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Sample records for irb institutional review

  1. The Effect of Computer Automation on Institutional Review Board (IRB) Office Efficiency

    Science.gov (United States)

    Oder, Karl; Pittman, Stephanie

    2015-01-01

    Companies purchase computer systems to make their processes more efficient through automation. Some academic medical centers (AMC) have purchased computer systems for their institutional review boards (IRB) to increase efficiency and compliance with regulations. IRB computer systems are expensive to purchase, deploy, and maintain. An AMC should…

  2. The Harvard Catalyst Common Reciprocal IRB Reliance Agreement: an innovative approach to multisite IRB review and oversight.

    Science.gov (United States)

    Winkler, Sabune J; Witte, Elizabeth; Bierer, Barbara E

    2015-02-01

    Reduction of duplicative Institutional Review Board (IRB) review for multiinstitutional studies is a desirable goal to improve IRB efficiency while enhancing human subject protections. Here we describe the Harvard Catalyst Master Reciprocal Common IRB Reliance Agreement (MRA), a system that provides a legal framework for IRB reliance, with the potential to streamline IRB review processes and reduce administrative burden and barriers to collaborative, multiinstitutional research. The MRA respects the legal autonomy of the signatory institutions while offering a pathway to eliminate duplicative IRB review when appropriate. The Harvard Catalyst MRA provides a robust and flexible model for reciprocal reliance that is both adaptable and scalable. © 2014 Wiley Periodicals, Inc.

  3. A New Ethical Challenge for Institutional Review Boards (IRBs/Ethics Committees (ECs in the Assessment of Pediatric Clinical Trials

    Directory of Open Access Journals (Sweden)

    Klaus Rose

    2015-05-01

    Full Text Available Both the US and EU have introduced pediatric pharmaceutical legislation to facilitate clinical trials in children and development of better medicines for children. The first concerns were published in 2014 that the European Medicines Agency (EMA’s Pediatric Committee (PDCO may be over-enthusiastic and has compelled questionable pediatric clinical trials from pharmaceutical companies. Numerous clinical trials are mandated in rare conditions for which not enough patients exist for even one trial. Furthermore, where these trials are mandated in adolescent patients, the legal age limit of the 18th birthday is confused with a medical age limit and can result in separate clinical trials in adolescent patients that neither make medical nor scientific sense nor will ever recruit enough patients for a meaningful outcome. To confirm our concerns we searched the registry clinicaltrials.gov and found examples for PDCO-triggered unethical trials. We conclude that such trials should not be accepted by institutional review boards (IRBs/ethics committees (ECs and that clinical trials resulting from negotiations with EMA’s PDCO need extra careful scrutiny by IRBs/ECs in order to prevent unethical studies and damage to pediatric research and unnecessary risks to pediatric patients.

  4. 75 FR 1790 - Draft Guidance for Institutional Review Boards, Clinical Investigators, and Sponsors: IRB...

    Science.gov (United States)

    2010-01-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-D-0605... clinical investigators and sponsors better understand their responsibilities related to continuing review...-463-6332 or 301-796-3400); or the Office of Communication, Outreach and Development (HFM-40), Center...

  5. 34 CFR 97.109 - IRB review of research.

    Science.gov (United States)

    2010-07-01

    ... Office of the Secretary, Department of Education PROTECTION OF HUMAN SUBJECTS Federal Policy for the Protection of Human Subjects (Basic ED Policy for Protection of Human Research Subjects) § 97.109 IRB review... subjects when in the IRB's judgment the information would meaningfully add to the protection of the rights...

  6. Customizable orthopaedic oncology implants: one institution's experience with meeting current IRB and FDA requirements.

    Science.gov (United States)

    Willis, Alexander R; Ippolito, Joseph A; Patterson, Francis R; Benevenia, Joseph; Beebe, Kathleen S

    2016-01-01

    Customizable orthopaedic implants are often needed for patients with primary malignant bone tumors due to unique anatomy or complex mechanical problems. Currently, obtaining customizable orthopaedic implants for orthopaedic oncology patients can be an arduous task involving submitting approval requests to the Institutional Review Board (IRB) and the Food and Drug Administration (FDA). There is great potential for the delay of a patient's surgery and unnecessary paperwork if the submission pathways are misunderstood or a streamlined protocol is not in place. The objective of this study was to review the existing FDA custom implant approval pathways and to determine whether this process was improved with an institutional protocol. An institutional protocol for obtaining IRB and FDA approval for customizable orthopaedic implants was established with the IRB at our institution in 2013. This protocol was approved by the IRB, such that new patients only require submission of a modification to the existing protocol with individualized patient information. During the two-year period of 2013-2014, eight patients were retrospectively identified as having required customizable implants for various orthopaedic oncology surgeries. The dates of request for IRB approval, request for FDA approval, and total time to surgery were recorded, along with the specific pathway utilized for FDA approval. The average patient age was 12 years old (7-21 years old). The average time to IRB approval of a modification to the pre-approved protocol was 14 days (7-21 days). Average time to FDA approval after submission of the IRB approval to the manufacturer was 12.5 days (7-19 days). FDA approval was obtained for all implants as compassionate use requests in accordance with Section 561 of the Federal Food Drug and Cosmetic Act's expanded access provisions. Establishment of an institutional protocol with pre-approval by the IRB can expedite the otherwise time-consuming and complicated

  7. IRB reliance: An informatics approach.

    Science.gov (United States)

    Obeid, Jihad S; Alexander, Randall W; Gentilin, Stephanie M; White, Brigette; Turley, Christine B; Brady, Kathleen T; Lenert, Leslie A

    2016-04-01

    Multi-site Institutional Review Board (IRB) review of clinical research projects is an important but complex and time-consuming activity that is hampered by disparate non-interoperable computer systems for management of IRB applications. This paper describes our work toward harmonizing the workflow and data model of IRB applications through the development of a software-as-a-service shared-IRB platform for five institutions in South Carolina. Several commonalities and differences were recognized across institutions and a core data model that included the data elements necessary for IRB applications across all institutions was identified. We extended and modified the system to support collaborative reviews of IRB proposals within routine workflows of participating IRBs. Overall about 80% of IRB application content was harmonized across all institutions, establishing the foundation for a streamlined cooperative review and reliance. Since going live in 2011, 49 applications that underwent cooperative reviews over a three year period were approved, with the majority involving 2 out of 5 institutions. We believe this effort will inform future work on a common IRB data model that will allow interoperability through a federated approach for sharing IRB reviews and decisions with the goal of promoting reliance across institutions in the translational research community at large. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Public service quality improvements: a case for exemption from IRB review of public administration research.

    Science.gov (United States)

    Jordan, Sara R

    2014-01-01

    Should the exemption from Institutional Review Board (IRB) evaluations currently in place for quality improvements research be extended to public administration research that addresses questions of improving the quality of public service delivery? As a means to both reduce the level of disdain held by a group of social science researchers for IRBs and to reduce the cost of review for minimal risk studies, I argue here that much of the current public administration research should also be exempted from normal processes of review by IRBs on the basis of their similarity to Quality Improvements (QI) research, a category of studies already granted exemption. This argument dovetails provisions currently in place for studies of public service and public benefit, but reframes these exemptions in the language of "quality improvements," which may be a more comfortable language for IRBs concerned to demonstrate compliance for review of all fields. To expedite this argument into the practices of IRBs, I included a checklist that researchers could use to self-identify their studies as QI, not research as such.

  9. 45 CFR 46.109 - IRB review of research.

    Science.gov (United States)

    2010-10-01

    ... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS Basic HHS Policy for Protection of Human Research Subjects § 46.109 IRB review of research. (a) An... judgment the information would meaningfully add to the protection of the rights and welfare of subjects. (c...

  10. Time to institutional review board approval with local versus central review in a multicenter pragmatic trial.

    Science.gov (United States)

    Neuman, Mark D; Gaskins, Lakisha J; Ziolek, Tracy

    2018-02-01

    Central institutional review board (IRB) review will be required for National Institutes of Health-funded multisite human subjects research as of January 2018, with similar requirements extending to most US multisite human research in 2020. Nonetheless, little is known regarding the relative efficiency of central versus local IRB review for multicenter studies. We compared the amount of time required for central versus local IRB review and approval for sites in one ongoing multicenter randomized trial. The REGAIN Trial (Regional versus General Anesthesia for Promoting Independence after Hip Fracture; clinicaltrials.gov number: NCT02507505) is an ongoing randomized trial comparing standard-care spinal anesthesia to standard-care general anesthesia for patients undergoing hip fracture surgery. After approval of the protocol by the sponsor IRB, each participating US site opted either to submit the protocol for local IRB review or to designate the sponsor IRB as the IRB of record (i.e. central IRB) via an authorization agreement after a limited local review. For each US REGAIN site approved through 18 April 2017, we assessed (1) the time in calendar days from protocol receipt to IRB submission, (2) the time in calendar days from IRB submission to IRB approval, and (3) the total time in calendar days from protocol receipt to IRB approval (i.e. time from protocol receipt to IRB submission plus time from IRB submission to IRB approval). The main study protocol was submitted to the sponsor IRB on 25 May 2015 and approved on 8 July 2015 (44 days). Out of 34 sites, 9 received initial approval from the central (sponsor) IRB; 25 sought initial approval via local review. The median time from protocol receipt to IRB submission was 39 days for sites approved by the central IRB (interquartile range: 35-134) versus 58 days for sites approved via local review (interquartile range: 41-105; p = 0.711). The median time from IRB submission to IRB approval for sites approved by

  11. IRB Process Improvements: A Machine Learning Analysis.

    Science.gov (United States)

    Shoenbill, Kimberly; Song, Yiqiang; Cobb, Nichelle L; Drezner, Marc K; Mendonca, Eneida A

    2017-06-01

    Clinical research involving humans is critically important, but it is a lengthy and expensive process. Most studies require institutional review board (IRB) approval. Our objective is to identify predictors of delays or accelerations in the IRB review process and apply this knowledge to inform process change in an effort to improve IRB efficiency, transparency, consistency and communication. We analyzed timelines of protocol submissions to determine protocol or IRB characteristics associated with different processing times. Our evaluation included single variable analysis to identify significant predictors of IRB processing time and machine learning methods to predict processing times through the IRB review system. Based on initial identified predictors, changes to IRB workflow and staffing procedures were instituted and we repeated our analysis. Our analysis identified several predictors of delays in the IRB review process including type of IRB review to be conducted, whether a protocol falls under Veteran's Administration purview and specific staff in charge of a protocol's review. We have identified several predictors of delays in IRB protocol review processing times using statistical and machine learning methods. Application of this knowledge to process improvement efforts in two IRBs has led to increased efficiency in protocol review. The workflow and system enhancements that are being made support our four-part goal of improving IRB efficiency, consistency, transparency, and communication.

  12. Genetics researchers’ and iRB professionals’ attitudes toward genetic research review: a comparative analysis

    Science.gov (United States)

    Edwards, Karen L.; Lemke, Amy A.; Trinidad, Susan B.; Lewis, Susan M.; Starks, Helene; Snapinn, Katherine W.; Griffin, Mary Quinn; Wiesner, Georgia L.; Burke, Wylie

    2012-01-01

    Purpose Genetic research involving human participants can pose challenging questions related to ethical and regulatory standards for research oversight. However, few empirical studies describe how genetic researchers and institutional review board (IRB) professionals conceptualize ethical issues in genetic research or where common ground might exist. Methods Parallel online surveys collected information from human genetic researchers (n = 351) and IRB professionals (n = 208) regarding their views about human participant oversight for genetic protocols. Results A range of opinions were observed within groups on most issues. In both groups, a minority thought it likely that people would be harmed by participation in genetic research or identified from coded genetic data. A majority of both groups agreed that reconsent should be required for four of the six scenarios presented. Statistically significant differences were observed between groups on some issues, with more genetic researcher respondents trusting the confidentiality of coded data, fewer expecting harms from reidentification, and fewer considering reconsent necessary in certain scenarios. Conclusions The range of views observed within and between IRB and genetic researcher groups highlights the complexity and unsettled nature of many ethical issues in genome research. Our findings also identify areas where researcher and IRB views diverge and areas of common ground. PMID:22241102

  13. Balanced Ethics Review: A Guide for Institutional Review Board Members

    Directory of Open Access Journals (Sweden)

    Ames Dhai

    2016-12-01

    Full Text Available The aim of this pocket-book size manual is to assist Institutional Review Board (IRB members and chairs conduct ethics review by balancing the two major morally relevant considerations in health research

  14. Meeting the Challenge: The National Cancer Institute's Central Institutional Review Board for Multi-Site Research.

    Science.gov (United States)

    Massett, Holly A; Hampp, Sharon L; Goldberg, Jacquelyn L; Mooney, Margaret; Parreco, Linda K; Minasian, Lori; Montello, Mike; Mishkin, Grace E; Davis, Catasha; Abrams, Jeffrey S

    2018-03-10

    The National Institutes of Health (NIH) issued a new policy that requires a single institutional review board (IRB) of record be used for all protocols funded by the NIH that are carried out at more than one site in the United States, effective January 2018. This policy affects several hundred clinical trials opened annually across the NIH. Limited data exist to compare the use of a single IRB to that of multiple local IRBs, so some institutions are resistant to or distrustful of single IRBs. Since 2001, the National Cancer Institute (NCI) has funded a central IRB (CIRB) that provides human patient reviews for its extensive national cancer clinical trials program. This paper presents data to show the adoption, efficiencies gained, and satisfaction of the CIRB among NCI trial networks and reviews key lessons gleaned from 16 years of experience that may be informative for others charged with implementation of the new NIH single-IRB policy.

  15. 40 CFR 26.109 - IRB review of research.

    Science.gov (United States)

    2010-07-01

    ... 26.109 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN SUBJECTS Basic EPA Policy for Protection of Subjects in Human Research Conducted or Supported by EPA § 26.109 IRB... subjects when in the IRB's judgment the information would meaningfully add to the protection of the rights...

  16. Computerized information management for institutional review boards.

    Science.gov (United States)

    Hood, Maureen N; Gugerty, Brian; Levine, Richard; Ho, Vincent B

    2005-01-01

    The use of human subjects for medical research in most industrialized nations requires the scientific and ethical scrutiny of research proposals by a governing institutional review board (IRB) or its equivalent. As part of their primary charge to protect human subjects, IRBs are responsible for the regulatory oversight of not only the research protocol itself but also the research conduct of the investigators and, if applicable, the funding sponsor. This article will discuss the regulatory requirements for an accurate account of IRB protocols and investigators and present an overview of the general flow of information for an IRB protocol. The current and potential uses of information management systems by IRBs will also be reviewed and accompanied by a discussion of the potential advantages and disadvantages of various computerized information systems for management of clinical research.

  17. Working with the institutional review board.

    Science.gov (United States)

    Byerly, Wesley G

    2009-01-15

    Working with an institutional review board (IRB) to ensure compliance and ethical conduct of research involving human subjects is discussed. The Department of Health and Human Services (DHHS) and Food and Drug Administration regulations for the conduct of human research are grounded in the principles of the Belmont Report. By establishing the requirements for the function and operation of the IRB, the criteria needed for the review and approval of research, and the requirements for obtaining and documenting informed consent, the federal regulations help ensure the safety, rights and welfare of subjects. In developing research protocols and submissions to the IRB, the investigator should include clear, detailed information that addresses the regulatory requirements for the review and approval of research. Before starting a research study, review and approval by the IRB is required unless the study is determined to be minimal risk and fits one of the defined categories. Some research projects involving observation of public behavior, collection of anonymous surveys of nonvulnerable individuals in which the information is not considered sensitive, and evaluation of standard education practices may be exempt from DHHS regulations. Informed consent is central to the protection of human subjects and is required unless the IRB allows a waiver or alteration of informed consent. Once the study is approved, the investigator must conduct the study as approved by the IRB and continue to meet the regulatory requirements related to modifications, reporting unanticipated events, and continuing review. IRB review is integral to ensuring regulatory compliance and ethical conduct of research involving human subjects. Working closely with the IRB or colleagues who have had experience with the IRB will help junior investigators better understand the IRB submission and review process.

  18. 40 CFR 26.1109 - IRB review of research.

    Science.gov (United States)

    2010-07-01

    ... 26.1109 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN SUBJECTS Basic Ethical Requirements for Third-Party Human Research for Pesticides Involving Intentional... meaningfully add to the protection of the rights and welfare of subjects. (c) An IRB shall require...

  19. 14 CFR 1230.107 - IRB membership.

    Science.gov (United States)

    2010-01-01

    ... human subjects. In addition to possessing the professional competence necessary to review specific... institutional commitments and regulations, applicable law, and standards of professional conduct and practice... information requested by the IRB. (f) An IRB may, in its discretion, invite individuals with competence in...

  20. A Case for Limiting the Reach of Institutional Review Boards

    Science.gov (United States)

    Hessler, Richard M.; Donnell-Watson, D. J.; Galliher, John F.

    2011-01-01

    Institutional review boards (IRBs) governing social and behavioral research seem to systematically exceed the guidelines established by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. We examine a clandestine study of prostitution and another of employment discrimination and conclude that IRBs,…

  1. Institutional review boards: Challenges and opportunities

    Directory of Open Access Journals (Sweden)

    Ravindra B Ghooi

    2014-01-01

    Full Text Available Institutional Review Boards (IRBs are an important link in subject protection program, and their function defines ethical credentials of research. Of late there has been a furore in the country over the number of deaths in clinical research, and allegations of unethical research. Clinical trials have been discussed in medical and lay press and even in the parliament, these discussions called for strengthening the subject protection program. The Central Drug Standards and Control Organization (CDSCO, amended the Schedule Y, by issuing three amendments to introduce new compensation rules and registration of IRBs functioning in the country. IRBs in India face a variety of challenges, and need support from the regulators or independent experts. This is also an opportunity to revamp the subject protection program and strengthen the IRB functioning. An independent advisory body comprising of experts who have hands on experience in administering IRBs, is essential to provide support to IRBs in the country. This body should be independent of regulatory influence and work with IRBs to strengthen them.

  2. Institutional review board and regulatory solutions in the dental PBRN

    DEFF Research Database (Denmark)

    Gilbert, Gregg H; Qvist, Vibeke; Moore, Sheila D

    2010-01-01

    Effectively addressing regulatory and human participant protection issues with Institutional Review Boards (IRBs, or ethics committees) and grants administration entities is an important component of conducting research in large collaborative networks. A dental practice-based research network...

  3. Biometrics IRB best practices and data protection

    Science.gov (United States)

    Boehnen, Christopher; Bolme, David; Flynn, Patrick

    2015-05-01

    The collection of data from human subjects for biometrics research in the United States requires the development of a data collection protocol that is reviewed by a Human Subjects Institutional Review Board (IRB). The IRB reviews the protocol for risks and approves it if it meets the criteria for approval specified in the relevant Federal regulations (45 CFR 46). Many other countries operate similar mechanisms for the protection of human subjects. IRBs review protocols for safety, confidentiality, and for minimization of risk associated with identity disclosure. Since biometric measurements are potentially identifying, IRB scrutiny of biometrics data collection protocols can be expected to be thorough. This paper discusses the intricacies of IRB best practices within the worldwide biometrics community. This is important because research decisions involving human subjects are made at a local level and do not set a precedent for decisions made by another IRB board. In many cases, what one board approves is not approved by another board, resulting in significant inconsistencies that prove detrimental to both researchers and human subjects. Furthermore, the level of biometrics expertise may be low on IRBs, which can contribute to the unevenness of reviews. This publication will suggest possible best practices for designing and seeking IRB approval for human subjects research involving biometrics measurements. The views expressed are the opinions of the authors.

  4. Time required for institutional review board review at one Veterans Affairs medical center.

    Science.gov (United States)

    Hall, Daniel E; Hanusa, Barbara H; Stone, Roslyn A; Ling, Bruce S; Arnold, Robert M

    2015-02-01

    Despite growing concern that institutional review boards (IRBs) impose burdensome delays on research, little is known about the time required for IRB review across different types of research. To measure the overall and incremental process times for IRB review as a process of quality improvement. After developing a detailed process flowchart of the IRB review process, 2 analysts abstracted temporal data from the records pertaining to all 103 protocols newly submitted to the IRB at a large urban Veterans Affairs medical center from June 1, 2009, through May 31, 2011. Disagreements were reviewed with the principal investigator to reach consensus. We then compared the review times across review types using analysis of variance and post hoc Scheffé tests after achieving normally distributed data through logarithmic transformation. Calendar days from initial submission to final approval of research protocols. Initial IRB review took 2 to 4 months, with expedited and exempt reviews requiring less time (median [range], 85 [23-631] and 82 [16-437] days, respectively) than full board reviews (median [range], 131 [64-296] days; P = .008). The median time required for credentialing of investigators was 1 day (range, 0-74 days), and review by the research and development committee took a median of 15 days (range, 0-184 days). There were no significant differences in credentialing or research and development times across review types (exempt, expedited, or full board). Of the extreme delays in IRB review, 80.0% were due to investigators' slow responses to requested changes. There were no systematic delays attributable to the information security officer, privacy officer, or IRB chair. Measuring and analyzing review times is a critical first step in establishing a culture and process of continuous quality improvement among IRBs that govern research programs. The review times observed at this IRB are substantially longer than the 60-day target recommended by expert panels

  5. Victor Frankenstein's Institutional Review Board Proposal, 1790.

    Science.gov (United States)

    Harrison, Gary; Gannon, William L

    2015-10-01

    To show how the case of Mary Shelley's Victor Frankenstein brings light to the ethical and moral issues raised in Institutional Review Board (IRB) protocols, we nest an imaginary IRB proposal dated August 1790 by Victor Frankenstein within a discussion of the importance and function of the IRB. Considering the world of science as would have appeared in 1790 when Victor was a student at Ingolstadt, we offer a schematic overview of a fecund moment when advances in comparative anatomy, medical experimentation and theories of life involving animalcules and animal electricity sparked intensive debates about the basic principles of life and the relationship between body and soul. Constructing an IRB application based upon myriad speculations circulating up to 1790, we imagine how Victor would have drawn upon his contemporaries' scientific work to justify the feasibility of his project, as well as how he might have outlined the ethical implications of his plan to animate life from "dead" tissues. In Mary Shelley's Frankenstein, Victor failed to consider his creature's autonomy, vulnerability, and welfare. In this IRB proposal, we show Victor facing those issues of justice and emphasize how the novel can be an important component in courses or workshops on research ethics. Had Victor Frankenstein had to submit an IRB proposal tragedy may have been averted, for he would have been compelled to consider the consequences of his experiment and acknowledge, if not fulfill, his concomitant responsibilities to the creature that he abandoned and left to fend for itself.

  6. An IRB Transformation: Increasing Quality and Efficiency Using Existing Resources

    Science.gov (United States)

    Andrews, Joseph E., Jr.; Moore, J. Brian; Means, Paula; Weinberg, Richard

    2012-01-01

    In an effort to increase review-quality and efficiency, research administration at Wake Forest School of Medicine initiated a change in the operational structure of the Institutional Review Board (IRB) via a reconfiguring of the boards and rescheduling of the convened meetings. The number of IRB Panels was doubled and each panel/board began…

  7. Assessing the quality of VA Human Research Protection Programs: VA vs. affiliated University Institutional Review Board.

    Science.gov (United States)

    Tsan, Min-Fu; Nguyen, Yen; Brooks, Robert

    2013-04-01

    We compared the Human Research Protection Program (HRPP) quality indicator data of the Department of Veterans Affairs (VA) facilities using their own VA institutional review boards (IRBs) with those using affiliated university IRBs. From a total of 25 performance metrics, 13 did not demonstrate statistically significant differences, while 12 reached statistically significance differences. Among the 12 with statistically significant differences, facilities using their own VA IRBs performed better on four of the metrics, while facilities using affiliate IRBs performed better on eight. However, the absolute difference was small (0.2-2.7%) in all instances, suggesting that they were of no practical significance. We conclude that it is acceptable for facilities to use their own VA IRBs or affiliated university IRBs as their IRBs of record.

  8. Institutional review board community members: who are they, what do they do, and whom do they represent?

    Science.gov (United States)

    Klitzman, Robert

    2012-07-01

    The roles of nonaffiliated and nonscientific institutional review board (IRB) members at academic medical centers have received some attention, but questions remain-Who are they, what do they do, and whom, if anyone, do they represent? The author interviewed 46 IRB chairs, directors, administrators, and members in 2007-2009. He contacted the leadership of 60 IRBs (every fourth one in the list of the top 240 institutions by National Institutes of Health funding), interviewed IRB leaders from 34 of these institutions, then recruited 7 additional members from these IRBs to interview. Regular IRB members often called these individuals community members and were confused as to who these members were, or should be, and whether they did, or should, represent anyone and, if so, whom. IRBs encountered challenges in finding, training, and retaining these community members. Tensions emerged because nonscientific members, by definition, have no scientific training, so they have difficulty understanding key aspects of protocols, making them feel unempowered to contribute to reviews. IRBs varied in how much they encouraged these members to participate, in what ways, and with what success. At academic medical centers, IRBs struggled with how to view, choose, employ, and retain nonaffiliated and nonscientific members, and they varied widely in these regards. Some IRBs had these members review entire protocols, others only limited parts (particularly reading consent forms for comprehension), pro forma. Yet, at times, these members' input proved very important. These findings have critical implications for policy, practice, and research.

  9. Institutional Review Boards at Very High Research Activity Universities: An Opportunity for Social Workers

    Science.gov (United States)

    Cannon, Clare; Buttell, Frederick

    2015-01-01

    Objectives: This study investigated to what degree social work was represented in the position of chair of social-behavioral institutional review boards (IRBs) at very high research activity (VHRA) universities in the United States. Method: We collected data on IRB rosters for all 108 schools designated by the Carnegie Foundation as VHRAs in the…

  10. "Members of the same club": challenges and decisions faced by US IRBs in identifying and managing conflicts of interest.

    Science.gov (United States)

    Klitzman, Robert

    2011-01-01

    Conflicts of interest (COIs) in research have received increasing attention, but many questions arise about how Institutional Review Boards (IRBs) view and approach these. I conducted in-depth interviews of 2 hours each with 46 US IRB chairs, administrators, and members, exploring COI and other issues related to research integrity. I contacted leaders of 60 IRBs (every fourth one among the top 240 institutions by NIH funding), and interviewed IRB leaders from 34 of these institutions (response rate = 55%). Data were analyzed using standard qualitative methods, informed by Grounded Theory. IRBs confront financial and non-financial COIs of PIs, institutions, and IRBs themselves. IRB members may seek to help, or compete with, principal investigators (PIs). Non-financial COI also often appear to be "indirect financial" conflicts based on gain (or loss) not to oneself, but to one's colleagues or larger institution. IRBs faced challenges identifying and managing these COI, and often felt that they could be more effective. IRBs' management of their own potential COI vary, and conflicted members may observe, participate, and/or vote in discussions. Individual IRB members frequently judge for themselves whether to recuse themselves. Challenges arise in addressing these issues, since institutions and PIs need funding, financial information is considered confidential, and COI can be unconscious. This study, the first to explore qualitatively how IRBs confront COIs and probe how IRBs confront non-financial COIs, suggests that IRBs face several types of financial and non-financial COIs, involving themselves, PIs, and institutions, and respond varyingly. These data have critical implications for practice and policy. Disclosure of indirect and non-financial COIs to subjects may not be feasible, partly since IRBs, not PIs, are conflicted. Needs exist to consider guidelines and clarifications concerning when and how, in protocol reviews, IRB members should recuse themselves

  11. Adherence of non-pharmaceutically sponsored oncology trial protocols to the International Conference on Harmonization (ICH) guidelines in an academic institution outside the ICH jurisdictions and the impact of IRB implementation on this adherence

    International Nuclear Information System (INIS)

    Zeeneldin, A.A.

    2013-01-01

    Purpose: To assess adherence of non-pharmaceutically sponsored trials (non-PSTs) to ICH protocol structure guidelines and to estimate the effect of implementing Institutional Review Boards (IRB) review on this adherence. Methods: This is a retrospective exploratory study where 60 non-PST clinical trial protocols (CTPs) were reviewed and halved to IRB-reviewed CTPs (IRCTPs) and non-lRB-reviewed CTPs (non-lRCTPs). Adherence score (AS) was calculated as the number of fulfilled items or sub-items divided by their total number. Results: Three adherence patterns were encountered: (1) items consistently present in both groups e.g. general and background information, objectives, inclusion criteria and intervention details, (2) items consistently absent in both groups and included contact information of investigators and trial sites, product accountability, randomization codes management, interim analyses and many other statistical aspects, and (3) items variably present in both groups where the effect of IRB was verifiable. Trial site details, potential benefits, discontinuation and exclusion criteria, and follow up for adverse events were more encountered in IRCTPs than non-IRCTPs. Withdrawal criteria monitoring of treatment compliance showed a reverse pattern (p < 0.05 for all). The total AS, administrative AS and ethics AS for IRCTPs was 43%, 22% and 70% compared to 38%, 16% and 33% for non-IRCTPs (p < 0.003, <0.001, 0.004), respectively. The scientific AS was 54% for both groups (p = 0.87). Conclusions: IRB-implementation at NCl-Egypt improved ethical and administrative sections of academic protocols. However, this improvement is modest and needs further actions including adoption of protocol templates. Scientific sections were as good after IRB-implementation as they were before that

  12. Research Ethics: Institutional Review Board Oversight of Art Therapy Research

    Science.gov (United States)

    Deaver, Sarah P.

    2011-01-01

    By having their research proposals reviewed and approved by Institutional Review Boards (IRBs), art therapists meet important ethical principles regarding responsibility to research participants. This article provides an overview of the history of human subjects protections in the United States; underlying ethical principles and their application…

  13. Institutional Review Boards: Perspectives from the United States

    Directory of Open Access Journals (Sweden)

    Alvita Nathaniel, Ph.D., FNP-BC, FAANP

    2010-12-01

    Full Text Available In the U.S., all research must be approved by an Institutional Review Board (IRB that evaluates research protocols for the purpose of protecting human subjects. This paper includes a brief history of the development of public policy that guides institutional review boards in the U.S. and commentary on the responsibilities of a grounded theory researcher interested in applying for approval for a research study.An institutional review board (IRB is a formally constituted committee that approves and monitors biomedical and behavioural research with the purpose of protecting the rights and welfare of research participants. An IRB performs scientific, ethical, and regulatory oversight functions. In the U.S., it is common for grounded theorists to experience frustration with the IRB protocol submission process. Facets of the application process may seem rigid, redundant, and non-applicable. Review board members may not seem to understand or appreciate qualitative methods and delays are common. In addition, a conglomeration of disparate policies and procedures coupled with a variety of types of review boards creates a system that defies description. Nevertheless, a researcher who understands public policy and the responsibilities of institutional review boards can learn to develop research applications that are quickly approved.

  14. An Analysis of Information Technology Adoption by IRBs of Large Academic Medical Centers in the United States.

    Science.gov (United States)

    He, Shan; Botkin, Jeffrey R; Hurdle, John F

    2015-02-01

    The clinical research landscape has changed dramatically in recent years in terms of both volume and complexity. This poses new challenges for Institutional Review Boards' (IRBs) review efficiency and quality, especially at large academic medical centers. This article discusses the technical facets of IRB modernization. We analyzed the information technology used by IRBs in large academic institutions across the United States. We found that large academic medical centers have a high electronic IRB adoption rate; however, the capabilities of electronic IRB systems vary greatly. We discuss potential use-cases of a fully exploited electronic IRB system that promise to streamline the clinical research work flow. The key to that approach utilizes a structured and standardized information model for the IRB application. © The Author(s) 2014.

  15. Spotlight on Ethics: Institutional Review Boards as Systemic Bullies

    Science.gov (United States)

    Carr, Caleb T.

    2015-01-01

    Bullying, often considered an interpersonal or intergroup behaviour, has not been explored as an unintended artefact of organisational structure. Institutional review boards (IRBs), the 'human research ethics committees' at US universities, help oversee the protection of human research subjects, particularly in the social sciences within…

  16. “Members of the Same Club”: Challenges and Decisions Faced by US IRBs in Identifying and Managing Conflicts of Interest

    Science.gov (United States)

    Klitzman, Robert

    2011-01-01

    Conflicts of interest (COIs) in research have received increasing attention, but many questions arise about how Institutional Review Boards (IRBs) view and approach these. Methods I conducted in-depth interviews of 2 hours each with 46 US IRB chairs, administrators, and members, exploring COI and other issues related to research integrity. I contacted leaders of 60 IRBs (every fourth one among the top 240 institutions by NIH funding), and interviewed IRB leaders from 34 of these institutions (response rate = 55%). Data were analyzed using standard qualitative methods, informed by Grounded Theory. Results IRBs confront financial and non-financial COIs of PIs, institutions, and IRBs themselves. IRB members may seek to help, or compete with, principal investigators (PIs). Non-financial COI also often appear to be “indirect financial” conflicts based on gain (or loss) not to oneself, but to one's colleagues or larger institution. IRBs faced challenges identifying and managing these COI, and often felt that they could be more effective. IRBs' management of their own potential COI vary, and conflicted members may observe, participate, and/or vote in discussions. Individual IRB members frequently judge for themselves whether to recuse themselves. Challenges arise in addressing these issues, since institutions and PIs need funding, financial information is considered confidential, and COI can be unconscious. Conclusions This study, the first to explore qualitatively how IRBs confront COIs and probe how IRBs confront non-financial COIs, suggests that IRBs face several types of financial and non-financial COIs, involving themselves, PIs, and institutions, and respond varyingly. These data have critical implications for practice and policy. Disclosure of indirect and non-financial COIs to subjects may not be feasible, partly since IRBs, not PIs, are conflicted. Needs exist to consider guidelines and clarifications concerning when and how, in protocol reviews, IRB

  17. A caution to Native American institutional review boards about scientism and censorship.

    Science.gov (United States)

    Askland, Andrew

    2002-01-01

    Native American Institutional Review Boards (IRBs) promote the health and welfare of tribes by reviewing protocols for research studies that focus on their tribes. The benefits of approved protocols should not be overstated lest good studies disappoint because they do not satisfy unachievable expectations. IRBs also should avoid the temptation to censor the outcomes of those studies. Science relies on candor and clarity about results and methods to move forward.

  18. Development of an institutional review board preapproval process for Doctor of Nursing Practice students: process and outcome.

    Science.gov (United States)

    Szanton, Sarah L; Taylor, Holly A; Terhaar, Mary

    2013-01-01

    As Doctor of Nursing Practice (DNP) programs proliferate, effective collaboration with institutional review boards (IRBs) is important to protect human subjects. It is particularly important that faculty and students recognize which DNP students' projects should be considered as "human subjects research" or "quality improvement." The former require IRB review, whereas the latter may be eligible for expedited review or may be considered exempt. We report outcomes following implementation of a combination of didactic training, one-to-one consultation, and a decision support protocol to improve preparation for and collaboration with the IRB at a large university. In the first year of using this protocol, 53% of projects were deemed human subjects research and received IRB review. The other 47% were deemed quality improvement projects and did not require IRB review. We offer our experience as an approach for teaching students how to protect the subjects included in their quality improvement activities. Copyright 2012, SLACK Incorporated.

  19. Justification and authority in institutional review board decision letters.

    Science.gov (United States)

    Clapp, Justin T; Gleason, Katharine A; Joffe, Steven

    2017-12-01

    While ethnographic study has described the discussions that occur during human subjects research ethics review, investigators have minimal access to the interactions of ethics oversight committees. They instead receive letters stipulating changes to their proposed studies. Ethics committee letters are central to the practice of research ethics: they change the nature of research, alter the knowledge it produces, and in doing so construct what ethical research is and how it is pursued. However, these letters have rarely been objects of analysis. Accordingly, we conducted a qualitative analysis of letters written by American institutional review boards (IRBs) overseeing biomedical and health behavioral research. We sought to clarify how IRBs exercise their authority by assessing the frequency with which they provided reasons for their stipulations as well as the nature of these reasons. We found that IRBs frequently do not justify their stipulations; rather, they often leave ethical or regulatory concerns implicit or frame their comments as boilerplate language replacements, procedural instructions, or demands for missing information. When they do provide justifications, their rationales exhibit substantial variability in explicitness and clarity. These rhetorical tendencies indicate that the authority of IRBs is grounded primarily in their role as bureaucratic gatekeepers. We conclude by suggesting that greater attention to justification could help shift the basis of the IRB-researcher relationship from compliance to mutual accountability. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. How US institutional review boards decide when researchers need to translate studies.

    Science.gov (United States)

    Klitzman, Robert

    2014-03-01

    Informed consent is crucial in research, but potential participants may not all speak the same language, posing questions that have not been examined concerning decisions by institutional review boards (IRBs) and research ethics committees' (RECs) about the need for researchers to translate consent forms and other study materials. Sixty US IRBs (every fourth one in the list of the top 240 institutions by The National Institutes of Health funding) were contacted, and leaders (eg, chairs) from 34 (response rate=57%) and an additional 12 members and administrators were interviewed. IRBs face a range of problems about translation of informed consent documents, questionnaires and manuals-what, when and how to translate (eg, for how many or what proportion of potential subjects), why to do so and how to decide. Difficulties can arise about translation of specific words and of broader cultural concepts regarding processes of informed consent and research, especially in the developing world. In these decisions, IRBs weigh the need for autonomy (through informed consent) and justice (to ensure fair distribution of benefits and burdens of research) against practical concerns about costs to researchers. At times IRBs may have to compromise between these competing goals. These data, the first to examine when and how IRBs/RECs require researchers to translate materials, thus highlight a range of problems with which these committees struggle, suggesting a need for further normative and empirical investigation of these domains, and consideration of guidelines to help IRBs deal with these tensions.

  1. How IRBs view and make decisions about coercion and undue influence.

    Science.gov (United States)

    Klitzman, Robert

    2013-04-01

    Scholars have debated how to define coercion and undue influence, but how institutional review boards (IRBs) view and make decisions about these issues in actual cases has not been explored. I contacted the leadership of 60 US IRBs (every fourth one in the list of the top 240 institutions by National Institutes of Health funding), and interviewed 39 IRB leaders or administrators from 34 of these institutions (response rate=55%), and 7 members. IRBs wrestled with defining of 'coercion' and 'undue inducement', most notably in deciding about participant compensation. IRBs often use these terms synonymously and define undue inducement in varying ways, often wrestling with these issues, relying on 'gut feelings', and seeking compromises. Ambiguities arose, partly reflecting underlying tensions: whether subjects should 'get paid' versus 'volunteer' (ie, whether subjects should be motivated by compensation vs altruism), and whether subjects should be paid differently based on income, given possible resultant selection bias. Lack of consistent standards emerged between and even on single IRBs. Questions arose concerning certain aspects and types of studies; for example, how to view and weigh providing free care in research, whether and how recruitment flyers should mention compensation, and how to avoid coercion in paediatric, developing world, or students research. These data, the first to probe qualitatively how IRBs view and approach questions about coercion, undue influence and participant compensation, and to examine how IRBs have reviewed actual cases, reveal several critical ambiguities and dilemmas, and have vital implications for future practice, education, policy and research.

  2. Why Public Comments Matter: The Case of the National Institutes of Health Policy on Single Institutional Review Board Review of Multicenter Studies.

    Science.gov (United States)

    Ervin, Ann-Margret; Taylor, Holly A; Ehrhardt, Stephan; Meinert, Curtis L

    2018-03-06

    In 2014, the National Institutes of Health (NIH) requested public comments on a draft policy requiring NIH-funded, U.S.-based investigators to use a single institutional review board (sIRB) for ethical review of multicenter studies. The authors conducted a directed content analysis and qualitative summary of the comments and discuss how they shaped the final policy. Two reviewers independently assessed support for the policy from a review of comments responding to the draft policy in 2016. A reviewer conducted an open text review to identify prespecified and additional comment themes. A second researcher reviewed 20% of the comments; discrepancies were resolved through discussion. The NIH received 167 comments: 65% (108/167) supportive of the policy, 23% (38/167) not supportive, and 12% (21/167) not indicating support. Clarifications or changes to the policy were suggested in 102/167 comments (61%). Criteria for selecting sIRBs were addressed in 32/102 comments (31%). Also addressed were IRB responsibilities (39/102; 38%), cost (27/102; 26%), the role of local IRBs (14/102; 14%), and allowable policy exceptions (19/102; 19%). The NIH further clarified or provided additional guidance for selection criteria, IRB responsibilities, and cost in the final policy (June 2016). Local IRB reviews and exemptions guidance were unchanged. In this case study, public comments were effective in shaping policy as the NIH modified provisions or planned supplemental guidance in response to comments. Yet critical knowledge gaps remain and empirical data are necessary. The NIH is considering mechanisms to support the establishment of best practices for sIRB implementation.

  3. 21 CFR 56.107 - IRB membership.

    Science.gov (United States)

    2010-04-01

    ... professional competence necessary to review the specific research activities, the IRB shall be able to..., applicable law, and standards or professional conduct and practice. The IRB shall therefore include persons... IRB may, in its discretion, invite individuals with competence in special areas to assist in the...

  4. An institutional review board-based clinical research quality assurance program.

    Science.gov (United States)

    Lad, Pramod M; Dahl, Rebecca

    2013-01-01

    Despite the acknowledged importance of quality assurance in the clinical research process, the problem of how such a program should be implemented at the level of an academic teaching hospital or a similar institution has not been addressed in the literature. Despite the fact that quality assurance is expected in programs which certify and accredit Institutional Review Boards (IRBs), very little is known about the role of the IRB in programs of clinical research quality assurance. In this article we consider the definition of clinical research quality assurance, and describe a program designed to achieve it. The key elements of such a program are education at the site level, which has both mandatory and voluntary components, and an auditing and monitoring program, which reinforces the education on quality assurance. The role of the IRB in achieving the program goals and the organizational placement of the quality assurance program within the IRB structure and function are important items of discussion.

  5. A qualitative study of institutional review board members' experience reviewing research proposals using emergency exception from informed consent.

    Science.gov (United States)

    McClure, Katie B; Delorio, Nicole M; Schmidt, Terri A; Chiodo, Gary; Gorman, Paul

    2007-05-01

    Emergency exception to informed consent regulation was introduced to provide a venue to perform research on subjects in emergency situations before obtaining informed consent. For a study to proceed, institutional review boards (IRBs) need to determine if the regulations have been met. To determine IRB members' experience reviewing research protocols using emergency exception to informed consent. This qualitative research used semistructured telephone interviews of 10 selected IRB members from around the US in the fall of 2003. IRB members were chosen as little is known about their views of exception to consent, and part of their mandate is the protection of human subjects in research. Interview questions focused on the length of review process, ethical and legal considerations, training provided to IRB members on the regulations, and experience using community consultation and notification. Content analysis was performed on the transcripts of interviews. To ensure validity, data analysis was performed by individuals with varying backgrounds: three emergency physicians, an IRB member and a layperson. Respondents noted that: (1) emergency exception to informed consent studies require lengthy review; (2) community consultation and notification regulations are vague and hard to implement; (3) current regulations, if applied correctly, protect human subjects; (4) legal counsel is an important aspect of reviewing exception to informed-consent protocols; and (5) IRB members have had little or no formal training in these regulations, but are able to access materials needed to review such protocols. This preliminary study suggests that IRB members find emergency exception to informed consent studies take longer to review than other protocols, and that community consultation and community notification are the most difficult aspect of the regulations with which to comply but that they adequately protect human subjects.

  6. How to do human-subjects research if you do not have an institutional review board.

    Science.gov (United States)

    Rice, Todd W

    2008-10-01

    Biomedical research with human subjects has expanded outside of traditional medical centers and hospitals into other health care entities, such as rehabilitation facilities, free-standing out-patient treatment centers, and even home-health agencies. Regardless of the location, federal regulations mandate that all human-subjects research must be overseen by an institutional review board (IRB) or ethics committee to ensure the research abide by the Code of Federal Regulations. Consequently, all human-subjects research must be reviewed and approved by an IRB prior to initiation of any research procedures. Unfortunately, many of these nontraditional research facilities do not have easy access to an IRB. This does not render such research exempt from federal oversight. Clinicians at these facilities have viable options for obtaining IRB approval and legally conducting such research. This paper outlines the available options and their pros and cons.

  7. Sustaining engagement and partnership: model of enhancing cultural capital among nonaffiliated IRB members.

    Science.gov (United States)

    Hung, Yvonne; Ayala, Armida; Morales, Francisco; Frierman-Hunt, Gina; Moreno, Alva; Nwachuku, Ijeoma

    2013-07-01

    Although federal regulations require the presence of at least one nonaffiliated member on the roster of an institutional review board (IRB), little research exists about how to foster their participation and satisfaction. Guided by principles of justice and diversity, the Kaiser Permanente Southern California IRB adapted the sociological concept of "cultural capital" to develop training and support with its nonaffiliated IRB members. Using in-depth qualitative interviews with four past and current nonaffiliated IRB members, we describe how our initial and ongoing activities enhanced their ability to analyze, communicate, and complete the ethical review of research. This case study is situated in the gaps of existing research about nonaffiliated IRB members by providing insights into how to sustain their engagement while protecting the rights of research volunteers, particularly from vulnerable communities.

  8. Approaches to facilitate institutional review board approval of multicenter research studies.

    Science.gov (United States)

    Marsolo, Keith

    2012-07-01

    Gaining Institutional Review Board (IRB) approval for a multicenter research study can be a lengthy and time-consuming process. It can increase the complexity of consent forms, decreasing patient understanding and lowering recruitment numbers. It also leads to increased costs through the duplication of effort. This paper examines some of the strategies used to streamline the IRB review process for multicenter studies and provides examples used by 2 existing multicenter comparative effectiveness research networks. A literature search was conducted to identify sources that described the challenges and potential strategies to facilitate multicenter IRB approval. The most promising avenues were identified and included in this review. Phone interviews were conducted with the Principal Investigators and Project Managers of 2 successful multicenter research networks to learn their "keys to success" and their lessons learned. Three strategies were identified that held the most promise: working with IRBs before submission, the use of central and/or federated IRBs, and the establishment of an umbrella protocol. Each of these strategies was used to some degree by the case study projects. Although the approaches documented here can help streamline the IRB approval process, they are not a "silver bullet." Because some of these approaches are still relatively new, empirical data are sparse. However, it is believed that they will significantly reduce the administrative burden of the project as a whole and lead to a decrease in the overall time to protocol approval.

  9. Academic and Institutional Review Board Collaboration to Ensure Ethical Conduct of Doctor of Nursing Practice Projects.

    Science.gov (United States)

    Foote, Jan M; Conley, Virginia; Williams, Janet K; McCarthy, Ann Marie; Countryman, Michele

    2015-07-01

    Navigating the regulations to protect human subjects and private health information for Doctor of Nursing Practice (DNP) projects can be a formidable task for students, faculty, and the institutional review board (IRB). Key stakeholders from the University of Iowa College of Nursing and the Human Subjects Office developed a standardized process for DNP students to follow, using a decision algorithm, a student orientation to the human subjects review process conducted by faculty and IRB chairs and staff, and a brief Human Subjects Research Determination form. Over 2 years, 109 students completed the process, and 96.3% of their projects were deemed not to be human subjects research. Every student submitted documentation of adherence to the standardized process. Less time was spent by students, faculty, and the IRB in preparing and processing review requests. The interprofessional collaboration resulted in a streamlined process for the timely review of DNP projects. Copyright 2015, SLACK Incorporated.

  10. Research ethics and Institutional Review Boards. The influence of moral constraints on emotion research.

    Science.gov (United States)

    Sontag, Michael

    2012-01-01

    Researchers in the twenty-first century face a set of challenges unknown to researchers a half century ago--the need to justify the moral acceptability of their research methods through formal review processes. However, the role that moral constraints play in the development and demise of scientific theories has largely gone unappreciated. The rise of Institutional Review Boards (IRB) in the 1960s compounded the impact of moral constraints on scientific research and on the theories that develop out of such highly monitored research. To demonstrate the effects of moral constraints on scientific theory and research, this paper offers a history and analysis of the interaction between evolving moral standards and twentieth century emotion theory. Recommendations regarding IRB reform are also reviewed. The paper concludes by arguing that, while appropriate IRB reform is important, it cannot eliminate the need for careful reflection on the broader forces that shape scientific practice and understanding.

  11. IRB PERSPECTIVES ON THE RETURN OF INDIVIDUAL RESULTS FROM GENOMIC RESEARCH

    Science.gov (United States)

    Dressler, Lynn G.; Smolek, Sondra; Ponsaran, Roselle; Markey, Janell M.; Starks, Helene; Gerson, Nancy; Lewis, Susan; Press, Nancy; Juengst, Eric; Wiesner, Georgia L.

    2012-01-01

    Purpose Return of individual research results from genomic studies is a hotly debated ethical issue in genomic research. However, the perspective of key stakeholders—Institutional Review Board (IRB) reviewers—has been missing from this dialogue. This study explores the positions and experiences of IRB members and staff regarding this issue. Methods In depth interviews with 31 IRB professionals at six sites across the United States. Results IRB professionals agreed that research results should be returned to research participants when results are medically actionable but only if the participants wanted to know the result. Many respondents expected researchers to address the issue of return of results (ROR) in the IRB application and informed-consent document. Many respondents were not comfortable with their expertise in genomics research, and only a few described actual experiences in addressing ROR. Although participants agreed that guidelines would be helpful, most were reticent to develop them in isolation. Even where IRB guidance exists (e.g., CLIA lab certification required for return), in practice, the guidance has been overruled to allow return (e.g., no CLIA lab performs the assay). Conclusion An IRB-researcher partnership is needed to help inform responsible and feasible institutional approaches to returning research results. PMID:22241094

  12. Local IRBs vs. federal agencies: shifting dynamics, systems, and relationships.

    Science.gov (United States)

    Klitzman, Robert L

    2012-07-01

    How IRBs relate to federal agencies, and the implications of these relationships, have received little, if any, systematic study. I interviewed 46 IRB chairs, directors, administrators, and members, contacting the leadership of 60 U.S. IRBs (every fourth one in the list of the top 240 institutions by NIH funding), interviewing IRB leaders from 34 (response rate=55%). IRBs describe complex direct and indirect relationships with federal agencies that affect IRBs through audits, guidance documents, and other communications, and can generate problems and challenges. Researchers often blame IRBs for frustrations, but IRBs often serve as the "local face" of federal regulations and agencies and are "stuck in the middle." These data have critical implications for policy, practice, and research.

  13. Applying the institutional review board data repository approach to manage ethical considerations in evaluating and studying medical education.

    Science.gov (United States)

    Thayer, Erin K; Rathkey, Daniel; Miller, Marissa Fuqua; Palmer, Ryan; Mejicano, George C; Pusic, Martin; Kalet, Adina; Gillespie, Colleen; Carney, Patricia A

    2016-01-01

    Medical educators and educational researchers continue to improve their processes for managing medical student and program evaluation data using sound ethical principles. This is becoming even more important as curricular innovations are occurring across undergraduate and graduate medical education. Dissemination of findings from this work is critical, and peer-reviewed journals often require an institutional review board (IRB) determination. IRB data repositories, originally designed for the longitudinal study of biological specimens, can be applied to medical education research. The benefits of such an approach include obtaining expedited review for multiple related studies within a single IRB application and allowing for more flexibility when conducting complex longitudinal studies involving large datasets from multiple data sources and/or institutions. In this paper, we inform educators and educational researchers on our analysis of the use of the IRB data repository approach to manage ethical considerations as part of best practices for amassing, pooling, and sharing data for educational research, evaluation, and improvement purposes. Fostering multi-institutional studies while following sound ethical principles in the study of medical education is needed, and the IRB data repository approach has many benefits, especially for longitudinal assessment of complex multi-site data.

  14. Institutional review board perspectives on obligations to disclose genetic incidental findings to research participants.

    Science.gov (United States)

    Gliwa, Catherine; Yurkiewicz, Ilana R; Lehmann, Lisa Soleymani; Hull, Sara Chandros; Jones, Nathan; Berkman, Benjamin E

    2016-07-01

    Researchers' obligations to disclose genetic incidental findings (GIFs) have been widely debated, but there has been little empirical study of the engagement of institutional review boards (IRBs) with this issue. This article presents data from the first extensive (n = 796) national survey of IRB professionals' understanding of, experience with, and beliefs surrounding GIFs. Most respondents had dealt with questions about GIFs (74%), but only a minority (47%) felt prepared to address them. Although a majority believed that there is an obligation to disclose GIFs (78%), there is still not consensus about the supporting ethical principles. Respondents generally did not endorse the idea that researchers' additional time and effort (7%), and lack of resources (29%), were valid reasons for diminishing a putative obligation. Most (96%) supported a right not to know, but this view became less pronounced (63%) when framed in terms of specific case studies. IRBs are actively engaged with GIFs but have not yet reached consensus. Respondents were uncomfortable with arguments that could be used to limit an obligation to return GIFs. This could indicate that IRBs are providing some of the impetus for the trend toward returning GIFs, although questions remain about the relative contribution of other stakeholders.Genet Med 18 7, 705-711.

  15. Patients come from populations and populations contain patients. A two-stage scientific and ethics review: The next adaptation for single institutional review boards.

    Science.gov (United States)

    Knopman, David; Alford, Eli; Tate, Kaitlin; Long, Mark; Khachaturian, Ara S

    2017-08-01

    For nearly 50 years, institutional review boards (IRB) and independent ethics committees have featured local oversight as a core function of research ethics reviews. However growing complexity in Alzheimer's clinical research suggests current approaches to research volunteer safety is hampering development of new therapeutics. As a partial response to this challenge, the NIH has mandated that all NIH-funded multi-site studies will use a single Institutional Review Board. The perspective describes a joint program to provide a single IRB of record (sIRB) for phases of multi-site studies. The approach follows two steps. One, an expert Scientific Review Committee (SRC) of senior researchers in the field will conduct the review principally of scientific merit, significance, feasibility, and the likelihood of meaningful results. The second step will be the IRB's regulatory and ethics review. The IRB will apply appropriate regulatory criteria for approval including minimization of risks to subjects and risks reasonable in relation to anticipated benefits, equitable subject selection, informed consent, protections for vulnerable populations, and application of local context considerations, among others. There is a steady demand for scientific, ethical and regulatory review of planned Alzheimer's studies. As of January 15, 2017, there are nearly 400 open studies, Phase II and III, industry and NIH sponsored trials on disease indications affecting memory, movement and mood in the US. The effort will initially accept protocols for studies of Alzheimer's disease, dementia, and related disorders effecting memory, movement and mood. Future aims will be to provide scientific review and, where applicable, regulatory and ethical review in an international context outside North America with sites possibly in Asia, Europe and Australia. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  16. Trends in the number and the quality of trial protocols involving children submitted to a French Institutional Review Board

    Directory of Open Access Journals (Sweden)

    Isabelle Gautier

    2017-08-01

    Full Text Available Abstract Background There is a great need for high quality clinical research for children. The European Pediatric Regulation aimed to improve the quality of clinical trials in order to increase the availability of treatments for children. The main purpose of this study was to assess the evolution of both the number and the quality of pediatric trial protocols that were submitted to a French Institutional Review Board (IRB00009118 before and after the initiation of the EU Pediatric Regulation. Methods All protocols submitted to the IRB00009118 between 2003 and 2014 and conducting research on subjects under eighteen years of age were eligible. The quality of randomized clinical trials was assessed according to the guidelines developed by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR Network and ranked using the Jadad score. Results Out of 622 protocols submitted to the Institutional Review Board (IRB, 21% (133/622 included children. Among these 133 pediatric protocols, the number of submitted pediatric protocols doubled between the two studied periods. From 2003 to 2008, 47 protocols including 21 institutionally sponsored were submitted to the IRB and from 2009 until 2014, 86 protocols including 48 institutionally sponsored were submitted. No significant trend was observed on the quality of RCTs. The overall median score of RCTs on the Jadad scale was high (3.5, 70.0% of protocols had a Jadad score ≥ 3, and 30.0% had a score < 3. Conclusion Following the EU Pediatric Regulation, the number of pediatric protocols submitted to the IRB00009118 tends to increase, but no change was noticed regarding their quality.

  17. 32 CFR 219.107 - IRB membership.

    Science.gov (United States)

    2010-07-01

    ... counsel in safeguarding the rights and welfare of human subjects. In addition to possessing the... subjects, such as children, prisoners, pregnant women, or handicapped or mentally disabled persons... IRB consists entirely of men or entirely of women, including the institution's consideration of...

  18. 10 CFR 745.107 - IRB membership.

    Science.gov (United States)

    2010-01-01

    ... advice and counsel in safeguarding the rights and welfare of human subjects. In addition to possessing... subjects, such as children, prisoners, pregnant women, or handicapped or mentally disabled persons... IRB consists entirely of men or entirely of women, including the institution's consideration of...

  19. Institutional review board challenges related to community-based participatory research on human exposure to environmental toxins: A case study

    Directory of Open Access Journals (Sweden)

    Rudel Ruthann A

    2010-07-01

    Full Text Available Abstract Background We report on the challenges of obtaining Institutional Review Board (IRB coverage for a community-based participatory research (CBPR environmental justice project, which involved reporting biomonitoring and household exposure results to participants, and included lay participation in research. Methods We draw on our experiences guiding a multi-partner CBPR project through university and state Institutional Review Board reviews, and other CBPR colleagues' written accounts and conference presentations and discussions. We also interviewed academics involved in CBPR to learn of their challenges with Institutional Review Boards. Results We found that Institutional Review Boards are generally unfamiliar with CBPR, reluctant to oversee community partners, and resistant to ongoing researcher-participant interaction. Institutional Review Boards sometimes unintentionally violate the very principles of beneficence and justice which they are supposed to uphold. For example, some Institutional Review Boards refuse to allow report-back of individual data to participants, which contradicts the CBPR principles that guide a growing number of projects. This causes significant delays and may divert research and dissemination efforts. Our extensive education of our university Institutional Review Board convinced them to provide human subjects protection coverage for two community-based organizations in our partnership. Conclusions IRBs and funders should develop clear, routine review guidelines that respect the unique qualities of CBPR, while researchers and community partners can educate IRB staff and board members about the objectives, ethical frameworks, and research methods of CBPR. These strategies can better protect research participants from the harm of unnecessary delays and exclusion from the research process, while facilitating the ethical communication of study results to participants and communities.

  20. Institutional Barriers to Research on Sensitive Topics: Case of Sex Communication Research Among University Students

    Directory of Open Access Journals (Sweden)

    Carey M. Noland

    2012-11-01

    Full Text Available When conducting research on sensitive topics, it is challenging to use new methods of data collection given the apprehensions of Institutional Review Boards (IRBs. This is especially worrying because sensitive topics of research often require novel approaches. In this article a brief personal history of navigating the IRB process for conducting sex communication research is presented, along with data from a survey that tested the assumptions long held by many IRBs. Results support some of the assumptions IRBs hold about sex communication research, but do not support some other assumptions.

  1. Ethical dilemmas in community-based participatory research: recommendations for institutional review boards.

    Science.gov (United States)

    Flicker, Sarah; Travers, Robb; Guta, Adrian; McDonald, Sean; Meagher, Aileen

    2007-07-01

    National and international codes of research conduct have been established in most industrialized nations to ensure greater adherence to ethical research practices. Despite these safeguards, however, traditional research approaches often continue to stigmatize marginalized and vulnerable communities. Community-based participatory research (CBPR) has evolved as an effective new research paradigm that attempts to make research a more inclusive and democratic process by fostering the development of partnerships between communities and academics to address community-relevant research priorities. As such, it attempts to redress ethical concerns that have emerged out of more traditional paradigms. Nevertheless, new and emerging ethical dilemmas are commonly associated with CBPR and are rarely addressed in traditional ethical reviews. We conducted a content analysis of forms and guidelines commonly used by institutional review boards (IRBs) in the USA and research ethics boards (REBs) in Canada. Our intent was to see if the forms used by boards reflected common CBPR experience. We drew our sample from affiliated members of the US-based Association of Schools of Public Health and from Canadian universities that offered graduate public health training. This convenience sample (n = 30) was garnered from programs where application forms were available online for download between July and August, 2004. Results show that ethical review forms and guidelines overwhelmingly operate within a biomedical framework that rarely takes into account common CBPR experience. They are primarily focused on the principle of assessing risk to individuals and not to communities and continue to perpetuate the notion that the domain of "knowledge production" is the sole right of academic researchers. Consequently, IRBs and REBs may be unintentionally placing communities at risk by continuing to use procedures inappropriate or unsuitable for CBPR. IRB/REB procedures require a new framework more

  2. Ethical Dilemmas in Community-Based Participatory Research: Recommendations for Institutional Review Boards

    Science.gov (United States)

    Travers, Robb; Guta, Adrian; McDonald, Sean; Meagher, Aileen

    2007-01-01

    National and international codes of research conduct have been established in most industrialized nations to ensure greater adherence to ethical research practices. Despite these safeguards, however, traditional research approaches often continue to stigmatize marginalized and vulnerable communities. Community-based participatory research (CBPR) has evolved as an effective new research paradigm that attempts to make research a more inclusive and democratic process by fostering the development of partnerships between communities and academics to address community-relevant research priorities. As such, it attempts to redress ethical concerns that have emerged out of more traditional paradigms. Nevertheless, new and emerging ethical dilemmas are commonly associated with CBPR and are rarely addressed in traditional ethical reviews. We conducted a content analysis of forms and guidelines commonly used by institutional review boards (IRBs) in the USA and research ethics boards (REBs) in Canada. Our intent was to see if the forms used by boards reflected common CBPR experience. We drew our sample from affiliated members of the US-based Association of Schools of Public Health and from Canadian universities that offered graduate public health training. This convenience sample (n = 30) was garnered from programs where application forms were available online for download between July and August, 2004. Results show that ethical review forms and guidelines overwhelmingly operate within a biomedical framework that rarely takes into account common CBPR experience. They are primarily focused on the principle of assessing risk to individuals and not to communities and continue to perpetuate the notion that the domain of “knowledge production” is the sole right of academic researchers. Consequently, IRBs and REBs may be unintentionally placing communities at risk by continuing to use procedures inappropriate or unsuitable for CBPR. IRB/REB procedures require a new framework

  3. 40 CFR 26.1115 - IRB records.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false IRB records. 26.1115 Section 26.1115 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN SUBJECTS Basic Ethical...-nursing Adults § 26.1115 IRB records. (a) An IRB shall prepare and maintain adequate documentation of IRB...

  4. Engaging Institutional Review Boards in Developing a Brief, Community-Responsive Human Subjects Training for Community Partners.

    Science.gov (United States)

    Calzo, Jerel P; Bogart, Laura M; Francis, Evelyn; Kornetsky, Susan Z; Winkler, Sabune J; Kaberry, Julie

    2016-01-01

    Engaging community partners as co-investigators in community-based participatory research (CBPR) requires certification in the rules, ethics, and principles governing research. Despite developments in making human research protection trainings more convenient and standardized (eg, self-paced Internet modules), time constraints and the structure of the content (which may favor academic audiences) may hinder the training of community partners. This paper is motivated by a case example in which academic and community partners, and stakeholders of a community-based organization actively engaged the leadership of a pediatric hospital-based institutional review board (IRB) in implementing a brief, community-responsive human subjects training session. A 2-hour, discussion-based human subjects training was developed via collaborations between the IRB and the community and academic partners. Interviews with trainees and facilitators after the training were used to evaluate its acceptability and possible future applications. Local IRBs have the potential to assist community partners in building sufficient knowledge of human subjects research protections to engage in specific projects, thereby expediting the progress of vital research to address community needs. We propose the need for developing truncated human subjects education materials to train and certify community partners, and creating formally organized entities within academic and medical institutions that specialize in community-based research to guide the development and implementation of alternative human subjects training certification opportunities for community partners.

  5. Ethical and regulatory challenges of research using pervasive sensing and other emerging technologies: IRB perspectives.

    Science.gov (United States)

    Nebeker, Camille; Harlow, John; Espinoza Giacinto, Rebeca; Orozco-Linares, Rubi; Bloss, Cinnamon S; Weibel, Nadir

    2017-01-01

    Vast quantities of personal health information and private identifiable information are being created through mobile apps, wearable sensors, and social networks. While new strategies and tools for obtaining health data have expanded researchers' abilities to design and test personalized and adaptive health interventions, the deployment of pervasive sensing and computational techniques to gather research data is raising ethical challenges for Institutional Review Boards (IRBs) charged with protecting research participants. To explore experiences with, and perceptions about, technology-enabled research, and identify solutions for promoting responsible conduct of this research we conducted focus groups with human research protection program and IRB affiliates. Our findings outline the need for increased collaboration across stakeholders in terms of: (1) shared and dynamic resources that improve awareness of technologies and decrease potential threats to participant privacy and data confidentiality, and (2) development of appropriate and dynamic standards through collaboration with stakeholders in the research ethics community.

  6. Deceased Donor Intervention Research: A Survey of Transplant Surgeons, Organ Procurement Professionals, and Institutional Review Board Members.

    Science.gov (United States)

    Rodrigue, J R; Feng, S; Johansson, A C; Glazier, A K; Abt, P L

    2016-01-01

    Innovative deceased donor intervention strategies have the potential to increase the number and quality of transplantable organs. Yet there is confusion over regulatory and legal requirements, as well as ethical considerations. We surveyed transplant surgeons (n = 294), organ procurement organization (OPO) professionals (n = 83), and institutional review board (IRB) members (n = 317) and found wide variations in their perceptions about research classification, risk assessment for donors and organ transplant recipients, regulatory oversight requirements, and informed consent in the context of deceased donor intervention research. For instance, when presented with different research scenarios, IRB members were more likely than transplant surgeons and OPO professionals to feel that study review and oversight were necessary by the IRBs at the investigator, donor, and transplant center hospitals. Survey findings underscore the need to clarify ethical, legal, and regulatory requirements and their application to deceased donor intervention research to accelerate the pace of scientific discovery and facilitate more transplants. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  7. Variation in standards of research compensation and child assent practices: a comparison of 69 institutional review board-approved informed permission and assent forms for 3 multicenter pediatric clinical trials.

    Science.gov (United States)

    Kimberly, Michael B; Hoehn, K Sarah; Feudtner, Chris; Nelson, Robert M; Schreiner, Mark

    2006-05-01

    To systematically compare standards for compensation and child participant assent in informed permission, assent, and consent forms (IP-A-CFs) approved by 55 local institutional review boards (IRBs) reviewing 3 standardized multicenter research protocols. Sixty-nine principal investigators participating in any of 3 national, multicenter clinical trials submitted standardized research protocols for their trials to their local IRBs for approval. Copies of the subsequently IRB-approved IP-A-CFs were then forwarded to an academic clinical research organization. This collection of IRB-approved forms allowed for a quasiexperimental retrospective evaluation of the variation in informed permission, assent, and consent standards operationalized by the local IRBs. Standards for compensation and child participant assent varied substantially across 69 IRB-approved IP-A-CFs. Among the 48 IP-A-CFs offering compensation, monetary compensation was offered by 33 as reimbursement for travel, parking, or food expenses, whereas monetary or material compensation was offered by 22 for subject inconvenience and by 13 for subject time. Compensation ranged widely within and across studies (study 1, $180-1425; study 2, $0-500; and study 3, $0-100). Regarding child participant assent, among the 57 IP-A-CFs that included a form of assent documentation, 33 included a line for assent on the informed permission or consent form, whereas 35 included a separate form written in simplified language. Of the IP-A-CFs that stipulated the documentation of assent, 31 specified > or =1 age ranges for obtaining assent. Informed permission or consent forms were addressed either to parents or child participants. In response to identical clinical trial protocols, local IRBs generate IP-A-CFs that vary considerably regarding compensation and child participant assent.

  8. Engaging Institutional Review Boards in Developing a Brief, Community-Responsive Human Subjects Training for Community Partners

    Science.gov (United States)

    Calzo, Jerel P.; Bogart, Laura M.; Francis, Evelyn; Kornetsky, Susan Z.; Winkler, Sabune J.; Kaberry, Julie M.

    2017-01-01

    BACKGROUND Engaging community partners as co-investigators in community-based participatory research (CBPR) requires certification in the rules, ethics, and principles governing research. Despite developments in making human research protection trainings more convenient and standardized (e.g., self-paced Internet modules), time constraints and the structure of the content (which may favor academic audiences) may hinder the training of community partners. OBJECTIVES This paper is motivated by a case example in which academic and community partners, and stakeholders of a community-based organization actively engaged the leadership of a pediatric hospital-based Institutional Review Board (IRB) in implementing a brief, community-responsive human subjects training session. METHODS A two hour, discussion-based human subjects training was developed via collaborations between the IRB and the community and academic partners. Interviews with trainees and facilitators after the training were used to evaluate its acceptability and possible future applications. CONCLUSIONS Local Institutional Review Boards have the potential to assist community partners in building sufficient knowledge of human subjects research protections to engage in specific projects, thereby expediting the progress of vital research to address community needs. We propose the need for developing truncated human subjects education materials to train and certify community partners, and creating formally organized entities within academic and medical institutions that specialize in community-based research to guide the development and implementation of alternative human subjects training certification opportunities for community partners. PMID:28230554

  9. Measuring inconsistency in research ethics committee review

    OpenAIRE

    Trace, Samantha; Kolstoe, Simon Erik

    2017-01-01

    Background The review of human participant research by Research Ethics Committees (RECs) or Institutional Review Boards (IRBs) is a complex multi-faceted process that cannot be reduced to an algorithm. However, this does not give RECs/ IRBs permission to be inconsistent in their specific requirements to researchers or in their final opinions. In England the Health Research Authority (HRA) coordinates 67 committees, and has adopted a consistency improvement plan including a process called “Sha...

  10. A Survey Study of Institutional Review Board Thought Processes in the United States and South Korea

    Directory of Open Access Journals (Sweden)

    Si-Kyung Jung

    2012-09-01

    Full Text Available Introduction: In the last several decades, South Korea has rapidly adopted Western customs and practices. Yet, cultural differences between South Korea and the United States exist. The purpose ofthis study was to identify and characterize potential cultural differences in the Korean and US institutional review board (IRB approach to certain topics.Methods: A qualitative analysis of a 9-item survey, describing 4 research study case scenarios, sent to IRB members from the United States and South Korea. The case scenarios involved the followingissues: (1 the need for consent for retrospective chart review when research subjects receive their care after the study is conceived; (2 child assent; (3 individual versus population benefit; and (4 exception from informed consent in emergency resuscitation research. The free-text responses were analyzed and abstracted for recurrent themes.Results: Twenty-three of the 45 survey recipients completed the survey, for an overall response rate of 51%. The themes that emerged were as follows: (1 the importance of parental authority among Korean participants versus the importance of child autonomy and child assent among US participants; (2 the recognition of the rights of a proxy or surrogate who can represent an individual’s values by all participants; and (3 the importance of the community, expressed by the Korean respondents, versus individualism, expressed by US respondents.Conclusion: Whereas US participants appear to emphasize the importance of the individual and the autonomy of a child, the Korean respondents stressed the importance of parental authority andbenefiting the community, above and beyond that of the individual person. However, there was substantial overlap in the themes expressed by respondents from both countries.

  11. 45 CFR 46.107 - IRB membership.

    Science.gov (United States)

    2010-10-01

    ... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS Basic HHS Policy for Protection of Human Research Subjects § 46.107 IRB membership. (a) Each IRB shall have... respect for its advice and counsel in safeguarding the rights and welfare of human subjects. In addition...

  12. 34 CFR 97.115 - IRB records.

    Science.gov (United States)

    2010-07-01

    ... the Secretary, Department of Education PROTECTION OF HUMAN SUBJECTS Federal Policy for the Protection of Human Subjects (Basic ED Policy for Protection of Human Research Subjects) § 97.115 IRB records... in sufficient detail to show attendance at the meetings; actions taken by the IRB; the vote on these...

  13. 40 CFR 26.115 - IRB records.

    Science.gov (United States)

    2010-07-01

    ... Policy for Protection of Subjects in Human Research Conducted or Supported by EPA § 26.115 IRB records... in sufficient detail to show attendance at the meetings; actions taken by the IRB; the vote on these...)(5). (b) The records required by this policy shall be retained for at least 3 years, and records...

  14. 7 CFR 1c.107 - IRB membership.

    Science.gov (United States)

    2010-01-01

    ... Office of the Secretary of Agriculture PROTECTION OF HUMAN SUBJECTS § 1c.107 IRB membership. (a) Each IRB... promote respect for its advice and counsel in safeguarding the rights and welfare of human subjects. In... knowledgeable about and experienced in working with these subjects. (b) Every nondiscriminatory effort will be...

  15. Eprints Institutional Repository Software: A Review

    Directory of Open Access Journals (Sweden)

    Mike R. Beazley

    2011-01-01

    Full Text Available Setting up an institutional repository (IR can be a daunting task. There are many software packages out there, some commercial, some open source, all of which offer different features and functionality. This article will provide some thoughts about one of these software packages: Eprints. Eprints was one of the first IR software packages to appear and has been available for 10 years. It is under continual development by its creators at the University of Southampton and the current version is v3.2.3. Eprints is open-source, meaning that anyone can download and make use of the software for free and the software can be modified however the user likes. This presents clear advantages for institutions will smaller budgets and also for institutions that have programmers on staff. Eprints requires some additional software to run: Linux, Apache, MySQL, and Perl. This software is all open-source and already present on the servers of many institutions. There is now a version of Eprints that will run on Windows servers as well, which will make the adoption of Eprints even easier for some. In brief, Eprints is an excellent choice for any institution looking to get an IR up and running quickly and easily. Installation is straightforward as is the initial configuration. Once the IR is up and running, users may upload documents and provide the necessary metadata for the records by filling out a simple web form. Embargoes on published documents are handled elegantly by the software, and the software links to the SHERPA/RoMEO database so authors can easily verify their rights regarding IR submissions. Eprints has some drawbacks, which will be discussed later in the review, but on the whole it is easy to recommend to anyone looking to start an IR. However, It is less clear that an institution with an existing IR based on another software package should migrate to Eprints.

  16. 78 FR 16401 - Institutional Review Boards; Correcting Amendments

    Science.gov (United States)

    2013-03-15

    .... 56.107 IRB membership. (a) * * * In addition to possessing the professional competence necessary to... professional conduct and practice. * * * * * * * * Dated: March 12, 2013. Leslie Kux, Assistant Commissioner...

  17. From anonymity to "open doors": IRB responses to tensions with researchers.

    Science.gov (United States)

    Klitzman, Robert

    2012-07-03

    Tensions between IRBs and researchers in the US and elsewhere have increased, and may affect whether, how, and to what degree researchers comply with ethical guidelines. Yet whether, how, when, and why IRBs respond to these conflicts have received little systematic attention. I contacted 60 US IRBs (every fourth one in the list of the top 240 institutions by NIH funding), and interviewed leaders from 34 (response rate = 55%) and an additional 12 members and administrators. IRBs often try to respond to tensions with researchers and improve relationships in several ways, but range widely in how, when, and to what degree (e.g., in formal and informal structure, content, and tone of interactions). IRBs varied from open and accessible to more distant and anonymous, and in the amount and type of "PR work" and outreach they do. Many boards seek to improve the quantity, quality, and helpfulness of communication with PIs, but differ in how. IRBs range in meetings from open to closed, and may have clinics and newsletters. Memos can vary in helpfulness and tone (e.g., using "charm"). IRBs range considerably, too, in the degrees to which they seek to educate PIs, showing them the underlying ethical principles. But these efforts take time and resources, and IRBs thus vary in degrees of responses to PI complaints. This study, the first to explore the mechanisms through which IRBs respond to tensions and interactions with PIs, suggests that these committees seek to respond to conflicts with PIs in varying ways - both formal and informal, involving both the form and content of communications. This study has important implications for future practice, research, and policy, suggesting needs for increased attention to not only what IRBs communicate to PIs, but how (i.e., the tone and the nature of interactions). IRBs can potentially improve relationships with PIs in several ways: using more "open doors" rather than anonymity, engaging in outreach (e.g., through clinics), enhancing

  18. From anonymity to “open doors”: IRB responses to tensions with researchers

    Directory of Open Access Journals (Sweden)

    Klitzman Robert

    2012-07-01

    Full Text Available Abstract Background Tensions between IRBs and researchers in the US and elsewhere have increased, and may affect whether, how, and to what degree researchers comply with ethical guidelines. Yet whether, how, when, and why IRBs respond to these conflicts have received little systematic attention. Findings I contacted 60 US IRBs (every fourth one in the list of the top 240 institutions by NIH funding, and interviewed leaders from 34 (response rate = 55% and an additional 12 members and administrators. IRBs often try to respond to tensions with researchers and improve relationships in several ways, but range widely in how, when, and to what degree (e.g., in formal and informal structure, content, and tone of interactions. IRBs varied from open and accessible to more distant and anonymous, and in the amount and type of “PR work” and outreach they do. Many boards seek to improve the quantity, quality, and helpfulness of communication with PIs, but differ in how. IRBs range in meetings from open to closed, and may have clinics and newsletters. Memos can vary in helpfulness and tone (e.g., using “charm”. IRBs range considerably, too, in the degrees to which they seek to educate PIs, showing them the underlying ethical principles. But these efforts take time and resources, and IRBs thus vary in degrees of responses to PI complaints. Conclusions This study, the first to explore the mechanisms through which IRBs respond to tensions and interactions with PIs, suggests that these committees seek to respond to conflicts with PIs in varying ways – both formal and informal, involving both the form and content of communications. This study has important implications for future practice, research, and policy, suggesting needs for increased attention to not only what IRBs communicate to PIs, but how (i.e., the tone and the nature of interactions. IRBs can potentially improve relationships with PIs in several ways: using more “open doors” rather

  19. Ethical review in Pakistan: the credibility gap.

    Science.gov (United States)

    Jafarey, Aamir Mustafa; Iqbal, Saima Pervaiz; Hassan, Mariam

    2012-12-01

    The concept of mandatory ethical review of research involving human participants is gradually taking root in Pakistani institutions. Based on the opinions of Institutional Review Board (IRB) members from institutions across the country, the process faces several challenges which threaten its integrity. The lack of registration or accreditation for IRBs has resulted in a wide variation in the calibre and working of such Boards. Despite the recent growth in numbers of people with formal bioethics degrees in the country, a majority of membership remains without any formal training for the work expected from them in ethical review. External pressures to influence deliberations, conflict of interest issues within board leadership and inconsistent application of review requirements all contribute in undermining the reliability of the process. Some of the most significant threats to independent and uninfluenced functioning of such boards arise from institutional leadership itself. In the opinions of IRB members, the review process has to be uniform, consistent and trustworthy if it is to gain the respect of researchers, and IRB need to be given the autonomous space to make independent decisions. Otherwise there is a real danger of IRBs being relegated to being no more than rubber stamping committees.

  20. Sex-Divergent Clinical Outcomes and Precision Medicine: An Important New Role for Institutional Review Boards and Research Ethics Committees

    Directory of Open Access Journals (Sweden)

    Ignacio Segarra

    2017-07-01

    Full Text Available The efforts toward individualized medicine have constantly increased in an attempt to improve treatment options. These efforts have led to the development of small molecules which target specific molecular pathways involved in cancer progression. We have reviewed preclinical studies of sunitinib that incorporate sex as a covariate to explore possible sex-based differences in pharmacokinetics and drug–drug interactions (DDI to attempt a relationship with published clinical outputs. We observed that covariate sex is lacking in most clinical outcome reports and suggest a series of ethic-based proposals to improve research activities and identify relevant different sex outcomes. We propose a deeper integration of preclinical, clinical, and translational research addressing statistical and clinical significance jointly; to embed specific sex-divergent endpoints to evaluate possible gender differences objectively during all stages of research; to pay greater attention to sex-divergent outcomes in polypharmacy scenarios, DDI and bioequivalence studies; the clear reporting of preclinical and clinical findings regarding sex-divergent outcomes; as well as to encourage the active role of scientists and the pharmaceutical industry to foster a new scientific culture through their research programs, practice, and participation in editorial boards and Institutional Ethics Review Boards (IRBs and Research Ethics Committees (RECs. We establish the IRB/REC as the centerpiece for the implementation of these proposals. We suggest the expansion of its competence to follow up clinical trials to ensure that sex differences are addressed and recognized; to engage in data monitoring committees to improve clinical research cooperation and ethically address those potential clinical outcome differences between male and female patients to analyze their social and clinical implications in research and healthcare policies.

  1. Research Review of the Institute of African Studies

    African Journals Online (AJOL)

    Please note: As of 2013 the Research Review of the Institute of African Studies is now publishing under the title Contemporary Journal of African Studies. You can view the CJAS pages on AJOL here: http://www.ajol.info/index.php/contjas/index. The Research Review of the Institute of African Studies at the University of ...

  2. Institutional Collaboration on MOOCs in Education--A Literature Review

    Science.gov (United States)

    Nortvig, Anne-Mette; Christiansen, René B.

    2017-01-01

    This literature review seeks to outline the state of the art regarding collaboration between educational institutions on Massive Open Online Courses (MOOCs) launched in Europe and in the US for the past 10 years. The review explores enablers and barriers that influence national institutional MOOC collaboration, and looks into how existing…

  3. 40 CFR 26.1112 - Review by institution.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Review by institution. 26.1112 Section 26.1112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN... Exposure of Non-pregnant, Non-nursing Adults § 26.1112 Review by institution. Research covered by this...

  4. 45 CFR 46.502 - What information must be provided when registering an IRB?

    Science.gov (United States)

    2010-10-01

    ..., facsimile number, and electronic mail address of the senior officer or head official of that institution or..., phone number, facsimile number, and electronic mail address of the contact person providing the... number, and electronic mail address. (d) The name, phone number, and electronic mail address of the IRB...

  5. 40 CFR 26.107 - IRB membership.

    Science.gov (United States)

    2010-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN SUBJECTS Basic EPA Policy for Protection of Subjects in Human Research Conducted or Supported by EPA § 26.107 IRB membership..., to promote respect for its advice and counsel in safeguarding the rights and welfare of human...

  6. 34 CFR 97.107 - IRB membership.

    Science.gov (United States)

    2010-07-01

    ... of the Secretary, Department of Education PROTECTION OF HUMAN SUBJECTS Federal Policy for the Protection of Human Subjects (Basic ED Policy for Protection of Human Research Subjects) § 97.107 IRB..., to promote respect for its advice and counsel in safeguarding the rights and welfare of human...

  7. 45 CFR 46.115 - IRB records.

    Science.gov (United States)

    2010-10-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS Basic HHS Policy... injuries to subjects. (2) Minutes of IRB meetings which shall be in sufficient detail to show attendance at... findings provided to subjects, as required by § 46.116(b)(5). (b) The records required by this policy shall...

  8. 15 CFR 27.107 - IRB membership.

    Science.gov (United States)

    2010-01-01

    ... Commerce and Foreign Trade Office of the Secretary of Commerce PROTECTION OF HUMAN SUBJECTS § 27.107 IRB..., to promote respect for its advice and counsel in safeguarding the rights and welfare of human... individuals who are knowledgeable about and experienced in working with these subjects. (b) Every...

  9. 22 CFR 225.107 - IRB membership.

    Science.gov (United States)

    2010-04-01

    ... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT PROTECTION OF HUMAN SUBJECTS § 225.107 IRB membership. (a..., to promote respect for its advice and counsel in safeguarding the rights and welfare of human... individuals who are knowledgeable about and experienced in working with these subjects. (b) Every...

  10. 49 CFR 11.107 - IRB membership.

    Science.gov (United States)

    2010-10-01

    ... Transportation Office of the Secretary of Transportation PROTECTION OF HUMAN SUBJECTS § 11.107 IRB membership. (a..., to promote respect for its advice and counsel in safeguarding the rights and welfare of human... individuals who are knowledgeable about and experienced in working with these subjects. (b) Every...

  11. 16 CFR 1028.107 - IRB membership.

    Science.gov (United States)

    2010-01-01

    ... Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL PROTECTION OF HUMAN SUBJECTS § 1028.107 IRB..., to promote respect for its advice and counsel in safeguarding the rights and welfare of human... individuals who are knowledgeable about and experienced in working with these subjects. (b) Every...

  12. 28 CFR 46.107 - IRB membership.

    Science.gov (United States)

    2010-07-01

    ... Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROTECTION OF HUMAN SUBJECTS § 46.107 IRB..., to promote respect for its advice and counsel in safeguarding the rights and welfare of human... individuals who are knowledgeable about and experienced in working with these subjects. (b) Every...

  13. Institutional Collaboration on MOOCs in Education—A Literature Review

    DEFF Research Database (Denmark)

    Nortvig, Anne-Mette; Christiansen, René Boyer

    2017-01-01

    This literature review seeks to outline the state of the art regarding collaboration between educational institutions on Massive Open Online Courses (MOOCs) launched in Europe and in the US for the past 10 years. The review explores enablers and barriers that influence national institutional MOOC...... collaboration, and looks into how existing knowledge about institutional collaboration on e-learning can be used in MOOC collaboration. The review is based on a literature search in databases and on snowballing techniques. It concludes that collaboration on MOOCs can be advantageous in terms of ensuring quality...... loss of their own national branding and the teachers’ hesitancy or passive resistance to new educational platforms and formats....

  14. Canadian Petroleum Products Institute 1996 annual review

    International Nuclear Information System (INIS)

    1996-01-01

    The Canadian Petroleum Products Institute (CPPI) is an association of Canadian companies involved in the downstream sector of the petroleum industry which includes refining, distributing and marketing of petroleum products. CPPI's mandate includes: (1) establishing environmental policies, (2) establishing working relationships with governments to develop public policy, (3) developing guidelines for the safe handling of petroleum products, and (4) providing information about the petroleum industry to the public. Canada's 19 refineries processed an average of 1.5 million barrels of crude oil per day in 1996. Domestic sources of crude made up 61 per cent of crude oil processed in 1996. Total exports during the year amounted to 105 million barrels. Some of the issues that the CPPI focused on during 1996 included the controversy over the future of the octane enhancing fuel additive MMT, fuel quality standards for transportation fuels and reformulated fuels, gasoline pricing, air quality and workplace safety. CPPI members' participation in the Voluntary Challenge and Registry (VCR) program towards reducing greenhouse gas emissions was also discussed. The industry was also actively involved in seeking to improve its refinery wastewater discharges

  15. Cooperative Institute for Research in the Atmosphere (CIRA) Requirements Review

    Energy Technology Data Exchange (ETDEWEB)

    Zurawski, Jason, W; Mace, Kathryn, P

    2016-08-11

    In August 2016 The Energy Sciences Network (ESnet) and Colorado State University (CSU) organized a review to characterize the networking requirements of the Cooperative Institute for Research in the Atmosphere (CIRA) located on the campus of Colorado State University. Several key findings highlighting the results from the review were discovered, with benefits to improve the overall scientific process for CIRA and CSU.

  16. GSBPP CAPSTONE REVIEW

    Science.gov (United States)

    2016-12-01

    Graduate School of Business and Public Policy IRB Institutional Review Board JPME Joint Professional Military Education LSS Lean Six Sigma NASPAA...checking” some of our statistical representations presented throughout this report. We wish to especially thank Terry Rea, Captain, U.S. Navy...relevance of [its] graduate education and research programs” (NPS, 2008, p. 3). Concerning this goal, NPS has instituted several policies and procedures that

  17. Lapse in Institutional Animal Care and Use Committee Continuing Reviews.

    Directory of Open Access Journals (Sweden)

    Min-Fu Tsan

    Full Text Available The United States federal animal welfare regulations and the Public Health Service Policy on Humane Care and Use of Laboratory Animals require that institutional animal care and use committees (IACUCs conduct continuing reviews of all animal research activities. However, little is known about the lapse rate of IACUC continuing reviews, and how frequently investigators continue research activities during the lapse. It is also not clear what factors may contribute to an institution's lapse in IACUC continuing reviews. As part of the quality assurance program, the Department of Veterans Affairs (VA has collected performance metric data for animal care and use programs since 2011. We analyzed IACUC continuing review performance data at 74-75 VA research facilities from 2011 through 2015. The IACUC continuing review lapse rates improved from 5.6% in 2011 to 2.7% in 2015. The rate of investigators continuing research activities during the lapse also decreased from 47.2% in 2012 to 7.4% in 2015. The type of IACUCs used and the size of animal research programs appeared to have no effect in facility's rates of lapse in IACUC continuing reviews. While approximately 80% of facilities reported no lapse in IACUC continuing reviews, approximately 14% of facilities had lapse rates of >10% each year. Some facilities appeared to be repeat offenders. Four facilities had IACUC lapse rates of >10% in at least 3 out of 5 years, suggesting a system problem in these facilities requiring remedial actions to improve their IACUC continuing review processes.

  18. Enhancing Proof Writing via Cross-Institutional Peer Review

    Science.gov (United States)

    Ernst, Dana C.; Hodge, Angie; Schultz, Andrew

    2015-01-01

    In the Spring of 2011, two of the authors of this paper taught number theory courses at their respective institutions. Twice during the semester, students in each class submitted proofs of two to three theorems to be peer reviewed by students in the other class. Each student wrote anonymous and formal referee reports of the submitted theorems,…

  19. Institutional review boards' attitudes towards remuneration in paediatric research

    DEFF Research Database (Denmark)

    Flege, Marius M; Thomsen, Simon F

    2017-01-01

    Remuneration in paediatric research poses an ethical dilemma. Too large a sum might cause parents to enrol their children in research projects with no benefit for the child, whereas too modest a sum might hamper recruitment. The institutional review boards have the responsibility to only approve ...

  20. Research Review of the Institute of African Studies: Contact

    African Journals Online (AJOL)

    Principal Contact. Prof. M.E. Kropp Dakubu Editor-in-Chief University of Ghana. Research Review. Institute of African Studies. P.O.Box LG73 Legon, Ghana. Phone: 211-24-4764006. Fax: 233-21-500512. Email: medakubu@ug.edu.gh. Support Contact. Dr Stephen Acheampong Phone: 211-24-4979233

  1. 40 CFR 26.1108 - IRB functions and operations.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false IRB functions and operations. 26.1108 Section 26.1108 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN... Exposure of Non-pregnant, Non-nursing Adults § 26.1108 IRB functions and operations. In order to fulfill...

  2. Characteristics and Causes for Non-Accrued Clinical Research (NACR) at an Academic Medical Institution.

    Science.gov (United States)

    Tice, Debra G; Carroll, Kelly A; Bhatt, Karishma H; Belknap, Steven M; Mai, David; Gipson, Heather J; West, Dennis P

    2013-06-01

    The impact of non-accrued clinical research (NACR) represents an important economic burden that is under consideration as the U.S. Department of Health and Human Services looks into reforming the regulations governing IRB review. NACR refers to clinical research projects that fail to enroll subjects. A delineation of the issues surrounding NACR is expected to enhance subject accrual and to minimize occurrence of NACR. The authors assessed demographics, characteristics, and reasons for NACR at an academic medical center, including time trends, funding source, research team (principal investigator, department), IRB resource utilization (IRB level of review, number of required IRB reviews, initial IRB turn-around time, and duration of NACR). The authors analyzed data from 848 clinical research study closures during 2010 and 2011 to determine proportion, incidence, and characteristics of NACR. Studies with subject enrollment during the same time period were used as a comparative measure. Data from 704 (83.0%) study closures reported enrollment of 1 or more subjects while 144 (17.0 %) reported NACR (zero enrollment). PI-reported reasons for NACR included: 32 (22.2%) contract or funding issues; 43 (30.0%) insufficient study-dedicated resources; 41 (28.4%) recruitment issues; 17 (11.8%) sponsor-initiated study closure and 11 (7.6%) were "other/reason unreported". NACR is not uncommon, affecting about one in six clinical research projects in the study population and reported to be more common in some other institutions. The complex and fluid nature of research conduct, non-realistic enrollment goals, and delays in both the approval and/or accrual processes contribute to NACR. Results suggest some simple strategies that investigators and institutions may use to reduce NACR, including careful feasibility assessment, reduction of institutional delays, and prompt initiation of subject accrual for multi-center studies using competitive enrollment. Institutional action to

  3. Adrift in the Gray Zone: IRB Perspectives on Research in the Learning Health System.

    Science.gov (United States)

    Lee, Sandra Soo-Jin; Kelley, Maureen; Cho, Mildred K; Kraft, Stephanie Alessi; James, Cyan; Constantine, Melissa; Meyer, Adrienne N; Diekema, Douglas; Capron, Alexander M; Wilfond, Benjamin S; Magnus, David

    2016-01-01

    Human subjects protection in healthcare contexts rests on the premise that a principled boundary distinguishes clinical research and clinical practice. However, growing use of evidence-based clinical practices by health systems makes it increasingly difficult to disentangle research from a wide range of clinical activities that are sometimes called "research on medical practice" (ROMP), including quality improvement activities and comparative effectiveness research. The recent growth of ROMP activities has created an ethical and regulatory gray zone with significant implications for the oversight of human subjects research. We conducted six semi-structured, open-ended focus group discussions with IRB members to understand their experiences and perspectives on ethical oversight of ROMP, including randomization of patients to standard treatments. Our study revealed that IRB members are unclear or divided on the central questions at stake in the current policy debate over ethical oversight of ROMP: IRB members struggle to make a clear distinction between clinical research and medical practice improvement, lack consensus on when ROMP requires IRB review and oversight, and are uncertain about what constitutes incremental risk when patients are randomized to different treatments, any of which may be offered in usual care. They characterized the central challenge as a balancing act, between, on the one hand, making information fully transparent to patients and providing adequate oversight, and on the other hand, avoiding a chilling effect on the research process or harming the physician-patient relationship. Evidence-based guidance that supports IRB members in providing adequate and effective oversight of ROMP without impeding the research process or harming the physician-patient relationship is necessary to realize the full benefits of the learning health system.

  4. Concordant, non-atypical breast papillomas do not require surgical excision: A 10-year multi-institution study and review of the literature.

    Science.gov (United States)

    Grimm, Lars J; Bookhout, Christine E; Bentley, Rex C; Jordan, Sheryl G; Lawton, Thomas J

    2018-05-01

    Non-atypical papillomas (NAPs) diagnosed on core needle biopsy (CNB) frequently undergo surgical excision due to highly variable upstaging rates. The purpose of this study is to document our dual-institution upgrade rates of NAPs diagnosed on core needle biopsy and review the upgrade rates reported in the literature. Following IRB approval, CNB results from Duke University (7/1/2004-6/30/2014) and the University of North Carolina Chapel Hill (1/1/04-6/30/2013) were reviewed to identify non-atypical papillomas. All cases with surgical excision or 2 years of imaging follow up were included. In addition, a literature review identified 60 published studies on upgrades of NAPs diagnosed at CNB. Cases in our cohort and the published literature were reviewed for confounding factors: [1] missing radiologic-pathologic concordance and/or discordance, [2] papillomas included with high-risk lesions, [3] high risk lesions counted as upgrades, [4] review by a nonspecialized breast pathologist, and [5] cancer incidentally detected. Of the 388 CNBs in our dual-institution cohort, 136 (35%) patients underwent surgical excision and 252 (65%) patients had imaging follow up. After controlling for confounders, no cancers (0/388) were found at surgical excision or during follow up imaging. The literature review upstaging rate was 4.0% (166/4157) but 1.8% (4/227) after excluding studies with confounders. The combined upstaging rate from the literature and this study was 0.6% (4/615). The upstaging rate for CNB diagnosed NAPs was 0% in our cohort and 0.6% overall after adjusting for confounders. This low rate does not warrant reflexive surgical excision and diagnostic imaging follow up should be discretionary. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Pediatric colonic volvulus: A single-institution experience and review.

    Science.gov (United States)

    Tannouri, Sami; Hendi, Aditi; Gilje, Elizabeth; Grissom, Leslie; Katz, Douglas

    2017-06-01

    Pediatric colonic volvulus is both rare and underreported. Existing literature consists only of case reports and small series. We present an analysis of cases (n=11) over 15 years at a single institution, focusing on workup and diagnosis. This was an institutional review board approved single-institution retrospective chart review of 11 cases of large bowel volvulus occurring over 15 years (2000-2015). In our series, the most common presenting symptoms were abdominal pain and distention. Afflicted patients often had prior abdominal surgery, a neurodevelopmental disorder or chronic constipation. Of the imaging modalities utilized in the 11 patients studied, colonic volvulus was correctly diagnosed by barium enema in 100% of both cases, CT in 55.6% of cases and by plain radiography of the abdomen in only 22.2%of cases. Colonic volvulus was confirmed by laparotomy in all cases. The cecum (n=5) was the most often affected colonic segment, followed by the sigmoid (n=3). Operative treatment mainly consisted of resection (63.6%) and ostomy creation (36.4%). Colopexy was performed in 18.2% of cases. Plain abdominal radiography may be performed as an initial diagnostic study, however, it should be followed CT or air or contrast enema in children where there is high clinical suspicion and who do not have indications for immediate laparotomy. CT may be the most specific and useful test in diagnosis of colonic volvulus and has the added advantage of detection of complications including bowel ischemia. We demonstrate a range of diagnostic and therapeutic modalities for pediatric colonic volvulus. This underscores the need for further study to draft standard best practices for this life-threatening condition. Prognosis Study: Level IV. Study of a Diagnostic Test: Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Pediatric Critical Care Telemedicine Program: A Single Institution Review.

    Science.gov (United States)

    Hernandez, Maria; Hojman, Nayla; Sadorra, Candace; Dharmar, Madan; Nesbitt, Thomas S; Litman, Rebecca; Marcin, James P

    2016-01-01

    Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care. We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital. Between the years 2000 and 2014, we reviewed all telemedicine consultations provided to children in rural and community EDs, classified the visits using a comprehensive evidence-based set of chief complaints, and reported the consultations' impact on patient disposition. We also reviewed the total number of pediatric ED visits to calculate the relative frequency with which telemedicine consultations were provided. During the study period, there were 308 consultations provided to acutely ill and/or injured children for a variety of chief complaints, most commonly for respiratory illnesses, acute injury, and neurological conditions. Since inception, the number of consultations has been increasing, as has the number of participating EDs (n = 18). Telemedicine consultations were conducted on 8.6% of seriously ill children, the majority of which resulted in admission to the receiving hospital (n = 150, 49%), with a minority of patients requiring transport to the university children's hospital (n = 103, 33%). This single institutional, university children's hospital-based review demonstrates that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community EDs is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.

  7. 77 FR 69631 - Draft Guidance for IRBs, Clinical Investigators, and Sponsors: IRB Responsibilities for Reviewing...

    Science.gov (United States)

    2012-11-20

    ...) is needed in order to assure the protection of the rights and welfare of human subjects in clinical... responsibilities. To enhance human subject protection and reduce regulatory burden, the Department of Health and Human Services (HHS) Office for Human Research Protections (OHRP) and FDA have been actively working to...

  8. Review paper on research ethics in Ethiopia: experiences and lessons learnt from Addis Ababa University College of Health Sciences 2007-2012.

    Science.gov (United States)

    Feleke, Yeweyenhareg; Addissie, Adamu; Wamisho, Biruk L; Davey, Gail

    2015-01-01

    Health research in Ethiopia is increasing both in volume and type, accompanied with expansion of higher education and research since the past few years. This calls for a proportional competence in the governance of medical research ethics in Ethiopia in the respective research and higher learning institutes. The paper highlights the evolution and progress ofthe ethics review at Addis Ababa University - College of Health Sciences (AAU-CHS) in the given context of health research review system in Ethiopia. Reflections are made on the key lessons to be drawnfrom the formative experiences of the Institutional Review Board (IRB) and their implications to the Ethiopian health research review system. This article is a review paper based on review of published and un published documents on research ethics in Ethiopia and the AAU-CHS (2007-2012). Thematic summaries of review findings are presented in thematic areas - formation of ethics review and key factors in the evolution of ethics review and implications. The IRB at AAU-CHS has been pivotal in providing review and follow-up for important clinical studies in Ethiopia. It has been one of the first IRBs to get WHO/SIDCER recognition from Africa and Ethiopia. Important factors in the successes of the IRB among others included leadership commitment, its placement in institutional structure, and continued capacity building. Financial challenges and sustainability issues need to be addressed for the sustained gains registered so far. Similar factors are considered important for the new and younger IRBs within the emergent Universities and research centers in the country.

  9. The Nuclear Review: the Institution of Nuclear Engineers' response to the Review of Nuclear Power

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    The United Kingdom Government's Nuclear Review currently underway, addresses whether and in what form nuclear power should continue to be part of the country's power generation capability. This article sets out the response of the Institution of Nuclear Engineers to the Nuclear Review. This pro-nuclear group emphasises the benefits to be gained from diversity of generation in the energy supply industry. The environmentally benign nature of nuclear power is emphasised, in terms of gaseous emissions. The industry's excellent safety record also argues in favour of nuclear power. Finally, as power demand increases globally, a health U.K. nuclear industry could generate British wealth through power exports and via the construction industry. The Institution's view on radioactive waste management is also set out. (UK)

  10. 21 CFR 56.113 - Suspension or termination of IRB approval of research.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Suspension or termination of IRB approval of research. 56.113 Section 56.113 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... termination of IRB approval of research. An IRB shall have authority to suspend or terminate approval of...

  11. Research data management in academic institutions: A scoping review.

    Directory of Open Access Journals (Sweden)

    Laure Perrier

    Full Text Available The purpose of this study is to describe the volume, topics, and methodological nature of the existing research literature on research data management in academic institutions.We conducted a scoping review by searching forty literature databases encompassing a broad range of disciplines from inception to April 2016. We included all study types and data extracted on study design, discipline, data collection tools, and phase of the research data lifecycle.We included 301 articles plus 10 companion reports after screening 13,002 titles and abstracts and 654 full-text articles. Most articles (85% were published from 2010 onwards and conducted within the sciences (86%. More than three-quarters of the articles (78% reported methods that included interviews, cross-sectional, or case studies. Most articles (68% included the Giving Access to Data phase of the UK Data Archive Research Data Lifecycle that examines activities such as sharing data. When studies were grouped into five dominant groupings (Stakeholder, Data, Library, Tool/Device, and Publication, data quality emerged as an integral element.Most studies relied on self-reports (interviews, surveys or accounts from an observer (case studies and we found few studies that collected empirical evidence on activities amongst data producers, particularly those examining the impact of research data management interventions. As well, fewer studies examined research data management at the early phases of research projects. The quality of all research outputs needs attention, from the application of best practices in research data management studies, to data producers depositing data in repositories for long-term use.

  12. Comitês de Ética em Pesquisa: adequação à Resolução 196/96 Institutional Review Boards: compliance with Resolution 196/96

    Directory of Open Access Journals (Sweden)

    Ellen Hardy

    2004-12-01

    Full Text Available OBJETIVO: Este artigo apresenta a avaliação da estrutura, funcionamento e atuação de 17 Comitês de Ética em Pesquisa, na opinião de seus presidentes, considerando as determinações da Resolução 196/96 do Conselho Nacional de Saúde, Ministério da Saúde, Brasil. MÉTODOS: Foram identificados os presidentes de 33 Comitês que avaliavam projetos de pesquisa em regulação da fecundidade. Eles foram indicados pelos responsáveis dos serviços de ginecologia de 46 faculdades de medicina no Brasil e pelos diretores de quatro centros de pesquisa em reprodução humana. Uma carta foi enviada aos presidentes, convidando-os a participar voluntariamente de uma pesquisa, preenchendo um questionário. RESULTADOS: Dezessete presidentes responderam o questionário. Os resultados mostraram uma série de violações à Resolução 196/96. Três Comitês não tinham representantes da comunidade; quatro demoravam mais de um mês para emitir o parecer final dos protocolos e 13 não acompanhavam o desenvolvimento dos projetos. A composição e arquivamento dos protocolos estavam de acordo com a Resolução, porém, o tempo de mandato era diferente do estabelecido em oito dos Comitês avaliados. Quase todos os presidentes (entre 14 e 17 consideraram a composição e atuação de seus CEPs adequados. A grande maioria dos presidentes (11 qualificou a Resolução como sendo apropriada, porém, difícil de ser cumprida. CONCLUSÃO: Os resultados sugerem que um amplo debate sobre a viabilidade operacional da Resolução seria oportuno. Este processo resultaria em sugestões valiosas para o aperfeiçoamento e aplicabilidade das normas. Isto contribuiria para a melhoria da qualidade cientifica e ética dos estudos desenvolvidos no Brasil.PURPOSE: This article intends to evaluate the structure, functioning and performance of 17 Institutional Review Boards (IRB, from the viewpoint of their presidents, in relation to the instructions of Resolution 196/96 of the

  13. Characterization of the peer review network at the Center for Scientific Review, National Institutes of Health.

    Science.gov (United States)

    Boyack, Kevin W; Chen, Mei-Ching; Chacko, George

    2014-01-01

    The National Institutes of Health (NIH) is the largest source of funding for biomedical research in the world. This funding is largely effected through a competitive grants process. Each year the Center for Scientific Review (CSR) at NIH manages the evaluation, by peer review, of more than 55,000 grant applications. A relevant management question is how this scientific evaluation system, supported by finite resources, could be continuously evaluated and improved for maximal benefit to the scientific community and the taxpaying public. Towards this purpose, we have created the first system-level description of peer review at CSR by applying text analysis, bibliometric, and graph visualization techniques to administrative records. We identify otherwise latent relationships across scientific clusters, which in turn suggest opportunities for structural reorganization of the system based on expert evaluation. Such studies support the creation of monitoring tools and provide transparency and knowledge to stakeholders.

  14. 77 FR 11555 - Guidance for Institutional Review Boards, Clinical Investigators, and Sponsors: Institutional...

    Science.gov (United States)

    2012-02-27

    ..., Office for Human Research Protections (OHRP) and FDA have been actively working to harmonize the Agencies... criteria, process, and frequency of continuing review to assure the protection of the rights and welfare of... review to assure the protection of the rights and welfare of subjects in clinical investigations. The...

  15. Operational Risk Management in Financial Institutions: A Literature Review

    Directory of Open Access Journals (Sweden)

    Suren Pakhchanyan

    2016-10-01

    Full Text Available Following the three-pillar structure of the Basel II/III framework, the article categorises and surveys 279 academic papers on operational risk in financial institutions, covering the period from 1998 to 2014. In doing so, different lines of both theoretical and empirical directions for research are identified. In addition, this study provides an overview of existing consortia databases and other publicly available sources on operational loss that may be incorporated into empirical research, as well as in risk measurement processes by financial institutions. Finally, this paper highlights the research gaps in operational risk and outlines recommendations for further research.

  16. Review of Public Forestry Administrations and Related Institutions in ...

    African Journals Online (AJOL)

    The main findings of a study on forest administration and related institutional arrangements (PFA) are highlighted. The relevance and changing roles of PFA in Sub-Saharan African (SSA) countries are covered in the context of new paradigm for sustainable forest management (SFM). The current weak capacities and low ...

  17. Operational risk management in financial institutions: A literature review

    OpenAIRE

    Pakhchanyan, Suren

    2016-01-01

    Following the three-pillar structure of the Basel II/III framework, the article categorises and surveys 279 academic papers on operational risk in financial institutions, covering the period from 1998 to 2014. In doing so, different lines of both theoretical and empirical directions for research are identified. In addition, this study provides an overview of existing consortia databases and other publicly available sources on operational loss that may be incorporated into empirical research, ...

  18. Literature Review of Enterprise Systems Research Using Institutional Theory: Towards a Conceptual Model

    DEFF Research Database (Denmark)

    Svejvig, Per

    This paper sets out to examine the use of institutional theory as a conceptually rich lens to study social issues of enterprise systems (ES) research. More precisely, the purpose is to categorize current ES research using institutional theory to develop a conceptual model that advances ES research...... model which advocates for multi-level and multi-theory approaches, and applies newer institutional aspects such as institutional logics. The findings show that institutional theory in ES research is in its infancy and adopts mainly traditional institutional aspects like isomorphism....... Key institutional features are presented such as isomorphism, rationalized myths, bridging macro and micro structures, and institutional logics and their implications for ES research are discussed. Through a literature review of 180 articles, of which 18 papers are selected, we build a conceptual...

  19. 77 FR 58111 - Notice of Submission for OMB Review; Institute of Education Sciences; FAFSA Completion Project...

    Science.gov (United States)

    2012-09-19

    ... DEPARTMENT OF EDUCATION Notice of Submission for OMB Review; Institute of Education Sciences; FAFSA Completion Project Evaluation SUMMARY: The Institute of Education Sciences (IES) at the U.S. Department of Education (ED) is conducting a rigorous study of the Free Application for Federal Student Aid...

  20. 78 FR 69426 - Submission for OMB Review; 30-Day Comment Request: NIH NCI Central Institutional Review Board...

    Science.gov (United States)

    2013-11-19

    ... Institutes of Health (NIH), has submitted to the Office of Management and Budget (OMB) a request for review... response time, should be directed to the: Office of Management and Budget, Office of Regulatory Affairs... 1 15/60 4 Reviewer Advertisement Checklist Board Members 10 1 20/60 3 Dated: November 7, 2013...

  1. Postpartum tubal ligation: A retrospective review of anesthetic management at a single institution and a practice survey of academic institutions.

    Science.gov (United States)

    McKenzie, Christine; Akdagli, Seden; Abir, Gillian; Carvalho, Brendan

    2017-12-01

    The primary aim was to evaluate institutional anesthetic techniques utilized for postpartum tubal ligation (PPTL). Secondarily, academic institutions were surveyed on their clinical practice for PPTL. An institutional-specific retrospective review of patients with ICD-9 procedure codes for PPTL over a 2-year period was conducted. Obstetric anesthesia fellowship directors were surveyed on anesthetic management of PPTL. Labor and delivery unit. Internet survey. 202 PPTL procedures were reviewed. 47 institutions were surveyed; 26 responses were received. Timing of PPTL, anesthetic management, postoperative pain and length of stay. There was an epidural catheter reactivation failure rate of 26% (18/69 epidural catheter reactivation attempts). Time from epidural catheter insertion to PPTL was a significant factor associated with failure: median [IQR; range] time for successful versus failed epidural catheter reactivation was 17h [10-25; 3-55] and 28h [14-33; 5-42], respectively (P=0.028). Epidural catheter reactivation failure led to significantly longer times to provide surgical anesthesia than successful epidural catheter reactivation or primary spinal technique: median [IQR] 41min [33-54] versus 15min [12-21] and 19min [15-24], respectively (P8h and >24h post-delivery, respectively. Epidural catheter reactivation failure increases with longer intervals between catheter placement and PPTL. Failed epidural catheter reactivation increases anesthetic and operating room times. Our results and the significant variability in practice from our survey suggest recommendations on the timing and anesthetic management are needed to reduce unfulfilled PPTL procedures. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Haemangiopericytoma - Queensland Radium Institute experience and review of the literature

    International Nuclear Information System (INIS)

    Ahern, V.A.; Roberts, S.J.

    1991-01-01

    The clinical characteristics, management, relapse patterns and survival of 17 patients with haemangiopericytoma treated at the Queensland Radium Institute, Australia from 1962 to 1989 are reported. Twelve patients were referred at the time of first diagnosis and were treated with curative intent. Three patients were treated with palliative intent when referred following initial diagnosis, and the remaining two patients were referred at the time of relapse. Disease was metastatic at presentation in 4 patients. Radiotherapy was used as a component of primary treatment of disease in 11 patients, in both patients referred for management of local relapse of haemangiopericytoma, and for palliation of metastatic disease. One patient received chemotherapy as part of initial treatment. Nine patients have died with survival from first treatment ranging from 3 to 139 months. All 8 surviving patients remain free of disease at 6 to 94 months from first treatment. It is concluded that haemangiopericytoma has an unpredictable clinical course, and may be indolent in some patients thus validating intensive local therapy and that there is no apparent benefit from incorporating chemotherapy in the primary management of haemangiopericytoma, although it may provide worth-while palliation in selected patients. Surgery combined with pre-or post-operative radiotherapy is recommended. 30 refs., 3 tabs

  3. [Patients assaulted in psychiatric institutions: Literature review and clinical implications].

    Science.gov (United States)

    Ladois-Do Pilar Rei, A; Chraïbi, S

    2018-02-01

    The psychiatric ward is a place where all forms of violence are treated. Occasionally, this violence involves acts of aggression between patients in emergency psychiatric units or hospital wards. Such events can lead to the development or worsening of posttraumatic stress disorder. To establish the context, we first examined the epidemiology data concerning posttraumatic stress disorder in psychiatric patients who were frequently exposed to assaults. Secondly, we examined the issue of sexual and physical assaults between patients receiving treatment in a psychiatric ward. In this context, we studied possible occurrence of posttraumatic stress disorder associated with exposure to assaults of this kind. In certain cases, potentially traumatic exposure to violence was unknown to the medical staff or not taken into consideration. This would induce a risk of later development of posttraumatic stress disorder that would not be treated during the stay in psychiatry. To date, few scientific studies have focused on the proportion of patients assaulted by other patients during treatment in a psychiatric ward and the subsequent development of peritraumatic reactions and/or posttraumatic stress disorder associated with these assaults. We know that an insufficient number of public and private health institutions report the existence of such facts to the competent authorities. Also, a minority of clinicians and caregivers are trained in screening and management of trauma victims. Yet, these issues are particularly relevant in the scope of public health and health promotion. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. Ethics Review for a Multi-Site Project Involving Tribal Nations in the Northern Plains.

    Science.gov (United States)

    Angal, Jyoti; Petersen, Julie M; Tobacco, Deborah; Elliott, Amy J

    2016-04-01

    Increasingly, Tribal Nations are forming ethics review panels, which function separately from institutional review boards (IRBs). The emergence of strong community representation coincides with a widespread effort supported by the U.S. Department of Health & Human Services and other federal agencies to establish a single IRB for all multi-site research. This article underscores the value of a tribal ethics review board and describes the tribal oversight for the Safe Passage Study-a multi-site, community-based project in the Northern Plains. Our experience demonstrates the benefits of tribal ethics review and makes a strong argument for including tribal oversight in future regulatory guidance for multi-site, community-based research. © The Author(s) 2016.

  5. Challenges for Smallholder Market Access: a review of literature on institutional arrangements in collective marketing

    NARCIS (Netherlands)

    Ton, G.

    2008-01-01

    Purpose of review: This review presents recent research on collective action in agricultural markets, focusing on the institutional settings that increase market access for smallholder farmers. It focuses attention on challenging research areas that try to understand and resolve the inherent

  6. 75 FR 49938 - Proposed Collection; Comment Request; NIH NCI Central Institutional Review Board (CIRB...

    Science.gov (United States)

    2010-08-16

    .... Frequency of Response: Once, except for the SAE Reviewer Worksheet. Affected Public: Includes the Federal...). Board Members CIRB SAE Reviewer Worksheet 10 15 30/60 (.5 hour) 75 (Attachment 6K). Total 2221 Request..., National Institutes of Health. [FR Doc. 2010-20167 Filed 8-13-10; 8:45 am] BILLING CODE 4140-01-P ...

  7. Some Visual Literacy Initiatives in Academic Institutions: A Literature Review from 1999 to the Present

    Science.gov (United States)

    Blummer, Barbara

    2015-01-01

    The ubiquitousness of images in the digital era highlights the importance of individuals' visual communication skills in the 21st Century. We conducted a literature review of visual literacy initiatives in academic institutions to illustrate best practices for imparting these skills in students. The literature review identified five categories of…

  8. A Review of Cash Management Policies, Procedures and Practices of Mississippi's Institutions of Higher Learning.

    Science.gov (United States)

    Mississippi State Legislature, Jackson. Performance Evaluation and Expenditure Review Committee.

    This report to the Mississippi Legislature presents the findings of a review of the cash management policies, procedures, and practices of the State Board of Trustees of Institutions of Higher Learning (IHL). The methodology involved review of: applicable Mississippi statutes; standards promulgated by the National Association of College and…

  9. Institutional ethical review and ethnographic research involving injection drug users: a case study.

    Science.gov (United States)

    Small, Will; Maher, Lisa; Kerr, Thomas

    2014-03-01

    Ethnographic research among people who inject drugs (PWID) involves complex ethical issues. While ethical review frameworks have been critiqued by social scientists, there is a lack of social science research examining institutional ethical review processes, particularly in relation to ethnographic work. This case study describes the institutional ethical review of an ethnographic research project using observational fieldwork and in-depth interviews to examine injection drug use. The review process and the salient concerns of the review committee are recounted, and the investigators' responses to the committee's concerns and requests are described to illustrate how key issues were resolved. The review committee expressed concerns regarding researcher safety when conducting fieldwork, and the investigators were asked to liaise with the police regarding the proposed research. An ongoing dialogue with the institutional review committee regarding researcher safety and autonomy from police involvement, as well as formal consultation with a local drug user group and solicitation of opinions from external experts, helped to resolve these issues. This case study suggests that ethical review processes can be particularly challenging for ethnographic projects focused on illegal behaviours, and that while some challenges could be mediated by modifying existing ethical review procedures, there is a need for legislation that provides legal protection of research data and participant confidentiality. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. The impacts of institutional child sexual abuse: A rapid review of the evidence.

    Science.gov (United States)

    Blakemore, Tamara; Herbert, James Leslie; Arney, Fiona; Parkinson, Samantha

    2017-12-01

    While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. 75 FR 70268 - Submission for OMB Review; Comment Request; NIH NCI Central Institutional Review Board (CIRB...

    Science.gov (United States)

    2010-11-17

    ... each time the person contacts the helpdesk. Frequency of Response: Once, except for the SAE Reviewer... Statistical Reviewer Form 20 1 2 hours 40 (Attachment 6J). Board Members CIRB SAE Reviewer Worksheet 10 15 30... 4140-01-P ...

  12. Review of the Development of Learning Analytics Applied in College-Level Institutes

    Directory of Open Access Journals (Sweden)

    Ken-Zen Chen

    2014-07-01

    Full Text Available This article focuses on the recent development of Learning Analytics using higher education institutional big-data. It addresses current state of Learning Analytics, creates a shared understanding, and clarifies misconceptions about the field. This article also reviews prominent examples from peer institutions that are conducting analytics, identifies their data and methodological framework, and comments on market vendors and non-for-profit initiatives. Finally, it suggests an implementation agenda for potential institutions and their stakeholders by drafting necessary preparations and creating iterative implementation flows.

  13. A rapid evidence review on the effectiveness of institutional health partnerships.

    Science.gov (United States)

    Kelly, Ema; Doyle, Vicki; Weakliam, David; Schönemann, Yvonne

    2015-12-14

    Institutional Health Partnerships are long-term, institution to institution partnerships between high income and low and middle income countries which seek to build capacity and strengthen health institutions in order to improve health service delivery and outcomes. Funding for Institutional Health Partnerships has increased in recent years. This paper outlines a rapid evidence review on the effectiveness of this modality. A rapid evidence review of published and grey literature was conducted. Content relating to the effectiveness of working in partnership and methods and frameworks used were extracted and analysed. The results of this analysis were used to structure a discussion regarding the next steps to strengthen the evidence base for the effectiveness of institutional health partnerships. The evidence review, including citation mapping, returned 27 published papers and 17 grey literature documents that met all of the inclusion criteria. Most of the literature did not meet the high standards of formal academic rigour and there was no original research amongst this literature that specifically addressed the effectiveness of institutional health partnerships. This was not surprising given institutional health partnerships do not lend themselves easily to case control studies and randomised control trials due to their high level of diversity and operation in complex social systems. There was, however, a body of practice based knowledge and experience. Evidence for the effectiveness of Institutional Health Partnerships is thin both in terms of quantity and academic rigour. There is a need to better define and differentiate Institutional Health Partnerships in order to measure and compare effectiveness across such a diverse group. Effectiveness needs to be measured at the level of individual partnerships, the bodies that facilitate partnership programmes and the level of health service delivery. There is a need to develop indicators and frameworks that specifically

  14. [Ethic review on clinical experiments of medical devices in medical institutions].

    Science.gov (United States)

    Shuai, Wanjun; Chao, Yong; Wang, Ning; Xu, Shining

    2011-07-01

    Clinical experiments are always used to evaluate the safety and validity of medical devices. The experiments have two types of clinical trying and testing. Ethic review must be done by the ethics committee of the medical department with the qualification of clinical research, and the approval must be made before the experiments. In order to ensure the safety and validity of clinical experiments of medical devices in medical institutions, the contents, process and approval criterions of the ethic review were analyzed and discussed.

  15. Brief review of topmost scientific results obtained in 2016 at the Joint Institute for Nuclear Research

    International Nuclear Information System (INIS)

    Kravchenko, E.I.; Sabaeva, E.V.

    2017-01-01

    This brief review presents the topmost scientific results obtained in 2016 at the Joint Institute for Nuclear Research in such fields as theoretical and experimental physics, radiation and radiobiological research, accelerators, information technology and computer physics. It also provides information about the publications by JINR staff members and activities carried out at the JINR University Centre in 2016. [ru

  16. 76 FR 70151 - Draft Guidance for Industry, Clinical Investigators, Institutional Review Boards, and Food and...

    Science.gov (United States)

    2011-11-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0790] Draft Guidance for Industry, Clinical Investigators, Institutional Review Boards, and Food and Drug Administration Staff; Food and Drug Administration Decisions for Investigational Device Exemption Clinical...

  17. Implementation of Blended Learning in Higher Learning Institutions: A Review of the Literature

    Science.gov (United States)

    Ma'arop, Amrien Hamila; Embi, Mohamed Amin

    2016-01-01

    While many educational premises including higher learning institutions favor blended learning over traditional approach and merely online learning, some academicians are still apprehensive about teaching in blended learning. The aim of this review is to synthesize the available evidence in the literature on challenges faced in implementing blended…

  18. Brief review of topmost scientific results obtained in 2015 at the Joint Institute for Nuclear Research

    International Nuclear Information System (INIS)

    Sabaeva, E.V.; Krupko, E.I.

    2016-01-01

    This brief review presents the topmost scientific results obtained in 2015 at the Joint Institute for Nuclear Research in such fields as theoretical and experimental physics, radiation and radiobiological research, accelerators, information technology and computer physics. It also provides information about the publications by JINR staff members, awards given to JINR scientists, and activities carried out at the JINR University Centre in 2015. [ru

  19. The Role of Universities and Other Institutions in Successful Entrepreneurship: Some Insights from a Literature Review

    Science.gov (United States)

    Zarate-Hoyos, German A.; Larios-Meoño, Fernando

    2015-01-01

    The purpose of this paper is to analyze the role of universities and other institutions in successful entrepreneurship. Insights are obtained following a literature review approach. Case studies from the United States (New York startup), Spain (Mondragon), and Germany provide strong evidence that universities are very instrumental in the creation,…

  20. 77 FR 48506 - Notice of Submission for OMB Review; Institute of Education Sciences; What Works Clearinghouse

    Science.gov (United States)

    2012-08-14

    ... DEPARTMENT OF EDUCATION Notice of Submission for OMB Review; Institute of Education Sciences; What... request to continue a currently approved collection under OMB Control Number 1850-0788 for the What Works... considered public records. Title of Collection: What Works Clearinghouse. OMB Control Number: 1850-0788. Type...

  1. Nigeria : Financial Sector Review, Volume 3. Non-Bank Financial Institutions and Markets

    OpenAIRE

    World Bank

    2000-01-01

    This report is a comprehensive review of the Nigerian financial system, covering the following areas: i) macro-financial environment; ii) safety and soundness of the banking system; iii) banking supervision; iv) development finance institutions; v) community banks and commercial banks' rural operations; vi) insurance and pensions; vii) housing finance; viii) money and capital markets; and ...

  2. Reviewing and Revising the Institutional Vision of U.S. Higher Education

    Directory of Open Access Journals (Sweden)

    Robert Abelman

    2014-02-01

    Full Text Available This article reviews the literature on the institutional vision of higher education in the United States – that is, the philosophical template through which colleges and universities define and communicate the kinds of human beings they are attempting to cultivate. Key linguistic components found to constitute a well conceived, viable, and easily diffused institutional vision are identified and significant issues, controversies and problems associated with these guiding, governing, and self-promotional mission and vision statements are examined. Particular attention is given to those types of schools recognized in the literature as the most maligned in the academic community or misrepresented in the popular press. A comparative analysis revisits the data of a subset of these investigations with the intention of generating greater insight into the institutional vision of higher education and offering a prescription for how these statements can better serve their institutions.

  3. Understanding bureaucracy in health science ethics: toward a better institutional review board.

    Science.gov (United States)

    Bozeman, Barry; Slade, Catherine; Hirsch, Paul

    2009-09-01

    Research involving human participants continues to grow dramatically, fueled by advances in medical technology, globalization of research, and financial and professional incentives. This creates increasing opportunities for ethical errors with devastating effects. The typical professional and policy response to calamities involving human participants in research is to layer on more ethical guidelines or strictures. We used a recent case-the Johns Hopkins University/Kennedy Kreiger Institute Lead Paint Study-to examine lessons learned since the Tuskegee Syphilis Study about the role of institutionalized science ethics in the protection of human participants in research. We address the role of the institutional review board as the focal point for policy attention.

  4. Engaging patients and stakeholders in research proposal review: the patient-centered outcomes research institute.

    Science.gov (United States)

    Fleurence, Rachael L; Forsythe, Laura P; Lauer, Michael; Rotter, Jason; Ioannidis, John P A; Beal, Anne; Frank, Lori; Selby, Joseph V

    2014-07-15

    The inaugural round of merit review for the Patient-Centered Outcomes Research Institute (PCORI) in November 2012 included patients and other stakeholders, as well as scientists. This article examines relationships among scores of the 3 reviewer types, changes in scoring after in-person discussion, and the effect of inclusion of patient and stakeholder reviewers on the review process. In the first phase, 363 scientists scored 480 applications. In the second phase, 59 scientists, 21 patients, and 31 stakeholders provided a "prediscussion" score and a final "postdiscussion" score after an in-person meeting for applications. Bland-Altman plots were used to characterize levels of agreement among and within reviewer types before and after discussion. Before discussion, there was little agreement among average scores given by the 4 lead scientific reviewers and patient and stakeholder reviewers. After discussion, the 4 primary reviewers showed mild convergence in their scores, and the 21-member panel came to a much stronger agreement. Of the 25 awards with the best (and lowest) scores after phase 2, only 13 had ranked in the top 25 after the phase 1 review by scientists. Five percent of the 480 proposals submitted were funded. The authors conclude that patient and stakeholder reviewers brought different perspectives to the review process but that in-person discussion led to closer agreement among reviewer types. It is not yet known whether these conclusions are generalizable to future rounds of peer review. Future work would benefit from additional data collection for evaluation purposes and from long-term evaluation of the effect on the funded research.

  5. Resisting the seduction of "ethics creep": using Foucault to surface complexity and contradiction in research ethics review.

    Science.gov (United States)

    Guta, Adrian; Nixon, Stephanie A; Wilson, Michael G

    2013-12-01

    In this paper we examine "ethics creep", a concept developed by Haggerty (2004) to account for the increasing bureaucratization of research ethics boards and institutional review boards (REB/IRBs) and the expanding reach of ethics review. We start with an overview of the recent surge of academic interest in ethics creep and similar arguments about the prohibitive effect of ethics review. We then introduce elements of Michel Foucault's theoretical framework which are used to inform our analysis of empirical data drawn from a multi-phase study exploring the accessibility of community-engaged research within existing ethics review structures in Canada. First, we present how ethics creep emerged both explicitly and implicitly in our data. We then present data that demonstrate how REB/IRBs are experiencing their own form of regulation. Finally, we present data that situate ethics review alongside other trends affecting the academy. Our results show that ethics review is growing in some ways while simultaneously being constrained in others. Drawing on Foucauldian theory we reframe ethics creep as a repressive hypothesis which belies the complexity of the phenomenon it purports to explain. Our discussion complicates ethics creep by proposing an understanding of REB/IRBs that locates them at the intersection of various neoliberal discourses about the role of science, ethics, and knowledge production. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Comprehensive review of the literature on institutional controls to limit land use

    International Nuclear Information System (INIS)

    1997-08-01

    A literature search was conducted to identify case studies that would provide a basis for establishing the effective duration of institutional controls to limit land use and to identify the attributes that contribute to their effectiveness. The literature on a variety of active and passive institutional controls to limit land use on government lands and on private lands adjacent to government lands was reviewed. No case studies and little detailed information were found concerning the periods for which the institutional controls remained effective over the long-term or the aspects of the controls that contributed to their effectiveness in limiting land use. The information available in the literature is discussed and an extensive bibliography and recommendations regarding future work are provided. (author)

  7. Comprehensive review of the literature on institutional controls to limit land use

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-08-01

    A literature search was conducted to identify case studies that would provide a basis for establishing the effective duration of institutional controls to limit land use and to identify the attributes that contribute to their effectiveness. The literature on a variety of active and passive institutional controls to limit land use on government lands and on private lands adjacent to government lands was reviewed. No case studies and little detailed information were found concerning the periods for which the institutional controls remained effective over the long-term or the aspects of the controls that contributed to their effectiveness in limiting land use. The information available in the literature is discussed and an extensive bibliography and recommendations regarding future work are provided. (author).

  8. Philanthropic Fundraising of Higher Education Institutions: A Review of the Malaysian and Australian Perspectives

    Directory of Open Access Journals (Sweden)

    Mohd Isa Rohayati

    2016-06-01

    Full Text Available Currently, higher education institutions are facing rapidly rising costs and limitations in governmental funding. Accordingly, higher education institutions need sustainable forms of funding to operate effectively and remain competitive. In their attempts to identify causes and initiatives, world universities have paid more attention to philanthropic support. In their effort to raise funds, many institutions have grappled with questions of why donors give and what motivates donors to give. To address these questions, scholars must consider the influence of demographic and socio-economic characteristics, as well as internal and external motivational parameters on successful giving behaviour. However, much more attention has been paid to universities in Western countries and the United States. This study aims to review the factors influencing organizational philanthropic fundraising success and to gain an understanding of factors affecting donors’ giving decisions and perceptions of giving. This work focuses on donors’ giving to Malaysian and Australian public universities.

  9. Accrual and recruitment practices at Clinical and Translational Science Award (CTSA) institutions: a call for expectations, expertise, and evaluation.

    Science.gov (United States)

    Kost, Rhonda G; Mervin-Blake, Sabrena; Hallarn, Rose; Rathmann, Charles; Kolb, H Robert; Himmelfarb, Cheryl Dennison; D'Agostino, Toni; Rubinstein, Eric P; Dozier, Ann M; Schuff, Kathryn G

    2014-08-01

    To respond to increased public and programmatic demand to address underenrollment of clinical translational research studies, the authors examined participant recruitment practices at Clinical and Translational Science Award (CTSA) sites and make recommendations for performance metrics and accountability. The CTSA Recruitment and Retention taskforce in 2010 invited representatives at 46 CTSAs to complete an online 48-question survey querying accrual and recruitment outcomes, practices, evaluation methods, policies, and perceived gaps in related knowledge/practice. Descriptive statistical and thematic analyses were conducted. Forty-six respondents representing 44 CTSAs completed the survey. Recruitment conducted by study teams was the most common practice reported (78%-91%, by study type); 39% reported their institution offered recruitment services to investigators. Respondents valued study feasibility assessment as a successful practice (39%); desired additional resources included feasibility assessments (49%) and participant registries (44%). None reported their institution systematically required justification of feasibility; some indicated relevant information was considered prior to institutional review board (IRB) review (30%) or contract approval (22%). All respondents' IRBs tracked study progress, but only 10% of respondents could report outcome data for timely accrual. Few reported written policies addressing poor accrual or provided data to support recruitment practice effectiveness. Many CTSAs lack the necessary frame work to support study accrual. Recom men dations to enhance accrual include articulating institutional expectations and policy for routine recruitment plan ning; providing recruitment expertise to inform feasibility assessment and recruit ment planning; and developing interdepartmental coordination and integrated informatics infrastructure to drive the conduct, evaluation, and improvement of recruitment practices.

  10. Political and institutional influences on the use of evidence in public health policy. A systematic review.

    Science.gov (United States)

    Liverani, Marco; Hawkins, Benjamin; Parkhurst, Justin O

    2013-01-01

    There is increasing recognition that the development of evidence-informed health policy is not only a technical problem of knowledge exchange or translation, but also a political challenge. Yet, while political scientists have long considered the nature of political systems, the role of institutional structures, and the political contestation of policy issues as central to understanding policy decisions, these issues remain largely unexplored by scholars of evidence-informed policy making. We conducted a systematic review of empirical studies that examined the influence of key features of political systems and institutional mechanisms on evidence use, and contextual factors that may contribute to the politicisation of health evidence. Eligible studies were identified through searches of seven health and social sciences databases, websites of relevant organisations, the British Library database, and manual searches of academic journals. Relevant findings were extracted using a uniform data extraction tool and synthesised by narrative review. 56 studies were selected for inclusion. Relevant political and institutional aspects affecting the use of health evidence included the level of state centralisation and democratisation, the influence of external donors and organisations, the organisation and function of bureaucracies, and the framing of evidence in relation to social norms and values. However, our understanding of such influences remains piecemeal given the limited number of empirical analyses on this subject, the paucity of comparative works, and the limited consideration of political and institutional theory in these studies. This review highlights the need for a more explicit engagement with the political and institutional factors affecting the use of health evidence in decision-making. A more nuanced understanding of evidence use in health policy making requires both additional empirical studies of evidence use, and an engagement with theories and approaches

  11. The match between institutional elderly care management research and management challenges - a systematic literature review

    Science.gov (United States)

    2012-01-01

    Background Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. Methods This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. Results The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Conclusions Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers’ and policymakers’ scientific literacy needs to be enhanced. PMID:23137416

  12. The match between institutional elderly care management research and management challenges - a systematic literature review

    Directory of Open Access Journals (Sweden)

    Kokkonen Kaija

    2012-11-01

    Full Text Available Abstract Background Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. Methods This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. Results The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Conclusions Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers’ and policymakers’ scientific literacy needs to be enhanced.

  13. The match between institutional elderly care management research and management challenges - a systematic literature review.

    Science.gov (United States)

    Kokkonen, Kaija; Rissanen, Sari; Hujala, Anneli

    2012-11-08

    Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers' and policymakers' scientific literacy needs to be enhanced.

  14. Microfinance institutions' failure to address poverty: A narrative critical literature review

    OpenAIRE

    Guðjónsson, Sigurður

    2017-01-01

    This critical literature review begins by giving a short introduction to the microfinance industry. Microfinance institutions (MFIs) are explained and an account is given of their dual performance goals of financial performance (‘financial sustainability’) and social performance (‘outreach’). While MFIs’ social performance is directly aimed at poverty reduction, it is noteworthy that often they fail to address poverty (i.e., they fail to deliver outreach). The aim of the paper is to answer th...

  15. Brief review of topmost scientific results obtained in 2013 at the Joint Institute for Nuclear Research

    International Nuclear Information System (INIS)

    Sabaeva, E.V.; Kravchenko, E.I.

    2014-01-01

    This brief review presents the topmost scientific results obtained in 2013 at the Joint Institute for Nuclear Research in such areas as theoretical physics, experimental physics, radiation and radiobiological research, accelerators, information technology and computer physics. It also provides information on the number of publications by JINR staff members, awards given to JINR scientists, and activities carried out at the JINR University Centre in 2013.

  16. Brief review of topmost scientific results obtained in 2014 at the Joint Institute for Nuclear Research

    International Nuclear Information System (INIS)

    Bulatova, V.V.; Sabaeva, E.V.

    2015-01-01

    This brief review presents the topmost scientific results obtained in 2014 at the Joint Institute for Nuclear Research in such fields as theoretical and experimental physics, radiation and radiobiological research, accelerators, information technology and computer physics. It also provides information about the publications by JINR staff members, patents for inventions, awards given to JINR scientists, and activities carried out at the JINR University Centre in 2014. [ru

  17. Review of ANSI [American National Standards Institute] N13.11: A status report

    International Nuclear Information System (INIS)

    Sims, C.S.

    1988-01-01

    In 1983, the American National Standards Institute (ANSI) issued the dosimetry standard titled ''Personnel Dosimetry Performance -- Criteria for Testing'' as ANSI N13.11. This standard forms the basis for the National Voluntary Laboratory Accreditation Program (NVLAP) which has become familiar to dosimeter processors in recent years. This standard is particularly important because the Nuclear Regulatory Commission (NRC) requires that all licensees have personnel dosimetry devices processed by processors that are NVLAP accredited. This standard is currently undergoing review and modifications are going to be made. This paper contains a brief history of the events leading to the development of ANSI N13.11 - 1983, information concerning the present standard and associated performance test results, and the selection of the review group. Following that, the status of the review is presented and statements regarding the future outlook for the standard are made. 10 refs., 5 tabs

  18. Structural, mechanical, and electronic properties of TaB2, TaB, IrB2, and IrB: First-principle calculations

    International Nuclear Information System (INIS)

    Zhao Wenjie; Wang Yuanxu

    2009-01-01

    First-principle calculations were performed to investigate the structural, elastic, and electronic properties of TaB 2 , TaB, IrB 2 , and IrB. The calculated equilibrium structural parameters, shear modulus, and Young's modulus of TaB 2 are well consistent with the available experimental data, and TaB 2 with P6/mmm space group has stronger directional bonding between ions than WB 2 , OsB 2 , IrN 2 , and PtN 2 . For TaB 2 , the hexagonal P6/mmm structure is more stable than the orthorhombic Pmmn one, while for IrB 2 the orthorhombic Pmmn structure is the most stable one. The high shear modulus of P6/mmm phase TaB 2 is mainly due to the strong covalent π-bonding of B-hexagon in the (0001) plane. Such a B-hexagon network can strongly resist against an applied [112-bar0] (0001) shear deformation. Correlation between the hardness and the elastic constants of TaB 2 was discussed. The band structure shows that P6/mmm phase TaB 2 and Pmmn phase IrB 2 are both metallic. The calculations show that both TaB and IrB are elastically stable with the hexagonal P6 3 /mmc structure. - Elastic constant c 44 of TaB 2 is calculated to be 235 GPa. This value is exceptionally high, exceeding those of WB 2 , OsB 2 , WB 4 , OsN 2 , IrN 2 , and PtN 2 .

  19. NRC review of Electric Power Research Institute's Advanced Light Reactor Utility Requirements Document - Program summary, Project No. 669

    International Nuclear Information System (INIS)

    1992-08-01

    The staff of the US Nuclear Regulatory Commission has prepared Volume 1 of a safety evaluation report (SER), ''NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document -- Program Summary,'' to document the results of its review of the Electric Power Research Institute's ''Advanced Light Water Reactor Utility Requirements Document.'' This SER provides a discussion of the overall purpose and scope of the Requirements Document, the background of the staff's review, the review approach used by the staff, and a summary of the policy and technical issues raised by the staff during its review

  20. Assessment of Competence in a Hospital Institution: The Vision of Reviews and Reviewers

    Directory of Open Access Journals (Sweden)

    Fabiana Camila Jorge

    2014-06-01

    Full Text Available This article aims to analyze the vision of reviews and reviewers about the performance evaluation process based on competencies, at a hospital. The research has predominantly qualitative nature, which strategy was concerned to the case study. The procedures used for data collection were document analysis, questionnaires and semi-structured interviews. For the analysis of the responses to the questionnaire, the descriptive statistical treatment of the data was used. The interviews, in turn, were interpreted by means of discourse analysis. Both analyzes converged on the triangulation of research methods. Strengths and opportunities for improvement in the processes of performance evaluation performed by the organization were evidenced. Furthermore, we discussed the common understanding on the part of users about their meaning and on their ability to enhance current practices and that there are reliable and valid benefits in applying this type of tool. It was also highlighted the importance of the possibility of revisiting the evaluation processes in order to be more effective and consistent with the organizational and individual expectations. The intention of this research was contribute to the affirmation of the necessary approximation of the academy with the reality of management, facilitating conversation and reflecting benefits to both.

  1. Review: Current Approaches to Business and Institutional Translation. Proceedings of the International Conference on Economic, Business, Financial and Institutional Translation

    Directory of Open Access Journals (Sweden)

    Miguel Tolosa Igualada

    2016-08-01

    Full Text Available Daniel Gallego-Hernández (ed.. Current Approaches to Business and Institutional Translation. Proceedings of the International Conference on Economic, Business, Financial and Institutional Translation / Enfoques actuales en traducción económica e institucional. Actas del Congreso Internacional de Traducción Económica, Comercial, Financiera e Institucional. Suíça: Peter Lang, 2015, 254 páginas. ISBN 978-3-0343-1656-9.

  2. Institutional framework for integrated Pharmaceutical Benefits Management: results from a systematic review

    Directory of Open Access Journals (Sweden)

    Tomasz Roman Hermanowski

    2015-09-01

    Full Text Available Objectives: In this paper, we emphasised that effective management of health plans beneficiaries access to reimbursed medicines requires proper institutional set-up. The main objective was to identify and recommend an institutional framework of integrated pharmaceutical care providing effective, safe and equitable access to medicines. Method: The institutional framework of drug policy was derived on the basis of publications obtained by systematic reviews. A comparative analysis concerning adaptation of coordinated pharmaceutical care services in the USA, the UK, Poland, Italy, Denmark and Germany was performed. Results: While most European Union Member States promote the implementation of selected e-Health tools, like e-Prescribing, these efforts do not necessarily implement an integrated package. There is no single agent who would manage an insured patients’ access to medicines and health care in a coordinated manner, thereby increasing the efficiency and safety of drug policy. More attention should be paid by European Union Member States as to how to integrate various e-Health tools to enhance benefits to both individuals and societies. One solution could be to implement an integrated “pharmacy benefit management” model, which is well established in the USA and Canada and provides an integrated package of cost-containment methods, implemented within a transparent institutional framework and powered by strong motivation of the agent.

  3. Nature-based interventions in institutional and organisational settings: a scoping review.

    Science.gov (United States)

    Moeller, Chris; King, Nigel; Burr, Viv; Gibbs, Graham R; Gomersall, Tim

    2018-04-26

    The objective of this review was to scope the literature on nature-based interventions that could be conducted in institutional settings where people reside full-time for care or rehabilitation purposes. Systematic searches were conducted across CINAHL, Medline, Criminal Justice Abstracts, PsycINFO, Scopus, Social Care Online and Cochrane CENTRAL. A total of 85 studies (reported in 86 articles) were included. Four intervention modalities were identified: Gardening/therapeutic horticulture; animal-assisted therapies; care farming and virtual reality-based simulations of natural environments. The interventions were conducted across a range of settings, including inpatient wards, care homes, prisons and women's shelters. Generally, favourable impacts were seen across intervention types, although the reported effects varied widely. There is a growing body of literature on nature-based interventions that could be applied to a variety of institutional settings. Within most intervention types, there is sufficient research data available to perform full systematic reviews. Recommendations for future systematic reviews are offered.

  4. Ethics support in institutional elderly care: a review of the literature.

    Science.gov (United States)

    van der Dam, Sandra; Molewijk, Bert; Widdershoven, Guy A M; Abma, Tineke A

    2014-09-01

    Clinical ethics support mechanisms in healthcare are increasing but little is known about the specific developments in elderly care. The aim of this paper is to present a systematic literature review on the characteristics of existing ethics support mechanisms in institutional elderly care. A review was performed in three electronic databases (Pubmed, CINAHL/PsycINFO, Ethxweb). Sixty papers were included in the review. The ethics support mechanisms are classified in four categories: 'institutional bodies' (ethics committee and consultation team); 'frameworks' (analytical tools to assist care professionals); 'educational programmes and moral case deliberation'; and 'written documents and policies'. For each category the goals, methods and ways of organising are described. Ethics support often serves several goals and can be targeted at various levels: case, professional or organisation. Over the past decades a number of changes have taken place in the development of ethics support in elderly care. Considering the goals, ethics support has become more outreaching and proactive, aiming to qualify professionals to integrate ethics in daily care processes. The approaches in clinical ethics support have become more diverse, more focused on everyday ethical issues and better adapted to the concrete learning style of the nursing staff. Ethics support has become less centrally organised and more connected to local contexts and primary process within the organisation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Concordance between local, institutional, and central pathology review in glioblastoma: implications for research and practice: a pilot study.

    Science.gov (United States)

    Gupta, Tejpal; Nair, Vimoj; Epari, Sridhar; Pietsch, Torsten; Jalali, Rakesh

    2012-01-01

    There is significant inter-observer variation amongst the neuro-pathologists in the typing, subtyping, and grading of glial neoplasms for diagnosis. Centralized pathology review has been proposed to minimize this inter-observer variation and is now almost mandatory for accrual into multicentric trials. We sought to assess the concordance between neuro-pathologists on histopathological diagnosis of glioblastoma. Comparison of local, institutional, and central neuro-oncopathology reporting in a cohort of 34 patients with newly diagnosed supratentorial glioblastoma accrued consecutively at a tertiary-care institution on a prospective trial testing the addition of a new agent to standard chemo-radiation regimen. Concordance was sub-optimal between local histological diagnosis and central review, fair between local diagnosis and institutional review, and good between institutional and central review, with respect to histological typing/subtyping. Twelve (39%) of 31 patients with local histological diagnosis had identical tumor type, subtype and grade on central review. Overall agreement was modestly better (52%) between local diagnosis and institutional review. In contrast, 28 (83%) of 34 patients had completely concordant histopathologic diagnosis between institutional and central review. The inter-observer reliability test showed poor agreement between local and central review (kappa statistic=0.12, 95% confidence interval (CI): -0.03-0.32, P=0.043), but moderate agreement between institutional and central review (kappa statistic=0.51, 95%CI: 0.17-0.84, P=0.00003). Agreement between local diagnosis and institutional review was fair. There exists significant inter-observer variation regarding histopathological diagnosis of glioblastoma with significant implications for clinical research and practice. There is a need for more objective, quantitative, robust, and reproducible criteria for better subtyping for accurate diagnosis.

  6. Dysphagia in the elderly in long-stay institutions - a systematic literature review

    Directory of Open Access Journals (Sweden)

    Bianca Paixão Santos

    Full Text Available ABSTRACT The objective of this study was to verify in the literature, through a systematic review, the dietary conditions of the elderly in long-stay institutions, seeking to observe the general care and agents that potentiate dysphagia, in order to review aspects of dysphagia and deglutition risk indicators in the elderly. A survey, regarding the articles published from 2009 on, with the descriptors "elderly, long-stay institution and dysphagia", in Portuguese and English, on Scielo, PubMed and Lilacs, was performed, totaling 423 articles in the initial search, from which, 13 that were in agreement with the inclusion criteria adopted were chosen, 2 being repeated in more than one research source. At the end, 11 articles were included for analysis and discussion. It was observed that most the long-stay institutions do not have adequate structure to treat the elderly in a multidisciplinary approach. In all those studies, the negligence with the elderly’s oral hygiene, which potentiates the development of pulmonary infections in cases of aspiration, was evidenced. The association between dementia, food dependency and increase in feeding time was also observed in the literature, as well as the association of medication use with the interference in food dynamics. In addition, many studies have shown that, although the Stomatognathic System structures are altered due to the aging process, the elderly have the functions of speech, chewing and swallowing adapted, without greater damage to their general health. It can be concluded that long-stay institutions do not offer adequate staff to care for the elderly to reduce the risks for dysphagia.

  7. HER2-positive male breast cancer with thyroid cancer: an institutional report and review of literature.

    Science.gov (United States)

    Bardhan, Pooja; Bui, Marilyn M; Minton, Susan; Loftus, Loretta; Carter, W Bradford; Laronga, Christine; Ismail-Khan, Roohi

    2012-01-01

    We report a rare finding of two male breast cancer patients with HER2-positive breast cancer who also developed thyroid cancer. We reviewed 45 male breast cancer patients treated in our institution from 2003 to 2008. Only five male breast cancer patients were HER2-positive. In reviewing the published data, we found no cases of thyroid cancer and concurrent breast cancer in men. However, breast cancer and thyroid cancer have shown close association in women. This finding therefore provokes speculation as to whether we should investigate whether women with HER2-positive breast cancer are at a higher risk for thyroid cancer. Although this observation seems to be clinically prevalent, publications are sparse in clinical research areas linking thyroid cancer to breast cancer.

  8. A REVIEW OF BALANCED SCORECARD FRAMEWORK IN HIGHER EDUCATION INSTITUTION (HEIS

    Directory of Open Access Journals (Sweden)

    Fahmi Fadhl Al-Hosaini

    2015-01-01

    Full Text Available Many studies have been conducted to investigate the effectives of the BSC in organisations. It is observed that many organisations adopt different perspectives suitable for their functions in line with their vison, mission and strategic themes. Some reseachers have highlighted its relevance to Higher Education institutions. However, previous studies have not defined wich perspectives are most relevant for public HEIs, which are not for profit by nature. Higher Educational Institutions (HEIs are involved in routine processes of providing tertiary education in colleges, universities, and institutes including both undergraduate and postgraduate programmes, vocational and education training. One of the aims of HEIs is to achieve results in terms of products and services for the customers and other stake holders. In this paper, we review recent studies in top journals using the Balanced Scorecard Framework in HEIs. The paper identifies the relenvant perspectives for HEIs and presents its contextual analysis. When implemented, this can be used to monitor their performance and enable them to adjust to emerging challenges that come as a result of implementing key strategies.

  9. Children as subjectos endowed with right: a systematic review of children in situation of institutional care

    Directory of Open Access Journals (Sweden)

    Thais Pacheco Epifânio

    2017-06-01

    Full Text Available Introduction: This study addresses the context of children in shelters and their rights after the implementation of the Child and Adolescent Statute (Estatuto da Criança e do Adolescente - ECA in 1990. Objective: To analyze the content of articles approaching children in situation of institutional care in the view of the guidelines proposed by ECA. Method: A systematic review was carried out in the LILACS database using the following descriptors: “institutionalized child” or “shelter” or “social shelter”, in Portuguese language. A total of 111 articles were found, of which 92 were excluded after reading the abstract as they did not meet the selection criteria set in the research. After reading the 19 remaining articles in full length, 5 were eliminated because they did not address the theme under study. Thus, 14 articles were used in the analysis. Results: After selection of relevant articles for research and analysis of content, three categories of analysis, based on the recurrent themes of the texts and their relation to the present research theme, were identified: “Shelters as institutions with complete institutional characteristics”, “Shelters and their stance in relation to ECA recommendations” and “The stigma of sheltered children: subjects with rights or subjugated mass?”. The description of shelters is evidently not in consonance with the law, but clearly resembles the old model of sheltering, with unpreparedness and lack of knowledge of laws from the part of professionals. This leads children to be viewed as objects of custody of the State. Conclusion: There is an evident need for training the professionals involved in the process of institutional shelter and also the need for raising empowerment and awareness of the rights of children in society.

  10. Review of research institute library activity through the contributed papers. The case of the Japan Atomic Energy Research Institute Library

    International Nuclear Information System (INIS)

    Ikeda, Kiyoshi; Habara, Tadashi; Ishikawa, Masashi; Itabashi, Keizo; Yonezawa, Minoru

    2007-03-01

    The Japan Atomic Energy Research Institute (JAERI) Library had contributed 312 papers through the library activities in half-century. We made the bibliography of these papers as well as categorized them into general', 'library functions', 'management and promotion of research results' and 'international exchange of information' and explained them under the four categories. A subject index, an author index of these papers and chronology of JAERI library activities were also compiled for reference. (author)

  11. Integración del brazo robot IRB120 en entorno ROS-MATLAB

    OpenAIRE

    Gómez Cuadrado, José Manuel

    2017-01-01

    Este proyecto usa el entorno ROS (Robot Operating System) para desarrollar el control del brazo robot IRB 120 y su implementación en el entorno de trabajo MATLAB. Se explicará la creación del modelo del robot, la planificación de trayectorias y la comunicación con dicho robot. This project uses the ROS (Robot Operating System) environment for developing the control of the IRB 120 robotic arm and its implementation in the MATLAB working environment. It will explain the creation of the...

  12. Telerobotics: through-the-Internet teleoperation of the ABB IRB 2000 industrial robot

    Science.gov (United States)

    Alvares, Alberto J.; Caribe de Carvalho, Guilherme; Paulinyi, Luis F. d. A.; Alfaro, Sadek C. A.

    1999-11-01

    Robotic systems can be controlled remotely through the use of telerobotics. This work presents a through-the-internet teleoperation system for remotely operating the IRB2000 industrial robot. The IRB2000 controller allows external access through a RS232 serial communication link, which is based on a 42 function proprietary communication protocol. The proposed teleoperation system uses this communication capability by connecting it to a local area network based on TCP/IP (Transport Control Protocol/Internet Protocol). The system was implemented using a Client/Server architecture, having as server a UNIX (LINUX) platform.

  13. INSTITUTE OF SCIENTIFIC REVIEW TO A PLURALITY OF MODERN SCIENCE: NEED OR FICTION?

    Directory of Open Access Journals (Sweden)

    Olga Mukha

    2013-08-01

    Full Text Available The current situation of plurality epistemological provokes distinct lack of clear criteria for scientific criticism humanities texts. This research raises the question of verification procedure for knowledge obtained humanities, its status and importance. Changes relate to the modern paradigm of scientific methodology in general, which involves switching from a focus on results orientation to the process of getting the truth (W.V.O. Quine, Thomas Kuhn, Paul Feyerabend, Imre Lakatos, etc.. To determine the relationships with the text as a carrier of the alleged truth reception is off ered three formats of relations: Text – Author, Text – Reader and Text – Reviewer. The article stresses questions of general and specific objectives for the scientifi c peer review, as well as the problem of plagiarism and its ethical and legal consequences. It is proposed to consider plan algorithm scientific review of the 26 criteria for it, which will help to streamline Institute of scientific criticism. Recent cover content requirements (which include: the incorporation of a scientific context, the definition of methodological systems, structured research, avoiding plagiarism, there is a real «increase of knowledge» and applied significance, etc. and technical design, the variable respectively specifi c edition. Compliance with a number of requirements set out will help improve the effi ciency and profitability of the humanities.

  14. 76 FR 38694 - Uranium From Russia; Institution of a Five-Year Review Concerning the Suspended Investigation on...

    Science.gov (United States)

    2011-07-01

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-539-C (Third Review)] Uranium From Russia; Institution of a Five-Year Review Concerning the Suspended Investigation on Uranium From Russia AGENCY: United...)) (the Act) to determine whether termination of the suspended investigation on uranium from Russia would...

  15. Suicide patterns in children and adolescents: a review from a pediatric institution in England.

    Science.gov (United States)

    Zainum, Khairul; Cohen, Marta C

    2017-06-01

    Suicide is a catastrophic event to both families and communities yet it is potentially preventable. This study aims to determine incidence and patterns of suicide in children and young adolescents in our region, raise awareness of this entity as a potentially preventable cause of death in this age group, and identify its possible associated risk factors. We retrospectively reviewed suicide cases presenting as sudden unexpected death in children and adolescents that underwent coronial post-mortems at our institution. This is the largest pathological review of completed suicide in children and young adolescents within a single institution in the United Kingdom. We identified 23 suicide cases during a 12 year period from 2003 to 2015, in which 18 cases (78%) were male and 5 cases (22%) were female. The age range was from 8 to 16 years (mean age 12.82 +/- 2.52 SD). With the exception of one case, all of the victims were Caucasian. The majority, 19 cases (81%), were found dead inside their place of residence, 15 of whom were discovered in their own bedrooms. Twenty-one cases (91%) died from neck compression due to hanging; 6 cases (26%) had used the cord of a dressing gown and 5 (22%) opted to use a belt as the ligature. Two cases (9%) that died from multiple-drug toxicity were female. In 7 cases (30.5%) there was evidence of self-harm and in 3 cases (13%) there was a history of previous suicide attempts. Petechial hemorrhages were found at autopsy in more than half of hanging victims and only three cases (14%) displayed dual distribution of post-mortem hypostasis (back and legs). Seven victims (30.5%) left some form of suicide message to family members and friends, 2 of which wrote the message on their arm. Parental separation, conflict with parents, and depression, were common amongst decedents prior to committing suicide. Substance abuse was uncommon in suicide within our cases. Valuable information is available from thorough review of suicide data in children and

  16. Anaesthesia-related haemodynamic complications in Williams syndrome patients: a review of one institution's experience.

    Science.gov (United States)

    Olsen, M; Fahy, C J; Costi, D A; Kelly, A J; Burgoyne, L L

    2014-09-01

    Williams syndrome is a genetic disorder associated with cardiac pathology, including supravalvular aortic stenosis and coronary artery stenosis. Sudden cardiac death has been reported in the perioperative period and attributed to cardiovascular pathology. In this retrospective audit, case note and anaesthetic records were reviewed for all confirmed Williams syndrome patients who had received an anaesthetic in our institution between July 1974 and November 2009. There were a total of 108 anaesthetics administered in 29 patients. Twelve of the anaesthetics (11.1%) were associated with cardiac complications including cardiac arrest in two cases (1.85%). Of the two cardiac arrests, one patient died within the first 24 hours postanaesthetic and the other patient survived, giving an overall mortality of 0.9% (3.4%). We conclude that Williams syndrome confers a significant anaesthetic risk, which should be recognised and considered by clinicians planning procedures requiring general anaesthesia.

  17. Readability of patient education materials in ophthalmology: a single-institution study and systematic review.

    Science.gov (United States)

    Williams, Andrew M; Muir, Kelly W; Rosdahl, Jullia A

    2016-08-03

    Patient education materials should be written at a level that is understandable for patients with low health literacy. The aims of this study are (1) to review the literature on readability of ophthalmic patient education materials and (2) to evaluate and revise our institution's patient education materials about glaucoma using evidence-based guidelines on writing for patients with low health literacy. A systematic search was conducted on the PubMed/MEDLINE database for studies that have evaluated readability level of ophthalmic patient education materials, and the reported readability scores were assessed. Additionally, we collected evidence-based guidelines for writing easy-to-read patient education materials, and these recommendations were applied to revise 12 patient education handouts on various glaucoma topics at our institution. Readability measures, including Flesch-Kincaid Grade Level (FKGL), and word count were calculated for the original and revised documents. The original and revised versions of the handouts were then scored in random order by two glaucoma specialists using the Suitability Assessment of Materials (SAM) instrument, a grading scale used to evaluate suitability of health information materials for patients. Paired t test was used to analyze changes in readability measures, word count, and SAM score between original and revised handouts. Finally, five glaucoma patients were interviewed to discuss the revised materials, and patient feedback was analyzed qualitatively. Our literature search included 13 studies that evaluated a total of 950 educational materials. Among the mean FKGL readability scores reported in these studies, the median was 11 (representing an eleventh-grade reading level). At our institution, handouts' readability averaged a tenth-grade reading level (FKGL = 10.0 ± 1.6), but revising the handouts improved their readability to a sixth-grade reading level (FKGL = 6.4 ± 1.2) (p readability and suitability of

  18. A Review of Criteria for Outdoor Classroom in Selected Tertiary Educational Institutions in Kuala Lumpur

    Science.gov (United States)

    Maheran, Y.; Fadzidah, A.; Nur Fadhilah, R.; Farha, S.

    2017-12-01

    A proper design outdoor environment in higher institutions contributes to the students’ learning performances and produce better learning outcomes. Campus surrounding has the potential to provide an informal outdoor learning environment, especially when it has the existing physical element, like open spaces and natural features, that may support the learning process. However, scholarly discourses on environmental aspects in tertiary education have minimal environmental inputs to fulfill students’ needs for outdoor exposure. Universities have always emphasized on traditional instructional methods in classroom settings, without concerning the importance of outdoor classroom towards students’ learning needs. Moreover, the inconvenience and discomfort outdoor surrounding in campus environment offers a minimal opportunity for students to study outside the classroom, and students eventually do not favor to utilize the spaces because no learning facility is provided. Hence, the objective of this study is to identify the appropriate criteria of outdoor areas that could be converted to be outdoor classrooms in tertiary institutions. This paper presents a review of scholars’ work in regards to the characteristics of the outdoor classrooms that could be designed as part of contemporary effective learning space, for the development of students’ learning performances. The information gathered from this study will become useful knowledge in promoting effective outdoor classroom and create successful outdoor learning space in landscape campus design. It I hoped that the finding of this study could provide guidelines on how outdoor classrooms should be designed to improve students’ academic achievement.

  19. 45 CFR 46.111 - Criteria for IRB approval of research.

    Science.gov (United States)

    2010-10-01

    ... Section 46.111 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS Basic HHS Policy for Protection of Human Research Subjects § 46.111 Criteria for IRB... protect the rights and welfare of these subjects. ...

  20. 40 CFR 26.1111 - Criteria for IRB approval of research.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Criteria for IRB approval of research. 26.1111 Section 26.1111 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION... subjects, and the importance of the knowledge that may reasonably be expected to result. In evaluating...

  1. From the Form to the Face to Face: IRBs, Ethnographic Researchers, and Human Subjects Translate Consent

    Science.gov (United States)

    Metro, Rosalie

    2014-01-01

    Based on my fieldwork with Burmese teachers in Thailand, I describe the drawbacks of using IRB-mandated written consent procedures in my cross-cultural collaborative ethnographic research on education. Drawing on theories of intersubjectivity (Mikhail Bakhtin), ethics (Emmanuel Levinas), and translation (Naoki Sakai), I describe face-to-face…

  2. 15 CFR 27.111 - Criteria for IRB approval of research.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Criteria for IRB approval of research. 27.111 Section 27.111 Commerce and Foreign Trade Office of the Secretary of Commerce PROTECTION OF... subjects are reasonable in relation to anticipated benefits, if any, to subjects, and the importance of the...

  3. 40 CFR 26.1113 - Suspension or termination of IRB approval of research.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Suspension or termination of IRB approval of research. 26.1113 Section 26.1113 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Pesticides Involving Intentional Exposure of Non-pregnant, Non-nursing Adults § 26.1113 Suspension or...

  4. Neutral atom analyzers for diagnosing hot plasmas: A review of research at the ioffe physicotechnical institute

    International Nuclear Information System (INIS)

    Kislyakov, A. I.; Petrov, M. P.

    2009-01-01

    Research on neutral particle diagnostics of thermonuclear plasmas that has been carried out in recent years at the Ioffe Physicotechnical Institute of the Russian Academy of Sciences (St. Petersburg, Russia) is reviewed. Work on the creation and improvement of neutral atom analyzers was done in two directions: for potential applications (in particular, on the International Thermonuclear Experimental Reactor, which is now under construction at Cadarache in France) and for investigation of the ion plasma component in various devices (in particular, in the largest tokamaks, such as JET, TFTR, and JT-60). Neutral atom analyzers are the main tool for studying the behavior of hydrogen ions and isotopes in magnetic confinement systems. They make it possible to determine energy spectra, to perform the isotope analysis of atom fluxes from the plasma, to measure the absolute intensity of the fluxes, and to record how these parameters vary with time. A comparative description of the analyzers developed in recent years at the Ioffe Institute is given. These are ACORD-12/24 analyzers for recording 0.2-100-keV hydrogen and deuterium atoms with a tunable range of simultaneously measured energies, CNPA compact analyzers for a fixed energy gain in the ranges 80-1000 eV and 0.8-100 keV, an ISEP analyzer for simultaneously recording the atoms of all the three hydrogen isotopes (H, D, and T) in the energy range 5-700 keV, and GEMMA analyzers for recording atom fluxes of hydrogen and helium isotopes in the range 0.1-4 MeV. The scintillating detectors of the ISEP and GEMMA analyzers have a lowered sensitivity to neutrons and thus can operate without additional shielding in neutron fields of up to 10 9 n/(cm 2 s). These two types of analyzers, intended to operate under deuterium-tritium plasma conditions, are prototypes of atom analyzers created at the Ioffe Institute for use in the International Thermonuclear Experimental Reactor. With these analyzers, a number of new results have been

  5. Predicting Discharge to Institutional Long-Term Care After Stroke: A Systematic Review and Metaanalysis.

    Science.gov (United States)

    Burton, Jennifer K; Ferguson, Eilidh E C; Barugh, Amanda J; Walesby, Katherine E; MacLullich, Alasdair M J; Shenkin, Susan D; Quinn, Terry J

    2018-01-01

    Stroke is a leading cause of disability worldwide, and a significant proportion of stroke survivors require long-term institutional care. Understanding who cannot be discharged home is important for health and social care planning. Our aim was to establish predictive factors for discharge to institutional care after hospitalization for stroke. We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42015023497) of observational studies. We searched MEDLINE, EMBASE, and CINAHL Plus to February 2017. Quantitative synthesis was performed where data allowed. Acute and rehabilitation hospitals. Adults hospitalized for stroke who were newly admitted directly to long-term institutional care at the time of hospital discharge. Factors associated with new institutionalization. From 10,420 records, we included 18 studies (n = 32,139 participants). The studies were heterogeneous and conducted in Europe, North America, and East Asia. Eight studies were at high risk of selection bias. The proportion of those surviving to discharge who were newly discharged to long-term care varied from 7% to 39% (median 17%, interquartile range 12%), and the model of care received in the long-term care setting was not defined. Older age and greater stroke severity had a consistently positive association with the need for long-term care admission. Individuals who had a severe stroke were 26 times as likely to be admitted to long-term care than those who had a minor stroke. Individuals aged 65 and older had a risk of stroke that was three times as great as that of younger individuals. Potentially modifiable factors were rarely examined. Age and stroke severity are important predictors of institutional long-term care admission directly from the hospital after an acute stroke. Potentially modifiable factors should be the target of future research. Stroke outcome studies should report discharge destination, defining the model of care provided in the long-term care setting.

  6. Reuse of samples: ethical issues encountered by two institutional ethics review committees in Kenya.

    Science.gov (United States)

    Langat, Simon K

    2005-10-01

    There is growing concern about the reuse and exploitation of biological materials (human tissues) for use in research worldwide. Most discussions about samples have taken place in developed countries, where genetic manipulation techniques have greatly advanced in recent years. There is very little discussion in developing countries, although collaborative research with institutions from developed countries is on the increase. The study sought to identify and describe ethical issues arising in the storage, reuse and exportation of samples in a developing country. Research protocols presented to two Ethics Review Committees in Kenya during a period of two years were reviewed. A record was made of the protocol title, sample collected, request for storage, reuse or exportation and whether or not subject consent was sought. The findings indicated that about 25% out of the 388 protocols sought permission for reuse and only half of those actually informed subjects of the contemplated re-use. Less than 20% requested storage and again, about half of them sought consent from subjects. There is an indication that investigators do not see the need to seek consent for storage, reuse and exportation of samples. It is proposed that these issues should be addressed through policy interventions at both the national and global levels.

  7. The quality of reports of medical and public health research from Palestinian institutions: a systematic review.

    Science.gov (United States)

    Albarqouni, Loai; Abu-Rmeileh, Niveen Me; Elessi, Khamis; Obeidallah, Mohammad; Bjertness, Espen; Chalmers, Iain

    2017-06-09

    Over the past decade, there has been an increase in reports of health research from Palestine, but no assessment of their quality. We have assessed the quality of reports of Palestinian health research and factors associated with it. This is a systematic review. We searched Medline and Scopus for reports of original research relevant to human health or healthcare authored by researchers affiliated with Palestinian institutions and published between January 2000 and August 2015 inclusive. We used international guidelines to assess report quality, classifying as adequate those with ≥50% of items completely addressed. Of 2383 reports identified, 497 met our inclusion criteria. Just over half (264; 55%) of these were published after 2010. 354 (71%) of first authors were affiliated with Palestinian institutions; 261 (53%) reports had coauthors from outside Palestine. The majority of the reports in our study were inadequately reported (342; 69%), and none had adequately reported all items. Of 439 observational studies, 11 (2.5%) reports provided adequate descriptions of eligibility criteria and selection procedures; 35 (8%) reported efforts to address potential sources of bias; 50 (11.4%) reported the basis for the study sample size; and funding sources were mentioned in 74 reports (17%). Higher reporting quality was associated with international affiliation of the first author (prevalence ratio (PR) 1.6 (95% CI 1.2 to 2.1)), international collaboration (PR 2.9 (95% CI 1.7 to 5.0)), international funding (PR 1.9 (95% CI1.5 to 2.5)), publication after 2005 (PR 3.9 (95% CI 1.8 to 8.5)) and four or more coauthors (PR 1.5 (95% CI 1.1 to 2.1)). Although the quality of reports of Palestinian research has improved in recent years, it remains well below an acceptable standard. International reporting guidelines should be used to guide research design and improve the quality of reports of research. The systematic review protocol was registered in the International Prospective

  8. Quality Assurance Peer Review Chart Rounds in 2011: A Survey of Academic Institutions in the United States

    International Nuclear Information System (INIS)

    Lawrence, Yaacov Richard; Whiton, Michal A.; Symon, Zvi; Wuthrick, Evan J.; Doyle, Laura; Harrison, Amy S.; Dicker, Adam P.

    2012-01-01

    Purpose: In light of concerns regarding the quality of radiation treatment delivery, we surveyed the practice of quality assurance peer review chart rounds at American academic institutions. Methods and Materials: An anonymous web-based survey was sent to the chief resident of each institution across the United States. Results: The response rate was 80% (57/71). The median amount of time spent per patient was 2.7 minutes (range, 0.6–14.4). The mean attendance by senior physicians and residents was 73% and 93%, respectively. A physicist was consistently present at peer review rounds in 66% of departments. There was a close association between attendance by senior physicians and departmental organization: in departments with protected time policies, good attendance was 81% vs. 31% without protected time (p = 0.001), and in departments that documented attendance, attending presence was 69% vs. 29% in departments without documentation (p 75% of institutions, whereas dosimetric details (beams, wedges), isodose coverage, intensity-modulated radiation therapy constraints, and dose–volume histograms were always peer reviewed in 63%, 59%, 42%, and 50% of cases, respectively. Chart rounds led to both minor (defined as a small multileaf collimator change/repeated port film) and major (change to dose prescription or replan with dosimetry) treatment changes. Whereas at the majority of institutions changes were rare (<10% of cases), 39% and 11% of institutions reported that minor and major changes, respectively, were made to more than 10% of cases. Conclusion: The implementation of peer review chart rounds seems inconsistent across American academic institutions. Brachytherapy and radiosurgical procedures are rarely reviewed. Attendance by senior physicians is variable, but it improves when scheduling clashes are avoided. The potential effect of a more thorough quality assurance peer review on patient outcomes is not known.

  9. Project risk management: A review of an institutional project life cycle

    Directory of Open Access Journals (Sweden)

    Wanjiru Gachie

    2017-11-01

    Full Text Available This article is a desktop analysis of project risk management involving a project management institutional restructuring. The pragmatic nature of this research allows for the literature review and the document analysis to be integrated and presented as both a descriptive and analytical research. The analysis demonstrates that the project committee did not proactively manage project risk. The restructuring was a change management project, entailing the implementation of many organisational changes, such as restructuring, lay-off of some part of the administrative workforce, adoption of new technology, provision of new approaches to well-established procedures, and implementation of new performance initiative, the process which should have been managed with an effective integrated risk strategy and plan. Analysis of the restructuring project risk management exhibits little evidence of a systematic (computer based or manual record that should have provided policies, procedures, and structures for managing risk. The article concludes that the restructuring risk process was inadequate and it could not have ensured a successful project. An analysis of the restructuring project risk monitoring and control exhibits a reactive rather than proactive application of risk management procedures. The analysis further indicates that the committee failed to make use of the various project risk management processes, standards, and guidelines. Based on the conclusions, the article recommends that project risk planning, strategy, control, and monitoring should be put in place for future institutional projects. The project management team should also put in place procedures for primary stakeholders engagements, identify and address their nature of interest and power in future risk management projects

  10. Computer Security for Commercial Nuclear Power Plants - Literature Review for Korea Hydro Nuclear Power Central Research Institute

    Energy Technology Data Exchange (ETDEWEB)

    Duran, Felicia Angelica [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Security Systems Analysis Dept.; Waymire, Russell L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Security Systems Analysis Dept.

    2013-10-01

    Sandia National Laboratories (SNL) is providing training and consultation activities on security planning and design for the Korea Hydro and Nuclear Power Central Research Institute (KHNPCRI). As part of this effort, SNL performed a literature review on computer security requirements, guidance and best practices that are applicable to an advanced nuclear power plant. This report documents the review of reports generated by SNL and other organizations [U.S. Nuclear Regulatory Commission, Nuclear Energy Institute, and International Atomic Energy Agency] related to protection of information technology resources, primarily digital controls and computer resources and their data networks. Copies of the key documents have also been provided to KHNP-CRI.

  11. Computer Security for Commercial Nuclear Power Plants - Literature Review for Korea Hydro Nuclear Power Central Research Institute

    International Nuclear Information System (INIS)

    Duran, Felicia Angelica; Waymire, Russell L.

    2013-01-01

    Sandia National Laboratories (SNL) is providing training and consultation activities on security planning and design for the Korea Hydro and Nuclear Power Central Research Institute (KHNPCRI). As part of this effort, SNL performed a literature review on computer security requirements, guidance and best practices that are applicable to an advanced nuclear power plant. This report documents the review of reports generated by SNL and other organizations [U.S. Nuclear Regulatory Commission, Nuclear Energy Institute, and International Atomic Energy Agency] related to protection of information technology resources, primarily digital controls and computer resources and their data networks. Copies of the key documents have also been provided to KHNP-CRI.

  12. Review on Overseas Contracts of a Nuclear Research Institute in Korea

    International Nuclear Information System (INIS)

    Lee, Myung Ho; Lee, Eui Jin

    2010-01-01

    Since its establishment, Korea Atomic Energy Research Institute (KAERI) has made various contracts in research, design, engineering and consultation with a lot of foreign counterparts all over the world, including international organizations. As one of the global nuclear energy research leaders, KAERI can make a large scale contract because it has already procured a turnkey EPC (Engineering, Procurement, Construction) contract for a research and training reactor in the spring of 2010 by forming a consortium with a construction and engineering company. A contract in nuclear business industries is to be made under the limited control of regulatory authorities because the contractors must ensure nuclear safety and follow the international nuclear non-proliferation guidelines to secure the peaceful use of nuclear energy at an international level. The export and import of strategic technologies, products or materials (including nuclear materials) must be directly controlled by the authorities in accordance with the applicable law. In 2009, KAERI organized a new team to manage the overseas contracts and to make the limited control reflected in the contract documentation. In large scale project contracts, more attention shall be given to the contracts to prevent claims and also to the consideration of the regulatory requirements. In this context, the nature of the past KAERI contracts was reviewed. The conditions of several recent KAERI contracts were also individually reviewed based on the FIDIC (Federation Internationale des Ingenieurs-Conseils) model service agreement, which is generally accepted by service contractors. Ways to increase the quality of future contracts and to improve the standard model agreement which is used to prepare the draft contract were also considered

  13. Retrograde Ureteroscopic Management of Large Renal Calculi: A Single Institutional Experience and Concise Literature Review.

    Science.gov (United States)

    Scotland, Kymora B; Rudnick, Benjamin; Healy, Kelly A; Hubosky, Scott G; Bagley, Demetrius H

    2018-06-06

    Advances in flexible ureteroscope design and accessory instrumentation have allowed for more challenging cases to be treated ureteroscopically. Here, we evaluate our experience with ureteroscopy (URS) for the management of large renal calculi (≥2 cm) and provide a concise review of recent reports. A retrospective review was undertaken of all URS cases between 2004 and 2014 performed by the endourologic team at a single academic tertiary care institution. We identified patients with at least one stone ≥2 cm managed with retrograde URS. Stone size was defined as the largest linear diameter of the index stone. Small diameter flexible ureteroscopes were used primarily with holmium laser. Patient demographics, intraoperative data, and postoperative outcomes were evaluated. We evaluated 167 consecutive patients who underwent URS for large renal stones ≥2 cm. The initial reason for choosing URS included patient preference (29.5%), failure of other therapies (8.2%), anatomic considerations/body habitus (30.3%), and comorbidities (28.8%). Mean patient age was 55.5 years (22-84). The mean stone size was 2.75 cm with mean number of procedures per patient of 1.65 (1-6). The single session stone-free rate was 57.1%, two-stage procedure stone-free rate was 90.2% and three-stage stone-free rate was 94.0%. Access sheaths were used in 47% of patients. An association was identified between stone size and patient outcomes; smaller stones correlated with decreased number of procedures. Postoperative complications were minor. Single or multi-stage retrograde ureteroscopic lithotripsy is a safe and effective mode of surgical management of large renal calculi. Total stone burden is a reliable predictor of the need for a staged procedure and of stone-free rate.

  14. Orbital exenteration: Institutional review of evolving trends in indications and rehabilitation techniques.

    Science.gov (United States)

    Kiratli, Hayyam; Koç, İrem

    2018-06-01

    To determine the changes in indications for orbital exenteration over 20 years and to assess its impact on patient survival. Evolving techniques of rehabilitation of the orbit in our institution were also evaluated. This was a retrospective review of hospital records of patients who underwent orbital exenteration from 1995 to 2015 in a tertiary care center. Data extracted included primary location of the tumor, preoperative treatments, interval between initial diagnosis and exenteration, status of surgical margins, presence of metastatic disease, and postoperative survival. The types of prosthesis utilized over the years were also reviewed. Cox regression analysis was performed for categorical variables. Kaplan-Meier analysis was used to estimate post-exenteration survival. Over a 20-year period, orbital exenteration was performed on 100 orbits of 100 patients. The mean age was 39.4 years (range: 2 months to 90 years). The most common indications among 98 malignant causes were retinoblastoma, squamous cell carcinoma, basal cell carcinoma, extraocular extension of uveal melanoma, and conjunctival melanoma. Postoperative survival was significantly related to age and tumor location but independent from gender, surgical margin, histopathological diagnosis, previous treatment modality, and preoperative interval. In the whole cohort, 1-year and 5-year survival rates were 97% and 84%, respectively. Exenteration appears to be life-saving in children with orbital extension of retinoblastoma. While patients exenterated for malignant eyelid tumors have the best chance of survival, those with orbital extension of uveal melanoma and adenoid cystic carcinoma of the lacrimal gland have the worst prognosis.

  15. Review on Overseas Contracts of a Nuclear Research Institute in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Ho; Lee, Eui Jin [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2010-10-15

    Since its establishment, Korea Atomic Energy Research Institute (KAERI) has made various contracts in research, design, engineering and consultation with a lot of foreign counterparts all over the world, including international organizations. As one of the global nuclear energy research leaders, KAERI can make a large scale contract because it has already procured a turnkey EPC (Engineering, Procurement, Construction) contract for a research and training reactor in the spring of 2010 by forming a consortium with a construction and engineering company. A contract in nuclear business industries is to be made under the limited control of regulatory authorities because the contractors must ensure nuclear safety and follow the international nuclear non-proliferation guidelines to secure the peaceful use of nuclear energy at an international level. The export and import of strategic technologies, products or materials (including nuclear materials) must be directly controlled by the authorities in accordance with the applicable law. In 2009, KAERI organized a new team to manage the overseas contracts and to make the limited control reflected in the contract documentation. In large scale project contracts, more attention shall be given to the contracts to prevent claims and also to the consideration of the regulatory requirements. In this context, the nature of the past KAERI contracts was reviewed. The conditions of several recent KAERI contracts were also individually reviewed based on the FIDIC (Federation Internationale des Ingenieurs-Conseils) model service agreement, which is generally accepted by service contractors. Ways to increase the quality of future contracts and to improve the standard model agreement which is used to prepare the draft contract were also considered

  16. Single-Institution Experience With Component Separation for Ventral Hernia Repair: A Retrospective Review.

    Science.gov (United States)

    Hill, Brian; Kambeyanda, Rohan; Fewell, Donna; Bryant, Stewart; Delaney, Kevin O; Herrera, Fernando A

    2018-06-01

    In this study, we reviewed our institution's experience using component separation for repair of ventral hernias. This was a retrospective review of all component separations for ventral hernia between July 2009 and December 2015. Recorded data included body mass index (BMI), preoperative albumin, smoking history, comorbidities, additional procedures, length of surgery, hospitalization, recurrence, and postoperative complications. One hundred ninety-six component separations were performed in the study period. The average patient age was 56 years, and 65.3% of patients were female. The average BMI was 32.6 kg/m; preoperative albumin was 3.59; 18.4% were current smokers; 28.1% were diabetic; and 14.3% had heart disease. Postoperative complications developed in 16.8% of patients. Recurrence developed in 8.7% of patients. Patients who developed a postoperative complication had a higher BMI (P = 0.025) and lower albumin (P = 0.047) compared with patients who did not develop complications. Current smokers were more likely to develop complications (P = 0.008). More than one third of patients had additional procedures at the time of the ventral hernia repair. The addition of a plastic surgery procedure was not associated with an increased risk of developing a complication (P = 0.25). Patients who developed complications had a significantly longer hospital course (P < 0.001) but no difference in total operative time (P = 0.975). Increased number of comorbidities did not statistically correlate with an increased complication rate (P = 0.65) or length of hospital stay (P = 0.43). We identified risk factors that increase the likelihood of postoperative complications and length of hospital stay. In addition, this study suggests that more comorbidities and additional procedures at the time of the hernia repair may not have as large of impact on complication risk as previously thought.

  17. Utility of MRCP in clinical decision making of suspected choledocholithiasis: An institutional analysis and literature review.

    Science.gov (United States)

    Badger, Wesley R; Borgert, Andrew J; Kallies, Kara J; Kothari, Shanu N

    2017-08-01

    The ideal treatment algorithm for suspected choledocholithiasis is not yet well defined. Imaging options include magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and intraoperative cholangiogram (IOC). MRCP is diagnostic, while the other two modalities can also be therapeutic. Each of these modalities for diagnosis and treatment carries its own set of risks, benefits, and institutional costs. We hypothesized that there would be a significant difference between the biochemical profiles and characteristics of patients who undergo ERCP vs. MRCP vs. operative intervention as the initial choice of treatment/imaging modality. We performed a retrospective review of the electronic medical records for all patients with a coded diagnosis of choledocholithiasis from 2011 to 2014. The initial diagnostic modality was assessed for each hospital encounter. The statistical characteristics of MRCP as compared to fluoroscopic imaging of the biliary tree (ERCP, IOC) were analyzed. Overall, 527 hospital encounters were identified. Initial intervention included ERCP in 63%, MRCP in 12%, and cholecystectomy in 25% of patients. Patients undergoing cholecystectomy first, compared to MRCP or ERCP, tended to have lower values for alkaline phosphatase (P utility in this patient population should be questioned. Further research is needed to better define the pretest characteristics which would predict which patients do not need further intervention after MRCP as well as defining the most cost-effective strategy. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. A Review and Analysis of the Ayurvedic Institute's Ayurvedic Studies Program.

    Science.gov (United States)

    Rogers, Curtis R.

    The Ayurvedic Institute, which has been licensed as a private institution of higher education in New Mexico since 1994, offers training in the traditional therapy of East Indian Ayurveda, which includes the use of herbs, nutrition, panchakarma cleansing, and accupressure massage. The institute also offers training in the related disciplines of…

  19. Measurement of Perceived Service Quality in Higher Education Institutions: A Review of HEdPERF Scale Use

    Science.gov (United States)

    Silva, Danilo Soares; de Morales, Gustavo Hermínio Salati Marcondes; Makiya, Ieda Kanashiro; Cesar, Francisco Ignácio Giocondo

    2017-01-01

    Purpose: This study aims to find evidence of the HEdPERF scale use for measuring the perceived service quality from the perspective of students in higher education institutions (HEIs) worldwide. Design/methodology/approach: A systematic review of the literature was conducted to find evidence of the scale use in articles published between January…

  20. 77 FR 53909 - Certain Pasta From Italy and Turkey; Institution of Five-year Reviews Concerning the...

    Science.gov (United States)

    2012-09-04

    ...)] Certain Pasta From Italy and Turkey; Institution of Five-year Reviews Concerning the Countervailing and Antidumping Duty Orders on Certain Pasta From Italy and Turkey AGENCY: United States International Trade... revocation of the countervailing and antidumping duty orders on certain pasta from Italy and Turkey would be...

  1. Das IRB-Modell des Kreditrisikos im Vergleich zum Modell einer logarithmisch normalverteilten Verlustfunktion

    OpenAIRE

    Vetter, Michael; Cremers, Heinz

    2008-01-01

    In 2004 the Basel Committee published an extensive revision of the capital charges which creates more risk sensitive capital requirements for banks. The New Accord called International Convergence of Capital Measurement and Capital Standard provides in its first pillar for a finer measurement of credit risk. Banks that have received supervisory approval to use the Internal Ratings-Based (IRB) approach may rely on their own internal estimates of risk components in determining the capital requi...

  2. Centre de la Manche institutional control period: after the first safety review - 59236

    International Nuclear Information System (INIS)

    Dutzer, Michel; Vervialle, Jean Pierre; Andre, Alain; Marchiol, Albert

    2012-01-01

    Centre de la Manche disposal facility is the first French surface disposal facility dedicated to low and intermediate level short lived radioactive waste. It started up in 1969. After a continuous improvement, in the design of disposal vaults, in operational modes, in the whole process of waste management, in the safety approach, the last packages were received in 1994. 527, 000 m 3 of waste packages have been disposed during the 25 years of operation. The facility was licensed for the institutional control period in 2003. The disposal vaults are covered with a multilayer capping system that includes a bituminous membrane to provide protection against rainwater infiltration. Water that might infiltrate through the membrane is collected by the bottom slab of the vaults to a pipe network implemented in an underground gallery. Measurements show an overall infiltration rate of about 3 l/m 2 /year that complies with the objective of Andra of a few liters per square meter and per year. Investigations are performed in order to assess the behavior of the membrane in the long term. For this purpose periodically samples of the bituminous membrane are taken and measurements are performed. As at the beginning of the operational period waste packages were not conditioned in accordance with the specifications that are presently prescribed to waste generators, some settlements can be observed on the ancient part or the facilities. At the end of 2009 some excavation works were performed in an area where a settlement of few tens of centimeters was observed. The integrity of the membrane could be observed and the adequacy of the selection of this option for the water-tightness of the capping system was so confirmed. Environmental monitoring includes radiological and chemical measurements for discharge, underground water and surface water. In the particular framework of Centre de la Manche, a contamination of groundwater by tritiated wastes occurred in 1976. Theses wastes were

  3. Fifteen years' review of advanced childhood neuroblastoma from a single institution in Hong Kong.

    Science.gov (United States)

    Leung, C K

    1998-05-01

    To assess the progress in the treatment of advanced childhood neuroblastoma. From 1981 to 1996, there were 32 children with neuroblastoma (NB) diagnosed, staged and treated in our institution. There were 4 patients with stage II NB (12%), 5 stage III (16%), 21 stage IV (66%) and 2 stage IV s (6%). The NBs were excised if CT scan indicated that the tumors were operable. For advanced NB, stages III and IV, multiple drug chemotherapy was started first and operability was assessed with serial CT scan examinations. Once the X-ray imaging indicated the tumors were operable, surgical interventions were done. The medical records of the advanced NB were reviewed. In the initial period of the study, 9 patients were treated using the VAC protocol [vincristine (vcr), adriamycin (adria) and cyclophosphamide (cyc)]. No patient was convertible to operable and all died with a mean survival of 10 months. OPEC [vcr, cyc, VM26, cisplatin (cis)], Rapid COJEC (carboplatin, VP16, vcr, cis and cyc) and more recently N6 protocol (cyc, adria, vcr, VP16, cis) was used for 17 patients. 80% of them were converted to operable. In 4 patients, surgical specimens showed only necrotic tissue without viable tumor tissue and 6 (35%) tumors were converted to ganglioneuroma or ganglioneuroblastoma. Although 2 (12%) patients died of fungal septicemia and 1 (6%) developed Fanconi's syndrome after chemotherapy, the mean survival period increased to 27 months. In the 10 survivors (60%), 4 had megatherapy with melphalan followed by autologous peripheral blood stem cell (PBSC) transplantation and 2 were waiting for transplantation. There is a high percentage of advanced NB on presentation in Hong Kong. With more potent multiple drug chemotherapy for advanced stage NB there are (1) improvement in the survival of these patients, (2) opportunities for more operations for tumor excision and (3) opportunities for autologous PBSC transplantation for better tumor eradication.

  4. A Phase-1 Clinical Trial of a DNA Vaccine for Venezuelan Equine Encephalitis Delivered by Intramuscular or Intradermal Electroporation

    Science.gov (United States)

    2016-05-25

    by the Aspire Institutional Review Board (IRB) http://aspire-irb.com and the Western IRB institutional biosafety committee was the Western IRB IBC...antibodies at each scheduled time point. Geometric mean titers, standard errors, and 95% CIs were calculated using log-transformed titers, replacing any

  5. The Utility of Expert Diagnosis in Surgical Neuropathology: Analysis of Consultations Reviewed at 5 National Comprehensive Cancer Network Institutions.

    Science.gov (United States)

    Bruner, Janet M; Louis, David N; McLendon, Roger; Rosenblum, Marc K; Archambault, W Tad; Most, Susan; Tihan, Tarik

    2017-03-01

    The aim of this study was to characterize the type and degree of discrepancies between non-expert and expert diagnoses of CNS tumors to identify the value of consultations in surgical neuropathology. Neuropathology experts from 5 National Comprehensive Cancer Network (NCCN) member institutions participated in the review of 1281 consultations selected based on inclusion criteria. The consultation cases were re-reviewed at the NCCN headquarters to determine concordance with the original diagnoses. Among all consultations, 249 (19.4%) were submitted for expert diagnoses without final diagnoses from the submitting institution. Within the remaining 1032 patients, the serious/major discrepancy rate was 4.8%, and less serious and minor discrepancies were seen in 19.4% of the cases. The discrepancy rate was higher among patients who were referred to NCCN institutions for consultation compared to those who were referred for treatment only. The discrepancy rates, patient demographics, type of consultations and submitting institutions varied among participating NCCN institutions. Expert consultations identified a subset of cases with significant diagnostic discrepancies, and constituted the initial diagnoses in some cases. These data indicate that expert consultations in glial tumors and all types of pediatric CNS tumors can improve accurate diagnosis and enable appropriate management. © 2017 American Association of Neuropathologists, Inc. All rights reserved.

  6. 77 FR 19022 - National Institute of Child Health and Human Development Submission for OMB Review; Comment...

    Science.gov (United States)

    2012-03-29

    ... under subsection (b) shall-- (1) Incorporate behavioral, emotional, educational, and contextual..., Analysis and Communication, National Institute of Child Health and Human Development, 31 Center Drive Room..., Analysis and Communications, National Institute of Child Health and Human Development. [FR Doc. 2012-7589...

  7. Review of the Confucius Institutes' Strategy for the Dissemination of Chinese Culture

    Science.gov (United States)

    Ying, Wu

    2016-01-01

    Following four years of continuous expansion in scale, the Confucius Institutes have begun entering the stage of implicit development: the most pressing question that needs answering is whether the Confucius Institutes, which are devoted to the dissemination of Chinese culture, can achieve the spread of Chinese culture overseas through day-to-day…

  8. A Review of Propulsion Industrial Base Studies and an Introduction to the National Institute of Rocket Propulsion Systems

    Science.gov (United States)

    Doreswamy, Rajiv; Fry, Emma K.

    2012-01-01

    Over the past decade there have been over 40 studies that have examined the state of the industrial base and infrastructure that supports propulsion systems development in the United States. This paper offers a comprehensive, systematic review of these studies and develops conclusions and recommendations in the areas of budget, policy, sustainment, infrastructure, workforce retention and development and mission/vision and policy. The National Institute for Rocket Propulsion System (NIRPS) is a coordinated, national organization that is responding to the key issues highlighted in these studies. The paper outlines the case for NIRPS and the specific actions that the Institute is taking to address these issues.

  9. Evolutionary institutionalism.

    Science.gov (United States)

    Fürstenberg, Dr Kai

    Institutions are hard to define and hard to study. Long prominent in political science have been two theories: Rational Choice Institutionalism (RCI) and Historical Institutionalism (HI). Arising from the life sciences is now a third: Evolutionary Institutionalism (EI). Comparative strengths and weaknesses of these three theories warrant review, and the value-to-be-added by expanding the third beyond Darwinian evolutionary theory deserves consideration. Should evolutionary institutionalism expand to accommodate new understanding in ecology, such as might apply to the emergence of stability, and in genetics, such as might apply to political behavior? Core arguments are reviewed for each theory with more detailed exposition of the third, EI. Particular attention is paid to EI's gene-institution analogy; to variation, selection, and retention of institutional traits; to endogeneity and exogeneity; to agency and structure; and to ecosystem effects, institutional stability, and empirical limitations in behavioral genetics. RCI, HI, and EI are distinct but complementary. Institutional change, while amenable to rational-choice analysis and, retrospectively, to criticaljuncture and path-dependency analysis, is also, and importantly, ecological. Stability, like change, is an emergent property of institutions, which tend to stabilize after change in a manner analogous to allopatric speciation. EI is more than metaphorically biological in that institutional behaviors are driven by human behaviors whose evolution long preceded the appearance of institutions themselves.

  10. 77 FR 17462 - Notice of Submission for OMB Review; Institute of Education Sciences; Quick Response Information...

    Science.gov (United States)

    2012-03-26

    ... surveys of the elementary/secondary sector (districts, schools) and public libraries. PEQIS conducts... for surveys of state education agencies, school districts, schools, postsecondary institutions, and libraries. Surveys of teachers, students, commercial establishments, and households are not included in this...

  11. MR neurography (MRN) of the long thoracic nerve: retrospective review of clinical findings and imaging results at our institution over 4 years

    Energy Technology Data Exchange (ETDEWEB)

    Deshmukh, Swati [Northwestern University, Chicago, IL (United States); Fayad, Laura M. [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Oncology, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Orthopaedic Surgery, Baltimore, MD (United States); Ahlawat, Shivani [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States)

    2017-11-15

    Long thoracic nerve (LTN) injury can result in ipsilateral serratus anterior palsy and scapular winging. Traditional means of evaluating patients with suspected LTN injury include physical examination and electrodiagnostic studies. The purpose of our study is to describe high-resolution magnetic resonance (MR) findings in patients with clinical suspicion of LTN neuropathy. In this HIPAA-compliant, IRB-approved, retrospective study, two radiologists reviewed MR imaging performed for long thoracic neuropathy. Clinical presentation, electrodiagnostic studies and MR imaging of 20 subjects [mean age 37 ± 13 years; 25% (5/20) female] were reviewed. Observers reviewed MR imaging for LTN signal intensity, size, course, presence or absence of mass and secondary findings [skeletal muscle denervation (serratus anterior, trapezius, rhomboid) and scapular winging]. Descriptive statistics were reported. Clinical indications included trauma (n = 5), hereditary neuropathy (n = 1), pain (n = 8), winged scapula (n = 6), brachial plexitis (n = 4) and mass (n = 1). Electrodiagnostic testing (n = 7) was positive for serratus anterior denervation in three subjects. Abnormal LTN signal intensity, size, course or mass was present in 0/20. Secondary findings included skeletal muscle denervation in the serratus anterior in 40% (8/20), trapezius in 20% (4/20) and rhomboid in 20% (4/20). In 5% (1/20), an osteochondroma simulated a winged scapula, and in 2/20 (10%) MR showed scapular winging. High-resolution MR imaging is limited in its ability to visualize the long thoracic nerve directly, but does reveal secondary signs that can confirm a clinical suspicion of LTN injury. (orig.)

  12. Role of institutional entrepreneurship in building adaptive capacity in community-based healthcare organisations: realist review protocol.

    Science.gov (United States)

    Iyengar, Sweatha; Katz, Aaron; Durham, Jo

    2016-03-24

    Over the past 3 decades, there has been a substantial shift to the marketisation of government-funded health services. For organisations traditionally buffered from the competitive pressures of for-profit enterprises, such as community-based organisations, this means developing the capacity to adapt to competitive tendering processes, shifting client expectations, and increasing demands for greater accountability. Drawing on ideas of institutional entrepreneurship, we believe that attempts to build adaptive capacity require the transformation of existing institutional arrangements. Key in this may be identifying and fostering institutional entrepreneurs--actors who take the lead in being the impetus for, and giving direction to, structural change. This study focuses on the strategies used by institutional entrepreneurs to build adaptive capacity in the community-based healthcare sector. The research will use an adapted rapid realist review. The review will find underlying theories that explain the circumstances surrounding the implementation of capacity-building strategies that shape organisational response and generate outcomes by activating causal mechanisms. An early scoping of the literature, and consultations with key stakeholders, will be undertaken to identify an initial programme theory. We will search for relevant journal articles and grey literature. Data will be extracted based on contextual factors, mechanisms and outcomes, and their configurations. The analysis will seek patterns and regularities in these configurations and will focus on confirming, refuting or refining our programme theory. The study does not involve primary research and, therefore, does not require formal ethical approval. However, ethical standards of utility, usefulness, feasibility, propriety, accuracy and accountability will be followed. The results will be written up according to the Realist and Meta-Review Evidence Synthesis: Evolving Standards guidelines. Once completed

  13. Institutional entrepreneurship:

    DEFF Research Database (Denmark)

    Gretzinger, Susanne

    2018-01-01

    Institutional entrepreneurship pays specific attention to the process and outcomes of agents who are willing and capable of changing institutions. It has some common ground with the political entrepreneur, a concept that proposes change in norms and institutions because of commitment and activities...... of agents or organisations in the policy arena. The present chapter understands institutional entrepreneurship as the process of changing institutionalised practices. Based on a literature review, it describes the triggers, activities and potential effects of institutional entrepreneurs. The chapter...... concludes by tentatively arguing that political entrepreneurs can be institutional entrepreneurs, but institutional entrepreneurship can be considered as the broader concept that incorporates strategies and visions as well as interpretative-discursive power into the conceptual framework....

  14. Book Review: Lobbying the European Union: Institutions, Actors and Issues, David Coen and Jeremy Richardson (eds.

    Directory of Open Access Journals (Sweden)

    Alexandra Pop

    2013-03-01

    Full Text Available The volume "Lobbying the European Union: Institutions, Actors and Issues", collects 16 articles on interest group politics at EU level, focusing on the main elements of European lobbying - the existing relations between the EU institutions and the special interests, the main differences between NGO and business lobbying, the specific lobbying strategies adopted in EU's main policy sectors or lobbying regulations. The volume captures the main changes that took place on the European lobbying scene in the last two decades, period in which most EU institutions developed new points of access for lobbyists, while the interest groups became more specialized. The success of an EU lobbying campaign seems to be determined by a combination of various factors such as: a good knowledge of the EU environment, a wise usage of both financial resources and expertise, direct lobbying complemented by an efficient usage of domestic routes and the capability of creating smart alliances.

  15. A review of formal institutions affecting water supply and access in Botswana

    Science.gov (United States)

    Mogomotsi, Patricia K.; Mogomotsi, Goemeone E. J.; Matlhola, Dimpho M.

    2018-06-01

    Over the years, many countries across the world have increasingly experienced the collapse of their ecosystems, leading to an elevated increase on the demand for freshwater resources. Botswana is not an exception. The problem of disrupted potable water supply is widespread across the country. However, the physical shortage of water in the country is arguably coupled by lack of effective and efficient water supply and management institutions and water infrastructure. Most of the research on water scarcity in Botswana is mostly inclined towards physical water scarcity, while little is investigated on how the design of institutions for water management in developing countries leads to water scarcity. Furthermore, the premises of most research is neoclassical economics ideas, thereby offering solutions as developing and/or reforming water markets and water pricing mechanisms, among other findings. This paper analyses potable water supply and access in Botswana within a new institutional economics paradigm. The study examines key features of water institutions in Botswana on how they affect water supply and access, applying new institutional economics fundamentals. The study extensively uses various secondary data sources including weather and climate reports, policy documents, maps and charts and survey data, among others. The paper argues that to achieve effective water allocation in Botswana, there is a need to balance social and environmental water resource needs through water policies and other statutory enactments, as well as the crafting of practical management strategies. The country, therefore, requires not only a swift institutional transformation in the water sector, but also needs practical governance structure necessary for implementing integrated water resources management and driving water resources towards sustainability.

  16. A short review of critical experiments performed at the Kurchatov Institute

    Energy Technology Data Exchange (ETDEWEB)

    Gagarinski, A.Yu.; Glushkov, Y.S.; Ponomarev-Stepnoi, N.N. [Kurchatov Institute (Russian Federation)

    1997-06-01

    Since the 1950s, the Institute of Atomic Energy (now the Russian Research Center Kurchatov Institute) has investigated nuclear reactors intended for various purposes. A summary of the present state of these assemblies is given in an attachment to the paper. A second attachment provides a brief description of critical experiments for small nuclear power systems intended for decentralized power generation. The critical assemblies for these experiments were moderated by water and zirconium hydride, and fuel elements ranged in enrichment from 5% to 95% uranium 235. 7 refs.

  17. A short review of critical experiments performed at the Kurchatov Institute

    International Nuclear Information System (INIS)

    Gagarinski, A.Yu.; Glushkov, Y.S.; Ponomarev-Stepnoi, N.N.

    1997-01-01

    Since the 1950s, the Institute of Atomic Energy (now the Russian Research Center Kurchatov Institute) has investigated nuclear reactors intended for various purposes. A summary of the present state of these assemblies is given in an attachment to the paper. A second attachment provides a brief description of critical experiments for small nuclear power systems intended for decentralized power generation. The critical assemblies for these experiments were moderated by water and zirconium hydride, and fuel elements ranged in enrichment from 5% to 95% uranium 235. 7 refs

  18. Bound by Tradition? Peer Review and New Scholarship: An Institutional Case Study

    Science.gov (United States)

    White, Barbara Jo; Cruz, Laura; Ellern, Jill; Ford, George; Moss, Hollye

    2012-01-01

    Peer review is by no means a routine process for traditional, or basic, research. Even so, peer review is even less routinized for other forms of scholarship. In 1990, Ernest Boyer called for a reconsideration of scholarship and extended the definition to be inclusive of non-traditional modes of scholarly production and delivery. However, peer…

  19. Implementing a Standardised Annual Programme Review Process in a Third-Level Institution

    Science.gov (United States)

    Wickham, Sheelagh; Brady, Malcolm; Ingle, Sarah; McMullan, Caroline; Nic Giolla Mhichíl, Mairéad; Walshe, Ray

    2017-01-01

    Purpose: Ideally, quality should be, and is, an integral element of education, yet capturing and articulating quality is not simple. Programme quality reviews in third-level education can demonstrate quality and identify areas for improvement, offering many potential benefits. However, details on the process of quality programme review are limited…

  20. Control del brazo robot IRB120 mediante el dispositivo háptico PHANTOM

    OpenAIRE

    Pardo Alía, Samuel

    2016-01-01

    El proyecto expuesto en el presente libro consiste en el control del brazo robot IRB120 a través de diferentes aplicaciones por medio de una interfaz gráfica creada con el software matemático MATLAB. Todo ello se llevará a cabo gracias a un socket de comunicación desarrollado en lenguaje RAPID que permite el envío simultáneo de varias posiciones al robot. Entre esas aplicaciones destaca el empleo del dispositivo háptico Phantom Omni para la creación de dibujos o textos a man...

  1. The Emerging Internet. Annual Review of the Institute for Information Studies.

    Science.gov (United States)

    Institute for Information Studies, Falls Church, VA.

    This document contains papers commissioned by the Institute for Information Studies to provide a variety of perspectives on a particular topic relating to the impact of communications and information technology. Among the subjects covered are the impact of the Internet on community, education, electronic commerce, international development, and…

  2. Characteristics of Education Doctoral Dissertation References: An Inter-Institutional Analysis of Review of Literature Citations.

    Science.gov (United States)

    Beile, Penny M.; Boote, David N.; Killingsworth, Elizabeth K.

    This study had two purposes: to examine the expertise of doctoral students in their use of the scholarly literature and to investigate the use of citation analysis as a tool for collection development. Analysis of 1,842 coded citations gleaned from 30 education dissertations awarded in 2000 from 3 institutions in the United States revealed that…

  3. A Systematic Review of Health-Promotion Programs in NCAA Division III Institutions

    Science.gov (United States)

    Hanson, Matthew

    2011-01-01

    Health-promotion in the workplace has existed for numerous years. However, the availability of health-promotion programs offered in institutions of higher education has seemed to lag behind other industries such as business. The purpose of this survey research project was to identify specific components of health-promotion programs within NCAA…

  4. Entrepreneurship Education in Malaysia's Public Institutions of Higher Learning--A Review of the Current Practices

    Science.gov (United States)

    Bin Yusoff, Mohd Nor Hakimin; Zainol, Fakhrul Anwar; Bin Ibrahim, Mohamed Dahlan

    2015-01-01

    The need for a practical and applicable model for entrepreneurial learning is becoming critical. In this study, we aimed to collect data related to entrepreneurship education practices by all institutes of higher learning (IHLs) in Malaysia as well as challenges faced, facilities, and supports offered by the universities. Given the important role…

  5. Impediments of E-Learning Adoption in Higher Learning Institutions of Tanzania: An Empirical Review

    Science.gov (United States)

    Mwakyusa, Wilson Pholld; Mwalyagile, Neema Venance

    2016-01-01

    It is experienced that most of the Higher Learning Institutions (HLIs) in developing countries including Tanzania fails to fully implement e-learning system as a an alternative method of delivering education to a large population in the universities. However, some of HLIs are practicing the blended method by which both elearning and traditional…

  6. 78 FR 44136 - Submission for OMB review; 30-day Comment Request: National Cancer Institute (NCI) Cancer...

    Science.gov (United States)

    2013-07-23

    ... award performance and the effectiveness of the program as a whole. The respondents are the Principal Investigators of the awards, along with their institutional business officials. The awards are administered by... costs to respondents other than their time. The estimated annualized burden hours are 72. Estimated...

  7. Research Review of the Institute of African Studies - Vol 24, No 1 ...

    African Journals Online (AJOL)

    Politicization, Elite Manipulation, or Institutional Weaknesses? The Search for Alternative Explanations to the Dagbon Chieftaincy Disputes in Northern Ghana · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. AS Anamzoya, 1-25. http://dx.doi.org/10.4314/rrias.v24i1.22974 ...

  8. Liver lesions in children post-oncologic therapy: Review of case reports and institutional observation

    OpenAIRE

    Rebecca Gologorsky; Victor Wong; W Nathan Holmes; Asghar Haider; David K Imagawa; Lilibeth R Torno

    2015-01-01

    Purpose: Focal nodular hyperplasia (FNH), a benign hepatic tumor with ill-defined etiology, has been increasingly reported in children treated for extra-hepatic malignancies. Serial imaging or biopsy may be needed when survivors present with liver lesions. This study aims to review the literature, compare them with our institution’s cohort and propose a less invasive diagnostic imaging modality for FNH utilizing Magnetic resonance imaging (MRI) with gadoxetate disodium. Methods: We reviewed 1...

  9. A review of research activities at the Research Reactor Institute of Kyoto University in view of research publication information

    International Nuclear Information System (INIS)

    Takeuchi, Takayuki; Mizuma, Mitsuo; Kimura, Itsuro.

    1995-01-01

    A database of research publication was constructed for the purpose of grasping all of the research activities at the Research Reactor Institute, Kyoto University. The database named KURRIP collects all of the research publications of the Institute by not only its own staff but also visiting scientists. The publications are in the form of original papers, review papers, papers in proceedings, short notes and letters, synopses over 3 pages presented orally at scientific meeting, books and doctoral theses. At present, the KURRIP database contains the information on 6,210 items which have been published for 30 years since the Institute was established as an interuniversity research institute for joint use of a research reactor and other related large facilities in 1963. By utilizing the KURRIP database, the analyses have been done: (1) affiliation of the authors, (2) kind of publications, (3) classification of publishers, (4) research fields, and (5) experimental facilities. The KURRIP database is now stored in the Data Processing Center of Kyoto University and can be utilized through a computer center at one of the main national universities in Japan. (author)

  10. Review of Literature for Inputs to the National Water Savings Model and Spreadsheet Tool-Commercial/Institutional

    Energy Technology Data Exchange (ETDEWEB)

    Whitehead, Camilla Dunham; Melody, Moya; Lutz, James

    2009-05-29

    Lawrence Berkeley National Laboratory (LBNL) is developing a computer model and spreadsheet tool for the United States Environmental Protection Agency (EPA) to help estimate the water savings attributable to their WaterSense program. WaterSense has developed a labeling program for three types of plumbing fixtures commonly used in commercial and institutional settings: flushometer valve toilets, urinals, and pre-rinse spray valves. This National Water Savings-Commercial/Institutional (NWS-CI) model is patterned after the National Water Savings-Residential model, which was completed in 2008. Calculating the quantity of water and money saved through the WaterSense labeling program requires three primary inputs: (1) the quantity of a given product in use; (2) the frequency with which units of the product are replaced or are installed in new construction; and (3) the number of times or the duration the product is used in various settings. To obtain the information required for developing the NWS-CI model, LBNL reviewed various resources pertaining to the three WaterSense-labeled commercial/institutional products. The data gathered ranged from the number of commercial buildings in the United States to numbers of employees in various sectors of the economy and plumbing codes for commercial buildings. This document summarizes information obtained about the three products' attributes, quantities, and use in commercial and institutional settings that is needed to estimate how much water EPA's WaterSense program saves.

  11. Measuring inconsistency in research ethics committee review.

    Science.gov (United States)

    Trace, Samantha; Kolstoe, Simon Erik

    2017-11-28

    The review of human participant research by Research Ethics Committees (RECs) or Institutional Review Boards (IRBs) is a complex multi-faceted process that cannot be reduced to an algorithm. However, this does not give RECs/ IRBs permission to be inconsistent in their specific requirements to researchers or in their final opinions. In England the Health Research Authority (HRA) coordinates 67 committees, and has adopted a consistency improvement plan including a process called "Shared Ethical Debate" (ShED) where multiple committees review the same project. Committee reviews are compared for consistency by analysing the resulting minutes. We present a description of the ShED process. We report an analysis of minutes created by research ethics committees participating in two ShED exercises, and compare them to minutes produced in a published "mystery shopper" exercise. We propose a consistency score by defining top themes for each exercise, and calculating the ratio between top themes and total themes identified by each committee for each ShED exercise. Our analysis highlights qualitative differences between the ShED 19, ShED 20 and "mystery shopper" exercises. The quantitative measure of consistency showed only one committee across the three exercises with more than half its total themes as top themes (ratio of 0.6). The average consistency scores for the three exercises were 0.23 (ShED19), 0.35 (ShED20) and 0.32 (mystery shopper). There is a statistically significant difference between the ShED 19 exercise, and the ShED 20 and mystery shopper exercises. ShED exercises are effective in identifying inconsistency between ethics committees and we describe a scoring method that could be used to quantify this. However, whilst a level of inconsistency is probably inevitable in research ethics committee reviews, studies must move beyond the ShED methodology to understand why inconsistency occurs, and what an acceptable level of inconsistency might be.

  12. Ihtisab (Accountability in Waqf Institutions: A Review and Synthesis of Literature

    Directory of Open Access Journals (Sweden)

    Yasmin Umar Assegaf

    2013-12-01

    should be good in akhlak (moral and bring his members into a good akhlak too as akhlak is a key success for Islamic institutions. Due to the fact that Synthesis of ihtisab research findings has not been done so far, it is expected that this synthesis of the studies can be the basis for subsequent researchers to continue and develop this findings on the other dimensions of theories and models by developing Islamic science and Islamic empirical methods in line with shariah.

  13. Characteristics of Education Doctoral Dissertation References: An Inter-Institutional Analysis of Review of Literature Citations

    OpenAIRE

    Beile, Penny; Boote, David; Killingsworth, Elizabeth

    2003-01-01

    This study had two purposes: to examine the expertise of doctoral students in their use of the scholarly literature and to investigate the use of citation analysis as a tool for collection development. Analysis of 1,842 coded citations gleaned from 30 education dissertations awarded in 2000 from 3 institutions in the United States revealed that journal articles, at 45%, were cited most frequently, followed by monographs (33.9%) and "other" (18.3%), with magazines and Web sites contributing le...

  14. Оn the new procedure for the creation of the arbitration institution (introduction to review

    Directory of Open Access Journals (Sweden)

    Yuri Gerasimenko

    2017-01-01

    Full Text Available УДК 342.951+347.999This informational introductory article is devoted to the peculiarities of the procedure of creation of the arbitration institution according to the new 2015 Federal Law "On arbitration (arbitration proceedings". The aim of the article is the identification of the new law preconditions to the emergence of administrative barriers in the establishment of arbitral institutions. The study is based on methods of formal law, analysis and synthesis, the sociological method of survey is also used. The results and scope of the results. The article notes the objective difficulties in the establishment of arbitration institutions as well as provides a critical analysis of the innovations in 2015 Federal Law "On arbitration (arbitration proceedings in the Russian Federation". The procedure for creating the arbitration courts became more bureaucratic and it is focused on filtering such institutions by tightening the requirements. The procedure for creating the arbitration courts can be described as permissive and multi-stage. The second noticeable trend in the 2015 Federal Law is broad sphere of control over arbitration courts and substitution of their competence by a competent court. According to the results of a survey of representatives of the business community authors identify the legislative background of administrative barriers on a way of establishment of arbitration courts. The results of the study can be used in the improvement of legislative procedures for the estab-lishment of arbitration courts. Conclusions. New Law actually creates a "quasi-judicial" bodies, that have highest level of bureaucratization, so arbitration courts lose their main characteristics: contractual and dispositive principles. Novels of Law, aimed at stricter administration and control, are obvious, however, a new quality for arbitration as the most popular form of alternative dispute resolution is still not created.

  15. Ethics review as a component of institutional approval for a multicentre continuous quality improvement project: the investigator's perspective

    Directory of Open Access Journals (Sweden)

    von Dadelszen Peter

    2010-07-01

    Full Text Available Abstract Background For ethical approval of a multicentre study in Canada, investigators must apply separately to individual Research Ethics Boards (REBs. In principle, the protection of human research subjects is of utmost importance. However, in practice, the process of multicentre ethics review can be time consuming and costly, requiring duplication of effort for researchers and REBs. We used our experience with ethical review of The Canadian Perinatal Network (CPN, to gain insight into the Canadian system. Methods The applications forms of 16 different REBs were abstracted for a list of standardized items. The application process across sites was compared. Correspondence between the REB and the investigators was documented in order to construct a timeline to approval, identify the specific issues raised by each board, and describe how they were resolved. Results Each REB had a different application form. Most (n = 9 had a two or three step application process. Overall, it took a median of 31 days (range 2-174 days to receive an initial response from the REB. Approval took a median of 42 days (range 4-443 days. Privacy and consent were the two major issues raised. Several additional minor or administrative issues were raised which delayed approval. Conclusions For CPN, the Canadian REB process of ethical review proved challenging. REBs acted independently and without unified application forms or submission procedures. We call for a critical examination of the ethical, privacy and institutional review processes in Canada, to determine the best way to undertake multicentre review.

  16. Transformation impacts of dissolved and solid phase Fe(II) on trichloroethylene (TCE) reduction in an iron-reducing bacteria (IRB) mixed column system: a mathematical model.

    Science.gov (United States)

    Bae, Yeunook; Kim, Dooil; Cho, Hyun-Hee; Singhal, Naresh; Park, Jae-Woo

    2012-12-01

    In this research, we conducted trichloroethylene (TCE) reduction in a column filled with iron and iron-reducing bacteria (IRB) and developed a mathematical model to investigate the critical reactions between active species in iron/IRB/contaminant systems. The formation of ferrous iron (Fe(II)) in this system with IRB and zero-valent iron (ZVI, Fe(0)) coated with a ferric iron (Fe(III)) crust significantly affected TCE reduction and IRB respiration in various ways. This study presents a new framework for transformation property and reducing ability of both dissolved (Fe(II)(dissolved)) and solid form ferrous iron (Fe(II)(solid)). Results showed that TCE reduction was strongly depressed by Fe(II)(solid) rather than by other inhibitors (e.g., Fe(III) and lactate), suggesting that Fe(II)(solid) might reduce IRB activation due to attachment to IRB cells. Newly exposed Fe(0) from the released Fe(II)(dissolved) was a strong contributor to TCE reduction compared to Fe(II)(solid). In addition, our research confirmed that less Fe(II)(solid) production strongly supported long-term TCE reduction because it may create an easier TCE approach to Fe(0) or increase IRB growth. Our findings will aid the understanding of the contributions of iron media (e.g., Fe(II)(solid), Fe(II)(dissolved), Fe(III), and Fe(0)) to IRB for decontamination in natural groundwater systems. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. The impact of Cochrane Reviews: a mixed-methods evaluation of outputs from Cochrane Review Groups supported by the National Institute for Health Research.

    Science.gov (United States)

    Bunn, Frances; Trivedi, Daksha; Alderson, Phil; Hamilton, Laura; Martin, Alice; Pinkney, Emma; Iliffe, Steve

    2015-04-01

    The last few decades have seen a growing emphasis on evidence-informed decision-making in health care. Systematic reviews, such as those produced by Cochrane, have been a key component of this movement. The National Institute for Health Research (NIHR) Systematic Review Programme currently supports 20 Cochrane Review Groups (CRGs) in the UK and it is important that this funding represents value for money. The overall aim was to identify the impacts and likely impacts on health care, patient outcomes and value for money of Cochrane Reviews published by 20 NIHR-funded CRGs during the years 2007-11. We sent questionnaires to CRGs and review authors, undertook interviews with guideline developers (GDs) and used bibliometrics and documentary review to get an overview of CRG impact and to evaluate the impact of a sample of 60 Cochrane Reviews. The evaluation was guided by a framework with four categories (knowledge production, research targeting, informing policy development and impact on practice/services). A total of 3187 new and updated reviews were published on the Cochrane Database of Systematic Reviews between 2007 and 2011, 1502 (47%) of which were produced by the 20 CRGs funded by the NIHR. We found 40 examples where reviews appeared to have influenced primary research and reviews had contributed to the creation of new knowledge and stimulated debate. Twenty-seven of the 60 reviews had 100 or more citations in Google Scholar™ (Google, CA, USA). Overall, 483 systematic reviews had been cited in 247 sets of guidance. This included 62 sets of international guidance, 175 sets of national guidance (87 from the UK) and 10 examples of local guidance. Evidence from the interviews suggested that Cochrane Reviews often play an instrumental role in informing guidance, although reviews being a poor fit with guideline scope or methods, reviews being out of date and a lack of communication between CRGs and GDs were barriers to their use. Cochrane Reviews appeared to have led

  18. 77 FR 57079 - Notice of Submission for OMB Review; Institute of Education Sciences; Teaching and Learning...

    Science.gov (United States)

    2012-09-17

    ... countries review current policy and develop informed education policy by providing accurate and relevant... principals to provide their perspectives on the state of education in their own countries. Both teacher and... Records Management Services, Office of Management, publishes this notice containing proposed information...

  19. Beliefs about Post-Tenure Review; the Influence of Autonomy, Collegiality, Career Stage, and Institutional Context

    Science.gov (United States)

    O'Meara, Kerry Ann

    2004-01-01

    This article draws upon the literature on academic culture and the academic profession to provide a context for beliefs about post-tenure review. Schein's (1992) theory of organizational culture and Kuh & Whitt's (1988) application of cultural theory to higher education settings divides culture into a conceptual hierarchy comprised of three…

  20. Review of urban and industrial air quality. Assessments at the Finnish meteorological institute

    Energy Technology Data Exchange (ETDEWEB)

    Pohjola, V.; Pesonen, R.; Karstastenpaeae, R.; Rantakrans, E.; Kukkonen, J.; Jokinen, J.; Maekinen, E.; Saari, H.; Hiltunen, V. [Finnish Meteorological Inst., Helsinki (Finland). Air Quality Dept.

    1995-12-31

    Air quality in urban and industrial environments has been investigated at the Finnish Meteorological Institute since the early 1970`s. The studies have included emission surveys, air quality measurements, dispersion model computations and bioindicator surveys A substantial fraction of these studies has been done as commissioned work for communities, public institutions, industrial establishments and private enterprises Major resources have also been committed to the development of methods and expertise. The studies in the 1970` s were mainly dispersion model computations and air pollution measurements In the 1980`s research activities increased rapidly due to the national Clean Air Act (coming into force in 1982) and the adoption of national ambient air quality standards (1984). Since the year 1980. About 90 separate air pollution assessments have been conducted; and model computations have been made for most Finnish cities and major communities In many of the surveys in the 1980` s and the 1990`s. Integrated studies of local air quality, which contain the results obtained with emission surveys, dispersion model computations, air quality measurements and bioindicator methods have been conducted. This integrated approach provides more versatile and reliable results on the state of the environment. For instance, the reliability and accuracy of computations can be directly analysed using simultaneous air quality measurements. An overview of the experimental and computational methods used in the air quality surveys is presented here. To illustrate the application of the methods, some selected results from an air quality investigation conducted in a major city in central Finland are discussed. (author)

  1. Institutional property rights structure, common pool resource (CPR), tragedy of the urban commons: A Review

    International Nuclear Information System (INIS)

    Ling, G; Ho, C S; Ali, H M

    2014-01-01

    There have been a plethora of researches on the significance of public open space (POS) in contributing to societies' sustainability. However, by virtue of identified maladaptive policy-based-property rights structure, such a shared good becomes vulnerable to tragedy of the urban commons (overexploitation) that subsequently leads to burgeoning number of mismanaged POS e.g., degraded and unkempt urban public spaces. By scrutinising the literatures within property rights domain and commons resources, an objective is highlighted in this paper which is to insightfully discourse institutional property rights structure pertaining to the mechanism, roles and interrelationship between property-rights regimes, bundle of property rights and resource domains; types of goods on how they act upon and tie in the POS with the social quandary. In summary, urban POS tragedy can potentially be triggered by the institutional structure especially if the ownership is left under open-access resource regime and ill-defined property rights which both successively constitute the natures of Common Pool Resource (CPR) within the commons, POS. Therefore, this paper sparks an idea to policy makers that property rights structure is a determinant in sustainably governing the POS in which adaptive assignment of property regimes and property rights are impelled

  2. Institutional property rights structure, common pool resource (CPR), tragedy of the urban commons: A Review

    Science.gov (United States)

    Ling, G.; Ho, C. S.; Ali, H. M.

    2014-02-01

    There have been a plethora of researches on the significance of public open space (POS) in contributing to societies' sustainability. However, by virtue of identified maladaptive policy-based-property rights structure, such a shared good becomes vulnerable to tragedy of the urban commons (overexploitation) that subsequently leads to burgeoning number of mismanaged POS e.g., degraded and unkempt urban public spaces. By scrutinising the literatures within property rights domain and commons resources, an objective is highlighted in this paper which is to insightfully discourse institutional property rights structure pertaining to the mechanism, roles and interrelationship between property-rights regimes, bundle of property rights and resource domains; types of goods on how they act upon and tie in the POS with the social quandary. In summary, urban POS tragedy can potentially be triggered by the institutional structure especially if the ownership is left under open-access resource regime and ill-defined property rights which both successively constitute the natures of Common Pool Resource (CPR) within the commons, POS. Therefore, this paper sparks an idea to policy makers that property rights structure is a determinant in sustainably governing the POS in which adaptive assignment of property regimes and property rights are impelled.

  3. Annual review of the Institute of Plasma Physics, Nagoya University, for fiscal 1987

    International Nuclear Information System (INIS)

    Akaishi, K.; Midzuno, Y.; Namba, C.

    1988-01-01

    During the past three years, the Institute acquired 47ha of land for the new site in Toki City. The new plan of a large helical system which will be undertaken in the Toki site has been developed by a special committee under the Ministry of Education, Science and Culture. After the 11th IAEA Conference held in Kyoto last autumn, the Institute started under the new organization in order to concentrate effort to the comprehensive study on toroidal confinement including the design study of the large herical system. The new organization and the related research program in this fiscal year were torus projects (NTX/JIPP T-11U tokamak, compact helical system, advanced torus experiment), RF heating, plasma and fusion technologies, theory and computer simulation, various centers and others. This report presents the summary of these research subjects. Nagoya torus experiment (NTX) and helical island diverter experiment (HIDEX) using the JIPP T-11U device, the compact helical system of Torsatron/Heliotron type, the RF system for fast wave current drive and ion Bernstein wave heating experiments in JIPP T-11U, wall-plasma interaction, NBI heating, the development of a long pulse positive ion source and a high current negative ion source, tritium diffusion and so on are reported. (K.I.)

  4. Annual review of the Institute of Plasma Physics, Nagoya University, for fiscal 1983

    International Nuclear Information System (INIS)

    1984-01-01

    As to the reacting plasma project, the design team performed the extensive analysis of highly elongated, high β plasma configuration in fiscal 1983. As physical issues, the experiments on lower hybrid wave current start-up and ion Bernstein wave heating were successfully carried out in the JIPP-T-2U tokamak device. For the research and development related to reacting plasma, a 1/4 module of a 120 keV neutral beam system was completed. The construction of a tritium handling facility, the development of fast pulsed superconduction and the development of new aluminum alloys were accomplished as the results of 3-year preparatory program ending in 1983. The Institute also tried to pursue the alternative concept on fusion plasma research by organizing the program based on a low β toroidal system, radio frequency containment, high energy beam experiment, Nagoya bumpy torus and high β pinch plasma. The scientific activities of the Institute related to reacting plasma physics, various preparatory experiments, various basic studies and plasma theory and computation are reported. Also the services of the Computer Center, the Research Information Center and other facilities are described. (Kako, I.)

  5. Review of urban and industrial air quality. Assessments at the Finnish meteorological institute

    Energy Technology Data Exchange (ETDEWEB)

    Pohjola, V; Pesonen, R; Karstastenpaeae, R; Rantakrans, E; Kukkonen, J; Jokinen, J; Maekinen, E; Saari, H; Hiltunen, V [Finnish Meteorological Inst., Helsinki (Finland). Air Quality Dept.

    1996-12-31

    Air quality in urban and industrial environments has been investigated at the Finnish Meteorological Institute since the early 1970`s. The studies have included emission surveys, air quality measurements, dispersion model computations and bioindicator surveys A substantial fraction of these studies has been done as commissioned work for communities, public institutions, industrial establishments and private enterprises Major resources have also been committed to the development of methods and expertise. The studies in the 1970` s were mainly dispersion model computations and air pollution measurements In the 1980`s research activities increased rapidly due to the national Clean Air Act (coming into force in 1982) and the adoption of national ambient air quality standards (1984). Since the year 1980. About 90 separate air pollution assessments have been conducted; and model computations have been made for most Finnish cities and major communities In many of the surveys in the 1980` s and the 1990`s. Integrated studies of local air quality, which contain the results obtained with emission surveys, dispersion model computations, air quality measurements and bioindicator methods have been conducted. This integrated approach provides more versatile and reliable results on the state of the environment. For instance, the reliability and accuracy of computations can be directly analysed using simultaneous air quality measurements. An overview of the experimental and computational methods used in the air quality surveys is presented here. To illustrate the application of the methods, some selected results from an air quality investigation conducted in a major city in central Finland are discussed. (author)

  6. Cysts of the periapical region in children: A 19-year institutional review

    Directory of Open Access Journals (Sweden)

    Ajay Telang

    2009-01-01

    Full Text Available Background: There are very few studies that have been done specifically on cysts of the periapical region in children. Aim: To do a retrospective analysis of specimens received as cysts of periapical region in children. Design: A Total of 3142 oral biopsies received over a period of 19 years (1987- 2005 at the department of oral pathology A.B. Shetty Memorial Institute of Dental Sciences, Derelakatte, Mangalore, India were retrieved and all paediatric oral biopsies were further histopathologically analyzed. Results: Our study found that 39% of the total paediatric oral biopsies received were cysts and the commonest cyst was radicular cyst (43.3% followed by dentigerous cyst (20.6′0, odontogenic keratocyst (8.6′0 and lateral periodontal cyst (1.7% which was different from most reported studies. Conclusion: Radicular cyst is the commonest cyst reported in this study which is different from most reported studies probably because of the type of biopsies received at our institute.

  7. The Impacts of State Performance Funding Systems on Higher Education Institutions: Research Literature Review and Policy Recommendations. CCRC Working Paper No. 37

    Science.gov (United States)

    Dougherty, Kevin J.; Reddy, Vikash

    2011-01-01

    Over the past three decades policymakers have been seeking new ways to secure improved performance from higher education institutions. One popular approach has been performance funding, which involves use of a formula to tie funding to institutional performance on specified indicators. This report reviews findings from studies on performance…

  8. The role of universities and other institutions in successful entrepreneurship:Some insights from a literature review

    Directory of Open Access Journals (Sweden)

    German A. Zarate - Hoyos

    2015-12-01

    Full Text Available The purpose of this paper is to analyze the role of universities and other institutions in successful entrepreneurship. Insights are obtained following a literature review approach. Case studies from the United States (New York startup, Spain (Mondragon, and Germany provide strong evidence that universities are very instrumental in the creation, design and implementation of entrepreneurial initiatives by providing new and ongoing entrepreneurs with human capital training, fundamentals, and theoretical and empirical models to contribute to lasting businesses. Results from university research on gender and risk-issues lead to believe that women are more risk averse than men to work and invest in star-up businesses. Other institutions, such as governments, are critical to provide with the necessary incentives to launch start-up businesses, including tax cuts, seed capital funding, investment in human capital, etc. While the evidence supporting the links between education and entrepreneurial outcomes is promisi g it is not yet definitive. In addition to providing a review of existing research, this paper suggests an integrative framework for future research.

  9. [Burden of relatives and their expectations towards psychiatric institutions. A review of the literature and own results].

    Science.gov (United States)

    Schmid, R; Spiessl, H; Vukovich, A; Cording, C

    2003-03-01

    This article aimed to provide an overview regarding the burden of relatives of mentally ill patients and their expectations towards psychiatric institutions. The literature was selected from Medline covering the years 1996 - 2002. 342 articles were reviewed, 145 of which were described in this review. The burden of relatives are manifold and can be classified into the following categories: time spent on caring, financial difficulties, occupational restrictions, detrimental effects on relatives own physical and psychological well-being, reduction in leisure activities, negative effects on social relationships, experiences of discrimination and refusal, deficiencies in information about illness, feelings of not being taken seriously, insufficient service support, long distance to mental health service, emotional burdens of caregivers and difficulties with the patients behaviour. The expectations of the relatives mainly refer to the categories "relationship between staff and relatives", "information about illness" and "establishing of institutions required". The various burdens of relatives and their expectations towards psychiatric services point to necessary improvements of mental health services in the sense of a consumer-oriented psychiatric care.

  10. Annual review of the Institute of Plasma Physics, Nagoya University, for fiscal 1978

    International Nuclear Information System (INIS)

    1979-01-01

    Activities of Institute of Plasma Physics, Nagoya University, from April 1978 to March 1979, are described in individual short summaries. As a main project, the JIPP T-II program aims at confinement and heating of hot plasmas in a tokamak/stellarator hybrid system. The STP-3 system for high beta pinch plasma has now almost been completed. Installation of the RFC-XX is now complete with the delivery of two rf oscillators for point cusp plugs. In high energy beam experiment, toroidal magnetic configurations maintained by intense relativistic currents were demonstrated. The Nagoya Bumpy Torus is a race track convertible to a circular torus. In parallel with the above research projects, there continued experiments on basic plasma physics, laser-produced plasma, the atomic processes and the surface physics related to the plasma-wall interaction. Theoretical and computational divisions worked in close collaboration with the above. (J.P.N.)

  11. Monte Carlo technique applications in field of radiation dosimetry at ENEA radiation protection institute: A Review

    International Nuclear Information System (INIS)

    Gualdrini, G.F.; Casalini, L.; Morelli, B.

    1994-12-01

    The present report summarizes the activities concerned with numerical dosimetry as carried out at the Radiation Protection Institute of ENEA (Italian Agency for New Technologies, Energy and the Environment) on photon dosimetric quantities. The first part is concerned with MCNP Monte Carlo calculation of field parameters and operational quantities for the ICRU sphere with reference photon beams for the design of personal dosemeters. The second part is related with studies on the ADAM anthropomorphic phantom using the SABRINA and MCNP codes. The results of other Monte Carlo studies carried out on electron conversion factors for various tissue equivalent slab phantoms are about to be published in other ENEA reports. The report has been produced in the framework of the EURADOS WG4 (numerical dosimetry) activities within a collaboration between the ENEA Environmental Department and ENEA Energy Department

  12. Evolving Management of Symptomatic Chronic Subdural Hematoma: Experience of a Single Institution and Review of the Literature

    Science.gov (United States)

    Balser, David; Rodgers, Shaun D.; Johnson, Blair; Shi, Chen; Tabak, Esteban; Samadani, Uzma

    2015-01-01

    Objective Chronic subdural hematoma has an increasing incidence and results in high morbidity and mortality. We review here the ten-year experience of a single institution and the literature regarding the treatment and major associations of chronic subdural hematoma (cSDH). Methods We retrospectively reviewed all cSDHs surgically treated from 2000 to 2010 at our institution to evaluate duration from admission to treatment, type of treatment, length of stay in critical care, length of stay in the hospital and recurrence. The literature was reviewed with regards to incidence, associations and treatment of cSDH. Results From 2000–2008, 44 patients were treated with burr holes. From 2008 to 2010, 29 patients were treated with twist drill evacuation (SEPS). 4 patients from each group were readmitted for reoperation (9% vs. 14%; p=.53). The average time to intervention for SEPS (11.2±15.3 hrs) was faster than for burr holes (40.3±69.1 hrs) (p=.02). The total hospital LOS was shorter for SEPS (9.3±6.8 days) versus burr holes (13.4±10.2 days) (p=.04); both were significantly longer than for a brain tumor patient undergoing craniotomy (7.0±0.5 days, n=94, P<.01). Conclusion Despite decreasing lengths of stay over time as treatment for cSDH evolved from burr holes to SEPS, the length of stay for a cSDH is still greater than that of a patient undergoing craniotomy for brain tumor. We noted 11% recurrence in our series of patients, which included individuals who recurred as late as 3 years after initial diagnosis. PMID:23485050

  13. The Value of a Resident Aesthetic Clinic: A 7-Year Institutional Review and Survey of the Chief Resident Experience.

    Science.gov (United States)

    Weissler, Jason M; Carney, Martin J; Yan, Chen; Percec, Ivona

    2017-10-16

    With the evolving plastic surgery training paradigm, there is an increasing emphasis on aesthetic surgery education during residency. In an effort to improve aesthetic education and to encourage preparation for independent practice, our institution has supported a resident-run aesthetic clinic for over two decades. To provide insight into the educational benefits of a resident-run cosmetic clinic through longitudinal resident follow up and institutional experiential review. A retrospective review was conducted to identify all clinic-based aesthetic operations performed between 2009 and 2016. To capture residents' perspectives on the cosmetic resident clinic, questionnaires were distributed to the cohort. Primary outcome measures included: volume and types of cases performed, impact of clinic experience on training, confidence level performing cosmetic procedures, and satisfaction with chief clinic. Unpaired t tests were calculated to compare case volume/type with level of confidence and degree of preparedness to perform cosmetic procedures independently. Overall, 264 operations performed by 18 graduated chief residents were reviewed. Surveys were distributed to 28 chief residents (71.4% completion rate). Performing twenty or more clinic-based procedures was associated with higher levels of preparedness to perform cosmetic procedures independently (P = 0.037). Residents reported the highest confidence when performing cosmetic breast procedures when compared to face/neck (P = 0.005), body/trunk procedures (P = 0.39), and noninvasive facial procedures (P = 0.85). The continued growth of aesthetic surgery highlights the need for comprehensive training and preparation for the new generation of plastic surgeons. Performing cosmetic procedures in clinic is a valuable adjunct to the traditional educational curriculum and increases preparedness and confidence for independent practice. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission

  14. Primary intracranial soft tissue sarcomas in children, adolescents, and young adults: single institution experience and review of the literature.

    Science.gov (United States)

    Maher, Ossama M; Khatua, Soumen; Mukherjee, Devashis; Olar, Adriana; Lazar, Alexander; Luthra, Raja; Liu, Diane; Wu, Jimin; Ketonen, Leena; Zaky, Wafik

    2016-03-01

    There is a paucity of literature reporting the outcome of intracranial sarcomas (IS) in children, adolescents, and young adults (CAYA). A multimodal therapeutic approach is commonly used, with no well-established treatment consensus. We conducted a retrospective review of CAYA with IS, treated at our institution, to determine their clinical findings, treatments, and outcomes. Immunohistochemistry (PDGFRA and EGFR) and DNA sequencing were performed on 5 tumor samples. A literature review of IS was also conducted. We reviewed 13 patients (median age, 7 years) with a primary diagnosis of IS between 1990 and 2015. Diagnoses included unclassified sarcoma (n = 9), chondrosarcoma (n = 2), and rhabdomyosarcoma (n = 2). Five patients underwent upfront gross total resection (GTR) of the tumor. The 5-drug regimen (vincristine, doxorubicin, cyclophosphamide, etoposide, and ifosfamide) was the most common treatment used. Nine patients died due to progression or recurrence (n = 8) or secondary malignancy (n = 1). The median follow-up period of the 4 surviving patients was 1.69 years (range 1.44-5.17 years). The 5-year progression-free survival and overall survival rates were 21 and 44 %, respectively. BRAF, TP53, KRAS, KIT, ERBB2, MET, RET, ATM, and EGFR mutations were detected in 4 of the 5 tissue samples. All 5 samples were immunopositive for PDGFRA, and only 2 were positive for EGFR. IS remain a therapeutic challenge due to high progression and recurrence rates. Collaborative multi-institutional studies are warranted to delineate a treatment consensus and investigate tumor biology to improve the disease outcome.

  15. Desarrollo de una interfaz para el control del robot IRB desde Matlab

    OpenAIRE

    Gutiérrez Corbacho, Azahara

    2014-01-01

    El objetivo de este proyecto es realizar la comunicación con el brazo robótico, IRB120 de ABB, a través de la herramienta de software matemático Matlab. Para ello desarrollaremos un socket de comunicación, que se encargará enviar y procesar los datos. Para comprobar que la comunicación funciona y que el envío de datos se realiza correctamente, se implementarán en Matlab, una serie de interfaces de comunicación con el robot y una aplicación final. La primera, será una interfaz gráfica r...

  16. Groundwater socio-ecology and governance: a review of institutions and policies in selected countries

    Science.gov (United States)

    Mukherji, Aditi; Shah, Tushaar

    2005-03-01

    Groundwater is crucial for the livelihoods and food security of millions of people, and yet, knowledge formation in the field of groundwater has remained asymmetrical. While, scientific knowledge in the discipline (hydrology and hydrogeology) has advanced remarkably, relatively little is known about the socio-economic impacts and institutions that govern groundwater use. This paper therefore has two objectives. The first is to provide a balanced view of the plus and the down side of groundwater use, especially in agriculture. In doing so, examples are drawn from countries such as India, Pakistan, Bangladesh, China, Spain and Mexico—all of which make very intensive use of groundwater. Second, institutions and policies that influence groundwater use are analyzed in order to understand how groundwater is governed in these countries and whether successful models of governance could be replicated elsewhere. Finally, the authors argue that there is a need for a paradigm shift in the way groundwater is presently perceived and managed—from management to governance mode. In this attempt, a number of instruments such as direct regulation, indirect policy levers, livelihood adaptation and people's participation will have to be deployed simultaneously in a quest for better governance. L'eau souterraine est cruciale pour la survie et la sécurité alimentaire de plusieurs millions de personnes mais cependant la foramtion en matière d'eaux souterraines reste asymmétrique. Alors que la connaissance scientifique dans la discipline (hydrologie et hydrogéologie) a avancée de manière remarquable, on connaît peu de choses sur les impacts socio-économiques et les institutions qui gouvernent l'utilisation des eaux souterraines. Cet article a par conséquent deux objectifs. Le premier est d'assurer un point de vue balancé entre le côté positif et le côté négatif de l'utilisation de l'eau souterraine, spécialement en agriculture. De cette manière, des exemples d

  17. Institutional barriers to DSM (demand side management): Reviewing the regulatory bargain

    Energy Technology Data Exchange (ETDEWEB)

    Warwick, W.M.

    1990-09-01

    The paper discusses traditional arguments for utility regulation in the context of the current utility environment. It reviews several DSM delivery options using a matrix of key financial considerations for utilities and consumers. The strengths and weaknesses of each option are discussed and an assessment of current prospects for DSM implementation is provided. The premise of the paper is that adoption of DSM by utilities and consumers has lagged because of technical and behavioral uncertainties. In addition, regulatory practices and DSM delivery mechanisms have not provided adequate means to extract the benefits of DSM and allocate the risks in a way that offers clear advantages over generating options. The paper concludes with a brief discussion of the potential for value of service approaches to resolve these problems.

  18. Barriers to cross--institutional health information exchange: a literature review.

    Science.gov (United States)

    Edwards, Ashley; Hollin, Ilene; Barry, Jeffrey; Kachnowski, Stan

    2010-01-01

    While the development of health information technology, particularly electronic health records (EHR), is a triumph for the advancement of healthcare, non-interoperable clinical data systems lead to fragmented communication and incomplete records. If interoperable HIT systems could be achieved integrated HIT could be leveraged to lessen medical errors, improve patient care and optimize epidemiological research. To understand the barriers to interoperability or health information exchange (HIE), we reviewed the literature on HIT and barriers to HIE. Our search yielded 492 articles, 25 meeting our inclusion criteria. In general, we found that the predominant barriers to HIE are need for standards, security concerns, economic loss to competitors, and federated systems. Research on interoperability is limited because most HIE programs are still in formative stages. More research is needed to fully understand interoperability of HIT, how to overcome the barriers to interoperability, and how to design HIT to better facilitate HIE.

  19. Breast cancer amongst Filipino migrants: a review of the literature and ten-year institutional analysis.

    Science.gov (United States)

    Simpson, Jory S; Briggs, Kaleigh; George, Ralph

    2015-06-01

    As one migrates from an area of low to high incidence of breast cancer their personal risk of developing breast cancer increases. This is however not equally distributed across all races and ethnicities. This paper specifically examines Filipino migrants. A literature review was conducted to summarize breast cancer incidence, screening practices and trends in treatment amongst Filipino migrants. In addition, a retrospective cohort study was conducted specifically examining the age in which Filipino women were diagnosed with breast cancer compared to Asian and Caucasian counterparts. Filipino women are diagnosed with breast cancer at a statistically significant younger age (53.2) compared to their Asian (55.1) and Caucasian (58.4) counterparts. In addition, they are at an increased risk of developing more aggressive breast cancer with noteworthy disparities in the care they are receiving. The evidence suggest this group is worthy of special focus when diagnosing and treating breast cancer.

  20. Constructive staff-family relationships in the care of older adults in the institutional setting: A systematic review.

    Science.gov (United States)

    Haesler, Emily; Bauer, Michael; Nay, Rhonda

    2004-01-01

    lists of studies retrieved during the first search stage. The search was limited to published and unpublished material in English language. The review was limited to studies involving residents and patients within acute, subacute, rehabilitation and residential settings, aged over 65 years, their family and health care staff. Papers addressing family members and health care staff perceptions of their relationships with each other were considered for this review. Studies in this review also included those relating to interventions to promote constructive staff-family relationships including organisational strategies, staff-family meetings, case conferencing, environmental approaches etc. The review considered both quantitative and qualitative research and opinion papers for inclusion. All retrieved papers were critically appraised for eligibility for inclusion and methodological quality independently by two reviewers, and the same reviewers collected details of eligible research. Appraisal forms and data extraction forms designed by the Joanna Briggs Institute as part of the QARI and NOTARI systematic review software packages were used for this review. Family members' perceptions of their relationships with staff showed that a strong focus was placed on opportunities for the family to be involved in the patient's care. Staff members also expressed a theoretical support for the collaborative process, however this belief often did not translate to the staff members' clinical practice. In the studies included in the review staff were frequently found to rely on traditional medical models of care in their clinical practice and maintaining control over the environment, rather than fully collaborating with families. Four factors were found to be essential to interventions designed to support a collaborative partnership between family members and health care staff: communication, information, education and administrative support. Based on the evidence analysed in this

  1. Cow-related trauma: a 10-year review of injuries admitted to a single institution.

    LENUS (Irish Health Repository)

    Murphy, Colin G

    2012-02-01

    INTRODUCTION: Bovine-related injuries to farmers are common in rural communities. Many injuries are significant requiring hospital admission and surgery. We reviewed all cattle-related injuries admitted to a regional trauma centre over 10 years and detail the nature of the injuries. METHOD: A retrospective review was undertaken, using hospital inpatient coding system (HIPE) to identify patients admitted following cow-related trauma for the last 10 years. From retrieved charts mechanism of injury was identified, demographics recorded and Injury Severity Score (ISS) and Trauma Injury Severity Score (TRISS) calculated based on the injuries sustained. RESULTS: 47 patients were identified, with a median age of 53 years. 4 injuries occurred in children, and 12 in patients over 65 years old. Three-quarters of those injured were male. Kicking was the most common mechanism of injury (n=21), but charge\\/head-butt injuries and trampling injuries were associated with more serious injury scores. 72% of patients were admitted under Orthopaedics as their primary care team, 25% under General Surgeons, with one patient admitted medically. Mean ISS score was 6.9 (range 1-50). 41 operative interventions were performed on 30 patients during their admission. 6.3% of patients required admission to Intensive Care with a mean length of stay of 12.3 days (range 2-21 days). There was no mortality. CONCLUSION: Cow-related trauma is a common among farming communities and is a potentially serious mechanism of injury that appears to be under-reported in a hospital context. Bovine-related head-butt and trampling injuries should be considered akin to high-velocity trauma.

  2. Factors associated with the utilization of institutional and home birth services among women in Ethiopia: A scoping review

    Directory of Open Access Journals (Sweden)

    Bronwyn Lapp

    2016-12-01

    Full Text Available Objective: To examine the factors associated with the use of institutional delivery and home birth services among women in Ethiopia. Methods: Fifteen peer-reviewed, primary research articles published between 2011 and 2015 were selected for this scoping review. The articles included case-control, cross-sectional, and retrospective follow-up studies conducted in Ethiopia. Results: Findings were categorized with use of content and factorial analysis. The data in this scoping review revealed a significant inequality in skilled care use among Ethiopian women with differences in economic status, education, residence, autonomy in decision making, parity, and antenatal care attendance. Conclusion: Sociodemographic, accessibility, and obstetric factors are key determinants of skilled care utilization. Strategies and policy changes to address maternal health service use should aim to improve economic status, facilitate higher education, increase access to care, promote the empowerment of women, and enhance antenatal care initiatives. Additional research should be conducted to evaluate the influence of the media and culture on skilled care utilization, since few studies have examined these factors.

  3. Gamma knife radiosurgery for typical trigeminal neuralgia: An institutional review of 108 patients

    Science.gov (United States)

    Elaimy, Ameer L.; Lamm, Andrew F.; Demakas, John J.; Mackay, Alexander R.; Lamoreaux, Wayne T.; Fairbanks, Robert K.; Pfeffer, Robert D.; Cooke, Barton S.; Peressini, Benjamin J.; Lee, Christopher M.

    2013-01-01

    Background: In this study, we present the previously unreported pain relief outcomes of 108 patients treated at Gamma Knife of Spokane for typical trigeminal neuralgia (TN) between 2002 and 2011. Methods: Pain relief outcomes were measured using the Barrow Neurological Institute (BNI) pain intensity scale. In addition, the effects gender, age at treatment, pain laterality, previous surgical treatment, repeat Gamma Knife radiosurgery (GKRS), and maximum radiosurgery dose have on patient pain relief outcomes were retrospectively analyzed. Statistical analysis was performed using Andersen 95% confidence intervals, approximate confidence intervals for log hazard ratios, and multivariate Cox proportional hazard models. Results: All 108 patients included in this study were grouped into BNI class IV or V prior to GKRS. The median clinical follow-up time was determined to be 15 months. Following the first GKRS procedure, 71% of patients were grouped into BNI class I-IIIb (I = 31%; II = 3%; IIIa = 19%; IIIb = 18%) and the median duration of pain relief for those patients was determined to be 11.8 months. New facial numbness was reported in 19% of patients and new facial paresthesias were reported in 7% of patients after the first GKRS procedure. A total of 19 repeat procedures were performed on the 108 patients included in this study. Following the second GKRS procedure, 73% of patients were grouped into BNI class I-IIIb (I = 44%; II = 6%; IIIa = 17%, IIIb = 6%) and the median duration of pain relief for those patients was determined to be 4.9 months. For repeat procedures, new facial numbness was reported in 22% of patients and new facial paresthesias were reported in 6% of patients. Conclusions: GKRS is a safe and effective management approach for patients diagnosed with typical TN. However, further studies and supporting research is needed on the effects previous surgical treatment, number of radiosurgery procedures, and maximum radiosurgery dose have on GKRS clinical

  4. Review of institutional and socioeconomic issues for radioactive waste repository siting

    International Nuclear Information System (INIS)

    Copenhaver, E.D.; Carnes, S.A.; Soderstrom, E.J.; Sorensen, J.H.; Peelle, E.; Bjornstad, D.J.

    1982-01-01

    In recent years, the importance of social and institutional issues in the siting of radioactive waste management repositories has been recognized. This study deals with the possibility of using incentives to assist in siting repositories and outlines some of their uses, limitations, and preconditions. Limited survey data and other studies indicate that incentives may help encourage people to formulate positive positions on radioactive waste repositories. In an overall siting strategy, incentives are just one part of a structured process involving the creation of a mutually acceptable set of arrangements that make certain guarantees and confer certain benefits in exchange for the acceptance of the proposed facility. Because the range of needs to be fulfilled is varied, a package of incentives is likely to be more acceptable than any one single incentive. The purpose of incentives is to encourage local approval by minimizing and redressing costs and providing missing benefits. Most previous discussions of incentives have emphasized mitigation mechanisms only. This paper also identifies compensation, incentives, and criteria by which compensation or an incentive system can be evaluated. The study provides the means by which incentives can be identified, assessed, negotiated, and implemented by affected parties and attempts to show where incentives fit into an overall siting strategy by developing a classification scheme and an analytical framework that capture: (1) the preconditions that must exist before any incentive system can be considered; (2) the objective features of an incentive; such as adequacy and ease of administration; (3) community perceptions of an incentive, such as interpretability and relevance; and (4) the consequences of implementing an incentive, such as distributional effects and conflict and consensus. 38 references, 1 figure, 2 tables

  5. Iodine-125 seed brachytherapy for early stage prostate cancer: a single-institution review

    International Nuclear Information System (INIS)

    Zuber, Simon; Weiß, Susan; Baaske, Dieter; Schöpe, Michael; Stevens, Simon; Bodis, Stephan; Zwahlen, Daniel R

    2015-01-01

    We are reporting the five-year biochemical control, toxicity profile and dosimetric parameters using iodine-125 low dose rate brachytherapy (BT) as monotherapy for early stage prostate cancer at a single institution. Between April 2006 and December 2010, 169 men with early stage prostate cancer were treated with BT. Biochemical failure was defined using the Phoenix definition (nadir + 2 ng/mL). Treatment-related morbidities, including urinary, rectal and sexual function, were measured, applying the International Prostate Symptom Score (IPSS), the 7-grade Quality of Life Scale (QoL) and medical status, the International Consultation on Incontinence Modular Questionnaire (ICIQ), the International Index of Erectile Function (IIEF-5) and the Common Terminology Criteria for Adverse Events (CTCAE v4.03). Seed migration and loss, dosimetric parameters and learning effects were also analyzed. Medium follow-up time was 50 months (range, 1–85 months). The five-year biochemical failure rate was 7%. Acute proctitis rates were 19% (grade 1) and 1% (grade 2), respectively. The overall incidence of incontinence was 19% (mild), 16% (moderate) and < 1% (severe). An increase in IPSS ≥ 5 points was detected in 59% of patients, with 38% regaining their baseline. Seed dislocation was found in 24% of patients and correlated with D90 and V100. A learning curve was found for seed migration, D90 and V100. QoL correlated with the general health condition of patient, incontinence symptoms and IPSS. BT for early stage prostate cancer offers excellent five-year biochemical control with low toxicities. QoL aspects are favorable. A learning curve was detected for procedural aspects but its impact on patient relevant endpoints remains inconclusive

  6. Radiation treatment for medulloblastoma. A review of 64 cases at a single institute

    International Nuclear Information System (INIS)

    Liu Yueping; Gao Li; Xu Guozhen; Yi Junhin; Liu Xinfan; Li Yexiong

    2005-01-01

    Although the optimal treatment mode for medulloblastoma is frequently discussed, results based on large series of cases, especially those treated in Asia, have rarely been reported. Our purpose was to evaluate the efficacy of postoperative radiation therapy, and to identify prognostic factors, in a relatively large cohort of patients with limited-stage medulloblastoma treated at a single institute in China. Between January 1996 and April 2001, 69 patients with Chang stage M0/M1 medulloblastoma were referred to our hospital for radiation therapy after total or subtotal resection of the primary tumor. All patients received 30 Gy to the craniospinal axis followed by a 20-25 Gy boost to the posterior fossa (median fraction, 1.8 Gy). Sixty-four patients were followed for a median period of 38.5 months. The rates of 3-year and 5-year overall survival were 68.8% and 55.7%, respectively; corresponding disease-free survival were 57.8% and 51.4%, respectively. Patients who had received radiation treatment within 25 days after resection had a greater probability of 3-year survival (81.5% versus 59.5%; P=0.11) and 3-year disease-free survival (74.1% versus 46.0%; P=0.03) than patients who began radiation treatment later. No relationship was found between survival and age, sex or tumor size. This regimen was comparatively ineffective in preventing recurrence of postoperative medulloblastoma; however, we found that the interval between surgery and radiation is a significant prognostic factor for disease-free survival. (author)

  7. NRC review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document - Evolutionary plant designs, Chapter 1, Project No. 669

    International Nuclear Information System (INIS)

    1992-08-01

    The staff of the US Nuclear Regulatory Commission has prepared Volume 2 (Parts 1 and 2) of a safety evaluation report (SER), ''NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document -- Evolutionary Plant Designs,'' to document the results of its review of the Electric Power Research Institute's ''Advanced Light Water Reactor Utility Requirements Document.'' This SER gives the results of the staff's review of Volume II of the Requirements Document for evolutionary plant designs, which consists of 13 chapters and contains utility design requirements for an evolutionary nuclear power plant (approximately 1300 megawatts-electric)

  8. NRC review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document - Evolutionary plant designs, Chapters 2--13, Project No. 669

    International Nuclear Information System (INIS)

    1992-08-01

    The staff of the US Nuclear Regulatory Commission has prepared Volume 2 (Parts 1 and 2) of a safety evaluation report (SER), ''NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document -- Evolutionary Plant Designs,'' to document the results of its review of the Electric Power Research Institute's ''Advanced Light Water Reactor Utility Requirements Document.'' This SER gives the results of the staff's review of Volume II of the Requirements Document for evolutionary plant designs, which consists of 13 chapters and contains utility design requirements for an evolutionary nuclear power plant (approximately 1300 megawatts-electric)

  9. Retrospective Review of Pediatric Blunt Renal Trauma: A Single Institution's Five Year Experience

    Science.gov (United States)

    Clark, Margaret E; Sutherland, Ronald S; Woo, Russell K

    2017-01-01

    Children are at higher risk of renal injury from blunt trauma than adults due to a variety of anatomic factors such as decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. Non-operative management is gaining in popularity for even major injuries, although there are no universally accepted guidelines. We present a retrospective review of pediatric major blunt renal injuries (grade 3 or higher) at a children's hospital in Hawai‘i over a 5-year period. Medical records were examined between January 2009 and September 2014 from Kapi‘olani Medical Center for Women and Children in Honolulu, Hawai‘i. Inclusion criteria were a diagnosis of renal trauma, or the diagnosis of blunt abdominal trauma with hematuria. Exclusion criteria were grade I or II renal injury or death due to an additional traumatic injury. Mechanism of injury, clinical characteristics on admission, blood product requirements, surgical interventions performed, and hospital length of stay were retrospectively analyzed. Eleven total patient records were examined, nine of which fit inclusion criteria. Uniquely, 33% of patients sustained their renal injury while surfing. No patients required laparotomy or nephrectomy, though 22% of patients received a blood transfusion and 44% of patients underwent ureteral stent placement. Non-operative management of major renal injuries in children is feasible and allows for preservation of renal tissue. A novel mechanism of surfing as a cause of major renal trauma is seen in the state of Hawai‘i. PMID:28484665

  10. Retrospective Review of Pediatric Blunt Renal Trauma: A Single Institution's Five Year Experience.

    Science.gov (United States)

    Richards, Carly R; Clark, Margaret E; Sutherland, Ronald S; Woo, Russell K

    2017-05-01

    Children are at higher risk of renal injury from blunt trauma than adults due to a variety of anatomic factors such as decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. Non-operative management is gaining in popularity for even major injuries, although there are no universally accepted guidelines. We present a retrospective review of pediatric major blunt renal injuries (grade 3 or higher) at a children's hospital in Hawai'i over a 5-year period. Medical records were examined between January 2009 and September 2014 from Kapi'olani Medical Center for Women and Children in Honolulu, Hawai'i. Inclusion criteria were a diagnosis of renal trauma, or the diagnosis of blunt abdominal trauma with hematuria. Exclusion criteria were grade I or II renal injury or death due to an additional traumatic injury. Mechanism of injury, clinical characteristics on admission, blood product requirements, surgical interventions performed, and hospital length of stay were retrospectively analyzed. Eleven total patient records were examined, nine of which fit inclusion criteria. Uniquely, 33% of patients sustained their renal injury while surfing. No patients required laparotomy or nephrectomy, though 22% of patients received a blood transfusion and 44% of patients underwent ureteral stent placement. Non-operative management of major renal injuries in children is feasible and allows for preservation of renal tissue. A novel mechanism of surfing as a cause of major renal trauma is seen in the state of Hawai'i.

  11. [Undifferentiated (embryonal) liver sarcoma: reviaew of 6 cases in National Cancer Institute, Lima, Peru. Review of the literature].

    Science.gov (United States)

    Dueñas, Daniela; Huanca, Lourdes; Cordero, Mónica; Webb, Patricia; Ruiz, Eloy

    2016-01-01

    Undifferentiated (embryonal) liver sarcoma is a rare tumor about 2% of all malignant liver tumors with a poor prognosis and usually occurs in children, this review aims to assess cases of primary embryonal sarcoma of the liver presented at our institution the past 8 years and improve recognition of its variants and evaluate immunohistochemical characteristics that help differentiated it from other tumors. Six cases of undifferentiated liver sarcoma were histologically evaluated and investigated by immunohistochemistry with a panel of antibodies using the equipment “Autostainer Link 48”. Usually masses were on average more than 20 cm, with solid, cystic, mucinous areas. The microscopic features include cells of spindle cell appearance, oval, starry, epithelioid and multinucleated cells densely arranged in a myxoid matrix. Trapped bile ducts and hepatic cords often present in the periphery of tumors. Intracellular and extracellular PAS positive hyaline globules. Immunohistochemistry showed very divergent differentiation.

  12. CT and MR imaging features of mucinous tubular and spindle cell carcinoma of the kidneys. A multi-institutional review

    Energy Technology Data Exchange (ETDEWEB)

    Cornelis, F.; Grenier, N. [Pellegrin Hospital, Department of Radiology, Bordeaux (France); Ambrosetti, D. [Pasteur Hospital, Department of Pathology, Nice (France); Rocher, L. [Kremlin-Bicetre Hospital, Department of Radiology, Paris (France); Derchi, L.E. [University of Genoa, IRCCS AOU Ospedale, San Martino IST, Department of Health Sciences (DISSAL), Genoa (Italy); Renard, B.; Puech, P. [Claude Huriez Hospital, Department of Radiology, Lille (France); Claudon, M. [Brabois Hospital, Department of Radiology, Vandoeuvre-les-Nancy (France); Rouviere, O. [E. Herriot Hospital, Department of Radiology, Lyon (France); Ferlicot, S. [Kremlin-Bicetre Hospital, Department of Pathology, Paris (France); Roy, C. [Civil Hospital, Department of Radiology, Strasbourg (France); Yacoub, M. [Pellegrin Hospital, Department of Pathology, Bordeaux (France); Bernhard, J.C. [Pellegrin Hospital, Department of Urologic Surgery, Bordeaux (France)

    2017-03-15

    Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney is a recently identified renal malignancy. Diagnosis of this rare subtype of renal tumour can be challenging for pathologists, and as such, any additional data would be helpful to improve diagnostic reliability. As imaging features of this new and rare sub-type have not yet been clearly described, the purpose of this study was to describe the main radiologic features on computed tomography (CT) and magnetic resonance imaging (MRI), based jointly on the literature and findings from a multi-institutional retrospective review of pathology and imaging databases. Using a combination of CT/MRI features, diagnosis of MTSCC could be suggested in many cases. A combination of slow enhancement with plateau on dynamic contrast-enhanced CT/MRI, intermediate to high T2 signal intensity contrasting with low apparent diffusion coefficient values on MRI appeared evocative of this diagnosis. (orig.)

  13. Investigation and technical reviews on the long term stability of buffer. Document prepared by other institute, based on the contract

    International Nuclear Information System (INIS)

    Takasu, Aki

    2003-03-01

    The main objectives of future research and development of geological disposal are to confirm that previous investigation and assessment method which have been arranged for generic geological environment will apply to real geological disposal environment, and the margin of system performance, which was assessed under simple and conservative viewpoint in the past, with assessment and recognition long term behavior of realistic system. Under present condition, we organized clay science specialist committee in Nuclear Safety Research Association and considered following themes comprehensively. To confirm the assessment methods for log term stability of the buffer in H12: Project to establish the scientific and technical basis for HLW disposal in Japan' and in other performance assessment reports, and to pick up subjects from them. Review on the research for long term stability assessment in Japan Nuclear Cycle Development Institute and in other researchers. This report is summarized the result of investigation. (author)

  14. Leiomyosarcoma of the head and neck: A 17-year single institution experience and review of the National Cancer Data Base.

    Science.gov (United States)

    Workman, Alan D; Farquhar, Douglas R; Brody, Robert M; Parasher, Arjun K; Carey, Ryan M; Purkey, Michael T; Nagda, Danish A; Brooks, John S; Hartner, Lee P; Brant, Jason A; Newman, Jason G

    2018-04-01

    Leiomyosarcoma is a rare neoplasm of the head and neck. The purpose of this study was to present our single-institution case series of head and neck leiomyosarcoma and a review of cases in the National Cancer Data Base (NCDB). Patients with head and neck leiomyosarcoma at the University of Pennsylvania and in the NCDB were identified. Demographic characteristics, tumor factors, treatment paradigms, and outcomes were evaluated for prognostic significance. Nine patients with head and neck leiomyosarcoma from the institution were identified; a majority had high-grade disease and cutaneous leiomyosarcoma, with a 5-year survival rate of 50%. Two hundred fifty-nine patients with leiomyosarcoma were found in the NCDB; macroscopic positive margins and high-grade disease were associated with poor prognosis (P < .01), and positive surgical margins were related to adjuvant radiation (P < .001). Head and neck leiomyosarcoma presents at a high grade and is preferentially treated with surgery. Several demographic and tumor-specific factors are associated with outcomes and prognosis. © 2017 Wiley Periodicals, Inc.

  15. Unusual Metastases in Renal Cell Carcinoma: A Single Institution Experience and Review of Literature

    Science.gov (United States)

    Villarreal-Garza, Cynthia; Perez-Alvarez, Sandra I.; Gonzalez-Espinoza, Ivan R.; Leon-Rodriguez, Eucario

    2010-01-01

    Background To report location and management of atypical metastases from renal cell carcinoma (RCC) in the Instituto Nacional de Ciencias Medicas e Investigacion Salvador Zubiran (INCMNSZ) in Mexico City. Methods Between 1987 to 2009, 545 patients with RCC were retrospectively identified at the INCMNSZ. Patients with unusual metastases confirmed by histopathology were analyzed. Epidemiological, clinical, diagnosis, treatment and outcome data were reviewed. Results Sixty patients developed 98 unusual metastases secondary to RCC. The group was comprised of 35 men (58.3%), with a median age of 60 years at diagnosis. Metachronous unusual metastases with primary renal cancer were observed in 37 individuals (61.7%). Median time from primary RCC diagnosis to the first unusual metastasis was 16.5 months. Median survival from diagnosis of the first unusual metastasis to death was 5.0 months (CI 95%: 2.8-7.2 months). Patients with an initial solitary metastatic lesion in an unusual site (28.3%) had a better survival compared to patients who primarily presented with multiple metastases, 17.0 (CI 95%: 6.1-27.9) Vs 3.0 months (CI 95%: 0.9-5.1), p = 0.001. Unusual metastasis resection (21 patients) improved survival, 25.0 (CI 95%: 5.1-44.9) Vs 3.0 months (CI 95%: 0.8-5.2), p < 0.0001. No survival difference was observed between localization of unsual metastases (p = 0.72). Conclusions In patients with advanced RCC we suggest an individual diagnostic and surgical approach to achieve complete resection with disease-free margins, even in the presence of unusual metastatic sites, multifocality, or history of metastasectomy. These strategy might provide not only palliation for symptoms, but an opportunity for meaningful disease free and overall survival. PMID:29147198

  16. Post-hemispherectomy hydrocephalus: results of a comprehensive, multi-institutional review

    Science.gov (United States)

    Lew, Sean M.; Matthews, Anne E.; Hartman, Adam L.; Haranhalli, Neil

    2012-01-01

    SUMMARY Purpose Hemispherectomy surgery for medically intractable epilepsy is known to cause hydrocephalus in a subset of patients. Existing data regarding the incidence of, and risk factors for developing, post-hemispherectomy hydrocephalus has been limited by the relatively small number of cases performed by any single center. Our goal was to better understand this phenomenon and to identify risk factors that may predispose patients to developing hydrocephalus after hemispherectomy surgery. Methods Fifteen pediatric epilepsy centers participated in this study. A retrospective chart review was performed on all available patients who had hemispherectomy surgery. Data collected included surgical techniques, etiology of seizures, prior brain surgery, symptoms and signs of hydrocephalus, timing of shunt placement and basic demographics. Key findings Data were collected from 736 patients who underwent hemispherectomy surgery between 1986 and 2011. Forty-six patients had pre-existing shunted hydrocephalus and were excluded from analysis, yielding 690 patients for this study. One hundred sixty-two patients (23%) required hydrocephalus treatment. The timing of hydrocephalus ranged from the immediate post-operative period to 8.5 years after surgery, with 43 patients (27%) receiving shunts more than 90 days after surgery. Multivariate regression analysis revealed anatomic hemispherectomies (OR 4.1, phydrocephalus. There was a trend towards significance for the use of hemostatic agents (O.R. 2.2, p=0.07) and the involvement of basal ganglia or thalamus in the resection (O.R. 2.2, p=0.08) as risk factors. Significance Hydrocephalus is a common sequela of hemispherectomy surgery. Surgical technique and prior brain surgery influence the occurrence of post-hemispherectomy hydrocephalus. A significant portion of patients develop hydrocephalus on a delayed basis, indicating the need for long-term surveillance. PMID:23106378

  17. Volumetric image-guidance: Does routine usage prompt adaptive re-planning? An institutional review

    International Nuclear Information System (INIS)

    Tanyi, James A.; Fuss, Martin H.

    2008-01-01

    Purpose. To investigate how the use of volumetric image-guidance using an on-board cone-beam computed tomography (CBCT) system impacts on the frequency of adaptive re-planning. Material and methods. Treatment courses of 146 patients who have undergone a course of external beam radiation therapy (EBRT) using volumetric CBCT image-guidance were analyzed. Target locations included the brain, head and neck, chest, abdomen, as well as prostate and non-prostate pelvis. The majority of patients (57.5%) were treated with hypo-fractionated treatment regimens (three to 15 fraction courses). The frequency of image-guidance ranged from daily (87.7%) to weekly or twice weekly. The underlying medical necessity for adaptive re-planning as well as frequency and consequences of plan adaptation to dose-volume parameters was assessed. Results. Radiation plans of 34 patients (23.3%) were adapted at least once (up to six time) during their course of EBRT as a result of image-guidance CBCT review. Most common causes for adaptive planning were: tumor change (mostly shrinkage: 10 patients; four patients more than one re-plan), change in abdominal girth (systematic change in hollow organ filling; n=7, two patients more than one re-plan), weight loss (n=5), and systematic target setup deviation from simulation (n=5). Adaptive re-plan was required mostly for conventionally fractionated courses; only 5 patient plans undergoing hypo-fractionated treatment were adjusted. In over 91% of adapted plans, the dose-volume parameters did deviate from the prescribed plan parameters by more than 5% for at least 10% of the target volume, or organs-at-risk in close proximity to the target volume. Discussion. Routine use of volumetric image-guidance has in our practice increased the demand for adaptive re-planning. Volumetric CBCT image-guidance provides sufficient imaging information to reliably predict the need for dose adjustment. In the vast majority of cases evaluated, the initial and adapted dose

  18. What Do Ethical Guidelines for Epidemiology Say About an Ethics Review? A Qualitative Systematic Review.

    Science.gov (United States)

    Piasecki, Jan; Waligora, Marcin; Dranseika, Vilius

    2017-06-01

    Epidemiological research is subject to an ethics review. The aim of this qualitative review is to compare existing ethical guidelines in English for epidemiological research and public health practice in regard to the scope and matter of an ethics review. Authors systematically searched PubMed, Google Scholar and Google Search for ethical guidelines. Qualitative analysis (constant comparative method) was applied to categorize important aspects of the an ethics review process. Eight ethical guidelines in English for epidemiological research were retrieved. Five main categories that are relevant to the review of epidemiological research by Institutional Review Boards/Research Ethics Committees were distinguished. Within the scope of main categories, fifty-nine subcategories were analyzed. There are important differences between the guidelines in terms of the scope and matter of an ethics review. Not all guidelines encompass all identified ethically important issues, and some do not define precisely the scope and matter of an ethics review, leaving much to the ethics of the individual researchers and the discretion of IRBs/RECs.

  19. Fostering Child Development by Improving Care Quality: A Systematic Review of the Effectiveness of Structural Interventions and Caregiver Trainings in Institutional Care.

    Science.gov (United States)

    Hermenau, Katharin; Goessmann, Katharina; Rygaard, Niels Peter; Landolt, Markus A; Hecker, Tobias

    2017-12-01

    Quality of child care has been shown to have a crucial impact on children's development and psychological adjustment, particularly for orphans with a history of maltreatment and trauma. However, adequate care for orphans is often impacted by unfavorable caregiver-child ratios and poorly trained, overburdened personnel, especially in institutional care in countries with limited resources and large numbers of orphans. This systematic review investigated the effects of structural interventions and caregiver trainings on child development in institutional environments. The 24 intervention studies included in this systematic review reported beneficial effects on the children's emotional, social, and cognitive development. Yet, few studies focused on effects of interventions on the child-caregiver relationship or the general institutional environment. Moreover, our review revealed that interventions aimed at improving institutional care settings have largely neglected violence and abuse prevention. Unfortunately, our findings are partially limited by constraints of study design and methodology. In sum, this systematic review sheds light on obstacles and possibilities for the improvement in institutional care. There must be greater efforts at preventing violence, abuse, and neglect of children living in institutional care. Therefore, we advocate for combining attachment theory-based models with maltreatment prevention approaches and then testing them using rigorous scientific standards. By using approaches grounded in the evidence, it could be possible to enable more children to grow up in supportive and nonviolent environments.

  20. Imaginary Worlds and the Institute for Clinical and Economic Review (ICER Evidence Report: Targeted Immune Modulators for Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Paul C Langley

    2017-05-01

    Full Text Available In April 2017, the Institute for Clinical and Economic Review (ICER issued its evidence report on the value of targeted immune modulators (TIMs in rheumatoid arthritis. The report made the case that for the TIMs to be accepted for formulary placement in the US, where notional willingness-to-pay thresholds are the ICER gateway criteria, manufacturers should be prepared to offer substantial unit price discounts. The purpose of this commentary is to make the case that the methodology underpinning the ICER claims for value assessment does not meet the required standards of normal science. None of the claims made for clinical and comparative cost-effectiveness are credible, evaluable and replicable. As such, formulary committees have no idea whether ICER recommendations are right or even if they are wrong. They are, in fact, immune to failure and should be rejected. Utilizing ICER claims generated by simulated projections, this review points out that it is entirely possible to justify the current WAC or net pricing structure of TIMS. The review concludes that if ICER is to contribute to the successful formulary placement of drugs and devices the methodology for pricing recommendation should be re-assessed. As it stands, questions must be raised regarding recommendations for, possibly unnecessary, price discounts. ICER needs to develop an assessment framework that focuses on developing claims for competing therapies that are robust, evaluable and replicable together with recommendations on how these claims are to be evaluated in a timeframe meaningful to health care decision makers.   Type: Commentary

  1. Organic matter and hydrogen as electron donor for SRB and IRB activities in a clayey medium

    International Nuclear Information System (INIS)

    Chautard, C.; Mifsud, A.; Libert, M.; Marsal, F.

    2012-01-01

    Document available in extended abstract form only. According to the French concept for the disposal of High-Level radioactive Waste (HLW), waste will be emplaced in an environment with multiple metallic components into a geological clay formation. The presence of microorganisms has recently been evidenced in deep clayey environment. Therefore, neither the introduction of microbial species during the construction and operational phases nor the survival of bacteria after the disposal closure can be excluded. Indeed, microbial species may be able to tolerate specific environment with few nutrients to sustain life under high temperature, dry and highly radioactive conditions. Moreover, despite the low porosity of clays, cracks in the excavated disturbed zone and remaining void spaces between disposal components may be favorable for bacterial growth. Sulfate-Reducing Bacteria (SRB) and Iron-Reducing Bacteria (IRB) activities are notably expected to influence iron-clay reactivity, including corrosion processes. Their potential development must be investigated in order to better assess their metabolism, which may in turn influence the evolution of metallic and clayey materials involved in a HLW disposal cell. More specifically, deep geological environments containing low amounts of biodegradable Organic Matter (OM) are generally nutrient poor for microbial development. However, the radiolysis of pore water and the corrosion of metallic components of HLW disposal cell in anoxic conditions will lead to the production of hydrogen, which may also be used as an electron donor for microbial activity. Thus, the purpose of the present work is to quantify the potential of bacterial growth stimulation due either to the production of hydrogen or the presence of OM. In a first step, characterization of DOM leached from Tournemire clay powder has been performed in order to identify and estimate the concentration of soluble organic matter available for bacteria activity which will

  2. Geophysical anomalies associated with Imjin River Belt (IRB) in the middle Korean Peninsula revealed by geomagnetic depth sounding and seismological data

    Science.gov (United States)

    Yang, J.; Choi, H.; Noh, M.; Im, C.

    2012-12-01

    Imjin River Belt (IRB), located in the middle of the Korean Peninsula, has been one of long-standing geological issues because it is a very important tectonic link to understand a tectonic evolution of north-eastern Asia including China, Korea and Japan. Although the IRB has been considered as an extension of collision belt between the North China Block (NCB) and South China Block (SCB), there is little geophysical observation or study on this issue. In recent, we compiled a new induction arrow map for the Korean Peninsula, on the basis of long-period magneto-telluric (MT) data and the geomagnetic depth sounding data performed since the late 1990's. This newly compiled map has finer spatial resolution expecially in the middle area of the peninsula, which helps us to present the geophysical evidence that the IRB is the continuation or extension of the collision belt to the peninsula. The overall pattern of induction arrows in the peninsula appears to indicate a northwest-southeast direction, which is well-known 'sea effect' by the surrounding seas. However, the results of observations in the middle of the peninsula distinctly show an anomalous pattern around the IRB, which can not be explained only by the surrounding seas. This anomalous pattern may be attributed to enhanced conductivity associated with tectonic events that Imjin River Belt has experienced. The 3-D electromagnetic modeling results, considering both surrounding seas and enhanced conductivity of the IRB, explain well the anomalous observations around the IRB. Furthermore, recent seismological study demonstrates that focal mechanism around the IRB is mainly normal faulting event, which may be interpreted as the reactivation of paleo structures that are related to the post collisional lithospheric delamination. All the geophysical evidences convince us that the IRB is an extension of the collision belt between the NCB and SCB to the peninsula.

  3. Are Female Applicants Disadvantaged in National Institutes of Health Peer Review? Combining Algorithmic Text Mining and Qualitative Methods to Detect Evaluative Differences in R01 Reviewers' Critiques.

    Science.gov (United States)

    Magua, Wairimu; Zhu, Xiaojin; Bhattacharya, Anupama; Filut, Amarette; Potvien, Aaron; Leatherberry, Renee; Lee, You-Geon; Jens, Madeline; Malikireddy, Dastagiri; Carnes, Molly; Kaatz, Anna

    2017-05-01

    Women are less successful than men in renewing R01 grants from the National Institutes of Health. Continuing to probe text mining as a tool to identify gender bias in peer review, we used algorithmic text mining and qualitative analysis to examine a sample of critiques from men's and women's R01 renewal applications previously analyzed by counting and comparing word categories. We analyzed 241 critiques from 79 Summary Statements for 51 R01 renewals awarded to 45 investigators (64% male, 89% white, 80% PhD) at the University of Wisconsin-Madison between 2010 and 2014. We used latent Dirichlet allocation to discover evaluative "topics" (i.e., words that co-occur with high probability). We then qualitatively examined the context in which evaluative words occurred for male and female investigators. We also examined sex differences in assigned scores controlling for investigator productivity. Text analysis results showed that male investigators were described as "leaders" and "pioneers" in their "fields," with "highly innovative" and "highly significant research." By comparison, female investigators were characterized as having "expertise" and working in "excellent" environments. Applications from men received significantly better priority, approach, and significance scores, which could not be accounted for by differences in productivity. Results confirm our previous analyses suggesting that gender stereotypes operate in R01 grant peer review. Reviewers may more easily view male than female investigators as scientific leaders with significant and innovative research, and score their applications more competitively. Such implicit bias may contribute to sex differences in award rates for R01 renewals.

  4. One- vs. Three-Fraction Pancreatic Stereotactic Body Radiation Therapy for Pancreatic Carcinoma: Single Institution Retrospective Review

    Directory of Open Access Journals (Sweden)

    Philip Anthony Sutera

    2017-11-01

    Full Text Available Background/introductionEarly reports of stereotactic body radiation therapy (SBRT for pancreatic ductal adenocarcinoma (PDAC used single fraction, but eventually shifted to multifraction regimens. We conducted a single institution review of our patients treated with single- or multifraction SBRT to determine whether any outcome differences existed.Methods and materialsPatients treated with SBRT in any setting for PDAC at our facility were included, from 2004 to 2014. Overall survival (OS, local control (LC, regional control (RC, distant metastasis (DM, and late grade 3 or greater radiation toxicities from the time of SBRT were calculated using Kaplan–Meier estimation to either the date of last follow-up/death or local/regional/distant failure.ResultsWe identified 289 patients (291 lesions with pathologically confirmed PDAC. Median age was 69 (range, 33–90 years. Median gross tumor volume was 12.3 (8.6–21.3 cm3 and planning target volume 17.9 (12–27 cm3. Single fraction was used in 90 (30.9% and multifraction in 201 (69.1% lesions. At a median follow-up of 17.3 months (IQR 10.1–29.3 months, the median survival for the entire cohort 17.8 months with a 2-year OS of 35.3%. Univariate analysis showed multifraction schemes to have a higher 2-year OS 30.5% vs. 37.5% (p = 0.019, it did not hold significance on MVA. Multifractionation schemes were found to have a higher LC on MVA (HR = 0.53, 95% CI, 0.33–0.85, p = 0.009. At 2 years, late grade 3+ toxicity was 2.5%. Post-SBRT CA19-9 was found on MVA to be a prognostic factor for OS (HR = 1.01, 95% CI, 1.01–1.01, p = 0.009, RC (HR = 1.01, 95% CI 1.01–1.01, p = 0.02, and DM (HR = 1.01, 95% CI, 1.01–1.01, p = 0.001.ConclusionOur single institution retrospective review is the largest to date comparing single and multifraction SBRT and the first to show multifraction regimen SBRT to have a higher LC than single fractionation. Additionally, we

  5. The programme 'fission product deposition' at the IRB of Juelich nuclear research centre

    International Nuclear Information System (INIS)

    Gottaut, H.; Iniotakis, N.; Malinowski, J.; Muenchow, K.H.; Sackmann, B.

    1976-01-01

    The transport and deposition behaviour of the non-gaseous fission and activation products in the primary circuit of HTR-type reactors determines the possibility of inspection and maintenance of single components of the primary circuit as well as the safety of the reactor in normal operation and during accidents. For the investigation of these problems, the programme 'fission product deposition' was started at Juelich nuclear research centre in 1969 in cooperation with a number of industrial firms. The programme covers in-pile and out-of-pile experiments, in which the HTR conditions are simulated as realistically as possible, as well as various laboratory experiments and extensive theoretical studies. It is the objective of this work to establish a realistic physical model and computer programme with which the transport and deposition of nuclides in the primary circuit of HTR reactors can be calculated in advance. A report is given on the experimental and theoretical studies carried out at the IRB of Juelich nuclear research centre. (orig./AK) [de

  6. Common Occupational Disability Tests and Case Law References: An Ontario MVA perspective on interpretation and best practice methodology supporting a holistic model, Part I of III (Pre-104 IRB).

    Science.gov (United States)

    Salmon, J Douglas; Gouws, Jacques J; Bachmann, Corina Anghel

    2016-05-01

    This three-part paper presents practical holistic models of determining impairment and occupational disability with respect to common "own occupation" and "any occupation" definitions. The models consider physical, emotional and cognitive impairments in unison, and draw upon case law support for empirically based functional assessment of secondary cognitive symptoms arising from psychological conditions, including chronic pain disorders. Case law is presented, primarily in the context of Ontario motor vehicle accident legislation, to demonstrate how triers of fact have addressed occupational disability in the context of chronic pain; and interpreted the "own occupation" and "any occupation" definitions. In interpreting the definitions of "own occupation" and "any occupation", courts have considered various concepts, such as: work as an integrated whole, competitive productivity, demonstrated job performance vs. employment, work adaptation relative to impairment stability, suitable work, retraining considerations, self-employment, and remuneration/socio-economic status. The first segment of the paper reviews the above concepts largely in the context of pre-104 Income Replacement Benefit (IRB) entitlement, while the second segment focuses on post-104 IRB entitlement. In the final segment, the paper presents a critical evaluation of computerized transferable skills analysis (TSAs) in the occupational disability context. By contrast, support is offered for the notion that (neuro) psychovocational assessments and situational work assessments should play a key role in "own occupation" disability determination, even where specific vocational rehabilitation/retraining recommendations are not requested by the referral source (e.g., insurer disability examination).

  7. Preventing and controlling foodborne disease in commercial and institutional food service settings: a systematic review of published intervention studies.

    Science.gov (United States)

    Viator, Catherine; Blitstein, Jonathan; Brophy, Jenna E; Fraser, Angela

    2015-02-01

    This study reviews the current literature on behavioral and environmental food safety interventions conducted in commercial and institutional food service settings. A systematic search of the published literature yielded 268 candidate articles, from which a set of 23 articles reporting intervention outcomes was retained for evaluation. A categorization of measured outcomes is reported; studies addressed multiple outcomes ranging from knowledge, attitudes, and behavior of personal hygiene and food safety to management practices and disease rates and outbreaks. This study also investigates the quality of reported research methods used to evaluate the effectiveness of the interventions, using a nine-point quality index adapted by the authors. The observed scores suggest that there are opportunities to improve the design and reporting of research in the field of foodborne disease prevention as it applies to food safety interventions that target the food service industry. The aim is to aid researchers in this area to design higher quality studies and to produce clearer and more useful reports of their research. In turn, this can help to create a more complete evidence base that can be used to continually improve interventions in this domain.

  8. Shari’ah Auditing: A Review of Shari’ah Audit Practices in Islamic Financial Institution (IFIs

    Directory of Open Access Journals (Sweden)

    Abdul Rashid Azwan

    2017-01-01

    Full Text Available With its increasing number of Islamic Financial Institutions (IFIs in the country, Malaysia has emerged as a leading hub when benchmarked against the other Islamic countries of the world. Unlike its conventional counterpart, the Islamic financial system focuses on the achievement of societal justice as evaluated within its own framework and uses its own criteria in order to achieve the objective of the Maqasid Ash-Shari’ah. To help achieve this objective, the Islamic finance industry is in need of Shari’ah auditors who are not only knowledgeable and competent in ensuring that the IFIs operate in accordance with Shari’ah principles, but also adequate in supply, in order to cater for the increasing number of IFIs in the country. Therefore, a major aim of this study is to conduct a comprehensive review of the auditing process performed by Shari’ah auditors in determining the achievement of the Maqasid Ash-Shari’ah by the IFIs. Another aim of this study is to assess the existing Shari’ah auditing framework and standards practiced by IFIs in Malaysia. The results of this study could serve as a reference point for the regulatory and professional bodies in assessing the implementation of a comprehensive Shari’ah auditing framework.

  9. A review of the studies on the wholesomeness of irradiated wheat, conducted at the National Institute of Nutrition, India

    International Nuclear Information System (INIS)

    Vijayalaxmi; Srikantia, S.G.; Mysore Univ. Coll.

    1989-01-01

    The wholesomeness of irradiated wheat was investigated in a series of experiments involving several species of animals and a small number of children, at the National Institute of Nutrition in India. Our observations indicated some effects following the feeding of freshly irradiated wheat while no such changes were found in the groups fed either unirradiated or stored irradiated wheat. Also, there were no significant differences between the groups fed unirradiated and stored irradiated wheat. Based on these results, a recommendation had been made to the government that when subjected to irradiation, wheat should be stored for at least 3 months before considering it as safe for human consumption. Similar experiments conducted in an establishment of the Department of Atomic Energy in India indicated no undesirable effects, unlike those found in our studies, and this had led to the development of a serious controversy. In this paper, we have not only reviewed our studies in the light of subsequent research independently carried out in other laboratories but also have tried to answer some of the criticisms made against our studies, so that some of the misunderstandings of our work are seen in proper perspective. (author)

  10. Contemporary Management of Renal Transplant Recipients With De Novo Urolithiasis: A Single Institution Experience and Review of the Literature.

    Science.gov (United States)

    Harraz, Ahmed M; Zahran, Mohamed H; Kamal, Ahmed I; El-Hefnawy, Ahmed S; Osman, Yasser; Soliman, Shady A; Kamal, Mohamed M; Ali-El-Dein, Beder; Shokeir, Ahmed A

    2017-06-01

    We report on the long-term follow-up of managing allograft stones at a single tertiary referral institution and review the relevant literature. A retrospective analysis of renal allograft recipient charts was performed to identify patients who developed allograft lithiasis between 1974 and 2009. Patient and stone characteristics, diagnoses, treatments, and outcomes were described. Sixteen patients developed 22 stones after a median follow-up of 170 months (range, 51-351 mo). The mean (standard deviation) and median diameter of the stones were 13.8 (8.5) mm and 11 mm. Among these, 3 stones were treated conservatively, 3 by shock-wave lithotripsy, and 7 by cystolitholapaxy. Seven patients underwent percutaneous treatment in the form of percutaneous nephrostomy tube fixation and spontaneous passage of stone (1 stone), shock-wave lithotripsy (1 stone), antegrade stenting (1 stone), and percutaneous nephrolithotomy (6 stones). All patients were stone free after treatment, except for 2 patients whose stones were stable and peripheral on long-term follow-up. Allograft lithiasis requires a multimodal treatment tailored according to stone and graft characteristics. Protocols regarding spontaneous passage can be adopted if there is no harm to the graft and the patient is compliant. Careful attention to the anatomy during percutaneous nephrostomy tube placement is mandatory to avoid intestinal loop injury. A more attentive follow-up is required for early stone management.

  11. 76 FR 22406 - National Institute on Drug Abuse (NIDA); Submission for OMB Review; Comment Request; Study of...

    Science.gov (United States)

    2011-04-21

    ... disorders; (2) attitudes of healthcare professionals toward patients with these disorders; and (3... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Drug... Drug Abuse (NIDA), the National Institutes of Health (NIH) will publish periodic summaries of proposed...

  12. Relevance of First-Tier, Peer-Reviewed Journals in the Tenure and Promotion Process at Non-Doctoral Granting Engineering Institutions

    Directory of Open Access Journals (Sweden)

    Amanda S. Florio

    2012-02-01

    Full Text Available The IEEE (formerly the Institute of Electrical and Electronics Engineers is the world's largest professional society dedicated to the advancement of technology. While it is indeed growing into multiple technology areas, the IEEE is still first an organization of electrical, electronics, and computer engineering professionals. It has over 400,000 members and publishes nearly 100, first-tier, peer-reviewed journals. As such a large purveyor of scholarly works, engineering faculty at almost all academic institutions (doctoral granting and non-doctoral granting are familiar with the IEEE. For this reason, the IEEE makes an excellent case study for the relevance of first-tier, peer-reviewed journals in the tenure and promotion process at non-doctoral granting engineering institutions. In our work, we surveyed editors of the 97 IEEE journals. 93% of respondents indicated that 10% or less of their submissions were from non-academic institutions. None (0% of the respondents believed that the number of non-doctoral granting institution submissions would be increasing over the next three years. In fact, a majority of the respondents (55% see the number of non-doctoral granting institution submissions decreasing in the same time frame. To correlate this data, we examined a sample of 2,099 articles published in the first issue of each IEEE journal in 2009. 357 (17% of these 2,099 articles were authored by individuals from academic institutions in the United States. Of the 357, only 35 were published by individuals from non-doctoral granting institutions (1.7%, with only 8 (0.38% from institutions where a bachelor degree is the highest offered.

  13. Ethical Conduct of Research in Children: Pediatricians and Their IRB (Part 1 of 2).

    Science.gov (United States)

    Rose, Carlos D

    2017-05-01

    As human experimentation continues to grow into an ever more complex and sophisticated endeavor, the relevant ethical and regulatory structures become more intricate. When pediatricians and general practitioners are invited by pharmaceutical companies to enroll their offices in a clinical trial or a multicenter observational study or when they develop their own research questions, they frequently find themselves at a loss in the human research environment. The legal and regulatory complexity may have an unintended deterring effect at a time when office-based high quality pediatric research is urgently needed to support evidence-based medicine. Unfortunately, in many instances, unaware practitioners become involved in low-risk research activities without knowing it and become entangled in legal, auditing, and compliance procedures. This paper, written in 2 parts, aims at providing a general guidance on the principles that regulate human research with a focus on pediatrics. Part 1 discusses the history, the legal framework, and the consent process and highlights some practical aspects of initial protocol submission, continued review, and institutional review board determinations with the main focus on multicenter clinical trials (industry-sponsored research). Part 2 focuses on pediatric research regulation, also known as subpart-D, and minimal risk research, which encompasses many research activities aimed at addressing questions that may emerge in pediatricians' practices (investigator-initiated research). Copyright © 2017 by the American Academy of Pediatrics.

  14. Disciplining governance in Africa : a comparison of the World Bank’s Country Policy and Institutional Assessment and the African Union’s African Peer Review Mechanism

    NARCIS (Netherlands)

    S. Kassa (Saba)

    2017-01-01

    markdownabstractThis study examines the promotion of governance in the African Continent. It compares the Country Policy and Institutional Assessment (CPIA) of the World Bank to the African Peer Review Mechanism (APRM) of the African Union. These governance assessments represent differing

  15. Postoperative complications following intraoperative radiotherapy in abdominopelvic malignancy: A single institution analysis of 113 consecutive patients.

    Science.gov (United States)

    Abdelfatah, Eihab; Page, Andrew; Sacks, Justin; Pierorazio, Phillip; Bivalacqua, Trinity; Efron, Jonathan; Terezakis, Stephanie; Gearhart, Susan; Fang, Sandy; Safar, Bashar; Pawlik, Timothy M; Armour, Elwood; Hacker-Prietz, Amy; Herman, Joseph; Ahuja, Nita

    2017-06-01

    Intraoperative radiotherapy (IORT) has advantages over external beam radiation therapy (EBRT). Few studies have described side effects associated with its addition. We evaluated our institution's experience with abdominopelvic IORT to assess safety by postoperative complication rates. Prospectively collected IRB-approved database of all patients receiving abdominopelvic IORT (via high dose rate brachytherapy) at Johns Hopkins Hospital between November 2006 and May 2014 was reviewed. Patients were discussed in multidisciplinary conferences. Those selected for IORT were patients for whom curative intent resection was planned for which IORT could improve margin-negative resection and optimize locoregional control. Perioperative complications were classified via Clavien-Dindo scale for postoperative surgical complications. A total of 113 patients were evaluated. Most common diagnosis was sarcoma (50/113, 44%) followed by colorectal cancer (45/113, 40%), most of which were recurrent (84%). There were no perioperative deaths. A total of 57% of patients experienced a complication Grade II or higher: 24% (27/113) Grade II; 27% (30/113) Grade III; 7% (8/113) Grade IV. Wound complications were most common (38%), then gastrointestinal (25%). No radiotherapy variables were significantly associated with complications on uni/multi-variate analysis. Our institution's experience with IORT demonstrated historically expected postoperative complication rates. IORT is safe, with acceptable perioperative morbidity. © 2017 Wiley Periodicals, Inc.

  16. Comparative Education Research Framed by Neo-Institutional Theory: A Review of Diverse Approaches and Conflicting Assumptions

    Science.gov (United States)

    Wiseman, Alexander W.; Astiz, M. Fernanda; Baker, David P.

    2014-01-01

    The rise in globalisation studies in comparative education places neo-institutional theory at the centre of many debates among comparative education researchers. However, uncertainty about how to interpret neo-institutional theory still persists among educational comparativists. With this uncertainty comes misinterpretation of its principles,…

  17. Bond deformation paths and electronic instabilities of ultraincompressible transition metal diborides: Case study of OsB2 and IrB2

    Science.gov (United States)

    Zhang, R. F.; Legut, D.; Wen, X. D.; Veprek, S.; Rajan, K.; Lookman, T.; Mao, H. K.; Zhao, Y. S.

    2014-09-01

    The energetically most stable orthorhombic structure of OsB2 and IrB2 is dynamically stable for OsB2 but unstable for IrB2. Both diborides have substantially lower shear strength in their easy slip systems than their metal counterparts. This is attributed to an easy sliding facilitated by out-of-plane weakening of metallic Os-Os bonds in OsB2 and by an in-plane bond splitting instability in IrB2. A much higher shear resistance of Os-B and B-B bonds than Os-Os ones is found, suggesting that the strengthened Os-B and B-B bonds are responsible for hardness enhancement in OsB2. In contrast, an in-plane electronic instability in IrB2 limits its strength. The electronic structure of deformed diborides suggests that the electronic instabilities of 5d orbitals are their origin of different bond deformation paths. Neither IrB2 nor OsB2 can be intrinsically superhard.

  18. Pregnancy Outcomes Complicated by Preterm Premature Rupture of Membranes: Retrospective Review of Cases in Three Institutions in Kazakhstan

    Directory of Open Access Journals (Sweden)

    Balkenzhe Imankulova

    2015-06-01

    Full Text Available Introduction. Pre-term premature rupture of membranes (PPROM is one of the leading causes of perinatal morbidity and mortality. This complication is diagnosed in 3% of pregnant women in Kazakhstan, and it is the leading cause of pre-term deliveries. The aim of this study was to determine the outcomes of pregnancies complicated by PPROM in gestation periods between 24 to 32 weeks among three institutions in Kazakhstan.Methods. This is descriptive analysis of 154 cases with PPROM observed between 24 to 32 weeks of gestation at Perinatal Centers #2 and #3 and the National Research Center for Maternal and Child Health, Astana, Kazakhstan. Cases were selected on the basis of retrospective chart review where PPROM diagnosis occurred in 2013. Descriptive statistics were utilized for data analysis.Results. The most frequent complications associated with PPROM were threat of miscarriage (13.6% of cases and chronic placental insufficiency (7.8%. The mean time between PPROM and onset of spontaneous labor was 12.1 ± 2.3 days.  Spontaneous labor within 3 days after PPROM started in patients with an amniotic fluid index of 3.0 ± 0.2 cm. Complications experienced by PPROM women during delivery and early postpartum period included: precipitous labor (6.4%, weakness of labor activity (16.2%, atonic hemorrhage (1.2%, and chorioamnionitis (3.2%. 37.6% of newborns in this study were admitted to the Intensive Care Unit. Their health complications included pneumonia (7.7%, conjunctivitis (1.3%, omphalitis and infectious-toxic shock (3.8%, intraventricular hemorrhage  (7.8%, and respiratory distress (10.3% .Conclusion. Thus, preterm rupture of membranes is associated with preterm delivery and an increase of neonatal morbidity. Therefore, it is necessary to find ways to effectively manage PPROM, including developing new techniques to restore the amniotic fluid volume in women experiencing PPROM during 24 to 32 weeks of gestation. 

  19. The Challenges of First-in-Human Stem Cell Clinical Trials: What Does This Mean for Ethics and Institutional Review Boards?

    Directory of Open Access Journals (Sweden)

    Roger A. Barker

    2018-05-01

    Full Text Available Stem cell-based clinical interventions are increasingly advancing through preclinical testing and approaching clinical trials. The complexity and diversity of these approaches, and the confusion created by unproven and untested stem cell-based “therapies,” create a growing need for a more comprehensive review of these early-stage human trials to ensure they place the patients at minimal risk of adverse events but are also based on solid evidence of preclinical efficacy with a clear scientific rationale for that effect. To address this issue and supplement the independent review process, especially that of the ethics and institutional review boards who may not be experts in stem cell biology, the International Society for Stem Cell Research (ISSCR has developed a set of practical questions to cover the major issues for which clear evidence-based answers need to be obtained before approving a stem cell-based trial. Keywords: human stem cell-derived interventions, early phase clinical trials, institutional review and ethics boards, review process, guidelines

  20. Scoping Review on Research on Food conducted in the Faculty of Social Sciences. Including other Institutions in the Norwich Research Park and Beyond

    OpenAIRE

    Howard Wilsher, Stephanie

    2014-01-01

    Executive summary The scoping review was commissioned to examine what research on food has been conducted in the Faculty of Social Sciences (SSF) at the University of East Anglia (UEA) since 2005. The aim of the report is to facilitate collaborative research between SSF and the rest of the Norwich Research Park (NRP), in particular, the Institute of Food Research (IFR). However, it is important to contextualise this beyond the NRP as the Eastern Academic Research Consortium (EARC) provides fu...

  1. Review of 40-year MD theses in Medical Oncology

    International Nuclear Information System (INIS)

    Zeeneldin, A.; Diyaa, A.; Elgammal, M.; Buhoush, W.; Manar Moneer, M.

    2014-01-01

    Background and objective: It is almost 40 years since the foundation of the Medical Oncology (MO) Department. We aimed to appraise the clinical research to fulfill the Medical Doctorate (MD) degree in MO at the National Cancer Institute, Cairo University (NCI, CU). Methods: This review included 62 MD theses containing 66 studies. They were reviewed regarding aims, type of study, clinical trial phase, design and methodology, statistical tests, results, limitations, consent and IRB approval. Theses were grouped into 3 periods: 1970-1989, 1990-1999 and 2000- 2008. Results: Almost 76% of the studies were interventional and 24% were observational. Informed consent and Institutional Review Board approval were mentioned in 18 and 2 studies, respectively. While all studies mentioned the aims, none, clearly mentioned the research question. Outcomes were mainly efficacy followed by safety. Study design was inadequately considered, especially in 70’s–80’s period (p = 0.038). Median sample size and study duration were almost stable through the three periods (p = 0.441, 0.354, respectively). Most of the studies used both descriptive and analytical statistical methods. In a descending order, researched cancers were lymphoma, breast, leukemia, liver, urinary bladder, lung and colorectal. The commonest stages researched were IV and III. The number of studies focused on assessing biomarkers, biomarkers plus drugs/procedures, drugs and procedures are 20, 20, 16 and 6, respectively. Conclusion: With time, research within MD theses in MO increased quantitatively and qualitatively. Improvements were noticeable in documentation of study design.

  2. The Challenges of First-in-Human Stem Cell Clinical Trials: What Does This Mean for Ethics and Institutional Review Boards?

    Science.gov (United States)

    Barker, Roger A; Carpenter, Melissa K; Forbes, Stuart; Goldman, Steven A; Jamieson, Catriona; Murry, Charles E; Takahashi, Jun; Weir, Gordon

    2018-05-08

    Stem cell-based clinical interventions are increasingly advancing through preclinical testing and approaching clinical trials. The complexity and diversity of these approaches, and the confusion created by unproven and untested stem cell-based "therapies," create a growing need for a more comprehensive review of these early-stage human trials to ensure they place the patients at minimal risk of adverse events but are also based on solid evidence of preclinical efficacy with a clear scientific rationale for that effect. To address this issue and supplement the independent review process, especially that of the ethics and institutional review boards who may not be experts in stem cell biology, the International Society for Stem Cell Research (ISSCR) has developed a set of practical questions to cover the major issues for which clear evidence-based answers need to be obtained before approving a stem cell-based trial. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Illuminating Engineering Research Institute Annual Report 1967. A Review of Project Activities and a Roundup of IERI Research Interests.

    Science.gov (United States)

    Illuminating Engineering Research Inst., New York, NY.

    Presented in this report are the Illuminating Engineering Research Institute's fundamental scientific concepts in a new frame of realism while relating them to an up-to-date accounting of the search for new basic knowledge. In addition to being an annual accounting, it is also intended to provide orientation. Its presented in dramatic and…

  4. 77 FR 68134 - Submission for OMB Review; Comment Request (30-day): National Institute of Nursing Research (NINR...

    Science.gov (United States)

    2012-11-15

    ... data collection plans and instruments, contact: Dr. Amanda Greene, Office of Science Policy and Public... participants are alumni of this training institute which began in 2000. The survey inquires about career activities, including research, clinical, teaching and educational activities, since completion of the NINR...

  5. Malignant thymomas – The experience of the Portuguese Oncological Institute, Porto, and literature review

    Directory of Open Access Journals (Sweden)

    Berta Sousa

    2007-07-01

    Full Text Available Introduction: Epithelial thymic tumours (ETT, which comprise the majority of thymomas, are neoplasias developed from the epithelial cells of the thymus and constitute around 30% of anterior mediastinal masses in adults. Thymomas consist of cells with no cytological characteristics of malignity; malignant behaviour is determined by invasion of the capsule and adjacent structures. These tumours present a broad spectrum of clinical and morphological characteristics and the small series of known patients makes establishing a standard treatment difficult. Material and methods: A retrospective study was made into thymoma diagnosed patients admitted to the Portuguese Oncology Institute in Porto (IPOPorto from 1983 to 2004. Clinical characteristics were analysed and a histological classification made in accordance with World Health Organization criteria, Masaoka staging, and their relation to treatment methods. A review of the clinical records of these patients was then made, as well as a review of histological material for classification in line with 1999 WHO criteria. Results: Twenty-eight ETT patients were treated at the IPO-Porto between 1983 and 2004. Of these, 21 had invasive thymomas and these are the subject of this study. Eleven subjects were male and 10 female, with a median age of 55 years (24-79 years. The WHO histological classification was as follows: 2 patients (9.5% type A, 6 (28.6% type AB, 4 (19% type B1, 2 (9.5% type B2, 7 (33.4% type B3. Masaoka staging was 9 patients (42.8% with stage II, 6 (28.6% with stage III and 6 (28.6% with stage IVa. The majority of patients had local symptoms, with only one subject diagnosed with erythrocyte aplasia and five with Myasthenia Gravis (MG.The 6 patients who were given complete surgical resection only showed no evidence of disease recurrence (2 type A-II, 2 type AB-II, 1 type B1-II, 1 type B2- IVa, with follow-up from 8-144 months. Ten patients with complete resection received adjuvant treatment

  6. Review of results of research and development work carried out by the Institut fuer Technische Physik in 1983

    International Nuclear Information System (INIS)

    1984-02-01

    At the Institute for Technical Physics (ITP), the emphasis of the studies lies with the application of full-load superconductivity, the main tasks being part of the nuclear fusion project. Additionally, magnet technology for applications in other fields of research and development is advanced. The technical research programme goes together with fundamental research in the fields of cryogenics and superconductors as well as with related studies. (orig./RW) [de

  7. Effectiveness of the Chinese Communist Party’s Anti-corruption Institutions and Policies: A Critical Review

    OpenAIRE

    WAHED, Mohammad Shakil

    2016-01-01

    The intensity of corruption in China has been progressively high since the 1980s. This seriously undermines the overall effectiveness of Chinese anti-corruption institutions and policies. This article argues that the existing anti-corruption measures in China have not been working properly to eliminate or even contain the problem at an acceptable level. It seems that something has been holding it back somewhere. This article argues that China badly needs, inter alia, a sincere demonstration o...

  8. NRC review of Electric Power Research Institute's advanced light water reactor utility requirements document. Passive plant designs, chapter 1, project number 669

    International Nuclear Information System (INIS)

    1994-08-01

    The Electric Power Research Institute (EPRI) is preparing a compendium of technical requirements, referred to as the open-quotes Advanced Light Water Reactor [ALWR] Utility Requirements Documentclose quotes, that is acceptable to the design of an ALWR power plant. When completed, this document is intended to be a comprehensive statement of utility requirements for the design, construction, and performance of an ALWR power plant for the 1990s and beyond. The Requirements Document consists of three volumes. Volume 1, open-quotes ALWR Policy and Summary of Top-Tier Requirementsclose quotes, is a management-level synopsis of the Requirements Document, including the design objectives and philosophy, the overall physical configuration and features of a future nuclear plant design, and the steps necessary to take the proposed ALWR design criteria beyond the conceptual design state to a completed, functioning power plant. Volume II consists of 13 chapters and contains utility design requirements for an evolutionary nuclear power plant [approximately 1350 megawatts-electric (MWe)]. Volume III contains utility design requirements for nuclear plants for which passive features will be used in their designs (approximately 600 MWe). In April 1992, the staff of the Office of Nuclear Reactor Regulation, U.S. Nuclear Regulatory Commission, issued Volume 1 and Volume 2 (Parts 1 and 2) of its safety evaluation report (SER) to document the results of its review of Volumes 1 and 2 of the Requirements Document. Volume 1, open-quotes NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document - Program Summaryclose quotes, provided a discussion of the overall purpose and scope of the Requirements Document, the background of the staff's review, the review approach used by the staff, and a summary of the policy and technical issues raised by the staff during its review

  9. NRC review of Electric Power Research Institute's advanced light water reactor utility requirements document. Passive plant designs, chapters 2-13, project number 669

    International Nuclear Information System (INIS)

    1994-08-01

    The Electric Power Research Institute (EPRI) is preparing a compendium of technical requirements, referred to as the open-quotes Advanced Light Water Reactor [ALWR] Utility Requirements Documentclose quotes, that is acceptable to the design of an ALWR power plant. When completed, this document is intended to be a comprehensive statement of utility requirements for the design, construction, and performance of an ALWR power plant for the 1990s and beyond. The Requirements Document consists of three volumes. Volume I, open-quotes ALWR Policy and Summary of Top-Tier Requirementsclose quotes, is a management-level synopsis of the Requirements Document, including the design objectives and philosophy, the overall physical configuration and features of a future nuclear plant design, and the steps necessary to take the proposed ALWR design criteria beyond the conceptual design state to a completed, functioning power plant. Volume II consists of 13 chapters and contains utility design requirements for an evolutionary nuclear power plant [approximately 1350 megawatts-electric (MWe)]. Volume III contains utility design requirements for nuclear plants for which passive features will be used in their designs (approximately 600 MWe). In April 1992, the staff of the Office of Nuclear Reactor Regulation, U.S. Nuclear Regulatory Commission, issued Volume 1 and Volume 2 (Parts 1 and 2) of its safety evaluation report (SER) to document the results of its review of Volumes 1 and 2 of the Requirements Document. Volume 1, open-quotes NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document - Program Summaryclose quotes, provided a discussion of the overall purpose and scope of the Requirements Document, the background of the staff's review, the review approach used by the staff, and a summary of the policy and technical issues raised by the staff during its review

  10. Northeast Regional Cancer Institute's Cancer Surveillance and Risk Factor Program

    Energy Technology Data Exchange (ETDEWEB)

    Lesko, Samuel M.

    2007-07-31

    . For colorectal cancer, the stage at diagnosis of cases diagnosed in northeast Pennsylvania was compared to data from prior years. A population-based interview study of healthy adults was conducted to document the status of cancer screening and to estimate the prevalence of established cancer risk factors in this community. This study is similar in design to that used by the Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS). EXPERIMENTAL METHODS AND PROCEDURES: This program includes two distinct but related projects. The first project uses existing data to conduct cancer surveillance in northeast Pennsylvania, and the second is a population-based study of cancer risk factors and cancer screening behaviors in this same population. HUMAN SUBJECTS CONSIDERATIONS This program includes two projects: cancer surveillance and a population-based study of cancer risk factors and screening behavior. The cancer surveillance project involves only the use of existing aggregate data or de-identified data. As such, the surveillance project is exempt from human subjects considerations. The study of cancer risk factors and screening behaviors includes data from a random sample of adult residents of northeast Pennsylvania who are 18 or more years of age. All races, ethnicities and both sexes are included in proportion to their representation in the population. Subjects are interviewed anonymously by telephone; those who are unable to complete an interview in English are ineligible. This project has been reviewed and approved by the Scranton-Temple Residency Program IRB (IRB00001355), which is the IRB for the Northeast Regional Cancer Institute.

  11. Characteristics and determinants of knowledge transfer policies at universities and public institutions in medical research--protocol for a systematic review of the qualitative research literature.

    Science.gov (United States)

    Jahn, Rosa; Müller, Olaf; Bozorgmehr, Kayvan

    2015-08-19

    Universities, public institutions, and the transfer of knowledge to the private sector play a major role in the development of medical technologies. The decisions of universities and public institutions regarding the transfer of knowledge impact the accessibility of the final product, making it easier or more difficult for consumers to access these products. In the case of medical research, these products are pharmaceuticals, diagnostics, or medical procedures. The ethical dimension of access to these potentially lifesaving products is apparent and distinguishes the transfer of medical knowledge from the transfer of knowledge in other areas. While the general field of technology transfer from academic and public to private actors is attracting an increasing amount of scholarly attention, the specifications of knowledge transfer in the medical field are not as well explored. This review seeks to provide a systematic overview and analysis of the qualitative literature on the characteristics and determinants of knowledge transfer in medical research and development. The review systematically searches the literature for qualitative studies that focus on knowledge transfer characteristics and determinants at medical academic and public research institutions. It aims at identifying and analyzing the literature on the content and context of knowledge transfer policies, decision-making processes, and actors at academic and public institutions. The search strategy includes the databases PubMed, Web of Science, ProQuest, and DiVa. These databases will be searched based on pre-specified search terms. The studies selected for inclusion in the review will be critically assessed for their quality utilizing the Qualitative Research Checklist developed by the Clinical Appraisal Skills Programme. Data extraction and synthesis will be based on the meta-ethnographic approach. This review seeks to further the understanding of the kinds of transfer pathways that exist in medical

  12. Influence of Pro-Qura-generated Plans on Postimplant Dosimetric Quality: A Review of a Multi-Institutional Database

    International Nuclear Information System (INIS)

    Allen, Zachariah; Merrick, Gregory S.; Grimm, Peter; Blasko, John; Sylvester, John; Butler, Wayne; Chaudry, Usman-Ul-Haq; Sitter, Michael

    2008-01-01

    The influence of Pro-Qura-generated plans vs. community-generated plans on postprostate brachytherapy dosimetric quality was compared. In the Pro-Qura database, 2933 postplans were evaluated from 57 institutions. A total of 1803 plans were generated by Pro-Qura and 1130 by community institutions. Iodine-125 ( 125 I) plans outnumbered Palladium 103 ( 103 Pd) plans by a ratio of 3:1. Postimplant dosimetry was performed in a standardized fashion by overlapping the preimplant ultrasound and the postimplant computed tomography (CT). In this analysis, adequacy was defined as a V 100 > 80% and a D 90 of 90% to 140% for both isotopes along with a V 150 125 I and 103 Pd. The mean postimplant V 100 and D 90 were 88.6% and 101.6% vs. 89.3% and 102.3% for Pro-Qura and community plans, respectively. When analyzed in terms of the first 8 sequence groups (10 patients/sequence group) for each institution, Pro-Qura planning resulted in less postimplant variability for V 100 (86.2-89.5%) and for D 90 (97.4-103.2%) while community-generated plans had greater V 100 (85.3-91.2%) and D 90 (95.9-105.2%) ranges. In terms of sequence groups, postimplant dosimetry was deemed 'too cool' in 11% to 30% of cases and 'too hot' in 12% to 27%. On average, no clinically significant postimplant dosimetric differences were discerned between Pro-Qura and community-based planning. However, substantially greater variability was identified in the community-based plan cohort. It is possible that the Pro-Qura plan and/or the routine postimplant dosimetric evaluation may have influenced dosimetric outcomes at community-based centers

  13. One-Step Nucleic Acid Amplification in Breast Cancer Sentinel Lymph Node: A Single Institutional Experience and a Short Review

    OpenAIRE

    Brambilla, Tatiana; Fiamengo, Barbara; Tinterri, Corrado; Testori, Alberto; Grassi, Massimo Maria; Sciarra, Amedeo; Abbate, Tommaso; Gatzemeier, Wolfgang; Roncalli, Massimo; Di Tommaso, Luca

    2015-01-01

    Sentinel lymph node (SLN) examination is a standard in breast cancer patients, with several methods employed along its 20 years history, the last one represented by one-step nucleic acid amplification (OSNA). The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3 years experience with OSNA (1122 patients) showed results overlapping those recorded in the same institution with a morphological evaluation (930 patients) of SLN. In detail,...

  14. 76 FR 38688 - Certain Welded Stainless Steel Pipe From Korea and Taiwan; Institution of a Five-Year Review...

    Science.gov (United States)

    2011-07-01

    ... major inputs into production); and factors related to the ability to shift supply among different... production of the product. In its original determinations and its full first five-year review determinations... comparable products which the Commission conducts under Title VII of the Act, or in internal audits and...

  15. 76 FR 54487 - Fresh Garlic From China; Institution of a Five-Year Review Concerning the Antidumping Duty Order...

    Science.gov (United States)

    2011-09-01

    ... proportion of the total domestic production of the product. In its original determination, the Commission... reviews or investigations of the same or comparable products which the Commission conducts under Title VII... general and/or your firm/entity specifically. In your response, please discuss the various factors...

  16. 77 FR 58110 - Notice of Submission for OMB Review; Institute of Education Sciences; NPEFS 2011-2014: Common...

    Science.gov (United States)

    2012-09-19

    ...; NPEFS 2011-2014: Common Core of Data (CCD) National Public Education Financial Survey SUMMARY: The National Public Education Financial Survey (NPEFS) is an annual collection of state-level finance data that...) National Public Education Financial Survey. OMB Control Number: 1850-0067. Type of Review: Extension. Total...

  17. Engineering Institute

    Science.gov (United States)

    Projects Past Projects Publications NSEC » Engineering Institute Engineering Institute Multidisciplinary engineering research that integrates advanced modeling and simulations, novel sensing systems and new home of Engineering Institute Contact Institute Director Charles Farrar (505) 665-0860 Email UCSD EI

  18. Systematic Review of the Research on Motor Fitness of 1st-Year Students Attending Polish Institutions of Higher Education

    Directory of Open Access Journals (Sweden)

    Robert Podstawski

    2013-10-01

    Full Text Available Aim of the study. To establish: 1 the amount of research on general motor fitness of 1st-year students, conducted at selected Polish institutions of higher education between 1953-2010; 2 the number and kind of motor tests applied in this kind of research as well as the frequency of these tests during the period under study. Material and methods: The material for this research was composed of the publications on motor fitness of the first-year students taking part in specific motor trials applied at Polish tertiary institutions between 1953 - 2010. A diagnostic poll method was used in the research. Results: Fifty-four original research cases conducted in the period under study were observed. Within this period the trials such as: “100m run”, “jump from the run-up”, “grenade throw” and “ shot put” were more popular during the earlier years, while the trials such us: “zig-zag run”, “standing long jump”, and “medicine ball throw” were characteristic of more recent studies. Some of the most popular motor trials were: “standing long jump” – 38 cases, “medicine ball throw” – 30 cases, “zig-zag run” – 28 cases, “shuttle runs” – 9 cases, "short distance runs” – 12 cases, “downward bend from standing position” – 10 cases, and "vertical jump” – 8 cases. Conclusions: 1. Little research concerning the level of physical fitness of first-year students attending Polish tertiary institutions was conducted in the years 1953-2010; 2. The amount of motor fitness research carried out during this period fails to provide constant systematic assessment of the state of the students’ physical condition, which is a result of too large dispersions in time and territory where the measurements were taken; 3. In the motor fitness tests conducted with 1st-year students the determining variable was mainly gender, and only few research cases were found in which general motor fitness was analyzed according to

  19. Quality Control Review of the Dixon Hughes Goodman LLP FY 2014 Single Audit of Logistics Management Institute

    Science.gov (United States)

    2016-09-29

    assurance , tax, and advisory services to United States and international clients. DHG employs more than 2,000 people in 12 states. DHG maintains...the review of indirect costs for the allowable costs/cost principles compliance requirement that needs to be addressed in future audits (Finding C...before payment when an item or service is received, but it is unclear how this internal control would provide assurance that LMI complied with

  20. 78 FR 65452 - Proposed Information Collection (Veterans, Researchers, and IRB Members Experiences With...

    Science.gov (United States)

    2013-10-31

    ... qualitative research methods to understand Veterans' preferences on research recruitment methods. The data... research study subjects and to explore Veterans views on recruitment procedures. DATES: Written comments... Members Experiences with Recruitment Restrictions). Type of Review: New collection. Abstracts: The VHA...

  1. Information Literacy Strategy Development: Study Prescribes Strategic Management Framework for Academic Institutions. A Review of: Corrall, Sheila.

    Directory of Open Access Journals (Sweden)

    Shandra Protzko

    2008-12-01

    Full Text Available Objective – To examine the development of information literacy (IL strategies in higher education by assessing content and presentation of IL strategy documentation, and to explore the application of corporate strategy concepts and techniques to IL strategy.Design – Comparative, multi-case study. Qualitative analysis.Setting – U.K. universities.Subjects – Twelve information literacy strategy documents from ten institutions.Methods – Google was searched for IL strategy documents (restricted to the ac.uk domain, the LISINFOLITERACY discussion list was queried, and the Web sites of all U.K. universities were searched for a total sample of 12 documents at 10 institutions. Results of the data capture were discussed in the context of the literature on strategic management.Main Results – Corporate strategy tools and techniques are extensive in the literature, trending toward an emphasis on holistic thinking and marketing concepts. Many themes identified in the documents were consistent with the literature. While the format and style varied, all documents emphasized the integration of IL into subject curricula. All stressed the need to build collaborative partnerships between library/information staff and academic staff.Significantly, many strategies aimed to reach the broader institution, although poor articulation undermined this ambitious goal. In three, IL intervention was intended for the whole university community. However, the target audience often was not well-defined. Seven of the IL strategies identified additional partnerships to effect change at the policy level. Another key theme was the adoption of recognized IL standards; seven proposed the SCONUL (1999 model. All strategies recognized the importance of learning outcomes; six stated them explicitly. Prominent was the integration of e-learning resources, namely online tutorials. Many strategies recognized the need for marketing and advocacy activities. Half considered

  2. MDCT of primary, locally recurrent, and metastatic duodenal gastrointestinal stromal tumours (GISTs): A single institution study of 25 patients with review of literature

    International Nuclear Information System (INIS)

    Cheng, J.M.; Tirumani, S.H.; Shinagare, A.B.; Jagannathan, J.P.; Hornick, J.L.; Raut, C.P.; Ramaiya, N.H.

    2014-01-01

    Aim: To describe the multidetector computed tomography (MDCT) features of primary, locally recurrent, and metastatic duodenal gastrointestinal stromal tumours (GISTs). Materials and methods: In this institutional review board-approved, Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant, retrospective study, 25 patients [13 men, 12 women; mean age 56 years (34–74 years)] with histopathologically confirmed duodenal GISTs seen at Dana Farber Cancer Institute and Brigham and Women's Hospital from December 1999 to October 2009 were identified. The MDCT of primary tumours in six patients and follow-up imaging in all the 25 patients was reviewed by two radiologists in consensus. Electronic medical records were reviewed to document the clinical characteristics and management. Results: The mean size of the primary tumour was 3.7 cm (range 2.5–5.6 cm). Three of six primary tumours were in the second and third portions of the duodenum, one in the third portion, one in the third and fourth portions, and one in the fourth portion. Three of six of the tumours were exophytic, two were both exophytic and intraluminal, and one was intramural. The tumours were well-circumscribed, round or oval masses, with few lobulations, and were either homogeneously hyper-enhancing or heterogeneously isodense at MDCT. None of the tumours had necrosis, haemorrhage, calcification, or loco regional lymphadenopathy on imaging. Sixteen of 25 (64%) patients developed metastatic disease, the most common sites being liver (14/16; 87.5%) and peritoneum (5/16; 31%). Conclusion: Duodenal GISTs are well-circumscribed, round or oval masses, and occur in the second through fourth portions of the duodenum, without lymphadenopathy or duodenal obstruction. Duodenal GISTS metastasize frequently to the liver and peritoneum

  3. One-Step Nucleic Acid Amplification in Breast Cancer Sentinel Lymph Node: A Single Institutional Experience and a Short Review.

    Science.gov (United States)

    Brambilla, Tatiana; Fiamengo, Barbara; Tinterri, Corrado; Testori, Alberto; Grassi, Massimo Maria; Sciarra, Amedeo; Abbate, Tommaso; Gatzemeier, Wolfgang; Roncalli, Massimo; Di Tommaso, Luca

    2015-01-01

    Sentinel lymph node (SLN) examination is a standard in breast cancer patients, with several methods employed along its 20 years history, the last one represented by one-step nucleic acid amplification (OSNA). The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3 years experience with OSNA (1122 patients) showed results overlapping those recorded in the same institution with a morphological evaluation (930 patients) of SLN. In detail, the data of OSNA were almost identical to those observed with standard post-operative procedure in terms of patients with positive SLN (30%) and micrometastatic/macrometastatic involvement of SLN (respectively, 38-45 and 62-55%). By contrast, when OSNA was compared to the standard intraoperatory procedure, it was superior in terms of accuracy, prompting the use of this molecular assay as a very valid, and reproducible for intra-operative evaluation of SLN. Further possibilities prompting the use of OSNA range from adhesion to quality control programs, saving of medical time, ability to predict, during surgery, additional nodal metastasis, and molecular bio-banking.

  4. ONE STEP NUCLEIC ACID AMPLIFICATION IN BREAST CANCER SENTINEL LYMPH NODE.A SINGLE INSTITUTIONAL EXPERIENCE AND A SHORT REVIEW.

    Directory of Open Access Journals (Sweden)

    Tatiana eBrambilla

    2015-06-01

    Full Text Available Sentinel lymph node (SLN examination is a standard in breast cancer patients, with several methods employed along its 20-years history, the last one represented by OSNA. The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3-years experience with OSNA (1122 patients showed results overlapping those recorded in the same Institution with a morphological evaluation (930 patients of SLN. In detail the data of OSNA were almost identical to those observed with standard post-operative procedure in terms of patients with positive SLN (30% and micrometastatic/macrometastatic involvement of SLN (respectively 38-45% and 62-55%. By contrast when OSNA was compared to the standard intra-operatory procedure it was superior in terms of accuracy, prompting the use of this molecular assay as a very valid and reproducible for intra-operative evaluation of SLN.Further possibilities prompting the use of OSNA range from adhesion to quality control programs, saving of medical time, ability to predict, during surgery, additional nodal metatastis and molecular bio-banking.

  5. Research Performance of Higher Education Institutions: A Review on the Measurements and Affecting Factors of Research Performance

    Directory of Open Access Journals (Sweden)

    Oya TAMTEKİN AYDIN

    2017-08-01

    Full Text Available Recently, the increasing competition in higher education has attracted attention by many researchers. They have emphasized that the aim of the growing competition between universities is to increase the number of students, the research performance and get research support, find qualified faculty members, and receive financial contributions. This paper aims to draw attention to “research performance” which is a significant part of the competition among the universities. In connection with this goal, the study tries to outline the results of an extensive literature review in the field of higher education research performance. Firstly, literature regarding research performance, its definition as a concept, and its indicators are discussed. Then, the factors influencing research performance are presented in a comprehensive manner. At the end of the study, a conceptual framework that will be useful for all university staff is provided. Understanding the concept of research performance and the factors affecting research performance can help relevant authorities improve their current positions.

  6. Institutional advantage

    NARCIS (Netherlands)

    Martin, Xavier

    Is there such a thing as institutional advantage—and what does it mean for the study of corporate competitive advantage? In this article, I develop the concept of institutional competitive advantage, as distinct from plain competitive advantage and from comparative institutional advantage. I first

  7. SU-F-T-101: Insight into Dosimetry Workload and Planning Timelines: A 6 Year Review at One Institution

    Energy Technology Data Exchange (ETDEWEB)

    Cardan, R; Popple, R; Smith, H; Fiveash, J [The University of Alabama at Birmingham, Birmingham, AL (United States)

    2016-06-15

    Purpose: To elucidate realistic clinical treatment planning workload and timelines to improve understanding for patients, payers, and other institutions involved in radiotherapy processes. Methods: A web based tool was developed using Oracle Express (Oracle Corp, Redwood City, CA) which allowed communication between the physicians and staff about the current state of the patient plan. For 6 years, all patient courses were logged and time-stamped in 22 discreet steps which detailed start and stop times for simulation, contouring, and treatment planning tasks. This data was combined with the treatment planning database (TPDB) using the Eclipse Scripting API (Varian Medical Systems, Palo Alto, CA) to cross-identify plans between the two systems. This time data was analyzed across our dosimetry staff and treatment modality. Results: In 6 years, 110,477 patient statuses were time-logged for 9683 courses of treatment using our internal software. The courses contained 8305 unique patients who were binned into one of 11 diagnosis site categories. 8253 courses could be reconciled against the TPDB using timestamp data from patient statuses. The average planning volume per dosimetrist was 375.8 ± 142.4 plans per year with the average number of planning revisions per dosimetrist of 71.0 ± 27.1 plans per year. The median treatment planning times by modality ranged from to 48.3 hours for IMRT plans 5 fields or less to 119.6 hours for IMRT with 8 or more fields. Two arc VMAT, three arc VMAT, and 3D plans median times were 89.1 hours, 113.8 hours, and 50.9 hours respectively. Conclusion: Using our web based tool, we have demonstrated the ability to quantify treatment planning timelines and workloads which could help in setting appropriate expectations for patients, payers, and hospital administration. COI: Author received monies from Varian Medical Systems for research and teaching honorarium.

  8. Residency characteristics that matter most to plastic surgery applicants: a multi-institutional analysis and review of the literature.

    Science.gov (United States)

    Sinno, Sammy; Mehta, Karan; Squitieri, Lee; Ranganathan, Kavitha; Koeckert, Michael S; Patel, Ashit; Saadeh, Pierre B; Thanik, Vishal

    2015-06-01

    The National Residency Matching Program Match is a very unique process in which applicants and programs are coupled to each other based on a ranking system. Although several studies have assessed features plastic surgery programs look for in applicants, no study in the present plastic surgery literature identifies which residency characteristics are most important to plastic surgery applicants. Therefore, we sought to perform a multi-institutional assessment as to which factors plastic surgery residency applicants consider most important when applying for residency. A validated and anonymous questionnaire containing 37 items regarding various program characteristics was e-mailed to 226 applicants to New York University, Albany, University of Michigan, and University of Southern California plastic surgery residency programs. Applicants were asked to rate each feature on a scale from 1 to 10, with 10 being the most important. The 37 variables were ranked by the sum of the responses. The median rating and interquartile range as well as the mean for each factor was then calculated. A Wilcoxon signed rank test was used to compare medians in rank order. A total of 137 completed questionnaires were returned, yielding a 61% response rate. The characteristics candidates considered most important were impressions during the interview, experiences during away rotations, importance placed on resident training/support/mentoring by faculty, personal experiences with residents, and the amount of time spent in general surgery. The characteristics candidates considered least important were second-look experiences, compensation/benefits, program reputation from Internet forums, accessibility of program coordinator, opportunity for laboratory research, and fellowship positions available at the program. Applicants value personal contact and time spent in general surgery when selecting residency programs. As the number of integrated programs continues to grow, programs will benefit

  9. Review and analysis of the over exposure cases in the non-DAE institutions in India during 2004-2007

    International Nuclear Information System (INIS)

    Varadharajan, Geetha; Srivastava, Kshama; Kolambe, D.H.; Punekar, M.P.; Kher, R.K.

    2008-01-01

    The radiation protection programme aims at providing adequate protection from undue radiation exposure to the personnel directly or indirectly involved with radiation, without limiting the benefits of radiation. Personnel Monitoring of the radiation workers is an integral part of effective radiation protection programme and is mandatory as per the Radiation Protection Rule-71 (RPR-71) and its revised version in 2004 (RPR -2004). In India, countrywide personnel monitoring of 65,000 radiation workers is carried out by 14 TLD units spread all over the country using CaSO 4 :Dy based TLD Badge system developed by Bhabha Atomic Research Centre. Prior to the accreditation of the first private laboratory in 1999, the personnel monitoring service was provided by Bhabha Atomic Research Centre. At present the total workload of about 35000 workers in the non-DAE sector has been transferred to the three private accredited laboratories catering the service in different zones of the country. The effective radiation control and safe work practices can be ensured by proper reporting of doses and investigation and follow up of overexposure cases. Any exposure exceeding 10 mSv in a singe monitoring period is treated as a case of over exposure and such cases are discussed by an AERB appointed investigation committee. The committee decides the genuineness of the exposure after looking into the various aspects relevant to these cases. This paper presents the analysis of over exposure cases reported for non-DAE institutions in the field of medicine, industry and research in India during 2004-2007. (author)

  10. Pediatric Burns: A Single Institution Retrospective Review of Incidence, Etiology, and Outcomes in 2273 Burn Patients (1995-2013).

    Science.gov (United States)

    Lee, Christina J; Mahendraraj, Krishnaraj; Houng, Abraham; Marano, Michael; Petrone, Sylvia; Lee, Robin; Chamberlain, Ronald S

    Unintentional burn injury is the third most common cause of death in the U.S. for children age 5 to 9, and accounts for major morbidity in the pediatric population. Pediatric burn admission data from U.S. institutions has not been reported recently. This study assesses all pediatric burn admissions to a State wide Certified Burn Treatment Center to evaluate trends in demographics, burn incidence, and cause across different age groups. Demographic and clinical data were collected on 2273 pediatric burn patients during an 18-year period (1995-2013). Pediatric patients were stratified by age into "age 0 to 6," "age 7 to 12," and "age 13 to 18." Data were obtained from National Trauma Registry of the American College of Surgeons and analyzed using standard statistical methodology. A total of 2273 burn patients under age 18 were treated between 1995 and 2013. A total of 1663 (73.2%) patients were ages 0 to 6, 294 (12.9%) were 7 to 12, and 316 (13.9%) were age 13 to 18. A total of 1400 (61.6%) were male and 873 (38.4%) were female (male:female ratio of 1.6:1). Caucasians had the highest burn incidence across all age groups (40.9%), followed by African-Americans (33.6%), P burns occurred at home, P burned was 8.9%, with lower extremity being the most common site (38.5%). Scald burns constituted the majority of cases (71.1%, n = 1617), with 53% attributable to hot liquids related to cooking, including coffee or tea, P burns were the dominant cause (53.8%). Overall mean length of stay was 10.5 ± 10.8 days for all patients, and15.5 ± 12 for those admitted to the intensive care unit, P burn injuries are scald burns that occur at home and primarily affect the lower extremities in Caucasian and African-American males. Among Caucasian teenagers flame burns predominate. Mean length of stay was 10 days, 23% of patients required skin grafting surgery, and mortality was 0.9%. The results of this study highlight the need for primary prevention programs focusing on avoiding

  11. Colorectal cancer in Crohn's disease--review of a 56-year experience in Karolinska Institute University Hospital.

    Science.gov (United States)

    Rubio, Carlos A; Befrits, Ragnar

    2008-01-01

    We previously reported that the frequency of colorectal carcinomas (CRC) in Crohn's disease (CD) had increased at this hospital between 1951 and May 1996. The aim was to compare the frequency of CRC in CD between June 1996 and September 2007 to that found between 1951 and May 1996. For that purpose colectomy specimens with an IBD-CRC diagnosis filed during the last 11 years were reviewed. It was found that 29 patients with IBD developed a CRC at this hospital: 21 had CD (or 1.91 cases/year) and the remaining eight, ulcerative colitis (or 0.72 cases/year). At this hospital, the number of cases of CRC in Crohn's colitis increased from 0.28/year between 1951 and the end of 1989, to 1.69 patients/year between 1990 and May 1996, and to 1.91 patients/year between June 1996 and September 2007 (present report). The marginal increase number of patients with CRC in Crohn's colitis/year during the last 11 years at this hospital might be only apparent, considering that the incidence of Crohn's disease in the county has dramatically increased, and that the localization of Crohn's disease has changed in later years, with a predilection for the colon and rectum.

  12. Comparative Review of Endurance Development in Cadets and Students in Track-and-Field Classes and Training at Educational Institutions of State Emergency Service of Ukraine

    Directory of Open Access Journals (Sweden)

    В. М. Жогло

    2016-08-01

    Full Text Available The purpose of the research is to provide a comparative review of the endurance development in cadets and students in track-and-field classes and training at educational institutions of the State Emergency Service of Ukraine. Research methods: analysis of scientific and methodological literature, pedagogical testing and methods of mathematical statistics of data reduction. Research results. The study resulted in a comparative analysis of the levels of endurance development in the cadets and the first-year students of the School of Psychology and the School of Emergency Rescue Forces of the National University of Civil Defence of Ukraine. Conclusions. The study results prove that the first-year students of the School of Psychology and the School of Emergency Rescue Forces have a low level of endurance (special and aerobic as compared to the cadets. In this regard, the physical training syllabus ought to include more exercises intended to develop special and aerobic endurance.

  13. Management of Clostridium difficile Infection in Inflammatory Bowel Disease: Expert Review from the Clinical Practice Updates Committee of the AGA Institute.

    Science.gov (United States)

    Khanna, Sahil; Shin, Andrea; Kelly, Ciarán P

    2017-02-01

    The purpose of this expert review is to synthesize the existing evidence on the management of Clostridium difficile infection in patients with underlying inflammatory bowel disease. The evidence reviewed in this article is a summation of relevant scientific publications, expert opinion statements, and current practice guidelines. This review is a summary of expert opinion in the field without a formal systematic review of evidence. Best Practice Advice 1: Clinicians should test patients who present with a flare of underlying inflammatory bowel disease for Clostridium difficile infection. Best Practice Advice 2: Clinicians should screen for recurrent C difficile infection if diarrhea or other symptoms of colitis persist or return after antibiotic treatment for C difficile infection. Best Practice Advice 3: Clinicians should consider treating C difficile infection in inflammatory bowel disease patients with vancomycin instead of metronidazole. Best Practice Advice 4: Clinicians strongly should consider hospitalization for close monitoring and aggressive management for inflammatory bowel disease patients with C difficile infection who have profuse diarrhea, severe abdominal pain, a markedly increased peripheral blood leukocyte count, or other evidence of sepsis. Best Practice Advice 5: Clinicians may postpone escalation of steroids and other immunosuppression agents during acute C difficile infection until therapy for C difficile infection has been initiated. However, the decision to withhold or continue immunosuppression in inflammatory bowel disease patients with C difficile infection should be individualized because there is insufficient existing robust literature on which to develop firm recommendations. Best Practice Advice 6: Clinicians should offer a referral for fecal microbiota transplantation to inflammatory bowel disease patients with recurrent C difficile infection. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  14. How effective are family-based and institutional nutrition interventions in improving children's diet and health? A systematic review.

    Science.gov (United States)

    Black, Andrew P; D'Onise, Katina; McDermott, Robyn; Vally, Hassan; O'Dea, Kerin

    2017-10-17

    Effective strategies to improve dietary intake in young children are a priority to reduce the high prevalence of chronic non-communicable diseases in adulthood. This study aimed to assess the impact of family-based and school/preschool nutrition programs on the health of children aged 12 or younger, including the sustainability of these impacts and the relevance to socio-economic inequalities. A systematic review of literature published from 1980 to December 2014 was undertaken. Randomised controlled trials involving families with children aged up to 12 years in high income countries were included. The primary outcomes were dietary intake and health status. Results were presented in a narrative synthesis due to the heterogeneity of the interventions and outcomes. The systematic search and assessment identified 39 eligible studies. 82% of these studies were set in school/preschools. Only one school study assessed the impact of involving parents systematically. The family-based programs which provided simple positive dietary advice to parents and regular follow-up reduced fat intake significantly. School and family-based studies, if designed and implemented well, increased F&V intake, particularly fruit. Effective school-based programs have incorporated role-models including peers, teachers and heroic figures, rewards and increased access to healthy foods. School nutrition programs in disadvantaged communities were as effective as programs in other communities. Family and school nutrition programs can improve dietary intake, however evidence of the long-term sustainability of these impacts is limited. The modest overall impact of even these successful programs suggest complementary nutrition interventions are needed to build a supportive environment for healthy eating generally.

  15. IDENTIFICANDO CONCEPCIONES DE INFANCIA: UNA MIRADA A LOS PROYECTOS EDUCATIVOS INSTITUCIONALES (IDENTIFYING INFANCY CONCEPTIONS: AN INSTITUTIONAL EDUCATION PROJECT REVIEW

    Directory of Open Access Journals (Sweden)

    Cisternas Pacheco Nicole

    2011-08-01

    Full Text Available Resumen:El presente artículo corresponde a una investigación cuyo foco alude a aquellas concepciones de infancia que construyen las escuelas. Para lo anterior, se utilizó como instrumento de análisis uno de sus dispositivos discursivos más relevantes: los Proyectos Educativos Institucionales (PEI. De esta manera, se seleccionaron 10 proyectos de escuelas de la Región Metropolitana de Chile insertas en contextos vulnerables. La metodología utilizada fue el Análisis de Discurso, a modo de identificar, a nivel textual e interpretativo, las diversas características y elementos que constituyen las nociones acerca de la infancia presentes en los discursos educativos. Las principales conclusiones que surgen de esta indagación son dos. La primera, en el plano textual vemos que la estructura de estos documentos imposibilita que aparezca la noción de infancia, que tiene como consecuencia la invisibilización del niño o la niña en el texto, pues al utilizar el formato de proyecto se privilegia la visión de futuro, los objetivos y las metas a lograr, en desmedro del proceso educativo presente. La segunda conclusión apunta al plano interpretativo, donde se aprecia que las concepciones de infancia presentes en los PEI revisados dan cuenta de tres características principales: la contradicción, porque conviven conceptos de la niñez basados en visiones contrapuestas, la invisibilización de niños y niñas en sus discursos al ser mencionados a través de categorías abstractas. Y la omisión del concepto de derechos de la infancia y carácter garante de la escuela.Abstract: The next article response to an investigation that is focus on those infancy conceptions who are build by schools itself. For this investigation, an analysis instrument was used, as one of the most relevant discursive devices: the Educative Institutional Projects (PEI for its Spanish abbreviation Hereby, 10 projects were chosen amongst schools insert in vulnerable contexts

  16. Imaging yield from 133 consecutive patients with prostate cancer and low trigger PSA from a single institution

    International Nuclear Information System (INIS)

    Shinagare, A.B.; Keraliya, A.; Somarouthu, B.; Tirumani, S.H.; Ramaiya, N.H.; Kantoff, P.W.

    2016-01-01

    Aim: To investigate the yield of imaging in patients with relapsed prostate cancer (PC) with a low trigger prostate-specific antigen (PSA). Materials and methods: This institutional review board (IRB)-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study included all 133 patients (mean age 68 years; range 45–88; median 69 months since original diagnosis; interquartile range [IQR]: 32–139) with hormone-sensitive PC (HSPC, n=28) or castration-resistant PC (CRPC, n=105) and trigger PSA 0.05 for all). Fifty-seven of the 133 (43%) patients had findings seen only at CT, of which 37 had new extra-osseous findings. Only 2/133 (2%) had findings at bone scintigraphy not seen at CT, both in areas not covered on CT. Conclusion: Imaging frequently demonstrated new metastatic and non-metastatic findings in patients with a low trigger PSA. CT is valuable in these patients because extra-osseous findings not visible at bone scintigraphy are frequently seen. - Highlights: • New and existing metastases common in prostate cancer with low trigger PSA. • Previous reports of threshold PSA levels may not apply in follow-up setting. • No difference in metastatic pattern between hormone sensitive and resistant disease. • CT showed extra-osseous findings not seen on bone scan in 44% patients. • Bone scan rarely showed findings not visible on concurrent CT.

  17. Innovation and Institutional Embeddedness of Multinational Corporations

    DEFF Research Database (Denmark)

    Pogrebnyakov, Nicolai

    2014-01-01

    Review of: Innovation and Institutional Embeddedness of Multinational Corporations / edited by Martin Heidenreich. (Cheltenham: Edward Elgar, 2012)......Review of: Innovation and Institutional Embeddedness of Multinational Corporations / edited by Martin Heidenreich. (Cheltenham: Edward Elgar, 2012)...

  18. Complete Decomposition of Li 2 CO 3 in Li–O 2 Batteries Using Ir/B 4 C as Noncarbon-Based Oxygen Electrode

    Energy Technology Data Exchange (ETDEWEB)

    Song, Shidong; Xu, Wu; Zheng, Jianming; Luo, Langli; Engelhard, Mark H.; Bowden, Mark E.; Liu, Bin; Wang, Chong-Min; Zhang, Ji-Guang

    2017-02-10

    Incomplete decomposition of Li2CO3 during charge process is a critical barrier for rechargeable Li-O2 batteries. Here we report complete decomposition of Li2CO3 in Li-O2 batteries using ultrafine iridium-decorated boron carbide (Ir/B4C) nanocomposite as oxygen electrode. The systematic investigation on charging the Li2CO3 preloaded Ir/B4C electrode in an ether-based electrolyte demonstrates that Ir/B4C electrode can decompose Li2CO3 with an efficiency close to 100% at below 4.37 V. In contrast, the bare B4C without Ir electrocatalyst can only decompose 4.7% of preloaded Li2CO3. The reaction mechanism of Li2CO3 decomposition in the presence of Ir/B4C electrocatalyst has been further investigated. A Li-O2 battery using Ir/B4C as oxygen electrode material shows highly enhanced cycling stability than that using bare B4C oxygen electrode. These results clearly demonstrate that Ir/B4C is an effecitive oxygen electrode amterial to completely decompose Li2CO3 at relatively low charge voltages and is of significant importance in improving the cycle performanc of aprotic Li-O2 batteries.

  19. When and why is surgical revascularization indicated for the treatment of moyamoya syndrome in patients with RASopathies? A systematic review of the literature and a single institute experience.

    Science.gov (United States)

    Scala, Marcello; Fiaschi, Pietro; Capra, Valeria; Garrè, Maria Luisa; Tortora, Domenico; Ravegnani, Marcello; Pavanello, Marco

    2018-07-01

    Moyamoya disease (MMD) is a cerebrovascular disorder characterized by the progressive occlusion of the supraclinoid internal carotid artery (ICA), resulting in the formation of an abnormal cerebral vascular network. When MMD occurs in association with an underlying medical condition, including some distinctive genetic disorders, it is named moyamoya syndrome (MMS). The discrimination between MMD and MMS has been validated by recent genetic researches and international reviews. Similarly to patients suffering from MMD, patients with MMS generally become symptomatic because of ischemic complications, which lead to hemiparesis, transient ischemic events, seizures, and sensory symptoms. RASopathies are a group of neurodevelopmental disorders that can be associated with MMS. We retrospectively reviewed 18 RASopathy patients with MMS treated at our institution from 2000 to 2015 (16 neurofibromatosis type 1, 1 Costello syndrome, and 1 Schimmelpenning syndrome). Here, we report clinical data, performed surgical procedures, and clinic-radiological outcome of these patients. Most of them received both indirect revascularization and medical therapy. At the moment, there are no univocal recommendations on which of these two treatment strategies is the treatment of choice in patients with RASopathies and MMS. We suggest that patients with a good overall prognosis (primarily depending on the distinctive underlying genetic disorder) and initial cerebrovascular disease could benefit from a prophylactic surgical revascularization, in order to prevent the cognitive impairment due to the progression of the vasculopathy.

  20. Clinical Practice Update: The Use of Per-Oral Endoscopic Myotomy in Achalasia: Expert Review and Best Practice Advice From the AGA Institute.

    Science.gov (United States)

    Kahrilas, Peter J; Katzka, David; Richter, Joel E

    2017-11-01

    The purpose of this review is to describe a place for per-oral endoscopic myotomy (POEM) among the currently available robust treatments for achalasia. The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed and EMbase. The Clinical Practice Updates Committee of the American Gastroenterological Association proposes the following recommendations: 1) in determining the need for achalasia therapy, patient-specific parameters (Chicago Classification subtype, comorbidities, early vs late disease, primary or secondary causes) should be considered along with published efficacy data; 2) given the complexity of this procedure, POEM should be performed by experienced physicians in high-volume centers because an estimated 20-40 procedures are needed to achieve competence; 3) if the expertise is available, POEM should be considered as primary therapy for type III achalasia; 4) if the expertise is available, POEM should be considered as treatment option comparable with laparoscopic Heller myotomy for any of the achalasia syndromes; and 5) post-POEM patients should be considered high risk to develop reflux esophagitis and advised of the management considerations (potential indefinite proton pump inhibitor therapy and/or surveillance endoscopy) of this before undergoing the procedure. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  1. Colonial Institutions

    DEFF Research Database (Denmark)

    McAtackney, Laura; Palmer, Russell

    2016-01-01

    and the USA which reveal that the study of colonial institutions should not be limited to the functional life of these institutions—or solely those that take the form of monumental architecture—but should include the long shadow of “imperial debris” (Stoler 2008) and immaterial institutions....

  2. Institutional upbringing

    DEFF Research Database (Denmark)

    Gulløv, Eva

    2008-01-01

    In the chapter, I discuss the role day care institutions play in the construction of the idea of proper childhood in Denmark. Drawing on findings from research on ethnic minority children in two Danish day care institutions, I begin with a discussion of how childcare institutions act as civilising...... agents, empowered with the legitimate right to define and control normality and proper ways of behaving oneself. I aim to show how institutions come to define the normal child and proper childhood in accordance with current efforts toward reinventing national culture, exemplified by legislation requiring...... current testing of Danish language fluency levels among pre-school minority children. Testing language skills marks and defines distinctions that reinforce images of deviance that, in turn, legitimize initiatives to enrol children, specifically minority children, in child care institutions....

  3. Review of central power magnetohydrodynamics at the University of Tennessee Space Institute and its relation to the world effort in MHD

    International Nuclear Information System (INIS)

    Dicks, J.B.

    1975-01-01

    The first generation of electrical plants powered by MHD generators performs at 50 to 55 percent thermal efficiencies, while later versions of these plants perform at efficiencies up to 75 percent. There are three types of MHD energy conversion: (1) the open-cycle system utilizes the fossil fuel as its heat source, the resulting combustion gas being the working fluid; (2) the closed-cycle generator usually refers to the closed-cycle plasma generator which requires an external heating source to heat a noble gas as the working fluid; and (3) there is the liquid-metal generator which is also closed-cycle, but utilizes a two-phase mixture. The open-cycle system is the most promising, the most advanced, and is emphasized in this paper; the Univ. of Tennessee Space Institute has focused its attention on directly coal-fired MHD generators and has succeeded in demonstrating successful operation. A review of MHD research in the USSR indicates that all three types of generators are being tested, but emphasis is also placed there on the open-cycle system. Its most important facility is the U-25 at the Institute of High Temperatures; this generator was expected to be delivering 20 MW by the end of 1975. The cost savings to the U. S. through the development of MHD power generation is discussed. It is concluded that from its development, the sulfur dioxide pollution in high-sulfur coals is reduced by 120 times, nitrogen oxides by many times, particulate matter by 10 times and finally, thermal pollution is reduced by more than 50 percent even without the use of cooling towers. The cost of this development is placed at $410 million in 10 years

  4. Carcinosarcoma of the uterus-a single institution retrospective analysis of the management and outcome and a brief review of literature.

    Science.gov (United States)

    Anupama, Rajanbabu; Kuriakose, Santhosh; Vijaykumar, D K; Pavithran, K; Jojo, Annie; Indu, R Nair; Sheejamol, V S

    2013-09-01

    Uterine carcinosarcomas are highly aggressive tumors of the uterus associated with a poor prognosis. Though initially classified as sarcomas, now these tumors are classified as carcinomas. The management approach of carcinosarcomas has also changed from those used for high grade sarcomas to that used for managing high grade endometrial carcinomas. The purpose of our study was to analyze the management and outcome of patients with uterine carcinosarcomas treated at our institution and also to attempt a brief review regarding the management of uterine carcinosarcomas. We did a retrospective analysis of all patients with a diagnosis of carcinosarcoma of the uterus treated at our Institution from January 2005 till December 2010. All Patients with a pathological diagnosis of carcinosacrcoma or malignant mixed mullerian tumours of the uterus were included. Data was obtained from the hospital electronic medical records and the hospital cancer registry. Data was analyzed using SPSS v.17. During this 6 year period we had 20 patients with carcinosarcoma of the uterus. 75 % of the patients belonged to Stage I and II. 95 % of the patients underwent Hysterectomy with Bilateral salpingo oophorectomy and 60 % had lymphadenectomy also along with hysterectomy.8 patients had disease recurrence . In patients who had gross extrauterine disease at the time of surgery , the survival was only 9 months whereas in patients who had complete staging with disease confined to the uterus , the survival was 36 months. Carcinosarcomas, accounts for more than 15 % of the uterine cancer associated deaths. Surgery remains the cornerstone of management for these tumors and surgery with pelvic and para aortic lymphadenectomy and peritoneal and omental biopsies is required for the correct staging of the disease and may also provide a survival advantage. Radiation therapy has been shown to provide only better local control without any survival advantage. Further studies are needed to assess

  5. Institutional actorhood

    DEFF Research Database (Denmark)

    Madsen, Christian Uhrenholdt

    In this paper I describe the changing role of intra-organizational experts in the face of institutional complexity of their field. I do this through a qualitative investigation of the institutional and organizational roles of actors in Danish organizations who are responsible for the efforts...... to comply with the Danish work environment regulation. And by doing so I also describe how institutional complexity and organizational responses to this complexity are particular important for the changing modes of governance that characterizes contemporary welfare states....

  6. Institutional Investors

    DEFF Research Database (Denmark)

    Birkmose, Hanne Søndergaard; Strand, Therese

    Research Question/Issue: Institutional investors are facing increased pressure and threats of legislation from the European Union to abandon passive ownership strategies. This study investigates the prerequisites for – and potential dissimilarities in the practice of, active ownership among...... institutional investors in two Scandinavian countries with diminutive legal and cultural distance in general. Research Findings/Insights: Using data on shareholder proposals from Danish and Swedish annual general meetings from 2006 throughout 2010, we find that institutional investors are approximately....../Policy Implications: Regulators should be aware of the impact by local governance mechanisms, and how shareholders react under different legal and practical prerequisites. The paper also highlights legal elements that differ between Denmark and Sweden, and which might affect institutional activism....

  7. Institutional Controls

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset consists of institutional control data from multiple Superfund sites in U.S. EPA Region 8. These data were acquired from multiple sources at different...

  8. Institutional Assessment

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

    Many approaches can and have helped research institutions in the developing .... There are many good texts on project and program evaluation, not to ...... has challenged managers and students of organizational development for decades.

  9. What scientists want from their research ethics committee.

    Science.gov (United States)

    Keith-Spiegel, Patricia; Tabachnick, Barbara

    2006-03-01

    Whereas investigators have directed considerable criticism against Institutional Review Boards (IRBs), the desirable characteristics of IRBs have not previously been empirically determined. A sample of 886 experienced biomedical and social and behavioral scientists rated 45 descriptors of IRB actions and functions as to their importance. Predictions derived from organizational justice research findings in other work settings were generally borne out. Investigators place high value on the fairness and respectful consideration of their IRBs. Expected differences between biomedical and social behavioral researchers and other variables were unfounded. Recommendations are offered for educating IRBs to accord researchers greater respect and fair treatment.

  10. Clarification of Institutional Controls at the Rocky Flats Site Central Operable Unit and Implementation of the Soil Disturbance Review Plan - 13053

    Energy Technology Data Exchange (ETDEWEB)

    DiSalvo, Rick [Stoller LMS Team, 11025 Dover St, Suite 1000, Westminster, CO 80021 (United States); Surovchak, Scott [U.S. Department of Energy, Office of Legacy Management, 11025 Dover St, Suite 1000, Westminster, CO 80021 (United States); Spreng, Carl [Colorado Department of Public Health and Environment, 4300 Cherry Creek Dr. S, Denver, CO 80246-1530 (United States); Moritz, Vera [U.S. Environmental Protection Agency, Region 8, 1595 Wynkoop St., Denver, CO 80202-1129 (United States)

    2013-07-01

    Cleanup and closure of DOE's Rocky Flats Site in Colorado, which was placed on the CERCLA National Priority List in 1989, was accomplished under CERCLA, RCRA, and the Colorado Hazardous Waste Act (CHWA). The physical cleanup work was completed in late 2005 and all buildings and other structures that composed the Rocky Flats industrial complex were removed from the surface, but remnants remain in the subsurface. Other remaining features include two landfills closed in place with covers, four groundwater treatment systems, and surface water and groundwater monitoring systems. Under the 2006 Corrective Action Decision/Record of Decision for Rocky Flats Plant (US DOE) Peripheral Operable Unit and the Central Operable Unit (CAD/ROD), the response actions selected for the Central Operable Unit (OU) are institutional controls (ICs), physical controls, and continued monitoring and maintenance. The objectives of these ICs were to prevent unacceptable exposure to remaining subsurface contamination and to prevent contaminants from mobilizing to surface water and to prevent interfering with the proper functioning of the engineered components of the remedy. An amendment in 2011 of the 2006 CAD/ROD clarified the ICs to prevent misinterpretation that would prohibit work to manage and maintain the Central OU property. The 2011 amendment incorporated a protocol for a Soil Disturbance Review Plan for work subject to ICs that requires approval from the State and public notification by DOE prior to conducting approved soil-disturbing work. (authors)

  11. M. A. Shudria private archival fonds deposited in the holdings of the Manuscript Institute of the V. Vernadsky National Library of Ukraine: the archeographical review

    Directory of Open Access Journals (Sweden)

    Gerasimova T.

    2014-01-01

    Full Text Available The article covers the history of accession of the private archive of a famous Ukrainian journalist, writer and T. Shevchenko prize laureate M. A. Shudria to the Manuscript Institute of the VNLU fonds. In the paper we have given the short biographical information about the fonds creator and outlined his creative career. We have applied a scheme of M. A. Shudria personal archive documents systematization based on thematical and chronological principles. Therefore the documents have been divided into ten categories: «Scientific and Creative Materials», «Notices and Reviews on the Fonds Creator Works», «Biographical Materials and Materials of the Fonds Creator Official, Professional and Social Activity», «Correspondence», «Materials of Other People», «Correspondence of Other People», «Photographic Materials», «Illustrated Materials», «Printed Materials» and «Documents with Donative Inscriptions». We have thoroughly discussed the activity of M. A. Shudria as a translator of fictional works. The seventh category of documents named «Materials of Other People» is particularly important as it comprises documents characterizing various areas of cultural, scientific and public life of Ukraine.

  12. Treatment of Advanced Malignant Uterine Perivascular Epithelioid Cell Tumor with mTOR Inhibitors: Single-institution Experience and Review of the Literature.

    Science.gov (United States)

    Starbuck, Kristen D; Drake, Richard D; Budd, G Thomas; Rose, Peter G

    2016-11-01

    Uterine perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors. Many have malignant behavior, and no successful treatment strategy has been established. Identification of mutations in the tuberous sclerosis 1 (TSC1) and TSC2 genes producing constitutive activation of the mammalian target of rapamycin (mTOR) pathway presents an opportunity for targeted therapy. Patients with advanced malignant uterine PEComa treated with mTOR inhibitors were identified and records were retrospectively reviewed for treatment response based on radiographic assessment. Three patients with advanced uterine PEComas underwent debulking surgery followed by mTOR inhibitor therapy; two had a complete response to therapy and disease in one patient progressed. Given the absence of effective therapies for malignant uterine PEComas, targeting the mTOR pathway is a logical strategy to pursue given the known pathobiology involving the Tuberous Sclerosis complex. Treatment of malignant uterine PEComas with mTOR inhibitors was effective in two out of three patients after surgical resection, with durable response. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  13. Intracranial CNS Manifestations of Myeloid Sarcoma in Patients with Acute Myeloid Leukemia: Review of the Literature and Three Case Reports from the Author’s Institution

    Directory of Open Access Journals (Sweden)

    Gustavo M. Cervantes

    2015-05-01

    Full Text Available Myeloid sarcoma (MS of the central nervous system (CNS is a rare presentation of leukemic mass infiltration outside of the bone marrow. It may involve the subperiosteum and dura mater and, on rare occasions, can also invade the brain parenchyma. The disease is most commonly seen in children or young adults; however, it has been described in multiple age groups. MS can be seen in patients with acute myeloid leukemia (AML, chronic myeloid leukemia and other myeloproliferative disorders. This entity has the potential to be underdiagnosed if the MS appearance precedes the first diagnosis of leukemia. The main reason is that their appearance on CT and MRI has a broad differential diagnosis, and proper diagnosis of MS can only be made if the imaging findings are correlated with the clinical history and laboratory findings. Herein, we describe the intracranial CNS manifestations of MS in patients with AML on CT and MRI involving the brain and/or meninges. This study is based on a systematic review of the literature. In addition, three case reports from the author’s institution with AML and intracranial involvement of MS are included. Our aim is to enhance the awareness of this entity among both clinicians and radiologists.

  14. Clinical Trials

    Medline Plus

    Full Text Available ... comparison groups by chance, rather than choice. This method helps ensure that any differences observed during a ... patients also have rights that help protect them. Scientific Oversight Institutional Review Board Institutional review boards (IRBs) ...

  15. Clinical Trials

    Medline Plus

    Full Text Available ... Studies Learn more about Children and Clinical Studies Importance of Children in Clinical Studies Children have often ... rights that help protect them. Scientific Oversight Institutional Review Board Institutional review boards (IRBs) help provide scientific ...

  16. Institutional Awareness

    DEFF Research Database (Denmark)

    Ahlvik, Carina; Boxenbaum, Eva

    Drawing on dual-process theory and mindfulness research this article sets out to shed light on the conditions that need to be met to create “a reflexive shift in consciousness” argued to be a key foundational mechanism for agency in institutional theory. Although past research has identified...... in consciousness to emerge and argue for how the varying levels of mindfulness in the form of internal and external awareness may manifest as distinct responses to the institutional environment the actor is embedded in....

  17. Review of 40-year MD theses in medical oncology.

    Science.gov (United States)

    Zeeneldin, Ahmed; Diyaa, Amira; Moneer, Manar; Elgammal, Mosaad; Buhoush, Wafa

    2014-09-01

    It is almost 40 years since the foundation of the Medical Oncology (MO) Department. We aimed to appraise the clinical research to fulfill the Medical Doctorate (MD) degree in MO at the National Cancer Institute, Cairo University (NCI, CU). This review included 62 MD theses containing 66 studies. They were reviewed regarding aims, type of study, clinical trial phase, design and methodology, statistical tests, results, limitations, consent and IRB approval. Theses were grouped into 3 periods: 1970-1989, 1990-1999 and 2000-2008. Almost 76% of the studies were interventional and 24% were observational. Informed consent and Institutional Review Board approval were mentioned in 18 and 2 studies, respectively. While all studies mentioned the aims, none, clearly mentioned the research question. Outcomes were mainly efficacy followed by safety. Study design was inadequately considered, especially in 70's-80's period (p=0.038). Median sample size and study duration were almost stable through the three periods (p=0.441, 0.354, respectively). Most of the studies used both descriptive and analytical statistical methods. In a descending order, researched cancers were lymphoma, breast, leukemia, liver, urinary bladder, lung and colorectal. The commonest stages researched were IV and III. The number of studies focused on assessing biomarkers, biomarkers plus drugs/procedures, drugs and procedures are 20, 20, 16 and 6, respectively. With time, research within MD theses in MO increased quantitatively and qualitatively. Improvements were noticeable in documentation of study design. Copyright © 2014. Production and hosting by Elsevier B.V.

  18. Survey of credit risk models in relation to capital adequacy framework for financial institutions

    Directory of Open Access Journals (Sweden)

    Poomjai Nacaskul

    2016-12-01

    Full Text Available This article (i iterates what is meant by credit risks and the mathematical-statistical modelling thereof, (ii elaborates the conceptual and technical links between credit risk modelling and capital adequacy framework for financial institutions, particularly as per the New Capital Accord (Basel II’s Internal Ratings-Based (IRB approach, (iii proffer a simple and intuitive taxonomy on contemporary credit risk modelling methodologies, and (iv discuses in some details a number of key models pertinent, in various stages of development, to various application areas in the banking and financial sector.

  19. European Institutions?

    NARCIS (Netherlands)

    Meacham, Darian

    2016-01-01

    The aim of this article is to sketch a phenomenological theory of political institutions and to apply it to some objections and questions raised by Pierre Manent about the project of the European Union and more specifically the question of “European Construction”, i.e. what is the aim of the

  20. Institution Morphisms

    Science.gov (United States)

    Goguen, Joseph; Rosu, Grigore; Norvig, Peter (Technical Monitor)

    2001-01-01

    Institutions formalize the intuitive notion of logical system, including both syntax and semantics. A surprising number of different notions of morphisim have been suggested for forming categories with institutions as objects, and a surprising variety of names have been proposed for them. One goal of this paper is to suggest a terminology that is both uniform and informative to replace the current rather chaotic nomenclature. Another goal is to investigate the properties and interrelations of these notions. Following brief expositions of indexed categories, twisted relations, and Kan extensions, we demonstrate and then exploit the duality between institution morphisms in the original sense of Goguen and Burstall, and the 'plain maps' of Meseguer, obtaining simple uniform proofs of completeness and cocompleteness for both resulting categories; because of this duality, we prefer the name 'comorphism' over 'plain map.' We next consider 'theoroidal' morphisms and comorphisims, which generalize signatures to theories, finding that the 'maps' of Meseguer are theoroidal comorphisms, while theoroidal morphisms are a new concept. We then introduce 'forward' and 'semi-natural' morphisms, and appendices discuss institutions for hidden algebra, universal algebra, partial equational logic, and a variant of order sorted algebra supporting partiality.

  1. Salvage Treatment for Recurrent Intracranial Germinoma After Reduced-Volume Radiotherapy: A Single-Institution Experience and Review of the Literature

    International Nuclear Information System (INIS)

    Hu, Yu-Wen; Huang, Pin-I; Wong, Tai-Tong; Ho, Donald Ming-Tak; Chang, Kai-Ping; Guo, Wan-Yuo; Chang, Feng-Chi; Shiau, Cheng-Yin; Liang, Muh-Lii; Lee, Yi-Yen

    2012-01-01

    Purpose: Intracranial germinomas (IGs) are highly curable with radiotherapy (RT). However, recurrence still occurs, especially when limited-field RT is applied, and the optimal salvage therapy remains controversial. Methods and Materials: Between January 1989 and December 2010, 14 patients with clinically or pathologically diagnosed recurrent IGs after RT were reviewed at our institution. Of these, 11 received focal-field RT, and the other 3 received whole-brain irradiation, whole-ventricle irradiation, and Gamma Knife radiosurgery as the respective first course of RT. In addition, we identified from the literature 88 patients with recurrent IGs after reduced-volume RT, in whom the details of salvage therapy were recorded. Results: The median time to recurrence was 30.3 months (range, 3.8–134.9 months). One patient did not receive further treatment and was lost during follow-up. Of the patients, 7 underwent salvage with craniospinal irradiation (CSI) plus chemotherapy (CT), 4 with CSI alone, 1 with whole-brain irradiation plus CT, and 1 with Gamma Knife radiosurgery. The median follow-up time was 105.1 months (range, 24.2–180.9 months). Three patients died without evidence of disease progression: two from second malignancies and one from unknown cause. The others remained disease free. The 3-year survival rate after recurrence was 83.3%. A total of 102 patients from our study and the literature review were analyzed to determine the factors affecting prognosis and outcomes. After recurrence, the 5-year survival rates were 71% and 92.9% for all patients and for those receiving salvage CSI, respectively. Univariate analysis showed that initial RT volume, initial RT dose, initial CT, and salvage RT type were significant prognostic predictors of survival. On multivariable analysis, salvage CSI was the most significant factor (p = 0.03). Conclusions: Protracted follow-up is recommended because late recurrence is not uncommon. CSI with or without CT is an effective

  2. Early Detection and Treatment of Neuroblastic Tumor with Opsoclonus-Myoclonus Syndrome Improve Neurological Outcome: A Review of Five Cases at a Single Institution in Japan.

    Science.gov (United States)

    Takama, Yuichi; Yoneda, Akihiro; Nakamura, Tetsuro; Nakaoka, Tatsuo; Higashio, Atsushi; Santo, Kenji; Kuki, Ichiro; Kawawaki, Hisashi; Tomiwa, Kiyotaka; Hara, Junichi

    2016-02-01

    Opsoclonus-myoclonus syndrome (OMS) is a paraneoplastic neurological disorder associated with neuroblastic tumor (NT) in childhood. Half of patients have neurological sequelae after the neurological and oncological treatment. We reviewed the neurological and oncological outcomes of NT with OMS, and discussed whether the treatment of NT would contribute to improving the neurological prognosis. We retrospectively assessed NT patients with OMS from January 2001 to December 2013 at a single institution in Japan. Demographic data, neurological and oncological status, histopathology, treatments, prognosis, and diagnosis and treatment timing were retrospectively reviewed from the records. The timings assessed were the interval between OMS onset and NT detection, initial NT therapy, and initial OMS therapy, the interval between NT therapy and OMS remission, and duration of OMS. A total of 73 patients with NT were treated during the study period, and 5 of 73 patients were diagnosed as having NT with OMS. The median age at onset of OMS was 22 months (range, 18-30 months). The median age at detection of NT was 29 months (range, 21-33 months). Three of five cases showed no uptake on meta-iodobenzylguanidine scintigraphy. The tumor histopathology was neuroblastoma in two patients, ganglioneuroblastoma in two patients, and ganglioneuroma in one patient. Primary resection was performed in three cases. All patients survived. Two of five cases presented with atypical neurological symptoms without opsoclonus. The initial neurological therapy was started within a mean of 20 days (range, 3-76 days) from the onset of OMS in all cases. Four patients received intravenous immunoglobulin, and one with persistent neurological problems received rituximab. Neurological symptoms resolved in three cases. The mean interval between the onset of OMS and the detection of NT in case without neurological sequelae was 57 days (range, 25-113 days), while in case with neurological sequelae it was 365

  3. Endovascular Mechanical Thrombectomy in Large-Vessel Occlusion Ischemic Stroke Presenting with Low National Institutes of Health Stroke Scale: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Griessenauer, Christoph J; Medin, Caroline; Maingard, Julian; Chandra, Ronil V; Ng, Wyatt; Brooks, Duncan Mark; Asadi, Hamed; Killer-Oberpfalzer, Monika; Schirmer, Clemens M; Moore, Justin M; Ogilvy, Christopher S; Thomas, Ajith J; Phan, Kevin

    2018-02-01

    Mechanical thrombectomy has become the standard of care for management of most large vessel occlusion (LVO) strokes. When patients with LVO present with minor stroke symptomatology, no consensus on the role of mechanical thrombectomy exists. A systematic review and meta-analysis were performed to identify studies that focused on mechanical thrombectomy, either as a standalone treatment or with intravenous tissue plasminogen activator (IV tPA), in patients with mild strokes with LVO, defined as a baseline National Institutes of Health Stroke Scale score ≤5 at presentation. Data on methodology, quality criteria, and outcome measures were extracted, and outcomes were compared using odds ratio as a summary statistic. Five studies met the selection criteria and were included. When compared with medical therapy without IV tPA, mechanical thrombectomy and medical therapy with IV tPA were associated with improved 90-day modified Rankin Scale (mRS) score. Among medical patients who were not eligible for IV tPA, those who underwent mechanical thrombectomy were more likely to experience good 90-day mRS than those who were not. There was no significant difference in functional outcome between mechanical thrombectomy and medical therapy with IV tPA, and no treatment subgroup was associated with intracranial hemorrhage or death. In patients with mild strokes due to LVO, mechanical thrombectomy and medical therapy with IV tPA led to better 90-day functional outcome. Mechanical thrombectomy plays an important role in the management of these patients, particularly in those not eligible for IV tPA. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. New technologies for information retrieval to achieve situational awareness and higher patient safety in the surgical operating room: the MRI institutional approach and review of the literature.

    Science.gov (United States)

    Kranzfelder, Michael; Schneider, Armin; Gillen, Sonja; Feussner, Hubertus

    2011-03-01

    Technical progress in the operating room (OR) increases constantly, but advanced techniques for error prevention are lacking. It has been the vision to create intelligent OR systems ("autopilot") that not only collect intraoperative data but also interpret whether the course of the operation is normal or deviating from the schedule ("situation awareness"), to recommend the adequate next steps of the intervention, and to identify imminent risky situations. Recently introduced technologies in health care for real-time data acquisition (bar code, radiofrequency identification [RFID], voice and emotion recognition) may have the potential to meet these demands. This report aims to identify, based on the authors' institutional experience and a review of the literature (MEDLINE search 2000-2010), which technologies are currently most promising for providing the required data and to describe their fields of application and potential limitations. Retrieval of information on the functional state of the peripheral devices in the OR is technically feasible by continuous sensor-based data acquisition and online analysis. Using bar code technologies, automatic instrument identification seems conceivable, with information given about the actual part of the procedure and indication of any change in the routine workflow. The dynamics of human activities also comprise key information. A promising technology for continuous personnel tracking is data acquisition with RFID. Emotional data capture and analysis in the OR are difficult. Although technically feasible, nonverbal emotion recognition is difficult to assess. In contrast, emotion recognition by speech seems to be a promising technology for further workflow prediction. The presented technologies are a first step to achieving an increased situational awareness in the OR. However, workflow definition in surgery is feasible only if the procedure is standardized, the peculiarities of the individual patient are taken into account

  5. Intensity modulated radiotherapy (IMRT in the treatment of children and Adolescents - a single institution's experience and a review of the literature

    Directory of Open Access Journals (Sweden)

    Huber Peter

    2009-09-01

    Full Text Available Abstract Background While IMRT is widely used in treating complex oncological cases in adults, it is not commonly used in pediatric radiation oncology for a variety of reasons. This report evaluates our 9 year experience using stereotactic-guided, inverse planned intensity-modulated radiotherapy (IMRT in children and adolescents in the context of the current literature. Methods Between 1999 and 2008 thirty-one children and adolescents with a mean age of 14.2 years (1.5 - 20.5 were treated with IMRT in our department. This heterogeneous group of patients consisted of 20 different tumor entities, with Ewing's sarcoma being the largest (5 patients, followed by juvenile nasopharyngeal fibroma, esthesioneuroblastoma and rhabdomyosarcoma (3 patients each. In addition a review of the available literature reporting on technology, quality, toxicity, outcome and concerns of IMRT was performed. Results With IMRT individualized dose distributions and excellent sparing of organs at risk were obtained in the most challenging cases. This was achieved at the cost of an increased volume of normal tissue receiving low radiation doses. Local control was achieved in 21 patients. 5 patients died due to progressive distant metastases. No severe acute or chronic toxicity was observed. Conclusion IMRT in the treatment of children and adolescents is feasible and was applied safely within the last 9 years at our institution. Several reports in literature show the excellent possibilities of IMRT in selective sparing of organs at risk and achieving local control. In selected cases the quality of IMRT plans increases the therapeutic ratio and outweighs the risk of potentially increased rates of secondary malignancies by the augmented low dose exposure.

  6. Institutional obligation

    International Nuclear Information System (INIS)

    Rowan, S.S.; Berwager, S.D.

    1988-01-01

    The institutional obligation is to act to meet primary responsibilities in the face of risks. There are risks involved in taking action, both of a quantifiable and unquantifiable nature. This paper explores weighing the risks, choosing approaches that balance primary obligations with broader ones, and presenting ethical philosophies upon which policies and strategies are based. Federal government organizations and utilities--and Bonneville Power Administration qualifies as both--have a variety of responsibilities to the public they serve. The common responsibility is that of service; for Bonneville the primary responsibility is to serve the energy related needs. It is this primary institutional obligation, as it relates to other responsibilities--and the resulting strategy for handling indoor air quality in Bonneville's new homes program--that this paper examines

  7. Minority-Serving Institutions and Disability, Health, Independent Living, and Rehabilitation Research Participation Challenges: A Review of the Literature and Policy

    Science.gov (United States)

    Manyibe, Edward O.; Moore, Corey L.; Aref, Fariborz; Sagini, Meshack M.; Zeng, Steve; Alston, Reginald J.

    2017-01-01

    Purpose: This article provided a comprehensive overview of select challenges that oftentimes prevent minority-serving institutions (MSIs) in the United States (i.e., historically Black colleges/universities, Hispanic-serving institutions, and American Indian tribal colleges/universities) from participating optimally in the federal research…

  8. A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems

    NARCIS (Netherlands)

    Taylor, T.L.; Killaspy, H.; Wright, C.; Turton, P.; White, S.; Kallert, T.W.; Schuster, M.; Cervilla, J.A.; Brangier, P.; Raboch, J.; Kalisova, L.; Onchev, G.; Dimitrov, H.; Mezzina, R.; Wolf, Kinou; Wiersma, D.; Visser, E.; Kiejna, A.; Piotrowski, P.; Ploumpidis, D.; Gonidakis, F.; Caldas-de-Almeida, J.; Cardoso, G.; King, M.B.

    2009-01-01

    Background: A proportion of people with mental health problems require longer term care in a psychiatric or social care institution. However, there are no internationally agreed quality standards for institutional care and no method to assess common care standards across countries. We aimed to

  9. Institutional shareholder activism in Nigeria

    OpenAIRE

    Uche, C.; Adegbite, E.; Jones, M.

    2016-01-01

    The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Abstract Purpose-The purpose of this paper is to investigate institutional shareholder activism in Nigeria. It addresses the paucity of empirical research on institutional shareholder activism in sub-Saharan Africa. Design/Methodology-This study employs agency theory to understand the institutional shareholder approach to shareholde...

  10. Blended Learning as Transformational Institutional Learning

    Science.gov (United States)

    VanDerLinden, Kim

    2014-01-01

    This chapter reviews institutional approaches to blended learning and the ways in which institutions support faculty in the intentional redesign of courses to produce optimal learning. The chapter positions blended learning as a strategic opportunity to engage in organizational learning.

  11. Use of 3.0-T MRI for Stereotactic Radiosurgery Planning for Treatment of Brain Metastases: A Single-Institution Retrospective Review

    International Nuclear Information System (INIS)

    Saconn, Paul A.; Shaw, Edward G.; Chan, Michael D.; Squire, Sarah E.; Johnson, Annette J.; McMullen, Kevin P.; Tatter, Stephen B.; Ellis, Thomas L.; Lovato, James; Bourland, J. Daniel; Ekstrand, Kenneth E.; DeGuzman, Allan F.; Munley, Michael T.

    2010-01-01

    Purpose: To investigate the efficacy of 3.0-T magnetic resonance imaging (MRI) for detecting brain metastases for stereotactic radiosurgery (SRS) planning. Methods and Materials: All adult patients scheduled for SRS treatment for brain metastases at our institution between October 2005 and January 2008 were eligible for analysis. All patients underwent radiosurgery treatment planning 3.0-T MRI on the day of scheduled radiosurgery and a diagnostic 1.5-T MRI in the days or weeks prior to radiosurgery for comparison. Both scans were interpreted by neuroradiologists who reported their findings in the radiology reports. We performed a retrospective review of the radiology reports to determine the number of brain metastases identified using each MRI system. Results: Of 254 patients scheduled for treatment from October 2005 to January 2008, 138 patients had radiology reports that explicitly described the number of metastases identified on both scans. With a median interval of 17 days (range, 1-82) between scans, the number of metastases detected using 1.5-T MRI system ranged from 1 to 5 and from 1 to 8 using the 3.0 T-MRI system. Twenty-two percent of patients were found to have a greater number of metastases with the 3.0 T-MRI system. The difference in number of metastases detected between the two scans for the entire cohort ranged from 0 to 6. Neither histology (p = 0.52 by chi-sq test) nor time between scans (p = 0.62 by linear regression) were significantly associated with the difference in number of metastases between scans. Conclusions: The 3.0-T MRI system appears to be superior to a 1.5-T MRI system for detecting brain metastases, which may have significant implications in determining the appropriate treatment modality. Our findings suggest the need for a prospectively designed study to further evaluate the use of a 3.0 T-MRI system for stereotactic radiosurgery planning in the treatment of brain metastases.

  12. Institutional ethnography

    DEFF Research Database (Denmark)

    Lund, Rebecca; Tienari, Janne

    2016-01-01

    The study of M&As is dominated by positivist and functionalist world views and the use of quantitative methods. Although extant research also uses qualitative and mixed methods, it can be criticized for viewing its subject matter through an abstract and external lens. The researcher is placed in ......, and point to some of the problems in M&A studies identified through this lens. Finally, we argue why institutional ethnography, in comparison with other methods of inquiry, is particularly fruitful in the study of mergers and acquisitions....

  13. Larger, Higher-level Academic Institutions in the US Do Not Necessarily Have Better-resourced Library Web Teams. A Review of: Connell, Ruth Sara.

    Directory of Open Access Journals (Sweden)

    Suzanne Lewis

    2008-12-01

    Full Text Available Objective – To discover how library Web teams’ staffing, backgrounds, tools, and professional development differ among various types of academic libraries.Design – Survey.Setting – Academic libraries in the United States.Subjects – Academic library Web team members.Methods – A systematic sample of every twelfth institution on The Carnegie Classification of Institutions of Higher Education list was used to establish a sample group. A Web search was carriedout to identify each institution’s library Web site and contact information for the Web site designer or most appropriate alternative person. Institutions were excluded from the sample if they had no Web site at all, had no library Web site, had a Web site that did not mention a library, or had a Spanish language Web site. In September 2006 an e-mail was sent to the contact for each institution in the sample group asking them to participate in an online survey. A follow up e-mail was sent two weeks later and the survey closed after one month. The survey respondents were asked to identify their institutions so that analysis of the results in relation to the sizeand type of institution could be carried out. The researchers used a simplified version of the Carnegie classification to sort the responding institutions into five main groups.Main Results – The systematic sample consisted of 288 institutions (sample size 6.5%. The profile of the responding institutions was as follows: associate’s colleges (35.5%, baccalaureate colleges (18.2%, master’s colleges and universities (20.9%, doctorate-granting universities (9% and special focus institutions (15.5%. A total of 110 institutions completed the survey, yielding a response rate of 38.19%, although not all respondents answered all the survey questions. The final sample of 110 was 2.5% of the total 4384 institutions on the Carnegielist. Seventy-one per cent of institutions with multiple libraries shared Web teams, with two

  14. 76 FR 31619 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2011-06-01

    ... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; SBIR Phase IIB...: To review and evaluate contract proposals. Place: National Institutes of Health, 6116 Executive...

  15. Institute news

    Science.gov (United States)

    1999-11-01

    Joining the team A new member of staff has recently joined the Institute of Physics Education Department (Schools and Colleges) team. (Dr) Steven Chapman will have managerial responsibility for physics education issues in the 11 - 16 age range, particularly on the policy side. He will work closely with Mary Wood, who spends much of her time out and about doing the practical things to support physics education pre-16. Catherine Wilson will be spending more of her time working to support the Post-16 Physics Initiative but retains overall responsibility for the department. Steven graduated in Physics and Astronomy and then went on to do his doctorate at Sussex University. He stayed in the research field for a while, including a period at NPL. Then, having decided to train as a teacher, he taught for the last five years, most recently at a brand new school in Sutton where he was Head of Physics. Physics update Dates for `Physics Update' courses in 2000, intended for practising science teachers, are as follows: 1 - 3 April: Malvern College 9 - 10 June: Stirling University 8 - 10 July: York University 8 - 10 December: Oxford University The deadline for applications for the course to be held on 11 - 13 December 1999 at the School of Physics, Exeter University, is 12 November, so any late enquiries should be sent to Leila Solomon at The Institute of Physics, 76 Portland Place, London W1N 3DH (tel: 020 7470 4821) right away. Name that teacher! Late nominations are still welcome for the Teachers of Physics/Teachers of Primary Science awards for the year 2000. Closing date for nominations is `the last week in November'. Further details can be obtained from Catherine Wilson or Barbara Hill in the Institute's Education Department. Forward and back! The Education Group's one-day meeting on 13 November is accepting bookings until almost the last minute, so don't delay your application! The day is entitled `Post-16 physics: Looking forward, learning from the past' and it aims to

  16. Informal institutions and radical ideologies under institutional transformation

    Directory of Open Access Journals (Sweden)

    Irina Starodubrovskaya

    2015-06-01

    Full Text Available This article questions one of the central postulates of institutional economic theory, i.e., that of the sustainability and purely evolutionary changes of informal institutions. To study the phenomenon of the destruction of informal institutions and its consequences, we use the tools of sociological theory, which acknowledge that a period of intensive urbanization is characterized by anomie, i.e., a lack of norms, in which traditional institutions are destroyed, while new urban institutions have not yet taken shape. We reviewed the possible reactions of communities and individuals to the conditions of anomie, including the compensatory mechanisms of ideologies. In the case of the Dagestan Republic, we show how the proliferation of fundamentalist Islamic ideology is associated with the state of anomie and the consequences to which it could lead from an institutional point of view. The analysis of the situation in Dagestan is based on long-term field research conducted in the region.

  17. Aligning institutional priorities: engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements.

    Science.gov (United States)

    Flanagan, Meghan R; Foster, Carolyn C; Schleyer, Anneliese; Peterson, Gene N; Mandell, Samuel P; Rudd, Kristina E; Joyner, Byron D; Payne, Thomas H

    2016-02-01

    House staff quality improvement projects are often not aligned with training institution priorities. House staff are the primary users of inpatient problem lists in academic medical centers, and list maintenance has significant patient safety and financial implications. Improvement of the problem list is an important objective for hospitals with electronic health records under the Meaningful Use program. House staff surveys were used to create an electronic problem list manager (PLM) tool enabling efficient problem list updating. Number of new problems added and house staff perceptions of the problem list were compared before and after PLM intervention. The PLM was used by 654 house staff after release. Surveys demonstrated increased problem list updating (P = .002; response rate 47%). Mean new problems added per day increased from 64 pre-PLM to 125 post-PLM (P house staff in institutional quality and safety initiatives with tangible institutional benefits. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Generación de trayectorias y evitación de obstáculos para el robot IRB120 en entorno Matlab

    OpenAIRE

    Blanco Fernández, Nicolás

    2015-01-01

    En este proyecto se abordará el desarrollo de una aplicación que permita una comunicación eficaz y fluida con el brazo robótico IRB120 de ABB desde el entorno Matlab, posibilitando la generación de trayectorias definidas por el usuario a través de unos “puntos de paso” intermedios, así como la detección de nuevos obstáculos presentes en la trayectoria del robot y la planificación de nuevas trayectorias recalculadas para evitarlos. La detección del área de trabajo se efectuará mediante el s...

  19. Quality Control Review of Berenson & Company LLP and the Defense Contract Audit Agency Riverside Research Institute Fiscal Year Ended November 30, 1996

    National Research Council Canada - National Science Library

    Smolenyak, Barbara

    1998-01-01

    .... We focused our review on the following qualitative aspects of the audit: due professional care, planning, supervision, independence, quality control, internal controls, substantive testing, general and specific compliance testing...

  20. Reviews

    Science.gov (United States)

    2002-11-01

    CD-ROM REVIEW (551) Essential Physics BOOK REVIEWS (551) Collins Advanced Science: Physics, 2nd edition Quarks, Leptons and the Big Bang, 2nd edition Do Brilliantly: A2 Physics IGCSE Physics Geophysics in the UK Synoptic Skills in Advanced Physics Flash! The hunt for the biggest explosions in the universe Materials Maths for Advanced Physics

  1. Surgical management of esophageal achalasia: Evolution of an institutional approach to minimally invasive repair.

    Science.gov (United States)

    Petrosyan, Mikael; Khalafallah, Adham M; Guzzetta, Phillip C; Sandler, Anthony D; Darbari, Anil; Kane, Timothy D

    2016-10-01

    Surgical management of esophageal achalasia (EA) in children has transitioned over the past 2 decades to predominantly involve laparoscopic Heller myotomy (LHM) or minimally invasive surgery (MIS). More recently, peroral endoscopic myotomy (POEM) has been utilized to treat achalasia in children. Since the overall experience with surgical management of EA is contingent upon disease incidence and surgeon experience, the aim of this study is to report a single institutional contemporary experience for outcomes of surgical treatment of EA by LHM and POEM, with regards to other comparable series in children. An IRB approved retrospective review of all patients with EA who underwent treatment by a surgical approach at a tertiary US children's hospital from 2006 to 2015. Data including demographics, operative approach, Eckardt scores pre- and postoperatively, complications, outcomes, and follow-up were analyzed. A total of 33 patients underwent 35 operative procedures to treat achalasia. Of these operations; 25 patients underwent laparoscopic Heller myotomy (LHM) with Dor fundoplication; 4 patients underwent LHM alone; 2 patients underwent LHM with Thal fundoplication; 2 patients underwent primary POEM; 2 patients who had had LHM with Dor fundoplication underwent redo LHM with takedown of Dor fundoplication. Intraoperative complications included 2 mucosal perforations (6%), 1 aspiration, 1 pneumothorax (1 POEM patient). Follow ranged from 8months to 7years (8-84months). There were no deaths and no conversions to open operations. Five patients required intervention after surgical treatment of achalasia for recurrent dysphagia including 3 who underwent between 1 and 3 pneumatic dilations; and 2 who had redo LHM with takedown of Dor fundoplication with all patients achieving complete resolution of symptoms. Esophageal achalasia in children occurs at a much lower incidence than in adults as documented by published series describing the surgical treatment in children. We

  2. Report on Quality Control Review of the Raich Ende Malter & Co. LLP FY 2009 Single Audit of the Riverside Research Institute

    Science.gov (United States)

    2012-03-07

    compliance was based on a determination that 10 of the 14 compliance requirements were applicable to the Institute. However, the audit working papers...for all 14 of the compliance requirements were not adequate to support conclusions on applicability, internal control, and the audit opinion on...compliance with laws, regulations, and award provisions applicable to the R&D cluster program. In addition, the audit firm did not appropriately report an

  3. 77 FR 76057 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2012-12-26

    ..., Scientific Review Officer, Resources and Training Review Branch, Division of Extramural Activities, National... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...--Institutional Training and Education Institutional Training and Education Grant. Date: February 25-26, 2013...

  4. Reviews.

    Science.gov (United States)

    Journal of Chemical Education, 1987

    1987-01-01

    Provides a review of both the Apple and IBM versions of ENZPACK, a software package which is designed to assist in the teaching of enzyme kinetics in courses where this topic is treated in some depth. (TW)

  5. Review

    Indian Academy of Sciences (India)

    2012-03-29

    Mar 29, 2012 ... The present review documents an overview of speciation mediated through behavioural ...... The Drosophila model (New York: Oxford University Press) .... second part of his big species book written from 1856–1858. (New ...

  6. KfK, Institute for Reactor Components. Results of research and development activities in 1989

    International Nuclear Information System (INIS)

    1990-03-01

    R and D activities at IRB (Institut fuer Reaktorbauelemente - Institute for Reactor Components) are dedicated to thermodynamics and fluid dynamics. Emphasis is on the design of nuclear reactor and fusion reactor components. Environmental engineering was added recently. Most activities are applications-oriented. Fundamental investigations focus on energy research and energy technology. The activities are carried out in the framework of different projects (PKF/nuclear fusion, PSF/nuclear safety, PSU/pollution control). Points of main effort are the development of basic liquid-metal-cooled blanket solutions, investigations on natural convection in reactor tanks, and the cooling properties of future containments for pressurized water reactors in the case of nuclear fusion accidents. (orig./GL) [de

  7. 76 FR 31633 - Tin- and Chromium-Coated Steel Sheet from Japan; Institution of a Five-Year Review Concerning the...

    Science.gov (United States)

    2011-06-01

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-860 (Second Review)] Tin- and Chromium... Tin- and Chromium-Coated Steel Sheet from Japan AGENCY: United States International Trade Commission... the antidumping duty order on tin- and chromium-coated steel sheet from Japan would be likely to lead...

  8. Fostering Institutional Creativity at Multiple Levels: Towards Facilitated Institutional Bricolage

    Directory of Open Access Journals (Sweden)

    Douglas J. Merrey

    2012-02-01

    Full Text Available Problems occur when institutional arrangements for collective management of food and water systems fail to meet demands. Many of the problems characterising river basins and other collectively managed water resource systems can be ascribed largely to the failure of institutions to enable problems beyond the individual to be managed collectively. The nature of these demands, and the institutional responses to them, vary widely and are not amenable to simple definitions and prescriptions. We begin with a brief review of conventional approaches to analysing institutions and organisations, focused largely, but not exclusively, on river basins. We observe that attempts to reduce the institutional landscape of river basins to over-simplistic formulas introduces more problems than solutions, because the reality is that institutions evolve through complex creative processes that adopt and adapt diverse ingredients – rather like making a stew. Despite such intricacies, institutions are clearly non-random, so we continue a search for a means of describing them. We adopt the concept of bricolage, as proposed by Cleaver and others, and use it to show the value of promoting and facilitating an organic creative approach to building and strengthening river basin and other water management institutions.

  9. Environmental Design for End-of-Life Care: An Integrative Review on Improving the Quality of Life and Managing Symptoms for Patients in Institutional Settings.

    Science.gov (United States)

    Sagha Zadeh, Rana; Eshelman, Paul; Setla, Judith; Kennedy, Laura; Hon, Emily; Basara, Aleksa

    2018-03-01

    The environment in which end-of-life (EOL) care is delivered can support or detract from the physical, psychological, social, and spiritual needs of patients, their families, and their caretakers. This review aims to organize and analyze the existing evidence related to environmental design factors that improve the quality of life and total well-being of people involved in EOL care and to clarify directions for future research. This integrated literature review synthesized and summarized research evidence from the fields of medicine, environmental psychology, nursing, palliative care, architecture, interior design, and evidence-based design. This synthesis analyzed 225 documents, including nine systematic literature reviews, 40 integrative reviews, three randomized controlled trials, 118 empirical research studies, and 55 anecdotal evidence. Of the documents, 192 were peer-reviewed, whereas 33 were not. The key environmental factors shown to affect EOL care were those that improved 1) social interaction, 2) positive distractions, 3) privacy, 4) personalization and creation of a home-like environment, and 5) the ambient environment. Possible design interventions relating to these topics are discussed. Examples include improvement of visibility and line of sight, view of nature, hidden medical equipment, and optimization of light and temperature. Studies indicate several critical components of the physical environment that can reduce total suffering and improve quality of life for EOL patients, their families, and their caregivers. These factors should be considered when making design decisions for care facilities to improve physical, psychological, social, and spiritual needs at EOL. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  10. Survival of T4aN0 and T3N+ laryngeal cancer patients: a retrospective institutional study and systematic review.

    Science.gov (United States)

    Khoueir, Nadim; Matar, Nayla; Farah, Chadi; Francis, Evana; Tabchy, Bassam; Haddad, Amine

    2015-01-01

    We aim to assess the correlation of tumor and nodal staging to survival in pT3N+ and T4aN0 laryngeal cancer with subgroup analysis within stage IVa (pT4N0 and pT3N2). Retrospective cohort study with systematic review of the literature. Hotel Dieu de France University Hospital (tertiary referral center). Laryngeal cancer patients' registries were reviewed from 1998 to 2012 selecting pT3N+ and pT4aN0 patients treated by primary total layngectomy. Overall survivals were compared using Log rank and Kaplan-Meier analysis. A systematic review was performed by 2 reviewers including all the articles reporting the outcome of these categories of patients. Online databases, including PubMed and EMBASE, were used. Reference sections of identified studies were examined for additional articles. Thirteen T3N+ patients and 19 T4aN0 patients treated by primary total laryngectomy were included. Five-year overall survival for T3N+, T3N2 and T4aN0 was respectively 33%, 32.1% and 73.7%. Due to the small sample, the difference was not significant. The systematic review revealed three articles reporting overall survival outcome for the T4N0 group and 6 articles for the T3N+. At 5years, the survival ranged from 62.5% to 73% in T4N0 and from 32.2% to 77% in T3N+. In advanced stage laryngeal cancer, T4aN0 tends toward a better survival than T3N+ especially when compared to T3N2 although they are grouped in the same TNM stage IVa. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Institutional Strength in Depth

    International Nuclear Information System (INIS)

    Weightman, M.

    2016-01-01

    Much work has been undertaken in order to identify, learn and implement the lessons from the TEPCO Fukushima Daiichi nuclear accident. These have mainly targeted on engineering or operational lessons. Less attention has been paid to the institutional lessons, although there have been some measures to improve individual peer reviews, particularly by the World Association of Nuclear Operators, and the authoritative IAEA report published in 2015 brought forward several important lessons for regulators and advocated a system approach. The report noted that one of the contributing factors the accident was the tendency of stakeholders not to challenge. Additionally, it reported deficiencies in the regulatory authority and system. Earlier, the root cause of the accident was identified by a Japanese independent parliamentary report as being cultural and institutional. The sum total of the institutions, the safety system, was ineffective. While it is important to address the many technical and operational lessons these may not necessary address this more fundamental lesson, and may not serve to provide robust defences against human or institutional failings over a wide variety of possible events and combinations. The overall lesson is that we can have rigorous and comprehensive safety standards and other tools in place to deliver high levels of safety, but ultimately what is important is the ability of the nuclear safety system to ensure that the relevant institutions diligently and effectively apply those standards and tools — to be robust and resilient. This has led to the consideration of applying the principles of the strength in depth philosophy to a nuclear safety system as a way of providing a framework for developing, assessing, reviewing and improving the system. At an IAEA conference in October 2013, a model was presented for a robust national nuclear safety system based on strength in depth philosophy. The model highlighted three main layers: industry, the

  12. Institutions, Entrepreneurship, and Economic Growth

    DEFF Research Database (Denmark)

    Bjørnskov, Christian; Foss, Nicolai Juul

    2016-01-01

    sample limitations, omitted variable biases, causality issues, and response heterogeneity. We argue that theories in management research, such as the resource-based view, transaction cost economics, and strategic entrepreneurship theory, can fill some of the conceptual and theoretical gaps.......We review the literature that links institutions, entrepreneurship, and economic growth outcomes, focusing in particular on empirical research. Most of the literature has an economics orientation, but we also review relevant literature from other social sciences, including management research...

  13. Malnutrition in healthcare institutions: a review of the prevalence of under-nutrition in hospitals and care homes since 1994 in England.

    Science.gov (United States)

    Ray, Sumantra; Laur, Celia; Golubic, Rajna

    2014-10-01

    One in four hospital patients in the UK are estimated to be affected by 'hospital malnutrition' (under-nutrition). There is a need for robust epidemiological data relating to the frequency, distribution and determinants of this clinical problem of public health importance. This review aims to undertake a narrative synthesis of data on the descriptive epidemiology of under-nutrition, and to address some of the methodological limitations. A methodical review of literature was undertaken, tracking the reported prevalence and incidence of under-nutrition in hospital, in the UK, since 1994. The 16 articles retrieved and reviewed demonstrate that nutrition in hospital is a long standing problem in UK hospitals and care homes. The existing literature is comprised mainly of cross-sectional surveys describing the prevalence of under-nutrition in hospital which ranges from 11 to 45%. There is considerable heterogeneity in the published literature on hospital malnutrition (under-nutrition) and very few studies either measure or have estimated incidence. Under-nutrition in hospital continues to be under-addressed, yet a major public health problem in the UK. Defining the descriptive epidemiology of this problem is one of the first steps towards understanding its aetiology or planning and evaluating appropriate prevention or treatment strategies. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  14. THE MUTIFACTORIAL PATTERN OF OSTEOPOROSIS: A REVIEW OF THE RESEARCHES OF THE DEPARTMENT OF THERAPY, INSTITUTE OF POSTGRADUATE EDUCATION, YAROSLAVL STATE MEDICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    O. B. Ershova

    2016-01-01

    Full Text Available Osteoporosis (OP is one of the most common diseases and is characterized by serious clinical manifestations such as low-energy bone fractures that cause severe social consequences. In this connection, OP is now receiving much attention worldwide. In Yaroslavl, the Department of Therapy (Head, Professor N.I. Korshunov, MD, Institute of Postgraduate Education, Yaroslavl State Medical University (Chancellor, Prof. A.V. Pavlov, MD, has been intensively conducting researches into different aspects of OP for more than 20 years. The main areas of the investigations performed are the issues of the epidemiology and outcomes of osteoporotic fractures, the relationship of OP to different diseases (rheumatoid arthritis, cardiovascular diseases, as well as the specific features of the development of OP in fertile men and women and the problem of calcium and vitamin D deficiency in pregnant women. 

  15. Effectiveness of maximal safe resection for glioblastoma including elderly and low karnofsky performance status patients. Retrospective review at a single institute

    International Nuclear Information System (INIS)

    Uzuka, Takeo; Takahashi, Hideaki; Aoki, Hiroshi; Natsumeda, Manabu; Fujii, Yukihiko

    2012-01-01

    Elderly and low Karnofsky performance status (KPS) patients have been excluded from most prospective trials. This retrospective study investigated glioblastoma treatment outcomes, including those of elderly and low KPS patients, and analyzed the prognostic factors using the medical records of 107 consecutive patients, 59 men and 48 women aged from 21 to 85 years (median 65 years), with newly diagnosed glioblastoma treated at our institute. There were 71 high-risk patients with age >70 years and/or KPS 6 -methylguanine-deoxyribonucleic acid methyltransferase-negative (p=0.027), and more than subtotal removal (p=0.003) were significant prognostic factors. The median postoperative KPS score tended to be better than the preoperative score, even in the high-risk group. We recommend maximal safe resection for glioblastoma patients, even those with advanced age and/or with low KPS scores. (author)

  16. Review

    DEFF Research Database (Denmark)

    Van Den Hazel, H B; Kielland-Brandt, Morten; Winther, Jakob R.

    1996-01-01

    The yeast vacuole, which is equivalent to the lysosome of higher eukaryotes, is one of the best characterized degradative organelles. This review describes the biosynthesis and function of yeast vacuolar proteases. Most of these enzymes are delivered to the vacuole via the early compartments...

  17. Reviews

    NARCIS (Netherlands)

    Adema, Frits

    1995-01-01

    This is the second volume of a revision of Tabernaemontana (Apocynaceae). The volume covers the New World species (44) and the genus Stemmadenia (10 species). This part of the revision of Tabernaemontana comes up to the high standards set in the first volume [see the review by Leenhouts, Blumea 38

  18. Reviews.

    Science.gov (United States)

    Science Teacher, 1989

    1989-01-01

    Reviews a software planetarium package called "Sky Travel." Includes two audiovisuals: "Conquest of Space" and "Windows on Science: Earth Science"; and four books: "Small Energy Sources: Choices that Work,""Stonehenge Complete,""Uneasy Careers and Intimate Lives: Women in Science…

  19. REVIEW

    African Journals Online (AJOL)

    2012-03-01

    Mar 1, 2012 ... narrowing the gap between recommended treatment protocols in ... for pregnant women is complicated by the need to take into account the health and safety of both the ... meta-analysis as at July 2011 (which reviews the APR and other ... 0.82 - 3.18) and relative risk of birth defects in EFV-containing ART.

  20. Review

    Indian Academy of Sciences (India)

    Review. J. Astrophys. Astr., Vol. 36, No. 4, December 2015, pp. 623–634 ..... 4000 K ≤ T ≤ 10000 K. The processes (1b) are characterized in this paper via ..... Mihajlov, A. A., Sreckovic, V. A., Ignjatovic, L. M., Klyucharev, A. N. 2012, J. Cluster.

  1. Review

    NARCIS (Netherlands)

    Kalkman, C.; Adema, F.

    1998-01-01

    This book intends (according to the preface) to afford at once a review, a general outline of what has been accomplished, and a set of signposts for the future. It attempts to do so in three sections on Origin and Diversification of Primitive Land Plants (4 papers), Origin and Diversification of

  2. Review

    NARCIS (Netherlands)

    Wilde, de W.J.J.O.

    1994-01-01

    This review marks the appearance of Volume II, after the publication of Volume I, Pteridophytes and Gymnosperms, in 1990; several more volumes are expected in the future before completion of the Vascular plants as a whole. The present volume contains 73 families out of some 250-500 families which

  3. 76 FR 17930 - National Human Genome Research Institute; Notice of Closed Meeting

    Science.gov (United States)

    2011-03-31

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research Institute Special... Review Officer, Scientific Review Branch, National Human Genome Research Institute, 5635 Fishers Lane...

  4. 78 FR 107 - National Human Genome Research Institute; Notice of Closed Meeting

    Science.gov (United States)

    2013-01-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... evaluate grant applications. Place: National Human Genome Research Institute, 3rd Floor Conference Room....D., Scientific Review Officer, Scientific Review Branch, National Human Genome Research Institute...

  5. 76 FR 58023 - National Human Genome Research Institute; Notice of Closed Meeting

    Science.gov (United States)

    2011-09-19

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research Institute Initial..., Scientific Review Officer, Office of Scientific Review, National Human Genome Research Institute, National...

  6. Why Do Institutions Offer MOOCs?

    Science.gov (United States)

    Hollands, Fiona M.; Tirthali, Devayani

    2014-01-01

    By reviewing the literature and interviewing 83 individuals knowledgeable about massive open online courses (MOOCs), we investigate the goals of institutions of higher education that are currently developing and delivering such courses. We identify six major goals for MOOC initiatives: extending reach and access, building and maintaining brand,…

  7. Data Linkage Strategies to Advance Youth Suicide Prevention: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop.

    Science.gov (United States)

    Wilcox, Holly C; Kharrazi, Hadi; Wilson, Renee F; Musci, Rashelle J; Susukida, Ryoko; Gharghabi, Fardad; Zhang, Allen; Wissow, Lawrence; Robinson, Karen A

    2016-12-06

    Linking national, state, and community data systems to data from prevention programs could allow for longer-term assessment of outcomes and evaluation of interventions to prevent suicide. To identify and describe data systems that can be linked to data from prevention studies to advance youth suicide prevention research. A systematic review, an environmental scan, and a targeted search were conducted to identify prevention studies and potentially linkable external data systems with suicide outcomes from January 1990 through December 2015. Studies and data systems had to be U.S.-based and include persons aged 25 years or younger. Data systems also had to include data on suicide, suicide attempt, or suicidal ideation. Information about participants, intervention type, suicide outcomes, primary analytic method used for linkage, statistical approach, analyses performed, and characteristics of data systems was abstracted by 2 reviewers. Of 47 studies (described in 59 articles) identified in the systematic review, only 6 were already linked to data systems. A total of 153 unique and potentially linkable data systems were identified, but only 66 were classified as "fairly accessible" and had data dictionaries available. Of the data systems identified, 19% were established primarily for research, 11% for clinical care or operations, 29% for administrative services (such as billing), and 52% for surveillance. About one third (37%) provided national data, 12% provided regional data, 63% provided state data, and 41% provided data below the state level (some provided coverage for >1 geographic unit). Only U.S.-based studies published in English were included. There is untapped potential to evaluate and enhance suicide prevention efforts by linking suicide prevention data with existing data systems. However, sparse availability of data dictionaries and lack of adherence to standard data elements limit this potential. Agency for Healthcare Research and Quality.

  8. Proceedings from the Third National Institutes of Health International Congress on Advances in Uterine Leiomyoma Research: comprehensive review, conference summary and future recommendations

    Science.gov (United States)

    Segars, James H.; Parrott, Estella C.; Nagel, Joan D.; Guo, Xiaoxiao Catherine; Gao, Xiaohua; Birnbaum, Linda S.; Pinn, Vivian W.; Dixon, Darlene

    2014-01-01

    BACKGROUND Uterine fibroids are the most common gynecologic tumors in women of reproductive age yet the etiology and pathogenesis of these lesions remain poorly understood. Age, African ancestry, nulliparity and obesity have been identified as predisposing factors for uterine fibroids. Symptomatic tumors can cause excessive uterine bleeding, bladder dysfunction and pelvic pain, as well as associated reproductive disorders such as infertility, miscarriage and other adverse pregnancy outcomes. Currently, there are limited noninvasive therapies for fibroids and no early intervention or prevention strategies are readily available. This review summarizes the advances in basic, applied and translational uterine fibroid research, in addition to current and proposed approaches to clinical management as presented at the ‘Advances in Uterine Leiomyoma Research: 3rd NIH International Congress’. Congress recommendations and a review of the fibroid literature are also reported. METHODS This review is a report of meeting proceedings, the resulting recommendations and a literature review of the subject. RESULTS The research data presented highlights the complexity of uterine fibroids and the convergence of ethnicity, race, genetics, epigenetics and environmental factors, including lifestyle and possible socioeconomic parameters on disease manifestation. The data presented suggest it is likely that the majority of women with uterine fibroids will have normal pregnancy outcomes; however, additional research is warranted. As an alternative to surgery, an effective long-term medical treatment for uterine fibroids should reduce heavy uterine bleeding and fibroid/uterine volume without excessive side effects. This goal has not been achieved and current treatments reduce symptoms only temporarily; however, a multi-disciplined approach to understanding the molecular origins and pathogenesis of uterine fibroids, as presented in this report, makes our quest for identifying novel

  9. Science review of the Beaufort Institute of Oceanography, the Halifax Fisheries Research Laboratory, and the St. Andrews Biological Station, 1990-91. Revue des sciences de l'Institut oceanographique de Bedford, du Laboratoire de recherche halieutique de Halifax, et de la Station biologique de St. Andrews, 1990-91

    Energy Technology Data Exchange (ETDEWEB)

    Smith, T E; Cook, J [eds.

    1992-01-01

    A review is presented of the research and survey programs being undertaken in 1990-91 at the Bedford Institute of Oceanography, the Halifax Fisheries Research Laboratory, and the St. Andrews Biological Station (all in Nova Scotia). The broad objectives of these programs are to perform applied research leading to the provision of advice on the management of marine and freshwater environments, including fisheries and offshore hydrocarbon resources; to perform targeted basic research in accordance with the mandates of Canada's Department of Fisheries and Oceans, Environment Canada, and Energy, Mines and Resources; to perform surveys and cartographic work; and to respond to major marine environmental emergencies. The research and survey work encompasses the fields of marine geology and geophysics, physical oceanography, marine chemistry, biological oceanography, fisheries research, seabird research, and navigational surveys and cartography. Topics of specific projects reviewed include marine pollution detection, phytoplankton profiling, seal populations, ocean mapping, geographic information systems, fish and invertebrate nutrition, shellfish culture, lobster habitat ecology, physics and biology of the Georges Bank frontal system, water-level instrumentation, data acquisition techniques, sea ice monitoring, salmon management, nearshore sedimentary processes, and oil/gas distribution in offshore basins. Separate abstracts have been prepared for three project reports from this review.

  10. Reviews

    Directory of Open Access Journals (Sweden)

    Philip Barker

    1998-12-01

    Full Text Available There were two copy-editing blunders in Clive Betts's review, in ALT-J 5 (3, of Shirley Fletcher's Designing Competence-Based Training, one in paragraph 2 line 1, the other in paragraph 3 line 8. The errors (the result of the Editor, Gabriel Jacobs, trying to perform a final proof of the journal at lightning speed in order to meet the printing deadline, and not of any mistake on the part of either Philip Barker or the University of Wales Press hardly affected meaning, but the fact that they appeared in a review of a book on competence makes the embarrassment all the more telling. The Editor apologizes, and thanks eagle-eyed readers. He has decided to read the book in the hope that such errors will not recur.

  11. Reviews

    Directory of Open Access Journals (Sweden)

    Wilma D'Ambrosio

    2013-12-01

    Full Text Available In the wake of the great interest raised by Maurizio Gabrieli’s review of the book Musical Networks. Parallel Distributed Perception and Performance (various authors; edited by Niall Griffith and Peter M. Todd, MA: MIT Press, Cambridge, 1999 which appeared in our last issue of Analitica, the present review section no longer follows the format used up to now but offers a survey of texts dedicated to the relationship between music analysis and technology. This decision was also made as a result of the request for more information on the subject by many of our readers. In coming issues we plan to extend this bibliography and comment on at least some of the most interesting texts published in recent years, among which we would immediately like to draw attention to the important work by Baroni, Dalmonte and Jacoboni published in 1999 (Le regole della musica. Indagine sui meccanismi della comunicazione, Torino, I Manuali EDT/SIdM, 1999.

  12. The use of Am-241 as Equivalence Thickness Measurement for Irradiation Room at National institute for Cancer and Malacca Hospital: A Review

    International Nuclear Information System (INIS)

    Mohd Khalid Matori; Azuhar Ripin; Husaini Salleh

    2013-01-01

    Lead equivalent thickness measurement of a shielding material in diagnostic radiology is very important to ensure that requirements for the purpose of radiation protection of patients, employees and the public are met. The Malaysian Ministry of Health (MOH) has established that the irradiation room must have sufficient shielding thickness, for example for general radiography it must be at least equal to 2.0 mm of Pb, for panoramic dental radiography at least equal to 1.5 mm of Pb and for mammography should be a minimum of 1.0 mm of Pb. This paper presents a technique using americium-241 source to test and verify the integrity of the shielding thickness in term of lead equivalent for irradiation room at National Institute for Cancer (IKN) and General Malacca Hospital. Results of measurement of 10 irradiation rooms conducted in 2012 were analyzed for this presentation. Technical comparison of the attenuation of gamma rays from Am-241 source through the walls of the irradiation room and pieces of lead were used to assess the lead equivalent thickness of the walls. Results showed that almost all the irradiation rooms tested meet the requirements of the Ministry of Health and is suitable for the installation of the intended diagnostic X-ray apparatus. Some specific positions such as door knobs and locks, electrical plug sockets were identified with potential to not met the required lead equivalent thickness hence may contribute to higher radiation exposure to workers and the public. (author)

  13. [Blood amylase: a biological marker in irradiation accidents? Preliminary results obtained at the Gustave-Roussy Institut (GRI) and a literature review].

    Science.gov (United States)

    Hennequin, C; Cosset, J M; Cailleux, P E; Girinsky, T; Ganem, G; Hubert, D; Comoy, E; Dutreix, J

    1989-01-01

    The retrospective evaluation of the dose after an irradiation accident is of paramount importance; it allows an adequate selection of patients and the most appropriate treatment can then be proposed. Classical physical dosimetry often lacks precision for dose assessment in such accidents. Cytogenetics, usually more reliable, is not 100% accurate and cannot be used in some particular instances. At the Institut Gustave-Roussy, we studied amylasemia in 15 patients who received a total body irradiation (TBI) for bone marrow grafting, at various dose levels (10, 2 and 1.35 Gy). Hyperamylasemia was found to be constant and dose-dependent. Ten additional patients given a localized irradiation of 2 Gy in the Waldeyer ring had a similar rise in amylasemia as did TBI patients who had received the same dose. In contrast, 13 patients given a pancreatic irradiation (as part of a localized abdominal irradiation) did not show any increase in amylasemia. This study seems to confirm reported data, which suggested that post-TBI hyperamylasemia is almost only related to salivary gland irradiation. Amylasemia could possibly be used as a "biological dosimeter"; however, the dose-effect relationship should be more precisely defined, as well as individual variations. Moreover, the definition of a "threshold-dose" below which hyperamylasemia can never be detected, would be of interest for radioprotection.

  14. Six-Year Retrospective Review of Hospital Data on Antimicrobial Resistance Profile of Staphylococcus aureus Isolated from Skin Infections from a Single Institution in Greece

    Directory of Open Access Journals (Sweden)

    Christina Stefanaki

    2017-12-01

    Full Text Available Objective: To determine the prevalence of resistant strains of Staphylococcus aureus (S. aureus isolated from Skin and soft tissue infections (SSTI to various antibiotics. Material and Methods: All culture-positive results for S. aureus from swabs taken from patients presenting at one Greek hospital with a skin infection between the years 2010–2015 were examined retrospectively. Bacterial cultures, identification of S. aureus and antimicrobial susceptibility testing were performed using the disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI guidelines and European Committee on Antimicrobial testing (EUCAST breakpoints. EUCAST breakpoints were applied if no CLSI were available. Results: Of 2069 S. aureus isolates identified, 1845 (88% were resistant to one or more antibiotics. The highest resistance was observed for benzylpenicillin (71.9%, followed by erythromycin (34.3%. Resistant strains to cefoxitin defined as MRSA (methicillin-resistant S. aureus represented 21% of total isolates. Interestingly, resistance to fusidic acid was 22.9% and to mupirocin as high as 12.7%. Low rates were observed for minocycline, rifampicin and trimethoprim/sulfamethoxazole (SXT. Resistance to antibiotics remained relatively stable throughout the six-year period, with the exception of cefoxitin, fusidic acid and SXT. A high percentage of MRSA strains were resistant to erythromycin (60%, fusidic acid (46%, clindamycin (38% and tetracycline (35.5%. Conclusions: Special attention is required in prescribing appropriate antibiotic therapeutic regimens, particularly for MRSA. These data on the susceptibility of S. aureus may be useful for guiding antibiotic treatment.

  15. Late effects after treatment of twenty children with soft tissue sarcomas of the head and neck. Experience at a single institution with a review of the literature

    International Nuclear Information System (INIS)

    Fromm, M.; Littman, P.; Raney, R.B.; Nelson, L.; Handler, S.; Diamond, G.; Stanley, C.

    1986-01-01

    Twenty children with soft tissue sarcomas of the head and neck, treated at the Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania from 1972 to 1981, were evaluated for the late deleterious effects of treatment. All patients received radiation therapy and combination chemotherapy with vincristine, dactinomycin, and cyclophosphamide; certain patients also received Adriamycin (doxorubicin). All had ophthalmologic, otologic, growth, and cosmetic evaluations; 15 also had dental and maxillofacial examinations. The median age at diagnosis was 6 years (range, 7 months-13 years). Median follow-up from time of diagnosis was 5.5 years with a minimum of 3 years in all but four patients. The major problems encountered were related to the eyes (xerophthalmia and cataracts), ears (hearing loss), teeth (maleruption and caries), glandular structures (xerostomia, hypopituitarism), and development (craniofacial deformity). It is concluded that children treated for soft tissue sarcomas of the head and neck with combined modality therapy, including radiation enhancers, may show a variety of late treatment-related adversities. These children require close multidisciplinary follow-up for detection of late effects in order that appropriate prophylactic or symptomatic treatment can be instituted to minimize their consequences

  16. Reviews

    Directory of Open Access Journals (Sweden)

    Lorraine Warren

    1994-12-01

    Full Text Available Europe in the Rotmdis a hypertextuall hypergraphical database of facts about Europe, biased towards education and training, but taking in its stride many peripheral areas relevant to anyone considering living and/or working in, or even visiting, a member state of the EU - population, economy, institutions, geography, climate and so forth - all making up thousands of interconnected screens. These screens contain maps with a selection of zooms and hotspots, all kinds of facts and figures about available educational and vocational courses (presented both textually and, where appropriate, as graphs, bar charts and such like, details of life in each EU member state, details of cities and what they have to offer, and a lot more. There are also extra facilities, such as being able to set currency exchange rates or to create customized notebooks.

  17. Reviews

    Directory of Open Access Journals (Sweden)

    Philip Barker

    2001-12-01

    Full Text Available The theme of this year's International Simulation and Gaming Yearbook - 'Transition and Change' - addresses the topical discourse on the improvement of pedagogy by the introduction of active and student-centred learning in UK higher education. Although the value of 'learning-by-doing' and experiential learning is well recognized by researchers in education, many subjects and university courses continue to employ teaching methods (such as lectures that favour a passive reproduction of information rather than the fostering of student understanding. In this regard, simulations and games are powerful tools that not only promote an active, student-centred approach to learning but have the potential to help realize government policies to improve the quality of teaching and learning in higher education institutions in the UK.

  18. Arresting HIV: Fostering Partnerships between Sex Workers and Police to Reduce HIV Risk and Promote Professionalization within Policing Institutions: A Realist Review.

    Science.gov (United States)

    Tenni, Brigitte; Carpenter, Jenae; Thomson, Nicholas

    2015-01-01

    In many countries around the world sex work is criminalised and its regulatory control is therefore often in the hands of the police. In addition to the impact of this criminalised legal environment, much literature describes the negative impact that certain police practices can have on the ability of sex workers and the programs that work with sex workers to access essential HIV prevention, treatment, care and support services. This situation has resulted in persistent concentrated HIV epidemics among sex workers in many countries of the world. The need for multi-sector partnerships between police and HIV programs is increasingly recognised in various UN declarations and resolutions yet descriptions of the process or key ingredients required to actually establish and sustain these necessary partnerships between police and sex workers [or the programs that provide essential services to sex workers] are sparse. The paper seeks to establish key considerations and critical processes that are required to foster partnerships that if further investigated and scaled up, could result in an enhanced enabling environment for the provision of essential HIV services for sex workers around the globe. This paper is based on a realist review that investigated isolated examples of partnership formation between law enforcement and HIV programs working with sex workers. This methodology research is designed to work with complex social interventions and is based on the emerging 'realist' approach to evaluation. A realist review methodology was chosen given the paucity of relevant literature in this vein and the authors' familiarity with the grey literature and relationships with experts who work in this sphere. The review found that political and police leadership, civil society strengthening and police reform in relation to HIV, are critical factors and key ingredients in changing the enabling environment in which sex work takes place to ensure that HIV prevention, individual and

  19. 75 FR 8374 - National Human Genome Research Institute; Notice of Closed Meeting

    Science.gov (United States)

    2010-02-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research Institute Special... Officer, Scientific Review Branch, National Human Genome Research Institute, National Institutes of Health...

  20. 77 FR 71604 - National Human Genome Research Institute; Notice of Closed Meeting

    Science.gov (United States)

    2012-12-03

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research Institute Special..., Scientific Review Branch, National Human Genome Research Institute, National Institutes of Health, 5635...

  1. Accuracy of chemical shift MR imaging in diagnosing indeterminate bone marrow lesions in the pelvis: review of a single institution's experience

    International Nuclear Information System (INIS)

    Kohl, Chad A.; Chivers, F.S.; Lorans, Roxanne; Roberts, Catherine C.; Kransdorf, Mark J.

    2014-01-01

    To re-assess the accuracy of chemical shift imaging in diagnosing indeterminate bone marrow lesions as benign or malignant. We retrospectively reviewed our experience with MR imaging of the pelvis to assess the accuracy of chemical shift imaging in distinguishing benign from malignant bone lesions. Two musculoskeletal radiologists retrospectively reviewed all osseous lesions biopsied since 2006, when chemical shift imaging was added to our routine pelvic imaging protocol. Study inclusion criteria required (1) MR imaging of an indeterminate bone marrow lesion about the pelvis and (2) subsequent histologic confirmation. The study group included 50 patients (29 male, 21 female) with an average age of 67 years (range, 41-89 years). MR imaging results were evaluated using biopsy results as the ''gold standard.'' There were 27 malignant and 23 benign lesions. Chemical shift imaging using an opposed-phase signal loss criteria of less than 20 % to indicate a malignant lesion, correctly diagnosed 27/27 malignant lesions and 14/23 benign lesions, yielding a 100 % sensitivity, 61 % specificity, 75 % PPV, 100 % NPV, and 82 % accuracy. The area under the receiver operator characteristic (ROC) curve was 0.88. The inter-rater and intra-rater agreement K values were both 1.0. Chemical shift imaging is a useful adjunct MR technique to characterize focal and diffuse marrow abnormalities on routine non-contrast pelvic imaging. It is highly sensitive in identifying malignant disease. Despite its lower specificity, the need for biopsy could be eliminated in more than 60 % of patients with benign disease. (orig.)

  2. Using institutional theory in enterprise systems research

    DEFF Research Database (Denmark)

    Svejvig, Per

    2013-01-01

    This paper sets out to examine the use of institutional theory as a conceptually rich lens to study social issues of enterprise systems (ES) research. More precisely, the purpose is to categorize current ES research using institutional theory to develop a conceptual model that advances ES research...... model that advocates multi-level and multi-theory approaches and applies newer institutional aspects such as institutional logics. The findings show that institutional theory in ES research is in its infancy and adopts mainly traditional institutional aspects like isomorphism, with the organization....... Key institutional features are presented such as isomorphism, rationalized myths, and bridging macro and micro structures, and institutional logics and their implications for ES research are discussed. Through a literature review of 181 articles, of which 18 papers are selected, we build a conceptual...

  3. CRIS and Institutional Repositories

    Directory of Open Access Journals (Sweden)

    A Asserson

    2010-04-01

    Full Text Available CRIS (Current Research Information Systems provide researchers, research managers, innovators, and others with a view over the research activity of a domain. IRs (institutional repositories provide a mechanism for an organisation to showcase through OA (open access its intellectual property. Increasingly, organizations are mandating that their employed researchers deposit peer-reviewed published material in the IR. Research funders are increasingly mandating that publications be deposited in an open access repository: some mandate a central (or subject-based repository, some an IR. In parallel, publishers are offering OA but replacing subscription-based access with author (or author institution payment for publishing. However, many OA repositories have metadata based on DC (Dublin Core which is inadequate; a CERIF (Common-European Research Information Format CRIS provides metadata describing publications with formal syntax and declared semantics thus facilitating interoperation or homogeneous access over heterogeneous sources. The formality is essential for research output metrics, which are increasingly being used to determine future funding for research organizations.

  4. issue 2 2008.indb

    African Journals Online (AJOL)

    situations, the roles of Institutional Review Boards (IRBs) may have to be ..... Research should be responsive to the needs of the victims of the emergency. 9. ... feeding in complex humanitarian emergencies: priorities and policy considerations.

  5. Download this PDF file

    African Journals Online (AJOL)

    This study was approved by the Loma Linda University. Institutional Review Board (IRB) ... about exclusive breastfeeding, he encouraged me to follow the instructions. .... Women also cited the benefits of adhering to exclusive breastfeeding for ...

  6. Robotic, laparoscopic and open surgery for gastric cancer compared on surgical, clinical and oncological outcomes: a multi-institutional chart review. A study protocol of the International study group on Minimally Invasive surgery for GASTRIc Cancer—IMIGASTRIC

    Science.gov (United States)

    Desiderio, Jacopo; Jiang, Zhi-Wei; Nguyen, Ninh T; Zhang, Shu; Reim, Daniel; Alimoglu, Orhan; Azagra, Juan-Santiago; Yu, Pei-Wu; Coburn, Natalie G; Qi, Feng; Jackson, Patrick G; Zang, Lu; Brower, Steven T; Kurokawa, Yukinori; Facy, Olivier; Tsujimoto, Hironori; Coratti, Andrea; Annecchiarico, Mario; Bazzocchi, Francesca; Avanzolini, Andrea; Gagniere, Johan; Pezet, Denis; Cianchi, Fabio; Badii, Benedetta; Novotny, Alexander; Eren, Tunc; Leblebici, Metin; Goergen, Martine; Zhang, Ben; Zhao, Yong-Liang; Liu, Tong; Al-Refaie, Waddah; Ma, Junjun; Takiguchi, Shuji; Lequeu, Jean-Baptiste; Trastulli, Stefano; Parisi, Amilcare

    2015-01-01

    Introduction Gastric cancer represents a great challenge for healthcare providers and requires a multidisciplinary treatment approach in which surgery plays a major role. Minimally invasive surgery has been progressively developed, first with the advent of laparoscopy and recently with the spread of robotic surgery, but a number of issues are currently being debated, including the limitations in performing an effective extended lymph node dissection, the real advantages of robotic systems, the role of laparoscopy for Advanced Gastric Cancer, the reproducibility of a total intracorporeal technique and the oncological results achievable during long-term follow-up. Methods and analysis A multi-institutional international database will be established to evaluate the role of robotic, laparoscopic and open approaches in gastric cancer, comprising of information regarding surgical, clinical and oncological features. A chart review will be conducted to enter data of participants with gastric cancer, previously treated at the participating institutions. The database is the first of its kind, through an international electronic submission system and a HIPPA protected real time data repository from high volume gastric cancer centres. Ethics and dissemination This study is conducted in compliance with ethical principles originating from the Helsinki Declaration, within the guidelines of Good Clinical Practice and relevant laws/regulations. A multicentre study with a large number of patients will permit further investigation of the safety and efficacy as well as the long-term outcomes of robotic, laparoscopic and open approaches for the management of gastric cancer. Trial registration number NCT02325453; Pre-results. PMID:26482769

  7. Synchronous Primary Cancers of the Endometrium and Ovary With the Same Histopathologic Type Versus Endometrial Cancer With Ovarian Metastasis: A Single Institution Review of 72 Cases.

    Science.gov (United States)

    Bese, Tugan; Sal, Veysel; Kahramanoglu, Ilker; Tokgozoglu, Nedim; Demirkiran, Fuat; Turan, Hasan; Ilvan, Sennur; Arvas, Macit

    2016-02-01

    The purpose of this study was to evaluate the clinicopathological characteristics and survival outcomes of women with simultaneous endometrial and ovarian carcinomas having the same histopathologic type. A review of medical records from 1997 to 2015 identified 72 patients with simultaneous carcinomas of the endometrium and ovary with the same histopathologic type. Patients with synchronous primary cancers of endometrium and ovary (SCEOs) were compared with patients with primary endometrial cancer with ovarian metastasis (ECOM). Clinical and pathological data were obtained from the patients' medical records. Clinicopathological variables including categorical data were analyzed by χ(2) or Fisher exact test and continuous data by a Student t test. A Kaplan-Meier survival analysis was performed and compared by using the log-rank test. A univariate and multivariate analysis of 72 patients with SCEO with the same histopathologic type revealed that SCEO is an independent prognostic factor of 10-year overall survival. There were 31 patients in the SCEO group and 41 patients in the ECOM group. With a mean follow-up time of 68.2 months, the 10-year overall survival rates were 61.3% and 36.6% in SCEO and ECOM groups, respectively (P = 0.029). Age, menopausal status, stage of ovarian cancer, performing lymphadenectomy, grade of endometrial tumor, omental metastasis, and residual tumor were found to be significant risk factors for recurrence in the synchronous group. The differentiation between SCEO and ECOM is of great clinical importance while our results showed a better prognosis for patients with SCEO compared with patients with ECOM. More aggressive therapeutic approaches may be considered for patients with SCEO who are older, postmenopausal, and/or have advanced grade of endometrial tumor, omental metastasis, and residual tumor. Lymphadenectomy should be performed in every patient with SCEO.

  8. Cellular mesoblastic nephroma (infantile renal fibrosarcoma): institutional review of the clinical, diagnostic imaging, and pathologic features of a distinctive neoplasm of infancy

    International Nuclear Information System (INIS)

    Bayindir, Petek; Guillerman, Robert Paul; Hicks, M.J.; Chintagumpala, M.M.

    2009-01-01

    Cellular mesoblastic nephroma has been associated with a more aggressive course than classic mesoblastic nephroma, including local recurrences and metastases. To define the clinicopathologic and imaging features distinguishing cellular from classic mesoblastic nephroma. Retrospective review of clinical charts and imaging studies of ten children with mesoblastic nephroma from 1996 to 2007 at a large children's hospital. In six children the mesoblastic nephroma was pure cellular, in two mixed, and in two classic. The mean ages at diagnosis were 107 days for those with the cellular form, and 32 days for those with the classic form. Hypoechoic or low-attenuation regions representing necrosis or hemorrhage were found in all children with the cellular form and in none of those with the classic form. Hypertension was present in 70% and hypercalcemia in 20% of the children and resolved following nephrectomy. Two cellular tumors encased major abdominal vessels. Local recurrence and metastases occurred within 6 months of tumor resection in two children with the cellular form. Intraspinal extension and intratumoral pseudoaneurysm were seen in one child with the cellular form. The cellular tumors shared histopathologic features with infantile fibrosarcoma (IFS), and RT-PCR testing in two children with the cellular form revealed the t(12;15) ETV6-NTRK3 gene fusion common to IFS. Distinct from the classic form, cellular mesoblastic nephroma is more heterogeneous in appearance on imaging, tends to be larger and present later in infancy, and can exhibit aggressive behavior including vascular encasement and metastasis. Intraspinal extension and intratumoral pseudoaneurysm are previously unreported findings encountered in our cellular mesoblastic nephroma series. The shared histopathology and translocation gene fusion support the concept of cellular mesoblastic nephroma as the renal form of IFS. (orig.)

  9. How effective are family-based and institutional nutrition interventions in improving children’s diet and health? A systematic review

    Directory of Open Access Journals (Sweden)

    Andrew P. Black

    2017-10-01

    Full Text Available Abstract Background Effective strategies to improve dietary intake in young children are a priority to reduce the high prevalence of chronic non-communicable diseases in adulthood. This study aimed to assess the impact of family-based and school/preschool nutrition programs on the health of children aged 12 or younger, including the sustainability of these impacts and the relevance to socio-economic inequalities. Methods A systematic review of literature published from 1980 to December 2014 was undertaken. Randomised controlled trials involving families with children aged up to 12 years in high income countries were included. The primary outcomes were dietary intake and health status. Results were presented in a narrative synthesis due to the heterogeneity of the interventions and outcomes. Results The systematic search and assessment identified 39 eligible studies. 82% of these studies were set in school/preschools. Only one school study assessed the impact of involving parents systematically. The family-based programs which provided simple positive dietary advice to parents and regular follow-up reduced fat intake significantly. School and family-based studies, if designed and implemented well, increased F&V intake, particularly fruit. Effective school-based programs have incorporated role-models including peers, teachers and heroic figures, rewards and increased access to healthy foods. School nutrition programs in disadvantaged communities were as effective as programs in other communities. Conclusions Family and school nutrition programs can improve dietary intake, however evidence of the long-term sustainability of these impacts is limited. The modest overall impact of even these successful programs suggest complementary nutrition interventions are needed to build a supportive environment for healthy eating generally.

  10. Recruitment Practices And Institutional Change

    DEFF Research Database (Denmark)

    Holm, Anna; Ulhøi, John Parm

    Up to now, there has been little research on recruitment practices from an organizational perspective, and in part it lags behind practice. This paper attempts to rectify this by studying recent changes in the recruitment practices of Danish organizations. We employ new institutional theory......, and individuals’ social cognition. Among other things, this is reflected in the use of online recruitment and employer branding. The study concludes that the recruitment field has transformed and reviewed its practices due to institutional changes in how individuals search for employment and expect to be hired....

  11. Sono-leather technology with ultrasound: a boon for unit operations in leather processing - review of our research work at Central Leather Research Institute (CLRI), India.

    Science.gov (United States)

    Sivakumar, Venkatasubramanian; Swaminathan, Gopalaraman; Rao, Paruchuri Gangadhar; Ramasami, Thirumalachari

    2009-01-01

    Ultrasound is a sound wave with a frequency above the human audible range of 16 Hz to 16 kHz. In recent years, numerous unit operations involving physical as well as chemical processes are reported to have been enhanced by ultrasonic irradiation. There have been benefits such as improvement in process efficiency, process time reduction, performing the processes under milder conditions and avoiding the use of some toxic chemicals to achieve cleaner processing. These could be a better way of augmentation for the processes as an advanced technique. The important point here is that ultrasonic irradiation is physical method activation rather than using chemical entities. Detailed studies have been made in the unit operations related to leather such as diffusion rate enhancement through porous leather matrix, cleaning, degreasing, tanning, dyeing, fatliquoring, oil-water emulsification process and solid-liquid tannin extraction from vegetable tanning materials as well as in precipitation reaction in wastewater treatment. The fundamental mechanism involved in these processes is ultrasonic cavitation in liquid media. In addition to this there also exist some process specific mechanisms for the enhancement of the processes. For instance, possible real-time reversible pore-size changes during ultrasound propagation through skin/leather matrix could be a reason for diffusion rate enhancement in leather processing as reported for the first time. Exhaustive scientific research work has been carried out in this area by our group working in Chemical Engineering Division of CLRI and most of these benefits have been proven with publications in valued peer-reviewed international journals. The overall results indicate that about 2-5-fold increase in the process efficiency due to ultrasound under the given process conditions for various unit operations with additional benefits. Scale-up studies are underway for converting these concepts in to a real viable larger scale operation. In

  12. Institutional Collaboration on MOOCs in Education

    DEFF Research Database (Denmark)

    Nortvig, Anne-Mette; Christiansen, René Boyer

    2017-01-01

    and innovation in the common learning designs, and that—in order to succeed—such projects need strategic and institutional support from all partners involved. Moreover, the review points out barriers concerning the reluctance of individual institutions to engage in national collaboration due to fear of potential...

  13. The Economic and Monetary Union's Institutional Framework

    DEFF Research Database (Denmark)

    Dosenrode, Søren

    2002-01-01

    The chapters emphasise is on the EMU's institutions. The chapter contains i.a. a short review of the contents, objectives, developments from 1990-2002 of the EMU, the ESCB (structure & tasks) as well as interaction with other institutions incuding the Council of Ministers. An underlying issue...

  14. Current issues on a standard for surrogate pregnancy procedures

    OpenAIRE

    Ha, Jung-Ok

    2012-01-01

    While Korea does not have any legal statement on surrogacy, treatments are carried out in practice. As a result, every Institutional Review Board (IRB) of each fertility clinic faces an ethical predicament in reviewing each case. There is a need to arrange the institutions' own standards of surrogate pregnancy procedures before the establishment of national or professional regulation. This article examines the legal, social, and medical issues of surrogacy to help IRBs to judge their cases.

  15. Current issues on a standard for surrogate pregnancy procedures.

    Science.gov (United States)

    Ha, Jung-Ok

    2012-12-01

    While Korea does not have any legal statement on surrogacy, treatments are carried out in practice. As a result, every Institutional Review Board (IRB) of each fertility clinic faces an ethical predicament in reviewing each case. There is a need to arrange the institutions' own standards of surrogate pregnancy procedures before the establishment of national or professional regulation. This article examines the legal, social, and medical issues of surrogacy to help IRBs to judge their cases.

  16. Institutions as Knowledge Capital

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul; Garzarelli, Giampaolo

    The paper revisits the socioeconomic theory of the Austrian School economist Ludwig M. Lachmann. By showing that the common claim that Lachmann's idiosyncratic (read: eclectic and multidisciplinary) approach to economics entails nihilism is unfounded, it reaches the following conclusions. (1......) Lachmann held a sophisticated institutional position to economics that anticipated developments in contemporary new institutional economics. (2) Lachmann's sociological and economic reading of institutions offers insights for the problem of coordination. (3) Lachmann extends contemporary new institutional...... theory without simultaneously denying the policy approach of comparative institutional analysis. (90 words.)KeywordsComparative institutional analysis, coordination, expectations, institutionalevolution, interpretative institutionalism.JEL CodesB31, B52, B53, D80....

  17. What are Institutional Logics

    DEFF Research Database (Denmark)

    Berg Johansen, Christina; Waldorff, Susanne Boch

    This study presents new insights into the explanatory power of the institutional logics perspective. With outset in a discussion of seminal theory texts, we identify two fundamental topics that frame institutional logics: overarching institutional orders guides by institutional logics, as well...... as change and agency generated by friction between logics. We use these topics as basis for an analysis of selected empirical papers, with the aim of understanding how institutional logics contribute to institutional theory at large, and which social matters institutional logics can and cannot explore...

  18. Results of 1989/90 research and development activities at KfK Institute for Reactor Components

    International Nuclear Information System (INIS)

    1991-03-01

    R and D activities at IRB (Institut fuer Reaktorbauelemente - Institute for Reactor Components) are dedicated to thermodynamics and fluid dynamics. Emphasis is on the design of nuclear reactor and fusion reactor components. Environmental engineering was added recently. Most activities are applications-oriented. Fundamental investigations focus on energy research and energy technology. The activities are carried out in the framework of different projects (PKF/nuclear fusion, PSF/nuclear safety, PSU/pollution control). Points of main effort are the development of basic liquid-metal-cooled blanket solutions, investigations on natural convection in reactor ranks, and the cooling properties of future containments for pressurized water reactors in the case of nuclear fusion accidents. (orig./GL) [de

  19. What are Institutional Logics

    OpenAIRE

    Berg Johansen, Christina; Bock Waldorff, Susanne

    2015-01-01

    This study presents new insights into the explanatory power of the institutional logics perspective. With outset in a discussion of seminal theory texts, we identify two fundamental topics that frame institutional logics: overarching institutional orders guided by institutional logics, as well as change and agency generated by friction between logics. We use these topics as basis for an analysis of selected empirical papers, with the aim of understanding how institutional logics contribute to...

  20. 78 FR 64222 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2013-10-28

    ... Conference Call). Contact Person: Robert Bird, Ph.D., Chief, Resources and Training Review Branch, Division....D., Scientific Review Officer, Resources and Training Review Branch, Division of Extramural... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

  1. Do democratic institutions and foreign direct investment affect ...

    African Journals Online (AJOL)

    Do democratic institutions and foreign direct investment affect economic growth? Evidence from ... International Journal of Development and Management Review ... The importance of sound democratic institutional structures and foreign direct investment for enhancing economic growth is well documentedin literature.

  2. Management of eight labor and delivery patients dependent on buprenorphine (Subutex™: A retrospective chart review [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Solina Tith

    2018-02-01

    Full Text Available Background: Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by “The American College of Obstetrics and Gynecology” as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists’ unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia. We reviewed our management and outcomes in this medically complex population. Methods: An Institutional Review Board (IRB approved retrospective chart review was conducted of women admitted to the University of Washington Medical Center Labor and Delivery unit from July 2012 to November 2013 using buprenorphine. All deliveries, including intrauterine fetal demise, were included. Results: Eight women were admitted during this period to our L&D floor on buprenorphine. All required peri-partum anesthetic management either for labor and/or cesarean delivery management. Analgesic management included dilaudid or fentanyl PCA and/or continued epidural infusion, and in one instance ketamine infusion, while the pre-admission buprenorphine regimen was continued. Five babies were viable, two women experienced intrauterine fetal death at 22 and 36 weeks gestational age (GSA, respectively, and one neonate died shortly after delivery due to a congenital diaphragmatic hernia. Conclusions: This case series illuminates the medical complexity of parturients using buprenorphine. Different treatment modalities in the absence of evidence-based guidelines included additional opioid administration and continued epidural analgesia. The management of post-cesarean pain in patients on partial μ-opioid agonists remains complex and variable, and evidence-based guidelines could be useful for clinicians to direct care.

  3. 76 FR 53685 - National Institutes of Health

    Science.gov (United States)

    2011-08-29

    ..., CSR management to enhance the operations, processes, organization of, and services provided by the... data collection projects, the Center for Scientific Review (CSR), National Institutes of Health (NIH), has submitted to the Office of Management and Budget (OMB) a request to review and approve the...

  4. Institutional Logics in Action

    DEFF Research Database (Denmark)

    Lounsbury, Michael; Boxenbaum, Eva

    2013-01-01

    This double volume presents state-of-the-art research and thinking on the dynamics of actors and institutional logics. In the introduction, we briefly sketch the roots and branches of institutional logics scholarship before turning to the new buds of research on the topic of how actors engage...... institutional logics in the course of their organizational practice. We introduce an exciting line of new works on the meta-theoretical foundations of logics, institutional logic processes, and institutional complexity and organizational responses. Collectively, the papers in this volume advance the very...... prolific stream of research on institutional logics by deepening our insight into the active use of institutional logics in organizational action and interaction, including the institutional effects of such (inter)actions....

  5. Canadian institute honours Hawking

    Science.gov (United States)

    Durrani, Matin

    2009-11-01

    The Perimeter Institute for Theoretical Physics in Waterloo, Canada, has announced that a major new extension to its campus will be known as the Stephen Hawking Centre. The extension, which is currently being built, is due to open in 2011 and will double the size of the institute. It will also provide a home for the institute's Masters students, the first of whom joined the Perimeter Institute this autumn as part of its Perimeter Scholars international programme.

  6. Multinationals and Institutional Competitiveness

    DEFF Research Database (Denmark)

    Hull Kristensen, Peer; Morgan, Glenn

    This article discusses how institutional competitiveness and multinationals are mutually enriching concepts. Seen from the perspective of Multinationals, institutional competitiveness becomes expressed at two levels. At the level of corporate HQs institutional competitiveness proves itself...... competitiveness of Liberal Market Economies and Coordinated Markets Economies under the current competitive regime....

  7. Olaratumab in Combination with Doxorubicin for the Treatment of Advanced Soft Tissue Sarcoma: An Evidence Review Group Perspective of a National Institute for Health and Care Excellence Single Technology Appraisal.

    Science.gov (United States)

    Tikhonova, Irina A; Jones-Hughes, Tracey; Dunham, James; Warren, Fiona C; Robinson, Sophie; Stephens, Peter; Hoyle, Martin

    2018-01-01

    The manufacturer of olaratumab (Lartruvo ® ), Eli Lilly & Company Limited, submitted evidence for the clinical and cost effectiveness of this drug, in combination with doxorubicin, for untreated advanced soft tissue sarcoma (STS) not amenable to surgery or radiotherapy, as part of the National Institute for Health and Care Excellence (NICE) Single Technology Appraisal process. The Peninsula Technology Assessment Group, commissioned to act as the Evidence Review Group (ERG), critically reviewed the company's submission. Clinical effectiveness evidence for the company's analysis was derived from an open-label, randomised controlled trial, JGDG. The analysis was based on a partitioned survival model with a time horizon of 25 years, and the perspective was of the UK National Health Service (NHS) and Personal Social Services. Costs and benefits were discounted at 3.5% per year. Given the available evidence, olaratumab is likely to meet NICE's end-of-life criteria. To improve the cost effectiveness of olaratumab, the company offered a discount through a Commercial Access Agreement (CAA) with the NHS England. When the discount was applied, the mean base-case and probabilistic incremental cost-effectiveness ratios (ICERs) for olaratumab plus doxorubicin versus the standard-of-care doxorubicin were £46,076 and £47,127 per quality-adjusted life-year (QALY) gained, respectively; the probability of this treatment being cost effective at the willingness-to-pay threshold of £50,000 per QALY gained, applicable to end-of-life treatments, was 0.54. The respective ICERs from the ERG's analysis were approximately £60,000/QALY gained, and the probability of the treatment being cost effective was 0.21. In August 2017, the NICE Appraisal Committee recommended olaratumab in combination with doxorubicin for this indication for use via the UK Cancer Drugs Fund under the agreed CAA until further evidence being collected in the ongoing phase III trial-ANNOUNCE-becomes available in

  8. Furthering critical institutionalism

    Directory of Open Access Journals (Sweden)

    Frances Dalton Cleaver

    2015-03-01

    Full Text Available This special issue furthers the study of natural resource management from a critical institutional perspective. Critical institutionalism (CI is a contemporary body of thought that explores how institutions dynamically mediate relationships between people, natural resources and society. It focuses on the complexity of institutions entwined in everyday social life, their historical formation, the interplay between formal and informal, traditional and modern arrangements, and the power relations that animate them. In such perspectives a social justice lens is often used to scrutinise the outcomes of institutional processes. We argue here that critical institutional approaches have potentially much to offer commons scholarship, particularly through the explanatory power of the concept of bricolage for better understanding institutional change.  Critical institutional approaches, gathering momentum over the past 15 years or so, have excited considerable interest but the insights generated from different disciplinary perspectives remain insufficiently synthesised. Analyses emphasising complexity can be relatively illegible to policy-makers, a fact which lessens their reach. This special issue therefore aims to synthesise critical institutional ideas and so to lay the foundation for moving beyond the emergent stage to make meaningful academic and policy impact. In bringing together papers here we define and synthesise key themes of critical institutionalism, outline the concept of institutional bricolage and identity some key challenges facing this school of thought.

  9. Entrepreneurship as institutional change

    DEFF Research Database (Denmark)

    Bjerregaard, Toke; Lauring, Jakob

    2012-01-01

    This paper responds to calls to make more explicit linkages between institutional theory and entrepreneurship research through studies on how entrepreneurs navigate and work with institutions. The research examines the micro-strategies and activities through which small-scale entrepreneurs maneuver...... between and exploit the multiple, potentially contradictory institutional logics of the different spheres in which they operate. While much research has elucidated how institutional entrepreneurs effect change, this study illustrates how effective entrepreneurs managing and exploiting institutional...... contradictions engage simultaneously in practices of maintaining and changing institutions to establish a balance between the poles on which their ventures depend. We illustrate this by two cases of small-scale entrepreneurship bridging institutional contradictions from an ethnographic study conducted under...

  10. 76 FR 57748 - National Cancer Institute Notice of Closed Meetings

    Science.gov (United States)

    2011-09-16

    ... Logistics Branch, Division of Extramural Activities, National Cancer Institute, 6116 Executive Boulevard... Crystal City, 2799 Jefferson Davis Highway, Arlington, VA 22202. Contact Person: Sergei Radaev, PhD..., Scientific Review Officer, Special Review Logistics Branch, Division of Extramural Activities, National...

  11. From Institutional Change to Experimentalist Institutions

    DEFF Research Database (Denmark)

    Hull Kristensen, Peer; Morgan, Glenn

    2012-01-01

    Institutionalist theory has shown how work and employment relations are shaped by national contexts. Recent developments in these theories have been increasingly concerned with the issue of institutional change. This reflects a shift in the nature of the competitive environment of firms from...... and institutions. In this paper, we emphasize that in the current context of globalization, firms and actors within firms are continuously developing the way in which they organize work and employment to produce goods and services that are competitive in global markets. The paper argues that new market conditions...... lead firms to constant experimentation in work organization as they seek to position themselves within systems of production and innovation that are global in nature. This creates a pressure for institutional change to facilitate the process of firm-level experimentation; it also tends to create...

  12. How Effective Are Clinical Pathways With and Without Online Peer-Review? An Analysis of Bone Metastases Pathway in a Large, Integrated National Cancer Institute-Designated Comprehensive Cancer Center Network

    Energy Technology Data Exchange (ETDEWEB)

    Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Rajagopalan, Malolan S.; Flickinger, John C.; Rakfal, Susan M. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Rodgers, Edwin [Via Oncology, Pittsburgh, PA (United States); Heron, Dwight E. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)

    2012-07-15

    Purpose: Clinical pathways are an important tool used to manage the quality in health care by standardizing processes. This study evaluated the impact of the implementation of a peer-reviewed clinical pathway in a large, integrated National Cancer Institute-Designated Comprehensive Cancer Center Network. Methods: In 2003, we implemented a clinical pathway for the management of bone metastases with palliative radiation therapy. In 2009, we required the entry of management decisions into an online tool that records pathway choices. The pathway specified 1 or 5 fractions for symptomatic bone metastases with the option of 10-14 fractions for certain clinical situations. The data were obtained from 13 integrated sites (3 central academic, 10 community locations) from 2003 through 2010. Results: In this study, 7905 sites were treated with 64% of courses delivered in community practice and 36% in academic locations. Academic practices were more likely than community practices to treat with 1-5 fractions (63% vs. 23%; p < 0.0001). The number of delivered fractions decreased gradually from 2003 to 2010 for both academic and community practices (p < 0.0001); however, greater numbers of fractions were selected more often in community practices (p < 0.0001). Using multivariate logistic regression, we found that a significantly greater selection of 1-5 fractions developed after implementation online pathway monitoring (2009) with an odds ratio of 1.2 (confidence interval, 1.1-1.4) for community and 1.3 (confidence interval, 1.1-1.6) for academic practices. The mean number of fractions also decreased after online peer review from 6.3 to 6.0 for academic (p = 0.07) and 9.4 to 9.0 for community practices (p < 0.0001). Conclusion: This is one of the first studies to examine the efficacy of a clinical pathway for radiation oncology in an integrated cancer network. Clinical pathway implementation appears to be effective in changing patterns of care, particularly with online clinical

  13. Analisis Konten dan Kebijakan Akses Institutional Repository

    Directory of Open Access Journals (Sweden)

    Amirul Ulum

    2016-07-01

    Abstract; Institutional repository has become a major concern of higher education in Indonesia. The number of institutional respository was increased, one of the reason is the ranking web of repositories has been conducted by the Cybermetrics Lab in 2008. At that time, many institutions started to build institutional repository in order to manage the scientific work and also trying to reach the better ranks. Meanwhile, it is an achievement of institution performance which can be promote and increase visibility for the institution. University of Surabaya has also developed the institutional repository and managed by the library. The aims of this study is to analyze the content availability and access policies defined by the University of Surabaya repository  providing services to the academic community and external users. The method used in this study by using observations of the institutional repository University of Surabaya with a literature review to clarify the analysis of the content and access policies. The results of this study indicate that the library's role is has the authority to manage the scientific work of academic community can be done through the institutional repository. However there is still need for library to be proactive to communicate regulations on mandatory deposit of scientific work and create intensive promotion of the institutional repository.

  14. 77 FR 5035 - National Human Genome Research Institute; Notice of Closed Meetings

    Science.gov (United States)

    2012-02-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... clearly unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research... Officer, Scientific Review Branch, National Human Genome Research Institute, National Institutes of Health...

  15. 78 FR 64222 - National Human Genome Research Institute; Notice of Closed Meetings

    Science.gov (United States)

    2013-10-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... clearly unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research... Review, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, 301...

  16. 77 FR 28888 - National Human Genome Research Institute Notice of Closed Meeting

    Science.gov (United States)

    2012-05-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research Institute Initial...: To review and evaluate grant applications. Place: National Human Genome Research Institute, 3635...

  17. 76 FR 5390 - National Human Genome Research Institute; Notice of Closed Meeting

    Science.gov (United States)

    2011-01-31

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... unwarranted invasion of personal privacy. Place: National Human Genome Research Institute Special Emphasis... Officer, Scientific Review Branch, National Human Genome Research Institute, 5635 Fishers Lane, Suite 4076...

  18. 76 FR 29772 - National Human Genome Research Institute; Notice of Closed Meetings

    Science.gov (United States)

    2011-05-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... clearly unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research... of Scientific Review, National Human Genome Research Institute, National Institutes of Health...

  19. Institutional Support : Ethiopian Development Research Institute ...

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

    The Ethiopian Development Research Institute (EDRI) was established in 1999 and became operational in 2003 as a semi-autonomous organization accountable to ... International Water Resources Association, in close collaboration with IDRC, is holding a webinar titled “Climate change and adaptive water management: ...

  20. 76 FR 27068 - National Heart, Lung, and Blood Institute; Notice of Closed Meetings

    Science.gov (United States)

    2011-05-10

    ... Institute Special Emphasis Panel, SBIR Contract Review. Date: June 2, 2011. Time: 1 p.m. to 4 p.m. Agenda: To review and evaluate contract proposals. Place: National Institutes of Health, 6701 Rockledge Drive...

  1. 76 FR 65204 - National Human Genome Research Institute; Notice of Closed Meetings

    Science.gov (United States)

    2011-10-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... constitute a clearly unwarranted invasion of personal privacy. Name of Committee: National Human Genome... Review Officer, Scientific Review Branch, National Human Genome Research Institute, 5635 Fishers Lane...

  2. 77 FR 59933 - National Human Genome Research Institute; Notice of Closed Meetings

    Science.gov (United States)

    2012-10-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Human Genome... clearly unwarranted invasion of personal privacy. Name of Committee: National Human Genome Research....D., Scientific Review Officer, Scientific Review Branch, National Human Genome Research Institute...

  3. Texas Heart Institute

    Science.gov (United States)

    ... of seminars and conferences. Resources Texas Heart Institute Journal Scientific Publications Library & Learning Resources Resources for Physicians Fellowships & Residencies School of Perfusion Technology THI Spotlight Check out the ...

  4. Perception and Information Behaviour of Institutional Repository End-Users Provides Valuable Insight for Future Development. A Review of: St. Jean, B., Rieh, S. Y., Yakel, E., & Markey, K. (2011. Unheard voices: Institutional repository end-users. College & Research Libraries, 72(1, 21-42.

    Directory of Open Access Journals (Sweden)

    Lisa Shen

    2012-06-01

    Full Text Available Objective – To determine the perceptions andinformation behavior of institutionalrepository (IR end-users.Design – Semi-structured interviews.Setting – The interviews were conducted overthe telephone.Subjects – Twenty end-users of five differentIRs were interviewed for the study. Seventeenof the interviewees were recruited viarecruitment forms the researchers placed on IRhomepages and the other three intervieweeswere referred to researchers by IR managers.The interviewees’ academic backgroundsvaried, including six undergraduates, fourmasters’ students, three doctorial students, fivefaculty, and two library or museum staffmembers. They represented disciplines in Artsand Humanities (5, Science and HealthSciences (10, and Social Sciences (5. Fifteen ofthe 20 interviewees were recruited throughtheir own institution’s IR. All except two of theinterviewees had used the IR for which theywere recruited less than six times.Methods – Forty-three potential intervieweeswere recruited using web recruitment formsand IR manager recommendations.Researchers subsequently excluded 23 (53.5%of the interviewees because they wereprimarily IR contributors rather than endusers,or could not be reached by phone.Twenty interviews ranging from 17 to 60 minutes were conducted between January and June 2008. The average interview time was 34 minutes. The recordings were transcribed then analyzed using qualitative data analysis software NVivo7. Coding categories were developed using both the original research questions and emerging themes from the actual transcripts. The final coding scheme had a Holsi Coefficient of Reliability of 0.732 for inter-coder reliability.Main Results – Researchers identified six common themes from the results:How do end-users characterize IRs?While most interviewees recognized that there is a relationship between the IR and its host institution, their understandings of the function and content of IRs varied widely. Interviewees

  5. Evaluation of Partial Breast Reirradiation with Intraoperative Radiotherapy after Prior Thoracic Radiation: A Single-Institution Report of Outcomes and Toxicity

    Directory of Open Access Journals (Sweden)

    Christine Chin

    2017-08-01

    Full Text Available IntroductionMastectomy is the current standard of care for ipsilateral breast tumor recurrences after prior whole breast irradiation (WBI. We report our single-institution experience with breast-conserving surgery (BCS followed by intraoperative radiotherapy (IORT as an alternative to salvage mastectomy for new or recurrent breast cancers that develop in the setting of prior thoracic radiation.MethodsWe performed an IRB-approved retrospective review of patients treated with breast IORT between September 2013 and November 2016. We identified 12 patients who declined salvage mastectomy for their breast cancer after prior thoracic radiation. IORT was delivered using the Intrabeam™ device (Carl Zeiss, Germany. A dose of 20 Gy was prescribed to the lumpectomy cavity surface using 50 kV X-rays. We graded both acute and late treatment-related breast toxicities using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Local control, mastectomy-free survival, distant metastasis, and overall survival were determined.ResultsOur study included nine patients who developed a new or recurrent ipsilateral breast cancer after prior WBI for early-stage breast cancer, two patients with primary breast cancer after mantle-field radiation for Hodgkin’s lymphoma, and one patient with a synchronous stage III non-small cell lung cancer treated with definitive radiation to the ipsilateral lung and mediastinum. The median time from prior radiation to presentation was 18 years (range: 2 months to 46 years. All patients successfully underwent partial breast reirradiation with IORT and were able to preserve their breast. At a median follow-up of 14 months (4–25 months, there were no local or distant recurrences. There was a single non-cancer-related death. In the acute setting, we observed grade 1 toxicity in 58% (n = 7, grade 2 toxicity in 17% (n = 2, and no grade 3 or higher toxicity. In the late setting, at

  6. 75 FR 48699 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2010-08-11

    ... personal privacy. Name of Committee: National Cancer Institute Initial Review Group, Subcommittee I--Career Development, NCI-I Career Development. Date: September 21, 2010. Time: 8 a.m. to 6 p.m. Agenda: To review and.... Contact Person: Sergei Radaev, PhD, Scientific Review Officer, Resources and Training Review Branch...

  7. 77 FR 28613 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2012-05-15

    ... Nanotechnology. Date: July 11-12, 2012. Time: 8:00 a.m. to 12:00 p.m. Agenda: To review and evaluate grant.... to 3:30 p.m. Agenda: To review and evaluate contract proposals. Place: National Institutes of Health... Call). Contact Person: Adriana Stoica, Ph.D., Scientific Review Officer, Special Review and Logistics...

  8. A Review of Long-Term Pain Relief after Genicular Nerve Radiofrequency Ablation in Chronic Knee Osteoarthritis.

    Science.gov (United States)

    Iannaccone, Ferdinand; Dixon, Samuel; Kaufman, Andrew

    2017-03-01

    Studies of radiofrequency ablation (RFA) of genicular nerves have reportedly significantly decreased pain up to 3 months post ablation, but no longer term effects have been reported. We performed an analysis of long-term pain relief of 31 RFA procedures of the genicular nerves to analyze the degree of pain relief past 3 months, culminating at 6 months. Chart review and study design was approved by Newark Health Sciences Institutional Review Board (IRB). Chart review and follow-up was performed on all patients who underwent genicular nerve RFA during the period of February 2014 through August of 2015. During this inclusion period 41 genicular nerve RFAs were performed on 31 patients, 5 patients received RFA procedure in both knees. Patient follow-up was performed via telephone interview or in-office visit at least 3 months and 6 months post RFA. Procedures were performed in Medical Special Procedures at University Hospital in Newark, NJ, and the Pain Management Center at Overlook Medical Arts Center in Summit, NJ. Chart review and study design was approved by Newark Health Sciences IRB. Chart review was performed from February 2014 and continued through August 2015. Patient follow-up was conducted at 3 and at least 6 months post treatment to gauge degree of pain relief (0 - none, 100% - complete), their current day's pain score, other treatment modalities tried before RFA, and the medications used. Patients were asked to quantify their satisfaction with procedure length, pre-procedure anxiety, complications, and if they would recommend this procedure to others. Primary and secondary goals were the duration of pain relief after RFA, the quality of pain relief, and the efficacy of our approach for RFA of genicular nerves versus prior published techniques. At 3 month follow-up, the average pain relief was 67% improvement from baseline knee pain, 0% being no relief and 100% being complete relief, and average 0 - 10 pain score was 2.9. At 6 month follow-up, of those who

  9. 77 FR 5032 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2012-02-01

    ... Initiatives; RFA and RFP Concept Reviews; and Scientific Presentations. Place: National Institutes of Health... Group(s); and Budget Presentations; Reports of Special Initiatives; RFA and RFP Concept Reviews; and Scientific Presentations. Place: National Institutes of Health, Building 31, 31 Center Drive, 6th Floor, Conf...

  10. The European Society of Therapeutic Radiology and Oncology-European Institute of Radiotherapy (ESTRO-EIR) report on 3D CT-based in-room image guidance systems: a practical and technical review and guide.

    Science.gov (United States)

    Korreman, Stine; Rasch, Coen; McNair, Helen; Verellen, Dirk; Oelfke, Uwe; Maingon, Philippe; Mijnheer, Ben; Khoo, Vincent

    2010-02-01

    The past decade has provided many technological advances in radiotherapy. The European Institute of Radiotherapy (EIR) was established by the European Society of Therapeutic Radiology and Oncology (ESTRO) to provide current consensus statement with evidence-based and pragmatic guidelines on topics of practical relevance for radiation oncology. This report focuses primarily on 3D CT-based in-room image guidance (3DCT-IGRT) systems. It will provide an overview and current standing of 3DCT-IGRT systems addressing the rationale, objectives, principles, applications, and process pathways, both clinical and technical for treatment delivery and quality assurance. These are reviewed for four categories of solutions; kV CT and kV CBCT (cone-beam CT) as well as MV CT and MV CBCT. It will also provide a framework and checklist to consider the capability and functionality of these systems as well as the resources needed for implementation. Two different but typical clinical cases (tonsillar and prostate cancer) using 3DCT-IGRT are illustrated with workflow processes via feedback questionnaires from several large clinical centres currently utilizing these systems. The feedback from these clinical centres demonstrates a wide variability based on local practices. This report whilst comprehensive is not exhaustive as this area of development remains a very active field for research and development. However, it should serve as a practical guide and framework for all professional groups within the field, focussed on clinicians, physicists and radiation therapy technologists interested in IGRT. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  11. "There Are No Known Benefits . . .": Considering the Risk/Benefit Ratio of Qualitative Research.

    Science.gov (United States)

    Opsal, Tara; Wolgemuth, Jennifer; Cross, Jennifer; Kaanta, Tanya; Dickmann, Ellyn; Colomer, Soria; Erdil-Moody, Zeynep

    2016-07-01

    Institutional review boards (IRBs) are responsible for weighing the risks and benefits of research participation. Qualitative researchers note numerous instances where IRB ethical frameworks fail to align with the ethics of their research projects and point out that IRB understandings of the benefits and risks of research often differ from those of the participants they seek to protect. This qualitative cross-case research investigates participants' interview experiences in six qualitative studies that differed in their methods, subject of focus, and populations. Our findings indicate that contemporary IRBs' use of population "vulnerability" and topic "sensitivity" to assess project risk does not adequately determine the benefits, risks, or ethicality of research. We recommend that IRBs treat as real the evidence for benefits in qualitative research, recognize that sensitivity and vulnerability do not predict risk, and encourage researchers to attend to relationships in their projects. © The Author(s) 2015.

  12. Medicine utilization review at a university teaching hospital in New Delhi

    Directory of Open Access Journals (Sweden)

    M Aqil

    2012-01-01

    Full Text Available Objective: A prospective medicine usage evaluation based on prescription monitoring was conducted in the medicine OPD of our university teaching hospital to know prescribing trends of different categories of medicines. Materials and Methods: A total of 600 patients were included in the study comprising of 339 (56.5% males and 261 (43.5% females. The data were recorded within the OPD by a registered pharmacist on a medicine usage evaluation form, approved by The University Institutional Review Board (IRB. Results: A total of 2365 medicines were prescribed to 600 patients during the 3 months study period. The mean number of medicines per prescription were found to be 3.94. Medicines were most frequently prescribed as solid dosage forms (85.62%, especially tablets (70.82%, and liquid formulations (14.12%. Oral route (96.17% was the most preferred mode of administration, followed by topical (2.11% and parenteral (1.60% routes. Combination therapy (94.33% was more prevalent than monotherapy (5.66%. An overwhelming tendency for prescribing medicines by brand names (99% was observed by the physicians. The most frequently prescribed class of medicines were antimicrobials > analgesics > cardiovascular > gastrointestinal agents. The most prescribed individual medicines among various therapeutic classes included isoniazid (antimicrobial, amlodipine (cardiovascular, metformin (hypoglycemic, cetirizine (antiallergic, rabeprazole (GI medicine, atorvastatin (hypolipidemic, dextromethorphan (respiratory medicine, alprazolam (sedative-hypnotic, paracetamol (analgesic. Conclusions: There is a considerable scope of improvement in the existing prescribing practice, especially prescribing by generic names, needs to be encouraged and a hospital formulary has to be developed for the purpose. The number of medicines to be included per prescription should be judged rationally and polypharmacy ought to be curbed. Use of antimicrobial also needs to be rationalized as over

  13. Fundamentals and Optimal Institutions

    DEFF Research Database (Denmark)

    Gonzalez-Eiras, Martin; Harmon, Nikolaj Arpe; Rossi, Martín

    2016-01-01

    of regulatory institutions such as revenue sharing, salary caps or luxury taxes. We show, theoretically and empirically, that these large differences in adopted institutions can be rationalized as optimal responses to differences in the fundamental characteristics of the sports being played. This provides...

  14. Political institutions since 1820

    NARCIS (Netherlands)

    Foldvari, Peter; Buzasi, Katalin

    2014-01-01

    Political institutions determine the degree of freedom people enjoy and their capacity to influence their social and political environment. This chapter provides historical evidence on the evolution of political institutions drawing upon two major research projects: the PolityIV dataset and the

  15. Astrophysical Institute, Potsdam

    Science.gov (United States)

    Murdin, P.

    2000-11-01

    Built upon a tradition of almost 300 years, the Astrophysical Institute Potsdam (AIP) is in an historical sense the successor of one of the oldest astronomical observatories in Germany. It is the first institute in the world which incorporated the term `astrophysical' in its name, and is connected with distinguished scientists such as Karl Schwarzschild and Albert Einstein. The AIP constitutes on...

  16. Discipline as Institutional Maintenance

    DEFF Research Database (Denmark)

    Rasche, Andreas; Hommel, Ulrich; Cornuel, Eric

    Drawing on the case of business school rankings, we study how institutions are maintained and remain persistent despite their contested nature. We argue that rankings as institutions can be maintained through subtle disciplinary practices that freeze power relations in recipient organizations. Ou...

  17. Institutional investor activism : Introduction

    NARCIS (Netherlands)

    Mc Cahery, Joseph; Bratton, William; Bratton, William; McCahery, Joseph A.

    2015-01-01

    The increase in institutional ownership of recent decades has been accompanied by an enhanced role played by institutions in monitoring companies’ corporate governance behaviour. Activist hedge funds and private equity firms have achieved a degree of success in actively shaping the business plans of

  18. Institutional Justification in Frames

    DEFF Research Database (Denmark)

    Baden, Christian; Schultz, Friederike

    consensus. It extents research on framing in mass communication by applying institutional theory and Boltanski and Thévenot’s (2006) theory on justification in order to explain how the success and failure of proposed interpretations depend on the mobilization of accepted social institutions to justify...

  19. 78 FR 12767 - Eunice Kennedy Shriver National Institute of Child Health & Human Development; Notice of Closed...

    Science.gov (United States)

    2013-02-25

    ... National Institute of Child Health & Human Development; Notice of Closed Meeting Pursuant to section 10(d... Institute of Child Health and Human Development Initial Review Group; Population Sciences Subcommittee. Date...., Scientific Review Officer, Division of Scientific Review, Eunice Kennedy Shriver National Institute, of Child...

  20. Changing institutions of knowing

    DEFF Research Database (Denmark)

    Koch, Christian; Bertelsen, Niels Haldor

    2014-01-01

    paper is to analyze enablers and barriers for this institutional change. The vocational education system in Denmark is strongly institutionalised with unions, employerÕs associations and the schools in central roles. Drawing on institutional theory contributions on labour market -, educational......In order to reach the EU 2020 goals for the climate, Danish vocational training units are currently in a process of institutional change triggered by the need of providing energy, and new process competences for the skilled and semiskilled workforce active in construction. The aim of the present...... - and professional institutions, the paper presents a study of institutional work inside and across schools and craft disciplines working in SMEs involved in new building and renovation with an energy aspect. Collaboration between four education committees for carpenters, masons, electricians and plumbers...

  1. INFLUENCE OF RELATIONS WITH INTERNATIONAL FINANCIAL INSTITUTIONS ON INSTITUTIONAL TRANSFORMATIONS OF ECONOMY

    Directory of Open Access Journals (Sweden)

    Galyna POCHENCHUK

    2014-12-01

    Full Text Available The article deals with the problem of the impact of transitional countries cooperation with international financial institutions on institutional changes which take place in emerging market economies, on the base of Ukraine. Research is carried out from the standpoint of institutional theory. The main reforms that took place in emerging market economy countries were based on the Washington Consensus strategy recommended by international financial institutions. The results of implementing this strategy are varied in different countries. In Ukraine strict adherence to requirements in the early stages of reforms without internal institutional conditions and characteristics led to a deep and protracted crisis of forming a "transformational stability." The general formal institutions of the market economy have been created according to the neoliberal concept which is provided by IFIs. However, experience of transitive economies including Ukraine, confirms the ineffectiveness of many established formal institutions borrowed from the developed countries. The author reviews the basic theory of institutional changes, argues that the terms of cooperation circulated by international financial institutions not only affect economic development strategy, but also determine the role of the national government in relations with markets. Under present conditions prevailing in Ukraine, it is impossible to manage without assistance of international financial institutions. But we need to pay more attention to technical and advisory cooperation in realization of institutional reforms, and credits – to take as a required time for receiving the results of reforms.

  2. Country program review Myanmar

    International Nuclear Information System (INIS)

    Boussaha, A.; Naqvi, S.H.M.; Poshyachinda, M.; Con, T.T.; Nemoto, S.

    1994-03-01

    Review of the past and present IAEA technical cooperation activities in the field of repair and maintenance of nuclear instrumentation and sectoral programs and institutional review in the same field are presented

  3. Country program review Myanmar

    Energy Technology Data Exchange (ETDEWEB)

    Boussaha, A; Naqvi, S H.M.; Poshyachinda, M; Con, T T; Nemoto, S

    1994-03-01

    Review of the past and present IAEA technical cooperation activities in the field of repair and maintenance of nuclear instrumentation and sectoral programs and institutional review in the same field are presented.

  4. SMEs, Institutions and Performance

    DEFF Research Database (Denmark)

    Jensen, Camilla; Low, Mei Peng

    2013-01-01

    for combining the resource-based theory with an institutions-based approach towards constructing a more practical and empirical oriented analytical framework. After the preliminary discussion and introduction to the different theories used, the authors then take a focus on the analytical framework used to study......This chapter addresses at the outset the topic of SMEs and economic development from an institutions perspective. The authors argue that the transaction cost theory is not helpful towards understanding the role that institutions play for SME performance for several reasons. Instead, they argue...

  5. FPG Child Development Institute

    Science.gov (United States)

    ... shows how implicit racial biases are adversely affecting African American students--especially boys... read more Emphasis Areas ... Development, Teaching, and Learning The Frank Porter Graham Child Development Institute will partner with Zero to Three ...

  6. Joint Quantum Institute

    Data.gov (United States)

    Federal Laboratory Consortium — The Joint Quantum Institute (JQI) is pursuing that goal through the work of leading quantum scientists from the Department of Physics of the University of Maryland...

  7. Contributions to institutional matters

    International Nuclear Information System (INIS)

    The papers included in this document deal with the institutional aspects and the legal framework of spent fuel management. The international management and storage of plutonium and spent fuel is addressed. Licensing procedures are discussed

  8. Advanced Transportation Institute 2008.

    Science.gov (United States)

    2009-02-01

    The seventh version of the Advanced Transportation Institute (ATI-08) was conducted in 2008 to encourage high school students to pursue careers in the field of transportation engineering. The University Transportation Center for Alabama partnered wit...

  9. Advanced Transportation Institute 2009.

    Science.gov (United States)

    2009-09-01

    The eighth version of the Advanced Transportation Institute (ATI-09) was conducted in 2009 to encourage high school students to pursue careers in the field of transportation engineering. The University Transportation Center for Alabama partnered with...

  10. Southern Universities Nuclear Institute

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    The Southern Universities Nuclear Institute was created in 1961 to provide postgraduate research and teaching facilities for the universities of Cape Town and Stellenbosch. The main research tool is the 6,0 MV Van de Graaff accelerator installed in 1964. Developments and improvements over the years have maintained the Institute's research effectiveness. The work of local research groups has led to a large number of M Sc and doctorate degrees and numerous publications in international journals. Research at the Institute includes front-line studies of basic nuclear and atomic physics, the development and application of nuclear analytical techniques and the application of radioisotope tracers to problems in science, industry and medicine. The Institute receives financial support from the two southern universities, the Department of National Education, the CSIR and the Atomic Energy Board

  11. Institutional profile questionnaire

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

    test

    Public (i.e., independent govt. body, corporate owned by govt., etc.) N.B. If you ... If yes, services threshold amount? ... How long is the procurement process? : ... Information on person authorized to sign financial reports on behalf of institution.

  12. Corruption, Institutions and Regulation

    OpenAIRE

    Michael Breen; Robert Gillanders

    2011-01-01

    We analyze the effects of corruption and institutional quality on the quality of business regulation. Our key findings indicate that corruption negatively aspects the quality of regulation and that general institutional quality is insignificant once corruption is controlled for. These findings hold over a number of specifications which include additional exogenous historical and geographic controls. The findings imply that policy-makers should focus on curbing corruption to improve regulat...

  13. Great Lakes Energy Institute

    Energy Technology Data Exchange (ETDEWEB)

    Alexander, J. Iwan [Case Western Reserve Univ., Cleveland, OH (United States)

    2012-11-18

    The vision of the Great Lakes Energy Institute is to enable the transition to advanced, sustainable energy generation, storage, distribution and utilization through coordinated research, development, and education. The Institute will place emphasis on translating leading edge research into next generation energy technology. The Institute’s research thrusts focus on coordinated research in decentralized power generation devices (e.g. fuel cells, wind turbines, solar photovoltaic devices), management of electrical power transmission and distribution, energy storage, and energy efficiency.

  14. Blogs in cultural institutions

    Directory of Open Access Journals (Sweden)

    Michał Kaczyński

    2013-03-01

    Full Text Available This article discusses examples of three blogs of the National Library, both in terms of their structure and content as highlighting elements that impact on the promotion of both the blog and the institutions they lead. Discussed the advantages of one of Poland’s most popular blogging platforms WordPress. It also presents a short briefings to customize the look of your blog based on WordPress platform needs to actuate the institution.

  15. Narrative and Institutional Economics

    Directory of Open Access Journals (Sweden)

    Vyacheslav V. Volchik

    2017-12-01

    Full Text Available This article addresses a range of questions associated with the occurrence of a new field of study – narrative economics, which is considered in the context of modern institutionalism. Pioneering works of R. Shiller, G. Akerlof and D. Snower spotlighted the importance of analyzing narratives and narrative influence when studying economic processes. In this paper, a qualitative study of narratives is seen through the prism of an answer to the question: «How do prescribed narratives influence institutions and change them? ». Narratives have much in common with institutions since very often, explicitly or implicitly, they contain value judgements about social interactions or normative aspects shaping behavioral patterns. The identification of dominating narratives enables us to understand better how institutions influence economic (social action. Repeated interactions among social actors are structured through understanding and learning the rules. Understanding of social rules comes from the language – we articulate and perceive the rules drawing on common narratives. Narratives and institutions are helpful when actors gain knowledge about various forms of social communication. Digital technologies, mass media and social networking sites facilitate the spread of narratives, values and beliefs; this process is characterized by increasing returns. Studying narratives and institutions is crucial for modern economic theory because it helps to improve qualitative and quantitative methods of analyzing empirical evidence and enables researchers to understand complex economic processes.

  16. 76 FR 58025 - National Heart, Lung and Blood Institute Notice of Closed Meetings

    Science.gov (United States)

    2011-09-19

    ... Institute Special Emphasis Panel; Gene Therapy Resource Program LentiVirus Vector Production. Date: October...: Tony L Creazzo, PhD, Scientific Review Officer, Office of Scientific Review/DERA, National Heart, Lung..., Scientific Review Officer, Office of Scientific Review/DERA, National Heart, Lung, and Blood Institute, 6701...

  17. The Leadership Criterion in Technological Institute

    International Nuclear Information System (INIS)

    Carvalho, Marcelo Souza de; Cussa, Adriana Lourenco d'Avila; Suita, Julio Cezar

    2005-01-01

    This paper introduces the Direction's 'Decision Making Practice'. It has recently been reviewed with the merging of the beddings of the Leadership Criterion (CE-PNQ). These changes improved the control of institutional plans of action which are the result of the global performance critical analysis and other information associated with the Decision Making Practice. (author)

  18. The Institutional Framing of the Market Economy

    DEFF Research Database (Denmark)

    Howells, John

    2003-01-01

    A review of the significance of the intellectual tool of the technology complex for an understanding of the role of innovation in the market economy. The framing of the market economy is understood as the way that institutions of finance, education and intellectual property are reformed to aid...

  19. The Legislative and Institutional Framework of Environmental ...

    African Journals Online (AJOL)

    This article shall present a detailed and critical review of the legislative and institutional framework of environmental protection and pollution control in the oil and gas sector in Nigeria; it shall conclude with some recommendations for a better, more efficient and effective environmental protection and pollution control regime ...

  20. Institutions and Modernity

    Directory of Open Access Journals (Sweden)

    Witold Morawski

    2013-09-01

    Full Text Available Purpose: Modernity consists of many confl icting aspects: It brings many empty promises, yet has resulted in new institutions that create bridges between the values and interests of millions of people who seek freedom, prosperity, quality of life, strengthened democracy and social justice. In this paper I attempt to a gain and loss account against modernity, because institutional rules are not only conducive to cooperative interactions, but to hostile interactions as well. People are not always guided by moral commitment, but rather more often driven by cold calculation or coercion.Methodology: Modernity has at least three defi nitions. The fi rst defi nition is based on ideas that took over the imagination of the era. The second defi nition is based on an analysis of the behavior of people who respond to reason as well as emotion and believe that they act more rationally than their ancestors or the traditional “others”. The third defi nition is the one closest to my heart, consisting of the use of institutional categories. Institutions offer practical ways of connecting ideas and people. The challenge for them is the result of deepening local and national interdependencies, but increasingly often also regional (e.g. European and global. Interdependencies are the result of the scientifi c and technological revolution, global markets, global governance mechanisms, the emergence of new social forces and cultural confl icts (against the background of reconciling identity and differences.Conclusions: The most important task is to identify the mechanisms of complex systems so that people know how to act under conditions of uncertainty, risk and crisis. Hence, the expectations toward institutions often exceed their abilities. Even though new institutions are being created and old ones are being fixed, we are witnessing and participating in, institutional paralysis and the decay (e.g. corruption. In this situation, it is imperative not only to