moving power from central public administration authorities to local authorities in the decentralization process, making authorities of administrative-territorial units eligible and the involvement of local community members in solving problems affecting them are clear evidence of the occurrence of autonomy in local public administration management.

  6. Supporting Public Administration with an Integrated BPR Environment

    Science.gov (United States)

    Ciaghi, Aaron; Villafiorita, Adolfo; Weldemariam, Komminist; Mattioli, Andrea; Phan, Quoc-Sang

    The definition or redesign of Public Administration (PA) procedures is particularly challenging. This is, for example, due to the requirement of cooperation of different organizational units and actors, different laws and procedures for the production of several artifacts, and maintaining traceability while integrating processes with new laws.

  7. Planning the future of JPL's management and administrative support systems around an integrated database

    Science.gov (United States)

    Ebersole, M. M.

    1983-01-01

    JPL's management and administrative support systems have been developed piece meal and without consistency in design approach over the past twenty years. These systems are now proving to be inadequate to support effective management of tasks and administration of the Laboratory. New approaches are needed. Modern database management technology has the potential for providing the foundation for more effective administrative tools for JPL managers and administrators. Plans for upgrading JPL's management and administrative systems over a six year period evolving around the development of an integrated management and administrative data base are discussed.

  8. Reliable implementation of evidence: a qualitative study of antenatal corticosteroid administration in Ohio hospitals.

    Science.gov (United States)

    Kaplan, Heather C; Sherman, Susan N; Cleveland, Charlena; Goldenhar, Linda M; Lannon, Carole M; Bailit, Jennifer L

    2016-03-01

    Antenatal corticosteroids (ANCS) reduce complications of preterm birth; however, not all eligible women receive them. Many hospitals and providers do not have the right processes and conditions to enable ANCS administration with high reliability. The objective of this study was to understand conditions that enable delivery of ANCS with high reliability among hospitals participating in an Ohio Perinatal Quality Collaborative (OPQC) ANCS project. We conducted focus groups and semistructured interviews with members of the OPQC project team (n=27) and other care providers (n=70) using a purposeful sample of 6 sites involved in the OPQC ANCS project. Participants including nurses (n=57), attending obstetricians (n=17), physician trainees (n=21) and certified nurse midwives (n=2) were asked to reflect on their experiences and to identify factors contributing to optimal use of ANCS. Focus groups and interviews were transcribed verbatim and were analysed by a multidisciplinary team using an iterative approach that combined inductive and deductive methods to identify and categorise themes. Six major themes supporting reliable implementation of ANCS at these hospitals emerged including: (1) presence of a high reliability culture, (2) processes that emphasise high reliability, (3) timely and efficient administration process, (4) multiple disciplines are involved, (5) evidence of benefit supports ANCS use and (6) benefit is recognised at all levels of the care team. Our findings identify the key processes and supports needed to ensure delivery of ASCS with high reliability and are reinforced by implementation and reliability science. They are useful for foundation of the successful implementation of other evidence-based practices at high levels of reliability. 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/

  9. Are claims made in orthodontic journal advertisements evidence-supported?

    NARCIS (Netherlands)

    Livas, Christos; Kouskoura, Thaleia; Ren, Yijin; Katsaros, Christos; Pandis, Nikolaos

    Objective: To examine the supporting evidence of advertisements published in six leading orthodontic journals. Materials and Methods: The 2012-2013 printed issues of American Journal of Orthodontics and Dentofacial Orthopedics, Australian Orthodontic Journal, Journal of Orthodontics, European

  10. Publication Voting Power (PVP): method of finding Evidence-Support

    African Journals Online (AJOL)

    Background: Extracting the best evidence that support a procedure is a difficult, time consuming task that needs expert statistical knowledge. A way to make weighting evidence more simple and straight for busy clinicians is needed. Methods: The publications about the procedure under question are lined in an ascending ...

  11. Evidence and Obesity Prevention: Developing Evidence Summaries to Support Decision Making

    Science.gov (United States)

    Clark, Rachel; Waters, Elizabeth; Armstrong, Rebecca; Conning, Rebecca; Allender, Steven; Swinburn, Boyd

    2013-01-01

    Public health practitioners make decisions based on research evidence in combination with a variety of other influences. Evidence summaries are one of a range of knowledge translation options used to support evidence-informed decision making. The literature relevant to obesity prevention requires synthesis for it to be accessible and relevant to…

  12. Scientific Evidence on the Supportive Cancer Care with Chinese Medicine

    Directory of Open Access Journals (Sweden)

    William CS CHO

    2010-03-01

    Full Text Available Complementary and alternative medicine has been increasingly utilized by cancer patients in developed countries. Among the various forms of complementary and alternative medicine, Traditional Chinese Medicine is one of the few that has a well constructed theoretical framework and established treatment approaches for diseases including cancer. Recent research has revealed growing evidence suggesting that Traditional Chinese Medicine is effective in the supportive care of cancer patients during and after major conventional cancer treatments. This paper succinctly summarizes some published clinical evidence and meta-analyses which support the usage of various Traditional Chinese Medicine treatment strategies including Chinese herbal medicine, acupuncture and Qigong in supportive cancer care.

  13. Organisational support for evidence-based practice: occupational therapists perceptions.

    Science.gov (United States)

    Bennett, Sally; Allen, Shelley; Caldwell, Elizabeth; Whitehead, Mary; Turpin, Merrill; Fleming, Jennifer; Cox, Ruth

    2016-02-01

    Barriers to the use of evidence-based practice extend beyond the individual clinician and often include organisational barriers. Adoption of systematic organisational support for evidence-based practice in health care is integral to its use. This study aimed to explore the perceptions of occupational therapy staff regarding the influence of organisational initiatives to support evidence-based practice on workplace culture and clinical practice. This study used semi-structured interviews with 30 occupational therapists working in a major metropolitan hospital in Brisbane, Australia regarding their perceptions of organisational initiatives designed to support evidence-based practice. Four themes emerged from the data: (i) firmly embedding a culture valuing research and EBP, (ii) aligning professional identity with the Research and Evidence in Practice model, (iii) experiences of change: pride, confidence and pressure and (iv) making evidence-based changes to clinical practices. Organisational initiatives for evidence-based practice were perceived as influencing the culture of the workplace, therapists' sense of identity as clinicians, and as contributing to changes in clinical practice. It is therefore important to consider organisational factors when attempting to increase the use of evidence in practice. © 2016 Occupational Therapy Australia.

  14. 77 FR 72691 - Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services

    Science.gov (United States)

    2012-12-06

    ... importantly, the Small Business Act requires SBA to establish one definition of what is a small business... SMALL BUSINESS ADMINISTRATION 13 CFR Part 121 RIN 3245-AG27 Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services AGENCY: U.S. Small Business Administration...

  15. Perceptions of Supportive Leadership Behaviors of School Site Administrators for Secondary Special Education Teachers

    Science.gov (United States)

    Roderick, Erin; Jung, Adrian Woo

    2012-01-01

    School administrators fall short of supporting special education teachers due to a lack of knowledge of and experience in special education. The purpose of this study was to identify and compare leadership behaviors perceived as supportive by special education teachers and school site administrators. Data collection involved a survey instrument…

  16. Administrative Support and Its Mediating Effect on US Public School Teachers

    Science.gov (United States)

    Tickle, Benjamin R.; Chang, Mido; Kim, Sunha

    2011-01-01

    This study examined the effect of administrative support on teachers' job satisfaction and intent to stay in teaching. The study employed a path analysis to the data of regular, full-time, public school teachers from the Schools and Staffing Survey teacher questionnaire. Administrative support was the most significant predictor of teachers' job…

  17. Library orientation on videotape: production planning and administrative support.

    Science.gov (United States)

    Shedlock, J; Tawyea, E W

    1989-01-01

    New student-faculty-staff orientation is an important public service in a medical library and demands creativity, imagination, teaching skill, coordination, and cooperation on the part of public services staff. The Northwestern University Medical Library (NUML) implemented a video production service in the spring of 1986 and used the new service to produce an orientation videotape for incoming students, new faculty, and medical center staff. Planning is an important function in video production, and the various phases of outlining topics, drafting scripts, matching video sequences, and actual taping of video, voice, and music are described. The NUML orientation videotape demonstrates how reference and audiovisual services merge talent and skills to benefit the library user. Videotape production, however, cannot happen in a vacuum of good intentions and high ideals. This paper also presents the management support and cost analysis needed to make video production services a reality for use by public service departments.

  18. ADDIS: A decision support system for evidence-based medicine

    NARCIS (Netherlands)

    G. van Valkenhoef (Gert); T. Tervonen (Tommi); T. Zwinkels (Tijs); B. de Brock (Bert); H.L. Hillege (Hans)

    2013-01-01

    textabstractClinical trials are the main source of information for the efficacy and safety evaluation of medical treatments. Although they are of pivotal importance in evidence-based medicine, there is a lack of usable information systems providing data-analysis and decision support capabilities for

  19. 34 CFR 35.4 - Administrative claim; evidence and information to be submitted.

    Science.gov (United States)

    2010-07-01

    ... the interval between injury and death. (8) Any other evidence or information which may have a bearing...) Death. In support of a claim based on death, the claimant may be required to submit the following evidence or information: (1) An authenticated death certificate or other competent evidence showing cause...

  20. 10 CFR 1014.4 - Administrative claims; evidence and information to be submitted.

    Science.gov (United States)

    2010-01-01

    ... between injury and death. (8) Any other evidence or information that may have a bearing on either the.... (a) Death. In support of a claim based on death, the claimant may be required to submit the following evidence or information: (1) An authenticated death certificate or other competent evidence showing the...

  1. NICU nurse educators: what evidence supports your teaching strategies?

    Science.gov (United States)

    Pilcher, Jobeth

    2013-01-01

    One of our roles as nurse educators is to teach best practices related to patient care. However, have you ever stopped to think about what evidence supports your teaching strategies? Just as our patients deserve care that is based on the best available evidence, our learners also deserve education that is based on evidence.1-3 With so many advances in knowledge, technology, and even life itself, it is interesting that education has changed very little over the past 100 years. A study among 946 nurse educators documented that most teach the way they were taught.4 In addition, even after learning new strategies, educators often continue teaching in the manner they are most comfortable. However, this trend is beginning to change. Nurse educators are becoming increasingly aware of and willing to try new and innovative teaching strategies. Educators are also seeking out evidence-based teaching strategies and are becoming more involved in nursing education research.

  2. SUPPORT Tools for evidence-informed health Policymaking (STP) 3: Setting priorities for supporting evidence-informed policymaking.

    Science.gov (United States)

    Lavis, John N; Oxman, Andrew D; Lewin, Simon; Fretheim, Atle

    2009-12-16

    This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policymakers have limited resources for developing--or supporting the development of--evidence-informed policies and programmes. These required resources include staff time, staff infrastructural needs (such as access to a librarian or journal article purchasing), and ongoing professional development. They may therefore prefer instead to contract out such work to independent units with more suitably skilled staff and appropriate infrastructure. However, policymakers may only have limited financial resources to do so. Regardless of whether the support for evidence-informed policymaking is provided in-house or contracted out, or whether it is centralised or decentralised, resources always need to be used wisely in order to maximise their impact. Examples of undesirable practices in a priority-setting approach include timelines to support evidence-informed policymaking being negotiated on a case-by-case basis (instead of having clear norms about the level of support that can be provided for each timeline), implicit (rather than explicit) criteria for setting priorities, ad hoc (rather than systematic and explicit) priority-setting process, and the absence of both a communications plan and a monitoring and evaluation plan. In this article, we suggest questions that can guide those setting priorities for finding and using research evidence to support evidence-informed policymaking. These are: 1. Does the approach to prioritisation make clear the timelines that have been set for addressing high-priority issues in different ways? 2. Does the approach incorporate explicit criteria for determining priorities? 3. Does the approach incorporate an explicit process for determining priorities? 4. Does the approach incorporate a communications strategy and a monitoring and evaluation plan?

  3. The Political Rationale of Administrative Reforms : Parliamentary Support of Output Control in Switzerland

    OpenAIRE

    Schedler, Kuno; Schmucki, Lukas

    2009-01-01

    Sufficient political support is a sine qua non of comprehensive administrative reforms. However, while the pros and cons of administrative reform measures have been extensively discussed in theory and research, only little is known about the political process which determines whether or not administrative reforms are implemented at all. Against this background, the article aims at throwing light on the politicians' backgrounds and mindsets which account for their attitude towards administrati...

  4. Evaluation of LMS Moodle's functionality for the purpose of supporting the application administrator

    OpenAIRE

    Šperková, Lucie

    2009-01-01

    This bachelor thesis deals with administrator environment of the Learning Management System Moodle. The aim is to provide a basic outline of the alternatives for administrative tools supporting the learning procedure in Moodle and to create a user's guide for LMS Moodle. The characterisation focuses on the administration of users, courses, modules, appearances, security and some other basic settings. A brief survey on functioning of the system among Czech universities is also a part of this t...

  5. Senior Level Administrators and HBCUs: The Role of Support for Black Women’s Success in STEM

    Directory of Open Access Journals (Sweden)

    Amanda Washington Lockett

    2018-04-01

    Full Text Available While it is important for college and university senior administrators to embrace the traditional roles of their administrative positions, senior administrators’ interactions with students also shape institutional culture, students’ engagement, and ultimately play a role in students’ motivation to succeed. This engagement is especially evident in the Historically Black College and University (HBCU context as senior administrators’ engagement with students can directly or indirectly affect how students perceive themselves and their ability to succeed. This article aims to illuminate the role that HBCU senior level administrators play in students’ motivation toward success. We also highlight the notion that senior level administrators’ role in organizational culture ultimately led historically-disempowered Black women students toward success in even the most historically inaccessible pathways in the science, technology, engineering, and math (STEM fields. The study used semi-structured interviews with 71 Black women STEM students across 10 HBCUs and asked questions to better understand how events in their lives and on their campuses shaped their choice to pursue and persist through a STEM degree program. The study found that the women were highly motivated by their HBCUs’ family-like community of support. Integral to this article, this support was not confined to professors and peers, but extended to senior administrators. We conclude that Black women STEM students’ perception of their ability to succeed and their motivation is influenced by the institutions’ senior administration.

  6. Administration

    DEFF Research Database (Denmark)

    Bogen handler om den praksis, vi kalder administration. Vi er i den offentlige sektor i Danmark hos kontorfolkene med deres sagsmapper, computere, telefoner,, lovsamlinger,, retningslinier og regneark. I bogen udfoldes en mangfoldighed af konkrete historier om det administrative arbejde fra...... forskellige områder i den offentlige sektor. Hensigten er at forstå den praksis og faglighed der knytter sig til det administrative arbejde...

  7. Trichloroethylene: Mechanistic, epidemiologic and other supporting evidence of carcinogenic hazard.

    Science.gov (United States)

    Rusyn, Ivan; Chiu, Weihsueh A; Lash, Lawrence H; Kromhout, Hans; Hansen, Johnni; Guyton, Kathryn Z

    2014-01-01

    The chlorinated solvent trichloroethylene (TCE) is a ubiquitous environmental pollutant. The carcinogenic hazard of TCE was the subject of a 2012 evaluation by a Working Group of the International Agency for Research on Cancer (IARC). Information on exposures, relevant data from epidemiologic studies, bioassays in experimental animals, and toxicity and mechanism of action studies was used to conclude that TCE is carcinogenic to humans (Group 1). This article summarizes the key evidence forming the scientific bases for the IARC classification. Exposure to TCE from environmental sources (including hazardous waste sites and contaminated water) is common throughout the world. While workplace use of TCE has been declining, occupational exposures remain of concern, especially in developing countries. The strongest human evidence is from studies of occupational TCE exposure and kidney cancer. Positive, although less consistent, associations were reported for liver cancer and non-Hodgkin lymphoma. TCE is carcinogenic at multiple sites in multiple species and strains of experimental animals. The mechanistic evidence includes extensive data on the toxicokinetics and genotoxicity of TCE and its metabolites. Together, available evidence provided a cohesive database supporting the human cancer hazard of TCE, particularly in the kidney. For other target sites of carcinogenicity, mechanistic and other data were found to be more limited. Important sources of susceptibility to TCE toxicity and carcinogenicity were also reviewed by the Working Group. In all, consideration of the multiple evidence streams presented herein informed the IARC conclusions regarding the carcinogenicity of TCE. © 2013.

  8. Shifting Spaces and Emerging Voices: Participation, Support, and Conflict in One School Administrative Team

    Science.gov (United States)

    Austin, Manila S.; Harkins, Debra A.

    2008-01-01

    Research Findings: Collaborative work and supportive relationships are highly valued by teachers and school administrators. Collaboration, however, necessitates constructive conflict resolution (P. M. Senge, 1990); yet conflict is often experienced as interpersonally threatening and undermining supportive working conditions. This contradiction is…

  9. 28 CFR 14.4 - Administrative claims; evidence and information to be submitted.

    Science.gov (United States)

    2010-07-01

    ... bearing on either the responsibility of the United States for the death or the damages claimed. (b... submitted. (a) Death. In support of a claim based on death, the claimant may be required to submit the following evidence or information: (1) An authenticated death certificate or other competent evidence...

  10. Are claims made in orthodontic journal advertisements evidence-supported?

    Science.gov (United States)

    Livas, Christos; Kouskoura, Thaleia; Ren, Yijin; Katsaros, Christos; Pandis, Nikolaos

    2015-03-01

    To examine the supporting evidence of advertisements published in six leading orthodontic journals. The 2012-2013 printed issues of American Journal of Orthodontics and Dentofacial Orthopedics, Australian Orthodontic Journal, Journal of Orthodontics, European Journal of Orthodontics, Journal of Clinical Orthodontics, and Journal of Orofacial Orthopedics were screened for advertisements implying superior performance compared with competitor products. Advertisements were classified according to type of product, availability, and currency of supporting references. A total of 99 unique advertisements claiming clinical benefit or superiority were identified. The overwhelming majority of the identified advertisements promoted appliance products (62.6%), orthodontic materials (14.1%), and dental operatory equipment, including imaging systems (12.1%). Advertisements were found to provide references or not regardless of the product type. Half of the advertisements referred to at least one peer-reviewed publication, whereas unpublished studies were cited by 25% of the advertisements. Most of the referenced articles were published within the past 5 years. The scientific background of advertisements in the orthodontic literature appears limited. While surveillance of journal advertising needs to be regulated, clinicians are urged to critically appraise the claims being made in orthodontic print advertisements by consulting the associated existing evidence.

  11. Evidence-informed health policy 2 - survey of organizations that support the use of research evidence.

    Science.gov (United States)

    Lavis, John N; Paulsen, Elizabeth J; Oxman, Andrew D; Moynihan, Ray

    2008-12-17

    Previous surveys of organizations that support the development of evidence-informed health policies have focused on organizations that produce clinical practice guidelines (CPGs) or undertake health technology assessments (HTAs). Only rarely have surveys focused at least in part on units that directly support the use of research evidence in developing health policy on an international, national, and state or provincial level (i.e., government support units, or GSUs) that are in some way successful or innovative or that support the use of research evidence in low- and middle-income countries (LMICs). We drew on many people and organizations around the world, including our project reference group, to generate a list of organizations to survey. We modified a questionnaire that had been developed originally by the Appraisal of Guidelines, Research and Evaluation in Europe (AGREE) collaboration and adapted one version of the questionnaire for organizations producing CPGs and HTAs, and another for GSUs. We sent the questionnaire by email to 176 organizations and followed up periodically with non-responders by email and telephone. We received completed questionnaires from 152 (86%) organizations. More than one-half of the organizations (and particularly HTA agencies) reported that examples from other countries were helpful in establishing their organization. A higher proportion of GSUs than CPG- or HTA-producing organizations involved target users in the selection of topics or the services undertaken. Most organizations have few (five or fewer) full-time equivalent (FTE) staff. More than four-fifths of organizations reported providing panels with or using systematic reviews. GSUs tended to use a wide variety of explicit valuation processes for the research evidence, but none with the frequency that organizations producing CPGs, HTAs, or both prioritized evidence by its quality. Between one-half and two-thirds of organizations do not collect data systematically about

  12. The Effects of Teacher Perceptions of Administrative Support, School Climate, and Academic Success in Urban Schools

    Science.gov (United States)

    Robinson, Lakishia N.

    2015-01-01

    Teacher turnover refers to major changes in teachers' assignments from one school year to the next. Past research has given an overview of several factors of teacher turnover. These factors include the school environment, teacher collaborative efforts, administrative support, school climate, location, salary, classroom management, academic…

  13. 31 CFR 285.1 - Collection of past-due support by administrative offset.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Collection of past-due support by administrative offset. 285.1 Section 285.1 Money and Finance: Treasury Regulations Relating to Money and Finance... include current basic pay, special pay, incentive pay, retainer pay, overtime, or in the case of an...

  14. Friend or Foe? New Managerialism and Technical, Administrative and Clerical Support Staff in Australian Universities

    Science.gov (United States)

    Pick, David; Teo, Stephen; Yeung, Melissa

    2012-01-01

    The aim of this paper is to assess and conceptualise the effects of new managerialism-related organisational reforms in three Australian public universities on technical, administrative and clerical support staff job stressors and job satisfaction. Using a mixed method approach consisting of a quantitative core component and qualitative…

  15. Hippocampal declarative memory supports gesture production: Evidence from amnesia.

    Science.gov (United States)

    Hilverman, Caitlin; Cook, Susan Wagner; Duff, Melissa C

    2016-12-01

    Spontaneous co-speech hand gestures provide a visuospatial representation of what is being communicated in spoken language. Although it is clear that gestures emerge from representations in memory for what is being communicated (De Ruiter, 1998; Wesp, Hesse, Keutmann, & Wheaton, 2001), the mechanism supporting the relationship between gesture and memory is unknown. Current theories of gesture production posit that action - supported by motor areas of the brain - is key in determining whether gestures are produced. We propose that when and how gestures are produced is determined in part by hippocampally-mediated declarative memory. We examined the speech and gesture of healthy older adults and of memory-impaired patients with hippocampal amnesia during four discourse tasks that required accessing episodes and information from the remote past. Consistent with previous reports of impoverished spoken language in patients with hippocampal amnesia, we predicted that these patients, who have difficulty generating multifaceted declarative memory representations, may in turn have impoverished gesture production. We found that patients gestured less overall relative to healthy comparison participants, and that this was particularly evident in tasks that may rely more heavily on declarative memory. Thus, gestures do not just emerge from the motor representation activated for speaking, but are also sensitive to the representation available in hippocampal declarative memory, suggesting a direct link between memory and gesture production. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. 45 CFR 35.4 - Administrative claims; evidence and information to be submitted.

    Science.gov (United States)

    2010-10-01

    ... bearing on either the responsibility of the United States for the death or the damages claimed. (b... information to be submitted. (a) Death. In support of a claim based on death, the claimant may be required to submit the following evidence or information: (1) An authenticated death certificate or other competent...

  17. The evidence of neuraxial administration of analgesics for cancer-related pain

    DEFF Research Database (Denmark)

    Kurita, G P; Benthien, K S; Nordly, M

    2015-01-01

    related to cancer, pain, neuraxial route, analgesic and side effects. The search was performed in PubMed, EMBASE, and Cochrane for the period until February 2014. Studies were analysed according to methods, results, quality of evidence, and strength of recommendation. RESULTS: The number of abstracts...... retrieved was 2147, and 84 articles were selected for full reading. The final selection comprised nine articles regarding randomised controlled trials (RCTs) divided in four groups: neuraxial combinations of opioid and adjuvant analgesic compared with neuraxial administration of opioid alone (n = 4); single...... neuraxial drug in bolus compared with continuous administration (n = 2); single neuraxial drug compared with neuraxial placebo (n = 1); and neuraxial opioid combined with or without adjuvant analgesic compared with other comprehensive medical management than neuraxial analgesics (n = 2). The RCTs presented...

  18. Job loss, firm-level heterogeneity and mortality: Evidence from administrative data.

    Science.gov (United States)

    Bloemen, Hans; Hochguertel, Stefan; Zweerink, Jochem

    2018-04-01

    This paper estimates the effect of job loss on mortality for older male workers with a strong labor force attachment. Using Dutch administrative data, we find that job loss due to firm closure increased the probability of death within five years by a sizable 0.60 percentage points. Importantly, this effect is estimated using a model that controls for firm-level worker characteristics, such as lagged firm-level annual average mortality rates. On the mechanism driving the effect of job loss on mortality, we provide evidence for an effect running through stress and changes in life style. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Micro-dose hCG as luteal phase support without exogenous progesterone administration

    DEFF Research Database (Denmark)

    Andersen, C Yding; Fischer, R; Giorgione, V

    2016-01-01

    RHa trigger to induce ovulation showed that exogenous progesterone administration without hCG supplementation was insufficient to obtain satisfactory pregnancy rates. This has prompted development of alternative strategies for LPS. Augmenting the local endogenous production of progesterone by the multiple......For the last two decades, exogenous progesterone administration has been used as luteal phase support (LPS) in connection with controlled ovarian stimulation combined with use of the human chorionic gonadotropin (hCG) trigger for the final maturation of follicles. The introduction of the Gn...... corpora lutea has been one focus with emphasis on one hand to avoid development of ovarian hyper-stimulation syndrome and, on the other hand, to provide adequate levels of progesterone to sustain implantation. The present study evaluates the use of micro-dose hCG for LPS support and examines the potential...

  20. Use of evidence-based management in healthcare administration decision-making.

    Science.gov (United States)

    Guo, Ruiling; Berkshire, Steven D; Fulton, Lawrence V; Hermanson, Patrick M

    2017-07-03

    Purpose The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare administrators consult during their decision-making. This study also intends to identify any relationship that might exist among adoption of EBMgt in healthcare management, attitudes towards EBMgt, demographic characteristics and organizational characteristics. Design/methodology/approach A cross-sectional study was conducted among US healthcare leaders. Spearman's correlation and logistic regression were performed using the Statistical Package for the Social Sciences (SPSS) 23.0. Findings One hundred and fifty-four healthcare leaders completed the survey. The study results indicated that 90 per cent of the participants self-reported having used an EBMgt approach for decision-making. Professional experiences (87 per cent), organizational data (84 per cent) and stakeholders' values (63 per cent) were the top three types of evidence consulted daily and weekly for decision-making. Case study (75 per cent) and scientific research findings (75 per cent) were the top two types of evidence consulted monthly or less than once a month. An exploratory, stepwise logistic regression model correctly classified 75.3 per cent of all observations for a dichotomous "use of EBMgt" response variable using three independent variables: attitude towards EBMgt, number of employees in the organization and the job position. Spearman's correlation indicated statistically significant relationships between healthcare leaders' use of EBMgt and healthcare organization bed size ( r s = 0.217, n = 152, p employees ( r s = 0.195, n = 152, p = 0.016). Originality/value This study generated new research findings on the practice of EBMgt in US healthcare administration decision-making.

  1. Professional Parity Between Co-Teachers in Secondary Science and Math As Influenced By Administrative Support

    Science.gov (United States)

    Nordh, Camilla S.

    2011-12-01

    School improvement plans, budget constraints, and compliance mandates targeting academic progress for all students indicate a need for maximal professional efficacy at every level in the educational system, including parity between co-teachers in the co-teaching service delivery model. However, research shows that the special education co-teacher frequently assumes an assistive role while the general education co-teacher adopts a leading role in the classroom. When the participants in a co-teaching partnership fail to equitably share the professional responsibilities for which both teachers are qualified to perform, overall efficacy is compromised in that the special education teacher is not exercising his or her qualified expertise. Administrative support can be a primary influencing factor in increasing parity between the co-teachers. A qualitative study using a phenomenological design was conducted to explore the influences of co-teacher attitudes and administrative support on professional parity in co-taught secondary science and math classrooms. Content analysis was used to interpret data from interviews with five special education and 15 general education co-teachers at eight secondary schools in a suburban school district in a mid-Atlantic state. Five themes emerged from the data: content mastery by the special education co-teacher, joint planning time for co-teachers, continuity within co-teaching dyads, compatible personalities between co-teachers, and clear administrative expectations about co-teaching. Results indicate that administrative support to consider the content mastery of the special education co-teacher is the most influential factor to parity, followed by the co-teaching partners having joint planning time and that both can be implemented through scheduling and assignment considerations rather than training initiatives. The results provide an examination of each theme as it pertains to the issue of professional efficacy in co-teaching and

  2. When Is Statistical Evidence Superior to Anecdotal Evidence in Supporting Probability Claims? The Role of Argument Type

    Science.gov (United States)

    Hoeken, Hans; Hustinx, Lettica

    2009-01-01

    Under certain conditions, statistical evidence is more persuasive than anecdotal evidence in supporting a claim about the probability that a certain event will occur. In three experiments, it is shown that the type of argument is an important condition in this respect. If the evidence is part of an argument by generalization, statistical evidence…

  3. Using web-based group support systems to enhance procedural fairness in administrative decision making in South Africa

    CSIR Research Space (South Africa)

    Twinomurinzi, H

    2009-11-01

    Full Text Available The authors are investigating whether Web-based Group Support System (GSS) tools can support and enhance procedural fairness in administrative decision making in South Africa. They report here on work that emanates from a masters dissertation...

  4. Explaining Perceptions of Administrative Support among Prison Treatment Staff: A Spotlight on Deputy Wardens in Charge of Treatment

    Science.gov (United States)

    Garland, Brett E.; McCarty, William P.

    2006-01-01

    This paper explores how perceptions of administrative support among 83 treatment staff working in a midwest prison system vary according to personal and work-related variables. It extends on previous literature by: (1) analyzing how perceptions of administrative support vary exclusively among prison treatment staff; (2) focusing on a single type…

  5. Family support programs and adolescent mental health: review of evidence

    Directory of Open Access Journals (Sweden)

    Kuhn ES

    2014-07-01

    Full Text Available Emily S Kuhn, Robert D Laird Department of Psychology, University of New Orleans, New Orleans, LA, USA Abstract: Family support programs aim to improve parent wellbeing and parenting as well as adolescent mental and behavioral health by addressing the needs of parents of adolescents experiencing or at risk for mental health problems. Family support programs can be part of the treatment for adolescents diagnosed with mental or behavioral health problems, or family support programs can be delivered as prevention programs designed to prevent the onset or escalation of mental or behavioral health problems. This review discusses the rationale for family support programs and describes the range of services provided by family support programs. The primary focus of the review is on evaluating the effectiveness of family support programs as treatments or prevention efforts delivered by clinicians or peers. Two main themes emerged from the review. First, family support programs that included more forms of support evidenced higher levels of effectiveness than family support programs that provided fewer forms of support. Discussion of this theme focuses on individual differences in client needs and program adaptions that may facilitate meeting diverse needs. Second, family support prevention programs appear to be most effective when serving individuals more in need of mental and behavioral health services. Discussion of this theme focuses on the intensity versus breadth of the services provided in prevention programs. More rigorous evaluations of family support programs are needed, especially for peer-delivered family support treatments. Keywords: intervention, parent, mental and behavioral health

  6. Program support of the automated system of planned calculations of the Oil and Gas Extracting Administration

    Energy Technology Data Exchange (ETDEWEB)

    Ashkinuze, V G; Reznikovskiy, P T

    1978-01-01

    An examination is made of the program support of the Automated System of Planned Calculations (ASPC) of the oil and Gas Extracting Administration (OGEA). Specific requirements for the ASPC of the OGEA are indicated and features of its program realization. In developing the program support of the system, an approach of parametric programming was used. A formal model of the ASPC OGEA is described in detail. It was formed in a theoretical-multiple language. Sets with structure of a tree are examined. They illustrate the production and administrative hierarchical structure of the planning objects in the oil region. The top of the tree corresponds to the OGEA as a whole. In the simplest realization, the tree has two levels of hierarchy: association and field. In general features, a procedure is described for possible use of the system by the planning workers. A plan is presented for program support of the ASPC OGEA, in light of whose specific nature a large part of the programs which realize this system are written in a language ASSEMBLER.

  7. Safety of intravenous tissue plasminogen activator administration with computed tomography evidence of prior infarction.

    Science.gov (United States)

    Lyerly, Michael J; Houston, J Thomas; Boehme, Amelia K; Albright, Karen C; Bavarsad Shahripour, Reza; Palazzo, Paola; Alvi, Muhammed; Rawal, Pawan V; Kapoor, Niren; Sisson, April; Alexandrov, Anne W; Alexandrov, Andrei V

    2014-07-01

    Prior stroke within 3 months excludes patients from thrombolysis; however, patients may have computed tomography (CT) evidence of prior infarct, often of unknown time of origin. We aimed to determine if the presence of a previous infarct on pretreatment CT is a predictor of hemorrhagic complications and functional outcomes after the administration of intravenous (IV) tissue plasminogen activator (tPA). We retrospectively analyzed consecutive patients treated with IV tPA at our institution from 2009-2011. Pretreatment CTs were reviewed for evidence of any prior infarct. Further review determined if any hemorrhagic transformation (HT) or symptomatic intracerebral hemorrhage (sICH) were present on repeat CT or magnetic resonance imaging. Outcomes included sICH, any HT, poor functional outcome (modified Rankin Scale score of 4-6), and discharge disposition. Of 212 IV tPA-treated patients, 84 (40%) had evidence of prior infarct on pretreatment CT. Patients with prior infarcts on CT were older (median age, 72 versus 65 years; P=.001) and had higher pretreatment National Institutes of Health Stroke Scale scores (median, 10 versus 7; P=.023). Patients with prior infarcts on CT did not experience more sICH (4% versus 2%; P=.221) or any HT (18% versus 14%; P=.471). These patients did have a higher frequency of poor functional outcome at discharge (82% versus 50%; P<.001) and were less often discharged to home or inpatient rehabilitation center (61% versus 73%; P=.065). Visualization of prior infarcts on pretreatment CT did not predict an increased risk of sICH in our study and should not be viewed as a reason to withhold systemic tPA treatment after clinically evident strokes within 3 months were excluded. Published by Elsevier Inc.

  8. Evidence supporting the use of recombinant activated factor VII in congenital bleeding disorders

    Directory of Open Access Journals (Sweden)

    Pär I Johansson

    2010-06-01

    Full Text Available Pär I Johansson, Sisse R OstrowskiCapital Region Blood Bank, Section for Transfusion Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, DenmarkBackground: Recombinant activated factor VII (rFVIIa, NovoSeven® was introduced in 1996 for the treatment of hemophilic patients with antibodies against coagulation factor VIII or IX.Objective: To review the evidence supporting the use of rFVIIa for the treatment of patients with congenital bleeding disorders.Patients and methods: English-language databases were searched in September 2009 for reports of randomized controlled trials (RCTs evaluating the ability of rFVIIa to restore hemostasis in patients with congenital bleeding disorders.Results: Eight RCTs involving 256 hemophilic patients with antibodies against coagulation factors, also known as inhibitors, were identified. The evidence supporting the use of rFVIIa in these patients was weak with regard to dose, clinical setting, mode of administration, efficacy, and adverse events, given the limited sample size of each RCT and the heterogeneity of the studies.Conclusion: The authors suggest that rFVIIa therapy in hemophilic patients with inhibitors should be based on the individual’s ability to generate thrombin and form a clot, and not on the patient’s weight alone. Therefore, assays for thrombin generation, such as whole-blood thromboelastography, have the potential to significantly improve the treatment of these patients.Keywords: hemophilia, inhibitors, coagulation factor VIII, coagulation factor IX, rFVIIa, NovoSeven, FEIBA, hemostasis, RCT

  9. Family support programs and adolescent mental health: review of evidence

    OpenAIRE

    Laird, Robert; Kuhn,Emily

    2014-01-01

    Emily S Kuhn, Robert D Laird Department of Psychology, University of New Orleans, New Orleans, LA, USA Abstract: Family support programs aim to improve parent wellbeing and parenting as well as adolescent mental and behavioral health by addressing the needs of parents of adolescents experiencing or at risk for mental health problems. Family support programs can be part of the treatment for adolescents diagnosed with mental or behavioral health problems, or family support programs can be deli...

  10. Evidence Supporting Broader Access To Safe Legal Abortion

    OpenAIRE

    Faundes; Anibal; Shah; Iqbal H.

    2016-01-01

    Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal con...

  11. Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence.

    Science.gov (United States)

    Keers, Richard N; Williams, Steven D; Cooke, Jonathan; Ashcroft, Darren M

    2013-11-01

    Underlying systems factors have been seen to be crucial contributors to the occurrence of medication errors. By understanding the causes of these errors, the most appropriate interventions can be designed and implemented to minimise their occurrence. This study aimed to systematically review and appraise empirical evidence relating to the causes of medication administration errors (MAEs) in hospital settings. Nine electronic databases (MEDLINE, EMBASE, International Pharmaceutical Abstracts, ASSIA, PsycINFO, British Nursing Index, CINAHL, Health Management Information Consortium and Social Science Citations Index) were searched between 1985 and May 2013. Inclusion and exclusion criteria were applied to identify eligible publications through title analysis followed by abstract and then full text examination. English language publications reporting empirical data on causes of MAEs were included. Reference lists of included articles and relevant review papers were hand searched for additional studies. Studies were excluded if they did not report data on specific MAEs, used accounts from individuals not directly involved in the MAE concerned or were presented as conference abstracts with insufficient detail. A total of 54 unique studies were included. Causes of MAEs were categorised according to Reason's model of accident causation. Studies were assessed to determine relevance to the research question and how likely the results were to reflect the potential underlying causes of MAEs based on the method(s) used. Slips and lapses were the most commonly reported unsafe acts, followed by knowledge-based mistakes and deliberate violations. Error-provoking conditions influencing administration errors included inadequate written communication (prescriptions, documentation, transcription), problems with medicines supply and storage (pharmacy dispensing errors and ward stock management), high perceived workload, problems with ward-based equipment (access, functionality

  12. Evidence based administration of risperidone and paliperidone for the treating conduct disorder

    Directory of Open Access Journals (Sweden)

    Ahmad Ghanizadeh

    2013-01-01

    Full Text Available Background: This study evaluates the evidence-based administration of risperidone and paliperidone for the treating children and adolescents with conduct disorder (CD. Materials and Methods: A review of the current literature from clinical trials that investigated the efficacy of risperidone and paliperidone on CD considering the inclusion criteria and search strategies was performed by a search of PubMed and Google Scholar databases. Results: Out of 53 titles, 31 were irrelevant. The abstract of 22 potentially related articles were studied. Only six articles reported the results of clinical trial. However, one of them reported the effect of risperidone on conduct behaviors in autistic disorders. One study was a re-analysis of two previous studies, one study reported the effects of maintenance versus withdrawal of risperidone treatment and two studies included children with sub-average intelligence. Headache, somnolence and increased appetite are among the most common reported adverse effects. No study examined the effect of paliperidone on CD was found. Conclusion: Current literature suggests that risperidone could be effective for treating some conduct behaviors in children and adolescents. The effect of risperidone on CD is not a well-researched area. There is no well-controlled evidence based reports about the safety and efficacy of risperidone for the treatment of CD. Further trials should examine the efficacy of these medications on CD rather than conduct behaviors or disruptive behavior disorders.

  13. A Multi-Criteria Methodology to Support Public Administration Decision Making Concerning Sustainable Energy Action Plans

    Directory of Open Access Journals (Sweden)

    Chiara Novello

    2013-08-01

    Full Text Available For municipalities that have joined the Covenant of Mayors promoted by the European Commission, the Sustainable Energy Action Plan (SEAP represents a strategic tool for achieving the greenhouse gas reductions required by 2020. So far as the energy retrofit actions in their residential building stock are concerned, which in the small-to-medium municipalities are responsible for more than 60% of CO2 emissions, the scenarios for intervening are normally decided on the basis of an economic (cost/performance analysis. This type of analysis, however, does not take into account important aspects for small and medium-sized communities such as social aspects, environmental impacts, local economic development and employment. A more comprehensive and effective tool to support the choices of public administrators is the multi-criteria analysis. This study proposes a methodology that integrates multi-criteria analysis in order to support Public Administration/Local Authorities in programming Sustainable Energy Action Plans with a more targeted approach to sustainability. The methodology, based on the ELECTRE III method, was applied to a medium-size municipality in the Lombardy region of Italy. The results obtained with this approach are discussed in this paper.

  14. Dental School Administrators' Attitudes Towards Providing Support Services for LGBT-Identified Students.

    Science.gov (United States)

    Behar-Horenstein, Linda S; Morris, Dustin R

    2015-08-01

    A lack of curriculum time devoted to teaching dental students about the needs of lesbian, gay, bisexual, and transgendered (LGBT) health care patient needs and biases against LGBT students and faculty have been reported. Understanding dental school administrators' attitudes about LGBT students' needs might provide further insight into these long-standing issues. The aims of this study were to develop a survey to assess dental administrators' attitudes regarding the support services they believe LGBT-identified students need, to identify dental schools' current diversity inclusion policies, and to determine what types of support dental schools currently provide to LGBT students. A survey developed with the aid of a focus group, cognitive interviewing, and pilot testing was sent to 136 assistant and associate deans and deans of the 65 U.S. and Canadian dental schools. A total of 54 responses from 43 (66%) schools were received from 13 deans, 29 associate deans, and 11 assistant deans (one participant did not report a position), for a 40% response rate. The findings suggest there is a considerable lack of knowledge or acknowledgment of LGBT dental students' needs. Future studies are needed to show the importance of creating awareness about meeting the needs of all dental student groups, perhaps through awareness campaigns initiated by LGBT students.

  15. Evidence supporting broader access to safe legal abortion.

    Science.gov (United States)

    Faúndes, Anibal; Shah, Iqbal H

    2015-10-01

    Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal condition for abortion is met. The present article aims to contribute to a better understanding that one can be in favor of greater access to safe abortion services, while at the same time not be "in favor of abortion," by reviewing the evidence that indicates that criminalization of abortion only increases mortality and morbidity without decreasing the incidence of induced abortion, and that decriminalization rapidly reduces abortion-related mortality and does not increase abortion rates. Copyright © 2015. Published by Elsevier Ireland Ltd.

  16. [Insufficient evidence supporting iron supplementation in anaemia during pregnancy].

    Science.gov (United States)

    Wiegerinck, Melanie M; Mol, Ben Willem J

    2012-01-01

    The Royal Dutch Organization of Midwives (KNOV) recently presented their practice guideline 'Anaemia in midwifery practice'. The guideline identified available evidence on diagnosis, prognosis and treatment of anaemia in pregnancy. Anaemia based on iron deficiency and subsequent treatment with iron supplementation are probably the most frequent aspects of care for pregnant women. However, there is surprisingly enough no evidence of the efficacy of iron supplementation treatment on relevant clinical outcomes in pregnant women with anaemia. We plead to make the next guideline a multidisciplinary one. Such a guideline may lead to a large pragmatic trial evaluating the efficacy of iron supplementation treatment for patients with anaemia.

  17. Report of Apollo 204 Review Board to the Administrator, National Aeronautics and Space Administration . Appendix F ; Schedule of Physical Evidence

    Science.gov (United States)

    1967-01-01

    Immediately following the Apollo 204 accident of January 27, 1961. all associated equipment and material were impounded. Release of this equipment and material for normal use was under the close control of the Apollo 204 Review Board. Apollo Review Board Administrative Procedure No. 11, February 11, 1961, established the Apollo 204 Review Board Material Release Record (MRR). This MRR was the official form used to release material from full impoundment and was valid only after being approved by the Board and signed by a Member. The form was used as the authority to place any impounded item into one of the three Categories defined in Administrative Procedure No. 11. This appendix contains all of the authorized MRR's. Each item submitted on an MRR was given a control number; a description, including the part number and serial number; the relevance and location to the accident; any constraints before release; and the control category. The categories placed on the equipment were as follows: Category A - Items which may have a significant influence or bearing on the results or findings of the Apollo 204 Review Board; Category B - All material other than Category A which is considered relevant to the Apollo 204 Review Board investigation; Category C - Material released from Board jurisdiction. Several classes of equipment were released by special Board action prior to the establishment of the MRR system. The operating procedure for release of these classes is Enclosure F-l to this appendix.

  18. IDRC evidence and innovation supports India's adaptation to climate ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2018-02-23

    Feb 23, 2018 ... (South Asia Consortium for Interdisciplinary Water Resources Studies, $536,500) ... The project seeks to improve the management of heat stress risks in India by ... It is expected to support at least 20 early-career researchers, train 30 officials from ... (Indian Institute for Human Settlements, $3,276,920).

  19. Evidence on Tips for Supporting Reading Skills at Home

    Science.gov (United States)

    What Works Clearinghouse, 2018

    2018-01-01

    This document begins by providing four tips parents and care takers can use to supporting childrens' reading skills at home: (1) Have conversations before, during, and after reading together; (2) Help children learn how to break sentences into words and words into syllables; (3) Help children sound out words smoothly; and (4) Model reading…

  20. How to support action prediction: Evidence from human coordination tasks

    DEFF Research Database (Denmark)

    Vesper, Cordula

    2014-01-01

    When two or more people perform actions together such as shaking hands, playing ensemble music or carrying an object together, they often naturally adjust the spatial and temporal parameters of their movements to facilitate smooth task performance. This paper reviews recent findings from experime......”) might be a useful approach also for robotic systems to assist human users, thereby reducing cognitive load and flexibly supporting the acquisition of new skills....

  1. The care unit in nursing home research: evidence in support of a definition.

    Science.gov (United States)

    Estabrooks, Carole A; Morgan, Debra G; Squires, Janet E; Boström, Anne-Marie; Slaughter, Susan E; Cummings, Greta G; Norton, Peter G

    2011-04-14

    Defining what constitutes a resident care unit in nursing home research is both a conceptual and practical challenge. The aim of this paper is to provide evidence in support of a definition of care unit in nursing homes by demonstrating: (1) its feasibility for use in data collection, (2) the acceptability of aggregating individual responses to the unit level, and (3) the benefit of including unit level data in explanatory models. An observational study design was used. Research (project) managers, healthcare aides, care managers, nursing home administrators and directors of care from thirty-six nursing homes in the Canadian prairie provinces of Alberta, Saskatchewan and Manitoba provided data for the study. A definition of care unit was developed and applied in data collection and analyses. A debriefing session was held with research managers to investigate their experiences with using the care unit definition. In addition, survey responses from 1258 healthcare aides in 25 of the 36 nursing homes in the study, that had more than one care unit, were analyzed using a multi-level modeling approach. Trained field workers administered the Alberta Context Tool (ACT), a 58-item self-report survey reflecting 10 organizational context concepts, to healthcare aides using computer assisted personal interviews. To assess the appropriateness of obtaining unit level scores, we assessed aggregation statistics (ICC(1), ICC(2), η², and ω²), and to assess the value of using the definition of unit in explanatory models, we performed multi-level modeling. In 10 of the 36 nursing homes, the care unit definition developed was used to align the survey data (for analytic purposes) to specific care units as designated by our definition, from that reported by the facility administrator. The aggregation statistics supported aggregating the healthcare aide responses on the ACT to the realigned unit level. Findings from the multi-level modeling further supported unit level aggregation. A

  2. Evidence supporting product standards for carcinogens in smokeless tobacco products.

    Science.gov (United States)

    Hatsukami, Dorothy K; Stepanov, Irina; Severson, Herb; Jensen, Joni A; Lindgren, Bruce R; Horn, Kimberly; Khariwala, Samir S; Martin, Julia; Carmella, Steven G; Murphy, Sharon E; Hecht, Stephen S

    2015-01-01

    Smokeless tobacco products sold in the United States vary significantly in yields of nicotine and tobacco-specific nitrosamines (TSNA). With the passage of the Family Smoking Prevention and Tobacco Control Act, the Food and Drug Administration now has the authority to establish product standards. However, limited data exist determining the relative roles of pattern of smokeless tobacco use versus constituent levels in the smokeless tobacco product in exposure of users to carcinogens. In this study, smokeless tobacco users of brands varying in nicotine and TSNA content were recruited from three different regions in the U.S. Participants underwent two assessment sessions. During these sessions, demographic and smokeless tobacco use history information along with urine samples to assess biomarkers of exposure and effect were collected. During the time between data collection, smokeless tobacco users recorded the amount and duration of smokeless tobacco use on a daily basis using their diary cards. Results showed that independent of pattern of smokeless tobacco use and nicotine yields, levels of TSNA in smokeless tobacco products played a significant role in carcinogen exposure levels. Product standards for reducing levels of TSNA in smokeless tobacco products are necessary to decrease exposure to these toxicants and potentially to reduce risk for cancer. ©2014 American Association for Cancer Research.

  3. Evidence for Evolution as Support for Big Bang

    Science.gov (United States)

    Gopal-Krishna

    1997-12-01

    With the exception of ZERO, the concept of BIG BANG is by far the most bizarre creation of the human mind. Three classical pillars of the Big Bang model of the origin of the universe are generally thought to be: (i) The abundances of the light elements; (ii) the microwave back-ground radiation; and (iii) the change with cosmic epoch in the average properties of galaxies (both active and non-active types). Evidence is also mounting for redshift dependence of the intergalactic medium, as discussed elsewhere in this volume in detail. In this contribution, I endeavour to highlight a selection of recent advances pertaining to the third category. The widely different levels of confidence in the claimed observational constraints in the field of cosmology can be guaged from the following excerpts from two leading astrophysicists: "I would bet odds of 10 to 1 on the validity of the general 'hot Big Bang' concept as a description of how our universe has evolved since it was around 1 sec. old" -M. Rees (1995), in 'Perspectives in Astrophysical Cosmology' CUP. "With the much more sensitive observations available today, no astrophysical property shows evidence of evolution, such as was claimed in the 1950s to disprove the Steady State theory" -F. Hoyle (1987), in 'Fifty years in cosmology', B. M. Birla Memorial Lecture, Hyderabad, India. The burgeoning multi-wavelength culture in astronomy has provided a tremendous boost to observational cosmology in recent years. We now proceed to illustrate this with a sequence of examples which reinforce the picture of an evolving universe. Also provided are some relevant details of the data used in these studies so that their scope can be independently judged by the readers.

  4. An empowerment framework for nursing leadership development: supporting evidence.

    Science.gov (United States)

    Macphee, Maura; Skelton-Green, Judith; Bouthillette, France; Suryaprakash, Nitya

    2012-01-01

    This article is a report on a descriptive study of nurse leaders' perspectives of the outcomes of a formal leadership programme. Effective nurse leaders are necessary to address complex issues associated with healthcare systems reforms. Little is known about the types of leadership development programmes that most effectively prepare nurse leaders for healthcare challenges. When nurse leaders use structural and psychological empowerment strategies, the results are safer work environments and better nurse outcomes. The leadership development programme associated with this study is based on a unifying theoretical empowerment framework to empower nurse leaders and enable them to empower others. Twenty seven front-line and mid-level nurse leaders with variable years of experience were interviewed for 1 year after participating in a formal leadership development programme. Data were gathered in 2008-2009 from four programme cohorts. Four researchers independently developed code categories and themes using qualitative content analysis. Evidence of leadership development programme empowerment included nurse leader reports of increased self-confidence with respect to carrying out their roles and responsibilities; positive changes in their leadership styles; and perceptions of staff recognition of positive stylistic changes. Regardless of years of experience, mid-level leaders had a broader appreciation of practice environment issues than front-line leaders. Time for reflection was valuable to all participants, and front-line leaders, in particular, appreciated the time to discuss nurse-specific issues with their colleagues. This study provides evidence that a theoretical empowerment framework and strategies can empower nurse leaders, potentially resulting in staff empowerment. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  5. The Generational Divide in Support for Environmental Policies. European Evidence

    International Nuclear Information System (INIS)

    Hersch, J.; Viscusi, W.K.

    2006-01-01

    This article examines age variations in support for environmental protection policies that affect climate change using a sample of over 14,000 respondents to a 1999 Eurobarometer survey. There is a steady decline with age in whether respondents are willing to incur higher gasoline prices to protect the environment. This relationship remains after controlling for socioeconomic characteristics. There are age-related differences in information about environmental risks, information sources about the environment, perceived health risks from climate change, and degree of worry about climate change. However, taking these factors into account does not eliminate the age variation in willingness to pay more for gasoline to protect the environment

  6. The Generational Divide in Support for Environmental Policies. European Evidence

    Energy Technology Data Exchange (ETDEWEB)

    Hersch, J. [Adjunct Professor of Law, Harvard Law School, Cambridge, MA 02138 (United States); Viscusi, W.K. [Cogan Professor of Law and Economics, Harvard Law School, Cambridge, MA 02138 (United States)

    2006-07-15

    This article examines age variations in support for environmental protection policies that affect climate change using a sample of over 14,000 respondents to a 1999 Eurobarometer survey. There is a steady decline with age in whether respondents are willing to incur higher gasoline prices to protect the environment. This relationship remains after controlling for socioeconomic characteristics. There are age-related differences in information about environmental risks, information sources about the environment, perceived health risks from climate change, and degree of worry about climate change. However, taking these factors into account does not eliminate the age variation in willingness to pay more for gasoline to protect the environment.

  7. How to support action prediction: Evidence from human coordination tasks

    DEFF Research Database (Denmark)

    Vesper, Cordula

    2014-01-01

    When two or more people perform actions together such as shaking hands, playing ensemble music or carrying an object together, they often naturally adjust the spatial and temporal parameters of their movements to facilitate smooth task performance. This paper reviews recent findings from experime......When two or more people perform actions together such as shaking hands, playing ensemble music or carrying an object together, they often naturally adjust the spatial and temporal parameters of their movements to facilitate smooth task performance. This paper reviews recent findings from......”) might be a useful approach also for robotic systems to assist human users, thereby reducing cognitive load and flexibly supporting the acquisition of new skills....

  8. Implementation of evidence-based supported employment in regional Australia.

    Science.gov (United States)

    Morris, Adrienne; Waghorn, Geoffrey; Robson, Emma; Moore, Lyndell; Edwards, Emma

    2014-06-01

    To implement the Individual Placement and Support (IPS) approach at 4 locations in regional New South Wales, Australia. Outcomes attained were compared with a national non-IPS program and with international trials of IPS within and outside the United States. Four IPS programs were established through formal partnerships between mental health services and disability employment services. Ninety-five mental health service clients commenced employment assistance and were tracked for a minimum of 12 months. Two sites achieved good fidelity to IPS principles, and 2 sites achieved fair fidelity. IPS clients had 3.5 times greater odds of attaining 13 weeks' employment than those receiving assistance in the national network of disability employment services. Implementing IPS is challenging in the Australian service delivery context. Factors other than program fidelity appear to contribute to excellent employment outcomes. Further research is needed to identify these factors.

  9. Supporting the education evidence portal via text mining

    Science.gov (United States)

    Ananiadou, Sophia; Thompson, Paul; Thomas, James; Mu, Tingting; Oliver, Sandy; Rickinson, Mark; Sasaki, Yutaka; Weissenbacher, Davy; McNaught, John

    2010-01-01

    The UK Education Evidence Portal (eep) provides a single, searchable, point of access to the contents of the websites of 33 organizations relating to education, with the aim of revolutionizing work practices for the education community. Use of the portal alleviates the need to spend time searching multiple resources to find relevant information. However, the combined content of the websites of interest is still very large (over 500 000 documents and growing). This means that searches using the portal can produce very large numbers of hits. As users often have limited time, they would benefit from enhanced methods of performing searches and viewing results, allowing them to drill down to information of interest more efficiently, without having to sift through potentially long lists of irrelevant documents. The Joint Information Systems Committee (JISC)-funded ASSIST project has produced a prototype web interface to demonstrate the applicability of integrating a number of text-mining tools and methods into the eep, to facilitate an enhanced searching, browsing and document-viewing experience. New features include automatic classification of documents according to a taxonomy, automatic clustering of search results according to similar document content, and automatic identification and highlighting of key terms within documents. PMID:20643679

  10. Evidence of co-production in public service provision: the case of the administrative arbitration centre in Portugal

    Directory of Open Access Journals (Sweden)

    Hugo Consciência Silvestre

    Full Text Available Abstract Co-production includes all actions where citizens assist, as volunteers, in the provision of services by public agencies in order to increase the efficiency and efficacy of the public services provided. This practice, known as co-production, is being adopted by governments in the resolution of conflicts, particularly those regarding administrative and fiscal matters. However, is co-production a more efficient and effective way of settling disputes in administrative and tax areas than the traditional administrative model? And why? In Portugal, the Administrative Arbitration Centre was created in 2009 with the aim of resolving disputes between public administration and taxpayers/service users by means of co-production. The available data support the thesis that efficiency and efficacy are higher under the co-production model. Nevertheless, users are not totally satisfied since the costs associated with the use of this service provision model are also higher.

  11. Evidence for The Domains Supporting The Construct of Intrinsic Capacity.

    Science.gov (United States)

    Cesari, Matteo; Araujo de Carvalho, Islene; Amuthavalli Thiyagarajan, Jotheeswaran; Cooper, Cyrus; Martin, Finbarr C; Reginster, Jean-Yves; Vellas, Bruno; Beard, John R

    2018-02-02

    Healthy ageing can be defined as "the process of developing and maintaining the functional ability that enables wellbeing in older age". Functional ability (i.e., the health-related attributes that enable people to be and to do what they have reason to value) is determined by intrinsic capacity (i.e., the composite of all the physical and mental capacities of an individual), the environment (i.e., all the factors in the extrinsic world that form the context of an individual's life), and the interactions between the two. This innovative model recently proposed by the World Health Organization has the potential to substantially modify the way in which clinical practice is currently conducted, shifting from disease-centered towards function-centered paradigms. By overcoming the multiple limitations affecting the construct of disease, this novel framework may allow the worldwide dissemination of a more proactive and function-based approach towards achieving optimal health status.In order to facilitate the translation of the current theoretical model into practice, it is important to identify the inner nature of its constituting constructs. In this paper, we consider intrinsic capacity. Using the International Classification of Functioning, Disability and Health (ICF) framework as background and taking into account available evidence, five domains (i.e., locomotion, vitality, cognition, psychological, sensory) are identified as pivotal for capturing the individual's intrinsic capacity (and therefore also reserves) and, through this, pave the way for its objective measurement. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Automatic evidence quality prediction to support evidence-based decision making.

    Science.gov (United States)

    Sarker, Abeed; Mollá, Diego; Paris, Cécile

    2015-06-01

    Evidence-based medicine practice requires practitioners to obtain the best available medical evidence, and appraise the quality of the evidence when making clinical decisions. Primarily due to the plethora of electronically available data from the medical literature, the manual appraisal of the quality of evidence is a time-consuming process. We present a fully automatic approach for predicting the quality of medical evidence in order to aid practitioners at point-of-care. Our approach extracts relevant information from medical article abstracts and utilises data from a specialised corpus to apply supervised machine learning for the prediction of the quality grades. Following an in-depth analysis of the usefulness of features (e.g., publication types of articles), they are extracted from the text via rule-based approaches and from the meta-data associated with the articles, and then applied in the supervised classification model. We propose the use of a highly scalable and portable approach using a sequence of high precision classifiers, and introduce a simple evaluation metric called average error distance (AED) that simplifies the comparison of systems. We also perform elaborate human evaluations to compare the performance of our system against human judgments. We test and evaluate our approaches on a publicly available, specialised, annotated corpus containing 1132 evidence-based recommendations. Our rule-based approach performs exceptionally well at the automatic extraction of publication types of articles, with F-scores of up to 0.99 for high-quality publication types. For evidence quality classification, our approach obtains an accuracy of 63.84% and an AED of 0.271. The human evaluations show that the performance of our system, in terms of AED and accuracy, is comparable to the performance of humans on the same data. The experiments suggest that our structured text classification framework achieves evaluation results comparable to those of human performance

  13. Nurses' perspectives on how an e-message system supports cross-sectoral communication in relation to medication administration

    DEFF Research Database (Denmark)

    Foged, Signe; Nørholm, Vibeke; Andersen, Ove

    2018-01-01

    AIMS AND OBJECTIVES: The aim was to describe nurses' perspectives on how an e-message system supports communication between hospital and home care nurses in relation to medication administration. BACKGROUND: Medication administration is a complex process involving a high risk of error. Unclear......: The e-message system did not provide the information needed by the home care nurses to ensure safe medication administration after discharge due to (a) limitations of the system, (b) hospital nurses' lack of knowledge about home care nurses' information needs, and (c) hospital nurses' lack of access...... safe medication administration; however, the e-message system did not support exchange of the information needed. This article is protected by copyright. All rights reserved....

  14. What evidence and support do state-level public health practitioners need to address obesity prevention.

    Science.gov (United States)

    Leeman, Jennifer; Teal, Randall; Jernigan, Jan; Reed, Jenica Huddleston; Farris, Rosanne; Ammerman, Alice

    2014-01-01

    Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. APPROACH OR DESIGN: Mixed-methods, cross-sectional interviews, and survey. State-level public health obesity prevention programs. Public health practitioners and CDC project officers. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

  15. Crisis Communication in the Spanish Public Administration: Organizational Culture and Empirical Evidence

    Directory of Open Access Journals (Sweden)

    Ismael Crespo

    2017-11-01

    Full Text Available Catastrophes, earthquakes, pandemics, epidemic diseases, emergencies and the disruption of basic services are just a few of the unpredictable events which show how rapidly crises can develop and how important it is for governments and public administrations to manage their crisis communication effectively.Experience from national crises (the politics behind the Ebola crisis, Lorca earthquake, the neighborhood movement of Gamonal in Burgos, the unauthorized strike by air traffic controllers in 2010 or the train crash in Angrois shows that effective communication requires extensive preparation and this article presents one of the first empirical works on the crisis communication of public administrations in Spain.This research aims to describe the state of the practice of crisis communication in the different levels of the Spanish Public Administration (State, Autonomous Communities and municipalities, based on the perceptions of its workers. To achieve this objective, a poll study was developed, with references to crisis cases managed by the Spanish Public Administration.

  16. The U.S. Federal Highway Administration winter Maintenance Decision Support System (MDSS) project

    Energy Technology Data Exchange (ETDEWEB)

    Pisano, P.A. [Federal Highway Administration, Road Weather Managment Program, Washington, D.C. (United States); Stern, A.D. [Mitretek Systems, Inc., Oceanic, Atmospheric and Space Systems, Falls Church, VA (United States); Mahoney, W.P. [National Center for Atmospheric Research, Research Applications Program, Boulder, CO (United States)

    2004-07-01

    Managing a winter maintenance program today is an increasingly complex endeavor. Just making sure that a plow blade is at the ready when the first flake falls is only a small part of the task. With tight budgets and the high expectation of the public for keeping roads clear of snow and ice, today's maintenance manager has to be able to handle multiple tasks or risk getting behind the onslaught of winter weather. Good information leads to effective practices, however all of the regulations concerning chemical applications, environmental impacts and multiple, often contradictory weather forecasts can lead to information overload. The United States Department of Transportation (DOT), Federal Highway Administration (FHWA) recognized this potential problem in the late 1990's as part of its Road Weather Management (RWM) program. Generally speaking, there were plenty of weather forecasts, along with a few companies that issued road-specific forecasts, but there was a lack of linkage between the information available and the decisions made by winter maintenance managers. It was this weak link that became the genesis for the winter Maintenance Decision Support System (MDSS). The MDSS has since matured into a functional prototype. During the winter of 2002-2003, the prototype was deployed at several maintenance garages in central Iowa for a field demonstration. This paper will document the implementation of the demonstration, a summary of lessons learned, and technology transfer activities. It will also describe plans for a longer, more comprehensive demonstration during the winter of 2003-2004. (orig.)

  17. Organizational Supports for Research Evidence Use in State Public Health Agencies: A Latent Class Analysis.

    Science.gov (United States)

    Hu, Hengrui; Allen, Peg; Yan, Yan; Reis, Rodrigo S; Jacob, Rebekah R; Brownson, Ross C

    2018-05-30

    Use of research evidence in public health decision making can be affected by organizational supports. Study objectives are to identify patterns of organizational supports and explore associations with research evidence use for job tasks among public health practitioners. In this longitudinal study, we used latent class analysis to identify organizational support patterns, followed by mixed logistic regression analysis to quantify associations with research evidence use. The setting included 12 state public health department chronic disease prevention units and their external partnering organizations involved in chronic disease prevention. Chronic disease prevention staff from 12 US state public health departments and partnering organizations completed self-report surveys at 2 time points, in 2014 and 2016 (N = 872). Latent class analysis was employed to identify subgroups of survey participants with distinct patterns of perceived organizational supports. Two classify-analyze approaches (maximum probability assignment and multiple pseudo-class draws) were used in 2017 to investigate the association between latent class membership and research evidence use. The optimal model identified 4 latent classes, labeled as "unsupportive workplace," "low agency leadership support," "high agency leadership support," and "supportive workplace." With maximum probability assignment, participants in "high agency leadership support" (odds ratio = 2.08; 95% CI, 1.35-3.23) and "supportive workplace" (odds ratio = 1.74; 95% CI, 1.10-2.74) were more likely to use research evidence in job tasks than "unsupportive workplace." The multiple pseudo-class draws produced comparable results with odds ratio = 2.09 (95% CI, 1.31-3.30) for "high agency leadership support" and odds ratio = 1.74 (95% CI, 1.07-2.82) for "supportive workplace." Findings suggest that leadership support may be a crucial element of organizational supports to encourage research evidence use. Organizational supports such

  18. Supporting Families of Young Children with Disabilities: Examining the Role of Administrative Structures

    Science.gov (United States)

    Epley, Pamela; Gotto, George S., IV; Summers, Jean Ann; Brotherson, Mary Jane; Turnbull, Ann P.; Friend, Anna

    2010-01-01

    This article presents findings from two early intervention agencies examining how administrative structures affect providers' ability to serve families of young children with disabilities. Based on previous research identifying three administrative structures (i.e., vision/leadership, organizational climate, and resources), this article…

  19. Evidence-Based Literacy Support: The "Literacy Octopus" Trial. Evaluation Report and Executive Summary

    Science.gov (United States)

    Lord, Pippa; Rabiasz, Adam; Roy, Palak; Harland, Jennie; Styles, Ben; Fowler, Katherine

    2017-01-01

    The Evidence-based Literacy Support-"Literacy Octopus" Trial tested a range of dissemination interventions and resources, all of which aimed to engage schools in using evidence-based materials to improve teaching and learning in Key Stage 2 literacy. Four delivery partners provided interventions. These included light-touch,…

  20. Supporting Implementation of Evidence-Based Practices through Practice-Based Coaching

    Science.gov (United States)

    Snyder, Patricia A.; Hemmeter, Mary Louise; Fox, Lise

    2015-01-01

    In active implementation science frameworks, coaching has been described as an important competency "driver" to ensure evidence-based practices are implemented as intended. Empirical evidence also has identified coaching as a promising job-embedded professional development strategy to support implementation of quality teaching practices.…

  1. Is the evidence supporting dental procedures strong? A survey of Cochrane systematic reviews in oral health.

    Science.gov (United States)

    Faggion, Clovis Mariano

    2012-09-01

    Every day a large number and variety of dental procedures are performed in clinical dental practice. There is, however, no information on the overall quality of evidence supporting these procedures. The objective of this study was to assess whether several common dental procedures are based on sound evidence. All Cochrane systematic reviews (CSR) published in dentistry were surveyed. The authors' conclusions about the quality of evidence supporting a specific clinical treatment were used as the measure of outcome. The evidence was considered adequate if the authors did not clearly state the evidence was weak in the conclusions while also suggesting some evidence of the effectiveness of the therapy. Of 120 CSRs assessed, in only 26 (22.0% of the reviews) was the quality of evidence regarded as adequate for supporting clinical decisions, although some methodological limitations were identified in the full text of these reviews. Moreover, the authors of most reviews reported weak or unavailable evidence. On the basis of CSRs, the overall quality of evidence can be regarded as low or nonexistent for most of the dental procedures assessed. The information reported may guide future research. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Examining the Feasibility and Impact of a Graduate Public Administration Course in Evidence-Informed Policy

    Science.gov (United States)

    Ouimet, Mathieu; Lapointe, Luc; Léon, Grégory

    2015-01-01

    A pilot controlled before-and-after design was used to assess the impact of a new master-level course in evidence-informed policy making on students' basic knowledge in evidence-based practice. The primary outcome variable was the mean percentage of pre-post improvement on the knowledge test. In the treatment group, the mean percentage of pre-post…

  3. The relationship between child health, developmental gaps, and parental education : Evidence from administrative data

    NARCIS (Netherlands)

    Salm, M.; Schunk, D.

    2012-01-01

    We use administrative German data to examine the role of physical and mental health conditions in explaining developmental gaps between children whose parents have different educational levels. Specifically, we employ sibling fixed effect models to estimate the effect of a comprehensive list of

  4. Administrator and Faculty Perceptions of Institutional Support for Online Education in Florida's College System

    Science.gov (United States)

    Thompson, Gerene M.

    2017-01-01

    Approximately 30% of Florida's college system (FCS) students are enrolled in distance learning courses (FLDOE, 2015). As FCS institutions continue to grow their online programs to meet demand, a lack of support from, and consensus among administrator and faculty stakeholders could undermine institutional efforts to sustain growth and quality…

  5. Supporting decision-making processes for evidence-based mental health promotion.

    Science.gov (United States)

    Jané-Llopis, Eva; Katschnig, Heinz; McDaid, David; Wahlbeck, Kristian

    2011-12-01

    The use of evidence is critical in guiding decision-making, but evidence from effect studies will be only one of a number of factors that will need to be taken into account in the decision-making processes. Equally important for policymakers will be the use of different types of evidence including implementation essentials and other decision-making principles such as social justice, political, ethical, equity issues, reflecting public attitudes and the level of resources available, rather than be based on health outcomes alone. This paper, aimed to support decision-makers, highlights the importance of commissioning high-quality evaluations, the key aspects to assess levels of evidence, the importance of supporting evidence-based implementation and what to look out for before, during and after implementation of mental health promotion and mental disorder prevention programmes.

  6. Proposal of a Holistic Model to Support Local-Level Evidence-Based Practice

    Directory of Open Access Journals (Sweden)

    Said Shahtahmasebi

    2010-01-01

    Full Text Available In response to a central drive for evidence-based practice, there have been many research support schemes, setups, and other practices concentrating on facilitating access to external research, such as the Centre for Evidence Based Healthcare Aotearoa, the Cochrane Collaboration, and the York Centre for Reviews and Dissemination. Very little attention has been paid to supporting internal research in terms of local evidence and internal research capabilities. The whole evidence-based practice movement has alienated internal decision makers and, thus, very little progress has been made in the context of evidence informing local policy formation. Health and social policies are made centrally based on dubious claims and often evidence is sought after implementation. For example, on record, most health care practitioners appear to agree with the causal link between depression and mental illness (sometimes qualified with other social factors with suicide; off the record, even some psychiatrists doubt that such a link is applicable to the population as a whole. Therefore, be it through misplaced loyalty or a lack of support for internal researchers/decision makers, local evidence informing local decision making may have been ignored in favour of external evidence. In this paper, we present a practical holistic model to support local evidence-based decision making. This approach is more relevant in light of a new approach to primary health care of “local knowledge” complementing external evidence. One possible outcome would be to network with other regional programmes around the world to share information and identify “best” practices, such as the “Stop Youth Suicide Campaign”(www.stopyouthsuicide.com.

  7. [Study of the occupational stress norm and it's application for the executive group and administrative support group].

    Science.gov (United States)

    Yang, Xin-wei; Wang, Zhi-ming; Jin, Tai-yi; Lan, Ya-jia

    2006-07-01

    A study of the occupational stress norm and it's application for the executive group and administrative support group. In this study, cross-sectional study method is used, and a synthetic way of sorting and randomized sampling is adopted to deal with research targets (263 executive group, 569 administrative support group). Descriptive statistics for OSI-R scale scores for the executive group, administrative support group were modulated. Scale raw score to T-score conversion tables derived from the OSI-R normative sample for executive group, administrative support group were established. OSI-R profile from for executive group, administrative support group were established. For the ORQ and PSQ scales, scores at or above 70 indicate a strong levels of maladaptive stress and strain. Score inthe range of 60 to 69 suggest middle levels of maladaptive stress and strain. Score in the range of 40 to 59 indicate normal levels of stress and strain. Score below 40 indicate a relative absence of occupational stress and strain. For the PRQ scales, score below 30 indicate a significant lack of coping resources. Score in the range of 30 to 39 suggest middle deficits in coping resources. Score in the range of 40 to 59 indicate average coping resources. Scores at or above 60 indicate a strong levels of coping resources. Based on occupational Stress norm, raw score to T-score conversion tables, OSI-R profile form and classification criterion, we could estimate the level of occupation stress, stressor, strain and coping resources in different occupation. In addition, we combined subjective and objective environment match model of occupational stress. The various individual and organizational intervention measures should be taken to reduce the occupational stress and to increase coping so as to improve the work ability.

  8. Evidence-informed health policy 2 – Survey of organizations that support the use of research evidence

    Directory of Open Access Journals (Sweden)

    Oxman Andrew D

    2008-12-01

    Full Text Available Abstract Background Previous surveys of organizations that support the development of evidence-informed health policies have focused on organizations that produce clinical practice guidelines (CPGs or undertake health technology assessments (HTAs. Only rarely have surveys focused at least in part on units that directly support the use of research evidence in developing health policy on an international, national, and state or provincial level (i.e., government support units, or GSUs that are in some way successful or innovative or that support the use of research evidence in low- and middle-income countries (LMICs. Methods We drew on many people and organizations around the world, including our project reference group, to generate a list of organizations to survey. We modified a questionnaire that had been developed originally by the Appraisal of Guidelines, Research and Evaluation in Europe (AGREE collaboration and adapted one version of the questionnaire for organizations producing CPGs and HTAs, and another for GSUs. We sent the questionnaire by email to 176 organizations and followed up periodically with non-responders by email and telephone. Results We received completed questionnaires from 152 (86% organizations. More than one-half of the organizations (and particularly HTA agencies reported that examples from other countries were helpful in establishing their organization. A higher proportion of GSUs than CPG- or HTA-producing organizations involved target users in the selection of topics or the services undertaken. Most organizations have few (five or fewer full-time equivalent (FTE staff. More than four-fifths of organizations reported providing panels with or using systematic reviews. GSUs tended to use a wide variety of explicit valuation processes for the research evidence, but none with the frequency that organizations producing CPGs, HTAs, or both prioritized evidence by its quality. Between one-half and two-thirds of organizations

  9. Public Hospital Spending in England: Evidence from National Health Service Administrative Records

    OpenAIRE

    Kelly, E.; Stoye, G.; Vera-Hernández, M.

    2016-01-01

    © 2016 The Authors. Fiscal Studies published by John Wiley & Sons Ltd. on behalf of Institute for Fiscal StudiesHealth spending per capita in England has almost doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the life cycle, and the concentration of spendi...

  10. Public hospital spending in England: Evidence from National Health Service administrative records

    OpenAIRE

    Kelly, Elaine; Stoye, George; Vera-Hernández, Marcos

    2015-01-01

    Health spending per capita in England has more than doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the lifecycle, and the concentration of spending among people and over time. We find that costs per person start to increase after age 50 and escalate after...

  11. Do Boys Benefit from Male Teachers in Elementary School? Evidence from Administrative Panel Data

    OpenAIRE

    Puhani, Patrick A.

    2017-01-01

    With girls having overtaken boys in many education indicators, the 'feminization' of elementary school teaching is causing debates about disadvantages for male students. Using administrative panel data on the universe of students, teachers and schools for a German state, I exploit within school and within teacher variation to determine teacher characteristics' effects on students' tracking outcomes. Germany tracks students at age 10 into more or less academic school types. I find hardly any e...

  12. District Central Office Leadership as Teaching: How Central Office Administrators Support Principals' Development as Instructional Leaders

    Science.gov (United States)

    Honig, Meredith I.

    2012-01-01

    Purpose: Research on educational leadership underscores the importance of principals operating as instructional leaders and intensive job-embedded supports for such work; this research also identifies central office staff as key support providers. However, it teaches little about what central office staff do when they provide such support and how…

  13. Twelve evidence-based principles for implementing self-management support in primary care.

    Science.gov (United States)

    Battersby, Malcolm; Von Korff, Michael; Schaefer, Judith; Davis, Connie; Ludman, Evette; Greene, Sarah M; Parkerton, Melissa; Wagner, Edward H

    2010-12-01

    Recommendations to improve self-management support and health outcomes for people with chronic conditions in primary care settings are provided on the basis of expert opinion supported by evidence for practices and processes. Practices and processes that could improve self-management support in primary care were identified through a nominal group process. In a targeted search strategy, reviews and meta-analyses were then identifed using terms from a wide range of chronic conditions and behavioral risk factors in combination with Self-Care, Self-Management, and Primary Care. On the basis of these reviews, evidence-based principles for self-management support were developed. The evidence is organized within the framework of the Chronic Care Model. Evidence-based principles in 12 areas were associated with improved patient self-management and/or health outcomes: (1) brief targeted assessment, (2) evidence-based information to guide shared decision-making, (3) use of a nonjudgmental approach, (4) collaborative priority and goal setting, (5) collaborative problem solving, (6) self-management support by diverse providers, (7) self-management interventions delivered by diverse formats, (8) patient self-efficacy, (9) active followup, (10) guideline-based case management for selected patients, (11) linkages to evidence-based community programs, and (12) multifaceted interventions. A framework is provided for implementing these principles in three phases of the primary care visit: enhanced previsit assessment, a focused clinical encounter, and expanded postvisit options. There is a growing evidence base for how self-management support for chronic conditions can be integrated into routine health care.

  14. Evidence Supporting Intralesional Stem Cell Therapy to Improve Equine Flexor Tendon Healing

    Directory of Open Access Journals (Sweden)

    Sushmitha Durgam

    2017-01-01

    Full Text Available Clinical bottom lineCurrent experimental evidence suggests that intralesional stem cell administration improves the histological characteristics and matrix organisation of healing equine superficial digital flexor tendons (SDFT; however, the clinical relevance of these findings are not clear. Current case-based evidence suggests that cell-based therapies improve the quality of tendon healing and reduce the recurrence rates of SDFT injuries but the lack of any randomised, controlled prospective studies with function-based outcomes is still concerning, given the widespread advocacy for and use of ‘stem cell’ therapies for the treatment of equine tendon injuries. 

  15. Small Business Administration Section 8 (A) Support Services Contracts at the Ballistic Missile Defense Organization

    National Research Council Canada - National Science Library

    1994-01-01

    ...%flc objectives were to determine whether the contract administration process and applicable internal controls were effective and whether costs charged to the contracts were allowable, reasonable, and allocable. In addition, we reviewed anonymous allegations sent to Senator David Pryor of fraud, waste, and abuse on CTI contracts with BMDO. We also reviewed internal controls applicable to the audit objectives.

  16. Soliciting Support for the American Public School: A Guide To Inform Administration and Educate Parents.

    Science.gov (United States)

    Nelson, Jeannette; Karr-Kidwell, PJ

    While teachers, administrators, and their schools are constantly being bombarded with demands for excellence, little attention has been paid to the role of parents to achieve high levels of learning with their children. An area of concern is the modeling parents can provide by placing high value on learning. Parents must become knowledgeable about…

  17. 76 FR 63509 - Small Business Size Standards: Administrative and Support, Waste Management and Remediation Services

    Science.gov (United States)

    2011-10-12

    ... Federal small business assistance, SBA establishes small business definitions (referred to as size... operated, (2) not dominant in its field of operation, and (3) within a specific small business definition... Vol. 76 Wednesday, No. 197 October 12, 2011 Part VI Small Business Administration 13 CFR Part 121...

  18. Supporting Fiscal Aspect of Land Administration through an LADM-based Valuation Information Model

    NARCIS (Netherlands)

    Kara, A.; Çağdaş, V.; Lemmen, C.H.J.; Işıkdağ, Ü.; van Oosterom, P.J.M.; Stubkjær, E.

    2018-01-01

    This paper presents an information system artifact for the fiscal aspect of land administration, a valuation information model for the specification of inventories or databases used in valuation for recurrently levied immovable property taxes. The information model is designed as an extension module

  19. School Transitions: A Qualitative Study of the Supports Provided by Washington State Special Education Administrators

    Science.gov (United States)

    Lewinsohn, Kari

    2013-01-01

    This study investigated the role of special education administrators in the transition planning process for children with disabilities ages 3-21 in selected Washington school districts. A basic qualitative study was selected to construct meaning from a described phenomenon. The study sought to identify and explain how special education…

  20. Assessing Confidence in Performance Assessments Using an Evidence Support Logic Methodology: An Application of Tesla

    International Nuclear Information System (INIS)

    Egan, M.; Paulley, A.; Lehman, L.; Lowe, J.; Rochette, E.; Baker, St.

    2009-01-01

    The assessment of uncertainties and their implications is a key requirement when undertaking performance assessment (PA) of radioactive waste facilities. Decisions based on the outcome of such assessments become translated into judgments about confidence in the information they provide. This confidence, in turn, depends on uncertainties in the underlying evidence. Even if there is a large amount of information supporting an assessment, it may be only partially relevant, incomplete or less than completely reliable. In order to develop a measure of confidence in the outcome, sources of uncertainty need to be identified and adequately addressed in the development of the PA, or in any overarching strategic decision-making processes. This paper describes a trial application of the technique of Evidence Support Logic (ESL), which has been designed for application in support of 'high stakes' decisions, where important aspects of system performance are subject to uncertainty. The aims of ESL are to identify the amount of uncertainty or conflict associated with evidence relating to a particular decision, and to guide understanding of how evidence combines to support confidence in judgments. Elicitation techniques are used to enable participants in the process to develop a logical hypothesis model that best represents the relationships between different sources of evidence to the proposition under examination. The aim is to identify key areas of subjectivity and other sources of potential bias in the use of evidence (whether for or against the proposition) to support judgments of confidence. Propagation algorithms are used to investigate the overall implications of the logic according to the strength of the underlying evidence and associated uncertainties. (authors)

  1. Is There Evidence to Support a Forefoot Strike Pattern in Barefoot Runners? A Review

    OpenAIRE

    Lorenz, Daniel S.; Pontillo, Marisa

    2012-01-01

    Context: Barefoot running is a trend among running enthusiasts that is the subject of much controversy. At this time, benefits appear to be more speculative and anecdotal than evidence based. Additionally, the risk of injuries is not well established. Evidence acquisition: A PubMed search was undertaken for articles published in English from 1980 to 2011. Additional references were accrued from reference lists of research articles. Results: While minimal data exist that definitively support b...

  2. Staff views on supporting evidence based practice for children with ASD.

    Science.gov (United States)

    Trembath, David; Sulek, Rhylee; Paynter, Jessica; Simpson, Kate; Keen, Deb

    2017-11-22

    A variety of empirically supported interventions are available for children with autism spectrum disorder (ASD), but previous research suggests that their selection and use within an evidence-based practice (EBP) framework in clinical settings is challenging. To date, research has primarily focused on identifying individual, organisational, and contextual barriers to EBP rather than identifying collaborative solutions to these barriers through consultation with staff. The aim of our study was to explore staff views on supporting EBP in their work with children with ASD. We conducted five focus groups involving 29 professional (e.g., speech pathologists, teachers), paraprofessional (e.g., childcare workers), and managerial staff to explore their views. Audio recordings were transcribed verbatim and analysed using thematic analysis. Two central themes, comprising six categories, emerged to account for the participants' views. Initiative and Effort accounted for the range of creative strategies staff had developed to support their engagement in EBP. They also expressed the need for A Better Way involving organisational-wide support such as this engagement, including peer-to-peer mentoring. The findings suggest that an organisational-wide model to support engagement in EBP, with peer-to-peer mentoring at its foundation, may provide a desirable, ecologically valid, and acceptable model. Implications for Rehabilitation Clinicians and educators recognise the importance of evidence-based practice. Efforts to support evidence-based practice have focused mostly on access to research evidence. Clinicians and educators in this study were developing their own strategies based on intuition. They identified a need for organisation-wide approaches to supporting evidence-based practice. Peer-to-peer mentoring appears to be an acceptable and viable strategy.

  3. 24 CFR 17.4 - Administrative claim; evidence and information to be submitted.

    Science.gov (United States)

    2010-04-01

    ... bearing on either the responsibility of the United States for the death or the damages claimed. (c... information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed. (b) Death. In support of a claim based on death, the claimant may be required...

  4. Electronic Administration Styles and Their Determinants. Evidence from Spanish Local Governments

    Directory of Open Access Journals (Sweden)

    José Valeriano FRÍAS-ACEITUNO

    2014-02-01

    Full Text Available This paper analyzes the factors underlying the development of e-government, as an overall process, as well as of each of the three stages identified in the prior literature (e-government, egovernance and e-democracy. The analysis has focused on 102 Spanish municipalities, and it consists in a content analysis of their web pages, based on an information index, in order to develop a dependency model. The results obtained indicate that Spanish municipalities show high information transparency regarding economic, environmental and social matters, allowing the undertaking of administrative proceedings online and actively promoting the participation of interest groups in strategic, sustainable and managerial issues. Our findings stress the importance of the municipality’s size and the ruling party’s political ideology of a deeper commitment with the development of e-government.

  5. Nutritional support team vs nonteam management of enteral nutritional support in a Veterans Administration Medical Center teaching hospital.

    Science.gov (United States)

    Powers, D A; Brown, R O; Cowan, G S; Luther, R W; Sutherland, D A; Drexler, P G

    1986-01-01

    One hundred one patients receiving enteral nutritional support (ENS) by tube feeding during a 5-month period were prospectively studied. Fifty patients were managed by a nutritional support team (T) and 51 patients were managed by the nonteam approach (NT). Demographics, primary diagnosis, chronic diseases, medical service, calculated basal energy expenditure (BEE), duration of ENS, and final patient disposition were recorded. Enteral formula, formula modifications, results of laboratory tests and calories delivered were obtained daily. Results of nitrogen balance studies were obtained when available and each patient was monitored for pulmonary, mechanical, gastrointestinal, and metabolic abnormalities. No significant difference was found between the team and nonteam managed groups in regard to total feeding days, mean feeding days per patient, total laboratory tests, laboratory tests per patient or laboratory tests per day. Significantly more team patients attained 1.2 times BEE (T = 47, NT = 38, p less than 0.05) for a significantly greater period of time (T = 398 days, NT = 281 days, p less than 0.05). Significantly more team patients achieved a measured positive nitrogen balance than nonteam patients (T = 42, NT = 1, p less than 0.05). Formula modifications to correct nutritional or metabolic aberrations were made in 15 (30%) team patients and five (9.8%) nonteam patients (p less than 0.05). The number of individual abnormalities (pulmonary, mechanical, gastrointestinal, and metabolic), as well as total abnormalities occurring in the team-managed group, was significantly lower than in the nonteam managed group (160 vs 695, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Support for school-based obesity prevention efforts: attitudes among administrators at nationally representative samples of US elementary schools.

    Science.gov (United States)

    Turner, Lindsey; Slater, Sandy J; Chaloupka, Frank J

    2013-08-01

    With the continued threat of childhood obesity, many public health intervention efforts focus on school settings. The current study sought to document administrator attitudes regarding obesity and interest in improving relevant school practices (i.e., nutrition and physical activity) in elementary schools. Mail-back surveys were used to gather data from public and private elementary schools during the 2006-2007, 2007-2008, 2008-2009, and 2010-2011 school years. In each year, a different set of items pertaining to administrator attitudes was included. Numbers of responding schools annually ranged from 259 to 336 private schools, and from 578 to 748 public schools. The vast majority of elementary school administrators (>90%) agreed that schools can play a role in addressing childhood obesity, physical education improves a variety of academic outcomes, and they were interested in improving practices at their school. Concern about childhood obesity and perceiving that schools can play a role in addressing obesity were both associated with more interest in improving school practices. However, only one-third of administrators agreed that parents were interested in participating in improving nutrition and physical activity practices, suggesting opportunities for efforts to improve collaboration. Administrators are generally very supportive of school-based efforts to improve nutrition and physical activity practices and see the value in doing so. Given the amount of time children spend in school, schools are an essential venue for efforts to address childhood obesity.

  7. Exploring Nurse Manager Support of Evidence-Based Practice: Clinical Nurse Perceptions.

    Science.gov (United States)

    Caramanica, Laura; Spiva, LeeAnna

    2018-05-01

    The study identifies what constitutes nurse manager (NM) support and other resources that enable clinical nurses (CNs) to engage in evidence-based practice (EBP). Clinical nurses report that NM support enables them to use EBP but what constitutes NM support is still unclear. Nurse managers, CNs, and EBP mentors received specialized education and use a team approach for EBP. Data were collected preintervention, mid-intervention, and postintervention from observations, interviews, journaling, and surveys. Results demonstrate how NMs can perform their role responsibilities and still engage CNs to develop a spirit of inquiry, seek answers to their clinical questions using EBP, and advance their clinical performance to improve patient outcomes. Four NM supportive behaviors emerged: cultivating a shared EBP vision, ensuring use of EBP, communicating the value of EBP, and providing resources for EBP. Through education and support, NMs describe supportive behaviors necessary for the successful conduction of EBP by CNs.

  8. A description of pharmacological analgesia administration by public sector advanced life support paramedics in the City of Cape Town

    Directory of Open Access Journals (Sweden)

    Ryan Matthews

    2017-03-01

    Discussion: Pre-hospital acute pain management in the Western Cape does not appear to conform to best practice as Advanced Life Support providers in the Western Cape use low doses of morphine. Chest pain is an important reason for drug administration in acute pre-hospital pain. Multimodal analgesia is not a feature of care in this pre-hospital service. The development of a Clinical Practice Guideline for and training in pre-hospital pain should be viewed as imperative.

  9. ARRA FEMP Technical Assistance -- Federal Aviation Administration Project 209 -- Control Tower and Support Building, Palm Springs, CA

    Energy Technology Data Exchange (ETDEWEB)

    Arends, J.; Sandusky, William F.

    2010-03-31

    This report represents findings of a design review team that evaluated construction documents (at the 100% level) and operating specifications for a new control tower and support building that will be built in Palm Springs, California by the Federal Aviation Administration (FAA). The focus of the review was to identify measures that could be incorporated into the final design and operating specifications that would result in additional energy savings for the FAA that would not have otherwise occurred.

  10. Are advertisements in dental journals supported by an appropriate evidence-base?

    Science.gov (United States)

    Chestnutt, Ivor G; Hardy, Robert

    2013-09-01

    Dental professionals are constantly exposed to advertisements in the dental literature. These promote products, either for use in the operatory or to recommend to patients. In an era of evidence-based practice, what references are provided to support claims made by the advertisers? This study aimed to determine if advertisements in four major dental journals, whose target audience is general dental practitioners, were supported by an appropriate evidence-base, readily accessible to readers. The 2010 printed volumes of the Australian Dental Journal, British Dental Journal, Dental Update and the Journal of the American Dental Association were hand searched to identify advertisements which made a claim of clinical benefit or superiority to competing products. Advertisements were categorized according to type of product being promoted and the availability, nature and number of any supporting references was recorded. Repeated advertisements were analyzed only once. A total of 390 advertisements were identified and 369 made a claim of benefit or superiority. When the 222 duplicates of the same advertisement were removed, 147 unique advertisements remained. Of these: 54 (37%) were advertisements related to dental devices for in-surgery use; 44 (30%) for dental materials, and 27 (18%) for dentifrices/medicaments. 113 (76.9%) advertisements offered no evidential support for claims made. Of the 34 advertisements that provided evidential support, only 20 provided a complete reference that could readily be sourced by an interested reader: 15 articles in refereed journals; 5 data on file; 3 in-house studies and combinations thereof. Four references were not accessible due to incomplete referencing. Two advertisements provided evidence that was not relevant to the product being advertised. The majority of advertisements in the dental literature do not provide an adequate evidence-base, readily available to readers, to support the claims being made. If evidence-based practice is

  11. Evidence-informed health policy 4 – Case descriptions of organizations that support the use of research evidence

    Directory of Open Access Journals (Sweden)

    Oxman Andrew D

    2008-12-01

    Full Text Available Abstract Background Previous efforts to produce case descriptions have typically not focused on the organizations that produce research evidence and support its use. External evaluations of such organizations have typically not been analyzed as a group to identify the lessons that have emerged across multiple evaluations. Case descriptions offer the potential for capturing the views and experiences of many individuals who are familiar with an organization, including staff, advocates, and critics. Methods We purposively sampled a subgroup of organizations from among those that participated in the second (interview phase of the study and (once from among other organizations with which we were familiar. We developed and pilot-tested a case description data collection protocol, and conducted site visits that included both interviews and documentary analyses. Themes were identified from among responses to semi-structured questions using a constant comparative method of analysis. We produced both a brief (one to two pages written description and a video documentary for each case. Results We conducted 51 interviews as part of the eight site visits. Two organizational strengths were repeatedly cited by individuals participating in the site visits: use of an evidence-based approach (which was identified as being very time-consuming and existence of a strong relationship between researchers and policymakers (which can be challenged by conflicts of interest. Two organizational weaknesses – a lack of resources and the presence of conflicts of interest – were repeatedly cited by individuals participating in the site visits. Participants offered two main suggestions for the World Health Organization (and other international organizations and networks: 1 mobilize one or more of government support, financial resources, and the participation of both policymakers and researchers; and 2 create knowledge-related global public goods. Conclusion The findings from

  12. A plea for quality in internship programmes – evidence from the business and administration students’ experience

    Directory of Open Access Journals (Sweden)

    Goia Simona

    2017-03-01

    Full Text Available The career of business students is nowadays definitely influenced by their involvement in different internships and volunteering activities. The internship programmes help them understand the context of business organisations and decide what field of activity is most suitable for their professional life. However, sometimes internship programmes are not very well organised and influence in a negative manner students′ final perception of a certain domain. Our research identified and analysed the main factors that might influence the quality of an internship programme from students′ perspective. The quantitative analysis relies on a questionnaire based survey among over 450 students from one of the most prestigious universities in Romania in the field of economics and business administration. By running factor analysis, we identified five factors which mainly determine the quality of internships: Job arrangements, Mentorship and employability benefits, Learning content, Academic supervision, Bureaucracy and accessibility. Subsequently we measured through multiple regression the way the identified factors influence the quality of the internships. We consider that the results of the study are relevant not only for academics but also for students and business organisations that have the power and instruments to improve internship programmes and the entire experience for all stakeholders involved.

  13. Comparative water law, policies, and administration in Asia: Evidence from 17 countries

    Science.gov (United States)

    Araral, Eduardo; Yu, David J.

    2013-09-01

    Conventional wisdom suggests that improving water governance is the key to solving water insecurity in developing countries but there are also many disagreements on operational and methodological issues. In this paper, we build on the work of Saleth and Dinar and surveyed 100 water experts from 17 countries in Asia to compare 19 indicators of water laws, policies, and administration among and within countries from 2001 to 2010. We present the results of our study in a comparative dashboard and report how water governance indicators vary with a country's level of economic development, which ones do not and how and why some indicators change overtime in some countries. We have two main results. First, our initial findings suggest the possibility of water Kuznet's curve, i.e., certain water governance indicators vary with a country's level of economic development. However, more studies are needed given the caveats and limitations of our study. Second, the results have practical value for policy makers and researchers for benchmarking with other countries and tracking changes within their countries overtime. We conclude with implications for a second-generation research agenda on water governance.

  14. Evidence Supporting an Early as Well as Late Heavy Bombardment on the Moon

    Science.gov (United States)

    Frey, Herbert

    2015-01-01

    Evidence supporting an intense early bombardment on the Moon in addition to the traditional Late Heavy Bombardment at approx. 4 BY ago include the distribution of N(50) Crater Retention Ages (CRAs) for candidate basins, a variety of absolute age scenarios for both a "young" and an "old" Nectaris age, and the decreasing contrasts in both topographic relief and Bouguer gravity with increasing CRA.

  15. Brief Report: An Independent Replication and Extension of Psychometric Evidence Supporting the Theory of Mind Inventory

    Science.gov (United States)

    Greenslade, Kathryn J.; Coggins, Truman E.

    2016-01-01

    This study presents an independent replication and extension of psychometric evidence supporting the "Theory of Mind Inventory" ("ToMI"). Parents of 20 children with ASD (4; 1-6; 7 years; months) and 20 with typical development (3; 1-6; 5), rated their child's theory of mind abilities in everyday situations. Other parent report…

  16. A Scaffolding Framework to Support the Construction of Evidence-Based Arguments among Middle School Students

    Science.gov (United States)

    Belland, Brian R.; Glazewski, Krista D.; Richardson, Jennifer C.

    2008-01-01

    Problem-based learning (PBL) is an instructional approach in which students in small groups engage in an authentic, ill-structured problem, and must (1) define, generate and pursue learning issues to understand the problem, (2) develop a possible solution, (3) provide evidence to support their solution, and (4) present their solution and the…

  17. Democratic Values and Support for Militancy: Evidence from a National Survey of Pakistan

    Science.gov (United States)

    2011-06-14

    our survey provides prima facie evidence that this technique reduced respondents’ concerns about reporting sensitive information.18 That the...the empirical underpinnings of popular support for militancy, researchers have a duty to minimize risk to all survey participants and enumerators

  18. Analysis of Evidence Supporting the Educational Leadership Constituent Council 2011 Educational Leadership Program Standards

    Science.gov (United States)

    Tucker, Pamela D.; Anderson, Erin; Reynolds, Amy L.; Mawhinney, Hanne

    2016-01-01

    This document analysis provides a summary of the research from high-impact journals published between 2008 and 2013 with the explicit purpose of determining the extent to which the current empirical evidence supports the individual 2011 Educational Leadership Constituent Council Program Standards and their elements. We found that the standards are…

  19. Violence in Al-Zahra Hospital from the Viewpoint of Administrative Support Staff: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Mahmoud Keyvanara

    2015-10-01

    Conclusion: Considering the high prevalence of violence in hospitals and its adverse effects on the societies, organizations and individuals, necessary measures must be taken to diminish the occurrence of this problem, some of which include: increasing insurance coverage, changing physical structure of hospitals to increase security, limiting the entrance of individuals, making administrative processes more transparent, culture-making about terms of visiting and patient companionship, holding workshops on violence and proper relationship with patients and families and using experienced staff to interact with clients.

  20. Anhedonia to music and mu-opioids: Evidence from the administration of naltrexone

    Science.gov (United States)

    Mallik, Adiel; Chanda, Mona Lisa; Levitin, Daniel J.

    2017-01-01

    Music’s universality and its ability to deeply affect emotions suggest an evolutionary origin. Previous investigators have found that naltrexone (NTX), a μ-opioid antagonist, may induce reversible anhedonia, attenuating both positive and negative emotions. The neurochemical basis of musical experience is not well-understood, and the NTX-induced anhedonia hypothesis has not been tested with music. Accordingly, we administered NTX or placebo on two different days in a double-blind crossover study, and assessed participants’ responses to music using both psychophysiological (objective) and behavioral (subjective) measures. We found that both positive and negative emotions were attenuated. We conclude that endogenous opioids are critical to experiencing both positive and negative emotions in music, and that music uses the same reward pathways as food, drug and sexual pleasure. Our findings add to the growing body of evidence for the evolutionary biological substrates of music. PMID:28176798

  1. Characteristics of efficacy evidence supporting approval of supplemental indications for prescription drugs in United States, 2005-14: systematic review.

    Science.gov (United States)

    Wang, Bo; Kesselheim, Aaron S

    2015-09-23

    To characterize the types of comparators and endpoints used in efficacy trials for approvals of supplemental indications, compared with the data supporting these drugs' originally approved indications. Systematic review. Publicly accessible data on supplemental indications approved by the US Food and Drug Administration from 2005 to 2014. Types of comparators (active, placebo, historical, none) and endpoints (clinical outcomes, clinical scales, surrogate) in the efficacy trials for these drugs' supplemental and original indication approvals. The cohort included 295 supplemental indications. Thirty per cent (41/136) of supplemental approvals for new indications were supported by efficacy trials with active comparators, compared with 51% (47/93) of modified use approvals and 11% (7/65) of approvals expanding the patient population (Pindications, 30% (28/93) of modified indication approvals, and 22% (14/65) of expanded population approvals (P=0.29). Orphan drugs had supplemental approvals for 40 non-orphan indications, which were supported by similar proportions of trials using active comparators (28% (11/40) for non-orphan supplemental indications versus 24% (10/42) for original orphan indications; P=0.70) and clinical outcome endpoints (25% (10/40) versus 31% (13/42); P=0.55). Wide variations were seen in the evidence supporting approval of supplemental indications, with the fewest active comparators and clinical outcome endpoints used in trials leading to supplemental approvals that expanded the patient population. © Wang et al 2015.

  2. Will mass drug administration eliminate lymphatic filariasis? Evidence from northern coastal Tanzania.

    Science.gov (United States)

    Parker, Melissa; Allen, Tim

    2013-07-01

    This article documents understandings and responses to mass drug administration (MDA) for the treatment and prevention of lymphatic filariasis among adults and children in northern coastal Tanzania from 2004 to 2011. Assessment of village-level distribution registers, combined with self-reported drug uptake surveys of adults, participant observation and interviews, revealed that at study sites in Pangani and Muheza districts the uptake of drugs was persistently low. The majority of people living at these highly endemic locations either did not receive or actively rejected free treatment. A combination of social, economic and political reasons explain the low uptake of drugs. These include a fear of treatment (attributable, in part, to a lack of trust in international aid and a questioning of the motives behind the distribution); divergence between biomedical and local understandings of lymphatic filariasis; and limited and ineffective communication about the rationale for mass treatment. Other contributory factors are the reliance upon volunteers for distribution within villages and, in some locations, strained relationships between different groups of people within villages as well as between local leaders and government officials. The article also highlights a disjuncture between self-reported uptake of drugs by adults at a village level and the higher uptake of drugs recorded in official reports. The latter informs claims that elimination will be a possibility by 2020. This gives voice to a broader problem: there is considerable pressure for those implementing MDA to report positive results. The very real challenges of making MDA work are pushed to one side - adding to a rhetoric of success at the expense of engaging with local realities. It is vital to address the kind of issues raised in this article if current attempts to eliminate lymphatic filariasis in mainland coastal Tanzania are to achieve their goal.

  3. A Systematic Review of the Economic Evidence for Home Support Interventions in Dementia.

    Science.gov (United States)

    Clarkson, Paul; Davies, Linda; Jasper, Rowan; Loynes, Niklas; Challis, David

    2017-09-01

    Recent evidence signals the need for effective forms of home support to people with dementia and their carers. The cost-effectiveness evidence of different approaches to support is scant. To appraise economic evidence on the cost-effectiveness of home support interventions for dementia to inform future evaluation. A systematic literature review of full and partial economic evaluations was performed using the British National Health Service Economic Evaluation Database supplemented by additional references. Study characteristics and findings, including incremental cost-effectiveness ratios, when available, were summarized narratively. Study quality was appraised using the National Health Service Economic Evaluation Database critical appraisal criteria and independent ratings, agreed by two reviewers. Studies were located on a permutation matrix describing their mix of incremental costs/effects to aid decision making. Of the 151 articles retrieved, 14 studies met the inclusion criteria: 8 concerning support to people with dementia and 6 to carers. Five studies were incremental cost-utility analyses, seven were cost-effectiveness analyses, and two were cost consequences analyses. Five studies expressed incremental cost-effectiveness ratios as cost per quality-adjusted life-year (£6,696-£207,942 per quality-adjusted life-year). In four studies, interventions were dominant over usual care. Two interventions were more costly but more beneficial and were favorable against current acceptability thresholds. Occupational therapy, home-based exercise, and a carers' coping intervention emerged as cost-effective approaches for which there was better evidence. These interventions used environmental modifications, behavior management, physical activity, and emotional support as active components. More robust evidence is needed to judge the value of these and other interventions across the dementia care pathway. Copyright © 2017 International Society for Pharmacoeconomics and

  4. Work management administration FY 1995 site support program plan WBS 6.2

    Energy Technology Data Exchange (ETDEWEB)

    Hale, N.S.

    1994-09-01

    Westinghouse Hanford Company`s (WHC) near-term vision is to implement a Site-wide work management program that is consistent from one facility to the other, and can realize workforce efficiencies, minimum down time, and familiarization with facilities uniqueness. Additionally, consistent Hanford Site work management processes can produce meaningful information to be shared complex-wide as the US Department of Energy (DOE) cleans up facilities Site-wide. It is the mission of the WHC Work Management Administration Program to provide guidance and program direction on how to implement consistent and effective work management across the Hanford Site that comply with the DOE and other regulatory requirements. This report describes the steps needed to implement a work management plan at Hanford.

  5. Evidence-informed health policy 3 - interviews with the directors of organizations that support the use of research evidence.

    Science.gov (United States)

    Lavis, John N; Oxman, Andrew D; Moynihan, Ray; Paulsen, Elizabeth J

    2008-12-17

    Only a small number of previous efforts to describe the experiences of organizations that produce clinical practice guidelines (CPGs), undertake health technology assessments (HTAs), or directly support the use of research evidence in developing health policy (i.e., government support units, or GSUs) have relied on interviews and then only with HTA agencies. Interviews offer the potential for capturing experiences in great depth, particularly the experiences of organizations that may be under-represented in surveys. We purposively sampled organizations from among those who completed a questionnaire in the first phase of our three-phase study, developed and piloted a semi-structured interview guide, and conducted the interviews by telephone, audio-taped them, and took notes simultaneously. Binary or categorical responses to more structured questions were counted when possible. Themes were identified from among responses to semi-structured questions using a constant comparative method of analysis. Illustrative quotations were identified to supplement the narrative description of the themes. We interviewed the director (or his or her nominee) in 25 organizations, of which 12 were GSUs. Using rigorous methods that are systematic and transparent (sometimes shortened to 'being evidence-based') was the most commonly cited strength among all organizations. GSUs more consistently described their close links with policymakers as a strength, whereas organizations producing CPGs, HTAs, or both had conflicting viewpoints about such close links. With few exceptions, all types of organizations tended to focus largely on weaknesses in implementation, rather than strengths. The advice offered to those trying to establish similar organizations include: 1) collaborate with other organizations; 2) establish strong links with policymakers and stakeholders; 3) be independent and manage conflicts of interest; 4) build capacity; 5) use good methods and be transparent; 6) start small and

  6. Levers supporting program evaluation culture and capacity in Romanian public administration: The role of leadership

    OpenAIRE

    Cristina Mora; Raluca Antonie

    2012-01-01

    Program evaluation culture and capacity is at the very beginning of its development in Romania. In this article we highlight one of the fundamental, but not always obvious, connections that support sustainable evaluation culture and capacity building and development: the link between leadership and program evaluation. If properly used, program evaluation results can be a strong instrument in leadership, just as leadership can fundamentally encourage the development of evaluation culture and c...

  7. [Boundaries of the autonomy of local health administration: innovation, creativity and evidence-based decision-making].

    Science.gov (United States)

    Silva, Silvio Fernandes da; Souza, Nathan Mendes; Barreto, Jorge Otávio Maia

    2014-11-01

    The scope of this article was to identify the boundaries of the autonomy of local administration in the context of the federal pact in the Brazilian Unified Health System and the importance and potential for promoting innovation, creativity and evidence-based decision-making by local governments. The methodology used was to ask questions that favored dialogue with the specific literature to identify the influence of centrally-formulated policies in spaces of local autonomy and then to identify strategies to foster innovation, creativity and the systematic use of evidence-based research in health policy implementation. A gradual reduction in municipal decision-making autonomy was detected due to increased financial commitment of the municipalities resulting from responsibilities assumed, albeit with the possibility of reverting this trend in the more recent context. Some determinants and challenges for the dissemination of innovative practices were analyzed and some relevant national and international experiences in this respect were presented. The conclusion drawn is that it is possible to make local decision-making more effective provided that initiatives are consolidated to promote this culture and the formulation and implementation of evidence-based health policies.

  8. Food and Drug Administration process validation activities to support 99Mo production at Sandia National Laboratories

    International Nuclear Information System (INIS)

    McDonald, M.J.; Bourcier, S.C.; Talley, D.G.

    1997-01-01

    Prior to 1989 99 Mo was produced in the US by a single supplier, Cintichem Inc., Tuxedo, NY. Because of problems associated with operating its facility, in 1989 Cintichem elected to decommission the facility rather than incur the costs for repair. The demise of the 99 Mo capability at Cintichem left the US totally reliant upon a single foreign source, Nordion International, located in Ottawa Canada. In 1992 the DOE purchased the Cintichem 99 Mo Production Process and Drug Master File (DMF). In 1994 the DOE funded Sandia National Laboratories (SNL) to produce 99 Mo. Although Cintichem produced 99 Mo and 99m Tc generators for many years, there was no requirement for process validation which is now required by the Food and Drug Administration (FDA). In addition to the validation requirement, the requirements for current Good manufacturing Practices were codified into law. The purpose of this paper is to describe the process validation being conducted at SNL for the qualification of SNL as a supplier of 99 Mo to US pharmaceutical companies

  9. Integration of evidence-based practice in bedside teaching paediatrics supported by e-learning.

    Science.gov (United States)

    Potomkova, Jarmila; Mihal, Vladimir; Zapletalova, Jirina; Subova, Dana

    2010-03-01

    Bedside teaching with evidence-based practice elements, supported by e-learning activities, can play an important role in modern medical education. Teachers have to incorporate evidence from the medical literature to increase student motivation and interactivity. An integral part of the medical curricula at Palacky University Olomouc (Czech Republic) are real paediatric scenarios supplemented with a review of current literature to enhance evidence-based bedside teaching & learning. Searching for evidence is taught through librarian-guided interactive hands-on sessions and/or web-based tutorials followed by clinical case presentations and feedback. Innovated EBM paediatric clerkship demonstrated students' preferences towards web-based interactive bedside teaching & learning. In two academic years (2007/2008, 2008/2009), learning-focused feedback from 106 and 131 students, resp. was obtained about their attitudes towards evidence-based bedside teaching. The assessment included among others the overall level of instruction, quality of practical evidence-based training, teacher willingness and impact of instruction on increased interest in the specialty. There was some criticism about excessive workload. A parallel survey was carried out on the perceived values of different forms of information skills training (i.e. demonstration, online tutorials, and librarian-guided interactive search sessions) and post-training self-reported level of search skills. The new teaching/learning paediatric portfolio is a challenge for further activities, including effective knowledge translation, continuing medical & professional development of teachers, and didactic, clinically integrated teaching approaches.

  10. Multiple Lines Of Evidence Supporting Natural Attenuation: Lines Of Inquiry Supporting Monitored Natural Attenuation And Enhanced Attenuatin Of Chlorinated Solvents

    Energy Technology Data Exchange (ETDEWEB)

    Vangelas, Karen; Widemeirer, T. H.; Barden, M.J.; Dickson, W. Z.; Major, David

    2004-12-31

    The Department of Energy (DOE) is sponsoring an initiative to facilitate efficient, effective and responsible use of Monitored Natural Attenuation (MNA) and Enhanced Attenuation (EA) for chlorinated solvents. This Office of Environmental Management (EM) ''Alternative Project,'' focuses on providing scientific and policy support for MNA/EA. A broadly representative working group of scientists supports the project along with partnerships with regulatory organizations such as the Interstate Technology Regulatory Council (ITRC) and the United States Environmental Protection Agency (USEPA). The initial product of the technical working group was a summary report that articulated the conceptual approach and central scientific tenants of the project, and that identified a prioritized listing of technical targets for field research. This report documented the process in which: (1) scientific ground rules were developed, (2) lines of inquiry were identified and then critically evaluated, (3) promising applied research topics were highlighted in the various lines of inquiry, and (4) these were discussed and prioritized. The summary report will serve as a resource to guide management and decision making throughout the period of the subject MNA/EA Alternative Project. To support and more fully document the information presented in the summary report, the DOE is publishing a series of supplemental documents that present the full texts from the technical analyses within the various lines of inquiry (see listing). The following report--documenting our evaluation of the state of the science for the lines of evidence for supporting decision-making for MNA--is one of those supplemental documents.

  11. Public administration of processes for supporting of inner ecology safety in Ukraine: organizational and legal aspect

    Directory of Open Access Journals (Sweden)

    Y. О. Romanenko

    2016-03-01

    Full Text Available The paper studied the legal framework that regulates social relations in the field of internal environmental safety and provides a unified state policy and the exercise of powers by the authorities at all levels. Thus, in the legal field there are the gaps on many issues that are important in solving the tasks, including the powers and responsibilities of the various subjects of law in an extreme situation, as well as management and leadership of emergency rescue activity and other urgent works in disaster areas. It is established that to increase the state’s role in protecting the population from emergency situations of natural character, it is necessary to achieve a qualitative change in the legal status of government, the formation of relevant legislation and conduct regulation. In general, the process of regulation in addressing the problems of population protection from emergency situations of different nature must be carry out through the systematization of the national, regional and local levels regulations that are relevant to the issues of prevention and liquidation of emergency situations; also we must eliminate inconsistencies in current legislation and coordinate the national legislation with international. Based on analysis of existing and unresolved problems of internal environmental safety it is necessity to implement new mechanisms of state influence to prevent environmental degradation, the use of methods and means of protecting the population from current anthropogenic influences; reorganization of the territory, defining the boundaries of zones of sanitary, medical and sanitary survey of the population; ensuring internal environmental safety is realized with the help of legal, operational and rescue, functional and territorial public administration practices; the use of multi-state management controls that are able to simultaneously influence the situation in the sphere of nature.

  12. Additional Interventions to Enhance the Effectiveness of Individual Placement and Support: A Rapid Evidence Assessment

    Directory of Open Access Journals (Sweden)

    Naomi Boycott

    2012-01-01

    Full Text Available Topic. Additional interventions used to enhance the effectiveness of individual placement and support (IPS. Aim. To establish whether additional interventions improve the vocational outcomes of IPS alone for people with severe mental illness. Method. A rapid evidence assessment of the literature was conducted for studies where behavioural or psychological interventions have been used to supplement standard IPS. Published and unpublished empirical studies of IPS with additional interventions were considered for inclusion. Conclusions. Six published studies were found which compared IPS alone to IPS plus a supplementary intervention. Of these, three used skills training and three used cognitive remediation. The contribution of each discrete intervention is difficult to establish. Some evidence suggests that work-related social skills and cognitive training are effective adjuncts, but this is an area where large RCTs are required to yield conclusive evidence.

  13. Further human evidence for striatal dopamine release induced by administration of ∆9-tetrahydrocannabinol (THC): selectivity to limbic striatum.

    Science.gov (United States)

    Bossong, Matthijs G; Mehta, Mitul A; van Berckel, Bart N M; Howes, Oliver D; Kahn, René S; Stokes, Paul R A

    2015-08-01

    Elevated dopamine function is thought to play a key role in both the rewarding effects of addictive drugs and the pathophysiology of schizophrenia. Accumulating epidemiological evidence indicates that cannabis use is a risk factor for the development of schizophrenia. However, human neurochemical imaging studies that examined the impact of ∆9-tetrahydrocannabinol (THC), the main psychoactive component in cannabis, on striatal dopamine release have provided inconsistent results. The objective of this study is to assess the effect of a THC challenge on human striatal dopamine release in a large sample of healthy participants. We combined human neurochemical imaging data from two previous studies that used [(11)C]raclopride positron emission tomography (PET) (n = 7 and n = 13, respectively) to examine the effect of THC on striatal dopamine neurotransmission in humans. PET images were re-analysed to overcome differences in PET data analysis. THC administration induced a significant reduction in [(11)C]raclopride binding in the limbic striatum (-3.65 %, from 2.39 ± 0.26 to 2.30 ± 0.23, p = 0.023). This is consistent with increased dopamine levels in this region. No significant differences between THC and placebo were found in other striatal subdivisions. In the largest data set of healthy participants so far, we provide evidence for a modest increase in human striatal dopamine transmission after administration of THC compared to other drugs of abuse. This finding suggests limited involvement of the endocannabinoid system in regulating human striatal dopamine release and thereby challenges the hypothesis that an increase in striatal dopamine levels after cannabis use is the primary biological mechanism underlying the associated higher risk of schizophrenia.

  14. Initiatives supporting evidence informed health system policymaking in Cameroon and Uganda: a comparative historical case study.

    Science.gov (United States)

    Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

    2014-11-29

    There is a scarcity of empirical data on institutions devoted to knowledge brokerage and their influence in Africa. Our objective was to describe two pioneering Knowledge Translation Platforms (KTPs) supporting evidence informed health system policymaking (EIHSP) in Cameroon and Uganda since 2006. This comparative historical case study of Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda using multiple methods comprised (i) a descriptive documentary analysis for a narrative historical account, (ii) an interpretive documentary analysis of the context, profiles, activities and outputs inventories and (iii) an evaluative survey of stakeholders exposed to evidence briefs produced and policy dialogues organized by the KTPs. Both initiatives benefited from the technical and scientific support from the global EVIPNet resource group. EVIPNet Cameroon secretariat operates with a multidisciplinary group of part-time researchers in a teaching hospital closely linked to the ministry of health. REACH-PI Uganda secretariat operates with a smaller team of full time staff in a public university. Financial resources were mobilized from external donors to scale up capacity building, knowledge management, and linkage and exchange activities. Between 2008 and 2012, twelve evidence briefs were produced in Cameroon and three in Uganda. In 2012, six rapid evidence syntheses in response to stakeholders' urgent needs were produced in Cameroon against 73 in Uganda between 2010 and 2012. Ten policy dialogues (seven in Cameroon and three in Uganda) informed by pre-circulated evidence briefs were well received. Both KTPs contributed to developing and testing new resources and tools for EIHSP. A network of local and global experts has created new spaces for evidence informed deliberations on priority health policy issues related to MDGs. This descriptive historical account of two KTPs housed in government

  15. The information infrastructure that supports evidence-based veterinary medicine: a comparison with human medicine.

    Science.gov (United States)

    Toews, Lorraine

    2011-01-01

    In human medicine, the information infrastructure that supports the knowledge translation processes of exchange, synthesis, dissemination, and application of the best clinical intervention research has developed significantly in the past 15 years, facilitating the uptake of research evidence by clinicians as well as the practice of evidence-based medicine. Seven of the key elements of this improved information infrastructure are clinical trial registries, research reporting standards, systematic reviews, organizations that support the production of systematic reviews, the indexing of clinical intervention research in MEDLINE, clinical search filters for MEDLINE, and point-of-care decision support information resources. The objective of this paper is to describe why these elements are important for evidence-based medicine, the key developments and issues related to these seven information infrastructure elements in human medicine, how these 7 elements compare with the corresponding infrastructure elements in veterinary medicine, and how all of these factors affect the translation of clinical intervention research into clinical practice. A focused search of the Ovid MEDLINE database was conducted for English language journal literature published between 2000 and 2010. Two bibliographies were consulted and selected national and international Web sites were searched using Google. The literature reviewed indicates that the information infrastructure supporting evidence-based veterinary medicine practice in all of the 7 elements reviewed is significantly underdeveloped in relation to the corresponding information infrastructure in human medicine. This lack of development creates barriers to the timely translation of veterinary medicine research into clinical practice and also to the conduct of both primary clinical intervention research and synthesis research.

  16. Exploring the relation between evidence and decision-making A political-administrative approach to health impact assessment

    International Nuclear Information System (INIS)

    Bekker, Marleen P.M.; Putters, Kim; Grinten, Tom E.D. van der

    2004-01-01

    Like any policy-relevant research, HIA faces the risk of not being used by decisions-makers. This article addresses the questions: 'How do policy decisions come about?' and 'How does this affect HIA?' Current literature in political-administrative sciences identifies three ways for decision-making: rational, incremental and mixed model. These models define the relationship between the policy process at stake and the HIA. In incremental or mixed model decision-making, use of HIA evidence by policy-makers is heavily dependent on their values in the context, which may result in conceptual utilization or may extend to strategic utilization. In rational decision-making, HIA provides information independent from the context, which results in instrumental utilization. HIA practitioners need to optimise utilization and produce an appropriate HIA by mapping the policy process. They can do this by asking the questions 'What? How? Who? and What context? and by maintaining continuous communication with the decision-makers. An appropriate HIA is policy-, time- and place-specific: reflecting the decision-making of the policy at stake. Furthermore, HIA concerns two policy fields with two different contexts and, in some cases, two different decision-making models. The administrative requirements for an appropriate HIA need further exploration

  17. Development of support system for maintenance and administration of reprocessing plant equipment

    International Nuclear Information System (INIS)

    Iwasaki, Syogo; Taniguchi, Takayuki; Shiraishi, Yoshihiko; Isaka, Kazuo

    1998-01-01

    Each year, maintenance work is carried out for about 10,000 pieces of equipment, including mechanical devices, electric equipment and instruments, at the Tokai Reprocessing Plant. Ninety percent of such maintenance work is preventive maintenance. In order to manage the information about the maintenance work, a computer support system was developed between 1985 and 1992. Twenty-seven thousand pieces of equipment and 180,000 maintenance histories have already been registered in the system. The system has been used for planning inspections and replacement of equipment as well as checking their maintenance histories. Actual usage of the system has shown that some auxiliary functions need to be added. The system will therefore be improved and extended. (author)

  18. Positive and negative social support and HPA-axis hyperactivity: Evidence from glucocorticoids in human hair.

    Science.gov (United States)

    Iob, Eleonora; Kirschbaum, Clemens; Steptoe, Andrew

    2018-06-12

    While positive social support is associated with lower prevalence of disease and better treatment outcomes, negative social relationships can instead have unfavourable consequences for several physical and mental health conditions. However, the specific mechanisms by which this nexus might operate remain poorly understood. Hypothalamic-pituitary-adrenal (HPA) axis hyperactivity owing to psychosocial stress has been proposed as a potential pathway underlying the link between social support and health. Hair glucocorticoids such as cortisol and cortisone are emerging as promising biomarkers of long-term retrospective HPA activation. Therefore, the aim of this investigation was to examine the effects of positive and negative experiences of social support within key relationships (i.e. spouse/partner, children, other family members, and friends) on cortisol and cortisone. These associations were tested in a sample of 2520 older adults (mean age 68.1) from the English Longitudinal Study of Ageing. Hair samples were collected in wave 6 (2012/13). To understand the impact of cumulative exposure to poor social support, the analysis used self-reported data from waves 4 (2008/09) and 6. Covariates included demographic, socioeconomic, lifestyle, and hair characteristics. In cross sectional analyses, lower positive support from all sources and specifically from children were associated with higher cortisol. Additionally, lower positive support from children was positively associated with cortisone. Similarly, higher overall negative support was related to higher cortisol, and greater negative support from children was also positively associated with cortisone. In longitudinal analyses, there was evidence for positive associations between hair glucocorticoids and cumulative exposure to poorer social support. Experiences of low positive and high negative social support, particularly from children, were both related to higher hair glucocorticoids. Hence, social relationships of

  19. How task characteristics and social support relate to managerial learning: empirical evidence from Dutch home care.

    Science.gov (United States)

    Ouweneel, A P Else; Taris, Toon W; Van Zolingen, Simone J; Schreurs, Paul J G

    2009-01-01

    Researchers have revealed that managers profit most from informal and on-the-job learning. Moreover, research has shown that task characteristics and social support affect informal learning. On the basis of these insights, the authors examined the effects of task characteristics (psychological job demands, job control) and social support from the supervisor and colleagues on informal on-the-job learning among 1588 managers in the Dutch home-care sector. A regression analysis revealed that high demands, high control, and high colleague and supervisor support were each associated with high levels of informal learning. The authors found no evidence for statistical interactions among the effects of these concepts. They concluded that to promote managers' informal workplace learning, employers should especially increase job control.

  20. Sustainability of evidence-based healthcare: research agenda, methodological advances, and infrastructure support.

    Science.gov (United States)

    Proctor, Enola; Luke, Douglas; Calhoun, Annaliese; McMillen, Curtis; Brownson, Ross; McCrary, Stacey; Padek, Margaret

    2015-06-11

    Little is known about how well or under what conditions health innovations are sustained and their gains maintained once they are put into practice. Implementation science typically focuses on uptake by early adopters of one healthcare innovation at a time. The later-stage challenges of scaling up and sustaining evidence-supported interventions receive too little attention. This project identifies the challenges associated with sustainability research and generates recommendations for accelerating and strengthening this work. A multi-method, multi-stage approach, was used: (1) identifying and recruiting experts in sustainability as participants, (2) conducting research on sustainability using concept mapping, (3) action planning during an intensive working conference of sustainability experts to expand the concept mapping quantitative results, and (4) consolidating results into a set of recommendations for research, methodological advances, and infrastructure building to advance understanding of sustainability. Participants comprised researchers, funders, and leaders in health, mental health, and public health with shared interest in the sustainability of evidence-based health care. Prompted to identify important issues for sustainability research, participants generated 91 distinct statements, for which a concept mapping process produced 11 conceptually distinct clusters. During the conference, participants built upon the concept mapping clusters to generate recommendations for sustainability research. The recommendations fell into three domains: (1) pursue high priority research questions as a unified agenda on sustainability; (2) advance methods for sustainability research; (3) advance infrastructure to support sustainability research. Implementation science needs to pursue later-stage translation research questions required for population impact. Priorities include conceptual consistency and operational clarity for measuring sustainability, developing evidence

  1. National Aeronautics and Space Administration (NASA) Environmental Control and Life Support (ECLS) Integrated Roadmap Development

    Science.gov (United States)

    Metcalf, Jordan; Peterson, Laurie; Carrasquillo, Robyn; Bagdigian, Robert

    2012-01-01

    Although NASA is currently considering a number of future human space exploration mission concepts, detailed mission requirements and vehicle architectures remain mostly undefined, making technology investment strategies difficult to develop and sustain without a top-level roadmap to serve as a guide. This paper documents the process and results of an effort to define a roadmap for Environmental Control and Life Support Systems (ECLSS) capabilities required to enhance the long-term operation of the International Space Station (ISS) as well as enable beyond-Low Earth Orbit (LEO) human exploration missions. Three generic mission types were defined to serve as a basis for developing a prioritized list of needed capabilities and technologies. Those are 1) a short duration micro-gravity mission; 2) a long duration microgravity mission; and 3) a long duration partial gravity (surface) exploration mission. To organize the effort, a functional decomposition of ECLSS was completed starting with the three primary functions: atmosphere, water, and solid waste management. Each was further decomposed into sub-functions to the point that current state-of-the-art (SOA) technologies could be tied to the sub-function. Each technology was then assessed by NASA subject matter experts as to its ability to meet the functional needs of each of the three mission types. When SOA capabilities were deemed to fall short of meeting the needs of one or more mission types, those gaps were prioritized in terms of whether or not the corresponding capabilities enable or enhance each of the mission types. The result was a list of enabling and enhancing capability needs that can be used to guide future ECLSS development, as well as a list of existing hardware that is ready to go for exploration-class missions. A strategy to fulfill those needs over time was then developed in the form of a roadmap. Through execution of this roadmap, the hardware and technologies intended to meet exploration needs

  2. Arthroplasty knee registry of Catalonia: What scientific evidence supports the implantation of our prosthesis?

    Science.gov (United States)

    Samaniego Alonso, R; Gaviria Parada, E; Pons Cabrafiga, M; Espallargues Carreras, M; Martinez Cruz, O

    2018-02-28

    In our environment, it is increasingly necessary to perform an activity based on scientific evidence and the field of prosthetic surgery should be governed by the same principles. The national arthroplasty registries allow us to obtain a large amount of data in order to evaluate this technique. The aim of our study is to analyse the scientific evidence that supports the primary total knee arthroplasties implanted in Catalonian public hospitals, based on the Arthoplasty Registry of Catalonia (RACat) MATERIAL AND METHODS: A review of the literature was carried out on knee prostheses (cruciate retaining, posterior stabilized, constricted and rotational) recorded in RACat between the period 2005-2013 in the following databases: Orthopedic Data Evaluation Panel, PubMed, TripDatabase and Google Scholar. The prostheses implanted in fewer than 10 units (1,358 prostheses corresponding to 62 models) were excluded. 41,947 prostheses (96.86%) were analysed out of 43,305 implanted, corresponding to 74 different models. In 13 models (n = 4,715) (11.24%) no clinical evidence to support their use was found. In the remaining 36 models (n = 13,609) (32.45%), level iv studies were the most predominant evidence. There was a significant number of implanted prostheses (11.24%) for which no clinical evidence was found. The number of models should be noted, 36 out of 110, with fewer than 10 units implanted. The use of arthroplasty registries has proved an extremely useful tool that allows us to analyse and draw conclusions in order to improve the efficiency of this surgical technique. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Factors affecting implementation of an evidence-based practice in the Veterans Health Administration: Illness management and recovery.

    Science.gov (United States)

    McGuire, Alan B; Salyers, Michelle P; White, Dominique A; Gilbride, Daniel J; White, Laura M; Kean, Jacob; Kukla, Marina

    2015-12-01

    Illness management and recovery (IMR) is an evidence-based practice that assists consumers in managing their illnesses and pursuing personal recovery goals. Although research has examined factors affecting IMR implementation facilitated by multifaceted, active roll-outs, the current study attempted to elucidate factors affecting IMR implementation outside the context of a research-driven implementation. Semi-structured interviews with 20 local recovery coordinators and 18 local IMR experts were conducted at 23 VA medical centers. Interviews examined perceived and experienced barriers and facilitators to IMR implementation. Data were analyzed via thematic inductive/deductive analysis in the form of crystallization/immersion. Six factors differed between sites implementing IMR from those not providing IMR: awareness of IMR, importer-champions, autonomy-supporting leadership, veteran-centered care, presence of a sensitive period, and presence of a psychosocial rehabilitation and recovery center. Four factors were common in both groups: recovery orientation, evidence-based practices orientation, perceived IMR fit within program structure, and availability of staff time. IMR can be adopted in lieu of active implementation support; however, knowledge dissemination appears to be key. Future research should examine factors affecting the quality of implementation. (c) 2015 APA, all rights reserved).

  4. Social support, volunteering and health around the world: cross-national evidence from 139 countries.

    Science.gov (United States)

    Kumar, Santosh; Calvo, Rocio; Avendano, Mauricio; Sivaramakrishnan, Kavita; Berkman, Lisa F

    2012-03-01

    High levels of social capital and social integration are associated with self-rated health in many developed countries. However, it is not known whether this association extends to non-western and less economically advanced countries. We examine associations between social support, volunteering, and self-rated health in 139 low-, middle- and high-income countries. Data come from the Gallup World Poll, an internationally comparable survey conducted yearly from 2005 to 2009 for those 15 and over. Volunteering was measured by self-reports of volunteering to an organization in the past month. Social support was based on self-reports of access to support from relatives and friends. We started by estimating random coefficient (multi-level) models and then used multivariate logistic regression to model health as a function of social support and volunteering, controlling for age, gender, education, marital status, and religiosity. We found statistically significant evidence of cross-national variation in the association between social capital variables and self-rated health. In the multivariate logistic model, self-rated health were significantly associated with having social support from friends and relatives and volunteering. Results from stratified analyses indicate that these associations are strikingly consistent across countries. Our results indicate that the link between social capital and health is not restricted to high-income countries but extends across many geographical regions regardless of their national-income level. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Ocean Acidification and the End-Permian Mass Extinction: To What Extent does Evidence Support Hypothesis?

    Directory of Open Access Journals (Sweden)

    Marie-Béatrice Forel

    2012-09-01

    Full Text Available Ocean acidification in modern oceans is linked to rapid increase in atmospheric CO2, raising concern about marine diversity, food security and ecosystem services. Proxy evidence for acidification during past crises may help predict future change, but three issues limit confidence of comparisons between modern and ancient ocean acidification, illustrated from the end-Permian extinction, 252 million years ago: (1 problems with evidence for ocean acidification preserved in sedimentary rocks, where proposed marine dissolution surfaces may be subaerial. Sedimentary evidence that the extinction was partly due to ocean acidification is therefore inconclusive; (2 Fossils of marine animals potentially affected by ocean acidification are imperfect records of past conditions; selective extinction of hypercalcifying organisms is uncertain evidence for acidification; (3 The current high rates of acidification may not reflect past rates, which cannot be measured directly, and whose temporal resolution decreases in older rocks. Thus large increases in CO2 in the past may have occurred over a long enough time to have allowed assimilation into the oceans, and acidification may not have stressed ocean biota to the present extent. Although we acknowledge the very likely occurrence of past ocean acidification, obtaining support presents a continuing challenge for the Earth science community.

  6. Safety and quality management and administration Fiscal Year 1995 site support program plan WBS 6.7.2.6

    Energy Technology Data Exchange (ETDEWEB)

    Hagan, J.W.

    1994-09-01

    The mission of the Emergency, Safety, and Quality Services (ESQ) management and Program Integration is to provide leadership for the ESQ Department, coordinate business management activities of the ESQ department, and the programs it supports, as well as to plan organize, direct, and control other activities that require department-wide coordination. Primary activities include providing strategic and business planning and reporting support to ESQ management; developing and documenting ESQ management systems and procedures; coordinating ESQ`s self-assessment and Award Fee self evaluation efforts; coordinating the ESQ departments`s communication, total quality, cost savings, and productivity efforts; and tracking ESQ commitments and staffing data. This program element also provides program direction and performance assessment for the ESH&Q division of ICF KH. The ESH&Q Division educates ICF KH management and employees to protect personnel and the environment; identifies, interprets and inspects to requirements; provides administrative and field support; performs final acceptance of construction; assesses effectiveness of ICF KH programs and processes, and performs baseline ESH&Q assessments.

  7. Safety and quality management and administration Fiscal Year 1995 site support program plan WBS 6.7.2.6

    International Nuclear Information System (INIS)

    Hagan, J.W.

    1994-09-01

    The mission of the Emergency, Safety, and Quality Services (ESQ) management and Program Integration is to provide leadership for the ESQ Department, coordinate business management activities of the ESQ department, and the programs it supports, as well as to plan organize, direct, and control other activities that require department-wide coordination. Primary activities include providing strategic and business planning and reporting support to ESQ management; developing and documenting ESQ management systems and procedures; coordinating ESQ's self-assessment and Award Fee self evaluation efforts; coordinating the ESQ departments's communication, total quality, cost savings, and productivity efforts; and tracking ESQ commitments and staffing data. This program element also provides program direction and performance assessment for the ESH ampersand Q division of ICF KH. The ESH ampersand Q Division educates ICF KH management and employees to protect personnel and the environment; identifies, interprets and inspects to requirements; provides administrative and field support; performs final acceptance of construction; assesses effectiveness of ICF KH programs and processes, and performs baseline ESH ampersand Q assessments

  8. The Juggling Act of Supervision in Community Mental Health: Implications for Supporting Evidence-Based Treatment.

    Science.gov (United States)

    Dorsey, Shannon; Pullmann, Michael D; Kerns, Suzanne E U; Jungbluth, Nathaniel; Meza, Rosemary; Thompson, Kelly; Berliner, Lucy

    2017-11-01

    Supervisors are an underutilized resource for supporting evidence-based treatments (EBTs) in community mental health. Little is known about how EBT-trained supervisors use supervision time. Primary aims were to describe supervision (e.g., modality, frequency), examine functions of individual supervision, and examine factors associated with time allocation to supervision functions. Results from 56 supervisors and 207 clinicians from 25 organizations indicate high prevalence of individual supervision, often alongside group and informal supervision. Individual supervision serves a wide range of functions, with substantial variation at the supervisor-level. Implementation climate was the strongest predictor of time allocation to clinical and EBT-relevant functions.

  9. Impact of distal median neuropathy on handwriting performance for patients with carpal tunnel syndrome in office and administrative support occupations.

    Science.gov (United States)

    Kuo, Li-Chieh; Hsu, Hsiao-Man; Wu, Po-Ting; Lin, Sheng-Che; Hsu, Hsiu-Yun; Jou, I-Ming

    2014-06-01

    This study investigates the handwriting performance of patients with carpal tunnel syndrome (CTS) and healthy controls in office and administrative support occupations, adopting both biomechanical and functional perspectives. This work also explores how surgical intervention altered the performance of the CTS patients. Fourteen CTS patients and 14 control subjects were recruited to complete a self-reported survey and participate in sensory tests, hand strength, dexterity and handwriting tasks using a custom force acquisition pen along with motion capture technology. Based on the results of these, the sensory measurements, along with functional and biomechanical parameters, were used to determine the differences between the groups and also reveal any improvements that occurred in the CTS group after surgical intervention. The CTS patients showed significantly poorer hand sensibility and dexterity than the controls, as well as excessive force exertion of the digits and pen tip, and less efficient force adjustment ability during handwriting. After surgery and sensory recovery, the hand dexterity and pen tip force of the CTS patients improved significantly. The force adjustment abilities of the digits also increased, but these changes were not statistically significant. This study provides the objective measurements and novel apparatus that can be used to determine impairments in the handwriting abilities of office or administrative workers with CTS. The results can also help clinicians or patients to better understand the sensory-related deficits in sensorimotor control of the hand related to CTS, and thus develop and implement more suitable training or adaptive protocols.

  10. Is there evidence to support a forefoot strike pattern in barefoot runners? A review.

    Science.gov (United States)

    Lorenz, Daniel S; Pontillo, Marisa

    2012-11-01

    Barefoot running is a trend among running enthusiasts that is the subject of much controversy. At this time, benefits appear to be more speculative and anecdotal than evidence based. Additionally, the risk of injuries is not well established. A PubMed search was undertaken for articles published in English from 1980 to 2011. Additional references were accrued from reference lists of research articles. While minimal data exist that definitively support barefoot running, there are data lending support to the argument that runners should use a forefoot strike pattern in lieu of a heel strike pattern to reduce ground reaction forces, ground contact time, and step length. Whether there is a positive or negative effect on injury has yet to be determined. Unquestionably, more research is needed before definitive conclusions can be drawn.

  11. A study conducted on the demographic factors of victims of violence in support and administrative departments of hospital in 2013.

    Science.gov (United States)

    Keyvanara, Mahmoud; Maracy, Mohammad Reza; Ziari, Najmeh Bahman

    2015-01-01

    Violence is now regarded as a serious problem and its complication causes heavy costs on the healthcare systems. The present study aimed to investigate the correlation between some demographic characteristics and confrontation with violence. Since there is no study on the prevalence of violence among the support and administration staff of hospitals in Iran, this study was conducted to investigate violence in these departments. This descriptive-analytical and correlation survey was carried out by census among the support and administrative staff interacting with patients and their companions in Al-Zahra University Hospital of Isfahan in 2013. Research tool was a researcher-made questionnaire including five domains: Personal information, workplace information, verbal violence, physical violence, and other violent acts. Its validity was evaluated by experts reviewing it and its reliability by test-retest (r =0.9). Finally, data were analyzed using descriptive statistical indicators and statistical tests such as Chi-square for sex, marital status, and work department and Mann-Whitney U test for age, level of education, work experience, and violence types by the statistical software SPSS version 20. According to the results obtained, 81% of subjects had been abused at least once and the most reported violence was related to verbal violence (78.4%). There was significant correlation between sex and violence and men were the main victims of violence, but there was no relation between marital status, age, and violence. Work experience was correlated to physical violence and other violent acts conversely. There was also an inverse correlation between physical violence and education; also, security staff faced more violence than others. As high prevalence of violence was found especially among the security staff and personnel with less education and work experience, it is suggested to take actions such as educating about patient accompaniment and visiting condition, holding

  12. Context Matters: Team and Organizational Factors Associated with Reach of Evidence-Based Psychotherapies for PTSD in the Veterans Health Administration.

    Science.gov (United States)

    Sayer, Nina A; Rosen, Craig S; Bernardy, Nancy C; Cook, Joan M; Orazem, Robert J; Chard, Kathleen M; Mohr, David C; Kehle-Forbes, Shannon M; Eftekhari, Afsoon; Crowley, Jill; Ruzek, Josef I; Smith, Brandy N; Schnurr, Paula P

    2017-11-01

    Evidence-based psychotherapies for PTSD are often underused. The objective of this mixed-method study was to identify organizational and clinic factors that promote high levels of reach of evidence-based psychotherapies for PTSD 10 years into their dissemination throughout the Veterans Health Administration. We conducted 96 individual interviews with staff from ten outpatient PTSD teams at nine sites that differed in reach of evidence-based psychotherapies for PTSD. Major themes associated with reach included clinic mission, clinic leader and staff engagement, clinic operations, staff perceptions, and the practice environment. Strategies to improve reach of evidence-based psychotherapies should attend to organizational and team-level factors.

  13. Getting to uptake: do communities of practice support the implementation of evidence-based practice?

    Science.gov (United States)

    Barwick, Melanie A; Peters, Julia; Boydell, Katherine

    2009-02-01

    Practitioners are increasingly encouraged to adopt evidence-based practices (EBP) leading to a need for new knowledge translation strategies to support implementation and practice change. This study examined the benefits of a community of practice in the context of Ontario's children's mental health sector where organizations are mandated to adopt a standardized outcome measure to monitor client response to treatment. Readiness for change, practice change, content knowledge, and satisfaction with and use of implementation supports were examined among practitioners newly trained on the measure who were randomly assigned to a community of practice (CoP) or a practice as usual (PaU) group. CoP practitioners attended 6 sessions over 12 months; PaU practitioners had access to usual implementation supports. Groups did not differ on readiness for change or reported practice change, although CoP participants demonstrated greater use of the tool in practice, better content knowledge and were more satisfied with implementation supports than PaU participants. CoPs present a promising model for translating EBP knowledge and promoting practice change in children's mental health that requires further study.

  14. METEOR: An Enterprise Health Informatics Environment to Support Evidence-Based Medicine.

    Science.gov (United States)

    Puppala, Mamta; He, Tiancheng; Chen, Shenyi; Ogunti, Richard; Yu, Xiaohui; Li, Fuhai; Jackson, Robert; Wong, Stephen T C

    2015-12-01

    The aim of this paper is to propose the design and implementation of next-generation enterprise analytics platform developed at the Houston Methodist Hospital (HMH) system to meet the market and regulatory needs of the healthcare industry. For this goal, we developed an integrated clinical informatics environment, i.e., Methodist environment for translational enhancement and outcomes research (METEOR). The framework of METEOR consists of two components: the enterprise data warehouse (EDW) and a software intelligence and analytics (SIA) layer for enabling a wide range of clinical decision support systems that can be used directly by outcomes researchers and clinical investigators to facilitate data access for the purposes of hypothesis testing, cohort identification, data mining, risk prediction, and clinical research training. Data and usability analysis were performed on METEOR components as a preliminary evaluation, which successfully demonstrated that METEOR addresses significant niches in the clinical informatics area, and provides a powerful means for data integration and efficient access in supporting clinical and translational research. METEOR EDW and informatics applications improved outcomes, enabled coordinated care, and support health analytics and clinical research at HMH. The twin pressures of cost containment in the healthcare market and new federal regulations and policies have led to the prioritization of the meaningful use of electronic health records in the United States. EDW and SIA layers on top of EDW are becoming an essential strategic tool to healthcare institutions and integrated delivery networks in order to support evidence-based medicine at the enterprise level.

  15. Women's Experiences of Social Reactions From Informal and Formal Supports: Using a Modified Administration of the Social Reactions Questionnaire.

    Science.gov (United States)

    DePrince, Anne P; Dmitrieva, Julia; Gagnon, Kerry L; Srinivas, Tejaswinhi

    2017-11-01

    A growing literature links social reactions to disclosures of intimate violence to posttraumatic outcomes. The Social Reactions Questionnaire (SRQ), a widely used measure developed to assess social reactions, asks about reactions received from people generally. The ability to examine the impact of social reactions from specific groups of people-such as criminal justice personnel versus community-based providers-has become increasingly more important from both research and practice perspectives. For example, as sexual assault responses nationally have relied on community-coordinated models that involve both criminal justice and community-based systems, tools are lacking to systematically assess the impact of social reactions from criminal justice personnel and community-based providers on survivors. Using the SRQ, the current study asked women to report separately on reactions received from criminal justice personnel, community-based providers, and informal supports. We recruited a diverse community sample of women ( N = 228, ages 18-63, 19% lesbian/bisexual, 44% ethnic minority) who experienced a sexual assault in the previous year and disclosed to the criminal justice system and/or a community-based provider. Multilevel analyses revealed considerable variability in the social reactions reported by women across criminal justice personnel, community-based providers, and informal supports. Analyses supported a seven-factor structure for the SRQ when the measure is yoked to particular experiences of disclosure, in this case to criminal justice personnel, community-based providers, or informal supports. The utility of this modified administration and scoring of the SRQ and the importance of considering reactions across different groups are described.

  16. An evidence-based approach to perioperative nutrition support in the elective surgery patient.

    Science.gov (United States)

    Miller, Keith R; Wischmeyer, Paul E; Taylor, Beth; McClave, Stephen A

    2013-09-01

    In surgical practice, great attention is given to the perioperative management of the elective surgical patient with regard to surgical planning, stratification of cardiopulmonary risk, and postoperative assessment for complication. However, growing evidence supports the beneficial role for implementation of a consistent and literature-based approach to perioperative nutrition therapy. Determining nutrition risk should be a routine component of the preoperative evaluation. As with the above issues, this concept begins with the clinician's first visit with the patient as risk is assessed and the severity of the surgical insult considered. If the patient is an appropriate candidate for benefit from preoperative support, a plan for initiation and reassessment should be implemented. Once appropriate nutrition end points have been achieved, special consideration should be given to beneficial practices the immediate day preceding surgery that may better prepare the patient for the intervention from a metabolic standpoint. In the operating room, consideration should be given to the potential placement of enteral access during the index operation as well as judicious and targeted intraoperative resuscitation. Immediately following the intervention, adequate resuscitation and glycemic control are key concepts, as is an evidence-based approach to the early advancement of an enteral/oral diet in the postoperative patient. Through the implementation of perioperative nutrition therapy plans in the elective surgery setting, outcomes can be improved.

  17. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review

    Directory of Open Access Journals (Sweden)

    Patrícia do Carmo Silva Parreira

    2014-03-01

    Full Text Available Questions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition of Kinesio Taping to other interventions more effective than other interventions alone in people with musculoskeletal conditions? Design: Systematic review of randomised trials. Participants: People with musculoskeletal conditions. Intervention: Kinesio Taping was compared with sham taping/placebo, no treatment, exercises, manual therapy and conventional physiotherapy. Outcome measures: Pain intensity, disability, quality of life, return to work, and global impression of recovery. Results: Twelve randomised trials involving 495 participants were included in the review. The effectiveness of the Kinesio Taping was tested in participants with: shoulder pain in two trials; knee pain in three trials; chronic low back pain in two trials; neck pain in three trials; plantar fasciitis in one trial; and multiple musculoskeletal conditions in one trial. The methodological quality of eligible trials was moderate, with a mean of 6.1 points on the 10-point PEDro Scale score. Overall, Kinesio Taping was no better than sham taping/placebo and active comparison groups. In all comparisons where Kinesio Taping was better than an active or a sham control group, the effect sizes were small and probably not clinically significant or the trials were of low quality. Conclusion: This review provides the most updated evidence on the effectiveness of the Kinesio Taping for musculoskeletal conditions. The current evidence does not support the use of this intervention in these clinical populations. PROSPERO registration: CRD42012003436. [Parreira PdCS, Costa LdCM, Hespanhol Junior LC, Lopes AD, Costa LOP (2014 Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. Journal of Physiotherapy 60: 31–39

  18. Measuring Clinical Decision Support Influence on Evidence-Based Nursing Practice.

    Science.gov (United States)

    Cortez, Susan; Dietrich, Mary S; Wells, Nancy

    2016-07-01

    To measure the effect of clinical decision support (CDS) on oncology nurse evidence-based practice (EBP).
. Longitudinal cluster-randomized design.
. Four distinctly separate oncology clinics associated with an academic medical center.
. The study sample was comprised of randomly selected data elements from the nursing documentation software. The data elements were patient-reported symptoms and the associated nurse interventions. The total sample observations were 600, derived from a baseline, posteducation, and postintervention sample of 200 each (100 in the intervention group and 100 in the control group for each sample).
. The cluster design was used to support randomization of the study intervention at the clinic level rather than the individual participant level to reduce possible diffusion of the study intervention. An elongated data collection cycle (11 weeks) controlled for temporary increases in nurse EBP related to the education or CDS intervention.
. The dependent variable was the nurse evidence-based documentation rate, calculated from the nurse-documented interventions. The independent variable was the CDS added to the nursing documentation software.
. The average EBP rate at baseline for the control and intervention groups was 27%. After education, the average EBP rate increased to 37%, and then decreased to 26% in the postintervention sample. Mixed-model linear statistical analysis revealed no significant interaction of group by sample. The CDS intervention did not result in an increase in nurse EBP.
. EBP education increased nurse EBP documentation rates significantly but only temporarily. Nurses may have used evidence in practice but may not have documented their interventions.
. More research is needed to understand the complex relationship between CDS, nursing practice, and nursing EBP intervention documentation. CDS may have a different effect on nurse EBP, physician EBP, and other medical professional EBP.

  19. [Clinical observation of preoperative administration of enteral nutrition support in gastric cancer patients at risk of malnutrition].

    Science.gov (United States)

    Chen, Bo; Zhou, Yong; Yang, Ping; Qin, Xian-peng; Li, Ning-ning; He, Dan; Feng, Jin-yan; Yan, Chuan-jing; Wu, Xiao-ting

    2013-11-01

    To evaluate safety and efficacy of preoperative administration of enteral nutrition support in gastric cancer patients at risk of malnutrition. A single center randomized controlled clinical trial was performed in 60 gastric cancer patients in West China Hospital from May to October 2012. Thirty patients were given enteral nutrition support(Ensure(R)) manufactured by Abbott Laboratories for ten consecutive days before surgical operation in the treatment group, and 30 patients were given an isocaloric and isonitrogenous homogenized diet in the control group for 10 days as well. The laboratory parameters of nutritional status and hepatorenal function were observed and compared between the two groups on admission, preoperative day 1 and postoperative day 3, respectively. Clinical observations, such as nausea and vomiting, were carried out until patients were discharged. Before the intervention, there were no significant differences in the baseline characteristics between the two groups. The levels of serum albumin [(33.9±5.6) g/L vs. (31.0±5.3) g/L, P0.05). Moreover, two patients with nausea and one with vomiting in each group were found. In clinical observation period, no severe treatment-related adverse event were observed. The enteral supplement with Ensure(R) in gastric cancer patients at risk of malnutrition during preoperative period is effective and safe, which is superior to homogenized diet and an appropriate choice for gastric cancer patients with nutritional risk.

  20. The Provision of Indirect Military Support by US Administration to the Afghan Mujahideens in the 1980s

    Directory of Open Access Journals (Sweden)

    Taisiуa V. Rabush

    2017-03-01

    Full Text Available This article presents the analysis of the US involvement in the process of providing indirect military and other kinds of support to the Afghan mujahedeens. The author also presents a brief overview of the main methods and means of US military aid to the Afghan rebels in the 1980s, as well as a detailed consideration of the process of providing such assistance. The author identifies three stages in the process of interaction between the US administration and the US intelligence agencies, on the one hand, and the Afghan insurgency, on the other hand: the first stage (1978-1979 refers to introduction of a limited contingent of Soviet troops in Afghanistan, where the US assistance to Afghan rebels was extremely cautious and measured; the second stage (1980 is marked by a considerable build-up of military assistance to Mujahedeens, but the United States sought to conceal their participation in this process; and during the third stage (since the election of Ronald Reagan up to the withdrawal of Soviet troops from Afghanistan, the assistance to Mujahedeens increased in several times, and the US stopped hiding this fact. The author briefly discusses the role and place of such countries slong with the US as Egypt, Saudi Arabia and Pakistan and so on in the structure of rendering support to the Afghan Mujahideens. The author also studies the US role in Afghanistan’s transformation into a “nest” for cultivating Islamic extremists.

  1. Life support decision making in critical care: Identifying and appraising the qualitative research evidence.

    Science.gov (United States)

    Giacomini, Mita; Cook, Deborah; DeJean, Deirdre

    2009-04-01

    The objective of this study is to identify and appraise qualitative research evidence on the experience of making life-support decisions in critical care. In six databases and supplementary sources, we sought original research published from January 1990 through June 2008 reporting qualitative empirical studies of the experience of life-support decision making in critical care settings. Fifty-three journal articles and monographs were included. Of these, 25 reported prospective studies and 28 reported retrospective studies. We abstracted methodologic characteristics relevant to the basic critical appraisal of qualitative research (prospective data collection, ethics approval, purposive sampling, iterative data collection and analysis, and any method to corroborate findings). Qualitative research traditions represented include grounded theory (n = 15, 28%), ethnography or naturalistic methods (n = 15, 28%), phenomenology (n = 9, 17%), and other or unspecified approaches (n = 14, 26%). All 53 documents describe the research setting; 97% indicate purposive sampling of participants. Studies vary in their capture of multidisciplinary clinician and family perspectives. Thirty-one (58%) report research ethics board review. Only 49% report iterative data collection and analysis, and eight documents (15%) describe an analytically driven stopping point for data collection. Thirty-two documents (60%) indicated a method for corroborating findings. Qualitative evidence often appears outside of clinical journals, with most research from the United States. Prospective, observation-based studies follow life-support decision making directly. These involve a variety of participants and yield important insights into interactions, communication, and dynamics. Retrospective, interview-based studies lack this direct engagement, but focus on the recollections of fewer types of participants (particularly patients and physicians), and typically address specific issues (communication and

  2. Shifting mindsets: a realist synthesis of evidence from self-management support training.

    Science.gov (United States)

    Davies, Freya; Wood, Fiona; Bullock, Alison; Wallace, Carolyn; Edwards, Adrian

    2018-03-01

    Accompanying the growing expectation of patient self-management is the need to ensure health care professionals (HCPs) have the required attitudes and skills to provide effective self-management support (SMS). Results from existing training interventions for HCPs in SMS have been mixed and the evidence base is weaker for certain settings, including supporting people with progressive neurological conditions (PNCs). We set out to understand how training operates, and to identify barriers and facilitators to training designed to support shifts in attitudes amongst HCPs. We undertook a realist literature synthesis focused on: (i) the influence of how HCPs, teams and organisations view and adopt self-management; and (ii) how SMS needs to be tailored for people with PNCs. A traditional database search strategy was used alongside citation tracking, grey literature searching and stakeholder recommendations. We supplemented PNC-specific literature with data from other long-term conditions. Key informant interviews and stakeholder advisory group meetings informed the synthesis process. Realist context-mechanism-outcome configurations were generated and mapped onto the stages described in Mezirow's Transformative Learning Theory. Forty-four original articles were included (19 relating to PNCs), from which seven refined theories were developed. The theories identified important training elements (evidence provision, building skills and confidence, facilitating reflection and generating empathy). The significant influence of workplace factors as possible barriers or facilitators was highlighted. Embracing SMS often required challenging traditional professional role boundaries. The integration of SMS into routine care is not an automatic outcome from training. A transformative learning process is often required to trigger the necessary mindset shift. Training should focus on how individual HCPs define and value SMS and how their work context (patient group and organisational

  3. How is research evidence used to support claims made in advertisements for wound care products?

    Science.gov (United States)

    Dumville, Jo C; Petherick, Emily S; O'Meara, Susan; Raynor, Pauline; Cullum, Nicky

    2009-05-01

    To investigate the amount, type and accuracy of citations use in support of product related claims from advertisements of wound care products. Although articles submitted to most medical journals are subjected to peer review, such scrutiny is often not required for the content of advertisements. A contents survey of advertisements from two wound care journals (Journal of Wound Care and Ostomy Wound Management) from 2002-2003 and the British Medical Journal, 2002-2003. Data collected from advertisements included identification of product related claims made and any corresponding citations. Where journal articles were cited to support claims, the articles were obtained. Where data on file were cited, this material was requested. In each case the accuracy of claims in relation to the content of the supporting citation was assessed. The use of citations to support product related claims was infrequent in advertisements from wound care journals, where 35% of advertisements containing a product related claim also contained at least one citation, compared with 63% of advertisements from the British Medical Journal. Of citations that were supplied, journal articles were less common in the wound journals (40% vs. 73% in the British Medical Journal) and data on file more common (38% vs. 6% in the British Medical Journal). Where journal articles were obtained, 56% of claims in the wound care journals advertisements were not supported by the cited article, compared with 12% of claims in the British Medical Journal. The wound journals advertised predominantly medical devices. The use and accuracy of referencing in advertisements from wound care journals was poor. Nurses have increasing responsibilities for the prescribing of both drugs and devices, which must be accompanied by the ability to interpret marketing materials and research evidence critically. Nurse educators must ensure that nurse education generally and nurse prescriber training particularly, builds skills of

  4. An online community of practice to support evidence-based physiotherapy practice in manual therapy.

    Science.gov (United States)

    Evans, Cathy; Yeung, Euson; Markoulakis, Roula; Guilcher, Sara

    2014-01-01

    The purpose of this study was to explore how a community of practice promoted the creation and sharing of new knowledge in evidence-based manual therapy using Wenger's constructs of mutual engagement, joint enterprise, and shared repertoire as a theoretical framework. We used a qualitative approach to analyze the discussion board contributions of the 19 physiotherapists who participated in the 10-week online continuing education course in evidence-based practice (EBP) in manual therapy. The course was founded on community of practice, constructivism, social, and situated learning principles. The 1436 postings on 9 active discussion boards revealed that the community of practice was a social learning environment that supported strong participation and mutual engagement. Design features such as consistent facilitation, weekly guiding questions, and collaborative assignments promoted the creation and sharing of knowledge. Participants applied research evidence to the contexts in which they worked through reflective comparison of what they were reading to its applicability in their everyday practice. Participants' shared goals contributed to the common ground established in developing collective knowledge about different study designs, how to answer research questions, and the difficulties of conducting sound research. An online longitudinal community of practice utilized as a continuing education approach to deliver an online course based on constructivist and social learning principles allowed geographically dispersed physiotherapists to be mutually engaged in a joint enterprise in evidence-based manual therapy. Advantages included opportunity for reflection, modeling, and collaboration. Future studies should examine the impact of participation on clinical practice. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital

  5. Equity and Blindness: Closing Evidence Gaps to Support Universal Eye Health.

    Science.gov (United States)

    Ramke, Jacqueline; Zwi, Anthony B; Palagyi, Anna; Blignault, Ilse; Gilbert, Clare E

    2015-01-01

    The World Health Organization Program for the Prevention of Blindness adopted the principles of universal health coverage (UHC) in its latest plan, Universal Eye Health: A Global Action Plan, 2014-2019. This plan builds on the achievements of Vision 2020, which aimed to reduce the global prevalence of avoidable blindness, and its unequal distribution, by the year 2020. We reviewed the literature on health equity and the generation and use of evidence to promote equity, particularly in eye health. We describe the nature and extent of the equity-focused evidence to support and inform eye health programs on the path to universal eye health, and propose ways to improve the collection and reporting of this evidence. Blindness prevalence decreased in all regions of the world between 1990 and 2010, albeit not at the same rate or to the same extent. In 2010, the prevalence of blindness in West Africa (6.0%) remained 15 times higher than in high-income regions (0.4%); within all regions, women had a higher prevalence of blindness than men. Beyond inter-regional and sex differences, there is little comparable data on the distribution of blindness across social groups within regions and countries, or on whether this distribution has changed over time. Similarly, interventions known to address inequity in blindness are few, and equity-relevant goals, targets and indicators for eye health programs are scarce. Equity aims of eye health programs can benefit from the global momentum towards achieving UHC, and the progress being made on collecting, communicating and using equity-focused evidence.

  6. Evidence supporting the use of cone-beam computed tomography in orthodontics.

    Science.gov (United States)

    van Vlijmen, Olivier J C; Kuijpers, Mette A R; Bergé, Stefaan J; Schols, Jan G J H; Maal, Thomas J J; Breuning, Hero; Kuijpers-Jagtman, Anne Marie

    2012-03-01

    The authors conducted a systematic review of cone-beam computed tomography (CBCT) applications in orthodontics and evaluated the level of evidence to determine whether the use of CBCT is justified in orthodontics. The authors identified articles by searching the Cochrane Library, PubMed, MEDLINE, Embase, Scopus and Cumulative Index to Nursing and Allied Health Literature databases. They searched the articles' reference lists manually for additional articles and had no language limitations. They did not search the gray literature. Inclusion criteria were CBCT use in orthodontics and that the participants be human. The lowest level of evidence accepted for inclusion was a case series with five or more participants. The authors evaluated the studies' methodological quality according to 13 criteria related to study design, measurements and statistical analysis. The authors identified 550 articles, and 50 met the inclusion criteria. Study topics included temporary anchorage devices, cephalometry, combined orthodontic and surgical treatment, airway measurements, root resorption and tooth impactions, and cleft lip and palate. The methodological quality averaged 53 percent (range, 15-77 percent) of the maximum score. The authors found no high-quality evidence regarding the benefits of CBCT use in orthodontics. Limited evidence shows that CBCT offers better diagnostic potential, leads to better treatment planning or results in better treatment outcome than do conventional imaging modalities. Only the results of studies on airway diagnostics provided sound scientific data suggesting that CBCT use has added value. The additional radiation exposure should be weighed against possible benefits of CBCT, which have not been supported in the literature. In future studies, investigators should evaluate the effects of CBCT on treatment procedures, progression and outcome quantitatively.

  7. The Significance of Ongoing Teacher Support in Earth Science Education Programs: Evidence from the GLOBE Program

    Science.gov (United States)

    Penuel, B.; Korbak, C.; Shear, L.

    2003-12-01

    study, SRI researchers used the data on student data reporting activity from different partners to identify candidate sites for case studies, where we might investigate the nature of follow-up activities provided by successful partners more closely. We worked to select 2 regional partners that had evidence of high percentages of teachers trained that reported data and that also offered follow-up to teachers. Case study researchers conducted observations within 2-3 active GLOBE schools supported by each regional partner organization and interviewed teachers, principals, and partner staff. On the basis of our observation data and transcripts from interviews, we compiled profiles of schools' implementation and analyzed the core activities of each regional partner. Researchers found that keys to promoting successful implementation in one partnership were: one partnership were: close alignment with state mathematics and science initiatives; mentors that helped teachers by modeling inquiry in GLOBE and by assisting with equipment set-up and curriculum planning; and allowing room for schools to adopt diverse goals for GLOBE. In the second partnership, keys to success included a strategic approach to developing funding for the program; a focus on integration of culturally-relevant knowledge into teacher preparation; follow-up support for teachers; and use of GLOBE as an opportunity to investigate local evidence of climate change. Both partner organizations were challenged by funding limitations that prevented them from providing as much follow-up support as they believe is necessary.

  8. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  9. Facilitating the implementation of evidence- based practice through contextual support and nursing leadership.

    Science.gov (United States)

    Kueny, Angela; Shever, Leah L; Lehan Mackin, Melissa; Titler, Marita G

    2015-01-01

    Nurse managers (NMs) play an important role promoting evidence-based practice (EBP) on clinical units within hospitals. However, there is a dearth of research focused on NM perspectives about institutional contextual factors to support the goal of EBP on the clinical unit. The purpose of this article is to identify contextual factors described by NMs to drive change and facilitate EBP at the unit level, comparing and contrasting these perspectives across nursing units. This study employed a qualitative descriptive design using interviews with nine NMs who were participating in a large effectiveness study. To stratify the sample, NMs were selected from nursing units designated as high or low performing based on implementation of EBP interventions, scores on the Meyer and Goes research use scale, and fall rates. Descriptive content analysis was used to identify themes that reflect the complex nature of infrastructure described by NMs and contextual influences that supported or hindered their promotion of EBP on the clinical unit. NMs perceived workplace culture, structure, and resources as facilitators or barriers to empowering nurses under their supervision to use EBP and drive change. A workplace culture that provides clear communication of EBP goals or regulatory changes, direct contact with CEOs, and clear expectations supported NMs in their promotion of EBP on their units. High-performing unit NMs described a structure that included nursing-specific committees, allowing nurses to drive change and EBP from within the unit. NMs from high-performing units were more likely to articulate internal resources, such as quality-monitoring departments, as critical to the implementation of EBP on their units. This study contributes to a deeper understanding of institutional contextual factors that can be used to support NMs in their efforts to drive EBP changes at the unit level.

  10. Facilitating the implementation of evidence-based practice through contextual support and nursing leadership

    Directory of Open Access Journals (Sweden)

    Kueny A

    2015-06-01

    Full Text Available Angela Kueny,1 Leah L Shever,2 Melissa Lehan Mackin,3 Marita G Titler4 1Luther College, Decorah, IA, 2The University of Michigan Hospital and Health Center, Ann Arbor, MI, 3University of Iowa College of Nursing, Iowa City, IA, 4University of Michigan School of Nursing, Ann Arbor, MI, USA Background/purpose: Nurse managers (NMs play an important role promoting evidence-based practice (EBP on clinical units within hospitals. However, there is a dearth of research focused on NM perspectives about institutional contextual factors to support the goal of EBP on the clinical unit. The purpose of this article is to identify contextual factors described by NMs to drive change and facilitate EBP at the unit level, comparing and contrasting these perspectives across nursing units. Methods: This study employed a qualitative descriptive design using interviews with nine NMs who were participating in a large effectiveness study. To stratify the sample, NMs were selected from nursing units designated as high or low performing based on implementation of EBP interventions, scores on the Meyer and Goes research use scale, and fall rates. Descriptive content analysis was used to identify themes that reflect the complex nature of infrastructure described by NMs and contextual influences that supported or hindered their promotion of EBP on the clinical unit. Results: NMs perceived workplace culture, structure, and resources as facilitators or barriers to empowering nurses under their supervision to use EBP and drive change. A workplace culture that provides clear communication of EBP goals or regulatory changes, direct contact with CEOs, and clear expectations supported NMs in their promotion of EBP on their units. High-performing unit NMs described a structure that included nursing-specific committees, allowing nurses to drive change and EBP from within the unit. NMs from high-performing units were more likely to articulate internal resources, such as quality

  11. Newborn screening for proximal urea cycle disorders: Current evidence supporting recommendations for newborn screening.

    Science.gov (United States)

    Merritt, J Lawrence; Brody, Linnea L; Pino, Gisele; Rinaldo, Piero

    2018-04-20

    Current newborn screening (NBS) for urea cycle disorders (UCD) is incomplete as only distal UCDs are included in most NBS programs by measuring elevated amino acid concentrations. NBS for the proximal UCDs involves the detection in NBS spots of low citrulline values, a finding which is often overlooked because it is considered to be inadequate. We retrospectively analyzed NBS blood spots from known UCD patients comparing the utility of the Region 4 Stork (R4S) interpretive tools to conventional cutoff based interpretation. This study shows the utility of R4S tools in detecting all UCDs, and provides evidence to support the nomination to add proximal UCDs to the recommended uniform screening panel. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Brief Report: An Independent Replication and Extension of Psychometric Evidence Supporting the Theory of Mind Inventory.

    Science.gov (United States)

    Greenslade, Kathryn J; Coggins, Truman E

    2016-08-01

    This study presents an independent replication and extension of psychometric evidence supporting the Theory of Mind Inventory (ToMI). Parents of 20 children with ASD (4; 1-6; 7 years; months) and 20 with typical development (3; 1-6; 5), rated their child's theory of mind abilities in everyday situations. Other parent report and child behavioral assessments included the Social Responsiveness Scale-2, Vineland Adaptive Behavior Scales-2, Peabody Picture Vocabulary Test-4, and Clinical Evaluation of Language Fundamentals-Preschool, 2. Results revealed high internal consistency, expected developmental changes in children with typical development, expected group differences between children with and without ASD, and strong correlations with other measures of social and communication abilities. The ToMI demonstrates strong psychometrics, suggesting considerable utility in identifying theory of mind deficits in children with ASD.

  13. Supporting Evidence Use in Networked Professional Learning: The Role of the Middle Leader

    Science.gov (United States)

    LaPointe-McEwan, Danielle; DeLuca, Christopher; Klinger, Don A.

    2017-01-01

    Background: In Canada, contemporary collaborative professional learning models for educators utilise multiple forms of evidence to inform practice. Commonly, two forms of evidence are prioritised: (a) research-based evidence and (b) classroom-based evidence of student learning. In Ontario, the integration of these two forms of evidence within…

  14. Evidence-based management of ambulatory electronic health record system implementation: an assessment of conceptual support and qualitative evidence.

    Science.gov (United States)

    McAlearney, Ann Scheck; Hefner, Jennifer L; Sieck, Cynthia; Rizer, Milisa; Huerta, Timothy R

    2014-07-01

    While electronic health record (EHR) systems have potential to drive improvements in healthcare, a majority of EHR implementations fall short of expectations. Shortcomings in implementations are often due to organizational issues around the implementation process rather than technological problems. Evidence from both the information technology and healthcare management literature can be applied to improve the likelihood of implementation success, but the translation of this evidence into practice has not been widespread. Our objective was to comprehensively study and synthesize best practices for managing ambulatory EHR system implementation in healthcare organizations, highlighting applicable management theories and successful strategies. We held 45 interviews with key informants in six U.S. healthcare organizations purposively selected based on reported success with ambulatory EHR implementation. We also conducted six focus groups comprised of 37 physicians. Interview and focus group transcripts were analyzed using both deductive and inductive methods to answer research questions and explore emergent themes. We suggest that successful management of ambulatory EHR implementation can be guided by the Plan-Do-Study-Act (PDSA) quality improvement (QI) model. While participants did not acknowledge nor emphasize use of this model, we found evidence that successful implementation practices could be framed using the PDSA model. Additionally, successful sites had three strategies in common: 1) use of evidence from published health information technology (HIT) literature emphasizing implementation facilitators; 2) focusing on workflow; and 3) incorporating critical management factors that facilitate implementation. Organizations seeking to improve ambulatory EHR implementation processes can use frameworks such as the PDSA QI model to guide efforts and provide a means to formally accommodate new evidence over time. Implementing formal management strategies and incorporating

  15. Working memory training in older adults: Bayesian evidence supporting the absence of transfer.

    Science.gov (United States)

    Guye, Sabrina; von Bastian, Claudia C

    2017-12-01

    The question of whether working memory training leads to generalized improvements in untrained cognitive abilities is a longstanding and heatedly debated one. Previous research provides mostly ambiguous evidence regarding the presence or absence of transfer effects in older adults. Thus, to draw decisive conclusions regarding the effectiveness of working memory training interventions, methodologically sound studies with larger sample sizes are needed. In this study, we investigated whether or not a computer-based working memory training intervention induced near and far transfer in a large sample of 142 healthy older adults (65 to 80 years). Therefore, we randomly assigned participants to either the experimental group, which completed 25 sessions of adaptive, process-based working memory training, or to the active, adaptive visual search control group. Bayesian linear mixed-effects models were used to estimate performance improvements on the level of abilities, using multiple indicator tasks for near (working memory) and far transfer (fluid intelligence, shifting, and inhibition). Our data provided consistent evidence supporting the absence of near transfer to untrained working memory tasks and the absence of far transfer effects to all of the assessed abilities. Our results suggest that working memory training is not an effective way to improve general cognitive functioning in old age. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. A review of the evidence supporting the aesthetic orthodontic treatment need indices.

    Science.gov (United States)

    Borzabadi-Farahani, Ali

    2012-11-01

    Aesthetic improvement and psychological enhancement have been cited as justifications for orthodontic treatment. This paper reviews the evidence that relates malocclusion to psychological health and quality of life and explores whether this evidence supports the most commonly used aesthetic Orthodontic Treatment Need Indices (OTNI). The relevant cited material from the MEDLINE, Web of Science, Scopus, Cochrane databases, and scientific textbooks were used. The citation rate was confirmed by using the Google Scholar. The subjective nature of aesthetic indices and the variable perception of attractiveness between clinicians and patients, and among various cultures or countries are a few limitations of aesthetic OTNI. The available evidence of mainly cross-sectional studies on the link between malocclusion and either psychosocial well-being or quality of life is not conclusive, and sometimes contradictory, to suggest these characteristics are affected by malocclusions. Further, the long-term longitudinal studies did not suggest that people with malocclusion are disadvantaged psychologically, or their quality of life would be worse off, which challenges using aesthetic OTNI to assess the social and psychological implications of malocclusion. The subjective nature of aesthetic OTNI and the minor contributory role of malocclusion in psychosocial health or quality of life undermine using aesthetic indices to assess the likely social and psychological implications of malocclusion. Consequently, using aesthetic OTNI, as a method to quantify malocclusion remains open to debate. Various soft and hard-tissue analyses are used before formulating a treatment plan (i.e., assessment of sagittal and vertical skeletal relationships). The addition of a shortened version of these analyses to the aesthetic OTNI can be a good substitute for the aesthetic components of OTNI, if an assessment of the aesthetic aspects of malocclusion is intended. This reduces subjectivity and improves the

  17. A Review of the Evidence Supporting the Vitamin D-Cancer Prevention Hypothesis in 2017.

    Science.gov (United States)

    Grant, William B

    2018-02-01

    The vitamin D-cancer prevention hypothesis has been evaluated through several types of studies, including geographical ecological studies related to indices of solar ultraviolet-B (UVB) dose (the primary source of vitamin D for most people), observational studies related to UVB exposure or serum 25-hydroxyvitamin D [25(OH)D] concentrations, laboratory studies of mechanisms, and clinical trials. Each approach has strengths and limitations. Ecological studies indirectly measure vitamin D production and incorporate the assumption that vitamin D mediates the effect of UVB exposure. Findings from observational studies with long follow-up times are affected by changing 25(OH)D concentrations over time. Most clinical trials have been poorly designed and conducted, based largely on guidelines for pharmaceutical drugs rather than on nutrients. However, three clinical trials do support the hypothesis. In general, the totality of the evidence, as evaluated using Hill's criteria for causality in a biological system, supports the vitamin D-cancer prevention hypothesis. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  18. Evidence - competence - discourse: the theoretical framework of the multi-centre clinical ethics support project METAP.

    Science.gov (United States)

    Reiter-Theil, Stella; Mertz, Marcel; Schürmann, Jan; Stingelin Giles, Nicola; Meyer-Zehnder, Barbara

    2011-09-01

    In this paper we assume that 'theory' is important for Clinical Ethics Support Services (CESS). We will argue that the underlying implicit theory should be reflected. Moreover, we suggest that the theoretical components on which any clinical ethics support (CES) relies should be explicitly articulated in order to enhance the quality of CES. A theoretical framework appropriate for CES will be necessarily complex and should include ethical (both descriptive and normative), metaethical and organizational components. The various forms of CES that exist in North-America and in Europe show their underlying theory more or less explicitly, with most of them referring to some kind of theoretical components including 'how-to' questions (methodology), organizational issues (implementation), problem analysis (phenomenology or typology of problems), and related ethical issues such as end-of-life decisions (major ethical topics). In order to illustrate and explain the theoretical framework that we are suggesting for our own CES project METAP, we will outline this project which has been established in a multi-centre context in several healthcare institutions. We conceptualize three 'pillars' as the major components of our theoretical framework: (1) evidence, (2) competence, and (3) discourse. As a whole, the framework is aimed at developing a foundation of our CES project METAP. We conclude that this specific integration of theoretical components is a promising model for the fruitful further development of CES. © 2011 Blackwell Publishing Ltd.

  19. Supporting Formulary Decisions: The Discovery of New Facts or Constructed Evidence?

    Directory of Open Access Journals (Sweden)

    Paul C Langley

    2016-07-01

    Full Text Available A critical question, given the growing importance of more targeted therapies to support personalized and precision medicine, is the credibility of the evidence base to support formulary decisions and pricing. On the one hand, for those who subscribe to the reference case model of the National Institute of Health and Care Excellence (NICE in the UK, the decision rests upon the creation of modeled or simulated imaginary worlds and the application of threshold willingness-to-pay cost-per-QALY thresholds. On the other hand, for those who subscribe to the standards of normal science, the decision rests upon the ability to evaluate competing claims, both clinical and cost-effective, in a timeframe that is meaningful to a formulary committee. If we subscribe to the scientific method where the focus is on the discovery of new facts, untestable claims for clinical benefit and cost-effectiveness, such as created claims for lifetime cost per-quality-adjusted discounted life years (QALYs, are properly relegated to the category of pseudoscience. We have no idea, and will never know, whether the claims are right or even if they are wrong. If formulary decisions are to respect the standards of normal science then there has to be a commitment to claims evaluation. A willingness to accept new products provisionally, subject to an agreed protocol to support the evaluation of clinical and cost-effectiveness claims. This dichotomy between the standards of normal science and pseudoscience is explored in the context of published claims for cost-effectiveness and recommendations for product pricing in the US.   Type: Commentary

  20. Social support in the post-abortion recovery room: evidence from patients, support persons and nurses in a Vancouver clinic.

    Science.gov (United States)

    Veiga, Mariana B; Lam, Melanie; Gemeinhardt, Carla; Houlihan, Edwina; Fitzsimmons, Brian P; Hodgson, Zoë G

    2011-03-01

    The benefits of social support in post-surgical recovery are well documented; social support decreases preoperative stress and postoperative recovery time. However, a paucity of studies have examined the effect of social support in the context of pregnancy termination. This study is the first to examine the effect of postoperative accompaniment from the patient, support person and nurses' perspective. This study was carried out in two phases. In Phase I, no accompaniment was allowed in the post-anesthesia recovery room (PAR); in Phase II, accompaniment was permitted. All participants completed pre- and postoperative questionnaires. The perception of accompaniment was overwhelmingly positive in patients and support people. Patients in Phase II demonstrated a high (over 95%) acceptance of accompaniment in the recovery room. It was found that 96.8% reported they would choose to be accompanied in the recovery room again if they had to have another abortion. Support persons felt very strongly that their presence was helpful to the patient. The decrease in pre- to postoperative anxiety levels was significantly greater in those women who were accompanied. However, overall, nurses demonstrated a negative attitude towards accompaniment in the recovery room. In summary, the presence of a support person in the PAR was perceived in a positive manner by patients and support people. However, the reasoning behind the negative opinion of nurses requires further study before PAR accompaniment can be considered a possibility in the context of pregnancy termination. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. A Comparison of Types of Support for Lower-Skill Workers: Evidence for the Importance of Family Supportive Supervisors

    Science.gov (United States)

    Muse, Lori A.; Pichler, Shaun

    2011-01-01

    The work-family literature to date does not offer a clear picture in terms of the relative importance of different types of supports for balancing work and family demands. Grounded in conservation or resources theory, we develop an integrative model relating multiple forms of social support, both formal (i.e., work-life benefit use) and informal…

  2. Is There Evidence to Support Brand to Generic Interchange of the Mycophenolic Acid Products?

    Science.gov (United States)

    Phillips, Karen; Reddy, Prabashni; Gabardi, Steven

    2017-02-01

    The uptake of generic immunosuppressants lags comparatively to other drug classes, despite that the Food and Drug Administration (FDA) uses identical bioequivalence standards for all drugs. Transplant societies acknowledge the cost savings associated with generic immunosuppressants and support their use following heart, lung, kidney, or bone marrow transplantation. Seven studies of the pharmacokinetics or clinical efficacy of generic mycophenolate mofetil compared to the innovator product are published; all studies and products were ex-United States. Three studies did not demonstrate any pharmacokinetic differences between generic and innovator products in healthy subjects, achieving FDA bioequivalence requirements. Two studies in renal allograft recipients demonstrated no difference in area under the curves between generic and innovator products, and in one, the maximum concentration (Cmax) fell outside the FDA regulatory range. Two studies revealed no difference in acute organ rejection or graft function in renal allograft recipients. Patient surveys indicate that cost is a barrier to immunosuppressant adherence. Generics present a viable method to reduce costs to payers, patients, and health care systems. Adherence to immunosuppressants is crucial to prevent graft failure. An affordable regimen potentially confers greater adherence. Concerns regarding the presumed inferiority of generic immunosuppressants should be assuaged by regulatory requirements for bioequivalency testing, transplant society position statements, and pharmacokinetic and clinical studies.

  3. Billing and insurance-related administrative costs in United States' health care: synthesis of micro-costing evidence.

    Science.gov (United States)

    Jiwani, Aliya; Himmelstein, David; Woolhandler, Steffie; Kahn, James G

    2014-11-13

    The United States' multiple-payer health care system requires substantial effort and costs for administration, with billing and insurance-related (BIR) activities comprising a large but incompletely characterized proportion. A number of studies have quantified BIR costs for specific health care sectors, using micro-costing techniques. However, variation in the types of payers, providers, and BIR activities across studies complicates estimation of system-wide costs. Using a consistent and comprehensive definition of BIR (including both public and private payers, all providers, and all types of BIR activities), we synthesized and updated available micro-costing evidence in order to estimate total and added BIR costs for the U.S. health care system in 2012. We reviewed BIR micro-costing studies across healthcare sectors. For physician practices, hospitals, and insurers, we estimated the % BIR using existing research and publicly reported data, re-calculated to a standard and comprehensive definition of BIR where necessary. We found no data on % BIR in other health services or supplies settings, so extrapolated from known sectors. We calculated total BIR costs in each sector as the product of 2012 U.S. national health expenditures and the percentage of revenue used for BIR. We estimated "added" BIR costs by comparing total BIR costs in each sector to those observed in existing, simplified financing systems (Canada's single payer system for providers, and U.S. Medicare for insurers). Due to uncertainty in inputs, we performed sensitivity analyses. BIR costs in the U.S. health care system totaled approximately $471 ($330 - $597) billion in 2012. This includes $70 ($54 - $76) billion in physician practices, $74 ($58 - $94) billion in hospitals, an estimated $94 ($47 - $141) billion in settings providing other health services and supplies, $198 ($154 - $233) billion in private insurers, and $35 ($17 - $52) billion in public insurers. Compared to simplified financing, $375

  4. Analysis of the National Modernizers Network for the Support of the Public Administration Reform Process from Romania

    Directory of Open Access Journals (Sweden)

    Alina PROFIROIU

    2010-10-01

    Full Text Available The reform process of the state and implicitly of the public administration was a priority for the past governments of Romania. During 2004- 2009, within the reform process, the main actors involved in the coordination, implementation and monitoring of reform measures were: the Prime Minister, the Superior Council for Public Administration Reform, Public Policy Coordination and Structural Adjustment, the Ministry of Public Finance, the General Secretariat of Government, Ministry of Administration and Interior (renamed for a short time Ministry of Interior and Administrative Reform, the Central Unit for Public Administration Reform, National Institute of Administration, the National Agency of Civil Servants, and the National Modernizers Network. For evaluation of aspects related to the reform process it was designed a selective research within the members of the National Modernizers Network, for assessing their perception of the public administration reform undertaken by the institutions presented above. Evaluating their opinion can be an important point in the revitalization of the area of the administration reform process. Also, the research conducted aimed at assessing the degree of modernizers’ involvement in activities related to important aspects of the reform process: strategic planning, formulating and evaluating public policies, financial management, human resources management, decentralization, introduction of new information and communication technologies and administrative simplification.

  5. The Evidence Base for How We Learn: Supporting Students' Social, Emotional, and Academic Development. Consensus Statements of Evidence from the Council of Distinguished Scientists

    Science.gov (United States)

    Jones, Stephanie M.; Kahn, Jennifer

    2017-01-01

    "The Evidence Base for How We Learn: Supporting Students' Social, Emotional, and Academic Development" articulates the scientific consensus regarding how people learn. The research brief presents a set of consensus statements--developed and unanimously signed onto by the Commission's Council of Distinguished Scientists--that affirm the…

  6. Motivations for Botanical Use by Socioeconomically Diverse, Urban Adults: Does Evidence Support Motivation?

    Science.gov (United States)

    Duffy, Grace F; Shupe, Emily Stave; Kuczmarski, Marie Fanelli; Zonderman, Alan B; Evans, Michele K

    2017-10-01

    The study objectives were to characterize botanical dietary supplement (BDS) use and to compare the motivations for botanical supplement (BS) use to the efficacy of the botanical in a socioeconomically and racially diverse urban adult population. Subjects were from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, a 20-year prospective health disparities study with African American and white adults from Baltimore, Maryland. All study participants completed two dietary recalls and a dietary supplement (DS) questionnaire in Wave 3 (n = 2140). Diet quality was evaluated by the Healthy Eating Index-2010 and the Mean Adequacy Ratio for 17 micronutrients. A comparison of reported motivations to efficacy reported in the literature of single BS was conducted. Approximately 50% (1062/2140) of participants took DS. Of these, 8% (n = 178) reported taking either BS or BDS. It was found that BDS users had better diet quality than DS users as well as nonusers of DS. The top three motivations for BDS users were to improve overall health, to maintain health, and to supplement the diet. There is limited evidence for the efficacy of most BS. Review of the efficacy of the 15 BS reported by ≥5% of the study population revealed beneficial health roles for only fiber, gingko biloba extract EGb 761, and hawthorn berry. To the authors' knowledge, this study is the first to report a better quality diet with BDS use for a racially diverse urban population. Yet, improvement in diet is needed because overall quality did not achieve current recommendations. To improve overall health, it may be beneficial for this population to focus on dietary modifications to reduce the risks associated with chronic diseases. In general, the reported motivations for BS use were not supported by clinical evidence.

  7. Feature engineering and a proposed decision-support system for systematic reviewers of medical evidence.

    Directory of Open Access Journals (Sweden)

    Tanja Bekhuis

    Full Text Available Evidence-based medicine depends on the timely synthesis of research findings. An important source of synthesized evidence resides in systematic reviews. However, a bottleneck in review production involves dual screening of citations with titles and abstracts to find eligible studies. For this research, we tested the effect of various kinds of textual information (features on performance of a machine learning classifier. Based on our findings, we propose an automated system to reduce screeing burden, as well as offer quality assurance.We built a database of citations from 5 systematic reviews that varied with respect to domain, topic, and sponsor. Consensus judgments regarding eligibility were inferred from published reports. We extracted 5 feature sets from citations: alphabetic, alphanumeric(+, indexing, features mapped to concepts in systematic reviews, and topic models. To simulate a two-person team, we divided the data into random halves. We optimized the parameters of a Bayesian classifier, then trained and tested models on alternate data halves. Overall, we conducted 50 independent tests.All tests of summary performance (mean F3 surpassed the corresponding baseline, P<0.0001. The ranks for mean F3, precision, and classification error were statistically different across feature sets averaged over reviews; P-values for Friedman's test were .045, .002, and .002, respectively. Differences in ranks for mean recall were not statistically significant. Alphanumeric(+ features were associated with best performance; mean reduction in screening burden for this feature type ranged from 88% to 98% for the second pass through citations and from 38% to 48% overall.A computer-assisted, decision support system based on our methods could substantially reduce the burden of screening citations for systematic review teams and solo reviewers. Additionally, such a system could deliver quality assurance both by confirming concordant decisions and by naming

  8. Evidence to Support the Anti-Cancer Effect of Olive Leaf Extract and Future Directions

    Science.gov (United States)

    Boss, Anna; Bishop, Karen S.; Marlow, Gareth; Barnett, Matthew P. G.; Ferguson, Lynnette R.

    2016-01-01

    The traditional Mediterranean diet (MD) is associated with long life and lower prevalence of cardiovascular disease and cancers. The main components of this diet include high intake of fruit, vegetables, red wine, extra virgin olive oil (EVOO) and fish, low intake of dairy and red meat. Olive oil has gained support as a key effector of health benefits and there is evidence that this relates to the polyphenol content. Olive leaf extract (OLE) contains a higher quantity and variety of polyphenols than those found in EVOO. There are also important structural differences between polyphenols from olive leaf and those from olive fruit that may improve the capacity of OLE to enhance health outcomes. Olive polyphenols have been claimed to play an important protective role in cancer and other inflammation-related diseases. Both inflammatory and cancer cell models have shown that olive leaf polyphenols are anti-inflammatory and protect against DNA damage initiated by free radicals. The various bioactive properties of olive leaf polyphenols are a plausible explanation for the inhibition of progression and development of cancers. The pathways and signaling cascades manipulated include the NF-κB inflammatory response and the oxidative stress response, but the effects of these bioactive components may also result from their action as a phytoestrogen. Due to the similar structure of the olive polyphenols to oestrogens, these have been hypothesized to interact with oestrogen receptors, thereby reducing the prevalence and progression of hormone related cancers. Evidence for the protective effect of olive polyphenols for cancer in humans remains anecdotal and clinical trials are required to substantiate these claims idea. This review aims to amalgamate the current literature regarding bioavailability and mechanisms involved in the potential anti-cancer action of olive leaf polyphenols. PMID:27548217

  9. Diagnosis of feline infectious peritonitis: Update on evidence supporting available tests.

    Science.gov (United States)

    Tasker, Séverine

    2018-03-01

    Practical relevance: Feline coronavirus (FCoV) infection is very common in cats, usually causing only mild intestinal signs such as diarrhoea. Up to 10% of FCoV infections, however, result in the fatal disease feline infectious peritonitis (FIP). Clinical challenges: Obtaining a definitive diagnosis of FIP based on non-invasive approaches is difficult. Confirmation of the disease relies on finding appropriate cytological or histopathological changes in association with positive immunostaining for FCoV antigen. In FIP cases with effusions, cytology and immunostaining on effusion samples can be relatively easy to perform; otherwise obtaining diagnostic samples is more challenging and collection of biopsies from tissues with gross lesions is necessary. In the absence of a definitive diagnosis, a high index of suspicion of FIP may be obtained from the cat's signalment and history, combined with findings on clinical examination and laboratory test results. If largely consistent with FIP, these can be used as a basis for discussion with the owner about whether additional, more invasive, diagnostic tests are warranted. In some cases it may be that euthanasia is discussed as an alternative to pursuing a definitive diagnosis ante-mortem, especially if financial limitations exist or where there are concerns over a cat's ability to tolerate invasive diagnostic procedures. Ideally, the diagnosis should be confirmed in such patients from samples taken at post-mortem examination. Global importance: FIP occurs wherever FCoV infection is present in cats, which equates to most parts of the world. Evidence base: This review provides a comprehensive overview of how to approach the diagnosis of FIP, focusing on the tests available to the veterinary practitioner and recently published evidence supporting their use.

  10. Evidence to Support the Anti-Cancer Effect of Olive Leaf Extract and Future Directions

    Directory of Open Access Journals (Sweden)

    Anna Boss

    2016-08-01

    Full Text Available The traditional Mediterranean diet (MD is associated with long life and lower prevalence of cardiovascular disease and cancers. The main components of this diet include high intake of fruit, vegetables, red wine, extra virgin olive oil (EVOO and fish, low intake of dairy and red meat. Olive oil has gained support as a key effector of health benefits and there is evidence that this relates to the polyphenol content. Olive leaf extract (OLE contains a higher quantity and variety of polyphenols than those found in EVOO. There are also important structural differences between polyphenols from olive leaf and those from olive fruit that may improve the capacity of OLE to enhance health outcomes. Olive polyphenols have been claimed to play an important protective role in cancer and other inflammation-related diseases. Both inflammatory and cancer cell models have shown that olive leaf polyphenols are anti-inflammatory and protect against DNA damage initiated by free radicals. The various bioactive properties of olive leaf polyphenols are a plausible explanation for the inhibition of progression and development of cancers. The pathways and signaling cascades manipulated include the NF-κB inflammatory response and the oxidative stress response, but the effects of these bioactive components may also result from their action as a phytoestrogen. Due to the similar structure of the olive polyphenols to oestrogens, these have been hypothesized to interact with oestrogen receptors, thereby reducing the prevalence and progression of hormone related cancers. Evidence for the protective effect of olive polyphenols for cancer in humans remains anecdotal and clinical trials are required to substantiate these claims idea. This review aims to amalgamate the current literature regarding bioavailability and mechanisms involved in the potential anti-cancer action of olive leaf polyphenols.

  11. SAT administrator

    International Nuclear Information System (INIS)

    Havas, A.

    1998-01-01

    SAT Administrator is the Information System for Nuclear Power Plant Personnel Training Program Design. It supports the design of training programs in the following phases: job analysis; task analysis; competency analysis; task competency association; definition of learning objectives to competencies; training program design; definition of test items. The general structure of the database and management software supports application of the SAT Administrator in any nuclear power installation

  12. Bureaucratic structure, geographical location and the autonomy of administrative systems. Evidence from the European External Action Service

    OpenAIRE

    Henökl, Thomas; Trondal, Jarle

    2013-01-01

    Presentation on department page: http://www.uia.no/no/portaler/om_universitetet/oekonomi_og_samfunnsvitenskap/statsvitenskap_og_ledelsesfag/ forskning_isl/isl_working_papers_series Formulating and implementing public policy in Europe has historically been a prerogative of national administrations. This paper explores how these prerogatives may have become challenged with the ‘autonomization’ of the European Union’s (EU’s) foreign affairs administration (The European External Action Service...

  13. Derivation and validation of the Personal Support Algorithm: an evidence-based framework to inform allocation of personal support services in home and community care.

    Science.gov (United States)

    Sinn, Chi-Ling Joanna; Jones, Aaron; McMullan, Janet Legge; Ackerman, Nancy; Curtin-Telegdi, Nancy; Eckel, Leslie; Hirdes, John P

    2017-11-25

    Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this project was to develop an evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. The sample included 128,169 Ontario home care patients assessed in 2013 and 25,800 Ontario community support clients assessed between 2014 and 2016. Independent variables were drawn from the Resident Assessment Instrument-Home Care and interRAI Community Health Assessment that are standardised, comprehensive, and fully compatible clinical assessments. Clinical expertise and regression analyses identified candidate variables that were entered into decision tree models. The primary dependent variable was the weekly hours of personal support calculated based on the record of billed services. The Personal Support Algorithm classified need for personal support into six groups with a 32-fold difference in average billed hours of personal support services between the highest and lowest group. The algorithm explained 30.8% of the variability in billed personal support services. Care coordinators and managers reported that the guidelines based on the algorithm classification were consistent with their clinical judgment and current practice. The Personal Support Algorithm provides a structured yet flexible decision-support framework that may facilitate a more transparent and equitable approach to the allocation of personal support services.

  14. Derivation and validation of the Personal Support Algorithm: an evidence-based framework to inform allocation of personal support services in home and community care

    Directory of Open Access Journals (Sweden)

    Chi-Ling Joanna Sinn

    2017-11-01

    Full Text Available Abstract Background Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this project was to develop an evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. Methods The sample included 128,169 Ontario home care patients assessed in 2013 and 25,800 Ontario community support clients assessed between 2014 and 2016. Independent variables were drawn from the Resident Assessment Instrument-Home Care and interRAI Community Health Assessment that are standardised, comprehensive, and fully compatible clinical assessments. Clinical expertise and regression analyses identified candidate variables that were entered into decision tree models. The primary dependent variable was the weekly hours of personal support calculated based on the record of billed services. Results The Personal Support Algorithm classified need for personal support into six groups with a 32-fold difference in average billed hours of personal support services between the highest and lowest group. The algorithm explained 30.8% of the variability in billed personal support services. Care coordinators and managers reported that the guidelines based on the algorithm classification were consistent with their clinical judgment and current practice. Conclusions The Personal Support Algorithm provides a structured yet flexible decision-support framework that may facilitate a more transparent and equitable approach to the allocation of personal support services.

  15. Organizational supports used by private child and family serving agencies to facilitate evidence use: a mixed methods study protocol.

    Science.gov (United States)

    Chuang, Emmeline; Collins-Camargo, Crystal; McBeath, Bowen

    2017-04-08

    Challenges to evidence use are well documented. Less well understood are the formal supports-e.g., technical infrastructure, inter-organizational relationships-organizations may put in place to help overcome these challenges. This study will identify supports for evidence use currently used by private child and family serving agencies delivering publicly funded behavioral health and/or human services; examine contextual, organizational, and managerial factors associated with use of such supports; and determine how identified supports affect evidence use by staff at multiple levels of the organization. We will use a sequential explanatory mixed methods design, with study activities occurring in two sequential phases: In phase 1, quantitative survey data collected from managers of private child and family serving agencies in six states (CA, IN, KY, MO, PA, and WI) and analyzed using both regression and qualitative comparative analysis (QCA) will identify organizational supports currently being used to facilitate evidence use and examine the contextual, organizational, and managerial factors associated with the use of such supports. In phase 2, data from phase 1 will be used to select a purposive sample of 12 agencies for in-depth case studies. In those 12 agencies, semi-structured interviews with key informants and managers, focus groups with frontline staff, and document analysis will provide further insight into agencies' motivation for investing in organizational supports for evidence use and the facilitators and barriers encountered in doing so. Semi-structured interviews with managers and focus groups with frontline staff will also assess whether and how identified supports affect evidence use at different levels of the organization (senior executives, middle managers, frontline supervisors, and frontline staff). Within- and between-case analyses supplemented by QCA will identify combinations of factors associated with the highest and lowest levels of staff

  16. Historic evidence to support a causal relationship between spirochetal infections and Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Judith eMiklossy

    2015-04-01

    Full Text Available Following previous observations a statistically significant association between various types of spirochetes and Alzheimer’s disease (AD fulfilled Hill’s criteria in favor of a causal relationship. If spirochetal infections can indeed cause AD, the pathological and biological hallmarks of AD should also occur in syphilitic dementia. To answer this question, observations and illustrations on the detection of spirochetes in the atrophic form of general paresis, which is known to be associated with slowly progressive dementia, were reviewed and compared with the characteristic pathology of AD. Historic observations and illustrations published in the first half of the 20th Century indeed confirm that the pathological hallmarks, which define AD, are also present in syphilitic dementia. Cortical spirochetal colonies are made up by innumerable tightly spiraled Treponema pallidum spirochetes, which are morphologically indistinguishable from senile plaques, using conventional light microscopy. Local brain amyloidosis also occurs in general paresis and, as in AD, corresponds to amyloid beta. These historic observations enable us to conclude that chronic spirochetal infections can cause dementia and reproduce the defining hallmarks of AD. They represent further evidence in support a causal relationship between various spirochetal infections and AD. They also indicate that local invasion of the brain by these helically shaped bacteria reproduce the filamentous pathology characteristic of AD. Chronic infection by spirochetes, and co-infection with other bacteria and viruses should be included in our current view on the etiology of AD. Prompt action is needed as AD might be prevented.

  17. On the observability of turbulent transport rates by Argo: supporting evidence from an inversion experiment

    Directory of Open Access Journals (Sweden)

    G. Forget

    2015-10-01

    Full Text Available Although estimation of turbulent transport parameters using inverse methods is not new, there is little evaluation of the method in the literature. Here, it is shown that extended observation of the broad-scale hydrography by Argo provides a path to improved estimates of regional turbulent transport rates. Results from a 20-year ocean state estimate produced with the ECCO v4 (Estimating the Circulation and Climate of the Ocean, version 4 non-linear inverse modeling framework provide supporting evidence. Turbulent transport parameter maps are estimated under the constraints of fitting the extensive collection of Argo profiles collected through 2011. The adjusted parameters dramatically reduce misfits to in situ profiles as compared with earlier ECCO solutions. They also yield a clear reduction in the model drift away from observations over multi-century-long simulations, both for assimilated variables (temperature and salinity and independent variables (biogeochemical tracers. Despite the minimal constraints imposed specifically on the estimated parameters, their geography is physically plausible and exhibits close connections with the upper-ocean stratification as observed by Argo. The estimated parameter adjustments furthermore have first-order impacts on upper-ocean stratification and mixed layer depths over 20 years. These results identify the constraint of fitting Argo profiles as an effective observational basis for regional turbulent transport rate inversions. Uncertainties and further improvements of the method are discussed.

  18. Visual working memory supports the inhibition of previously processed information: evidence from preview search.

    Science.gov (United States)

    Al-Aidroos, Naseem; Emrich, Stephen M; Ferber, Susanne; Pratt, Jay

    2012-06-01

    In four experiments we assessed whether visual working memory (VWM) maintains a record of previously processed visual information, allowing old information to be inhibited, and new information to be prioritized. Specifically, we evaluated whether VWM contributes to the inhibition (i.e., visual marking) of previewed distractors in a preview search. We evaluated this proposal by testing three predictions. First, Experiments 1 and 2 demonstrate that preview inhibition is more effective when the number of previewed distractors is below VWM capacity than above; an effect that can only be observed at small preview set sizes (Experiment 2A) and when observers are allowed to move their eyes freely (Experiment 2B). Second, Experiment 3 shows that, when quantified as the number of inhibited distractors, the magnitude of the preview effect is stable across different search difficulties. Third, Experiment 4 demonstrates that individual differences in preview inhibition are correlated with individual differences in VWM capacity. These findings provide converging evidence that VWM supports the inhibition of previewed distractors. More generally, these findings demonstrate how VWM contributes to the efficiency of human visual information processing--VWM prioritizes new information by inhibiting old information from being reselected for attention.

  19. Providing Evidence-Based, Intelligent Support for Flood Resilient Planning and Policy: The PEARL Knowledge Base

    Directory of Open Access Journals (Sweden)

    George Karavokiros

    2016-09-01

    Full Text Available While flood risk is evolving as one of the most imminent natural hazards and the shift from a reactive decision environment to a proactive one sets the basis of the latest thinking in flood management, the need to equip decision makers with necessary tools to think about and intelligently select options and strategies for flood management is becoming ever more pressing. Within this context, the Preparing for Extreme and Rare Events in Coastal Regions (PEARL intelligent knowledge-base (PEARL KB of resilience strategies is presented here as an environment that allows end-users to navigate from their observed problem to a selection of possible options and interventions worth considering within an intuitive visual web interface assisting advanced interactivity. Incorporation of real case studies within the PEARL KB enables the extraction of (evidence-based lessons from all over the word, while the KB’s collection of methods and tools directly supports the optimal selection of suitable interventions. The Knowledge-Base also gives access to the PEARL KB Flood Resilience Index (FRI tool, which is an online tool for resilience assessment at a city level available to authorities and citizens. We argue that the PEARL KB equips authorities with tangible and operational tools that can improve strategic and operational flood risk management by assessing and eventually increasing resilience, while building towards the strengthening of risk governance. The online tools that the PEARL KB gives access to were demonstrated and tested in the city of Rethymno, Greece.

  20. The evidence for the use of nutritional support in liver disease.

    Science.gov (United States)

    Koretz, Ronald L

    2014-03-01

    Although there is a well established association between malnutrition and poorer clinical outcomes in patients with liver disease, that fact alone does not prove that improving the malnutrition will improve outcome. The best way to determine if nutritional interventions are effective is to compare them to untreated control groups in well designed and executed randomized clinical trials. A recent systematic review assessed 37 trials that compared parenteral nutrition, enteral nutrition, or nutritional supplements to no nutritional therapy in patients with a variety of liver diseases. Since the publication of that review, an additional three trials have become available. Whereas all but one of the trials did have methodologic shortcomings that may have allowed the introduction of bias (which usually results in an overestimation of benefit), the trials failed to show much, if any, benefit. In fact, the single trial at low risk of bias found that more deaths occurred in the recipients of the supplements. Although malnutrition may be associated with a poor outcome, the current best evidence indicates that the provision of adjunctive nutritional support (parenteral or enteral nutrition, or nutritional supplements) to patients with a variety of liver diseases (alcoholic hepatitis, cirrhosis, hepatocellular carcinoma, liver surgery, liver transplantation, obstructive jaundice, hepatitis C antiviral treatment) does not improve clinical outcomes.

  1. Modeling the Construct of an Expert Evidence-Adaptive Knowledge Base for a Pressure Injury Clinical Decision Support System

    Directory of Open Access Journals (Sweden)

    Peck Chui Betty Khong

    2017-07-01

    Full Text Available The selection of appropriate wound products for the treatment of pressure injuries is paramount in promoting wound healing. However, nurses find it difficult to decide on the most optimal wound product(s due to limited live experiences in managing pressure injuries resulting from successfully implemented pressure injury prevention programs. The challenges of effective decision-making in wound treatments by nurses at the point of care are compounded by the yearly release of wide arrays of newly researched wound products into the consumer market. A clinical decision support system for pressure injury (PI-CDSS was built to facilitate effective decision-making and selection of optimal wound treatments. This paper describes the development of PI-CDSS with an expert knowledge base using an interactive development environment, Blaze Advisor. A conceptual framework using decision-making and decision theory, knowledge representation, and process modelling guided the construct of the PI-CDSS. This expert system has incorporated the practical and relevant decision knowledge of wound experts in assessment and wound treatments in its algorithm. The construct of the PI-CDSS is adaptive, with scalable capabilities for expansion to include other CDSSs and interoperability to interface with other existing clinical and administrative systems. The algorithm was formatively evaluated and tested for usability. The treatment modalities generated after using patient-specific assessment data were found to be consistent with the treatment plan(s proposed by the wound experts. The overall agreement exceeded 90% between the wound experts and the generated treatment modalities for the choice of wound products, instructions, and alerts. The PI-CDSS serves as a just-in-time wound treatment protocol with suggested clinical actions for nurses, based on the best evidence available.

  2. Evidence-based radiology (part 1): Is there sufficient research to support the use of therapeutic injections for the spine and sacroiliac joints?

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Cynthia; Hodler, Juerg [Orthopaedic University Hospital of Balgrist, Radiology, Zuerich (Switzerland)

    2010-01-15

    This review article addresses the best evidence currently available for therapeutic injection therapy for conditions targeting the spine and sacroiliac joints. The article is presented by spinal region. Controversies and areas of interest for further studies are identified. There is conclusive evidence supporting the effectiveness of the caudal approach for the administration of epidural steroid injections for patients with low back pain from a variety of causes. In general, there is moderate-to-strong evidence supporting the use of transforaminal therapeutic epidural injections for lumbar nerve-root compression and facet injections for joint pain arising from these joints in the cervical, thoracic and lumbar spine, but further subgroup analysis is needed to help predict which specific patients may receive the most benefit from these procedures. No randomized controlled trials, meta-analyses or systematic reviews addressing the effectiveness of therapeutic sacroiliac joint injections have been found. For some injections, corticosteroids may not provide better outcomes compared to local anesthetic injections alone. (orig.)

  3. Administrative Data Repository (ADR)

    Data.gov (United States)

    Department of Veterans Affairs — The Administrative Data Repository (ADR) was established to provide support for the administrative data elements relative to multiple categories of a person entity...

  4. Career Pathing among General Administrative and Support Services Employees Based on Holland?s Typology of Personality Theory and Personal Style Inventory

    Science.gov (United States)

    Mendoza, Catalino N.

    2009-01-01

    The study is about the prevailing differences, commonalities and significant contributions of the career pathing among the general administrative and support services employees based on Holland's Typology of Personality Theory and Personal Style Inventory of selected higher educational institutions in Metro Manila.

  5. Managing symptoms during cancer treatments: evaluating the implementation of evidence-informed remote support protocols

    Directory of Open Access Journals (Sweden)

    Stacey Dawn

    2012-11-01

    Full Text Available Abstract Background Management of cancer treatment-related symptoms is an important safety issue given that symptoms can become life-threatening and often occur when patients are at home. With funding from the Canadian Partnership Against Cancer, a pan-Canadian steering committee was established with representation from eight provinces to develop symptom protocols using a rigorous methodology (CAN-IMPLEMENT©. Each protocol is based on a systematic review of the literature to identify relevant clinical practice guidelines. Protocols were validated by cancer nurses from across Canada. The aim of this study is to build an effective and sustainable approach for implementing evidence-informed protocols for nurses to use when providing remote symptom assessment, triage, and guidance in self-management for patients experiencing symptoms while undergoing cancer treatments. Methods A prospective mixed-methods study design will be used. Guided by the Knowledge to Action Framework, the study will involve (a establishing an advisory knowledge user team in each of three targeted settings; (b assessing factors influencing nurses’ use of protocols using interviews/focus groups and a standardized survey instrument; (c adapting protocols for local use, ensuring fidelity of the content; (d selecting intervention strategies to overcome known barriers and implementing the protocols; (e conducting think-aloud usability testing; (f evaluating protocol use and outcomes by conducting an audit of 100 randomly selected charts at each of the three settings; and (g assessing satisfaction with remote support using symptom protocols and change in nurses’ barriers to use using survey instruments. The primary outcome is sustained use of the protocols, defined as use in 75% of the calls. Descriptive analysis will be conducted for the barriers, use of protocols, and chart audit outcomes. Content analysis will be conducted on interviews/focus groups and usability testing

  6. Understanding the Concept of Fit-For-Purpose Land Administration in Support of the Post 2015 Global Agenda

    DEFF Research Database (Denmark)

    Enemark, Stig

    2015-01-01

    on top-end technical solutions and high accuracy surveys. Of course, such flexibility allows for land administration systems to be incrementally improved over time. This paper unfolds the Fit-For-Purpose concept by analysing the three core components: • The spatial framework (large scale land parcel......This paper argues that the fit-for-purpose approach to building land administration systems in less developed countries will enable provision of the basic administrative frameworks for managing the people to land relationship that is fundamental for meeting the upcoming post 2015 global agenda....... The term “Fit-For-Purpose Land Administration” indicates that the approach used for building land administration systems in less developed countries should be flexible and focused on serving the purpose of the systems (such as providing security of tenure and control of land use) rather than focusing...

  7. The Melbourne Family Support Program: evidence-based strategies that prepare family caregivers for supporting palliative care patients

    Science.gov (United States)

    Hudson, Peter; Aranda, Sanchia

    2014-01-01

    Background A key component of palliative care is support for family caregivers. Although some family caregivers identify positive aspects, the impact is typically burdensome; they are prone to physical and psychological morbidity, financial disadvantage and social isolation. Outcomes of systematic reviews have highlighted the importance of investment in family caregiver intervention research. Purpose To provide an overview of the development, evaluation and outcomes arising from of a programme of research (The Melbourne Family Support Program (FSP)), which focused on reducing the psychosocial burden of family caregivers. Methods Developmental work involved a systematic literature review; focus groups with family caregivers and health professionals; and identification of a conceptual framework. Following a pilot randomised controlled trial (RCT), a programme of psychoeducational intervention studies was developed and tested; one via RCT, the others via prepost test. Results Four psychoeducational interventions, incorporating one-to-one and group format delivery, conducted in both the home and inpatient hospital/hospice were evaluated. Statistically significant outcomes included improvements in family caregivers’ preparedness, competence, positive emotions, more favourable levels of psychological wellbeing and a reduction in unmet needs. Internationally endorsed guidelines for the psychosocial support of family caregivers were produced and several resources were constructed. Fifteen publications in international peer-reviewed journals have arisen from this programme. Conclusions The interventions and resources from the Melbourne FSP provide several evidenced-based and clinically relevant approaches that focus on reducing the psychosocial burden of the caregiving role. In several instances, however, more rigorous methodological testing is advocated. PMID:24644195

  8. What supports do health system organizations have in place to facilitate evidence-informed decision-making? A qualitative study.

    Science.gov (United States)

    Ellen, Moriah E; Léon, Gregory; Bouchard, Gisèle; Lavis, John N; Ouimet, Mathieu; Grimshaw, Jeremy M

    2013-08-06

    Decisions regarding health systems are sometimes made without the input of timely and reliable evidence, leading to less than optimal health outcomes. Healthcare organizations can implement tools and infrastructures to support the use of research evidence to inform decision-making. The purpose of this study was to profile the supports and instruments (i.e., programs, interventions, instruments or tools) that healthcare organizations currently have in place and which ones were perceived to facilitate evidence-informed decision-making. In-depth semi-structured telephone interviews were conducted with individuals in three different types of positions (i.e., a senior management team member, a library manager, and a 'knowledge broker') in three types of healthcare organizations (i.e., regional health authorities, hospitals and primary care practices) in two Canadian provinces (i.e., Ontario and Quebec). The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. A total of 57 interviews were conducted in 25 organizations in Ontario and Quebec. The main findings suggest that, for the healthcare organizations that participated in this study, the following supports facilitate evidence-informed decision-making: facilitating roles that actively promote research use within the organization; establishing ties to researchers and opinion leaders outside the organization; a technical infrastructure that provides access to research evidence, such as databases; and provision and participation in training programs to enhance staff's capacity building. This study identified the need for having a receptive climate, which laid the foundation for the implementation of other tangible initiatives and supported the use of research in decision-making. This study adds to the literature on organizational efforts that can increase the use of research evidence in decision-making. Some of the identified supports may increase the use of

  9. The Effect of Disability Insurance on Health Investment: Evidence from the Veterans Benefits Administration's Disability Compensation Program

    Science.gov (United States)

    Singleton, Perry

    2009-01-01

    I examine whether individuals respond to monetary incentives to detect latent medical conditions. The effect is identified by a policy that deemed diabetes associated with herbicide exposure a compensable disability under the Veterans Benefits Administration's Disability Compensation program. Since a diagnosis is a requisite for benefit…

  10. Medical School Librarians Need More Training to Support their Involvement in Evidence Based Medicine Curricula

    Directory of Open Access Journals (Sweden)

    Aislinn Conway

    2016-04-01

    Full Text Available Objective – To describe the self-perceived role of librarians in developing evidence based medicine (EBM curricula and identify their current and desired level of training to support these activities. Design – Multi-institutional qualitative study. Setting – Nine medical schools in Canada and the United States of America. Subjects – Nine librarians identified by medical school faculty as central to the provision of EBM training for medical students at their institution. Methods – The researchers designed a semi-structured interview schedule based on a review of the literature and their own experiences as librarians teaching EBM. The topics covered were; librarians’ perceptions of their roles in relation to the curriculum, the training required to enable them to undertake these roles, and their professional development needs. The interviews were conducted by telephone and then audio-recorded and transcribed verbatim. The authors present five main themes; curricular design, curricular deployment, curricular assessment, educational training, and professional development. Profiles were developed for each participant based on the latter two themes and from this information common characteristics were identified. Main Results – The participants described the importance of collaboration with faculty and student bodies when designing a curriculum. Information literacy instruction and specifically literature searching and forming a research question were taught by all of the participants to facilitate curricular deployment. Some of the librarians were involved or partly involved in curricular assessment activities such as formulating exam questions or providing feedback on assignments. Educational training of participants varied from informal observation to formal workshops offered by higher education institutions. All librarians indicated a willingness to partake in professional development focused on teaching and EBM. The subjects

  11. The Melbourne Family Support Program: evidence-based strategies that prepare family caregivers for supporting palliative care patients.

    Science.gov (United States)

    Hudson, Peter; Aranda, Sanchia

    2014-09-01

    A key component of palliative care is support for family caregivers. Although some family caregivers identify positive aspects, the impact is typically burdensome; they are prone to physical and psychological morbidity, financial disadvantage and social isolation. Outcomes of systematic reviews have highlighted the importance of investment in family caregiver intervention research. To provide an overview of the development, evaluation and outcomes arising from of a programme of research (The Melbourne Family Support Program (FSP)), which focused on reducing the psychosocial burden of family caregivers. Developmental work involved a systematic literature review; focus groups with family caregivers and health professionals; and identification of a conceptual framework. Following a pilot randomised controlled trial (RCT), a programme of psychoeducational intervention studies was developed and tested; one via RCT, the others via prepost test. Four psychoeducational interventions, incorporating one-to-one and group format delivery, conducted in both the home and inpatient hospital/hospice were evaluated. Statistically significant outcomes included improvements in family caregivers' preparedness, competence, positive emotions, more favourable levels of psychological wellbeing and a reduction in unmet needs. Internationally endorsed guidelines for the psychosocial support of family caregivers were produced and several resources were constructed. Fifteen publications in international peer-reviewed journals have arisen from this programme. The interventions and resources from the Melbourne FSP provide several evidenced-based and clinically relevant approaches that focus on reducing the psychosocial burden of the caregiving role. In several instances, however, more rigorous methodological testing is advocated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Evidence-informed health policy 1 - synthesis of findings from a multi-method study of organizations that support the use of research evidence.

    Science.gov (United States)

    Lavis, John N; Oxman, Andrew D; Moynihan, Ray; Paulsen, Elizabeth J

    2008-12-17

    Organizations have been established in many countries and internationally to support the use of research evidence by producing clinical practice guidelines, undertaking health technology assessments, and/or directly supporting the use of research evidence in developing health policy on an international, national, and state or provincial level. Learning from these organizations can reduce the need to 'reinvent the wheel' and inform decisions about how best to organize support for such organizations, particularly in low- and middle-income countries (LMICs). We undertook a multi-method study in three phases - a survey, interviews, and case descriptions that drew on site visits - and in each of the second and third phases we focused on a purposive sample of those involved in the previous phase. We used the seven main recommendations that emerged from the advice offered in the interviews to organize much of the synthesis of findings across phases and methods. We used a constant comparative method to identify themes from across phases and methods. Seven recommendations emerged for those involved in establishing or leading organizations that support the use of research evidence in developing health policy: 1) collaborate with other organizations; 2) establish strong links with policymakers and involve stakeholders in the work; 3) be independent and manage conflicts of interest among those involved in the work; 4) build capacity among those working in the organization; 5) use good methods and be transparent in the work; 6) start small, have a clear audience and scope, and address important questions; and 7) be attentive to implementation considerations, even if implementation is not a remit. Four recommendations emerged for the World Health Organization (WHO) and other international organizations and networks: 1) support collaborations among organizations; 2) support local adaptation efforts; 3) mobilize support; and 4) create global public goods. This synthesis of

  13. Evidence-informed health policy 1 – Synthesis of findings from a multi-method study of organizations that support the use of research evidence

    Directory of Open Access Journals (Sweden)

    Moynihan Ray

    2008-12-01

    Full Text Available Abstract Background Organizations have been established in many countries and internationally to support the use of research evidence by producing clinical practice guidelines, undertaking health technology assessments, and/or directly supporting the use of research evidence in developing health policy on an international, national, and state or provincial level. Learning from these organizations can reduce the need to 'reinvent the wheel' and inform decisions about how best to organize support for such organizations, particularly in low- and middle-income countries (LMICs. Methods We undertook a multi-method study in three phases – a survey, interviews, and case descriptions that drew on site visits – and in each of the second and third phases we focused on a purposive sample of those involved in the previous phase. We used the seven main recommendations that emerged from the advice offered in the interviews to organize much of the synthesis of findings across phases and methods. We used a constant comparative method to identify themes from across phases and methods. Results Seven recommendations emerged for those involved in establishing or leading organizations that support the use of research evidence in developing health policy: 1 collaborate with other organizations; 2 establish strong links with policymakers and involve stakeholders in the work; 3 be independent and manage conflicts of interest among those involved in the work; 4 build capacity among those working in the organization; 5 use good methods and be transparent in the work; 6 start small, have a clear audience and scope, and address important questions; and 7 be attentive to implementation considerations, even if implementation is not a remit. Four recommendations emerged for the World Health Organization (WHO and other international organizations and networks: 1 support collaborations among organizations; 2 support local adaptation efforts; 3 mobilize support; and 4 create

  14. Coherence of evidence from systematic reviews as a basis for evidence strength - a case study in support of an epistemological proposition

    Directory of Open Access Journals (Sweden)

    Mickenautsch Steffen

    2012-01-01

    Full Text Available Abstract Background This article aims to offer, on the basis of Coherence theory, the epistemological proposition that mutually supportive evidence from multiple systematic reviews may successfully refute radical, philosophical scepticism. Methods A case study including seven systematic reviews is presented with the objective of refuting radical philosophical scepticism towards the belief that glass-ionomer cements (GIC are beneficial in tooth caries therapy. The case study illustrates how principles of logical and empirical coherence may be applied as evidence in support of specific beliefs in healthcare. Results The results show that radical scepticism may epistemologically be refuted on the basis of logical and empirical coherence. For success, several systematic reviews covering interconnected beliefs are needed. In praxis, these systematic reviews would also need to be of high quality and its conclusions based on reviewed high quality trials. Conclusions A refutation of radical philosophical scepticism to clinical evidence may be achieved, if and only if such evidence is based on the logical and empirical coherence of multiple systematic review results. Practical application also requires focus on the quality of the systematic reviews and reviewed trials.

  15. Investigation assessing the publicly available evidence supporting postmarketing withdrawals, revocations and suspensions of marketing authorisations in the EU since 2012

    Science.gov (United States)

    Lynn, Elizabeth; Shakir, Saad

    2018-01-01

    Objectives To assess the sources of publicly available evidence supporting withdrawal, revocation or suspension of marketing authorisations (‘regulatory actions’) due to safety reasons in the EU since 2012 and to investigate the time taken since initial marketing authorisation to reach these regulatory decisions. Setting This investigation examined the sources of evidence supporting 18 identified prescription medicinal products which underwent regulatory action due to safety reasons within the EU in the period 1 July 2012 to 31 December 2016. Results Eighteen single or combined active substances (‘medicinal products’) withdrawn, revoked or suspended within the EU for safety reasons between 2012 and 2016 met the inclusion criteria. Case reports were most commonly cited, supporting 94.4% of regulatory actions (n=17), followed by randomised controlled trial, meta-analyses, animal and in vitro, ex vivo or in silico study designs, each cited in 72.2% of regulatory actions (n=13). Epidemiological study designs were least commonly cited (n=8, 44.4%). Multiple sources of evidence contributed to 94.4% of regulatory decisions (n=17). Death was the most common adverse drug reaction leading to regulatory action (n=5; 27.8%), with four of these related to medication error or overdose. Median (IQR) time taken to reach a decision from the start of regulatory review was found to be 204.5 days (143, 535 days) and decreased across the study period. Duration of marketing prior to regulatory action, from the medicinal product’s authorisation date, increased across the period 2012–2016. Conclusions The sources of evidence supporting pharmacovigilance regulatory activities appear to have changed since implementation of Directive 2010/84/EU and Regulation (EU) No. 1235/2010. This, together with a small improvement in regulatory efficiency, suggests progress towards more rapid regulatory decisions based on more robust evidence. Future research should continue to monitor

  16. The effects of perceived organisational support on employees' affective outcomes: evidence from the hotel industry

    OpenAIRE

    Colakoglu, Ulker; Culha, Osman; Atay, Hakan

    2010-01-01

    Previous studies mainly analysed the relationship between perceived organisational support and organisational commitment in a direct way. Limited studies of tourism, however, have found that job satisfaction is a mediator variable in the relationship between perceived organisational support and organisational commitment. The aim of this study is, (i) to analyse the effect of organisational support on job satisfaction, (ii) to analyse the effect of organisational support on the dimensions of o...

  17. Supporting Evidence-Informed Teaching in Biomedical and Health Professions Education Through Knowledge Translation: An Interdisciplinary Literature Review.

    Science.gov (United States)

    Tractenberg, Rochelle E; Gordon, Morris

    2017-01-01

    Phenomenon: The purpose of "systematic" reviews/reviewers of medical and health professions educational research is to identify best practices. This qualitative article explores the question of whether systematic reviews can support "evidence informed" teaching and contrasts traditional systematic reviewing with a knowledge translation (KT) approach to this objective. Degrees of freedom analysis (DOFA) is used to examine the alignment of systematic review methods with educational research and the pedagogical strategies and approaches that might be considered with a decision-making framework developed to support valid assessment. This method is also used to explore how KT can be used to inform teaching and learning. The nature of educational research is not compatible with most (11/14) methods for systematic review. The inconsistency of systematic reviewing with the nature of educational research impedes both the identification and implementation of "best-evidence" pedagogy and teaching. This is primarily because research questions that do support the purposes of review do not support educational decision making. By contrast to systematic reviews of the literature, both a DOFA and KT are fully compatible with informing teaching using evidence. A DOFA supports the translation of theory to a specific teaching or learning case, so could be considered a type of KT. The DOFA results in a test of alignment of decision options with relevant educational theory, and KT leads to interventions in teaching or learning that can be evaluated. Examples of how to structure evaluable interventions are derived from a KT approach that are simply not available from a systematic review. Insights: Systematic reviewing of current empirical educational research is not suitable for deriving or supporting best practices in education. However, both "evidence-informed" and scholarly approaches to teaching can be supported as KT projects, which are inherently evaluable and can generate

  18. Further human evidence for striatal dopamine release induced by administration of ∆9-tetrahydrocannabinol (THC): selectivity to limbic striatum.

    NARCIS (Netherlands)

    Bossong, MG; Mehta, Mitul; van Berckel, Bart; Howes, Oliver; Kahn, RS; Stokes, Paul

    2015-01-01

    RATIONALE: Elevated dopamine function is thought to play a key role in both the rewarding effects of addictive drugs and the pathophysiology of schizophrenia. Accumulating epidemiological evidence indicates that cannabis use is a risk factor for the development of schizophrenia. However, human

  19. Person First, Student Second: Staff and Administrators of Color Supporting Students of Color Authentically in Higher Education

    Science.gov (United States)

    Luedke, Courtney L.

    2017-01-01

    In this qualitative study I explored the mentoring roles of staff and administrators for first-generation Black, Latinx, and Biracial students. Social reproduction theory (which assesses how inequality is perpetuated or disrupted generationally) was used to analyze social capital cultivated by mentors. Staff of Color nurtured the capital that…

  20. The Influence of Classroom Management, Administrative Support, Parental Involvement, and Economic Factors on the Retention of Novice Teachers

    Science.gov (United States)

    Dwyer, Katrina Moody

    2013-01-01

    The purpose of this study was to examine the impact of selected factors upon the intent of novice teachers to remain in the classroom. Teachers are leaving the profession in numbers that have prompted significant concern among policymakers and administrators. Many qualified college students are not considering the field of education as a potential…

  1. Danish evidence-based clinical guideline for use of nutritional support in pulmonary rehabilitation of undernourished patients with stable COPD

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Iepsen, Ulrik Winning; Topperup, Randi

    2015-01-01

    Background and aims Disease-related under-nutrition is a common problem in individuals with COPD. The rationale for nutritional support in pulmonary rehabilitation therefore seems obvious. However there is limited evidence regarding the patient-relevant outcomes i.e. activities of daily living (ADL......) or quality of life. Therefore the topic was included in The Danish Health and Medicines Authority's development of an evidence-based clinical guideline for rehabilitation of patients with stable COPD. Methods The methods were specified by The Danish Health and Medicines Authority as part of a standardized...... studies had been published. There were evidence of moderate quality that nutritional support for undernourished patients with COPD lead to a weight gain of 1.7 kg (95% confidence interval: 1.3 to 2.2 kg), but the effect was quantified as a mean change from baseline, which is less reliable. There were...

  2. 5 CFR 2423.4 - Contents of the charge; supporting evidence and documents.

    Science.gov (United States)

    2010-01-01

    ... section(s) and paragraph(s) of the Federal Service Labor-Management Relations Statute and the date and..., applicable regulations, statements of position and other documentary evidence. The Charging Party also shall...

  3. Ocean Acidification and the End-Permian Mass Extinction: To What Extent does Evidence Support Hypothesis?

    OpenAIRE

    Kershaw, Stephen; Crasquin, Sylvie; Li, Yue; Collin, Pierre-Yves; Forel, Marie-Béatrice

    2012-01-01

    Ocean acidification in modern oceans is linked to rapid increase in atmospheric CO2, raising concern about marine diversity, food security and ecosystem services. Proxy evidence for acidification during past crises may help predict future change, but three issues limit confidence of comparisons between modern and ancient ocean acidification, illustrated from the end-Permian extinction, 252 million years ago: (1) problems with evidence for ocean acidification preserved in sedimentary rocks, wh...

  4. Ocean Acidification and the End-Permian Mass Extinction: To What Extent does Evidence Support Hypothesis?

    OpenAIRE

    Kershaw , Stephen; Crasquin , Sylvie; Li , Yue; Collin , Pierre-Yves; Forel , Marie-Béatrice

    2012-01-01

    International audience; Ocean acidification in modern oceans is linked to rapid increase in atmospheric CO 2 , raising concern about marine diversity, food security and ecosystem services. Proxy evidence for acidification during past crises may help predict future change, but three issues limit confidence of comparisons between modern and ancient ocean acidification, illustrated from the end-Permian extinction, 252 million years ago: (1) problems with evidence for ocean acidification preserve...

  5. A Fit-For-Purpose approach to Land Administration in Africa in support of the new 2030 Global Agenda

    DEFF Research Database (Denmark)

    Enemark, Stig

    2017-01-01

    on legacy approaches, have been fragmented and have not delivered the required pervasive changes and improvements at scale. The solutions have not helped the most needy - the poor and disadvantaged that have no security of tenure. In fact the beneficiaries have often been the elite and organizations...... involved in land grabbing. It is time to rethink the approaches. New solutions are required that can deliver security of tenure for all, are affordable and can be quickly developed and incrementally improved over time. The Fit-For-Purpose (FFP) approach to land administration has emerged to meet...... administration systems is the only viable solution to solving the global security of tenure divide. The FFP approach is flexible and includes the adaptability to meet the actual and basic needs of society today and having the capability to be incrementally improved over time. This will be triggered in response...

  6. Parental Maltreatment, Bullying, and Adolescent Depression: Evidence for the Mediating Role of Perceived Social Support

    Science.gov (United States)

    Seeds, Pamela M.; Harkness, Kate L.; Quilty, Lena C.

    2010-01-01

    The support deterioration model of depression states that stress deteriorates the perceived availability and/or effectiveness of social support, which then leads to depression. The present study examined this model in adolescent depression following parent-perpetrated maltreatment and peer-perpetrated bullying, as assessed by a rigorous contextual…

  7. The Efficacy of Positive Behavioural Support with the Most Challenging Behaviour: The Evidence and Its Implications

    Science.gov (United States)

    LaVigna, Gary W.; Willis, Thomas J.

    2012-01-01

    Background: Positive behaviour support (PBS) is behaviour analysis applied in support of people with challenging behaviour. Questions have been raised as to PBS effectiveness, costs, and accessibility. Method: Outcome studies meeting specified criteria for PBS were selected for review. All told, 12 outcome studies encompassing 423 cases were…

  8. Measuring change in health care equity using small-area administrative data - evidence from the English NHS 2001-2008.

    Science.gov (United States)

    Cookson, Richard; Laudicella, Mauro; Donni, Paolo Li

    2012-10-01

    This study developed a method for measuring change in socio-economic equity in health care utilisation using small-area level administrative data. Our method provides more detailed information on utilisation than survey data but only examines socio-economic differences between neighbourhoods rather than individuals. The context was the English NHS from 2001 to 2008, a period of accelerated expenditure growth and pro-competition reform. Hospital records for all adults receiving non-emergency hospital care in the English NHS from 2001 to 2008 were aggregated to 32,482 English small areas with mean population about 1500 and combined with other small-area administrative data. Regression models of utilisation were used to examine year-on-year change in the small-area association between deprivation and utilisation, allowing for population size, age-sex composition and disease prevalence including (from 2003 to 2008) cancer, chronic kidney disease, coronary heart disease, diabetes, epilepsy, hypertension, hypothyroidism, stroke, transient ischaemic attack and (from 2006 to 2008) atrial fibrillation, chronic obstructive pulmonary disease, obesity and heart failure. There was no substantial change in small-area associations between deprivation and utilisation for outpatient visits, hip replacement, senile cataract, gastroscopy or coronary revascularisation, though overall non-emergency inpatient admissions rose slightly faster in more deprived areas than elsewhere. Associations between deprivation and disease prevalence changed little during the period, indicating that observed need did not grow faster in more deprived areas than elsewhere. We conclude that there was no substantial deterioration in socio-economic equity in health care utilisation in the English NHS from 2001 to 2008, and if anything, there may have been a slight improvement. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Glucose administration prior to a divided attention task improves tracking performance but not word recognition: evidence against differential memory enhancement?

    Science.gov (United States)

    Scholey, Andrew B; Sünram-Lea, Sandra I; Greer, Joanna; Elliott, Jade; Kennedy, David O

    2009-01-01

    The cognition-enhancing effects of glucose administration to humans have been well-documented; however, it remains unclear whether this effect preferentially targets episodic memory or other cognitive domains. The effect of glucose on the allocation of attentional resources during memory encoding was assessed using a sensitive dual-attention paradigm. One hundred and twenty volunteers (mean age 21.60, SD 4.89, 77 females) took part in this randomised, double-blind, placebo-controlled, parallel groups study where each consumed a 25-g glucose drink or a placebo. Half of the participants in each drink condition attempted to track a moving on-screen target during auditory word presentation. The distance between the cursor and the tracking target was used as an index of attentional cost during encoding. Effects of drink and tracking on recognition memory and drink on tracking performance were assessed. Self-rated appetite and mood were co-monitored. Co-performing the tracking task significantly impaired memory performance irrespective of drink condition. In the placebo-tracking condition, there was a cost to tracking manifest as greater deviation from target during and immediately following word presentation. Compared with placebo, the glucose drink significantly improved tracking performance during encoding. There were significant time-related changes in thirst and alertness ratings but these were not differentially affected by drink or tracking conditions. Tracking but not memory was enhanced by glucose. This finding suggests that, under certain task conditions, glucose administrations does not preferentially enhance memory performance. One mechanism through which glucose acts as a cognition enhancer is through allowing greater allocation of attentional resources.

  10. Gender, social support, and well-being: Evidence from a Greek community sample

    Directory of Open Access Journals (Sweden)

    Konstantinos Kafetsios

    2007-12-01

    Full Text Available The importance of social support for psychological well-being has been aptly highlighted in epidemiological and psychological research. However, it is not clear from the existing research whether gender differences in structural (relationship status, network size, frequency of interactions with friends and functional (support satisfaction aspects of social support exist and -if they do- to what extent they affect males’ and females’ well-being. Hierarchical regression analyses of crossectional data from a Greek community sample showed that support satisfaction was an important predictor of well-being outcomes in males whereas several structural indicators were predictors of different well-being outcomes in females. Females’ anxiety, perceived stress, and loneliness were adversely affected by frequency of interaction with acquaintances. The results are discussed with regard to gender-role differences that may be underlying the social support effects on well-being, as well as related cultural values.

  11. A framework for production of systematic review based briefings to support evidence-informed decision-making.

    Science.gov (United States)

    Chambers, Duncan; Wilson, Paul

    2012-07-09

    We have developed a framework for translating existing sources of synthesized and quality-assessed evidence, primarily systematic reviews, into actionable messages in the form of short accessible briefings. The service aims to address real-life problems in response to requests from decision-makers.Development of the framework was based on a scoping review of existing resources and our initial experience with two briefing topics, including models of service provision for young people with eating disorders. We also drew on previous experience in dissemination research and practice. Where appropriate, we made use of the SUPporting POlicy relevant Reviews and Trials (SUPPORT) tools for evidence-informed policymaking. To produce a product that it is fit for this purpose it has been necessary to go beyond a traditional summary of the available evidence relating to effectiveness. Briefings have, therefore, included consideration of cost effectiveness, local applicability, implications relating to local service delivery, budgets, implementation and equity. Our first evidence briefings produced under this framework cover diagnostic endoscopy by specialist nurses and integrated care pathways in mental healthcare settings. The framework will enable researchers to present and contextualize evidence from systematic reviews and other sources of synthesized and quality-assessed evidence. The approach is designed to address the wide range of questions of interest to decision-makers, especially those commissioning services or managing service delivery and organization in primary or secondary care. Evaluation of the use and usefulness of the evidence briefings we produce is an integral part of the framework and will help to fill a gap in the literature.

  12. Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE): protocol and preliminary results.

    Science.gov (United States)

    Treweek, Shaun; Oxman, Andrew D; Alderson, Philip; Bossuyt, Patrick M; Brandt, Linn; Brożek, Jan; Davoli, Marina; Flottorp, Signe; Harbour, Robin; Hill, Suzanne; Liberati, Alessandro; Liira, Helena; Schünemann, Holger J; Rosenbaum, Sarah; Thornton, Judith; Vandvik, Per Olav; Alonso-Coello, Pablo

    2013-01-09

    Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear. GRADE is a systematic approach towards assessing the quality of evidence and the strength of recommendations in healthcare. GRADE also gives advice on how to go from evidence to decisions. It has been developed to address the weaknesses of other grading systems and is now widely used internationally. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) consortium (http://www.decide-collaboration.eu/), which includes members of the GRADE Working Group and other partners, will explore methods to ensure effective communication of evidence-based recommendations targeted at key stakeholders: healthcare professionals, policymakers, and managers, as well as patients and the general public. Surveys and interviews with guideline producers and other stakeholders will explore how presentation of the evidence could be improved to better meet their information needs. We will collect further stakeholder input from advisory groups, via consultations and user testing; this will be done across a wide range of healthcare systems in Europe, North America, and other countries. Targeted communication strategies will be developed, evaluated in randomized trials, refined, and assessed during the development of real guidelines. Results of the DECIDE project will improve the communication of evidence-based healthcare recommendations. Building on the work of the GRADE Working Group, DECIDE will develop and evaluate methods that address communication needs of guideline users. The project will produce strategies for communicating recommendations that have been rigorously evaluated in diverse settings, and it will support the transfer of research into practice in healthcare systems globally.

  13. A framework for production of systematic review based briefings to support evidence-informed decision-making

    Directory of Open Access Journals (Sweden)

    Chambers Duncan

    2012-07-01

    Full Text Available Abstract Background We have developed a framework for translating existing sources of synthesized and quality-assessed evidence, primarily systematic reviews, into actionable messages in the form of short accessible briefings. The service aims to address real-life problems in response to requests from decision-makers. Development of the framework was based on a scoping review of existing resources and our initial experience with two briefing topics, including models of service provision for young people with eating disorders. We also drew on previous experience in dissemination research and practice. Where appropriate, we made use of the SUPporting POlicy relevant Reviews and Trials (SUPPORT tools for evidence-informed policymaking. Findings To produce a product that it is fit for this purpose it has been necessary to go beyond a traditional summary of the available evidence relating to effectiveness. Briefings have, therefore, included consideration of cost effectiveness, local applicability, implications relating to local service delivery, budgets, implementation and equity. Our first evidence briefings produced under this framework cover diagnostic endoscopy by specialist nurses and integrated care pathways in mental healthcare settings. Conclusions The framework will enable researchers to present and contextualize evidence from systematic reviews and other sources of synthesized and quality-assessed evidence. The approach is designed to address the wide range of questions of interest to decision-makers, especially those commissioning services or managing service delivery and organization in primary or secondary care. Evaluation of the use and usefulness of the evidence briefings we produce is an integral part of the framework and will help to fill a gap in the literature.

  14. Entrepreneurs' attitudes to training and support initiatives: evidence from Ireland and The Netherlands

    NARCIS (Netherlands)

    De Faoite, D.; Henry, C.; Johnston, K.; van der Sijde, Peter

    2004-01-01

    Increasingly, academics, practitioners and governments recognise the need to examine the role and effectiveness of entrepreneurship training and support. Studies to date have examined the importance of training and other skil development opportunities in promoting entrepreneurship in the context of

  15. Does Government Support for Private Innovation Matter? Firm-Level Evidence from Turkey and Poland

    OpenAIRE

    Wojciech Grabowski; Teoman Pamukcu; Krzysztof Szczygielski; Sinan Tandogan

    2013-01-01

    The aim of the project is to analyze government support for innovation in a comparative perspective by first examining the main existing instruments of financial support for innovation in Turkey and Poland, and secondly to assess their effectiveness by applying recent econometric techniques to firm-level data for both countries obtained from the Community Innovation Survey (CIS). Comparing Turkey to Poland is both meaningful and promising from a policy-analysis point of view. Both countries a...

  16. How experimental biology and ecology can support evidence-based decision-making in conservation: avoiding pitfalls and enabling application.

    Science.gov (United States)

    Cooke, Steven J; Birnie-Gauvin, Kim; Lennox, Robert J; Taylor, Jessica J; Rytwinski, Trina; Rummer, Jodie L; Franklin, Craig E; Bennett, Joseph R; Haddaway, Neal R

    2017-01-01

    Policy development and management decisions should be based upon the best available evidence. In recent years, approaches to evidence synthesis, originating in the medical realm (such as systematic reviews), have been applied to conservation to promote evidence-based conservation and environmental management. Systematic reviews involve a critical appraisal of evidence, but studies that lack the necessary rigour (e.g. experimental, technical and analytical aspects) to justify their conclusions are typically excluded from systematic reviews or down-weighted in terms of their influence. One of the strengths of conservation physiology is the reliance on experimental approaches that help to more clearly establish cause-and-effect relationships. Indeed, experimental biology and ecology have much to offer in terms of building the evidence base that is needed to inform policy and management options related to pressing issues such as enacting endangered species recovery plans or evaluating the effectiveness of conservation interventions. Here, we identify a number of pitfalls that can prevent experimental findings from being relevant to conservation or would lead to their exclusion or down-weighting during critical appraisal in a systematic review. We conclude that conservation physiology is well positioned to support evidence-based conservation, provided that experimental designs are robust and that conservation physiologists understand the nuances associated with informing decision-making processes so that they can be more relevant.

  17. Validity-Supporting Evidence of the Self-Efficacy for Teaching Mathematics Instrument

    Science.gov (United States)

    McGee, Jennifer R.; Wang, Chuang

    2014-01-01

    The purpose of this study is to provide evidence of reliability and validity of the Self-Efficacy for Teaching Mathematics Instrument (SETMI). Self-efficacy, as defined by Bandura, was the theoretical framework for the development of the instrument. The complex belief systems of mathematics teachers, as touted by Ernest provided insights into the…

  18. Evidence supporting the use of cone-beam computed tomography in orthodontics.

    NARCIS (Netherlands)

    Vlijmen, O.J.C. van; Kuijpers, M.A.R.; Berge, S.J.; Schols, J.G.J.H.; Maal, T.J.J.; Breuning, H.; Kuijpers-Jagtman, A.M.

    2012-01-01

    BACKGROUND: The authors conducted a systematic review of cone-beam computed tomography (CBCT) applications in orthodontics and evaluated the level of evidence to determine whether the use of CBCT is justified in orthodontics. TYPES OF STUDIES REVIEWED: The authors identified articles by searching

  19. Observational evidence of the complementary relationship in regional evaporation lends strong support for Bouchet's hypothesis

    Science.gov (United States)

    Jorge A. Ramirez; Michael T. Hobbins; Thomas C. Brown

    2005-01-01

    Using independent observations of actual and potential evapotranspiration at a wide range of spatial scales, we provide direct observational evidence of the complementary relationship in regional evapotranspiration hypothesized by Bouchet in 1963. Bouchet proposed that, for large homogeneous surfaces with minimal advection of heat and moisture, potential and actual...

  20. Is There Evidence to Support the Use of Social Skills Interventions for Students with Emotional Disabilities?

    Science.gov (United States)

    Sullivan, Amanda L.; Sadeh, Shanna S.

    2014-01-01

    Scholars and practitioners advocate for the use of social skills interventions for students with emotional disabilities because significant social skills deficits are common among these students. Yet contemporary practices must be vetted for empirical evidence of their efficacy and effectiveness to ensure students are provided appropriate…

  1. Vulnerable Children of Mentally Ill Parents: Towards Evidence-Based Support for Improving Resilience

    Science.gov (United States)

    Pretis, Manfred; Dimova, Aleksandra

    2008-01-01

    The increasing prevalence of mental illness among parents always represents a stressor affecting the biopsychosocial development of a child. However, due to varying inherent resilience factors, not all children are affected to the same extent. The presence of evidence-based resilience factors is able to minimise or prevent the adverse effects…

  2. Physical fitness and academic performance: empirical evidence from the National Administrative Senior High School Student Data in Taiwan.

    Science.gov (United States)

    Liao, Pei-An; Chang, Hung-Hao; Wang, Jiun-Hao; Wu, Min-Chen

    2013-06-01

    This study examined the relationship between the changes of physical fitness across the 3-year spectrum of senior high school study and academic performance measured by standardized tests in Taiwan. A unique dataset of 149 240 university-bound senior high school students from 2009 to 2011 was constructed by merging two nationwide administrative datasets of physical fitness test performance and the university entrance exam scores. Hierarchical linear regression models were used. All regressions included controls for students' baseline physical fitness status, changes of physical fitness performance over time, age and family economic status. Some notable findings were revealed. An increase of 1 SD on students' overall physical fitness from the first to third school year is associated with an increase in the university entrance exam scores by 0.007 and 0.010 SD for male and female students, respectively. An increase of 1 SD on anaerobic power (flexibility) from the first to third school year is positively associated with an increase in the university entrance exam scores by 0.018 (0.010) SD among female students. We suggest that education and school health policymakers should consider and design policies to improve physical fitness as part of their overall strategy of improving academic performance.

  3. Using Getting To Outcomes to facilitate the use of an evidence-based practice in VA homeless programs: a cluster-randomized trial of an implementation support strategy.

    Science.gov (United States)

    Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Byrne, Thomas Hugh; Smelson, David A

    2017-03-09

    Incorporating evidence-based integrated treatment for dual disorders into typical care settings has been challenging, especially among those serving Veterans who are homeless. This paper presents an evaluation of an effort to incorporate an evidence-based, dual disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) into case management teams serving Veterans who are homeless, using an implementation strategy called Getting To Outcomes (GTO). This Hybrid Type III, cluster-randomized controlled trial assessed the impact of GTO over and above MISSION-Vet Implementation as Usual (IU). Both conditions received standard MISSION-Vet training and manuals. The GTO group received an implementation manual, training, technical assistance, and data feedback. The study occurred in teams at three large VA Medical Centers over 2 years. Within each team, existing sub-teams (case managers and Veterans they serve) were the clusters randomly assigned. The trial assessed MISSION-Vet services delivered and collected via administrative data and implementation barriers and facilitators, via semi-structured interview. No case managers in the IU group initiated MISSION-Vet while 68% in the GTO group did. Seven percent of Veterans with case managers in the GTO group received at least one MISSION-Vet session. Most case managers appreciated the MISSION-Vet materials and felt the GTO planning meetings supported using MISSION-Vet. Case manager interviews also showed that MISSION-Vet could be confusing; there was little involvement from leadership after their initial agreement to participate; the data feedback system had a number of difficulties; and case managers did not have the resources to implement all aspects of MISSION-Vet. This project shows that GTO-like support can help launch new practices but that multiple implementation facilitators are needed for successful execution of a complex evidence

  4. Administrative IT

    Science.gov (United States)

    Grayson, Katherine, Ed.

    2006-01-01

    When it comes to Administrative IT solutions and processes, best practices range across the spectrum. Enterprise resource planning (ERP), student information systems (SIS), and tech support are prominent and continuing areas of focus. But widespread change can also be accomplished via the implementation of campuswide document imaging and sharing,…

  5. Reproductive toxicity after levetiracetam administration in male rats: Evidence for role of hormonal status and oxidative stress.

    Directory of Open Access Journals (Sweden)

    Merve Baysal

    Full Text Available Levetiracetam (LEV is an antiepileptic drug commonly used in the treatment of epilepsy because of its excellent safety profile in all age groups. It is remarkable that there are no studies evaluating the toxic effects of this drug on the male reproductive system, as it is commonly used in male patients of reproductive age. From this point of view, our aim was to evaluate the possible toxic effects of LEV on the male reproductive system. Therefore, LEV was administered to male rats orally at 50, 150, and 300 mg/kg for 70 consecutive days. At the end of this period, alterations to body and organ weights were calculated, and sperm concentration, motility, and morphology were investigated by a computer-assisted sperm analysis system. Sperm DNA damage was determined by comet assay and histopathological examination of the testes was carried out. Serum testosterone, follicle-stimulating hormone (FSH, and luteinizing hormone (LH levels were measured by ELISAs to determine the effects of hormonal status, while glutathione, superoxide dismutase, catalase, and malondialdehyde levels in the testes were measured by colorimetric assay kits to determine the role of oxidative status in potential toxicity. According to the results, sperm quality was decreased by LEV treatment in a dose-dependent manner. LEV induced significant DNA damage in the 150 and 300 mg/kg LEV-administered groups. Histopathology of the testes showed that LEV resulted in testicular injury in the 300 mg/kg LEV-administered group. Serum testosterone, FSH, and LH levels were significantly decreased in the 300 mg/kg LEV-administered group. Glutathione, superoxide dismutase, and catalase levels were significantly decreased in all experimental groups while malondialdehyde levels were significantly increased in 150 and 300 mg/kg LEV-administered groups. According to these results, it was determined that LEV administration decreased sperm quality and it was alleged that hormonal alteration and

  6. Nephropathy after administration of iso-osmolar and low-osmolar contrast media: evidence from a network meta-analysis.

    Science.gov (United States)

    Biondi-Zoccai, Giuseppe; Lotrionte, Marzia; Thomsen, Henrik S; Romagnoli, Enrico; D'Ascenzo, Fabrizio; Giordano, Arturo; Frati, Giacomo

    2014-03-15

    Contrast-induced nephropathy (CIN) may be a severe complication to the administration of iodine-based contrast media for diagnostic or interventional procedure using radiation exposure. Whether there is a difference in nephrotoxic potential between the various agents is uncertain. We aimed to perform a systematic review and network meta-analysis of randomized trials on iodine-based contrast agents. Randomized trials of low-osmolar or iso-osmolar contrast media were searched in CENTRAL, Google Scholar, MEDLINE/PubMed, and Scopus. Risk of CIN was appraised within a hierarchical Bayesian model computing absolute rates (AR) and odds ratios (OR) with 95% credibility intervals, and probability of being best (Pbest) for each agent. A total of 42 trials (10048 patients) were included focusing on 7 different iodine-based contrast media. Risk of CIN was similarly low with iodixanol (AR=5.7% [2.2%-13.9%], Pbest=18.8%), iomeprol (AR=6.0% [2.2%-15.4%], Pbest=24.8%), iopamidol (AR=6.1% [2.2%-15.5%], Pbest=21.5%), and ioversol (AR=6.0% [2.1%-16.4%], Pbest=31.3%). Conversely, CIN was twice as common with iohexol (AR=11.2% [4.1%-29.5%], Pbest=0.1%) and ioxaglate (AR=11.0% [4.0%-26.9%], Pbestcontrast media with a similar renal safety profile. Iohexol and ioxaglate have a poorer renal safety profile, whereas further data may be required on iopromide. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. NMR evidence of metal-support interaction in syngas conversion catalyst Co-TiO2

    International Nuclear Information System (INIS)

    Murty, A.N.; Seamster, M.; Thorpe, A.N.; Obermyer, R.T.; Rao, V.U.S.

    1990-01-01

    To examine the relation between catalytic and magnetic properties, the zero-field NMR spectra and hysteresis loops of cobalt supported on silica, alumina, magnesia, titania, and ZSM-5 with and without the promoter thoria were investigated. Cobalt was incorporated on the support by simple physical admixture of precipitated cobalt and support, and by aqueous impregnation technique. Our studies indicate that the particle sizes are consistently lower in the presence of thoria. Of all the catalysts examined, the Co/Th/TiO 2 catalyst exhibits a high saturation magnetization value---about 20% higher than pure cobalt. In addition, the NMR spectrum of the aqueous impregnation Co/TiO 2 catalyst is distinctly different from the rest. All the NMR lines are shifted to a higher frequency by about 4 MHz. These two features---enhancement of the magnetic moment of cobalt atoms and increases in the hyperfine field at the Co nucleus---clearly indicate that there occurs strong metal-support interaction between cobalt and titania support. The higher hydrocarbon yields observed by the earlier investigators with Co/TiO 2 catalysts might be related to this phenomenon

  8. Fostering integrity in postgraduate research: an evidence-based policy and support framework.

    Science.gov (United States)

    Mahmud, Saadia; Bretag, Tracey

    2014-01-01

    Postgraduate research students have a unique position in the debate on integrity in research as students and novice researchers. To assess how far policies for integrity in postgraduate research meet the needs of students as "research trainees," we reviewed online policies for integrity in postgraduate research at nine particular Australian universities against the Australian Code for Responsible Conduct of Research (the Code) and the five core elements of exemplary academic integrity policy identified by Bretag et al. (2011 ), i.e., access, approach, responsibility, detail, and support. We found inconsistency with the Code in the definition of research misconduct and a lack of adequate detail and support. Based on our analysis, previous research, and the literature, we propose a framework for policy and support for postgraduate research that encompasses a consistent and educative approach to integrity maintained across the university at all levels of scholarship and for all stakeholders.

  9. Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review

    DEFF Research Database (Denmark)

    Loving, Sys; Nordling, Jørgen; Jaszczak, Poul

    2012-01-01

    dysfunction is frequently cited as a possible aetiology. Physiotherapy is therefore recommended as one treatment modality. The aim of this systematic review was to source and critically evaluate the evidence for an effect of physiotherapy on pain, physical activity and quality of life in the treatment...... (RevMan) version 5.0 was used for data analysis. Effect estimates (relative risk, mean difference and mean change) with 95% confidence intervals were calculated for the above outcomes. For significant outcomes the numbers needed to treat were calculated. Results The search strategy identified 3469...... is a new approach that appears to be promising and randomised clinical trials are underway in order to establish its evidence base. Implications Based on the findings of this review, recommendations for physiotherapy in chronic pelvic pain clinical guidelines, textbooks and narrative reviews should...

  10. Salaries and Wages Paid Professional and Support Personnel in Public Schools, 2009-2010. A Reference Tool for School Administrators

    Science.gov (United States)

    Protheroe, Nancy; Licciardi, Christopher M.; Cooke, Willa D.

    2010-01-01

    This report presents salary and wage data collected as part of the 37th edition of the "ERS National Survey of Salaries and Wages in Public Schools, 2009-2010." The survey, conducted in fall 2008, collected data on salaries scheduled and salaries paid for 23 selected professional positions and 10 selected support positions in public school systems…

  11. Salaries and Wages Paid Professional and Support Personnel in Public Schools, 2008-09. A Reference Tool for School Administrators

    Science.gov (United States)

    Educational Research Service, 2009

    2009-01-01

    This report presents salary and wage data collected as part of the "Educational Research Service (ERS) National Survey of Salaries and Wages in Public Schools, 2008-2009." The survey, conducted in fall 2008, collected data on salaries scheduled and salaries paid for 23 selected professional positions and 10 selected support positions in public…

  12. Perceptual support promotes strategy generation: Evidence from equation solving.

    Science.gov (United States)

    Alibali, Martha W; Crooks, Noelle M; McNeil, Nicole M

    2017-08-30

    Over time, children shift from using less optimal strategies for solving mathematics problems to using better ones. But why do children generate new strategies? We argue that they do so when they begin to encode problems more accurately; therefore, we hypothesized that perceptual support for correct encoding would foster strategy generation. Fourth-grade students solved mathematical equivalence problems (e.g., 3 + 4 + 5 = 3 + __) in a pre-test. They were then randomly assigned to one of three perceptual support conditions or to a Control condition. Participants in all conditions completed three mathematical equivalence problems with feedback about correctness. Participants in the experimental conditions received perceptual support (i.e., highlighting in red ink) for accurately encoding the equal sign, the right side of the equation, or the numbers that could be added to obtain the correct solution. Following this intervention, participants completed a problem-solving post-test. Among participants who solved the problems incorrectly at pre-test, those who received perceptual support for correctly encoding the equal sign were more likely to generate new, correct strategies for solving the problems than were those who received feedback only. Thus, perceptual support for accurate encoding of a key problem feature promoted generation of new, correct strategies. Statement of Contribution What is already known on this subject? With age and experience, children shift to using more effective strategies for solving math problems. Problem encoding also improves with age and experience. What the present study adds? Support for encoding the equal sign led children to generate correct strategies for solving equations. Improvements in problem encoding are one source of new strategies. © 2017 The British Psychological Society.

  13. An Evidence Based Approach to Designing Medical Support for Long Duration, Interplanetary Missions

    Science.gov (United States)

    Watkins, S. D.; McGrath, T. L.; Bauman, D. K.; Wu, J. H.; Barsten, K. N.; Barr, Y. R.; Kerstman, E. L.

    2011-01-01

    The Exploration Medical Capability (ExMC) element is one of six elements under NASA's Human Research Program (HRP). The goal of the ExMC element is to address the risk of the "inability to adequately recognize or treat an ill or injured crewmember." This poster highlights the evidence-based approach that the ExMC element has taken to address this goal, and the ExMC element's current areas of interest.

  14. Evidence-based architectural and space design supports Magnet® empirical outcomes.

    Science.gov (United States)

    Ecoff, Laurie; Brown, Caroline E

    2010-12-01

    This department expands nursing leaders' knowledge and competencies in health facility design. The editor of this department, Dr Jaynelle Stichler, asked guest authors, Drs Ecoff and Brown, to describe the process of using the conceptual models of a nursing evidence-based practice model and the Magnet Recognition Program® as a structured process to lead decision making in the planning and design processes and to achieve desired outcomes in hospital design.

  15. Important nonurgent imaging findings: use of a hybrid digital and administrative support tool for facilitating clinician communication.

    Science.gov (United States)

    Johnson, Evan; Sanger, Joseph; Rosenkrantz, Andrew B

    2015-01-01

    A departmental tool that provides a digital/administrative solution for communication of important imaging findings was evaluated. The tool allows the radiologist to click a button to mark an examination for ordering physician follow-up with subsequent fax and confirmation. The tool's log was reviewed. Of 466 entries; 99.4% were successfully faxed with phone confirmation. Most common reasons for usage were lung nodule/mass (29.2%) and osseous fracture (12.4%). Subsequent clinical action was documented in 41.0% of entries. Our data show the reliability of the tool in assisting the communication of findings, as well as providing documentation of notification, with minimal workflow disruption. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Creating infrastructure supportive of evidence-based nursing practice: leadership strategies.

    Science.gov (United States)

    Newhouse, Robin P

    2007-01-01

    Nursing leadership is the cornerstone of successful evidence-based practice (EBP) programs within health care organizations. The key to success is a strategic approach to building an EBP infrastructure, with allocation of appropriate human and material resources. This article indicates the organizational infrastructure that enables evidence-based nursing practice and strategies for leaders to enhance evidence-based practice using "the conceptual model for considering the determinants of diffusion, dissemination, and implementation of innovations in health service delivery and organization." Enabling EBP within organizations is important for promoting positive outcomes for nurses and patients. Fostering EBP is not a static or immediate outcome, but a long-term developmental process within organizations. Implementation requires multiple strategies to cultivate a culture of inquiry where nurses generate and answer important questions to guide practice. Organizations that can enable the culture and build infrastructure to help nurses develop EBP competencies will produce a professional environment that will result in both personal growth for their staff and improvements in quality that would not otherwise be possible.

  17. Pharmacokinetics of repeated sodium salicylate administration to laying hens: evidence for time dependent increase in drug elimination from plasma and eggs.

    Directory of Open Access Journals (Sweden)

    Błażej Poźniak

    Full Text Available Salicylates were the first non-steroid anti-inflammatory drugs (NSAIDs to be used in any species and are still widely used in humans and livestock. However, the data on their pharmacokinetics in animals is limited, especially after repeated administration. Evidence exist that in chickens (Gallus gallus salicylate (SA may induce its own elimination. The aim of this study was to investigate salicylate pharmacokinetics and egg residues during repeated administration of sodium salicylate (SS to laying hens. Pharmacokinetics of SA was assessed during 14 d oral administration of SS at daily doses of 50 mg/kg and 200 mg/kg body weight to laying hens. On the 1st, 7th and 14th d a 24 h-long pharmacokinetic study was carried out, whereas eggs were collected daily. Salicylate concentrations in plasma and eggs were determined using high-performance liquid chromatography with ultraviolet detection and pharmacokinetic variables were calculated using a non-compartmental model. Mean residence time (MRT, minimal plasma concentration (Cmin, C16h and elimination half-life (T1/2el of SA showed gradual decrease in layers administered with a lower dose. Total body clearance (ClB increased. Layers administered with the higher dose showed a decrease only in the T1/2el. In the low dose group, SA was found only in the egg white and was low throughout the experiment. Egg whites from the higher dose group showed initially high SA levels which significantly decreased during the experiment. Yolk SA levels were lower and showed longer periods of accumulation and elimination. Repeated administration of SS induces SA elimination, although this effect may differ depending on the dose and production type of a chicken. Decreased plasma drug concentration may have clinical implications during prolonged SS treatment.

  18. Restoring State Control Over Forest Resources Through Administrative Procedures: Evidence From a Community Forestry Programme in Central Java, Indonesia

    Directory of Open Access Journals (Sweden)

    Ahmad Maryudi

    2012-01-01

    Full Text Available In recent years, community forestry has emerged as a means to reform power constellations with regard to forest governance. Through community forestry, the central state promised to devolve several forest rights to local communities and encouraged them to get involved in decision making processes and the implementation of forest activities. However, experience in some countries indicates that the implementation of community forestry programmes is rarely followed by genuine power devolution to local forest users. Instead, these programmes may even serve as a means to retain or restore the central state’s control over forests. Using a case study of a community forestry programme implemented in Java, Indonesia, by a state forest company, this paper argues that the implementation of community forestry is also driven by the state’s interests to regain control over the forests. Research in eight villages in Central Java province reveals that the community forestry programmes are carefully structured according to numerous administrative procedures and estab- lish a mode of control through a bureaucratic design. ----- In den letzten Jahren hat sich community forestry als Mittel zur Reform von Machtkonstellationen in Bezug auf die Verwaltung von Wäldern herausgebildet. Der Zentralstaat versprach durch community forestry bestimmte Waldrechte an lokale Communities abzugeben und ermutigte sie, sich an Entscheidungsprozessen und der Implementierung von Forstaktivitäten zu beteiligen. Erfahrungen in einigen Ländern zeigen jedoch, dass die Implementierung von community forestry-Programmen selten mit einem tatsächlichen Machttransfer an lokale ForstnutzerInnen einhergeht, sondern diese Programme sogar als Mittel zur Rückgewinnung von zentralstaatlicher Kontrolle über Wälder dienen können. Anhand eines Fallbeispiels eines community forestry-Programms, das in Java, Indonesien, von einem staatlichen Forstunternehmen implementiert wird, argumentiere ich

  19. Risk Aversion and Support for Merit Pay: Theory and Evidence from Minnesota's Q Comp Program

    Science.gov (United States)

    Nadler, Carl; Wiswall, Matthew

    2011-01-01

    Recent research attributes the lack of merit pay in teaching to the resistance of teachers. This article examines whether the structure of merit pay affects the types of teachers who support it. We develop a model of the relative utility teachers receive from merit pay versus the current fixed schedule of raises. We show that if teachers are risk…

  20. Mobbing, Organizational Identification, and Perceived Support: Evidence from a Higher Education Institution

    Science.gov (United States)

    Coskuner, Selda; Costur, Recai; Bayhan-Karapinar, Pinar; Metin-Camgoz, Selin; Ceylan, Savas; Demirtas-Zorbaz, Selen; Aktas, Emine Feyza; Ciffiliz, Gonca

    2018-01-01

    Purpose: The aim of the current study is twofold. First, it investigates the relationship between mobbing and organizational identification (OI) as an organizational attitude. Second, it explores the moderating effect of perceived organizational support (POS) on the relationship between mobbing and organizational identification. We proposed that…

  1. The Influence of Social and Organizational Support on Transfer of Training: Evidence from Thailand

    Science.gov (United States)

    Homklin, Tassanee; Takahashi, Yoshi; Techakanont, Kriengkrai

    2014-01-01

    This study focused on integrating social and organizational support as moderators into the main analysis model of the relationship between learning -- specifically perceived knowledge retained -- and its transfer as perceived by participants. We used hierarchical regression analysis in order to test our hypotheses. Results were generally…

  2. Education, Income, and Support for Suicide Bombings: Evidence from Six Muslim Countries

    Science.gov (United States)

    Shafiq, M. Najeeb; Sinno, Abdulkader H.

    2010-01-01

    The authors examine the effect of educational attainment and income on support for suicide bombing among Muslim publics in six predominantly Muslim countries that have experienced suicide bombings: Indonesia, Jordan, Lebanon, Morocco, Pakistan, and Turkey. The authors make two contributions. First, they present a conceptual model, which has been…

  3. Empirically Supported Psychotherapy in Social Work Training Programs: Does the Definition of Evidence Matter?

    Science.gov (United States)

    Bledsoe, Sarah E.; Weissman, Myrna M.; Mullen, Edward J.; Ponniah, Kathryn; Gameroff, Marc J.; Verdeli, Helen; Mufson, Laura; Fitterling, Heidi; Wickramaratne, Priya

    2007-01-01

    Objectives: A national survey finds that 62% of social work programs do not require didactic and clinical supervision in any empirically supported psychotherapy (EST). The authors report the results of analysis of national survey data using two alternative classifications of EST to determine if the results are because of the definition of EST used…

  4. Does public awareness increase support for invasive species management? Promising evidence across taxa and landscape types

    Czech Academy of Sciences Publication Activity Database

    Novoa, Ana; Dehnen-Schmutz, K.; Fried, J.; Vimercati, G.

    2017-01-01

    Roč. 19, č. 12 (2017), s. 3691-3705 ISSN 1387-3547 R&D Projects: GA ČR GB14-36079G Institutional support: RVO:67985939 Keywords : alien species * attitudes * non-native species * pPublic opposition * public perception Subject RIV: EH - Ecology, Behaviour OBOR OECD: Ecology Impact factor: 2.473, year: 2016

  5. Teacher Support and Engagement in Math and Science: Evidence from the High School Longitudinal Study

    Science.gov (United States)

    Kelly, Sean; Zhang, Yuan

    2016-01-01

    Supportive teacher-student relationships are associated with increased levels of engagement and higher levels of achievement. Yet, studies also show that higher achieving students typically receive the most encouragement. Moreover, many studies of teacher-student relationships pertain to elementary and middle school students; by the time students…

  6. Do knowledge infrastructure facilities support Evidence-Based Practice in occupational health? An exploratory study across countries among occupational physicians enrolled on Evidence-Based Medicine courses

    Directory of Open Access Journals (Sweden)

    van Dijk Frank JH

    2009-01-01

    Full Text Available Abstract Background Evidence-Based Medicine (EBM is an important method used by occupational physicians (OPs to deliver high quality health care. The presence and quality of a knowledge infrastructure is thought to influence the practice of EBM in occupational health care. This study explores the facilities in the knowledge infrastructure being used by OPs in different countries, and their perceived importance for EBM practice. Methods Thirty-six OPs from ten countries, planning to attend an EBM course and to a large extent recruited via the European Association of Schools of Occupational Medicine (EASOM, participated in a cross-sectional study. Results Research and development institutes, and knowledge products and tools are used by respectively more than 72% and more than 80% of the OPs and they are rated as being important for EBM practice (more than 65 points (range 0–100. Conventional knowledge access facilities, like traditional libraries, are used often (69% but are rated as less important (46.8 points (range 0–100 compared to the use of more novel facilities, like question-and-answer facilities (25% that are rated as more important (48.9 points (range 0–100. To solve cases, OPs mostly use non evidence-based sources. However, they regard the evidence-based sources that are not often used, e.g. the Cochrane library, as important enablers for practising EBM. The main barriers are lack of time, payment for full-text articles, language barrier (most texts are in English, and lack of skills and support. Conclusion This first exploratory study shows that OPs use many knowledge infrastructure facilities and rate them as being important for their EBM practice. However, they are not used to use evidence-based sources in their practice and face many barriers that are comparable to the barriers physicians face in primary health care.

  7. Does the scientific evidence support the advertising claims made for products containing Lactobacillus casei and Bifidobacterium lactis? A systematic review.

    Science.gov (United States)

    Meléndez-Illanes, Lorena; González-Díaz, Cristina; Chilet-Rosell, Elisa; Álvarez-Dardet, Carlos

    2016-09-01

    To analyse the scientific evidence that exists for the advertising claims made for two products containing Lactobacillus casei and Bifidobacterium lactis and to conduct a comparison between the published literature and what is presented in the corporate website. Systematic review, using Medline through Pubmed and Embase. We included human clinical trials that exclusively measured the effect of Lactobacillus casei or Bifidobacterium lactis on a healthy population, and where the objective was related to the health claims made for certain products in advertising. We assessed the levels of evidence and the strength of the recommendation according to the classification criteria established by the Oxford Centre for Evidence Based Medicine (CEBM). We also assessed the outcomes of the studies published on the website that did not appear in the search. Of the 440 articles identified, 16 met the inclusion criteria. Only four (25%) of these presented a level of evidence of 1b and a recommendation grade of A, all corresponding to studies on product containing Bifidobacterium lactis, and only 12 of the 16 studies were published on the corporate website (47). There is insufficient scientific evidence to support the health claims made for these products, especially in the case of product containing Lactobacillus casei. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Early administration of venovenous extracorporeal life support for status asthmaticus during anaesthetic induction: case report and literature review

    Directory of Open Access Journals (Sweden)

    Chang Won Ho

    2018-03-01

    Full Text Available Here we report a case of a 40-year-old man who visited the emergency room with severe chest pain. He showed a Stanford type B aortic dissection on chest-computed tomography. Despite medical treatment and malperfusion of lower extremities, acute renal failure developed; hence thoracic endovascular aortic repair (TEVAR was considered under general anaesthesia. After endotracheal intubation, ventilation with low tidal volume required high inspiratory airway pressure. An arterial blood gas analysis showed PaCO2 of 61.8mmHg and PaO2 of 26.4mmHg, indicating a status asthmaticus of hypoxaemia and hypercarbia, which did not respond to bronchodilator or mechanical ventilation. Impending cardiac arrest was treated using venovenous extracorporeal life support, which was administered by percutaneous femoral cannulation. Surgical procedure was completed without any complications. Extracorporeal life support was weaned at one day after the operation. The patient was discharged without any complications.

  9. Application of SIG and OLAP technologies on IBGE databases as a decision support tool for the county administration

    Directory of Open Access Journals (Sweden)

    REGO, E. A.

    2008-06-01

    Full Text Available This paper shows a Decision Support System development for any brazilian county. The system is free of any costs research. For doing so, one uses the datawarehouse, OLAP and GIS technologies all together with the IBGE's database to give to the user a query building tool, showing the results in maps or/and tables format, on a very simple and efficient way.

  10. [Work-to-family influence and social supports: job satisfaction in a north-Italy public health organization --differences between medical and administrative staff].

    Science.gov (United States)

    Colombo, Lara; Zito, Margherita; Ghislieri, Chiara

    2012-01-01

    In recent years, the interest in the well-being at work has grown considerably, also considering the latest law directives. Several scholars have devoted particular attention to the topic of the work-to-family influence and of social supports, as elements able to affect the perceived well-being. The well-being in health care has to consider the particular nature of work and the relevant relational dimensions that require special attention for the emotional side. The research was promoted by the Committee for Equal Opportunities of a public health organization in the North-West Italy. Referring to the job demands-resources theoretical model, this study investigated the role of organizational and family supports, work-to-family spillover (positive and negative) and family workload as possible determinants of job satisfaction, intended as an indicator of psychological well-being at work. Respondents to the questionnaire are 541 (55% of the total employees), their average age is 43 and they are mostly women (80%). Data analysis showed the central role of supervisors supports, of the co-workers supports and, to a lesser extent, the role of the work-to-family spillover in influencing job satisfaction. Moreover, significant differences between medical and administrative staff were detected. The centrality of supports, especially those of supervisors in determining job satisfaction, is in line with studies indicating that a supportive leadership and a family-friendly culture can facilitate the arise of positive outcomes for both workers and organizations.

  11. Social support and leisure-time physical activity: longitudinal evidence from the Brazilian Pró-Saúde cohort study

    Directory of Open Access Journals (Sweden)

    Werneck Guilherme L

    2011-07-01

    Full Text Available Abstract Background Although social support has been observed to exert a beneficial influence on leisure-time physical activity (LTPA, multidimensional approaches examining social support and prospective evidence of its importance are scarce. The purpose of this study was to investigate how four dimensions of social support affect LTPA engagement, maintenance, type, and time spent by adults during a two-year follow-up. Methods This paper reports on a longitudinal study of 3,253 non-faculty public employees at a university in Rio de Janeiro (the Pró-Saúde study. LTPA was evaluated using a dichotomous question with a two-week reference period, and further questions concerning LTPA type (individual or group and time spent on the activity. Social support was measured by the Medical Outcomes Study Social Support Scale (MOS-SSS. To assess the association between social support and LTPA, two different statistical models were used: binary and multinomial logistic regression models for dichotomous and polytomous outcomes, respectively. Models were adjusted separately for those who began LTPA in the middle of the follow up (engagement group and for those who had maintained LTPA since the beginning of the follow up (maintenance group. Results After adjusting for confounders, statistically significant associations (p Conclusions All dimensions of social support influenced LTPA type or the time spent on the activity. However, our findings suggest that social support is more important in engagement than in maintenance. This finding is important, because it suggests that maintenance of LTPA must be associated with other factors beyond the individual's level of social support, such as a suitable environment and social/health policies directed towards the practice of LTPA.

  12. Moderating effects of nurses' organizational justice between organizational support and organizational citizenship behaviors for evidence-based practice.

    Science.gov (United States)

    Chang, Ching-Sheng

    2014-10-01

    Lack of existing literature on the correlation among organizational justice, organizational support, and organizational citizenship behaviors has created a research gap in previous evidence-based practice (EBP) studies on nursing personnel. To investigate whether organizational justice among nurses has a moderating effect between their organizational support and organizational citizenship behaviors in order to bridge such a gap of existing literature with the EBP study on nursing personnel. Nursing staff of one large and influential hospital in Taiwan was surveyed. Four hundred questionnaires were distributed, and 386 were collected with a valid response rate of 96.50%. SPSS 17.0 and Amos 17.0 statistical software packages were used for data analysis. Nurses' organizational support positively influences their organizational citizenship behaviors, and their organizational justice perception has a positive moderating effect between organizational support and organizational citizenship behaviors. Results call hospitals' attention to the type of individual behaviors that may improve organizational performance. When nursing staff perceive fair and impartial treatment by the organization and supportive emotional attachment, behaviors beneficial for the organization are expressed in return. Subjective perceptions of nursing staff play an important role in organizational exchange relationship; the higher the degree of nursing staff's perceived organizational justice, the higher the degree of their organizational support, perception, and exhibition of organizational citizenship behaviors such as altruistic behavior and dedication to the work. © 2014 Sigma Theta Tau International.

  13. Spectroscopic evidence for origins of size and support effects on selectivity of Cu nanoparticle dehydrogenation catalysts.

    Science.gov (United States)

    Witzke, M E; Dietrich, P J; Ibrahim, M Y S; Al-Bardan, K; Triezenberg, M D; Flaherty, D W

    2017-01-03

    Selective dehydrogenation catalysts that produce acetaldehyde from bio-derived ethanol can increase the efficiency of subsequent processes such as C-C coupling over metal oxides to produce 1-butanol or 1,3-butadiene or oxidation to acetic acid. Here, we use in situ X-ray absorption spectroscopy and steady state kinetics experiments to identify Cu δ+ at the perimeter of supported Cu clusters as the active site for esterification and Cu 0 surface sites as sites for dehydrogenation. Correlation of dehydrogenation and esterification selectivities to in situ measures of Cu oxidation states show that this relationship holds for Cu clusters over a wide-range of diameters (2-35 nm) and catalyst supports and reveals that dehydrogenation selectivities may be controlled by manipulating either.

  14. Evidence Supports Tradition: The in Vitro Effects of Roman Chamomile on Smooth Muscles

    OpenAIRE

    Zsolt Sándor; Javad Mottaghipisheh; Katalin Veres; Judit Hohmann; Tímea Bencsik; Attila Horváth; Dezső Kelemen; Róbert Papp; Loránd Barthó; Dezső Csupor; Dezső Csupor

    2018-01-01

    The dried flowers of Chamaemelum nobile (L.) All. have been used in traditional medicine for different conditions related to the spasm of the gastrointestinal system. However, there have been no experimental studies to support the smooth muscle relaxant effect of this plant. The aim of our research was to assess the effects of the hydroethanolic extract of Roman chamomile, its fractions, four of its flavonoids (apigenin, luteolin, hispidulin, and eupafolin), and its essential oil on smooth mu...

  15. Mechanical evidence that flamingos can support their body on one leg with little active muscular force.

    Science.gov (United States)

    Chang, Young-Hui; Ting, Lena H

    2017-05-01

    Flamingos (Phoenicopteridae) often stand and sleep on one leg for long periods, but it is unknown how much active muscle contractile force they use for the mechanical demands of standing on one leg: body weight support and maintaining balance. First, we demonstrated that flamingo cadavers could passively support body weight on one leg without any muscle activity while adopting a stable, unchanging, joint posture resembling that seen in live flamingos. By contrast, the cadaveric flamingo could not be stably held in a two-legged pose, suggesting a greater necessity for active muscle force to stabilize two-legged versus one-legged postures. Our results suggest that flamingos engage a passively engaged gravitational stay apparatus (proximally located) for weight support during one-legged standing. Second, we discovered that live flamingos standing on one leg have markedly reduced body sway during quiescent versus alert behaviours, with the point of force application directly under the distal joint, reducing the need for muscular joint torque. Taken together, our results highlight the possibility that flamingos stand for long durations on one leg without exacting high muscular forces and, thus, with little energetic expenditure. © 2017 The Author(s).

  16. Little Evidence Exists To Support The Expectation That Providers Would Consolidate To Enter New Payment Models.

    Science.gov (United States)

    Neprash, Hannah T; Chernew, Michael E; McWilliams, J Michael

    2017-02-01

    Provider consolidation has been associated with higher health care prices and spending. The prevailing wisdom is that payment reform will accelerate consolidation, especially between physicians and hospitals and among physician groups, as providers position themselves to bear financial risk for the full continuum of patient care. Drawing on data from a number of sources from 2008 onward, we examined the relationship between Medicare's accountable care organization (ACO) programs and provider consolidation. We found that consolidation was under way in the period 2008-10, before the Affordable Care Act (ACA) established the ACO programs. While the number of hospital mergers and the size of specialty-oriented physician groups increased after the ACA was passed, we found minimal evidence that consolidation was associated with ACO penetration at the market level or with physicians' participation in ACOs within markets. We conclude that payment reform has been associated with little acceleration in consolidation in addition to trends already under way, but there is evidence of potential defensive consolidation in response to new payment models. Project HOPE—The People-to-People Health Foundation, Inc.

  17. Influenza vaccination coverage estimates in the fee-for service Medicare beneficiary population 2006 - 2016: Using population-based administrative data to support a geographic based near real-time tool.

    Science.gov (United States)

    Shen, Angela K; Warnock, Rob; Brereton, Stephaeno; McKean, Stephen; Wernecke, Michael; Chu, Steve; Kelman, Jeffrey A

    2018-04-11

    Older adults are at great risk of developing serious complications from seasonal influenza. We explore vaccination coverage estimates in the Medicare population through the use of administrative claims data and describe a tool designed to help shape outreach efforts and inform strategies to help raise influenza vaccination rates. This interactive mapping tool uses claims data to compare vaccination levels between geographic (i.e., state, county, zip code) and demographic (i.e., race, age) groups at different points in a season. Trends can also be compared across seasons. Utilization of this tool can assist key actors interested in prevention - medical groups, health plans, hospitals, and state and local public health authorities - in supporting strategies for reaching pools of unvaccinated beneficiaries where general national population estimates of coverage are less informative. Implementing evidence-based tools can be used to address persistent racial and ethnic disparities and prevent a substantial number of influenza cases and hospitalizations.

  18. ProVac Global Initiative: a vision shaped by ten years of supporting evidence-based policy decisions.

    Science.gov (United States)

    Jauregui, Barbara; Janusz, Cara Bess; Clark, Andrew D; Sinha, Anushua; Garcia, Ana Gabriela Felix; Resch, Stephen; Toscano, Cristiana M; Sanderson, Colin; Andrus, Jon Kim

    2015-05-07

    The Pan American Health Organization (PAHO) created the ProVac Initiative in 2004 with the goal of strengthening national technical capacity to make evidence-based decisions on new vaccine introduction, focusing on economic evaluations. In view of the 10th anniversary of the ProVac Initiative, this article describes its progress and reflects on lessons learned to guide the next phase. We quantified the output of the Initiative's capacity-building efforts and critically assess its progress toward achieving the milestones originally proposed in 2004. Additionally, we reviewed how country studies supported by ProVac have directly informed and strengthened the deliberations around new vaccine introduction. Since 2004, ProVac has conducted four regional workshops and supported 24 health economic analyses in 15 Latin American and Caribbean countries. Five Regional Centers of Excellence were funded, resulting in six operational research projects and nine publications. Twenty four decisions on new vaccine introductions were supported with ProVac studies. Enduring products include the TRIVAC and CERVIVAC cost-effectiveness models, the COSTVAC program costing model, methodological guides, workshop training materials and the OLIVES on-line data repository. Ten NITAGs were strengthened through ProVac activities. The evidence accumulated suggests that initiatives with emphasis on sustainable training and direct support for countries to generate evidence themselves, can help accelerate the introduction of the most valuable new vaccines. International and Regional Networks of Collaborators are necessary to provide technical support and tools to national teams conducting analyses. Timeliness, integration, quality and country ownership of the process are four necessary guiding principles for national economic evaluations to have an impact on policymaking. It would be an asset to have a model that offers different levels of complexity to choose from depending on the vaccine being

  19. Further Evidence in Support of the Universal Nilpotent Grammatical Computational Paradigm of Quantum Physics

    International Nuclear Information System (INIS)

    Marcer, Peter J.; Rowlands, Peter

    2010-01-01

    Further evidence is presented in favour of the computational paradigm, conceived and constructed by Rowlands and Diaz, as detailed in Rowlands' book Zero to Infinity (2007), and in particular the authors' paper 'The Grammatical Universe: the Laws of Thermodynamics and Quantum Entanglement'. The paradigm, which has isomorphic group and algebraic quantum mechanical language interpretations, not only predicts the well-established facts of quantum physics, the periodic table, chemistry / valence and of molecular biology, whose understanding it extends; it also provides an elegant, simple solution to the unresolved quantum measurement problem. In this fundamental paradigm, all the computational constructs / predictions that emerge, follow from the simple fact, that, as in quantum mechanics, the wave function is defined only up to an arbitrary fixed phase. This fixed phase provides a simple physical understanding of the quantum vacuum in quantum field theory, where only relative phases, known to be able to encode 3+1 relativistic space-time geometries, can be measured. It is the arbitrary fixed measurement standard, against which everything that follows is to be measured, even though the standard itself cannot be, since nothing exists against which to measure it. The standard, as an arbitrary fixed reference phase, functions as the holographic basis for a self-organized universal quantum process of emergent novel fermion states of matter where, following each emergence, the arbitrary standard is re-fixed anew so as to provide a complete history / holographic record or hologram of the current fixed past, advancing an unending irreversible evolution, such as is the evidence of our senses. The fermion states, in accord with the Pauli exclusion principle, each correspond to a unique nilpotent symbol in the infinite alphabet (which specifies the grammar in this nilpotent universal computational rewrite system (NUCRS) paradigm); and the alphabet, as Hill and Rowlands

  20. Support groups for children and adolescents bereaved by suicide: Lots of interventions, little evidence.

    Science.gov (United States)

    Journot-Reverbel, Katia; Raynaud, Jean-Philippe; Bui, Eric; Revet, Alexis

    2017-04-01

    Though many different interventions are proposed for suicide-bereaved children and adolescents, few data exist concerning their efficiency. This literature review focused on psychosocial interventions specifically targeting children and adolescents bereaved by suicide to try to provide some validate therapeutic guidelines propositions for clinicians. We only found two articles specifically targeting children or adolescents: both of them seemed to show some efficacy in reducing some psychosocial variables (anxiety, depression…) in suicide-bereaved children but results were limited by methodological problems. This review failed to provide evidence-based guidelines propositions for suicide-bereaved children and underline the crucial need for research in this field. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  1. American Society for Microbiology resources in support of an evidence-based approach to teaching microbiology.

    Science.gov (United States)

    Merkel, Susan M

    2016-08-01

    Numerous national reports have addressed the need for changing how science courses in higher education are taught, so that students develop a deeper understanding of critical concepts and the analytical and cognitive skills needed to address future challenges. This review presents some evidence-based approaches to curriculum development and teaching. Results from discipline-based education research indicate that it is critically important for educators to formulate learning goals, provide frequent and authentic assessments and actively engage students in their learning. Professional societies can play a role in helping to put these changes into practice. To this end, the American Society for Microbiology has developed a number of educational programs and resources, which are described here to encourage the implementation of student-centered learning in microbiology education. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Evidence to support IL-13 as a risk locus for psoriatic arthritis but not psoriasis vulgaris.

    LENUS (Irish Health Repository)

    Bowes, John

    2011-06-01

    There is great interest in the identification of genetic factors that differentiate psoriatic arthritis (PsA) from psoriasis vulgaris (PsV), as such discoveries could lead to the identification of distinct underlying aetiological pathways. Recent studies identified single nucleotide polymorphisms (SNPs) in the interleukin 13 (IL-13) gene region as risk factors for PsV. Further investigations in one of these studies found the effect to be primarily restricted to PsA, thus suggesting the discovery of a specific genetic risk factor for PsA. Given this intriguing evidence, association to this gene was investigated in large collections of PsA and PsV patients and healthy controls.

  3. Synthetic Cannabinoids-Further Evidence Supporting the Relationship Between Cannabinoids and Psychosis.

    Science.gov (United States)

    Fattore, Liana

    2016-04-01

    Consumption of synthetic mind-altering compounds, also known as "new psychoactive substances," is increasing globally at an alarming rate. Synthetic cannabinoids (SCs) are among the most commonly used new psychoactive substances. They are usually purchased as marijuana-like drugs, marketed as herbal blends and perceived as risk-free by inexperienced users. Yet, contrary to Δ(9)-tetrahydrocannabinol, SCs may lead to severe health consequences, including anxiety, tachycardia, hallucinations, violent behavior, and psychosis. This review focuses on the latest (2010-2015) evidence of psychotic symptoms induced by ingestion of products containing SCs. Reports suggesting that SCs may either exacerbate previously stable psychotic symptoms (in vulnerable individuals) or trigger new-onset psychosis (in individuals with no previous history of psychosis) are reviewed. Pharmacology and toxicology of these compounds are discussed, with particular reference to their psychoactive effects. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  4. Promoting energy efficiency: supporting Public Administration and Local Bodies; Promuovere l'efficienza energetica : il supporto alla Pubblica Amministrazione e agli Enti Locali

    Energy Technology Data Exchange (ETDEWEB)

    Fasano, G; Manila, E [Dipartimento tecnologie per l' energia, le fonti rinnovabili e il risparmio energetico, ENEA (Italy)

    2008-11-15

    ENEAS's institutional tasks include technical and scientific support to Public Administration and Local Bodies in the field of energy. Recently such a role has been strengthened by setting up the Agency for Energy Efficiency which ENEA is responsible for. [Italian] Tra i compiti istituzionali dell'ENEA vi e quello di fornire un supporto tecnico scientifico alla PA e agli Enti Locali in tema di energia. Tale ruolo e stato di recente rafforzato con l'istituzione dell'Agenzia per l'Efficienza Energetica affidata all'Ente.

  5. Working group reports: Evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project

    Science.gov (United States)

    The "Evaluation of the Evidence to Support Practice Guidelines for the Nutritional Care of Preterm Infants: The Pre-B Project" is the first phase in a process to present the current state of knowledge and to support the development of evidence-informed guidance for the nutritional care of preterm an...

  6. Scrape-off layer turbulence in TCV: evidence in support of stochastic modelling

    Czech Academy of Sciences Publication Activity Database

    Theodorsen, A.; Garcia, O.E.; Horáček, Jan; Kube, R.; Pitts, R.A.

    2016-01-01

    Roč. 58, č. 4 (2016), č. článku 044006. ISSN 0741-3335 R&D Projects: GA ČR(CZ) GAP205/12/2327 Institutional support: RVO:61389021 Keywords : turbulence * intermittency * transport * scrape-off layer * tcv * plasma * tokamak Subject RIV: BL - Plasma and Gas Discharge Physics OBOR OECD: Fluids and plasma physics (including surface physics) Impact factor: 2.392, year: 2016 http://iopscience.iop.org/article/10.1088/0741-3335/58/4/044006/meta

  7. Danish evidence-based clinical guideline for use of nutritional support in pulmonary rehabilitation of undernourished patients with stable COPD.

    Science.gov (United States)

    Beck, Anne Marie; Iepsen, Ulrik Winning; Tobberup, Randi; Jørgensen, Karsten Juhl

    2015-02-01

    Disease-related under-nutrition is a common problem in individuals with COPD. The rationale for nutritional support in pulmonary rehabilitation therefore seems obvious. However there is limited evidence regarding the patient-relevant outcomes i.e. activities of daily living (ADL) or quality of life. Therefore the topic was included in The Danish Health and Medicines Authority's development of an evidence-based clinical guideline for rehabilitation of patients with stable COPD. The methods were specified by The Danish Health and Medicines Authority as part of a standardized approach to evidence-based national clinical practice guidelines. They included formulation of a PICO with pre-defined criteria for the Population, Intervention, Control and Outcomes. Existing guidelines or systematic reviews were used after assessment using the AGREE II tool or AMSTAR, if possible. We identified primary studies by means of a systematic literature search (July to December 2013), and any identified studies were then quality assessed using the Cochrane risk of bias tool and the GRADE approach. The extracted data on our pre-defined outcomes were summarized in meta-analyses when possible, or meta-analyses from existing guidelines or systematic reviews were adapted. The results were used for labeling and wording of the recommendations. Data from 12 randomized controlled trials were included in a systematic review, which formed the basis for our recommendations as no new primary studies had been published. There were evidence of moderate quality that nutritional support for undernourished patients with COPD lead to a weight gain of 1.7kg (95% confidence interval: 1.3 to 2.2kg), but the effect was quantified as a mean change from baseline, which is less reliable. There were evidence of moderate quality that nutritional therapy does not increase in the 6 minute walking distance of 13 m (95% confidence interval: -27 to 54 m) when results in the intervention and control groups were

  8. What is the evidence to support the use of therapeutic gardens for the elderly?

    Science.gov (United States)

    Detweiler, Mark B; Sharma, Taral; Detweiler, Jonna G; Murphy, Pamela F; Lane, Sandra; Carman, Jack; Chudhary, Amara S; Halling, Mary H; Kim, Kye Y

    2012-06-01

    Horticulture therapy employs plants and gardening activities in therapeutic and rehabilitation activities and could be utilized to improve the quality of life of the worldwide aging population, possibly reducing costs for long-term, assisted living and dementia unit residents. Preliminary studies have reported the benefits of horticultural therapy and garden settings in reduction of pain, improvement in attention, lessening of stress, modulation of agitation, lowering of as needed medications, antipsychotics and reduction of falls. This is especially relevant for both the United States and the Republic of Korea since aging is occurring at an unprecedented rate, with Korea experiencing some of the world's greatest increases in elderly populations. In support of the role of nature as a therapeutic modality in geriatrics, most of the existing studies of garden settings have utilized views of nature or indoor plants with sparse studies employing therapeutic gardens and rehabilitation greenhouses. With few controlled clinical trials demonstrating the positive or negative effects of the use of garden settings for the rehabilitation of the aging populations, a more vigorous quantitative analysis of the benefits is long overdue. This literature review presents the data supporting future studies of the effects of natural settings for the long term care and rehabilitation of the elderly having the medical and mental health problems frequently occurring with aging.

  9. Communicating Program Outcomes to Encourage Policymaker Support for Evidence-Based State Tobacco Control

    Directory of Open Access Journals (Sweden)

    Allison M. Schmidt

    2014-12-01

    Full Text Available Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003–2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1 high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2 the primacy of economic concerns in making policy decisions, (3 ideological differences in views of the state’s role in tobacco control, (4 the impact of lobbyist and constituent in-person appeals, and (5 the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.

  10. Public Policies to Support Entrepreneurship and SMEs. Empirical Evidences from Romania

    Directory of Open Access Journals (Sweden)

    Sorin Gabriel ANTON

    2016-02-01

    Full Text Available Based on a set of variables measured in the Global Entrepreneurship Monitor (GEM study, we analyzed the entrepreneurial profi le of Romanian economy after the onset of fi nancial crisis. We found a positive attitude towards entrepreneurship in Romania, but the fi nancial crisis started in 2008 severely affected the entrepreneurial environment. In many countries, the lack of an entrepreneurial culture and fi nancial constraints are seen as critical barriers to entrepreneurship. In the light of global fi nancial crisis, the support of entrepreneurial activities has risen as the entrepreneurship has the potential to foster economic recovery. In the second part of the paper we analyze policy actions implemented by the Romanian authorities in order to support SMEs in coping with the effects of fi nancial crisis. We have found that the most used policy tools have been public subsidies for new businesses and loan guarantees. The paper highlights the main weaknesses in the design and implementation of public policies in Romania and recommends some policy action to improve SMEs’ access to fi nance. The results of this study can be useful for improving the local entrepreneurial environment and also for designing new policy actions aimed to improve the SMEs’ access to fi nancing.

  11. Communicating program outcomes to encourage policymaker support for evidence-based state tobacco control.

    Science.gov (United States)

    Schmidt, Allison M; Ranney, Leah M; Goldstein, Adam O

    2014-12-04

    Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003-2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans) and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1) high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2) the primacy of economic concerns in making policy decisions, (3) ideological differences in views of the state's role in tobacco control, (4) the impact of lobbyist and constituent in-person appeals, and (5) the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.

  12. Levers supporting tariff growth for water services: evidence from a contingent valuation analysis.

    Science.gov (United States)

    Guerrini, Andrea; Vigolo, Vania; Romano, Giulia; Testa, Federico

    2018-02-01

    The backwardness of the water utilities sector necessitates urgent investment in infrastructure to improve water quality and efficiency in water supply networks. A policy of tariff growth represents the main source to sustain such investments. Therefore, customer engagement in the form of willingness to pay (WTP) is highly desirable by water utilities to obtain social legitimization and support. This study examines the determinants of consumers' WTP for improvement programs for three drinking water issues: quality of water sources, renewal of water mains, and building of new wastewater treatment plants. The study is based on a survey conducted among a sample of 587 customers of a water utility located in the province of Verona in the north of Italy. The contingence valuation method is used to measure WTP. Specifically, an ordinal logistic regression model yields the following significant determinants of WTP: quality of water and services provided, preference for privatization of the water utility, sustainable consumption of water, and some socio-demographic variables. The findings provide interesting insights into the drivers of WTP as well as managerial recommendations for water utilities. In particular, the findings show that water utilities need to improve service and water quality to increase customers' acceptance of tariff growth. In addition, utilities should invest in customer education and communication activities focusing on specific age groups (e.g., older customers) to enhance their WTP. Finally, communication strategies should reinforce the possible role of liberalization and privatization in supporting infrastructure investments. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. A Theory of Sex Differences in Technical Aptitude and Some Supporting Evidence.

    Science.gov (United States)

    Schmidt, Frank L

    2011-11-01

    In this article, I present a theory that explains the origin of sex differences in technical aptitudes. The theory takes as proven that there are no sex differences in general mental ability (GMA), and it postulates that sex differences in technical aptitude (TA) stem from differences in experience in technical areas, which is in turn based on sex differences in technical interests. Using a large data set, I tested and found support for four predictions made by this theory: (a) the construct level correlation between technical aptitude and GMA is larger for females than males, (b) the observed and true score variability of technical aptitude is greater among males than females, (c) at every level of GMA females have lower levels of technical aptitude, and (d) technical aptitude measures used as estimates of GMA for decision purposes would result in underestimation of GMA levels for girls and women. Given that GMA carries the weight of prediction of job performance, the support found for this last prediction suggests that, for many jobs, technical aptitude tests may underpredict the job performance of female applicants and employees. Future research should examine this question. © Association for Psychological Science 2011.

  14. When and How do Bureaucratic Conflicts Matter in Trade Policy? Evidence from the US Trade Policymaking Process during the Clinton Administration (1993–2001

    Directory of Open Access Journals (Sweden)

    Rodrigo Fagundes Cézar

    Full Text Available Abstract The study of the role played by bureaucracies contributed substantively to the analysis of the domestic determinants of foreign policy outcomes, particularly by softening the premise of the state as a unitary-rational actor. However, the potential of focusing on bureaucracies to analyse US trade policy outcomes has been severely underestimated by the most recent IPE scholarship, which tends to focus on the Congress and interest groups, and to consider the Executive a unitary actor. Based on elements of the bureaucratic politics model, this article uses evidence from the US trade policy during Clinton’s administration (1993–2001 in order to present arguments regarding how and when bureaucratic conflicts matter the most, and highlight the relevance of these conflicts in the trade decision-making process.

  15. The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance.

    Science.gov (United States)

    Balen, Adam H; Morley, Lara C; Misso, Marie; Franks, Stephen; Legro, Richard S; Wijeyaratne, Chandrika N; Stener-Victorin, Elisabet; Fauser, Bart C J M; Norman, Robert J; Teede, Helena

    2016-11-01

    Here we describe the consensus guideline methodology, summarise the evidence-based recommendations we provided to the World Health Organisation (WHO) for their consideration in the development of global guidance and present a narrative review on the management of anovulatory infertility in women with polycystic ovary syndrome (PCOS). The aim of this paper was to present an evidence base for the management of anovulatory PCOS. The evidence to support providing recommendations involved a collaborative process for: (i) identification of priority questions and critical outcomes, (ii) retrieval of up-to-date evidence and exiting guidelines, (iii) assessment and synthesis of the evidence and (iv) the formulation of draft recommendations to be used for reaching consensus with a wide range of global stakeholders. For each draft recommendation, the methodologist evaluated the quality of the supporting evidence that was then graded as very low, low, moderate or high for consideration during consensus. Evidence was synthesized and we made recommendations across the definition of PCOS including hyperandrogenism, menstrual cycle regulation and ovarian assessment. Metabolic features and the impact of ethnicity were covered. Management includes lifestyle changes, bariatric surgery, pharmacotherapy (including clomiphene citrate (CC), aromatase inhibitors, metformin and gonadotropins), as well as laparoscopic surgery. In-vitro fertilization (IVF) was considered as were the risks of ovulation induction and of pregnancy in PCOS. Approximately 80% of women who suffer from anovulatory infertility have PCOS. Lifestyle intervention is recommended first in women who are obese largely on the basis of general health benefits. Bariatric surgery can be considered where the body mass index (BMI) is ≥35 kg/m 2 and lifestyle therapy has failed. Carefully conducted and monitored pharmacological ovulation induction can achieve good cumulative pregnancy rates and multiple pregnancy rates can be

  16. National Aeronautics and Space Administration (NASA) Environmental Control and Life Support (ECLS) Capability Roadmap Development for Exploration

    Science.gov (United States)

    Bagdigian, Robert M.; Carrasquillo, Robyn L.; Metcalf, Jordan; Peterson, Laurie

    2012-01-01

    NASA is considering a number of future human space exploration mission concepts. Although detailed requirements and vehicle architectures remain mostly undefined, near-term technology investment decisions need to be guided by the anticipated capabilities needed to enable or enhance the mission concepts. This paper describes a roadmap that NASA has formulated to guide the development of Environmental Control and Life Support Systems (ECLSS) capabilities required to enhance the long-term operation of the International Space Station (ISS) and enable beyond-Low Earth Orbit (LEO) human exploration missions. Three generic mission types were defined to serve as a basis for developing a prioritized list of needed capabilities and technologies. Those are 1) a short duration micro gravity mission; 2) a long duration transit microgravity mission; and 3) a long duration surface exploration mission. To organize the effort, ECLSS was categorized into three major functional groups (atmosphere, water, and solid waste management) with each broken down into sub-functions. The ability of existing, flight-proven state-of-the-art (SOA) technologies to meet the functional needs of each of the three mission types was then assessed. When SOA capabilities fell short of meeting the needs, those "gaps" were prioritized in terms of whether or not the corresponding capabilities enable or enhance each of the mission types. The resulting list of enabling and enhancing capability gaps can be used to guide future ECLSS development. A strategy to fulfill those needs over time was then developed in the form of a roadmap. Through execution of this roadmap, the hardware and technologies needed to enable and enhance exploration may be developed in a manner that synergistically benefits the ISS operational capability, supports Multi-Purpose Crew Vehicle (MPCV) development, and sustains long-term technology investments for longer duration missions. This paper summarizes NASA s ECLSS capability roadmap

  17. Economic Growth and Expansion of China’s Urban Land Area: Evidence from Administrative Data and Night Lights, 1993–2012

    Directory of Open Access Journals (Sweden)

    John Gibson

    2014-11-01

    Full Text Available The relationship between economic growth, expansion of urban land area and the broader issue of cultivated land conversion in China has been closely examined for the late 1980s and 1990s. Much less is known about recent urban expansion and if the effects of economic growth on this expansion have changed over time. This paper updates estimates of urban expansion for China and examines the relationship with city economic growth for 1993–2012. To see if patterns are robust to different types of evidence, administrative data on the area of 225 urban cores are compared to estimates of brightly lit areas from remotely sensed night lights. The trend annual expansion rate in lit area is 8% and was significantly faster in the decade to 2002 than in the most recent decade. Expansion is slower according to administrative data, at just 5% per annum, with no change in unconditional expansion rates between decades, while conditional expansion rates have declined. The elasticity of area with respect to city economic output is about 0.3. Over time, expansion of urban land area is becoming less responsive to the growth of the local non-agricultural population.

  18. Using support vector machines to identify literacy skills: Evidence from eye movements.

    Science.gov (United States)

    Lou, Ya; Liu, Yanping; Kaakinen, Johanna K; Li, Xingshan

    2017-06-01

    Is inferring readers' literacy skills possible by analyzing their eye movements during text reading? This study used Support Vector Machines (SVM) to analyze eye movement data from 61 undergraduate students who read a multiple-paragraph, multiple-topic expository text. Forward fixation time, first-pass rereading time, second-pass fixation time, and regression path reading time on different regions of the text were provided as features. The SVM classification algorithm assisted in distinguishing high-literacy-skilled readers from low-literacy-skilled readers with 80.3 % accuracy. Results demonstrate the effectiveness of combining eye tracking and machine learning techniques to detect readers with low literacy skills, and suggest that such approaches can be potentially used in predicting other cognitive abilities.

  19. The use of ICT tools to support collaborative product development activities: evidences from Brazilian industry

    Directory of Open Access Journals (Sweden)

    Daisy Valle Enrique

    2018-06-01

    Full Text Available Abstract Paper aims This paper aims to understand the relationship between Information & Communication Technology (ICT, collaborative New Product Development (NPD and customer satisfaction (NPD performance. Originality We target the relationship between ICT, collaborative NPD and NPD performance. ICT is assessed as a set of specific tools adopted by the companies. Research method We test the mediating role of collaborative practices in the effect of ICT tools on customer satisfaction (as NPD performance by means of a survey of 105 Brazilian firms. Main findings Collaboration with customers and suppliers has an important role for customer satisfaction and the use of ICT has significant effect on NPD performance through the mediating role of collaborative practices. Implications for theory and practice Implementing only ICT tools is not enough to achieve higher level of success in NPD. Managers should first strength the relationship between stakeholders and then adopt ICT tools to support the cooperation.

  20. Attribution of Regional Responsibilities for Public Services and Citizen Support of Decentralisation: Evidence from Spain

    Directory of Open Access Journals (Sweden)

    JULIO LÓPEZ LABORDA

    2015-01-01

    Full Text Available Probit/logit techniques are applied to the data from Barometer No. 2,829 published by the Centro de Investigaciones Sociológicas to examine three problems related with public sector decentralisation. The paper concludes, first, that citizens? perception of efficiency gains from decentralisation have a positive effect on their support for decentralised government. Second, that citizens are more likely to perceive the efficiency gains from decentralisation if they correctly ascribe responsibility for education and health services to regions. And third, that citizens who most accurately identify regional responsibility for the provision of those services tend to be better educated, older, engaged in paid work or public employment, concerned about regional politics and resident in one region with higher initial level of devolved powers.

  1. Evidence supporting a zoonotic origin of human coronavirus strain NL63.

    Science.gov (United States)

    Huynh, Jeremy; Li, Shimena; Yount, Boyd; Smith, Alexander; Sturges, Leslie; Olsen, John C; Nagel, Juliet; Johnson, Joshua B; Agnihothram, Sudhakar; Gates, J Edward; Frieman, Matthew B; Baric, Ralph S; Donaldson, Eric F

    2012-12-01

    The relationship between bats and coronaviruses (CoVs) has received considerable attention since the severe acute respiratory syndrome (SARS)-like CoV was identified in the Chinese horseshoe bat (Rhinolophidae) in 2005. Since then, several bats throughout the world have been shown to shed CoV sequences, and presumably CoVs, in the feces; however, no bat CoVs have been isolated from nature. Moreover, there are very few bat cell lines or reagents available for investigating CoV replication in bat cells or for isolating bat CoVs adapted to specific bat species. Here, we show by molecular clock analysis that alphacoronavirus (α-CoV) sequences derived from the North American tricolored bat (Perimyotis subflavus) are predicted to share common ancestry with human CoV (HCoV)-NL63, with the most recent common ancestor between these viruses occurring approximately 563 to 822 years ago. Further, we developed immortalized bat cell lines from the lungs of this bat species to determine if these cells were capable of supporting infection with HCoVs. While SARS-CoV, mouse-adapted SARS-CoV (MA15), and chimeric SARS-CoVs bearing the spike genes of early human strains replicated inefficiently, HCoV-NL63 replicated for multiple passages in the immortalized lung cells from this bat species. These observations support the hypothesis that human CoVs are capable of establishing zoonotic-reverse zoonotic transmission cycles that may allow some CoVs to readily circulate and exchange genetic material between strains found in bats and other mammals, including humans.

  2. Interprofessional education in maternity services: Is there evidence to support policy?

    Science.gov (United States)

    Davies, Nigel; Fletcher, Simon; Reeves, Scott

    2016-11-01

    Against a backdrop of poor maternity and obstetric care, identified in the Morecambe Bay Inquiry, the UK government has recently called for improvements and heralded investment in training. Given the complex mix of professionals working closely together in maternity services addressing the lack of joined up continuing professional development (CPD) is necessary. This led us to ask whether there is evidence of IPE in maternity services. As part of a wider systematic review of IPE, we searched for studies related to CPD in maternity services between May 2005 and June 2014. A total of 206 articles were identified with 24 articles included after initial screening. Further review revealed only eight articles related to maternity care, none of which met the inclusion criteria for the main systematic review. The main reasons for non-inclusion included weak evaluation, a focus on undergraduate IPE, and articles referring to paediatric/neonatal care only. Fewer articles were found than anticipated given the number of different professions working together in maternity services. This gap suggests further investigation is warranted.

  3. European Union research in support of environment and health: Building scientific evidence base for policy.

    Science.gov (United States)

    Karjalainen, Tuomo; Hoeveler, Arnd; Draghia-Akli, Ruxandra

    2017-06-01

    Opinion polls show that the European Union citizens are increasingly concerned about the impact of environmental factors on their health. In order to respond and provide solid scientific evidence for the numerous policies related to the protection of human health and the environment managed at the Union level, the European Union made a substantial investment in research and innovation in the past two decades through its Framework Programmes for Research and Technological Development, including the current programme, Horizon 2020, which started in 2014. This policy review paper analysed the portfolio of forty collaborative projects relevant to environment and health, which received a total amount of around 228 million euros from the EU. It gives details on their contents and general scientific trends observed, the profiles of the participating countries and institutions, and the potential policy implications of the results obtained. The increasing knowledge base is needed to make informed policy decisions in Europe and beyond, and should be useful to many stakeholders including the scientific community and regulatory authorities. Copyright © 2017. Published by Elsevier Ltd.

  4. Evidence supporting oral sensitivity to complex carbohydrates independent of sweet taste sensitivity in humans.

    Directory of Open Access Journals (Sweden)

    Julia Y Q Low

    Full Text Available Compared to simple sugars, complex carbohydrates have been assumed invisible to taste. However, two recent studies proposed that there may be a perceivable taste quality elicited by complex carbohydrates independent of sweet taste. There is precedent with behavioural studies demonstrating that rats are very attracted to complex carbohydrates, and that complex carbohydrates are preferred to simple sugars at low concentrations. This suggests that rats may have independent taste sensors for simple sugars and complex carbohydrates. The aim of this paper is to investigate oral sensitivities of two different classes of complex carbohydrates (a soluble digestible and a soluble non-digestible complex carbohydrate, and to compare these to other caloric and non-nutritive sweeteners in addition to the prototypical tastes using two commonly used psychophysical measures. There were strong correlations between the detection thresholds and mean intensity ratings for complex carbohydrates (maltodextrin, oligofructose (r = 0.94, P 0.05. However, moderate correlations were observed between perceived intensities of complex carbohydrates and sweeteners (r = 0.48-0.61, P < 0.05. These data provide evidence that complex carbohydrates can be sensed in the oral cavity over a range of concentrations independent of sweet taste sensitivity at low concentrations, but with partial overlap with sweet taste intensity at higher concentrations.

  5. Ontology supported system for searching evidence of wild animals trafficking in social network posts

    Directory of Open Access Journals (Sweden)

    Rafael da Silva Carrasco

    2014-04-01

    Full Text Available O comércio ilegal de animais silvestres é uma das atividades criminais mais lucrativas da atualidade. No Brasil, a grande variedade de fauna nativa tem alimentado o mercado ilegal, o que gera sérias implicações ambientais e sociais. A luta contra o comércio ilegal de animais silvestres é crucial para ajudar a proteger os recursos naturais e evitar a disseminação de outras formas de crime. Esse tipo de comércio ilegal usa cada vez mais, a internet para realizar suas atividades. A fim de combater tal crime, um sistema automático de monitorização é essencial. No entanto, para realizar essa tarefa de forma eficaz, o sistema deve ser capaz de analisar as mensagens trocadas durante essa prática. Para isso, é necessário o conhecimento dos conceitos e relações que ocorrem nesse domínio. Este artigo apresenta um sistema multiagente apoiado por ontologia de domínio e frames semânticos para buscar evidências de comércio ilegal de animais silvestres. No artigo, é mostrado como o sistema pode ser usado na tarefa de rastreamento do comércio ilegal de animais silvestres, além de apresentar os resultados da aplicação do sistema em um pequeno corpus.

  6. System administrator's manual (SAM) for the enhanced logistics intratheater support tool (ELIST) database segment version 8.1.0.0 for solaris 7.; TOPICAL

    International Nuclear Information System (INIS)

    Dritz, K.

    2002-01-01

    This document is the System Administrator's Manual (SAM) for the Enhanced Logistics Intratheater Support Tool (ELIST) Database Segment. It covers errors that can arise during the segment's installation and deinstallation, and it outlines appropriate recovery actions. It also tells how to extend the database storage available to Oracle if a datastore becomes filled during the use of ELIST. The latter subject builds on some of the actions that must be performed when installing this segment, as documented in the Installation Procedures (IP) for the Enhanced Logistics Intratheater Support Tool (ELIST) Global Data Segment, Database Instance Segment, Database Fill Segment, Database Segment, Database Utility Segment, Software Segment, and Reference Data Segment (referred to in portions of this document as the ELIST IP). The information in this document is expected to be of use only rarely. Other than errors arising from the failure to follow instructions, difficulties are not expected to be encountered during the installation or deinstallation of the segment. The need to extend database storage likewise typically arises infrequently. Most administrators will only need to be aware of the help that is provided in this document and will probably not actually need to read and make use of it

  7. System administrator's manual (SAM) for the enhanced logistics intratheater support tool (ELIST) database instance segment version 8.1.0.0 for solaris 7.; TOPICAL

    International Nuclear Information System (INIS)

    Dritz, K.

    2002-01-01

    This document is the System Administrator's Manual (SAM) for the Enhanced Logistics Intratheater Support Tool (ELIST) Database Instance Segment. It covers errors that can arise during the segment's installation and deinstallation, and it outlines appropriate recovery actions. It also tells how to change the password for the SYSTEM account of the database instance after the instance is created, and it discusses the creation of a suitable database instance for ELIST by means other than the installation of the segment. The latter subject is covered in more depth than its introductory discussion in the Installation Procedures (IP) for the Enhanced Logistics Intratheater Support Tool (ELIST) Global Data Segment, Database Instance Segment, Database Fill Segment, Database Segment, Database Utility Segment, Software Segment, and Reference Data Segment (referred to in portions of this document as the ELIST IP). The information in this document is expected to be of use only rarely. Other than errors arising from the failure to follow instructions, difficulties are not expected to be encountered during the installation or deinstallation of the segment. By the same token, the need to create a database instance for ELIST by means other than the installation of the segment is expected to be the exception, rather than the rule. Most administrators will only need to be aware of the help that is provided in this document and will probably not actually need to read and make use of it

  8. Peripheral Faulting of Eden Patera: Potential Evidence in Support of a New Volcanic Construct on Mars

    Science.gov (United States)

    Harlow, J.

    2016-12-01

    Arabia Terra's (AT) pock-marked topography in the expansive upland region of Mars Northern Hemisphere has been assumed to be the result of impact crater bombardment. However, examination of several craters by researchers revealed morphologies inconsistent with neighboring craters of similar size and age. These 'craters' share features with terrestrial super-eruption calderas, and are considered a new volcanic construct on Mars called `plains-style' caldera complexes. Eden Patera (EP), located on the northern boundary of AT is a reference type for these calderas. EP lacks well-preserved impact crater morphologies, including a decreasing depth to diameter ratio. Conversely, Eden shares geomorphological attributes with terrestrial caldera complexes such as Valles Caldera (New Mexico): arcuate caldera walls, concentric fracturing/faulting, flat-topped benches, irregular geometric circumferences, etc. This study focuses on peripheral fractures surrounding EP to provide further evidence of calderas within the AT region. Scaled balloon experiments mimicking terrestrial caldera analogs have showcased fracturing/faulting patterns and relationships of caldera systems. These experiments show: 1) radial fracturing (perpendicular to caldera rim) upon inflation, 2) concentric faulting (parallel to sub-parallel to caldera rim) during evacuation, and 3) intersecting radial and concentric peripheral faulting from resurgence. Utilizing Mars Reconnaissance Orbiter Context Camera (CTX) imagery, peripheral fracturing is analyzed using GIS to study variations in peripheral fracture geometries relative to the caldera rim. Visually, concentric fractures dominate within 20 km, radial fractures prevail between 20 and 50 km, followed by gradation into randomly oriented and highly angular intersections in the fretted terrain region. Rose diagrams of orientation relative to north expose uniformly oriented mean regional stresses, but do not illuminate localized caldera stresses. Further

  9. Pedagogical Scholarship in Public Health: A Call for Cultivating Learning Communities to Support Evidence-Based Education.

    Science.gov (United States)

    Merzel, Cheryl; Halkitis, Perry; Healton, Cheryl

    Public health education is experiencing record growth and transformation. The current emphasis on learning outcomes necessitates attention to creating and evaluating the best curricula and learning methods for helping public health students develop public health competencies. Schools and programs of public health would benefit from active engagement in pedagogical research and additional platforms to support dissemination and implementation of educational research findings. We reviewed current avenues for sharing public health educational research, curricula, and best teaching practices; we identified useful models from other health professions; and we offered suggestions for how the field of public health education can develop communities of learning devoted to supporting pedagogy. Our goal was to help advance an agenda of innovative evidence-based public health education, enabling schools and programs of public health to evaluate and measure success in meeting the current and future needs of the public health profession.

  10. The Role of Philanthropic Funding in Building Research Evidence to Support an Aging Population: A Case Study from Ireland.

    Science.gov (United States)

    Cochrane, Andy; McGilloway, Sinéad

    2017-01-01

    This case study examines the role of philanthropic funding in building capacity for aging research in Ireland, and how this investment has addressed the lack of evidence to support planning for an aging population. The funding has supported a range of initiatives including the national longitudinal study on aging (TILDA), the creation of three professorships/chairs, and the establishment of four new research centers. Important potential outcomes are emerging across other domains including research-informed policy development and the generation of health benefits. The efforts of academic researchers to ensure that their findings are readily accessible to end users and to forge robust working relationships with all stakeholders have helped to enhance the use of research findings. Overall, philanthropy has played a pivotal role in building capacity, infrastructure, and expertise in academic settings in Ireland. Moreover, this work provides an excellent example of how such efforts can begin to inform effective planning and service provision.

  11. Social support and leisure-time physical activity: longitudinal evidence from the Brazilian Pró-Saúde cohort study.

    Science.gov (United States)

    Oliveira, Aldair J; Lopes, Claudia S; de Leon, Antônio C Ponce; Rostila, Mikael; Griep, Rosane H; Werneck, Guilherme L; Faerstein, Eduardo

    2011-07-26

    Although social support has been observed to exert a beneficial influence on leisure-time physical activity (LTPA), multidimensional approaches examining social support and prospective evidence of its importance are scarce. The purpose of this study was to investigate how four dimensions of social support affect LTPA engagement, maintenance, type, and time spent by adults during a two-year follow-up. This paper reports on a longitudinal study of 3,253 non-faculty public employees at a university in Rio de Janeiro (the Pró-Saúde study). LTPA was evaluated using a dichotomous question with a two-week reference period, and further questions concerning LTPA type (individual or group) and time spent on the activity. Social support was measured by the Medical Outcomes Study Social Support Scale (MOS-SSS). To assess the association between social support and LTPA, two different statistical models were used: binary and multinomial logistic regression models for dichotomous and polytomous outcomes, respectively. Models were adjusted separately for those who began LTPA in the middle of the follow up (engagement group) and for those who had maintained LTPA since the beginning of the follow up (maintenance group). After adjusting for confounders, statistically significant associations (p time spent on LTPA (OR = 2.01; 95% CI 1.2-3.9). In the maintenance group, material support was associated with group LTPA (OR = 1.80; 95% CI; 1.1-3.1) and the positive social interaction dimension was associated with time spent on LTPA (OR = 1.65; 95% CI; 1.1-2.7). All dimensions of social support influenced LTPA type or the time spent on the activity. However, our findings suggest that social support is more important in engagement than in maintenance. This finding is important, because it suggests that maintenance of LTPA must be associated with other factors beyond the individual's level of social support, such as a suitable environment and social/health policies directed towards the

  12. Internet interventions to support lifestyle modification for diabetes management: a systematic review of the evidence.

    Science.gov (United States)

    Cotter, Alexander P; Durant, Nefertiti; Agne, April A; Cherrington, Andrea L

    2014-01-01

    The Internet presents a widely accessible, 24-h means to promote chronic disease management. The objective of this review is to identify studies that used Internet based interventions to promote lifestyle modification among adults with type 2 diabetes. We searched PubMed using the terms: [internet, computer, phone, smartphone, mhealth, mobile health, web based, telehealth, social media, text messages] combined with [diabetes management and diabetes control] through January 2013. Studies were included if they described an Internet intervention, targeted adults with type 2 diabetes, focused on lifestyle modification, and included an evaluation component with behavioral outcomes. Of the 2803 papers identified, nine met inclusion criteria. Two studies demonstrated improvements in diet and/or physical activity and two studies demonstrated improvements in glycemic control comparing web-based intervention with control. Successful studies were theory-based, included interactive components with tracking and personalized feedback, and provided opportunities for peer support. Website utilization declined over time in all studies that reported on it. Few studies focused on high risk, underserved populations. Web-based strategies provide a viable option for facilitating diabetes self-management. Future research is needed on the use of web-based interventions in underserved communities and studies examining website utilization patterns and engagement over time. © 2014 Elsevier Inc. All rights reserved.

  13. Evidence that transferrin supports cell proliferation by supplying iron for DNA synthesis

    International Nuclear Information System (INIS)

    Laskey, J.; Webb, I.; Schulman, H.M.; Ponka, P.

    1988-01-01

    Transferrin is essential for cell proliferation and it was suggested that it may trigger a proliferative response following its interaction with receptors, serving as a growth factor. However, since the only clearly defined function of transferrin is iron transport, it may merely serve as an iron donor. To further clarify this issue, the authors took advantage of an iron chelate, ferric salicylaldehyde isonicotinoyl hydrazone (Fe-SIH), which they developed and previously demonstrated to efficiently supply iron to cells without using physiological transferrin receptor pathway. As expected, they observed that blocking monoclonal antibodies against transferrin receptors inhibited proliferation of both Raji and murine erythroleukemia cells. This inhibited cell growth was rescued upon the addition of Fe-SIH which was also shown to deliver iron to Raji cells in the presence of blocking anti-transferrin receptor antibodies. Moreover, blocking anti-transferrin receptor antibodies inhibited [ 3 H]thymidine incorporation into DNA and this inhibition could be overcome by added Fe-SIH. In addition, Fe-SIH slightly stimulated, while SIH (an iron chelator) significantly inhibited, DNA synthesis in phytohemagglutinin-stimulated peripheral blood lymphocytes. Taken together, these results indicate that the only function of transferrin supporting cell proliferation is to supply cells with iron

  14. Evidence to support the use of vildagliptin monotherapy in the treatment of type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Dejager S

    2012-05-01

    Full Text Available Sylvie Dejager,1 Anja Schweizer,2 James E Foley31Novartis Pharma SAS, Rueil Malmaison, France; 2Novartis Pharma AG, Basel, Switzerland; 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, USAAbstract: The efficacy and safety of the dipeptidyl peptidase-4 inhibitor, vildagliptin, as monotherapy have been widely confirmed in a large body of clinical studies of up to 2 years’ duration in various populations with type 2 diabetes mellitus. This paper reviews the data supporting the use of vildagliptin in monotherapy. Consideration based on baseline glycated hemoglobin levels and age is given to patient segments where metformin is not appropriate. In addition, although prediabetes is not an indication, this manuscript briefly reviews some of the existing data showing that the mechanisms at work in diabetic populations are active in patients currently classified as prediabetic, with impaired glucose tolerance or impaired fasting glucose. Finally, the rationale for vildagliptin dosing frequency in monotherapy is discussed. In summary, this review aims to define where in community practice the use of vildagliptin as monotherapy is most desirable, focusing on segments of the population with type 2 diabetes mellitus that might receive the greatest benefit from vildagliptin in the management of their disease.Keywords: vildagliptin, type 2 diabetes, dipeptidyl peptidase-4 inhibitors, monotherapy, elderly

  15. Evidence to support the use of vildagliptin monotherapy in the treatment of type 2 diabetes mellitus

    Science.gov (United States)

    Dejager, Sylvie; Schweizer, Anja; Foley, James E

    2012-01-01

    The efficacy and safety of the dipeptidyl peptidase-4 inhibitor, vildagliptin, as monotherapy have been widely confirmed in a large body of clinical studies of up to 2 years’ duration in various populations with type 2 diabetes mellitus. This paper reviews the data supporting the use of vildagliptin in monotherapy. Consideration based on baseline glycated hemoglobin levels and age is given to patient segments where metformin is not appropriate. In addition, although prediabetes is not an indication, this manuscript briefly reviews some of the existing data showing that the mechanisms at work in diabetic populations are active in patients currently classified as prediabetic, with impaired glucose tolerance or impaired fasting glucose. Finally, the rationale for vildagliptin dosing frequency in monotherapy is discussed. In summary, this review aims to define where in community practice the use of vildagliptin as monotherapy is most desirable, focusing on segments of the population with type 2 diabetes mellitus that might receive the greatest benefit from vildagliptin in the management of their disease. PMID:22661900

  16. Chemiluminescence evidence supporting the selective role of ligands in the permanganate oxidation of micropollutants.

    Science.gov (United States)

    Roderick, Mark S; Adcock, Jacqui L; Terry, Jessica M; Smith, Zoe M; Parry, Samuel; Linton, Stuart M; Thornton, Megan T; Barrow, Colin J; Francis, Paul S

    2013-10-10

    The selective increase in the oxidation rate of certain organic compounds with permanganate in the presence of environmental "ligands" and reduced species has been ascribed to the different reactivity of the target compounds toward Mn(III), which bears striking similarities to recent independent investigations into the use of permanganate as a chemiluminescence reagent. In spite of the importance of Mn(III) in the light-producing pathway, the dependence of the oxidation mechanism for any given compound on this intermediate could not be determined solely through the emission intensity. However, target compounds susceptible to single-electron oxidation by Mn(III) (such as bisphenol A and triclosan) can be easily distinguished by the dramatic increase in chemiluminescence intensity when a permanganate reagent containing high, stable concentrations of Mn(III) is used. The differences are accentuated under the low pH conditions that favor the chemiluminescence emission due to the greater reactivity of Mn(III) and the greater influence of complexing agents. This study supports the previously postulated selective role of ligands and reducing agents in permanganate oxidations and demonstrates a new approach to explore the chemistry of environmental manganese redox processes.

  17. Mobile DNA and the TE-Thrust hypothesis: supporting evidence from the primates

    Directory of Open Access Journals (Sweden)

    Oliver Keith R

    2011-05-01

    Full Text Available Abstract Transposable elements (TEs are increasingly being recognized as powerful facilitators of evolution. We propose the TE-Thrust hypothesis to encompass TE-facilitated processes by which genomes self-engineer coding, regulatory, karyotypic or other genetic changes. Although TEs are occasionally harmful to some individuals, genomic dynamism caused by TEs can be very beneficial to lineages. This can result in differential survival and differential fecundity of lineages. Lineages with an abundant and suitable repertoire of TEs have enhanced evolutionary potential and, if all else is equal, tend to be fecund, resulting in species-rich adaptive radiations, and/or they tend to undergo major evolutionary transitions. Many other mechanisms of genomic change are also important in evolution, and whether the evolutionary potential of TE-Thrust is realized is heavily dependent on environmental and ecological factors. The large contribution of TEs to evolutionary innovation is particularly well documented in the primate lineage. In this paper, we review numerous cases of beneficial TE-caused modifications to the genomes of higher primates, which strongly support our TE-Thrust hypothesis.

  18. The Support of MPA (Marine Protected Area) in Coral Triangle Area: Evidence from Kei Islands, Indonesia

    Science.gov (United States)

    Hamid, Syahibul K.; Teniwut, Wellem A.; Teniwut, Roberto M. K.; Rahantoknam, Meyske A.; Hasyim, Cawalinya L.; Hungan, Marselus

    2017-10-01

    Kei Islands located inside the coral triangle. Therefore, the biodiversity level on the sea in this area is considered high. United nation has proposed for water that included in the coral triangle has to apply marine protected area (MPA) to preserve the area. The main problem is most of the community especially in Kei Islands have depended on the sea as their sources of the economy even fisheries commodity like fish play a large part on the inflation rate and other prosperity indicators likes school and housing. Also, Kei Islands practice on form local wisdom for owning areal of the sea which calls “petuanan laut” by certain of villages or group of villages in one area. This study aimed to map the cluster of catching fisheries area based on the quantity of fish supply on a local market in Kei Islands and measure each cluster on their support and perspective on Marine Protected Area (MPA). We conducted a focus group discussion and collecting additional data by questionnaires with descriptive and quantitative analysis with logistic regression. The implication of this study can provide a clear view of coastal communities view on MPA program also to identify an area that has marine resources, human resources, and equipment to provide government an empirical view on catching fisheries in Kei Islands to issued better policy to develop fishing industry in Kei Islands.

  19. Evidence to support a food-based dietary guideline on sugar consumption in South Africa.

    Science.gov (United States)

    Steyn, Nelia P; Temple, Norman J

    2012-07-04

    To review studies undertaken in South Africa (SA) which included sugar intake associated with dental caries, non-communicable diseases, diabetes, obesity and/or micronutrient dilution, since the food-based dietary guideline: "Use foods and drinks that contain sugar sparingly and not between meals" was promulgated by the Department of Health (DOH) in 2002. Three databases (PubMed, Cochrane Library, and ScienceDirect), and SA Journal of Clinical Nutrition (SAJCN), DOH and SA Medical Research Council (SAMRC) websites were searched for SA studies on sugar intake published between 2000 and January 2012. Studies were included in the review if they evaluated the following: sugar intake and dental caries; sugar intake and non-communicable diseases; sugar and diabetes; sugar and obesity and/or sugar and micronutrient dilution. The initial search led to 12 articles in PubMed, 0 in Cochrane, 35 in ScienceDirect, 5 in the SAJCN and 3 reports from DOH/SAMRC. However, after reading the abstracts only 7 articles from PubMed, 4 from SAJCN and 3 reports were retained for use as being relevant to the current review. Hand searching of reference lists of SAJCN articles produced two more articles. Intake of sugar appears to be increasing steadily across the South African (SA) population. Children typically consume about 50 g per day, rising to as much as 100 g per day in adolescents. This represents about 10% of dietary energy, possibly as much as 20%. It has been firmly established that sugar plays a major role in development of dental caries. Furthermore, a few studies have shown that sugar has a diluting effect on the micronutrient content of the diet which lowers the intake of micronutrients. Data from numerous systematic reviews have shown that dietary sugar increases the risk for development of both obesity and type 2 diabetes. Risk for development of these conditions appears to be especially strong when sugar is consumed as sugar-sweetened beverages. Based on the evidence

  20. Predicting nonstationary flood frequencies: Evidence supports an updated stationarity thesis in the United States

    Science.gov (United States)

    Luke, Adam; Vrugt, Jasper A.; AghaKouchak, Amir; Matthew, Richard; Sanders, Brett F.

    2017-07-01

    Nonstationary extreme value analysis (NEVA) can improve the statistical representation of observed flood peak distributions compared to stationary (ST) analysis, but management of flood risk relies on predictions of out-of-sample distributions for which NEVA has not been comprehensively evaluated. In this study, we apply split-sample testing to 1250 annual maximum discharge records in the United States and compare the predictive capabilities of NEVA relative to ST extreme value analysis using a log-Pearson Type III (LPIII) distribution. The parameters of the LPIII distribution in the ST and nonstationary (NS) models are estimated from the first half of each record using Bayesian inference. The second half of each record is reserved to evaluate the predictions under the ST and NS models. The NS model is applied for prediction by (1) extrapolating the trend of the NS model parameters throughout the evaluation period and (2) using the NS model parameter values at the end of the fitting period to predict with an updated ST model (uST). Our analysis shows that the ST predictions are preferred, overall. NS model parameter extrapolation is rarely preferred. However, if fitting period discharges are influenced by physical changes in the watershed, for example from anthropogenic activity, the uST model is strongly preferred relative to ST and NS predictions. The uST model is therefore recommended for evaluation of current flood risk in watersheds that have undergone physical changes. Supporting information includes a MATLAB® program that estimates the (ST/NS/uST) LPIII parameters from annual peak discharge data through Bayesian inference.

  1. Support for an auto-associative model of spoken cued recall: evidence from fMRI.

    Science.gov (United States)

    de Zubicaray, Greig; McMahon, Katie; Eastburn, Mathew; Pringle, Alan J; Lorenz, Lina; Humphreys, Michael S

    2007-03-02

    Cued recall and item recognition are considered the standard episodic memory retrieval tasks. However, only the neural correlates of the latter have been studied in detail with fMRI. Using an event-related fMRI experimental design that permits spoken responses, we tested hypotheses from an auto-associative model of cued recall and item recognition [Chappell, M., & Humphreys, M. S. (1994). An auto-associative neural network for sparse representations: Analysis and application to models of recognition and cued recall. Psychological Review, 101, 103-128]. In brief, the model assumes that cues elicit a network of phonological short term memory (STM) and semantic long term memory (LTM) representations distributed throughout the neocortex as patterns of sparse activations. This information is transferred to the hippocampus which converges upon the item closest to a stored pattern and outputs a response. Word pairs were learned from a study list, with one member of the pair serving as the cue at test. Unstudied words were also intermingled at test in order to provide an analogue of yes/no recognition tasks. Compared to incorrectly rejected studied items (misses) and correctly rejected (CR) unstudied items, correctly recalled items (hits) elicited increased responses in the left hippocampus and neocortical regions including the left inferior prefrontal cortex (LIPC), left mid lateral temporal cortex and inferior parietal cortex, consistent with predictions from the model. This network was very similar to that observed in yes/no recognition studies, supporting proposals that cued recall and item recognition involve common rather than separate mechanisms.

  2. Clonal mutations in primary human glial tumors: evidence in support of the mutator hypothesis

    Directory of Open Access Journals (Sweden)

    Sarkar Chitra

    2007-10-01

    Full Text Available Abstract Background A verifiable consequence of the mutator hypothesis is that even low grade neoplasms would accumulate a large number of mutations that do not influence the tumor phenotype (clonal mutations. In this study, we have attempted to quantify the number of clonal mutations in primary human gliomas of astrocytic cell origin. These alterations were identified in tumor tissue, microscopically confirmed to have over 70% neoplastic cells. Methods Random Amplified Polymorphic DNA (RAPD analysis was performed using a set of fifteen 10-mer primers of arbitrary but definite sequences in 17 WHO grade II astrocytomas (low grade diffuse astrocytoma or DA and 16 WHO grade IV astrocytomas (Glioblastoma Multiforme or GBM. The RAPD profile of the tumor tissue was compared with that of the leucocyte DNA of the same patient and alteration(s scored. A quantitative estimate of the overall genomic changes in these tumors was obtained by 2 different modes of calculation. Results The overall change in the tumors was estimated to be 4.24% in DA and 2.29% in GBM by one method and 11.96% and 6.03% in DA and GBM respectively by the other. The difference between high and lower grade tumors was statistically significant by both methods. Conclusion This study demonstrates the presence of extensive clonal mutations in gliomas, more in lower grade. This is consistent with our earlier work demonstrating that technique like RAPD analysis, unbiased for locus, is able to demonstrate more intra-tumor genetic heterogeneity in lower grade gliomas compared to higher grade. The results support the mutator hypothesis proposed by Loeb.

  3. Clonal mutations in primary human glial tumors: evidence in support of the mutator hypothesis

    International Nuclear Information System (INIS)

    Misra, Anjan; Chattopadhyay, Parthaprasad; Chosdol, Kunzang; Sarkar, Chitra; Mahapatra, Ashok K; Sinha, Subrata

    2007-01-01

    A verifiable consequence of the mutator hypothesis is that even low grade neoplasms would accumulate a large number of mutations that do not influence the tumor phenotype (clonal mutations). In this study, we have attempted to quantify the number of clonal mutations in primary human gliomas of astrocytic cell origin. These alterations were identified in tumor tissue, microscopically confirmed to have over 70% neoplastic cells. Random Amplified Polymorphic DNA (RAPD) analysis was performed using a set of fifteen 10-mer primers of arbitrary but definite sequences in 17 WHO grade II astrocytomas (low grade diffuse astrocytoma or DA) and 16 WHO grade IV astrocytomas (Glioblastoma Multiforme or GBM). The RAPD profile of the tumor tissue was compared with that of the leucocyte DNA of the same patient and alteration(s) scored. A quantitative estimate of the overall genomic changes in these tumors was obtained by 2 different modes of calculation. The overall change in the tumors was estimated to be 4.24% in DA and 2.29% in GBM by one method and 11.96% and 6.03% in DA and GBM respectively by the other. The difference between high and lower grade tumors was statistically significant by both methods. This study demonstrates the presence of extensive clonal mutations in gliomas, more in lower grade. This is consistent with our earlier work demonstrating that technique like RAPD analysis, unbiased for locus, is able to demonstrate more intra-tumor genetic heterogeneity in lower grade gliomas compared to higher grade. The results support the mutator hypothesis proposed by Loeb

  4. Evidence Supports Tradition: The in Vitro Effects of Roman Chamomile on Smooth Muscles

    Directory of Open Access Journals (Sweden)

    Zsolt Sándor

    2018-04-01

    Full Text Available The dried flowers of Chamaemelum nobile (L. All. have been used in traditional medicine for different conditions related to the spasm of the gastrointestinal system. However, there have been no experimental studies to support the smooth muscle relaxant effect of this plant. The aim of our research was to assess the effects of the hydroethanolic extract of Roman chamomile, its fractions, four of its flavonoids (apigenin, luteolin, hispidulin, and eupafolin, and its essential oil on smooth muscles. The phytochemical compositions of the extract and its fractions were characterized and quantified by HPLC-DAD, the essential oil was characterized by GC and GC-MS. Neuronally mediated and smooth muscle effects were tested in isolated organ bath experiments on guinea pig, rat, and human smooth muscle preparations. The crude herbal extract induced an immediate, moderate, and transient contraction of guinea pig ileum via the activation of cholinergic neurons of the gut wall. Purinoceptor and serotonin receptor antagonists did not influence this effect. The more sustained relaxant effect of the extract, measured after pre-contraction of the preparations, was remarkable and was not affected by an adrenergic beta receptor antagonist. The smooth muscle-relaxant activity was found to be associated with the flavonoid content of the fractions. The essential oil showed only the relaxant effect, but no contracting activity. The smooth muscle-relaxant effect was also detected on rat gastrointestinal tissues, as well as on strip preparations of human small intestine. These results suggest that Roman chamomile extract has a direct and prolonged smooth muscle-relaxant effect on guinea pig ileum which is related to its flavonoid content. In some preparations, a transient stimulation of enteric cholinergic motoneurons was also detected. The essential oil also had a remarkable smooth muscle relaxant effect in this setting. Similar relaxant effects were also detected on

  5. Evidence Supports Tradition: The in Vitro Effects of Roman Chamomile on Smooth Muscles.

    Science.gov (United States)

    Sándor, Zsolt; Mottaghipisheh, Javad; Veres, Katalin; Hohmann, Judit; Bencsik, Tímea; Horváth, Attila; Kelemen, Dezső; Papp, Róbert; Barthó, Loránd; Csupor, Dezső

    2018-01-01

    The dried flowers of Chamaemelum nobile (L.) All. have been used in traditional medicine for different conditions related to the spasm of the gastrointestinal system. However, there have been no experimental studies to support the smooth muscle relaxant effect of this plant. The aim of our research was to assess the effects of the hydroethanolic extract of Roman chamomile, its fractions, four of its flavonoids (apigenin, luteolin, hispidulin, and eupafolin), and its essential oil on smooth muscles. The phytochemical compositions of the extract and its fractions were characterized and quantified by HPLC-DAD, the essential oil was characterized by GC and GC-MS. Neuronally mediated and smooth muscle effects were tested in isolated organ bath experiments on guinea pig, rat, and human smooth muscle preparations. The crude herbal extract induced an immediate, moderate, and transient contraction of guinea pig ileum via the activation of cholinergic neurons of the gut wall. Purinoceptor and serotonin receptor antagonists did not influence this effect. The more sustained relaxant effect of the extract, measured after pre-contraction of the preparations, was remarkable and was not affected by an adrenergic beta receptor antagonist. The smooth muscle-relaxant activity was found to be associated with the flavonoid content of the fractions. The essential oil showed only the relaxant effect, but no contracting activity. The smooth muscle-relaxant effect was also detected on rat gastrointestinal tissues, as well as on strip preparations of human small intestine. These results suggest that Roman chamomile extract has a direct and prolonged smooth muscle-relaxant effect on guinea pig ileum which is related to its flavonoid content. In some preparations, a transient stimulation of enteric cholinergic motoneurons was also detected. The essential oil also had a remarkable smooth muscle relaxant effect in this setting. Similar relaxant effects were also detected on other visceral

  6. Genetic Evidence Supports the Multiethnic Character of Teopancazco, a Neighborhood Center of Teotihuacan, Mexico (AD 200-600.

    Directory of Open Access Journals (Sweden)

    Brenda A Álvarez-Sandoval

    Full Text Available Multiethnicity in Teopancazco, Teotihuacan, is supported by foreign individuals found in the neighborhood center as well as by the diversity observed in funerary rituals at the site. Studies of both stable and strontium isotopes as well as paleodietary analysis, suggest that the population of Teopancazco was composed by three population groups: people from Teotihuacan, people from nearby sites (Tlaxcala-Hidalgo-Puebla, and people from afar, including the coastal plains. In an attempt to understand the genetic dynamics in Teopancazco we conducted an ancient DNA (aDNA analysis based on mtDNA. Our results show that the level of genetic diversity is consistent with the multiethnicity phenomenon at the neighborhood center. Levels of genetic diversity at different time periods of Teopancazco's history show that multiethnicity was evident since the beginning and lasted until the collapse of the neighborhood center. However, a PCA and a Neighbor-Joining tree suggested the presence of a genetically differentiated group (buried at the Transitional phase compared to the population from the initial phase (Tlamimilolpa as well as the population from the final phase (Xolalpan of the history of Teopancazco. Genetic studies showed no differences in genetic diversity between males and females in the adult population of Teopancazco, this data along with ample archaeological evidence, suggest a neolocal post-marital pattern of residence in Teopancazco. Nevertheless, genetic analyses on the infant population showed that the males are significantly more heterogeneous than the females suggesting a possible differential role in cultural practices by sex in the infant sector. Regarding interpopulation analysis, we found similar indices of genetic diversity between Teopancazco and heterogeneous native groups, which support the multiethnic character of Teopancazco. Finally, our data showed a close genetic relationship between Teopancazco and populations from the

  7. 44 CFR 295.41 - Administrative appeal.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Administrative appeal. 295.41 Section 295.41 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... supplement the statement of reasons and provide any additional documentary evidence supporting the appeal...

  8. Systemic lipopolysaccharide administration impairs retrieval of context-object discrimination, but not spatial, memory: Evidence for selective disruption of specific hippocampus-dependent memory functions during acute neuroinflammation.

    Science.gov (United States)

    Czerniawski, Jennifer; Miyashita, Teiko; Lewandowski, Gail; Guzowski, John F

    2015-02-01

    Neuroinflammation is implicated in impairments in neuronal function and cognition that arise with aging, trauma, and/or disease. Therefore, understanding the underlying basis of the effect of immune system activation on neural function could lead to therapies for treating cognitive decline. Although neuroinflammation is widely thought to preferentially impair hippocampus-dependent memory, data on the effects of cytokines on cognition are mixed. One possible explanation for these inconsistent results is that cytokines may disrupt specific neural processes underlying some forms of memory but not others. In an earlier study, we tested the effect of systemic administration of bacterial lipopolysaccharide (LPS) on retrieval of hippocampus-dependent context memory and neural circuit function in CA3 and CA1 (Czerniawski and Guzowski, 2014). Paralleling impairment in context discrimination memory, we observed changes in neural circuit function consistent with disrupted pattern separation function. In the current study we tested the hypothesis that acute neuroinflammation selectively disrupts memory retrieval in tasks requiring hippocampal pattern separation processes. Male Sprague-Dawley rats given LPS systemically prior to testing exhibited intact performance in tasks that do not require hippocampal pattern separation processes: novel object recognition and spatial memory in the water maze. By contrast, memory retrieval in a task thought to require hippocampal pattern separation, context-object discrimination, was strongly impaired in LPS-treated rats in the absence of any gross effects on exploratory activity or motivation. These data show that LPS administration does not impair memory retrieval in all hippocampus-dependent tasks, and support the hypothesis that acute neuroinflammation impairs context discrimination memory via disruption of pattern separation processes in hippocampus. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Does Current Scientific Evidence Support a Link Between Light at Night and Breast Cancer Among Female Night-Shift Nurses?

    Science.gov (United States)

    Dickerman, Barbra; Liu, Jianghong

    2014-01-01

    Breast cancer is increasingly prevalent in industrialized regions of the world, and exposure to light at night (LAN) has been proposed as a potential risk factor. Epidemiological observations have documented an increased breast cancer risk among female night-shift workers, and strong experimental evidence for this relationship has also been found in rodent models. Indirect support for the LAN hypothesis comes from studies involving blind women, sleep duration, bedroom light levels, and community nighttime light levels. This article reviews the literature, discusses possible mechanisms of action, and provides recommendations for occupational health nursing research, practice, and education. Research is needed to further explore the relationship between exposure to LAN and breast cancer risk and elucidate the mechanisms underlying this relationship before interventions can be designed for prevention and mitigation of breast cancer. PMID:22658734

  10. Consistent evidence to support the use of xylitol- and sorbitol-containing chewing gum to prevent dental caries

    DEFF Research Database (Denmark)

    Twetman, Svante

    2009-01-01

    DATA SOURCES: Studies were identified using searches with Medline, the Cochrane Library and Google Scholar. STUDY SELECTION: Studies were screened independently and were included if they evaluated the effect of one or more chewing gums containing at least one polyol (xylitol, sorbitol, mannitol...... randomised controlled trials (RCT) of which four were cluster RCT, nine controlled clinical trials (CCT) and four cohort studies]. Two RCT had a Jadad score of three or higher. The mean preventive fraction for the four main gum types are shown in the table 1, results of all except the sorbitol -mannitol...... blend were statistically significant. Sensitivity analyses confirmed the robustness of the findings. CONCLUSIONS: Although research gaps exist, particularly on optimal dosing and relative polyol efficacy, there is consistent evidence to support the use of xylitol- and sorbitol-containing chewing gum...

  11. Effects of a Flexibility/Support Intervention on Work Performance: Evidence From the Work, Family, and Health Network.

    Science.gov (United States)

    Bray, Jeremy W; Hinde, Jesse M; Kaiser, David J; Mills, Michael J; Karuntzos, Georgia T; Genadek, Katie R; Kelly, Erin L; Kossek, Ellen E; Hurtado, David A

    2018-05-01

    To estimate the effects of a workplace initiative to reduce work-family conflict on employee performance. A group-randomized multisite controlled experimental study with longitudinal follow-up. An information technology firm. Employees randomized to the intervention (n = 348) and control condition (n = 345). An intervention, "Start. Transform. Achieve. Results." to enhance employees' control over their work time, to increase supervisors' support for this change, and to increase employees' and supervisors' focus on results. We estimated the effect of the intervention on 9 self-reported employee performance measures using a difference-in-differences approach with generalized linear mixed models. Performance measures included actual and expected hours worked, absenteeism, and presenteeism. This study found little evidence that an intervention targeting work-family conflict affected employee performance. The only significant effect of the intervention was an approximately 1-hour reduction in expected work hours. After Bonferroni correction, the intervention effect is marginally insignificant at 6 months and marginally significant at 12 and 18 months. The intervention reduced expected working time by 1 hour per week; effects on most other employee self-reported performance measures were statistically insignificant. When coupled with the other positive wellness and firm outcomes, this intervention may be useful for improving employee perceptions of increased access to personal time or personal wellness without sacrificing performance. The null effects on performance provide countervailing evidence to recent negative press on work-family and flex work initiatives.

  12. Gateway Effects: Why the Cited Evidence Does Not Support Their Existence for Low-Risk Tobacco Products (and What Evidence Would

    Directory of Open Access Journals (Sweden)

    Carl V. Phillips

    2015-05-01

    Full Text Available It is often claimed that low-risk drugs still create harm because of “gateway effects”, in which they cause the use of a high-risk alternative. Such claims are popular among opponents of tobacco harm reduction, claiming that low-risk tobacco products (e.g., e-cigarettes, smokeless tobacco cause people to start smoking, sometimes backed by empirical studies that ostensibly support the claim. However, these studies consistently ignore the obvious alternative causal pathways, particularly that observed associations might represent causation in the opposite direction (smoking causes people to seek low-risk alternatives or confounding (the same individual characteristics increase the chance of using any tobacco product. Due to these complications, any useful analysis must deal with simultaneity and confounding by common cause. In practice, existing analyses seem almost as if they were designed to provide teaching examples about drawing simplistic and unsupported causal conclusions from observed associations. The present analysis examines what evidence and research strategies would be needed to empirically detect such a gateway effect, if there were one, explaining key methodological concepts including causation and confounding, examining the logic of the claim, identifying potentially useful data, and debunking common fallacies on both sides of the argument, as well as presenting an extended example of proper empirical testing. The analysis demonstrates that none of the empirical studies to date that are purported to show a gateway effect from tobacco harm reduction products actually does so. The observations and approaches can be generalized to other cases where observed association of individual characteristics in cross-sectional data could result from any of several causal relationships.

  13. Supported employment for people with severe mental illness: systematic review and meta-analysis of the international evidence.

    Science.gov (United States)

    Modini, Matthew; Tan, Leona; Brinchmann, Beate; Wang, Min-Jung; Killackey, Eoin; Glozier, Nicholas; Mykletun, Arnstein; Harvey, Samuel B

    2016-07-01

    Individual placement and support (IPS) is a vocational rehabilitation programme that was developed in the USA to improve employment outcomes for people with severe mental illness. Its ability to be generalised to other countries and its effectiveness in varying economic conditions remains to be ascertained. To investigate whether IPS is effective across international settings and in different economic conditions. A systematic review and meta-analysis of randomised controlled trials comparing IPS with traditional vocational services was undertaken; 17 studies, as well as 2 follow-up studies, were included. Meta-regressions were carried out to examine whether IPS effectiveness varied according to geographic location, unemployment rates or gross domestic product (GDP) growth. The overall pooled risk ratio for competitive employment using IPS compared with traditional vocational rehabilitation was 2.40 (95% CI 1.99-2.90). Meta-regressions indicated that neither geographic area nor unemployment rates affected the overall effectiveness of IPS. Even when a country's GDP growth was less than 2% IPS was significantly more effective than traditional vocational training, and its benefits remained evident over 2 years. Individual placement and support is an effective intervention across a variety of settings and economic conditions and is more than twice as likely to lead to competitive employment when compared with traditional vocational rehabilitation. © The Royal College of Psychiatrists 2016.

  14. Numerical morphology supports early number word learning: Evidence from a comparison of young Mandarin and English learners

    Science.gov (United States)

    Corre, Mathieu Le; Li, Peggy; Huang, Becky H.; Jia, Gisela; Carey, Susan

    2016-01-01

    Previous studies showed that children learning a language with an obligatory singular/plural distinction (Russian and English) learn the meaning of the number word for one earlier than children learning Japanese, a language without obligatory number morphology (Barner, Libenson, Cheung, & Takasaki, 2009; Sarnecka, Kamenskaya, Yamana, Ogura, & Yudovina, 2007). This can be explained by differences in number morphology, but it can also be explained by many other differences between the languages and the environments of the children who were compared. The present study tests the hypothesis that the morphological singular/plural distinction supports the early acquisition of the meaning of the number word for one by comparing young English learners to age and SES matched young Mandarin Chinese learners. Mandarin does not have obligatory number morphology but is more similar to English than Japanese in many crucial respects. Corpus analyses show that, compared to English learners, Mandarin learners hear number words more frequently, are more likely to hear number words followed by a noun, and are more likely to hear number words in contexts where they denote a cardinal value. Two tasks show that, despite these advantages, Mandarin learners learn the meaning of the number word for one three to six months later than do English learners. These results provide the strongest evidence to date that prior knowledge of the numerical meaning of the distinction between singular and plural supports the acquisition of the meaning of the number word for one. PMID:27423486

  15. Numerical morphology supports early number word learning: Evidence from a comparison of young Mandarin and English learners.

    Science.gov (United States)

    Le Corre, Mathieu; Li, Peggy; Huang, Becky H; Jia, Gisela; Carey, Susan

    2016-08-01

    Previous studies showed that children learning a language with an obligatory singular/plural distinction (Russian and English) learn the meaning of the number word for one earlier than children learning Japanese, a language without obligatory number morphology (Barner, Libenson, Cheung, & Takasaki, 2009; Sarnecka, Kamenskaya, Yamana, Ogura, & Yudovina, 2007). This can be explained by differences in number morphology, but it can also be explained by many other differences between the languages and the environments of the children who were compared. The present study tests the hypothesis that the morphological singular/plural distinction supports the early acquisition of the meaning of the number word for one by comparing young English learners to age and SES matched young Mandarin Chinese learners. Mandarin does not have obligatory number morphology but is more similar to English than Japanese in many crucial respects. Corpus analyses show that, compared to English learners, Mandarin learners hear number words more frequently, are more likely to hear number words followed by a noun, and are more likely to hear number words in contexts where they denote a cardinal value. Two tasks show that, despite these advantages, Mandarin learners learn the meaning of the number word for one three to six months later than do English learners. These results provide the strongest evidence to date that prior knowledge of the numerical meaning of the distinction between singular and plural supports the acquisition of the meaning of the number word for one. Copyright © 2016. Published by Elsevier Inc.

  16. Supporting Better Evidence Generation and Use within Social Innovation in Health in Low- and Middle-Income Countries: A Qualitative Study.

    Science.gov (United States)

    Ballard, Madeleine; Tran, Jenny; Hersch, Fred; Lockwood, Amy; Hartigan, Pamela; Montgomery, Paul

    2017-01-01

    While several papers have highlighted a lack of evidence to scale social innovations in health, fewer have explored decision-maker understandings of the relative merit of different types of evidence, how such data are interpreted and applied, and what practical support is required to improve evidence generation. The objectives of this paper are to understand (1) beliefs and attitudes towards the value of and types of evidence in scaling social innovations for health, (2) approaches to evidence generation and evaluation used in systems and policy change, and (3) how better evidence-generation can be undertaken and supported within social innovation in health. Thirty-two one-on-one interviews were conducted between July and November 2015 with purposively selected practitioners, policymakers, and funders from low- and middle- income countries (LMICs). Data were analysed using a Framework Analysis Approach. While practitioners, funders, and policymakers said they held outcome evidence in high regard, their practices only bear out this assertion to varying degrees. Few have given systematic consideration to potential unintended consequences, in particular harm, of the programs they implement, fund, or adopt. Stakeholders suggest that better evidence-generation can be undertaken and supported within social innovation in health by supporting the research efforts of emerging community organizations; creating links between practitioners and academia; altering the funding landscape for evidence-generation; providing responsive technical education; and creating accountability for funders, practitioners, and policymakers. How better evidence-generation can be undertaken and supported within social innovation in health is a previously under-operationalised aspect of the policy-making process that remains essential in order to refrain from causing harm, enable the optimization of existing interventions, and ultimately, to scale and fund what works.

  17. Supporting Better Evidence Generation and Use within Social Innovation in Health in Low- and Middle-Income Countries: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Madeleine Ballard

    Full Text Available While several papers have highlighted a lack of evidence to scale social innovations in health, fewer have explored decision-maker understandings of the relative merit of different types of evidence, how such data are interpreted and applied, and what practical support is required to improve evidence generation. The objectives of this paper are to understand (1 beliefs and attitudes towards the value of and types of evidence in scaling social innovations for health, (2 approaches to evidence generation and evaluation used in systems and policy change, and (3 how better evidence-generation can be undertaken and supported within social innovation in health.Thirty-two one-on-one interviews were conducted between July and November 2015 with purposively selected practitioners, policymakers, and funders from low- and middle- income countries (LMICs. Data were analysed using a Framework Analysis Approach.While practitioners, funders, and policymakers said they held outcome evidence in high regard, their practices only bear out this assertion to varying degrees. Few have given systematic consideration to potential unintended consequences, in particular harm, of the programs they implement, fund, or adopt. Stakeholders suggest that better evidence-generation can be undertaken and supported within social innovation in health by supporting the research efforts of emerging community organizations; creating links between practitioners and academia; altering the funding landscape for evidence-generation; providing responsive technical education; and creating accountability for funders, practitioners, and policymakers.How better evidence-generation can be undertaken and supported within social innovation in health is a previously under-operationalised aspect of the policy-making process that remains essential in order to refrain from causing harm, enable the optimization of existing interventions, and ultimately, to scale and fund what works.

  18. Improving GRADE evidence tables part 3: detailed guidance for explanatory footnotes supports creating and understanding GRADE certainty in the evidence judgments

    NARCIS (Netherlands)

    Santesso, Nancy; Carrasco-Labra, Alonso; Langendam, Miranda; Brignardello-Petersen, Romina; Mustafa, Reem A.; Heus, Pauline; Lasserson, Toby; Opiyo, Newton; Kunnamo, Ilkka; Sinclair, David; Garner, Paul; Treweek, Shaun; Tovey, David; Akl, Elie A.; Tugwell, Peter; Brozek, Jan L.; Guyatt, Gordon; Schünemann, Holger J.

    2016-01-01

    The Grading of Recommendations Assessment, Development and Evaluation (GRADE) is widely used and reliable and accurate for assessing the certainty in the body of health evidence. The GRADE working group has provided detailed guidance for assessing the certainty in the body of evidence in systematic

  19. Improving GRADE evidence tables part 3 : Detailed guidance for explanatory footnotes supports creating and understanding GRADE certainty in the evidence judgments

    NARCIS (Netherlands)

    Santesso, Nancy; Carrasco-Labra, Alonso; Langendam, Miranda; Brignardello-Petersen, Romina; Mustafa, Reem A.; Heus, Pauline; Lasserson, Toby; Opiyo, Newton; Kunnamo, Ilkka; Sinclair, David; Garner, Paul; Treweek, Shaun; Tovey, David; Akl, Elie A.; Tugwell, Peter; Brozek, Jan L.; Guyatt, Gordon; Schünemann, Holger J.

    Background The Grading of Recommendations Assessment, Development and Evaluation (GRADE) is widely used and reliable and accurate for assessing the certainty in the body of health evidence. The GRADE working group has provided detailed guidance for assessing the certainty in the body of evidence in

  20. Line-depth-ratio temperatures for the close binary ν Octantis: new evidence supporting the conjectured circumstellar retrograde planet

    Science.gov (United States)

    Ramm, D. J.

    2015-06-01

    We explore the possibly that either star-spots or pulsations are the cause of a periodic radial velocity (RV) signal (P ˜ 400 d) from the K-giant binary ν Octantis (P ˜ 1050 d, e ˜ 0.25), alternatively conjectured to have a retrograde planet. Our study is based on temperatures derived from 22 line-depth ratios (LDRs) for ν Oct and 20 calibration stars. Empirical evidence and stability modelling provide unexpected support for the planet since other standard explanations (star-spots, pulsations and additional stellar masses) each have credibility problems. However, the proposed system presents formidable challenges to planet formation and stability theories: it has by far the smallest stellar separation of any claimed planet-harbouring binary (a_{_bin} ˜ 2.6 au) and an equally unbelievable separation ratio (a_{_pl}/a_{_bin} ˜ 0.5), hence the necessity that the circumstellar orbit be retrograde. The LDR analysis of 215 ν Oct spectra acquired between 2001 and 2007, from which the RV perturbation was first revealed, have no significant periodicity at any frequency. The LDRs recover the original 21 stellar temperatures with an average accuracy of 45 ± 25 K. The 215 ν Oct temperatures have a standard deviation of only 4.2 K. Assuming the host primary is not pulsating, the temperatures converted to magnitude differences strikingly mimic the very stable photometric Hipparcos observations 15 years previously, implying the long-term stability of the star and demonstrating a novel use of LDRs as a photometric gauge. Our results provide substantial new evidence that conventional star-spots and pulsations are unlikely causes of the RV perturbation. The controversial system deserves continued attention, including with higher resolving-power spectra for bisector and LDR analyses.

  1. Examining the use of evidence-based and social media supported tools in freely accessible physical activity intervention websites.

    Science.gov (United States)

    Vandelanotte, Corneel; Kirwan, Morwenna; Rebar, Amanda; Alley, Stephanie; Short, Camille; Fallon, Luke; Buzza, Gavin; Schoeppe, Stephanie; Maher, Carol; Duncan, Mitch J

    2014-08-17

    It has been shown that physical activity is more likely to increase if web-based interventions apply evidence-based components (e.g. self-monitoring) and incorporate interactive social media applications (e.g. social networking), but it is unclear to what extent these are being utilized in the publicly available web-based physical activity interventions. The purpose of this study was to evaluate whether freely accessible websites delivering physical activity interventions use evidence-based behavior change techniques and provide social media applications. In 2013, a systematic search strategy examined 750 websites. Data was extracted on a wide range of variables (e.g. self-monitoring, goal setting, and social media applications). To evaluate website quality a new tool, comprising three sub-scores (Behavioral Components, Interactivity and User Generated Content), was developed to assess implementation of behavior change techniques and social media applications. An overall website quality scored was obtained by summing the three sub-scores. Forty-six publicly available websites were included in the study. The use of self-monitoring (54.3%), goal setting (41.3%) and provision of feedback (46%) was relatively low given the amount of evidence supporting these features. Whereas the presence of features allowing users to generate content (73.9%), and social media components (Facebook (65.2%), Twitter (47.8%), YouTube (48.7%), smartphone applications (34.8%)) was relatively high considering their innovative and untested nature. Nearly all websites applied some behavioral and social media applications. The average Behavioral Components score was 3.45 (±2.53) out of 10. The average Interactivity score was 3.57 (±2.16) out of 10. The average User Generated Content Score was 4.02 (±2.77) out of 10. The average overall website quality score was 11.04 (±6.92) out of 30. Four websites (8.7%) were classified as high quality, 12 websites (26.1%) were classified as moderate

  2. Can Scientific Evidence Support Using Bangladeshi Traditional Medicinal Plants in the Treatment of Diarrhoea? A Review on Seven Plants

    Science.gov (United States)

    Wangensteen, Helle; Klarpås, Line; Alamgir, Mahiuddin; Samuelsen, Anne B. C.; Malterud, Karl E.

    2013-01-01

    Diarrhoea is a common disease which causes pain and may be deadly, especially in developing countries. In Bangladesh, diarrhoeal diseases affect thousands of people every year, and children are especially vulnerable. Bacterial toxins or viral infections are the most common cause of the disease. The diarrhoea outbreaks are often associated with flood affected areas with contaminated drinking water and an increased risk of spreading the water-borne disease. Not surprisingly, plants found in the near surroundings have been taken into use by the local community as medicine to treat diarrhoeal symptoms. These plants are cheaper and more easily available than conventional medicine. Our question is: What is the level of documentation supporting the use of these plants against diarrhoea and is their consumption safe? Do any of these plants have potential for further exploration? In this review, we have choosen seven plant species that are used in the treatment of diarrhoea; Diospyros peregrina, Heritiera littoralis, Ixora coccinea, Pongamia pinnata, Rhizophora mucronata, Xylocarpus granatum, and Xylocarpus moluccensis. Appearance and geographical distribution, traditional uses, chemical composition, and biological studies related to antidiarrhoeal activity will be presented. This review reveals that there is limited scientific evidence supporting the traditional use of these plants. Most promising are the barks from D. peregrina, X. granatum and X. moluccensis which contain tannins and have shown promising results in antidiarrhoeal mice models. The leaves of P. pinnata also show potential. We suggest these plants should be exploited further as possible traditional herbal remedies against diarrhoea including studies on efficacy, optimal dosage and safety. PMID:23698166

  3. Can scientific evidence support using Bangladeshi traditional medicinal plants in the treatment of diarrhoea? A review on seven plants.

    Science.gov (United States)

    Wangensteen, Helle; Klarpås, Line; Alamgir, Mahiuddin; Samuelsen, Anne B C; Malterud, Karl E

    2013-05-22

    Diarrhoea is a common disease which causes pain and may be deadly, especially in developing countries. In Bangladesh, diarrhoeal diseases affect thousands of people every year, and children are especially vulnerable. Bacterial toxins or viral infections are the most common cause of the disease. The diarrhoea outbreaks are often associated with flood affected areas with contaminated drinking water and an increased risk of spreading the water-borne disease. Not surprisingly, plants found in the near surroundings have been taken into use by the local community as medicine to treat diarrhoeal symptoms. These plants are cheaper and more easily available than conventional medicine. Our question is: What is the level of documentation supporting the use of these plants against diarrhoea and is their consumption safe? Do any of these plants have potential for further exploration? In this review, we have choosen seven plant species that are used in the treatment of diarrhoea; Diospyros peregrina, Heritiera littoralis, Ixora coccinea, Pongamia pinnata, Rhizophora mucronata, Xylocarpus granatum, and Xylocarpus moluccensis. Appearance and geographical distribution, traditional uses, chemical composition, and biological studies related to antidiarrhoeal activity will be presented. This review reveals that there is limited scientific evidence supporting the traditional use of these plants. Most promising are the barks from D. peregrina, X. granatum and X. moluccensis which contain tannins and have shown promising results in antidiarrhoeal mice models. The leaves of P. pinnata also show potential. We suggest these plants should be exploited further as possible traditional herbal remedies against diarrhoea including studies on efficacy, optimal dosage and safety.

  4. MANAGEMENT OF DIABETES DURING AIR TRAVEL: A SYSTEMATIC LITERATURE REVIEW OF CURRENT RECOMMENDATIONS AND THEIR SUPPORTING EVIDENCE.

    Science.gov (United States)

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

    2018-02-01

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

  5. Can Scientific Evidence Support Using Bangladeshi Traditional Medicinal Plants in the Treatment of Diarrhoea? A Review on Seven Plants

    Directory of Open Access Journals (Sweden)

    Karl E. Malterud

    2013-05-01

    Full Text Available Diarrhoea is a common disease which causes pain and may be deadly, especially in developing countries. In Bangladesh, diarrhoeal diseases affect thousands of people every year, and children are especially vulnerable. Bacterial toxins or viral infections are the most common cause of the disease. The diarrhoea outbreaks are often associated with flood affected areas with contaminated drinking water and an increased risk of spreading the water-borne disease. Not surprisingly, plants found in the near surroundings have been taken into use by the local community as medicine to treat diarrhoeal symptoms. These plants are cheaper and more easily available than conventional medicine. Our question is: What is the level of documentation supporting the use of these plants against diarrhoea and is their consumption safe? Do any of these plants have potential for further exploration? In this review, we have choosen seven plant species that are used in the treatment of diarrhoea; Diospyros peregrina, Heritiera littoralis, Ixora coccinea, Pongamia pinnata, Rhizophora mucronata, Xylocarpus granatum, and Xylocarpus moluccensis. Appearance and geographical distribution, traditional uses, chemical composition, and biological studies related to antidiarrhoeal activity will be presented. This review reveals that there is limited scientific evidence supporting the traditional use of these plants. Most promising are the barks from D. peregrina, X. granatum and X. moluccensis which contain tannins and have shown promising results in antidiarrhoeal mice models. The leaves of P. pinnata also show potential. We suggest these plants should be exploited further as possible traditional herbal remedies against diarrhoea including studies on efficacy, optimal dosage and safety.

  6. Methodological approach and tools for systems thinking in health systems research: technical assistants' support of health administration reform in the Democratic Republic of Congo as an application.

    Science.gov (United States)

    Ribesse, Nathalie; Bossyns, Paul; Marchal, Bruno; Karemere, Hermes; Burman, Christopher J; Macq, Jean

    2017-03-01

    In the field of development cooperation, interest in systems thinking and complex systems theories as a methodological approach is increasingly recognised. And so it is in health systems research, which informs health development aid interventions. However, practical applications remain scarce to date. The objective of this article is to contribute to the body of knowledge by presenting the tools inspired by systems thinking and complexity theories and methodological lessons learned from their application. These tools were used in a case study. Detailed results of this study are in process for publication in additional articles. Applying a complexity 'lens', the subject of the case study is the role of long-term international technical assistance in supporting health administration reform at the provincial level in the Democratic Republic of Congo. The Methods section presents the guiding principles of systems thinking and complex systems, their relevance and implication for the subject under study, and the existing tools associated with those theories which inspired us in the design of the data collection and analysis process. The tools and their application processes are presented in the results section, and followed in the discussion section by the critical analysis of their innovative potential and emergent challenges. The overall methodology provides a coherent whole, each tool bringing a different and complementary perspective on the system.

  7. Overview evidence on interventions for population suicide with an eye to identifying best-supported strategies for LMICs.

    Science.gov (United States)

    Fleischmann, A; Arensman, E; Berman, A; Carli, V; De Leo, D; Hadlaczky, G; Howlader, S; Vijayakumar, L; Wasserman, D; Saxena, S

    2016-01-01

    Globally, over 800 000 people died by suicide in 2012 and there are indications that for each adult who died of suicide there were likely to be many more attempting suicide. There are many millions of people every year who are affected by suicide and suicide attempts, taking into consideration the family members, friends, work colleagues and communities, who are bereaved by suicide. In the WHO Mental Health Action Plan 2013-2020, Member States committed themselves to work towards the global target of reducing the suicide rate in countries by 10% by 2020. Hence, the first-ever WHO report on suicide prevention, Preventing suicide: a global imperative, published in September 2014, is a timely call to take action using effective evidence-based interventions. Their relevance for low- and middle-income countries is discussed in this paper, highlighting restricting access to means, responsible media reporting, introducing mental health and alcohol policies, early identification and treatment, training of health workers, and follow-up care and community support following a suicide attempt.

  8. Ethnography, fidelity, and the evidence that anthropology adds: supplementing the fidelity process in a clinical trial of supported employment.

    Science.gov (United States)

    Smith-Morris, Carolyn; Lopez, Gilberto; Ottomanelli, Lisa; Goetz, Lance; Dixon-Lawson, Kimberly

    2014-06-01

    This discussion considers the role and findings of ethnographic research within a clinical trial of supported employment for veterans with spinal cord injury. Contributing to qualitative evaluation research and to debates over anthropological evidence vis-à-vis clinical trials, we demonstrate how enactors of a randomized controlled trial can simultaneously attend to both the trial's evidentiary and procedural requirements and to the lived experiences and needs of patients and clinicians. Three major findings are described: (1) contextual information essential to fidelity efforts within the trial; (2) the role of human interrelationships and idiosyncratic networks in the trial's success; and (3) a mapping of the power and authority structures relevant to the staff's ability to perform the protocol. We emphasize strengths of anthropological ethnography in clinical trials that include the provision of complementary, qualitative data, the capture of otherwise unmeasured parts of the trial, and the realization of important information for the translation of the clinical findings into new settings. © 2014 by the American Anthropological Association.

  9. Evidence to support a conspecific nature of allopatric cytological races of Anopheles nitidus (Diptera: Culicidae) in Thailand.

    Science.gov (United States)

    Songsawatkiat, Siripan; Baimai, Visut; Thongsahuan, Sorawat; Otsuka, Yasushi; Taai, Kritsana; Hempolchom, Chayanit; Srisuka, Wichai; Poolphol, Petchaboon; Choochote, Wej; Saeung, Atiporn

    2014-01-01

    Metaphase karyotype investigation on two allopatric strains of Anopheles nitidus Harrison, Scanlon, and Reid (Diptera: Culicidae) was conducted in Thailand during 2011-2012. Five karyotypic forms, i.e., Form A (X1, Y1), Form B (X1, Y2), Form C (X2, Y3), Form D (X1, X3, Y4), and Form E (X1, X2, X3, Y5) were obtained from a total of 21 isofemale lines. Forms A, B, and C were confined to Phang Nga Province, southern Thailand, whereas Forms D and E were restricted to Ubon Ratchathani Province, northeastern Thailand. Cross-mating experiments among the five isofemale lines, which were representative of five karyotypic forms of An. nitidus, revealed genetic compatibility by providing viable progenies and synaptic salivary gland polytene chromosomes through F2 generations. The results suggest that the forms are conspecific, and An. nitidus comprises five cytological races. The very low intraspecific sequence variations (average genetic distances = 0.002-0.008) of the nucleotide sequences in ribosomal DNA (internal transcribed spacer 2) and mitochondrial DNA (cytochrome c oxidase subunits I and II) among the five karyotypic forms were very good supportive evidence. © The Author 2014. Published by Oxford University Press on behalf of the Entomological Society of America.

  10. The Registry of Knowledge Translation Methods and Tools: a resource to support evidence-informed public health.

    Science.gov (United States)

    Peirson, Leslea; Catallo, Cristina; Chera, Sunita

    2013-08-01

    This paper examines the development of a globally accessible online Registry of Knowledge Translation Methods and Tools to support evidence-informed public health. A search strategy, screening and data extraction tools, and writing template were developed to find, assess, and summarize relevant methods and tools. An interactive website and searchable database were designed to house the registry. Formative evaluation was undertaken to inform refinements. Over 43,000 citations were screened; almost 700 were full-text reviewed, 140 of which were included. By November 2012, 133 summaries were available. Between January 1 and November 30, 2012 over 32,945 visitors from more than 190 countries accessed the registry. Results from 286 surveys and 19 interviews indicated the registry is valued and useful, but would benefit from a more intuitive indexing system and refinements to the summaries. User stories and promotional activities help expand the reach and uptake of knowledge translation methods and tools in public health contexts. The National Collaborating Centre for Methods and Tools' Registry of Methods and Tools is a unique and practical resource for public health decision makers worldwide.

  11. Toward an evidence-based system for innovation support for implementing innovations with quality: tools, training, technical assistance, and quality assurance/quality improvement.

    Science.gov (United States)

    Wandersman, Abraham; Chien, Victoria H; Katz, Jason

    2012-12-01

    An individual or organization that sets out to implement an innovation (e.g., a new technology, program, or policy) generally requires support. In the Interactive Systems Framework for Dissemination and Implementation, a Support System should work with Delivery Systems (national, state and/or local entities such as health and human service organizations, community-based organizations, schools) to enhance their capacity for quality implementation of innovations. The literature on the Support System [corrected] has been underresearched and under-developedThis article begins to conceptualize theory, research, and action for an evidence-based system for innovation support (EBSIS). EBSIS describes key priorities for strengthening the science and practice of support. The major goal of EBSIS is to enhance the research and practice of support in order to build capacity in the Delivery System for implementing innovations with quality, and thereby, help the Delivery System achieve outcomes. EBSIS is guided by a logic model that includes four key support components: tools, training, technical assistance, and quality assurance/quality improvement. EBSIS uses the Getting To Outcomes approach to accountability to aid the identification and synthesis of concepts, tools, and evidence for support. We conclude with some discussion of the current status of EBSIS and possible next steps, including the development of collaborative researcher-practitioner-funder-consumer partnerships to accelerate accumulation of knowledge on the Support System.

  12. Evaluation of Organizational Readiness in Clinical Settings for Social Supporting Evidence-Based Information Seeking Behavior after Introducing IT in a Developing Country.

    Science.gov (United States)

    Kahouei, Mehdi; Alaei, Safollah; Panahi, Sohaila Sadat Ghazavi Shariat; Zadeh, Jamileh Mahdi

    2015-01-01

    The health sector of Iran has endeavored to encourage physicians and medical students to use research findings in their practice. Remarkable changes have occurred, including: holding computer skills courses, digital library workshops for physicians and students, and establishing websites in hospitals. The findings showed that a small number of the participants completely agreed that they were supported by supervisors and colleagues to use evidence-based information resources in their clinical decisions. Health care organizations in Iran need other organizational facilitators such as social influences, organizational support, leadership, strong organizational culture, and climate in order to implement evidence-based practice.

  13. Evidence in Support of the Independent Channel Model Describing the Sensorimotor Control of Human Stance Using a Humanoid Robot.

    Science.gov (United States)

    Pasma, Jantsje H; Assländer, Lorenz; van Kordelaar, Joost; de Kam, Digna; Mergner, Thomas; Schouten, Alfred C

    2018-01-01

    The Independent Channel (IC) model is a commonly used linear balance control model in the frequency domain to analyze human balance control using system identification and parameter estimation. The IC model is a rudimentary and noise-free description of balance behavior in the frequency domain, where a stable model representation is not guaranteed. In this study, we conducted firstly time-domain simulations with added noise, and secondly robot experiments by implementing the IC model in a real-world robot (PostuRob II) to test the validity and stability of the model in the time domain and for real world situations. Balance behavior of seven healthy participants was measured during upright stance by applying pseudorandom continuous support surface rotations. System identification and parameter estimation were used to describe the balance behavior with the IC model in the frequency domain. The IC model with the estimated parameters from human experiments was implemented in Simulink for computer simulations including noise in the time domain and robot experiments using the humanoid robot PostuRob II. Again, system identification and parameter estimation were used to describe the simulated balance behavior. Time series, Frequency Response Functions, and estimated parameters from human experiments, computer simulations, and robot experiments were compared with each other. The computer simulations showed similar balance behavior and estimated control parameters compared to the human experiments, in the time and frequency domain. Also, the IC model was able to control the humanoid robot by keeping it upright, but showed small differences compared to the human experiments in the time and frequency domain, especially at high frequencies. We conclude that the IC model, a descriptive model in the frequency domain, can imitate human balance behavior also in the time domain, both in computer simulations with added noise and real world situations with a humanoid robot. This

  14. Evidence in Support of the Independent Channel Model Describing the Sensorimotor Control of Human Stance Using a Humanoid Robot

    Directory of Open Access Journals (Sweden)

    Jantsje H. Pasma

    2018-03-01

    Full Text Available The Independent Channel (IC model is a commonly used linear balance control model in the frequency domain to analyze human balance control using system identification and parameter estimation. The IC model is a rudimentary and noise-free description of balance behavior in the frequency domain, where a stable model representation is not guaranteed. In this study, we conducted firstly time-domain simulations with added noise, and secondly robot experiments by implementing the IC model in a real-world robot (PostuRob II to test the validity and stability of the model in the time domain and for real world situations. Balance behavior of seven healthy participants was measured during upright stance by applying pseudorandom continuous support surface rotations. System identification and parameter estimation were used to describe the balance behavior with the IC model in the frequency domain. The IC model with the estimated parameters from human experiments was implemented in Simulink for computer simulations including noise in the time domain and robot experiments using the humanoid robot PostuRob II. Again, system identification and parameter estimation were used to describe the simulated balance behavior. Time series, Frequency Response Functions, and estimated parameters from human experiments, computer simulations, and robot experiments were compared with each other. The computer simulations showed similar balance behavior and estimated control parameters compared to the human experiments, in the time and frequency domain. Also, the IC model was able to control the humanoid robot by keeping it upright, but showed small differences compared to the human experiments in the time and frequency domain, especially at high frequencies. We conclude that the IC model, a descriptive model in the frequency domain, can imitate human balance behavior also in the time domain, both in computer simulations with added noise and real world situations with a

  15. Evidence-Based Support for the Characteristics of Tsunami Warning Messages for Local, Regional and Distant Sources

    Science.gov (United States)

    Gregg, C. E.; Johnston, D. M.; Sorensen, J. H.; Vogt Sorensen, B.; Whitmore, P.

    2014-12-01

    Many studies since 2004 have documented the dissemination and receipt of risk information for local to distant tsunamis and factors influencing people's responses. A few earlier tsunami studies and numerous studies of other hazards provide additional support for developing effective tsunami messages. This study explores evidence-based approaches to developing such messages for the Pacific and National Tsunami Warning Centers in the US. It extends a message metric developed for the NWS Tsunami Program. People at risk to tsunamis receive information from multiple sources through multiple channels. Sources are official and informal and environmental and social cues. Traditionally, official tsunami messages followed a linear dissemination path through relatively few channels from warning center to emergency management to public and media. However, the digital age has brought about a fundamental change in the dissemination and receipt of official and informal communications. Information is now disseminated in very non-linear paths and all end-user groups may receive the same message simultaneously. Research has demonstrated a range of factors that influence rapid respond to an initial real or perceived threat. Immediate response is less common than one involving delayed protective actions where people first engage in "milling behavior" to exchange information and confirm the warning before taking protective action. The most important message factors to achieve rapid response focus on the content and style of the message and the frequency of dissemination. Previously we developed a tsunami message metric consisting of 21 factors divided into message content and style and receiver characteristics. Initially, each factor was equally weighted to identify gaps, but here we extend the work by weighting specific factors. This utilizes recent research that identifies the most important determinants of protective action. We then discuss the prioritization of message information

  16. Pilot study on developing a decision support tool for guiding re-administration of chemotherapeutic agent after a serious adverse drug reaction

    Directory of Open Access Journals (Sweden)

    Chew Lita

    2011-07-01

    Full Text Available Abstract Background Currently, there are no standard guidelines for recommending re-administration of a chemotherapeutic drug to a patient after a serious adverse drug reaction (ADR incident. The decision on whether to rechallenge the patient is based on the experience of the clinician and is highly subjective. Thus the aim of this study is to develop a decision support tool to assist clinicians in this decision making process. Methods The inclusion criteria for patients in this study are: (1 had chemotherapy at National Cancer Centre Singapore between 2004 to 2009, (2 suffered from serious ADRs, and (3 were rechallenged. A total of 46 patients fulfilled the inclusion criteria. A genetic algorithm attribute selection method was used to identify clinical predictors for patients' rechallenge status. A Naïve Bayes model was then developed using 35 patients and externally validated using 11 patients. Results Eight patient attributes (age, chemotherapeutic drug, albumin level, red blood cell level, platelet level, abnormal white blood cell level, abnormal alkaline phosphatase level and abnormal alanine aminotransferase level were identified as clinical predictors for rechallenge status of patients. The Naïve Bayes model had an AUC of 0.767 and was found to be useful for assisting clinical decision making after clinicians had identified a group of patients for rechallenge. A platform independent version and an online version of the model is available to facilitate independent validation of the model. Conclusion Due to the limited size of the validation set, a more extensive validation of the model is necessary before it can be adopted for routine clinical use. Once validated, the model can be used to assist clinicians in deciding whether to rechallenge patients by determining if their initial assessment of rechallenge status of patients is accurate.

  17. The Role of Land Records in Support of Post-Conflict Land Administration within overall State Building – the Case of Rwanda

    NARCIS (Netherlands)

    Todorovski, D.; Manirakiza, Jean Guillaume; Zevenbergen, J.A.; Boerboom, L.G.J.

    2018-01-01

    An essential component of every land administration system are the land records. These records contain information about ownership, value and use of land. Conflict and post-conflict contexts, both in literature and in practice, have shown that land administration systems are mostly affected by the

  18. Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study.

    Science.gov (United States)

    Ellen, Moriah E; Léon, Grégory; Bouchard, Gisèle; Ouimet, Mathieu; Grimshaw, Jeremy M; Lavis, John N

    2014-12-05

    Mobilizing research evidence for daily decision-making is challenging for health system decision-makers. In a previous qualitative paper, we showed the current mix of supports that Canadian health-care organizations have in place and the ones that are perceived to be helpful to facilitate the use of research evidence in health system decision-making. Factors influencing the implementation of such supports remain poorly described in the literature. Identifying the barriers to and facilitators of different interventions is essential for implementation of effective, context-specific, supports for evidence-informed decision-making (EIDM) in health systems. The purpose of this study was to identify (a) barriers and facilitators to implementing supports for EIDM in Canadian health-care organizations, (b) views about emerging development of supports for EIDM, and (c) views about the priorities to bridge the gaps in the current mix of supports that these organizations have in place. This qualitative study was conducted in three types of health-care organizations (regional health authorities, hospitals, and primary care practices) in two Canadian provinces (Ontario and Quebec). Fifty-seven in-depth semi-structured telephone interviews were conducted with senior managers, library managers, and knowledge brokers from health-care organizations that have already undertaken strategic initiatives in knowledge translation. The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. Limited resources (i.e., money or staff), time constraints, and negative attitudes (or resistance) toward change were the most frequently identified barriers to implementing supports for EIDM. Genuine interest from health system decision-makers, notably their willingness to invest money and resources and to create a knowledge translation culture over time in health-care organizations, was the most frequently identified facilitator to

  19. Just in Time: How Evidence-on-Demand Services Support Decision Making in Ontario's Child and Youth Mental Health Sector

    Science.gov (United States)

    Notarianni, Maryann; Sundar, Purnima; Carter, Charles

    2016-01-01

    Using the best available evidence to inform decision making is important for the design or delivery of effective health-related services and broader public policy. Several studies identify barriers and facilitators to evidence-informed decision making in Canadian health settings. This paper describes how the Ontario Centre of Excellence for Child…

  20. Lessons from the Social Innovation Fund: Supporting Evaluation to Assess Program Effectiveness and Build a Body of Research Evidence

    Science.gov (United States)

    Zandniapour, Lily; Deterding, Nicole M.

    2018-01-01

    Tiered evidence initiatives are an important federal strategy to incentivize and accelerate the use of rigorous evidence in planning, implementing, and assessing social service investments. The Social Innovation Fund (SIF), a program of the Corporation for National and Community Service, adopted a public-private partnership approach to tiered…

  1. Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE): protocol and preliminary results

    NARCIS (Netherlands)

    Treweek, Shaun; Oxman, Andrew D.; Alderson, Philip; Bossuyt, Patrick M.; Brandt, Linn; Brożek, Jan; Davoli, Marina; Flottorp, Signe; Harbour, Robin; Hill, Suzanne; Liberati, Alessandro; Liira, Helena; Schünemann, Holger J.; Rosenbaum, Sarah; Thornton, Judith; Vandvik, Per Olav; Alonso-Coello, Pablo; Hartley, Claire; Loudon, Kirsty; Slater, William; Stewart, Neil; Glenton, Claire; Kristiansen, Annette; Lewin, Simon; Moberg, Jenny; Morelli, Angela; Oxman, Andy; Ødgaard-Jensen, Jan; Martinez-García, Laura; Rigau, David; Solà, Ivan; Sanabria, Andrea Juliana; Amato, Laura; Brunetti, Massimo; Magrini, Nicola; Parmelli, Elena; Nonino, Francesco; de Palma, Rossana; Papini, Donato; Pregno, Silvia; Saitto, Carlo; Gopalakrishna, Gowri; Langendam, Miranda; Leeflang, Mariska; Scholten, Rob; Gülmezoglu, Metin; Permanand, Govin; Weerasuriyak, Krisantha; Antes, Gerd; Meerpohl, Jörg

    2013-01-01

    Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear. GRADE is a systematic approach towards assessing the quality of evidence and the

  2. Problem-Based Learning and Argumentation: Testing a Scaffolding Framework to Support Middle School Students' Creation of Evidence-Based Arguments

    Science.gov (United States)

    Belland, Brian R.; Glazewski, Krista D.; Richardson, Jennifer C.

    2011-01-01

    Students engaged in problem-based learning (PBL) units solve ill-structured problems in small groups, and then present arguments in support of their solution. However, middle school students often struggle developing evidence-based arguments (Krajcik et al., "J Learn Sci" 7:313-350, 1998). Using a mixed method design, the researchers examined the…

  3. Supporting patients in obtaining and oncologists in providing evidence-based health-related quality of life information prior to and after esophageal cancer surgery

    NARCIS (Netherlands)

    Jacobs, M.

    2015-01-01

    The overall aim of this thesis was to support patients in obtaining and oncologists in providing evidence-based HRQL data prior to and following esophageal cancer surgery. This thesis is divided in two parts. In Part I, we addressed the information needs of esophageal cancer patients prior to and

  4. Legal and administrative measures to support police enforcement of traffic rules. The "Escape" Project, Deliverable 5. Project funded by the European Commission under the Transport RTD Programme of the 4th Framework Programme.

    NARCIS (Netherlands)

    Goldenbeld, C. Heidstra, J. Christ, R. Mäkinen, T. & Hakkert, A.S.

    2005-01-01

    This report addresses the question of how legal and administrative systems may support the operation or effectiveness of the total system of traffic law enforcement. In this first chapter we present road safety and traffic enforcement as the efforts of several interlinked organisations and

  5. SIAT: Information system of support to the administration of technology; SIAT: Sistema de informacion de apoyo a la administracion de la tecnologia

    Energy Technology Data Exchange (ETDEWEB)

    Molina Gonzalez, Ricardo; Herrera Lavin, Jesus; Rodriguez Ortiz, Guillermo [Instituto de Investigaciones Electricas, Temixco, Morelos (Mexico)

    1999-07-01

    A general introduction is made of the administration problem of the technology and a brief description of the process implemented in Petroleos Mexicanos (PEMEX) Exploration and Production (PEP) for the administration of the technology in PEP and the benefits that it provides. [Spanish] Se presenta una introduccion general del problema de administracion de la tecnologia y una breve descripcion del proceso implantado en Petroleos Mexicanos (Pemex) Exploracion y Produccion (PEP) para la administracion de las tecnologias en PEP y los beneficios que proporciona.

  6. Social Support and Supervisory Quality Interventions in the Workplace: A Stakeholder-Centered Best-Evidence Synthesis of Systematic Reviews on Work Outcomes

    Directory of Open Access Journals (Sweden)

    SL Wagner

    2015-10-01

    Full Text Available Background: There is controversy surrounding the impact of workplace interventions aimed at improving social support and supervisory quality on absenteeism, productivity and financial outcomes. Objective: To determine the value of social support interventions for work outcomes. Methods: Databases were searched for systematic reviews between 2000 and 2012 to complete a synthesis of systematic reviews guided by the PRISMA statement and the IOM guidelines for systematic reviews. Assessment of articles for inclusion and methodological quality was conducted independently by at least two researchers, with differences resolved by consensus. Results: The search resulted in 3363 titles of which 3248 were excluded following title/abstract review, leaving 115 articles that were retrieved and underwent full article review. 10 articles met the set inclusion criteria, with 7 focusing on social support, 2 on supervisory quality and 1 on both. We found moderate and limited evidence, respectively, that social support and supervisory quality interventions positively impact workplace outcomes. Conclusion: There is moderate evidence that social support and limited evidence that supervisory quality interventions have a positive effect on work outcomes.

  7. Social Support and Supervisory Quality Interventions in the Workplace: A Stakeholder-Centered Best-Evidence Synthesis of Systematic Reviews on Work Outcomes.

    Science.gov (United States)

    Wagner, S L; White, M I; Schultz, I Z; Williams-Whitt, K; Koehn, C; Dionne, C E; Koehoorn, M; Harder, H G; Pasca, R; Wärje, O; Hsu, V; McGuire, L; Lama, I; Schulz, W; Kube, D; Wright, M D

    2015-10-01

    There is controversy surrounding the impact of workplace interventions aimed at improving social support and supervisory quality on absenteeism, productivity and financial outcomes. To determine the value of social support interventions for work outcomes. Databases were searched for systematic reviews between 2000 and 2012 to complete a synthesis of systematic reviews guided by the PRISMA statement and the IOM guidelines for systematic reviews. Assessment of articles for inclusion and methodological quality was conducted independently by at least two researchers, with differences resolved by consensus. The search resulted in 3363 titles of which 3248 were excluded following title/abstract review, leaving 115 articles that were retrieved and underwent full article review. 10 articles met the set inclusion criteria, with 7 focusing on social support, 2 on supervisory quality and 1 on both. We found moderate and limited evidence, respectively, that social support and supervisory quality interventions positively impact workplace outcomes. There is moderate evidence that social support and limited evidence that supervisory quality interventions have a positive effect on work outcomes.

  8. Transportation Security Administration

    Science.gov (United States)

    ... content Official website of the Department of Homeland Security Transportation Security Administration A - Z Index Blog What Can I ... Search form Search the Site Main menu Travel Security Screening Special Procedures TSA Pre✓® Passenger Support Travel ...

  9. Low carbon mini grids 'Identifying the gaps; building the evidence base', Support Study for DFID - Final Report

    International Nuclear Information System (INIS)

    2013-11-01

    This report represents the final report on the support study on 'Identifying the gaps and building the evidence base on low carbon mini-grids'. The review forms part of a preliminary initiative of DFID to promote Green Mini-Grids (GMG) in Africa under the International Climate Fund (ICF) with the objective of providing guidance and recommendations for DFID intervention and program implementation. The support study started in November 2012 and ended in September 2013. The report is based on activities which have included kick-off meetings, development of the methodological framework, literature and web review of documents relevant to the state-of-the-art practices for mini-grids, collation of relevant international experience, and a field visit in 2 targeted African countries (Kenya and Mozambique) to conduct interviews with key stakeholders and to collect field data. The report is structured in 8 chapters as per the requirements of the TOR, with a 'Highlights' section: 1- International Review of Mini-Grids and Data Collection, overview of the technologies, and of implementation schemes. The reality of the target countries is that while there are a number of diesel based mini-grids run either by private operators with low service and high cost, outside any regulated framework, and some run through various forms of Public Private Partnerships, there are extremely few Green Mini-Grids. Some Renewable Energy Power Generation operations are found to be for self-consumption or feeding into the grid, but very seldom for powering a Mini-Grid isolated from the interconnected network. 2 - Relevance of Mini-Grid Solutions, proposes an approach to help the planner identify whether in a given country/region, Mini-Grids - and further Green Mini-Grids are a viable option for access to electricity services. These mini-grid areas are those which will remain out reach of the interconnected grid for a few years to come, and yet where there is sufficient load density to ensure the

  10. Evidence Support and Guidelines for Using Heated, Humidified, High-Flow Nasal Cannulae in Neonatology: Oxford Nasal High-Flow Therapy Meeting, 2015.

    Science.gov (United States)

    Roehr, Charles C; Yoder, Bradley A; Davis, Peter G; Ives, Kevin

    2016-12-01

    Nasal high-flow therapy (nHFT) has become a popular form of noninvasive respiratory support in neonatal intensive care units. A meeting held in Oxford, UK, in June 2015 examined the evidence base and proposed a consensus statement. In summary, nHFT is effective for support of preterm infants following extubation. There is growing evidence evaluating its use in the primary treatment of respiratory distress. Further study is needed to assess which clinical conditions are most amenable to nHFT support, the most effective flow rates, and escalation and weaning strategies. Its suitability as first-line treatment needs to be further evaluated. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Incorporation of radioactive leucine as an evidence for protein synthesis in Lizard epididymis. Studies during the reproductive cycle and after testoterone administration to intact and castrated animals

    International Nuclear Information System (INIS)

    Gigon, Annie; Dufaure, J.-P.

    1975-01-01

    Lizard epididymis activity during the reproductive cycle and after testosterone administration results in a marked increase of radioactive leucine incorporation in vivo and in vitro. The electrophoretic distribution of soluble proteins shows different peaks of radioactivity. Comparison between histological response and pattern of electrophoresis suggests that one of these peaks may correspond to an activity of secretion [fr

  12. Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs

    Directory of Open Access Journals (Sweden)

    Melissa F. Peskin

    2017-08-01

    Full Text Available In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular, a systematic design framework that uses theory, empirical evidence, and input from the community to develop CHoosing And Maintaining Effective Programs for Sex Education in Schools (iCHAMPSS, an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings.

  13. Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs.

    Science.gov (United States)

    Peskin, Melissa F; Hernandez, Belinda F; Gabay, Efrat K; Cuccaro, Paula; Li, Dennis H; Ratliff, Eric; Reed-Hirsch, Kelly; Rivera, Yanneth; Johnson-Baker, Kimberly; Emery, Susan Tortolero; Shegog, Ross

    2017-01-01

    In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs) have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance) of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular), a systematic design framework that uses theory, empirical evidence, and input from the community to develop CH oosing A nd M aintaining Effective P rograms for S ex Education in S chools ( iCHAMPSS ), an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings.

  14. Evidence of the effect of dipyrone on the central nervous system as a determinant of delayed gastric emptying observed in rats after its administration

    Directory of Open Access Journals (Sweden)

    E.F. Collares

    2003-10-01

    Full Text Available Dipyrone administered intravenously (iv delays gastric emptying (GE in rats. The objectives of the present study were to assess: 1 the effect of the dose of dipyrone and time after its iv administration on GE in rats, 2 the effect of subdiaphragmatic vagotomy (VgX and bilateral electrolytic lesion of the paraventricular nucleus (PVNX on the delayed GE induced by the drug, and 3 the intracerebroventricular (icv action of dipyrone and of one of its metabolites, 4-aminoantipyrine on GE. Male Wistar rats received saline labeled with phenol red intragastrically as a test meal. GE was indirectly assessed by the determination of percent gastric retention (GR of the test meal 10 min after administration by gavage. Dipyrone delays GE in a dose- and time-dependent manner. Thirty minutes after the iv administration of 80 mg/kg dipyrone, the animals showed significantly higher GR (mean = 62.6% compared to those receiving vehicle (31.5%. VgX and PVNX significantly reduced the iv effect of 80 mg/kg dipyrone (mean %GR: VgX = 28.3 vs Sham = 55.5 and PVNX = 34.5 vs Sham = 52.2. Icv administration of 4 µmol dipyrone caused a significant increase in GR (54.1% of the test meal 10 min later, whereas administration of 4 µmol 4-aminoantipyrine had no effect (34.4%. Although the dipyrone dose administered icv was 16 times lower than that applied iv, for the same time of action (10 min, the GR of animals that received the drug icv (54.1% or iv (54.5% did not differ significantly. In conclusion, the present results suggest that the effect of dipyrone in delaying GE is due to the action of the drug on the central nervous system, with the participation of the PVN and of the vagus nerve.

  15. Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study.

    Science.gov (United States)

    Bailie, Ross; Matthews, Veronica; Larkins, Sarah; Thompson, Sandra; Burgess, Paul; Weeramanthri, Tarun; Bailie, Jodie; Cunningham, Frances; Kwedza, Ru; Clark, Louise

    2017-10-05

    To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. Mixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care. Indigenous primary healthcare services across five states/territories of Australia. 175 Indigenous primary healthcare services. A range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines). Progressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities. Health authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Administrating Solr

    CERN Document Server

    Mohan, Surendra

    2013-01-01

    A fast-paced, example-based guide to learning how to administrate, monitor, and optimize Apache Solr.""Administrating Solr"" is for developers and Solr administrators who have a basic knowledge of Solr and who are looking for ways to keep their Solr server healthy and well maintained. A basic working knowledge of Apache Lucene is recommended, but this is not mandatory.

  17. Administrative Synergy

    Science.gov (United States)

    Hewitt, Kimberly Kappler; Weckstein, Daniel K.

    2012-01-01

    One of the biggest obstacles to overcome in creating and sustaining an administrative professional learning community (PLC) is time. Administrators are constantly deluged by the tyranny of the urgent. It is a Herculean task to carve out time for PLCs, but it is imperative to do so. In this article, the authors describe how an administrative PLC…

  18. Regulators as agents: Modelling personality and power as evidence is brokered to support decisions on environmental risk

    Energy Technology Data Exchange (ETDEWEB)

    Davies, G.J. [Cranfield University, Centre for Environmental Risks and Futures, School of Applied Sciences, Cranfield MK43 0AL (United Kingdom); Kendall, G. [University of Nottingham, School of Computer Science, Nottingham NG8 1BB (United Kingdom); University of Nottingham Malaysia Campus, Jalan Broga, 43500 Semenyih, Selangor Darul Ehsan (Malaysia); Soane, E. [London School of Economics and Political Science, Department of Management, London WC2A 2AE (United Kingdom); Li, J. [University of Nottingham, School of Computer Science, Nottingham NG8 1BB (United Kingdom); Rocks, S.A.; Jude, S.R. [Cranfield University, Centre for Environmental Risks and Futures, School of Applied Sciences, Cranfield MK43 0AL (United Kingdom); Pollard, S.J.T., E-mail: s.pollard@cranfield.ac.uk [Cranfield University, Centre for Environmental Risks and Futures, School of Applied Sciences, Cranfield MK43 0AL (United Kingdom)

    2014-01-01

    Complex regulatory decisions about risk rely on the brokering of evidence between providers and recipients, and involve personality and power relationships that influence the confidence that recipients may place in the sufficiency of evidence and, therefore, the decision outcome. We explore these relationships in an agent-based model; drawing on concepts from environmental risk science, decision psychology and computer simulation. A two-agent model that accounts for the sufficiency of evidence is applied to decisions about salt intake, animal carcass disposal and radioactive waste. A dynamic version of the model assigned personality traits to agents, to explore their receptivity to evidence. Agents with ‘aggressor’ personality sets were most able to imbue fellow agents with enhanced receptivity (with ‘avoider’ personality sets less so) and clear confidence in the sufficiency of evidence. In a dynamic version of the model, when both recipient and provider were assigned the ‘aggressor’ personality set, this resulted in 10 successful evidence submissions in 71 days, compared with 96 days when both agents were assigned the ‘avoider’ personality set. These insights suggest implications for improving the efficiency and quality of regulatory decision making by understanding the role of personality and power. - Highlights: •The role of personality and power in regulatory decision-making is poorly represented. •We built a rudimentary two-agent model to explore environmental risk decisions. •Our two agent model accounted for decisions about the sufficiency of evidence. •We examined the influence personality and power has on confidence gained. •By giving agents personality we might predict the time taken to reach consensus.

  19. Regulators as agents: Modelling personality and power as evidence is brokered to support decisions on environmental risk

    International Nuclear Information System (INIS)

    Davies, G.J.; Kendall, G.; Soane, E.; Li, J.; Rocks, S.A.; Jude, S.R.; Pollard, S.J.T.

    2014-01-01

    Complex regulatory decisions about risk rely on the brokering of evidence between providers and recipients, and involve personality and power relationships that influence the confidence that recipients may place in the sufficiency of evidence and, therefore, the decision outcome. We explore these relationships in an agent-based model; drawing on concepts from environmental risk science, decision psychology and computer simulation. A two-agent model that accounts for the sufficiency of evidence is applied to decisions about salt intake, animal carcass disposal and radioactive waste. A dynamic version of the model assigned personality traits to agents, to explore their receptivity to evidence. Agents with ‘aggressor’ personality sets were most able to imbue fellow agents with enhanced receptivity (with ‘avoider’ personality sets less so) and clear confidence in the sufficiency of evidence. In a dynamic version of the model, when both recipient and provider were assigned the ‘aggressor’ personality set, this resulted in 10 successful evidence submissions in 71 days, compared with 96 days when both agents were assigned the ‘avoider’ personality set. These insights suggest implications for improving the efficiency and quality of regulatory decision making by understanding the role of personality and power. - Highlights: •The role of personality and power in regulatory decision-making is poorly represented. •We built a rudimentary two-agent model to explore environmental risk decisions. •Our two agent model accounted for decisions about the sufficiency of evidence. •We examined the influence personality and power has on confidence gained. •By giving agents personality we might predict the time taken to reach consensus

  20. Informal support networks of low-income senior women living alone: evidence from Fort St. John, BC.

    Science.gov (United States)

    Ryser, Laura; Halseth, Greg

    2011-01-01

    Within the context of an aging Canadian rural and small-town landscape, there is a growing trend of low-income senior women living alone. While there is a perception that rural seniors have well-developed social networks to meet their daily needs, some research suggests that economic and social restructuring processes have impacted the stability of seniors' support networks in small places. While much of the research on seniors' informal networks focuses upon small towns in decline, booming resource economies can also produce challenges for low-income senior women living alone due to both a higher cost of living and the retrenchment of government and service supports. Under such circumstances, an absence of informal supports can impact seniors' health and quality of life and may lead to premature institutionalization. Drawing upon a household survey in Fort St. John, British Columbia, we explore informal supports used by low-income senior women living alone in this different context of the Canadian landscape. Our findings indicate that these women not only have a support network that is comparable to other groups, but that they are also more likely to draw upon such supports to meet their independent-living needs. These women rely heavily on family support, however, and greater efforts are needed to diversify both their formal and informal sources of support as small family networks can quickly become overwhelmed.

  1. Supply chain relationships, supplier support programs and stimulating on-farm investment: evidence from the Armenian dairy sector

    NARCIS (Netherlands)

    Dries, L.K.E.; Gorton, M.; Urutyan, V.; White, J.

    2014-01-01

    Purpose – The purpose of this paper is to evaluate the determinants of supply chain relationships, the provision of supplier support measures and the role that support measures play in stimulating investment by suppliers in emerging economies. Design/methodology/approach – The paper draws on survey

  2. Working group reports: evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project.

    Science.gov (United States)

    Raiten, Daniel J; Steiber, Alison L; Carlson, Susan E; Griffin, Ian; Anderson, Diane; Hay, William W; Robins, Sandra; Neu, Josef; Georgieff, Michael K; Groh-Wargo, Sharon; Fenton, Tanis R

    2016-02-01

    The "Evaluation of the Evidence to Support Practice Guidelines for the Nutritional Care of Preterm Infants: The Pre-B Project" is the first phase in a process to present the current state of knowledge and to support the development of evidence-informed guidance for the nutritional care of preterm and high-risk newborn infants. The future systematic reviews that will ultimately provide the underpinning for guideline development will be conducted by the Academy of Nutrition and Dietetics' Evidence Analysis Library (EAL). To accomplish the objectives of this first phase, the Pre-B Project organizers established 4 working groups (WGs) to address the following themes: 1) nutrient specifications for preterm infants, 2) clinical and practical issues in enteral feeding of preterm infants, 3) gastrointestinal and surgical issues, and 4) current standards of infant feeding. Each WG was asked to 1) develop a series of topics relevant to their respective themes, 2) identify questions for which there is sufficient evidence to support a systematic review process conducted by the EAL, and 3) develop a research agenda to address priority gaps in our understanding of the role of nutrition in health and development of preterm/neonatal intensive care unit infants. This article is a summary of the reports from the 4 Pre-B WGs. © 2016 American Society for Nutrition.

  3. A multi-site randomised controlled trial of evidence-based supported employment for adults with severe and persistent mental illness.

    Science.gov (United States)

    Waghorn, Geoffrey; Dias, Shannon; Gladman, Beverley; Harris, Meredith; Saha, Sukanta

    2014-12-01

    The Individual Placement and Support (IPS) approach is an evidence-based form of supported employment for people with severe and persistent mental illness. This approach is not yet widely available in Australia even though there is mounting evidence of its generalisability outside the USA. One previous Australian randomised controlled trial found that IPS is effective for young people with first episode psychosis. The aim of the current trial was to assess the effectiveness of evidence-based supported employment when implemented for Australian adult consumers of public mental health services by utilising existing service systems. A four-site randomised control trial design (n = 208) was conducted in Brisbane (two sites), Townsville and Cairns. The intervention consisted of an IPS supported employment service hosted by a community mental health team. The control condition was delivered at each site by mental health teams referring consumers to other disability employment services in the local area. At 12 months, those in the IPS condition had 2.4 times greater odds of commencing employment than those in the control condition (42.5% vs. 23.5%). The conditions did not differ on secondary employment outcomes including job duration, hours worked, or job diversity. Attrition was higher than expected in both conditions with 28.4% completing the baseline interview but taking no further part in the study. The results support previous international findings that IPS-supported employment is more effective than non-integrated supported employment. IPS can be successfully implemented this way in Australia, but with a loss of effect strength compared to previous USA trials. © 2014 Occupational Therapy Australia.

  4. Evidence for H2/D2 isotope effects on Fischer-Tropsch synthesis over supported ruthenium catalysts

    International Nuclear Information System (INIS)

    Kellner, C.S.; Bell, A.T.

    1981-01-01

    The effects of using D 2 rather than H 2 during Fischer-Tropsch synthesis were investigated using alumina- and silica-supported Ru catalysts. For the alumina-supported catalysts, the rate of CD 4 formation was 1.4 to 1.6 times faster than the formation of CH 4 . A noticeable isotope effect was also observed for higher molecular weight products. The magnitude of the isotope effects observed using the silica-supported catalyst was much smaller than that found using the alumina-supported catalysts. The formation of olefins relative to paraffins was found to be higher when H 2 rather than D 2 was used, independent of the catalyst support. The observed isotope effects are explained in terms of a mechanism for CO hydrogenation and are shown to arise from a complex combination of the kinetic and equilibrium isotope effects associated with elementary processes occurring on the catalyst surface

  5. Administrative Circulars

    CERN Document Server

    Département des Ressources humaines

    2004-01-01

    Administrative Circular N° 2 (Rev. 2) - May 2004 Guidelines and procedures concerning recruitment and probation period of staff members This circular has been revised. It cancels and replaces Administrative Circular N° 2 (Rev. 1) - March 2000. Administrative Circular N° 9 (Rev. 3) - May 2004 Staff members contracts This circular has been revised. It cancels and replaces Administrative Circular N° 9 (Rev. 2) - March 2000. Administrative Circular N° 26 (Rev. 4) - May 2004 Procedure governing the career evolution of staff members This circular has also been revised. It Administrative Circulars Administrative Circular N° 26 (Rev. 3) - December 2001 and brings up to date the French version (Rev. 4) published on the HR Department Web site in January 2004. Operational Circular N° 7 - May 2004 Work from home This circular has been drawn up. Operational Circular N° 8 - May 2004 Dealing with alcohol-related problems...

  6. Understanding land administration systems

    DEFF Research Database (Denmark)

    P. Williamson, Ian; Enemark, Stig; Wallace, Judy

    2008-01-01

    This paper introduces basic land administration theory and highlights four key concepts that are fundamental to understanding modern land administration systems - firstly the land management paradigm and its influence on the land administration framework, secondly the role that the cadastre plays...... in contributing to sustainable development, thirdly the changing nature of ownership and the role of land markets, and lastly a land management vision that promotes land administration in support of sustainable development and spatial enablement of society. We present here the first part of the paper. The second...

  7. Neonatal non-invasive respiratory support: synchronised NIPPV, non-synchronised NIPPV or bi-level CPAP: what is the evidence in 2013?

    Science.gov (United States)

    Roberts, C T; Davis, P G; Owen, L S

    2013-01-01

    Nasal continuous positive airway pressure (NCPAP) has proven to be an effective mode of non-invasive respiratory support in preterm infants; however, many infants still require endotracheal ventilation, placing them at an increased risk of morbidities such as bronchopulmonary dysplasia. Several other modes of non-invasive respiratory support beyond NCPAP, including synchronised and non-synchronised nasal intermittent positive pressure ventilation (SNIPPV and nsNIPPV) and bi-level positive airway pressure (BiPAP) are now also available. These techniques require different approaches, and the exact mechanisms by which they act remain unclear. SNIPPV has been shown to reduce the rate of reintubation in comparison to NCPAP when used as post-extubation support, but the evidence for nsNIPPV and BiPAP in this context is less convincing. There is some evidence that NIPPV (whether synchronised or non-synchronised) used as primary respiratory support is beneficial, but the variation in study methodology makes this hard to translate confidently into clinical practice. There is currently no evidence to suggest a reduction in mortality or important morbidities such as bronchopulmonary dysplasia, with NIPPV or BiPAP in comparison to NCPAP, and there is a lack of appropriately designed studies in this area. This review discusses the different approaches and proposed mechanisms of action of SNIPPV, nsNIPPV and BiPAP, the challenges of applying the available evidence for these distinct modalities of non-invasive respiratory support to clinical practice, and possible areas of future research. © 2013 S. Karger AG, Basel.

  8. A Reference-Intensive Embedded Librarian Program: Kresge Business Administration Library's Program to Support Action-Based Learning at the Ross School of Business

    Science.gov (United States)

    Berdish, Laura; Seeman, Corey

    2010-01-01

    While a great deal of literature on embedded librarians in academic libraries is focused on the role of instructor, there are many other services that could be provided by librarians working closely with students. The Kresge Business Administration Library (Stephen M. Ross School of Business at the University of Michigan) has created a unique…

  9. SUPPORT Tools for Evidence-informed policymaking in health 6: Using research evidence to address how an option will be implemented

    Directory of Open Access Journals (Sweden)

    Lavis John N

    2009-12-01

    Full Text Available Abstract This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. After a policy decision has been made, the next key challenge is transforming this stated policy position into practical actions. What strategies, for instance, are available to facilitate effective implementation, and what is known about the effectiveness of such strategies? We suggest five questions that can be considered by policymakers when implementing a health policy or programme. These are: 1. What are the potential barriers to the successful implementation of a new policy? 2. What strategies should be considered in planning the implementation of a new policy in order to facilitate the necessary behavioural changes among healthcare recipients and citizens? 3. What strategies should be considered in planning the implementation of a new policy in order to facilitate the necessary behavioural changes in healthcare professionals? 4. What strategies should be considered in planning the implementation of a new policy in order to facilitate the necessary organisational changes? 5. What strategies should be considered in planning the implementation of a new policy in order to facilitate the necessary systems changes?

  10. Views of NHS commissioners on commissioning support provision. Evidence from a qualitative study examining the early development of clinical commissioning groups in England.

    Science.gov (United States)

    Petsoulas, Christina; Allen, Pauline; Checkland, Kath; Coleman, Anna; Segar, Julia; Peckham, Stephen; Mcdermott, Imelda

    2014-10-15

    The 2010 healthcare reform in England introduced primary care-led commissioning in the National Health Service (NHS) by establishing clinical commissioning groups (CCGs). A key factor for the success of the reform is the provision of excellent commissioning support services to CCGs. The Government's aim is to create a vibrant market of competing providers of such services (from both for-profit and not-for-profit sectors). Until this market develops, however, commissioning support units (CSUs) have been created from which CCGs are buying commissioning support functions. This study explored the attitudes of CCGs towards outsourcing commissioning support functions during the initial stage of the reform. The research took place between September 2011 and June 2012. We used a case study research design in eight CCGs, conducting in-depth interviews, observation of meetings and analysis of policy documents. We conducted 96 interviews and observed 146 meetings (a total of approximately 439 h). Many CCGs were reluctant to outsource core commissioning support functions (such as contracting) for fear of losing local knowledge and trusted relationships. Others were disappointed by the absence of choice and saw CSUs as monopolies and a recreation of the abolished PCTs. Many expressed doubts about the expectation that outsourcing of commissioning support functions will result in lower administrative costs. Given the nature of healthcare commissioning, outsourcing vital commissioning support functions may not be the preferred option of CCGs. Considerations of high transaction costs, and the risk of fragmentation of services and loss of trusted relationships involved in short-term contracting, may lead most CCGs to decide to form long-term partnerships with commissioning support suppliers in the future. This option, however, limits competition by creating 'network closure' and calls into question the Government's intention to create a vibrant market of commissioning support

  11. Evaluating the Evidence Base of Shared Story Reading to Promote Literacy for Students with Extensive Support Needs

    Science.gov (United States)

    Hudson, Melissa E.; Test, David W.

    2011-01-01

    This study reviewed published literature to determine the level of evidence for using shared story reading to promote literacy. Shared story reading was defined as a practice used to access age-appropriate literature through reader-listener interaction in which a story is read aloud and student interaction with the reader and the story is…

  12. Recent Social Work Practitioners' Understanding and Use of Evidence-Based Practice and Empirically Supported Treatments

    Science.gov (United States)

    Grady, Melissa D.; Wike, Traci; Putzu, Caren; Field, Sara; Hill, Jacqueline; Bledsoe, Sarah E.; Bellamy, Jennifer; Massey, Michael

    2018-01-01

    The aim of this study was to evaluate how [the Council on Social Work Education's] (CSWE's) 2008 shift placing more emphasis on research have affected newly trained social workers' use of evidence-based practice (EBP). This qualitative study examined the educational and practice experiences of newly trained social workers and how those experiences…

  13. Prospective Links between Friendship and Early Physical Aggression: Preliminary Evidence Supporting the Role of Friendship Quality through a Dyadic Intervention

    Science.gov (United States)

    Salvas, Marie-Claude; Vitaro, Frank; Brendgen, Mara; Cantin, Ste´phane

    2016-01-01

    Positive friendships have been related to decreasing levels of children's physical aggression over time. While this evidence calls for interventions aimed at helping children build good-quality friendships, tests of causality through experimental manipulations are still needed. The goal of this study was to examine whether an intervention aimed to…

  14. Beyond ROC Curvature: Strength Effects and Response Time Data Support Continuous-Evidence Models of Recognition Memory

    Science.gov (United States)

    Dube, Chad; Starns, Jeffrey J.; Rotello, Caren M.; Ratcliff, Roger

    2012-01-01

    A classic question in the recognition memory literature is whether retrieval is best described as a continuous-evidence process consistent with signal detection theory (SDT), or a threshold process consistent with many multinomial processing tree (MPT) models. Because receiver operating characteristics (ROCs) based on confidence ratings are…

  15. 27 CFR 53.182 - Supporting evidence required in case of tax-paid articles used for further manufacture.

    Science.gov (United States)

    2010-04-01

    ... required in case of tax-paid articles used for further manufacture. 53.182 Section 53.182 Alcohol, Tobacco... articles used for further manufacture. (a) Evidence to be submitted by claimant. No claim for credit or... material in the manufacture or production of, or as a component part of, a second article manufactured or...

  16. The Human Experience With Ghrelin Administration

    Science.gov (United States)

    Garin, Margaret C.; Burns, Carrie M.; Kaul, Shailja

    2013-01-01

    Context: Ghrelin is an endogenous stimulator of GH and is implicated in a number of physiological processes. Clinical trials have been performed in a variety of patient populations, but there is no comprehensive review of the beneficial and adverse consequences of ghrelin administration to humans. Evidence Acquisition: PubMed was utilized, and the reference list of each article was screened. We included 121 published articles in which ghrelin was administered to humans. Evidence Synthesis: Ghrelin has been administered as an infusion or a bolus in a variety of doses to 1850 study participants, including healthy participants and patients with obesity, prior gastrectomy, cancer, pituitary disease, diabetes mellitus, eating disorders, and other conditions. There is strong evidence that ghrelin stimulates appetite and increases circulating GH, ACTH, cortisol, prolactin, and glucose across varied patient populations. There is a paucity of evidence regarding the effects of ghrelin on LH, FSH, TSH, insulin, lipolysis, body composition, cardiac function, pulmonary function, the vasculature, and sleep. Adverse effects occurred in 20% of participants, with a predominance of flushing and gastric rumbles and a mild degree of severity. The few serious adverse events occurred in patients with advanced illness and were not clearly attributable to ghrelin. Route of administration may affect the pattern of adverse effects. Conclusions: Existing literature supports the short-term safety of ghrelin administration and its efficacy as an appetite stimulant in diverse patient populations. There is some evidence to suggest that ghrelin has wider ranging therapeutic effects, although these areas require further investigation. PMID:23533240

  17. The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance-challenges and future research opportunities.

    Science.gov (United States)

    Barratt, Christopher L R; Björndahl, Lars; De Jonge, Christopher J; Lamb, Dolores J; Osorio Martini, Francisco; McLachlan, Robert; Oates, Robert D; van der Poel, Sheryl; St John, Bianca; Sigman, Mark; Sokol, Rebecca; Tournaye, Herman

    2017-11-01

    Herein, we describe the consensus guideline methodology, summarize the evidence-based recommendations we provided to the World Health Organization (WHO) for their consideration in the development of global guidance and present a narrative review of the diagnosis of male infertility as related to the eight prioritized (problem or population (P), intervention (I), comparison (C) and outcome(s) (O) (PICO)) questions. Additionally, we discuss the challenges and research gaps identified during the synthesis of this evidence. The aim of this paper is to present an evidence-based approach for the diagnosis of male infertility as related to the eight prioritized PICO questions. Collating the evidence to support providing recommendations involved a collaborative process as developed by WHO, namely: identification of priority questions and critical outcomes; retrieval of up-to-date evidence and existing guidelines; assessment and synthesis of the evidence; and the formulation of draft recommendations to be used for reaching consensus with a wide range of global stakeholders. For each draft recommendation the quality of the supporting evidence was then graded and assessed for consideration during a WHO consensus. Evidence was synthesized and recommendations were drafted to address the diagnosis of male infertility specifically encompassing the following: What is the prevalence of male infertility and what proportion of infertility is attributable to the male? Is it necessary for all infertile men to undergo a thorough evaluation? What is the clinical (ART/non ART) value of traditional semen parameters? What key male lifestyle factors impact on fertility (focusing on obesity, heat and tobacco smoking)? Do supplementary oral antioxidants or herbal therapies significantly influence fertility outcomes for infertile men? What are the evidence-based criteria for genetic screening of infertile men? How does a history of neoplasia and related treatments in the male impact on (his and

  18. Administrative Reform

    DEFF Research Database (Denmark)

    Plum, Maja

    Through the example of a Danish reform of educational plans in early childhood education, the paper critically addresses administrative educational reforms promoting accountability, visibility and documentation. Drawing on Foucaultian perspectives, the relation between knowledge and governing...... of administrative technology, tracing how the humanistic values of education embed and are embedded within ‘the professional nursery teacher' as an object and subject of administrative practice. Rather than undermining the humanistic potential of education, it is argued that the technology of accounting...

  19. Supporting patients in obtaining and oncologists in providing evidence-based health-related quality of life information prior to and after esophageal cancer surgery

    OpenAIRE

    Jacobs, M.

    2015-01-01

    The overall aim of this thesis was to support patients in obtaining and oncologists in providing evidence-based HRQL data prior to and following esophageal cancer surgery. This thesis is divided in two parts. In Part I, we addressed the information needs of esophageal cancer patients prior to and following esophageal surgery, the barriers and facilitators patients experienced when discussing their information needs with their oncologist, and the development of a web-based question prompt shee...

  20. Effects of Soft Loans and Credit Guarantees on Performance of Supported Firms: Evidence from the Czech Public Programme START

    Directory of Open Access Journals (Sweden)

    Ondřej Dvouletý

    2017-12-01

    Full Text Available The purpose of this article was to conduct an empirical evaluation of the Czech public programme START, which was funded from the European Regional Development Fund. The programme lasted from 2007–2011, and supported new entrepreneurs through the zero interest soft loans and credit guarantees. The counterfactual analysis (using three matching techniques: propensity score, nearest neighbour, and kernel was conducted on the firm level and investigated the changes in financial performance (net profits, return on assets (ROA, return on equity (ROE, sales, assets turnover, and debt ratio of the supported firms four years after the end of intervention. The obtained findings could not support the hypothesis assuming a positive impact of the programme on the firm’s performance. On the contrary, supported companies reported on average lower sales and lower return on assets, when compared to the control group. The remaining variables could not prove any statistically significant impact of the programme. Indicators measuring firm’s profitability (net profit, return on assets, and return on equity suggested a negative influence of the programme and the variable representing debt ratio further indicated that firms that were supported by the programme reported on average higher debt ratio in comparison with the control group. Several policy implications are discussed in the study.

  1. New evidence of neuroprotection by lactate after transient focal cerebral ischaemia: extended benefit after intracerebroventricular injection and efficacy of intravenous administration.

    Science.gov (United States)

    Berthet, Carole; Castillo, Ximena; Magistretti, Pierre J; Hirt, Lorenz

    2012-01-01

    Lactate protects mice against the ischaemic damage resulting from transient middle cerebral artery occlusion (MCAO) when administered intracerebroventricularly at reperfusion, yielding smaller lesion sizes and a better neurological outcome 48 h after ischaemia. We have now tested whether the beneficial effect of lactate is long-lasting and if lactate can be administered intravenously. Male ICR-CD1 mice were subjected to 15-min suture MCAO under xylazine + ketamine anaesthesia. Na L-lactate (2 µl of 100 mmol/l) or vehicle was administered intracerebroventricularly at reperfusion. The neurological deficit was evaluated using a composite deficit score based on the neurological score, the rotarod test and the beam walking test. Mice were sacrificed at 14 days. In a second set of experiments, Na L-lactate (1 µmol/g body weight) was administered intravenously into the tail vein at reperfusion. The neurological deficit and the lesion volume were measured at 48 h. Intracerebroventricularly injected lactate induced sustained neuroprotection shown by smaller neurological deficits at 7 days (median = 0, min = 0, max = 3, n = 7 vs. median = 2, min = 1, max = 4.5, n = 5, p mouse brain against ischaemic damage when supplied intracerebroventricularly during reperfusion with behavioural and histological benefits persisting 2 weeks after ischaemia. Importantly, lactate also protects after systemic intravenous administration, a more suitable route of administration in a clinical emergency setting. These findings provide further steps to bring this physiological, commonly available and inexpensive neuroprotectant closer to clinical translation for stroke. Copyright © 2012 S. Karger AG, Basel.

  2. Genetic and Antigenic Evidence Supports the Separation of Hepatozoon canis and Hepatozoon americanum at the Species Level

    OpenAIRE

    Baneth, Gad; Barta, John R.; Shkap, Varda; Martin, Donald S.; Macintire, Douglass K.; Vincent-Johnson, Nancy

    2000-01-01

    Recognition of Hepatozoon canis and Hepatozoon americanum as distinct species was supported by the results of Western immunoblotting of canine anti-H. canis and anti-H. americanum sera against H. canis gamonts. Sequence analysis of 368 bases near the 3′ end of the 18S rRNA gene from each species revealed a pairwise difference of 13.59%.

  3. Risk Aversion and Support for Merit Pay: Theory and Evidence from Minnesota's Q Comp Program. Working Paper #09-05

    Science.gov (United States)

    Nadler, Carl; Wiswall, Matthew

    2009-01-01

    Recent research attributes the lack of merit pay in teaching to the resistance of teachers. This paper examines whether the structure of merit pay affects the types of teachers who support it. We develop a model of the relative utility teachers receive from merit pay versus the current fixed schedule of raises. We show that if teachers are risk…

  4. Use of Evidence-Based Practice Resources and Empirically Supported Treatments for Posttraumatic Stress Disorder among University Counseling Center Psychologists

    Science.gov (United States)

    Juel, Morgen Joray

    2012-01-01

    In the present study, an attempt was made to determine the degree to which psychologists at college and university counseling centers (UCCs) utilized empirically supported treatments with their posttraumatic stress disorder (PTSD) clients. In addition, an attempt was made to determine how frequently UCC psychologists utilized a number of…

  5. Distant from input: Evidence of regions within the default mode network supporting perceptually-decoupled and conceptually-guided cognition.

    Science.gov (United States)

    Murphy, Charlotte; Jefferies, Elizabeth; Rueschemeyer, Shirley-Ann; Sormaz, Mladen; Wang, Hao-Ting; Margulies, Daniel S; Smallwood, Jonathan

    2018-05-01

    The default mode network supports a variety of mental operations such as semantic processing, episodic memory retrieval, mental time travel and mind-wandering, yet the commonalities between these functions remains unclear. One possibility is that this system supports cognition that is independent of the immediate environment; alternatively or additionally, it might support higher-order conceptual representations that draw together multiple features. We tested these accounts using a novel paradigm that separately manipulated the availability of perceptual information to guide decision-making and the representational complexity of this information. Using task based imaging we established regions that respond when cognition combines both stimulus independence with multi-modal information. These included left and right angular gyri and the left middle temporal gyrus. Although these sites were within the default mode network, they showed a stronger response to demanding memory judgements than to an easier perceptual task, contrary to the view that they support automatic aspects of cognition. In a subsequent analysis, we showed that these regions were located at the extreme end of a macroscale gradient, which describes gradual transitions from sensorimotor to transmodal cortex. This shift in the focus of neural activity towards transmodal, default mode, regions might reflect a process of where the functional distance from specific sensory enables conceptually rich and detailed cognitive states to be generated in the absence of input. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Evidence for the Effectiveness of Visual Supports in Helping Children with Disabilities Access the Mainstream Primary School Curriculum

    Science.gov (United States)

    Foster-Cohen, Susan; Mirfin-Veitch, Brigit

    2017-01-01

    Removing barriers to learning for children with mild to moderate disabilities in mainstream primary classrooms calls for creative approaches that exploit the cognitive and sensory strengths of each child. Although their efficacy has not been fully explored, pictorial, symbolic and written supports are often used with the intention of helping…

  7. Compiling an Evidence-Based Improvement Plan for the Support of Distance-Education Students at a Southern African University

    Science.gov (United States)

    Makhakhane, Bothephana; Wilkinson, Annette C.; Ndeya-Ndereya, Charity N.

    2016-01-01

    This article illustrates how an event guide can be used to organise, systematise and prioritise the large amount of findings from an extensive study. The study aimed to enhance student support at a distance-education institute in a Southern African country (Lesotho). In this case study an improvement-oriented evaluation of the strengths,…

  8. The Effects of Principal's Leadership Style on Support for Innovation: Evidence from Korean Vocational High School Change

    Science.gov (United States)

    Park, Joo-Ho

    2012-01-01

    A climate of innovation and principal leadership in schools are regarded as significant factors in successfully implementing school change or innovation. Nevertheless, the relationship between the school climate supportive of innovation and the principal's leadership has rarely been addressed to determine whether schools successfully perform their…

  9. The Dopamine D2 Receptor Gene, Perceived Parental Support, and Adolescent Loneliness: Longitudinal Evidence for Gene-Environment Interactions

    Science.gov (United States)

    van Roekel, Eeske; Goossens, Luc; Scholte, Ron H. J.; Engels, Rutger C. M. E.; Verhagen, Maaike

    2011-01-01

    Background: Loneliness is a common problem in adolescence. Earlier research focused on genes within the serotonin and oxytocin systems, but no studies have examined the role of dopamine-related genes in loneliness. In the present study, we focused on the dopamine D2 receptor gene (DRD2). Methods: Associations among the DRD2, sex, parental support,…

  10. Perceived effectiveness of environmental decision support systems in participatory planning: Evidence from small groups of end-users

    NARCIS (Netherlands)

    Inman, D.; Blind, M.; Ribarova, I.; Krause, A.; Roosenschoon, O.R.; Kassahun, A.; Scholten, H.; Arampatzis, G.; Abrami, G.; McIntosh, B.S.; Jeffrey, P.

    2011-01-01

    The challenges associated with evaluating the effectiveness of environmental decision support systems (EDSS) based on the perceptions of only a small sample of end-users are well understood. Although methods adopted from Management Information Systems (MISs) evaluation research have benefited from

  11. Experimental Evidence that In Vivo Intracerebral Administration of L-2-Hydroxyglutaric Acid to Neonatal Rats Provokes Disruption of Redox Status and Histopathological Abnormalities in the Brain.

    Science.gov (United States)

    Ribeiro, Rafael Teixeira; Zanatta, Ângela; Amaral, Alexandre Umpierrez; Leipnitz, Guilhian; de Oliveira, Francine Hehn; Seminotti, Bianca; Wajner, Moacir

    2018-04-01

    Tissue accumulation of L-2-hydroxyglutaric acid (L-2-HG) is the biochemical hallmark of L-2-hydroxyglutaric aciduria (L-2-HGA), a rare neurometabolic inherited disease characterized by neurological symptoms and brain white matter abnormalities whose pathogenesis is not yet well established. L-2-HG was intracerebrally administered to rat pups at postnatal day 1 (P1) to induce a rise of L-2-HG levels in the central nervous system (CNS). Thereafter, we investigated whether L-2-HG in vivo administration could disturb redox homeostasis and induce brain histopathological alterations in the cerebral cortex and striatum of neonatal rats. L-2-HG markedly induced the generation of reactive oxygen species (increase of 2',7'-dichloroflurescein-DCFH-oxidation), lipid peroxidation (increase of malondialdehyde concentrations), and protein oxidation (increase of carbonyl formation and decrease of sulfhydryl content), besides decreasing the antioxidant defenses (reduced glutathione-GSH) and sulfhydryl content in the cerebral cortex. Alterations of the activities of various antioxidant enzymes were also observed in the cerebral cortex and striatum following L-2-HG administration. Furthermore, L-2-HG-induced lipid peroxidation and GSH decrease in the cerebral cortex were prevented by the antioxidant melatonin and by the classical antagonist of NMDA glutamate receptor MK-801, suggesting the involvement of reactive species and of overstimulation of NMDA receptor in these effects. Finally, L-2-HG provoked significant vacuolation and edema particularly in the cerebral cortex with less intense alterations in the striatum that were possibly associated with the unbalanced redox homeostasis caused by this metabolite. Taken together, it is presumed that these pathomechanisms may underlie the neurological symptoms and brain abnormalities observed in the affected patients.

  12. Narrative and evidence. How can case studies from the history of science support claims in the philosophy of science?

    Science.gov (United States)

    Kinzel, Katherina

    2015-02-01

    A common method for warranting the historical adequacy of philosophical claims is that of relying on historical case studies. This paper addresses the question as to what evidential support historical case studies can provide to philosophical claims and doctrines. It argues that in order to assess the evidential functions of historical case studies, we first need to understand the methodology involved in producing them. To this end, an account of historical reconstruction that emphasizes the narrative character of historical accounts and the theory-laden character of historical facts is introduced. The main conclusion of this paper is that historical case studies are able to provide philosophical claims with some evidential support, but that, due to theory-ladenness, their evidential import is restricted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Genetic and Antigenic Evidence Supports the Separation of Hepatozoon canis and Hepatozoon americanum at the Species Level

    Science.gov (United States)

    Baneth, Gad; Barta, John R.; Shkap, Varda; Martin, Donald S.; Macintire, Douglass K.; Vincent-Johnson, Nancy

    2000-01-01

    Recognition of Hepatozoon canis and Hepatozoon americanum as distinct species was supported by the results of Western immunoblotting of canine anti-H. canis and anti-H. americanum sera against H. canis gamonts. Sequence analysis of 368 bases near the 3′ end of the 18S rRNA gene from each species revealed a pairwise difference of 13.59%. PMID:10699047

  14. The Racial and Economic Context of Trump Support: Evidence for Threat, Identity, and Contact Effects in the 2016 Presidential Election

    OpenAIRE

    Tropp, Linda; Knowles, Eric

    2018-01-01

    Donald Trump's ascent to the Presidency of the United States defied the expectations of many social scientists, pundits, and laypeople. To date, most efforts to understand Trump's rise have focused on personality and demographic characteristics of White Americans. In contrast, the present work leverages a nationally representative sample of Whites to examine how contextual factors may have shaped support for Trump during the 2016 presidential primaries. Results reveal that neighborhood-level ...

  15. The Right Hemisphere Planum Temporale Supports Enhanced Visual Motion Detection Ability in Deaf People: Evidence from Cortical Thickness

    OpenAIRE

    Shiell, Martha M.; Champoux, Fran?ois; Zatorre, Robert J.

    2016-01-01

    After sensory loss, the deprived cortex can reorganize to process information from the remaining modalities, a phenomenon known as cross-modal reorganization. In blind people this cross-modal processing supports compensatory behavioural enhancements in the nondeprived modalities. Deaf people also show some compensatory visual enhancements, but a direct relationship between these abilities and cross-modally reorganized auditory cortex has only been established in an animal model, the congenita...

  16. Social support, social strain and inflammation: Evidence from a national longitudinal study of U.S. adults

    Science.gov (United States)

    Yang, Yang Claire; Schorpp, Kristen; Harris, Kathleen Mullan

    2014-01-01

    Social relationships have long been held to have powerful effects on health and survival, but it remains unclear whether such associations differ by function and domain of relationships over time and what biophysiological mechanisms underlie these links. This study addressed these gaps by examining the longitudinal associations of persistent relationship quality across a ten year span with a major indicator of immune function. Specifically, we examined how perceived social support and social strain from relationships with family, friends, and spouse at a prior point in time are associated with subsequent risks of inflammation, as assessed by overall inflammation burden comprised of five markers (C-reactive protein, interleukin-6, fibrinogen, E-selectin, and intracellular adhesion molecule-1) in a national longitudinal study of 647 adults from the Midlife Development in the United States (1995–2009). Results from multivariate regression analysis show that (1) support from family, friends, and spouse modestly protected against risks of inflammation; (2) family, friend, and total social strain substantially increased risks of inflammation; and (3) the negative associations of social strain were stronger than the positive associations of social support with inflammation. The findings highlight the importance of enriched conceptualizations, measures, and longitudinal analyses of both social and biological stress processes to elucidate the complex pathways linking social relationships to health and illness. PMID:24607674

  17. A Universal Velocity Dispersion Profile for Pressure Supported Systems: Evidence for MONDian Gravity across Seven Orders of Magnitude in Mass

    Energy Technology Data Exchange (ETDEWEB)

    Durazo, R.; Hernandez, X.; Sánchez, S. F. [Instituto de Astronomía, Universidad Nacional Autónoma de México, Apartado Postal 70-264 C.P. 04510 México D.F., México (Mexico); Sodi, B. Cervantes [Instituto de Radioastronomía y Astrofísica, Universidad Nacional Autónoma de México, Campus Morelia, A.P. 3-72, C.P. 58089 Michoacán, México (Mexico)

    2017-03-10

    For any MONDian extended theory of gravity where the rotation curves of spiral galaxies are explained through a change in physics rather than the hypothesis of dark matter, a generic dynamical behavior is expected for pressure supported systems: an outer flattening of the velocity dispersion profile occurring at a characteristic radius, where both the amplitude of this flat velocity dispersion and the radius at which it appears are predicted to show distinct scalings with the total mass of the system. By carefully analyzing the dynamics of globular clusters and elliptical galaxies, we are able to significantly extend the astronomical diversity of objects in which MONDian gravity has been tested, from spiral galaxies to the much larger mass range covered by pressure supported systems. We show that a universal projected velocity dispersion profile accurately describes various classes of pressure supported systems, and further, that the expectations of extended gravity are met across seven orders of magnitude in mass. These observed scalings are not expected under dark matter cosmology, and would require particular explanations tuned at the scales of each distinct astrophysical system.

  18. Evidence of the paradoxical effect of social network support: A study among Filipino domestic workers in China.

    Science.gov (United States)

    Mendoza, Norman B; Mordeno, Imelu G; Latkin, Carl A; Hall, Brian J

    2017-09-01

    Labor migrants are at an increased risk for poor mental health. Post-migration stressors contribute significantly to this risk. Social network supports are vitally important to protect health but little is known about the role of social network supports among labor migrants. The current study evaluated the role of migration stressors on poor mental health among Filipino female domestic workers (FDW) and whether family and friend social network support (SNS) modified this relationship. Data were collected from 261 FDWs in Macau, China from May to September 2013. Hierarchical multiple regression was conducted to test for direct and moderating effects of social networks on psychological distress. Post-migration stress was associated with increased anxiety, depression, somatization, and post-traumatic stress disorder symptoms. SNS from family was not associated with the four psychological symptoms nor did it modify the association between stress and these symptoms. SNS from friends was positively associated with these symptoms, and significantly moderated the relationship between stress and these symptoms. Counterintuitive to the known buffering effects of SNS, greater SNS was associated with greater psychological symptoms among FDWs exposed to post-migration stressors. The present findings suggest that reliance on SNS to cope with post-migration stressors may worsen psychological distress. Copyright © 2017. Published by Elsevier B.V.

  19. Transcriptome-derived evidence supports recent polyploidization and a major phylogeographic division in Trithuria submersa (Hydatellaceae, Nymphaeales).

    Science.gov (United States)

    Marques, Isabel; Montgomery, Sean A; Barker, Michael S; Macfarlane, Terry D; Conran, John G; Catalán, Pilar; Rieseberg, Loren H; Rudall, Paula J; Graham, Sean W

    2016-04-01

    Relatively little is known about species-level genetic diversity in flowering plants outside the eudicots and monocots, and it is often unclear how to interpret genetic patterns in lineages with whole-genome duplications. We addressed these issues in a polyploid representative of Hydatellaceae, part of the water-lily order Nymphaeales. We examined a transcriptome of Trithuria submersa for evidence of recent whole-genome duplication, and applied transcriptome-derived microsatellite (expressed-sequence tag simple-sequence repeat (EST-SSR)) primers to survey genetic variation in populations across its range in mainland Australia. A transcriptome-based Ks plot revealed at least one recent polyploidization event, consistent with fixed heterozygous genotypes representing underlying sets of homeologous loci. A strong genetic division coincides with a trans-Nullarbor biogeographic boundary. Patterns of 'allelic' variation (no more than two variants per EST-SSR genotype) and recently published chromosomal evidence are consistent with the predicted polyploidization event and substantial homozygosity underlying fixed heterozygote SSR genotypes, which in turn reflect a selfing mating system. The Nullarbor Plain is a barrier to gene flow between two deep lineages of T. submersa that may represent cryptic species. The markers developed here should also be useful for further disentangling species relationships, and provide a first step towards future genomic studies in Trithuria. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.

  20. Real-World Evidence In Support Of Precision Medicine: Clinico-Genomic Cancer Data As A Case Study.

    Science.gov (United States)

    Agarwala, Vineeta; Khozin, Sean; Singal, Gaurav; O'Connell, Claire; Kuk, Deborah; Li, Gerald; Gossai, Anala; Miller, Vincent; Abernethy, Amy P

    2018-05-01

    The majority of US adult cancer patients today are diagnosed and treated outside the context of any clinical trial (that is, in the real world). Although these patients are not part of a research study, their clinical data are still recorded. Indeed, data captured in electronic health records form an ever-growing, rich digital repository of longitudinal patient experiences, treatments, and outcomes. Likewise, genomic data from tumor molecular profiling are increasingly guiding oncology care. Linking real-world clinical and genomic data, as well as information from other co-occurring data sets, could create study populations that provide generalizable evidence for precision medicine interventions. However, the infrastructure required to link, ensure quality, and rapidly learn from such composite data is complex. We outline the challenges and describe a novel approach to building a real-world clinico-genomic database of patients with cancer. This work represents a case study in how data collected during routine patient care can inform precision medicine efforts for the population at large. We suggest that health policies can promote innovation by defining appropriate uses of real-world evidence, establishing data standards, and incentivizing data sharing.

  1. Redesigning Radiotherapy Quality Assurance: Opportunities to Develop an Efficient, Evidence-Based System to Support Clinical Trials

    Science.gov (United States)

    Bekelman, Justin E.; Deye, James A.; Vikram, Bhadrasain; Bentzen, Soren M.; Bruner, Deborah; Curran, Walter J.; Dignam, James; Efstathiou, Jason A.; FitzGerald, T. J.; Hurkmans, Coen; Ibbott, Geoffrey S.; Lee, J. Jack; Merchant, Timothy E.; Michalski, Jeff; Palta, Jatinder R.; Simon, Richard; Ten Haken, Randal K.; Timmerman, Robert; Tunis, Sean; Coleman, C. Norman; Purdy, James

    2012-01-01

    Background In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute (NCI) sponsored a two day workshop to examine the challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Methods Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. Lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities like proton beam therapy, and the international harmonization of clinical trial QA. Results Four recommendations were made: 1) Develop a tiered (and more efficient) system for radiotherapy QA and tailor intensity of QA to clinical trial objectives. Tiers include (i) general credentialing, (ii) trial specific credentialing, and (iii) individual case review; 2) Establish a case QA repository; 3) Develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and 4) Explore the feasibility of consolidating clinical trial QA in the United States. Conclusion Radiotherapy QA may impact clinical trial accrual, cost, outcomes and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based. PMID:22425219

  2. Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare.

    Science.gov (United States)

    Dolan, James G

    2010-01-01

    Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers.Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine "hard data" with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings.The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP).

  3. Learning Cassandra for administrators

    CERN Document Server

    Parthasarathy, Vijay

    2013-01-01

    This book is a practical, hands-on guide, taking the reader from the basics of using Cassandra though to the installation and the running.Learning Cassandra for Administrators is for administrators who manage a large deployment of Cassandra clusters, and support engineers who would like to install the monitoring tools and who are also in charge of making sure the cluster stays the same, ensuring that the service is always up and running.

  4. Integration of Administrative, Clinical, and Environmental Data to Support the Management of Type 2 Diabetes Mellitus: From Satellites to Clinical Care.

    Science.gov (United States)

    Dagliati, Arianna; Marinoni, Andrea; Cerra, Carlo; Decata, Pasquale; Chiovato, Luca; Gamba, Paolo; Bellazzi, Riccardo

    2015-12-01

    A very interesting perspective of "big data" in diabetes management stands in the integration of environmental information with data gathered for clinical and administrative purposes, to increase the capability of understanding spatial and temporal patterns of diseases. Within the MOSAIC project, funded by the European Union with the goal to design new diabetes analytics, we have jointly analyzed a clinical-administrative dataset of nearly 1.000 type 2 diabetes patients with environmental information derived from air quality maps acquired from remote sensing (satellite) data. Within this context we have adopted a general analysis framework able to deal with a large variety of temporal, geo-localized data. Thanks to the exploitation of time series analysis and satellite images processing, we studied whether glycemic control showed seasonal variations and if they have a spatiotemporal correlation with air pollution maps. We observed a link between the seasonal trends of glycated hemoglobin and air pollution in some of the considered geographic areas. Such findings will need future investigations for further confirmation. This work shows that it is possible to successfully deal with big data by implementing new analytics and how their exploration may provide new scenarios to better understand clinical phenomena. © 2015 Diabetes Technology Society.

  5. Comparing a Mobile Decision Support System Versus the Use of Printed Materials for the Implementation of an Evidence-Based Recommendation: Protocol for a Qualitative Evaluation.

    Science.gov (United States)

    Camacho, Jhon; Medina Ch, Ana María; Landis-Lewis, Zach; Douglas, Gerald; Boyce, Richard

    2018-04-13

    The distribution of printed materials is the most frequently used strategy to disseminate and implement clinical practice guidelines, although several studies have shown that the effectiveness of this approach is modest at best. Nevertheless, there is insufficient evidence to support the use of other strategies. Recent research has shown that the use of computerized decision support presents a promising approach to address some aspects of this problem. The aim of this study is to provide qualitative evidence on the potential effect of mobile decision support systems to facilitate the implementation of evidence-based recommendations included in clinical practice guidelines. We will conduct a qualitative study with two arms to compare the experience of primary care physicians while they try to implement an evidence-based recommendation in their clinical practice. In the first arm, we will provide participants with a printout of the guideline article containing the recommendation, while in the second arm, we will provide participants with a mobile app developed after formalizing the recommendation text into a clinical algorithm. Data will be collected using semistructured and open interviews to explore aspects of behavioral change and technology acceptance involved in the implementation process. The analysis will be comprised of two phases. During the first phase, we will conduct a template analysis to identify barriers and facilitators in each scenario. Then, during the second phase, we will contrast the findings from each arm to propose hypotheses about the potential impact of the system. We have formalized the narrative in the recommendation into a clinical algorithm and have developed a mobile app. Data collection is expected to occur during 2018, with the first phase of analysis running in parallel. The second phase is scheduled to conclude in July 2019. Our study will further the understanding of the role of mobile decision support systems in the implementation

  6. FCJ-201 Visual Evidence from Above: Assessing the Value of Earth Observation Satellites for Supporting Human Rights

    Directory of Open Access Journals (Sweden)

    Tanya Notley

    2016-03-01

    Full Text Available Public access to data collected by remote sensing Earth Observation Satellites has, until recently, been very limited. Now, citizens and rights advocacy groups are increasingly utilising satellite-collected images to interrogate justice issues; to document, prevent and verify rights abuses; and to imagine and propose social change. Yet while other communication technologies have received substantial critical analysis regarding their value as tools of social justice, activism and resistance, satellites have received comparatively scant attention. This article examines the uses of satellite-collected images in human rights contexts including the opportunities, challenges and risks they pose. We conclude this examination by arguing that if satellites are to be used effectively to collect evidence from above by rights advocates, greater attention to and capacity for ensuring accountability from below is required.

  7. The Weight of Evidence Does Not Support the Listing of Styrene as “Reasonably Anticipated to be a Human Carcinogen” in NTP's Twelfth Report on Carcinogens

    Science.gov (United States)

    Rhomberg, Lorenz R.; Goodman, Julie E.; Prueitt, Robyn L.

    2013-01-01

    Styrene was listed as “reasonably anticipated to be a human carcinogen” in the twelfth edition of the National Toxicology Program's Report on Carcinogens based on what we contend are erroneous findings of limited evidence of carcinogenicity in humans, sufficient evidence of carcinogenicity in experimental animals, and supporting mechanistic data. The epidemiology studies show no consistent increased incidence of, or mortality from, any type of cancer. In animal studies, increased incidence rates of mostly benign tumors have been observed only in certain strains of one species (mice) and at one tissue site (lung). The lack of concordance of tumor incidence and tumor type among animals (even within the same species) and humans indicates that there has been no particular cancer consistently observed among all available studies. The only plausible mechanism for styrene-induced carcinogenesis—a non-genotoxic mode of action that is specific to the mouse lung—is not relevant to humans. As a whole, the evidence does not support the characterization of styrene as “reasonably anticipated to be a human carcinogen,” and styrene should not be listed in the Report on Carcinogens. PMID:23335843

  8. Assessing the ability of health information systems in hospitals to support evidence-informed decisions in Kenya

    Directory of Open Access Journals (Sweden)

    Elesban Kihuba

    2014-07-01

    Full Text Available Background: Hospital management information systems (HMIS is a key component of national health information systems (HIS, and actions required of hospital management to support information generation in Kenya are articulated in specific policy documents. We conducted an evaluation of core functions of data generation and reporting within hospitals in Kenya to facilitate interpretation of national reports and to provide guidance on key areas requiring improvement to support data use in decision making. Design: The survey was a cross-sectional, cluster sample study conducted in 22 hospitals in Kenya. The statistical analysis was descriptive with adjustment for clustering. Results: Most of the HMIS departments complied with formal guidance to develop departmental plans. However, only a few (3/22 had carried out a data quality audit in the 12 months prior to the survey. On average 3% (range 1–8% of the total hospital income was allocated to the HMIS departments. About half of the records officer positions were filled and about half (13/22 of hospitals had implemented some form of electronic health record largely focused on improving patient billing and not linked to the district HIS. Completeness of manual patient registers varied, being 90% (95% CI 80.1–99.3%, 75.8% (95% CI 68.7–82.8%, and 58% (95% CI 50.4–65.1% in maternal child health clinic, maternity, and pediatric wards, respectively. Vital events notification rates were low with 25.7, 42.6, and 71.3% of neonatal deaths, infant deaths, and live births recorded, respectively. Routine hospital reports suggested slight over-reporting of live births and under-reporting of fresh stillbirths and neonatal deaths. Conclusions: Study findings indicate that the HMIS does not deliver quality data. Significant constraints exist in data quality assurance, supervisory support, data infrastructure in respect to information and communications technology application, human resources, financial

  9. Flat and complex temperate reefs provide similar support for fish: Evidence for a unimodal species-habitat relationship.

    Directory of Open Access Journals (Sweden)

    Avery B Paxton

    Full Text Available Structural complexity, a form of habitat heterogeneity, influences the structure and function of ecological communities, generally supporting increased species density, richness, and diversity. Recent research, however, suggests the most complex habitats may not harbor the highest density of individuals and number of species, especially in areas with elevated human influence. Understanding nuances in relationships between habitat heterogeneity and ecological communities is warranted to guide habitat-focused conservation and management efforts. We conducted fish and structural habitat surveys of thirty warm-temperate reefs on the southeastern US continental shelf to quantify how structural complexity influences fish communities. We found that intermediate complexity maximizes fish abundance on natural and artificial reefs, as well as species richness on natural reefs, challenging the current paradigm that abundance and other fish community metrics increase with increasing complexity. Naturally occurring rocky reefs of flat and complex morphologies supported equivalent abundance, biomass, species richness, and community composition of fishes. For flat and complex morphologies of rocky reefs to receive equal consideration as essential fish habitat (EFH, special attention should be given to detecting pavement type rocky reefs because their ephemeral nature makes them difficult to detect with typical seafloor mapping methods. Artificial reefs of intermediate complexity also maximized fish abundance, but human-made structures composed of low-lying concrete and metal ships differed in community types, with less complex, concrete structures supporting lower numbers of fishes classified largely as demersal species and metal ships protruding into the water column harboring higher numbers of fishes, including more pelagic species. Results of this study are essential to the process of evaluating habitat function provided by different types and shapes of

  10. Iron isotopes in ancient and modern komatiites: Evidence in support of an oxidised mantle from Archean to present

    Science.gov (United States)

    Hibbert, K. E. J.; Williams, H. M.; Kerr, A. C.; Puchtel, I. S.

    2012-03-01

    The mantle of the modern Earth is relatively oxidised compared to the initially reducing conditions inferred for core formation. The timing of the oxidation of the mantle is not conclusively resolved but has important implications for the timing of the development of the hydrosphere and atmosphere. In order to examine the timing of this oxidation event, we present iron isotope data from three exceptionally well preserved komatiite localities, Belingwe (2.7 Ga), Vetreny (2.4 Ga) and Gorgona (0.089 Ga). Measurements of Fe isotope compositions of whole-rock samples are complemented by the analysis of olivine, spinel and pyroxene separates. Bulk-rock and olivine Fe isotope compositions (δ57Fe) define clear linear correlations with indicators of magmatic differentiation (Mg#, Cr#). The mean Fe isotope compositions of the 2.7-2.4 Ga and 0.089 Ga samples are statistically distinct and this difference can be explained by greater extent of partial melting represented by the older samples and higher mantle ambient temperatures in the Archean and early Proterozoic relative to the present day. Significantly, samples of all ages define continuous positive linear correlations between bulk rock δ57Fe and V/Sc and δ57Fe and V, and between V/Sc and V with TiO2, providing evidence for the incompatible behaviour of V (relative to Sc) and of isotopically heavy Fe. Partial melting models calculated using partition coefficients for V at oxygen fugacities (fO2s) of 0 and + 1 relative to the fayalite-magnetite-quartz buffer (FMQ) best match the data arrays, which are defined by all samples, from late Archean to Tertiary. These data, therefore, provide evidence for komatiite generation under moderately oxidising conditions since the late Archean, and argue against a change in mantle fO2 concomitant with atmospheric oxygenation at ~ 2.4 Ga.

  11. Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm.

    Science.gov (United States)

    Friedli, Natalie; Stanga, Zeno; Culkin, Alison; Crook, Martin; Laviano, Alessandro; Sobotka, Lubos; Kressig, Reto W; Kondrup, Jens; Mueller, Beat; Schuetz, Philipp

    2018-03-01

    Refeeding syndrome (RFS) can be a life-threatening metabolic condition after nutritional replenishment if not recognized early and treated adequately. There is a lack of evidence-based treatment and monitoring algorithm for daily clinical practice. The aim of the study was to propose an expert consensus guideline for RFS for the medical inpatient (not including anorexic patients) regarding risk factors, diagnostic criteria, and preventive and therapeutic measures based on a previous systematic literature search. Based on a recent qualitative systematic review on the topic, we developed clinically relevant recommendations as well as a treatment and monitoring algorithm for the clinical management of inpatients regarding RFS. With international experts, these recommendations were discussed and agreement with the recommendation was rated. Upon hospital admission, we recommend the use of specific screening criteria (i.e., low body mass index, large unintentional weight loss, little or no nutritional intake, history of alcohol or drug abuse) for risk assessment regarding the occurrence of RFS. According to the patient's individual risk for RFS, a careful start of nutritional therapy with a stepwise increase in energy and fluids goals and supplementation of electrolyte and vitamins, as well as close clinical monitoring, is recommended. We also propose criteria for the diagnosis of imminent and manifest RFS with practical treatment recommendations with adoption of the nutritional therapy. Based on the available evidence, we developed a practical algorithm for risk assessment, treatment, and monitoring of RFS in medical inpatients. In daily routine clinical care, this may help to optimize and standardize the management of this vulnerable patient population. We encourage future quality studies to further refine these recommendations. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Will Governmental Incentives in Developing Countries Support Companies to Innovate More? Evidences from Skin Care Patent Applications in Brazil

    Directory of Open Access Journals (Sweden)

    Ivan Domicio da Silva Souza

    2014-09-01

    Full Text Available Recent Brazilian Governments have provided incentives to support domestic innovation; however, some claim that the country has set conflicting policies towards innovation, industrial property and biodiversity exploitation. After an analysis of patent applications filled in the Brazilian National Institute of Industrial Property, we observed that current governmental measures have not performed as expected, at least in the skin care industry. Throughout the paper we discuss plausible reasons why this sector has not managed to innovate more, reasons that may affect other businesses as well. This case is exemplary to developing economies that have implemented or are in the process of renewing their innovation policies.

  13. Offentlig administration

    DEFF Research Database (Denmark)

    Nielsen, Elof Nellemann; Rehr, Preben René

    En undervisningsbog der henvender sig til administrationsbacheloruddannelsen. Kapitlerne er inddelt efter modulerne på uddannelsen og indeholder derfor elementer af administration, forvaltning, økonomistyring, innovation, samfundsvidenskabelige metoder og politisk styrede organisationer.......En undervisningsbog der henvender sig til administrationsbacheloruddannelsen. Kapitlerne er inddelt efter modulerne på uddannelsen og indeholder derfor elementer af administration, forvaltning, økonomistyring, innovation, samfundsvidenskabelige metoder og politisk styrede organisationer....

  14. What works for wellbeing in culture and sport? Report of a DELPHI process to support coproduction and establish principles and parameters of an evidence review.

    Science.gov (United States)

    Daykin, Norma; Mansfield, Louise; Payne, Annette; Kay, Tess; Meads, Catherine; D'Innocenzo, Giorgia; Burnett, Adele; Dolan, Paul; Julier, Guy; Longworth, Louise; Tomlinson, Alan; Testoni, Stefano; Victor, Christina

    2017-09-01

    There is a growing recognition of the ways in which culture and sport can contribute to wellbeing. A strong evidence base is needed to support innovative service development and a 3-year research programme is being undertaken to capture best evidence of wellbeing impacts and outcomes of cultural and sporting activities in order to inform UK policy and practice. This article provides an overview of methods and findings from an initial coproduction process with key stakeholders that sought to explore and agree principles and parameters of the evidence review for culture, sport and wellbeing (CSW). A two-stage DELPHI process was conducted with a purposeful sample of 57 stakeholders between August and December 2015. Participants were drawn from a range of culture and sport organisations and included commissioners and managers, policy makers, representatives of service delivery organisations (SDOs) and scholars. The DELPHI 1 questionnaire was developed from extensive consultation in July and August 2015. It explored definitions of wellbeing, the role of evidence, quality assessment, and the culture and sport populations, settings and interventions that are most likely to deliver wellbeing outcomes. Following further consultation, the results, presented as a series of ranked statements, were sent back to participants (DELPHI 2), which allowed them to reflect on and, if they wished, express agreement or disagreement with the emerging consensus. A total of 40 stakeholders (70.02%) responded to the DELPHI questionnaires. DELPHI 1 mapped areas of agreement and disagreement, confirmed in DELPHI 2. The exercise drew together the key priorities for the CSW evidence review. The DELPHI process, in combination with face-to-face deliberation, enabled stakeholders to engage in complex discussion and express nuanced priorities while also allowing the group to come to an overall consensus and agree outcomes. The results will inform the CSW evidence review programme until its

  15. Recommendations on evidence needed to support measurement equivalence between electronic and paper-based patient-reported outcome (PRO) measures: ISPOR ePRO Good Research Practices Task Force report.

    Science.gov (United States)

    Coons, Stephen Joel; Gwaltney, Chad J; Hays, Ron D; Lundy, J Jason; Sloan, Jeff A; Revicki, Dennis A; Lenderking, William R; Cella, David; Basch, Ethan

    2009-06-01

    Patient-reported outcomes (PROs) are the consequences of disease and/or its treatment as reported by the patient. The importance of PRO measures in clinical trials for new drugs, biological agents, and devices was underscored by the release of the US Food and Drug Administration's draft guidance for industry titled "Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims." The intent of the guidance was to describe how the FDA will evaluate the appropriateness and adequacy of PRO measures used as effectiveness end points in clinical trials. In response to the expressed need of ISPOR members for further clarification of several aspects of the draft guidance, ISPOR's Health Science Policy Council created three task forces, one of which was charged with addressing the implications of the draft guidance for the collection of PRO data using electronic data capture modes of administration (ePRO). The objective of this report is to present recommendations from ISPOR's ePRO Good Research Practices Task Force regarding the evidence necessary to support the comparability, or measurement equivalence, of ePROs to the paper-based PRO measures from which they were adapted. The task force was composed of the leadership team of ISPOR's ePRO Working Group and members of another group (i.e., ePRO Consensus Development Working Group) that had already begun to develop recommendations regarding ePRO good research practices. The resulting task force membership reflected a broad array of backgrounds, perspectives, and expertise that enriched the development of this report. The prior work became the starting point for the Task Force report. A subset of the task force members became the writing team that prepared subsequent iterations of the report that were distributed to the full task force for review and feedback. In addition, review beyond the task force was sought and obtained. Along with a presentation and discussion period at an ISPOR meeting

  16. Strong evidence for terrestrial support of zooplankton in small lakes based on stable isotopes of carbon, nitrogen, and hydrogen

    Science.gov (United States)

    Cole, J.J.; Carpenter, S.R.; Kitchell, J.; Pace, M.L.; Solomon, C.T.; Weidel, B.

    2011-01-01

    Cross-ecosystem subsidies to food webs can alter metabolic balances in the receiving (subsidized) system and free the food web, or particular consumers, from the energetic constraints of local primary production. Although cross-ecosystem subsidies between terrestrial and aquatic systems have been well recognized for benthic organisms in streams, rivers, and the littoral zones of lakes, terrestrial subsidies to pelagic consumers are more difficult to demonstrate and remain controversial. Here, we adopt a unique approach by using stable isotopes of H, C, and N to estimate terrestrial support to zooplankton in two contrasting lakes. Zooplankton (Holopedium, Daphnia, and Leptodiaptomus) are comprised of ???20-40% of organic material of terrestrial origin. These estimates are as high as, or higher than, prior measures obtained by experimentally manipulating the inorganic 13C content of these lakes to augment the small, natural contrast in 13C between terrestrial and algal photosynthesis. Our study gives credence to a growing literature, which we review here, suggesting that significant terrestrial support of pelagic crustaceans (zooplankton) is widespread.

  17. Implementing a Multi-Tiered System of Support (MTSS): Collaboration between School Psychologists and Administrators to Promote Systems-Level Change

    Science.gov (United States)

    Eagle, John W.; Dowd-Eagle, Shannon E.; Snyder, Andrew; Holtzman, Elizabeth Gibbons

    2015-01-01

    Current educational reform mandates the implementation of school-based models for early identification and intervention, progress monitoring, and data-based assessment of student progress. This article provides an overview of interdisciplinary collaboration for systems-level consultation within a Multi-Tiered System of Support (MTSS) framework.…

  18. Positive Behavior Support in Schools (PBSIS): An Administrative Perspective on the Implementation of a Comprehensive School-Wide Intervention in an Urban Charter School

    Science.gov (United States)

    Christofferson, Remi Dabney; Callahan, Kathe

    2015-01-01

    This research explores the implementation of a school-wide intervention program that was designed to foster and instill intrinsic values based on an external reward system. The Positive Behavior Support in Schools (PBSIS) is an intervention intended to improve the climate of schools using system-wide positive behavioral interventions to discourage…

  19. Evidence and possible mechanism for the permanent decline in tuberoinfundibular dopaminergic neuronal activity after chronic estradiol administration in Fischer 233 rats

    International Nuclear Information System (INIS)

    Gottschall, P.E.

    1986-01-01

    The objective of these studies was to determine if the decline in tuberoinfundibular dopaminergic (TIDA) neuronal function observed during chronic estradiol-17-β (E 2 ) administration persisted after E 2 was removed. Ovariectomized (OVX) Fischer 344 rats were implanted with an E 2 -containing Silastic capsule for 4 weeks. Anterior pituitary (AP) weight and serum prolactin was greatly increased at the end of the E 2 treatment, that persisted 4 and 26 weeks after E 2 was withdrawn. Ag the end of E 2 treatment and 4 weeks after E 2 was withdrawn, TIDA function, as evaluated by electrical stimulation of median eminence tissue in vitro after allowing for uptake of 3 H-DA, was decreased compared to OVX controls. In an attempt to elucidate the mechanism by which E 2 results in a permanent decline in TIDA function, F344 rats were given daily bromocryptine injections in addition to a 30-day E 2 treatment. TIDA neuronal release was reduced in both E 2 and E 2 and bromocryptine treated groups. However, by 30 days after discontinuing treatment only rats given E 2 alone showed a persistent decline in TIDA function. Since permanent damage to hypothalamic neurons by an enlarged AP was speculated to be the result of E 2 treatment, neurons which regulate other AP hormones may also be damaged. To evaluate this possibility, pulsatile release of prolactin, growth hormone (GH) and luteinizing hormone (LH) was evaluated in OVX control rats, chronically E 2 -treated rats, and rats 120 days after chronic E 2 treatment. Only the frequency of prolactin pulses, but not the frequency of GH and LH pulses, was reduced in rats 120 days after E 2 treatment. This suggests selectivity in the hypothalamic damage produced by the enlarged AP

  20. Development of an administrative record system and information repository system to support environmental cleanup at the Hanford Site in Richland, Washington

    International Nuclear Information System (INIS)

    Sprouse, B.S.

    1991-09-01

    The purpose of this paper is to describe the development of an administrative record (AR) file system for the Hanford Site in Richland, Washington. This paper will focus on the background of the AR system and its implementation at the Hanford Site; the types of documents to be included in an AR file; the management system used to develop and implement the AR system; the unique characteristics of the AR system and the role of the information repositories. The objective of this session is to present the methodology used in developing an AR and information repository system so that common hurdles from various sites can be addressed and resolved similarly. Therefore unnecessary effort does not have to be put forth to resolve the same issues over and over again. The concepts described can be applied to all federal facility sites with a minimum amount of modification and revision. 9 refs

  1. Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration.

    Science.gov (United States)

    Sullivan, Jennifer L; Adjognon, Omonyêlé L; Engle, Ryann L; Shin, Marlena H; Afable, Melissa K; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

    From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Anticipating potential pitfalls of

  2. Flood Risk and Probabilistic Benefit Assessment to Support Management of Flood-Prone Lands: Evidence From Candaba Floodplains, Philippines

    Science.gov (United States)

    Juarez, A. M.; Kibler, K. M.; Sayama, T.; Ohara, M.

    2016-12-01

    Flood management decision-making is often supported by risk assessment, which may overlook the role of coping capacity and the potential benefits derived from direct use of flood-prone land. Alternatively, risk-benefit analysis can support floodplain management to yield maximum socio-ecological benefits for the minimum flood risk. We evaluate flood risk-probabilistic benefit tradeoffs of livelihood practices compatible with direct human use of flood-prone land (agriculture/wild fisheries) and nature conservation (wild fisheries only) in Candaba, Philippines. Located north-west to Metro Manila, Candaba area is a multi-functional landscape that provides a temporally-variable mix of possible land uses, benefits and ecosystem services of local and regional value. To characterize inundation from 1.3- to 100-year recurrence intervals we couple frequency analysis with rainfall-runoff-inundation modelling and remotely-sensed data. By combining simulated probabilistic floods with both damage and benefit functions (e.g. fish capture and rice yield with flood intensity) we estimate potential damages and benefits over varying probabilistic flood hazards. We find that although direct human uses of flood-prone land are associated with damages, for all the investigated magnitudes of flood events with different frequencies, the probabilistic benefits ( 91 million) exceed risks by a large margin ( 33 million). Even considering risk, probabilistic livelihood benefits of direct human uses far exceed benefits provided by scenarios that exclude direct "risky" human uses (difference of 85 million). In addition, we find that individual coping strategies, such as adapting crop planting periods to the flood pulse or fishing rather than cultivating rice in the wet season, minimize flood losses ( 6 million) while allowing for valuable livelihood benefits ($ 125 million) in flood-prone land. Analysis of societal benefits and local capacities to cope with regular floods demonstrate the

  3. Supporting implementation of evidence-based behavioral interventions: the role of data liquidity in facilitating translational behavioral medicine.

    Science.gov (United States)

    Abernethy, Amy P; Wheeler, Jane L; Courtney, Paul K; Keefe, Francis J

    2011-03-01

    The advancement of translational behavioral medicine will require that we discover new methods of managing large volumes of data from disparate sources such as disease surveillance systems, public health systems, and health information systems containing patient-centered data informed by behavioral and social sciences. The term "liquidity," when applied to data, refers to its availability and free flow throughout human/computer interactions. In seeking to achieve liquidity, the focus is not on creating a single, comprehensive database or set of coordinated datasets, nor is it solely on developing the electronic health record as the "one-stop shopping" source of health-related data. Rather, attention is on ensuring the availability of secure data through the various methods of collecting and storing data currently existent or under development-so that these components of the health information infrastructure together support a liquid data system. The value of accessible, interoperable, high-volume, reliable, secure, and contextually appropriate data is becoming apparent in many areas of the healthcare system, and health information liquidity is currently viewed as an important component of a patient-centered healthcare system. The translation from research interventions to behavioral and psychosocial indicators challenges the designers of healthcare systems to include this new set of data in the correct context. With the intention of advancing translational behavioral medicine at the local level, "on the ground" in the clinical office and research institution, this commentary discusses data liquidity from the patient's and clinician's perspective, requirements for a liquid healthcare data system, and the ways in which data liquidity can support translational behavioral medicine.

  4. Preclinical evidence supporting the clinical development of central pattern generator-modulating therapies for chronic spinal cord-injured patients

    Directory of Open Access Journals (Sweden)

    Pierre eGuertin

    2014-05-01

    Full Text Available Ambulation or walking is one of the main gaits of locomotion. In terrestrial animals, it may be defined as a series of rhythmic and bilaterally coordinated movement of the limbs which creates a forward movement of the body. This applies regardless of the number of limbs - from arthropods with six or more limbs to bipedal primates. These fundamental similarities among species may explain why comparable neural systems and cellular properties have been found, thus far, to control in similar ways locomotor rhythm generation in most animal models. The aim of this article is to provide a comprehensive review of the known structural and functional features associated with central nervous system (CNS networks that are involved in the control of ambulation and other stereotyped motor patterns - specifically Central Pattern Generators (CPGs that produce basic rhythmic patterned outputs for locomotion, micturition, ejaculation, and defecation. Although there is compelling evidence of their existence in humans, CPGs have been most studied in reduced models including in vitro isolated preparations, genetically-engineered mice and spinal cord-transected animals. Compared with other structures of the CNS, the spinal cord is generally considered as being well-preserved phylogenetically. As such, most animal models of SCI should be considered as valuable tools for the development of novel pharmacological strategies aimed at modulating spinal activity and restoring corresponding functions in chronic spinal cord-injured patients.

  5. A Randomized Controlled Trial Provides Evidence to Support Aromatherapy to Minimize Anxiety in Women Undergoing Breast Biopsy.

    Science.gov (United States)

    Trambert, Renee; Kowalski, Mildred Ortu; Wu, Betty; Mehta, Nimisha; Friedman, Paul

    2017-10-01

    Aromatherapy has been used to reduce anxiety in a variety of settings, but usefulness associated with breast biopsies has not been documented. This study was conducted in women undergoing image-guided breast biopsy. We explored the use of two different aromatherapy scents, compared to placebo, aimed at reducing anxiety with the intent of generating new knowledge. This was a randomized, placebo-controlled study of two different types of external aromatherapy tabs (lavender-sandalwood and orange-peppermint) compared with a matched placebo-control delivery system. Anxiety was self-reported before and after undergoing a breast biopsy using the Spielberger State Anxiety Inventory Scale. Eighty-seven women participated in this study. There was a statistically significant reduction in self-reported anxiety with the use of the lavender-sandalwood aromatherapy tab compared with the placebo group (p = .032). Aromatherapy tabs reduced anxiety during image-guided breast biopsy. The completion of the biopsy provided some relief from anxiety in all groups. The use of aromatherapy tabs offers an evidence-based nursing intervention to improve adaptation and reduce anxiety for women undergoing breast biopsy. Lavender-sandalwood aromatherapy reduced anxiety and promoted adaptation more than orange-peppermint aromatherapy or placebo. © 2017 Sigma Theta Tau International.

  6. Reviewing the current evidence supporting early B-cells as the cellular origin of Merkel cell carcinoma.

    Science.gov (United States)

    Sauer, C M; Haugg, A M; Chteinberg, E; Rennspiess, D; Winnepenninckx, V; Speel, E-J; Becker, J C; Kurz, A K; Zur Hausen, A

    2017-08-01

    Merkel cell carcinoma (MCC) is a highly malignant skin cancer characterized by early metastases and poor survival. Although MCC is a rare malignancy, its incidence is rapidly increasing in the U.S. and Europe. The discovery of the Merkel cell polyomavirus (MCPyV) has enormously impacted our understanding of its etiopathogenesis and biology. MCCs are characterized by trilinear differentiation, comprising the expression of neuroendocrine, epithelial and B-lymphoid lineage markers. To date, it is generally accepted that the initial assumption of MCC originating from Merkel cells (MCs) is unlikely. This is owed to their post-mitotic character, absence of MCPyV in MCs and discrepant protein expression pattern in comparison to MCC. Evidence from mouse models suggests that epidermal/dermal stem cells might be of cellular origin in MCC. The recently formulated hypothesis of MCC originating from early B-cells is based on morphology, the consistent expression of early B-cell lineage markers and the finding of clonal immunoglobulin chain rearrangement in MCC cells. In this review we elaborate on the cellular ancestry of MCC, the identification of which could pave the way for novel and more effective therapeutic regimens. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  7. Scientific Evidence Supporting Policy Change: A Study on Secondhand Smoke Exposure in Non-smoking Areas of PC Rooms in Korea.

    Science.gov (United States)

    Hong, Soon-Yeol; Lim, Min Kyung; Yun, E Hwa; Park, Eun Young; Jeong, Bo Yoon; Yang, Wonho; Lee, Do-Hoon

    2016-04-01

    The objective of this study was to measure secondhand smoke (SHS) exposure in personal computer (PC) rooms with the purpose of determining the strength of scientific evidence supporting the legislative ban on smoking in PC rooms located in the Republic of Korea. From June to September 2012, particulate matter (PM2.5) and air nicotine concentration (ANC) were measured in the smoking and non-smoking areas of PC rooms in Goyang City, Korea. In 28 randomly sampled PC rooms, field investigators completed an observational questionnaire on building characteristics, smoking policies, and evidence of smoking. The geometric means (GM) of PM2.5 and ANC in smoking and non-smoking areas were compared. Evidence of smoking was identified in both the smoking and non-smoking areas of all PC rooms. The GMs of PM2.5 and ANC in both areas were high and did not differ significantly (174.77 μg/m(3) and 48.95 μg/m(3) in smoking areas; 93.38 μg/m(3) and 41.30 μg/m(3) in non-smoking areas). Overall PM2.5 concentrations were 5.5-fold higher than those listed in the World Health Organization guidelines. This study supported previous reports that a partial smoking ban did not protect individuals from SHS exposure. Furthermore, the results from our study suggest how research can support policy. Countries in which smoke-free policies are not yet comprehensive may find our results useful.

  8. An investigation into drug products withdrawn from the EU market between 2002 and 2011 for safety reasons and the evidence used to support the decision-making.

    Science.gov (United States)

    McNaughton, Rhian; Huet, Gwenaël; Shakir, Saad

    2014-01-15

    The objective of this study was to determine the nature of evidence used to support the withdrawal of marketing authorisations of drug products for safety reasons throughout the European Union (EU) between 2002 and 2011. Products withdrawn, either by a medicines agency or a marketing authorisation holder, during the period 2002-2011 were identified by conducting detailed searches of the WHO, the European Medicines Agency (EMA) and national medicines agency websites throughout the EU plus Norway, Iceland and Liechtenstein. The scientific evidence used to support the decision was identified from a search within PubMed, the EMA and national medicines agencies websites. Information about spontaneous case reports entered into EudraVigilance and unavailable on the EMA website was received by email from the EMA. 19 drugs were withdrawn from the market, throughout the EU, for safety reasons from 2002 to 2011. Case reports were cited in 95% of withdrawals (18/19) and case-control studies (4/19), cohort studies (4/19), randomised controlled trials (RCTs) (12/19) or meta-analysis (5/19) were cited in 63% of withdrawals (12/19). Cardiovascular events or disorders were the main reason for withdrawal (9/19), followed by hepatic disorders (4/19) and neurological or psychiatric disorders (4/19). This study has shown that the level of evidence used to support drug withdrawal has improved during the past 10 years, with an increased use of case-control studies, cohort studies, RCTs and meta-analyses. This research has demonstrated that such studies have contributed to decision-making in almost two-thirds of cases.

  9. How good are we at implementing evidence to support the management of birth related perineal trauma? A UK wide survey of midwifery practice

    Science.gov (United States)

    2012-01-01

    perform perineal repair all of the time. Two thirds of midwives (63.5%) felt confident to perform an episiotomy. Midwives qualified for 20 years or longer and those on more senior clinical grades were most likely to implement evidence based recommendations and feel confident about perineal management. Conclusions There are considerable gaps with implementation of evidence to support management of perineal trauma. PMID:22731799

  10. Synthetic Growth Hormone-Releasing Peptides (GHRPs: A Historical Appraisal of the Evidences Supporting Their Cytoprotective Effects

    Directory of Open Access Journals (Sweden)

    Jorge Berlanga-Acosta

    2017-02-01

    Full Text Available Background: Growth hormone-releasing peptides (GHRPs constitute a group of small synthetic peptides that stimulate the growth hormone secretion and the downstream axis activity. Mounting evidences since the early 1980s delineated unexpected pharmacological cardioprotective and cytoprotective properties for the GHRPs. However, despite intense basic pharmacological research, alternatives to prevent cell and tissue demise before lethal insults have remained as an empty niche in the clinical armamentarium. Here, we have rigorously reviewed the investigational development of GHRPs and their clinical niching perspectives. Methodology: PubMed/MEDLINE databases, including original research and review articles, were explored. The search design was date escalated from 1980 and included articles in English only. Results and Conclusions: GHRPs bind to two different receptors (GHS-R1a and CD36, which redundantly or independently exert relevant biological effects. GHRPs’ binding to CD36 activates prosurvival pathways such as PI-3K/AKT1, thus reducing cellular death. Furthermore, GHRPs decrease reactive oxygen species (ROS spillover, enhance the antioxidant defenses, and reduce inflammation. These cytoprotective abilities have been revealed in cardiac, neuronal, gastrointestinal, and hepatic cells, representing a comprehensive spectrum of protection of parenchymal organs. Antifibrotic effects have been attributed to some of the GHRPs by counteracting fibrogenic cytokines. In addition, GHRP family members have shown a potent myotropic effect by promoting anabolia and inhibiting catabolia. Finally, GHRPs exhibit a broad safety profile in preclinical and clinical settings. Despite these fragmented lines incite to envision multiple pharmacological uses for GHRPs, especially as a myocardial reperfusion damage-attenuating candidate, this family of “drugable” peptides awaits for a definitive clinical niche.

  11. Synthetic Growth Hormone-Releasing Peptides (GHRPs): A Historical Appraisal of the Evidences Supporting Their Cytoprotective Effects.

    Science.gov (United States)

    Berlanga-Acosta, Jorge; Abreu-Cruz, Angel; Herrera, Diana García-Del Barco; Mendoza-Marí, Yssel; Rodríguez-Ulloa, Arielis; García-Ojalvo, Ariana; Falcón-Cama, Viviana; Hernández-Bernal, Francisco; Beichen, Qu; Guillén-Nieto, Gerardo

    2017-01-01

    Growth hormone-releasing peptides (GHRPs) constitute a group of small synthetic peptides that stimulate the growth hormone secretion and the downstream axis activity. Mounting evidences since the early 1980s delineated unexpected pharmacological cardioprotective and cytoprotective properties for the GHRPs. However, despite intense basic pharmacological research, alternatives to prevent cell and tissue demise before lethal insults have remained as an empty niche in the clinical armamentarium. Here, we have rigorously reviewed the investigational development of GHRPs and their clinical niching perspectives. PubMed/MEDLINE databases, including original research and review articles, were explored. The search design was date escalated from 1980 and included articles in English only. GHRPs bind to two different receptors (GHS-R1a and CD36), which redundantly or independently exert relevant biological effects. GHRPs' binding to CD36 activates prosurvival pathways such as PI-3K/AKT1, thus reducing cellular death. Furthermore, GHRPs decrease reactive oxygen species (ROS) spillover, enhance the antioxidant defenses, and reduce inflammation. These cytoprotective abilities have been revealed in cardiac, neuronal, gastrointestinal, and hepatic cells, representing a comprehensive spectrum of protection of parenchymal organs. Antifibrotic effects have been attributed to some of the GHRPs by counteracting fibrogenic cytokines. In addition, GHRP family members have shown a potent myotropic effect by promoting anabolia and inhibiting catabolia. Finally, GHRPs exhibit a broad safety profile in preclinical and clinical settings. Despite these fragmented lines incite to envision multiple pharmacological uses for GHRPs, especially as a myocardial reperfusion damage-attenuating candidate, this family of "drugable" peptides awaits for a definitive clinical niche.

  12. Evidence supporting see-and-treat management of cervical intraepithelial neoplasia: a systematic review and meta-analysis.

    Science.gov (United States)

    Ebisch, R M F; Rovers, M M; Bosgraaf, R P; van der Pluijm-Schouten, H W; Melchers, W J G; van den Akker, P A J; Massuger, L F A G; Bekkers, R L M

    2016-01-01

    Studies of see-and-treat management of cervical intraepithelial neoplasia (CIN) vary in their inclusion criteria, resulting in a broad range of overtreatment rates. To determine overtreatment rates in see-and-treat management of women referred for colposcopy because of suspected CIN, in order to define circumstances supporting see-and-treat management. MEDLINE, EMBASE, and the Cochrane Library were searched from inception up to 12 May 2014. Studies of see-and-treat management in women with a reported cervical smear result, colposcopic impression, and histology result were included. Methodological quality was assessed with the Newcastle-Ottawa scale. We used the inverse variance method for pooling incidences, and a random-effects model was used to account for heterogeneity between studies. Overtreatment was defined as treatment in patients with no CIN or CIN1. Thirteen studies (n = 4611) were included. The overall overtreatment rate in women with a high-grade cervical smear and a high-grade colposcopic impression was 11.6% (95% CI 7.8-15.3%). The overtreatment rate in women with a high-grade cervical smear and low-grade colposcopic impression was 29.3% (95% CI 16.7-41.9%), and in the case of a low-grade smear and high-grade colposcopic impression it was 46.4% (95% CI 15.7-77.1%). In women with a low-grade smear and low-grade colposcopic impression, the overtreatment rate was 72.9% (95% CI 68.1-77.7%). The pooled overtreatment rate in women with a high-grade smear and high-grade colposcopic impression is at least comparable with the two-step procedure, which supports the use of see-and-treat management in this subgroup of women. See-and-treat management is justified in the case of a high-grade smear and a high-grade colposcopic impression. © 2015 Royal College of Obstetricians and Gynaecologists.

  13. Who Supports the Successful Implementation and Sustainability of Evidence-Based Practices? Defining and Understanding the Roles of Intermediary and Purveyor Organizations.

    Science.gov (United States)

    Franks, Robert P; Bory, Christopher T

    2015-01-01

    Research on implementation science has increased significantly over the past decade. In particular, psychologists have looked closely at the value and importance of bridging the gap between science and practice. As evidence-based practices (EBPs) become more prevalent, concrete mechanisms are needed to bring these scientifically supported treatments and interventions to community-based settings. Intermediary and purveyor organizations (IPOs) have emerged in recent years that specialize in bringing research to practice. Using a framework developed by Franks (), this descriptive study surveyed respondents that self-identified as IPOs and focused on identifying shared definitions, functions, and activities. Results indicated that seven descriptive roles previously identified were supported by this survey and many common shared activities, goals, and functions across these organizations were observed. Further, these organizations appear to be influenced by the growing field of implementation science. Limitations and implications of this study are discussed. © 2015 Wiley Periodicals, Inc.

  14. Counterbalancing patient demands with evidence: results from a pan-Canadian randomized clinical trial of brief supportive-expressive group psychotherapy for women with systemic lupus erythematosus.

    Science.gov (United States)

    Dobkin, Patricia L; Da Costa, Deborah; Joseph, Lawrence; Fortin, Paul R; Edworthy, Steven; Barr, Susan; Ensworth, Stephanie; Esdaile, John M; Beaulieu, André; Zummer, Michel; Senécal, Jean-Luc; Goulet, Jean-Richard; Choquette, Denis; Rich, Eric; Smith, Doug; Cividino, Alfred; Gladman, Dafna; St-Pierre, Yvan; Clarke, Ann E

    2002-01-01

    To evaluate the effect of Brief Supportive-Expressive Group Psychotherapy as an adjunct to standard medical care in reducing psychological distress, medical symptoms, and health care costs and improving quality of life in women with systemic lupus erythematosus (SLE). A randomized clinical trial was conducted with 133 SLE female patients from 9 clinics across Canada. Clinical and psychosocial measures were taken at baseline, posttreatment, and 6 and 12 months posttreatment. Outcomes assessed were psychological distress, quality of life, disease activity, health service utilization, and diminished productivity. Intention-to-treat analyses revealed that there were no clinically important group differences on any of the outcome measures. Although both groups improved over time on several measures (e.g., decreases in psychological distress, stress, and emotion-oriented coping), these changes could not be attributed to the psychotherapeutic intervention. Thus, evidence does not support the referral of these patients to this type of intervention.

  15. The Right Hemisphere Planum Temporale Supports Enhanced Visual Motion Detection Ability in Deaf People: Evidence from Cortical Thickness.

    Science.gov (United States)

    Shiell, Martha M; Champoux, François; Zatorre, Robert J

    2016-01-01

    After sensory loss, the deprived cortex can reorganize to process information from the remaining modalities, a phenomenon known as cross-modal reorganization. In blind people this cross-modal processing supports compensatory behavioural enhancements in the nondeprived modalities. Deaf people also show some compensatory visual enhancements, but a direct relationship between these abilities and cross-modally reorganized auditory cortex has only been established in an animal model, the congenitally deaf cat, and not in humans. Using T1-weighted magnetic resonance imaging, we measured cortical thickness in the planum temporale, Heschl's gyrus and sulcus, the middle temporal area MT+, and the calcarine sulcus, in early-deaf persons. We tested for a correlation between this measure and visual motion detection thresholds, a visual function where deaf people show enhancements as compared to hearing. We found that the cortical thickness of a region in the right hemisphere planum temporale, typically an auditory region, was greater in deaf individuals with better visual motion detection thresholds. This same region has previously been implicated in functional imaging studies as important for functional reorganization. The structure-behaviour correlation observed here demonstrates this area's involvement in compensatory vision and indicates an anatomical correlate, increased cortical thickness, of cross-modal plasticity.

  16. Terrestrial-style feeding in a very early aquatic tetrapod is supported by evidence from experimental analysis of suture morphology.

    Science.gov (United States)

    Markey, Molly J; Marshall, Charles R

    2007-04-24

    There is no consensus on when in the fish-tetrapod transition suction feeding, the primary method of prey capture in the aquatic realm, evolved into the direct biting on prey typical of terrestrial animals. Here, we show that differences in the morphology of selected cranial sutures between species that span the fish-tetrapod transition (the Devonian osteolepiform fish Eusthenopteron, the aquatic Devonian tetrapod Acanthostega, and the Permian terrestrial tetrapod Phonerpeton) can be used to infer when terrestrial feeding first appeared. Our approach consists of defining a sutural morphospace, assigning functional fields to that morphospace based on our previous measurements of suture function made during feeding in the living fish Polypterus, inferring the functions of the fossil sutures based on where they fall in the morphospace, and then using the correlation between feeding mode and the patterns of inferred suture function across the skull roof in taxa where feeding mode is unambiguous to infer the feeding mode practiced by Acanthostega. Using this procedure, we find that the suture morphologies of Acanthostega are inconsistent with the hypothesis that it captured prey primarily by means of suction, which suggests that it may have bitten directly on prey at or near the water's edge. Thus, our data strongly support the hypothesis that the terrestrial mode of feeding first emerged in aquatic taxa.

  17. Field Evidence Supporting Conventional Onion Curing Practices as a Strategy To Mitigate Escherichia coli Contamination from Irrigation Water.

    Science.gov (United States)

    Wright, Daniel; Feibert, Erik; Reitz, Stuart; Shock, Clint; Waite-Cusic, Joy

    2018-03-01

    The Produce Safety Rule of the U.S. Food Safety Modernization Act includes restrictions on the use of agricultural water of poor microbiological quality. Mitigation options for poor water quality include the application of an irrigation-to-harvest interval of onion production includes an extended irrigation-to-harvest interval (onion fields (randomized block design; n = 5) via drip tape on the final day of irrigation. Onions remained undisturbed for 7 days and were then lifted to the surface to cure for an additional 21 days before harvest. Water, onions, and soil were tested for presence of rifampin-resistant E. coli. One day after irrigation, 13.3% of onions (20 of 150) receiving the poorest quality water (3 log CFU/mL) tested positive for E. coli; this prevalence was reduced to 4% (6 of 150 onions) after 7 days. Regardless of inoculum level, E. coli was not detected on any onions beyond 15 days postirrigation. These results support conventional dry bulb onion curing practices as an effective strategy to mitigate microbiological concerns associated with poor quality irrigation water.

  18. Introducing the Adults with Chronic Healthcare Needs (ACHCN) definition and screening instrument: Rationale, supporting evidence and testing.

    Science.gov (United States)

    Gulley, Stephen P; Rasch, Elizabeth K; Altman, Barbara M; Bethell, Christina D; Carle, Adam C; Druss, Benjamin G; Houtrow, Amy J; Reichard, Amanda; Chan, Leighton

    2018-04-01

    Among working age adults in the United States, there is a large, heterogeneous population that requires ongoing and elevated levels of healthcare and related services. At present, there are conflicting approaches to the definition and measurement of this population in health services research. An expert panel was convened by the National Institutes of Health with the objective of developing a population-level definition of Adults with Chronic Healthcare Needs (ACHCN). In addition, the panel developed a screening instrument and methods for its use in health surveys to identify and stratify the population consistently. The panel employed multiple methods over the course of the project, including scoping literature reviews, quantitative analyses from national data sources and cognitive testing. The panel defined the ACHCN population as "Adults (age 18-65) with [1] ongoing physical, cognitive, or mental health conditions or difficulties functioning who [2] need health or related support services of a type or amount beyond that needed by adults of the same sex and similar age." The screener collects information on chronic health conditions, functional difficulties, and elevated use of or unmet need for healthcare services. Adapted from the Maternal and Child Health Bureau definition that identifies Children with Special Healthcare Needs, aligned with the ACS-6 disability measure, and consistent with the HHS Multiple Chronic Condition Framework, this definition and screener provide the research community with a common denominator for the identification of ACHCN. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Change of muscle architecture following body weight support treadmill training for persons after subacute stroke: evidence from ultrasonography.

    Science.gov (United States)

    Liu, Peng; Wang, Yanjun; Hu, Huijing; Mao, Yurong; Huang, Dongfeng; Li, Le

    2014-01-01

    Although the body weight support treadmill training (BWSTT) in rehabilitation therapy has been appreciated for a long time, the biomechanical effects of this training on muscular system remain unclear. Ultrasonography has been suggested to be a feasible method to measure muscle morphological changes after neurological diseases such as stroke, which may help to enhance the understanding of the mechanism underlying the impaired motor function. This study investigated the muscle architectural changes of tibialis anterior and medial gastrocnemius in patients after subacute stroke by ultrasound. As expected, we found the effect of BWSTT on the muscular system. Specifically, the results showed larger pennation angle and muscle thickness of tibialis anterior and longer fascicle length of medial gastrocnemius after the training. The findings of this study suggest that the early rehabilitation training of BWSTT in subacute stage of stroke provides positive changes of the muscle architecture, leading to the potential improvement of the force generation of the muscle. This may not only help us understand changes of subacute stroke in muscular system but also have clinical implications in the evaluation of rehabilitation training after neurological insults.

  20. Jellyfish support high energy intake of leatherback sea turtles (Dermochelys coriacea: video evidence from animal-borne cameras.

    Directory of Open Access Journals (Sweden)

    Susan G Heaslip

    Full Text Available The endangered leatherback turtle is a large, highly migratory marine predator that inexplicably relies upon a diet of low-energy gelatinous zooplankton. The location of these prey may be predictable at large oceanographic scales, given that leatherback turtles perform long distance migrations (1000s of km from nesting beaches to high latitude foraging grounds. However, little is known about the profitability of this migration and foraging strategy. We used GPS location data and video from animal-borne cameras to examine how prey characteristics (i.e., prey size, prey type, prey encounter rate correlate with the daytime foraging behavior of leatherbacks (n = 19 in shelf waters off Cape Breton Island, NS, Canada, during August and September. Video was recorded continuously, averaged 1:53 h per turtle (range 0:08-3:38 h, and documented a total of 601 prey captures. Lion's mane jellyfish (Cyanea capillata was the dominant prey (83-100%, but moon jellyfish (Aurelia aurita were also consumed. Turtles approached and attacked most jellyfish within the camera's field of view and appeared to consume prey completely. There was no significant relationship between encounter rate and dive duration (p = 0.74, linear mixed-effects models. Handling time increased with prey size regardless of prey species (p = 0.0001. Estimates of energy intake averaged 66,018 kJ • d(-1 but were as high as 167,797 kJ • d(-1 corresponding to turtles consuming an average of 330 kg wet mass • d(-1 (up to 840 kg • d(-1 or approximately 261 (up to 664 jellyfish • d(-1. Assuming our turtles averaged 455 kg body mass, they consumed an average of 73% of their body mass • d(-1 equating to an average energy intake of 3-7 times their daily metabolic requirements, depending on estimates used. This study provides evidence that feeding tactics used by leatherbacks in Atlantic Canadian waters are highly profitable and our results are consistent with estimates of mass gain prior to

  1. Decision boxes for clinicians to support evidence-based practice and shared decision making: the user experience

    Directory of Open Access Journals (Sweden)

    Giguere Anik

    2012-08-01

    -making process were added with the intent of clarifying the tool’s purpose. Information about the risks and benefits according to risk levels was added to the Decision Boxes, to try to ease the adaptation of the information to individual patients. Conclusion Results will guide the development of the eight remaining Decision Boxes. A future study will evaluate the effect of Decision Boxes on the integration of evidence-based and shared decision making principles in clinical practice.

  2. Facultative anoxygenic photosynthesis in cyanobacteria driven by arsenite and sulfide with evidence for the support of nitrogen fixation

    Science.gov (United States)

    Wolfe-Simon, F.; Hoeft, S. E.; Baesman, S. M.; Oremland, R. S.

    2010-12-01

    The rise in atmospheric oxygen (O2) over geologic time is attributed to the evolution and widespread proliferation of oxygenic photosynthesis in cyanobacteria. However, cyanobacteria maintain a metabolic flexibility that may not always result in O2 release. In the environment, cyanobacteria may use a variety of alternative electron donors rather than water that are known to be used by other anoxygenic phototrophs (eg. purple sulfur bacteria) including reduced forms of sulfur, iron, nitrogen, and arsenic. Recent evidence suggests cyanobacteria actively take advantage of at least a few of these alternatives. We used a classical Winogradsky approach to enrich for cyanobacteria from the high salinity, elevated pH and arsenic-enriched waters of Mono Lake (CA). Experiments, optimized for cyanobacteria, revealed light-dependent, anaerobic arsenite-oxidation in sub-cultured sediment-free enrichments dominated by a filamentous cyanobacteria. We isolated and identified the dominant member of this enrichment to be a member of the Oscillatoriales by 16S rDNA. Addition of 1 mM arsenite induced facultative anoxygenic photosynthesis under continuous and circadian light. This isolate also oxidized sulfide under the same light-based conditions. Aerobic conditions elicited no arsenite oxidation in the light or dark and the isolate grew as a typical cyanobacterium using oxygenic photosynthesis. Under near-infrared light (700 nm) there was a direct correlation of enhanced growth with an increase in the rate arsenite or sulfide oxidation suggesting the use of photosystem I. Additionally, to test the wide-spread nature of this metabolism in the Oscillatoriales, we followed similar arsenite- and sulfide-driven facultative anoxygenic photosynthesis as well as nitrogen fixation (C2H2 reduction) in the axenic isolate Oscillatoria sp. CCMP 1731. Future characterization includes axenic isolation of the Mono Lake Oscillatoria sp. as well as the arsenite oxidase responsible for electron

  3. Supporting evidence from the EPICA Dronning Maud Land ice core for atmospheric CO2 changes during the past millennium

    International Nuclear Information System (INIS)

    Siegenthaler, Urs; Monnin, Eric; Kawamura, Kenji; Spahni, Renato; Schwander, Jakob; Stauffer, Bernhard; Stocker, Thomas F.; Fischer, Hubertus

    2005-01-01

    The most direct method of investigating past variations of the atmospheric CO 2 concentration before 1958, when continuous direct atmospheric CO 2 measurements started, is the analysis of air extracted from suitable ice cores. Here we present a new detailed CO 2 record from the Dronning Maud Land (DML) ice core, drilled in the framework of the European Project for Ice Coring in Antarctica (EPICA) and some new measurements on a previously drilled ice core from the South Pole. The DML CO 2 record shows an increase from about 278 to 282 parts per million by volume (ppmv) between ad 1000 and ad 1200 and a fairly continuous decrease to a mean value of about 277 ppmv around ad 1700. While the new South Pole measurements agree well with DML at the minimum at ad 1700 they are on average about 2 ppmv lower during the period ad 1000-1500. Published measurements from the coastal high-accumulation site Law Dome are considered as very reliable because of the reproducibility of the measurements, high temporal resolution and an accurate time scale. Other Antarctic ice cores could not, or only partly, reproduce the pre-industrial measurements from Law Dome. A comparison of the trends of DML and Law Dome shows a general agreement. However we should be able to rule out co-variations caused by the same artefact. Two possible effects are discussed, first production of CO 2 by chemical reactions and second diffusion of dissolved air through the ice matrix into the bubbles. While the first effect cannot be totally excluded, comparison of the Law Dome and DML record shows that dissolved air diffusing to bubbles cannot be responsible for the pre-industrial variation. Therefore, the new record is not a proof of the Law Dome results but the first very strong support from an ice core of the Antarctic plateau

  4. Network analysis to support research management: evidence from the Fiocruz Observatory in Science, Technology and Innovation in Health

    Energy Technology Data Exchange (ETDEWEB)

    Fonseca, B.; Sampaio, R.B.; Silva, M.V.; Dos Santos, P.X.

    2016-07-01

    Brazil has been encouraging the establishment of research networks to address strategic health issues in response to social demands, creating an urgent need to develop indicators for their evaluation. The Oswaldo Cruz Foundation (Fiocruz), a national research, training and production institution, has initiated the development of an “Observatory in Science, Technology and Innovation in Health” to monitor and evaluate research and technological development for the formulation of institutional policies. In this context, we are proposing the use of social network analysis to map cooperation in strategic areas of research, identify prominent researchers and support internal research networks. In this preliminary study, coauthorship analysis was used to map the cooperative relations of Fiocruz in tuberculosis (TB) research, an important public health issue for which diagnosis and adequate treatment are still challenging. Our findings suggest that Brazilian research organizations acting in TB research are embedded in highly connected networks. The large number of international organizations present in the Brazilian network reflects the global increase in scientific collaboration and Brazil’s engagement in international collaborative research efforts. Fiocruz frequent cooperation with high-income countries demonstrates its concern in benefiting from the access to facilities, funding, equipment and networks that are often limited in its research setting. Collaboration with high burden countries has to be strengthened, as it could improve access to local knowledge and better understanding of the disease in different endemic contexts. Centrality analysis consolidated information on the importance of Fiocruz in connecting TB research institutions in Brazil. Fiocruz Observatory intends to advance this analysis by looking into the mechanisms of collaboration, identifying priority themes and assessing comparative advantages of the network members, an important contribution

  5. Group 13 ligand supported heavy-metal complexes: first structural evidence for gallium-lead and gallium-mercury bonds.

    Science.gov (United States)

    Prabusankar, Ganesan; Gemel, Christian; Winter, Manuela; Seidel, Rüdiger W; Fischer, Roland A

    2010-05-25

    Heavy-metal complexes of lead and mercury stabilized by Group 13 ligands were derived from the oxidative addition of Ga(ddp) (ddp=HC(CMeNC(6)H(3)-2,6-iPr(2))(2), 2-diisopropylphenylamino-4-diisopropyl phenylimino-2-pentene) with corresponding metal precursors. The reaction of Me(3)PbCl and Ga(ddp) afforded compound [{(ddp)Ga(Cl)}PbMe(3)] (1) composed of Ga-Pb(IV) bonds. In addition, the monomeric plumbylene-type compound [{(ddp)Ga(OSO(2)CF(3))}(2)Pb(thf)] (2a) with an unsupported Ga-Pb(II)-Ga linkage was obtained by the reaction of [Pb(OSO(2)CF(3))(3)] with Ga(ddp) (2 equiv). Compound 2a falls under the rare example of a discrete plumbylene-type compound supported by a nonclassical ligand. Interesting structural changes were observed when [Pb(OSO(2)CF(3))(3)]2.H(2)O was treated with Ga(ddp) in a 1:2 ratio to yield [{(ddp)Ga(mu-OSO(2)CF(3))}(2)(OH(2))Pb] (2b) at below -10 degrees C. Compound 2b consists of a bent Ga-Pb-Ga backbone with a bridging triflate group between the Ga-Pb bond and a weakly interacting water molecule at the gallium center. Similarly, the reaction of mercury thiolate Hg(SC(6)F(5)) with Ga(ddp) (2 equiv) produced the bimetallic homoleptic compounds anti-[{(ddp)Ga(SC(6)F(5))}(2)Hg] (3a) and gauche-[{(ddp)Ga(SC(6)F(5))}(2)Hg] (3b), respectively, with a linear Ga-Hg-Ga linkage. Compounds 1-3 were structurally characterized and these are the first examples of compounds comprised of Ga-Pb(II), Ga-Pb(IV), and Ga-Hg bonds.

  6. Evidence Supporting a Role for Constitutive Ghrelin Receptor Signaling in Fasting-Induced Hyperphagia in Male Mice.

    Science.gov (United States)

    Fernandez, Gimena; Cabral, Agustina; Andreoli, María F; Labarthe, Alexandra; M'Kadmi, Céline; Ramos, Jorge G; Marie, Jacky; Fehrentz, Jean-Alain; Epelbaum, Jacques; Tolle, Virginie; Perello, Mario

    2018-02-01

    Ghrelin is a potent orexigenic peptide hormone that acts through the growth hormone secretagogue receptor (GHSR), a G protein-coupled receptor highly expressed in the hypothalamus. In vitro studies have shown that GHSR displays a high constitutive activity, whose physiological relevance is uncertain. As GHSR gene expression in the hypothalamus is known to increase in fasting conditions, we tested the hypothesis that constitutive GHSR activity at the hypothalamic level drives the fasting-induced hyperphagia. We found that refed wild-type (WT) mice displayed a robust hyperphagia that continued for 5 days after refeeding and changed their food intake daily pattern. Fasted WT mice showed an increase in plasma ghrelin levels, as well as in GHSR expression levels and ghrelin binding sites in the hypothalamic arcuate nucleus. When fasting-refeeding responses were evaluated in ghrelin- or GHSR-deficient mice, only the latter displayed an ∼15% smaller hyperphagia, compared with WT mice. Finally, fasting-induced hyperphagia of WT mice was significantly smaller in mice centrally treated with the GHSR inverse agonist K-(D-1-Nal)-FwLL-NH2, compared with mice treated with vehicle, whereas it was unaffected in mice centrally treated with the GHSR antagonists D-Lys3-growth hormone-releasing peptide 6 or JMV2959. Taken together, genetic models and pharmacological results support the notion that constitutive GHSR activity modulates the magnitude of the compensatory hyperphagia triggered by fasting. Thus, the hypothalamic GHSR signaling system could affect the set point of daily food intake, independently of plasma ghrelin levels, in situations of negative energy balance. Copyright © 2018 Endocrine Society.

  7. Mitochondrial DNA phylogeography of lake cisco (Coregonus artedi): evidence supporting extensive secondary contacts between two glacial races.

    Science.gov (United States)

    Turgeon, J; Bernatchez, L

    2001-04-01

    The comparative molecular phylogeography of regional fish fauna has revealed the wide distribution of young clades in freshwater fishes of formerly glaciated areas as well as interspecific incongruences in their refugial origins and recolonization routes. In this study, we employed single-strand conformation polymorphism (SSCP) and sequence analyses to describe mitochondrial DNA (mtDNA) polymorphism among 27 populations of the lake cisco (Coregonus artedi) from its entire range of distribution in order to evaluate the hypothesis of dual glacial refuges proposed by Bernatchez & Dodson against the traditional view that this species is solely of Mississippian origin. Results indicate that this taxon is composed of two closely related groups that are widely distributed and intermixed over most of the sampled range. The estimated level of divergence (0.48%), the contrast in the geographical distribution of each group, as well as the general distribution of C. artedi in North America together support the hypothesis that one group dispersed from a Mississippian refuge via the proglacial lakes, while the other is of Atlantic origin and also took advantages of earlier dispersal routes towards eastern Hudson Bay drainages. However, the signal of past range fragmentation revealed by a nested clade analysis was weak, and did not allow to formally exclude the hypothesis of a single Mississippian origin for both lineages. Comparisons with the phylogeographic patterns of other Nearctic freshwater fishes suggest that the salinity tolerance and thermal sensitivity of lake cisco may have been determinant for its extensive postglacial dispersal. The presence or co-occurrence of sympatric or allopatric eco/morphotypes were not found to be necessarily associated with the presence of both haplotype groups.

  8. Y-chromosome evidence supports widespread signatures of three-species Canis hybridization in eastern North America.

    Science.gov (United States)

    Wilson, Paul J; Rutledge, Linda Y; Wheeldon, Tyler J; Patterson, Brent R; White, Bradley N

    2012-09-01

    There has been considerable discussion on the origin of the red wolf and eastern wolf and their evolution independent of the gray wolf. We analyzed mitochondrial DNA (mtDNA) and a Y-chromosome intron sequence in combination with Y-chromosome microsatellites from wolves and coyotes within the range of extensive wolf-coyote hybridization, that is, eastern North America. The detection of divergent Y-chromosome haplotypes in the historic range of the eastern wolf is concordant with earlier mtDNA findings, and the absence of these haplotypes in western coyotes supports the existence of the North American evolved eastern wolf (Canis lycaon). Having haplotypes observed exclusively in eastern North America as a result of insufficient sampling in the historic range of the coyote or that these lineages subsequently went extinct in western geographies is unlikely given that eastern-specific mtDNA and Y-chromosome haplotypes represent lineages divergent from those observed in extant western coyotes. By combining Y-chromosome and mtDNA distributional patterns, we identified hybrid genomes of eastern wolf, coyote, gray wolf, and potentially dog origin in Canis populations of central and eastern North America. The natural contemporary eastern Canis populations represent an important example of widespread introgression resulting in hybrid genomes across the original C. lycaon range that appears to be facilitated by the eastern wolf acting as a conduit for hybridization. Applying conventional taxonomic nomenclature and species-based conservation initiatives, particularly in human-modified landscapes, may be counterproductive to the effective management of these hybrids and fails to consider their evolutionary potential.

  9. Physicians' perception of alternative displays of clinical research evidence for clinical decision support - A study with case vignettes.

    Science.gov (United States)

    Slager, Stacey L; Weir, Charlene R; Kim, Heejun; Mostafa, Javed; Del Fiol, Guilherme

    2017-07-01

    To design alternate information displays that present summaries of clinical trial results to clinicians to support decision-making; and to compare the displays according to efficacy and acceptability. A 6-between (information display presentation order) by 3-within (display type) factorial design. Two alternate displays were designed based on Information Foraging theory: a narrative summary that reduces the content to a few sentences; and a table format that structures the display according to the PICO (Population, Intervention, Comparison, Outcome) framework. The designs were compared with the summary display format available in PubMed. Physicians were asked to review five clinical studies retrieved for a case vignette; and were presented with the three display formats. Participants were asked to rate their experience with each of the information displays according to a Likert scale questionnaire. Twenty physicians completed the study. Overall, participants rated the table display more highly than either the text summary or PubMed's summary format (5.9vs. 5.4vs. 3.9 on a scale between 1 [strongly disagree] and 7 [strongly agree]). Usefulness ratings of seven pieces of information, i.e. patient population, patient age range, sample size, study arm, primary outcome, results of primary outcome, and conclusion, were high (average across all items=4.71 on a 1 to 5 scale, with 1=not at all useful and 5=very useful). Study arm, primary outcome, and conclusion scored the highest (4.9, 4.85, and 4.85 respectively). Participants suggested additional details such as rate of adverse effects. The table format reduced physicians' perceived cognitive effort when quickly reviewing clinical trial information and was more favorably received by physicians than the narrative summary or PubMed's summary format display. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Needs-based Funding for Home Care and Community Support Services in Ontario: A New Approach Based on Linked Survey and Administrative Data

    OpenAIRE

    Jeremiah Hurley; Brian Hutchison; Gioia Buckley; Christel Woodward

    2003-01-01

    1.0 Background Since 1994, the Ontario Ministry of Health and Long-term Care (MOHLTC) has used an equity funding formula to allocate new funding for the delivery of long-term care (LTC) community services, which includes home care services and community support services in the province.[Ontario Ministry of Health 2000] The objective of the formula is to reduce historical disparities in funding among Community Care Access Centre (CCAC) regions by allocating new funds on the basis of the relati...

  11. Safeguards and security by design support for the next generation nuclear plant project - Progress in safeguards by design (SBD) by the United States National Nuclear Security Administration (NNSA)

    International Nuclear Information System (INIS)

    Bjornard, T.; Casey Durst, P.

    2013-01-01

    The Next Generation Nuclear Plant (NGNP) project was authorized by the United States Energy Policy Act of 2005 with the principal objective of designing, licensing, and building a Generation IV nuclear plant capable of producing both high-temperature process heat and electricity. The two candidate NGNP reactor concepts are pebble- and prismatic-fueled high-temperature gas reactors that will be licensed by the U.S. Nuclear Regulatory Commission (NRC). The conceptual design phase of the project was completed in December 2010. This paper summarizes support provided to the NGNP project to facilitate consideration of international safeguards during the design phase, or safeguards by design (SBD). Additional support was provided for domestic safeguards (material control and accounting) and physical protection, or safeguards and security by design (2SBD). The main focus of this paper is on SBD and international safeguards. Included is an overview of the international safeguards guidance contained in guidance reports for SBD. These reports contain guidance and suggestions intended to be useful to the industry design teams, but they do not contain ready-made solutions. Early and frequent interaction of design stakeholders with the International Atomic Energy Agency and the NRC are essential to a successful endeavor. The paper is followed by the slides of the presentation. (author)

  12. Evidence-based radiology (part 2): Is there sufficient research to support the use of therapeutic injections into the peripheral joints?

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Cynthia; Hodler, Juerg [Orthopaedic University Hospital of Balgrist, Radiology, Zuerich (Switzerland)

    2010-01-15

    This review article addresses the best evidence currently available for the effectiveness of injection therapy for musculoskeletal conditions involving the peripheral joints. The research is presented by anatomical region and areas of controversy and the need for additional research are identified. Randomized controlled trials, meta-analyses and systematic reviews are lacking that address the effectiveness of therapeutic injections to the sternoclavicular, acromioclavicular, ankle and foot joints. No research studies of any kind have been reported for therapeutic injections of the sternoclavicular joint. With the exception of the knee, possibly the hip and patients with inflammatory arthropathies, research does not unequivocally support the use of therapeutic joint injections for most of the peripheral joints, including the shoulder. Additionally, controversy exists in some areas as to whether or not corticosteroids provide better outcomes compared to local anesthetic injections alone. When viscosupplementation injections are compared to corticosteroids in patients with osteoarthritis of the knee, the evidence supports the use of viscosupplementation for more prolonged improvement in outcomes, with corticosteroids being good for short-term relief. (orig.)

  13. Evidence-based radiology (part 2): Is there sufficient research to support the use of therapeutic injections into the peripheral joints?

    International Nuclear Information System (INIS)

    Peterson, Cynthia; Hodler, Juerg

    2010-01-01

    This review article addresses the best evidence currently available for the effectiveness of injection therapy for musculoskeletal conditions involving the peripheral joints. The research is presented by anatomical region and areas of controversy and the need for additional research are identified. Randomized controlled trials, meta-analyses and systematic reviews are lacking that address the effectiveness of therapeutic injections to the sternoclavicular, acromioclavicular, ankle and foot joints. No research studies of any kind have been reported for therapeutic injections of the sternoclavicular joint. With the exception of the knee, possibly the hip and patients with inflammatory arthropathies, research does not unequivocally support the use of therapeutic joint injections for most of the peripheral joints, including the shoulder. Additionally, controversy exists in some areas as to whether or not corticosteroids provide better outcomes compared to local anesthetic injections alone. When viscosupplementation injections are compared to corticosteroids in patients with osteoarthritis of the knee, the evidence supports the use of viscosupplementation for more prolonged improvement in outcomes, with corticosteroids being good for short-term relief. (orig.)

  14. Nicotine dependence and cost-effectiveness of individualized support for smoking cessation: evidence from practice at a worksite in Japan.

    Directory of Open Access Journals (Sweden)

    Koshi Nakamura

    Full Text Available Given the lack of economic studies evaluating the outcomes of smoking cessation programs from the viewpoint of program sponsors, we conducted a case study to provide relevant information for worksites. The present study was carried out between 2006 and 2008 at a manufacturing factory in the Toyama Prefecture of Japan and included subjects who voluntarily entered a smoking cessation program. The program included face-to-face counselling followed by weekly contact to provide encouragement over six months using e-mail or inter-office mail. Nicotine patches were available if required. All 151 participants stopped smoking immediately. Over the 24-month study period, self-report showed 49.7% abstained continuously from smoking. The rate of 24-month consecutive abstinence was higher in participants with lower Fagerström Test scores for Nicotine Dependence at baseline than in those with higher scores (63.6% for 0-2 points vs. 46.5% for 3-6 points vs. 43.8% for 7-10 points; chi-square test p = 0.19. A logistic regression model showed a significant linear trend for the association between the score and abstinence status after adjustment for possible confounding factors (p = 0.03. The crude incremental cost for one individual to successfully quit smoking due to the support program was ¥46,379 (i.e., ¥100 = $1.28, £0.83, or €1.03 at foreign exchange rates. The corresponding costs for the three categories of the Fagerström Test score for Nicotine Dependence were ¥31,953, ¥47,450 and ¥64,956, respectively. When a sensitivity analysis was conducted based on the 95% confidence interval of the success rate, the variance in the corresponding costs was ¥25,514-45,034 for 0-2 points, ¥38,344-61,824 for 3-6 points, and ¥45,698-108,260 for 7-10 points. The degree of nicotine dependence may therefore be an important determinant of the cost-effectiveness of smoking cessation programs.

  15. Nicotine dependence and cost-effectiveness of individualized support for smoking cessation: evidence from practice at a worksite in Japan.

    Science.gov (United States)

    Nakamura, Koshi; Sakurai, Masaru; Miura, Katsuyuki; Morikawa, Yuko; Nagasawa, Shin-ya; Ishizaki, Masao; Kido, Teruhiko; Naruse, Yuchi; Suwazono, Yasushi; Nakagawa, Hideaki

    2013-01-01

    Given the lack of economic studies evaluating the outcomes of smoking cessation programs from the viewpoint of program sponsors, we conducted a case study to provide relevant information for worksites. The present study was carried out between 2006 and 2008 at a manufacturing factory in the Toyama Prefecture of Japan and included subjects who voluntarily entered a smoking cessation program. The program included face-to-face counselling followed by weekly contact to provide encouragement over six months using e-mail or inter-office mail. Nicotine patches were available if required. All 151 participants stopped smoking immediately. Over the 24-month study period, self-report showed 49.7% abstained continuously from smoking. The rate of 24-month consecutive abstinence was higher in participants with lower Fagerström Test scores for Nicotine Dependence at baseline than in those with higher scores (63.6% for 0-2 points vs. 46.5% for 3-6 points vs. 43.8% for 7-10 points; chi-square test p = 0.19). A logistic regression model showed a significant linear trend for the association between the score and abstinence status after adjustment for possible confounding factors (p = 0.03). The crude incremental cost for one individual to successfully quit smoking due to the support program was ¥46,379 (i.e., ¥100 = $1.28, £0.83, or €1.03 at foreign exchange rates). The corresponding costs for the three categories of the Fagerström Test score for Nicotine Dependence were ¥31,953, ¥47,450 and ¥64,956, respectively. When a sensitivity analysis was conducted based on the 95% confidence interval of the success rate, the variance in the corresponding costs was ¥25,514-45,034 for 0-2 points, ¥38,344-61,824 for 3-6 points, and ¥45,698-108,260 for 7-10 points. The degree of nicotine dependence may therefore be an important determinant of the cost-effectiveness of smoking cessation programs.

  16. Administrative circular

    CERN Multimedia

    2003-01-01

    • N° 21 - August 2003 Special leave This circular has been amended. Copies of this circular are available in the Divisional Secretariats. In addition, administrative and operational circulars, as well as the lists of those in force, are available for consultation on the Web at: http://cern.ch/hr-div/internal/admin_services/admincirc/listadmincirc.asp Human Resources Division Tel. 74128

  17. Database Administrator

    Science.gov (United States)

    Moore, Pam

    2010-01-01

    The Internet and electronic commerce (e-commerce) generate lots of data. Data must be stored, organized, and managed. Database administrators, or DBAs, work with database software to find ways to do this. They identify user needs, set up computer databases, and test systems. They ensure that systems perform as they should and add people to the…

  18. Male circumcision to prevent syphilis in 1855 and HIV in 1986 is supported by the accumulated scientific evidence to 2015: Response to Darby.

    Science.gov (United States)

    Morris, Brian J; Wamai, Richard G; Krieger, John N; Banerjee, Joya; Klausner, Jeffrey D

    2017-10-01

    An article by Darby disparaging male circumcision (MC) for syphilis prevention in Victorian times (1837-1901) and voluntary medical MC programs for HIV prevention in recent times ignores contemporary scientific evidence. It is one-sided and cites outlier studies as well as claims by MC opponents that support the author's thesis, but ignores high quality randomised controlled trials and meta-analyses. While we agree with Darby that risky behaviours contribute to syphilis and HIV epidemics, there is now compelling evidence that MC helps reduce both syphilis and HIV infections. Although some motivations for MC in Victorian times were misguided, others, such as protection against syphilis, penile cancer, phimosis, balanitis and poor hygiene have stood the test of time. In the absence of a cure or effective prophylactic vaccine for HIV, MC should help lower heterosexually acquired HIV, especially when coupled with other interventions such as condoms and behaviour. This should save lives, as well as reducing costs and suffering. In contrast to Darby, our evaluation of the evidence leads us to conclude that MC would likely have helped reduce syphilis in Victorian times and, in the current era, will help lower both syphilis and HIV, so improving global public health.

  19. Supporting middle school students' construction of evidence-based arguments: Impact of and student interactions with computer-based argumentation scaffolds

    Science.gov (United States)

    Belland, Brian Robert

    Middle school students have difficulty creating evidence-based arguments (EBAs) during problem-based learning (PBL) units due to challenges (a) adequately representing the unit's central problem (Ge & Land, 2004; Liu & Bera, 2005), (b) determining and obtaining the most relevant evidence (Pedersen & Liu, 2002-2003), and (c) synthesizing gathered information to construct a sound argument (Cho & Jonassen, 2002). I designed and developed the Connection Log to support middle school students in this process. This study addressed (1) the Connection Log's impact on (a) argument evaluation ability, and (b) group argument quality and (2) how and why middle school science students used the Connection Log. Four sections of a 7th-grade science class participated. Student groups selected a stakeholder position related to the Human Genome Project (HGP) and needed to decide on and promote a plan to use $3 million to further their position as pertains to the HGP. I randomly assigned one higher-achieving and one lower-achieving class to Connection Log or no Connection Log conditions. Students completed an argument evaluation test, and impact on argument evaluation ability was determined using nested ANOVA. Two graduate students, blind to treatment conditions, rated group arguments, and impact on group argument quality was determined using nested MANOVA. To determine how and why students used the Connection Log, I videotaped and interviewed one small group from each class in the experimental condition. I coded transcripts and generated themes, triangulating the two data sources with informal observations during all class sessions and what students wrote in the Connection Log. I detected no significant differences on claim, evidence, or connection of claim to evidence ratings of debate performances. However, students used the Connection Log to counter different difficulties, and I found a significant main effect of the Connection Log on argument evaluation ability, as well as a

  20. Spatially enabled land administration

    DEFF Research Database (Denmark)

    Enemark, Stig

    2006-01-01

    enabling of land administration systems managing tenure, valuation, planning, and development will allow the information generated by these activities to be much more useful. Also, the services available to private and public sectors and to community organisations should commensurably improve. Knowledge....... In other words: Good governance and sustainable development is not attainable without sound land administration or - more broadly – sound land management. The paper presents a land management vision that incorporates the benefits of ICT enabled land administration functions. The idea is that spatial...... the communication between administrative systems and also establish more reliable data due to the use the original data instead of copies. In Denmark, such governmental guidelines for a service-oriented ITarchitecture in support of e-government are recently adopted. Finally, the paper presents the role of FIG...