Robson, Mark E; Bradbury, Angela R; Arun, Banu; Domchek, Susan M; Ford, James M; Hampel, Heather L; Lipkin, Stephen M; Syngal, Sapna; Wollins, Dana S; Lindor, Noralane M
The American Society of Clinical Oncology (ASCO) has long affirmed that the recognition and management of individuals with an inherited susceptibility to cancer are core elements of oncology care. ASCO released its first statement on genetic testing in 1996 and updated that statement in 2003 and 2010 in response to developments in the field. In 2014, the Cancer Prevention and Ethics Committees of ASCO commissioned another update to reflect the impact of advances in this area on oncology practice. In particular, there was an interest in addressing the opportunities and challenges arising from the application of massively parallel sequencing-also known as next-generation sequencing-to cancer susceptibility testing. This technology introduces a new level of complexity into the practice of cancer risk assessment and management, requiring renewed effort on the part of ASCO to ensure that those providing care to patients with cancer receive the necessary education to use this new technology in the most effective, beneficial manner. The purpose of this statement is to explore the challenges of new and emerging technologies in cancer genetics and provide recommendations to ensure their optimal deployment in oncology practice. Specifically, the statement makes recommendations in the following areas: germline implications of somatic mutation profiling, multigene panel testing for cancer susceptibility, quality assurance in genetic testing, education of oncology professionals, and access to cancer genetic services. © 2015 by American Society of Clinical Oncology.
Jacobs, Michelle; Alonso, Alina M; Sherin, Kevin M; Koh, Yumi; Dhamija, Asha; Lowe, Andrea L
Secondhand smoke (SHS) exposure poses serious health risks for all nonsmokers, especially children and pregnant women. SHS is estimated to contribute to heart attacks in nonsmokers and nearly 53,800 deaths in the U.S. annually. A literature review of English-language articles was performed using PubMed, organizational websites, and pertinent review articles. Over the past 25 years, smokefree policies have protected nearly half the U.S. population from the adverse health effects of SHS. Smokefree policies have been shown to improve health outcomes with no consequences to local businesses. As of April 2013, a total of 24 states and 561 municipalities and territories, including the District of Columbia, New York City, Puerto Rico, and the U.S. Virgin Islands, have established laws that require nonhospitality workplaces, restaurants, and bars to be 100% smokefree. Four other states-Florida, Indiana, Louisiana, and Nevada-have smokefree laws that cover restaurants but provide an exemption for stand-alone bars. At least 14 states have no smokefree laws. This paper describes the benefits of policies that reduce SHS and concludes with recommendations for future directions. The American College of Preventive Medicine (ACPM) recommends expanded clean indoor air policies for workplaces, stand-alone bars, restaurants, and multi-use family housing such as apartment buildings. ACPM recommends clean air policies for all university campuses, secondary school campuses, primary schools, child care centers, and city landmarks to further shift social norms and protect the health of children, adolescents, and adults. ACPM recommends closing existing gaps in clean indoor air policies. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Kon, Alexander A; Davidson, Judy E; Morrison, Wynne; Danis, Marion; White, Douglas B
Shared decision making is endorsed by critical care organizations; however, there remains confusion about what shared decision making is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define shared decision making, recommend when shared decision making should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. The American College of Critical Care Medicine and American Thoracic Society Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of American College of Critical Care Medicine and American Thoracic Society were included in the statement. Six recommendations were endorsed: 1) DEFINITION: Shared decision making is a collaborative process that allows patients, or their surrogates, and clinicians to make healthcare decisions together, taking into account the best scientific evidence available, as well as the patient's values, goals, and preferences. 2) Clinicians should engage in a shared decision making process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their "default" approach a shared decision making process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable, including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision
Young, Deborah R; Spengler, John O; Frost, Natasha; Evenson, Kelly R; Vincent, Jeffrey M; Whitsel, Laurie
Most Americans are not sufficiently physically active, even though regular physical activity improves health and reduces the risk of many chronic diseases. Those living in rural, non-White, and lower-income communities often have insufficient access to places to be active, which can contribute to their lower level of physical activity. The shared use of school recreational facilities can provide safe and affordable places for communities. Studies suggest that challenges to shared use include additional cost, liability protection, communication among constituencies interested in sharing space, and decision-making about scheduling and space allocation. This American Heart Association policy statement has provided recommendations for federal, state, and local decision-makers to support and expand opportunities for physical activity in communities through the shared use of school spaces.
Journal of Education for Sustainable Development, 2009
This article presents nine resources that focus on environmental education and sustainability. These include: (1) "Sustainability Statement and Policy," Dalhousie University, Nova Scotia, Canada, 2009, which is available at http://office.sustainability.dal.ca/Governance; (2) "Climate Literacy: The Essential Principles of Climate…
Kon, Alexander A.; Davidson, Judy E.; Morrison, Wynne; Danis, Marion; White, Douglas B.
Objectives Shared decision-making (SDM) is endorsed by critical care organizations, however there remains confusion about what SDM is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define SDM, recommend when SDM should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. Methods The American College of Critical Care Medicine (ACCM) and American Thoracic Society (ATS) Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of ACCM and ATS were included in the statement. Main Results Six recommendations were endorsed: 1) Definition: Shared decision-making is a collaborative process that allows patients, or their surrogates, and clinicians to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values, goals, and preferences. 2) Clinicians should engage in a SDM process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their “default” approach a SDM process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making strategies. Conclusions Patient and surrogate preferences for decision-making roles regarding value
Tobacco use and secondhand tobacco-smoke (SHS) exposure are major national and international health concerns. Pediatricians and other clinicians who care for children are uniquely positioned to assist patients and families with tobacco-use prevention and treatment. Understanding the nature and extent of tobacco use and SHS exposure is an essential first step toward the goal of eliminating tobacco use and its consequences in the pediatric population. The next steps include counseling patients and family members to avoid SHS exposures or cease tobacco use; advocacy for policies that protect children from SHS exposure; and elimination of tobacco use in the media, public places, and homes. Three overarching principles of this policy can be identified: (1) there is no safe way to use tobacco; (2) there is no safe level or duration of exposure to SHS; and (3) the financial and political power of individuals, organizations, and government should be used to support tobacco control. Pediatricians are advised not to smoke or use tobacco; to make their homes, cars, and workplaces tobacco free; to consider tobacco control when making personal and professional decisions; to support and advocate for comprehensive tobacco control; and to advise parents and patients not to start using tobacco or to quit if they are already using tobacco. Prohibiting both tobacco advertising and the use of tobacco products in the media is recommended. Recommendations for eliminating SHS exposure and reducing tobacco use include attaining universal (1) smoke-free home, car, school, work, and play environments, both inside and outside, (2) treatment of tobacco use and dependence through employer, insurance, state, and federal supports, (3) implementation and enforcement of evidence-based tobacco-control measures in local, state, national, and international jurisdictions, and (4) financial and systems support for training in and research of effective ways to prevent and treat tobacco use and SHS
... INSPECTION Policy Statement and Regulations Governing the Extension of Tobacco Inspection and Price Support Services to New Markets and to Additional Sales on Designated Markets § 29.2 Policy statement. Inspection... 7 Agriculture 2 2010-01-01 2010-01-01 false Policy statement. 29.2 Section 29.2 Agriculture...
... INSPECTION Policy Statement and Regulations Governing Availability of Tobacco Inspection and Price Support Services to Flue-Cured Tobacco on Designated Markets § 29.9402 Policy statement. The sets of inspectors... 7 Agriculture 2 2010-01-01 2010-01-01 false Policy statement. 29.9402 Section 29.9402 Agriculture...
Zon, Robin T.; Goss, Elizabeth; Vogel, Victor G.; Chlebowski, Rowan T.; Jatoi, Ismail; Robson, Mark E.; Wollins, Dana S.; Garber, Judy E.; Brown, Powel; Kramer, Barnett S.
Oncologists have a critical opportunity to utilize risk assessment and cancer prevention strategies to interrupt the initiation or progression of cancer in cancer survivors and individuals at high risk of developing cancer. Expanding knowledge about the natural history and prognosis of cancers positions oncologists to advise patients regarding the risk of second malignancies and treatment-related cancers. In addition, as recognized experts in the full spectrum of cancer care, oncologists are afforded opportunities for involvement in community-based cancer prevention activities. Although oncologists are currently providing many cancer prevention and risk assessment services to their patients, economic barriers exist, including inadequate or lack of insurance, that may compromise uniform patient access to these services. Additionally, insufficient reimbursement for existing and developing interventions may discourage patient access to these services. The American Society of Clinical Oncology (ASCO), the medical society representing cancer specialists involved in patient care and clinical research, is committed to supporting oncologists in their wide-ranging involvement in cancer prevention. This statement on risk assessment and prevention counseling, although not intended to be a comprehensive overview of cancer prevention describes the current role of oncologists in risk assessment and prevention; provides examples of risk assessment and prevention activities that should be offered by oncologists; identifies potential opportunities for coordination between oncologists and primary care physicians in prevention education and coordination of care for cancer survivors; describes ASCO's involvement in education and training of oncologists regarding prevention; and proposes improvement in the payment environment to encourage patient access to these services. PMID:19075281
Dunbar, Sandra B; Khavjou, Olga A; Bakas, Tamilyn; Hunt, Gail; Kirch, Rebecca A; Leib, Alyssa R; Morrison, R Sean; Poehler, Diana C; Roger, Veronique L; Whitsel, Laurie P
attributable to CVD. The burden of informal caregiving for patients with CVD is significant; accounting for these costs increases total CVD costs to $616 billion in 2015 and $1.2 trillion in 2035. These estimates have important research and policy implications, and they may be used to guide policy development to reduce the burden of CVD on patients and their caregivers. © 2018 American Heart Association, Inc.
Brandon, Thomas H; Goniewicz, Maciej L; Hanna, Nasser H; Hatsukami, Dorothy K; Herbst, Roy S; Hobin, Jennifer A; Ostroff, Jamie S; Shields, Peter G; Toll, Benjamin A; Tyne, Courtney A; Viswanath, Kasisomayajula; Warren, Graham W
Combustible tobacco use remains the number one preventable cause of disease, disability, and death in the United States. Electronic nicotine delivery systems (ENDS), which include e-cigarettes, are devices capable of delivering nicotine in an aerosolized form. ENDS use by both adults and youth has increased rapidly, and some have advocated these products could serve as harm-reduction devices and smoking cessation aids. ENDS may be beneficial if they reduce smoking rates or prevent or reduce the known adverse health effects of smoking. However, ENDS may also be harmful, particularly to youth, if they increase the likelihood that nonsmokers or formers smokers will use combustible tobacco products or if they discourage smokers from quitting. The American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO) recognize the potential ENDS have to alter patterns of tobacco use and affect the public's health; however, definitive data are lacking. AACR and ASCO recommend additional research on these devices, including assessing the health impacts of ENDS, understanding patterns of ENDS use, and determining what role ENDS have in cessation. Key policy recommendations include supporting federal, state, and local regulation of ENDS; requiring manufacturers to register with the FDA and report all product ingredients, requiring childproof caps on ENDS liquids, and including warning labels on products and their advertisements; prohibiting youth-oriented marketing and sales; prohibiting child-friendly ENDS flavors; and prohibiting ENDS use in places where cigarette smoking is prohibited. ©2015 American Association for Cancer Research and American Society of Clinical Oncology.
The Supplemental Security Income (SSI) program remains an important source of financial support for low-income families of children with special health care needs and disabling conditions. In most states, SSI eligibility also qualifies children for the state Medicaid program, providing access to health care services. The Social Security Administration (SSA), which administers the SSI program, considers a child disabled under SSI if there is a medically determinable physical or mental impairment or combination of impairments that results in marked and severe functional limitations. The impairment(s) must be expected to result in death or have lasted or be expected to last for a continuous period of at least 12 months. The income and assets of families of children with disabilities are also considered when determining financial eligibility. When an individual with a disability becomes an adult at 18 years of age, the SSA considers only the individual's income and assets. The SSA considers an adult to be disabled if there is a medically determinable impairment (or combination of impairments) that prevents substantial gainful activity for at least 12 continuous months. SSI benefits are important for youth with chronic conditions who are transitioning to adulthood. The purpose of this statement is to provide updated information about the SSI medical and financial eligibility criteria and the disability-determination process. This statement also discusses how pediatricians can help children and youth when they apply for SSI benefits.
Kim, W.S.; Kim, H.J.; Choi, K.S.; Choi, Y.S.; Park, D.K.
Full text: Wide varieties of programs to enhance nuclear safety have been established and implemented by the Korean government in accordance with the Nuclear Safety Policy Statement announced in September 1994. The policy statement was intended to set the long-term policy goals for maintaining and achieving high-level of nuclear safety and also help the public understand the national policy and a strong will of the government toward nuclear safety. It has been recognized as very effective in developing safety culture in nuclear-related organizations and also enhancing nuclear safety in Korea. However, ageing of operating nuclear power plants and increasing of new nuclear facilities have demanded a new comprehensive national safety policy to cover the coming decade, taking the implementation results of the policy statement of 1994 and the changing environment of nuclear industries into consideration. Therefore, the results of safety policy implementation have been reviewed and, considering changing environment and future prospects, a new nuclear safety policy statement as a highest level national policy has been developed. The implementation results of 11 regulatory policy directions such as the use of Probabilistic Safety Assessment, introduction of Periodic Safety Review, strengthening of safety research, introduction of Risk Based Regulation stipulated in the safety policy statement of 1994 were reviewed and measures taken after various symposia on nuclear safety held in Nuclear Safety Days since 1995 were evaluated. The changing international and domestic environment of nuclear industry were analysed and future prospects were explored. Based on the analysis and review results, a draft of new nuclear safety policy statement was developed. The draft was finalized after the review of many prominent experts in Korea. Considering changing environment and future prospects, new policy statement that will show government's persistent will for nuclear safety has been
Goic, Alejando; Armas, Rodolfo
The ALANAM (Association of Latin American National Academies of Medicine) statement on public health policy, issued following its 19th Congress, held October 28–30, 2010, in Santiago, Chile, declares that cardiovascular diseases, cancer, accidents and violence are the leading causes of death in the region, while in several of its member nations, emergent and re-emergent infectious diseases, malnutrition, and mother-child illnesses remain prevalent. The statement calls attention to the lack of functioning water supply and sewage systems in many villages and rural areas. After describing the social causes of the present state of public health in Latin America (poverty levels reaching upwards of 44% of the total population, or some 110 million people), it calls on governments, first, to spare no efforts in the task of eradicating extreme poverty in the short-term, and poverty in the long-term. Second, considering that about 15 million 3-to-6 year-olds have no access to education, it recommends extending educational services to these children, and to improve the quality of existing pre-school and primary education. Third, the statement calls for universal health care coverage and for equal access to good quality medical care for everyone, and for programs aimed at promoting healthy personal habits and self-care. In this regard, it also recommends that disease prevention programs be sustained over time, that national sanitary objectives be defined, and that its results be periodically reviewed. Fourth, it recommends that primary health care be extended to everyone, and that it be enhanced by improving coverage and coordination with secondary and tertiary level health care institutions. The statement lays special stress on the need for adopting public health policies aimed at lowering the cost of medicines; to this end, it calls for the creation of an official list of generic drugs. The statement ends by calling on governments to support public health research as a
Purpose The primary goal of this Policy Statement is to educate patients, physicians, medical providers, reviewers, adjustors, case managers, insurers, and all others involved or affected by insurance coverage decisions regarding lumbar disc replacement surgery. Procedures This Policy Statement was developed by a panel of physicians selected by the Board of Directors of ISASS for their expertise and experience with lumbar TDR. The panel's recommendation was entirely based on the best evidence-based scientific research available regarding the safety and effectiveness of lumbar TDR. PMID:25785243
Slatore, Christopher G; Horeweg, Nanda; Jett, James R
BACKGROUND: Pulmonary nodules are frequently detected during diagnostic chest imaging and as a result of lung cancer screening. Current guidelines for their evaluation are largely based on low-quality evidence, and patients and clinicians could benefit from more research in this area. METHODS......: In this research statement from the American Thoracic Society, a multidisciplinary group of clinicians, researchers, and patient advocates reviewed available evidence for pulmonary nodule evaluation, characterized six focus areas to direct future research efforts, and identified fundamental gaps in knowledge...... demographic and nodule characteristics with patient-level outcomes. Methods to share data from registries are also necessary. CONCLUSIONS: This statement may help researchers to develop impactful and innovative research projects and enable funders to better judge research proposals. We hope...
... NUCLEAR REGULATORY COMMISSION [NRC-2013-0081] Policy Statement on Adequacy and Compatibility of Agreement State Programs; Statement of Principles and Policy for the Agreement State Program AGENCY: Nuclear Regulatory Commission. ACTION: Policy statements; extension of comment period. SUMMARY: The U.S. Nuclear...
A critical review of Dr. Charles S. Greene's article titled "Managing the Care of Patients with Temporomandibular Disorders: a new Guideline for Care" and a revision of the American Association for Dental Research's 1996 policy statement on temporomandibular disorders, approved by the AADR Council in March 2010, published in the Journal of the American Dental Association September 2010.
Simmons, H Clifton
Dr. Charles Greene's article, "Managing the Care of Patients with TMDs A New Guideline for Care," and the American Association for Dental Research's (AADR) 2010 Policy Statement on Temporomandibular Disorders, published in the Journal of the American Dental Association (JADA) September 2010, are reviewed in detail. The concept that all temporomandibular disorders (TMDs) should be lumped into one policy statement for care is inappropriate. TMDs are a collection of disorders that are treated differently, and the concept that TMDs must only be managed within a biopsychosocial model of care is inappropriate. TMDs are usually a musculoskeletal orthopedic disorder, as defined by the AADR. TMD orthopedic care that is peer-reviewed and evidence-based is available and appropriate for some TMDs. Organized dentistry, including the American Dental Association, and mainstream texts on TMDs, support the use of orthopedics in the treatment of some TMDs. TMDs are not psychological or social disorders. Informed consent requires that alternative care is discussed with patients. Standard of care is a legal concept that is usually decided by a court of law and not decided by a policy statement, position paper, guidelines or parameters of care handed down by professional organizations. The 2010 AADR Policy Statement on TMD is not the standard of care in the United States. Whether a patient needs care for a TMD is not decided by a diagnostic test, but by whether the patient has significant pain, dysfunction and/or a negative change in quality of life from a TMD and they want care. Some TMDs need timely invasive and irreversible care.
Farnan, Jeanne M; Snyder Sulmasy, Lois; Worster, Brooke K; Chaudhry, Humayun J; Rhyne, Janelle A; Arora, Vineet M
User-created content and communications on Web-based applications, such as networking sites, media sharing sites, or blog platforms, have dramatically increased in popularity over the past several years, but there has been little policy or guidance on the best practices to inform standards for the professional conduct of physicians in the digital environment. Areas of specific concern include the use of such media for nonclinical purposes, implications for confidentiality, the use of social media in patient education, and how all of this affects the public's trust in physicians as patient-physician interactions extend into the digital environment. Opportunities afforded by online applications represent a new frontier in medicine as physicians and patients become more connected. This position paper from the American College of Physicians and the Federation of State Medical Boards examines and provides recommendations about the influence of social media on the patient-physician relationship, the role of these media in public perception of physician behaviors, and strategies for physician-physician communication that preserve confidentiality while best using these technologies.
An official American Thoracic Society/International Society for Heart and Lung Transplantation/Society of Critical Care Medicine/Association of Organ and Procurement Organizations/United Network of Organ Sharing Statement: ethical and policy considerations in organ donation after circulatory determination of death.
Gries, Cynthia J; White, Douglas B; Truog, Robert D; Dubois, James; Cosio, Carmen C; Dhanani, Sonny; Chan, Kevin M; Corris, Paul; Dark, John; Fulda, Gerald; Glazier, Alexandra K; Higgins, Robert; Love, Robert; Mason, David P; Nakagawa, Thomas A; Shapiro, Ron; Shemie, Sam; Tracy, Mary Fran; Travaline, John M; Valapour, Maryam; West, Lori; Zaas, David; Halpern, Scott D
Donation after circulatory determination of death (DCDD) has the potential to increase the number of organs available for transplantation. Because consent and management of potential donors must occur before death, DCDD raises unique ethical and policy issues. To develop an ethics and health policy statement on adult and pediatric DCDD relevant to critical care and transplantation stakeholders. A multidisciplinary panel of stakeholders was convened to develop an ethics and health policy statement. The panel consisted of representatives from the American Thoracic Society, Society of Critical Care Medicine, International Society for Heart and Lung Transplantation, Association of Organ Procurement Organizations, and the United Network of Organ Sharing. The panel reviewed the literature, discussed important ethics and health policy considerations, and developed a guiding framework for decision making by stakeholders. A framework to guide ethics and health policy statement was established, which addressed the consent process, pre- and post mortem interventions, the determination of death, provisions of end-of-life care, and pediatric DCDD. The information presented in this Statement is based on the current evidence, experience, and clinical rationale. New clinical research and the development and dissemination of new technologies will eventually necessitate an update of this Statement.
American Foundation for the Blind, New York, NY.
The policy statement by the American Foundation for the Blind deals with nature trails, braille trails, foot paths, fragrance gardens, and touch museums for the blind. It is stated that the foundation approves of services such as provision of tape recorded guides and planting of fragrant shrubs which would benefit all users while recognizing…
This document includes the US Nuclear Regulatory Commission`s (NRC`s or Commission`s) revised General Statement of Policy and Procedure for Enforcement Actions (Enforcement Policy) as it was published in the Federal Register on May 13, 1998 (63 ER 26630). The Enforcement Policy is a general statement of policy explaining the NRC`s policies and procedures in initiating enforcement actions, and of the presiding officers and the Commission in reviewing these actions. This policy statement is applicable to enforcement matters involving the radiological health and safety of the public, including employees` health and safety, the common defense and security, and the environment.
This document includes the US Nuclear Regulatory Commission's (NRC's or Commission's) revised General Statement of Policy and Procedure for Enforcement Actions (Enforcement Policy) as it was published in the Federal Register on May 13, 1998 (63 ER 26630). The Enforcement Policy is a general statement of policy explaining the NRC's policies and procedures in initiating enforcement actions, and of the presiding officers and the Commission in reviewing these actions. This policy statement is applicable to enforcement matters involving the radiological health and safety of the public, including employees' health and safety, the common defense and security, and the environment
...-determination. (b) Congressional declaration of policy. It is the policy of the Tribal Self-Governance Act to... parallel reduction in the Federal bureaucracy. (c) Secretarial self-governance policies. (1) It is the...-governance a reality. (4) It is the policy of the Secretary to have all bureaus of the Department actively...
... CARCINOGENS The Osha Cancer Policy § 1990.111 General statement of regulatory policy. (a) This part establishes the criteria and procedures under which substances will be regulated by OSHA as potential... case-by-case basis in the rulemaking proceedings on individual substances. Any permissible exposure...
Healthy lifestyle interventions to combat noncommunicable disease-a novel nonhierarchical connectivity model for key stakeholders: a policy statement from the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine.
Arena, Ross; Guazzi, Marco; Lianov, Liana; Whitsel, Laurie; Berra, Kathy; Lavie, Carl J; Kaminsky, Leonard; Williams, Mark; Hivert, Marie-France; Cherie Franklin, Nina; Myers, Jonathan; Dengel, Donald; Lloyd-Jones, Donald M; Pinto, Fausto J; Cosentino, Francesco; Halle, Martin; Gielen, Stephan; Dendale, Paul; Niebauer, Josef; Pelliccia, Antonio; Giannuzzi, Pantaleo; Corra, Ugo; Piepoli, Massimo F; Guthrie, George; Shurney, Dexter; Arena, Ross; Berra, Kathy; Dengel, Donald; Franklin, Nina Cherie; Hivert, Marie-France; Kaminsky, Leonard; Lavie, Carl J; Lloyd-Jones, Donald M; Myers, Jonathan; Whitsel, Laurie; Williams, Mark; Corra, Ugo; Cosentino, Francesco; Dendale, Paul; Giannuzzi, Pantaleo; Gielen, Stephan; Guazzi, Marco; Halle, Martin; Niebauer, Josef; Pelliccia, Antonio; Piepoli, Massimo F; Pinto, Fausto J; Guthrie, George; Lianov, Liana; Shurney, Dexter
Noncommunicable diseases (NCDs) have become the primary health concern for most countries around the world. Currently, more than 36 million people worldwide die from NCDs each year, accounting for 63% of annual global deaths; most are preventable. The global financial burden of NCDs is staggering, with an estimated 2010 global cost of $6.3 trillion (US dollars) that is projected to increase to $13 trillion by 2030. A number of NCDs share one or more common predisposing risk factors, all related to lifestyle to some degree: (1) cigarette smoking, (2) hypertension, (3) hyperglycemia, (4) dyslipidemia, (5) obesity, (6) physical inactivity, and (7) poor nutrition. In large part, prevention, control, or even reversal of the aforementioned modifiable risk factors are realized through leading a healthy lifestyle (HL). The challenge is how to initiate the global change, not toward increasing documentation of the scope of the problem but toward true action-creating, implementing, and sustaining HL initiatives that will result in positive, measurable changes in the previously defined poor health metrics. To achieve this task, a paradigm shift in how we approach NCD prevention and treatment is required. The goal of this American Heart Association/European Society of Cardiology/European Association for Cardiovascular Prevention and Rehabilitation/American College of Preventive Medicine policy statement is to define key stakeholders and highlight their connectivity with respect to HL initiatives. This policy encourages integrated action by all stakeholders to create the needed paradigm shift and achieve broad adoption of HL behaviors on a global scale. © 2015 Mayo Foundation for Medical Education and Research, and the European Society of Cardiology. This article is being published concurrently in Mayo Clinic Proceedings . The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when
This paper aims to present some important aspects of the decision revaluation of tangible assets in the financial statements of the Romanians companies .Reassessment of the assets shows special interest for the beneficiaries accounting information because only a suitable policy will lead to credibility assessment and relevant data financial statements of assets. Although there have been numerous concerns to find optimal pricing model, currently neither practitioners nor researchers have not r...
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Nature and effect of policy statements. 399.4 Section 399.4 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION... Statements § 399.4 Nature and effect of policy statements. Policy statements published in this part will be...
Lee, Y. E.; Lee, S. H.; Chang, H. S.; Choi, K. S.; Jung, S. J.
Nuclear safety policy in Korea is currently declared in the Nuclear Safety Charter as the highest tier document and safety principles and directions are announced in the Nuclear Safety Policy Statement. As the circumstances affecting on the nuclear safety policy change, it needs to revise the Statement. This study aims to develop the revised Nuclear Safety Policy Statement to declare that securing safety is a prerequisite to the utilization of nuclear energy, and that all workers in nuclear industry and regulatory body must adhere to the principle of priority to safety. As a result, two different types of revision are being prepared as of August. One is based on the spirit of Nuclear Safety Charter as well as the direction of future-oriented safety policies including the changes in the environment after declaration of the Statement. The other is to declare the fundamental safety objective and safety principles as the top philosophy of national nuclear safety policy by adopting the '10 Safety Principles in IAEA Safety Fundamental' instead of the current Charter. Both versions of revision are subject to further in-depth discussion. However once the revision is finalized and declared, it would be useful to accomplish effectively the organizational responsibilities and to enhance the public confidence in nuclear safety by performing the regulatory activities in a planned and systematic manner and promulgating the government's dedication to priority to safety
Luckasson, Ruth; Ford, Marty E.; McMillan, Elise D.; Misilo, Frederick M., Jr.; Nygren, Margaret A.
The American Association on Intellectual and Developmental Disabilities (AAIDD) and The Arc of the United States (The Arc) have a long history of joined efforts to develop, express, and evaluate disability policies. These efforts have resulted in a series of formal statements on critical issues such as education, healthcare, human rights, and…
Corelli, Robin L; Chai, Tiffany; Karic, Alda; Fairman, Melinda; Baez, Karina; Hudmon, Karen Suchanek
To characterize the extent to which state and national professional pharmacy associations have implemented formal policies addressing the sale of tobacco and alcohol products in community pharmacies. To determine existence of tobacco and alcohol policies, national professional pharmacy associations (n = 10) and state-level pharmacy associations (n = 86) affiliated with the American Pharmacists Association (APhA) and/or the American Society of Health-System Pharmacists (ASHP) were contacted via telephone and/or e-mail, and a search of the association websites was conducted. Of 95 responding associations (99%), 14% have a formal policy opposing the sale of tobacco products in pharmacies and 5% have a formal policy opposing the sale of alcohol in pharmacies. Of the associations representing major tobacco-producing states, 40% have a formal policy against tobacco sales in pharmacies, significantly more than the 8% of non-tobacco state associations with such policies. Among national professional pharmacy associations, only APhA and ASHP have formal policy statements opposing the sale of both tobacco and alcohol in pharmacies. Most state-level professional pharmacy associations affiliated with these two national organizations have no formal policy statement or position.
Nurses, individually and collectively, have an obligation to provide comprehensive and compassionate end-of-life care which includes the promotion of comfort and the relief of pain and, at times, forgoing life-sustaining treatments. The American Nurses Association (ANA) believes that the nurse should not participate in assisted suicide. Such an act is in violation of the Code for Nurses with Interpretive Statements (Code for Nurses) and the ethical traditions of the profession.
... best efforts in contributing to the mission of the FCA. Workplace Harassment It is the policy of the... discrimination based on sexual orientation and status as a parent; Executive Order 13166 (Improving Access to... accordance with laws and regulations, [[Page 65099
New Frontiers in Education, 1978
An eight-point policy statement on adult education in India is presented, followed by an outline of operational details for putting it into effect. Focus is on combatting illiteracy by providing those citizens with skills for self-directed learning. (LBH)
Healthy Lifestyle Interventions to Combat Noncommunicable Disease—A Novel Nonhierarchical Connectivity Model for Key Stakeholders: A Policy Statement From the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine.
Arena, Ross; Guazzi, Marco; Lianov, Liana; Whitsel, Laurie; Berra, Kathy; Lavie, Carl J; Kaminsky, Leonard; Williams, Mark; Hivert, Marie-France; Franklin, Nina Cherie; Myers, Jonathan; Dengel, Donald; Lloyd-Jones, Donald M; Pinto, Fausto J; Cosentino, Francesco; Halle, Martin; Gielen, Stephan; Dendale, Paul; Niebauer, Josef; Pelliccia, Antonio; Giannuzzi, Pantaleo; Corra, Ugo; Piepoli, Massimo F; Guthrie, George; Shurney, Dexter
Noncommunicable diseases (NCDs) have become the primary health concern for most countries around the world. Currently, more than 36 million people worldwide die from NCDs each year, accounting for 63% of annual global deaths; most are preventable. The global financial burden of NCDs is staggering, with an estimated 2010 global cost of $6.3 trillion (US dollars) that is projected to increase to $13 trillion by 2030. A number of NCDs share one or more common predisposing risk factors, all related to lifestyle to some degree: (1) cigarette smoking, (2) hypertension, (3) hyperglycemia, (4) dyslipidemia, (5) obesity, (6) physical inactivity, and (7) poor nutrition. In large part, prevention, control, or even reversal of the aforementioned modifiable risk factors are realized through leading a healthy lifestyle (HL). The challenge is how to initiate the global change, not toward increasing documentation of the scope of the problem but toward true action-creating, implementing, and sustaining HL initiatives that will result in positive, measurable changes in the previously defined poor health metrics. To achieve this task, a paradigm shift in how we approach NCD prevention and treatment is required. The goal of this American Heart Association/European Society of Cardiology/European Association for Cardiovascular Prevention and Rehabilitation/American College of Preventive Medicine policy statement is to define key stakeholders and highlight their connectivity with respect to HL initiatives. This policy encourages integrated action by all stakeholders to create the needed paradigm shift and achieve broad adoption of HL behaviors on a global scale. Copyright © 2015 Mayo Foundation for Medical Education and Research and the European Society of Cardiology. Published by Elsevier Inc. All rights reserved.
... culture policy statement, including: (1) development of a common safety culture definition; and (2... NUCLEAR REGULATORY COMMISSION [NRC-2009-0485] Draft Safety Culture Policy Statement: Request for...: Issuance of draft safety culture policy statement and notice of opportunity for public comment; Extension...
Inequalities in distribution of wealth, uneven use and distribution of resources, and human settlement patterns contribute more to environmental degradation than does population size. Current global economic strategies and policy decisions affect population and the natural environment. Large-scale technology and communications, the globalization of capital, subordination within world markets, and increasing consumption levels have broken down livelihoods and the environment. Therefore, contrary to popular opinion, population growth is not the key variable in environmental degradation. The erosion of livelihoods really affect women, especially poor women. Legal and political rights, women's economic independence, education, health, access to reproductive health services, and improved child survival greatly influence fertility decline. The disintegration of women's livelihoods restricts their access to health services and education. We cannot depend on capitalism to protect our livelihoods or the health of the environment. So nongovernmental organizations, international agencies, and national and local governments must do so. Assessments of intensive agriculture, industries destroying the social and physical environment, and military activities are critically needed. We need to reassess the macroeconomic forces affecting the natural environment and livelihoods of the poor. Communities should influence and demand policies and regulations preserving their access to resources. Women must participate more intensely in decision making. They should have access to key services. Citizens should have more access to information on environmental damage of industrialized products and processes. All of us need to advocate for more environmentally sound and sustainable forms of development and technology. People at the local, national, and global levels must work to change values that have caused overconsumption, thereby promoting a new ethic centering on caring for people and the
Luckasson, Ruth; Ford, Marty E; McMillan, Elise D; Misilo, Frederick M; Nygren, Margaret A
The American Association on Intellectual and Developmental Disabilities (AAIDD) and The Arc of the United States (The Arc) have a long history of joined efforts to develop, express, and evaluate disability policies. These efforts have resulted in a series of formal statements on critical issues such as education, healthcare, human rights, and criminal justice. Their joint efforts further important policy goals including providing clear strong communication about important policy values and directions, promulgating key principles of high quality supports and services, affirming best professional practices, and emphasizing personal outcomes. In addition, the joint efforts (a) affirm important aspects of organization identity; (b) enhance the organizations' abilities to assure the input of a wide variety of perspectives; (c) engage members' expanded ranges of experiences and talents; (d) multiply staff and leadership resources; (e) increase communication strength and avenues; and (f) establish processes for timely review and revision of policies as critical disability issues arise or change, and new opportunities for policy integration and advancement occur. This article describes the processes used to develop, express, and evaluate the position statements; summarizes the policy content of several joint statements; and discusses the role of these organization position statements.
The new organization of American economic policy has shown some effects also in the sectoral policies apart from the revision of the concept, new focuses in economic policy - e.g. the struggle against inflation - and the structural re-orientation concerning the role of the government as well as the private sector. Energy policy can be regarded as a paradigm of Reagan's concept of a 'supply-oriented economic policy'. The following contribution gives a survey of the outlines of American energy policy. Chapter one sketches the philosophy of 'supply-oriented' economic policy which is in obvious contrast to the former practice of American energy policy (chapter two). Chapter three deals with the essential problem of the new approach, the deregulation of the price controls especially for natural gas. Chapter four comments on measures of tax policy. Chapter five deals with the price-independent deregulation and the sectors concerned, i.e. coal, electricity and nuclears. Chapter six discusses the governmental quantity policy (distribution of licences). Chapter seven explains the policy of research promotion for synthetic gas. Finally an assessment is made.
This article explores the history of gifted education policy and practice in the United States over the last five decades, documenting the lack of sustained progress in obtaining sustained federal support. It also highlights two case examples, one at the state level and a second at the national level of where a policy in a specific aspect of…
Carnethon, Mercedes R; Pu, Jia; Howard, George; Albert, Michelle A; Anderson, Cheryl A M; Bertoni, Alain G; Mujahid, Mahasin S; Palaniappan, Latha; Taylor, Herman A; Willis, Monte; Yancy, Clyde W
Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites. The objectives of the present scientific statement are to describe cardiovascular health in African Americans and to highlight unique considerations for disease prevention and management. The primary sources of information were identified with PubMed/Medline and online sources from the Centers for Disease Control and Prevention. The higher prevalence of traditional cardiovascular risk factors (eg, hypertension, diabetes mellitus, obesity, and atherosclerotic cardiovascular risk) underlies the relatively earlier age of onset of cardiovascular diseases among African Americans. Hypertension in particular is highly prevalent among African Americans and contributes directly to the notable disparities in stroke, heart failure, and peripheral artery disease among African Americans. Despite the availability of effective pharmacotherapies and indications for some tailored pharmacotherapies for African Americans (eg, heart failure medications), disease management is less effective among African Americans, yielding higher mortality. Explanations for these persistent disparities in cardiovascular disease are multifactorial and span from the individual level to the social environment. The strategies needed to promote equity in the cardiovascular health of African Americans require input from a broad set of stakeholders, including clinicians and researchers from across multiple disciplines. © 2017 American Heart Association, Inc.
This article examines the trend toward centralization in American education policy over the last century through a variety of lenses. The overall picture that emerges is one of a continuous tug-of-war, with national and local policymakers stumbling together toward incrementally more standardized and centralized policies. There is a center of power…
Youth violence continues to be a serious threat to the health of children and adolescents in the United States. It is crucial that pediatricians clearly define their role and develop the appropriate skills to address this threat effectively. From a clinical perspective, pediatricians should become familiar with Connected Kids: Safe, Strong, Secure, the American Academy of Pediatrics' primary care violence prevention protocol. Using this material, practices can incorporate preventive education, screening for risk, and linkages to community-based counseling and treatment resources. As advocates, pediatricians may bring newly developed information regarding key risk factors such as exposure to firearms, teen dating violence, and bullying to the attention of local and national policy makers. This policy statement refines the developing role of pediatricians in youth violence prevention and emphasizes the importance of this issue in the strategic agenda of the American Academy of Pediatrics.
This policy document of the American Speech-Language-Hearing Association (ASHA) reflects the Association's position that the Certificate of Clinical Competence-Audiology (CCC-A) is a nationally recognized quality indicator and education standard for the profession. The following statement includes the CCC-A as the appropriate credential for audiologists supervising support personnel. The consensus panel document's exclusion of the CCC-A conflicts with ASHA's policy. Member organizations that composed the consensus panel on support personnel in audiology included: Academy of Dispensing Audiologists (ADA), American Academy of Audiology (AAA), ASHA, Educational Audiology Association (EAA), Military Audiology Association (MAA), and the National Hearing Conservation Association (NHCA). Representatives to the panel included Donald Bender (AAA) and Evelyn Cherow (ASHA), co-chairs; James McDonald and Meredy Hase (ADA); Albert deChiccis and Cheryl deConde Johnson (AAA); Chris Halpin and Deborah Price (ASHA); Peggy Benson (EAA); James Jerome (MAA); and Lloyd Bowling and Richard Danielson (NHCA). ASHA's Legislative Council and Executive Board elected not to adopt the consensus panel document because it excluded the CCC-A. In all others aspects, the documents remain similar. This position statement and guidelines supersede the audiology sections of the Guidelines for the Employment and Utilization of Supportive Personnel (LC 32-80).
... serve as a guide to both agency decision making and to individual behavior as NRC employees. There are... nuclear community. The American taxpayer, the rate-paying consumer, and licensees are all entitled to the... Agreement States to have early and substantive involvement in rulemaking, policy, and guidance development...
This paper reports on the role of coal in establishing America's energy security. There is no mismatch of subject and keynote, for in the truest sense the author's topic is nothing less than the health and safety of the United States. Both will begin with the way we handle things in the coal mines at the working face. If energy policy were a piece of new equipment, the National Energy Strategy would be the equivalent of specifications---what the new hardware should be capable of doing. The National Energy Security Act of 1991 is the blueprint for the equipment. The hardware still must be assembled, tested and perfected. Undertaken between oil-related U.S. military deployments to stabilize the oil-exporting regions of the Persian Gulf that dominate world markets, the strategy has two objectives. There are multiple threats to America's energy security
Bailey, Rahn K; Fileti, Cecelia Pozo; Keith, Jeanette; Tropez-Sims, Susanne; Price, Winston; Allison-Ottey, Sharon Denise
Dairy foods contribute nine essential nutrients to the diet including calcium, potassium and vitamin D; nutrients identified by the 2010 Dietary Guidelines for Americans as being "of public health concern" within the U.S. population. Milk and milk product intake is associated with better diet quality and has been associated with a reduced risk of chronic diseases or conditions including hypertension, cardiovascular disease, metabolic syndrome, Type 2 Diabetes and osteoporosis. Some research also indicates dairy food intake may be linked to reduced body fat, when accompanied by energy-restriction. On average, both African Americans and Hispanic Americans consume less than the recommended levels of dairy foods, and perceived or actual lactose intolerance can be a primary reason for limiting or avoiding dairy intake. True lactose intolerance prevalence is not known because healthcare providers do not routinely measure for it, and no standardized assessment method exists. Avoiding dairy may lead to shortfalls of essential nutrients and increased susceptibility to chronic disease. This updated Consensus Statement aims to provide the most current information about lactose intolerance and health, with specific relevance to the African American and Hispanic American communities. Topics covered include diagnostic considerations, actual and recommended dairy food intake and levels of consumption of key dairy nutrients among African Americans and Hispanic Americans; prevalence of self-reported lactose intolerance among various racial/ethnic groups; the association between dairy food intake, lactose intolerance and chronic disease; and research-based management recommendations for those with lactose intolerance.
The science committee of International Organization for Medical Physics (IOMP) developed a policy statement on the predictions of radiation-induced cancers and cancer deaths in patients exposed to low doses (<100 mSv) of ionizing radiation during medical imaging; this statement has been approved by the IOMP council. In order to attract the attention of medical physicists, an editorial (1) titled 'Risk of Medical Imaging' that includes the said statement has recently been published in Medical Physics journal of American Association of Physicists in Medicine (AAPM). As stated, IOMP represents 80 national and 6 regional medical physics organizations and 18,000 medical physicists worldwide. The IOMP affiliated bodies/organizations in different countries (such as Association of Medical Physicists of India, AMPI) have been encouraged to reproduce the IOMP statement in their journals/newsletters for the benefit of larger community of medical physicists. The IOMP statement is reproduced below (readers may also go through the supportive literature listed in references). It is hoped that this policy statement will have some deterrent influence on the continued propagation of unproven risk related to medical imaging procedures conducted with small doses.
... [Docket No. FAA-2012-0953] Policy Statement on Occupational Safety and Health Standards for Aircraft Cabin... announced a proposed policy statement regarding the regulation of some occupational safety and health conditions affecting cabin crewmembers on aircraft by the Occupational Safety and Health Administration. The...
... [Docket No.: FAA-2012-0953] Policy Statement on Occupational Safety and Health Standards for Aircraft... regarding the regulation of some occupational safety and health conditions affecting cabin crewmembers on aircraft by the Occupational Safety and Health Administration (OSHA). This policy statement will enhance...
... Holloway, Assistant General Counsel, or Margaret Forman, Attorney, 999 E Street NW., Washington, DC 20463... FEDERAL ELECTION COMMISSION [Notice 2013-14] Policy Statement Regarding a Program for Requesting Consideration of Legal Questions by the Commission AGENCY: Federal Election Commission. ACTION: Policy statement...
... CONTACT: Lorenzo Holloway, Assistant General Counsel, or Allison T. Steinle, Attorney, 999 E Street, NW... FEDERAL ELECTION COMMISSION [Notice 2011-11] Policy Statement Regarding a Program for Requesting Consideration of Legal Questions by the Commission AGENCY: Federal Election Commission. ACTION: Policy Statement...
... Interagency Policy Statement on Funding and Liquidity Risk Management AGENCY: Office of the Comptroller of the... policy statement summarizes the principles of sound liquidity risk management that the agencies have.... Ray Diggs, Group Leader: Balance Sheet Management, Credit and Market Risk Division, (202) 874-5670...
Skachkova Irina Ivanovna
Full Text Available The article is a continuation of studies of the theoretical aspects of language policy in a multinational state in the U.S. example. The study of language policy in highly developed countries can make a considerable contribution to solving language and national problems of the states that have begun democratic transformation not long ago. Now, some politicians and scientists again raise the question of the recognition of English official, despite the fact that English is the official language, de facto and this status is not threatened. Therefore, using the statistical method, and the analysis of the collected data and documentary sources, the author examines the classification of statements of U.S. researchers on the need of the state language policy in the U.S., the history of debates and legal disputes over the language policy of the state language, different points of view as to why the founding fathers did not secure the official status of English in the constitution. The author also discusses the differences between assimilation and multicultural model of the state. In conclusion, the author says that minority groups are now realizing the value of their languages and making great efforts to save them. Status of the English language is currently not threatened, so the desire of many scientists and politicians to legalize the official status of the English language is most likely due to the approval of the English language as a national symbol.
Warchal, Judith R.; Ruiz, Ana I.; You, Di
This study focuses on the inclusion of the American Psychological Association's learning goals in the mission statements of undergraduate psychology programs across the US. We reviewed the mission statements available on websites for 1336 psychology programs listed in the Carnegie classification. Results of a content analysis revealed that of the…
Energy policy can be considered as a paragon of Reagan's plan of a supply-oriented economic policy . Chapter 1 outlines the philosophy of the supply-oriented economic policy which stands in a striking contrast to the previous practice of American energy policy (chapter 2). Chapter 3 deals with the main idea of the new plan, i.e. the de-regulation of the price controls especially for natural gas. Measures of tax policy are mentioned in chapter 4. Chapter 5 is concerned with the non-price-determined de-regulation and the respective fields of coal, electricity, and nuclear power. Chapter 6 discusses the governmental quantity policy (distribution of licences). In chapter 7 the research promotion policy for synthetic gas is explained. In conclusion, an assessment is made. At the time when this manuscript was written a number of measures had not definitely been fixed yet, either because the new administration had not yet commented on actual objectives or because the alteration of intended measures during the legislative process could not be anticipated.
Anderson, Norman B
This year marks the 60th anniversary of the American Psychologist (AP). Since the publication of its first issue in January 1946, AP has served as the flagship journal for the American Psychological Association (APA) and has played an important and unique role for the field of psychology. Because of the quality of the articles published in AP, the journal has evolved into one of the most influential and widely cited publications in psychology. The purpose of this editorial is to outline a revised set of policies for the journal that builds on and expands those developed by previous editors (see, e.g., Fowler, 1993; Goodstein, 1987; Kiesler, 1976; Pallack, 1981). Before outlining these policies, I would like to explore the relative status and influence of AP within the universe of psychological and social science journals. 2006 APA, all rights reserved.
Williams, P.M.; King, T.L.
On March 26, 1985, the US Nuclear Regulatory Commission issued for public comment a ''Proposed Policy for Regulation of Advanced Nuclear Power Plants'' (50 FR 11884). This report presents and discusses the Commission's final version of that policy as titled and published on July 8, 1986 ''Regulation of Advanced Nuclear Power Plants, Statement of Policy'' (51 FR 24643). It provides an overview of comments received from the public, of the significant changes from the proposed Policy Statement to the final Policy Statement, and of the Commission's response to six questions contained in the proposed Policy Statement. The report also discusses the definition for advanced reactors, the establishment of an Advanced Reactors Group, the staff review approach and information needs, and the utilization of the Policy Statement in relation to other NRC programs, including the policies for safety goals, severe accidents and standardization. In addition, guidance for advanced reactors with respect to operating experience, technology development, foreign information and data, and prototype testing is provided. Finally, a discussion on the use of less prescriptive and nonprescriptive design criteria for advanced reactors, which the Policy Statement encourages, is presented
Allen, Michele L; Salsberg, Jon; Knot, Michaela; LeMaster, Joseph W; Felzien, Maret; Westfall, John M; Herbert, Carol P; Vickery, Katherine; Culhane-Pera, Kathleen A; Ramsden, Vivian R; Zittleman, Linda; Martin, Ruth Elwood; Macaulay, Ann C
In 1998, the North American Primary Care Research Group (NAPCRG) adopted a groundbreaking Policy Statement endorsing responsible participatory research (PR) with communities. Since that time, PR gained prominence in primary care research. To reconsider the original 1998 Policy Statement in light of increased uptake of PR, and suggest future directions and applications for PR in primary care. This work contributed to an updated Policy Statement endorsed by NAPCRG in 2015. 32 university and 30 community NAPCRG-affiliated research partners, convened a workshop to document lessons learned about implementing processes and principles of PR. This document emerged from that session and reflection and discussion regarding the original Policy Statement, the emerging PR literature, and our own experiences. The foundational principles articulated in the 1998 Policy Statement remain relevant to the current PR environment. Lessons learned since its publication include that the maturation of partnerships is facilitated by participatory processes that support increased community responsibility for research projects, and benefits generated through PR extend beyond research outcomes. Future directions that will move forward the field of PR in primary care include: (i) improve assessment of PR processes to better delineate the links between how PR teams work together and diverse PR outcomes, (ii) increase the number of models incorporating PR into translational research from project inception to dissemination, and (iii) increase application of PR approaches that support patient engagement in clinical settings to patient-provider relationship and practice change research. PR has markedly altered the manner in which primary care research is undertaken in partnership with communities and its principles and philosophies continue to offer means to assure that research results and processes improve the health of all communities. © The Author 2016. Published by Oxford University Press. All
Shihab A. Hameed
Full Text Available In this information and knowledge era; ICT development and industry are growing very fast and associated with huge procurement force. Today, the global society is facing serious challenges in improving environmental performance, particularly with climate change, global warming, and resource management. ICT industry is widely contributing to the global economy associating with innovation, invention and rapid development of almost all the aspect of human life. On other hand; ICT industry is responsible for global CO2 emissions. Global environmental problems are affecting directly many countries' energy and industrial policies. The rapid increasing of ICT usage means more energy consumption and more environmental problems and the estimated ICT consumption of energy will be about 15% of the total consumption worldwide in 2020. Therefore, many countries are establishing Green ICT policies which increase energy efficiency due to correspondence climate change. Therefore, governments especially in developing and Islamic countries need to adopt new strategic policies for efficient energy use in ICT. This study presents the current environmental problems related to green ICT and the efforts to solve it. Several studies have warning from the current energy consumption paradigm, based on newly changed ICT practices. This study provides guidelines for decision makers and ICT professionals to enhance their work toward green ICT and eliminating environmental problems. Islamic viewpoint on environment and its protection is considered since it offers comprehensive, stable, and fair viewpoint that is based on main Islamic sources; Quran and Sunnah. Hundreds of Quranic verses and prophet Hadiths clarify (directly or indirectly the right manner in dealing and protection of environment resources. This paper proposes a framework for strategy and policy statements of green ICT based on Islamic perspective to serve the world especially developing and Islamic countries
Ирина Ивановна Скачкова
Full Text Available The article is a continuation of studies of the theoretical aspects of language policy in a multinational state in theU.S.example. The study of language policy in highly developed countries can make a considerable contribution to solving language and national problems of the states that have begun democratic transformation not long ago. Now, some politicians and scientists again raise the question of the recognition of English official, despite the fact that English is the official language, de facto and this status is not threatened. Therefore, using the statistical method, and the analysis of the collected data and documentary sources, the author examines the classification of statements of U.S. researchers on the need of the state language policy in the U.S., the history of debates and legal disputes over the language policy of the state language, different points of view as to why the founding fathers did not secure the official status of English in the constitution. The author also discusses the differences between assimilation and multicultural model of the state. In conclusion, the author says that minority groups are now realizing the value of their languages and making great efforts to save them. Status of the English language is currently not threatened, so the desire of many scientists and politicians to legalize the official status of the English language is most likely due to the approval of the English language as a national symbol.DOI: http://dx.doi.org/10.12731/2218-7405-2013-3-25
Meropol, Neal J; Schrag, Deborah; Smith, Thomas J; Mulvey, Therese M; Langdon, Robert M; Blum, Diane; Ubel, Peter A; Schnipper, Lowell E
community. It also recommends that the following steps be taken to address immediate needs: recognition that patient-physician discussions regarding the cost of care are an important component of high-quality care; the design of educational and support tools for oncology providers to promote effective communication about costs with patients; and the development of resources to help educate patients about the high cost of cancer care to help guide their decision making regarding treatment options. Looking to the future, this Guidance Statement also recommends that ASCO develop policy positions to address the underlying factors contributing to the increased cost of cancer care. Doing so will require a clear understanding of the factors that drive these costs, as well as potential modifications to the current cancer care system to ensure that all Americans have access to high-quality, cost-effective care.
Cobin, Rhoda H; Goodman, Neil F
EXECUTIVE SUMMARY This American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) Position Statement is designed to update the previous menopause clinical practice guidelines published in 2011 but does not replace them. The current document reviews new clinical trials published since then as well as new information regarding possible risks and benefits of therapies available for the treatment of menopausal symptoms. AACE reinforces the recommendations made in its previous guidelines and provides additional recommendations on the basis of new data. A summary regarding this position statement is listed below: New information available from randomized clinical trials and epidemiologic studies reported after 2011 was critically reviewed. No previous recommendations from the 2011 menopause clinical practice guidelines have been reversed or changed. Newer information enhances AACE's guidance for the use of hormone therapy in different subsets of women. Newer information helps to support the use of various types of estrogens, selective estrogen-receptor modulators (SERMs), and progesterone, as well as the route of delivery. Newer information supports the previous recommendation against the use of bioidentical hormones. The use of nonhormonal therapies for the symptomatic relief of menopausal symptoms is supported. Newer information enhances AACE's guidance for the use of hormone therapy in different subsets of women. Newer information helps to support the use of various types of estrogens, SERMs, and progesterone, as well as the route of delivery. Newer information supports the previous recommendation against the use of bioidentical hormones. The use of nonhormonal therapies for the symptomatic relief of menopausal symptoms is supported. New recommendations in this position statement include: 1. the use of menopausal hormone therapy in symptomatic postmenopausal women should be based on consideration of all risk factors for
Oliver, June; Coggins, Candace; Compton, Peggy; Hagan, Susan; Matteliano, Deborah; Stanton, Marsha; St. Marie, Barbara; Strobbe, Stephen; Turner, Helen N.
The American Society for Pain Management Nursing (ASPMN) has updated its position statement on managing pain in patients with substance use disorders. This position statement is endorsed by the International Nurses Society on Addictions (IntNSA) and includes clinical practice recommendations based on current evidence. It is the position of ASPMN and IntNSA that every patient with pain, including those with substance use disorders, has the right to be treated with dignity, respect, and high qu...
Bethany House Publishers, 1998), 71. For a very good commentary on this subject, read the chapters entitled, “The Absolutism of Moral Relativism ...Religious Roots: A Prolegomenon to Moral Judgment in American Policy by Lieutenant Colonel Greg Johnson Oregon Air...COVERED (From - To) 4. TITLE AND SUBTITLE Religious Roots: A Prolegomenon to Moral Judgment in American Policy Policy 5a. CONTRACT
... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration FAA Policy Statement on Expungement.... SUMMARY: The FAA has temporarily suspended its policy of expunging certain records of legal enforcement... effects on pilots is available at: http://www.faa.gov/pilots/lic_cert/pria/guidance/pilotfaq . Further...
Frisch, Morten; Aigrain, Yves; Barauskas, Vidmantas; Bjarnason, Ragnar; Boddy, Su-Anna; Czauderna, Piotr; de Gier, Robert P E; de Jong, Tom P V M; Fasching, Günter; Fetter, Willem; Gahr, Manfred; Graugaard, Christian; Greisen, Gorm; Gunnarsdottir, Anna; Hartmann, Wolfram; Havranek, Petr; Hitchcock, Rowena; Huddart, Simon; Janson, Staffan; Jaszczak, Poul; Kupferschmid, Christoph; Lahdes-Vasama, Tuija; Lindahl, Harry; MacDonald, Noni; Markestad, Trond; Märtson, Matis; Nordhov, Solveig Marianne; Pälve, Heikki; Petersons, Aigars; Quinn, Feargal; Qvist, Niels; Rosmundsson, Thrainn; Saxen, Harri; Söder, Olle; Stehr, Maximilian; von Loewenich, Volker C H; Wallander, Johan; Wijnen, Rene
The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report's conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non-US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.
Cruz-Flores, Salvador; Rabinstein, Alejandro; Biller, Jose; Elkind, Mitchell S V; Griffith, Patrick; Gorelick, Philip B; Howard, George; Leira, Enrique C; Morgenstern, Lewis B; Ovbiagele, Bruce; Peterson, Eric; Rosamond, Wayne; Trimble, Brian; Valderrama, Amy L
Our goal is to describe the effect of race and ethnicity on stroke epidemiology, personal beliefs, access to care, response to treatment, and participation in clinical research. In addition, we seek to determine the state of knowledge on the main factors that may explain disparities in stroke care, with the goal of identifying gaps in knowledge to guide future research. The intended audience includes physicians, nurses, other healthcare professionals, and policy makers. Members of the writing group were appointed by the American Heart Association Stroke Council Scientific Statement Oversight Committee and represent different areas of expertise in relation to racial-ethnic disparities in stroke care. The writing group reviewed the relevant literature, with an emphasis on reports published since 1972. The statement was approved by the writing group; the statement underwent peer review, then was approved by the American Heart Association Science Advisory and Coordinating Committee. There are limitations in the definitions of racial and ethnic categories currently in use. For the purpose of this statement, we used the racial categories defined by the US federal government: white, black or African American, Asian, American Indian/Alaskan Native, and Native Hawaiian/other Pacific Islander. There are 2 ethnic categories: people of Hispanic/Latino origin or not of Hispanic/Latino origin. There are differences in the distribution of the burden of risk factors, stroke incidence and prevalence, and stroke mortality among different racial and ethnic groups. In addition, there are disparities in stroke care between minority groups compared with whites. These disparities include lack of awareness of stroke symptoms and signs and lack of knowledge about the need for urgent treatment and the causal role of risk factors. There are also differences in attitudes, beliefs, and compliance among minorities compared with whites. Differences in socioeconomic status and insurance coverage
Folger, P. F.
The results of hydrological research are increasingly important to decision-makers grappling with problems as diverse as global climate change, non-point source pollution, extreme weather events, and damage from flooding. In some cases scientific aspects of these problems are interwoven with economic, political and social disputes, and policy makers often seek the consensus scientific opinion to help shape the debate. Policy or position statements issued by scientific societies like AGU can embody scientific consensus and thus inform the public and policy makers. But this is not always the case. The potential for creating public misunderstanding is ever present. Therefore, the process leading to a policy statement needs to be deliberative, inclusive to the extent possible, and circumspect. In contrast to advocacy organizations or trade groups, as a learned society AGU and members acting on its behalf should only advocate positions on political or social issues that are based solely on available geophysical data and recognized scientific debate. That does not mean that AGU and other scientific societies must refrain from entering a political debate. AGU has a responsibility to its members to adopt positions of advocacy on geophysical science issues based on their intrinsic merits and needs. However, a learned society like AGU should state only what is credible about the scientific aspects of a political debate and not overstep its authority as an objective source of analysis and commentary for the geophysical sciences. Before adopting an advocacy position, AGU's volunteers follow a process that includes checks and balances so that the final statement is based on sound scientific issues and reflects the interests of the Union as a whole. Any AGU member or committee can propose a position statement, but the Committee on Public Affairs (COPA) decides whether the proposal fall within the guidelines for advocacy. If it does and if COPA considers the issue worthy of an
Warner, Linda Sue
This paper discusses American Indian educational policies and implications for educational leadership by Indian women. The paper begins with an overview of federal Indian educational policies from 1802 to the 1970s. As the tribes have moved toward self-determination in recent years, a growing number of American Indian women have assumed leadership…
Kahn, Alfred E.; Goolsbee, Austan; Bailey, Elizabeth E.; Faulhaber, Gerald R.; Mayo, John; Flamm, Kenneth; Baily, Martin Neil; Milgrom, Paul; Cramton, Peter; Gilbert, Richard; Hall, Robert E.; Litan, Robert E.; Hahn, Robert W.; Greenstein, Shane; Hazlett, Thomas W.
In this statement, a group of economists assembled by the AEI-Brookings Joint Center makes the following two recommendations to improve the competitive provision of broadband services. First, Congress should eliminate local franchising regulations, which serve as a barrier to new entry. Second, Congress and the Federal Communications Commission should make more spectrum available to private parties and allow them to use it as they see fit or trade their licenses in the market, so that spectru...
Minerals Policy Statement 2 (MPS2) sets out the policies and considerations that the UK Government expects Mineral Planning Authorities to follow when preparing development plans and in considering application for minerals development. This supercedes Minerals Policy Guidance 11 (MPG 11). Annex 1: Dust to MPS2 sets out the policy considerations in relation to dust from mineral workings and associated operations, and how they should be dealt with in local development plans and in considering individual applications. Annex 2: Noise to MPS2 addresses policy in relation to noise from mineral workings. These have been abstracted separately for the Coal Abstracts database. 58 refs., 2 apps.
Objective This position statement aimed to update the evidence-based position statement published by The North American Menopause Society (NAMS) in 2010 regarding recommendations for hormone therapy (HT) for postmenopausal women. This updated position statement further distinguishes the emerging differences in the therapeutic benefit-risk ratio between estrogen therapy (ET) and combined estrogen-progestogen therapy (EPT) at various ages and time intervals since menopause onset. Methods An Advisory Panel of expert clinicians and researchers in the field of women’s health was enlisted to review the 2010 NAMS position statement, evaluate new evidence, and reach consensus on recommendations. The Panel’s recommendations were reviewed and approved by the NAMS Board of Trustees as an official NAMS position statement. Results Current evidence supports the use of HT for perimenopausal and postmenopausal women when the balance of potential benefits and risks is favorable for the individual woman. This position statement reviews the effects of ET and EPT on many aspects of women’s health and recognizes the greater safety profile associated with ET. Conclusions Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms and to prevent osteoporosis in women at high risk of fracture. The more favorable benefit-risk ratio for ET allows more flexibility in extending the duration of use compared with EPT, where the earlier appearance of increased breast cancer risk precludes a recommendation for use beyond 3 to 5 years. PMID:22367731
Vinik, Aaron I; Camacho, Pauline M; Davidson, Jaime A; Handelsman, Yehuda; Lando, Howard M; Leddy, Anne L; Reddy, Sethu K; Cook, Richard; Spallone, Vicenza; Tesfaye, Solomon; Ziegler, Dan
This document represents the official position of the American Association of Clinical Endocrinologists and the American College of Endocrinology. Where there were no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.
Goodman, Neil; Guay, Andre; Dandona, Paresh; Dhindsa, Sandeep; Faiman, Charles; Cunningham, Glenn R
This document represents the official position of the American Association of Clinical Endocrinologists and the American College of Endocrinology. Where there were no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.
Full Text Available This article describes data for 78 intergovernmental organizations (IGOs working on topics related to energy governance, environmental protection, and the economy. The number of IGOs covered also includes organizations active in other sectors. The point of departure for data construction was the Correlates of War dataset, from which we selected this sample of IGOs. We updated and expanded the empirical information on the IGOs selected by manual coding. Most importantly, we collected the primary law texts of the individual IGOs in order to code whether they commit themselves to environmental policy integration (EPI, climate policy integration (CPI and/or energy policy integration (EnPI.
Pope, Kenneth S
After 9-11, the United States began interrogating detainees at settings such as Abu Ghraib, Bagram, and Guantanamo. The American Psychological Association (APA) supported psychologists' involvement in interrogations, adopted formal policies, and made an array of public assurances. This article's purpose is to highlight key APA decisions, policies, procedures, documents, and public statements in urgent need of rethinking and to suggest questions that may be useful in a serious assessment, such as, "However well intended, were APA's interrogation policies ethically sound?"; "Were they valid, realistic, and able to achieve their purpose?"; "Were other approaches available that would address interrogation issues more directly, comprehensively, and actively, that were more ethically and scientifically based, and that would have had a greater likelihood of success?"; and "Should APA continue to endorse its post-9-11 detainee interrogation policies?"
Pope, Kenneth S.
After 9–11, the United States began interrogating detainees at settings such as Abu Ghraib, Bagram, and Guantanamo. The American Psychological Association (APA) supported psychologists’ involvement in interrogations, adopted formal policies, and made an array of public assurances. This article’s purpose is to highlight key APA decisions, policies, procedures, documents, and public statements in urgent need of rethinking and to suggest questions that may be useful in a serious assessment, such as, “However well intended, were APA’s interrogation policies ethically sound?”; “Were they valid, realistic, and able to achieve their purpose?”; “Were other approaches available that would address interrogation issues more directly, comprehensively, and actively, that were more ethically and scientifically based, and that would have had a greater likelihood of success?”; and “Should APA continue to endorse its post-9–11 detainee interrogation policies?” PMID:22096660
Oliver, June; Coggins, Candace; Compton, Peggy; Hagan, Susan; Matteliano, Deborah; Stanton, Marsha; St Marie, Barbara; Strobbe, Stephen; Turner, Helen N
The American Society for Pain Management Nursing (ASPMN) has updated its position statement on managing pain in patients with substance use disorders. This position statement is endorsed by the International Nurses Society on Addictions (IntNSA) and includes clinical practice recommendations based on current evidence. It is the position of ASPMN and IntNSA that every patient with pain, including those with substance use disorders, has the right to be treated with dignity, respect, and high-quality pain assessment and management. Failure to identify and treat the concurrent conditions of pain and substance use disorders will compromise the ability to treat either condition effectively. Barriers to caring for these patients include stigmatization, misconceptions, and limited access to providers skilled in these two categories of disorders. Topics addressed in this position statement include the scope of substance use and related disorders, conceptual models of addiction, ethical considerations, addiction risk stratification, and clinical recommendations.
.... Please use the title ``Proposed Addendum to the Interagency Policy Statement on Income Tax Allocation in... to the Interagency Policy Statement on Income Tax Allocation in a Holding Company Structure'' to... for the Institution. Any tax refund attributable to income earned, taxes paid, and losses incurred by...
...-Level Radioactive Waste Management AGENCY: Nuclear Regulatory Commission. ACTION: Reopening of comment... for public comment a draft Policy Statement on Volume Reduction and Low-Level Radioactive Waste...-based approaches to managing waste are also needed to safely manage Low-Level Radioactive Waste. The...
... NUCLEAR REGULATORY COMMISSION [NRC-2013-0254] Conceptual Example of a Proposed Risk Management Regulatory Framework Policy Statement AGENCY: Nuclear Regulatory Commission. ACTION: Conceptual example of a... ``openness,'' a white paper on a Conceptual Example of a Proposed Risk Management Regulatory Framework (RMRF...
... CONTROL (REGULATION Y) Regulations Financial Holding Companies Interpretations § 225.143 Policy statement on nonvoting equity investments by bank holding companies. (a) Introduction. (1) In recent months, a... company has the power, directly or indirectly, to exercise a controlling influence over the management or...
... individuals. DATES: Effective Date: January 19, 2010. FOR FURTHER INFORMATION CONTACT: Joan McKown, Chief.... SUPPLEMENTARY INFORMATION: The Securities and Exchange Commission is issuing a policy statement announcing the... (``Investigation''); the importance of the underlying matter in which the individual cooperated; the societal...
... culture. Experience has shown that certain personal and organizational traits are present in a positive safety culture. A trait, in this case, is a pattern of thinking, feeling, and behaving that emphasizes... organizational environments. IV. Changes to the Initial Draft Statement of Policy Like the initial draft SOP, the...
... securities issued to the Treasury through the Small Business Lending Fund established under the Small... subject to the Policy Statement as in effect on May 19, 2010. The CPP Subordinated Securities may be... Subordinated Securities from debt. SBLF Subordinated Securities Under the Small Business Jobs Act of 2010 (SBJA...
Chapman, Amy; Mangion, Antoine; Buchanan, Rachel
This article describes ways in which the equity agenda, as outlined in the Bradley Review of Higher Education (Bradley et al., 2008), is translated into action in one Australian university. Drawing on the conceptual work of Ahmed (2012) to elaborate institutional life, we investigate the effects of the widening participation policy. Ahmed (2012)…
..., energy security and economic stability for aviation. The aviation industry has made a commitment to... developing aviation in a manner that enhances and promotes the Nation's economic, environmental, and social... effectiveness of various policies, including economic incentives to limit and reduce CO 2 emissions. The U.S. is...
... Business of the Farm Credit Administration Board FCA-PS-65 Release of Consolidated Reporting System... FCS Building Association Management Operations Policies and Practices FCA-PS-71 Disaster Relief... the Members of Farm Credit System Institutions FCA-PS-81 Ethics, Independence, Arm's-Length Role, Ex...
Reynolds, Janice; Drew, Debra; Dunwoody, Colleen
Pain at the end of life continues to be of great concern as it may be unrecognized or untreated. While nurses have an ethical obligation to reduce suffering at the end of life, barriers remain regarding appropriate and adequate pain management at the end of life. This position statement from the American Society for Pain Management Nursing contains recommendations for nurses, prescribers, and institutions that would improve pain management for this vulnerable population. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
Fila, Brian D
How could any serious student at the National War College assert that militarism is on the rise in American foreign policy in today's political environment characterized by military overutilization...
Liaw, Lucy; Freedman, Jane E; Becker, Lance B; Mehta, Nehal N; Liscum, Laura
The biomedical research enterprise depends on the fair and objective peer review of research grants, leading to the distribution of resources through efficient and robust competitive methods. In the United States, federal funding agencies and foundations collectively distribute billions of dollars annually to support biomedical research. For the American Heart Association, a Peer Review Subcommittee is charged with establishing the highest standards for peer review. This scientific statement reviews the current literature on peer review practices, describes the current American Heart Association peer review process and those of other agencies, analyzes the strengths and weaknesses of American Heart Association peer review practices, and recommends best practices for the future. © 2017 American Heart Association, Inc.
M.A. Spruit (Martijn); S.J. Singh (Sally); C. Garvey (Chris); R. Zu Wallack (Richard); L. Nici (Linda); C. Rochester (Carolyn); K. Hill (Kylie); A.E. Holland (Anne); S.C. Lareau (Suzanne); W.D.-C. Man (William); F. Pitta (Fabio); L. Sewell (Louise); J. Raskin (Jonathan); J. Bourbeau (Jean); R. Crouch (Rebecca); F.M.E. Franssen (Frits); R. Casaburi (Richard); J.H. Vercoulen (Jan); I. Vogiatzis (Ioannis); R.A.A.M. Gosselink (Rik); E.M. Clini (Enrico); T.W. Effing (Tanja); F. Maltais (François); J. van der Palen (Job); T. Troosters; D.J.A. Janssen (Daisy); E. Collins (Eileen); J. Garcia-Aymerich (Judith); D. Brooks (Dina); B.F. Fahy (Bonnie); M.A. Puhan (Milo); M. Hoogendoorn (Martine); R. Garrod (Rachel); A.M.W.J. Schols (Annemie); B. Carlin (Brian); R. Benzo (Roberto); P. Meek (Paula); M. Morgan (Mike); M.P.M.H. Rutten-van Mölken (Maureen); A.L. Ries (Andrew); B. Make (Barry); R.S. Goldstein (Roger); C.A. Dowson (Claire); J.L. Brozek (Jan); C.F. Donner (Claudio); E.F.M. Wouters (Emiel)
textabstractBackground: Pulmonary rehabilitation is recognized as a core component of themanagement of individuals with chronic respiratory disease. Since the 2006 American Thoracic Society (ATS)/European Respiratory Society (ERS) Statement on Pulmonary Rehabilitation, there has been considerable
This paper presented Nova Scotia's policy related to gas distribution. The government of Nova Scotia views natural gas as an economic enabler and is committed to ensuring that natural gas is available and accessible to Nova Scotians where it is economically feasible. Natural gas will give the province an efficient and clean burning energy supply that will make existing businesses more competitive. The province will support and facilitate the construction and operation of a gas distribution system by the private sector and will ensure that there is regulatory oversight by the Nova Scotia Utility and Review Board to protect the public interest. The government will also develop a plan for early conversion of government buildings to natural gas. This paper described the province's policy on gas distribution in relation to: (1) a province-wide franchise, (2) a supplemental franchise, (3) cost of service/performance based rates, (4) postage stamp rates, (5) a Maritimes and Northeast lateral policy, (6) direct access/bypass, (7) existing direct access user, (8) bundling of gas sales and other products and services, (9) licensing of gas marketers, (10) benefits, (11), regulatory efficiency, (12) municipal taxes, and (13) municipal operating agreements.
Evans, R W
Medical tourism has emerged as a global health care phenomenon, valued at $60 billion worldwide in 2006. Transplant tourism, unlike other more benign forms of medical tourism, has become a flashpoint within the transplant community, underscoring the uneasy relationships among science, religion, politics, ethics and international health care policies concerning the commercialization of transplantation. Numerous professional associations have drafted or issued position statements condemning transplant tourism. Often the criticism is misdirected. The real issue concerns both the source and circumstances surrounding the procurement of donor organs, including commercialization. Unfortunately, many of the position statements circulated to date represent an ethnocentric and decidedly western view of transplantation. As such, the merits of culturally insensitive policy statements issued by otherwise well-intended transplant professionals, and the organizations they represent, must be evaluated within the broader context of foreign relations and diplomacy, as well as cultural and ethical relativity. Having done so, many persons may find themselves reluctant to endorse statements that have produced a misleading social desirability bias, which, to a great extent, has impeded more thoughtful and inclusive deliberations on the issues. Therefore, instead of taking an official position on policy matters concerning the commercial aspects of transplantation, international professional associations should offer culturally respectful guidance.
Van Horn, Linda; Carson, Jo Ann S; Appel, Lawrence J; Burke, Lora E; Economos, Christina; Karmally, Wahida; Lancaster, Kristie; Lichtenstein, Alice H; Johnson, Rachel K; Thomas, Randal J; Vos, Miriam; Wylie-Rosett, Judith; Kris-Etherton, Penny
In 2013, the American Heart Association and American College of Cardiology published the "Guideline on Lifestyle Management to Reduce Cardiovascular Risk," which was based on a systematic review originally initiated by the National Heart, Lung, and Blood Institute. The guideline supports the American Heart Association's 2020 Strategic Impact Goals for cardiovascular health promotion and disease reduction by providing more specific details for adopting evidence-based diet and lifestyle behaviors to achieve those goals. In addition, the 2015-2020 Dietary Guidelines for Americans issued updated evidence relevant to reducing cardiovascular risk and provided additional recommendations for adopting healthy diet and lifestyle approaches. This scientific statement, intended for healthcare providers, summarizes relevant scientific and translational evidence and offers practical tips, tools, and dietary approaches to help patients/clients adapt these guidelines according to their sociocultural, economic, and taste preferences. © 2016 American Heart Association, Inc.
The analysis of the environmental impacts for storage of domestic fuel shows that the impacts for the full range of alternatives considered are relatively small compared with available resources or background exposure of the population from natural radiation sources. The differences in impacts of storage of domestic fuel are attributed to the amount of fuel stored in Independent Spent Fuel Storage (ISFS) facilities, the storage time, and, to a lesser degree, the differences in spent fuel transportation. The differences between comparable alternatives of implementing the policy or not implementing the policy are small. The difference in impacts of storage of foreign fuel are attributed to the amount of fuel received under the policy and to the disposition mode analyzed. The impact of storage of foreign fuel (a small fraction of the amount of domestic fuel considered) is also small. As a result of the small differences in environmental impacts of all cases considered for foreign fuel, environmental impacts probably will not strongly influence the selection of the case that best meets US nonproliferation goals. Proliferation benefits of the various cases analyzed vary significantly. The structure and level of fee charged for storage of spent fuel will affect the degree of participation in the spent fuel storage program by utilities. However, the range of participation is within the range of alternatives analyzed in the draft EISs on storage of US and foreign fuels, for which the environmental effects were found to be relatively small. The fee computed on the basis of full recovery of government costs should not significantly affect the cost of generating nuclear power
Strasburger, Victor C
The causes of adolescent substance use are multifactorial, but the media can play a key role. Tobacco and alcohol represent the 2 most significant drug threats to adolescents. More than $25 billion per year is spent on advertising for tobacco, alcohol, and prescription drugs, and such advertising has been shown to be effective. Digital media are increasingly being used to advertise drugs. In addition, exposure to PG-13- and R-rated movies at an early age may be a major factor in the onset of adolescent tobacco and alcohol use. The American Academy of Pediatrics recommends a ban on all tobacco advertising in all media, limitations on alcohol advertising, avoiding exposure of young children to substance-related (tobacco, alcohol, prescription drugs, illegal drugs) content on television and in PG-13- and R-rated movies, incorporating the topic of advertising and media into all substance abuse-prevention programs, and implementing media education programs in the classroom.
Fox, Caroline S; Hall, Jennifer L; Arnett, Donna K; Ashley, Euan A; Delles, Christian; Engler, Mary B; Freeman, Mason W; Johnson, Julie A; Lanfear, David E; Liggett, Stephen B; Lusis, Aldons J; Loscalzo, Joseph; MacRae, Calum A; Musunuru, Kiran; Newby, L Kristin; O'Donnell, Christopher J; Rich, Stephen S; Terzic, Andre
The field of genetics and genomics has advanced considerably with the achievement of recent milestones encompassing the identification of many loci for cardiovascular disease and variable drug responses. Despite this achievement, a gap exists in the understanding and advancement to meaningful translation that directly affects disease prevention and clinical care. The purpose of this scientific statement is to address the gap between genetic discoveries and their practical application to cardiovascular clinical care. In brief, this scientific statement assesses the current timeline for effective translation of basic discoveries to clinical advances, highlighting past successes. Current discoveries in the area of genetics and genomics are covered next, followed by future expectations, tools, and competencies for achieving the goal of improving clinical care. © 2015 American Heart Association, Inc.
The National Environmental Policy Act (NEPA) of 1969 requires that all agencies of the federal government prepare a detailed statement on any action significantly affecting the quality of the human environment. Such a statement must include the environmental impact of the proposed action, any adverse environmental effects that cannot be avoided should the proposed action be implemented, and alternatives to the proposed action. In requiring environmental statements, NEPA encourages viewing related actions collectively and looking at cumulative impacts. A programmatic environmental impact statement (PEIS) is a broad environmental analysis of a program or policy prepared when actions are connected and may have cumulative environmental impacts. The PEIS benefits include providing input into an agency's planning and decision making, assessing potential environmental consequences of a wide range of alternatives before options have been foreclosed, and allowing consideration of systemwide impacts of various alternatives early in the decision-making process. The US Department of Energy (DOE) will prepare its PEIS on Environmental Restoration and Waste Management program. The PEIS will consider programmatic issues and integrated approaches to the program; address national, program-wide alternatives rather than site-specific actions; and provide for subsequent NEPA documents of narrower scope to be prepared to address site-specific or project-specific actions
16-44. Sharma, Avi. "Who Leads in a G-Zero World? Multi-Nationals, Sustainable Development, and Corporate Social Responsibility in a Changing...Policies in the U.S. & Western Europe." Public Finance & Management 7, no. 3(September 2007): 295-339. Tiltiņš, Alekss and Baiba Šavriņa. "Alternative
Thurston, George D; Kipen, Howard; Annesi-Maesano, Isabella; Balmes, John; Brook, Robert D; Cromar, Kevin; De Matteis, Sara; Forastiere, Francesco; Forsberg, Bertil; Frampton, Mark W; Grigg, Jonathan; Heederik, Dick; Kelly, Frank J; Kuenzli, Nino; Laumbach, Robert; Peters, Annette; Rajagopalan, Sanjay T; Rich, David; Ritz, Beate; Samet, Jonathan M; Sandstrom, Thomas; Sigsgaard, Torben; Sunyer, Jordi; Brunekreef, Bert
The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have
The objective of financial statements is to give a true and fair view of financial position and of the performance, a true and fair view which will be useful for a wide range of users to take economic decisions. Accounting policies choice involves setting options that generate the best financial and accounting information. The best information must be in agreement with the most accurate image of financial position, performance and changes in financial position and performance. The pre...
Mozaffarian, Dariush; Afshin, Ashkan; Benowitz, Neal L.; Bittner, Vera; Daniels, Stephen R.; Franch, Harold A.; Jacobs, David R.; Kraus, William E.; Kris-Etherton, Penny M.; Krummel, Debra A.; Popkin, Barry M.; Whitsel, Laurie P.; Zakai, Neil A.
Background Poor lifestyle, including suboptimal diet, physical inactivity, and tobacco use are leading causes of preventable diseases globally. Although even modest population shifts in risk substantially alter health outcomes, the optimal population-level approaches to improve lifestyle are not well established. Methods and Results For this American Heart Association Scientific Statement, the writing group systematically reviewed and graded the current scientific evidence for effective population approaches to improve dietary habits, increase physical activity, and reduce tobacco use. Strategies were considered in 6 broad domains: (1) media and education campaigns; (2) labeling and consumer information; (3) taxation, subsidies, and other economic incentives; (4) school and workplace approaches; (5) local environmental changes; and (6) direct restrictions and mandates. The writing group also reviewed the potential contributions of healthcare systems and surveillance systems to behavior change efforts. Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified, providing a set of specific evidence-based strategies that deserve close attention and prioritization for wider implementation. Effective interventions included specific approaches in all 6 domains evaluated for improving diet, increasing activity, and reducing tobacco use. The writing group also identified several specific interventions in each of these domains for which current evidence was less robust, as well as other inconsistencies and evidence gaps, informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies. Conclusions This systematic review identified and graded the evidence for a range of population-based strategies to promote lifestyle change. The findings provide a framework for policy makers, advocacy groups, researchers, clinicians, communities, and other
... of this policy statement do not establish a binding norm but instead provide general guidance. In... challenged and are subject to further consideration. The procedure prescribed conforms with the NGPA's..., Pub. L. 95-621, 92 Stat. 3350, (15 U.S.C. 3301-3432)) [47 FR 6262, Feb. 11, 1982] Statement of...
Full Text Available The objective of financial statements is to give a true and fair view of financial position and of the performance, a true and fair view which will be useful for a wide range of users to take economic decisions. Accounting policies choice involves setting options that generate the best financial and accounting information. The best information must be in agreement with the most accurate image of financial position, performance and changes in financial position and performance. The present paper intends to present three different accounting policies used for the same situations and the results of their implementation. Starting question is: which of the results are the true and fair view?
van Diepen, Sean; Katz, Jason N; Albert, Nancy M; Henry, Timothy D; Jacobs, Alice K; Kapur, Navin K; Kilic, Ahmet; Menon, Venu; Ohman, E Magnus; Sweitzer, Nancy K; Thiele, Holger; Washam, Jeffrey B; Cohen, Mauricio G
Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities. © 2017 American Heart Association, Inc.
In its statement to Commencement Ceremony At American University in Cairo (AUC) the Director General of the IAEA reminisced about his life - the twists and turns it had taken, and the lessons he had learned along the way. His messages to the students was to keep thinking and learning, be ready for opportunity when it comes, treat others with the understanding that we are all part of one human family, live your own life, and take joy in it, be proud of your heritage and engage fully in the future of Egypt.
The U.S. is rapidly negotiating a raft of new regional and bilateral trade agreements. The most recent agreement, with Central America, [was to] come before Congress for a vote as soon as late May. There is growing concern that international trade agreements threaten health care and the health of communities. . . . The Draft Public Health Statement on the U.S.-Central American Free Trade Agreement (CAFTA), developed by CPATH which planned a campaign around the issues, analyzes key provisions from the perspective of public health and suggests reframing the trade debate in terms of health.
In its statement to Commencement Ceremony At American University in Cairo (AUC) the Director General of the IAEA reminisced about his life - the twists and turns it had taken, and the lessons he had learned along the way. His messages to the students was to keep thinking and learning, be ready for opportunity when it comes, treat others with the understanding that we are all part of one human family, live your own life, and take joy in it, be proud of your heritage and engage fully in the future of Egypt
The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and approved by the NAMS Board of Trustees.Hormone therapy (HT) remains the most effective treatment for vasomotor symptoms (VMS) and the genitourinary syndrome of menopause (GSM) and has been shown to prevent bone loss and fracture. The risks of HT differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. Treatment should be individualized to identify the most appropriate HT type, dose, formulation, route of administration, and duration of use, using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of the benefits and risks of continuing or discontinuing HT.For women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications, the benefit-risk ratio is most favorable for treatment of bothersome VMS and for those at elevated risk for bone loss or fracture. For women who initiate HT more than 10 or 20 years from menopause onset or are aged 60 years or older, the benefit-risk ratio appears less favorable because of the greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia. Longer durations of therapy should be for documented indications such as persistent VMS or bone loss, with shared decision making and periodic reevaluation. For bothersome GSM symptoms not
... the basic principles that guide the FDIC in its promulgation and review of regulations and written... basic principles which guide the FDIC's promulgation and review of regulations and written statements of... Housing Finance Agency) has become more common. Some rulemakings also require consultation with the...
Khosla, Seema; Deak, Maryann C; Gault, Dominic; Goldstein, Cathy A; Hwang, Dennis; Kwon, Younghoon; O'Hearn, Daniel; Schutte-Rodin, Sharon; Yurcheshen, Michael; Rosen, Ilene M; Kirsch, Douglas B; Chervin, Ronald D; Carden, Kelly A; Ramar, Kannan; Aurora, R Nisha; Kristo, David A; Malhotra, Raman K; Martin, Jennifer L; Olson, Eric J; Rosen, Carol L; Rowley, James A
Consumer sleep technologies (CSTs) are widespread applications and devices that purport to measure and even improve sleep. Sleep clinicians may frequently encounter CST in practice and, despite lack of validation against gold standard polysomnography, familiarity with these devices has become a patient expectation. This American Academy of Sleep Medicine position statement details the disadvantages and potential benefits of CSTs and provides guidance when approaching patient-generated health data from CSTs in a clinical setting. Given the lack of validation and United States Food and Drug Administration (FDA) clearance, CSTs cannot be utilized for the diagnosis and/or treatment of sleep disorders at this time. However, CSTs may be utilized to enhance the patient-clinician interaction when presented in the context of an appropriate clinical evaluation. The ubiquitous nature of CSTs may further sleep research and practice. However, future validation, access to raw data and algorithms, and FDA oversight are needed. © 2018 American Academy of Sleep Medicine.
Lackland, Daniel T; Roccella, Edward J; Deutsch, Anne F; Fornage, Myriam; George, Mary G; Howard, George; Kissela, Brett M; Kittner, Steven J; Lichtman, Judith H; Lisabeth, Lynda D; Schwamm, Lee H; Smith, Eric E; Towfighi, Amytis
Stroke mortality has been declining since the early 20th century. The reasons for this are not completely understood, although the decline is welcome. As a result of recent striking and more accelerated decreases in stroke mortality, stroke has fallen from the third to the fourth leading cause of death in the United States. This has prompted a detailed assessment of the factors associated with the change in stroke risk and mortality. This statement considers the evidence for factors that have contributed to the decline and how they can be used in the design of future interventions for this major public health burden. Writing group members were nominated by the committee chair and co-chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council's Scientific Statements Oversight Committee and the American Heart Association Manuscript Oversight Committee. The writers used systematic literature reviews, references to published clinical and epidemiological studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize evidence and to indicate gaps in current knowledge. All members of the writing group had the opportunity to comment on this document and approved the final version. The document underwent extensive American Heart Association internal peer review, Stroke Council leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the American Heart Association Science Advisory and Coordinating Committee. The decline in stroke mortality over the past decades represents a major improvement in population health and is observed for both sexes and for all racial/ethnic and age groups. In addition to the overall impact on fewer lives lost to stroke, the major decline in stroke mortality seen among people factor control interventions. Although it is difficult to
Pelletier, David L
The US Food and Drug Administration's (FDA's) 1992 policy statement was developed in the context of critical gaps in scientific knowledge concerning the compositional effects of genetic transformation and severe limitations in methods for safety testing. FDA acknowledged that pleiotropy and insertional mutagenesis may cause unintended changes, but it was unknown whether this happens to a greater extent in genetic engineering compared with traditional breeding. Moreover, the agency was not able to identify methods by which producers could screen for unintended allergens and toxicants. Despite these uncertainties, FDA granted genetically engineered foods the presumption of GRAS (Generally Recognized As Safe) and recommended that producers use voluntary consultations before marketing them.
Cook, Samuel DuBois; And Others
This volume contains four papers dealing with key social issues confronting American society; racial conflict; education (especially concerning national policies and goals); rationale for limited war for a nonmilitaristic nation; and the generation gap. Dr. Cook discusses black identity and white response and the problem of inculcating hope where…
García-Ramírez, Jorge A; Vélez-Álvarez, Consuelo
The study was aimed at identifying Latin-American countries' public policy which has been related to the social determinants of health. A topic review was thus made of papers kept in the 22 Latin-American countries' databases and official documents issued by their multilateral organisations and ministries of health. The World Health Organization's concept of the social determinants of health has been summarised and a history given of the pertinent work developed worldwide in regions such as Europe and Latin-America. Public policy regarding the field of study in Argentina, Brazil, Bolivia, Chile, Colombia, Costa Rica, México and Venezuela has been described. It was concluded that Latin-America provides a panorama of inequality regarding the application of policy concerning the social determinants of health and that there was segmented intervention, mainly regarding intermediate determinants of health, without taking an integrated approach from different entrance points into account, according to the stated conceptual framework.
Lopez-Jimenez, Francisco; Kramer, Valerie Carroll; Masters, Barbara; Stuart, Patricia Mickey W; Mullooly, Cathy; Hinshaw, Ling; Haas, Linda; Warwick, Kathy
Diabetes mellitus is a highly prevalent condition in patients participating in cardiopulmonary rehabilitation. However, research and subsequent guidelines specifically applicable to patients with diabetes, participating in cardiopulmonary rehabilitation, are limited. Recognizing this limitation, the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) initiated this statement, with the goal of developing a template that incorporated recommendations provided in the AACVPR Core Components and the American Association of Diabetes Educators 7 Self-Care Behaviors. This statement describes key processes regarding evaluation, interventions, and expected outcomes in each of the core components for the management of patients with diabetes in a cardiopulmonary rehabilitation program.
Shaw, Leslee J; Blankstein, Ron; Jacobs, Jill E; Leipsic, Jonathon A; Kwong, Raymond Y; Taqueti, Viviany R; Beanlands, Rob S B; Mieres, Jennifer H; Flamm, Scott D; Gerber, Thomas C; Spertus, John; Di Carli, Marcelo F
The aims of the current statement are to refine the definition of quality in cardiovascular imaging and to propose novel methodological approaches to inform the demonstration of quality in imaging in future clinical trials and registries. We propose defining quality in cardiovascular imaging using an analytical framework put forth by the Institute of Medicine whereby quality was defined as testing being safe, effective, patient-centered, timely, equitable, and efficient. The implications of each of these components of quality health care are as essential for cardiovascular imaging as they are for other areas within health care. Our proposed statement may serve as the foundation for integrating these quality indicators into establishing designations of quality laboratory practices and developing standards for value-based payment reform for imaging services. We also include recommendations for future clinical research to fulfill quality aims within cardiovascular imaging, including clinical hypotheses of improving patient outcomes, the importance of health status as an end point, and deferred testing options. Future research should evolve to define novel methods optimized for the role of cardiovascular imaging for detecting disease and guiding treatment and to demonstrate the role of cardiovascular imaging in facilitating healthcare quality. © 2017 American Heart Association, Inc.
Bartolome R. Celli
Full Text Available Chronic obstructive pulmonary disease (COPD is a leading cause of morbidity, mortality and resource use worldwide. The goal of this official American Thoracic Society (ATS/European Respiratory Society (ERS Research Statement is to describe evidence related to diagnosis, assessment, and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management. Clinicians, researchers and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified. Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus. Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS research statement highlights the types of research that leading clinicians, researchers and patient advocates believe will have the greatest impact on patient-centred outcomes.
Feingold, Brian; Mahle, William T; Auerbach, Scott; Clemens, Paula; Domenighetti, Andrea A; Jefferies, John L; Judge, Daniel P; Lal, Ashwin K; Markham, Larry W; Parks, W James; Tsuda, Takeshi; Wang, Paul J; Yoo, Shi-Joon
For many neuromuscular diseases (NMDs), cardiac disease represents a major cause of morbidity and mortality. The management of cardiac disease in NMDs is made challenging by the broad clinical heterogeneity that exists among many NMDs and by limited knowledge about disease-specific cardiovascular pathogenesis and course-modifying interventions. The overlay of compromise in peripheral muscle function and other organ systems, such as the lungs, also makes the simple application of endorsed adult or pediatric heart failure guidelines to the NMD population problematic. In this statement, we provide background on several NMDs in which there is cardiac involvement, highlighting unique features of NMD-associated myocardial disease that require clinicians to tailor their approach to prevention and treatment of heart failure. Undoubtedly, further investigations are required to best inform future guidelines on NMD-specific cardiovascular health risks, treatments, and outcomes. © 2017 American Heart Association, Inc.
interesting paradox – American culture is both loved and feared – and it is not uncommon to hear stories of popular international McDonald’s franchises also...Mark McDonald , “Egyptians Growing More Resentful of U.S. Foreign Policy,” Philadelphia Inquirer, 16 December 2002, sec. A, p. 1. 24 Michael J. Jordan...2002, sec. A, p. 1. McDonald , Mark. “Egyptians Growing More Resentful of U.S. Foreign Policy.” Philadelphia Inquirer, 16 December 2002, sec. A, p. 1
In June 1977 an NRC study group seeking to identify ways to improve the effectiveness of NRC nuclear power plant licensing procedures, recommended (among other measures) that rulemaking should be considered for the generic resolution of certain major issues that are presently litigated in individual licensing proceedings (NUREG--0292). In response to a Commission directive, the staff prepared an interim statement of general policy and plans for rulemaking, which the Commission approved for publication n the Federal Register at Affirmation Session 78-7 held on October 26, 1978. This interim policy statement fully supports Executive Order 12044 of March 23, 1978, requesting improvement of existing and future government regulations so as to be as simple and clear as possible and avoid imposing unnecessary burdens on the economy, on individuals, on public and private organizations, or on State and local governments. This NUREG publication includes the full text of the Federal Register notice published concurrently. Also provided are Enclosures A and B which contain more complete information than is presented in the FR notice regarding the selection and discussion of issues proposed by the staff for generic rulemaking. However, the discussion of issues avoids being overly specific about the likely outcome of rulemaking in order to stimulate creative public and industry comments as desirable inputs to shaping the ultimate form of generic rules
Salah K. Kabanda
Spruit, Martijn A.; Singh, Sally J.; Garvey, Chris; ZuWallack, Richard; Nici, Linda; Rochester, Carolyn; Hill, Kylie; Holland, Anne E.; Lareau, Suzanne C.; Man, W.D.C.; Pitta, Fabio; Sewell, Louise; Raskin, Jonathan; Bourbeau, Jean; Crouch, Rebecca; Franssen, Frits M.E.; Casaburi, Richard; Vercoulen, Jan H.; Vogiatzit, Ioannis; Gosselink, Rik; Clini, Enrico M.; Effing, T.W.; Maltais, Francois; van der Palen, Jacobus Adrianus Maria; Troosters, Thierry; Janssen, Daisy J.A.; Collins, Eileen; Garcia-Aymerich, Judith; Brooks, Dina; Fahy, Bonnie F.; Puhan, Milo A.; Hoogendoorn, Martine; Garrod, Rachel; Schols, Annemie M.W.J.; Carlin, Brian; Benzo, Roberto; Meek, Paula; Morgan, Mike; Rutten-van Mölken, Maureen P.M.H.; Ries, Andrew L.; Make, Barry; Goldstein, Roger S.; Dowson, Claire A.; Brozek, Jan L.; Donner, Claudio F.; Wouters, Emiel F.M.
Background: Pulmonary rehabilitation is recognized as a core component of the management of individuals with chronic respiratory disease. Since the 2006 American Thoracic Society (ATS)/European Respiratory Society (ERS) Statement on Pulmonary Rehabilitation, there has been considerable growth in our
Prakash, Y S; Halayko, Andrew J; Gosens, Reinoud; Panettieri Jr., Reynold A; Camoretti-Mercado, Blanca; Penn, Raymond B; Burgess, Janette K
BACKGROUND: Airway remodeling (AR) is a prominent feature of asthma and other obstructive lung diseases that is minimally affected by current treatments. The goals of this Official American Thoracic Society (ATS) Research Statement are to discuss the scientific, technological, economic, and
Full Text Available En este artículo se explora los efectos del anti-americanismo en la política comercial de Brasil durante la negociación del Área de Libre Comercio de las Américas y en la política comercial francesa durante la Ronda Uruguay del GATT. Aunque mucho se ha escrito sobre la conceptualización del anti-americanismo, sus causas y su presencia en distintos estados nacionales, la investigación acerca de sus efectos sobre la política y las políticas públicas es escasa. Este artículo contribuye al debate al comparar dos estudios de caso y al reflexionar sobre los efectos del anti-americanismo en el proceso de toma de decisiones y en la política comercial bajo distintas circunstancias. English: This article traces the effects of anti-Americanism on Brazilian trade policy-making during the negotiations of the Free Trade Agreement of the Americas (FTAA and French trade policy-making during the Uruguay Round of the General Agreement on Tariffs and Trade (GATT. While much has been published on the conceptualisation of anti-Americanism, its causes, and its presence in different states, research into the effects of anti-Americanism on politics and policies is rather limited. This article adds to the debate by conducting a comparative study of the Brazilian and French cases and by reflecting on the effects of anti-Americanism on decision-making and policies under different circumstances.
In October 1977, the Department of Energy (DOE) announced a Spent Fuel Storage Policy for nuclear power reactors. Under this policy, as approved by the President, US utilities will be given the opportunity to deliver spent fuel to US Government custody in exchange for payment of a fee. The US Government will also be prepared to accept a limited amount of spent fuel from foreign sources when such action would contribute to meeting nonproliferation goals. Under the new policy, spent fuel transferred to the US Government will be delivered - at user expense - to a US Government-approved site. Foreign spent fuel would be stored in Interim Spent Fuel Storage (ISFS) facilities with domestic fuel. This volume of the environmental impact statement includes effects associated with implementing or not implementing the Spent Fuel Storage Policy for the foreign fuels. The analyses show that there are no substantial radiological health impacts whether the policy is implemented or not. In no case considered does the population dose commitment exceed 0.000006% of the world population dose commitment from natural radiation sources over the period analyzed. Full implementation of the US offer to accept a limited amount of foreign spent fuel for storage provides the greatest benefits for US nonproliferation policy. Acceptance of lesser quantities of foreign spent fuel in the US or less US support of foreign spent fuel storage abroad provides some nonproliferation benefits, but at a significantly lower level than full implementation of the offer. Not implementing the policy in regard to foreign spent fuel will be least productive in the context of US nonproliferation objectives. The remainder of the summary provides a brief description of the options that are evaluated, the facilities involved in these options, and the environmental impacts, including nonproliferation considerations, associated with each option
Vos, Miriam B; Kaar, Jill L; Welsh, Jean A; Van Horn, Linda V; Feig, Daniel I; Anderson, Cheryl A M; Patel, Mahesh J; Cruz Munos, Jessica; Krebs, Nancy F; Xanthakos, Stavra A; Johnson, Rachel K
Poor lifestyle behaviors are leading causes of preventable diseases globally. Added sugars contribute to a diet that is energy dense but nutrient poor and increase risk of developing obesity, cardiovascular disease, hypertension, obesity-related cancers, and dental caries. For this American Heart Association scientific statement, the writing group reviewed and graded the current scientific evidence for studies examining the cardiovascular health effects of added sugars on children. The available literature was subdivided into 5 broad subareas: effects on blood pressure, lipids, insulin resistance and diabetes mellitus, nonalcoholic fatty liver disease, and obesity. Associations between added sugars and increased cardiovascular disease risk factors among US children are present at levels far below current consumption levels. Strong evidence supports the association of added sugars with increased cardiovascular disease risk in children through increased energy intake, increased adiposity, and dyslipidemia. The committee found that it is reasonable to recommend that children consume ≤25 g (100 cal or ≈6 teaspoons) of added sugars per day and to avoid added sugars for children added sugars most likely can be safely consumed in low amounts as part of a healthy diet, few children achieve such levels, making this an important public health target. © 2017 American Heart Association, Inc.
Chung, Shan Shan; Fryxell, Gerald E; Lo, Carlos W H
For decades, industry has been the main source of pollution in China. Determined to make changes, the mainland Chinese authorities have decided to promote mechanisms that incorporate environmental concerns into the internal management of enterprises. This is manifested in the rapid adoption of the ISO14000 standards, including a significant increase in ISO14001 registrations in China. Thus, this study examined the environmental policy statements of 106 certified facilities in mainland China against a strict interpretation of the mandatory requirements of the ISO 14001:1996 standard and the nonmandatory ISO14004 requirements in order to shed some light on the implementation of environmental management systems in an emerging economic giant. It was decided to analyze the environmental policy statement because such a statement is a core element in the ISO system of environmental management of each facility and there are relatively clear and specific requirements on what an environmental policy statement shall include. An analysis of the contents of the environmental policy statements shows that conformance to the relevant requirements of both the mandatory ISO14001 standard and the nonmandatory ISO14004 standard is far from impressive and that the facilities in our sample seldom went beyond the minimum requirements. By using ISO14001 and ISO14004 conformance scores as the dependent variables, we found that conformity to ISO14001 and overall conformance to ISO14000 series can be explained to some extent by the degree of top management commitment, the experience with informal environmental management systems, and the form of ownership of the facilities.
Carpenter, Janet S; Laine, Tei; Harrison, Blake; LePage, Meghan; Pierce, Taran; Hoteling, Nathan; Börner, Katy
We sought to depict the topical, geospatial, and temporal diffusion of the 2015 North American Menopause Society position statement on the nonhormonal management of menopause-associated vasomotor symptoms released on September 21, 2015, and its associated press release from September 23, 2015. Three data sources were used: online news articles, National Public Radio, and Twitter. For topical diffusion, we compared keywords and their frequencies among the position statement, press release, and online news articles. We also created a network figure depicting relationships across key content categories or nodes. For geospatial diffusion within the United States, we compared locations of the 109 National Public Radio (NPR) stations covering the statement to 775 NPR stations not covering the statement. For temporal diffusion, we normalized and segmented Twitter data into periods before and after the press release (September 12, 2015 to September 22, 2015 vs September 23, 2015 to October 3, 2015) and conducted a burst analysis to identify changes in tweets from before to after. Topical information diffused across sources was similar with the exception of the more scientific terms "vasomotor symptoms" or "vms" versus the more colloquial term "hot flashes." Online news articles indicated media coverage of the statement was mainly concentrated in the United States. NPR station data showed similar proportions of stations airing the story across the four census regions (Northeast, Midwest, south, west; P = 0.649). Release of the statement coincided with bursts in the menopause conversation on Twitter. The findings of this study may be useful for directing the development and dissemination of future North American Menopause Society position statements and/or press releases.
Moreau, William J.; Nabhan, Dustin C.; Roecker, Christopher; Kimura, Melissa Nagare; Klein, Andrew; Guimard, Brett; Pierce, Kevin; Helma, Patrick; Nelson, Robert; Bahr, Kelly Shockley; Nelson, Laney; Williams, Perry
Objective The purpose of this paper is to present a position statement of best practices for the provision of a safe and high-quality pre-participation examination (PPE) and to provide recommendations on education requirements for doctors of chiropractic providing the PPE. Methods In 2014, the American Chiropractic Board of Sports Physicians (ACBSP) Board of Directors identified a need to review and update the ACBSP position statements and practice guidelines in order to be current with evolving best practices. Twelve ACBSP certificants, 10 Diplomates of the ACBSP, and 2 Certified Chiropractic Sports Physicians, met in April 2015 to author a pre-participation position statement using an expert consensus process. Panel members excluded anyone with commercial conflicts of interest and included individuals with expertise in clinical sports medicine and the performance of PPEs. A literature review was performed and circulated in advance for use by the panel in addressing the topic. The position statement was written through a consensus process and accepted by the ACBSP Board of Directors in May of 2015. Results The ACBSP Position Statement on Pre-participation Examinations identifies the qualifications and best practices for doctors of chiropractic to perform a PPE. Conclusion This position statement states that doctors of chiropractic with post graduate education and current Diplomates of the ACBSP or Certified Chiropractic Sports Physicians certification have the prerequisite education and qualifying skills to perform PPEs. PMID:26778931
Moreau, William J; Nabhan, Dustin C; Roecker, Christopher; Kimura, Melissa Nagare; Klein, Andrew; Guimard, Brett; Pierce, Kevin; Helma, Patrick; Nelson, Robert; Bahr, Kelly Shockley; Nelson, Laney; Williams, Perry
The purpose of this paper is to present a position statement of best practices for the provision of a safe and high-quality pre-participation examination (PPE) and to provide recommendations on education requirements for doctors of chiropractic providing the PPE. In 2014, the American Chiropractic Board of Sports Physicians (ACBSP) Board of Directors identified a need to review and update the ACBSP position statements and practice guidelines in order to be current with evolving best practices. Twelve ACBSP certificants, 10 Diplomates of the ACBSP, and 2 Certified Chiropractic Sports Physicians, met in April 2015 to author a pre-participation position statement using an expert consensus process. Panel members excluded anyone with commercial conflicts of interest and included individuals with expertise in clinical sports medicine and the performance of PPEs. A literature review was performed and circulated in advance for use by the panel in addressing the topic. The position statement was written through a consensus process and accepted by the ACBSP Board of Directors in May of 2015. The ACBSP Position Statement on Pre-participation Examinations identifies the qualifications and best practices for doctors of chiropractic to perform a PPE. This position statement states that doctors of chiropractic with post graduate education and current Diplomates of the ACBSP or Certified Chiropractic Sports Physicians certification have the prerequisite education and qualifying skills to perform PPEs.
The Native American Resource Document is a summary of opinions expressed by the Consolidated Group of Tribes and Organizations (CGTO) regarding the Environmental Impact Statement for the Nevada Test Site and Other Off-Site Locations within the State of Nevada (NTS EIS). The document contains (a) general concerns regarding long-term impacts of the U.S. Department of Energy's (DOE) operations on the NTS and (b) a synopsis of specific comments made by the American Indian Writers Subgroup (AIWS) for various chapters of the NTS EIS. The Native American Resource Document was produced in response to consultation required for the NTS EIS, in accordance with DOE Order 1230.2, American Indian Tribal Government Policy. The consultation focused specifically on four alternative management decisions concerning the future mission of the NTS and related off-site locations in Nevada. However, the present CGTO's response to this consultation is not limited to EIS alternatives, but also integrates relevant recommendations made by Indian people for previous DOE projects in which American Indians participated
Levine, Glenn N; Lange, Richard A; Bairey-Merz, C Noel; Davidson, Richard J; Jamerson, Kenneth; Mehta, Puja K; Michos, Erin D; Norris, Keith; Ray, Indranill Basu; Saban, Karen L; Shah, Tina; Stein, Richard; Smith, Sidney C
Despite numerous advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains a leading cause of morbidity and mortality. Novel and inexpensive interventions that can contribute to the primary and secondary prevention of cardiovascular disease are of interest. Numerous studies have reported on the benefits of meditation. Meditation instruction and practice is widely accessible and inexpensive and may thus be a potential attractive cost-effective adjunct to more traditional medical therapies. Accordingly, this American Heart Association scientific statement systematically reviewed the data on the potential benefits of meditation on cardiovascular risk. Neurophysiological and neuroanatomical studies demonstrate that meditation can have long-standing effects on the brain, which provide some biological plausibility for beneficial consequences on the physiological basal state and on cardiovascular risk. Studies of the effects of meditation on cardiovascular risk have included those investigating physiological response to stress, smoking cessation, blood pressure reduction, insulin resistance and metabolic syndrome, endothelial function, inducible myocardial ischemia, and primary and secondary prevention of cardiovascular disease. Overall, studies of meditation suggest a possible benefit on cardiovascular risk, although the overall quality and, in some cases, quantity of study data are modest. Given the low costs and low risks of this intervention, meditation may be considered as an adjunct to guideline-directed cardiovascular risk reduction by those interested in this lifestyle modification, with the understanding that the benefits of such intervention remain to be better established. Further research on meditation and cardiovascular risk is warranted. Such studies, to the degree possible, should utilize randomized study design, be adequately powered to meet the primary study outcome, strive to achieve low drop-out rates, include long
Robinson, Paul D; Latzin, Philipp; Ramsey, Kathryn A; Stanojevic, Sanja; Aurora, Paul; Davis, Stephanie D; Gappa, Monika; Hall, Graham L; Horsley, Alex; Jensen, Renee; Lum, Sooky; Milla, Carlos; Nielsen, Kim G; Pittman, Jessica E; Rosenfeld, Margaret; Singer, Florian; Subbarao, Padmaja; Gustafsson, Per M; Ratjen, Felix
Obstructive airway disease is nonuniformly distributed throughout the bronchial tree, although the extent to which this occurs can vary among conditions. The multiple-breath washout (MBW) test offers important insights into pediatric lung disease, not available through spirometry or resistance measurements. The European Respiratory Society/American Thoracic Society inert gas washout consensus statement led to the emergence of validated commercial equipment for the age group 6 years and above; specific recommendations for preschool children were beyond the scope of the document. Subsequently, the focus has shifted to MBW applications within preschool subjects (aged 2-6 yr), where a "window of opportunity" exists for early diagnosis of obstructive lung disease and intervention. This preschool-specific technical standards document was developed by an international group of experts, with expertise in both custom-built and commercial MBW equipment. A comprehensive review of published evidence was performed. Recommendations were devised across areas that place specific age-related demands on MBW systems. Citing evidence where available in the literature, recommendations are made regarding procedures that should be used to achieve robust MBW results in the preschool age range. The present work also highlights the important unanswered questions that need to be addressed in future work. Consensus recommendations are outlined to direct interested groups of manufacturers, researchers, and clinicians in preschool device design, test performance, and data analysis for the MBW technique.
With the increasing complexity of new nuclear facilities and the extent to which automation is being applied, it is essential that the staff who operate a facility be considered as integral components in the design and safety analyses. This policy statement is proposed to indicate those areas of facility design and operation where the role of the human operator must be especially examined
.... OCC-2012-0016] Policy Statement on the Principles for Development and Distribution of Annual Stress... the stress test horizon. The variables specified for each scenario generally address economic activity... institutions by November 15th of each year. This document articulates the principles that the OCC will apply to...
... FEDERAL DEPOSIT INSURANCE CORPORATION 12 CFR Part 325 Policy Statement on the Principles for... stress test horizon. The variables specified for each scenario generally address economic activity, asset..., 2012, that articulated the principles the FDIC will apply to develop and distribute the stress test...
... immunology, hematology, stem cell research, bone marrow transplantation, cancer research, in-vivo immunology..., calibrators, and in devices for biological and medical research. To develop its draft policy statement, the... National Research Council of the National Academies in 2008, recommended eliminating Category 1 and 2 CsCl...
... biomedical research, CsCl irradiation has been used for over 40 years in fields such as immunology, stem cell... devices for biological and medical research. To develop its draft policy statement, the NRC initiated and..., industry, and research and, while unlikely, due to the physical and chemical characteristics of CsCl, these...
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What should our agency-wide mail management policy statement cover? 102-192.155 Section 102-192.155 Public Contracts and... REGULATION ADMINISTRATIVE PROGRAMS 192-MAIL MANAGEMENT Other Agency Responsibilities § 102-192.155 What...
... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Statement of policy respecting take or pay provisions in gas purchase contracts. 2.103 Section 2.103 Conservation of Power and... the prices of deregulated and other higher cost gas from market constraints, the Commission sets forth...
This paper provides a summary of selected portions of the United States Department of Energy's ''Implementation Plan for the Environmental Impact Statement on a Proposed Policy for Acceptance of Foreign Research Reactor Spent Nuclear Fuel'', DOE/EIS-0218, October 1994
... is working towards increasing the attention that is given to safety culture as part of its efforts to... NUCLEAR REGULATORY COMMISSION Development of U.S. Nuclear Regulatory Commission Safety Culture..., Nevada hearing facility to solicit comments on the revision of its draft safety culture policy statement...
... business days between 7:00 a.m. and 5:00 p.m. (EDT). Instructions: Please use the title ``Policy Statement..., exist in applying this guidance generally or at particular banking organizations and are there any terms... the consolidated earnings, losses, and capital of a covered bank over the planning horizon, taking...
Frans L. Leeuw
Full Text Available The article addresses two questions:1. Can Legal Realism be seen as a scientific research programme enabling growth of knowledge? To answer that question, the author uses Lakatos’s work on the methodology of scientific research programmes as a frame of reference.2. What has been the role of American Legal Realism during the first part of the 20th century in helping to develop and implement the New Deal policy vis-à-vis its scientific work?After outlining some characteristics of American Legal Realism and Lakatos’s concept, the author studies LR from this perspective and concludes that LR can at the maximum be seen as a research programme of a very rudimentary nature with largely only a focus on procedures/methods. Despite this conclusion, LR has been important in stimulating questions in which social science research and law came together. Next, the professor-realist-relationship that helped President Roosevelt to have his New Deal developed and implemented is also discussed. A downside of this ‘professor-realist-advisor-partnership’ may have been that a LR scientific research programme has not been developed. Given the increased visibility of New Legal Realism, the paper finally stresses the relevance of working with scientific research programmes and the importance of being on the alert when linking research to (legal policies.
Hinkle, Janice L; Becker, Kyra J; Kim, Jong S; Choi-Kwon, Smi; Saban, Karen L; McNair, Norma; Mead, Gillian E
At least half of all stroke survivors experience fatigue; thus, it is a common cause of concern for patients, caregivers, and clinicians after stroke. This scientific statement provides an international perspective on the emerging evidence surrounding the incidence, prevalence, quality of life, and complex pathogenesis of poststroke fatigue. Evidence for pharmacological and nonpharmacological interventions for management are reviewed, as well as the effects of poststroke fatigue on both stroke survivors and caregivers. © 2017 American Heart Association, Inc.
Garber, Alan J; Abrahamson, Martin Julian; Barzilay, Joshua I; Blonde, Lawrence; Bloomgarden, Zachary T; Bush, Michael A; Dagogo-Jack, Samuel; Davidson, Michael B; Einhorn, Daniel; Garber, Jeffrey R; Garvey, W Timothy; Grunberger, George; Handelsman, Yehuda; Hirsch, Irl B; Jellinger, Paul S; McGill, Janet B; Mechanick, Jeffrey I; Rosenblit, Paul David; Umpierrez, Guillermo E
This document represents the official position of the American Association of Clinical Endocrinologists and the American College of Endocrinology. Where there were no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.
Marino, Bradley S; Tabbutt, Sarah; MacLaren, Graeme; Hazinski, Mary Fran; Adatia, Ian; Atkins, Dianne L; Checchia, Paul A; DeCaen, Allan; Fink, Ericka L; Hoffman, George M; Jefferies, John L; Kleinman, Monica; Krawczeski, Catherine D; Licht, Daniel J; Macrae, Duncan; Ravishankar, Chitra; Samson, Ricardo A; Thiagarajan, Ravi R; Toms, Rune; Tweddell, James; Laussen, Peter C
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms. The American College of Cardiology/American Heart Association classification of recommendations and levels of evidence for practice guidelines were used. The recommendations in this statement concur with the critical components of the 2015 American Heart Association pediatric basic life support and pediatric advanced life support guidelines and are meant to serve as a resuscitation supplement. This statement is meant for caregivers of children with heart disease in the prehospital and in-hospital settings. Understanding the anatomy and physiology of the high-risk pediatric cardiac population will promote early recognition and treatment of decompensation to prevent cardiac arrest, increase survival from cardiac arrest by providing high-quality resuscitations, and improve outcomes with postresuscitation care. © 2018 American Heart Association, Inc.
Weiss, Curtis H; Krishnan, Jerry A; Au, David H; Bender, Bruce G; Carson, Shannon S; Cattamanchi, Adithya; Cloutier, Michelle M; Cooke, Colin R; Erickson, Karen; George, Maureen; Gerald, Joe K; Gerald, Lynn B; Goss, Christopher H; Gould, Michael K; Hyzy, Robert; Kahn, Jeremy M; Mittman, Brian S; Mosesón, Erika M; Mularski, Richard A; Parthasarathy, Sairam; Patel, Sanjay R; Rand, Cynthia S; Redeker, Nancy S; Reiss, Theodore F; Riekert, Kristin A; Rubenfeld, Gordon D; Tate, Judith A; Wilson, Kevin C; Thomson, Carey C
Many advances in health care fail to reach patients. Implementation science is the study of novel approaches to mitigate this evidence-to-practice gap. The American Thoracic Society (ATS) created a multidisciplinary ad hoc committee to develop a research statement on implementation science in pulmonary, critical care, and sleep medicine. The committee used an iterative consensus process to define implementation science and review the use of conceptual frameworks to guide implementation science for the pulmonary, critical care, and sleep community and to explore how professional medical societies such as the ATS can promote implementation science. The committee defined implementation science as the study of the mechanisms by which effective health care interventions are either adopted or not adopted in clinical and community settings. The committee also distinguished implementation science from the act of implementation. Ideally, implementation science should include early and continuous stakeholder involvement and the use of conceptual frameworks (i.e., models to systematize the conduct of studies and standardize the communication of findings). Multiple conceptual frameworks are available, and we suggest the selection of one or more frameworks on the basis of the specific research question and setting. Professional medical societies such as the ATS can have an important role in promoting implementation science. Recommendations for professional societies to consider include: unifying implementation science activities through a single organizational structure, linking front-line clinicians with implementation scientists, seeking collaborations to prioritize and conduct implementation science studies, supporting implementation science projects through funding opportunities, working with research funding bodies to set the research agenda in the field, collaborating with external bodies responsible for health care delivery, disseminating results of implementation
Huynh, Que-Lam; Devos, Thierry; Altman, Hannah R
We sought to document that the extent to which different ethnic groups are perceived as embodying the American identity is more strongly linked to anti-minority policy attitudes and acculturation ideologies among majority group members (European Americans) than among minority group members (Asian Americans or Latino/as). Participants rated 13 attributes of the American identity as they pertain to different ethnic groups, and reported their endorsement of policy attitudes and acculturation ideologies. We found a relative consensus across ethnic groups regarding defining components of the American identity. However, European Americans were perceived as more prototypical of this American identity than ethnic minorities, especially by European American raters. Moreover, for European Americans but not for ethnic minorities, relative ingroup prototypicality was related to anti-minority policy attitudes and acculturation ideologies. These findings suggest that for European Americans, perceptions of ethnic group prototypicality fulfill an instrumental function linked to preserving their group interests and limiting the rights afforded to ethnic minorities.
Thigpen, Charles A; Shaffer, Michael A; Gaunt, Bryce W; Leggin, Brian G; Williams, Gerald R; Wilcox, Reg B
This is a consensus statement on rehabilitation developed by the American Society of Shoulder and Elbow Therapists. The purpose of this statement is to aid clinical decision making during the rehabilitation of patients after arthroscopic rotator cuff repair. The overarching philosophy of rehabilitation is centered on the principle of the gradual application of controlled stresses to the healing rotator cuff repair with consideration of rotator cuff tear size, tissue quality, and patient variables. This statement describes a rehabilitation framework that includes a 2-week period of strict immobilization and a staged introduction of protected, passive range of motion during weeks 2-6 postoperatively, followed by restoration of active range of motion, and then progressive strengthening beginning at postoperative week 12. When appropriate, rehabilitation continues with a functional progression for return to athletic or demanding work activities. This document represents the first consensus rehabilitation statement developed by a multidisciplinary society of international rehabilitation professionals specifically for the postoperative care of patients after arthroscopic rotator cuff repair. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
Weaver, J L
In population planning in Latin America the programs are as successful as the government's support of family planning. Colombia is one of the few Latin American countries which has actively exhorted its populace to birth control. If the propensity for large families reflects a belief in the economic or social utility of children, instead of machismo, birthrates will fall with expanded social security and economic welfare programs. If birthrates are the result of machismo, new gender models stressing the positive rewards and social esteem to be gained through responsible parenthood would have to be taught to both adults and children. The position profamily planning in most Latin American countries is generally supported by the ministers, technocrats, corporations, businessmen, middle-class women, doctors, mass media, protestant congregations, and working-class women. Family planning is usually opposed by members of the armed forces, Catholic hierarchy, Catholic lay organizations, oligarchy, university students, leftist intellectuals, Marxist insurgents, Indian communities, and peasants. The portion of the total national populations encompassed by the groups composing the core combination, ideological bias, and stability group ranges from 50-60% in Argentina, Uruguay, and Venezuela to 10-20% in Central America, Bolivia, Ecuador, and Paraguay. Most groups are outside the policy-making process.
David P. Dolowitz
Full Text Available From the 1940s until the 1980s the federal government gradually extended its authority over the structure of the American stormwater management system. The goal was to improve the water quality of the nation’s waterways by regulating the pollution loads entering the system, primarily through the use of gray infrastructure. However during the1980s the Environmental Protection Agency (EPA began to explore new approaches toward the regulation of stormwater pollution. Instead of focusing only on gray mechanisms, the EPA began developing and promoting the use of low impact development (LID techniques as an element municipal governments could use to achieve their total maxim daily load of pollutants allowable under the National Pollutant Discharge Elimination System permit system. In light of the incentive offered by the EPA for the use of LID in the management of stormwater, it should be expected to provide a perfect area to observe policy transfer between federal, state and local governments; but it does not. This article will establish why the EPA began promoting a green approach to stormwater management and why this has not led to a widespread transfer of best management practices in the ways the literatures associated with federalism and policy transfer would suggest.
The health disparities that are prevalent among American Indian and Alaska Native (AI/AN) communities are connected to the ideology of sovereignty and often ignored in social work and public health literature. Therefore, the purpose of this paper is to examine the health outcomes of American Indians from the time of contact with European settlers to the present through the ideology of sovereignty and federal government AI health policy. The foundation for the health outcomes of AIs and the governmental policies affecting them lie in the ideology of tribal sovereignty. This ideology has greatly impacted how the government views and treats AIs and consequently, how it has impacted their health. From the earliest treaties between European settlers and AIs, this legal relationship has been and remains a perplexing issue. With the examination of tribal sovereignty comes the realization that colonization and governmental polices have greatly contributed to the many social and health problems that AIs suffer from today. Understanding that the health disparities that exist among AI/AN populations cannot only be attributed to individual behavior and choice but is driven by societal, economic and political factors may be used to inform social work education, practice, and research.
Ligibel, Jennifer A; Alfano, Catherine M; Courneya, Kerry S; Demark-Wahnefried, Wendy; Burger, Robert A; Chlebowski, Rowan T; Fabian, Carol J; Gucalp, Ayca; Hershman, Dawn L; Hudson, Melissa M; Jones, Lee W; Kakarala, Madhuri; Ness, Kirsten K; Merrill, Janette K; Wollins, Dana S; Hudis, Clifford A
Rates of obesity have increased significantly over the last three decades in the United States and globally. In addition to contributing to heart disease and diabetes, obesity is a major unrecognized risk factor for cancer. Obesity is associated with worsened prognosis after cancer diagnosis and also negatively affects the delivery of systemic therapy, contributes to morbidity of cancer treatment, and may raise the risk of second malignancies and comorbidities. Research shows that the time after a cancer diagnosis can serve as a teachable moment to motivate individuals to adopt risk-reducing behaviors. For this reason, the oncology care team--the providers with whom a patient has the closest relationships in the critical period after a cancer diagnosis--is in a unique position to help patients lose weight and make other healthy lifestyle changes. The American Society of Clinical Oncology is committed to reducing the impact of obesity on cancer and has established a multipronged initiative to accomplish this goal by 1) increasing education and awareness of the evidence linking obesity and cancer; 2) providing tools and resources to help oncology providers address obesity with their patients; 3) building and fostering a robust research agenda to better understand the pathophysiology of energy balance alterations, evaluate the impact of behavior change on cancer outcomes, and determine the best methods to help cancer survivors make effective and useful changes in lifestyle behaviors; and 4) advocating for policy and systems change to address societal factors contributing to obesity and improve access to weight management services for patients with cancer. © 2014 by American Society of Clinical Oncology.
Notice of availability of the draft environmental impact statement for storage of US spent power reactor fuel was published by DOE in the Federal Register on September 6, 1978. A subsequent notice was published in the Federal Register on December 14, 1978, on the availability of the draft EISs on storage of foreign fuel, on charge for spent fuel storage, and a supplement to the draft EIS on storage of US fuel. Copies of the draft EISs were distributed for review and comment by appropriate Federal agencies, state governments, and other organizations and individuals who were known to have an interest in spent fuel storage activities and those who requested them. Comments and views concerning the draft EISs were requested from other interested agencies, organizations, and individuals by means of the Federal Register notices. Approximately 1600 copies each of the draft Domestic, Foreign, and Charge EISs were distributed for comment. The closing date for comments to be received on the draft EISs was February 15, 1979. Copies of the EISs (upon publication) and comment letters received were placed for public inspection in DOE public document rooms at 10 locations throughout the country. To the extent practicable, comments received after the closing date were also considered in the preparation of the final EIS. A total of 78 comment letters (some with supplements) were received. These comment letters are reproduced in their entirety in Section I of this volume. Approximately 600 specific comments were identified in these letters
The American Nurses Association (ANA) believes that the health of communities benefits from a mix of health care facilities, including both public and nonprofit private facilities where feasible. ANA is concerned by the rate of conversion of nonprofit facilities and plans to for-profit status. Privatization of public facilities and the conversion of nonprofit facilities and health plans to for-profit status requires careful public oversight to ensure continued access to affordable, quality services, including a maintenance of uncompensated care; a fair accounting of the assets of the entity being privatized or converted; and an assurance that converted assets are used to maintain and improve access to affordable, safe and quality health care services. The rights and benefits of employees must be carefully safe-guarded in any privatization or conversion move. All hospitals, regardless of ownership or tax status, should be held accountable for the delivery of safe, quality services, and should be required to disclose data regarding staffing, patient outcomes, cost and delivery of uncompensated care. Continued data collection will be necessary to guide further development of public policy to address privatization and for-profit conversion.
Hartlep, Nicholas Daniel; Lowinger, Robert Jay
This exploratory study examined white undergraduate students' (a) racial attitudes towards Asian Americans, (b) principled policy attitudes toward affirmative action, and (c) self-interest in relation to their support for college-based affirmative action policies for Asian Americans at a Midwestern university. A sample (n = 264, 28% male, 72%…
Christofides, S; Isidoro, J; Pesznyak, C; Bumbure, L; Cremers, Fn; Schmidt, WF
This EFOMP Policy Statement is an update of Policy Statement No. 6 first published in 1994. The present version takes into account the European Union Parliament and Council Directive 2013/55/EU that amends Directive 2005/36/EU on the recognition of professional qualifications and the European Union Council Directive 2013/59/EURATOM laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation. The European Commission Radiation Protection...
National Commission on Technology, Automation and Economic Progress, Washington, DC.
Forty-seven statements by industrial and business spokesmen, union and association representatives, and professors concern the broad impact of technological change on individuals, establishments, and society in general. Some of the longer presentations are (1) "The Poverty and Unemployment Crisis," by Walter Buckingham, (2) "Technological…
Nagayama Hall, Gordon C.; Yee, Alicia
Although Asian Americans are proportionally the fastest-growing ethnic group in the United States, federal mental health policies have neglected their special needs. U.S. federal mental health policy has shifted in the past 50 years from an emphasis on increasing accessibility to treatment to improving the quality of care and focusing on the brain as the basis of mental illness. However, the mental health needs of Asian Americans have been a relatively low priority. Myths about Asian American...
Objective To update for both clinicians and the lay public the evidence-based position statement published by The North American Menopause Society (NAMS) in March 2007 regarding its recommendations for menopausal hormone therapy (HT) for postmenopausal women, with consideration for the therapeutic benefit-risk ratio at various times through menopause and beyond. Design An Advisory Panel of clinicians and researchers expert in the field of women’s health was enlisted to review the March 2007 NAMS position statement, evaluate new evidence through an evidence-based analysis, and reach consensus on recommendations. The Panel’s recommendations were reviewed and approved by the NAMS Board of Trustees as an official NAMS position statement. The document was provided to other interested organizations to seek their endorsement. Results Current evidence supports a consensus regarding the role of HT in postmenopausal women, when potential therapeutic benefits and risks around the time of menopause are considered. This paper lists all these areas along with explanatory comments. Conclusions that vary from the 2007 position statement are highlighted. Addenda include a discussion of risk concepts, a new component not included in the 2007 paper, and a recommended list of areas for future HT research. A suggested reading list of key references is also provided. Conclusions Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms; to treat or reduce the risk of certain disorders, such as osteoporosis or fractures in select postmenopausal women; or both. The benefit-risk ratio for menopausal HT is favorable close to menopause but decreases with aging and with time since menopause in previously untreated women. PMID:18580541
Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra
The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep n...
... requirements and FTA policy. 27.19 Section 27.19 Transportation Office of the Secretary of Transportation... General § 27.19 Compliance with Americans with Disabilities Act requirements and FTA policy. (a... subpart F of this part. (b) Consistent with FTA policy, any recipient of Federal financial assistance from...
Fruin, Christine; Sutton, Shan
Recognizing the paucity of quantitative and qualitative data from North American educational institutions that have pursued open access policies, the authors devised a survey to collect information on the characteristics of these institutions, as well as the elements of the open access policies, the methods of promoting these policies, faculty…
Knoppers, Bartha M; Isasi, Rosario; Benvenisty, Nissim; Kim, Ock-Joo; Lomax, Geoffrey; Morris, Clive; Murray, Thomas H; Lee, Eng Hin; Perry, Margery; Richardson, Genevra; Sipp, Douglas; Tanner, Klaus; Wahlström, Jan; de Wert, Guido; Zeng, Fanyi
Novel methods and associated tools permitting individual identification in publicly accessible SNP databases have become a debatable issue. There is growing concern that current technical and ethical safeguards to protect the identities of donors could be insufficient. In the context of human embryonic stem cell research, there are no studies focusing on the probability that an hESC line donor could be identified by analyzing published SNP profiles and associated genotypic and phenotypic information. We present the International Stem Cell Forum (ISCF) Ethics Working Party's Policy Statement on "Publishing SNP Genotypes of Human Embryonic Stem Cell Lines (hESC)". The Statement prospectively addresses issues surrounding the publication of genotypic data and associated annotations of hESC lines in open access databases. It proposes a balanced approach between the goals of open science and data sharing with the respect for fundamental bioethical principles (autonomy, privacy, beneficence, justice and research merit and integrity).
AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY 2018 POSITION STATEMENT ON INTEGRATION OF INSULIN PUMPS AND CONTINUOUS GLUCOSE MONITORING IN PATIENTS WITH DIABETES MELLITUS.
Grunberger, George; Handelsman, Yehuda; Bloomgarden, Zachary T; Fonseca, Vivian A; Garber, Alan J; Haas, Richard A; Roberts, Victor L; Umpierrez, Guillermo E
This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician. AACE/ACE Task Force on Integration of Insulin Pumps and Continuous Glucose Monitoring in the Management of Patients With Diabetes Mellitus Chair George Grunberger, MD, FACP, FACE Task Force Members Yehuda Handelsman, MD, FACP, FNLA, MACE Zachary T. Bloomgarden, MD, MACE Vivian A. Fonseca, MD, FACE Alan J. Garber, MD, PhD, FACE Richard A. Haas, MD, FACE Victor L. Roberts, MD, MBA, FACP, FACE Guillermo E. Umpierrez, MD, CDE, FACP, FACE Abbreviations: AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology A1C = glycated hemoglobin BGM = blood glucose monitoring CGM = continuous glucose monitoring CSII = continuous subcutaneous insulin infusion DM = diabetes mellitus FDA = Food & Drug Administration MDI = multiple daily injections T1DM = type 1 diabetes mellitus T2DM = type 2 diabetes mellitus SAP = sensor-augmented pump SMBG = self-monitoring of blood glucose STAR 3 = Sensor-Augmented Pump Therapy for A1C Reduction phase 3 trial.
Fox, Caroline S.; Hall, Jennifer L.; Arnett, Donna K.; Ashley, Euan A.; Delles, Christian; Engler, Mary B.; Freeman, Mason W.; Johnson, Julie A.; Lanfear, David E.; Liggett, Stephen B.; Lusis, Aldons J.; Loscalzo, Joseph; MacRae, Calum A.; Musunuru, Kiran; Newby, L. Kristin
The field of genetics and genomics has advanced considerably with the achievement of recent milestones encompassing the identification of many loci for cardiovascular disease and variable drug responses. Despite this achievement, a gap exists in the understanding and advancement to meaningful translation that directly affects disease prevention and clinical care. The purpose of this scientific statement is to address the gap between genetic discoveries and their practical application to cardi...
Tradewell, Michael; Pariser, Joseph J.; Nimeh, Tony
Urinary tract infection (UTI) is a source of morbidity and healthcare costs in adults with spina bifida (ASB). UTI prevention strategies are often recommended, but the evidence of various approaches remains unclear. We performed a systematic review to inform a best practice policy statement for UTI prevention in ASB. On behalf of the Neurogenic Bladder Research Group (NBRG.org), we developed an a priori protocol and searched the published English literature for 30 outcomes questions addressing UTI prevention in ASB. The questions spanned the categories of antibiotics, oral supplements, bladder management factors and social support. Where there was little literature in ASB, we included literature from similar populations with neurogenic bladder (NB). Data was abstracted and then reviewed with recommendations made by consensus of all authors. Level of Evidence (LoE) and Grade of Recommendation (GoR) were according to the Oxford grading system. Of 6,433 articles identified by our search, we included 99 publications. There was sufficient evidence to support use of the following: saline bladder irrigation (LoE 1, GoR B), gentamicin bladder instillation (LoE 3, GoR C), single-use intermittent catheterization (IC) (LoE 2, GoR B), hydrophilic catheters for IC (LoE 2, GoR C), intradetrusor onabotulinumtoxinA injection (LoE 3, GoR C), hyaluronic acid (HA) instillation (LoE 1, GoR B), and care coordination (LoE 3, GoR C). There was sufficient evidence to recommend against use of the following: sterile IC (LoE 1, GoR B), oral antibiotic prophylaxis (LoE 2, GoR B), treatment of asymptomatic bacteriuria (LoE 2, GoR B), cranberry (LoE 2, GoR B), methenamine salts (LoE 1, GoR B), and ascorbic acid (LoE1, GoR B). There was insufficient evidence to make a recommendation for other outcomes. Overall, there are few studies in UTI prevention in the specific population of ASB. Research in populations similar to ASB helps to guide recommendations for UTI prevention in the challenging
Gafaranga, Joseph; Niyomugabo, Cyprien; Uwizeyimana, Valentin
An invitation to integrate macro and micro level analyses has been extended to researchers as this integration is felt to be the way forward for language policy research (Ricento, Ideology, politics and language policies: Focus on english, John Benjamins, Amsterdam, 2000). In turn, the notion of 'micro' in language policy has been specified as…
The attached guidelines on "Commercial Support of Continuing Nursing Education" have been developed by the American Nurses Association (ANA) to assist/guide nursing continuing educators who wish to utilize the resources of corporations to provide continuing education programs. These guidelines enable the provider to maintain a balance between the need for industry-supported dissemination of scientific information and promotional activities which meet the requirements of law, as well as professional standards of the American Nurses Association.
Lindsey, Merry L; Mayr, Manuel; Gomes, Aldrin V; Delles, Christian; Arrell, D Kent; Murphy, Anne M; Lange, Richard A; Costello, Catherine E; Jin, Yu-Fang; Laskowitz, Daniel T; Sam, Flora; Terzic, Andre; Van Eyk, Jennifer; Srinivas, Pothur R
The year 2014 marked the 20th anniversary of the coining of the term proteomics. The purpose of this scientific statement is to summarize advances over this period that have catalyzed our capacity to address the experimental, translational, and clinical implications of proteomics as applied to cardiovascular health and disease and to evaluate the current status of the field. Key successes that have energized the field are delineated; opportunities for proteomics to drive basic science research, facilitate clinical translation, and establish diagnostic and therapeutic healthcare algorithms are discussed; and challenges that remain to be solved before proteomic technologies can be readily translated from scientific discoveries to meaningful advances in cardiovascular care are addressed. Proteomics is the result of disruptive technologies, namely, mass spectrometry and database searching, which drove protein analysis from 1 protein at a time to protein mixture analyses that enable large-scale analysis of proteins and facilitate paradigm shifts in biological concepts that address important clinical questions. Over the past 20 years, the field of proteomics has matured, yet it is still developing rapidly. The scope of this statement will extend beyond the reaches of a typical review article and offer guidance on the use of next-generation proteomics for future scientific discovery in the basic research laboratory and clinical settings. © 2015 American Heart Association, Inc.
... ``a consumer is offered or extended the right to acquire `money, property, insurance, or services... the protections and rights available to the consumer under the Act.''). The proposed statement of the... collectors they hire usually have the right to collect on the person's debts from the assets of his or her...
St-Onge, Marie-Pierre; Ard, Jamy; Baskin, Monica L; Chiuve, Stephanie E; Johnson, Heather M; Kris-Etherton, Penny; Varady, Krista
Eating patterns are increasingly varied. Typical breakfast, lunch, and dinner meals are difficult to distinguish because skipping meals and snacking have become more prevalent. Such eating styles can have various effects on cardiometabolic health markers, namely obesity, lipid profile, insulin resistance, and blood pressure. In this statement, we review the cardiometabolic health effects of specific eating patterns: skipping breakfast, intermittent fasting, meal frequency (number of daily eating occasions), and timing of eating occasions. Furthermore, we propose definitions for meals, snacks, and eating occasions for use in research. Finally, data suggest that irregular eating patterns appear less favorable for achieving a healthy cardiometabolic profile. Intentional eating with mindful attention to the timing and frequency of eating occasions could lead to healthier lifestyle and cardiometabolic risk factor management. © 2017 American Heart Association, Inc.
... PROPERTY REAL ESTATE Policy § 643.39 Policy—American National Red Cross. (a) Title 10 U.S.C. 2670... quarters for Red Cross activities and personnel when assigned to duty with the Armed Forces in accordance...
In the United States there is a prevalence of obesity among ethnic groups, especially African American girls. The author in this column examines through an ecological lens selected American federal, state, and city policies and program interventions aimed at reducing obesity. Specifically, the eating behavior of African American girls is discussed as a population subset for which significant gaps are present in current obesity policy and implementation. Policy recommendations should include parents as research has shown a significant relationship in the eating behaviors of African American girls and their parents. Opportunities for nurses in practice and research to test the effectiveness of family and community level policy and program initiatives that address the ecological perspectives of the adolescent environment are discussed.
Christofides, Stelios; Isidoro, Jorge; Pesznyak, Csilla; Bumbure, Lada; Cremers, Florian; Schmidt, Werner F O
This EFOMP Policy Statement is an update of Policy Statement No. 6 first published in 1994. The present version takes into account the European Union Parliament and Council Directive 2013/55/EU that amends Directive 2005/36/EU on the recognition of professional qualifications and the European Union Council Directive 2013/59/EURATOM laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation. The European Commission Radiation Protection Report No. 174, Guidelines on Medical Physics Expert and the EFOMP Policy Statement No. 12.1, Recommendations on Medical Physics Education and Training in Europe 2014, are also taken into consideration. The EFOMP National Member Organisations are encouraged to update their Medical Physics registration schemes where these exist or to develop registration schemes taking into account the present version of this EFOMP Policy Statement (Policy Statement No. 6.1"Recommended Guidelines on National Registration Schemes for Medical Physicists"). Copyright © 2016. Published by Elsevier Ltd.
Chow, Sheryl L; Maisel, Alan S; Anand, Inder; Bozkurt, Biykem; de Boer, Rudolf A; Felker, G Michael; Fonarow, Gregg C; Greenberg, Barry; Januzzi, James L; Kiernan, Michael S; Liu, Peter P; Wang, Thomas J; Yancy, Clyde W; Zile, Michael R
Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers may provide added value to medical management, which could potentially lower risk of mortality and readmissions. The purpose of this scientific statement is to summarize the existing literature and to provide guidance for the utility of currently available biomarkers. The writing group used systematic literature reviews, published translational and clinical studies, clinical practice guidelines, and expert opinion/statements to summarize existing evidence and to identify areas of inadequacy requiring future research. The panel reviewed the most relevant adult medical literature excluding routine laboratory tests using MEDLINE, EMBASE, and Web of Science through December 2016. The document is organized and classified according to the American Heart Association to provide specific suggestions, considerations, or contemporary clinical practice recommendations. A number of biomarkers associated with HF are well recognized, and measuring their concentrations in circulation can be a convenient and noninvasive approach to provide important information about disease severity and helps in the detection, diagnosis, prognosis, and management of HF. These include natriuretic peptides, soluble suppressor of tumorgenicity 2, highly sensitive troponin, galectin-3, midregional proadrenomedullin, cystatin-C, interleukin-6, procalcitonin, and others. There is a need to further evaluate existing and novel markers for guiding therapy and to summarize their data in a standardized format to improve communication among researchers and practitioners. HF is a complex syndrome involving diverse pathways and pathological processes that can manifest in circulation as biomarkers. A number of such biomarkers are now clinically available, and monitoring their
Hamel, Rainer Enrique; Álvarez López, Elisa; Carvalhal, Tatiana Pereira
This article starts with an overview of the sociolinguistic situation in Latin America as a context for language policy and planning (LPP) decisions in the academic field. Then it gives a brief overview of the language policy challenges faced by universities to cope with neoliberal internationalisation. A conceptualisation of the domain as a…
Kurtz, Theodore W; DiCarlo, Stephen E; Pravenec, Michal; Morris, R Curtis
: Recently, the American Heart Association (AHA) published a scientific statement on salt sensitivity of blood pressure which emphasized a decades old conceptual framework for the pathogenesis of this common disorder. Here we examine the extent to which the conceptual framework for salt sensitivity emphasized in the AHA Statement accommodates contemporary findings and views of the broader scientific community on the pathogenesis of salt sensitivity. In addition, we highlight alternative conceptual frameworks and important contemporary theories of salt sensitivity that are little discussed in the AHA Statement. We suggest that greater consideration of conceptual frameworks and theories for salt sensitivity beyond those emphasized in the AHA Statement may help to advance understanding of the pathogenesis of salt-induced increases in blood pressure and, in consequence, may lead to improved approaches to preventing and treating this common disorder.
Griggs, Jennifer; Maingi, Shail; Blinder, Victoria; Denduluri, Neelima; Khorana, Alok A; Norton, Larry; Francisco, Michael; Wollins, Dana S; Rowland, Julia H
ASCO is committed to addressing the needs of sexual and gender minority (SGM) populations as a diverse group at risk for receiving disparate care and having suboptimal experiences, including discrimination, throughout the cancer care continuum. This position statement outlines five areas of recommendations to address the needs of both SGM populations affected by cancer and members of the oncology workforce who identify as SGM: (1) patient education and support; (2) workforce development and diversity; (3) quality improvement strategies; (4) policy solutions; and (5) research strategies. In making these recommendations, the Society calls for increased outreach and educational support for SGM patients; increased SGM cultural competency training for providers; improvement of quality-of-care metrics that include sexual orientation and gender information variables; and increased data collection to inform future work addressing the needs of SGM communities.
... contractual clauses or provisions 2. Tying sales (either explicitly or implicitly through pricing policies) of... Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings... (the ``Agencies'') are proposing an enforcement policy regarding the application of the antitrust laws...
Huynh, Que-Lam; Devos, Thierry; Altman, Hannah R.
We sought to document that the extent to which different ethnic groups are perceived as embodying the American identity is more strongly linked to anti-minority policy attitudes and acculturation ideologies among majority group members (European Americans) than among minority group members (Asian Americans or Latino/as). Participants rated 13 attributes of the American identity as they pertain to different ethnic groups, and reported their endorsement of policy attitudes and acculturation ideologies. We found a relative consensus across ethnic groups regarding defining components of the American identity. However, European Americans were perceived as more prototypical of this American identity than ethnic minorities, especially by European American raters. Moreover, for European Americans but not for ethnic minorities, relative ingroup prototypicality was related to anti-minority policy attitudes and acculturation ideologies. These findings suggest that for European Americans, perceptions of ethnic group prototypicality fulfill an instrumental function linked to preserving their group interests and limiting the rights afforded to ethnic minorities. PMID:26347578
Konstam, Marvin A; Kiernan, Michael S; Bernstein, Daniel; Bozkurt, Biykem; Jacob, Miriam; Kapur, Navin K; Kociol, Robb D; Lewis, Eldrin F; Mehra, Mandeep R; Pagani, Francis D; Raval, Amish N; Ward, Carey
The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality. The purpose of this scientific statement is to provide guidance on the assessment and management of RHF. The writing group used systematic literature reviews, published translational and clinical studies, clinical practice guidelines, and expert opinion/statements to summarize existing evidence and to identify areas of inadequacy requiring future research. The panel reviewed the most relevant adult medical literature excluding routine laboratory tests using MEDLINE, EMBASE, and Web of Science through September 2017. The document is organized and classified according to the American Heart Association to provide specific suggestions, considerations, or reference to contemporary clinical practice recommendations. Chronic RHF is associated with decreased exercise tolerance, poor functional capacity, decreased cardiac output and progressive end-organ damage (caused by a combination of end-organ venous congestion and underperfusion), and cachexia resulting from poor absorption of nutrients, as well as a systemic proinflammatory state. It is the principal cause of death in patients with pulmonary arterial hypertension. Similarly, acute RHF is associated with hemodynamic instability and is the primary cause of death in patients presenting with massive pulmonary embolism, RV myocardial infarction, and postcardiotomy shock associated with cardiac surgery. Functional assessment of the right side of the heart can be hindered by its complex geometry. Multiple
Edwards, Beatrice J; Hellstein, John W; Jacobsen, Peter L; Kaltman, Steven; Mariotti, Angelo; Migliorati, Cesar A
and Overview. In 2005, the American Dental Association (ADA) Council on Scientific Affairs convened an expert panel to develop clinical recommendations for dentists treating patients who are receiving oral bisphosphonate therapy. The Journal of the American Dental Association published the resulting report in 2006. This 2008 advisory statement is the first of projected periodic updates of the 2006 clinical recommendations. This 2008 advisory statement concludes, on the basis of a review of the current literature, that for patients receiving bisphosphonate therapy, the risk of developing bisphosphonate-associated osteonecrosis (BON) of the jaw apparently remains low. It also newly concludes that current screening and diagnostic tests are unreliable for predicting a patient's risk of developing the condition. This statement updates the 2006 recommendations regarding general dentistry, management of periodontal diseases, implant placement and maintenance, oral and maxillofacial surgery, endodontics, restorative dentistry and prosthodontics, and orthodontics.
Full Text Available This article reviews the development of the Ninth Clinical Consensus Statement by SIBEN (the Ibero-American of Neonatology on “Early Detection with Pulse Oximetry (SpO2 of Hypoxemic Neonatal Conditions”. It describes the process of the consensus, and the conclusions and recommendations for screening newborns with pulse oximetry.
P.P.L. Berkers (Pauwke)
textabstractThis article addresses the extent and ways in which ethnic diversity has been part of American, Dutch and German national literary policy from 1965 until 2005. By analyzing the content of policy documents of the National Endowment of the Arts and the Dutch and German Literary Fund, I
Smith, David; Baston, Lewis; Bocock, Jean; Scott, Peter
Investigates history of US influence on UK higher education policy and practice during the second half of the 20th century within broader context of cultural and policy encounters between the two nations during these years and considers relevance of the contested concept of "Americanization." Concludes that US exercised an important but…
Cardiovascular Consequences of Childhood Secondhand Tobacco Smoke Exposure: Prevailing Evidence, Burden, and Racial and Socioeconomic Disparities: A Scientific Statement From the American Heart Association.
Raghuveer, Geetha; White, David A; Hayman, Laura L; Woo, Jessica G; Villafane, Juan; Celermajer, David; Ward, Kenneth D; de Ferranti, Sarah D; Zachariah, Justin
vulnerable population. This statement reviews relevant data from epidemiological studies, laboratory-based experiments, and controlled behavioral trials concerning SHS and cardiovascular disease risk in children. Information on the effects of SHS exposure on the cardiovascular system in animal and pediatric studies, including vascular disruption and platelet activation, oxidation and inflammation, endothelial dysfunction, increased vascular stiffness, changes in vascular structure, and autonomic dysfunction, is examined. The epidemiological, observational, and experimental evidence accumulated to date demonstrates the detrimental cardiovascular consequences of SHS exposure in children. Increased awareness of the adverse, lifetime cardiovascular consequences of childhood SHS may facilitate the development of innovative individual, family-centered, and community health interventions to reduce and ideally eliminate SHS exposure in the vulnerable pediatric population. This evidence calls for a robust public health policy that embraces zero tolerance of childhood SHS exposure. © 2016 American Heart Association, Inc.
Weng, Suzie S; Spaulding-Givens, Jennifer
This qualitative study used snowball sampling of individuals known to provide informal assistance to Asian American community members with their mental health problems in a locality in the South where there has been an exponential increase of the Asian American population. The major themes found include: (1) the existence of cultural, language, knowledge, and transportation barriers and the importance of policy in addressing them; (2) the impact of the model minority myth and the need for inclusive policymaking; and (3) the unique service and policy needs of immigrants. Findings demonstrate the importance and value of including diverse Asian American individuals in mental health policymaking efforts.
Hennessey, James V; Garber, Jeffrey R; Woeber, Kenneth A; Cobin, Rhoda; Klein, Irwin
Hypothyroidism and hyperthyroidism can be readily diagnosed and can be treated in a safe, cost-effective manner. Professional organizations have given guidance on how and when to employ thyroid-stimulating hormone testing for the detection of thyroid dysfunction. Most recently, the United States Preventive Services Task Force did not endorse screening for thyroid dysfunction based on a lack of proven benefit and potential harm of treating those with thyroid dysfunction, which is mostly subclinical disease. The American Association of Clinical Endocrinologists (AACE) is concerned that this may discourage physicians from testing for thyroid dysfunction when clinically appropriate. Given the lack of specificity of thyroid-associated symptoms, the appropriate diagnosis of thyroid disease requires biochemical confirmation. The Thyroid Scientific Committee of the AACE has produced this White Paper to highlight the important difference between screening and case-based testing in the practice of clinical medicine. We recommend that thyroid dysfunction should be frequently considered as a potential etiology for many of the nonspecific complaints that physicians face daily. The application and success of safe and effective interventions are dependent on an accurate diagnosis. We, therefore, advocate for an aggressive case-finding approach, based on identifying those persons most likely to have thyroid disease that will benefit from its treatment.
The American Nurses Association (ANA) believes that nurses should reject assignment that puts patients or themselves in serious, immediate jeopardy. ANA supports the nurses obligation to reject an assignment in these situations even where there is not a specific legal protection for rejecting such an assignment. The professional obligations to the nurse to safeguard clients are grounded in the ethical norms of the profession, the Standards of Clinical Nursing Practice and state nurse practice acts.
Licata, Angelo A; Binkley, Neil; Petak, Steven M; Camacho, Pauline M
High-quality dual-energy X-ray absorptiometry (DXA) scans are necessary for accurate diagnosis of osteoporosis and monitoring of therapy; however, DXA scan reports may contain errors that cause confusion about diagnosis and treatment. This American Association of Clinical Endocrinologists/American College of Endocrinology consensus statement was generated to draw attention to many common technical problems affecting DXA report conclusions and provide guidance on how to address them to ensure that patients receive appropriate osteoporosis care. The DXA Writing Committee developed a consensus based on discussion and evaluation of available literature related to osteoporosis and osteodensitometry. Technical errors may include errors in scan acquisition and/or analysis, leading to incorrect diagnosis and reporting of change over time. Although the International Society for Clinical Densitometry advocates training for technologists and medical interpreters to help eliminate these problems, many lack skill in this technology. Suspicion that reports are wrong arises when clinical history is not compatible with scan interpretation (e.g., dramatic increase/decrease in a short period of time; declines in previously stable bone density after years of treatment), when different scanners are used, or when inconsistent anatomic sites are used for monitoring the response to therapy. Understanding the concept of least significant change will minimize erroneous conclusions about changes in bone density. Clinicians must develop the skills to differentiate technical problems, which confound reports, from real biological changes. We recommend that clinicians review actual scan images and data, instead of relying solely on the impression of the report, to pinpoint errors and accurately interpret DXA scan images. AACE = American Association of Clinical Endocrinologists; BMC = bone mineral content; BMD = bone mineral density; DXA = dual-energy X-ray absorptiometry; ISCD = International
Thurston, George D; Kipen, Howard; Annesi-Maesano, Isabella; Balmes, John; Brook, Robert D; Cromar, Kevin; De Matteis, Sara; Forastiere, Francesco; Forsberg, Bertil; Frampton, Mark W; Grigg, Jonathan; Heederik, Dick; Kelly, Frank J; Kuenzli, Nino; Laumbach, Robert; Peters, Annette; Rajagopalan, Sanjay T; Rich, David; Ritz, Beate; Samet, Jonathan M; Sandstrom, Thomas; Sigsgaard, Torben; Sunyer, Jordi; Brunekreef, Bert
The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies.This current report seeks to integrate the latest science into a general framework for interpreting the adversity of the human health effects of air pollution. Rather than trying to provide a catalogue of what is and what is not an adverse effect of air pollution, we propose a set of considerations that can be applied in forming judgments of the adversity of not only currently documented, but also emerging and future effects of air pollution on human health. These considerations are illustrated by the inclusion of examples for different types of health effects of air pollution. Copyright ©ERS 2017.
Thurston, George D.; Kipen, Howard; Annesi-Maesano, Isabella; Balmes, John; Brook, Robert D.; Cromar, Kevin; De Matteis, Sara; Forastiere, Francesco; Forsberg, Bertil; Frampton, Mark W.; Grigg, Jonathan; Heederik, Dick; Kelly, Frank J.; Kuenzli, Nino; Laumbach, Robert; Peters, Annette; Rajagopalan, Sanjay T.; Rich, David; Ritz, Beate; Samet, Jonathan M.; Sandstrom, Thomas; Sigsgaard, Torben; Sunyer, Jordi; Brunekreef, Bert
The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies. This current report seeks to integrate the latest science into a general framework for interpreting the adversity of the human health effects of air pollution. Rather than trying to provide a catalogue of what is and what is not an adverse effect of air pollution, we propose a set of considerations that can be applied in forming judgments of the adversity of not only currently documented, but also emerging and future effects of air pollution on human health. These considerations are illustrated by the inclusion of examples for different types of health effects of air pollution. PMID:28077473
Children with chronic medical conditions rely on complex management plans for problems that cause them to be at increased risk for suboptimal outcomes in emergency situations. The emergency information form (EIF) is a medical summary that describes medical condition(s), medications, and special health care needs to inform health care providers of a child's special health conditions and needs so that optimal emergency medical care can be provided. This statement describes updates to EIFs, including computerization of the EIF, expanding the potential benefits of the EIF, quality-improvement programs using the EIF, the EIF as a central repository, and facilitating emergency preparedness in disaster management and drills by using the EIF.
Musunuru, Kiran; Sheikh, Farah; Gupta, Rajat M; Houser, Steven R; Maher, Kevin O; Milan, David J; Terzic, Andre; Wu, Joseph C
Induced pluripotent stem cells (iPSCs) offer an unprece-dented opportunity to study human physiology and disease at the cellular level. They also have the potential to be leveraged in the practice of precision medicine, for example, personalized drug testing. This statement comprehensively describes the provenance of iPSC lines, their use for cardiovascular disease modeling, their use for precision medicine, and strategies through which to promote their wider use for biomedical applications. Human iPSCs exhibit properties that render them uniquely qualified as model systems for studying human diseases: they are of human origin, which means they carry human genomes; they are pluripotent, which means that in principle, they can be differentiated into any of the human body's somatic cell types; and they are stem cells, which means they can be expanded from a single cell into millions or even billions of cell progeny. iPSCs offer the opportunity to study cells that are genetically matched to individual patients, and genome-editing tools allow introduction or correction of genetic variants. Initial progress has been made in using iPSCs to better understand cardiomyopathies, rhythm disorders, valvular and vascular disorders, and metabolic risk factors for ischemic heart disease. This promising work is still in its infancy. Similarly, iPSCs are only just starting to be used to identify the optimal medications to be used in patients from whom the cells were derived. This statement is intended to (1) summarize the state of the science with respect to the use of iPSCs for modeling of cardiovascular traits and disorders and for therapeutic screening; (2) identify opportunities and challenges in the use of iPSCs for disease modeling and precision medicine; and (3) outline strategies that will facilitate the use of iPSCs for biomedical applications. This statement is not intended to address the use of stem cells as regenerative therapy, such as transplantation into the body to
The conventional view of emigration holds that it represents a loss of resources from a country and that the only possible policy response is to discourage new emigration while promoting return of those who have left. A new policy is needed based on a fuller understanding of the potential benefits of emigration for the country of origin. The cost of emigration is usually counted as the loss of educational investment, the loss of labor force, and the loss of the contributions to development that would have been made by talented emigrants. But such views usually do not include a serious treatment of the economic problems of labor supply and demand in general or of skilled labor in particular. Underemployment or unemployment of highly educated persons and overproduction of educated persons are problems throughout Latin America and much of the developing world. A truer evaluation of the costs of education which considered decreasing marginal costs rather than average costs per student, nominally variable costs that actually behave as fixed costs, and an adequate assignment of costs for students leaving school before graduating would lead to much lower estimates of average cost per university student in Latin America. Significant emigration may actually result indirectly in an increase in national income by reducing pressure on the labor market and allowing wages to rise for remaining workers. Remittances for emigrants and repatriation of savings may contribute significantly to national income and balance of payments, and may compensate for or even exceed the economic losses of emigration. National policy for emigrants should aim at maximizing the economic benefits of emigration by providing incentives for the accumulation of capital obtained abroad and its transfer to the country of origin. The 1st major goal of emigration policy should be to maintain affective and social ties between the emigrant and the country of origin as a necessary condition for channeling
Wijdicks, Eelco F M; Sheth, Kevin N; Carter, Bob S; Greer, David M; Kasner, Scott E; Kimberly, W Taylor; Schwab, Stefan; Smith, Eric E; Tamargo, Rafael J; Wintermark, Max
There are uncertainties surrounding the optimal management of patients with brain swelling after an ischemic stroke. Guidelines are needed on how to manage this major complication, how to provide the best comprehensive neurological and medical care, and how to best inform families facing complex decisions on surgical intervention in deteriorating patients. This scientific statement addresses the early approach to the patient with a swollen ischemic stroke in a cerebral or cerebellar hemisphere. The writing group used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge. The panel reviewed the most relevant articles on adults through computerized searches of the medical literature using MEDLINE, EMBASE, and Web of Science through March 2013. The evidence is organized within the context of the American Heart Association framework and is classified according to the joint American Heart Association/American College of Cardiology Foundation and supplementary American Heart Association Stroke Council methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive American Heart Association internal peer review. Clinical criteria are available for hemispheric (involving the entire middle cerebral artery territory or more) and cerebellar (involving the posterior inferior cerebellar artery or superior cerebellar artery) swelling caused by ischemic infarction. Clinical signs that signify deterioration in swollen supratentorial hemispheric ischemic stroke include new or further impairment of consciousness, cerebral ptosis, and changes in pupillary size. In swollen cerebellar infarction, a decrease in level of consciousness occurs as a result of brainstem compression and therefore may
Smith, Benjamin D.; Arthur, Douglas W.; Buchholz, Thomas A.; Haffty, Bruce G.; Hahn, Carol A.; Hardenbergh, Patricia H.; Julian, Thomas B.; Marks, Lawrence B.; Todor, Dorin A. Ph.D.; Vicini, Frank A.; Whelan, Timothy J.; White, Julia; Wo, Jennifer Y.; Harris, Jay R.
Purpose: To present guidance for patients and physicians regarding the use of accelerated partial-breast irradiation (APBI), based on current published evidence complemented by expert opinion. Methods and Materials: A systematic search of the National Library of Medicine's PubMed database yielded 645 candidate original research articles potentially applicable to APBI. Of these, 4 randomized trials and 38 prospective single-arm studies were identified. A Task Force composed of all authors synthesized the published evidence and, through a series of meetings, reached consensus regarding the recommendations contained herein. Results: The Task Force proposed three patient groups: (1) a 'suitable' group, for whom APBI outside of a clinical trial is acceptable, (2) a 'cautionary' group, for whom caution and concern should be applied when considering APBI outside of a clinical trial, and (3) an 'unsuitable' group, for whom APBI outside of a clinical trial is not generally considered warranted. Patients who choose treatment with APBI should be informed that whole-breast irradiation (WBI) is an established treatment with a much longer track record that has documented long-term effectiveness and safety. Conclusion: Accelerated partial-breast irradiation is a new technology that may ultimately demonstrate long-term effectiveness and safety comparable to that of WBI for selected patients with early breast cancer. This consensus statement is intended to provide guidance regarding the use of APBI outside of a clinical trial and to serve as a framework to promote additional clinical investigations into the optimal role of APBI in the treatment of breast cancer.
Watson, Nathaniel F; Badr, M Safwan; Belenky, Gregory; Bliwise, Donald L; Buxton, Orfeu M; Buysse, Daniel; Dinges, David F; Gangwisch, James; Grandner, Michael A; Kushida, Clete; Malhotra, Raman K; Martin, Jennifer L; Patel, Sanjay R; Quan, Stuart F; Tasali, Esra
The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. © 2015 Associated Professional Sleep Societies, LLC.
Caruana, Carmel J; Tsapaki, Virginia; Damilakis, John; Brambilla, Marco; Martín, Guadalupe Martín; Dimov, Asen; Bosmans, Hilde; Egan, Gillian; Bacher, Klaus; McClean, Brendan
On 5 December 2013 the European Council promulgated Directive 2013/59/EURATOM. This Directive is important for Medical Physicists and Medical Physics Experts as it puts the profession on solid foundations and describes it more comprehensively. Much commentary regarding the role and competences has been developed in the context of the European Commission project "European Guidelines on the Medical Physics Expert" published as Radiation Protection Report RP174. The guidelines elaborate on the role and responsibilities under 2013/59/EURATOM in terms of a mission statement and competence profile in the specialty areas of Medical Physics relating to medical radiological services, namely Diagnostic and Interventional Radiology, Radiation Oncology and Nuclear Medicine. The present policy statement summarises the provisions of Directive 2013/59/EURATOM regarding the role and competences, reiterates the results of the European Guidelines on the Medical Physics Expert document relating to role and competences of the profession and provides additional commentary regarding further issues arising following the publication of the RP174 guidelines. Copyright © 2018. Published by Elsevier Ltd.
In order to establish a safe environment for nurses and patients, the American Nurses Association (ANA) supports actions and policies that result in the elimination of manual patient handling. Patient handling, such as lifting, repositioning, and transferring, has conventionally been performed by nurses. The performance of these tasks exposes nurses to increased risk for work-related musculoskeletal disorders. With the development of assistive equipment, such as lift and transfer devices, the risk of musculoskeletal injury can be significantly reduced. Effective use of assistive equipment and devices for patient handling creates a safe healthcare environment by separating the physical burden from the nurse and ensuring the safety, comfort, and dignity of the patient.
Thomas, D Travis; Erdman, Kelly Anne; Burke, Louise M
It is the position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy of Nutrition and Dietetics, Dietitians of Canada (DC), and American College of Sports Medicine (ACSM), other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian/nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics (CSSD) is a registered dietitian/nutritionist and a credentialed sports nutrition expert.
Lichtenstein, Alice H; Appel, Lawrence J; Brands, Michael; Carnethon, Mercedes; Daniels, Stephen; Franch, Harold A; Franklin, Barry; Kris-Etherton, Penny; Harris, William S; Howard, Barbara; Karanja, Njeri; Lefevre, Michael; Rudel, Lawrence; Sacks, Frank; Van Horn, Linda; Winston, Mary; Wylie-Rosett, Judith
Improving diet and lifestyle is a critical component of the American Heart Association's strategy for cardiovascular disease risk reduction in the general population. This document presents recommendations designed to meet this objective. Specific goals are to consume an overall healthy diet; aim for a healthy body weight; aim for recommended levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides; aim for normal blood pressure; aim for a normal blood glucose level; be physically active; and avoid use of and exposure to tobacco products. The recommendations are to balance caloric intake and physical activity to achieve and maintain a healthy body weight; consume a diet rich in vegetables and fruits; choose whole-grain, high-fiber foods; consume fish, especially oily fish, at least twice a week; limit intake of saturated fat to foods with added sugars; choose and prepare foods with little or no salt; if you consume alcohol, do so in moderation; and when you eat food prepared outside of the home, follow these Diet and Lifestyle Recommendations. By adhering to these diet and lifestyle recommendations, Americans can substantially reduce their risk of developing cardiovascular disease, which remains the leading cause of morbidity and mortality in the United States.
Exposure to violence in media, including television, movies, music, and video games, represents a significant risk to the health of children and adolescents. Extensive research evidence indicates that media violence can contribute to aggressive behavior, desensitization to violence, nightmares, and fear of being harmed. Pediatricians should assess their patients' level of media exposure and intervene on media-related health risks. Pediatricians and other child health care providers can advocate for a safer media environment for children by encouraging media literacy, more thoughtful and proactive use of media by children and their parents, more responsible portrayal of violence by media producers, and more useful and effective media ratings. Office counseling has been shown to be effective.
From a health viewpoint, early sexual activity among US adolescents is a potential problem because of the risk of pregnancy and sexually transmitted infections. New evidence points to the media adolescents use frequently (television, music, movies, magazines, and the Internet) as important factors in the initiation of sexual intercourse. There is a major disconnect between what mainstream media portray-casual sex and sexuality with no consequences-and what children and teenagers need-straightforward information about human sexuality and the need for contraception when having sex. Television, film, music, and the Internet are all becoming increasingly sexually explicit, yet information on abstinence, sexual responsibility, and birth control remains rare. It is unwise to promote "abstinence-only" sex education when it has been shown to be ineffective and when the media have become such an important source of information about "nonabstinence." Recommendations are presented to help pediatricians address this important issue.
The European Federation of Organisations for Medical Physics Policy Statement No 14, The role of the Medical Physicist in the management of safety within the magnetic resonance imaging environment, EFOMP recommendations
Hand, J.; Bosmans, H.; Caruana, C.; Keevil, S.; Norris, David Gordon; Padovani, R.; Speck, O.
This European Federation of Organisations for Medical Physics (EFOMP) Policy Statement outlines the way in which a Safety Management System can be developed for MRI units. The Policy Statement can help eliminate or at least minimize accidents or incidents in the magnetic resonance environment and is
Hill, Joseph A; Ardehali, Reza; Clarke, Kimberli Taylor; Del Zoppo, Gregory J; Eckhardt, Lee L; Griendling, Kathy K; Libby, Peter; Roden, Dan M; Sadek, Hesham A; Seidman, Christine E; Vaughan, Douglas E
Recent decades have witnessed robust successes in conquering the acutely lethal manifestations of heart and vascular diseases. Many patients who previously would have died now survive. Lifesaving successes like these provide a tremendous and easily recognized benefit to individuals and society. Although cardiovascular mortality has declined, the devastating impact of chronic heart disease and comorbidities on quality of life and healthcare resources continues unabated. Future strides, extending those made in recent decades, will require continued research into mechanisms underlying disease prevention, pathogenesis, progression, and therapeutic intervention. However, severe financial constraints currently jeopardize these efforts. To chart a path for the future, this report analyzes the challenges and opportunities we face in continuing the battle against cardiovascular disease and highlights the return on societal investment afforded by fundamental cardiovascular research. © 2017 American Heart Association, Inc.
Purcell, Laura K; Leblanc, Claire Ma
Thousands of boys and girls younger than 19 years of age participate in boxing in North America. Although boxing provides benefits for participants, including exercise, self-discipline and self-confidence, the sport of boxing encourages and rewards deliberate blows to the head and face. Participants in boxing are at risk of head, face and neck injuries, including chronic and even fatal neurological injuries. Concussions are one of the most common injuries occurring in boxing. Because of the risk of head and facial injuries, the Canadian Paediatric Society and the American Academy of Pediatrics vigorously oppose boxing as a sport for children and adolescents. These organizations recommend that physicians oppose boxing in youth and encourage patients to participate in alternative sports in which intentional head blows are not central to the sport.
The US decision since the 1960s to link foreign policy with family planning and population control is noteworthy for its intention to change the demographic structure of foreign countries and the magnitude of the initiative. The current population ideologies are part of the legacy of 19th century views on science, morality, and political economy. Strong constraints were placed on US foreign policy since World War II, particularly due to presumptions about the role of developing countries in Cold War ideology. Domestic debates revolved around issues of feminism, birth control, abortion, and family political issues. Since the 1960s, environmental degradation and resource depletion were an added global dimension of US population issues. Between 1935 and 1958 birth control movements evolved from the ideologies of utopian socialists, Malthusians, women's rights activists, civil libertarians, and advocates of sexual freedom. There was a shift from acceptance of birth control to questions about the role of national government in supporting distribution of birth control. Immediately postwar the debates over birth control were outside political circles. The concept of family planning as a middle class family issue shifted the focus from freeing women from the burdens of housework to making women more efficient housewives. Family planning could not be taken as a national policy concern without justification as a major issue, a link to national security, belief in the success of intervention, and a justifiable means of inclusion in public policy. US government involvement began with agricultural education, technological assistance, and economic development that would satisfy the world's growing population. Cold War politics forced population growth as an issue to be considered within the realm of foreign policy and diplomacy. US government sponsored family planning was enthusiastic during 1967-74 but restrained during the 1980s. The 1990s has been an era of redefinition of
The American Meteorological Society (AMS) has prepared a draft policy statement on geoengineering the climate system, which the AMS Council is considering for approval. The statement notes, “Geoengineering will not substitute for either aggressive mitigation or proactive adaptation. It could contribute to a comprehensive risk management strategy to slow climate change and alleviate its negative impacts, but the potential for adverse and unintended consequences implies a need for adequate research, appropriate regulation, and transparent consideration.” The statement, if adopted, indicates that AMS recommends enhanced research on the scientific and technological potential for geoengineering the climate system; additional study of the historical, ethical, legal, political, and societal aspects of the geoengineering issues; and the development and analysis of policy options to promote transparency and international cooperation in exploring geoengineering options along with restrictions on reckless efforts to manipulate the climate system. AMS is accepting comments on the draft statement until 23 April. For more information, visit http://ametsoc.org/policy/draftstatements/index.html#draft.
The United States Government policy relating to nuclear fuel reprocessing, which was announced by President Carter on April 7, 1977, provides for an indefinite deferral of reprocessing, and thus commits light water reactor (LWR) plants to a once-through fuel cycle during that indefinite period. In a subsequent action implementing that policy, the Department of Energy (DOE) on October 18, 1977 announced a spent fuel policy which would enable domestic, and on a selective basis, foreign utilities to deliver spent fuel to the US Government for interim storage and final geologic disposal, and pay the Government a fee for such services. This volume addresses itself to whether the fee charged for these services, by its level or its structure, would have any effect on the environmental impacts of implementing the Spent Fuel Policy itself. This volume thus analyzes the fee and various alternatives to determine the interaction between the fee and the degree of participation by domestic utilities and foreign countries in the proposed spent fuel program for implementing the Spent Fuel Policy. It also analyzes the effect, if any, of the fee on the growth of nuclear power
White, Eric S; Borok, Zea; Brown, Kevin K; Eickelberg, Oliver; Guenther, Andreas; Jenkins, R Gisli; Kolb, Martin; Martinez, Fernando J; Roman, Jesse; Sime, Patricia
Pulmonary fibrosis encompasses a group of lung-scarring disorders that occur owing to known or unknown insults and accounts for significant morbidity and mortality. Despite intense investigation spanning decades, much remains to be learned about the natural history, pathophysiology, and biologic mechanisms of disease. To identify the most pressing research needs in the lung fibrosis community and to provide a roadmap of priorities to investigators, funding agencies, patient advocacy groups, and other interested stakeholders. An ad hoc international working group of the American Thoracic Society with experience in clinical, translational, and bench-based research in fibrotic lung diseases was convened. The group used an iterative consensus process to identify successes and challenges in pulmonary fibrosis research. The group identified five main priority areas in which substantial resources should be invested to advance our understanding and to develop novel therapies for patients with pulmonary fibrosis. These priorities include develop newer models of human lung fibrosis, engage current and new stakeholders to provide sustained funding for the initiatives, create a global infrastructure for storing patient-derived materials, establish collaborative preclinical and clinical research networks in fibrotic lung disease, and create a global lung fibrosis initiative that unites these multifaceted efforts into a single virtual umbrella structure. Despite recent advances in the treatment of some forms of lung fibrosis, many gaps in knowledge about natural history, pathophysiology, and treatment remain. Investment in the research priorities enumerated above will help address these shortcomings and enhance patient care worldwide.
Yeh, Michael W; Bauer, Andrew J; Bernet, Victor A; Ferris, Robert L; Loevner, Laurie A; Mandel, Susan J; Orloff, Lisa A; Randolph, Gregory W; Steward, David L
The success of surgery for thyroid cancer hinges on thorough and accurate preoperative imaging, which enables complete clearance of the primary tumor and affected lymph node compartments. This working group was charged by the Surgical Affairs Committee of the American Thyroid Association to examine the available literature and to review the most appropriate imaging studies for the planning of initial and revision surgery for thyroid cancer. Ultrasound remains the most important imaging modality in the evaluation of thyroid cancer, and should be used routinely to assess both the primary tumor and all associated cervical lymph node basins preoperatively. Positive lymph nodes may be distinguished from normal nodes based upon size, shape, echogenicity, hypervascularity, loss of hilar architecture, and the presence of calcifications. Ultrasound-guided fine-needle aspiration of suspicious lymph nodes may be useful in guiding the extent of surgery. Cross-sectional imaging (computed tomography with contrast or magnetic resonance imaging) may be considered in select circumstances to better characterize tumor invasion and bulky, inferiorly located, or posteriorly located lymph nodes, or when ultrasound expertise is not available. The above recommendations are applicable to both initial and revision surgery. Functional imaging with positron emission tomography (PET) or PET-CT may be helpful in cases of recurrent cancer with positive tumor markers and negative anatomic imaging.
Sakauye, Kenneth M; Streim, Joel E; Kennedy, Gary J; Kirwin, Paul D; Llorente, Maria D; Schultz, Susan K; Srinivasan, Shilpa
The Disaster Preparedness Task Force of the American Association for Geriatric Psychiatry was formed after Hurricane Katrina devastated New Orleans to identify and address needs of the elderly after the disaster that led to excess health disability and markedly increased rates of hopelessness, suicidality, serious mental illness (reported to exceed 60% from baseline levels), and cognitive impairment. Substance Abuse and Mental Health Services Administration (SAMHSA) outlines risk groups which fail to address later effects from chronic stress and loss and disruption of social support networks. Range of interventions recommended for Preparation, Early Response, and Late Response reviewed in the report were not applied to elderly for a variety of reasons. It was evident that addressing the needs of elderly will not be made without a stronger mandate to do so from major governmental agencies (Federal Emergency Management Agency [FEMA] and SAMHSA). The recommendation to designate frail elderly and dementia patients as a particularly high-risk group and a list of specific recommendations for research and service and clinical reference list are provided.
Culver, Bruce H; Graham, Brian L; Coates, Allan L; Wanger, Jack; Berry, Cristine E; Clarke, Patricia K; Hallstrand, Teal S; Hankinson, John L; Kaminsky, David A; MacIntyre, Neil R; McCormack, Meredith C; Rosenfeld, Margaret; Stanojevic, Sanja; Weiner, Daniel J
The American Thoracic Society committee on Proficiency Standards for Pulmonary Function Laboratories has recognized the need for a standardized reporting format for pulmonary function tests. Although prior documents have offered guidance on the reporting of test data, there is considerable variability in how these results are presented to end users, leading to potential confusion and miscommunication. A project task force, consisting of the committee as a whole, was approved to develop a new Technical Standard on reporting pulmonary function test results. Three working groups addressed the presentation format, the reference data supporting interpretation of results, and a system for grading quality of test efforts. Each group reviewed relevant literature and wrote drafts that were merged into the final document. This document presents a reporting format in test-specific units for spirometry, lung volumes, and diffusing capacity that can be assembled into a report appropriate for a laboratory's practice. Recommended reference sources are updated with data for spirometry and diffusing capacity published since prior documents. A grading system is presented to encourage uniformity in the important function of test quality assessment. The committee believes that wide adoption of these formats and their underlying principles by equipment manufacturers and pulmonary function laboratories can improve the interpretation, communication, and understanding of test results.
Tong, Elisa K; Tang, Hao; Tsoh, Janice; Wong, Candice; Chen, Moon S.
Background California has significantly decreased racial/ethnic and educational disparities in smoke-free home and indoor work policies. California's ethnic-specific surveys present an opportunity to disaggregate data and examine the impact of California's smoke-free social norm campaign for Asian-American women. Methods The California Tobacco Use Surveys for Chinese Americans and Korean Americans were conducted in 2003 and analyzed in 2008 to compare women with lower (≤ high school graduate) or higher education status for smoke-free policy adoption and enforcement. Results Lower-educated and higher-educated women had similar proportions of smoke-free policies at home (58%) or indoor work (90%). However, lower-educated women were more likely than higher-educated women to report anyone ever smoking at home (OR=1.62, 95% CI=1.06, 2.48, p=0.03) and exposure during the past 2 weeks at an indoor workplace (OR=2.43, 95% CI= 1.30, 4.55, p=0.005), even after controlling for ethnicity, smoke-free policy, knowledge about the health consequences of secondhand smoke exposure, and acculturation. There was no interaction between education and knowledge about secondhand smoke health harms. Conclusions The intended consequences of California's tobacco-control efforts have resulted in similar rates of smoke-free policies at home and in indoor work environments among Asian-American women across educational levels. However, an unintended consequence of this success is a disparity in enforcement by educational status, with lower-educated Asian-American women reporting greater smoke exposure despite similar rates of knowledge about the health consequences of secondhand smoke exposure. Besides establishing policies, lower-educated Asian-American women may need to be empowered to assert and enforce their right to smoke-free environments. PMID:19591754
Tong, Elisa K; Tang, Hao; Tsoh, Janice; Wong, Candice; Chen, Moon S
California has significantly decreased racial/ethnic and educational disparities in smoke-free home and indoor work policies. California's ethnic-specific surveys present an opportunity to disaggregate data and examine the impact of California's smoke-free social norm campaign for Asian-American women. The California Tobacco Use Surveys for Chinese Americans and Korean Americans were conducted in 2003 and analyzed in 2008 to compare women with lower (education status for smoke-free policy adoption and enforcement. Lower-educated and higher-educated women had similar proportions of smoke-free policies at home (58%) or indoor work (90%). However, lower-educated women were more likely than higher-educated women to report anyone ever smoking at home (OR=1.62, 95% CI=1.06, 2.48, p=0.03) and exposure during the past 2 weeks at an indoor workplace (OR=2.43, 95% CI= 1.30, 4.55, p=0.005), even after controlling for ethnicity, smoke-free policy, knowledge about the health consequences of secondhand smoke exposure, and acculturation. There was no interaction between education and knowledge about secondhand smoke health harms. The intended consequences of California's tobacco-control efforts have resulted in similar rates of smoke-free policies at home and in indoor work environments among Asian-American women across educational levels. However, an unintended consequence of this success is a disparity in enforcement by educational status, with lower-educated Asian-American women reporting greater smoke exposure despite similar rates of knowledge about the health consequences of secondhand smoke exposure. Besides establishing policies, lower-educated Asian-American women may need to be empowered to assert and enforce their right to smoke-free environments.
American Nurses' Association, New York, NY.
TO SOLVE THE NURSING PERSONNEL SHORTAGE, THE AMERICAN NURSES' ASSOCIATION RECOMMENDED--(1) THE FIRST PRIORITY FOR FEDERAL MONIES FOR TRAINING HEALTH WORKERS FOR NURSING SERVICES SHOULD BE TO PREPARE REGISTERED NURSES FOR TEACHING, SUPERVISION, AND ADMINISTRATION, (2) A CONCERTED EFFORT SHOULD BE MADE TO RECRUIT YOUNG PEOPLE AND TO ATTRACT INACTIVE…
Healthcare facility mergers and acquisitions are becoming more common as the industry consolidates. Many critical issues must be considered in mergers and acquisitions, including the management of patient health information. In addition to operational issues, licensure, regulatory, and accreditation requirements must be addressed. To ensure availability of health information to all legitimate users, patient records should be consolidated or linked in the master patient index. A record retention policy should be developed and implemented to meet user needs and assure compliance with legal, regulatory, and accreditation requirements. If health information from closed facilities will be stored for a period of time, its integrity and confidentiality must be preserved, and it must be readily accessible for patient care. The compatibility and functionality of existing information systems should be assessed, and a plan should be formulated for integration of the systems to the extent possible. Such integration may be essential for the organization to successfully meet the demands of integrated delivery systems. Existing databases should be maintained in an accessible form to meet anticipated future needs.
Pincus, Harold Alan; Pike, Kathleen M; Spaeth-Rublee, Brigitta; Elinson, Lynn
As the size of the elderly population increases, so do the challenges of and barriers to high-quality, affordable health care. The Health and Aging Policy Fellows (HAPF) Program is designed to provide health and aging professionals with the skills and experience to help lead the effort in reducing these barriers and shaping a healthy and productive future for older Americans. Since its inception in 2008, the program has affected not only the fellows who participate, but also the field of health and aging policy. Work needs to be done to sustain this program so that more fellows can participate and sound policies for the elderly population can continue to be shaped and improved. This report describes the HAPF Program, including its background (rationale, description, partners, progress, effect), lessons learned, challenges and solutions, and policy implications. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Harmon, Kimberly G; Drezner, Jonathan A; Gammons, Matthew; Guskiewicz, Kevin M; Halstead, Mark; Herring, Stanley A; Kutcher, Jeffrey S; Pana, Andrea; Putukian, Margot; Roberts, William O
PURPOSE OF THE STATEMENT: ▸ To provide an evidence-based, best practises summary to assist physicians with the evaluation and management of sports concussion. ▸ To establish the level of evidence, knowledge gaps and areas requiring additional research. ▸ Sports medicine physicians are frequently involved in the care of patients with sports concussion. ▸ Sports medicine physicians are specifically trained to provide care along the continuum of sports concussion from the acute injury to return-to-play (RTP) decisions. ▸ The care of athletes with sports concussion is ideally performed by healthcare professionals with specific training and experience in the assessment and management of concussion. Competence should be determined by training and experience, not dictated by specialty. ▸ While this statement is directed towards sports medicine physicians, it may also assist other physicians and healthcare professionals in the care of patients with sports concussion. ▸ Concussion is defined as a traumatically induced transient disturbance of brain function and involves a complex pathophysiological process. Concussion is a subset of mild traumatic brain injury (MTBI) which is generally self-limited and at the less-severe end of the brain injury spectrum. ▸ Animal and human studies support the concept of postconcussive vulnerability, showing that a second blow before the brain has recovered results in worsening metabolic changes within the cell. ▸ Experimental evidence suggests the concussed brain is less responsive to usual neural activation and when premature cognitive or physical activity occurs before complete recovery the brain may be vulnerable to prolonged dysfunction. ▸ It is estimated that as many as 3.8 million concussions occur in the USA per year during competitive sports and recreational activities; however, as many as 50% of the concussions may go unreported. ▸ Concussions occur in all sports with the highest incidence in football, hockey
There are a number of issues that EPA must consider in translating broad policy considerations into environmental protection criteria for high-level and TRU-contaminated waste. This paper reviews these issues and suggests some questions for discussion at this workshop
Full Text Available This essay uses Justice Scalia’s and Breyer’s dueling opinions in FCC v. Fox Television Stations, Inc. (2009, as a vehicle for exploring the contested relationship between politics and policy change in administrative law. In Fox, a five – justice majority led by Justice Scalia insisted that an agency’s abandonment of an old policy position in favor of a new one should survive review for arbitrariness so long as the agency explains why its new position is reasonable. A different five – justice majority (yes – that adds up to ten led by Justice Breyer thought that Justice Scalia’s stance left too much room for politicization of policymaking. To curb such influence, Justice Breyer insisted that an agency, to justify abandoning an old policy, must explain why it was reasonable to change from its old policy to the new one. Neither of these two approaches in Fox hits quite the right note. Justice Scalia’s view unduly minimizes the problem of politicization. Justice Breyer’s solution seems formalistic and easy to evade. A better way forward may lie in combining Justice Scalia’s simpler framework with Justice Breyer’s more suspicious attitude. Taking a cue from Justice Frankfurter in Universal Camera, the courts should respond to the potential for excessive politicization of agency policymaking not with more doctrinal metaphysics but with a suspicious “mood.” Cet article se base sur les opinions adverses des juges Scalia et Breyer dans FCC v. Fox Television Stations Inc. (2009 comme véhicule pour explorer le rapport contesté entre la politique et les changements de politiques en droit administratif. Dans Fox, une majorité de cinq juges dirigée par le juge Scalia a insisté que l’abandon d’une ancienne politique par une agence en faveur d’une nouvelle politique devrait survivre à un examen pour juger si elle est arbitraire en autant que l’agence explique pourquoi sa nouvelle politique est raisonnable. Une autre
Nagayama Hall, Gordon C; Yee, Alicia
Although Asian Americans are proportionally the fastest-growing ethnic group in the United States, federal mental health policies have neglected their special needs. U.S. federal mental health policy has shifted in the past 50 years from an emphasis on increasing accessibility to treatment to improving the quality of care and focusing on the brain as the basis of mental illness. However, the mental health needs of Asian Americans have been a relatively low priority. Myths about Asian Americans that have led to the general neglect of their mental health needs are that they: (a) are a small group; (b) are a successful group and do not experience problems; and (c) do not experience mental health disparities. Nevertheless, Asian Americans are a significant proportion of the population which experiences acculturative stress and discrimination that are often associated with psychopathology. However, Asian Americans who experience psychopathology are less likely than other groups to use mental health services. Political efforts must be made to get Asian Americans into positions of leadership and power in which they can make decisions about mental health policy priorities.
Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra
Sleep is essential for optimal health. The American Academy of Sleep Medicine (AASM) and Sleep Research Society (SRS) developed a consensus recommendation for the amount of sleep needed to promote optimal health in adults, using a modified RAND Appropriateness Method process. The recommendation is summarized here. A manuscript detailing the conference proceedings and evidence supporting the final recommendation statement will be published in SLEEP and the Journal of Clinical Sleep Medicine.
Statement on energy policy 1988. Statement by the Ministry of Energy on laws concerning energy policy measures and Danish Oil and Natural Gas A/S. [Denmark]. Energipolitisk redegoerelse 1988. Energiministeriets redegoerelse til lov om energipolitiske foranstaltninger samt lov om Dansk Olie og Naturgas A/S
A brief statement by the Danish Ministry of Energy on the present situation in Denmark and its effect on future policy in the field of energy. The importance of environmental protection, and the lowering of prices, is emphasized in relation to the European Communities' single market. With regard to electric power, it is stated that production must increase in the 1990's, but it will be necessary to reduce costs. There are present economical problems where the natural gas heating project is concerned, and, also because of concern for pollution abatement, it will become more important to use collective heating systems. The statement describes principles and policy in relation to energy consumption, renewable energy, research activities, and oil and natural gas. Lastly, the statement describes the present situation situation and (briefly) future policy with regard to Danish oil and/or natural gas companies, ie. DANGAS, DOPAS, DOFAS, and DORAS. (AB).
This article raises the question of whether in both the United States and in France, an individual's autonomy and private decision-making right(s) in matters of health care and access to reproductive technologies can be conciliated with the general interest, and more specifically, the role of the State. Can a full-fledged right to privacy, the ability to exercise one's autonomy, exist alongside the general interest, and depend neither on financial resources like in the United States nor on centralised government decisions or the medical hierarchy like in France? The contrast between these two modern democracies justify the importance of comparing them. I will demonstrate that overlaps do exist: the free exercise of religion and opinion, freedom of expression, the inherent value of each individual. What differs, however, are the institutions and how they provide, protect, promote, or frame access to and expressions of these democratic principles. The impact of the global economy, the exposure of people around the world to each other via the internet, and the mirror effects of social media, blogs, and other such forums, have created new perspectives that countries project onto one another. For example, does France now seem to tout 'autonomy' as a new and important value because it appears to be an 'American success story'? Does the United States now seem to value human rights and a social-democratic approach because of the 'French model'? There seems to be some truth behind these assertions, but as this article will demonstrate, the portrayals of what the 'right to privacy' is in the United States and what 'socialised medicine' is in France are not necessarily fully accurate.
Bickel, Kathleen E; McNiff, Kristen; Buss, Mary K; Kamal, Arif; Lupu, Dale; Abernethy, Amy P; Broder, Michael S; Shapiro, Charles L; Acheson, Anupama Kurup; Malin, Jennifer; Evans, Tracey; Krzyzanowska, Monika K
Integrated into routine oncology care, palliative care can improve symptom burden, quality of life, and patient and caregiver satisfaction. However, not all oncology practices have access to specialist palliative medicine. This project endeavored to define what constitutes high-quality primary palliative care as delivered by medical oncology practices. An expert steering committee outlined 966 palliative care service items, in nine domains, each describing a candidate element of primary palliative care delivery for patients with advanced cancer or high symptom burden. Using modified Delphi methodology, 31 multidisciplinary panelists rated each service item on three constructs: importance, feasibility, and scope within medical oncology practice. Panelists endorsed the highest proportion of palliative care service items in the domains of End-of-Life Care (81%); Communication and Shared Decision Making (79%); and Advance Care Planning (78%). The lowest proportions were in Spiritual and Cultural Assessment and Management (35%) and Psychosocial Assessment and Management (39%). In the largest domain, Symptom Assessment and Management, there was consensus that all symptoms should be assessed and managed at a basic level, with more comprehensive management for common symptoms such as nausea, vomiting, diarrhea, dyspnea, and pain. Within the Appropriate Palliative Care and Hospice Referral domain, there was consensus that oncology practices should be able to describe the difference between palliative care and hospice to patients and refer patients appropriately. This statement describes the elements comprising high-quality primary palliative care for patients with advanced cancer or high symptom burden, as delivered by oncology practices. Oncology providers wishing to enhance palliative care delivery may find this information useful to inform operational changes and quality improvement efforts. Copyright © 2016 by American Society of Clinical Oncology.
Association of American Universities, 2008
In this document, the Association of American Universities offers a series of research and technology policy recommendations that would help our nation to continue its global pre-eminence in science and high technology, improve the quality of life and national security of our citizens, and speed our nation's economic recovery. After policy…
Lewis, Anne, Ed.
This volume contains 14 essays and commentaries on youth development penned by educators, policymakers, and leaders of youth development organizations. The papers, written to commemorate 10 years of American Youth Policy Forum's service, were originally presented at a forum in Washington, D.C., in January 2003. Following are the papers: "Genesis…
From Retreat to Re-engagement: The New American Foreign Policy for ... that the re-engagement with Sub-Saharan Africa, is based on US perception of threats ... in the subordination of the region to the world's only superpower and its allies.
Integrity in the publication process requires impartiality at all levels of review. The American Journal of Clinical Nutrition (AJCN) adheres to the policy of the International Committee of Medical Journal Editors (ICMJE), Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writin...
Newman, Michael; Patino-Santos, Adriana; Trenchs-Parera, Mireia
This study explores the connections between language policy implementation in three Barcelona-area secondary schools and the language attitudes and behaviors of Spanish-speaking Latin American newcomers. Data were collected through interviews and ethnographic participant observation document indexes of different forms of language socialization…
Munshi, Medha N; Florez, Hermes; Huang, Elbert S; Kalyani, Rita R; Mupanomunda, Maria; Pandya, Naushira; Swift, Carrie S; Taveira, Tracey H; Haas, Linda B
Diabetes is more common in older adults, has a high prevalence in long-term care (LTC) facilities, and is associated with significant disease burden and higher cost. The heterogeneity of this population with regard to comorbidities and overall health status is critical to establishing personalized goals and treatments for diabetes. The risk of hypoglycemia is the most important factor in determining glycemic goals due to the catastrophic consequences in this population. Simplified treatment regimens are preferred, and the sole use of sliding scale insulin (SSI) should be avoided. This position statement provides a classification system for older adults in LTC settings, describes how diabetes goals and management should be tailored based on comorbidities, delineates key issues to consider when using glucose-lowering agents in this population, and provides recommendations on how to replace SSI in LTC facilities. As these patients transition from one setting to another, or from one provider to another, their risk for adverse events increases. Strategies are presented to reduce these risks and ensure safe transitions. This article addresses diabetes management at end of life and in those receiving palliative and hospice care. The integration of diabetes management into LTC facilities is important and requires an interprofessional team approach. To facilitate this approach, acceptance by administrative personnel is needed, as are protocols and possibly system changes. It is important for clinicians to understand the characteristics, challenges, and barriers related to the older population living in LTC facilities as well as the proper functioning of the facilities themselves. Once these challenges are identified, individualized approaches can be designed to improve diabetes management while lowering the risk of hypoglycemia and ultimately improving quality of life. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly
It is a great pleasure for me to address this distinguished audience. The Lowy Institute for International Policy has established itself in less than a decade as a major contributor to serious thinking on foreign policy. Coming, as I do, from Japan, I welcome your focus on issues that particularly affect the Asia-Pacific region. This region sometimes has a different perspective on global affairs from Europe and North America. The research programmes and events organized by the Institute help to focus fresh thinking on issues critical to this region, and indeed to the whole world. The International Atomic Energy Agency has been around quite a bit longer than the Lowy Institute - 55 years, in fact. I suppose that makes us middle-aged. But I can assure you that the Agency has lost none of its youthful vigour when it comes to tackling the challenging mandate entrusted to us by our 155 Member States. Our mission is manifold, but can be summarised very simply. We help to make nuclear science and technology available to all countries for peaceful purposes - especially to countries in the developing world. And we work to prevent the spread of nuclear weapons
US national energy policy recognizes that the continued development of commercial nuclear power in the United States is vital to US national security and energy stability since it is a significant domestic energy resource that is relatively free from international pressures. As of this writing (August 1989) the United States had 108 nuclear power reactors in commercial status. In January 1989 nuclear energy produced 46 billion KwH or 20% of total US electricity generated in contrast to 45 billion KwH (18.8%) produced in January 1988. The US Federal Government has been engaged in a variety of activities to ensure that nuclear energy remains a safe, economically competitive and environmentally acceptable option. Much of the federal effort in recent months has been devoted to developing initiatives designed to remove institutional and regulatory obstacles to the continued use of nuclear power as part of the US energy system. Within this context, the following paragraphs summarize the major features of the current status of the US nuclear energy program and policies
Bieszk, Nella; Grabner, Michael; Wei, Wenhui; Bonine, Nicole G; Stephenson, Judith J
To evaluate awareness of the 2012 American Diabetes Association (ADA) Position Statement among physicians and assess its effects on patient-centered glycated hemoglobin (A1C) goals in the management of type 2 diabetes (T2D). The Summarizing Real-World Individualized TrEatmEnT GoalS and Potential SuppOrT Systems in Type 2 Diabetes (SWEET SPOTS) study used the HealthCore claims database to identify T2D patients, stratified by risk, and their treating physicians to assess primary care physician and endocrinologist awareness of the 2012 ADA Position Statement. Physicians completed online surveys on A1C targets before and after receiving an educational intervention to review the position statement. Of 125 responding physicians (mean age 50.3 years, 12.8% endocrinologists) who were linked to 125 patient profiles (mean age 56.9 years, 42% female, mean A1C 7.2%), 92% were at least somewhat aware of the position statement prior to the intervention and 59% believed that the statement would impact how they set A1C targets. The educational intervention resulted in mostly less stringent goal setting for both lower and higher risk patients, but changes were not significant. The proportion of physician-assigned A1C targets within ADA-recommended ranges increased from 56% to 66% post-intervention ( P ADA Position Statement and believe that it may influence treatment goals. While patient-specific A1C targets were not significantly impacted, physicians indicated that they would make targets more or less stringent for lower and higher risk patients, respectively, across their practice. Further research into optimizing physician education regarding individualized A1C targets is warranted.
The Director General has received a note verbale, dated 12 September 2001, from the Permanent Mission of France to the IAEA in the enclosures of which the Government of France has made available statements of the stocks of highly enriched uranium held by it as of 31 December 1999 and 31 December 2000. With reference to the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998), the Permanent Mission of France has also conveyed in its note verbale that 'Concerned to promote transparency in the management of highly enriched uranium used for peaceful nuclear activities, the Government of the French Republic has decided to publish, on a voluntary basis, information on the highly enriched uranium it holds for civil purposes'. In the light of the request expressed by the Government of France in its note verbale of 28 November 1997 concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), and the request in its note verbale of 12 September 2001, the texts of the enclosures of the note verbale of 12 September 2001 are attached for the information of all Member States
Draft Environmental Impact Statement for the Nevada Test Site and off-site locations in the State of Nevada. Volume 1, Appendix G: American Indian comments for the Nevada Test Site Environmental Impact Statement
The purpose of this report is to provide a record of activities of the American Indian Writers Subgroup (AIWS) so they can communicate better with the tribes and Indian organizations they represent. This is a living document, which may be modified as long as the AIWS is working on the Nevada Test Site Environmental Impact Statement (NTS EIS). This document has been submitted to the Consolidated Group of Tribes and Organizations for review and comment. The Consolidated Group of Tribes and Organizations comments will be incorporated into the final version which will be sent to all Indian tribes and organizations represented by the Consolidated Group of Tribes and Organizations. This document is composed of the following sections: Section G.1 -- AIWS and Meeting Summaries; Section G.2 -- Writing Tasks; Section G.3 -- American Indian Comments for the NTS EIS; and Section G.4 -- References
Stramba-Badiale, Marco; Fox, Kim M; Priori, Silvia G; Collins, Peter; Daly, Caroline; Graham, Ian; Jonsson, Benct; Schenck-Gustafsson, Karin; Tendera, Michal
Cardiovascular diseases (CVD) are the leading cause of mortality both in men and women. In Europe, about 55% of all females' deaths are caused by CVD, especially coronary heart disease and stroke. Unfortunately, however, the risk of heart disease in women is underestimated because of the perception that women are 'protected' against ischaemic heart disease. What is not fully understood is that women during the fertile age have a lower risk of cardiac events, but this protection fades after menopause thus leaving women with untreated risk factors vulnerable to develop myocardial infarction, heart failure, and sudden cardiac death. Furthermore, clinical manifestations of ischaemic heart disease in women may be different from those commonly observed in males and this factor may account for under-recognition of the disease. The European Society of Cardiology has recently initiated an extensive 'Women at heart' program to coordinate research and educational initiatives on CVD in women. A Policy Conference on CVD in Women was one of the first steps in the development of this program. The objective of the conference was to collect the opinion of experts in the field coming from the European Society of Cardiology member countries to: (1) summarize the state-of-the-art from an European perspective; (2) to identify the scientific gaps on CVD in women; and (3) to delineate the strategies for changing the misperception of CVD in women, improving risk stratification, diagnosis, and therapy from a gender perspective and increasing women representation in clinical trials. The Policy Conference has provided the opportunity to review and comment on the current status of knowledge on CVD in women and to prioritize the actions needed to advance this area of knowledge in cardiology. In the preparation of this document we intend to provide the medical community and the stakeholders of this field with an overview of the more critical aspects that have emerged during the discussion. We
membership base, and gave both women and youth active roles in party affairs. This organizing effort to make the PDG representative of all Guineans was...to accept a certain degree of indigenous private enterprise, it has instituted a policy which excludes the entreprenuers from holding party posts...mobilize the nation’s youth 37 and women . To accomplish the first task the PDG leadership made Diallo Saifoulaye (a Foulah) Vice President of the
I. D. Loshkariov
Full Text Available The article analyzes resources of political influence on the foreign policy of the country of residence that Polish diaspora in the United States possesses. This analysis is useful for two reasons. Firstly, it will expand the focus of research in the study of pressure groups and their influence on the American foreign policy. Secondly, the Polish diaspora in the United States is rarely the object of research in migrant and ethnic lobbying, despite its the significant share of the country’s population. Analysis of the given resources that the Polish diaspora (American Polonia has leads to the following. Firstly, the foreign policy agenda of the Polish diaspora in the United States faces no strong opponents. This fact means the diaspora has sufficiently developed structural resource. In addition, the Polish diaspora possesses an organizational resource: its institutions are in close cooperation and are coordinated by the Polish American Congress. Secondly, the Polish diaspora in the US is a significant group of the population, especially in the states of Wisconsin, Michigan, Connecticut, New York and Illinois. However, its electoral and financial capacities are not used to the fullest extent. Finally, there are certain difficulties with the discursive political resource of Polish diaspora. The social and political perception provides of Polonia in the USA two opposing narratives. The first one stresses that it is important for the Americans of Polish descent to share such values as democracy, defending his position, including by military means. The second narrative is a reproduction of widespread stereotypes about Poles, including in the popular culture. Thus, institutions of the American Polonia face several tasks. The most important tasks are the search for new ways of political mobilization of the diaspora and the formation of a balanced image of Polish Americans in the social and political perception in the United States.
Schwartz, Stanley S
The position statement on the management of hyperglycemia in patients with type 2 diabetes mellitus issued in 2012 by the American Diabetes Association and the European Association for the Study of Diabetes contains significant improvements over the 2009 version, including an emphasis on patient-centered care, enhanced strategies for lifestyle modification, a focus on comprehensive cardiovascular risk reduction, and increased pharmacotherapy choices. As diabetes management evolves over time, further improvements may be made in future consensus statements, including a focus on prevention and early treatment and improved glycemic control in all patients, including those with comorbidities. These goals will be achievable by waning use of therapies known to cause hypoglycemia and weight gain and the increased use of therapies that do not carry these risks.
To update and expand The North American Menopause Society's evidence-based position on nonhormonal management of menopause-associated vasomotor symptoms (VMS), previously a portion of the position statement on the management of VMS. NAMS enlisted clinical and research experts in the field and a reference librarian to identify and review available evidence. Five different electronic search engines were used to cull relevant literature. Using the literature, experts created a document for final approval by the NAMS Board of Trustees. Nonhormonal management of VMS is an important consideration when hormone therapy is not an option, either because of medical contraindications or a woman's personal choice. Nonhormonal therapies include lifestyle changes, mind-body techniques, dietary management and supplements, prescription therapies, and others. The costs, time, and effort involved as well as adverse effects, lack of long-term studies, and potential interactions with medications all need to be carefully weighed against potential effectiveness during decision making. Clinicians need to be well informed about the level of evidence available for the wide array of nonhormonal management options currently available to midlife women to help prevent underuse of effective therapies or use of inappropriate or ineffective therapies. Recommended: Cognitive-behavioral therapy and, to a lesser extent, clinical hypnosis have been shown to be effective in reducing VMS. Paroxetine salt is the only nonhormonal medication approved by the US Food and Drug Administration for the management of VMS, although other selective serotonin reuptake/norepinephrine reuptake inhibitors, gabapentinoids, and clonidine show evidence of efficacy. Recommend with caution: Some therapies that may be beneficial for alleviating VMS are weight loss, mindfulness-based stress reduction, the S-equol derivatives of soy isoflavones, and stellate ganglion block, but additional studies of these therapies are
Full Text Available This is a report of the "Health Policy and Programs Evaluative Research for Social Change" Ibero-American Symposium held in Guadalajara, Mexico November 1-3, 2006. Attendees represented eight countries, and were associated with NGO's and academic and health services organizations. The most important themes included in the debates were the meaning of qualitative and evaluative health research for social change, the challenges of teaching for change, ethical challenges, and possibilities for making the findings of qualitative research available to different groups or stakeholders (users, policy makers, professionals, and the population as a whole. URN: urn:nbn:de:0114-fqs0802194
This article reviews the U.S. perception of the Turkic–speaking space in light of the official discourse and policies, as well as the significance of the Turkic world’s fast–moving strategic and economic dynamics for the American interests. It is claimed here that the U.S. engagements with the region are largely shaped by Washington’s strategic and economic interests and that it pursues a conjunctural, pragmatic and region–oriented foreign policy towards the Turkic world in parallel with thos...
Olson, Brad; Soldz, Stephen; Davis, Martha
Abstract The Psychological Ethics and National Security (PENS) task force was assembled by the American Psychological Association (APA) to guide policy on the role of psychologists in interrogations at foreign detention centers for the purpose of U.S. national security. The task force met briefly in 2005, and its report was quickly accepted by the APA Board of Directors and deemed consistent with the APA Ethics Code by the APA Ethics Committee. This rapid acceptance was unusual for a number o...
matters as diverse as public diplomacy and U4S security commitments, and since 1977 has been a policy analyst for tne Unicorn Group, Ltd., an international... growing Soviet military power. The administration’s strengthening of NATO and its recent support of Thailand and North Yemen prove that some officials...9 Needless to say, such developments point to a significant and growing American military commitment to Saudi Arabia. Physical commitment on the
Bieszk, Nella; Grabner, Michael; Wei, Wenhui; Bonine, Nicole G; Stephenson, Judith J
Nella Bieszk,1 Michael Grabner,2 Wenhui Wei,1 Nicole G Bonine,2 Judith J Stephenson,2 1Sanofi US, Inc., Bridgewater, NJ, 2HealthCore, Inc., Wilmington, DE, USA Objective: To evaluate awareness of the 2012 American Diabetes Association (ADA) Position Statement among physicians and assess its effects on patient-centered glycated hemoglobin (A1C) goals in the management of type 2 diabetes (T2D). Research design and methods: The Summarizing Real-World Individualized TrEatmEnT GoalS and Potential ...
McCall, Leslie; Burk, Derek; Laperrière, Marie; Richeson, Jennifer A
Economic inequality has been on the rise in the United States since the 1980s and by some measures stands at levels not seen since before the Great Depression. Although the strikingly high and rising level of economic inequality in the nation has alarmed scholars, pundits, and elected officials alike, research across the social sciences repeatedly concludes that Americans are largely unconcerned about it. Considerable research has documented, for instance, the important role of psychological processes, such as system justification and American Dream ideology, in engendering Americans' relative insensitivity to economic inequality. The present work offers, and reports experimental tests of, a different perspective-the opportunity model of beliefs about economic inequality. Specifically, two convenience samples (study 1, n = 480; and study 2, n = 1,305) and one representative sample (study 3, n = 1,501) of American adults were exposed to information about rising economic inequality in the United States (or control information) and then asked about their beliefs regarding the roles of structural (e.g., being born wealthy) and individual (e.g., hard work) factors in getting ahead in society (i.e., opportunity beliefs). They then responded to policy questions regarding the roles of business and government actors in reducing economic inequality. Rather than revealing insensitivity to rising inequality, the results suggest that rising economic inequality in contemporary society can spark skepticism about the existence of economic opportunity in society that, in turn, may motivate support for policies designed to redress economic inequality.
Brinker, Garrett C.
As the effects of climate change become increasingly clear, nations, international organizations, and corporations are working together to help mitigate these negative effects before they become irreversible. The United States, as the world's largest emitter per capita, has a responsibility to take quick and decisive action to decrease carbon emissions. And while an overwhelming majority of Americans believe that green energy policies are the right step forward, few have taken meaningful steps to actually implement these policies. Green and energy efficient technologies such as hybrid and electric cars, smart meters, and solar panels---technologies that would reduce our carbon footprint---are currently purchased or used by very few households. There is a clear gap between our words and deeds. Using the University of Texas at Austin Energy Poll dataset, this paper examines this gap and analyzes how income may influence what people say, versus how they act, seeking to better understand how income influences peoples' energy behaviors. Previous literature suggests that income has proven to be an inconsistent measure of concern for energy use. Through two OLS models, this paper finds that income is negatively correlated with Americans' concern for energy usage, while finding that there is a positive correlation between income and Americans' implementation of energy efficient technologies. Further, there is a nonlinear relationship between income groups and how Americans both think about their energy usage and actually implement more energy efficient measures.
Cristina Soreanu Pecequilo
Full Text Available The aim of the article is to present, based on theoretical studies of integration, the evolution of this process in Latin America and, most recently, in South America. Based on these studies, the goal is to analyze the role played by Brazil in the process, which defines as priorities of its foreign policy a regional and global framework for its international action that is based on both cooperation and power projection.The research has been conducted based on theories of integration, an historical background on Latin American integration and in Brazilian foreign policy, through its contemporary agenda. The answer was based on a comparative agenda and in a bibliographical critical analysis of the research material.The main findings of the paper point out that Latin American integration has specific features linked to the economic, political and stragetic realities of the continent that show the limitations of some theories applied to the European process, also that it depends on Brazilian foreign policy actions, that still sees the region as instrumental to its interests. So, Brazil sometimes fail to fulfill some requisites of integration that are essential to sustain its projects. Therefore, there is a cycle of enlargement and deepening of regional integration process in this political space that point out to the need of a more sustained compromise of Brazilian foreign policy towards these projects. If Brazil continues not to sustain these projects, they will lose momentum and significance once more, increasing power asymmetries in the region.
A review of Mexican energy and climate change policies was presented with reference to the implications for Mexico regarding energy supply, security and climate change policies. Mexico's development and energy indicators are considerably behind those of Canada and the United States, but its greenhouse gas emissions are also low in comparison. Mexican energy consumption and gross domestic product levels per capita are far below those of the United States and Canada. Although Mexico, a signatory of the United Nations Framework Convention on Climate Change and the Kyoto Protocol, is not obligated to commit itself to any target greenhouse gas emissions, it has implemented an active climate change policy that promotes energy efficiency, fuel substitution, development of alternative energy sources, forest conservation and reforestation, and climate change research. The author concluded that in addition to constitutional reform, a fully integrated North American energy market would need physical connections for electricity and natural gas. 4 figs
This dissertation focuses on the relationship of American nuclear energy to democracy. It examines whether the nuclear policy processes have furthered the legitimacy-government accountability and citizen participation-which the democratic institutes are based. Nuclear policy and its institutions have placed severe limitations on democratic practices. Contravened democracy is seen most clearly in the decoupling of policy from politics. Decoupling refers to the weakening of institutional linkages between citizens and government, and to the erosion of the norms that ground liberal democracy. Decoupling is manifested in policy centralization, procedural biases, technical rationality, and the spatial displacement of conflict. Decoupling has normative implications: While federal accountability was limited and citizen participation was shackled, other major groups enjoyed privileged access to policy making. The decoupling of nuclear policy from politics arose within the context of US liberal-democratic capitalism. The federal government pursued its own goals of defense and world leadership. Yet, it was not structurally autonomous from the hegemony of the political-economic context. Economically, the Atomic Energy Act did not permit federal agencies to directly invest in power plant construction, and did not authorize them to commercially generate electricity. Private industry was structurally placed to domesticate the atom. Politically, the liberal-democratic system hampered an unquestioning pursuit of atomic energy. Federal institutions have been forced to heed some of the anti-nuclear concerns. The pervasive influence of the US political economy on nuclear policy has come to transgress democracy. Nuclear power's growth faltered during the 1970s. The political and economic constraints on federal actions have limited the means available to revive a becalmed nuclear industry; this has exerted strong pressure on federal institutions to decouple policy from participation
Caruana, C J; Christofides, S; Hartmann, G H
In 2010, EFOMP issued Policy Statement No. 12: "The present status of Medical Physics Education and Training in Europe. New perspectives and EFOMP recommendations" to be applied to education and training in Medical Physics within the context of the developments in the European Higher Education Area arising from the Bologna Declaration and with a view to facilitate the free movement of Medical Physics professionals within Europe. Concurrently, new recommendations regarding qualifications frameworks were published by the European Parliament and Council which introduced new terminology and a new qualifications framework - the European Qualifications Framework (EQF) for lifelong learning. In addition, a new European directive involving the medical use of ionizing radiations and set to replace previous directives in this area was in the process of development. This has now been realized as Council Directive 2013/59/Euratom of 5 December 2013 which has repealed directive 97/43/Euratom. In this regard, a new document was developed in the context of the EC financed project "European Guidelines on the Medical Physics Expert" and published as RP174. Among other items, these guidelines refer to the mission statement, key activities, qualification framework and curricula for the specialty areas of Medical Physics relating to radiological devices and protection from ionizing radiation. These developments have made necessary an update of PS12; this policy statement provides the necessary update. Copyright © 2014. Published by Elsevier Ltd.
Hamm, Larry F; Sanderson, Bonnie K; Ades, Philip A; Berra, Kathy; Kaminsky, Leonard A; Roitman, Jeffrey L; Williams, Mark A
Cardiac rehabilitation/secondary prevention (CR/SP) services are typically delivered by a multidisciplinary team of health care professionals. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) recognizes that to provide high-quality services, it is important for these health care professionals to possess certain core competencies. This update to the previous statement identifies 10 areas of core competencies for CR/SP health care professionals and identifies specific knowledge and skills for each core competency. These core competency areas are consistent with the current list of core components for CR/SP programs published by the AACVPR and the American Heart Association and include comprehensive cardiovascular patient assessment; management of blood pressure, lipids, diabetes, tobacco cessation, weight, and psychological issues; exercise training; and counseling for psychosocial, nutritional, and physical activity issues.
... AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY... with another substance to cure a product must be identified in the ingredients statement on the label...
Full Text Available Nella Bieszk,1 Michael Grabner,2 Wenhui Wei,1 Nicole G Bonine,2 Judith J Stephenson,2 1Sanofi US, Inc., Bridgewater, NJ, 2HealthCore, Inc., Wilmington, DE, USA Objective: To evaluate awareness of the 2012 American Diabetes Association (ADA Position Statement among physicians and assess its effects on patient-centered glycated hemoglobin (A1C goals in the management of type 2 diabetes (T2D. Research design and methods: The Summarizing Real-World Individualized TrEatmEnT GoalS and Potential SuppOrT Systems in Type 2 Diabetes (SWEET SPOTS study used the HealthCore claims database to identify T2D patients, stratified by risk, and their treating physicians to assess primary care physician and endocrinologist awareness of the 2012 ADA Position Statement. Physicians completed online surveys on A1C targets before and after receiving an educational intervention to review the position statement. Results: Of 125 responding physicians (mean age 50.3 years, 12.8% endocrinologists who were linked to 125 patient profiles (mean age 56.9 years, 42% female, mean A1C 7.2%, 92% were at least somewhat aware of the position statement prior to the intervention and 59% believed that the statement would impact how they set A1C targets. The educational intervention resulted in mostly less stringent goal setting for both lower and higher risk patients, but changes were not significant. The proportion of physician-assigned A1C targets within ADA-recommended ranges increased from 56% to 66% post-intervention (P<0.0001. Conclusion: Physicians treating T2D are aware of the 2012 ADA Position Statement and believe that it may influence treatment goals. While patient-specific A1C targets were not significantly impacted, physicians indicated that they would make targets more or less stringent for lower and higher risk patients, respectively, across their practice. Further research into optimizing physician education regarding individualized A1C targets is warranted. Keywords
Krumholz, Harlan M; Currie, Peter M; Riegel, Barbara; Phillips, Christopher O; Peterson, Eric D; Smith, Renee; Yancy, Clyde W; Faxon, David P
Disease management has shown great promise as a means of reorganizing chronic care and optimizing patient outcomes. Nevertheless, disease management programs are widely heterogeneous and lack a shared definition of disease management, which limits our ability to compare and evaluate different programs. To address this problem, the American Heart Association's Disease Management Taxonomy Writing Group developed a system of classification that can be used both to categorize and compare disease management programs and to inform efforts to identify specific factors associated with effectiveness. The AHA Writing Group began with a conceptual model of disease management and its components and subsequently validated this model over a wide range of disease management programs. A systematic MEDLINE search was performed on the terms heart failure, diabetes, and depression, together with disease management, case management, and care management. The search encompassed articles published in English between 1987 and 2005. We then selected studies that incorporated (1) interventions designed to improve outcomes and/or reduce medical resource utilization in patients with heart failure, diabetes, or depression and (2) clearly defined protocols with at least 2 prespecified components traditionally associated with disease management. We analyzed the study protocols and used qualitative research methods to develop a disease management taxonomy with our conceptual model as the organizing framework. The final taxonomy includes the following 8 domains: (1) Patient population is characterized by risk status, demographic profile, and level of comorbidity. (2) Intervention recipient describes the primary targets of disease management intervention and includes patients and caregivers, physicians and allied healthcare providers, and healthcare delivery systems. (3) Intervention content delineates individual components, such as patient education, medication management, peer support, or some
Griswold, John S.; Jarvis, William F.
Successful investing for long-term funds requires a strategic plan. This is true despite--indeed, because of--the fact that the future is unknowable. The plan must be specific, embodying in concrete terms the best thinking of the board of trustees about the investment pool, its goals and purposes; but it also needs to be sufficiently flexible to…
Lipids and bariatric procedures part 1 of 2: Scientific statement from the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and Obesity Medicine Association: EXECUTIVE SUMMARY.
Bays, Harold E; Jones, Peter H; Jacobson, Terry A; Cohen, David E; Orringer, Carl E; Kothari, Shanu; Azagury, Dan E; Morton, John; Nguyen, Ninh T; Westman, Eric C; Horn, Deborah B; Scinta, Wendy; Primack, Craig
Bariatric procedures often improve lipid levels in patients with obesity. This 2-part scientific statement examines the potential lipid benefits of bariatric procedures and represents contributions from authors representing the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and the Obesity Medicine Association. The foundation for this scientific statement was based on data published through June 2015. Part 1 of this 2-part scientific statement provides an overview of: (1) adipose tissue, cholesterol metabolism, and lipids; (2) bariatric procedures, cholesterol metabolism, and lipids; (3) endocrine factors relevant to lipid influx, synthesis, metabolism, and efflux; (4) immune factors relevant to lipid influx, synthesis, metabolism, and efflux; (5) bariatric procedures, bile acid metabolism, and lipids; and (6) bariatric procedures, intestinal microbiota, and lipids, with specific emphasis on how the alterations in the microbiome by bariatric procedures influence obesity, bile acids, and inflammation, which in turn, may all affect lipid levels. Included in part 2 of this comprehensive scientific statement will be a review of: (1) the importance of nutrients (fats, carbohydrates, and proteins) and their absorption on lipid levels; (2) the effects of bariatric procedures on gut hormones and lipid levels; (3) the effects of bariatric procedures on nonlipid cardiovascular disease risk factors; (4) the effects of bariatric procedures on lipid levels; (5) effects of bariatric procedures on cardiovascular disease; and finally (6) the potential lipid effects of vitamin, mineral, and trace element deficiencies that may occur after bariatric procedures. This document represents the executive summary of part 1. Copyright © 2016 National Lipid Association. All rights reserved.
Lipids and bariatric procedures part 1 of 2: Scientific statement from the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and Obesity Medicine Association: FULL REPORT.
Bays, Harold E; Jones, Peter H; Jacobson, Terry A; Cohen, David E; Orringer, Carl E; Kothari, Shanu; Azagury, Dan E; Morton, John; Nguyen, Ninh T; Westman, Eric C; Horn, Deborah B; Scinta, Wendy; Primack, Craig
Bariatric procedures often improve lipid levels in patients with obesity. This 2 part scientific statement examines the potential lipid benefits of bariatric procedures and represents the contributions from authors representing the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and the Obesity Medicine Association. The foundation for this scientific statement was based on published data through June 2015. Part 1 of this 2 part scientific statement provides an overview of: (1) adipose tissue, cholesterol metabolism, and lipids; (2) bariatric procedures, cholesterol metabolism, and lipids; (3) endocrine factors relevant to lipid influx, synthesis, metabolism, and efflux; (4) immune factors relevant to lipid influx, synthesis, metabolism, and efflux; (5) bariatric procedures, bile acid metabolism, and lipids; and (6) bariatric procedures, intestinal microbiota, and lipids, with specific emphasis on how the alterations in the microbiome by bariatric procedures influence obesity, bile acids, and inflammation, which in turn, may all affect lipid levels. Included in part 2 of this comprehensive scientific statement will be a review of (1) the importance of nutrients (fats, carbohydrates, and proteins) and their absorption on lipid levels; (2) the effects of bariatric procedures on gut hormones and lipid levels; (3) the effects of bariatric procedures on nonlipid cardiovascular disease (CVD) risk factors; (4) the effects of bariatric procedures on lipid levels; (5) effects of bariatric procedures on CVD; and finally, (6) the potential lipid effects of vitamin, mineral, and trace element deficiencies that may occur after bariatric procedures. This document represents the full report of part 1. Copyright © 2016 National Lipid Association. All rights reserved.
Rosanne Evangelista Dias
Full Text Available Teaching has become a central issue in the Ibero-American discourses for basic education, in order to attribute, as a privilege, to the teaching work the guarantee of students‟ school success and, consequently, reach quality in education. From such discourses, the policy texts have defended the production of evaluation policies aiming at controlling the curriculums of teaching education (initial and continuous development and action. In this paper, which is theoretically and methodologically guided by Ernesto Laclau‟s and Chantal Mouffe‟s Discourse Theory, I analyze the processes of discourse articulation present in the texts by Organização dos Estados Iberoamericanos – OEI (Ibero-American States Organization and UNESCO (United Nations Educational, Scientific and Cultural Organization, highlighting the significant performance as the focus of evaluation. In the analysis of discourses regarding teachers‟ education and work established as a target for the Ibero-American region, with focus on the professional performance, the competences gain importance as a model of curricular organization. I conclude pointing out that the attempts to control the teaching professional community regarding their education and work assign new roles, marked by accountability, to the teachers.
Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association.
Fox, Caroline S; Golden, Sherita Hill; Anderson, Cheryl; Bray, George A; Burke, Lora E; de Boer, Ian H; Deedwania, Prakash; Eckel, Robert H; Ershow, Abby G; Fradkin, Judith; Inzucchi, Silvio E; Kosiborod, Mikhail; Nelson, Robert G; Patel, Mahesh J; Pignone, Michael; Quinn, Laurie; Schauer, Philip R; Selvin, Elizabeth; Vafiadis, Dorothea K
Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus. © 2015 American Heart Association, Inc.
Baddour, Larry M; Wilson, Walter R; Bayer, Arnold S; Fowler, Vance G; Tleyjeh, Imad M; Rybak, Michael J; Barsic, Bruno; Lockhart, Peter B; Gewitz, Michael H; Levison, Matthew E; Bolger, Ann F; Steckelberg, James M; Baltimore, Robert S; Fink, Anne M; O'Gara, Patrick; Taubert, Kathryn A
Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex with today's myriad healthcare-associated factors that predispose to infection. Moreover, changes in pathogen prevalence, in particular a more common staphylococcal origin, have affected outcomes, which have not improved despite medical and surgical advances. This statement updates the 2005 iteration, both of which were developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It includes an evidence-based system for diagnostic and treatment recommendations used by the American College of Cardiology and the American Heart Association for treatment recommendations. Infective endocarditis is a complex disease, and patients with this disease generally require management by a team of physicians and allied health providers with a variety of areas of expertise. The recommendations provided in this document are intended to assist in the management of this uncommon but potentially deadly infection. The clinical variability and complexity in infective endocarditis, however, dictate that these recommendations be used to support and not supplant decisions in individual patient management. © 2015 American Heart Association, Inc.
determined more by economic forces than by flood protection. Thus, if inadequate flood protection rendered development in portions of the American River flood...1978 Patwin. In: Handbook of North American Indians: Volume 8 California, Robert F. Heizer , volume editor. Smithsonian Institution, Washington, D.C. pp...Norman L. & Arlean H. Towne. 1978 Nisenan. In: Handbook of North American Indians: Volume 8 California, Robert F. Heizer , volume editor. Smithsonian
Anderson, Gary L.; Donchik, Liliana Montoro
In this article, we examine the American Legislative Exchange Council (ALEC) as an example of a unique node within larger policy networks composed of new policy entrepreneurs (e.g., venture philanthropists, think tanks, private "edubusinesses" and their lobbyists, advocacy organizations, and social entrepreneurs). These new policy…
Wilson-Armour, Carole Cristine
The purpose of this study was to determine how policies regarding remedial education can influence the experiences of students who identify as low socioeconomic (SES) Native American women at a Midwestern community college. This study proposed to use interpretive policy analysis and phenomenological qualitative research to learn more about how low…
Handelsman, Yehuda; Henry, Robert R; Bloomgarden, Zachary T; Dagogo-Jack, Sam; DeFronzo, Ralph A; Einhorn, Daniel; Ferrannini, Ele; Fonseca, Vivian A; Garber, Alan J; Grunberger, George; LeRoith, Derek; Umpierrez, Guillermo E; Weir, Matthew R
AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology DKA = diabetic ketoacidosis EMA = European Medicines Agency FDA = U.S. Food and Drug Administration SGLT-2 = sodium glucosecotransporter 2 T1D = type 1 diabetes T2D = type 2 diabetes.
Lichtman, Judith H; Froelicher, Erika S; Blumenthal, James A; Carney, Robert M; Doering, Lynn V; Frasure-Smith, Nancy; Freedland, Kenneth E; Jaffe, Allan S; Leifheit-Limson, Erica C; Sheps, David S; Vaccarino, Viola; Wulsin, Lawson
Although prospective studies, systematic reviews, and meta-analyses have documented an association between depression and increased morbidity and mortality in a variety of cardiac populations, depression has not yet achieved formal recognition as a risk factor for poor prognosis in patients with acute coronary syndrome by the American Heart Association and other health organizations. The purpose of this scientific statement is to review available evidence and recommend whether depression should be elevated to the status of a risk factor for patients with acute coronary syndrome. Writing group members were approved by the American Heart Association's Scientific Statement and Manuscript Oversight Committees. A systematic literature review on depression and adverse medical outcomes after acute coronary syndrome was conducted that included all-cause mortality, cardiac mortality, and composite outcomes for mortality and nonfatal events. The review assessed the strength, consistency, independence, and generalizability of the published studies. A total of 53 individual studies (32 reported on associations with all-cause mortality, 12 on cardiac mortality, and 22 on composite outcomes) and 4 meta-analyses met inclusion criteria. There was heterogeneity across studies in terms of the demographic composition of study samples, definition and measurement of depression, length of follow-up, and covariates included in the multivariable models. Despite limitations in some individual studies, our review identified generally consistent associations between depression and adverse outcomes. Despite the heterogeneity of published studies included in this review, the preponderance of evidence supports the recommendation that the American Heart Association should elevate depression to the status of a risk factor for adverse medical outcomes in patients with acute coronary syndrome.
Boyd Jonathan A.
Full Text Available Recent events have created a sense of urgency within the U.S. foreign policy establishment to update its strategy towards Russia. The Baltic states are seen to be particularly vulnerable and because of its NATO commitments and its history of underwriting security in the region, the U.S. is under pressure to develop an appropriate response. Policy and research institutes-or think tanks-are an important part of the U.S. foreign policy establishment, and given the influence they often have on American foreign policy, it is sensible for any student of Baltic security to evaluate the think tanks’ current perspectives on the viability and desirability of U.S. security commitments in the region. To that end, this article evaluates the outputs of twelve prominent U.S. foreign policy think tanks according to the views they expressed across four general groupings of issues: positions on U.S. grand strategy, perceptions of Moscow’s intentions and capabilities, assessments of NATO’s heath and its value to U.S. security, and the level of commitment to, and assessment of, the security vulnerabilities of the Baltic states. The findings dispel a common misperception that U.S. foreign policy think tanks are generally shifting towards a realist perspective on the Baltic states; they generally do not support U.S. retrenchment, most consider Russia as having revanchist motives, and as a whole support bolstering the defences of NATO’s easternmost flank. However, it would also be an exaggeration to conclude that the U.S. think tank community overall were staunch defenders of the Baltic states, as for many there is a prevailing inattentiveness to Baltic security issues.
Full Text Available Recently passed the Russian ‘Foreign Agent’ law against foreign funding of NGOs and civil society has attracted criticism from almost every quarter. From home to abroad all party concerned (i.e., civil society organizations, NGO groups, donor countries (especiallyAmericaand European countries as well as some Russian opposition political parties are of the view that this bill has been introduced to scuttle the independent civic activities and in this way unconstitutional. However on the basis of overall analysis of ‘Foreign Agent’ law in the context of American democratic promotion policy this paper is of the view that this law simply cannot be characterized as anti-democratic, which is against the very basis of freedom and rule of law, by the anti-democratic Russian government but it should be seen as extension of same challenge which American democratic promotion policy is facing around the whole world. It is because of its illegal and unconstitutional method of regime change policy, with the help of foreign funded NGOs, and civil society which has compelled various countries includingRussiato resort this type of law. It is important to note that the promise of peace, stability and prosperity by the democratic promotion protagonists after the fall ofSoviet Unionhas not been realised till today. Instead what post-Soviet states are witnessing today is emergence of chauvinist nationalist government in respective countries which witnessed colour revolution. Whole region is now plunging into economic turmoil, ethnic nationalism, rise of religious fundamentalism and identity politics. Recent overthrow of legitimate Viktor Yanukovych government inUkraineand subsequent decision by incumbent government to exclude Russian as administrative language can be sited as example. That is why former American Republican Congressman Ron Paul is of the view that “US‘Democracy Promotion’ Destroys Democracy Overseas’’. In this context this paper
Claudia Cecilia Lardizabal
Full Text Available The energy matrix of Latin American and the Caribbean countries has one of the largest renewable energy components when compared to other regions of the world. Nonetheless, by 2009 nearly three-quarters of its structure corresponded to fossil fuels, with most of the countries being net importers of these fuels. This situation marks the region´s dependence on the effects of changes in energy commodities. Therefore, the opportunity lies in higher use of renewable energy sources that contribute to the country´s energy security and represent significant environmental benefits. The purpose of this paper is to provide a comparative analysis of current energy scenarios of six Latin American countries (Mexico, Honduras, Nicaragua, Brazil, Ecuador and Chile in order to evaluate the policies, programs and strategies implemented in the search for greater participation of renewable energy. Considering the importance of the water-energy nexus that could serve to promote renewables under conditions of water scarcity, a qualitative data comparison was accomplished, considering energy consumption, CO2 emissions, GDP and water withdrawals per country. The authors conclude that, despite technological and financial constraints, all the involved countries are moving towards the substitution of a fossil fuel based matrix to a renewable one. This process could be seen as a result of clear policies and strategies that have been set, which include (but are not limited to price regulations setting, preferential prices to electricity generated through renewable energy technologies and incentives formulated to encourage the production of biofuels.
Hutchins, J C; Rydell, C M; Griggs, R C; Sagsveen, M; Bernat, J L
To examine the American Academy of Neurology (AAN)'s prevention and limitation of conflicts of interest (COI) related to relationships with pharmaceutical and medical device manufacturers and other medically related commercial product and service companies (industry). We reviewed the AAN's polices governing its interactions with industry, mechanisms for enforcement, and the recent findings of the board-appointed COI task force, in the context of the 2009 David Rothman and colleagues' article in JAMA, the Council of Medical Specialty Societies (CMSS) Code for Interactions with Companies (Code), efforts of the American Medical Association in this area, and increased public and Congressional scrutiny of physician/physician organizations' relationships with industry. The AAN's Policy on Conflicts of Interest provides 4 mechanisms for addressing COI: avoidance, separation, disclosure, and regulation. The AAN's Principles Governing Academy Relationships with External Sources of Support, including recent amendments proposed by the COI task force, regulate industry interaction with AAN programming, products, and leadership. With the Policy, Principles, and other methods of COI prevention, the AAN meets or exceeds all recommendations of the CMSS Code. With its adherence to the Principles since 2004, the AAN has been a leader among professional medical associations in appropriately managing COI related to interactions with industry. Recent amendments to the Principles maintain the AAN's position as a leader in a time of increased public scrutiny of physicians' and professional medical associations' relationships with industry. The AAN is responsive to the recommendations of the COI task force, and has adopted the CMSS Code.
Goldstein, Benjamin I; Carnethon, Mercedes R; Matthews, Karen A; McIntyre, Roger S; Miller, Gregory E; Raghuveer, Geetha; Stoney, Catherine M; Wasiak, Hank; McCrindle, Brian W
In the 2011 "Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents," several medical conditions among youth were identified that predispose to accelerated atherosclerosis and early cardiovascular disease (CVD), and risk stratification and management strategies for youth with these conditions were elaborated. Major depressive disorder (MDD) and bipolar disorder (BD) among youth satisfy the criteria set for, and therefore merit inclusion among, Expert Panel tier II moderate-risk conditions. The combined prevalence of MDD and BD among adolescents in the United States is ≈10%, at least 10 times greater than the prevalence of the existing moderate-risk conditions combined. The high prevalence of MDD and BD underscores the importance of positioning these diseases alongside other pediatric diseases previously identified as moderate risk for CVD. The overall objective of this statement is to increase awareness and recognition of MDD and BD among youth as moderate-risk conditions for early CVD. To achieve this objective, the primary specific aims of this statement are to (1) summarize evidence that MDD and BD are tier II moderate-risk conditions associated with accelerated atherosclerosis and early CVD and (2) position MDD and BD as tier II moderate-risk conditions that require the application of risk stratification and management strategies in accordance with Expert Panel recommendations. In this scientific statement, there is an integration of the various factors that putatively underlie the association of MDD and BD with CVD, including pathophysiological mechanisms, traditional CVD risk factors, behavioral and environmental factors, and psychiatric medications. © 2015 American Heart Association, Inc.
... employee means a train employee who is engaged in commuter or intercity rail passenger transportation, as... Interpretations of Travel Time Involving Signal Employees I. Executive Summary of the Second Interim Statement of... passenger transportation or intercity rail passenger transportation were subject to Sec. 21103 as it existed...
There is a clear epidemiologic association between glycemic control and cardiovascular disease. There is strong evidence of a microvascular benefit by lowering glycated hemoglobin diabetic patients, to control all major cardiovascular risk factors such as obesity, hypertension, and dyslipidemia. These risk factors, easily measurable, account for 90% of acute myocardial infarction. In this review, the update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus from the American Heart Association and the American Diabetes Association is discussed and commented.
Christofides, Stelios; Isidoro, Jorge; Pesznyak, Csilla; Cremers, Florian; Figueira, Rita; van Swol, Christiaan; Evans, Stephen; Torresin, Alberto
Continuing Professional Development (CPD) is vital to the medical physics profession if it is to embrace the pace of change occurring in medical practice. As CPD is the planned acquisition of knowledge, experience and skills required for professional practice throughout one's working life it promotes excellence and protects the profession and public against incompetence. Furthermore, CPD is a recommended prerequisite of registration schemes (Caruana et al. 2014) and is implied in the Council Directive 2013/59/EURATOM (EU BSS) and the International Basic Safety Standards (BSS). It is to be noted that currently not all national registration schemes require CPD to maintain the registration status necessary to practise medical physics. Such schemes should consider adopting CPD as a prerequisite for renewing registration after a set period of time. This EFOMP Policy Statement, which is an amalgamation and an update of the EFOMP Policy Statements No. 8 and No. 10, presents guidelines for the establishment of national schemes for CPD and activities that should be considered for CPD. Copyright © 2016. Published by Elsevier Ltd.
Upjohn (W.E.) Inst. for Employment Research, Kalamazoo, MI.
This volume contains four papers presented at a 1982 conference sponsored by the National Council on Employment Policy. It begins with a brief policy statement warning that labor force and productivity data systems face deterioration because of budget cuts that have forced a decline in the quality and quantity of the published information and…
Valles, Edith Gladys; Bernacchi, Adriana Silvina
During the past decade, a number of journals have implemented dual-use policies in order to analyze whether the papers submitted for publication could raise concern because of the potential for misuse of their content. In this context, an analysis was performed on Latin American scientific journals to examine whether they apply formal written dual-use review policies and whether they inform their authors and reviewers about potentially sensitive issues in this area, as other international journals do. Peer-reviewed life sciences journals indexed in Latindex from Brazil, Mexico, Argentina, and Chile were analyzed. The Guide for Authors and the Instructions to Referees of 216 journals included in the Latindex catalogue (which means that they meet the best quality standards of the Latindex system) were screened for biosecurity-related information using the keywords biosecurity, biological weapons, and dual-use research of concern. Results showed that the screened publications had a total lack of dual-use review policies, even though some of them pointed out ethical behaviors to be followed related to authorship, plagiarism, simultaneous submission, research results misappropriation, ethical principles for medical research involving human subjects, guiding principles for the care and use of animals in research, research standard violations, and reviewer bias, among others.
This book examines the implementation of science, technology and innovation (STI) policy in eight Latin American countries and the different paths these policies have taken. It provides empirical evidence to examine the extent to which STI policies are contributing to the development of the region, as well as to the solution of market failures and the stimulus of the region’s innovation systems. Since the pioneering work of Solow (1957), it has been recognized that innovation is critical for economic growth both in developed and in less-developed countries. Unfortunately Latin America lags behind world trends, and although over the last 20 years the region has established a more stable and certain macroeconomic regime, it is also clear that these changes have not been enough to trigger a process of innovation and productivity to catch-up. Against this rather grim scenario there is some optimism emerging throughout the region. After many years of inaction the region has begun to invest in science, technology...
Without an equal sharing of costs and benefits of natural and human resources worldwide, imbalances and lack of human development lead to migration within and between countries. Economic integration blocks in Latin America provide a context for shared development: in Central America, in the Andean Region, and in the Southern Cone. Over the past 60 years migration policy was based on national protectionism, labor supply, and/or occupation of territory. When economic conditions changed to market economies and world markets, migration policy was redefined. Each of the economic integration blocks has developed its own strategies. The Andean Agreement on Labor Migrations was established to determine the rules for bilateral and multilateral treatment of problems. In the Southern Cone bilateral agreements have been longstanding. Multilateral efforts were recently underway within the Southern Common Market and throughout the region. The Central American Organization for Migrations has spearheaded the adoption of a multilateral strategy. All three regions have made considerable progress in the last three years in constructing multilateral policies for economic integration. Government awareness has been the primary force in these policy changes. Government has come to an understanding that clear domestic and regional migration policies were lacking and that obsolete migration practices of the 1930s did not meet the needs of the 1990s. Migration policy was considered an instrument of development. Movement of economic factors or goods was considered equally with movement of labor. Migration policies must integrate the human rights of migrants into their definitions. Methods of facilitating the movements of populations need to be constructed within the computerization and modernization of the migration administration. Legalization of illegal immigrants has occurred among a number of countries. PROCAM and PRIMCOS were action programs which aimed to integrate migration and
Researchers have established a relationship between political orientation and cognitive styles (A. Chirumbolo, 2002; J. T. Jost, J. Glaser, A. W. Kruglanski, & F. Sulloway, 2003a, 2003b; M. Kemmelmeier, 1997). In this article, the author examined whether this finding is true in the political elite, whether the relationship is linear or curvilinear, and whether interest in politics moderates the relationship between political orientation and cognitive styles. He used a 1966 sample of American foreign policy officials (N = 95) to examine the relationship between self-described conservatism and party identification and individual differences in rigidity and dogmatism. Rigidity was related to self-described conservatism, but this relationship was only significant among participants high in political interest, whereas dogmatism was unconditionally related to party identification. All relationships were linear and did not contain a curvilinear component.
Mechanick, Jeffrey I; Hurley, Daniel L; Garvey, W Timothy
The American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) have created a chronic care model, advanced diagnostic framework, clinical practice guidelines, and clinical practice algorithm for the comprehensive management of obesity. This coordinated effort is not solely based on body mass index as in previous models, but emphasizes a complications-centric approach that primarily determines therapeutic decisions and desired outcomes. Adiposity-Based Chronic Disease (ABCD) is a new diagnostic term for obesity that explicitly identifies a chronic disease, alludes to a precise pathophysiologic basis, and avoids the stigmata and confusion related to the differential use and multiple meanings of the term "obesity." Key elements to further the care of patients using this new ABCD term are: (1) positioning lifestyle medicine in the promotion of overall health, not only as the first algorithmic step, but as the central, pervasive action; (2) standardizing protocols that comprehensively and durably address weight loss and management of adiposity-based complications; (3) approaching patient care through contextualization (e.g., primordial prevention to decrease obesogenic environmental risk factors and transculturalization to adapt evidence-based recommendations for different ethnicities, cultures, and socio-economics); and lastly, (4) developing evidence-based strategies for successful implementation, monitoring, and optimization of patient care over time. This AACE/ACE blueprint extends current work and aspires to meaningfully improve both individual and population health by presenting a new ABCD term for medical diagnostic purposes, use in a complications-centric management and staging strategy, and precise reference to the obesity chronic disease state, divested from counterproductive stigmata and ambiguities found in the general public sphere. AACE = American Association of Clinical Endocrinologists ABCD = Adiposity
Clausen, Helene Balslev
. Still the Mexican state does not seize the second home owners as a resource and ‘producers’ rather only as consumers of different Mexican objects, food etc. The chapter addresses this research gap and proposes rather than only perceive North American second home owners as part of tourism development...... participate in reshaping and reconfigure public policy and Mexican culture/identity construction. The purpose of the chapter is to explore the role of the North American second home owners and their impact on the planning and regulation of Mexican state policies, and how they might reconfigure practices and...
Odoms-Young, Angela M; Zenk, Shannon; Mason, Maryann
Obesity is a major public health concern in the U.S. As compared to whites, minority populations are disproportionately at risk, with the highest prevalence rates of overweight and obesity occurring among African American women. Although researchers and policymakers argue that environmental approaches have the greatest potential to reverse the rising prevalence of obesity, critical gaps remain in our understanding of the complex mechanisms that underlie the associations between neighborhood food environments and weight status. A major challenge has been the need for reliable and valid measures to assess aspects of the neighborhood food environment that encourage or inhibit healthful eating behaviors and weight management. Investigators have made considerable gains in the development of tools and approaches to measure neighborhood food environments overall, but few studies focus on the specific challenges and issues associated with characterizing neighborhood food environments in communities of color. This paper highlights important considerations for measuring food environments in African-American neighborhoods and their implications for developing programmatic and policy solutions to reduce racial disparities in overweight.
Windheim, L S
It has been evident to some future-looking individuals for some time that both the availability of abundant cheap energy supplies and the exponential increasing use of unlimited amounts must change. However, official energy policy thinking in the U.S. either fails to believe that 'times have changed' or, if believing, is responding in a deleterious and counter-productive manner. This fantastically pervasive and interactive problem cannot be dealt with in the long run by any policy of 'normalizing', of trying to return to doing more with more. The more successful the U.S. is in maintaining or increasing its total energy consumption under conditions of declining net energy, or striving for simplistic first-law efficiencies without analyzing the second level or entropy effects or realizing that every energy exchange adds a minute but rapidly aggregating portion to the environmental pollution limit--doing more with more--the more rapidly inflation, unemployment, and general economic instability will increase. A small group of architectural professionals, the American Institute of Architects, has proposed an alternate energy strategy, essentially doing more with less which, if pursued, can provide more jobs, less inflation, less pollution, and the potential for better matching of energy task and source (entropy efficiency). This strategy exemplifies the characteristics of an appropriate technology response. It stresses capital and energy as well as labor productivity.
Full Text Available Abstract The Psychological Ethics and National Security (PENS task force was assembled by the American Psychological Association (APA to guide policy on the role of psychologists in interrogations at foreign detention centers for the purpose of U.S. national security. The task force met briefly in 2005, and its report was quickly accepted by the APA Board of Directors and deemed consistent with the APA Ethics Code by the APA Ethics Committee. This rapid acceptance was unusual for a number of reasons but primarily because of the APA's long-standing tradition of taking great care in developing ethical policies that protected anyone who might be impacted by the work of psychologists. Many psychological and non-governmental organizations (NGOs, as well as reputable journalists, believed the risk of harm associated with psychologist participation in interrogations at these detention centers was not adequately addressed by the report. The present critique analyzes the assumptions of the PENS report and its interpretations of the APA Ethics Code. We demonstrate that it presents only one (and not particularly representative side of a complex set of ethical issues. We conclude with a discussion of more appropriate psychological contributions to national security and world peace that better respect and preserve human rights.
Lei, Mia; Acharya, Neha; Kwok Man Lee, Edith; Catherine Holcomb, Emma; Kapoor, Veronica
ABSTRACT The American Mock World Health Organization (AMWHO) is a model for experiential-based learning and student engagement in global health diplomacy. AMWHO was established in 2014 at the University of North Carolina at Chapel Hill with a mission to engage students in health policy by providing a simulation of the World Health Assembly (WHA), the policy-forming body of the World Health Organization that sets norms and transforms the global health agenda. AMWHO conferences are designed to allow students to take their knowledge of global health beyond the classroom and practice their skills in diplomacy by assuming the role of WHA delegates throughout a 3-day weekend. Through the process of developing resolutions like those formed in the WHA, students have the unique opportunity to understand the complexities behind the conflict and compromise that ensues through the lens of a stakeholder. This article describes the structure of the first 2 AMWHO international conferences, analyzes survey results from attendees, and discusses the expansion of the organization into a multi-campus national network. The AMWHO 2014 and 2015 post-conference survey results found that 98% and 90% of participants considered the conference "good" or "better," respectively, and survey responses showed that participants considered the conference "influential" in their careers and indicated that it "allowed a paradigm shift not possible in class." PMID:28351883
Olson, Brad; Soldz, Stephen; Davis, Martha
The Psychological Ethics and National Security (PENS) task force was assembled by the American Psychological Association (APA) to guide policy on the role of psychologists in interrogations at foreign detention centers for the purpose of U.S. national security. The task force met briefly in 2005, and its report was quickly accepted by the APA Board of Directors and deemed consistent with the APA Ethics Code by the APA Ethics Committee. This rapid acceptance was unusual for a number of reasons but primarily because of the APA's long-standing tradition of taking great care in developing ethical policies that protected anyone who might be impacted by the work of psychologists. Many psychological and non-governmental organizations (NGOs), as well as reputable journalists, believed the risk of harm associated with psychologist participation in interrogations at these detention centers was not adequately addressed by the report. The present critique analyzes the assumptions of the PENS report and its interpretations of the APA Ethics Code. We demonstrate that it presents only one (and not particularly representative) side of a complex set of ethical issues. We conclude with a discussion of more appropriate psychological contributions to national security and world peace that better respect and preserve human rights.
Romano, Eduardo; Cano, Saúl; Lauer, Elizabeth; Jiménez, Avelino; Voas, Robert B; Lange, James E
Several thousand young Americans visit the bars in Tijuana, Mexico, each weekend night, raising concerns on both sides of the border. Measures implemented in San Diego, California, and Tijuana have successfully reduced the number of American visitors to Mexican bars. Although San Diego policies have been well-documented, this is the first article on investigation of measures enacted south of the border. Information on Tijuana alcohol policies was obtained from a survey of 29-36 bars from 1997 to 1999. The Tijuana police provided data on Americans arrested in Tijuana from 1998 to 1999. Our study found alcohol regulations are poorly enforced in Tijuana, suggesting that regulatory agencies are captured by bar owners. However, such a capture may be weakening. The importance of identifying and supporting Mexican interest groups, as opposed to the bar owners, as a mechanism to impede the capture of Tijuana's regulatory agencies is discussed. The number of Americans involved in alcohol-related crimes in Tijuana sharply decreased over time. However, such a success is largely related to the success of the San Diego efforts in reducing the number of American visitors to Tijuana. Also, by demonstrating the racial/ethnic heterogeneity of American visitors to Tijuana bars, our study points out the need for prevention policies designed north of the border to take such heterogeneity into account.
Strath, Scott J; Kaminsky, Leonard A; Ainsworth, Barbara E; Ekelund, Ulf; Freedson, Patty S; Gary, Rebecca A; Richardson, Caroline R; Smith, Derek T; Swartz, Ann M
The deleterious health consequences of physical inactivity are vast, and they are of paramount clinical and research importance. Risk identification, benchmarks, efficacy, and evaluation of physical activity behavior change initiatives for clinicians and researchers all require a clear understanding of how to assess physical activity. In the present report, we have provided a clear rationale for the importance of assessing physical activity levels, and we have documented key concepts in understanding the different dimensions, domains, and terminology associated with physical activity measurement. The assessment methods presented allow for a greater understanding of the vast number of options available to clinicians and researchers when trying to assess physical activity levels in their patients or participants. The primary outcome desired is the main determining factor in the choice of physical activity assessment method. In combination with issues of feasibility/practicality, the availability of resources, and administration considerations, the desired outcome guides the choice of an appropriate assessment tool. The decision matrix, along with the accompanying tables, provides a mechanism for this selection that takes all of these factors into account. Clearly, the assessment method adopted and implemented will vary depending on circumstances, because there is no single best instrument appropriate for every situation. In summary, physical activity assessment should be considered a vital health measure that is tracked regularly over time. All other major modifiable cardiovascular risk factors (diabetes mellitus, hypertension, hypercholesterolemia, obesity, and smoking) are assessed routinely. Physical activity status should also be assessed regularly. Multiple physical activity assessment methods provide reasonably accurate outcome measures, with choices dependent on setting-specific resources and constraints. The present scientific statement provides a guide to
The American Nurses Association (ANA) is committed to safeguarding the public, protecting and advancing the careers of professional nurses, supporting individual and collective efforts by registered nurses to protect their clients and enhancing the professional development and job security of registered nurses. As the nation's health care system is restructured, ANA is actively engaged in initiatives to strengthen the economic and general welfare of registered nurses, the safety and care for the public, and, in partnership with the state nurses associations (SNAs), oppose efforts to replace registered nurses with inappropriate substitutes.
Full Text Available The crisis in Ukraine, that broke out in 2013 and escalated in 2014, has led to sanction policy and the emergence of significant political divergences between Russian Federation and the West. This has resulted in an intensification of Russia’s foreign and economic policy alliances with its neighboring countries as well as with the rest of the BRICS members. In his interview with Cuba’s Prensa Latina, Vladimir Putin further classified cooperation with Latin American states as one of the key and very promising lines of Russia’s foreign policy.
Full Text Available Joseph Raz has introduced an interesting class of statements —detached statements— into the philosophical lexicon. In brief, such statements are (informa- tive normative statements, yet the speaker does not, in so uttering them, express or convey acceptance of the point of view of the hearer to whom they are addressed (as contrasted with committed statements, where the speaker does express or convey such acceptance. I propose to offer a novel analysis of such statements (and to clear away some confusions about them. In brief, such statements will be analysed as wide-scope normative conditionals.
The United States Department of Energy and United States Department of State are jointly proposing to adopt a policy to manage spent nuclear fuel from foreign research reactors. Only spent nuclear fuel containing uranium enriched in the United States would be covered by the proposed policy. The purpose of the proposed policy is to promote U.S. nuclear weapons nonproliferation policy objectives, specifically by seeking to reduce highly-enriched uranium from civilian commerce. Environmental effects and policy considerations of three Management Alternative approaches for implementation of the proposed policy are assessed. The three Management Alternatives analyzed are: (1) acceptance and management of the spent nuclear fuel by the Department of Energy in the United States, (2) management of the spent nuclear fuel at one or more foreign facilities (under conditions that satisfy United States nuclear weapons nonproliferation policy objectives), and (3) a combination of components of Management Alternatives 1 and 2 (Hybrid Alternative). A No Action Alternative is also analyzed. For each Management Alternative, there are a number of alternatives for its implementation. For Management Alternative 1, this document addresses the environmental effects of various implementation alternatives such as varied policy durations, management of various quantities of spent nuclear fuel, and differing financing arrangements. Environmental impacts at various potential ports of entry, along truck and rail transportation routes, at candidate management sites, and for alternate storage technologies are also examined. For Management Alternative 2, this document addresses two subalternatives: (1) assisting foreign nations with storage; and (2) assisting foreign nations with reprocessing of the spent nuclear fuel. Management Alternative 3 analyzes a hybrid alternative. This document is Vol. 1 of 2 plus summary volume
Itai Nartzizenfield Sneh
Full Text Available El Presidente Jimmy Carter no consiguió traducir sus palabras e ideales referentes a derechos humanos a hechos y prácticas en la política exterior de E.E.U.U. Carter, ya en el primer período de su administración en 1976-77, tenía una perspectiva demasiado conservadora y tradicional con respecto a las relaciones internacionales. Sus ideas eran correctas, sin embargo seguió enfocando su política en la guerra fría más que en una puesta en práctica constante de un nuevo paradigma para los derechos humanos, especialmente con respecto a los aliados americanos en los territorios subdesarrollados. Carter no reformó suficientemente la práctica de la política exterior de los E.E.U.U. Él no creyó bastantes en la lucha por los derechos humanos así que fue imposible una modifica significativa de las prioridades tradicionales. Carter confió en las políticas, las conductas, las personalidades y estructuras administrativas vigentes. La intención de Carter de cambiar la política americana así como los principios y la comisión, fue minada seriamente por el Consejo de Seguridad Nacional (especialmente Zbigniew Brzezinksi mucho antes de los bien conocidos cambios de SALT II, de los tratados del Canal de Panamá, y del Oriente Medio.__________ABSTRACT:President Jimmy Carter failed to translate his words and ideals concerning human rights into deeds and practices in US foreign policy. Carter, already in the formative period of his administration in 1976-7, was too conservative and traditional in his outlook on international relations. While his heart was at the right place, the Cold War was still his focus rather than a consistent implementation of a new human rights paradigm, especially with respect to American allies in the Developing World. Carter did not sufficiently reform the practice of US foreign policy. He did not believe enough in advocating human rights so a meaningful recast of traditional priorities was difficult. Carter relied on
Full Text Available Writing policy that applies to First Nations, Inuit and Métis peoples in Canada has become more interactive as communities and their representative organizations press for practical recognition of an Aboriginal right of self-determination. When the policy in development is aimed at supporting “respect for human dignity” as it is in the case of ethics of research involving humans, the necessity of engaging the affected population becomes central to the undertaking.
Wittkopf, Eugene R.; Maggiotto, Michael A.
An analysis of two foreign policy surveys taken in the 1970s showed that Americans viewed the role of the United States in world affairs as either cooperative or militant internationalism. There was no consensus. Political philosophy, education, and region of the country consistently affected the respondents' attitudes. (Author/RM)
Hayes, Sharonne N; Kim, Esther S H; Saw, Jacqueline; Adlam, David; Arslanian-Engoren, Cynthia; Economy, Katherine E; Ganesh, Santhi K; Gulati, Rajiv; Lindsay, Mark E; Mieres, Jennifer H; Naderi, Sahar; Shah, Svati; Thaler, David E; Tweet, Marysia S; Wood, Malissa J
Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction. High rates of recurrent SCAD; its association with female sex, pregnancy, and physical and emotional stress triggers; and concurrent systemic arteriopathies, particularly fibromuscular dysplasia, highlight the differences in clinical characteristics of SCAD compared with atherosclerotic disease. Recent insights into the causes of, clinical course of, treatment options for, outcomes of, and associated conditions of SCAD and the many persistent knowledge gaps are presented. © 2018 American Heart Association, Inc.
Ramar, Kannan; Rosen, Ilene M; Kirsch, Douglas B; Chervin, Ronald D; Carden, Kelly A; Aurora, R Nisha; Kristo, David A; Malhotra, Raman K; Martin, Jennifer L; Olson, Eric J; Rosen, Carol L; Rowley, James A
The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. Positive airway pressure (PAP) therapy remains the most effective treatment for OSA, although other treatment options continue to be explored. Limited evidence citing small pilot or proof of concept studies suggest that the synthetic medical cannabis extract dronabinol may improve respiratory stability and provide benefit to treat OSA. However, side effects such as somnolence related to treatment were reported in most patients, and the long-term effects on other sleep quality measures, tolerability, and safety are still unknown. Dronabinol is not approved by the United States Food and Drug Administration (FDA) for treatment of OSA, and medical cannabis and synthetic extracts other than dronabinol have not been studied in patients with OSA. The composition of cannabinoids within medical cannabis varies significantly and is not regulated. Synthetic medical cannabis may have differential effects, with variable efficacy and side effects in the treatment of OSA. Therefore, it is the position of the American Academy of Sleep Medicine (AASM) that medical cannabis and/or its synthetic extracts should not be used for the treatment of OSA due to unreliable delivery methods and insufficient evidence of effectiveness, tolerability, and safety. OSA should be excluded from the list of chronic medical conditions for state medical cannabis programs, and patients with OSA should discuss their treatment options with a licensed medical provider at an accredited sleep facility. Further research is needed to understand the functionality of medical cannabis extracts before recommending them as a treatment for OSA. Copyright © 2018 American Academy of Sleep Medicine. All rights reserved.
Skolarus, Lesli E; Wing, Jeffrey J; Morgenstern, Lewis B; Brown, Devin L; Lisabeth, Lynda D
Greater poststroke disability and U.S. employment policies may disadvantage minority stroke survivors from returning to work. We explored ethnic differences in return to work among Mexican Americans (MAs) and non-Hispanic whites (NHWs) working at the time of their stroke. Stroke patients were identified from the population-based BASIC (Brain Attack Surveillance in Corpus Christi) study from August 2011 to December 2013. Employment status was obtained at baseline and 90-day interviews. Sequential logistic regression models were built to assess ethnic differences in return to work after accounting for the following: (1) age (working at the time of their stroke, of which 125 (63%) completed the 90-day outcome interview. Forty-nine (40%) stroke survivors returned to work by 90 days. MAs were less likely to return to work (OR = .45, 95% CI .22-.94) than NHWs. The ethnic difference became nonsignificant after adjusting for NIHSS (OR = .59, 95% CI .24-1.44) and further attenuated after adjusting for education (OR = .85, 95% CI .32- 2.22). The majority of stroke survivors did not return to work within 90 days of their stroke. MA stroke survivors were less likely to return to work after stroke than NHW stroke survivors which was due to their greater neurological deficits and lower educational attainment compared with that of NHW stroke survivors. Future work should focus on clinical and policy efforts to reduce ethnic disparities in return to work. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Nelin Timur Vladimirovich-
Full Text Available This article studies the policy of the first presidential administrations of the USA in relation to the Native Americans. The policy was established during the period of George Washington’s presidency. The key factor of this policy was the education of aboriginals, the inurement of skills necessary for the integration with white people. The development of trade relations between nations became the beginning of this process. Trade relations required competent management and special laws regulating the process of trade and intercourse with the Native Americans. Government trading houses (factories had to urge the process of civilization. The author shows the influence of the Enlightenment philosophy of Thomas Jefferson on his idea to educate the aboriginals. The close attention is paid not only to the political views of the third president of the USA, but also to his activity in the process of realizing the educational policy towards the Natives. Educational programs had a purpose to integrate aboriginal tribes into the US society. It was uneasy task and the government tried to find more constructive forms of working instead of common trade and intercourse acts with the Indians. The Louisiana Purchase gave new opportunities for developing the federal policy. Lewis and Clark explored the West and collected comprehensive information about its tribes, their habits and way of life. It was very useful for the government in its idea to civilize the indigenous peoples. The author studies the letters of Thomas Jefferson to some American politics and to the Natives, that the president wrote about his plans about the future of the American Indians. Revival movement of the Second Great Awaking found good allies for the US government. The author shows the role of protestant missionaries in the educational policy of the USA towards the Natives.
Eisner, Mark D.; Anthonisen, Nicholas; Coultas, David; Kuenzli, Nino; Perez-Padilla, Rogelio; Postma, Dirkje; Romieu, Isabelle; Silverman, Edwin K.; Balmes, John R.
Rationale: Although cigarette smoking is the most important cause of chronic obstructive pulmonary disease (COPD), a substantial proportion of COPD cases cannot be explained by smoking alone. Objectives: To evaluate the risk factors for COPD besides personal cigarette smoking. Methods: We
Garber, Alan J; Abrahamson, Martin J; Barzilay, Joshua I; Blonde, Lawrence; Bloomgarden, Zachary T; Bush, Michael A; Dagogo-Jack, Samuel; DeFronzo, Ralph A; Einhorn, Daniel; Fonseca, Vivian A; Garber, Jeffrey R; Garvey, W Timothy; Grunberger, George; Handelsman, Yehuda; Hirsch, Irl B; Jellinger, Paul S; McGill, Janet B; Mechanick, Jeffrey I; Rosenblit, Paul D; Umpierrez, Guillermo E
A1C = hemoglobin A1C; AACE = American Association of Clinical Endocrinologists; ACCORD = Action to Control Cardiovascular Risk in Diabetes; ACCORD BP = Action to Control Cardiovascular Risk in Diabetes Blood Pressure; ACEI = angiotensin-converting enzyme inhibitor; ADVANCE = Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation; AGI = alpha-glucosidase inhibitor; apo B = apolipoprotein B; ASCVD = atherosclerotic cardiovascular disease; BAS = bile acid sequestrant; BCR-QR = bromocriptine quick release; BMI = body mass index; BP = blood pressure; CCB = calcium channel blocker; CHD = coronary heart disease; CKD = chronic kidney disease; CVD = cardiovascular disease; DASH = Dietary Approaches to Stop Hypertension; DPP4 = dipeptidyl peptidase 4; eGFR = estimated glomerular filtration rate; ER = extended release; FDA = Food and Drug Administration; GLP1 = glucagon-like peptide 1; HDL-C = high-density lipoprotein cholesterol; IMPROVE-IT = Improved Reduction of Outcomes: Vytorin Efficacy International Trial; LDL-C = low-density lipoprotein cholesterol; LDL-P = low-density lipoprotein particle; Look AHEAD = Look Action for Health in Diabetes; NPH = neutral protamine Hagedorn; OSA = obstructive sleep apnea; RCT = randomized controlled trial; SU = sulfonylurea; SGLT2 = sodium glucose cotransporter-2; SMBG = self-monitoring of blood glucose; T2D = type 2 diabetes; TZD = thiazolidinedione; VADT = Veterans Affairs Diabetes Trial.
Kotloff, Robert M; Blosser, Sandralee; Fulda, Gerard J; Malinoski, Darren; Ahya, Vivek N; Angel, Luis; Byrnes, Matthew C; DeVita, Michael A; Grissom, Thomas E; Halpern, Scott D; Nakagawa, Thomas A; Stock, Peter G; Sudan, Debra L; Wood, Kenneth E; Anillo, Sergio J; Bleck, Thomas P; Eidbo, Elling E; Fowler, Richard A; Glazier, Alexandra K; Gries, Cynthia; Hasz, Richard; Herr, Dan; Khan, Akhtar; Landsberg, David; Lebovitz, Daniel J; Levine, Deborah Jo; Mathur, Mudit; Naik, Priyumvada; Niemann, Claus U; Nunley, David R; O'Connor, Kevin J; Pelletier, Shawn J; Rahman, Omar; Ranjan, Dinesh; Salim, Ali; Sawyer, Robert G; Shafer, Teresa; Sonneti, David; Spiro, Peter; Valapour, Maryam; Vikraman-Sushama, Deepak; Whelan, Timothy P M
This document was developed through the collaborative efforts of the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations. Under the auspices of these societies, a multidisciplinary, multi-institutional task force was convened, incorporating expertise in critical care medicine, organ donor management, and transplantation. Members of the task force were divided into 13 subcommittees, each focused on one of the following general or organ-specific areas: death determination using neurologic criteria, donation after circulatory death determination, authorization process, general contraindications to donation, hemodynamic management, endocrine dysfunction and hormone replacement therapy, pediatric donor management, cardiac donation, lung donation, liver donation, kidney donation, small bowel donation, and pancreas donation. Subcommittees were charged with generating a series of management-related questions related to their topic. For each question, subcommittees provided a summary of relevant literature and specific recommendations. The specific recommendations were approved by all members of the task force and then assembled into a complete document. Because the available literature was overwhelmingly comprised of observational studies and case series, representing low-quality evidence, a decision was made that the document would assume the form of a consensus statement rather than a formally graded guideline. The goal of this document is to provide critical care practitioners with essential information and practical recommendations related to management of the potential organ donor, based on the available literature and expert consensus.
... Chairman, Joint Chiefs of Staff; Subject: Review of Discharges Under Other Than Honorable Conditions Issued... applications for such review from former service members. Each Secretary is authorized to issue a discharge... States Code 1553. “This policy shall apply to those service members whose cases are finalized or in...
Carty, Sally E; Doherty, Gerard M; Inabnet, William B; Pasieka, Janice L; Randolph, Gregory W; Shaha, Ashok R; Terris, David J; Tufano, Ralph P; Tuttle, R Michael
Thyroid cancer specialists require specific perioperative information to develop a management plan for patients with thyroid cancer, but there is not yet a model for effective interdisciplinary data communication. The American Thyroid Association Surgical Affairs Committee was asked to define a suggested essential perioperative dataset representing the critical information that should be readily available to participating members of the treatment team. To identify and agree upon a multidisciplinary set of critical perioperative findings requiring communication, we examined diverse best-practice documents relating to thyroidectomy and extracted common features felt to enhance precise, direct communication with nonsurgical caregivers. Suggested essential datasets for the preoperative, intraoperative, and immediate postoperative findings and management of patients undergoing surgery for thyroid cancer were identified and are presented. For operative reporting, the essential features of both a dictated narrative format and a synoptic computer format are modeled in detail. The importance of interdisciplinary communication is discussed with regard to the extent of required resection, the final pathology findings, surgical complications, and other factors that may influence risk stratification, adjuvant treatment, and surveillance. Accurate communication of the important findings and sequelae of thyroidectomy for cancer is critical to individualized risk stratification as well as to the clinical issues of thyroid cancer care that are often jointly managed in the postoperative setting. True interdisciplinary care is essential to providing optimal care and surveillance.
Lui, George K; Saidi, Arwa; Bhatt, Ami B; Burchill, Luke J; Deen, Jason F; Earing, Michael G; Gewitz, Michael; Ginns, Jonathan; Kay, Joseph D; Kim, Yuli Y; Kovacs, Adrienne H; Krieger, Eric V; Wu, Fred M; Yoo, Shi-Joon
Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease and its risk factors are becoming increasingly prevalent. Disorders of psychosocial and cognitive development are key factors affecting the quality of life of these individuals. It is incumbent on physicians who care for patients with CHD to be mindful of the effects that disease of organs other than the heart may have on the well-being of adults with CHD. Further research is needed to understand how these noncardiac complications may affect the long-term outcome in these patients and what modifiable factors can be targeted for preventive intervention. © 2017 American Heart Association, Inc.
This issue of 'Energies et Matieres Premieres' comprises 7 papers dealing successively with: the French policy for the development of renewable energies (talk given by C. Pierret, French state secretary of Industry, at the colloquium 'energy diversification and environment protection: the renewable energies at the 2010 vista'); the statement of the renewable energies development policy (wood-fuel, wind energy, thermal solar energy, electrification of isolated areas, biomass for power production, revalorization of the conditions of power repurchase); the recent development of cogeneration in France (advantages, promotion, financial incentives, contracts, future developments); the natural gas distribution or how to combine public utility and market deregulation; the crude oil rates (key-role of Saudi Arabia, effect of speculation, perspectives and uncertainties); the human, technical, financial and legal problems linked with mines decommissioning; the European helps in favour of energy mastery (the fifth R and D management program, the energy program and its 6 specific programs: ETAP, SYNERGY, ALTENER, SAVE, CARNOT, SURE). (J.S.)
Addison, Clifton; Jenkins, Brenda W Campbell; White, Monique; Henderson, Frances; McGill, Dorothy J; Antoine-LaVigne, Donna; Payton, Marinelle
The present study aimed to examine the perceptions of African American communities regarding the involvement of political leaders in facilitating policy and environmental change promoting healthy eating and physical activity. We selected the Metro Jackson Area comprised of Hinds, Madison and Rankin Counties because it is a combination of urban and rural communities. The sample consisted of 70 participants from seven sites. A total of seven focus groups were asked to respond to one question to assess political leaders' involvement in healthy living: "When you think about your political leaders that you have in the Jackson, Mississippi area, do any of them promote healthy eating and physical activity?" Focus groups consisted of six to 12 participants and were asked to comment on their participation in physical activity. The focus group interviews were digitally recorded. The recorded interviews were transcribed by a professional transcriptionist. Community members could not recollect much participation from political leaders in the health prevention/intervention efforts. In each of the counties, there was evidence that there was some involvement by local politicians in health promotion issues, but not on a large scale. In conclusion, making healthy foods and products available in neighborhood stores has long been associated with healthy behaviors and positive health outcomes. This can make a difference in the Mississippi communities where supermarkets are not accessible and health disparities abound.
Inglez-Dias, Aline; Ribeiro, José Mendes; Bastos, Francisco I; Page, Kimberly
Given the rapid spread of the HIV epidemic and the need to control its transmission among intravenous drug users (IDU), harm reduction strategies have been incorporated in many countries, including Brazil. Considering these aspects and taking into account the emergence of drugs as a core concern on the government's agenda, especially crack cocaine, this article presents some of the contributions acquired from observing and recording the practices of an American model of research and care for IDUs, namely the UFO (You Find Out) Study. Issues such as participants' access and adherence, financing difficulties, sustainability and outcome evaluation were considered. The study involved documental research, systematic observation and interviews with key informants. Some of the UFO features that could contribute to the formulation of harm reduction policies in Brazil are highlighted. The UFO appears to be a successful example of harm reduction initiatives that successfully contact and guarantee the commitment of that risk group, ensuring its access to health services and reducing risks associated with drug use.
Miravitlles, Marc; Dirksen, Asger; Ferrarotti, Ilaria
lung disease. A large proportion of individuals affected remain undiagnosed and therefore without access to appropriate care and treatment.The most recent international statement on AATD was published by the American Thoracic Society and the European Respiratory Society in 2003. Since then there has...
... basis of policy disagreements. At the same time, such signing statements serve a legitimate function in... United States, its departments, agencies, or entities, its officers, employees, or agents, or any other...
Statement of Dr. Marilyn L. Miller, Immediate Past President, American Association of School Librarians, a Division of the American Library Association, before the Subcommittee on Education, Arts, and Humanities, Senate Labor and Human Resources Committee on Reauthorization of Chapter 2, Education Consolidation and Improvement Act, July 16, 1987.
Miller, Marilyn L.
This statement in support of Education Consolidation Improvement Act reauthorization discusses six topics related to school libraries: (1) purpose of school libraries; (2) research supporting need for school libraries; (3) current status; (4) funding realities; (5) deteriorating book collections; and (6) impact of federal aid. An American Library…
The intercomparison of seven chemical mechanisms for their suitability for air quality policy formulation and assessment is described. Box modeling techniques were employed using 44 sets of background environmental conditions covering North America to constrain the chemical development of the longer lived species. The selected mechanisms were modified to enable an unbiased assessment of the adequacy of the parameterizations of photochemical ozone production from volatile organic compound (VOC) oxidation in the presence of NO x . Photochemical ozone production rates responded differently to 30% NO x and VOC reductions with the different mechanisms, despite the striking similarities between the base-case ozone production rates. The 30% reductions in NO x and VOCs also produced changes in OH. The responses in OH to 30% reductions in NO x and VOCs appeared to be more sensitive to mechanism choice, compared with the responses in the photochemical ozone production rates. Although 30% NO x reductions generally led to decreases in OH, 30% reductions in VOCs led to increases in OH, irrespective of mechanism choice and background environmental conditions. The different mechanisms therefore gave different OH responses to NO x and VOC reductions and so would give different responses in terms of changes in the fate and behavior of air toxics, acidification and eutrophication, and fine particle formation compared with others, in response to ozone control strategies. Policymakers need to understand that there are likely to be inherent differences in the responses to ozone control strategies between different mechanisms, depending on background environmental conditions and the extents of NO x and VOC reductions under consideration. The purpose of this paper is to compare predicted ozone responses to NO x and VOC reductions with seven chemical mechanisms under North American conditions. The good agreement found between the tested mechanisms should provide some support for their
Avin, Keith G; Hanke, Timothy A; Kirk-Sanchez, Neva; McDonough, Christine M; Shubert, Tiffany E; Hardage, Jason; Hartley, Greg
Falls in older adults are a major public health concern due to high prevalence, impact on health outcomes and quality of life, and treatment costs. Physical therapists can play a major role in reducing fall risk for older adults; however, existing clinical practice guidelines (CPGs) related to fall prevention and management are not targeted to physical therapists. The purpose of this clinical guidance statement (CGS) is to provide recommendations to physical therapists to help improve outcomes in the identification and management of fall risk in community-dwelling older adults. The Subcommittee on Evidence-Based Documents of the Practice Committee of the Academy of Geriatric Physical Therapy developed this CGS. Existing CPGs were identified by systematic search and critically appraised using the Appraisal of Guidelines, Research, and Evaluation in Europe II (AGREE II) tool. Through this process, 3 CPGs were recommended for inclusion in the CGS and were synthesized and summarized. Screening recommendations include asking all older adults in contact with a health care provider whether they have fallen in the previous year or have concerns about balance or walking. Follow-up should include screening for balance and mobility impairments. Older adults who screen positive should have a targeted multifactorial assessment and targeted intervention. The components of this assessment and intervention are reviewed in this CGS, and barriers and issues related to implementation are discussed. A gap analysis supports the need for the development of a physical therapy-specific CPG to provide more precise recommendations for screening and assessment measures, exercise parameters, and delivery models. This CGS provides recommendations to assist physical therapists in the identification and management of fall risk in older community-dwelling adults. © 2015 American Physical Therapy Association.
The Director General has received a Note Verbale, dated 12 October 2004, from the Permanent Mission of France to the IAEA in the enclosures of which the Government of France, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2003. The Government of France has also made available a statement of its annual figures for holdings of civil high enriched uranium (HEU) as of 31 December 2003. In light of the request expressed by the Government of France in its Note Verbale of 28 November 1997 concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), the enclosures of the Note Verbale of 12 October 2004 are attached for the information of all Member States
Lokesh R. Maharajh
Full Text Available This article examined on teachers’ experiences on the implementation of CAPS, using three primary schools in KwaZulu-Natal. This article employed the curriculum theory as an analytical framework. The aim of this article is to examine teacher’s experiences of the implementation of the Curriculum and Assessment Policy Statement (CAPS. The article employed a qualitative research design to gather data. The data gathered through the use of semi-structured face to face interviews with teachers. The findings of the article reveal that there are many dynamics and possibilities relating to curriculum change in South Africa. The findings of the article further reveal that despite the challenges facing CAPS, South Africa’s education system as a whole is plagued by challenges. The challenges are attributed to lack of resources and poorly trained teachers. The article concludes that understanding these dynamics depend, to a large extent, on paying attention to constraints and challenges influencing curriculum change. This article fills the knowledge-gap with reference to teacher’s first-hand knowledge of CAPS and the challenges associated with it. The article thus recommends that appropriate resources should be made available in order to ensure efficient and effective implementation of curriculum implementation. It also recommends that a teacher: learner ratio of 1:30 should be practiced to ensure that teachers give special attention to each learner.
The Director General has received a letter dated 18 April 2005 from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2004. The Government of the Federal Republic of Germany has also made available a statement of the estimated amounts of high enriched uranium (HEU) as of 31 December 2004. In light of the request expressed by the Federal Republic of Germany in its Note Verbale of 1 December 1997 concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), the enclosures of the letter of 18 April 2005 are attached for the information of all Member States
The Director General has received a Note Verbale, dated 2 September 2003, from the Permanent Mission of France to the IAEA in the enclosures of which the Government of France, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2002. The Government of France has also made available a statement of its annual figures for holdings of civil high-enriched uranium (HEU) as of 31 December 2002. In light of the request expressed by the Government of France in its Note Verbale of 28 November 1997 concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), the enclosures of the Note Verbale of 2 September 2003 are attached for the information of all Member States
Huo, Yuen J; Dovidio, John F; Jiménez, Tomás R; Schildkraut, Deborah J
In the past 15 years, the adoption of subnational immigration policies in the United States, such as those established by individual states, has gone from nearly zero to over 300 per year. These include welcoming policies aimed at attracting and incorporating immigrants, as well as unwelcoming policies directed at denying immigrants access to public resources and services. Using data from a 2016 random digit-dialing telephone survey with an embedded experiment, we examine whether institutional support for policies that are either welcoming or hostile toward immigrants differentially shape Latinos' and whites' feelings of belonging in their state (Arizona/New Mexico, adjacent states with contrasting immigration policies). We randomly assigned individuals from the representative sample ( n = 1,903) of Latinos (US and foreign born) and whites (all US born) to consider policies that were either welcoming of or hostile toward immigrants. Across both states of residence, Latinos, especially those foreign born, regardless of citizenship, expressed more positive affect and greater belonging when primed with a welcoming (vs. hostile) policy. Demonstrating the importance of local norms, these patterns held among US-born whites, except among self-identified politically conservative whites, who showed more negative affect and lower levels of belonging in response to welcoming policies. Thus, welcoming immigration policies, supported by institutional authorities, can create a sense of belonging not only among newcomers that is vital to successful integration but also among a large segment of the population that is not a direct beneficiary of such policies-US-born whites.
quality consensus conference was underwrit- ten in part by unrestricted educational grants from Molnlycke Health Care and Baxter Health Care. Address... nutrition , psychological outcomes, resuscitation, and wound repair. After reviewing the literature, debating the issues at the consensus conference and...need for intubation, concomitant trauma. 3. Resuscitation characteristics: Lab values (base defi- cit, lactate, hemoglobin /hematocrit, blood urea
Brush, John E; Handberg, Eileen M; Biga, Cathleen; Birtcher, Kim K; Bove, Alfred A; Casale, Paul N; Clark, Michael G; Garson, Arthur; Hines, Jerome L; Linderbaum, Jane A; Rodgers, George P; Shor, Robert A; Thourani, Vinod H; Wyman, Janet F
The mission of the American College of Cardiology is "to transform cardiovascular care and improve heart health." Cardiovascular team-based care is a paradigm for practice that can transform care, improve heart health, and help meet the demands of the future. One strategic goal of the College is to help members successfully transition their clinical practices to the future, with all its complexity, challenges, and opportunities. The ACC's strategic plan is aligned with the triple aim of improved care, improved population health, and lower costs per capita. The traditional understanding of quality, access, and cost is that you cannot improve one component without diminishing the others. With cardiovascular team-based care, it is possible to achieve the triple aim of improving quality, access, and cost simultaneously to also improve cardiovascular health. Striving to serve the best interests of patients is the true north of our guiding principles. Cardiovascular team-based care is a model that can improve care coordination and communication and allow each team member to focus more on the quality of care. In addition, the cardiovascular team-based care model increases access to cardiovascular care and allows expansion of services to populations and geographic areas that are currently underserved. This document will increase awareness of the important components of cardiovascular team-based care and create an opportunity for more discussion about the most creative and effective means of implementing it. We hope that this document will stimulate further discussions and activities within the ACC and beyond about team-based care. We have identified areas that need improvement, specifically in APP education and state regulation. The document encourages the exploration of collaborative care models that should enable team members to optimize their education, training, experience, and talent. Improved team leadership, coordination, collaboration, engagement, and efficiency
A standard that may be used as a guide for persons making independent examinations of nuclear materials statements or reports regarding inventory quantities on hand, receipts, production, shipment, losses, etc. is presented. The objective of the examination of nuclear materials statements by the independent auditor is the expression of an opinion on the fairness with which the statements present the nuclear materials position of a nuclear materials facility and the movement of such inventory materials for the period under review. The opinion is based upon an examination made in accordance with auditing criteria, including an evaluation of internal control, a test of recorded transactions, and a review of measured discards and materials unaccounted for (MUF). The standard draws heavily upon financial auditing standards and procedures published by the American Institute of Certified Public Accountants
Yaoqi Zhang; Bin Zheng; Ge Sun; Peilei Fan Fan
Lawn has been used for landscaping, gardening, and beautification of homes and cities for a long time. The evolution of the lawn reflects important cultural and biophysical interactions between humans and nature. The American lawn, which was from Europe and has been a part of the American dream for home ownership and culture, has become an area going against nature for...
Menard, Lauren A.
American opinion on spanking has shifted. Most Americans agreed with the necessity of sometimes spanking children, but proportions disagreeing increased 15 percentage point (94% overall) between 1986 (16%) and 2010 (31%). Growing proportions disagreed with spanking in each consecutive decade for all significant generational cohorts, with the…
Braae, Ellen Marie
A reflection on the relation between Danish landscape architecture policy and the statements made through current landscape architectural project.......A reflection on the relation between Danish landscape architecture policy and the statements made through current landscape architectural project....
Byrne, John; Hughes, Kristen; Rickerson, Wilson; Kurdgelashvili, Lado
Climate change threatens significant impacts on global ecosystems and human populations. To address this challenge, industrialized nations have ratified the Kyoto Protocol and undertaken commitments to reduce emissions of greenhouse gases, the primary agents linked to anthropogenic alteration of earth's climate. By contrast, the US government, led by the Bush Administration, has rejected mandatory targets for curbing emissions under the Protocol, and has instead pursued voluntary mitigation measures amid a larger push for clean coal and 'next generation' nuclear technologies. These actions in total have fueled global perceptions that the US is not acting in substantial ways to address climate change. Nevertheless, action within the US is indeed moving forward, with states, cities and regional partnerships filling the federal leadership vacuum. This paper reviews the diverse policies, strategies, and cooperative frameworks that have emerged at regional, state and local levels to guide climate protection, and identifies the environmental and economic benefits linked to such programs. The paper also attempts to explain the existing federal impasse on climate policy, with attention given to how sub-national efforts may ultimately obviate national governmental inaction
physical health , leading to a decrease in morbidity and mortality from obesity. Nootropics on pharmacy shelves combat hunger, low energy, and...office of the future. 14. SUBJECT TERMS futures, megatrends, emerging technologies, drug policy, public health , war on drugs, forecasting, behavioral... health , scenarios, trends, innovation, regulation, policy, artificial intelligence, brain-computer interface, neural stimulation, nootropics
Fulmer, William E.
This is the twenty-eighth of a series of studies conducted to determine variances in industrial employment practices of Negroes and to develop appropriate hiring policies. This particular study sought to examine current racial employment policies in the furniture industry within the context of the industry's structure and history. Interviews with…
... and Involve repeated tradeoffs and multi-front approaches It's also true that regardless of the energies and resources mustered and expended, an actual policy change may hinge on the unbending personality, influence, and commitment of a single key player Therefore, U S policy rarely moves in a logical and measured fashion from Point A to Point B.
As a distinct foreign-policy group, neoconservatives emerged in a period of social unrest and political cynicism—a time when insurgent presidential candidates can have profound effects on the outlook and conduct of foreign policy. The George McGovern insurgency is an important historical event that
... 46 Shipping 9 2010-10-01 2010-10-01 false Environmental impact statements. 504.7 Section 504.7... POLICY ANALYSIS § 504.7 Environmental impact statements. (a) General. (1) An environmental impact... environmental impact statements. (1) A draft environmental impact statement (DEIS) will initially be prepared in...
American Psychologist, 2008
Each year, the American Psychological Association's Policy and Planning Board takes the pulse of the Association and the discipline as a whole and writes a report that represents the Board's best appraisal of a fundamental policy. Our main objective, however, is not simply to assess the current situation but to look forward on behalf of the…
Solomon, Barry D; Banerjee, Aparajita; Acevedo, Alberto; Halvorsen, Kathleen E; Eastmond, Amarella
Rapid growth of biofuel production in the United States and Brazil over the past decade has increased interest in replicating this success in other nations of the Pan American region. However, the continued use of food-based feedstock such as maize is widely seen as unsustainable and is in some cases linked to deforestation and increased greenhouse gas emissions, raising further doubts about long-term sustainability. As a result, many nations are exploring the production and use of cellulosic feedstock, though progress has been extremely slow. In this paper, we will review the North-South axis of biofuel production in the Pan American region and its linkage with the agricultural sectors in five countries. Focus will be given to biofuel policy goals, their results to date, and consideration of sustainability criteria and certification of producers. Policy goals, results, and sustainability will be highlighted for the main biofuel policies that have been enacted at the national level. Geographic focus will be given to the two largest producers-the United States and Brazil; two smaller emerging producers-Argentina and Canada; and one stalled program-Mexico. However, several additional countries in the region are either producing or planning to produce biofuels. We will also review alternative international governance schemes for biofuel sustainability that have been recently developed, and whether the biofuel programs are being managed to achieve improved environmental quality and sustainable development.
White, Tarsha D.
Broad inferences have been made that the election of a Black American President indicates that America now functions in a post-racist society. This optimism has fueled a major discussion for changes in American policies which directly affect minorities; in particular, those related to affirmative action in higher education are under attack. Due to…
Hjelholt, Morten; Jensen, Tina Blegind
IT projects are often complex arrangements of technological components, social actions, and organizational transformation that are difficult to manage in practice. This paper takes an analytical discourse perspective to explore the process of legitimizing IT projects. We introduce the concept...... of resonating statements to highlight how central actors navigate in various discourses over time. Particularly, the statements and actions of an IT project manager are portrayed to show how individuals can legitimize actions by connecting statements to historically produced discourses. The case study...... as part of a feedback loop to re-attach the localized IT project to the broader national discourse. The paper concludes with reflections on how to actively build on resonating statements as a strategic resource for legitimizing IT projects...
Financial Statements and accompanying notes provided on .... to good governance principles. there is the risk that ...... responsibilities of the centre's internal auditor includes reviewing internal controls, including accounting and financial.
David Mermin suggests that my recent proof pertaining to quantum nonlocality is undermined by an essential ambiguity pertaining to the meaning of counterfactual statements in quantum physics. The ambiguity he cites arises from his imposition of a certain criterion for the meaningfulness of such counterfactual statements. That criterion conflates the meaning of a counterfactual statement with the details of a proof of its validity in such a way as to make the meaning of such a statement dependent upon the context in which it occurs. That dependence violates the normal demand in logic that the meaning of a statement be defined by the words in the statement itself, not by the context in which the statement occurs. My proof conforms to that normal requirement. I describe the context-independent meaning within my proof of the counterfactual statements in question. copyright 1998 American Association of Physics Teachers
From the analysis of the juridical and political possibilities conditions of a trans-national market of the exploitation permits, the author shows the great degradation of the institutional environment of petroleum contracts from 1960 to 1970. Then he studies the american strategy of the market reconstruction initiated by the Reagan administration: standards, modalities of diffusion, the transposition in the juridical system. The second part is devoted to the elaboration of a model aiming to detail the market construction and extension policy in a key domain of the international relations. The tradition of the liberal economic policy allows to understand the market promotion in the internal and the international order. (A.L.B.)
disagreement between religious conservatives and liberal constitutionalists, the efforts of the Shah to restore the power of the monarchy, and the ongoing...interests in the region. In response, the United States adopted a policy of containment aimed at restoring a regional power balance favorable to the...oil market , and the consequences of the Arab Spring, have wrought significant changes to the region. After thirty-seven years of policy aimed at
The transition to a more sustainable energy system requires a much faster development of new and renewable energy technologies for electricity generation (RENe). Thus, involving new challenges in the regulation of electricity sector. Additionally, a stronger commitment by emerging and developing countries for a deeper decarbonization trajectory, calls for the strengthening of renewable energy policies. Such policies include designing regulatory instruments that are better adapted for their specific economic and institutional needs. This thesis deals with the evaluation and the redesign of policies that encourage the diffusion of RENe in the context of Latin America's countries. To this end, we first use Environmental Economics theory to analyse the different regulatory instruments available, characterize them and to propose evaluation criteria based on a thorough review of the literature. We then carry out a panel data econometric study, to identify the determining factors of investments in regards to new RENe production capacity; and in particular, to measure the effectiveness of such policies. In a third phase, we mobilize the evolutionary theory of technological change to analyse the process of policy implementation, the existing barriers and the obtained results. This analysis is based on three case studies in the electricity sector of Chile, Brazil and Argentina. And finally, we focus on the challenges related to the massive deployment of RENe in Latin America by 2030-2040: the integration of intermittent energy sources, the access to financing and the industrial challenge. Our research shows that the evolution of the economic and institutional context encourages a dynamic which conditions public policy choices as well as their performance. We therefore propose the basis of an analytical framework for the design and assessment of ambitious long-term promoting policies. These policies must be integrated into a multidimensional and coherent project for the
Palley, Howard A
This paper deals primarily with social policy considerations relevant to the development of long-term care policy for the frail elderly in the United States. However, it also includes some commentary on meeting the acute care needs of the frail elderly. It defines chronic care treatment as a mix of "short-term" and "long-term" modes of care. Furthermore, it explores the need for treatment of such long-term illnesses to recognize the importance of alternative modes of caring which include strategies, both medical and nonmedical, delivered within and outside of hospitals and nursing homes. The paper includes an analysis of public and private sector priorities based in data published by the U.S. Health Care Financing Administration. It also includes some discussion of the PACE program in the United States and some other efforts to stimulate more in-home and community-based alternatives to nursing home care. Furthermore, it includes a discussion of the policy goal of "appropriateness" in developing long-term care (as well as general health priorities) and provides a critical discussion of problems with utilizing "cost/benefit analysis." The study concludes that too exclusive a focus on nursing home care for the elderly in the United States is unfortunate-both in terms of the desires of the elderly, their families and friends and in terms of focusing on "appropriateness" as a legitimate policy goal in the development of long-term care policy for the elderly in the United States.
Jean de Kervasdoué
Full Text Available Although American health policy debates address similar problems to other developed nations, it has factual and ideological specificities. I agree with Chinitz and Rodwin on the dominance of micro-economics thinking. However, I am not certain that learning from management theory or modifying medical education will be powerful enough to change the system. The vested interests of the stakeholders are too powerful, the more so when they are supported by economists who ideologically reinforce them and by neglecting the fact that the basic premises of market ideology are false when applied to medical care. There is enough empirical evidence to support that but, apparently, these facts do not dent these beliefs.
Noel, Pierre; Reiner, David
In its oil and energy security policy, the Bush Administration has shown a willingness to serve industrial and regional interests while relying on rhetoric of crisis - energy crisis and national security crisis. The 'Bush energy plan' of stimulating internal energy production by weakening environmental and other regulations has failed politically. In climate change policy, the Bush Administration decided not to sign the Kyoto protocol as well as not to regulate greenhouse gas emissions in the U.S. This policy has had far reaching adverse consequences for the Bush Administration, in both domestic and foreign politics. The Administration has failed at making its technology-only approach accepted as a credible alternative to regulating emissions
El Salvador , Guatemala, Honduras, Paraguay, Peru and Uruguay have contributed to or led multi-national security operations and United Nations (UN...critical support during the initial stages of the Haiti earthquake relief effort. As military forces often have a unique capability to respond
Public mass schooling was the major instrument used by the Americans in the performance of their mission to "civilize" Filipinos. Free primary education was implemented right after the islands' annexation in 1899 and was a critical component (alongside armed force) of the programme for their "pacification". For the elite,…
Fox, Darin J
To achieve lasting security in the Arabian Gulf region, U.S. policy, though currently focused on Iraq, must engage Saudi Arabia and Iran with all of its instruments of national power to encourage the spread of democracy within the region...
Stephen J. Randall
Full Text Available The article explores the ambitions, challenges, successes and perceived failures and disappointments of the policies pursued by the Democratic administrations of President Barack Obama, with particular focus on Honduras, Mexico and Colombia. The article notes the eloquent and optimistic rhetoric of Obama, in his first presidential campaign and in the early days of his first administration, commitments to significant change in U.S. policy toward Latin America. In contrast the record of the first five years of his administrations have witnessed the continuation of policies which are difficult to distinguish from those of his predecessor. The article also notes the general decline in U.S. influence in the region. There has been insignificant change in Cuban policy, save for a liberalization of family travel to Cuba. His administration implemented the controversial Free Trade Agreement with Colombia which his own party leaders had long opposed. He has maintained the funding levels of the equally controversial Plan Colombia which began under Bill Clinton, and he has continued to adhere to a largely Republican agenda on border security with Mexico.
This policy brief is the third in a series of in-depth case studies exploring how top-performing charter schools have incorporated civic learning in their school curriculum and school culture. The UNO Charter School Network includes 13 schools serving some 6,500 students across Chicago. Located in predominantly Hispanic neighborhoods, the…
Eigen, Lewis D.
This white paper describes the extent of drinking on college campuses; the health, social, academic, and economic costs thereof; means of education and intervention available to schools; and the relationship of many university policies and practices to this problem. The paper is organized into two major sections. The first describes the nature of…
Kopp, R.; Hessler, Ch.
The 15 january 2002 brought together two eminent experts on US energy politics and some forty government, private sector and university French decision makers to discuss the topic of the US energy policies in the context of climatic change. the main ideas of the discussions are summarized in this document. (A.L.B.)
Smith, Katherine Elizabeth; Fooks, Gary; Gilmore, Anna B; Collin, Jeff; Weishaar, Heide
Over the past fifteen years, an interconnected set of regulatory reforms, known as Better Regulation, has been adopted across Europe, marking a significant shift in the way that European Union policies are developed. There has been little exploration of the origins of these reforms, which include mandatory ex ante impact assessment. Drawing on documentary and interview data, this article discusses how and why large corporations, notably British American Tobacco (BAT), worked to influence and promote these reforms. Our analysis highlights (1) how policy entrepreneurs with sufficient resources (such as large corporations) can shape the membership and direction of advocacy coalitions; (2) the extent to which "think tanks" may be prepared to lobby on behalf of commercial clients; and (3) why regulated industries (including tobacco) may favor the use of "evidence tools," such as impact assessments, in policy making. We argue that a key aspect of BAT's ability to shape regulatory reform involved the deliberate construction of a vaguely defined idea that could be strategically adapted to appeal to diverse constituencies. We discuss the theoretical implications of this finding for the Advocacy Coalition Framework, as well as the practical implications of the findings for efforts to promote transparency and public health in the European Union. Copyright © 2015 by Duke University Press.
Gilmore, Anna; Collin, Jeff; Townsend, Joy
Objectives. The International Monetary Fund encourages privatization of state-owned tobacco industries. Privatization tends to lower cigarette prices, which encourages consumption. This could be countered with effective tax policies. We explored how investment by British American Tobacco (BAT) influenced tax policy in Uzbekistan during privatization there. Methods. We obtained internal documents from BAT and analyzed them using a hermeneutic process to create a chronology of events. Results. BAT thoroughly redesigned the tobacco taxation system in Uzbekistan. It secured (1) a reduction of approximately 50% in the excise tax on cigarettes, (2) an excise system to benefit its brands and disadvantage those of its competitors (particularly Philip Morris), and (3) a tax stamp system from which it hoped to be exempted, because this would likely facilitate its established practice of cigarette smuggling and further its competitive advantage.. Conclusions. Privatization can endanger effective tobacco excise policies. The International Monetary Fund should review its approach to privatization and differentiate the privatization of an industry whose product kills from privatization of other industries. PMID:17138915
Claudia Cecilia Lardizabal; Ismene Rosales; Janaina Camile Pasqual; Gricelda Herrera; Sandra Mejia; Mariel Álvarez Cancino
The energy matrix of Latin American and the Caribbean countries has one of the largest renewable energy components when compared to other regions of the world. Nonetheless, by 2009 nearly three-quarters of its structure corresponded to fossil fuels, with most of the countries being net importers of these fuels. This situation marks the region´s dependence on the effects of changes in energy commodities. Therefore, the opportunity lies in higher use of renewable energy sources that contribute ...
America Since 1920,” Journal of Latin American Studies, 1983: 276. 11 Kevin Sullivan, “El Salvador: On Unfinished Road to Reform; Despite Being...different than those of President Carter. In fact, a substantial part of his party plank cited key differences between his and the ex-president’s Central...true: Castro himself was influential with FMLN leadership ; in fact, the FMLN formed at his urging.42 The full extent to which Castro, the Soviets or
time and space with similar proportions to that of the mid-century airplane, the great “civilizing” force of Billy Mitchell’s day.2 The means of war...shift in the ways of war—victory through information dominance.3 2 William “ Billy ” Mitchell...former Assistant Secretary of Defense for Policy and Plans and Special Advisor to the Secretary of Defense, political scientist Graham Allison
Mario D. Tello; José Távara
This paper assesses the institutional setting and productive impact of selected productive development policies (PDPs), institutions, and programs implemented in Peru during the period 1990-2007. The assessment is based on a simple, basic framework of a series of economic or market failures that may have constrained the transformation of the productive structure, the process of innovation, and the growth of total factor productivity. Evidence indicates that the PDPs and structural reforms imp...
Amal Hatem Alkhaldi
Full Text Available Global competition in the international business environment has pushed companies to achieve competitive advantage through mergers, acquisitions and through locating their subsidiaries in less developed counties for cost effectiveness. Consequently, the competitive pressure has increased the significance of human resource management (HRM in multinational companies (MNCs, and MNCs have recognised the significance of the transfer HRM process across borders. This study examines the transfer of HRM policies and practices of US MNCs to their subsidiaries in Saudi Arabia. The aim of the study is to determine the extent to which US MNCs transfer HRM policies and practices from their Headquarters to their subsidiaries in Saudi Arabia; and identify the factors that facilitate and inhibit HRM transfer. The paper is based on an investigation of the interaction between home-country and host-country effects in determining HRM policies and practices in MNCs in the context of the Middle East. The study adopts a mixed methods approach of documentary analysis, focus group interviews of employees and in depth interviews of key informants in four subsidiaries of US owned international hotel chains located in Riyadh, Saudi Arabia.
Gundersen, Linda C.; Townsend, Randy
Creating an ethics policy for a large, diverse geosciences organization is a challenge, especially in the midst of the current contentious dialogue in the media related to such issues as climate change, sustaining natural resources, and responding to natural hazards. In 2011, the American Geophysical Union (AGU) took on this challenge, creating an Ethics Task Force to update their ethics policies to better support their new Strategic Plan and respond to the changing scientific research environment. Dialogue with AGU members and others during the course of creating the new policy unveiled some of the following issues to be addressed. Scientific results and individual scientists are coming under intense political and public scrutiny, with the efficacy of the science being questioned. In some cases, scientists are asked to take sides and/or provide opinions on issues beyond their research, impacting their objectivity. Pressure related to competition for funding and the need to publish high quality and quantities of papers has led to recent high profile plagiarism, data fabrication, and conflict of interest cases. The complexities of a continuously advancing digital environment for conducting, reviewing, and publishing science has raised concerns over the ease of plagiarism, fabrication, falsification, inappropriate peer review, and the need for better accessibility of data and methods. Finally, students and scientists need consistent education and encouragement on the importance of ethics and integrity in scientific research. The new AGU Scientific Integrity and Ethics Policy tries to address these issues and provides an inspirational code of conduct to encourage a responsible, positive, open, and honest scientific research environment.
These documents include the report from independent auditors balance sheet, the statement of income, the statement of changes in equity, the statement of cash flows and the explanatory notes to the financial statements.
Wirtz, V J; Herrera-Patino, J J; Santa-Ana-Tellez, Y; Dreser, A; Elseviers, M; Vander Stichele, R H
To describe and evaluate policies implemented in Chile, Colombia, Venezuela and Mexico (1995-2009) to prohibit antibiotic OTC sales and explore limitations in available data. We searched and analysed legislation, grey literature and peer-reviewed publications on regulatory interventions and implementation strategies to enforce prohibition of OTC antibiotic sales. We also assessed the impact using private sector retail sales data of antibiotics studying changes in level and consumption trends before and after the policy change using segmented time series analysis. Finally, we assessed the completeness and data quality through an established checklist to test the suitability of the data for analysis of the interventions. Whereas Chile implemented a comprehensive package of interventions to accompany regulation changes, Colombia's reform was limited to the capital district and Venezuela's limited to only some antibiotics and without awareness campaigns. In Mexico, no enforcement was enacted. The data showed a differential effect of the intervention among the countries studied with a significant change in level of consumption in Chile (-5.56 DID) and in Colombia (-1.00DID). In Venezuela and Mexico, no significant change in level and slope was found. Changes in population coverage were identified as principal limitations of using sales data for evaluating the reform impact. Retail sales data can be useful when assessing policy impact but should be supplemented by other data sources such as public sector sales and prescription data. Implementing regulatory enforcement has shown some impact, but a sustainable, concerted approach will be needed to address OTC sales in the future. © 2013 John Wiley & Sons Ltd.
This presentation outlined the energy policy in the United States and its impact on frontier development in Alaska, deepwater offshore fields and in the western oil shale resources. The energy strategy focuses on technologies that increase domestic production from existing resources as well as technologies that create new sources of energy. In addition to emphasizing the cooperation between Canada and the United States in ensuring energy supply security and stability, this paper discussed the importance of overall bilateral trade between the 2 countries. It was noted that Canada is the United State's most secure and reliable energy partner and is the number 1 supplier of imported oil, natural gas, electricity and uranium. The Bush administration's energy policy is based on the mandate to supply stable, reliable, secure, affordable and environmentally sound energy for the country's growing economy. The energy strategy focuses on increasing energy supplies, promoting energy conservation, repairing and modernizing the energy infrastructure, protecting the environment and improving energy security. Basic changes to the way energy is produced and used will be needed in order to meet these challenges. Energy security can be met through efficiency gains, diversification and use of alternative energy sources. The strategy involves a balance of supply sources, ranging from increasing domestic oil and gas production to such sources as clean coal generation, nuclear power and hydropower. The policy also balances the use of traditional energy sources with renewables such as geothermal, solar, wind and hydrogen. The United States, Canada and Mexico have identified the following 9 areas as critical for interaction on energy: energy data, electricity, regulatory cooperation, energy efficiency, natural gas, oil sands, nuclear and energy science and technology. Construction of the Alaska Natural Gas Pipeline is also one of the Bush administration's highest priorities, along with
Full Text Available The importance of the Marxism in the Latin-American thought has been indicated in repeated opportunities. Its aptitude to generate diverse political and cultural projects was a central characteristic of the above mentioned tradition, opened across different agents and institutions from the arrival of the writings of Marx and Engels to Latin America at the end of the XIXth century. Nevertheless, good part of this history is still partial, anchored in national perspectives and little commits an outrage against the study of its material forms, this is, to those aspects across which the Marxist speech managed to shape a specific materiality, so much for the theoretical making as the action of militants, workers, students and intellectuals. The work aims to propose an exploration of the Latin-American Marxism from the perspective of the reconstruction of its printed world, from delineating a series of problems, topics and reflections settled in the study of the publishing house Coyoacán of Jorge Abelardo Ramos in the early 1960s in Argentina
... NUCLEAR REGULATORY COMMISSION [NRC-2008-0497] NRC Enforcement Policy Revision AGENCY: Nuclear Regulatory Commission. ACTION: Policy statement. SUMMARY: The Nuclear Regulatory Commission (NRC or Commission) is publishing a major revision to its Enforcement Policy (Enforcement Policy or Policy) to...
Williams, R.C.; Cantelon, P.L.
In selecting these historical documents the authors have applied three general tests: first, does the document help tell the story of the development of American nuclear policy in a nontechnical way; second, is the source primary rather than secondary, written by an actor in the drama rather than by a member of the audience; third, does the document provide coverage of the major chapters in the story? The Manhattan Project was America's $2 billion secret project to build an atomic bomb. Many documents associated with the project have come to light only in recent years. In Section II they use the letters of J. Robert Oppenheimer and the recently declassified minutes of policy committees to tell the story of how the bomb was designed and built and how the decision was made to drop the first uranium and plutonium devices on the Japanese cities of Hiroshima and Nagasaki in 1945. How did a weapon of war become the key to a peacetime industry? In considering atomic energy after World War II, they focus in Section III on the legislative enabling acts that established the Atomic Energy Commission, the short-lived dream of international control of nuclear weapons under the Baruch Plan, and the ''atoms for peace'' program of President Dwight D. Eisenhower. By 1954 the highly classified work on nuclear weapons paralleled a new development of nuclear energy and power reactors. Knowledge was shared with both private industry and other countries. The fruits of this program are considered in the later section on nuclear power
Monique E Muggli
Full Text Available Each year, 540 million Chinese are exposed to secondhand smoke (SHS, resulting in more than 100,000 deaths. Smoke-free policies have been demonstrated to decrease overall cigarette consumption, encourage smokers to quit, and protect the health of nonsmokers. However, restrictions on smoking in China remain limited and ineffective. Internal tobacco industry documents show that transnational tobacco companies (TTCs have pursued a multifaceted strategy for undermining the adoption of restrictions on smoking in many countries.To understand company activities in China related to SHS, we analyzed British American Tobacco's (BAT's internal corporate documents produced in response to litigation against the major cigarette manufacturers to understand company activities in China related to SHS. BAT has carried out an extensive strategy to undermine the health policy agenda on SHS in China by attempting to divert public attention from SHS issues towards liver disease prevention, pushing the so-called "resocialisation of smoking" accommodation principles, and providing "training" for industry, public officials, and the media based on BAT's corporate agenda that SHS is an insignificant contributor to the larger issue of air pollution.The public health community in China should be aware of the tactics previously used by TTCs, including efforts by the tobacco industry to co-opt prominent Chinese benevolent organizations, when seeking to enact stronger restrictions on smoking in public places.
Muggli, Monique E; Lee, Kelley; Gan, Quan; Ebbert, Jon O; Hurt, Richard D
Each year, 540 million Chinese are exposed to secondhand smoke (SHS), resulting in more than 100,000 deaths. Smoke-free policies have been demonstrated to decrease overall cigarette consumption, encourage smokers to quit, and protect the health of nonsmokers. However, restrictions on smoking in China remain limited and ineffective. Internal tobacco industry documents show that transnational tobacco companies (TTCs) have pursued a multifaceted strategy for undermining the adoption of restrictions on smoking in many countries. To understand company activities in China related to SHS, we analyzed British American Tobacco's (BAT's) internal corporate documents produced in response to litigation against the major cigarette manufacturers to understand company activities in China related to SHS. BAT has carried out an extensive strategy to undermine the health policy agenda on SHS in China by attempting to divert public attention from SHS issues towards liver disease prevention, pushing the so-called "resocialisation of smoking" accommodation principles, and providing "training" for industry, public officials, and the media based on BAT's corporate agenda that SHS is an insignificant contributor to the larger issue of air pollution. The public health community in China should be aware of the tactics previously used by TTCs, including efforts by the tobacco industry to co-opt prominent Chinese benevolent organizations, when seeking to enact stronger restrictions on smoking in public places.
Robinson, Daniel D.
This document presents the background and analysis of the American Institute of Certified Public Accountants (AICPA) guide to auditing colleges and universities. Highlights include the approval of the market value option, the treatment of endowment gains, debt services as transfers, the decisions on pledges, the use of financial statements, the…
Roberto Ren-rang Chyou
Full Text Available The People's Republic of China has always followed a policy of no alignment, even with its neighbors of the Southeast Asian region. But since every rule has an exception, the People's Republic of China changed its position in 1990, by joining the core of the Asian Region, in an action interpreted as remuneration for the support received in favor of its legal status, and for the political support to the principle of the "One China" In time, the financial Asian crisis has created a bi-polar development, with the Southern countries still under the influence of the financial sequels of the crisis, and the Northern ones, as the People's Republic of China, Japan, South Korea, Taiwan and Hong Kong attaining evident economic achievements. With the financial crisis, Beijing was invited to participate in the Asian Forum of BOAO, under the political clout of the "ASEAN+3" group. The People's Republic of China also actively cooperates in the Forum for East Asia-Latin America Cooperation (FEALAC, in order to project a "southern political sphere", able to act as a fence around the Capitalist World Axis, under the leadership of USA. The People's Republic of China, after gaining the desired success in the BOAO by projecting the image of "a China in peaceful emergence", has been able to come out as the leader of the Southeast Asian region, and also has managed to focus the international attention in the FEALAC. Nowadays, everybody tries to understand the real intentions of China in this forum. Does China look at it as a mere negotiation forum for South to South relations or it wants to turn it into a replica of the BOAO, to use it as a tool to influence Latin America?
Muller, Nicholas Z; Jha, Akshaya
Modern cities are engines of production, innovation, and growth. However, urbanization also increases both local and global pollution from household consumption and firms' production. Do emissions change proportionately to city size or does pollution tend to outpace or lag urbanization? Do emissions scale differently with population versus economic growth or are emissions, population, and economic growth inextricably linked? How are the scaling relationships between emissions, population, and economic growth affected by environmental regulation? This paper examines the link between urbanization, economic growth and pollution using data from Metropolitan Statistical Areas (MSAs) in the United States between 1999 and 2011. We find that the emissions of local air pollution in these MSAs scale according to a ¾ power law with both population size and gross domestic product (GDP). However, the monetary damages from these local emissions scale linearly with both population and GDP. Counties that have previously been out of attainment with the local air quality standards set by the Clean Air Act show an entirely different relationship: local emissions scale according to the square root of population, while the monetary damages from local air pollution follow a 2/3rds power law with population. Counties out of attainment are subject to more stringent emission controls; we argue based on this that enforcement of the Clean Air Act induces sublinear scaling between emissions, damages, and city size. In contrast, we find that metropolitan GDP scales super-linearly with population in all MSAs regardless of attainment status. Summarizing, our findings suggest that environmental policy limits the adverse effects of urbanization without interfering with the productivity benefits that manifest in cities.
... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Interim financial statements... AND CONTENT OF AND REQUIREMENTS FOR FINANCIAL STATEMENTS, SECURITIES ACT OF 1933, SECURITIES EXCHANGE... ADVISERS ACT OF 1940, AND ENERGY POLICY AND CONSERVATION ACT OF 1975 Article 8 Financial Statements of...
... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Annual financial statements... AND CONTENT OF AND REQUIREMENTS FOR FINANCIAL STATEMENTS, SECURITIES ACT OF 1933, SECURITIES EXCHANGE... ADVISERS ACT OF 1940, AND ENERGY POLICY AND CONSERVATION ACT OF 1975 Article 8 Financial Statements of...
... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Age of financial statements... AND CONTENT OF AND REQUIREMENTS FOR FINANCIAL STATEMENTS, SECURITIES ACT OF 1933, SECURITIES EXCHANGE... ADVISERS ACT OF 1940, AND ENERGY POLICY AND CONSERVATION ACT OF 1975 Article 8 Financial Statements of...
... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Income statements. 210.7-04... 1940, AND ENERGY POLICY AND CONSERVATION ACT OF 1975 Insurance Companies § 210.7-04 Income statements... face of the income statements and in the notes thereto filed for persons to whom this article pertains...
... 47 Telecommunication 1 2010-10-01 2010-10-01 false Environmental impact statements (EISs). 1.1314... Procedures Implementing the National Environmental Policy Act of 1969 § 1.1314 Environmental impact statements (EISs). (a) Draft Environmental Impact Statements (DEISs) (§ 1.1315) and Final Environmental...
... 39 Postal Service 1 2010-07-01 2010-07-01 false Environmental impact statements. 775.11 Section... POLICY ACT PROCEDURES § 775.11 Environmental impact statements. (a) Determining scope. Before an environmental impact statement is prepared, the following procedures must be followed to determine what issues...
... 7 Agriculture 12 2010-01-01 2010-01-01 false Environmental impact statement. 1794.61 Section 1794..., DEPARTMENT OF AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Procedure for Environmental Impact Statements § 1794.61 Environmental impact statement. An EIS shall be prepared in accordance with...
... financial statements, such as a statement of significant accounting policies and practices, details of... degree as allowed in this paragraph) and disclosures required by Statement of Financial Accounting... Financial Accounting Standards Board that requires such change. (7) Any material retroactive prior period...
Until fairly recently, most segments of the American public, particularly our various elites, supported American nuclear policy, namely the maintenance of large and expanding nuclear stockpiles, the official foreswearing of the use of these weapons in a strategic first-strike, and the policy of threatening retaliation for Soviet nuclear attacks in war, by nuclear attacks on enemy cities and military centers. There is increasing evidence that this support is rapidly eroding; especially among key American elites. This is shown through increasingly vocal dissatisfaction with the continued growth and modernization of the nuclear stockpile; and second, in the dawning awareness of a discrepancy between our official policy of no first-strike and contingency plans to employ first-strike tactical nuclear weapons in the event of a Warsaw Pact attack upon Western Europe. Concerns have surfaced here due both to distaste at the growing size of our nuclear arsenal and the perception that we have not been altogether honest in our official stance of a no first-strike with nuclear weapons. Increasing numbers of Americans are coming to see our nuclear policy as inconsistent, senseless, and, most significantly, immoral, and therefore support a nuclear freeze.
... Standards Nursing Quality Ethics / Genetics & Genomics Code of Ethics Workplace Safety / Safe Patient Handling Needlestick Prevention Environmental Health Policy & Advocacy / Take Action Position Statements Member ...
Qaseem, Amir; Wilt, Timothy J; Kansagara, Devan; Horwitch, Carrie; Barry, Michael J; Forciea, Mary Ann
The American College of Physicians developed this guidance statement to guide clinicians in selecting targets for pharmacologic treatment of type 2 diabetes. The National Guideline Clearinghouse and the Guidelines International Network library were searched (May 2017) for national guidelines, published in English, that addressed hemoglobin A1c (HbA1c) targets for treating type 2 diabetes in nonpregnant outpatient adults. The authors identified guidelines from the National Institute for Health and Care Excellence and the Institute for Clinical Systems Improvement. In addition, 4 commonly used guidelines were reviewed, from the American Association of Clinical Endocrinologists and American College of Endocrinology, the American Diabetes Association, the Scottish Intercollegiate Guidelines Network, and the U.S. Department of Veterans Affairs and Department of Defense. The AGREE II (Appraisal of Guidelines for Research and Evaluation II) instrument was used to evaluate the guidelines. Clinicians should personalize goals for glycemic control in patients with type 2 diabetes on the basis of a discussion of benefits and harms of pharmacotherapy, patients' preferences, patients' general health and life expectancy, treatment burden, and costs of care. Clinicians should aim to achieve an HbA1c level between 7% and 8% in most patients with type 2 diabetes. Clinicians should consider deintensifying pharmacologic therapy in patients with type 2 diabetes who achieve HbA1c levels less than 6.5%. Clinicians should treat patients with type 2 diabetes to minimize symptoms related to hyperglycemia and avoid targeting an HbA1c level in patients with a life expectancy less than 10 years due to advanced age (80 years or older), residence in a nursing home, or chronic conditions (such as dementia, cancer, end-stage kidney disease, or severe chronic obstructive pulmonary disease or congestive heart failure) because the harms outweigh the benefits in this population.
Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology Position Statement on Dyslipidemia Management: differences between the European and American Guidelines.
Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón
The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention.
American River canyon provided by Dr. B. Allen- Diaz at the University of California at Berkeley, tree densities were calculated at between 50 and 130...air quality, fisheries, recreation, and Comment/Response appendix SEIS 12-1 List of Preparers Name/Expertise Experience Role in Preparing SEIS Alicia
Home Economics Education Association, Gainesville, VA.
This pamphlet contains the statement of the Coalition of the American Home Economics Association, American Vocational Association, and Home Economics Education Association regarding the scope and definition of vocational home economics education. It is intended to serve as a basis for professional action. Sections of this statement address the…
Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association
Golden, Sherita Hill; Anderson, Cheryl; Bray, George A.; Burke, Lora E.; de Boer, Ian H.; Deedwania, Prakash; Eckel, Robert H.; Ershow, Abby G.; Fradkin, Judith; Inzucchi, Silvio E.; Kosiborod, Mikhail; Nelson, Robert G.; Patel, Mahesh J.; Pignone, Michael; Quinn, Laurie; Schauer, Philip R.; Selvin, Elizabeth; Vafiadis, Dorothea K.
Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus. PMID:26246459
Crowley, Ryan A
Electronic nicotine delivery systems (ENDS), which include electronic cigarettes, or e-cigarettes, are growing in popularity, but their safety and efficacy as a smoking cessation aid are not well understood. Some argue that they have the potential to reduce tobacco-related morbidity and mortality and could be a useful tool for reducing tobacco-related harm. Others express concern that the health effects of ENDS use are unknown, that they may appeal to young people, and that they may encourage dual use of ENDS and traditional tobacco products. Although ENDS are a new and unregulated product, the U.S. Food and Drug Administration has proposed regulations that would deem ENDS to be subject to the Family Smoking Prevention and Tobacco Control Act, which regulates cigarettes and other tobacco products. In this position paper, the American College of Physicians offers policy recommendations on ENDS regulation and oversight, taxation, flavorings, promotion and marketing, indoor and public use, and research. This paper is not intended to offer clinical guidance or serve as an exhaustive literature review of existing ENDS-related evidence but to help direct the College, policymakers, and regulators on how to address these products.
Lipids and bariatric procedures Part 2 of 2: scientific statement from the American Society for Metabolic and Bariatric Surgery (ASMBS), the National Lipid Association (NLA), and Obesity Medicine Association (OMA).
Bays, Harold; Kothari, Shanu N; Azagury, Dan E; Morton, John M; Nguyen, Ninh T; Jones, Peter H; Jacobson, Terry A; Cohen, David E; Orringer, Carl; Westman, Eric C; Horn, Deborah B; Scinta, Wendy; Primack, Craig
Bariatric procedures generally improve dyslipidemia, sometimes substantially so. Bariatric procedures also improve other major cardiovascular risk factors. This 2-part Scientific Statement examines the lipid effects of bariatric procedures and reflects contributions from authors representing the American Society for Metabolic and Bariatric Surgery (ASMBS), the National Lipid Association (NLA), and the Obesity Medicine Association (OMA). Part 1 was published in the Journal of Clinical Lipidology, and reviewed the impact of bariatric procedures upon adipose tissue endocrine and immune factors, adipose tissue lipid metabolism, as well as the lipid effects of bariatric procedures relative to bile acids and intestinal microbiota. This Part 2 reviews: (1) the importance of nutrients (fats, carbohydrates, and proteins) and their absorption on lipid levels; (2) the effects of bariatric procedures on gut hormones and lipid levels; (3) the effects of bariatric procedures on nonlipid cardiovascular disease (CVD) risk factors; (4) the effects of bariatric procedures on lipid levels; (5) effects of bariatric procedures on CVD; and finally, (6) the potential lipid effects of vitamin, mineral, and trace element deficiencies, that may occur after bariatric procedures. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
... 10 Energy 2 2010-01-01 2010-01-01 false Scoping-environmental impact statement and supplement to environmental impact statement. 51.29 Section 51.29 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED... Environmental Policy Act-Regulations Implementing Section 102(2) Scoping § 51.29 Scoping-environmental impact...
Watson, Nathaniel F; Martin, Jennifer L; Wise, Merrill S; Carden, Kelly A; Kirsch, Douglas B; Kristo, David A; Malhotra, Raman K; Olson, Eric J; Ramar, Kannan; Rosen, Ilene M; Rowley, James A; Weaver, Terri E; Chervin, Ronald D
During adolescence, internal circadian rhythms and biological sleep drive change to result in later sleep and wake times. As a result of these changes, early middle school and high school start times curtail sleep, hamper a student's preparedness to learn, negatively impact physical and mental health, and impair driving safety. Furthermore, a growing body of evidence shows that delaying school start times positively impacts student achievement, health, and safety. Public awareness of the hazards of early school start times and the benefits of later start times are largely unappreciated. As a result, the American Academy of Sleep Medicine is calling on communities, school boards, and educational institutions to implement start times of 8:30 AM or later for middle schools and high schools to ensure that every student arrives at school healthy, awake, alert, and ready to learn. © 2017 American Academy of Sleep Medicine
Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology position statement on dyslipidemia management. Differences between the European and American guidelines.
Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón
The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
[Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology position statement on dyslipidemia management. Differences between the European and American guidelines].
Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón
The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention. Full English text available from:www.revespcardiol.org/en. Copyright © 2014. Published by Elsevier España.
Paruthi, Shalini; Brooks, Lee J.; D'Ambrosio, Carolyn; Hall, Wendy A.; Kotagal, Suresh; Lloyd, Robin M.; Malow, Beth A.; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F.; Rosen, Carol L.; Troester, Matthew M.; Wise, Merrill S.
Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours pe...
Educational and psychological interventions to improve outcomes for recipients of implantable cardioverter defibrillators and their families: a scientific statement from the American Heart Association.
Dunbar, Sandra B; Dougherty, Cynthia M; Sears, Samuel F; Carroll, Diane L; Goldstein, Nathan E; Mark, Daniel B; McDaniel, George; Pressler, Susan J; Schron, Eleanor; Wang, Paul; Zeigler, Vicki L
Significant mortality benefits have been documented in recipients of implantable cardioverter defibrillators (ICDs); however, the psychosocial distress created by the underlying arrhythmia and its potential treatments in patients and family members may be underappreciated by clinical care teams. The disentanglement of cardiac disease and device-related concerns is difficult. The majority of ICD patients and families successfully adjust to the ICD, but optimal care pathways may require additional psychosocial attention to all ICD patients and particularly those experiencing psychosocial distress. This state-of-the-science report was developed on the basis of an analysis and critique of existing science to (1) describe the psychological and quality-of-life outcomes after receipt of an ICD and describe related factors, such as patient characteristics; (2) describe the concerns and educational/informational needs of ICD patients and their family members; (3) outline the evidence that supports interventions for improving educational and psychological outcomes for ICD patients; (4) provide recommendations for clinical approaches for improving patient outcomes; and (5) identify priorities for future research in this area. The ultimate goal of this statement is to improve the precision of identification and care of psychosocial distress in ICD patients to maximize the derived benefit of the ICD.
Denier van der Gon, H.A.C.; Gerlofs-Nijland, M.E.; Gehrig, R.; Gustafsson, M.; Janssen, N.; Harrison, R.M.; Hulskotte, J.; Johansson, C.; Jozwicka, M.; Keuken, M.; Krijgsheld, K.; Ntziachristos, L.; Riediker, M.; Cassee, F.R.
Road transport emissions are a major contributor to ambient particulate matter concentrations and have been associated with adverse health effects. Therefore, these emissions are targeted through increasingly stringent European emission standards. These policies succeed in reducing exhaust
Using evidence-based policy, systems, and environmental strategies to increase access to healthy food and opportunities for physical activity among Asian Americans, Native Hawaiians, and Pacific Islanders.
Patel, Shilpa; Kwon, Simona; Arista, Pedro; Tepporn, Ed; Chung, Marianne; Ko Chin, Kathy; Rideout, Catlin; Islam, Nadia; Trinh-Shevrin, Chau
Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities.
... Staff Issues AIBS Position Statements Funding for the Biological Sciences Supporting Scientific Collections Advocating for Research Policy ... Public Policy Leadership Award Graduate students in the biological sciences who have demonstrated initiative and leadership in ...
Avin, Keith G.; Hanke, Timothy A.; Kirk-Sanchez, Neva; McDonough, Christine M.; Shubert, Tiffany E.; Hartley, Greg
Background Falls in older adults are a major public health concern due to high prevalence, impact on health outcomes and quality of life, and treatment costs. Physical therapists can play a major role in reducing fall risk for older adults; however, existing clinical practice guidelines (CPGs) related to fall prevention and management are not targeted to physical therapists. Objective The purpose of this clinical guidance statement (CGS) is to provide recommendations to physical therapists to help improve outcomes in the identification and management of fall risk in community-dwelling older adults. Design and Methods The Subcommittee on Evidence-Based Documents of the Practice Committee of the Academy of Geriatric Physical Therapy developed this CGS. Existing CPGs were identified by systematic search and critically appraised using the Appraisal of Guidelines, Research, and Evaluation in Europe II (AGREE II) tool. Through this process, 3 CPGs were recommended for inclusion in the CGS and were synthesized and summarized. Results Screening recommendations include asking all older adults in contact with a health care provider whether they have fallen in the previous year or have concerns about balance or walking. Follow-up should include screening for balance and mobility impairments. Older adults who screen positive should have a targeted multifactorial assessment and targeted intervention. The components of this assessment and intervention are reviewed in this CGS, and barriers and issues related to implementation are discussed. Limitations A gap analysis supports the need for the development of a physical therapy–specific CPG to provide more precise recommendations for screening and assessment measures, exercise parameters, and delivery models. Conclusion This CGS provides recommendations to assist physical therapists in the identification and management of fall risk in older community-dwelling adults. PMID:25573760
Anderson, Norman B; Belar, Cynthia D; Cubic, Barbara A; Garrison, Ellen G; Johnson, Suzanne Bennett; Kaslow, Nadine J
Comments on the article "Joint principles: Integrating behavioral health care into the patient-centered medical home" (see record 2014-24217-011), presented by the Working Party Group on Integrated Behavioral Healthcare. The American Psychological Association (APA) shares concerns about the lack of reference to behavioral health care in the original 2007 Joint Principles of the Patient-Centered Medical Home for which this new document is intended to supplement but not replace. The decision to support the supplemental Joint Principles was not an easy one for APA, as there is one area of significant concern. That concern is related to the use of the term "physician-directed medical practice"
This introductory speech covered the following: allocation, within United Kingdom government departments, of responsibilities for radioactive waste management policy; non-departmental organizations concerned; public relations; inventories of radioactive waste; research programmes; high-level wastes - vitrification and underground disposal; low- and intermediate-level wastes - consultation with public before fixing disposal sites; sea disposal. (U.K.)
users make on the basis of the financial information. .... IDRC's brand and reputation could impact partner- .... building and to provide internal services in support of the ...... maintains books of accounts, information systems, and financial and management controls that .... The significant accounting policies of the Centre are: a.
Dalbeth, Nicola; Bardin, Thomas; Doherty, Michael; Lioté, Frédéric; Richette, Pascal; Saag, Kenneth G; So, Alexander K; Stamp, Lisa K; Choi, Hyon K; Terkeltaub, Robert
In November 2016, the American College of Physicians (ACP) published a clinical practice guideline on the management of acute and recurrent gout. This guideline differs substantially from the latest guidelines generated by the American College of Rheumatology (ACR), European League Against Rheumatism (EULAR) and 3e (Evidence, Expertise, Exchange) Initiative, despite reviewing largely the same body of evidence. The Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN) convened an expert panel to review the methodology and conclusions of these four sets of guidelines and examine possible reasons for discordance between them. The G-CAN position, presented here, is that the fundamental pathophysiological knowledge underlying gout care, and evidence from clinical experience and clinical trials, supports a treat-to-target approach for gout aimed at lowering serum urate levels to below the saturation threshold at which monosodium urate crystals form. This practice, which is truly evidence-based and promotes the steady reduction in tissue urate crystal deposits, is promoted by the ACR, EULAR and 3e Initiative recommendations. By contrast, the ACP does not provide a clear recommendation for urate-lowering therapy (ULT) for patients with frequent, recurrent flares or those with tophi, nor does it recommend monitoring serum urate levels of patients prescribed ULT. Results from emerging clinical trials that have gout symptoms as the primary end point are expected to resolve this debate for all clinicians in the near term future.
Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition).
Becker, Patricia; Carney, Liesje Nieman; Corkins, Mark R; Monczka, Jessica; Smith, Elizabeth; Smith, Susan E; Spear, Bonnie A; White, Jane V
The Academy of Nutrition and Dietetics (the Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), utilizing an evidence-informed, consensus-derived process, recommend that a standardized set of diagnostic indicators be used to identify and document pediatric malnutrition (undernutrition) in routine clinical practice. The recommended indicators include z scores for weight-for-height/length, body mass index-for-age, or length/height-for-age or mid-upper arm circumference when a single data point is available. When 2 or more data points are available, indicators may also include weight gain velocity (nutritional risk is not the purpose of this paper. Clinicians should use as many data points as available to identify and document the presence of malnutrition. The universal use of a single set of diagnostic parameters will expedite the recognition of pediatric undernutrition, lead to the development of more accurate estimates of its prevalence and incidence, direct interventions, and promote improved outcomes. A standardized diagnostic approach will also inform the prediction of the human and financial responsibilities and costs associated with the prevention and treatment of undernutrition in this vulnerable population and help to further ensure the provision of high-quality, cost-effective nutritional care. © 2014 American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics.
Lazaro, M.A.; Policastro, A.J.; Antonopoulos, A.A.; Hartmann, H.M.; Koebnick, B.; Dovel, M.; Stoll, P.W.
The hazardous waste risk assessment modeling (HaWRAM) database is being developed to analyze the risk from treatment technology operations and potential transportation accidents associated with the hazardous waste management alternatives. These alternatives are being assessed in the Department of Energy's Environmental Restoration and Waste Management Programmatic Environmental Impact Statement (EM PEIS). To support the risk analysis, the current database contains complexwide detailed information on hazardous waste shipments from 45 Department of Energy installations during FY 1992. The database is currently being supplemented with newly acquired data. This enhancement will improve database information on operational hazardous waste generation rates, and the level and type of current on-site treatment at Department of Energy installations
The Director General has received a letter dated 16 July 2009 from the Permanent Mission of the Federal Republic of Germany to the IAEA in enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2008. 2. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil high enriched uranium (HEU) as of 31 December 2008 [es
The Director General has received a note verbale dated 14 October 2010 from the Permanent Mission of the Federal Republic of Germany to the IAEA in enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2009. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil high enriched uranium (HEU) as of 31 December 2009 [es
The Secretariat has received a note verbale dated 20 September 2012 from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2011. The Government of the Federal Republic of Germany has also made available a statement of the estimated amounts of highly enriched uranium (HEU) as of 31 December 2011 [es
The Director General has received a Note Verbale dated 3 July 2007 from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2006. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil highly enriched uranium (HEU) as of 31 December 2006 [es
The Secretariat has received a note verbale dated 2 July 2013 from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2012. The Government of the Federal Republic of Germany has also made available a statement of the estimated amounts of highly enriched uranium (HEU) as of 31 December 2012 [es
The Director General has received a note verbale dated 29 April 2011 from the Permanent Mission of the Federal Republic of Germany to the IAEA in enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2010. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil high enriched uranium (HEU) as of 31 December 2010 [es
The Director General has received a note verbale dated 29 April 2011 from the Permanent Mission of the Federal Republic of Germany to the IAEA in enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2010. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil high enriched uranium (HEU) as of 31 December 2010 [fr
The Director General has received a Note Verbale dated 3 July 2007 from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2006. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil highly enriched uranium (HEU) as of 31 December 2006
The Secretariat has received a note verbale dated 20 September 2012 from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2011. The Government of the Federal Republic of Germany has also made available a statement of the estimated amounts of highly enriched uranium (HEU) as of 31 December 2011
The Director General has received a note verbale dated 14 October 2010 from the Permanent Mission of the Federal Republic of Germany to the IAEA in enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2009. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil high enriched uranium (HEU) as of 31 December 2009
The Director General has received a note verbale dated 29 April 2011 from the Permanent Mission of the Federal Republic of Germany to the IAEA in enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2010. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil high enriched uranium (HEU) as of 31 December 2010
The Director General has received a letter dated 16 July 2009 from the Permanent Mission of the Federal Republic of Germany to the IAEA in enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2008. 2. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil high enriched uranium (HEU) as of 31 December 2008
The Secretariat has received a note verbale dated 2 July 2013 from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2012. The Government of the Federal Republic of Germany has also made available a statement of the estimated amounts of highly enriched uranium (HEU) as of 31 December 2012
The Director General has received a note verbale dated 14 October 2010 from the Permanent Mission of the Federal Republic of Germany to the IAEA in enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2009. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil high enriched uranium (HEU) as of 31 December 2009
The Secretariat has received a note verbale dated 2 July 2013 from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2012. The Government of the Federal Republic of Germany has also made available a statement of the estimated amounts of highly enriched uranium (HEU) as of 31 December 2012 [fr
The Director General has received a Note Verbale dated 3 July 2007 from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2006. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil highly enriched uranium (HEU) as of 31 December 2006 [fr
The Director General has received a note verbale dated 14 October 2010 from the Permanent Mission of the Federal Republic of Germany to the IAEA in enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2009. The Government of the Federal Republic of Germany has also made available a statement of its annual figures for holdings of civil high enriched uranium (HEU) as of 31 December 2009 [fr
The Secretariat has received a note verbale dated 20 September 2012 from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/5491 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2011. The Government of the Federal Republic of Germany has also made available a statement of the estimated amounts of highly enriched uranium (HEU) as of 31 December 2011 [fr
Nutrigenomics, the Microbiome, and Gene-Environment Interactions: New Directions in Cardiovascular Disease Research, Prevention, and Treatment: A Scientific Statement From the American Heart Association.
Ferguson, Jane F; Allayee, Hooman; Gerszten, Robert E; Ideraabdullah, Folami; Kris-Etherton, Penny M; Ordovás, José M; Rimm, Eric B; Wang, Thomas J; Bennett, Brian J
Cardiometabolic diseases are the leading cause of death worldwide and are strongly linked to both genetic and nutritional factors. The field of nutrigenomics encompasses multiple approaches aimed at understanding the effects of diet on health or disease development, including nutrigenetic studies investigating the relationship between genetic variants and diet in modulating cardiometabolic risk, as well as the effects of dietary components on multiple "omic" measures, including transcriptomics, metabolomics, proteomics, lipidomics, epigenetic modifications, and the microbiome. Here, we describe the current state of the field of nutrigenomics with respect to cardiometabolic disease research and outline a direction for the integration of multiple omics techniques in future nutrigenomic studies aimed at understanding mechanisms and developing new therapeutic options for cardiometabolic disease treatment and prevention. © 2016 American Heart Association, Inc.
Paruthi, Shalini; Brooks, Lee J; D'Ambrosio, Carolyn; Hall, Wendy A; Kotagal, Suresh; Lloyd, Robin M; Malow, Beth A; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F; Rosen, Carol L; Troester, Matthew M; Wise, Merrill S
Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. A commentary on this article apears in this issue on page 1439. © 2016 American Academy of Sleep Medicine
Marijuana in the Workplace: Guidance for Occupational Health Professionals and Employers: Joint Guidance Statement of the American Association of Occupational Health Nurses and the American College of Occupational and Environmental Medicine.
Phillips, Jennan A; Holland, Michael G; Baldwin, Debra D; Gifford-Meuleveld, Linda; Mueller, Kathryn L; Perkison, Brett; Upfal, Mark; Dreger, Marianne
Employers are often put in a difficult position trying to accommodate state laws that allow the use of marijuana for medical purposes while enforcing federal rules or company drug-use policies based on federal law. To ensure workplace safety as well as compliance with state and federal legislation, employers should review state laws on discrimination against marijuana users and ensure that policies enacted are consistent with the state’s antidiscrimination statutes. Although it appears that in most states that allow medical marijuana use, employers can continue enforcing policies banning or restricting the use of marijuana, this approach may change on the basis of future court decisions. The Joint Task Force recommends that marijuana use be closely monitored for all employees in safety-sensitive positions, whether or not covered by federal drug-testing regulations. Best practice would support employers prohibiting marijuana use at work. Employers, in compliance with applicable state laws, may choose to simply prohibit their employees from working while using or impaired by marijuana. In some states, employers may choose to prohibit marijuana use by all members of their workforce whether on or off duty. Nevertheless, in all cases, a clear policy to guide decisions on when marijuana use is allowed and how to evaluate for impairment must be widely distributed and carefully explained to all workers. Legal consultation during policy development and continual review is imperative to ensure compliance with federal, state, and case law. Drug-use and drug-testing policies should clearly delineate expectations regarding on-the-job impairment and marijuana use outside of work hours. Specific criteria for use by supervisors and HR personnel when referring employees suspected of impairment for an evaluation by a qualified occupational health professional are critical. Detailed actions based on the medical evaluation results must also be clearly delineated for HRs, supervisors
Barnason, Susan; White-Williams, Connie; Rossi, Laura P; Centeno, Mae; Crabbe, Deborah L; Lee, Kyoung Suk; McCabe, Nancy; Nauser, Julie; Schulz, Paula; Stamp, Kelly; Wood, Kathryn
The burden of cardiovascular disease as a chronic illness increasingly requires patients to assume more responsibility for their self-management. Patient education is believed to be an essential component of cardiovascular care; however, there is limited evidence about specific therapeutic patient education approaches used and the impact on patient self-management outcomes. An integrative review of the literature was conducted to critically analyze published research studies of therapeutic patient education for self-management in selected cardiovascular conditions. There was variability in methodological approaches across settings and disease conditions. The most effective interventions were tailored to individual patient needs, used multiple components to improve self-management outcomes, and often used multidisciplinary approaches. This synthesis of evidence expands the base of knowledge related to the development of patient self-management skills and provides direction for more rigorous research. Recommendations are provided to guide the implementation of therapeutic patient education in clinical practice and the design of comprehensive self-management interventions to improve outcomes for cardiovascular patients. © 2017 American Heart Association, Inc.
Music plays an important role in the socialization of children and adolescents. Popular music is present almost everywhere, and it is easily available through the radio, various recordings, the Internet, and new technologies, allowing adolescents to hear it in diverse settings and situations, alone or shared with friends. Parents often are unaware of the lyrics to which their children are listening because of the increasing use of downloaded music and headphones. Research on popular music has explored its effects on schoolwork, social interactions, mood and affect, and particularly behavior. The effect that popular music has on children's and adolescents' behavior and emotions is of paramount concern. Lyrics have become more explicit in their references to drugs, sex, and violence over the years, particularly in certain genres. A teenager's preference for certain types of music could be correlated or associated with certain behaviors. As with popular music, the perception and the effect of music-video messages are important, because research has reported that exposure to violence, sexual messages, sexual stereotypes, and use of substances of abuse in music videos might produce significant changes in behaviors and attitudes of young viewers. Pediatricians and parents should be aware of this information. Furthermore, with the evidence portrayed in these studies, it is essential for pediatricians and parents to take a stand regarding music lyrics.
Definitions for overweight and obesity are universally applied using body mass index (BMI), based on morbidity and mortality data derived from white populations. However, several studies have shown higher body fat, excess metabolic perturbations, and cardiovascular risk factors at lower value of BMI in Asian versus white populations. Definitive guidelines have been published to classify a BMI of ≥23 kg/m(2) and ≥25 kg/m(2) as overweight and obese, respectively, by the Indian Consensus Group (for Asian Indians residing in India) and a BMI of ≥23 kg/m(2) for screening for diabetes by the National Institute of Health and Care Excellence of the United Kingdom (for migrant south Asians) and, in an encouraging initiative recently (2015), by the American Diabetes Association (for all Asian ethnic groups in the United States). Overall, multiple studies, and now several guidelines, emphasize early intervention with diet and physical activity in Asian ethnic groups for prevention and management of obesity-related noncommunicable diseases. By application of these guidelines, an additional 10-15% of the population in India would be labeled as overweight/obese, and more South Asians/Asians will be diagnosed with diabetes in the United Kingdom and the United States. Additional health resources need to be allocated to deal with increasing numbers of Asians with obesity-related noncommunicable diseases, and research is needed to evolve cost-effective interventions. Finally, consensus based on data is needed so that the World Health Organization and other international agencies could take definitive steps for revision of classification of BMI for Asian populations globally.
Mitchell, Michael S; Koen, Clifford M; Darden, Stephen M
As more and more individuals express themselves with tattoos and body piercings and push the envelope on what is deemed appropriate in the workplace, employers have an increased need for creation and enforcement of reasonable dress codes and appearance policies. As with any employment policy or practice, an appearance policy must be implemented and enforced without regard to an individual's race, color, sex, national origin, religion, disability, age, or any other protected status. A policy governing dress and appearance based on the business needs of an employer that is applied fairly and consistently and does not have a disproportionate effect on any protected class will generally be upheld if challenged in court. By examining some of the more common legal challenges to dress codes and how courts have resolved the disputes, health care managers can avoid many potential problems. This article, the third part of a 3-part examination of dress codes and appearance policies, focuses on the issues of race and national origin under the Civil Rights Act, disability under the Americans With Disabilities Act, and employees' rights to engage in concerted activities under the National Labor Relations Act. Pertinent court cases that provide guidance for employers are addressed.
Innovation policy involves using policy instruments to achieve societal goals. In order to learn from both past and foreign experiences, scholars and practitioners very often value sources of knowledge about these instruments. This dissertation deals with the role of Strategic Intelligence in both
Gurschick, Lauren; Mayer, Deborah K; Hanson, Laura C
To describe the suggested clinical practice of palliative sedation as it is presented in the literature and discuss available guidelines for its use. CINAHL, PubMed, and Web of Science were searched for publications since 1997 for recommended guidelines and position statements on palliative sedation as well as data on its provision. Keywords included palliative sedation, terminal sedation, guidelines, United States, and end of life. Inclusion criteria were palliative sedation policies, frameworks, guidelines, or discussion of its practice, general or oncology patient population, performance of the intervention in an inpatient unit, for humans, and in English. Exclusion criteria were palliative sedation in children, acute illness, procedural, or burns, and predominantly ethical discussions. Guidelines were published by American College of Physicians-American Society of Internal Medicine (2000), Hospice and Palliative Nurses Association (2003), American Academy of Hospice and Palliative Medicine (2006), American Medical Association (2008), Royal Dutch Medical Association (2009), European Association for Palliative Care (2009), National Hospice and Palliative Care Organization (2010), and National Comprehensive Cancer Network (2012). Variances throughout guidelines include definitions of the practice, indications for its use, continuation of life-prolonging therapies, medications used, and timing/prognosis. The development and implementation of institutional-based guidelines with clear stance on the discussed variances is necessary for consistency in practice. Data on provision of palliative sedation after implementation of guidelines needs to be collected and disseminated for a better understanding of the current practice in the United States. © The Author(s) 2014.
Laruelle, Ph.; Snegaroff, Th.; Moreau, S.; Tellenne, C.; Brunel, S.
Fourth chapter of the book on the geo-policy of the sustainable development, this chapter deal with the different and international policies concerned by the problem. The authors analyze the american energy attitude and policy, the economical equilibrium facing the environmental equilibrium for the european policy, the sanctified and sacrificed nature and the japanese attitude, India and China, the great fear of the 21 century and the sustainable development in Africa. (A.L.B.)
In an otherwise insightful and thoughtful article, Sebastian Pfotenhauer (Trade Policy Is Science Policy,” Issues, Fall 2013) might better have entitled his contribution “Trade Policy Needs to Be Reconciled with Science Policy.” The North American Free Trade Agreement (NAFTA) and the agreements administered by the World Trade Organization, particularly the General Agreement on Tariffs and Trade (GATT) and the Technical Barriers to Trade (TBT), were adopted to promote international trade and i...
American Development Bank, and United States Export -Import Bank combined for that year.”7 Furthermore, China has signed free trade agreements with... American Relations, 930. 23 two countries is the result of China’s export to Mexico . China’s investment in Mexico is also substantially larger than... Mexico at War Against China in the WTO (2005) China Hits Markets (2005) The Dragon Monopolizes (2005) Chinese Pirates Invade Chiapas (2005
This article focuses on analyzing of a consolidated financial statements of a hypothetically SME. The interpretation of the financial position and performances is based on the more than 40 financial key ratios computed by using financial data from consolidated income statement, consolidated financial position and cash flow. However additional data from notes to financial statements are provided.
... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Age of financial statements at... FOR FINANCIAL STATEMENTS, SECURITIES ACT OF 1933, SECURITIES EXCHANGE ACT OF 1934, PUBLIC UTILITY... POLICY AND CONSERVATION ACT OF 1975 General Instructions As to Financial Statements § 210.3-12 Age of...
Communication received from the United Kingdom of Great Britain and Northern Ireland concerning its policies regarding the management of plutonium. Statements on the management of plutonium and of highly enriched uranium
The Director General has received a Note Verbale, dated 17 July 2003, from the Permanent Mission of the United Kingdom of Great Britain and Northern Ireland to the IAEA in the enclosures of which the Government of the United Kingdom, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for its national holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2002. The Government of the United Kingdom has also made available a statement of its annual figures for holdings of civil high enriched uranium (HEU), and of civil depleted, natural and low enriched uranium (DNLEU) in the civil nuclear fuel cycle, as of 31 December 2002. 3. In the light of the requests expressed by the Government of the United Kingdom in its Note Verbale of 1 December 1997 concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998) and in its Note Verbale of 17 July 2003, the Note Verbale of 17 July 2003 and the enclosures thereto are attached for the information of all Member States
Communication Received from the Government of the Federal Republic of Germany Concerning its Policies Regarding the Management Of Plutonium. Statements on the Management of Plutonium and of Highly Enriched Uranium
The Director General has received a note verbale dated 7 November 2001 from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of the Federal Republic of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines') and with reference to the statement on the policies which it has decided to apply to the management of plutonium (contained in INFCIRC/549/Add.2), has made available the data on the plutonium inventory on German territory as of 31 December 2000. The Government of the Federal Republic of Germany has conveyed in its note verbale that 'Regarding any material that has been shipped abroad, especially for reprocessing, Germany would like to point out that the data on such material are not available at the German side. This should be taken into consideration whenever these data are used for statistical purposes. All nuclear materials within the states of the EU are property of the European Union, represented by the EURATOM Supply Agency'
Communication received from the Government of the Federal Republic of Germany concerning its policies regarding the management of plutonium. Statements on the management of plutonium and of high enriched uranium
The Director General has received a Note Verbale, dated 22 September 2003, from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2002. 2. The Government of the Federal Republic of Germany has also made available a statement of the estimated amounts of high enriched uranium (HEU) as of 31 December 2002. 3. In light of the request expressed by the Federal Republic of Germany in its Note Verbale of 1 December 1997 concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), the Note Verbale of 22 September 2003 and the enclosures thereto are attached for the information of all Member States
Communication received from the Government of the Federal Republic of Germany concerning its policies regarding the management of plutonium. Statements on the management of plutonium and of high enriched uranium
The Director General has received a Note Verbale, dated 17 September 2004, from the Permanent Mission of the Federal Republic of Germany to the IAEA in the enclosures of which the Government of Germany, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2003. The Government of the Federal Republic of Germany has also made available a statement of the estimated amounts of highly enriched uranium (HEU) as of 31 December 2003. In light of the request expressed by the Federal Republic of Germany in its Note Verbale of 1 December 1997 concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), the Note Verbale of 17 September 2004 and the enclosures thereto are attached for the information of all Member States
Evaluation of Current Consensus Statement Recommendations for Accelerated Partial Breast Irradiation: A Pooled Analysis of William Beaumont Hospital and American Society of Breast Surgeon MammoSite Registry Trial Data
Wilkinson, J. Ben [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Beitsch, Peter D. [Dallas Surgical Group, Dallas, Texas (United States); Shah, Chirag [Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri (United States); Arthur, Doug [Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia (United States); Haffty, Bruce G. [Department of Radiation Oncology, Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Camden, New Jersey (United States); Wazer, David E. [Department of Radiation Oncology, Tufts Medical Center, Boston, Massachusetts and Rhode Island Hospital/Brown University, Providence, Rhode Island (United States); Keisch, Martin [Department of Radiation Oncology, Cancer Healthcare Associates, Miami, Florida (United States); Shaitelman, Simona F. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lyden, Maureen [Biostat International, Inc, Tampa, Florida (United States); Chen, Peter Y. [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Vicini, Frank A., E-mail: firstname.lastname@example.org [Department of Radiation Oncology, Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, Michigan (United States)
Purpose: To determine whether the American Society for Radiation Oncology (ASTRO) Consensus Statement (CS) recommendations for accelerated partial breast irradiation (APBI) are associated with significantly different outcomes in a pooled analysis from William Beaumont Hospital (WBH) and the American Society of Breast Surgeons (ASBrS) MammoSite® Registry Trial. Methods and Materials: APBI was used to treat 2127 cases of early-stage breast cancer (WBH, n=678; ASBrS, n=1449). Three forms of APBI were used at WBH (interstitial, n=221; balloon-based, n=255; or 3-dimensional conformal radiation therapy, n=206), whereas all Registry Trial patients received balloon-based brachytherapy. Patients were divided according to the ASTRO CS into suitable (n=661, 36.5%), cautionary (n=850, 46.9%), and unsuitable (n=302, 16.7%) categories. Tumor characteristics and clinical outcomes were analyzed according to CS group. Results: The median age was 65 years (range, 32-94 years), and the median tumor size was 10.0 mm (range, 0-45 mm). The median follow-up time was 60.6 months. The WBH cohort had more node-positive disease (6.9% vs 2.6%, P<.01) and cautionary patients (49.5% vs 41.8%, P=.06). The 5-year actuarial ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), and distant metastasis (DM) for the whole cohort were 2.8%, 0.6%, 1.6%. The rate of IBTR was not statistically higher between suitable (2.5%), cautionary (3.3%), or unsuitable (4.6%) patients (P=.20). The nonsignificant increase in IBTR for the cautionary and unsuitable categories was due to increased elsewhere failures and new primaries (P=.04), not tumor bed recurrence (P=.93). Conclusions: Excellent outcomes after breast-conserving surgery and APBI were seen in our pooled analysis. The current ASTRO CS guidelines did not adequately differentiate patients at an increased risk of IBTR or tumor bed failure in this large patient cohort.
Evaluation of Current Consensus Statement Recommendations for Accelerated Partial Breast Irradiation: A Pooled Analysis of William Beaumont Hospital and American Society of Breast Surgeon MammoSite Registry Trial Data
Wilkinson, J. Ben; Beitsch, Peter D.; Shah, Chirag; Arthur, Doug; Haffty, Bruce G.; Wazer, David E.; Keisch, Martin; Shaitelman, Simona F.; Lyden, Maureen; Chen, Peter Y.; Vicini, Frank A.
Purpose: To determine whether the American Society for Radiation Oncology (ASTRO) Consensus Statement (CS) recommendations for accelerated partial breast irradiation (APBI) are associated with significantly different outcomes in a pooled analysis from William Beaumont Hospital (WBH) and the American Society of Breast Surgeons (ASBrS) MammoSite® Registry Trial. Methods and Materials: APBI was used to treat 2127 cases of early-stage breast cancer (WBH, n=678; ASBrS, n=1449). Three forms of APBI were used at WBH (interstitial, n=221; balloon-based, n=255; or 3-dimensional conformal radiation therapy, n=206), whereas all Registry Trial patients received balloon-based brachytherapy. Patients were divided according to the ASTRO CS into suitable (n=661, 36.5%), cautionary (n=850, 46.9%), and unsuitable (n=302, 16.7%) categories. Tumor characteristics and clinical outcomes were analyzed according to CS group. Results: The median age was 65 years (range, 32-94 years), and the median tumor size was 10.0 mm (range, 0-45 mm). The median follow-up time was 60.6 months. The WBH cohort had more node-positive disease (6.9% vs 2.6%, P<.01) and cautionary patients (49.5% vs 41.8%, P=.06). The 5-year actuarial ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), and distant metastasis (DM) for the whole cohort were 2.8%, 0.6%, 1.6%. The rate of IBTR was not statistically higher between suitable (2.5%), cautionary (3.3%), or unsuitable (4.6%) patients (P=.20). The nonsignificant increase in IBTR for the cautionary and unsuitable categories was due to increased elsewhere failures and new primaries (P=.04), not tumor bed recurrence (P=.93). Conclusions: Excellent outcomes after breast-conserving surgery and APBI were seen in our pooled analysis. The current ASTRO CS guidelines did not adequately differentiate patients at an increased risk of IBTR or tumor bed failure in this large patient cohort
MacKenzie, Ross; Collin, Jeff
British American Tobacco Cambodia (BATC) has dominated the country's tobacco market since its launch in 1996. Aggressive marketing in a weak regulatory environment and strategies to influence tobacco control policy have contributed to an emerging tobacco-related public health crisis. Analysis of internal tobacco industry documents, issues of BATC's in-house newsletter, civil society reports and media demonstrate that BATC officials have successfully sought to align the company with Cambodia's increasingly controversial political and business leadership that is centred around the Cambodian People's Party with the aim of gaining access to policy-makers and influencing the policy process. Connections to the political elite have resulted in official recognition of the company's ostensible contribution to Cambodia's economic and social development and, more significantly, provided BATC with opportunities to petition policy-makers and to dilute tobacco control regulation. Corporate promotion of its contribution to Cambodia's economic and social development is at odds with its determined efforts to thwart public health regulation and Cambodia's compliance with the Framework Convention on Tobacco Control.
Virginity testing (virginity examination) is a gynecological examination that is intended to correlate the status and appearance of the hymen with previous sexual contact to determine whether a female has had or is habituated to sexual intercourse. Virginity examinations are practiced in many countries, often forcibly, including in detention places; on women who allege rape or are accused of prostitution; and as part of public or social policies to control sexuality. The Independent Forensic Expert Group (IFEG) - thirty-five preeminent independent forensic experts from eighteen countries specialized in evaluating and documenting the physical and psychological effects of torture and ill-treatment - released a statement on the practice in December 2014. In its statement, the IFEG outlines the physical and psychological effects of forcibly conducting virginity examinations on females based on its collective experience. The Group assesses whether, based on the effects, forcibly conducted virginity examinations constitute cruel, inhuman, or degrading treatment or torture. Finally, the IFEG addresses the medical interpretation, relevance, and ethical implications of such examinations. The IFEG concludes that virginity examinations are medically unreliable and have no clinical or scientific value. These examinations are inherently discriminatory and, in almost all instances, when conducted forcibly, result in significant physical and mental pain and suffering, thereby constituting cruel, inhuman and degrading treatment or torture. When virginity examinations are forcibly conducted and involve vaginal penetration, the examination should be considered as sexual assault and rape. Involvement of health professionals in these examinations violates the basic standards and ethics of the professions. Copyright © 2015 Torture. Published by Elsevier Ltd.. All rights reserved.
The European Federation of Organisations for Medical Physics. Policy Statement No. 7.1: The roles, responsibilities and status of the medical physicist including the criteria for the staffing levels in a Medical Physics Department approved by EFOMP Council on 5th February 2016.
Evans, Stephen; Christofides, Stelios; Brambilla, Marco
This EFOMP Policy Statement is an amalgamation and an update of the EFOMP Policy Statements No. 2, 4 and 7. It presents guidelines for the roles, responsibilities and status of the medical physicist together with recommended minimum staffing levels. These recommendations take into account the ever-increasing demands for competence, patient safety, specialisation and cost effectiveness of modern healthcare services, the requirements of the European Union Council Directive 2013/59/Euratom laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation, the European Commission's Radiation Protection Report No. 174: "Guidelines on medical physics expert", as well as the relevant publications of the International Atomic Energy Agency. The provided recommendations on minimum staffing levels are in very good agreement with those provided by both the European Commission and the International Atomic Energy Agency. Copyright © 2016. Published by Elsevier Ltd.
... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Official advertising statement requirements... OF GENERAL POLICY ADVERTISEMENT OF MEMBERSHIP § 328.3 Official advertising statement requirements. (a... medium, that is designed to attract public attention or patronage to a product or business. (b) Official...
... DEPARTMENT OF TRANSPORTATION Federal Highway Administration Environmental Impact Statement: Harris... (TxDOT) are issuing this notice to advise the public that an environmental impact statement (EIS) will..., Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU) and the National Environmental Policy...
... 10 Energy 4 2010-01-01 2010-01-01 false Environmental impact statements. 1021.310 Section 1021.310 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NATIONAL ENVIRONMENTAL POLICY ACT IMPLEMENTING PROCEDURES Implementing Procedures § 1021.310 Environmental impact statements. DOE shall prepare and...
Le Prioux, Bruna [Centro de Pesquisa e Documentacao da America Latina (CREDAL) (France)
The international energy context in the first decade of the 21st century can be described by the following points. First, the growing concerns with climatic changes and the greenhouse effect, which the main cause is the massive use of fossil fuels. Second, the energy vulnerability, due to the mistrust in the main hydrocarbon producers, to the increasing consumption from the so-called developing countries and to the idea of a possible end of oil reserves. And third, as a consequence of the least factor, an intense speculation in international market has increased the prices of oil barrel and gas since 2005. In this context, each country tries to adapt to their way of such changes. Beyond local solutions, South American countries have historic attempts of regional integration through energy, which can be presented as a complement of national policies. This research focuses on the study of the gas energy policy of some producers' and consumers' countries in South America, their choices and procedures in the national and international scope. Thus, the main goal of this article is to analyze how national energy policies affect the regional energy action of these South American countries. In order to answer this question, our goals are: (1) diagnosing the energy potentialities and disadvantages of each country; (2) identifying concepts related to energy questions; and (3) relating the two past steps to analyze the energy interaction in South America. The countries selected to this research are: Brazil, Argentina and Chile, due to their economic magnitude in South America and their intense energy consumption; and Bolivia and Venezuela, due to their energy reserves and surplus. The study of national energy systems was made through SWOT analysis (Strengths, Weaknesses, Opportunities and Threat), in order to have a synthetically diagnosis about the energetic potentials and disadvantages of each country. Thereafter, we intersect this data with concepts as
Katherine E Smith
Full Text Available Impact assessment (IA of all major European Union (EU policies is now mandatory. The form of IA used has been criticised for favouring corporate interests by overemphasising economic impacts and failing to adequately assess health impacts. Our study sought to assess how, why, and in what ways corporations, and particularly the tobacco industry, influenced the EU's approach to IA.In order to identify whether industry played a role in promoting this system of IA within the EU, we analysed internal documents from British American Tobacco (BAT that were disclosed following a series of litigation cases in the United States. We combined this analysis with one of related literature and interviews with key informants. Our analysis demonstrates that from 1995 onwards BAT actively worked with other corporate actors to successfully promote a business-oriented form of IA that favoured large corporations. It appears that BAT favoured this form of IA because it could advance the company's European interests by establishing ground rules for policymaking that would: (i provide an economic framework for evaluating all policy decisions, implicitly prioritising costs to businesses; (ii secure early corporate involvement in policy discussions; (iii bestow the corporate sector with a long-term advantage over other actors by increasing policymakers' dependence on information they supplied; and (iv provide businesses with a persuasive means of challenging potential and existing legislation. The data reveal that an ensuing lobbying campaign, largely driven by BAT, helped secure binding changes to the EU Treaty via the Treaty of Amsterdam that required EU policymakers to minimise legislative burdens on businesses. Efforts subsequently focused on ensuring that these Treaty changes were translated into the application of a business orientated form of IA (cost-benefit analysis [CBA] within EU policymaking procedures. Both the tobacco and chemical industries have since
Rendall, Michael; Aracil, Encarnacion; Bagavos, Christos; Couet, Christine; DeRose, Alessandra; DiGiulio, Paola; Lappegard, Trude; Robert-Bobée, Isabelle; Rønsen, Marit; Smallwood, Steve; Verropoulou, Georgia
Family-policy regimes unfavourable to combining employment with motherhood have been claimed to increase socio-economic differentials in fertility as combining employment and motherhood has become more normative. This claim has to date been explored mainly in reference to ‘liberal’ Anglo-American regimes. Comparing education differentials in age at first birth among native-born women of 1950s and 1960s birth cohorts in seven countries representing three regime types, we find persistence in early first births among low-educated women not only in Britain and the United States but also in Greece, Italy, and Spain. Shifts towards later first births, however, were more extreme in Southern Europe and involved to some extent women at all education levels. The educationally-heterogeneous changes in age patterns of first births seen in the Southern European and Anglo-American family-policy regimes contrast with educationally-homogeneous changes across birth cohorts seen in the study’s two ‘universalistic’ countries, Norway and France. PMID:20954097
Hauptman, Arthur M.
Rapid increases in what colleges charge and what they spend per student have been and remain one of the most controversial aspects of American higher education. Tuition, fees, and other college charges have increased in both the public and private sectors at more than twice the rate of inflation for over a quarter century. Trends over time in what…
This article reflects on three narratives that affected American women's participation in higher education during the first twenty years after World War II. In hindsight, the educators of the 1950s and early 1960s may seem gratuitously meek and self-effacing. In comparison to later efforts, their activism can appear unnecessarily limited and too…
McDannold, Thomas A.
A survey was conducted to identify the degree to which the Association of American Geographers (AAG) 1970 recommendations on geography programs in two-year colleges were reflected in geography programs offered in the Ventura County Community College District (California). Results indicated that the recommendations were followed to a great extent,…
remarked that Plutarch is what kept the United States a republic. 10 True or not, the direct influence of classical history on American political thought...person’s inability to read Plutarch in the original, however, need have been no barrier. Colbourn’s title lists make clear that English 28 translations of
Holck, Lasse; Saiz, Monika Contreras
This article compares the methods and means employed by the state to enforce the education of (semi-)autonomous indigenous groups in southern Chile and northwestern Mexico (Sonora), border regions in the Latin American periphery, covering the transition from colonial times to the consolidation of independent republics until the middle of the…
Di Capua, Giuseppe; Peppoloni, Silvia; Bobrowsky, Peter
IGC the scientific event that opened a new phase for Geoethics and for the Association. In order to celebrate this passage, the IAPG has produced the "Cape Town Statement on Geoethics" (CTSG), a document recognized as the result of an international effort to focus the attention of geoscientists on the development of shared policies, guidelines, strategies and tools, with the long-range goal of fostering the regular adoption of ethical values and practices in the geoscience community. The final document (available at http://www.geoethics.org/ctsg) sums the values, concepts, and contents developed in the first 4-year activity of IAPG, giving a perspective for the future development of geoethics. This presentation illustrates the content of the "Cape Town Statement on Geoethics", that is now supported officially by several geoscience organizations.
Chafetz, M D; Williams, M A; Ben-Porath, Y S; Bianchini, K J; Boone, K B; Kirkwood, M W; Larrabee, G J; Ord, J S
The milestone publication by Slick, Sherman, and Iverson (1999) of criteria for determining malingered neurocognitive dysfunction led to extensive research on validity testing. Position statements by the National Academy of Neuropsychology and the American Academy of Clinical Neuropsychology (AACN) recommended routine validity testing in neuropsychological evaluations. Despite this widespread scientific and professional support, the Social Security Administration (SSA) continued to discourage validity testing, a stance that led to a congressional initiative for SSA to reevaluate their position. In response, SSA commissioned the Institute of Medicine (IOM) to evaluate the science concerning the validation of psychological testing. The IOM concluded that validity assessment was necessary in psychological and neuropsychological examinations (IOM, 2015 ). The AACN sought to provide independent expert guidance and recommendations concerning the use of validity testing in disability determinations. A panel of contributors to the science of validity testing and its application to the disability process was charged with describing why the disability process for SSA needs improvement, and indicating the necessity for validity testing in disability exams. This work showed how the determination of malingering is a probability proposition, described how different types of validity tests are appropriate, provided evidence concerning non-credible findings in children and low-functioning individuals, and discussed the appropriate evaluation of pain disorders typically seen outside of mental consultations. A scientific plan for validity assessment that additionally protects test security is needed in disability determinations and in research on classification accuracy of disability decisions.
Lee, Jaekyung; Park, Daekwon
This study examines key school reform policies and outcomes of the USA and Korea over the past three decades from comparative perspectives. Since the two nations' unique educational problems brought divergent educational reform paths--standardization versus differentiation, high-stakes testing versus individualized assessment, and centralization…
of the draft environmental statement was conducted and found to be in accord with the requirements set forth in the Environmental Policy Act of 1969...furnishcd by the Government or through GovernraenT- cncd facilities for the use of the liconse, inclumire the liccnzee’s proportionate share of the cost of...Commerce, Bureau of the Census I4 Osweqo, N.Y.. Greater Oswego Chamber of Commerce, Inc. IJ 15 Land Use and Transportation Plan - Policies for- Action
It was also revealed in this study that the financial reporting objectives of an enterprise will determine the choice of revenue recognition policy to be taken. The study equally revealed some subtle manipulations that can vitiate the true position of financial statements hence the revenue to be recognised by a business ...
This report contains the audited consolidated financial reports for the Churchill Falls (Labrador) Corporation Limited and those for the Twin Falls Power Corporation Limited, together with the appropriate notes to the consolidated financial statements and summaries of significant accounting policies as they apply to the data provided in this report
... Position Statements Publications Bookstore American Journal of Geriatric Psychiatry Legislative & Regulatory Agenda AAGP eNews (Members Only) Tools ... Funding Training Resources and Curricula For Clinicians >> Geriatric Psychiatry Identifier Webinar: Billing and Coding Consumer Material Clinical ...
2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiología Intervencionista; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention).
Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas
This article provides a brief summary of the relevant recommendations and references related to percutaneous mechanical circulatory support. The goal was to provide the clinician with concise, evidence-based contemporary recommendations, and the supporting documentation to encourage their application. The full text includes disclosure of all relevant relationships with industry for each writing committee member. A fundamental aspect of all expert consensus statements is that these carefully developed, evidence-based documents can neither encompass all clinical circumstances, nor replace the judgment of individual physicians in management of each patient. The science of medicine is rooted in evidence, and the art of medicine is based on the application of this evidence to the individual patient. This expert consensus statement has adhered to these principles for optimal management of patients requiring percutaneous mechanical circulatory support. © 2015 by The Society for Cardiovascular Angiography and Interventions, The American College of Cardiology Foundation, the Heart Failure Society of America, and The Society for Thoracic Surgery.
Iglesias Cavicchioli, Manuel
This article analyzes the nature of the conflict generated in South America by the adoption of the new military agreement between the U.S. and Colombia. The article will evaluate the political and the geostrategic implications of this agreement, especially its repercussions for the regional integration process of South America. It will also analyze the stances of the local actors in order to consider prospective scenarios, and will assess the U.S. approach to South American int...
... TENNESSEE VALLEY AUTHORITY Supplemental Environmental Impact Statement for Sequoyah Nuclear Plant... National Environmental Policy Act. TVA will prepare a supplemental environmental impact statement (SEIS) to update information in the 1974 Final Environmental Statement for Sequoyah Nuclear Plant Units 1 and 2...
... environmental impact statement. 380.7 Section 380.7 Conservation of Power and Water Resources FEDERAL ENERGY... ENVIRONMENTAL POLICY ACT § 380.7 Format of an environmental impact statement. In addition to the requirements for an environmental impact statement prescribed in 40 CFR 1502.10 of the regulations of the Council...
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Draft environmental impact statements... Environmental Policy Act of 1969 § 1.84 Draft environmental impact statements: Availability and comment. Except for proposals for legislation, environmental impact statements shall be prepared in two stages: Draft...
... environmental impact statement. 380.6 Section 380.6 Conservation of Power and Water Resources FEDERAL ENERGY... ENVIRONMENTAL POLICY ACT § 380.6 Actions that require an environmental impact statement. (a) Except as provided in paragraph (b) of this section, an environmental impact statement will normally be prepared first...
... IMPLEMENTATION OF THE NATIONAL ENVIRONMENTAL POLICY ACT OF 1969 Environmental Impact Statements § 46.445 Preparing a legislative environmental impact statement. When required under 40 CFR 1506.8, the Department must ensure that a legislative environmental impact statement is included as a part of the formal...
... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Original cost statement... POLICIES ACT OF 1978 STATEMENTS AND REPORTS (SCHEDULES) § 141.100 Original cost statement of utility... predecessors of an electric operating unit or system, the original cost, estimated, if not known, the cost of...
Amal Hatem Alkhaldi
Full Text Available Global competition in the international business environment has pushed companies to achieve competitive advantage through mergers, acquisitions and through locating their subsidiaries in less developed counties for cost effectiveness. Consequently, the competitive pressure has increased the significance of human resource management (HRM in multinational companies (MNCs, and MNCs have recognised the significance of the transfer HRM process across borders. This study examines the transfer of HRM policies and practices of US MNCs to their subsidiaries in Saudi Arabia. The aim of the study is to determine the extent to which US MNCs transfer HRM policies and practices from their Headquarters to their subsidiaries in Saudi Arabia; and identify the factors that facilitate and inhibit HRM transfer. The paper is based on an investigation of the interaction between home-country and host-country effects in determining HRM policies and practices in MNCs in the context of the Middle East. The study adopts a mixed methods approach of documentary analysis, focus group interviews of employees and in depth interviews of key informants in four subsidiaries of US owned international hotel chains located in Riyadh, Saudi Arabia.Keywords: Home country, host country, human resource managem transfer,Institutional theory, culture conditions.
game tool Game Tool Interactive Media Element The purpose of this interactive exercise is to help you understand the math in the income statement and balance sheet., Give the proper mathematical computations in order to correctly prepare the income statement and the balance sheet.The exercise is divided into 3 parts: The income Statement, The Balance Sheet - Assets, The Balance Sheet - Liabilities, GB3050 Financial Reporting and Analysis
Ciocirlan, Cristina E.
The environmental economics literature consistently suggests that properly designed and implemented economic incentives are superior to command-and-control regulation in reducing pollution. Economic incentives, such as green taxes, cap-and-trade programs, tax incentives, are able to reduce pollution in a cost-effective manner, provide flexibility to industry and stimulate innovation in cleaner technologies. In the past few decades, both federal and state governments have shown increased use of economic incentives in environmental policy. Some states have embraced them in an active manner, while others have failed to do so. This research uses a three-step analysis. First, it asks why some states employ more economic incentives than others to stimulate consumption of renewable energy by the residential, commercial and industrial sectors. Second, it asks why some states employ stronger incentives than others. And third, it asks why certain states employ certain instruments, such as electricity surcharges, cap-and-trade programs, tax incentives or grants, while others do not. The first two analyses were conducted using factor analysis and multiple regression analysis, while the third analysis employed logistic regression models to analyze the data. Data for all three analyses were obtained from a combination of primary and secondary sources. To address these questions, a theory of instrument choice at the state level, which includes both internal and external determinants of policy-making, was developed and tested. The state level of analysis was chosen. States have proven to be pioneers in designing policies to address greenhouse gases (see, for instance, the recent cap-and-trade legislation passed in California). The theory was operationalized with the help of four models: needs/responsiveness, interest group influence, professionalism/capacity and innovation-and-diffusion. The needs/responsiveness model suggests that states tend to choose more and stronger economic
This policy reader comprises: Correspondence; Memorandum of Understanding between the US Department of Transportation and the US Department of Energy for the Transportation of Radioactive Materials under the Nuclear Waste Policy Act; Internal Guidelines for Interactions with Communities and Local Governments; Statement by Ben C. Rusche before the Committee on Interior and Insular Affairs, Subcommittee on Energy and the Environment, US House of Representatives, September 13, 1985; Speech presented by Ben C. Rusche before the ANS/CNS/AESJ/ENS Topical Meeting, Pasco, Washington, September 24, 1985 - ''Status of the United States' High-Level Nuclear Waste Disposal Program''; and ''DOE Seeks Comments on Nuclear Transportation Planning,'' DOE News, September 30, 1985
Schneider, Linda M; Schermbeck, Rebecca M; Chriqui, Jamie F; Chaloupka, Frank J
The Healthy, Hunger-Free Kids Act of 2010 authorized the Secretary of the US Department of Agriculture to establish science-based nutrition standards for competitive foods and beverages sold in school that are, at a minimum, aligned with the 2010 Dietary Guidelines for Americans (DGA), while still providing districts with discretion in regulating the competitive food and beverage environment. The objective of this study was to examine the extent to which district competitive food and beverage policies had specific and required limits aligned with 2010 DGA recommendations, and to inform US Department of Agriculture efforts as they develop competitive food and beverage standards. Competitive food and beverage policies were compiled for the 2009-2010 school year from a nationally representative sample of 622 districts. Each policy was double-coded for compliance with selected 2010 DGA recommendations (ie, restrictions on sugars, fats, trans fats, and sodium in foods and restrictions on regular soda, other sugar-sweetened beverages, and fat content of milk). Descriptive statistics were computed, clustered to account for the sample design, and weighted to account for districts nationwide. District nutrition policies were strongest for elementary schools. Nationwide, content of foods and soda availability were more commonly addressed. Areas that require attention include stronger nutrition standards at the secondary level, limits on trans fats, sodium, sugar-sweetened beverages other than soda, and fat content of milk, and greater availability of produce and whole grains at all sale locations. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
The following statement was prepared by the Special Committee to Revise the Joint American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology Position on Cone Beam Computed Tomography, and approved by the AAE Board of Directors and AAOMR Executive Council in May 2015. AAE members may reprint this position statement for distribution to patients or referring dentists. Copyright © 2015 American Academy of Oral and Maxillofacial Radiology and American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Healthcare Policy Statement on the Utility of Coronary Computed Tomography for Evaluation of Cardiovascular Conditions and Preventive Healthcare: From the Health Policy Working Group of the Society of Cardiovascular Computed Tomography.
Slim, Ahmad M; Jerome, Scott; Blankstein, Ron; Weigold, Wm Guy; Patel, Amit R; Kalra, Dinesh K; Miller, Ryan; Branch, Kelley; Rabbat, Mark G; Hecht, Harvey; Nicol, Edward D; Villines, Todd C; Shaw, Leslee J
The rising cost of healthcare is prompting numerous policy and advocacy discussions regarding strategies for constraining growth and creating a more efficient and effective healthcare system. Cardiovascular imaging is central to the care of patients at risk of, and living with, heart disease. Estimates are that utilization of cardiovascular imaging exceeds 20 million studies per year. The Society of Cardiovascular CT (SCCT), alongside Rush University Medical Center, and in collaboration with government agencies, regional payers, and industry healthcare experts met in November 2016 in Chicago, IL to evaluate obstacles and hurdles facing the cardiovascular imaging community and how they can contribute to efficacy while maintaining or even improving outcomes and quality. The summit incorporated inputs from payers, providers, and patients' perspectives, providing a platform for all voices to be heard, allowing for a constructive dialogue with potential solutions moving forward. This article outlines the proceedings from the summit, with a detailed review of past hurdles, current status, and potential solutions as we move forward in an ever-changing healthcare landscape. Copyright © 2017 Society of Cardiovascular Computed Tomography. All rights reserved.
Full Text Available The article will present the role of the humanitarian aid in the process of creating the US foreign policy. The study will examine two interesting case studies: the Polish Medical Aid Project and the creation of the American Research Hospital for Children in Poland. The work will show the most important aspects of the planning and implementation of those initiatives. This approach will be aimed at answering the title question and will try to define the extent to which the humanitarian aid offered to Poland within a certain period was a political calculation. The final analysis of the congressional hearings conducted in 1962 presents and confirms the complexity of the process of helping the “Captive Nations” in Central Eastern Europe.
Full Text Available This paper offers an analysis of the illiberal practices and discourse of the Global War on Terror (GWoT and demonstrates how the United States of America used the liberal argument as a qualitative metric of its success and failure in the GWoT. I argue that ‘the othering’ of Salafi Jihadists as well the full military involvement in Afghanistan and Iraq were both philosophically rooted in the liberal thinking of Immanuel Kant and John Stuart Mill, which have traditionally guided US foreign policy. More significantly, these liberal philosophies of history and international relations hold within them the seeds of illiberalism by depicting non-liberal, undemocratic societies/organisations as ‘barbaric’ – and as such prime candidates for intervention and regime change. Predicated upon this logic, the discourse of the GWoT framed Al Qaeda as a key existential threat to not only the United States but also the ‘civilised world’ in general and one which required a ‘liberal defensive war’ in response. It was the successful securitisation of Al Qaeda that essentially enabled the United States to adopt deeply illiberal policies to counter this so-called existential threat by using any means at its disposal.
... within a district that is experiencing financial stress. They also note that the FCA has authority to... evaluate the adequacy of managerial resources of the troubled System institution. The Corporation is... caused the need for assistance. The plan must include an internal control system to monitor ongoing...
... their disputes by consent. Such procedures include, but are not limited to, mediation, conciliation... are encouraged to attend educational and training programs relating to the theory and application of... their overall job performance. Though staff commitment is important, the role of supervisors is...
... financial institutions regulatory agency engages in, contracts for, or regulates; and b) requires the... officer, director, employee or agent of a federally regulated financial institution would not be permitted... FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL [Docket No. AS13-13] Appraisal Subcommittee...
... SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT General Provisions... which might hinder Indian tribes and tribal organizations including obstacles that hinder tribal...
..., shipping containers constructed with uranium as shielding are not used by the public in the form of.... These include: (a) Use of uranium to color glass for certain decorative purposes; and (b) Thorium in...
This article examines the rationale for my teaching philosophy. Using a personal perspective, I explain my objectives, mission, and vision in writing my philosophy of teaching statements. This article also creates a road map and reference points for educators who want to write their own teaching philosophy statements to help them make informed…
After years of good service, EU legislation on chemicals is currently subject to a major review. This process, initiated by the Council of Ministers at Chester in April 1998, will soon lead to new legislative proposals. In the meantime, a review of the Commission's White Paper on "Strategy for a Future Chemicals Policy," published in February 2001, clearly shows that the regulatory landscape in this area will be significantly reshaped and that a new burden will be imposed on industry to demonstrate that the production and use of chemicals indeed conform to high standards of protection of human health and the environment. In the view of industry, on both sides of the Atlantic, while the objectives of the proposed reform can be supported, the measures proposed in the White Paper to implement these objectives are not properly balanced and will lead to substantial societal and economic drawbacks, unless significant adjustments are made. The purpose of this article is to present the pitfalls and difficulties of the reform as they are perceived by the EU Committee of the American Chamber of Commerce in Brussels, an organization that regroups about 150 European companies of American parentage, belonging to a broad range of European business sectors, including producers and users of chemicals. In view of the transatlantic and cross-business character of its membership, the EU Committee offers a different perspective on the debate.
Sovacool, Benjamin K. [National University of Singapore, Lee Kuan Yew School of Public Policy Centre on Asia and Globalisation, 469C Bukit Timah Road, Singapore 259772 (Singapore)
From its inception in 1977, the U.S. Department of Energy (DOE) has been responsible for maintaining the nation's nuclear stockpile, leading the country in terms of basic research, setting national energy goals, and managing thousands of individual programs. Despite these gains, however, the DOE research and development (R and D) model does not appear to offer the nation an optimal strategy for assessing long-term energy challenges. American energy policy continues to face constraints related to three I's: inconsistency, incrementalism, and inadequacy. An overly rigid management structure and loss of mission within the DOE continues to plague its programs and create inconsistencies in terms of a national energy policy. Various layers of stove-piping within and between the DOE and national laboratories continue to fracture collaboration between institutions and engender only slow, incremental progress on energy problems. And funding for energy research and development continues to remain inadequate, compromising the country's ability to address energy challenges. To address these concerns, an R and D organization dedicated to transformative, creative research is proposed. (author)
Policies and economic drivers concerning the natural gas industry were the focus of this conference, which was divided into 3 sessions. The first session examined various policy issues and perspectives from government officials in North America. High energy prices and regulations concerning land access were reviewed, as well as supply costs and infrastructure needs. Outlooks for the natural gas industry in Alberta and British Columbia were presented. Issues concerning coalbed methane (CBM) and accessing off-shore natural gas were discussed. Activities in the Yukon were outlined. Land claim settlements were reviewed, and the development of a liquefied natural gas (LNG) infrastructure in Mexico was examined. Issues concerning the role of the natural gas industry in oil sands developments were addressed, as well as pipelines challenges and gas price impacts. Session 2 examined pipeline developments and infrastructure needs. Issues concerning stress corrosion cracking and the increase in Canadian pipelines were reviewed along with rates of return and market needs. Challenges facing natural gas infrastructure in the northeast were outlined and the impacts of LNG and northern supply were evaluated. Session 3 examined the impact of high gas prices. Macroeconomic impacts to the United States economy were discussed, as well as the impact of rising natural gas prices on the industrial sector. Issues concerning contract terms, credit terms, traded volumes and hedging were examined. Advances in temperature forecasting were reviewed. Short term price impacts and fundamental supply and demand issues were reviewed in relation to marketplace needs. Eleven presentations were given at this conference, of which 5 have been catalogued separately for inclusion in this database. tabs., figs
White, K. S.; Teich, A. H.
Apart from the journals they produce, scientific societies play an important role in communicating scientific findings and norms to the broader society. The American Association for the Advancement of Science (AAAS) includes among its goals to promote and defend the integrity of science and its use; provide a voice for science on societal issues; promote the responsible use of science in public policy; and increase public engagement with science and technology. AAAS websites and programs, including Communicating Science (www.aaas.org/communicatingscience), Working with Congress (http://www.aaas.org/spp/cstc/wwc/book.htm) and ScienceCareers.org (http://sciencecareers.sciencemag.org), provide tools for scientists to become more directly engaged in effectively communicating their findings and involved in the policy process. Education programs work to build the next generation of scientists and a science-literate public. To bridge the current communication gap between scientists, the public and policymakers, AAAS, like other scientific societies, maintains policy and outreach programs with limited budgets and staff. AAAS works to engage policymakers and provide scientific underpinning to key issues through congressional briefings, meetings, policy briefs, and media outreach. AAAS responds to challenges to accepted scientific findings and processes through op-eds, letters to government officials, resolutions, and Board statements. Some of these initiatives occur on a local level in partnership with local civic leaders, whose endorsement makes them more powerful. On a national scale, they assure that the voice of science is included in the debate. The changing media landscape presents opportunities and challenges for future AAAS endeavors.
Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists.
Easton, J Donald; Saver, Jeffrey L; Albers, Gregory W; Alberts, Mark J; Chaturvedi, Seemant; Feldmann, Edward; Hatsukami, Thomas S; Higashida, Randall T; Johnston, S Claiborne; Kidwell, Chelsea S; Lutsep, Helmi L; Miller, Elaine; Sacco, Ralph L
This scientific statement is intended for use by physicians and allied health personnel caring for patients with transient ischemic attacks. Formal evidence review included a structured literature search of Medline from 1990 to June 2007 and data synthesis employing evidence tables, meta-analyses, and pooled analysis of individual patient-level data. The review supported endorsement of the following, tissue-based definition of transient ischemic attack (TIA): a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction. Patients with TIAs are at high risk of early stroke, and their risk may be stratified by clinical scale, vessel imaging, and diffusion magnetic resonance imaging. Diagnostic recommendations include: TIA patients should undergo neuroimaging evaluation within 24 hours of symptom onset, preferably with magnetic resonance imaging, including diffusion sequences; noninvasive imaging of the cervical vessels should be performed and noninvasive imaging of intracranial vessels is reasonable; electrocardiography should occur as soon as possible after TIA and prolonged cardiac monitoring and echocardiography are reasonable in patients in whom the vascular etiology is not yet identified; routine blood tests are reasonable; and it is reasonable to hospitalize patients with TIA if they present within 72 hours and have an ABCD(2) score >or=3, indicating high risk of early recurrence, or the evaluation cannot be rapidly completed on an outpatient basis.
23 delegations have submitted general reports and statements on the situation and evolution of the nuclear fuel cycle. Each report reflects the particular interests of the country that submitted it. All in all, these reports provide general background information on the subject of the conference
Holden, Chris; Lee, Kelley; Gilmore, Anna; Fooks, Gary; Wander, Nathaniel
Tobacco market liberalization can have a profound impact on health. This article analyzes internal documents of British American Tobacco (BAT), released as a result of litigation in the United States, in order to examine the company's attempts to influence negotiations over China's accession to the World Trade Organization. The documents demonstrate that BAT attempted to influence these negotiations through a range of mechanisms, including personal access of BAT employees and lobbyists to policymakers; employment of former civil servants from key U.K. government departments; use of organized business groups such as the Multinational Chairmen's Group and the European Round Table; and participation and leadership in forums organized by Chatham House. These processes contributed to significant concessions on the liberalization of the tobacco market in China, although the failure to break the Chinese state monopoly over the manufacture and distribution of cigarettes has ensured that foreign tobacco companies' share of the Chinese market has remained small. World Trade Organization accession has nevertheless led to a profound restructuring of the Chinese tobacco industry in anticipation of foreign competition, which may result in more market-based and internationally oriented Chinese tobacco firms.
Eberlin, Kyle R; Perdikis, Galen; Damitz, Lynn; Krochmal, Dan J; Kalliainen, Loree K; Bonawitz, Steven C
With the advancement of technology, electronic communication has become an important mode of communication within plastic and reconstructive surgery. This can take the form of e-mail, text messaging, video conferencing, and social media, among others. There are currently no defined American Society of Plastic Surgeons guidelines for appropriate professional use of these technologies. A search was performed on PubMed and the Cochrane database; terms included "telemedicine," "text messaging," "HIPAA," "metadata," "video conferencing," "photo sharing," "social media," "Facebook," "Twitter," and "Instagram." Initial screening of all identified articles was performed; the level of evidence, limitations, and recommendations were evaluated and articles were reviewed. A total of 654 articles were identified in the level I screening process; after more comprehensive review, 41 articles fit inclusion criteria: social networking, 12; telemedicine, 11; text messaging, 10; metadata, four; video conferencing, three; and Health Insurance Portability and Accountability Act, one. General themes were identified from these articles and guidelines proposed. Electronic communication can provide an efficient method of information exchange for professional purposes within plastic surgery but should be used thoughtfully and with all professional, legal, and ethical considerations.