WorldWideScience

Sample records for pre-travel advice sources

  1. Pre-travel advice: an overview.

    Science.gov (United States)

    Sanford, Christopher

    2002-12-01

    The message of the pre-travel provider is necessarily paradoxic. First the provider lists a score of causes of illness and premature demise, and then states, "But it sounds like a great trip and I think you'll have fun." Pre-travel providers need to walk a fine line: they must encourage patients to be cautious but not paranoid, optimistic but realistic. This discussion is complicated further by the fact that risk reduction is not the only consideration; if it were, practitioners would advise patients to remain in the developed world and foray from their homes only to visit health clubs and the fruit-and-vegetable section of grocery stores. A tacit assumption in travel medicine is that some degree of acceptance of heightened risk is tolerated for the benefit of improved quality of life offered by travel abroad. The amount of risk that is reasonable to accept for a given benefit in quality of life yielded by travel cannot be quantified, however. Providers must render judgments on what is "reasonable" and what is not, and this complex decision is based on equal parts medical knowledge and intuition. At one extreme, mountaineers in Nepal have been found to have a 2.4% mortality rate per expedition [83,84]. The travel provider might make the reasonable decision to counsel these travelers to avoid that activity. These travelers most likely will ignore that advice, at which point the provider must endeavor to reduce risk to the extent possible. Other situations in which the provider should advise a change in itinerary or activities include counseling parents who plan to take an infant to high altitude or a pregnant woman who plans to scuba dive. If travelers remain cloistered in their hotel rooms, eating all meals from room service and watching CNN, then it could be suggested that they are overly risk-adverse and might consider foraying out of the hotel, despite the potential associated increased risks to health. Conversely, if travelers find themselves on motorcycles

  2. [Pre-travel advice and patient education of Hungarian travellers].

    Science.gov (United States)

    Lengyel, Ingrid; Felkai, Péter

    2018-03-01

    According to international surveys, over half of the travellers face some kind of health issue when travelling. The overwhelming majority of travel-related illnesses can be prevented with pre-travel medical consultations, but the syllabus and content of the consultation have to match the travel habits and culture of the given society. This publication explores the specificities and travel habits of Hungarian travellers. One hundred participants of a travel exhibition completed a survey about their international travel. As the survey was not representative, the data could only be processed through simple statistical methods. However, since the exhibition was presumably attended by those wishing to travel, the conclusions drawn from the results are worth publishing, since no similar survey in Hungary has been published before. Based on the suitable classification of age groups in travel medicine, 11% of the participants were adolescents / young adults (aged 15-24), 81% adults (25-59) and 8% elderly (60-74). Twenty-eight percent of the participants travel multiple times a year, 40% yearly and 32% of them less frequently; 16% of the adults, 8% of the adolescents and 4% of the elderly age group travel multiple times a year. The travel destinations of Hungarian travellers have remained practically unchanged since a study was conducted 13 years ago: the vast majority (95%) travelled within Europe, 2% to the United States, and 11% of them elsewhere. Since Hungarians do not travel to endemic areas, only 5% consulted their general practitioners (GPs) prior to travelling, and 29% did when they had to be vaccinated. Forty-two percent of those wishing to travel never consult their GPs, even though 29% of them are aware of some chronic illness. Instead, 51% gather their health information from the internet and only 6% from their doctors. By the contradiction between the poor health status of the majority of Hungarian travellers and the negligence of seeking pre-travel advice

  3. Pre-travel advice seeking from GPs by travellers with chronic illness seen at a travel clinic.

    Science.gov (United States)

    Gagneux-Brunon, Amandine; Andrillat, Carole; Fouilloux, Pascale; Daoud, Fatiha; Defontaine, Christiane; Charles, Rodolphe; Lucht, Frédéric; Botelho-Nevers, Elisabeth

    2016-03-01

    Travellers are ageing and frequently report chronic illness. Pre-travel health advice is crucial, particularly in this subgroup, and general practitioners (GPs) are first in line for treatment adjustment before departure. Our aim is to evaluate pre-travel health advice seeking from GPs by travellers with chronic illness seen at a travel clinic. A cross-sectional observational survey using a questionnaire was conducted between August 2013 and July 2014 in travellers attending the travel medicine clinic of a tertiary university hospital in France. During the study, 2019 travellers were included. Mean age was 39.4 years (±18.8). Three hundred and ninety-one (19.4%) travellers reported a history of a chronic illness. Arterial hypertension and diabetes mellitus were the most frequently reported illnesses, affecting, respectively, 168 (8.3%) travellers and 102 (5.1%). Hajj pilgrims were more likely to report a history of chronic illness than other travellers. Only 810 (40.1%) travellers sought pre-travel advice from their GP. Six hundred and fifty-two (40.1%) healthy travellers and 158 (40.5%) travellers reporting chronic illness sought pre-travel advice from their GP (P = 0.96). Travellers with a history of chronic illness do not seek pre-travel health advice from their GP more frequently than healthy travellers. Travel health specialists are generally not the best practitioners to manage the care of underlying medical conditions presenting risks during travel. However, GPs offer continuity and disease management expertise to improve the specificity of pre-travel planning. Thus, ongoing collaboration between the traveller, GP and travel health specialist is likely to yield the best outcomes. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

  4. Pre-travel advice, attitudes and hepatitis A and B vaccination rates among travellers from seven countries†

    Science.gov (United States)

    Heywood, Anita E.; Nothdurft, Hans; Tessier, Dominique; Moodley, Melissa; Rombo, Lars; Marano, Cinzia; De Moerlooze, Laurence

    2017-01-01

    Background: Knowledge about the travel-associated risks of hepatitis A and B, and the extent of pre-travel health-advice being sought may vary between countries. Methods: An online survey was undertaken to assess the awareness, advice-seeking behaviour, rates of vaccination against hepatitis A and B and adherence rates in Australia, Finland, Germany, Norway, Sweden, the UK and Canada between August and October 2014. Individuals aged 18–65 years were screened for eligibility based on: travel to hepatitis A and B endemic countries within the past 3 years, awareness of hepatitis A, and/or combined hepatitis A&B vaccines; awareness of their self-reported vaccination status and if vaccinated, vaccination within the last 3 years. Awareness and receipt of the vaccines, sources of advice, reasons for non-vaccination, adherence to recommended doses and the value of immunization reminders were analysed. Results: Of 27 386 screened travellers, 19 817 (72%) were aware of monovalent hepatitis A or combined A&B vaccines. Of these 13 857 (70%) had sought advice from a healthcare provider (HCP) regarding combined hepatitis A&B or monovalent hepatitis A vaccination, and 9328 (67%) were vaccinated. Of 5225 individuals eligible for the main survey (recently vaccinated = 3576; unvaccinated = 1649), 27% (841/3111) and 37% (174/465) of vaccinated travellers had adhered to the 3-dose combined hepatitis A&B or 2-dose monovalent hepatitis A vaccination schedules, respectively. Of travellers partially vaccinated against combined hepatitis A&B or hepatitis A, 84% and 61%, respectively, believed that they had received the recommended number of doses. Conclusions: HCPs remain the main source of pre-travel health advice. The majority of travellers who received monovalent hepatitis A or combined hepatitis A&B vaccines did not complete the recommended course. These findings highlight the need for further training of HCPs and the provision of reminder services to improve traveller

  5. Pre-travel advice concerning vector-borne diseases received by travelers prior to visiting Cuzco, Peru.

    Science.gov (United States)

    Mejia, Christian R; Centeno, Emperatriz; Cruz, Briggitte; Cvetkovic-Vega, Aleksandar; Delgado, Edison; Rodriguez-Morales, Alfonso J

    2016-01-01

    Peru is an increasingly popular tourist destination that poses a risk to travelers due to endemic vector-borne diseases (VBDs). The objective of our study was to determine which factors are associated with receiving pre-travel advice (PTA) for VBDs among travelers visiting Cuzco, Peru. A cross-sectional secondary analysis based on data from a survey among travelers departing Cuzco at Alejandro Velazco Astete International Airport during the period January-March 2012 was conducted. From the 1819 travelers included in the original study, 1717 were included in secondary data analysis. Of these participants, 42.2% received PTA and 2.9% were informed about vector-borne diseases, including yellow fever (1.8%), malaria (1.6%) and dengue fever (0.1%). Receiving information on VBDs was associated with visiting areas endemic to yellow fever and dengue fever in Peru. The only disease travelers received specific recommendations for before visiting an endemic area for was yellow fever. Only 1 in 30 tourists received information on VBD prevention; few of those who traveled to an endemic area were warned about specific risks for infectious diseases prior to their trip. These important findings show that most tourists who travel to Peru do not receive PTA for the prevention of infectious and VBD, which can affect not only the travelers but their countries of origin as well. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  6. Pre-travel advice at a crossroad: Medical preparedness of travellers to South and Southeast-Asia - The Hamburg Airport Survey.

    Science.gov (United States)

    Rolling, Thierry; Mühlenpfordt, Melina; Addo, Marylyn M; Cramer, Jakob P; Vinnemeier, Christof D

    Specific travel-related recommendations exist for the prevention or self-treatment of infectious diseases contracted by travellers to the tropics. In the current study, we assessed the medical preparedness per these recommendations, focusing on whether travellers carried antidiarrheal and antimalarial medication with them stratified by type of pre-travel advice. We surveyed travellers departing from Hamburg International Airport to South or Southeast Asia, using a questionnaire on demographic, medical and travel characteristics. 975 travellers were analysed - the majority (817, 83%) being tourists. A large proportion packed any antidiarrheal medication (612, 63%) - most frequently loperamide (440, 72%). Only 176 of 928 (19%) travellers to destinations with low-to medium risk for malaria packed a recommended antimalarial medication. The majority (162, 17%) of them carried antimalarials as stand-by emergency treatment (SBET). 468 (48%) travellers had a pre-travel medical consultation. This lead to higher odds of carrying SBET- with the highest odds associated with a consultation at a travel medicine specialist (OR 7.83 compared to no consultation). Attending a travel medicine specialist was associated with better adherence to current recommendations concerning the carriage of stand-by emergency treatment of malaria. However, the proportion of travellers seeking pre-travel health advice was overall low in our population. Promoting pre-travel consultations may, therefore, lead to higher adherence to the current recommendations in travel medicine. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Pre-travel health advice for human immunodeficiency virus-infected travelers, from Rio de Janeiro Aconselhamento pré-viagem para os viajantes infectados pelo vírus da imunodeficiência humana no Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Ricardo Pereira Igreja

    2009-06-01

    Full Text Available Counseling for human immunodeficiency virus infected travelers is becoming increasingly specialized. Previous studies have reported the experience of HIV-infected travelers from temperate-climate countries but little is known about HIV-infected travelers from tropical countries. A retrospective study was conducted on HIV-infected travelers presenting at a travel health clinic in Rio de Janeiro. Eleven journeys by ten people were recorded. Brazil (Amazon region and Northeast was the destination for six journeys. Other destinations were Peru, Angola, Europe and Asia. Nine attendees were undergoing antiretroviral therapy. Few HIV-infected people from Rio de Janeiro consulted a travel medicine specialist before traveling. Since they travel to destinations in Brazil and abroad where there are endemic diseases not encountered in Rio de Janeiro, careful pre-travel planning needs to be undertaken. Strategies for increasing the frequency of pre-travel consultations need to be developed, such as closer collaboration between HIV clinics and travel health clinics.O aconselhamento para os viajantes infectados pelo vírus da imunodeficiência humana está se especializando cada vez mais. Estudos prévios relatam a experiência dos viajantes infectados pelo vírus da imunodeficiência humana dos países de clima temperado, mas pouco se sabe sobre os viajantes infectados pelo vírus da imunodeficiência humana dos países tropicais. Foi realizado um estudo retrospectivo dos viajantes infectados pelo vírus da imunodeficiência humana que consultaram um serviço de medicina de viagem no Rio de Janeiro. Dez viajantes realizaram onze viagens. O Brasil (Amazônia e Nordeste foi o destino de seis viagens. Outros destinos foram Peru, Angola, Europa e Ásia. Nove pacientes estavam sob terapia anti-retroviral. No Rio de Janeiro, poucas pessoas infectadas pelo vírus da imunodeficiência humana consultaram um especialista em medicina de viagem antes de viajar. Como elas

  8. Antimalarial measures - type, sources of advice and compliance ...

    African Journals Online (AJOL)

    1994-06-01

    Jun 1, 1994 ... basis from which to document further changes in prophylactic advice and usage. The results are being ... as posing a higher risk from malaria than the KBNR's more southerly regions. The diversity of accommodation ... Compliance, drug type and sources of advice were documented. Use of personal barrier ...

  9. Consider the source: adolescents and adults similarly follow older adult advice more than peer advice.

    Science.gov (United States)

    Lourenco, Frederico S; Decker, Johannes H; Pedersen, Gloria A; Dellarco, Danielle V; Casey, B J; Hartley, Catherine A

    2015-01-01

    Individuals learn which of their actions are likely to be rewarded through trial and error. This form of learning is critical for adapting to new situations, which adolescents frequently encounter. Adolescents are also greatly influenced by their peers. The current study tested the extent to which adolescents rely on peer advice to guide their actions. Adolescent and young adult participants completed a probabilistic learning task in which they chose between four pairs of stimuli with different reinforcement probabilities, with one stimulus in each pair more frequently rewarded. Participants received advice about two of these pairs, once from a similarly aged peer and once from an older adult. Crucially, this advice was inaccurate, enabling the dissociation between experience-based and instruction-based learning. Adolescents and adults learned equally well from experience and no age group difference was evident in the overall influence of advice on choices. Surprisingly, when considering the source of advice, there was no evident influence of peer advice on adolescent choices. However, both adolescents and adults were biased toward choosing the stimulus recommended by the older adult. Contrary to conventional wisdom, these data suggest that adolescents may prioritize the advice of older adults over that of peers in certain decision-making contexts.

  10. Pre-Travel Medical Preparation of Business and Occupational Travelers

    Science.gov (United States)

    Khan, Nomana M.; Jentes, Emily S.; Brown, Clive; Han, Pauline; Rao, Sowmya R.; Kozarsky, Phyllis; Hagmann, Stefan H.F.; LaRocque, Regina C.; Ryan, Edward T.

    2016-01-01

    Objectives: The aim of the study was to understand more about pre-travel preparations and itineraries of business and occupational travelers. Methods: De-identified data from 18 Global TravEpiNet clinics from January 2009 to December 2012 were analyzed. Results: Of 23,534 travelers, 61% were non-occupational and 39% occupational. Business travelers were more likely to be men, had short times to departure and shorter trip durations, and commonly refused influenza, meningococcal, and hepatitis B vaccines. Most business travelers indicated that employers suggested the pre-travel health consultation, whereas non-occupational travelers sought consultations because of travel health concerns. Conclusions: Sub-groups of occupational travelers have characteristic profiles, with business travelers being particularly distinct. Employers play a role in encouraging business travelers to seek pre-travel consultations. Such consultations, even if scheduled immediately before travel, can identify vaccination gaps and increase coverage. PMID:26479857

  11. Parents' Primary Professional Sources of Parenting Advice Moderate Predictors of Parental Attitudes toward Corporal Punishment.

    Science.gov (United States)

    Taylor, Catherine A; McKasson, Sarah; Hoy, Guenevere; DeJong, William

    2017-02-01

    Despite the risk it poses to children's mental and physical health, approval and use of corporal punishment (CP) remains high in the United States. Informed by the Theory of Planned Behavior, we examined potential predictors of attitudes supportive of CP while assessing the moderating effects of parents' (N=500) chosen primary professional source of advice regarding child discipline: pediatricians (47.8%), religious leaders (20.8%), mental health professionals (MHPs) (n=18.4%), or other identified professionals (13.0%). We conducted a random-digit-dial telephone survey among parents ages 18 and over within New Orleans, LA. The main outcome measure was derived from the Attitudes Toward Spanking scale (ATS). The main "predictors" were: perceived injunctive norms (i.e., perceived approval of CP by professionals; and by family and friends), perceived descriptive norms of family and friends regarding CP, and expected outcomes of CP use. We used multivariate OLS models to regress ATS scores on the predictor variables for each subset of parents based on their chosen professional source of advice. Perceived approval of CP by professionals was the strongest predictor of parental attitudes supportive of CP, except for those seeking advice from MHPs. Perceived injunctive and descriptive norms of family and friends were important, but only for those seeking advice from pediatricians or religious leaders. Positive expected outcomes of CP mattered, but only for those seeking advice from religious leaders or MHPs. In conclusion, the strength and relevance of variables predicting attitudes toward CP varied according to the professional from which the parent was most likely to seek advice.

  12. Parents’ Primary Professional Sources of Parenting Advice Moderate Predictors of Parental Attitudes toward Corporal Punishment

    Science.gov (United States)

    Taylor, Catherine A.; McKasson, Sarah; Hoy, Guenevere; DeJong, William

    2016-01-01

    Despite the risk it poses to children’s mental and physical health, approval and use of corporal punishment (CP) remains high in the United States. Informed by the Theory of Planned Behavior, we examined potential predictors of attitudes supportive of CP while assessing the moderating effects of parents’ (N=500) chosen primary professional source of advice regarding child discipline: pediatricians (47.8%), religious leaders (20.8%), mental health professionals (MHPs) (n=18.4%), or other identified professionals (13.0%). We conducted a random-digit-dial telephone survey among parents ages 18 and over within New Orleans, LA. The main outcome measure was derived from the Attitudes Toward Spanking scale (ATS). The main “predictors” were: perceived injunctive norms (i.e., perceived approval of CP by professionals; and by family and friends), perceived descriptive norms of family and friends regarding CP, and expected outcomes of CP use. We used multivariate OLS models to regress ATS scores on the predictor variables for each subset of parents based on their chosen professional source of advice. Perceived approval of CP by professionals was the strongest predictor of parental attitudes supportive of CP, except for those seeking advice from MHPs. Perceived injunctive and descriptive norms of family and friends were important, but only for those seeking advice from pediatricians or religious leaders. Positive expected outcomes of CP mattered, but only for those seeking advice from religious leaders or MHPs. In conclusion, the strength and relevance of variables predicting attitudes toward CP varied according to the professional from which the parent was most likely to seek advice. PMID:28529440

  13. Use of pre-travel vaccine-preventable disease serology as a screening tool to identify patients in need of pre-travel vaccination: a retrospective audit.

    Science.gov (United States)

    Turner, David P; McGuinness, Sarah L; Cohen, Jonathan; Waring, Lynette J; Leder, Karin

    2017-05-01

    Vaccination is a safe and effective public health intervention that not only protects individual travellers from vaccine-preventable diseases (VPDs), but prevents them from becoming a source of disease in their destination and on their return. Obtaining an accurate vaccination history from travellers during a pre-travel review can be difficult; serology may be used to identify patients who are non-immune to specific diseases in order to guide vaccination requirements. Clinically relevant data about the usefulness of serology in this setting are lacking. We performed a retrospective audit of pre-travel VPD serology requested by practitioners of a busy community-based travel clinic. All serological results for measles, mumps, rubella, varicella zoster virus, hepatitis A and B requested over a 5-year period were extracted and analysed. Results were stratified by gender and year of birth and compared using Stata. Four thousand four hundred and fifty-one serological assays from 1445 individual were assessed. Overall, 47% of patients tested had at least one negative serological result. High rates of seropositivity for measles, mumps and rubella were seen in those born prior to 1966 but >10% of travellers born after 1966 lacked serological evidence of protection against these diseases. Hepatitis A and B serological results revealed broadly lower rates of immunity in our community likely reflecting the absence of these vaccines from historical vaccine protocols. Serology can be a useful tool in the identification of non-immune travellers to enable targeted vaccination prior to travel. We recommend that travel health clinicians assess patients' vaccination and infection histories, and strongly consider serology or vaccination where there is doubt about immunity. This will help protect the traveller and prevent importation of disease into destination or home communities. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights

  14. Travel risk behaviors as a determinants of receiving pre-travel health consultation and prevention.

    Science.gov (United States)

    Shady, Ibrahim; Gaafer, Mohammed; Bassiony, Lamiaa

    2015-01-01

    An estimated 30-60 % of travelers experience an illness while traveling. The incidence of travel-related illness can be reduced by preventive measures such as those provided by the Traveler Health Clinic (THC) in Kuwait. The present study is an analytical comparative study between groups of travelers visiting the THC during the study period (May 2009 - December 2010) and an age- and gender-matched control group of non-visitors (800 people). Both groups completed a modified pre-departure questionnaire. Bivariate analysis revealed that Kuwaitis (68.2 %), those traveling for work (25.3 %) or leisure (59.5 %), those living in camps (20.4 %) or hotels (64.0 %), and those with knowledge of the THC from the media (28.1 %) or other sources (57.3 %), were more likely to be associated with a high frequency of visits to the THC ( p  travelers heading to Africa (47 %) and South America (10 %) visited the THC more than did others ( P  travel, duration of stay, and choice of travel destination are independent predictors of receiving pre-travel consultation from the THC. Nationality, purpose of travel, length of stay, and travel destination are predictors for receiving a pre-travel consultation from the THC.

  15. Trends and characteristics among HIV-infected and diabetic travelers seeking pre-travel advice

    NARCIS (Netherlands)

    Elfrink, Floor; van den Hoek, Anneke; Sonder, Gerard J. B.

    2014-01-01

    The number of individuals with a chronic disease increases. Better treatment options have improved chronic patients' quality of life, likely increasing their motivation for travel. This may have resulted in a change in the number of HIV-infected travelers and/or travelers with Diabetes Mellitus (DM)

  16. Parents’ professional sources of advice regarding child discipline and their use of corporal punishment

    Science.gov (United States)

    Taylor, Catherine A.; Moeller, William; Hamvas, Lauren; Rice, Janet C.

    2014-01-01

    Parents (n=500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents that sought advice from religious leaders (vs. pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported they were more likely to follow the advice of pediatricians than any other professional; however, Black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents. PMID:23185082

  17. Parents' professional sources of advice regarding child discipline and their use of corporal punishment.

    Science.gov (United States)

    Taylor, Catherine A; Moeller, William; Hamvas, Lauren; Rice, Janet C

    2013-02-01

    Parents (n = 500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of the parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents who sought advice from religious leaders (vs pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported that they were more likely to follow the advice of pediatricians than any other professional; however, black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents.

  18. Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia

    Directory of Open Access Journals (Sweden)

    Heywood Anita E

    2012-02-01

    Full Text Available Abstract Background Forward planning and preventative measures before travelling can significantly reduce the risk of many vaccine preventable travel-related infectious diseases. Higher education students may be at an increased risk of importing infectious disease as many undertake multiple visits to regions with higher infectious disease endemicity. Little is known about the health behaviours of domestic or international university students, particularly students from low resource countries who travel to high-resource countries for education. This study aimed to assess travel-associated health risks and preventative behaviours in a sample of both domestic and international university students in Australia. Methods In 2010, a 28 item self-administered online survey was distributed to students enrolled at the University of New South Wales, Sydney, Australia. Multiple methods of distributing links to the online survey were utilised. The survey examined the international travel history, travel intentions, infection control behaviours and self-reported vaccination history. Results A total of 1663 respondents completed the online survey, 22.1% were international students and 83.9% were enrolled at an undergraduate level. Half had travelled internationally in the previous 12 months, with 69% of those travelling only once during that time with no difference in travel from Australia between domestic and international students (p = 0.8. Uptake of pre-travel health advice was low overall with 68% of respondents reporting they had not sought any advice from a health professional prior to their last international trip. Domestic students were more likely to report uptake of a range of preventative travel health measures compared to international students, including diarrhoeal medication, insect repellent, food avoidance and condoms (P Conclusions Our study highlights the need to educate students about the risk associated with travel and improve preventative

  19. Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia

    Science.gov (United States)

    2012-01-01

    Background Forward planning and preventative measures before travelling can significantly reduce the risk of many vaccine preventable travel-related infectious diseases. Higher education students may be at an increased risk of importing infectious disease as many undertake multiple visits to regions with higher infectious disease endemicity. Little is known about the health behaviours of domestic or international university students, particularly students from low resource countries who travel to high-resource countries for education. This study aimed to assess travel-associated health risks and preventative behaviours in a sample of both domestic and international university students in Australia. Methods In 2010, a 28 item self-administered online survey was distributed to students enrolled at the University of New South Wales, Sydney, Australia. Multiple methods of distributing links to the online survey were utilised. The survey examined the international travel history, travel intentions, infection control behaviours and self-reported vaccination history. Results A total of 1663 respondents completed the online survey, 22.1% were international students and 83.9% were enrolled at an undergraduate level. Half had travelled internationally in the previous 12 months, with 69% of those travelling only once during that time with no difference in travel from Australia between domestic and international students (p = 0.8). Uptake of pre-travel health advice was low overall with 68% of respondents reporting they had not sought any advice from a health professional prior to their last international trip. Domestic students were more likely to report uptake of a range of preventative travel health measures compared to international students, including diarrhoeal medication, insect repellent, food avoidance and condoms (P students reported low risk perception of travel threats and a low corresponding concern for these threats. Conclusions Our study highlights the need to

  20. Advice to give advice.

    Science.gov (United States)

    Zheng, Patricia Z; Smuck, Matthew

    2017-10-01

    Matthew L. Stevens, Chung-Wei C. Lin, Flavia A. de Carvalho, Kevin Phan, Bart Koes, Chris G. Maher. Advice for acute low back pain: A comparison of what research supports and what guidelines recommend. The Spine Journal, In Press. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Travel-associated infection presenting in Europe (2008-12): an analysis of EuroTravNet longitudinal, surveillance data, and evaluation of the effect of the pre-travel consultation.

    Science.gov (United States)

    Schlagenhauf, Patricia; Weld, Leisa; Goorhuis, Abraham; Gautret, Philippe; Weber, Rainer; von Sonnenburg, Frank; Lopez-Vélez, Rogelio; Jensenius, Mogens; Cramer, Jakob P; Field, Vanessa K; Odolini, Silvia; Gkrania-Klotsas, Effrossyni; Chappuis, Francois; Malvy, Denis; van Genderen, Perry J J; Mockenhaupt, Frank; Jauréguiberry, Stéphane; Smith, Catherine; Beeching, Nicholas J; Ursing, Johan; Rapp, Christophe; Parola, Philippe; Grobusch, Martin P

    2015-01-01

    Travel is important in the acquisition and dissemination of infection. We aimed to assess European surveillance data for travel-related illness to profile imported infections, track trends, identify risk groups, and assess the usefulness of pre-travel advice. We analysed travel-associated morbidity in ill travellers presenting at EuroTravNet sites during the 5-year period of 2008-12. We calculated proportionate morbidity per 1000 ill travellers and made comparisons over time and between subgroups. We did 5-year trend analyses (2008-12) by testing differences in proportions between subgroups using Pearson's χ(2) test. We assessed the effect of the pre-travel consultation on infection acquisition and outcome by use of proportionate morbidity ratios. The top diagnoses in 32 136 patients, ranked by proportionate morbidity, were malaria and acute diarrhoea, both with high proportionate morbidity (>60). Dengue, giardiasis, and insect bites had high proportionate morbidity (>30) as well. 5-year analyses showed increases in vector borne infections with significant peaks in 2010; examples were increased Plasmodium falciparum malaria (χ(2)=37·57, ptravel consultation was associated with significantly lower proportionate morbidity ratios for P falciparum malaria and also for acute hepatitis and HIV/AIDS. The pattern of travel-related infections presenting in Europe is complex. Trend analyses can inform on emerging infection threats. Pre-travel consultation is associated with reduced malaria proportionate morbidity ratios and less severe illness. These findings support the importance and effectiveness of pre-travel advice on malaria prevention, but cast doubt on the effectiveness of current strategies to prevent travel-related diarrhoea. European Centre for Disease Prevention and Control, University Hospital Institute Méditerranée Infection, US Centers for Disease Control and Prevention, and the International Society of Travel Medicine. Copyright © 2015 Elsevier Ltd

  2. Sources of Social Capital: Effects of Altruistic Citizenship Behavior and Job Involvement on Advice Network Centrality

    Science.gov (United States)

    Zhang, Mian; Zheng, Wei; Wei, Jun

    2009-01-01

    Social capital has been receiving increasing attention in HRD research. However, the sources of social capital have received inadequate attention. Little has been done to reveal how people obtain their social capital in the workplace. This study investigated the effects of employees' altruistic citizenship behavior and job involvement on their…

  3. Sealed Radioactive Sources. Information, Resources, and Advice for Key Groups about Preventing the Loss of Control over Sealed Radioactive Sources

    International Nuclear Information System (INIS)

    2013-10-01

    Among its many activities to improve the safety and security of sealed sources, the IAEA has been investigating the root causes of major accidents and incidents since the 1980's and publishes findings so that others can learn from them. There are growing concerns today about the possibility that an improperly stored source could be stolen and used for malicious purposes. To improve both safety and security, information needs to be in the hands of those whose actions and decisions can prevent a source from being lost or stolen in the first place. The IAEA developed this booklet to help improve communication with key groups about hazards that may result from the loss of control over sealed radioactive sources and measures that should be implemented to prevent such loss of control. Many people may benefit from the information contained in this booklet, particularly those working with sources and those likely to be involved if control over a source is lost; especially: officials in government agencies, first responders, medical users, industrial users and the metal recycling industry. The general public may also benefit from an understanding of the fundamentals of radiation safety. This booklet is comprised of several stand-alone chapters intended to communicate with these key groups. Various accidents that are described and information that is provided are relevant to more than one key group and therefore, some information is repeated throughout the booklet. This booklet seeks to raise awareness of the importance of the safety and security of sealed radioactive sources. However, it is not intended to be a comprehensive 'how to' guide for implementing safety and security measures for sealed radioactive sources. For more information on these measures, readers are encouraged to consult the key IAEA safety and security-related publications identified in this booklet

  4. Travel itinerary uncertainty and the pre-travel consultation--a pilot study.

    Science.gov (United States)

    Flaherty, Gerard; Md Nor, Muhammad Najmi

    2016-01-01

    Risk assessment relies on the accuracy of the information provided by the traveller. A questionnaire was administered to 83 consecutive travellers attending a travel medicine clinic. The majority of travellers was uncertain about destinations within countries, transportation or type of accommodation. Most travellers were uncertain if they would be visiting malaria regions. The degree of uncertainty about itinerary potentially impacts on the ability of the travel medicine specialist to perform an adequate risk assessment, select appropriate vaccinations and prescribe malaria prophylaxis. This study reveals high levels of traveller uncertainty about their itinerary which may potentially reduce the effectiveness of their pre-travel consultation. © The Author 2016. Published by Oxford University Press on behalf of International society of travel medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Advice on malaria and yellow fever prevention provided at travel agencies in Cuzco, Peru.

    Science.gov (United States)

    Villanueva-Meyer, Pablo G; Garcia-Jasso, Carlos A; Springer, Chelsea A; Lane, Jenna K; Su, Bonny S; Hidalgo, Idania S; Goodrich, Mary R; Deichsel, Emily L; White, A C; Cabada, Miguel M

    2015-01-01

    Travelers receive medical advice from a variety of sources, including travel agencies. The aim of this study is to describe the quality of pre-travel advice provided by travel agencies in Cuzco to travelers interested in visiting malaria and yellow fever endemic areas. Trained medical students posed as tourists and visited travel agencies in Cuzco requesting travel advice for a trip to the southern Amazon of Peru, recording advice regarding risk and prevention of malaria and yellow fever. A total of 163 registered travel agencies were included in the study. The mean proposed tour duration was 6.8 days (±1.4 days) with a median time to departure of 3 days and a median tour cost of 805 US dollars (USD) [interquartile range (IQR) 580-1,095]. Overall, 45% employees failed to mention the risk for any illness. Eighteen percent of the employees acknowledged risk of malaria and 53% risk of yellow fever. However, 36% denied malaria risk and 2% denied risk of yellow fever in the region. The price of tours from travel agencies that did not mention any health risk was significantly lower [1,009.6 ± 500.5 vs 783.9 ± 402 USD, t (152) = 3, p yellow fever (100%) were able to provide at least one recommendation for prevention. However, advice was not always accurate or spontaneously volunteered. Only 7% of the employees provided both correct scheduling and location information for administration of the yellow fever vaccine. The majority of registered travel agencies in Cuzco did not provide sufficient and accurate information regarding risk and prevention of malaria and yellow fever to travelers inquiring about trips to the southern Amazon of Peru. © 2014 International Society of Travel Medicine.

  6. Professional advice

    DEFF Research Database (Denmark)

    Ottaviani, Marco; Sørensen, Peter Norman

    2006-01-01

    on the basis of the advice given and the realized state of the world. In equilibrium of this reputational cheap-talk game, no more than two messages are effectively reported. The model is extended to consider sequential communication by experts with conditionally independent signals. In the long run, learning...... is incomplete and herd behavior arises...

  7. Pre-Travel Health Preparation of Pediatric International Travelers: Analysis From the Global TravEpiNet Consortium.

    Science.gov (United States)

    Hagmann, Stefan; LaRocque, Regina C; Rao, Sowmya R; Jentes, Emily S; Sotir, Mark J; Brunette, Gary; Ryan, Edward T

    2013-12-01

    Children frequently travel internationally. Health-related data on such children are limited. We sought to investigate the demographics, health characteristics, and preventive interventions of outbound US international pediatric travelers. We analyzed data from 32 099 travelers presenting for pre-travel healthcare at the Global TravEpiNet (GTEN), a national consortium of 19 travel clinics, from January 1, 2009 to June 6, 2012. A total of 3332 (10%) of all GTEN travelers were children (traveled mostly for leisure (36%) or to visit friends or relatives (VFR) (36%). Most popular destination regions were Africa (41%), Southeast Asia (16%), Central America (16%), and the Caribbean (16%). Compared with children traveling for leisure, VFR children were more likely to present travel consultation (44% vs 28%), intended to travel for 28 days or longer (70% vs 22%), and to travel to Africa (62% vs 32%). Nearly half of the pediatric travelers (46%) received at least 1 routine vaccine, and most (83%) received at least 1 travel-related vaccine. Parents or guardians of one third of the children (30%) refused at least 1 recommended travel-related vaccine. Most pediatric travelers visiting a malaria-endemic country (72%) received a prescription for malaria chemoprophylaxis. Ten percent of travelers seeking pre-travel healthcare at GTEN sites are children. VFR-travel, pre-travel consultation close to time of departure, and refusal of recommended vaccines may place children at risk for travel-associated illness. Strategies to engage pediatric travelers in timely, pre-travel care and improve acceptance of pre-travel healthcare interventions are needed. © The Author 2013. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  8. Characteristics and pre-travel preparation of travelers at a Canadian pediatric tertiary care travel clinic: A retrospective analysis.

    Science.gov (United States)

    Ma, Xiao Wei; Pell, Lisa G; Akseer, Nadia; Khan, Sarah; Lam, Ray E; Louch, Debra; Science, Michelle; Morris, Shaun K

    2016-01-01

    International travelers are susceptible to a wide spectrum of travel related morbidities. Despite rising number of international travelers in Canada, the demographics, risk profiles, and preventative strategies of high-risk traveler groups, including pediatric travelers visiting friends and relatives (VFRs) are not well described. A descriptive analysis was conducted on pre-travel consultations completed between January 2013 and August 2014 at a large pediatric tertiary care center in Toronto, Canada. Data on demographics, travel characteristics, and pre-travel interventions were extracted from 370 pre-travel consultations. Results were compared between all VFR and non-VFR travelers, as well as between children traveling to visit friends and relatives, for vacation, and for education and/or volunteer purposes. Forty-eight percent of consultations were for children travel to visit friends and/or relatives than for other purposes (29% vs 9%, p travel for >28 days than children traveling for vacation (43% vs 1%, p traveling for education/volunteer purposes (43% vs 21%, p = 0.03). Around half of cVFRs traveled to destinations in Asia (51%). The majority stayed with locals, friends and/or relatives (85%), and nearly all traveled to urban destinations (98%). The most prescribed interventions for children were azithromycin (84%), Dukoral (66%), and the hepatitis A vaccine (60%). Atovaquone/proguanil was the most commonly prescribed antimalarial for children. Children that travel to visit friends and relatives represent a unique travel group and may require specific considerations during pre-travel preparations. Our findings can help develop targeted pre-travel strategies for children VFRs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. [Characteristics associated with pre travel medical consultation in tourists visiting Cuzco, Peru].

    Science.gov (United States)

    Mejia, Christian R; Cvetkovic-Vega, Aleksandar; Cruz, Briggite; Cárdenas, Matlin M; Quiñones-Laveriano, Dante M; Rodríguez-Morales, Alfonso J

    2016-02-01

    International tourism is increasing. Preventive Medicine remains important, especially the Pre-Travel Consultation (PTC). To determinate, the characteristics of tourists associated with PTC in tourists at Cuzco, Peru. A cross-sectional, analytical study, a secondary analysis of data from a database generated by survey of foreign tourists who visited Cuzco, in the waiting room of the airport was performed. The main variable was to have had a PTC at the tourist's country of residence, the area of residence was categorized according to health/risk of acquiring infectious diseases as traveler's diarrhea during their stay. These and other variables were analyzed and statistical association with generalized linear models were done. Of the 1827 tourists, 875 (48%) were men, with a median age of 33 years (range 18-88 years); 42% had a PTC. In the multivariate analysis, it was found that a PTC lower frequency was associated with male gender (aPR: 0.84; 95% CI: 0.75-0.94), and a higher frequency was associated with have born (aPR: 1.77; 95% CI: 1.39-2.27) and reside in an area of low risk of acquiring infectious diseases (aPR: 1.95; 95% CI: 1.26-3.00), adjusted for the history of a disease. Sex, region of birth and residence of tourists (as risk of acquiring infectious diseases) are associated with having a PTC. These findings may serve the health and government attending tourists who come to our country.

  10. Is there an isotope on your books? Advice to receivers and liquidators on dealing with X-ray sources and X-ray equipment

    International Nuclear Information System (INIS)

    Colgan, Tony.

    1987-01-01

    The paper outlines advice to receivers and liquidators on dealing with radioactive sources and X-ray equipment. When companies go into liquidation it is important that the accountants handling the winding up are aware of the law and their responsibilities if radioactive materials are present. Guidelines are presented here which may help indicate to the accountant the likely presence of radioactive materials and the procedure which should be followed when arranging sale or disposal of these items

  11. Effectiveness of pre-travel consultation in the prevention of travel-related diseases: a retrospective cohort study.

    Science.gov (United States)

    Tafuri, Silvio; Guerra, Rocco; Gallone, Maria Serena; Cappelli, Maria Giovanna; Lanotte, Serafina; Quarto, Michele; Germinario, Cinzia

    2014-01-01

    This study aims to evaluate the effectiveness of pre-travel counselling carried out in Travel Clinics. This is a retrospective cohort. Three hundred international travellers were enrolled; 150 people were from users of Bari Travel Clinic, 150 were users of a travel agency. Enrolled subjects were interviewed using a questionnaire. The average age of the enrolled subjects was 37.5 ± 13.9, without statistically significant differences between the two groups. 86% of cases and 19.3% of the controls reported the use of anti-malaria prophylaxis (p Travel Clinic users, 6% reported diarrhoea and these figures were 27% in the control group (p travel counselling; in the future, new studies must investigate the cost-effectiveness of pre-travel prevention measures.

  12. International travel in the immunocompromised patient: a cross-sectional survey of travel advice in 254 consecutive patients.

    Science.gov (United States)

    Bialy, C; Horne, K; Dendle, C; Kanellis, J; Littlejohn, G; Ratnam, I; Woolley, I

    2015-06-01

    Our primary aim was to determine the rate of overseas travel in immunocompromised individuals attending appropriate clinics at an Australian tertiary care hospital. We also aimed to characterise health-seeking behaviour prior to travel and investigated sources of pre-travel advice, compared travel patterns and activities between three specific immunosuppressed groups, and examined pre-immunosuppression patient serology. We implemented a cross-sectional survey of patients between February and August 2012. This survey was implemented among three outpatient populations at Monash Medical Centre, an Australian tertiary care hospital. We recruited 254 immunosuppressed adults from three patient populations: human immunodeficiency virus-positive individuals, renal transplant patients and rheumatology patients requiring immunosuppressive therapy. No clinical intervention was performed. In the 10 years preceding the survey, 153 (60.2%) participants reported international travel. Of these, 105 (68.6%) were immunosuppressed at the time of travel. These patients were 47.6% male and 60% Australian born. Forty per cent were visiting friends and relatives as part of their travel. Fifty-four per cent of those immunocompromised at the time of travel were going to high-risk destinations. Pathology files indicated that serological screening was frequently not performed prior to immunosuppression in the renal transplant and rheumatology groups. Immunocompromised patients often travel to high-risk destinations with limited or inadequate pre-travel preparations. Doctors caring for the immunocompromised should be aware of travel risks, suitable vaccination protocols and when to refer to specialist travel clinics. © 2015 Royal Australasian College of Physicians.

  13. Pre-Travel Medical Preparation of Business and Occupational Travelers: An Analysis of the Global TravEpiNet Consortium, 2009 to 2012.

    Science.gov (United States)

    Khan, Nomana M; Jentes, Emily S; Brown, Clive; Han, Pauline; Rao, Sowmya R; Kozarsky, Phyllis; Hagmann, Stefan H F; LaRocque, Regina C; Ryan, Edward T

    2016-01-01

    The aim of the study was to understand more about pre-travel preparations and itineraries of business and occupational travelers. De-identified data from 18 Global TravEpiNet clinics from January 2009 to December 2012 were analyzed. Of 23,534 travelers, 61% were non-occupational and 39% occupational. Business travelers were more likely to be men, had short times to departure and shorter trip durations, and commonly refused influenza, meningococcal, and hepatitis B vaccines. Most business travelers indicated that employers suggested the pre-travel health consultation, whereas non-occupational travelers sought consultations because of travel health concerns. Sub-groups of occupational travelers have characteristic profiles, with business travelers being particularly distinct. Employers play a role in encouraging business travelers to seek pre-travel consultations. Such consultations, even if scheduled immediately before travel, can identify vaccination gaps and increase coverage.

  14. Pre-travel preparation practices among business travellers to tropical and subtropical destinations: results from the Athens International Airport Survey.

    Science.gov (United States)

    Pavli, Androula; Silvestros, Chrysovalantis; Patrinos, Stavros; Lymperi, Ioanna; Maltezou, Helena C

    2014-01-01

    The number of business travellers from Greece to tropical and subtropical areas has recently increased. The study aimed to assess travel health preparation practices of business travellers departing to Africa, the Middle East and Asia. A questionnaire-based survey was conducted at Athens International Airport, from 1st of November 2011 to 30th of April 2013. A total of 684 business travellers participated in the study; the majority were men (86.1%), of Greek nationality (95.3%), with tertiary education (90.8%) and employed (98%). Their mean age was 40 years; 62% and 26% of them were 35-49 and 19-34 years of age respectively. 84.8% were travelling alone. Most frequent destinations were the Middle East (46.8%) and sub-Saharan Africa (16%). For 23.5% of the travellers it was their first trip to a tropical or subtropical country. Only 58.8% pursued pre-travel health consultation; vaccination and malaria chemoprophylaxis were administered to 24.7% and 25.7% of the travellers, respectively. Hepatitis A and typhoid vaccination rates were lower than expected (70% and 35%, respectively). Nearly half of the travellers who visited malaria endemic areas did not receive any chemoprophylaxis. Having elementary education level, travelling to the Middle East or North Africa, travelling for less than 1 month duration, and staying in a house or a hotel were associated with a higher probability of not pursuing health consultation. Significant gaps were found in pre-travel health practices of business travellers departing to Africa, the Middle East and Asia. Strategies should be developed in order to improve awareness of business travellers. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Nutrition Advice and Recipes

    Science.gov (United States)

    ... Sign-Up Home Patient Information Nutrition Advice & Recipes Nutrition Advice & Recipes This is a very important section ... information on all aspects of daily life, including nutrition, medical treatments, pain management, and practical tips. For ...

  16. Risk factors and pre-travel healthcare of international travellers attending a Dutch travel clinic: a cross-sectional analysis.

    Science.gov (United States)

    Wieten, Rosanne W; van der Schalie, Maurice; Visser, Benjamin J; Grobusch, Martin P; van Vugt, Michèle

    2014-01-01

    The number of international travellers is currently estimated to exceed one billion annually. To address travel related health risks and facilitate risk reduction strategies, detailed knowledge of travellers' characteristics is important. In this cross-sectional study, data of a 20% sample of travellers visiting the Academic Medical Center (AMC) travel clinic Amsterdam from July 2011 to July 2012 was collected. Itineraries and protection versus exposure rates of preventable infectious diseases were mapped and reported according to STROBE guidelines. 1749 travellers were included. South-Eastern Asia, South-America and West-Africa were most frequently visited. 26.2% of the population had pre-existing medical conditions (often cardiovascular). Young and VFR travellers had a longer median travel time (28 and 30 days) compared to the overall population (21 days). Young adult travellers were relatively often vaccinated against hepatitis B (43.9% vs. 20.5%, p travellers. Pre-travel guidelines were well adhered to. Young adult travellers had high-risk itineraries but were adequately protected. Improvement of hepatitis B and rabies protection would be desirable, specifically for VFRs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. A comparison of patient recall of smoking cessation advice with advice recorded in electronic medical records.

    Science.gov (United States)

    Szatkowski, Lisa; McNeill, Ann; Lewis, Sarah; Coleman, Tim

    2011-05-10

    Brief cessation advice delivered to smokers during routine primary care consultations increases smoking cessation rates. However, in previous studies investigating recall of smoking cessation advice, smokers have reported more advice being received than is actually documented in their medical records. Recording of smoking cessation advice in UK primary care medical records has increased since the introduction of the Quality and Outcomes Framework (QOF) in 2004, and so we compare recall and recording of cessation advice since this time to assess whether or not agreement between these two data sources has improved. For each year from 2000 to 2009, the proportion of patients in The Health Improvement Network Database (THIN) with a recording of cessation advice in their notes in the last 12 months was calculated. In 2004, 2005 and 2008, these figures were compared to rates of patients recalling having received cessation advice in the last 12 months in the Primary Care Trust (PCT) Patient Surveys, with adjustment for age, sex and regional differences between the populations. In 2004 there was good agreement between the proportion of THIN patients who had cessation advice recorded in their medical records and the proportion recalling advice in the Patient Survey. However, in both 2005 and 2008, more patients had cessation advice recorded in their medical records than recalled receiving advice. Since the introduction of the QOF, the rate of recording of cessation advice in primary care medical records has exceeded that of patient recall. Whilst both data sources have limitations, our study suggests that, in recent years, the proportion of smokers being advised to quit by primary care health professionals may not have improved as much as the improved recording rates imply.

  18. Regulating household financial advice

    Directory of Open Access Journals (Sweden)

    Benjamin F. Cummings

    2012-08-01

    Full Text Available This paper reviews economic theory related to investment advice. This theory explains 1 why financial advisors need to be carefully regulated for the benefit of both the investment advice industry and for consumers, 2 why principles-based regulation (e.g., a fiduciary standard is more efficient than rules-based regulation, 3 why dual regulation of financial professionals providing investment or insurance advice is inefficient and inequitable policy, and 4 why the application of a universal and uniform fiduciary standard will be difficult to implement.

  19. Financial Advice: Who Pays

    Science.gov (United States)

    Finke, Michael S.; Huston, Sandra J.; Winchester, Danielle D.

    2011-01-01

    Using a cost-benefit framework for financial planning services and proprietary data collected in the summer of 2008, the client characteristics that are associated with the likelihood of paying for professional financial advice, as well as the type of financial services purchased, are identified. Results indicate that respondents who pay for…

  20. Combining Expert Advice Efficiently

    NARCIS (Netherlands)

    W.M. Koolen-Wijkstra (Wouter); S. de Rooij (Steven)

    2008-01-01

    htmlabstractWe show how models for prediction with expert advice can be defined concisely and clearly using hidden Markov models (HMMs); standard HMM algorithms can then be used to efficiently calculate, among other things, how the expert predictions should be weighted according to the model. We

  1. Travel risk assessment, advice and vaccinations in immunocompromised travellers (HIV, solid organ transplant and haematopoeitic stem cell transplant recipients): A review.

    Science.gov (United States)

    Aung, A K; Trubiano, J A; Spelman, D W

    2015-01-01

    International travellers with immunocompromising conditions such as human immunodeficiency virus (HIV) infection, solid organ transplantation (SOT) and haematopoietic stem cell transplantation (HSCT) are at a significant risk of travel-related illnesses from both communicable and non-communicable diseases, depending on the intensity of underlying immune dysfunction, travel destinations and activities. In addition, the choice of travel vaccinations, timing and protective antibody responses are also highly dependent on the underlying conditions and thus pose significant challenges to the health-care providers who are involved in pre-travel risk assessment. This review article provides a framework of understanding and approach to aforementioned groups of immunocompromised travellers regarding pre-travel risk assessment and management; in particular travel vaccinations, infectious and non-infectious disease risks and provision of condition-specific advice; to reduce travel-related mortality and morbidity. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Safety advice sheets

    CERN Multimedia

    HSE Unit

    2013-01-01

    You never know when you might be faced with questions such as: when/how should I dispose of a gas canister? Where can I find an inspection report? How should I handle/store/dispose of a chemical substance…?   The SI section of the DGS/SEE Group is primarily responsible for safety inspections, evaluating the safety conditions of equipment items, premises and facilities. On top of this core task, it also regularly issues “Safety Advice Sheets” on various topics, designed to be of assistance to users but also to recall and reinforce safety rules and procedures. These clear and concise sheets, complete with illustrations, are easy to display in the appropriate areas. The following safety advice sheets have been issued so far: Other sheets will be published shortly. Suggestions are welcome and should be sent to the SI section of the DGS/SEE Group. Please send enquiries to general-safety-visits.service@cern.ch.

  3. Implicit normativity in scientific advice

    DEFF Research Database (Denmark)

    Folker, Anna Paldam; Andersen, Hanne; Sandøe, Peter

    2008-01-01

    This paper focuses on implicit normative considerations underlying scientific advice-those normative questions, decisions, or issues that scientific advisers and the general public are not fully aware of but that nevertheless have implications for the character of the advice given. Using...... nutritional science as an example, we identify three such implicit normative issues. The first concerns the aim of scientific advice: whether it is about avoiding harm or promoting good. The second concerns the intended beneficiaries of the advice: whether advice should be framed to benefit the society...... as a whole or with special concern for the most vulnerable members of the population. The third consideration involves scientific advisers' attempts to balance the strengths of the scientific evidence with the expected consequences of scientific advice. We hope to promote more explicit discussion...

  4. Implicit normativity in scientific advice

    DEFF Research Database (Denmark)

    Folker, Anna Paldam; Andersen, Hanne; Sandøe, Peter

    2008-01-01

    This paper focuses on implicit normative considerations underlying scientific advice-those normative questions, decisions, or issues that scientific advisers and the general public are not fully aware of but that nevertheless have implications for the character of the advice given. Using nutritio...

  5. Dietary advice in family medicine.

    NARCIS (Netherlands)

    Weel, C. van

    2003-01-01

    This article discusses the conceptual basis of dietary advice in family medicine. Given the large number of illnesses and diseases encountered in family practice for which diet and nutrition are relevant interventions, food-related advice is an important part of daily practice. To enhance the

  6. Young children heed advice selectively.

    Science.gov (United States)

    Rakoczy, Hannes; Ehrling, Christoph; Harris, Paul L; Schultze, Thomas

    2015-10-01

    A rational strategy to update and revise one's uncertain beliefs is to take advice by other agents who are better informed. Adults routinely engage in such advice taking in systematic and selective ways depending on relevant characteristics such as reliability of advisors. The current study merged research in social and developmental psychology to examine whether children also adjust their initial judgment to varying degrees depending on the characteristics of their advisors. Participants aged 3 to 6 years played a game in which they made initial judgments, received advice, and subsequently made final judgments. They systematically revised their judgments in light of the advice, and they did so selectively as a function of advisor expertise. They made greater adjustments to their initial judgment when advised by an apparently knowledgeable informant. This suggests that the pattern of advice taking studied in social psychology has its roots in early development. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Advice concerning radiotherapy

    International Nuclear Information System (INIS)

    1984-01-01

    Dutch National cancer incidence figures were calculated by using the reliable data on cancer incidence in the Eindhoven area and population forecasts and information obtained from the Central Bureau of Statistics. Several radiotherapy departments suffer from under capacity (a lack of resources and understaffing). Data have also shown that 35% of cancer patients receive radiotherapy, instead of 50%. Calculations have been made by the committee on the present and future needs with regard to equipment and staff. In 1983, the number of megavoltage therapy units amounted to 38, but should have been 65. It should be 80 in 1990 and 90 in 2000. Since building and installing such equipment is a lengthy process a considerable effort is needed to make up for the arrears. The committee advocates the extension of the system of regional cooperation in cancer care (comprehensive cancer centres), in which radiotherapy departments play a crucial role. Working parties from the committee provided a comprehensive description of current radiotherapy practice with reference to physical, technical, clinical and management aspects. Another working party assessed the results of cancer treatment with regard to many different tumour sites. Recent and expected developments were analysed or indicated. The Radiotherapy Committee commissioned an external team to conduct a project to achieve a picture of future developments using methods different to those of the committee's. An interim advice has been added on this subject. (Auth.)

  8. Physician advice for smoking cessation.

    Science.gov (United States)

    Stead, Lindsay F; Buitrago, Diana; Preciado, Nataly; Sanchez, Guillermo; Hartmann-Boyce, Jamie; Lancaster, Tim

    2013-05-31

    Healthcare professionals frequently advise people to improve their health by stopping smoking. Such advice may be brief, or part of more intensive interventions. The aims of this review were to assess the effectiveness of advice from physicians in promoting smoking cessation; to compare minimal interventions by physicians with more intensive interventions; to assess the effectiveness of various aids to advice in promoting smoking cessation, and to determine the effect of anti-smoking advice on disease-specific and all-cause mortality. We searched the Cochrane Tobacco Addiction Group trials register in January 2013 for trials of interventions involving physicians. We also searched Latin American databases through BVS (Virtual Library in Health) in February 2013. Randomised trials of smoking cessation advice from a medical practitioner in which abstinence was assessed at least six months after advice was first provided. We extracted data in duplicate on the setting in which advice was given, type of advice given (minimal or intensive), and whether aids to advice were used, the outcome measures, method of randomisation and completeness of follow-up.The main outcome measure was abstinence from smoking after at least six months follow-up. We also considered the effect of advice on mortality where long-term follow-up data were available. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates where available. People lost to follow-up were counted as smokers. Effects were expressed as relative risks. Where possible, we performed meta-analysis using a Mantel-Haenszel fixed-effect model. We identified 42 trials, conducted between 1972 and 2012, including over 31,000 smokers. In some trials, participants were at risk of specified diseases (chest disease, diabetes, ischaemic heart disease), but most were from unselected populations. The most common setting for delivery of advice was primary care. Other settings included hospital

  9. Actions and advice in coli

    DEFF Research Database (Denmark)

    Knoche, Hendrik; Jamadagni, HS; Rao, PR Sheshagiri

    2015-01-01

    To improve their agricultural output, farmers require timely and contextualized information and advice. Relevant information and advice provided by trusted peers represents a promising approach. We present the considerations for the design of coli, an agricultural information network on touch...... screen equipped smart phones and results from its 10-month trial with 15 farmers in a village in India. Although some farmers avoided dispensing prescriptive advice in person due to fear of liability, they had no reservations about sharing their farming activities via a mobile phone application. Richer...

  10. Young tertiary students and help-seeking for health advice.

    Science.gov (United States)

    Batten, Lesley; Dutton, Jane

    2011-11-01

    Help-seeking is an active process used by people of all ages to obtain assistance to solve problems. This research sought to investigate a component of help-seeking related to health concerns. A health related help-seeking model, was adapted to frame questions for an anonymous, self-administered questionnaire. Seventy-five students aged between 16 and 24 years responded and data were analysed using content and descriptive statistical techniques. Findings indicated that young people perceived the need to seek advice when unwell, needing support or information, are resourceful, and were motivated to seek help from a variety of sources. Parents and whānau formed one usual source of advice, but young people reported one of the best sources of advice as General Practice nurses and doctors. Barriers to seeking advice included distrusting sources, and concerns about confidentiality. Unsurprisingly, many respondents used the Internet for health information, although some mistrusted that information. Nurses need to be aware of the sources of health advice and support that young people choose to use. Motivations for selecting services, providers, or sources clearly replicated what young people hold as important--sources with which they feel comfortable, have a relationship, trust, and which they perceived as maintaining confidentiality.

  11. Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature

    Directory of Open Access Journals (Sweden)

    Hulshof Carel

    2005-08-01

    Full Text Available Abstract Background Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based practice and EBM we compared professional advice on occupational health topics with best evidence from the literature. Methods We asked 14 occupational physicians to consult their usual information sources on 12 pre-conceived occupational health problems. The problems were presented in the form of case vignettes which contained sufficient clinical information to be used by the occupational physicians for the consultation of their experts. We had searched the literature for the best available evidence on the 12 problems, which made it possible to answer the clinical questions with a clear yes or no. Results The cases could be used by the occupational physicians as arising from their own practice. All together the occupational physicians consulted 75 different experts. Almost half of the consulted experts were near colleagues, 10% were industrial hygienists, 8% medical specialists and the rest had a varied background. Fifty three percent (95% confidence interval 42% to 65% of all professional advice was not in line with the research literature. In 18 cases (24% professional advice explicitly referred to up-to-date research literature as their used source. These cases were substantially less incorrect (17% than advice that had not mentioned the literature as a source (65% (difference 48%, 95% Confidence Interval from 27% to 69%. Conclusion Advice that occupational physicians routinely get in their daily practice differs substantially from best evidence from the literature. Occupational physicians who ask professional advice should always ask about the evidence of this advice.

  12. What Really Drives Advice Seeking Behaviour? Looking Beyond the Subject of Legal Disputes

    Directory of Open Access Journals (Sweden)

    Stian Reimers

    2011-10-01

    Full Text Available When faced with a broad range of justiciable problems, people seek advice for around half of them, and advice from lawyers on around 13% of occasions. Various factors have been found to link to advice seeking behaviour, but it is commonly recognized that problem type ‘swamps’ other factors. This study draws on an Internet survey of 1,031 respondents, aged between 16 and 66, in which respondents were presented with a range of problem scenarios and asked to place them on a severity scale, characterize them (as legal or otherwise and suggest an appropriate source of advice. The study assesses the impact of problem severity and legal characterization on the likelihood of identifying legal advice, advice sector advice or other advice as being appropriate. Even having controlled for problem type, both problem severity and characterization have a highly significant impact on adviser choice. As severity increases, so does the likelihood of suggesting legal advice is appropriate. Where problems are characterized as legal, there is a significant increase in the likelihood of suggesting a lawyer across problem types. However, choice of advice sector advice was relatively unaffected by characterization. The findings move us beyond problem type being the primary explanation of advice seeking behaviour, and are discussed in the context of legal service delivery as well as with reference to Felstiner et al’s model of disputing behaviour.DOWNLOAD THIS PAPER FROM SSRN: http://ssrn.com/abstract=1934140

  13. Advice dilemmas: Managing advice against the competing public ...

    African Journals Online (AJOL)

    Key to resolving this issue is an acknowledgement that, whether as counsellor or health adviser, persuasion and influence are central features of the VCT interaction. Clear practice guidelines and tools are required to assist counsellors to distinguish between advice, suggestion or mere confirmation of an intended client ...

  14. Sleep Deprivation and Advice Taking

    NARCIS (Netherlands)

    Hausser, J.A.; Leder, J.; Ketturat, C.; Dresler, M.; Faber, N.S.

    2016-01-01

    Judgements and decisions in many political, economic or medical contexts are often made while sleep deprived. Furthermore, in such contexts individuals are required to integrate information provided by - more or less qualified - advisors. We asked if sleep deprivation affects advice taking. We

  15. Financial Literacy, Confidence and Financial Advice Seeking

    NARCIS (Netherlands)

    Kramer, Marc M.

    2016-01-01

    We find that people with higher confidence in their own financial literacy are less likely to seek financial advice, but no relation between objective measures of literacy and advice seeking. The negative association between confidence and advice seeking is more pronounced among wealthy households.

  16. Advice taking from humans and machines: an fMRI and effective connectivity study

    Directory of Open Access Journals (Sweden)

    Kimberly Goodyear

    2016-11-01

    Full Text Available With new technological advances, advice can come from different sources such as machines or humans, but how individuals respond to such advice and the neural correlates involved need to be better understood. We combined functional MRI and multivariate Granger causality analysis with an X-ray luggage-screening task to investigate the neural basis and corresponding effective connectivity involved with advice utilization from agents framed as experts. Participants were asked to accept or reject good or bad advice from a human or machine agent with low reliability (high false alarm rate. We showed that unreliable advice decreased performance overall and participants interacting with the human agent had a greater depreciation of advice utilization during bad advice compared to the machine agent. These differences in advice utilization can be perceivably due to reevaluation of expectations arising from association of dispositional credibility for each agent. We demonstrated that differences in advice utilization engaged brain regions that may be associated with evaluation of personal characteristics and traits (precuneus, posterior cingulate cortex, temporoparietal junction and interoception (posterior insula. We found that the right posterior insula and left precuneus were the drivers of the advice utilization network that were reciprocally connected to each other and also projected to all other regions. Our behavioral and neuroimaging results have significant implications for society because of progressions in technology and increased interactions with machines.

  17. Specific antismoking advice after stroke

    DEFF Research Database (Denmark)

    Hornnes, Nete; Larsen, Klaus; Brink-Kjær, Tove

    2014-01-01

    INTRODUCTION: Many stroke survivors would benefit from modification of their lifestyle in order to reduce their risk of recurrent stroke. We investigated if tailored smoking cessation advice would yield a higher smoking cessation rate and a higher rate with sustained abstinence in ex......-smokers in the intervention group than among controls. MATERIAL AND METHODS: Patients admitted with an acute stroke or a transient ischaemic attack were included in a randomised controlled trial focusing on control of lifestyle risk factors and hypertension. Here, we report the intervention focused on smoking cessation. We...

  18. Giving advice to agents with hidden goals

    CSIR Research Space (South Africa)

    Rosman, Benjamin S

    2014-05-01

    Full Text Available on an approximation of the trade-off in utility between potential benefits to the exploring agent and the costs incurred in giving this advice. This model is evaluated on a maze world domain by providing advice to different types of agents, and we show that this leads...

  19. Young Children's Trust in Overtly Misleading Advice

    Science.gov (United States)

    Heyman, Gail D.; Sritanyaratana, Lalida; Vanderbilt, Kimberly E.

    2013-01-01

    The ability of 3- and 4-year-old children to disregard advice from an overtly misleading informant was investigated across five studies (total "n" =212). Previous studies have documented limitations in young children's ability to reject misleading advice. This study was designed to test the hypothesis that these limitations are primarily…

  20. Explaining customer experience of digital financial advice

    NARCIS (Netherlands)

    van Raaij, W.F.

    2017-01-01

    The goal of this paper is to analyze the customer experience of digital-driven financial advice systems. It is the objective of this study to develop a cross-cultural model for validating customer experiences of digital financial advice. In doing so, both objective and subjective system aspects have

  1. 5 CFR 2635.107 - Ethics advice.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Ethics advice. 2635.107 Section 2635.107 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.107 Ethics advice. (a) As required by §§ 2638.201...

  2. Advice on protection against ultraviolet radiation. Consultation document

    International Nuclear Information System (INIS)

    McKinlay, A.; Driscoll, C.; Meara, J.

    2002-01-01

    The National Radiological Protection Board (NRPB) has a statutory responsibility to provide advice and information on standards of protection for exposure to non-ionising radiation. This includes the health effects and hazards associated with exposure to ultraviolet radiation (UVR). The Board discharges its responsibility to review and summarise the relevant scientific evidence in part through its independent Advisory Group on Non-ionising Radiation (AGNIR) which has a remit: 'to review work on the biological effects of non-ionising radiation relevant to human health and to advise on research priorities'. In its seventh report AGNIR (2002) updated its previous review of the health effects of exposure to UVR (AGNIR, 1995) and provided general guidance on methods of protection against exposure. In this consultation document, NRPB gives advice on limiting exposure to UVR. Both quantitative limits on exposure that will prevent short-term adverse effects on health and cautionary measures to reduce exposure and the risk of long-term adverse effects are provided. It also presents practical guidance on protection against UVR exposure from the sun and from artificial sources and aims to increase awareness of these effects. This advice applies to members of the public and to those who are occupationally exposed. This advice does not apply to exposures arising as a result of diagnostic or treatment procedures carried out under the supervision of a qualified medical practitioner. (author)

  3. Development and feasibility of falls prevention advice.

    Science.gov (United States)

    van Harten-Krouwel, Diny; Schuurmans, Marieke; Emmelot-Vonk, Mariëlle; Pel-Littel, Ruth

    2011-10-01

    This study examined the feasibility of nursing falls prevention advice and factors influencing feasibility. The frequency and seriousness of falls in hospitalised patients are underestimated, and such falls should be preventable because of the presence of professionals. A best practice-based falls prevention advice was developed to decrease the incidence of secondary falls and the incidence of primary falls in the long term and to increase the knowledge of nurses about falls prevention and the seriousness of falls. A descriptive, explorative study. Feasibility of the advice for 30 patients was assessed 82 times (theoretically, three times per patient) by observation and by interviewing nurses, patients and their families. The falls prevention advice was used in 48% of the assessments. There was a difference in use between interventions. Interventions that required more knowledge, communication and extra activities were implemented the least. The absence of materials and knowledge about falls prevention were important determinants of the non-implementation of certain interventions. Before falls prevention advice is implemented, it is important to educate nurses about falls, communication skills and implementation of the advice. The falls prevention advice might help nurses to prevent falls and increase their knowledge about falls prevention. © 2011 Blackwell Publishing Ltd.

  4. Opioid Overdose Prevention: Safety Advice for Patients & Family Members

    Science.gov (United States)

    SAMHSA Opioid Overdose Prevention TOOLKIT: Safety Advice for Patients & Family Members TABLE OF CONTENTS Safety Advice for Patients & Family ... Advice for Patients & Family Members. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 What Are Opioids. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Preventing Overdose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 If You Suspect an ...

  5. Destination image and crime in Mexico: An analysis of foreign government travel advice

    Directory of Open Access Journals (Sweden)

    J. Carlos Monterrubio

    2013-01-01

    Full Text Available Destination image has been recognised as an influential component of travel decision processes. Although organic sources of information play an important role in shaping destination image, researchers have often ignored the types of sources and the information they deliver. In particular, official websites where government travel advice is given, especially in relation to crime, have been widely excluded from scholarly research. This paper analyses the relationship between crime-related travel advice given by foreign governments and Mexico’s destination image. Qualitative content analysis of official websites from the US, Canada, the UK and Spain reveals that the travel advice given relates largely to the violence and insecurity that Mexico is currently experiencing. “No advisory in effect”, “Exercise caution” and “Defer non-essential travel” are messages commonly found in the governments’ travel advice about Mexico.

  6. Nutritional advice for community patients: insights from a panel discussion.

    Science.gov (United States)

    Thomas, Linda V; Jenkins, Gill; Belton, Julie; Clements, Suzie; Jacob, Ciara; Johnson, Naomi; Joy, Deirdre; Low, Jennifer; Munson, Eileen; Sheppard, Jessica

    2016-03-01

    This article describes the conclusions of an expert panel that discussed four case studies; these were examples of patients typically encountered by nurses working in the community. The panel considered the nutritional and lifestyle advice that could be given by nurses relating to conditions such as irritable bowel syndrome (IBS), depression, chronic fatigue syndrome, vulnerability to common infections, elderly care, recurrent urinary tract infection, antibiotic use, and risk of type 2 diabetes. A general conclusion was the importance of motivational interviewing techniques in achieving full understanding of patients' concerns and to determine the best health strategy. As well as specific guidance appropriate for each disorder, a range of information sources for both health professionals and patients are listed in the paper. The panel noted that, although general nutritional advice can be given by nurses working at GP surgeries and in the community, patients should always be referred to registered dietitians or nutritionists if significant dietary changes are considered.

  7. Explaining customer experience of digital financial advice

    OpenAIRE

    van Raaij, W.F.

    2017-01-01

    The goal of this paper is to analyze the customer experience of digital-driven financial advice systems. It is the objective of this study to develop a cross-cultural model for validating customer experiences of digital financial advice. In doing so, both objective and subjective system aspects have been considered. It is found that experiential subjective system aspects are the most important. Surveys have been conducted in The United Kingdom and The Netherlands. In exploratory factor analys...

  8. Advice for running a successful research team.

    Science.gov (United States)

    Stanley, David; Anderson, Judith

    2015-11-01

    To explore what is meant by a 'research team' and offer practical suggestions for supporting an effective and productive, collaborative research team. Collaborative research has become one of the main objectives of most higher education institutions and running effective research teams is central to achieving this aim. However, there is limited guidance in the literature about how to run or steer a research team. Search engines/databases used: CINAHL, Nursing and Allied Health Source, Primo search, Google search and Health Collection to access research articles and publications to support this topic. Literature search was extended to the end of 2014. Publications were reviewed for relevance to the topic via standard literature search. Research teams vary in size and composition, however they all require effective collaboration if they are to establish successful and flexible working relationships and produce useful and trustworthy research outputs. This article offers guidance for establishing and managing successful collaborative research relationships, building trust and a positive research team culture, clarifying team member roles, setting the teams' research agenda and managing the teams' functions so that team members feel able to contribute fully to the research goals and build a culture of support and apply 'emotional intelligence' throughout the process of building and running a successful research team. Collaboration is a central component of establishing successful research teams and enabling productive research outputs. This article offers guidance for research teams to help them to function more effectively and allow all members to contribute fully to each team's goals. Research teams that have established trust and a positive team culture will result in more efficient working relationships and potentially greater productivity. The advice offered reinforces the value of having research teams with diverse members from different disciplines

  9. 4 CFR 28.8 - Informal procedural advice.

    Science.gov (United States)

    2010-01-01

    ... 4 Accounts 1 2010-01-01 2010-01-01 false Informal procedural advice. 28.8 Section 28.8 Accounts... Procedures § 28.8 Informal procedural advice. (a) Persons may seek informal advice on all aspects of the..., General Counsel or the Clerk of the Board. (b) Informal procedural advice will be supplied within the...

  10. Linked analysis for definition of nurse advice line syndrome groups, and comparison to encounters.

    Science.gov (United States)

    Magruder, Steven F; Henry, J; Snyde, M

    2005-08-26

    Nurse advice call centers are a potentially important source of data for syndromic surveillance purposes. For this reason, researchers at Johns Hopkins University Applied Physics Laboratory and Kaiser Permanente of the Mid-Atlantic States (KPMAS) have been collaborating to develop methods to use this data within the ESSENCE II Syndromic Surveillance System in the National Capital Region. The objective of this report is to present a general method for finding syndrome groups in data sources that can be linked to physician encounters and to determine effective advice call syndrome groups for use with KPMAS advice data. Advice calls are linked to physician encounters and stratified by patient age. They are placed in groups according to a maximum positive predictive value criterion. The groups are evaluated by correlating the resulting syndrome time series against physician encounter data. Potentially useful advice syndrome groups are found for respiratory, lower gastrointestinal (GI), and total GI syndromes for each age stratum. The time series of the advice data for respiratory, lower GI, and upper GI syndromes accurately predict the physician encounter time series for the corresponding syndromes for each age stratum.

  11. Following celebrities’ medical advice: meta-narrative analysis

    Science.gov (United States)

    Tan, Charlie

    2013-01-01

    Objective To synthesise what is known about how celebrities influence people’s decisions on health. Design Meta-narrative analysis of economics, marketing, psychology, and sociology literatures. Data sources Systematic searches of electronic databases: BusinessSource Complete (1886-), Communication & Mass Media Complete (1915-), Humanities Abstracts (1984-), ProQuest Political Science (1985-), PsycINFO (1806-), PubMed (1966-), and Sociology Abstracts (1952-). Inclusion criteria Studies discussing mechanisms of celebrities’ influence on people in any context. Results Economics literature shows that celebrity endorsements act as signals of credibility that differentiate products or ideas from competitors and can catalyse herd behaviour. Marketing studies show that celebrities transfer their desirable attributes to products and use their success to boost their perceived credibility. Psychology shows that people are classically conditioned to react positively to the advice of celebrities, experience cognitive dissonance if they do not, and are influenced by congruencies with their self conceptions. Sociology helps explain the spread of celebrity medical advice as a contagion that diffuses through social networks and people’s desire to acquire celebrities’ social capital. Conclusions The influence of celebrity status is a deeply rooted process that can be harnessed for good or abused for harm. A better understanding of celebrity can empower health professionals to take this phenomenon seriously and use patient encounters to educate the public about sources of health information and their trustworthiness. Public health authorities can use these insights to implement regulations and restrictions on celebrity endorsements and design counter marketing initiatives—perhaps even partnering with celebrities—to discredit bogus medical advice while promoting evidence based practices.

  12. Post-tonsillectomy dietary advice: systematic review.

    Science.gov (United States)

    Millington, A J F; Gaunt, A C; Phillips, J S

    2016-10-01

    To determine if there is evidence that post-tonsillectomy dietary advice affects post-operative morbidity. A systematic review was conducted of Embase, Medline, the Cumulative Index to Nursing and Allied Health Literature and PsycInfo, to November 2014. Seventeen articles were included; their heterogeneous nature prevented meta-analysis. Of these, all three small, randomised studies showed no statistical difference in morbidity between restricted and non-restricted diets. Most post-tonsillectomy dietary advice is based on historical anecdotes and not rigorous scientific testing. The existing small-scale, randomised studies show no statistical difference in morbidity between non-restricted and restricted diets.

  13. [Pharmaceutical advice concerning different pharmaceutical dosage forms].

    Science.gov (United States)

    Szakonyi, Gergely; Zelkó, Romána

    2010-01-01

    The present paper summarizes the commonly applied types of drug uptake and the pharmacists' advice concerning a certain dosage form. The manuscript also deals with the modified release dosage forms and their abbreviations in the name of the marketing authorized products.

  14. Advice Complexity of the Online Search Problem

    DEFF Research Database (Denmark)

    Clemente, Jhoirene; Hromkovič, Juraj; Komm, Dennis

    2016-01-01

    The online search problem is a fundamental problem in finance. The numerous direct applications include searching for optimal prices for commodity trading and trading foreign currencies. In this paper, we analyze the advice complexity of this problem. In particular, we are interested in identifying...

  15. Generating personalized advice for schizophrenia patients

    NARCIS (Netherlands)

    Emerencia, A.; van der Krieke, Lian; Sytema, S.; Petkov, N.; Aiello, M.

    The results of routine patient assessments in psychiatric healthcare in the Northern Netherlands are primarily used to support clinicians. We developed Wegweis, a web-based advice platform, to make this data accessible and understandable for patients. Objective: We show that a fully automated

  16. Advice under uncertainty in the marine system

    DEFF Research Database (Denmark)

    Dankel, Dorothy J.; Aps, Robert; Padda, Gurpreet

    2012-01-01

    lacking. Fisheries science that gives advice to policy-making is plagued by uncertainties; the stakes of the policies are high and value-laden and need therefore to be treated as an example of “post-normal science” (PNS). To achieve robust governance, understanding of the characteristics and implications...

  17. A New Paradigm in Mortgage Loan Advice

    DEFF Research Database (Denmark)

    Otterstedt, Margrét Sesselja; Rasmussen, Kourosh Marjani; Kulahci, Murat

    2013-01-01

    The Danish mortgage market has undergone considerable changes during the last 15 years. New and more complex variations of loan products have been introduced. Nevertheless, mortgage loan advice has remained, by large, unchanged. This paper addresses a study where a number of new refinancing rules...

  18. Voting Advice Applications and electoral turnout

    NARCIS (Netherlands)

    Gemenis, Konstantinos; Rosema, Martin

    2014-01-01

    In the last two decades Voting Advice Applications (VAAs) have become popular tools among voters, especially in several countries with a multi-party system. In this paper we test if the use of VAAs stimulates electoral participation. We use survey data from the Netherlands, where such tools are

  19. Dietary advice in HFE-hemochromatosis

    NARCIS (Netherlands)

    Doorn, van G.M.; Gosselink, I.M.G.

    2012-01-01

    This report aims to provide dietary advice which is based on what is known so far about the effect of a diet, particularly on iron overload in HFE-hemochromatosis. The reason that the recommendations in principle apply only to the group of individuals with HFE-gene mutations and are focused on the

  20. 5 CFR 2641.105 - Advice.

    Science.gov (United States)

    2010-01-01

    ... Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS POST-EMPLOYMENT CONFLICT OF INTEREST RESTRICTIONS General Provisions § 2641.105 Advice. (a) Agency ethics officials.Current or former employees or... designated agency ethics official or another agency ethics official. The agency in which an individual...

  1. Mortgage risks, debt literacy and financial advice

    NARCIS (Netherlands)

    van Ooijen, Raun; van Rooij, Maarten C.J.

    2016-01-01

    A limited understanding of mortgage contracts and the risks involved may have contributed to the outbreak of the 2007–2008 financial crisis. We developed a special questionnaire relating mortgage loan decisions to financial knowledge and financial advice. Our results demonstrate that homeowners

  2. Advice to young behavioral and cognitive scientists.

    Science.gov (United States)

    Weisman, Ronald G

    2008-02-01

    Modeled on Medawar's Advice to a Young Scientist [Medawar, P.B., 1979. Advice to a Young Scientist. Basic Books, New York], this article provides advice to behavioral and cognitive scientists. An important guiding principle is that the study of comparative cognition and behavior are natural sciences tasked with explaining nature. The author advises young scientists to begin with a natural phenomenon and then bring it into the laboratory, rather than beginning in the laboratory and hoping for an application in nature. He suggests collaboration as a way to include research outside the scientist's normal competence. He then discusses several guides to good science. These guides include Tinbergen's [Tinbergen, N., 1963. On aims and methods of ethology. Zeitschrift für Tierpsychologie, 20, 410-433. This journal was renamed Ethology in 1986. Also reprinted in Anim. Biol. 55, 297-321, 2005] four "why" questions, Platt's [Platt, J.R., 1964. Strong inference. Science 146, 347-353, (http://weber.ucsd.edu/~jmoore/courses/Platt1964.pdf)] notion of strong inference using multiple alternative hypotheses, and the idea that positive controls help scientists to follow Popper's [Popper, K.R., 1959. The Logic of Scientific Discovery. Basic Books, New York, p. 41] advice about disproving hypotheses. The author also recommends Strunk and White's [Strunk, W., White, E.B., 1979. The Elements of Style, third ed. Macmillan, New York] rules for sound writing, and he provides his personal advice on how to use the anticipation of peer review to improve research and how to decode editors' and reviewers' comments about submitted articles.

  3. Nutrigenomics-based personalised nutritional advice: in search of a business model?

    Science.gov (United States)

    Ronteltap, Amber; van Trijp, Hans; Berezowska, Aleksandra; Goossens, Jo

    2013-03-01

    Nutritional advice has mainly focused on population-level recommendations. Recent developments in nutrition, communication, and marketing sciences have enabled potential deviations from this dominant business model in the direction of personalisation of nutrition advice. Such personalisation efforts can take on many forms, but these have in common that they can only be effective if they are supported by a viable business model. The present paper takes an inventory of approaches to personalised nutrition currently available in the market place as its starting point to arrive at an identification of their underlying business models. This analysis is presented as a unifying framework against which the potential of nutrigenomics-based personalised advice can be assessed. It has uncovered nine archetypical approaches to personalised nutrition advice in terms of their dominant underlying business models. Differentiating features among such business models are the type of information that is used as a basis for personalisation, the definition of the target group, the communication channels that are being adopted, and the partnerships that are built as a part of the business model. Future research should explore the consumer responses to the diversity of "archetypical" business models for personalised nutrition advice as a source of market information on which the delivery of nutrigenomics-based personalised nutrition advice may further build.

  4. Are pharmacists ready for a greater role in travel health? An evaluation of the knowledge and confidence in providing travel health advice of pharmacists practicing in a community pharmacy chain in Alberta, Canada.

    Science.gov (United States)

    Bascom, Christina S; Rosenthal, Meagen M; Houle, Sherilyn K D

    2015-01-01

    Patients often consult community pharmacists for medication needs related to travel, but little is known of pharmacists' knowledge and readiness to provide this care. The aim of this study was to evaluate pharmacists' knowledge in travel health, and to assess their confidence in providing travel-related advice to patients. A web-based survey was developed and distributed to 84 pharmacists practicing in a mid-size pharmacy chain in Alberta, Canada. The survey included knowledge and confidence assessment components. To assess knowledge, pharmacists were provided two cases, along with multiple-choice questions examining pre-travel risk assessment, and advice on travel at altitude, vaccines, malaria, travelers' diarrhea, and other potential travel health risks. Confidence was assessed by asking respondents to report their level of confidence in answering each knowledge assessment question and providing travel advice overall, using a 5-point Likert scale. Respondents were also asked to indicate preferred means for receiving additional training in travel health. A total of 53 pharmacists responded to the survey, with a response rate of 63%. Most (61%) indicated that they had some level of training in travel health and 69% counseled on travel health more than once a month. Only one respondent correctly answered all six questions in the knowledge assessment section. The mean knowledge score (proportion of correct answers, unaided) for the group was 27%. However, the majority (66%) felt confident that they would know where to seek the information required to answer the questions. Overall confidence in this group of pharmacists was determined to be low, with only 21% of respondents reporting that they felt highly confident in providing travel health advice. Travel health is becoming an increasingly common topic of discussion between patients and pharmacists. This study suggests that pharmacists' baseline knowledge of travel health may be incomplete, affecting their

  5. Dietary advice for muscularity, leanness and weight control in Men's Health magazine: a content analysis.

    Science.gov (United States)

    Cook, Toni M; Russell, Jean M; Barker, Margo E

    2014-10-11

    The dietary content of advice in men's lifestyle magazines has not been closely scrutinised. We carried out an analysis of such content in all 2009 issues (n = 11) of Men's Health (MH) focusing on muscularity, leanness and weight control. Promotion of a mesomorphic body image underpinned advice to affect muscle building and control weight. Diet advice was underpinned by a strong pseudo-scientific discourse, with citation of expert sources widely used to legitimise the information. Frequently multiple dietary components were advocated within one article e.g. fat, omega-3 fatty acids, thiamine, zinc and high-glycaemic index foods. Furthermore advice would cover numerous nutritional effects, e.g. strengthening bones, reducing stress and boosting testosterone, with little contextualisation. The emphasis on attainment of a mesomorphic body image permitted promotion of slimming diets.Advice to increase calorie and protein intake to augment muscle mass was frequent (183 and 262 references, respectively). Such an anabolic diet was advised in various ways, including consumption of traditional protein foods (217 references) and sports foods (107 references), thereby replicating muscle magazines' support for nutritional supplements. Although advice to increase consumption of red meat was common (52 references), fish and non-flesh sources of protein (eggs, nuts & pulses, and soy products) together exceeded red meat in number of recommendations (206 references). Advice widely asserted micronutrients and phytochemicals from plant food (161 references) as being important in muscle building. This emphasis diverges from stereotypical gender-based food consumption patterns.Dietary advice for control of body weight largely replicated that of muscularity, with strong endorsement to consume fruits and vegetables (59 references), diets rich in nuts and pulses and fish (66 references), as well as specific micronutrients and phytochemicals (62 references). Notably there was emphasis on

  6. Leaping ''out of the doubt''- nutrition advice

    DEFF Research Database (Denmark)

    Folker, Anna Paldam; Sandøe, Peter

    2008-01-01

    This article deals with scientific advice to the public where the relevant science is subject to public attention and uncertainty of knowledge. It focuses on a tension in the management and presentation of scientific uncertainty between the uncertain nature of science and the expectation that sci......This article deals with scientific advice to the public where the relevant science is subject to public attention and uncertainty of knowledge. It focuses on a tension in the management and presentation of scientific uncertainty between the uncertain nature of science and the expectation....... The analysis is structured around the extremes of either total concealment or full openness regarding scientific uncertainty. The result of analysis is that scientific advisers should not simply ''feed'' scientific conclusions to the public. They should rather attempt to promote the ability and willingness...

  7. Communication of Science Advice to Government.

    Science.gov (United States)

    Hutchings, Jeffrey A; Stenseth, Nils Chr

    2016-01-01

    There are various ways to construct good processes for soliciting and understanding science. Our critique of advisory models finds that a well-supported chief science advisor (CSA) best ensures the provision of deliberative, informal, and emergency advice to government. Alternatively, bias, increasingly manifest as science-based advocacy, can hinder communication, diminish credibility, and distort scientific evidence. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Agent Argumentation with Opinions and Advice

    Science.gov (United States)

    Debenham, John; Sierra, Carles

    In argumentation-based negotiation the rhetorical illocutionary particles Appeals, Rewards and Threats have implications for the players that extend beyond a single negotiation and are concerned with building (business) relationships. This paper extends an agent's relationship-building argumentative repertoire with Opinions and Advice. A framework is described that enables agents to model their relationships and to use argumentative dialogue strategically both to achieve good negotiation outcomes and to build and sustain valuable relationships.

  9. Maintaining clinical governance when giving telephone advice.

    Science.gov (United States)

    Alazawi, William; Agarwal, Kosh; Suddle, Abid; Aluvihare, Varuna; Heneghan, Michael A

    2013-10-01

    Delivering excellent healthcare depends on accurate communication between professionals who may be in different locations. Frequently, the first point of contact with the liver unit at King's College Hospital (KCH) is through a telephone call to a specialist registrar or liver fellow, for whom no case notes are available in which to record information. The aim of this study was to improve the clinical governance of telephone referrals and to generate contemporaneous records that could be easily retrieved and audited. An electronic database for telephone referrals and advice was designed and made securely available to registrars in our unit. Service development in a tertiary liver centre that receives referrals from across the UK and Europe. Demographic and clinical data were recorded prospectively and analysed retrospectively. Data from 350 calls were entered during 5 months. The information included the nature and origin of the call (200 from 75 different institutions), disease burden and severity of disease among the patients discussed with KCH, and outcome of the call. The majority of cases were discussed with consultants or arrangements were made for formal review at KCH. A telephone referrals and advice database provides clinical governance, serves as a quality indicator and forms a contemporaneous record at the referral centre. Activity data and knowledge of disease burden help to tailor services to the needs of referrers and commissioners. We recommend implementation of similar models in other centres that give extramural verbal advice.

  10. Regulations and classification advice: transport safety

    International Nuclear Information System (INIS)

    Davies, M.; Owen, K.

    1990-01-01

    The packaging of radioactive material for transport must conform with the regulations of the International Atomic Energy Agency (IAEA). These regulations are extensive and complex and require specialist interpretation. Packaging must be designed to contain the material, to limit radiation to safe levels, and to maintain the material in a safe state under both normal and accident conditions. British Nuclear Fuels Ltd. (BNFL) developed the TRANAID expert system to provide automated expert advice on the subject. It is used at BNFL and by other users internationally. The system was produced to meet an internal BNFL emphasis on accurate consistent and reliable interpretation of the complex IAEA regulations; and to provide a commercial product which would meet an external need. TRANAID provides reliable and consistent advice on safe transport procedures which reduce the workload on scarce skilled personnel, and allows them to concentrate on their primary task of packaging design. TRANAID also avoids overclassifying radioactive shipments, which would lead to the use of more expensive packaging than strictly is required. The IAEA regulations are applied internationally, and so there is a large potential worldwide market. The indications from the initial response are that future sales and use are expected to more than cover the investment. Other non-quantifiable benefits include the provision of consistent advice within a uniform approach, the safe-guarding of knowledge of the IAEA regulations, training and improvement in the expertise of users, improved management control, and enhancement of the professional image of BNFL. (author)

  11. Lifestyle advice provision to teenage and young adult cancer patients: the perspective of health professionals in the UK.

    Science.gov (United States)

    Pugh, Gemma; Hough, Rachael; Gravestock, Helen; Williams, Kate; Fisher, Abigail

    2017-12-01

    Health professionals are an important source of information for teenage and young adult (TYA) cancer patients. However, little is known about health professionals' provision of lifestyle advice to young people with cancer who are in their care. An online survey was distributed to health professionals within the UK who identified themselves as working with TYA cancer patients. Health professional awareness of lifestyle guidance, provision of lifestyle advice to young people and views on lifestyle information format and delivery were explored. Ninety-five health professionals (44% nurses; 28% allied health professionals; 17% physicians) completed the survey. The majority (72%) of respondents were aware of some lifestyle guidance for cancer patients. However, less than half of TYA health professionals (46%) were able to successfully recall the source of the guidelines and less than a third reported proving specific advice to the majority of their patients on weight management, smoking, alcohol consumption and sun safety. Many health professionals (38%) felt that they were not the right person to provide advice and cited lack of resources as a key barrier to advice provision. The majority (95%) reported being interested in a resource containing relevant lifestyle information that could be given to young people with cancer. TYA health professionals' awareness of lifestyle guidance and provision of advice regarding health behaviour is sub-optimal. Clear and comprehensive guidance written specifically for TYA health professionals could overcome the reported barriers and improve professionals' confidence in addressing and providing advice on lifestyle to young people with cancer.

  12. Content and Style of Advice in Iran and Canada

    Science.gov (United States)

    Tavakoli, Mahin

    2013-01-01

    The content and nature of nonprofessional advice in Iran, a hierarchical and collectivist culture, was compared to the same type of advice in Canada, an egalitarian and individualist culture. A researcher developed a questionnaire that consisted of 10 letters, each describing a writer's problem and asking for advice. The responses of participants…

  13. The speech act of advice in Setswana educational contexts | Dlali ...

    African Journals Online (AJOL)

    The main purpose of this article is to examine the linguistic pragmatics of advice in Setswana. This article will attempt to present an account of the speech act of advice within the broad framework of Brown and Levinson's (1987) politeness theory and explore a range of features of advice in Setswana. The research ...

  14. Stepwise Advice Negotiation in Writing Center Peer Tutoring

    Science.gov (United States)

    Park, Innhwa

    2014-01-01

    While the delivery and reception of advice is a practice integral to a wide range of settings, little attention has been given to the detailed practices of advice resistance and how it leads to advice negotiation. Based on 7 hours of videotaped tutoring interactions among 6 tutors and 11 tutees, this conversation analytic study examines the…

  15. 32 CFR 776.10 - Informal ethics advice.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Informal ethics advice. 776.10 Section 776.10... § 776.10 Informal ethics advice. (a) Advisors. Covered attorneys may seek informal ethics advice either... of Director, JA Division, HQMC; and (5) Head, Standards of Conduct/Government Ethics Branch...

  16. Assessment of producers' response to Salmonella biosecurity issues and uptake of advice on laying hen farms in England and Wales.

    Science.gov (United States)

    Gosling, R J; Martelli, F; Wintrip, A; Sayers, A R; Wheeler, K; Davies, R H

    2014-01-01

    High standards of biosecurity are known to reduce the risk of disease outbreaks; however, uptake of advice and implementation of biosecurity measures are dependent on many factors. This study assessed the uptake of targeted biosecurity advice by 60 laying hen farms provided during biosecurity audit visits. Advice was provided as bullet point cards focusing on specific areas identified as benefitting from improvement. These covered site entrance, site tidiness, vaccination, boot hygiene, hand hygiene, house tidiness, rodent control, fly control, red mite control and cleaning and disinfection between flocks. Background knowledge of Salmonella and biosecurity and farmers' willingness and intent to implement additional measures were assessed. About 50% of the principal decision-makers had basic background knowledge of Salmonella, with 22% considered well informed; almost all agreed that biosecurity could impact on Salmonella control and many appeared willing to implement additional biosecurity measures. Sixty-three per cent of study farms were categorised using the Defra Farmer Segmentation Model as Modern Family Businesses (MFBs), with 7-11% of farms being categorised as Custodian, Lifestyle Choice, Pragmatist or Challenged Enterprise; however, categorisation, did not determine uptake of advice. The most frequently used advice cards were boot hygiene, red mite control, hand hygiene, site entrance and cleaning and disinfection; uptake of advice ranged from 54 to 80% depending on the advice card. Uptake of advice by the farmers was encouraging, especially considering it was being provided by people other than their usual source of biosecurity information. Those who did not implement the recommended measures cited cost, difficulty of enforcement and practicality as the main reasons. However, the positive uptake of advice and implementation of recommended measures by many farmers demonstrates that targeted advice, discussed face to face with farmers, on a small number of

  17. Using plant clinic registers to assess the quality of diagnoses and advice given to farmers

    DEFF Research Database (Denmark)

    Danielsen, Solveig; Boa, Eric; Mafabi, Moses

    2012-01-01

    Purpose: This study developed a framework for quality assessment of diagnoses and advice given at plant clinics. Design/methodology/approach: Clinic registers from five plant clinics in Uganda (2006-2010) were used to develop quality assessment protocols for diagnoses and advice given by plant...... validated diagnoses. The majority of recommendations (82%) were assessed ‘partially effective’. ‘Best practice’ was recommended for 10% and ineffective advice was given in 8% of the cases with considerable variation between diseases. Practical implications: Plant doctors need more training in symptom...... clinic registers have been used to systematically assess quality of plant clinic services. Apart from being a valuable tool for quality assessment of extension, the plant clinic registers constitute a novel source of regular information about pests, diseases and farmer demand that can help improve...

  18. Sources

    International Nuclear Information System (INIS)

    Duffy, L.P.

    1991-01-01

    This paper discusses the sources of radiation in the narrow perspective of radioactivity and the even narrow perspective of those sources that concern environmental management and restoration activities at DOE facilities, as well as a few related sources. Sources of irritation, Sources of inflammatory jingoism, and Sources of information. First, the sources of irritation fall into three categories: No reliable scientific ombudsman to speak without bias and prejudice for the public good, Technical jargon with unclear definitions exists within the radioactive nomenclature, and Scientific community keeps a low-profile with regard to public information. The next area of personal concern are the sources of inflammation. This include such things as: Plutonium being described as the most dangerous substance known to man, The amount of plutonium required to make a bomb, Talk of transuranic waste containing plutonium and its health affects, TMI-2 and Chernobyl being described as Siamese twins, Inadequate information on low-level disposal sites and current regulatory requirements under 10 CFR 61, Enhanced engineered waste disposal not being presented to the public accurately. Numerous sources of disinformation regarding low level radiation high-level radiation, Elusive nature of the scientific community, The Federal and State Health Agencies resources to address comparative risk, and Regulatory agencies speaking out without the support of the scientific community

  19. Advice on Writing a Scientific Paper

    Science.gov (United States)

    Sterken, C.

    2006-04-01

    What makes one author a good communicator and another a poor one? What turns out one manuscript a swift editorial task, and another an editorial nightmare? Based on direct experience from the manuscripts of the lectures and papers presented during this school, advice is given on what to do and on what to avoid when writing a scientific paper. Some feedback recommendation is also provided on how to prepare manuscripts, handle copyright and permissions to reproduce, how to anticipate plagiarism, how to deal with editors and referees, and how to avoid common errors. A few illustrations of English grammar and style for the foreign author are given.

  20. Nutritional supplement use by elite young UK athletes: fallacies of advice regarding efficacy

    OpenAIRE

    Petr?czi, Andrea; Naughton, Declan P; Pearce, Gemma; Bailey, Richard; Bloodworth, Andrew; McNamee, Michael

    2008-01-01

    Abstract Background The objective was to study nutritional supplement use among young elite UK athletes to establish whether a rationale versus practice incongruence exists, and to investigate the sources of information. Survey data were analysed for association between supplements used and motives for using such substances among young athletes along with the sources of advice and literature precedents on supplement effects. Methods Participants were elite UK male and female athletes, within ...

  1. Let Me Give You a Piece of Advice: Empirical Papers about Advice Taking in Marketing

    NARCIS (Netherlands)

    S.C. Tzioti (Stefanie)

    2010-01-01

    textabstractUsing advice in decision making is widespread for all sorts of important personal and professional decisions. Yet, traditional research on individual decision making has failed to systematically study the impact that social interactions about a decision problem can have on the decision

  2. sources

    Directory of Open Access Journals (Sweden)

    Shu-Yin Chiang

    2002-01-01

    Full Text Available In this paper, we study the simplified models of the ATM (Asynchronous Transfer Mode multiplexer network with Bernoulli random traffic sources. Based on the model, the performance measures are analyzed by the different output service schemes.

  3. The Financial Coaching Advice Model: An Exploration into how it Satisfies Expectations of Quality Advice

    Directory of Open Access Journals (Sweden)

    Julie Knutsen

    2012-11-01

    Full Text Available For 20 years, the financial planning sector in Australia has been transitioning from a sales-orientated force to aprofession of qualified and skilled practitioners. Today, the potential for professional financial planning adviceto benefit Australians financially, economically and psychologically is recognised by government. Financially,these benefits include increased savings, less interest expense through faster debt reduction, higher investmentreturns and appropriate levels of insurance. Economically, a more financially literate society has the potentialfor less reliance on an already burdened social security system. Psychologically, the benefits include the peaceof mind that comes from an individual being confident in financial matters. However, despite this level ofrecognition and development, national surveys have reported that only a small percentage of the populationactually seek professional financial advice. The factors attributing to these low percentages included the gapsin financial literacy limiting an individual’s engagement in financial matters and consumer’s current mistrust ofthe financial advice business models that remain dominated by commission-driven product sales. Thesedeficiencies have led some financial planning firms to break from financial product sales as the primary advicemodel and focus on financial coaching. Exploratory interviews with the practitioners and clients of a selectedfinancial planning firm have generated insightful discussion into how a financial coaching advice model isachieving the financial, economic and psychological benefits recognised by government as the potentialoutcomes of professional financial advice. The aim of this paper is to present the findings from that discussionand demonstrate the opportunities embedded within a financial coaching advice model. It is argued that thisdiscussion offers a foundation for future research direction in an area currently under researched in

  4. Advice from working women with retired partners.

    Science.gov (United States)

    Cooley, Eileen L; Adorno, Gail

    2016-01-01

    in the 21st century, as more women are employed full-time and couples increasingly share egalitarian values, more women continue employment after their partners have voluntarily retired. However, we know very little about the experiences of this growing population of women. We asked working women with retired partners to share their advice for other women who may face this developmental transition. Open-ended responses from 97 women were analyzed to identify pertinent issues and themes. Four primary content areas were identified: time management, division of household labor, financial planning, and communication. Communication between partners was both a topic of concern as well as the solution suggested to resolve conflicts or differences that may arise when women live with a retired partner. It is expected that future changes in the workforce and improvements in the gender balance within relationships will continue to impact experiences for working women with retired partners.

  5. Home visits for dietary advice reduce caries.

    Science.gov (United States)

    John, Jeyanthi

    2008-01-01

    This was a randomised field trial using block randomisation. A control group received routine assistance from their paediatricians in the health service, with research assessment usually within 1 month of the child's 6- and 12-month anniversary, then dietary advice by a fieldworker after the 12-month research assessment. The intervention group received home visits to advise the mother about healthy breastfeeding and weaning within 10 days of the child's birth, then monthly up to 6 months, then at 8, 10 and 12 months. This group also received the 6-month and 12-month research assessment and routine assistance from their paediatricians. Outcome measures were early childhood caries (ECC), defined as one or more caries surface of a tooth, duration of breastfeeding and dietary behaviours. Of the intervention group, 10.2% (16 out of 157) babies had caries compared with 18.3% (40 out of 219) babies in the control group. The odds of dental caries was 48% lower for the intervention group than for the controls (odds ratio, 0.52; 95% confidence interval, 0.27-0.97), after adjustment for the confounding effect of number of teeth. The intervention group had a longer mean duration of exclusive breastfeeding (X(2) P 0.000), later introduction of sugar (X(2) P 0.005) and a lower probability of their baby ever having eaten honey (X(2) P 0.003), chocolate or sweets (X(2) P 0.001), soft drinks (X(2) P 0.020), biscuits (X(2) P 0.000) and fromage frais cheese (X(2) P 0.001). Home visits for dietary advice appear to help reduce dental caries in infants. Greater efforts are needed to tackle cariogenic dietary behaviours, however, and further studies are required to examine any longer-term effect.

  6. Pretravel health advice among international travelers visiting Cuzco, Peru.

    Science.gov (United States)

    Cabada, Miguel M; Maldonado, Fernando; Quispe, Wanda; Serrano, Edson; Mozo, Karen; Gonzales, Elsa; Seas, Carlos; Verdonck, Kristien; Echevarria, Juan I; Gotuzzo, Eduardo

    2005-01-01

    Cuzco, a Peruvian city of historical interest located 3,326 m above sea level, is a frequent destination for tourists. We conducted a descriptive study to assess the extent and sources of pretravel health advice received by international travelers before their arrival to Cuzco. Data were collected as part of a health survey among travelers. Between August and November 2002, travelers between 15 and 65 years old were invited to fill out a questionnaire in the departing area of Cuzco's international airport. A total of 5,988 travelers participated. The mean age was 35.4 years (SD 11.4 yr); 50.6% were female and 50.8% were single. Tourism was the reason for traveling in 90.2% of the participants, and 89.3% of them were traveling with companions. Pretravel health information was received by 93.6%. The median number of information sources was two, with books (41.5%), travel medicine clinics (38.8%), the Internet (23.3%), and general practitioners (22.7%) as the main sources. Most frequently received recommendations were about safe food and water consumption (85%), use of insect repellents (66.0%), sunburn protection (64.4%), and condom use (22%). Only 16.5% took medication to prevent altitude sickness, and 14.2% took medication to prevent traveler's diarrhea. Variables independently associated with receiving pretravel health information from a health care professional were female gender, country of residence other than the United States, length of stay in Cuzco > 7 days, length of stay in other Peruvian cities > 7 days, tourism as the main reason for visiting Cuzco, traveling with companions, and consulting of more than one source of information. Most travelers arriving to Cuzco had received pretravel health information, and the majority obtained it from more than one source. Recommendations addressed for specific health risks, such as altitude sickness prophylaxis, were received by few travelers.

  7. What Makes Proteges Take Mentors' Advice in Formal Mentoring Relationships?

    Science.gov (United States)

    Son, SuJin; Kim, Do-Yeong

    2013-01-01

    This study examines the factors affecting a protege's willingness to take a mentor's advice. The sample for this study consisted of 183 proteges from two different South Korean organizations who were part of formal mentoring programs. We found protege commitment to be the principal factor that predisposes a protege to take advice from mentors and…

  8. 5 CFR 1304.4607 - Advice to former Government employees.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Advice to former Government employees. 1304.4607 Section 1304.4607 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES POST EMPLOYMENT CONFLICT OF INTEREST § 1304.4607 Advice to former Government employees. The Office...

  9. 29 CFR 1400.735-3 - Advice and counseling service.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Advice and counseling service. 1400.735-3 Section 1400.735-3 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE STANDARDS OF CONDUCT, RESPONSIBILITIES, AND DISCIPLINE General § 1400.735-3 Advice and counseling service...

  10. Advising in austerity reflections on challenging times for advice agencies

    CERN Document Server

    Kirwan, Samuel

    2016-01-01

    Advising in austerity provides a lively and thought-provoking account of the conditions, consequences and challenges of advice work in the UK. It examines how advisors negotiate the private troubles of those who come to Citizens Advice Bureaux (CAB) and construct ways forward.

  11. Emotions in Advice Taking: The Roles of Agency and Valence

    NARCIS (Netherlands)

    Hooge, de I.E.; Verlegh, P.W.J.; Tzioti, S.C.

    2014-01-01

    Recently, advice taking has received attention in decision-making research, and some studies suggest that emotions may play a role in this process. Yet a clear account of how emotions influence advice taking is lacking. The current research introduces a parsimonious explanation by suggesting that

  12. Emotions in advice taking: the roles of agency and valence

    NARCIS (Netherlands)

    de Hooge, I.E.; Verlegh, P.W.J.; Tzioti, S.C.

    2014-01-01

    Recently, advice taking has received attention in decision-making research, and some studies suggest that emotions may play a role in this process. Yet a clear account of how emotions influence advice taking is lacking. The current research introduces a parsimonious explanation by suggesting that

  13. Discharge against medical advice amongst orthopaedic patients in ...

    African Journals Online (AJOL)

    Background: Discharge Against Medical Advice (DAMA) is a term used when patients opt to leave a hospital against the advice of the doctor. Trauma patients account for a significant percentage of these. This study was aimed at determining the prevalence of and reasons for DAMA amongst Orthopaedic and trauma ...

  14. Discharge from hospital against medical advice among paediatric ...

    African Journals Online (AJOL)

    Background: The reasons underlying discharge against medical advice by Paediatric patients varies from place to place. Discharge against medical advice is frustrating to the medical personnel and deprives the patient of adequate medical care. This study aims to determine the prevalence and factors associated with ...

  15. "Relinquish the reins": persuasion and consensus in the discourse of pregnancy and childbirth advice literature.

    Science.gov (United States)

    Rodgers, Ornaith

    2015-03-01

    Popular pregnancy and childbirth advice books constitute an important source of information for pregnant women. These texts shape women's perceptions of pregnancy, childbirth and the medical care they will receive during this time. This article reports on a study of the enactment of power relations between pregnant women and their medical caregivers in the discourse of pregnancy and childbirth advice literature and its implications for practice. The study focuses on the discursive positioning of women in relation to medical personnel through a critical discourse analysis of two popular advice books, one in English and one in French. The article suggests that through the use of a number of key discursive strategies, pregnant women are constructed as under the control of the medical institution in these texts. However, this control is not achieved by an overt oppressive discourse, instead it is achieved through persuasion and consensus by generating the consent of pregnant women to comply with medical norms. The medical institution is represented in these texts as a dominant force while women are constructed as powerless recipients of medical care. Medical professionals should firstly consider whether the power relations represented in these texts correspond to those enacted in clinics and delivery rooms. Secondly, caregivers should be cautious about recommending popular pregnancy and childbirth advice books to women as the relationship between pregnant women and their caregivers may be undermined by the negative power asymmetry enacted in these texts. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  16. How do government health departments in Australia access health economics advice to inform decisions for health? A survey.

    Science.gov (United States)

    Madden, Lynne; King, Lesley; Shiell, Alan

    2009-04-09

    Government anticipates that health economic analysis will contribute to evidence-based policy development. Early examples in Australia where this expectation has been met include the economic evaluations of breast and cervical screening. However, the level of integration of health economics within health services that require this advice appears uneven. We sought to describe how government health departments in Australia use specialist health economic advice to inform policy and planning and the mechanisms through which they access this advice. Information describing the arrangements for gaining health economics input into health decision-making was sought through interviews with a purposeful sample of economists and non-economists employed by all departments of health in Australia (state, territories and national). The survey was undertaken in August 2004. To aid interpretation of the results eight health economic functions were identified. As a comparison, four other government departments in NSW provided information about their access to economic advice. All health departments except one reported being current users of health economics expertise. A variety of arrangements were described to source this, from building organisational capacity with self-sufficient in-house units to forging links with external sources. However, specialist positions for economists or health economists employed within health were few. A framework mapping these arrangements for sourcing advice with the eight common health economic functions to be met is presented. All other non-health government departments approached accessed economic advice, with three having in-house units. A small health economics capacity in Australia has been established over the past 30 years through a variety of structural and strategic mechanisms. Health departments value health economic advice and use a variety of arrangements to obtain this. These arrangements have strengths and weaknesses depending upon the

  17. Career Advice for Young Allergy Patients.

    Science.gov (United States)

    Radon, Katja; Nowak, Dennis; Vogelberg, Christian; Ruëff, Franziska

    2016-08-08

    One-third of all young persons entering the work force have a history of atopic disease. Occupationally induced allergy and asthma generally arise in the first few months on the job, while pre-existing symptoms tend to worsen. Young persons with a history of an atopic disease should receive evidence-based advice before choosing a career. We systematically searched PubMed for cohort studies investigating the new onset of asthma, rhinitis, or hand eczema among job trainees from before the start of training and onward into the first few years on the job. The search revealed 514 articles; we read their abstracts and selected 85 full-text articles for further analysis. 24 of these met the inclusion criteria. According to present evidence, atopy and a history of allergic disease (allergic rhinitis, atopic dermatitis) are the main risk factors for occupationally induced disease. The predictive value of a personal history of allergic diseases for the later development of an occupationally induced disease varies from 9% to 64% in the studies we analyzed. It follows that only young people with severe asthma or severe atopic eczema should be advised against choosing a job that is associated with a high risk of allergy, e.g., hairdressing or working with laboratory animals. Young people with a history of other atopic diseases should be counseled about their individual risk profile. In view of the relatively poor predictive value of pre-existing atopic disease, secondary prevention is particularly important. This includes frequent medical follow-up of the course of symptoms over the first few years on the job. If sensitization or allergic symptoms arise, it should be carefully considered whether exposure reduction will enable the apprentice to stay on the job.

  18. Innovation and Patchwork Partnerships: Advice Services in Austere Times

    Directory of Open Access Journals (Sweden)

    Alice Forbess

    2017-12-01

    Full Text Available In the UK’s austerity regime, government spending has been slashed, while audit regimes tie up officers of charitable organisations in bureaucracy rather than leaving them free to attend to the substance of their jobs. These funding-cuts-masquerading-as-market-based-restructuring have drastically affected the provision of advice to welfare dependents. But advisers, and the organisations they work for, piece together new patchworks of funds, devise new forms of face-to-face advice, and rework the boundaries of the law. Local authority funds are invested to yield returns from centrally-funded sources. People are helped to honour their tax commitments while challenging debts incurred from the incorrect award and reclaim of benefits, and to pay their council tax and rent. For advisers, austerity is more a matter of seeking new resource flows, inventing novel interventions, and creating new spaces where justice may be sought and found, than of passively accepting funding cuts. En el Reino Unido, las políticas de recortes de fondos maquilladas como restructuraciones basadas en el mercado han afectado drásticamente la provisión a los dependientes de la asistencia social. Pero los asesores y las organizaciones para las que trabajan forman nuevos tejidos de fondos financieros, ingenian nuevas formas de ayudar en persona y reconfiguran los límites de la ley. Los fondos financieros de los gobiernos locales se invierten para obtener réditos de fuentes de financiación centralizada. Se ayuda a la gente a cumplir con sus obligaciones fiscales y, al mismo tiempo, a recortar las deudas generadas por una incorrecta concesión y reclamación de prestaciones, y a pagar sus tasas municipales y sus alquileres. Para los asesores, la austeridad es una cuestión de buscar nuevos flujos de recursos, idear nuevas formas de intervención y crear nuevos espacios en los que la justicia pueda ser buscada y hallada. DOWNLOAD THIS PAPER FROM SSRN: http

  19. Occupational Exposure to HIV: Advice for Health Care Workers

    Science.gov (United States)

    ... Prevention and Wellness Staying Healthy Healthy Living Travel Occupational Health First Aid and Injury Prevention Crisis Situations Pets ... PoisoningAcute Bronchitis Home Prevention and Wellness Staying Healthy Occupational Health Occupational Exposure to HIV: Advice for Health Care ...

  20. An Expert's Advice: What To Do If You Have Psoriasis

    Science.gov (United States)

    ... on. Feature: Living with Psoriasis An Expert's Advice: What To Do If You Have Psoriasis Past Issues / ... the Dermatology Foundation, and the American Skin Association. What is psoriasis? Psoriasis is a chronic (long-term) ...

  1. A qualitative investigation of alcohol use advice during pregnancy: experiences of Dutch midwives, pregnant women and their partners.

    Science.gov (United States)

    van der Wulp, Nickie Y; Hoving, Ciska; de Vries, Hein

    2013-11-01

    two studies aimed to explore the advice Dutch midwives give and the information Dutch pregnant women and partners of pregnant women receive about alcohol consumption in pregnancy. study 1 included individual semi-structured interviews with midwives. Study 2 involved focus groups and individual semi-structured interviews with pregnant women and partners. Interview content was based on the I-Change Model. study 1 was conducted nation-wide; Study 2 was conducted in the central and southern regions of the Netherlands. 10 midwives in Study 1; 25 pregnant women and nine partners in Study 2. study 1 showed that midwives intended to advise complete abstinence, although this advice was mostly given when women indicated to consume alcohol. Midwives reported to lack good screening skills and sufficient knowledge about the mechanisms and consequences of antenatal alcohol use and did not involve partners in their alcohol advice. In Study 2, the views of pregnant women and partners were congruent to the findings reported in Study 1. In addition, pregnant women and partners considered midwives as an important source of information on alcohol in pregnancy. Partners were interested in the subject, had a liberal view on antenatal alcohol use and felt ignored by midwives and websites. Pregnant women indicated to receive conflicting alcohol advice from their health professionals. midwives' alcohol advice requires improvement with regard to screening, knowledge about mechanisms and consequences of antenatal alcohol use and the involvement of the partners in alcohol advice during pregnancy. training should be given to Dutch midwives to increase their screening skills and their alcohol related knowledge to pregnant women. Research is needed to determine how the midwife's alcohol advice to the partner should be framed in order to optimise the partner's involvement concerning alcohol abstinence in pregnancy. More attention to the topic at a national level, for example via mass media

  2. Advice to Stay Active or Structured Exercise in the Management of Sciatica: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Fernandez, Matt; Hartvigsen, Jan; Ferreira, Manuela L; Refshauge, Kathryn M; Machado, Aryane F; Lemes, Ítalo R; Maher, Chris G; Ferreira, Paulo H

    2015-09-15

    A systematic review and meta-analysis. To evaluate the evidence on comparative effectiveness of advice to stay active versus supervised structured exercise in the management of sciatica. Conservative management of sciatica usually includes interventions to promote physical activity in the form of advice to stay active or exercise, but there has been no systematic review directly comparing the effectiveness of these 2 approaches. Data Sources included MEDLINE, CINAHL, EMBASE, and PEDro databases. Studies were randomized controlled trials comparing advice with exercise. Two independent reviewers extracted data and assessed methodological quality using the PEDro scale. Pain and disability data were extracted for all time points and converted to a common 0 to 100 scale. Data were pooled with a random effects model for short, intermediate, and long-term follow-ups. The GRADE approach was used to summarize the strength of evidence. Five trials were included in the meta-analysis, which showed a significant, although small effect favoring exercise over advice for reducing leg pain intensity in the short term (weighted mean difference: 11.43 [95% confidence interval, 0.71-22.16]) but no difference for disability (weighted mean difference: 1.45 [95% confidence interval, -2.86 to 5.76]). Furthermore, there was no difference at intermediate and long-term follow-ups between advice and exercise for patient-relevant outcomes. There is low-quality evidence (GRADE) that exercise provides small, superior effects compared with advice to stay active on leg pain in the short term for patients experiencing sciatica. However, there is moderate-quality evidence showing no difference between advice to stay active and exercise on leg pain and disability status in people with sciatica in the long term. 1.

  3. GYNOTEL: telephone advice to gynaecological surgical patients after discharge.

    Science.gov (United States)

    Caljouw, Monique A A; Hogendorf-Burgers, Marja E H J

    2010-12-01

    To investigate in surgical gynaecological patients the types of health problems arising or persisting up to six weeks after discharge and the effectiveness of telephone advice. The decreasing length of hospital stay has increased the need for specific instructions about the postdischarge period. Telephone advice could be a valuable tool to address this problem. To our knowledge, postdischarge health problems and the value of telephone advice have not been investigated among gynaecological patients. Randomised controlled trial. Gynaecological patients expected to stay in the ward longer than 24 hour were invited to participate. A pilot study showed that wound healing, pain, mobility, urination, defecation and vaginal bleeding were the most common health problems postdischarge. Based on that information, guidelines were formulated that were used by trained nurses to give telephone advice to the intervention group (n=235), in addition to the usual care. The control group of gynaecological patients (n=233) received usual care only. Of all 468 participants, about 50% were operated for general gynaecology. At discharge, wound pain (56%), mobility problems (54%) and constipation (27%) were the most frequently mentioned problems in both groups. Participants who completely followed the advice with regard to wound healing (p=0.02), pain (p=0.01), vaginal bleeding (p=0.03) and mobility (p=0.04) experienced greater improvement than participants who did not follow, or only partly followed, the advice. The telephone advice appears to make a significant contribution to help gynaecological surgical patients to solve or reduce their postdischarge health problems. The positive effect of such advice can be interpreted as an improvement in the quality of life of the postoperative gynaecological patient. © 2010 Blackwell Publishing Ltd.

  4. Targeting the robo-advice customer: the development of a psychographic segmentation model for financial advice robots

    NARCIS (Netherlands)

    van Thiel, D.; van Raaij, W.F.

    2017-01-01

    The purpose of this study is to develop the world’s first psychographic market segmentation model that supports personalization, customer education, customer activation, and customer engagement strategies with financial advice robots. As traditional segmentation models in consumer finance primarily

  5. 'How to stop a nosebleed': an assessment of the quality of epistaxis treatment advice on YouTube.

    Science.gov (United States)

    Haymes, A T; Harries, V

    2016-08-01

    Video hosting websites are increasingly being used to disseminate health education messages. This study aimed to assess the quality of advice contained within YouTube videos on the conservative management of epistaxis. YouTube.com was searched using the phrase 'how to stop a nosebleed'. The first 50 videos were screened. Objective advice scores and subjective production quality scores were attributed by independent raters. Forty-five videos were analysed. The mean advice score was 2.0 out of 8 and the mean production quality score was 1.6 out of 3. There were no correlations between a video's advice score and its search results rank (ρ = -0.28, p = 0.068), its view count (ρ = 0.20, p = 0.19) or its number of 'likes' (ρ = 0.21, p = 0.18). The quality of information on conservative epistaxis management within YouTube videos is extremely variable. A high search rank is no indication of video quality. Many videos proffer inappropriate and dangerous 'alternative' advice. We do not recommend YouTube as a source for patient information.

  6. Depression: an emotional obstacle to seeking medical advice for infertility.

    Science.gov (United States)

    Herbert, Danielle L; Lucke, Jayne C; Dobson, Annette J

    2010-10-01

    To investigate the mental and general health of infertile women who had not sought medical advice for their recognized infertility and were therefore not represented in clinical populations. Longitudinal cohort study. Population based. Participants in the Australian Longitudinal Study on Women's Health aged 28-33 years in 2006 who had ever tried to conceive or had been pregnant (n = 5,936). None. Infertility, not seeking medical advice. Compared with fertile women (n = 4,905), infertile women (n = 1,031) had higher odds of self-reported depression (odds ratio [OR] 1.20, 95% confidence interval [CI] 1.01-1.43), endometriosis (5.43, 4.01-7.36), polycystic ovary syndrome (9.52, 7.30-12.41), irregular periods (1.99, 1.68-2.36), type II diabetes (4.70, 1.79-12.37), or gestational diabetes (1.66, 1.12-2.46). Compared with infertile women who sought medical advice (n = 728), those who had not sought medical advice (n = 303) had higher odds of self-reported depression (1.67, 1.18-2.37), other mental health problems (3.14, 1.14-8.64), urinary tract infections (1.67, 1.12-2.49), heavy periods (1.63, 1.16-2.29), or a cancer diagnosis (11.33, 2.57-49.89). Infertile women who had or had not sought medical advice had similar odds of reporting an anxiety disorder or anxiety-related symptoms. Women with self-reported depression were unlikely to have sought medical advice for infertility. Depression and depressive symptoms may be barriers to seeking medical advice for infertility. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. The travel advice as an inhibiting factor of tourist movement

    Directory of Open Access Journals (Sweden)

    Mylonopoulos Dimitrios

    2016-01-01

    Full Text Available Tourism is significantly affected by unpredictable and uncertain factors such as the occurrence of a terrorist attack, an epidemic outbreak or a natural disaster, etc. The impact of these phenomena on the tourist movement of the country or the place where the event occurred is aggravated by the way it is presented by the media both locally and internationally. The adverse climate gets worse by the issuance of travel advice that usually accompanies such phenomena and has the effect of limiting or even halting tourist flows. In order to identify and study the different types of travel advice that have been issued during international tourism crisis incidents, an internet search was carried out using keywords. Moreover, a study on the travel advice issued by major tourists' origin states, as the USA, Australia, Canada, Germany, the United Kingdom, etc. was carried out. Incidents (terrorist attacks, epidemics, natural disasters which had a great impact on tourism were then selected. In addition, the issuance of travel advice, their different issuing authorities, the classification level and the impact on the tourism of the country or the place in question were examined. An analysis of the reaction and the instructions of major international organizations (World Health Organization, World Tourism Organization concerning the management of such crises, directly or indirectly affecting tourism, were also analyzed. The study of the relevant websites, the international literature and the recorded incidents shows that the issuing of travel advice has negative effects on many sectors of tourism activity and is a bottleneck for tourism development. In fact, in many cases, travel advice is used by countries to exert pressure on other countries in order to achieve a desired result. Due to the enormous economic and social effects when issuing travel advice, the states proper management is necessary in order to minimize the negative consequences and avoid

  8. Advice-Implicative Interrogatives: Building "Client-Centered" Support in a Children's Helpline

    Science.gov (United States)

    Butler, Carly W.; Potter, Jonathan; Danby, Susan; Emmison, Michael; Hepburn, Alexa

    2010-01-01

    Interactional research on advice giving has described advice as normative and asymmetric. In this paper we examine how these dimensions of advice are softened by counselors on a helpline for children and young people through the use of questions. Through what we term "advice-implicative interrogatives," counselors ask clients about the…

  9. Where Do Women Get Advice About Weight, Eating, and Physical Activity During Pregnancy?

    Science.gov (United States)

    Mercado, Adrian; Marquez, Becky; Abrams, Barbara; Phipps, Maureen G; Wing, Rena R; Phelan, Suzanne

    2017-09-01

    Most women report not receiving information about gestational weight gain (GWG) from prenatal providers, but less is known about other sources of information and their potential impacts on GWG. The purpose of this study was to investigate sources of information about diet, physical activity, and weight control during pregnancy, and the impact of information sources on maternal GWG. Participants were 183 women with normal weight and 172 women with overweight/obesity who had enrolled in a prenatal lifestyle intervention trial. At 6 weeks postpartum, women were asked whether they had received information about "diet, physical activity, or weight control" from 12 sources uninvolved in the trial (e.g., physician, Internet, and friend) and, if received, the extent to which they followed the advice. Information sources were examined in relation to odds of exceeding Institute of Medicine (IOM) GWG guidelines based on measured weights. Most women reported receiving information from a book (60.6%) or the Internet (58.3%). Advice from physicians, dietitians, or nurses was reported in 55.6%, 48.2%, and 33.9% of women, respectively. Reported receipt of information from physicians was associated with reduced Odds Ratio ([95% Confidence Interval] = 0.55 [0.35-0.88]; p = 0.01) of exceeding IOM GWG guidelines. Reported receipt of information from other sources was not related to GWG. Books and the Internet were the most prevalent information sources reported for prenatal diet, physical activity, and weight control. However, of all sources, only physician provision of information was associated with reduced odds of excessive GWG.

  10. Red meats: time for a paradigm shift in dietary advice.

    Science.gov (United States)

    Binnie, Mary Ann; Barlow, Karine; Johnson, Valerie; Harrison, Carol

    2014-11-01

    Recent evidence suggests dietary advice to limit red meat is unnecessarily restrictive and may have unintended health consequences. As nutrient-rich high quality protein foods, red meats can play an important role in helping people meet their essential nutrient needs. Yet dietary advice to limit red meat remains standard in many developed countries, even though red meat intakes appear to be within current guidelines. Meanwhile, energy intakes from processed foods have increased dramatically at the expense of nutrient-rich foods, such as red meat. Research suggests these food trends are associated with the growing burden of obesity and associated diseases in recent decades. It is time for dietary advice that emphasizes the value of unprocessed red meat as part of a healthy balanced diet. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Board advice following publication of the 1990 Recommendations of ICRP

    CERN Document Server

    United Kingdom. At. Energy Res. Establ. Nat. Radiolog. Protect. Board. Harwell

    1991-01-01

    The International Commission on Radiological Protection (ICRP) has published new Recommendations and the board has a statutory duty to advise Government and those with responsibilities for radiation protection on the acceptability to and the applicability in the UK of those Recommendations. The Board wishes to consult widely before finalising the advice which is proposed in this document. In general, the Board endorses the conceptual framework for radiological protection recommended by ICRP. In particular, the distinction between practices and intervention is useful and is consistent with the way in which the Board has presented its recent advice. A major new concept is that of a constraint. The Board believes that the introduction of constraints provides a powerful method for improving protection against ionising radiation. The advice in this consultative document is for maximum generic values of dose constraints for both workers and the public. Finally the Board proposes to endorse the use of the radiologic...

  12. Board advice following publication of the 1990 Recommendations of ICRP

    International Nuclear Information System (INIS)

    1991-11-01

    The International Commission on Radiological Protection (ICRP) has published new Recommendations and the Board has a statutory duty to advise Government and those with responsibilities for radiation protection on the acceptability to and the applicability in the UK of those Recommendations. The Board wishes to consult widely before finalising the advice which is proposed in this document. In general, the Board endorses the conceptual framework for radiological protection recommended by ICRP. In particular, the distinction between practices and intervention is useful and is consistent with the way in which the Board has presented its recent advice. A major new concept is that of a constraint. The Board believes that the introduction of constraints provides a powerful method for improving protection against ionising radiation. The advice in this consultative document is for maximum generic values of dose constraints for both workers and the public. Finally the Board proposes to endorse the use of the radiological quantities recommended by ICRP. (author)

  13. The 2014 FIFA World Cup: communicable disease risks and advice for visitors to Brazil--a review from the Latin American Society for Travel Medicine (SLAMVI).

    Science.gov (United States)

    Gallego, Viviana; Berberian, Griselda; Lloveras, Susana; Verbanaz, Sergio; Chaves, Tania S S; Orduna, Tomas; Rodriguez-Morales, Alfonso J

    2014-01-01

    The next FIFA World Cup will be held in Brazil in June-July 2014. Around 600,000 international visitors and participants (as well over 3 million domestic travelers) are expected. This event will take place in twelve cities. This event poses specific challenges, given its size and the diversity of attendees, including the potential for the transmission of imported or endemic communicable diseases, especially those that have an increased transmission rate as a result of close human proximity, eg, seasonal influenza, measles but also tropical endemic diseases. In anticipation of increased travel, a panel of experts from the Latin American Society for Travel Medicine (SLAMVI) developed the current recommendations regarding the epidemiology and risks of the main communicable diseases in the major potential destinations, recommended immunizations and other preventives measures to be used as a basis for advice for travelers and travel medicine practitioners. Mosquito-borne infections also pose a challenge. Dengue poses a significant risk in all states, including the host cities. Vaccination against yellow fever is recommended except for travelers who will only visit coastal areas. Travelers visiting high-risk areas for malaria (Amazon) should be assessed regarding the need for chemoprophylaxis. Chikunguya fever may be a threat for Brazil, given the presence of Aedes aegypti, vector of dengue, and the possibility of travelers bringing the virus with them when attending the event. Advice on the correct timing and use of repellents and other personal protection measures is key to preventing these vector-borne infections. Other important recommendations for travelers should focus on preventing water and food-borne diseases such as hepatitis A, typhoid fever, giardiasis and traveler's diarrhea. Sexually transmitted diseases (STD) should be also mentioned and the use of condoms advocated. This review addresses pre-travel, preventive strategies to reduce the risk of acquiring

  14. The Back 2 Activity Trial: education and advice versus education and advice plus a structured walking programme for chronic low back pain

    Directory of Open Access Journals (Sweden)

    Bradbury Ian

    2010-07-01

    Full Text Available Abstract Background Current evidence supports the use of exercise-based treatment for chronic low back pain that encourages the patient to assume an active role in their recovery. Walking has been shown it to be an acceptable type of exercise with a low risk of injury. However, it is not known whether structured physical activity programmes are any more effective than giving advice to remain active. Methods/Design The proposed study will test the feasibility of using a pedometer-driven walking programme, as an adjunct to a standard education and advice session in participants with chronic low back pain. Fifty adult participants will be recruited via a number of different sources. Baseline outcome measures including self reported function; objective physical activity levels; fear-avoidance beliefs and health-related quality of life will be recorded. Eligible participants will be randomly allocated under strict, double blind conditions to one of two treatments groups. Participants in group A will receive a single education and advice session with a physiotherapist based on the content of the 'Back Book'. Participants in group B will receive the same education and advice session. In addition, they will also receive a graded pedometer-driven walking programme prescribed by the physiotherapist. Follow up outcomes will be recorded by the same researcher, who will remain blinded to group allocation, at eight weeks and six months post randomisation. A qualitative exploration of participants' perception of walking will also be examined by use of focus groups at the end of the intervention. As a feasibility study, treatment effects will be represented by point estimates and confidence intervals. The assessment of participant satisfaction will be tabulated, as will adherence levels and any recorded difficulties or adverse events experienced by the participants or therapists. This information will be used to modify the planned interventions to be used in a

  15. Lay Evaluation of Financial Experts: The Action Advice Effect and Confirmation Bias.

    Science.gov (United States)

    Zaleskiewicz, Tomasz; Gasiorowska, Agata; Stasiuk, Katarzyna; Maksymiuk, Renata; Bar-Tal, Yoram

    2016-01-01

    The goal of this experimental project was to investigate lay peoples' perceptions of epistemic authority (EA) in the field of finance. EA is defined as the extent to which a source of information is treated as evidence for judgments independently of its objective expertise and based on subjective beliefs. Previous research suggested that EA evaluations are biased and that lay people tend to ascribe higher EA to experts who advise action (in the case of medical experts) or confirm clients' expectations (in the case of politicians). However, there has been no research into biases in lay evaluations of financial experts and this project is aimed to fill this gap. Experiment 1 showed that lay people tended to ascribe greater authority to financial consultants who gave more active advice to clients considering taking out a mortgage. Experiment 2 confirmed the action advice effect found in Experiment 1. However, the outcomes of Experiments 2 and - particularly - 3 suggested that this bias might also be due to clients' desire to confirm their own opinions. Experiment 2 showed that the action advice effect was moderated by clients' own opinions on taking loans. Lay people ascribed the greatest EA to the advisor in the scenario in which he advised taking action and where this coincided with the client's positive opinion on the advisability of taking out a loan. In Experiment 3 only participants with a positive opinion on the financial product ascribed greater authority to experts who recommended it; participants whose opinion was negative tended to rate consultants who advised rejecting the product more highly. To conclude, these three experiments revealed that lay people ascribe higher EA to financial consultants who advise action rather than maintenance of the status quo , but this effect is limited by confirmation bias: when the client's a priori opinion is salient, greater authority is ascribed to experts whose advice confirms it. In this sense, results presented in the

  16. Lay Evaluation of Financial Experts: The Action Advice Effect and Confirmation Bias

    Directory of Open Access Journals (Sweden)

    Tomasz Zaleskiewicz

    2016-09-01

    Full Text Available The goal of this experimental project was to investigate lay peoples’ perceptions of epistemic authority (EA in the field of finance. EA is defined as the extent to which a source of information is treated as evidence for judgments independently of its objective expertise and based on subjective beliefs. Previous research suggested that EA evaluations are biased and that lay people tend to ascribe higher EA to experts who advise action (in the case of medical experts or confirm clients’ expectations (in the case of politicians. However, there has been no research into biases in lay evaluations of financial experts and this project is aimed to fill this gap. Experiment 1 showed that lay people tended to ascribe greater authority to financial consultants who gave more active advice to clients considering taking out a mortgage. Experiment 2 confirmed the action advice effect found in Experiment 1. However, the outcomes of Experiments 2 and – particularly – 3 suggested that this bias might also be due to clients’ desire to confirm their own opinions. Experiment 2 showed that the action advice effect was moderated by clients’ own opinions on taking loans. Lay people ascribed the greatest EA to the advisor in the scenario in which he advised taking action and where this coincided with the client’s positive opinion on the advisability of taking out a loan. In Experiment 3 only participants with a positive opinion on the financial product ascribed greater authority to experts who recommended it; participants whose opinion was negative tended to rate consultants who advised rejecting the product more highly. To conclude, these three experiments revealed that lay people ascribe higher EA to financial consultants who advise action rather than maintenance of the status quo, but this effect is limited by confirmation bias: when the client’s a priori opinion is salient, greater authority is ascribed to experts whose advice confirms it. In this

  17. Sexuality and Romance in Advice Books for the Elderly.

    Science.gov (United States)

    Arluke, Arnold; And Others

    1984-01-01

    Analyzed 65 advice books for the elderly to assess their romantic and sexual content. Results indicated that sexual activity is encouraged now more than in the past for the elderly, suggesting a trend which stresses activity rather than disengagement. However, little support for remarriage and dating was found. (Author/JAC)

  18. An Evaluation of an Occupational Health Advice Service

    Science.gov (United States)

    Shearn, P.; Ford, Norma J.; Murphy, R. G.

    2010-01-01

    Objective: The objective of this article is to identify the profile of service users of an occupational health (OH) support service and establish areas of need, and to gather client feedback on the experience of participating in the support service and perceived outcomes and the impact of the advice received. Design and Setting: We carried out…

  19. Use and preference of advice on small children's food

    DEFF Research Database (Denmark)

    Nielsen, Annemette Ljungdalh; Krasnik, Allan; Vassard, Ditte

    2015-01-01

    with ethnic minority status were more likely to find the advice obtained in this way incompatible with their family eating habits. Although existing dietary health communication strategies delivered by public health nurses appear to work well in all household types, parents from minority households seem...

  20. Sense about Sex: Media, Sex Advice, Education and Learning

    Science.gov (United States)

    Attwood, Feona; Barker, Meg John; Boynton, Petra; Hancock, Justin

    2015-01-01

    The media are widely acknowledged as important in sex and relationship education, but they are usually associated with "bad" effects on young people in contrast to the "good" knowledge represented by more informational and educational formats. In this paper we look at sex advice giving in newspapers, magazines and television in…

  1. factors associated with discharge against medical advice among ...

    African Journals Online (AJOL)

    OBJECTIVE: the main objective of this study was to investigate factors associated with discharge against medical advice among patients ... current situation compared to other hospitals, UCTH receives the most ... Emilia James Oyira, Department of Nursing Science, University of Calabar, Calabar, Cross River State, Nigeria.

  2. Productive ward 2: practical advice to facilitators implementing the programme.

    Science.gov (United States)

    Allsopp, Pete; Faruqi, Joe; Gascoigne, Laura; Tennyson, Rachel

    This is the second in a two-part series looking at the implementation of Productive Ward. Part one looked at roll-out of the initiative across a hospital This part offers advice to facilitators involved in implementing the programme.

  3. Advice for Writing a Thesis (Based on What Examiners Do)

    Science.gov (United States)

    Golding, Clinton

    2017-01-01

    In the article, "What examiners do: What thesis students should know", we identified 11 things that thesis examiners do as they read and judge a thesis. But, we left a gap in the research: knowing this, What should thesis students do to write for their examiners? In this article, I fill the gap. The advice for thesis students is: first,…

  4. Advice to Graduate Students: From Application to Career.

    Science.gov (United States)

    ADE Bulletin, 1998

    1998-01-01

    Offers advice to graduate students studying English and those studying foreign languages, covering issues relevant to candidates for master's degrees or doctorates. Suggests questions to ask when selecting a graduate program, including those related to investigating the program and inquiring about employment and financial assistance, teaching…

  5. Advice to White Allies: Insights from Faculty of Color

    Science.gov (United States)

    Boutte, Gloria S.; Jackson, Tambra O.

    2014-01-01

    This article interweaves discussions of successes and tensions surrounding cross-racial collaborative social justice efforts in teacher education. It addresses frustrations that often occur for faculty of Color when working with White allies in P-12 settings and schools of education at Predominantly White Institutions. Advice is offered with the…

  6. Essay-Writing: Do Study Manuals Give Relevant Advice?

    Science.gov (United States)

    Mahalski, Pauline A.

    1992-01-01

    A study of the writing of 28 geography students at Otago University (New Zealand) compared aspects of the essays with grading and rater comments. It is concluded that, although study manuals for essay-writing can help some students, their advice may not be useful to all; other methods may be more helpful. (Author/MSE)

  7. Web accessibility practical advice for the library and information professional

    CERN Document Server

    Craven, Jenny

    2008-01-01

    Offers an introduction to web accessibility and usability for information professionals, offering advice on the concerns relevant to library and information organizations. This book can be used as a resource for developing staff training and awareness activities. It will also be of value to website managers involved in web design and development.

  8. 75 FR 9360 - Investment Advice-Participants and Beneficiaries

    Science.gov (United States)

    2010-03-02

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 29 CFR 2550 RIN 1210-AB35 Investment... Security Act, and parallel provisions of the Internal Revenue Code of 1986, relating to the provision of investment advice to participants and beneficiaries in individual account plans, such as 401(k) plans, and...

  9. Personalized nutrition advice : an everyday-life perspective

    NARCIS (Netherlands)

    Bouwman, L.I.

    2009-01-01

    This thesis presents societal preconditions for Personalized Nutrition Advice (PNA) that result from an everyday-life perspective on this innovative approach. Generally, PNA is regarded as promising, because it provides users with highly specific information on individual health risks and benefits

  10. Discharge against medical advice: Ethico-legal implications from an ...

    African Journals Online (AJOL)

    Background. Discharge against medical advice (DAMA) is a problematic issue for physicians worldwide, which can disrupt the physicianpatient relationship, have adverse medical outcomes and increase healthcare costs. This review aims to highlight the ethical and legal aspects of the issue from the perspective of ...

  11. A Career Advice Helpline: A Case Study from South Africa

    Science.gov (United States)

    Flederman, Patricia

    2011-01-01

    This case study presents the new career guidance helpline managed by the South African Qualifications Authority in South Africa, a middle-income country. The National Qualifications Framework and Career Advice Helpline represent a national equity-driven initiative using technology to expand access. The model has drawn on contemporary international…

  12. Factors associated with discharge against medical advice among ...

    African Journals Online (AJOL)

    Objective: the main objective of this study was to investigate factors associated with discharge against medical advice among patients in UCTH. To achieve the aim of this study, the following hypotheses were formulated to direct the study. There is no significant relationship between patients' factors associated with ...

  13. Discharge against medical advice (Dama) in children's ward the ...

    African Journals Online (AJOL)

    Background: Until recovery, discharge against medical advice (DAMA) is a rare thing that does happen when one is admitted in a Health facility, but these days it appears to be a common occurrence due to some factors. Objective: To evaluate the factors responsible for DAMA in children's ward of Amaku general hospital ...

  14. Lebanese medical students' intention to deliver smoking cessation advice.

    Science.gov (United States)

    Jradi, Hoda; Wewers, Mary Ellen; Pirie, Phyllis P; Binkley, Philip F; Ferketich, Amy K

    2015-06-01

    Objectives of this study were to examine the constructs of the Theory of Planned Behavior and determine how they predict Lebanese medical students' behavioral intention to advise patients to quit smoking. This was a cross-sectional study conducted among 191 medical students from six medical schools in Lebanon. The instrument contained scales that measured attitudes toward the behavior, behavioral beliefs, subjective norms, and perceived behavioral control. Psychometric properties of the scale were examined. Item to total scale score correlations were determined and linear regression was conducted to predict the intention to advise smokers to quit. Respondents had a positive, but not very high, intention to deliver smoking cessation advice. Students reported a positive attitude toward advising patients to quit cigarette smoking and a strong belief in the physician's obligations in smoking cessation advising. The majority reported lack of time to provide smoking cessation advice, insufficient knowledge of pharmacological aids, and the lack of openness of the patient to receive the advice. The attitude scale was the only variable that yielded a significant prediction of the intended behavior. The construct of attitude toward the behavior appeared to be the most predictive of the intention to deliver advice to quit smoking among Lebanese medical students. Focusing training efforts on this construct could improve the rate of delivery of brief cessation counseling. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  15. Perceptions of genetic testing for personalized nutrition: a randomized trial of DNA-based dietary advice.

    Science.gov (United States)

    Nielsen, Daiva E; Shih, Sarah; El-Sohemy, Ahmed

    2014-01-01

    Direct-to-consumer (DTC) genetic tests have facilitated easy access to personal genetic information related to health and nutrition; however, consumer perceptions of the nutritional information provided by these tests have not been evaluated. The objectives of this study were to assess individual perceptions of personalized nutrition and genetic testing and to determine whether a personalized nutrition intervention modifies perceptions. A double-blind, parallel-group, randomized controlled trial was conducted among healthy men and women aged 20-35 years (n = 138). Participants in the intervention group (n = 92) were given a report of DNA-based dietary advice and those in the control group (n = 46) were given a general dietary advice report. A survey was completed at baseline and 3 and 12 months after distributing the reports to assess perceptions between the two groups. No significant differences in perceptions of personalized nutrition and genetic testing were observed between the intervention and control group, so responses of both groups were combined. As compared to baseline, participant responses increased significantly toward the positive end of a Likert scale at 3 months for the statement 'I am interested in the relationship between diet and genetics' (mean change ± SD: 0.28 ± 0.99, p = 0.0002). The majority of participants indicated that a university research lab (47%) or health care professional (41%) were the best sources for obtaining accurate personal genetic information, while a DTC genetic testing company received the fewest selections (12%). Most participants (56%) considered dietitians to be the best source of personalized nutrition followed by medical doctors (27%), naturopaths (8%) and nurses (6%). These results suggest that perceptions of personalized nutrition changed over the course of the intervention. Individuals view a research lab or health care professional as better providers of genetic information than a DTC genetic testing company

  16. Smoking cessation advice for people with serious mental illness.

    Science.gov (United States)

    Khanna, Priya; Clifton, Andrew V; Banks, David; Tosh, Graeme E

    2016-01-28

    People with a serious mental illness are more likely to smoke more and to be more dependent smokers than the general population. This may be due to a wide range of factors that could include a common aetiology to both smoking and the illness, self medication, smoking to alleviate adverse effects of medications, boredom in the existing environment, or a combination of these factors. It is important to undertake this review to facilitate improvements in both the health and safety of people with serious mental illness who smoke, and to reduce the overall burden of costs (both financial and health) to the smoker and, eventually, to the taxpayer. To review the effects of smoking cessation advice for people with serious mental illness. We searched the Cochrane Schizophrenia Group Specialized Trials Register up to 2 April 2015, which is based on regular searches of CENTRAL, BIOSIS, PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, and trial registries. We also undertook unsystematic searches of a sample of the component databases (BNI, CINHAL, EMBASE, MEDLINE, and PsycINFO), up to 2 April 2015, and searched references of all identified studies We planned to include all randomised controlled trials (RCTs) that focussed on smoking cessation advice versus standard care or comparing smoking cessation advice with other more focussed methods of delivering care or information. The review authors (PK, AC, and DB) independently screened search results but did not identify any trials that fulfilled the inclusion criteria of this review. We did not identify any RCTs that evaluated advice regarding smoking cessation for people with serious mental illness. The excluded studies illustrate that randomisation of packages of care relevant to smokers with serious mental illness is possible. People with serious mental illness are more likely to smoke than the general population. Yet we could not find any high quality evidence to guide the smoking cessation advice healthcare professionals pass onto

  17. Dietary advice on prescription: experiences with a weight reduction programme.

    Science.gov (United States)

    Bräutigam-Ewe, Marie; Lydell, Marie; Månsson, Jörgen; Johansson, Gunnar; Hildingh, Cathrine

    2017-03-01

    To describe overweight persons' experiences with weight reduction and participation in the dietary advice on prescription. Approximately 20% of overweight individuals are able to successfully lose weight. Experiences from earlier weight reduction programmes indicate that those who succeed typically manage to avoid overeating to handle stress and have high motivation to lose weight. Those who fail have low self-control and engage in negative health behaviours such as eating when experiencing negative emotions and stress. The study used a descriptive qualitative design and was conducted at a Primary Health Care Centre in south-west Sweden. The first nineteen study participants who completed the weight reduction programme in two years responded in writing to five open questions about their experiences with the programme. Data were analysed using inductive content analysis. The participants appreciated the face-to-face meetings with the nurse because they felt seen and listened to during these sessions. They also felt their life situations and self-discipline had an impact on how well they were able to follow the programme. Dietary advice on prescription advice was considered to be helpful for achieving behavioural changes and losing weight. People who succeeded in sustainably losing weight described the importance of support from partners or close friends. To achieve sustainable weight reduction, it is important to individualise the programme in order to address each person's life situation and the unique difficulties they may encounter. Motivational interviewing appears to be a good technique for developing a successful relationship between the nurse and the patient. The dietary advice on prescription advice was perceived to be a good way to improve food habits and can easily be used at many Primary Health Care Centres. Patient's partners should also be offered the opportunity to participate in the programme. © 2016 John Wiley & Sons Ltd.

  18. Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature

    NARCIS (Netherlands)

    Schaafsma, Frederieke; Verbeek, Jos; Hulshof, Carel; van Dijk, Frank

    2005-01-01

    Background: Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM) promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based

  19. A phenomenologic investigation of pediatric residents' experiences being parented and giving parenting advice.

    Science.gov (United States)

    Bax, A C; Shawler, P M; Blackmon, D L; DeGrace, E W; Wolraich, M L

    2016-09-01

    Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The primary purpose of this study was to examine pediatric residents' self-reported experiences giving parenting advice and explore the relationship between parenting advice given and types of parenting residents received as children. Thirteen OUHSC pediatric residents were individually interviewed to examine experiences being parented and giving parenting advice. Phenomenological methods were used to explicate themes and secondary analyses explored relationships of findings based upon Baumrind's parenting styles (authoritative, authoritarian, permissive). While childhood experiences were not specifically correlated to the parenting advice style of pediatric residents interviewed, virtually all reported relying upon childhood experiences to generate their advice. Those describing authoritative parents reported giving more authoritative advice while others reported more variable advice. Core interview themes related to residents' parenting advice included anxiety about not being a parent, varying advice based on families' needs, and emphasis of positive interactions and consistency. Themes related to how residents were parented included discipline being a learning process for their parents and recalling that their parents always had expectations, yet always loved them. Pediatric residents interviewed reported giving family centered parenting advice with elements of positive interactions and consistency, but interviews highlighted many areas of apprehension residents have around giving parenting advice. Our study suggests that pediatric residents may benefit from more general educational opportunities to develop the content of their parenting advice, including reflecting on any impact from their own upbringing.

  20. No Effect of Writing Advice on Reading Comprehension

    DEFF Research Database (Denmark)

    Balling, Laura Winther

    2018-01-01

    This article considers text comprehension through the integrated perspectives of language processing research and practical writing advice as expressed in writing guides and language policies. Such guides for instance include advice to use active constructions instead of passives and sentences...... instead of nominalizations. These recommended and problem constructions and two other contrasts were investigated in an eye-tracking experiment where 27 students read four authentic texts where the target constructions had been manipulated. A mixed-effects regression analysis showed no difference between...... recommended and problem constructions, while several control variables were significant. This result indicates that the linguistic manipulations are not in themselves crucial to text comprehension, and it is hypothesized that the central aspect for text comprehension is how the linguistic manipulations...

  1. Nutrigenomics-based personalised nutritional advice: in search of a business model?

    NARCIS (Netherlands)

    Ronteltap, A.; Trijp, van J.C.M.; Berezowska, A.; Goossens, Jo

    2013-01-01

    Nutritional advice has mainly focused on population-level recommendations. Recent developments in nutrition, communication, and marketing sciences have enabled potential deviations from this dominant business model in the direction of personalisation of nutrition advice. Such personalisation efforts

  2. Advice on the accelerated market implementation of advanced biofuels

    International Nuclear Information System (INIS)

    2008-04-01

    The Platform for Sustainable Mobility aims to promote the accelerated market introduction of more sustainable motor fuels and vehicle technology. The Platform distinguishes four transition paths: hybridization of the fleet of cars; implementation of biofuels; hydrogen-fuelled driving (driving on natural gas and biogas); intelligent transport systems (ITS). This advice involves part of the transition path for the implementation of biofuels, i.e. accelerated market introduction of advances biofuels. [mk] [nl

  3. Millennials at Work: The Advice of Great Leaders

    Science.gov (United States)

    2015-04-01

    on leadership will “bring out the best” from the millennial generation and benefit every generation. Millennials are fluent in technology , possess... Millennials at Work The Advice of Great Leaders Carol Axten Axten has more than 30 years of experience in Defense Department engineering, program...million members of the millennial generation will enter the workforce and by 2030 will make up 75 percent of all working professionals. As managers in the

  4. Getting started on your research: practical advice for medical educators.

    Science.gov (United States)

    Markert, Ronald J

    2010-10-01

    Guidance and mentorship benefit faculty who having little or no background conducting research in medical education. From his experience the author suggests three characteristics that distinguish medical educators who are especially productive in their scholarly activities: intrinsic rather than extrinsic motivation, collaboration with colleagues, and the personal qualities of patience and organization. He then expands on these characteristics by offering practical advice in the form of eight tips for faculty seeking to acquire or improve their medical education research skills.

  5. Do British travel agents provide adequate health advice for travellers?

    Science.gov (United States)

    Lawlor, D A; Burke, J; Bouskill, E; Conn, G; Edwards, P; Gillespie, D

    2000-07-01

    Travel-related illness is a burden for primary care, with more than two million travellers consulting a general practitioner each year. The annual cost of travel-related illness in the United Kingdom is 11 million Pounds. Travel agents are in a unique position to influence this burden as the most common and most serious problems are preventable with simple advice and/or immunisation. This study, using covert researchers, suggests this potential is not being fully utilised.

  6. Do British travel agents provide adequate health advice for travellers?

    OpenAIRE

    Lawlor, D A; Burke, J; Bouskill, E; Conn, G; Edwards, P; Gillespie, D

    2000-01-01

    Travel-related illness is a burden for primary care, with more than two million travellers consulting a general practitioner each year. The annual cost of travel-related illness in the United Kingdom is 11 million Pounds. Travel agents are in a unique position to influence this burden as the most common and most serious problems are preventable with simple advice and/or immunisation. This study, using covert researchers, suggests this potential is not being fully utilised.

  7. Unanticipated bleeding with the etonogestrel implant: advice and therapeutic interventions.

    OpenAIRE

    Dickson, Jane; Hoggart, Lesley; Newton, Victoria Louise

    2014-01-01

    A common problem with etonogestrel contraceptive implants is irregular bleeding, for which women are often unprepared despite adequate pre-insertion advice. Dickson et al.’s commentary is a useful summary of management options. It will refresh readers’ ability to deal with this problem and it's a reminder to avoid ‘watchful waiting’, which risks women losing confidence in this highly effective contraceptive method.

  8. Advice from creative consumers: a study of online hotel reviews

    OpenAIRE

    Lee, LW

    2014-01-01

    This study explores what creative consumers are compelled to say about hotels through online reviews. Online reviews are highly influential, with consumers preferring the advice of other consumers over industry experts or information provided by the marketer. Over 7,000 online hotel reviews posted on TripAdvisor were examined, using Leximancer, a content analysis tool. This study provides insights on the factors contributing to guest satisfaction and dissatisfaction in luxury hotels and moder...

  9. Attending physician and patient in radiotherapeutic treatment: practical advices

    International Nuclear Information System (INIS)

    2008-03-01

    This brochure is devoted to external radiotherapy and provides some pieces of practical advices for each stage of the patient's treatment: before, during and after radiotherapy. The monitoring and management of short-, medium- and long-term side-effects represent a major stake. Such side-effects and their treatments are presented in tables for each affected part of the body or affected organ. (J.S.)

  10. Nurses' perceptions of providing advice via a telephone care line.

    Science.gov (United States)

    Ström, Mayvor; Marklund, Bertil; Hildingh, Cathrine

    The provision of advice over the telephone in the health service has become more common in the Western world and in Sweden this task is allocated to nurses. There are several million calls a year to the medical care telephone helpline. Nurses answer the calls, provide advice and direct the flow of patients to the most appropriate treatment level. The aim of this study was to describe how nurses perceive their job of providing telephone advice to patients. Interviews with 12 nurses were analyzed using a phenomenographic approach. The nurses perceived their work as stimulating, autonomous and challenging. They also felt exposed because extensive knowledge is required and there is a risk of being criticized, as they are in a front-line position. Nurses who are responsive, determined and not anxious about their prestige can carry out the work well, provided they have a good level of self-awareness. Personal qualities and the confidence of superiors make even an exposed position with considerable requirements manageable.

  11. Against professional advice: treatment attrition among pregnant methamphetamine users

    Directory of Open Access Journals (Sweden)

    Terplan M

    2011-10-01

    Full Text Available Brianna Lindsay1, Jennifer Albrecht1, Mishka Terplan1,21Department of Epidemiology and Public Health, University of Maryland, 2Department of Obstetrics, Gynecology, and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USAAbstract: Pregnant methamphetamine users who leave substance use treatment against professional advice may be at risk of poorer health outcomes. To examine the hypothesis that methamphetamine use during pregnancy may be associated with leaving substance use treatment against professional advice, the 2006 Treatment Episode Data Set was analyzed. A logistic regression adjusting for age, race, service setting, prior substance abuse treatment, criminal justice referral, and education was conducted. Inclusion criteria were met by 18,688 pregnant admissions; 26.4% identified methamphetamines as their primary substance of use. Frequency of use was identified as an effect modifier, therefore results were stratified by less than weekly use and weekly or more use. Methamphetamine use was significantly associated with leaving treatment against professional advice regardless of usage level. However, the odds of leaving treatment were greater among women using methamphetamine less than weekly. Further investigation into this association may be warranted due to the complications that may result from methamphetamine use during pregnancy.Keywords: pregnancy, methamphetamines, treatment, attrition

  12. Diversity in action: Interpersonal networks and the distribution of advice.

    Science.gov (United States)

    Vargas, Nicholas; Schafer, Markus H

    2013-01-01

    Does diversity beget the active dissemination of social support in the form of advice to others? Previous research by Robert Putnam suggests that individuals in compositionally diverse geographical areas become closed off from their social ties and less trusting of others, which are both antithetical to social support exchange. We argue, however, that studies of compositional diversity are ill-suited to reflect diversity as it is actually lived and experienced in social life. Drawing from the first nationally representative study with comprehensive indicators of interactional diversity in social life, we analyze self-reports of advice-giving across a variety of social roles. Results of regression analysis are consistent: greater interactional diversity is positively associated with advice-giving, whether the target is stranger, neighbor, close friend, or family member. These findings hold independent of important covariates such as reciprocity, sociability, and homophily. This research contributes to a growing literature set on identifying the unanticipated benefits of diversity in modern society. In sum, we call future research to consider not only diversity in structure, but also diversity in action. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Reinforcement learning agents providing advice in complex video games

    Science.gov (United States)

    Taylor, Matthew E.; Carboni, Nicholas; Fachantidis, Anestis; Vlahavas, Ioannis; Torrey, Lisa

    2014-01-01

    This article introduces a teacher-student framework for reinforcement learning, synthesising and extending material that appeared in conference proceedings [Torrey, L., & Taylor, M. E. (2013)]. Teaching on a budget: Agents advising agents in reinforcement learning. {Proceedings of the international conference on autonomous agents and multiagent systems}] and in a non-archival workshop paper [Carboni, N., &Taylor, M. E. (2013, May)]. Preliminary results for 1 vs. 1 tactics in StarCraft. {Proceedings of the adaptive and learning agents workshop (at AAMAS-13)}]. In this framework, a teacher agent instructs a student agent by suggesting actions the student should take as it learns. However, the teacher may only give such advice a limited number of times. We present several novel algorithms that teachers can use to budget their advice effectively, and we evaluate them in two complex video games: StarCraft and Pac-Man. Our results show that the same amount of advice, given at different moments, can have different effects on student learning, and that teachers can significantly affect student learning even when students use different learning methods and state representations.

  14. 77 FR 48169 - The Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 1...

    Science.gov (United States)

    2012-08-13

    ... Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 1; The Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 2 AGENCY: United States... Technology Agreement: Advice and Information on the Proposed Expansion: Part 1, and investigation No. 332-536...

  15. Targeting the robo-advice customer: the development of a psychographic segmentation model for financial advice robots

    OpenAIRE

    van Thiel, D.; van Raaij, W.F.

    2017-01-01

    The purpose of this study is to develop the world’s first psychographic market segmentation model that supports personalization, customer education, customer activation, and customer engagement strategies with financial advice robots. As traditional segmentation models in consumer finance primarily focus on externally observed demographics or economic criteria such as profession, age, income, or wealth, post-hoc psychographic segmentation further supports personalization in the digital adviso...

  16. Neural computations underpinning the strategic management of influence in advice giving.

    Science.gov (United States)

    Hertz, Uri; Palminteri, Stefano; Brunetti, Silvia; Olesen, Cecilie; Frith, Chris D; Bahrami, Bahador

    2017-12-19

    Research on social influence has focused mainly on the target of influence (e.g., consumer and voter); thus, the cognitive and neurobiological underpinnings of the source of the influence (e.g., politicians and salesmen) remain unknown. Here, in a three-sided advice-giving game, two advisers competed to influence a client by modulating their own confidence in their advice about which lottery the client should choose. We report that advisers' strategy depends on their level of influence on the client and their merit relative to one another. Moreover, blood-oxygenation-level-dependent (BOLD) signal in the temporo-parietal junction is modulated by adviser's current level of influence on the client, and relative merit prediction error affects activity in medial-prefrontal cortex. Both types of social information modulate ventral striatum response. By demonstrating what happens in our mind and brain when we try to influence others, these results begin to explain the biological mechanisms that shape inter-individual differences in social conduct.

  17. Early outbreak detection by linking health advice line calls to water distribution areas retrospectively demonstrated in a large waterborne outbreak of cryptosporidiosis in Sweden

    Directory of Open Access Journals (Sweden)

    Pär Bjelkmar

    2017-04-01

    Full Text Available Abstract Background In the winter and spring of 2011 a large outbreak of cryptosporidiosis occurred in Skellefteå municipality, Sweden. This study summarizes the outbreak investigation in terms of outbreak size, duration, clinical characteristics, possible source(s and the potential for earlier detection using calls to a health advice line. Methods The investigation included two epidemiological questionnaires and microbial analysis of samples from patients, water and other environmental sources. In addition, a retrospective study based on phone calls to a health advice line was performed by comparing patterns of phone calls between different water distribution areas. Results Our analyses showed that approximately 18,500 individuals were affected by a waterborne outbreak of cryptosporidiosis in Skellefteå in 2011. This makes it the second largest outbreak of cryptosporidiosis in Europe to date. Cryptosporidium hominis oocysts of subtype IbA10G2 were found in patient and sewage samples, but not in raw water or in drinking water, and the initial contamination source could not be determined. The outbreak went unnoticed to authorities for several months. The analysis of the calls to the health advice line provides strong indications early in the outbreak that it was linked to a particular water treatment plant. Conclusions We conclude that an earlier detection of the outbreak by linking calls to a health advice line to water distribution areas could have limited the outbreak substantially.

  18. An Examination of Family, Healthcare Professionals, and Peer Advice on Physical Activity Behaviors among Adolescents at High Risk for Type 2 Diabetes.

    Science.gov (United States)

    Amuta, Ann O; Jacobs, Wura; Barry, Adam E

    2017-07-01

    Studies have shown that many college students do not meet the recommended daily physical activity (PA) levels, and about 22% of these students are overweight. Given that engaging in PA is a protective behavior against many chronic conditions, it is imperative to understand what sources of information/advice to engage in PA is most influential. Hence, the purpose of this study was to examine the relative impact of different sources of advice regarding exercise and PA on actual PA engagement among obese/overweight adolescents. Using data from 319 overweight/obese college students, multivariate regression analyses were conducted to examine which source of advice (from parents, peers, or healthcare provider) to engage in PA was associated with PA behavior among these adolescents. Influence of type 2 diabetes (T2D) family history on PA behavior was also examined. Moderate and vigorous PA behavior was more likely among obese/overweight adolescents who received advice to exercise or engage in PA from their peers (B = 200.85, β = 0.193, p = 0.001; B = 121.19, β = 0.145, p = 0.014). Overweight/obese adolescents with a T2D family history were more likely to walk compared with those without a T2D family history (χ 2  = 12.97, p = 0.000). Findings suggest that although healthcare professionals advise obese/overweight adolescents, those who received advice regarding PA behavior from their peers were more likely to heed the advice and exercise/engage in PA. In essence, intervention efforts should focus on employing peer ambassadors to counsel other adolescents on the importance of PA.

  19. Use of healthcare information and advice among non-urgent patients visiting emergency department or primary care.

    Science.gov (United States)

    Backman, Ann-Sofie; Lagerlund, Magdalena; Svensson, Tobias; Blomqvist, Paul; Adami, Johanna

    2012-12-01

    Healthcare information provided by telephone service and internet sources is growing but has not been shown to reduce inappropriate emergency department (ED) visits. To describe the use of advice or healthcare information among patients with non-urgent illnesses seeking care before attendance at an ED, or primary care (PC) centres in an urban region in Sweden. Patients with non-urgent illnesses seeking care at an ED or patients attending the PC were followed up with a combination of patient interviews, a questionnaire to the treating physician and a prospective follow-up of healthcare use through a population-based registry. Half of the non-urgent patients attending the ED had used healthcare information or advice before the visit, mainly from a healthcare professional source. In PC, men were more likely to have used information or advice compared with women (OR 2.5 95% CI 1.3 to 5.0), whereas the situation was reversed among ED patients (OR=0.4 95% CI 0.2 to 0.9). Men with no previous healthcare experience attending the ED had the lowest use of healthcare information (pinformation on the internet in a case of perceived emergency. ED patients rated as non-urgent by the triage nurse used more advice and healthcare information than PC patients, irrespective of the physician-rated urgency of the symptoms. The problem seems not to be lack of information about appropriate ED use, but to find ways to direct the information to the right target group.

  20. A quantitative analysis of the quality and content of the health advice in popular Australian magazines.

    Science.gov (United States)

    Wilson, Amanda; Smith, David; Peel, Roseanne; Robertson, Jane; Kypri, Kypros

    2017-06-01

    To examine how health advice is provided in popular magazines and the quality of that advice. A prospective quantitative analysis of the quality of health advice provided in Australian magazines between July and December 2011 was conducted. A rating instrument was adapted from the Media Doctor Australia rating tool used to assess quality of health news reporting. Criteria included: recommends seeing a doctor; advice based on reliable evidence; advice clear and easily applied; benefits presented meaningfully; potential harms mentioned; evidence of disease mongering; availability and cost of treatments; obvious advertising; vested interest, and anecdotal evidence. 163 health advice articles were rated showing a wide variation in the quality of advice presented between magazines. Magazines with 'health' in the title, rated most poorly with only 36% (26/73) of these articles presenting clear and meaningful advice and 52% (38/73) giving advice based on reliable evidence. Australian magazines, especially those with health in the title, generally presented poor quality, unreliable health advice. Teen magazine Dolly provided the highest quality advice. Consumers need to be aware of this when making health choices. © 2016 Public Health Association of Australia.

  1. More about software requirements thorny issues and practical advice

    CERN Document Server

    Wiegers, Karl E

    2006-01-01

    No matter how much instruction you've had on managing software requirements, there's no substitute for experience. Too often, lessons about requirements engineering processes lack the no-nonsense guidance that supports real-world solutions. Complementing the best practices presented in his book, Software Requirements, Second Edition, requirements engineering authority Karl Wiegers tackles even more of the real issues head-on in this book. With straightforward, professional advice and practical solutions based on actual project experiences, this book answers many of the tough questions rais

  2. Delivering effective science communication: advice from a professional science communicator.

    Science.gov (United States)

    Illingworth, Sam

    2017-10-01

    Science communication is becoming ever more prevalent, with more and more scientists expected to not only communicate their research to a wider public, but to do so in an innovative and engaging manner. Given the other commitments that researchers and academics are required to fulfil as part of their workload models, it is unfair to be expect them to also instantly produce effective science communication events and activities. However, by thinking carefully about what it is that needs to be communicated, and why this is being done, it is possible to develop high-quality activities that are of benefit to both the audience and the communicator(s). In this paper, I present some practical advice for developing, delivering and evaluating effective science communication initiatives, based on over a decade of experience as being a professional science communicator. I provide advice regarding event logistics, suggestions on how to successfully market and advertise your science communication initiatives, and recommendations for establishing effective branding and legacy. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  3. ADVICE for a healthier life: Adult Vaccination Campaign in Europe.

    Science.gov (United States)

    Ozisik, Lale; Tanriover, Mine Durusu; Rigby, Shirley; Unal, Serhat

    2016-09-01

    Immunization is one of the most effective public health measures to prevent disease. Despite relatively good vaccination rates in childhood in many parts of the world, vaccines to prevent diseases are underused in the adult population and adult vaccination rates are still far below the target. The European Federation of Internal Medicine (EFIM), declared that 'internal medicine must focus on better care for individuals, better health care for populations and lower costs'. Adult vaccination is a good example of a public health initiative aimed at reducing morbidity and mortality, but awareness of the need for adult vaccination and uptake of the programs across Europe is variable. The Adult Vaccination Campaign in Europe (ADVICE) was developed with an aim to raise awareness for adult vaccination and to understand the dynamics of the vaccination practices and the possible barriers against achieving targeted vaccination rates in Europe. In order to reach vaccination targets, we need evidence based, up to date guidelines; recommendations at national and international levels; surveillance for vaccination rates; and opportunities to provide vaccines more readily. Leadership at a European level and a firm research and action agenda are crucial. The European Federation of Internal Medicine can take the lead as it declared its interest on 'better care for individuals, better health care for populations'. Hence, we consider ADVICE a very timely and very valuable initiative to draw a roadmap to improve adult vaccination rates in Europe. Copyright © 2016. Published by Elsevier B.V.

  4. Breastfeeding, co-sleeping and dental health advice.

    Science.gov (United States)

    Wert, Katie M Lapps; Lindemeyer, Rochelle; Spatz, Diane L

    2015-01-01

    To identify dental health advice offered by healthcare providers (HCPs) to mothers that cosleep and breastfeed at night. Mothers were recruited via local contacts, e-mail, and support groups. In-person, digitally recorded interviews were conducted with 14 cosleeping, breastfeeding mothers with children from 6 months to 2 years. Interviews included seven open-ended questions about cosleeping patterns, night breastfeeding patterns, and dental health advice offered by HCPs. These HCPs included pediatricians, family medicine physicians, midwives, and obstetricians. Interviews were transcribed verbatim and qualitative descriptive analysis was done. The majority of women reported keeping their child in bed with them for most, if not all, of the night. All of the mothers reported breastfeeding on demand. Approximately half of the mothers did not disclose their sleeping patterns to their HCP. Mothers reported few HCPs initiated a discussion on cosleeping or oral hygiene for their child. Mothers did not readily share their cosleeping, nor did most HCPs initiate a conversation about cosleeping and dental hygiene. This qualitative study identifies the need for education on anticipatory guidance of oral hygiene discussions from HCPs. As HCPs, it is our responsibility to initiate the conversation with the mother because this study demonstrates that mothers will be unlikely to do so.

  5. Unrealistic optimism in advice taking: A computational account.

    Science.gov (United States)

    Leong, Yuan Chang; Zaki, Jamil

    2018-02-01

    Expert advisors often make surprisingly inaccurate predictions about the future, yet people heed their suggestions nonetheless. Here we provide a novel, computational account of this unrealistic optimism in advice taking. Across 3 studies, participants observed as advisors predicted the performance of a stock. Advisors varied in their accuracy, performing reliably above, at, or below chance. Despite repeated feedback, participants exhibited inflated perceptions of advisors' accuracy, and reliably "bet" on advisors' predictions more than their performance warranted. Participants' decisions tightly tracked a computational model that makes 2 assumptions: (a) people hold optimistic initial expectations about advisors, and (b) people preferentially incorporate information that adheres to their expectations when learning about advisors. Consistent with model predictions, explicitly manipulating participants' initial expectations altered their optimism bias and subsequent advice-taking. With well-calibrated initial expectations, participants no longer exhibited an optimism bias. We then explored crowdsourced ratings as a strategy to curb unrealistic optimism in advisors. Star ratings for each advisor were collected from an initial group of participants, which were then shown to a second group of participants. Instead of calibrating expectations, these ratings propagated and exaggerated the unrealistic optimism. Our results provide a computational account of the cognitive processes underlying inflated perceptions of expertise, and explore the boundary conditions under which they occur. We discuss the adaptive value of this optimism bias, and how our account can be extended to explain unrealistic optimism in other domains. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  6. Patients who leave the emergency department against medical advice.

    Science.gov (United States)

    Lee, Choung Ah; Cho, Joon Pil; Choi, Sang Cheon; Kim, Hyuk Hoon; Park, Ju Ok

    2016-06-01

    Discharge against medical advice (DAMA) from the emergency department (ED) accounts for 0.1% to 2.7% of all ED discharges. DAMA carries a risk of increased mortality and readmissions. Our aim was to investigate the general characteristics of DAMA patients and the differences between them and non-DAMA patients. We reviewed data collected by the National Emergency Medical Center between 2010 and 2011. Subjects were categorized into 2 groups, namely, the DAMA group and the non-DAMA group. We compared these groups with respect to age, gender, trauma or non-trauma status, type of hospital, health insurance, level of consciousness on admission, and diagnosis. Of 8,000,529 patients, 222,389 (2.78%) left against medical advice. The risk factors for DAMA across all age groups were as follows: no medical insurance (odds ratio [OR], 1.993), initial response to voice (OR, 2.753) or pain (OR, 2.101), trauma admission (OR, 1.126), admission to a local emergency medical center (OR, 1.215), and increased age. A high risk of DAMA was observed among patients with immune, endocrine, psychiatric, neurological, circulatory diseases, and external causes of morbidity and mortality. Although DAMA cases account for only a small percentage of hospital discharges, they are important because DAMA patients have high readmission and mortality rates. It is therefore important to understand the general characteristics and predictors of DAMA in order to improve patient outcome and minimize the economic burden on the healthcare system.

  7. Diagnostic medical exposures: advice on exposure to ionising radiation during pregnancy

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The NRPB offers advice on exposure to ionizing radiation during pregnancy, based on data published since 1985. In providing this advice the Board has considered risks to the developing embryo and fetus of death, malformation, mental impairment, cancer (solid tumours and leukaemias) and genetic damage from irradiation after the first missed menstrual period. The possible risks from irradiation of the early (up to 3-4 weeks) conceptus and from gonodal irradiation of patients is also covered in the present advice. (Author)

  8. Patient responses to inhaler advice given by community pharmacies

    DEFF Research Database (Denmark)

    Kaae, Susanne; Aarup, Kristine Hallberg Friis; Sporrong, Sofia Kälvemark

    2017-01-01

    BACKGROUND: The value of counseling in community pharmacy depends on its ability to help patients improve their use of medicine and thereby health status, by their adherence to recommendations. Studies showing how patients respond to daily pharmacy counseling are, however, scarce. The aim...... of this study was therefore to investigate how patients respond to medical advice given by pharmacy staff. METHODS: A heterogeneous sample of patients who received the 'Inhaler Technique Assessment Service' (ITAS) in Denmark were interviewed, using a semi-structured schedule. Meaning condensation...... proposed by pharmacy staff. CONCLUSIONS: ITAS recommendations seemed important to adhere with for patients despite experiencing difficulties when doing so and secondly not feeling an immediate improvement of health. Reasons for this appear to be connected with the concept of meaningfulness. Hence...

  9. Sport participation and Ramadan observance: Advice for the athlete

    Directory of Open Access Journals (Sweden)

    Roy J. Shephard

    2015-07-01

    Full Text Available Introduction: A growing number of Muslim athletes now engage in international competition. This raises the question of the advice they should be given if a major event occurs during the month of Ramadan. Methods: A narrative review has been based upon books and extensive reviews completed by the author and other investigators. Results: Practical considerations hamper assessment of the effects of Ramadan upon physical performance, but there seem small decreases in muscular strength and both anaerobic and aerobic capacity.  Nevertheless, athletes who wish to observe Ramadan can reduce such effects by prior adjustment of diet and training plans, minimizing sleep loss, and careful management of fluid and food intake during the period of intermittent fasting. Conclusion: Competitors in most events can observe Ramadan with a small loss of athletic performance. However, intermittent fasting can endanger health for individuals with type I diabetes mellitus, and for participants in ultra-endurance events (particularly under hot conditions.

  10. Advice and dissent: rating the corporate governance compact.

    Science.gov (United States)

    Wharton, C R; Lorsch, J W; Hanson, L

    1991-01-01

    The July-August 1991 HBR presented "A New Compact for Owners and Directors," a set of principles for reconciling differences between owners and managers. In "Advice and Dissent: Rating the Corporate Governance Compact," a panel of three experts evaluates the Compact--and takes issue with its fundamental recommendation. Clifton R. Wharton, Jr., chairman and CEO of TIAA-CREF, describes how his organization brings delinquent managers and directors to task. Harvard Business School professor Jay W. Lorsch explains why strengthening the role of outside directors will develop more effective corporate control. And Lord Hanson, chairman of Hanson PLC, reaffirms the importance of maintaining a unitary board of directors and maximizing shareholder value.

  11. Telemedical advice to long-distance passenger ferries

    DEFF Research Database (Denmark)

    Jensen, Olaf C; Bo Bøggild, Niels; Kristensen, Søren

    2005-01-01

    BACKGROUND: Radio medical (RM) advice for seafarers and traveling passengers is important and can be crucial for the optimal medical treatment on board ships. The aim of this study was to analyze the data from consultations with passenger ferries to identify areas for possible improvements. METHODS......: Data from the journals for 1 year from Radio Medical Denmark consultations with the medical officers on passenger ferries were analyzed retrospectively. RESULTS: Two hundred fourteen RM records, 73% pertaining to passengers and 27% for crew members, were analyzed. Passenger patients were generally...... older and more seriously ill than patients among the crew. A high number of potential and life-threatening medical conditions such as angina pectoris was seen among the passengers, and nine of these patients were evacuated by helicopter. Sixty-three percent (n = 135) of the calls related to pain...

  12. The effects of civility on advice, leadership, and performance.

    Science.gov (United States)

    Porath, Christine L; Gerbasi, Alexandra; Schorch, Sebastian L

    2015-09-01

    Workplace incivility is rampant and on the rise-with costs to individuals and organizations. Despite the increased need for civility, little is known about potential individual benefits of civility, defined as behavior involving politeness and regard for others in the workplace, within workplace norms for respect (Andersson & Pearson, 1999). Recent research has suggested that being civil may be hazardous to influence, power, and income (see Forni, 2002; Judge et al., 2012).Yet, throughout history, civil behavior has been extolled because it paid dividends to the person who behaved well. The focus of this research is whether that holds true in organizations. Using social exchange theory, we developed hypotheses about how civility benefits people, and investigated this in 2 studies. First, in a 2-wave social network study of a research and development department (n = 31) of a biotechnology firm, we found that people who perceived a colleague as civil would be more likely to seek that person out for work advice and to see that person as a leader. The more the individual was perceived as civil by others in his or her network, the better his or her performance. Being sought out for work advice and being viewed as a leader mediated this effect. In the second experiment (n = 162), we extended our understanding of what drove these benefits. We found that people who are civil were perceived as warm and competent, and these positive perceptions, in turn, helped to explain the benefits garnered. We discuss theoretical and practical implications. (c) 2015 APA, all rights reserved).

  13. Nutritional Advice for Patients with Melasma in Iranian Traditional Medicine

    Directory of Open Access Journals (Sweden)

    Mahdis Mojtabaee

    2016-03-01

    Full Text Available Background Melasma (called Kalaf in Iranian traditional medicine is a common acquired hypermelanosis that affects sun-exposed areas of skin. Several factors including exposure to sunlight, pregnancy, and endocrine diseases increase the risk for Melasma. In traditional medicine, antecedent philosophers and physicians have tried to understand the nature and mechanisms of different systems of the human body for the diagnosis and management of Melasma; they have offered different solutions for it. This study is important since Melasma is a disease causing mental side effects in patients, due to darkness and opacity of the skin; therefore, the treatment of Melasma in terms of its psychological complications is of particular importance. In addition, texts of Iranian traditional medicine contain a wealth of nutritional advice for patients with Melasma. These texts have, until now, not yet been reviewed. The present study has considered the most important references of Iranian traditional medicine texts. Objectives The objective of this study was to extract and categorize the nutritional advice of Iranian traditional medicine texts for the treatment of Melasma. Results Dietary recommendations, not only for treatment but also for prevention of diseases and staying healthy, are very efficient. Conclusions Based on the traditional medicine texts, it is helpful to avoid Soda-producing food as well as to identify appropriate food in order to eliminate the accumulation of Soda or black bile from the blood. This study offers a set of analytical and clinical research on food, which in traditional medicine is called Soda-producing as well as Soda reducing.

  14. Science advice in the white house? Continuation of a debate.

    Science.gov (United States)

    Skolnikoff, E B; Brooks, H

    1975-01-10

    Thus, we are skeptical of the commonly stated arguments for re-creation of a science office at the White House, but are ultimately convinced that such an office is justified. A three-man CST is a reasonable proposal, although the detailed structure is less critical than the mandate given to the office, and the general understanding within government of its functions and limitations and of its relationship to the President. To give it permanence, the office should be grounded in a science policy management and oversight function that is critically needed today. That kind of strong office could lead a president to use it as his personal science advisory staff, but the decision must be made anew by each president. The President does have other ways of obtaining scientific advice, although the right kind of science office would be a preferable route in our view. The importance of such an office being able to present its analyses and recommendations in policy terms useful to other policy-makers cannot be overestimated. This has important implications for the kind of competence required to staff and work with such a council; it also requires recognition of the fact that policy-relevant studies and advice can never be value-free, even when carried out by scientists and engineers. And finally, such a council could bring intensive and continuous attention to the international dimension of U.S. science policy, which seems to us to be particularly neglected. It is not yet clear whether there will be any structural changes in the new Administration. But it is not too soon to be clearer about the essential factors that should underlie a sensible proposal for this or the next Administration.

  15. From single-species advice to mixed-species management: taking the next step

    DEFF Research Database (Denmark)

    Vinther, Morten; Reeves, S.A.; Patterson, K.R.

    2004-01-01

    that accounts for mixed-fishery effects, but in the short term there is a need for approaches to resolve the conflicting management advice for different species within the same fishery, and to generate catch or effort advice that accounts for the mixed-species nature of the fishery. This paper documents...... a recent approach used to address these problems. The approach takes the single-species advice for each species in the fishery as a starting point, then attempts to resolve it into consistent catch or effort advice using fleet-disaggregated catch forecasts in combination with explicitly stated management...

  16. Dietary advice with or without oral nutritional supplements for disease-related malnutrition in adults.

    Science.gov (United States)

    Baldwin, Christine; Weekes, Christine Elizabeth

    2011-09-07

    Disease-related malnutrition has been reported in 10% to 55% of people in hospital and the community. Dietary advice encouraging the use of energy- and nutrient-rich foods rather than oral nutritional supplements has been suggested as the initial approach for managing disease-related malnutrition. To examine evidence that dietary advice in adults with disease-related malnutrition improves survival, weight and anthropometry; to estimate the size of any additional effect of nutritional supplements combined with dietary advice and to compare the effects of dietary advice with oral nutritional supplements. Relevant publications were identified from comprehensive electronic database searches and handsearching.Last search: 14 February 2010. Randomised controlled trials of dietary advice with or without oral nutritional supplements in people with disease-related malnutrition in any health-care setting compared with no advice, oral nutritional supplements or dietary advice given alone. Two authors independently assessed trial eligibility, risk of bias and extracted data. Forty-five studies (3186 participants) met the inclusion criteria; (dietary advice compared with: no advice (1053 participants); with oral nutritional supplements (332 participants); with dietary advice and oral nutritional supplements (731 participants); and dietary advice plus oral nutritional supplements compared with no additional intervention (1070 participants). Follow-up ranged from 18 days to 24 months. No comparison showed a significant difference between groups for mortality or morbidity. There was a significant change in weight found between groups when comparing dietary advice to no advice for interventions lasting greater than 12 months, mean difference 3.75 kg (95% confidence interval 0.97 to 6.53), and when all studies were combined, mean difference 1.47 kg (95% confidence interval 0.32 to 2.61) although there was significant heterogeneity in the combined analysis (I(2) = 90%). Similar

  17. Internet provision of tailored advice on falls prevention activities for older people: a randomized controlled evaluation.

    Science.gov (United States)

    Yardley, Lucy; Nyman, Samuel R

    2007-06-01

    Falls are very common in older persons and can result in substantial disability and distress. By undertaking strength and balance training (SBT) exercises, older people can reduce their risk of falling. The Internet offers a potentially cost-effective means of disseminating information about SBT to older people and their carers. A particular advantage of using the Internet for this purpose is that the advice given can be 'tailored' to the needs of the individual. This study used a randomized controlled design to evaluate an interactive web-based program that tailored advice about undertaking SBT activities. The participants were 280 people with an age range of 65-97 years recruited by advertising the website by email and the Internet. Those randomized to the tailored advice were presented with advice tailored to their personal self-rated balance capabilities, health problems and activity preferences. Those in the control group were presented with all the advice from which the tailored advice was selected. After reading the advice, those in the tailored advice group (n = 144) had more positive attitudes (p < 0.01) than those in the control group (n = 136), reporting greater perceived relevance of the SBT activities, greater confidence in the ability to carry them out, and hence stronger intentions to undertake the activities. This study provides an initial indication that an interactive website might offer a cost-effective way to provide personalized advice to some older people. Further research is required to determine whether website-based advice on falls prevention changes behavior as well as intentions and whether the advice needs to be supplemented by other forms of support.

  18. Sports Nutrition Knowledge, Perceptions, Resources, and Advice Given by Certified CrossFit Trainers

    Directory of Open Access Journals (Sweden)

    Cassie Maxwell

    2017-03-01

    Full Text Available Background: CrossFit is a large, growing force in the fitness community. Currently, Level 1 and 2 CrossFit certification classes do not include nutrition education. The purpose of this study was to identify sports nutrition knowledge, perceptions, resources, and advice given by Certified CrossFit Trainers. Methods: An online questionnaire that measured these four constructs was placed on a private Facebook community, open only to certified CrossFit trainers, for 10 days. Results: Complete surveys were obtained from 289 CrossFit trainers. The mean Sport Nutrition Knowledge (SNK score was 11.1 ± 2.1, equivalent to 65.3% ± 12.4% correct. The trainers perceived nutrition to be extremely important to athletic performance (9.4 ± 0.9 on a 10 point scale. Overall, the trainers graded their SNK higher than that of their CrossFit peers. The internet and CrossFit peers were the most frequently reported sources for nutrition information; Registered Dietitians were the least reported source. The Paleo and Zone diets were the most common dietary regimens recommended by CrossFit trainers. Results indicated a positive correlation between a CrossFit trainer’s self-reported hours of nutrition education and their SNK score (r = 0.17; p < 0.01. Conclusion: Nutrition education modules for Level 1 and 2 CrossFit trainers, developed with input from Board Certified Specialists in Sports Dietetics, are recommended.

  19. Quality of Extension Advice: A Gendered Case Study from Ghana and Sri Lanka

    Science.gov (United States)

    Lamontagne-Godwin, Julien; Williams, Frances; Bandara, Willoru Mudiyansele Palitha Thilakasiri; Appiah-Kubi, Ziporah

    2017-01-01

    Purpose: Women farmers have less access to extension services than male farmers, even though they make up almost half of the global agricultural workforce. Gender-focused international development programmes have focused on how ensuring women receive better access to advice. However, the quality of the technical advice and the service women…

  20. 75 FR 33824 - Pharmaceutical Products and Chemical Intermediates, Fourth Review: Advice Concerning the Addition...

    Science.gov (United States)

    2010-06-15

    ... Intermediates, Fourth Review: Advice Concerning the Addition of Certain Products to the Pharmaceutical Appendix..., Pharmaceutical Products and Chemical Intermediates, Fourth Review: Advice Concerning the Addition of Certain...-zero initiative are conducting a fourth review to determine if products can be added to the initiative...

  1. The role of financial literacy and advice in fi nancial decision making ...

    African Journals Online (AJOL)

    A growing body of research is focused on determining to what extent fi nancial advice can act as a substitute for low levels of fi nancial literacy. To date, studies have found confl icting results. This study used data from a national survey of South Africans to determine whether advice could substitute for low levels of fi nancial ...

  2. Patients, evidence and genes: an exploration of GPs' perspectives on gene-based personalized nutrition advice

    NARCIS (Netherlands)

    Bouwman, L.I.; Molder, te H.F.M.; Hiddink, G.J.

    2008-01-01

    Background. Nutrigenomics science examines the response of individuals to food compounds using post-genomics technology. It is expected that in the future, personalized nutrition advice can be provided based on information about genetic make-up. Objectives. Gene-based personalized nutrition advice

  3. Empowering Girls through Sport? Sports Advice Books for Young Female Readers

    Science.gov (United States)

    Heinecken, Dawn

    2016-01-01

    Advice books by female athletes are among the top selling sports books for young readers in the US. Though they have received little attention to date, sports advice books are important to examine because of how they function as a form of conduct manual instructing girls in specific understandings of female identity. Implying that girls face…

  4. An experimental study into the influence of works council advice on managerial decision-making

    NARCIS (Netherlands)

    Sapulete, S.; van Witteloostuijn, A.; Kaufmann, W.

    This paper experimentally studies the effect of works council advice on managerial decision-making, aiming to gain more insights into the fundamental mechanisms that may underlie the impact of works council advice. We conducted laboratory experiments in which subjects played a two-player Prisoner's

  5. Young People's Use of Friends and Family for Sex and Relationships Information and Advice

    Science.gov (United States)

    Powell, Eryl

    2008-01-01

    With the recognition that improving access to advice and support on sex and relationships is vital in helping young people make positive healthy choices, the present paper explores how young people gain such information and advice. Drawing on the analysis of questionnaire and interview data collected for a local study of 401 young people from…

  6. Assessing drivers ability to carry out headway advice in motorway car driving

    NARCIS (Netherlands)

    Risto, Malte; Martens, Marieke Hendrikje; nb,

    2011-01-01

    In order to improve throughput on motorways, a headway advisory system is being developed. This system could enable drivers to choose their headway differently by providing in-vehicle advice. How well are drivers able to follow a time or a distance headway advice and what effect has vehicle speed

  7. Peer Tutoring in a Graduate Writing Centre: Identity, Expertise, and Advice Resisting

    Science.gov (United States)

    Waring, Hansun Zhang

    2005-01-01

    Compared to research on the giving of advice (e.g. Hutchby 1995), relatively less work has been conducted on the receiving or resisting of advice, where the interactionally problematic nature of advising is crystallized (e.g. Heritage and Sefi 1992). Moreover, the notion of advising in education settings has predominantly concerned procedural…

  8. Who Leaves the Hospital Against Medical Advice in the Orthopaedic Setting?

    NARCIS (Netherlands)

    Menendez, Mariano E.; van Dijk, C. Niek; Ring, David

    2015-01-01

    Patients who leave the hospital against medical advice are at risk for readmission and for a variety of complications and are likely to consume more healthcare resources. However, little is known about which factors, if any, may be associated with self-discharge (discharge against medical advice)

  9. The binding study advice in medical education: a 2-year experience.

    Science.gov (United States)

    Eijsvogels, Thijs M H; Goorden, Ronald; van den Bosch, Wil; Hopman, Maria T E

    2015-02-01

    To improve the effectiveness of higher education, Dutch universities implemented the binding study advice at medical faculties. Accordingly, medicine students of Radboud University need to gain ≥ 42 out of 60 European Credit Transfer System (ECTS) credits to obtain a positive binding study advice and to continue their study programme. In case of a negative advice, the student is obliged to terminate the study, and he/she cannot register for the same study programme in the Netherlands within the next three years. The purpose of this manuscript is to evaluate the effect of implementation of the binding study advice on study outcomes. First, the binding study advice did not impact on student performance, as the average ECTS credits were comparable before and after its introduction. Second, study progress improved 8 % with 93 % of the students obtaining access to the second year of the study programme after binding study advice implementation. Third, the binding study advice did not impact propaedeutic graduation rates. These data demonstrate that the implementation of the binding study advice in medical faculties has only a small impact on study outcomes. The high performance levels of medical students compared with peers at other faculties are likely to contribute to these findings and suggest a 'ceiling effect' in the potential improvement of study outcomes at medical faculties.

  10. The binding study advice in medical education: a 2-year experience.

    NARCIS (Netherlands)

    Eijsvogels, T.M.H.; Goorden, R.; Bosch, W.J.H.M. van den; Hopman, M.T.E.

    2015-01-01

    To improve the effectiveness of higher education, Dutch universities implemented the binding study advice at medical faculties. Accordingly, medicine students of Radboud University need to gain >/= 42 out of 60 European Credit Transfer System (ECTS) credits to obtain a positive binding study advice

  11. 19 CFR 181.99 - Issuance of NAFTA advance rulings or other advice.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Issuance of NAFTA advance rulings or other advice... Procedures § 181.99 Issuance of NAFTA advance rulings or other advice. (a) NAFTA advance ruling letters—(1... administration of the NAFTA provisions to do so. Otherwise, a request for an advance ruling will be answered by...

  12. Tapping into Alumni as a Source of Authentic Information and Advice on Careers in Psychology

    Science.gov (United States)

    Lawson, Timothy J.

    2018-01-01

    This article describes how my psychology department utilizes our alumni to educate current and prospective students about careers in psychology. I explain how we developed an alumni careers website and on-campus alumni careers sessions for students. High school students and our psychology majors reported that they found this information valuable,…

  13. Professional and Scholarly Writing: Advice for Information Professionals and Academics

    Directory of Open Access Journals (Sweden)

    Cox, Richard J.

    2015-12-01

    Full Text Available There has been an explosion of new research and writing about all aspects of the information disciplines. Nevertheless, both academics and practitioners often find it difficult to engage in successful writing strategies. Indeed, writing is hard work, and doing it in a way that leads to publication is an even harder task. Since reading is essential to good writing, the challenges of learning to write are obvious. In this essay, I am drawing on many years of experience in writing and publishing, as well as considerable reading of writers’ memoirs, advice books on writing, literary studies, and other perspectives on the experience of writing in order to offer a set of approaches that can be pursued over a lifetime of scholarship and practice. Writing is a craft or art to be learned, and learning demands paying attention to the audience, having clear objectives, being an avid reader, and possessing the ability to accept and learn from criticism. While information professionals and scholars incessantly write for each other, there are large segments of the public and other disciplines who they ignore. Fortunately, the tools and resources for improving one’s writing are both broad and deep; discipline and realistic strategies are all that are required to improve one’s writing and, ultimately, to achieve success in publishing.

  14. Top-selling childbirth advice books: a discourse analysis.

    Science.gov (United States)

    Kennedy, Holly Powell; Nardini, Katrina; McLeod-Waldo, Rebecca; Ennis, Linda

    2009-12-01

    Recent evidence suggests that one-third of women receive information about pregnancy and childbirth through books. Messages about what characteristics are normal (or expected) in childbirth are disseminated in a variety of ways, including popular childbirth education books, but little study of them has been conducted. The purpose of this investigation is to address that gap by examining the discussions about childbirth in the 10 top-selling books in the United States. Discourse analysis (relating to the public, personal, and political discussions about a specific phenomenon) was used to study 10 best-selling United States childbirth advice books marketed to childbearing women during the first week of November 2007. Book styles ranged from clinical descriptions of pregnancy and birth primarily offering reassurance, self-help information, and danger signs to more folksy and humorous commentaries. Presentation of scientific evidence to support recommendations was uneven and at times inaccurate. Five focal areas of discourse included body image, labor and birth, pain, power and control, and life preparation for motherhood. Top-selling books shine an interesting light on the current state of United States maternity practices. Women and health professionals should assess them carefully and engage with each other about their recommendations and implications for childbirth.

  15. Whatever happens to trauma patients who leave against medical advice?

    Science.gov (United States)

    Olufajo, Olubode A; Metcalfe, David; Yorkgitis, Brian K; Cooper, Zara; Askari, Reza; Havens, Joaquim M; Brat, Gabriel A; Haider, Adil H; Salim, Ali

    2016-04-01

    Although trauma patients are frequently discharged against medical advice (AMA), the fate of these patients remains mostly unknown. Patients with traumatic injuries were identified in the California State Inpatient Database, 2007 to 2011. Readmission characteristics of patients discharged AMA were compared with patients discharged home. There were 203,756 (75.65%) patients discharged home and 4,480 (1.66%) discharged AMA. Compared with those discharged home, patients discharged AMA had significantly higher 30-day readmission rates (17.12% vs 6.75%), rates of multiple readmissions (3.83% vs 1.12%), and likelihood of being readmitted at different hospitals (44.83% vs 33.82%) (all P < .001). The commonest reasons for readmission in patients discharged AMA were psychiatric conditions [adjusted odds ratio: 1.67 (1.21 to 2.27)]. Discharge AMA is associated with multiple readmissions and higher rates of readmissions at different hospitals. Early identification of vulnerable patients and improved modalities to prevent discharge AMA among these patients may reduce the negative outcomes associated with discharge AMA among trauma patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Advice concerning the early diagnosis of bronchial carcinoma

    International Nuclear Information System (INIS)

    1982-01-01

    Bronchial carcinoma is in the Netherlands for men the most frequent type of cancer; the incidence in women is rising. In the Netherlands nowadays, per year about 7100 persons die of this disease which therefore constitutes an important public health problem. The request of advice asks - among other things - whether in the future the periodical X-ray examination of the thorax for the detection of tuberculosis of persons over 40 years can be continued for presymptomatic cases of bronchial carcinoma. The available relevant literature does not yet give indications that periodical mass radiography has any influence on the morbidity and mortality of the disease. On the other hand, literature describing clinical experience shows that the prognosis of patients with bronchial carcinoma, detected in an early presymptomatic stage, is essentially better than in the case of patients with symptomatic disease. A critical analysis of the literature does not furnish epidemiological arguments to recommend periodical mass radiography for bronchial carcinoma. However, because lungcancer forms an extremely important public health problem and because the scarcity of randomized; controlled studies in this field, the committee advises - from a scientific point of view - to perform such a study in one or preferably two regions in the Netherlands. A number of conditions are mentioned which such a study at least should meet. (Auth.)

  17. Vascular injuries during gynecological laparoscopy: the vascular surgeon's advice

    Directory of Open Access Journals (Sweden)

    Marcello Barbosa Barros

    Full Text Available CONTEXT: Iatrogenic vascular problems due to laparoscopy are a well recognized problem and lead to significant repercussions. In this context, a ten-year review of cases topic is presented, based on experience gained while heading two important vascular surgery services. CASES: Five patients with vascular injuries during elective laparoscopy are described. These patients presented with seven lesions of iliac vessels. All cases were evaluated immediately and required laparotomy, provisional hemostasis and urgent attendance by a vascular surgeon. Direct suturing was performed in three cases. One aortoiliac bypass and one ilioiliac reversed venous graft were made. Venous lesions were sutured. One case of a point-like perforation of the small bowel was found. There were no deaths and no complications during the postoperative period. DISCUSSION: Important points on this subject are made, and advice is given. There needs to be immediate recognition of the vascular injury, and expert repair by a vascular surgeon is recommended, in order to significantly reduce the degree of complications.

  18. Advice 14-2014 of the Scientific Committee of the Belgian Food Safety Agency and the Superior Health Council Nr. 9160 on food safety

    OpenAIRE

    Federal Agency for the Safety of the Food Chain

    2014-01-01

    In the search for alternative dietary protein sources, insects appear to offer great potential. Currently there are no specific regulations neither in Belgium, nor in Europe, on the breeding and marketing of insects destined for human consumption. The trade of a number of insect species destined for human consumption is however tolerated in Belgium. In this context, the Scientific Committee and the Superior Health Council are asked to give advice on the potential risk...

  19. Inequalities in advice provided by public health workers to women during antenatal sessions in rural India.

    Directory of Open Access Journals (Sweden)

    Abhishek Singh

    Full Text Available Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India.The District Level Household Survey (2007-08 was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%-72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice.A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver appropriate and recommended advice to all clients

  20. Does the "script" need a rewrite? Is medication advice in television medical dramas appropriate?

    Science.gov (United States)

    Cowley, M; Naunton, M; Thomas, J; Waddington, F; Peterson, G M

    2017-12-01

    Television medical dramas depict the healthcare industry and draw considerable interest from the public, while pharmacists play an integral part in providing medication-related advice to the public and other health practitioners in real life. The main objective of this retrospective, observational study was to assess the appropriateness of medication advice given in televised medical dramas and how frequently pharmacists were involved in providing the medication advice. Show selection was based on fictional series with a medical drama theme and having the highest viewership. Approximately 100 randomly selected hours of five medical television dramas (House, Grey's Anatomy, Nurse Jackie, Doc Martin and Royal Pains) were assessed for the appropriateness of advice given based on the medication indicated, number of safety checks performed, and the level of adherence to standard clinical guidelines. The appropriateness of medication advice was assessed as appropriate, mostly appropriate, partially appropriate and inappropriate using a piloted, 0-6 point scale. Other parameters recorded included patient demographics, health professionals involved, and the categories of medicines. Medications were mentioned on 424 occasions (on average four times per hour), including 239 occasions where medication advice was given. A pharmacist was involved in giving medication advice only 16 times (7%). Using the assessment tool, overall, medication advice was deemed to be appropriate 24% of the time, mostly appropriate 34%, partially appropriate 13% and inappropriate 7%. Although the medication advice given was often for the correct indication and the advice somewhat followed clinical guidelines, it frequently omitted adequate safety checks. Doc Martin had the highest mean appropriateness score, whereas House and Grey's Anatomy had the lowest. Medication was often used for the correct indication in television medical dramas; however, key safety checks were frequently omitted and other

  1. Advice for salt, sugar and fat intake habits among adults: a national-based study

    Directory of Open Access Journals (Sweden)

    Suele Manjourany Silva

    2013-12-01

    Full Text Available INTRODUCTION : A healthy diet is recognized as an important strategy for promoting health as an essential part of non-pharmacological therapy of various health problems. OBJECTIVE : To analyze the reported advice for the intake of salt, sugar and fat for the Brazilian adults living in urban areas. METHODOLOGY : National-based cross-sectional study with 12,402 adults interviewed in 100 Brazilian cities. RESULTS : The most prevalent advice was to low fat intake (38%, followed by the advice to low salt and sugar intake (36% and sugar (29%. The percentage of receiving different advice was similar and more common among women, older people, those with a partner, higher economic class, former smokers, active and in person with physician diagnoses of hypertension, diabetes and overweight. People with white skin color received more advice to eat healthy food, except for the orientation to low salt intake. CONCLUSION : The results show a low prevalence of advice, which configures a missed opportunity to prevent health problems. Although dietary counseling should not be understood only as the transmission of advice regarding some nutrients, it is important to develop actions in order to qualify services and health professionals, allowing the population to have access to qualified information about the benefits of having healthy lifestyles.

  2. Weight Management Advice for Clients with Overweight or Obesity: Allied Health Professional Survey

    Directory of Open Access Journals (Sweden)

    Suzanne J. Snodgrass

    2016-11-01

    Full Text Available The prevalence of obesity is increasing. The potential for allied health professionals to intervene through the provision of lifestyle advice is unknown. This study aimed to determine the knowledge, attitudes and practices of health professionals in the provision of dietary and physical activity advice for clients with overweight or obesity. Dietitians, exercise physiologists, nurses, occupational therapists, physiotherapists and psychologists (n = 296 working in New South Wales were surveyed using paper-based and online methods. The majority of health professionals (71% believed that providing weight management advice was within their scope of practice; 81% provided physical activity advice but only 57% provided dietary advice. Other than dietitians, few had received training in client weight management during their professional qualification (14% or continuing education (16%. Providing dietary advice was associated with: believing it was within their scope of practice (OR 3.9, 95% CI 1.9–7.9, p < 0.01, training during their entry-level qualification (OR 7.2, 3.2–16.4, p < 0.01 and having departmental guidelines (OR 4.7, 2.1–10.9, p < 0.01. Most health professionals are willing to provide lifestyle advice to clients with overweight or obesity but few have received required training. Developing guidelines and training for in client weight management may potentially impact on rising obesity levels.

  3. Communicating curriculum reform to students: Advice in hindsight.....

    Directory of Open Access Journals (Sweden)

    McLean Michelle M

    2003-06-01

    Full Text Available Abstract Backgound In view of the changing health care needs of communities, curriculum reform of traditional curricula is inevitable. In order to allay the apprehension that may accompany such change, curriculum development and implementation should be an inclusive process, with both staff and students being well informed of the planned reform. In 2001, the Nelson R. Mandela School of Medicine implemented Year 1 of a problem-based learning curriculum. During the design phase, students and staff were invited to take part in the development and were kept abreast of developments through meetings and newsletters. Method A survey of Years 1–5 students of the last intake into the traditional curriculum was undertaken a few months prior to the implementation of the new programme. Results Students were generally well informed about the impending change, having heard about it from fellow students and staff. The more senior the students, the less the perceived impact of the reform. Although most of what students had heard was correct, some, however, had misconceptions that were generally extreme views (e.g. all self-directed learning; no Anatomy about the new programme. Others expressed valid concerns (e.g. underpreparedness of students from disadvantaged schools; overcrowding in hospitals. Conclusions Advice offered to institutions considering curriculum reform include using various methods to inform internal and external affected parties, ensuring that the student representative body and staff is well informed, reiterating the need for the change, confirming that the new programme meets recognised standards and that the students most affected are reassured about their future studies.

  4. Healthcare Providers' Knowledge of Diets and Dietary Advice.

    Science.gov (United States)

    Arora, Sonali; Atreya, Auras R; Bernstein, Adam M; Kleppel, Reva; Friderici, Jennifer; Schramm, Sarah; Lagu, Tara; Rothberg, Michael B

    2015-09-01

    Little is known about healthcare providers' knowledge of dietary evidence or about what dietary advice providers offer to patients. The objective of our study was to determine which diets providers recommended to patients and providers' beliefs about the evidence behind those recommendations. This was a 22-question cross-sectional survey conducted between February 2013 and September 2013, in 45 ambulatory practices within two health systems. Attending physicians, housestaff, and advanced practitioners in internal medicine, medicine-pediatrics, family medicine, cardiology, and endocrinology practices were audited. Providers' attitudes, perceptions, and beliefs about diet modification were collected. Knowledge scores were constructed based on the number of correct responses to specific questions. Of 343 provider responses, largely from primary care specialties (n = 3027, 90%), the top dietary recommendations were low-salt diet (71%) for hypertension, low-carbohydrate diet (64%) for uncontrolled diabetes mellitus, low saturated fat diet (73%) for dyslipidemia, low-calorie diet (72%) for obesity, and low saturated fat diet (63%) for coronary heart disease. Providers believed that 51% of diet recommendations were supported by randomized trial evidence when they were not. Respondents' overall knowledge of randomized trial evidence for dietary interventions was low (mean [standard deviation] knowledge score 44.3% [22.4%], range 0.0%-100.0%). The survey study from two health systems, using a nonvalidated survey tool limits external and internal validity. Providers report recommending different diets depending on specific risk factors and generally believe that their recommendations are evidence based. Substantial gaps between their knowledge and the randomized trial evidence regarding diet for disease prevention remain.

  5. An exploration of knowledge, attitudes and advice given by health professionals to parents in Ireland about the introduction of solid foods. A pilot study.

    LENUS (Irish Health Repository)

    Allcutt, Claire

    2010-04-21

    ABSTRACT: BACKGROUND: For the purposes of this paper "weaning is defined as the introduction of the first solid foods to infants". Global recommendations by the World Health Organisation (WHO) recommend that all infants be exclusively breast-fed for the first six months of life. No global recommendations have been made for formula fed infants. In Europe it is recommended that weaning foods should be introduced between 18 weeks and 26 weeks regardless of whether infants are breast or formula fed. In the United Kingdom it is recommended that solids be introduced at around six-months for both breast and formula fed infants. In Ireland official guidelines recommend that breast fed infants should be introduced solids at 6 months of age while for formula fed infants the recommendation is for 4 months. The disparity between these global, European, UK and local recommendations may be a source of confusion for parents and health care professional based in Ireland. Emerging evidence suggests that babies in Ireland are given solid foods before the recommended age but there has been little investigation of the weaning advice provided by health professionals. Since community health professionals have routine parent interactions in the pre-weaning and early-weaning period and hence are in a unique position to positively influence parental weaning decisions, this study aimed to explore their knowledge, attitudes and advice practices about weaning. METHODS: A mixed-methods approach was used for the research, commencing with a multi-disciplinary focus group to guide and develop a questionnaire. Questionnaires were then distributed in a postal survey to General Practitioners (GPs) (n 179), Practice Nurses (PNs) (n 121), Public Health Nurses (PHNs) (n 107) and Community Dieticians (CDs) (n 8). RESULTS: The results indicate varying levels of knowledge of official weaning recommendations and a variety of advice practices. CDs and PHNs acknowledged a clear role in providing weaning

  6. Diagnostic medical exposures. Advice on exposure to ionising radiation during pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Sharp, C.; Shrimpton, J.; Bury, R

    1998-07-01

    The main objective of NRPB advice concerning in utero exposures to ionising radiations is 'to prevent unnecessary exposure of the fetus when medical diagnostic procedures involving ionising radiations are indicated during pregnancy'. In addition, advice is meant to help to avoid unnecessary concern or action if an exposure does occur. NRPB issued ASP8 (Exposure to ionising radiation of pregnant women: advice on the diagnostic exposure of women who are, or who may be, pregnant) in 1985. This advice suggested that there would be no risks to the concepts following irradiation during the first 10 days of the menstrual cycle and that subsequent risks in the remainder of the first 4 week period would be likely to be so small that no special limitation on exposure was required - sometimes known as 'the 28-day rule'. In 1993, NRPB published further advice to replace ASP8 in the Documents of the NRPB series, in Volume 4, No 4 - henceforth referred to as Doc NRPB 4(4){sup 2} - which drew upon data published since 1985. The more recent data suggest that risks in the interval between 10 days and the date at which the next menstrual period is due, although still small for most diagnostic procedures, may be significant for higher dose procedures. Consequently, it is considered there is a need to operate a modified policy for such higher dose procedures. This pocket publication has been produced to present in a concise and user-friendly format the basis of the most recent NRPB advice and to provide a guide for the implementation of that advice in the everyday practice of diagnostic radiology. The opportunity has also been taken to provide the most up to date data on doses in the UK. This publication is split into three parts: an introduction to the terms used in the document, a practical guide to implementation of the advice, and the scientific background to the advice.

  7. Health behaviour advice from health professionals to Canadian adults with hypertension: results from a national survey.

    Science.gov (United States)

    Walker, Robin L; Gee, Marianne E; Bancej, Christina; Nolan, Robert P; Kaczorowski, Janusz; Joffres, Michel; Bienek, Asako; Gwadry-Sridhar, Femida; Campbell, Norman R C

    2011-01-01

    Health professionals play an important role in providing health information to patients. The objectives of this study were to examine the type of advice that Canadians with hypertension recall receiving from health professionals to manage their condition, and to assess if there is an association between health behaviour advice provided by health professionals and self-reported engagement in health behaviour modification. Respondents of the 2009 Survey on Living with Chronic Diseases in Canada (N = 6142) were asked about sociodemographic characteristics, health care utilization, and health behaviour modification to control hypertension. Association between receipt of advice from health professional and ever engaging, continuing to engage, and not engaging in health behaviour modification was quantified by prevalence rate ratios. Most participants (90.9%; 95% confidence interval [CI], 89.6-92.2) reported that the health professional most responsible for treating their high blood pressure was their general practitioner. Approximately 9% reported that they had not received or do not recall receiving any advice for blood pressure control. The most commonly reported advice received from a health professional was to participate in physical activity or exercise (70.0%). Respondents who had received advice on health behaviour change to manage their high blood pressure were more likely to report engaging in the behaviour compared with those who did not receive such advice. Many Canadians with hypertension receive health behaviour change advice from their health professionals. Receiving this advice was associated with a greater likelihood of attempting health behaviour change and attempting to sustain that change. Copyright © 2011 Canadian Cardiovascular Society. All rights reserved.

  8. Utilisation of Business Advice in Small Innovative Firms: the Role of Trust and Tacit Knowledge

    Directory of Open Access Journals (Sweden)

    Katarzyna Łobacz

    2016-06-01

    Full Text Available Objective: The aim of this paper is to expand the understanding of the influence of trust relationship, as well as tacit knowledge on the process of business advice utilisation in small innovative firms. Research Design & Methods: The  analysis  is  based  on  empirical  research  conducted with the use of the explorative approach. The multiple case study methodology was used. Findings: Trust relationships as well as tacit knowledge were identified as factors essential to the process of utilisation of business advice in small innovative firms. It was recognised that the significance of both factors is related not only to the process of advice, but also as a purpose of activities happening prior to advice. They are referred to as the initial phase. Implications & Recommendations: The  findings  provide  implications  for  further  research of the structure of the process of business advice utilisation. It is related to the inclusion of the “initial phase”, as well as to the  necessity to include both factors in further research. The paper also provides implicationsrelated to the measurement of business advice output, and recommendations on the construction of public policy instruments. Contribution & Value Added: The originality of this work lies in using the process perspective and qualitative methodology in the field of the utilisation of business advice. It extends our understanding of the processes of business advice with regard to trust, as well as the use of tacit knowledge. The original contribution is to add the “initial phase” to the description of the business advice process.

  9. Diagnostic medical exposures. Advice on exposure to ionising radiation during pregnancy

    International Nuclear Information System (INIS)

    Sharp, C.; Shrimpton, J.; Bury, R.

    1998-01-01

    The main objective of NRPB advice concerning in utero exposures to ionising radiations is 'to prevent unnecessary exposure of the fetus when medical diagnostic procedures involving ionising radiations are indicated during pregnancy'. In addition, advice is meant to help to avoid unnecessary concern or action if an exposure does occur. NRPB issued ASP8 (Exposure to ionising radiation of pregnant women: advice on the diagnostic exposure of women who are, or who may be, pregnant) in 1985. This advice suggested that there would be no risks to the concepts following irradiation during the first 10 days of the menstrual cycle and that subsequent risks in the remainder of the first 4 week period would be likely to be so small that no special limitation on exposure was required - sometimes known as 'the 28-day rule'. In 1993, NRPB published further advice to replace ASP8 in the Documents of the NRPB series, in Volume 4, No 4 - henceforth referred to as Doc NRPB 4(4) 2 - which drew upon data published since 1985. The more recent data suggest that risks in the interval between 10 days and the date at which the next menstrual period is due, although still small for most diagnostic procedures, may be significant for higher dose procedures. Consequently, it is considered there is a need to operate a modified policy for such higher dose procedures. This pocket publication has been produced to present in a concise and user-friendly format the basis of the most recent NRPB advice and to provide a guide for the implementation of that advice in the everyday practice of diagnostic radiology. The opportunity has also been taken to provide the most up to date data on doses in the UK. This publication is split into three parts: an introduction to the terms used in the document, a practical guide to implementation of the advice, and the scientific background to the advice

  10. Sexual Orientation Differences in Adolescent Health Care Access and Health-Promoting Physician Advice.

    Science.gov (United States)

    Luk, Jeremy W; Gilman, Stephen E; Haynie, Denise L; Simons-Morton, Bruce G

    2017-11-01

    Physician screening and advice on health-related behaviors are an integral part of adolescent health care. Sexual minority adolescents encounter more barriers to health services; yet, no prior research has examined whether they also experience disparity in physician screening and advice. We examined possible sexual orientation disparities in health care access, physician screening, and advice on six health-related behaviors. Data were from a national sample of U.S. adolescents who participated in wave 2 of the NEXT Generation Health Study (n = 2023). Poisson regressions were conducted separately for males and females to estimate sexual orientation differences in health care access and health-related screening and advice. Compared with heterosexual males, sexual minority males were more likely to report unmet medical needs in the past year (adjusted relative risk [ARR] = 2.23) but did not differ with respect to receiving physician advice concerning health-related behaviors. Compared with heterosexual females, sexual minority females were more likely to report no routine physical checkup in the past year (ARR = 1.67) but were more likely to receive physician advice to reduce or stop drinking, smoking, drug use, increase physical activity, and improve diet (ARRs = 1.56-1.99), even after controlling for corresponding health-related behaviors. Sexual minority females were also more likely to receive advice about risk associated with sexual behavior (ARR = 1.35) and advice to avoid sexually transmitted diseases (ARR = 1.49). Both sexual minority males and females experienced disparities in some aspects of health care access. Improved health-promoting advice would better serve sexual minority males. Published by Elsevier Inc.

  11. Increased risk of mortality and readmission among patients discharged against medical advice.

    Science.gov (United States)

    Southern, William N; Nahvi, Shadi; Arnsten, Julia H

    2012-06-01

    Approximately 500,000 patients are discharged from US hospitals against medical advice annually, but the associated risks are unknown. We examined 148,810 discharges from an urban, academic health system between July 1, 2002 and June 30, 2008. Of these, 3544 (2.4%) were discharged against medical advice, and 80,536 (54.1%) were discharged home. We excluded inpatient deaths, transfers to other hospitals or nursing facilities or discharges with home care. Using adjusted and propensity score-matched analyses, we compared 30-day mortality, 30-day readmission, and length of stay between discharges against medical advice and planned discharges. Discharge against medical advice was associated with higher mortality than planned discharge, after adjustment (odds ratio [OR](adj) 2.05; 95% confidence interval [CI], 1.48-2.86), and in propensity-matched analysis (OR(matched) 2.46; 95% CI, 1.29-4.68). Discharge against medical advice also was associated with higher 30-day readmission after adjustment (OR(adj) 1.84; 95% CI, 1.69-2.01), and in propensity-matched analysis (OR(matched) 1.65; 95% CI, 1.46-1.87). Finally, discharges against medical advice had shorter lengths of stay than matched planned discharges (3.37 vs 4.16 days, P medical advice is associated with increased risk for mortality and readmission. In addition, discharges against medical advice have shorter lengths of stay than matched planned discharges, suggesting that the increased risks associated with discharge against medical advice are attributable to premature discharge. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Seeking health advice from social networks in low-income urban neighborhoods.

    Science.gov (United States)

    Cook-Craig, Patricia; Ely, Gretchen; Flaherty, Chris; Dignan, Mark; White, Carol R

    2012-11-01

    To examine how individuals residing in low-income neighborhoods use their social networks for health advice. Secondary data analysis of 363 individuals living in low-income neighborhoods was conducted using social network analysis and logistic regression techniques. Findings suggest that residents typically seek health advice from one or 2 friends and family members rather than a health professional. Age and family history of illness increased the likelihood that one would seek support whereas the combination of anxiety and depression decreased advice seeking. Findings support the need for multidisciplinary strategies for disseminating health information through informal social networks.

  13. On Advice Complexity of the k-server Problem under Sparse Metrics

    DEFF Research Database (Denmark)

    Gupta, S.; Kamali, S.; López-Ortiz, A.

    2013-01-01

    We consider the k-Server problem under the advice model of computation when the underlying metric space is sparse. On one side, we introduce Θ (1)-competitive algorithms for a wide range of sparse graphs, which require advice of (almost) linear size. Namely, we show that for graphs of size N...... for the 2-server problem on a path metric of size N ≥ 5. Through another lower bound argument, we show that at least n/2 (log α - 1.22) bits of advice is required to obtain an optimal solution for metric spaces of treewidth α, where 4 ≤ α

  14. The potential carcinogenic risk of tanning beds: clinical guidelines and patient safety advice

    International Nuclear Information System (INIS)

    Mogensen, Mette; Jemec, Gregor BE

    2010-01-01

    In 2009, the WHO listed ultraviolet (UV) radiation as a group 1 carcinogen. In spite of this, each year, millions of people tan indoor in Western countries. The aim of this review is to summarize evidence of tanning bed carcinogenesis and to present guidelines for use of tanning beds and patient safety advice. A narrative review of the literature was conducted based on both PubMed and Medline searches and on literature review of the retrieved papers. Use of indoor tanning beds represents a significant and avoidable risk factor for the development of both melanoma and nonmelanoma skin cancers. Frequent tanners are more often adolescent females. Tanning beds have additional potential adverse effects such as burns, solar skin damage, infection, and possibly also addictive behavior. The effort in preventing UV light-induced carcinogenesis should currently be aimed at developing new strategies for public health information. Tanning beds are one preventable source of UV radiation. In the majority of people solar UV radiation continues to be the major factor and therefore anti-tanning campaigns must always include sunbathers

  15. 77 FR 47880 - U.S.-Trans-Pacific Partnership Free Trade Agreement Including Canada and Mexico: Advice on the...

    Science.gov (United States)

    2012-08-10

    ....S.-Trans-Pacific Partnership Free Trade Agreement Including Malaysia: Advice on Probable Economic... Partnership Free Trade Agreement Including Canada and Mexico: Advice on the Probable Economic Effect of... Mexico: Advice on the Probable Economic Effect of Providing Duty-Free Treatment for Imports. DATES...

  16. Quality of travel health advice in higher-education establishments in the United Kingdom and its relationship to the demographic background of the provider.

    Science.gov (United States)

    Porter, J F Hugh; Knill-Jones, Robin P

    2004-01-01

    The number of international trips undertaken by residents of the United Kingdom has risen dramatically over the past 50 years. Likewise, the numbers studying in higher education have also shown a huge increase. This study aimed to assess the appropriateness of advice given to traveling students by higher education-based health services and to relate this to the demography and experience of the professionals involved. A postal questionnaire describing three hypothetical groups of students traveling to different parts of the world was sent to 335 doctors and nurses. These clinicians belonged to the British Association of Health Services in Higher Education. They worked in 105 practices that serve higher-educational establishments in the United Kingdom. Main outcome measures included whether appropriate immunizations were advised and given correctly through the National Health Service (NHS) or privately, and whether appropriate advice was given regarding malaria, human immunodeficiency virus (HIV), and miscellaneous risks. The sources of information used to advise travelers were also asked, and the effect of demographic characteristics of the respondents on the quality of advice was investigated. Two hundred fifteen (64%) questionnaires were returned. The mean score for whether the correct immunizations were advised was 77%, and for whether these were given correctly through the NHS or privately was 79.6%. For malaria, HIV, and miscellaneous risks, the scores were lower at 65%, 38%, and 32%, respectively. The score for correct immunizations was significantly affected by sex, with females respondents scoring higher (p = .036). Previous training in travel medicine improved scores for immunizations (p = .034) and for the correct choice being given through the NHS or privately (p = .006). Age, hours worked, role, and size of practice had no influence on scores. Charts in the general practice free newspapers were the most popular source of information. Practices serving

  17. Rheumatology telephone advice line – Experience of a Portuguese department

    Directory of Open Access Journals (Sweden)

    Ricardo Ferreira

    2015-04-01

    Full Text Available Background: Telephone helplines for patients are tool for information and advice. They can contribute to patient’s satisfaction with care and to the effectiveness and safety of treatments. In order to achieve this, they need to be adequately adapted to the target populations, as to incorporate their abilities and expectations. Aims: a Evaluate the adherence of patients to a telephone helpline managed by nurses in a Portuguese Rheumatology Department, b Analyse the profile of users and their major needs, c Analyse the management of calls by the nurses. Material/Methods: The target population of this phone service are the patients treated at Day Care Hospital and Early Arthritis Clinic of our department. Nurses answered phone calls immediately between 8am and 4pm of working days. In the remaining hours messages were recorded on voice mail and answered as soon as possible. Details of the calls were registered in a dedicated sheet and patients were requested permission to use data to improve the service, with respect for their rights of confidentiality, anonymity and freedom of decision. Results: In 18 months 173 calls were made by 79 patients, with a mean age of 47.9 years (sd=9.13. Considering the proportions of men and women in the target population, it was found that men called more frequently (M= 32.7% vs F= 20.4%, p=.016. The reasons for these calls can be divided into three categories: instrumental help, such as the request for results of complementary tests or rescheduling appointments (43.9% of calls; counselling on side effects or worsening of the disease/pain (31.2 %; counselling on therapy management (24.9%. Neither sex nor patient age were significantly related to these reasons for calling. Nurses resolved autonomously half (50.3% of the calls and in 79.8% of the cases there was no need for patient referral to other health services. Conclusions: About a quarter of patients adhered to the telephone helpline.. Patients called to obtain

  18. Personal recommender system to advice learning tasks in Moodle

    NARCIS (Netherlands)

    Drachsler, Hendrik; Van den Berg, Bert; Nadolski, Rob; Berlanga, Adriana; Hummel, Hans

    2007-01-01

    Drachsler, H., Van den Berg, B., Nadolski, R., Berlanga, A., & Hummel, H. (2007). Personal recommender system to advise learning tasks in Moodle. [Software source code and documentation] Available under the three clause BSD licence, Copyright TENCompetence Foundation.

  19. 32 CFR 719.151 - Furnishing of advice and counsel to accused placed in pretrial confinement.

    Science.gov (United States)

    2010-07-01

    ... with advice as to the confinee's right to consult with lawyer counsel and his right to prepare for trial. Lawyer counsel may be either a civilian lawyer provided by the confinee at his own expense or a...

  20. Advice to health professionals: Use of lignocaine as a diluent to ...

    African Journals Online (AJOL)

    Advice to health professionals: Use of lignocaine as a diluent to reduce the pain associated with the administration of benzathine penicillin G. Geoffrey Madeira, Ana Olga Mocumbi, Bongani M Mayosi ...

  1. Discharge against medical advice: Factors and patients′ characteristics in Abuth, Zaria

    Directory of Open Access Journals (Sweden)

    T Dahiru

    2011-01-01

    Conclusion: Discharge against medical advice is prevalent in ABUTH and factors significantly influence DAMA include young age, male gender, admission through ER, involvement in road accident, surgical as well as OBGYdiagnoses.

  2. Advice to the high school teacher in the conduct of its work teachers

    Directory of Open Access Journals (Sweden)

    Carlos Rosales López

    2011-09-01

    Full Text Available This paper analyzes the characteristics of advice to high school teacher for the realization of their basic teaching duties. We beging to identify current features of this stage as openness to multiple choice and the consequent need of guidance, the increase in enrollment in it, the decline in academic performance, diversification of its students, the increase in disruptive and violent behavior and the introduction of new technologies. It is emphasized that the high school teacher needs advice on a variety of tasks such as planning ac- cording to various perspectives, diverse and cooperative teaching and learning assessment. This advice can be external or internal to the school, can be performed by different professionals and according to different modalities. It is a task of the support and help to optimize your professional intervention and in this sense is con- sidered to constitute a component of teacher training. advice; secondary education; teaching duties; planning; methodology; evaluation. 

  3. Smoking cessation advice in consultations with health problems not related to smoking?

    DEFF Research Database (Denmark)

    Guassora, Ann Dorrit Kristiane; Baarts, Charlotte

    2010-01-01

    Objective. To identify frames of interaction that allow smoking cessation advice in general practice consultations. Design . Qualitative study based on individual in-depth interviews with GPs and their patients. Each of the GPs’ consultations were observed during a three-day period. Interviews...... consultations by relevance criteria. Relevance criteria served the purpose of limiting the number of issues in individual consultations. Issues could be included if they connected to something already communicated in a consultation. Smoking cessation advice was subject to these relevance criteria...... and was primarily discussed if it posed a particular risk to a particular patient. Smoking cessation advice also occurred in conversations addressing the patient ’ s well-being. If occurring without any other readable frame, smoking cessation advice was apt to be perceived by patients as part of a public campaign...

  4. Methods to identify and locate spent radiation sources

    International Nuclear Information System (INIS)

    1995-07-01

    The objective of this manual is to provide essential guidance to Member States with nuclear applications involving the use of a wide range of sealed radiation sources on the practical task of physically locating spent radiation sources not properly accounted for. Advice is also provided to render the located source safe on location. Refs, figs and tabs

  5. Methods to identify and locate spent radiation sources

    International Nuclear Information System (INIS)

    1997-06-01

    The objective of this manual is to provide essential guidance to Member States with nuclear applications involving the use of a wide range of sealed radiation sources on the practical task of physically locating spent radiation sources not properly accounted for. Advice is also provided to render the located source safe on location. Refs, figs, tabs

  6. Hospital admission for schizophrenia and discharge against medical advice in the United States.

    Science.gov (United States)

    Sclar, David A; Robison, Linda M

    2010-01-01

    Hospital discharge against medical advice may leave a patient at risk for adverse health outcomes and/or readmission, yet little is known regarding its occurrence, especially among patients with mental illness. The objective of this study was to discern the prevalence of, and predictive factors for, being discharged against medical advice among hospitalized patients with a primary diagnosis of schizophrenia. The 2004 US Healthcare Cost and Utilization Project Nationwide Inpatient Sample was used to discern demographic predictors, length of stay, and costs for discharge against medical advice relative to discharge with medical approval. Inpatient discharges from US community hospitals for patients of all ages with The International Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes 295.0-295.9 were included. Conditional logistic regression was used to discern factors predictive of discharge against medical advice, and least squares mean analysis was used to examine differences in length of stay and mean cost per day relative to discharge with medical approval. Least squares means were adjusted for age (continuous), sex, race, region, payer, hospital setting, and bed size. Within the study population, 1.6% of patients admitted for schizophrenia were discharged against medical advice (n = 3,382/210,722). Patients discharged against medical advice were significantly more likely to be younger (OR = 0.985, 95% CI, 0.982-0.987) and male (OR = 1.421, 95% CI, 1.321-1.529). Race was not a significant factor. Mean +/- SE length of stay for discharge against medical advice was 5.0 +/- 0.24 days, as compared to 8.7 +/- 0.06 days for patients discharged with medical approval (P medical advice ($1,886.02 +/- 49.67 vs $1,565.79 +/- 13.42, P medical advice was small, the numeric magnitude on a nationwide basis was substantial. The adjusted mean length of stay for discharge against medical advice was significantly reduced, while cost per day was

  7. Nutritional supplement use by elite young UK athletes: fallacies of advice regarding efficacy

    Directory of Open Access Journals (Sweden)

    Bloodworth Andrew

    2008-12-01

    Full Text Available Abstract Background The objective was to study nutritional supplement use among young elite UK athletes to establish whether a rationale versus practice incongruence exists, and to investigate the sources of information. Survey data were analysed for association between supplements used and motives for using such substances among young athletes along with the sources of advice and literature precedents on supplement effects. Methods Participants were elite UK male and female athletes, within the age range between 12 and 21 (n = 403, mean age 17.66 ± 1.99. Associations between type of supplements and reasons for using supplements were tested by calculating Pearson's χ2 and the strength of these symmetric associations shown by phi (ϕ association coefficients. Results Single supplement use was reported by 48.1%, with energy drinks being the most popular, consumed by 41.7% of all athletes and 86.6% of the supplement users in the sample. No agreement was observed between athletes' rationale and behaviour in relation to nutritional supplements except for creatine. Among health professionals, nutritionists and physiotherapists, followed by coaches, were most frequently consulted. Answers regarding reasons and supplements used showed incongruence and suggest widespread misinformation regarding supplements and their effects is an issue for the young athlete. Conclusion Widespread supplement taking behaviour was evidenced in the young elite athlete population with the most notable congruence between rationale and practice among young athletes being performance-related. Young athletes in the present sample appear to be less 'health conscious' and more 'performance focused' than their adult counterparts. Further research, using a full list of supplements, is warranted to test the hypothesis that health consciousness is less dominant in supplement choice by young athletes.

  8. Nutritional supplement use by elite young UK athletes: fallacies of advice regarding efficacy.

    Science.gov (United States)

    Petróczi, Andrea; Naughton, Declan P; Pearce, Gemma; Bailey, Richard; Bloodworth, Andrew; McNamee, Michael

    2008-12-15

    The objective was to study nutritional supplement use among young elite UK athletes to establish whether a rationale versus practice incongruence exists, and to investigate the sources of information. Survey data were analysed for association between supplements used and motives for using such substances among young athletes along with the sources of advice and literature precedents on supplement effects. Participants were elite UK male and female athletes, within the age range between 12 and 21 (n = 403), mean age 17.66 +/- 1.99. Associations between type of supplements and reasons for using supplements were tested by calculating Pearson's chi2 and the strength of these symmetric associations shown by phi association coefficients. Single supplement use was reported by 48.1%, with energy drinks being the most popular, consumed by 41.7% of all athletes and 86.6% of the supplement users in the sample. No agreement was observed between athletes' rationale and behaviour in relation to nutritional supplements except for creatine. Among health professionals, nutritionists and physiotherapists, followed by coaches, were most frequently consulted. Answers regarding reasons and supplements used showed incongruence and suggest widespread misinformation regarding supplements and their effects is an issue for the young athlete. Widespread supplement taking behaviour was evidenced in the young elite athlete population with the most notable congruence between rationale and practice among young athletes being performance-related. Young athletes in the present sample appear to be less 'health conscious' and more 'performance focused' than their adult counterparts. Further research, using a full list of supplements, is warranted to test the hypothesis that health consciousness is less dominant in supplement choice by young athletes.

  9. Association of Provider Advice and Pregnancy Weight Gain in a Predominantly Hispanic Population.

    Science.gov (United States)

    Liu, Jihong; Whitaker, Kara M; Yu, Stella M; Chao, Shin M; Lu, Michael C

    2016-01-01

    This study sought to determine whether women's report of gestational weight gain (GWG) advice from a health care provider is consistent with the Institute of Medicine (IOM) guidelines and the association between provider advice and women's weight gain during pregnancy. Data came from the 2007 Los Angeles Mommy and Baby study (n = 3,402). The 1990 IOM GWG guidelines were used to define whether the provider's advice on weight gain and women's weight gain were below, within, or above the guidelines. Approximately 4 months after delivery, 18.8% of the women reported having not discussed weight gain with any health care providers during pregnancy. Among those who reported such discussions, 42% reported receiving weight gain advice from a health care provider within IOM guidelines, 16.5% below guidelines, and 10% above. An additional 13.5% reported the discussion but did not report the recommended weight gain amount. Compared with women who reported provider advice on weight gain within guidelines, women who reported advice below guidelines were 1.7 times (95% confidence interval [CI], 1.3-2.2) more likely to gain less than the IOM recommended amount. Women who reported provider advice above IOM guidelines were 2.0 times (95% CI, 1.4-2.9) more likely to exceed guidelines. There is a need for more women to receive advice consistent with the IOM GWG guidelines from their prenatal care providers. Intervention strategies are needed to educate providers about IOM guidelines and how to counsel on GWG. Copyright © 2016 Jacobs Institute of Women's Health. All rights reserved.

  10. Nutrigenomics-based personalised nutritional advice: in search of a business model?

    OpenAIRE

    Ronteltap, Amber; van Trijp, Hans; Berezowska, Aleksandra; Goossens, Jo

    2012-01-01

    Nutritional advice has mainly focused on population-level recommendations. Recent developments in nutrition, communication, and marketing sciences have enabled potential deviations from this dominant business model in the direction of personalisation of nutrition advice. Such personalisation efforts can take on many forms, but these have in common that they can only be effective if they are supported by a viable business model. The present paper takes an inventory of approaches to personalise...

  11. Midwives' Role in Providing Nutrition Advice during Pregnancy: Meeting the Challenges? A Qualitative Study

    OpenAIRE

    Arrish, Jamila; Yeatman, Heather; Williamson, Moira

    2017-01-01

    This study explored the Australian midwives' role in the provision of nutrition advice. Little is known about their perceptions of this role, the influence of the model of care, and the barriers and facilitators that may influence them providing quality nutrition advice to pregnant women. Semistructured telephone interviews were undertaken with a subsample (n = 16) of the members of the Australian College of Midwives who participated in an online survey about midwives' nutrition knowledge, at...

  12. Psychological effects of prescriptive vs general lifestyle advice for weight loss in young women.

    Science.gov (United States)

    Lim, Siew S; Norman, Robert J; Clifton, Peter M; Noakes, Manny

    2009-11-01

    This study aimed to investigate the effects of prescriptive lifestyle advice with quantifiable dietary and physical goals compared to general lifestyle advice on weight and psychological outcomes in young women with overweight or obesity. A total of 203 women (body mass index 33.3+/-0.3, age 28+/-0.3 years) received either prescriptive or general lifestyle advice for weight loss over 12 weeks. Linear mixed models found that the prescriptive lifestyle advice group had significantly greater weight loss (4.2+/-0.4 kg vs 0.6+/-0.2 kg, Pself-esteem (3.2+/-0.8 vs -0.04+/-0.04, Pself-esteem remained significantly different between groups after correcting for weight loss. Food cravings decreased significantly over time without group differences (P0.05). Drop-outs had greater baseline psychological distress (15.1+/-0.7 vs 12.5+/-0.4, P<0.01) and higher food cravings (2.42+/-0.07 vs 2.24+/-0.05, P=0.049) compared to completers. In conclusion, a prescriptive approach is associated with greater weight loss and greater improvements in psychological outcomes in young women compared to general lifestyle advice. However, these quantitative targets should be accompanied with qualitative advice on how they could be met in a variety of circumstances.

  13. The implementation of ergonomics advice and the stage of change approach.

    Science.gov (United States)

    Rothmore, Paul; Aylward, Paul; Karnon, Jonathan

    2015-11-01

    This paper investigates the implementation of injury prevention advice tailored according to the Stage of Change (SOC) approach. The managers of 25 workgroups, drawn from medium to large companies across a wide range of occupational sectors were allocated to receive either standard ergonomics advice or ergonomics advice tailored according to the workgroup SOC. Twelve months after the advice was provided, semi-structured interviews were conducted with each manager. In a multivariate model, managers who had received tailored advice were found to have implemented significantly more of the recommended changes (IRR = 1.68, 95% CI 1.07-2.63) and more "additional" changes (IRR = 1.90, 95% CI 1.12-3.20). Qualitative analysis identified that the key barriers and facilitators to the implementation of changes were largely related to worker resistance to change and the attitudes of senior managers towards health and safety. The findings from this study suggest that the implementation of ergonomics recommendations may be improved by the tailoring of advice according to SOC principles. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  14. A survey of exercise advice and recommendations in United Kingdom paediatric cardiac clinics.

    Science.gov (United States)

    Williams, Craig A; Gowing, Lucy; Horn, Richard; Stuart, Alan Graham

    2017-07-01

    Physical activity and exercise have important health benefits for children and adolescents with CHD. The objective of this study was to survey the provision of advice and recommendations in United Kingdom paediatric CHD clinics. A three-page questionnaire was sent out to paediatric cardiac consultants in the United Kingdom, paediatric consultants with expertise in cardiology, and nursing staff (Paediatricians with Expertise in Cardiology Special Interest Group), as well as all members of the British Congenital Cardiovascular Association. The aim of this questionnaire was to determine the extent and scope of current information provision and to assess the importance that clinicians place on this advice. There were 68 responses in total, and the data showed that, of these, 24 (36%) clinicians had never provided paediatric CHD patients with written advice about exercise. Only 27 (39%) clinicians provided physical activity advice at every appointment. Lack of time during consultation (n=39, 56.9%), lack of training (n=38, 55.2%), and uncertainty about appropriate recommendations (n=38, 55.2%) were identified as the main factors preventing clinicians from providing patients with advice about physical activity. Although healthcare providers consider physical activity to be very important, the provision of clear, specific advice and recommendations is underutilised; therefore, more education and provision of resources to support the promotion of exercise need to be provided to clinicians and their support teams.

  15. Lifestyle advice and lifestyle change: to what degree does lifestyle advice of healthcare professionals reach the population, focusing on gender, age and education?

    Science.gov (United States)

    Brobeck, Elisabeth; Bergh, Håkan; Odencrants, Sigrid; Hildingh, Cathrine

    2015-03-01

    Health promotion practice in health care has a high priority in the endeavour to achieve equal opportunities for health and diversity in health among the population. The purpose of the study was to investigate whether there is any connection between the lifestyle advice given by healthcare professionals and the lifestyle change of the population, focusing on age, gender and education level. The study is based on the data from a national population survey in Sweden in which 52 595 patients who had attended health care were interviewed by phone. The participants were asked whether healthcare professionals had raised the subject of lifestyle during the visit and whether the advice they gave had contributed to a lifestyle change. The results indicated that lifestyle issues were raised with 32.2% of those who attended health care, particularly among men, younger patients and those with a high education level. When lifestyle issues were raised, the advice contributed to 39.2% of patients making a lifestyle change, to a higher extent among men, older patients and those with a low education level. The study shows that lifestyle advice given by healthcare professionals, during both emergency and outpatient healthcare visits, is an important contributor to patients' lifestyle change. © 2014 Nordic College of Caring Science.

  16. A Flexible Architecture For Pointcut-Advice Language Implementations

    NARCIS (Netherlands)

    Bockisch, Christoph; Mezini, Mira

    Current implementations for aspect-oriented programming languages map the aspect-oriented concepts of source programs to object-oriented bytecode. This hinders execution environments with dedicated support for such concepts in applying their optimizations, as they have to recover the original aspect

  17. Leaving the Hospital Against Medical Advice Among People Who Use Illicit Drugs: A Systematic Review

    Science.gov (United States)

    Ti, Lianlian

    2015-01-01

    Background. Leaving the hospital against medical advice is an increasing problem in acute care settings and is associated with an array of negative health consequences that may lead to readmission for a worsened health outcome or mortality. Leaving the hospital against medical advice is particularly common among people who use illicit drugs (PWUD) and has been linked to a number of complex issues; however, few studies have focused specifically on this population beyond identifying them as being at an increased risk of leaving the hospital prematurely. Furthermore, programs and interventions for reducing the rate of leaving the hospital against medical advice among PWUD in acute care settings have not been well studied. Objectives. We systematically assessed the literature examining hospital discharge against medical advice from acute care among this population and identified potential methods to minimize the occurrence of this phenomenon. Search methods. We searched 5 electronic databases (from database inception to August 2014) and article reference lists for articles investigating hospital discharge from acute care against medical advice among PWUD. Search terms consistent across databases included “patient discharge,” “hospital discharge,” “against medical advice,” “drug user,” “substance-related disorders,” and “intravenous substance abuse.” Selection criteria. Studies were eligible for inclusion if they were published in a peer-reviewed journal as an original research article in English. We excluded gray literature, case reports, case series, reviews, and editorials. We retained original studies that reported illicit drug use as a predictor of leaving the hospital against medical advice and studies of discharge against medical advice that included PWUD as a population of interest, and we assessed significance through appropriate statistical tests. We excluded studies that reported patients leaving the hospital against medical advice

  18. Leaving the Hospital Against Medical Advice Among People Who Use Illicit Drugs: A Systematic Review.

    Science.gov (United States)

    Ti, Lianping; Ti, Lianlian

    2015-12-01

    Leaving the hospital against medical advice is an increasing problem in acute care settings and is associated with an array of negative health consequences that may lead to readmission for a worsened health outcome or mortality. Leaving the hospital against medical advice is particularly common among people who use illicit drugs (PWUD) and has been linked to a number of complex issues; however, few studies have focused specifically on this population beyond identifying them as being at an increased risk of leaving the hospital prematurely. Furthermore, programs and interventions for reducing the rate of leaving the hospital against medical advice among PWUD in acute care settings have not been well studied. We systematically assessed the literature examining hospital discharge against medical advice from acute care among this population and identified potential methods to minimize the occurrence of this phenomenon. We searched 5 electronic databases (from database inception to August 2014) and article reference lists for articles investigating hospital discharge from acute care against medical advice among PWUD. Search terms consistent across databases included "patient discharge," "hospital discharge," "against medical advice," "drug user," "substance-related disorders," and "intravenous substance abuse." Studies were eligible for inclusion if they were published in a peer-reviewed journal as an original research article in English. We excluded gray literature, case reports, case series, reviews, and editorials. We retained original studies that reported illicit drug use as a predictor of leaving the hospital against medical advice and studies of discharge against medical advice that included PWUD as a population of interest, and we assessed significance through appropriate statistical tests. We excluded studies that reported patients leaving the hospital against medical advice from psychiatric hospitals, drug treatment centers and emergency departments, and

  19. Characteristics of patients with cirrhosis who are discharged from the hospital against medical advice.

    Science.gov (United States)

    Myers, Robert P; Shaheen, Abdel Aziz M; Hubbard, James N; Kaplan, Gilaad G

    2009-07-01

    Patients discharged from hospital against medical advice are at risk of adverse health outcomes. The frequency and predictors of self-discharge in cirrhotic patients have not been examined. By using the 1993-2005 US Nationwide Inpatient Sample, we identified 581,380 cirrhotic patients who had been admitted to hospitals. The proportion discharged against medical advice and predictors of self-discharge were analyzed by using regression models with adjustments for clinical factors, including illness severity. Of the patients with cirrhosis identified, 2.8% left their hospital against medical advice. Self-discharge was most common in patients with alcoholic cirrhosis (4.2%) and hepatitis B or C ( approximately 3%) and least common among those with chronic cholestasis (0.4%). Independent predictors of self-discharge included male sex, younger age, non-private insurance, and admission to urban, nonteaching hospitals. Patients undergoing surgery and those with more comorbidities were less likely to leave against medical advice, whereas those with human immunodeficiency virus, drug and alcohol abuse, or psychosis were more likely to leave against medical advice. Self-discharge was less common among patients with hepatic decompensation (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.76-0.82), primary liver cancer (OR, 0.49; 95% CI, 0.41-0.59), or prior transplantation (OR, 0.37; 95% CI, 0.25-0.55). Length of stay and hospital charges were lower in patients discharged against medical advice (P medical advice. Self-discharge is most common among patients with alcoholic cirrhosis, lower socioeconomic status, psychiatric disorders, substance abuse, and less severe liver disease. These findings might assist in the prevention of self-discharge and, ultimately, improve health outcomes in patients with cirrhosis.

  20. The Radioactive Waste Management Advisory Committee's. Advice on issues which need to be addressed in the Guidance to be given to the Environment Agencies on the Principles for determining Radioactive Waste Discharge Authorisations - the 'Principles Document'

    International Nuclear Information System (INIS)

    1998-07-01

    In January 1998, the Minister for the Environment, Mr Michael Meacher, informed the Radioactive Waste Management Advisory Committee (RWMAC) that, during the coming year, he would welcome the Committee's advice on proposals for guidance from the Department of the Environment, Transport and the Regions (DETR) to the Environment Agencies on assessment principles for determining radioactive waste discharge authorisations. This will hereafter be referred to as the Principles Document. The RWMAC has provided advice on the process of regulating radioactive waste discharges for many years. A summary of some of this activity is given in Annex 1. As a result, it has been pressing for this Principles Document guidance to be made available since its Twelfth Report in 1991. In response to the Minister's request, the RWMAC offered to assemble and submit early advice on what it believes the guidance needs to cover: this document fulfils that offer. The fundamental purpose of the advice is to help promote clarity of the regulatory regime for the benefit of the regulators themselves who must apply it, the industry to whom it is applied and, most importantly, the public whose safety it is designed to protect. Clarification of a number of aspects of the process is also likely to provide opportunity for efficiency gains. At a subsequent stage, the RWMAC will be happy to provide comment on any draft principles documentation prepared by the DETR. The RWMAC acknowledges that some of the issues it raises in this advice could be taken by others to be either outside the scope of the Principles Document or, by implying a need for more fundamental consideration of the discharge authorisation process, could potentially preclude its early publication. In the first instance, reference to an alternative source of relevant advice might suffice, providing this advice is itself easily accessible and understandable. In the second, the issue itself might be one to be fed into the Government's planned

  1. Are Canadian clinicians providing consistent sport-related concussion management advice?

    Science.gov (United States)

    Carson, James D; Rendely, Alexandra; Garel, Alisha; Meaney, Christopher; Stoller, Jacqueline; Kaicker, Jatin; Hayden, Leigh; Moineddin, Rahim; Frémont, Pierre

    2016-06-01

    To compare the knowledge and use of recommendations for the management of sport-related concussion (SRC) among sport and exercise medicine physicians (SEMPs) and emergency department physicians (EDPs) to assess the success of SRC knowledge transfer across Canada. A self-administered, multiple-choice survey accessed via e-mail by SEMPs and EDPs. The survey had been assessed for content validity. Canada. The survey was completed between May and July 2012 by SEMPs who had passed the diploma examination of the Canadian Academy of Sport and Exercise Medicine and by EDPs who did not hold this diploma. Knowledge and identification of sources of concussion management information, use of concussion diagnosis strategies, and whether physicians use common and consistent terminology when explaining cognitive rest strategies to patients after an SRC. There was a response rate of 28% (305 of 1085). The SEMP and EDP response rates were 41% (147 of 360) and 22% (158 of 725), respectively. Of the responses, 41% of EDPs and 3% of SEMPs were unaware of any consensus statements on concussion in sport; 74% of SEMPs used the Sport Concussion Assessment Tool, version 2 (SCAT2), "usually or always," whereas 88% of EDPs never used the SCAT2. When queried about how cognitive rest could best be achieved after an SRC, no consistent answer was documented. Differences and a lack of consistency in the implementation of recommendations for SRC patients were identified for SEMPs and EDPs. It appears that the SCAT2 is used more in the SEMP setting than in the emergency context. Further knowledge transfer efforts and research should address the barriers to achieving more consistent advice given by physicians who attend SRC patients. Copyright© the College of Family Physicians of Canada.

  2. How to support teenagers who are losing a parent to cancer: Bereaved young adults' advice to healthcare professionals-A nationwide survey.

    Science.gov (United States)

    Alvariza, Anette; Lövgren, Malin; Bylund-Grenklo, Tove; Hakola, Pia; Fürst, Carl Johan; Kreicbergs, Ulrika

    2017-06-01

    The loss of a parent to cancer is considered one of the most traumatic events a teenager can experience. Studies have shown that teenagers, from the time of diagnosis, are already extremely worried about the consequences of a parent's cancer but tend to be left to manage these concerns on their own. The present study aimed to explore young adults' advice to healthcare professionals on how to support teenagers who are losing a parent to cancer. This work derives from a Swedish nationwide survey and employs a qualitative approach with a descriptive/interpretive design to obtain answers to an open-ended question concerning advice to healthcare professionals. Of the 851 eligible young adults who had lost a parent to cancer when they were 13-16 years of age within the previous 6 to 9 years, 622 participated in our survey (response rate = 73%). Of these 622 young adults, 481 responded to the open-ended question about what advice to give healthcare professionals. Four themes emerged: (1) to be seen and acknowledged; (2) to understand and prepare for illness, treatment, and the impending death; (3) to spend time with the ill parent, and (4) to receive support tailored to the individual teenager's needs. This nationwide study contributes hands-on suggestions to healthcare staff regarding attitudes, communication, and support from the perspective of young adults who, in their teenage years, lost a parent to cancer. Teenagers may feel better supported during a parent's illness if healthcare professionals take this manageable advice forward into practice and see each teenager as individuals; explain the disease, its treatments, and consequences; encourage teenagers to spend time with their ill parent; and recommend sources of support.

  3. Genetic test feedback with weight control advice: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Meisel Susanne F

    2012-12-01

    Full Text Available Abstract Background Genetic testing for risk of weight gain is already available over the internet despite uncertain benefits and concerns about adverse emotional or behavioral effects. Few studies have assessed the effect of adding genetic test feedback to weight control advice, even though one of the proposed applications of genetic testing is to stimulate preventive action. This study will investigate the motivational effect of adding genetic test feedback to simple weight control advice in a situation where weight gain is relatively common. Methods/design First-year university students (n = 800 will be randomized to receive either 1 their personal genetic test result for a gene (FTO related to weight gain susceptibility in addition to a leaflet with simple weight control advice (‘Feedback + Advice’ group, FA, or 2 only the leaflet containing simple weight control advice (‘Advice Only’ group, AO. Motivation to avoid weight gain and active use of weight control strategies will be assessed one month after receipt of the leaflet with or without genetic test feedback. Weight and body fat will be measured at baseline and eight months follow-up. We will also assess short-term psychological reactions to the genetic test result. In addition, we will explore interactions between feedback condition and gene test status. Discussion We hope to provide a first indication of the clinical utility of weight-related genetic test feedback in the prevention context. Trial registration Current controlled trials ISRCTN91178663

  4. Advice networks in teams: the role of transformational leadership and members' core self-evaluations.

    Science.gov (United States)

    Zhang, Zhen; Peterson, Suzanne J

    2011-09-01

    This article examines the team-level factors promoting advice exchange networks in teams. Drawing upon theory and research on transformational leadership, team diversity, and social networks, we hypothesized that transformational leadership positively influences advice network density in teams and that advice network density serves as a mediating mechanism linking transformational leadership to team performance. We further hypothesized a 3-way interaction in which members' mean core self-evaluation (CSE) and diversity in CSE jointly moderate the transformational leadership-advice network density relationship, such that the relationship is positive and stronger for teams with low diversity in CSE and high mean CSE. In addition, we expected that advice network centralization attenuates the positive influence of network density on team performance. Results based on multisource data from 79 business unit management teams showed support for these hypotheses. The results highlight the pivotal role played by transformational leadership and team members' CSEs in enhancing team social networks and, ultimately, team effectiveness. PsycINFO Database Record (c) 2011 APA, all rights reserved

  5. Friends with Benefits, but without the Sex: Straight Women and Gay Men Exchange Trustworthy Mating Advice

    Directory of Open Access Journals (Sweden)

    Eric M. Russell

    2013-01-01

    Full Text Available Although research has made progress in elucidating the benefits exchanged within same- and opposite-sex friendships formed between heterosexual men and women, it is less clear why straight women and gay men form close relationships with one another. The current experiments begin to address this question by exploring a potential benefit hypothesized to be uniquely available to straight women and gay men in the context of these friendships: trustworthy mating advice. Experiment 1 revealed that straight women perceive mating-relevant advice from a gay man to be more trustworthy than similar advice offered by a straight man or woman. Experiment 2 demonstrated that gay men perceive mating advice offered by a straight woman to be more trustworthy than advice offered by a lesbian woman or another gay man. Overall, the results provide initial experimental evidence that relationships between gay men and straight women may be characterized by a mutual exchange of mating-relevant benefits in the absence of sexual interest or competition.

  6. Evidence-based first aid advice for paediatric burns in the United Kingdom.

    Science.gov (United States)

    Varley, Alice; Sarginson, Julia; Young, Amber

    2016-05-01

    Burn and scald injuries are common in children. First aid advice for paediatric burns is offered by a range of health organisations and charities in the UK. Despite this, children still present to emergency departments and burn services having received little or inadequate first aid. A survey was undertaken regarding the content and consistency of the advice given by a cross-section of UK health organisations involved in first aid prevention and education. The advice was subsequently examined to determine if it was evidence-based. Our study has demonstrated inconsistencies in the content of the first aid advice provided by the 21 organisations included in the study. Seventy-one percent of the information was only available online. The temperature, method and duration of cooling varied substantially, as did the advice recommended for the removal of clothing and jewellery and methods for covering the burn immediately after injury. Results from the literature review concluded the following based on available evidence; cool the burn with running tap water for 20min, remove clothing and jewellery and cover the burn with cling film or a clean non-adhesive dressing. This study highlights the lack of consistency between first aid guidance provided by health organisations and charities in the UK. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  7. Developing leaflets to give dental health advice to Aboriginal families with young children.

    Science.gov (United States)

    Blinkhorn, Fiona; Wallace, Janet; Smith, Leanne; Blinkhorn, Anthony S

    2014-08-01

    Dental caries (decay) is a serious problem for young Aboriginal children, causing pain and stress. Treatment often involves extraction of teeth under a general anaesthetic. However, dental caries can be prevented by reducing the frequency of sugar consumption and brushing teeth twice a day with fluoride toothpaste. Such straightforward advice could be given to families by Aboriginal Health Workers who are trusted by their communities and have an existing advisory role. This paper reports on the development of dental health advice leaflets for use in Aboriginal communities. An Aboriginal reference panel was recruited to comment on dental health advice leaflets prepared by an Aboriginal graphic designer. The panel was asked to consider the design, cultural appropriateness and practicality of the leaflets. Comments were collected through email and face-to-face discussions, which were collated and the leaflets altered accordingly. The advice from the panel resulted in greater use of pictures. For example large green ticks and red crosses highlighted healthy and unhealthy behaviours, respectively. The tooth brushing leaflet was amended to emphasise the safe storage of toothpaste in order to keep it out of reach of young children. The panel stated that all leaflets should incorporate the Aboriginal flag, and proposed that fridge magnets might be beneficial as all family members would benefit from seeing the messages every day. The consultation process refined dental advice leaflets to reflect the views of an Aboriginal Reference Panel, in terms of design, cultural competence and practicality. © 2014 FDI World Dental Federation.

  8. Friends with benefits, but without the sex: straight women and gay men exchange trustworthy mating advice.

    Science.gov (United States)

    Russell, Eric M; DelPriore, Danielle J; Butterfield, Max E; Hill, Sarah E

    2013-02-09

    Although research has made progress in elucidating the benefits exchanged within same- and opposite-sex friendships formed between heterosexual men and women, it is less clear why straight women and gay men form close relationships with one another. The current experiments begin to address this question by exploring a potential benefit hypothesized to be uniquely available to straight women and gay men in the context of these friendships: trustworthy mating advice. Experiment 1 revealed that straight women perceive mating-relevant advice from a gay man to be more trustworthy than similar advice offered by a straight man or woman. Experiment 2 demonstrated that gay men perceive mating advice offered by a straight woman to be more trustworthy than advice offered by a lesbian woman or another gay man. Overall, the results provide initial experimental evidence that relationships between gay men and straight women may be characterized by a mutual exchange of mating-relevant benefits in the absence of sexual interest or competition.

  9. [Scientific advice by the national and European approval authorities concerning advanced therapy medicinal products].

    Science.gov (United States)

    Jost, Nils; Schüssler-Lenz, Martina; Ziegele, Bettina; Reinhardt, Jens

    2015-11-01

    The aim of scientific advice is to support pharmaceutical developers in regulatory and scientific questions, thus facilitating the development of safe and efficacious new medicinal products. Recent years have shown that the development of advanced therapy medicinal products (ATMPs) in particular needs a high degree of regulatory support. On one hand, this is related to the complexity and heterogeneity of this group of medicinal products and on the other hand due to the fact that mainly academic research institutions and small- and medium-sized enterprises (SMEs) are developing ATMPs. These often have limited regulatory experience and resources. In 2009 the Paul-Ehrlich-Institut (PEI) initiated the Innovation Office as a contact point for applicants developing ATMPs. The mandate of the Innovation Office is to provide support on regulatory questions and to coordinate national scientific advice meetings concerning ATMPs for every phase in drug development and especially with view to the preparation of clinical trial applications. On the European level, the Scientific Advice Working Party (SAWP) of the Committee for Medicinal Products for Human Use (CHMP) of the European Medicinal Agency (EMA) offers scientific advice. This article describes the concepts of national and EMA scientific advice concerning ATMPs and summarizes the experience of the last six years.

  10. Lifestyle advice with or without pelvic floor muscle training for pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: We evaluated the effect of adding pelvic floor muscle training (PFMT) to a structured lifestyle advice program. METHODS: This was a single-blinded randomized trial of women with symptomatic pelvic organ prolapse (POP) stage ≥ II. Participants were randomized to a stru......INTRODUCTION AND HYPOTHESIS: We evaluated the effect of adding pelvic floor muscle training (PFMT) to a structured lifestyle advice program. METHODS: This was a single-blinded randomized trial of women with symptomatic pelvic organ prolapse (POP) stage ≥ II. Participants were randomized...... to a structured lifestyle advice program with or without PFMT. Both groups received similar lifestyle advice in six separate group sessions. The combined group performed group PFMT after an individual assessment. Primary outcome was a global improvement scale at six-month follow-up. Secondary outcomes were...... %) completed six-month follow-up. At both follow-ups, significantly more women in the combined group reported improvement in the global scale. At the three-month follow-up, the combined group only had significant improvement of POP symptoms while only the lifestyle advice group had significant improvement...

  11. Patients leaving against medical advice: an inpatient psychiatric hospital-based study.

    Science.gov (United States)

    Hayat, Aalia Akhtar; Ahmed, Muhammad Munir; Minhas, Fareed Aslam

    2013-05-01

    To determine the frequency of patients leaving against medical advice (LAMA) in an inpatient psychiatric facility in Rawalpindi, Pakistan. Descriptive cross-sectional study. Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, from August 2010 to February 2011. Patients who got admitted during study period irrespective of duration of illness and mode of admission were recruited through non-probability consecutive sampling and followed till discharge to determine their mode of leaving hospital. A thirteen-item proforma was developed and information was obtained on demographic, socioeconomic, patient related and disease related variables. Descriptive statistics were calculated on SPSS 14. The total number (n) of participants was 246. Among the participants, 96 (39%) left against medical advice (LAMA) whereas 150 (61%) left on regular discharge on physician's advice. Frequency of patients who left against medical advice was found to be more in males (63.5%), younger age groups (21 - 30 years), lesser educated (more than half were under matric) and with the ICD-10 diagnosis of substance abuse (23.9%). About half of patients who LAMA had a prior history of psychiatric illness and a significant number (37.5%) had a history of previous psychiatric admission. Leaving against medical advice is a frequent problem in psychiatric inpatients and is a matter of great concern for the treating doctors.

  12. Patients discharged against medical advice from a psychiatric hospital in Iran: a prospective study.

    Science.gov (United States)

    Sheikhmoonesi, Fatemeh; Khademloo, Mohammad; Pazhuheshgar, Samaneh

    2014-03-30

    Self- discharged patients are at high risk for readmission and ultimately higher cost for care.We intended to find the proportion of patients who leave hospital against medical advice and explore some of their characteristics. This prospective study of discharge against medical advice was conducted in psychiatric wards of Zare hospital in Iran, 2011. A psychologist recorded some information on a checklist based on the documented information about the patient who wanted to leave against medical advice. The psychologist interviewed these patients and recorded the reasons for discharge against medical advice. Descriptive statistics were calculated for the variables. The rate of premature discharge was 34.4%. Compared to patients with regular discharges, patients with premature discharge were significantly more likely to be male, self-employed, to have co morbid substance abuse and first admission and positive family history of psychiatric disorder. Disappearance of symptoms was the most frequent reason for premature discharge. The 34.4% rate of premature discharge observed in our study is higher than rate reported in other studies. One possible explanation is our teaching hospital serves a low-income urban area and most patients had low socioeconomic status. Further studies are needed to compare teaching and non-teaching hospital about the rate of premature discharge and the reasons of patients who want to leave against medical advice.

  13. Discharge against medical advice in a pediatric emergency center in the State of Qatar

    Directory of Open Access Journals (Sweden)

    Hala Abdulateef

    2012-05-01

    Full Text Available Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice, reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

  14. Differences between Japanese and American college students in giving advice about help seeking to rape victims.

    Science.gov (United States)

    Yamawaki, Niwako

    2007-10-01

    In this study, the author investigated differences in Japanese and American college students' tendencies to advise a hypothetical rape victim (their sister) to seek help from police, family members, or mental health professionals. Japanese students tended to encourage the victim to seek help from her family members, whereas American students tended to encourage her to seek help from police and mental health counselors. Cross-cultural discrepancies were marked by the following factors: (a) feelings of shame moderated advice to seek help from police; (b) minimization of rape mediated the likelihood to advise the involvement of police and mental health counselors; (c) attitudes toward mental health counselors mediated advice to seek help from them; and (d) the type of rape (stranger vs. date rape) moderated advice to report the crime to police.

  15. Tariff advice for the supply of heat to small-scale consumers in 1999

    International Nuclear Information System (INIS)

    1998-12-01

    The title advice is based on the principle of 'not more than otherwise' (nmda, abbreviated in Dutch), which principle is applied for the calculation of the contribution for connection to the energy supply system, the reduced rate for those paying standing charges, and the price of heat. The principle implies that the determined tariff for the supply of heat is such that, on average, the consumer of heat does not pay more than in case natural gas is used for an individual central heating system. In his advice attention is paid to the connection contribution, the reduced rate, and the heat price. In the final chapter the indexation and updating of the different tariff elements of the advice are discussed

  16. Nurse provision of healthy lifestyle advice to people who are overweight or obese.

    Science.gov (United States)

    Kable, Ashley; James, Carole; Snodgrass, Suzanne; Plotnikoff, Ronald; Guest, Maya; Ashby, Samantha; Oldmeadow, Christopher; Collins, Clare

    2015-12-01

    A cross-sectional survey was conducted in a regional area in Australia to measure nurses' perceptions, practices, and knowledge in regard to providing healthy lifestyle advice to people who are overweight or obese. Responses were compared between geographic regions. Participation was voluntary and anonymous. Of the 79 nurse participants, 68% considered that provision of healthy lifestyle advice was within their scope of practice. Only 28% reported frequently estimating body mass index in the practice setting. Nurses often recommended increasing activity levels (44%), but recommended reducing daily caloric intake less often (25%). Nurses' knowledge about weight management was variable and the proportion of correct answers to knowledge items ranged from 33-99%. Nurses have many opportunities to deliver healthy lifestyle advice in a range of practice settings. The variation in practices and knowledge of nurses indicates a need for improved healthy lifestyle education for undergraduate and practicing nurses. © 2015 Wiley Publishing Asia Pty Ltd.

  17. Women's motivations for choosing a high risk birth setting against medical advice in the Netherlands: a qualitative analysis.

    Science.gov (United States)

    Hollander, Martine; de Miranda, Esteriek; van Dillen, Jeroen; de Graaf, Irene; Vandenbussche, Frank; Holten, Lianne

    2017-12-16

    Home births in high risk pregnancies and unassisted childbirth seem to be increasing in the Netherlands. Until now there were no qualitative data on women's motivations for these choices in the Dutch maternity care system where integrated midwifery care and home birth are regular options in low risk pregnancies. We aimed to examine women's motivations for birthing outside the system in order to provide medical professionals with insight and recommendations regarding their interactions with women who have birth wishes that go against medical advice. An exploratory qualitative research design with a constructivist approach and a grounded theory method were used. In-depth interviews were performed with 28 women on their motivations for going against medical advice in choosing a high risk childbirth setting. Open, axial and selective coding of the interview data was done in order to generate themes. A focus group was held for a member check of the findings. Four main themes were found: 1) Discrepancy in the definition of superior knowledge, 2) Need for autonomy and trust in the birth process, 3) Conflict during negotiation of the birth plan, and 4) Search for different care. One overarching theme emerged that covered all other themes: Fear. This theme refers both to the participants' fear (of interventions and negative consequences of their choices) and to the providers' fear (of a bad outcome). Where for some women it was a positive choice, for the majority of women in this study the choice for a home birth in a high risk pregnancy or an unassisted childbirth was a negative one. Negative choices were due to previous or current negative experiences with maternity care and/or conflict surrounding the birth plan. The main goal of working with women whose birthing choices do not align with medical advice should not be to coerce them into the framework of protocols and guidelines but to prevent negative choices. Recommendations for maternity caregivers can be summarized as

  18. Effects of yoga, strength training and advice on back pain: a randomized controlled trial.

    Science.gov (United States)

    Brämberg, Elisabeth Björk; Bergström, Gunnar; Jensen, Irene; Hagberg, Jan; Kwak, Lydia

    2017-03-29

    Among the working population, non-specific low-back pain and neck pain are one of the most common reasons for sickness absenteeism. The aim was to evaluate the effects of an early intervention of yoga - compared with strength training or evidence-based advice - on sickness absenteeism, sickness presenteeism, back and neck pain and disability among a working population. A randomized controlled trial was conducted on 159 participants with predominantly (90%) chronic back and neck pain. After screening, the participants were randomized to kundalini yoga, strength training or evidence-based advice. Primary outcome was sickness absenteeism. Secondary outcomes were sickness presenteeism, back and neck pain and disability. Self-reported questionnaires and SMS text messages were completed at baseline, 6 weeks, 6 and 12 months. The results did not indicate that kundalini yoga and strength training had any statistically significant effects on the primary outcome compared with evidence-based advice. An interaction effect was found between adherence to recommendations and sickness absenteeism, indicating larger significant effects among the adherers to kundalini yoga versus evidence-based advice: RR = 0.47 (CI 0.30; 0.74, p = 0.001), strength training versus evidence-based advice: RR = 0.60 (CI 0.38; 0.96, p = 0.032). Some significant differences were also found for the secondary outcomes to the advantage of kundalini yoga and strength training. Guided exercise in the forms of kundalini yoga or strength training does not reduce sickness absenteeism more than evidence-based advice alone. However, secondary analyses reveal that among those who pursue kundalini yoga or strength training at least two times a week, a significantly reduction in sickness absenteeism was found. Methods to increase adherence to treatment recommendations should be further developed and applied in exercise interventions. Clinicaltrials.gov NCT01653782, date of registration: June, 28

  19. Cigarette smoking and advice to quit in a national sample of homeless adults.

    Science.gov (United States)

    Baggett, Travis P; Rigotti, Nancy A

    2010-08-01

    Cigarette smoking is common among homeless people, but its characteristics in this vulnerable population have not been studied at a national level. Whether homeless smokers receive advice to quit from healthcare providers is also unknown. To determine the prevalence and predictors of current cigarette smoking, smoking cessation, and receipt of clinician advice to quit in a national sample of homeless adults. This study analyzed data from 966 adult respondents to the 2003 Health Care for the Homeless User Survey, representing more than 436,000 people nationally. Using multivariable logistic regression, the independent predictors of smoking, quitting, and receiving advice to quit were identified. Analyses were conducted in 2008-2009. The prevalence of current smoking was 73%. The lifetime quit rate among ever smokers was 9%. Among past-year smokers, 54% reported receiving clinician advice to quit. Factors independently associated with current smoking included out-of-home placement in childhood (AOR=2.79, 95% CI=1.03, 7.52); victimization while homeless (AOR=2.36, 95% CI=1.15, 4.83); past-year employment (AOR=2.52, 95% CI=1.13, 5.58); and prior illicit drug use (AOR=7.21, 95% CI=3.11, 16.7) or problem alcohol use (AOR=7.42, 95% CI=2.51, 21.9). Respondents with multiple homeless episodes had higher odds of receiving quit advice (AOR=2.51, 95% CI=1.30, 4.83) but lower odds of quitting (AOR=0.47, 95% CI=0.29, 0.78). Compared to the general population, homeless people are far more likely to smoke and much less likely to quit, even though more than half of smokers received quit advice in the past year. Interventions for homeless smokers should address the unique comorbidities and vulnerabilities of this population. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  20. Providers' advice concerning smoking cessation: Evidence from the Medical Expenditures Panel Survey.

    Science.gov (United States)

    Kaplan, Robert M; Fang, Zhengyi; Morgan, Glen

    2016-10-01

    We estimate how often adult smokers are advised to quit using a nationally representative sample of adults in the United States. Data are from the 2012-2013 household component of the United States (US) Medical Expenditures Panel Survey (MEPS). Current smoking and advice to quit offered by providers. Smoking was reported by 18.26% (CI 17.13%-19.38%) of 2012 MEPS respondents. Less than half of adult smokers (47.24%, CI 44.30%-50.19%) were advised to quit by their physicians although 17.57% (CI 15.37%-19.76%) had not seen a doctor in the last 12months. Advice to quit was given significantly less often to respondents classified as: aged 18-44 (40.29%), men (40.20%), less educated (42.26%), lower family income (43.51%), Hispanic (33.82%), never married (39.55%), and living outside the northeast. Smoking status at year 2 for patients who had received advice to quit was similar (85.13%: SE 1.62%) to those who had seen a physician but were not advised to quit (81.95%: SE 2.05%). Advice to quit smoking was less common than the use of common medical screening tests. Smoking cessation advice is given to less than half of current cigarette smokers and it is least likely to be given to the most vulnerable populations. Efforts to reduce smoking are deployed less often than other preventive practices. The rate of advice to quit has not changed over the last decade. Health care providers are missing an important opportunity to affect health behaviors and outcomes. Published by Elsevier Inc.

  1. Maternal perceptions of advice on sleep in young children: How, what, and when?

    Science.gov (United States)

    Hatton, Rosalind E M; Gardani, Maria

    2018-02-27

    Parental knowledge on sleep hygiene in children may be a contributing factor for sleep difficulties in preschoolers. As sleep is crucial for healthy development, it is important to understand how parental knowledge can be improved. The aim of this qualitative study was to develop an understanding of advice available in the United Kingdom (UK) on sleep in young children. This study employed constructivist grounded theory methodology. Participants were recruited via social media and a previously constructed participant database. Interviews were audio-recorded, transcribed, and analysed. Fourteen mothers were interviewed independently, whilst one mother was interviewed together with her husband. Themes relating to how UK mothers wish advice on sleep to be formulated, what they believe it should include and when they would like to receive it, were identified from the data. Specifically, this study suggests that UK mothers value experience and thus recommends that advice be made through collaboration projects involving both professionals and parents. It also suggests that advice should be readily available and given to expecting parents prior to the arrival of their baby as well as at regular follow-ups. In addition, the participating mothers wanted advice to be balanced and non-judgemental. This study looks at the views of mainly White British mothers currently residing within the United Kingdom. Thus, it may not represent the views of everyone in the United Kingdom. Nevertheless, it still makes important recommendations for practice. For example, relationships between health professionals and parents need to be improved and information on different sleeping practices widely dispersed. Statement of contribution What is already known on this subject? Poor sleep is common in young children. Young children's sleep quality can be affected by parental behaviours. Parents lack knowledge of sleep in young children. What does this study add? According to this study: It would

  2. A review of the provision of appropriate advice by pharmacy staff for self-medication in developing countries.

    Science.gov (United States)

    Brata, Cecilia; Gudka, Sajni; Schneider, Carl R; Clifford, Rhonda M

    2015-01-01

    Patients in developing countries often prefer to self-medicate via community pharmacies. Pharmacy staff are therefore in a strategic position to optimize the health of the public by providing appropriate advice to patients who self-medicate. To determine the proportion of pharmacy staff who provide appropriate advice when handling self-medication requests in developing countries. A literature search was undertaken via MEDLINE, EMBASE, CINAHL Plus, Web of Science and International Pharmaceutical Abstracts. Studies that reported on the proportion of pharmacy staff providing appropriate advice when handling self-medication requests in developing countries were included. The appropriateness of advice was determined by each author's definition in the original studies. Twenty-eight studies met the inclusion criteria. There were variations in methods, scenarios, how the authors reported and defined appropriate advice, and study populations. The proportion of pharmacy staff providing appropriate advice varied widely from 0% to 96%, with a minority providing appropriate advice in 83% of the scenarios performed. There was considerable variation in results, with the majority of studies reporting that inappropriate advice was provided by pharmacy staff when handling self-medication requests in developing countries. Consistent and robust methods are required to provide comparisons across practice settings. There is also a need to identify contributing factors to poor provision of advice for developing intervention strategies for practice improvement. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Vegan diets: practical advice for athletes and exercisers.

    Science.gov (United States)

    Rogerson, David

    2017-01-01

    With the growth of social media as a platform to share information, veganism is becoming more visible, and could be becoming more accepted in sports and in the health and fitness industry. However, to date, there appears to be a lack of literature that discusses how to manage vegan diets for athletic purposes. This article attempted to review literature in order to provide recommendations for how to construct a vegan diet for athletes and exercisers. While little data could be found in the sports nutrition literature specifically, it was revealed elsewhere that veganism creates challenges that need to be accounted for when designing a nutritious diet. This included the sufficiency of energy and protein; the adequacy of vitamin B12, iron, zinc, calcium, iodine and vitamin D; and the lack of the long-chain n -3 fatty acids EPA and DHA in most plant-based sources. However, via the strategic management of food and appropriate supplementation, it is the contention of this article that a nutritive vegan diet can be designed to achieve the dietary needs of most athletes satisfactorily. Further, it was suggested here that creatine and β-alanine supplementation might be of particular use to vegan athletes, owing to vegetarian diets promoting lower muscle creatine and lower muscle carnosine levels in consumers. Empirical research is needed to examine the effects of vegan diets in athletic populations however, especially if this movement grows in popularity, to ensure that the health and performance of athletic vegans is optimised in accordance with developments in sports nutrition knowledge.

  4. Why do older adults avoid seeking financial advice? Adviser anxiety in the Netherlands

    NARCIS (Netherlands)

    Van Dalen, Hendrik P.; Henkens, Kène; Hershey, Douglas A.

    Why is it that many people fail to seek retirement planning advice when doing so is clearly indicated? Distrust of financial intermediaries is often presented as the common answer. But this paper shows that trust issues are only part of the answer; an appreciable proportion of individuals experience

  5. Why do older adults avoid seeking financial advice? Adviser anxiety in the Netherlands

    NARCIS (Netherlands)

    van Dalen, H.P.; Henkens, K.; Hershey, D.

    2017-01-01

    Why is it that many people fail to seek retirement planning advice when doing so is clearly indicated? Distrust of financial intermediaries is often presented as the common answer. But this paper shows that trust issues are only part of the answer; an appreciable proportion of individuals experience

  6. Home care nursing advice for patients with head and neck cancer in India

    Directory of Open Access Journals (Sweden)

    Rosemund Sister

    2006-01-01

    Full Text Available Please feel free to print and use this article to support patients and their families. You may wish to translate or alter this depending on your local needs. If you are only using one section, remember to include the introduction. The advice contained in this article is aimed to support patients who have limited access to hospital care and equipment.

  7. Relationship Advice Columns from Two Popular Magazines: Implications for Therapy with Women, Men and Heterosexual Couples

    Science.gov (United States)

    Kogan, Lori R.; Kellaway, Julie A.

    2004-01-01

    The relationship advice columns for two popular magazines (one targeted to female and the other to male readers) were discussed within the conceptual frameworks of centerfold syndrome and appearance obsession. Centerfold syndrome is a theory that describes the way men view women and sexuality. The female counterpart is appearance obsession which…

  8. Response Scales in Voting Advice Applications : Do Different Designs Produce Different Outcomes?

    NARCIS (Netherlands)

    Rosema, M.; Louwerse, T.

    2016-01-01

    Voting Advice Applications (VAAs) represent popular election campaign tools in many countries, enabling voters to discover which party or candidate provides the best match with their political preferences. This article examines the effects of design choices on these tools by focusing on the response

  9. Response Scales in Voting Advice Applications: Do Different Designs Produce Different Outcomes?

    NARCIS (Netherlands)

    Rosema, Martin; Louwerse, Tom

    2016-01-01

    Voting Advice Applications (VAAs) represent popular election campaign tools in many countries, enabling voters to discover which party or candidate provides the best match with their political preferences. This article examines the effects of design choices on these tools by focusing on the response

  10. Performance of precautionary reference points in providing management advice on North Sea fish stocks

    NARCIS (Netherlands)

    Piet, G.J.; Rice, J.C.

    2004-01-01

    For 17 stocks in the North Sea. the performance and effectiveness of management advice using precautionary reference points was evaluated. Three criteria were used to identify whether a stock was within safe biological limits: SSB F-pa, or SSB F-pa. Four

  11. An Examination of College Students' Receptiveness to Alcohol-Related Information and Advice

    Science.gov (United States)

    Leahy, Matthew M.; Jouriles, Ernest N.; Walters, Scott T.

    2013-01-01

    This project examined the reliability and validity of a newly developed measure of college students' receptiveness to alcohol related information and advice. Participants were 116 college students who reported having consumed alcohol at some point in their lifetime. Participants completed a measure of receptiveness to alcohol-related…

  12. Adaptive Advice in Learning With a Computer-Based Knowledge Management Simulation Game

    NARCIS (Netherlands)

    Leemkuil, Hendrik H.; de Jong, Anthonius J.M.

    2012-01-01

    Despite the long tradition of game-based learning, there are still many unanswered questions regarding the instructional design of educational games. An important issue is the support that learners can be given in a game to enhance their learning. One recommended type of support is “advice,” which

  13. Pharmacist advice is accepted more for medical than for surgical patients in an emergency department

    DEFF Research Database (Denmark)

    Backer Mogensen, Christian; Olsen, Inger; Thisted, Anette Rehn

    2013-01-01

    Pharmacists' advice may reduce medication errors in the emergency department (ED). However, pharmacists' recommendations are of little value if not acknowledged by physicians. The aim of the present study was to analyze how often and which categories of pharmacist recommendations were taken...

  14. 17 CFR 202.2 - Pre-filing assistance and interpretative advice.

    Science.gov (United States)

    2010-04-01

    ... filings with the Commission may receive advice of a general nature as to the preparation thereof..., except in connection with matters under the Public Utility Holding Company Act of 1935 and certain matters under the Investment Company Act of 1940, at one of its regional offices. [25 FR 6736, July 15...

  15. Some Advice about the Water Strategy of China to Keep the Water ...

    African Journals Online (AJOL)

    All the models are based on the forecast of the water demand and supply of China in 2025. Based on the result of these models, we propose some advice about the water strategy to meet the water demand of China in 2025, such as: building desalination plants in the coastal provinces which are lack of water, carrying out ...

  16. Parenting an Overweight or Obese Teen: Issues and Advice from Parents

    Science.gov (United States)

    Boutelle, Kerri N.; Feldman, Shira; Neumark-Sztainer, Dianne

    2012-01-01

    Objective: This qualitative study addresses: (1) what challenges parents of overweight adolescents face and (2) what advice parents of overweight adolescents have for other parents. Design: One-on-one interviews were conducted with parents of overweight or previously overweight adolescents. Setting: Medical clinic at the University of Minnesota.…

  17. The influential role of personal advice networks on general practitioners' performance: a social capital perspective.

    Science.gov (United States)

    Calciolari, Stefano; González-Ortiz, Laura G; Lega, Federico

    2017-08-08

    In several health systems of advanced countries, reforms have changed primary care in the last two decades. The literature has assessed the effects of a variety of interventions and individual factors on the behavior of general practitioners (GPs). However, there has been a lack of investigation concerning the influence of the resources embedded in the GPs' personal advice networks (i.e., social capital) on GPs' capacity to meet defined objectives. The present study has two goals: (a) to assess the GPs' personal advice networks according to the social capital framework and (b) to test the influence of such relationships on GPs' capacity to accomplish organizational goals. The data collection relied on administrative data provided by an Italian local health authority (LHA) and a survey administered to the GPs of the selected LHA. The GPs' personal advice networks were assessed through an ad-hoc instrument and interpreted as egocentric networks. Multivariate regression analyses assessed two different performance measures. Social capital may influence the GPs' capacity to meet targets, though the influence differs according to the objective considered. In particular, the higher the professional heterogeneity of a GP personal advice network, the lower her/his capacity is to meet targets of prescriptive appropriateness. Our findings might help to design more effective primary care reforms depending on the pursued goals. However, further research is needed.

  18. Program of medical advice in radioprotection of the Argentinean nuclear regulatory authority

    International Nuclear Information System (INIS)

    Perez, M.R.; Gisone, P.; Di Trano, J.L.; Dubher, D.; Michelin, S.

    1998-01-01

    The objective of this program is to have a system with the aim of guaranteing an appropriate medical response in the case of radiological or nuclear accidents and to offer medical advice in aspects related to the biological effects of ionizing radiations

  19. Procedural advice on self-assessment and task selection in learner-controlled education

    NARCIS (Netherlands)

    Taminiau, Bettine; Corbalan, Gemma; Kester, Liesbeth; Van Merriënboer, Jeroen; Kirschner, Paul A.

    2011-01-01

    Taminiau, E. M. C., Corbalan, G., Kester, L., Van Merriënboer, J. J. G., & Kirschner, P. A. (2010, March). Procedural advice on self-assessment and task selection in learner-controlled education. Presentation at the ICO Springschool, Niederalteich, Germany.

  20. Procedural advice on self-assessment and task selection in learner-controlled education

    NARCIS (Netherlands)

    Taminiau, Bettine; Kester, Liesbeth; Corbalan, Gemma; Van Merriënboer, Jeroen; Kirschner, Paul A.

    2010-01-01

    Taminiau, E. M. C., Kester, L., Corbalan, G., Van Merriënboer, J. J. G., & Kirschner, P. A. (2010, July). Procedural advice on self-assessment and task selection in learner-controlled education. Paper presented at the Junior Researchers of EARLI Conference 2010, Frankfurt, Germany.

  1. Advice about Work-Related Issues to Peers and Employers from Head and Neck Cancer Survivors

    NARCIS (Netherlands)

    Dewa, Carolyn S.; Trojanowski, Lucy; Tamminga, Sietske J.; Ringash, Jolie; McQuestion, Maurene; Hoch, Jeffrey S.

    2016-01-01

    The purpose of this exploratory and descriptive study is to contribute to the sparse return-to-work literature on head and neck cancer (HNC) survivors. Interview participants were asked to reflect upon their work-related experience with cancer by answering two specific questions: (1) What advice

  2. Methodological Challenges in the Analysis of Voting Advice Application Generated Data

    NARCIS (Netherlands)

    Mendez, Fernando; Gemenis, Konstantinos; Djouvas, Constantinos

    2014-01-01

    Voting advice applications (VAA) have become an increasingly popular feature of electoral campaigns. VAAs are online tools that use survey techniques to measure the degree to which the policy preferences of citizens match those of political parties or candidates. In some cases, such as The

  3. Developing a Job Description for a Vice Chair of Education in Radiology: The ADVICER Template.

    Science.gov (United States)

    Lewis, Petra J; Probyn, Linda; McGuinness, Georgeann; Nguyen, Jeremy; Mullins, Mark E; Resnik, Charles; Oldham, Sandra

    2015-07-01

    The newly formed Alliance of Directors and Vice Chairs of Education in Radiology (ADVICER), a group within the Alliance for Clinician Educators in Radiology, identified an acute need for a generic job description template for Vice Chairs of Education in Radiology, a role that is being developed in many academic Departments of Radiology. Eighty-three percent of current members who responded to a survey had no detailed job description, and over half had no job description at all. Having a comprehensive and detailed job description is vital to developing this key position. Using the results of a survey sent to ADVICER members and seven Education Vice Chair job descriptions provided by members, the authors developed a detailed job description encompassing all potential elements of this position. Only 17% of survey respondents had a detailed job description. The role of an Education Vice Chair varies significantly between institutions in its scope and level of responsibilities. The resultant generic job description that was devised is intended to provide a template that would be modified by the candidate or the Department Chair. It is unlikely that any one individual would perform all the described activities. ADVICER has developed a comprehensive, flexible job description for Vice Chair of Education in Radiology that can be adapted by institutions as appropriate. It can be downloaded from http://aur.org/ADVICER/. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  4. Regular surveillance for Li-fraumeni syndrome: advice, adherence and perceived benefits

    NARCIS (Netherlands)

    C.R.M. Lammens (Chantal); E.M.A. Bleiker (Eveline); N.K. Aaronson (Neil); A. Wagner (Anja); R.H. Sijmons (Rolf); M.G.E.M. Ausems (Margreet); A.H.J.T. Vriends (Anette); M.W.G. Ruijs (Marielle); T.A.M. van Os (Theo); L. Spruijt (Liesbeth); E.B. Gómez García (Encarna); A. Cats (Annemieke); T. Nagtegaal; S. Verhoef

    2010-01-01

    textabstractLi Fraumeni Syndrome (LFS) is a hereditary cancer syndrome characterized by a high risk of developing various types of cancer from birth through late adulthood. Clinical benefits of surveillance for LFS are limited. The aim of this study is to investigate which advice for regular

  5. Regular surveillance for Li-fraumeni syndrome: advice, adherence and perceived benefits

    NARCIS (Netherlands)

    Lammens, C.R.M.; Bleiker, E.M.A.; Aaronson, N.K.; Wagner, A.; Sijmons, R.H.; Ausems, M.G.E.M.; Vriends, A.H.J.T.; Ruijs, M.W.G.; van Os, T.A.M.; Spruijt, L.; Gómez García, E.B.; Cats, A.; Nagtegaal, T.; Verhoef, S.

    2010-01-01

    Li Fraumeni Syndrome (LFS) is a hereditary cancer syndrome characterized by a high risk of developing various types of cancer from birth through late adulthood. Clinical benefits of surveillance for LFS are limited. The aim of this study is to investigate which advice for regular surveillance, if

  6. Integrating guideline development and implementation: analysis of guideline development manual instructions for generating implementation advice.

    Science.gov (United States)

    Gagliardi, Anna R; Brouwers, Melissa C

    2012-07-23

    Guidelines are important tools that inform healthcare delivery based on best available research evidence. Guideline use is in part based on quality of the guidelines, which includes advice for implementation and has been shown to vary. Others hypothesized this is due to limited instructions in guideline development manuals. The purpose of this study was to examine manual instructions for implementation advice. We used a directed and summative content analysis approach based on an established framework of guideline implementability. Six manuals identified by another research group were examined to enumerate implementability domains and elements. Manuals were similar in content but lacked sufficient detail in particular domains. Most frequently this was Accomodation, which includes information that would help guideline users anticipate and/or overcome organizational and system level barriers. In more than one manual, information was also lacking for Communicability, information that would educate patients or facilitate their involvement in shared decision making, and Applicability, or clinical parameters to help clinicians tailor recommendations for individual patients. Most manuals that direct guideline development lack complete information about incorporating implementation advice. These findings can be used by those who developed the manuals to consider expanding their content in these domains. It can also be used by guideline developers as they plan the content and implementation of their guidelines so that the two are integrated. New approaches for guideline development and implementation may need to be developed. Use of guidelines might be improved if they included implementation advice, but this must be evaluated through ongoing research.

  7. Advice to stay active or structured exercise in the management of sciatica

    DEFF Research Database (Denmark)

    Fernandez, Matt; Hartvigsen, Jan; Ferreira, Manuela L

    2015-01-01

    STUDY DESIGN: A systematic review and meta-analysis. OBJECTIVE: To evaluate the evidence on comparative effectiveness of advice to stay active versus supervised structured exercise in the management of sciatica. SUMMARY OF BACKGROUND DATA: Conservative management of sciatica usually includes inte...

  8. Self-Monitoring of Blood Glucose : Professional Advice and Daily Practice of Patients With Diabetes

    NARCIS (Netherlands)

    Hortensius, Johanna; van der Bijl, Jaap J.; Kleefstra, Nanne; Houweling, Sebastiaan T.; Bilo, Henk J. G.

    2012-01-01

    Purpose This study investigated the advice given by diabetes educators in Europe, and the daily practice of Dutch patients with diabetes regarding the use of the first or second drop of blood and other aspects concerning self-monitoring of blood glucose (SMBG). Method During a diabetes conference in

  9. 41 CFR 105-50.202-7 - Technical information and advice.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Technical information... Property Management Regulations System (Continued) GENERAL SERVICES ADMINISTRATION 50-PROVISION OF SPECIAL... Services Administration § 105-50.202-7 Technical information and advice. GSA will provide technical...

  10. Positive vs. Negative : The Impact of Question Polarity in Voting Advice Applications

    NARCIS (Netherlands)

    Holleman, Bregje; Kamoen, Naomi; Krouwel, Andre; van de Pol, Jasper; de Vreese, Claes

    2016-01-01

    Online Voting Advice Applications (VAAs) are survey-like instruments that help citizens to shape their political preferences and compare them with those of political parties. Especially in multi-party democracies, their increasing popularity indicates that VAAs play an important role in opinion

  11. Help! I don't love my husband” Advice Columns as Teaching ...

    African Journals Online (AJOL)

    This paper is concerned with the use of teaching materials that are salient to students' life experiences, hold their interest and facilitate transformatory learning and critical feminist thinking about gender and sexualities. Based on the experience of the use of Ghanaian advice columns as part of the curriculum in a gender and ...

  12. 12 CFR 9.101 - Providing investment advice for a fee.

    Science.gov (United States)

    2010-01-01

    ... activities generally do not entail providing investment advice for a fee: (i) Financial advisory and counseling activities, including strategic planning of a financial nature, merger and acquisition advisory services, advisory and structuring services related to project finance transactions, and providing market...

  13. Oxytocin facilitation of acceptance of social advice is dependent upon the perceived trustworthiness of individual advisors.

    Science.gov (United States)

    Luo, Ruixue; Xu, Lei; Zhao, Weihua; Ma, Xiaole; Xu, Xiaolei; Kou, Juan; Gao, Zhao; Becker, Benjamin; Kendrick, Keith M

    2017-09-01

    The neuropeptide oxytocin may increase social cohesion by making us more willing to trust others and/or to conform to their opinions. Here we investigated whether intranasal oxytocin can influence acceptance of advice given on solving everyday social problems by either individual expert (psychologist) or non-expert advisors with or without influencing their perceived likeability or trustworthiness. In a double-blind, between-subject, placebo-control design study in 160 male and female subjects, intranasal oxytocin (24IU) only significantly enhanced acceptance of advice given by female psychologists who were rated as the most trustworthy advisors. However, oxytocin itself did not alter either trustworthiness or likeability ratings. The oxytocin effect on acceptance of the female psychologist's advice was not maintained after a week, with subjects mainly reverting to their original solutions. These findings suggest that while oxytocin can transiently increase acceptance of advice from the most trustworthy individuals this is because it makes subjects more likely to conform to their opinions rather than enhancing their perceived trustworthiness or likeability. Thus in every day contexts oxytocin may primarily promote social cohesion by facilitating conformity towards the opinions of the most trusted individuals. Copyright © 2017. Published by Elsevier Ltd.

  14. Literature review on the tele medical advice for ships (TMAS) 2005-2015

    DEFF Research Database (Denmark)

    Canals, M. Luisa; Jensen, Olaf Chresten; Eliseo Prisno-III, Don

    interesting articles can be found. Conclusions: The cross-sectional studies show that cardio-vascular disease and injuries form the main parts of the radio medical advice in the merchant, the fishing and the passenger/cruise ships segments. Even if the national TMAS centres have highly technical developed...

  15. Discharge against medical advice from Neonatal Intensive Care Unit: 10 years experience at a University Hospital.

    Science.gov (United States)

    Al-Turkistani, Hatim K

    2013-05-01

    Discharging patients against medical advice is a problem of every age-group. However, because of their physiological vulnerability, the risk for the neonatal population is greater when discharged against medical advice (DAMA). This article is a study of the prevalence of the problem, the possible causes and/or risk factors. A retrospective review of 10 years of medical records of neonates discharged against medical advice from a Neonatal Intensive Care Unit (NICU) at a university hospital. The overall prevalence of DAMA was 1.6%. Most of the 51 infants who were taken out of hospital against medical advice (AMA) were term (72.5%) with a mean gestational age of 37.78 ± 2.5 weeks, of normal birth weight, with a mean of 2736 ± 661 g, Saudis (96%), those delivered vaginally (69%), and those that were provisionally diagnosed with transient tachypnea of newborn (TTN) and/or query sepsis (49%). There was no difference between males and females (M/F = 1.2). There was an association between DAMA and the timing of DAMA (27.5% of DAMA at weekends and 67% of DAMA from May to October). DAMA of neonates is particularly critical. The causes and risk factors are many and difficult to predict. In addition to several other factors, its prevalence is influenced negatively by some socio-cultural beliefs.

  16. [Cost-benefit of medical advice for quitting smoking in the Region of Murcia].

    Science.gov (United States)

    López-Nicolás, Angel; Trapero-Bertran, Marta; Muñoz, Celia

    To perform a cost-benefit analysis of brief medical advice to quit smoking in the Region of Murcia. A cost-benefit analysis is performed on brief medical advice to quit smoking versus non-intervention. A Markov model is used to estimate the costs (€ in 2014), under the perspective of the National Health System, and health outcomes. These are measured in quality-adjusted life years (QALY). The time horizon of the analysis is 20years, and costs and health outcomes were discounted at 3%. A univariate and multivariate deterministic sensitivity analysis is performed. Region of Murcia. Smokers in the Region of Murcia. Brief advice to quit smoking. Quality Adjusted Life Years (QALYs). With a time horizon of 5years (2018), the incremental cost-effectiveness ratio (ICER) would be €172,400 per QALY gained; at 10years (2023) the ICER was €30,300 per QALY gained; and, for the maximum horizon considered by the model, the ICER was €7,260 per QALY gained. Brief advice intervention is more efficient in the long-term than in the short-term and, depending on the Spanish cost-benefit threshold, public funding for this intervention would be recommended. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  17. 3D visualization as a communicative aid in pharmaceutical advice-giving over distance.

    Science.gov (United States)

    Ostlund, Martin; Dahlbäck, Nils; Petersson, Göran Ingemar

    2011-07-18

    Medication misuse results in considerable problems for both patient and society. It is a complex problem with many contributing factors, including timely access to product information. To investigate the value of 3-dimensional (3D) visualization paired with video conferencing as a tool for pharmaceutical advice over distance in terms of accessibility and ease of use for the advice seeker. We created a Web-based communication service called AssistancePlus that allows an advisor to demonstrate the physical handling of a complex pharmaceutical product to an advice seeker with the aid of 3D visualization and audio/video conferencing. AssistancePlus was tested in 2 separate user studies performed in a usability lab, under realistic settings and emulating a real usage situation. In the first study, 10 pharmacy students were assisted by 2 advisors from the Swedish National Co-operation of Pharmacies' call centre on the use of an asthma inhaler. The student-advisor interview sessions were filmed on video to qualitatively explore their experience of giving and receiving advice with the aid of 3D visualization. In the second study, 3 advisors from the same call centre instructed 23 participants recruited from the general public on the use of 2 products: (1) an insulin injection pen, and (2) a growth hormone injection syringe. First, participants received advice on one product in an audio-recorded telephone call and for the other product in a video-recorded AssistancePlus session (product order balanced). In conjunction with the AssistancePlus session, participants answered a questionnaire regarding accessibility, perceived expressiveness, and general usefulness of 3D visualization for advice-giving over distance compared with the telephone and were given a short interview focusing on their experience of the 3D features. In both studies, participants found the AssistancePlus service helpful in providing clear and exact instructions. In the second study, directly comparing

  18. The role of advice in medication administration errors in the pediatric ambulatory setting.

    Science.gov (United States)

    Lemer, Claire; Bates, David W; Yoon, Catherine; Keohane, Carol; Fitzmaurice, Garrett; Kaushal, Rainu

    2009-09-01

    In the pediatric setting, adverse events occurring at the administration stage are the most common type of preventable adverse drug events. Few data are available on the effect of advice from medical professionals on medication safety. This is a prospective cohort study of 1685 pediatric patients, 6 office practices in the Boston area. Data were collected from parental interviews, review of duplicate prescriptions, and chart review. Incidents were stratified by type (medication error, near miss, or preventable adverse drug event) and stage of the medication process. Descriptive analysis was followed by a multivariable analysis to determine which factors influenced the occurrence of reported medication administration errors. Advice from both office and pharmacy was assessed to be poor in quality and limited in provision. Health care providers most often failed to offer information. Fifty-seven percent of families who did not receive information were not presented with information, rather than refusing it. Multivariable analysis did not demonstrate that advice form or location reduced the rate of medication administration errors (errors occurring during delivery of the medication, usually in the home). However, taking more than 1 medication (odds ratio = 1.68; 95% confidence interval, 1.15-2.46) and age younger than 5 years (odds ratio = 2.35; 95% confidence interval, 1.05-5.28) were correlated with risk of a medication administration error. Inadequate advice was provided. The current approach for delivering advice does not prevent against medication administration errors. Those at highest risk of such errors are the youngest children and those on multiple medications.

  19. Advice about Work-Related Issues to Peers and Employers from Head and Neck Cancer Survivors.

    Science.gov (United States)

    Dewa, Carolyn S; Trojanowski, Lucy; Tamminga, Sietske J; Ringash, Jolie; McQuestion, Maurene; Hoch, Jeffrey S

    2016-01-01

    The purpose of this exploratory and descriptive study is to contribute to the sparse return-to-work literature on head and neck cancer (HNC) survivors. Interview participants were asked to reflect upon their work-related experience with cancer by answering two specific questions: (1) What advice would you give someone who has been newly diagnosed with head and neck cancer? (2) What advice would you give to employers of these people? Data were gathered through 10 individual semi-structured in-depth interviews with HNC clinic patients at a regional cancer center's head and neck clinic in Ontario, Canada. A constant comparative method of theme development was used. Codes identified in and derived from the data were discussed by research team members until consensus was reached. Codes with similar characteristics were grouped together and used to develop overarching themes. Work-related advice for peers focused on personal self-care and interactions within workplaces. Work-related advice to employers focused on demonstrating basic human values as well as the importance of communication. The study results suggest HNC clinic patients should be proactive with employers and help to set reasonable expectations and provide a realistic plan for work to be successfully completed. HNC clinic patients should develop communication skills to effectively disclose their cancer and treatment to employers. In this exploratory study, HNC clinic patients' advice was solution-focused underscoring the importance of self-care and pro-active communication and planning with employers. Employers were advised to demonstrate core human values throughout all phases of the work disability episode beginning at diagnosis.

  20. Different roles of electromagnetic field experts when giving policy advice: an expert consultation.

    Science.gov (United States)

    Spruijt, Pita; Knol, Anne B; Petersen, Arthur C; Lebret, Erik

    2015-01-21

    The overall evidence for adverse health effects of electromagnetic fields (EMF) at levels of exposure normally experienced by the public is generally considered weak. However, whether long-term health effects arise remains uncertain and scientific policy advice is therefore given against a background of uncertainty. Several theories exist about different roles that experts may take when they provide advice on complex issues such as EMF. To provide empirical evidence for these theories, we conducted an expert consultation with as main research question: What are the different roles of EMF experts when they provide policy advice? Q methodology was used to empirically test theoretical notions on the existence and determinants of different expert roles and to analyze which roles actually play out in the domain of EMF. Experts were selected based on a structured nominee process. In total 32 international EMF experts participated. Responses were analyzed using Principal Component Analysis and for the open questions we used Atlas.ti. Four expert roles were found. Most striking differences between the four roles are whether experts consider current EMF policies adequate or not, whether additional -precautionary- measures are needed, and how experts view their position vis-à-vis policymakers and/or other stakeholders. This empirical study provides support for the so far mainly theoretical debate about the existence of different roles of experts when they give policy advice. The experts' assessment of the degree of uncertainty of the issue turned out to be highly associated with their role. We argue that part of the controversy that exists in the debate regarding scientific policy advice on EMF is about different values and roles.

  1. Patients, evidence and genes: an exploration of GPs' perspectives on gene-based personalized nutrition advice.

    Science.gov (United States)

    Bouwman, Laura; Te Molder, Hedwig; Hiddink, Gerrit

    2008-12-01

    Nutrigenomics science examines the response of individuals to food compounds using post-genomics technology. It is expected that in the future, personalized nutrition advice can be provided based on information about genetic make-up. Gene-based personalized nutrition advice emerges at the junction of different disciplines and technologies and may directly influence people's lives. Therefore, public concern is to be expected. Because GPs are gatekeepers of health care, their involvement in early stages of the development process is desirable. In 2006, 15 GPs were interviewed to collect their perceived barriers and opportunities towards involvement in gene-based nutrition advice. The interviews were qualitatively analysed with use of Atlas.ti, a qualitative analysis programme. The participants held a mostly critical view towards such personalized nutrition advice. They argued that findings of nutritional studies lacked robustness, were not based on patients' needs and were often equivocal. And that a patient central perspective urges them to question consequences for patients. Participants argued that GPs should be involved in selecting and monitoring patients in nutrigenomics studies. Early involvement of GPs in the development process is needed to allow for the integration of their practical, social and ethical considerations in the technical and scientific agendas. However, the background of their critical attitude towards nutrigenomics-based personalized nutrition, and nutrition advice more generally, has to be explored further. To facilitate a joint learning process and to improve socio-technical decision making with respect to this innovation, initiatives that allow different stakeholders to exchange their perspectives should be organized.

  2. Joint influence of individual choices, parenting practices, and physician advice on adolescent obesity, Nebraska, 2008.

    Science.gov (United States)

    Wang, Hongmei; Kim, Jungyoon; Su, Dejun; Xu, Liyan; Chen, Li-Wu; Huang, Terry T-K

    2014-10-09

    Reducing childhood obesity remains a public health priority given its high prevalence and its association with increased risk of adult obesity and chronic diseases. The objective of this study was to examine the joint influence of multiple risk factors on adolescent overweight status. We conducted a random-digit-dialed telephone survey of adolescents aged 12 to 19 years in fall 2008 in a Midwestern city in Nebraska. On the basis of survey data for 791 youths aged 12 to 18 years, we conducted latent class analysis to group youths by the joint occurrence of dietary behavior, physical activity, parenting practices, and physician advice. We then examined the association between the groups and overweight status by using logistic regression, controlling for age, sex, race/ethnicity, and parent and family information. Youths were clustered into 3 groups. Group I (52%) were youths with healthy dietary behavior and physical activity, less permissive parenting practices, and physician advice; Group II (30%) were youths with moderately healthy dietary behavior and physical activity, less permissive parenting practices, and no physician advice; and Group III (18%) were youths with unhealthy dietary behavior and physical activity, permissive parenting practices, and physician advice. Youths in Groups I and II were less likely to be overweight than youths in Group III. Youths with healthier behavior and less permissive parenting practices were less likely to be overweight. Study findings highlight the need to address obesity risk factors among youths with unhealthy dietary behavior, inadequate exercise, permissive parenting practices, and some physician advice. Tailored interventions should be used to target youths with different obesity risk factors.

  3. Do not shoot the messenger: ICES advice for an ecosystem approach to fisheries management in the European Union

    DEFF Research Database (Denmark)

    Ballesteros, Marta; Chapela, Rosa; Monsalve, Maria Paulina Ramirez

    2017-01-01

    The International Council for the Exploration of the Sea (ICES) occupies a central role in the advice system to support the implementation of an ecosystem approach to fisheries management (EAFM) in the European Union. Despite improvements in its capacity to deliver ecosystem advice, it seems...

  4. Weight management including dietary and physical activity advice provided by Australian physiotherapists: a pilot cross-sectional survey.

    Science.gov (United States)

    Snodgrass, Suzanne J; Carter, Amy E; Guest, Maya; Collins, Clare E; James, Carole; Kable, Ashley K; Ashby, Samantha E; Plotnikoff, Ronald C

    2014-08-01

    Physiotherapists may have an impact on obesity prevention and treatment by providing nutrition and physical activity advice to overweight or obese clients; yet little is known about physiotherapists' beliefs and practices related to client weight management. The aim of this pilot study was to determine the practices, beliefs, attitudes and knowledge of physiotherapists regarding the provision of weight management advice to overweight or obese clients. Physiotherapists (n = 65) working in multiple practice settings completed a self-administered questionnaire. Logistic regression determined factors associated with the provision of dietary and physical activity advice for weight management. The majority of physiotherapists (n = 53 [81.5%]) believed providing weight management advice was within their scope of practice, yet only a minority had received training during their professional entry level education (n = 13 [20%]) or through professional development (n = 7 [11%]). Most physiotherapists (n = 55 [84.6%]) provided physical activity advice for weight management, but a minority (n = 27 [41.5%]) provided dietary advice. Having received training in weight management during their professional entry level education was associated with providing dietary advice (Odds ratio 8.8, 95% confidence interval 2.0-38.9, p = 0.004). Training in weight management may increase the likelihood of physiotherapists providing dietary advice, improving physiotherapists' management of obesity.

  5. 75 FR 65031 - U.S.-Trans-Pacific Partnership Free Trade Agreement Including Malaysia: Advice on the Probable...

    Science.gov (United States)

    2010-10-21

    ... Partnership Free Trade Agreement Including Malaysia: Advice on the Probable Economic Effect of Providing Duty...-2104-027, U.S.-Trans-Pacific Partnership Free Trade Agreement Including Malaysia: Advice on the Probable Economic Effect of Providing Duty-Free Treatment for Imports. DATES: November 10, 2010: Deadline...

  6. 5 CFR 2641.203 - One-year restriction on any former employee's representations, aid, or advice concerning ongoing...

    Science.gov (United States)

    2010-01-01

    ... employee's representations, aid, or advice concerning ongoing trade or treaty negotiation. 2641.203 Section... CONFLICT OF INTEREST RESTRICTIONS Prohibitions § 2641.203 One-year restriction on any former employee's representations, aid, or advice concerning ongoing trade or treaty negotiation. (a) Basic prohibition of 18 U.S.C...

  7. Can genetic-based advice help you lose weight? Findings from the Food4Me European randomized controlled trial

    NARCIS (Netherlands)

    Celis-Morales, C.; Marsaux, C.F.M.; Livingstone, K.M.; Navas-Carretero, S.; San-Cristobal, R.; Fallaize, R.; Macready, A.L.; O'Donovan, C.; Woolhead, C.; Forster, H.; Kolossa, S.; Daniel, H.; Moschonis, G.; Mavrogianni, C.; Manios, Y.; Surwillo, A.; Traczyk, I.; Drevon, C.A.; Grimaldi, K.; Bouwman, J.; Gibney, M.J.; Walsh, M.C.; Gibney, E.R.; Brennan, L.; Lovegrove, J.A.; Martinez, J.A.; Saris, W.H.M.; Mathers, J.C.

    2017-01-01

    Background: There has been limited evidence about whether genotype-tailored advice provides extra benefits in reducing obesityrelated traits compared with the benefits of conventional one-size-fitsall advice. Objective: We determined whether the disclosure of information on fat-mass and

  8. Using Plant Clinic Registers to Assess the Quality of Diagnoses and Advice Given to Farmers: A Case Study from Uganda

    Science.gov (United States)

    Danielsen, Solveig; Boa, Eric; Mafabi, Moses; Mutebi, Emmanuel; Reeder, Robert; Kabeere, Flavia; Karyeija, Robert

    2013-01-01

    Purpose: This study developed a framework for quality assessment of diagnoses and advice given at plant clinics. Design/methodology/approach: Clinic registers from five plant clinics in Uganda (2006-2010) were used to develop quality assessment protocols for diagnoses and advice given by plant doctors. Assessment of quality of diagnoses was based…

  9. Pre‐operative oral nutritional supplementation with dietary advice versus dietary advice alone in weight‐losing patients with colorectal cancer: single‐blind randomized controlled trial

    Science.gov (United States)

    Gibson, Debra J.; Lal, Simon; Hill, James; Pilling, Mark; Soop, Mattias; Ramesh, Aswatha; Todd, Chris

    2017-01-01

    Abstract Background Pre‐operative weight loss has been consistently associated with increased post‐operative morbidity. The study aims to determine if pre‐operative oral nutritional supplements (ONSs) with dietary advice reduce post‐operative complications. Methods Single‐blinded randomized controlled trial. People with colorectal cancer scheduled for surgery with pre‐operative weight loss >1 kg/3–6 months were randomized by using stratified blocks (1:1 ratio) in six hospitals (1 November 2013–28 February 2015). Intervention group was given 250 mL/day ONS (10.1 KJ and 0.096 g protein per mL) and dietary advice. Control group received dietary advice alone. Oral nutritional supplements were administered from diagnosis to the day preceding surgery. Research team was masked to group allocation. Primary outcome was patients with one or more surgical site infection (SSI) or chest infection; secondary outcomes included percentage weight loss, total complications, and body composition measurements. Intention‐to‐treat analysis was performed with both unadjusted and adjusted analyses. A sample size of 88 was required. Results Of 101 participants, (55 ONS, 46 controls) 97 had surgery. In intention‐to‐treat analysis, there were 21/45 (47%) patients with an infection—either an SSI or chest infection in the control group vs. 17/55 (30%) in the ONS group. The odds ratio of a patient incurring either an SSI or chest infection was 0.532 (P = 0.135 confidence interval 0.232 to 1.218) in the unadjusted analysis and when adjusted for random differences at baseline (age, gender, percentage weight loss, and cancer staging) was 0.341 (P = 0.031, confidence interval 0.128 to 0.909). Pre‐operative percentage weight loss at the first time point after randomization was 4.1% [interquartile range (IQR) 1.7–7.0] in ONS group vs. 6.7% (IQR 2.6–10.8) in controls (Mann–Whitney U P = 0.021) and post‐operatively was 7.4% (IQR 4.3–10.0) in

  10. An Alternative View of Self-Discharge Against Medical Advice: An Opportunity to Demonstrate Empathy, Empowerment, and Care.

    Science.gov (United States)

    Machin, Laura L; Goodwin, Dawn; Warriner, David

    2018-04-01

    In this article, we present the experiences of discharging against medical advice from the perspectives of 17 hospital and community-based health care practitioners, and 16 patients, and relatives from a range of medical and surgical wards. Semistructured, in-depth interviews were conducted and thematically analyzed. We identified that practitioners, patients, and relatives frequently expressed empathy for each other during the interviews, and discharge against medical advice was presented as a way for patients to have control over their health. Contrary to predominantly negative framings that highlight increased mortality and morbidity, and portray people who discharge against medical advice as poor decision makers, we conclude discharge against medical advice can be framed positively. It can be an opportunity to empathize, empower, and care. We recommend that the vocabulary used in hospital discharge against medical advice policies and documents should be updated to reflect a culture of medicine that values patient autonomy, patient centeredness, and shared decision making.

  11. The Radioactive Waste Management Advisory Committee's advice to ministers on the problems of 'small users' of radioactive materials

    International Nuclear Information System (INIS)

    2000-09-01

    The Radioactive Waste Management Advisory Committee (RWMAC) is the independent body that advises the UK Government, including the devolved administrations for Scotland and Wales, on issues relating to the management of civil radioactive waste. Radioactive wastes are produced by the civil nuclear industry, by the Ministry of Defence, and by a varied group of organisations known as 'Small Users'. Small Users include hospitals, universities and some non-nuclear industries, which use radioactive materials and, in turn, produce radioactive waste. In 1991, and again in 1996, RWMAC provided the Government with advice on the problems encountered by Small Users. These difficulties were associated both with specific aspects of the radioactive waste management required and with the controls exercised by the regulators. As part of its work programme for 1999-2000, Ministers asked the Committee to return to these issues. In volume, Small User radioactive wastes make up only a small part of the total UK inventory. However, like those produced by the nuclear and defence sectors, it is vital that they are managed properly, as some carry the potential for considerable harm. Equally, it is important that the financial costs imposed on Small Users as a result of regulation are commensurate with the actual health risk involved. Otherwise, for example, the benefits accruing from use of radioactive materials in medicine might be prejudiced. We have tried to strike an appropriate balance in arriving at the views set out in our report. The report draws attention to a number of areas that Government could usefully consider in respect of Small User waste management, possibly as part of its forthcoming radioactive waste management policy review. A key issue is the need to get to grips with the problem of historic redundant radioactive sources held under registration by Small Users. Many such sources are in the public sector and, under current funding arrangements, Small Users encounter

  12. Examining the content of weight, nutrition and physical activity advices provided by Dutch practice nurses in primary care: analysis of videotaped consultations.

    Science.gov (United States)

    van Dillen, S M E; Noordman, J; van Dulmen, S; Hiddink, G J

    2014-01-01

    To examine the content of Dutch practice nurses' (PNs') advices about weight, nutrition and physical activity to overweight and obese patients. A 100 videotaped real-life PN consultations (The Netherlands, 2010/2011) with overweight or obese patients were selected. An observational checklist was developed to assess frequency and content. Personalization of advices was scored, as also the guidelines on which PNs based their advices. Content analysis was used to identify different categories of advices. About one quarter of advices concerned weight, over two-thirds nutrition and one-third physical activity. Lose weight, eat less fat and be more physically active in general were the main categories for each type of advice. Despite high clarity of advices, lower scores were found for specificity and personalization. Very few nutrition advices were provided in combination with physical activity advices. Weight advices often related to the patient's complaint. PNs seldom set a concrete weight goal. Although benefits of physical activity were discussed, often no practical advices were provided about how to achieve this. Integrated lifestyle advice was not common: advices about nutrition and physical activity were fragmented throughout the consultation. Obesity prevention needs more emphasis in PNs' educational programs.

  13. Analysis of safety supervision of medical radioactive source of categories I in south China

    International Nuclear Information System (INIS)

    Lou Hongxin; Chen Min; Zhang Jian; Zhou Rongbing; Wang Jin; Feng Zhanglin

    2009-01-01

    Actuality of radioactivity therapy medical apparatus using radioactive source of categories I in south China is analyzed from the point of management. The problems, such as the low license possession rate and discrepancy of radioactive source activity to the radiation safety license as well as the orderless disposal of disused radioactive sources, are indicated. Some corresponding advices are denoted. (authors)

  14. Increasing the frequency of physical activity very brief advice for cancer patients. Development of an intervention using the behaviour change wheel.

    Science.gov (United States)

    Webb, J; Foster, J; Poulter, E

    2016-04-01

    Being physically active has multiple benefits for cancer patients. Despite this only 23% are active to the national recommendations and 31% are completely inactive. A cancer diagnosis offers a teachable moment in which patients might be more receptive to lifestyle changes. Nurses are well placed to offer physical activity advice, however, only 9% of UK nurses involved in cancer care talk to all cancer patients about physical activity. A change in the behaviour of nurses is needed to routinely deliver physical activity advice to cancer patients. As recommended by the Medical Research Council, behavioural change interventions should be evidenced-based and use a relevant and coherent theoretical framework to stand the best chance of success. This paper presents a case study on the development of an intervention to improve the frequency of delivery of very brief advice (VBA) on physical activity by nurses to cancer patients, using the Behaviour Change Wheel (BCW). The eight composite steps outlined by the BCW guided the intervention development process. An iterative approach was taken involving key stakeholders (n = 45), with four iterations completed in total. This was not defined a priori but emerged during the development process. A 60 min training intervention, delivered in either a face-to-face or online setting, with follow-up at eight weeks, was designed to improve the capability, opportunity and motivation of nurses to deliver VBA on physical activity to people living with cancer. This intervention incorporates seven behaviour change techniques of goal setting coupled with commitment; instructions on how to perform the behaviour; salience of the consequences of delivering VBA; a demonstration on how to give VBA, all delivered via a credible source with objects added to the environment to support behavioural change. The BCW is a time consuming process, however, it provides a useful and comprehensive framework for intervention development and greater control

  15. Nutritional Advice

    Directory of Open Access Journals (Sweden)

    Khursheed N Jeejeebhoy

    1994-01-01

    suggested that bowel rest did not aid the induction of remission but enteral feeding of defined formula diets did induce remission to the same degree as steroids in some but not all studies. Recently a controlled trial suggested the remission induced by a defined formula diet could be prolonged by the use of elimination diets. The use of specific nutrients capable of reducing inflammation or promoting epithelial integrity await study.

  16. HSE Advice

    CERN Multimedia

    2011-01-01

      var flash_video_player=get_video_player_path(); insert_player_for_external('Video/Public/Movies/2011/CERN-MOVIE-2011-152/CERN-MOVIE-2011-152-0753-kbps-480x360-25-fps-audio-64-kbps-44-kHz-stereo', '', 'false', 480, 360, 'https://mediastream.cern.ch/MediaArchive/Video/Public/Movies/2011/CERN-MOVIE-2011-152/CERN-MOVIE-2011-152-posterframe-480x360-at-30-percent.jpg', '1388277', true, '');   You can also download the presentation for future reference.

  17. Communication of alcohol and smoking lifestyle advice to the gastroenterological patient.

    Science.gov (United States)

    Spence, Andrew D; Khasawneh, Mais; Allen, Patrick B; Addley, Jennifer

    2017-10-01

    Effective communication between healthcare staff and patients is central to development of the patient-professional relationship. Many barriers influence this communication, often resulting in patients' lack of understanding and retention of information, particularly affecting advice regarding lifestyle habits, such as alcohol consumption and smoking. Alcohol and smoking misuse are potentially modifiable risk factors known to adversely affect a variety of gastroenterological conditions and improvements in communication with patients regarding this is an important management component. This review discusses the clinical impact of these factors and how healthcare professionals can improve communication. We discuss how enhancing verbal communication skills through medical training leads to greater outcomes in patient satisfaction and adherence to treatment and advice. In addition, with the rapid digitalisation of society, platforms such as social media and smartphone applications may be considered as adjuncts to traditional forms of communication. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Predicting disease progression from short biomarker series using expert advice algorithm

    Science.gov (United States)

    Morino, Kai; Hirata, Yoshito; Tomioka, Ryota; Kashima, Hisashi; Yamanishi, Kenji; Hayashi, Norihiro; Egawa, Shin; Aihara, Kazuyuki

    2015-05-01

    Well-trained clinicians may be able to provide diagnosis and prognosis from very short biomarker series using information and experience gained from previous patients. Although mathematical methods can potentially help clinicians to predict the progression of diseases, there is no method so far that estimates the patient state from very short time-series of a biomarker for making diagnosis and/or prognosis by employing the information of previous patients. Here, we propose a mathematical framework for integrating other patients' datasets to infer and predict the state of the disease in the current patient based on their short history. We extend a machine-learning framework of ``prediction with expert advice'' to deal with unstable dynamics. We construct this mathematical framework by combining expert advice with a mathematical model of prostate cancer. Our model predicted well the individual biomarker series of patients with prostate cancer that are used as clinical samples.

  19. Conditional advice and inducements: are readers sensitive to implicit speech acts during comprehension?

    Science.gov (United States)

    Haigh, Matthew; Stewart, Andrew J; Wood, Jeffrey S; Connell, Louise

    2011-03-01

    Conditionals can implicitly convey a range of speech acts including promises, tips, threats and warnings. These are traditionally divided into the broader categories of advice (tips and warnings) and inducements (promises and threats). One consequence of this distinction is that speech acts from within the same category should be harder to differentiate than those from different categories. We examined this in two self-paced reading experiments. Experiment 1 revealed a rapid processing penalty when inducements (promises) and advice (tips) were anaphorically referenced using a mismatching speech act. In Experiment 2 a delayed penalty was observed when a speech act (promise or threat) was referenced by a mismatching speech act from the same category of inducements. This suggests that speech acts from the same category are harder to discriminate than those from different categories. Our findings not only support a semantic distinction between speech act categories, but also reveal pragmatic differences within categories. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Advice to a young scientist (by someone who doesn't know how to give it).

    Science.gov (United States)

    Denic, Vladimir

    2015-11-01

    While trying to extract original and general advice from the details of my career, I realized this might not be possible. My path, like those of so many others, had too many idiosyncratic twists and turns that had to work out just the way they did to be mined for generally useful strategies. So I abandon the conceit of advice and simply give you my story. There are many like it, but this one is mine. Take what you wish from it. © 2015 Denic. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  1. Education of patients after whiplash injury: is oral advice any better than a pamphlet?

    DEFF Research Database (Denmark)

    Kongsted, Alice; Qerama, Erisela; Kasch, Helge

    2008-01-01

    information was observed and the question how patients should be educated to reduce the risk of chronicity after whiplash is worth further investigation, since no treatment have been proven to prevent long-lasting symptoms, and all forms of advice or educational therapy are so cheap that even a modest effect......STUDY DESIGN: Randomized parallel-group trial with 1-year follow-up. OBJECTIVE: To evaluate whether education of patients communicated orally by a specially trained nurse is superior to giving patients a pamphlet after a whiplash injury. SUMMARY OF BACKGROUND DATA: Long-lasting pain and physical...... outcome parameters, even though the outcome tended to be better for the group receiving personal advice. CONCLUSION: Prognosis did not differ between patients who received personal education and those who got a pamphlet. However, a systematic tendency toward better outcome with personal communicated...

  2. [Quality of scientific advice to politics. Lecture at the Berlin-Brandenburg Academy of Science and Humanities].

    Science.gov (United States)

    Kurth, R; Glasmacher, S

    2008-04-01

    Scientific advice to politics is a primary function of governmental research. The advisory process is, in the ideal situation, a collective duty of science and politics. The final decision rests ultimately with politicians. An understanding of the differences between science and politics is necessary for successfully providing advice to politicians. The requirements necessary to allow politics to substantially follow the advice of scientists are multifarious. The first of these is trust from the side of politics and the public and from the side of science competitive research, respect and communication skills, neutrality and integrity. From these requirements it is possible to derive criteria for quality assurance in advice to politics. The maintenance of scientific expertise at the competitive international level demands independent, qualified and adequately financed research. Governmental institutes have an antenna function: they have to recognize in good time whether risks are increasing, whether the government has to be informed and whether there is a need for action. The continuing maintenance of excellence requires measures of quality assurance at all levels. Evidence for the quality of advice to politics can, for example, be found in the good reputation of an institution and its prominent representatives. Success in research is an indirect quality criterion that can be and should be measured to a certain extent. The influence of advisory activities on political decisions is direct evidence for the quality of the advice. A classic example of highly successful policy advice is the development of the German AIDS policy.

  3. Users and non-users of web-based health advice service among Finnish university students – chronic conditions and self-reported health status (a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Castrén Johanna

    2008-01-01

    Full Text Available Abstract Background The Internet is increasingly used by citizens as source of health information. Young, highly educated adults use the Internet frequently to search for health-related information. Our study explores whether reported chronic conditions or self-reported health status differed among Finnish university students using the Finnish Student Health Services web-based health advice service compared with those not using the service. Methods Cross-sectional study performed by a national postal survey in 2004. Material: A random sample (n = 5 030 of a population of 101 805 undergraduate Finnish university students aged 19–35. The response rate: 63% (n = 3 153. Main outcome measures: Proportion of university students reporting use a of web-based health advice service, diagnosed chronic conditions, and self-reported health status of users and non-users of a web-based health advice service. Statistical methods: Data were presented with frequency distributions and cross-tabulations and the χ2 test was used. Results 12% (n = 370 of Finnish undergraduate students had used the web-based health advice service and were identified as 'users'. The proportion of male students reporting allergic rhinitis or conjunctivitis was greater among users than non-users (24%, n = 22 vs. 15%, n = 154, χ2, P = .03. The proportion of female students reporting chronic mental health problems was greater among users than non-users (12%, n = 34 vs. 8%, n = 140, χ2, P = .03. There was no statistical significance between the group differences of male or female users and non-users in self-reported health status (good or fairly good, average, rather poor or poor. Conclusion Among young, highly educated adults the use of a web-based health advice service is not associated with self-reported health status. However, a web-based health advice service could offer support for managing several specific chronic conditions. More research data is needed to evaluate the role of

  4. Making LibrariesAccessible for Visually Impaired Users: Practical Advice For Librarians

    Directory of Open Access Journals (Sweden)

    Devney Hamilton

    2011-12-01

    Full Text Available This article provides an introduction to making university libraries accessible to visually impaired users. It includes a summary of how visually impaired students access information and how libraries can provide access to materials, devices and software, and staff support to ensure visually impaired students ’ equal opportunity to use the library. The practical advice for librarians are based on interviews with 18 visually impaired university students and professionals who specialize in media, library services and information retrieval.

  5. Turing Machines with One-sided Advice and Acceptance of the co-RE Languages

    Czech Academy of Sciences Publication Activity Database

    van Leeuwen, J.; Wiedermann, Jiří

    2017-01-01

    Roč. 153, č. 4 (2017), s. 347-366 ISSN 0169-2968 Grant - others:GA ČR(CZ) GA15-04960S Institutional support: RVO:67985807 Keywords : advice functions * co-RE languages * machine models * Turing machines Subject RIV: IN - Informatics, Computer Science OBOR OECD: Computer sciences, information science, bioinformathics (hardware development to be 2.2, social aspect to be 5.8) Impact factor: 0.687, year: 2016

  6. Did public health travel advice reach EURO 2012 football fans? A social network survey.

    Science.gov (United States)

    Janiec, J; Zielicka-Hardy, A; Polkowska, A; Rogalska, J; Sadkowska-Todys, M

    2012-08-02

    We posted a survey on the Union of European Football Associations (UEFA)’s EURO 2012 Facebook profile to evaluate whether public health travel advice, specifically on the importance of measles vaccination,reached fans attending EURO 2012. Responses suggested that these messages were missed by 77% of fans. Social networks could serve as innovative platforms to conduct surveys, enabling rapid access to target populations at low cost and could be of use during upcoming mass gatherings such as the Olympics.

  7. Sports Nutrition Knowledge, Perceptions, Resources, and Advice Given by Certified CrossFit Trainers

    OpenAIRE

    Cassie Maxwell; Kyle Ruth; Carol Friesen

    2017-01-01

    Background: CrossFit is a large, growing force in the fitness community. Currently, Level 1 and 2 CrossFit certification classes do not include nutrition education. The purpose of this study was to identify sports nutrition knowledge, perceptions, resources, and advice given by Certified CrossFit Trainers. Methods: An online questionnaire that measured these four constructs was placed on a private Facebook community, open only to certified CrossFit trainers, for 10 days. Results: Complete sur...

  8. Integrating guideline development and implementation: analysis of guideline development manual instructions for generating implementation advice

    Science.gov (United States)

    2012-01-01

    Background Guidelines are important tools that inform healthcare delivery based on best available research evidence. Guideline use is in part based on quality of the guidelines, which includes advice for implementation and has been shown to vary. Others hypothesized this is due to limited instructions in guideline development manuals. The purpose of this study was to examine manual instructions for implementation advice. Methods We used a directed and summative content analysis approach based on an established framework of guideline implementability. Six manuals identified by another research group were examined to enumerate implementability domains and elements. Results Manuals were similar in content but lacked sufficient detail in particular domains. Most frequently this was Accomodation, which includes information that would help guideline users anticipate and/or overcome organizational and system level barriers. In more than one manual, information was also lacking for Communicability, information that would educate patients or facilitate their involvement in shared decision making, and Applicability, or clinical parameters to help clinicians tailor recommendations for individual patients. Discussion Most manuals that direct guideline development lack complete information about incorporating implementation advice. These findings can be used by those who developed the manuals to consider expanding their content in these domains. It can also be used by guideline developers as they plan the content and implementation of their guidelines so that the two are integrated. New approaches for guideline development and implementation may need to be developed. Use of guidelines might be improved if they included implementation advice, but this must be evaluated through ongoing research. PMID:22824094

  9. The ICMJE and URM: Providing Independent Advice for the Conduct of Biomedical Research and Publication

    OpenAIRE

    Van der Weyden, Martin B

    2007-01-01

    The International Committee of Medical Journal Editors (ICMJE) is a working group of editors of selected medical journals that meets annually. Founded in Vancouver, Canada, in 1978, it currently consists of 11 member journals and a representative of the US National Library of Medicine. The major purpose of the Committee is to address and provide guidance for the conduct and publishing of biomedical research and the ethical tenets underpinning these activities. This advice is detailed in the C...

  10. Making LibrariesAccessible for Visually Impaired Users: Practical Advice For Librarians

    OpenAIRE

    Devney Hamilton; Burcu Keten

    2011-01-01

    This article provides an introduction to making university libraries accessible to visually impaired users. It includes a summary of how visually impaired students access information and how libraries can provide access to materials, devices and software, and staff support to ensure visually impaired students ’ equal opportunity to use the library. The practical advice for librarians are based on interviews with 18 visually impaired university students and professionals who specialize in medi...

  11. The association between acute alcohol consumption and discharge against medical advice of injured patients in the ED.

    Science.gov (United States)

    Jeong, Joo; Song, Kyoung Jun; Kim, Yu Jin; Cho, Jin Seong; Park, Ju Ok; Lee, Seung Chul; Ro, Young Sun; Holmes, James F

    2016-03-01

    A paucity of data exists on the prevalence and predictors of discharging injured patients against medical advice from emergency departments. The aim of this study is to investigate the association between acute alcohol use and being discharged against medical advice. We performed a prospective, observational study of injured patients enrolled into the Korean Centers for Disease and Prevention injury surveillance program in 7 tertiary, academic, and teaching hospitals from June 1, 2008, to November 31, 2011. Injured patients were assigned to 1 of 3 groups: discharged against medical advice, regular discharge, and transferred or admitted. Multivariable logistic regression models were used to analyze the association between acute alcohol use and being discharged against medical advice. A total of 125,327 patients were enrolled, and 3473 (2.8%) were discharged against medical advice. The proportion of acute alcohol use was significantly higher among the patients who were discharged against medical advice (40.1%) than the regular discharged (16.6%) or transferred/admitted (15.5%) patients. In a regression model, acute alcohol use increased the risk of being discharged against medical advice (adjusted odds ratio, 1.86; 95% confidence interval, 1.70-2.03). In addition, we identified the interaction between acute alcohol use and intention of injury. Acute alcohol use had a significant association with the discharge against medical advice with the unintentional injury (adjusted odds ratio, 2.56; 95% confidence interval, 2.30-2.84). Patients with acute alcohol use before sustaining an injury are at increased risk of being discharged against medical advice from the emergency departments. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Clinical and radiographic improvement of rickets in Bangladeshi children as a result of nutritional advice.

    Science.gov (United States)

    Arnaud, J; Pettifor, J M; Cimma, J P; Fischer, P R; Craviari, T; Meisner, C; Haque, S

    2007-09-01

    Calcium-deficiency rickets is common in south-east Bangladesh and responds to calcium supplementation. To evaluate the healing effect on active rickets of a five-component nutritional advice programme aimed at doubling dietary calcium intakes. Forty-nine children aged rickets were followed over a period of 12 months. All were provided with a five-component nutritional advice programme advocating (i) the routine addition of 1 g limestone/kg rice, (ii) consuming small fish (including bones) instead of large ones, and (iii) daily consumption of 5 g ground sesame seeds, (iv) 100 g leafy vegetables and, if possible, (v) 100 ml of milk. Radiographic scores improved in 90% of children. The response was positively associated with age (r=0.34, n=48, p=0.01) and severity of radiographic score at baseline (r=0.85, n=49, prickets, nutritional advice may be a cost-effective treatment and possibly a valuable long-term solution to the problem.

  13. Prospective study of factors predicting adherence to medical advice in men with testicular cancer.

    Science.gov (United States)

    Moynihan, Clare; Norman, Andy R; Barbachano, Yolanda; Burchell, Louise; Huddart, Robert; Dearnaley, David P; Horwich, Alan

    2009-05-01

    To identify predictive factors of adherence to medical advice, specifically the likelihood of attendance to a recommended follow-up regimen in patients with newly diagnosed testicular cancer. PATIENTS AND METHODS; This was a prospective study measuring initially not only aspects of the doctor-patient interview, but also a range of demographic, psychological, social, and medical factors, and then recording attendance behavior on follow-up. All 209 new patients with testicular cancer referred between June 1992 and May 1995 were approached, and 184 men consented and completed questionnaires. The nonadherence end point (nonattender) was two failures to attend an outpatient appointment at least 1 month apart, despite a written reminder. Thirty-two participants (17%) were classified as nonattenders. No significant differences were found between attenders and nonattenders in the majority of psychosocial and medical variables that might have predicted nonadherence to medical advice. There was a highly significant association between nonattendance and a patient's perception of an unsatisfactory affective relationship with his clinician (P = .005; hazard ratio, 3.1; 95% CI, 1.4 to 6.6). Patients who perceived an unsatisfactory affective relationship with their clinician that included an inability to trust the clinician and a perception that they were not being treated as "a person" were subsequently more likely to disregard medical advice regarding follow-up. Attention to the ways young men may wish to communicate with their clinicians is important, bearing in mind that they may not necessarily adhere to stereotypical images of masculine self-dependence.

  14. A prospective study of the workload of a newly formed PEG advice team.

    Science.gov (United States)

    Matthewson, K; White, S; Torrance, A; Clark, S; Bottrill, P

    2001-02-01

    A multidisciplinary advice team may be the optimal way of providing the long-term nutritional and percutaneous endoscopic gastrostomy (PEG)-related care for patients dependent on PEG feeding but the workload involved is unknown. To study prospectively the workload of a proactive, multidisciplinary PEG advice team over a 2-year period. Separate documentation from main case notes of each episode of the team's contact with PEG or potential PEG patients, including assessment, advice and therapy given, from the time of its establishment, for four consecutive 6-monthly periods. During the audit, 89 patients were referred to the team for consideration of PEG insertion and PEGs were placed in 74. Eighty-nine additional patients were referred for follow up having had a PEG placed elsewhere. During the four audit periods the rate of new PEG insertions increased by 53%, the rate of PEG replacements by 315%, and the number of patients under the team increased from 16 to 70, an increase of 337%. Numbers of inpatient and outpatient consultations, and visits to other institutions by members of the team increased commensurately. The rapidly increasing workload of the team suggests it is playing a valued role but there are significant resource implications.

  15. Age Differences among Female Sex Workers in the Philippines: Sexual Risk Negotiations and Perceived Manager Advice

    Directory of Open Access Journals (Sweden)

    Lianne A. Urada

    2012-01-01

    Full Text Available Consistent condom use among high risk groups such as female sex workers (FSWs remains low. Adolescent female sex workers are especially at higher risk for HIV/STI infections. However, few published studies have compared the sexual risk negotiations among adolescent, emerging adult, and older age groups or the extent a manager’s advice about condom use is associated with an FSW’s age. Of 1,388 female bar/spa workers surveyed in the southern Philippines, 791 FSW who traded sex in the past 6 months were included in multivariable logistic regression models. The oldest FSWs (aged 36–48 compared to adolescent FSWs (aged 14–17 were 3.3 times more likely to negotiate condoms when clients refused condom use. However, adolescent FSWs received more advice from their managers to convince clients to use condoms or else to refuse sex, compared to older FSWs. Both adolescent and the oldest FSWs had elevated sexually transmitted infections (STIs and inconsistent condom use compared to other groups. Having a condom rule at the establishment was positively associated with condom negotiation. Factors such as age, the advice managers give to their workers, and the influence of a condom use rule at the establishment need to be considered when delivering HIV/STI prevention interventions.

  16. Lessons learned and advice from Vietnam war nurses: a qualitative study.

    Science.gov (United States)

    Scannell-Desch, Elizabeth A

    2005-03-01

    The aim of this paper is to describe guidance for nurses today from the lessons learned by nurses who served in the Vietnam War. There is little research focusing on nurses' experiences in the Vietnam War. Lessons learned and subsequent advice from nurses who served in Vietnam may be helpful to those serving in current and future wars. A Husserlian phenomenological approach was taken, using interviews with a purposive sample of Registered Nurses who were female, and had served in the United States of America armed forces in Vietnam during the war. Seven theme clusters described the lesson learned and guidance offered by the Vietnam War nurses: advice about journaling, training, caring for yourself, use of support systems, talking about your experiences, understanding the mission, and lack of preparation for war. Much can be learned from the lessons learned and advice given by Vietnam War nurses. These lessons stress that nurses need to take a pro-active role in preparing themselves for deployment to a war zone, and that institutional training for war needs to be intensive and realistic. The environmental, cultural, technological, clinical and psychosocial demands of war nursing need to be comprehensively addressed before nurses deploy to a war.

  17. State-level prevalence of cigarette smoking and treatment advice, by disability status, United States, 2004.

    Science.gov (United States)

    Armour, Brian S; Campbell, Vincent A; Crews, John E; Malarcher, Ann; Maurice, Emmanuel; Richard, Roland A

    2007-10-01

    To our knowledge, no study has determined whether smoking prevalence is higher among people with disabilities than among people without disabilities across all U.S. states. Neither do we know whether people with disabilities and people without disabilities receive the same quality of advice about tobacco-cessation treatment from medical providers. We analyzed data from the 2004 Behavioral Risk Factor Surveillance System to estimate differences between people with and people without disabilities in smoking prevalence and the receipt of tobacco-cessation treatment advice from medical providers. We found that smoking prevalence for people with disabilities was approximately 50% higher than for people without disabilities. Smokers with disabilities were more likely than smokers without disabilities to have visited a medical provider at least once in the previous 12 months and to have received medical advice to quit. More than 40% of smokers with disabilities who were advised to quit, however, reported not being told about the types of tobacco-cessation treatment available. Ensuring that people with disabilities are included in state-based smoking cessation programs gives states an opportunity to eliminate health disparities and to improve the health and wellness of this group. Ways to reduce unmet preventive health care needs of people with disabilities include provider adoption of the Public Health Service's clinical practice guideline for treating tobacco use and dependence and the provision of smoking cessation services that include counseling and effective pharmaceutical treatment.

  18. Pre-operative oral nutritional supplementation with dietary advice versus dietary advice alone in weight-losing patients with colorectal cancer: single-blind randomized controlled trial.

    Science.gov (United States)

    Burden, Sorrel T; Gibson, Debra J; Lal, Simon; Hill, James; Pilling, Mark; Soop, Mattias; Ramesh, Aswatha; Todd, Chris

    2017-06-01

    Pre-operative weight loss has been consistently associated with increased post-operative morbidity. The study aims to determine if pre-operative oral nutritional supplements (ONSs) with dietary advice reduce post-operative complications. Single-blinded randomized controlled trial. People with colorectal cancer scheduled for surgery with pre-operative weight loss >1 kg/3-6 months were randomized by using stratified blocks (1:1 ratio) in six hospitals (1 November 2013-28 February 2015). Intervention group was given 250 mL/day ONS (10.1 KJ and 0.096 g protein per mL) and dietary advice. Control group received dietary advice alone. Oral nutritional supplements were administered from diagnosis to the day preceding surgery. Research team was masked to group allocation. Primary outcome was patients with one or more surgical site infection (SSI) or chest infection; secondary outcomes included percentage weight loss, total complications, and body composition measurements. Intention-to-treat analysis was performed with both unadjusted and adjusted analyses. A sample size of 88 was required. Of 101 participants, (55 ONS, 46 controls) 97 had surgery. In intention-to-treat analysis, there were 21/45 (47%) patients with an infection-either an SSI or chest infection in the control group vs. 17/55 (30%) in the ONS group. The odds ratio of a patient incurring either an SSI or chest infection was 0.532 (P = 0.135 confidence interval 0.232 to 1.218) in the unadjusted analysis and when adjusted for random differences at baseline (age, gender, percentage weight loss, and cancer staging) was 0.341 (P = 0.031, confidence interval 0.128 to 0.909). Pre-operative percentage weight loss at the first time point after randomization was 4.1% [interquartile range (IQR) 1.7-7.0] in ONS group vs. 6.7% (IQR 2.6-10.8) in controls (Mann-Whitney U P = 0.021) and post-operatively was 7.4% (IQR 4.3-10.0) in ONS group vs. 10.2% (IQR 5.1-18.5) in controls (P = 0.016). Compared

  19. [Discharge of children against medical advice at CHU of Brazzaville (Congo)].

    Science.gov (United States)

    Mabiala-Babela, J R; Nika, E R; Ollandzobo, L C; Samba Louaka, C; Mouko, A; Mbika Cardorelle, A; Moyen, G M

    2011-12-01

    In a prospective study conducted from January to December 2010 in the Teaching Hospital of Brazzaville (Congo), we compared the discharge of hospitalized children against medical advice at the parents' request (group 1 - cases) with those admitted during same period with routine discharge (group 2 - controls). Two hundred and seven (7.7%) hospitalized children, 117 boys and 90 girls, were discharged at the parents request. The mean age was 18.0 ± 13.5 months (range: 1 month-5 years). Among these patients, 150 (72.5%) children were from biparental families, and 30.9% of children were the first and/or only child of the household. Among the parents of Congolese nationality, 147 (71%) had a secondary school level education, including 66.7% of mothers and 58% of the fathers 59.9% of children were admitted between 15 and 7 hours, and 75.4% were hospitalized during working days. The duration of hospitalization did not exceed 3 days in 147 cases (71%). The main reasons for hospitalization were digestive disorders (27%), fever (16.4%), convulsions (11.1%) and anaemia (11.1%). Among patients discharged against medical advice, 34.8% left on the first day of hospitalization (72 cases), 36.7% before the start of treatment (76 cases of which 36 during check-up) and 63.3% during treatment (131 cases). The main reasons for discharge request were improvement in the clinical condition improvement (30.9% of cases), lack of money (28% of cases), supposed insufficient medical care (7.7% of cases), unsatisfactory hospitalization conditions (6.3% of cases), care of other children at home (6.3% of cases), traditional and/or religious beliefs (5.8% of cases) and disagreements with nurses (5.3%). Patients discharge against medical advice was correlated strongly with the educational level of parents, age of the child, delay of consultation, time of admission, rank of the child in family and nationality of parents. Discharge against medical advice is associated to the distrust between the

  20. Grandmothers' advice about disciplining grandchildren: is it accepted by mothers, and does its rejection influence grandmothers' subsequent guidance?

    Science.gov (United States)

    Tomlin, A M; Passman, R H

    1991-06-01

    To test whether maternal grandmothers' advice affects mothers' punishing of their children and whether mothers' disciplinary actions influence subsequent suggestions by these grandmothers, 40 three-generational families were examined. After receiving advice purportedly from the grandmothers, mothers rewarded and punished their 10-year-olds' successes and errors on a task. Participants were in separate rooms so that simulated information about the grandmothers' advice, mothers' disciplinary decisions, and children's performances could be systematically manipulated under controlled conditions. The grandmothers' sham "suggestions" to mothers about punishing appeared either to begin leniently but progressively intensify or to start harshly but gradually mollify. Information to grandmothers about the mothers' "punishing" likewise either became increasingly severe or indulgent. All children, however, appeared to continue performing uniformly. Mothers generally modified their disciplining to correspond to the grandmothers' apparent advice, and grandmothers' actual suggestions conformed toward the mothers' simulated discipline. Grandmothers appear to be one of many influences affecting mothers' decisions about their children.

  1. Scaffolding advice on task selection: A safe path toward self-directed learning in on-demand education.

    NARCIS (Netherlands)

    Kicken, Wendy; Brand-Gruwel, Saskia; Van Merriënboer, Jeroen

    2008-01-01

    Kicken, W., Brand-Gruwel, S., & Van Merrienboer, J. J. G. (2008). Scaffolding advice on task selection: A safe path toward self-directed learning in on-demand education. Journal of Vocational Education and Training, 60, 223-239.

  2. 78 FR 5205 - Advice Concerning Possible Modifications to the U.S. Generalized System of Preferences, 2012...

    Science.gov (United States)

    2013-01-24

    ... under the U.S. GSP program and providing certain advice regarding the effect of a waiver of the... following articles for all beneficiary developing countries under the GSP program: sweetheart, spray and...

  3. A self-help book is better than sleep hygiene advice for insomnia: a randomized controlled comparative study.

    Science.gov (United States)

    Bjorvatn, Bjørn; Fiske, Eldbjørg; Pallesen, Ståle

    2011-12-01

    The objective was to compare the effects of two types of written material for insomnia in a randomized trial with follow-up after three months. Insomniacs were recruited through newspaper advertisements to a web-based survey with validated questionnaires about sleep, anxiety, depression, and use of sleep medications. A self-help book focusing on cognitive behavioral therapy for insomnia was compared to standard sleep hygiene advice; 77 and 78 participants were randomized to self-help book or sleep hygiene advice, respectively. The response rate was 81.9%. The self-help book gave significantly better scores on the sleep questionnaires compared to sleep hygiene advice. The proportion using sleep medications was reduced in the self-help book group, whereas it was increased in the sleep hygiene group. Compared to pre-treatment, the self-help book improved scores on the sleep (effect sizes 0.61-0.62) and depression (effect size 0.18) scales, whereas the sleep hygiene advice improved scores on some sleep scales (effect sizes 0.24-0.28), but worsened another (effect size -0.36). In addition, sleep hygiene advice increased the number of days per week where they took sleep medications (effect size -0.50). To conclude, in this randomized controlled trial, the self-help book improved sleep and reduced the proportion using sleep medications compared to sleep hygiene advice. The self-help book is an efficient low-threshold intervention, which is cheap and easily available for patients suffering from insomnia. Sleep hygiene advice also improved sleep at follow-up, but increased sleep medication use. Thus, caution is warranted when sleep hygiene advice are given as a single treatment. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

  4. Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia.

    Science.gov (United States)

    Mehmood, Syed Imran; Norcini, John J; Borleffs, Jan C C

    2013-01-01

    Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to identify cross-cultural similarities and differences. A cross-sectional design study was conducted using a questionnaire to elicit the responses of participants from newly qualified doctors concerning the availability and significance of career advice. SPSS (version 11.0; Chicago, IL) was used to analyze the data and statistical tests, such as chi-square and unpaired t tests, were used to analyze the observations. A response rate of 94.7% was obtained. Among this group, 102 were males and 78 were females. Only 53% did receive career advice. The majority of men felt that career advice during medical studies was inadequate, while women were less negative (69% versus 32%; p = 0.0001). Furthermore, men were more disappointed about the possibilities for career advice after graduating than women (34% versus 13%, p = 0.0001). The results show that only half of newly graduated doctors had received any career advice during medical training. As the health care system cannot afford the potential waste of time and resources for doctors, career guidance should begin in undergraduate training so that the process of thinking about their future career starts longtime before they make their career choice.

  5. Influence of Antiflatulent Dietary Advice on Intrafraction Motion for Prostate Cancer Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lips, Irene M., E-mail: I.M.Lips@umcutrecht.nl [Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands); Kotte, Alexis N.T.J. [Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands); Gils, Carla H. van [Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht (Netherlands); Leerdam, Monique E. van [Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam (Netherlands); Heide, Uulke A. van der; Vulpen, Marco van [Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands)

    2011-11-15

    Purpose: To evaluate the effect of an antiflatulent dietary advice on the intrafraction prostate motion in patients treated with intensity-modulated radiotherapy (IMRT) for prostate cancer. Methods and Materials: Between February 2002 and December 2009, 977 patients received five-beam IMRT for prostate cancer to a dose of 76 Gy in 35 fractions combined with fiducial markers for position verification. In July 2008, the diet, consisting of dietary guidelines to obtain regular bowel movements and to reduce intestinal gas by avoiding certain foods and air swallowing, was introduced to reduce the prostate motion. The intrafraction prostate movement was determined from the portal images of the first segment of all five beams. Clinically relevant intrafraction motion was defined as {>=}50% of the fractions with an intrafraction motion outside a range of 3 mm. Results: A total of 739 patients were treated without the diet and 105 patients were treated with radiotherapy after introduction of the diet. The median and interquartile range of the average intrafraction motion per patient was 2.53 mm (interquartile range, 2.2-3.0) without the diet and 3.00 mm (interquartile range, 2.4-3.5) with the diet (p < .0001). The percentage of patients with clinically relevant intrafraction motion increased statistically significant from 19.1% without diet to 42.9% with a diet (odds ratio, 3.18; 95% confidence interval, 2.07-4.88; p < .0001). Conclusions: The results of the present study suggest that antiflatulent dietary advice for patients undergoing IMRT for prostate cancer does not reduce the intrafraction movement of the prostate. Therefore, antiflatulent dietary advice is not recommended in clinical practice for this purpose.

  6. Sexuality advice on the radio: an overview in the United States and around the world.

    Science.gov (United States)

    Kuriansky, J

    1996-01-01

    It is posited that the radio is a useful vehicle for communicating information and responsible advice on sexuality issues. Radio call-in shows can be highly effective, particularly in situations of stress, dysfunction, and dissatisfaction for all age groups. More evaluation research is needed on techniques and long-term results and on measurement of impact and efficacy. The goal of radio call-in shows offering advice on sexuality issues is to answer callers' questions about love, sexuality, and relationships. The information and advice help callers clarify their values, attitudes, and behavior and to develop self-esteem and skills in decision making, interpersonal relationships, and communication. The radio call-in format offers anonymity for communicating fearful, embarrassing, or shameful emotional experiences. The author of this article, who hosts a nationally syndicated show in the US, encourages respect, responsibility, and the right to say yes or no. A sample of callers revealed that popular topics were sexual behavior, dating problems, and rejection. A questionnaire survey revealed that 25% of callers' concerns were about sexual and emotional conflicts. Almost 20% were psychological questions. Almost 10% were about masturbation. Older people were concerned about sex drive, while younger people were more concerned about saying no to sexual relations. Sometimes an initial question will uncover a deeper problem such as depression or abuse. It is important that radio advisers have professional credentials, including degrees, licenses, and experience in the mental and sexual health fields. The author recommends that the adviser have an in-depth understanding of psychological dynamics in order to deal with the complicated issues behind even straightforward or simple questions. Follow-up services after the show should be available through the development of an extensive network of organizations and professionals.

  7. Smoking cessation advice: Knowledge, attitude, and practice among clinical dental students'

    Directory of Open Access Journals (Sweden)

    Allama Prabhu

    2017-01-01

    Full Text Available Background: Smoking is the single most important public health challenge facing the National Health Service. The detrimental effects on the general health of tobacco smoking are well documented. Smoking is a primary risk factor for oral cancer and many oral diseases. Dental professional scan plays an important role in preventing adverse health effects by promoting smoking cessation. Objective: To assess the knowledge, attitude, and practice among clinical dental students in giving smoking cessation advice and to explore the barriers to this activity. Materials and Methods: A total of 262 clinical dental trainee of two dental colleges (College of Dental Sciences and Bapuji Dental College of Davangere city were included in the survey. A self-administered questionnaire was administered to assess the knowledge, attitude, and practice toward Tobacco Cessation Advise. Results: Among the 262 participants in the study, around 51% said they know about Nicotine Replacement Therapy, and among them, only 4.6% were aware of the options available in the market. When asked about 5A's of tobacco cessation, only 35.5% were aware of it. Similarly, when asked about 5R's of tobacco cessation, 48.5% were unaware of it. Conclusions: The respondents did not have sufficient knowledge regarding tobacco cessation advice. With patient's disinterest and lack of time being quoted as the important barriers in providing tobacco cessation advice, it is highly recommended that there is need to incorporate few chapters on tobacco, its effect and cessation of habit in the undergraduate dental curriculum with simultaneous application of the same in clinical practice.

  8. Discharge against medical advice at a tertiary center in southeastern Nigeria: sociodemographic and clinical dimensions

    Directory of Open Access Journals (Sweden)

    Boniface Eze

    2010-09-01

    Full Text Available Boniface Eze1, Kenneth Agu2, Jones Nwosu31Department of Ophthalmology, 2Department of Surgery, 3Department of Otorhinolaryngology, University of Nigeria Teaching Hospital (UNTH, Ituku-Ozalla, Enugu, Enugu State, Nigeria Objective: To assess the sociodemographic and clinical characteristics of patients discharged against medical advice (DAMA at the University of Nigeria Teaching Hospital (UNTH, Enugu, Nigeria.Methods: The UNTH’s admission and discharge records between 1997 and 2006 were examined. Patients DAMA were identified; relevant sociodemographic and clinical data were extracted from their recalled clinical charts. Data were analyzed to generate rates, percentages, and proportions, and a level of P < 0.05 (one degree of freedom was considered statistically significant.Results: Of the 64,856 admissions (45.2% male, 54.8% female, 113 (0.002%; males: 54%, females: 46% were discharged against medical advice. DAMA rate was highest in Surgery (0.4%, and lowest in Obstetrics and Gynecology (0.1% and Pediatrics (0.1%. Infections (32.7%, trauma (29.2%, and cancer (16.8% were the leading diagnoses in patients DAMA. Financial constraints (37.2%, unsatisfactory response to treatment (17.7%, and dissatisfaction with hospital environment (15.0% were the main reasons for patients choosing to discharge themselves. DAMA was associated with a short admission period (P < 0.05, patients having high levels of formal education (P < 0.05, and those who had not been previously hospitalized (P < 0.05; but not with age (P = 0.398, gender (P = 0.489, or employment (P = 0.091.Conclusion: Comparatively, the rate of DAMA at UNTH is low. The causes of DAMA are preventable; for example, strengthening of the national health insurance scheme, enhancement of doctor-patient communication, and improvement of hospital environment would further reduce DAMA rate. Keywords: discharge against medical advice, tertiary center, sociodemographic characteristics, clinical

  9. Influence of Antiflatulent Dietary Advice on Intrafraction Motion for Prostate Cancer Radiotherapy

    International Nuclear Information System (INIS)

    Lips, Irene M.; Kotte, Alexis N.T.J.; Gils, Carla H. van; Leerdam, Monique E. van; Heide, Uulke A. van der; Vulpen, Marco van

    2011-01-01

    Purpose: To evaluate the effect of an antiflatulent dietary advice on the intrafraction prostate motion in patients treated with intensity-modulated radiotherapy (IMRT) for prostate cancer. Methods and Materials: Between February 2002 and December 2009, 977 patients received five-beam IMRT for prostate cancer to a dose of 76 Gy in 35 fractions combined with fiducial markers for position verification. In July 2008, the diet, consisting of dietary guidelines to obtain regular bowel movements and to reduce intestinal gas by avoiding certain foods and air swallowing, was introduced to reduce the prostate motion. The intrafraction prostate movement was determined from the portal images of the first segment of all five beams. Clinically relevant intrafraction motion was defined as ≥50% of the fractions with an intrafraction motion outside a range of 3 mm. Results: A total of 739 patients were treated without the diet and 105 patients were treated with radiotherapy after introduction of the diet. The median and interquartile range of the average intrafraction motion per patient was 2.53 mm (interquartile range, 2.2–3.0) without the diet and 3.00 mm (interquartile range, 2.4–3.5) with the diet (p < .0001). The percentage of patients with clinically relevant intrafraction motion increased statistically significant from 19.1% without diet to 42.9% with a diet (odds ratio, 3.18; 95% confidence interval, 2.07–4.88; p < .0001). Conclusions: The results of the present study suggest that antiflatulent dietary advice for patients undergoing IMRT for prostate cancer does not reduce the intrafraction movement of the prostate. Therefore, antiflatulent dietary advice is not recommended in clinical practice for this purpose.

  10. Addressing the Financial Consequences of Cancer: Qualitative Evaluation of a Welfare Rights Advice Service

    Science.gov (United States)

    Moffatt, Suzanne; Noble, Emma; White, Martin

    2012-01-01

    Background The onset, treatment and trajectory of cancer is associated with financial stress among patients across a range of health and welfare systems and has been identified as a significant unmet need. Welfare rights advice can be delivered effectively in healthcare settings, has the potential to alleviate financial stress, but has not yet been evaluated. We present an evaluation of a welfare rights advice intervention designed to address the financial consequences of cancer. Methods Descriptive study of welfare outcomes among 533 male and 641 female cancer patients and carers aged 4–95 (mean 62) years, who accessed the welfare rights advice service in North East England between April 2009 and March 2010; and qualitative interview study of a maximum variation sample of 35 patients and 9 carers. Results Over two thirds of cancer patients and carers came from areas of high socio-economic deprivation. Welfare benefit claims were successful for 96% of claims made and resulted in a median increase in weekly income of £70.30 ($109.74, €84.44). Thirty-four different types of benefits or grants were awarded. Additional resources were perceived to lessen the impact of lost earnings, help offset costs associated with cancer, reduce stress and anxiety and increase ability to maintain independence and capacity to engage in daily activities, all of which were perceived to impact positively on well-being and quality of life. Key barriers to accessing benefit entitlements were knowledge, system complexity, eligibility concerns and assumptions that health professionals would alert patients to entitlements. Conclusions The intervention proved feasible, effectively increased income for cancer patients and was highly valued. Addressing the financial sequelae of cancer can have positive social and psychological consequences that could significantly enhance effective clinical management and suitable services should be routinely available. Further research is needed to evaluate

  11. Addressing the financial consequences of cancer: qualitative evaluation of a welfare rights advice service.

    Science.gov (United States)

    Moffatt, Suzanne; Noble, Emma; White, Martin

    2012-01-01

    The onset, treatment and trajectory of cancer is associated with financial stress among patients across a range of health and welfare systems and has been identified as a significant unmet need. Welfare rights advice can be delivered effectively in healthcare settings, has the potential to alleviate financial stress, but has not yet been evaluated. We present an evaluation of a welfare rights advice intervention designed to address the financial consequences of cancer. Descriptive study of welfare outcomes among 533 male and 641 female cancer patients and carers aged 4-95 (mean 62) years, who accessed the welfare rights advice service in North East England between April 2009 and March 2010; and qualitative interview study of a maximum variation sample of 35 patients and 9 carers. Over two thirds of cancer patients and carers came from areas of high socio-economic deprivation. Welfare benefit claims were successful for 96% of claims made and resulted in a median increase in weekly income of £70.30 ($109.74, €84.44). Thirty-four different types of benefits or grants were awarded. Additional resources were perceived to lessen the impact of lost earnings, help offset costs associated with cancer, reduce stress and anxiety and increase ability to maintain independence and capacity to engage in daily activities, all of which were perceived to impact positively on well-being and quality of life. Key barriers to accessing benefit entitlements were knowledge, system complexity, eligibility concerns and assumptions that health professionals would alert patients to entitlements. The intervention proved feasible, effectively increased income for cancer patients and was highly valued. Addressing the financial sequelae of cancer can have positive social and psychological consequences that could significantly enhance effective clinical management and suitable services should be routinely available. Further research is needed to evaluate health outcomes definitely and assess

  12. Nutritional advice for prevention of acute pancreatitis: review of current opinion

    Directory of Open Access Journals (Sweden)

    Lowe ME

    2012-12-01

    Full Text Available Mark E Lowe, Wednesday A SevillaDivision of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USAAbstract: Pancreatitis is inflammation of the pancreas that can be acute and self-limiting or, in a small percentage of patients, recurrent. Patients with recurrent episodes of acute pancreatitis (RAP often progress to chronic pancreatitis. Pancreatitis in all forms causes significant economic and social burdens. Prevention of RAP may decrease those burdens and halt progression to chronic disease. Unfortunately, no therapy has proven effective at altering the course of RAP. While enteral nutritional therapy plays an important role in the treatment of acute pancreatitis during episodes, nutritional advice provided to patients in an attempt to prevent recurrent episodes has not proven effective in most cases. Discontinuing alcohol consumption and treating dyslipidemia with diet and medication can help patients with these issues. In patients whose pancreatitis is associated with celiac disease or eosinophilic gastroenteritis, a gluten-free diet and avoidance of food allergens can be effective in stopping RAP. Advice to take pancreatic enzyme replacement therapy, lose weight, control diabetes, decrease dietary sucrose, decrease dietary fat or avoid monosodium glutamate has little to no evidence of efficacy. Some studies suggest that an antioxidant cocktail may decrease the frequency of RAP and the intensity of chronic pain, but the evidence is weak. Nutritional therapy may have a role in the treatment of patients with RAP. At present, there are no clear guidelines for nutritional advice to give these patients. More studies are needed to identify nutritional interventions that will benefit patients with RAP.Keywords: pancreatitis, nutrition, pancreatic enzyme replacement therapy, antioxidants, herbal supplements

  13. Characteristics and outcomes of discharges against medical advice among hospitalised patients.

    Science.gov (United States)

    Yong, T Y; Fok, J S; Hakendorf, P; Ben-Tovim, D; Thompson, C H; Li, J Y

    2013-07-01

    Discharge against medical advice (DAMA) occurs when an in-patient chooses to leave the hospital before discharge is recommended by the treating clinicians. The long-term outcomes of patients who DAMA are not well documented. The objective of this long-term and hospital-wide study is to examine characteristics of patients who DAMA, their rates of readmission and mortality after self-discharge. Administrative data of admissions to Flinders Medical Centre between July 2002 and June 2011 were used to compare readmissions and mortality among patients who DAMA with those who did not. The outcomes were adjusted for age, gender, emergency admission status, comorbidity, mental health diagnoses, and alcohol and substance abuse. In the study period, 1562 episodes (1.3%) of 121,986 admissions to Flinders Medical Centre were DAMA. Compared with those who did not leave against medical advice, these patients were younger, more often male, more likely of indigenous ethnicity and had less physical comorbidity, but greater mental health comorbidity. Half of the DAMA group stayed less than 3 days. In multivariate analysis, the relative risk for 7-day, 28-day and 1-year readmission in the DAMA group was 2.36 (95% confidence interval (CI), 1.99-2.81; P medical advice carry a significant risk of readmission and mortality. Patients with characteristics of 'at risk of DAMA' should have greater attention paid to their care before and especially after any premature discharge. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  14. Unscheduled Return Visits and Leaving the Chest Pain Unit Against Medical Advice.

    Science.gov (United States)

    Jenab, Yaser; Haghani, Shima; Jalali, Arash; Darabi, Farzad

    2015-05-01

    Rate of Unscheduled Return Visits (URVs) to the Emergency Department has been considered as a key indicator for evaluating the quality of the Emergency Department care for decades. A higher rate of URVs can have a negative impact on the quality of health care. Investigations of the reasons for these returns have indicated that many of these visits can be preventable. Given that there are no clear findings about the frequency and reasons for 72 hours URVs to the Chest Pain Unit (CPU), in the present study, we investigated the causes of 72 hours URVs to our CPU in order to find out the inadequacies, and propose preventive strategies. This research was a single-center retrospective case control study in the setting of CPU of Tehran Heart Center (a 460-bed, tertiary-care teaching hospital), Tehran, Iran. The medical records of the patients who were presented to our CPU with the chief complaint of chest pain between December 28(th), 2010 and February 28(th), 2011 were reviewed. Of the 6247 eligible patients, forty-nine URVs that fulfilled our criteria were identified. The control group consisted of 196 patients who did not return to the Emergency Department during our study period. Patient-related factors accounted for most 72 hours URVs (49%). Multivariable analysis revealed that in our CPU, leaving Against medical advice was the most important predictor for 72 hours URVs (P value Medical Advice (AMA) during their first attendance, we recommend that further appropriate strategies be devised to prevent leaving against medical advice.

  15. Manual material handling advice and assistive devices for preventing and treating back pain in workers.

    Science.gov (United States)

    Verbeek, Jos H; Martimo, Kari-Pekka; Karppinen, Jaro; Kuijer, P Paul Fm; Viikari-Juntura, Eira; Takala, Esa-Pekka

    2011-06-15

    Training and the provision of assistive devices are considered major interventions to prevent back pain and its related disability among workers exposed to manual material handling (MMH). To determine the effectiveness of MMH advice and training and the provision of assistive devices in preventing and treating back pain. We searched CENTRAL (The Cochrane Library 2011, issue 1), MEDLINE, EMBASE, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT to February 2011. We included randomised controlled trials (RCT) and cohort studies with a concurrent control group that were aimed at changing human behaviour in MMH and measured back pain, back pain-related disability or sickness absence. Two authors independently extracted the data and assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group for RCTs and MINORS for the cohort studies.We based the results and conclusions on the analysis of RCTs only. We compared these with the results from cohort studies. We included nine RCTs (20,101 employees) and nine cohort studies (1280 employees) on the prevention of back pain in this updated review. Studies compared training to no intervention (4), professional education (2), a video (3), use of a back belt (3) or exercise (2). Other studies compared training plus lifting aids to no intervention (3) and to training only (1). The intensity of training ranged from a single educational session to very extensive personal biofeedback.Six RCTs had a high risk of bias.None of the included studies showed evidence of a preventive effect of training on back pain.There was moderate quality evidence from seven RCTs (19,317 employees) that those who received training reported levels of back pain similar to those who received no intervention, with an odds ratio of 1.17 (95% confidence intervals (CI) 0.68 to 2.02) or minor advice (video), with a relative risk of 0.93 (95% CI 0.69 to 1.25). Confidence intervals around the effect estimates were still

  16. Working in Law’s Borderlands: Translation and the Work of an Advice Office

    Directory of Open Access Journals (Sweden)

    Morag McDermont

    2017-12-01

    Full Text Available Increasingly people in the UK are turning to voluntary sector advice organisations for help and support in dealing with everyday problems. Here we argue that advice organisations, who work in the borderlands of law, are nevertheless key players in legal arenas, focusing on local Citizens Advice offices supporting clients with employment problems. We look at the making of advisers as border-workers through programmes which turn volunteers into employment advisers; and the paid advisers who inhabit spaces on the edges of the profession. We examine the social practices of these advisers, the ways in which law-work becomes translation and advice-work becomes a process of co-production between adviser and client. In concluding, we consider how far into the legal arena it is possible to go with limited resources; and what happens when translating the technicalities of law no longer works. Translation comes to mean advisers turning to their activist-selves and adopting political tactics.Las autoras del artículo argumentamos que las organizaciones de asistencia, que operan en los límites de la legalidad, son no obstante actores claves en el campo jurídico. Nos centramos en las oficinas locales de Atención al Ciudadano, y nos fijamos en los asistentes como trabajadores en los límites, a través de programas que forman a los voluntarios para ser orientadores laborales; y los asesores pagados que habitan espacios en los márgenes de la profesión. Examinamos las prácticas sociales de estos asesores, las formas en que el trabajo jurídico se convierte en trabajo de interpretación y el trabajo de asesoramiento se convierte en un proceso de coproducción entre asesor y cliente. Para concluir, reflexionamos sobre cuán lejos se puede llegar en el campo jurídico con recursos limitados, y sobre qué sucede cuando ya no sirve la interpretación de los tecnicismos legales. La interpretación viene a significar que los asesores recurren a su papel de

  17. Vivrelec's summer comfort advice; Le conseil confort d'ete Vivrelec

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-05-01

    After the 2003 heat wave and dryness, Electricite de France (EdF) has launched on May 17, 2004 the Vivrelec summer comfort advice in order to give help to its clients and to improve their thermal comfort during summer time. This document presents first the origins of discomfort, the heat supplies inside a dwelling and the way to limit the indoor temperature rise. Then, the use of suitable appliances is presented: fans, air cooling systems, air-conditioning systems. The different types of air-conditioning systems are presented in the appendix. (J.S.)

  18. Advice to a young researcher: with reminiscences of a life in science.

    Science.gov (United States)

    Thompson, J Michael T

    2013-06-28

    This paper provides an informal guide to young researchers in science and engineering as they progress for their first 10 or so years from the time that they first started thinking about doing a PhD. This advice is drawn, with examples and anecdotes, from my own research career which started at the Cambridge Engineering Department in 1958, and progressed through 48 years at University College London to a part-time chair that I now hold in Aberdeen. I hope it may encourage and help tomorrow's scientists on whom the Earth's future very much depends.

  19. Concussion in sport: the importance of accurate and reliable discharge advice.

    Science.gov (United States)

    Norton, Cormac

    2018-03-09

    Concussion in sport is a common presentation in urgent and emergency care settings, so it is essential that nurses have a full understanding of the condition. Most patients who attend an emergency department with concussion are discharged and discharge advice must be well-informed and evidence based. This article outlines the normal anatomy of the brain and the pathophysiology of concussion, and discusses the guidelines on returning to sport following this injury. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  20. Master thesis - Constructing an information system for advice on antibiotic therapy

    DEFF Research Database (Denmark)

    Gardi, Jonathan Eyal; Nielsen, Anders Møller

    This report documents the development of a framework for medical information systems. The framework consists of connectivity between the users, the clinical database and the decision support system. This framework is designed to be independent of the information type and the decision support syst...... is to build a distributed web-based medical information system integrated with a decision support system designed for providing advice on antibiotic therapy.......This report documents the development of a framework for medical information systems. The framework consists of connectivity between the users, the clinical database and the decision support system. This framework is designed to be independent of the information type and the decision support system...

  1. Who leaves the hospital against medical advice in the orthopaedic setting?

    Science.gov (United States)

    Menendez, Mariano E; van Dijk, C Niek; Ring, David

    2015-03-01

    Patients who leave the hospital against medical advice are at risk for readmission and for a variety of complications and are likely to consume more healthcare resources. However, little is known about which factors, if any, may be associated with self-discharge (discharge against medical advice) among orthopaedic inpatients. We studied the frequency and factors associated with self-discharge in patients hospitalized for orthopaedic trauma and musculoskeletal infection. Using discharge records from the Nationwide Inpatient Sample (2002-2011), we identified approximately 7,067,432 patient hospitalizations for orthopaedic trauma and 5,488,686 for musculoskeletal infection. We calculated the proportions of admissions that ended in self-discharge for both trauma and infection patients; then, we examined patient demographics, diagnoses, and hospital factors. Multivariable logistic regression models were constructed to determine independent predictors of self-discharge. Approximately one in 333 (0.3%) patients hospitalized for an isolated fracture and one in 47 (2.1%) patients with musculoskeletal infection left against medical advice. Patient characteristics associated with self-discharge included age medical comorbidity (trauma: OR 0.94 per one-unit increase in the number of comorbidities, 95% CI 0.93-0.95, p medical advice than patients with lower extremity fractures. Among infection hospitalizations, patients with cellulitis had the highest odds of self-discharge compared with carbuncle/furuncle (OR 1.3, 95% CI 1.2-1.5, p < 0.001). Self-discharges were more likely to occur at hospitals of larger size (trauma: OR 1.2, 95% CI 1.1-1.2, p < 0.001; infection: nonsignificant), located in urban settings (trauma: OR 1.3, 95% CI 1.2-1.4, p < 0.001; infection: OR 1.6, 95% CI 1.5-1.6, p < 0.001), and in the Northeast (trauma: OR 1.7, 95% CI 1.6-1.8, p < 0.001; infection: OR 1.6, 95% CI 1.6-1.6, p < 0.001) than at small, rural hospitals in the South. Our data can be used to

  2. Uneconomical tops of renewable electricity options. Advice with regard to the determination of the MEP subsidies for the period July up to and including December 2006 and 2007

    International Nuclear Information System (INIS)

    Van Sambeek, E.J.W.; De Vries, H.; Cleijne, J.W.; Pfeiffer, E.A.

    2004-11-01

    On assignment of the Dutch Ministry of Economic Affairs ECN and KEMA investigated the financial gaps of renewable electricity production technologies. These form the basis for determining the level of the MEP-subsidies (subsidy for the environmental quality of power generation) for different renewable electricity sources and technologies by the Ministry. This report contains an advice on the financial gaps that are to be used for determining the subsidy levels. The calculation of the financial gaps is based on an earlier report on the inputs for the calculations and on the subsequent stakeholder consultation with respect to these inputs. A detailed description is given of the assumptions, calculations and stakeholder inputs underlying the financial gaps for the establishment of the MEP-subsidies for new projects starting from July 2006 till December 2007 [nl

  3. Safety assessment plans for authorization and inspection of radiation sources

    International Nuclear Information System (INIS)

    1999-09-01

    The objective of this TECDOC is to enhance the efficacy, quality and efficiency of the whole regulatory process. It provides advice on good practice administrative procedures for the regulatory process for preparation of applications, granting of authorizations, inspection, and enforcement. It also provides information on the development and use of standard safety assessment plans for authorization and inspection. The plans are intended to be used in conjunction with more detailed advice related to specific practices. In this sense, this TECDOC provides advice on a systematic approach to evaluations of protection and safety while other IAEA Safety Guides assist the user to distinguish between the acceptable and the unacceptable. This TECDOC covers administrative advice to facilitate the regulatory process governing authorization and inspection. It also covers the use of standard assessment and inspection plans and provides simplified plans for the more common, well established uses of radiation sources in medicine and industry, i.e. sources for irradiation facilities, industrial radiography, well logging, industrial gauging, unsealed sources in industry, X ray diagnosis, nuclear medicine, teletherapy and brachytherapy

  4. Individual traveller health priorities and the pre-travel health consultation.

    Science.gov (United States)

    Flaherty, Gerard T; Chen, Bingling; Avalos, Gloria

    2017-09-01

    The purpose of this study was to examine the principal travel health priorities of travellers. The most frequently selected travel health concerns were accessing medical care abroad, dying abroad, insect bites, malaria, personal safety and travel security threats. The travel health risks of least concern were culture shock, fear of flying, jet lag and sexually transmitted infections. This study is the first to develop a hierarchy of self-declared travel health risk priorities among travellers. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  5. The Readability of Electronic Cigarette Health Information and Advice: A Quantitative Analysis of Web-Based Information.

    Science.gov (United States)

    Park, Albert; Zhu, Shu-Hong; Conway, Mike

    2017-01-06

    The popularity and use of electronic cigarettes (e-cigarettes) has increased across all demographic groups in recent years. However, little is currently known about the readability of health information and advice aimed at the general public regarding the use of e-cigarettes. The objective of our study was to examine the readability of publicly available health information as well as advice on e-cigarettes. We compared information and advice available from US government agencies, nongovernment organizations, English speaking government agencies outside the United States, and for-profit entities. A systematic search for health information and advice on e-cigarettes was conducted using search engines. We manually verified search results and converted to plain text for analysis. We then assessed readability of the collected documents using 4 readability metrics followed by pairwise comparisons of groups with adjustment for multiple comparisons. A total of 54 documents were collected for this study. All 4 readability metrics indicate that all information and advice on e-cigarette use is written at a level higher than that recommended for the general public by National Institutes of Health (NIH) communication guidelines. However, health information and advice written by for-profit entities, many of which were promoting e-cigarettes, were significantly easier to read. A substantial proportion of potential and current e-cigarette users are likely to have difficulty in fully comprehending Web-based health information regarding e-cigarettes, potentially hindering effective health-seeking behaviors. To comply with NIH communication guidelines, government entities and nongovernment organizations would benefit from improving the readability of e-cigarettes information and advice. ©Albert Park, Shu-Hong Zhu, Mike Conway. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 06.01.2017.

  6. Discharge Against Medical Advice in the Pediatric Wards in Boo-ali Sina Hospital, Sari, Iran 2010.

    Science.gov (United States)

    Mohseni Saravi, Benyamin; Reza Zadeh, Esmaeil; Siamian, Hasan; Yahghoobian, Mahboobeh

    2013-12-01

    Since children neither comprehended nor contribute to the decision, discharge against medical advice is a challenge of health care systems in the world. Therefore, the current study was designed to determine the rate and causes of discharge against medical advice. This descriptive cross-sectional study was done by reviewing the medical records by census method. Data was analyzed using SPSS software and x(2) statistics was used to determine the relationship between variables. The value of Pmedical advice was 108 (2.2%). Mean of age and length of stay were 2.8±4 (SD).3 years old and 3.7±5.4 (SD) days, respectively. Totally, 95 patients (88.7%) had health insurance and 65 (60.2%) patients lived in urban areas. History of psychiatric disease and addiction in 22 (20.6%) of the parents were negative. In addition, 100 (92.3%) patients admitted for medical treatment and the others for surgery. The relationship of the signatory with patients (72.3%) was father. Of 108 patients discharged against medical advice, 20 (12%) were readmitted. The relationship between the day of discharge and discharge against medical advice was significant (ρ =0/03). Rate of discharge against medical advice in Boo-ali hospital is the same as the other studies in the same range. The form which is used for this purpose did not have suitable data elements about description of consequence of such discharge, and it has not shown the real causes of discharge against medical advice.

  7. Rates of readmission and death associated with leaving hospital against medical advice: a population-based study.

    Science.gov (United States)

    Garland, Allan; Ramsey, Clare D; Fransoo, Randy; Olafson, Kendiss; Chateau, Daniel; Yogendran, Marina; Kraut, Allen

    2013-10-01

    Leaving hospital against medical advice may have adverse consequences. Previous studies have been limited by evaluating specific types of patients, small sample sizes and incomplete determination of outcomes. We hypothesized that leaving hospital against medical advice would be associated with increases in subsequent readmission and death. In a population-based analysis involving all adults admitted to hospital and discharged alive in Manitoba from Apr. 1, 1990, to Feb. 28, 2009, we evaluated all-cause 90-day mortality and 30-day hospital readmission. We used multivariable regression, adjusted for age, sex, socioeconomic status, year of hospital admission, patient comorbidities, hospital diagnosis, past frequency of admission to hospital, having previously left hospital against medical advice and data clustering (patients with multiple admissions). For readmission, we assessed both between-person and within-person effects of leaving hospital against medical advice. Leaving against medical advice occurred in 21 417 of 1 916 104 index hospital admissions (1.1%), and was associated with higher adjusted rates of 90-day mortality (odds ratio [OR] 2.51, 95% confidence interval [CI] 2.18-2.89), and 30-day hospital readmission (within-person OR 2.10, CI 1.99-2.21; between-person OR 3.04, CI 2.79-3.30). In our additional analyses, elevated rates of readmission and death associated with leaving against medical advice were manifest within 1 week and persisted for at least 180 days after discharge. Adults who left the hospital against medical advice had higher rates of hospital readmission and death. The persistence of these effects suggests that they are not solely a result of incomplete treatment of acute illness. Interventions aimed at reducing these effects may need to include longitudinal interventions extending beyond admission to hospital.

  8. Operational availability improvement through online monitoring and advice for emergency diesel generator

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Beom; Kim, Han Gon; Kim, Byong Sup [Korea Electric Power Research Institute, Taejon (Korea, Republic of); Golay, M.; Kang, C. W.; Sui, Y. [Massachusetts Institute of Technology, Massachusetts (United States)

    1998-12-31

    This research broadens the prime concern of nuclear power plant operations from safe performance to both economic and safe performance. First, emergency diesel generator is identified as one of main contributors for the lost plant availability through the review of plant forced outage records. The framework of an integrated architecture of performing modern on-line condition for operational availability improvement is configured in this work. For the development of the comprehensive sensor networks for complex target systems, and integrated methodology incorporating a structural hierarchy, a functional hierarchy, and a fault-symptom matrix is formulated. The second part of our research is development of intelligent diagnosis and maintenance advisory system, which employs Bayesian Belief Networks (BBNs) as a high level reasoning tool for incorporating inherent uncertainty for use in probabilistic inference. Our prototype diagnosis algorithms are represented explicitly through topological symbols and links between them in a causal direction. As new evidence from sensor network developed is entered into the model especially, our advisory system provides operational advice concerning both availability and safety, so that the operator is able to determine the likely failure modes, diagnose the system state, locate root causes, and take the most advantageous action. Thereby, this advice improves operational availability. 6 refs., 7 figs., 1 tab. (Author)

  9. Model-based aviation advice on distal volcanic ash clouds by assimilating aircraft in situ measurements

    Directory of Open Access Journals (Sweden)

    G. Fu

    2016-07-01

    Full Text Available The forecast accuracy of distal volcanic ash clouds is important for providing valid aviation advice during volcanic ash eruption. However, because the distal part of volcanic ash plume is far from the volcano, the influence of eruption information on this part becomes rather indirect and uncertain, resulting in inaccurate volcanic ash forecasts in these distal areas. In our approach, we use real-life aircraft in situ observations, measured in the northwestern part of Germany during the 2010 Eyjafjallajökull eruption, in an ensemble-based data assimilation system combined with a volcanic ash transport model to investigate the potential improvement on the forecast accuracy with regard to the distal volcanic ash plume. We show that the error of the analyzed volcanic ash state can be significantly reduced through assimilating real-life in situ measurements. After a continuous assimilation, it is shown that the aviation advice for Germany, the Netherlands and Luxembourg can be significantly improved. We suggest that with suitable aircrafts measuring once per day across the distal volcanic ash plume, the description and prediction of volcanic ash clouds in these areas can be greatly improved.

  10. Optimal management of Alzheimer’s disease patients: Clinical guidelines and family advice

    Directory of Open Access Journals (Sweden)

    Julia Haberstroh

    2010-05-01

    Full Text Available Julia Haberstroh, Harald Hampel, Johannes PantelDepartment of Psychiatry, Psychosomatic Medicine & Psychotherapy, Johann Wolfgang Goethe-University, Frankfurt, a.M., GermanyAbstract: Family members provide most of the patient care and administer most of the treatments to patients with Alzheimer’s disease (AD. Family caregivers have an important impact on clinical outcomes, such as quality of life (QoL. As a consequence of this service, family caregivers suffer high rates of psychological and physical illness as well as social and financial burdens. Hence, it is important to involve family caregivers in multimodal treatment settings and provide interventions that are both suitable and specifically tailored to their needs. In recent years, several clinical guidelines have been presented worldwide for evidence-based treatment of AD and other forms of dementia. Most of these guidelines have considered family advice as integral to the optimal clinical management of AD. This article reviews current and internationally relevant guidelines with emphasis on recommendations concerning family advice.Keywords: caregivers, management, quality of life, treatment

  11. Frequency and trends of hospital discharges against medical advice (DAMA in a large administrative database

    Directory of Open Access Journals (Sweden)

    Mario Saia

    2014-12-01

    Full Text Available OBJECTIVE: The aim of this research was to characterize hospitalizations associated with discharges against medical advice (DAMA in a large, population-based data system. MATERIALS AND METHODS: This was a retrospective cohort study on 11 436 500 hospital admissions. The hospital discharge records for residents of the Veneto region (north-east Italy discharged from 2001 to 2012, from both public and accredited private hospitals, were considered. The DAMA rate was calculated by type of hospital admission, excluding patients who died. The time trend of the DAMA rate was charted from the average annual percent changes. RESULTS: During the period considered, 66 549 DAMA were recorded, amounting to an overall DAMA rate of 6.0‰ admissions. Analyzing the diagnostic categories, admissions for substance abuse (drugs or alcohol and dependence coincided with the highest DAMA rate (83.5‰, followed by poisoning (40.2‰, psychiatric disorders (24.7 ‰, traumas (21.1‰, HIV-related diseases (19.9‰, burns (10.5‰, and - for women - issues relating to pregnancy, childbirth and the postnatal period (11.2‰. The DAMA rate dropped from 6.72 to 5.55 from 2000 to 2008, then remained stable. CONCLUSION: The DAMA rate dropped slightly over the period considered. Several diagnostic categories are associated with a higher likelihood of patients leaving hospital against their doctor's advice.

  12. The stage of change approach for implementing ergonomics advice - Translating research into practice.

    Science.gov (United States)

    Rothmore, Paul; Aylward, Paul; Oakman, Jodi; Tappin, David; Gray, Jodi; Karnon, Jonathan

    2017-03-01

    The Stage of Change (SOC) approach has been proposed as a method to improve the implementation of ergonomics advice. However, despite evidence for its efficacy there is little evidence to suggest it has been adopted by ergonomics consultants. This paper investigates barriers and facilitators to the implementation, monitoring and effectiveness of ergonomics advice and the adoption of the SOC approach in a series of focus groups and a subsequent survey of members of the Human Factors Societies of Australia and New Zealand. A proposed SOC assessment tool developed for use by ergonomics practitioners is presented. Findings from this study suggest the limited application of a SOC based approach to work-related musculoskeletal injury prevention by ergonomics practitioners is due to the absence of a suitable tool in the ergonomists' repertoire, the need for training in this approach, and their limited access to relevant research findings. The final translation of the SOC assessment tool into professional ergonomics practice will require accessible demonstration of its real-world usability to practitioners and the training of ergonomics practitioners in its application. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Parastomal hernia and physical activity. Are patients getting the right advice?

    Science.gov (United States)

    Russell, Sarah

    2017-09-28

    This article draws on a large nationwide survey (2631 respondents) that investigated the physical health and wellbeing of people living with stomas in the UK. It specifically considers the findings relating to parastomal hernia (where additional loops of bowel protrude through the abdominal wall around the stoma, creating a bulge). In this survey, 26% of respondents reported that they had a medically diagnosed parastomal hernia, which is below average when compared with other estimates. The impact of parastomal hernia on physical activity levels was the most significant finding: 32% of those with a medically diagnosed hernia reported being 'much less active' than they were prior to their surgery (compared with 19% without a hernia). This creates a more serious problem for general health-significantly increasing their risk of co-morbidities such as cancer, stroke, diabetes and other chronic conditions related to physical inactivity. Clinical guidelines clearly state that patients should be informed of exercises to strengthen core muscles, as part of hernia prevention, but 88% of patients did not engage in any sort of abdominal or core exercises. When asked, 69% of patients did not realise it was important and 82% of patients could not recall being given advice to do abdominal exercises as part of their recovery. There is a significant gap in the patient care pathway regarding advice on physical activity, core/abdominal exercises and hernia prevention and management after stoma surgery. This is an area that urgently needs more research and education for patients and all health professionals.

  14. Exploring the provision of alcohol advice by clinicians to breast cancer patients.

    Science.gov (United States)

    Simapivapan, P; Hodge, A; Boltong, A

    2018-01-01

    Interactions between clinicians and patients along the cancer trajectory provide an opportunity to deliver key messages regarding drinking behaviours and long-term health. This study aimed to explore the extent and nature of clinician-patient discussions regarding alcohol intake and cancer outcomes in the clinical breast cancer setting, using a qualitative research design involving semi-structured interviews. Purposive sampling was used to recruit 27 breast cancer clinicians (eight dietitians, nine breast care nurses, 10 oncologists) across Victoria, Australia. Interview data were analysed using descriptive statistics and a content analysis approach. Clinicians' knowledge of national alcohol recommendations was found to be inconsistent. Clinicians reported a lack of patient awareness of the link between alcohol and breast cancer. Current frameworks for assessing and advising on patient alcohol intake were felt to be impractical. The extent and nature of advice provided about alcohol was influenced by several patient and clinician factors. The provision of alcohol advice in the clinical breast cancer setting is not practiced systematically by any professional group. New approaches are needed to support patient education about alcohol intake and survivorship in the clinical oncology setting. © 2017 John Wiley & Sons Ltd.

  15. Rosacea patients seeking advice: Qualitative analysis of patients' posts on a rosacea support forum.

    Science.gov (United States)

    Alinia, Hossein; Moradi Tuchayi, Sara; Farhangian, Michael E; Huang, Karen E; Taylor, Sarah L; Kuo, Sandy; Richardson, Irma; Feldman, Steven R

    2016-01-01

    Social media have become outlets for patients to voice opinions and ask questions. Since suffering from rosacea is an isolating experience and the disease is poorly understood, patients use social media to expand their knowledge about the condition. To understand rosacea patients' online health information seeking habits to obtain a better insight of their educational needs. Ten percent of posts in online rosacea forum composed of 3350 members and 27 051 posts, discussing patient viewpoints and concern, selected by stratified random sampling. Three hundred and nine queries were directly categorized to patients "seeking advice" by two investigators and qualitatively analyzed. Patients primarily sought advice about treatments (n = 155, 50.1%), triggers (n = 53, 17.1%), diet (n = 48, 15.5%), skin care (n = 37, 11.9%) and special presentations of the disease (n = 22, 7.1%). Questions frequently pertained to adverse effects, efficacy and target of therapy (78, 49, 30 posts, respectively). Proactively providing reliable resources and comprehensive explanations on treatments, triggers, diet and skin care could be helpful in reducing patients' confusion about rosacea and enhancing rosacea patient-physician relationships.

  16. The provision of expert advice to government on environmental matters: the role of advisory committees

    International Nuclear Information System (INIS)

    Everest, D.A.

    1990-01-01

    This paper discusses some of the ways in which expert advice is given to the British government on environmental matters, concentrating on the contribution of the formal advisory committees which have important roles with respect to legitimacy, authority, mediation and education. How seven of these committees operate has been studied by interviews with committee secretariats, past and present Chairmen and members, and supplemented by published material. Only in one case did committee-imposed restrictions prevent satisfactory coverage. The committees studied fall into three typology classes. The first is the independent and influential Royal Commission on Environmental Pollution which has a mixed membership and considerable freedom to select topics and to publish its conclusions. The second group consists primarily of regulatory bodies. The two chosen were the advisory Committee on Pesticides and the Advisory Committee on Genetic Manipulation. The third class consist of departmental committees which provide policy related advice. Examples studied were the two which support the government Chief Medical Officer on the health effects of contamination of soil and water or of radiation in the environment, the committee which advises Ministers on the treatment and disposal of radioactive waste, or that advising the Health and Safety Commission and Executive on the safety of nuclear installations. (author)

  17. The (co-)production of public uncertainty: UK scientific advice on mobile phone health risks.

    Science.gov (United States)

    Stilgoe, Jack

    2007-01-01

    UK scientific advice on the possible health risks of mobile phones has embraced (or seems to be embracing) broader engagement with interested non-experts. This paper explains the context of lost credibility that made such a development necessary, and the implications of greater engagement for the construction (and expert control) of "public concern." I narrate how scientific advice matured from an approach based on compliance with guidelines to a style of "public science" in which issues such as trust and democracy were intertwined with scientific risk assessment. This paper develops existing conceptions of the "public understanding of science" with an explanation based around the co-production of scientific and social order. Using a narrative drawn from a series of in-depth interviews with scientists and policymakers, I explain how expert reformulation of the state of scientific uncertainty within a public controversy reveals constructions of "The Public," and the desired extent of their engagement. Constructions of the public changed at the same time as a construction of uncertainty as solely an expert concern was molded into a state of politically workable public uncertainty. This paper demonstrates how publics can be constructed as instruments of credible policymaking, and suggests the potential for public alienation if nonexperts feel they have not been fairly represented.

  18. Hospitalized Pregnant Women Who Leave Against Medical Advice: Attributes and Reasons.

    Science.gov (United States)

    Tabatabaei, Seyed Mehdi; Sargazi Moakhar, Zahra; Behmanesh Pour, Fateme; Shaare Mollashahi, Sedighe; Zaboli, Maryam

    2016-01-01

    To identify the contributing factors for discharge against medical advice (DAMA) among pregnant women in Sistan and Balouchestan Province, southeastern Iran. This hospital-based case-control study included a total of 168 DAMA pregnant women and 191 pregnant women who left hospital with medical approval. The participants were recruited between August 2012 and August 2013. Logistic regression models were used for data analysis. Factors that increased the chance of DAMA in pregnant women included older age, younger spouse age, low level of education, low income level and having a health insurance. History of DAMA in previous hospitalizations, referral from other clinics, emergency admission and admission advice from non-physician individuals for hospitalization, and giving birth at home during previous pregnancies, were associated with an increase in the risk of DAMA. The most common hospital-related reason for DAMA was the teaching environment of the hospital (26.2%) followed by hospital staff misconduct (23.8%) and overcrowding in the hospital wards (23.2%). The most frequent patient-related factors for DAMA were willingness of the patients to continue treatment at home (58.9%) and feeling relative improvement (58.3%). We found that both hospital and patient related factors contribute to DAMA among pregnant women. Early identification of women at risk of DAMA and improvement of medical staff communication skills may decrease the occurrence of DAMA and improve health outcomes of pregnant women.

  19. Factors influencing adherence to referral advice following pre-referral treatment with artesunate suppositories in children in rural Tanzania.

    Science.gov (United States)

    Simba, Daudi O; Warsame, Marian; Kimbute, Omari; Kakoko, Deodatus; Petzold, Max; Tomson, Goran; Premji, Zul; Gomes, Melba

    2009-07-01

    WHO recommends artemisinin suppository formulations as pre-referral treatment for children who are unable to take oral medication and cannot rapidly reach a facility for parenteral treatment. We investigated factors influencing caretakers' adherence to referral advice following pre-referral treatment of their children with rectal artesunate suppositories. The study was nested within an intervention study that involved pre-referral treatment of all children who came to a community dispenser for treatment because they were unable to take oral medications because of repeated vomiting, lethargy, convulsions or altered consciousness. All patients who did not comply with referral advice were stratified by actions taken post-referral: taking their children to a drug shop, a traditional healer, or not seeking further treatment, and added to a random selection of patients who complied with referral advice. Caretakers of the children were interviewed about their socio-economic status (SES), knowledge about malaria, referral advice given and actions they took following pre-referral treatment. Interview data for 587 caretakers were matched with symptoms of the children, the time of treatment, arrival at a health facility or other actions taken post-pre-referral treatment. The majority (93.5%) of caretakers reported being given referral advice by the community drug dispenser. The odds of adherence with this advice were three times greater for children with altered consciousness and/or convulsions than for children with other symptoms [odds ratio (OR) 3.47, 95% confidence interval (CI) 2.32-5.17, P < 0.001]. When questioned, caretakers who remembered when (OR 2.19, 95% CI 1.48-3.23, P < 0.001) and why (OR 1.77, 95% CI 1.07-2.95, P = 0.026) they were advised to proceed to health facility - were more likely to follow referral advice. Cost did not influence adherence except within a catchment area of facilities that charged for services. In these areas, costs deterred adherence by

  20. Physiotherapists' use of advice and exercise for the management of chronic low back pain: a national survey.

    Science.gov (United States)

    Liddle, S Dianne; David Baxter, G; Gracey, Jacqueline H

    2009-04-01

    The objective of the study was to establish the specific use of advice and exercise by physiotherapists, for the management of chronic low back pain (LBP). A questionnaire was mailed to a random sample of 600 members of the Irish Society of Chartered Physiotherapists. Open and closed questions were used to obtain information on treatments provided to chronic LBP patients. Respondents' treatment goals were also investigated, along with the typical methods used to assess treatment outcome. Four hundred and nineteen of the sample returned the questionnaire; 280/419 (67%) indicated that they currently treated LBP of which 76% (n=214) were senior grade therapists. Advice and exercise, respectively, were the treatments most frequently used for chronic LBP: advice was most commonly delivered as part of an exercise programme, with strengthening (including core stability) the most frequently used exercise type. Supervision of exercise and follow-up advice were underutilised with respect to the recommendations of relevant clinical guidelines. Pain relief was an important treatment goal. Emphasis on exercise programme supervision, incorporating reassurance that its safe to stay active and 'hurt does not mean harm', must be more effectively disseminated and promoted in practice. The influence of follow-up advice on exercise adherence warrants further investigation.

  1. Advice for prevention from HIV-positive African-American women: 'My story is not just a story'.

    Science.gov (United States)

    Robillard, Alyssa; Padi, Akhila; Lewis, Kaleea; Julious, Carmen; Troutman, Jamie

    2017-05-01

    Large disparities in HIV incidence, prevalence and mortality exist for African-American women, especially in the southern region of the USA. Based on the culture-centric health promotion model, HIV-positive African American women can use their stories to support primary prevention. The purpose of this study was to document advice from HIV-positive African-American women (n = 25) to young African-American women, as described in their own cultural narratives collected through qualitative interviews. Content analysis of women's advice identified five common themes revolving broadly around: (1) advice for prevention, (2) support systems for prevention, (3) education, (4) empowerment/self-care and (5) potential barriers to prevention. Advice reflected recommendations based on personal experience and highlighted social determinants linked to HIV, such as stigma, access to education and healthcare, social support, and gender and power dynamics. Women also offered advice for coping with an HIV-positive diagnosis. Communication with parents, family and friends regarding education and social support emerged as an important interpersonal factor for participants, as were interactions with sexual/romantic partners. Stigma, at the community level, was consistently discussed as a hindrance to prevention. Narratives of HIV-positive women as community health agents of change can enhance the effectiveness of HIV prevention interventions for young US African-American women.

  2. Discharge against medical advice: a case study in a public teaching hospital in Tehran, Iran in 2012.

    Science.gov (United States)

    Bahadori, Mohammadkarim; Raadabadi, Mehdi; Salimi, Mohammad; Ravangard, Ramin

    2013-09-27

     Discharging against medical advice is to leave the hospital despite the advice of the doctor, which can result in complications and readmissions. This study aimed to examine the prevalence of patients' discharge against medical advice (DAMA) and their reasons in a public teaching hospital in Tehran, Iran in 2012. This was an applied and cross-sectional study in which all patients (2601 patients) who had been discharged against medical advice from the studied hospital in 2012 were studied. Required data were collected using a data collection form. Collected data were analyzed using SPSS 18.0 and descriptive and analytical tests including Frequencies and Fisher's Exact Test. The most and least common reasons for DAMA were, respectively, feeling complete recovery by patients (45.4%) and financial problems (1.3%). The results showed that there were significant differences between DAMA prevalence and patients' sex and age (Pmedical advice process in order to inform patients about its complications and adverse consequences.

  3. Consumers’ intention to use health recommendation systems to receive personalized nutrition advice

    Science.gov (United States)

    2013-01-01

    Background Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. Methods 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. Results We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. Conclusions We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to

  4. The 12-month effects of structured lifestyle advice and pelvic floor muscle training for pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2016-01-01

    INTRODUCTION: We evaluated the 12-month effects of adding pelvic floor muscle training to a lifestyle advice program in women with symptomatic pelvic organ prolapse stage II-III and the number of women who had sought further treatment. MATERIAL AND METHODS: This study was a 12-month follow up...... of a randomized controlled trial comparing a structured lifestyle advice program alone (lifestyle group) or in combination with pelvic floor muscle training (training and lifestyle group). Both programs consisted of six separate group sessions within 12 weeks. RESULTS: Data were available from 83 (76%) of the 109...... surgery. More severe anterior prolapse and more bladder symptoms at the 3-month follow up were significantly associated with having sought further treatment in both groups. CONCLUSIONS: At 12-month follow up, the effects of adding pelvic floor muscle training to a structured lifestyle advice program were...

  5. Gender differences in medical advice and health behavior of obese African Americans with and without type 2 diabetes.

    Science.gov (United States)

    Vaccaro, Joan A; Huffman, Fatma G

    2012-09-01

    This study examined gender differences in medical advice related to diet and physical activity for obese African American adults (N = 470) with and without diabetes. Data from the 2007-2008 National Health and Nutrition Examination Survey were analyzed using logistic regression analyses. Even after sociodemographic adjustments, men were less likely to report receiving medical advice as compared with women. Both men and women given dietary and physical activity advice were more likely to follow it. Men were less likely to report currently reducing fat or calories, yet men with diabetes were 5 times more likely to state that they were reducing fat and calories as compared with women with diabetes. Gender- and disease state-specific interventions are needed comparing standard care with enhanced patient education. Moreover, these findings necessitate studies that characterize the role of the health care professional in the diagnosis and treatment of obesity and underscore patient-provider relationships.

  6. Brief advice and active referral for smoking cessation services among community smokers: a study protocol for randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Yi Nam Suen

    2016-05-01

    Full Text Available Abstract Background Most smokers do not use smoking cessation (SC services although it increases successful quits. Passive referral providing SC information to smokers is commonly used in SC studies. Little was known about active referral in the community setting. This study aims to motivate community smokers to quit by brief SC advice using a validated AWARD model (Ask, Warn, Advise, Refer and Do-it-again that adjunct with active referral of smokers to various SC services in Hong Kong. Methods/Design This is a single-blinded, parallel three-armed cluster randomized controlled trial (RCT with two treatment groups of (1 brief SC advice using the AWARD model, active referral to SC services plus a referral card and a health warning leaflet (active referral group and (2 brief SC advice using AWARD model and health warning leaflet (brief advice group and a control group receives general very brief advice with a self-help booklet. A total of 1291 smokers will be recruited from 66 clusters (recruitment sessions with 22 will be allocated to each of the two intervention and one control groups. SC ambassadors will be trained for delivering the interventions and conducting telephone follow-up. The primary outcomes are self-reported 7-days point prevalence (PP abstinence at 3 and 6 months follow-up. Intention-to-treat principle and multi-level regressions will be used for data analysis. Discussion This is the first RCT on assessing a model combining brief advice and active referral to SC services among community smokers. The results will inform the practices of SC services and intervention studies. Trial registration NCT02539875 (ClinicalTrials.gov registry; registered retrospectively on 22 July 2015

  7. Ovarian Reserve Assessment in Users of Oral Contraception Seeking Fertility Advice on their Reproductive Lifespan

    DEFF Research Database (Denmark)

    Petersen, K. Birch; Hvidman, H. W.; Forman, J. L.

    2016-01-01

    in the antral follicles of 5-7 and 8-10 mm with the highest number of AMH secreting granulosa cells. It is essential to be aware of the impact of OC use on ovarian reserve parameters when guiding OC users on their fertility status and reproductive lifespan. STUDY FUNDING/COMPETING INTERESTS: The FAC Clinic......STUDY QUESTION: To what extent does oral contraception (OC) impair ovarian reserve parameters in women who seek fertility assessment and counselling to get advice on whether their remaining reproductive lifespan is reduced? SUMMARY ANSWER: Ovarian reserve parameters defined by anti...... ageing. In women, AMH declines with age and data suggest a relationship with remaining reproductive lifespan and age at menopause. OC may alter parameters related to ovarian reserve assessment but the extent of the reduction is uncertain. STUDY DESIGN, SIZE, DURATION: A cross-sectional study of 887 women...

  8. Ovarian reserve assessment in users of oral contraception seeking fertility advice on their reproductive lifespan

    DEFF Research Database (Denmark)

    Birch Petersen, K; Hvidman, H W; Forman, J L

    2015-01-01

    in the antral follicles of 5-7 and 8-10 mm with the highest number of AMH secreting granulosa cells. It is essential to be aware of the impact of OC use on ovarian reserve parameters when guiding OC users on their fertility status and reproductive lifespan. STUDY FUNDING/COMPETING INTERESTS: The FAC Clinic......STUDY QUESTION: To what extent does oral contraception (OC) impair ovarian reserve parameters in women who seek fertility assessment and counselling to get advice on whether their remaining reproductive lifespan is reduced? SUMMARY ANSWER: Ovarian reserve parameters defined by anti...... ageing. In women, AMH declines with age and data suggest a relationship with remaining reproductive lifespan and age at menopause. OC may alter parameters related to ovarian reserve assessment but the extent of the reduction is uncertain. STUDY DESIGN, SIZE, DURATION: A cross-sectional study of 887 women...

  9. Motivational interviewing versus brief advice for cigarette smokers in residential alcohol treatment.

    Science.gov (United States)

    Rohsenow, Damaris J; Martin, Rosemarie A; Monti, Peter M; Colby, Suzanne M; Day, Anne M; Abrams, David B; Sirota, Alan D; Swift, Robert M

    2014-03-01

    Residential treatment for substance use disorders (SUD) provides opportunity for smoking intervention. A randomized controlled trial compared: (1) motivational interviewing (MI) to brief advice (BA), (2) in one session or with two booster sessions, for 165 alcoholics in SUD treatment. All received nicotine replacement (NRT). MI and BA produced equivalent confirmed abstinence, averaging 10% at 1 month, and 2% at 3, 6 and 12 months. However, patients with more drug use pretreatment (>22 days in 6 months) given BA had more abstinence at 12 months (7%) than patients in MI or with less drug use (all 0%). Boosters produced 16-31% fewer cigarettes per day after BA than MI. Substance use was unaffected by treatment condition or smoking cessation. Motivation to quit was higher after BA than MI. Thus, BA plus NRT may be a cost-effective way to reduce smoking for alcoholics with comorbid substance use who are not seeking smoking cessation. © 2014.

  10. Improving energy decisions towards better scientific policy advice for a safe and secure future energy system

    CERN Document Server

    Droste-Franke, Bert; Kaiser, M; Schreurs, Miranda; Weber, Christoph; Ziesemer, Thomas

    2015-01-01

    Managing a successful transition of the current energy supply system to less carbon emitting options, ensuring a safe and secure supply during the whole process and in the long term, is one of the largest challenges of our time. Various approaches and first implementations show that it is not only technological issue, but also a matter of societal acceptance and acceptability, considering basic ethic values of the society. The main foci of the book are, thus, to develop an understanding about the specific challenges of the scientific policy advice in the area, to explore typical current approaches for the analysis of future energy systems and to develop criteria for the quality assessment and guidelines for the improvement of such studies. The book provides assistance to the interpretation of existing studies and guidelines for setting up and carrying out new analyses as well as for communicating and applying the results. Thereby, it aims to support the involved actors such as the respective scientific expert...

  11. Information and advice on the numerical software available for the Fusion Energy program at Oak Ridge

    International Nuclear Information System (INIS)

    Gaffney, P.W.

    1979-11-01

    The purpose of this report is to describe some of the numerical routines that have been obtained for the Fusion Energy program at Oak Ridge. The report is organized by problem area. Each area contains a list of relevant numerical routines. These routines are described in detail and, where appropriate, we give advice on their correct use. Furthermore, we have ranked the subroutine libraries NAG, IMSL, and HARWELL according to how satisfactory their routines are for that particular area. In an Appendix we provide information on how to access the routines and the subroutine libraries described in this report. Moreover, we describe a growing online data base which contains a condensed version of the information in this report

  12. Ancient Israelite and African proverbs as advice, reproach, warning, encouragement and explanation

    Directory of Open Access Journals (Sweden)

    David T. Adamo

    2015-11-01

    Full Text Available With few exceptions, the majority of biblical scholars (Euroamericans and Africans concentrate on comparing ancient Israelite proverbs with the so-called ancient Near Eastern proverbs. Despite the importance of proverbs in Sub-Saharan Africa it is doubly unfortunate that the majority of African biblical scholars did not think it wise to compare proverbs from ancient Israel with Sub-Saharan African proverbs. It is also a double tragedy that young people in Sub-Saharan Africa are ignorant of proverbs because they have refused to learn them because they think them archaic. Proverbs in both ancient Israel and in Africa are similar in function and classification. Thus, they serve as advice, reproach, warning, encouragement and further explanation of some facts. They have great value and importance, such as giving a sense of identity, community, culture, respect for authority and elders, sacredness of everything under the sun and a sense of hospitality and others.

  13. The risks associated with consumer magazines giving advice on complementary therapies.

    Science.gov (United States)

    Mantle, Fiona

    The increased popularity of complementary and alternative medicine (CAM) has led to increased demand for information on it, giving rise to the concept of "new experts". However, there is concern about the quality and accuracy of this information, much of which is published in popular magazines and written by contributors with no medical qualifications. To examine the extent of CAM product advice in women's and health magazines, and the potential for adverse drug/herbal interaction. Fifteen women's magazines were examined over one month. A total of 150 articles were identified, of which 131 were written by non-medically qualified contributors, mainly journalists. Out of the 150, 95 discussed ingested herbs which had the potential for adverse interactions and are contraindicated for certain groups. The findings have legal and ethical implications. The re-evaluation of the journalists' code of conduct to reflect this development in journalism should be considered.

  14. Working with interpreters: practical advice for use of an interpreter in healthcare.

    Science.gov (United States)

    Hadziabdic, Emina; Hjelm, Katarina

    2013-03-01

    The aim of this descriptive commentary is to improve communication in healthcare when an interpreter is used by providing practical advice to healthcare staff when they consider using interpreters. This descriptive commentary considered the issues of preparation and implementation of interpretation sessions to reveal the complexities and dilemmas of an effective healthcare encounter with interpreters. Using the design of a discursive paper, this article seeks to explore and position of what is published in the literature on the topic studied and on the basis of previous studies to provide practical advice on the use of interpreters. The descriptive commentary showed that the interpreter should be used not only as a communication aid but also as a practical and informative guide in the healthcare system. In preparing the interpretation session, it is important to consider the type (trained professional interpreter, family member or bilingual healthcare staff as interpreters) and mode (face to face and telephone) of interpreting. Furthermore, it is important to consider the interpreter's ethnic origin, religious background, gender, language or dialect, social group, clothes, appearance and attitude. During the healthcare encounter, the interpreter should follow the recommendations given in guidelines for interpreters. Healthcare staff should choose an appropriate room and be aware of their own behaviour, appearance and attitude during the healthcare encounter. Good planning is needed, with carefully considered choices concerning the right kind of interpreter, mode of interpretation and individual preferences for the interpretation in order to deliver high-quality and cost-effective healthcare. Depending on the nature of the healthcare encounter, healthcare staff need to plan interpreting carefully and in accordance with the individuals' desires and choose the type of interpreter and mode of interpreting that best suits the need in the actual healthcare situation in

  15. Family medicine physicians' advice about use of nonconventional modalities for menopausal symptom management.

    Science.gov (United States)

    Grant, Kathryn; Burg, Mary Ann; Fraser, Kathryn; Gui, Serena; Kosch, Shae Graham; Nierenberg, Barry; Oyama, Oliver; Pomm, Heidi; Sibille, Kimberly; Spruill, Timothy; Swartz, Virginia

    2007-05-01

    This study explores the beliefs and practices of family medicine physicians regarding the use of nonconventional modalities for menopausal symptom management. Anonymous self-administered questionnaires were distributed to faculty and residents from eight participating family medicine residency programs around Florida, with an overall response rate of 66% (212 respondents). The survey explored what physicians report about patterns of patient inquiries and their responses to patients' inquiries about nonconventional modalities for specific menopausal symptoms and what physicians' report on their advice to patients about using specific herbs and supplements for menopausal symptom relief. Behavioral approaches were encouraged more than herbal therapies, acupuncture, and body therapies for the treatment of most of the menopausal symptoms. However, the most frequent response category was No advice. Resident physicians were significantly more likely than faculty to encourage acupuncture. Faculty physicians were more likely than residents to recommend particular herbal remedies. The majority of the respondents believed there was not sufficient evidence for recommending any of the herbs and supplements listed. These data reveal some important trends about how family medicine physicians respond to nontraditional approaches for menopausal symptom management. Because family medicine physicians typically receive some training in behavioral and psychotherapeutic approaches and there is some evidence for the effectiveness of behavioral strategies in menopausal symptom management, it is not surprising that they are more likely to endorse these approaches. Most family medicine physicians, however, have little or no training in the other nonconventional modalities, and our data show that these modalities received lower levels of endorsement, suggesting that physicians are not clear on their advantages or disadvantages.

  16. Regulatory scientific advice in drug development: does company size make a difference?

    Science.gov (United States)

    Putzeist, Michelle; Mantel-Teeuwisse, Aukje K; Gispen-De Wied, Christine C; Hoes, Arno W; Leufkens, Hubert G

    2011-02-01

    To assess whether the content of Scientific Advice (SA) questions addressed to a national drug regulatory agency is associated with company size. This may help to increase understanding about the knowledge, strategic, and regulatory gaps companies face during drug development. A cross-sectional analysis was performed of SA provided by the Dutch Medicines Evaluation Board (MEB) in 2006-2008. Definition of company size was based on ranking by total revenues (Scrip's Pharmaceutical Company League Tables 2008). The content of each SA question was scored according to predefined domains (quality, nonclinical, clinical, regulatory, and product information), their subdomains (e.g., efficacy), and a selection of additional content variables (e.g., endpoints, choice of active comparator). In total, 201 SA documents including 1,087 questions could be identified. Small, medium-sized, and large companies asked for SA 110 (54.7%), 40 (19.9%), and 51 (25.4%) times, respectively. Clinical questions were asked most often (65.9%), mainly including efficacy (33.2%) and safety questions (24.0%). The most frequent topics were overall efficacy and safety strategy. Small companies asked quality and nonclinical questions more often (P companies (P = 0.004). Small companies asked significantly more clinical questions about pharmacokinetics, including bioequivalence, than medium-sized and large companies (P < 0.001). The array of topics addressed in SA provides an interesting outlook on what industry considers to be still unresolved in drug development and worthwhile to discuss with regulators. Company size is associated with the content of SA questions. MEB advice accommodates both innovative and noninnovative drug development.

  17. Positive vs. Negative: The Impact of Question Polarity in Voting Advice Applications

    Science.gov (United States)

    Krouwel, André; van de Pol, Jasper; de Vreese, Claes

    2016-01-01

    Online Voting Advice Applications (VAAs) are survey-like instruments that help citizens to shape their political preferences and compare them with those of political parties. Especially in multi-party democracies, their increasing popularity indicates that VAAs play an important role in opinion formation for citizens, as well as in the public debate prior to elections. Hence, the objectivity and transparency of VAAs are crucial. In the design of VAAs, many choices have to be made. Extant research in survey methodology shows that the seemingly arbitrary choice to word questions positively (e.g., ‘The city council should allow cars into the city centre’) or negatively (‘The city council should ban cars from the city centre’) systematically affects the answers. This asymmetry in answers is in line with work on negativity bias in other areas of linguistics and psychology. Building on these findings, this study investigated whether question polarity also affects the answers to VAA statements. In a field experiment (N = 31,112) during the Dutch municipal elections we analysed the effects of polarity for 16 out of 30 VAA statements with a large variety of linguistic contrasts. Analyses show a significant effect of question wording for questions containing a wide range of implicit negations (such as ‘forbid’ vs. ‘allow’), as well as for questions with explicit negations (e.g., ‘not’). These effects of question polarity are found especially for VAA users with lower levels of political sophistication. As these citizens are an important target group for Voting Advice Applications, this stresses the need for VAA builders to be sensitive to wording choices when designing VAAs. This study is the first to show such consistent wording effects not only for political attitude questions with implicit negations in VAAs, but also for political questions containing explicit negations. PMID:27723776

  18. Computerized pediatric telephone triage and advice programs at children's hospitals: operating and financial characteristics.

    Science.gov (United States)

    Melzer, S M; Poole, S R

    1999-08-01

    To describe the operating characteristics, financial performance, and perceived value of computerized children's hospital-based telephone triage and advice (TTA) programs. A written survey of all 32 children's hospital-based TTA programs in the United States that used the same proprietary pediatric TTA software product for at least 6 months. The expense, revenues, and perceived value of children's hospital-based TTA programs. Of 30 programs (94%) responding, 27 (90%) were eligible for the study and reported on their experience with nearly 1.3 million TTA calls over a 12-month period. Programs provided pediatric TTA services for 1560 physicians, serving an average of 82 physicians (range, 10-340 physicians) and answering 38880 calls (range, 8500-140000 calls) annually. The mean call duration was 11.3 minutes and the estimated mean total expense per call was $12.45. Of programs charging fees for TTA services, 16 (59%) used a per-call fee and 7 (26%) used a monthly service fee. All respondents indicated that fees did not cover all associated costs. Telephone triage and advice programs, when examined on a stand-alone basis, were all operating with annual deficits (mean, $447000; median, $325000; range, $74000-$1.3 million), supported by the sponsoring children's hospitals and their companion programs. Using a 3-point Likert scale, the TTA program managers rated the value of the TTA program very highly as a mechanism for marketing to physicians (2.85) and increasing physician (2.92) and patient (2.80) satisfaction. Children's hospital-based TTA programs operate at substantial financial deficits. Ongoing support of these programs may derive from the perception that they are a valuable mechanism for marketing and increase patient and physician satisfaction. Children's hospitals should develop strategies to ensure the long-term financial viability of TTA programs or they may have to discontinue these services.

  19. E-Cigarette Advice to Patients From Physicians and Dentists in the United States.

    Science.gov (United States)

    Drouin, Olivier; McMillen, Robert C; Klein, Jonathan D; Winickoff, Jonathan P

    2017-01-01

    To report on adults' recall of discussion by physicians and dentists about e-cigarettes. A nationally representative cross-sectional survey (Internet and random digit dialing) in the United States. Adults who ever used e-cigarettes. Participant-reported discussion about the potential benefits and harms of e-cigarettes with their doctor, dentist, or child's doctor in the past 12 months. Fisher exact test for the analysis between benefits and harms for each type of provider and for rates of advice between provider types. Among the 3030 adults who completed the survey, 523 (17.2%) had ever used e-cigarettes. Of those who had seen their doctor, dentist, or child's doctor in the last year, 7.3%, 1.7%, and 10.1%, respectively, reported discussing potential harms of e-cigarettes. Conversely, 5.8%, 1.7%, and 9.3% of patients who had seen their doctor, dentist, or child's doctor in the last year reported that the clinician discussed the potential benefits of e-cigarettes. Each clinician type was as likely to discuss harms as benefits. Rates of advice were similar between doctors and child's doctors but lower for dentists. Rates were comparable when the analysis was limited to current e-cigarette users, participants with children, or those who reported using both e-cigarettes and combusted tobacco. Few physicians and dentists discuss either the harms or benefits of e-cigarettes with their patients. These data suggest an opportunity to educate, train, and provide resources for physicians and dentists about e-cigarettes and their use.

  20. THE VITAL IMPORTANCE OF PROVIDING SOUND SCIENTIFIC ADVICE TO POLICY MAKERS IN GOVERNMENT

    Directory of Open Access Journals (Sweden)

    G. S. Pearson

    2013-08-01

    Full Text Available The article gives an idea of the scope of professional activity of scientists working in the field of biosafety in terms of providing timely and effective advice for politicians and diplomats in the government. It should be acknowledged that politicians and diplomats are also involved in a varying degree with biosafety issues such as toxicological and biological weapons, formulated in the relevant Convention: Biological and Toxin Weapons Convention. However taking into account their professional interests, they mightn’t have appropriate information on relevant events in these and other activities. The value of these activities of qualified scientists knowing the latest information in the field of biosafety is difficult to overestimate, as they have the possibility to analyze any situation on the range of relevant activities and use their knowledge to make informed proposals which could be acceptable for their co-worker scientists in other areas of biological science. For highly qualified scientists such activities appeared to be effective, it is a vital aspect of their professional activity, because such scientists are able to provide scientific advice, analyze and summarize relevant scientific aspects on a specific topic of interest for politicians and diplomats. Such an analysis should include identification of key elements that are relevant to a given scientific problem and should be formulated so as the consequences of the various elements of the Convention were clearly appreciated and understood by politicians and diplomats. In other words, the rele vant scientific aspects should be analyzed, summarized and presented in the context of the Convention, together with suggestions on what steps in this direction should be taken by politicians and diplomats.

  1. Advice about infant feeding for allergy prevention: A confusing picture for Australian consumers?

    Science.gov (United States)

    Netting, Merryn J; Allen, Katrina J

    2017-09-01

    Early feeding plays an important role in programming the immune system, particularly the risk of food allergy. There are many infant feeding guides published for consumers available in Australia, with most based on the National Health and Medical Research Council (NHMRC) 2012 Infant Feeding Guidelines for Health Workers and the Australasian Society of Clinical Immunology and Allergy (ASCIA) Infant Feeding Advice for allergy prevention. We sought to compare allergy-specific content of infant feeding educational material written for parents with these two documents. Australian websites of children's hospitals, early child health organisations and consumer groups providing information about diet during pregnancy, breastfeeding and early infancy were compared with NHMRC and ASCIA guidelines. Twenty-five sets of infant feeding information were identified. Food allergy was discussed in 18 resources. Recommended length of exclusive breastfeeding and timing of commencing solid foods was consistently around 6 months, with some variation in wording. Advice regarding to include and not delay introduction of common allergens into babies' diets was generally consistent with NHMRC and ASCIA recommendations, however the audit identified some resources that still recommended delayed introduction of common allergens. As consumers have access to a plethora of health information it is imperative that information about infant feeding from health-care authorities is simple, evidence-based and consistent to avoid confusion. Use of consensus wording related to infant feeding guidelines to prevent allergies will provide clear messages related to the timing of introduction to solid foods and inclusion of allergens in the early diet. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  2. Reasons for Discharge against Medical Advice: A Case Study of Emergency Departments in Iran.

    Science.gov (United States)

    Noohi, Kaveh; Komsari, Samaneh; Nakhaee, Nouzar; Yazdi Feyzabadi, Vahid

    2013-08-01

    Incomplete hospitalization is the cause of disease relapse, readmission, and increase in medical costs. Discharge Against Medical Advice (DAMA) in emergency department (ED) is critical for hospitals. This paper aims to explore the underlying reasons behind DAMA in ED of four teaching hospitals in Kerman, Iran. This was a cross-sectional study in which the samples were drawn from the patients who chose to leave against medical advice from the ED of teaching hospitals in Kerman from February to March 2011. The sampling was based on census. Data were gathered by a self-constructed questionnaire. The reasons for DAMA were divided into three parts: reasons related to patient, medical staff, and hospital environment. The questionnaire was filled out by a face-to-face interview with patient or a reliable companion. There were 121 cases (5.6%) of DAMA out of the total admissions. The main reason of AMA discharges was related to patient factors in 43.9% of cases, while two other factors (i.e., hospital environment and medical staff) constituded 41.2% and 35.2% of cases, respectively. The majority of patients 65.9% (80 cases) were either uninformed or less informed of the entailing side effects and outcomes of their decision to DAMA. In comparison to studies conducted in other countries, the rate of DAMA is markedly higher in Iran. The results revealed that patients awareness of the consequences of their decisions is evidently inadequate. The study suggests a number of recommendations. These include, increasing patient awareness of the potential side effects of DAMA and creating the necessary culture for this, improving hospital facilities, and a more careful supervision of medical staff performance.

  3. Public health benefits of hair-mercury analysis and dietary advice in lowering methylmercury exposure in pregnant women

    DEFF Research Database (Denmark)

    Kirk, Line E; Jørgensen, Jan S; Nielsen, Flemming

    2017-01-01

    AIMS: To evaluate whether a public health intervention using focused dietary advice combined with a hair-mercury analysis can lower neurotoxic methylmercury exposure among pregnant women without decreasing their overall intake of seafood. METHODS: A total of 146 pregnant women were consecutively......% three months later. Average hair-mercury concentrations decreased by 21%. However, the total seafood intake remained at the same level after three months. CONCLUSIONS: Increased exposure to methylmercury among pregnant women is an important public health concern in Denmark. The observed lowering of hair......-mercury concentrations associated with dietary advice corresponds to a substantial public health benefit that probably makes such an intervention highly profitable....

  4. [Scientific advice by the nationally competent authority and by the EMEA on the conduct of clinical trials].

    Science.gov (United States)

    Dejas-Eckertz, P; Schäffner, G

    2005-04-01

    Scientific advice for potential applicants for marketing authorization for medicinal products has been part of the tasks of the European Medicines Agency (EMEA) ever since its establishment in 1995, and has been of increasing significance. Based on Article 56(3) of Regulation (EC) No. 726/2004, this task is now the responsibility of an independent working group of the EMEA, the Scientific Advice Working Party (SAWP). National scientific and regulatory advice has also been part of the work of two national authorities in Germany, the Federal Agency for Medicinal Products and Medical Devices (BfArM) and the Paul Ehrlich Institute (PEI) for several years, but has gained in significance especially over the past 3 years. The basis for advice at a national level is Article 71c of the Law on Administrative Procedures (Verwaltungs-Verfahrensgesetz), the Drug Law, the Guidelines for the Evaluation of Medicinal Products (Arzneimittelprufrichtlinien), and relevant guidelines defining the scientific state of the art. A company developing medicinal products may consult the EMEA or the national authority at any time in order to obtain opinions on the investigations and studies on the pharmaceutical, preclinical and clinical development required for a particular stage of development. In this context, the focus is exclusively on the data required for the planned authorization and the assessment of the evaluation strategy suggested by the company itself. The agreement between the company and the regulatory authority prior to marketing approval is designed to achieve a more effective development of the product and to obtain a more rapid decision on a future authorization procedure. An important component of the scientific advice procedure is the discussion between the company and the agencies. The results of this oral exchange is always summarised in writing. Advice is available for all medicinal products, including "orphan drugs". At the European level, the authorization procedure

  5. Design and Implementation of a Telephone Triage/Advice Service: An Instrument of Demand Management at USA Medical Department Activity-Heidelberg

    National Research Council Canada - National Science Library

    Hamilton, Priscilla

    1997-01-01

    .... Demand management systems may involve health care "gatekeepers," prevention and wellness programs, self-care instruction, and frequently employ telephone triage and advice capabilities Telephonic...

  6. Advice given to women in Argentina about breast-feeding and the use of alcohol

    Science.gov (United States)

    Pepino, M. Yanina; Mennella, Julie A.

    2006-01-01

    Objective To explore the types of advice that women in Argentina received from health professionals, family members, and friends about drinking alcoholic beverages and about alcohol usage during pregnancy and lactation. Methods In December 2001 and December 2002, structured interviews were conducted with a total of 167 women who were then breast-feeding or who had recently breast-fed their infant. Mothers were asked about the type of advice, if any, that they had received about the use of alcohol from health professionals and from family members and friends. Also included were questions related to the usage of the traditional Argentine beverage “mate” (an infusion widely consumed in South America that is prepared from the leaves of the Ilex paraguayensis plant) and the types of advice the women had received about breast-feeding and neonatal care in general. Results Of the 167 women studied, 96.4% of them reported that their physician had advised them to breast-feed their infant. In addition, 93.4% of the women said they had treated their infant’s umbilical cord stump with alcohol. Fewer than half of the women (46.7%) reported that their physician had advised them about drinking alcoholic beverages during pregnancy, and even fewer (25.7%) received such advice during lactation. Family and friends were about equally likely to give advice about the consumption of alcoholic beverages during pregnancy (42.6%) and during lactation (47.9%). However, the type of advice changed, with the family and friends being significantly more likely to encourage drinking when the women were lactating than when they were pregnant (P lactancia. Métodos En diciembre de 2001 y diciembre de 2002 se llevaron a cabo entrevistas estructuradas con un total de 167 mujeres que estaban amamantando o que habían amamantado recientemente. A las madres se les preguntó qué tipo de consejos, en caso de haberlos, les dieron los profesionales de la salud y sus parientes y amistades acerca del

  7. Compliance with telephone triage advice among adults aged 45 years and older: an Australian data linkage study.

    Science.gov (United States)

    Tran, Duong Thuy; Gibson, Amy; Randall, Deborah; Havard, Alys; Byrne, Mary; Robinson, Maureen; Lawler, Anthony; Jorm, Louisa R

    2017-08-01

    Middle-aged and older patients are prominent users of telephone triage services for timely access to health information and appropriate referrals. Non-compliance with advice to seek appropriate care could potentially lead to poorer health outcomes among those patients. It is imperative to assess the extent to which middle-aged and older patients follow triage advice and how this varies according to their socio-demographic, lifestyle and health characteristics as well as features of the call. Records of calls to the Australian healthdirect helpline (July 2008-December 2011) were linked to baseline questionnaire data from the 45 and Up Study (participants age ≥ 45 years), records of emergency department (ED) presentations, hospital admissions, and medical consultation claims. Outcomes of the call included compliance with the advice "Attend ED immediately"; "See a doctor (immediately, within 4 hours, or within 24 hours)"; "Self-care"; and self-referral to ED or hospital within 24 h when given a self-care or low-urgency care advice. Multivariable logistic regression was used to investigate associations between call outcomes and patient and call characteristics. This study included 8406 adults (age ≥ 45 years) who were subjects of 11,088 calls to the healthdirect helpline. Rates of compliance with the advices "Attend ED immediately", "See a doctor" and "Self-care" were 68.6%, 64.6% and 77.5% respectively, while self-referral to ED within 24 h followed 7.0% of calls. Compliance with the advice "Attend ED immediately" was higher among patients who had three or more positive lifestyle behaviours, called after-hours, or stated that their original intention was to attend ED, while it was lower among those who lived in rural and remote areas or reported high or very high levels of psychological distress. Compliance with the advice "See a doctor" was higher in patients who were aged ≥65 years, worked full-time, or lived in socio-economically advantaged areas

  8. Different types of dietary advice for women with gestational diabetes mellitus.

    Science.gov (United States)

    Han, Shanshan; Middleton, Philippa; Shepherd, Emily; Van Ryswyk, Emer; Crowther, Caroline A

    2017-02-25

    Dietary advice is the main strategy for managing gestational diabetes mellitus (GDM). It remains unclear what type of advice is best. To assess the effects of different types of dietary advice for women with GDM for improving health outcomes for women and babies. We searched Cochrane Pregnancy and Childbirth's Trials Register (8 March 2016), PSANZ's Trials Registry (22 March 2016) and reference lists of retrieved studies. Randomised controlled trials comparing the effects of different types of dietary advice for women with GDM. Two authors independently assessed study eligibility, risk of bias, and extracted data. Evidence quality for two comparisons was assessed using GRADE, for primary outcomes for the mother: hypertensive disorders of pregnancy; caesarean section; type 2 diabetes mellitus; and child: large-for-gestational age; perinatal mortality; neonatal mortality or morbidity composite; neurosensory disability; secondary outcomes for the mother: induction of labour; perineal trauma; postnatal depression; postnatal weight retention or return to pre-pregnancy weight; and child: hypoglycaemia; childhood/adulthood adiposity; childhood/adulthood type 2 diabetes mellitus. In this update, we included 19 trials randomising 1398 women with GDM, at an overall unclear to moderate risk of bias (10 comparisons). For outcomes assessed using GRADE, downgrading was based on study limitations, imprecision and inconsistency. Where no findings are reported below for primary outcomes or pre-specified GRADE outcomes, no data were provided by included trials. Primary outcomes Low-moderate glycaemic index (GI) versus moderate-high GI diet (four trials): no clear differences observed for: large-for-gestational age (risk ratio (RR) 0.71, 95% confidence interval (CI) 0.22 to 2.34; two trials, 89 infants; low-quality evidence); severe hypertension or pre-eclampsia (RR 1.02, 95% CI 0.07 to 15.86; one trial, 95 women; very low-quality evidence); eclampsia (RR 0.34, 95% CI 0.01 to 8

  9. Antenatal dietary advice and supplementation to increase energy and protein intake.

    Science.gov (United States)

    Ota, Erika; Tobe-Gai, Ruoyan; Mori, Rintaro; Farrar, Diane

    2012-09-12

    Gestational weight gain is positively associated with fetal growth, and observational studies of food supplementation in pregnancy have reported increases in gestational weight gain and fetal growth. To assess the effects of advice during pregnancy to increase energy and protein intake, or of actual energy and protein supplementation, on energy and protein intakes, and the effect on maternal and infant health outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (22 July 2011) and contacted researchers in the field. We updated the search on 12 July 2012 and added the results to the awaiting classification section of the review. Randomised controlled trials of dietary advice to increase energy and protein intake, or of actual energy and protein supplementation, during pregnancy. Two review authors independently assessed trials for inclusion and assessed risk of bias. Two review authors independently extracted data and checked for accuracy. Extracted data were supplemented by additional information from the trialists we contacted. We examined 110 reports corresponding to 46 trials. Of these trials, 15 were included, 30 were excluded, and one is ongoing. Overall, 15 trials involving 7410 women were included.Nutritional advice (four trials, 790 women)Women given nutritional advice had a lower relative risk of having a preterm birth (two trials, 449 women) (risk ratio (RR) 0.46, 95% CI 0.21 to 0.98 ), head circumference at birth was increased in one trial (389 women) (mean difference (MD) 0.99 cm, 95% CI 0.43 to 1.55) and protein intake increased (three trials, 632 women) (protein intake: MD +6.99 g/day, 95% CI 3.02 to 10.97). No significant differences were observed on any other outcomes.Balanced energy and protein supplementation (11 trials, 5385 women)Risk of stillbirth was significantly reduced for women given balanced energy and protein supplementation (RR 0.62, 95% CI 0.40 to 0.98, five trials, 3408 women), mean birthweight was

  10. Knowledge and reported confidence of final year midwifery students regarding giving advice on contraception and sexual health.

    Science.gov (United States)

    Walker, Susan H; Davis, Geraldine

    2014-05-01

    this study explored the views of three cohorts of final year midwifery students, regarding their confidence in giving advice to women on contraception and sexual health in the postnatal period. The project also investigated knowledge of contraception using a factual quiz, based on clinical scenarios regarding contraception and sexual health in the postpartum period. a mixed method design using qualitative data from focus groups, and mixed qualitative and quantitative data from a paper based questionnaire was used. the project was carried out in one higher educational institution in England. findings demonstrate that expressed confidence varies according to contraceptive method, with most confidence being reported when advising on the male condom. The findings of the factual quiz indicate that students applied theoretical knowledge poorly in a practically oriented context. These findings also indicated that most students limited advice to general advice. the paper concludes that midwifery students need more practically oriented education in contraception and sexual health, and that the role of mentors is very important in helping students feel confident when giving advice in this area. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. I don't get it : Response difficulties in answering political attitude statements in Voting Advice Applications

    NARCIS (Netherlands)

    Kamoen, Naomi; Holleman, Bregje

    2017-01-01

    What question characteristics are related to comprehension problems in political attitude questions? And what type of answering behaviour do people expose when they do not understand the question? We investigated these issues in the context of Voting Advice Applications (VAAs). These online tools

  12. The International Diversification of Banks and the Value of their Cross-Border M&A Advice

    NARCIS (Netherlands)

    de Jong, A.; Ongena, S.; van der Poel, M.

    2010-01-01

    This paper investigates the effects of international diversification of banks on the value of their M&A advice. We study bidder returns to 1,253 cross-border M&A announcements. We find that acquirers engaging a more internationally diversified financial advisor generate lower excess returns.

  13. 78 FR 28623 - U.S.-Trans-Pacific Partnership Free Trade Agreement Including Japan: Advice on the Probable...

    Science.gov (United States)

    2013-05-15

    ... Probable Economic Effect of Providing Duty-Free Treatment for Imports after Malaysia joined the... Partnership Free Trade Agreement Including Japan: Advice on the Probable Economic Effect of Providing Duty... Economic Effect of Providing Duty-Free Treatment for Imports. DATES: May 28, 2013: Deadline for filing...

  14. Effect of Ergonomic Advice on Neck Pain among Engineering Students of Belagavi City, Karnataka: An Observational Study

    Directory of Open Access Journals (Sweden)

    Naik Prashant P

    2017-06-01

    Full Text Available Background and aim: Neck pain is a common health problem experienced by engineering students. Majority of the times, neck pain is due to poor workstation posture, improper workstation structure. Thus, the aim of the study was to analyze the effect of ergonomic advice on neck pain among engineering students of Belagavi. Materials and methodology: An observational study was carried out among engineering students of all academic levels in local engineering institutes of Belagavi. Data of study was collected in academic year 2016-2017 using Neck pain and disability scale from 331 students. Initially, a baseline data was collected and then booklet consisting of ergonomic advice was given and follow-up was done after 4 weeks by using same questionnaire. Results: Overall 33.96% of reduction in neck pain was seen after ergonomic advice. In accordance with movements associated with neck pain, there was significant pain reduction in relation to up-down movement. Conclusion: Ergonomic advice is effective in terms of reducing neck pain among engineering students and it should be adopted for prevention of neck pain.

  15. I don’t get it : Response difficulties in answering political attitude statements in Voting Advice Applications

    NARCIS (Netherlands)

    Kamoen, Naomi; Holleman, Bregje

    2017-01-01

    Political knowledge and feelings of political competence are essential for political participation. Voting Advice Applications (VAAs) aim to contribute to that. In a VAA, users respond to a set of attitude statements about political issues. Based on a comparison between the users’ answers and the

  16. More Than Needles: The Importance of Explanations and Self-Care Advice in Treating Primary Dysmenorrhea with Acupuncture.

    Science.gov (United States)

    Armour, Michael; Dahlen, Hannah G; Smith, Caroline A

    2016-01-01

    Background. Primary dysmenorrhea is a common gynaecological condition. Traditional Chinese medicine (TCM) acupuncturists commonly treat primary dysmenorrhea and dispense specific self-care advice for this condition. The impact of self-care advice on primary dysmenorrhea is unknown. Methods. 19 TCM acupuncture practitioners from New Zealand or Australia and 12 New Zealand women who had recently undergone acupuncture treatment for primary dysmenorrhea as part of a randomised controlled trial participated in this qualitative, pragmatic study. Focus groups and semistructured interviews were used to collect data. These were recorded, transcribed, and analysed using thematic analysis. Results. The overarching theme was that an acupuncture treatment consisted of "more than needles" for both practitioners and participants. Practitioners and participants both discussed the partnership they engaged in during treatment, based on openness and trust. Women felt that the TCM self-care advice was related to positive outcomes for their dysmenorrhea and increased their feelings of control over their menstrual symptoms. Conclusions. Most of the women in this study found improved symptom control and reduced pain. A contributing factor for these improvements may be an increased internal health locus of control and an increase in self-efficacy resulting from the self-care advice given during the clinical trial.

  17. 77 FR 11589 - Advice Concerning Possible Modifications to the U.S. Generalized System of Preferences, 2011...

    Science.gov (United States)

    2012-02-27

    ... under the U.S. GSP program and providing advice on whether any industry in the United States is likely... beneficiary developing countries under the GSP program: Sacks and bags (including cones) for the conveyance or... developing countries under the GSP program: HTS subheadings 5201.00.18 (Cotton, not carded or combed, having...

  18. Randomized controlled trial of motivational interviewing compared with drug information and advice for early intervention among young cannabis users.

    Science.gov (United States)

    McCambridge, Jim; Slym, Renee L; Strang, John

    2008-11-01

    To test the effectiveness of motivational interviewing (MI) in comparison with drug information and advice in opportunistically securing reductions in drug-related risk among young cannabis users not seeking help. Randomized controlled trial. Eleven London Further Education colleges. A total of 326 students aged 16-19 years who smoked cannabis weekly or more frequently. Participants were randomized to a single-session intervention of MI or drug information and advice-giving. Cannabis use, cigarette smoking and alcohol consumption and harm outcomes were assessed after both 3 and 6 months. No differences were found between MI and drug information and advice, although MI fidelity was not high. There were wide-ranging individual practitioner effects on observed outcomes and a practitioner-intervention interaction was detected in relation to cannabis cessation after 3 months. Change over time was more pronounced for cannabis use than for other drug use. Further study of the nature and consequences of MI fidelity, and individual practitioner effects more generally, is needed. Advice may be an effective brief intervention with young cannabis users in its own right and should be evaluated further in trials.

  19. The Role of Parents in Young Adolescents' Competence with Peers: An Observational Study of Advice Giving and Intrusiveness

    Science.gov (United States)

    Poulin, Francois; Nadeau, Karine; Scaramella, Laura V.

    2012-01-01

    Young adolescents who encounter difficulties with peers can consult with their parents to help solve these problems. In this context, this study examines the contribution of adolescents' disclosure, parental advice giving, and parental intrusiveness into adolescents' social and behavioral adjustment. Young adolescents (N = 93; 49% girls; mean age…

  20. Developing the public health role of a front line clinical service: integrating stop smoking advice into routine podiatry services.

    Science.gov (United States)

    Gray, Jackie; Eden, Gary; Williams, Maria

    2007-06-01

    Although smoking is a major public health problem, many clinicians do not routinely provide evidence-based health improvement advice to smokers to help them to quit. Plan, Do, Study, Act (PDSA) cycle methodology was used to design and implement a service development so that health improvement advice for smokers featured in all podiatry consultations provided by a Primary Care Trust in North East England. IT systems were developed to record the number and proportion of patients for whom smoking status was assessed, and the number and proportion of smokers who were given advice to quit and referred for specialist support. A questionnaire to staff explored their perceptions of the development on their clinics and consultations. During a 6-month period, smoking status was recorded for all 8831 (100%) patients attending podiatry clinics; 83% of smokers were given brief advice to quit; 7% of smokers were given help to access specialist stop smoking support services. Improvements were introduced within existing budgets and did not prolong clinics. It is straightforward and inexpensive to develop clinical services so that public health guidance is routinely implemented. More widespread implementation of similar service developments could lead to national improvements in public health.

  1. More Than Needles: The Importance of Explanations and Self-Care Advice in Treating Primary Dysmenorrhea with Acupuncture

    Directory of Open Access Journals (Sweden)

    Michael Armour

    2016-01-01

    Full Text Available Background. Primary dysmenorrhea is a common gynaecological condition. Traditional Chinese medicine (TCM acupuncturists commonly treat primary dysmenorrhea and dispense specific self-care advice for this condition. The impact of self-care advice on primary dysmenorrhea is unknown. Methods. 19 TCM acupuncture practitioners from New Zealand or Australia and 12 New Zealand women who had recently undergone acupuncture treatment for primary dysmenorrhea as part of a randomised controlled trial participated in this qualitative, pragmatic study. Focus groups and semistructured interviews were used to collect data. These were recorded, transcribed, and analysed using thematic analysis. Results. The overarching theme was that an acupuncture treatment consisted of “more than needles” for both practitioners and participants. Practitioners and participants both discussed the partnership they engaged in during treatment, based on openness and trust. Women felt that the TCM self-care advice was related to positive outcomes for their dysmenorrhea and increased their feelings of control over their menstrual symptoms. Conclusions. Most of the women in this study found improved symptom control and reduced pain. A contributing factor for these improvements may be an increased internal health locus of control and an increase in self-efficacy resulting from the self-care advice given during the clinical trial.

  2. 78 FR 23954 - U.S.-EU Transatlantic Trade and Investment Partnership Agreement: Advice on the Probable Economic...

    Science.gov (United States)

    2013-04-23

    ... INTERNATIONAL TRADE COMMISSION [Investigation Nos. TA-131-037 and TA-2104-029] U.S.-EU.... TA-131-037 and TA-2104-029, U.S.-EU Transatlantic Trade and Investment Partnership Agreement: Advice... Commission may also be obtained by accessing its Internet server ( http://www.usitc.gov ). Persons with...

  3. The Swedish radiation protection institute's regulations and general advice on nuclear medicine; issued on April 28, 2000

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-04-01

    These regulations and general advice are applicable to nuclear medicine within human medical care. The regulations are also applicable to activities where radioactive substances are administered to individuals in connection to medical or biomedical research and medical examinations for insurance or legal purposes.

  4. The Swedish radiation protection institute's regulations and general advice on nuclear medicine; issued on April 28, 2000

    International Nuclear Information System (INIS)

    2000-04-01

    These regulations and general advice are applicable to nuclear medicine within human medical care. The regulations are also applicable to activities where radioactive substances are administered to individuals in connection to medical or biomedical research and medical examinations for insurance or legal purposes

  5. Patient use and compliance with medical advice delivered by a web-based triage system in primary care

    NARCIS (Netherlands)

    Nijland, N.; Cranen, Karlijn; Cranen, Karlijn; Boer, Henk; Boer, Hendrik; van Gemert-Pijnen, Julia E.W.C.; Seydel, E.R.

    2010-01-01

    We studied a web-based triage system which was accessible to the general public in the Netherlands. In a retrospective analysis we investigated the type of complaints that were submitted and the kind of advice provided. Over a period of 15 months, 13,133 different people began using the web-based

  6. Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia

    NARCIS (Netherlands)

    Mehmood, Syed Imran; Norcini, John J.; Borleffs, Jan C. C.

    2013-01-01

    Background: Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to

  7. Addressing the elephant in the room: a possible new way to increase patient adherence to medical advice.

    Science.gov (United States)

    Grønhaug, Gudmund

    2017-01-01

    Lack of patient adherence to medical advice (PAMA) is recognized as an area of interest. None of the previous initiatives to improve PAMA, such as patient centered care and shared decision making, have proved to be successful in terms of improving patient adherence. The aim of the present study is to assess beliefs about priorities in public health care, and adherence to medical advice, to establish a novel approach to increase PAMA. The present study is based on responses to two questions in an experimental survey from the Norwegian Citizen Panel, addressing people's attitudes to priorities in public health care and adherence to medical advice. The questions on priorities in the health care sector are organized into six groups. The questions on adherence are organized into three groups. All questions are answered on a 7-point Likert scale. This study is the first to use experimental surveys to assess PAMA. The results indicate that if health care providers refer to national expertise and patient organizations' recommendations on a given treatment, PAMA could improve. Although technical and methodological interventions in health care have, to some extent, improved PAMA, medical adherence is still low. In the present study, it is shown that integrating either national expertise or collaborated messages with other health professions and patient organizations' recommendations in everyday care may help improve patients adherence to medical advice. A minor change in how treatment suggestions are presented could improve PAMA.

  8. (NotGood Parents’ Advices? The Value of Parental Permissions, Drivers and Injunctions in the Life of Modern Youth. The Research Educational Transactional Analyst’s Perspective [(Niedobre rady rodziców? Obecność rodzicielskich, przyzwoleń, nakazów i zakazów w życiu współczesnej młodzieży. Badawcza perspektywa edukacjnego analityka transakcyjnego

    Directory of Open Access Journals (Sweden)

    Adrianna SARNAT-CIASTKO

    2017-11-01

    Full Text Available The main purpose of this paper is to determine the relevance of advices that are given to children by their parents on their development. The author assumed that these types of messages might have a diagnostic value, because it may not only show the direction in which – according to the mothers or fathers – their child should follow, but also contain a set of practical tips which help achieve this goal. The parental advices may also be a source of knowledge about the quality of family relations and upbringing style that is used in a particular household. They can also indicate a lack of mutual contact. Making such an insight into the parental advices can be done by means of the tools provided by the transactional analysis which will also be presented in this text by the analysis of collected research material.

  9. Effectiveness of web-based tailored advice on parents' child safety behaviors: randomized controlled trial.

    Science.gov (United States)

    van Beelen, Mirjam Elisabeth Johanna; Beirens, Tinneke Monique Jozef; den Hertog, Paul; van Beeck, Eduard Ferdinand; Raat, Hein

    2014-01-24

    Injuries at home are a major cause of death, disability, and loss of quality of life among young children. Despite current safety education, required safety behavior of parents is often lacking. To prevent various childhood disorders, the application of Web-based tools has increased the effectiveness of health promotion efforts. Therefore, an intervention with Web-based, tailored, safety advice combined with personal counseling (E-Health4Uth home safety) was developed and applied. To evaluate the effect of E-Health4Uth home safety on parents' safety behaviors with regard to the prevention of falls, poisoning, drowning, and burns. A randomized controlled trial was conducted (2009-2011) among parents visiting well-baby clinics in the Netherlands. Parents were randomly assigned to the intervention group (E-Health4Uth home safety intervention) or to the control condition consisting of usual care. Parents in the intervention condition completed a Web-based safety behavior assessment questionnaire; the resulting tailored safety advice was discussed with their child health care professional at a well-baby visit (age approximately 11 months). Parents in the control condition received counseling using generic safety information leaflets at this well-baby visit. Parents' child safety behaviors were derived from self-report questionnaires at baseline (age 7 months) and at follow-up (age 17 months). Each specific safety behavior was classified as safe/unsafe and a total risk score was calculated. Logistic and linear regression analyses were used to reveal differences in safety behavior between the intervention and the control condition at follow-up. A total of 1292 parents (response rate 44.79%) were analyzed. At follow-up, parents in the intervention condition (n=643) showed significantly less unsafe behavior compared to parents in the control condition (n=649): top of staircase (23.91% vs. 32.19%; OR 0.65, 95% CI 0.50-0.85); bottom of staircase (63.53% vs. 71.94%; OR 0

  10. Effectiveness of Web-Based Tailored Advice on Parents’ Child Safety Behaviors: Randomized Controlled Trial

    Science.gov (United States)

    2014-01-01

    Background Injuries at home are a major cause of death, disability, and loss of quality of life among young children. Despite current safety education, required safety behavior of parents is often lacking. To prevent various childhood disorders, the application of Web-based tools has increased the effectiveness of health promotion efforts. Therefore, an intervention with Web-based, tailored, safety advice combined with personal counseling (E-Health4Uth home safety) was developed and applied. Objective To evaluate the effect of E-Health4Uth home safety on parents’ safety behaviors with regard to the prevention of falls, poisoning, drowning, and burns. Methods A randomized controlled trial was conducted (2009-2011) among parents visiting well-baby clinics in the Netherlands. Parents were randomly assigned to the intervention group (E-Health4Uth home safety intervention) or to the control condition consisting of usual care. Parents in the intervention condition completed a Web-based safety behavior assessment questionnaire; the resulting tailored safety advice was discussed with their child health care professional at a well-baby visit (age approximately 11 months). Parents in the control condition received counseling using generic safety information leaflets at this well-baby visit. Parents’ child safety behaviors were derived from self-report questionnaires at baseline (age 7 months) and at follow-up (age 17 months). Each specific safety behavior was classified as safe/unsafe and a total risk score was calculated. Logistic and linear regression analyses were used to reveal differences in safety behavior between the intervention and the control condition at follow-up. Results A total of 1292 parents (response rate 44.79%) were analyzed. At follow-up, parents in the intervention condition (n=643) showed significantly less unsafe behavior compared to parents in the control condition (n=649): top of staircase (23.91% vs 32.19%; OR 0.65, 95% CI 0.50-0.85); bottom of

  11. Patients' perceptions of their general practitioner's health and weight influences their perceptions of nutrition and exercise advice received

    Directory of Open Access Journals (Sweden)

    Fraser SE

    2013-12-01

    Full Text Available INTRODUCTION: General practitioners (GPs play an important role in the management of patients who are overweight or obese. Previous research suggests that GPs' physical characteristics may influence patients' perceptions of health care received during consultations, mediating the likelihood of patients following health advice provided by GPs. This study aimed to explore patients' perceptions of their GP's health status and its influence on patients' perceptions of healthy eating and exercise advice. METHODS: An interpretive approach to phenomenology underpinned the qualitative inquiry and study design. Twenty-one participants (aged 55.9 ± 6.5 years; 14 females, 7 males who had previously received healthy eating and/or exercise advice from a GP participated in an individual semi-structured interview. A constant comparison approach to thematic analysis was conducted. FINDINGS: Participants identified three key indicators of perceived health of their GP. These included the GP's physical appearance, particularly weight status; perceived absence of ill health; and disclosure of a GP's health behaviours. Participants expressed favourable perceptions of the weight status of their GP. Participants expected their GP to be a healthy role model and often, but not always, felt more confident receiving advice from a GP that they perceived as healthy. CONCLUSION: The findings highlight that a GP's perceived health status influences patients' perceptions of the health advice received during consultations. These findings provide a foundation for future research that may allow GPs to modify patients' perceptions of their health status in order to facilitate behaviour change in overweight or obese patients.

  12. The effect of physicians' body weight on patient attitudes: implications for physician selection, trust and adherence to medical advice.

    Science.gov (United States)

    Puhl, R M; Gold, J A; Luedicke, J; DePierre, J A

    2013-11-01

    Research has documented negative stigma by health providers toward overweight and obese patients, but it is unknown whether physicians themselves are vulnerable to weight bias from patients. This study assessed public perceptions of normal weight, overweight or obese physicians to identify how physicians' body weight affects patients' selection, trust and willingness to follow the medical advice of providers. An online sample of 358 adults were randomly assigned to one of three survey conditions in which they completed a questionnaire assessing their perceptions of physicians who were described as normal weight, overweight or obese. Participants also completed a measure of explicit weight bias (Fat Phobia Scale) to determine whether antifat attitudes are associated with weight-related perceptions of physicians. Respondents reported more mistrust of physicians who are overweight or obese, were less inclined to follow their medical advice, and were more likely to change providers if the physician was perceived to be overweight or obese, compared to normal-weight physicians who elicited significantly more favorable reactions. These weight biases remained present regardless of participants' own body weight. Inspection of interaction effects revealed opposing effects of weight bias between the obese/overweight and normal-weight physician conditions. Stronger weight bias led to higher trust, more compassion, more inclination to follow advice, and less inclination to change doctors when the physician was presented as normal weight. In contrast, stronger weight bias led to less trust, less compassion, less inclination to follow advice and higher inclination to change doctors when the physician was presented as obese. This study suggests that providers perceived to be overweight or obese may be vulnerable to biased attitudes from patients, and that providers' excess weight may negatively affect patients' perceptions of their credibility, level of trust and inclination to

  13. Metabotyping for the development of tailored dietary advice solutions in a European population: the Food4Me study.

    Science.gov (United States)

    O'Donovan, Clare B; Walsh, Marianne C; Woolhead, Clara; Forster, Hannah; Celis-Morales, Carlos; Fallaize, Rosalind; Macready, Anna L; Marsaux, Cyril F M; Navas-Carretero, Santiago; Rodrigo San-Cristobal, S; Kolossa, Silvia; Tsirigoti, Lydia; Mvrogianni, Christina; Lambrinou, Christina P; Moschonis, George; Godlewska, Magdalena; Surwillo, Agnieszka; Traczyk, Iwona; Drevon, Christian A; Daniel, Hannelore; Manios, Yannis; Martinez, J Alfredo; Saris, Wim H M; Lovegrove, Julie A; Mathers, John C; Gibney, Michael J; Gibney, Eileen R; Brennan, Lorraine

    2017-10-01

    Traditionally, personalised nutrition was delivered at an individual level. However, the concept of delivering tailored dietary advice at a group level through the identification of metabotypes or groups of metabolically similar individuals has emerged. Although this approach to personalised nutrition looks promising, further work is needed to examine this concept across a wider population group. Therefore, the objectives of this study are to: (1) identify metabotypes in a European population and (2) develop targeted dietary advice solutions for these metabotypes. Using data from the Food4Me study (n 1607), k-means cluster analysis revealed the presence of three metabolically distinct clusters based on twenty-seven metabolic markers including cholesterol, individual fatty acids and carotenoids. Cluster 2 was identified as a metabolically healthy metabotype as these individuals had the highest Omega-3 Index (6·56 (sd 1·29) %), carotenoids (2·15 (sd 0·71) µm) and lowest total saturated fat levels. On the basis of its fatty acid profile, cluster 1 was characterised as a metabolically unhealthy cluster. Targeted dietary advice solutions were developed per cluster using a decision tree approach. Testing of the approach was performed by comparison with the personalised dietary advice, delivered by nutritionists to Food4Me study participants (n 180). Excellent agreement was observed between the targeted and individualised approaches with an average match of 82 % at the level of delivery of the same dietary message. Future work should ascertain whether this proposed method could be utilised in a healthcare setting, for the rapid and efficient delivery of tailored dietary advice solutions.

  14. Tailoring Nutritional Advice for Mexicans Based on Prevalence Profiles of Diet-Related Adaptive Gene Polymorphisms

    Directory of Open Access Journals (Sweden)

    Claudia Ojeda-Granados

    2017-11-01

    Full Text Available Diet-related adaptive gene (DRAG polymorphisms identified in specific populations are associated with chronic disorders in carriers of the adaptive alleles due to changes in dietary and lifestyle patterns in recent times. Mexico’s population is comprised of Amerindians (AM and Mestizos who have variable AM, European (EUR and African genetic ancestry and an increased risk of nutrition-related chronic diseases. Nutritional advice based on the Mexican genome and the traditional food culture is needed to develop preventive and therapeutic strategies. Therefore, we aimed to provide a prevalence profile of several DRAG polymorphisms in the Mexican population, including Central West (CW Mexico subpopulations. Geographic heat maps were built using ArcGIS10 (Esri, Redlands, CA, USA software, based on the published data of the MTHFR C677T (rs1801133, ABCA1 Arg230Cys (rs9282541, APOE T388C (rs429358/C526T (rs7412, LCT C-13910T (rs4988235 polymorphisms and AMY1 copy number variation (CNV. Also, new data obtained by allelic discrimination-real-time polymerase chain reaction (RT-PCR assays for the MTHFR, ABCA1, and APOE polymorphisms as well as the AMY1 CNV in the CW Mexico subpopulations with different proportions of AM and EUR ancestry were included. In the CW region, the highest frequency of the MTHFR 677T, ABCA1 230C and APOE ε4 adaptive alleles was observed in the AM groups, followed by Mestizos with intermediate AM ancestry. The LCT-13910T allele frequency was highest in Mestizos-EUR but extremely low in AM, while the AMY1 diploid copy number was 6.82 ± 3.3 copies. Overall, the heat maps showed a heterogeneous distribution of the DRAG polymorphisms, in which the AM groups revealed the highest frequencies of the adaptive alleles followed by Mestizos. Given these genetic differences, genome-based nutritional advice should be tailored in a regionalized and individualized manner according to the available foods and Mexican traditional food culture that

  15. Pediatrician’s perspectives on discharge against medical advice (DAMA among pediatric patients: a qualitative study

    Directory of Open Access Journals (Sweden)

    Macrohon Bernadette C

    2012-06-01

    Full Text Available Abstract Background The phenomenon of discharge against medical advice (DAMA among pediatric patients places pediatricians in a dilemma between respect for the parent’s decision and the desire to provide complete care for the vulnerable child-patient. Little has been written about factors that affect a pediatrician’s decision to allow a parent to discharge his child against medical advice. This qualitative study aims to answer the question of how pediatric residents in a tertiary government hospital perceive and decide on a DAMA request from a parent or primary caregiver. Methods Using a focus group discussion approach, 11 pediatric residents from a government-run tertiary hospital were recruited for the study. The session was digitally recorded and dominant themes were coded and identified. Results There were three prominent themes that arose in the discussion: variability of definitions of DAMA, factors considered before “allowing” the patient to be DAMA, and the implications of a DAMA request on their performance as pediatricians. Definitions vary from one resident to another based on the main reason for DAMA (terminal, cultural, or financial. A conflict was noted in the definition of Home per Request (HPR versus DAMA. Factors that influence a pediatrician to sign out a case as DAMA include: their ability to do something about the reason given for the DAMA request, the condition of the patient when the DAMA request was given, their impression of the kind of care that the parents provide, and their legal liabilities. Pediatric residents generally maintain a positive attitude towards the parents who request for DAMA and in the event of readmission, accept the patient into their care again. The occurrence of a variety of definitions and subcategories for DAMA may cause confusion among the pediatricians and should be clarified. The familiarity with cultural traditions contributes to their ability to handle situations that may lead to DAMA

  16. What do patients think about the role of optometrists in providing advice about smoking and nutrition?

    Science.gov (United States)

    Downie, Laura E; Douglass, Amanda; Guest, Daryl; Keller, Peter R

    2017-03-01

    Tobacco smoking and nutrition are key lifestyle factors with long-term effects on eye health. However, little is known about patients' perceptions and experiences in these areas in relation to the care received from optometrists. The main aim was to survey patients' perceptions and prior experience regarding the role of optometrists in enquiring and providing advice about tobacco smoking and nutrition. An anonymous, paper-based survey was distributed to a convenience sample of 225 adults attending the University of Melbourne eye care clinic. Respondents provided demographic and other information (age, sex, length of time since last eye examination, country of most recent eye examination, smoking status and intake of nutritional supplements) and indicated their level of agreement (using a five-step Likert scale) with a series of statements relating to the care provided by optometrists in the areas of health, smoking and nutrition. The statements were designed to assess the perceived scope of practice of optometrists and the extent to which patients expect, and feel comfortable, discussing these issues with their optometrist. 220 completed surveys were returned. Most respondents (>80%) agreed that they visit their optometrist to quantify their refractive error and to examine their eye health. About two-thirds of respondents indicated that they expect their optometrist to ask about their general health, with almost half expecting their optometrist to communicate with their general medical practitioner. Approximately one-third of respondents indicated having been routinely questioned about their smoking status, diet and nutritional supplement intake by their optometrist. This was despite about half expecting their optometrist to question them about these factors and almost three out of four respondents indicating that they felt comfortable talking with their optometrist about these lifestyle behaviours. This study provides novel insight into patients' perceptions and

  17. Advice for Sex Advisors: A Guide for "Agony Aunts", Relationship Therapists and Sex Educators Who Want to Work with the Media

    Science.gov (United States)

    Boynton, Petra M.

    2007-01-01

    Education programmes for sex and relationships are greatly needed globally. One way such information can be delivered is via the media. Sex and relationship advice has long been a popular media component, but the quality, accuracy and effectiveness of such advice--particularly from the sex "expert" or "agony aunt"--has not been adequately…

  18. A Cross-Cultural Study of Offering Advice Speech Acts by Iranian EFL Learners and English Native Speakers: Pragmatic Transfer in Focus

    Science.gov (United States)

    Babaie, Sherveh; Shahrokhi, Mohsen

    2015-01-01

    The purpose of the present study was to compare the speech act of offering advice as realized by Iranian EFL learners and English native speakers. The study, more specifically, attempted to find out whether there was any pragmatic transfer from Persian (L1) among Iranian EFL learners while offering advice in English. It also examined whether…

  19. MedMinify: An Advice-giving System for Simplifying the Schedules of Daily Home Medication Regimens Used to Treat Chronic Conditions

    Science.gov (United States)

    Flynn, Allen J.; Klasnja, Predrag; Friedman, Charles P.

    2014-01-01

    For those with high blood pressure, diabetes, or high cholesterol, adherence to a home medication regimen is important for health. Reductions in the number of daily medication-taking events or daily pill burden improve adherence. A novel advice-giving computer application was developed using the SMART platform to generate advice on how to potentially simplify home medication regimens. MedMinify generated advice for 41.3% of 1,500 home medication regimens for adults age 60 years and older with chronic medical conditions. If the advice given by MedMinify were implemented, 320 regimen changes would have reduced daily medication-taking events while an additional 295 changes would have decreased the daily pill burden. The application identified four serious drug-drug interactions and so advised against taking two pairs of medications simultaneously. MedMinify can give advice to change home medication regimens that could result in simpler home medication-taking schedules. PMID:25954445

  20. A survey of the prevalence of smoking and smoking cessation advice received by inpatients in a large teaching hospital in Ireland.

    LENUS (Irish Health Repository)

    Bartels, C

    2012-01-06

    BACKGROUND: The adverse effects of smoking are well documented and it is crucial that this modifiable risk factor is addressed routinely. Professional advice can be effective at reducing smoking amongst patients, yet it is not clear if all hospital in-patient smokers receive advice to quit. AIMS: To explore smoking prevalence amongst hospital in-patients and smoking cessation advice given by health professionals in a large university teaching hospital. METHODS: Interviews were carried out over 2 weeks in February 2011 with all eligible in-patients in Beaumont Hospital. RESULTS: Of the 205 patients who completed the survey, 61% stated they had been asked about smoking by a healthcare professional in the past year. Only 44% of current\\/recent smokers stated they had received smoking cessation advice from a health professional within the same timeframe. CONCLUSIONS: Interventions to increase rates of healthcare professional-provided smoking cessation advice are urgently needed.

  1. It ain't what you do, it's the way that you do it: a qualitative study of advice for young cannabis users.

    Science.gov (United States)

    Faulkner, Nathan; McCambridge, Jim; Slym, Renee L; Rollnick, Stephen

    2009-03-01

    Advice is a widely recommended and practised intervention with young drug users. Study of precisely how advice is given and received in any setting has, however, been limited. We qualitatively analysed 106 audio-recordings of advice sessions on cannabis use for young people within a randomised trial. Inductive data analysis was guided by a focus on practitioner behaviour which served to engage the active participation of the young drug user in the session. A cluster of 'Information Management' activities was identified together with an 'Interactive Orientation' evident in a series of specific behaviours. Participants were most successfully engaged when both were combined, understood here as 'Personalised Advice-giving'. These components identified in this exploratory study might assist further research in rectifying the absence of a solid empirical basis for effective practice in advice giving with young drug users and more widely.

  2. Individual Risk and Prevention of Complications: Doctors' Advice to Persons Wishing a New Tattoo.

    Science.gov (United States)

    Serup, Jørgen

    2017-01-01

    Doctors who are consulted about health and tattoo risks have an important role in the prevention of an individual's tattoo complications. Tattooing is a tremendous exposure of the human body to needle operation, particles, and chemicals. The risk is related to a person's health condition, level of insight, decision-making, and to the operation of tattooing, tattoo inks and utensils, tattoo parlour, and the aftercare. Tattooing is painful minor surgery performed without anesthesia. It can be associated with syncope. It is major needle trauma with histamine release and wheal and flare in the operation field. The skin barrier is broken. Bacterial infections come early. Chronically intermittent and mild complaints affect 4/10 of all the tattooed, and 2/10 have sensitivity to sun. Chronic complications with allergy in red tattoos and nodules due to pigment agglomeration and foreign body formation in black tattoos are less common but certainly at the level of cumbersome skin disease. Reactions to black tattoos are strongly associated with sarcoidosis. There are many other distinct entities of tattoo complications. A campaign called 'Tattoo - know your risk' is presented with detailed fact sheets about tattoos, tattoo problems, how to reduce risk, and a checklist for the tattoo customer before decision-making. The sheets with keynote information are useful aids for doctors giving advice to persons curious about acquiring a tattoo. © 2017 S. Karger AG, Basel.

  3. Oral health education (advice and training) for people with serious mental illness.

    Science.gov (United States)

    Khokhar, Mariam A; Khokhar, Waqqas Ahmad; Clifton, Andrew V; Tosh, Graeme E

    2016-09-08

    People with serious mental illness not only experience an erosion of functioning in day-to-day life over a protracted period of time, but evidence also suggests that they have a greater risk of experiencing oral disease and greater oral treatment needs than the general population. Poor oral hygiene has been linked to coronary heart disease, diabetes, and respiratory disease and impacts on quality of life, affecting everyday functioning such as eating, comfort, appearance, social acceptance, and self esteem. Oral health, however, is often not seen as a priority in people suffering with serious mental illness. To review the effects of oral health education (advice and training) with or without monitoring for people with serious mental illness. We searched the Cochrane Schizophrenia Group's Trials Register (5 November 2015), which is based on regular searches of MEDLINE, EMBASE, CINAHL, BIOSIS, AMED, PubMed, PsycINFO, and clinical trials registries. There are no language, date, document type, or publication status limitations for inclusion of records in the register. All randomised clinical trials focusing on oral health education (advice and training) with or without monitoring for people with serious mental illness. We extracted data independently. For binary outcomes, we calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data, we estimated the mean difference (MD) between groups and its 95% CI. We employed a fixed-effect model for analyses. We assessed risk of bias for included studies and created 'Summary of findings' tables using GRADE. We included three randomised controlled trials (RCTs) involving 1358 participants. None of the studies provided useable data for the key outcomes of not having seen a dentist in the past year, not brushing teeth twice a day, chronic pain, clinically important adverse events, and service use. Data for leaving the study early and change in plaque index scores were provided

  4. A Word to the Wise: Advice for Scientists Engaged in Collaborative Adaptive Management

    Science.gov (United States)

    Hopkinson, Peter; Huber, Ann; Saah, David S.; Battles, John J.

    2017-05-01

    Collaborative adaptive management is a process for making decisions about the environment in the face of uncertainty and conflict. Scientists have a central role to play in these decisions. However, while scientists are well trained to reduce uncertainty by discovering new knowledge, most lack experience with the means to mitigate conflict in contested situations. To address this gap, we drew from our efforts coordinating a large collaborative adaptive management effort, the Sierra Nevada Adaptive Management Project, to offer advice to our fellow environmental scientists. Key challenges posed by collaborative adaptive management include the confusion caused by multiple institutional cultures, the need to provide information at management-relevant scales, frequent turnover in participants, fluctuations in enthusiasm among key constituencies, and diverse definitions of success among partners. Effective strategies included a dedication to consistency, a commitment to transparency, the willingness to communicate frequently via multiple forums, and the capacity for flexibility. Collaborative adaptive management represents a promising, new model for scientific engagement with the public. Learning the lessons of effective collaboration in environmental management is an essential task to achieve the shared goal of a sustainable future.

  5. Advice When Children Come Out: The Cultural “Tool Kits” of Parents

    Science.gov (United States)

    Martin, Karin A.; Hutson, David J.; Kazyak, Emily; Scherrer, Kristin S.

    2010-01-01

    The family is one of the main areas of social life where the normalization of gay/lesbian identity is incomplete. Most research analyzes the individual and psychological aspects of how families respond to children’s disclosure of a gay/lesbian identity, and ignores the social, cultural, and historical contexts. An examination of the cultural discourses, tools, and strategies that are available to parents is necessary for a full understanding of how families respond to gay/lesbian children. We conduct an interpretive content analysis of 29 advice books in order to assess this cultural field and its institutional resources. We find three broad strategies offered to parents: relying on professionals for overcoming the grief of having a gay/lesbian child, normalizing gay/lesbian identity, and utilizing “good” parenting skills. We discuss how these strategies demonstrate the unsettled and often contradictory cultural field of gay/lesbian identity in the family and its implications for sexual identities beyond the closet. PMID:20606708

  6. Fitness to fly in the paediatric population, how to assess and advice.

    Science.gov (United States)

    Israëls, Joël; Nagelkerke, Ad F; Markhorst, Dick G; van Heerde, Marc

    2018-02-26

    The number of children on commercial aircrafts is rising steeply and poses a need for their treating physicians to be aware of the physiologic effects and risks of air travel. The most important risk factors while flying are a decrease in partial oxygen pressure, expansion of trapped air volume, low cabin humidity, immobility, recirculation of air and limited options for medical emergencies. Because on-board medical emergencies mostly concern exacerbations of chronic disease, the medical history, stability of current disease and previous flight experience should be assessed before flight. If necessary, hypoxia altitude simulation testing can be performed to simulate the effects of in-flight hypoxia. Although the literature on paediatric safety of air travel is sparse, recommendations for many different situations can be given. We present an overview of the most up to date recommendations to ensure the safety of children during flight. What is Known: • Around 65% of on-board medical emergencies are complications of underlying disease. • In children, the three most common emergencies during flight concern respiratory, neurological and infectious disease. What is New: • Although studies are scarce, some advices to ensure safe air travel can be given for most underlying medical conditions in children, based on physiology, studies in adults and expert opinions. • In former preterm infants without chronic lung disease, hypoxia altitude simulation testing to rule out in-flight desaturation is not recommended.

  7. "El Sexo no es Malo": Maternal Values Accompanying Contraceptive Use Advice to Young Latina Adolescent Daughters.

    Science.gov (United States)

    Romo, Laura F; Bravo, Magali; Cruz, Maria Elena; Rios, Rebeca M; Kouyoumdjian, Claudia

    2010-06-01

    In this study, we utilized observational methods to identify maternal values and concerns accompanying contraceptive use advice in Latina mother-daughter sexuality conversations. The sample included non-sexually active early adolescents around 12 years of age and their mostly Spanish-speaking Latina mothers. Videotaped conversations were coded for the prevalence of messages related to four sexual values (abstinence, delay sex until older, sex is "normal", sex is "improper") and concerns about pregnancy and STD transmission. We examined whether the duration of time spent conversing about these messages was associated with participant characteristics, general communication openness, and the amount of time the dyads spent discussing contraceptive use. Results indicated that Latina mothers who had fewer years of education and lower family income talked longer to their daughters about the need to delay sex, avoid risky situations that would increase their chances of getting pregnant or acquiring an STD, and engage in self-protective practices. Less perceived openness in general communication as reported by both the mothers and the daughters was associated with increased time discussing that sex is improper. Although the duration of contraceptive use messages was brief, mothers and daughters who discussed the fact that sex is normal, and who communicated more about the importance of delaying sex, talked longer about contraceptive use practices compared to mothers and daughters who engaged in minimal discussion of these sexual values.

  8. Dealing With Deans and Academic Medical Center Leadership: Advice From Leaders.

    Science.gov (United States)

    Sanfilippo, Fred; Powell, Deborah; Folberg, Robert; Tykocinski, Mark

    2018-01-01

    The 2017 Association of Pathology Chairs Annual Meeting included a session for department chairs and other department leaders on "how to deal with deans and academic medical center leadership." The session was focused on discussing ways to foster positive relationships with university, medical school, and health system leaders, and productively address issues and opportunities with them. Presentations and a panel discussion were provided by 4 former pathology chairs who subsequently have served as medical deans and in other leadership positions including university provost, medical center CEO, and health system board chair. There was a strong consensus among the participants on how best to deal with superiors about problems, conflicts, and requests for additional resources and authority. The importance of teamwork and accountability in developing a constructive and collaborative relationship with leaders and peers was discussed in detail. Effectiveness in communication, negotiation, and departmental advocacy were highlighted as important skills. As limited resources and increased regulations have become growing problems for universities and health systems, internal stress and competition have increased. In this rapidly changing environment, advice on how chairs can interact most productively with institutional leaders is becoming increasingly important.

  9. What is the quality of smoking cessation advice in guidelines of tobacco-related diseases?

    Science.gov (United States)

    Bogdanovica, Ilze; Agrawal, Sanjay; Gregory, Benjamin; Britton, John; Leonardi-Bee, Jo

    2015-12-01

    Smoking is a major risk factor for a range of diseases, and quitting smoking provides considerable benefits to health. It therefore follows that clinical guidelines on disease management, particularly for diseases caused by smoking, should include smoking cessation. The aim of this study was to determine the extent to which this is the case. We conducted a systematic review investigating clinical guidelines and recommendations issued by UK national or European transnational medical speciality associations and societies issued between 2000 and 2012 on a range of diseases caused by smoking. We then investigated whether selected guidelines contained reference to smoking cessation and smoking cessation advice. Although the extent to which smoking and smoking cessation was mentioned in the guidelines varied between diseases, only 60% of guidelines identified recognised that smoking is a risk factor for the development of the disease and 40% recommended smoking cessation. Only 19% of guidelines provided detailed information on how to deliver smoking cessation support. Smoking cessation is not comprehensively addressed in current UK and transnational European clinical practice guidelines and recommendations. © Royal College of Physicians 2015. All rights reserved.

  10. Improving clinical outcome in patients with intestinal failure using individualised nutritional advice.

    Science.gov (United States)

    Culkin, A; Gabe, S M; Madden, A M

    2009-08-01

    Patients with intestinal failure are required to adhere to a complex regimen. Written information may increase knowledge leading to improvements in clinical outcomes. The present study aimed to evaluate the effectiveness of nutrition advice incorporating the use of a booklet. Each patient completed a questionnaire evaluating their knowledge of the regime and quality of life and kept a diet and gastrointestinal output diary. The diary was assessed and they were given the booklet with a verbal explanation tailored to individual requirements. The booklet explained the causes of intestinal failure, diet and fluid recommendations in relation to intestinal anatomy, information on medications and long-term monitoring. Patients were reassessed at their next appointment using the same tools. The primary endpoint was an improvement in knowledge. Secondary endpoints were an improvement in oral nutritional intake, nutritional status, quality of life and the content of home parenteral nutrition. Forty-eight patients completed the study. Knowledge improved significantly after dietetic intervention in association with the provision of the booklet (P nutrition showed a reduction in parenteral energy (P = 0.02), nitrogen (P = 0.003), volume (P = 0.02) and frequency (P = 0.003). A booklet for patients with intestinal failure in conjunction with personalised dietary counselling improves knowledge and clinical outcomes.

  11. Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India

    Directory of Open Access Journals (Sweden)

    Bhanu Devpura

    2016-01-01

    Full Text Available Objective. We explored reasons for discharged against medical advice (DAMA of neonates from a neonatal intensive care unit (NICU through in-depth interviews of the parents/guardians. Methods. Of 456 babies admitted to NICU during April 2014 to March 2015, 116 babies were DAMA. Parents of randomly selected 50 babies of these 116, residing within 50 kilometers, were approached for in-depth interviews at their homes. Audio recordings were done and manually transcribed, analyzed in detail to explore common threads leading to DAMA. Basic demographic information of the newborns was retrieved from hospital records. Results. The prevalence of DAMA was 25.4%. Of 50 parents approached, 41 in-depth interviews were completed. Nonaffordability (38.6%, no improvement (14.6%, poor prognosis (12%, and inappropriate behavior of the patient relation office personnel (10.6% were major factors contributing to DAMA. Parents of 6.6% neonates wanted guarantee of survival and 5.3% parents reported poor behavior of nurses. No gender bias was observed related to DAMA. One-third of neonates (34.1% were DAMA on first day of admission. Conclusions. The issue of DAMA needs attention. Besides nonaffordability and clinical characteristics of the baby, communication (breaking bad news, counseling, etc. and lack of adequate infrastructure for relatives emerged as modifiable factors leading to DAMA.

  12. Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India.

    Science.gov (United States)

    Devpura, Bhanu; Bhadesia, Pranav; Nimbalkar, Somashekhar; Desai, Sandeep; Phatak, Ajay

    2016-01-01

    Objective . We explored reasons for discharged against medical advice (DAMA) of neonates from a neonatal intensive care unit (NICU) through in-depth interviews of the parents/guardians. Methods . Of 456 babies admitted to NICU during April 2014 to March 2015, 116 babies were DAMA. Parents of randomly selected 50 babies of these 116, residing within 50 kilometers, were approached for in-depth interviews at their homes. Audio recordings were done and manually transcribed, analyzed in detail to explore common threads leading to DAMA. Basic demographic information of the newborns was retrieved from hospital records. Results . The prevalence of DAMA was 25.4%. Of 50 parents approached, 41 in-depth interviews were completed. Nonaffordability (38.6%), no improvement (14.6%), poor prognosis (12%), and inappropriate behavior of the patient relation office personnel (10.6%) were major factors contributing to DAMA. Parents of 6.6% neonates wanted guarantee of survival and 5.3% parents reported poor behavior of nurses. No gender bias was observed related to DAMA. One-third of neonates (34.1%) were DAMA on first day of admission. Conclusions . The issue of DAMA needs attention. Besides nonaffordability and clinical characteristics of the baby, communication (breaking bad news, counseling, etc.) and lack of adequate infrastructure for relatives emerged as modifiable factors leading to DAMA.

  13. Neonatal discharge against medical advice: Experience from a rural tertiary hospital in North Western Nigeria

    Directory of Open Access Journals (Sweden)

    Umma Idris Abdullahi

    2017-01-01

    Full Text Available Background: Discharge against medical advice (DAMA is a major public health issue, especially among children owing to its adverse outcome. The aim of this study is to determine the prevalence and reasons for DAMA among neonates admitted in Federal Medical Centre Birnin (FMCB Kudu, Jigawa State. Materials and Methods: This cross-sectional study was conducted over a period of 5 years in the Special Care Baby Unit of FMCB Kudu, Jigawa State. All the case folders of the neonate whose parents signed DAMA were retrieved, and relevant data were extracted. Results: There were 155 cases of neonatal DAMA during the study. Eighty-three were males (53.5% with an average duration of hospital stay of 4 ± 3.2 days with most DAMA occurring in the 1st week of admission. Neonatal infections, birth asphyxia, and prematurity were the most common diagnoses. Financial constraint was the major reason for DAMA. Fathers were the signatories in the majority of cases. Conclusion: DAMA is prevalent and is mainly due to socio-cultural and economic factors.

  14. The impact of repeated spirometry and smoking cessation advice on smokers with mild COPD.

    Science.gov (United States)

    Stratelis, Georgios; Mölstad, Sigvard; Jakobsson, Per; Zetterström, Olle

    2006-09-01

    Smoking cessation is the most important therapeutic intervention in patients with chronic obstructive pulmonary diseases (COPD) and the health benefits are immediate and substantial. Major efforts have been made to develop methods with high smoking cessation rates. To study whether a combination of spirometry and brief smoking cessation advice to smokers with COPD, annually for three years, increased their smoking cessation rate in comparison with groups of smokers with normal lung function. Prospective, randomized study in primary care. Smoking cessation rates were compared between smokers with COPD followed-up yearly over a period of three years and smokers with normal lung function followed-up yearly for three years or followed-up only once after three years. The point-prevalence abstinence rate and prolonged abstinence rate at 6 and 12 months increased yearly and in smokers with COPD at year 3 was 29%, 28%, and 25%, respectively. The abstinence rates were significantly higher in smokers with COPD than in smokers with normal lung function. Smoking cessation rates among smokers with normal lung function did not increase with increasing number of follow-ups. Smokers diagnosed with COPD stopped smoking significantly more often than those with normal lung function.

  15. A Word to the Wise: Advice for Scientists Engaged in Collaborative Adaptive Management.

    Science.gov (United States)

    Hopkinson, Peter; Huber, Ann; Saah, David S; Battles, John J

    2017-05-01

    Collaborative adaptive management is a process for making decisions about the environment in the face of uncertainty and conflict. Scientists have a central role to play in these decisions. However, while scientists are well trained to reduce uncertainty by discovering new knowledge, most lack experience with the means to mitigate conflict in contested situations. To address this gap, we drew from our efforts coordinating a large collaborative adaptive management effort, the Sierra Nevada Adaptive Management Project, to offer advice to our fellow environmental scientists. Key challenges posed by collaborative adaptive management include the confusion caused by multiple institutional cultures, the need to provide information at management-relevant scales, frequent turnover in participants, fluctuations in enthusiasm among key constituencies, and diverse definitions of success among partners. Effective strategies included a dedication to consistency, a commitment to transparency, the willingness to communicate frequently via multiple forums, and the capacity for flexibility. Collaborative adaptive management represents a promising, new model for scientific engagement with the public. Learning the lessons of effective collaboration in environmental management is an essential task to achieve the shared goal of a sustainable future.

  16. Self-discharge against medical advice from tertiary health institution: A call for concern.

    Science.gov (United States)

    Yusuf, Moruf Babatunde; Ogunlusi, Johnson Dare; Popoola, Sunday Ogunsuyi; Ogunlayi, Sheriff Olawale; Babalola, Waheed Olaide; Oluwadiya, Kehinde Sunday

    2017-01-01

    Self-discharge by patients without completing their treatment is a problematic issue in healthcare and is strongly associated with readmission and poor treatment outcome. A descriptive study of the rate and reasons why patients with limb injuries took self-discharge against medical advice (DAMA) from our facility, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria, a tertiary health institution between May 2011 and April 2014. One hundred and thirty-one (16.2%) patients took DAMA out of 810 patients seen with limb injuries. Age ranges from 3 to 95 years with a mean of 36.31 ± 19.34 years. Road traffic crash accounted for 110 (84%) of the injuries. One hundred and sixteen (88.5%) had fractures and 9 (6.9%) had soft tissue injuries. Fifty-eight (44.3%) of the patients were referred cases, 128 (97.7%) signed DAMA form while 3 (2.3%) absconded from the hospital. Reasons for DAMA were mainly; belief more in traditional bone setters (TBSs) (36.6%); pressure from relations (22.9%) and high cost of hospital care (19.8%). One hundred and one (77.1%) of the patients volunteered that they were going to TBS for continued care. High percentage of patients DAMA from our facility and majority of them were in favour of unorthodox form of treatment.

  17. "Against Medical Advice" Discharges Among HIV-Infected Patients: Health and Health Services Outcomes.

    Science.gov (United States)

    Alfandre, David; Yang, Jingyan; Harwood, Katherine; Gordon, Peter; Lekas, Helen-Maria; Chang, Steven J; Yin, Michael T

    Nurses are often first to identify and manage a patient leaving against medical advice (AMA), and so they are critical contributors to the development of strategies to address this problem. We studied AMA discharge in order to help develop useful interventions. We performed a cross-sectional analysis of 55,938 discharges from a single urban hospital for the years 2002-2003 and 2012-2013. AMA discharge rates were higher for HIV-infected patients than for patients with alcohol-related disorders or sickle cell anemia in both time periods, even after adjustment for age, race, sex, insurance status, and household income. For HIV infection, 25% of AMA discharges occurred in patients with multiple AMA discharges and 30-day readmission rates were higher after an AMA discharge: odds ratio 1.57 (95% confidence interval 1.01 to 2.43, p = .046). Team-based and nursing interventions that incorporate the treatment-based values and preferences of HIV-infected patients with prior AMA discharges may improve linkage to care and reduce readmissions. Published by Elsevier Inc.

  18. The use of a Swedish telephone medical advice service by the elderly – a population-based study

    Science.gov (United States)

    Dahlgren, K.; Holzmann, M. J.; Carlsson, A. C.; Wändell, P.; Hasselström, J.; Ruge, T.

    2017-01-01

    Objective The present study aimed to describe contact made by the elderly to Sweden’s nationwide medical helpline, Healthcare Guide 1177 by Phone (HGP). Other objectives were to study potential gender differences and the association between different HGP referral levels and acute visits to hospital-based emergency departments and acute visits to primary care centres. Design De-identified data from recorded calls to HGP was extracted for analysis (n = 7477 for the oldest age group). Information about acute visits to emergency departments and to primary care reception was extracted from the patient administration system. Setting Västerbotten County, Sweden. Subjects Patients over 80 years. Main outcome measures Calling and visiting frequencies for different age groups as well as reasons for contact and individual recommendations. Results The utilisation rate of the telephone advice service for the oldest age group was high, with an incidence rate of 533 per 1000 person-years. Women had a 1.17 times higher incidence rate compared with men. The most common reason for contact was drug-related questions (17% of all contacts). Calls that were recommended to care by a medical specialist correlated with total emergency department visits (r = 0.30, p advice correlated with acute primary healthcare visits (r = 0.38, p = 0.005). Conclusion The high utilisation of the telephone advice service by the elderly gives the telephone advice service a unique ability to function as a gatekeeper to further healthcare. Our data suggest that with the telephone advice service’s present guidelines, a significant proportion of all calls are being directed to further medical help. The high frequency of drug-related questions raises concerns about the elderly’s medication regimens. Key points Patients over 80 years of age had a high utilisation of the telephone medical advice service compared with other age groups. Drug-related questions were the most common reason for

  19. Who Do Hospital Physicians and Nurses Go to for Advice About Medications? A Social Network Analysis and Examination of Prescribing Error Rates.

    Science.gov (United States)

    Creswick, Nerida; Westbrook, Johanna Irene

    2015-09-01

    To measure the weekly medication advice-seeking networks of hospital staff, to compare patterns across professional groups, and to examine these in the context of prescribing error rates. A social network analysis was conducted. All 101 staff in 2 wards in a large, academic teaching hospital in Sydney, Australia, were surveyed (response rate, 90%) using a detailed social network questionnaire. The extent of weekly medication advice seeking was measured by density of connections, proportion of reciprocal relationships by reciprocity, number of colleagues to whom each person provided advice by in-degree, and perceptions of amount and impact of advice seeking between physicians and nurses. Data on prescribing error rates from the 2 wards were compared. Weekly medication advice-seeking networks were sparse (density: 7% ward A and 12% ward B). Information sharing across professional groups was modest, and rates of reciprocation of advice were low (9% ward A, 14% ward B). Pharmacists provided advice to most people, and junior physicians also played central roles. Senior physicians provided medication advice to few people. Many staff perceived that physicians rarely sought advice from nurses when prescribing, but almost all believed that an increase in communication between physicians and nurses about medications would improve patient safety. The medication networks in ward B had higher measures for density, reciprocation, and fewer senior physicians who were isolates. Ward B had a significantly lower rate of both procedural and clinical prescribing errors than ward A (0.63 clinical prescribing errors per admission [95%CI, 0.47-0.79] versus 1.81/ admission [95%CI, 1.49-2.13]). Medication advice-seeking networks among staff on hospital wards are limited. Hubs of advice provision include pharmacists, junior physicians, and senior nurses. Senior physicians are poorly integrated into medication advice networks. Strategies to improve the advice-giving networks between senior

  20. Source Water Protection Contaminant Sources

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — Simplified aggregation of potential contaminant sources used for Source Water Assessment and Protection. The data is derived from IDNR, IDALS, and US EPA program...

  1. Reconciling single-species TACs in the North Sea demersal fisheries using the Fcube mixed-fisheries advice framework

    DEFF Research Database (Denmark)

    Ulrich, Clara; Reeves, Stuart A.; Vermard, Youen

    2011-01-01

    be exhausted before the TAC of another, leading to catches of valuable fish that cannot be landed legally. This important issue is, however, usually not quantified and not accounted for in traditional management advice. A simple approach using traditional catch and effort information was developed, estimating...... in the North Sea and shaped into the advice framework. The substantial overquota catches of North Sea cod likely under the current fisheries regimes are quantified, and it is estimated that the single-species management targets for North Sea cod cannot be achieved unless substantial reductions in TACs of all......Single-species management is a cause of discarding in mixed fisheries, because individual management objectives may not be consistent with each other and the species are caught simultaneously in relatively unselective fishing operations. As such, the total allowable catch (TAC) of one species may...

  2. Willingness to Consult a Veterinarian on Physician's Advice for Zoonotic Diseases: A Formal Role for Veterinarians in Medicine?

    Science.gov (United States)

    Speare, Rick; Mendez, Diana; Judd, Jenni; Reid, Simon; Tzipori, Saul; Massey, Peter D

    2015-01-01

    Physicians appear to find zoonotic diseases a challenge and consider that this topic belongs more to the veterinary profession. However, veterinarians have no formal role in clinical medicine. Data were collected as part of the Queensland Social Survey 2014 to determine the willingness of the public, if diagnosed with a zoonotic disease, to consult a veterinarian on the advice of a physician. Self-reported willingness to consult with a veterinarian at the respondent's own expense was 79.8% (95% CI: 81.96%-77.46%) (976/1223). If the cost was funded by Medicare, the Australian public health insurance scheme, 90.7% (95% CI: 92.18%-88.92%) (1109/1223) would be willing to consult a veterinarian. Therefore, a large majority of Australian residents would be willing to consult with a veterinarian on the advice of their physician if they had a zoonotic disease. Does this indicate a possible new role for veterinarians under Clinical One Health?

  3. Factors associated with prevalence and types of 'may be fit' advice on fit notes: a cross-sectional primary care analysis.

    Science.gov (United States)

    Shiels, Chris; Gabbay, Mark; Hillage, Jim

    2014-03-01

    The 'fit note', with the opportunity for the GP to advise that a patient 'may be fit' to do some work, was introduced in April 2010. To estimate numbers of fit notes with 'may be fit' advice, the types of advice, and factors associated with any inclusion of such advice in the fit note. Cross-sectional analysis of fit note data from 68 general practices in eight regions of England, Wales and Scotland. Collection of practice fit note data via GP use of carbonised pads of fit notes for a period of 12 months. The 'may be fit' box was ticked on 5080 fit notes (6.4% of all fit notes in study). But there was a wide variation in completion rates across the 68 practices (from 1% to 15%). The most prevalent individual item of advice was to 'amend duties' of patient as a prerequisite for return to work (included in 42% of all notes containing any 'may be fit' advice). Advice was often incomplete or irrelevant, with some GPs failing to comply with official guidance. Inclusion of any 'may be fit' advice was independently associated with the patient being female, less socially deprived and having a physical health reason for receiving a fit note. Unlike other studies that have relied upon eliciting opinion, this study investigates how the fit note is being used in practice. Findings provide some evidence that the fit note is not yet being used to the optimum benefit of patients (and their employers).

  4. Self-reported feeding advice by physicians for common childhood illnesses.

    Science.gov (United States)

    Nizami, S Q; Bhutta, Z A

    1999-12-01

    A nutritious diet is important for recovery during illnesses. Dietary advice by physicians and consumption of food by the patients are often based upon their hot and cold concepts and beliefs about various foods rather than on scientific basis. To look at the food-advising behaviour of physicians during illnesses and to know the maternal concepts about various foods being hot or cold. A questionnaire was served to the physicians participating in a continuous medical education session held at the Aga Khan University and Hospital, asking them to write the foods they advise or restrict during different illnesses such as fever, jaundice etc. Mothers of sick children suffering from diarrhea and other illnesses were also interviewed to know their concepts about various foods. Six (10%) out of sixty physicians believed in hot and cold concepts of the food. A variety of common foods were either restricted or strongly recommended by 10% to 50% of these physicians without any scientific basis, 23% physicians restricted fatty foods in jaundice, 17% physicians restricted in cough and cold. Although the interviewed mothers believed in hot-cold concepts of food but 55-63% of them were not sure what is meant by hot or cold food. In spite of that 70-80% of these mothers classified chicken, meat, egg, brinjal, masoor and mangoes are hot foods and rice, yogurt, moong, banana and orange as cold foods. Hot-Cold concept of food exists not only in mothers but also in physicians. Proper education regarding food intake is mandatory for both mothers and physicians to ascertain adequate intake of calories during sickness.

  5. Personal features of children in client families who receive psychological advice

    Directory of Open Access Journals (Sweden)

    Sergey A. Kapustin

    2015-03-01

    Full Text Available The paper includes results of the research, where influence of main parenting styles on developing children’s personality and appearing child-parent problems were considered. It covers client families of psychological advice (with overprotection and over exactingness. It is indicated that the key factor emerging child-parent problems in this families is the abnormality of the parent personality identified through so-called existential criterion, which is displayed in their parenting styles. The parenting styles contribute to shaping child abnormal personality types, also identified through existential criteria are designated as “directed at external assistance”, “directed at complying with the requirements of other people” and “directed at protesting against compliance with the requirements of other people”. Children of such personality types have problems communicating with others as communication is addressed to children with normal personal development and is not relevant for abnormal personal abilities. As the problems mentioned above are connected with maladjustment to social environment requirements they can be classified as problems of social adaptation. There is a connection of a personality type “directed at complying with the requirements of other people” with abnormal personality predisposed to various life problems and mental disorders mentioned in the works of E. Fromm, S. Freud, A. Adler, С. Jung, C. Rogers, and V. Frankl. It suggests the understanding of the personality of this type to be regarded as a classical type of personality which the authors mentioned above were dealing with in their psychotherapeutic practice at different times.

  6. Primary health care providers' advice for a dental checkup and dental use in children.

    Science.gov (United States)

    Beil, Heather A; Rozier, R Gary

    2010-08-01

    In this study we estimated factors associated with children being advised to see the dentist by a doctor or other health provider; tested for an association between the advisement on the likelihood that the child would visit the dentist; and estimated the effect of the advisement on dental costs. We identified a sample of 5268 children aged 2 to 11 years in the 2004 Medical Expenditures Panel Survey. A cross-sectional analysis with logistic regression models was conducted to estimate the likelihood of the child receiving a recommendation for a dental checkup, and to determine its effect on the likelihood of having a dental visit. Differences in cost for children who received a recommendation were assessed by using a linear regression model. All analyses were conducted separately on children aged 2 to 5 (n = 2031) and aged 6 to 11 (n = 3237) years. Forty-seven percent of 2- to 5-year-olds and 37% of 6- to 11-year-olds had been advised to see the dentist. Children aged 2 to 5 who received a recommendation were more likely to have a dental visit (odds ratio: 2.89 [95% confidence interval: 2.16-3.87]), but no difference was observed among older children. Advice had no effect on dental costs in either age group. Health providers' recommendation that pediatric patients visit the dentist was associated with an increase in dental visits among young children. Providers have the potential to play an important role in establishing a dental home for children at an early age. Future research should examine potential interventions to increase effective dental referrals by health providers.

  7. Meeting Ontario's electricity needs : a critical review of the Ontario Power Authority's supply mix advice report

    International Nuclear Information System (INIS)

    Gibbons, J.; Fracassi, J.

    2006-01-01

    In December, 2005 the Ontario Power Authority (OPA) outlined its proposed blueprint for meeting Ontario's electricity needs to 2025 in the document entitled Supply Mix Advice Report. As a result of the actions taken by the current government, the OPA believes that Ontario will have adequate electricity supplies to meet the province's needs until 2013. However, it stated that Ontario will require an additional 15,000 megawatts of new generation capacity between 2013 and 2025. The OPA also recommends that a significant proportion of this new generation capacity be nuclear. The Ontario Clean Air Alliance undertook a review of the OPA report and identified several discrepancies including an over-estimation of Ontario's rate of electricity load growth from 2005 to 2025; an under-estimation of the potential for electricity productivity improvements to reduce electricity demand and raise living standards; an under-estimation of renewable energy supply potential; an under-estimation of the potential for biomass and natural gas fired combined heat and power plants to meet electricity needs and increase the competitiveness of Ontario's industries; an under-estimation of the economic costs and risks of nuclear power; and a biased recommendation for a 70 million dollar resource acquisition budget against energy efficiency investments that would reduce demand and raise living standards. This report provides the Ontario Clean Air Alliances' analysis of the OPA report and presents it own recommendations for how Ontario can increase its electricity productivity and meet its electricity supply needs until 2025. The report concluded that the Government of Ontario should direct the OPA to develop a long-term strategy to raise the price of electricity up to its full cost without raising the electricity bills of low income consumers or impairing the competitiveness of Ontario's industries. It was suggested that Ontario's electricity productivity should be increased to the same level as

  8. Getting hired: successfully employed people with disabilities offer advice on disclosure, interviewing, and job search.

    Science.gov (United States)

    Jans, Lita H; Kaye, H Stephen; Jones, Erica C

    2012-06-01

    Many people with disabilities want to work, but face employment barriers that have resulted in dismal employment rates. Successfully employed people with disabilities have valuable experience that can help others seeking employment, yet research literature provides little information about their strategies for discussing disabilities with employers and negotiating the hiring process. In five focus groups, 41 people competitively employed for at least 5 years discussed employment experiences related to their varied disabilities. The sample excluded people in disability-related jobs or self-employed. Data were coded and analyzed using a grounded theory method. Disclosure and discussion decisions were influenced by the nature of disability (visible, hidden, stigmatized, multiple), whether and when people needed accommodations, and the perceived "disability-friendliness" of organizations. Qualitative data analysis suggested guidelines for whether, when, and how to discuss disability, while acknowledging the complexity of decision-making depending on workplace culture and personal choices. Interview strategies included ways to emphasize strengths, gather information about duties and work environment, handle inappropriate questions, and address unspoken employer concerns. Participants gave disability-specific advice to help job-seekers balance their abilities and interests, and use networking and other approaches to find favorable opportunities. Concluding that people with disabilities must work harder than others to get a job, they described approaches and tools to help others achieve success. Findings suggest approaches to assist job-seekers to make decisions about disclosing or discussing their disability, present themselves in a straight-forward, disability-positive manner, and find satisfying work based on their skills and interests.

  9. Discharge Against Medical Advice in Traumatic Brain Injury: Follow-Up and Readmission Rate.

    Science.gov (United States)

    Marcoux, Judith; Alkutbi, Mohammad; Lamoureux, Julie; Feyz, Mitra; Saluja, Rajeet S; de Guise, Elaine

    2017-05-01

    Patients who leave hospital against medical advice (AMA) may be at risk of adverse health outcomes, medical complications, and readmission. In this study, we examined the characteristics of patients who left AMA after traumatic brain injury (TBI), their rates of follow-up visits, and readmission. We retrospectively studied 106 consecutive patients who left the tertiary trauma center AMA (1.8% of all admitted patients with a TBI). Preinjury health and social issues, mechanism of injury, computed tomography findings, and injury markers were collected. They were correlated to compliance with follow-up visits and unplanned emergency room (ER) visits and readmission rates. The most prevalent premorbid health or social-related issues were alcohol abuse (33%) and assault as a mechanism of trauma (33%). Only 15 (14.2%) subjects came to follow-up visit for their TBI. Sixteen (15.1%) of the 106 subjects had multiple readmissions and/or ER visits related to substance abuse. Seven (6.6%) had multiple readmissions or ER visits with psychiatric reasons. Those patients with multiple readmissions and ER visits showed in higher proportion preexisting neurological condition (p=0.027), homelessness (p=0.012), previous neurosurgery (p=0.014), preexisting encephalomalacia (p=0.011), and had a higher ISS score (p=0.014) than those who were not readmitted multiple times. The significantly increased risks of multiple follow-up visits and readmission among TBI patients who leave hospital AMA are related to a premorbid vulnerability and psychosocial issues. Clinicians should target AMA TBI patients with premorbid vulnerability for discharge transition interventions.

  10. Screening for cancer: advice for high-value care from the American College of Physicians.

    Science.gov (United States)

    Wilt, Timothy J; Harris, Russell P; Qaseem, Amir

    2015-05-19

    Cancer screening is one approach to reducing cancer-related morbidity and mortality rates. Screening strategies vary in intensity. Higher-intensity strategies are not necessarily higher value. High-value strategies provide a degree of benefits that clearly justifies the harms and costs incurred; low-value screening provides limited or no benefits to justify the harms and costs. When cancer screening leads to benefits, an optimal intensity of screening maximizes value. Some aspects of screening practices, especially overuse and underuse, are low value. Screening strategies for asymptomatic, average-risk adults for 5 common types of cancer were evaluated by reviewing clinical guidelines and evidence syntheses from the American College of Physicians (ACP), U.S. Preventive Services Task Force, American Academy of Family Physicians, American Cancer Society, American Congress of Obstetricians and Gynecologists, American Gastroenterological Association, and American Urological Association. "High value" was defined as the lowest screening intensity threshold at which organizations agree about screening recommendations for each type of cancer and "low value" as agreement about not recommending overly intensive screening strategies. This information is supplemented with additional findings from randomized, controlled trials; modeling studies; and studies of costs or resource use, including information found in the National Cancer Institute's Physician Data Query and UpToDate. The ACP provides high-value care screening advice for 5 common types of cancer; the specifics are outlined in this article. The ACP strongly encourages clinicians to adopt a cancer screening strategy that focuses on reaching all eligible persons with these high-value screening options while reducing overly intensive, low-value screening.

  11. Advice from Moral Experts: An Assessment of the European Group on Ethics in Science and New Technologies (EGE)

    OpenAIRE

    Hegstad, Eilev

    2016-01-01

    Moral experts – people who presumably know more about moral issues than others – play an important role in giving advice to governments on how to deal with ethical questions through ethics committees. The existence of these committees raises fundamental normative questions concerning the limits and the legitimate role of moral experts in decision-making processes. It is contested whether moral expertise exists. However, it is difficult to have any meaningful understanding of these institution...

  12. Goal conflict, goal facilitation, and health professionals' provision of physical activity advice in primary care: an exploratory prospective study.

    Science.gov (United States)

    Presseau, Justin; Francis, Jill J; Campbell, Neil C; Sniehotta, Falko F

    2011-07-15

    The theory of planned behaviour has well-evidenced utility in predicting health professional behaviour, but focuses on a single behaviour isolated from the numerous potentially conflicting and facilitating goal-directed behaviours performed alongside. Goal conflict and goal facilitation may influence whether health professionals engage in guideline-recommended behaviours, and may supplement the predictive power of the theory of planned behaviour. We hypothesised that goal facilitation and goal conflict contribute to predicting primary care health professionals' provision of physical activity advice to patients with hypertension, over and above predictors of behaviour from the theory of planned behaviour. Using a prospective predictive design, at baseline we invited a random sample of 606 primary care health professionals from all primary care practices in NHS Grampian and NHS Tayside (Scotland) to complete postal questionnaires. Goal facilitation and goal conflict were measured alongside theory of planned behaviour constructs at baseline. At follow-up six months later, participants self-reported the number of patients, out of those seen in the preceding two weeks, to whom they provided physical activity advice. Forty-four primary care physicians and nurses completed measures at both time points (7.3% response rate). Goal facilitation and goal conflict improved the prediction of behaviour, accounting for substantial additional variance (5.8% and 8.4%, respectively) in behaviour over and above intention and perceived behavioural control. Health professionals' provision of physical activity advice in primary care can be predicted by perceptions about how their conflicting and facilitating goal-directed behaviours help and hinder giving advice, over and above theory of planned behaviour constructs. Incorporating features of multiple goal pursuit into the theory of planned behaviour may help to better understand health professional behaviour.

  13. The use of a Swedish telephone medical advice service by the elderly - a population-based study.

    Science.gov (United States)

    Dahlgren, K; Holzmann, M J; Carlsson, A C; Wändell, P; Hasselström, J; Ruge, T

    2017-03-01

    The present study aimed to describe contact made by the elderly to Sweden's nationwide medical helpline, Healthcare Guide 1177 by Phone (HGP). Other objectives were to study potential gender differences and the association between different HGP referral levels and acute visits to hospital-based emergency departments and acute visits to primary care centres. De-identified data from recorded calls to HGP was extracted for analysis (n = 7477 for the oldest age group). Information about acute visits to emergency departments and to primary care reception was extracted from the patient administration system. Västerbotten County, Sweden. Patients over 80 years. Calling and visiting frequencies for different age groups as well as reasons for contact and individual recommendations. The utilisation rate of the telephone advice service for the oldest age group was high, with an incidence rate of 533 per 1000 person-years. Women had a 1.17 times higher incidence rate compared with men. The most common reason for contact was drug-related questions (17% of all contacts). Calls that were recommended to care by a medical specialist correlated with total emergency department visits (r = 0.30, p elderly gives the telephone advice service a unique ability to function as a gatekeeper to further healthcare. Our data suggest that with the telephone advice service's present guidelines, a significant proportion of all calls are being directed to further medical help. The high frequency of drug-related questions raises concerns about the elderly's medication regimens. Key points Patients over 80 years of age had a high utilisation of the telephone medical advice service compared with other age groups. Drug-related questions were the most common reason for contact. A significant proportion of all calls made resulted in further heatlhcare contacts.

  14. The effect of antenatal dietary and lifestyle advice for women who are overweight or obese on emotional well-being: the LIMIT randomized trial.

    Science.gov (United States)

    Dodd, Jodie M; Newman, Angela; Moran, Lisa J; Deussen, Andrea R; Grivell, Rosalie M; Yelland, Lisa N; Crowther, Caroline A; McPhee, Andrew J; Wittert, Gary; Owens, Julie A; Turnbull, Deborah; Robinson, Jeffrey S

    2016-03-01

    Our aim was to evaluate the effect of dietary and lifestyle advice given to women who were overweight or obese during pregnancy on maternal quality of life, anxiety and risk of depression, and satisfaction with care. We conducted a randomized trial, involving pregnant women with body mass index ≥25 kg/m(2) , recruited from maternity units in South Australia. Women were randomized to Lifestyle Advice or Standard Care, and completed questionnaires assessing risk of depression (Edinburgh Postnatal Depression Scale), anxiety (Spielberger State-Trait Anxiety Inventory), and quality of life (SF-36) at trial entry, 28 and 36 weeks' gestation, and 4 months postpartum. Secondary trial outcomes assessed for this analysis were risk of depression, anxiety, maternal quality of life, and satisfaction with care. One or more questionnaires were completed by 976 of 1108 (90.8%) women receiving Lifestyle Advice and 957 of 1104 (89.7%) women receiving Standard Care. The risk of depression [adjusted risk ratio 1.01; 95% confidence interval (CI) 0.82-1.24; p = 0.95], anxiety (adjusted risk ratio 1.09; 95% CI 0.93-1.27; p = 0.31), and health-related quality of life were similar between the two groups. Women receiving Lifestyle Advice reported improved healthy food choice [Lifestyle Advice 404 (68.9%) vs. Standard Care 323 (51.8%); p Lifestyle Advice 444 (75.8%) vs. Standard Care 367 (58.8%); p Lifestyle Advice 499 (85.3%) vs. Standard Care 485 (77.9%); p = 0.0112], and health of their baby [Lifestyle Advice 527 (90.2%) vs. Standard Care 545 (87.6%); p = 0.0143]. Lifestyle advice in pregnancy improved knowledge and provided reassurance without negatively impacting well-being. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Lifestyle Advice and Self-Care Integral to Acupuncture Treatment for Patients with Chronic Neck Pain: Secondary Analysis of Outcomes Within a Randomized Controlled Trial.

    Science.gov (United States)

    MacPherson, Hugh; Elliot, Ben; Hopton, Ann; Lansdown, Harriet; Birch, Stephen; Hewitt, Catherine

    2017-03-01

    Lifestyle advice is widely considered as an integral component of acupuncture treatment. However, it is unclear whether lifestyle advice and related self-care are important for sustaining benefit over the longer term. In a novel secondary analysis of trial data, this paper explores the nature and impact of acupuncture-related diagnosis, and associated lifestyle advice and self-care, in patients with chronic neck pain. In a three-arm, randomized, controlled multicenter trial with 12 months of follow-up, a total of 517 patients with chronic neck pain were randomized in equal proportions to acupuncture, Alexander technique, or usual care alone. For each acupuncture patient, practitioners reported treatment components that included an acupuncture-related diagnosis and provision of associated lifestyle advice. Patients reported at baseline, 3, 6, and 12 months on variables related to treatment, which included aspects of self-care, self-efficacy, and lifestyle advice acted upon, as well as pain and disability scores. Congruence between practitioner advice and patient take-up was assessed using chi-squared test. Impact of lifestyle advice and self-efficacy on outcome was evaluated using regression models. Among patients randomized to acupuncture, the most common diagnostic framework involved the Zang-Fu syndromes for 139/160 (87%) patients. Lifestyle advice was provided by practitioners to 134/160 (84%) of patients, most commonly related to exercise, relaxation, diet, rest, and work. Significant congruence with patient take-up was found for diet, rest, and work. Moreover, patients in the acupuncture group improved their ability to use what they had learnt and increased their self-efficacy. In turn, these characteristics were associated with significant reductions in pain and disability scores at 12 months. Acupuncture-related lifestyle advice helped patients improve the way they live and care for themselves and enhanced self-efficacy and ability to use what they had

  16. The traditional food of migrants: Meat, water, and other challenges for dietary advice. An ethnography in Guanajuato, Mexico.

    Science.gov (United States)

    Smith-Morris, Carolyn

    2016-10-01

    The term "traditional diet" is used variously in public health and nutrition literature to refer to a substantial variety of foodways. Yet it is difficult to draw generalities about dietary tradition for specific ethnic groups. Given the strong association between migration and dietary change, it is particularly important that dietary advice for migrants be both accurate and specific. In this article, I examine the cultural construct of "traditional foods" through mixed method research on diet and foodways among rural farmers in Guanajuato, MX and migrants from this community to other Mexican and U.S. destinations. Findings reveal first, that quantitatively salient terms may contain important variation, and second, that some "traditional" dietary items -like "refresco," "carne," and "agua" - may be used in nutritionally contradictory ways between clinicians and Mexican immigrant patients. Specifically, the term "traditional food" in nutritional advice for Mexican migrants may be intended to promote consumption of fresh produce or less meat; but it may also invoke other foods (e.g., meats or corn), inspire more regular consumption of formerly rare foods (e.g., meats, flavored waters), or set up financially impossible goals (e.g., leaner meats than can be afforded). Salience studies with ethnographic follow up in target populations can promote the most useful and accurate terms for dietary advice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Maternal Assessment of Physician Qualification to Give Advice on AAP-Recommended Infant Sleep Practices Related to SIDS

    Science.gov (United States)

    Smith, Lauren A.; Colson, Eve R.; Rybin, Denis; Margolis, Amy; Colton, Theodore; Lister, George; Corwin, Michael J.

    2011-01-01

    Objective The American Academy of Pediatrics (AAP) strongly recommends the supine-only sleep position for infants and issued 2 more sudden infant death syndrome (SIDS) reduction recommendations: avoid bed sharing and use pacifiers during sleep. In this study, we investigated the following: 1) if mothers from at risk populations rate physicians as qualified to give advice about sleep practices and 2) if these ratings were associated with reports of recommended practice. Methods A cross-sectional survey of mothers (N = 2355) of infants aged pacifier during sleep.” Results Physician qualification ratings varied by topic: sleep position (80%), bed sharing (69%), and pacifier use (60%). High ratings of physician qualification were associated with maternal reports of recommended behavior: supine sleep (adjusted odds ratio [AOR] 2.1, 95% confidence interval [CI], 1.6–2.6); usually no bed sharing (AOR 1.5, 95% CI, 1.2–1.9), and usually use a pacifier during sleep (AOR 1.2, 95% CI, 1.0–1.5). Conclusions High maternal ratings of physician qualification to give advice on 2 of the 3 recommended sleep practices targeted to reduce the risk of SIDS were significantly associated with maternal report of using these behaviors. Lower ratings of physician qualification to give advice about these sleep practices may undermine physician effectiveness in promoting the recommended behavior. PMID:21075318

  18. DISCHARGE AGAINST MEDICAL ADVICE (DAMA AMONG THE PAEDIATRIC AGE GROUP IN ENUGU STATE UNIVERSITY TEACHING HOSPITAL PARKLANE, ENUGU.

    Directory of Open Access Journals (Sweden)

    2016-11-01

    Full Text Available Discharge against medical advice (DAMA can be defined as a situation in which a patient chooses to leave the hospital before the managing physician recommends discharge. It presents a peculiar challenge amongst the pediatric population because children are dependent on their parents or care givers for decisions regarding healthcare. Understanding the risks and reasons for DAMA is important for health system policy and the proactive management of those at risk of DAMA. This was a retrospective study that reviewed the medical records of children aged one day to 17 years discharged against medical advice in the Paediatrics Department of ESUTH, over a three-year period from 1st January, 2013 to 31st December, 2015.A total of 5464 patients were admitted into CHER, Newborn and the Children\\'s wards during the study period. Out of these, 170 patients, representing 3.1%, were DAMA. Among the age groups, DAMA was more common amongst infants (45.6%. Malaria was the most common condition on discharge against medical advice (20.1% followed by pneumonia (15.7% and sepsis (12.3%.All the patients had evidence of signed documentation in the form of a signed entry in the case files. There was no alternative treatment plan offered to 111 (97.4% cases and no option for follow up in 109 (95.6%. We recommend that the current documentation for DAMA as a signed entry in the case notes should be reviewed.

  19. A systematic review and meta-analysis of nutrition therapy compared with dietary advice in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Møller, Grith; Andersen, Henning Keinke; Snorgaard, Ole

    2017-01-01

    Background: Despite recommendations, many patients with type 2 diabetes receive dietary advice from nurses or doctors instead of individualized nutrition therapy (INT) that is provided by a dietitian. Objective: We performed a meta-analysis to compare the effect of INT that is provided by a regis......Background: Despite recommendations, many patients with type 2 diabetes receive dietary advice from nurses or doctors instead of individualized nutrition therapy (INT) that is provided by a dietitian. Objective: We performed a meta-analysis to compare the effect of INT that is provided......) that assessed the outcomes glycated hemoglobin (HbA1c), weight, body mass index (BMI; in kg/m2), and LDL cholesterol. Risk of bias and the quality of evidence were assessed according to the Grading of Recommendations Assessment, Development and Evaluation guidelines. Results: We identified 5 RCTs comprising 912...... participants in total. In the first year of intervention (at 6 or 12 mo), nutrition therapy compared with dietary advice was followed by a 0.45% (95% CI: 0.36%, 0.53%) lower mean difference in HbA1c, a 0.55 (95% CI: 0.02, 1.1) lower BMI, a 2.1-kg (95% CI: 1.2-, 2.9-kg) lower weight, and a 0.17-mmol/L (95% CI...

  20. Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary

    Directory of Open Access Journals (Sweden)

    Beto JA

    2016-02-01

    Full Text Available Judith A Beto, Katherine A Schury, Vinod K Bansal Division of Nephrology and Hypertension, Loyola University Healthcare System, Loyola University of Chicago, Maywood, IL, USA Abstract: Chronic kidney disease (CKD requires extensive changes to food and lifestyle. Poor adherence to diet, medications, and treatments has been estimated to vary between 20% and 70%, which in turn can contribute to increased mortality and morbidity. Delivering effective nutritional advice in patients with CKD coordinates multiple diet components including calories, protein, sodium, potassium, calcium, phosphorus, and fluid. Dietary intake studies have shown difficulty in adhering to the scope and complexity of the CKD diet parameters. No single educational or clinical strategy has been shown to be consistently effective across CKD populations. Highest adherence has been observed when both diet and education efforts are individualized to each patient and adapted over time to changing lifestyle and CKD variables. This narrative review and commentary summarizes nutrition education literature and published strategies for providing nutritional advice in CKD. A cohort of practical and effective strategies for increasing dietary adherence to nutritional advice are provided that include communicating with "talking control" principles, integrating patient-owned technology, acknowledging the typical food pattern may be snacking rather than formal meals, focusing on a single goal rather than multiple goals, creating active learning and coping strategies (frozen sandwiches, visual hands-on activities, planting herb gardens, and involving the total patient food environment. Keywords: talking control, technology-enhanced learning, hemodialysis, nutrition education, education strategies