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Sample records for chiropractic practice results

  1. Danish Chiropractic Practice

    DEFF Research Database (Denmark)

    Myburgh, Cornelius; Boyle, Eleanor; Christensen, Henrik Wulff

    2015-01-01

    . Patients value competence and professionalism in their clinical encounter with their chiropractor. Conclusion: Danish chiropractic practice is strongly influenced by modern consumer behaviour and team-oriented practice trends. Furthermore, the administrative hub plays an important role in operationalizing...... this multi-practitioner approach, thus shaping the patient’s experience. And whilst patients appear receptive of this type of clinical encounter, the anchoring role of a competent chiropractor (lead clinician) is key....

  2. A description of children and adolescents in Danish chiropractic practice: results from a nationwide survey

    DEFF Research Database (Denmark)

    Hestbaek, Lise; Jørgensen, Anette; Hartvigsen, Jan

    2009-01-01

    OBJECTIVE: The purpose of this study was to describe Danish chiropractic patients younger than 18 years. METHODS: Questionnaires were mailed to all chiropractic clinics in Denmark during a randomly assigned month between September 2007 and September 2008. All patients younger than 18 years or the...... treatment effectiveness indicate the need for further research in these age groups....

  3. Danish Chiropractic Practice

    DEFF Research Database (Denmark)

    Myburgh, Cornelius; Boyle, Eleanor; Christensen, Henrik Wulff

    , face-to-face interviews and video analysis. Data was analysed for content and thematic emergence. Results: A purposive sampling framework yielded 11 clinic sites, representative of prevalent practice models. Data collected over a 6-month period included interviews with 60 patients, 22 health care...... professionals and 12 administrative staff. These were supplemented with video recordings of 33 clinical interactions. Health care encounters potentially start before patients enter clinics as individuals search websites to identify a suitable environment. In this regard modern, ‘cosy’ clinics are often favoured....... Danish chiropractors rarely function in a mono-professional setting, thus patients typically encounter one or more non-chiropractor during their treatment. Administrative staff is integral to the functioning of multi-disciplinary clinics, but also appear to function as ‘informal’ sources of information...

  4. Chiropractic practice in the Danish public health care sector

    DEFF Research Database (Denmark)

    Myburgh, Corrie

    2009-01-01

    This commentary offers preliminary considerations around a phenomenological investigation of chiropractic services in a Danish public sector setting. In this narrative description, the main venue for chiropractic public (secondary) sector practice in the Danish context is briefly described and...

  5. The perceptions, attitudes and knowledge of physiotherapy and chiropractic students regarding each others’ professional practice

    Directory of Open Access Journals (Sweden)

    N. Naidoo

    2009-02-01

    Full Text Available Introduction: The roles of physiotherapists and chiropractors demon-strate some overlap. Both are members of a multidisciplinary team and contributeto the holistic care of patients. Good understanding of each others’ professionalpractice may lead to good working relationships with effective referrals, inter -disciplinary and multidisciplinary management of patients. Purpose: To investigate the perceptions, attitudes and knowledge of undergraduatephysiotherapy and chiropractic students about each others’ professional roles inclinical practice. Methodology: Data was obtained using a questionnaire with closed and open-ended questions. First and final-yearphysiotherapy (n = 72 and chiropractic students (n = 49 participated. Results: First and final year physiotherapy students scored 58% and 62% respectively in the “test” on chiropractic;chiropractic students scored 52% and 68% respectively in the test on physiotherapy. Seventy percent of the chiropractic and 14% of the physiotherapy students had visited the practice of other profession. Sixty seven percent of the chiropractic and 38% of the physiotherapy students found it was effective. Forty seven percent chiropractic and 80% physiotherapy students considered physiotherapy and chiropractic to be in direct competition. Sixty six percentof the chiropractic students and 49% of the physiotherapy students expressed the intention of working together withthe other profession.  Discussion: The reason for the possible feelings of competitiveness could be because in South A frica there is vastoverlap of practice in both professions; Physiotherapists and chiropractors are seen to use modalities that are similar.This may be viewed as an indication of the importance in defining the roles, scope and characteristics of both physio-therapy and chiropractic.Conclusion: The knowledge of the physiotherapy and chiropractic students is equal, however, chiropractic studentshave more positive perceptions

  6. Chiropractic Health Care: A National Study of Cost of Education, Service Utilization, Number of Practicing Doctors of Chiropractic, and Other Key Policy Issues. Volumes I-II.

    Science.gov (United States)

    von Kuster, Thomas, Jr.

    Results from the first federally sponsored study of the chiropractic health care profession are presented, and a broad range of facts and issues of concern to policy-makers, the profession, and the public are described. The two-year project included three national surveys of: service providers (doctors of chiropractic in practice more than two…

  7. Self-reported recognition of undiagnosed life threatening conditions in chiropractic practice: a random survey

    Directory of Open Access Journals (Sweden)

    Daniel Dwain M

    2012-07-01

    Full Text Available Abstract Background The purpose of this study was to identify the type and frequency of previously undiagnosed life threatening conditions (LTC, based on self-reports of chiropractic physicians, which were first recognized by the chiropractic physician. Additionally this information may have a preliminary role in determining whether chiropractic education provides the knowledge necessary to recognize these events. Methods The study design was a postal, cross-sectional, epidemiological self-administered survey. Two thousand Doctors of Chiropractic in the US were randomly selected from a list of 57878. The survey asked respondents to state the number of cases from the list where they were the first physician to recognize the condition over the course of their practice careers. Space was provided for unlisted conditions. Results The response rate was 29.9%. Respondents represented 11442 years in practice and included 3861 patients with a reported undiagnosed LTC. The most commonly presenting conditions were in rank order: carcinoma, abdominal aneurysm, deep vein thrombosis, stroke, myocardial infarction, subdural hematoma and a large group of other diagnoses. The occurrence of a previously undiagnosed LTC can be expected to present to the chiropractic physician every 2.5 years based on the responding doctors reports. Conclusion Based on this survey chiropractic physicians report encountering undiagnosed LTC’s in the normal course of practice. The findings of this study are of importance to the chiropractic profession and chiropractic education. Increased awareness and emphasis on recognition of LTC is a critical part of the education process and practice life.

  8. Prevalence of hip osteoarthritis in chiropractic practice in denmark

    DEFF Research Database (Denmark)

    Poulsen, Erik; Christensen, Henrik W; Overgaard, Søren; Hartvigsen, Jan

    2012-01-01

    The purposes of this study were to measure the prevalence of clinical and radiographic hip osteoarthritis (OA) and first-time diagnosis of hip OA in consecutive patients presenting to chiropractic practices in Denmark and to report the components of the initial treatment rendered by the...

  9. The use of diagnostic coding in chiropractic practice

    DEFF Research Database (Denmark)

    Testern, Cecilie D; Hestbæk, Lise; French, Simon D

    2015-01-01

    BACKGROUND: Diagnostic coding has several potential benefits, including improving the feasibility of data collection for research and clinical audits and providing a common language to improve interdisciplinary collaboration. The primary aim of this study was to determine the views and perspectives...... extension (ICPC-2 PLUS) provided the 14 chiropractors with some experience in diagnostic coding, followed by an interview on the topic. The interviews were analysed thematically. The participating chiropractors and an independent coder applied ICPC-2 PLUS terms to the diagnoses of 10 patients. Then the...... practice, 2) ICPC-2 PLUS terminology issues for chiropractic practice and 3) Implementation of a coding system into chiropractic practice. The participating chiropractors did not uniformly support or condemn the idea of using diagnostic coding. However there was a strong agreement that the terminology in...

  10. Evidence-Based Chiropractic Education: Are We Equipping Graduates for Clinical Practice with Improved Patient Outcomes?

    OpenAIRE

    Shreeve, Michael W.

    2012-01-01

    Evidence-based practice has emerged as a driving factor in current curriculum development in chiropractic education. This commentary discusses educational strategies incorporating evidence-based practices in the doctor of chiropractic curriculum and explores whether all five steps of the evidence-based process and patient outcomes from evidence-based practice are being assessed.

  11. International web survey of chiropractic students about evidence-based practice: a pilot study

    Directory of Open Access Journals (Sweden)

    Banzai Ryunosuke

    2011-03-01

    Full Text Available Abstract Background Positive attitude toward evidence-based practice (EBP principles in healthcare education may be one of the first steps for motivating a healthcare professional student to later apply EBP principles in clinical decision-making. The objectives for this project were to pilot an international web-based survey of chiropractic students and to describe student attitudes, behaviors, and knowledge about EBP principles. Methods We used SurveyMonkey™ to develop our survey based on an existing questionnaire used to measure basic knowledge, skills and beliefs about EBP among allied healthcare professionals and CAM practitioners. We invited 26 chiropractic educational institutions teaching in English and accredited by official organizations to participate. Academic officials and registrars at participating institutions forwarded an invitation email and two reminders to students between July and September 2010. The invitation contained a link to the 38-item web-based questionnaire. Descriptive statistics were performed for analysis. Results Fourteen institutions from Australia, Canada, US, Denmark and New Zealand participated. Among an estimated 7,142 student recipients of invitation letters, 674 participated in the survey for an estimated response rate of 9.4%. Most respondents reported having access to medical/healthcare literature through the internet, but only 11% read literature every week and 21% did not read literature at all. Respondents generally agreed that the use of research evidence in chiropractic was important. Although 76% of respondents found it easy to understand research evidence and 81% had some level of confidence assessing the general worth of research articles, 71% felt they needed more training in EBP to be able to apply evidence in chiropractic care. Respondents without previous training in research methods had lower confidence in assessing published papers. While more than 60% marked the correct answer for two

  12. Chiropractic Handbook.

    Science.gov (United States)

    New York State Education Dept., Albany. Office of the Professions.

    This reference guide contains laws, regulations, and licensing requirements and procedures governing chiropractic practice in New York State. Following a general introduction to professional regulation in New York State, licensure requirements are spelled out in detail, including general requirements, education requirements, examination…

  13. Clinical decision-making to facilitate appropriate patient management in chiropractic practice: 'the 3-questions model'

    Directory of Open Access Journals (Sweden)

    Amorin-Woods Lyndon G

    2012-03-01

    Full Text Available Abstract Background A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. Discussion This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Summary Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.

  14. Health care encounters in Danish chiropractic practice from a consumer perspectives - a mixed methods investigation

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Boyle, Eleanor; Larsen, Johanne Brinch;

    2016-01-01

    patients and 36 follow-up patients and finally video recorded 11 new and 24 follow-up consultations. Categorization and analysis led to the emergence six consumer touch point themes: 'the internet', 'the physical environment', 'practice models', 'administrative staff', 'the consultation sequence and timing......BACKGROUND: Perceived value is the key ingredient to carving and maintaining a competitive business niche. The opportunities to interact with consumers to understand and enhance perceived value are termed 'touch points'. Due to the out-of-pocket expense incurred by patients, Danish chiropractors...... are subject to consumer trends and behaviors. The purpose of this investigation was to explore and describe consumer touch points relevant to perceived value through healthcare journeys in chiropractic practices. METHOD: We designed a convergent parallel, mixed methods study. Our purposive sampling framework...

  15. Health care encounters in Danish chiropractic practice from a consumer perspectives - a mixed methods investigation

    DEFF Research Database (Denmark)

    Myburgh, Cornelius

    2016-01-01

    , 12 new patients and 36 follow-up patients and finally video recorded 11 new and 24 follow-up consultations. Categorization and analysis led to the emergence six consumer touch point themes: ‘the internet’, ‘the physical environment’, ‘practice models’, ‘administrative staff’, ‘the consultation......Background Perceived value is the key ingredient to carving and maintaining a competitive business niche. The opportunities to interact with consumers to understand and enhance perceived value are termed ‘touch points’. Due to the out-of-pocket expense incurred by patients, Danish chiropractors...... are subject to consumer trends and behaviors. Purpose The purpose of this investigation was to To explore and describe consumer touch points relevant to perceived value through healthcare journeys in chiropractic practices. Method We designed a convergent parallel, mixed methods study. Our purposive sampling...

  16. Core Competencies of the Certified Pediatric Doctor of Chiropractic: Results of a Delphi Consensus Process.

    Science.gov (United States)

    Hewitt, Elise; Hestbaek, Lise; Pohlman, Katherine A

    2016-04-01

    An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical education. These statements were distributed to the Delphi panel, reaching consensus when 80% of the panelists approved each segment. The panel consisted of 23 specialists in chiropractic pediatrics (14 females) from across the broad spectrum of the chiropractic profession. Sixty-one percent of panelists had postgraduate pediatric certifications or degrees, 39% had additional graduate degrees, and 74% were faculty at a chiropractic institution and/or in a postgraduate pediatrics program. The panel were initially given 10 statements with related substatements formulated by the study's steering committee. On all 3 rounds of the Delphi process the panelists reached consensus; however, multiple rounds occurred to incorporate the valuable qualitative feedback received. PMID:26739669

  17. Chiropractic. State of the Art.

    Science.gov (United States)

    Schafer, R. C., Ed.

    The review covers: (1) the discipline (description, scientific theories and principles, its practice, contributions to the health field, and history); (2) the profession (a doctor profile, patients, students, and the American Chiropractic Association); (3) chiropractic education (colleges, career opportunities, standard basic curriculum,…

  18. Chiropractic. New York State.

    Science.gov (United States)

    New York State Education Dept., Albany. Office of the Professions.

    A reference guide to laws, rules, and regulations that govern the chiropractic practice in New York State is presented. After an overview of professional regulation in the state, licensing requirements/procedures for chiropractors are described. Provisions of Title VIII, Articles 130 and 132, of the Education Law are also covered, along with…

  19. Texas Chiropractic College Practice Management Education: The Patient's Point of View.

    Science.gov (United States)

    Waigandt, Alex; And Others

    A survey was conducted to determine the patient's perception of treatment received from clinicians at the Texas Chiropractic College Clinic in Pasadena, Texas. A questionnaire designed to assess various aspects of the school's clinical and dispensary services was administered to 79 patients who had completed their treatment prescriptions. The…

  20. An Investigation into the Faculty Development Practices in Chiropractic Education Programs

    Science.gov (United States)

    Scaringe, John G.

    2010-01-01

    A descriptive case study design using a cross-sectional quantitative survey method was used to investigate the impact of faculty development programs on teaching effectiveness perceived by faculty teaching at chiropractic colleges in the United States. The availability of faculty development programs related to teaching and student learning was…

  1. Code of safe practice for the use of x-rays in diagnosis (chiropractic)

    International Nuclear Information System (INIS)

    The purpose of this code is to provide criteria for working procedures, x-ra diagnosis according to currently accepted standards of safety. The code is intended to apply to chiropractic diagnostic uses of x-rays. Reference is also made to radiation protection aspects of installation and servicing of diagnostic x-ray machines. refs., 1 fig., 1 ill

  2. Pregnant Students in the Gross Anatomy Laboratory: Policies and Practices at Chiropractic Colleges

    Science.gov (United States)

    Duray, Stephen M.; Mekow, Craig L.

    2011-01-01

    Chiropractic and medical colleges have experienced a significant increase in the number of female applicants in recent years, a percentage of whom are pregnant or become pregnant following admission. It is therefore important to ask the question: How do institutions that educate future health care providers address the issue of pregnancy and the…

  3. CHIROPRACTIC AND OSTEOPATHIC EDUCATION AT ROYAL MELBOURNE INSTITUTE TECHNOLOGY

    OpenAIRE

    French, Simon D.; Marshall, Simone J.; Webb, Michael; Tucker, Cynthia

    1999-01-01

    Objective: To assess the attitudes of undergraduate chiropractic and osteopathic students at Royal Melbourne Institute of Technology (RMIT) in 1992 on the education they are receiving and on the effectiveness of chiropractic and osteopathic care. Design: Cross-sectional descriptive survey. Participants: Undergraduate chiropractic and osteopathic students enrolled at RMIT School of Chiropractic and Osteopathy in 1992. Results: This study surveyed 272 students, 196 who were chiropractic student...

  4. Medical-chiropractic correspondence *

    OpenAIRE

    Cassidy, J David; Mierau, Dale R; Nykoliation, Jim W.; Arthur, Brian

    1985-01-01

    The authors are engaged in a multidisciplinary practice setting and have accumulated years of experience in medical-chiropractic co-operation. This paper outlines the importance of effective communication between disciplines in day-to-day clinical practice. It is important to know when and how to write letters of referral and chart notes. The proper development of these skills will foster greater interdisciplinary co-operation, better practice management skills, and an increased number of pat...

  5. The perceptions, attitudes and knowledge of physiotherapy and chiropractic students regarding each others’ professional practice

    OpenAIRE

    Naidoo, N; Bühler, L.

    2009-01-01

    Introduction: The roles of physiotherapists and chiropractors demon-strate some overlap. Both are members of a multidisciplinary team and contributeto the holistic care of patients. Good understanding of each others’ professionalpractice may lead to good working relationships with effective referrals, inter -disciplinary and multidisciplinary management of patients. Purpose: To investigate the perceptions, attitudes and knowledge of undergraduatephysiotherapy and chiropractic students about e...

  6. Legislative approaches to the regulation of the chiropractic profession

    OpenAIRE

    Chapman-Smith, David A

    1996-01-01

    Traditional or complementary health care services have a growing and significant role in both developed and developing countries. In the United Kingdom there was new legislation to regulate the chiropractic and osteopathy professions in 1993 and 1994. This was supported by the British Medical Association. There is now legislation regulating chiropractic practice in many jurisdictions. In general chiropractic is regulated as a separate discipline, although chiropractic and osteopathy are joint...

  7. A longitudinal study of chiropractic use among older adults in the United States

    Directory of Open Access Journals (Sweden)

    Jones Michael P

    2010-12-01

    Full Text Available Abstract Background Longitudinal patterns of chiropractic use in the United States, particularly among Medicare beneficiaries, are not well documented. Using a nationally representative sample of older Medicare beneficiaries we describe the use of chiropractic over fifteen years, and classify chiropractic users by annual visit volume. We assess the characteristics that are associated with chiropractic use versus nonuse, as well as between different levels of use. Methods We analyzed data from two linked sources: the baseline (1993-1994 interview responses of 5,510 self-respondents in the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD, and their Medicare claims from 1993 to 2007. Binomial logistic regression was used to identify factors associated with chiropractic use versus nonuse, and conditional upon use, to identify factors associated with high volume relative to lower volume use. Results There were 806 users of chiropractic in the AHEAD sample yielding a full period prevalence for 1993-2007 of 14.6%. Average annual prevalence between 1993 and 2007 was 4.8% with a range from 4.1% to 5.4%. Approximately 42% of the users consumed chiropractic services only in a single calendar year while 38% used chiropractic in three or more calendar years. Chiropractic users were more likely to be women, white, overweight, have pain, have multiple comorbid conditions, better self-rated health, access to transportation, higher physician utilization levels, live in the Midwest, and live in an area with fewer physicians per capita. Among chiropractic users, 16% had at least one year in which they exceeded Medicare's "soft cap" of 12 visits per calendar year. These over-the-cap users were more likely to have arthritis and mobility limitations, but were less likely to have a high school education. Additionally, these over-the-cap individuals accounted for 58% of total chiropractic claim volume. High volume users saw chiropractors the most among

  8. What Is Chiropractic?

    Science.gov (United States)

    ... ACA News Digital Edition Archives: ACA News Articles Advertising Opportunities News Newsroom News Releases Letters to the Editor Facts About Chiropractic Chiropractic in the Media ACA Radio Chiropractic Cares Social Media Facebook Twitter YouTube Instagram LinkedIn Advocacy Regulatory Policy Issue ...

  9. History of Chiropractic Care

    Science.gov (United States)

    ... ACA News Digital Edition Archives: ACA News Articles Advertising Opportunities News Newsroom News Releases Letters to the Editor Facts About Chiropractic Chiropractic in the Media ACA Radio Chiropractic Cares Social Media Facebook Twitter YouTube Instagram LinkedIn Advocacy Regulatory Policy Issue ...

  10. American Chiropractic Association

    Science.gov (United States)

    ... ACA News Digital Edition Archives: ACA News Articles Advertising Opportunities News Newsroom News Releases Letters to the Editor Facts About Chiropractic Chiropractic in the Media ACA Radio Chiropractic Cares Social Media Facebook Twitter YouTube Instagram LinkedIn Advocacy Regulatory Policy Issue ...

  11. Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice

    DEFF Research Database (Denmark)

    Eirikstoft, Heidi; Kongsted, Alice

    2014-01-01

    Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe...

  12. Chiropractic and CAM Utilization: A Descriptive Review

    Directory of Open Access Journals (Sweden)

    Meeker William C

    2007-01-01

    Full Text Available Abstract Objective To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions Data Sources A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. Data Selection A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Data Synthesis Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Results Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Conclusion Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

  13. The prevalence of the term subluxation in North American English-Language Doctor of chiropractic programs

    Directory of Open Access Journals (Sweden)

    Mirtz Timothy A

    2011-06-01

    Full Text Available Abstract Background The subluxation construct has been a divisive term in the chiropractic profession. There is a paucity of evidence to document the subluxation. Some authors have questioned the propriety of continuing to use the term. Aim The purpose of this study is to examine current North American English language chiropractic college academic catalogs and determine the prevalence of the term subluxation in the respective chiropractic program curricula. Methods Sixteen current English-language North American chiropractic college academic catalogs were studied. The term subluxation was searched for in each of the catalogs. Categories were developed for the usage of the term. These included "total times mentioned", "subluxation mentioned in a course description", "subluxation mentioned in a course title", "subluxation mentioned in a technique course description", and "subluxation mentioned in a philosophy course description." The prevalence of the "subluxation mentioned in a course description" was compared to the total programmatic curriculum. Results Palmer College in Florida devoted 22.72% of its curriculum to courses mentioning the subluxation followed by Life University (Marietta, GA and Sherman College with 16.44% and 12.80% respectively. As per specific coursework or subjects, an average of 5.22 courses or subjects have descriptions mentioning the term subluxation. Three schools made no mention of the term subluxation in their academic catalogs; they were National University of Health Sciences, Canadian Memorial Chiropractic College, and Southern California University of Health Sciences. Conclusion Despite the controversies and paucity of evidence the term subluxation is still found often within the chiropractic curricula of most North American chiropractic programs. Future research should determine if changes in accreditation standards and research on evidence based practice will affect this prevalence.

  14. Educational Standards for Chiropractic Colleges.

    Science.gov (United States)

    Council on Chiropractic Education, Des Moines, IA.

    The policy of accreditation for the chiropractic profession and educational standards for chiropractic colleges are presented. The following types are historical development of chiropractic accreditation; the structure and function of the Council on Chiropractic Education; and eligibility, procedures, and classifications for status as an…

  15. Chiropractic and children

    DEFF Research Database (Denmark)

    Leboeuf-Yde, Charlotte; Hestbæk, Lise

    2010-01-01

    , possible, or unsuitable.In this thematic series of Chiropractic & Osteopathy a number of reviews are presented, in which the research status of pediatric chiropractic is scrutinized and found wanting. Two important aspects were studied in these reviews: the effect of treatment and safety issues. Two types...

  16. Use of the term subluxation in publications during the formative years of the chiropractic profession

    OpenAIRE

    Johnson, Claire

    2011-01-01

    The term subluxation has come to have different meanings for different health care professions in the United States for over the past century. This controversy has resulted in some contention both internal and external to the chiropractic profession. Some current factions within the chiropractic profession hold the term subluxation to be synonymous with the identity of chiropractic itself; however, this term was not solely used by chiropractic during its formative years. The purpose of this a...

  17. The chiropractic profession in Norway 2011

    DEFF Research Database (Denmark)

    Kvammen, O. C.; Leboeuf-Yde, C.

    2014-01-01

    BACKGROUND: The chiropractic profession in Norway has increased five-fold in the last two decades. As there is no academic graduate program in Norway, all chiropractors have been trained outside of Norway, in either Europe, America or Australia. This might have given Norwegian chiropractors...... Norway. METHOD: Two surveys were distributed to all 530 registered chiropractors in Norway in 2011. One survey was for all chiropractors (Survey 1) and the other for clinic owners (Survey 2). Results have been reported as tables and as approximate percentages in the text for ease of reading. RESULT......: Response rates were 61% (Survey 1, N = 320) and 71% (Survey 2, N = 217). More than two-thirds of the chiropractors in Norway had been in practice for under a decade. Only one in four chiropractors worked in solo practice and the majority shared premises with at least one colleague, typically at least one...

  18. The Effects of Chiropractic Treatment on Students With Learning and Behavioral Impairments Due to Neurological Dysfunction.

    Science.gov (United States)

    Walton, E. V.; Brzozowski, Walter T.

    The effects of chiropractic treatment on children with learning and behavioral problems was investigated with 24 elementary and secondary level students, 12 receiving regular chiropractic treatment and 12 receiving medication. Results indicated that chiropractic treatment was more effective for the wide range symptoms common in the neurological…

  19. The new chiropractic

    OpenAIRE

    Walker, Bruce F.

    2016-01-01

    Background Physical manipulation and manual therapies are thousands of years old. The most popular western world iteration of these therapies is delivered by chiropractors. It can be argued that the collective public health benefit from chiropractic for spinal pain has been very substantial, however as chiropractic has transitioned from craft to profession it has encountered many internally and externally driven machinations that have retarded its progress to a fully accepted allied health pr...

  20. Chiropractic care for back pain

    Science.gov (United States)

    Chiropractic care is a way to diagnose and treat health problems that affect the nerves, muscles, bones, ... the body. A health care provider who provides chiropractic care is called a chiropractor. Hands-on adjustment ...

  1. Frequently Asked Questions about Chiropractic

    Science.gov (United States)

    ... ACA News Digital Edition Archives: ACA News Articles Advertising Opportunities News Newsroom News Releases Letters to the Editor Facts About Chiropractic Chiropractic in the Media ACA Radio Chiropractic Cares Social Media Facebook Twitter YouTube Instagram LinkedIn Advocacy Regulatory Policy Issue ...

  2. Attitudes towards chiropractic: an analysis of written comments from a survey of north american orthopaedic surgeons

    Directory of Open Access Journals (Sweden)

    Busse Jason W

    2011-10-01

    Full Text Available Abstract Background There is increasing interest by chiropractors in North America regarding integration into mainstream healthcare; however, there is limited information about attitudes towards the profession among conventional healthcare providers, including orthopaedic surgeons. Methods We administered a 43-item cross-sectional survey to 1000 Canadian and American orthopaedic surgeons that inquired about demographic variables and their attitudes towards chiropractic. Our survey included an option for respondants to include written comments, and our present analysis is restricted to these comments. Two reviewers, independantly and in duplicate, coded all written comments using thematic analysis. Results 487 surgeons completed the survey (response rate 49%, and 174 provided written comments. Our analysis revealed 8 themes and 24 sub-themes represented in surgeons' comments. Reported themes were: variability amongst chiropractors (n = 55; concerns with chiropractic treatment (n = 54; areas where chiropractic is perceived as effective (n = 43; unethical behavior (n = 43; patient interaction (n = 36; the scientific basis of chiropractic (n = 26; personal experiences with chiropractic (n = 21; and chiropractic training (n = 18. Common sub-themes endorsed by surgeon's were diversity within the chiropractic profession as a barrier to increased interprofessional collaboration, endorsement for chiropractic treatment of musculoskeletal complaints, criticism for treatment of non-musculoskeletal complaints, and concern over whether chiropractic care was evidence-based. Conclusions Our analysis identified a number of issues that will have to be considered by the chiropractic profession as part of its efforts to further integrate chiropractic into mainstream healthcare.

  3. Children and chiropractic care

    DEFF Research Database (Denmark)

    Hartvigsen, Jan; Hestbaek, Lise

    2009-01-01

    care profession has convincingly assumed the responsibility of spinal and musculoskeletal health for children. Considering the magnitude of the challenges ahead for both researchers and clinicians, this may be a good opportunity for doctors of chiropractic to take responsibility and engage...

  4. The Council on Chiropractic Education's New Wellness Standard: A call to action for the chiropractic profession

    Directory of Open Access Journals (Sweden)

    Rupert Ronald

    2006-10-01

    Full Text Available Abstract Background The chiropractic profession has long considered itself to be a preventive science. Recently the Council on Chiropractic Education (CCE has defined a set of standards that must be implemented at all US chiropractic colleges as of January of 2007. These are specific to wellness measures and health promoting efforts that should be performed by chiropractors. This will mandate traditional health promotion and prevention methods be taught to students at accredited colleges and to practicing chiropractors. Objective To present the idea of performing traditional health promotion and wellness-concepts in chiropractic practice as a call to action for clinicians and generate discussion on the topic. Discussion This manuscript discusses relevant topics of health promotion and prevention for chiropractors and other practicing clinicians that should be made priorities with patients in order to enhance both patient health and community and population health. Conclusion All practicing chiropractors, as well as other clinicians should take these new standards from the CCE as a call to action to begin helping patients address the removable causes of morbidity, disability and premature mortality where they exist, in addition to treating their painful spinal conditions.

  5. Cortex-sparing infarction in triple cervical artery dissection following chiropractic neck manipulation

    Science.gov (United States)

    Melikyan, Gayane; Kamran, Saadat; Akhtar, Naveed; Deleu, Dirk; Miyares, Francisco Ruiz

    2015-01-01

    Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery territory infarctions and large cortical-sparing left middle cerebral artery infarction. This suggests the presence of functionally patent and interconnecting leptomeningeal anastomoses between cerebral arteries, which may provide sufficient blood flow to salvage penumbral regions when a supplying artery is occluded. Conclusion: Chiropractic cervical manipulation can result in catastrophic vascular lesions preventable if these practices are limited to highly specialized personnel under very specific situations. PMID:26835412

  6. The Journal of Chiropractic Medicine and selected specialties in the chiropractic profession

    OpenAIRE

    Johnson, Claire

    2010-01-01

    This article presents a brief description of the specialty chiropractic groups that are affiliated with the Journal of Chiropractic Medicine: American Academy of Chiropractic Physicians (AACP), The American Chiropractic Board of Sports Physicians (ACBSP), The College on Forensic Sciences (CFS), and The International Academy of Chiropractic Neurology (IACN).

  7. The Journal of Chiropractic Medicine: an update on selected specialties in the chiropractic profession☆

    OpenAIRE

    Johnson, Claire

    2012-01-01

    This article presents a brief description of the specialty chiropractic groups that are affiliated with the Journal of Chiropractic Medicine: American Academy of Chiropractic Physicians (AACP), The American Chiropractic Board of Sports Physicians (ACBSP), The College on Forensic Sciences (CFS), and The International Academy of Chiropractic Neurology (IACN), and the Council on Diagnostic Imaging (CDI).

  8. Cortex-sparing infarction in triple cervical artery dissection following chiropractic neck manipulation

    OpenAIRE

    Melikyan, Gayane; Kamran, Saadat; Akhtar, Naveed; Deleu, Dirk; Miyares, Francisco Ruiz

    2016-01-01

    Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery ter...

  9. Chiropractic & Osteopathy. A new journal

    OpenAIRE

    Walker Bruce F; French Simon D; Cameron Melainie

    2005-01-01

    Abstract Both chiropractic and osteopathy are over a century old. They are now regarded as complementary health professions. There is an imperative for both professions to research the principles and claims that underpin them, and the new journal Chiropractic & Osteopathy provides a scientific forum for the publication of such research.

  10. Chiropractic & Osteopathy. A new journal

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2005-04-01

    Full Text Available Abstract Both chiropractic and osteopathy are over a century old. They are now regarded as complementary health professions. There is an imperative for both professions to research the principles and claims that underpin them, and the new journal Chiropractic & Osteopathy provides a scientific forum for the publication of such research.

  11. Chiropractic radiology in Canada: an anthology of the Chiropractic College of Radiologists (Canada) Inc

    OpenAIRE

    Shrubb, Eric F.

    1990-01-01

    Although there are numerous chiropractic institutions, one which receives little acclaim, but contributes significantly to chiropractic life in Canada, is the Chiropractic College of Radiologists (Canada) Inc. The following presentation represents a brief historical perspective of this most prestigious organization.

  12. Chiropractic care and public health

    DEFF Research Database (Denmark)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre;

    2012-01-01

    The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues t...... prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?......The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...... through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries in...

  13. Integrating Massage, Chiropractic, and Acupuncture in University Clinics: A Guided Student Observation

    Science.gov (United States)

    Estrin Dashe, Alejandra A.

    2012-01-01

    Background Several studies have reported on the health benefits of applying an integrated complementary health care model. Purpose This paper presents the results of pilot research focusing on the observations massage therapy students made about complementary health care education and integration during massage, chiropractic, and acupuncture treatments at two university clinics. Setting: Observations took place at Northwestern Health Sciences University’s associated clinics that offered massage, chiropractic, and acupuncture. Research Design: Students directly observed how clinicians and interns educated their patients and integrated other forms of complementary health care into their practice. Participants: chiropractors, massage therapists, and acupuncturists, and their patients. All participants were English-speaking and 18–65 years old. Main Outcome Measures: Observations recorded by students in journals about education and integration during massage therapy, chiropractic, and acupuncture treatments were coded and counted. Results Qualitative observations showed that clinicians and interns educated patients to some degree, but the clinicians were less apt to integrate other modalities than the interns. Conclusions Observations support that professional integrity may limit clinicians in their ability to integrate multiple modalities of health care while treating patients. Since it is well established that integration of multiple health care modalities is beneficial to patient health, it is recommended that clinics assist their clinical staff in applying an integrative approach to their practice. PMID:22811755

  14. Assessing patient-centered care in patients with chronic health conditions attending chiropractic practice: protocol for a mixed-methods study

    OpenAIRE

    Stuber, Kent Jason; Langweiler, Mark; Mior, Silvano; McCarthy, Peter William

    2016-01-01

    Background The management of chronic health conditions increasingly requires an organized, coordinated, and patient-centered approach to care. The Chronic Care Model (CCM) has been adopted in primary care to improve care delivery for those with chronic health conditions. Chiropractors manage chronic health conditions; however, little is known if such care is patient-centered. The primary aim of this study is to determine to what extent chiropractic patients with chronic health conditions perc...

  15. Chiropractic at the crossroads or are we just going around in circles?

    Directory of Open Access Journals (Sweden)

    Reggars John W

    2011-05-01

    Full Text Available Abstract Background Chiropractic in Australia has seen many changes over the past 30 years. Some of these changes have advanced the professional status of chiropractic, improved undergraduate training and paved the way for a research culture. Unfortunately, other changes or lack of changes, have hindered the growth, public utilisation and professional standing of chiropractic in Australia. This article explores what influences have impacted on the credibility, advancement and public utilisation of chiropractic in Australia. Discussion The 1970's and 1980's saw a dramatic change within the chiropractic profession in Australia. With the advent of government regulation, came government funded teaching institutions, quality research and increased public acceptance and utilisation of chiropractic services. However, since that time the profession appears to have taken a backward step, which in the author's opinion, is directly linked to a shift by sections of the profession to the fundamentalist approach to chiropractic and the vertebral subluxation complex. The abandonment, by some groups, of a scientific and evidenced based approach to practice for one founded on ideological dogma is beginning to take its toll. Summary The future of chiropractic in Australia is at a crossroads. For the profession to move forward it must base its future on science and not ideological dogma. The push by some for it to become a unique and all encompassing alternative system of healthcare is both misguided and irrational.

  16. Integration of Chiropractic Services in Military and Veteran Health Care Facilities: A Systematic Review of the Literature.

    Science.gov (United States)

    Green, Bart N; Johnson, Claire D; Daniels, Clinton J; Napuli, Jason G; Gliedt, Jordan A; Paris, David J

    2016-04-01

    This literature review examined studies that described practice, utilization, and policy of chiropractic services within military and veteran health care environments. A systematic search of Medline, CINAHL, and Index to Chiropractic Literature was performed from inception through April 2015. Thirty articles met inclusion criteria. Studies reporting utilization and policy show that chiropractic services are successfully implemented in various military and veteran health care settings and that integration varies by facility. Doctors of chiropractic that are integrated within military and veteran health care facilities manage common neurological, musculoskeletal, and other conditions; severe injuries obtained in combat; complex cases; and cases that include psychosocial factors. Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high. Preliminary findings show that chiropractic management of common conditions shows significant improvement. PMID:26677851

  17. Chiropractic Manipulation: Reasons for Concern?

    OpenAIRE

    Gouveia, LO; Castanho, P.; Ferreira, JJ; Guedes, MM; Falcão, F; Pinho e Melo, T

    2007-01-01

    Chiropractic's popularity is rising among the general population. Moreover, few studies have been conducted to properly evaluate its safety. We report three cases of serious neurological adverse events in patients treated with chiropractic manipulation. The first case is a 41 years old woman who developed a vertebro-basilar stroke 48 h after cervical manipulation. The second case represents a 68 years old woman who presented a neuropraxic injury of both radial nerves after three sessions of s...

  18. Chiropractic wellness on the web: the content and quality of information related to wellness and primary prevention on the Internet

    Directory of Open Access Journals (Sweden)

    Evans Marion

    2011-02-01

    Full Text Available Abstract Background The Internet has become a common source of information for patients wishing to learn about health information. Previous studies found information related to back pain poor and often contradictory to current guidelines. Wellness has become a common topic in the field of chiropractic and accrediting agencies have standards on delivery of wellness-based content in college curricula as well as directives for clinical applications. The purpose of this study was to evaluate the quality of the information on the Internet using the terms "chiropractic wellness," or "wellness chiropractic". Methods Five commonly used search engines were selected and the first 10 sites found using the strategy above were evaluated by two raters. Demographic assessments of the sites were made along with whether they were Health on the Net Foundation (HON certified, contained standard wellness content, mentioned any Healthy People Focus Areas, and other chiropractic topics. Kappa statistics compared inter-rater agreement. Results Potential patients appeared to be the audience 87% of the time and a private doctor of chiropractic appeared to be the typical site owner. The sites usually promoted the provider. No sites displayed HON certification logo nor did any appear to meet the HON certification criteria. Twenty-six sites (55% promoted regular physical activity in some manner and 18 (38% had information on health risks of tobacco. Four (9% had mental health or stress-reduction content but none had information supportive of vaccination. Some had information contradictory to common public health measures. Conclusions Patients searching the Internet for chiropractic wellness information will often find useless information that will not help them maintain health or become well. Most simply market the chiropractic practice or allow for a patients to provide personal information in exchange for more 'wellness' information. More research should be done on how

  19. Chiropractic and children: Is more research enough?

    Directory of Open Access Journals (Sweden)

    Leboeuf-Yde Charlotte

    2010-06-01

    Full Text Available Abstract Many health science research and review articles end with the words: "More research is needed". However, when it comes to research, it is not as much a question of quantity as of quality. There are a number of important prerequisites before research should be initiated. The three pillars, relevance, quality and ethics should be respected but for a project to be meaningful, it must also be based on plausible rationale. In evidence-based (informed practice, one takes into account not only research-based evidence but also clinical expertise and the patients' perspectives. In this paper, we briefly discuss how this should be handled in clinical practice is briefly discussed, using the concept of "traffic lights" (red, yellow, green. We explain how the combination of evidence and plausibility can be used to reach a decision as to whether a treatment or diagnostic procedure is suitable, possible, or unsuitable. In this thematic series of Chiropractic & Osteopathy a number of reviews are presented, in which the research status of pediatric chiropractic is scrutinized and found wanting. Two important aspects were studied in these reviews: the effect of treatment and safety issues. Two types of problems were identified: the lack of research in general and the lack of research using the appropriate study designs and methodology in particular. Therefore, we discuss the meager research noted in the areas of chiropractic care in children and the clinical consequences this should have. The prerequisites for "more research" are scrutinized and an example given of suitable research programs. Finally, the important issue of implementation of research findings is covered, emphasizing the responsibility of all stakeholders involved at both the undergraduate and the postgraduate level, within professional associations, and on an individual level.

  20. An educational campaign to increase chiropractic intern advising roles on patient smoking cessation

    Directory of Open Access Journals (Sweden)

    Strasser Sheryl M

    2006-10-01

    Full Text Available Abstract Background Tobacco use, particularly smoking, is the most preventable cause of death in the United States. More than 400,000 premature deaths are associated with its use and the health care costs are in the billions. All health care provider groups should be concerned with patients who continue to smoke and use tobacco. The US Preventive Services Taskforce and Health People 2010 guidelines encourage providers to counsel smokers on cessation. Current studies, though limited regarding chiropractic advising practices indicate a low engagement rate when it comes to providing cessation information. Objective To test a campaign regarding initial impact aimed at increasing chiropractic interns advising on cessation and delivery of information to smokers on cessation. Discussion Chiropractic interns do engage patients on smoking status and can be encouraged to provide more cessation messages and information to patients. The initial impact assessment of this campaign increased the provision of information to patients by about 25%. The prevalence of smoking among chiropractic patients, particularly at teaching clinics may be lower than the national averages. Conclusion Chiropractic interns can and should be encouraged to advise smokers about cessation. A systematic method of intake information on smoking status is needed and a standardized education protocol for chiropractic colleges is needed. Chiropractic colleges should assess the adequacy of their advising roles and implement changes to increase cessation messages to their patients as soon as possible.

  1. Assessing the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after an educational intervention.

    Science.gov (United States)

    Wong, Jessica J; Di Loreto, Luciano; Kara, Alim; Yu, Kavan; Mattia, Alicia; Soave, David; Weyman, Karen; Kopansky-Giles, Deborah

    2014-10-01

    Objective : We assessed the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after a 1-hour educational intervention. Methods : A mixed-methods approach was used with a 52-item cross-sectional paper survey and 1 focus group of third-year medical students. The views of these medical students towards chiropractic were assessed previously in their second-year of medical school. ANOVA and the Wilcoxon rank-sum test were used to assess between-group differences between the medical students' views before and after the educational intervention. The constant comparative method for analyzing qualitative data was used to identify emergent themes from the focus group transcript. Results : Of 112 third-year medical students, 58 completed the survey (51.7% response rate). The focus group consisted of 6 medical students. Self-reported understanding of chiropractic and number of attitude-positive responses were significantly higher in the group after the educational session. The average number of correct responses assessing knowledge on chiropractic also was significantly higher. Focus group themes were that medical students wanted exposure to chiropractic in clinical settings, had negative attitudes towards chiropractic formed from hidden curriculum, had concerns regarding evidence and safety of chiropractic, and thought that timing of the session on chiropractic was too late in the curriculum. Conclusions : The attitudes and knowledge of medical students towards chiropractic improved immediately after a 1-hour educational intervention. Formally educating medical students on chiropractic may help minimize hidden curriculum issues regarding chiropractic, as identified by the medical students, and facilitate collaboration between medical and chiropractic providers. PMID:25237768

  2. Assessing the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after an educational intervention*

    Science.gov (United States)

    Wong, Jessica J.; Di Loreto, Luciano; Kara, Alim; Yu, Kavan; Mattia, Alicia; Soave, David; Weyman, Karen; Kopansky-Giles, Deborah

    2014-01-01

    Objective We assessed the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after a 1-hour educational intervention. Methods A mixed-methods approach was used with a 52-item cross-sectional paper survey and 1 focus group of third-year medical students. The views of these medical students towards chiropractic were assessed previously in their second-year of medical school. ANOVA and the Wilcoxon rank-sum test were used to assess between-group differences between the medical students' views before and after the educational intervention. The constant comparative method for analyzing qualitative data was used to identify emergent themes from the focus group transcript. Results Of 112 third-year medical students, 58 completed the survey (51.7% response rate). The focus group consisted of 6 medical students. Self-reported understanding of chiropractic and number of attitude-positive responses were significantly higher in the group after the educational session. The average number of correct responses assessing knowledge on chiropractic also was significantly higher. Focus group themes were that medical students wanted exposure to chiropractic in clinical settings, had negative attitudes towards chiropractic formed from hidden curriculum, had concerns regarding evidence and safety of chiropractic, and thought that timing of the session on chiropractic was too late in the curriculum. Conclusions The attitudes and knowledge of medical students towards chiropractic improved immediately after a 1-hour educational intervention. Formally educating medical students on chiropractic may help minimize hidden curriculum issues regarding chiropractic, as identified by the medical students, and facilitate collaboration between medical and chiropractic providers. PMID:25237768

  3. Robotic Measurement and Control for Chiropractic Research

    Directory of Open Access Journals (Sweden)

    P. Goldsmith

    2006-01-01

    Full Text Available The precision and programmability of robotic manipulators makes them suitable for biomechanics research, particularly when an experimental procedure must be accurately repeated multiple times. This paper describes a robotic system used to investigate biomechanical mechanisms of stroke in humans. A parallel robot manipulator is used to reproduce chiropractic manipulations on animal subjects using a 3-D vision system. An algorithm for calibrating the system is proposed and tested on the robot. An iterative learning control scheme is then introduced to improve positional accuracy. Experimental results demonstrate that the calibration procedure and learning scheme are both effective.

  4. A randomized clinical trial of chiropractic treatment and self-management in patients with acute musculoskeletal chest pain

    DEFF Research Database (Denmark)

    Stochkendahl, Mette J; Christensen, Henrik W; Vach, Werner;

    2012-01-01

    We have previously reported short-term follow-up from a pragmatic randomized clinical trial comparing 2 treatments for acute musculoskeletal chest pain: (1) chiropractic treatment and (2) self-management. Results indicated a positive effect in favor of the chiropractic treatment after 4 and 12...

  5. Psychosocial factors and their predictive value in chiropractic patients with low back pain: a prospective inception cohort study

    OpenAIRE

    Breen Alan C; Langworthy Jennifer M

    2007-01-01

    Abstract Background Being able to estimate the likelihood of poor recovery from episodes of back pain is important for care. Studies of psychosocial factors in inception cohorts in general practice and occupational populations have begun to make inroads to these problems. However, no studies have yet investigated this in chiropractic patients. Methods A prospective inception cohort study of patients presenting to a UK chiropractic practice for new episodes of non-specific low back pain (LBP) ...

  6. Does Chiropractic “Add Years to Life”?

    OpenAIRE

    Gleberzon, Brian J.

    2004-01-01

    The chiropractic cliché “Chiropractic Adds Life to Years and Years to Life” was examined for validity. It was assumed that chiropractors themselves would be the best informed about the health benefits of chiropractic care. Chiropractors would therefore be most likely to receive some level of chiropractic care, and do so on a long-term basis. If chiropractic care significantly improves general health then chiropractors themselves should demonstrate longer life spans than the general population...

  7. Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews

    Directory of Open Access Journals (Sweden)

    Alireza Salehi

    2015-10-01

    Full Text Available Abstract Chiropractic is a complementary medicine that has been growing increasingly in different countries over recent decades. It addresses the prevention, diagnosis and treatment of the neuromusculoskeletal system disorders and their effects on the whole body health. This study aims to evaluate the effectiveness of chiropractic in the treatment of different diseases. To gather data, scientific electronic databases, such as Cochrane, Medline, Google Scholar, and Scirus were searched and all systematic reviews in the field of chiropractic were obtained. Reviews were included if they were specifically concerned with the effectiveness of chiropractic treatment, included evidence from at least one clinical trial, included randomized studies and focused on a specific disease. The research data including the article’s first author’s name, type of disease, intervention type, number and types of research used, meta-analysis, number of participants, and overall results of the study, were extracted, studied and analyzed. Totally, 23 chiropractic systematic reviews were found, and 11 articles met the defined criteria. The results showed the influence of chiropractic on improvement of neck pain, shoulder and neck trigger points, and sport injuries. In the cases of asthma, infant colic, autism spectrum disorder, gastrointestinal problems, fibromyalgia, back pain and carpal tunnel syndrome, there was no conclusive scientific evidence. There is heterogeneity in some of the studies and also limited number of clinical trials in the assessed systematic reviews. Thus, conducting comprehensive studies based on more reliable study designs are highly recommended.

  8. Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews.

    Science.gov (United States)

    Salehi, Alireza; Hashemi, Neda; Imanieh, Mohammad Hadi; Saber, Mahboobeh

    2015-10-01

    Chiropractic is a complementary medicine that has been growing increasingly in different countries over recent decades. It addresses the prevention, diagnosis and treatment of the neuromusculoskeletal system disorders and their effects on the whole body health. This study aims to evaluate the effectiveness of chiropractic in the treatment of different diseases. To gather data, scientific electronic databases, such as Cochrane, Medline, Google Scholar, and Scirus were searched and all systematic reviews in the field of chiropractic were obtained. Reviews were included if they were specifically concerned with the effectiveness of chiropractic treatment, included evidence from at least one clinical trial, included randomized studies and focused on a specific disease. The research data including the article's first author's name, type of disease, intervention type, number and types of research used, meta-analysis, number of participants, and overall results of the study, were extracted, studied and analyzed. Totally, 23 chiropractic systematic reviews were found, and 11 articles met the defined criteria. The results showed the influence of chiropractic on improvement of neck pain, shoulder and neck trigger points, and sport injuries. In the cases of asthma, infant colic, autism spectrum disorder, gastrointestinal problems, fibromyalgia, back pain and carpal tunnel syndrome, there was no conclusive scientific evidence. There is heterogeneity in some of the studies and also limited number of clinical trials in the assessed systematic reviews. Thus, conducting comprehensive studies based on more reliable study designs are highly recommended. PMID:26448951

  9. Assessing the attitudes, knowledge and perspectives of medical students to chiropractic

    Science.gov (United States)

    Wong, Jessica J.; Di Loreto, Luciano; Kara, Alim; Yu, Kavan; Mattia, Alicia; Soave, David; Weyman, Karen; Kopansky-Giles, Deborah

    2013-01-01

    Objective: To assess second-year medical students’ views on chiropractic. Methods: A three-step triangulation approach was designed, comprising a 53-item survey, nine key informant interviews and one focus group of 8 subjects. ANOVA was used to assess attitude-response survey totals over grouping variables. Constant comparison method and NVivo was used for thematic analysis. Results: 112 medical students completed the survey (50% response rate). Subjects reporting no previous chiropractic experience/exposure or interest in learning about chiropractic were significantly more attitude-negative towards chiropractic. Thematically, medical students viewed chiropractic as an increasingly evidence-based complementary therapy for low back/chronic pain, but based views on indirect sources. Within formal curriculum, they wanted to learn about clinical conditions and benefits/risks related to treatment, as greater understanding was needed for future patient referrals. Conclusion: The results highlight the importance of exposure to chiropractic within the formal medical curriculum to help foster future collaboration between these two professions. PMID:23482682

  10. Clinical evaluation tools: a survey of doctors of chiropractic and students at one chiropractic college

    Science.gov (United States)

    Mansholt, Barbara A.; Vining, Robert D.

    2016-01-01

    Introduction: The reliability and validity of many evaluation tools leading to clinical decision-making for spinal manipulation are varied. We surveyed senior students and DC employees at one chiropractic college regarding 1) which analysis tools should be used and 2) factors that influence their choices. Methods: The survey queried which tools should be used on a routine patient encounter. Clinical evaluation tools included palpation, skin temperature analysis, leg length analysis, and radiographs. Results: Surveys were collected from 58 doctors of chiropractic (DCs) and 74 students. Respondents from both groups reported to most commonly use static palpation, followed by motion palpation and leg length analysis. DC respondents ranked evidence and personal experience high for rationale; student respondents frequently chose patient preference. Conclusion: DC and student respondents reported use of clinical evaluation tools consistently. However, some variations in rationale were noted. It is important for educators to provide a balanced presentation of the strengths and limitations of clinical analysis procedures to support the development of well-justified evidence-based clinical decision-making skills. PMID:27069264

  11. The first research agenda for the chiropractic profession in Europe

    DEFF Research Database (Denmark)

    Rubinstein, Sidney M; Bolton, Jenni; Webb, Alexandra L;

    2014-01-01

    in an independent institution. In total, 58% of the participants were from the UK and Denmark, collectively representing 44% of the chiropractors working in Europe. In total, 70 research priorities were identified, of which 19 reached consensus as priorities for future research. The following three items were...... to best channel the available resources and facilitate advancement of the profession. METHODS: In total, 60 academics and clinicians working in a chiropractic setting, and who had attended any of the annual European Chiropractors' Union/European Academy of Chiropractic (ECU/EAC) Researchers' Day meetings...... since their inception in 2008, were invited to participate. Data collection consisted of the following phases: phase 1 identification of themes; phase 2 consensus, which employed a Delphi process and allowed us to distill the list of research priorities; and phase 3 presentation of the results during...

  12. The establishment of the Chiropractic & Osteopathic College of Australasia in Queensland (1996–2002

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2005-04-01

    Full Text Available Abstract Introduction For chiropractors and osteopaths after graduation, the learning process continues by way of experience and continuing education (CE. The provision of CE and other vocational services in Queensland between 1996 and 2002 is the subject of this paper. Methods The Chiropractic & Osteopathic College of Australasia (COCA implemented a plan, which involved continuing education, with speakers from a broad variety of health provider areas; and the introduction of the concepts of evidence-based practice. The plan also involved building membership. Results Membership of COCA in Queensland grew from 3 in June 1996 to 167 in 2002. There were a total of 25 COCA symposia in the same period. Evidence-based health care was introduced and attendees were generally satisfied with the conferences. Discussion The development of a vocational body (COCA for chiropractors and osteopaths in Queensland was achieved. Registrants in the field have supported an organisation that concentrates on the vocational aspects of their practice.

  13. Back problems. Chiropractic evaluation and management.

    Science.gov (United States)

    Haussler, K K

    1999-04-01

    A thorough knowledge of equine spinal anatomy, biomechanics, and potential pathology is required to understand the principles and theories behind chiropractic and to apply its techniques properly. Chiropractic provides additional diagnostic and therapeutic means that may help equine practitioners to identify and treat the primary cause of lameness or poor performance. Specialized training in the evaluation and treatment of vertebral joint dysfunction and neuromusculoskeletal disorders places chiropractic in the forefront of conservative treatment of spinal-related disorders. Nevertheless, limited research is currently available on equine chiropractic and other nontraditional modalities in veterinary medicine. In 1996, the American Veterinary Medicine Association's Committee on Alternative and Complementary Therapies suggested that the research community should be encouraged to prioritize avenues of research and to allocate research funds to projects that are designed to provide further scientific evaluation of these modalities. The future of equine chiropractic in veterinary medicine is dependent on future research into the clinical effects of chiropractic techniques and the basic pathophysiology of spinal-related disorders in horses. PMID:10218250

  14. Chiropractic manipulation in Adolescent Idiopathic Scoliosis: a pilot study

    Directory of Open Access Journals (Sweden)

    Stoline Michael R

    2006-08-01

    Full Text Available Abstract Background Adolescent idiopathic scoliosis (AIS remains the most common deforming orthopedic condition in children. Increasingly, both adults and children are seeking complementary and alternative therapy, including chiropractic treatment, for a wide variety of health concerns. The scientific evidence supporting the use chiropractic intervention is inadequate. The purpose of this study was to conduct a pilot study and explore issues of safety, patient recruitment and compliance, treatment standardization, sham treatment refinement, inter-professional cooperation, quality assurance, and outcome measure selection. Methods Six patients participated in this 6-month study, 5 of whom were female. One female was braced. The mean age of these patients was 14 years, and the mean Cobb angle was 22.2 degrees. The study design was a randomized controlled clinical trial with two independent and blinded observers. Three patients were treated by standard medical care (observation or brace treatment, two were treated with standard medical care plus chiropractic manipulation, and one was treated with standard medical care plus sham manipulation. The primary outcome measure was Cobb, and the psychosocial measure was Scoliosis Quality of Life Index. Results Orthopedic surgeons and chiropractors were easily recruited and worked cooperatively throughout the trial. Patient recruitment and compliance was good. Chiropractic treatments were safely employed, and research protocols were successful. Conclusion Overall, our pilot study showed the viability for a larger randomized trial. This pilot confirms the strength of existing protocols with amendments for use in a full randomized controlled trial. Trial registration This trial has been assigned an international standard randomized controlled trial number by Current Controlled Trials, Ltd. http://www.controlled-trials.com/isrctn/. The number is ISRCTN41221647.

  15. Case management of chiropractic patients with cervical brachialgia

    DEFF Research Database (Denmark)

    Guenoun, Olivier; Debarle, Michel; Garnesson, Coralie; Proisl, Sylvie; Ray, Delphine; Leboeuf-Yde, Charlotte

    2011-01-01

    Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues.......Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues....

  16. Attitudes Toward Chiropractic: A Survey of Canadian Obstetricians.

    Science.gov (United States)

    Weis, Carol Ann; Stuber, Kent; Barrett, Jon; Greco, Alexandra; Kipershlak, Alexander; Glenn, Tierney; Desjardins, Ryan; Nash, Jennifer; Busse, Jason

    2016-04-01

    We assessed the attitudes of Canadian obstetricians toward chiropractic with a 38-item cross-sectional survey. Ninety-one obstetricians completed the survey, for a response rate of 14% (91 of 659). Overall, 30% of respondents held positive views toward chiropractic, 37% were neutral, and 33% reported negative views. Most (77%) reported that chiropractic care was effective for some musculoskeletal complaints, but 74% disagreed that chiropractic had a role in treatment of non-musculoskeletal conditions. Forty percent of respondents referred at least some patients for chiropractic care each year, and 56% were interested in learning more about chiropractic care. Written comments from respondents revealed concerns regarding safety of spinal manipulation and variability among chiropractors. Canadian obstetricians' attitudes toward chiropractic are diverse and referrals to chiropractic care for their patients who suffer from pregnancy-related low back pain are limited. Improved interprofessional relations may help optimize care of pregnant patients suffering from low back pain. PMID:26350243

  17. Chiropractic care for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder: A systematic review

    Directory of Open Access Journals (Sweden)

    Bonello Rod

    2010-06-01

    Full Text Available Abstract Background Psychostimulants are first line of therapy for paediatric and adolescent AD/HD. The evidence suggests that up to 30% of those prescribed stimulant medications do not show clinically significant outcomes. In addition, many children and adolescents experience side-effects from these medications. As a result, parents are seeking alternate interventions for their children. Complementary and alternative medicine therapies for behavioural disorders such as AD/HD are increasing with as many as 68% of parents having sought help from alternative practitioners, including chiropractors. Objective The review seeks to answer the question of whether chiropractic care can reduce symptoms of inattention, impulsivity and hyperactivity for paediatric and adolescent AD/HD. Methods Electronic databases (Cochrane CENTRAL register of Controlled Trials, Cochrane Database of Systematic reviews, MEDLINE, PsycINFO, CINAHL, Scopus, ISI Web of Science, Index to Chiropractic Literature were searched from inception until July 2009 for English language studies for chiropractic care and AD/HD. Inclusion and exclusion criteria were applied to select studies. All randomised controlled trials were evaluated using the Jadad score and a checklist developed from the CONSORT (Consolidated Standards of Reporting Trials guidelines. Results The search yielded 58 citations of which 22 were intervention studies. Of these, only three studies were identified for paediatric and adolescent AD/HD cohorts. The methodological quality was poor and none of the studies qualified using inclusion criteria. Conclusions To date there is insufficient evidence to evaluate the efficacy of chiropractic care for paediatric and adolescent AD/HD. The claim that chiropractic care improves paediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of paediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous

  18. The journal 'chiropractic & osteopathy' changes its title to 'chiropractic & manual therapies'. a new name, a new era

    OpenAIRE

    Walker Bruce F; French Simon D; Cameron Melanie; Perle Stephen M; Lebouef-Yde Charlotte; Rubinstein Sidney M

    2011-01-01

    Abstract Chiropractic & Osteopathy changes its title to Chiropractic & Manual Therapies in January 2011. This change reflects the expanding base of submissions from clinical scientists interested in the discipline of manual therapy. It is also in accord with the findings of a review of the journal content and a joint venture between the original parent organisation the Chiropractic and Osteopathic College of Australasia and a new partner the European Academy of Chiropractic, which is a subsid...

  19. The effect of chiropractic techniques on the Cobb angle in idiopathic scoliosis arising in adolescence

    Science.gov (United States)

    Byun, Sunghak; Han, Dongwook

    2016-01-01

    [Purpose] The purpose of this study was to examine whether chiropractic techniques would reduce the curvature of idiopathic scoliosis, which commonly occurs in elementary school children. [Subjects] The subjects of this study were 5 healthy elementary students who listened to an explanation of the study methods and purpose of the study and agreed to participate in the experiment. [Methods] The Cobb angle was measured by taking an X-ray (FCT-1, Dongmun, Goyangsi, Republic of Korea) taken from the rear, using X-ray film. The method of intervention this study used was application of chiropractic techniques. Spinal correction was carried out for 30 minutes per session, which included soft tissue massage, 3 times a week for 8 weeks. [Results] It was established that the Cobb angle was noticeably decreased after 4 weeks of the intervention. Post Hoc analysis revealed that the Cobb angle noticeably decreased after 4 weeks compared with the Cobb angle before the chiropractic techniques were applied. However, no significant difference in Cobb angle was evident after the fourth week. [Conclusion] This study demonstrated that chiropractic techniques can effectively reduce the Cobb angle within as little as 4 weeks. So, we can confirm that the chiropractic techniques were effective for reducing the curvature of idiopathic scoliosis.

  20. Chiropractic Name techniques in Canada: a continued look at demographic trends and their impact on issues of jurisprudence

    OpenAIRE

    Gleberzon, Brain J

    2002-01-01

    In a previous article, the author reported on the recommendations gathered from student projects between 1996 and 1999 investigating their preferences for including certain chiropractic Name technique systems into the curriculum at the Canadian Memorial Chiropractic College (CMCC). These results were found to be congruent with the professional treatment technique used by Canadian chiropractors. This article reports on the data obtained during the 2000 and 2001 academic years, comparing these ...

  1. The forgotten cousins : dental and chiropractic radiography

    International Nuclear Information System (INIS)

    Radiation protection surveillance methods should be appropriate to the particular use of x-rays employed. Dentists use small fixed position radiation fields with low output machines, making frequent routine visits unnecessary. There are also large numbers of them. On the other hand chiropractors use large fields and potentially high doses as well as a wide variety of projections and filters, which makes routine visits necessary. These differences have not unsurprisingly led to the National Radiation Laboratory adopting quite different approaches to monitoring these domains. In dental radiography past surveys have shown that the x-ray units themselves to be very robust and stable. A simple postal test was developed for dentists. A small number of visits are also made to dental x-ray facilities per year. Because of the greater possible level of hazard involved routine visits are made to chiropractic establishments. Chiropractic radiation protection surveys have now been extended to include calculating patient doses. The wide variety of projections and the extensive use of beam shaping filters and diaphragms means that we had to develop a program (called Chirodos) to allow for these filters in calculating the chiropractic patient doses. Data collected during the radiation protection surveys includes technique factors, filter materials, positions, and shielding. A national database of chiropractic doses has led us to establish reference doses for chiropractic x-ray exams. (author)

  2. Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies

    Science.gov (United States)

    Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane; Boruff, Jill; Harrison, Pamela; Bussières, André

    2016-01-01

    Background Context Low back pain (LBP) is one of the leading causes of disability worldwide and among the most common reasons for seeking primary sector care. Chiropractors, physical therapists and general practitioners are among those providers that treat LBP patients, but there is only limited evidence regarding the effectiveness and economic evaluation of care offered by these provider groups. Purpose To estimate the clinical effectiveness and to systematically review the literature of full economic evaluation of chiropractic care compared to other commonly used care approaches among adult patients with non-specific LBP. Study Design Systematic reviews of interventions and economic evaluations. Methods A comprehensive search strategy was conducted to identify 1) pragmatic randomized controlled trials (RCTs) and/or 2) full economic evaluations of chiropractic care for low back pain compared to standard care delivered by other healthcare providers. Studies published between 1990 and 4th June 2015 were considered. Primary outcomes included pain, functional status and global improvement. Study selection, critical quality appraisal and data extraction were conducted by two independent reviewers. Data from RCTs with low risk of bias were included in a meta-analysis to determine effect estimates. Cost estimates of full economic evaluations were converted to 2015 USD and results summarized using Slavin’s qualitative best-evidence synthesis. Results Six RCTs and three full economic evaluations were scientifically admissible. Five RCTs with low risk of bias compared chiropractic care to exercise therapy (n = 1), physical therapy (n = 3) and medical care (n = 1). Overall, we found similar effects for chiropractic care and the other types of care and no reports of serious adverse events. Three low to high quality full economic evaluations studies (one cost-effectiveness, one cost-minimization and one cost-benefit) compared chiropractic to medical care. Given the divergent

  3. Chiropractic as spine care: a model for the profession

    Directory of Open Access Journals (Sweden)

    Metz R Douglas

    2005-07-01

    Full Text Available Abstract Background More than 100 years after its inception the chiropractic profession has failed to define itself in a way that is understandable, credible and scientifically coherent. This failure has prevented the profession from establishing its cultural authority over any specific domain of health care. Objective To present a model for the chiropractic profession to establish cultural authority and increase market share of the public seeking chiropractic care. Discussion The continued failure by the chiropractic profession to remedy this state of affairs will pose a distinct threat to the future viability of the profession. Three specific characteristics of the profession are identified as impediments to the creation of a credible definition of chiropractic: Departures from accepted standards of professional ethics; reliance upon obsolete principles of chiropractic philosophy; and the promotion of chiropractors as primary care providers. A chiropractic professional identity should be based on spinal care as the defining clinical purpose of chiropractic, chiropractic as an integrated part of the healthcare mainstream, the rigorous implementation of accepted standards of professional ethics, chiropractors as portal-of-entry providers, the acceptance and promotion of evidence-based health care, and a conservative clinical approach. Conclusion This paper presents the spine care model as a means of developing chiropractic cultural authority and relevancy. The model is based on principles that would help integrate chiropractic care into the mainstream delivery system while still retaining self-identity for the profession.

  4. Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

    DEFF Research Database (Denmark)

    Stochkendahl, Mette Jensen; Sørensen, Jan; Vach, Werner;

    2016-01-01

    AIMS: To assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain. METHODS AND RESULTS: 115 adults aged 18-75 years with acute...... information session aimed at encouraging self-management as complementary to usual care (n=56). Data on resource use were obtained from Danish national registries and valued from a societal perspective. Patient cost and health-related quality-adjusted life years (QALYs; based on EuroQol five...... QALYs between the groups were negligible. CONCLUSIONS: Chiropractic care was more cost-effective than self-management. Therefore, chiropractic care can be seen as a good example of a targeted primary care approach for a subgroup of patients with non-specific chest pain. TRIAL REGISTRATION NUMBER: NCT...

  5. Patient doses in chiropractic radiography

    International Nuclear Information System (INIS)

    In New Zealand chiroptractic radiography is of the spinal column and pelvis. A wide variety of different techniques is used and in particular because of their need to assess the relationships of bone and spinal structures to each other, chiropractors tend to use large x-ray field sizes. This in turn gives rise to the use of beam-shaping filters and diaphragms, to improve image quality over areas of the body where the body thickness may vary markedly, and to reduce the patient dose. Reference doses and examples of good radiographic technique for chiropractic radiography have been derived using the survey data. The examples of good chiroptractic radiographic technuique have some similarities with those for medical radiography of corresponding body parts, with the addition of the use of beam shaping filters and diaphragms whter appropriate. The diagnostic requiremnets for each chiroptractic radiographic projection have not been specifies. It is hoped that the chiroptractic profession can provide this information. (author). 3 refs., 1 tab

  6. Plantar fasciitis: corticosteroid injection versus chiropractic therapy

    Directory of Open Access Journals (Sweden)

    Siddharth Raveendran

    2014-04-01

    Full Text Available The diagnosis of plantar fasciitis is usually clinical and rarely needs to be investigated further. The patient complains of pain in the medial side of the heel, most noticeable with initial steps after a period of inactivity and usually lessens with increasing level of activity during the day, but will tend to worsen toward the end of the day. Symptoms may become worse following prolonged weight bearing, and often precipitated by increase in weight bearing activities. Paresthesia is uncommon. It is usually unilateral, but up to 30% of cases have a bilateral presentation. In our study patients who received chiropractic therapy were treated by rest, heat, ice pack, non-steroidal anti-inflammatory drugs (NSAIDS, heel pads, magnetic insole, night splints, walking cast, taping, ultrasound, plantar and Achilles stretching for a period of 6 weeks scheduled accordingly. Patients receiving corticosteroid injection were administered 80mg methyl prednisolone locally at the heel. Each patient received 3 doses of methyl prednisolone injections on 1st day, 2nd week, and 4th week. The results with corticosteroid injection were better when analyzed with numeric rating scale over a period of 6 weeks. [Int J Res Med Sci 2014; 2(2.000: 639-642

  7. Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

    Science.gov (United States)

    Sørensen, Jan; Vach, Werner; Christensen, Henrik Wulff; Høilund-Carlsen, Poul Flemming; Hartvigsen, Jan

    2016-01-01

    Aims To assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain. Methods and results 115 adults aged 18–75 years with acute, non-specific chest pain of musculoskeletal origin were recruited from a cardiology department in Denmark. After ruling out acute coronary syndrome and receiving usual care, patients with musculoskeletal chest pain were randomised to 4 weeks of community-based chiropractic care (n=59) or to a single information session aimed at encouraging self-management as complementary to usual care (n=56). Data on resource use were obtained from Danish national registries and valued from a societal perspective. Patient cost and health-related quality-adjusted life years (QALYs; based on EuroQol five-dimension questionnaire (EQ-5D) and Short Form 36-item Health Survey (SF-36)) were compared in cost-effectiveness analyses over 12 months from baseline. Mean costs were €2183 lower for the group with chiropractic care, but not statistically significant (95% CI −4410.5 to 43.0). The incremental cost-effectiveness ratio suggested that chiropractic care was cost-effective with a probability of 97%, given a threshold value of €30 000 per QALY gained. In both groups, there was an increase in the health-related quality of life, and the mean increases were similar over the 12-month evaluation period. The mean differences in QALYs between the groups were negligible. Conclusions Chiropractic care was more cost-effective than self-management. Therefore, chiropractic care can be seen as a good example of a targeted primary care approach for a subgroup of patients with non-specific chest pain. Trial registration number NCT00462241. PMID:27175285

  8. The Nordic back pain subpopulation program: predicting outcome among chiropractic patients in Finland

    Directory of Open Access Journals (Sweden)

    Pekkarinen Harri

    2008-11-01

    Full Text Available Abstract Background In a previous Swedish study it was shown that it is possible to predict which chiropractic patients with persistent LBP will not report definite improvement early in the course of treatment, namely those with LBP for altogether at least 30 days in the past year, who had leg pain, and who did not report definite general improvement by the second treatment. The objectives of this study were to investigate if the predictive value of this set of variables could be reproduced among chiropractic patients in Finland, and if the model could be improved by adding some new potential predictor variables. Methods The study was a multi-centre prospective outcome study with internal control groups, carried out in private chiropractic practices in Finland. Chiropractors collected data at the 1st, 2nd and 4th visits using standardized questionnaires on new patients with LBP and/or radiating leg pain. Status at base-line was identified in relation to pain and disability, at the 2nd visit in relation to disability, and "definitely better" at the 4th visit in relation to a global assessment. The Swedish questionnaire was used including three new questions on general health, pain in other parts of the spine, and body mass index. Results The Swedish model was reproduced in this study sample. An alternative model including leg pain (yes/no, improvement at 2nd visit (yes/no and BMI (underweight/normal/overweight or obese was also identified with similar predictive values. Common throughout the testing of various models was that improvement at the 2nd visit had an odds ratio of approximately 5. Additional analyses revealed a dose-response in that 84% of those patients who fulfilled none of these (bad criteria were classified as "definitely better" at the 4th visit, vs. 75%, 60% and 34% of those who fulfilled 1, 2 or all 3 of the criteria, respectively. Conclusion When treating patients with LBP, at the first visits, the treatment strategy should be

  9. Curriculum reform in a public health course at a chiropractic college: are we making progress toward improving clinical relevance?

    Science.gov (United States)

    Borody, Cameron; Till, Hettie

    2007-01-01

    Improving education in health promotion and prevention has been identified as a priority for all accredited professional health care training programs, an issue recently addressed by a collaboration of stakeholders in chiropractic education who developed a model course outline for public health education. Using a course evaluation questionnaire, the authors surveyed students in the public health course at the Canadian Memorial Chiropractic College (CMCC) before and after the implementation of new course content based on the model course outline. Following the new course, there were significant improvements in perceived relevance to chiropractic practice and motivation to learn the material as a foundation for clinical practice. Changes made to the content and delivery of the course based on the model course outline were well received in the short term. PMID:18483637

  10. Individual and population doses in Manitoba from chiropractic x-ray procedures

    International Nuclear Information System (INIS)

    Manitoba (population of 1.0 million) has 37 chiropractors who perform x-rays on behalf of 100 practising chiropractors. In 1987 these specialists performed approximately 33 300 spinal x-ray studies. Cervical spine examinations contribute the lowest patient dose (average HE of 26 μSv); thoracic and lumbar spine examinations show considerably higher patient dose (HE in the range 24-410 μSv) Average patient HE was determined to be 220 μSv. Lumbar spine examinations account for 45% of all chiropractic x-ray examinations (84% of the collective dose). Cervical spine examinations also account for 45% of chiropractic x-ray examinations, but contribute only 5% of the collective dose with thoracic spine examinations contributing the 11% balance of the collective dose. Patients undergoing chiropractic procedures involving exposure to x-rays account for about 3.6% of all diagnostic x-ray procedures. The per caput dose contribution from chiropractic practice was calculated to be 7.3 μSv (1.2% of total population dose from diagnostic procedures employing ionising radiation). (author)

  11. Individual and population doses in Manitoba from chiropractic x-ray procedures

    Energy Technology Data Exchange (ETDEWEB)

    Huda, W.; Sourkes, A.M. (Manitoba Cancer Treatment and Research Foundation, Winnipeg, MB (Canada))

    1989-12-01

    Manitoba (population of 1.0 million) has 37 chiropractors who perform x-rays on behalf of 100 practising chiropractors. In 1987 these specialists performed approximately 33 300 spinal x-ray studies. Cervical spine examinations contribute the lowest patient dose (average H{sub E} of 26 {mu}Sv); thoracic and lumbar spine examinations show considerably higher patient dose (H{sub E} in the range 24-410 {mu}Sv) Average patient H{sub E} was determined to be 220 {mu}Sv. Lumbar spine examinations account for 45% of all chiropractic x-ray examinations (84% of the collective dose). Cervical spine examinations also account for 45% of chiropractic x-ray examinations, but contribute only 5% of the collective dose with thoracic spine examinations contributing the 11% balance of the collective dose. Patients undergoing chiropractic procedures involving exposure to x-rays account for about 3.6% of all diagnostic x-ray procedures. The per caput dose contribution from chiropractic practice was calculated to be 7.3 {mu}Sv (1.2% of total population dose from diagnostic procedures employing ionising radiation). (author).

  12. Chiropractic Colleges Seek Legitimacy amid Financial Woes

    Science.gov (United States)

    Fuller, Andrea

    2012-01-01

    Many of the nation's chiropractic colleges, like other small colleges that rely heavily on tuition, are struggling to stay in business. At the same time that they are working to improve their stature in higher education and broadening their missions to increase their appeal, a number of the colleges are seeing enrollments plummet--and revenues are…

  13. Correlations Between Chiropractic National Board (Part I) Scores and Basic Science Course Grades and Related Data.

    Science.gov (United States)

    Wolfenberger, Virginia

    1999-01-01

    A study at one institution found significant correlations between students' scores on the National Board of Chiropractic Examiners test and academic achievement data. Results indicate that it is not always course subject matter that influences the relationship between course grade and board scores, but may instead be the ability to assimilate…

  14. Do chiropractic college faculty understand informed consent: a pilot study

    Directory of Open Access Journals (Sweden)

    Hondras Maria A

    2006-12-01

    Full Text Available Abstract Background The purpose of this study was to survey full-time faculty at a single chiropractic college concerning their knowledge of Institutional Review Board (IRB policies in their institution as they pertain to educational research. Methods All full-time faculty were invited to participate in an anonymous survey. Four scenarios involving educational research were described and respondents were asked to select from three possible courses of action for each. In addition, respondents were queried about their knowledge of IRB policies, how they learned of these policies and about their years of service and departmental assignments. Results The response rate was 55%. In no scenario did the level of correct answers by all respondents score higher than 41% and in most, the scores were closer to just under 1 in 3. Sixty-five percent of respondents indicated they were unsure whether Palmer had any policies in place at all, while 4% felt that no such policies were in place. Just over one-quarter (27% were correct in noting that students can decline consent, while more than half (54% did not know whether there were any procedures governing student consent. Conclusion Palmer faculty have only modest understanding about institutional policies regarding the IRB and human subject research, especially pertaining to educational research. The institution needs to develop methods to provide knowledge and training to faculty. The results from this pilot study will be instrumental in developing better protocols for a study designed to survey the entire chiropractic academic community.

  15. Evidence-based medicine and its implications for the profession of chiropractic.

    Science.gov (United States)

    Villanueva-Russell, Yvonne

    2005-02-01

    Evidence-based medicine (EBM) has grown in popularity and prominence in the world of orthodox medicine since the 1980s. The focus of this article is on the process of developing practice guidelines (one type of EBM) and its effects upon chiropractic, a profession with a "philosophy, science and art" that is constructed upon divergent epistemological and methodological tenets (namely, the idea of "vitalism"). The EBM movement is conceptualized as part of a larger political economy surrounding the health care environment that creates a new set of imperatives for orthodox medicine, and also branches of alternative medicine that are in the process of professionalization. The quantitative, positivist and empiricist assumptions of EBM dictate which approaches to treatment and which clinical procedures are legitimate and perhaps reimbursable under systems of managed care. The ramifications of practice guidelines and its effects upon the intraprofessional segments of the chiropractic profession are also discussed. PMID:15550303

  16. Predictors of outcome in neck pain patients undergoing chiropractic care: comparison of acute and chronic patients

    Directory of Open Access Journals (Sweden)

    Peterson Cynthia

    2012-08-01

    Full Text Available Abstract Background Neck pain is a common complaint in patients presenting for chiropractic treatment. The few studies on predictors for improvement in patients while undergoing treatment identify duration of symptoms, neck stiffness and number of previous episodes as the strong predictor variables. The purpose of this study is to continue the research for predictors of a positive outcome in neck pain patients undergoing chiropractic treatment. Methods Acute ( 3 months (n = 255 neck pain patients with no chiropractic or manual therapy in the prior 3 months were included. Patients completed the numerical pain rating scale (NRS and Bournemouth questionnaire (BQ at baseline prior to treatment. At 1 week, 1 month and 3 months after start of treatment the NRS and BQ were completed along with the Patient Global Impression of Change (PGIC scale. Demographic information was provided by the clinician. Improvement at each of the follow up points was categorized using the PGIC. Multivariate regression analyses were done to determine significant independent predictors of improvement. Results Baseline mean neck pain and total disability scores were significantly (p  Conclusions The most consistent predictor of clinically relevant improvement at both 1 and 3 months after the start of chiropractic treatment for both acute and chronic patients is if they report improvement early in the course of treatment. The co-existence of either radiculopathy or dizziness however do not imply poorer prognosis in these patients.

  17. The journal 'chiropractic & osteopathy' changes its title to 'chiropractic & manual therapies'. a new name, a new era.

    Science.gov (United States)

    Walker, Bruce F; French, Simon D; Cameron, Melanie; Perle, Stephen M; Lebouef-Yde, Charlotte; Rubinstein, Sidney M

    2011-01-01

    Chiropractic & Osteopathy changes its title to Chiropractic & Manual Therapies in January 2011. This change reflects the expanding base of submissions from clinical scientists interested in the discipline of manual therapy. It is also in accord with the findings of a review of the journal content and a joint venture between the original parent organisation the Chiropractic and Osteopathic College of Australasia and a new partner the European Academy of Chiropractic, which is a subsidiary body of the European Chiropractors' Union. The title change should encourage submissions from all professionals interested in manual therapy including chiropractors, osteopaths, physiotherapists, medical doctors and scientists interested in this field. PMID:21247414

  18. The journal 'chiropractic & osteopathy' changes its title to 'chiropractic & manual therapies'. a new name, a new era

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2011-01-01

    Full Text Available Abstract Chiropractic & Osteopathy changes its title to Chiropractic & Manual Therapies in January 2011. This change reflects the expanding base of submissions from clinical scientists interested in the discipline of manual therapy. It is also in accord with the findings of a review of the journal content and a joint venture between the original parent organisation the Chiropractic and Osteopathic College of Australasia and a new partner the European Academy of Chiropractic, which is a subsidiary body of the European Chiropractors' Union. The title change should encourage submissions from all professionals interested in manual therapy including chiropractors, osteopaths, physiotherapists, medical doctors and scientists interested in this field.

  19. Iowa Chiropractic Students Outlook for Practitioners and Need for State-Funded Assistance.

    Science.gov (United States)

    Greiner, Keith

    This state-mandated study examined the needs of Iowa chiropractic students and the Iowa demand for chiropractic health care in order to determine the feasibility of establishing a chiropractic forgivable loan program. The project used financial aid data and repayment rate data to evaluate the need for financial aid for chiropractic students;…

  20. Core Competencies of the Certified Pediatric Doctor of Chiropractic

    DEFF Research Database (Denmark)

    Hewitt, Elise; Hestbaek, Lise; Pohlman, Katherine A

    2016-01-01

    An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical...

  1. National Board Scores versus Student GPA's in Chiropractic Education.

    Science.gov (United States)

    Kalthoff, Theodore J.

    1985-01-01

    The relationship between student GPAs and scores on the National Board of Chiropractic Examiners tests was investigated in an effort to determine if the chiropractic curriculum was properly preparing students to be licensed. The study found that there was a significant correlation between GPAs and board scores. (Author/MLW)

  2. Chiropractic Use by Urban and Rural Residents with Insurance Coverage

    Science.gov (United States)

    Lind, Bonnie K.; Diehr, Paula K.; Grembowski, David E.; Lafferty, William E.

    2009-01-01

    Purpose: To describe the use of chiropractic care by urban and rural residents in Washington state with musculoskeletal diagnoses, all of whom have insurance coverage for this care. The analyses investigate whether restricting the analyses to insured individuals attenuates previously reported differences in the prevalence of chiropractic use…

  3. Annotated bibliography of the biomedical literature pertaining to chiropractic, pediatrics and manipulation in relation to the treatment of health conditions

    Science.gov (United States)

    Gotlib, Allan C; Beingessner, Melanie

    1995-01-01

    Biomedical literature retrieval, both indexed and non-indexed, with respect to the application of manipulative therapy with therapeutic intent and pediatric health conditions (ages 0 to 17 years) yielded 66 discrete documents which met specified inclusion and exclusion criteria. There was one experimental study (RCT’s), 3 observational (cohort, case control) studies and 62 descriptive studies (case series, case reports, surveys, literature reviews). An independent rating panel determined consistency with a modified quality of evidence scale adopted from procedure ratings system 1 of Clinical Guidelines for Chiropractic Practice in Canada. Results indicate minimal Class 1 and Class 2 and some Class 3 evidence for a variety of pediatric conditions utilizing the application of manipulation with therapeutic intent.

  4. Psychosocial factors and their predictive value in chiropractic patients with low back pain: a prospective inception cohort study

    Directory of Open Access Journals (Sweden)

    Breen Alan C

    2007-03-01

    Full Text Available Abstract Background Being able to estimate the likelihood of poor recovery from episodes of back pain is important for care. Studies of psychosocial factors in inception cohorts in general practice and occupational populations have begun to make inroads to these problems. However, no studies have yet investigated this in chiropractic patients. Methods A prospective inception cohort study of patients presenting to a UK chiropractic practice for new episodes of non-specific low back pain (LBP was conducted. Baseline questionnaires asked about age, gender, occupation, work status, duration of current episode, chronicity, aggravating features and bothersomeness using Deyo's 'Core Set'. Psychological factors (fear-avoidance beliefs, inevitability, anxiety/distress and coping, and co-morbidity were also assessed at baseline. Satisfaction with care, number of attendances and pain impact were determined at 6 weeks. Predictors of poor outcome were sought by the calculation of relative risk ratios. Results Most patients presented within 4 weeks of onset. Of 158 eligible and willing patients, 130 completed both baseline and 6-week follow-up questionnaires. Greatest improvements at 6 weeks were in interference with normal work (ES 1.12 and LBP bothersomeness (ES 1.37. Although most patients began with moderate-high back pain bothersomeness scores, few had high psychometric ones. Co-morbidity was a risk for high-moderate interference with normal work at 6 weeks (RR 2.37; 95% C.I. 1.15–4.74. An episode duration of >4 weeks was associated with moderate to high bothersomeness at 6 weeks (RR 2.07; 95% C.I. 1.19 – 3.38 and negative outlook (inevitability with moderate to high interference with normal work (RR 2.56; 95% C.I. 1.08 – 5.08. Conclusion Patients attending a private UK chiropractic clinic for new episodes of non-specific LBP exhibited few psychosocial predictors of poor outcome, unlike other patient populations that have been studied. Despite

  5. Physical injury assessment of male versus female chiropractic students when learning and performing various adjustive techniques: a preliminary investigative study

    Directory of Open Access Journals (Sweden)

    Huber Laura L

    2006-08-01

    Full Text Available Abstract Background Reports of musculoskeletal injuries that some chiropractic students experienced while in the role of adjustor became increasingly evident and developed into the basis of this study. The main objective of this study was to survey a select student population and identify, by gender, the specific types of musculoskeletal injuries they experienced when learning adjustive techniques in the classroom, and performing them in the clinical setting. Methods A survey was developed to record musculoskeletal injuries that students reported to have sustained while practicing chiropractic adjustment set-ups and while delivering adjustments. The survey was modeled from similar instruments used in the university's clinic as well as those used in professional practice. Stratified sampling was used to obtain participants for the study. Data reported the anatomical areas of injury, adjustive technique utilized, the type of injury received, and the recovery time from sustained injuries. The survey also inquired as to the type and area of any past physical injuries as well as the mechanism(s of injury. Results Data obtained from the study identified injuries of the shoulder, wrist, elbow, neck, low back, and mid-back. The low back was the most common injury site reported by females, and the neck was the most common site reported by males. The reported wrist injuries in both genders were 1% male complaints and 17% female complaints. A total of 13% of female respondents reported shoulder injuries, whereas less than 1% of male respondents indicated similar complaints. Conclusion The data collected from the project indicated that obtaining further information on the subject would be worthwhile, and could provide an integral step toward developing methods of behavior modification in an attempt to reduce and/or prevent the incidence of musculoskeletal injuries.

  6. Process versus outcome: challenges of the chiropractic wellness paradigm

    OpenAIRE

    Russell, Eric G.

    2010-01-01

    Objective The purpose of this article is to discuss the term wellness in the context of the philosophy of chiropractic. Discussion PubMed and Index to Chiropractic Literature show an upward trend in use of the term wellness. Wellness may be used differently depending upon the profession and may be considered a process by some and an outcome by others. Conclusion There appears to be no consensus on the definition of wellness or how it is being used. Wellness is not exclusive to chiropractic, a...

  7. The Nordic maintenance care program – case management of chiropractic patients with low back pain: A survey of Swedish chiropractors

    Directory of Open Access Journals (Sweden)

    Jørgensen Kristian

    2008-06-01

    Full Text Available Abstract Background Chiropractic treatment for low back pain (LBP can often be divided into two phases: Initial treatment of the problem to attempt to remove pain and bring it back into its pre-clinical or maximum improvement status, and "maintenance care", during which it is attempted to maintain this status. Although the use of chiropractic maintenance care has been described and discussed in the literature, there is no information as to its precise indications. The objective of this study is to investigate if there is agreement among Swedish chiropractors on the overall patient management for various types of LBP-scenarios, with a special emphasis on maintenance care. Method The design was a mailed questionnaire survey. Members of the Swedish Chiropractors' Association, who were participants in previous practice-based research, were sent a closed-end questionnaire consisting of nine case scenarios and six clinical management alternatives and the possibility to create one's own alternative, resulting in a "nine-by-seven" table. The research team defined its own pre hoc choice of "clinically logical" answers based on the team's clinical experience. The frequency of findings was compared to the suggestions of the research team. Results Replies were received from 59 (60% of the 99 persons who were invited to take part in the study. A pattern of self-reported clinical management strategies emerged, largely corresponding to the "clinically logical" answers suggested by the research team. In general, patients of concern would be referred out for a second opinion, cases with early recovery and without a history of previous low back pain would be quickly closed, and cases with quick recovery and a history of recurring events would be considered for maintenance care. However, also other management patterns were noted, in particular in the direction of maintenance care. Conclusion To a reasonable extent, Swedish chiropractors participating in this

  8. Reflex control of the spine and posture: a review of the literature from a chiropractic perspective

    Directory of Open Access Journals (Sweden)

    Schlappi Mark

    2005-08-01

    Full Text Available Abstract Objective This review details the anatomy and interactions of the postural and somatosensory reflexes. We attempt to identify the important role the nervous system plays in maintaining reflex control of the spine and posture. We also review, illustrate, and discuss how the human vertebral column develops, functions, and adapts to Earth's gravity in an upright position. We identify functional characteristics of the postural reflexes by reporting previous observations of subjects during periods of microgravity or weightlessness. Background Historically, chiropractic has centered around the concept that the nervous system controls and regulates all other bodily systems; and that disruption to normal nervous system function can contribute to a wide variety of common ailments. Surprisingly, the chiropractic literature has paid relatively little attention to the importance of neurological regulation of static upright human posture. With so much information available on how posture may affect health and function, we felt it important to review the neuroanatomical structures and pathways responsible for maintaining the spine and posture. Maintenance of static upright posture is regulated by the nervous system through the various postural reflexes. Hence, from a chiropractic standpoint, it is clinically beneficial to understand how the individual postural reflexes work, as it may explain some of the clinical presentations seen in chiropractic practice. Method We performed a manual search for available relevant textbooks, and a computer search of the MEDLINE, MANTIS, and Index to Chiropractic Literature databases from 1970 to present, using the following key words and phrases: "posture," "ocular," "vestibular," "cervical facet joint," "afferent," "vestibulocollic," "cervicocollic," "postural reflexes," "spaceflight," "microgravity," "weightlessness," "gravity," "posture," and "postural." Studies were selected if they specifically tested any or

  9. Inappropriate use of the title 'chiropractor' and term 'chiropractic manipulation' in the peer-reviewed biomedical literature

    Directory of Open Access Journals (Sweden)

    Wenban Adrian B

    2006-08-01

    Full Text Available Abstract Background The misuse of the title 'chiropractor' and term 'chiropractic manipulation', in relation to injury associated with cervical spine manipulation, have previously been reported in the peer-reviewed literature. The objectives of this study were to - 1 Prospectively monitor the peer-reviewed literature for papers reporting an association between chiropractic, or chiropractic manipulation, and injury; 2 Contact lead authors of papers that report such an association in order to determine the basis upon which the title 'chiropractor' and/or term 'chiropractic manipulation' was used; 3 Document the outcome of submission of letters to the editors of journals wherein the title 'chiropractor', and/or term 'chiropractic manipulation', had been misused and resulted in the over-reporting of chiropractic induced injury. Methods One electronic database (PubMed was monitored prospectively, via monthly PubMed searches, during a 12 month period (June 2003 to May 2004. Once relevant papers were located, they were reviewed. If the qualifications and/or profession of the care provider/s were not apparent, an attempt was made to confirm them via direct e-mail communication with the principal researcher of each respective paper. A letter was then sent to the editor of each involved journal. Results A total of twenty four different cases, spread across six separate publications, were located via the monthly PubMed searches. All twenty four cases took place in one of two European countries. The six publications consisted of four case reports, each containing one patient, one case series, involving twenty relevant cases, and a secondary report that pertained to one of the four case reports. In each of the six publications the authors suggest the care provider was a chiropractor and that each patient received chiropractic manipulation of the cervical spine prior to developing symptoms suggestive of traumatic injury. In two of the four case reports

  10. Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

    OpenAIRE

    Stochkendahl, Mette Jensen; Sørensen, Jan; Vach, Werner; Christensen, Henrik Wulff; Høilund-Carlsen, Poul Flemming; Hartvigsen, Jan

    2016-01-01

    Aims To assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain. Methods and results 115 adults aged 18–75 years with acute, non-specific chest pain of musculoskeletal origin were recruited from a cardiology department in Denmark. After ruling out acute coronary syndrome and receiving usual care, patients with musculoskelet...

  11. The role of chiropractic care in older adults

    Directory of Open Access Journals (Sweden)

    Dougherty Paul E

    2012-02-01

    Full Text Available Abstract There are a rising number of older adults; in the US alone nearly 20% of the population will be 65 or older by 2030. Chiropractic is one of the most frequently utilized types of complementary and alternative care by older adults, used by an estimated 5% of older adults in the U.S. annually. Chiropractic care involves many different types of interventions, including preventive strategies. This commentary by experts in the field of geriatrics, discusses the evidence for the use of spinal manipulative therapy, acupuncture, nutritional counseling and fall prevention strategies as delivered by doctors of chiropractic. Given the utilization of chiropractic services by the older adult, it is imperative that providers be familiar with the evidence for and the prudent use of different management strategies for older adults.

  12. Stress in chiropractic education: a student survey of a five-year course.

    Science.gov (United States)

    Hester, Hilary; Cunliffe, Christina; Hunnisett, Adrian

    2013-01-01

    Objective : Stress encompasses academic issues, such as time management, increased work load, and new subject matter, but cannot be separated from stressors, such as social adjustment and financial pressure. Our study investigated whether perceived level of academic or practical attainment and the method of study were associated with the amount of perceived stress during students" studies. Methods : A semi-structured self-administered questionnaire was piloted and distributed to 134 students at a chiropractic college at the end of a lecture. Results : The survey had a response rate of 81%. Students in their fourth year consistently reported the highest perceived levels of stress, with 81% feeling that their ability to study was affected by their financial situation and 56% felt overwhelmed at their ability to cope with their college workload. All year groups were stressed during their course of studies, but the stressor varies depending on the year of study. Conclusions : Year 4 consistently demonstrated the highest levels of stress. All students, regardless of year group, experienced varying degrees of stress while studying and the central stressor changed depending on the time position within the course. PMID:23957319

  13. Creating European guidelines for Chiropractic Incident Reporting and Learning Systems (CIRLS: relevance and structure

    Directory of Open Access Journals (Sweden)

    Wangler Martin

    2011-04-01

    Full Text Available Abstract Background In 2009, the heads of the Executive Council of the European Chiropractors' Union (ECU and the European Academy of Chiropractic (EAC involved in the European Committee for Standardization (CEN process for the chiropractic profession, set out to establish European guidelines for the reporting of adverse reactions to chiropractic treatment. There were a number of reasons for this: first, to improve the overall quality of patient care by aiming to reduce the application of potentially harmful interventions and to facilitate the treatment of patients within the context of achieving maximum benefit with a minimum risk of harm; second, to inform the training objectives for the Graduate Education and Continuing Professional Development programmes of all 19 ECU member nations, regarding knowledge and skills to be acquired for maximising patient safety; and third, to develop a guideline on patient safety incident reporting as it is likely to be part of future CEN standards for ECU member nations. Objective To introduce patient safety incident reporting within the context of chiropractic practice in Europe and to help individual countries and their national professional associations to develop or improve reporting and learning systems. Discussion Providing health care of any kind, including the provision of chiropractic treatment, can be a complex and, at times, a risky activity. Safety in healthcare cannot be guaranteed, it can only be improved. One of the most important aspects of any learning and reporting system lies in the appropriate use of the data and information it gathers. Reporting should not just be seen as a vehicle for obtaining information on patient safety issues, but also be utilised as a tool to facilitate learning, advance quality improvement and to ultimately minimise the rate of the occurrence of errors linked to patient care. Conclusions Before a reporting and learning system can be established it has to be clear

  14. Plastination: a modern approach to chiropractic teaching

    Science.gov (United States)

    Grondin, Gilles

    1998-01-01

    Plastination is a unique method for the preservation of biological material for teaching and research. The plastinated specimens are dry, odorless, non-toxic and durable. They can be manipulated by teachers and students without protective equipment like gloves. Invented in 1978 by Doctor Gunther von Hagens from the University of Heidelberg, this technique, that involves the replacement of water by a curable polymer, has spread rapidly all around the world and is actually used in over 250 universities and colleges. To our knowledge, the Université du Québec à Trois-Rivières, is the first institution to use plastinated specimens for teaching anatomy, neuroanatomy, pathology and radiology to students in chiropractic. This paper describes the various steps of the method (fixation, dehydration, impregnation and curing) and presents some examples of the utilization of plastinated specimens. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6

  15. Medical Simulation Practices 2010 Survey Results

    Science.gov (United States)

    McCrindle, Jeffrey J.

    2011-01-01

    Medical Simulation Centers are an essential component of our learning infrastructure to prepare doctors and nurses for their careers. Unlike the military and aerospace simulation industry, very little has been published regarding the best practices currently in use within medical simulation centers. This survey attempts to provide insight into the current simulation practices at medical schools, hospitals, university nursing programs and community college nursing programs. Students within the MBA program at Saint Joseph's University conducted a survey of medical simulation practices during the summer 2010 semester. A total of 115 institutions responded to the survey. The survey resus discuss overall effectiveness of current simulation centers as well as the tools and techniques used to conduct the simulation activity

  16. Use of the measure your medical outcome profile (MYMOP2 and W-BQ12 (Well-Being outcomes measures to evaluate chiropractic treatment: an observational study

    Directory of Open Access Journals (Sweden)

    Polus Barbara I

    2011-03-01

    Full Text Available Abstract Background The objective was to assess the use of the Measure Yourself Medical Outcome Profile (MYMOP2 and W-BQ12 well-being questionnaire for measuring clinical change associated with a course of chiropractic treatment. Methods Chiropractic care of the patients involved spinal manipulative therapy (SMT, mechanically assisted techniques, soft tissue therapy, and physiological therapeutic devices. Outcome measures used were MYMOP2 and the Well-Being Questionnaire 12 (W-BQ12. Results Statistical and clinical significant changes were demonstrated with W-BQ12 and MYMOP2. Conclusions The study demonstrated that MYMOP2 was responsive to change and may be a useful instrument for assessing clinical changes among chiropractic patients who present with a variety of symptoms and clinical conditions.

  17. Attitudes of non-practicing chiropractors: a pilot survey concerning factors related to attrition

    Directory of Open Access Journals (Sweden)

    Wyatt Lawrence H

    2010-11-01

    Full Text Available Abstract Background Research into attitudes about chiropractors who are no longer engaged in active clinical practice is non-existent. Yet non-practicing chiropractors (NPCs represent a valid sub-group worthy of study. Aim The purpose of this research was to assess attrition attitudes of NPCs about the chiropractic profession and develop a scale to assess such attitudes. Methods A 48 item survey was developed using the PsychData software. This survey included 35 Likert-style items assessing various aspects of the profession namely financial, educational, psychosocial and political. An internet discussion site where NPCs may be members was accessed for recruitment purposes. Results A total of 70 valid responses were received for analysis. A majority of respondents were male with 66% being in non-practice status for 3 to 5 years and less with 43% indicating that they had graduated since the year 2000. Most respondents were employed either in other healthcare professions and non-chiropractic education. A majority of NPCs believed that business ethics in chiropractic were questionable and that overhead expense and student loans were factors in practice success. A majority of NPCs were in associate practice at one time with many believing that associates were encouraged to prolong the care of patients and that associate salaries were not fair. Most NPCs surveyed believed that chiropractic was not a good career choice and would not recommend someone to become a chiropractor. From this survey, a 12 item scale was developed called the "chiropractor attrition attitude scale" for future research. Reliability analysis of this novel scale demonstrated a coefficient alpha of 0.90. Conclusion The low response rate indicates that findings cannot be generalized to the NPC population. This study nonetheless demonstrates that NPCs attrition attitudes can be assessed. The lack of a central database of NPCs is a challenge to future research. Appropriate

  18. The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?

    Directory of Open Access Journals (Sweden)

    Stochkendahl Mette

    2010-06-01

    Full Text Available Abstract Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact on adult musculoskeletal health. Thus, this is an important part of the chiropractors' scope of practice, and the objective of this review is to assess the evidence base for manual treatment of musculoskeletal disorders in children and adolescents. Randomized, quasi-randomized and non-randomized clinical studies were included if they investigated the effect of manual therapy on musculoskeletal disorders in children and/or adolescents. The MEDLINE and MANTIS databases were searched, and studies published in English, Danish, Swedish or Norwegian were included. Only three studies were identified that in some way attempted to look at the effectiveness of manual therapy for children or adolescents with spinal problems, and none of these was a randomized controlled clinical trial. As for the rest of the musculoskeletal system, only one study of temporomandibular disorder was identified. With this review, we have detected a paradox within the chiropractic profession: Although the major reason for pediatric patients to attend a chiropractor is spinal pain, no adequate studies have been performed in this area. It is time for the chiropractic profession to take responsibility and systematically investigate the efficiency of joint manipulation of problems relating to the developing musculoskeletal system.

  19. Mixed-Methods Research in a Complex Multisite VA Health Services Study: Variations in the Implementation and Characteristics of Chiropractic Services in VA

    Directory of Open Access Journals (Sweden)

    Raheleh Khorsan

    2013-01-01

    Full Text Available Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs’ healthcare system. Understanding the implementation process and characteristics of new chiropractic clinics and the determinants and consequences of these processes and characteristics is a critical first step in guiding quality improvement. This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches—insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS. Challenges and solutions are presented in areas ranging from selection and recruitment of sites and participants to the collection and analysis of varied data sources. The VICCS study illustrates the importance of several factors in successful mixed-methods approaches, including (1 the importance of a formal, fully developed logic model to identify and link data sources, variables, and outcomes of interest to the study’s analysis plan and its data collection instruments and codebook and (2 ensuring that data collection methods, including mixed-methods, match study aims. Overall, successful application of a mixed-methods approach requires careful planning, frequent trade-offs, and complex coding and analysis.

  20. Effects of Expanded Coverage for Chiropractic Services on Medicare Costs in a CMS Demonstration

    Science.gov (United States)

    Stason, William B.; Ritter, Grant A; Prottas, Jeffrey; Tompkins, Christopher; Shepard, Donald S.

    2016-01-01

    Background Moderately convincing evidence supports the benefits of chiropractic manipulations for low back pain. Its effectiveness in other applications is less well documented, and its cost-effectiveness is not known. These questions led the Centers for Medicaid and Medicare Services (CMS) to conduct a two-year demonstration of expanded Medicare coverage for chiropractic services in the treatment of beneficiaries with neuromusculoskeletal (NMS) conditions affecting the back, limbs, neck, or head. Methods The demonstration was conducted in 2005–2007 in selected counties of Illinois, Iowa, and Virginia and the entire states of Maine and New Mexico. Medicare claims were compiled for the preceding year and two demonstration years for the demonstration areas and matched comparison areas. The impact of the demonstration was analyzed through multivariate regression analysis with a difference-in-difference framework. Results Expanded coverage increased Medicare expenditures by $50 million or 28.5% in users of chiropractic services and by $114 million or 10.4% in all patients treated for NMS conditions in demonstration areas during the two-year period. Results varied widely among demonstration areas ranging from increased costs per user of $485 in Northern Illinois and Chicago counties to decreases in costs per user of $59 in New Mexico and $178 in Scott County, Iowa. Conclusion The demonstration did not assess possible decreases in costs to other insurers, out-of-pocket payments by patients, the need for and costs of pain medications, or longer term clinical benefits such as avoidance of orthopedic surgical procedures beyond the two-year period of the demonstration. It is possible that other payers or beneficiaries saved money during the demonstration while costs to Medicare were increased. PMID:26928221

  1. A demographic and epidemiological study of a Mexican chiropractic college public clinic

    Directory of Open Access Journals (Sweden)

    Ndetan Harrison T

    2009-03-01

    Full Text Available Abstract Background Descriptive studies of chiropractic patients are not new, several have been performed in the U.S., Australia, Canada, and Europe. None have been performed in a Latin American country. The purpose of this study is to describe the patients who visited a Mexican chiropractic college public clinic with respect to demographics and clinical characteristics. Methods This study was reviewed and approved by the IRB of Parker College of Chiropractic and the Universidad Estatal del Valle de Ecatepec (UNEVE. Five hundred patient files from the UNEVE public clinic from May 2005 to May 2007 were selected from an approximate total number of 3,700. Information was collected for demographics, chief complaints, associated complaints, and previous care sought. Results The sample comprised 306 (61.2% female. Most files (44.2% were in the age range of 40–59 years (mean of 43.4 years. The most frequent complaints were lumbar pain (29.2% and extremity pain (28.0%, most commonly the knee. Most (62.0% described their complaints as greater than one year. Trauma (46.6% was indicated as the initial cause. Mean VAS score was 6.26/10 with 20% rated at 8/10. Conclusion Demographic results compared closer to studies conducted with private clinicians (females within the ages of 40–59. The primary complaint and duration was similar to previous studies (low back pain and chronic, except in this population the cause was usually initiated by trauma. The most striking features were the higher number of extremity complaints and the marked increased level of VAS score (20% rated as 8/10.

  2. Chiropractic patients in Denmark 2002: an expanded description and comparison with 1999 survey

    DEFF Research Database (Denmark)

    Sorensen, Line Press; Stochkendahl, Mette Jensen; Hartvigsen, Jan; Nilsson, Niels Grunnet

    2006-01-01

    randomly assigned week in 2002 using a survey questionnaire. All 52 weeks of the year 2002 were represented with an even dispersion of weeks (182 clinics participated). Outcome measures included age, sex, education, occupation, location and duration of chief complaint, pain intensity, limitation of...... activities of daily living, mode of referral, duration of sick leave, previous treatments, comorbidity, SF-12, smoking habits, and use of x-ray. RESULTS: Eighty-five percent of all chiropractic clinics in Denmark participated in the study, and 1595 patients (81%) filled out a self-administered questionnaire...

  3. Effects of Expanded Coverage for Chiropractic Services on Medicare Costs in a CMS Demonstration.

    Directory of Open Access Journals (Sweden)

    William B Stason

    Full Text Available Moderately convincing evidence supports the benefits of chiropractic manipulations for low back pain. Its effectiveness in other applications is less well documented, and its cost-effectiveness is not known. These questions led the Centers for Medicaid and Medicare Services (CMS to conduct a two-year demonstration of expanded Medicare coverage for chiropractic services in the treatment of beneficiaries with neuromusculoskeletal (NMS conditions affecting the back, limbs, neck, or head.The demonstration was conducted in 2005-2007 in selected counties of Illinois, Iowa, and Virginia and the entire states of Maine and New Mexico. Medicare claims were compiled for the preceding year and two demonstration years for the demonstration areas and matched comparison areas. The impact of the demonstration was analyzed through multivariate regression analysis with a difference-in-difference framework.Expanded coverage increased Medicare expenditures by $50 million or 28.5% in users of chiropractic services and by $114 million or 10.4% in all patients treated for NMS conditions in demonstration areas during the two-year period. Results varied widely among demonstration areas ranging from increased costs per user of $485 in Northern Illinois and Chicago counties to decreases in costs per user of $59 in New Mexico and $178 in Scott County, Iowa.The demonstration did not assess possible decreases in costs to other insurers, out-of-pocket payments by patients, the need for and costs of pain medications, or longer term clinical benefits such as avoidance of orthopedic surgical procedures beyond the two-year period of the demonstration. It is possible that other payers or beneficiaries saved money during the demonstration while costs to Medicare were increased.

  4. Case management of chiropractic patients with cervical brachialgia: A survey of French chiropractors

    Directory of Open Access Journals (Sweden)

    Guenoun Olivier

    2011-09-01

    Full Text Available Abstract Background Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues. Objectives The first objective was to investigate if French chiropractors' management choices appeared reasonable for various neck problem scenarios. The second objective was to investigate if there was agreement between chiropractors on the patient management. The third objective was to see to which degree and at what stages chiropractors would consider to interact with other health-care practitioners, such as physiotherapists, general practitioners and specialists. Method A questionnaire was sent to a randomly selected sample of all French chiropractors known to the national chiropractic college. It consisted of an invitation to participate in the study, a brief case description, and drawings of five stages of how a case of neck pain gradually evolves into a brachialgia to end up with a compromised spinal cord. Each stage offered five management choices. Participants were asked at what stages patients would be treated solely by the chiropractor and when patients would be referred out for second opinion or other care without chiropractic treatment, plus an open ended option, resulting in a "five-by-six" table. The percentages of respondents choosing the different management strategies were identified for the different scenarios and the 95% confidence intervals were calculated. There was a pre hoc agreement on when chiropractic care would or would not be suitable. Consensus was arbitrarily defined as "moderate" when 50- 69% of respondents agreed on the same management choice and as "excellent" when 70% or more provided the same answer. It was expected that inter professional contacts would be rare. Results The response rate was 53% out of 254 potential participants. The first two uncomplicated cases would generally have been treated by the chiropractors. As the patient worsened, the responses tended towards

  5. Australian chiropractic sports medicine: half way there or living on a prayer?

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    Dragasevic George

    2007-09-01

    Full Text Available Abstract Sports chiropractic within Australia has a chequered historical background of unorthodox individualistic displays of egocentric treatment approaches that emphasise specific technique preference and individual prowess rather than standardised evidence based management. This situation has changed in recent years with the acceptance of many within sports chiropractic to operate under an evidence informed banner and to embrace a research culture. Despite recent developments within the sports chiropractic movement, the profession is still plagued by a minority of practitioners continuing to espouse certain marginal and outlandish technique systems that beleaguer the mainstream core of sports chiropractic as a cohesive and homogeneous group. Modern chiropractic management is frequently multimodal in nature and incorporates components of passive and active care. Such management typically incorporates spinal and peripheral manipulation, mobilisation, soft tissue techniques, rehabilitation and therapeutic exercises. Externally, sports chiropractic has faced hurdles too, with a lack of recognition and acceptance by organized and orthodox sports medical groups. Whilst some arguments against the inclusion of chiropractic may be legitimate due to its historical baggage, much of the argument appears to be anti-competitive, insecure and driven by a closed-shop mentality.sequently, chiropractic as a profession still remains a pariah to the organised sports medicine world. Add to this an uncertain continuing education system, a lack of protection for the title 'sports chiropractor', a lack of a recognized specialist status and a lack of support from traditional chiropractic, the challenges for the growth and acceptance of the sports chiropractor are considerable. This article outlines the historical and current challenges, both internal and external, faced by sports chiropractic within Australia and proposes positive changes that will assist in

  6. The present use of guinea pigs for chiropractic research *

    OpenAIRE

    McGregor, Marion; Wiles, Michael R.; Grice, Adrian S.

    1980-01-01

    The necessity for an animal model in chiropractic research is considered and a short review of previous experimentation of manipulation on animals is presented. The guinea pig is proposed as a suitable animal model, and research into its suitability is presented. Analysis includes the animal’s physical characteristics, the choice of anesthetic and parametric and roentgenographic evaluation. A device for supporting the anesthetized animal during standard and motion roentgenographic examination...

  7. THE JOURNAL OF THE CHIROPRACTIC & OSTEOPATHIC COLLEGE OF AUSTRALASIA

    OpenAIRE

    Walker, Bruce F.

    1998-01-01

    The first edition of the Journal of the Chiropractic and Osteopathic College of Australasia was known as COMSIG Review and was published in November, 1992 to coincide with a large conference that COCA had organised in Melbourne. In the first few years the majority of articles were magazine style reviews, similar to these found in the Australian Family Physician. The first Editor was Bruce Walker and subsequent Editors have included John Drinkwater, Stephanie Campbell and John Reggars. The cur...

  8. Potential unique causes of burnout for chiropractic professionals

    OpenAIRE

    Williams, Shawn

    2011-01-01

    Objective The objective of this narrative review is to discuss the potential for burnout in chiropractic practitioners. This discussion is grounded in the job demands-resource model, the conservation of resources model, the unique profession-specific stressors experienced by chiropractors, and information from similar health care professions. Methods A search using both the indexed (PubMed and PsychLit) and nonindexed psychosocial literature was used. Other resources included the Cochrane Lib...

  9. Improvements in The Journal of Chiropractic Education for 2013

    OpenAIRE

    Green, Bart N.

    2013-01-01

    This editorial introduces new developments with the Journal of Chiropractic Education that will help the journal fulfill its mission more effectively. Recent improvements include a website upgrade, early online posting of accepted and edited papers, “in press” citations in PubMed, a new electronic web-based manuscript submission and peer-review system, cross linking of references, a new appearance for the journal cover, and improved page format. Improvements in publication processes with the ...

  10. Improvement in hearing after chiropractic care: a case series

    Directory of Open Access Journals (Sweden)

    Di Duro Joseph O

    2006-01-01

    Full Text Available Abstract Background The first chiropractic adjustment given in 1895 was reported to have cured deafness. This study examined the effects of a single, initial chiropractic visit on the central nervous system by documenting clinical changes of audiometry in patients after chiropractic care. Case presentation Fifteen patients are presented (9 male, 6 female with a mean age of 54.3 (range 34–71. A Welch Allyn AudioScope 3 was used to screen frequencies of 1000, 2000, 4000 and 500 Hz respectively at three standard decibel levels 20 decibels (dB, 25 dB and 40 dB, respectively, before and immediately after the first chiropractic intervention. Several criteria were used to determine hearing impairment. Ventry & Weinstein criteria of missing one or more tones in either ear at 40 dB and Speech-frequency criteria of missing one or more tones in either ear at 25 dB. All patients were classified as hearing impaired though greater on the right. At 40 dB using the Ventry & Weinstein criteria, 6 had hearing restored, 7 improved and 2 had no change. At 25 dB using the Speech-frequency criteria, none were restored, 11 improved, 4 had no change and 3 missed a tone. Conclusion A percentage of patients presenting to the chiropractor have a mild to moderate hearing loss, most notably in the right ear. The clinical progress documented in this report suggests that manipulation delivered to the neuromusculoskeletal system may create central plastic changes in the auditory system.

  11. 78 FR 48904 - United States v. Chiropractic Associates, Ltd. of South Dakota; Public Comment and Response on...

    Science.gov (United States)

    2013-08-12

    ... Antitrust Division United States v. Chiropractic Associates, Ltd. of South Dakota; Public Comment and... United States v. Chiropractic Associates, Ltd. of South Dakota., Civil Action No. 13-CV- 4030-LLP, which... DIVISION UNITED STATES OF AMERICA, Plaintiff, v. CHIROPRACTIC ASSOCIATES, LTD. OF SOUTH DAKOTA,...

  12. Racial Disparities in Use of Chiropractic Services by Medicare Beneficiaries Aged 65 to 99 in Los Angeles County, California.

    Science.gov (United States)

    Whedon, James M; Kimura, Melissa N; Phillips, Reed B

    2016-04-01

    Racial and ethnic disparities in utilization of chiropractic services have been described at the state level, but little is known about such local disparities. We analyzed Medicare data for the year 2008 to evaluate by ZIP code for utilization of chiropractic services among older adults in Los Angeles County, California. We evaluated for availability and use of chiropractic services by racial/ethnic category, quantified geographic variations by coefficient of variation, and mapped utilization by selected racial/ethnic categories. Among 7502 beneficiaries who used chiropractic services, 72% were white, 12% Asian, 1% black, 1% Hispanic, and 14% other/unknown. Variation in the number of beneficiaries per ZIP code who used chiropractic services was highest among Hispanics, blacks, and Asians. We found evidence of racial disparities in use of chiropractic services at the local level in Los Angeles County. Older blacks and Hispanics in Los Angeles County may be underserved with regard to chiropractic care. PMID:26350244

  13. Academic Advising Assessment Practices: Results of a National Study

    Science.gov (United States)

    Powers, Keith L.; Carlstrom, Aaron H.

    2014-01-01

    Best practices of academic advising assessment involve identification of student learning outcomes, the development and use of multiple measures of student learning, and sound professional judgment to understand the information gathered and to improve student learning. However, the assessment results often come from minimal, narrow, and…

  14. Some aspects of practical application of studies results

    International Nuclear Information System (INIS)

    Present article is devoted to aspects of practical application of studies results. Thus, the application of petroleum fractions of Kichik-Bel deposit for impregnation of asphalt-concrete cover for recovery of initial properties of asphalt-concrete cover is considered. The modification of lacquer coatings by corrosion inhibitors is considered as well.

  15. Chiropractic management of a patient with benign paroxysmal positional vertigo

    DEFF Research Database (Denmark)

    Nørregaard, Anette R; Lauridsen, Henrik H; Hartvigsen, Jan

    2009-01-01

    OBJECTIVE: This article describes and discusses the case of a patient with benign paroxysmal positional vertigo (BPPV) characterized by severe vertigo with dizziness, nausea, and nystagmus, treated without the use of spinal manipulation by a doctor of chiropractic. CLINICAL FEATURES: A 46-year......-old woman presented for care with complaints of acute vertigo and dizziness. INTERVENTION AND OUTCOME: The patient was examined and diagnosed with left posterior canalolithiasis by means of the Dix-Hallpike maneuver. She was treated successfully with the Epley maneuver once and subsequently discharged...

  16. Practical Results of Forecasting for the Natural Gas Market

    OpenAIRE

    Potocnik, Primoz; Govekar, Edvard

    2010-01-01

    Natural gas consumption forecasting is required to balance the supply and consumption of natural gas. Companies and natural gas distributors are motivated to forecast their consumption by the economic incentive model that dictates the cash flow rules corresponding to the forecasting accuracy. The rules are quite challenging but enable the company to gain positive cash flow by forecasting accurately their short-term natural gas consumption. In this chapter, some practical forecasting results f...

  17. A descriptive report of management strategies used by chiropractors, as reviewed by a single independent chiropractic consultant in the Australian workers compensation system

    Directory of Open Access Journals (Sweden)

    de Luca Katie

    2009-11-01

    Full Text Available Abstract Background In New South Wales, Australia, an injured worker enters the workers compensation system with the case often managed by a pre-determined insurer. The goal of the treating practitioner is to facilitate the claimant to return to suitable duties and progress to their pre-injury status, job and quality of life. Currently, there is very little documentation on the management of injured workers by chiropractors in the Australian healthcare setting. This study aims to examine treatment protocols and recommendations given to chiropractic practitioners by one independent chiropractic reviewer in the state of New South Wales, and to discuss management strategies recommended for the injured worker. Methods A total of 146 consecutive Independent Chiropractic Consultant reports were collated into a database. Pain information and management recommendations made by the Independent Chiropractic Consultant were tabulated and analysed for trends. The data formulated from the reports is purely descriptive in nature. Results The Independent Chiropractic Consultant determined the current treatment plan to be "reasonable" (80.1% or "unreasonable" (23.6%. The consultant recommended to "phase out" treatment in 74.6% of cases, with an average of six remaining treatments. In eight cases treatment was unreasonable with no further treatment; in five cases treatment was reasonable with no further treatment. In 78.6% of cases, injured workers were to be discharged from treatment and 21.4% were to be reassessed for the need of a further treatment plan. Additional recommendations for treatment included an active care program (95.2%, general fitness program (77.4%, flexibility/range of movement exercises (54.1%, referral to a chronic pain specialist (50.7% and work hardening program (22.6%. Conclusion It is essential chiropractic practitioners perform 'reasonably necessary treatment' to reduce dependency on passive treatment, increase compliance to active

  18. Comparison of the lumbosacral spine radiographic examination performed in hospitals and nonhospital and chiropractic facilities

    International Nuclear Information System (INIS)

    This paper estimates the average entrance skin exposure (ESE) and associated technical parameters for the lumbosacral diagnostic radiographic examination as conducted in hospitals, nonhospitals, and chiropractic facilities. A random sample of facilities was selected for survey utilizing the Nationwide Evaluation of X-Ray Trends (NEXT) protocol, which employs a clinically validated patient-equivalent phantom for exposure measurements. Radiation exposure, technique factors, equipment data, and film processing parameters were collected from 250 hospitals, 135 nonhospital radiography facilities, and 152 chiropractic facilities. Average observed ESEs were 420 mR for hospitals, 420 mR for nonhospital facilities and 430 mR for chiropractic facilities

  19. Symptomatic reactions, clinical outcomes and patient satisfaction associated with upper cervical chiropractic care: A prospective, multicenter, cohort study

    Directory of Open Access Journals (Sweden)

    Hurwitz Eric L

    2011-10-01

    Full Text Available Abstract Background Observational studies have previously shown that adverse events following manipulation to the neck and/or back are relatively common, although these reactions tend to be mild in intensity and self-limiting. However, no prospective study has examined the incidence of adverse reactions following spinal adjustments using upper cervical techniques, and the impact of this care on clinical outcomes. Methods Consecutive new patients from the offices of 83 chiropractors were recruited for this practice-based study. Clinical outcome measures included 1 Neck pain disability index (100-point scale, 2 Oswestry back pain index (100-point scale, 3 11-point numerical rating scale (NRS for neck, headache, midback, and low back pain, 4 treatment satisfaction, and 5 Symptomatic Reactions (SR. Data were collected at baseline, and after approximately 2 weeks of care. A patient reaching sub-clinical status for pain and disability was defined as a follow-up score 30% based on an 11-point numeric rating scale occurring Results A total of 1,090 patients completed the study having 4,920 (4.5 per patient office visits requiring 2,653 (2.4 per patient upper cervical adjustments over 17 days. Three hundred thirty- eight (31.0% patients had SRs meeting the accepted definition. Intense SR (NRS ≥8 occurred in 56 patients (5.1%. Outcome assessments were significantly improved for neck pain and disability, headache, mid-back pain, as well as lower back pain and disability (p 5 million career upper cervical adjustments without a reported incidence of serious adverse event. Conclusions Upper cervical chiropractic care may have a fairly common occurrence of mild intensity SRs short in duration (

  20. Environmental scan of anal cancer screening practices: worldwide survey results

    International Nuclear Information System (INIS)

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

  1. Environmental scan of anal cancer screening practices: worldwide survey results.

    Science.gov (United States)

    Patel, Jigisha; Salit, Irving E; Berry, Michael J; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-08-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening. PMID:24740973

  2. Time to Talk: 5 Tips on Safety of Mind and Body Practices for Children and Teens

    Science.gov (United States)

    ... X Y Z 5 Tips on Safety of Mind and Body Practices for Children and Teens Share: Nearly 12 ... such as chiropractic care, deep breathing, and yoga. Mind and body interventions are physical techniques usually administered by a ...

  3. Compensation claims for chiropractic in Denmark and Norway 2004-2012

    DEFF Research Database (Denmark)

    Jevne, Jørgen; Hartvigsen, Jan; Christensen, Henrik Wulff

    2014-01-01

    .3%). A total financial payment of €2,305,757 (median payment €7,730) were distributed among the forty-one cases with complaints relating to a few cases of cervical artery dissection (n = 11, 5.7%) accounting for 88.7% of the total amount. CONCLUSION: Chiropractors in Denmark and Norway received......BACKGROUND: Adverse events are commonly observed in all parts of health care and have been reported extensively following manual therapy, including chiropractic. The majority of reported adverse events following chiropractic care are mild, transitory and self-limiting. However, little is known...... about patient filed compensation claims related to the chiropractic consultation process. The aim of this study was to describe claims reported to the Danish Patient Compensation Association and the Norwegian System of Compensation to Patients related to chiropractic from 2004 to 2012. METHODS: All...

  4. Transition questions in clinical practice - validity and reproducibility

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein

    2008-01-01

    Transition questions in CLINICAL practice - validity and reproducibility Lauridsen HH1, Manniche C3, Grunnet-Nilsson N1, Hartvigsen J1,2 1   Clinical Locomotion Science, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark. e-mail: hlauridsen......@health.sdu.dk 2   Nordic Institute of Chiropractic and Clinical Biomechanics, Part of Clinical Locomotion Science, Odense, Denmark 3   Backcenter Funen, Part of Clinical Locomotion Science, Ringe, Denmark   Abstract  Understanding a change score is indispensable for interpretation of results from clinical studies...

  5. The implementation of problem-based learning in collaborative groups in a chiropractic program in Malaysia

    OpenAIRE

    Ni Ni Win; Nadarajah, Vishna Devi V; Daw Khin Win

    2015-01-01

    Purpose: Problem-based learning (PBL) is usually conducted in small-group learning sessions with approximately eight students per facilitator. In this study, we implemented a modified version of PBL involving collaborative groups in an undergraduate chiropractic program and assessed its pedagogical effectiveness. Methods: This study was conducted at the International Medical University, Kuala Lumpur, Malaysia, and involved the 2012 chiropractic student cohort. Six PBL cases were provided to c...

  6. Development of disease-specific quality indicators for danish chiropractic patients with low back pain

    DEFF Research Database (Denmark)

    Sorensen, Line P; Krog, Birgitte R; Kongsted, Alice; Bronfort, Gert; Hartvigsen, Jan

    2011-01-01

    The purpose of this study is to develop disease-specific quality indicators for Danish chiropractic patients with low back pain (LBP) as an initial effort to include chiropractors in the Danish Health Care Quality Programme.......The purpose of this study is to develop disease-specific quality indicators for Danish chiropractic patients with low back pain (LBP) as an initial effort to include chiropractors in the Danish Health Care Quality Programme....

  7. Effectiveness and economic evaluation of chiropractic care for the treatment of low back pain: a systematic review protocol

    OpenAIRE

    Blanchette, Marc-André; Bussières, André; Stochkendahl, Mette Jensen; Boruff, Jill; Harrison, Pamela

    2015-01-01

    Background Chiropractic care is a common treatment for low back pain (LBP). Previous studies have failed to clarify the relative cost-effectiveness of chiropractic care in comparison with other commonly used approaches because previous attempts to synthetize the economic literature has only included partial economic evaluations. The objective of this project is to estimate the clinical effectiveness and cost-effectiveness of chiropractic care compared to other commonly used care approaches am...

  8. Constructing a philosophy of chiropractic: evolving worldviews and postmodern core☆

    Science.gov (United States)

    Senzon, Simon A.

    2011-01-01

    Objective The purpose of this article is to explore the postmodern, postrational, and postconventional core of DD Palmer's self-sense and philosophy. Discussion DD Palmer's self and philosophy can be viewed as a reaction to the self of modernity and its challenges of a fracture between mind and body, spirit, and nature. It is argued that Palmer's solution to these vexing problems facing the modern self was to use postrational and postconventional logic to overcome the dualisms. His philosophy resonates with similar postrational approaches, most notably, the German idealist Schelling. Conclusion It is argued that Palmer was one of the first postrational individuals in America and that chiropractic was an attempt at the first postrational health profession. PMID:22693480

  9. [Eslicarbazepine acetate in clinical practice. Efficacy and safety results].

    Science.gov (United States)

    Serrano-Castro, Pedro J; Payán-Ortiz, Manuel; Cimadevilla, José M; Quiroga-Subirana, Pablo; Fernández-Pérez, Javier

    2013-03-16

    INTRODUCTION. Eslicarbazepine acetate (ESL) is a new antiepileptic drug (AED) licensed in Spain in February 2011 as an adjunctive therapy in adults with partial seizures with or without secondary generalization. Clinical trials with ESL have demonstrated acceptable efficacy and safety. AIM. To evaluate the results of ESL in our epilepsy unit during its first year of clinical experience with this AED. PATIENTS AND METHODS. We included all patients who started treatment with ESL at our epilepsy unit from March 2011 to May 2012. We collected the following variables: gender, aetiology of epilepsy, epileptogenic area, reason for switch to ESL, clinical response after initiation of ESL, adverse effects of ESL, refractoriness criteria and treatment discontinuation. A bivariate factor-to-factor correlation study was carried out to establish associations between the independent variables and the clinical response. RESULTS. We recruited 105 patients (51.4% male). 20,7% of patients remained seizure-free and 58.4% showed > 50% improvement after introduction of ESL. At 6 months, 18.1% had experienced some type of side effect, with cognitive disorders being the most common, and 11.5% had discontinued treatment. Combination with lacosamide proved to be significantly less effective in the control of seizures. Combination of ESL with the rest of sodium channel inhibitors was similar in efficacy to others combinations. CONCLUSIONS. ESL is a well-tolerated and effective AED when is used as adjunctive treatment with most of other AED in clinical practice. PMID:23483464

  10. Preliminary study into the components of the fear-avoidance model of LBP: change after an initial chiropractic visit and influence on outcome

    Directory of Open Access Journals (Sweden)

    Newell Dave

    2010-07-01

    Full Text Available Abstract Background In the last decade the sub grouping of low back pain (LBP patients according to their likely response to treatment has been identified as a research priority. As with other patient groups, researchers have found few if any factors from the case history or physical examination that are helpful in predicting the outcome of chiropractic care. However, in the wider LBP population psychosocial factors have been identified that are significantly prognostic. This study investigated changes in the components of the LBP fear-avoidance beliefs model in patients pre- and post- their initial visit with a chiropractor to determine if there was a relationship with outcomes at 1 month. Methods Seventy one new patients with lower back pain as their primary complaint presenting for chiropractic care to one of five clinics (nine chiropractors completed questionnaires before their initial visit (pre-visit and again just before their second appointment (post-visit. One month after the initial consultation, patient global impression of change (PGIC scores were collected. Pre visit and post visit psychological domain scores were analysed for any association with outcomes at 1 month. Results Group mean scores for Fear Avoidance Beliefs (FAB, catastrophisation and self-efficacy were all improved significantly within a few days of a patient's initial chiropractic consultation. Pre-visit catastrophisation as well as post-visit scores for catastrophisation, back beliefs (inevitability and self-efficacy were weakly correlated with patient's global impression of change (PGIC at 1 month. However when the four assessed psychological variables were dichotomised about pre-visit group medians those individuals with 2 or more high variables post-visit had a substantially increased risk (OR 36.4 (95% CI 6.2-213.0 of poor recovery at 1 month. Seven percent of patients with 1 or fewer adverse psychological variables described poor benefit compared to 73% of those

  11. Radiological protection survey results about radiodiagnosis protection practices in Cuba

    International Nuclear Information System (INIS)

    In order to identify radiation protection current situation in national X-ray diagnostic practice , the State (cuban) Supervision System for Radiation and Nuclear Safety carried out in 1992 a survey which was planned for projection of future regulatory activities in this field. Survey covers the most important aspects related to radiation protection of occupationally exposed workers, patients and general population. Surveyed sample included a total of 52 X-ray units, sited in 7 dental clinics, 2 polyclinics and 13 hospitals, from 7 provinces of the country. Results showed that the organization of radiation protection in terms of personnel specially designated to carry out surveillance and control activities and level of documentation is deficient. Survey evidenced the general lack of safety and quality culture among technologists and radiologists which is mainly reflected in non regular application of basic patient protection measures (shielding, collimation, use of proper filtration among others) and non regular execution of basic quality inspection of employed radiographic systems. (authors). 4 refs., 1 fig

  12. Dentists’ practice patterns regarding caries prevention: results from a dental practice-based research network

    OpenAIRE

    Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gilbert, Gregg H.; Gordan, Valeria V.

    2013-01-01

    Objective The purposes of this study were to (1) quantify dentists' practice patterns regarding caries prevention and (2) test the hypothesis that certain dentists' characteristics are associated with these practice patterns. Design The study used a cross-sectional study design consisting of a questionnaire survey. Participants The study queried dentists who worked in outpatient dental practices who were affiliated with the Dental Practice-Based Research Network Japan, which seeks to engage d...

  13. Deforestation as a result of unsustainable agricultural practices

    OpenAIRE

    Travis, A.J.

    2005-01-01

    Deforestation is rampant in this region. The soil is depleted by current farming practices, particularly for cotton and tobacco. This leads to more deforestation as farming plots become useless within just a few years. LTRA-2 (An Agricultural Markets Model for Biodiversity Conservation)

  14. Generalizability of a composite student selection procedure at a university-based chiropractic program

    DEFF Research Database (Denmark)

    O'Neill, Lotte D; Korsholm, Lars; Wallstedt, Birgitta;

    2009-01-01

    PURPOSE: Non-cognitive admission criteria are typically used in chiropractic student selection to supplement grades. The reliability of non-cognitive student admission criteria in chiropractic education has not previously been examined. In addition, very few studies have examined the overall test...... generalizability of composites of non-cognitive admission variables in admission to health science programs. The aim of this study was to estimate the generalizability of a composite selection to a chiropractic program, consisting of: application form information, a written motivational essay, a common knowledge...... generalizability was found for the common knowledge test (G=1.00) and the admission interview (G=0.88). Good generalizability was found for application form information (G=0.75) and moderate generalizability (G=0.50) for the written motivation essay. The generalizability of the final composite admission procedure...

  15. Environmental scan of anal cancer screening practices: worldwide survey results

    OpenAIRE

    Patel, Jigisha; Salit, Irving E.; Berry, Michael J.; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-01-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey ...

  16. Outcomes of usual chiropractic, harm & efficacy, the ouch study: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2011-10-01

    Full Text Available Abstract Background Previous studies have demonstrated that adverse events occur during chiropractic treatment. However, because of these studies design we do not know the frequency and extent of these events when compared to sham treatment. The principal aims of this study are to establish the frequency and severity of adverse effects from short term usual chiropractic treatment of the spine when compared to a sham treatment group. The secondary aim of this study is to establish the efficacy of usual short term chiropractic care for spinal pain when compared to a sham intervention. Methods One hundred and eighty participants will be randomly allocated to either usual chiropractic care or a sham intervention group. To be considered for inclusion the participants must have experienced non-specific spinal pain for at least one week. The study will be conducted at the clinics of registered chiropractors in Western Australia. Participants in each group will receive two treatments at intervals no less than one week. For the usual chiropractic care group, the selection of therapeutic techniques will be left to the chiropractors' discretion. For the sham intervention group, de-tuned ultrasound and de-tuned activator treatment will be applied by the chiropractors to the regions where spinal pain is experienced. Adverse events will be assessed two days after each appointment using a questionnaire developed for this study. The efficacy of short term chiropractic care for spinal pain will be examined at two week follow-up by assessing pain, physical function, minimum acceptable outcome, and satisfaction with care, with the use of the following outcome measures: Numerical Rating Scale, Functional Rating Index, Neck Disability Index, Minimum Acceptable Outcome Questionnaire, Oswestry Disability Index, and a global measure of treatment satisfaction. The statistician, outcome assessor, and participants will be blinded to treatment allocation. Trial

  17. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Morton Adam

    2012-12-01

    Full Text Available Abstract A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature.

  18. A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder

    DEFF Research Database (Denmark)

    DeVocht, James W; Goertz, Christine M; Hondras, Maria;

    2013-01-01

    BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80 particip......BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80...... that will provide clinicians with information that should be helpful when discussing treatment options for patients with TMD....

  19. ACCOUNTING PRACTICES FOR ADJUNSTING THE ENTITY’S RESULTS

    OpenAIRE

    L. Cernuşca

    2013-01-01

    An enterprise’s financial result is the main source of information for all those interested in the company’s activity. As a result of being normalized and audited, the information offered by accounting receives the “social recognition”, recognition which allows them to be used to evaluate the enterprise’s activities and performances. Although there are accounting laws, the options and/or the imprecision in the accounting texts allow for the possibility to manipulate the financial result and t...

  20. VARK Learning Preferences and Mobile Anatomy Software Application Use in Pre-Clinical Chiropractic Students

    Science.gov (United States)

    Meyer, Amanda J.; Stomski, Norman J.; Innes, Stanley I.; Armson, Anthony J.

    2016-01-01

    Ubiquitous smartphone ownership and reduced face-to-face teaching time may lead to students making greater use of mobile technologies in their learning. This is the first study to report on the prevalence of mobile gross anatomy software applications (apps) usage in pre-clinical chiropractic students and to ascertain if a relationship exists…

  1. The development of contemporary chiropractic education in Denmark: an exploratory study

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Mouton, Johan

    2008-01-01

    quo issues around education at the University of Southern Denmark, and 1 explored perceived health care integration benefits attributable to the chosen model of education. CONCLUSION: The Danish chiropractic profession's incentive to raise its legitimacy lay in the access it stood to gain, through a...

  2. Self-Regulation of a Chiropractic Association through Participatory Action Research

    Science.gov (United States)

    Sheppard, Lorraine A.; Jorgensen, Anna Maria S.; Crowe, Michael J.

    2012-01-01

    Participatory action research (PAR) can be used in the health professions to redefine their roles. This study investigated a small health professional group, the members of The Chiropractic Association Singapore (TCAS), by using a PAR method; researchers and participants gained insights into the self-regulation of a health profession. A…

  3. Practical Results of a Five-level Flying Capacitor Inverter

    Directory of Open Access Journals (Sweden)

    O. Sivkov

    2010-01-01

    Full Text Available This paper investigates the realization of a five-level Flying Capacitor Inverter. After a brief description of general Power Electronic Converters and an introduction to the advantages of Multilevel Inverters over conventional two-level Inverters the main focus is on the five-level Flying Capacitor Inverter. The Flying Capacitor Multilevel Inverter (FCMI is a Multilevel Inverter (MI where the capacitor voltage can be balanced using only a control strategy for any number of levels. After a general description of five-level FCMI topology, the simulation and experimental results are presented. The capacitor voltage is stabilized here with various output voltage amplitude values. The simulation and experimental results of five-level FCMI show that the voltage is stabilized on capacitors using the control strategy. A single-phase five-level FCMI model is currently being developed and constructed in the laboratory. Some of the experimental results are available.

  4. Interpretation of cytogenetic results in multiple myeloma for clinical practice

    OpenAIRE

    Rajan, A M; Rajkumar, S V

    2015-01-01

    The interpretation of cytogenetic abnormalities in multiple myeloma (MM) is often a challenging task. MM is characterized by several cytogenetic abnormalities that occur at various time points in the disease course. The interpretation of cytogenetic results in MM is complicated by the number and complexity of the abnormalities, the methods used to detect them and the disease stage at which they are detected. Specific cytogenetic abnormalities affect clinical presentation, progression of smold...

  5. ACCOUNTING PRACTICES FOR ADJUNSTING THE ENTITY’S RESULTS

    Directory of Open Access Journals (Sweden)

    L. CERNUŞCA

    2013-07-01

    Full Text Available An enterprise’s financial result is the main source of information for all those interested in the company’s activity. As a result of being normalized and audited, the information offered by accounting receives the “social recognition”, recognition which allows them to be used to evaluate the enterprise’s activities and performances. Although there are accounting laws, the options and/or the imprecision in the accounting texts allow for the possibility to manipulate the financial result and the content of the financial statements Within the liberty offered by the different source of accounting law, the enterprises can choose between the options which are at the base of presenting the financial statements. The choices made by the enterprise’s management with the purpose of modeling in a legal way, the presentation and the content of the financial statements are known as accounting policy. Within an enterprise, developing the accounting policies represent a primary aspect, because applying these policies determine a high degree of financial information relevance and lead to better management choices.

  6. CONTINUOUS IMPROVEMENT PRACTICE IN LARGE ENTERPRISES: STUDY RESULTS

    Directory of Open Access Journals (Sweden)

    Dorota Stadnicka

    2015-03-01

    Full Text Available Continuous improvement is indispensable for ensuring the company's development and its survival on the constantly changing global market. Continuous improvement is particularly important in the quality and production management systems. A company should deliver a product compliant with a client's requirements in a specified time and at an appropriate price. That is why, continuous improvement refers to different areas of an organization's functioning and it is an integral part of Lean Manufacturing. This article presents the results of the study conducted in production enterprises on a limited area. The aim of the study was the assessment of the implementation of continuous improvement in Lean Manufacturing, and, in particular, employees' involvement in the problem identification and in reporting improvements as well as the way of motivating employees to involve themselves. The authors also tried to identify the factors influencing the elements of a continuous improvement system.

  7. Delineating inflammatory and mechanical sub-types of low back pain: a pilot survey of fifty low back pain patients in a chiropractic setting

    Directory of Open Access Journals (Sweden)

    Riksman Janine S

    2011-02-01

    Full Text Available Abstract Background An instrument known as the Mechanical and Inflammatory Low Back Pain (MAIL Scale was drafted using the results of a previous expert opinion study. A pilot survey was conducted to test the feasibility of a larger study designed to determine the MAIL Scale's ability to distinguish two potential subgroups of low back pain: inflammatory and mechanical. Methods Patients with a primary complaint of low back pain (LBP presenting to chiropractic clinics in Perth, Western Australia were asked to fill out the MAIL Scale questionnaire. The instrument's ability to separate patients into inflammatory and mechanical subgroups of LBP was examined using the mean score of each notional subgroup as an arbitrary cut-off point. Results Data were collected from 50 patients. The MAIL Scale did not appear to separate cases of LBP into the two notionally distinct groups of inflammatory (n = 6 or mechanical (n = 5. A larger "mixed symptom" group (n = 39 was revealed. Conclusions In this pilot study the MAIL Scale was unable to clearly discriminate between what is thought to be mechanical and inflammatory LBP in 50 cases seen in a chiropractic setting. However, the small sample size means any conclusions must be viewed with caution. Further research within a larger study population may be warranted and feasible.

  8. A survey of chiropractors practicing in Germany: practice characteristics, professional reading habits, and attitudes and perceptions toward research

    Directory of Open Access Journals (Sweden)

    Hondras Maria A

    2007-05-01

    Full Text Available Abstract Background In 2004, a survey conducted by the European Chiropractor's Union among member countries reported that "there appears to be little interest in research among chiropractors in Germany." However, no research has tested this statement. The objective of this study was to explore the attitudes and perceptions of practicing chiropractors in Germany regarding research, to look at their reading and research habits, and to gather demographic and practice data. Methods A questionnaire was developed and distributed among participants at a seminar held by the German Chiropractors' Association in 2005. The questionnaire was mailed to any members of the association who did not attend the seminar. Results A total of 49 (72% of 68 distributed questionnaires were returned. Forty-five (92% respondents stated they would support research efforts in Germany and 15 (31% declared interest in participating in practiced based research. An average of three hours per week were reportedly spent reading scientific literature by 44 (85% respondents. However, few journals listed by respondents were peer-reviewed and indexed; most were newsletters of chiropractic organizations or free publications. Most participants agreed on the importance of research for the profession, but when asked about the most pressing issue for chiropractic in Germany, legislation and recognition of the profession were the dominant themes. Conclusion The results of this survey show that there is a general interest in supporting and participating in research activities among chiropractors practicing in Germany. Next steps could consist of educating practitioners about the resources available to read and interpret the scientific literature and thus further the understanding of research.

  9. Perspectives of older adults on co-management of low back pain by doctors of chiropractic and family medicine physicians: a focus group study

    DEFF Research Database (Denmark)

    Lyons, K. J.; Salsbury, S. A.; Hondras, M. A.; Jones, M. E.; Andresen, A. A.; Goertz, C. M.

    2013-01-01

    systems that allowed exchange of health information between clinics, and practice settings where providers worked in one location. Perceived barriers to the co-management of LBP included the financial costs associated with receiving care from multiple providers concurrently, duplication of tests or...... by MDs and DCs. Older adults considered patient-centered communication, collegial interdisciplinary interactions between these providers, and administrative supports such as scheduling systems and health record sharing as key components for successful LBP co-management.......Background: While older adults may seek care for low back pain (LBP) from both medical doctors (MDs) and doctors of chiropractic (DCs), co-management between these providers is uncommon. The purposes of this study were to describe the preferences of older adults for LBP co-management by MDs and DCs...

  10. Feasibility of the STarT back screening tool in chiropractic clinics: a cross-sectional study of patients with low back pain

    DEFF Research Database (Denmark)

    Kongsted, Alice; Johannesen, Else; Leboeuf-Yde, Charlotte

    2011-01-01

    Avoidance Beliefs Questionnaire (FABQ), and the Coping Strategies Questionnaire. Associations between the continuous scores of the psychological questionnaires and the SBT were tested by means of linear regression, and the diagnostic performance of the SBT in relation to the other questionnaires was...... described in terms of sensitivity, specificity and likelihood ratios.In this cohort 59% were in the SBT low risk, 29% in the medium risk and 11% in high risk group. The SBT risk groups were positively associated with all of the psychological questionnaires. The SBT high risk group had positive likelihood...... ratios for having a risk profile on the psychological scales ranging from 3.8 (95% CI 2.3 - 6.3) for the MDI to 7.6 (95% CI 4.9 - 11.7) for the FABQ. The SBT questionnaire was feasible to use in chiropractic practice and risk groups were related to the presence of well-established psychological...

  11. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    OpenAIRE

    Morton Adam

    2012-01-01

    Abstract A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE) immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection fo...

  12. Brief screening questions for depression in chiropractic patients with low back pain

    DEFF Research Database (Denmark)

    Kongsted, Alice; Aambakk, Benedicte; Bossen, Sanne;

    2014-01-01

    Depression is an important prognostic factor in low back pain (LBP) that appears to be infrequent in chiropractic populations. Identification of depression in few patients would consequently implicate screening of many. It is therefore desirable to have brief screening tools for depression. The...... objective of this study was to investigate if one or two items from the Major Depression Inventory (MDI) could be a reasonable substitute for the complete scale....

  13. Acupuncture, chiropractic and osteopathy use in Australia: a national population survey

    OpenAIRE

    Polus Barbara; Myers Ray; Lin Vivian; Zhang Anthony L; Xue Charlie CL; Story David F

    2008-01-01

    Abstract Background There have been no published national studies on the use in Australia of the manipulative therapies, acupuncture, chiropractic or osteopathy, or on matters including the purposes for which these therapies are used, treatment outcomes and the socio-demographic characteristics of users. Methods This study on the three manipulative therapies was a component of a broader investigation on the use of complementary and alternative therapies. For this we conducted a cross-sectiona...

  14. Audit of a system for dealing with a practice's laboratory test results.

    OpenAIRE

    Stephenson, P.

    1993-01-01

    In order to improve efficiency in a non-computerized practice of 4700 patients the system for dealing with laboratory test results and communicating them to patients was audited over a two-week period. The audit involved a questionnaire for the practice team, a postal questionnaire to 36 patients, and an analysis of doctors' and receptionists' workload when dealing with laboratory test results. A new system was introduced, with two receptionists logging investigation details into a newly desi...

  15. Frequency of yoga practice predicts health: results of a national survey of yoga practitioners.

    Science.gov (United States)

    Ross, Alyson; Friedmann, Erika; Bevans, Margaret; Thomas, Sue

    2012-01-01

    Background. Yoga shows promise as a therapeutic intervention, but relationships between yoga practice and health are underexplored. Purpose. To examine the relationship between yoga practice and health (subjective well-being, diet, BMI, smoking, alcohol/caffeine consumption, sleep, fatigue, social support, mindfulness, and physical activity). Methods. Cross-sectional, anonymous internet surveys distributed to 4307 randomly selected from 18,160 individuals at 15 US Iyengar yoga studios; 1045 (24.3%) surveys completed. Results. Mean age 51.7 (± 11.7) years; 84.2% female. Frequency of home practice favorably predicted (P vegetarian status, sleep, and fatigue. Each component of yoga practice (different categories of physical poses, breath work, meditation, philosophy study) predicted at least 1 health outcome (P health better than years of practice or class frequency. Different physical poses and yoga techniques may have unique health benefits. PMID:22927885

  16. Do side-effects/injuries from yoga practice result in discontinued use? Results of a national survey

    OpenAIRE

    M Kim Holton; Barry, Adam E.

    2014-01-01

    Context: Yoga-related injuries are of increasing concern as the use of yoga continues to rise. Aims: The aim of the following study is to examine whether a national sample of yoga practitioners would report discontinued use of yoga due to injury from the practice, assess what injuries resulted in discontinued use, determine what injuries were most common and identify injuries requiring medical attention. Methods: Secondary data analysis of a nationally representative sample of adults in...

  17. Prevalence of pain-free weeks in chiropractic subjects with low back pain - a longitudinal study using data gathered with text messages

    Directory of Open Access Journals (Sweden)

    Lemeunier Nadège

    2011-12-01

    Full Text Available Abstract Introduction The use of automated text messages has made it possible to identify different courses of low back pain (LBP, and it has been observed that pain often fluctuates and that absolute recovery is rather rare. The purpose of this study was to describe the prevalence of pain-free weeks and pain-free periods in subjects with non-specific LBP treated by chiropractors, and to compare subjects from two different countries in these aspects. Methods Data were obtained from two practice-based multicentre prospective outcome studies, one Danish and one Swedish, involving subjects being treated by chiropractors for non-specific LBP. Over 18 weeks, subjects answered a weekly automated text message question on the number of days in the past week that they had experienced bothersome LBP, i.e. a number between 0 and 7. The number of weeks in a row without any LBP at all ("zero weeks" as well as the maximum number of zero weeks in a row was determined for each individual. Comparisons were made between the two study samples. Estimates are presented as percentages with 95% confidence intervals. Results In the Danish and the Swedish populations respectively, 93/110 (85% and 233/262 (89% of the subjects were eligible for analysis. In both groups, zero weeks were rather rare and were most commonly (in 40% of the zero weeks reported as a single isolated week. The prevalence of pain free periods, i.e. reporting a maximum of 0, 1 or 2, or 3-6 zero weeks in a row, were similar in the two populations (20-31%. Smaller percentages were reported for ≥ 7 zero weeks in a row. There were no significant differences between the two study groups. Conclusion It was uncommon that chiropractic subjects treated for non-specific LBP experienced an entire week without any LBP at all over 18 weeks. When this occurred, it was most commonly reported for brief periods only. Hence, recovery in the sense that patients become absolutely pain free is rare, even in a primary

  18. Transfer Paths of Research Results to the Practice: Observations From the Receiving End

    Science.gov (United States)

    Findikakis, A. N.

    2005-12-01

    A non-scientific poll of fellow practicing professionals suggests that there is a range of opinions regarding the effectiveness of different ways of becoming acquainted with and using the results of academic research in their practice. Journal articles remain the dominant path for transferring research results to the profession, even though accessing them is becoming more difficult with time. Driven primarily by cost considerations personal and corporate subscriptions seem to be on the decline. Libraries are one of the first victims of cost cutting measures in the industry. Even though the availability of journal articles in electronic form facilitates their availability, their prices are prohibitive. This is especially true during when a professional is searching for a solution to a problem and may have to review several papers on the subject. One colleague suggested that the professional organizations and other publishers of research articles could learn from the experience of the music industry, by lowering the cost of downloading individual papers to something like a dollar per article, recovering thus their production costs through the increase in the volume of purchased articles. The posting on the internet of special reports and dissertations by research institutions is viewed as very useful by those working in practice. The distribution through the internet of reports by federal organizations conducting or sponsoring research, such as the U.S. Geological Survey and the U.S. Environmental Protection Agency is greatly appreciated by the practicing professionals. The use of leading researchers as consultants provides a direct path for bringing research results to the practice, but it is limited to a small number of cases where bringing in a consultant can be justified. Short courses are viewed as an effective way of familiarizing professionals with the latest research findings on specific subjects. The notes distributed in such courses are considered

  19. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA)

    DEFF Research Database (Denmark)

    Goertz, Christine M; Salsbury, Stacie A; Vining, Robert D;

    2013-01-01

    one month, from a community-based sample in the Quad-Cities, Iowa/Illinois, USA. Eligible participants are allocated in a 1:1:1 ratio to receive 12 weeks of medical care, concurrent medical and chiropractic care, or collaborative medical and chiropractic care. Primary outcomes are self-rated back pain...... also are evaluated. Process outcomes are assessed through qualitative interviews with study participants and research clinicians, chart audits of progress notes and content analysis of clinical trial notes. DISCUSSION: This pragmatic, pilot randomized controlled trial uses a mixed method approach to...

  20. A comparative analysis of chiropractic and general practitioner patients in North America: Findings from the joint Canada/United States survey of health, 2002–03

    Directory of Open Access Journals (Sweden)

    Chiang Lu-May

    2006-04-01

    Full Text Available Abstract Background Scientifically rigorous general population-based studies comparing chiropractic with primary-care medical patients within and between countries have not been published. The objective of this study is to compare care seekers of doctors of chiropractic (DCs and general practitioners (GPs in the United States and Canada on a comprehensive set of sociodemographic, quality of life, and health-related variables. Methods Data are from the Joint Canada/U.S. Survey of Health (JCUSH, 2002–03, a random sample of adults in Canada (N = 3505 and the U.S. (N = 5183. Respondents were categorized according to their pattern of health-care use in the past year. Distributions, percentages, and estimates (adjusted odds ratios weighted to reflect the complex survey design were produced. Results Nearly 80% of respondents sought care from GPs; 12% sought DC care. Compared with GP only patients, DC patients in both countries tend to be under 65 and white, with arthritis and disabling back or neck pain. U.S. DC patients are more likely than GP only patients to be obese and to lack a regular doctor; Canadian DC patients are more likely than GP only patients to be college educated, to have higher incomes, and dissatisfied with MD care. Compared with seekers of both GP and DC care, DC only patients in both countries have fewer chronic conditions, take fewer drugs, and have no regular doctor. U.S. DC only patients are more likely than GP+DC patients to be uninsured and dissatisfied with health care; Canadian DC only patients are more likely than GP+DC patients to be under 45, male, less educated, smokers, and not obese, without disabling back or neck pain, on fewer drugs, and lacking a regular doctor. Conclusion Chiropractic and GP patients are dissimilar in both Canada and the U.S., with key differences between countries and between DC patients who do and do not seek care from GPs. Such variation has broad and potentially far-reaching health policy and

  1. Lost and Found, Letters and Methods: Assessing Attitudes toward Chiropractic and Medical Care

    Directory of Open Access Journals (Sweden)

    William H. Yeaton

    2010-01-01

    Full Text Available Attitudes toward traditional and chiropractic medicine were compared using Milgram's lost letter technique. A total of 192 letters were placed on the windshields of vehicles in parking lots at six restaurants and department stores in each of four quadrants of a medium-sized, Southeastern city. These letters were addressed to "Admissions" at either a fictitious Institute of Medicine or Institute of Chiropractic Care. Return addresses included either a male or a female name. Thus, those who found a lost letter were faced with the option of returning or not returning a letter from either a male or a female, addressed to an Institute of traditional or non-traditional medicine. After examining previous studies which had used the lost letter technique, numerous methodological improvements were implemented. For example, letters were randomly assigned to potential drop spots for each of 24 study locations (six study locations in each of four city quadrants, and a Latin square design was used to control for possible order effects in the four study conditions that were implemented. Nearly 65% of the letters (124 of 192 were returned. We found: 1 letters addressed to a fictitious Institute of Chiropractic Care were just as likely to be returned as those addressed to a fictitious Institute of Medicine; 2 letters with female return addresses were as likely to be returned as those with male return addresses; 3 there was no interaction between study conditions; 4 based on what was essentially a replication study, a comparison of the pattern of returns using the first and second cycle of lost letters (n = 96 for each cycle revealed an equivalent pattern of no-difference findings.

  2. Adding chiropractic to standard medical therapy for nonspecific low back pain

    DEFF Research Database (Denmark)

    Goertz, Christine M; Long, Cynthia R; Hondras, Maria;

    2013-01-01

    Study Design. Randomized controlled trial.Objective. To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military...... controlled trials demonstrates that manipulative therapy may be as effective as other conservative treatments of LBP, but its appropriate role in the healthcare delivery system has not been established.Methods. Prospective, 2-arm randomized controlled trial pilot study comparing SMC plus CMT with only SMC...

  3. Complementary and alternative treatment for neck pain: chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais.

    Science.gov (United States)

    Plastaras, Christopher T; Schran, Seth; Kim, Natasha; Sorosky, Susan; Darr, Deborah; Chen, Mary Susan; Lansky, Rebecca

    2011-08-01

    Of the multitude of treatment options for the management of neck pain, no obvious single treatment modality has been shown to be most efficacious. As such, the clinician should consider alternative treatment modalities if a modality is engaging, available, financially feasible, potentially efficacious, and is low risk for the patient. As evidence-based medicine for neck pain develops, the clinician is faced with the challenge of which treatments to encourage patients to pursue. Treatment modalities explored in this article, including chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais, represent reasonable complementary and alternative medicine methods for patients with neck pain. PMID:21824591

  4. Frequency of Yoga Practice Predicts Health: Results of a National Survey of Yoga Practitioners

    Directory of Open Access Journals (Sweden)

    Alyson Ross

    2012-01-01

    Full Text Available Background. Yoga shows promise as a therapeutic intervention, but relationships between yoga practice and health are underexplored. Purpose. To examine the relationship between yoga practice and health (subjective well-being, diet, BMI, smoking, alcohol/caffeine consumption, sleep, fatigue, social support, mindfulness, and physical activity. Methods. Cross-sectional, anonymous internet surveys distributed to 4307 randomly selected from 18,160 individuals at 15 US Iyengar yoga studios; 1045 (24.3% surveys completed. Results. Mean age 51.7 (± 11.7 years; 84.2% female. Frequency of home practice favorably predicted (P < .001: mindfulness, subjective well-being, BMI, fruit and vegetable consumption, vegetarian status, sleep, and fatigue. Each component of yoga practice (different categories of physical poses, breath work, meditation, philosophy study predicted at least 1 health outcome (P < .05. Conclusions. Home practice of yoga predicted health better than years of practice or class frequency. Different physical poses and yoga techniques may have unique health benefits.

  5. Access to complementary medicine via general practice.

    OpenAIRE

    Thomas, K.J.; Nicholl, J P; Fall, M.

    2001-01-01

    BACKGROUND: The popularity of complementary medicine continues to be asserted by the professional associations and umbrella organisations of these therapies. Within conventional medicine there are also signs that attitudes towards some of the complementary therapies are changing. AIM: To describe the scale and scope of access to complementary therapies (acupuncture, chiropractic, homoeopathy, hypnotherapy, medical herbalism, and osteopathy) via general practice in England. DESIGN OF STUDY: A ...

  6. Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Nadgir, R.N.; Ahmed, T. [University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States); Loevner, L.A.; Moonis, G.; Slawek, K.; Imbesi, S. [Neuroradiology Section, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States); Chalela, J. [Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States)

    2003-05-01

    Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation. (orig.)

  7. Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature

    International Nuclear Information System (INIS)

    Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation. (orig.)

  8. The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?

    DEFF Research Database (Denmark)

    Hestbæk, Lise; Stochkendahl, Mette Jensen

    2010-01-01

    ABSTRACT: Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact on...

  9. Organic farming practices result in compositional shifts in nematode communities that exceed crop-related changes

    NARCIS (Netherlands)

    Quist, Casper W.; Schrama, Maarten; de Haan, Janjo J.; Smant, Geert; Bakker, Jaap; van der Putten, Wim H.; Helder, Johannes

    2016-01-01

    Intensification of conventional agriculture has resulted in a decline of soil ecosystem functioning. Organic agriculture intends to manage soil biota in a manner that is more geared towards adequate cycling of nutrients with minimal losses. Ecological interpretation of agricultural practices-induced

  10. Retrospective case series of clinical outcomes associated with chiropractic management for veterans with low back pain

    Directory of Open Access Journals (Sweden)

    Andrew S. Dunn, DC, MS, MEd

    2011-10-01

    Full Text Available Musculoskeletal complaints, most notably low back pain (LBP, are prevalent among veterans. Despite a focus on LBP management by chiropractors within the Veterans Health Administration, limited published accounts detail clinical outcomes with chiropractic management of LBP among veterans. This was a retrospective case series of 171 veterans with a chief complaint of LBP who were managed with chiropractic care. Descriptive statistics and paired t-tests were used, with the Numeric Rating Scale (NRS and the Back Bournemouth Questionnaire (BBQ serving as the outcome measures. A minimum clinically important difference (MCID was set as 30% improvement from baseline for both measures. The mean number of treatments was 8.7. For the NRS, the mean raw score improvement was 2.2 points, representing 37.4% change from baseline; 103 (60.2% patients met or exceeded the MCID. For the BBQ, the mean raw score improvement was 13.6 points, representing 34.6% change from baseline; 92 patients (53.8% met or exceeded the MCID. For this sample of veterans with LBP, the mean percentages of clinical improvement were statistically significant and clinically meaningful for both the NRS and BBQ.

  11. Application of lead-acrylic compensating filters in chiropractic full spine radiography: a technical report

    Energy Technology Data Exchange (ETDEWEB)

    Buehler, M.T.; Hrejsa, A.F.

    1985-09-01

    X-raying the entire spinal column in the standing position in a single exposure (mainly the AP projection) is an often-used chiropractic radiography procedure which has also found some application in medical scoliosis screening program. Aside from any controversy of clinical objectives or medical necessity, the primary agreed-upon requisite for such procedure is twofold; achieving the best possible film image quality with the least amount of radiation exposure to the patient. A popular method of accomplishing this objective is by the use of collimator-attached devices designed to selectively filter the primary x-ray beam in accordance with regional variations of body thickness and/or density. This study was conducted to evaluate the use of a new lead-acrylic filter system under specialized chiropractic conditions. In comparison to other available systems, it was concluded that this new system; a) is generally equivalent in its radiation dose reduction capabilities; b) is capable of producing full spine radiographs with good to above average image quality; and c) is appreciably easier to use.

  12. Application of lead-acrylic compensating filters in chiropractic full spine radiography: a technical report

    International Nuclear Information System (INIS)

    X-raying the entire spinal column in the standing position in a single exposure (mainly the AP projection) is an often-used chiropractic radiography procedure which has also found some application in medical scoliosis screening program. Aside from any controversy of clinical objectives or medical necessity, the primary agreed-upon requisite for such procedure is twofold; achieving the best possible film image quality with the least amount of radiation exposure to the patient. A popular method of accomplishing this objective is by the use of collimator-attached devices designed to selectively filter the primary x-ray beam in accordance with regional variations of body thickness and/or density. This study was conducted to evaluate the use of a new lead-acrylic filter system under specialized chiropractic conditions. In comparison to other available systems, it was concluded that this new system; a) is generally equivalent in its radiation dose reduction capabilities; b) is capable of producing full spine radiographs with good to above average image quality; and c) is appreciably easier to use

  13. Practice and professional development plans (PPDPs: results of a feasibility study

    Directory of Open Access Journals (Sweden)

    Hocking Paul

    2001-03-01

    Full Text Available Abstract Background Dissatisfaction with uniprofessional education structures as a means of improving the quality of healthcare has led to proposals to develop ways of integrating professional learning and organisational development. Aims Test the feasibility of introducing practice and professional development plans using a centrally sponsored project in Wales. Design Qualitative observational study. Study sample All 541 practices in Wales were alerted to the project and invited to apply. A selection process was suggested to Health Authorities but not always efficiently conducted: 23 practices were selected and 18 participated in the process. Method Central funding was made available to health authorities. The project framework was designed by an educational department and conceptualised as the development of personal portfolios linked to one key organisation change in each practice, facilitated by external consultants who would typically hold workshops or other events. An independent researcher using non-participant observation techniques at workshops and practices undertook documentary analysis and fieldwork in four health authorities. Results Difficulties were encountered with the process of implementing the project: marketing and practice selection inconsistencies delayed the work and it was difficult to recruit practices into the project. The lack of experienced individuals to do the work and practitioner suspicion about perceived 'management' agendas were significant problems. After initial hesitancies most practices appreciated the value of developing wider ownership and commitment to proposed practice changes. Organisations found it difficult to support individual completion of the personal portfolio component of the plans. The ability to develop systems for clinical services was dependent on having already established a culture of effective teamwork in the organisation. Conclusions This work supports the view that organisational

  14. Association of worker characteristics and early reimbursement for physical therapy, chiropractic and opioid prescriptions with workers’ compensation claim duration, for cases of acute low back pain: an observational cohort study

    Science.gov (United States)

    Busse, Jason W; Ebrahim, Shanil; Heels-Ansdell, Diane; Wang, Li; Couban, Rachel; Walter, Stephen D

    2015-01-01

    Objective To assess the association between early reimbursement for physiotherapy, chiropractic and opioid prescriptions for acute low back pain (LBP) with disability claim duration. Design Observational cohort study. Setting and participants From a random sample of 6665 claims for acute, uncomplicated LBP approved by the Ontario Workplace Safety and Insurance Board (WSIB) in 2005, we analysed 1442 who remained on full benefits at 4 weeks after claim approval. Primary outcome measure Our primary outcome was WSIB claim duration. Results We had complete data for all but 3 variables, which had $920 vs ≤$480/week=0.34; 99% CI 0.17 to 0.68). Missing data for union membership (HR=1.27; 99% CI 1.01 to 1.59), and working for an employer with a return-to-work programme were associated with fewer days on claim (HR=1.78; 99% CI 1.45 to 2.18). Neither reimbursement for physiotherapy (HR=1.01; 99% CI 0.86 to 1.19) nor chiropractic care (HR for active claims at 60 days=1.15; 99% CI 0.94 to 1.41) within the first 4 weeks was associated with claim duration. Our meta-analysis of 3 studies (n=51 069 workers) confirmed a strong association between early opioid use and prolonged claim duration (HR=0.57, 95% CI 0.48 to 0.69; low certainty evidence). Conclusions Our analysis found that early WSIB reimbursement for physiotherapy or chiropractic care, in claimants fully off work for more than 4 weeks, was not associated with claim duration, and that early reimbursement for opioids predicted prolonged claim duration. Well-designed randomised controlled trials are needed to verify our findings and establish causality between these variables and claim duration. PMID:26310398

  15. Using Evidence Based Practice in LIS Education: Results of a Test of a Communities of Practice Model

    Directory of Open Access Journals (Sweden)

    Joyce Yukawa

    2010-03-01

    Full Text Available Objective ‐ This study investigated the use of a communities of practice (CoP model for blended learning in library and information science (LIS graduate courses. The purposes were to: (1 test the model’s efficacy in supporting student growth related to core LIS concepts, practices, professional identity, and leadership skills, and (2 develop methods for formative and summative assessment using the model.Methods ‐ Using design‐based research principles to guide the formative and summative assessments, pre‐, mid‐, and post‐course questionnaires were constructed to test the model and administered to students in three LIS courses taught by the author. Participation was voluntary and anonymous. A total of 34 students completed the three courses; response rate for the questionnaires ranged from 47% to 95%. The pre‐course questionnaire addressed attitudes toward technology and the use of technology for learning. The mid‐course questionnaire addressed strengths and weaknesses of the course and suggestions for improvement. The post‐course questionnaire addressed what students valued about their learning and any changes in attitude toward technology for learning. Data were analyzed on three levels. Micro‐level analysis addressed technological factors related to usability and participant skills and attitudes. Meso‐level analysis addressed social and pedagogical factors influencing community learning. Macro‐level analysis addressed CoP learning outcomes, namely, knowledge of core concepts and practices, and the development of professional identity and leadership skills.Results ‐ The students can be characterized as adult learners who were neither early nor late adopters of technology. At the micro‐level, responses indicate that the online tools met high standards of usability and effectively supported online communication and learning. Moreover, the increase in positive attitudes toward the use of technology for learning at

  16. Wildlife and habitat inventory for a results-based Forest Practices Code

    OpenAIRE

    Pendergast, B.

    2002-01-01

    Two significant changes are occurring within the forest industry in British Columbia, both of which will necessitate a greater reliance on species and habitat monitoring and inventories. First, as British Columbia moves towards adopting the "New Era" principles of the provincial government, the Forest Practices Code will change from regulatory-based to "results-based". This means that forest companies will have to be monitored to ensure they meet the desired results outlined by the provincial...

  17. Chiropractic Treatment vs Self-Management in Patients With Acute Chest Pain: A Randomized Controlled Trial of Patients Without Acute Coronary Syndrome

    DEFF Research Database (Denmark)

    Stochkendahl, Mette J; Christensen, Henrik W; Vach, Werner; Høilund-Carlsen, Poul F; Haghfelt, Torben; Hartvigsen, Jan

    2012-01-01

    ) self-management as an example of minimal intervention. METHODS: In a nonblinded, randomized, controlled trial set at an emergency cardiology department and 4 outpatient chiropractic clinics, 115 consecutive patients with acute chest pain and no clear medical diagnosis at initial presentation were...... included. After a baseline evaluation, patients with musculoskeletal chest pain were randomized to 4 weeks of chiropractic treatment or self-management, with posttreatment questionnaire follow-up 4 and 12 weeks later. Primary outcome measures were numeric change in pain intensity (11-point box numerical...... chiropractic treatment at 4 weeks regarding the primary outcome of self-perceived change in chest pain and at 12 weeks with respect to the primary outcome of numeric change in pain intensity. CONCLUSIONS: To the best of our knowledge, this is the first randomized trial assessing chiropractic treatment vs...

  18. The Impact of Knowledge Management Practices on NPP Organizational Performance - Results of a Global Survey

    International Nuclear Information System (INIS)

    The IAEA has been asked by Member States in the 2012 General Conference Resolutions to ''further increase the level of awareness of efforts in managing nuclear knowledge'' and to continue ''to further develop and disseminate guidance and methodologies for planning, designing, and implementing nuclear knowledge management programs''. The present report summarizes the results of empirical research on the relationship between KM practices in nuclear power plants, their impact on the quality of organizational knowledge processes and the resulting effects on the organizational effectiveness of nuclear power plants. It presents the basic findings of the ''IAEA Global Nuclear Power Plant Survey: Investigating the Link Between Knowledge Management Practices and Organizational Performance'', which was conducted in 2010. This benchmark survey of KM practices in nuclear power plants was developed using a standard research methodology. The survey was made available on a global basis to all nuclear power plant sites. Senior operations managers were asked to complete the survey with input, as required, from their plant management team. Data from individual survey responses were treated as confidential, and only aggregate findings were reported. A total of 124 station ''site organizations'' participated in the survey, representing a response rate of approximately 60%. The findings provide empirical evidence of the importance of KM practices in improving the organizational effectiveness of nuclear power plants. They provide information about the current state of the industry with respect to KM practices, illustrating the direct and tangible benefits of implementing such practices and justifying continued or further efforts to ensure that KM programmes and systems are strategically planned and implemented in operating nuclear power plants. The research provides insights into the mechanisms by which KM practices have an impact on organizational effectiveness and provides a basis for

  19. Good practices and health policy analysis in European sports stadia: results from the 'Healthy Stadia' project.

    Science.gov (United States)

    Drygas, Wojciech; Ruszkowska, Joanna; Philpott, Matthew; Björkström, Olav; Parker, Mike; Ireland, Robin; Roncarolo, Federico; Tenconi, Maria

    2013-06-01

    Sport plays an important role within society and sports stadia provide significant settings for public health strategies. In addition to being places of mass gathering, stadia are often located in less affluent areas and are traditionally attended by 'harder to reach' communities. Unfortunately sports stadia and the clubs they host are rarely perceived as places that promote healthy lifestyles. Fast food, alcohol and tobacco are commonly advertized, served and consumed during sports games giving the spectators and TV fans contradictory messages concerning healthy choices. As part of a wider programme of work part-funded by the European Union, a study was therefore designed to explore current 'good practice' relating to positive health interventions in sports stadia across a number of European countries. Using a specially designed questionnaire, information about health policies and good practices relating to food offerings in stadia, physical activity promotion among local communities, tobacco policy, positive mental health initiatives, environmental sustainability practices and social responsibility policies were collected in 10 European countries (England and Northern Ireland, Finland, Georgia, Greece, Ireland, Italy, Latvia, Poland, Spain and Sweden) involving 88 stadia. The audit results show that stadia health policies differ considerably between specific countries and sports. Based on the literature analysed, the examples of good practices collected through the study, and the subsequent instigation of a European Healthy Stadia Network, it shows that there is considerable potential for stadia to become health promoting settings. PMID:22139638

  20. Ethanol Marketing and Input Procurement Practices of U.S. Ethanol Producers: 2008 Survey Results

    OpenAIRE

    Schmidgall, Timothy J.; Tudor, Kerry W.; Spaulding, Aslihan D.; Winter, J. Randy

    2010-01-01

    A mail survey was used to collect information about input procurement and ethanol and co-product marketing practices from 60 U.S. ethanol production facilities. Data were used to answer questions about the conduct or behavior of ethanol producers. It was anticipated that firm conduct or behavior would be fairly homogeneous because the ethanol industry was in Stage II of the industry life-cycle, and societal support for ethanol production resulted in large volumes of publicly available informa...

  1. Chiropractic management of patients post-disc arthroplasty: eight case reports

    Directory of Open Access Journals (Sweden)

    Descarreaux Martin

    2010-04-01

    Full Text Available Abstract Background When conservative therapies for low back pain (LBP are not effective, elective surgery may be proposed to these patients. Over the last 20 years, a new technology, disc replacement, has become increasingly popular because it is believed to maintain or restore the integrity of spinal movement and minimize the side-effects compared to fusion. Although disc replacement may relieve a patient from pain and related disability, soreness and stiffness of the lumbopelvic region seem to be common aftermaths of the surgery. This prospective case series was undertaken to identify and describe potential adverse events of lumbar spinal manipulation, a common therapy for low back pain, in a group of patients with symptoms after disc prostheses. Cases presentation Eight patients who underwent lumbar spine total disc replacement were referred by an orthopaedic surgeon for chiropractic treatments. These patients had 1 or 2 total lumbar disc replacements and were considered stable according to the surgical protocol but presented persistent, post-surgical, non-specific LBP or pelvic pain. They were treated with lumbar spine side posture manipulations only and received 8 to 10 chiropractic treatments based on the clinical evolution and the chiropractor's judgment. Outcome measures included benign, self-limiting, and serious adverse events after low back spinal manipulative therapy. The Oswestry Disability Index, a pain scale and the fear avoidance belief questionnaire were administered to respectively assess disability, pain and fear avoidance belief about work and physical activity. This prospective case series comprised 8 patients who all had at least 1 total disc replacement at the L4/L5 or L5/S1 level and described persistent post-surgical LBP interfering with their daily activities. Commonly-reported side-effects of a benign nature included increased pain and/or stiffness of short duration in nearly half of the chiropractic treatment period

  2. Using Evidence Based Practice in LIS Education: Results of a Test of a Communities of Practice Model

    OpenAIRE

    Joyce Yukawa

    2010-01-01

    Objective ‐ This study investigated the use of a communities of practice (CoP) model for blended learning in library and information science (LIS) graduate courses. The purposes were to: (1) test the model’s efficacy in supporting student growth related to core LIS concepts, practices, professional identity, and leadership skills, and (2) develop methods for formative and summative assessment using the model.Methods ‐ Using design‐based research principles to guide the formative and summative...

  3. How similar are the changes in neural activity resulting from mindfulness practice in contrast to spiritual practice?

    Science.gov (United States)

    Barnby, Joseph M; Bailey, Neil W; Chambers, Richard; Fitzgerald, Paul B

    2015-11-01

    Meditation and spiritual practices are conceptually similar, eliciting similar subjective experiences, and both appear to provide similar benefits to the practicing individuals. However, no research has examined whether the mechanism of action leading to the beneficial effects is similar in both practices. This review examines the neuroimaging research that has focused on groups of meditating individuals, groups who engage in religious/spiritual practices, and research that has examined groups who perform both practices together, in an attempt to assess whether this may be the case. Differences in the balance of activity between the parietal and prefrontal cortical activation were found between the three groups. A relative prefrontal increase was reflective of mindfulness, which related to decreased anxiety and improved well-being. A relative decrease in activation of the parietal cortex, specifically the inferior parietal cortex, appears to be reflective of spiritual belief, whether within the context of meditation or not. Because mindful and spiritual practices differ in focus regarding the 'self' or 'other' (higher being), these observations about neurological components that reflect spirituality may continue work towards understanding how the definition of 'self' and 'other' is represented in the brain, and how this may be reflected in behaviour. Future research can begin to use cohorts of participants in mindfulness studies which are controlled for using the variable of spirituality to explicitly examine how functional and structural similarities and differences may arise. PMID:26172520

  4. Research Priorities in Correctional Nursing Practice: Results of a Three-Round Delphi Study.

    Science.gov (United States)

    Schoenly, Lorry

    2015-10-01

    Correctional nursing has been recognized as a specialty since 1985, but research to describe and support nursing practice in the criminal justice system has been sparse. The development of a research agenda can stimulate the research necessary to provide an evidence base for specialty practice development. A three-round Delphi study was undertaken to elicit a prioritized list of research topics to guide future research efforts for meaningful results. Six predominant themes emerged from an analysis of top research questions generated by a panel of 18 correctional nursing experts. Research priorities include critical thinking and clinical judgment, competency and educational level, assessment, nursing protocols, effect on patient outcomes, and the environment of care. PMID:26285595

  5. The development of vaccination perspectives among chiropractic, naturopathic and medical students: a case study of professional enculturation.

    Science.gov (United States)

    McMurtry, Angus; Wilson, Kumanan; Clarkin, Chantalle; Walji, Rishma; Kilian, Brendan C; Kilian, Carney C; Lohfeld, Lynne; Alolabi, Bashar; Hagino, Carol; Busse, Jason W

    2015-12-01

    An important influence on parents' decisions about pediatric vaccination (children under 6 years of age) is the attitude of their health care providers, including complementary and alternative medicine (CAM) providers. Very limited qualitative research exists, however, on how attitudes towards vaccination develop among healthcare professionals in-training. We explored perspective development among three groups of students: medical, chiropractic, and naturopathic. We conducted focus group sessions with participants from each year of study at three different healthcare training programs in Ontario, Canada. Semi-structured and open-ended questions were used to elicit dynamic interaction among participants and explore how they constructed their attitudes toward vaccination at the beginning and part way through their professional training. Analyses of verbatim transcripts of audiotaped interviews were conducted both inductively and deductively using questions structured by existing literature on learning, professional socialization and interprofessional relations. We found five major themes and each theme was illustrated with representative quotes. Numerous unexpected insights emerged within these themes, including students' general open-mindedness towards pediatric vaccination at the beginning of their training; the powerful influence of both formal education and informal socialization; uncritical acceptance of the vaccination views of senior or respected professionals; students' preference for multiple perspectives rather than one-sided, didactic instruction; the absence of explicit socio-cultural tensions among professions; and how divergences among professional students' perspectives result from differing emphases with respect to lifestyle, individual choice, public health and epidemiological factors-rather than disagreement concerning the biomedical evidence. This last finding implies that their different perspectives on pediatric vaccination may be complementary

  6. Barriers to Implementing a Reporting and Learning Patient Safety System: Pediatric Chiropractic Perspective.

    Science.gov (United States)

    Pohlman, Katherine A; Carroll, Linda; Hartling, Lisa; Tsuyuki, Ross T; Vohra, Sunita

    2016-04-01

    A reporting and learning system is a method of monitoring the occurrence of incidents that affect patient safety. This cross-sectional survey asked pediatric chiropractors about factors that may limit their participation in such a system. The list of potential barriers for participation was developed using a systematic approach. All members of the 2 pediatric councils associated with US national chiropractic organizations were invited to complete the survey (N = 400). The cross-sectional survey was created using an online survey tool (REDCap) and sent directly to member emails addressed by the respective executive committees. Of the 400 potential respondents, 81 responded (20.3%). The most common limitations to participating were identified as time pressure (96%) and patient concerns (81%). Reporting and learning systems have been utilized to increase safety awareness in many high-risk industries. To be successful, future patient safety studies with pediatric chiropractors need to ensure these barriers are understood and addressed. PMID:26438719

  7. The chiropractic profession in Denmark 2010-2014

    DEFF Research Database (Denmark)

    Nielsen, Orla Lund; Kongsted, Alice; Christensen, Henrik Wulff

    2015-01-01

    . RESULTS: Response rates varied between 59 and 78 % for the clinic questionnaires and 75 to 86 % for the individual questionnaires. Almost half the Danish chiropractors were educated in Denmark and a small majority was female. The average Danish chiropractor of 2014 was 44 years old, graduated 17 years...

  8. Practices of Disciplinarity and Interdisciplinarity in Quebec Elementary Schools: Results of Twenty Years of Research

    Directory of Open Access Journals (Sweden)

    Yves Lenoir

    2006-12-01

    Full Text Available This article presents a synthesis of different research projects that have been carried out inthe province of Quebec, Canada over the past 20 years concerning the representations and practices ofelementary teachers regarding the relative importance given to subject matter and the use ofinterdisciplinarity in their teaching practice. The first section will explain the context of the Quebecschool system on a socio-historical and political level and review the emergence of the concept ofinterdisciplinarity in Quebec. The second section will present succinctly the different research projectsthat have been conducted since 1980 and the conceptual framework they were based on. The thirdsection will consider the main results of the various research projects from two angles: first, therepresentations and practices of the teachers regarding interdisciplinarity; secondly, the relativeimportance and role that the teachers give to interdisciplinarity. In the conclusion, we will highlightamong other things the central position teachers give to the role of socialization and their minimalconsideration for the teaching of disciplinary knowledge.

  9. [Selective screening for hypercholesterolemia. Results from a screening model in general practice].

    Science.gov (United States)

    Agner, E; Christensen, T E; Mahnfeldt, M S; Baastrup, A; Jacobsen, K; Jensen, S E

    1990-11-01

    At present, it appears to be probable that both dietary changes and medicinal treatment can reduce the risk of development of coronary disease in middle-aged men with moderately to severely raised blood cholesterol values. Internationally, the limits for cholesterol intervention are considerably lower than in Denmark. Extensive cholesterol screening is, however, very expensive and the identified persons with high cholesterol values will frequently be found in sex and age groups where the beneficial effect of intervention is probably limited. A model for selective cholesterol screening in high risk groups in general practice is described here. In 20 general practices, all of the men aged 45-59 years belonging to the practice were invited to examination of cholesterol and blood pressure. Plasma cholesterol was measured by means of a Reflotron (results are available within three minutes) and the blood pressure and tobacco consumption were registered. After this, the patient's own general practitioner calculated with each of the persons the risk for development of myocardial infarction within the next ten years and intervention could be commenced immediately. 41% of those invited came for examination. Out of these, 29% had cholesterol values greater than or equal to 7.0 mmol/l (Danish limiting value), 44% greater than or equal to 6.5 mmol/l (limiting value in the remainder of Western Europe), and 5% greater than or equal to 9.0 mmol/l (severe hypercholesterolaemia) while only 18% had completely normal cholesterol less than 5.2 mmol/l. In every practice, two patients on an average were found with severe hypercholesterolaemia greater than or equal to 9.0 mmol/l. 28% of the participants had at least two of the three risk factors investigated. (ABSTRACT TRUNCATED AT 250 WORDS) PMID:2238223

  10. Substance use and dietary practices among students attending alternative high schools: results from a pilot study

    Directory of Open Access Journals (Sweden)

    Hannan Peter J

    2011-04-01

    Full Text Available Abstract Background Substance use and poor dietary practices are prevalent among adolescents. The purpose of this study was to examine frequency of substance use and associations between cigarette, alcohol and marijuana use and selected dietary practices, such as sugar-sweetened beverages, high-fat foods, fruits and vegetables, and frequency of fast food restaurant use among alternative high school students. Associations between multi-substance use and the same dietary practices were also examined. Methods A convenience sample of adolescents (n = 145; 61% minority, 52% male attending six alternative high schools in the St Paul/Minneapolis metropolitan area completed baseline surveys. Students were participants in the Team COOL (Controlling Overweight and Obesity for Life pilot study, a group randomized obesity prevention pilot trial. Mixed model multivariate analyses procedures were used to assess associations of interest. Results Daily cigarette smoking was reported by 36% of students. Cigarette smoking was positively associated with consumption of regular soda (p = 0.019, high-fat foods (p = 0.037, and fast food restaurant use (p = 0.002. Alcohol (p = 0.005 and marijuana use (p = 0.035 were positively associated with high-fat food intake. With increasing numbers of substances, a positive trend was observed in high-fat food intake (p = 0.0003. There were no significant associations between substance use and fruit and vegetable intake. Conclusions Alternative high school students who use individual substances as well as multiple substances may be at high risk of unhealthful dietary practices. Comprehensive health interventions in alternative high schools have the potential of reducing health-compromising behaviors that are prevalent among this group of students. This study adds to the limited research examining substance use and diet among at-risk youth. Trial registration number ClinicalTrials.gov: NCT01315743

  11. A method for obtaining practical flutter-suppression control laws using results of optimal control theory

    Science.gov (United States)

    Newson, J. R.

    1979-01-01

    The results of optimal control theory are used to synthesize a feedback filter. The feedback filter is used to force the output of the filtered frequency response to match that of a desired optimal frequency response over a finite frequency range. This matching is accomplished by employing a nonlinear programing algorithm to search for the coefficients of the feedback filter that minimize the error between the optimal frequency response and the filtered frequency response. The method is applied to the synthesis of an active flutter-suppression control law for an aeroelastic wind-tunnel model. It is shown that the resulting control law suppresses flutter over a wide range of subsonic Mach numbers. This is a promising method for synthesizing practical control laws using the results of optimal control theory.

  12. Comprehensive Geriatric Assessment (CGA in general practice: Results from a pilot study in Vorarlberg, Austria

    Directory of Open Access Journals (Sweden)

    Mann Eva

    2004-05-01

    Full Text Available Abstract Background Most comprehensive geriatric assessment (CGA programs refer to hospital-based settings. However the body of geriatric healthcare is provided by general practitioners in their office. Structured geriatric problem detection by means of assessment instruments is crucial for efficient geriatric care giving in the community. Methods We developed and pilot tested a German language geriatric assessment instrument adapted for general practice. Nine general practices in a rural region of Austria participated in this cross-sectional study and consecutively enrolled 115 persons aged over 75 years. The prevalence of specific geriatric problems was assessed, as well as the frequency of initiated procedures following positive and negative tests. Whether findings were new to the physician was studied exemplarily for the items visual and hearing impairment and depression. The acceptability was recorded by means of self-administered questionnaires. Results On average, each patient reported 6.4 of 14 possible geriatric problems and further consequences resulted in 43.7% (27.5% to 59.8% of each problem. The items with either the highest prevalence and/or the highest number of initiated actions by the GPs were osteoporosis risk, urinary incontinence, decreased hearing acuity, missing pneumococcal vaccination and fall risk. Visual impairment was newly detected in only 18% whereas hearing impairment and depression was new to the physician in 74.1% and 76.5%, respectively. A substantial number of interventions were initiated not only following positive tests (43.7% per item; 95% CI 27.5% to 59.8%, but also as a consequence of negative test results (11.3% per item; 95% CI 1.7% to 20.9%. The mean time expenditure to accomplish the assessment was 31 minutes (SD 10 min. Patients (89% and all physicians confirmed the CGA to provide new information in general on the patient's health status. All physicians judged the CGA to be feasible in everyday

  13. Intermediate results of the observational program on the Eligard (45 mg administration in the clinical practice

    Directory of Open Access Journals (Sweden)

    V. B. Matveev

    2016-01-01

    Full Text Available This article deals with the intermediate results of the multicentral observational program on the 6-month prodrug leuprorelin acetate (Eligard 45 mg administration. The study objective is to confirm the efficiency and safety of the Eligard 45 mg administration in patients with the prostate cancer in the clinical practice of the oncourology specialists in Russia. In 12 months of the hormone therapy with the Eligard 45 mg there was the clinically relevant decrease of the prostatic specific antigen (PSA levels secondary to the appropriate suppression of the testosterone level lower than the castration one < 20 ng / dl. The PSA level decreased, at an average, on 82 % (from 41.4 to 7.65 ng / ml. In 89 % of patients, treated with Eligard 45 mg, the testosterone level was < 20 ng / dl. The patients», treated with Eligard 45 mg, quality of life analysis showed the improvement of this criteria in the course of the treatment. Thus, intermediate results of the multicentral observational program, proved the favorable tolerability and efficiency of the 6-month prodrug Eligard 45 mg towards the PSA and testosterone serum levels suppression in the routine clinical practice in prostate cancer patients.

  14. Chiropractic and self-care for back-related leg pain: design of a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Schulz Craig A

    2011-03-01

    Full Text Available Abstract Background Back-related leg pain (BRLP is a common variation of low back pain (LBP, with lifetime prevalence estimates as high as 40%. Often disabling, BRLP accounts for greater work loss, recurrences, and higher costs than uncomplicated LBP and more often leads to surgery with a lifetime incidence of 10% for those with severe BRLP, compared to 1-2% for those with LBP. In the US, half of those with back-related conditions seek CAM treatments, the most common of which is chiropractic care. While there is preliminary evidence suggesting chiropractic spinal manipulative therapy is beneficial for patients with BRLP, there is insufficient evidence currently available to assess the effectiveness of this care. Methods/Design This study is a two-site, prospective, parallel group, observer-blinded randomized clinical trial (RCT. A total of 192 study patients will be recruited from the Twin Cities, MN (n = 122 and Quad Cities area in Iowa and Illinois (n = 70 to the research clinics at WHCCS and PCCR, respectively. It compares two interventions: chiropractic spinal manipulative therapy (SMT plus home exercise program (HEP to HEP alone (minimal intervention comparison for patients with subacute or chronic back-related leg pain. Discussion Back-related leg pain (BRLP is a costly and often disabling variation of the ubiquitous back pain conditions. As health care costs continue to climb, the search for effective treatments with few side-effects is critical. While SMT is the most commonly sought CAM treatment for LBP sufferers, there is only a small, albeit promising, body of research to support its use for patients with BRLP. This study seeks to fill a critical gap in the LBP literature by performing the first full scale RCT assessing chiropractic SMT for patients with sub-acute or chronic BRLP using important patient-oriented and objective biomechanical outcome measures. Trial Registration ClinicalTrials.gov NCT00494065

  15. Epidural analgesia practices for labour: results of a 2005 national survey in Ireland.

    LENUS (Irish Health Repository)

    Fanning, Rebecca A

    2012-02-01

    BACKGROUND AND OBJECTIVE: The last 25 years have seen changes in the management of epidural analgesia for labour, including the advent of low-dose epidural analgesia, the development of new local anaesthetic agents, various regimes for maintaining epidural analgesia and the practice of combined spinal-epidural analgesia. We conducted a survey of Irish obstetric anaesthetists to obtain information regarding the conduct and management of obstetric epidural analgesia in Ireland in 2005. The specific objective of this survey was to discover whether new developments in obstetric anaesthesia have been incorporated into clinical practice. METHODS: A postal survey was sent to all anaesthetists with a clinical commitment for obstetric anaesthesia in the sites approved for training by the College of Anaesthetists, Ireland. RESULTS: Fifty-three per cent of anaesthetists surveyed responded. The majority of anaesthetists (98%) use low-dose epidural analgesia for the maintenance of analgesia. Only 11% use it for test-dosing and 32% for the induction of analgesia. The combined spinal-epidural analgesia method is used by 49%, but two-thirds of those who use it perform fewer than five per month. Patient-controlled epidural analgesia was in use at only one site. CONCLUSION: It appears that Irish obstetric anaesthetists have adopted the low-dose epidural analgesia trend for the maintenance of labour analgesia. This practice is not as widespread, however, for test dosing, the induction of analgesia dose or in the administration of intermittent epidural boluses to maintain analgesia when higher concentrations are used. Since its introduction in 2000, levobupivacaine has become the most popular local anaesthetic agent.

  16. What is the Effect of Operational Managerial Practices on Dairy Farm Efficiency? Some Results from Sweden

    OpenAIRE

    Johansson, Helena; Ohlmer, Bo

    2007-01-01

    The article aims to investigate how operational managerial practices can contribute to improved farm level efficiency at dairy farms. Operational managerial practices are defined as animal health, breeding, and feeding practices. The main contribution of the article is that it investigates aspects that can be adjusted every day to improve farm efficiency. Aspects describing each of the considered managerial practices are regressed on farm level data envelopment efficiency scores based on farm...

  17. Implant removal of osteosynthesis: the Dutch practice. Results of a survey

    Directory of Open Access Journals (Sweden)

    Vos Dagmar

    2012-08-01

    Full Text Available Abstract Background The aim of this survey study was to evaluate the current opinion and practice of trauma and orthopaedic surgeons in the Netherlands in the removal of implants after fracture healing. Methods A web-based questionnaire consisting of 44 items was sent to all active members of the Dutch Trauma Society and Dutch Orthopaedic Trauma Society to determine their habits and opinions about implant removal. Results Though implant removal is not routinely done in the Netherlands, 89% of the Dutch surgeons agreed that implant removal is a good option in case of pain or functional deficits. Also infection of the implant or bone is one of the main reasons for removing the implant (> 90%, while making money was a motivation for only 1% of the respondents. In case of younger patients (p = 0.002. Though the far majority removes elastic nails in children (95%. Most of the participants (56% did not agree that leaving implants in is associated with an increased risk of fractures, infections, allergy or malignancy. Yet in case of the risk of fractures, residents all agreed to this statement (100% whereas staff specialists disagreed for 71% (p  Conclusion This survey indicates that there is no general opinion about implant removal after fracture healing with a lack of policy guidelines in the Netherlands. In case of symptomatic patients a majority of the surgeons removes the implant, but this is not standard practice for every surgeon.

  18. Homeopathic medical practice: Long-term results of a cohort study with 3981 patients

    Directory of Open Access Journals (Sweden)

    Baur Roland

    2005-11-01

    Full Text Available Abstract Background On the range of diagnoses, course of treatment, and long-term outcome in patients who chose to receive homeopathic medical treatment very little is known. We investigated homeopathic practice in an industrialized country under everyday conditions. Methods In a prospective, multicentre cohort study with 103 primary care practices with additional specialisation in homeopathy in Germany and Switzerland, data from all patients (age >1 year consulting the physician for the first time were observed. The main outcome measures were: Patient and physician assessments (numeric rating scales from 0 to 10 and quality of life at baseline, and after 3, 12, and 24 months. Results A total of 3,981 patients were studied including 2,851 adults (29% men, mean age 42.5 ± 13.1 years; 71% women, 39.9 ± 12.4 years and 1,130 children (52% boys, 6.5 ± 3.9 years; 48% girls, 7.0 ± 4.3 years. Ninety-seven percent of all diagnoses were chronic with an average duration of 8.8 ± 8 years. The most frequent diagnoses were allergic rhinitis in men, headache in women, and atopic dermatitis in children. Disease severity decreased significantly (p Conclusion Disease severity and quality of life demonstrated marked and sustained improvements following homeopathic treatment period. Our findings indicate that homeopathic medical therapy may play a beneficial role in the long-term care of patients with chronic diseases.

  19. 臭氧联合整脊手法治疗腰椎退行性骨关节病的临床分析%Clinical analysis of ozone combined with chiropractic manipulation in treating degenerative osteoarthritis of lumbar spine

    Institute of Scientific and Technical Information of China (English)

    宋永达; 黄俊卿; 王宏坤

    2013-01-01

    Objective:To investigate the clinical efficacy of ozone combined with chiropractic manipulation in treating degenerative osteoarthritis of lumbar spine. Methods:120 cases of lumbar degenerative joint disease were randomly divided into the treated group and the control group, 60 cases in each group. The treated group was treated with injection of ozone combined with chiropractic manipulation, control group treated by chiropractic therapy. Before and after treatment by visual analogue score (VAS), refers to the distance (FFD) and modified Japanese department of orthopedics association low back pain score (JOA) assessment. Results: After 4 weeks of treatment, compared with before treatment, after treatment, 2 groups of visual analogue score (VAS), FFD index decreased significantly (P<0.05), JOA scale score was significantly increased (P<0.05); compared with the control group, the treated group visual analogue score (VAS), FFD index decreased significantly (P<0.05), JOA questionnaire score was significantly increased (P<0.05); after treatment, the clinical total efficiency was higher than that of the control group (P<0.05). Conclusion: The injection of ozone combined with chiropractic manipulation in the treatment of lumbar degenerative joint disease has remarkable clinical curative effect. The chiropractic manipulation is simple. It is worthy of clinical application.%  目的:探讨臭氧联合整脊手法治疗腰椎退行性骨关节病的临床疗效。方法:将120例腰椎退行性骨关节病患者随机分为治疗组和对照组各60例,治疗组采用臭氧注射联合整脊手法,对照组采用单纯整脊手法治疗。治疗前后采用疼痛视觉类比评分法(VAS)、指地距离(FFD)及改良日本骨科学会下腰痛评分(JOA)进行评定。结果:治疗4周后与治疗前相比较,治疗后两组疼痛视觉类比评分法(VAS)、FFD指标显著降低(P<0.05),JOA问卷记分显著升高(P<0.05);与对

  20. Parent education after separation: results from a multi-site study on best practices.

    Science.gov (United States)

    McKenzie, Brad; Bacon, Brenda

    2002-01-01

    Although parent education after separation in Canada is relatively new, most provinces and territories now have some type of program that provides separating parents with information on their children's needs, co-parenting options, and strategies for improving communication. A 1999-2000 survey of parents in 10 such program sites throughout Canada: (a) demonstrates a high level of parent satisfaction with the programs, (b) chronicles benefits related to reduced conflict and improved child well-being 3 to 4 months following program attendance, and (c) identifies several implications for best practices. Results of this study suggest that parent education is but one program within a network of services needed to support both parents and children after separation. PMID:14664107

  1. Practical Calculational Scheme Implementing the Wilsonian RG Results for Nuclear Effective Field Theory Including Pions

    International Nuclear Information System (INIS)

    On the basis of the Wilsonian renormalization group (WRG) analysis of nuclear effective field theory (NEFT) including pions, we propose a practical calculational scheme in which the short-distance part of one-pion exchange (S-OPE) is removed and represented as contact terms. The long-distance part of one-pion exchange (L-OPE) is treated as perturbation. The use of dimensional regularization (DR) for diagrams consisting only of contact interactions considerably simplifies the calculation of scattering amplitude and the renormalization group equations. NLO results for nucleon-nucleon elastic scattering in the S-waves are obtained and compared with experiments. A brief comment on NNLO calculations is given. (author)

  2. SUSTAINABLE SUCCESS IN HIGHER EDUCATION BY SHARING THE BEST PRACTICES AS A RESULT OF BENCHMARKING PROCESS

    Directory of Open Access Journals (Sweden)

    Anca Gabriela Ilie

    2011-11-01

    Full Text Available The paper proposes to review the main benchmarking criteria, based on the quality indicators used by the higher education institutions and to present new indicators of reference as a result of the inter-universities cooperation. Once these indicators are defined, a national database could be created and through benchmarking methods, there could be established the level of national performance of the educational system. Going forward and generalizing the process, we can compare the national educational system with the European one, using the benchmarking approach. The final purpose is that of establishing a group of universities who come together to explore opportunities for benchmarks and best practices sharing on common interest areas in order to create a „quality culture” for the Romanian higher education system

  3. The BirthPlace collaborative practice model: results from the San Diego Birth Center Study.

    Science.gov (United States)

    Swartz; Jackson; Lang; Ecker; Ganiats; Dickinson; Nguyen

    1998-07-01

    birth center and $5,535 for the traditional care group. Final results based on the full study sample (full data available February 1998) details of payor costs such as provider, facility, NICU, and ancillary along with costs from the health care system perspective and patient satisfaction results will be presented.Conclusion: Current results suggest similar morbidity and mortality between the birth center program and traditional care groups, with less resource utilization translating to lower costs in the collaborative practice model. Results suggest that collaborative practice using a freestanding birth center as an adjunct to an integrated perinatal health care system may provide a quality, lower-cost alternative for the provision of perinatal services. PMID:10838392

  4. Clinical practice of image-guided spine radiosurgery - results from an international research consortium

    Directory of Open Access Journals (Sweden)

    Guckenberger Matthias

    2011-12-01

    Full Text Available Abstract Background Spinal radiosurgery is a quickly evolving technique in the radiotherapy and neurosurgical communities. However, the methods of spine radiosurgery have not been standardized. This article describes the results of a survey about the methods of spine radiosurgery at five international institutions. Methods All institutions are members of the Elekta Spine Radiosurgery Research Consortium and have a dedicated research and clinical focus on image-guided radiosurgery. The questionnaire consisted of 75 items covering all major steps of spine radiosurgery. Results Strong agreement in the methods of spine radiosurgery was observed. In particular, similarities were observed with safety and quality assurance playing an important role in the methods of all institutions, cooperation between neurosurgeons and radiation oncologists in case selection, dedicated imaging for target- and organ-at-risk delineation, application of proper safety margins for the target volume and organs-at-risk, conformal planning and precise image-guided treatment delivery, and close clinical and radiological follow-up. In contrast, three major areas of uncertainty and disagreement were identified: 1 Indications and contra-indications for spine radiosurgery; 2 treatment dose and fractionation and 3 tolerance dose of the spinal cord. Conclusions Results of this study reflect the current practice of spine radiosurgery in large academic centers. Despite close agreement was observed in many steps of spine radiosurgery, further research in form of retrospective and especially prospective studies is required to refine the details of spinal radiosurgery in terms of safety and efficacy.

  5. Scoliosis short-term rehabilitation (SSTR according to 'Best Practice' standards - are the results repeatable?

    Directory of Open Access Journals (Sweden)

    Borysov Maksym

    2012-01-01

    Full Text Available Abstract Claims have been made in a pilot study that a new form of short-term rehabilitation according to 'Best Practice' standards would change signs and symptoms of patients with scoliosis in the short-term. Aim of this study is to repeat the study published 2010 with a larger sample of patients using the same protocol. Both authors have undergone training in this special approach to scoliosis rehabilitation in 2010. Materials and methods 34 patients with Adolescent Idiopathic Scoliosis (AIS, 32 girls and 2 boys, average age 13.7 years and an average Cobb angle of 28.7 degrees (21-43 degrees underwent Scoliosis Short-Term Rehabilitation (SSTR of seven days. Two days with an intensity of 3 × 90 min sessions/day, and five days with an intensity of 2 × 60 min sessions/day. Angle of trunk rotation (ATR was measured before and after the time of treatment as well as the active correctability of the ATR after the programme as it has been done in the pilot investigation. Additionally to that, we also recorded the changes in Vital Capacity (VC before and after the programme. Results ATR was reduced significantly from 11,5 degrees to 8,4 degrees, the active correctability as measured with the Scoliometer (TM was also reduced significantly from the ATR after treatment 8,9 degrees to 6,5 degrees in the patients with thoracic curves. VC improved significantly (P Discussion The results achieved in the pilot investigation published previously are repeatable. The deformity of the trunk can be reduced significantly after SSTR. During the pilot study VC was not investigated. In our study VC improved significantly. Therefore, also shorter rehabilitation times with an appropriate programme seem to be able to change signs and symptoms of a patient with scoliosis. Like the out-patient Schroth programme as described in a study from Turkey, the SSTR provides benefits leading to an improvement of the condition. Conclusion Out-patient rehabilitation following the

  6. Practice.

    Science.gov (United States)

    Chambers, David W

    2008-01-01

    Practice refers to a characteristic way professionals use common standards to customize solutions to a range of problems. Practice includes (a) standards for outcomes and processes that are shared with one's colleagues, (b) a rich repertoire of skills grounded in diagnostic acumen, (c) an ability to see the actual and the ideal and work back and forth between them, (d) functional artistry, and (e) learning by doing that transcends scientific rationality. Communities of practice, such as dental offices, are small groups that work together in interlocking roles to achieve these ends. PMID:19413050

  7. Alien plants in Poland: research directions and putting the results into practice

    Directory of Open Access Journals (Sweden)

    Tokarska-Guzik Barbara

    2014-09-01

    Full Text Available The aim of this study was: (i to complete and verify the prior review of research on alien plants conducted in Poland and the practical use of their results, and (ii to attempt to assess the contribution of the research from the area of Poland to the research conducted on an international level. The analysis was performed based on the information gathered during a literature search which covered the last 200 years, using over 1400 publications out of the 3000 which were available in the pool. As a result, the main areas of biological sciences in the context of the research undertaken on alien plants in Poland (distribution, ecology and biology of the species, the most common thematic studies (new species, new localities, and lists of alien species, and the most often investigated species, as well as tendencies over time were indicated. Although studies on the migration and distribution of alien plants in Poland have over 100 years of tradition, and the part of the studies conducted by Polish researchers contributes to the international scale research, it is still necessary to further analyse many issues and answer numerous questions.

  8. Clinical practice of image-guided spine radiosurgery - results from an international research consortium

    International Nuclear Information System (INIS)

    Spinal radiosurgery is a quickly evolving technique in the radiotherapy and neurosurgical communities. However, the methods of spine radiosurgery have not been standardized. This article describes the results of a survey about the methods of spine radiosurgery at five international institutions. All institutions are members of the Elekta Spine Radiosurgery Research Consortium and have a dedicated research and clinical focus on image-guided radiosurgery. The questionnaire consisted of 75 items covering all major steps of spine radiosurgery. Strong agreement in the methods of spine radiosurgery was observed. In particular, similarities were observed with safety and quality assurance playing an important role in the methods of all institutions, cooperation between neurosurgeons and radiation oncologists in case selection, dedicated imaging for target- and organ-at-risk delineation, application of proper safety margins for the target volume and organs-at-risk, conformal planning and precise image-guided treatment delivery, and close clinical and radiological follow-up. In contrast, three major areas of uncertainty and disagreement were identified: 1) Indications and contra-indications for spine radiosurgery; 2) treatment dose and fractionation and 3) tolerance dose of the spinal cord. Results of this study reflect the current practice of spine radiosurgery in large academic centers. Despite close agreement was observed in many steps of spine radiosurgery, further research in form of retrospective and especially prospective studies is required to refine the details of spinal radiosurgery in terms of safety and efficacy

  9. Proceduralization, transfer of training and retention of knowledge as a result of output practice

    Directory of Open Access Journals (Sweden)

    Mehrnoosh Fakharzadeh

    2013-11-01

    Full Text Available This study investigated the effect of output practice on the proceduralization, transfer and retention of knowledge on English modals, adopting Anderson's ACT-R model of skill acquisition. A pretest posttest and delayed posttest design was used where the procedural knowledge on production skill was specifically operationalized through the groups’ performance on Dual Task Timed Completion Test and transfer of training was measures through a Dual Task Timed Grammaticality Judgment Test. Two intact classes of intermediate EFL learners were randomly assigned to treatment and control groups. The output group (n= 27 received explicit grammar instruction, a combination of three output tasks including dictogloss, individual text reconstruction, and corrected-close translation, and feedback. The control group (n=25 were just exposed to the identical texts trough listening and reading tasks followed by some questions irrelevant to the target structure. Results showed that on the posttest, three days after the last treatment session, the output group outperformed the control group in both measures of procedural knowledge and transfer of knowledge. As for retention, forty days later, the output group’s performance was still significantly better than that on the pretest. This group also succeeded in retaining its outperformance on both measures of procedural knowledge and transfer of knowledge delayed posttest. The results may help language teachers design more effective activities for the learners considering the institutional constraints.

  10. Daylighting practices of the architectural industry (baseline results of a national survey)

    Energy Technology Data Exchange (ETDEWEB)

    Hattrup, M.P.

    1990-05-01

    A national survey of over 300 commercial design architects was conducted to develop baseline information on their knowledge, perceptions, and use of daylighting in commercial building designs. Pacific Northwest Laboratory conducted the survey for the US Department of Energy's (DOE) Office of Building and Community Systems (BCS). In the survey daylighting was defined as the intentional use of natural light as a partial substitute for artificially generated light. The results suggested that architects need to be educated about the true benefits of daylighting and the impacts it can have on a building's energy performance. Educational programs that will increase the architects' understanding and awareness of modern daylighting technologies and practices should be developed by utilities, stage agencies, and the federal government. If more architects can be made aware of the true effectiveness and positive attributes of daylighting systems and technologies, daylighting may be used in more commercial buildings. The results of the survey show that the more familiar architects feel they are with daylighting, the more they use daylighting. 3 refs., 19 tabs.

  11. What Is Evidence-Based Practice? Research-to-Results Brief. Publication #2007-14

    Science.gov (United States)

    Metz, Allison J. R.; Espiritu, Rachele; Moore, Kristin A.

    2007-01-01

    This brief represents part 1 in a series on fostering the adoption of evidence-based practices in out-of-school time programs. The lag between discovering effective practices and using them "on the ground" can be unnecessarily long, sometimes taking 15 to 20 years! The purpose of this brief is to provide practitioners with a better understanding…

  12. Core Practices for Teaching History: The Results of a Delphi Panel Survey

    Science.gov (United States)

    Fogo, Bradley

    2014-01-01

    Recent education literature and research has focused on identifying effective core teaching practices to inform and help shape teacher education and professional development. Although a rich literature on the teaching and learning of history has continued to develop over the past decade, core practice research has largely overlooked…

  13. Embedding evidence-based practice among nursing undergraduates: Results from a pilot study.

    Science.gov (United States)

    André, Beate; Aune, Anne G; Brænd, Jorunn A

    2016-05-01

    Evidence-based practice is currently one of the most important developments in health care. Research in nursing science is rapidly growing; however, translating the knowledge based on this research into clinical practice is often hampered, and may be dependent on reflective skills. The aim of this study was to see how undergraduate nursing students in nursing should increase their skills and knowledge related to evidence-based practice through participation in clinical research projects. A qualitative approach was used in collecting and analyzing the data. Students participated in a pilot clinical research project and a received guidance related to their bachelor thesis. After the project was completed, all students filled in a questionnaire. The students' motivation to participate in this study was reported to be high, but they reported low knowledge related to evidence-based practice. All students reported that their attitude towards evidence-based practice changed in a positive direction during their participation in the project. Evidence-based practice influenced nursing practices by putting more focus on critical thinking, increasing pride and giving a sense of ownership in the clinical field. The curricula and the pedagogical perspectives in nursing education can influence the attitude towards evidence-based practice and skills among nursing bachelor students. PMID:27235563

  14. Design and Practice on Metadata Service System of Surveying and Mapping Results Based on Geonetwork

    Science.gov (United States)

    Zha, Z.; Zhou, X.

    2011-08-01

    Based on the analysis and research on the current geographic information sharing and metadata service,we design, develop and deploy a distributed metadata service system based on GeoNetwork covering more than 30 nodes in provincial units of China.. By identifying the advantages of GeoNetwork, we design a distributed metadata service system of national surveying and mapping results. It consists of 31 network nodes, a central node and a portal. Network nodes are the direct system metadata source, and are distributed arround the country. Each network node maintains a metadata service system, responsible for metadata uploading and management. The central node harvests metadata from network nodes using OGC CSW 2.0.2 standard interface. The portal shows all metadata in the central node, provides users with a variety of methods and interface for metadata search or querying. It also provides management capabilities on connecting the central node and the network nodes together. There are defects with GeoNetwork too. Accordingly, we made improvement and optimization on big-amount metadata uploading, synchronization and concurrent access. For metadata uploading and synchronization, by carefully analysis the database and index operation logs, we successfully avoid the performance bottlenecks. And with a batch operation and dynamic memory management solution, data throughput and system performance are significantly improved; For concurrent access, , through a request coding and results cache solution, query performance is greatly improved. To smoothly respond to huge concurrent requests, a web cluster solution is deployed. This paper also gives an experiment analysis and compares the system performance before and after improvement and optimization. Design and practical results have been applied in national metadata service system of surveying and mapping results. It proved that the improved GeoNetwork service architecture can effectively adaptive for distributed deployment

  15. CODES AND PRACTICES OF IMPLEMENTATION OF CORPORATE GOVERNANCE IN ROMANIA AND RESULTS REPORTING

    Directory of Open Access Journals (Sweden)

    GROSU MARIA

    2011-12-01

    Full Text Available Corporate governance refers to the manner in which companies are directed and controlled. Business management was always guided by certain principles, but the current meaning of corporate governance concerns and the contribution that companies must have the overall development of modern society. Romania used quite late in adopting a code of good practice in corporate governance, being driven, in particular, the privatization process, but also the transfer of control and surveillance of political organizations by the Board of Directors (BD. Adoption of codes of corporate governance is necessary to harmonize internal business requirements of a functioning market economy. In addition, the CEE countries, the European Commission adopted an action plan announcing measures to modernize company law and enhance corporate governance. Romania takes steps in this direction by amending the Company Law, and other regulations, although the practice does not necessarily keep pace with the requirements. This study aims on the one hand, an analysis of the evolution of corporate governance codes adopted in Romania, but also an empirical research of the implementation of corporate governance principles of a representative sample of companies listed on the Bucharest Stock Exchange (BSE. Consider relevant research methodology, because the issuer of the Codes of CG in Romania is BSE listed companies requesting their voluntary implementation. Implementation results are summarized and interpreted at the expense of public reports of the companies studied. Most studies undertaken in this direction have been made on multinational companies which respects the rule of corporate governance codes of countries of origin. In addition, many studies also emphasize the fair treatment of stakeholders rather than on models of governance adopted (monist/dualist with implications for optimizing economic objectives but also social. Undertaken research attempts to highlight on the one

  16. Analysis of hemoglobin electrophoresis results and physicians investigative practices in Saudi Arabia

    Science.gov (United States)

    Mehdi, Syed Riaz; Al Dahmash, Badr Abdullah

    2013-01-01

    BACKGROUND AND OBJECTIVES: Riyadh and central province falls in a moderate prevalent zone of hemoglobinopathies in Saudi Arabia. However, it has been observed that the physicians working in Saudi Arabia invariably advise all cases of anemia for hemoglobin electrophoresis (HE). The present work was carried out to study the yield of the HE in Riyadh and the investigative practices of the physicians advising HE. SETTINGS AND DESIGN: The study was carried out in the hospitals of King Saud University from 2009 to 2011 in order to assess the yield of HE in referred cases of clinical anemia. MATERIALS AND METHODS: A total of 1073 cases divided in two groups of males and females had undergone complete blood count and red blood cell morphology. Cellulose acetate HE was performed and all the positive results were reconfirmed on the high performance liquid chromatography (HPLC). The results were analyzed for the type of hemoglobinopathies. For statistical analysis Statistical Package for Social Sciences 15 version (SPSS Inc., Chicago, IL, USA) was used. RESULTS: A total of 405 males and 668 females blood samples were included in the present study. 116 (28.5%) males and 167 (25%) females showed an abnormal pattern on HE. The incidence of beta thalassemia trait was higher in females while sickle cell trait was predominantly seen in males. Red cell indices were reduced considerably in thalassemias, but were unaffected in sickle cell disorders, except those which had concurrent alpha trait. The total yield of HE was 26.6% which was much less than expected. CONCLUSION: The physicians are advised to rule out iron deficiency and other common causes of anemia before investigating the cases for hemoglobinopathies, which employs time consuming and expensive tests of HE and HPLC. PMID:24339548

  17. Analysis of hemoglobin electrophoresis results and physicians investigative practices in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Syed Riaz Mehdi

    2013-01-01

    Full Text Available Background and Objectives: Riyadh and central province falls in a moderate prevalent zone of hemoglobinopathies in Saudi Arabia. However, it has been observed that the physicians working in Saudi Arabia invariably advise all cases of anemia for hemoglobin electrophoresis (HE. The present work was carried out to study the yield of the HE in Riyadh and the investigative practices of the physicians advising HE. Settings and Design: The study was carried out in the hospitals of King Saud University from 2009 to 2011 in order to assess the yield of HE in referred cases of clinical anemia. Materials and Methods: A total of 1073 cases divided in two groups of males and females had undergone complete blood count and red blood cell morphology. Cellulose acetate HE was performed and all the positive results were reconfirmed on the high performance liquid chromatography (HPLC. The results were analyzed for the type of hemoglobinopathies. For statistical analysis Statistical Package for Social Sciences 15 version (SPSS Inc., Chicago, IL, USA was used. Results: A total of 405 males and 668 females blood samples were included in the present study. 116 (28.5% males and 167 (25% females showed an abnormal pattern on HE. The incidence of beta thalassemia trait was higher in females while sickle cell trait was predominantly seen in males. Red cell indices were reduced considerably in thalassemias, but were unaffected in sickle cell disorders, except those which had concurrent alpha trait. The total yield of HE was 26.6% which was much less than expected. Conclusion: The physicians are advised to rule out iron deficiency and other common causes of anemia before investigating the cases for hemoglobinopathies, which employs time consuming and expensive tests of HE and HPLC.

  18. [Formalized dietary advice in hypercholesterolemia. Results in 110 men diagnosed by selective screening in general practice].

    Science.gov (United States)

    Agner, E; Christensen, T E; Jacobsen, K; Baastrup, A; Mahnfeldt, M S; Jensen, S E

    1990-11-01

    In connection with a screening investigation for high blood cholesterol in middle-aged men in general practice in the Municipality of Copenhagen, all participants with cholesterol values greater than or equal to 7.5 mmol/l were given brief advice by their own general practitioner and were invited to come for fasting blood lipid tests approximately ten days later. In cases with continued cholesterol greater than or equal to 6.8 mmol/l, the participants together with wives or partners were invited to formalized dietary advice in small groups. Already before the formalized dietary advice, an average decrease in serum cholesterol of 10% was observed. This was attributed to biological variation, absence of fasting, the degree of error between the measuring methods and also a genuine decrease on the basis of the brief dietary advice by the general practitioner. On control after dietary advice, a further decrease in cholesterol of 15% was observed while low density lipoprotein cholesterol fell by 20% and triglycerides by 23%. These decreases must be considered to result mainly from the dietary advice. It is concluded that a single but professional session of dietary advice in small groups and with involvement of the wives or partners is an effective method of treatment in hypercholesterolaemia. If the decrease in cholesterol obtained can be maintained, the literature suggests that the risk of development of ischaemic heart disease during the subsequent 5-7 years is reduced by 20-30%. PMID:2238224

  19. Cold chain and consumers’ practices: exploratory results of focus group interviews

    Directory of Open Access Journals (Sweden)

    Stefania Balzan

    2014-12-01

    Full Text Available The aim of this qualitative survey was to gain an insight into the ways consumers purchase, transport and storage fresh and frozen food. In particular, this paper considered consumers’ behaviour and the knowledge they have about cold chain. An explorative study was held using focus group interviews (n. 4 as the method for data collection. The sampling group was composed of 24 consumers (4 males and 20 females and the age ranged from 33 to 78. Data revealed that food safety knowledge is at a fairly good level, however consumer practices in certain cases were inappropriate particularly with respect to transport from the store to home, storage and thaw. Consumers were particularly concerned about frozen food that should not be thawed during shopping or transportation. Knowledge about eggs storage seemed to be dodgy as well. Due to the restricted extent of the sample survey the results cannot be generalized to the whole Italian population; still, this method is particularly useful for discovering not only what people think but why they think that way.

  20. Bioactive maca (Lepidium meyenii) alkamides are a result of traditional Andean postharvest drying practices.

    Science.gov (United States)

    Esparza, Eliana; Hadzich, Antonella; Kofer, Waltraud; Mithöfer, Axel; Cosio, Eric G

    2015-08-01

    Maca, Lepidium meyenii Walpers (Brassicaceae), is an annual herbaceous plant native to the high plateaus of the Peruvian central Andes. Its underground storage hypocotyls have been a traditional medicinal agent and dietary staple since pre-Columbian times. Reported properties include energizing and fertility-enhancing effects. Published reports have focused on the benzylalkamides (macamides) present in dry hypocotyls as one of the main bioactive components. Macamides are secondary amides formed by benzylamine and a fatty acid moiety, with varying hydrocarbon chain lengths and degree of unsaturation. Although it has been assumed that they are usually present in fresh undamaged tissues, analyses show them to be essentially absent from them. However, hypocotyls dried by traditional Andean postharvest practices or industrial oven drying contain up to 800μgg(-1) dry wt (2.3μmolg(-1) dry wt) of macamides. In this study, the generation of macamides and their putative precursors were studied during nine-week traditional drying trials at 4200m altitude and in ovens under laboratory conditions. Freeze-thaw cycles in the open field during drying result in tissue maceration and release of free fatty acids from storage and membrane lipids up to levels of 1200μgg(-1) dry wt (4.3μmolg(-1) dry wt). Endogenous metabolism of the isothiocyanates generated from glucosinolate hydrolysis during drying results in maximal benzylamine values of 4300μgg(-1) dry wt (40.2μmolg(-1) dry wt). Pearson correlation coefficients of the accumulation profiles of benzylamine and free fatty acid to that of macamides showed good values of 0.898 and 0.934, respectively, suggesting that both provide sufficient substrate for amide synthesis during the drying process. PMID:25817836

  1. Benchmarking the burden of 100 diseases: results of a nationwide representative survey within general practices

    OpenAIRE

    Grimaldi-Bensouda, Lamiae; Begaud, Bernard; Lert, France; Rouillon, Frederic; Massol, Jacques; Guillemot, Didier; Avouac, Bernard; Duru, Gerard; Magnier, Anne-Marie; Rossignol, Michel; Abenhaim, Lucien; ,

    2011-01-01

    Objective To assess the burden of diseases and quality of life (QOL) of patients for a large variety of diseases within general practice. Design In a representative nationwide cross-sectional study, a total of 825 general practitioners (GPs) were randomly selected from across France. Independent investigators recruited 8559 patients attending the GPs' practices. Data on QOL (12-Item Short Form questionnaire) and other individual characteristics were documented by the independent investigators...

  2. Frequency of Yoga Practice Predicts Health: Results of a National Survey of Yoga Practitioners

    OpenAIRE

    Alyson Ross; Erika Friedmann; Margaret Bevans; Sue Thomas

    2012-01-01

    Background. Yoga shows promise as a therapeutic intervention, but relationships between yoga practice and health are underexplored. Purpose. To examine the relationship between yoga practice and health (subjective well-being, diet, BMI, smoking, alcohol/caffeine consumption, sleep, fatigue, social support, mindfulness, and physical activity). Methods. Cross-sectional, anonymous internet surveys distributed to 4307 randomly selected from 18,160 individuals at 15 US Iyengar yoga studios; 10...

  3. Building pathology in the Netherlands – main problems and results through research and practice.

    OpenAIRE

    Thomsen, A.F.

    2014-01-01

    This report is dedicated to the main problems of building pathologies in the Netherlands and the main solutions through research and practice as questioned by the CIB W086 Building Pathology Commission for its 2014 meeting in Sao Paulo, Brazil. Objective is to contribute to the Research Roadmap 2014-2016 as communicated in January 2014. The content is based on a quick scan of Dutch practice in the field of building pathology and interviews with some key experts. In the Netherlands, building p...

  4. Workforce trends in general practice in the UK: results from a longitudinal study of doctors' careers

    OpenAIRE

    Jones, Lorelei; Fisher, Tania

    2006-01-01

    The career paths of 544 UK medical school graduates were followed for 10 years. Although general practice was not attractive to graduates initially, it became popular in subsequent years, mainly because it was seen as offering a superior quality of life. Once in general practice both men and women chose to work reduced hours and/or in non-principal posts. The findings suggest the need to look more closely at the nature of these trends and the implications for patient care and service provision.

  5. Cerebral aneurysm treatment in India: Results of a national survey regarding practice patterns in India

    Directory of Open Access Journals (Sweden)

    Sudheer Ambekar

    2016-01-01

    Conclusion: Our study demonstrates the prevailing practice patterns in the management of IAs in India. Surgical clipping is the preferred treatment of choice for anterior circulation aneurysms and EVT for aneurysms along the posterior circulation. Corticosteroids and prophylactic "triple-H" therapy are still used by a large proportion of physicians.

  6. Distance Education Practices: Summary Results of the AACRAO February 2015 60 Second Survey

    Science.gov (United States)

    American Association of Collegiate Registrars and Admissions Officers (AACRAO), 2015

    2015-01-01

    The February 2015 American Association of Collegiate Registrars and Admissions Officers (AACRAO) "60 Second Survey" asked respondents to identify whether or not their institution offers distance education, and if so, to answer additional questions about distance education course practices. The survey received 838 unique institutional…

  7. FERPA Training Practices: Results of the AACRAO January 2016 60 Second Survey

    Science.gov (United States)

    American Association of Collegiate Registrars and Admissions Officers (AACRAO), 2016

    2016-01-01

    The January 2016 American Association of Collegiate Registrars and Admissions Officers (AACRAO) "60 Second Survey" focused on institutional Family Educational Rights and Privacy Act (FERPA) training practices and measuring the level of interest in an AACRAO-developed online FERPA training module. The survey received 878 usable responses.…

  8. Does Professional Development Change Teaching Practice? Results from a Three-Year Study.

    Science.gov (United States)

    Porter, Andrew C.; Garet, Michael S.; Desimone, Laura; Yoon, Kwang Suk; Birman, Beatrice F.

    This report, the third in a series of reports from the longitudinal evaluation of the Eisenhower Professional Development Program, examines the effects of professional development on improving classroom teaching practice. The Eisenhower Professional Development Program, Title II of the Elementary and Secondary Education Act, is the federal…

  9. Female Sexual Abuse Evaluation in the Urological Practice : Results of a Dutch Survey

    NARCIS (Netherlands)

    Beck, Jack; Bekker, Milou; Van Driel, Mels; Putter, Hein; Pelger, Rob; Nijeholt, A. A. B. Lycklama A.; Elzevier, Henk Willem

    2010-01-01

    Introduction. There is a strong association between urological complaints and a history of sexual abuse, especially in females. It is not known whether urologists integrate these facts in their daily practice. Aim. To evaluate whether Dutch urologists address the issues of sexual abuse in their fema

  10. VARK learning preferences and mobile anatomy software application use in pre-clinical chiropractic students.

    Science.gov (United States)

    Meyer, Amanda J; Stomski, Norman J; Innes, Stanley I; Armson, Anthony J

    2016-05-01

    Ubiquitous smartphone ownership and reduced face-to-face teaching time may lead to students making greater use of mobile technologies in their learning. This is the first study to report on the prevalence of mobile gross anatomy software applications (apps) usage in pre-clinical chiropractic students and to ascertain if a relationship exists between preferred learning styles as determined by the validated VARK(©) questionnaire and use of mobile anatomy apps. The majority of the students who completed the VARK questionnaire were multimodal learners with kinesthetic and visual preferences. Sixty-seven percent (73/109) of students owned one or more mobile anatomy apps which were used by 57 students. Most of these students owned one to five apps and spent less than 30 minutes per week using them. Six of the top eight mobile anatomy apps owned and recommended by the students were developed by 3D4Medical. Visual learning preferences were not associated with time spent using mobile anatomy apps (OR = 0.40, 95% CI 0.12-1.40). Similarly, kinesthetic learning preferences (OR = 1.88, 95% CI 0.18-20.2), quadmodal preferences (OR = 0.71, 95% CI 0.06-9.25), or gender (OR = 1.51, 95% CI 0.48-4.81) did not affect the time students' spent using mobile anatomy apps. Learning preferences do not appear to influence students' time spent using mobile anatomy apps. Anat Sci Educ 9: 247-254. © 2015 American Association of Anatomists. PMID:26109371

  11. Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS

    OpenAIRE

    Akizawa, Tadao; Ronald L Pisoni; Akiba, Takashi; Saito, Akira; Fukuhara, Shunichi; Asano, Yasushi; Hasegawa, Takeshi; Port, Friedrich K; Kurokawa, Kiyoshi

    2008-01-01

    Background. Japanese haemodialysis (HD) patients not only have a very low mortality and hospitalization risk but also low haemoglobin (Hb) levels. Internationally, anaemia is associated with mortality, hospitalization and health-related quality of life (QoL) measures of HD patients. Methods. Longitudinal data collected from 1999 to 2006 from 60 to 64 representative Japanese dialysis units participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) were used to describe anaemia ...

  12. Distribution of episodes of mental illness in general practice: results from the Second National Morbidity Survey.

    OpenAIRE

    Smeeton, N C

    1986-01-01

    The Second National Morbidity Survey, conducted in England and Wales between 1970 and 1976, contains a unique body of information on episodes of mental illness experienced by individuals registered in a representative sample of general practices around the country. This information is used to construct the episode distribution among the individuals surveyed. The Poisson and negative binomial distributions are then used to model the episodes. The Poisson model gives a very poor fit but the neg...

  13. CODES AND PRACTICES OF IMPLEMENTATION OF CORPORATE GOVERNANCE IN ROMANIA AND RESULTS REPORTING

    OpenAIRE

    GROSU MARIA

    2011-01-01

    Corporate governance refers to the manner in which companies are directed and controlled. Business management was always guided by certain principles, but the current meaning of corporate governance concerns and the contribution that companies must have the overall development of modern society. Romania used quite late in adopting a code of good practice in corporate governance, being driven, in particular, the privatization process, but also the transfer of control and surveillance of politi...

  14. Health practice correlates in three adult age groups: results from two community surveys.

    OpenAIRE

    Rakowski, W; Lefebvre, R C; Assaf, A R; Lasater, T M; Carleton, R A

    1990-01-01

    Independently done surveys of a target population can make an important contribution to knowledge about the determinants of personal health behavior by highlighting variables that consistently emerge as significant predictors. This investigation examined the correlates of four health practice and knowledge indices related to cardiovascular disease (CVD) in two baseline community surveys of the Pawtucket Heart Health Program (N = 2,413; N = 2,808). An additional dimension was the use of three ...

  15. [Pharmacists' Behavior in Clinical Practice: Results from a Questionnaire Survey of Pharmacy Students].

    Science.gov (United States)

    Nakada, Akiko; Akagawa, Keiko; Yamamoto, Hitomi; Kato, Yasuhisa; Yamamoto, Toshinori

    2016-01-01

    A questionnaire survey was performed to obtain pharmacy students' impressions of pharmacists' behavior, to classify these based on professionalism, and to analyze the relationship between these experiences and students' satisfaction with their clinical practice in Japan. The questionnaire was answered by 327 5th-year pharmacy school students upon completing clinical practice at community pharmacies from 2011 to 2012. They rated their satisfaction with their clinical practice using a 6-point Likert scale, and provided descriptions of their experience such as, "This health provider is professional", or "What a great person he/she is as a health provider". We counted the words and then categorized the responses into 10 traits, as defined by the American Pharmaceutical Association Academy of Students of Pharmacy-American Association of Colleges of Pharmacy, Council of Deans Task Force on Professionalism 1999, using text mining. We analyzed the relationship between their experiences with respectful persons, and satisfaction, using the Mann-Whitney U-test (significance leveltext mining analysis after excluding unsuitable responses. The word most used was "patient" (121 times). Many students noted their impression that the pharmacists had answered patients' questions. Of the 10 trait categories, "professional knowledge and skills" was mentioned most often (151 students). PMID:26831812

  16. Prevalence of pain-free weeks in chiropractic subjects with low back pain - a longitudinal study using data gathered with text messages

    DEFF Research Database (Denmark)

    Lemeunier, Nadege; Kongsted, Alice; Axen, Iben

    2011-01-01

    -31 %). Smaller percentages were reported for [greater than or equal to] 7 zero weeks in a row. There were no significant differences between the two study groups. CONCLUSION: It was uncommon that chiropractic subjects treated for non-specific LBP experienced an entire week without any LBP at all over 18 weeks...

  17. 49 CFR 385.321 - What failures of safety management practices disclosed by the safety audit will result in a...

    Science.gov (United States)

    2010-10-01

    ... disclosed by the safety audit will result in a notice to a new entrant that its USDOT new entrant... MOTOR CARRIER SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.321 What failures of safety management practices disclosed by the safety audit will result in a...

  18. Consumer Shell Egg Consumption and Handling Practices: Results from a National Survey.

    Science.gov (United States)

    Kosa, Katherine M; Cates, Sheryl C; Bradley, Samantha; Godwin, Sandria; Chambers, Delores

    2015-07-01

    Numerous cases and outbreaks of Salmonella infection are attributable to shell eggs each year in the United States. Safe handling and consumption of shell eggs at home can help reduce foodborne illness attributable to shell eggs. A nationally representative Web survey of 1,504 U.S. adult grocery shoppers was conducted to describe consumer handling practices and consumption of shell eggs at home. Based on self-reported survey data, most respondents purchase shell eggs from a grocery store (89.5%), and these eggs were kept refrigerated (not at room temperature; 98.5%). As recommended, most consumers stored shell eggs in the refrigerator (99%) for no more than 3 to 5 weeks (97.6%). After cracking eggs, 48.1% of respondents washed their hands with soap and water. More than half of respondents who fry and/or poach eggs cooked them so that the whites and/or the yolks were still soft or runny, a potentially unsafe practice. Among respondents who owned a food thermometer (62.0%), only 5.2% used it to check the doneness of baked egg dishes when they prepared such a dish. Consumers generally followed two of the four core "Safe Food Families" food safety messages ("separate" and "chill") when handling shell eggs at home. To prevent Salmonella infection associated with shell eggs, consumers should improve their practices related to the messages "clean" (i.e., wash hands after cracking eggs) and "cook" (i.e., cook until yolks and whites are firm and use a food thermometer to check doneness of baked egg dishes) when preparing shell eggs at home. These findings will be used to inform the development of science-based consumer education materials that can help reduce foodborne illness from Salmonella infection. PMID:26197282

  19. Relationship between Ontario chiropractors’ attitudes toward drug prescription rights and Canadian versus non-Canadian college of graduation: results from an online survey

    Science.gov (United States)

    Emary, Peter Charles; Stuber, Kent Jason

    2016-01-01

    Objective: To investigate differences between chiropractors’ attitudes toward drug prescription rights based on chiropractic college of graduation. Methods: A secondary data analysis of a 2015 survey of chiropractors from Ontario, Canada was performed. The questionnaire included 14 items concerning chiropractors’ knowledge and attitudes toward drug prescription including demographics. Results: 960 of 2,677 deliverable questionnaires were completed (36% response rate). The majority of respondents favoured limited prescribing rights for chiropractors regardless of college of graduation. Respondents who graduated from Canadian institutions were significantly more in favour of these privileges compared to graduates from non-Canadian schools. Over three-quarters of all respondents opposed the idea of chiropractors having full prescribing rights. No significant association was found between respondents’ philosophical orientation and school attended. Conclusion: Ontario chiropractors who graduated from Canadian chiropractic institutions were most interested in obtaining limited drug prescription rights for the profession compared to non-Canadian chiropractic institution graduates. PMID:27069262

  20. Results of ultrasonic disintegration of sewage sludge in practice; Ergebnisse des Praxiseinsatzes der Schlammdesintegration mittels Ultraschall

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, E. [IWE-Ingenieurgesellschaft fuer Wasser und Entsorgung mbH, Radebeul (Germany); Friedrich, H. [Fraunhofer-Institut fuer Keramische Technologien und Sinterwerkstoffe (IKTS), Dresden (Germany); Hielscher, H. [Hielscher GmbH, Teltow (Germany)

    1999-07-01

    Using high-performance ultrasonic sludge disintegration in different stages of sewage and sludge treatment is found to be an innovative approach for reducing the accruing amounts of sewage sludge in terms of both mass and volume. By means of practical tests with sludge disintegration at sewage treatment plants, its effects are demonstrated. (orig.) [German] Der Einsatz einer Hochleistungs-Ultraschalltechnik zur Schlammdesintegration in verschiedenen Stufen der Abwasser- und Schlammbehandlung zeigt sich als innovativer Loesungsweg zur weitestgehenden massenmaessigen sowie volumenmaessigen Minimierung des Klaerschlammanfalles. An Hand von Einsatzerprobungen der Desintegration in der Klaeranlagenpraxis werden die Effekte der Desintegration vorgestellt. (orig.)

  1. Colorectal cancer screening practices of primary care providers: results of a national survey in Malaysia.

    Science.gov (United States)

    Norwati, Daud; Harmy, Mohamed Yusoff; Norhayati, Mohd Noor; Amry, Abdul Rahim

    2014-01-01

    The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics. PMID:24761922

  2. Improvement in fresh frozen plasma transfusion practice: results of an outcome audit.

    Science.gov (United States)

    Kakkar, N; Kaur, R; Dhanoa, J

    2004-06-01

    Blood components have been in use in clinical practice for many decades now. In spite of fairly clear guidelines regarding their use, inappropriate prescriptions for components are still rampant. We undertook this work to assess the appropriateness of fresh frozen plasma (FFP) transfusions in our hospital. A prospective audit of 504 transfusion orders for 1761 FFP units was conducted over a 6-month period which was followed by a re-audit of 294 FFP prescriptions for 961 units. In the initial audit, we identified 304 (60.3%) prescriptions which were inappropriate according to the British Committee for Standardization in Hematology (BCSH) guidelines. The re-audit performed after an educational campaign among clinicians showed a reduction in inappropriate requests by 26.6%. The specific areas of misuse were FFP transfusions in patients with hypoproteinaemic states (40.5%), anaemia (36.5%), bleeding without coagulation factor deficiency (10.2%) and volume depletion (9.2%). A significant 50.3% of requests in the initial audit and 38.4% in the re-audit were for single- or two-unit transfusions, which were subtherapeutic. FFP transfusions carry the same risks to the patients as any other blood component. Prescribers of these transfusions need to be aware of the clinical setting where their use is appropriate. Local hospital transfusion committees can play a vital role in overseeing transfusion practices to ensure optimal use of blood/component therapy. PMID:15180815

  3. The effect of quality management practices on operational and business results in the petroleum industry in Iran

    Science.gov (United States)

    Mellat Parast, Mahour

    The trend toward globalization has challenged management thinking, organizational practices, and the ways companies interact with their customers and suppliers as well as with other segments of society. One such practice, Total Quality Management (TQM), has emerged as a management paradigm for enhancing organizational performance and profitability, to the extent that it has been regarded as "the second industrial revolution" (Kanji, 1990). Despite extensive research in quality management, little empirical research has been done on this in an international context, especially in the Middle East. This study attempts to investigate: (1) the relationship among quality management constructs based on the Malcolm Baldrige National Quality Award; and (2) the effect of quality management practices on operational and business results in the petroleum industry. A validated and reliable survey instrument was used for the study to collect data from 31 project managers/consultants in the petroleum industry in Iran. The results of the correlation analysis show that top management support is the major driver of quality management, which significantly correlates with other quality management practices. It was also found that customer orientation is not significantly correlated with external quality results (profitability). A regression analysis indicated top management support, employee training, and employee involvement as the three statistically significant variables in explaining the variability in internal quality results. Furthermore, it was found that internal quality results was statistically significant in explaining the variability of external quality results.

  4. Using spirometry results in occupational medicine and research: Common errors and good practice in statistical analysis and reporting

    OpenAIRE

    Wagner N; Beckett W; Steinberg R

    2006-01-01

    Spirometry appears to be a simple and inexpensive method to measure disorders of the respiratory tract. In reality however, a simple spirometry test requires knowledge and skill to correctly conduct and evaluate the test and its results. This review addresses common misunderstandings in using, evaluating and reporting spirometry results in Occupational Health practice, clinical medicine and research. Results of spirometry need to be evaluated in relation to reference values. The factory medic...

  5. Empirical Evidence on the Link Between Compliance with Governance of Best Practice and Firms' Operating Results

    Directory of Open Access Journals (Sweden)

    Tek B. Lama

    2012-12-01

    Full Text Available This study provides robust evidence in support of the agency theory argument that corporate governancematters for a firm’s operating performance. Using the corporate governance ratings as the governance proxyfrom Horwath 2006 Corporate Governance Report (mid-sized Australian ASX companies andMid-CapCorporate Governance Report 2007 (The University of Newcastle 2006; 2007, I examine 60 sample firms toreveal that a firm’s governance is positively and significantly related to firm performance as measured by returnon equity, earning yield and return on assets. This study extends the findings of these two reports which founda disturbing trend in the corporate governance practice of Australian mid-cap companies – both a decrease incompanies with excellent corporate governance, and an increase in companies with significant corporategovernance deficiencies. The findings of this study suggest that those mid-size companies who have allowedcorporate governance to deteriorate have adversely affected their shareholder returns.

  6. Risk management policies and practices regarding radio frequency electromagnetic fields: results from a WHO survey

    International Nuclear Information System (INIS)

    This study aims to describe current risk management practices and policies across the world in relation to personal exposures from devices emitting radiofrequency fields, environmental exposures from fixed installations and exposures in the work environment. Data from 86 countries representing all WHO regions were collected through a survey. The majority of countries (76.8 %) had set exposure limits for mobile devices, almost all (90.7 %) had set public exposure limits for fixed installations and 76.5 % had specified exposure limits for personnel in occupational settings. A number of other policies had been implemented at the national level, ranging from information provisions on how to reduce personal exposures and restrictions of usage for certain populations, such as children or pregnant women to prevention of access around base stations. This study suggests that countries with higher mobile subscriptions tend to have set radiofrequency exposure limits for mobile devices and to have provisions on exposure measurements about fixed installations. (authors)

  7. Chronic disease management in general practice: results from a national study.

    LENUS (Irish Health Repository)

    Darker, C

    2012-04-01

    The aim of this study was to provide baseline data on chronic disease management (CDM) provision in Irish general practice (GP). The survey instrument was previously used in a study of primary care physicians in 11 countries, thus allowing international comparisons. The response rate was 72% (380\\/527).The majority of GPs (240\\/380; 63%) reported significant changes are needed in our health care system to make CDM work better. Small numbers of routine clinical audits are being performed (95\\/380; 25%). Irish GPs use evidence based guidelines for treatment of diabetes (267\\/380; 71%), asthma \\/ COPD (279\\/380; 74%) and hypertension (297\\/380; 79%), to the same extent as international counterparts. Barriers to delivering chronic care include increased workload (379\\/380; 99%), lack of appropriate funding (286\\/380; 76%), with GPs interested in targeted payments (244\\/380; 68%). This study provides baseline data to assess future changes in CDM.

  8. Post-graduated course 'Basic aspects of medical physics in nuclear medicine': theoretical/practical intensive version: preliminary results

    International Nuclear Information System (INIS)

    Full text: Using national and international recommendation about human resource in nuclear medicine, a group of experts organized a national course for the education and training of physicist who works in Cuban hospital, adapted to national condition and practice of nuclear medicine. The program was approved for National Authorities in Nuclear Security and University School in Medicine and content three intensive theoretic and practical courses (15 days of full time duration each), complemented with 4 months full time in Nuclear Medicine Service monitored by accredited expert and 2 months at distance with practical task. The theoretical/practical intensive courses have final evaluation: combining practical exercise and write final test. When all docent activities finish the students should pass a final evaluation by a testing board composed for (at least) three accredited experts. The first theoretical/practical course included 19 physicists who work in hospital, the second 17 and the third 16 students. With 100 point of maximum score and 60 point minimum to pass, the partial final tests included: true or false choice (with 10 aspects to verify, 1 point/correct answer) and questions to write developed answer. The average result was 83.02 points/ students (range 65-100 points). The students evaluated satisfactory the quality of different courses (in anonymous poll), reporting like very good; the quality of conferences, excellent; the usefulness of different charters, very good; the support bibliography, and recommended the repetition of this kind of education and training in order to warranty the human resource, in the same way and content, and included others item in the future. Conclusion: the theoretical/practice intensive courses of this post-graduated course were successful and satisfied the objective of education and training of medical physicist in nuclear medicine. (author)

  9. Nutritional practices, knowledge, and attitudes of psychiatric healthcare professionals: unexpected results.

    Science.gov (United States)

    Ryan, V C; Rao, L O; Rekers, G

    1990-01-01

    This study investigated inter-relationships among nutrition knowledge, habits, and attitudes of psychiatric healthcare providers. Data of nutritional intake was compared with that of the general population of the state of South Carolina, obtained from a previous public health study. Nutritional habits were determined from both a 24-hour recall and a separate three-day recall of dietary intake. Nutrition knowledge and attitudes were determined by validated questionnaires. The knowledge questionnaire consisted of 50 multiple-choice questions. Attitudes were determined using a semantic differential instrument consisting of phrases of descriptive bipolar adjectives. Dietary intake was analyzed using the Food Processor software and compared with the RDAs and with the intake of the general population. Nutrition knowledge was measured by the number of correct responses. Nutrition attitudes were assigned numerical scores and measured by a Likert scale. Only 3 of the subjects met 70% of indicator nutrients (iron, calcium, vitamin B6, and vitamin C). No significant relationships were established among attitudes, habits, and knowledge. Sixty-three percent of subjects perceived themselves as role models to patients, yet 90% of them practiced poor nutrition habits as compared with 97% of the general population. The higher the education level, the more likely that subjects felt nutrition is important for health. A comprehensive nutrition education program is essential for health care providers to promote successful nutrition education for the patients they serve. PMID:10112799

  10. Four Years of Practical Arrangements between IAEA and Moscow SIA 'Radon': Preliminary Results - 13061

    International Nuclear Information System (INIS)

    The International Education Training Centre (IETC) at Moscow State Unitary Enterprise Scientific and Industrial Association 'Radon' (SIA 'Radon'), in co-operation with the International Atomic Energy Agency (IAEA), has developed expertise and provided training to waste management personnel for the last 15 years. Since 1997, the educational system of the enterprise with the support of the IAEA has acquired an international character: more than 470 experts from 35 countries- IAEA Member States completed the professional development. Training is conducted at various thematic courses or fellowships for individual programs and seminars on IAEA technical projects. In June 2008 a direct agreement (Practical Arrangements) was signed between SIA 'Radon' and the IAEA on cooperation in the field of development of new technologies, expert's advice to IAEA Member States, and, in particular, the training of personnel in the field of radioactive waste management (RWM), which opens up new perspectives for fruitful cooperation of industry professionals. The paper summarizes the current experience of the SIA 'Radon' in the organization and implementation of the IAEA sponsored training and others events and outlines some of strategic educational elements, which IETC will continue to pursue in the coming years. (authors)

  11. Reducing/adjusting painful management practices in piglets: an attempt to improve animal welfare and zootechnical results

    OpenAIRE

    Van Beirendonck, Sanne

    2012-01-01

    In the pig industry, farmers always strive for optimal productions results. In order to obtain these results, they carry out several management practices on piglets like tail docking (to avoid tail biting; routinely prohibited), teeth shortening (to avoid wounding to the udder of the sow or to litter mates; routinely prohibited), castration of male piglets (to avoid boar taint),… All these procedures are however considered to be painful and therefore can also influence animal welfare and zoot...

  12. A best practice method to maximize pigging results in high velocity pipelines

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, Eric; Strong, Robert; Drysdale, Colin [T.D. Williamson Inc. (United States)

    2009-07-01

    Many pipelines run at high product velocities which inhibits the results of maintenance pigging. In order to compensate for this, some operators temporarily slow flow rates or run pigs at the higher velocities. Each of these approaches yields different costs and effectiveness. T.D. Williamson (TDW) has developed a patent-pending speed reducing venturi pig (or SR-21 Raptor{sup TM}-Pig), which utilizes high bypass flow through the pig body designed to reduce pig travel speed, while incorporating an inertia/flow actuated valve to minimize stalling and surging. The aim of this paper is to summarize performance characteristics and field testing results for this patent-pending venturi pig, and how it may deliver better results in high-velocity pipeline conditions. (author)

  13. Application and practice of EU FP5. Research results in the area key action water - pollution prevention: are results fit for use?

    Energy Technology Data Exchange (ETDEWEB)

    Bittens, M. [Univ. Tuebingen (Germany). Center for Applied Geoscience; Prokop, G. [Umweltbundesamt, Wien (Austria)

    2003-07-01

    Embedded in the EU-funded project 'Innovative Management of Groundwater Resources in Europe - Training and RTD Co-ordination (IMAGE-TRAIN)' a two-phase (identification and testing) evaluation process was performed on basis of delivered research results from scientific projects running in the FP5 Key Action 'Management and Quality of Water - Pollution Prevention'. The 'Application and Practice Report', APR, documents available methods, concepts, and applications, which are qualified for supporting and enhancing the implementation processes of European policies and regulations with regard to the management and quality of water. Additionally, the APR determines boundary conditions for the application of available deliverable as result of the testing phase and facilitates the selection of the best available techniques for accompanying European implementation processes in accordance with the sustainable solutions strategy of European Union's 6{sup th} Environmental Action Programme 'Our Future, or choice'. IMAGE-TRAIN has the ambition to improve cooperation and interaction between ongoing research projects in the field of soil and groundwater contamination and to communicate new technology achievements to young scientists by means of training courses. IMAGE-TRAIn is a three year project which started in September 2001 and operates at two levels. (1) Senior level: At this level cluster meetings for researchers of ongoing research projects are being organised with the objective to establish topic links between RTD projects, dealing with contaminated land and groundwater and to promote their practical application. Furthermore practical case studies with selected experts are being organised to perform short feasibility studies related to current groundwater or mine water problems. (2) Junior level: At this level Advanced Study Courses are organised with theobjective to quickly transfer existing and emerging knowledge to young

  14. Use of hyperlinks in electronic test result communication: a survey study in general practice

    Directory of Open Access Journals (Sweden)

    Mukai Thomas

    2012-10-01

    Full Text Available Abstract Background Information is essential in healthcare. Recording, handling and sharing healthcare information is important in order to ensure high quality of delivered healthcare. Information and communication technology (ICT may be a valuable tool for handling these challenges. One way of enhancing the exchange of information could be to establish a link between patient-specific and general information sent to the general practitioner (GP. The aim of the present paper is to study GPs' use of a hyperlink inserted into electronic test result communication. Methods We inserted a hyperlink into the electronic test result communication sent to the patients’ GPs who participated in a regional, systematic breast cancer screening program. The hyperlink target was a web-site with information on the breast cancer screening program and breast cancer in general. Different strategies were used to increase the GPs’ use of this hyperlink. The outcome measure was the GPs’ self-reported use of the link. Data were collected by means of a one-page paper-based questionnaire. Results The response rate was 73% (n=242. In total, 108 (45% of the GPs reported to have used the link. In all, 22% (n=53 of the GPs used the web-address from a paper letter and 37% (n=89 used the hyperlink in the electronic test result communication (Δ = 15%[95%confidence  int erval(CI = 8 − 22%P  Conclusions The results suggest that hyperlinks in electronic test result communication could be a feasible strategy for combining and sharing different types of healthcare information.

  15. Environmental strategies and their motives and results in Slovenian business practice

    Directory of Open Access Journals (Sweden)

    Barbara Čater

    2009-11-01

    Full Text Available The results of a survey on 153 Slovenian manufacturing companies show that companies implement environmental strategies primarily as a refl ection of the commitment of their top management, followed by public concern, regulatory forces and expected competitive advantage. They report a relatively high level of implementation of the corporate environmental strategy while, among functional strategies, environmental issues are most commonly included in the production and marketing strategies, followed by purchasing and personnel strategies. Large companies develop and execute environmental strategies to a greater extent than small companies. The results also reveal a positive but very weak relationship between environmental strategies and company performance.

  16. Practical experience and results with an advanced on-line gasoline blend optimization system

    Energy Technology Data Exchange (ETDEWEB)

    Serpemen, Y.; Baumeister, K.H.; Hubel, A.; Raichel, P. (Veba Oel Entwicklungs-Gessellschaft mbH, Gelsenkirchen (DE))

    1989-01-01

    Refinery profit margins increased significantly by using the on-line gasoline blend optimization system which allows considerable savings resulting from octane give-away reduction, appreciably enhanced butane utilization, optimum use of the available blend components, and increased operating flexibility by elimination of reblends. The experience with this advanced on-line blending system is described in this paper.

  17. Incentive Pay Programs Do Not Affect Teacher Motivation or Reported Practices: Results from Three Randomized Studies

    Science.gov (United States)

    Yuan, Kun; Le, Vi-Nhuan; McCaffrey, Daniel F.; Marsh, Julie A.; Hamilton, Laura S.; Stecher, Brian M.; Springer, Matthew G.

    2013-01-01

    This study drew on teacher survey responses from randomized experiments exploring three different pay-for-performance programs to examine the extent to which these programs motivated teachers to improve student achievement and the impact of such programs on teachers' instruction, number of hours worked, job stress, and collegiality. Results showed…

  18. The Role of Chiropractic Care in the Treatment of Dizziness or Balance Disorders: Analysis of National Health Interview Survey Data.

    Science.gov (United States)

    Ndetan, Harrison; Hawk, Cheryl; Sekhon, Vishaldeep Ka; Chiusano, Miguel

    2016-04-01

    The purpose of this study was to explore the role of chiropractic in the treatment of dizziness or balance disorders through an analysis of data from the 2008 National Health Interview Survey. Odds ratios and 95% confidence intervals (CIs) were used to assess the likelihood that respondents with dizziness or balance problems perceived that they were helped by specified practitioners. Eleven percent of respondents reported having had a balance or dizziness problem; more than 35% were aged 65 years and older. The odds ratio for perceiving being helped by a chiropractor was 4.36 (95% CI, 1.17-16.31) for respondents aged 65 years or older; 9.5 (95% CI, 7.92-11.40) for respondents reporting head or neck trauma; and 13.78 (95% CI, 5.59-33.99) for those reporting neurological or muscular conditions as the cause of their balance or dizziness. PMID:26362851

  19. Libraries and Inter-Generational Communication Good Practices and Their Educational Results

    OpenAIRE

    Petrova - Vasileva, Rositsa

    2014-01-01

    The process of changes today, on the border between traditional and digital culture, is a clear sign for a change of the communication characteristics and habits of man. As a result of the expansion of new information technologies people who have different communication skills are born and brought up, and rapid technological changes create communication gap between generations living together in a common period of time. Availability and / or lack of information literacy nowaday...

  20. Policy impacts on pedagogical practice and ICT use: An exploration of the results from SITES 2006

    OpenAIRE

    Law, N.; Lee, MW; Chan, A.

    2010-01-01

    The Second Information Technology in Education Study (SITES) 2006 results reveal that principals' perceived presence of lifelong learning-related pedagogical activities in their schools had changed markedly since the same data was collected in 1998 in SITES-M1. More intriguing was the fact that the directions of the changes were quite different depending on the education systems concerned - many of the Asian countries reported very high increases while some of the European countries reported ...

  1. Sustainable Success in Higher Education by Sharing the Best Practices as a Result of Benchmarking Process

    OpenAIRE

    Anca Gabriela Ilie; Mihaela Maftei; Oana Antonia Colibăşanu

    2011-01-01

    The paper proposes to review the main benchmarking criteria, based on the quality indicators used by the higher education institutions and to present new indicators of reference as a result of the inter-universities cooperation. Once these indicators are defined, a national database could be created and through benchmarking methods, there could be established the level of national performance of the educational system. Going forward and generalizing the process, we can compare the national ed...

  2. Assessment of soil-structure interaction practice based on synthesized results from Lotung experiment - earthquake response

    International Nuclear Information System (INIS)

    On the assumption that the foundation can be appropriately modeled, it would be difficult to distinguish between the computational capabilities of the SASSI, CLASSI and SUPERALUSH/CLASSI methods of SSI analysis. Given the appropriate model, all three methodologies would produce very similar valid results. However, both CLASSI (Bechtel) and Soil-Spring methods should be used cautiously within their known limitations. The use of FLUSH should be limited to essentially 2D problems. More than the computational methods, the differences in the seismic response results obtained are due to the modeling of the soil-structure system and the characterization of the input motions. A number of insights have been obtained with respect to the validity of SSI analysis methodologies for earthquake response. Among these are the following: vertical wave propagation assumption in performing SSI is adequate to describe the wave field; equivalent linear analysis of soil response for SSI analysis, such as performed by the SHAKE code, provides acceptable results; a significant but non-permanent degradation of soil modulus occurs during earthquakes; the development of soil stiffness degradation and damping curves as a function of strain, based on geophysical and laboratory tests, requires improvement to reduce variability and uncertainty; backfill stiffness plays an important role in determining impedance functions and possibly input motions; scattering of ground motion due to embedment is an important element in performing SSI analysis. (author)

  3. Incident somatic comorbidity after psychosis: Results from a retrospective cohort study based on Flemish general practice data

    OpenAIRE

    Truyers Carla; Buntinx Frank; De Lepeleire Jan; De Hert Marc; Van Winkel Ruud; Aertgeerts Bert; Bartholomeeusen Stefaan; Lesaffre Emmanuel

    2011-01-01

    Abstract Background Psychotic conditions and especially schizophrenia, have been associated with increased morbidity and mortality. Many studies are performed in specialized settings with a strong focus on schizophrenia. Somatic comorbidity after psychosis is studied, using a general practice comorbidity registration network. Methods Hazard ratios are presented resulting from frailty models to assess the risk of subsequent somatic disease after a diagnosis of psychosis compared to people with...

  4. Evaluation of Anti-Nuclear antibody test results in clinical practice

    Directory of Open Access Journals (Sweden)

    Nevreste Çelikbilek

    2015-06-01

    Full Text Available Objective: Aim of this study is to evaluate anti-nuclear antibody (ANA test results obtained between 2009 and 2011. Methods: Of a totally 5068 cases tested for ANA by indirect immunofluorescence method (IIFA, randomly chosen 982 ANA-positive cases were reviewed in terms of gender, level and pattern of fluorescence, anti-dsDNA (anti-double stranded DNA and anti-extractable nuclear antigen (ENA profile. Anti-dsDNA levels and anti-ENA profiles were determined by enzyme linked immune assay (ELISA and immune-blotting (IB, respectively. Results: Sex distribution of ANA positive patients was determined as 756 (77% females and 226 (23% males. Fifty per cent of the cases were from rheumatology department, 20% from gastroenterology and 30% from other units. Fluorescence levels were considered borderline or weak positive in 62.6% of the samples. The most frequent patterns were homogeneous (23%, speckled (22%, homogeneous-speckled (15.5% and nucleolar (13.5%. Anti-dsDNA were studied in 759 ANA positive patients and 66 (8.7% samples were found positive, being 44 of them (68.8% with homogeneous pattern and the rest with speckled, nucleolar, nuclear dots, centromeric or midbody patterns. Totally 131 (31.6% of 414 samples studied for anti-ENA profile were found positive. The first four frequent profiles were SSA (34.4%, SSA-SSB (16.8%, Scl70 (16% and Sm/RNP (9.2%. Conclusion: Our results are similar with the current related literature. It is known that autoantibodies can be detectable before clinical symptoms being apparent, especially in SLE. Therefore, borderline or weak fluorescence levels should also be reported and the patients having them should be followed-up carefully. J Microbiol Infect Dis 2015;5(2: 63-68

  5. [Practice report: the process-based indicator dashboard. Visualising quality assurance results in standardised processes].

    Science.gov (United States)

    Petzold, Thomas; Hertzschuch, Diana; Elchlep, Frank; Eberlein-Gonska, Maria

    2014-01-01

    Process management (PM) is a valuable method for the systematic analysis and structural optimisation of the quality and safety of clinical treatment. PM requires a high motivation and willingness to implement changes of both employees and management. Definition of quality indicators is required to systematically measure the quality of the specified processes. One way to represent comparable quality results is the use of quality indicators of the external quality assurance in accordance with Sect. 137 SGB V—a method which the Federal Joint Committee (GBA) and the institutions commissioned by the GBA have employed and consistently enhanced for more than ten years. Information on the quality of inpatient treatment is available for 30 defined subjects throughout Germany. The combination of specified processes with quality indicators is beneficial for the information of employees. A process-based indicator dashboard provides essential information about the treatment process. These can be used for process analysis. In a continuous consideration of these indicator results values can be determined and errors will be remedied quickly. If due consideration is given to these indicators, they can be used for benchmarking to identify potential process improvements. PMID:25523849

  6. Audit of radiotherapy dosimetry in New Zealand: Practical considerations and results

    International Nuclear Information System (INIS)

    In order to verify regulatory compliance, every two years staff of the National Radiation Laboratory (NRL) of New Zealand visit each of the radiotherapy departments in New Zealand to carry out an independent audit of the dosimetry of their external radiation beams. The audit is carried out under Technical Reports Series No. 277 reference conditions using dosimetry equipment belonging to the NRL to maximize the independence of the measurements. Audits have been carried out regularly since 1991 and the results show that discrepancies of up to 2% for linac beams are within normal output variability. However, much greater discrepancies are observed in kilovoltage X ray beams.This is due to the use of different dosimetry protocols rather than error. Experience to date suggests that the dosimetry audit is of continuing benefit to radiotherapy departments, but should be supplemented with dosimetry of planned treatments in an anthropomorphic phantom. (author)

  7. Secondary water chemistry control practices and results of the Japanese PWR plants

    International Nuclear Information System (INIS)

    the concept of the Japanese water chemistry specification, the status and the results of the chemical treatment of all the Japanese PWR plants, and examples of the water chemistry improvement program and the results at the representative plants. (authors)

  8. The New Zealand audit of radiotherapy dosimetry: Practical considerations and results

    International Nuclear Information System (INIS)

    The New Zealand Radiation Protection Regulations 1982 state that the dose delivered to a radiotherapy patient must be within ±5% of the prescribed dose. Following the overdose of 153 patients because of an error in dosimetry at Royal Devon and Exeter Hospital, UK, in 1988 it was decided to audit compliance with this routinely. Since 1991 every high-energy beam in NZ used for teletherapy has been independently measured every two years by staff from NRL. Since 1997 all kV x-ray beams have been measured as well. The measurements follow the dosimetry protocol TRS-277. A Sr-90 check is taken at each site to verify stability of the measurement system. Agreement within 0.5% is accepted. The SSD on a linear accelerator is set using the optical distance indicator after checking it against a mechanical front pointer. Recombination corrections are measured on each linear accelerator beam and polarity corrections as well in the case of electron beams. The results for high-energy beams have been reassuring both to the regulators and to the physicists who appreciate the independent check. The only disagreements significantly greater than 2% have caused by the use of a cylindrical chamber on a 4MV electron beam by a hospital, and confusion between SSD and isocentric set-up. When we repeated the measurement using the same set-up as the hospital the difference was resolved

  9. Patterns of Care outcome Studies: results of the national practice in adenocarcinoma of the prostate

    International Nuclear Information System (INIS)

    The Patterns of Care Study reviewed the processes and outcome of 682 patients with carcinoma of the prostate treated with radiation therapy from 1973-1976. The study and patient sampling were designed to reflect a valid representation of how prostate cancer is treated by radiation oncologists in the United States. The outcome results represent national benchmarks. The three year actuarial survival was 91% for Stage A, 88% for Stage B, and 76% for Stage C. Stage, grade, elevated serum acid phosphatase, Karnofsky performance status, previous hormonal therapy, age, and prior transurethral resection were identified by multivariate regression analysis to be important independent prognostic variables. Local control was related to the dose of the primary site, paraprostatic region, and pelvic sidewall. Major complications occurred in 9% of patients with Stage A, 2% of Stage B, and 6% with Stage C disease. Complications were related to dose and treatment technique. The Patterns of Care Process Survey identified that only 60% of patients surveyed had the necessary pretreatment evaluation studies required for best current management of adenocarcinoma of the prostate

  10. Analysis of portal dose prediction verification results: Small clinic practical view

    International Nuclear Information System (INIS)

    Patient-specific quality assurance results with Portal Dose Calculation (PDC, EclipseTM 8.1, Varian Medical Systems, Palo Alto, CA) for pre-treatment verification of 243 sliding window IMRT fields were analyzed for a linear accelerator Clinac iX (Varian Medical Systems) with nominal 6 MV energy and Millenium MLC incorporating 120 leaves. The linac is equipped with a flat panel amorphous silicon (a-Si) electronic portal imaging device (EPID) a-SlOOO with image detection unit (IDU) and image acquisition software (IAS) versions IDU-20/IAS3. Data were collected during an approximately one-year period around 2009. The properties of the Varian PDC method and the gamma evaluation method that it exploits as an error detection method have been described elsewhere. All the plans were calculated with a dose rate of 300 MU/min, source to detector distance (SDD) 105 cm, for 4 to 7 (before automatic split) field IMRT plans with different treatment doses in the range of 14 to 70 Gy (mean 52.9 Gy). The measurements were made with no additional build-up with gantry angle reset to zero. One field was excluded because the imager was not aligned to the correct distance before measurement. Three fields were excluded because the PDC routine did not correctly deal with artificial reference images for split fields that were divided into more than two subfields. Twenty-one fields were excluded because the fields extended over the detector area (crossplane axis > 14.2 cm). The remaining fields were divided into groups firstly by field size, because for field axes less than 7.5 cm the effect of nonuniform backscatter is minimal, secondly by split or non-split carriage property and thirdly by treatment site. The fields were analyzed using ROI covering 1 cm around the collimator positions and gamma index 3% global dose difference and 3 mm distance to agreement as acceptance values. Maximum gamma, average gamma and percentage of area with gamma >1.0 values were recorded. All fields were also

  11. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA): study protocol for a randomized controlled trial

    OpenAIRE

    Goertz Christine M; Salsbury Stacie A; Vining Robert D; Long Cynthia R; Andresen Andrew A; Jones Mark E; Lyons Kevin J; Hondras Maria A; Killinger Lisa Z; Wolinsky Fredric D; Wallace Robert B

    2013-01-01

    Abstract Background Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary and alternative medicine providers, most commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care fo...

  12. An Examination of Growing Trends in Land Tenure and Conservation Practice Adoption: Results from a Farmer Survey in Iowa

    Science.gov (United States)

    Varble, Sarah; Secchi, Silvia; Druschke, Caroline Gottschalk

    2016-02-01

    Tenants and part-owners are farming an increasing number of acres in the United States, while full-owners are farming fewer acres. This shift in ownership is a potential cause for concern because some previous research indicated that tenant and part-owner farmers were less likely to adopt conservation practices than farmers who owned the land they farmed. If that trend persists, ownership changes would signal a national drop in conservation adoption. Here we examine this issue using a survey of agricultural operators in the Clear Creek watershed in Iowa, a state with intensive agricultural production. We compare adoption of conservation practices, and preferences for conservation information sources and communication channels, between farmers who rent some portion of the land they farm (tenants and part-owners) and farmers who own all of the land they farm (full-owners). We find that renters are more likely to practice conservation tillage than full-owners, though they are less likely to rotate crops. In addition, renters report using federal government employees (specifically, Natural Resource Conservation Service and Farm Service Agency) as their primary sources of conservation information, while full-owners most frequently rely on neighbors, friends, and County Extension. These findings are significant for conservation policy because, unlike some past research, they indicate that renters are not resistant to all types of conservation practices, echoing recent studies finding an increase in conservation adoption among non-full-owners. Our results emphasize the importance of government conservation communication and can inform outreach efforts by helping tailor effective, targeted conservation strategies for owners and renters.

  13. Practice patterns of naturopathic physicians: results from a random survey of licensed practitioners in two US States

    Directory of Open Access Journals (Sweden)

    Smith Michael J

    2004-10-01

    Full Text Available Abstract Background Despite the growing use of complementary and alternative medicine (CAM by consumers in the U.S., little is known about the practice of CAM providers. The objective of this study was to describe and compare the practice patterns of naturopathic physicians in Washington State and Connecticut. Methods Telephone interviews were conducted with state-wide random samples of licensed naturopathic physicians and data were collected on consecutive patient visits in 1998 and 1999. The main outcome measures were: Sociodemographic, training and practice characteristics of naturopathic physicians; and demographics, reasons for visit, types of treatments, payment source and visit duration for patients. Result One hundred and seventy practitioners were interviewed and 99 recorded data on a total of 1817 patient visits. Naturopathic physicians in Washington and Connecticut had similar demographic and practice characteristics. Both the practitioners and their patients were primarily White and female. Almost 75% of all naturopathic visits were for chronic complaints, most frequently fatigue, headache, and back symptoms. Complete blood counts, serum chemistries, lipids panels and stool analyses were ordered for 4% to 10% of visits. All other diagnostic tests were ordered less frequently. The most commonly prescribed naturopathic therapeutics were: botanical medicines (51% of visits in Connecticut, 43% in Washington, vitamins (41% and 43%, minerals (35% and 39%, homeopathy (29% and 19% and allergy treatments (11% and 13%. The mean visit length was about 40 minutes. Approximately half the visits were paid directly by the patient. Conclusion This study provides information that will help other health care providers, patients and policy makers better understand the nature of naturopathic care.

  14. Knowledge, attitudes and practices of HIV-positive patients regarding disclosure of HIV results at Betesda Clinic in Namibia

    Directory of Open Access Journals (Sweden)

    Penelope Tom

    2013-01-01

    Full Text Available Background: This study examined the practices, knowledge, attitudes, and the reasons for disclosure and non-disclosure of HIV-positive patients with regard to the disclosure of HIV results at Betesda Clinic in Windhoek, Namibia.Objectives: The objectives of the study were to determine knowledge, attitudes, and practices of HIV-positive patients regarding the disclosure of HIV status at Betesda Clinic in Namibia, and to determine the reasons for disclosure and non-disclosure.Methods: This was a cross-sectional descriptive study and 263 HIV-positive patients were enrolled in the study.Results: Analyses revealed that knowledge on disclosure was good, with 68% who thought it was important. The majority (73% have disclosed and 60% disclosed within 1 week of receiving their results. The most common reasons for disclosure were that 32% needed help, 25% wanted his or her partner to go for testing, and 20% wanted to let relatives know. Reasons for non-disclosure were mainly the fear of gossip (79%. Seventy-three per cent had disclosed to their partners, and 23% had disclosed to more than one person. People’s reactions were supportive in 43%, whereas 29% understood, 9% accepted and 6% were angry. Upon disclosure 40% received help, 24% of partners were tested, 23% received psychological support and 5% were stigmatised. Disclosure was higher amongst the married and cohabitating.Conclusion: The attitude was positive with regard to knowledge of disclosure, with most participants thinking that disclosure was important and good. The attitudes and actual practices of disclosure were encouraging; however, people are disclosing only to trusted individuals in the society and the fear of stigma is still present although the actual stigma was very low.

  15. Knowledge, attitudes and practices of HIV-positive patients regarding disclosure of HIV results at Betesda Clinic in Namibia

    Directory of Open Access Journals (Sweden)

    Penelope Tom

    2013-02-01

    Full Text Available Background: This study examined the practices, knowledge, attitudes, and the reasons for disclosure and non-disclosure of HIV-positive patients with regard to the disclosure of HIV results at Betesda Clinic in Windhoek, Namibia.Objectives: The objectives of the study were to determine knowledge, attitudes, and practices of HIV-positive patients regarding the disclosure of HIV status at Betesda Clinic in Namibia, and to determine the reasons for disclosure and non-disclosure.Methods: This was a cross-sectional descriptive study and 263 HIV-positive patients were enrolled in the study.Results: Analyses revealed that knowledge on disclosure was good, with 68% who thought it was important. The majority (73% have disclosed and 60% disclosed within 1 week of receiving their results. The most common reasons for disclosure were that 32% needed help, 25% wanted his or her partner to go for testing, and 20% wanted to let relatives know. Reasons for non-disclosure were mainly the fear of gossip (79%. Seventy-three per cent had disclosed to their partners, and 23% had disclosed to more than one person. People’s reactions were supportive in 43%, whereas 29% understood, 9% accepted and 6% were angry. Upon disclosure 40% received help, 24% of partners were tested, 23% received psychological support and 5% were stigmatised. Disclosure was higher amongst the married and cohabitating.Conclusion: The attitude was positive with regard to knowledge of disclosure, with most participants thinking that disclosure was important and good. The attitudes and actual practices of disclosure were encouraging; however, people are disclosing only to trustedindividuals in the society and the fear of stigma is still present although the actual stigma was very low.

  16. A case study in technology utilization: Industrial products and practices. [summary of benefits to national economy resulting from space programs

    Science.gov (United States)

    1973-01-01

    In pursuit of such missions as Apollo, the National Aeronautics and Space Administration has called into being unique equipment that obviously has little direct application beyond the achievement of mission objectives. Yet, to assume that further direct application of space program hardware is somehow a measure of the industrial benefits accruing to the nation is to misunderstand how the creation of new technology affects modern industrial capability. This document presents a profile of the significant ways in which technological developments in response to aerospace mission requirements have been coupled into industrial practice, with the result being that improved products and processes are now being utilized to benefit the nation.

  17. Using spirometry results in occupational medicine and research: Common errors and good practice in statistical analysis and reporting

    Directory of Open Access Journals (Sweden)

    Wagner N

    2006-01-01

    Full Text Available Spirometry appears to be a simple and inexpensive method to measure disorders of the respiratory tract. In reality however, a simple spirometry test requires knowledge and skill to correctly conduct and evaluate the test and its results. This review addresses common misunderstandings in using, evaluating and reporting spirometry results in Occupational Health practice, clinical medicine and research. Results of spirometry need to be evaluated in relation to reference values. The factory medical officer has to decide first whether the test was technically correctly executed and is acceptable for medical interpretation. The next step is to compare results of the individual to published reference values. A 10% reduction of reference values for North Indians and Pakistanis and a 12 to 13% reduction for South Indians is recommended when Caucasian reference tables are used. In occupational health practice the worker′s spirometry performance over time needs to be considered. Common errors in reporting summarized results, for instance from groups of workers, are the incorrect use of tests of significance and incorrect presentation of aggregated spirometry results. The loss of respiratory function is recommended as an indicator of difference between two groups. That way, early changes in function can seen without waiting for a drop of function below the usually used 80%-of-predicted limit. This procedure increases the sensitivity of medical surveillance. In research the more precise Lower Limit of Normal should be calculated and used. Correct reference equations, good patient coaching, decision on the technical quality (acceptability of each spirometry test and critical re-evaluation of the machine′s readout are essential parts of a correct spirometry test. A good understanding how results are calculated is crucial for further statistical evaluation.

  18. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Goertz Christine M

    2013-01-01

    Full Text Available Abstract Background Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary and alternative medicine providers, most commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care for Older Adults Clinical Trial is to develop and evaluate the clinical effectiveness and feasibility of a patient-centered, collaborative care model with family medicine physicians and doctors of chiropractic for the treatment of low back pain in older adults. Methods/design This pragmatic, pilot randomized controlled trial will enroll 120 participants, age 65 years or older with subacute or chronic low back pain lasting at least one month, from a community-based sample in the Quad-Cities, Iowa/Illinois, USA. Eligible participants are allocated in a 1:1:1 ratio to receive 12 weeks of medical care, concurrent medical and chiropractic care, or collaborative medical and chiropractic care. Primary outcomes are self-rated back pain and disability. Secondary outcomes include general and functional health status, symptom bothersomeness, expectations for treatment effectiveness and improvement, fear avoidance behaviors, depression, anxiety, satisfaction, medication use and health care utilization. Treatment safety and adverse events also are monitored. Participant-rated outcome measures are collected via self-reported questionnaires and computer-assisted telephone interviews at baseline, and at 4, 8, 12, 24, 36 and 52 weeks post-randomization. Provider-rated expectations for treatment effectiveness and participant improvement also are evaluated. Process outcomes are assessed through qualitative interviews with study participants and research clinicians, chart audits

  19. The cost-effectiveness of point of care testing in a general practice setting: results from a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Briggs Nancy E

    2010-06-01

    Full Text Available Abstract Background While point of care testing (PoCT for general practitioners is becoming increasingly popular, few studies have investigated whether it represents value for money. This study aims to assess the relative cost-effectiveness of PoCT in general practice (GP compared to usual testing practice through a pathology laboratory. Methods A cost-effectiveness analysis based on a randomized controlled trial with 4,968 patients followed up for 18 months and fifty-three general practices in urban, rural and remote locations across three states in Australia. The incremental costs and health outcomes associated with a clinical strategy of PoCT for INR, HbA1c, lipids, and ACR were compared to those from pathology laboratory testing. Costs were expressed in year 2006 Australian dollars. Non-parametric bootstrapping was used to generate 95% confidence intervals. Results The point estimate of the total direct costs per patient to the health care sector for PoCT was less for ACR than for pathology laboratory testing, but greater for INR, HbA1c and Lipids, although none of these differences was statistically significant. PoCT led to significant cost savings to patients and their families. When uncertainty around the point estimates was taken into account, the incremental cost-effectiveness ratio (ICER for PoCT was found to be unfavourable for INR, but somewhat favourable for ACR, while substantial uncertainty still surrounds PoCT for HbA1c and Lipids. Conclusions The decision whether to fund PoCT will depend on the price society is willing to pay for achievement of the non-standard intermediate outcome indicator. Trial registration Australian New Zealand Clinical Trial Registry ACTRN12605000272695

  20. The relationship between dual practice and physicians’ work behaviour in the public hospitals: Results from the Danish survey

    OpenAIRE

    Socha, Karolina; Bech, Mickael

    2011-01-01

    In numerous healthcare systems, some physicians combine public hospital employment with a private practice - a phenomenon referred to as physician dual practice. Dual practice raises numerous concerns with regard to its possible negative effects on the work performance of physicians in public hospitals. The purpose of this study is to test the theoretical predictions with regards to the dual-practice effects on work inputs of public hospital physicians. We use a crosssectional data on physici...

  1. Current practice for diagnosis and management of silent atrial fibrillation: results of the European Heart Rhythm Association survey.

    Science.gov (United States)

    Dobreanu, Dan; Svendsen, Jesper Hastrup; Lewalter, Thorsten; Hernández-Madrid, Antonio; Lip, Gregory Y H; Blomström-Lundqvist, Carina

    2013-08-01

    Although it is well known that silent atrial fibrillation (AF) is associated with morbidity and mortality rates similar to those of symptomatic AF, no specific strategy for screening and management of this form of AF has been advocated. The purpose of this survey was to identify current practices for the diagnosis and management of silent AF. This survey is based on an electronic questionnaire sent to the European Heart Rhythm Association Research Network partners. Responses were received from 33 centres in 16 countries. The preferred screening methods for silent AF in patients with rhythm control by pharmacological therapy was 12-lead electrocardiogram (ECG) at outpatient visits (31.3%) and periodical 24 h Holter ECG recordings (34.4%), while after pulmonary vein isolation the corresponding figures were 6.3 and 65.6%, respectively. No consensus has been reached concerning the therapeutic approach for such patients. Most responders preferred rate control over rhythm control in patients with silent AF, although some favoured pulmonary vein isolation in young patients. However, oral anticoagulant therapy in patients at high thromboembolic risk was considered mandatory by most, provided that at least one episode of silent AF was documented, without recommending further investigations. The results of this survey have confirmed that there is currently no consensus regarding the screening and management of patients with silent AF and that clinical practice is not always consistent with the few existing evidence-based recommendations. PMID:23878150

  2. Patterns of radiotherapy practice for biliary tract cancer in Japan: results of the Japanese radiation oncology study group (JROSG) survey

    International Nuclear Information System (INIS)

    The patterns of radiotherapy (RT) practice for biliary tract cancer (BTC) in Japan are not clearly established. A questionnaire-based national survey of RT used for BTC treatment between 2000 and 2011 was conducted by the Japanese Radiation Oncology Study Group. Detailed information was collected for 555 patients from 31 radiation oncology institutions. The median age of the patients was 69 years old (range, 33–90) and 81% had a good performance status (0–1). Regarding RT treatment, 78% of the patients were treated with external beam RT (EBRT) alone, 17% received intraluminal brachytherapy, and 5% were treated with intraoperative RT. There was no significant difference in the choice of treatment modality among the BTC subsites. Many patients with EBRT were treated with a total dose of 50 or 50.4 Gy (~40%) and only 13% received a total dose ≥60 Gy, even though most institutions (90%) were using CT-based treatment planning. The treatment field consisted of the primary tumor (bed) only in 75% of the patients. Chemotherapy was used for 260 patients (47%) and was most often administered during RT (64%, 167/260), followed by after RT (63%, 163/260). Gemcitabine was the most frequently used drug for chemotherapy. This study established the general patterns of RT practice for BTC in Japan. Further surveys and comparisons with results from other countries are needed for development and optimization of RT for patients with BTC in Japan

  3. Evidence-Based Practice Knowledge, Use, and Factors that Influence Decisions: Results from an Evidence-Based Practice Survey of Providers in American Indian/Alaska Native Communities

    Science.gov (United States)

    Sheehan, Angela; Walrath-Greene, Christine; Fisher, Sylvia; Crossbear, Shannon; Walker, Joseph

    2007-01-01

    Data from the Evidence-based Treatment Survey were used to compare providers serving families in American Indian and Alaska Native communities to their counterparts in non-American Indian/Alaska Native communities on provider characteristics and factors that influence their decision to use evidence-based practices (N = 467). The findings suggest…

  4. Diagnosing asthma in general practice with portable exhaled nitric oxide measurement – results of a prospective diagnostic study

    Directory of Open Access Journals (Sweden)

    Laux Gunter

    2009-03-01

    Full Text Available Abstract Background To evaluate the sensitivity, specificity and predictive values of fractional exhaled nitric oxide (FENO for the diagnosis of asthma in general practice. Methods Prospective diagnostic study with 160 patients attending 10 general practices for the first time with complaints suspicious of obstructive airway disease (OAD. Patients were referred to a lung function laboratory for diagnostic investigation. The index test was FENO measured with a portable FENO analyser based on electrochemical sensor. The reference standard was the Tiffeneau ratio (FEV1/VC as received by spirometric manoeuvre and/or results of bronchial provocation. Bronchial provocation with methacholine was performed to determine bronchial hyper-responsiveness (BHR in the event of inconclusive spirometric results. Results 88 (55% were female; their average age was 43.9 years. 75 (46.9% patients had asthma, 25 (15.6% had COPD, 8 (5.0% had an overlap of COPD and asthma, and 52 (32.5% had no OAD. At a cut-off level of 46 parts per billion (ppb (n = 30; 18.8%, sensitivity was 32% (95%CI 23–43%, specificity 93% (95%CI 85–97%, positive predictive value (PPV 80% (95%CI 63–91%, negative predictive value (NPV 61% (95%CI 52–69% when compared with a 20% fall in FEV1 from the baseline value (PC20 after inhaling methacholine concentration ≤ 16 mg/ml. At 76 ppb (n = 11; 6.9% specificity was 100% (95%CI 96–100% and PPV was 100% (95%CI 72–100. At a cut-off level of 12 ppb (n = 34; 21.3%, sensitivity was 90% (95%CI 79–95%, specificity 25% (95%CI 17–34%, PPV 40% (95%CI 32–50, NPV 81% (95%CI 64–91% when compared with a 20% fall of FEV1 after inhaling methacholine concentration ≤ 4 mg/ml. Three patients with unsuspicious spirometric results have to be tested with FENO to save one bronchial provocation test. Conclusion Asthma could be ruled in with FENO > 46 ppb. Mild and moderate to severe asthma could be ruled out with FENO ≤ 12 ppb. FENO measurement with

  5. The results of an Australian and New Zealand Survey on the current practice of chest immobilisation during radiation therapy

    International Nuclear Information System (INIS)

    To determine how widely chest immobilisation and 3D planning are currently being used, a survey was sent to each Chief Radiation Therapist of Australia (31) and New Zealand (6) in 2001. Questions were focused to radiation therapy practice when planning and treating patients with lung cancer with curative intent. There was a high response rate of 86 per cent (32/37) from the Radiation Oncology Departments of Australia (26/31) and New Zealand (6/6). 87.5 per cent (28/32) of departments use chest immobilisation (Australia, 22/26; New Zealand, 6/6) and of these, 82.1 per cent (23/28) use a 3D planning system. Furthermore, 78.6 per cent (22/28) practice conformal therapy. There are three main devices for chest immobilisation that are routinely used in Australia and one in New Zealand. The devices comprise: a) Personally contoured chest immobilisation (6/22) such as Vac Fix(Registered Trade Mark). This was the only device used in New Zealand. b) Adjustable chest immobilisation (7/22), consisting of movable shoulder and hand support such as Wing Board (Med-Tec(Registered Trade Mark)) or a device created in the department. c) A device comprised of (a) and (b), utilising the personalised contoured device and adjustable hand and shoulder supports (9/22). The results also showed that 65.6% (21/32) of users of chest immobilisation and no immobilisation reported satisfaction with the devices utilised in their department. Chest immobilisation was routinely used in 90.5% (19/21) of these departments. Copyright (2003) Australian Institute of Radiography

  6. Knowledge, attitudes, and practices concerning malaria in pregnancy: results from a qualitative study in Madang, Papua New Guinea.

    Directory of Open Access Journals (Sweden)

    Erin V W Andrew

    Full Text Available Malaria is the leading cause of illness and death in Papua New Guinea (PNG. Infection during pregnancy with falciparum or vivax malaria, as occurs in PNG, has health implications for mother and child, causing complications such as maternal anemia, low birth weight and miscarriage. This article explores knowledge, attitudes and practices concerning malaria during pregnancy and it's prevention in Madang, PNG, a high prevalence area.As part of a qualitative study in Madang, exploring MiP, participatory techniques (free-listing and sorting were conducted along with focus group discussions, in-depth interviews (with pregnant women, health staff and other community members and observations in the local community and health facilities.The main themes explored were attitudes towards and knowledge of MiP, its risks, and prevention. Although there was a general awareness of the term "malaria", it was often conflated with general sickness or with pregnancy-related symptoms. Moreover, many preventive methods for MiP were related to practices of general healthy living. Indeed, varied messages from health staff about the risks of MiP were observed. In addition to ideas about the seriousness and risk of MiP, other factors influenced the uptake of interventions: availability and perceived comfort of sleeping under insecticide-treated mosquito nets were important determinants of usage, and women's heavy workload influenced Chloroquine adherence.The non-specific symptoms of MiP and its resultant conflation with symptoms of pregnancy that are perceived as normal have implications for MiP prevention and control. However, in Madang, PNG, this was compounded by the inadequacy of health staff's message about MiP.

  7. Crossing New Uncharted Territory: Shifts in Academic Identity as a Result of Modifying Teaching Practice in Undergraduate Mathematics

    Science.gov (United States)

    Kensington-Miller, Barbara; Sneddon, Jamie; Stewart, Sepideh

    2014-01-01

    The changes in academic identity a teacher may undergo, as they modify their teaching practice, will vary depending on their experiences and the support they receive. In this paper, we describe the shifts in academic identity of two lecturers, a mathematician and a mathematics educator, as they both made changes to their teaching practice by…

  8. US Urban Elementary Teachers' Knowledge and Practices in Teaching Science to English Language Learners: Results from the first year of a professional development intervention

    Science.gov (United States)

    Santau, Alexandra O.; Secada, Walter; Maerten-Rivera, Jaime; Cone, Neporcha; Lee, Okhee

    2010-10-01

    The study examined US elementary teachers' knowledge and practices in four key domains of science instruction with English language learning (ELL) students. The four domains included: (1) teachers' knowledge of science content, (2) teaching practices to promote scientific understanding, (3) teaching practices to promote scientific inquiry, and (4) teaching practices to support English language development during science instruction. The study was part of a larger five-year research and development intervention aimed at promoting science and literacy achievement of ELL students in urban elementary schools. It involved 32 third grade, 21 fourth grade, and 17 fifth grade teachers participating in the first-year implementation of the intervention. Based on teachers' questionnaire responses and classroom observation ratings, results indicated that (1) teachers' knowledge and practices were within the bounds of acceptability but short of reform-oriented practices and (2) grade-level differences existed, especially between Grades 3 and 5.

  9. Assistant practitioners (APs) perceptions of their developing role and practice in radiography: Results from a national survey

    International Nuclear Information System (INIS)

    Introduction: In 2000, the NHS Plan set out the government's plans for investment and reform across the NHS. Through the introduction of a new workforce at assistant practitioner (AP) level the Department of Health intended to implement new ways in which to deliver a more efficient service. At the time, little published information existed on the integration of these assistants into the contemporary radiography workforce. Publications were limited to experiences gained by various individual departments ranging in their perception of the role and education of APs. Further research was suggested to track the continuing implementation of the 4-tier structure, establish the precise nature and scope of the roles across Trusts and determine their impact on workload and patient care. Aim: To establish the number and employment locality of APs in radiography professions in England, and to explore their scope of applied practice. Method and materials: The study was conducted over three phases and employed a mixed methods design to address the aims and objectives. Phase I was a scoping exercise performed prior to data collection in which n = 226 radiography sites were identified for contact across England. Phase II utilized a questionnaire as data collection tool to investigate the role of APs in radiography and explore how their roles were integrated into the radiography workforce in England. Results from phase III of the study which utilized semi-structured qualitative interviews are not included in this paper. Conclusion and discussion: Key findings depict the nature and variety of roles and responsibilities undertaken by APs in radiography. This study was the first of its kind to identify the integration of APs in radiography across a sizable geographical region. There were mixed responses to the question asking APs if they were required to perform duties outside their scope of practice. Questionnaire data revealed that a high numbers of APs were working in areas under

  10. 针刺、整脊疗法配合阿米替林治疗纤维肌痛综合征的临床研究%Clinical research of acupuncture, chiropractic therapy combined with amitriptyline in the treatment of fibromyalgia syndrome

    Institute of Scientific and Technical Information of China (English)

    陈柚杕

    2015-01-01

    目的:观察针刺、整脊疗法配合阿米替林治疗纤维肌痛综合征(FS)的临床疗效。方法42例纤维肌痛综合征患者,按就诊时间顺序分为治疗组(针刺、整脊疗法配合阿米替林治疗)和对照组(单纯用阿米替林治疗),各21例。比较两组治疗前后麦吉尔疼痛量表(MPQ)和汉密顿抑郁量表(HAMD)计分变化情况,并对两组的临床疗效进行评定。结果治疗后治疗组临床治疗效果及MPQ、HAMD计分均明显优于对照组,差异有统计学意义(P<0.01)。结论针刺、整脊疗法配合阿米替林是治疗纤维肌痛综合征的有效治疗方法,值得临床应用。%Objective To observe clinical effect of acupuncture, chiropractic therapy combined with amitriptyline in the treatment of fibromyalgia syndrome (FS). Methods A total of 42 fibromyalgia syndrome patients were divided by admission time into treatment group (acupuncture, chiropractic therapy combined with amitriptyline for treatment) and control group (amitriptyline alone for treatment), and each group contained 21 cases. Changes of McGill pain questionnaire (MPQ) and Hamilton depression scale (HAMD) were compared between the two groups before and after treatment, and clinical effects of the two groups were evaluated. Results The treatment group had obviously better clinical effect, MPQ and HAMD scores than the control group after treatment, and their difference had statistical significance (P<0.01). Conclusion It is effective for treating fibromyalgia syndrome by acupuncture, chiropractic therapy combined with amitriptyline. This method is worthy of clinical application.

  11. Applicability and generalisability of the results of systematic reviews to public health practice and policy: a systematic review

    Directory of Open Access Journals (Sweden)

    Dechartres Agnès

    2010-02-01

    Full Text Available Abstract Background The purpose of the study was to evaluate systematic reviews of research into two public health priorities, tobacco consumption and HIV infection, in terms of the reporting of data related to the applicability of trial results (i.e., whether the results of a trial can be reasonably applied or generalized to a definable group of patients in a particular setting in routine practice, also called external validity or generalisability. Methods All systematic reviews of interventions aimed at reducing or stopping tobacco use and treating or preventing HIV infection published in the Cochrane database of systematic reviews and in journals indexed in MEDLINE between January 1997 and December 2007 were selected. We used a standardized data abstraction form to extract data related to applicability in terms of the context of the trial, (country, centres, settings, participants (recruitment, inclusion and exclusion criteria, baseline characteristics of participants such as age, sex, ethnicity, coexisting diseases or co-morbidities, and socioeconomic status, treatment (duration, intensity/dose of treatment, timing and delivery format, and the outcomes assessment from selected reviews. Results A total of 98 systematic reviews were selected (57 Cochrane reviews and 41 non-Cochrane reviews; 49 evaluated interventions aimed at reducing or stopping tobacco use and 49 treating or preventing HIV infection. The setting of the individual studies was reported in 45 (46% of the systematic reviews, the number of centres in 21 (21%, and the country where the trial took place in 62 (63%. Inclusion and exclusion criteria of the included studies were reported in 16 (16% and 13 (13% of the reviews, respectively. Baseline characteristics of participants in the included studies were described in 59 (60% of the reviews. These characteristics concerned age in about half of the reviews, sex in 46 (47%, and ethnicity in 9 (9%. Applicability of results was

  12. Improvement in treatment results for hypopharyngeal cancer through the advance of treatment methods. The usefulness of team practice

    International Nuclear Information System (INIS)

    Treatment results were analyzed in 392 hypopharyngeal cancer patients who were radically treated at Kurume University Hospital between 1960 and 2003. In the analysis, they were divided into three chronological groups: the first consisting of 37 patients treated between 1960 and 1970, the second of 122 patients treated between 1971 and 1988, and the third of 233 patients treated between 1989 and 2003. The cause-specific 5-year survival rate for the second group was 38%. In contrast, the survival rate for the third group rose to 67%. The first choice of treatment for early hypopharyngeal cancer in the first and second groups was partial pharyngectomy. However, that of the third group was CO2 laser resection or radiotherapy followed by laser resection. The cause-specific 5-year survival rate with laser surgery was 86%. Over the years, the method of reconstruction after total resection for advanced hypopharyngeal cancer has changed. At present free jejunum reconstructive surgery after total pharyngo-laryngo-esophagectomy is considered to be a safe and most stable method, because it enables resection of the primary lesion with sufficient margin as required. Failure of reconstruction by jejunum graft was detected in only three of 137 patients (2%) who received total pharyngo-laryngo-esophagectomy. In patients who received free jejunum reconstructive surgery, the rate of cause of death tied to primary or metastatic lymph node decreased by resecting the primary lesion with sufficient margin as required, bilateral neck dissection, bilateral Rouviere and paratracheal neck dissection, and post-operative radiation. The findings indicate that treatment results for hypopharyngeal cancer improved dramatically by team practice involving a head and neck surgeon, surgeon, plastic surgeon and radiation oncologist. (author)

  13. Results of practical application of questionnaire to determine the level of dentophobia and dynamics in the doctor— patient relationship

    Directory of Open Access Journals (Sweden)

    Savina Е.А.

    2013-09-01

    Full Text Available Objective: to develop a questionnaire for assessing the level of dentophobia and dynamics of the relationship in the «doctor-patient» in the course of treatment and to conduct its clinical trials. Material and Methods. 90 patients aged 26-56 years with chronic generalized periodontitis have been examined. The research has been conducted by Hospital Anxiety and depression (HADS questionnaire to determine the level of dentophobia; psychophysiological testing was carried out on the hardware-software complex (APC «NS-Psychotest» (LLC «Neurosoft», Russia, Ivanovo, 2007. Clinical examination included examination of the mouth and the index of assessment of hard tissue of teeth and peri-odontal tissue: a defining simplified oral hygiene index (UIG, sulcus bleeding index (IR, gingival index (PMA. The survey was carried out before the treatment and 3 months after the treatment. Statistical analysis was performed in the program Statistica. Using non-parametric methods (Wilcoxon test, criterion A2, Spearman correlation coefficient. Statistically significant differences with p < 0,05 were considered. Results. The development of the questionnaire was carried out in accordance with all generally accepted standards. The initial testing was performed easily by patients. During the clinical trials visible results of the proposed questionnaire were obtained that proved its sensitivity to the changes in dental and psychological status of the oral cavity. Conclusion. The practical application of the questionnaire determines the level of dentophobia during the first visit. The data of the questionnaire identify the differentiated deontological approach. It improves the relationship with the patient, reduces his level of dentophobia. The reduced dentophobia promotes compliance and psychologically comfortable communication in the doctor-patient system, which also contributes to the prevention of emotional burn out among dentists.

  14. Translating Evidence-Based Falls Prevention into Clinical Practice in Nursing Facilities: Results and Lessons from a Quality Improvement Collaborative

    Science.gov (United States)

    Colón-Emeric, Cathleen; Schenck, Anna; Gorospe, Joel; McArdle, Jill; Dobson, Lee; DePorter, Cindy; McConnell, Eleanor

    2007-01-01

    OBJECTIVES To describe the changes in process of care before and after an evidence-based fall reduction quality improvement collaborative in nursing facilities. DESIGN Natural experiment with nonparticipating facilities serving as controls. SETTING Community nursing homes. PARTICIPANTS Thirty-six participating and 353 non-participating nursing facilities in North Carolina. INTERVENTION Two in-person learning sessions, monthly teleconferences, and an e-mail discussion list over 9 months. The change package emphasized screening, labeling, and risk-factor reduction. MEASUREMENTS Compliance was measured using facility self-report and chart abstraction (n = 832) before and after the intervention. Fall rates as measured using the Minimum Data Set (MDS) were compared with those of nonparticipating facilities as an exploratory outcome. RESULTS Self-reported compliance with screening, labeling, and risk-factor reduction approached 100%. Chart abstraction revealed only modest improvements in screening (51% to 68%, P<.05), risk-factor reduction (4% to 7%, P = .30), and medication assessment (2% to 6%, P = .34). There was a significant increase in vitamin D prescriptions (40% to 48%, P = .03) and decrease in sedative-hypnotics (19% to 12%, P = .04) but no change in benzodiazepine, neuroleptic, or calcium use. No significant changes in proportions of fallers or fall rates were observed according to chart abstraction (28.6% to 37.5%, P = .17), MDS (18.2% to 15.4%, P = .56), or self-report (6.1–5.6 falls/1,000 bed days, P = .31). CONCLUSON Multiple-risk-factor reduction tasks are infrequently implemented, whereas screening tasks appear more easily modifiable in a real-world setting. Substantial differences between self-reported practice and medical record documentation require that additional data sources be used to assess the change-in-care processes resulting from quality improvement programs. Interventions to improve interdisciplinary collaboration need to be developed. PMID

  15. Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2007-09-01

    Full Text Available Abstract Background In 1996 the guideline 'The Red Eye' was first published by the Dutch College of General Practitioners. The extent to which general practitioners adhere to this guideline is unclear. Recently, data on the management of infectious conjunctivitis by general practitioners became available from the Second Dutch National Survey of General Practice. We measured the age-specific incidence of infectious conjunctivitis, described its management by Dutch general practitioners, and then compared these findings with the recommendations made in the guideline. Methods In 2001, over a 12-month period, data from all patient contacts with 195 general practitioners were taken from electronic medical records. Registration was episode-oriented; all consultations dealing with the same health problem were grouped into disease episodes. Data concerning all episodes of infectious conjunctivitis (ICPC-code F70 and sub codes were analysed. Results Over one year, 5,213 new and recurrent episodes of infectious conjunctivitis were presented to general practitioners from a population of N = 375,899, resulting in an overall incidence rate of 13.9 per 1000 person-years, varying from more than 80/1000 py in children up to one-year old, to less than 12/1000 py in children over the age of 4. Topical ophthalmic ointments were prescribed in 87% of the episodes, of which 80% was antibiotic treatment. Fusidic acid gel was most frequently prescribed (69%. In most episodes general practitioners did not adhere to the guideline. Conclusion In 2001, the management of infectious conjunctivitis by Dutch general practitioners was not in accordance with the recommendations of the consensus-based guideline published five years previously, despite its wide distribution. In 2006 this guideline was revised. Its successful implementation requires more than distribution alone. Probably the most effective way to achieve this is by following a model for systemic implementation.

  16. Practice patterns of naturopathic physicians: results from a random survey of licensed practitioners in two US States

    OpenAIRE

    Smith Michael J; Cramer Elaine H; Booker Jennifer; Milliman Bruce; Sherman Karen J; Erro Janet; Cherkin Daniel C; Boon Heather S; Deyo Richard A; Eisenberg David M

    2004-01-01

    Abstract Background Despite the growing use of complementary and alternative medicine (CAM) by consumers in the U.S., little is known about the practice of CAM providers. The objective of this study was to describe and compare the practice patterns of naturopathic physicians in Washington State and Connecticut. Methods Telephone interviews were conducted with state-wide random samples of licensed naturopathic physicians and data were collected on consecutive patient visits in 1998 and 1999. T...

  17. [Reaching Target Groups--Shaping Accessibility. Results of a Survey Among Experts on Recommendations for Science and Practice].

    Science.gov (United States)

    Jahn, I; Gansefort, D; Lehmann, F; Walter, U; Brand, T

    2015-09-01

    In an online survey, in which 18 experts participated, recommendations for research and practice to improve access to target groups were discussed. The recommendations were developed within the context of the KNP project. For the implementation of the recommendations, not only is an increased cooperation between science and practice particularly important, but also materials and training as well as standardization of methods. Furthermore, financial resources, especially for conducting evaluation studies are needed. PMID:26406533

  18. Developmental issues in chiropractic: a South African practitioner and patient perspective

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Mouton, Johan

    2007-01-01

    health care practices as part of the education process and the concomitant perceived lack of exposure especially to black South Africans emerged as interesting and pertinent developmental themes in the local context. CONCLUSIONS: The international discourse related to issues in the domains of philosophy...

  19. Real-world treatment practice in patients with advanced melanoma in the era before ipilimumab: results from the IMAGE study.

    Science.gov (United States)

    Middleton, Mark R; Dalle, Stéphane; Claveau, Joel; Mut, Pilar; Hallmeyer, Sigrun; Plantin, Patrice; Highley, Martin; Kotapati, Srividya; Le, Trong Kim; Brokaw, Jane; Abernethy, Amy P

    2016-07-01

    The therapeutic landscape for advanced melanoma has recently been transformed by several novel agents (immune checkpoint inhibitors and molecular-targeted agents). The prospective, multi-site, observational study IMAGE (ipilimumab: management of advanced melanoma in real practice) included a retrospective cohort to describe real-world treatment prior to approval of the immune checkpoint inhibitor ipilimumab. This retrospective cohort of patients, who started second-line/subsequent treatment (index therapy) for advanced melanoma within 3 years before ipilimumab approval, was selected randomly by chart review. Collected data included treatment history, patient outcomes, and healthcare resource utilization. All patients had ≥1 year of follow-up data. This analysis included 177 patients from Europe (69%) and North America (31%). The most common index therapies (used alone or in combination) were fotemustine (23%), dacarbazine (21%), temozolomide (14%), and platinum-based chemotherapy (14%). Most patients (89%) discontinued index treatment during the study period; the most common reason was disease progression (59%). Among patients with tumor assessment (153/177; 86%), 2% had complete response, 5% had partial response, and 12% had stable disease on last tumor assessment. At 1-year study follow-up, median progression-free survival was 2.6 months (95% confidence interval [CI], 2.1-2.9) and median overall survival was 8.8 months (95% CI, 6.5-9.7). During follow-up, 95% of the patients had healthcare visits for advanced melanoma, 74% of whom were hospitalized or admitted to a hospice facility. These results provide insights into patient care with advanced melanoma in the era before ipilimumab and may serve as a benchmark for new agents in future real-world studies. PMID:27118102

  20. Forecasting the Effect of the Change in Timing of the ABR Diagnostic Radiology Examinations: Results of the ACR Survey of Practice Leaders.

    Science.gov (United States)

    Bluth, Edward I; Muroff, Lawrence R; Cernigliaro, Joseph G; Moore, Arl V; Smith, Geoffrey G; Flug, Jonathan; DeStigter, Kristen K; Allen, Bibb; Thorwarth, William T; Roberts, Anne C

    2015-05-01

    The results of a survey sent to practice leaders in the ACR Practice of Radiology Environment Database show that the majority of responding groups will continue to hire recently trained residents and fellows even though they have been unable to take the final ABR diagnostic radiology certifying examination. However, a significant minority of private practice groups will not hire these individuals. The majority of private practices expect the timing change for the ABR certifying examinations to affect their groups' function. In contrast, the majority of academic medical school practices expect little or no impact. Residents and fellows should not expect work time off or protected time to study for the certifying examination or for their maintenance of certification examinations in the future. PMID:25737379

  1. Exploring the gap between the practical and theoretical world of ERP implementations: results of a global survey.

    NARCIS (Netherlands)

    Catersels, R.; Helms, R.W.; Batenburg, R.

    2010-01-01

    This paper describes the differences between the theoretical world of ERP researchers and the practical world of ERP consultants. A survey was held among 129 ERP consultants to explore their opinion and experience with regard to a number of subjects that have been researched in many papers, such as

  2. Teaching Practice of Life Study Lesson of Classroom Teacher Candidates Analysis of the Results of Peer Assessment

    Science.gov (United States)

    Bektas, Mustafa

    2013-01-01

    The purpose of this study is to examine peer assessments that the classroom candidates applied at teaching practice on life study lesson. The cross sectional survey method which is one of the survey methods has been used in the research. In this study the sampling criteria, one of the purposive sampling methods, is used. Thus, in the fall semester…

  3. Do radiation oncologists practice evidence based medicine? Results of a survey of management of the axilla in operable breast cancer

    International Nuclear Information System (INIS)

    In 2002 the Radiation Oncology Expert Advisory Group (ROEAG) of the National Breast Cancer Centre (NBCC) and RANZCR Faculty of Radiation Oncology, posted a questionnaire to practicing radiation oncologists in Australia and New Zealand seeking information on a variety of practical issues in the radiation oncology treatment of women with operable breast cancer. The questionnaire aimed to evaluate the influence of the guidelines and discussion papers published in a resource for radiation oncologists and registrars by the NBCC in the preceding three years. This paper reports on the responses to the questions relating to management of the axilla . A discussion paper containing guidelines on management of the axilla was published in 2001. 102 responses were received (41% response rate) with 93% acknowledging receipt of the paper on management of the axilla. 74% of respondents stated that this paper was important or very important to their practice. Four questions investigating when radiation oncologists would irradiate the entire axilla following an axillary dissection were asked. While 100% of respondents would irradiate the axilla if the surgeon reported unresectable disease in the axilla, 56% of respondents would irradiate the axilla if the pathologist describes extra nodal spread in the report on the operative specimen. The paper 'Management of the Axilla' clearly states that there is no level I or II evidence to support axillary irradiation in patients with' breast cancer based solely on reported extra nodal spread. Factors influencing radiation oncologist's clinical practice will be briefly discussed, as well as the implications for changing practice in response to new clinical trial evidence

  4. Farmers' knowledge and perception of cotton pests and pest control practices in Benin: results of a diagnostic study

    OpenAIRE

    Sinzogan, A.A.C.; Huis, van, A.; Kossou, D.K.; Jiggins, J.L.S.; Vodouhè, S.

    2004-01-01

    Cotton production constraints in Benin as perceived by farmers were studied from May to July 2003. The knowledge, perceptions and practices of farmers growing cotton under different pest management regimes were analysed. The methods used were open and semi-structured interviews with groups and individuals, as well as participatory exercises (brainstorming, prioritization, and problem analysis). Pest damage, low price of produce, late payment for seed cotton, and increasing input costs were th...

  5. Exploring the gap between the practical and theoretical world of ERP implementations: results of a global survey.

    OpenAIRE

    Catersels, R.; Helms, R.W.; Batenburg, R.

    2010-01-01

    This paper describes the differences between the theoretical world of ERP researchers and the practical world of ERP consultants. A survey was held among 129 ERP consultants to explore their opinion and experience with regard to a number of subjects that have been researched in many papers, such as the use of ERP implementation methods, ERP phase models, critical success factors (CSF’s), and critical failure factors (CFF’s). A central question was to investigate the consultants’ use of scient...

  6. Main results of the Monte Carlo studies carried out for nuclear medicine practices within the ORAMED project

    International Nuclear Information System (INIS)

    The aim of ORAMED work package 4 was the optimization of the medical practices in nuclear medicine during the preparation of radiopharmaceuticals and their administration to the patient. During the project a wide campaign of measurements was performed in the nuclear medicine departments of the collaborating hospitals. Such data were intrinsically characterized by a large variability that depended on the procedure, the employed techniques and the operator’s habits. That variability could easily hide some important parameter, for example, the effectiveness of the adopted shielding (for syringe and vial) or the effect of the distances from the source. This information is necessary for a valuable optimization purpose of radiation protection. To this end a sensitivity analysis was carried out through Monte Carlo simulations employing voxel models, representing operator’s hand during the considered practices. Such analysis allowed understanding at what extent the range of personal dose equivalent evaluated during measurements can be considered intrinsically related to the procedures. Furthermore, with the Monte Carlo simulations it was possible to study the appropriateness of the shielding usually utilized in these practices. -- Highlights: ► Radiation protection optimization in nuclear medicine for medical staff was the aim. ► Measurements in hospitals were coupled with simulations through hand voxel models. ► 99mTc, 18F and 18Y, shielding and various hand configurations were considered. ► The calculations proved the range of the intrinsic variability of the measurements. ► The simulations showed that optimization is achievable with simple changes in habits.

  7. Practices and trends of telework in the Portuguese industry: the results of surveys in the textile, metal and software sectors

    OpenAIRE

    Urze, Paula; Moniz, António; Barroso, Sónia

    2003-01-01

    The aim of the TeleRisk Project on labour relations and professional risks within the context of teleworking in Portugal – supported by IDICT – Institute for Development and Inspection of Working Conditions (Ministry of Labour), is to study the practices and forms of teleworking in the manufacturing sectors in Portugal. The project chose also the software industry as a reference sector, even though it does not intend to exclude from the study any other sector of activity or the so-called “hyb...

  8. Infant feeding practices at routine PMTCT sites, South Africa: results of a prospective observational study amongst HIV exposed and unexposed infants - birth to 9 months

    Directory of Open Access Journals (Sweden)

    Goga Ameena E

    2012-04-01

    Full Text Available Abstract Background We sought to investigate infant feeding practices amongst HIV-positive and -negative mothers (0-9 months postpartum and describe the association between infant feeding practices and HIV-free survival. Methods Infant feeding data from a prospective observational cohort study conducted at three (of 18 purposively-selected routine South African PMTCT sites, 2002-2003, were analysed. Infant feeding data (previous 4 days were gathered during home visits at 3, 5, 7, 9, 12, 16, 20, 24, 28, 32 and 36 weeks postpartum. Four feeding groups were of interest, namely exclusive breastfeeding, mixed breastfeeding, exclusive formula feeding and mixed formula feeding. Cox proportional hazards models were fitted to investigate associations between feeding practices (0-12 weeks and infant HIV-free survival. Results Six hundred and sixty five HIV-positive and 218 HIV-negative women were recruited antenatally and followed-up until 36 weeks postpartum. Amongst mothers who breastfed between 3 weeks and 6 months postpartum, significantly more HIV-positive mothers practiced exclusive breastfeeding compared with HIV-negative: at 3 weeks 130 (42% versus 33 (17% (p Conclusions Although feeding practices were poor amongst HIV-positive and -negative mothers, HIV-positive mothers undertake safer infant feeding practices, possibly due to counseling provided through the routine PMTCT programme. The data on differences in infant outcome by feeding practice and site validate the WHO 2009 recommendations that site differences should guide feeding practices amongst HIV-positive mothers. Strong interventions are needed to promote exclusive breastfeeding (to 6 months with continued breastfeeding thereafter amongst HIV-negative motherswho are still the majority of mothers even in high HIV prevalence setting like South Africa.

  9. Reanalysis of two studies with contrasting results on the association between statin use and fracture risk : the General Practice Research Database

    NARCIS (Netherlands)

    de Vries, Frank; de Vries, Corinne; Cooper, Cyrus; Leufkens, Bert; van Staa, Tjeerd-Pieter

    2006-01-01

    BACKGROUND: Two recent case-control studies by Meier et al. and van Staa et al. used the UK General Practice Research Database (GPRD) to examine the association between the use of statins and the risk of fractures, with different results. The objective of the present study was to examine methodologi

  10. A Retrospective Analysis of the Cultural Competence of Chiropractic Students in a Public Health Course

    OpenAIRE

    Khauv, Kim B.; Alcantara, Joel

    2012-01-01

    Purpose: Diverse communities require chiropractors to be culturally competent to serve diverse populations. The purpose of this analysis is to describe the effect on knowledge and confidence to serve diverse populations following 6 hours of cultural competency training. Methods: Using a quasi-experimental one-group design, a paired t-test using a 40-item questionnaire to assess knowledge and a 15-item questionnaire to rate confidence was used for the stated purpose. Results: A total of 45 stu...

  11. Best Practices in Grid Integration of Variable Wind Power: Summary of Recent US Case Study Results and Mitigation Measures

    Energy Technology Data Exchange (ETDEWEB)

    Smith, J. Charles [Utility Wind Integration Group (UWIG), Reston, VA (United States); Parsons, Brian [National Renewable Energy Lab. (NREL), Golden, CO (United States); Acker, Thomas [Northern Arizona Univ., Flagstaff, AZ (United States); Milligan, Michael [National Renewable Energy Lab. (NREL), Golden, CO (United States); Zavidil, Robert [EnerNex Corporation, Knoxville, TN (United States); Schuerger, Matthew [Energy Systems Consulting Services, St. Paul, MN (United States); DeMeo, Edgar [Renewable Energy Consulting Services, Palo Alto, CA (United States)

    2010-01-22

    This paper will summarize results from a number of utility wind integration case studies conducted recently in the US, and outline a number of mitigation measures based on insights from those studies.

  12. Characterisation of patients receiving moxifloxacin for acute bacterial rhinosinusitis in clinical practice: results from an international, observational cohort study.

    Directory of Open Access Journals (Sweden)

    Ralph Mösges

    Full Text Available We conducted a prospective, non-controlled, multi-centre Phase IV observational cohort study of patients with acute bacterial rhinosinusitis who were treated with moxifloxacin in clinical practice in 19 countries in Asia Pacific, Europe and the Middle East. With the data collected we evaluated the presentation and course of the current disease episode, particularly in terms of the principal clinical signs and symptoms of acute rhinosinusitis and diagnostic procedures. A final assessment of moxifloxacin therapy was made to evaluate the impact of the sinusitis episode on activities of daily life and on sleep disturbance, and to evaluate the clinical outcome of treatment. A total of 7,090 patients were enrolled, of whom 3909 (57.6% were included in the valid for clinical outcome and safety population. Regional differences were observed in the main symptoms of acute rhinosinusitis and, according to several characteristics, disease episodes appeared to be more severe in patients in Europe than in the Asia Pacific or Middle East regions. The sinusitis episode impacted on daily living for mean (SD periods of 3.6 (3.2, 4.6 (3.9 and 3.1 (3.0 days and disturbed sleep for 3.6 (3.2, 4.6 (3.9 and 3.1 (3.0 nights in the Asia Pacific, Europe and Middle East regions, respectively. With moxifloxacin treatment, the mean (SD time to improvement of symptoms was 3.0 (1.5, 3.4 (1.6 and 3.2 (1.5 days, and the time to resolution of symptoms was 4.8 (2.6 days, 5.7 (2.4 days and 5.5 (2.5 days, in the Asia Pacific, Europe and Middle East regions, respectively. In conclusion, acute rhinosinusitis remains a substantial health burden with significant impact on patients' quality of life, and there are differences between global regions in the clinical presentation, diagnosis and clinical course of disease episodes. Moxifloxacin was an effective and well-tolerated treatment option in the overall population.ClinicalTrials.gov Identifier: NCT00930488.

  13. Review of the results of routine radiation protection surveys of radiography-only diagnostic x-ray machines, February 1987-May 1991

    International Nuclear Information System (INIS)

    The results are given of routine radiation protection surveys performed during the period February 1987-May 1991 by National Radiation Laboratory (NRL) health physicists on 432 radiography-only x-ray machines used in medical diagnosis and 92 used in chiropractic diagnosis. Compliance was high with the more explicit radiation protection requirements of the NRL codes of safe practice for the use of x-rays in diagnosis, viz, x-ray beam filtration, timer function, x-ray tube leakage, protective barrier and x-ray room shieldings. However, for those aspects of the codes dealing with x-ray machine performance there were less satisfactory results. While compliance for reproducibility of radiation output was >99%, it fell to 91% for accuracy of exposure timers, to 84% for linearity of x-ray output with adjacent mA and mAs settings, and from 70% for kilovoltage calibrations of multi-pulse x-ray machines to 54% for kilovoltage calibrations of 1- and 2- pulse machines. (author). 24 refs., 15 tabs., 5 figs

  14. Influence of FGR complexity modelling on the practical results in gas pressure calculation of selected fuel elements from Dukovany NPP

    International Nuclear Information System (INIS)

    A modernization fuel system and advanced fuel for operation up to the high burnup are used in present time in Dukovany NPP. Reloading of the cores are evaluated using computer codes for thermomechanical behavior of the most loaded fuel rods. The paper presents results of parametric calculations performed by the NRI Rez integral code PIN, version 2000 (PIN2k) to assess influence of fission gas release modelling complexity on achieved results. The representative Dukovany NPP fuel rod irradiation history data are used and two cases of fuel parameter variables (soft and hard) are chosen for the comparison. Involved FGR models where the GASREL diffusion model developed in the NRI Rez plc and standard Weisman model that is recommended in the previous version of the PIN integral code. FGR calculation by PIN2k with GASREL model represents more realistic results than standard Weisman's model. Results for linear power, fuel centre temperature, FGR and gas pressure versus burnup are given for two fuel rods

  15. Chiropractic manipulation in pediatric health conditions – an updated systematic review

    Directory of Open Access Journals (Sweden)

    Gotlib Allan

    2008-09-01

    Full Text Available Abstract Objective Our purpose was to review the biomedical literature from January 2004 to June 2007 inclusive to determine the extent of new evidence related to the therapeutic application of manipulation for pediatric health conditions. This updates a previous systematic review published in 2005. No critical appraisal of the evidence is undertaken. Data Sources We searched both the indexed and non-indexed biomedical manual therapy literature. This included PubMed, MANTIS, CINAHL, ICL, as well as reference tracking. Other resources included the Cochrane Library, CCOHTA, PEDro, WHO ICTRP, AMED, EMBASE and AHRQ databases, as well as research conferences and symposium proceedings. Results The search identified 1275 citations of which 57 discrete citations met the eligibility criteria determined by three reviewers who then determined by consensus, each citation's appropriate level on the strength of evidence scale. The new evidence from the relevant time period was 1 systematic review, 1 RCT, 2 observational studies, 36 descriptive case studies and 17 conference abstracts. When this additional evidence is combined with the previous systematic review undertaken up to 2003, there are now in total, 2 systematic reviews, 10 RCT's, 3 observational studies, 177 descriptive studies, and 31 conference abstracts defining this body of knowledge. Summary There has been no substantive shift in this body of knowledge during the past 3 1/2 years. The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric health conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions. The evidence rests primarily with clinical experience, descriptive case studies and very few observational and experimental studies. The health interests of pediatric patients would be advanced if more rigorous scientific

  16. Proceedings of the joint CEC OECD IAEA specialists meeting on non-destructive examination - Practice and results

    International Nuclear Information System (INIS)

    This meeting was organized to be an international forum for discussion of recent application results and of utility experience with non-destructive methods used for the inspection of steel components and weldments; it was also the closing meeting of the Round Robin Tests phase of PISC III (Programme for the Inspection of Steel Components). Lessons learned, data base available and first results were presented and discussed in view of further detailed analysis of all the information generated by that programme. The meeting addressed, in terms of the state of art, the capability and reliability of NDT procedures applied to the major nuclear reactor components. Special emphasis was placed on NDE techniques to detect and size flaws in order to assure structural integrity during plant design life or beyond. Related topics included qualification with emphasis on performance demonstration and application of NDT in plant life management

  17. Sustainable permaculture systems demonstration in the high mountain desert region of New Mexico -- results of three years practice

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, V. [EarthLink, Santa Fe, NM (United States)

    1995-11-01

    This paper reports on three years of results in the Permaculture restoration of a mountain drylands ranch outside Santa Fe, New Mexico which receives less than 11 inches rainfall/year. Dramatic results have been produced in the areas of erosion control, pastureland restoration, wild species propagation, aquaculture, riparian zone (wetland) restoration, edible landscape design and installation methodologies. Additionally, significant work has been performed in the area of youth education and community development. Current work includes a grant-financed (US Fish and Wildlife Service ``Partners for Wildlife`` Program) replanting and redevelopment of the entire riparian zone of the ranch and the design and development of a trout-spawning pond system that is self contained and self-purifying, with circulation through a structured wetland provided by a photovoltaic pumping system. This paper presents the design philosophy, overall design strategy and significant details of specific strategies, projects, and systems.

  18. Sustainable Permaculture systems demonstration in the high mountain desert region of New Mexico -- results of five years practice

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, V. [Apache Creek Ranch, Santa Fe, NM (United States)

    1997-12-31

    This paper reports on five years of results in the Permaculture restoration of a mountain drylands ranch outside Santa Fe, New Mexico. Dramatic results have been produced in the areas of erosion control, pastureland restoration, wild species propagation, aquaculture, riparian zone (wetland) restoration, edible landscape design and installation methodologies. Recently completed work includes a grant-financed (US Fish and Wildlife Service Partners for Wildlife Program) replanting and redevelopment of the entire riparian zone of the ranch and the design and development of a trout-spawning pond system that is self contained and self-purifying, with circulation through a structured wetland provided by a photovoltaic pumping system. The paper presents the design philosophy, overall design strategy and significant details of specific strategies, projects, and systems.

  19. Current practice vs. guideline based imaging in abdominal radiology in the German speaking area. Results of an online survey

    International Nuclear Information System (INIS)

    The working group for abdominal imaging within the German Roentgen Society (DRG) performed an online survey amongst radiologist concerning the current status of techniques for abdominal imaging. The results of this survey were compared with the most recent guidelines. We performed an online survey open for all members of the DRG during a 76-day period with 65 questions and an overall estimated time for finishing the questionnaire of 15 minutes concerning technical specifications for abdominal radiological imaging. The results were evaluated using descriptive statistics. 90 of all participants, who filled out the survey covering more than 80 % of the questions, were included in the statistical evaluation. 27 % of all participants were registered radiologists while 73 % represented radiologists working in a hospital. Most participants worked in a managerial position. The participants gave detailed information regarding the radiological techniques used in dedicated organ systems (esophagus, stomach, pancreas, liver, small intestines, colon) regarding acquired contrast phases and oral and intravenous administration of contrast medium. The results confirm that most radiologists participating in this survey perform their examinations and choose their modalities in conformity with the current existing clinical guidelines. Because most clinical guidelines do not specify radiological examinations in detail, there is a noteworthy heterogeneity of the acquired contrast phases and major divergence in terms of technical parameters. Therefore a joint radiological effort should be initiated for developing and publishing updated radiological parameters for abdominal imaging.

  20. Risk-Based Immunization Policies and Tuberculosis Screening Practices for Animal Care and Research Workers in the United States: Survey Results and Recommendations

    OpenAIRE

    Weigler, Benjamin J; Cooper, Donna R; Hankenson, F Claire

    2012-01-01

    A national survey was conducted to assess immunization practices and tuberculosis screening methods for animal care and research workers in biomedical settings throughout the United States. Veterinarians (n = 953) were surveyed via a web-based mechanism; completed surveys (n = 308) were analyzed. Results showed that occupational health and safety programs were well-developed, enrolling veterinary, husbandry, and research staff at rates exceeding 90% and involving multiple modalities of health...

  1. Morbidity and health-care use of people with intellectual disabilities in general practice: first results of a survey in the Netherlands.

    OpenAIRE

    Schrojenstein Lantman-de Valk, H.J.M. van; Wierik, M.J.M. te; Akker, M. van den; Wullink, M.; Schellevis, F.G.; Dinant, G. J.; Metsemakers, J. F. M.

    2004-01-01

    Reported here are the preliminary results of the second Dutch National Survey of General Practice in which data were collected on all contacts with general practitioners (GPs) during a 12-month period to determine characteristics of patients with intellectual disabilities (ID). Sociodemographic characteristics differed significantly between people with ID and controls, indicating significant differences in morbidity between the two groups (people with ID were found to have more psychological ...

  2. Practical measuring system for the ambient equivalent dose rate by PSF driven by USB and its actual results

    International Nuclear Information System (INIS)

    This paper describes the detailed system in the title developed, and results obtained by its actual application to a contaminated region around Fukushima prefecture. The system is driven by USB, measures the linear distribution of the dose with plastic scintillation fiber (PSF), by parallel moving of which, the plane distribution of the dose can be measurable. The system is composed from 4 components of the radio-sensor PSF, photon detectors, pulse processor where the photon signal is converted to position information with time-of-flight principle, and display on PC. Three kinds of exchangeable PSF (length 20 m) with different bundle numbers (12, 7 and 1) are prepared to measure the low, middle and high dose levels of radiation, respectively, and each is rigidified by insertion in the individual metal flexible tube. The processor can convert the count rate to dose rate with linearity corrected by 137Cs gamma source; e.g., for the low dose rate, 0.1-10 mcSv, linearity is confirmed. The processor has 3 cables and 550 g weight in contrast to the ordinary machine's 12 cables and 20 kg. PSF and processor are waterproof for outdoor use. A software for mapping the measured results is also developed for color display. Mapping results of the application of the system to 80 m x 60 m site around a public hall and the swimming pool of a primary school are quite persuasive before and after de-contamination work like disappearance of hot spots after the work, and suggestive of its usefulness in dealing with the Fukushima contamination problems. (T.T.)

  3. MODARIA WG5: Towards a practical guidance for including uncertainties in the results of dose assessment of routine releases

    Energy Technology Data Exchange (ETDEWEB)

    Mora, Juan C. [Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas - CIEMAT (Spain); Telleria, Diego [International Atomic Energy Agency - IAEA (Austria); Al Neaimi, Ahmed [Emirates Nuclear Energy Corporation - ENEC (United Arab Emirates); Blixt Buhr, Anna Ma [Vattenfall AB (Sweden); Bonchuk, Iurii [Radiation Protection Institute - RPI (Ukraine); Chouhan, Sohan [Atomic Energy of Canada Limited - AECL (Canada); Chyly, Pavol [SE-VYZ (Slovakia); Curti, Adriana R. [Autoridad Regulatoria Nuclear - ARN (Argentina); Da Costa, Dejanira [Instituto de Radioprotecao e Dosimetria - IRD (Brazil); Duran, Juraj [VUJE Inc (Slovakia); Galeriu, Dan [Horia Hulubei National Institute of Physics and Nuclear Engineering - IFIN-HH (Romania); Haegg, Ann- Christin; Lager, Charlotte [Swedish Radiation Safety Authority - SSM (Sweden); Heling, Rudie [Nuclear Research and Consultancy Group - NRG (Netherlands); Ivanis, Goran; Shen, Jige [Ecometrix Incorporated (Canada); Iosjpe, Mikhail [Norwegian Radiation Protection Authority - NRPA (Norway); Krajewski, Pawel M. [Central Laboratory for Radiological Protection - CLOR (Poland); Marang, Laura; Vermorel, Fabien [Electricite de France - EdF (France); Mourlon, Christophe [Institut de Radioprotection et de Surete Nucleaire - IRSN (France); Perez, Fabricio F. [Belgian Nuclear Research Centre - SCK (Belgium); Woodruffe, Andrew [Federal Authority for Nuclear Regulation - FANR (United Arab Emirates); Zorko, Benjamin [Jozef Stefan Institute (Slovenia)

    2014-07-01

    MODARIA (Modelling and Data for Radiological Impact Assessments) project was launched in 2012 with the aim of improving the capabilities in radiation dose assessment by means of acquisition of improved data for model testing, model testing and comparison, reaching consensus on modelling philosophies, approaches and parameter values, development of improved methods and exchange of information. The project focuses on areas where uncertainties remain in the predictive capability of environmental models, emphasizing in reducing associated uncertainties or developing new approaches to strengthen the evaluation of the radiological impact. Within MODARIA, four main areas were defined, one of them devoted to Uncertainty and Variability. In this area four working groups were included, Working Group 5 dealing with the 'uncertainty and variability analysis for assessments of radiological impacts arising from routine discharges of radionuclides'. Whether doses are estimated by using measurement data, by applying models, or through a combination of measurements and calculations, the variability and uncertainty contribute to a distribution of possible values. The degree of variability and uncertainty is represented by the shape and extent of that distribution. The main objective of WG5 is to explore how to consider uncertainties and variabilities in the results of assessment of doses in planned situations for controlling the impact of routine releases from radioactive and nuclear installations to the environment. The final aim is to produce guidance for the calculation of uncertainties in these exposure situations and for the presentation of such results to the different stakeholders. To achieve that objective the main tasks identified were: to find tools and methods for uncertainty and variability analysis applicable to dose assessments in routine radioactive discharges, to define scenarios where information on uncertainty and variability of parameters is available

  4. Assessing Rates of Inadequate Feeding Practices Among Children 12-24 months: Results from a Cross-Sectional Survey in Myanmar.

    Science.gov (United States)

    Thet, May Me; Richards, Leah-Mari; Sudhinaraset, May; Paw, Naw Eh Thi; Diamond-Smith, Nadia

    2016-08-01

    Objectives To ensure proper nutrition and optimal health outcomes, it is critical that infants are exclusively breastfed (0-6 months) and then receive adequate feeding from 6-23 months (breastfeeding and frequent feedings of complementary foods). Despite policies and guidelines on adequate feeding in Myanmar, past research has found low rates of adequately fed infants 0-11 months and little is known about the adequacy of feeding practices for children 12-23 months. The aim of this study is to understand the feeding practices of children aged 0-24 months in Myanmar and maternal characteristics associated with adequate feeding practices. Methods This study examines the rates of adequately fed infants and young children (0-23 months) in hard-to-reach townships in Myanmar from a cross-sectional, multistage cluster survey. Survey data on nutritional practices were collected from 489 mothers. Data were analyzed using multivariate regressions. Results We found that 41.8 % of infants under 6 months were exclusively breastfed, 63.2 % of those aged 6-11 months were adequately fed, and 10.3 % of 12-23 month-olds were adequately fed. In multivariate regressions we found that antenatal care visits [1-4 visits, AOR = 6.59 (p 4 visits, AOR = 6.63 (p breastfeeding for under 6 month old infants. Having >4 antenatal care visits [AOR = 9.97 (p < 0.05)] was associated with adequate feeding for 6-11 months old infants. Conclusions Future nutritional interventions and policies should focus on improving messaging about adequate feeding practices, especially for 12-23 months olds. PMID:27003151

  5. Your First Chiropractic Visit

    Science.gov (United States)

    ... examination procedures such as blood pres- sure, pulse, respiration, and temperature, the examina- tion will include specific ... heat, trac- tion, soft-tissue massage, and rehabilitative exercises, may also be used. When Will I Feel ...

  6. Chiropractic: An Introduction

    Science.gov (United States)

    ... Events Multimedia (Video, Images, and Audio) NCCIH Clinical Digest A monthly newsletter with evidence-based information on ... require a viewer such as the free Adobe Reader . NCCIH Pub No.: D403 Date Created: November 2007 ...

  7. In vivo EPR dosimetry of accidental exposures to radiation: experimental results indicating the feasibility of practical use in human subjects

    International Nuclear Information System (INIS)

    Low frequency electron paramagnetic resonance (EPR) provides the potential advantage of making accurate and sensitive measurements of absorbed radiation dose in teeth in situ, i.e. without removing the teeth from the potential victim. The potential limiting factors for making such measurements are: (1) whether low frequency EPR is sufficiently sensitive to detect radiation-induced signal in human teeth; (2) whether sufficient sensitivity can be maintained under in vivo conditions. In this manuscript, we summarize results indicating that this approach is feasible. Using 1.2 GHz EPR spectroscopy, we found that the lower limit for these measurements in isolated human teeth is 0.2 Gy or lower. Measurements of radiation-induced EPR signals in the teeth of living rats were achieved with sufficient sensitivity to indicate that, when taking into consideration the larger mass of human teeth, similar measurements in human teeth in situ would provide sensitivity in the dose range for potential accidental exposures. We estimate that the current lower limit for detecting radiation doses in human teeth in situ (in vivo) is 0.5-1.0 Gy; this would be sufficient for determining if a person has been exposed to potentially life threatening doses of ionizing radiation. The limiting factor for sensitivity appears to be background signals rather than signal/noise, and there are feasible means to overcome this problem and further increase sensitivity. The additional instrumental developments required to make an effective in vivo EPR dosimetric spectrometer for the measurements in teeth in human subjects in situ, seem quite achievable

  8. Alcohol consumption in patients with cardiovascular diseases (results of the survey of cardiac patients in outpatient practice

    Directory of Open Access Journals (Sweden)

    O. D. Ostroumova

    2015-12-01

    Full Text Available Aim. To study the frequency and characteristics of alcohol use in outpatients with cardiovascular diseases and to determine their preferences regarding the help in limiting alcohol consumption.Material and methods. Voluntary and anonymous survey using AUDIT-C and CAGE questionnaires was conducted in 199 patients. The data of 182 patients (82 women and 100 men, mean age 56.4±5.8 years was included in the analysis.Results. Arterial hypertension (70%, heart rhythm disorders (25%, ischemic heart disease (20%, functional class I-II chronic heart failure (21% predominated among all clinical entities. Positive AUDIT-C test was found in 30% of men and 7.3% of women. 17% of men and 23.2% of women did not use alcohol at all. Positive responses to all 4 questions of the CAGE test were given by 3% of men and none of women, positive answers to 3 questions – by 15% of men and none of women, to 2 questions - by 17% of men and 11% of women. Positive answer to the question about the need to reduce alcohol consumption was given by 36% of men and 13.4% of women.Conclusion. Simultaneous testing using AUDIT-C and CAGE questionnaires in outpatients with cardiovascular diseases allows identifying a subgroup of patients (more in men who have a potential problem with an excessive alcohol consumption and need to reduce the intake of alcoholic beverages.

  9. Imparting carrier status results detected by universal newborn screening for sickle cell and cystic fibrosis in England: a qualitative study of current practice and policy challenges

    Directory of Open Access Journals (Sweden)

    Ulph Fiona

    2007-12-01

    Full Text Available Abstract Background Universal newborn screening for early detection of children affected by sickle cell disorders and cystic fibrosis is currently being implemented across England. Parents of infants identified as carriers of these disorders must also be informed of their baby's result. However there is a lack of evidence for most effective practice internationally when doing so. This study describes current or proposed models for imparting this information in practice and explores associated challenges for policy. Methods Thematic analysis of semi-structured interviews with Child Health Coordinators from all English Health Regions. Results Diverse methods for imparting carrier results, both within and between regions, and within and between conditions, were being implemented or planned. Models ranged from result by letter to in-person communication during a home visit. Non-specialists were considered the best placed professionals to give results and a similar approach for both conditions was emphasised. While national guidance has influenced choice of models, other factors contributed such as existing service structures and lack of funding. Challenges included uncertainty about guidance specifying face to face notification; how best to balance allaying parental anxiety by using familiar non-specialist health professionals with concerns about practitioner competence; and extent of information parents should be given. Inadequate consideration of resource and service workload was seen as the main policy obstacle. Clarification of existing guidance; more specific protocols to ensure consistent countrywide practice; integration of the two programmes; and 'normalising' carrier status were suggested as improvements. Conclusion Differing models for communicating carrier results raise concerns about equity and clinical governance. However, this variation provides opportunity for evaluation. Timely and more detailed guidance on protocols with

  10. The state-of-the-practice in low enriched UF6 isotopic measurements in the European Community: results of REIMEP UF6

    International Nuclear Information System (INIS)

    After the interruption of the SALE programme, CBNM has established a Regular European Interlaboratory Measurement Evaluation Programme (REIMEP) with the support of the ESARDA Working Group for techniques and standards for destructive analysis (WGDA), the ESARDA Working Group for techniques and standards for non-destructive analysis (WGNDA) and the IAEA. On the basis of a questionnaire with answers from 41 laboratories, 36 laboratories have announced their interest for such a programme. In this paper we report on the 1986/87 round of the programme establishing the measurement capability or State Of the Practice in UF6 isotopic measurements by methods left at the discretion of the participants (thermal ionization mass spectrometry, electron impact mass spectrometry and gamma-ray spectrometry). Pictures of the State Of the Practice are presented as graphs displaying participants results

  11. Decreased management of genital warts in young women in Australian general practice post introduction of national HPV vaccination program: results from a nationally representative cross-sectional general practice study.

    Directory of Open Access Journals (Sweden)

    Christopher Harrison

    Full Text Available OBJECTIVES: Since the introduction of Australia's human papillomavirus vaccination program, the management rate of genital warts in sexual health clinics and private hospitals has decreased in women of vaccine-eligible age. However, most genital warts in Australia are managed in general practice. This study examines whether a similar decrease occurred in Australian general practice after the introduction of the program. METHODS: Analysis of a nationally representative cross-sectional database of Australian general practice activity (1,175,879 patient encounters with 11,780 general practitioners. Genital warts management rates were estimated for the periods before and after introduction of the program (Pre-program, July 2002-June 2006; Post-program, July 2008-June 2012. Control conditions included genital herpes and gardnerella/bacterial vaginosis in female patients and genital herpes and urethritis in male patients. Trends in management rates by year, pre-vaccine (July 2000-June 2007 and post-vaccine (July 2007-June 2012 were also calculated. RESULTS: Management rate of genital warts among women potentially covered by program (aged 15-27 years decreased by 61% from 4.33 per 1,000 encounters in the Pre-program period to 1.67 in the Post-program period. Trend analysis of the post-vaccine period showed, among women of vaccine eligible age, a significant year-on-year reduction in the rate of genital warts management (p<0.0001 and a significant increase in the management rate of control conditions per year (p<0.0001. For all other age-sex groups there was no significant change in the management rate of genital warts between the Pre- and Post-program periods. CONCLUSION: The large decrease in general practice management of genital warts in women of vaccine-eligible age highlights the success of the program in the wider community.

  12. Low Back Pain in Primary Care

    DEFF Research Database (Denmark)

    Hestbæk, Lise; Munck, Anders; Hartvigsen, Lisbeth;

    2014-01-01

    Study Design. Baseline description of a multicenter cohort study. Objective. To describe patients with low back pain (LBP) in both chiropractic and general practice in Denmark. Background. To optimize standards of care in the primary healthcare sector, detailed knowledge of the patient populations...... in different settings is needed. In Denmark, most LBP-patients access primary healthcare through chiropractic or general practice. Methods. Chiropractors and general practitioners recruited adult patients seeking care for LBP. Extensive baseline questionnaires were obtained and descriptive analyses presented...... separately for general and chiropractic practice patients, Mann-Whitney rank sum test and Pearson's chi-square test, were used to test for differences between the two populations. Results. Questionnaires were returned from 934 patients in chiropractic practice and 319 patients from general practice. Four out...

  13. Effects of psychosocial stimulation on improving home environment and child-rearing practices: results from a community-based trial among severely malnourished children in Bangladesh

    Directory of Open Access Journals (Sweden)

    Nahar Baitun

    2012-08-01

    Full Text Available Abstract Background Parenting programmes are effective in enhancing parenting practices and child development. This study evaluated the effects of a intervention with psychosocial stimulation (PS on the quality of the home environment and mothers’ child-rearing practices in a community-based trial with severely malnourished Bangladeshi children. Method Severely underweight children (n = 507, 6–24 months of age, were randomly assigned to five groups: PS; food supplementation (FS; PS + FS; clinic-control (CC; and, hospital-control (CH. PS included fortnightly follow-up visits for six months at community clinics where a play leader demonstrated play activities and gave education on child development and child rearing practices. FS comprised cereal-based supplements (150–300 kcal/day for three months. All groups received medical care, micronutrient supplements and growth monitoring. Mothers were given the Home Observation for Measurement of the Environment (HOME inventory and a questionnaire on parenting at baseline and after six months to assess the outcome. Results 322 children completed the study. After six months of intervention the PS + FS and PS groups benefitted in the total HOME score (depending on the comparison group, effect sizes varied from 0.66 to 0.33 SD The PS + FS and PS groups also benefitted in two HOME subscales: maternal involvement (effect sizes: 0.8 to 0.55 SD and play materials, (effect sizes: 0.46 to 0.6 SD, and child-rearing practices scores (effect size: 1.5 to 1.1 SD. The PS + FS group benefitted 4.0 points in total HOME score compared with CH, 4.8 points compared with CC and 4.5 points compared with FS (p  Conclusions Child-rearing practices of mothers of severely malnourished children and the quality of their home environment can be improved through community-based psychosocial stimulation with or without food supplementation. This may be of importance to promote child development.

  14. Patients with Postpartum Depression in Gynaecological Practices in Germany – Results of a Representative Survey of Local Gynaecologists about Diagnosis and Management

    Science.gov (United States)

    Pawils, S.; Metzner, F.; Wendt, C.; Raus, S.; Shedden-Mora, M.; Wlodarczyk, O.; Härter, M.

    2016-01-01

    Theoretical Background and Current Issues: For the sake of pre-emptive child protection it is necessary to recognise signs of postpartum depression (PPD) in pregnant women and young mothers as early as possible and to initiate adequate assistance. Because of their high acceptance, especially in the phases of pregnancy and birth, the local gynaecologists offer ideal prerequisites for access to the parents. This study evaluates the current status of diagnosis and management of PPD in gynaecological practices. Material and Methods: In a representative German nation-wide questionnaire survey taking the regional distribution into account n = 3000 local gynaecologists were selected at random and contacted by post. The questionnaire addressed their approaches to the diagnosis and management of PPD as well as the encountered barriers. Results: Among the n = 1034 participating gynaecologists (response rate: 35 %) half of them dealt actively with PPD; 16 % used a questionnaire for this purpose. Consultation by the gynaecologist (84 %) or referral to therapists or hospitals (86 %) were among the most common interventions in the management of PPD. A need for improvement in the management of women with PPD was recognised equally often. As barriers the gynaecologists mentioned above all the lack of time, the low reimbursements for consultations and the lack of effective treatment options. Predictors for an active anamnesis were found to be female gender of the gynaecologist, possession of an additional psychosomatic qualification and practice located in an urban catchment area or state of the former West Germany. Conclusion: The results clearly demonstrate a high acceptance for the management of PPD by gynaecologists as well as the need for further action to improve the care of patients with PPD in gynaecological practices. PMID:27582583

  15. Environmental management of the OSBAT 24'' oil pipeline: reached practical results; Gestao ambiental do Oleoduto OSBAT 24{sup :} resultados praticos alcancados

    Energy Technology Data Exchange (ETDEWEB)

    Serra, Ricardo N.; Garibaldi, Celia M.; Kagawa, Adriana; Serra, Maira B.; Oliveira, Flavio M. de; Perim, Leandro A. [LENC - Laboratorio de Engenharia e Consultoria Ltda., Cotia, SP (Brazil); Baptista, Sidney L. [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2008-07-01

    The main objective of this article is to present considerations about the practical results obtained over the implementation of specialized technical services for environmental monitoring and control of the work of maintenance of OSBAT 24'' pipeline, located in a stretch of about 32 km from the Aquatic Terminal of Sao Sebastiao - SP (TASSE) to the district Camburi. This area is characterized by intense environmental complexity by the presence of the Serra do Mar State Park, under enormous natural diversity of preserved Mata Atlantica forest, contrasting with a considerable pole of urban sprawl whose population growth rates (4.66% pa) and economic they are above the average for the Sao Paulo State. The presentation of results considers the practical implementation of the package of environmental management tools used and seek verification of the scope and quality of the following items: general Review of care as environmental registers occurred at different periods (eg monthly, bimonthly, half, etc.); survey of the nature of environmental registers; environmental registers recovered; cases of non-compliance and the main control measures implemented; evaluation of environmental performance; recommendations and learning. (author)

  16. Shared decision making for prostate cancer screening: the results of a combined analysis of two practice-based randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Sheridan Stacey L

    2012-11-01

    Full Text Available Abstract Background Professional societies recommend shared decision making (SDM for prostate cancer screening, however, most efforts have promoted informed rather than shared decision making. The objective of this study is to 1 examine the effects of a prostate cancer screening intervention to promote SDM and 2 determine whether framing prostate information in the context of other clearly beneficial men’s health services affects decisions. Methods We conducted two separate randomized controlled trials of the same prostate cancer intervention (with or without additional information on more clearly beneficial men’s health services. For each trial, we enrolled a convenience sample of 2 internal medicine practices, and their interested physicians and male patients with no prior history of prostate cancer (for a total of 4 practices, 28 physicians, and 128 men across trials. Within each practice site, we randomized men to either 1 a video-based decision aid and researcher-led coaching session or 2 a highway safety video. Physicians at each site received a 1-hour educational session on prostate cancer and SDM. To assess intervention effects, we measured key components of SDM, intent to be screened, and actual screening. After finding that results did not vary by trial, we combined data across sites, adjusting for the random effects of both practice and physician. Results Compared to an attention control, our prostate cancer screening intervention increased men’s perceptions that screening is a decision (absolute difference +41%; 95% CI 25 to 57% and men’s knowledge about prostate cancer screening (absolute difference +34%; 95% CI 19% to 50%, but had no effect on men’s self-reported participation in shared decisions or their participation at their preferred level. Overall, the intervention decreased screening intent (absolute difference −34%; 95% CI −50% to −18% and actual screening rates (absolute difference −22%; 95% CI −38 to

  17. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 31: The technical communications practices of US aerospace engineers and scientists: Results of the phase 1 SME mail survey

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical communications practices of U.S. aerospace engineers and scientists affiliated with, not necessarily belonging to, the Society of Manufacturing Engineers (SME).

  18. Logistic feasibility of health related quality of life measurement in clinical practice: results of a prospective study in a large population of chronic liver patients

    Directory of Open Access Journals (Sweden)

    de Man Robert A

    2008-11-01

    Full Text Available Abstract Background The objective of the present study was to provide a complete and detailed report of technical and logistical feasibility problems with the implementation of routine computerized HRQoL measurement at a busy outpatient department of Hepatology that can serve as a tool for future researchers interested in the procedure. Methods Practical feasibility was assessed by observing problems encountered during the development of the computer program, observing patients' ability to complete the HRQoL questionnaires, monitoring the number of times that patients completed the HRQoL questionnaires and observing logistics at the outpatient department. Patients' reasons for not completing the HRQoL questionnaires were assessed retrospectively by means of a mailed questionnaire. Physicians' attitudes towards the availability of computerized HRQoL information about their patients were assessed by means semi-structured interviews and by means of checklists administered after each consultation with s study participant. Results All physicians (n = 11 and 587 patients agreed to participate in the study. Practical feasibility problems concerned complicated technical aspects of developing a user-friendly computer program and safe data transmission over the Internet, patients' lack of basic computer skills and patients' lack of compliance (completion of questionnaires on only 43% of the occasions. The main reason given for non-compliance was simply forgetting, which seemed to be related to reception employees' passive attitude towards sending patients to the computer. Physicians were generally positive about the instant computerized availability of HRQoL information. They requested the information in 92% of the consultations and found the information useful in 45% of the consultations, especially when it provided them with new information. Conclusion This study was among the first to implement the complete procedure of routine computerized HRQo

  19. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2006-04-01

    Full Text Available Abstract Background We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. Method During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral. Results The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred. Conclusion This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral.

  20. Using the Quebec Task Force Classification to subgroup low back pain patients in primary care: an analysis of longitudinal clinical data from chiropractic and general practice

    DEFF Research Database (Denmark)

    Hartvigsen, Lisbeth; Kongsted, Alice; Hestbæk, Lise;

    Background Low back pain (LBP) patients with related leg pain and signs of nerve root involvement (NRI) are considered to have a worse prognosis than patients with LBP alone. However, knowledge is limited about the importance of distinguishing between leg pain above or below the knee and leg pain...

  1. [Dimensions of parental rearing styles in alcohol dependent patients: first results of the questionnaire on parental attitudes and rearing practices (FEPS)].

    Science.gov (United States)

    Lotzin, Annett; Kriston, Levente; Richter-Appelt, Hertha; Leichsenring, Irina; Ramsauer, Brigitte; Schäfer, Ingo

    2013-07-01

    To date no instrument for the assessment of parenting styles is available in the German -language area that has been validated in patients with addictive disorders. Therefore the aim of this study was the confirmatory evaluation of the factor structure of the Questionnaire on Parental Attitudes and Rearing Practices (FEPS) in 186 alcohol dependent patients. The model as proposed by the test developers with the 4 factors Care, Autonomy, Low Punishment, and Low Material Reinforcement showed acceptable fit when residual correlations were allowed (mother: χ(2)/df=1,92, RMSEA=0,07, TLI=0,79; father: χ(2)/df=1,75, RMSEA=0,07, TLI=0,82). All factors showed sufficient factor reliabilities as well as good to very good internal consistencies. Factor loadings, discriminations and difficulties of the indicators could be regarded as good, with the exception of 2 items. These results indicate the factorial validity of the FEPS in patients with alcohol dependence. PMID:23446826

  2. Combining Real-Time fMRI Neurofeedback Training of the DLPFC with N-Back Practice Results in Neuroplastic Effects Confined to the Neurofeedback Target Region.

    Science.gov (United States)

    Sherwood, Matthew S; Weisend, Michael P; Kane, Jessica H; Parker, Jason G

    2016-01-01

    In traditional fMRI, individuals respond to exogenous stimuli and are naïve to the effects of the stimuli on their neural activity patterns. Changes arising in the fMRI signal are analyzed post-hoc to elucidate the spatial and temporal activation of brain regions associated with the tasks performed. The advent of real-time fMRI has enabled a new method to systematically alter brain activity across space and time using neurofeedback training (NFT), providing a new tool to study internally-driven processes such as neuroplasticity. In this work, we combined n-back practice with fMRI-NFT of the left dorsolateral prefrontal cortex (DLPFC) to better understand the relationship between open- and closed-loop neuromodulation. FMRI data were acquired during both traditional n-back and NFT across five imaging sessions. Region-of-interest (ROI) and voxel-wise 2 × 2 within subjects ANOVAs were carried out to determine the effects of, and interaction between, training session and neuromodulation type. A main effect of training session was identified for only a single, highly focused cluster that shared spatial properties with the fMRI-NFT target region (left DLPFC). This finding indicates that combined open- and closed-loop neuroplastic enhancement techniques result in focal changes that are confined to the target area of NFT, and do not affect up- or down-stream network components that are normally engaged during working memory. Additionally, we identified a main effect of neuromodulation type for 15 clusters with significantly different activation between open- and closed-loop neuromodulation during training, 12 of which demonstrated higher activity during the open-loop neuromodulation. Our results, taken together with previous reports, indicate that fMRI-NFT combined with n-back practice leads to a highly focal volume exhibiting neuroplasticity without additional network effects. PMID:27445733

  3. External audit of clinical practice and medical decision making in a new Asian oncology center: Results and implications for both developing and developed nations

    International Nuclear Information System (INIS)

    Purpose: The external audit of oncologist clinical practice is increasingly important because of the incorporation of audits into national maintenance of certification (MOC) programs. However, there are few reports of external audits of oncology practice or decision making. Our institution (The Cancer Institute, Singapore) was asked to externally audit an oncology department in a developing Asian nation, providing a unique opportunity to explore the feasibility of such a process. Methods and Materials: We audited 100 randomly selected patients simulated for radiotherapy in 2003, using a previously reported audit instrument assessing clinical documentation/quality assurance and medical decision making. Results: Clinical documentation/quality assurance, decision making, and overall performance criteria were adequate 74.4%, 88.3%, and 80.2% of the time, respectively. Overall 52.0% of cases received suboptimal management. Multivariate analysis revealed palliative intent was associated with improved documentation/clinical quality assurance (p = 0.07), decision making (p 0.007), overall performance (p = 0.003), and optimal treatment rates (p 0.07); non-small-cell lung cancer or central nervous system primary sites were associated with better decision making (p = 0.001), overall performance (p = 0.03), and optimal treatment rates (p = 0.002). Conclusions: Despite the poor results, the external audit had several benefits. It identified learning needs for future targeting, and the auditor provided facilitating feedback to address systematic errors identified. Our experience was also helpful in refining our national revalidation audit instrument. The feasibility of the external audit supports the consideration of including audit in national MOC programs

  4. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 24: The technical communications practices of US aerospace engineers and scientists: Results of the phase 1 SAE mail survey

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis the technical communications practices of U.S. aerospace engineers and scientists affiliated with the Society of Automotive Engineers (SAE).

  5. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 33: The technical communications practices of US aerospace engineers and scientists: Results of the phase 1 AIAA mail survey

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1995-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis the technical communications practices of U.S. aerospace engineers and scientists who are members of the American Institute of Aeronautics and Astronautics (AIAA).

  6. Food use in middle and high school fundraising: Does policy support healthy practice? Results from a survey of Minnesota school principals

    OpenAIRE

    Kubik, Martha Y; Lytle, Leslie A.; Farbakhsh, Kian; Moe, Stacey; Samuelson, Anne

    2009-01-01

    This descriptive, cross-sectional study aimed to examine classroom, school-wide and club/sports teams fundraising policies and practices of middle and high schools; concordance between policy and practice; and associations between healthy policy/practice scores and selected school characteristics. In 2006, principals/designees of middle (n=45) and high (n=71) schools in the St. Paul/Minneapolis, Minnesota metropolitan area completed a self-administered mailed survey. Schools were attended by ...

  7. Mobile Technology and Social Media in the Clinical Practice of Young Radiation Oncologists: Results of a Comprehensive Nationwide Cross-sectional Study

    Energy Technology Data Exchange (ETDEWEB)

    Bibault, Jean-Emmanuel, E-mail: jebibault@gmail.com [Academic Radiation Oncology Department, Oscar Lambret Center, Lille (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Leroy, Thomas [Academic Radiation Oncology Department, Oscar Lambret Center, Lille (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Blanchard, Pierre [Academic Radiation Oncology Department, Gustave Roussy Institute, Villejuif Cedex (France); Biostatistics and Epidemiology Department, Gustave Roussy, Villejuif Cedex (France); Biau, Julian [Radiation Oncology Department, Jean-Perrin Center, Clermont-Ferrand cedex (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Cervellera, Mathilde [Radiation Oncology Department, Jean-Godinot Center, Reims (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Diaz, Olivia [Radiation Oncology Department, Lyon Sud University Hospital, Pierre-Bénite Cedex (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Faivre, Jean Christophe [Academic Radiation Oncology and Brachytherapy Departement, Alexis-Vautrin Center, Avenue de Bourgogne, 54511 Vandoeuvre-lès-Nancy (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); and others

    2014-09-01

    Purpose: Social media and mobile technology are transforming the way in which young physicians are learning and practicing medicine. The true impact of such technologies has yet to be evaluated. Methods and Materials: We performed a nationwide cross-sectional survey to better assess how young radiation oncologists used these technologies. An online survey was sent out between April 24, 2013, and June 1, 2013. All residents attending the 2013 radiation oncology French summer course were invited to complete the survey. Logistic regressions were performed to assess predictors of use of these tools in the hospital on various clinical endpoints. Results: In all, 131 of 140 (93.6%) French young radiation oncologists answered the survey. Of these individuals, 93% owned a smartphone and 32.8% owned a tablet. The majority (78.6%) of the residents owning a smartphone used it to work in their department. A total of 33.5% had more than 5 medical applications installed. Only 60.3% of the residents verified the validity of the apps that they used. In all, 82.9% of the residents had a social network account. Conclusions: Most of the residents in radiation oncology use their smartphone to work in their department for a wide variety of tasks. However, the residents do not consistently check the validity of the apps that they use. Residents also use social networks, with only a limited impact on their relationship with their patients. Overall, this study highlights the irruption and the risks of new technologies in the clinical practice and raises the question of a possible regulation of their use in the hospital.

  8. Mobile Technology and Social Media in the Clinical Practice of Young Radiation Oncologists: Results of a Comprehensive Nationwide Cross-sectional Study

    International Nuclear Information System (INIS)

    Purpose: Social media and mobile technology are transforming the way in which young physicians are learning and practicing medicine. The true impact of such technologies has yet to be evaluated. Methods and Materials: We performed a nationwide cross-sectional survey to better assess how young radiation oncologists used these technologies. An online survey was sent out between April 24, 2013, and June 1, 2013. All residents attending the 2013 radiation oncology French summer course were invited to complete the survey. Logistic regressions were performed to assess predictors of use of these tools in the hospital on various clinical endpoints. Results: In all, 131 of 140 (93.6%) French young radiation oncologists answered the survey. Of these individuals, 93% owned a smartphone and 32.8% owned a tablet. The majority (78.6%) of the residents owning a smartphone used it to work in their department. A total of 33.5% had more than 5 medical applications installed. Only 60.3% of the residents verified the validity of the apps that they used. In all, 82.9% of the residents had a social network account. Conclusions: Most of the residents in radiation oncology use their smartphone to work in their department for a wide variety of tasks. However, the residents do not consistently check the validity of the apps that they use. Residents also use social networks, with only a limited impact on their relationship with their patients. Overall, this study highlights the irruption and the risks of new technologies in the clinical practice and raises the question of a possible regulation of their use in the hospital

  9. Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 4. Results: specific problem solving skills.

    Science.gov (United States)

    Hummers-Pradier, Eva; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; van Royen, Paul

    2010-09-01

    The 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. The previous articles presented background, objectives, and methodology, as well results on 'primary care management' and 'community orientation' and the person-related core competencies of GP/FM. This article reflects on the general practitioner's 'specific problem solving skills'. These include decision making on diagnosis and therapy of specific diseases, accounting for the properties of primary care, but also research questions related to quality management and resource use, shared decision making, or professional education and development. Clinical research covers most specific diseases, but often lacks pragmatism and primary care relevance. Quality management is a stronghold of GP/FM research. Educational interventions can be effective when well designed for a specific setting and situation. However, their message that 'usual care' by general practitioners is insufficient may be problematic. GP and their patients need more research into diagnostic reasoning with a step-wise approach to increase predictive values in a setting characterized by uncertainty and low prevalence of specific diseases. Pragmatic comparative effectiveness studies of new and established drugs or non-pharmaceutical therapy are needed. Multi-morbidity and complexity should be addressed. Studies on therapy, communication strategies and educational interventions should consider impact on health and sustainability of effects. PMID:20825274

  10. Problems, Visions and Concerns of Pre-Service Music and General Education Teachers in Greece Resulting from Their Teaching Practice in Music

    Science.gov (United States)

    Kokkidou, May; Dionyssiou, Zoe; Androutsos, Polyvios

    2014-01-01

    This study explores music education teaching practice in Greece, collecting data from three university departments: two music departments (M1 and M2) and one primary education department (P) during the academic year 2006-2007. The project was based on data from 84 students (N = 84). Fieldwork in students' teaching practice comprised a…

  11. How Do Continence Nurses Address Sexual Function and a History of Sexual Abuse in Daily Practice? Results of a Pilot Study

    NARCIS (Netherlands)

    Bekker, Milou D.; Van Driel, Mels F.; Pelger, Rob C. M.; Nijeholt, Guus A. B. Lycklama A.; Elzevier, Henk W.

    2011-01-01

    Introduction. There is a strong association between urological complaints, sexual dysfunction, and history of sexual abuse (SA), and it is unknown whether urological continence nurses integrate this knowledge in their daily practice. Aim. To evaluate how, in their daily practice, Dutch urological co

  12. How often do GPs use rapid computer access to laboratory results? A description of 18 months’ use by 72 practices in Tayside

    Directory of Open Access Journals (Sweden)

    Deborah Clark

    2004-02-01

    This pattern conforms to that describing the introduction of new technologies in other settings. Continued use in practice and the concordance of usage between practices confirms that rapid and reliable access to laboratory reports from primary care is both useful and used.

  13. The role of 'confounding by indication' in assessing the effect of quality of care on disease outcomes in general practice: results of a case-control study

    Directory of Open Access Journals (Sweden)

    Prins Ad

    2005-01-01

    Full Text Available Abstract Background In quality of care research, limited information is found on the relationship between quality of care and disease outcomes. This case-control study was conducted with the aim to assess the effect of guideline adherence for stroke prevention on the occurrence of stroke in general practice. We report on the problems related to a variant of confounding by indication, that may be common in quality of care studies. Methods Stroke patients (cases and controls were recruited from the general practitioner's (GP patient register, and an expert panel assessed the quality of care of cases and controls using guideline-based review criteria. Results A total of 86 patients was assessed. Compared to patients without shortcomings in preventive care, patients who received sub-optimal care appeared to have a lower risk of experiencing a stroke (OR 0.60; 95% CI 0.24 to 1.53. This result was partly explained by the presence of risk factors (6.1 per cases, 4.4 per control, as reflected by the finding that the OR came much closer to 1.00 after adjustment for the number of risk factors (OR 0.82; 95% CI 0.29 to 2.30. Patients with more risk factors for stroke had a lower risk of sub-optimal care (OR for the number of risk factors present 0.76; 95% CI 0.61 to 0.94. This finding represents a variant of 'confounding by indication', which could not be fully adjusted for due to incomplete information on risk factors for stroke. Conclusions At present, inaccurate recording of patient and risk factor information by GPs seriously limits the potential use of a case-control method to assess the effect of guideline adherence on disease outcome in general practice. We conclude that studies on the effect of quality of care on disease outcomes, like other observational studies of intended treatment effect, should be designed and performed such that confounding by indication is minimized.

  14. Following the Results of Research and Practice Session «Theory and Practice of Educational Activity: Tradition and Innovation» to Mark the 85th Anniversary of the Birth of V.V. Davydov.

    OpenAIRE

    Rubtsov V. V.,; Sobkin V. S.,; Kudryavcev V. T.,; Froumin I. D.,; Panov V. I.,; Vasilev V.,; Chudinova E. V; Bolotov V. A.,; Zuckerman G. A.,; Krasavina N. Yu.,

    2015-01-01

    Research and Practice Session «Theory and Practice of Educational Activity: Tradition and Innovation» was held September 24, 2015 at the Psychological Institute of Russian Academy of Education in Moscow. The event was held in the form of discourse seminar as part of the research Master's program «Culturalhistorical psychology and activity approach to education». Research Master's program is being tested as part of the project "Development and testing of new modules of the basic educational Ma...

  15. Trends in the knowledge, attitudes and practices of travel risk groups towards prevention of malaria: Results from the Dutch Schiphol airport survey 2002 to 2009

    NARCIS (Netherlands)

    P.J.J. van Genderen (Perry); P.P.A.M. van Thiel (Pieter P. A.); P.G.H. Mulder (Paul); D. Overbosch (David)

    2012-01-01

    textabstractBackground: Previous studies investigating the travellers knowledge, attitudes and practices (KAP) profile indicated an important educational need among those travelling to risk destinations. Initiatives to improve such education should target all groups of travellers, including business

  16. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies

    DEFF Research Database (Denmark)

    Mandl, Peter; Naredo, Esperanza; Conaghan, Philip G;

    2012-01-01

    Objectives. To document the practice and training opportunities of US-guided arthrocentesis and joint injection (UGAJ) among rheumatologists in the member countries of the European League Against Rheumatism (EULAR). Methods. An English-language questionnaire, containing questions on demographics...

  17. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies.

    LENUS (Irish Health Repository)

    Mandl, Peter

    2012-01-01

    To document the practice and training opportunities of US-guided arthrocentesis and joint injection (UGAJ) among rheumatologists in the member countries of the European League Against Rheumatism (EULAR).

  18. Trends in the knowledge, attitudes and practices of travel risk groups towards prevention of malaria: results from the Dutch Schiphol Airport Survey 2002 to 2009

    Directory of Open Access Journals (Sweden)

    van Genderen Perry JJ

    2012-05-01

    Full Text Available Abstract Background Previous studies investigating the travellers’ knowledge, attitudes and practices (KAP profile indicated an important educational need among those travelling to risk destinations. Initiatives to improve such education should target all groups of travellers, including business travellers, those visiting friends and relatives (VFRs, and elderly travellers. Methods In the years 2002 to 2009, a questionnaire-based survey was conducted at the Dutch Schiphol Airport with the aim to study trends in KAP of travel risk groups towards prevention of malaria. The risk groups last-minute travellers, solo-travellers, business travellers, VFRs and elderly travellers were specifically studied. Results A total of 3,045 respondents were included in the survey. Travellers to destinations with a high risk for malaria had significantly more accurate risk perceptions (knowledge than travellers to low-risk destinations. The relative risk for malaria in travellers to high-risk destinations was probably mitigated by higher protection rates against malaria as compared with travellers to low risk destinations. There were no significant differences in intended risk-taking behaviour. Trend analyses showed a significant change over time in attitude towards more risk-avoiding behaviour and towards higher protection rates against malaria in travellers to high-risk destinations. The KAP profile of last-minute travellers substantially increased their relative risk for malaria, which contrasts to the slight increase in relative risk of solo travellers, business travellers and VFRs for malaria. Conclusions The results of this sequential cohort survey in Dutch travellers suggest an annual 1.8% increase in protection rates against malaria coinciding with an annual 2.5% decrease in intended risk-seeking behaviour. This improvement may reflect the continuous efforts of travel health advice providers to create awareness and to propagate safe and healthy travel

  19. Occupational health legislation and practices related to seafarers on passenger ships focused on communicable diseases: results from a European cross-sectional study (EU SHIPSAN PROJECT

    Directory of Open Access Journals (Sweden)

    Bartlett Christopher LR

    2010-02-01

    Full Text Available Abstract Background Seafarers play an important role in the transmission of communicable diseases. The aim of the present study is to draw information and identify possible gaps on occupational health practices related to seafarers sailing on ships within the European Union Member States (EU MS with focus on communicable diseases. Methods A structured questionnaire was sent to competent authorities from 21 EU MS. The questionnaire included questions about occupational health policies, medical certification of seafarers, communicable diseases reporting and relevant legislation. Descriptive analysis of the data was conducted by the use of Epi Info software: EU MS were categorized in four priority groups (A, B, C, D based on: number of passenger ships visits, volume of passengers, and number of ports in each country. Moreover, EU MS were categorized to old and new, based on the date of entry in the EU. Results All 21 countries with relevant competent authorities responded to the questionnaire. The existence of specific national legislation/regulation/guidelines related to vaccination of seafarers was reported by three out of the 21 (14% responding authorities. Surveillance data of communicable diseases related to seafarers are collected and analyzed by 4 (19% authorities. Five out of 21 of the responding countries (24% reported that tuberculin test result is required for the issuance of seafarer's medical certificate while a great variety of medical examination is required for the issuance of this certificate among countries. Gaps on occupational health services focused on communicable diseases related to maritime occupation have been reported by 33% of the responding countries. Responding authorities from Group A and B had the highest percentage of reported gaps followed by groups C and D. Old MS reported a higher frequency regarding gaps on occupational health services in comparison to new MS. Conclusion Our results revealed heterogeneity

  20. Results of concurrent radio-chemotherapy for the treatment of head and neck squamous cell carcinoma in everyday clinical practice with special reference to early mortality

    International Nuclear Information System (INIS)

    Randomized controlled trials have established concurrent chemo-radiotherapy as the preferred treatment option for inoperable local-regionally advanced head and neck squamous cell carcinomas (HNSCCs). Because many patients have multiple co-morbidities and would not fulfill the eligibility criteria of clinical trials, the results need to be re-evaluated in daily clinical practice with special reference to early mortality. 167 consecutive patients with HNSCC who received concurrent chemo-radiotherapy at the Basel University Hospital between 1988 and 2006 were analyzed retrospectively with a special focus on early deaths and risk factors for an unfavorable outcome. In our cohort, the 3- and 5-year overall survival rates were 54% and 47%, respectively. The therapy was associated with relevant toxicity and an early mortality rate of 5.4%. Patients dying early were analyzed individually for the cause of death. Patients with elevated white blood cell counts (HR: 2.66 p = 0,016) and vascular co-morbidities (HR: 5.3, p = 0,047) showed significantly worse survival rates. The same factors were associated with a trend toward increased treatment-related mortality. The 3-year survival rate improved from approximately 43% for patients treated before the year 2000 to 65% for patients treated after the year 2000 (Fisher’s exact test p = 0.01). Although many patients who received concurrent chemo-radiotherapy would not have qualified for clinical trials, the outcome was favorable and has significantly improved in recent years. However the early mortality was slightly worse than what is described in the literature

  1. Factors that Determine Academic Versus Private Practice Career Interest in Radiation Oncology Residents in the United States: Results of a Nationwide Survey

    International Nuclear Information System (INIS)

    Purpose: To determine what factors US radiation oncology residents consider when choosing academic or nonacademic careers. Methods and Materials: A 20-question online survey was developed and sent to all US radiation oncology residents to assess factors that influence their career interest. Residents were asked to rate their interest in academics (A) versus private practice (PP) on a 0 (strong interest in A) to 100 (strong interest in PP) scale. Responses were classified as A (0-30), undecided (40-60), and PP (70-100). Residents were also asked to rank 10 factors that most strongly influenced their career interest. Results: Three hundred thirty-one responses were collected, of which 264 were complete and form the basis for this analysis. Factors that correlated with interest in A included having a PhD (P=.018), postgraduate year level (P=.0006), research elective time (P=.0003), obtaining grant funding during residency (P=.012), and number of publications before residency (P=.0001), but not number of abstracts accepted in the past year (P=.65) or publications during residency (P=.67). The 3 most influential factors for residents interested in A were: (1) baseline interest before residency; (2) academic role models; and (3) research opportunities during residency. The 3 most influential factors for residents interested in PP were: (1) baseline interest before residency; (2) academic role models; and (3) academic pressure and obligations. Conclusions: Interest in A correlated with postgraduate year level, degree, and research time during residency. Publications before but not during residency correlated with academic interest, and baseline interest was the most influential factor. These data can be used by residency program directors to better understand what influences residents' career interest

  2. Nuclear cardiology practice and associated radiation doses in Europe: results of the IAEA Nuclear Cardiology Protocols Study (INCAPS) for the 27 European countries

    International Nuclear Information System (INIS)

    Nuclear cardiology is widely used to diagnose coronary artery disease and to guide patient management, but data on current practices, radiation dose-related best practices, and radiation doses are scarce. To address these issues, the IAEA conducted a worldwide study of nuclear cardiology practice. We present the European subanalysis. In March 2013, the IAEA invited laboratories across the world to document all SPECT and PET studies performed in one week. The data included age, gender, weight, radiopharmaceuticals, injected activities, camera type, positioning, hardware and software. Radiation effective dose was calculated for each patient. A quality score was defined for each laboratory as the number followed of eight predefined best practices with a bearing on radiation exposure (range of quality score 0 - 8). The participating European countries were assigned to regions (North, East, South, and West). Comparisons were performed between the four European regions and between Europe and the rest-of-the-world (RoW). Data on 2,381 European patients undergoing nuclear cardiology procedures in 102 laboratories in 27 countries were collected. A cardiac SPECT study was performed in 97.9 % of the patients, and a PET study in 2.1 %. The average effective dose of SPECT was 8.0 ± 3.4 mSv (RoW 11.4 ± 4.3 mSv; P < 0.001) and of PET was 2.6 ± 1.5 mSv (RoW 3.8 ± 2.5 mSv; P < 0.001). The mean effective doses of SPECT and PET differed between European regions (P < 0.001 and P = 0.002, respectively). The mean quality score was 6.2 ± 1.2, which was higher than the RoW score (5.0 ± 1.1; P < 0.001). Adherence to best practices did not differ significantly among the European regions (range 6 to 6.4; P = 0.73). Of the best practices, stress-only imaging and weight-adjusted dosing were the least commonly used. In Europe, the mean effective dose from nuclear cardiology is lower and the average quality score is higher than in the RoW. There is regional variation in effective dose in

  3. Nuclear cardiology practice and associated radiation doses in Europe: results of the IAEA Nuclear Cardiology Protocols Study (INCAPS) for the 27 European countries

    Energy Technology Data Exchange (ETDEWEB)

    Lindner, Oliver; Burchert, Wolfgang [University Hospital of the Ruhr University, Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine-Westphalia Bochum, Bad Oeynhausen (Germany); Pascual, Thomas N.B.; Kashyap, Ravi; Dondi, Maurizio; Paez, Diana [International Atomic Energy Agency, Section of Nuclear Medicine and Diagnostic Imaging, Division of Human Health, Vienna (Austria); Mercuri, Mathew [Columbia University Medical Center and New York-Presbyterian Hospital, Division of Cardiology, Department of Medicine, New York, NY (United States); Acampa, Wanda [National Council of Research, Institute of Biostructures and Bioimaging, Naples (Italy); Flotats, Albert [Universitat Autonoma de Barcelona, Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain); Kaufmann, Philipp A. [University Hospital Zurich, Department of Nuclear Medicine and Cardiac Imaging, Zurich (Switzerland); Kitsiou, Anastasia [Sismanoglio Hospital, Department of Cardiology, Athens (Greece); Knuuti, Juhani [University of Turku, and Turku University Hospital, Turku PET Centre, Turku (Finland); Underwood, S.R. [Imperial College London, National Heart and Lung Institute, London (United Kingdom); Royal Brompton and Harefield Hospitals, Department of Nuclear Medicine, London (United Kingdom); Vitola, Joao V. [Quanta Diagnostico and Terapia, Curitiba (Brazil); Mahmarian, John J. [Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology, Houston, TX (United States); Karthikeyan, Ganesan [All India Institute of Medical Sciences, Department of Cardiology, New Delhi (India); Better, Nathan [Royal Melbourne Hospital and University of Melbourne, Department of Nuclear Medicine, Melbourne (Australia); Rehani, Madan M. [International Atomic Energy Agency, Radiation Protection of Patients Unit, Vienna (Austria); Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Einstein, Andrew J. [Columbia University Medical Center and New York-Presbyterian Hospital, Division of Cardiology, Department of Medicine, New York, NY (United States); Columbia University Medical Center and New York-Presbyterian Hospital, Department of Radiology, New York, NY (United States); Collaboration: for the INCAPS Investigators Group

    2016-04-15

    Nuclear cardiology is widely used to diagnose coronary artery disease and to guide patient management, but data on current practices, radiation dose-related best practices, and radiation doses are scarce. To address these issues, the IAEA conducted a worldwide study of nuclear cardiology practice. We present the European subanalysis. In March 2013, the IAEA invited laboratories across the world to document all SPECT and PET studies performed in one week. The data included age, gender, weight, radiopharmaceuticals, injected activities, camera type, positioning, hardware and software. Radiation effective dose was calculated for each patient. A quality score was defined for each laboratory as the number followed of eight predefined best practices with a bearing on radiation exposure (range of quality score 0 - 8). The participating European countries were assigned to regions (North, East, South, and West). Comparisons were performed between the four European regions and between Europe and the rest-of-the-world (RoW). Data on 2,381 European patients undergoing nuclear cardiology procedures in 102 laboratories in 27 countries were collected. A cardiac SPECT study was performed in 97.9 % of the patients, and a PET study in 2.1 %. The average effective dose of SPECT was 8.0 ± 3.4 mSv (RoW 11.4 ± 4.3 mSv; P < 0.001) and of PET was 2.6 ± 1.5 mSv (RoW 3.8 ± 2.5 mSv; P < 0.001). The mean effective doses of SPECT and PET differed between European regions (P < 0.001 and P = 0.002, respectively). The mean quality score was 6.2 ± 1.2, which was higher than the RoW score (5.0 ± 1.1; P < 0.001). Adherence to best practices did not differ significantly among the European regions (range 6 to 6.4; P = 0.73). Of the best practices, stress-only imaging and weight-adjusted dosing were the least commonly used. In Europe, the mean effective dose from nuclear cardiology is lower and the average quality score is higher than in the RoW. There is regional variation in effective dose in

  4. Early predictors of the long-term outcome of low back pain - results of a 22-year prospective cohort study from general practice

    DEFF Research Database (Denmark)

    Lonnberg, F.; Pedersen, P.; Siersma, V.

    2010-01-01

    BACKGROUND: Poor outcome of low back pain in patients seen in general practice is related to the pain history, physical impairment and working conditions, at least in short-term follow-ups. We do not know if these findings hold, seen from the perspective of decades. OBJECTIVES: To show if patients...... low back pain. The setting of the study is a single general practice in a suburb of Copenhagen, Denmark. METHODS: Selected predictors were separated into pain characteristics, clinical signs and indicators related to the work history. Outcome measures were the 1-year period prevalence of low back pain...

  5. Centers for practical radiological culture - highly functional element of public radiation control structure on the territories affected in the result of the Chernobyl NPP disaster

    International Nuclear Information System (INIS)

    The article covers the experience related to operation of the Centers for Practical Radiological Culture created on the affected territories to facilitate radioecological information outreach and improve the skills of the affected population in terms of safe residence and nature management. (authors)

  6. The Identification and Description of Critical Thinking Behaviors in the Practice of Clinical Laboratory Science, Part 1: Design, Implementation, Evaluation, and Results of a National Survey.

    Science.gov (United States)

    Kenimer, Elizabeth A.

    2002-01-01

    A survey of 1,562 clinical laboratory scientists ranked critical thinking behaviors used in practice. Important behaviors were cognitive, behavioral, affective, and situated/contextual. Findings support a view of critical thinking as a metaprocess that spans learning domains. (Contains 17 references.) (SK)

  7. Interim report of a study on gastroenteritis in sentinel practices in the Netherlands (NIVEL) 1996-1999. Results of the first two years

    NARCIS (Netherlands)

    Wit MAS de; Koopmans MPG; Kortbeek LM; Leeuwen WJ van; Vinje J; Duijnhoven YTPH van; CIE

    1999-01-01

    In 1996, a study was started on gastroenteritis in collaboration with the Netherlands Institute of Primary Health Care (NIVEL) among gastroentritis patients in care of a general practitioner. This study was aimed at estimating the incidence of gastroenteritis in general practices, evaluating the eff

  8. RESULTS OF AN OBSERVATIONAL PROSPECTIVE STUDY OF THE EFFICACY AND SAFETY OF BELIMUMAB (BENLYSTA® IN SYSTEMIC LUPUS ERYTHEMATOSUS IN REAL CLINICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    E. A. Aseeva

    2016-01-01

    Full Text Available Therapy for systemic lupus erythematosus (SLE remains challenging. The long-term use of glucocorticoids (GC and cytostatics considerably improves life expectancy, but at the same time favors the development of irreversible organ damages. To evaluate the efficacy of belimumab (BLM, a biological agent, that blocks B-lymphocyte-stimulating factor registered for the treatment of active SLE, is an important task of the practice of rheumatology.Objective: to evaluate the efficacy and safety of BLM in patients with high and moderate SLE activity.Subjects and methods. The investigation enrolled 16 patients with a Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K score of 6 to 19, who were positive for antinuclear factor (100% and had low complement levels and high anti-native DNA antibodies (81%. BLM was used as monthly intravenous infusions at a dose of 10 mg/kg. The efficiency and safety of the therapy were evaluated monthly and 1 year after the initiation of treatment with BLM; SLE activity was estimated using SLEDAI-2K; a physician’s global assessment of disease activity on a visual analogue scale (VAS; anti-DNA antibody level changes, complement levels, a GC dose, damage index, and adverse events were determined.Results and discussion. BLM therapy proved to be effective in 62% of cases at 1 year after therapy initiation. At 1 month, SLE activity significantly decreased with SLEDAI-2K score diminishment from 9.31±3.21 to 6.25±2.80 in the entire group (p < 0.04. Over a month, the physician’s global assessment of disease activity significantly reduced from 19.25±6.60 to 13.68±3.97 mm (р<0.01 and reached minimum (8.28±6.87 mm by 10 months of therapy. There was a significant decrease in anti-DNA antibodies and an increase in complement C4 level at 5 and 3 months of therapy, respectively. Six of the 10 patients who had received a complete cycle of BLM therapy achieved remission at 12 months. The dose of GC was significantly reduced

  9. Effect of savings-led economic empowerment on HIV preventive practices among orphaned adolescents in rural Uganda: results from the Suubi-Maka randomized experiment.

    Science.gov (United States)

    Jennings, Larissa; Ssewamala, Fred M; Nabunya, Proscovia

    2016-01-01

    Improving economic resources of impoverished youth may alter intentions to engage in sexual risk behaviors by motivating positive future planning to avoid HIV risk and by altering economic contexts contributing to HIV risk. Yet, few studies have examined the effect of economic-strengthening on economic and sexual behaviors of orphaned youth, despite high poverty and high HIV infection in this population. Hierarchal longitudinal regressions were used to examine the effect of a savings-led economic empowerment intervention, the Suubi-Maka Project, on changes in orphaned adolescents' cash savings and attitudes toward savings and HIV-preventive practices over time. We randomized 346 Ugandan adolescents, aged 10-17 years, to either the control group receiving usual orphan care plus mentoring (n = 167) or the intervention group receiving usual orphan care plus mentoring, financial education, and matched savings accounts (n = 179). Assessments were conducted at baseline, 12, and 24 months. Results indicated that intervention adolescents significantly increased their cash savings over time (b = $US12.32, ±1.12, p < .001) compared to adolescents in the control group. At 24 months post-baseline, 92% of intervention adolescents had accumulated savings compared to 43% in the control group (p < .001). The largest changes in savings goals were the proportion of intervention adolescents valuing saving for money to buy a home (ΔT1-T0 = +14.9, p < .001), pursue vocational training (ΔT1-T0 = +8.8, p < .01), and start a business (T1-T0 = +6.7, p < .01). Intervention adolescents also had a significant relative increase over time in HIV-preventive attitudinal scores (b = +0.19, ±0.09, p < .05), most commonly toward perceived risk of HIV (95.8%, n = 159), sexual abstinence or postponement (91.6%, n = 152), and consistent condom use (93.4%, n = 144). In addition, intervention adolescents had 2.017 significantly greater

  10. The Grit in the Oyster – does an appreciation of threshold concepts in an adult literacies teaching qualification result in pearls of practice

    Directory of Open Access Journals (Sweden)

    David Wallace

    2010-08-01

    Full Text Available This paper draws from the experiences of a new adult literacies teaching qualification in Scotland that has been designed for experienced but unqualified adult literacies tutors.  Created to respond to an approach to adult literacies as social practices (Scottish Executive 2001, 2005, Tett et al 2006, the course team employs a sociocultural pedagogy that explicitly rejects transmission and seeks to build critical reflection through learning from experience, collaborative activities and the creation of an on-line community (Ackland and Wallace 2006.  Recognising that ‘moments of conflict and disjuncture may form the spaces in which learning occurs’ (Lewis, Enciso and Moje 2007:5 the paper explores whether ideas about liminality and threshold concepts (Cousin 2006:1, Land, Meyer and Smith 2008 illuminate the learning process.  It concludes that engagement with these concepts may assist adult literacies tutors to develop transformed practice (Cope and Kalantzis 2003:35.

  11. Trends in the knowledge, attitudes and practices of travel risk groups towards prevention of malaria: results from the Dutch Schiphol Airport Survey 2002 to 2009

    OpenAIRE

    van Genderen Perry JJ; van Thiel Pieter PAM; Mulder Paul GH; Overbosch David

    2012-01-01

    Abstract Background Previous studies investigating the travellers’ knowledge, attitudes and practices (KAP) profile indicated an important educational need among those travelling to risk destinations. Initiatives to improve such education should target all groups of travellers, including business travellers, those visiting friends and relatives (VFRs), and elderly travellers. Methods In the years 2002 to 2009, a questionnaire-based survey was conducted at the Dutch Schiphol Airport with the a...

  12. Implementation of Departmental Quality Strategies Is Positively Associated with Clinical Practice: Results of a Multicenter Study in 73 Hospitals in 7 European Countries

    OpenAIRE

    Suñol, R; Wagner, C.; Arah, O.A.; Kristensen, S.; Pfaff, H.; Klazinga, N; Thompson, C.A.; Wang, A.; Dersarkissian, M.; Bartels, P; Michel, P.; Groene, O

    2015-01-01

    Background: Given the amount of time and resources invested in implementing quality programs in hospitals, few studies have investigated their clinical impact and what strategies could be recommended to enhance its effectiveness. Objective: To assess variations in clinical practice and explore associations with hospital- and department-level quality management systems. Design: Multicenter, multilevel cross-sectional study. Setting and Participants: Seventy-three acute care hospitals with 276 ...

  13. An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY Challenge

    DEFF Research Database (Denmark)

    Brownstein, Catherine A; Beggs, Alan H; Homer, Nils; Merriman, Barry; Yu, Timothy W; Flannery, Katherine C; DeChene, Elizabeth T; Towne, Meghan C; Savage, Sarah K; Price, Emily N; Dworzynski, Piotr

    2014-01-01

    reporting. The CLARITY Challenge was designed to spur convergence in methods for diagnosing genetic disease starting from clinical case history and genome sequencing data. DNA samples were obtained from three families with heritable genetic disorders and genomic sequence data were donated by sequencing...... provides a comprehensive assessment of current practices for using genome sequencing to diagnose and report genetic diseases. There is remarkable convergence in bioinformatic techniques, but medical interpretation and reporting are areas that require further development by many groups....

  14. Evaluating the psychological impact of practice dispatch-assisted cardiopulmonary instructions using the ALERT protocol: preliminary results in Liege dispatching centre.

    OpenAIRE

    Hirtz, Elodie; Ghuysen, Alexandre; STIPULANTE, Samuel; EL-FASSI, Mehdi; Etienne, Anne-Marie

    2013-01-01

    ABSTRACT Background. The ALERT algorithm, an effective compression-only phone cardiopulmonary resuscitation (CPR) protocol has the potential to help bystanders initiate CPR. This study evaluates the psychological impact of the CPR’s practice on untrained persons (UP). Methods. This is a quasi experimental longitudinal study (n = 153). We used: demographics data, CPR’ emotional characteristics; the Peritraumatic Dissociative Experiences Questionnaire ; the Way of Coping Check List and th...

  15. Diagnostic Certainty as a Source of Medical Practice Variation in Coronary Heart Disease: Results from a Cross-National Experiment of Clinical Decision Making

    OpenAIRE

    Lutfey, KE; Link, C; Marceau, C.; Grant, RW; Adams, A; Arber, S; Siegrist, J.; Bonte. M,; von dem Knesebeck, O; McKinlay, J.

    2009-01-01

    The authors examined physician diagnostic certainty as one reason for cross-national medical practice variation. Data are from a factorial experiment conducted in the United States, the United Kingdom, and Germany, estimating 384 generalist physicians’ diagnostic and treatment decisions for videotaped vignettes of actor patients depicting a presentation consistent with coronary heart disease (CHD). Despite identical vignette presentations, the authors observed significant differences across h...

  16. Do changes in prescription practice in patients with rheumatoid arthritis treated with biological agents affect treatment response and adherence to therapy? Results from the nationwide Danish DANBIO Registry

    DEFF Research Database (Denmark)

    Hetland, M L; Lindegaard, H M; Hansen, A;

    2008-01-01

    BACKGROUND: Prescription practice for tumour necrosis factor alpha (TNFalpha) inhibitors has changed towards treating patients with lower disease activity. OBJECTIVE: To determine the trend in treatment response in cohorts of patients with rheumatoid arthritis who started TNFalpha inhibitor...... treatment between 2000 and 2005. METHODS: 1813 patients with RA starting treatment with biological agents in 2000-5 were registered prospectively in the nationwide DANBIO Registry. Baseline disease activity and 12 months' treatment responses were determined in cohorts based on start year (2000/1; 2002; 2003...

  17. Effectiveness of trivalent and pandemic influenza vaccines in England and Wales 2008-2010: results from a cohort study in general practice.

    Science.gov (United States)

    Hardelid, Pia; Fleming, Douglas M; Andrews, Nick; Barley, Michele; Durnall, Hayley; Mangtani, Punam; Pebody, Richard

    2012-02-01

    Estimation of influenza vaccine effectiveness (VE) is complicated by various degrees of mismatch between circulating and vaccine strains each season. We carried out a cohort study to estimate VE of trivalent (TIV) and pandemic influenza vaccines (PIV) in preventing various respiratory outcomes among general practice (GP) patients in England and Wales between 2008 and 2010. Dates of consultations for influenza-like illness (ILI), acute respiratory tract infection (ARTI), lower respiratory tract infection (LRTI) and nasopharyngeal swabs were obtained from the patient-level electronic records of the 100 practices enrolled in a national GP network. Dates of vaccination with TIV and PIV were also extracted. Confounders including age, time period and consultation frequency were adjusted for through Poisson regression models. In the winter of 2008/9, adjusted VE of TIV in preventing ILI was 22.3% (95% CI 13.5%, 30.2%). During the 2009/10 winter VE for PIV in preventing ILI was 21.0% (5.3%, 34.0%). The VE for PIV in preventing PCR-confirmed influenza A/H1N1 (2009) was 63.7% (-6.1%, 87.6%). TIV during the period of influenza circulation of 2008/9 and PIV in the winter of 2009/10 were effective in preventing GP consultations for ILI. The cohort study design could be used each season to estimate VE; however, residual confounding by indication could still present issues, despite adjustment for propensity to consult. PMID:22178524

  18. Establishing force and speed training targets for lumbar spine high-velocity, low-amplitude chiropractic adjustments*

    Science.gov (United States)

    Owens, Edward F.; Hosek, Ronald S.; Sullivan, Stephanie G.B.; Russell, Brent S.; Mullin, Linda E.; Dever, Lydia L.

    2016-01-01

    Objective: We developed an adjusting bench with a force plate supporting the lumbar portion to measure loads transmitted during lumbar manual adjustment. It will be used to provide force-feedback to enhance student learning in technique labs. The study goal is to define the learning target loads and speeds, with instructors as expert models. Methods: A total of 11 faculty members experienced in teaching Gonstead technique methods performed 81 simulated adjustments on a mannequin on the force plate. Adjustments were along 9 lumbopelvic “listings” at 3 load levels: light, normal, and heavy. We analyzed the thrusts to find preload, peak load, duration, and thrust rate. Results: Analysis of 891 thrusts showed wide variations between doctors. Peak loads ranged from 100 to 1400 N. All doctors showed clear distinctions between peak load levels, but there was overlap between high and low loads. Thrust rates were more uniform across doctors, averaging 3 N/ms. Conclusion: These faculty members delivered a range of thrusts, not unlike those seen in the literature for high velocity, low amplitude manipulation. We have established at least minimum force and speed targets for student performance, but more work must be done to create a normative adjustment to guide refinement of student learning. PMID:26600272

  19. Enhancing the Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department (EQUiPPED): Preliminary Results from Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department, a Novel Multicomponent Interdisciplinary Quality Improvement Initiative.

    Science.gov (United States)

    Stevens, Melissa B; Hastings, Susan Nicole; Powers, James; Vandenberg, Ann E; Echt, Katharina V; Bryan, William E; Peggs, Kiffany; Markland, Alayne D; Hwang, Ula; Hung, William W; Schmidt, Anita J; McGwin, Gerald; Ikpe-Ekpo, Edidiong; Clevenger, Carolyn; Johnson, Theodore M; Vaughan, Camille P

    2015-05-01

    Suboptimal medication prescribing for older adults has been described in a number of emergency department (ED) studies. Despite this, few studies have examined ED-targeted interventions aimed at reducing the use of potentially inappropriate medications (PIMs). Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the ED (EQUiPPED) is an ongoing multicomponent, interdisciplinary quality improvement initiative in eight Department of Veterans Affairs EDs. The project aims to decrease the use of PIMs, as identified by the Beers criteria, prescribed to veterans aged 65 and older at the time of ED discharge. Interventions include provider education; informatics-based clinical decision support with electronic medical record-embedded geriatric pharmacy order sets and links to online geriatric content; and individual provider education including academic detailing, audit and feedback, and peer benchmarking. Poisson regression was used to compare the number of PIMs that staff providers prescribed to veterans aged 65 and older discharged from the ED before and after the initiation of the EQUiPPED intervention. Initial data from the first implementation site show that the average monthly proportion of PIMs that staff providers prescribed was 9.4±1.5% before the intervention and 4.6±1.0% after the initiation of EQUiPPED (relative risk=0.48, 95% confidence interval=0.40-0.59, P<.001). Preliminary evaluation demonstrated a significant and sustained reduction of ED-prescribed PIMs in older veterans after implementation of EQUiPPED. Longer follow-up and replication at collaborating sites would allow for an assessment of the effect on health outcomes and costs. PMID:25945692

  20. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 26: The technical communication practices of aerospace engineering students: Results of the phase 3 AIAA National Student Survey

    Science.gov (United States)

    Pinelli, Thomas E.; Hecht, Laura M.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    This report describes similarities and differences between undergraduate and graduate engineering students in the context of two general aspects of the educational experience. First, we explore the extent to which students differ regarding the factors that lead to the choice of becoming an engineer, current satisfaction with that choice, and career-related goals and objectives. Second, we look at the technical communication practices, habits, and training of aerospace engineering students. The reported data were obtained from a survey of student members of the American Institute of Aeronautics and Astronautics (AIAA). The survey was undertaken as a phase 3 activity of the NASA/DoD Aerospace Knowledge Diffusion Research Project. Data are reported for the following categories: student demographics; skill importance, skill training, and skill helpfulness; collaborative writing; computer and information technology use and importance; use of electronic networks; use and importance of libraries and library services; use and importance of information sources and products; use of foreign language technical reports; and foreign language (reading and speaking) skills.

  1. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 27: The technical communication practices of engineering and science students: Results of the phase 3 academic surveys

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Hecht, Laura M.; Kennedy, John M.

    1994-01-01

    This report describes similarities and differences between undergraduate and graduate engineering science students in the context of two general aspects of the educational experience. First, we explore the extent to which students differ regarding the factors that lead to the choice of becoming an engineer or a scientist, current satisfaction with that choice, and career-related goals and objectives. Second, we look at the technical communication practices, habits, and training of engineers and science (Physics) students. The reported data were obtained from a survey of students enrolled in the College of Engineering at the University of Illinois at Urbana-Champaign, Bowling Green State University, and Texas A&M University. The survey was undertaken as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. Data are reported for the following categories: student demographics; skill importance, skill training, and skill helpfulness; collaborative writing; computer and information technology use and importance, use of electronic networks; use and importance of libraries and library services; use and importance of information sources and products; use of foreign technical reports; and foreign language (reading and speaking) skills.

  2. Impact of eLearning course on nurses' professional competence in seclusion and restraint practices: 9-month follow-up results of a randomized controlled study (ISRCTN32869544).

    Science.gov (United States)

    Kontio, R; Hätönen, H; Joffe, G; Pitkänen, A; Lahti, M; Välimäki, M

    2013-04-01

    eLearning may facilitate continuing vocational education, but data on the long-term effects of an eLearning course are lacking. The aim of this study was to explore the long-term impact of an eLearning course entitled ePsychNurse.Net on psychiatric nurses' professional competence in practicing seclusion and restraint and on their job satisfaction and general self-efficacy at 9-month follow-up. In a randomized controlled study, 12 wards were randomly assigned to the ePsychNurse.Net (intervention) or training as usual (control). Baseline and 9-month follow-up data on nurses' knowledge of coercion-related legislation, physical restraint and seclusion, their attitudes towards physical restraint and seclusion, job satisfaction and general self-efficacy were analysed for 137 completers (those who participated in the 9-month follow-up assessment). No between-group differences were found on any variable, with the exception of a change in attitude to seclusion in favour of the control group. The findings of the long-term effects did not differ from the immediate outcomes (3-month follow-up) and the improved level of knowledge acquired and further consolidation of that knowledge did not take place in the 6-month period after the 3-month ePsychNurse.Net course. The ePsychNurse.Net should be further developed and its future modifications will require additional studies, probably with some new outcome measures. PMID:22672441

  3. The Effectiveness of Visual Short-Time Neurofeedback on Brain Activity and Clinical Characteristics in Alcohol Use Disorders: Practical Issues and Results.

    Science.gov (United States)

    Lackner, Nina; Unterrainer, Human F; Skliris, Dimitris; Wood, Guilherme; Wallner-Liebmann, Sandra J; Neuper, Christa; Gruzelier, John H

    2016-07-01

    The present study was carried out to examine the efficacy of alpha/theta neurofeedback (NF) with a new visual paradigm in a cohort of alcohol use disordered (AUD) patients (n = 25) treated in an Austrian therapeutic community center. The experimental study design focused on changes in absolute and relative resting EEG band power as well as in clinical variables, including depression (Beck Depresion Inventory [BDI-V]), psychiatric symptoms (Brief Symptom Inventory [BSI], coping (Freiburg Questionnaire on Coping with Illness [FKV-lis]), psychotherapy motivation (Therapy Motivation Questionnaire [FPTM-23]), sense of coherence (Sense of Coherence Scale [SOC-13]), posttraumatic growth (Posttraumatic Growth Inventory [PPR]), and alcohol cravings (Alcohol Craving Questionnaire [ACQ]). For measuring training effects, participants were randomly allocated to 2 groups: an experimental group (EG, n = 13) and a control group (CG, n = 12). Patients in EG received 12 sessions of visual NF training over a period of 6 weeks to enhance alpha (8-12 Hz) and theta (4-7 Hz) frequency band power in addition to the standard treatment program of the rehabilitation center. Participants in CG received no additional NF intervention. The multivariate analysis of covariance (MANCOVA) showed a change by trend in absolute alpha and theta power in the EG. Even though no MANCOVA effects were found in the clinical scales, AUD patients reported increasing control of their brain activity during the course of NF. However, changes in several clinical scales (BDI-V, BSI, FKV-lis, PPR) from pre- to posttest were observed only in the EG contrary to the CG. The findings of this pilot study provide first evidence for the practicality and effectiveness of visual short-term NF as an additive intervention in the therapeutic community. PMID:26415612

  4. Reducing antibiotic prescriptions for respiratory tract infections in family practice: results of a cluster randomized controlled trial evaluating a multifaceted peer-group-based intervention.

    Science.gov (United States)

    Vervloet, Marcia; Meulepas, Marianne A; Cals, Jochen W L; Eimers, Mariëtta; van der Hoek, Lucas S; van Dijk, Liset

    2016-01-01

    Irrational antibiotic use for respiratory tract infections (RTI) is a major driver of bacterial resistance. The aim of this study was to evaluate the effect of a multifaceted peer-group based intervention aiming to reduce RTI-related antibiotic prescriptions in family practice. This was a cluster randomized controlled trial with pre- and follow-up measurement. The intervention was implemented through PharmacoTherapy Audit Meetings (PTAM) in which family physicians (FPs) and pharmacists collaborate. Four PTAM groups received the intervention consisting of: (1) FP communication skills training, including communication about delayed prescribing; (2) implementation of antibiotic prescribing agreements in FPs' Electronic Prescribing Systems; (3) quarterly feedback figures for FPs. Four other PTAM groups were matched controls. Primary outcome measure was the number of RTI-related antibiotic prescriptions after the intervention, assessed with multilevel linear regression analyses. Total number and number of prescriptions stratified by age (under/over 12 years) were analysed. At baseline, the average total number of RTI-related antibiotic prescriptions per 1,000 patients was 207.9 and 176.7 in the intervention and control PTAM groups, respectively. At follow-up, FPs in both the intervention and control groups prescribed significantly less antibiotics. For adolescents and adults, the drop in number of antibiotic prescription was significantly larger in the intervention groups (-27.8 per 1,000 patients) than the control groups (-7.2 per 1,000 patients; Ppeer-group-based intervention was effective in reducing the number of RTI-related antibiotic prescriptions for adolescents and adults. To affect antibiotic prescribing in children other methods are needed. PMID:26845640

  5. Delivery of care to diabetic patients with foot ulcers in daily practice: results of the Eurodiale Study, a prospective cohort study

    DEFF Research Database (Denmark)

    Prompers, L.; Huijberts, M.; Apelqvist, J.;

    2008-01-01

    Aims To determine current management and to identify patient-related factors and barriers that influence management strategies in diabetic foot disease. Methods The Eurodiale Study is a prospective cohort study of 1232 consecutive individuals presenting with a new diabetic foot ulcer in 14 centres...... suggest that current guidelines are too general and that healthcare organizational barriers and personal beliefs result in underuse of recommended therapies. Action should be undertaken to overcome these barriers and to guarantee the delivery of optimal care for the many individuals with diabetic foot...... across Europe. We determined the use of management strategies: referral, use of offloading, vascular imaging and revascularization. Results Twenty-seven percent of the patients had been treated for > 3 months before referral to a foot clinic. This varied considerably between countries (6-55%). At study...

  6. Practical Results from the Application of Model Checking and Test Generation from UML/SysML Models of On-Board Space Applications

    Science.gov (United States)

    Faria, J. M.; Mahomad, S.; Silva, N.

    2009-05-01

    The deployment of complex safety-critical applications requires rigorous techniques and powerful tools both for the development and V&V stages. Model-based technologies are increasingly being used to develop safety-critical software, and arguably, turning to them can bring significant benefits to such processes, however, along with new challenges. This paper presents the results of a research project where we tried to extend current V&V methodologies to be applied on UML/SysML models and aiming at answering the demands related to validation issues. Two quite different but complementary approaches were investigated: (i) model checking and the (ii) extraction of robustness test-cases from the same models. These two approaches don't overlap and when combined provide a wider reaching model/design validation ability than each one alone thus offering improved safety assurance. Results are very encouraging, even though they either fell short of the desired outcome as shown for model checking, or still appear as not fully matured as shown for robustness test case extraction. In the case of model checking, it was verified that the automatic model validation process can become fully operational and even expanded in scope once tool vendors help (inevitably) to improve the XMI standard interoperability situation. For the robustness test case extraction methodology, the early approach produced interesting results but need further systematisation and consolidation effort in order to produce results in a more predictable fashion and reduce reliance on expert's heuristics. Finally, further improvements and innovation research projects were immediately apparent for both investigated approaches, which point to either circumventing current limitations in XMI interoperability on one hand and bringing test case specification onto the same graphical level as the models themselves and then attempting to automate the generation of executable test cases from its standard UML notation.

  7. Exposures to patients in Australian radiological practice

    Energy Technology Data Exchange (ETDEWEB)

    Paix, D. (South Australian Inst. of Tech., Adelaide)

    1983-11-01

    The findings of a 1980 Australian Radiation Laboratory study of genetic and bone-marrow doses to the population from medical, dental and chiropractic uses of ionising radiation are discussed. Attention is drawn to the large variability in patient exposure: maximum values were from five to eleven times greater than the means.

  8. Exposures to patients in Australian radiological practice

    International Nuclear Information System (INIS)

    The findings of a 1980 Australian Radiation Laboratory study of genetic and bone-marrow doses to the population from medical, dental and chiropractic uses of ionising radiation are discussed. Attention is drawn to the large variability in patient exposure: maximum values were from five to eleven times greater than the means

  9. The clinical aspects of the acute facet syndrome: results from a structured discussion among European chiropractors

    Directory of Open Access Journals (Sweden)

    Jensen Tue

    2009-02-01

    Full Text Available Abstract Background The term 'acute facet syndrome' is widely used and accepted amongst chiropractors, but poorly described in the literature, as most of the present literature relates to chronic facet joint pain. Therefore, research into the degree of consensus on the subject amongst a large group of chiropractic practitioners was seen to be a useful contribution. Methods During the annual congress of The European Chiropractors Union (ECU in 2008, the authors conducted a workshop involving volunteer chiropractors. Topics were decided upon in advance, and the participants were asked to form into groups of four or five. The groups were asked to reach consensus on several topics relating to a basic case of a forty-year old man, where an assumption was made that his pain originated from the facet joints. First, the participants were asked to agree on a maximum of three keywords on each of four topics relating to the presentation of pain: 1. location, 2. severity, 3. aggravating factors, and 4. relieving factors. Second, the groups were asked to agree on three orthopaedic and three chiropractic tests that would aid in diagnosing pain from the facet joints. Finally, they were asked to agree on the number, frequency and duration of chiropractic treatment. Results Thirty-four chiropractors from nine European countries participated. They described the characteristics of an acute, uncomplicated facet syndrome as follows: local, ipsilateral pain, occasionally extending into the thigh with pain and decreased range of motion in extension and rotation both standing and sitting. They thought that the pain could be relieved by walking, lying with knees bent, using ice packs and taking non-steroidal anti-inflammatory drugs, and aggravated by prolonged standing or resting. They also stated that there would be no signs of neurologic involvement or antalgic posture and no aggravation of pain from sitting, flexion or coughing/sneezing. Conclusion The chiropractors

  10. A Practical Approach to Aid Physician Interpretation of Clinically Actionable Predictive Biomarker Results in a Multi-Platform Tumor Profiling Service.

    Directory of Open Access Journals (Sweden)

    KennethJosephRussell

    2014-04-01

    Full Text Available Patients in whom the standard of care has failed or who have uncommon tumors for which no standard of care exists are often treated with drugs selected based on the physician’s best guess. The rate of success for this method is generally low. With the advent of fast, affordable tumor profiling technologies, and a growth in the understanding of predictive biomarkers, it is now possible to identify drugs potentially associated with clinical benefit for such patients. We present the Caris approach to evidence-based tumor profiling and two patients with advanced ovarian and prostate cancer in whom standard of care had failed and tumor profiling identified an effective treatment schedule. To establish Caris Molecular Intelligence™ (CMI, over 120,000 clinical publications were screened and graded to characterize the predictive value of biomarkers that form the panel of tests. CMI includes multiple technologies to measure changes in proteins, ribonucleic acid (RNA, and deoxyribonucleic acid (DNA and proprietary software that matches the test results with the published evidence. The CMI results enable physicians to select drugs that are more likely to benefit the patients, avoid drugs that are not likely to work, and find treatment options that otherwise would not be considered. Worldwide, over 60,000 cancer patients have undergone evidence based tumor profiling with CMI. In the cases reported in this article, CMI identified treatments that would not have been routinely used in the respective clinical setting. The clinical outcomes observed help to illustrate the utility of this approach.

  11. Nearshoring Practices

    DEFF Research Database (Denmark)

    Slepniov, Dmitrij; Brazinskas, Sigitas; Wæhrens, Brian Vejrum

    2013-01-01

    factors affected them. The survey results reveal the perspective of Lithuanian vendors regarding their relationships with Scandinavian partners. These findings are used in assessing the future prospects of nearshoring in the Baltic region. Practical implications: The study relates the key attributes of...... and secondary statistical data. Part of the empirical base of the study is an examination of three Scandinavian firms that offshore their operations to vendors in the Baltics. To provide a more complete view of the practices and processes of offshoring in the region, we complement the case studies of...... Swedish and Danish manufacturers with a survey of 55 Lithuanian vendors and other statistical data. Findings: The paper outlines the main drivers of nearshoring for Scandinavian manufacturing firms. Based on in-depth insights into nearshoring initiatives, we elucidate how the initiatives evolved and what...

  12. APPROACH AND TREATMENT OF SUICIDAL BEHAVIOR IN THE CLINICAL PRACTICE OF DIFFERENT GROUPS OF HEALTH PROFESSIONALS IN SPAIN: RESULTS OF THE PROJECT EUREGENA.

    Directory of Open Access Journals (Sweden)

    Juan Luis Muñoz

    2014-12-01

    Full Text Available According to the WHO (World Health Organization and the European Union, suicide is considered to be a health problem of prime importance and to be one of the principal causes of unnatural death. In Spain, the number of suicides has increased 12% since 2005 . The Research Project “European Regions Enforcing Actions against Suicide (EUREGENAS, funded by the Health Program 2008-2013, has as main objective the description of an integrated model of Mental Health orientated to the prevention of suicide. The differences that allow distinguishing the meaning of prevention in suicide behavior are described and explained through a qualitative methodological strategy and through the creation of discussion groups formed by different groups of health professionals. The results highlight the existing differences between the diverse health professionals who come more in contact with this problem and it shows as well the coincidence of meaning that suicide has to be considered as a priority in the field of health.

  13. Risk Factors Associated with Unsafe Injection Practices at the First Injection Episode among Intravenous Drug Users in France: Results from PrimInject, an Internet Survey

    Directory of Open Access Journals (Sweden)

    Anne Guichard

    2015-01-01

    Full Text Available Background. New drug use patterns may increase the risk of human immunodeficiency virus and hepatitis infections. In France, new injection patterns among youths with diverse social backgrounds have emerged, which may explain the persistently high rates of hepatitis C virus infection. This study explores factors associated with injection risk behaviours at first injection among users who began injecting in the post-2000 era. Methods. A cross-sectional study was conducted on the Internet from October 2010 to March 2011, through an online questionnaire. Multivariate logistic regression identified the independent correlates of needle sharing and equipment (cooker/cotton filter sharing. Results. Among the 262 respondents (mean age 25 years, 65% were male. Both risk behaviours were positively associated with initiation before 18 years of age (aOR 3.7 CI 95% 1.3–10.6 and aOR 3.0 CI 95% 1.3–7.0 and being injected by another person (aOR 3.1 CI 95% 1.0–9.9 and aOR 3.0 CI 95% 1.3–7.1. Initiation at a party was an independent correlate of equipment sharing (aOR 2.6 95% CI 1.0–6.8. Conclusions. Results suggest a need for innovative harm reduction programmes targeting a variety of settings and populations, including youths and diverse party scenes. Education of current injectors to protect both themselves and those they might initiate into injection is critically important.

  14. Results from a National Central Auditory Processing Disorder Service: A Real-World Assessment of Diagnostic Practices and Remediation for Central Auditory Processing Disorder.

    Science.gov (United States)

    Cameron, Sharon; Glyde, Helen; Dillon, Harvey; King, Alison; Gillies, Karin

    2015-11-01

    This article describes the development and evaluation of a national service to diagnose and remediate central auditory processing disorder (CAPD). Data were gathered from 38 participating Australian Hearing centers over an 18-month period from 666 individuals age 6, 0 (years, months) to 24, 8 (median 9, 0). A total of 408 clients were diagnosed with either a spatial processing disorder (n = 130), a verbal memory deficit (n = 174), or a binaural integration deficit (n = 104). A hierarchical test protocol was used so not all children were assessed on all tests in the battery. One hundred fifty clients decided to proceed with deficit-specific training (LiSN & Learn or Memory Booster) and/or be fitted with a frequency modulation system. Families were provided with communication strategies targeted to a child's specific listening difficulties and goals. Outcomes were measured using repeat assessment of the relevant diagnostic test, as well as the Client Oriented Scale of Improvement measure and Listening Inventories for Education teacher questionnaire. Group analyses revealed significant improvements postremediation for all training/management options. Individual posttraining performance and results of outcome measures also are discussed. PMID:27587910

  15. NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 54: The technical communications practices of engineering technology students: Results of the NASA/DOD Aerospace Knowledge Diffusion Research Project phase 3 student surveys

    Science.gov (United States)

    Pinelli, Thomas E.; England, Mark; Barclay, Rebecca O.; Kennedy, John M.

    1995-01-01

    Engineering technology programs are characterized by their focus on application and practice, and by their approximately 50/50 mix of theory and laboratory experience. Engineering technology graduates are employed across the technological spectrum and are often found in areas that deal with application, implementation, and production. Yet we know very little about the communications practices and information-use skills of engineering technology students. In this paper, we report selected results of an exploratory study of engineering technology students enrolled in three U.S. institutions of higher education. Data are presented for the following topics: career goals and aspirations; the importance of, receipt of, and helpfulness of communications and information-use skills instruction; collaborative writing; use of libraries; and the use of electronic (computer) networks.

  16. Classification of complementary and alternative medical practices: Family physicians' ratings of effectiveness.

    Science.gov (United States)

    Fries, Christopher J

    2008-11-01

    ABSTRACTOBJECTIVETo develop a classification of complementary and alternative medicine (CAM) practices widely available in Canada based on physicians' effectiveness ratings of the therapies.DESIGNA self-administered postal questionnaire asking family physicians to rate their "belief in the degree of therapeutic effectiveness" of 15 CAM therapies.SETTINGProvince of Alberta.PARTICIPANTSA total of 875 family physicians.MAIN OUTCOME MEASURESDescriptive statistics of physicians' awareness of and effectiveness ratings for each of the therapies; factor analysis was applied to the ratings of the 15 therapies in order to explore whether or not the data support the proposed classification of CAM practices into categories of accepted and rejected.RESULTSPhysicians believed that acupuncture, massage therapy, chiropractic care, relaxation therapy, biofeedback, and spiritual or religious healing were effective when used in conjunction with biomedicine to treat chronic or psychosomatic indications. Physicians attributed little effectiveness to homeopathy or naturopathy, Feldenkrais or Alexander technique, Rolfing, herbal medicine, traditional Chinese medicine, and reflexology. The factor analysis revealed an underlying dimensionality to physicians' effectiveness ratings of the CAM therapies that supports the classification of these practices as either accepted or rejected.CONCLUSIONThis study provides Canadian family physicians with information concerning which CAM therapies are generally accepted by their peers as effective and which are not. PMID:19005130

  17. The impact of differences in operating practices on the development and use of advanced reactor design plant procedures: results from the US-APWR human-system interface test program

    International Nuclear Information System (INIS)

    The application of standardized plant designs across countries must be sensitive to the differences in operating practices and nowhere is this more evident than in the design of the Human-System Interface (HSI). This paper presents and discusses the critical differences that must be considered in the development and use of plant procedures. Specifically, the operating practices of Japan and the United States, and their resulting effects on the design and application of a procedure system are used as an example. Over a three-year period, the US-APWR program completed a series of human-in-the-loop dynamic tests, with the principal purpose of identifying the modifications needed in the basic Japanese HSI design as it moves into the United States (US). Using the Mitsubishi Electric Power Products (MEPPI) simulator, licensed US operating crews and preselected test scenarios, both subjective and objective data were collected on crew performance for various specific interface design elements. These data were then analyzed for impacts on individual and crew performance including workload, situation awareness, the ability to keep pace with evolving plant events and the ability to look ahead. As would be expected, one important topic that affected each of these performance areas was that of the procedure design and implementation. As the tests were performed, subsequent designs of the procedure system moved from a simple translation into English of the Japanese style procedures, to the currently in use format of US paper procedures, to the simple computerization of these US paper procedures, IEEE level 1, to the resulting final design of a computer based procedure (CBP) system, IEEE level 2, that supports the US operating practices. This paper describes the differences between the US and Japanese practices along with a discussion of why the authors believe both have been highly successful in their respective countries but are not one to one applicable between the countries

  18. Regulatory Practices on Ageing Management and Long Term Operation of Nuclear Power Plants in the Ibero-American Region. Results of the FORO/IAEA Programme on Nuclear and Radiation Safety in Ibero-America

    International Nuclear Information System (INIS)

    Although the operating lifetime of a nuclear power plant was originally anticipated to be in the range of 30-40 years, 200 of the 434 currently in operation are over 30 years old. In this context, Member States have assigned high priority to continuing the operation of nuclear power plants beyond the lifetime initially planned - while also maintaining the highest safety conditions possible. It is thus essential to encourage international cooperative efforts in the development of safety regulatory practices on ageing management and long term operation. Established in 1997, the Ibero-American Forum of Radiological and Nuclear Regulatory Agencies (FORO) aims to strengthen its members' radiological and nuclear safety regulatory organizations. Through a regional network of radiological and nuclear safety regulators, States in the Ibero-American region have worked together to strengthen radiation protection for patients, to improve safety at radiation installations, to tightten controls on radioactive sources used in medicine, agriculture and industry, and to improve safety and security at nuclear power plants. Since FORO's creation, it has cooperated with the IAEA in areas of mututal interest, and a technical programme administered by the IAEA was established in 2003 and formalized in Practical Arrangements signed in 2010. This publication presents the results of the 2009-2010 FORO/IAEA project on regulatory practices on ageing management and safety considerations for extending the operating lifetime of nuclear power plants. The purpose of the project was to provide nuclear regulators in the region with guidance on regulatory criteria, assessment, regulatory inspection and periodic safety reviews relating to ageing management and long term operation of nuclear power plants. The results are presented in a set of four reports, with guidelines for FORO members and a summary report of the project. These reports contain valuable information for the development of future

  19. Pro NET Best Practices

    CERN Document Server

    Ritchie, Stephen D

    2011-01-01

    Pro .NET Best Practices is a practical reference to the best practices that you can apply to your .NET projects today. You will learn standards, techniques, and conventions that are sharply focused, realistic and helpful for achieving results, steering clear of unproven, idealistic, and impractical recommendations. Pro .NET Best Practices covers a broad range of practices and principles that development experts agree are the right ways to develop software, which includes continuous integration, automated testing, automated deployment, and code analysis. Whether the solution is from a free and

  20. Management practices for improving sustainable crop production in tropical acid soils. Results of a coordinated research project organized by the Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture

    International Nuclear Information System (INIS)

    As a result of the burgeoning world population, there is an urgent need to increase food crop production. This can be achieved through intensification, diversification and specialization of agricultural production systems in existing cultivated land or by expansion of the land under cultivation. According to FAO estimates, only 11% of the earth's surface is currently cultivated (1406 Mha) and about 24% (3900 Mha) is potentially arable, most of which, 2500 Mha, is composed of acid soils with 1700 Mha located in the humid tropics. Thus, the greatest potential for expanding agricultural land lies in the tropical forest and savannah regions dominated by highly weathered, acid, infertile soils, mostly Oxisols and Ultisols. Soil acidification problems are also likely to increase, with rising CO2 levels in the atmosphere, continuous use of ammonium-based nitrogenous fertilizers, removal of nutrients in farm products without replenishment and nitrate leaching. The savannahs are mainly located in humid and subhumid tropical areas and suitable for rainfed cropping conditions. They comprise a sizeable amount of the agricultural land in many countries of Africa and Latin America and include also the largely anthropic savannahs of tropical Asia. The acid savannah soils are mostly considered marginal because of their inherent low fertility and high susceptibility to rapid degradation. The cultivation of these soils without proper soil management and conservation practices has resulted in an accelerated rate of degradation of the natural resource base. Therefore, management practices must be developed/improved to avoid further degradation of the resource base and to sustain cop productivity in tropical acid soils. This Coordinated Research Project (CRP) was conceived as a follow-up of the CRP on 'The use of nuclear and related techniques to evaluate the agronomic effectiveness of phosphatic fertilizers in particular rock phosphates' (1993-1998), where P fertilizer management

  1. 重庆市强化实验室监(检)测结果技术依托的做法%Practice of Intensifying Test Results Technology Based Laboratory in Chongqing

    Institute of Scientific and Technical Information of China (English)

    曹芸; 曾政; 熊仲良; 范首君; 黄诚; 黄恒

    2015-01-01

    兽医实验室是动物防疫技术支撑体系的重要环节,在疫病防控中起着基础性作用。在长期的工作实践中,重庆市不断探索如何充分发挥兽医实验室的职能职责,推动兽医实验室建设和可持续发展,结合重庆市兽医工作“三项制度”的建设情况,探索建立以兽医实验室监(检)测结果为导向、推进兽医实验室建设与发展的工作模式。%Veterinary labs provide strong technical support to animal epidemic prevention system,and play basis role in animal disease prevention and control. Chongqing CADC,in the long term working practice,continued efforts to fulfill functions and duties of veterinary labs,promote veterinary labs construction and sustainable development. This article discussed a veterinary labs test result guiding brand-new working pattern,and combined with "three systems" in Chongqing veterinary work practice,to promote construction and development of veterinary labs.

  2. Implementation of the international code of practice on dosimetry in radiotherapy (TRS 398): Review of testing results. Final report of the coordinated research projects on implementation of the international code of practice TRS 398 at Secondary Standards Dosimetry Laboratories and hospitals

    International Nuclear Information System (INIS)

    In 2000 the IAEA published the Code of Practice (CoP) entitled Absorbed Dose Determination in External Beam Radiotherapy: An International Code of Practice for Dosimetry Based on Standards of Absorbed Dose to Water (IAEA Technical Reports Series No. 398). This CoP recommends procedures to determine absorbed dose to water from measurements made with an ionization chamber in photon, electron, proton and heavy-ion beams. The implementation of TRS 398 decreases the uncertainty in the dosimetry of radiotherapy beams and provides the Member States with a unified and consistent framework, which had not existed before. TRS 398 is gradually replacing the CoPs published earlier by the IAEA such as TRS 277 and TRS 381, which most Member States use today, and evidence of improvement in practical dosimetry is necessary to advocate its implementation. TRS 398 is addressed both to standards dosimetry laboratories, especially Secondary Standards Dosimetry Laboratories (SSDLs), and to hospitals. To provide practical guidance to SSDLs on the calibrations and dissemination of calibration coefficients to hospitals in accordance with TRS 398, a coordinated research project (CRP E2.10.04) was established. Furthermore, to provide guidelines for practical implementation of TRS 398 for the hospital users in Member States, the coordinated research project (CRP E2.40.09) was extended. The main goal of the extended project was to test the procedures recommended in TRS 398 for different types of radiation beams and ionization chambers, and to compare the results with those obtained following other major dosimetry protocols that are in use all over the world. The testing of TRS 398 was performed by a group of medical physicists from hospitals and various institutions around the world. The two CRPs, CRP E2.10.04 and the extension of CRP E2.40.09, were conducted for three and two years respectively. The present publication is a compilation of the results and findings by the participants of both

  3. Deficient crisis-probing practices and taken-for-granted assumptions in health organisations

    Directory of Open Access Journals (Sweden)

    Deon V. Canyon

    2011-04-01

    Full Text Available The practice of crisis-probing in proactive organisations involves meticulous and sustained investigation into operational processes and management structures for potential weaknesses and flaws before they become difficult to resolve. In health organisations, crisis probing is a necessary part of preparing to manage emerging health threats. This study examined the degree of pre-emptive probing in health organisations and the type of crisis training provided to determine whether or not they are prepared in this area. This evidence-based study draws on cross-sectional responses provided by executives from chiropractic, physiotherapy, and podiatry practices; dental and medical clinics; pharmacies; aged care facilities; and hospitals. The data show a marked lack of mandatory probing and a generalised failure to reward crisis reporting. Crisis prevention training is poor in all organisations except hospitals and aged care facilities where it occurs at an adequate frequency. However this training focuses primarily on natural disasters, fails to address most other crisis types, is mostly reactive and not designed to probe for and uncover key taken-for-granted assumptions. Crisis-probing in health organisations is inadequate, and improvements in this area may well translate into measurable improvements in preparedness and response outcomes.

  4. An Analysis of Media Ethics Anomie Resulting from Informal Media Relations Practice%论非正式媒体关系活动导致的媒体伦理失范现象

    Institute of Scientific and Technical Information of China (English)

    冯丙奇

    2011-01-01

    Informal media relations practices by public relations practitioners can result in media ethics anomie. Researchers in the field of media relations have analyzed related phenomena, focusing on the relationship between public relations practitioners and me%公关人员开展的非正式媒体关系活动会导致特定媒体伦理失范现象发生。媒体关系领域的研究者以公关人员与媒体人员之间的关系为出发点,对相关现象进行了关注。本文通过文献研究,试图对非正式媒体关系活动及其导致的媒体伦理失范现象进行解析。

  5. Associations between Parental Concerns about Preschoolers’ Weight and Eating and Parental Feeding Practices: Results from Analyses of the Child Eating Behavior Questionnaire, the Child Feeding Questionnaire, and the Lifestyle Behavior Checklist

    Science.gov (United States)

    Ek, Anna; Sorjonen, Kimmo; Eli, Karin; Lindberg, Louise; Nyman, Jonna; Marcus, Claude; Nowicka, Paulina

    2016-01-01

    Introduction Insight into parents’ perceptions of their children’s eating behaviors is crucial for the development of successful childhood obesity programs. However, links between children’s eating behaviors and parental feeding practices and concerns have yet to be established. This study aims to examine associations between parental perceptions of preschoolers’ eating behaviors and parental feeding practices. First, it tests the original 8-factor structure of the Child Eating Behavior Questionnaire (CEBQ). Second, it examines the associations with parental feeding practices, measured with the Child Feeding Questionnaire (CFQ). Materials and Methods Questionnaires were sent to parents from 25 schools/preschools in Stockholm, Sweden and to parents starting a childhood obesity intervention. The CEBQ factor structure was tested with confirmatory factor analysis (CFA). Associations between CEBQ subscales Food approach and Food avoidance and CFQ factors Restriction, Pressure to eat and Monitoring were examined with structural equation modelling (SEM), adjusting for child and parental characteristics, and parental confidence, measured with the Lifestyle Behavior Checklist (LBC). CFQ Concern for child weight and Perceived responsibility for child eating were used as mediators. Results 478 parents completed the questionnaires (children: 52% girls, mean age 5.5 years, 20% overweight/obese). A modified 8-factor structure showed an acceptable fit (TLI = 0.91, CFI = 0.92, RMSEA = 0.05 and SRMR = 0.06) after dropping one item and allowing three pairs of error terms to correlate. The SEM model demonstrated that Food approach had a weak direct effect on Restriction, but a moderate (β = 0.30) indirect effect via Concern, resulting in a substantial total effect (β = 0.37). Food avoidance had a strong positive effect on Pressure to eat (β = 0.71). Discussion The CEBQ is a valid instrument for assessing parental perceptions of preschoolers’ eating behaviors. Parental

  6. Associations between Parental Concerns about Preschoolers' Weight and Eating and Parental Feeding Practices: Results from Analyses of the Child Eating Behavior Questionnaire, the Child Feeding Questionnaire, and the Lifestyle Behavior Checklist.

    Directory of Open Access Journals (Sweden)

    Anna Ek

    Full Text Available Insight into parents' perceptions of their children's eating behaviors is crucial for the development of successful childhood obesity programs. However, links between children's eating behaviors and parental feeding practices and concerns have yet to be established. This study aims to examine associations between parental perceptions of preschoolers' eating behaviors and parental feeding practices. First, it tests the original 8-factor structure of the Child Eating Behavior Questionnaire (CEBQ. Second, it examines the associations with parental feeding practices, measured with the Child Feeding Questionnaire (CFQ.Questionnaires were sent to parents from 25 schools/preschools in Stockholm, Sweden and to parents starting a childhood obesity intervention. The CEBQ factor structure was tested with confirmatory factor analysis (CFA. Associations between CEBQ subscales Food approach and Food avoidance and CFQ factors Restriction, Pressure to eat and Monitoring were examined with structural equation modelling (SEM, adjusting for child and parental characteristics, and parental confidence, measured with the Lifestyle Behavior Checklist (LBC. CFQ Concern for child weight and Perceived responsibility for child eating were used as mediators.478 parents completed the questionnaires (children: 52% girls, mean age 5.5 years, 20% overweight/obese. A modified 8-factor structure showed an acceptable fit (TLI = 0.91, CFI = 0.92, RMSEA = 0.05 and SRMR = 0.06 after dropping one item and allowing three pairs of error terms to correlate. The SEM model demonstrated that Food approach had a weak direct effect on Restriction, but a moderate (β = 0.30 indirect effect via Concern, resulting in a substantial total effect (β = 0.37. Food avoidance had a strong positive effect on Pressure to eat (β = 0.71.The CEBQ is a valid instrument for assessing parental perceptions of preschoolers' eating behaviors. Parental pressure to eat was strongly associated with children

  7. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 45; The Technical Communications Practices of US Aerospace Engineers and Scientists: Results of the Phase 3 US Aerospace Engineering Educators Survey

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1996-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. Little is also known about the intermediary-based system that is used to transfer the results of federally funded R&D to the U.S. aerospace industry. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports, present a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis the technical communication practices of U.S. aerospace engineers and scientists who were members of the American Institute of Aeronautics and Astronautics (AIAA) and identified themselves as educators.

  8. NASA/DoD Aerospace Knowledge Diffusion Research Project: Report 43: The Technical Communication Practices of U.S. Aerospace Engineers and Scientists: Results of the Phase 1 Mail Survey -- Manufacturing and Production Perspective

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1996-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis the technical communication practices of U.S. aerospace engineers and scientists who were members of the Society of Manufacturing Engineers.

  9. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report No. 36: The Technical Communications Practices of US Aerospace Engineers and Scientists: Results of the Phase 1 NASA Langley Research Center Mail Survey

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1995-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis the technical communications practices of U.S. aerospace engineers and scientists who were assigned to the Research and Technology Group (RTG) at the NASA Langley Research Center in September 1995.

  10. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 25: The technical communications practices of British aerospace engineers and scientists: Results of the phase 4 RAeS mail survey

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    The U.S. government technical report is a primary means by which the results of federally funded research and development (R&D) are transferred to the U.S. aerospace industry. However, little is known about this information product in terms of its actual use, importance, and value in the transfer of federally funded R&D. To help establish a body of knowledge, the U.S. government technical report is being investigated as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. In this report, we summarize the literature on technical reports and provide a model that depicts the transfer of federally funded aerospace R&D via the U.S. government technical report. We present results from our investigation of aerospace knowledge diffusion vis-a-vis the U.S. government technical report, and present the results of research that investigated aerospace knowledge diffusion vis-a-vis the technical communications practices of British aerospace engineers and scientists.

  11. A formação médica e a clínica ampliada: resultados de uma experiência brasileira The medical education and the extended general practice: results of a Brazilian experiment

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Marmorato Botta Hafner

    2010-06-01

    Full Text Available Trata-se de um estudo qualitativo que faz parte de uma pesquisa de avaliação de um curso de medicina com o uso de metodologias ativas de ensino-aprendizagem, baseada na triangulação de métodos. O objetivo é avaliar resultados relacionados ao conceito de clínica ampliada. As fontes de informação utilizadas no estudo abrangem dezessete entrevistas semiestruturadas com egressos e uma situação que simulava a prática médica, da qual participaram sete egressos e uma paciente simulada. A análise das informações e a produção dos dados baseiam-se no método de interpretação de sentidos, segundo referencial da hermenêutica-dialética. Os resultados apontam aspectos que fundamentam a clínica ampliada, evidenciados em duas temáticas: a relação médico-paciente e abordagem do paciente. Em termos de conclusão, observa-se que o curso de medicina avaliado se aproxima da formação do médico generalista, humanista, crítico e reflexivo, que pode intervir tanto nos diferentes níveis de atenção de saúde quanto no enfoque individual e coletivo. Conclui-se, ainda, que há limites para a efetivação de uma clínica ampliada nos diversos cenários de saúde.This is a qualitative study that is part of an evaluation research of a medicine course with the use of active teaching-learning methodologies based on the triangulation of methods. The aim is to evaluate the results related to the extended general practice concept. The sources of information used in the study include 17 semi-structured interviews with ex-prisoners and a situation that simulated the medical practice, of which seven ex-prisoners and a simulated patient participated. The analysis of the information and the production of the data were based on the method of interpretation of senses, according to the referential hermeneutic-dialectic system. The results point to aspects that justify the extended general practice, evidenced in two themes: the doctor-patient relationship

  12. Progress and goals for INMM ASC N15 consensus standard ""Administrative practices for the determination and reporting of results of non-destructive assay measurements of nuclear material in situ for safeguards nuclear criticality safety and other purposes

    Energy Technology Data Exchange (ETDEWEB)

    Bracken, David S [Los Alamos National Laboratory; Lamb, Frank W [UNWIN CORPORATION

    2009-01-01

    This paper will discuss the goals and progress to date on the development of INMM Accredited Standard Committee (ASC) N15 consensus standard Administrative Practices for the Determination and Reporting of Results of Non-Destructive Assay Measurements of Nuclear Material in situ for Safeguards, Nuclear Criticality Safety, and Other Purposes. This standard will define administrative practices in the areas of data generation and reporting of NDA assay of holdup deposits with consideration of the stakeholders of the reported results. These stakeholders may include nuclear material accounting and safeguards, nuclear criticality safety, waste management, health physics, facility characterization, authorization basis, radiation safety, and site licensing authorities. Stakeholder input will be solicited from interested parties and incorporated during the development of the document. Currently only one consensus standard exists that explicitly deals with NDA holdup measurements: ASTM C1455 Standard Test Method for Nondestructive Assay of Special Nuclear Material Holdup Using Gamma-Ray Spectroscopic Methods. The ASTM International standard emphasizes the activities involved in actually making measurements, and was developed by safeguards and NDA experts. This new INMM ASC N15 standard will complement the existing ASTM international standard. One of the largest driving factors for writing this new standard was the recent emphasis on in situ NDA measurements by the safeguards community due to the Defense Nuclear Facility Safety Board (DNFSB) recommendation 2007-1 on in situ NDA measurements. Specifically, DNFSB recommendation 2007-1 referenced the lack of programmatic requirements for accurate in situ measurements and the use of measurement results for compliance with safety based requirements. That being the case, this paper will also discuss the progress made on the Implementation Plan for Defense Nuclear Facilities Safety Board Recommendation 2007-1 Safety-Related In Situ

  13. Social Practices

    DEFF Research Database (Denmark)

    Schmidt, Kirsten

    2013-01-01

    The present understanding of LCM as a product management system supported by a number of tools and methods does not pay attention to the importance of social practices that the employees develop in relation to the systematic approach. A new conceptual model of LCM including the social practices i...

  14. Ophthalmic practice.

    OpenAIRE

    Sue Stevens

    2005-01-01

    Eye health workers carry out many basic routine procedures. Sometimes bad practice develops and this, in turn, may lead to new members of staff learning unsafe methods. Community Eye Health Journal plans to run a series on practical procedures, when applicable, relating to the theme.

  15. Ophthalmic practice

    Directory of Open Access Journals (Sweden)

    Sue Stevens

    2005-03-01

    Full Text Available Eye health workers carry out many basic routine procedures. Sometimes bad practice develops and this, in turn, may lead to new members of staff learning unsafe methods. Community Eye Health Journal plans to run a series on practical procedures, when applicable, relating to the theme.

  16. Best Practices in Project Management

    OpenAIRE

    Liviu ILIES; Emil CRISAN; Ioana Natalia MURESAN

    2010-01-01

    Project management has evolved over time, becoming the principal mean of dealing with change in modern organizations. Best practices have occurred as a result of business evolution and of practicing project management at a global level. Best practices in project management, if followed, increase the chances of success in achieving goals when dealing with projects. In this article we present the concept of best practice, the advantages of using best practices in project management, which are t...

  17. Industrial practices

    International Nuclear Information System (INIS)

    This document reports the industrial practices carried out by the author viewing the requirements fulfilled for obtention the academic degree in chemical engineering of the San Andres University - Bolivia

  18. Practicing induction:

    DEFF Research Database (Denmark)

    Sprogøe, Jonas; Rohde, Nicolas

    2009-01-01

    We claim that induction potentially triggers both individual and organizational learning and by drawing on practice-based theory we discuss how the interplay between individual and organization, what we call a generative dance, ignites both kinds of learning....

  19. Resultados percibidos obtenidos por las empresas asociados al uso de las prácticas de alta implicación (HIWP (perceived results obtained by companies associated to the use of high involvement work practices

    Directory of Open Access Journals (Sweden)

    Graziela Conci

    2012-06-01

    Full Text Available El objetivo principal de este artículo es investigar las relaciones entre las prácticas de alta implicación (HIWP y los resultados percibidos por los mandos de las empresas. En la investigación identificamos los metaanalisis y revisiones de literatura realizados en los últimos 25 años. Aportamos una revisión de literatura de los artículos publicados en los años no contenidos en las revisiones anteriores (del 2007 al 2011 y que analizan la asociación de los indicadores de productividad, satisfacción, calidad, competitividad o atención al cliente como resultados de la aplicación de las HIWP. Como principal conclusión podemos indicar que la adopción de las HIWP, en general, aporta resultados positivos a las organizaciones. (The main goal of this article is to investigate the relationships between high involvement work practices (HIWP and the results perceived by managers of the companies using them. In the research we identify both the meta-analyses and the literature reviews done in the last 25 years. We present a revision of the literature of the articles published in the years not included in the previous revisions (from 2007 to 2011 and that analyze the association of productivity, satisfaction, quality, competitiveness or customer care indicators, as a result of the use of HIWP. As a main conclusion we can show that the adoption of HIWP, in general, contribute with positive results to the organizations.

  20. Recovery of the external anticorrosion protection systems of onshore pipelines - evaluation methods and practical results; Recuperacao de sistemas de protecao anticorrosiva externa de dutos terrestres - metodos de avaliacao e resultados praticos

    Energy Technology Data Exchange (ETDEWEB)

    Castinheiras, Wilson; Koebsch, Andre; Silva, Flavio A. da [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil)

    2003-07-01

    The rehabilitation of an old pipeline means to increase its lifetime, making it safety to operate in the necessaries conditions to transport the product. The pipe steel wall evaluation, related to it thickness reduction, due to, basically, internal and external corrosion, is fundamental to guide its rehabilitation. The techniques used to this evaluation are 'pig' and specials field survey. These last surveys are realized over the soil surface (digs is not necessary to access the pipeline or the pipeline operation is not necessary to stop) and objective to verify the pipeline coating and Cathodic Protection System conditions. Due to the actual authors experience, this paper will only treat of the Rehabilitation of the External Anti corrosive Protection System (coating and cathodic protection) of onshore pipelines. This paper present the techniques current attenuation, ON-OFF pipe-to-soil potential close interval survey and DCVG and same practical results obtained with the application of these techniques on the Sergipe/Bahia gas pipeline. (author)

  1. Analysis of Practice and Results of Quality Control Circle in Pharmacy Intravenous Admixture Services%品管圈在静脉用药调配中心的实践与结果分析

    Institute of Scientific and Technical Information of China (English)

    薛进; 罗建华; 张先明

    2013-01-01

    Objective:Through carrying out quality control circle (QCC) in pharmacy intravenous admixture services (PIVAS),to reduce medicine configuration errors,ensure patients' medication safety and improve the level of pharmaceutical affairs management in hospital.Methods:Introduce concept of quality management,use a variety of statistical methods,and solve problems in practice work by seven QC gimmick.Results:Configuration errors in the process of PIVAS fell by an average of 34.00 per month to an average of 17.17 per month after implementation of QCC.Conclusions:Operating QCC on the management of medicine configuration and quality in PIVAS,can greatly exert the team cooperation ability of whole department,reduce the medicine configuration errors,improve the quality of the medicine,and reduce the risk in the process of practice.%目的:通过在静脉用药调配中心(PIVAS)推行品管圈活动,减少药物调配差错,保障患者用药安全,提高医院药事管理水平.方法:引入品质管理概念,运用多种统计方法,按照品管七大手法来解决实际工作中的问题.结果:PIVAS药物调配过程的差错由改善前的平均每月34.00例降低至改善后的平均每月17.17例.结论:将品管圈的改善方法运用于PIVAS的药物调配质量管理中,可以极大发挥整个科室团队协作能力,减少药物调配差错,提高药物调配质量,降低工作过程中的风险.

  2. Analysis of disease patterns and cost of treatments for prevention of deep venous thrombosis after total knee or hip replacement: results from the Practice Analysis of THromboprophylaxis after Orthopaedic Surgery (PATHOS study

    Directory of Open Access Journals (Sweden)

    Degli Esposti L

    2012-12-01

    Full Text Available Luca Degli Esposti,1 Guido Didoni,2 Teresa Simon,3 Stefano Buda,1 Diego Sangiorgi,1 Ezio Degli Esposti11CliCon Health, Economics and Outcomes Research, Ravenna, Italy; 2BMS Italy, Rome, Italy; 3BMS Global, Princeton, NJ, USAIntroduction: Venous thromboembolism (VTE is a well-known complication of total hip replacement (THR and total knee replacement (TKR. Various drugs have been introduced in an attempt to reduce the mortality as well as the short-term and long-term morbidity associated with the development of VTE. The aim of this study was to analyze drug utilization for thromboprophylaxis and the cost of illness in real clinical practice in patients with THR or TKR.Materials and methods: A multicenter, retrospective, observational cohort study based on local health unit administrative databases was conducted. All patients (≥18 years old discharged for THR/TKR procedures between January 1, 2007 and December 31, 2008 were included in the study. The date of first hospital discharge was the index date; patients were followed up for a period of 12 months.Results: A total of 10,389 patients were included: 3516 males (33.8%, 69.4 ± 10.4 years and 6873 females (66.2%, 71.7 ± 9.0 years, of which 5483 (52.8% were discharged for THR and 4906 (47.2% for TKR. First antithrombotic treatments after discharge were enoxaparin (3937, 37.9%, heparin (3752, 36.1%, antiplatelet agents (658, 6.3%, vitamin K antagonists (276, 2.7%, fondaparinux (136, 1.3%, combinations (185, 1.8%, and no therapy (1445, 13.9%. Overall, we observed 2347 (22.6% treatment changes; median duration of antithrombotic treatment was 23 days (range 11–47 for THR and 22 days (range 11–46 for TKR. During the follow-up period, we observed 129 cases of VTE (120 per 10,000 patients, five post-thrombotic syndrome (4.8 per 10,000 patients, and three heparin-induced thrombocytopenia (2.9 per 10,000 patients. Median cost for both THR and TKR was €9052.00 (range €8063.00–€9084.96, with

  3. Reverse auction results for implementation of decentralized retrofit best management practices in a small urban watershed (Cincinnati OH)Participatory storm water management and sustainability – what are the connections?

    Science.gov (United States)

    Urban stormwater is typically conveyed to centralized infrastructure, and there is great potential for reducing stormwater runoff quantity through decentralization. In this case we hypothesize that smaller-scale retrofit best management practices (BMPs) such as rain gardens and r...

  4. Shielding practice

    International Nuclear Information System (INIS)

    The basis of shielding practice against external irradiation is shown in a simple way. For most sources of radiation (point sources) occurring in shielding practice, the basic data are given, mainly in the form of tables, which are required to solve the shielding problems. The application of these data is explained and discussed using practical examples. Thickness of shielding panes of glove boxes for α and β radiation; shielding of sealed γ-radiography sources; shielding of a Co-60 radiation source, and of the manipulator panels for hot cells; damping factors for γ radiation and neutrons; shielding of fast and thermal neutrons, and of bremsstrahlung (X-ray tubes, Kr-85 pressure gas cylinders, 42 MeV betatrons, 20 MeV linacs); two-fold shielding (lead glass windows for hot cells, 14 MeV neutron generators); shielding against scattered radiation. (orig./HP)

  5. Practice makes…?

    OpenAIRE

    Simpson, Adam

    2010-01-01

    One vivid memory from my time as a student was a quirk of a lecturer of mine, who would let us know that our performance in presentations was inadequate by writing ‘5P’ on a piece of paper and handing it to us. The term 5P referred to ‘plenty of practice prevents poor performance.’ Receiving a 5P meant that your performance wasn’t up to scratch and that you should have practiced more. I’m happy to report that I was never the recipient of such a note. The five Ps can of course be applied to an...

  6. Academic Practice

    DEFF Research Database (Denmark)

    Nielsen, Sandro; Heine, Carmen

    Vejledning i at undgå plagiering ved at følge de normer, der gælder for good academic practice. Dette indebærer at man angiver kilder korrekt, og når det er nødvendigt, og at man har en korrekt udformet fortegnelse over referencer. Vejledningen indeholder konkrete eksempler på korrekt kildeangive...

  7. Practical Latex

    CERN Document Server

    Grätzer, George

    2014-01-01

    Accessible at 200+ pages to all who want to learn the practical usages of LaTeX Avoids technical subjects like font usage Friendly and easy to read, with many examples included Extra source materials include sample LaTeX files and suggestions for further reading

  8. Practical Metallurgy

    DEFF Research Database (Denmark)

    Bissacco, Giuliano; Deganello, Davide

    2003-01-01

    This is the report regards the activities carried out during the practical metatllurgy course concerning material properties and structures and their testing & analysis methods. During the course several aspects of the materials have been considered and different techniques have been analyzed....

  9. Differentiation in Classroom Practice

    DEFF Research Database (Denmark)

    Mottelson, Martha

    2015-01-01

    Differentiation in School Practice is an ongoing research project currently being carried out in UCC’s research department by myself and my coworker Christina Jørgensen. The project includes a field study of everyday life in a Danish 5th grade classroom with the aim to observe, describe and analyze...... those everyday practices in the classroom that ultimately result in offering students different positions, identities and opportunities for participation....

  10. Trends in the knowledge, attitudes and practices of travel risk groups toward prevention of hepatitis B: Results from the repeated cross-sectional Dutch Schiphol Airport Survey 2002-2009

    NARCIS (Netherlands)

    P.J. van Genderen (P.); P.P.A.M. van Thiel (Pieter P. A.); P.G.H. Mulder (Paul); D. Overbosch (David)

    2014-01-01

    textabstractBackground Previous studies investigating the travellers' knowledge, attitudes and practices (KAP) profile indicated an important educational need among those travelling to risk destinations. Methods In the years 2002-2009 an annually repeated cross-sectional questionnaire-based survey w

  11. Results of the PAS Study: A Randomized Controlled Trial Evaluating the Effectiveness of a Web-Based Multiple Tailored Smoking Cessation Program Combined With Tailored Counseling by Practice Nurses.

    Science.gov (United States)

    Smit, E S; Candel, M J J M; Hoving, C; de Vries, H

    2016-09-01

    This study investigated the effects of Web-based multiple computer tailoring and counseling by a practice nurse (MTC) compared with computer tailoring without counseling (MT) and usual care (UC) on smoking cessation rates, via a randomized controlled trial with 414 Dutch adult smokers, recruited by 91 practice nurses from May 2009 to June 2010. Logistic multilevel regression analyses were conducted with 24-hour point prevalence, 7-day point prevalence, and prolonged abstinence after 6 and 12 months as dependent variables and experimental condition as the independent variable. After 6 and 12 months, 38% and 56% of respondents were followed up, respectively. At both follow-ups, no main effects of the interventions could be identified when comparing them with care as usual and with each other-neither in analyses using available data nor in analyses using a negative scenario in which respondents lost to follow-up were considered to still be smoking. A Web-based multiple computer-tailored smoking cessation program combined with a single face-to-face counseling session by a practice nurse may not be more effective than this computer-tailored program alone or than usual smoking cessation care in the general practice setting. Yet before concluding that the addition of counseling to Web-based computer tailoring cannot be successful, more research needs to be conducted to identify the optimal number of counseling sessions to be combined with the Web-based program and to how to best attune the two modalities. PMID:26934538

  12. Modelling Practice

    DEFF Research Database (Denmark)

    Cameron, Ian; Gani, Rafiqul

    2011-01-01

    This chapter deals with the practicalities of building, testing, deploying and maintaining models. It gives specific advice for each phase of the modelling cycle. To do this, a modelling framework is introduced which covers: problem and model definition; model conceptualization; model data...... requirements; model construction; model solution; model verification; model validation and finally model deployment and maintenance. Within the adopted methodology, each step is discussedthrough the consideration of key issues and questions relevant to the modelling activity. Practical advice, based on many...... years of experience is providing in directing the reader in their activities.Traps and pitfalls are discussed and strategies also given to improve model development towards “fit-for-purpose” models. The emphasis in this chapter is the adoption and exercise of a modelling methodology that has proven very...

  13. Practice Makes…

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    英语有句古谚,PRACTICE MACES PERFECT.但在下面这个小笑话中,却变成了——In Sunday school(主日学校,基督教会在周日开办的儿童班),the minister was trying to illus- trate the word"miracle.""Boys and girls,"he said,"suppose I stood on the roof of a ten-story

  14. Diffusing Best Practices

    DEFF Research Database (Denmark)

    Pries-Heje, Jan; Baskerville, Richard

    2014-01-01

    approach. The study context is a design case in which an organization desires to diffuse its best practices across different groups. The design goal is embodied in organizational mechanisms to achieve this diffusion. The study used Theory of Planned Behavior (TPB) as a kernel theory. The artifacts...... resulting from the design were two-day training workshops conceptually anchored to TBP. The design theory was evaluated through execution of eight diffusion workshops involving three different groups in the same company. The findings indicate that the match between the practice and the context materialized...... that the behavior will be effective). These two factors were especially critical if the source context of the best practice is qualitatively different from the target context into which the organization is seeking to diffuse the best practice....

  15. Prevention in practice

    DEFF Research Database (Denmark)

    Birch, Stephen; Bridgman, Colette; Brocklehurst, Paul;

    2015-01-01

    BACKGROUND: This paper is a summary document of the Prevention in Practice Conference and Special Supplement of BMC Oral Health. It represents the consensus view of the presenters and captures the questions, comments and suggestions of the assembled audience. METHODS: Using the prepared manuscripts...... for the conference, collected materials from scribes during the conference and additional resources collated in advance of the meeting, authors agreed on the summary document. RESULTS: The Prevention in Practice conference aimed to collate information about which diseases could be prevented in...... practice, how diseases could be identified early enough to facilitate prevention, what evidence based therapies and treatments were available and how, given the collective evidence, could these be introduced in general dental practice within different reimbursement models. CONCLUSIONS: While examples of...

  16. Cephalometry in orthodontic practice

    International Nuclear Information System (INIS)

    Cephalometry is applied in orthodontic practice to: - obtain information on the growth of the skull - assist diagnosis of the relationship between the jaws and abnormalities in dentition - evaluate the results of treatment. The course of the diagnostic procedure with the aid of the Ricketts analysis and evaluation of the treatment results using five superimpositions is demonstrated by means of two examples. (Auth.)

  17. Chiropractors in Finland – a demographic survey

    Directory of Open Access Journals (Sweden)

    Malmqvist Stefan

    2008-08-01

    Full Text Available Abstract Background The Finnish chiropractic profession is young and not fully accepted by Finnish healthcare authorities. The demographic profile and style of practice has not been described to date. However, as the profession seems to be under rapid development, it would be of interest to stakeholders, both chiropractic and political, to obtain a baseline description of this profession with a view to the development of future goals and strategies for the profession. The purpose of this study was to describe the chiropractic profession in Finland in relation to its demographic background, the demographics of their clinics, practice patterns, interactions with other health care practitioners and some of the professions' plans for the future. Methods A structured questionnaire survey was conducted in 2005, in which all 50 members of the Finnish Chiropractic Union were invited to participate. Results In all, 44 questionnaires were returned (response rate 88%. Eighty percent of the respondents were men, and 77% were aged 30 to 44 years old, most of whom graduated after 1990 with either a university-based bachelors' or masters' degree in chiropractic. Solo practice was their main practice pattern. The vast majority described their scope of practice to be based on a musculoskeletal approach, using the Diversified Technique, performing Soft Tissue Therapy and about two-thirds also used an Activator Instrument (mechanical adjusting instrument. The mean number of patient visits reported to have been seen weekly was 59 of which nine were new patients. Most practitioners found this number of patients satisfactory. At the initial consultation, 80% of respondents spent 30–45 minutes with their patients, 75% spent 20–30 minutes with "new old" patients and on subsequent visits 80% of respondents spent 15–30 minutes. Interactions with other health care professions were reasonably good and most of chiropractors intended to remain within the profession

  18. Eating practices

    DEFF Research Database (Denmark)

    Christensen, Bodil Just

    The objective of the thesis is to describe and discuss how hunger and fullness are practiced (Mol and Law 2004), and emerge as multiple objects (Mol 2002). Within a theoretical framework inspired by Actor Network Theory and material semiotics, this is accomplished through a critical discussion...... at a public hospital. Through notions of partiality (Strathern 1991), multiplicity (Mol 2002) and performativity (Law 1999) the thesis attempts to develop a novel approach by drawing on aspects of material semiotics and Actor Network Theory, yet combining these with a more ethnographic orientation. In so...

  19. Practical knowledge

    DEFF Research Database (Denmark)

    Christensen, Jens

    2006-01-01

    The chapter aims to develop conceptions of practical knowledge, relevant to skills and Bildung in engineering science. The starting point is Francis Bacon’s ideas of new science, developed 400 years ago. It is argued that Bacon’s vision has become dogmatized during the course of history, whereas...... his critical attitude has become superseded. A critical discussion on the heritage from Bacon leads to a focus on the concepts of truth, utility, and goodness. Unification of skills and Bildung, it is stated, should imply the ability to deal explicitly with these concepts and their interrelations...

  20. Fatores geradores de competitividade na manufatura: uma relação entre práticas e resultados FACTORS THAT GENERATE COMPETITIVENESS IN MANUFACTURING: A RELATIONSHIP BETWEEN PRACTICES AND RESULTS

    Directory of Open Access Journals (Sweden)

    Rolf Hermann Erdmann

    2011-04-01

    Full Text Available The current context and rapid change a lot of possibilities of decisions organizational environment becomes more complex. The global dimension of competition requires that companies will be administeredunder a new perspective that relations between the different areas of the organization. To this end, it is necessary to observe which are competitive surrounding priorities on the areas and leading the Organization to achieve higher levels of competitiveness. This work, through a vast documentary research in books, journals and Annals, installed a waiver in respect of the main priorities competitive. The consolidated results in 100 (one hundred and thirteen items generators of competitiveness. These were classified into 14 (fourteen groups: Lean Production, Benchmarking, Customer Relations, Technology, Integration, Eco Responsibility, Information, Flexibility, Cost, Quality, Innovation, Reliability, Training and Speed. Still, examined the interrelation between them through a vision of practices and outcomes. From this conclusion future objective studies for the use of these items or factors in the development of an organizational diagnostic tool that takes into account the complex relations of a production system. Normal 0 21 false false false PT-BR X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabela normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso

  1. IMRT practice

    International Nuclear Information System (INIS)

    Described are details of the author's experience of IMRT (intensity-modulated radiation therapy) in his hospital, and for establishing its routine practice to treat prostate cancer. Before introduction of IMRT equipment ELEKTA PRECISE (Elekta Instr.), needed are the estimation of manpower (technologists, doctors and nurses) and their working hours (CT for therapy planning, validation, dosimetry, dose distribution measurement and IMRT practice); conformity to the Health Insurance Standard of facility and manpower; desirable staff cooperation; indication of the disease (prostate cancer, here) and its stage; treatment dose; evaluation of outcomes; cooperative connection with other departments; and cost. Actually, CT therapy planning is conducted with the simulator Pinnacle3 (Philips Healthcare) for dose distribution to define the isocenter by manufacturers of the simulator, of the IMRT equipment and hospital personnel through inverse treatment planning of patients with the cancer of low to intermediate risk. The subjects necessary for parameter setting are the objectives and constraints of the prostate (the planning target volume and its ring) and surround ring (rectum, bladder, femoral head and rectum overlap), respectively. IMRT is conducted with the equipment above by step and shooting technique as a boost treatment with 6 MV X-ray with dose of 72-76 Gy (depending on age and stage) after completion of 3D-CRT (3D conformal RT) at 50 Gy. Dose and its distribution are assured by the R-Tec's dosimeters of ionization chamber type and KODAK EDR-2 film through DD-system (R-Tec), respectively. At present, the median prostatic specific antigen (PSA) value of 17.6 ng/mL before therapy is found to be reduced to <1.0 in 105 (82%) of 128 patients observed over 1.5 years post IMRT, and late adverse effects of < grade 2 proctitis and grade 1 cystitis are seen only in 5 and 3 cases, respectively: satisfactory efficacy and safety are recognized. (T.T.)

  2. Email consultations in general practice

    Directory of Open Access Journals (Sweden)

    Ron Neville

    2004-12-01

    Conclusions Use of an email consultation facility worked well within an urban practice, was deemed helpful by patients, and resulted in no apparent increase in GP workload. Our results suggest that there may be an unmet need amongst patients for clinical email services, and that such services may have positive outcomes for patients and practices.

  3. Internet-based discussion on climate-compatible power supply. Results and evaluation of the practical pilot study; Internetgestuetzter Diskurs 'Klimavertraegliche Energieversorgung'. Ergebnisse und Auswertung der Praxis-Pilotstudie

    Energy Technology Data Exchange (ETDEWEB)

    Beckmann, J.; Wienhoefer, E.

    1999-12-01

    certain agreements that all other participants and moderators have access to the course and results of such local meetings in the Internet. To sum up: An Internet-Based Discourse makes sense technically and methodologically. The main elements of the method prooved to be apt for practice. The procedure can be modified where imperfections and defects turned up. The following points are concerned: - A stimulation of the discussion by synchronic elements (chats). - A stronger coverage of small group discussions on the spot. - An improvement of support by experts (online), also during the procedure. - An improvement of access to the Internet for the participants. - The main criteria for choosing participants should be 'representative' and 'fair'. Remembering these modifications, an Internet-Based Discourse gives a method which might help to fulfil the mission statement of the Center of Technology Assessment - discourse - better and with less effort in the long run. (orig.) [German] Das Projekt 'Internetgestuetzter Diskurs' sollte den Weg zu einer intensiveren Nutzung des Internets als Diskursmedium bahnen. Ein konstituierendes Element der Methode des in diesem Kontext erprobten internetgestuetzten Diskurses ist die Kombination von realer mit netzgestuetzter Kommunikation. Sie hat die in sie gesetzten Erwartungen einer hoeheren Verbindlichkeit der Teilnahme, der Vermeidung von Kommunikationspathologien und der Initiierung und Unterstuetzung von Gruppenprozessen voll erfuellt. Solange der Verbreitungsgrad von Internetanschluessen noch nicht den des Telefons erreicht hat, ist aus Gruenden einer demokratischen Teilnahme-Chancengleichheit an gesellschaftlichen Diskursen zur Technikfolgenbewertung die Bereitstellung von Netzzugaengen durch den Veranstalter unumgaenglich. Im Interesse einer kontinuierlichen Diskussion sind unbeschraenkte Zugangsmoeglichkeiten zum Internet notwendig. Dieses Ziel kann durch die abendliche Mitbenutzung von Rechnerraeumen z

  4. Piaget's Psychology in Practice

    Science.gov (United States)

    Smedslund, J.

    1977-01-01

    As a result of eight years' experience of Piagetian research and subsequent work as a practicing psychologist, certain aspects of Piaget's theories are criticized. In particular the existential status of operatory structures, the relation between logicality and understanding, and the representativeness of the tasks are questioned. (Editor)

  5. Plastination: a modern approach to chiropractic teaching

    OpenAIRE

    Grondin, Gilles

    1998-01-01

    Plastination is a unique method for the preservation of biological material for teaching and research. The plastinated specimens are dry, odorless, non-toxic and durable. They can be manipulated by teachers and students without protective equipment like gloves.

  6. Practical occupational medicine in "practice"

    DEFF Research Database (Denmark)

    Ingemann Larsen, Anders; Schmidt, Jan; Jepsen, Jørgen Riis

    2016-01-01

    In Denmark, the practice of occupational medicine tends to be carried out by specialists in occupational medicine and less so by family physicians. The provision of health service to workers is therefore limited. This constraint may also apply in other developed countries and even more in countries...... with few occupational health resources. This Editorial argues that family physicians are indeed in a position where they can make a major positive difference for their working patients and for the enterprises where they work. Without specialist knowledge in occupational medicine, the family physician......’s empiric knowledge in combination with a narrative approach to the patient permits the contribution from family medicine not only with regard to diagnosis and treatment, but also relating to actions targeted to optimize the patient’s future accommodation at work as well as to protect other similarly...

  7. Practical quantum retrieval games

    Science.gov (United States)

    Arrazola, Juan Miguel; Karasamanis, Markos; Lütkenhaus, Norbert

    2016-06-01

    Complex cryptographic protocols are often constructed from simpler building blocks. In order to advance quantum cryptography, it is important to study practical building blocks that can be used to develop new protocols. An example is quantum retrieval games (QRGs), which have broad applicability and have already been used to construct quantum money schemes. In this work, we introduce a general construction of quantum retrieval games based on the hidden matching problem and show how they can be implemented in practice using available technology. More precisely, we provide a general method to construct (1-out-of-k ) QRGs, proving that their cheating probabilities decrease exponentially in k . In particular, we define QRGs based on coherent states of light, which can be implemented even in the presence of experimental imperfections. Our results constitute a tool in the arsenal of the practical quantum cryptographer.

  8. KNOWLEDGE DEVELOPMENT THROUGH REFLECTIVE PRACTICE

    OpenAIRE

    Kehily, Dermot

    2012-01-01

    This paper examines the development of knowledge through reflective practice and more specifically the development of the author’s knowledge as a result of engaging in reflection on an issue in the field of the author’s research interest. The author commences by consulting and analysing existing published research on reflective practice. The paper sets out the theory of reflective practice as documented by eminent authors in the field. The author addresses the concept of action learning and f...

  9. The scope and practice of behaviour change communication to improve infant and young child feeding in low- and middle-income countries: results of a practitioner study in international development organizations.

    Science.gov (United States)

    Pelto, Gretel H; Martin, Stephanie L; Van Liere, Marti; Fabrizio, Cecilia S

    2016-04-01

    We describe features of the landscape of behaviour change communication (BCC) practice devoted to infant and young child feeding (IYCF) in low- and middle-income countries by practitioners in international development organizations. We used an iterative, snowball sampling procedure to identify participants, and the self-administered questionnaire contained pre-coded questions and open-ended questions, relying primarily on content analysis to derive generalizations. Highlights of findings include (i) IYCF-specific BCC is usually delivered within the context of other public health messages and programmes; (ii) technical assistance with programme development and implementation are primary activities, and evaluation-related work is also common; and (iii) formative research and evaluation is universal, but process evaluation is not. With respect to scaling up nutrition: (i) use of mass media and digital technology generally play only a minor role in BCC activities and are not currently an integral part of BCC programming strategies and (ii) only 58% of the participants report activities related to communication with policy makers. The individuals who comprise the community of BCC leaders in the area of IYCF are a diverse group from the perspective of academic backgrounds and nationalities. In addition to nutrition, public health, agriculture and adult learning are common disciplinary backgrounds. In our view, this diversity is a source of strength. It facilitates continuing growth and maturation in the field by assuring inputs of different perspectives, theoretical orientations and experiences. PMID:25753402

  10. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 28: The technical communication practices of aerospace engineering and science students: Results of the phase 4 cross-national surveys

    Science.gov (United States)

    Pinelli, Thomas E.; Hecht, Laura M.; Barclay, Rebecca O.; Kennedy, John M.

    1994-01-01

    This report describes similarities and differences between undergraduate and graduate aerospace engineering and science students in the context of two general aspects of the educational experience. First, we explore the extent to which students differ regarding the factors that lead to the choice of becoming an aerospace engineer or a scientist, current satisfaction with that choice, and career-related goals and objectives. Second, we look at the technical communication skills, practices, habits, and training of aerospace engineering and science students. The reported data were obtained from a survey of students enrolled in aerospace engineering and science programs at universities in India, Japan, Russia, and the United Kingdom. The surveys were undertaken as part of the NASA/DOD Aerospace Knowledge Diffusion Research Project. Data are reported for the following categories: student demographics; skill importance, skill training, and skill helpfulness; collaborative writing; computer and information technology use and importance, use of electronic networks; use and importance of libraries and library services; use and importance of information sources and products; use of foreign language technical reports; and foreign language (reading and speaking) skills.

  11. 南方电网开展综合能源服务的实践及成效%The practice and results of the Southern Power Grid to carry out comprehensive energy service

    Institute of Scientific and Technical Information of China (English)

    曹重

    2016-01-01

    介绍南网能源公司以合同能源管理商业模式为主导,开发拓展综合能源服务业务,在政策研究、行业综合节能、电机能效提升、分布式光伏开发、清洁能源开发、能源互联网建设等方面的实践活动,为构建以节能为核心的现代能源服务体系,打造具有独特竞争力的新型综合能源服务商提供了样本参考。%The article introduces the Southern Power Grid Company carries out comprehensive energy services business which is dominated by contract energy management business model, the practice business includes policy research, comprehensive industrial energy saving, electrical efficiency motors, distributed photovoltaic development, clean energy development, energy Internet construc⁃tion, to build modern energy services system as the core of energy conservation. The business provides a sample reference to create a new unique competitive comprehensive energy service provider.

  12. Clinical practice

    OpenAIRE

    de Winter, J. Peter; de Vries, Machteld A. G.; Zimmermann, Luc J. I.

    2010-01-01

    The most important goal of introducing noninvasive ventilation (NIV) has been to decrease the need for intubation and, therefore, mechanical ventilation in newborns. As a result, this technique may reduce the incidence of bronchopulmonary dysplasia (BPD). In addition to nasal CPAP, improvements in sensors and flow delivery systems have resulted in the introduction of a variety of other types of NIV. For the optimal application of these novelties, a thorough physiological knowledge of mechanic...

  13. Breast-feeding practices in Mexico: results from the Second National Nutrition Survey 1999 Prácticas de lactancia en México: resultados de la Segunda Encuesta Nacional de Nutrición 1999

    Directory of Open Access Journals (Sweden)

    Teresa González-Cossío

    2003-01-01

    Full Text Available OBJECTIVE: To assess breast-feeding (BF practices and determinants of exclusive BF (EBF OBJETIVO: Evaluar las prácticas de lactancia y las determinantes de la lactancia exclusiva (LE hasta <4 y <6 m, en mujeres con hijos menores de 24 m de la segunda Encuesta Nacional de Nutrición 1999. MATERIAL Y MÉTODOS: Las prácticas de lactancia se estimaron del día y la noche anteriores a la entrevista. Los determinantes de LE<4m y LE<6m fueron analizados mediante regresión logística para muestras complejas. RESULTADOS: La prevalencia de LE<4m fue 25.7%, y <6 m 20.3%. La tasa de lactancia continuada (segundo año 30.9%, mediana de duración de lactancia 9 m, y proporción de amamantados alguna vez 92.3%. La probabilidad (pLE<4m estuvo determinada por edad, y el sexo del infante, por el nivel socioeconómico y etnicidad maternas, y por la interacción entre el sexo y el nivel socioeconómico. La p LE<6m estuvo determinada por edad y la longitud del infante y por el empleo, etnicidad y nivel socioeconómico de la madre. CONCLUSIONES: La duración y prevalencia de LE son bajas en México, poco mejores que hace 20 años. Las características del infante y de la madre determinan la p LME. Para promover la salud del niño, es urgente implementar programas agresivos de protección y promoción de la lactancia, así como evaluar y adecuar formalmente los existentes.

  14. Deferasirox treatment of iron-overloaded chelation-naïve and prechelated patients with myelodysplastic syndromes in medical practice: results from the observational studies eXtend and eXjange.

    Science.gov (United States)

    Gattermann, Norbert; Jarisch, Andrea; Schlag, Rudolf; Blumenstengel, Klaus; Goebeler, Mariele; Groschek, Matthias; Losem, Christoph; Procaccianti, Maria; Junkes, Alexia; Leismann, Oliver; Germing, Ulrich

    2012-03-01

    EXtend and eXjange were prospective, 1-yr, non-interventional, observational, multicentre studies that investigated deferasirox, a once-daily oral iron chelator, in iron-overloaded chelation-naïve and prechelated patients with myelodysplastic syndromes (MDS), respectively, treated in the daily-routine setting of office-based physicians. No inclusion or exclusion criteria or additional monitoring procedures were applied. Deferasirox was administered as recommended in the European Summary of Product Characteristics. Haematological parameters and adverse events (AEs) were collected at two-monthly intervals. Data from 123 chelation-naïve patients with MDS (mean age 70.4 yrs) with median baseline serum ferritin level of 2679 (range 184-16,500) ng/mL, and 44 prechelated patients with MDS (mean age 69.6 yrs) with median baseline serum ferritin level of 2442 (range 521-8565) ng/mL, were assessed. The mean prescribed daily dose of deferasirox at the first visit was 15.7 and 18.7 mg/kg/d, respectively. Treatment with deferasirox produced a significant reduction in median serum ferritin levels in chelation-naïve patients with MDS from 2679 to 2000 ng/mL (P = 0.0002) and a pronounced decrease in prechelated patients with MDS from 2442 to 2077 ng/mL (P = 0.06). The most common drug-related AEs were gastrointestinal, increased serum creatinine levels and rash. These studies demonstrate that deferasirox used in physicians' medical practices is effective in managing iron burden in transfusion-dependent patients with MDS. PMID:22023452

  15. Ares Launch Vehicles Lean Practices Case Study

    Science.gov (United States)

    Doreswamy, Rajiv, N.; Self, Timothy A.

    2008-01-01

    This viewgraph presentation describes test strategies and lean philisophies and practices that are applied to Ares Launch Vehicles. The topics include: 1) Testing strategy; 2) Lean Practices in Ares I-X; 3) Lean Practices Applied to Ares I-X Schedule; 4) Lean Event Results; 5) Lean, Six Sigma, and Kaizen Practices in the Ares Projects Office; 6) Lean and Kaizen Success Stories; and 7) Ares Six Sigma Practices.

  16. Partnership for practice change and knowledge development

    DEFF Research Database (Denmark)

    Larsen, Stina Meyer; Stokholm, Gitte; Madsen, Anette Judithe;

    2014-01-01

    and various practice fi elds and (B) to develop students ’ competences in practice research and collaboration, thus building up a framework in which research-based change in occupational therapy practice can be pursued through students ’ practice research. The practice research undertaken in the students...... and the students ’ bachelor ’ s theses. Results of the evaluations showed that (A) the developed institutional partnerships promoted the goals of the initiative, including research-based proposals for change in the practice fi eld and that (B) the students acquired competences in practice research and collaboration...

  17. OSART results

    International Nuclear Information System (INIS)

    The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States for enhancing the operational safety of nuclear power plants. OSART reviews are available to all countries with nuclear power plants in operation or approaching operation. Most of these countries have participated in the programme, by hosting one or more OSART missions or by making experts available to participate in missions. The observations of the OSART members are documented in technical notes which are then used as source material for the official OSART Report submitted to the government of the host country. The technical notes contain recommendations for improvements and descriptions of commendable good practices. The same notes have been used to compile the present summary report which is intended for wide distribution to all organizations constructing, operating or regulating nuclear power plants. This document presents significant observations made by OSART missions during the period August 1983 to May 1987. The most significant concerns and recommendations are listed in the first part. In the second part, we discuss in detail the findings of OSART missions in eight subject areas. It is hoped that operators - especially those of plants which have not yet been visited by review teams - will take note. The safety record of the nuclear industry is only as good as that of its weakest plant

  18. PEDAGOGICAL PRACTICE WAY OF CONNECTING PEDAGOGICAL THEORY AND PRACTICE

    Directory of Open Access Journals (Sweden)

    Božo Obradović

    2013-12-01

    Full Text Available The issue of linking educational theory to educational practice (educational work with young people is highly topical and important issue for the science of pedagogy. One way of achieving this task is a pedagogical practice (PP students. In paper we deal with identifying, comparing, and analyzing the curricula of vocational (Curriculum for Preschool Teacher (2007 and academic (Curriculum for Educators (2007. Studies Teacher Training in Serbia, as well as educational disciplines and areas of pedagogical science derived from them. The results showed many similarities, but also differences when it comes to educational disciplines that are taught, the name of pedagogical practice, the number of classes to implement, ECTS (European Credit Transfer System, which affect the quality and coherence of educational theory and educational practice. In order to identify similarities and overcome weaknesses that accompany the pedagogical practice analysis, we came to know about the specifics of each of the six pedagogical practice. For each pedagogical practice defined specific goals and tasks arising from the curriculum, and in particular pedagogical disciplines taught at university. Each of these pedagogical practices is the ability to connect educational theory and educational practice and direct way to increase the quality of training and competence of future teachers for direct work with children.

  19. Management practice: phenomenological approach

    Directory of Open Access Journals (Sweden)

    Myriam Siqueira da Cunha

    2005-01-01

    Full Text Available This work has the aim of understanding the lived experiences by managers in relation to organizational changes in an enterprise in the food area, located in the State of Rio Grande do Sul, Brazil. The role of managers has been constantly evaluated and their capacity of continuous learning and also the ability of transforming the learning in good organizational results is reacquired every instant. In this work, my intention is to show, using an interpretative analysis, real and practical situations, from lived experiences. The methodological way followed was the hermeneutic phenomenological approach, trying to give a global and a contextual treatment to the theme. The results achieved offer subsides for a new look over the management practice and point out the importance of the study of what is lived, as an inspiration source for the strategic decisions in the enterprises.

  20. Civic ecology practices: insights from practice theory

    Directory of Open Access Journals (Sweden)

    Marianne E. Krasny

    2015-06-01

    Full Text Available Our aim was to explore the use of practice theory as an approach to studying urban environmental stewardship. Urban environmental stewardship, or civic ecology practice, contributes to ecosystem services and community well-being and has been studied using social-ecological systems resilience, property rights, communities of practice, and governance frameworks. Practice theory, which previously has been applied in studies of consumer behaviors, adds a new perspective to urban stewardship research, focusing on how elements of a practice, such as competencies, meanings, and physical resource, together define the practice. We applied practice theory to eight different civic ecology practices, including oyster gardening in New York City, a civil society group engaged in litter cleanup in Iran, and village grove restoration in South Korea. Our analysis suggests that in applying practice theory to the civic ecology context, consideration should be given to social and communication competencies, how meanings can motivate volunteers and sustain practice, and the nature of the resource that is being stewarded. Future studies may want to focus on how practice elements interact within and vary across practices and may be used to more systematically analyze and share ideas among diverse civic ecology practices.

  1. Digitization Best Practices

    Energy Technology Data Exchange (ETDEWEB)

    Xue, Fei [Los Alamos National Laboratory; Holtkamp, Irma S. [Los Alamos National Laboratory; Knudson, Frances L. [Los Alamos National Laboratory

    2012-07-31

    This project involved performing tests and documenting results to determine best practices for digitizing older print documents. The digitization process is complicated, especially when original documents exhibit non-standard fonts and are faded. Tests focused on solutions to improve high quality scanning, increase OCR accuracy, and efficiently use embedded metadata. Results are summarized. From the test results on the right sides, we know that when we plan to digitize documents, we should balance Quantity and Quality based on our expectation, and then make final decision for the digitization process.

  2. How an Organization's Environmental Orientation Impacts Environmental Performance and Its Resultant Financial Performance through Green Computing Hiring Practices: An Empirical Investigation of the Natural Resource-Based View of the Firm

    Science.gov (United States)

    Aken, Andrew Joseph

    2010-01-01

    This dissertation uses the logic embodied in Strategic Fit Theory, the Natural Resource- Based View of the Firm (NRBV), strategic human resource management, and other relevant literature streams to empirically demonstrate how the environmental orientation of a firm's strategy impacts their environmental performance and resultant financial…

  3. Civic ecology practices: insights from practice theory

    OpenAIRE

    Marianne E. Krasny; Philip Silva; Cornelia Barr; Zahra Golshani; Eunju Lee; Robert Ligas; Eve Mosher; Andrea Reynosa

    2015-01-01

    Our aim was to explore the use of practice theory as an approach to studying urban environmental stewardship. Urban environmental stewardship, or civic ecology practice, contributes to ecosystem services and community well-being and has been studied using social-ecological systems resilience, property rights, communities of practice, and governance frameworks. Practice theory, which previously has been applied in studies of consumer behaviors, adds a new perspective to urban stewardship resea...

  4. Enceladus Results

    Data.gov (United States)

    National Aeronautics and Space Administration — Here are some results from the Spectra Decomposition Algorithm on infrared spectral images of Saturn's moon Enceladus. Figure 1 is the spatial contribution of the...

  5. Completely practicable

    International Nuclear Information System (INIS)

    This interview with Peter Hartmann and Hansruedi Preisig takes a look at the question why today's housing should be mechanically ventilated, why in spite of this such installations are quite few and far between and what must be done to change the situation. Questions covered include the reasons why housing should be equipped with such systems, the damage due to condensation and dampness resulting from too low an air-exchange rate. The use of such ventilation systems in northern countries is discussed and the history of efforts made in this direction in Switzerland is reviewed. The reasons for the limited success of fan-assisted balanced ventilation are reviewed. Health aspects are also discussed as are the main arguments for the installation of such systems in modern housing. The weak points of present day systems are looked at and measures to be taken are discussed. Finally, the role of architects in propagating the idea of fan-assisted balanced ventilation is discussed

  6. Theory into Practice

    Science.gov (United States)

    Kaplan, Sandra N.

    2012-01-01

    The importance of putting theory into practice can be addressed and advocated to educators and gifted students through the presentation of a Continuum of Practice. Articulating the sequence and phases of practice can underscore how practice can take place; it also can change the perspective and meaning of practice.

  7. Current practice vs. guideline based imaging in abdominal radiology in the German speaking area. Results of an online survey; Versorgungsrealitaet vs. leitliniengerechte Bildgebung in der Abdominalradiologie im deutschsprachigen Raum. Ergebnisse einer Online-Umfrage

    Energy Technology Data Exchange (ETDEWEB)

    Schreyer, A.G. [University Hospital Regenburg (Germany). Dept. of Radiology; Wessling, J. [Clemens Hospital Muenchen (Germany). Dept. of Radiology; Grenacher, L. [Diagnostic Muenchen (Germany). Diagnostic Imaging Center

    2016-03-15

    The working group for abdominal imaging within the German Roentgen Society (DRG) performed an online survey amongst radiologist concerning the current status of techniques for abdominal imaging. The results of this survey were compared with the most recent guidelines. We performed an online survey open for all members of the DRG during a 76-day period with 65 questions and an overall estimated time for finishing the questionnaire of 15 minutes concerning technical specifications for abdominal radiological imaging. The results were evaluated using descriptive statistics. 90 of all participants, who filled out the survey covering more than 80 % of the questions, were included in the statistical evaluation. 27 % of all participants were registered radiologists while 73 % represented radiologists working in a hospital. Most participants worked in a managerial position. The participants gave detailed information regarding the radiological techniques used in dedicated organ systems (esophagus, stomach, pancreas, liver, small intestines, colon) regarding acquired contrast phases and oral and intravenous administration of contrast medium. The results confirm that most radiologists participating in this survey perform their examinations and choose their modalities in conformity with the current existing clinical guidelines. Because most clinical guidelines do not specify radiological examinations in detail, there is a noteworthy heterogeneity of the acquired contrast phases and major divergence in terms of technical parameters. Therefore a joint radiological effort should be initiated for developing and publishing updated radiological parameters for abdominal imaging.

  8. Amount of health care and self-care following a randomized clinical trial comparing flexion-distraction with exercise program for chronic low back pain

    Directory of Open Access Journals (Sweden)

    Keenum Michael

    2006-08-01

    Full Text Available Abstract Background Previous clinical trials have assessed the percentage of participants who utilized further health care after a period of conservative care for low back pain, however no chiropractic clinical trial has determined the total amount of care during this time and any differences based on assigned treatment group. The objective of this clinical trial follow-up was to assess if there was a difference in the total number of office visits for low back pain over one year after a four week clinical trial of either a form of physical therapy (Exercise Program or a form of chiropractic care (Flexion Distraction for chronic low back pain. Methods In this randomized clinical trial follow up study, 195 participants were followed for one year after a four-week period of either a form of chiropractic care (FD or a form of physical therapy (EP. Weekly structured telephone interview questions regarded visitation of various health care practitioners and the practice of self-care for low back pain. Results Participants in the physical therapy group demonstrated on average significantly more visits to any health care provider and to a general practitioner during the year after trial care (p Conclusion During a one-year follow-up, participants previously randomized to physical therapy attended significantly more health care visits than those participants who received chiropractic care.

  9. Lactose malabsorption testing in daily clinical practice: a critical retrospective analysis and comparison of the hydrogen/methane breath test and genetic test (c/t-13910 polymorphism) results.

    Science.gov (United States)

    Enko, Dietmar; Rezanka, Erwin; Stolba, Robert; Halwachs-Baumann, Gabriele

    2014-01-01

    The aim of this study was to establish a retrospective evaluation and comparison of the hydrogen/methane (H2/CH4) breath test and genetic test (C/T-13910 polymorphism) results in lactose malabsorption testing. In total 263 consecutive patients with suspected lactose malabsorption were included in this study. They underwent the H2/CH4 breath test following the ingestion of 50 g lactose and were tested for the C/T-13910 polymorphism. In total 51 patients (19.4%) had a C/C-13910 genotype, indicating primary lactose malabsorption. Only 19 patients (7.2%) also had a positive H2/CH4 breath test. All in all 136 patients (51.69%) had a C/T-13910 and 76 patients (28.91%) a T/T-13910 genotype, indicating lactase persistence. Four patients (1.5%) with the C/T-13910 genotype and one patient (0.4%) with the T/T-13910 genotype had a positive H2/CH4 breath test result, indicating secondary lactose malabsorption. Cohen's Kappa measuring agreement between the two methods was 0.44. Twenty patients (7.6%) with a positive H2/CH4 peak within 60 minutes after lactose ingestion were classified as patients with lactose-dependent small intestinal bacterial overgrowth (SIBO). In conclusion, only moderate agreement between the breath test and the genetic test was shown. Secondary lactose malabsorption as well as preanalytical limitations of the combined H2/CH4 breath test procedure can cause discrepant results. This trial is registered with K-42-13. PMID:24829570

  10. Synthetic industrial gear oils for drive engineering - energy saving potentials, enhanced wear protection - most advanced results from practice and test stands; Synthetische Industriegetriebeoele in der Antriebstechnik - Energiesparpotentiale, verbesserter Verschleissschutz - neueste Ergebnisse aus der Praxis und dem Pruefstand

    Energy Technology Data Exchange (ETDEWEB)

    Bock, W.; Heinemann, H.; Braun, J. [FUCHS Europe Schmierstoffe GmbH, Mannehim (Germany)

    2009-07-01

    Increasing economic and technical demands will lead increasingly to the use of synthetic lubricants and lubricating oils. These synthetic oils have many excellent properties, resulting in longer oil change intervals, lower friction, higher efficiency, and higher reliability. The wear protection properties of synthetic lubricants are far better than those of mineral oil products, so systems will be reliably protected against wear for longer periods of time and in the most varied operating conditions, e.g. high or low rotational speed, changing temperatures, environmental influences. Synthetic lubricating oils will enhance the efficiency of plants, machine elements, and gearing, and also offer a great potential for energy conservation.

  11. Current practice in the management of acute/unstable slipped capital femoral epiphyses in the United Kingdom and the Netherlands: results of a survey of the membership of the British Society of Children's Orthopaedic Surgery and the Werkgroep Kinder Orthopaedie.

    Science.gov (United States)

    Witbreuk, Melinda; Besselaar, Philip; Eastwood, Deborah

    2007-03-01

    A questionnaire was sent to all members of the British Society for Children's Orthopaedic Surgery and the Werkgroep Kinder Orthopaedie to identify points of agreement/disagreement on the management of the acute unstable slip of the upper femoral epiphysis and to compare these European results with those from a similar North American survey. Sixty-five per cent responded. Overall, both countries evaluated cases similarly and believed in their urgent management. Sixty-six per cent did not reposition the slip. Significant differences were observed in attitude towards single screw usage, prophylactic pinning and metalwork removal both between the two countries and in comparison with North America. PMID:17273031

  12. From numbers to a biological sense: How the strategy chosen for metabolomics data treatment may affect final results. A practical example based on urine fingerprints obtained by LC-MS.

    Science.gov (United States)

    Godzien, Joanna; Ciborowski, Michal; Angulo, Santiago; Barbas, Coral

    2013-10-01

    Application of high-throughput technologies in metabolomics studies increases the quantity of data obtained, which in turn imposes several problems during data analysis. Correctly and clearly addressed biological question and comprehensive knowledge about data structure and properties are definitely necessary to select proper chemometric tools. However, there is a broad range of chemometric tools available for use with metabolomics data, which makes this choice challenging. Precisely performed data treatment enables valuable extraction of information and its proper interpretation. The effect of an error made at an early stage will be enhanced throughout the later stages, which in combination with other errors made at each step can accumulate and significantly affect the data interpretation. Moreover, adequate application of these tools may help not only to detect, but sometimes also to correct, biological, analytical, or methodological errors, which may affect truthfulness of obtained results. This report presents steps and tools used for LC-MS based metabolomics data extraction, reduction, and visualization. Following such steps as data reprocessing, data pretreatment, data treatment, and data revision, authors want to show how to extract valuable information and how to avoid misinterpretation of results obtained. The purpose of this work was to emphasize problematic characteristics of metabolomics data and the necessity for their attentive and precise treatment. The dataset used to illustrate metabolomics data properties and to illustrate major data treatment challenges was obtained utilizing an animal model of control and diabetic rats, both with and without rosemary treatment. Urine samples were fingerprinted employing LC-QTOF-MS. PMID:23775708

  13. DFM in practice: results of a three way partnership between a leading fabless design house, foundry, and EDA company to implement alternating-phase shift mask (Alt-PSM) on a 90-nm FPGA chip

    Science.gov (United States)

    Yu, Chun-Chi; Shieh, Ming-Feng; Liu, Erick; Lin, Benjamin; Lin, Henry; Chacko, Manoj; Li, Xiaoyang; Lei, Wen-Kang; Ho, Jonathan; Wu, Xin

    2005-05-01

    At the sub 90nm nodes, resolution enhancement techniques (RETs) such as optical proximity correction (OPC), phase-shifting masks (PSM), sub-resolution assist features (SRAF) have become essential steps in the post-physical verification 'Mask Synthesis' process and a key component of design for manufacturing (DFM). Several studies have been conducted and the results have been published on the implication and application of the different types of RETs on mask printability and costs. More specifically, double-exposure-based, dark-field, alternating PSM (Alt-PSM) technology has received lot of attention with respect to the mask manufacturing challenges and its implementation into a production flow, despite its yield and critical dimension (CD) control superiority. Implementation of Alt-PSM generally requires phase compliance rules and proper phase topology in the layout and this has been successful for the technology node with these rules implemented. However, this may not be true for a matured, production process technology, in this case 90 nm. Especially, in the foundry-fabless business model where the foundry provides a standard set of design rules to its customers for a given process technology, and where not all the foundry customers require Alt-PSM in their tapeout flow. What follows is an in-depth review of the DFM challenges to each partner faced, its effect on the tapeout flow, and how design, manufacturing, and EDA teams worked together to resolve phase conflicts, tapeout the chip, and finally verify the silicon results in production.

  14. ESR teleradiology survey: results.

    Science.gov (United States)

    2016-08-01

    With recent developments of teleradiology technology and services, it has become necessary to better evaluate its extent and use among different countries in Europe. With this goal in mind, the ESR launched two specific surveys intended to gather the current state of adoption and implementation of teleradiology in clinical practice. A special focus on differentiating between insourcing teleradiology services among partners of the same organisation and outsourcing to external services was an essential part of the design of these surveys. The first survey was addressed to 44 national societies of different countries in Europe, while the second survey was intended for all practicing radiologist ESR members. While the results of these surveys reported here may provide a wealth of information to better understand the trends in adoption of teleradiology in Europe, they only represent a snapshot at a certain point in time. The rapid development of telecommunication tools as well as a fundamental change in practice and healthcare economics will certainly influence these observations in the upcoming years. These data, however, will provide objective and relevant parameters for supporting the efforts of experts and policy makers in promoting appropriate criteria and guidelines for adequate use of teleradiology in clinical practice. Main Messages • Understand concepts and challenges of teleradiology • Provide insight into current trends and solutions for teleradiology • Compare differences in teleradiolgy strategies between countries in Europe • Establish a reference on statistical data of usage of teleradiology in Europe. PMID:27188379

  15. Energy plants increasingly important. Scientific results and practical experiences on the production of biogas plants and short rotation coppices. Symposium; Energiepflanzen im Aufwind. Wissenschaftliche Ergebnisse und praktische Erfahrungen zur Produktion von Biogaspflanzen und Feldholz. Fachtagung

    Energy Technology Data Exchange (ETDEWEB)

    Heiermann, M.; Scholz, V.; Foltan, H. (comps.)

    2007-05-15

    The conference proceedings contain 15 contributions on energy plants: energy plant production in Germany - developments and research activities; potentials and constraints of cultivating energy crops; environmental aspects of production and utilization of energy plants; costs of energy crop supply; crops for the biogas production in the territory of Brandenburg; mixed cropping systems on sandy soils - alternative cropping strategies; impact of ensiling process on biogas production - recent research results; solid state anaerobic digestion of renewable biomass sources - state of research and development; energy crops as feedstock in a biogas plant; proffer and demand of wood fuel in the State of Brandenburg; regulatory framework of growing short rotation coppice; mechanization of SRC production; 20 years of short rotation coppice; willow production and marketing in Denmark; short rotation coppice production in Italy.

  16. Design Methods in Practice

    DEFF Research Database (Denmark)

    Jensen, Torben Elgaard; Andreasen, Mogens Myrup

    2010-01-01

    engineering design, and on the other hand the understanding of method use, which has emerged from micro-sociological studies of practice (ethnomethodology). Second, it reviews a number of case studies conducted by engineering students, who were instructed to investigate the actual use of design methods in......The paper challenges the dominant and widespread view that a good design method will guarantee a systematic approach as well as certain results. First, it explores the substantial differences between on the one hand the conception of methods implied in Pahl & Beitz’s widely recognized text book on...... Danish companies. The paper concludes that design methods in practice deviate substantially from Pahl & Beitz’s description of method use: The object and problems, which are the starting points for method use, are more contested and less given than generally assumed; The steps of methods are often...

  17. SAGE results

    International Nuclear Information System (INIS)

    The Russian-American Gallium solar neutrino Experiment (SAGE) is described. The solar neutrino flux measured by 31 extractions through October, 1993 is presented. The result of 69+/-10(stat)+5/-7(syst) SNU is to be compared with a Standard Solar Model prediction of 132 SNU. The initial results of a measurement of experimental efficiencies are also discussed by exposing the gallium target to neutrinos from an artificial source. The capture rate of neutrinos from this source is very close to that which is expected. The result can be expressed as a ratio of the measured capture rate to the anticipated rate from the source activity. This ratio is 0.93+0.15, -0.17 where the systematic and statistical errors have been combined. To first order the experimental efficiencies are in agreement with those determined during solar neutrino measurements and in previous auxiliary measurements. One must conclude that the discrepancy between the measured solar neutrino flux and that predicted by the solar models can not arise from an experimental artifact. (author)

  18. Psychotherapy in Contemporary Psychiatric Practice

    Science.gov (United States)

    Hadjipavlou, George; Hernandez, Carlos A Sierra; Ogrodniczuk, John S

    2015-01-01

    Objective: American data suggest a declining trend in the provision of psychotherapy by psychiatrists. Nevertheless, the extent to which such findings generalize to psychiatric practice in other countries is unclear. We surveyed psychiatrists in British Columbia to examine whether the reported decline in psychotherapy provision extends to the landscape of Canadian psychiatric practice. Method: A survey was mailed to the entire population of fully licensed psychiatrists registered in British Columbia (n = 623). The survey consisted of 30 items. Descriptive statistics were used to characterize the sample and psychotherapy practice patterns. Associations between variables were evaluated using nonparametric tests. Results: A total of 423 psychiatrists returned the survey, yielding a response rate of 68%. Overall, 80.9% of psychiatrists (n = 342) reported practicing psychotherapy. A decline in the provision of psychotherapy was not observed; in fact, there was an increase in psychotherapy provision among psychiatrists entering practice in the last 10 years. Individual therapy was the predominant format used by psychiatrists. The most common primary theoretical orientation was psychodynamic (29.9%). Regarding actual practice, supportive psychotherapy was practiced most frequently. Professional time constraints were perceived as the most significant barrier to providing psychotherapy. The majority (85%) of clinicians did not view remuneration as a significant barrier to treating patients with psychotherapy. Conclusions: Our findings challenge the prevailing view that psychotherapy is in decline among psychiatrists. Psychiatrists in British Columbia continue to integrate psychotherapy and pharmacotherapy in clinical practice, thus preserving their unique place in the spectrum of mental health services. PMID:26175328

  19. Virologic and immunologic effectiveness of darunavir-based salvage therapy in HIV-1-infected adults in a Brazilian clinical practice setting: results of a multicenter and retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Karina Mota Ribeiro

    2014-01-01

    Full Text Available Background: Darunavir has been proven efficacious for antiretroviral-experienced HIV-1-infected patients in randomized trials. However, effectiveness of darunavir-based salvage therapy is understudied in routine care in Brazil. Methods: Retrospective cohort study of HIV-1-infected patients from three public referral centers in Belo Horizonte, who received a darunavir-based therapy between 2008 and 2010, after virologic failure. Primary endpoint was the proportion of patients with viral load <50 copies/mL at week 48. Change in CD4 cell count was also evaluated. Outcome measures were analyzed on an intent-to-treat basis applied to observational studies. Sensitivity analysis was conducted to evaluate the impact of missing data at week 48. Predictors of virologic failure were examined using rare-event, finite sample, bias-corrected logistic regression. Results: Among 108 patients, the median age was 44.2 years, and 72.2% were male. They had long-standing HIV-1 infection (median 11.6 years and advanced disease (76.9% had an AIDS-defining event. All patients had previously received protease inhibitors and nucleoside reverse transcriptase inhibitors, 75% nonnucleoside reverse transcriptase inhibitors, and 4.6% enfuvirtide. The median length of protease inhibitor use was 8.9 years, and 90.8% of patients had prior exposure to unboosted protease inhibitor. Genotypic resistance profile showed a median of three primary protease inhibitor mutations and 10.2% had three or more darunavir resistance-associated mutations. Virologic success at week 48 was achieved by 78.7% (95% CI = 69.7–86% of patients and mean CD4 cell count increase from baseline was 131.5 cells/μL (95% CI = 103.4–159.6. In multiple logistic regression analysis, higher baseline viral load (RR = 1.04 per 10,000 copies/mL increase; 95% CI = 1.01–1.09 and higher number of darunavir resistance-associated mutations (RR = 1.23 per each; 95% CI = 0.95–1.48 were independently associated with

  20. Late Urinary Side Effects 10 Years After Low-Dose-Rate Prostate Brachytherapy: Population-Based Results From a Multiphysician Practice Treating With a Standardized Protocol and Uniform Dosimetric Goals

    Energy Technology Data Exchange (ETDEWEB)

    Keyes, Mira, E-mail: mkeyes@bccancer.bc.ca; Miller, Stacy; Pickles, Tom; Halperin, Ross; Kwan, Winkle; Lapointe, Vincent; McKenzie, Michael; Spadinger, Ingrid; Pai, Howard; Chan, Elisa K.; Morris, W. James

    2014-11-01

    Purpose: To determine late urinary toxicity (>12 months) in a large cohort of uniformly treated low-dose-rate prostate brachytherapy patients. Methods and Materials: From 1998 to 2009, 2709 patients with National Comprehensive Cancer Network–defined low-risk and low-tier intermediate-risk prostate cancer were treated with Iodine 125 ({sup 125}I) low-dose-rate prostate brachytherapy; 2011 patients with a minimum of 25 months of follow-up were included in the study. Baseline patients, treatment, implant factors, and late urinary toxicity (Radiation Therapy Oncology Group [RTOG] grading system and International Prostate Symptom Score [IPSS]) were recorded prospectively. Time to IPSS resolution, late RTOG genitourinary toxicity was examined with Kaplan-Meier and log-rank tests. Cox proportional hazards regression was done for individual covariates and multivariable models. Results: Median follow-up was 54.5 months (range, 2-13 years). Actuarial toxicity rates reached 27% and 10% (RTOG ≥2 and ≥3, respectively) at 9-13 years. Symptoms resolved quickly in the majority of patients (88% in 6-12 months). The prevalence of RTOG 0, 1, 2, 3, and 4 toxicity with a minimum of 7 years' follow-up was 70%, 21%, 6.4%, 2.3%, and 0.08%, respectively. Patients with a larger prostate volume, higher baseline IPSS, higher D90, acute toxicity, and age >70 years had more late RTOG ≥2 toxicity (all P≤.02). The IPSS resolved slower in patients with lower baseline IPSS and larger ultrasound prostate volume, those not receiving androgen deprivation therapy, and those with higher D90. The crude rate of RTOG 3 toxicity was 6%. Overall the rate of transurethral resection of the prostate was 1.9%; strictures, 2%; incontinence, 1.3%; severe symptoms, 1.8%; late catheterization, 1.3%; and hematuria, 0.8%. The majority (80%) resolved their symptoms in 6-12 months. Conclusion: Long-term urinary toxicity after brachytherapy is low. Although actuarial rates increase with longer