WorldWideScience

Sample records for position statement preventing

  1. Bullying Prevention in Schools. Position Statement

    Science.gov (United States)

    DeSisto, Marie C.; Smith, Suzanne

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) is a crucial member of the team participating in the prevention of bullying in schools. School nurses are the experts in pediatric health in schools and, therefore, can have an impact on the…

  2. ECSS Position Statement 2009: Prevention of acute sports injuries

    NARCIS (Netherlands)

    Steffen, K.; Andersen, T.E.; Krosshaug, T.; van Mechelen, W.; Myklebust, G.; Verhagen, E.A.L.M.; Bahr, R.

    2010-01-01

    To maximize the health benefits of sports and exercise and to minimize the direct and indirect costs associated with injuries, developing and adopting injury prevention strategies is an important goal. The aim of this ECSS consensus paper on injury prevention is to review current evidence on injury

  3. National Athletic Trainers' Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes

    Science.gov (United States)

    Kaminski, Thomas W.; Hertel, Jay; Amendola, Ned; Docherty, Carrie L.; Dolan, Michael G.; Hopkins, J. Ty; Nussbaum, Eric; Poppy, Wendy; Richie, Doug

    2013-01-01

    Objective: To present recommendations for athletic trainers and other allied health care professionals in the conservative management and prevention of ankle sprains in athletes. Background: Because ankle sprains are a common and often disabling injury in athletes, athletic trainers and other sports health care professionals must be able to implement the most current and evidence-supported treatment strategies to ensure safe and rapid return to play. Equally important is initiating preventive measures to mitigate both first-time sprains and the chance of reinjury. Therefore, considerations for appropriate preventive measures (including taping and bracing), initial assessment, both short- and long-term management strategies, return-to-play guidelines, and recommendations for syndesmotic ankle sprains and chronic ankle instability are presented. Recommendations: The recommendations included in this position statement are intended to provide athletic trainers and other sports health care professionals with guidelines and criteria to deliver the best health care possible for the prevention and management of ankle sprains. An endorsement as to best practice is made whenever evidence supporting the recommendation is available. PMID:23855363

  4. Exercise and Sports Science Australia position statement on exercise and falls prevention in older people.

    Science.gov (United States)

    Tiedemann, Anne; Sherrington, Catherine; Close, Jacqueline C T; Lord, Stephen R

    2011-11-01

    Falls affect a significant number of older Australians and present a major challenge to health care providers and health systems. The purpose of this statement is to inform and guide exercise practitioners and health professionals in the safe and effective prescription of exercise for older community-dwelling people with the goal of preventing falls. Falls in older people are not random events but can be predicted by assessing a number of risk factors. Of particular importance are lower limb muscle strength, gait and balance, all of which can be improved with appropriate exercise. There is now extensive evidence to demonstrate that many falls are preventable, with exercise playing a crucial role in prevention. Research evidence has identified that programs which include exercises that challenge balance are more effective in preventing falls than those which do not challenge balance. It is important for exercise to be progressively challenging, ongoing and of sufficient dose to maximise its benefits in reducing falls. Other (non-exercise) interventions are necessary for certain people with complex medical conditions or recent hospitalisation and risk factors relating to vision and the use of psychotropic medications. Qualified exercise professionals are well placed to implement the research evidence and to prescribe and supervise specific exercise aimed at preventing falls in both healthy older community-dwelling people and those with co-morbidities. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  5. Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis.

    Science.gov (United States)

    Beck, Belinda R; Daly, Robin M; Singh, Maria A Fiatarone; Taaffe, Dennis R

    2017-05-01

    Osteoporotic fractures are associated with substantial morbidity and mortality. Although exercise has long been recommended for the prevention and management of osteoporosis, existing guidelines are often non-specific and do not account for individual differences in bone health, fracture risk and functional capacity. The aim of the current position statement is to provide health practitioners with specific, evidence-based guidelines for safe and effective exercise prescription for the prevention or management of osteoporosis, accommodating a range of potential comorbidities. Position statement. Interpretation and application of research reports describing the effects of exercise interventions for the prevention and management of low bone mass, osteoporosis and osteoporotic fracture. Evidence from animal and human trials indicates that bone responds positively to impact activities and high intensity progressive resistance training. Furthermore, the optimisation of muscle strength, balance and mobility minimises the risk of falls (and thereby fracture), which is particularly relevant for individuals with limited functional capacity and/or a very high risk of osteoporotic fracture. It is important that all exercise programs be accompanied by sufficient calcium and vitamin D, and address issues of comorbidity and safety. For example, loaded spine flexion is not recommended, and impact activities may require modification in the presence of osteoarthritis or frailty. Specific guidelines for safe and effective exercise for bone health are presented. Individual exercise prescription must take into account existing bone health status, co-morbidities, and functional or clinical risk factors for falls and fracture. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  6. Immunizations. Position Statement. Revised

    Science.gov (United States)

    Bobo, Nichole; Garrett, Jennifer; Teskey, Carmen; Duncan, Kay; Strasser, Kathy; Burrows-Mezu, Alicia L.

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that immunizations are essential to primary prevention of disease from infancy through adulthood. Promotion of immunizations by the registered professional school nurse (hereinafter referred to as school nurse) is central to the public health focus of school nursing practice…

  7. The Australasian Society of Clinical Immunology and Allergy position statement: Summary of allergy prevention in children.

    Science.gov (United States)

    Prescott, Susan L; Tang, Mimi L K

    2005-05-02

    A family history of allergy and asthma identifies children at high risk of allergic disease. Dietary restrictions in pregnancy are not recommended. Avoiding inhalant allergens during pregnancy has not been shown to reduce allergic disease, and is not recommended. Breastfeeding should be recommended because of other beneficial effects, but if breast feeding is not possible, a hydrolysed formula is recommended (rather than conventional cow's milk formulas) in high-risk infants only. Maternal dietary restrictions during breastfeeding are not recommended. Soy formulas and other formulas (eg, goat's milk) are not recommended for reducing food allergy risk. Complementary foods (including normal cow's milk formulas) should be delayed until a child is aged at least 4-6 months, but a preventive effect from this measure has only been demonstrated in high-risk infants. There is no evidence that an elimination diet after age 4-6 months has a protective effect, although this needs additional investigation. Further research is needed to determine the relationship between house dust mite exposure at an early age and the development of sensitisation and disease; no recommendation can yet be made about avoidance measures for preventing allergic disease. No recommendations can be made about exposure to pets in early life and the development of allergic disease. If a family already has pets it is not necessary to remove them, unless the child develops evidence of pet allergy (as assessed by an allergy specialist). Women should be advised not to smoke while pregnant, and parents should be advised not to smoke. No recommendations can be made on the use of probiotic supplements (or other microbial agents) for preventing allergic disease at this time. Immunotherapy may be considered as a treatment option for children with allergic rhinitis, and may prevent the subsequent development of asthma.

  8. Policies to restrict secondhand smoke exposure: American College of Preventive Medicine Position Statement.

    Science.gov (United States)

    Jacobs, Michelle; Alonso, Alina M; Sherin, Kevin M; Koh, Yumi; Dhamija, Asha; Lowe, Andrea L

    2013-09-01

    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.

  9. Delegation. Position Statement. Revised

    Science.gov (United States)

    Board, Connie; Bushmiaer, Margo; Davis-Alldritt, Linda; Fekaris, Nina; Morgitan, Judith; Murphy, M. Kathleen; Yow, Barbara

    2010-01-01

    It is the position of the National Association of School Nurses (NASN) that the delegation of nursing tasks in the school setting can be a valuable tool for the school nurse, when based on the nursing definition of delegation and in compliance with state nursing regulations and guidance. Delegation in school nursing is a complex process in which…

  10. Marijuana and Children. Position Statement

    Science.gov (United States)

    Endsley, Patricia; Embrey, Mary Louise

    2014-01-01

    Registered professional school nurses (hereinafter referred to as school nurses) promote wellness and disease prevention to improve health outcomes for our nation's children. It is the position of the National Association of School Nurses (NASN) that the marijuana plant remain under the United States Drug Enforcement Agency's (DEA) Schedule I…

  11. Position Statement on Active Outdoor Play

    OpenAIRE

    Tremblay, Mark S.; Gray, Casey; Babcock, Shawna; Barnes, Joel; Costas Bradstreet, Christa; Carr, Dawn; Chabot, Guylaine; Choquette, Louise; Chorney, David; Collyer, Cam; Herrington, Susan; Janson, Katherine; Janssen, Ian; Larouche, Richard; Pickett, William

    2015-01-01

    A diverse, cross-sectorial group of partners, stakeholders and researchers, collaborated to develop an evidence-informed Position Statement on active outdoor play for children aged 3–12 years. The Position Statement was created in response to practitioner, academic, legal, insurance and public debate, dialogue and disagreement on the relative benefits and harms of active (including risky) outdoor play. The Position Statement development process was informed by two systematic reviews, a critic...

  12. Position Statement on Active Outdoor Play

    Science.gov (United States)

    Tremblay, Mark S.; Gray, Casey; Babcock, Shawna; Barnes, Joel; Costas Bradstreet, Christa; Carr, Dawn; Chabot, Guylaine; Choquette, Louise; Chorney, David; Collyer, Cam; Herrington, Susan; Janson, Katherine; Janssen, Ian; Larouche, Richard; Pickett, William; Power, Marlene; Sandseter, Ellen Beate Hansen; Simon, Brenda; Brussoni, Mariana

    2015-01-01

    A diverse, cross-sectorial group of partners, stakeholders and researchers, collaborated to develop an evidence-informed Position Statement on active outdoor play for children aged 3–12 years. The Position Statement was created in response to practitioner, academic, legal, insurance and public debate, dialogue and disagreement on the relative benefits and harms of active (including risky) outdoor play. The Position Statement development process was informed by two systematic reviews, a critical appraisal of the current literature and existing position statements, engagement of research experts (N = 9) and cross-sectorial individuals/organizations (N = 17), and an extensive stakeholder consultation process (N = 1908). More than 95% of the stakeholders consulted strongly agreed or somewhat agreed with the Position Statement; 14/17 participating individuals/organizations endorsed it; and over 1000 additional individuals and organizations requested their name be listed as a supporter. The final Position Statement on Active Outdoor Play states: “Access to active play in nature and outdoors—with its risks— is essential for healthy child development. We recommend increasing children’s opportunities for self-directed play outdoors in all settings—at home, at school, in child care, the community and nature.” The full Position Statement provides context for the statement, evidence supporting it, and a series of recommendations to increase active outdoor play opportunities to promote healthy child development. PMID:26062040

  13. Position Statement on Active Outdoor Play.

    Science.gov (United States)

    Tremblay, Mark S; Gray, Casey; Babcock, Shawna; Barnes, Joel; Bradstreet, Christa Costas; Carr, Dawn; Chabot, Guylaine; Choquette, Louise; Chorney, David; Collyer, Cam; Herrington, Susan; Janson, Katherine; Janssen, Ian; Larouche, Richard; Pickett, William; Power, Marlene; Sandseter, Ellen Beate Hansen; Simon, Brenda; Brussoni, Mariana

    2015-06-08

    A diverse, cross-sectorial group of partners, stakeholders and researchers, collaborated to develop an evidence-informed Position Statement on active outdoor play for children aged 3-12 years. The Position Statement was created in response to practitioner, academic, legal, insurance and public debate, dialogue and disagreement on the relative benefits and harms of active (including risky) outdoor play. The Position Statement development process was informed by two systematic reviews, a critical appraisal of the current literature and existing position statements, engagement of research experts (N=9) and cross-sectorial individuals/organizations (N=17), and an extensive stakeholder consultation process (N=1908). More than 95% of the stakeholders consulted strongly agreed or somewhat agreed with the Position Statement; 14/17 participating individuals/organizations endorsed it; and over 1000 additional individuals and organizations requested their name be listed as a supporter. The final Position Statement on Active Outdoor Play states: "Access to active play in nature and outdoors--with its risks--is essential for healthy child development. We recommend increasing children's opportunities for self-directed play outdoors in all settings--at home, at school, in child care, the community and nature." The full Position Statement provides context for the statement, evidence supporting it, and a series of recommendations to increase active outdoor play opportunities to promote healthy child development.

  14. Position Statement on Active Outdoor Play

    Directory of Open Access Journals (Sweden)

    Mark S. Tremblay

    2015-06-01

    Full Text Available A diverse, cross-sectorial group of partners, stakeholders and researchers, collaborated to develop an evidence-informed Position Statement on active outdoor play for children aged 3–12 years. The Position Statement was created in response to practitioner, academic, legal, insurance and public debate, dialogue and disagreement on the relative benefits and harms of active (including risky outdoor play. The Position Statement development process was informed by two systematic reviews, a critical appraisal of the current literature and existing position statements, engagement of research experts (N = 9 and cross-sectorial individuals/organizations (N = 17, and an extensive stakeholder consultation process (N = 1908. More than 95% of the stakeholders consulted strongly agreed or somewhat agreed with the Position Statement; 14/17 participating individuals/organizations endorsed it; and over 1000 additional individuals and organizations requested their name be listed as a supporter. The final Position Statement on Active Outdoor Play states: “Access to active play in nature and outdoors—with its risks— is essential for healthy child development. We recommend increasing children’s opportunities for self-directed play outdoors in all settings—at home, at school, in child care, the community and nature.” The full Position Statement provides context for the statement, evidence supporting it, and a series of recommendations to increase active outdoor play opportunities to promote healthy child development.

  15. Dietary exposures and allergy prevention in high-risk infants: a joint position statement of the Canadian Society of Allergy and Clinical Immunology and the Canadian Paediatric Society.

    Science.gov (United States)

    Chan, Edmond S; Cummings, Carl; Atkinson, Adelle; Chad, Zave; Francoeur, Marie-Josée; Kirste, Linda; Mack, Douglas; Primeau, Marie-Noël; Vander Leek, Timothy K; Watson, Wade Ta

    2014-01-01

    Allergic conditions in children are a prevalent health concern in Canada. The burden of disease and the societal costs of proper diagnosis and management are considerable, making the primary prevention of allergic conditions a desirable health care objective. This position statement reviews current evidence on dietary exposures and allergy prevention in infants at high risk of developing allergic conditions. It revisits previous dietary recommendations for pregnancy, breastfeeding and formula-feeding, and provides an approach for introducing solid foods to high-risk infants. While there is no evidence that delaying the introduction of any specific food beyond six months of age helps to prevent allergy, the protective effect of early introduction of potentially allergenic foods (at four to six months) remains under investigation. Recent research appears to suggest that regularly ingesting a new, potentially allergenic food may be as important as when that food is first introduced. This article has already been published (Paediatr Child Health. 2013 Dec;18(10):545-54), and is being re-published with permission from the original publisher, the Canadian Paediatric Society.

  16. Society of Behavioral Medicine (SBM) position statement: restore CDC funding for firearms and gun violence prevention research.

    Science.gov (United States)

    Behrman, Pamela; Redding, Colleen A; Raja, Sheela; Newton, Tamara; Beharie, Nisha; Printz, Destiny

    2018-02-21

    The Society for Behavioral Medicine (SBM) urges restoration of Centers for Disease Control and Prevention (CDC) funding for firearms and gun violence prevention research. Gun violence in the United States is an important and costly public health issue in need of research attention. Unfortunately, there have been no concerted CDC-funded research efforts in this area since 1996, due to the passage of the Dickey Amendment. To remedy the information-gathering restrictions caused by the Dickey Amendment bans, it is recommended that Congress remove 'policy riders' on federal appropriations bills that limit firearms research at the CDC; expand NVDRS firearms-related data collection efforts to include all fifty states; fund CDC research on the risk and protective factors of gun use and gun violence prevention; fund research on evidence-based primary, secondary, and tertiary prevention and treatment initiatives for communities that are seriously impacted by the effects of gun violence; and support the development of evidence-based policy and prevention recommendations for gun use and ownership.

  17. European position statement on lung cancer screening

    DEFF Research Database (Denmark)

    Oudkerk, Matthijs; Devaraj, Anand; Vliegenthart, Rozemarijn

    2017-01-01

    Lung cancer screening with low-dose CT can save lives. This European Union (EU) position statement presents the available evidence and the major issues that need to be addressed to ensure the successful implementation of low-dose CT lung cancer screening in Europe. This statement identified...... specific actions required by the European lung cancer screening community to adopt before the implementation of low-dose CT lung cancer screening. This position statement recommends the following actions: a risk stratification approach should be used for future lung cancer low-dose CT programmes...... need to set a timeline for implementing lung cancer screening....

  18. December 2012 Connecticut School Shooting Position Statement

    Science.gov (United States)

    Journal of School Violence, 2013

    2013-01-01

    In response to the killing of 20 children and 6 adults at Sandy Hook Elementary School on December 17, 2012, this position statement argues that research supports a thoughtful approach to safer schools, guided by four key elements--balance, communication, connectedness, and support--along with strengthened attention to mental health needs in the…

  19. [Position statement: surgery and diabetes mellitus].

    Science.gov (United States)

    Fasching, Peter; Huber, Joakim; Clodi, Martin; Abrahamian, Heidemarie; Ludvik, Bernhard

    2016-04-01

    This position statement reflects the opinion of the Austrian Diabetes Association concerning the perioperative management of patients with diabetes mellitus based on the available scientific evidence. The paper covers necessary preoperative examinations from an internal/diabetological point of view as well as the perioperative metabolic control by means of oral antidiabetics and/or insulin therapy.

  20. Core competencies for cardiac rehabilitation/secondary prevention professionals: 2010 update: position statement of the American Association of Cardiovascular and Pulmonary Rehabilitation.

    Science.gov (United States)

    Hamm, Larry F; Sanderson, Bonnie K; Ades, Philip A; Berra, Kathy; Kaminsky, Leonard A; Roitman, Jeffrey L; Williams, Mark A

    2011-01-01

    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.

  1. 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.

    Science.gov (United States)

    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

    2015-01-01

    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.

  2. 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.

    Science.gov (United States)

    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

    2014-11-01

    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.

  3. [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].

    Science.gov (United States)

    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

    2015-01-01

    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.

  4. 29 CFR 2200.39 - Statement of position.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Statement of position. 2200.39 Section 2200.39 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION RULES OF PROCEDURE... intervene, may file a statement of position with respect to any or all issues to be heard. The Judge may...

  5. Position Statement: Palliative Care for Children.

    Science.gov (United States)

    Death Studies, 1993

    1993-01-01

    Notes that International Work Group on Death, Dying, and Bereavement recognizes wide variation of attitudes, beliefs, and behaviors pertaining to childhood death, dying, and bereavement. Statement identifies set of assumptions which can serve as guidelines, across cultures, in care of children with terminal illness and their families. (Author/NB)

  6. Alcohol and cancer: a position statement from Cancer Council Australia.

    Science.gov (United States)

    Winstanley, Margaret H; Pratt, Iain S; Chapman, Kathryn; Griffin, Hayley J; Croager, Emma J; Olver, Ian N; Sinclair, Craig; Slevin, Terry J

    2011-05-02

    The Cancer Council Australia (CCA) Alcohol Working Group has prepared a position statement on alcohol use and cancer. The statement has been reviewed by external experts and endorsed by the CCA Board. Alcohol use is a cause of cancer. Any level of alcohol consumption increases the risk of developing an alcohol-related cancer; the level of risk increases in line with the level of consumption. It is estimated that 5070 cases of cancer (or 5% of all cancers) are attributable to long-term chronic use of alcohol each year in Australia. Together, smoking and alcohol have a synergistic effect on cancer risk, meaning the combined effects of use are significantly greater than the sum of individual risks. Alcohol use may contribute to weight (fat) gain, and greater body fatness is a convincing cause of cancers of the oesophagus, pancreas, bowel, endometrium, kidney and breast (in postmenopausal women). The existing evidence does not justify the promotion of alcohol use to prevent coronary heart disease, as the previously reported role of alcohol in reducing heart disease risk in light-to-moderate drinkers appears to have been overestimated. CCA recommends that to reduce their risk of cancer, people limit their consumption of alcohol, or better still avoid alcohol altogether. For individuals who choose to drink alcohol, CCA recommends that they drink only within the National Health and Medical Research Council guidelines for alcohol consumption.

  7. Society for Health Psychology (APA Division 38) and Society of Behavioral Medicine joint position statement on the Medicare Diabetes Prevention Program.

    Science.gov (United States)

    Fitzpatrick, Stephanie L; Wilson, Dawn K; Pagoto, Sherry L

    2017-06-01

    Beginning in January 2018, the Centers for Medicare and Medicaid Services (CMS) plans to cover the Diabetes Prevention Program (DPP), also referred to as Medicare DPP. The American Psychological Association Society for Health Psychology (SfHP) and the Society for Behavioral Medicine (SBM) reviewed the proposed plan. SfHP and SBM are in support of the CMS decision to cover DPP for Medicare beneficiaries but have a significant concern that aspects of the proposal will limit the public health impact. Concerns include the emphasis on weight outcomes to determine continued coverage and the lack of details regarding requirements for coaches. SfHP and SBM are in strong support of modifications to the proposal that would remove the minimum weight loss stipulation to determine coverage and to specify type and qualifications of "coaches."

  8. Prevention of multidrug-resistant infections from contaminated duodenoscopes: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA).

    Science.gov (United States)

    Beilenhoff, Ulrike; Biering, Holger; Blum, Reinhard; Brljak, Jadranka; Cimbro, Monica; Dumonceau, Jean-Marc; Hassan, Cesare; Jung, Michael; Neumann, Christiane; Pietsch, Michael; Pineau, Lionel; Ponchon, Thierry; Rejchrt, Stanislav; Rey, Jean-François; Schmidt, Verona; Tillett, Jayne; van Hooft, Jeanin

    2017-11-01

    Patients should be informed about the benefits and risks of endoscopic retrograde cholangiopancreatography (ERCP)Only specially trained and competent personnel should carry out endoscope reprocessing.Manufacturers of duodenoscopes should provide detailed instructions on how to use and reprocess their equipment.In the case of modifications to their equipment, manufacturers should provide updated instructions for use.Detailed reprocessing protocols based on the manufacturer's instructions for use should clearly lay out the different reprocessing steps necessary for each endoscope model.Appropriate cleaning equipment should be used for duodenoscopes in compliance with the manufacturer's instructions for use. Only purpose-designed, endoscope type-specific, single-use cleaning brushes should be used, to ensure optimal cleaning. As soon as the endoscope is withdrawn from the patient, bedside cleaning should be performed, followed by leak testing, thorough manual cleaning steps, and automated reprocessing, in order to: · Remove debris from external and internal surfaces;. · Prevent any drying of body fluids, blood, or debris;. · Prevent any formation of biofilms.. In addition to the leak test, visual inspection of the distal end as well as regular maintenance of duodenoscopes should be performed according to the manufacturer's instructions for use, in order to detect any damage at an early stage.The entire reprocessing procedure in endoscope washer-disinfectors (EWDs) should be validated according to the European and International Standard, EN ISO 15883. Routine technical tests of EWDs should be performed according to the validation reports.Microbiological surveillance of a proportion of the department's endoscopes should be performed every 3 months, with the requirement that all endoscopes used in the unit are tested at least once a year.In the case of suspected endoscopy-related infection, the relevant device (e. g., endoscope, EWD) should be taken out of service

  9. Physical activity prescription: a critical opportunity to address a modifiable risk factor for the prevention and management of chronic disease: a position statement by the Canadian Academy of Sport and Exercise Medicine.

    Science.gov (United States)

    Thornton, Jane S; Frémont, Pierre; Khan, Karim; Poirier, Paul; Fowles, Jonathon; Wells, Greg D; Frankovich, Renata J

    2016-09-01

    Non-communicable disease is a leading threat to global health. Physical inactivity is a large contributor to this problem; in fact, the WHO ranks it as the fourth leading risk factor for overall morbidity and mortality worldwide. In Canada, at least 4 of 5 adults do not meet the Canadian Physical Activity Guidelines of 150 min of moderate-to-vigorous physical activity per week. Physicians play an important role in the dissemination of physical activity (PA) recommendations to a broad segment of the population, as over 80% of Canadians visit their doctors every year and prefer to get health information directly from them. Unfortunately, most physicians do not regularly assess or prescribe PA as part of routine care, and even when discussed, few provide specific recommendations. PA prescription has the potential to be an important therapeutic agent for all ages in primary, secondary and tertiary prevention of chronic disease. Sport and exercise medicine (SEM) physicians are particularly well suited for this role and should collaborate with their primary care colleagues for optimal patient care. The purpose of this Canadian Academy and Sport and Exercise Medicine position statement is to provide an evidence-based, best practices summary to better equip SEM and primary care physicians to prescribe PA and exercise, specifically for the prevention and management of non-communicable disease. This will be achieved by addressing common questions and perceived barriers in the field.Author note This position statement has been endorsed by the following nine sport medicine societies: Australasian College of Sports and Exercise Physicians (ACSEP), American Medical Society for Sports Medicine (AMSSM), British Association of Sports and Exercise Medicine (BASEM), European College of Sport & Exercise Physicians (ECOSEP), Norsk forening for idrettsmedisin og fysisk aktivite (NIMF), South African Sports Medicine Association (SASMA), Schweizerische Gesellschaft für Sportmedizin

  10. The 2012 Hormone Therapy Position Statement of The North American Menopause Society

    Science.gov (United States)

    2012-01-01

    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

  11. Brazilian guidelines on prevention of cardiovascular disease in patients with diabetes: a position statement from the Brazilian Diabetes Society (SBD), the Brazilian Cardiology Society (SBC) and the Brazilian Endocrinology and Metabolism Society (SBEM).

    Science.gov (United States)

    Bertoluci, Marcello Casaccia; Moreira, Rodrigo Oliveira; Faludi, André; Izar, Maria Cristina; Schaan, Beatriz D; Valerio, Cynthia Melissa; Bertolami, Marcelo Chiara; Chacra, Ana Paula; Malachias, Marcus Vinicius Bolivar; Vencio, Sérgio; Saraiva, José Francisco Kerr; Betti, Roberto; Turatti, Luiz; Fonseca, Francisco Antonio Helfenstein; Bianco, Henrique Tria; Sulzbach, Marta; Bertolami, Adriana; Salles, João Eduardo Nunes; Hohl, Alexandre; Trujilho, Fábio; Lima, Eduardo Gomes; Miname, Marcio Hiroshi; Zanella, Maria Teresa; Lamounier, Rodrigo; Sá, João Roberto; Amodeo, Celso; Pires, Antonio Carlos; Santos, Raul D

    2017-01-01

    Since the first position statement on diabetes and cardiovascular prevention published in 2014 by the Brazilian Diabetes Society, the current view on primary and secondary prevention in diabetes has evolved as a result of new approaches on cardiovascular risk stratification, new cholesterol lowering drugs, and new anti-hyperglycemic drugs. Importantly, a pattern of risk heterogeneity has emerged, showing that not all diabetic patients are at high or very high risk. In fact, most younger patients who have no overt cardiovascular risk factors may be more adequately classified as being at intermediate or even low cardiovascular risk. Thus, there is a need for cardiovascular risk stratification in patients with diabetes. The present panel reviews the best current evidence and proposes a practical risk-based approach on treatment for patients with diabetes. The Brazilian Diabetes Society, the Brazilian Society of Cardiology, and the Brazilian Endocrinology and Metabolism Society gathered to form an expert panel including 28 cardiologists and endocrinologists to review the best available evidence and to draft up-to-date an evidence-based guideline with practical recommendations for risk stratification and prevention of cardiovascular disease in diabetes. The guideline includes 59 recommendations covering: (1) the impact of new anti-hyperglycemic drugs and new lipid lowering drugs on cardiovascular risk; (2) a guide to statin use, including new definitions of LDL-cholesterol and in non-HDL-cholesterol targets; (3) evaluation of silent myocardial ischemia and subclinical atherosclerosis in patients with diabetes; (4) hypertension treatment; and (5) the use of antiplatelet therapy. Diabetes is a heterogeneous disease. Although cardiovascular risk is increased in most patients, those without risk factors or evidence of sub-clinical atherosclerosis are at a lower risk. Optimal management must rely on an approach that will cover both cardiovascular disease prevention in

  12. Service Animals in School. Position Statement

    Science.gov (United States)

    Garret, Jennifer; Teskey, Carmen; Duncan, Kay; Strasser, Kathy

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that registered school nurses (hereinafter referred to as school nurses) are integral to the team planning process necessary to successfully integrate "service animals" into schools. A request to bring a service animal into the school setting presents questions due to…

  13. AWHONN Position Statement. Intimate partner violence.

    Science.gov (United States)

    2015-01-01

    The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) opposes laws and other policies that require nurses to report the results of screening for intimate partner violence (IPV) to law enforcement or other regulatory agencies without the consent of the woman who experiences the IPV. Nurses and other health care professionals, however, should become familiar with laws on mandatory reporting in their states and comply as applicable. Women should be universally screened for IPV in private, safe settings where health care is provided. Nurses are ideally positioned to screen for IPV for the purpose of initiating a referral for services and support when applicable. To protect the woman's safety, AWHONN supports policies that require a woman's consent before reporting occurs.

  14. Climate change and respiratory disease: European Respiratory Society position statement.

    Science.gov (United States)

    Ayres, J G; Forsberg, B; Annesi-Maesano, I; Dey, R; Ebi, K L; Helms, P J; Medina-Ramón, M; Windt, M; Forastiere, F

    2009-08-01

    Climate change will affect individuals with pre-existing respiratory disease, but the extent of the effect remains unclear. The present position statement was developed on behalf of the European Respiratory Society in order to identify areas of concern arising from climate change for individuals with respiratory disease, healthcare workers in the respiratory sector and policy makers. The statement was developed following a 2-day workshop held in Leuven (Belgium) in March 2008. Key areas of concern for the respiratory community arising from climate change are discussed and recommendations made to address gaps in knowledge. The most important recommendation was the development of more accurate predictive models for predicting the impact of climate change on respiratory health. Respiratory healthcare workers also have an advocatory role in persuading governments and the European Union to maintain awareness and appropriate actions with respect to climate change, and these areas are also discussed in the position statement.

  15. A Position Statement on Population Data Science:

    Directory of Open Access Journals (Sweden)

    Kim McGrail

    2018-02-01

    Full Text Available Information is increasingly digital, creating opportunities to respond to pressing issues about human populations in near real time using linked datasets that are large, complex, and diverse. The potential social and individual benefits that can come from data-intensive science are large, but raise challenges of balancing individual privacy and the public good, building appropriate socio-technical systems to support data-intensive science, and determining whether defining a new field of inquiry might help move those collective interests and activities forward. A combination of expert engagement, literature review, and iterative conversations led to our conclusion that defining the field of Population Data Science (challenge 3 will help address the other two challenges as well. We define Population Data Science succinctly as the science of data about people and note that it is related to but distinct from the fields of data science and informatics. A broader definition names four characteristics of: data use for positive impact on citizens and society; bringing together and analyzing data from multiple sources; finding population-level insights; and developing safe, privacy-sensitive and ethical infrastructure to support research. One implication of these characteristics is that few people possess all of the requisite knowledge and skills of Population Data Science, so this is by nature a multi-disciplinary field. Other implications include the need to advance various aspects of science, such as data linkage technology, various forms of analytics, and methods of public engagement. These implications are the beginnings of a research agenda for Population Data Science, which if approached as a collective field, can catalyze significant advances in our understanding of trends in society, health, and human behavior.

  16. Panel established to revise position statement on climate change

    Science.gov (United States)

    President Robert Dickinson has appointed a panel to review the current AGU position statement on climate change and greenhouse gases, and to consider revising the statement to reflect scientific progress over the last four years. Marvin Geller of the State University of New York-Stonybrook chairs the panel.Other panel members include: Andre Berger, George Lemaître Catholic University of Louvain, Belgium; Anny Cazenave, Observatoire Midi-Pyrénées, Toulouse, France; John Christy, University of Alabama, Huntsville; Ellen Druffel, University of California, Irvine; Jack Fellows, University Consortium for Atmospheric Research, Boulder; Hiroshi Kanzawa, Nagoya University, Japan; William Schlesinger, Duke University, Durham; William (Jim) Shuttleworth, University of Arizona; Eric Sundquist, U.S. Geological Survey, Woods Hole; Richard Turco, University of California, Los Angeles; Ilana Wainer, Universidade Cidade Sao Paulo, Brazil.

  17. Diabetes Australia position statement. A new language for diabetes

    DEFF Research Database (Denmark)

    Speight, J.; Conn, J.; Dunning, T.

    2012-01-01

    can be the language used to refer to diabetes, its management and the person with diabetes. The way verbal and written language is used reflects and shapes people's thoughts, beliefs and behaviours. Language has the power to persuade, change or reinforce beliefs and stereotypes - for better or worse...... and countered. Diabetes Australia believes optimal communication increases the motivation, health and well-being of people with diabetes, and that careless or negative language can be de-motivating, is often inaccurate, and can be harmful. Diabetes Australia developed this position statement to encourage...

  18. National Athletic Trainers' Association Position Statement: Anabolic-Androgenic Steroids

    Science.gov (United States)

    Kersey, Robert D.; Elliot, Diane L.; Goldberg, Linn; Kanayama, Gen; Leone, James E.; Pavlovich, Mike; Pope, Harrison G.

    2012-01-01

    This NATA position statement was developed by the NATA Research & Education Foundation. Objective This manuscript summarizes the best available scholarly evidence related to anabolic-androgenic steroids (AAS) as a reference for health care professionals, including athletic trainers, educators, and interested others. Background Health care professionals associated with sports or exercise should understand and be prepared to educate others about AAS. These synthetic, testosterone-based derivatives are widely abused by athletes and nonathletes to gain athletic performance advantages, develop their physiques, and improve their body image. Although AAS can be ergogenic, their abuse may lead to numerous negative health effects. Recommendations Abusers of AAS often rely on questionable information sources. Sports medicine professionals can therefore serve an important role by providing accurate, reliable information. The recommendations provide health care professionals with a current and accurate synopsis of the AAS-related research. PMID:23068595

  19. Palliative Sedation: An Analysis of International Guidelines and Position Statements.

    Science.gov (United States)

    Gurschick, Lauren; Mayer, Deborah K; Hanson, Laura C

    2015-09-01

    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.

  20. Sex and Prevention Concerns for Positive People

    Science.gov (United States)

    ... with any comments or concerns. February 17, 2011 Sex and prevention concerns for positive people Facebook Twitter ... partner, and vice versa. The reality of safer sex You put yourself at risk for infections through ...

  1. Bully Prevention in Positive Behavior Support

    OpenAIRE

    Ross, Scott W.; Horner, R. H.

    2009-01-01

    Bullying behaviors are a growing concern in U.S. schools. We present here a behavioral approach to bully prevention utilizing a schoolwide intervention. Bully prevention in positive behavior support (BP-PBS) teaches students to withhold the social rewards hypothesized to maintain bullying. A single-subject multiple baseline design across 6 students and three elementary schools was implemented in an empirical evaluation of the intervention's effectiveness. Results indicated that implementation...

  2. European Society of Endodontology position statement: The use of CBCT in Endodontics

    NARCIS (Netherlands)

    Patel, S.; Durack, C.; Abella, F.; Roig, M.; Shemesh, H.; Lambrechts, P.; Lemberg, K.

    2014-01-01

    This Position Statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the use of Cone Beam Computed Tomography (CBCT). The statement is based on the current scientific evidence, and provides the clinician with evidence-based criteria on when

  3. American Society for Pain Management Nursing Position Statement: Pain Management in Patients with Substance Use Disorders

    OpenAIRE

    Oliver, June; Coggins, Candace; Compton, Peggy; Hagan, Susan; Matteliano, Deborah; Stanton, Marsha; St. Marie, Barbara; Strobbe, Stephen; Turner, Helen N.

    2012-01-01

    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...

  4. American Nurses Association. position statement on assisted suicide.

    Science.gov (United States)

    1995-01-01

    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.

  5. The Process for the Formulation of the International Telehealth Position Statement for Occupational Therapy

    Science.gov (United States)

    JACOBS, KAREN; CASON, JANA; MCCULLOUGH, ANN

    2015-01-01

    The World Federation of Occupational Therapists (WFOT) consists of 84 member organizations representing over 420,000 occupational therapists internationally (WFOT, 2014). In 2014, WFOT published the WFOT Telehealth Position Statement on the use of telehealth in occupational therapy. The process for the formulation of the official document involved reviewing WFOT member organizations’ telehealth position statements and data collected from a survey sent to member organizations’ delegates in April 2014. Qualitative data from 39 countries yielded factors to consider in five key areas: licensure/registration requirements, the cost of technology, privacy and security, reimbursement/payment models, and other issues (e.g., need for collaboration/transfer of knowledge, client selection, provider competencies, standard of care). The WFOT Telehealth Position Statement addressed each of these areas. The collaborative effort resulting in the development of the WFOT Telehealth Position Statement serves as a model for other international organizations. PMID:27563380

  6. 75 FR 54802 - Requirement of a Statement Disclosing Uncertain Tax Positions

    Science.gov (United States)

    2010-09-09

    ... return. Corporations that prepare financial statements are required by generally accepted accounting principles to identify and quantify all uncertain tax positions as described in Financial Accounting..., including International Financial Reporting Standards and country-specific generally accepted accounting...

  7. Defense Business Operations Fund Consolidated Statement of Financial Position for FY 1994

    National Research Council Canada - National Science Library

    Rau, Russell

    1995-01-01

    The objective of the audit was to determine whether the Statement of Financial Position of the Defense Business Operations Fund for FY 1994 was fairly presented in accordance with Office of Management...

  8. European Society of Endodontology position statement: the use of CBCT in endodontics.

    Science.gov (United States)

    Patel, S; Durack, C; Abella, F; Roig, M; Shemesh, H; Lambrechts, P; Lemberg, K

    2014-06-01

    This Position Statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the use of Cone Beam Computed Tomography (CBCT). The statement is based on the current scientific evidence, and provides the clinician with evidence-based criteria on when to use CBCT in Endodontics. Given the dynamic and changing nature of research, development of new devices and clinical practice relating to CBCT, this Position Statement will be updated within 3 years, or before that time should new evidence become available. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  9. AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update.

    Science.gov (United States)

    2015-10-01

    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.

  10. Major Deficiencies Preventing Favorable Audit Opinions on the FY 1997 DoD Financial Statements

    National Research Council Canada - National Science Library

    Lane, F

    1998-01-01

    The audit objective was to identify and summarize the major deficiencies that prevented favorable audit opinions on the FY 1997 DoD Financial Statements, and to identify the actions taken or under way...

  11. The 2017 hormone therapy position statement of The North American Menopause Society.

    Science.gov (United States)

    2017-07-01

    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

  12. An EASO Position Statement on Multidisciplinary Obesity Management in Adults

    Directory of Open Access Journals (Sweden)

    Volkan Yumuk

    2014-03-01

    Full Text Available Obesity has proven to be a gateway to ill health. It has already reached epidemic proportions becoming one of the leading causes of death and disability in Europe and world-wide. Obesity plays a central role in the development of a number of risk factors and chronic diseases like hypertension, dyslipidaemia and type 2 diabetes mellitus inducing cardiovascular morbidity and mortality. Therefore weight management plays a central role in controlling the respective risk factors and their consequences. Obesity is a complex condition of multifactorial origin. Biological but also psychological and social factors interfere to lead to excess body weight and its deleterious outcomes. Obesity management cannot focus any more only on weight (and BMI reduction. More attention is to be paid to waist circumference (or waist-to-hip ratio, especially in females, the improvement in body composition (measured with body composition tracking systems like BOD POD, dual energy X-ray absorptiometry or bioelectrical impedance analysis which is focusing on ameliorating or maintaining fat-free mass and decreasing fat mass. Management of co-morbidities, improving quality of life and well-being of obese patients are also included in treatment aims. This statement emphasises the importance of a comprehensive approach to obesity management.

  13. Chronic Health Conditions Managed by School Nurses. Position Statement. Revised

    Science.gov (United States)

    Morgitan, Judith; Bushmiaer, Margo; DeSisto, Marie C.; Duff, Carolyn; Lambert, C. Patrice; Murphy, M. Kathleen; Roland, Sharon; Selser, Kendra; Wyckoff, Leah; White, Kelly

    2012-01-01

    It is the position of the National Association of School Nurses that students with chronic health conditions have access to a full-time registered professional school nurse (hereinafter referred to as school nurse). School districts should include school nurse positions in their full-time instructional support personnel to provide health services…

  14. School Nurse Role in Electronic School Health Records. Position Statement

    Science.gov (United States)

    Hiltz, Cynthia; Johnson, Katie; Lechtenberg, Julia Rae; Maughan, Erin; Trefry, Sharonlee

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that Electronic Health Records (EHRs) are essential for the registered professional school nurse (hereinafter referred to as school nurse) to provide efficient and effective care in the school and monitor the health of the entire student population. It is also the position of…

  15. American Society for Pain Management nursing position statement: pain management in patients with substance use disorders.

    Science.gov (United States)

    Oliver, June; Coggins, Candace; Compton, Peggy; Hagan, Susan; Matteliano, Deborah; Stanton, Marsha; St Marie, Barbara; Strobbe, Stephen; Turner, Helen N

    2012-10-01

    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.

  16. Audiological practices and findings post HPCSA position statement ...

    African Journals Online (AJOL)

    Ethical clearance was obtained from the Medical Human Research .... study conducted in Malaysia identified that children were receiving initial evaluation before 3 months ... in decreasing false positives, which take up time and resources, and.

  17. IOF position statement: vitamin D recommendations for older adults

    NARCIS (Netherlands)

    Dawson-Hughes, B.; Mithal, A.; Bonjour, J.P.; Boonen, S.; Burckhardt, P.; Fuleihan, G.E.; Josse, R.G.; Lips, P.T.A.M.; Morales-Torres, J.; Yoshimura, N.

    2010-01-01

    This position paper of the International Osteoporosis Foundation makes recommendations for vitamin D nutrition in elderly men and women from an evidence-based perspective. © 2010 International Osteoporosis Foundation and National Osteoporosis Foundation.

  18. The detection and prevention of manipulations in the balance sheet and the cash flow statement

    Directory of Open Access Journals (Sweden)

    Dragomir Dimitrijevic

    2015-08-01

    Full Text Available Financial statements which consist of objective, real and reliable information represent the key basis for making many business decisions. If, when writing financial statements, certain manipulation techniques are used for displaying the best possible results of transactions, the quality of financial reports will be endangered. Many financial frauds have led to a great mistrust in the system of financial reporting and the profession of accounting and auditing, which are often accused of the emergence of fraud and losing trust in the reliability of financial information by many users and economic decision makers. These are the reasons why the paper discusses the techniques of manipulation in financial statements, especially in balance sheets and cash flow statements, since these forms of manipulation are harder to detect and prevent when compared to manipulations of revenues and expenses in the income statement.

  19. National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses.

    Science.gov (United States)

    Casa, Douglas J; DeMartini, Julie K; Bergeron, Michael F; Csillan, Dave; Eichner, E Randy; Lopez, Rebecca M; Ferrara, Michael S; Miller, Kevin C; O'Connor, Francis; Sawka, Michael N; Yeargin, Susan W

    2015-09-01

    To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation. Certified athletic trainers recognize and treat athletes with EHIs, often in high-risk environments. Although the proper recognition and successful treatment strategies are well documented, EHIs continue to plague athletes, and exertional heat stroke remains one of the leading causes of sudden death during sport. The recommendations presented in this document provide athletic trainers and allied health providers with an integrated scientific and clinically applicable approach to the prevention, recognition, treatment of, and return-to-activity guidelines for EHIs. These recommendations are given so that proper recognition and treatment can be accomplished in order to maximize the safety and performance of athletes. Athletic trainers and other allied health care professionals should use these recommendations to establish onsite emergency action plans for their venues and athletes. The primary goal of athlete safety is addressed through the appropriate prevention strategies, proper recognition tactics, and effective treatment plans for EHIs. Athletic trainers and other allied health care professionals must be properly educated and prepared to respond in an expedient manner to alleviate symptoms and minimize the morbidity and mortality associated with these illnesses.

  20. Screening for Syphilis Infection in Pregnancy : US Preventive Services Task Force Reaffirmation Recommendation Statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen; Gregory, Kimberly D.; Grossman, David; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Schwartz, J. Sanford; Wilt, Timothy

    2009-01-01

    Description: Update of the 2004 U. S. Preventive Services Task Force statement about screening for syphilis in pregnancy. Methods: The U. S. Preventive Services Task Force did a targeted literature search for evidence on the benefits of screening, the harms of screening, and the harms of treatment

  1. National Athletic Trainers' Association Position Statement: Management of Sport Concussion

    Science.gov (United States)

    Broglio, Steven P.; Cantu, Robert C.; Gioia, Gerard A.; Guskiewicz, Kevin M.; Kutcher, Jeffrey; Palm, Michael; McLeod, Tamara C. Valovich

    2014-01-01

    Objective: To provide athletic trainers, physicians, and other health care professionals with best-practice guidelines for the management of sport-related concussions. Background: An estimated 3.8 million concussions occur each year in the United States as a result of sport and physical activity. Athletic trainers are commonly the first medical providers available onsite to identify and evaluate these injuries. Recommendations: The recommendations for concussion management provided here are based on the most current research and divided into sections on education and prevention, documentation and legal aspects, evaluation and return to play, and other considerations. PMID:24601910

  2. The Role of School Nursing in Telehealth. Position Statement

    Science.gov (United States)

    Haynie, Kathey M.; Mauter, Elaine; Lindahl, Brenda; Simons-Major, Keisha; Meadows, Lynne; Maughan, Erin D.

    2017-01-01

    It is the position of the National Association of School Nurses (NASN) that utilization of telehealth technology may be a valuable tool to assist registered professional school nurses (herein referred to as a school nurse) to provide school health services. The health of many students is impacted by lack of access to primary care and specialty…

  3. School Nurse Workload: Staffing for Safe Care. Position Statement

    Science.gov (United States)

    Dolatowski, Rosemary; Endsley, Patricia; Hiltz, Cynthia; Johansen, Annette; Maughan, Erin; Minchella, Lindsey; Trefry, Sharonlee

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that daily access to a registered professional school nurse (hereinafter referred to as a school nurse) can significantly improve students' health, safety, and abilities to learn. To meet the health and safety needs of students, families, and school communities, school nurse…

  4. Diabetes Management in the School Setting. Position Statement

    Science.gov (United States)

    Butler, Sarah; Fekaris, Nina; Pontius, Deborah; Zacharski, Susan

    2012-01-01

    It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as school nurse) is the only school staff member who has the skills, knowledge base, and statutory authority to fully meet the healthcare needs of students with diabetes in the school setting. Diabetes management…

  5. Concussions--The Role of the School Nurse. Position Statement

    Science.gov (United States)

    Diaz, Anne L.; Wyckoff, Leah J.

    2012-01-01

    It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as school nurse) is an essential member of the team addressing concussions. As the school-based clinical professional on the team, the school nurse has the knowledge and skills to provide concussion prevention…

  6. School Health Education about Human Sexuality. Position Statement. Revised

    Science.gov (United States)

    Bradley, Beverly J.; Mancuso, Patty; Cagginello, Joan B.; Board, Connie; Clark, Sandra; Harvel, Robin; Kelts, Susan

    2012-01-01

    It is the position of the National Association of School Nurses (NASN) that age-appropriate health education about human sexuality should be included as part of a comprehensive school health education program and be accessible to all students in schools. NASN recognizes the role of parents and families as the primary source of education about…

  7. Osteoporosis management in patients with breast cancer : EMAS position statement

    NARCIS (Netherlands)

    Trémollieres, Florence A; Ceausu, Iuliana; Depypere, Herman; Lambrinoudaki, Irene; Mueck, Alfred; Pérez-López, Faustino R; van der Schouw, Yvonne T; Senturk, Levent M; Simoncini, Tommaso; Stevenson, John C; Stute, Petra; Rees, Margaret

    Aromatase inhibitors (AIs) are the first-line recommended standard of care for postmenopausal estrogen receptor-positive breast cancer. Because they cause a profound suppression of estrogen levels, concerns regarding their potential to increase the risk of fracture were rapidly raised. There is

  8. Diabetes Management in the School Setting. Position Statement. Revised

    Science.gov (United States)

    Wright, Janet B.; Easterling, Traci; Hardy, Alicen

    2017-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) is the school staff member who has the knowledge, skills, and statutory authority to fully meet the healthcare needs of students with diabetes in the school setting. Diabetes management in…

  9. National Strength and Conditioning Association Position Statement on Long-Term Athletic Development.

    Science.gov (United States)

    Lloyd, Rhodri S; Cronin, John B; Faigenbaum, Avery D; Haff, G Gregory; Howard, Rick; Kraemer, William J; Micheli, Lyle J; Myer, Gregory D; Oliver, Jon L

    2016-06-01

    There has recently been a growing interest in long-term athletic development for youth. Because of their unique physical, psychological, and social differences, children and adolescents should engage in appropriately prescribed exercise programs that promote physical development to prevent injury and enhance fitness behaviors that can be retained later in life. Irrespective of whether a child is involved in organized sport or engages in recreational physical activity, there remains a need to adopt a structured, logical, and evidence-based approach to the long-term development of athleticism. This is of particular importance considering the alarmingly high number of youth who fail to meet global physical activity recommendations and consequently present with negative health profiles. However, appropriate exercise prescription is also crucial for those young athletes who are physically underprepared and at risk of overuse injury because of high volumes of competition and an absence of preparatory conditioning. Whether the child accumulates insufficient or excessive amounts of exercise, or falls somewhere between these opposing ends of the spectrum, it is generally accepted that the young bodies of modern day youth are often ill-prepared to tolerate the rigors of sports or physical activity. All youth should engage in regular physical activity and thus should be viewed as "athletes" and afforded the opportunity to enhance athleticism in an individualized, holistic, and child-centered manner. Because of emerging interest in long-term athletic development, an authorship team was tasked on behalf of the National Strength and Conditioning Association (NSCA) to critically synthesize existing literature and current practices within the field and to compose a relevant position statement. This document was subsequently reviewed and formally ratified by the NSCA Board of Directors. A list of 10 pillars of successful long-term athletic development are presented, which summarize

  10. Effectiveness of the Positioning Statement: Experimental Test on Brand Awareness in Competitive Contexts

    Directory of Open Access Journals (Sweden)

    Rafael Barreiros Porto

    2018-03-01

    Full Text Available Good positioning statements have an effect on consumer brand awareness. However, the competitive context formed by the novelty of the category and the brand market structure may hinder the assimilation of positioning and its association with the pre-existing image. This study assesses the effectiveness of positioning statements in the generation of brand awareness, considering its competitive context. Using an experimental design, with a group of control, the exposure of brands and their competitive contexts were manipulated and the positioning statement remained constant for a sample of consumers. The results show the positioning statement had an effect on both assimilation of the message and valence of image association, which adds awareness for the brand, but only for the traditional category. The effectiveness on the message assimilation occurred within the weak brand and within the less known median brand. For the image valence, it occurred only between the weak brand and the strong one from the traditional category. These findings are distinct among consumer segments. The research brings up a classic theme, but presents a new methodological approach to measure the effectiveness of brand positioning.

  11. Education, licensure, and certification of school nurses: position statement.

    Science.gov (United States)

    2013-07-01

    It is the position of the National Association of School Nurses (NASN) that every school-age child deserves a school nurse who has a baccalaureate degree in nursing from an accredited college or university and is licensed as a registered nurse through the state board of nursing. These requirements constitute minimal preparation needed to practice at the entry level of school nursing (American Nurses Association [ANA] & NASN, 2011). Additionally, NASN supports state school nurse certification, where required, and promotes national certification of school nurses through the National Board for Certification of School Nurses.

  12. Position statement on efficiency of technologies for diabetes management.

    Science.gov (United States)

    Martín-Vaquero, Pilar; Martínez-Brocca, María Asunción; García-López, José Manuel

    2014-12-01

    Di@bet.es study results are impressive, showing that diabetes affects 13.8% of the Spanish population. Not only the statistical facts are alarming, but the increasing incidence of this disease is a major problem, as pandemic proportions of type 2 diabetes are expected. Thus, the study of diabetes represents a challenge not only for health services, but also for the Ministries of Health and Finance. Technology has become an essential tool in the quality are of patients with diabetes, as it helps in the healthcare processes to obtain an optimum metabolic balance and prevent possible complications. Insulin pumps, continuous glucose monitoring nd self-monitoring blood glucose have all proved their efficiency, and telemedicine it is making good progress. The indirect costs of diabetes in Spain are much higher than the directones, showing the importance of inverting the paradox. The optimization of resources depends not only on the ability of the physicians, but also the administration, to implant and sustain technological innovations in our system, and with that make it effective in terms of benefits. Cost-effectiveness and cost-utility analysis are needed to prioritize and allow health management services to make the correct choices for approaching this prevalent chronic disease.

  13. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON MENOPAUSE-2017 UPDATE.

    Science.gov (United States)

    Cobin, Rhoda H; Goodman, Neil F

    2017-07-01

    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

  14. Italian Society of Surgery and Association of Stoma Care Nurses Joint Position Statement on Preoperative Stoma Siting.

    Science.gov (United States)

    Roveron, Gabriele; De Toma, Giorgio; Barbierato, Maria

    2016-01-01

    Drawing on the existing position statements approved by the Wound, Ostomy and Continence Nursing Society in collaboration with the American Society of Colon & Rectal Surgeons and the American Urological Association, the Italian Association of Stoma care Nurses and the Italian Society of Surgery jointly developed and approved this document on July 27, 2013. Its purpose was to provide a formal recommendation for preoperative stoma siting and associated counseling for all patients undergoing enterostomy or urostomy surgery, with the goals of preventing complications, enhancing health-related quality of life, improving care, achieving better health outcomes, and reducing health care costs.

  15. NASN position statement: role of the school nurse.

    Science.gov (United States)

    2012-03-01

    It is the position of the National Association of School Nurses that the registered professional school nurse is the leader in the school community to oversee school health policies and programs. The school nurse serves in a pivotal role to provide expertise and oversight for the provision of school health services and promotion of health education. Using clinical knowledge and judgment, the school nurse provides health care to students and staff, performs health screenings and coordinates referrals to the medical home or private healthcare provider. The school nurse serves as a liaison between school personnel, family, community and healthcare providers to advocate for health care and a healthy school environment (National Association of School Nurses/American Nurses Association [NASN/ANA], 2005).

  16. Palliative sedation: the position statement of the Italian National Committee for Bioethics.

    Science.gov (United States)

    Orsi, Luciano; Gristina, Giuseppe R

    2017-05-01

    In January 2016 the Italian National Bioethics Committee (NBC) published a position statement entitled Deep and continuous palliative sedation in the imminence of death, related to the use of sedation and analgesia for relief from pain and psychological distress in dying patients. In this statement the Committee points out the clinical and ethical appropriateness of palliative sedation as a therapeutic procedure. As a result, today palliative sedation has to be considered useful, scientifically safe and reliable, and acknowledged as an integral part of good clinical practice. At the same time, the position statement, once and for all, makes clear that palliative sedation cannot and must not be equated with the practice of euthanasia. Thus, this document should be known by health professionals caring for dying patients not only in palliative as well as in intensive care settings, but it should be also considered as a milestone aimed to encourage and ease a widespread implementation of this procedure in all health care settings.

  17. World Federation of Occupational Therapists' Position Statement on Telehealth

    Directory of Open Access Journals (Sweden)

    World Federation of Occupational Therapists

    2014-09-01

    Full Text Available The purpose of this document is to state the World Federation of Occupational Therapists’ (WFOT position on the use of telehealth for the delivery of occupational therapy services. Telehealth is the use of information and communication technologies (ICT to deliver health-related services when the provider and client are in different physical locations. Additional terms used to describe this service delivery model include: tele-occupational therapy, telerehabilitation, teletherapy, telecare, telemedicine, and telepractice, among other terms. Telehealth may be used by occupational therapy practitioners for evaluation, intervention, monitoring, supervision, and consultation (between remote therapist, client, and/or local health-care provider as permitted by jurisdictional, institutional, and professional regulations and policies governing the practice of occupational therapy.Occupational therapy services via telehealth should be appropriate to the individuals, groups and cultures served,and contextualized to the occupations and interests of clients. Important considerations related to licensure/registration, collaboration with local occupational therapists, client selection, consent to treat, professional liability insurance, confidentiality, personal and cultural attributes, provider competence/standards of care, reimbursement/payer guidelines, and authentic occupational therapy practice are discussed.

  18. Reimbursement for school nursing health care services: position statement.

    Science.gov (United States)

    Lowe, Janet; Cagginello, Joan; Compton, Linda

    2014-09-01

    Children come to school with a variety of health conditions, varying from moderate health issues to multiple, severe chronic health illnesses that have a profound and direct impact on their ability to learn. The registered professional school nurse (hereinafter referred to as school nurse) provides medically necessary services in the school setting to improve health outcomes and promote academic achievement. The nursing services provided are reimbursable services in other health care settings, such as hospitals, clinics, and home care settings. The National Association of School Nurses (NASN) believes that school nursing services that are reimbursable nursing services in other health care systems should also be reimbursable services in the school setting, while maintaining the same high quality care delivery standards. Traditionally, local and state tax revenues targeted to fund education programs have paid for school nursing health services. School nurses are in a strategic position to advocate for improving clinical processes to better fit with community health care providers and to align reimbursements with proposed changes. Restructuring reimbursement programs will enable health care funding streams to assist in paying for school nursing services delivered to students in the school setting. Developing new innovative health financing opportunities will help to increase access, improve quality, and reduce costs. The goal is to promote a comprehensive and cost-effective health care delivery model that integrates schools, families, providers, and communities.

  19. Teaching the Statement of Changes in Financial Position--A Worksheet Approach.

    Science.gov (United States)

    Byrd, David B.; Byrd, Sandra D.

    1986-01-01

    The worksheet approach to preparing a Statement of Changes in Financial Position (SCFP) is presented. An example that has been developed for presentation to the class during the first class period spent on SCFPs is discussed. Conversion of working capital to cash is also explained. (CT)

  20. Evaluation of Increasing Antecedent Specificity in Goal Statements on Adherence to Positive Behavior-Management Strategies

    Science.gov (United States)

    Cohrs, Corey M.; Shriver, Mark D.; Burke, Raymond V.; Allen, Keith D.

    2016-01-01

    We evaluated the impact of antecedent specificity in goal statements on adherence to positive behavior-management strategies. Teaching staff were recruited from 2 different school settings where there were routine expectations to use behavior-specific praise in the classroom, but adherence was poor. In a concurrent multiple baseline design, the…

  1. Implementation of the 2017 Berlin Concussion in Sport Group Consensus Statement in contact and collision sports: a joint position statement from 11 national and international sports organisations.

    OpenAIRE

    Patricios, JS; Ardern, CL; Hislop, MD; Aubry, M; Bloomfield, P; Broderick, C; Clifton, P; Echemendia, RJ; Ellenbogen, RG; Falvey, ÉC; Fuller, GW; Grand, J; Hack, D; Harcourt, PR; Hughes, D

    2018-01-01

    The 2017 Berlin Concussion in Sport Group Consensus Statement provides a global summary of best practice in concussion prevention, diagnosis and management, underpinned by systematic reviews and expert consensus. Due to their different settings and rules, individual sports need to adapt concussion guidelines according to their specific regulatory environment. At the same time, consistent application of the Berlin Consensus Statement's themes across sporting codes is likely to facilitate super...

  2. Ethnocentrism is an unacceptable rationale for health care policy: a critique of transplant tourism position statements.

    Science.gov (United States)

    Evans, R W

    2008-06-01

    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.

  3. Developing an affirmative position statement on sexual and gender diversity for psychology professionals in South Africa

    Directory of Open Access Journals (Sweden)

    Cornelius J. Victor

    2017-06-01

    Full Text Available Background. Against the background of the dominance of patriarchy and heteronormativity in Africa and the resultant stigma, discrimination and victimisation of sexually and gender-diverse people, this article reports on the development of an affirmative position statement by the Psychological Society of South Africa (PsySSA for psychology professionals working with sexually and gender-diverse people. The position statement is an attempt to contribute positively to the de-stigmatisation, amongst psychology professionals, of all people with diverse sexual and gender identities. Objective. In documenting and reflecting on the process of developing the statement — a first on the African continent — the article aims to contribute to the potential resources available to others in their work on similar projects around the world. Design. Although initially intended to be relevant to the African continent, the position statement is appropriate to the South African context specifically, but developed in consultation with a range of stakeholders, also from other African countries. Results. Concerns expressed during stakeholder consultations, and thus taken into account in the development of the statement, include relevance to other African countries, negotiating the politics of representation and language, the importance of including gender and biological variance in addition to sexuality, and the need to be sensitive to how Western influence is constructed in some African contexts. Conclusion. Other national psychology organisations stand to benefit by ‘lessons learned’ during this country-specific process with global implications, especially with respect to broadening the lens from lesbian, gay, bisexual, transgender and intersex (LGBTI to sexual and gender diversity, as well as an acknowledgement of the multiple and fluid developmental pathways around sexuality and gender, in general.

  4. International Association for Hospice and Palliative Care Position Statement: Euthanasia and Physician-Assisted Suicide.

    Science.gov (United States)

    De Lima, Liliana; Woodruff, Roger; Pettus, Katherine; Downing, Julia; Buitrago, Rosa; Munyoro, Esther; Venkateswaran, Chitra; Bhatnagar, Sushma; Radbruch, Lukas

    2017-01-01

    Reports about regulations and laws on Euthanasia and Physician Assisted Suicide (PAS) are becoming increasingly common in the media. Many groups have expressed opposition to euthanasia and PAS while those in favor argue that severely chronically ill and debilitated patients have a right to control the timing and manner of their death. Others argue that both PAS and euthanasia are ethically legitimate in rare and exceptional cases. Given that these discussions as well as the new and proposed laws and regulations may have a powerful impact on patients, caregivers, and health care providers, the International Association for Hospice and Palliative Care (IAHPC) has prepared this statement. To describe the position of the IAHPC regarding Euthanasia and PAS. The IAHPC formed a working group (WG) of seven board members and two staff officers who volunteered to participate in this process. An online search was performed using the terms "position statement", "euthanasia" "assisted suicide" "PAS" to identify existing position statements from health professional organizations. Only statements from national or pan-national associations were included. Statements from seven general medical and nursing associations and statements from seven palliative care organizations were identified. A working document including a summary of the different position statements was prepared and based on these, an initial draft was prepared. Online discussions among the members of the WG took place for a period of three months. The differences were reconciled by email discussions. The resulting draft was shared with the full board. Additional comments and suggestions were incorporated. This document represents the final version approved by the IAHPC Board of Directors. IAHPC believes that no country or state should consider the legalization of euthanasia or PAS until it ensures universal access to palliative care services and to appropriate medications, including opioids for pain and dyspnea. In

  5. International Association for Hospice and Palliative Care Position Statement: Euthanasia and Physician-Assisted Suicide

    Science.gov (United States)

    Woodruff, Roger; Pettus, Katherine; Downing, Julia; Buitrago, Rosa; Munyoro, Esther; Venkateswaran, Chitra; Bhatnagar, Sushma; Radbruch, Lukas

    2017-01-01

    Abstract Background: Reports about regulations and laws on Euthanasia and Physician Assisted Suicide (PAS) are becoming increasingly common in the media. Many groups have expressed opposition to euthanasia and PAS while those in favor argue that severely chronically ill and debilitated patients have a right to control the timing and manner of their death. Others argue that both PAS and euthanasia are ethically legitimate in rare and exceptional cases. Given that these discussions as well as the new and proposed laws and regulations may have a powerful impact on patients, caregivers, and health care providers, the International Association for Hospice and Palliative Care (IAHPC) has prepared this statement. Purpose: To describe the position of the IAHPC regarding Euthanasia and PAS. Method: The IAHPC formed a working group (WG) of seven board members and two staff officers who volunteered to participate in this process. An online search was performed using the terms “position statement”, “euthanasia” “assisted suicide” “PAS” to identify existing position statements from health professional organizations. Only statements from national or pan-national associations were included. Statements from seven general medical and nursing associations and statements from seven palliative care organizations were identified. A working document including a summary of the different position statements was prepared and based on these, an initial draft was prepared. Online discussions among the members of the WG took place for a period of three months. The differences were reconciled by email discussions. The resulting draft was shared with the full board. Additional comments and suggestions were incorporated. This document represents the final version approved by the IAHPC Board of Directors. Result: IAHPC believes that no country or state should consider the legalization of euthanasia or PAS until it ensures universal access to palliative care services and to

  6. Best practice in nurse-led chemotherapy review: a position statement from the United Kingdom Oncology Nursing Society

    OpenAIRE

    Lennan, E; Vidall, C; Roe, H; Jones, P; Smith, J; Farrell, C

    2012-01-01

    This position statement has been formulated by nurses from the United Kingdom Oncology Nursing Society (UKONS) to provide guidance on the provision of nurse-led chemotherapy review clinics for adult patients. For the purposes of this statement, a nurse-led chemotherapy clinic is defined as one that conducts formal review (in a consultation room) before the decision to proceed and prescribe the next cycle of chemotherapy. This statement does not address the toxicity checks that take place imme...

  7. Algorithm for the treatment of type 2 diabetes: a position statement of Brazilian Diabetes Society

    OpenAIRE

    Lerario, Antonio C; Chacra, Antonio R; Pimazoni-Netto, Augusto; Malerbi, Domingos; Gross, Jorge L; Oliveira, Jos? EP; Gomes, Marilia B; Santos, Raul D; Fonseca, Reine MC; Betti, Roberto; Raduan, Roberto

    2010-01-01

    Abstract The Brazilian Diabetes Society is starting an innovative project of quantitative assessment of medical arguments of and implementing a new way of elaborating SBD Position Statements. The final aim of this particular project is to propose a new Brazilian algorithm for the treatment of type 2 diabetes, based on the opinions of endocrinologists surveyed from a poll conducted on the Brazilian Diabetes Society website regarding the latest algorithm proposed by American Diabetes Associatio...

  8. Diabetes Canada Position Statement for People with Types 1 and 2 Diabetes Who Fast During Ramadan.

    Science.gov (United States)

    Bajaj, Harpreet Singh; Abouhassan, Tyceer; Ahsan, Muhammad Rauf; Arnaout, Amel; Hassanein, Mohamed; Houlden, Robyn L; Khan, Tayyab; Khandwala, Hasnain; Verma, Subodh

    2018-04-27

    Fasting from dawn to dusk during Ramadan, including abstaining from water and food, is 1 of the pillars of Islam and is observed by the majority of Muslims. Most research concerning diabetes and fasting during Ramadan originates from Middle Eastern or South Asian countries; however, differences exist in hours of work and fasting, pharmacotherapy and blood glucose monitoring between these countries and Canada. An expert forum of 7 Canadian experts and 1 international expert collaborated to develop Canadian guidelines using the same evidence-based principles, with the exception of an independent methods review used for the Diabetes Canada clinical practice guidelines. Diabetes Canada scientific leadership and Canadian health-care providers performed independent external reviews. Religious leaders endorsed the position statement and provided letters of support. An informed patient participated in the position-statement development. Each recommendation was approved with 100% consensus of the expert forum. Recommendations for risk stratification, education, pharmacotherapy and blood glucose monitoring for adults with type 1 and type 2 diabetes who intend to fast during Ramadan have been developed. This is the first Canadian position statement on the topic of Ramadan fasting and diabetes. It was developed by an expert faculty and endorsed by Diabetes Canada, and provides guidance about pharmacotherapy and glucose monitoring for health-care providers so that they can assist Canadian Muslims living with diabetes to observe fasting during Ramadan safely. Copyright © 2018. Published by Elsevier Inc.

  9. [Statement of the Spanish Interdisciplinary Cardiovascular Prevention Committee (CEIPC) on the 2012 European Cardiovascular Prevention Guidelines].

    Science.gov (United States)

    Royo-Bordonada, Miguel Ángel; Lobos Bejarano, José María; Villar Alvarez, Fernando; Sans, Susana; Pérez, Antonio; Pedro-Botet, Juan; Moreno Carriles, Rosa María; Maiques, Antonio; Lizcano, Angel; Lizarbe, Vicenta; Gil Núñez, Antonio; Fornés Ubeda, Francisco; Elosua, Roberto; de Santiago Nocito, Ana; de Pablo Zarzosa, Carmen; de Álvaro Moreno, Fernando; Cortés, Olga; Cordero, Alberto; Camafort Babkowski, Miguel; Brotons Cuixart, Carlos; Armario, Pedro

    2013-01-01

    Based on the two main frameworks for evaluating scientific evidence--SEC and GRADE--European cardiovascular prevention guidelines recommend interventions across all life stages using a combination of population-based and high-risk strategies with diet as the cornerstone of prevention. The evaluation of cardiovascular risk (CVR) incorporates HDL levels and psychosocial factors, a very high risk category, and the concept of age-risk. They also recommend cognitive-behavioural methods (e.g., motivational interviewing, psychological interventions, led by health professionals and with the participation of the patient's family, to counterbalance psychosocial stress and reduce CVR through the institution of positive habits such as a healthy diet, physical activity, smoking cessation, and adherence to treatment. Additionally, public health interventions--such as smoking ban in public areas or the elimination of trans fatty acids from the food chain--are also essential. Other innovations include abandoning antiplatelet therapy in primary prevention and the recommendation of maintaining blood pressure (BP) within the 130-139/80-85 mmHg range in diabetic patients and individuals with high CVR. Finally, due to the significant impact on patient progress and medical costs, special emphasis is given to the low therapeutic adherence levels observed. In sum, improving cardiovascular prevention requires a true partnership among the political class, public administrations, scientific and professional associations, health foundations, consumer associations, patients and their families. Such partnership would promote population-based and individual strategies by taking advantage of the broad spectrum of scientific evidence available, from clinical trials to observational studies and mathematical models to evaluate population-based interventions, including cost-effectiveness analyses.

  10. Reconceptualizing Media Literacy in the Social Studies: A Pragmatist Critique of the NCSS Position Statement on Media Literacy

    Science.gov (United States)

    Mason, Lance; Metzger, Scott Alan

    2012-01-01

    The National Council for the Social Studies Position Statement on Media Literacy argues that media literacy can facilitate participatory democracy if students' interest in media is harnessed. The statement conceives of media technology as neutral and under-conceptualizes socializing aspects of media technologies that foster atomized individualism.…

  11. Anxiety management training for anxiety states: positive compared with negative self-statements.

    Science.gov (United States)

    Ramm, E; Marks, I M; Yuksel, S; Stern, R S

    1982-04-01

    Twelve patients complaining of chronic free-floating anxiety, usually also with panic attacks, were assigned at random to treatment by six hour-long sessions of anxiety-management training, either with positive or with negative self-statements, given over six weeks. Patients in both treatment conditions improved, with a small trend favouring positive over negative self-instruction, especially at follow-up. It is unclear how much self-instruction, rather than therapeutic attention or mere passage of time, accounted for the bulk of the modest improvement obtained.

  12. Polish Society of Endocrinology Position statement on endocrine disrupting chemicals (EDCs).

    Science.gov (United States)

    Rutkowska, Aleksandra; Rachoń, Dominik; Milewicz, Andrzej; Ruchała, Marek; Bolanowski, Marek; Jędrzejuk, Diana; Bednarczuk, Tomasz; Górska, Maria; Hubalewska-Dydejczyk, Alicja; Kos-Kudła, Beata; Lewiński, Andrzej; Zgliczyński, Wojciech

    2015-01-01

    With the reference to the position statements of the Endocrine Society, the Paediatric Endocrine Society, and the European Society of Paediatric Endocrinology, the Polish Society of Endocrinology points out the adverse health effects caused by endocrine disrupting chemicals (EDCs) commonly used in daily life as components of plastics, food containers, pharmaceuticals, and cosmetics. The statement is based on the alarming data about the increase of the prevalence of many endocrine disorders such as: cryptorchidism, precocious puberty in girls and boys, and hormone-dependent cancers (endometrium, breast, prostate). In our opinion, it is of human benefit to conduct epidemiological studies that will enable the estimation of the risk factors of exposure to EDCs and the probability of endocrine disorders. Increasing consumerism and the industrial boom has led to severe pollution of the environment with a corresponding negative impact on human health; thus, there is great necessity for the biomonitoring of EDCs in Poland.

  13. WNA position statement on safe management of nuclear waste and used nuclear fuel

    International Nuclear Information System (INIS)

    Saint-Pierre, S.

    2006-01-01

    This World nuclear association (W.N.A.) Position Statement summarizes the worldwide nuclear industry's record, progress and plans in safely managing nuclear waste and used nuclear fuel. The global industry's safe waste management practices cover the entire nuclear fuel-cycle, from the mining of uranium to the long-term disposal of end products from nuclear power reactors. The Statement's aim is to provide, in clear and accurate terms, the nuclear industry's 'story' on a crucially important subject often clouded by misinformation. Inevitably, each country and each company employs a management strategy appropriate to a specific national and technical context. This Position Statement reflects a confident industry consensus that a common dedication to sound practices throughout the nuclear industry worldwide is continuing to enhance an already robust global record of safe management of nuclear waste and used nuclear fuel. This text focuses solely on modern civil programmes of nuclear-electricity generation. It does not deal with the substantial quantities of waste from military or early civil nuclear programmes. These wastes fall into the category of 'legacy activities' and are generally accepted as a responsibility of national governments. The clean-up of wastes resulting from 'legacy activities' should not be confused with the limited volume of end products that are routinely produced and safely managed by today's nuclear energy industry. On the significant subject of 'Decommissioning of Nuclear Facilities', which is integral to modern civil nuclear power programmes, the W.N.A. will offer a separate Position Statement covering the industry's safe management of nuclear waste in this context. The safe management of nuclear waste and used nuclear fuel is a widespread, well-demonstrated reality. This strong safety record reflects a high degree of nuclear industry expertise and of industry responsibility toward the well-being of current and future generations

  14. British Society of Gastroenterology position statement on serrated polyps in the colon and rectum.

    Science.gov (United States)

    East, James E; Atkin, Wendy S; Bateman, Adrian C; Clark, Susan K; Dolwani, Sunil; Ket, Shara N; Leedham, Simon J; Phull, Perminder S; Rutter, Matt D; Shepherd, Neil A; Tomlinson, Ian; Rees, Colin J

    2017-07-01

    Serrated polyps have been recognised in the last decade as important premalignant lesions accounting for between 15% and 30% of colorectal cancers. There is therefore a clinical need for guidance on how to manage these lesions; however, the evidence base is limited. A working group was commission by the British Society of Gastroenterology (BSG) Endoscopy section to review the available evidence and develop a position statement to provide clinical guidance until the evidence becomes available to support a formal guideline. The scope of the position statement was wide-ranging and included: evidence that serrated lesions have premalignant potential; detection and resection of serrated lesions; surveillance strategies after detection of serrated lesions; special situations-serrated polyposis syndrome (including surgery) and serrated lesions in colitis; education, audit and benchmarks and research questions. Statements on these issues were proposed where the evidence was deemed sufficient, and re-evaluated modified via a Delphi process until >80% agreement was reached. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool was used to assess the strength of evidence and strength of recommendation for finalised statements. Key recommendation : we suggest that until further evidence on the efficacy or otherwise of surveillance are published, patients with sessile serrated lesions (SSLs) that appear associated with a higher risk of future neoplasia or colorectal cancer (SSLs ≥10 mm or serrated lesions harbouring dysplasia including traditional serrated adenomas) should be offered a one-off colonoscopic surveillance examination at 3 years ( weak recommendation, low quality evidence, 90% agreement ). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. A new blood glucose management algorithm for type 2 diabetes: a position statement of the Australian Diabetes Society.

    Science.gov (United States)

    Gunton, Jenny E; Cheung, N Wah; Davis, Timothy M E; Zoungas, Sophia; Colagiuri, Stephen

    2014-12-11

    Lowering blood glucose levels in people with type 2 diabetes has clear benefits for preventing microvascular complications and potential benefits for reducing macrovascular complications and death. Treatment needs to be individualised for each person with diabetes. This should start with selecting appropriate glucose and glycated haemoglobin targets, taking into account life expectancy and the patient's wishes. For most people, early use of glucose-lowering therapies is warranted. A range of recently available therapies has added to the options for lowering glucose levels, but this has made the clinical pathway for treating diabetes more complicated. This position statement from the Australian Diabetes Society outlines the risks, benefits and costs of the available therapies and suggests a treatment algorithm incorporating the older and newer agents.

  16. Comparative Study on Presentation of Statement of Financial Position in the Public Sector

    Directory of Open Access Journals (Sweden)

    Carmen Crețu

    2011-06-01

    Full Text Available Although it is more than a decade since the elaboration of the first public accountingstandards, countries are still reluctant to adopt them, preferring rather an adaptation of nationallegislation with the provisions IPSASs. Concerns about the necessity and usefulness of the applicationof International Public Sector Accounting Standards are due to economic influences, cultural, social,which made their mark on philosophy, doctrine and national accounting policies. Although financialstatements may appear similar from country to country, there are differences that can be caused by avariety of social, economic and legal factors, and that some countries when setting the nationalrequirements have considered the needs of different users of financial statements. These factors haveled to the use of different definitions of the structures of financial statements, such as assets,liabilities, equity, revenues and expenses. Scope and disclosures in the financial statements were alsoaffected. Therefore, this paper intends to emphasize similarities, but especially the differencesbetween the two frames of reference - national norms to international standards - regarding Statementof financial position on a public institution.

  17. American Society of Clinical Oncology Policy Statement: The Role of the Oncologist in Cancer Prevention and Risk Assessment

    Science.gov (United States)

    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.

    2009-01-01

    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

  18. The Australasian radiation protection society's position statement on risks fro low levels of ionizing radiation

    International Nuclear Information System (INIS)

    Higson, D.J.

    2006-01-01

    Full text: Controversy continues in the radiation protection literature on whether or not ionizing radiation is harmful at low doses, with unresolved scientific uncertainty about effects below a few tens of millisieverts. To settle what regulatory controls (if any) should apply in this dose region, an assumption has to be made relating dose to the possibility of harm or benefit. The assumption made and the way it is applied can have far-reaching effects, not only on the scale of regulatory compliance required but also on public perception of risk, and therefore on the technological choices made by society. It is important therefore that decisions reached concerning the regulation of low doses of ionizing radiation derive from rational arguments and are perceived to have an ethical basis. It is also important that such decisions are neither portrayed nor perceived as resolving the scientific uncertainties: rather, they serve merely to facilitate the implementation of appropriate measures to ensure safety. At its Annual General Meeting in 2004, the Australasian Radiation Protection Society (ARPS) set up a working group to draft a statement of the Society's position on this matter. The resulting position statement was adopted by the Society at its Annual General Meeting on 14 November 2005. Its salient features are as follows: There is insufficient evidence to establish a dose-effect relationship for doses that are less than a few tens of millisieverts in a year. A linear extrapolation from higher dose levels should be assumed only for the purpose of applying regulatory controls; Estimates of collective dose arising from individual doses that are less than some tens of millisieverts in a year should not be used to predict numbers of fatal cancers; The risk to an individual of doses significantly less than 100 microsieverts in a year is so small, if it exists at all, that regulatory requirements to control exposure at this level are not warranted. The paper will

  19. American Society for Pain Management Nursing position statement: pain management at the end of life.

    Science.gov (United States)

    Reynolds, Janice; Drew, Debra; Dunwoody, Colleen

    2013-09-01

    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.

  20. 17 CFR 210.3-02 - Consolidated statements of income and changes in financial positions.

    Science.gov (United States)

    2010-04-01

    ... General Instructions As to Financial Statements § 210.3-02 Consolidated statements of income and changes... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Consolidated statements of... SECURITIES AND EXCHANGE COMMISSION FORM AND CONTENT OF AND REQUIREMENTS FOR FINANCIAL STATEMENTS, SECURITIES...

  1. The American Chiropractic Board of Sports Physicians Position Statement on Pre-Participation Examinations: An Expert Consensus

    Science.gov (United States)

    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

    2015-01-01

    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

  2. The American Chiropractic Board of Sports Physicians Position Statement on Pre-Participation Examinations: An Expert Consensus.

    Science.gov (United States)

    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

    2015-09-01

    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.

  3. World Nuclear Association position statement: Safe management of nuclear waste and used nuclear fuel

    International Nuclear Information System (INIS)

    Saint-Pierre, Sylvain

    2006-01-01

    This WNA Position Statement summarises the worldwide nuclear industry's record, progress and plans in safely managing nuclear waste and used nuclear fuel. The global industry's safe waste management practices cover the entire nuclear fuel-cycle, from the mining of uranium to the long-term disposal of end products from nuclear power reactors. The Statement's aim is to provide, in clear and accurate terms, the nuclear industry's 'story' on a crucially important subject often clouded by misinformation. Inevitably, each country and each company employs a management strategy appropriate to a specific national and technical context. This Position Statement reflects a confident industry consensus that a common dedication to sound practices throughout the nuclear industry worldwide is continuing to enhance an already robust global record of safe management of nuclear waste and used nuclear fuel. This text focuses solely on modern civil programmes of nuclear-electricity generation. It does not deal with the substantial quantities of waste from military or early civil nuclear programmes. These wastes fall into the category of 'legacy activities' and are generally accepted as a responsibility of national governments. The clean-up of wastes resulting from 'legacy activities' should not be confused with the limited volume of end products that are routinely produced and safely managed by today's nuclear energy industry. On the significant subject of 'Decommissioning of Nuclear Facilities', which is integral to modern civil nuclear power programmes, the WNA will offer a separate Position Statement covering the industry's safe management of nuclear waste in this context. The paper's conclusion is that the safe management of nuclear waste and used nuclear fuel is a widespread, well-demonstrated reality. This strong safety record reflects a high degree of nuclear industry expertise and of industry responsibility toward the well-being of current and future generations. Accumulating

  4. Algorithm for the treatment of type 2 diabetes: a position statement of Brazilian Diabetes Society.

    Science.gov (United States)

    Lerario, Antonio C; Chacra, Antonio R; Pimazoni-Netto, Augusto; Malerbi, Domingos; Gross, Jorge L; Oliveira, José Ep; Gomes, Marilia B; Santos, Raul D; Fonseca, Reine Mc; Betti, Roberto; Raduan, Roberto

    2010-06-08

    The Brazilian Diabetes Society is starting an innovative project of quantitative assessment of medical arguments of and implementing a new way of elaborating SBD Position Statements. The final aim of this particular project is to propose a new Brazilian algorithm for the treatment of type 2 diabetes, based on the opinions of endocrinologists surveyed from a poll conducted on the Brazilian Diabetes Society website regarding the latest algorithm proposed by American Diabetes Association /European Association for the Study of Diabetes, published in January 2009.An additional source used, as a basis for the new algorithm, was to assess the acceptability of controversial arguments published in international literature, through a panel of renowned Brazilian specialists. Thirty controversial arguments in diabetes have been selected with their respective references, where each argument was assessed and scored according to its acceptability level and personal conviction of each member of the evaluation panel.This methodology was adapted using a similar approach to the one adopted in the recent position statement by the American College of Cardiology on coronary revascularization, of which not only cardiologists took part, but also specialists of other related areas.

  5. The Australasian radiation protection society's position statement on risks from low levels of ionizing radiation

    International Nuclear Information System (INIS)

    Don, Higson; Ches, Mason; Andrew, McEwan; Peter, Burns; Riaz, Akber; Ron, Cameron; Pamela, Sykes; Joe, Young

    2006-01-01

    At its Annual General Meeting in 2004, the Australasian Radiation Protection Society (A.R.P.S.) set up a working group to draft a statement of the Society's position on risks from low levels of exposure to ionizing radiation. The resulting position statement was adopted by the Society at its Annual General Meeting in 2005. Its salient features are as follows: First, there is insufficient evidence to establish a dose-effect relationship for doses that are less than a few tens of milli sieverts in a year. A linear extrapolation from higher dose levels should be assumed only for the purpose of applying regulatory controls. Secondly, estimates of collective dose arising from individual doses that are less than some tens of milli sieverts in a year should not be used to predict numbers of fatal cancers. Thirdly, the risk to an individual of doses significantly less than 100 micro sieverts in a year is so small, if it exists at all, that regulatory requirements to control exposure at this level are not warranted. (authors)

  6. Endocrine Society of Australia position statement on male hypogonadism (part 2): treatment and therapeutic considerations.

    Science.gov (United States)

    Yeap, Bu B; Grossmann, Mathis; McLachlan, Robert I; Handelsman, David J; Wittert, Gary A; Conway, Ann J; Stuckey, Bronwyn Ga; Lording, Douglas W; Allan, Carolyn A; Zajac, Jeffrey D; Burger, Henry G

    2016-09-05

    Part 1 of this position statement dealt with the assessment of male hypogonadism, including the indications for testosterone therapy. This article, Part 2, focuses on treatment and therapeutic considerations for male hypogonadism and identifies key questions for future research. Key points and recommendations are:Excess cardiovascular events have been reported in some but not all studies of older men without pathological hypogonadism who were given testosterone treatment. Additional studies are needed to clarify whether testosterone therapy influences cardiovascular risk.Testosterone is the native hormone that should be replaced in men being treated for pathological hypogonadism. Convenient and cost-effective treatment modalities include depot intramuscular injection and transdermal administration (gel, cream or liquid formulations).Monitoring of testosterone therapy is recommended for efficacy and safety, focusing on ameliorating symptoms, restoring virilisation, avoiding polycythaemia and maintaining or improving bone mineral density.Treatment aims to relieve an individual's symptoms and signs of androgen deficiency by administering standard doses and maintaining circulating testosterone levels within the reference interval for eugonadal men.Evaluation for cardiovascular disease and prostate cancer risks should be undertaken as appropriate for eugonadal men of similar age. Nevertheless, when there is a reasonable possibility of substantive pre-existing prostate disease, digital rectal examination and prostate-specific antigen testing should be performed before commencing testosterone treatment.Changes in management as result of the position statement: Treatment aims to relieve symptoms and signs of androgen deficiency, using convenient and effective formulations of testosterone. Therapy should be monitored for efficacy and safety.

  7. Position statement on ethics, equipoise and research on charged particle radiation therapy.

    Science.gov (United States)

    Sheehan, Mark; Timlin, Claire; Peach, Ken; Binik, Ariella; Puthenparampil, Wilson; Lodge, Mark; Kehoe, Sean; Brada, Michael; Burnet, Neil; Clarke, Steve; Crellin, Adrian; Dunn, Michael; Fossati, Piero; Harris, Steve; Hocken, Michael; Hope, Tony; Ives, Jonathan; Kamada, Tadashi; London, Alex John; Miller, Robert; Parker, Michael; Pijls-Johannesma, Madelon; Savulescu, Julian; Short, Susan; Skene, Loane; Tsujii, Hirohiko; Tuan, Jeffrey; Weijer, Charles

    2014-08-01

    The use of charged-particle radiation therapy (CPRT) is an increasingly important development in the treatment of cancer. One of the most pressing controversies about the use of this technology is whether randomised controlled trials are required before this form of treatment can be considered to be the treatment of choice for a wide range of indications. Equipoise is the key ethical concept in determining which research studies are justified. However, there is a good deal of disagreement about how this concept is best understood and applied in the specific case of CPRT. This report is a position statement on these controversies that arises out of a workshop held at Wolfson College, Oxford in August 2011. The workshop brought together international leaders in the relevant fields (radiation oncology, medical physics, radiobiology, research ethics and methodology), including proponents on both sides of the debate, in order to make significant progress on the ethical issues associated with CPRT research. This position statement provides an ethical platform for future research and should enable further work to be done in developing international coordinated programmes of research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Cone-beam CT in paediatric dentistry. DIMITRA project position statement

    International Nuclear Information System (INIS)

    Oenning, Anne Caroline; Jacobs, Reinhilde; Pauwels, Ruben; Stratis, Andreas; Hedesiu, Mihaela; Salmon, Benjamin

    2018-01-01

    DIMITRA (dentomaxillofacial paediatric imaging: an investigation towards low-dose radiation induced risks) is a European multicenter and multidisciplinary project focused on optimizing cone-beam CT exposures for children and adolescents. With increasing use of cone-beam CT for dentomaxillofacial diagnostics, concern arises regarding radiation risks associated with this imaging modality, especially for children. Research evidence concerning cone-beam CT indications in children remains limited, while reports mention inconsistent recommendations for dose reduction. Furthermore, there is no paper using the combined and integrated information on the required indication-oriented image quality and the related patient dose levels. In this paper, therefore, the authors initiate an integrated approach based on current evidence regarding image quality and dose, together with the expertise of DIMITRA's members searching for a state of the art. The aim of this DIMITRA position statement is to provide indication-oriented and patient-specific recommendations regarding the main cone-beam CT applications in the pediatric field. The authors will review this position statement document when results regarding multidisciplinary approaches evolve, in a period of 5 years or earlier. (orig.)

  9. Position statement and guidelines on support personnel in audiology. American Speech-Language Hearing Association.

    Science.gov (United States)

    1998-01-01

    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).

  10. Algorithm for the treatment of type 2 diabetes: a position statement of Brazilian Diabetes Society

    Directory of Open Access Journals (Sweden)

    Lerario Antonio C

    2010-06-01

    Full Text Available Abstract The Brazilian Diabetes Society is starting an innovative project of quantitative assessment of medical arguments of and implementing a new way of elaborating SBD Position Statements. The final aim of this particular project is to propose a new Brazilian algorithm for the treatment of type 2 diabetes, based on the opinions of endocrinologists surveyed from a poll conducted on the Brazilian Diabetes Society website regarding the latest algorithm proposed by American Diabetes Association /European Association for the Study of Diabetes, published in January 2009. An additional source used, as a basis for the new algorithm, was to assess the acceptability of controversial arguments published in international literature, through a panel of renowned Brazilian specialists. Thirty controversial arguments in diabetes have been selected with their respective references, where each argument was assessed and scored according to its acceptability level and personal conviction of each member of the evaluation panel. This methodology was adapted using a similar approach to the one adopted in the recent position statement by the American College of Cardiology on coronary revascularization, of which not only cardiologists took part, but also specialists of other related areas.

  11. Policy statement--Role of the pediatrician in youth violence prevention.

    Science.gov (United States)

    2009-07-01

    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.

  12. Position statement on use of hand-held portable dental X-ray equipment

    International Nuclear Information System (INIS)

    2014-06-01

    The position statement focuses on justification in the medical field, in particular on the use of hand-held portable dental x-ray equipment. It supplements another HERCA position paper, providing a general overview of the use of all hand-held portable X-ray equipment. Key Messages: - HERCA finds that the use of hand-held portable X-ray devices should be discouraged except in special circumstances. - As a general rule, these devices should only be used in scenarios where an intraoral radiograph is deemed necessary for a patient and the use of a fixed or semi-mobile x-ray unit is impractical, e.g.: - nursing homes, residential care facilities or homes for persons with disabilities; - forensic odontology, - military operations abroad without dental facilities

  13. Folic Acid for the Prevention of Neural Tube Defects : US Preventive Services Task Force Recommendation Statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen J.; Gregory, Kimberly D.; Grossman, David; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne M.; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Schwartz, J. Sanford; Wilt, Timothy

    2009-01-01

    Description: In 1996, the U. S. Preventive Services Task Force (USPSTF) recommended that all women planning or capable of pregnancy take a multivitamin supplement containing folic acid for the prevention of neural tube defects. This recommendation is an update of the 1996 USPSTF recommendation.

  14. Intellectual Disability Policy as Developed, Expressed, and Evaluated in AAIDD/The Arc Joint Statements: The Role of Organization Position Statements.

    Science.gov (United States)

    Luckasson, Ruth; Ford, Marty E; McMillan, Elise D; Misilo, Frederick M; Nygren, Margaret A

    2017-07-01

    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.

  15. 'Risk or Right': a discourse analysis of midwifery and obstetric colleges' homebirth position statements.

    Science.gov (United States)

    Licqurish, Sharon; Evans, Alicia

    2016-03-01

    Within the context of global debates about safety and ethics of supporting women to give birth at home, it is important to analyse documents governing midwifery and obstetric practice and influence decision-making around place of birth. In Australia, the United States and the United Kingdom, relatively small numbers of women choose to give birth at home despite their midwifery colleges' support. In the United States and Australia, the obstetric colleges do not support homebirth and these countries have lower numbers of women who birth at home, compared with the United Kingdom. There are numerous regulatory and industry challenges for midwives attending homebirths. This paper reports on a Foucauldian analysis of Australian obstetric and midwifery colleges' position statements about homebirth, who have conflicting views, with the view to understanding their arguments and underlying assumptions. The documents highlighted tensions between competing discourses of risk and autonomy and differences in academic argument. Opportunities for strengthening their statements are highlighted. The methodology is applicable for future analysis of similar documents governing practice in other countries. © 2015 John Wiley & Sons Ltd.

  16. Evaluation of the Positive Prevention HIV/STD Curriculum

    Science.gov (United States)

    LaChausse, Robert G.

    2006-01-01

    This study evaluated the effectiveness of Positive Prevention, a theory-based, HIV/STD prevention education curriculum for high school youth. Three hundred fifty-three students participated in a longitudinal experimental design to determine the impact of the curriculum on HIV/AIDS knowledge, self-efficacy to abstain from sex, self-efficacy of…

  17. American Medical Society for Sports Medicine position statement: concussion in sport.

    Science.gov (United States)

    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

    2013-01-01

    undefined. Their practical usefulness with or without an individual baseline test is also largely unknown. ▸ Balance disturbance is a specific indicator of a concussion, but not very sensitive. Balance testing on the sideline may be substantially different than baseline tests because of differences in shoe/cleat-type or surface, use of ankle tape or braces, or the presence of other lower extremity injury. ▸ Imaging is reserved for athletes where intracerebral bleeding is suspected. ▸ There is no same day RTP for an athlete diagnosed with a concussion. ▸ Athletes suspected or diagnosed with a concussion should be monitored for deteriorating physical or mental status. ▸ Neuropsychological (NP) tests are an objective measure of brain-behaviour relationships and are more sensitive for subtle cognitive impairment than clinical exam. ▸ Most concussions can be managed appropriately without the use of NP testing. ▸ Computerised neuropsychological (CNP) testing should be interpreted by healthcare professionals trained and familiar with the type of test and the individual test limitations, including a knowledgeable assessment of the reliable change index, baseline variability and false-positive and false-negative rates. ▸ Paper and pencil NP tests can be more comprehensive, test different domains and assess for other conditions which may masquerade as or complicate assessment of concussion. ▸ NP testing should be used only as part of a comprehensive concussion management strategy and should not be used in isolation. ▸ The ideal timing, frequency and type of NP testing have not been determined. ▸ In some cases, properly administered and interpreted NP testing provides an added value to assess cognitive function and recovery in the management of sports concussions. ▸ It is unknown if use of NP testing in the management of sports concussion helps prevent recurrent concussion, catastrophic injury or long-term complications. ▸ Comprehensive NP evaluation is

  18. Preventing Stress in Organizations How to Develop Positive Managers

    CERN Document Server

    Donaldson-Feilder, Emma; Yarker, Joanna

    2011-01-01

    Preventing Stress in Organizations:How to Develop Positive Managersoffers an innovative, evidence-based approach to help managers prevent and reduce workplace stress in their staff.Provides information on the critical skills managers must develop in order to prevent stress in their staff, and the key ongoing behaviours that promote a healthy work environmentShows practitioners in occupational psychology, HR, Health and Safety and related professions how positive management can be integrated into an organization???s existing practices and processesServes as an essential guide for managers thems

  19. Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force recommendation statement.

    Science.gov (United States)

    Moyer, Virginia A

    2014-06-01

    Update of the 2004 US Preventive Services Task Force (USPSTF) recommendation on prevention of dental caries in preschool-aged children. The USPSTF reviewed the evidence on prevention of dental caries by primary care clinicians in children 5 years and younger, focusing on screening for caries, assessment of risk for future caries, and the effectiveness of various interventions that have possible benefits in preventing caries. This recommendation applies to children age 5 years and younger. The USPSTF recommends that primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride. (B recommendation) The USPSTF recommends that primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening examinations for dental caries performed by primary care clinicians in children from birth to age 5 years. (I Statement). Copyright © 2014 by the American Academy of Pediatrics.

  20. WOCN Society and AUA Position Statement on Preoperative Stoma Site Marking for Patients Undergoing Urostomy Surgery.

    Science.gov (United States)

    Salvadalena, Ginger; Hendren, Samantha; McKenna, Linda; Muldoon, Roberta; Netsch, Debra; Paquette, Ian; Pittman, Joyce; Ramundo, Janet; Steinberg, Gary

    2015-01-01

    Marking the optimal location for a stoma preoperatively enhances the likelihood of a patient's independence in stoma care, predictable pouching system wear times, and resumption of normal activities. Urologists and certified ostomy nurses are the optimal clinicians to select and mark stoma sites, as this skill is a part of their education, practice, and training. However, these providers are not always available, particularly in emergency situations. The purpose of this position statement, developed by the Wound, Ostomy and Continence Nurses Society in collaboration with the American Urological Association and the American Society of Colon and Rectal Surgeons, is to provide a guideline to assist clinicians (especially those who are not surgeons or WOC nurses) in selecting an effective stoma site.

  1. Consumer Sleep Technology: An American Academy of Sleep Medicine Position Statement.

    Science.gov (United States)

    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

    2018-05-15

    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.

  2. NASN position statement: Sexual orientation and gender identity/expression (sexual minority students): school nurse practice.

    Science.gov (United States)

    Bradley, Beverly; Kelts, Susan; Robarge, Deb; Davis, Catherine; Delger, Suzey; Compton, Linda

    2013-03-01

    It is the position of the National Association of School Nurses that all students, regardless of their sexual orientation or the sexual orientation of their parents and family members, are entitled to a safe school environment and equal opportunities for a high level of academic achievement and school participation/involvement. Sexual minority persons are those who identify themselves as gay, lesbian, or bisexual (LGB) or are unsure of their sexual orientation, or those who have had sexual contact with persons of the same sex or both sexes (Kann et al., 2011). Sexual minority is thought to be a more inclusive and neutral term. For the purposes of this statement, the term sexual minority will be used in lieu of LGBTQ (lesbian, gay, bisexual, transgender, or questioning).

  3. [2015 updated position statement of the management of hyperglycaemia in type 2 diabetes].

    Science.gov (United States)

    Scheen, A J; Paquot, N

    2015-08-26

    The strategy for the management ot type 2 diabetes, summarized by a group of European and American experts, has been updated early 2015. A patient-centered approach is recommended and the first drug choice is metformin combined with lifestyle improvement. After failure of metformin monotherapy, the selection of a second drug should be based on the efficacy, safety and cost of each pharmacological class. When compared to the position statement of 2012, the most important changes are the possible addition of a gliptin to a dual oral therapy or even to insulin, the commercialization of sodium-glucose cotransporters type 2 (SGLT2) inhibitors (gliflozins, to be used in dual or triple therapy, even in combination with insulin) and the possible combination of a glucagon-like peptide-I receptor agonist together with a basal insulin.

  4. Diabetes and Anemia: International Diabetes Federation (IDF) - Southeast Asian Region (SEAR) position statement.

    Science.gov (United States)

    Sahay, Manisha; Kalra, Sanjay; Badani, Rajesh; Bantwal, Ganapathi; Bhoraskar, Anil; Das, A K; Dhorepatil, Bharati; Ghosh, Sujoy; Jeloka, Tarun; Khandelwal, Deepak; Latif, Zafar Ahmed; Nadkar, Milind; Pathan, Md Faruque; Saboo, Banshi; Sahay, Rakesh; Shimjee, Suleiman; Shrestha, Dina; Siyan, Ali; Talukdar, Shamim Hayder; Tiwaskar, Mangesh; Unnikrishnan, A G

    2017-12-01

    Anemia is often associated with diabetes mellitus and is known to intensify the risk of developing diabetes-related microvascular and macrovascular complications. There is paucity in understanding of co-existence of these conditions, especially in Southeast Asian countries. Iron and/or erythropoietin deficiencies are the major causes of anemia in diabetes, and diabetic kidney disease plays a key role. Patients with diabetes need to be screened for anemia along with other risk factors and anemia should be corrected appropriately to improve overall clinical outcomes. This position statement aims to provide a comprehensive overview and an algorithm for appropriate management of anemia in patients with diabetes. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  5. Indication, organization, practical implementation and interpretation guidelines for retrospective CGM recording: A French position statement.

    Science.gov (United States)

    Joubert, M; Baillot-Rudoni, S; Catargi, B; Charpentier, G; Esvant, A; Franc, S; Guerci, B; Guilhem, I; Melki, V; Merlen, E; Penfornis, A; Renard, E; Riveline, J P; Schaepelynck, P; Sola-Gazagnes, A; Hanaire, H

    2015-12-01

    The benefits of retrospective continuous glucose monitoring (retroCGM) recording have been widely explored in clinical studies, and many diabetes physicians routinely use this examination. However, the method of interpretation of CGM recordings has never been precisely described. An expert French panel of physicians met for two days to discuss several aspects of retroCGM use and to produce a position statement. The guidelines cover the indications for retroCGM, the general organization and practical implementation of CGM recordings, a description of the different devices available and guidelines for the interpretation of retroCGM recordings. This consensus document should help clinicians in the proper use of retroCGM. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Care of Victims of Child Maltreatment: The School Nurse's Role. Position Statement

    Science.gov (United States)

    Ondeck, Lynnette; Combe, Laurie; Feeser, Cindy Jo; King, Rebecca

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that prevention, early recognition, intervention and treatment of child maltreatment are critical to the physical well-being and academic success of students. Registered professional school nurses (hereinafter referred to as school nurses) serve a vital role in the recognition…

  7. A practice-based approach to the 2012 position statement of the American Diabetes Association and the European Association for the Study of Diabetes.

    Science.gov (United States)

    Schwartz, Stanley S

    2013-07-01

    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.

  8. Youth resistance training: updated position statement paper from the national strength and conditioning association.

    Science.gov (United States)

    Faigenbaum, Avery D; Kraemer, William J; Blimkie, Cameron J R; Jeffreys, Ian; Micheli, Lyle J; Nitka, Mike; Rowland, Thomas W

    2009-08-01

    Faigenbaum, AD, Kraemer, WJ, Blimkie, CJR, Jeffreys, I, Micheli, LJ, Nitka, M, and Rowland, TW. Youth resistance training: Updated position statement paper from the National Strength and Conditioning Association. J Strength Cond Res 23(5): S60-S79, 2009-Current recommendations suggest that school-aged youth should participate daily in 60 minutes or more of moderate to vigorous physical activity that is developmentally appropriate and enjoyable and involves a variety of activities (). Not only is regular physical activity essential for normal growth and development, but also a physically active lifestyle during the pediatric years may help to reduce the risk of developing some chronic diseases later in life (). In addition to aerobic activities such as swimming and bicycling, research increasingly indicates that resistance training can offer unique benefits for children and adolescents when appropriately prescribed and supervised (). The qualified acceptance of youth resistance training by medical, fitness, and sport organizations is becoming universal ().Nowadays, comprehensive school-based programs are specifically designed to enhance health-related components of physical fitness, which include muscular strength (). In addition, the health club and sport conditioning industry is getting more involved in the youth fitness market. In the U.S.A., the number of health club members between the ages of 6 and 17 years continues to increase () and a growing number of private sport conditioning centers now cater to young athletes. Thus, as more children and adolescents resistance train in schools, health clubs, and sport training centers, it is imperative to determine safe, effective, and enjoyable practices by which resistance training can improve the health, fitness, and sports performance of younger populations.The National Strength and Conditioning Association (NSCA) recognizes and supports the premise that many of the benefits associated with adult resistance training

  9. Topical, geospatial, and temporal diffusion of the 2015 North American Menopause Society position statement on nonhormonal management of vasomotor symptoms.

    Science.gov (United States)

    Carpenter, Janet S; Laine, Tei; Harrison, Blake; LePage, Meghan; Pierce, Taran; Hoteling, Nathan; Börner, Katy

    2017-10-01

    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.

  10. An International Position Statement on the Management of Frailty in Diabetes Mellitus: Summary of Recommendations 2017.

    Science.gov (United States)

    Sinclair, A J; Abdelhafiz, A; Dunning, T; Izquierdo, M; Rodriguez Manas, L; Bourdel-Marchasson, I; Morley, J E; Munshi, M; Woo, J; Vellas, B

    2018-01-01

    The International Position Statement provides the opportunity to summarise all existing clinical trial and best practice evidence for older people with frailty and diabetes. It is the first document of its kind and is intended to support clinical decisions that will enhance safety in management and promote high quality care. The Review Group sought evidence from a wide range of studies that provide sufficient confidence (in the absence of grading) for the basis of each recommendation. This was supported by a given rationale and key references for our recommendations in each section, all of which have been reviewed by leading international experts. Searches for any relevant clinical evidence were generally limited to English language citations over the previous 15 years. The following databases were examined: Embase, Medline/PubMed, Cochrane Trials Register, Cinahl, and Science Citation. Hand searching of 16 key major peer-reviewed journals was undertaken by two reviewers (AJS and AA) and these included Lancet, Diabetes, Diabetologia, Diabetes Care, British Medical Journal, New England Journal of Medicine, Journal of the American Medical Association, Journal of Frailty and Aging, Journal of the American Medical Directors Association, and Journals of Gerontology - Series A Biological Sciences and Medical Sciences. Two scientific supporting statements have been provided that relate to the area of frailty and diabetes; this is accompanied by evidence-based decisions in 9 clinical domains. The Summary has been supported by diagrammatic figures and a table relating to the inter-relations between frailty and diabetes, a frailty assessment pathway, an exercise-based programme of intervention, a glucose-lowering algorithm with a description of available therapies. We have provided an up to date evidence-based approach to practical decision-making for older adults with frailty and diabetes. This Summary document includes a user-friendly set of recommendations that should be

  11. Prone position for the prevention of lung infection.

    Science.gov (United States)

    Beuret, P

    2002-04-01

    Pulmonary infection is frequent in brain injured patients. It has been identified as an independent predictor of unfavorable neurological outcome, calling for attempts of prevention. We recently evaluated intermittent prone positioning for the prevention of ventilator-associated pneumonia (VAP) in comatose brain injured patients, in a randomized study. 25 patients were included in the prone position (PP) group: they were positioned on prone four hours once daily until they could get up to sit in an armchair; 26 patients were included in the supine position (SP) group. The main characteristics of the patients from the two groups were similar at randomization. The primary end-point was the incidence of lung worsening, defined by an increase in the Lung Injury Score by at least one point since the time of randomization. The incidence of lung worsening was lower in the PP group (12%) than in the SP group (50%) (p=0.003). The incidence of VAP was 38.4% in the SP group and 20% in the PP group (p=0.14). There was no serious complication attributable to prone positioning. In conclusion, the beneficial effect of prone positioning for prevention of lung infection in brain injured patients is not well established. However, in those patients, prone positioning is able to avoid the worsening of pulmonary function, especially in oxygenation.

  12. Defining Quality in Visual Art Education for Young Children: Building on the Position Statement of the Early Childhood Art Educators

    Science.gov (United States)

    McClure, Marissa; Tarr, Patricia; Thompson, Christine Marmé; Eckhoff, Angela

    2017-01-01

    This article reflects the collective voices of four early childhood visual arts educators, each of whom is a member of the Early Childhood Art Educators (ECAE) Issues Group of the National Arts Educators Association. The authors frame the article around the ECAE position statement, "Art: Essential for Early Learning" (2016), which…

  13. Correlative Studies in Clinical Trials: A Position Statement From the International Thyroid Oncology Group.

    Science.gov (United States)

    Bible, Keith C; Cote, Gilbert J; Demeure, Michael J; Elisei, Rossella; Jhiang, Sissy; Ringel, Matthew D

    2015-12-01

    Patients with progressive thyroid cancer in distant metastatic sites represent a population with a need for new therapeutic options. Aspiring to improve the treatment of such patients, the objective of this position statement from the International Thyroid Oncology Group (ITOG) is to clarify the importance of incorporating high-quality correlative studies into clinical trials. ITOG was formed to develop and support high-quality multicenter and multidisciplinary clinical trials for patients with aggressive forms of thyroid cancer. The Correlative Sciences Committee of the ITOG focuses on the quality and types of correlative studies included in ITOG-associated clinical trials. This document represents expert consensus from ITOG regarding this issue based on extensive collective experience in clinical and translational trials informed by basic science. The Correlative Studies Committee identified an international writing group representative of diverse specialties, including basic sciences. Drafts were reviewed by all members of the writing group, the larger committee, and the ITOG board. After consideration of all comments by the writing group and modification of the document, the final document was then approved by the authors and the ITOG board. High-quality correlative studies, which include variety in the types of correlates, should be intrinsic to the design of thyroid cancer clinical trials to offer the best opportunity for each study to advance treatment for patients with advanced and progressive thyroid cancer.

  14. Australian Institute of Sport and Australian Medical Association position statement on concussion in sport.

    Science.gov (United States)

    Elkington, Lisa J; Hughes, David C

    2017-01-16

    Sport-related concussion is a growing health concern in Australia. Public concern is focused on the incidence and potential long term consequences of concussion. Children may be more prone to concussion and take longer to recover. The Australian Institute of Sport and the Australian Medical Association have collaborated to present the most contemporary evidence-based information in a format appropriate for all stakeholders. This position statement aims to ensure that participant safety and welfare is paramount when dealing with concussion in sport.First aid principles apply in the management of the athlete with suspected concussion, including protection of the cervical spine. Tools exist for use by members of the community, allowing identification of key symptoms and signs that raise the suspicion of concussion. Medical professionals should use the Sport Concussion Assessment Tool 3, in conjunction with clinical assessment for the diagnosis of concussion. Clinical assessment includes mechanism of injury, symptoms and signs, cognitive functioning, and neurological assessment including balance testing. In any situation where concussion is suspected, the athlete must be immediately removed from sport and not be allowed to return to activity until they have been assessed by a medical practitioner. "If in doubt, sit them out."A diagnosis of concussion requires immediate physical and cognitive rest, followed by a structured, graduated return to physical activity. Children require a longer period of recovery from concussion. Algorithms are provided for use by medical and non-medically trained stakeholders in the recognition and management of concussion.

  15. Practice guidelines on the use of esophageal manometry - A GISMAD-SIGE-AIGO medical position statement.

    Science.gov (United States)

    Savarino, Edoardo; de Bortoli, Nicola; Bellini, Massimo; Galeazzi, Francesca; Ribolsi, Mentore; Salvador, Renato; Savarino, Vincenzo; Penagini, Roberto

    2016-10-01

    Patients with esophageal symptoms potentially associated to esophageal motor disorders such as dysphagia, chest pain, heartburn and regurgitation, represent one of the most frequent reasons for referral to gastroenterological evaluation. The utility of esophageal manometry in clinical practice is: (1) to accurately define esophageal motor function, (2) to identify abnormal motor function, and (3) to establish a treatment plan based on motor abnormalities. With this in mind, in the last decade, investigations and technical advances, with the introduction of high-resolution esophageal manometry, have enhanced our understanding and management of esophageal motility disorders. The following recommendations were developed to assist physicians in the appropriate use of esophageal manometry in modern patient care. They were discussed and approved after a comprehensive review of the medical literature pertaining to manometric techniques and their recent application. This position statement created under the auspices of the Gruppo Italiano di Studio per la Motilità dell'Apparato Digerente (GISMAD), Società Italiana di Gastroenterologia ed Endoscopia Digestiva (SIGE) and Associazione Italiana Gastroenterologi ed Endoscopisti Digestivi Ospedalieri (AIGO) is intended to help clinicians in applying manometric studies in the most fruitful manner within the context of their patients with esophageal symptoms. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  16. Harmonizing and consolidating the measurement of patient-reported information at health care institutions: a position statement of the Mayo Clinic

    Directory of Open Access Journals (Sweden)

    Eton DT

    2014-02-01

    Full Text Available David T Eton,1,2 Timothy J Beebe,1,2 Philip T Hagen,3 Michele Y Halyard,4 Victor M Montori,1,5 James M Naessens,1,2 Jeff A Sloan,6 Carrie A Thompson,7 Douglas L Wood1,81Division of Heath Care Policy and Research, Department of Health Sciences Research, 2Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 3Department of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN, 4Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, 5Knowledge and Evaluation Research Unit, 6Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, 7Division of Hematology, Department of Medicine, 8Center for Innovation, Mayo Clinic, Rochester, MN, USAAbstract: Patient-reported outcomes (PROs capture how patients perceive their health and their health care; their use in clinical research is longstanding. Today, however, PROs increasingly are being used to inform the care of individual patients, and document the performance of health care entities. We recently wrote and internally distributed an institutional position statement titled "Harmonizing and Consolidating the Measurement of Patient-Reported Outcomes at Mayo Clinic: A Position Statement for the Center for the Science of Health Care Delivery". The statement is meant to educate clinicians, clinical teams, and institutional administrators about the merits of using PROs in a systematic manner for clinical care and quality measurement throughout the institution. The present article summarizes the most important messages from the statement, describing PROs and their use, identifying practical considerations for implementing them in routine practice, elucidating potential barriers to their use, and formulating strategies to overcome these barriers. The lessons learned from our experience – including pitfalls, challenges, and successes – may inform other health care institutions that are interested in

  17. Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Siu, Albert L

    2016-02-16

    Update of the 2009 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for breast cancer. The USPSTF reviewed the evidence on the following: effectiveness of breast cancer screening in reducing breast cancer-specific and all-cause mortality, as well as the incidence of advanced breast cancer and treatment-related morbidity; harms of breast cancer screening; test performance characteristics of digital breast tomosynthesis as a primary screening strategy; and adjunctive screening in women with increased breast density. In addition, the USPSTF reviewed comparative decision models on optimal starting and stopping ages and intervals for screening mammography; how breast density, breast cancer risk, and comorbidity level affect the balance of benefit and harms of screening mammography; and the number of radiation-induced breast cancer cases and deaths associated with different screening mammography strategies over the course of a woman's lifetime. This recommendation applies to asymptomatic women aged 40 years or older who do not have preexisting breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age. The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. (B recommendation) The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years. (C recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to

  18. Position statement on 'Economic Impact of Oil and Gas Development within the Province of Newfoundland and Labrador

    International Nuclear Information System (INIS)

    1998-01-01

    This document contains the statement outlining the official position of the Newfoundland Ocean Industries Association (NOIA) concerning the report on the 'Economic Impact of Oil and Gas Development within the Province of Newfoundland and Labrador'. NOIA's position reflects the concern that Newfoundland businesses and individuals be involved in this emerging industry. Not unexpectedly, the statement is directed primarily towards improving economic opportunity for its members, but it also argues in favour of increasing economic activity within the province as whole. The Position Statement addresses six major issues of concern. These are: a full and fair opportunity for Newfoundland-resident supply and service companies to bid on an internationally competitive basis; a level playing field for all those who submit bids for contracts; enhancement of Newfoundland technology, expertise and facilities, as well as support of technology transfer to interested and capable Newfoundland businesses or companies; a life-of-field approach to planning, or linking capital expenditure and operational expenditure in order to achieve long-term positive economic impact within Newfoundland and Labrador; a supplier development program to encourage the development of an internationally competitive Newfoundland supply community; and the encouragement of operators and major contractors to fulfill specific requirements for positive economic impact within the province

  19. Systematic review and practice policy statements on urinary tract infection prevention in adults with spina bifida

    Science.gov (United States)

    Tradewell, Michael; Pariser, Joseph J.; Nimeh, Tony

    2018-01-01

    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

  20. Implementation of the 2017 Berlin Concussion in Sport Group Consensus Statement in contact and collision sports: a joint position statement from 11 national and international sports organisations.

    Science.gov (United States)

    Patricios, Jon S; Ardern, Clare L; Hislop, Michael David; Aubry, Mark; Bloomfield, Paul; Broderick, Carolyn; Clifton, Patrick; Echemendia, Ruben J; Ellenbogen, Richard G; Falvey, Éanna Cian; Fuller, Gordon Ward; Grand, Julie; Hack, Dallas; Harcourt, Peter Rex; Hughes, David; McGuirk, Nathan; Meeuwisse, Willem; Miller, Jeffrey; Parsons, John T; Richiger, Simona; Sills, Allen; Moran, Kevin B; Shute, Jenny; Raftery, Martin

    2018-05-01

    The 2017 Berlin Concussion in Sport Group Consensus Statement provides a global summary of best practice in concussion prevention, diagnosis and management, underpinned by systematic reviews and expert consensus. Due to their different settings and rules, individual sports need to adapt concussion guidelines according to their specific regulatory environment. At the same time, consistent application of the Berlin Consensus Statement's themes across sporting codes is likely to facilitate superior and uniform diagnosis and management, improve concussion education and highlight collaborative research opportunities. This document summarises the approaches discussed by medical representatives from the governing bodies of 10 different contact and collision sports in Dublin, Ireland in July 2017. Those sports are: American football, Australian football, basketball, cricket, equestrian sports, football/soccer, ice hockey, rugby league, rugby union and skiing. This document had been endorsed by 11 sport governing bodies/national federations at the time of being published. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Dietary exposures and allergy prevention in high-risk infants: A joint statement with the Canadian Society of Allergy and Clinical Immunology.

    Science.gov (United States)

    Chan, Edmond S; Cummings, Carl

    2013-12-01

    Allergic conditions in children are a prevalent health concern in Canada. The burden of disease and the societal costs of proper diagnosis and management are considerable, making the primary prevention of allergic conditions a desirable health care objective. This position statement reviews current evidence on dietary exposures and allergy prevention in infants at high risk for developing allergic conditions. It revisits previous dietary recommendations for pregnancy, breastfeeding and formula feeding, and provides an approach for introducing solid foods to high-risk infants. While there is no evidence that delaying the introduction of any specific food beyond six months of age helps to prevent allergy, the protective effect of early introduction of potentially allergenic foods (at four to six months of age) remains under investigation. Recent research appears to suggest that regularly ingesting a new, potentially allergenic food may be as important as when that food is first introduced.

  2. Implementation of the 2017 Berlin Concussion in Sport Group Consensus Statement in contact and collision sports: a joint position statement from 11 national and international sports organisations

    Science.gov (United States)

    Patricios, Jon S; Hislop, Michael David; Aubry, Mark; Bloomfield, Paul; Broderick, Carolyn; Clifton, Patrick; Ellenbogen, Richard G; Falvey, Éanna Cian; Grand, Julie; Hack, Dallas; Harcourt, Peter Rex; Hughes, David; McGuirk, Nathan; Meeuwisse, Willem; Miller, Jeffrey; Parsons, John T; Richiger, Simona; Sills, Allen; Moran, Kevin B; Shute, Jenny; Raftery, Martin

    2018-01-01

    The 2017 Berlin Concussion in Sport Group Consensus Statement provides a global summary of best practice in concussion prevention, diagnosis and management, underpinned by systematic reviews and expert consensus. Due to their different settings and rules, individual sports need to adapt concussion guidelines according to their specific regulatory environment. At the same time, consistent application of the Berlin Consensus Statement’s themes across sporting codes is likely to facilitate superior and uniform diagnosis and management, improve concussion education and highlight collaborative research opportunities. This document summarises the approaches discussed by medical representatives from the governing bodies of 10 different contact and collision sports in Dublin, Ireland in July 2017. Those sports are: American football, Australian football, basketball, cricket, equestrian sports, football/soccer, ice hockey, rugby league, rugby union and skiing. This document had been endorsed by 11 sport governing bodies/national federations at the time of being published. PMID:29500252

  3. Prevention and management of non-communicable disease: the IOC consensus statement, Lausanne 2013.

    Science.gov (United States)

    Matheson, Gordon O; Klügl, Martin; Engebretsen, Lars; Bendiksen, Fredrik; Blair, Steven N; Börjesson, Mats; Budgett, Richard; Derman, Wayne; Erdener, Uğur; Ioannidis, John P A; Khan, Karim M; Martinez, Rodrigo; van Mechelen, Willem; Mountjoy, Margo; Sallis, Robert E; Schwellnus, Martin; Shultz, Rebecca; Soligard, Torbjørn; Steffen, Kathrin; Sundberg, Carl Johan; Weiler, Richard; Ljungqvist, Arne

    2013-11-01

    Morbidity and mortality from preventable, non-communicable chronic disease (NCD) threatens the health of our populations and our economies. The accumulation of vast amounts of scientific knowledge has done little to change this. New and innovative thinking is essential to foster new creative approaches that leverage and integrate evidence through the support of big data, technology, and design thinking. The purpose of this paper is to summarize the results of a consensus meeting on NCD prevention sponsored by the International Olympic Committee (IOC) in April, 2013. Within the context of advocacy for multifaceted systems change, the IOC's focus is to create solutions that gain traction within health care systems. The group of participants attending the meeting achieved consensus on a strategy for the prevention and management of chronic disease that includes the following: 1. Focus on behavioural change as the core component of all clinical programs for the prevention and management of chronic disease. 2. Establish actual centres to design, implement, study, and improve preventive programs for chronic disease. 3. Use human-centered design in the creation of prevention programs with an inclination to action, rapid prototyping and multiple iterations. 4. Extend the knowledge and skills of Sports and Exercise Medicine (SEM) professionals to build new programs for the prevention and treatment of chronic disease focused on physical activity, diet and lifestyle. 5. Mobilize resources and leverage networks to scale and distribute programs of prevention. True innovation lies in the ability to align thinking around these core strategies to ensure successful implementation of NCD prevention and management programs within health care. The IOC and SEM community are in an ideal position to lead this disruptive change. The outcome of the consensus meeting was the creation of the IOC Non-Communicable Diseases ad-hoc Working Group charged with the responsibility of moving this

  4. Prevention and management of noncommunicable disease: the IOC Consensus Statement, Lausanne 2013.

    Science.gov (United States)

    Matheson, Gordon O; Klügl, Martin; Engebretsen, Lars; Bendiksen, Fredrik; Blair, Steven N; Börjesson, Mats; Budgett, Richard; Derman, Wayne; Erdener, Uğur; Ioannidis, John P A; Khan, Karim M; Martinez, Rodrigo; van Mechelen, Willem; Mountjoy, Margo; Sallis, Robert E; Schwellnus, Martin; Shultz, Rebecca; Soligard, Torbjørn; Steffen, Kathrin; Sundberg, Carl Johan; Weiler, Richard; Ljungqvist, Arne

    2013-11-01

    Morbidity and mortality from preventable, noncommunicable chronic disease (NCD) threatens the health of our populations and our economies. The accumulation of vast amounts of scientific knowledge has done little to change this. New and innovative thinking is essential to foster new creative approaches that leverage and integrate evidence through the support of big data, technology, and design thinking. The purpose of this paper is to summarize the results of a consensus meeting on NCD prevention sponsored by the International Olympic Committee (IOC) in April 2013. Within the context of advocacy for multifaceted systems change, the IOC's focus is to create solutions that gain traction within health care systems. The group of participants attending the meeting achieved consensus on a strategy for the prevention and management of chronic disease that includes the following: 1. Focus on behavioral change as the core component of all clinical programs for the prevention and management of chronic disease. 2. Establish actual centers to design, implement, study, and improve preventive programs for chronic disease. 3. Use human-centered design (HCD) in the creation of prevention programs with an inclination to action, rapid prototyping and multiple iterations. 4. Extend the knowledge and skills of Sports and Exercise Medicine (SEM) professionals to build new programs for the prevention and treatment of chronic disease focused on physical activity, diet, and lifestyle. 5. Mobilize resources and leverage networks to scale and distribute programs of prevention. True innovation lies in the ability to align thinking around these core strategies to ensure successful implementation of NCD prevention and management programs within health care. The IOC and SEM community are in an ideal position to lead this disruptive change. The outcome of the consensus meeting was the creation of the IOC Non-Communicable Diseases ad hoc Working Group charged with the responsibility of moving this

  5. Addressing Household Food Insecurity in Canada - Position Statement and Recommendations - Dietitians of Canada.

    Science.gov (United States)

    2016-09-01

    POSITION STATEMENT It is the position of Dietitians of Canada that household food insecurity is a serious public health issue with profound effects on physical and mental health and social well-being. All households in Canada must have sufficient income for secure access to nutritious food after paying for other basic necessities. Given the alarming prevalence, severity and impact of household food insecurity in Canada, Dietitians of Canada calls for a pan-Canadian, government-led strategy to specifically reduce food insecurity at the household level, including policies that address the unique challenges of household food insecurity among Indigenous Peoples. Regular monitoring of the prevalence and severity of household food insecurity across all of Canada is required. Research must continue to address gaps in knowledge about household vulnerability to food insecurity and to evaluate the impact of policies developed to eliminate household food insecurity in Canada. Dietitians of Canada recommends: Development and implementation of a pan-Canadian government-led strategy that includes coordinated policies and programs, to ensure all households have consistent and sufficient income to be able to pay for basic needs, including food. Implementation of a federally-supported strategy to comprehensively address the additional and unique challenges related to household food insecurity among Indigenous Peoples, including assurance of food sovereignty, with access to lands and resources, for acquiring traditional/country foods, as well as improved access to more affordable and healthy store-bought/market foods in First Nation reserves and northern and remote communities. Commitment to mandatory, annual monitoring and reporting of the prevalence of marginal, moderate and severe household food insecurity in each province and territory across Canada, including among vulnerable populations, as well as regular evaluation of the impact of poverty reduction and protocols for

  6. Audit of the US Department of Energy`s consolidated statement of financial position as of September 30, 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-02-29

    In preparation for fulfilling our responsibilities under the Government Management Reform Act of 1994, we planned to conduct an audit of the Department of Energy`s FY 1995 Consolidated Statement of Financial Position. As discussed in the accompanying reports, the Office of Inspector General (OIG) could not express an opinion on the reasonableness of the value of assets and liabilities of the Department because of matters outside the control of the auditors that restricted the scope of their work. Although the OIG could not express an opinion, the audit disclosed reportable conditions in the Department`s internal control structure that adversely affected its ability to manage and account for its assets and liabilities. Corrective management actions on these reportable conditions should help the Department in preparing its Fiscal Year (FY) 1996 Statement of Financial Position.

  7. Position statement of the Australian Diabetes Society: individualisation of glycated haemoglobin targets for adults with diabetes mellitus.

    Science.gov (United States)

    Cheung, N Wah; Conn, Jennifer J; d'Emden, Michael C; Gunton, Jenny E; Jenkins, Alicia J; Ross, Glynis P; Sinha, Ashim K; Andrikopoulos, Sofianos; Colagiuri, Stephen; Twigg, Stephen M

    2009-09-21

    Tight glycaemic control reduces the risk of development and progression of organ complications in people with type 1 or type 2 diabetes. In this position statement, the Australian Diabetes Society recommends a general target glycated haemoglobin (HbA(1c)) level of position statement also provides guidelines for the individualisation of glycaemic targets to a tighter or lesser degree, with a recommended target HbA(1c) level of diabetes and its duration, pregnancy, diabetes medication being taken, presence of cardiovascular disease, risk of and problems from hypoglycaemia, and comorbidities. Management of diabetes also includes: adequate control of other cardiovascular risk factors, including weight, blood pressure and lipid serum levels; antiplatelet therapy; and smoking cessation.

  8. Screening for Obstructive Sleep Apnea in Adults: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Davidson, Karina W; Epling, John W; García, Francisco A R; Herzstein, Jessica; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phillips, William R; Phipps, Maureen G; Pignone, Michael P; Silverstein, Michael; Tseng, Chien-Wen

    2017-01-24

    Based on data from the 1990s, estimated prevalence of obstructive sleep apnea (OSA) in the United States is 10% for mild OSA and 3.8% to 6.5% for moderate to severe OSA; current prevalence may be higher, given the increasing prevalence of obesity. Severe OSA is associated with increased all-cause mortality, cardiovascular disease and cerebrovascular events, diabetes, cognitive impairment, decreased quality of life, and motor vehicle crashes. To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for OSA in asymptomatic adults. The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of screening for OSA in asymptomatic adults seen in primary care, including those with unrecognized symptoms. The USPSTF also evaluated the evidence on the benefits and harms of treatment of OSA on intermediate and final health outcomes. The USPSTF found insufficient evidence on screening for or treatment of OSA in asymptomatic adults or adults with unrecognized symptoms. Therefore, the USPSTF was unable to determine the magnitude of the benefits or harms of screening for OSA or whether there is a net benefit or harm to screening. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for OSA in asymptomatic adults. (I statement).

  9. Position statement: start middle and high schools at 8:30 am or later to promote student health and learning.

    Science.gov (United States)

    Trevorrow, Tracy; Zhou, Eric S; Dietch, Jessica R; Gonzalez, Brian D

    2018-03-13

    The Society of Behavioral Medicine recommends school officials start middle and high school classes at 8:30 am or later. Such a schedule promotes students' sleep health, resulting in improvements in physical health, psychological well-being, attention and concentration, academic performance, and driving safety. In this position statement, we propose a four-tiered approach to promote later school start times for middle and high schools.

  10. Estrogen and progestogen use in postmenopausal women: July 2008 position statement of The North American Menopause Society

    Science.gov (United States)

    2009-01-01

    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

  11. Ethics of genetic testing and research in sport: a position statement from the Australian Institute of Sport

    OpenAIRE

    Vlahovich, Nicole; Fricker, Peter A; Brown, Matthew A; Hughes, David

    2016-01-01

    As Australia's peak high-performance sport agency, the Australian Institute of Sport (AIS) has developed this position statement to address the implications of recent advances in the field of genetics and the ramifications for the health and well-being of athletes. Genetic testing has proven of value in the practice of clinical medicine. There are, however, currently no scientific grounds for the use of genetic testing for athletic performance improvement, sport selection or talent identifica...

  12. A Clustered Randomized Controlled Trial of the Positive Prevention PLUS Adolescent Pregnancy Prevention Program.

    Science.gov (United States)

    LaChausse, Robert G

    2016-09-01

    To determine the impact of Positive Prevention PLUS, a school-based adolescent pregnancy prevention program on delaying sexual intercourse, birth control use, and pregnancy. I randomly assigned a diverse sample of ninth grade students in 21 suburban public high schools in California into treatment (n = 2483) and control (n = 1784) groups that participated in a clustered randomized controlled trial. Between October 2013 and May 2014, participants completed baseline and 6-month follow-up surveys regarding sexual behavior and pregnancy. Participants in the treatment group were offered Positive Prevention PLUS, an 11-lesson adolescent pregnancy prevention program. The program had statistically significant impacts on delaying sexual intercourse and increasing the use of birth control. However, I detected no program effect on pregnancy rates at 6-month follow-up. The Positive Prevention PLUS program demonstrated positive impacts on adolescent sexual behavior. This suggests that programs that focus on having students practice risk reduction skills may delay sexual activity and increase birth control use.

  13. National Athletic Trainers' Association position statement: safe weight loss and maintenance practices in sport and exercise.

    Science.gov (United States)

    Turocy, Paula Sammarone; DePalma, Bernard F; Horswill, Craig A; Laquale, Kathleen M; Martin, Thomas J; Perry, Arlette C; Somova, Marla J; Utter, Alan C

    2011-01-01

    To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes and clients to achieve and maintain weight and body composition goals. Unsafe weight management practices can compromise athletic performance and negatively affect health. Athletes and clients often attempt to lose weight by not eating, limiting caloric or specific nutrients from the diet, engaging in pathogenic weight control behaviors, and restricting fluids. These people often respond to pressures of the sport or activity, coaches, peers, or parents by adopting negative body images and unsafe practices to maintain an ideal body composition for the activity. We provide athletic trainers with recommendations for safe weight loss and weight maintenance in sport and exercise. Although safe weight gain is also a concern for athletic trainers and their athletes and clients, that topic is outside the scope of this position statement. Athletic trainers are often the source of nutrition information for athletes and clients; therefore, they must have knowledge of proper nutrition, weight management practices, and methods to change body composition. Body composition assessments should be done in the most scientifically appropriate manner possible. Reasonable and individualized weight and body composition goals should be identified by appropriately trained health care personnel (eg, athletic trainers, registered dietitians, physicians). In keeping with the American Dietetics Association (ADA) preferred nomenclature, this document uses the terms registered dietitian or dietician when referring to a food and nutrition expert who has met the academic and professional requirements specified by the ADA's Commission on Accreditation for Dietetics Education. In some cases, a registered nutritionist may have equivalent credentials and be the

  14. Overweight and obesity in youth in schools-the role of the school nurse: position statement.

    Science.gov (United States)

    2014-05-01

    It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as the school nurse) has the knowledge and expertise to promote the prevention of overweight and obesity and address the needs of overweight and obese youth in schools. The school nurse collaborates with students, families, school personnel, and health care providers to promote healthy weight and identify overweight and obese youth who may be at risk for health problems. The school nurse can refer and follow up with students who may need to see a health care provider. The school nurse also educates and advocates for changes in school and district policies that promote a healthy lifestyle for all students.

  15. The Patient Protection and Affordable Care Act - The Role of the School Nurse: Position Statement.

    Science.gov (United States)

    2015-07-01

    It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as the school nurse) serves a vital role in the delivery of health care to our nation’s students within the health care system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as the Affordable Care Act (ACA). This law presents an opportunity to transform the health care system through three primary goals: expanding access, improving quality, and reducing cost (U.S. Government Printing Office, 2010). School nurses stand at the forefront of this system change and continue to provide evidence-based, quality interventions and preventive care that, according to recent studies, actually save health care dollars (Wang et al., 2014). NASN supports the concept that school nursing services receive the same financial parity as other health care providers to improve overall health outcomes, including insurance reimbursement for services provided to students.

  16. The influence of publication of financial statements, risk of takeover and financial position of the auditee on public auditors' unethical behaviour

    NARCIS (Netherlands)

    van Dijk, M

    2000-01-01

    This study examines the effects of publication of financial statements, the risk of a takeover of the auditee and the auditee's financial position on auditors' willingness to allow material errors in financial statements in case of management pressure. The results show that all factors significantly

  17. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON TESTING FOR AUTONOMIC AND SOMATIC NERVE DYSFUNCTION.

    Science.gov (United States)

    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

    2017-12-01

    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.

  18. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON THE ASSOCIATION OF TESTOSTERONE AND CARDIOVASCULAR RISK.

    Science.gov (United States)

    Goodman, Neil; Guay, Andre; Dandona, Paresh; Dhindsa, Sandeep; Faiman, Charles; Cunningham, Glenn R

    2015-09-01

    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.

  19. Spirometry training courses: Content, delivery and assessment - a position statement from the Australian and New Zealand Society of Respiratory Science.

    Science.gov (United States)

    Swanney, Maureen P; O'Dea, Christopher A; Ingram, Emily R; Rodwell, Leanne T; Borg, Brigitte M

    2017-10-01

    Spirometry training courses are provided by health services and training organizations to enable widespread use of spirometry testing for patient care or for monitoring health. The primary outcome of spirometry training courses should be to enable participants to perform spirometry to international best practice, including testing of subjects, quality assurance and interpretation of results. Where valid results are not achieved or quality assurance programmes identify errors in devices, participants need to be able to adequately manage these issues in accordance with best practice. It is important that potential participants are confident in the integrity of the course they attend and that the course meets their expectations in terms of training. This position statement lists the content that the Australian and New Zealand Society of Respiratory Science (ANZSRS) has identified as required in a spirometry training course to adequately meet the primary outcomes mentioned above. The content requirements outlined in this position statement are based on the current international spirometry standards set out by the American Thoracic Society and European Respiratory Society. Furthermore, recommendations around course delivery for theoretical and practical elements of spirometry testing and post-course assessment are outlined in this statement. © 2017 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.

  20. Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society.

    Science.gov (United States)

    2015-11-01

    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

  1. Vitamin, mineral, and multivitamin supplements for the primary prevention of cardiovascular disease and cancer: U.S. Preventive services Task Force recommendation statement.

    Science.gov (United States)

    Moyer, Virginia A

    2014-04-15

    Update of the 2003 U.S. Preventive Services Task Force (USPSTF) recommendation on vitamin supplementation to prevent cardiovascular disease and cancer. The USPSTF reviewed the evidence on the efficacy of multivitamin or mineral supplements in the general adult population for the prevention of cardiovascular disease and cancer. This recommendation applies to healthy adults without special nutritional needs (typically aged 50 years or older). It does not apply to children, women who are pregnant or may become pregnant, or persons who are chronically ill or hospitalized or have a known nutritional deficiency. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of multivitamins for the prevention of cardiovascular disease or cancer. (I statement). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of single- or paired-nutrient supplements (except β-carotene and vitamin E) for the prevention of cardiovascular disease or cancer. (I statement). The USPSTF recommends against β-carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer. (D recommendation).

  2. World Sight Day 2013 Memorandum - Farabi Statement on the Prevention of Blindness and Eye Health

    Directory of Open Access Journals (Sweden)

    S-Farzad Mohammadi

    2013-12-01

    Tested’.1 This call will encourage the public to seek care and challenge the local eye healthcare facilities for eye care and services. WSD at Farabi Eye Hospital During the past years, WSD has been held in Iran through a variety of events. Farabi Eye Hospital organized a celebration of the WSD 2013 in collaboration with the Ministry of Health and the National Institute for Health Research. The municipality socio-cultural department of the Hospital locality also organized the social aspects of the event. The scientific program titled ‘Ophthalmic Epidemiology & Eye Health Seminar’ was held for the 1st time in Iran. The scientific program comprised three symposia: evidence on eye health and diseases in Iran; policy making for eye health; and low vision and disability. We had 2 keynote lectures on ‘social determinants of eye health’ and ‘universal access to eye health’. The morning sessions were concluded by articulating the Farabi Statement on the Prevention of Blindness and Eye Health 2013 by the event presidents (see Appendix, pages 322-323. In the afternoon, 2 workshops on diabetic retinopathy screening and artificial intelligence were held. Participants included ophthalmologists, optometrists, and community medicine, public health, and epidemiology experts, and young scholars. The social program offered free of charge optometry services for local senior citizens referred by the district Community Houses (i.e. Get Your Eyes Tested!. We also held a painting competition on the theme of sight for children younger than 10, and a best text message competition. The event received massive media coverage. Farabi Eye Hospital is now more than ever committed to public eye health.

  3. Statement of the Spanish Interdisciplinary Cardiovascular Prevention Committee (CEIPC for its Spanish acronym) on the 2012 European Cardiovascular Prevention Guidelines.

    Science.gov (United States)

    Royo-Bordonada, M A; Lobos Bejarano, J M; Villar Alvarez, F; Sans, S; Pérez, A; Pedro-Botet, J; Moreno Carriles, R M; Maiques, A; Lizcano, Á; Lizarbe, V; Gil Núñez, A; Fornés Ubeda, F; Elosua, R; de Santiago Nocito, A; de Pablo Zarzosa, C; de Álvaro Moreno, F; Cortés, O; Cordero, A; Camafort Babkowski, M; Brotons Cuixart, C; Armario, P

    2016-04-01

    Based on the two main frameworks for evaluating scientific evidence (SEC and GRADE) European cardiovascular prevention guidelines recommend interventions across all life stages using a combination of population-based and high-risk strategies with diet as the cornerstone of prevention. The evaluation of cardiovascular risk (CVR) incorporates HDL levels and psychosocial factors, a very high risk category, and the concept of age-risk. They also recommend cognitive-behavioural methods (e.g., motivational interviewing, psychological interventions) led by health professionals and with the participation of the patient's family, to counterbalance psychosocial stress and reduce CVR through the institution of positive habits such as a healthy diet, physical activity, smoking cessation, and adherence to treatment. Additionally, public health interventions - such as smoking ban in public areas or the elimination of trans fatty acids from the food chain - are also essential. Other innovations include abandoning antiplatelet therapy in primary prevention and the recommendation of maintaining blood pressure within the 130-139/80-85 mmHg range in diabetic patients and individuals with high CVR. Finally, due to the significant impact on patient progress and medical costs, special emphasis is given to the low therapeutic adherence levels observed. In sum, improving cardiovascular prevention requires a true partnership among the political class, public administrations, scientific and professional associations, health foundations, consumer associations, patients and their families. Such partnership would promote population-based and individual strategies by taking advantage of the broad spectrum of scientific evidence available, from clinical trials to observational studies and mathematical models to evaluate population-based interventions, including cost-effectiveness analyses. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights

  4. [Statement of the Spanish Interdisciplinary Cardiovascular Prevention Committee (CEIPC for its Spanish acronym) on the 2012 European Cardiovascular Prevention Guidelines].

    Science.gov (United States)

    Royo-Bordonada, Miguel Angel; Lobos Bejarano, José María; Villar Alvarez, Fernando; Sans, Susana; Pérez, Antonio; Pedro-Botet, Juan; Moreno Carriles, Rosa María; Maiques, Antonio; Lizcano, Angel; Lizarbe, Vicenta; Gil Núñez, Antonio; Fornés Ubeda, Francisco; Elosua, Roberto; de Santiago Nocito, Ana; de Pablo Zarzosa, Carmen; de Álvaro Moreno, Fernando; Cortés, Olga; Cordero, Alberto; Camafort Babkowski, Miguel; Brotons Cuixart, Carlos; Armario, Pedro

    2013-01-01

    Based on the two main frameworks for evaluating scientific evidence (SEC and GRADE) European cardiovascular prevention guidelines recommend interventions across all life stages using a combination of population-based and high-risk strategies with diet as the cornerstone of prevention. The evaluation of cardiovascular risk (CVR) incorporates HDL levels and psychosocial factors, a very high risk category, and the concept of age-risk. They also recommend cognitive-behavioural methods (e.g., motivational interviewing, psychological interventions) led by health professionals and with the participation of the patient's family, to counterbalance psychosocial stress and reduce CVR through the institution of positive habits such as a healthy diet, physical activity, smoking cessation, and adherence to treatment. Additionally, public health interventions - such as smoking ban in public areas or the elimination of trans fatty acids from the food chain - are also essential. Other innovations include abandoning antiplatelet therapy in primary prevention and the recommendation of maintaining blood pressure within the 130-139/80-85mmHg range in diabetic patients and individuals with high CVR. Finally, due to the significant impact on patient progress and medical costs, special emphasis is given to the low therapeutic adherence levels observed. In sum, improving cardiovascular prevention requires a true partnership among the political class, public administrations, scientific and professional associations, health foundations, consumer associations, patients and their families. Such partnership would promote population-based and individual strategies by taking advantage of the broad spectrum of scientific evidence available, from clinical trials to observational studies and mathematical models to evaluate population-based interventions, including cost-effectiveness analyses. Copyright © 2013 Elsevier España, S.L. y SEA. All rights reserved.

  5. Major Deficiencies Preventing Auditors From Rendering Audit Opinions on DOD General Fund Financial Statements

    National Research Council Canada - National Science Library

    Rauu, Russell

    1995-01-01

    .... This report gives Congress, the Secretary of Defense, the DoD Chief Financial Officer, financial managers, and the audit community an assessment of progress made in audited financial statements of DoD general funds...

  6. Organization position statements and the stance of "studied neutrality" on euthanasia in palliative care.

    Science.gov (United States)

    Johnstone, Megan-Jane

    2012-12-01

    In recent years, palliative care and related organizations have increasingly adopted a stance of "studied neutrality" on the question of whether euthanasia should be legalized as a bona fide medical regimen in palliative care contexts. This stance, however, has attracted criticism from both opponents and proponents of euthanasia. Pro-euthanasia activists see the stance as an official position of indecision that is fundamentally disrespectful of a patient's right to "choose death" when life has become unbearable. Some palliative care constituents, in turn, are opposed to the stance, contending that it reflects an attitude of "going soft" on euthanasia and as weakening the political resistance that has hitherto been successful in preventing euthanasia from becoming more widely legalized. In this article, attention is given to examining critically the notion and possible unintended consequences of adopting a stance of studied neutrality on euthanasia in palliative care. It is argued that although palliative care and related organizations have an obvious stake in the outcome of the euthanasia debate, it is neither unreasonable nor inconsistent for such organizations to be unwilling to take a definitive stance on the issue. It is further contended that, given the long-standing tenets of palliative care, palliative care organizations have both a right and a responsibility to defend the integrity of the principles and practice of palliative care and to resist demands for euthanasia to be positioned either as an integral part or logical extension of palliative care. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  7. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation.

    Science.gov (United States)

    Bray, G A; Kim, K K; Wilding, J P H

    2017-07-01

    This paper considers the argument for obesity as a chronic relapsing disease process. Obesity is viewed from an epidemiological model, with an agent affecting the host and producing disease. Food is the primary agent, particularly foods that are high in energy density such as fat, or in sugar-sweetened beverages. An abundance of food, low physical activity and several other environmental factors interact with the genetic susceptibility of the host to produce positive energy balance. The majority of this excess energy is stored as fat in enlarged, and often more numerous fat cells, but some lipid may infiltrate other organs such as the liver (ectopic fat). The enlarged fat cells and ectopic fat produce and secrete a variety of metabolic, hormonal and inflammatory products that produce damage in organs such as the arteries, heart, liver, muscle and pancreas. The magnitude of the obesity and its adverse effects in individuals may relate to the virulence or toxicity of the environment and its interaction with the host. Thus, obesity fits the epidemiological model of a disease process except that the toxic or pathological agent is food rather than a microbe. Reversing obesity will prevent most of its detrimental effects. © 2017 World Obesity Federation.

  8. Position Statement on Motivations, Methodologies, and Practical Implications of Educational Neuroscience Research: fMRI Studies of the Neural Correlates of Creative Intelligence

    Science.gov (United States)

    Geake, John

    2011-01-01

    In this position statement it is argued that educational neuroscience must necessarily be relevant to, and therefore have implications for, both educational theory and practice. Consequently, educational neuroscientific research necessarily must embrace educational research questions in its remit.

  9. Personal Services and Benefits Expenses in The FY 1996 Statement of Operations and Changes in Net Position of the Other Defense Organizations

    National Research Council Canada - National Science Library

    1997-01-01

    .... Specifically, we reviewed the DoD Chief Financial Officers Other Defense Organizations Statement of Operations and Changes in Net Position for the year ended September 30, 1996, to determine whether...

  10. Radon Gas in Ireland Joint Position Statement by the Radiological Protection Institute of Ireland and the Health Service Executive

    International Nuclear Information System (INIS)

    Part, A.M.; Colgan, P.A.; Fenton, D.; Kelly, I.; Long, S.; O'Mahony, M.; Pollard, D.

    2010-04-01

    This position statement is written by the Health Service Executive and the Radiological Protection Institute of Ireland with a view to forming and influencing policy in this area. It provides a summary of the health risks associated with radon exposure in Ireland and the steps that can be taken to reduce those risks. It outlines suggested ongoing work to reduce both the population dose from radon and the individual dose to those most at risk and considers future work needed to improve national policy to achieve these objectives

  11. Society position statement : Canadian Cardiovascular Society/Canadian Anesthesiologists' Society/Canadian Heart Rhythm Society joint position statement on the perioperative management of patients with implanted pacemakers, defibrillators, and neurostimulating devices.

    Science.gov (United States)

    Healey, Jeff S; Merchant, Richard; Simpson, Chris; Tang, Timothy; Beardsall, Marianne; Tung, Stanley; Fraser, Jennifer A; Long, Laurene; van Vlymen, Janet M; Manninen, Pirjo; Ralley, Fiona; Venkatraghavan, Lashmi; Yee, Raymond; Prasloski, Bruce; Sanatani, Shubhayan; Philippon, François

    2012-04-01

    There are more than 200,000 Canadians living with permanent pacemakers or implantable defibrillators, many of whom will require surgery or invasive procedures each year. They face potential hazards when undergoing surgery; however, with appropriate planning and education of operating room personnel, adverse device-related outcomes should be rare. This joint position statement from the Canadian Cardiovascular Society (CCS) and the Canadian Anesthesiologists' Society (CAS) has been developed as an accessible reference for physicians and surgeons, providing an overview of the key issues for the preoperative, intraoperative, and postoperative care of these patients. The document summarizes the limited published literature in this field, but for most issues, relies heavily on the experience of the cardiologists and anesthesiologists who contributed to this work. This position statement outlines how to obtain information about an individual's type of pacemaker or implantable defibrillator and its programming. It also stresses the importance of determining if a patient is highly pacemaker-dependent and proposes a simple approach for nonelective evaluation of dependency. Although the document provides a comprehensive list of the intraoperative issues facing these patients, there is a focus on electromagnetic interference resulting from electrocautery and practical guidance is given regarding the characteristics of surgery, electrocautery, pacemakers, and defibrillators which are most likely to lead to interference. The document stresses the importance of preoperative consultation and planning to minimize complications. It reviews the relative merits of intraoperative magnet use vs reprogramming of devices and gives examples of situations where one or the other approach is preferable.

  12. The Australasian radiation protection society's position statement on risks from low levels of ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Don, Higson; Ches, Mason; Andrew, McEwan; Peter, Burns; Riaz, Akber; Ron, Cameron; Pamela, Sykes; Joe, Young [Australasian Radiation Protection Society (Australia)

    2006-07-01

    At its Annual General Meeting in 2004, the Australasian Radiation Protection Society (A.R.P.S.) set up a working group to draft a statement of the Society's position on risks from low levels of exposure to ionizing radiation. The resulting position statement was adopted by the Society at its Annual General Meeting in 2005. Its salient features are as follows: First, there is insufficient evidence to establish a dose-effect relationship for doses that are less than a few tens of milli sieverts in a year. A linear extrapolation from higher dose levels should be assumed only for the purpose of applying regulatory controls. Secondly, estimates of collective dose arising from individual doses that are less than some tens of milli sieverts in a year should not be used to predict numbers of fatal cancers. Thirdly, the risk to an individual of doses significantly less than 100 micro sieverts in a year is so small, if it exists at all, that regulatory requirements to control exposure at this level are not warranted. (authors)

  13. Do published ADA studies support the ADA-EASD position statement for the management of hyperglycaemia in type 2 diabetics?

    Science.gov (United States)

    Rimareix, Frédérique; Bauduceau, Bernard

    2013-07-01

    The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published a position statement in 2012 on the management of hyperglycaemia in patients with type 2 diabetes. The Société Francophone du Diabète (SFD) adopted it while awaiting future French recommendations. This new care approach individualises the therapeutic choices and objectives for each patient based on their characteristics, through emphasis on the need for mutual cooperation with the patient in decision-making. Glycaemic management should naturally be considered in the context of overall cardiovascular risk reduction, which should remain the primary objective of treatment. The cornerstone of this treatment is based on lifestyle modifications, with the addition of metformin monotherapy if the desired glycaemic control is not attained. There are multiple second- and third-line treatment possibilities, and insulin therapy is an option that can be considered early in the bitherapy stage. On the whole, large published studies at the ADA conference in Philadelphia in June 2012, which are the subject of this article, support this patient-centred position statement. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  14. Vision Screening in Children Aged 6 Months to 5 Years: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2017-09-05

    One of the most important causes of vision abnormalities in children is amblyopia (also known as "lazy eye"). Amblyopia is an alteration in the visual neural pathway in a child's developing brain that can lead to permanent vision loss in the affected eye. Among children younger than 6 years, 1% to 6% have amblyopia or its risk factors (strabismus, anisometropia, or both). Early identification of vision abnormalities could prevent the development of amblyopia. Studies show that screening rates among children vary by race/ethnicity and family income. Data based on parent reports from 2009-2010 indicated identical screening rates among black non-Hispanic children and white non-Hispanic children (80.7%); however, Hispanic children were less likely than non-Hispanic children to report vision screening (69.8%). Children whose families earned 200% or more above the federal poverty level were more likely to report vision screening than families with lower incomes. To update the 2011 US Preventive Services Task Force (USPSTF) recommendation on screening for amblyopia and its risk factors in children. The USPSTF reviewed the evidence on the accuracy of vision screening tests and the benefits and harms of vision screening and treatment. Surgical interventions were considered to be out of scope for this review. Treatment of amblyopia is associated with moderate improvements in visual acuity in children aged 3 to 5 years, which are likely to result in permanent improvements in vision throughout life. The USPSTF concluded that the benefits are moderate because untreated amblyopia results in permanent, uncorrectable vision loss, and the benefits of screening and treatment potentially can be experienced over a child's lifetime. The USPSTF found adequate evidence to bound the potential harms of treatment (ie, higher false-positive rates in low-prevalence populations) as small. Therefore, the USPSTF concluded with moderate certainty that the overall net benefit is moderate for

  15. Statement of Financial Position for the Commissary Resale Stock Fund, as of September 30, 1994

    National Research Council Canada - National Science Library

    Young, Shelton

    1995-01-01

    .... We evaluated the DeCA and DFAS-CO internal control structure for ensuring that material misstatements were prevented or detected in asset and liability account balances as well as their compliance...

  16. The clinical application of genome-wide sequencing for monogenic diseases in Canada: Position Statement of the Canadian College of Medical Geneticists

    OpenAIRE

    Boycott, Kym; Hartley, Taila; Adam, Shelin; Bernier, Francois; Chong, Karen; Fernandez, Bridget A; Friedman, Jan M; Geraghty, Michael T; Hume, Stacey; Knoppers, Bartha M; Laberge, Anne-Marie; Majewski, Jacek; Mendoza-Londono, Roberto; Meyn, M Stephen; Michaud, Jacques L

    2015-01-01

    Purpose and scope The aim of this Position Statement is to provide recommendations for Canadian medical geneticists, clinical laboratory geneticists, genetic counsellors and other physicians regarding the use of genome-wide sequencing of germline DNA in the context of clinical genetic diagnosis. This statement has been developed to facilitate the clinical translation and development of best practices for clinical genome-wide sequencing for genetic diagnosis of monogenic diseases in Canada; it...

  17. Position Statement: Drug Holiday in Osteoporosis Treatment with Bisphosphonates in South Korea

    Science.gov (United States)

    Lee, Seung Hun; Gong, Hyun Sik; Kim, Tae-Hee; Park, Si Young; Shin, Jung-Ho; Cho, Sun Wook

    2015-01-01

    Bisphosphonates have been widely used in the treatment of osteoporosis with robust data from many placebo-controlled trials demonstrating its efficacy in fracture risk reduction over 3 to 5 years of treatment. Although bisphosphonates are generally safe and well tolerated, concerns have emerged about the adverse effects related to its long-term use, including osteonecrosis of the jaw and atypical femur fractures. Because bisphosphonates are incorporated into the skeleton and continue to exert an anti-resorptive effect for a period of time after the discontinuation of drugs, the concept of a "drug holiday" has emerged, whereby the risk of adverse effects might be decreased while the patient still benefits from anti-fracture efficacy. As randomized clinical trial evidence is not yet available on who may qualify for a drug holiday, there is considerable controversy regarding the selection of candidates for the drug holiday and monitoring during a drug holiday, both of which should be based on individual assessments of risk and benefit. This statement will provide suggestions for clinicians in South Korea on the identification of possible candidates and monitoring during a bisphosphonate drug holiday. PMID:26713307

  18. Neuromodulation of chronic headaches: position statement from the European Headache Federation

    Science.gov (United States)

    2013-01-01

    The medical treatment of patients with chronic primary headache syndromes (chronic migraine, chronic tension-type headache, chronic cluster headache, hemicrania continua) is challenging as serious side effects frequently complicate the course of medical treatment and some patients may be even medically intractable. When a definitive lack of responsiveness to conservative treatments is ascertained and medication overuse headache is excluded, neuromodulation options can be considered in selected cases. Here, the various invasive and non-invasive approaches, such as hypothalamic deep brain stimulation, occipital nerve stimulation, stimulation of sphenopalatine ganglion, cervical spinal cord stimulation, vagus nerve stimulation, transcranial direct current stimulation, repetitive transcranial magnetic stimulation, and transcutaneous electrical nerve stimulation are extensively published although proper RCT-based evidence is limited. The European Headache Federation herewith provides a consensus statement on the clinical use of neuromodulation in headache, based on theoretical background, clinical data, and side effect of each method. This international consensus further gives recommendations for future studies on these new approaches. In spite of a growing field of stimulation devices in headaches treatment, further controlled studies to validate, strengthen and disseminate the use of neurostimulation are clearly warranted. Consequently, until these data are available any neurostimulation device should only be used in patients with medically intractable syndromes from tertiary headache centers either as part of a valid study or have shown to be effective in such controlled studies with an acceptable side effect profile. PMID:24144382

  19. The Complementary Roles of the School Nurse and School Based Health Centers. Position Statement

    Science.gov (United States)

    Ondeck, Lynnette; Combe, Laurie; Baszler, Rita; Wright, Janet

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that the unique combination of school nursing services and school-based health centers (SBHCs) facilitate positive health outcomes for students. The registered professional school nurse (hereinafter referred to as school nurse) is responsible for management of the daily health…

  20. The School Nurse's Role in Behavioral Health of Students. Position Statement

    Science.gov (United States)

    McDermott, Elizabeth; Bohnenkamp, Jill Haak; Freedland, Mary; Baker, Dian; Palmer, Karla

    2017-01-01

    It is the position of the National Association of School Nurses (NASN) that registered, professional school nurses (hereinafter referred to as school nurses) serve a vital role in promoting positive behavioral health outcomes in students through evidence-based programs and curricula in schools and communities. Behavioral health is as critical to…

  1. Adolescent Health Care in School-Based Health Centers. Position Statement

    Science.gov (United States)

    National Assembly on School-Based Health Care, 2008

    2008-01-01

    School-based health centers (SBHCs) are considered one of the most effective strategies for delivering preventive care, including reproductive and mental health care services, to adolescents--a population long considered difficult to reach. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies to assure…

  2. Clinical value, cost-effectiveness, and safety of myocardial perfusion scintigraphy: a position statement

    DEFF Research Database (Denmark)

    Marcassa, C.; Bax, J.J.; Bengel, F.

    2008-01-01

    Mortality rates due to coronary artery disease (CAD) have declined in recent years as result of improved prevention, diagnosis, and management. Nonetheless, CAD remains the leading cause of death worldwide with most casualties expected to occur in developing nations. Myocardial perfusion scintigr...

  3. Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, Seth; Mangione, Carol M; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2018-04-17

    benefits and harms of vitamin D and calcium supplementation, alone or combined, for the primary prevention of fractures in community-dwelling, asymptomatic men and premenopausal women. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of daily supplementation with doses greater than 400 IU of vitamin D and greater than 1000 mg of calcium for the primary prevention of fractures in community-dwelling, postmenopausal women. (I statement) The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D and 1000 mg or less of calcium for the primary prevention of fractures in community-dwelling, postmenopausal women. (D recommendation) These recommendations do not apply to persons with a history of osteoporotic fractures, increased risk for falls, or a diagnosis of osteoporosis or vitamin D deficiency.

  4. Cardiac Society of Australia and New Zealand Position Statement: Coronary Artery Calcium Scoring.

    Science.gov (United States)

    Liew, Gary; Chow, Clara; van Pelt, Niels; Younger, John; Jelinek, Michael; Chan, Jonathan; Hamilton-Craig, Christian

    2017-12-01

    Coronary Artery Calcium Scoring (CAC) is a non-invasive quantitation of coronary artery calcification using computed tomography (CT). It is a marker of atherosclerotic plaque burden and an independent predictor of future myocardial infarction and mortality. Coronary Artery Calcium Scoring provides incremental risk information beyond traditional risk calculators (eg. Framingham Risk Score). Its use for risk stratification is confined to primary prevention of cardiovascular events, and can be considered as "individualised coronary risk scoring" for those not considered to be of high or low risk. Medical practitioners should carefully counsel patients prior to CAC. Coronary Artery Calcium Scoring should only be undertaken if an alteration in therapy including embarking on pharmacotherapy is being considered based on the test result. Patient Groups to Consider Coronary Calcium Scoring: Patient Groups in Whom Coronary Calcium Scoring Should Not be Considered: Coronary Artery Calcium Scoring is not recommended for patients who are: Interpretation of CAC CAC=0 A zero score confers a very low risk of death, 75th centile. Moderately high risk, 15-20% CAC >400 High risk, >20% Management Recommendations Based on CAC Optimal diet and lifestyle measures are encouraged in all risk groups and form the basis of primary prevention strategies. Patients with moderately-high or high risk based on CAC score are recommended to receive preventative medical therapy such as aspirin and statins. The evidence for pharmacotherapy is less robust in patients at intermediate levels of CAC 100-400, with modest benefit for aspirin use; though statins may be reasonable if they are above 75th centile. Aspirin and statins are generally not recommended in patients with CAC calcium score, routine re-scanning is not currently recommended. However, an annual increase in CAC of >15% or annual increase of CAC >100 units are predictive of future myocardial infarction and mortality. Cost Effectiveness of CAC

  5. WOCN Society and ASCRS Position Statement on Preoperative Stoma Site Marking for Patients Undergoing Colostomy or Ileostomy Surgery.

    Science.gov (United States)

    Salvadalena, Ginger; Hendren, Samantha; McKenna, Linda; Muldoon, Roberta; Netsch, Debra; Paquette, Ian; Pittman, Joyce; Ramundo, Janet; Steinberg, Gary

    2015-01-01

    Marking the optimal location for a stoma preoperatively enhances the likelihood of a patient's independence in stoma care, predictable pouching system wear times, and resumption of normal activities. Colon and rectal surgeons and certified ostomy nurses are the optimal clinicians to select and mark stoma sites, as this skill is a part of their education, practice, and training. However, these providers are not always available, particularly in emergency situations. The purpose of this position statement, developed by the Wound, Ostomy and Continence Nurses Society in collaboration with the American Society of Colon and Rectal Surgeons and the American Urological Association, is to provide a guideline to assist clinicians (especially those who are not surgeons or WOC nurses) in selecting an effective stoma site.

  6. American Society of Clinical Oncology Position Statement: Strategies for Reducing Cancer Health Disparities Among Sexual and Gender Minority Populations.

    Science.gov (United States)

    Griggs, Jennifer; Maingi, Shail; Blinder, Victoria; Denduluri, Neelima; Khorana, Alok A; Norton, Larry; Francisco, Michael; Wollins, Dana S; Rowland, Julia H

    2017-07-01

    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.

  7. Position statement of the Slovenian society of anaesthesiology and intensive care medicine on the use of sugammadex

    Directory of Open Access Journals (Sweden)

    Neva Požar Lukanović

    2018-06-01

    Full Text Available We present our position statement for the use of sugammadex, a specific binder for aminosteroid muscle relaxants, in the most common clinical circumstances (in the case of an emergency intubation, when the patient cannot be ventilated or intubated; in patients with neuro-muscular disease, in patients with liver failure, in patients with renal failure, in patients with allergic reaction to sugammadex or to rocuronium, in cases of residual muscle relaxation and when we have to use a muscle relaxant short time after sugammadex application. Sugammadex is the drug of choice in cases of cardiac arhythmia, COPD, asthma, neuro-muscular diseases, pathological obesity, intraoperative use of continuous infusion of aminoglycoside muscle relaxants. It is therefore necessary to control the neuro-muscular block during surgery due to different response of patients to the muscle relaxant. Clinical tests alone are not an adequate substitute for objective control of muscular strength recovery.

  8. Insulin Therapy for Adult Patients with Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association, 2017.

    Science.gov (United States)

    Lee, Byung Wan; Kim, Jin Hwa; Ko, Seung Hyun; Hur, Kyu Yeon; Kim, Nan Hee; Rhee, Sang Youl; Kim, Hyun Jin; Moon, Min Kyong; Park, Seok O; Choi, Kyung Mook

    2017-10-01

    The Korean Diabetes Association (KDA) has regularly updated its Clinical Practice Guidelines. In 2017, the KDA published a position statement on the use of antihyperglycemic agents for patients with type 2 diabetes mellitus (T2DM). Growing evidence from new multinational clinical trials using novel and traditional insulin analogues has also been accumulated. Following global trends, many results of clinical trials, especially concerning the clinical efficacy and safety of insulin therapy, have been published about Korean patients with T2DM. After a systematic search of recent evidence, the KDA updated and modified its clinical practice recommendations regarding the initiation, choice, and intensification of insulin and created an insulin treatment algorithm for the first time to guide physicians caring for adult Korean patients with T2DM. Copyright © 2017 Korean Diabetes Association.

  9. Insulin Therapy for Adult Patients with Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association, 2017

    Directory of Open Access Journals (Sweden)

    Byung-Wan Lee

    2017-10-01

    Full Text Available The Korean Diabetes Association (KDA has regularly updated its Clinical Practice Guidelines. In 2017, the KDA published a position statement on the use of antihyperglycemic agents for patients with type 2 diabetes mellitus (T2DM. Growing evidence from new multinational clinical trials using novel and traditional insulin analogues has also been accumulated. Following global trends, many results of clinical trials, especially concerning the clinical efficacy and safety of insulin therapy, have been published about Korean patients with T2DM. After a systematic search of recent evidence, the KDA updated and modified its clinical practice recommendations regarding the initiation, choice, and intensification of insulin and created an insulin treatment algorithm for the first time to guide physicians caring for adult Korean patients with T2DM.

  10. Canadian Association of Emergency Physicians position statement on acute ischemic stroke.

    Science.gov (United States)

    Harris, Devin; Hall, Christopher; Lobay, Kevin; McRae, Andrew; Monroe, Tanya; Perry, Jeffrey J; Shearing, Anthony; Wollam, Gabe; Goddard, Tom; Lang, Eddy

    2015-03-01

    The CAEP Stroke Practice Committee was convened in the spring of 2013 to revisit the 2001 policy statement on the use of thrombolytic therapy in acute ischemic stroke. The terms of reference of the panel were developed to include national representation from urban academic centres as well as community and rural centres from all regions of the country. Membership was determined by attracting recognized stroke leaders from across the country who agreed to volunteer their time towards the development of revised guidance on the topic. The guideline panel elected to adopt the GRADE language to communicate guidance after review of existing systematic reviews and international clinical practice guidelines. Stroke neurologists from across Canada were engaged to work alongside panel members to develop guidance as a dyad-based consensus when possible. There was no unique systematic review performed to support this guidance, rather existing efficacy data was relied upon. After a series of teleconferences and face to face meetings, a draft guideline was developed and presented to the CAEP board in June of 2014. The panel noted the development of significant new evidence to inform a number of clinical questions related to acute stroke management. In general terms the recommendations issued by the CAEP Stroke Practice Committee are supportive of the use of thrombolytic therapy when treatment can be administered within 3 hours of symptom onset. The committee is also supportive of system-level changes including pre-hospital interventions, the transport of patients to dedicated stroke centers when possible and tele-health measures to support thrombolytic therapy in a timely window. Of note, after careful deliberation, the panel elected to issue a conditional recommendation against the use of thrombolytic therapy in the 3–4.5 hour window. The view of the committee was that as a result of a narrow risk benefit balance, one that is considerably narrower than the same considerations

  11. Endocrine Society of Australia position statement on male hypogonadism (part 1): assessment and indications for testosterone therapy.

    Science.gov (United States)

    Yeap, Bu B; Grossmann, Mathis; McLachlan, Robert I; Handelsman, David J; Wittert, Gary A; Conway, Ann J; Stuckey, Bronwyn Ga; Lording, Douglas W; Allan, Carolyn A; Zajac, Jeffrey D; Burger, Henry G

    2016-08-15

    This article, Part 1 of the Endocrine Society of Australia's position statement on male hypogonadism, focuses on assessment of male hypogonadism, including the indications for testosterone therapy. (Part 2 will deal with treatment and therapeutic considerations.) Key points and recommendations are:Pathological hypogonadism arises due to diseases of the hypothalamus or pituitary gland (hypogonadotropic hypogonadism) or testes (hypergonadotropic hypogonadism). It is a clinical diagnosis with a pathological basis, confirmed by hormone assays.Hormonal assessment is based on measurement of circulating testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) concentrations. Measurement of sex hormone-binding globulin levels can be informative, but use of calculated free testosterone is not recommended for clinical decision making.Testosterone replacement therapy is warranted in men with pathological hypogonadism, regardless of age.Currently, there are limited data from high-quality randomised controlled trials with clinically meaningful outcomes to justify testosterone treatment in older men, usually with chronic disease, who have low circulating testosterone levels but without hypothalamic, pituitary or testicular disease.Obesity, metabolic syndrome and type 2 diabetes are associated with lowering of circulating testosterone level, but without elevation of LH and FSH levels. Whether these are non-specific consequences of non-reproductive disorders or a correctable deficiency state is unknown, but clear evidence for efficacy and safety of testosterone therapy in this setting is lacking.Glucocorticoid and opioid use is associated with possibly reversible reductions in circulating testosterone level, without elevation of LH and FSH levels. Where continuation of glucocorticoid or opioid therapy is necessary, review by an endocrinologist may be warranted.Changes in management as result of the position statement: Men with pathological hypogonadism should

  12. Position statement--altitude training for improving team-sport players' performance: current knowledge and unresolved issues.

    Science.gov (United States)

    Girard, Olivier; Amann, Markus; Aughey, Robert; Billaut, François; Bishop, David J; Bourdon, Pitre; Buchheit, Martin; Chapman, Robert; D'Hooghe, Michel; Garvican-Lewis, Laura A; Gore, Christopher J; Millet, Grégoire P; Roach, Gregory D; Sargent, Charli; Saunders, Philo U; Schmidt, Walter; Schumacher, Yorck O

    2013-12-01

    Despite the limited research on the effects of altitude (or hypoxic) training interventions on team-sport performance, players from all around the world engaged in these sports are now using altitude training more than ever before. In March 2013, an Altitude Training and Team Sports conference was held in Doha, Qatar, to establish a forum of research and practical insights into this rapidly growing field. A round-table meeting in which the panellists engaged in focused discussions concluded this conference. This has resulted in the present position statement, designed to highlight some key issues raised during the debates and to integrate the ideas into a shared conceptual framework. The present signposting document has been developed for use by support teams (coaches, performance scientists, physicians, strength and conditioning staff) and other professionals who have an interest in the practical application of altitude training for team sports. After more than four decades of research, there is still no consensus on the optimal strategies to elicit the best results from altitude training in a team-sport population. However, there are some recommended strategies discussed in this position statement to adopt for improving the acclimatisation process when training/competing at altitude and for potentially enhancing sea-level performance. It is our hope that this information will be intriguing, balanced and, more importantly, stimulating to the point that it promotes constructive discussion and serves as a guide for future research aimed at advancing the bourgeoning body of knowledge in the area of altitude training for team sports.

  13. Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2017-12-12

    Menopause occurs at a median age of 51.3 years, and the average US woman who reaches menopause is expected to live another 30 years. The prevalence and incidence of most chronic conditions, such as coronary heart disease, dementia, stroke, fractures, and breast cancer, increase with age; however, the excess risk for these conditions that can be attributed to menopause alone is uncertain. Since the publication of findings from the Women's Health Initiative that hormone therapy use is associated with serious adverse health effects in postmenopausal women, use of menopausal hormone therapy has declined. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on the use of menopausal hormone therapy for the primary prevention of chronic conditions. The USPSTF reviewed the evidence on the benefits and harms of systemic (ie, oral or transdermal) hormone therapy for the prevention of chronic conditions in postmenopausal women and whether outcomes vary among women in different subgroups or by timing of intervention after menopause. The review did not address hormone therapy for preventing or treating menopausal symptoms. Although the use of hormone therapy to prevent chronic conditions in postmenopausal women is associated with some benefits, there are also well-documented harms. The USPSTF determined that the magnitude of both the benefits and the harms of hormone therapy in postmenopausal women is small to moderate. Therefore, the USPSTF concluded with moderate certainty that combined estrogen and progestin has no net benefit for the primary prevention of chronic conditions for most postmenopausal women with an intact uterus and that estrogen alone has no net benefit for the primary prevention of chronic conditions for most postmenopausal women who have had a hysterectomy. The USPSTF recommends against the use of combined estrogen and progestin for the primary prevention of chronic conditions in postmenopausal women. (D recommendation) The USPSTF

  14. Emergency Preparedness--The Role of the School Nurse. Position Statement

    Science.gov (United States)

    Cagginello, Joan B.; Clark, Sandra; Compton, Linda; Davis, Catherine; Healy, Marilyn; Hoffmann, Susan; Tuck, Christine M.

    2011-01-01

    It is the position of the National Association of School Nurses (NASN) that school nurses provide leadership in all phases of emergency preparedness and management and are a vital part of the school team that develops emergency response procedures for the school setting, using an all-hazards approach. The school nurse is a vital school…

  15. The Patient Protection and Affordable Care Act: The Role of the School Nurse. Position Statement

    Science.gov (United States)

    Combe, Laurie G.; Sharpe, Susan; Feeser, Cynthia Jo; Ondeck, Lynnette; Fekaris, Nina

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) serves a vital role in the delivery of health care to our nation's students within the healthcare system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as…

  16. Unlicensed Assistive Personnel: Their Role on the School Health Services Team. Position Statement

    Science.gov (United States)

    Rose, Kathleen C.; Disney, Jody; Andresen, Kathleen; Tuck, Christine; Porter, Jessica; Bobo, Nicole

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that, where laws permit, unlicensed assistive personnel (UAP) can have valuable and necessary roles as assistants to school nurses. It is the professional responsibility of the registered professional school nurse (herein after referred to as school nurse) to identify UAP in…

  17. The Use of Volunteers in School Health Services. Position Statement. Revised

    Science.gov (United States)

    Rose, Kathleen C.; Blout, JoAnn; DiGregorio, Heiddy; Selekman, Janice

    2012-01-01

    It is the position of the National Association of School Nurses (NASN) that quality health care within the school environment can best be attained through the employment of a full-time registered professional school nurse (hereinafter referred to as school nurse) for each school building. The health services needed by students at school continue…

  18. Whole School, Whole Community, Whole Child: Implications for 21st Century School Nurses. Position Statement

    Science.gov (United States)

    Neumann, Linda; Combe, Laurie; Lambert, Patrice; Bartholomew, Kim; Morgan, Susan; Bobo, Nichole

    2017-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) be knowledgeable about and participate in the implementation of Whole School, Whole Community, Whole Child (WSCC) approach in the educational setting (ASCD & Centers for Disease Control…

  19. Do Not Attempt Resuscitation (DNAR)--The Role of the School Nurse. Position Statement

    Science.gov (United States)

    Tuck, Christine M.; Jordan, Alicia; Lambert, Patrice; Porter, Jessica

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that each student with a Do Not Attempt Resuscitation (DNAR) order have an Individualized Healthcare Plan (IHP) and an Emergency Care Plan (ECP) developed by the registered professional school nurse (hereinafter referred to as school nurse) with input from parents or guardians,…

  20. Students with Chronic Health Conditions: The Role of The School Nurse. Position Statement

    Science.gov (United States)

    Combe, Laurie G.; Mattern, Cheryl; Fleming, Laurie; Killingsworth, Suzie

    2017-01-01

    It is the position of the National Association of School Nurses (NASN) that to optimize student health, safety, and learning, a professional registered school nurse (hereinafter referred to as school nurse) be present all day, every day. The American Academy of Pediatrics' Council on School Health (2016) highlights the important role school nurses…

  1. Nursing Delegation to Unlicensed Assistive Personnel in the School Setting. Position Statement. Revised

    Science.gov (United States)

    Cagginello, Joan; Blackborow, Mary; Porter, Jessica; Disney, Jody; Andresen, Kathleen; Tuck, Christine

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that the delegation of nursing tasks in the school setting can be a valuable tool for the registered professional school nurse (hereinafter referred to as school nurse), when based on the nursing definition of delegation (American Nurses Association [ANA], 2012) and in…

  2. Sexual Orientation and Gender Identity/Expression (Sexual Minority Students): School Nurse Practice. Position Statement. Revised

    Science.gov (United States)

    Bradley, Beverly

    2012-01-01

    It is the position of the National Association of School Nurses that all students, regardless of their sexual orientation or the sexual orientation of their parents and family members, are entitled to a safe school environment and equal opportunities for a high level of academic achievement and school participation/involvement. Establishment of…

  3. Individualized Healthcare Plans: The Role of the School Nurse. Position Statement. Revised

    Science.gov (United States)

    McDowell, Bernadette Moran; Buswell, Sue A.; Mattern, Cheryl; Westendorf, Georgene; Clark, Sandra

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse), in collaboration with the student, family and healthcare providers, shall meet nursing regulatory requirements and professional standards by developing an Individualized Healthcare Plan…

  4. The Use of Restraints or Seclusion in the School Setting. Position Statement

    Science.gov (United States)

    Clark, Elizabeth; Compton, Linda; Westendorf, Georgene; Buswell, Sue; Chau, Elizabeth

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) is an essential advocate for the health and well-being of all students. Promoting a safe and secure environment is vital to the educational success and emotional development of children. The…

  5. 75 FR 78160 - Requirement of a Statement Disclosing Uncertain Tax Positions

    Science.gov (United States)

    2010-12-15

    ... amendments to the Income Tax Regulations (26 CFR part 1) under section 6012 relating to the returns of income... every person liable for income tax to make the returns required by regulation. Section 6012 requires... corporations to file a schedule disclosing uncertain tax positions related to the tax return as required by the...

  6. Sensitivity Analyses of Alternative Methods for Disposition of High-Level Salt Waste: A Position Statement

    International Nuclear Information System (INIS)

    Harris, S.P.; Tuckfield, R.C.

    1998-01-01

    This position paper provides the approach and detail pertaining to a sensitivity analysis for the Phase II definition of weighted evaluation criteria weights and utility function values on the total utility scores for each Initial List alternative due to uncertainty and bias in engineering judgment

  7. Physical Activity and Psychological Benefits. International Society of Sport Psychology Position Statement.

    Science.gov (United States)

    Physician and Sportsmedicine, 1992

    1992-01-01

    International Society of Sport Psychology clarifies the psychological benefits of physical activity, noting the positive relationship between physical activity level and mental health. Exercise can reduce anxiety, decrease depression levels, reduce neuroticism and anxiety, reduce stress, and have beneficial emotional effects for both sexes across…

  8. Allergy/Anaphylaxis Management in the School Setting. Position Statement. Revised

    Science.gov (United States)

    Zacharski, Susan; DeSisto, Marie; Pontius, Deborah; Sheets, Jodi; Richesin, Cynthia

    2012-01-01

    It is the position of the National Association of School Nurses (NASN) that the safe and effective management of allergies and anaphylaxis in schools requires a collaborative, multidisciplinary team approach. The registered professional school nurse (hereinafter referred to as the school nurse), is the leader in a comprehensive management approach…

  9. Position statement of the SEMI, SED, redGDPS, SEC, SEEDO, SEEN, SEMERGEN y SEMFYC.

    Science.gov (United States)

    Gómez Huelgas, R; Gómez Peralta, F; Carrillo Fernández, L; Galve, E; Casanueva, F F; Puig Domingo, M; Mediavilla Bravo, J J; Orozco Beltrán, D; Muñoz, J Ena; Menéndez Torre, E; Artola Menendez, S; Mazón Ramos, P; Monereo Megías, S; Caixas Pedrágos, A; López Simarro, F; Álvarez Guisasola, F

    2015-12-01

    Obesity and excess weight are the main preventable causes of type 2 diabetes (DM2). When diagnosing type 2 diabetes, clinicians should establish the degree of obesity according to the body mass index (BMI) and, for patients with excess weight, measure the waist circumference. The proper treatment of DM2 requires a simultaneous approach to excess weight/obesity and the other cardiovascular risk factors, such as hypertension, dyslipidaemia and smoking. Nondrug interventions (e.g., diet and exercise) have proven benefits in preventing and treating patients with DM2 and excess weight/obesity and should follow an individual and multidisciplinary approach, with structured programs equipped with specific resources. Weight gain associated with antidiabetic treatment can hinder glycaemic control, compromise treatment adherence, worsen the vascular risk profile and limit the cardiovascular benefits of treatment. Therefore, it is significant to avoid weight gain, a measure that can be cost-effective. Antidiabetic drugs with benefits in body weight have also demonstrated their benefit in patients with BMIs <30. In general, the treatment of patients with DM2 and obesity will depend both on the degree of obesity and the associated comorbidity. Clinical trials on DM2 intervention should consider combined objectives that include not only glycaemic control but also other variables such as the risk of hypoglycaemia and the effect of treatment on body weight. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  10. Overweight and Obesity in Youth in Schools--The Role of the School Nurse. Position Statement. Revised

    Science.gov (United States)

    Mehrley, Melissa; Leibold, Nancyruth

    2011-01-01

    It is the position of the National Association of School Nurses that school nurses have the knowledge and expertise to promote the prevention of overweight and obesity and address the needs of overweight and obese youth in schools. The school nurse collaborates with students, families, school personnel, and health care providers to promote healthy…

  11. Intellectual Disability Policy as Developed, Expressed, and Valuated in AAIDD/The Arc Joint Statements: The Role of Organization Position Statements

    Science.gov (United States)

    Luckasson, Ruth; Ford, Marty E.; McMillan, Elise D.; Misilo, Frederick M., Jr.; Nygren, Margaret A.

    2017-01-01

    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…

  12. Management of non variceal upper gastrointestinal bleeding: position statement of the Catalan Society of Gastroenterology.

    Science.gov (United States)

    García-Iglesias, Pilar; Botargues, Josep-Maria; Feu Caballé, Faust; Villanueva Sánchez, Càndid; Calvet Calvo, Xavier; Brullet Benedi, Enric; Cánovas Moreno, Gabriel; Fort Martorell, Esther; Gallach Montero, Marta; Gené Tous, Emili; Hidalgo Rosas, José-Manuel; Lago Macía, Amelia; Nieto Rodríguez, Ana; Papo Berger, Michel; Planella de Rubinat, Montserrat; Saló Rich, Joan; Campo Fernández de Los Ríos, Rafel

    2017-05-01

    In recent years there have been advances in the management of non-variceal upper gastrointestinal bleeding that have helped reduce rebleeding and mortality. This document positioning of the Catalan Society of Digestologia is an update of evidence-based recommendations on management of gastrointestinal bleeding peptic ulcer. Copyright © 2016 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  13. Sports Dietitians Australia position statement: sports nutrition for the adolescent athlete.

    Science.gov (United States)

    Desbrow, Ben; McCormack, Joanna; Burke, Louise M; Cox, Gregory R; Fallon, Kieran; Hislop, Matthew; Logan, Ruth; Marino, Nello; Sawyer, Susan M; Shaw, Greg; Star, Anita; Vidgen, Helen; Leveritt, Michael

    2014-10-01

    It is the position of Sports Dietitians Australia (SDA) that adolescent athletes have unique nutritional requirements as a consequence of undertaking daily training and competition in addition to the demands of growth and development. As such, SDA established an expert multidisciplinary panel to undertake an independent review of the relevant scientific evidence and consulted with its professional members to develop sports nutrition recommendations for active and competitive adolescent athletes. The position of SDA is that dietary education and recommendations for these adolescent athletes should reinforce eating for long term health. More specifically, the adolescent athlete should be encouraged to moderate eating patterns to reflect daily exercise demands and provide a regular spread of high quality carbohydrate and protein sources over the day, especially in the period immediately after training. SDA recommends that consideration also be given to the dietary calcium, Vitamin D and iron intake of adolescent athletes due to the elevated risk of deficiency of these nutrients. To maintain optimal hydration, adolescent athletes should have access to fluids that are clean, cool and supplied in sufficient quantities before, during and after participation in sport. Finally, it is the position of SDA that nutrient needs should be met by core foods rather than supplements, as the recommendation of dietary supplements to developing athletes over-emphasizes their ability to manipulate performance in comparison with other training and dietary strategies.

  14. NCI Statement on the U.S. Surgeon General's "Call to Action to Prevent Skin Cancer"

    Science.gov (United States)

    As the Federal Government's principal agency for cancer research and training, the National Cancer Institute (NCI) endorses the U.S. Surgeon General’s “Call to Action to Prevent Skin Cancer,” which provides a comprehensive evaluation of the current state of skin cancer prevention efforts in the United States and recommends actions for improvement in the future.

  15. American Society for Pain Management Nursing (ASPMN) position statement: male infant circumcision pain management.

    Science.gov (United States)

    O'Conner-Von, Susan; Turner, Helen N

    2013-12-01

    The ASPMN strongly recommends that infants who are being circumcised must receive optimal pain management. ‘‘If a decision for circumcision is made, procedural analgesia should be provided’’ (AAP, 1999, p. 691). Therefore, it is the position of the ASPMN that optimal pain management must be provided throughout the circumcision process. Furthermore, parents must be prepared for the procedure and educated about infant pain assessment. They must also be informed of pharmacologic and integrative pain management therapies that are appropriate before, during, and after the procedure.

  16. 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries

    Science.gov (United States)

    Ekås, Guri Ranum; Grindem, Hege; Moksnes, Håvard; Anderson, Allen F; Chotel, Franck; Cohen, Moises; Forssblad, Magnus; Ganley, Theodore J; Feller, Julian A; Karlsson, Jón; Kocher, Minider S; LaPrade, Robert F; McNamee, Michael; Mandelbaum, Bert; Micheli, Lyle; Mohtadi, Nicholas; Reider, Bruce; Roe, Justin; Seil, Romain; Siebold, Rainer; Witvrouw, Erik; Engebretsen, Lars

    2018-01-01

    In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions. PMID:29478021

  17. The SWEET SPOTS study: a real-world interpretation of the 2012 American Diabetes Association Position Statement regarding individualized A1C targets.

    Science.gov (United States)

    Bieszk, Nella; Grabner, Michael; Wei, Wenhui; Bonine, Nicole G; Stephenson, Judith J

    2016-01-01

    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.

  18. American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance.

    Science.gov (United States)

    Thomas, D Travis; Erdman, Kelly Anne; Burke, Louise M

    2016-03-01

    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.

  19. (Re)politicising and (re)positioning prevention: community ...

    African Journals Online (AJOL)

    They also signal a need to critically re-evaluate “community mobilisation” as an AIDS prevention tradition. Intersecting social and political power dynamics play a significant role in both opening up and constraining community mobilisation efforts. This paper proposes the need for a pedagogical turn to “deep organising” and ...

  20. Financial Statements Analysis

    OpenAIRE

    Tănase Alin-Eliodor

    2014-01-01

    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.

  1. Exercise and sports science Australia (ESSA) position statement on exercise and spinal cord injury.

    Science.gov (United States)

    Tweedy, Sean M; Beckman, Emma M; Geraghty, Timothy J; Theisen, Daniel; Perret, Claudio; Harvey, Lisa A; Vanlandewijck, Yves C

    2017-02-01

    Traumatic spinal cord injury (SCI) may result in tetraplegia (motor and/or sensory nervous system impairment of the arms, trunk and legs) or paraplegia (motor and/or sensory impairment of the trunk and/or legs only). The adverse effects of SCI on health, fitness and functioning are frequently compounded by profoundly sedentary behaviour. People with paraplegia (PP) and tetraplegia (TP) have reduced exercise capacity due to paralysis/paresis and reduced exercising stroke volume. TP often further reduces exercise capacity due to lower maximum heart-rate and respiratory function. There is strong, consistent evidence that exercise can improve cardiorespiratory fitness and muscular strength in people with SCI. There is emerging evidence for a range of other exercise benefits, including reduced risk of cardio-metabolic disease, depression and shoulder pain, as well as improved respiratory function, quality-of-life and functional independence. Exercise recommendations for people with SCI are: ≥30min of moderate aerobic exercise on ≥5d/week or ≥20min of vigorous aerobic ≥3d/week; strength training on ≥2d/week, including scapula stabilisers and posterior shoulder girdle; and ≥2d/week flexibility training, including shoulder internal and external rotators. These recommendations may be aspirational for profoundly inactive clients and stratification into "beginning", "intermediate" and "advanced" will assist application of the recommendations in clinical practice. Flexibility exercise is recommended to preserve upper limb function but may not prevent contracture. For people with TP, Rating of Perceived Exertion may provide a more valid indication of exercise intensity than heart rate. The safety and effectiveness of exercise interventions can be enhanced by initial screening for autonomic dysreflexia, orthostatic hypotension, exercise-induced hypotension, thermoregulatory dysfunction, pressure sores, spasticity and pain. Copyright © 2016 Sports Medicine Australia

  2. [Spanish Society of Hypertension position statement on the 2017 ACC/AHA hypertension guidelines].

    Science.gov (United States)

    Gijón-Conde, T; Gorostidi, M; Camafort, M; Abad-Cardiel, M; Martín-Rioboo, E; Morales-Olivas, F; Vinyoles, E; Armario, P; Banegas, J R; Coca, A; de la Sierra, A; Martell-Claros, N; Redón, J; Ruilope, L M; Segura, J

    2018-04-24

    The American College of Cardiology (ACC) and the American Heart Association (AHA) have recently published their guidelines for the prevention, detection, evaluation, and management of hypertension in adults. The most controversial issue is the classification threshold at 130/80mmHg, which will allow a large number of patients to be diagnosed as hypertensive who were previously considered normotensive. Blood pressure (BP) is considered normal (<120mmHg systolic and <80mmHg diastolic), elevated (120-129 and <80mmHg), stage 1 (130-139 or 80-89mmHg), and stage 2 (≥140 or ≥90mmHg). Out-of-office BP measurements are recommended to confirm the diagnosis of hypertension and for titration of BP-lowering medication. In management, cardiovascular risk would be determinant since those with grade 1 hypertension and an estimated 10-year risk of atherosclerotic cardiovascular disease ≥10%, and those with cardiovascular disease, chronic kidney disease and/or diabetes will require pharmacological treatment, the rest being susceptible to non-pharmacological treatment up to the 140/90mmHg threshold. These recommendations would allow patients with level 1 hypertension and high atherosclerotic cardiovascular disease to benefit from pharmacological therapies and all patients could also benefit from improved non-pharmacological therapies. However, this approach should be cautious because inadequate BP measurement and/or lack of systematic atherosclerotic cardiovascular disease calculation could lead to overestimation in diagnosing hypertension and to overtreatment. Guidelines are recommendations, not impositions, and the management of hypertension should be individualized, based on clinical decisions, preferences of the patients, and an adequate balance between benefits and risks. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Diabetes Australia position statement. A new language for diabetes: improving communications with and about people with diabetes.

    Science.gov (United States)

    Speight, J; Conn, J; Dunning, T; Skinner, T C

    2012-09-01

    Diabetes is the fastest growing chronic condition in Australia, affecting 1.7 million Australians, requiring daily self-care, and known to reduce quantity and quality of life. On average, people with diabetes experience greater emotional distress than those without diabetes. One source of distress can be the language used to refer to diabetes, its management and the person with diabetes. The way verbal and written language is used reflects and shapes people's thoughts, beliefs and behaviours. Language has the power to persuade, change or reinforce beliefs and stereotypes - for better or worse. Words do more than reflect people's reality: they create reality and affect how people view the world and their diabetes. Language needs to engage people with diabetes and support their self-care efforts. Importantly, language that de-motivates or induces fear, guilt or distress needs to be avoided and countered. Diabetes Australia believes optimal communication increases the motivation, health and well-being of people with diabetes, and that careless or negative language can be de-motivating, is often inaccurate, and can be harmful. Diabetes Australia developed this position statement to encourage greater awareness of the language surrounding diabetes and provide recommendations for more careful and positive language use. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  4. Screening for gestational diabetes mellitus : US preventive services task force recommendation statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Gordis, Leon; Gregory, Kimberly D.; Harris, Russell; Isham, George; LeFevre, Michael L.; Loveland-Cherry, Carol; Marion, Lucy N.; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Siu, Albert L.; Teutsch, Steven M.; Yawn, Barbara P.

    2008-01-01

    Description: Update of 2003 U. S. Preventive Services Task Force (USPSTF) recommendation about screening for gestational diabetes. Methods: The USPSTF weighed the evidence on maternal and neonatal benefits (reduction in preeclampsia, mortality, brachial plexus injury, clavicular fractures, admission

  5. Major Deficiencies Preventing Auditors From Rendering Audit Opinions on DOD General Fund Financial Statements

    National Research Council Canada - National Science Library

    Rauu, Russell

    1995-01-01

    .... We plan to issue a similar report each year. The audit objective was to identify and summarize the major deficiencies that prevented auditors from rendering audit opinions, other than disclaimers, on Army and Air Force general fund financial...

  6. Public acceptance of nuclear power: some ethical issues. [Position statement of World Council of Churches

    Energy Technology Data Exchange (ETDEWEB)

    Abrecht, P; Arungu-Olende, S; Francis, J M; de Gaspar, D; Nashed, W; Nwosu, B C.E.; Rose, D J; Shinn, R L

    1977-12-01

    The World Council of Churches favors the widest possible discussion of nuclear power issues with the immediate purpose of raising the level of public awareness of the social, political, and technical risks that are inevitably associated with the large-scale and accelerating adoption of nuclear power generation. Its general position on nuclear energy is presented as follows. (A) The availability of nuclear energy is a controversial feature of today's world in that it affords the opportunity to provide a large fraction of the world's energy needs, counter-balanced by the exceptional nature of the risks involved, and other problems related to the employment of large-scale, capital-intensive high technology. (B) The maturity of the nuclear energy system is not yet such as to justify its worldwide application; the consequences of large-scale expansion of nuclear energy production are still relatively poorly understood and require further assessment. (C) The rights of access to nuclear technology should be preserved to the extent that the nuclear ''haves'' may not deny the nuclear ''have nots'' by any form of exclusive consultation. (D) There should be sufficient discussion of the factors governing access to nuclear technology to bring all nations to a new awareness of its risks and uncertainties as well as its opportunities; and the collective responsibility for monitoring and administering safeguards should reside with the IAEA rather than with individual governments. (E) Public confidence in the use of nuclear energy, seriously shaken in recent years, can be revived only by the widest possible public discussion of the technical options and of the value judgements underlying present patterns of energy consumption.

  7. American Society of Clinical Oncology position statement on obesity and cancer.

    Science.gov (United States)

    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

    2014-11-01

    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.

  8. Prevention and Management of Non-Communicable Disease: The IOC Consensus Statement, Lausanne 2013

    NARCIS (Netherlands)

    Matheson, G.O.; Klugl, M.; Engebretsen, L.; Bendiksen, F.; Blair, S.N.; Borjesson, M.; Budgett, R.; Derman, W.; Erdener, U.; Ioannidis, J.P.A.; Khan, K.M.; Martinez, R.; van Mechelen, W.; Mountjoy, M.; Sallis, R.E.; Schwellnus, M.; Shultz, R.; Soligard, T.; Steffen, K.; Sundberg, C.J.; Weiler, R.; Ljungqvist, A.

    2013-01-01

    Morbidity and mortality from preventable, non-communicable chronic disease (NCD) threatens the health of our populations and our economies. The accumulation of vast amounts of scientific knowledge has done little to change this. New and innovative thinking is essential to foster new creative

  9. Ethics of genetic testing and research in sport: a position statement from the Australian Institute of Sport

    Science.gov (United States)

    Vlahovich, Nicole; Fricker, Peter A; Brown, Matthew A; Hughes, David

    2017-01-01

    As Australia's peak high-performance sport agency, the Australian Institute of Sport (AIS) has developed this position statement to address the implications of recent advances in the field of genetics and the ramifications for the health and well-being of athletes. Genetic testing has proven of value in the practice of clinical medicine. There are, however, currently no scientific grounds for the use of genetic testing for athletic performance improvement, sport selection or talent identification. Athletes and coaches should be discouraged from using direct-to-consumer genetic testing because of its lack of validation and replicability and the lack of involvement of a medical practitioner in the process. The transfer of genetic material or genetic modification of cells for performance enhancement is gene doping and should not be used on athletes. There are, however, valid roles for genetic research and the AIS supports genetic research which aims to enhance understanding of athlete susceptibility to injury or illness. Genetic research is only to be conducted after careful consideration of a range of ethical concerns which include the provision of adequate informed consent. The AIS is committed to providing leadership in delivering an ethical framework that protects the well-being of athletes and the integrity of sport, in the rapidly changing world of genomic science. PMID:27899345

  10. Ethics of genetic testing and research in sport: a position statement from the Australian Institute of Sport.

    Science.gov (United States)

    Vlahovich, Nicole; Fricker, Peter A; Brown, Matthew A; Hughes, David

    2017-01-01

    As Australia's peak high-performance sport agency, the Australian Institute of Sport (AIS) has developed this position statement to address the implications of recent advances in the field of genetics and the ramifications for the health and well-being of athletes. Genetic testing has proven of value in the practice of clinical medicine. There are, however, currently no scientific grounds for the use of genetic testing for athletic performance improvement, sport selection or talent identification. Athletes and coaches should be discouraged from using direct-to-consumer genetic testing because of its lack of validation and replicability and the lack of involvement of a medical practitioner in the process. The transfer of genetic material or genetic modification of cells for performance enhancement is gene doping and should not be used on athletes. There are, however, valid roles for genetic research and the AIS supports genetic research which aims to enhance understanding of athlete susceptibility to injury or illness. Genetic research is only to be conducted after careful consideration of a range of ethical concerns which include the provision of adequate informed consent. The AIS is committed to providing leadership in delivering an ethical framework that protects the well-being of athletes and the integrity of sport, in the rapidly changing world of genomic science. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Treatment of Type 2 Diabetes: From "Guidelines" to "Position Statements" and Back: Recommendations of the Israel National Diabetes Council.

    Science.gov (United States)

    Mosenzon, Ofri; Pollack, Rena; Raz, Itamar

    2016-08-01

    Given the increased prevalence of type 2 diabetes worldwide, most patients are treated by their primary health care team (PHCT). PHCTs need guidance in choosing the best treatment regimen for patients, since the number of glucose-lowering agents (GLAs) is rapidly increasing, as is the amount of clinical data regarding these drugs. The American Diabetes Association/European Association for the Study of Diabetes Position Statement emphasizes the importance of personalized treatment and lists drug efficacy, risk of hypoglycemia, effect on weight, side effects, and cost as important parameters to consider when choosing GLAs. The suggested Israeli guidelines refocus earlier international recommendations from 2012 and 2015, based on emerging data from cardiovascular outcome trials as well as what we believe are important issues for patient care (i.e., durability, hypoglycemia risk, and weight gain). © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  12. Antihyperglycemic Agent Therapy for Adult Patients with Type 2 Diabetes Mellitus 2017: A Position Statement of the Korean Diabetes Association.

    Science.gov (United States)

    Ko, Seung Hyun; Hur, Kyu Yeon; Rhee, Sang Youl; Kim, Nan Hee; Moon, Min Kyong; Park, Seok O; Lee, Byung Wan; Kim, Hyun Jin; Choi, Kyung Mook; Kim, Jin Hwa

    2017-10-01

    In 2017, the Korean Diabetes Association (KDA) published a position statement on the use of antihyperglycemic agents for patients with type 2 diabetes mellitus (T2DM). The KDA regularly updates its Clinical Practice Guidelines, but since the last update in 2015, many results from clinical trials have been introduced, and domestic data from studies performed in Korean patients with T2DM have been published. Recently, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorporated into the recommendations. Additionally, new data from clinical trials using dipeptidyl peptidase 4 inhibitors and thiazolidinediones in Korean patients with T2DM were added. Following a systematic review and assessment of recent evidence, the KDA updated and modified its clinical practice recommendations regarding the use of antihyperglycemic agents and revised the treatment algorithm for Korean adult patients with T2DM. Copyright © 2017 Korean Diabetes Association.

  13. Antihyperglycemic Agent Therapy for Adult Patients with Type 2 Diabetes Mellitus 2017: A Position Statement of the Korean Diabetes Association

    Directory of Open Access Journals (Sweden)

    Seung-Hyun Ko

    2017-10-01

    Full Text Available In 2017, the Korean Diabetes Association (KDA published a position statement on the use of antihyperglycemic agents for patients with type 2 diabetes mellitus (T2DM. The KDA regularly updates its Clinical Practice Guidelines, but since the last update in 2015, many results from clinical trials have been introduced, and domestic data from studies performed in Korean patients with T2DM have been published. Recently, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorporated into the recommendations. Additionally, new data from clinical trials using dipeptidyl peptidase 4 inhibitors and thiazolidinediones in Korean patients with T2DM were added. Following a systematic review and assessment of recent evidence, the KDA updated and modified its clinical practice recommendations regarding the use of antihyperglycemic agents and revised the treatment algorithm for Korean adult patients with T2DM.

  14. New possibilities in the prevention of eating disorders: The introduction of positive body image measures.

    Science.gov (United States)

    Piran, Niva

    2015-06-01

    Delineating positive psychological processes in inhabiting the body, as well as quantitative measures to assess them, can facilitate progress in the field of prevention of eating disorders by expanding outcome evaluation of prevention interventions, identifying novel mediators of change, and increasing highly needed research into protective factors. Moreover, enhancing positive ways of inhabiting the body may contribute toward the maintenance of gains of prevention interventions. Integrated social etiological models to eating disorders that focus on gender and other social variables, such as the Developmental Theory of Embodiment (Piran & Teall, 2012a), can contribute to positive body image intervention development and research within the prevention field. Using the Developmental Theory of Embodiment as a lens, this article explores whether existing prevention programs (i.e., Cognitive Dissonance and Media Smart) may already work to promote positive body image, and whether prevention programs need to be expanded toward this goal. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Genetic testing for exercise prescription and injury prevention: AIS-Athlome consortium-FIMS joint statement.

    Science.gov (United States)

    Vlahovich, Nicole; Hughes, David C; Griffiths, Lyn R; Wang, Guan; Pitsiladis, Yannis P; Pigozzi, Fabio; Bachl, Nobert; Eynon, Nir

    2017-11-14

    There has been considerable growth in basic knowledge and understanding of how genes are influencing response to exercise training and predisposition to injuries and chronic diseases. On the basis of this knowledge, clinical genetic tests may in the future allow the personalisation and optimisation of physical activity, thus providing an avenue for increased efficiency of exercise prescription for health and disease. This review provides an overview of the current status of genetic testing for the purposes of exercise prescription and injury prevention. As such there are a variety of potential uses for genetic testing, including identification of risks associated with participation in sport and understanding individual response to particular types of exercise. However, there are many challenges remaining before genetic testing has evidence-based practical applications; including adoption of international standards for genomics research, as well as resistance against the agendas driven by direct-to-consumer genetic testing companies. Here we propose a way forward to develop an evidence-based approach to support genetic testing for exercise prescription and injury prevention. Based on current knowledge, there is no current clinical application for genetic testing in the area of exercise prescription and injury prevention, however the necessary steps are outlined for the development of evidence-based clinical applications involving genetic testing.

  16. Linking the Prevention of Problem Behaviors and Positive Youth Development: Core Competencies for Positive Youth Development and Risk Prevention

    Science.gov (United States)

    Guerra, Nancy G.; Bradshaw, Catherine P.

    2008-01-01

    In this chapter, we present a brief review of the developmental literature linking healthy adjustment to five core competencies: (1) positive sense of self, (2) self-control, (3) decision-making skills, (4) a moral system of belief, and (5) prosocial connectedness. A central premise of this chapter and the rest of the volume is that promoting…

  17. Serologic Screening for Genital Herpes Infection: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Davidson, Karina W; Epling, John W; García, Francisco A R; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phillips, William R; Phipps, Maureen G; Pignone, Michael P; Silverstein, Michael; Tseng, Chien-Wen

    2016-12-20

    Genital herpes is a prevalent sexually transmitted infection in the United States, occurring in almost 1 in 6 persons aged 14 to 49 years. Infection is caused by 2 subtypes of the herpes simplex virus (HSV), HSV-1 and HSV-2. Antiviral medications may provide symptomatic relief from outbreaks but do not cure HSV infection. Neonatal herpes infection, while uncommon, can result in substantial morbidity and mortality. To update the 2005 US Preventive Services Task Force (USPSTF) recommendation on screening for genital herpes. The USPSTF reviewed the evidence on the accuracy, benefits, and harms of serologic screening for HSV-2 infection in asymptomatic persons, including those who are pregnant, as well as the effectiveness and harms of preventive medications and behavioral counseling interventions to reduce future symptomatic episodes and transmission to others. Based on the natural history of HSV infection, its epidemiology, and the available evidence on the accuracy of serologic screening tests, the USPSTF concluded that the harms outweigh the benefits of serologic screening for genital HSV infection in asymptomatic adolescents and adults, including those who are pregnant. The USPSTF recommends against routine serologic screening for genital HSV infection in asymptomatic adolescents and adults, including those who are pregnant. (D recommendation).

  18. Which technology to select for primary focal treatment of prostate cancer?-European Section of Urotechnology (ESUT) position statement.

    Science.gov (United States)

    Ganzer, Roman; Arthanareeswaran, Vinodh Kumar Adithyaa; Ahmed, Hashim U; Cestari, Andrea; Rischmann, Pascal; Salomon, Georg; Teber, Dogu; Liatsikos, Evangelos; Stolzenburg, Jens-Uwe; Barret, Eric

    2018-05-09

    With growing interest in focal therapy (FT) of prostate cancer (PCa) there is an increasing armamentarium of treatment modalities including high-intensity focused ultrasound (HIFU), cryotherapy, focal laser ablation (FLA), irreversible electroporation (IRE), vascular targeted photodynamic therapy (VTP), focal brachytherapy (FBT) and stereotactic ablative radiotherapy (SABR). Currently there are no clear recommendations as to which of these technologies are appropriate for individual patient characteristics. Our intention was to review the literature for special aspects of the different technologies that might be of advantage depending on individual patient and tumour characteristics. The current literature on FT was screened for the following factors: morbidity, repeatability, tumour risk category, tumour location, tumour size and prostate volume and anatomical issues. The ESUT expert panel arrived at consensus regarding a position statement on a structured pathway for available FT technologies based on a combination of the literature and expert opinion. Side effects were low across different studies and FT modalities with urinary continence rates of 90-100% and erectile dysfunction between 5 and 52%. Short to medium cancer control based on post-treatment biopsies were variable between ablative modalities. Expert consensus suggested that posterior lesions are better amenable to FT using HIFU. Cryotherapy provides best possible outcomes for anterior tumours. Apical lesions, when treated with FBT, may yield the least urethral morbidity. Further prospective trials are required to assess medium to long term disease control of different ablative modalities for FT. Amongst different available FT modalities our ESUT expert consensus suggests that some may be better for diffe`rent tumour locations. Tumour risk, tumour size, tumour location, and prostate volume are all important factors to consider and might aid in designing future FT trials.

  19. Management of Diabetes in Long-term Care and Skilled Nursing Facilities: A Position Statement of the American Diabetes Association.

    Science.gov (United States)

    Munshi, Medha N; Florez, Hermes; Huang, Elbert S; Kalyani, Rita R; Mupanomunda, Maria; Pandya, Naushira; Swift, Carrie S; Taveira, Tracey H; Haas, Linda B

    2016-02-01

    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

  20. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement.

    Science.gov (United States)

    Colberg, Sheri R; Sigal, Ronald J; Fernhall, Bo; Regensteiner, Judith G; Blissmer, Bryan J; Rubin, Richard R; Chasan-Taber, Lisa; Albright, Ann L; Braun, Barry

    2010-12-01

    Although physical activity (PA) is a key element in the prevention and management of type 2 diabetes, many with this chronic disease do not become or remain regularly active. High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently, but it is now well established that participation in regular PA improves blood glucose control and can prevent or delay type 2 diabetes, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. Structured interventions combining PA and modest weight loss have been shown to lower type 2 diabetes risk by up to 58% in high-risk populations. Most benefits of PA on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. The benefits of physical training are discussed, along with recommendations for varying activities, PA-associated blood glucose management, diabetes prevention, gestational diabetes mellitus, and safe and effective practices for PA with diabetes-related complications.

  1. Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Grossman, David C; Bibbins-Domingo, Kirsten; Curry, Susan J; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

    2017-06-20

    Based on year 2000 Centers for Disease Control and Prevention growth charts, approximately 17% of children and adolescents aged 2 to 19 years in the United States have obesity, and almost 32% of children and adolescents are overweight or have obesity. Obesity in children and adolescents is associated with morbidity such as mental health and psychological issues, asthma, obstructive sleep apnea, orthopedic problems, and adverse cardiovascular and metabolic outcomes (eg, high blood pressure, abnormal lipid levels, and insulin resistance). Children and adolescents may also experience teasing and bullying behaviors based on their weight. Obesity in childhood and adolescence may continue into adulthood and lead to adverse cardiovascular outcomes or other obesity-related morbidity, such as type 2 diabetes. Although the overall rate of child and adolescent obesity has stabilized over the last decade after increasing steadily for 3 decades, obesity rates continue to increase in certain populations, such as African American girls and Hispanic boys. These racial/ethnic differences in obesity prevalence are likely a result of both genetic and nongenetic factors (eg, socioeconomic status, intake of sugar-sweetened beverages and fast food, and having a television in the bedroom). To update the 2010 US Preventive Services Task Force (USPSTF) recommendation on screening for obesity in children 6 years and older. The USPSTF reviewed the evidence on screening for obesity in children and adolescents and the benefits and harms of weight management interventions. Comprehensive, intensive behavioral interventions (≥26 contact hours) in children and adolescents 6 years and older who have obesity can result in improvements in weight status for up to 12 months; there is inadequate evidence regarding the effectiveness of less intensive interventions. The harms of behavioral interventions can be bounded as small to none, and the harms of screening are minimal. Therefore, the USPSTF

  2. The SWEET SPOTS study: a real-world interpretation of the 2012 American Diabetes Association Position Statement regarding individualized A1C targets

    Directory of Open Access Journals (Sweden)

    Bieszk N

    2016-11-01

    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

  3. 2018 International Olympic Committee Consensus Statement on Prevention, Diagnosis, and Management of Pediatric Anterior Cruciate Ligament Injuries

    Science.gov (United States)

    Ardern, Clare L.; Ekås, Guri; Grindem, Hege; Moksnes, Håvard; Anderson, Allen F.; Chotel, Franck; Cohen, Moises; Forssblad, Magnus; Ganley, Theodore J.; Feller, Julian A.; Karlsson, Jón; Kocher, Mininder S.; LaPrade, Robert F.; McNamee, Mike; Mandelbaum, Bert; Micheli, Lyle; Mohtadi, Nicholas G.H.; Reider, Bruce; Roe, Justin P.; Seil, Romain; Siebold, Rainer; Silvers-Granelli, Holly J.; Soligard, Torbjørn; Witvrouw, Erik; Engebretsen, Lars

    2018-01-01

    In October 2017, the International Olympic Committee hosted an international expert group of physical therapists and orthopaedic surgeons who specialize in treating and researching pediatric anterior cruciate ligament (ACL) injuries. The purpose of this meeting was to provide a comprehensive, evidence-informed summary to support the clinician and help children with ACL injury and their parents/guardians make the best possible decisions. Representatives from the following societies attended: American Orthopaedic Society for Sports Medicine; European Paediatric Orthopaedic Society; European Society for Sports Traumatology, Knee Surgery, and Arthroscopy; International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine; Pediatric Orthopaedic Society of North America; and Sociedad Latinoamericana de Artroscopia, Rodilla, y Deporte. Physical therapists and orthopaedic surgeons with clinical and research experience in the field and an ethics expert with substantial experience in the area of sports injuries also participated. This consensus statement addresses 6 fundamental clinical questions regarding the prevention, diagnosis, and management of pediatric ACL injuries. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision making with children and the potential long-term ramifications of the injury. PMID:29594177

  4. Proton-pump inhibitors adverse effects: a review of the evidence and position statement by the Sociedad Española de Patología Digestiva.

    Science.gov (United States)

    de la Coba Ortiz, Cristóbal; Argüelles Arias, Federico; Martín de Argila de Prados, Carlos; Júdez Gutiérrez, Javier; Linares Rodríguez, Antonio; Ortega Alonso, Aida; Rodríguez de Santiago, Enrique; Rodríguez-Téllez, Manuel; Vera Mendoza, María Isabel; Aguilera Castro, Lara; Álvarez Sánchez, Ángel; Andrade Bellido, Raúl Jesús; Bao Pérez, Fidencio; Castro Fernández, Manuel; Giganto Tomé, Froilán

    2016-04-01

    In the last few years a significant number of papers have related the use of proton-pump inhibitors (PPIs) to potential serious adverse effects that have resulted in social unrest. The goal of this paper was to provide a literature review for the development of an institutional position statement by Sociedad Española de Patología Digestiva (SEPD) regarding the safety of long-term PPI use. A comprehensive review of the literature was performed to draw conclusions based on a critical assessment of the following: a) current PPI indications; b) vitamin B12 deficiency and neurological disorders; c) magnesium deficiency; d) bone fractures; e) enteric infection and pneumonia; f) interactions with thienopyridine derivatives; e) complications in cirrhotic patients. Current PPI indications have remained unchanged for years now, and are well established. A general screening of vitamin B12 levels is not recommended for all patients on a PPI; however, it does seem necessary that magnesium levels be measured at therapy onset, and then monitored in subjects on other drugs that may induce hypomagnesemia. A higher risk for bone fractures is present, even though causality cannot be concluded for this association. The association between PPIs and infection with Clostridium difficile is mild to moderate, and the risk for pneumonia is low. In patients with cardiovascular risk receiving thienopyridines derivatives it is prudent to adequately consider gastrointestinal and cardiovascular risks, given the absence of definitive evidence regardin potential drug-drug interactions; if gastrointestinal risk is found to be moderate or high, effective prevention should be in place with a PPI. PPIs should be cautiously indicated in patients with decompensated cirrhosis. PPIs are safe drugs whose benefits outweigh their potential side effects both short-term and long-term, provided their indication, dosage, and duration are appropriate.

  5. Present and future of clinical cardiovascular PET imaging in Europe - a position statement by the European Council of Nuclear Cardiology (ECNC)

    International Nuclear Information System (INIS)

    Le Guludec, D.; Lautamaeki, R.; Bengel, F.M.; Knuuti, J.; Bax, J.J.

    2008-01-01

    This position statement was prepared by the European Council of Nuclear Cardiology and summarises the current and future potential of PET as a clinical cardiovascular diagnostic imaging tool. The first section describes how methodological developments have positively influenced the transition of PET from a research tool towards a clinical diagnostic test. In the second section, evidence in support of its superior diagnostic accuracy, its value to guide decision making and to predict outcome and its cost effectiveness is summarised. The third section finally outlines new PET-based approaches and concepts, which will likely influence clinical cardiovascular medicine in the future. The notion that integration of cardiac PET into healthcare systems and disease management algorithms will advance quality of care is increasingly supported by the literature highlighted in this statement. (orig.)

  6. [Consensus statement on monitoring of HIV: pregnancy, birth, and prevention of mother-to-child transmission].

    Science.gov (United States)

    Polo Rodríguez, Rosa; Muñoz Galligo, Eloy; Iribarren, José Antonio; Domingo Pedrol, Pere; Leyes García, María; Maiques Montesinos, Vicente; Miralles Martín, Pilar; Noguera Julian, Antoni; Ocampo Hernández, Antonio; Péres Bares, María Lourdes; López Rojano, Marta; Suy Franch, Anna; Viñuela Beneitez, María Carmen; González Tomé, María Isabel

    2014-05-01

    The main objective in the management of HIV-infected pregnant women is prevention of mother-to-child transmission; therefore, it is essential to provide universal antiretroviral treatment, regardless of CD4 count. All pregnant women must receive adequate information and undergo HIV serology testing at the first visit. We assembled a panel of experts appointed by the Secretariat of the National AIDS Plan (SPNS) and the other participating Scientific Societies, which included internal medicine physicians with expertise in the field of HIV infection, gynecologists, pediatricians and psychologists. Four panel members acted as coordinators. Scientific information was reviewed in publications and conference reports up to November 2012. In keeping with the criteria of the Infectious Diseases Society of America, 2levels of evidence were applied to support the proposed recommendations: the strength of the recommendation according to expert opinion (A, B, C), and the level of empirical evidence (I, II, III). This approach has already been used in previous documents from SPNS. The aim of this paper was to review current scientific knowledge, and, accordingly, develop a set of recommendations regarding antiretroviral therapy (ART), regarding the health of the mother, and from the perspective of minimizing mother-to-child transmission (MTCT), also taking into account the rest of the health care of pregnant women with HIV infection. We also discuss and evaluate other strategies to reduce the MTCT (elective Cesarean, child's treatment…), and different aspects of the topic (ARV regimens, their toxicity, monitoring during pregnancy and postpartum, etc.). Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  7. Positioning functional foods in an ecological approach to the prevention of overweight and obesity

    NARCIS (Netherlands)

    Wieringa, N.F.; van der Windt, H.J.; Zuiker, R.R.M.; Dijkhuizen, L.; Verkerk, M.A.; Vonk, R.J.; Swart, J.A.A.

    2008-01-01

    To contribute to the social debate about the role of functional foods in the prevention of overweight and obesity using an ecological model to study the positioning of functional foods and their social implications. Positioning was conceptualized as the relative attention given to functional foods

  8. Presentation of Consolidated Statement of Cash Flows under IAS 7, Statement of Cash Flows

    OpenAIRE

    Calota Traian-Ovidiu; Tănase Alin-Eliodor

    2013-01-01

    The consolidated financial statements must includ a specific statement, regarding cash flows from all activities of the entity, called „consolidated statement of cash flow”. Information for preparing cash flow statements can be found in all other components of the financial statements, such as financial position, statement of comprehensive income and statement of changes in equity. The cash flow statement shall report cash flows during the period classified by operating, investing and financi...

  9. The SWEET SPOTS study: a real-world interpretation of the 2012 American Diabetes Association Position Statement regarding individualized A1C targets

    OpenAIRE

    Bieszk, Nella; Grabner, Michael; Wei, Wenhui; Bonine, Nicole G; Stephenson, Judith J

    2016-01-01

    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 ...

  10. The clinical application of genome-wide sequencing for monogenic diseases in Canada: Position Statement of the Canadian College of Medical Geneticists

    Science.gov (United States)

    Boycott, Kym; Hartley, Taila; Adam, Shelin; Bernier, Francois; Chong, Karen; Fernandez, Bridget A; Friedman, Jan M; Geraghty, Michael T; Hume, Stacey; Knoppers, Bartha M; Laberge, Anne-Marie; Majewski, Jacek; Mendoza-Londono, Roberto; Meyn, M Stephen; Michaud, Jacques L; Nelson, Tanya N; Richer, Julie; Sadikovic, Bekim; Skidmore, David L; Stockley, Tracy; Taylor, Sherry; van Karnebeek, Clara; Zawati, Ma'n H; Lauzon, Julie; Armour, Christine M

    2015-01-01

    Purpose and scope The aim of this Position Statement is to provide recommendations for Canadian medical geneticists, clinical laboratory geneticists, genetic counsellors and other physicians regarding the use of genome-wide sequencing of germline DNA in the context of clinical genetic diagnosis. This statement has been developed to facilitate the clinical translation and development of best practices for clinical genome-wide sequencing for genetic diagnosis of monogenic diseases in Canada; it does not address the clinical application of this technology in other fields such as molecular investigation of cancer or for population screening of healthy individuals. Methods of statement development Two multidisciplinary groups consisting of medical geneticists, clinical laboratory geneticists, genetic counsellors, ethicists, lawyers and genetic researchers were assembled to review existing literature and guidelines on genome-wide sequencing for clinical genetic diagnosis in the context of monogenic diseases, and to make recommendations relevant to the Canadian context. The statement was circulated for comment to the Canadian College of Medical Geneticists (CCMG) membership-at-large and, following incorporation of feedback, approved by the CCMG Board of Directors. The CCMG is a Canadian organisation responsible for certifying medical geneticists and clinical laboratory geneticists, and for establishing professional and ethical standards for clinical genetics services in Canada. Results and conclusions Recommendations include (1) clinical genome-wide sequencing is an appropriate approach in the diagnostic assessment of a patient for whom there is suspicion of a significant monogenic disease that is associated with a high degree of genetic heterogeneity, or where specific genetic tests have failed to provide a diagnosis; (2) until the benefits of reporting incidental findings are established, we do not endorse the intentional clinical analysis of disease-associated genes

  11. Towards an integration of positive and sickness paradigms in the prevention of eating disorders in adolescents

    Directory of Open Access Journals (Sweden)

    Vanesa C. Góngora

    2015-09-01

    Full Text Available Eating disorders problems are highly relevant in adolescence and require intervention through the implementation of prevention and promotion health programs. A Few primary prevention programmers to fight eating disorders have reached satisfactory results. The most successful results have been obtained with approaches that promote media literacy, the use of cognitive dissonance and the enhancement of self-esteem. Since many of the programs based on the disease model have failed to prevent such difficulties, the prevention of eating disorders may be improved by taking the contributions of positive psychology. Studies have shown that interventions based on this paradigm are effective to increase the feeling of happiness and subjective well-being. Unlike the traditional approach that works with the identification of risk and protective factors, positive psychology emphasizes the identification and promotion of healthy factors. Positive interventions assume that strengthening the positive, the dysfunctional or negative will be diminished. The integration of both contributions will enrich the approach to promote healthy behavior in adolescents.

  12. "Yes Means Yes:" A New Approach to Sexual Assault Prevention and Positive Sexuality Promotion

    Science.gov (United States)

    Lafrance, Dawn E.; Loe, Meika; Brown, Scott C.

    2012-01-01

    "Yes Means Yes" (YMY) is an interdisciplinary, noncredit, five-week, positive sexuality seminar offered at a small liberal arts college as part of a campus-wide initiative to improve students' relationship skills and behaviors. Most university campuses employ some sort of sexual assault prevention program to help protect students from problematic…

  13. Consensus statement: Management of drug-induced liver injury in HIV-positive patients treated for TB

    Directory of Open Access Journals (Sweden)

    E Jong

    2013-09-01

    Full Text Available Drug-induced liver injury (DILI in HIV/tuberculosis (TB co-infected patients is a common problem in the South African setting, and re-introduction of anti-TB drugs can be challenging for the healthcare worker. Although international guidelines on the re-introduction of TB treatment are available, the definition of DILI is not uniform, management of antiretroviral therapy (ART in HIV co-infection is not mentioned, and the guidance on management is not uniform and lacks a practical approach. In this consensus statement, we summarise important aspects of DILI and provide practical guidance for healthcare workers for different patient groups and healthcare settings on the re-introduction of anti-TB drugs and ART in HIV/TB co-infected individuals presenting with DILI.

  14. Positive impact of infection prevention on the management of nosocomial outbreaks at an academic hospital.

    Science.gov (United States)

    Dik, Jan-Willem H; Sinha, Bhanu; Lokate, Mariëtte; Lo-Ten-Foe, Jerome R; Dinkelacker, Ariane G; Postma, Maarten J; Friedrich, Alexander W

    2016-10-01

    Infection prevention (IP) measures are vital to prevent (nosocomial) outbreaks. Financial evaluations of these are scarce. An incremental cost analysis for an academic IP unit was performed. On a yearly basis, we evaluated: IP measures; costs thereof; numbers of patients at risk for causing nosocomial outbreaks; predicted outbreak patients; and actual outbreak patients. IP costs rose on average yearly with €150,000; however, more IP actions were undertaken. Numbers of patients colonized with high-risk microorganisms increased. The trend of actual outbreak patients remained stable. Predicted prevented outbreak patients saved costs, leading to a positive return on investment of 1.94. This study shows that investments in IP can prevent outbreak cases, thereby saving enough money to earn back these investments.

  15. Semi-recumbent position versus supine position for the prevention of ventilator-associated pneumonia in adults requiring mechanical ventilation.

    Science.gov (United States)

    Wang, Li; Li, Xiao; Yang, Zongxia; Tang, Xueli; Yuan, Qiang; Deng, Lijing; Sun, Xin

    2016-01-08

    Ventilator-associated pneumonia (VAP) is associated with increased mortality, prolonged length of hospital stay and increased healthcare costs in critically ill patients. Guidelines recommend a semi-recumbent position (30º to 45º) for preventing VAP among patients requiring mechanical ventilation. However, due to methodological limitations in existing systematic reviews, uncertainty remains regarding the benefits and harms of the semi-recumbent position for preventing VAP. To assess the effectiveness and safety of semi-recumbent positioning versus supine positioning to prevent ventilator-associated pneumonia (VAP) in adults requiring mechanical ventilation. We searched CENTRAL (2015, Issue 10), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1946 to October 2015), EMBASE (2010 to October 2015), CINAHL (1981 to October 2015) and the Chinese Biomedical Literature Database (CBM) (1978 to October 2015). We included randomised controlled trials (RCTs) comparing semi-recumbent versus supine positioning (0º to 10º), or RCTs comparing alternative degrees of positioning in mechanically ventilated patients. Our outcomes included clinically suspected VAP, microbiologically confirmed VAP, intensive care unit (ICU) mortality, hospital mortality, length of ICU stay, length of hospital stay, duration of ventilation, antibiotic use and any adverse events. Two review authors independently and in duplicate screened titles, abstracts and full texts, assessed risk of bias and extracted data using standardised forms. We calculated the mean difference (MD) and 95% confidence interval (95% CI) for continuous data and the risk ratio (RR) and 95% CI for binary data. We performed meta-analysis using the random-effects model. We used the grading of recommendations, assessment, development and evaluation (GRADE) approach to grade the quality of evidence. We included 10 trials involving 878 participants, among which 28 participants in two

  16. Transition of gastroenterological patients from paediatric to adult care: A position statement by the Italian Societies of Gastroenterology.

    Science.gov (United States)

    Elli, Luca; Maieron, Roberto; Martelossi, Stefano; Guariso, Graziella; Buscarini, Elisabetta; Conte, Dario; di Giulio, Emilio; Staiano, Annamaria; Barp, Jacopo; Bassotti, Gabrio; Bianco, Maria Antonia; Buri, Luigi; Carrara, Maurizio; Ghidini, Benedetta; Giannini, Olivia; Knafelz, Daniela; Miele, Erasmo; Peralta, Sergio; Riccio, Elisabetta; Tomba, Carolina; Zilli, Maurizio; Guadagnini, Tiziana

    2015-09-01

    In 2013, four Italian Gastroenterological Societies (the Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition, the Italian Society of Hospital Gastroenterologists and Endoscopists, the Italian Society of Endoscopy, and the Italian Society of Gastroenterology) formed a joint panel of experts with the aim of preparing an official statement on transition medicine in Gastroenterology. The transition of adolescents from paediatric to adult care is a crucial moment in managing chronic diseases such as celiac disease, inflammatory bowel disease, liver disease and liver transplantation. Improved medical treatment and availability of new drugs and surgical techniques have improved the prognosis of many paediatric disorders, prolonging survival, thus making the transition to adulthood possible and necessary. An inappropriate transition or the incomplete transmission of data from the paediatrician to the adult Gastroenterologist can dramatically decrease compliance to treatment and prognosis of a young patient, particularly in the case of severe disorders. For these reasons, the Italian gastroenterological societies decided to develop an official shared transition protocol. The resulting document discusses the factors influencing the transition process and highlights the main points to accomplish to optimize compliance and prognosis of gastroenterological patients during the difficult transition from childhood to adolescence and adulthood. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline.

    Science.gov (United States)

    Azziz, Ricardo; Carmina, Enrico; Dewailly, Didier; Diamanti-Kandarakis, Evanthia; Escobar-Morreale, Hector F; Futterweit, Walter; Janssen, Onno E; Legro, Richard S; Norman, Robert J; Taylor, Ann E; Witchel, Selma F

    2006-11-01

    The Androgen Excess Society (AES) charged a task force to review all available data and recommend an evidence-based definition for polycystic ovary syndrome (PCOS), whether already in use or not, to guide clinical diagnosis and future research. Participants included expert investigators in the field. Based on a systematic review of the published peer-reviewed medical literature, by querying MEDLINE databases, we tried to identify studies evaluating the epidemiology or phenotypic aspects of PCOS. The task force drafted the initial report, following a consensus process via electronic communication, which was then reviewed and critiqued by the AES Board of Directors. No section was finalized until all members were satisfied with the contents and minority opinions noted. Statements that were not supported by peer-reviewed evidence were not included. Based on the available data, it is the view of the AES Task Force on the Phenotype of PCOS that there should be acceptance of the original 1990 National Institutes of Health criteria with some modifications, taking into consideration the concerns expressed in the proceedings of the 2003 Rotterdam conference. A principal conclusion was that PCOS should be first considered a disorder of androgen excess or hyperandrogenism, although a minority considered the possibility that there may be forms of PCOS without overt evidence of hyperandrogenism but recognized that more data are required before validating this supposition. Finally, the task force recognized, and fully expects, that the definition of this syndrome will evolve over time to incorporate new research findings.

  18. The clinical application of genome-wide sequencing for monogenic diseases in Canada: Position Statement of the Canadian College of Medical Geneticists.

    Science.gov (United States)

    Boycott, Kym; Hartley, Taila; Adam, Shelin; Bernier, Francois; Chong, Karen; Fernandez, Bridget A; Friedman, Jan M; Geraghty, Michael T; Hume, Stacey; Knoppers, Bartha M; Laberge, Anne-Marie; Majewski, Jacek; Mendoza-Londono, Roberto; Meyn, M Stephen; Michaud, Jacques L; Nelson, Tanya N; Richer, Julie; Sadikovic, Bekim; Skidmore, David L; Stockley, Tracy; Taylor, Sherry; van Karnebeek, Clara; Zawati, Ma'n H; Lauzon, Julie; Armour, Christine M

    2015-07-01

    The aim of this Position Statement is to provide recommendations for Canadian medical geneticists, clinical laboratory geneticists, genetic counsellors and other physicians regarding the use of genome-wide sequencing of germline DNA in the context of clinical genetic diagnosis. This statement has been developed to facilitate the clinical translation and development of best practices for clinical genome-wide sequencing for genetic diagnosis of monogenic diseases in Canada; it does not address the clinical application of this technology in other fields such as molecular investigation of cancer or for population screening of healthy individuals. Two multidisciplinary groups consisting of medical geneticists, clinical laboratory geneticists, genetic counsellors, ethicists, lawyers and genetic researchers were assembled to review existing literature and guidelines on genome-wide sequencing for clinical genetic diagnosis in the context of monogenic diseases, and to make recommendations relevant to the Canadian context. The statement was circulated for comment to the Canadian College of Medical Geneticists (CCMG) membership-at-large and, following incorporation of feedback, approved by the CCMG Board of Directors. The CCMG is a Canadian organisation responsible for certifying medical geneticists and clinical laboratory geneticists, and for establishing professional and ethical standards for clinical genetics services in Canada. Recommendations include (1) clinical genome-wide sequencing is an appropriate approach in the diagnostic assessment of a patient for whom there is suspicion of a significant monogenic disease that is associated with a high degree of genetic heterogeneity, or where specific genetic tests have failed to provide a diagnosis; (2) until the benefits of reporting incidental findings are established, we do not endorse the intentional clinical analysis of disease-associated genes other than those linked to the primary indication; and (3) clinicians should

  19. Promoting success or preventing failure: cultural differences in motivation by positive and negative role models.

    Science.gov (United States)

    Lockwood, Penelope; Marshall, Tara C; Sadler, Pamela

    2005-03-01

    In two studies, cross-cultural differences in reactions to positive and negative role models were examined. The authors predicted that individuals from collectivistic cultures, who have a stronger prevention orientation, would be most motivated by negative role models, who highlight a strategy of avoiding failure; individuals from individualistic cultures, who have a stronger promotion focus, would be most motivated by positive role models, who highlight a strategy of pursuing success. In Study 1, the authors examined participants' reported preferences for positive and negative role models. Asian Canadian participants reported finding negative models more motivating than did European Canadians; self-construals and regulatory focus mediated cultural differences in reactions to role models. In Study 2, the authors examined the impact of role models on the academic motivation of Asian Canadian and European Canadian participants. Asian Canadians were motivated only by a negative model, and European Canadians were motivated only by a positive model.

  20. Feasibility of the Positive Thoughts and Actions Prevention Program for Middle Schoolers at Risk for Depression

    Directory of Open Access Journals (Sweden)

    Carolyn A. McCarty

    2011-01-01

    Full Text Available Despite the importance of adolescent depression, few school-based prevention programs have been developed and tested in the United States with middle school populations. This study examined the acceptability and changes in targeted outcomes for a new preventative program, Positive Thoughts and Actions (PTA. Sixty-seven 7th grade students with elevated depressive symptoms were recruited from public schools and randomized to the 12-week PTA program with a parent-component or to a school-as-usual control group. The PTA prevention program was well received by students and parents, yielding high rates of participation and satisfaction among those randomized to receive the intervention. However, analyses of the efficacy of the program in changing depressive symptoms were not significant. In terms of our proximal program targets, most differences were not statistically significant, though effect sizes suggested advantage of PTA over control group in coping, cognitive style, and parent-child communication. This preliminary research highlights a need for further testing of programs for school-based prevention of depression and promotion of positive emotional health.

  1. Backrest position in prevention of pressure ulcers and ventilator-associated pneumonia: Conflicting recommendations

    OpenAIRE

    Burk, Ruth Srednicki; Jo Grap, Mary

    2012-01-01

    Pressure ulcers and ventilator-associated pneumonia (VAP) are both common in acute and critical care settings and are considerable sources of morbidity, mortality, and health care costs. To prevent pressure ulcers, guidelines limit bed backrest elevation to less than 30 degrees, whereas recommendations to reduce VAP include use of backrest elevations of 30 degrees or more. Although a variety of risk factors beyond patient position have been identified for both pressure ulcers and VAP, this ar...

  2. Detached Statements

    Directory of Open Access Journals (Sweden)

    Mark McBride

    2018-04-01

    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.

  3. The effect of obesity prevention interventions according to socioeconomic position: a systematic review.

    Science.gov (United States)

    Beauchamp, A; Backholer, K; Magliano, D; Peeters, A

    2014-07-01

    Obesity prevention is a major public health priority. It is important that all groups benefit from measures to prevent obesity, but we know little about the differential effectiveness of such interventions within particular population subgroups. This review aimed to identify interventions for obesity prevention that evaluated a change in adiposity according to socioeconomic position (SEP) and to determine the effectiveness of these interventions across different socioeconomic groups. A systematic search of published and grey literature was conducted. Studies that described an obesity prevention intervention and reported anthropometric outcomes according to a measure of SEP were included. Evidence was synthesized using narrative analysis. A total of 14 studies were analysed, representing a range of study designs and settings. All studies were from developed countries, with eight conducted among children. Three studies were shown to have no effect on anthropometric outcomes and were not further analysed. Interventions shown to be ineffective in lower SEP participants were primarily based on information provision directed at individual behaviour change. Studies that were shown to be effective in lower SEP participants primarily included community-based strategies or policies aimed at structural changes to the environment. Interventions targeting individual-level behaviour change may be less successful in lower SEP populations. It is essential that our efforts to prevent obesity do not leave behind the most disadvantaged members of society. © 2014 The Authors. obesity reviews © 2014 International Association for the Study of Obesity.

  4. CONSOLIDATED FINANCIAL STATEMENTS UNDER IFRS

    OpenAIRE

    Tănase Alin-Eliodor; Calotă Traian-Ovidiu

    2013-01-01

    This article is focuses on accounting consolidation techniques and the preparation of consolidation worksheets for the components of financial statements (statement of comprehensive income, statement of changes in equity, and financial position). The presented group includes parent company, two subsidiaries (only one fully controlled by the parent company) and a jointly controlled entity. The financial statements are presented under the following standards IFRS 3 Business Combination, IAS 27 ...

  5. Recommendations for treatment of hypothyroidism with levothyroxine and levotriiodothyronine: a 2016 position statement of the Italian Society of Endocrinology and the Italian Thyroid Association.

    Science.gov (United States)

    Biondi, B; Bartalena, L; Chiovato, L; Lenzi, A; Mariotti, S; Pacini, F; Pontecorvi, A; Vitti, P; Trimarchi, F

    2016-12-01

    Levothyroxine (L-T4) is recommended as lifelong replacement therapy for hypothyroidism. Recent clinical and experimental data support the addition of levotriiodothyronine (L-T3) treatment in some selected hypothyroid patients when their symptoms persist and their quality of life remains impaired despite adequate L-T4 monotherapy. An increase in L-T3 prescriptions has been recently observed in Italy due to availability of different L-T3 formulations, making it possible to clinicians to prescribe L-T3 alone or in combination with L-T4. The aim of the present position statement was to define the correct clinical indications, schedule, duration of treatment and contraindications of combined treatment with L-T4 and L-T3 in hypothyroid patients in an attempt to guide clinicians and to avoid potential adverse effects of overtreatment.

  6. Autologous hematopoietic progenitor cell mobilization and collection in adult patients presenting with multiple myeloma and lymphoma: A position-statement from the Turkish Society of Apheresis (TSA).

    Science.gov (United States)

    Tekgündüz, Emre; Arat, Mutlu; Göker, Hakan; Özdoğu, Hakan; Kaynar, Leylagül; Çağırgan, Seçkin; Erkurt, Mehmet Ali; Vural, Filiz; Kiki, İlhami; Altuntaş, Fevzi; Demirkan, Fatih

    2017-12-01

    Autologous hematopoietic cell transplantation (AHCT) is a routinely used procedure in the treatment of adult patients presenting with multiple myeloma (MM), Hodgkin lymphoma (HL) and various subtypes of non-Hodgkin lymphoma (NHL) in upfront and relapsed/refractory settings. Successful hematopoietic progenitor cell mobilization (HPCM) and collection are the rate limiting first steps for application of AHCT. In 2015, almost 1700 AHCT procedures have been performed for MM, HL and NHL in Turkey. Although there are recently published consensus guidelines addressing critical issues regarding autologous HPCM, there is a tremendous heterogeneity in terms of mobilization strategies of transplant centers across the world. In order to pave the way to a more standardized HPCM approach in Turkey, Turkish Society of Apheresis (TSA) assembled a working group consisting of experts in the field. Here we report the position statement of TSA regarding autologous HPCM mobilization strategies in adult patients presenting with MM and lymphoma. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. A comprehensive approach in high-grade glioma management: position statement from the Neuro-Oncology Scientific Club (NOSC), Shiraz, Iran.

    Science.gov (United States)

    Ansari, Mansour; Mosalaei, Ahmad; Ahmadloo, Niloufar; Rasekhi, Alireza; Geramizadeh, Bita; Razmkon, Ali; Anvari, Kazem; Afarid, Mohammad; Dadras, Ali; Nafarieh, Leila; Mohammadianpanah, Mohammad; Nasrolahi, Hamid; Hamedi, Seyed Hasan; Omidvari, Shapour; Nami, Mohammad

    2017-01-01

    Establishing a robust teamwork model in the practice of neuro-oncology requires continued interdisciplinary efforts. The Neuro-Oncology Scientific Club (NOSC) initiative is an interdisciplinary clinical forum promoting the comprehensive approach across involved disciplines in the management of central nervous system (CNS) malignancies. With its provincial founding panels and national steering board, NOSC has been operational in Iran since 2011. This initiative has pursued its mission through interval strategic meetings, tumor boards, case discussions as well as publishing neuro-oncology updates, case study periodicals, and newsletters. A provincial meeting of NOSC in Shiraz put together insights from international practice guidelines, emerging evidence, and expert opinions to draw a position statement on high-grade glioma management in adults. The present report summarizes key highlights from the above clinical forum.

  8. A comprehensive approach in high-grade glioma management: position statement from the Neuro-Oncology Scientific Club (NOSC, Shiraz, Iran

    Directory of Open Access Journals (Sweden)

    Ansari, Mansour

    2017-02-01

    Full Text Available Establishing a robust teamwork model in the practice of neuro-oncology requires continued interdisciplinary efforts. The Neuro-Oncology Scientific Club (NOSC initiative is an interdisciplinary clinical forum promoting the comprehensive approach across involved disciplines in the management of central nervous system (CNS malignancies. With its provincial founding panels and national steering board, NOSC has been operational in Iran since 2011. This initiative has pursued its mission through interval strategic meetings, tumor boards, case discussions as well as publishing neuro-oncology updates, case study periodicals, and newsletters. A provincial meeting of NOSC in Shiraz put together insights from international practice guidelines, emerging evidence, and expert opinions to draw a position statement on high-grade glioma management in adults. The present report summarizes key highlights from the above clinical forum.

  9. Glucagon-Like Peptide-1 Receptor Agonists for the Treatment of Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association

    Directory of Open Access Journals (Sweden)

    Hyun Jin Kim

    2017-12-01

    Full Text Available The glucagon-like peptide-1 receptor agonists (GLP-1RAs were recommended as a monotherapy or combination therapy with oral hypoglycemic agents or basal insulin in the position statement of the Korean Diabetes Association 2017 for pharmacological therapy. Many randomized clinical trials and systematic reviews report that GLP-1RAs have considerable glucose-lowering effect and lead to weight reduction and low risk of hypoglycemia when used as a monotherapy or combination therapy. The cardiovascular safety of GLP-1RAs has been assessed in several randomized clinical trials and systematic reviews. The results of cardiovascular outcome trials of long-acting GLP-1RAs (liraglutide, semaglutide demonstrated cardiovascular benefits in subjects with type 2 diabetes mellitus and a high risk of cardiovascular disease. The GLP-1RA may be a choice of therapy when weight control and avoidance of hypoglycemia are important, and patients with high risk of cardiovascular disease might also favor choosing GLP-1RA.

  10. Italian Association of Clinical Endocrinologists (AME) & Italian Association of Clinical Diabetologists (AMD) Position Statement : Diabetes mellitus and thyroid disorders: recommendations for clinical practice.

    Science.gov (United States)

    Guastamacchia, Edoardo; Triggiani, Vincenzo; Aglialoro, Alberto; Aiello, Antimo; Ianni, Lucia; Maccario, Mauro; Zini, Michele; Giorda, Carlo; Guglielmi, Rinaldo; Betterle, Corrado; Attanasio, Roberto; Borretta, Giorgio; Garofalo, Piernicola; Papini, Enrico; Castello, Roberto; Ceriello, Antonio

    2015-06-01

    Thyroid disease and diabetes mellitus, the most common disorders in endocrine practice, are not infrequently associated in the same subject. An altered thyroid function may affect glucose tolerance and worsen metabolic control in patients with diabetes. Thyrotoxicosis increases the risk of hyperglycemic emergencies, while a clinically relevant hypothyroidism may have a detrimental effect on glycemic control in diabetic patients. The association of alterations in thyroid function with diabetes mellitus may adversely affect the risk of cardiovascular and microvascular complications resulting from diabetes. Moreover, the treatments used for both diabetes and thyroid disease, respectively, can impact one other. Finally, multinodular goiter, but not thyroid carcinoma, was shown to be more prevalent in type 2 diabetes mellitus. Aim of the present Position Statement is to focus on the evidence concerning the association of thyroid disease and diabetes mellitus and to provide some practical suggestions for an updated clinical management.

  11. Position statement: Gender dysphoria in childhood and adolescence. Working Group on Gender Identity and Sexual Development of the Spanish Society of Endocrinology and Nutrition (GIDSEEN).

    Science.gov (United States)

    Esteva de Antonio, Isabel; Asenjo Araque, Nuria; Hurtado Murillo, Felipe; Fernández Rodríguez, María; Vidal Hagemeijer, Ángela; Moreno-Pérez, Oscar; Lucio Pérez, María Jesús; López Siguero, Juan Pedro

    2015-10-01

    Gender dysphoria (GD) in childhood and adolescence is a complex condition where early detection and comprehensive treatment are essential to improve quality of life, decrease mental comorbidity, and improve GD. In this position statement, the Working Group on Gender Identity and Sexual Development of the Spanish Society of Endocrinology and Nutrition (GIDSEEN), consisting of specialists in Endocrinology, Psychology, Psychiatry, Pediatrics and Sociology, sets out recommendations for evaluation and treatment of GD in children and adolescents. Interdisciplinary management of GD should be carried out at specialized units (UTIGs), considering that any clinical intervention should follow the principles of scientific rigor, experience, ethical and deontological principles, and the necessary caution in front of chronic, aggressive, and irreversible treatments. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  12. Treating tobacco dependence: guidance for primary care on life-saving interventions. Position statement of the IPCRG.

    Science.gov (United States)

    Van Schayck, O C P; Williams, S; Barchilon, V; Baxter, N; Jawad, M; Katsaounou, P A; Kirenga, B J; Panaitescu, C; Tsiligianni, I G; Zwar, N; Ostrem, A

    2017-06-09

    recognises that clinical decisions should be tailored to the individual's circumstances and attitudes and be influenced by the availability and affordability of drugs and specialist services. Finally it argues that the role of the International Primary Care Respiratory Group is to improve the confidence as well as the competence of primary care and, therefore, makes recommendations about clinical education and evaluation. We also advocate for an update to the WHO Model List of Essential Medicines to optimise each primary-care intervention. This International Primary Care Respiratory Group statement has been endorsed by the Member Organisations of World Organization of Family Doctors Europe.

  13. Canadian Cardiovascular Society/Canadian Anesthesiologists' Society/Canadian Heart Rhythm Society joint position statement on the perioperative management of patients with implanted pacemakers, defibrillators, and neurostimulating devices.

    Science.gov (United States)

    Healey, Jeff S; Merchant, Richard; Simpson, Chris; Tang, Timothy; Beardsall, Marianne; Tung, Stanley; Fraser, Jennifer A; Long, Laurene; van Vlymen, Janet M; Manninen, Pirjo; Ralley, Fiona; Venkatraghavan, Lashmi; Yee, Raymond; Prasloski, Bruce; Sanatani, Shubhayan; Philippon, François

    2012-01-01

    There are more than 200,000 Canadians living with permanent pacemakers or implantable defibrillators, many of whom will require surgery or invasive procedures each year. They face potential hazards when undergoing surgery; however, with appropriate planning and education of operating room personnel, adverse device-related outcomes should be rare. This joint position statement from the Canadian Cardiovascular Society (CCS) and the Canadian Anesthesiologists' Society (CAS) has been developed as an accessible reference for physicians and surgeons, providing an overview of the key issues for the preoperative, intraoperative, and postoperative care of these patients. The document summarizes the limited published literature in this field, but for most issues, relies heavily on the experience of the cardiologists and anesthesiologists who contributed to this work. This position statement outlines how to obtain information about an individual's type of pacemaker or implantable defibrillator and its programming. It also stresses the importance of determining if a patient is highly pacemaker-dependent and proposes a simple approach for nonelective evaluation of dependency. Although the document provides a comprehensive list of the intraoperative issues facing these patients, there is a focus on electromagnetic interference resulting from electrocautery and practical guidance is given regarding the characteristics of surgery, electrocautery, pacemakers, and defibrillators which are most likely to lead to interference. The document stresses the importance of preoperative consultation and planning to minimize complications. It reviews the relative merits of intraoperative magnet use vs reprogramming of devices and gives examples of situations where one or the other approach is preferable. Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  14. Positive deviance as a strategy to prevent and control bloodstream infections in intensive care

    Directory of Open Access Journals (Sweden)

    Francimar Tinoco de Oliveira

    Full Text Available Abstract OBJECTIVE To describe the application of positive deviance as a strategy to prevent and control bloodstream infections. METHOD An intervention study with nursing and medical team members working in an intensive care unit in a university hospital, between June and December 2014. The four steps of the positive defiance methodology were applied: to define, to determine, to discover and to design. RESULTS In 90 days, 188 actions were observed, of these, 36.70% (n=69 were related to catheter dressing. In 81.15% (n=56 of these dressings, the professionals most adhered to the use of flexible sterile cotton-tipped swabs to perform antisepsis at catheter entry sites and fixation dressing. CONCLUSION Positive deviance contributed to the implementation of proposals to improve work processes and team development related to problems identified in central venous catheter care.

  15. Emergency Preparedness and Response in the School Setting--The Role of the School Nurse. Position Statement

    Science.gov (United States)

    Tuck, Christine M.; Haynie, Kathey; Davis, Catherine

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) provides leadership in all phases of emergency preparedness and response. School nurses are a vital part of the school team responsible for developing emergency response procedures for the…

  16. Phonemic Awareness and the Teaching of Reading. A Position Statement from the Board of Directors of the International Reading Association.

    Science.gov (United States)

    International Reading Association, Newark, DE.

    This position paper considers the complex relation between phonemic awareness and reading. The paper seeks to define phonemic awareness (although there is no single definition), stating that it is typically described as an insight about oral language and in particular about the segmentation of sounds that are used in speech communication. It also…

  17. School-Sponsored Before, After and Extended School Year Programs: The Role of the School Nurse. Position Statement

    Science.gov (United States)

    Clark, Elizabeth; Buswell, Sue Ann; Morgitan, Judith; Compton, Linda; Westendorf, Georgene; Chau, Elizabeth

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) has the educational and clinical background to coordinate the necessary school health services to provide students with the same health, nutrition, and safety needs while attending…

  18. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: U.S. preventive services task force recommendation statement.

    Science.gov (United States)

    Moyer, Virginia A

    2013-08-06

    Update of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening and behavioral counseling interventions in primary care to reduce alcohol misuse. The USPSTF reviewed new evidence on the effectiveness of screening for alcohol misuse for improving health outcomes, the accuracy of various screening approaches, the effectiveness of various behavioral counseling interventions for improving intermediate or long-term health outcomes, the harms of screening and behavioral counseling interventions, and influences from the health care system that promote or detract from effective screening and counseling interventions for alcohol misuse. These recommendations apply to adolescents aged 12 to 17 years and adults aged 18 years or older. These recommendations do not apply to persons who are actively seeking evaluation or treatment of alcohol misuse. The USPSTF recommends that clinicians screen adults aged 18 years or older for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse. (Grade B recommendation)The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening and behavioral counseling interventions in primary care settings to reduce alcohol misuse in adolescents. (I statement)

  19. Infectious Diseases Society of America (IDSA) POSITION STATEMENT: Why IDSA Did Not Endorse the Surviving Sepsis Campaign Guidelines.

    Science.gov (United States)

    2018-05-02

    IDSA did not endorse the 2016 Surviving Sepsis Campaign Guidelines despite being represented in the working group that drafted the guidelines document. Leadership from the IDSA, the Surviving Sepsis Campaign Guidelines, and the Society of Critical Care Medicine had numerous amicable discussions primarily regarding the bolded, rated guidelines recommendations. Our societies had different perspectives, however, regarding the interpretation of the major studies that informed the guidelines' recommendations, thus leading us to different conclusions and different perspectives on the recommendations. IDSA consequently elected not to endorse the guidelines. IDSA nonetheless hopes to be able to continue collaborating with the Surviving Sepsis Campaign and the Society of Critical Care Medicine to resolve our differences and to develop further strategies together to prevent sepsis and septic shock as well as reduce death and disability from these conditions both nationally and globally.

  20. Initial rotor position estimation and sliding preventing for elevators with surface-mounted PMSMs

    Science.gov (United States)

    Liu, Feng; Shen, Anwen; Tang, Qipeng; Xu, Jinbang

    2016-03-01

    Improved methods of initial rotor position estimation and sliding prevention are presented in this paper for elevators with surface-mounted permanent magnet synchronous machines (SPMSMs). In contrast to most of the existing literature, in this paper, estimation errors caused by stator resistance and dead time are analysed in detail. The improved estimation method can reduce the errors greatly without dead-time compensations and knowledge of motor parameters. Besides, an observer-based feedforward compensation of load torque is introduced to elevator applications to prevent sliding during the starting process. Since the torque observer is widely used in other motor applications, we focus on the impact caused by the change in inertia. Finally, a series of experiments are performed on a testing system with two 13.4 kW SPMSMs and drivers to illustrate the effectiveness and improvement of the method.

  1. [Commentary by the German Society for Thoracic and Cardiovascular Surgery on the positions statement by the German Cardiology Society on quality criteria for transcatheter aortic valve implantation (TAVI)].

    Science.gov (United States)

    Cremer, Jochen; Heinemann, Markus K; Mohr, Friedrich Wilhelm; Diegeler, Anno; Beyersdorf, Friedhelm; Niehaus, Heidi; Ensminger, Stephan; Schlensak, Christian; Reichenspurner, Hermann; Rastan, Ardawan; Trummer, Georg; Walther, Thomas; Lange, Rüdiger; Falk, Volkmar; Beckmann, Andreas; Welz, Armin

    2014-12-01

    Surgical aortic valve replacement is still considered the first-line treatment for patients suffering from severe aortic valve stenosis. In recent years, transcatheter aortic valve implantation (TAVI) has emerged as an alternative for selected high-risk patients. According to the latest results of the German external quality assurance program, mandatory by law, the initially very high mortality and procedural morbidity have now decreased to approximately 6 and 12%, respectively. Especially in Germany, the number of patients treated by TAVI has increased exponentially. In 2013, a total of 10.602 TAVI procedures were performed. TAVI is claimed to be minimally invasive. This is true concerning the access, but it does not describe the genuine complexity of the procedure, defined by the close neighborhood of the aortic valve to delicate intracardiac structures. Hence, significant numbers of life-threatening complications may occur and have been reported. Owing to the complexity of TAVI, there is a unanimous concordance between cardiologists and cardiac surgeons in the Western world demanding a close heart team approach for patient selection, intervention, handling of complications, and pre- as well as postprocedural care, respectively. The prerequisite is that TAVI should not be performed in centers with no cardiac surgery on site. This is emphasized in all international joint guidelines and expert consensus statements. Today, a small number of patients undergo TAVI procedures in German hospitals without a department of cardiac surgery on site. To be noted, most of these hospitals perform less than 20 cases per year. Recently, the German Cardiac Society (DGK) published a position paper supporting this practice pattern. Contrary to this statement and concerned about the safety of patients treated this way, the German Society for Thoracic and Cardiovascular Surgery (DGTHG) still fully endorses the European (ESC/EACTS) and other actual international guidelines and

  2. Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    St-Onge, Marie-Pierre; Ard, Jamy; Baskin, Monica L; Chiuve, Stephanie E; Johnson, Heather M; Kris-Etherton, Penny; Varady, Krista

    2017-02-28

    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.

  3. Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    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

    2017-05-30

    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

  4. Assessment of a head support system to prevent pediatric out-of-position: an observational study.

    Science.gov (United States)

    Lopez-Valdes, Francisco J; Forman, Jason L; Ash, Joseph H; Kent, Richard; Alba, Juan J; Segui-Gomez, Maria

    Head injuries are the most common severe injuries sustained by pediatric occupants in road traffic crashes. Preventing children from adopting positions that can result in an increased injury risk due to unfavorable interactions with the restraints is fundamental. The objective of this paper was to assess the effect of a head support system (SS) on the lateral position of the head, the vertical position of the sternum and the shoulder belt fit. Thirty pediatric rear-seat passengers were exposed to two 75-minute trials. Volunteers were restrained by a three-point belt and, if needed, used the appropriate child restraint system for their anthropometry (high-back booster, low-back booster, no booster). A case crossover study was designed in which the volunteers used the head support system (SS) during one of the trials, acting as their own controls (No SS) in the other. Compared to the control group, the head support reduced significantly the 90(th) percentile value of the absolute value of the relative lateral motion of the head, regardless of the restraint used. The system also reduced the maximum downward position of the sternal notch within the low-back booster group. As for the belt fit, the use of the head support improved significantly the position of the shoulder belt on the occupant in the low-back booster and in the no booster groups.

  5. American Nurses Association position statement on elimination of manual patient handling to prevent work-related musculoskeletal disorders.

    Science.gov (United States)

    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.

  6. The use of biosimilar medicines in oncology - position statement of the Brazilian Society of Clinical Oncology (SBOC).

    Science.gov (United States)

    Fernandes, G S; Sternberg, C; Lopes, G; Chammas, R; Gifoni, M A C; Gil, R A; Araujo, D V

    2018-01-11

    A biosimilar is a biologic product that is similar to a reference biopharmaceutical product, the manufacturing process of which hinders the ability to identically replicate the structure of the original product, and therefore, it cannot be described as an absolute equivalent of the original medication. The currently available technology does not allow for an accurate copy of complex molecules, but it does allow the replication of similar molecules with the same activity. As biosimilars are about to be introduced in oncology practice, these must be evaluated through evidence-based medicine. This manuscript is a position paper, where the Brazilian Society of Clinical Oncology (SBOC) aims to describe pertinent issues regarding the approval and use of biosimilars in oncology. As a working group on behalf of SBOC, we discuss aspects related to definition, labeling/nomenclature, extrapolation, interchangeability, switching, automatic substitution, clinical standards on safety and efficacy, and the potential impact on financial burden in healthcare. We take a stand in favor of the introduction of biosimilars, as they offer a viable, safe, and cost-effective alternative to the biopharmaceutical products currently used in cancer. We hope this document can provide valuable information to support therapeutic decisions that maximize the clinical benefit for the thousands of cancer patients in Brazil and can contribute to expedite the introduction of this new drug class in clinical practice. We expect the conveyed information to serve as a basis for further discussion in Latin America, this being the first position paper issued by a Latin American Oncology Society.

  7. Position statement on opportunistic genomic screening from the Association of Genetic Nurses and Counsellors (UK and Ireland).

    Science.gov (United States)

    Middleton, Anna; Patch, Chris; Wiggins, Jennifer; Barnes, Kathy; Crawford, Gill; Benjamin, Caroline; Bruce, Anita

    2014-08-01

    The American College of Medical Genetics and Genomics released recommendations for reporting incidental findings (IFs) in clinical exome and genome sequencing. These suggest 'opportunistic genomic screening' should be available to both adults and children each time a sequence is done and would be undertaken without seeking preferences from the patient first. Should opportunistic genomic screening be implemented in the United Kingdom, the Association of Genetic Nurses and Counsellors (AGNC), which represents British and Irish genetic counsellors and nurses, feels strongly that the following must be considered (see article for complete list): (1) Following appropriate genetic counselling, patients should be allowed to consent to or opt out of opportunistic genomic screening. (2) If true IFs are discovered the AGNC are guided by the report from the Joint Committee on Medical Genetics about the sharing of genetic testing results. (3) Children should not be routinely tested for adult-onset conditions. (4) The formation of a list of variants should involve a representative from the AGNC as well as a patient support group. (5) The variants should be for serious or life-threatening conditions for which there are treatments or preventative strategies available. (6) There needs to be robust evidence that the benefits of opportunistic screening outweigh the potential harms. (7) The clinical validity and utility of variants should be known. (8) There must be a quality assurance framework that operates to International standards for laboratory testing. (9) Psychosocial research is urgently needed in this area to understand the impact on patients.

  8. Position statement for the use of omalizumab in the management of chronic spontaneous urticaria in Indian patients

    Directory of Open Access Journals (Sweden)

    Kiran Godse

    2016-01-01

    Full Text Available Chronic spontaneous urticaria (CSU affects 1% of the world population and also their quality of life, and 50% of these patients are refractory to H1-antihistamines. Omalizumab is a humanized monoclonal anti-IgE antibody that binds with free IgE antibodies and reduces the circulating levels of free IgE. This reduction in free IgE prevents mast-cell degranulation. The EAACI/GA2LEN/EDF/WAO guidelines recommend omalizumab as the third-line of therapy as an add-on to antihistamines. The recommended dose of omalizumab is 300 mg, 4 weekly in the management of CSU refractory to standard of care with H1-antihistamines in adults and adolescents ≥12 years of age. In some patients, a dose of 150 mg may be acceptable. Omalizumab has a good safety profile. However, due to the biologic nature of the drug, all patients administered omalizumab must be observed for 2 h after administration for anaphylactoid reactions. There have been no studies on the effect of impaired renal or hepatic function on the pharmacokinetics of omalizumab. While no particular dose adjustment is recommended, omalizumab should be administered with caution in these patients.

  9. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON THYROID DYSFUNCTION CASE FINDING.

    Science.gov (United States)

    Hennessey, James V; Garber, Jeffrey R; Woeber, Kenneth A; Cobin, Rhoda; Klein, Irwin

    2016-02-01

    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.

  10. Prone position as prevention of lung injury in comatose patients: a prospective, randomized, controlled study.

    Science.gov (United States)

    Beuret, Pascal; Carton, Marie-Jose; Nourdine, Karim; Kaaki, Mahmoud; Tramoni, Gerard; Ducreux, Jean-Claude

    2002-05-01

    Comatose patients frequently exhibit pulmonary function worsening, especially in cases of pulmonary infection. It appears to have a deleterious effect on neurologic outcome. We therefore conducted a randomized trial to determine whether daily prone positioning would prevent lung worsening in these patients. Prospective, randomized, controlled study. Sixteen-bed intensive care unit. Fifty-one patients who required invasive mechanical ventilation because of coma with Glascow coma scores of 9 or less. In the prone position (PP) group: prone positioning for 4 h once daily until the patients could get up to sit in an armchair; in the supine position (SP) group: supine positioning. The primary end point was the incidence of lung worsening defined by an increase in the Lung Injury Score of at least 1 point since the time of randomization. The secondary end point was the incidence of ventilator-associated pneumonia (VAP). A total of 25 patients were randomly assigned to the PP group and 26 patients to the SP group. The characteristics of the patients from the two groups were similar at randomization. The incidence of lung worsening was lower in the PP group (12%) than in the SP group (50%) ( p=0.003). The incidence of VAP was 20% in the PP group and 38.4% in the SP group ( p=0.14). There was no serious complication attributable to prone positioning, however, there was a significant increase of intracranial pressure in the PP. In a selected population of comatose ventilated patients, daily prone positioning reduced the incidence of lung worsening.

  11. Feasibility and effects of the semirecumbent position to prevent ventilator-associated pneumonia: a randomized study.

    Science.gov (United States)

    van Nieuwenhoven, Christianne A; Vandenbroucke-Grauls, Christine; van Tiel, Frank H; Joore, Hans C A; van Schijndel, Rob J M Strack; van der Tweel, Ingeborg; Ramsay, Graham; Bonten, Marc J M

    2006-02-01

    for semirecumbent positioning was not reached in the conditions of the present randomized study. The achieved difference in treatment position (28 degrees vs. 10 degrees ) did not prevent the development of VAP.

  12. Backrest position in prevention of pressure ulcers and ventilator-associated pneumonia: conflicting recommendations.

    Science.gov (United States)

    Burk, Ruth Srednicki; Grap, Mary Jo

    2012-01-01

    Pressure ulcers and ventilator-associated pneumonia (VAP) are both common in acute and critical care settings and are considerable sources of morbidity, mortality, and health care costs. To prevent pressure ulcers, guidelines limit bed backrest elevation to less than 30 degrees, whereas recommendations to reduce VAP include use of backrest elevations of 30 degrees or more. Although a variety of risk factors beyond patient position have been identified for both pressure ulcers and VAP, this article will focus on summarizing the major evidence for each of these apparently conflicting positioning strategies and discuss implications for practice in managing mechanically ventilated patients with risk factors for both pressure ulcers and VAP. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement.

    Science.gov (United States)

    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

    2018-03-30

    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.

  14. 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.

    Science.gov (United States)

    Grunberger, George; Handelsman, Yehuda; Bloomgarden, Zachary T; Fonseca, Vivian A; Garber, Alan J; Haas, Richard A; Roberts, Victor L; Umpierrez, Guillermo E

    2018-03-01

    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.

  15. [Preventing Facial Pressure Injuries in Patients Who Use Noninvasive Positive Pressure Ventilators: The Efficiency of Dressings].

    Science.gov (United States)

    Tai, Chia-Hua; Hsu, Mei-Yu

    2016-10-01

    Noninvasive positive pressure ventilation (NPPV) provides ventilation without tracheal intubation. Facial pressure injury is a recognized complication of this technique, making the prevention of facial pressure injuries an important issue for NPPV patients. The present study compared the effects of foam dressing and hydrocolloid dressing in preventing facial pressure injuries in NPPV patients. A randomized clinical trial was used to evaluate participants that were referred from the intensive care unit of a medical center in eastern Taiwan. Participants were randomized into two groups: the foam dressing group and the hydrocolloid dressing group. Statistics used in analysis were: analysis mean, standard deviation, chi-square, independent t-test, and the generalized estimating equation. Sixty participants were enrolled as participants. The incidence rate of facial pressure injury was 11.7% (7/60). No significant difference was found between the two groups in terms of duration of NPPV use, incidence of facial pressure injury, and occurrence time of facial pressure injury. However, the hydrocolloid dressing group had a higher usage amount than the foam dressing group (p < .05). Foam and hydrocolloid dressings are both helpful in preventing facial pressure injury when used in conjunction with regular skin assessments.

  16. Strategies to prevent positioning-related complications associated with the lateral suboccipital approach.

    Science.gov (United States)

    Furuno, Yuichi; Sasajima, Hiroyasu; Goto, Yukihiro; Taniyama, Ichita; Aita, Kazuyasu; Owada, Kei; Tatsuzawa, Kazunori; Mineura, Katsuyoshi

    2014-02-01

    The lateral positioning used for the lateral suboccipital surgical approach is associated with various pathophysiologic complications. Strategies to avoid complications including an excessive load on the cervical vertebra and countermeasures against pressure ulcer development are needed. We retrospectively investigated positioning-related complications in 71 patients with cerebellopontine angle lesions undergoing surgery in our department between January 2003 and December 2010 using the lateral suboccipital approach. One patient postoperatively developed rhabdomyolysis, and another presented with transient peroneal nerve palsy on the unaffected side. Stage I and II pressure ulcers were noted in 22 and 12 patients, respectively, although neither stage III nor more severe pressure ulcers occurred. No patients experienced cervical vertebra and spinal cord impairments, brachial plexus palsy, or ulnar nerve palsy associated with rotation and flexion of the neck. Strategies to prevent positioning-related complications, associated with lateral positioning for the lateral suboccipital surgical approach, include the following: atraumatic fixation of the neck focusing on jugular venous perfusion and airway pressure, trunk rotation, and sufficient relief of weightbearing and protection of nerves including the peripheral nerves of all four extremities.

  17. Clinical Oncology Society of Australia position statement on the use of complementary and alternative medicine by cancer patients.

    Science.gov (United States)

    Braun, Lesley; Harris, Jessica; Katris, Paul; Cain, Michael; Dhillon, Haryana; Koczwara, Bogda; Olver, Ian; Robotin, Monica

    2014-12-01

    Health professionals involved in the clinical management of cancer are becoming increasingly aware that their patients use complementary and alternative medicine (CAM). As cancer incidence and survival rates increase, use of CAM is also likely to increase. This paper outlines the position of the Clinical Oncology Society of Australia (COSA) on the use of CAM by cancer patients and provides guidance for health professionals involved with the treatment of cancer patients who are using or wish to use CAM. Key definitions and common communication scenarios are presented along with evidence-based recommended steps for health professionals when discussing CAM use. COSA encourages health professionals to focus on open discussion with their patients regarding CAM, to become familiar with reputable resources for CAM information, to discuss with patients the concept of evidence-based medicine, to recognize limitations to their knowledge of CAM and seek further advice when necessary, and to be respectful of the patients' right to autonomy. © 2014 Wiley Publishing Asia Pty Ltd.

  18. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium.

    Science.gov (United States)

    Gribble, Phillip A; Delahunt, Eamonn; Bleakley, Chris; Caulfield, Brian; Docherty, Carrie; Fourchet, François; Fong, Daniel Tik-Pui; Hertel, Jay; Hiller, Claire; Kaminski, Thomas; McKeon, Patrick; Refshauge, Kathryn; van der Wees, Philip; Vincenzino, Bill; Wikstrom, Erik

    2014-07-01

    While research on chronic ankle instability (CAI) and awareness of its impact on society and health care systems has grown substantially in the last 2 decades, the inconsistency in participant/patient selection criteria across studies presents a potential obstacle to addressing the problem properly. This major gap within the literature limits the ability to generalise this evidence to the target patient population. Therefore, there is a need to provide standards for patient/participant selection criteria in research focused on CAI with justifications using the best available evidence. The International Ankle Consortium provides this position paper to present and discuss an endorsed set of selection criteria for patients with CAI based on the best available evidence to be used in future research and study designs. These recommendations will enhance the validity of research conducted in this clinical population with the end goal of bringing the research evidence to the clinician and patient. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Role of neuropsychologists in the evaluation and management of sport-related concussion: an inter-organization position statement.

    Science.gov (United States)

    Echemendia, Ruben J; Iverson, Grant L; McCrea, Michael; Broshek, Donna K; Gioia, Gerard A; Sautter, Scott W; Macciocchi, Stephen N; Barr, William B

    2011-11-01

    Over the past 20 years, clinical neuropsychologists have been at the forefront of both scientific and clinical initiatives aimed at developing evidence-based approaches to the evaluation and management of sport-related concussion. These efforts have directly impacted current policy on strategies for injury assessment and return-to-play by athletes after concussion. Many states are considering legislation requiring (a) education of athletes, parents, coaches, and school/organization officials on the recognition, evaluation, and management of sport-related concussions; (b) removal from play of any youth athlete that is suspected of having sustained a concussion; and (c) not allowing the student to return to participation until the student is evaluated and cleared for return to participation in writing by an appropriate healthcare professional. It is the official position of the American Academy of Clinical Neuropsychology (AACN), American Board of Neuropsychology (ABN), Division 40 (Neuropsychology) of the American Psychological Association (APA), and the National Academy of Neuropsychology (NAN) that neuropsychologists should be included among the licensed health care professionals authorized to evaluate, clinically manage, and provide return to play clearance for athletes who sustain a sport-related concussion.

  20. Messages on pregnancy and family planning that providers give women living with HIV in the context of a Positive Health, Dignity, and Prevention intervention in Mozambique

    Directory of Open Access Journals (Sweden)

    Hilliard S

    2014-12-01

    Full Text Available Starr Hilliard, Sarah A Gutin, Carol Dawson Rose Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, CA, USA Background: Family planning is an important HIV prevention tool for women living with HIV (WLHIV. In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. Methods: In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT. In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Results: Analysis showed that providers' clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. Conclusion: These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health

  1. Geolocalisation of athletes for out-of-competition drug testing: ethical considerations. Position statement by the WADA Ethics Panel.

    Science.gov (United States)

    Borry, Pascal; Caulfield, Timothy; Estivill, Xavier; Loland, Sigmund; McNamee, Michael; Knoppers, Bartha Maria

    2018-04-01

    Through the widespread availability of location-identifying devices, geolocalisation could potentially be used to place athletes during out-of-competition testing. In light of this debate, the WADA Ethics Panel formulated the following questions: (1) should WADA and/or other sponsors consider funding such geolocalisation research projects?, (2) if successful, could they be proposed to athletes as a complementary device to Anti-Doping Administration and Management System to help geolocalisation and reduce the risk of missed tests? and (3) should such devices be offered on a voluntary basis, or is it conceivable that they would be made mandatory for all athletes in registered testing pools? In this position paper, the WADA Ethics Panel concludes that the use of geolocalisation could be useful in a research setting with the goal of understanding associations between genotype, phenotype and environment; however, it recognises that the use of geolocalisation as part of or as replacement of whereabouts rules is replete with ethical concerns. While benefits remain largely hypothetical and minimal, the potential invasion of privacy and the data security threats are real. Considering the impact on privacy, data security issues, the societal ramifications of offering such services and various pragmatic considerations, the WADA Ethics Panel concludes that at this time, the use of geolocalisation should neither be mandated as a tool for disclosing whereabouts nor implemented on a voluntary basis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Establishing a pragmatic framework to optimise health outcomes in heart failure and multimorbidity (ARISE-HF): A multidisciplinary position statement.

    Science.gov (United States)

    Stewart, Simon; Riegel, Barbara; Boyd, Cynthia; Ahamed, Yasmin; Thompson, David R; Burrell, Louise M; Carrington, Melinda J; Coats, Andrew; Granger, Bradi B; Hides, Julie; Weintraub, William S; Moser, Debra K; Dickson, Victoria Vaughan; McDermott, Cressida J; Keates, Ashley K; Rich, Michael W

    2016-06-01

    Multimorbidity in heart failure (HF), defined as HF of any aetiology and multiple concurrent conditions that require active management, represents an emerging problem within the ageing HF patient population worldwide. To inform this position paper, we performed: 1) an initial review of the literature identifying the ten most common conditions, other than hypertension and ischaemic heart disease, complicating the management of HF (anaemia, arrhythmias, cognitive dysfunction, depression, diabetes, musculoskeletal disorders, renal dysfunction, respiratory disease, sleep disorders and thyroid disease) and then 2) a review of the published literature describing the association between HF with each of the ten conditions. From these data we describe a clinical framework, comprising five key steps, to potentially improve historically poor health outcomes in this patient population. We identified five key steps (ARISE-HF) that could potentially improve clinical outcomes if applied in a systematic manner: 1) Acknowledge multimorbidity as a clinical syndrome that is associated with poor health outcomes, 2) Routinely profile (using a standardised protocol - adapted to the local health care system) all patients hospitalised with HF to determine the extent of concurrent multimorbidity, 3) Identify individualised priorities and person-centred goals based on the extent and nature of multimorbidity, 4) Support individualised, home-based, multidisciplinary, case management to supplement standard HF management, and 5) Evaluate health outcomes well beyond acute hospitalisation and encompass all-cause events and a person-centred perspective in affected individuals. We propose ARISE-HF as a framework for improving typically poor health outcomes in those affected by multimorbidity in HF. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  3. Hybrid cardiac imaging: SPECT/CT and PET/CT. A joint position statement by the European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC)

    DEFF Research Database (Denmark)

    Flotats, Albert; Gutberlet, Matthias; Knuuti, Juhani

    2011-01-01

    . The European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC) in this paper want to present a position statement of the institutions on the current roles of SPECT/CT and PET/CT hybrid cardiac imaging in patients...

  4. Public-private collaboration in clinical research during pregnancy, lactation, and childhood: joint position statement of the Early Nutrition Academy and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition

    NARCIS (Netherlands)

    Koletzko, Berthold; Benninga, Marc A.; Godfrey, Keith M.; Hornnes, Peter J.; Kolaček, Sanja; Koletzko, Sibylle; Lentze, Michael J.; Mader, Silke; McAuliffe, Fionnuala M.; Oepkes, Dick; Oddy, Wendy H.; Phillips, Alan; Rzehak, Peter; Socha, Piotr; Szajewska, Hania; Symonds, Michael E.; Taminiau, Jan; Thapar, Nikhil; Troncone, Riccardo; Vandenplas, Yvan; Veereman, Gigi

    2014-01-01

    This position statement summarises a view of academia regarding standards for clinical research in collaboration with commercial enterprises, focussing on trials in pregnant women, breast-feeding women, and children. It is based on a review of the available literature and an expert workshop

  5. Does pre-emptive transplantation versus post start of dialysis transplantation with a kidney from a living donor improve outcomes after transplantation? A systematic literature review and position statement by the Descartes Working Group and ERBP.

    Science.gov (United States)

    Abramowicz, Daniel; Hazzan, Marc; Maggiore, Umberto; Peruzzi, Licia; Cochat, Pierre; Oberbauer, Rainer; Haller, Maria C; Van Biesen, Wim

    2016-05-01

    This position statement brings up guidance on pre-emptive kidney transplantation from living donors. The provided guidance is based on a systematic review of the literature. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  6. European Association for Cardio-Thoracic Surgery expert consensus statement on the prevention and management of mediastinitis

    DEFF Research Database (Denmark)

    Abu-Omar, Yasir; Kocher, Gregor J; Bosco, Paolo

    2017-01-01

    Mediastinitis continues to be an important and life-threatening complication after median sternotomy despite advances in prevention and treatment strategies, with an incidence of 0.25-5%. It can also occur as extension of infection from adjacent structures such as the oesophagus, airways and lung...

  7. 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.

    Science.gov (United States)

    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

    2015-08-14

    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 [1]. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when

  8. Structural Network Position and Performance of Health Leaders Within an HIV Prevention Trial.

    Science.gov (United States)

    Mulawa, Marta I; Yamanis, Thespina J; Kajula, Lusajo J; Balvanz, Peter; Maman, Suzanne

    2018-04-28

    The effectiveness of peer leaders in promoting health may depend on the position they occupy within their social networks. Using sociocentric (whole network) and behavioral data from the intervention arm of a cluster-randomized HIV prevention trial in Dar es Salaam, Tanzania, we used generalized linear models with standardized predictors to examine the association between heath leaders' baseline structural network position (i.e., in-degree and betweenness centrality) and their 12-month self-reported (1) confidence in educating network members about HIV and gender-based violence (GBV) and (2) number of past-week conversations about HIV and GBV. As in-degree centrality increased, leaders reported fewer HIV-related conversations. As betweenness centrality increased, leaders reported greater number of conversations about GBV. Network position was not significantly associated with confidence in discussing either topic. Our results suggest that peer leaders who occupy spaces between sub-groups of network members may be more effective in engaging their peers in sensitive or controversial topics like GBV than more popular peer leaders.

  9. Growth and endocrine disorders in thalassemia: The international network on endocrine complications in thalassemia (I-CET position statement and guidelines

    Directory of Open Access Journals (Sweden)

    Vincenzo De Sanctis

    2013-01-01

    Full Text Available The current management of thalassemia includes regular transfusion programs and chelation therapy. It is important that physicians be aware that endocrine abnormalities frequently develop mainly in those patients with significant iron overload due to poor compliance to treatment, particularly after the age of 10 years. Since the quality of life of thalassemia patients is a fundamental aim, it is vital to monitor carefully their growth and pubertal development in order to detect abnormalities and to initiate appropriate and early treatment. Abnormalities should be identified and treatment initiated in consultation with a pediatric or an adult endocrinologist and managed accordingly. Appropriate management shall put in consideration many factors such as age, severity of iron overload, presence of chronic liver disease, thrombophilia status, and the presence of psychological problems. All these issues must be discussed by the physician in charge of the patient′s care, the endocrinologist and the patient himself. Because any progress in research in the field of early diagnosis and management of growth disorders and endocrine complications in thalassemia should be passed on to and applied adequately to all those suffering from the disease, on the 8 May 2009 in Ferrara, the International Network on Endocrine Complications in Thalassemia (I-CET was founded in order to transmit the latest information on these disorders to the treating physicians. The I-CET position statement outlined in this document applies to patients with transfusion-dependent thalassemia major to help physicians to anticipate, diagnose, and manage these complications properly.

  10. Hybrid cardiac imaging using PET/MRI: a joint position statement by the European Society of Cardiovascular Radiology (ESCR) and the European Association of Nuclear Medicine (EANM).

    Science.gov (United States)

    Nensa, Felix; Bamberg, Fabian; Rischpler, Christoph; Menezes, Leon; Poeppel, Thorsten D; la Fougère, Christian; Beitzke, Dietrich; Rasul, Sazan; Loewe, Christian; Nikolaou, Konstantin; Bucerius, Jan; Kjaer, Andreas; Gutberlet, Matthias; Prakken, Niek H; Vliegenthart, Rozemarijn; Slart, Riemer H J A; Nekolla, Stephan G; Lassen, Martin L; Pichler, Bernd J; Schlosser, Thomas; Jacquier, Alexis; Quick, Harald H; Schäfers, Michael; Hacker, Marcus

    2018-05-02

    Positron emission tomography (PET) and magnetic resonance imaging (MRI) have both been used for decades in cardiovascular imaging. Since 2010, hybrid PET/MRI using sequential and integrated scanner platforms has been available, with hybrid cardiac PET/MR imaging protocols increasingly incorporated into clinical workflows. Given the range of complementary information provided by each method, the use of hybrid PET/MRI may be justified and beneficial in particular clinical settings for the evaluation of different disease entities. In the present joint position statement, we critically review the role and value of integrated PET/MRI in cardiovascular imaging, provide a technical overview of cardiac PET/MRI and practical advice related to the cardiac PET/MRI workflow, identify cardiovascular applications that can potentially benefit from hybrid PET/MRI, and describe the needs for future development and research. In order to encourage its wide dissemination, this article is freely accessible on the European Radiology and European Journal of Hybrid Imaging web sites. • Studies and case-reports indicate that PET/MRI is a feasible and robust technology. • Promising fields of application include a variety of cardiac conditions. • Larger studies are required to demonstrate its incremental and cost-effective value. • The translation of novel radiopharmaceuticals and MR-sequences will provide exciting new opportunities.

  11. Glucagon-Like Peptide-1 Receptor Agonists for the Treatment of Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association.

    Science.gov (United States)

    Kim, Hyun Jin; Park, Seok O; Ko, Seung Hyun; Rhee, Sang Youl; Hur, Kyu Yeon; Kim, Nan Hee; Moon, Min Kyong; Lee, Byung Wan; Kim, Jin Hwa; Choi, Kyung Mook

    2017-12-01

    The glucagon-like peptide-1 receptor agonists (GLP-1RAs) were recommended as a monotherapy or combination therapy with oral hypoglycemic agents or basal insulin in the position statement of the Korean Diabetes Association 2017 for pharmacological therapy. Many randomized clinical trials and systematic reviews report that GLP-1RAs have considerable glucose-lowering effect and lead to weight reduction and low risk of hypoglycemia when used as a monotherapy or combination therapy. The cardiovascular safety of GLP-1RAs has been assessed in several randomized clinical trials and systematic reviews. The results of cardiovascular outcome trials of long-acting GLP-1RAs (liraglutide, semaglutide) demonstrated cardiovascular benefits in subjects with type 2 diabetes mellitus and a high risk of cardiovascular disease. The GLP-1RA may be a choice of therapy when weight control and avoidance of hypoglycemia are important, and patients with high risk of cardiovascular disease might also favor choosing GLP-1RA. Copyright © 2017 Korean Diabetes Association.

  12. Androgen Excess- Polycystic Ovary Syndrome Society: position statement on depression, anxiety, quality of life, and eating disorders in polycystic ovary syndrome.

    Science.gov (United States)

    Dokras, Anuja; Stener-Victorin, Elisabeth; Yildiz, Bulent O; Li, Rong; Ottey, Sasha; Shah, Duru; Epperson, Neill; Teede, Helena

    2018-05-01

    To formulate clinical consensus recommendations for screening depression, anxiety, health-related quality of life (HRQoL), and disordered eating symptoms in women with polycystic ovary syndrome (PCOS) and review prevalence based on phenotypes and ethnicity, changes over time, etiology, and impact of treatment. Systematic reviews and preparation of position statement. Not applicable. Women with PCOS and controls screened using validated tools. None. Depressive symptoms, anxiety symptoms, disordered eating, and HRQoL scores. Several studies demonstrate that women with PCOS have an increased prevalence of higher depression and anxiety scores and higher odds of moderate and severe depressive and anxiety symptoms compared with controls. Obesity, hyperandrogenism, and fertility have a weak association with these symptoms. HRQoL scores are consistently reduced in PCOS, with infertility and weight concerns having the most significant impact. Some studies suggest an increased prevalence of disordered eating in women with PCOS compared with controls. The few studies that have evaluated the impact of PCOS-related treatments (lifestyle interventions and pharmacotherapy) show no detrimental effect or some improvement in depressive and anxiety symptoms and HRQoL scores. In women with PCOS, screening for depressive and anxiety symptoms should be offered at the time of diagnosis and screening for disordered eating should be considered. Further research is required across PCOS phenotypes, in longitudinal cohorts and on impact of therapy on depressive and anxiety syptoms, HRQOL, and disordered eating. Copyright © 2018 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Prevention of Moderate Acute Malnutrition (MAM) Positive Deviance Hearth (PDH) Approach in Burundi

    International Nuclear Information System (INIS)

    Madagasha, Aristide; Tse, Carmen; Baik, Diane

    2014-01-01

    Full text: Background and Objectives: PDH approach utilizes local resources and solutions to rehabilitate and prevent future malnutrition in children under five. Although PDH focuses on addressing underweight, PDH includes children with MAM and may have potential to address and prevent MAM where community-based management of acute malnutrition (CMAM), specifically targeted supplementary feeding component, may not be appropriate. The objectives are: 1) to assess the effectiveness of PDH to reduce moderate and severe underweight in participant children as well as prevent malnutrition in younger siblings of participant children; and 2) to assess PDH’s effectiveness for treatment and prevention of MAM in ten villages in Burundi. Methods: Starting September to November 2012, PDH was implemented by trained community volunteers in the ten villages. A “positive deviant” inquiry identified local practices that positively impact child nutritional status. These practices were transferred to families of malnourished children through experiential learning during 12 days of “Hearth” sessions. Two weeks of home visits followed Hearth. Mid-upper arm circumference of participant children (n = 70) were measured on the first day of Hearth, with appropriate referral for cases of severe acute malnutrition. Weights of children were assessed at Day 1 (n = 94), 12 (n = 94), 30 (n = 74) and one year after the start of Hearth (n = 92). Weight gain of children at Day 12 and 30 were compared with standard weight gains for PDH (200-250 grams for Day 12 and 400 grams for Day 30). Younger siblings were also weighed at the one year follow-up (n = 73). Results: Mean weight-for-age z-scores (WAZ) of the children improved from -3.1±0.2 to -1.1±0.1 (p<0.001), showing sustained catch-up growth at home. Almost all children achieved the standard weight gain on Day 12 and Day 30 (92.6% (87/94) and 98.6% (73/74), respectively). Within one year, severe and moderate underweight decreased from 77

  14. Positive deviance as a strategy to prevent and control bloodstream infections in intensive care.

    Science.gov (United States)

    Oliveira, Francimar Tinoco de; Ferreira, Maria Manuela Frederico; Araújo, Silvia Teresa Carvalho de; Bessa, Amanda Trindade Teixeira de; Moraes, Advi Catarina Barbachan; Stipp, Marluci Andrade Conceição

    2017-04-03

    To describe the application of positive deviance as a strategy to prevent and control bloodstream infections. An intervention study with nursing and medical team members working in an intensive care unit in a university hospital, between June and December 2014. The four steps of the positive defiance methodology were applied: to define, to determine, to discover and to design. In 90 days, 188 actions were observed, of these, 36.70% (n=69) were related to catheter dressing. In 81.15% (n=56) of these dressings, the professionals most adhered to the use of flexible sterile cotton-tipped swabs to perform antisepsis at catheter entry sites and fixation dressing. Positive deviance contributed to the implementation of proposals to improve work processes and team development related to problems identified in central venous catheter care. Descrever a aplicação do Positive Deviance como estratégia na prevenção e no controle da infecção de corrente sanguínea. Estudo de intervenção realizado na Unidade de Terapia Intensiva de um hospital universitário, com os membros das equipes de enfermagem e médica, de junho a dezembro de 2014. Foram aplicados os quatro passos da metodologia Positive Deviance: Definir, Determinar, Descobrir e Desenhar. Em 90 dias 188 ações foram observadas, destas, 36,70% (n=69) estavam relacionadas aos curativos dos cateteres. Em 81,15% (n=56) desses curativos, o uso da haste flexível estéril para realização da antissepsia do local de inserção do cateter e de sua placa de fixação foi a ação de maior adesão. O Positive Deviance auxiliou na implementação de propostas de melhorias de processo de trabalho e no desenvolvimento da equipe para os problemas identificados no cuidado com o cateter venoso central.

  15. Conservation Education: A Position Statement.

    Science.gov (United States)

    Soil Conservation Society of America, Ankeny, IA.

    The Soil Conservation Society of America's (SCSA) aim is to advance the science and art of good land and water use. Conservation education has a significant role in achieving the wise use of these resources. In this report, perspectives are offered on: (1) the requirements for effective conservation education programs; (2) rationale for…

  16. Infrastructure package. Draft position statement

    International Nuclear Information System (INIS)

    Mascarin, Guillaume

    2011-01-01

    The European Commission published on 17 November 2010 the communication entitled: 'COM(2010)0677 - Energy infrastructure priorities for 2020 and beyond - A Blueprint for an integrated European energy network'. It aims at ensuring that strategic energy networks and storage facilities are completed by 2020. To this end, the EC has identified 12 priority corridors and areas covering electricity, gas, oil and carbon dioxide transport networks. It proposes a regime of 'common interest' for projects contributing to implementing these priorities and having obtained this label. The UFE, the professional association for the electricity sector, has analyzed the EC communication and presents its remarks in this document. UFE's focusses its analysis on 5 key points: 1. Towards a European 'strategic planning' tool for future investment; 2. The correlation between networks and security of Supply (production capacities, energy mix); 3. Financing; 4. Acceptability of projects; 5. Accelerate authorisation procedures

  17. SOGC–GOC–SCC Joint Policy Statement. No. 255, March 2011. Cervical cancer prevention in low-resource settings.

    Science.gov (United States)

    Elit, Laurie; Jimenez, Waldo; McAlpine, Jessica; Ghatage, Prafull; Miller, Dianne; Plante, Marie

    2011-03-01

    To help care providers understand the current status of cervical cancer in low-resource countries. The most effective and practical options for cervical screening and treatment in low-resource countries are evaluated. Improvement in rates of prevention and early detection of cervical cancer in low-resource countries. PubMed or Medline, CINAHL, and The Cochrane Library were searched for studies published in English between January 2006 and December 2009. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table). RECOMMENDATIONS 1. All girls 9 years old or over should have access to the cervical cancer vaccine before they become sexually active. (I-A) 2. Cervical cancer screening by visual inspection with acetic acid is suggested for low-resource settings acceptable. Cervical cytology or human papillomavirus testing may also be used when practical. (II-2B) 3. Cryotherapy is a safe, effective, and low-cost therapy that should be included in pre-invasive cervical cancer treatment. (III-B) 4. All countries should have a documented cervical cancer prevention strategy that includes public education built on existing outreach programs. (III-C) 5. Countries should define a centre or centres of excellence for the management of cervical cancer. (III-C) Because these units would serve a larger population, they would be able to identify leaders and develop their skills, and would be able to invest in

  18. Executive summary of the Consensus Statement on monitoring HIV: pregnancy, birth, and prevention of mother-to-child transmission.

    Science.gov (United States)

    Polo Rodríguez, Rosa; Muñoz Galligo, Eloy; Iribarren, José Antonio; Domingo Pedrol, Pere; Leyes García, María; Maiques Montesinos, Vicente; Miralles Martín, Pilar; Noguera Julian, Antoni; Ocampo Hernandez, Antonio; Peres Bares, María Lourdes; López Rojano, Marta; Suy Franch, Anna; Viñuela Beneitez, M Carmen; González Tomé, María Isabel

    2014-05-01

    The main objective in the management of HIV-infected pregnant women is prevention of mother-to-child transmission; therefore, it is essential to provide universal antiretroviral treatment, regardless of CD4 count. All pregnant women must receive adequate information and undergo HIV serology testing at the first visit. If the serological status is unknown at the time of delivery, or in the immediate postpartum, HIV serology testing has to be performed as soon as possible. In this document, recommendations are made regarding the health of the mother and from the perspective of minimizing mother-to-child transmission. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  19. Weaving Student Engagement into the Core Practices of Schools. A National Dropout Prevention Center/Network Position Paper

    Science.gov (United States)

    Dary, Teri; Pickeral, Terry; Shumer, Rob; Williams, Anderson

    2016-01-01

    This position paper on student engagement is organized in response to major questions on how student engagement aligns with dropout prevention. Through a set of questions and responses, the "Weaving Student Engagement Into the Core Practices of Schools" position paper on student engagement : (1) defines the term "student…

  20. Nasal continuous positive airways pressure immediately after extubation for preventing morbidity in preterm infants.

    Science.gov (United States)

    Davis, P G; Henderson-Smart, D J

    2003-01-01

    Preterm infants being extubated following a period of intermittent positive pressure ventilation via an endotracheal tube are at risk of developing respiratory failure as a result of apnea, respiratory acidosis and hypoxia. Nasal continuous positive airway pressure appears to stabilise the upper airway, improve lung function and reduce apnea and may therefore have a role in facilitating extubation in this population. In preterm infants having their endotracheal tube removed following a period of intermittent positive pressure ventilation (IPPV), does management with nasal continuous positive airways pressure (NCPAP) lead to an increased proportion remaining free of additional ventilatory support, compared to extubation directly to headbox oxygen? Searches were made of the Oxford Database of Perinatal Trials, MEDLINE up to November 2002, Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2002), previous reviews including cross references, abstracts of conferences and symposia proceedings, expert informants and journal handsearching mainly in the English language. All trials utilising random or quasi-random patient allocation, in which NCPAP (delivered by any method) was compared with headbox oxygen for post-extubation care were included. Methodological quality was assessed independently by the two authors. Data were extracted independently by the two authors. Prespecified subgroup analysis to determine the impact of different levels of NCPAP, differences in duration of IPPV and use of aminophylline were also performed using the same package. Data were analysed using relative risk (RR), risk difference (RD) and number needed to treat (NNT). Nasal CPAP, when applied to preterm infants being extubated following IPPV, reduces the incidence of adverse clinical events (apnea, respiratory acidosis and increased oxygen requirements) indicating the need for additional ventilatory support [RR 0.62 (0.49, 0.77), RD -0.17 (-0.24,-0.10), NNT 6 (4,10)]. nasal

  1. Regulatory barriers to pollution prevention: A position paper of the implementation council of the American institute for pollution prevention

    International Nuclear Information System (INIS)

    Byers, R.L.

    1991-01-01

    Pollution prevention/waste minimization is a win-win-win situation for government, industry, and the public, which offers more than just protection of the environment for all. Industry gains from reduced capital and operating costs, reduced liabilities, cleaner and safer working conditions, conservation of energy and material resources, and the opportunity for government and industry to work together in a cooperative manner. However, a number of regulatory barriers exist which discourage pollution prevention/waste minimization. This paper provides examples for the aluminum, chemical, petroleum, and wood treating industries of how these regulatory barriers become disincentives. To promote pollusion prevention/waste minimization, Congress and the US EPA need to reexamine those RCRA provisions which support a command and control strategy that creates the barriers. The barriers include the distinction between value and valueless materials, offsite storage requirements prior to reuse/recycle, the Derived from Rule, the Burning for Fuel Rule, land ban technology standards, and RD and D restrictions. A new RCRA Pollution Prevention/Waste Minimization subtitle is proposed to eliminate or minimize these barriers

  2. Peritoneal catheter fixation combined with straight upward tunnel and low implant position to prevent catheter malfunction.

    Science.gov (United States)

    Zhang, Qingyan; Jiang, Chunming; Zhu, Wei; Sun, Cheng; Xia, Yangyang; Tang, Tianfeng; Wan, Cheng; Shao, Qiuyuan; Liu, Jing; Jin, Bo; Zhang, Miao

    2018-03-01

    Catheter malfunction is the main reason for early peritoneal dialysis (PD) technique failure. This study aimed to evaluate the effect of a new surgery technique with catheter fixation to the lower abdominal wall combined with straight upward tunnel and low implant position in reducing catheter malfunction. Patients with end stage renal disease who received PD in our centre from January 2013 to December 2015 were involved in this study. They were randomly divided into three groups according to surgical technique: traditional open surgery group, modified open surgery group and modified open surgery with catheter fixation group. All patients were followed up for six months after surgery. Catheter- related complications were analyzed. A total of 152 patients were involved. Among them, 49 received traditional open surgery (TOS group), 49 received modified open surgery (MOS group), and 54 received modified open surgery with catheter fixation (MOS-F group). During follow-up, no patients (0%) in MOS-F group developed catheter malfunction which was significantly lower than that of the TOS group (0 vs 16.33%, P = 0.002). Although not statistically significant, the incidence of catheter malfunction was lower in MOS-F group than that in MOS group (0 vs 4.08%, P = 0.134). No significant difference was observed in the episodes of infection, bleeding, leakage, inflow or outflow pain, hernia and delayed wound healing among the three groups (all P > 0.05). Catheter fixation combined with straight upward tunnel and low implant position can effectively prevent catheter malfunction in PD catheter placement. © 2016 Asian Pacific Society of Nephrology.

  3. 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.

    Science.gov (United States)

    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

    2015-08-01

    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.

  4. Exercise and type 2 diabetes: American College of Sports Medicine and the American Diabetes Association: joint position statement. Exercise and type 2 diabetes.

    Science.gov (United States)

    Colberg, Sheri R; Albright, Ann L; Blissmer, Bryan J; Braun, Barry; Chasan-Taber, Lisa; Fernhall, Bo; Regensteiner, Judith G; Rubin, Richard R; Sigal, Ronald J

    2010-12-01

    Although physical activity (PA) is a key element in the prevention and management of type 2 diabetes mellitus (T2DM), many with this chronic disease do not become or remain regularly active. High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently, but it is now well established that participation in regular PA improves blood glucose control and can prevent or delay T2DM, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. Structured interventions combining PA and modest weight loss have been shown to lower T2DM risk by up to 58% in high-risk populations. Most benefits of PA on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. The benefits of physical training are discussed, along with recommendations for varying activities, PA-associated blood glucose management, diabetes prevention, gestational diabetes, and safe and effective practices for PA with diabetes-related complications.

  5. Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement.

    Science.gov (United States)

    Lin, Kenneth; Fajardo, Kevin

    2008-07-01

    Asymptomatic bacteriuria is common, and screening for this condition in pregnant women is a well-established, evidence-based standard of current medical practice. Screening other groups of adults has not been shown to improve outcomes. To review new and substantial evidence on screening for asymptomatic bacteriuria, to support the work of the U.S. Preventive Services Task Force. English-language studies of adults (age >18 years) indexed in PubMed and the Cochrane Library and published from 1 January 2002 through 30 April 2007. For benefits of screening or treatment for screened populations, systematic reviews; meta-analyses; and randomized, controlled trials were included. For harms of screening, systematic reviews; meta-analyses; randomized, controlled trials; cohort studies; case-control studies; and case series of large multisite databases were included. Two reviewers independently reviewed titles, abstracts, and full articles for inclusion. Two reviewers extracted data from studies on benefits of screening and treatment (including decreases in the incidence of adverse maternal and fetal outcomes, symptomatic urinary tract infections, hypertension, and renal function decline). An updated Cochrane systematic review of 14 randomized, controlled trials of treatment supports screening for asymptomatic bacteriuria in pregnant women. A randomized, controlled trial and a prospective cohort study show that screening nonpregnant women with diabetes for asymptomatic bacteriuria is unlikely to produce benefits. No new evidence on screening men for asymptomatic bacteriuria or on harms of screening was found. The focused search strategy may have missed some smaller studies on the benefits and harms of screening for asymptomatic bacteriuria. The available evidence continues to support screening for asymptomatic bacteriuria in pregnant women, but not in other groups of adults.

  6. Positioning the principles of precision medicine in care pathways for allergic rhinitis and chronic rhinosinusitis - A EUFOREA-ARIA-EPOS-AIRWAYS ICP statement.

    Science.gov (United States)

    Hellings, P W; Fokkens, W J; Bachert, C; Akdis, C A; Bieber, T; Agache, I; Bernal-Sprekelsen, M; Canonica, G W; Gevaert, P; Joos, G; Lund, V; Muraro, A; Onerci, M; Zuberbier, T; Pugin, B; Seys, S F; Bousquet, J

    2017-09-01

    Precision medicine (PM) is increasingly recognized as the way forward for optimizing patient care. Introduced in the field of oncology, it is now considered of major interest in other medical domains like allergy and chronic airway diseases, which face an urgent need to improve the level of disease control, enhance patient satisfaction and increase effectiveness of preventive interventions. The combination of personalized care, prediction of treatment success, prevention of disease and patient participation in the elaboration of the treatment plan is expected to substantially improve the therapeutic approach for individuals suffering from chronic disabling conditions. Given the emerging data on the impact of patient stratification on treatment outcomes, European and American regulatory bodies support the principles of PM and its potential advantage over current treatment strategies. The aim of the current document was to propose a consensus on the position and gradual implementation of the principles of PM within existing adult treatment algorithms for allergic rhinitis (AR) and chronic rhinosinusitis (CRS). At the time of diagnosis, prediction of success of the initiated treatment and patient participation in the decision of the treatment plan can be implemented. The second-level approach ideally involves strategies to prevent progression of disease, in addition to prediction of success of therapy, and patient participation in the long-term therapeutic strategy. Endotype-driven treatment is part of a personalized approach and should be positioned at the tertiary level of care, given the efforts needed for its implementation and the high cost of molecular diagnosis and biological treatment. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  7. Resonating Statements

    DEFF Research Database (Denmark)

    Hjelholt, Morten; Jensen, Tina Blegind

    2015-01-01

    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...

  8. Financial Statements

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

    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.

  9. 17 CFR 250.28 - Inconsistent financial statements.

    Science.gov (United States)

    2010-04-01

    ... Accounts § 250.28 Inconsistent financial statements. Except as otherwise authorized or required by the..., financial statements which are inconsistent with the book accounts of such company or financial statements... prevent the distribution or publication of reasonable condensations or of unaudited financial statements...

  10. Prevention of Hypoxemia During Apnea Testing: A Comparison of Oxygen Insufflation And Continuous Positive Airway Pressure.

    Science.gov (United States)

    Kramer, Andreas H; Couillard, Philippe; Bader, Ryan; Dhillon, Peter; Kutsogiannis, Demetrios J; Doig, Christopher J

    2017-08-01

    Apnea testing is an essential step in the clinical diagnosis of brain death. Current international guidelines recommend placement of an oxygen (O 2 ) insufflation catheter into the endotracheal tube to prevent hypoxemia, but use of a continuous positive airway pressure (CPAP) valve may be more effective at limiting arterial partial pressure of O 2 (PO 2 ) reduction. We performed a multicenter study assessing consecutive apnea tests in 14 intensive care units (ICUs) in two cities utilizing differing protocols. In one city, O 2 catheters are placed and arterial blood gases (ABGs) performed at intervals determined by the attending physician. In the other city, a resuscitation bag with CPAP valve is attached to the endotracheal tube, and ABGs performed every 3-5 min. We assessed arterial PO 2 , partial pressure of carbon dioxide (PCO 2 ), pH, and blood pressure at the beginning and termination of each apnea test. Thirty-six apnea tests were performed using an O 2 catheter and 50 with a CPAP valve. One test per group was aborted because of physiological instability. There were no significant differences in the degree of PO 2 reduction (-59 vs. -32 mmHg, p = 0.72), rate of PCO 2 rise (3.2 vs. 3.9 mmHg per min, p = 0.22), or pH decline (-0.02 vs. -0.03 per min, p = 0.06). Performance of ABGs at regular intervals was associated with shorter test duration (10 vs. 7 min, p pressure decline (p = 0.006). Both methods of O 2 supplementation are associated with similar changes in arterial PO 2 and PCO 2 . Performance of ABGs at regular intervals shortens apnea test duration and may avoid excessive pH reduction and consequent hemodynamic effects.

  11. Positive prevention: reducing HIV transmission among people living with HIV/AIDS

    National Research Council Canada - National Science Library

    Kalichman, Seth C

    2005-01-01

    ... of New South Wales, Australia Rise Goldstein, Center for HIV Identification, Prevention, and Treatment Services, Department of Psychiatry University of California, Los Angeles Lauren K. Gooden,...

  12. Understanding Financial Statements. Financial Matters. Board Basics.

    Science.gov (United States)

    McCarthy, John H.; Turner, Robert M.

    1998-01-01

    This booklet for trustees of higher education institutions offers guidelines to help trustees understand the institution's financial statements. Individual sections describe the three major financial statements and cover topics such as: (1) standards of the Financial Accounting Standards Board; (2) the "statement of financial position,"…

  13. The State of Prescreening Discussions About Prostate-specific Antigen Testing Following Implementation of the 2012 United States Preventive Services Task Force Statement.

    Science.gov (United States)

    Turini, George A; Gjelsvik, Annie; Renzulli, Joseph F

    2017-06-01

    To determine if the quality of prescreening discussions has changed following release of the United States Preventive Services Task Force statement against prostate cancer screening. This cross-sectional study used the 2012 and 2014 Behavioral Risk Factor Surveillance System surveys. Respondents were categorized based on the year in which they responded to the Behavioral Risk Factor Surveillance System Survey. Quality of prescreening discussion was operationalized as having discussed only advantages, only disadvantages, both advantages and disadvantages, or neither. Race/ethnicity, education level, income, insurance status, and having a prostate-specific antigen (PSA) level actually drawn after prescreening counseling served as confounders in our multivariate analysis. Among 217,053 men in the analytic sample, 37% were told about only advantages of PSA screening compared to 30% of men who were advised about both advantages and disadvantages. Men who were told about neither advantages nor disadvantages were more likely to be Hispanic, not graduate high school, have low income, and not have insurance. Controlling for covariates, men in 2014 were significantly more likely to have undergone PSA testing without having discussed either advantages or disadvantages than men in 2012. Comprehensive prescreening discussions about advantages and disadvantages of PSA testing are critical to informed decision making about prostate cancer screening. Disparities not only exist with regard to the quality of prescreening discussions that patients receive from their providers prior to PSA testing across categories of race/ethnicity, education, income, and insurance status, but these disparities became more substantial between 2012 and 2014. Further investigation is warranted to elicit more specific reasons behind these variations. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Auditing nuclear materials statements

    International Nuclear Information System (INIS)

    Anon.

    1973-01-01

    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

  15. Young Women's Lived Experience of Participating in a Positive Youth Development Programme: The "Teens & Toddlers" Pregnancy Prevention Intervention

    Science.gov (United States)

    Sorhaindo, Annik; Mitchell, Kirstin; Fletcher, Adam; Jessiman, Patricia; Keogh, Peter; Bonell, Chris

    2016-01-01

    Purpose: Evaluation of the Teens & Toddlers (T&T) positive youth development (PYD) and teenage pregnancy prevention programme suggested that the intervention had minimal effectiveness partly due to its unclear theory of change. The purpose of this paper is to examine the lived experiences of young women participating in the programme to…

  16. Woman to Woman: Coming Together for Positive Change--Using Empowerment and Popular Education to Prevent HIV in Women

    Science.gov (United States)

    Romero, Lisa; Wallerstein, Nina; Lucero, Julie; Fredine, Heidi Grace; Keefe, Joanna; O'Connell, JoAnne

    2006-01-01

    HIV risk is the product of social, cultural, economic, and interpersonal forces that create sex-role definitions and expectations that can lead to gender inequalities in health. Woman to Woman: Coming Together for Positive Change is an HIV/AIDS prevention intervention that takes into account that choices and actions may be constrained by poverty,…

  17. Prevention of Vitamin K Deficiency Bleeding in Newborn Infants: A Position Paper by the ESPGHAN Committee on Nutrition

    NARCIS (Netherlands)

    Mihatsch, Walter A.; Braegger, Christian; Bronsky, Jiri; Campoy, Cristina; Domellöf, Magnus; Fewtrell, Mary; Mis, Nataša F.; Hojsak, Iva; Hulst, Jessie; Indrio, Flavia; Lapillonne, Alexandre; Mlgaard, Christian; Embleton, Nicholas; van Goudoever, Johannes

    2016-01-01

    Vitamin K deficiency bleeding (VKDB) due to physiologically low vitamin K plasma concentrations is a serious risk for newborn and young infants and can be largely prevented by adequate vitamin K supplementation. The aim of this position paper is to define the condition, describe the prevalence,

  18. Tapping into the Power of School Climate to Prevent Bullying: One Application of Schoolwide Positive Behavior Interventions and Supports

    Science.gov (United States)

    Bosworth, Kris; Judkins, Maryann

    2014-01-01

    Preventing bullying requires a comprehensive approach that includes a focus on school climate. We review the climate features shown to reduce bullying, then illustrate how School-wide Positive Behavioral Interventions and Supports (SWPBIS) applies these principles in practice. SWPBIS, grounded in multiple theories--behaviorism, social learning…

  19. Human Rights, Positive Obligations, and Measures to Prevent Human Trafficking in the UK

    OpenAIRE

    Turner, Ian David

    2015-01-01

    Article 4 of the European Convention on Human Rights is freedom from slavery. A key feature of this right is the obligation it imposes on states such as the UK to prevent violations of the freedom, such as the trafficking in human beings, by third parties. This piece finds that the UK’s response to its duties in preventing human trafficking is patchy but concludes that this will be much improved with its new Modern Slavery Bill 2014-15.

  20. Consolidated financial statements for fiscal year 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    The following overview and accompanying audited financial statements have been prepared for Fiscal Year (FY) 1996 to report the financial position and the results of operations of the Department of Energy. These statements include the consolidated Statement of Financial Position and the consolidated Statement of Operations and Changes in Net Position. The statements have been prepared in accordance with the Office of Management and Budget Bulletin No. 94-01, Form and Content for Agency Financial Statements, and were developed in accordance with the hierarchy of accounting standards described therein. The overview provides a narrative on the Department of Energy`s mission, activities, and accomplishments. Utilizing performance measures as the primary vehicle for communicating Departmental accomplishments and results, this overview discusses the most significant measures while others are discussed in the supplemental information to the financial statements.

  1. Rio 2016 financial statements

    OpenAIRE

    2015-01-01

    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.

  2. Assessment and management of bone health in women with oestrogen receptor-positive breast cancer receiving endocrine therapy: Position statement of the Endocrine Society of Australia, the Australian and New Zealand Bone & Mineral Society, the Australasian Menopause Society and the Clinical Oncology Society of Australia.

    Science.gov (United States)

    Grossmann, Mathis; Ramchand, Sabashini; Milat, Frances; Vincent, Amanda; Lim, Elgene; Kotowicz, Mark A; Hicks, Jill; Teede, Helena

    2018-05-09

    To formulate clinical consensus recommendations on bone health assessment and management of women with oestrogen receptor-positive early breast cancer receiving endocrine therapy. Representatives appointed by relevant Australian Medical Societies used a systematic approach for adaptation of guidelines (ADAPTE) to derive an evidence-informed position statement addressing five key questions. Women receiving adjuvant aromatase inhibitors and the subset of premenopausal woman on tamoxifen have accelerated bone loss and increased fracture risk. Both bisphosphonates and denosumab prevent bone loss, additionally denosumab has proven anti-fracture benefit. Women considering endocrine therapy need fracture risk assessment, including clinical risk factors, biochemistry and bone mineral density (BMD) measurement, with monitoring based on risk factors. Weight-bearing exercise, vitamin D and calcium sufficiency is recommended routinely. Antiresorptive treatment should be considered in women with prevalent or incident clinical or morphometric fractures, a T-score (or Z-scores in women <50 years) of <-2.0 at any site, or if annual bone loss is ≥5%, considering baseline BMD and other fracture risk factors. Duration of antiresorptive treatment can be individualised based on absolute fracture risk. Relative to their skeletal benefits, risks of adverse events with antiresorptive treatments are low. Skeletal health should be considered in the decision-making process regarding choice and duration of endocrine therapy. Before and during endocrine therapy, skeletal health should be assessed regularly, optimised by nonpharmacological intervention and where indicated antiresorptive treatment, in an individualised, multidisciplinary approach. Clinical trials are needed to better delineate long-term fracture risks of adjuvant endocrine therapy, and to determine the efficacy of interventions designed to minimise these risks. This article is protected by copyright. All rights reserved. This

  3. The Effectiveness of Interventions based on Positive Psychotherapy on Improving Coping Styles, Relapse Prevention in Individuals with Substance Use Disorder

    Directory of Open Access Journals (Sweden)

    maryam kadivar

    2016-01-01

    Full Text Available The aim of the study was to evaluate the effectiveness of interventions based on positive psychotherapy on improving coping styles, relapse prevention in individuals diagnosed with substance use disorder. The research design was quasi-experimental with pretest-posttest, a month Follow-up and control group. Thirty-one individuals with substance use disorder, who were admitted to addiction treatment centers in Zahedan city, were selected through purposeful sampling method and were randomly assigned to an experimental (14 persons and control (17 persons groups. Both groups were asked to respond to Coping Styles Questionnaire by Billings and Mouse, at the pretest stage. In later stages of research, the experimental group received an intervention based on positive psychotherapy for ten sessions each session60 minutes. Data was analyzed using covariance and chi-square test. The results showed that intervention based on positive psychotherapy improved the coping styles and relapse prevention in the experimental group and the effect of the intervention was significant in post-test and follow-up stages. The result also showed that interventions based on positive psychotherapy could be used as an efficient technique to improve coping skills and relapse prevention in patients with substance use disorder.

  4. A Positive Model for Reducing and Preventing School Burnout in High School Students

    Science.gov (United States)

    Aypay, Ayse

    2017-01-01

    This study aims to develop and test the validity of a model limited to attitude towards the future and subjective well-being for reducing and preventing the school burnout that high school students can experience. The study is designed as a relational screening model conducted over 389 high school students. The data in this study are analyzed…

  5. Positive and Negative Effects of a Child Sexual Abuse Prevention Program.

    Science.gov (United States)

    Taal, Margot; Edelaar, Monique

    1997-01-01

    Evaluation of a Dutch sexual abuse prevention program, "Right for Security," for elementary school children (ages 8 to 12) found differences in short-term and long-term effects. In the long run, children thought refusing to cooperate with the intruder more feasible and younger children showed less social anxiousness. However, the oldest…

  6. Continuous Positive Airway Pressure (CPAP for prevention of recurrent pneumonia in the Neuromyelitis Optica patient

    Directory of Open Access Journals (Sweden)

    James A. Welker

    2014-01-01

    Conclusions: Patients with Neuromyelitis Optica differ from those with traumatic spinal cord injury as they have a chronic progressive systemic illness that causes continued deterioration of their nervous system resulting in the need for routine monitoring that ensures the timely addition of CPAP for the prevention of pneumonia and its associated medical expenses.

  7. Usage of internal statements in making consolidated financial statement

    Directory of Open Access Journals (Sweden)

    V.N. Herman

    2016-12-01

    Full Text Available The emergence of the consolidated financial statements is the result of integration processes in the businesses that lead to pooling of different companies. As consolidated financial statements present an aggregated look at the financial position of a parent and its subsidiaries, they let you gauge the overall health of an entire group of companies as opposed to one company’s standalone position. Consolidation of financial statements requires from the participants of joining elaborating their individual statements. The article describes the general scheme of consolidation process and defines the key trends of consolidation adjustments, in particular, financial investments, internal operations, goodwill and exchange rate differences. It is found out that to get information about internal operations and financial investments such data have to be synthesized from internal statements. This approach allows using the same accounting methods to parent and subsidiary entities. The objects, the users and the subject domain of internal statements are determined in order to make consolidation of financial statements of joining.

  8. Preventive maintenance and load testing of fixed position cranes in support of major operations

    International Nuclear Information System (INIS)

    Detrick, C.K.

    1980-01-01

    This paper will address load testing and preventive maintenance of fixed in-place cranes in general, and maintenance and load testing of the 200 ton Polar Gantry Crane at the FFTF in particular. This paper also covers the installation of a 100-ton bridge crane in the FFTF's Reactor Service Building, as well as use of these cranes in making important lifts of FFTF equipment

  9. ADIPOSITY-BASED CHRONIC DISEASE AS A NEW DIAGNOSTIC TERM: THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT.

    Science.gov (United States)

    Mechanick, Jeffrey I; Hurley, Daniel L; Garvey, W Timothy

    2017-03-01

    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

  10. 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.

    Science.gov (United States)

    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

    2015-08-25

    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.

  11. 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

    Science.gov (United States)

    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.

    2015-01-01

    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

  12. The association between Colombian medical students' healthy personal habits and a positive attitude toward preventive counseling: cross-sectional analyses

    Science.gov (United States)

    Duperly, John; Lobelo, Felipe; Segura, Carolina; Sarmiento, Francisco; Herrera, Deisy; Sarmiento, Olga L; Frank, Erica

    2009-01-01

    Background Physician-delivered preventive counseling is important for the prevention and management of chronic diseases. Data from the U.S. indicates that medical students with healthy personal habits have a better attitude towards preventive counseling. However, this association and its correlates have not been addressed in rapidly urbanized settings where chronic disease prevention strategies constitute a top public health priority. This study examines the association between personal health practices and attitudes toward preventive counseling among first and fifth-year students from 8 medical schools in Bogotá, Colombia. Methods During 2006, a total of 661 first- and fifth-year medical students completed a culturally adapted Spanish version of the "Healthy Doctor = Healthy Patient" survey (response rate = 78%). Logistic regression analyses were used to assess the association between overall personal practices on physical activity, nutrition, weight control, smoking, alcohol use (main exposure variable) and student attitudes toward preventive counseling on these issues (main outcome variable), stratified by year of training and adjusting by gender and medical training-related factors (basic knowledge, perceived adequacy of training and perception of the school's promotion on each healthy habit). Results The median age and percentage of females for the first- and fifth-year students were 21 years and 59.5% and 25 years and 65%, respectively. After controlling for gender and medical training-related factors, consumption of ≥ 5 daily servings of fruits and/or vegetables, not being a smoker or binge drinker were associated with a positive attitude toward counseling on nutrition (OR = 4.71; CI = 1.6–14.1; p = 0.006 smoking (OR = 2.62; CI = 1.1–5.9; p = 0.022), and alcohol consumption (OR = 2.61; CI = 1.3–5.4; p = 0.009), respectively. Conclusion As for U.S. physician and medical students, a positive association was found between the personal health habits of

  13. Position of the Academy of Nutrition and Dietetics: interventions for the prevention and treatment of pediatric overweight and obesity.

    Science.gov (United States)

    Hoelscher, Deanna M; Kirk, Shelley; Ritchie, Lorrene; Cunningham-Sabo, Leslie

    2013-10-01

    It is the position of the Academy of Nutrition and Dietetics that prevention and treatment of pediatric overweight and obesity require systems-level approaches that include the skills of registered dietitians, as well as consistent and integrated messages and environmental support across all sectors of society to achieve sustained dietary and physical-activity behavior change. This position paper provides guidance and recommendations for levels of intervention targeting overweight and obesity prevention and treatment from preschool age through adolescence. Methods included a review of the literature from 2009 to April 2012, including the Academy's 2009 evidence analysis school-based reviews. Multicomponent interventions show the greatest impact for primary prevention; thus, early childhood and school-based interventions should integrate behavioral and environmental approaches that focus on dietary intake and physical activity using a systems-level approach targeting the multilevel structure of the socioecological model as well as interactions and relationships between levels. Secondary prevention and tertiary prevention/treatment should emphasize sustained family-based, developmentally appropriate approaches that include nutrition education, dietary counseling, parenting skills, behavioral strategies, and physical-activity promotion. For obese youth with concomitant serious comorbidities, structured dietary approaches and pharmacologic agents should be considered, and weight-loss surgery can be considered for severely obese adolescents. Policy and environmental interventions are recommended as feasible and sustainable ways to support healthful lifestyles for children and families. The Academy supports commitment of resources for interventions, policies, and research that promote healthful eating and physical-activity behaviors to ensure that all youth have the opportunity to achieve and maintain a weight that is optimal for health. Copyright © 2013 Academy of

  14. Breast radiotherapy in the lateral decubitus position: A technique to prevent lung and heart irradiation

    International Nuclear Information System (INIS)

    Campana, Francois; Kirova, Youlia M.; Rosenwald, Jean-Claude; Dendale, Remi; Vilcoq, Jacques R.; Dreyfus, Helene; Fourquet, Alain

    2005-01-01

    Purpose: To present an original technique for breast radiotherapy, with the aim of limiting lung and heart irradiation, satisfying quality assurance criteria. Methods and Material: An original radiotherapy technique for breast irradiation has been developed at the Institute Curie in January 1996. It consists of isocentric breast irradiation in the lateral decubitus position (isocentric lateral decubitus [ILD]). This technique is indicated for voluminous or pendulous breasts needing breast irradiation only. Thin carbon fiber supports and special patient positioning devices have been developed especially for this technique. In vivo measurements were performed to check the dose distribution before the routine use of the technique. Results: ILD has been successfully implemented in routine practice, and 500 patients have been already treated. Breast radiotherapy is performed using a dose of 50 Gy at ICRU point in 25 fractions. ILD shows good homogeneity of the dose in breast treatment volume, treatment fields are perpendicular to the skin ensuring its protection, and extremely low dose is delivered to the underlying lung and heart. Conclusion: In cases of voluminous breasts or patients with a history of lung and heart disease, our technique provides several advantages over the conventional technique with opposing tangential fields. This technique improves the dose homogeneity according to the ICRU recommendations

  15. [Edoxaban for stroke prevention in atrial fibrillation and treatment of venous thromboembolism: an expert position paper].

    Science.gov (United States)

    Weiss, Thomas W; Rohla, Miklos; Dieplinger, Benjamin; Domanovits, Hans; Fries, Dietmar; Vosko, Milan R; Gary, Thomas; Ay, Cihan

    2018-04-01

    Edoxaban is the most recent available representative of the Non-Vitamin K antagonist oral anticoagulants (NOAC). The approval was based on the largest phase III trials of NOACs for stroke prevention in patients with non-valvular atrial fibrillation (AF, ENGAGE-AF), and for the treatment of venous thromboembolism (VTE, HOKUSAI-VTE). In both trials, edoxaban was associated with similar efficacy and a significant reduction in bleeding events with respect to the pre-defined primary safety endpoints, as compared to warfarin.Additionally, the once daily dosing of edoxaban, the clinically investigated strategy for dose-reduction based on clearly defined criteria and the favorable pharmacokinetic profile might further support the clinical applicability of the substance.In the light of recent data, this expert consensus document aims to summarize the latest clinical trial results while providing a concise overview of current guideline recommendations on the management of patients with non-valvular AF and VTE.

  16. Position paper on nuclear proliferation issues preventing nuclear proliferation. A duty for the nuclear community

    Energy Technology Data Exchange (ETDEWEB)

    Goldschmidt, Pierre; Bonin, Bernard [ENS High Scientific Council, Brussels (Belgium)

    2010-06-15

    The production of electricity from nuclear power plants is widely seen today as having an increasing role to play in meeting global energy requirements in a sustainable manner. Conscious of the inherently sensitive nature of nuclear technology and materials the ENS-HSC (European Nuclear Society - High Scientific Council) is well aware that a severe safety, security, environmental or proliferation mishap stemming from nuclear energy anywhere in the world would undermine the potential for nuclear energy to contribute to the global energy supply and the minimization of harmful carbon emissions. While the safety of nuclear power plants has continuously improved over the last three decades, the same degree of success cannot be claimed when it comes to the achievements of the international community in stemming the risk of nuclear weapons proliferation. This unfortunate situation is due to both technical and political reasons. The European nuclear industry is committed to the exclusively peaceful use of nuclear energy and to export nuclear facilities and related materials, equipment and technology solely in accordance with relevant national export laws and regulations, Nuclear Suppliers Group guidelines and pertinent United Nations Security Council Resolutions. The ENS-HSC considers that, as a manifestation of their strong commitment to nonproliferation, it is important for the nuclear industry to pay special attention to and promote proliferation-resistant designs and to take IAEA safeguards requirements into account at the design stage. Preventing nuclear proliferation is primarily the responsibility of states but, as major stakeholders, the nuclear industry and scientific community should actively support nuclear disarmament as foreseen in the Non-Proliferation Treaty and measures necessary to strengthen the non-proliferation regime, particularly the international control of the flux of nuclear material and technology. (orig.)

  17. Position paper on nuclear proliferation issues preventing nuclear proliferation. A duty for the nuclear community

    International Nuclear Information System (INIS)

    Goldschmidt, Pierre; Bonin, Bernard

    2010-01-01

    The production of electricity from nuclear power plants is widely seen today as having an increasing role to play in meeting global energy requirements in a sustainable manner. Conscious of the inherently sensitive nature of nuclear technology and materials the ENS-HSC (European Nuclear Society - High Scientific Council) is well aware that a severe safety, security, environmental or proliferation mishap stemming from nuclear energy anywhere in the world would undermine the potential for nuclear energy to contribute to the global energy supply and the minimization of harmful carbon emissions. While the safety of nuclear power plants has continuously improved over the last three decades, the same degree of success cannot be claimed when it comes to the achievements of the international community in stemming the risk of nuclear weapons proliferation. This unfortunate situation is due to both technical and political reasons. The European nuclear industry is committed to the exclusively peaceful use of nuclear energy and to export nuclear facilities and related materials, equipment and technology solely in accordance with relevant national export laws and regulations, Nuclear Suppliers Group guidelines and pertinent United Nations Security Council Resolutions. The ENS-HSC considers that, as a manifestation of their strong commitment to nonproliferation, it is important for the nuclear industry to pay special attention to and promote proliferation-resistant designs and to take IAEA safeguards requirements into account at the design stage. Preventing nuclear proliferation is primarily the responsibility of states but, as major stakeholders, the nuclear industry and scientific community should actively support nuclear disarmament as foreseen in the Non-Proliferation Treaty and measures necessary to strengthen the non-proliferation regime, particularly the international control of the flux of nuclear material and technology. (orig.)

  18. FINANCIAL AUDIT: Capitol Preservation Fund's Fiscal Years 2001 and 2000 Financial Statements

    National Research Council Canada - National Science Library

    Franzel, Jeanette

    2002-01-01

    The statements of the financial position of the Capitol Preservation Fund (the Fund) as of September 30, 2001, and 2000 were audited, and the related statements of activities and statements of cash flows for the fiscal years then ended...

  19. Reference values for spirometry and their use in test interpretation: A Position Statement from the Australian and New Zealand Society of Respiratory Science.

    Science.gov (United States)

    Brazzale, Danny; Hall, Graham; Swanney, Maureen P

    2016-10-01

    Traditionally, spirometry testing tended to be confined to the realm of hospital-based laboratories but is now performed in a variety of health care settings. Regardless of the setting in which the test is conducted, the fundamental basis of spirometry is that the test is both performed and interpreted according to the international standards. The purpose of this Australian and New Zealand Society of Respiratory Science (ANZSRS) statement is to provide the background and recommendations for the interpretation of spirometry results in clinical practice. This includes the benchmarking of an individual's results to population reference data, as well as providing the platform for a statistically and conceptually based approach to the interpretation of spirometry results. Given the many limitations of older reference equations, it is imperative that the most up-to-date and relevant reference equations are used for test interpretation. Given this, the ANZSRS recommends the adoption of the Global Lung Function Initiative (GLI) 2012 spirometry reference values throughout Australia and New Zealand. The ANZSRS also recommends that interpretation of spirometry results is based on the lower limit of normal from the reference values and the use of Z-scores where available. © 2016 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.

  20. Positive benefits: preventive impact of post-exposure prophylaxis awareness among those with diagnosed HIV.

    Science.gov (United States)

    Dodds, C

    2008-04-01

    To consider the extent to which those presenting for post-exposure prophylaxis (PEP) after sexual risk had been encouraged to do so by their PEP-aware partners with (diagnosed) HIV. Thirty men who had completed the 2005 UK Gay Men's Sex Survey who said they had ever tried to get PEP took part in a 30 minute telephone interview. Fifteen men in the sample described a sexual exposure incident where they had knowledge that their partner was diagnosed with having HIV. Of these, only five knew about their partner's HIV diagnosis prior to sexual contact. The remaining 10 sought PEP because their sexual partner revealed his positive status following potential sexual exposure. Our analysis revealed that word of mouth from friends, sexual partners and health professionals played a key role in men's knowledge about the existence of PEP. It is important for HIV and sexual health specialists to ensure that PEP information is not only targeted at those who are tested negative for HIV or are untested but also to people with diagnosed HIV.

  1. Saskatchewan Energy Holdings Ltd. consolidated financial statements

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    The consolidated financial statements of Saskatchewan Energy Holdings Ltd. (formerly Saskatchewan Energy Corporation) as of December 31, 1990, and the consolidated statements of earnings and retained earnings and changes in cash position for the year are presented. Data include an inventory of supplies, natural gas in storage, property, plant and equipment. Financial statements are also presented for the year ending December 31, 1989, with comparative figures for the seven months ending December 31, 1988.

  2. Saskatchewan Energy Holdings Ltd. consolidated financial statements

    International Nuclear Information System (INIS)

    1991-01-01

    The consolidated financial statements of Saskatchewan Energy Holdings Ltd. (formerly Saskatchewan Energy Corporation) as of December 31, 1990, and the consolidated statements of earnings and retained earnings and changes in cash position for the year are presented. Data include an inventory of supplies, natural gas in storage, property, plant and equipment. Financial statements are also presented for the year ending December 31, 1989, with comparative figures for the seven months ending December 31, 1988

  3. Options for combination therapy in type 2 diabetes: comparison of the ADA/EASD position statement and AACE/ACE algorithm.

    Science.gov (United States)

    Bailey, Timothy

    2013-09-01

    Treating patients with diabetes is one of the most challenging and important activities a physician (primary care physician or specialist) can undertake. A key to successful therapy for type 2 diabetes is the insight that this condition is progressive and that the need for additional agents over time is normative. The ability to individualize therapy by patient and medication characteristics comes from experience and knowledge of pertinent clinical studies. However, guidelines from expert bodies such as the American Diabetes Association/European Association for the Study of Diabetes and American Association of Clinical Endocrinologists/American College of Endocrinology can help clinicians of all levels of expertise to approach therapy choices more rationally. There is unity across these guidelines about the role and benefits of metformin as first-line pharmacological treatment, probability of good efficacy, low risk of hypoglycemia, modest weight loss, and overall long-term data. Unfortunately, this unity does not extend to recommendations for subsequent pharmacological agents and their use in combination to intensify treatment when insulin is not (yet) appropriate. Across both statements, some drug classes seem more prominent, and looking at their benefit-risk profile, it is clear why this is the case. The most profound recent change in diabetes therapy has been the introduction of incretin therapies. Incretin therapies minimize 2 important adverse effects seen with many other therapies: hypoglycemia and weight gain. These agents have increased the range of options available for early intensification of treatment of type 2 diabetes. In combination with more established therapies, there are more opportunities than ever to accommodate patient preferences while improving glycemic control and harnessing extraglycemic benefits of a second (or third) agent. Copyright © 2013. Published by Elsevier Inc.

  4. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  5. Sex position, marital status, and HIV risk among Indian men who have sex with men: clues to optimizing prevention approaches.

    Science.gov (United States)

    Hemmige, Vagish; Snyder, Hannah; Liao, Chuanhong; Mayer, Kenneth; Lakshmi, Vemu; Gandham, Sabitha R; Orunganti, Ganesh; Schneider, John

    2011-12-01

    A divide exists between categories of men who have sex with men (MSM) in India based on their sex position, which has consequences for the design of novel HIV prevention interventions. We examine the interaction between sex position and other attributes on existing HIV risk including previous HIV testing, unprotected anal intercourse (UAI), and HIV serostatus among MSM recruited from drop-in centers and public cruising areas in the twin cities of Hyderabad and Secunderabad, India. A survey was administered by trained research assistants and minimally invasive HIV testing was performed by finger-stick or oral testing. HIV seropositive MSM underwent CD4+ lymphocyte count measurement. In our sample (n = 676), 32.6% of men were married to women, 22.2% of receptive only participants were married, and 21.9% of men were HIV seropositive. In bivariate analysis, sex position was associated with previous HIV testing, UAI, HIV serostatus, and CD4+ lymphocyte count at diagnosis. In multivariate analysis with interaction terms, dual unmarried men were more likely to have undergone an HIV test than insertive unmarried men (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.2-6.5), a relationship that did not hold among married men. Conversely, dual married men were less likely than insertive married men to engage in UAI (OR 0.3; 95% CI 0.1-0.6), a relationship that did not hold among unmarried men. Further implementation research is warranted in order to best direct novel biologic and behavioral prevention interventions towards specific risk behaviors in this and other similar contexts.

  6. Reflections on the Swiss Consensus Statement in the context of qualitative interviews with heterosexuals living with HIV.

    Science.gov (United States)

    Persson, A

    2010-12-01

    In 2008, the Swiss Federal AIDS Commission released a statement concluding that people with HIV who are on treatment and have an undetectable viral load are non-infectious and can safely practice unprotected sex with their HIV-negative partner under certain conditions. Contradicting over 25 years of HIV prevention messages, the so called Swiss Consensus Statement sparked a polarised international debate. One key concern is that the Statement will be misinterpreted to imply that everybody on treatment can have unprotected sex. Therefore, critics warn against any departure from the emphasis on condoms as the most effective prevention method. Given this concern, it is useful to reflect on what relevance the Swiss Statement may have for those concerned. This paper draws on qualitative interviews with HIV-positive heterosexuals and HIV-negative partners in Australia. Conducted both before and after the release of the Statement, these interviews revealed that sexual decision-making was not based solely on calculations of risk, but shaped by complex emotions and relationship priorities. The interviews also revealed that participants were sceptical towards the Statement's prevention message. These findings call into question the central concerns that drive this debate.

  7. Should patients with CKD stage 5D and biochemical evidence of secondary hyperparathyroidism be prescribed calcimimetic therapy? An ERA-EDTA position statement

    NARCIS (Netherlands)

    Goldsmith, David; Covic, Adrian; Vervloet, Marc; Cozzolino, Mario; Nistor, Ionut; Vervloet, Mark; Brandenburg, Vincent; Bover, Jordi; Evenepoel, Pieter; Massy, Ziad; Mazzaferro, Sandro; Urena-Torres, Pablo; Abramowicz, D.; Bolignano, D.; Cannata Andia, G.; Cochat, P.; Covic, A.; Delvecchio, L.; Drechsler, C.; Eckardt, K. U.; Fouque, D.; Fox, J.; Haller, M.; Heimburger, O.; Jager, K. J.; Lindley, E.; Marti Monros, A. M.; Nagler, E.; Oberbauer, R.; Spasovski, G.; Tattersall, J.; van Biesen, W.; Vander Veer, S.; Vanholder, R.; Wanner, C.; Wheeler, D.; Whithers, W.; Wiecek, A.; Zoccali, C.

    2015-01-01

    This paper reflects the position of the CKD-MBD workgroup, an official working group of ERA-EDTA and of the ERBP advisory board, the official guideline-producing body of ERA-EDTA, on the topic of the use of calcimimetics in patients with CKD stage 5D, as based on two recent meta-analysis

  8. Fifteen to Twenty Seconds of Eye Movements Have No Effect on Believability of Positive Personal Verbal Statements : Results From a Working Memory Study

    NARCIS (Netherlands)

    Matthijssen, S.J.M.A.; van den Hout, M.A.

    2016-01-01

    According to working memory theory, a task that taxes working memory during simultaneous focus on a memory will tend to reduce memory vividness and emotional intensity. Results have been found for both negative and positive memories. Some studies have shown the necessity of modality-specific tasks,

  9. Childhood socioeconomic position, young adult intelligence and fillings of prescribed medicine for prevention of cardiovascular disease in middle-aged men

    DEFF Research Database (Denmark)

    Kriegbaum, Margit; Kildemoes, Helle Wallach; Rasmussen, Jeppe Nørgaard

    2014-01-01

    To explore the relationship between childhood socioeconomic position (SEP) and filling of medicine prescriptions for prevention of cardiovascular diseases (CVDs), with young adult intelligence (IQ) as a potential mediator....

  10. Head midline position for preventing the occurrence or extension of germinal matrix-intraventricular hemorrhage in preterm infants.

    Science.gov (United States)

    Romantsik, Olga; Calevo, Maria Grazia; Bruschettini, Matteo

    2017-07-20

    Preterm birth is known to constitute the major risk factor for development of germinal matrix-intraventricular hemorrhage (GM-IVH). Head position may affect cerebral hemodynamics and thus may be involved indirectly in development of GM-IVH. Turning the head toward one side may functionally occlude jugular venous drainage on the ipsilateral side while increasing intracranial pressure and cerebral blood volume. Thus, it has been suggested that cerebral venous pressure is reduced and hydrostatic brain drainage improved if the patient is in supine midline position with the bed tilted 30°. The midline position might be achieved in the supine position and, with the use of physical aids, in the lateral position as well. Midline position should be kept, at least when the incidence of GM-IVH is greatest, that is, during the first two to three days of life. Primary objective To assess whether head midline position is more effective than any other head position for preventing or extending germinal matrix-intraventricular hemorrhage in infants born at ≤ 32 weeks' gestational age. Secondary objectives To perform subgroup analyses regarding gestational age, birth weight, intubated versus not intubated, and with or without GM-IVH at trial entry. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8), MEDLINE via PubMed (1966 to September 19, 2016), Embase (1980 to September 19,.2016), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to September 19, 2016). We searched clinical trials databases, conference proceedings, and reference lists of retrieved articles for randomized controlled trials and quasi-randomized trials. Randomized clinical controlled trials, quasi-randomized trials, and cluster-randomized controlled trials comparing placing very preterm infants in a head midline position versus placing them in a prone or lateral decubitus

  11. Predictive, Preventive and Personalised Medicine as the hardcore of ‘Horizon 2020’: EPMA position paper

    Science.gov (United States)

    2014-01-01

    The European Association for Predictive, Preventive and Personalised Medicine (EPMA) considers acute problems in medical sciences as well as the quality and management of medical services challenging health care systems in Europe and worldwide. This actuality has motivated the representatives of EPMA to comment on the efforts in promoting an integrative approach based on multidisciplinary expertise to advance health care-related research and management. The current paper provides a global overview of the problems related to medical services: pandemic scenario in the progression of common non-communicable diseases, delayed interventional approaches of reactive medicine, poor economy of health care systems, lack of specialised educational programmes, problematic ethical aspects of several treatments as well as inadequate communication among professional groups and policymakers. In the form of individual paragraphs, the article presents a consolidated position of PPPM professionals towards the new European programme ‘Horizon 2020’ providing the long-lasting instruments for scientific and technological progress in medical services and health care-related programmes. In the author's opinion, Horizon 2020 provides unlimited room for research and implementation in Predictive, Preventive and Personalised Medicine. However, the overall success of the programme strongly depends on the effective communication and consolidation of professionals relevant for PPPM as well as the communication quality with policymakers. Smart political decision is the prerequisite of the effective PPPM implementation in the health care sector. This position is focused on the patients' needs, innovative medical sciences, optimal health and disease management, expert recommendations for the relevant medical fields and optimal solutions which have a potential to advance health care services if the long-term strategies were to be effectively implemented as proposed here. PMID:24708704

  12. A Family Focused Randomized Controlled Trial to Prevent Adolescent Alcohol and Tobacco Use: The Moderating Roles of Positive Parenting and Adolescent Gender

    Science.gov (United States)

    Jones, Deborah J.; Olson, Ardis L.; Forehand, Rex; Gaffney, Cecelia A.; Zens, Michael S.; Bau, J. J.

    2005-01-01

    Four years of longitudinal data from 2,153 families with a 5th- or 6th-grade preadolescent participating in a family-focused pediatric primary-care-based prevention program were used to examine whether prevention effects were moderated by positive parenting and/or adolescent gender. Alcohol and tobacco use, internalizing problems, and…

  13. [The relationship between mobbing and depression syndrome in the female working population of service industry: the problem statement and the prevention strategies in Sicilian environment].

    Science.gov (United States)

    Romano, C; De Giovanni, L; Santoro, P E; Spataro, M

    2007-01-01

    The concept of "work" and the social interactions in the workplace contribute to develop the working satisfaction and the social and personal identity of the adult. The aim of the survey is that of checking up on the presence of a statistically significant relation between The Depression Syndrome and The Mobbing Phenomenon. It is necessary to understand and value if and how some of the employer's behaviours could have a heavy influence on the worker's psychophysical condition, up to causing a state of anxiety and depression. It has been used the now famous "LIPT" (Leymann Inventory of Psychological Terror), elaborated by Leymann at the beginning of the 90's. It is a short anonymous questionnaire recognized all over Europe as a standard to confirm the Mobbing existence in organizational contexts. The current version of the questionnaire is called "LIPT EGE", a more suitable tool to check the seven parameters of the Mobbing determination, as well as the quantification of the consequent harm. Some scales for depressive symptoms evaluation have been added to the Mobbing questionnaire: The Self Rating Depression Scale (SDS) and The Depression Status Inventory (DSI) of Zung. The questionnaires are administered to 500 workers women in public and private corporation in Sicily, exactly in Siracusa and Catania provinces. 206 women aged 34-50 have answered the questionnaires. In addition to the age and the sex, the distinction variables of the examined people are the position in the firm, nationality, vocational qualification, and the yearly gross income. The research has begun in july and has continued on august 2006. Attention has been focused only on the administrative sectors. Through the chi2 test and the exact Fisher test, the dependence between the changeable presence of depression in the two questionnaires (Zung 1 and Zung 2) and every single variable of the questionnaire on the Mobbing has been pointed out. In particular, the results establish a connection between

  14. First update of the International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of porcine islet products in type 1 diabetes--Chapter 5: recipient monitoring and response plan for preventing disease transmission.

    Science.gov (United States)

    Denner, Joachim; Tönjes, Ralf R; Takeuchi, Yasu; Fishman, Jay; Scobie, Linda

    2016-01-01

    Xenotransplantation of porcine cells, tissues, and organs may be associated with the transmission of porcine microorganisms to the human recipient. A previous, 2009, version of this consensus statement focused on strategies to prevent transmission of porcine endogenous retroviruses (PERVs). This version addresses potential transmission of all porcine microorganisms including monitoring of the recipient and provides suggested approaches to the monitoring and prevention of disease transmission. Prior analyses assumed that most microorganisms other than the endogenous retroviruses could be eliminated from donor animals under appropriate conditions which have been called "designated pathogen-free" (DPF) source animal production. PERVs integrated as proviruses in the genome of all pigs cannot be eliminated in that manner and represent a unique risk. Certain microorganisms are by nature difficult to eliminate even under DPF conditions; any such clinically relevant microorganisms should be included in pig screening programs. With the use of porcine islets in clinical trials, special consideration has to be given to the presence of microorganisms in the isolated islet tissue to be used and also to the potential use of encapsulation. It is proposed that microorganisms absent in the donor animals by sensitive microbiological examination do not need to be monitored in the transplant recipient; this will reduce costs and screening requirements. Valid detection assays for donor and manufacturing-derived microorganisms must be established. Special consideration is needed to preempt potential unknown pathogens which may pose a risk to the recipient. This statement summarizes the main achievements in the field since 2009 and focus on issues and solutions with microorganisms other than PERV. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Proposal for the creation of a national strategy for precision medicine in cancer: a position statement of SEOM, SEAP, and SEFH.

    Science.gov (United States)

    Garrido, P; Aldaz, A; Vera, R; Calleja, M A; de Álava, E; Martín, M; Matías-Guiu, X; Palacios, J

    2018-04-01

    Precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person. Precision medicine is transforming clinical and biomedical research, as well as health care itself from a conceptual, as well as a methodological viewpoint, providing extraordinary opportunities to improve public health and lower the costs of the healthcare system. However, the implementation of precision medicine poses ethical-legal, regulatory, organizational, and knowledge-related challenges. Without a national strategy, precision medicine, which will be implemented one way or another, could take place without the appropriate planning that can guarantee technical quality, equal access of all citizens to the best practices, violating the rights of patients and professionals, and jeopardizing the solvency of the healthcare system. With this paper from the Spanish Societies of Medical Oncology, Pathology, and Hospital Pharmacy, we highlight the need to institute a consensual national strategy for the development of precision medicine in our country, review the national and international context, comment on the opportunities and challenges for implementing precision medicine, and outline the objectives of a national strategy on precision medicine in cancer.

  16. Delaying Middle School and High School Start Times Promotes Student Health and Performance: An American Academy of Sleep Medicine Position Statement.

    Science.gov (United States)

    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

    2017-04-15

    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

  17. Exercise prescription for patients with type 2 diabetes and pre-diabetes: a position statement from Exercise and Sport Science Australia.

    Science.gov (United States)

    Hordern, Matthew D; Dunstan, David W; Prins, Johannes B; Baker, Michael K; Singh, Maria A Fiatarone; Coombes, Jeff S

    2012-01-01

    Type 2 diabetes mellitus (T2DM) and pre-diabetic conditions such as impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are rapidly increasing in prevalence. There is compelling evidence that T2DM is more likely to develop in individuals who are insufficiently active. Exercise training, often in combination with other lifestyle strategies, has beneficial effects on preventing the onset of T2DM and improving glycaemic control in those with pre-diabetes. In addition, exercise training improves cardiovascular risk profile, body composition and cardiorespiratory fitness, all strongly related to better health outcomes. Based on the evidence, it is recommended that patients with T2DM or pre-diabetes accumulate a minimum of 210 min per week of moderate-intensity exercise or 125 min per week of vigorous intensity exercise with no more than two consecutive days without training. Vigorous intensity exercise is more time efficient and may also result in greater benefits in appropriate individuals with consideration of complications and contraindications. It is further recommended that two or more resistance training sessions per week (2-4 sets of 8-10 repetitions) should be included in the total 210 or 125 min of moderate or vigorous exercise, respectively. It is also recommended that, due to the high prevalence and incidence of comorbid conditions in patients with T2DM, exercise training programs should be written and delivered by individuals with appropriate qualifications and experience to recognise and accommodate comorbidities and complications. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  18. Clinical worthlessness of genetic prediction of common forms of diabetes mellitus and related chronic complications: A position statement of the Italian Society of Diabetology.

    Science.gov (United States)

    Buzzetti, R; Prudente, S; Copetti, M; Dauriz, M; Zampetti, S; Garofolo, M; Penno, G; Trischitta, V

    2017-02-01

    We are currently facing several attempts aimed at marketing genetic data for predicting multifactorial diseases, among which diabetes mellitus is one of the more prevalent. The present document primarily aims at providing to practicing physicians a summary of available data regarding the role of genetic information in predicting diabetes and its chronic complications. Firstly, general information about characteristics and performance of risk prediction tools will be presented in order to help clinicians to get acquainted with basic methodological information related to the subject at issue. Then, as far as type 1 diabetes is concerned, available data indicate that genetic information and counseling may be useful only in families with many affected individuals. However, since no disease prevention is possible, the utility of predicting this form of diabetes is at question. In the case of type 2 diabetes, available data really question the utility of adding genetic information on top of well performing, easy available and inexpensive non-genetic markers. Finally, the possibility of using the few available genetic data on diabetic complications for improving our ability to predict them will also be presented and discussed. For cardiovascular complication, the addition of genetic information to models based on clinical features does not translate in a substantial improvement in risk discrimination. For all other diabetic complications genetic information are currently very poor and cannot, therefore, be used for improving risk stratification. In all, nowadays the use of genetic testing for predicting diabetes and its chronic complications is definitively of little value in clinical practice. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  19. Ethnic-Specific Criteria for Classification of Body Mass Index: A Perspective for Asian Indians and American Diabetes Association Position Statement.

    Science.gov (United States)

    Misra, Anoop

    2015-09-01

    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.

  20. Prevention of parastomal hernias with 3D funnel meshes in intraperitoneal onlay position by placement during initial stoma formation.

    Science.gov (United States)

    Köhler, G; Hofmann, A; Lechner, M; Mayer, F; Wundsam, H; Emmanuel, K; Fortelny, R H

    2016-02-01

    In patients with terminal ostomies, parastomal hernias (PSHs) occur on a frequent basis. They are commonly associated with various degrees of complaints and occasionally lead to life-threatening complications. Various strategies and measures have been tested and evaluated, but to date there is a lack of published evidence with regard to the best surgical technique for the prevention of PSH development. We conducted a retrospective analysis of prospectively collected data of eighty patients, who underwent elective permanent ostomy formation between 2009 and 2014 by means of prophylactic implantation of a three-dimensional (3D) funnel mesh in intraperitoneal onlay (IPOM) position. PSH developed in three patients (3.75%). No mesh-related complications were encountered and none of the implants had to be removed. Ostomy-related complications had to be noted in seven (8.75%) cases. No manifestation of ostomy prolapse occurred. Follow-up time was a median 21 (range 3-47) months. The prophylactical implantation of a specially shaped, 3D mesh implant in IPOM technique during initial formation of a terminal enterostomy is safe, highly efficient and comparatively easy to perform. As opposed to what can be achieved with flat or keyhole meshes, the inner boundary areas of the ostomy itself can be well covered and protected from the surging viscera with the 3D implants. At the same time, the vertical, tunnel-shaped part of the mesh provides sufficient protection from an ostomy prolapse. Further studies will be needed to compare the efficacy of various known approaches to PSH prevention.

  1. Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC).

    Science.gov (United States)

    De Hert, M; Dekker, J M; Wood, D; Kahl, K G; Holt, R I G; Möller, H-J

    2009-09-01

    People with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed in part to an increased risk of the modifiable coronary heart disease risk factors; obesity, smoking, diabetes, hypertension and dyslipidaemia. Antipsychotic medication and possibly other psychotropic medication like antidepressants can induce weight gain or worsen other metabolic cardiovascular risk factors. Patients may have limited access to general healthcare with less opportunity for cardiovascular risk screening and prevention than would be expected in a non-psychiatric population. The European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) published this statement with the aim of improving the care of patients suffering from severe mental illness. The intention is to initiate cooperation and shared care between the different healthcare professionals and to increase the awareness of psychiatrists and primary care physicians caring for patients with severe mental illness to screen and treat cardiovascular risk factors and diabetes.

  2. The Interim Financial Statements: The Case of Greece

    OpenAIRE

    Rogdaki, E.I.; Kazantzis, Ch.

    1999-01-01

    The following paper refers to the accounting and auditing issues which emerge in the preparation of the interim financial statements of the companies: Firstly, the interim financial statements are defined as being the financial statements that provide useful information about the financial position and the financial results of a company which are realized and accrued during the fiscal year. The interim financial statements can be prepared on a monthly basis, on a quarterly basis or covering a...

  3. IAS 1 Presentation of Financial Statements - A Closer Look

    OpenAIRE

    Muthupandian, K S

    2008-01-01

    The International Accounting Standards Committee issued the International Accounting Standard 1 Presentation of Financial Statements. The objective of IAS 1 is to prescribe the basis for presentation of general purpose financial statements (GPFS), to ensure comparability both with the entity's financial statements of previous periods and with the financial statements of other entities. The objective of GPFS is to provide information about the financial position, financial performance, and cas...

  4. Implementation and assessment of a prevention with positives intervention among people living with HIV at five hospitals in Thailand.

    Science.gov (United States)

    Baipluthong, Benjamas; Anekthananon, Thanomsak; Munsakul, Warangkana; Jirajariyavej, Supunnee; Asavapiriyanont, Suvanna; Hancharoenkit, Ubonsri; Roongpisuthipong, Anuvat; Pattanasin, Sarika; Martin, Michael; Guntamala, Lisa; Lolekha, Rangsima

    2017-01-01

    We implemented a hospital-based prevention with positives (PwP) intervention among people living with HIV (PLHIV) that included HIV transmission risk screening, short HIV prevention messages, family planning, HIV disclosure counseling, and partner HIV testing at five hospitals in Thailand. We assessed changes in sexual risk behaviors among PLHIV who received the PwP services at the hospitals. From January 2008-March 2009, we systematically selected a subset of PLHIV receiving care at the five hospitals to offer participation in the PwP intervention. We collected demographic, risk behavior, and laboratory data using a standardized questionnaire. We analyzed data from PLHIV who completed at least four visits, using generalized estimating equations to identify baseline participant characteristics that were associated with adopting sexual practices less likely to be associated with HIV transmission during follow-up. A total of 830 PLHIV were interviewed and 756 (91.1%) completed four visits. The median age of these 756 participants was 37 years, 400 (52.9%) were women, and 475 (62.8%) had a steady partner. At baseline, 353 (74.3%) of the steady partners had been tested for HIV and 132 (37.4%) had tested negative. Among the 756 PLHIV, 427 (56.5%) reported having sex in the 3 months before enrollment and 413 (54.6%) in the 3 months before the fourth visit. The proportion reporting having vaginal or anal sex without a condom decreased from 20.8% at baseline to 5.1% at the fourth visit (p<0.001). Factors associated (p<0.05) with abstinence or 100% condom use at follow-up visits included: completing ≥ two visits, being diagnosed with HIV for longer than 3 months, and receiving HIV prevention messages from a doctor (versus a nurse or counselor). Safe sex behaviors increased among PLHIV receiving PwP services, suggesting that expansion of hospital-based PwP services may reduce the number of new HIV infections in Thailand.

  5. Treatment of idiopathic pulmonary fibrosis in Australia and New Zealand: A position statement from the Thoracic Society of Australia and New Zealand and the Lung Foundation Australia.

    Science.gov (United States)

    Jo, Helen E; Troy, Lauren K; Keir, Gregory; Chambers, Daniel C; Holland, Anne; Goh, Nicole; Wilsher, Margaret; de Boer, Sally; Moodley, Yuben; Grainge, Christopher; Whitford, Helen; Chapman, Sally; Reynolds, Paul N; Glaspole, Ian; Beatson, David; Jones, Leonie; Hopkins, Peter; Corte, Tamera J

    2017-10-01

    Idiopathic pulmonary fibrosis (IPF) is a fibrosing interstitial lung disease (ILD) of unknown aetiology with a median survival of only 2-5 years. It is characterized by progressive dyspnoea and worsening lung function, ultimately resulting in death. Until recently, there were no effective therapies for IPF; however, with the publication of two landmark clinical trials in 2014, the anti-fibrotic therapies, nintedanib and pirfenidone, have gained widespread approval. This position paper aims to highlight the current evidence for the treatment of IPF, with particular application to the Australian and New Zealand population. We also consider areas in which evidence is currently lacking, especially with regard to the broader IPF severity spectrum and treatment of co-morbid conditions. The utility of non-pharmacological therapies including pulmonary rehabilitation, oxygen as well as symptom management thought to be important in the holistic care of IPF patients are also discussed. © 2017 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.

  6. Substance Use Among Nurses and Nursing Students: A Joint Position Statement of the Emergency Nurses Association and the International Nurses Society on Addictions.

    Science.gov (United States)

    Strobbe, Stephen; Crowley, Melanie

    Alcohol and other substance use by nurses potentially places patients, the public, and nurses themselves at risk for serious injury or death. Nursing students are also at risk for problems related to substance use. When viewed and treated as a chronic medical illness, treatment outcomes for substance use disorders are comparable with those of other diseases and can result in lasting benefits. Professional monitoring programs that employ an alternative-to-discipline approach have been shown to be effective in the treatment of health professionals with substance use disorders and are considered a standard for recovery, with high rates of completion and return to practice. It is the position of the Emergency Nurses Association and the International Nurses Society on Addictions that 1. health care facilities provide education to nurses and other employees regarding alcohol and other drug use and establish policies, procedures, and practices to promote safe, supportive, drug-free workplaces; 2. health care facilities and schools of nursing adopt alternative-to-discipline approaches to treating nurses and nursing students with substance use disorders, with stated goals of retention, rehabilitation, and reentry into safe, professional practice; 3. drug diversion, in the context of personal use, is viewed primarily as a symptom of a serious and treatable disease and not exclusively as a crime; and 4. nurses and nursing students are aware of the risks associated with substance use, impaired practice, and drug diversion and have the responsibility and means to report suspected or actual concerns.

  7. A report with consensus statements of the International Society of Nephrology 2004 Consensus Workshop on Prevention of Progression of Renal Disease, Hong Kong, June 29, 2004

    NARCIS (Netherlands)

    Li, Philip Kam-Tao; Weening, Jan J.; Dirks, John; Lui, Sing Leung; Szeto, Cheuk Chun; Tang, Sydney; Atkins, Robert C.; Mitch, William E.; Chow, Kai Ming; D'Amico, Giuseppe; Freedman, Barry I.; Harris, David C.; Hooi, Lai-Seong; de Jong, Paul E.; Kincaid-Smith, Priscilla; Lai, Kar Neng; Lee, Evan; Li, Fu-Keung; Lin, Shan-Yan; Lo, Wai-Kei; Mani, M. K.; Mathew, Timothy; Murakami, Mutsumi; Qian, Jia-Qi; Ramirez, Sylvia; Reiser, Thomas; Tomino, Yasuhiko; Tong, Matthew K.; Tsang, Wai-Kay; Tungsanga, Kriang; Wang, Haiyan; Wong, Andrew K.; Wong, Kim Ming; Yang, Wu-Chang; de Zeeuw, Dick; Yu, Alex W.; Remuzzi, Giuseppe

    2005-01-01

    This report summarizes the discussions of the International Society of Nephrology (ISN) 2004 Consensus Workshop on Prevention of Progression of Renal Disease, which was held in Hong Kong on June 29, 2004. Three key areas were discussed during the workshop: (1) screening for chronic kidney disease;

  8. Randomized, multicenter trial of lateral Trendelenburg versus semirecumbent body position for the prevention of ventilator-associated pneumonia.

    Science.gov (United States)

    Li Bassi, Gianluigi; Panigada, Mauro; Ranzani, Otavio T; Zanella, Alberto; Berra, Lorenzo; Cressoni, Massimo; Parrini, Vieri; Kandil, Hassan; Salati, Giovanni; Selvaggi, Paola; Amatu, Alessandro; Sanz-Moncosi, Miquel; Biagioni, Emanuela; Tagliaferri, Fernanda; Furia, Mirella; Mercurio, Giovanna; Costa, Antonietta; Manca, Tullio; Lindau, Simone; Babel, Jaksa; Cavana, Marco; Chiurazzi, Chiara; Marti, Joan-Daniel; Consonni, Dario; Gattinoni, Luciano; Pesenti, Antonio; Wiener-Kronish, Janine; Bruschi, Cecilia; Ballotta, Andrea; Salsi, Pierpaolo; Livigni, Sergio; Iotti, Giorgio; Fernandez, Javier; Girardis, Massimo; Barbagallo, Maria; Moise, Gabriella; Antonelli, Massimo; Caspani, Maria Luisa; Vezzani, Antonella; Meybohm, Patrick; Gasparovic, Vladimir; Geat, Edoardo; Amato, Marcelo; Niederman, Michael; Kolobow, Theodor; Torres, Antoni

    2017-11-01

    The lateral Trendelenburg position (LTP) may hinder the primary pathophysiologic mechanism of ventilator-associated pneumonia (VAP). We investigated whether placing patients in the LTP would reduce the incidence of VAP in comparison with the semirecumbent position (SRP). This was a randomized, multicenter, controlled study in invasively ventilated critically ill patients. Two preplanned interim analyses were performed. Patients were randomized to be placed in the LTP or the SRP. The primary outcome, assessed by intention-to-treat analysis, was incidence of microbiologically confirmed VAP. Major secondary outcomes included mortality, duration of mechanical ventilation, and intensive care unit length of stay. At the second interim analysis, the trial was stopped because of low incidence of VAP, lack of benefit in secondary outcomes, and occurrence of adverse events. A total of 194 patients in the LTP group and 201 in the SRP group were included in the final intention-to-treat analysis. The incidence of microbiologically confirmed VAP was 0.5% (1/194) and 4.0% (8/201) in LTP and SRP patients, respectively (relative risk 0.13, 95% CI 0.02-1.03, p = 0.04). The 28-day mortality was 30.9% (60/194) and 26.4% (53/201) in LTP and SRP patients, respectively (relative risk 1.17, 95% CI 0.86-1.60, p = 0.32). Likewise, no differences were found in other secondary outcomes. Six serious adverse events were described in LTP patients (p = 0.01 vs. SRP). The LTP slightly decreased the incidence of microbiologically confirmed VAP. Nevertheless, given the early termination of the trial, the low incidence of VAP, and the adverse events associated with the LTP, the study failed to prove any significant benefit. Further clinical investigation is strongly warranted; however, at this time, the LTP cannot be recommended as a VAP preventive measure. CLINICALTRIALS. NCT01138540.

  9. Management of adenovirus infection in patients after haematopoietic stem cell transplantation: State-of-the-art and real-life current approach: A position statement on behalf of the Infectious Diseases Working Party of the European Society of Blood and Marrow Transplantation.

    Science.gov (United States)

    Hiwarkar, Prashant; Kosulin, Karin; Cesaro, Simone; Mikulska, Malgorzata; Styczynski, Jan; Wynn, Robert; Lion, Thomas

    2018-05-01

    The important insights gained over the past years in diagnosis and treatment of invasive adenoviral infections provide new paradigms for the monitoring and clinical management of these life-threatening complications. A meeting was held to discuss and subsequently disseminate the current advances in our understanding of the aetiology/pathogenesis and future treatment options facilitating effective control or prevention of adenovirus-related diseases in the allogeneic haematopoietic stem cell transplant setting. Invited experts in the field discussed recent progress with leading members of the Infectious Diseases Working Party of the European Society of Blood and Marrow Transplantation at the "State-of-the-art" Meeting in Poznan, Poland, in October 2017. In this review article, the panel of experts presents a concise summary of the current evidence based on published data from the last 15 years and on recent achievements resulting from real-life practice. The present position statement reflects an expert opinion on current approaches to clinical management of adenovirus infections in patients undergoing allogeneic haematopoietic stem cell transplant and provides graded recommendations of the panel for diagnostic approaches and preemptive therapy reflecting the present state of knowledge. Copyright © 2018 John Wiley & Sons, Ltd.

  10. The South African Society of Psychiatrists (SASOP and SASOP State Employed Special Interest Group (SESIG position statements on psychiatric care in the public sector

    Directory of Open Access Journals (Sweden)

    Bernard Janse van Rensburg

    2012-08-01

    Full Text Available Executive summary. National mental health policy: SASOP extends its support for the process of formalising a national mental health policy as well as for the principles and content of the current draft policy. Psychiatry and mental health: psychiatrists should play a central role, along with the other mental health disciplines, in the strategic and operational planning of mental health services at local, provincial and national level. Infrastructure and human resources: it is essential that the state takes up its responsibility to provide adequate structures, systems and funds for the specified services and facilities on national, provincial and facility level, as a matter of urgency. Standard treatment guidelines (STGs and essential drug lists (EDLs: close collaboration and co-ordination should occur between the processes of establishing SASOP and national treatment guidelines, as well as the related decisions on EDLs for different levels. HIV/AIDS in children: national HIV programmes have to promote awareness of the neurocognitive problems and psychiatric morbidity associated with HIV in children. HIV/AIDS in adults: the need for routine screening of all HIV-positive individuals for mental health and cognitive impairments should also be emphasised as many adult patients have a mental illness, either before or as a consequence of HIV infection, constituting a ‘special needs’ group. Substance abuse and addiction: the adequate diagnosis and management of related substance abuse and addiction problems should fall within the domain of the health sector and, in particular, that of mental health and psychiatry. Community psychiatry and referral levels: the rendering of ambulatory specialist psychiatric services on a community-centred basis should be regarded as a key strategy to make these services more accessible to users closer to where they live. Recovery and re-integration: a recovery framework such that personal recovery outcomes, among

  11. Enhanced 911/global position system wizard: a telemedicine application for the prevention of severe hypoglycemia--monitor, alert, and locate.

    Science.gov (United States)

    Dassau, Eyal; Jovanovic, Lois; Doyle, Francis J; Zisser, Howard C

    2009-11-01

    Intensive insulin therapy has an inherent risk of hypoglycemia that can lead to loss of consciousness, cardiac arrhythmia, seizure, and death ("dead-in-bed syndrome"). This risk of hypoglycemia is a major concern for patients, families, and physicians. The need for an automated system that can alert in the event of severe hypoglycemia is evident. In engineering systems, where there is a risk of malfunction of the primary control system, alert and safety mechanisms are implemented in layers of protection. This concept has been adopted in the proposed system that integrates a hypoglycemia prediction algorithm with a global position system (GPS) locator and short message service such that the current glucose value with the rate of change (ROC) and the location of the subject can be communicated to a predefined list. Furthermore, if the system is linked to the insulin pump, it can suspend the pump or decrease the basal insulin infusion rate to prevent the pending event. The system was evaluated on clinical datasets of glucose tracings from the DexCom Seven system. Glucose tracings were analyzed for hypoglycemia events and then a text message was broadcast to a predefined list of people who were notified with the glucose value, ROC, GPS coordinates, and a Google map of the location. In addition to providing a safety layer to a future artificial pancreas, this system also can be easily implemented in current continuous glucose monitors to help provide information and alerts to people with diabetes.

  12. EU Universities’ Mission Statements

    Directory of Open Access Journals (Sweden)

    Liudmila Arcimaviciene

    2015-04-01

    Full Text Available In the last 10 years, a highly productive space of metaphor analysis has been established in the discourse studies of media, politics, business, and education. In the theoretical framework of Conceptual Metaphor Theory and Critical Discourse Analysis, the restored metaphorical patterns are especially valued for their implied ideological value as realized both conceptually and linguistically. By using the analytical framework of Critical Metaphor Analysis and procedurally employing Pragglejaz Group’s Metaphor Identification Procedure, this study aims at analyzing the implied value of the evoked metaphors in the mission statements of the first 20 European Universities, according to the Webometrics ranking. In this article, it is proposed that Universities’ mission statements are based on the positive evaluation of the COMMERCE metaphor, which does not fully correlate with the ideological framework of sustainability education but is rather oriented toward consumerism in both education and society. Despite this overall trend, there are some traceable features of the conceptualization reflecting the sustainability approach to higher education, as related to freedom of speech, tolerance, and environmental concerns. Nonetheless, these are suppressed by the metaphoric usages evoking traditional dogmas of the conservative ideology grounded in the concepts of the transactional approach to relationship, competitiveness for superiority, the importance of self-interest and strength, and quantifiable quality.

  13. Limit of detection and threshold for positivity of the Centers for Disease Control and Prevention assay for factor VIII inhibitors.

    Science.gov (United States)

    Miller, C H; Boylan, B; Shapiro, A D; Lentz, S R; Wicklund, B M

    2017-10-01

    Essentials Immunologic methods detect factor VIII (FVIII) antibodies in some inhibitor-negative specimens. Specimens were tested by modified Nijmegen-Bethesda assay (NBA) and fluorescence immunoassay. The NBA with preanalytical heat inactivation detects FVIII inhibitors down to 0.2 NBU. IgG 4 frequency validates the established threshold for positivity of ≥ 0.5 NBU for this NBA. Background The Bethesda assay for measurement of factor VIII inhibitors called for quantification of positive inhibitors by using dilutions producing 25-75% residual activity (RA), corresponding to 0.4-2.0 Bethesda units, with the use of 'more sensitive methods' for samples with RA closer to 100% being recommended. The Nijmegen modification (Nijmegen-Bethesda assay [NBA]) changed the reagents used but not these calculations. Some specimens negative by the NBA have been shown to have FVIII antibodies detectable with sensitive immunologic methods. Objective To examine the performance at very low inhibitor titers of the Centers for Disease Control and Prevention (CDC)-modified NBA (CDC-NBA), which includes preanalytic heat inactivation to liberate bound anti-FVIII antibodies. Methods Specimens with known inhibitors were tested with the CDC-NBA. IgG 4 anti-FVIII antibodies were measured by fluorescence immunoassay (FLI). Results Diluted inhibitors showed linearity below 0.4 Nijmegen-Bethesda units (NBU). With four statistical methods, the limit of detection of the CDC-NBA was determined to be 0.2 NBU. IgG 4 anti-FVIII antibodies, which correlate most strongly with functional inhibitors, were present at rates above the background rate of healthy controls in specimens with titers ≥ 0.2 NBU and showed an increase in frequency from 14.3% at 0.4 NBU to 67% at the established threshold for positivity of 0.5 NBU. Conclusions The CDC-NBA can detect inhibitors down to 0.2 NBU. The FLI, which is more sensitive, demonstrates anti-FVIII IgG 4 in some patients with negative (NBA, supporting the need for

  14. [Cardiovascular disease prevention in adults with type 2 diabetes mellitus according to the recent statement from the American Heart Association/American Diabetes Association].

    Science.gov (United States)

    Avogaro, Angelo

    2016-03-01

    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.

  15. Audit of the US Department of Energy`s consolidated financial statements for Fiscal Year 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-24

    The Office of Inspector General audited the Department`s Consolidated Statement of Financial position as of September 30, 1996, and the related Statement of Operations and Changes in Net Position for the year ended. Results are described.

  16. Recommendations for the use of tolvaptan in autosomal dominant polycystic kidney disease: a position statement on behalf of the ERA-EDTA Working Groups on Inherited Kidney Disorders and European Renal Best Practice.

    Science.gov (United States)

    Gansevoort, Ron T; Arici, Mustafa; Benzing, Thomas; Birn, Henrik; Capasso, Giovambattista; Covic, Adrian; Devuyst, Olivier; Drechsler, Christiane; Eckardt, Kai-Uwe; Emma, Francesco; Knebelmann, Bertrand; Le Meur, Yannick; Massy, Ziad A; Ong, Albert C M; Ortiz, Alberto; Schaefer, Franz; Torra, Roser; Vanholder, Raymond; Więcek, Andrzej; Zoccali, Carmine; Van Biesen, Wim

    2016-03-01

    Recently, the European Medicines Agency approved the use of the vasopressin V2 receptor antagonist tolvaptan to slow the progression of cyst development and renal insufficiency of autosomal dominant polycystic kidney disease (ADPKD) in adult patients with chronic kidney disease stages 1-3 at initiation of treatment with evidence of rapidly progressing disease. In this paper, on behalf of the ERA-EDTA Working Groups of Inherited Kidney Disorders and European Renal Best Practice, we aim to provide guidance for making the decision as to which ADPKD patients to treat with tolvaptan. The present position statement includes a series of recommendations resulting in a hierarchical decision algorithm that encompasses a sequence of risk-factor assessments in a descending order of reliability. By examining the best-validated markers first, we aim to identify ADPKD patients who have documented rapid disease progression or are likely to have rapid disease progression. We believe that this procedure offers the best opportunity to select patients who are most likely to benefit from tolvaptan, thus improving the benefit-to-risk ratio and cost-effectiveness of this treatment. It is important to emphasize that the decision to initiate treatment requires the consideration of many factors besides eligibility, such as contraindications, potential adverse events, as well as patient motivation and lifestyle factors, and requires shared decision-making with the patient. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA.

  17. Methodology and technology for peripheral and central blood pressure and blood pressure variability measurement: current status and future directions - Position statement of the European Society of Hypertension Working Group on blood pressure monitoring and cardiovascular variability.

    Science.gov (United States)

    Stergiou, George S; Parati, Gianfranco; Vlachopoulos, Charalambos; Achimastos, Apostolos; Andreadis, Emanouel; Asmar, Roland; Avolio, Alberto; Benetos, Athanase; Bilo, Grzegorz; Boubouchairopoulou, Nadia; Boutouyrie, Pierre; Castiglioni, Paolo; de la Sierra, Alejandro; Dolan, Eamon; Head, Geoffrey; Imai, Yutaka; Kario, Kazuomi; Kollias, Anastasios; Kotsis, Vasilis; Manios, Efstathios; McManus, Richard; Mengden, Thomas; Mihailidou, Anastasia; Myers, Martin; Niiranen, Teemu; Ochoa, Juan Eugenio; Ohkubo, Takayoshi; Omboni, Stefano; Padfield, Paul; Palatini, Paolo; Papaioannou, Theodore; Protogerou, Athanasios; Redon, Josep; Verdecchia, Paolo; Wang, Jiguang; Zanchetti, Alberto; Mancia, Giuseppe; O'Brien, Eoin

    2016-09-01

    Office blood pressure measurement has been the basis for hypertension evaluation for almost a century. However, the evaluation of blood pressure out of the office using ambulatory or self-home monitoring is now strongly recommended for the accurate diagnosis in many, if not all, cases with suspected hypertension. Moreover, there is evidence that the variability of blood pressure might offer prognostic information that is independent of the average blood pressure level. Recently, advancement in technology has provided noninvasive evaluation of central (aortic) blood pressure, which might have attributes that are additive to the conventional brachial blood pressure measurement. This position statement, developed by international experts, deals with key research and practical issues in regard to peripheral blood pressure measurement (office, home, and ambulatory), blood pressure variability, and central blood pressure measurement. The objective is to present current achievements, identify gaps in knowledge and issues concerning clinical application, and present relevant research questions and directions to investigators and manufacturers for future research and development (primary goal).

  18. Nutritional management and follow up of infants and children with food allergy: Italian Society of Pediatric Nutrition/Italian Society of Pediatric Allergy and Immunology Task Force Position Statement.

    Science.gov (United States)

    Giovannini, Marcello; D'Auria, Enza; Caffarelli, Carlo; Verduci, Elvira; Barberi, Salvatore; Indinnimeo, Luciana; Iacono, Iride Dello; Martelli, Alberto; Riva, Enrica; Bernardini, Roberto

    2014-01-03

    Although the guidelines on the diagnosis and treatment of food allergy recognize the role of nutrition, there is few literature on the practical issues concerning the nutritional management of children with food allergies. This Consensus Position Statement focuses on the nutritional management and follow-up of infants and children with food allergy.It provides practical advices for the management of children on exclusion diet and it represents an evidence-based consensus on nutritional intervention and follow-up of infants and children with food allergy. Children with food allergies have poor growth compared to non-affected subjects directly proportional to the quantity of foods excluded and the duration of the diet. Nutritional intervention, if properly planned and properly monitored, has proven to be an effective mean to substantiate a recovery in growth. Nutritional intervention depends on the subject's nutritional status at the time of the diagnosis. The assessment of the nutritional status of children with food allergies should follow a diagnostic pathway that involves a series of successive steps, beginning from the collection of a detailed diet-history. It is essential that children following an exclusion diet are followed up regularly. The periodic re-evaluation of the child is needed to assess the nutritional needs, changing with the age, and the compliance to the diet. The follow- up plan should be established on the basis of the age of the child and following the growth pattern.

  19. Public-private collaboration in clinical research during pregnancy, lactation, and childhood: joint position statement of the Early Nutrition Academy and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

    Science.gov (United States)

    Koletzko, Berthold; Benninga, Marc A; Godfrey, Keith M; Hornnes, Peter J; Kolaček, Sanja; Koletzko, Sibylle; Lentze, Michael J; Mader, Silke; McAuliffe, Fionnuala M; Oepkes, Dick; Oddy, Wendy H; Phillips, Alan; Rzehak, Peter; Socha, Piotr; Szajewska, Hania; Symonds, Michael E; Taminiau, Jan; Thapar, Nikhil; Troncone, Riccardo; Vandenplas, Yvan; Veereman, Gigi

    2014-04-01

    This position statement summarises a view of academia regarding standards for clinical research in collaboration with commercial enterprises, focussing on trials in pregnant women, breast-feeding women, and children. It is based on a review of the available literature and an expert workshop cosponsored by the Early Nutrition Academy and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Clinical research collaborations between academic investigators and commercial enterprises are encouraged by universities, public funding agencies, and governmental organisations. One reason is a pressing need to obtain evidence on the effects, safety, and benefits of drugs and other commercial products and services. The credibility and value of results obtained through public-private research collaborations have, however, been questioned because many examples of inappropriate research practice have become known. Clinical research in pregnant and breast-feeding women, and in infants and children, raises sensitive scientific, ethical, and societal questions and requires the application of particularly high standards. Here we provide recommendations for the conduct of public-private research collaborations in these populations. In the interest of all stakeholders, these recommendations should contribute to more reliable, credible, and acceptable results of commercially sponsored trials and to reducing the existing credibility gap.

  20. Adaptation of the Positive Deviance Hearth Approach in Urban Slums, Phnom Penh, for the Prevention and Treatment of Moderate Malnutrition

    International Nuclear Information System (INIS)

    Vong, Lenin

    2014-01-01

    Full text: Objective: To sustainably rehabilitate malnourished children living in poor urban communities, and prevent future child malnutrition. Methods: Survey data shows an increase in young child malnutrition in urban areas. During the last decade there has been a huge influx of poor rural migrant families to Phnom Penh. Migrant parents work long hours in factories or construction sites, while their young children are cared for by grandmothers or older relatives. Housing conditions are basic with limited sanitation facilities. Following a situational analysis in the target communities, an adapted Positive Deviance approach was implemented. At the beginning of the program 1,127 children aged 0-36 months were weighed; 29% or 328 children were mild and moderately underweight. The following steps were conducted: community mobilization around the issue of child malnutrition, positive deviance inquiry, training of community volunteers, implementation of positive deviance hearth sessions, follow up home visits and ongoing community growth monitoring. Innovations introduced to the project were: mobilization and training of local food vendors to promote, prepare and sell safe, nutritious and affordable locally available complementary foods. The food vendor’s menus were also promoted during the Hearth sessions. In addition mobile phone messages were sent to the caregivers to reinforce key infant and young child care and feeding practices. The length of hearth sessions were adapted to the urban context with five days, then five day practice of new behaviors at home, followed by five additional days of Hearth sessions, to share experiences and challenges for practicing the new behaviors. Despite their low income all the caregivers were able to contribute food for the preparation of complementary food, such as meat, vegetables and rice. Caregiver also actively participated in cooking nutritious foods and discussions about the importance of food variety, amounts and

  1. Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

    DEFF Research Database (Denmark)

    Corrà, Ugo; Piepoli, Massimo F; Carré, François

    2010-01-01

    of a healthy lifestyle. These secondary prevention targets are included in the overall goal of cardiac rehabilitation (CR). Cardiac rehabilitation can be viewed as the clinical application of preventive care by means of a professional multi-disciplinary integrated approach for comprehensive risk reduction...... and global long-term care of cardiac patients. The CR approach is delivered in tandem with a flexible follow-up strategy and easy access to a specialized team. To promote implementation of cardiac prevention and rehabilitation, the CR Section of the EACPR (European Association of Cardiovascular Prevention...... and Rehabilitation) has recently completed a Position Paper, entitled 'Secondary prevention through cardiac rehabilitation: A condition-oriented approach'. Components of multidisciplinary CR for seven clinical presentations have been addressed. Components include patient assessment, physical activity counselling...

  2. Nutrigenomics, the Microbiome, and Gene-Environment Interactions: New Directions in Cardiovascular Disease Research, Prevention, and Treatment: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    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

    2016-06-01

    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.

  3. Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

    DEFF Research Database (Denmark)

    Piepoli, Massimo Francesco; Corrà, Ugo; Benzer, Werner

    2010-01-01

    Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR) to card......Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR......) to cardiovascular health outcomes. Secondary prevention through exercise-based CR is the intervention with the best scientific evidence to contribute to decrease morbidity and mortality in coronary artery disease, in particular after myocardial infarction but also incorporating cardiac interventions and chronic...... makers and consumers in the recognition of the comprehensive nature of CR. Those charged with responsibility for secondary prevention of cardiovascular disease, whether at European, national or individual centre level, need to consider where and how structured programmes of CR can be delivered to all...

  4. Early introduction of allergenic foods for the prevention of food allergy from an Asian perspective-An Asia Pacific Association of Pediatric Allergy, Respirology & Immunology (APAPARI) consensus statement.

    Science.gov (United States)

    Tham, Elizabeth Huiwen; Shek, Lynette Pei-Chi; Van Bever, Hugo Ps; Vichyanond, Pakit; Ebisawa, Motohiro; Wong, Gary Wk; Lee, Bee Wah

    2018-02-01

    Emerging evidence for the early introduction of allergenic foods for the prevention of food allergies, such as peanut allergy in Western populations, has led to the recent publication of guidelines in the USA and Europe recommending early peanut introduction for high-risk infants with severe eczema or egg allergy. Peanut allergy is, however, much less prevalent in Asia compared to the West. Varying patterns of food allergy are seen even within Asian countries-such as a predominance of wheat allergy in Japan and Thailand and shellfish allergy in Singapore and the Philippines. Customs and traditions, such as diet and infant feeding practices, also differ between Asian populations. Hence, there are unique challenges in adapting guidelines on early allergenic food introduction to the Asian setting. In this paper, we review the evidence and discuss the possible approaches to guide the timely introduction of allergenic food in high-risk infants in Asia. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  5. Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism.

    Science.gov (United States)

    Ikizler, T Alp; Cano, Noel J; Franch, Harold; Fouque, Denis; Himmelfarb, Jonathan; Kalantar-Zadeh, Kamyar; Kuhlmann, Martin K; Stenvinkel, Peter; TerWee, Pieter; Teta, Daniel; Wang, Angela Yee-Moon; Wanner, Christoph

    2013-12-01

    Protein energy wasting (PEW) is common in patients with chronic kidney disease (CKD) and is associated with adverse clinical outcomes, especially in individuals receiving maintenance dialysis therapy. A multitude of factors can affect the nutritional and metabolic status of CKD patients requiring a combination of therapeutic maneuvers to prevent or reverse protein and energy depletion. These include optimizing dietary nutrient intake, appropriate treatment of metabolic disturbances such as metabolic acidosis, systemic inflammation, and hormonal deficiencies, and prescribing optimized dialytic regimens. In patients where oral dietary intake from regular meals cannot maintain adequate nutritional status, nutritional supplementation, administered orally, enterally, or parenterally, is shown to be effective in replenishing protein and energy stores. In clinical practice, the advantages of oral nutritional supplements include proven efficacy, safety, and compliance. Anabolic strategies such as anabolic steroids, growth hormone, and exercise, in combination with nutritional supplementation or alone, have been shown to improve protein stores and represent potential additional approaches for the treatment of PEW. Appetite stimulants, anti-inflammatory interventions, and newer anabolic agents are emerging as novel therapies. While numerous epidemiological data suggest that an improvement in biomarkers of nutritional status is associated with improved survival, there are no large randomized clinical trials that have tested the effectiveness of nutritional interventions on mortality and morbidity.

  6. Feasibility Analysis of an Evidence-Based Positive Prevention Intervention for Youth Living with HIV/AIDS in Kinshasa, Democratic Republic of the Congo

    Science.gov (United States)

    Parker, L.; Maman, S.; Pettifor, A.; Chalachala, J. L.; Edmonds, A.; Golin, C. E.; Moracco, K.; Behets, F.

    2013-01-01

    We evaluated the feasibility of a Positive Prevention intervention adapted for youth living with HIV/AIDS (YLWH) ages 15-24 in Kinshasa, Democratic Republic of the Congo. We conducted in-depth interviews and focus group discussions with intervention facilitators and YLWH participants on the following four areas of a feasibility framework:…

  7. Adult congenital heart disease nurse coordination: Essential skills and role in optimizing team-based care a position statement from the International Society for Adult Congenital Heart Disease (ISACHD).

    Science.gov (United States)

    Sillman, Christina; Morin, Joanne; Thomet, Corina; Barber, Deena; Mizuno, Yoshiko; Yang, Hsiao-Ling; Malpas, Theresa; Flocco, Serena Francesca; Finlay, Clare; Chen, Chi-Wen; Balon, Yvonne; Fernandes, Susan M

    2017-02-15

    Founded in 1992, the International Society for Adult Congenital Heart Disease (ISACHD) is the leading global organization of professionals dedicated to pursuing excellence in the care of adults with congenital heart disease (CHD) worldwide. Among ISACHD's objectives is to "promote a holistic team-based approach to the care of the adult with CHD that is comprehensive, patient-centered, and interdisciplinary" (http://www.isachd.org). This emphasis on team-based care reflects the fact that adults with CHD constitute a heterogeneous population with a wide spectrum of disease complexity, frequent association with other organ involvement, and varied co-morbidities and psychosocial issues. Recognizing the vital role of the adult CHD (ACHD) nurse coordinator (ACHD-NC) in optimizing team-based care, ISACHD established a task force to elucidate and provide guidance on the roles and responsibilities of the ACHD-NC. Acknowledging that nursing roles can vary widely from region to region based on factors such as credentials, scopes of practice, regulations, and local culture and tradition, an international panel was assembled with experts from North America, Europe, East Asia, and Oceania. The writing committee was tasked with reviewing key aspects of the ACHD-NC's role in team-based ACHD care. The resulting ISACHD position statement addresses the ACHD-NC's role and skills required in organizing, coordinating, and facilitating the care of adults with CHD, holistic assessment of the ACHD patient, patient education and counseling, and support for self-care management and self-advocacy. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  8. Financial Statement Math

    OpenAIRE

    2007-01-01

    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

  9. Teaching Philosophy Statements

    Science.gov (United States)

    Faryadi, Qais

    2015-01-01

    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…

  10. Prevention measures for avoiding unexpected drifting of marine component in recovery equipment of significant metals from sea water. Positioning and monitoring system for marine component and improvement of its positioning accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Tamada, Masao; Kasai, Noboru; Seko, Noriaki; Hasegawa, Shin; Takeda, Hayato; Katakai, Akio; Sugo, Takanobu [Japan Atomic Energy Research Inst., Takasaki, Gunma (Japan). Takasaki Radiation Chemistry Research Establishment; Kawabata, Yukiya [Ebara Reseach Co., Ltd., Fujisawa, Kanagawa (Japan); Onuma, Kenji [Mitsubishi Materials Corp., Tokyo (Japan)

    2001-11-01

    Positioning and monitoring system for marine component in recovery equipment of significant metals from seawater with adsorbent was designed and assembled to avoid unexpected drifting accident. This system which was set on float part of the marine component obtains the positioning data from GPS satellites and sends them to Takasaki and Mutsu establishments through satellite communication. In both establishments, the position data were shown in computer displays. As characteristic test for 20 days in the real sea, 262 data were obtained every 2 hours. The twice of the distance root mean square (2DRMS) was 223.7 m. To improve this performance, three new functions were added to the present firmware. There are to raise positioning resolutions in longitude and latitude from 0.001 to 0.00001 degree, to remove the reflection of GPS signal from sea surface, and to average remaining three positioning data after maximum and minimum data were omitted from continuous five positioning data. The improved system shows the 2DRMS positioning of 15.5 m. This performance is enough to prevent marine component from its drifting accident. (author)

  11. Breaking the glass ceiling: structural, cultural, and organizational barriers preventing women from achieving senior and executive positions.

    Science.gov (United States)

    Johns, Merida L

    2013-01-01

    The business case for gender diversity in senior and executive positions is compelling. Studies show that companies that have the best records for promoting women outstrip their competition on every measure of profitability. Yet women disproportionately are failing to attain high-level positions. Reviewing current data on women in the workplace, findings of studies on the relationship between gender diversity in senior management and company performance, and the literature on gender behavioral differences and the workplace, this article explores the possible reasons for the persistent wage and gender gap between women and men in senior leadership positions and discusses possible remedies.

  12. Financial Management: U.S. Army Corps of Engineers Financial Information Imported Into the Defense Departmental Reporting System - Audited Financial Statements

    National Research Council Canada - National Science Library

    Granetto, Paul J; Peek, Marvin L; Armstrong, Jack L; Wenzel, Paul C; Furey, Kathleen A; Zimmerman, Craig W

    2004-01-01

    .... The USACE Civil Works principal financial statements consist of a consolidated balance sheet, a consolidated statement of net cost, a consolidated statement of changes ill net position, a combined...

  13. Federal Energy Regulatory Commission`s fiscal year 1996 financial statement audit

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-14

    This report presents the results of the independent certified public accountants` audit of the Federal Energy Regulatory Commission`s (FERC) financial statements as of September 30, 1996. The auditors have expressed an unqualified opinion on the 1996 statement of financial position and the related statements of operations and changes in net position.

  14. Pre/post evaluation of a pilot prevention with positives training program for healthcare providers in North West Province, Republic of South Africa.

    Science.gov (United States)

    Kemp, Christopher G; de Kadt, Julia; Pillay, Erushka; Gilvydis, Jennifer M; Naidoo, Evasen; Grignon, Jessica; Weaver, Marcia R

    2017-05-02

    Prevention interventions for people living with HIV/AIDS are an important component of HIV programs. We report the results of a pilot evaluation of a four-hour, clinic-based training for healthcare providers in South Africa on HIV prevention assessments and messages. This pre/post pilot evaluation examined whether the training was associated with providers delivering more prevention messages. Seventy providers were trained at four public primary care clinics with a high volume of HIV patients. Pre- and post-training patient exit surveys were conducted using Audio-Computer Assisted Structured Interviews. Seven provider appropriate messaging outcomes and one summary provider outcome were compared pre- and post-training using Poisson regression. Four hundred fifty-nine patients pre-training and 405 post-training with known HIV status were interviewed, including 175 and 176 HIV positive patients respectively. Among HIV positive patients, delivery of all appropriate messages by providers declined post-training. The summary outcome decreased from 56 to 50%; adjusted rate ratio 0.92 (95% CI = 0.87-0.97). Sensitivity analyses adjusting for training coverage and time since training detected fewer declines. Among HIV negative patients the summary score was stable at 32% pre- and post-training; adjusted rate ratio 1.05 (95% CI = 0.98-1.12). Surprisingly, this training was associated with a decrease in prevention messages delivered to HIV positive patients by providers. Limited training coverage and delays between training and post-training survey may partially account for this apparent decrease. A more targeted approach to prevention messages may be more effective.

  15. Breaking the Glass Ceiling: Structural, Cultural, and Organizational Barriers Preventing Women from Achieving Senior and Executive Positions

    OpenAIRE

    Johns, Merida L.

    2013-01-01

    The business case for gender diversity in senior and executive positions is compelling. Studies show that companies that have the best records for promoting women outstrip their competition on every measure of profitability. Yet women disproportionately are failing to attain high-level positions. Reviewing current data on women in the workplace, findings of studies on the relationship between gender diversity in senior management and company performance, and the literature on gender behaviora...

  16. Sexual risk reduction for HIV-infected persons: a meta-analytic review of "positive prevention" randomized clinical trials.

    Science.gov (United States)

    Yin, Lu; Wang, Na; Vermund, Sten H; Shepherd, Bryan E; Ruan, Yuhua; Shao, Yiming; Qian, Han-Zhu

    2014-01-01

    Prevention intervention trials have been conducted to reduce risk of sexual transmission among people living with HIV/AIDS (PLWHA), but the findings were inconsistent. We performed a systematic review and meta-analysis to evaluate overall efficacy of prevention interventions on unprotected vaginal or anal intercourse (UVAI) among PLWHA from randomized clinical trials (RCTs). RCTs of prevention interventions among PLWHA published as of February 2012 were identified by systematically searching thirteen electronic databases. The primary outcome was UVAI. The difference of standardized mean difference (SMD) of UVAI between study arms, defined as effect size (ES), was calculated for each study and then pooled across studies using standard meta-analysis with a random effects model. Lower likelihood of UVAI was observed in the intervention arms compared with the control arms either with any sexual partners (mean ES: -0.22; 95% confidence interval [CI]: -0.32, -0.11) or with HIV-negative or unknown-status sexual partners (mean ES and 95% CI: -0.13 [-0.22, -0.04]). Short-term efficacy of interventions with ≤ 10 months of follow up was significant in reducing UVAI (1-5 months: -0.27 [-0.45, -0.10]; 6-10 months: -0.18 [-0.30, -0.07]), while long-term efficacy of interventions was weaker and might have been due to chance (11-15 months: -0.13 [-0.34, 0.08]; >15 months: -0.05 [-0.43, 0.32]). Our meta-analyses confirmed the short-term impact of prevention interventions on reducing self-reported UVAI among PLWHA irrespective of the type of sexual partner, but did not support a definite conclusion on long-term effect. It is suggested that booster intervention sessions are needed to maintain a sustainable reduction of unprotected sex among PLWHA in future risk reduction programs.

  17. Predictive, Preventive and Personalised Medicine as the hardcore of ‘Horizon 2020’: EPMA position paper

    OpenAIRE

    Golubnitschaja, Olga; Kinkorova, Judita; Costigliola, Vincenzo

    2014-01-01

    The European Association for Predictive, Preventive and Personalised Medicine (EPMA) considers acute problems in medical sciences as well as the quality and management of medical services challenging health care systems in Europe and worldwide. This actuality has motivated the representatives of EPMA to comment on the efforts in promoting an integrative approach based on multidisciplinary expertise to advance health care-related research and management. The current paper provides a global ove...

  18. Opening statements and general statements by delegation

    International Nuclear Information System (INIS)

    1978-01-01

    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

  19. Infant feeding practice and associated factors of HIV positive mothers attending prevention of mother to child transmission and antiretroviral therapy clinics in Gondar Town health institutions, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Muluye Dagnachew

    2012-03-01

    Full Text Available Abstract Background It has been estimated that 430,000 children under 15 years of age were newly infected with HIV in 2008, and more than 71% are living in sub-Saharan Africa. In the absence of intervention to prevent mother-to-child transmission, 30-45% of infants born to HIV-positive mothers in developing countries become infected during pregnancy, delivery and breastfeeding. The aim of this study was to assess infant feeding practice and associated factors of HIV positive mothers attending prevention of mother to child transmission and antiretroviral therapy clinics of Northwest Ethiopia. Methods Institution based cross sectional study was conducted from January to May 2011 among all HIV positive mothers with less than two years old child attending prevention of mother to child transmission and antiretroviral therapy clinics in Gondar Town health institutions. A structured pre-tested questionnaire using interview technique was used for data collection. The data was entered and analyzed using SPSS version 16 statistical package. Results A total of 209 HIV positive mothers were included in the study. Of these, 187 (89.5% had followed the recommended way of infant feeding practice while significant percentage (10.5% had practiced mixed breast feeding. In multivariate analysis, disclosure of HIV status with their spouse, insufficient breast milk and occupational status were found to be independently associated (p-value of Conclusions Higher proportion of respondents used the recommended way of infant feeding practice by WHO as well as by Ethiopian Ministry of Health. However, mixed feeding in the first 6 months of age, an undesirable practice in infant feeding, were reported in this study. Infant feeding education that is aligned to national policy should be strengthened in primary health care, particularly in situations where prevention of mother to child transmission of HIV is prioritized.

  20. Higher risk sexual behaviour is associated with unawareness of HIV-positivity and lack of viral suppression - implications for Treatment as Prevention.

    Science.gov (United States)

    Huerga, Helena; Venables, Emilie; Ben-Farhat, Jihane; van Cutsem, Gilles; Ellman, Tom; Kenyon, Chris

    2017-11-23

    Efficacy of Treatment as Prevention Strategy depends on a variety of factors including individuals' likelihood to test and initiate treatment, viral load and sexual behaviour. We tested the hypothesis that people with higher risk sexual behaviour are less likely to know their HIV-positive status and be virologically suppressed. A cross-sectional population-based survey of individuals aged 15-59 years old was conducted in 2013 in KwaZulu-Natal, South Africa. A two-stage cluster probability sampling was used. After adjustment for age and sex, lack of awareness of HIV-positivity was strongly associated with having more than one sexual partner in the preceding year (aOR: 2.1, 95%CI: 1.5-3.1). Inconsistent condom use was more common in individuals with more than one sexual partner (aOR: 16.6, 95%CI: 7.6-36.7) and those unaware (aOR: 3.7, 95%CI: 2.6-5.4). Among people aware of their HIV-positivity, higher risk sexual behaviour was associated with lack of viral suppression (aOR: 2.2, 95%CI: 1.1-4.5). Risky sexual behaviour seems associated with factors linked to poor health-seeking behaviour which may have negative implications for HIV testing and Treatment as Prevention. Innovative strategies, driven by improved epidemiological and anthropological understanding, are needed to enable comprehensive approaches to HIV prevention.

  1. 2017 Position Paper of the Italian Society for Cardiovascular Prevention (SIPREC) for an Updated Clinical Management of Hypercholesterolemia and Cardiovascular Risk: Executive Document.

    Science.gov (United States)

    Volpe, Massimo; Volpe, Roberto; Gallo, Giovanna; Presta, Vivianne; Tocci, Giuliano; Folco, Emanuela; Peracino, Andrea; Tremoli, Elena; Trimarco, Bruno

    2017-09-01

    The benefits achieved by implementing cardiovascular prevention strategies in terms of reduced incidence of atherosclerotic diseases and mortality are accepted, worldwide. In particular, the clinical management of hypercholesterolemia has a fundamental role for all preventive strategies, both in primary and secondary prevention, at each stage of cardiovascular risk. Since the net clinical benefit of lipid-lowering therapy largely depends on baseline individual cardiovascular risk profile, the assessment of individual risk is essential to establish type and intensity of both preventive and therapeutic strategies. Thus, the real challenge in a setting of clinical practice is not only to identify whom to treat among individuals at low-to-moderate risk, but mostly how much and how long to treat high or very-high risk patients. This manuscript, which reflects concepts and positions that have been published in a more extensive document of the Italian Society for Cardiovascular Prevention (SIPREC), deals with the diagnostic and therapeutic management of patients with dyslipidaemia, with an evidence-based approach adapted and updated from recent guidelines of the European Society of Cardiology and very recent results of randomized clinical trials. The purpose is to suggest a multidimensional and integrated actions aimed at eliminating or minimizing the impact of cardiovascular diseases and their related disabilities and mortality in patients with hypercholesterolemia.

  2. The polypill in cardiovascular prevention: evidence, limitations and perspective - position paper of the European Society of Hypertension.

    Science.gov (United States)

    Coca, Antonio; Agabiti-Rosei, Enrico; Cifkova, Renata; Manolis, Athanasios J; Redón, Josep; Mancia, Giuseppe

    2017-08-01

    : Antihypertensive, lipid lowering, antidiabetic and antiplatelet treatments all substantially reduce the risk of cardiovascular morbid and fatal events. In real life, however, effective implementation of these treatments is rare, and thus their contribution to cardiovascular prevention is much less than it could be, based on research data. This article reviews the pros and cons of cardiovascular prevention by the polypill approach. It is argued that the high prevalence of individuals with a multifactorial risk profile provides a strong rationale for a therapeutic strategy based on the combination in a single tablet of drugs against different risk factors. It is further argued that other important favourable arguments exist. First, in real-life adherence to all above treatments is very low, leading to a major increase in the incidence and risk of cardiovascular outcomes. Second, although a large number of factors are involved, adherence is adversely affected by the complexity of the prescribed treatment regimen and can be considerably improved by treatment simplification. Third, recent studies in patients with a history of manifest cardiovascular disease have documented that different cardiovascular drugs can be combined in a single tablet with no loss of their individual efficacy or unexpected inconveniences and this does favour adherence to treatment and multiple risk factor control, supporting use of the polypill in secondary cardiovascular prevention. It is finally also mentioned, however, that the polypill may have some drawbacks and that at present no evidence is available that this approach reduces cardiovascular outcome to a greater degree than standard treatment strategies. Trials are under way to provide an answer to this question and thus allow the therapeutic value of this approach to be known.

  3. Under general anesthesia arginine vasopressin prevents hypotension but impairs cerebral oxygenation during arthroscopic shoulder surgery in the beach chair position.

    Science.gov (United States)

    Cho, Soo Y; Kim, Seok J; Jeong, Cheol W; Jeong, Chang Y; Chung, Sung S; Lee, JongUn; Yoo, Kyung Y

    2013-12-01

    Patients undergoing surgery in the beach chair position (BCP) are at a risk of cerebral ischemia. We evaluated the effect of arginine vasopressin (AVP) on hemodynamics and cerebral oxygenation during surgery in the BCP. Thirty patients undergoing shoulder surgery in BCP under propofol-remifentanil anesthesia were randomly allocated either to receive IV AVP 0.07 U/kg (AVP group, N = 15) or an equal volume of saline (control group, N = 15) 2 minutes before taking BCP. Mean arterial blood pressure (MAP), heart rate (HR), jugular venous bulb oxygen saturation (SjvO2), and regional cerebral tissue oxygen saturation (SctO2) were measured after induction of anesthesia and before (presitting in supine position) and after patients took BCP. AVP itself given before the positioning increased MAP and decreased SjvO2 and SctO2 (P 20% SctO2 decrease from presitting value) (80% vs 13%; P = 0.0003) was higher in the AVP group. The incidence of jugular desaturation (SjvO2 shoulder surgery under general anesthesia. However, it was associated with regional cerebral but not jugular venous oxygen desaturation on upright positioning.

  4. Prevention options for positives: the effects of a health communication intervention for men who have sex with men living with HIV/AIDS.

    Science.gov (United States)

    Lapinski, Maria Knight; Randall, Liisa M; Peterson, Mark; Peterson, Amy; Klein, Katherine A

    2009-09-01

    This article reports the results of a small-scale quasi-experiment that tested the efficacy of the Prevention Options for Positives intervention. The experiment tested for the outcomes of group sessions combined with individual-level counseling (ILC) versus ILC-only for men who have sex with men who are HIV positive. Both arms of the intervention were based on behavior change theory and dealt specifically with communication outcomes. The results indicate that the group- and individual-level interventions combined have a greater impact on risk communication behaviors with main partners than did the ILC-only sessions. group-session/ILC participants were more likely to decide not to have sex if they were drunk or high, and more likely to tell their partner and ask their partner about HIV status than were participants in the ILC groups. Knowledge about HIV was relatively high, and there was little change across groups. The Prevention Options for Positives intervention influenced the relative importance of various referent groups, but normative beliefs were not affected. The implications of these findings for communication practice and research with HIV-positive men who have sex with men are addressed.

  5. Positive-Themed Suicide Prevention Messages Delivered by Adolescent Peer Leaders: Proximal Impact on Classmates' Coping Attitudes and Perceptions of Adult Support.

    Science.gov (United States)

    Petrova, Mariya; Wyman, Peter A; Schmeelk-Cone, Karen; Pisani, Anthony R

    2015-12-01

    Developing science-based communication guidance and positive-themed messages for suicide prevention are important priorities. Drawing on social learning and elaboration likelihood models, we designed and tested two positive-focused presentations by high school peer leaders delivered in the context of a suicide prevention program (Sources of Strength). Thirty-six classrooms in four schools (N = 706 students) were randomized to (1) peer leader modeling of healthy coping, (2) peer leader modeling plus audience involvement to identify trusted adults, or (3) control condition. Students' attitudes and norms were assessed by immediate post-only assessments. Exposure to either presentation enhanced positive coping attitudes and perceptions of adult support. Students who reported suicide ideation in the past 12 months benefited more than nonsuicidal students. Beyond modeling alone, audience involvement modestly enhanced expectations of adult support, congruent with the elaboration likelihood model. Positive peer modeling is a promising alternative to communications focused on negative consequences and directives and may enhance social-interpersonal factors linked to reduced suicidal behaviors. © 2015 The American Association of Suicidology.

  6. The rocky road to prosocial behavior at work: The role of positivity and organizational socialization in preventing interpersonal strain.

    Science.gov (United States)

    Livi, Stefano; Theodorou, Annalisa; Rullo, Marika; Cinque, Luigi; Alessandri, Guido

    2018-01-01

    Among relevant consequences of organizational socialization, a key factor is the promotion of organizational citizenship behaviors toward individuals (i.e. OCBI). However, the relation between organizational socialization and OCBI has received little attention. This study tests the validity of a moderated mediation model in which we examine the mediating effect of a decreased interpersonal strain on the relationship between organizational socialization and OCBI, and the moderation role of a positive personal resource in reducing interpersonal strain when an unsuccessful socialization subsists. A cross-sectional study was conducted on 765 new recruits of the Guardia di Finanza-a military Police Force reporting to the Italian Minister of Economy. Findings confirm our hypothesis that interpersonal strain mediates the relationship between organizational socialization and OCBI. The index of moderated mediation results significant, showing that this effect exists at different levels of positivity. Theoretical and practical implications for promoting pro-organizational behaviors are discussed.

  7. The rocky road to prosocial behavior at work: The role of positivity and organizational socialization in preventing interpersonal strain

    Science.gov (United States)

    Theodorou, Annalisa; Rullo, Marika; Cinque, Luigi; Alessandri, Guido

    2018-01-01

    Among relevant consequences of organizational socialization, a key factor is the promotion of organizational citizenship behaviors toward individuals (i.e. OCBI). However, the relation between organizational socialization and OCBI has received little attention. This study tests the validity of a moderated mediation model in which we examine the mediating effect of a decreased interpersonal strain on the relationship between organizational socialization and OCBI, and the moderation role of a positive personal resource in reducing interpersonal strain when an unsuccessful socialization subsists. A cross-sectional study was conducted on 765 new recruits of the Guardia di Finanza–a military Police Force reporting to the Italian Minister of Economy. Findings confirm our hypothesis that interpersonal strain mediates the relationship between organizational socialization and OCBI. The index of moderated mediation results significant, showing that this effect exists at different levels of positivity. Theoretical and practical implications for promoting pro-organizational behaviors are discussed. PMID:29494621

  8. Estrogen receptor (ESR1) mRNA expression and benefit from tamoxifen in the treatment and prevention of estrogen receptor-positive breast cancer.

    Science.gov (United States)

    Kim, Chungyeul; Tang, Gong; Pogue-Geile, Katherine L; Costantino, Joseph P; Baehner, Frederick L; Baker, Joffre; Cronin, Maureen T; Watson, Drew; Shak, Steven; Bohn, Olga L; Fumagalli, Debora; Taniyama, Yusuke; Lee, Ahwon; Reilly, Megan L; Vogel, Victor G; McCaskill-Stevens, Worta; Ford, Leslie G; Geyer, Charles E; Wickerham, D Lawrence; Wolmark, Norman; Paik, Soonmyung

    2011-11-01

    Several mechanisms have been proposed to explain tamoxifen resistance of estrogen receptor (ER) -positive tumors, but a clinically useful explanation for such resistance has not been described. Because the ER is the treatment target for tamoxifen, a linear association between ER expression levels and the degree of benefit from tamoxifen might be expected. However, such an association has never been demonstrated with conventional clinical ER assays, and the ER is currently used clinically as a dichotomous marker. We used gene expression profiling and ER protein assays to help elucidate molecular mechanism(s) responsible for tamoxifen resistance in breast tumors. We performed gene expression profiling of paraffin-embedded tumors from National Surgical Adjuvant Breast and Bowel Project (NSABP) trials that tested the worth of tamoxifen as an adjuvant systemic therapy (B-14) and as a preventive agent (P-1). This was a retrospective subset analysis based on available materials. In B-14, ESR1 was the strongest linear predictor of tamoxifen benefit among 16 genes examined, including PGR and ERBB2. On the basis of these data, we hypothesized that, in the P-1 trial, a lower level of ESR1 mRNA in the tamoxifen arm was the main difference between the two study arms. Only ESR1 was downregulated by more than two-fold in ER-positive cancer events in the tamoxifen arm (P < .001). Tamoxifen did not prevent ER-positive tumors with low levels of ESR1 expression. These data suggest that low-level expression of ESR1 is a determinant of tamoxifen resistance in ER-positive breast cancer. Strategies should be developed to identify, treat, and prevent such tumors.

  9. Estrogen Receptor (ESR1) mRNA Expression and Benefit From Tamoxifen in the Treatment and Prevention of Estrogen Receptor–Positive Breast Cancer

    Science.gov (United States)

    Kim, Chungyeul; Tang, Gong; Pogue-Geile, Katherine L.; Costantino, Joseph P.; Baehner, Frederick L.; Baker, Joffre; Cronin, Maureen T.; Watson, Drew; Shak, Steven; Bohn, Olga L.; Fumagalli, Debora; Taniyama, Yusuke; Lee, Ahwon; Reilly, Megan L.; Vogel, Victor G.; McCaskill-Stevens, Worta; Ford, Leslie G.; Geyer, Charles E.; Wickerham, D. Lawrence; Wolmark, Norman; Paik, Soonmyung

    2011-01-01

    Purpose Several mechanisms have been proposed to explain tamoxifen resistance of estrogen receptor (ER) –positive tumors, but a clinically useful explanation for such resistance has not been described. Because the ER is the treatment target for tamoxifen, a linear association between ER expression levels and the degree of benefit from tamoxifen might be expected. However, such an association has never been demonstrated with conventional clinical ER assays, and the ER is currently used clinically as a dichotomous marker. We used gene expression profiling and ER protein assays to help elucidate molecular mechanism(s) responsible for tamoxifen resistance in breast tumors. Patients and Methods We performed gene expression profiling of paraffin-embedded tumors from National Surgical Adjuvant Breast and Bowel Project (NSABP) trials that tested the worth of tamoxifen as an adjuvant systemic therapy (B-14) and as a preventive agent (P-1). This was a retrospective subset analysis based on available materials. Results In B-14, ESR1 was the strongest linear predictor of tamoxifen benefit among 16 genes examined, including PGR and ERBB2. On the basis of these data, we hypothesized that, in the P-1 trial, a lower level of ESR1 mRNA in the tamoxifen arm was the main difference between the two study arms. Only ESR1 was downregulated by more than two-fold in ER-positive cancer events in the tamoxifen arm (P < .001). Tamoxifen did not prevent ER-positive tumors with low levels of ESR1 expression. Conclusion These data suggest that low-level expression of ESR1 is a determinant of tamoxifen resistance in ER-positive breast cancer. Strategies should be developed to identify, treat, and prevent such tumors. PMID:21947828

  10. Behaviors Influencing Human Immunodeficiency Virus Transmission in the Context of Positive Prevention among People Living with HIV/Acquired Immunodeficiency Syndrome in Iran: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Seyed Ramin Radfar

    2014-01-01

    Full Text Available Background: Identifying factors, which influence health behaviors is critical to designing appropriate and effective preventive programs. Human immunodeficiency virus (HIV transmission is highly related to people behaviors and understanding factors influencing healthy behaviors among Iranian people living with HIVs (PLHIVs/acquired immunodeficiency syndrome (AIDS is very important to tailor an effective response to HIV/AIDS epidemic. Methods: This study was conducted as a qualitative study by methods of focus group discussion and in-depth interview in six provinces of Iran with 64 PLHIVs to determine factors influence engagement in positive prevention. Results: Knowledge and education, feelings of responsibility and positive prevention practices were identified as the primary domains of engagement. These domains were found to be influenced by feelings of ostracism and frustration, poverty, barriers to disclosure of HIV status, access to and utilization of drug abuse treatment services and antiretroviral therapy, adherence to treatment, age, religiousness, sex work, singleness, and incarceration. Conclusions: Designing new interventions and updating current interventions directed toward the aforementioned factors should be addressed by responsible Iranian authorities in order to have a national effective response on the HIV/AIDS epidemic.

  11. Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort?

    Science.gov (United States)

    Hahlweg, Kurt; Heinrichs, Nina; Kuschel, Annett; Bertram, Heike; Naumann, Sebastian

    2010-05-16

    Approximately 20% of children experience internalizing or externalizing DSM-IV-TR disorders. This prevalence rate cannot be reduced through treatment only. Effective preventive interventions are therefore urgently needed. The aim of the current investigation is to evaluate the two-year efficacy of the group Triple P parenting program administered universally for the prevention of child behavior problems. Based on their respective preschool, N = 280 families were randomly assigned either to the parent training or to the control group. The efficacy was analyzed using multi-source assessments, including questionnaires by mother and father, behavioral observation of mother-child interaction, and teacher evaluations. At the 2-year follow-up, both parents in the Triple P intervention reported significant reductions in dysfunctional parenting behavior, and mothers also an increase in positive parenting behavior. In addition, mothers reported significant reductions in internalizing and externalizing child behavior. Single-parent mothers in the Triple P intervention did not report significant changes in parenting or child problem behavior which is primarily due to inexplicable high positive effects in single parent mothers of the control group. Neither mother-child interactions nor teacher ratings yielded significant results. The results support the long-term efficacy of the Triple P - group program as a universal prevention intervention for changing parenting behavior in two-parent households, but not necessarily in single-parent mothers.

  12. Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort?

    Directory of Open Access Journals (Sweden)

    Bertram Heike

    2010-05-01

    Full Text Available Abstract Background Approximately 20% of children experience internalizing or externalizing DSM-IV-TR disorders. This prevalence rate cannot be reduced through treatment only. Effective preventive interventions are therefore urgently needed. The aim of the current investigation is to evaluate the two-year efficacy of the group Triple P parenting program administered universally for the prevention of child behavior problems. Methods Based on their respective preschool, N = 280 families were randomly assigned either to the parent training or to the control group. The efficacy was analyzed using multi-source assessments, including questionnaires by mother and father, behavioral observation of mother-child interaction, and teacher evaluations. Results At the 2-year follow-up, both parents in the Triple P intervention reported significant reductions in dysfunctional parenting behavior, and mothers also an increase in positive parenting behavior. In addition, mothers reported significant reductions in internalizing and externalizing child behavior. Single-parent mothers in the Triple P intervention did not report significant changes in parenting or child problem behavior which is primarily due to inexplicable high positive effects in single parent mothers of the control group. Neither mother-child interactions nor teacher ratings yielded significant results. Conclusions The results support the long-term efficacy of the Triple P - group program as a universal prevention intervention for changing parenting behavior in two-parent households, but not necessarily in single-parent mothers.

  13. Marking Closely or on the Bench?: An Australian's Benchmark Statement.

    Science.gov (United States)

    Jones, Roy

    2000-01-01

    Reviews the benchmark statements of the Quality Assurance Agency for Higher Education in the United Kingdom. Examines the various sections within the benchmark. States that in terms of emphasizing the positive attributes of the geography discipline the statements have wide utility and applicability. (CMK)

  14. Teachers' Interpretations of Student Statements about Slope

    Science.gov (United States)

    Nagle, Courtney; Moore-Russo, Deborah; Styers, Jodie L.

    2017-01-01

    This paper describes seven in-service teachers' interpretations of student statements about slope. The teachers interpreted sample student work, conjectured about student contributions, assessed the students' understanding, and positioned the students' statements in the mathematics curriculum. The teachers' responses provide insight into their…

  15. 7 CFR 1427.1081 - General statement and administration.

    Science.gov (United States)

    2010-01-01

    ... by the Director, KCCO, or the Director's designee, the financial statement of a parent company, which includes the financial position of a wholly-owned subsidiary, may be used to meet the CCC standards for... Linters,” (2) A current financial statement on Form WA-51, “Financial Statement”, supported by such...

  16. Continuous Positive Airway Pressure Prevents Hypoxia in Dental Patient with Obstructive Sleep Apnea Syndrome under Intravenous Sedation.

    Science.gov (United States)

    Kasatkin, Anton A; Reshetnikov, Aleksei P; Urakov, Aleksandr L; Baimurzin, Dmitrii Y

    2017-01-01

    Use of sedation in patients with obstructive sleep apnea (OSA) in dentistry is limited. Hypoxia may develop during medication sleep in dental patients with OSA because of repetitive partial or complete obstruction of the upper airway. In this regard, anesthesiologists prefer not to give any sedative to surgical patients with OSA or support the use of general anesthesia due to good airway control. We report a case where we could successfully sedate a dental patient with OSA using intraoperative continuous positive airway pressure (CPAP) without hypoxia. Use of sedation and intraoperative CPAP in patients with OSA may be considered only if the effectiveness at home CPAP therapy is proven.

  17. Preventing HIV Transmission Among Partners of HIV-Positive Male Sex Workers in Mexico City: A Modeling Study.

    Science.gov (United States)

    Monteiro, João Filipe G; Marshall, Brandon D L; Escudero, Daniel; Sosa-Rubí, Sandra G; González, Andrea; Flanigan, Timothy; Operario, Don; Mayer, Kenneth H; Lurie, Mark N; Galárraga, Omar

    2015-09-01

    Mexico has a concentrated HIV epidemic, with male sex workers constituting a key affected population. We estimated annual HIV cumulative incidence among male sex workers' partners, and then compared incidence under three hypothetical intervention scenarios: improving condom use; and scaling up HIV treatment as prevention, considering current viral suppression rates (CVS, 60.7 %) or full viral suppression among those treated (FVS, 100 %). Clinical and behavioral data to inform model parameterization were derived from a sample (n = 79) of male sex workers recruited from street locations and Clínica Condesa, an HIV clinic in Mexico City. We estimated annual HIV incidence among male sex workers' partners to be 8.0 % (95 % CI: 7.3-8.7). Simulation models demonstrated that increasing condom use by 10 %, and scaling up HIV treatment initiation by 50 % (from baseline values) would decrease the male sex workers-attributable annual incidence to 5.2, 4.4 % (CVS) and 3.2 % (FVS), respectively. Scaling up the number of male sex workers on ART and implementing interventions to ensure adherence is urgently required to decrease HIV incidence among male sex workers' partners in Mexico City.

  18. Prevalence, Predictors, and Same Day Treatment of Positive VIA Enhanced by Digital Cervicography and Histopathology Results in a Cervical Cancer Prevention Program in Cameroon.

    Science.gov (United States)

    DeGregorio, Geneva A; Bradford, Leslie S; Manga, Simon; Tih, Pius M; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Schwaiger, Constance; Rao, Sowmya R; Kalmakis, Karen; Kennedy Sheldon, Lisa; Nulah, Kathleen; Welty, Edith; Welty, Thomas; Ogembo, Javier Gordon

    2016-01-01

    In 2007, the Cameroon Baptist Convention Health Services (CBCHS) implemented a screen-and-treat cervical cancer prevention program using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC). We retrospectively analyzed 46,048 medical records of women who received care through the CBCHS Women's Health Program from 2007 through 2014 to determine the prevalence and predictors of positive VIA-DC, rates of same day treatment, and cohort prevalence of invasive cervical cancer (ICC). Of the 44,979 women who were screened for cervical cancer, 9.0% were VIA-DC-positive, 66.8% were VIA-DC-negative, 22.0% were VIA-DC-inadequate (normal ectocervix, but portions of the transformation zone were obscured), and 2.2% were VIA-DC-uncertain (cervical abnormalities confounding VIA-DC interpretation). Risk factors significantly associated with VIA-DC-positive screen were HIV-positivity, young age at sexual debut, higher lifetime number of sexual partners, low education status and higher gravidity. In 2014, 31.1% of women eligible for cryotherapy underwent same day treatment. Among the 32,788 women screened from 2007 through 2013, 201 cases of ICC were identified corresponding to a cohort prevalence of 613 per 100,000. High rate of VIA-DC-positive screens suggests a significant burden of potential cervical cancer cases and highlights the need for expansion of cervical cancer screening and prevention throughout the 10 regions of Cameroon. VIA-DC-inadequate rates were also high, especially in older women, and additional screening methods are needed to confirm whether these results are truly negative. In comparison to similar screening programs in sub-Saharan Africa there was low utilization of same day cryotherapy treatment. Further studies are required to characterize possible program specific barriers to treatment, for example cultural demands, health system challenges and cost of procedure. The prevalence of ICC among women who presented for screening was high

  19. Bcl-2 over-expression fails to prevent age-related loss of calretinin positive neurons in the mouse dentate gyrus

    Directory of Open Access Journals (Sweden)

    Han Mingbo

    2006-08-01

    Full Text Available Abstract Background Cognitive performance declines with increasing age. Possible cellular mechanisms underlying this age-related functional decline remain incompletely understood. Early studies attributed this functional decline to age-related neuronal loss. Subsequent studies using unbiased stereological techniques found little or no neuronal loss during aging. However, studies using specific cellular markers found age-related loss of specific neuronal types. To test whether there is age-related loss of specific neuronal populations in the hippocampus, and subsequently, whether over-expression of the B-cell lymphoma protein-2 (Bcl-2 in these neurons could delay possible age-related neuronal loss, we examined calretinin (CR positive neurons in the mouse dentate gyrus during aging. Result In normal mice, there was an age-related loss of CR positive cells in the dentate gyrus. At the same region, there was no significant decrease of total numbers of neurons, which suggested that age-related loss of CR positive cells was due to the decrease of CR expression in these cells instead of cell death. In the transgenic mouse line over-expressing Bcl-2 in neurons, there was an age-related loss of CR positive cells. Interestingly, there was also an age-related neuronal loss in this transgenic mouse line. Conclusion These data suggest an age-related loss of CR positive neurons but not total neuronal loss in normal mice and this age-related neuronal change is not prevented by Bcl-2 over-expression.

  20. Revenue Recognition Challenges and Financial Statement Reporting

    African Journals Online (AJOL)

    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 ...

  1. 29 CFR 531.25 - Introductory statement.

    Science.gov (United States)

    2010-07-01

    ... such interpretations of this Act “provide a practical guide to employers and employees as to how the... PAYMENTS UNDER THE FAIR LABOR STANDARDS ACT OF 1938 Interpretations § 531.25 Introductory statement. (a... responsibilities of administration and enforcement (Skidmore v. Swift, 323 U.S. 134). In order that these positions...

  2. Monacolin and atorvastatin in cardiovascular prevention – an attempt at positioning

    Directory of Open Access Journals (Sweden)

    Marcin Barylski

    2017-03-01

    Full Text Available Cardiovascular diseases are the leading cause of premature death worldwide. Dyslipidemia, in turn, is the most common modifiable cardiovascular risk factor. According to NATPOL 2011, hypercholesterolaemia defined as total cholesterol of at least 190 mg/dL is diagnosed in 61% of adult Poles. Non-pharmacological management, i.e. lifestyle modification, including, in the first place, physical activity and a proper diet, is the basis of intervention aimed to normalise cholesterol levels. Statins are the most important and the most common class of agents in the treatment of lipid disorders and there is strong and clear evidence supporting their effects on lipid reduction and prognosis improvement. These agents are well tolerated and safe, and their efficacy in primary and secondary cardiovascular prevention was well-documented in clinical trials. The use of a dietary supplement in the form of monacolin K contained in the red yeast rice, whose efficacy in reducing cholesterol levels has been demonstrated in a number of randomised clinical trials, may be an intermediate stage between non-pharmacological treatment and statin therapy. In everyday practice, patients who do not qualify for aggressive lipidlowering therapy, but show no desired effects when on behavioural therapy, are often encountered. It seems that monacolin K therapy may be used in such cases. However, it should be strongly emphasised that monacolin K may be only an adjuvant, and not a substitute for behavioural therapy. This paper presents the potential place of monacolin K and atorvastatin in modern cardiovascular pharmacotherapy, attempting to define target patient populations for both these substances.

  3. Triamcinolone acetonide activates an anti-inflammatory and folate receptor-positive macrophage that prevents osteophytosis in vivo.

    Science.gov (United States)

    Siebelt, Michiel; Korthagen, Nicoline; Wei, Wu; Groen, Harald; Bastiaansen-Jenniskens, Yvonne; Müller, Christina; Waarsing, Jan Hendrik; de Jong, Marion; Weinans, Harrie

    2015-12-05

    Triamcinolone acetonide (TA) is used for osteoarthritis management to reduce pain, and pre-clinical studies have shown that TA limits osteophyte formation. Osteophyte formation is known to be facilitated by synovial macrophage activation. TA injections might influence macrophage activation and subsequently reduce osteophytosis. Although widely applied in clinical care, the mechanism through which TA exerts this effect remains unknown. In this animal study, we investigated the in vivo effects of TA injections on macrophage activation, osteophyte development and joint degeneration. Furthermore, in vitro macrophage differentiation experiments were conducted to further explain working mechanisms of TA effects found in vivo. Osteoarthritis was induced in rat knees using papain injections and a running protocol. Untreated and TA-treated animals were longitudinally monitored for 12 weeks with in vivo micro-computed tomography (μCT) to measure subchondral bone changes. Synovial macrophage activation was measured in vivo using folate receptor β (FRβ)-targeted single-photon emission computed tomography/computed tomography. Articular cartilage was analyzed at 6 and 12 weeks with ex vivo contrast-enhanced μCT and histology. To further explain the outcomes of our in vivo study, TA on macrophages was also studied in vitro. These cultured macrophages were either M1- or M2-activated, and they were analyzed using fluorescence-activated cell sorting for CD163 and FRβ expression as well as for messenger RNA (mRNA) expression of interleukin (IL)-10. Our in vivo study showed that intra-articular injections with TA strongly enhanced FRβ(+) macrophage activation. Despite stimulated macrophage activation, osteophyte formation was fully prevented. There was no beneficial effect of TA against cartilage degradation or subchondral bone sclerosis. In vitro macrophage cultures showed that TA strongly induced monocyte differentiation towards CD163(+) and FRβ(+) macrophages. Furthermore

  4. The effect of "in favor of myself": preventive program to enhance positive self and body image among adolescents.

    Science.gov (United States)

    Golan, Moria; Hagay, Noaa; Tamir, Snait

    2013-01-01

    Positive self-esteem, emotional well-being, school achievements and family connectedness are considered protective factors against health-compromising behaviors. This study examined the effect of an interactive, community-based, media literacy and dissonance wellness program, In Favor of Myself, on the self-image, body image, eating attitudes and behavior of young adolescents. A preliminary cohort study was conducted among 972 program participants who did not take part in the controlled trial. Over 75% of participants said they would recommend the program to their friends. A controlled trial was conducted to evaluate program acceptability, efficacy and effectiveness among 259 participants (210 in the intervention group and 49 in the control group), aged 12-14 years, who completed questionnaires during at least two assessment times. Program materials were provided, along with leaders' training, in order to ensure quality program delivery and creation of a wide network of committed program leaders. The program significantly reduced drive for thinness and self-worth contingent upon others' approval, the gap between current body figure and ideal figure, and the impact of mood on girls' self-image. Superiority was found among those participating in the intervention group with respect to recognizing media strategies, the influence of media on desire to change, and the influence of appearance on self-confidence and drive for thinness. In Favor of Myself shows promising results for strengthening adolescents' ability to cope with the challenges of their life stage. Suggestions for improving In Favor of Myself are presented.

  5. The Effect of “In Favor of Myself”: Preventive Program to Enhance Positive Self and Body Image among Adolescents

    Science.gov (United States)

    Golan, Moria; Hagay, Noaa; Tamir, Snait

    2013-01-01

    Background Positive self-esteem, emotional well-being, school achievements and family connectedness are considered protective factors against health-compromising behaviors. This study examined the effect of an interactive, community-based, media literacy and dissonance wellness program, In Favor of Myself, on the self-image, body image, eating attitudes and behavior of young adolescents. A preliminary cohort study was conducted among 972 program participants who did not take part in the controlled trial. Over 75% of participants said they would recommend the program to their friends. Methods A controlled trial was conducted to evaluate program acceptability, efficacy and effectiveness among 259 participants (210 in the intervention group and 49 in the control group), aged 12–14 years, who completed questionnaires during at least two assessment times. Program materials were provided, along with leaders' training, in order to ensure quality program delivery and creation of a wide network of committed program leaders. Results The program significantly reduced drive for thinness and self-worth contingent upon others' approval, the gap between current body figure and ideal figure, and the impact of mood on girls' self-image. Superiority was found among those participating in the intervention group with respect to recognizing media strategies, the influence of media on desire to change, and the influence of appearance on self-confidence and drive for thinness. Conclusions In Favor of Myself shows promising results for strengthening adolescents' ability to cope with the challenges of their life stage. Suggestions for improving In Favor of Myself are presented. PMID:24265681

  6. The Relationship of Repeated Technical Assistance Support Visits to the Delivery of Positive Health, Dignity, and Prevention (PHDP) Messages by Healthcare Providers in Mozambique: A Longitudinal Multilevel Analysis.

    Science.gov (United States)

    Gutin, Sarah A; Amico, K Rivet; Hunguana, Elsa; Munguambe, António Orlando; Rose, Carol Dawson

    Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.

  7. Consensus statement on genetic research in dementia

    DEFF Research Database (Denmark)

    Rikkert, M.G. Olde; der, V van; Burns, A.

    2008-01-01

    In this article, the authors describe how the European Dementia Consensus Network developed a consensus on research ethics in dementia, taking into account the questions posed by the era of genetic research and its new research methods. The consensus process started with a Delphi procedure...... to analyze relevant stakeholders' positions by describing their statements on the possibilities and limitations of research into genetic determinants of Alzheimer disease and to describe and analyze the moral desirability of genetic research on Alzheimer disease. The conclusions drawn from the Delphi...... procedure fuelled the development of the consensus statement, which is presented in this paper. The consensus statement aims to stimulate ethically acceptable research in the field of dementia and the protection of vulnerable elderly patients with dementia from application of inadequate research methods...

  8. Financial Ratio Analysis of Audited Federal Financial Statements

    National Research Council Canada - National Science Library

    Kenney, Shane

    2000-01-01

    .... The purpose of these statements is to fully reveal federal entities' financial position, in the hope of enabling a better understanding of these federal entities, and to assist in resource management...

  9. Defense Commissary Resale Stock Fund Financial Statements For FY 1992

    National Research Council Canada - National Science Library

    Young, Shelton

    1993-01-01

    The initial objectives of the audit were to determine whether the FY 1992 Commissary Resale Stock fund financial statements present fairly the financial position and results of operation of the fund...

  10. THE STATEMENT OF CASH FLOWS USING FINANCIAL STATEMENT EQUATIONS

    OpenAIRE

    Harold Fletcher; Thomas Ulrich

    2010-01-01

    This paper addresses one of the more difficult topics in teaching MBA level financial management, the statement of cash flows. By employing financial statement equations in preparing the statement of cash flows, students: (1) are employing tools that they are more familiar and comfortable with which mitigates their anxiety and enhances their understanding, (2) are better able to understand the logic of the statement of cash flows and the relationships that exist between it and the income stat...

  11. Federal Energy Regulatory Commission fiscal year 1997 annual financial statements

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-02-24

    This report presents the results of the independent certified public accountants` audit of the Federal Energy Regulatory commission`s statements of financial position, and the related statements of operations and changes in net position. The auditors` work was conducted in accordance with generally accepted government auditing standards. An independent public accounting firm conducted the audit. The auditors` reports on the Commission`s internal control structure and compliance with laws and regulations disclosed no reportable conditions or instances of noncompliance.

  12. Be Vigilant on Financial Statements.

    Science.gov (United States)

    Freed, DeBow

    2002-01-01

    Highlights areas on university's financial statements that warrant careful review by trustees and suggests ways they can check to see whether an institution's financial statements are clear and valid indicators of its financial status. (EV)

  13. Corporate Information Management Financial Statements

    National Research Council Canada - National Science Library

    Gimble, Thomas

    1995-01-01

    The audit objective was to determine whether the OASD(C31) methods for preparing FY 1996 CIM, general purpose financial statements will result in auditable and complete general purpose financial statements...

  14. Understanding financial statements.

    Science.gov (United States)

    Tarantino, D P

    2001-01-01

    In his premier column for The Physician Executive, David Tarantino takes a look at those critical "financials" that can make or break a business. If you're considering a career move, you need to know the financial condition of future employers. Learn how to read the statements and glean valuable information from the numbers.

  15. Sustainability Statement and Policy

    Science.gov (United States)

    Journal of Education for Sustainable Development, 2009

    2009-01-01

    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…

  16. European Respiratory Society statement

    DEFF Research Database (Denmark)

    Miravitlles, Marc; Dirksen, Asger; Ferrarotti, Ilaria

    2017-01-01

    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...

  17. Statement on Plagiarism

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 13; Issue 5. Statement on Plagiarism. S Mahadevan N Mukunda. Editorial Volume 13 Issue 5 May 2008 pp 403-404. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/reso/013/05/0403-0404. Author Affiliations.

  18. Consolidating Financial Statements.

    Science.gov (United States)

    Wood, Marcia R.

    This publication is designed to be a desktop reference and assist financial officers in both public and independent institutions of higher education in the preparation of consolidated financial statements. Chapter 1 covers generally accepted accounting principles and other accounting literature, and summarizes reporting rules of the Financial…

  19. Consolidated financial statements

    OpenAIRE

    Blaha, Miroslav

    2010-01-01

    This work provides basic information about consolidation and consolidated financial statements. In the beginning there are definisions of the members of the group under discussion and their relationship. Hereafter concepts of consolidation, accounting methods and methods of consolidation are discussed. It also compares approach of different accounting systems to consolidation.

  20. Uranium enrichment services activity. Financial statements for fiscal year ended June 30, 1975

    International Nuclear Information System (INIS)

    1975-01-01

    Financial statements for the Uranium Enrichment Services Activity, covering both ERDA and its contractors, are presented to provide information concerning the operations and financial position of this operation

  1. Internal Controls and Compliance With Laws and Regulations for the Defense Business Operations Fund Consolidated Financial Statements for FY 1995

    National Research Council Canada - National Science Library

    Lane, Frederick

    1996-01-01

    The objective of the audit was to determine whether the Consolidated Statement of Financial Position and selected accounts on the Statement of Operations of the Defense Business Operations Fund for FY...

  2. Fundamentals of Financial Statements Audit

    OpenAIRE

    World Bank

    2011-01-01

    The purpose of an audit is to enhance the degree of confidence of intended users in the financial statements. The objective of an audit of financial statements is to enable an auditor to express an opinion as to whether the financial statements are prepared, in all material respects, in accordance with International Financial Reporting Standards or another identified financial reporting fr...

  3. The relationship between BMI and insulin resistance and progression from single to multiple autoantibody positivity and type 1 diabetes among TrialNet Pathway to Prevention participants.

    Science.gov (United States)

    Meah, Farah A; DiMeglio, Linda A; Greenbaum, Carla J; Blum, Janice S; Sosenko, Jay M; Pugliese, Alberto; Geyer, Susan; Xu, Ping; Evans-Molina, Carmella

    2016-06-01

    The incidence of type 1 diabetes is increasing at a rate of 3-5% per year. Genetics cannot fully account for this trend, suggesting an influence of environmental factors. The accelerator hypothesis proposes an effect of metabolic factors on type 1 diabetes risk. To test this in the TrialNet Pathway to Prevention (PTP) cohort, we analysed the influence of BMI, weight status and insulin resistance on progression from single to multiple islet autoantibodies (Aab) and progression from normoglycaemia to diabetes. HOMA1-IR was used to estimate insulin resistance in Aab-positive PTP participants. Cox proportional hazards models were used to evaluate the effects of BMI, BMI percentile (BMI%), weight status and HOMA1-IR on the progression of autoimmunity or the development of diabetes. Data from 1,310 single and 1,897 multiple Aab-positive PTP participants were included. We found no significant relationships between BMI, BMI%, weight status or HOMA1-IR and the progression from one to multiple Aabs. Similarly, among all Aab-positive participants, no significant relationships were found between BMI, weight status or HOMA1-IR and progression to diabetes. Diabetes risk was modestly increased with increasing BMI% among the entire cohort, in obese participants 13-20 years of age and with increasing HOMA1-IR in adult Aab-positive participants. Analysis of the accelerator hypothesis in the TrialNet PTP cohort does not suggest a broad influence of metabolic variables on diabetes risk. Efforts to identify other potentially modifiable environmental factors should continue.

  4. Intimate partner violence and HIV-positive women's non-adherence to antiretroviral medication for the purpose of prevention of mother-to-child transmission in Lusaka, Zambia.

    Science.gov (United States)

    Hampanda, Karen M

    2016-03-01

    Prevention of mother-to-child transmission (PMTCT) depends critically on HIV-positive women's adherence to antiretroviral drugs during and after pregnancy. Adherence among pregnant and breastfeeding women remains a challenge across sub-Saharan Africa. Power dynamics within couples, such as intimate partner violence, has largely been neglected in research regarding PMTCT adherence. This study aims to determine if there is a relationship between intimate partner violence and non-adherence to PMTCT. In 2014, using a verbally administered cross-sectional survey at a large public health clinic in Lusaka, Zambia, 320 HIV-positive postpartum women, who were currently married or living with a man, provided information on their drug adherence during and after pregnancy, as well as relationship dynamics. Adherence was defined as the woman reporting she took or gave to the infant at least 80% of prescribed medication doses. Experiencing intimate partner violence was associated with decreased odds of adherence to PMTCT during and after pregnancy. Different forms of violence affected PMTCT adherence differentially. Physical violence had a less pronounced effect on non-adherence than emotional and sexual violence. A dose-response relationship between intimate partner violence and non-adherence was also observed. Intimate partner violence is associated with non-adherence to PMTCT during and after pregnancy, which deserves increased attention in the effort to eliminate mother-to-child transmission of HIV. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Maintenance of energy expenditure on high-protein vs. high-carbohydrate diets at a constant body weight may prevent a positive energy balance.

    Science.gov (United States)

    Martens, E A; Gonnissen, H K; Gatta-Cherifi, B; Janssens, P L; Westerterp-Plantenga, M S

    2015-10-01

    Relatively high-protein diets are effective for body weight loss, and subsequent weight maintenance, yet it remains to be shown whether these diets would prevent a positive energy balance. Therefore, high-protein diet studies at a constant body weight are necessary. The objective was to determine fullness, energy expenditure, and macronutrient balances on a high-protein low-carbohydrate (HPLC) diet compared with a high-carbohydrate low-protein (HCLP) diet at a constant body weight, and to assess whether effects are transient or sustained after 12 weeks. A randomized parallel study was performed in 14 men and 18 women [mean ± SD age: 24 ± 5 y; BMI (in kg/m(2)): 22.8 ± 2.0] on diets containing 30/35/35 (HPLC) or 5/60/35 (HCLP) % of energy from protein/carbohydrate/fat. Significant interactions between dietary intervention and time on total energy expenditure (TEE) (P = 0.013), sleeping metabolic rate (SMR) (P = 0.040), and diet-induced thermogenesis (DIT) (P = 0.027) appeared from baseline to wk 12. TEE was maintained in the HPLC diet group, while it significantly decreased throughout the intervention period in the HCLP diet group (wk 1: P = 0.002; wk 12: P = 0.001). Energy balance was maintained in the HPLC diet group, and became positive in the HCLP diet group at wk 12 (P = 0.008). Protein balance varied directly according to the amount of protein in the diet, and diverged significantly between the diets (P = 0.001). Fullness ratings were significantly higher in the HPLC vs. the HCLP diet group at wk 1 (P = 0.034), but not at wk 12. Maintenance of energy expenditure on HPLC vs. HCLP diets at a constant body weight may prevent development of a positive energy balance, despite transiently higher fullness. The study was registered on clinicaltrials.gov with Identifier: NCT01551238. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  6. Sexual seroadaptation: lessons for prevention and sex research from a cohort of HIV-positive men who have sex with men.

    Directory of Open Access Journals (Sweden)

    J Jeff McConnell

    Full Text Available BACKGROUND: Surveillance data on sexually transmitted infections (STIs and behavioral characteristics identified in studies of the risk of seroconversion are often used as to track sexual behaviors that spread HIV. However, such analyses can be confounded by "seroadaptation"--the restriction of unprotected anal intercourse (UAI, especially unprotected insertive UAI, to seroconcordant partnerships. METHODS: We utilized sexual network methodology and repeated-measures statistics to test the hypothesis that seroadaptive strategies reduce the risk of HIV transmission despite numerous partnerships and frequent UAI. PRINCIPAL FINDINGS: In a prospective cohort study of HIV superinfection including 168 HIV-positive men who have sex with men (MSM, we found extensive seroadaptation. UAI was 15.5 times more likely to occur with a positive partner than a negative one (95% confidence interval [CI], 9.1-26.4. Receptive UAI was 4.3 times more likely in seroconcordant partnerships than with negative partners (95% CI, 2.8-6.6, but insertive UAI was 13.6 times more likely with positives (95% CI, 7.2-25.6. Our estimates suggest that seroadaptation reduced HIV transmissions by 98%. CONCLUSION: Potentially effective HIV prevention strategies, such as seroadaptation, have evolved in communities of MSM before they have been recognized in research or discussed in the public health forum. Thus, to be informative, studies of HIV risk must be designed to assess seroadaptive behaviors rather than be limited to individual characteristics, unprotected intercourse, and numbers of partners. STI surveillance is not an effective indicator of trends in HIV incidence where there are strong patterns of seroadaptation.

  7. Comparing ELISA test-positive prevalence, risk factors and management recommendations for Johne's disease prevention between organic and conventional dairy farms in Ontario, Canada.

    Science.gov (United States)

    Pieper, Laura; Sorge, Ulrike S; DeVries, Trevor; Godkin, Ann; Lissemore, Kerry; Kelton, David

    2015-11-01

    Johne's disease (JD) is a chronic, infectious disease in cattle. Between 2010 and 2013, a voluntary JD control program was successfully launched in Ontario, Canada, including a Risk Assessment and Management Plan (RAMP) and JD ELISA testing of the entire milking herd. Over the last decade, the organic dairy sector has been growing. However, organic farming regulations and philosophies may influence the risk for JD transmission on Ontario organic dairy farms. The aim of this cross-sectional study was to investigate differences in JD ELISA test positive prevalence, risk factors for JD and recommendations for JD prevention between organic and conventional dairy herds in Ontario. RAMP results (i.e. RAMP scores and recommendations) and ELISA results were available for 2103 dairy herds, including 42 organic herds. If available, additional data on milk production, milk quality, and herd characteristics were gathered. Organic and conventional herds had a similar herd-level JD ELISA test-positive prevalence (26.2% and 27.2%, respectively). Organic herds (4.2%) had a higher within-herd JD ELISA test-positive prevalence compared to conventional herds (2.3%) if they had at least one JD test-positive animal on the farm. Organic farms had lower risk scores for biosecurity (9 points lower), and higher scores in the calving (7 points higher) and the calf-rearing management areas (4 points higher). After accounting for RAMP score, organic farms received fewer recommendations for the calving management area (Odds Ratio=0.41) and more recommendations in the adult cow management area (Odds Ratio=2.70). A zero-inflated negative binomial model was built with purchase of animals and the herd size included in the logistic portion of the model. Herd type (organic or conventional), colostrum and milk feeding practices, average bulk tank somatic cell count, and presence of non-Holstein breeds were included in the negative binomial portion of the model. Organic farms had a higher number of

  8. Translation of Financial Statements

    OpenAIRE

    Dalthan Simas; Otavio De Medeiros

    2005-01-01

    This paper has the purpose of surveying and critically analyzing the effects of accounting procedures which are closely related to groups of companies operating multinationally. These are the methods for translation of financial statements, e.g. the Temporal and the Closing- rate Methods, as far as those methods are embodied in accounting standards which have been either recommended or adopted by countries such as the UK and US. We conclude that with regard to changing prices, General Price L...

  9. Python Switch Statement

    Directory of Open Access Journals (Sweden)

    2008-06-01

    Full Text Available The Python programming language does not have a built in switch/case control structure as found in many other high level programming languages. It is thought by some that this is a deficiency in the language, and the control structure should be added. This paper demonstrates that not only is the control structure not needed, but that the methods available in Python are more expressive than built in case statements in other high level languages.

  10. Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes.

    Science.gov (United States)

    Sinclair, Alan; Morley, John E; Rodriguez-Mañas, Leo; Paolisso, Giuseppe; Bayer, Tony; Zeyfang, Andrej; Bourdel-Marchasson, Isabelle; Vischer, Ulrich; Woo, Jean; Chapman, Ian; Dunning, Trisha; Meneilly, Graydon; Rodriguez-Saldana, Joel; Gutierrez Robledo, Luis Miguel; Cukierman-Yaffe, Tali; Gadsby, Roger; Schernthaner, Guntram; Lorig, Kate

    2012-07-01

    Diabetes mellitus is a highly prevalent metabolic condition in ageing societies associated with high levels of morbidity, multiple therapies, and functional deterioration that challenges even the best of health care systems to deliver high-quality, individualized care. Most international clinical guidelines have ignored the often-unique issues of frailty, functional limitation, changes in mental health, and increasing dependency that characterize many aged patients with diabetes. A collaborative Expert Group of the IAGG and EDWPOP and an International Task Force have explored the key issues that affect diabetes in older people using a robust method comprising a Delphi process and an evidence-based review of the literature. Eight domains of interest were initially agreed and discussed: hypoglycemia, therapy, care home diabetes, influence of comorbidities, glucose targets, family/carer perspectives, diabetes education, and patient safety. A set of "consensus" statements was produced in each domain of interest. These form a foundation for future policy development in this area and should influence the clinical behavior and approach of all health professionals engaged in delivering diabetes care to older people. Copyright © 2012 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

  11. Organization of the Statutory Audit of Financial Statements in Romania

    Directory of Open Access Journals (Sweden)

    Gabriela Ungureanu

    2010-12-01

    Full Text Available Economic entities around the world, regardless of their membership - public or private sector - the size, the object of activity, prepare financial statements for presentation of financial information users (investors, creditors, customers, suppliers, public institutions. The financial statements provide information about financial position, performance and changes in financial position of an entity - information underlying to base decision process. For Romania, the financial audit was not a tradition. Recognized as a top area of the accounting profession, financial audit was legislated in 1999. Statutory audit, audit of annual financial statements or consolidated annual statements have been established 9 years later (Emergency Regulation no. 90 June 24, 2008, by transposing Directive 2006/43/EC of 17 May 2006 of the European Parliament and of Council on statutory audit of annual accounts and consolidated accounts, in order to ensure oversight of auditors, in the public interest.

  12. Konsensusstatement "Praktische Fertigkeiten im Medizinstudium" – ein Positionspapier des GMA-Ausschusses für praktische Fertigkeiten [A Consensus Statement on Practical Skills in Medical School – a position paper by the GMA Committee on Practical Skills

    Directory of Open Access Journals (Sweden)

    Schnabel, Kai P.

    2011-11-01

    Full Text Available [english] Introduction: Encouraged by the change in licensing regulations the practical professional skills in Germany received a higher priority and are taught in medical schools therefore increasingly. This created the need to standardize the process more and more. On the initiative of the German skills labs the German Medical Association Committee for practical skills was established and developed a competency-based catalogue of learning objectives, whose origin and structure is described here.Goal of the catalogue is to define the practical skills in undergraduate medical education and to give the medical schools a rational planning basis for the necessary resources to teach them.Methods: Building on already existing German catalogues of learning objectives a multi-iterative process of condensation was performed, which corresponds to the development of S1 guidelines, in order to get a broad professional and political support.Results: 289 different practical learning goals were identified and assigned to twelve different organ systems with three overlapping areas to other fields of expertise and one area of across organ system skills. They were three depths and three different chronological dimensions assigned and the objectives were matched with the Swiss and the Austrian equivalent.Discussion: This consensus statement may provide the German faculties with a basis for planning the teaching of practical skills and is an important step towards a national standard of medical learning objectives.Looking ahead: The consensus statement may have a formative effect on the medical schools to teach practical skills and plan the resources accordingly.[german] Einleitung: Angestoßen durch die Änderung der Approbationsordnung haben die berufspraktischen Kompetenzen in Deutschland eine höhere Priorität erhalten und werden in den medizinischen Fakultäten deswegen vermehrt vermittelt. Dadurch entstand die Notwendigkeit, den Prozess mehr und mehr zu

  13. Ratio analysis specifics of the family dairies' financial statements

    OpenAIRE

    Mitrović Aleksandra; Knežević Snežana; Veličković Milica

    2015-01-01

    The subject of this paper is the evaluation of the financial analysis specifics of the dairy enterprises with a focus on the implementation of the ratio analysis of financial statements. The ratio analysis is a central part of financial analysis, since it is based on investigating the relationship between logically related items in the financial statements to assess the financial position of the observed enterprise and its earning capacity. Speaking about the reporting of financial performanc...

  14. A joint procedural position statement on imaging in cardiac sarcoidosis : from the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine, the European Association of Cardiovascular Imaging, and the American Society of Nuclear Cardiology

    NARCIS (Netherlands)

    Slart, Riemer H J A; Glaudemans, Andor W J M; Lancellotti, Patrizio; Hyafil, Fabien; Blankstein, Ron; Schwartz, Ronald G; Jaber, Wael A; Russell, Raymond; Gimelli, Alessia; Rouzet, François; Hacker, Marcus; Gheysens, Olivier; Plein, Sven; Miller, Edward J; Dorbala, Sharmila; Donal, Erwan

    2017-01-01

    This joint position paper illustrates the role and the correct use of echocardiography, radionuclide imaging with F-18-fluorodeoxyglucose positron emission tomography, radionuclide myocardial perfusion imaging and cardiovascular magnetic resonance imaging for the evaluation and management of

  15. A joint procedural position statement on imaging in cardiac sarcoidosis: from the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine, the European Association of Cardiovascular Imaging, and the American Society of Nuclear Cardiology

    NARCIS (Netherlands)

    Slart, Riemer H. J. A.; Glaudemans, Andor W. J. M.; Lancellotti, Patrizio; Hyafil, Fabien; Blankstein, Ron; Schwartz, Ronald G.; Jaber, Wael A.; Russell, Raymond; Gimelli, Alessia; Rouzet, Francois; Hacker, Marcus; Gheysens, Olivier; Plein, Sven; Miller, Edward J.; Dorbala, Sharmila; Donal, Erwan; Sciagra, Roberto; Bucerius, Jan; Verberne, Hein J.; Lindner, Oliver; Uebleis, Christopher; Agostini, Denis; Signore, Alberto; Edvardsen, Thor; Neglia, Danilo; Beanlands, Rob S.; Di Carli, Marcelo; Chareonthaitawee, Panithaya; Dilsizian, Vasken; Soman, Prem; Habib, Gilbert

    2017-01-01

    This joint position paper illustrates the role and the correct use of echocardiography, radionuclide imaging with F-18-fluorodeoxyglucose positron emission tomography, radionuclide myocardial perfusion imaging and cardiovascular magnetic resonance imaging for the evaluation and management of

  16. Childhood Obesity Is a Chronic Disease Demanding Specific Health Care - a Position Statement from the Childhood Obesity Task Force (COTF of the European Association for the Study of Obesity (EASO

    Directory of Open Access Journals (Sweden)

    Nathalie J. Farpour-Lambert

    2015-10-01

    Full Text Available Childhood obesity is one of the greatest health challenges of the 21st century. The EASO COTF is convinced that classifying obesity as a chronic disease in children and adolescents is a crucial step for increasing individual and societal awareness, and for improving early diagnosis and intervention. Such a classification will enhance the development of novel preventive and treatment approaches, health care policies and systems, and the education of healthcare workers. The management of obesity prior to the appearance of co-morbidities may prevent their escalation into significant medical and psychosocial problems, and reduce their economic and societal impact. Childhood is a unique window of opportunity to influence lifetime effects on health, quality of life, prevention of non-communicable chronic diseases and disabilities. The Convention on the Rights of the Child by UNICEF states that parties shall strive to ensure that no child is deprived of his or her right of access to health care services. The EASO COTF is aiming to address these issues via educational activities for health care workers, identification of research agendas, and the promotion of collaborations among clinicians, researchers, health institutions, organizations and states across Europe.

  17. Childhood Obesity Is a Chronic Disease Demanding Specific Health Care--a Position Statement from the Childhood Obesity Task Force (COTF) of the European Association for the Study of Obesity (EASO).

    Science.gov (United States)

    Farpour-Lambert, Nathalie J; Baker, Jennifer L; Hassapidou, Maria; Holm, Jens Christian; Nowicka, Paulina; O'Malley, Grace; Weiss, Ram

    2015-01-01

    Childhood obesity is one of the greatest health challenges of the 21st century. The EASO COTF is convinced that classifying obesity as a chronic disease in children and adolescents is a crucial step for increasing individual and societal awareness, and for improving early diagnosis and intervention. Such a classification will enhance the development of novel preventive and treatment approaches, health care policies and systems, and the education of healthcare workers. The management of obesity prior to the appearance of co-morbidities may prevent their escalation into significant medical and psychosocial problems, and reduce their economic and societal impact. Childhood is a unique window of opportunity to influence lifetime effects on health, quality of life, prevention of non-communicable chronic diseases and disabilities. The Convention on the Rights of the Child by UNICEF states that parties shall strive to ensure that no child is deprived of his or her right of access to health care services. The EASO COTF is aiming to address these issues via educational activities for health care workers, identification of research agendas, and the promotion of collaborations among clinicians, researchers, health institutions, organizations and states across Europe. © 2015 S. Karger GmbH, Freiburg.

  18. Childhood Obesity Is a Chronic Disease Demanding Specific Health Care - a Position Statement from the Childhood Obesity Task Force (COTF) of the European Association for the Study of Obesity (EASO)

    Science.gov (United States)

    Farpour-Lambert, Nathalie J.; Baker, Jennifer L.; Hassapidou, Maria; Holm, Jens Christian; Nowicka, Paulina; O'Malley, Grace; Weiss, Ram

    2015-01-01

    Childhood obesity is one of the greatest health challenges of the 21st century. The EASO COTF is convinced that classifying obesity as a chronic disease in children and adolescents is a crucial step for increasing individual and societal awareness, and for improving early diagnosis and intervention. Such a classification will enhance the development of novel preventive and treatment approaches, health care policies and systems, and the education of healthcare workers. The management of obesity prior to the appearance of co-morbidities may prevent their escalation into significant medical and psychosocial problems, and reduce their economic and societal impact. Childhood is a unique window of opportunity to influence lifetime effects on health, quality of life, prevention of non-communicable chronic diseases and disabilities. The Convention on the Rights of the Child by UNICEF states that parties shall strive to ensure that no child is deprived of his or her right of access to health care services. The EASO COTF is aiming to address these issues via educational activities for health care workers, identification of research agendas, and the promotion of collaborations among clinicians, researchers, health institutions, organizations and states across Europe. PMID:26469067

  19. Prevention of Internalising Disorders in 9-10 year old children: Efficacy of the Aussie Optimism Positive Thinking Skills Program at 30-month follow-up

    Directory of Open Access Journals (Sweden)

    David eMorrison

    2013-12-01

    Full Text Available The Aussie Optimism: Positive Thinking Skills Program (AOPTP is a school-based prevention program aimed at addressing anxious and depressive symptoms in children aged 9-10 years. Nine-hundred and ten students from 22 Australian primary schools situated in low socio-economic areas were randomly assigned to either an intervention or control group, and assessed at a 30-month follow up. Those in the intervention group received the AOPTP program, where the control group continued to receive the regular health education course. Students completed self-report measures regarding their levels of depression, anxiety, and attribution style. Parents also reported on their children’s externalising and internalising problems outside of school. There were no significant differences between groups in regard to anxiety or depression, as well as no significant differences in attributional styles. Parents reported significantly less hyperactive behaviours from children in the intervention group. This finding suggests that AOP-PTS has the capacity to treat externalising problems at a medium term effect. The decrease in the externalising problems provides evidence of a partial medium term intervention effect. Future studies should continue to evaluate the program at a long term follow up.

  20. Topical grape seed proanthocyandin extract reduces sunburn cells and mutant p53 positive epidermal cell formation, and prevents depletion of Langerhans cells in an acute sunburn model.

    Science.gov (United States)

    Yuan, Xiao-Ying; Liu, Wei; Hao, Jian-Chun; Gu, Wei-Jie; Zhao, Yan-Shuang

    2012-01-01

    The purpose of this study was to investigate whether grape seed proanthocyanidin extract (GSPE) can provide photoprotection against ultraviolet (UV) irradiation. Study has shown that GSPE is a natural oxidant, and is used in many fields such as ischemia-reperfusion injury, chronic pancreatitis, and even cancer. However, the effect of GSPE on UV irradiation is as yet unknown. Cutaneous areas on the backs of normal volunteers were untreated or treated with GSPE solutions or vehicles 30 min before exposure to two minimal erythema doses (MED) of solar simulated radiation. Cutaneous areas at different sites were examined histologically for the number of sunburn cells, or immunohistochemically for Langerhans cells and mutant p53 epidermal cells. On histological and immunohistochemical examination, skin treated with GSPE before UV radiation showed fewer sunburn cells and mutant p53-positive epidermal cells and more Langerhans cells compared with skin treated with 2-MED UV radiation only (p<0.001, p<0.001, and p<0.01, respectively). GSPE may be a possible preventive agent for photoprotection.

  1. Prevention of Depression and Anxiety Symptoms in Adolescents: 42 and 54 Months Follow-Up of the Aussie Optimism Program-Positive Thinking Skills.

    Directory of Open Access Journals (Sweden)

    Julie eJohnstone

    2014-05-01

    Full Text Available Anxiety and depression are the most commonly reported mental health problems amongst Australian children and adolescents. The Aussie Optimism Program: Positive Thinking Skills (AOP- PTS is a universal intervention program based on cognitive and behavioral strategies and aimed to prevent anxiety and depression in the middle primary school children aged 9-10 years old. 370 students randomly assigned to the intervention and control condition participated in the 42 and 54 months follow – up study. The intervention group received the AOP-PTS 10-week program and the control group received the regular Health Education curriculum. Students were assessed on anxiety, depression and attribution style at school whilst parents reported on their child’s externalizing and internalising problems at home. Results showed there were no significant reduction across groups in the depressive and anxiety symptoms, and attribution style at either 42 or 54 months follow-up. These findings suggest that AOP-PTS has short and medium term effects but were not sustained in longer term period. Future strategies to achieve the desirable outcomes in a longitudinal study are discussed.

  2. 7 CFR 1212.51 - Financial statements.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Financial statements. 1212.51 Section 1212.51... statements. (a) The Board shall prepare and submit financial statements to the Department on a periodic basis. Each such financial statement shall include, but not be limited to, a balance sheet, income statement...

  3. 7 CFR 3052.310 - Financial statements.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Financial statements. 3052.310 Section 3052.310....310 Financial statements. (a) Financial statements. The auditee shall prepare financial statements... appropriate, cash flows for the fiscal year audited. The financial statements shall be for the same...

  4. Back to the basics: identifying positive youth development as the theoretical framework for a youth drug prevention program in rural Saskatchewan, Canada amidst a program evaluation.

    Science.gov (United States)

    Dell, Colleen Anne; Duncan, Charles Randy; DesRoches, Andrea; Bendig, Melissa; Steeves, Megan; Turner, Holly; Quaife, Terra; McCann, Chuck; Enns, Brett

    2013-10-22

    Despite endorsement by the Saskatchewan government to apply empirically-based approaches to youth drug prevention services in the province, programs are sometimes delivered prior to the establishment of evidence-informed goals and objectives. This paper shares the 'preptory' outcomes of our team's program evaluation of the Prince Albert Parkland Health Region Mental Health and Addiction Services' Outreach Worker Service (OWS) in eight rural, community schools three years following its implementation. Before our independent evaluation team could assess whether expectations of the OWS were being met, we had to assist with establishing its overarching program goals and objectives and 'at-risk' student population, alongside its alliance with an empirically-informed theoretical framework. A mixed-methods approach was applied, beginning with in-depth focus groups with the OWS staff to identify the program's goals and objectives and targeted student population. These were supplemented with OWS and school administrator interviews and focus groups with school staff. Alignment with a theoretical focus was determined though a review of the OWS's work to date and explored in focus groups between our evaluation team and the OWS staff and validated with the school staff and OWS and school administration. With improved understanding of the OWS's goals and objectives, our evaluation team and the OWS staff aligned the program with the Positive Youth Development theoretical evidence-base, emphasizing the program's universality, systems focus, strength base, and promotion of assets. Together we also gained clarity about the OWS's definition of and engagement with its 'at-risk' student population. It is important to draw on expert knowledge to develop youth drug prevention programming, but attention must also be paid to aligning professional health care services with a theoretically informed evidence-base for evaluation purposes. If time does not permit for the establishment of

  5. Southwestern Power Administration Combined Financial Statements, 2006-2009

    Energy Technology Data Exchange (ETDEWEB)

    None

    2009-09-01

    We have audited the accompanying combined balance sheets of the Southwestern Federal Power System (SWFPS), as of September 30, 2009, 2008, 2007, and 2006, and the related combined statements of revenues and expenses, changes in capitalization, and cash flows for the years then ended. As described in note 1(a), the combined financial statement presentation includes the hydroelectric generation functions of another Federal agency (hereinafter referred to as the generating agency), for which Southwestern Power Administration (Southwestern) markets and transmits power. These combined financial statements are the responsibility of the management of Southwestern and the generating agency. Our responsibility is to express an opinion on these combined financial statements based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the combined financial statements are free of material misstatement. An audit includes consideration of internal control over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of Southwestern and the generating agency’s internal control over financial reporting. Accordingly, we express no such opinion. An audit also includes examining, on a test basis, evidence supporting the amounts and disclosures in the combined financial statements, assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall combined financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the combined financial statements referred to above present fairly, in all material respects, the respective financial position of the Southwestern Federal Power

  6. Reducing and preventing internalizing and externalizing behavior problems in children with type 1 diabetes: a randomized controlled trial of the Triple P-Positive Parenting Program.

    Science.gov (United States)

    Westrupp, E M; Northam, E; Lee, K J; Scratch, S E; Cameron, F

    2015-11-01

    Children with type 1 diabetes are at increased risk of mental health problems, which in turn are associated with poor glycemic control, diabetes-related complications, and long-term psychiatric morbidity. We tested the efficacy of the Triple P-Positive Parenting Program in reducing or preventing mental health problems and improving glycemic control in children with type 1 diabetes in a randomized controlled trial. Participants were recruited from the Diabetes Clinic, Royal Children's Hospital, Melbourne, Australia, and randomized to Triple P or standard diabetes care. The primary outcome was child internalizing and externalizing behavior problems 3 and 12 months postrandomization. Secondary outcomes were glycemic control, parent mental health, parenting skills, and family functioning at 3 and 12 months, and glycemic control at 24 months. A total of 76 participants were randomized (38 to intervention and 38 to control), 60 completed 3-month, and 57 completed 12-month assessments. Benefits of Triple P were evident at 3 months for parent mental health, parenting skills, and family functioning (p externalizing behavior problems indicated greater improvements in child mental health, parent mental health, parenting skills, and diabetes family conflict (p parenting self-efficacy at 3 months. Improvements in parent mental health and parenting competency associated with Triple P were sustained to 12 months for children with pre-existing mental health problems. This study provides some support for the efficacy of Triple P in improving parent and family outcomes, and reducing child internalizing and externalizing behavior problems primarily in children who have pre-existing mental health problems. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Reading and understanding financial statements.

    Science.gov (United States)

    White, Joseph P

    2005-01-01

    Feeling comfortable reading and understanding financial statements is critical to the success of healthcare executives and physicians involved in management. Businesses use three primary financial statements: a balance sheet represents the equation, Assets = Liabilities + Equity; an income statement represents the equation, Revenues - Expenses = Net Income; a statement of cash flows reports all sources and uses of cash during the represented period. The balance sheet expresses financial indicators at one particular moment in time, whereas the income statement and the statement of cash flows show activity that occurred over a stretch of time. Additional information is disclosed in attached footnotes and other supplementary materials. There are two ways to prepare financial statements. Cash-basis accounting recognizes revenue when it is received and expenses when they are paid. Accrual-basis accounting recognizes revenue when it is earned and expenses when they are incurred. Although cash-basis is acceptable, periodically using the accrual method reveals important information about receivables and liabilities that could otherwise remain hidden. Become more engaged with your financial statements by spending time reading them, tracking key performance indicators, and asking accountants and financial advisors questions. This will help you better understand your business and build a successful future.

  8. CORPORATE SOCIAL REPORTING AS APPENDIX TO FINANCIAL STATEMENT

    Directory of Open Access Journals (Sweden)

    I. Derun

    2015-10-01

    Full Text Available The paper deals with essence and importance of corporate social reporting in the management of business entity management. The study examines several approaches for providing data about economic, ecological and social aspects of the companies. There are approaches of formulating of separated reports as addition to financial statements (for example Value Added Statement, Intellectual Capital Statement and integrated reporting. The article examines positive and negative factors that could significantly influence the implementation process of corporate social reporting for companies in Ukraine and around the world. Principles of corporate social reporting are considered. The research analyzes methodical approaches of preparing of integrating statements for large companies and data needs of stakeholders for making effective management decisions.

  9. Deficiencies in FY 1998 DOD Financial Statements and Progress Toward Improved Financial Reporting

    National Research Council Canada - National Science Library

    Lane, F

    1999-01-01

    The audit objectives were to identify and summarize the major deficiencies that prevented favorable audit opinions on the FY 1998 DoD financial statements and to identify the actions taken or planned...

  10. Statement on virginity testing.

    Science.gov (United States)

    2015-07-01

    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.

  11. The current status of diabetes professional educational standards and competencies in the UK--a position statement from the Diabetes UK Healthcare Professional Education Competency Framework Task and Finish Group.

    Science.gov (United States)

    Walsh, N; George, S; Priest, L; Deakin, T; Vanterpool, G; Karet, B; Simmons, D

    2011-12-01

    Diabetes is a significant health concern, both in the UK and globally. Management can be complex, often requiring high levels of knowledge and skills in order to provide high-quality and safe care. The provision of good, safe, quality care lies within the foundations of healthcare education, continuing professional development and evidence-based practice, which are inseparable and part of a continuum during the career of any health professional. Sound education provides the launch pad for effective clinical management and positive patient experiences. This position paper reviews and discusses work undertaken by a Working Group under the auspices of Diabetes UK with the remit of considering all health professional educational issues for people delivering care to people with diabetes. This work has scoped the availability of education for those within the healthcare system who may directly or indirectly encounter people with diabetes and reviews alignment to existing competency frameworks within the UK's National Health Service. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  12. NIH consensus development statement on management of hepatitis B.

    Science.gov (United States)

    Belongia, E A; Costa, J; Gareen, I F; Grem, J L; Inadomi, J M; Kern, E R; McHugh, J A; Petersen, G M; Rein, M F; Sorrell, M F; Strader, D B; Trotter, H T

    To provide health care providers, patients, and the general public with a responsible assessment of currently available data on the management of hepatitis B. A non-DHHS, nonadvocate 12-member panel representing the fields of hepatology and liver transplantation, gastroenterology, public health and epidemiology, infectious diseases, pathology, oncology, family practice, internal medicine, and a public representative. In addition, 22 experts from pertinent fields presented data to the panel and conference audience. Presentations by experts and a systematic review of the literature prepared by the Minnesota Evidence-based Practice Center, through the Agency for Healthcare Research and Quality. Scientific evidence was given precedence over anecdotal experience. The panel drafted its statement based on scientific evidence presented in open forum and on published scientific literature. The draft statement was presented on the final day of the conference and circulated to the audience for comment. The panel released a revised statement later that day at http://consensus.nih.gov. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government. The most important predictors of cirrhosis or hepatocellular carcinoma in persons who have chronic HBV are persistently elevated HBV DNA and ALT levels in blood. Other risk factors include HBV genotype C infection, male sex, older age, family history of hepatocellular carcinoma, and co-infection with HCV or HIV. The major goals of anti-HBV therapy are to prevent the development of progressive disease, specifically cirrhosis and liver failure, as well as hepatocellular carcinoma development and subsequent death. To date, no RCTs of anti-HBV therapies have demonstrated a beneficial impact on overall mortality, liver-specific mortality, or development of hepatocellular carcinoma. Most published reports of hepatitis therapy use changes in short-term virologic, biochemical, and

  13. REGARDING THE USERS OF FINANCIAL STATEMENTS AND THEIR INFORMATION NEEDS

    Directory of Open Access Journals (Sweden)

    Mihaela Luca

    2008-12-01

    Full Text Available In order to satisfy the information needs of users from inside and outside the organizations, accounting elaborated a proper method of generalization and synthesizing of information it produces, which involved the development of some appropriate tools, known as financial statements. For users outside the company, these are often the only source of information available directly from the organization. The knowledge of the interests of different categories of users has an important role in trying to improve the quality of financial statements, which should allow taking correct decisions based on the financial position, the results of economic and financial activity and the changes in the financial position of the company.

  14. Bubble vs conventional continuous positive airway pressure for prevention of extubation failure in preterm very low birth weight infants: a pilot study.

    Science.gov (United States)

    Yadav, Sucheta; Thukral, Anu; Sankar, M Jeeva; Sreenivas, V; Deorari, Ashok K; Paul, Vinod K; Agarwal, Ramesh

    2012-09-01

    To compare the efficacy of bubble and conventional nasal continuous positive airway pressure (CPAP) in preventing extubation failure (EF) in preterm infants. Infants of gestation ≤32 wk and birth weight <1500 g, ready for initial extubation within first wk of life were randomly allocated to either bubble (n = 16) or conventional (n = 16) CPAP. A standardized protocol was used for extubation. Bubble CPAP was delivered by Fischer and Paykel equipment using short binasal prongs and conventional CPAP was delivered by a ventilator using Argyle short binasal prongs. CPAP was initiated at a pressure of 4-6 cm of H(2)O and FiO(2) of 0.4-0.5 and adjusted to maintain normal saturation (90-93%) and comfortable breathing. Primary outcome was EF, defined as need for mechanical ventilation within 72 h of extubation. Baseline characteristics including birth weight (g; 1027 ± 243 vs. 1018 ± 227; p = 0.83), gestation (wk; 28.7 ± 1.8 vs. 28.4 ± 1.6; p = 0.30), infants <28 wk gestation (6 vs. 7, p = 0.72) were comparable between the two groups. Respiratory distress syndrome was the indication for ventilation in 13 (81%) and 14 (87%) infants on bubble CPAP and conventional CPAP groups respectively. (p = 0.99). There was no difference in the EF rates between the bubble (n = 4) and conventional CPAP (n = 9) groups. (RR 0.49; 95% CI 0.20-1.2; p = 0.14). Median time to extubation failure was also comparable between the two groups (h; median [range]: 29 [14-49] vs. 17 [7-28]; p = 0.35). The possibility that bubble CPAP may be associated with reduced EF as suggested in this pilot study requires further investigation in an adequately powered multicentric study.

  15. The 2017 Academic College of Emergency Experts and Academy of Family Physicians of India position statement on preventing violence against health-care workers and vandalization of health-care facilities in India.

    Science.gov (United States)

    Chauhan, Vivek; Galwankar, Sagar; Kumar, Raman; Raina, Sunil Kumar; Aggarwal, Praveen; Agrawal, Naman; Krishnan, S Vimal; Bhoi, Sanjeev; Kalra, O P; Soans, Santosh T; Aggarwal, Vandana; Kubendra, Mohan; Bijayraj, R; Datta, Sumana; Srivastava, R P

    2017-01-01

    There have been multiple incidents where doctors have been assaulted by patient relatives and hospital facilities have been vandalized. This has led to mass agitations by Physicians across India. Violence and vandalism against health-care workers (HCWs) is one of the biggest public health and patient care challenge in India. The sheer intensity of emotional hijack and the stress levels in both practicing HCWs and patient relative's needs immediate and detail attention. The suffering of HCWs who are hurt, the damage to hospital facilities and the reactionary agitation which affects patients who need care are all together doing everything to damage the delivery of health care and relationship between a doctor and a patient. This is detrimental to India where illnesses and Injuries continue to be the biggest challenge to its growth curve. The expert group set by The Academic College of Emergency Experts and The Academy of Family Physicians of India makes an effort to study this Public Health and Patient Care Challenge and provide recommendations to solve it.

  16. Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort?

    OpenAIRE

    Hahlweg, Kurt; Heinrichs, Nina; Kuschel, Annett; Bertram, Heike; Naumann, Sebastian

    2010-01-01

    Abstract Background Approximately 20% of children experience internalizing or externalizing DSM-IV-TR disorders. This prevalence rate cannot be reduced through treatment only. Effective preventive interventions are therefore urgently needed. The aim of the current investigation is to evaluate the two-year efficacy of the group Triple P parenting program administered universally for the prevention of child behavior problems. Methods Based on their respective preschool, N = 280 families were ra...

  17. Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology.

    Science.gov (United States)

    Gorter, Thomas M; van Veldhuisen, Dirk J; Bauersachs, Johann; Borlaug, Barry A; Celutkiene, Jelena; Coats, Andrew J S; Crespo-Leiro, Marisa G; Guazzi, Marco; Harjola, Veli-Pekka; Heymans, Stephane; Hill, Loreena; Lainscak, Mitja; Lam, Carolyn S P; Lund, Lars H; Lyon, Alexander R; Mebazaa, Alexandre; Mueller, Christian; Paulus, Walter J; Pieske, Burkert; Piepoli, Massimo F; Ruschitzka, Frank; Rutten, Frans H; Seferovic, Petar M; Solomon, Scott D; Shah, Sanjiv J; Triposkiadis, Filippos; Wachter, Rolf; Tschöpe, Carsten; de Boer, Rudolf A

    2018-01-01

    There is an unmet need for effective treatment strategies to reduce morbidity and mortality in patients with heart failure with preserved ejection fraction (HFpEF). Until recently, attention in patients with HFpEF was almost exclusively focused on the left side. However, it is now increasingly recognized that right heart dysfunction is common and contributes importantly to poor prognosis in HFpEF. More insights into the development of right heart dysfunction in HFpEF may aid to our knowledge about this complex disease and may eventually lead to better treatments to improve outcomes in these patients. In this position paper from the Heart Failure Association of the European Society of Cardiology, the Committee on Heart Failure with Preserved Ejection Fraction reviews the prevalence, diagnosis, and pathophysiology of right heart dysfunction and failure in patients with HFpEF. Finally, potential treatment strategies, important knowledge gaps and future directions regarding the right side in HFpEF are discussed. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  18. Influence of Customer Focused Mission Statement on Customer Satisfaction

    Directory of Open Access Journals (Sweden)

    Chijioke Nwachukwu

    2017-01-01

    Full Text Available The purpose of this study is to examine the influence of customer‑focused mission statements on customer satisfaction in selected cell phone manufacturing companies in the United States. The study employed content analysis for the mission statement and data from America customer satisfaction index (ACSI. In analysing our data, Pearson correlation, and multiple regression techniques were used. The result showed that product and service, technology, philosophy, self‑concept, and public image mission statement components are strongly positively correlated with customer satisfaction. Customer, survival, growth and profitability and market mission statement components are insignificantly negatively correlated with customer satisfaction. The study, therefore, recommends that companies that want to remain competitive by enhancing customer satisfaction should formulate mission statements from a customer perspective so that they include product and service, technology, philosophy, self‑concept, and public image components. The main limitation of the study represents the sample size and structure. This study empirically investigated the correlation and association of nine mission statement components with customer satisfaction.

  19. A process for updating a philosophy of education statement.

    Science.gov (United States)

    Gambescia, Stephen F

    2013-01-01

    Most health education specialists have been introduced to the idea of having a philosophy of education statement. Although some in the field have been writing about this career development exercise, little has been written about the process of developing one's philosophy of education statement. This brief essay explains a sample process health education specialists can use to create or update their philosophy of education statement. The author gives a firsthand account of a systematic, disciplined, intellectually liberating, and reflective approach to articulating one's philosophy of education statement, by considering the writings of select intellectual giants who have acted on human experience, thought, and practice in education. A philosophy of education statement should be useful to any health education specialist regardless of type of work, site, position in the organization, population served, or health topic. The resultant updated and precisely written statement serves to sharpen a health education specialist's future role as a health educator, as well as contribute to his or her journey in lifelong learning.

  20. [The ALANAM statement on public health policy].

    Science.gov (United States)

    Goic, Alejando; Armas, Rodolfo

    2010-12-01

    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