WorldWideScience

Sample records for providing supplemental appropriations

  1. 78 FR 66841 - Israel Loan Guarantees Issued Under the Emergency Wartime Supplemental Appropriations Act of 2003...

    Science.gov (United States)

    2013-11-07

    ... DEVELOPMENT 22 CFR Part 230 Israel Loan Guarantees Issued Under the Emergency Wartime Supplemental... and conditions applicable to loan guarantees issued for the benefit of the Government of Israel on behalf of the State of Israel. Pursuant to the Emergency Wartime Supplemental Appropriations Act of 2003...

  2. Providing Culturally Appropriate Care to American Muslims With Cancer.

    Science.gov (United States)

    Mataoui, Fatma; Kennedy Sheldon, Lisa

    2016-02-01

    Worldwide, Islam is the second most populous religion and, in many countries in the Middle East, South and Southeast Asia, and Africa, it is the predominant religion. The population of Muslims in the United States is projected to dramatically increase in the next few decades. Understanding the role of Islam for people who believe in and follow Islam-Muslims-will provide nurses with important perspectives that affect health behaviors, cancer screening, treatment decision-making, and end-of-life care.
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  3. 40 CFR 35.910-7 - Fiscal Year 1977 Supplemental Appropriations Act allotments.

    Science.gov (United States)

    2010-07-01

    ... Construction of Publicly Owned Waste Water Treatment Facilities—1974 Needs Survey”; (3) 25 percent on each... Treatment Works-Clean Water Act § 35.910-7 Fiscal Year 1977 Supplemental Appropriations Act allotments. (a... (secondary treatment, more stringent treatment required to meet water quality standards, and interceptor...

  4. Importance of body weight and skin color in determining appropriate vitamin D3 supplement doses for children and adolescents.

    Science.gov (United States)

    Weishaar, Tom; Rajan, Sonali

    2015-02-01

    Deficiencies in vitamin D directly impact children's health and place minority and obese youth at risk for a range of health issues. The Institute of Medicine (IOM) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium has set both a recommended daily allowance (RDA) for vitamin D supplementation and a population-wide sufficiency target for the biomarker of vitamin D status, serum 25-hydroxyvitamin D (25(OH)D). However, new research suggests that the RDA is not sufficient to meet the target biomarker status for individuals who are heavy or who have dark skin. Our objective was to provide appropriate daily vitamin D supplementation levels for these individuals. Using data derived from the National Health and Nutrition Examination Survey (NHANES) and a recently published dosing formula, we calculated the required supplemental dose of vitamin D to meet the IOM target in children and adolescents. To be sure that 95% of the target population meets the IOM's population-wide biomarker target, some individuals require a daily dose of up to 2,000 international units (IUs) of supplemental vitamin D. Health professionals should work with their patients to encourage lifelong vitamin D supplement use at a dosage sufficient to obtain adequate 25(OH)D levels.

  5. Providing Appropriate Technology for Emerging Markets: Case Study on China’s Solar Thermal Industry

    Directory of Open Access Journals (Sweden)

    Jianghua Zhou

    2017-01-01

    Full Text Available Building on a case study of five Chinese solar thermal companies and one association, our study aims to understand how the innovator’s choices regarding the use of technology and organizational practices for new product development enable companies to design and diffuse appropriate technology in emerging markets. The study uncovers two critical factors that enhance the appropriateness of technology: redefining the identity of technology and building a local supply system. Our analysis shows that synergic innovation in both architecture and component leads to the appropriate functionalities desired by emerging markets. Moreover, modular design and the building of a local supply system enhance the process appropriateness of technology. Our study provides an empirical basis for advocating going beyond minor adaptations of existing products to creating appropriate technology for emerging markets, and extends our understandings of the upstream process of designing appropriate technology. Moreover, the emphasis on the local supply system reflects a holistic framework for shaping and delivering appropriate technology, expanding the existing research focus on the perspective of the technology itself. Our research also has managerial implications that may help firms tap into emerging markets.

  6. Interventions to provide culturally-appropriate maternity care services: factors affecting implementation.

    Science.gov (United States)

    Jones, Eleri; Lattof, Samantha R; Coast, Ernestina

    2017-08-31

    The World Health Organization recently made a recommendation supporting 'culturally-appropriate' maternity care services to improve maternal and newborn health. This recommendation results, in part, from a systematic review we conducted, which showed that interventions to provide culturally-appropriate maternity care have largely improved women's use of skilled maternity care. Factors relating to the implementation of these interventions can have implications for their success. This paper examines stakeholders' perspectives and experiences of these interventions, and facilitators and barriers to implementation; and concludes with how they relate to the effects of the interventions on care-seeking outcomes. We based our analysis on 15 papers included in the systematic review. To extract, collate and organise data on the context and conditions from each paper, we adapted the SURE (Supporting the Use of Research Evidence) framework that lists categories of factors that could influence implementation. We considered information from the background and discussion sections of papers included in the systematic review, as well as cost data and qualitative data when included. Women's and other stakeholders' perspectives on the interventions were generally positive. Four key themes emerged in our analysis of facilitators and barriers to implementation. Firstly, interventions must consider broader economic, geographical and social factors that affect ethnic minority groups' access to services, alongside providing culturally-appropriate care. Secondly, community participation is important in understanding problems with existing services and potential solutions from the community perspective, and in the development and implementation of interventions. Thirdly, respectful, person-centred care should be at the core of these interventions. Finally, cohesiveness is essential between the culturally-appropriate service and other health care providers encountered by women and their

  7. Social models provide a norm of appropriate food intake for young women.

    Directory of Open Access Journals (Sweden)

    Lenny R Vartanian

    Full Text Available It is often assumed that social models influence people's eating behavior by providing a norm of appropriate food intake, but this hypothesis has not been directly tested. In three experiments, female participants were exposed to a low-intake model, a high-intake model, or no model (control condition. Experiments 1 and 2 used a remote-confederate manipulation and were conducted in the context of a cookie taste test. Experiment 3 used a live confederate and was conducted in the context of a task during which participants were given incidental access to food. Participants also rated the extent to which their food intake was influenced by a variety of factors (e.g., hunger, taste, how much others ate. In all three experiments, participants in the low-intake conditions ate less than did participants in the high-intake conditions, and also reported a lower perceived norm of appropriate intake. Furthermore, perceived norms of appropriate intake mediated the effects of the social model on participants' food intake. Despite the observed effects of the social models, participants were much more likely to indicate that their food intake was influenced by taste and hunger than by the behavior of the social models. Thus, social models appear to influence food intake by providing a norm of appropriate eating behavior, but people may be unaware of the influence of a social model on their behavior.

  8. Key Factors for Providing Appropriate Medical Care in Secondary School Athletics: Athletic Training Services and Budget

    Science.gov (United States)

    Wham, George S.; Saunders, Ruth; Mensch, James

    2010-01-01

    Abstract Context: Research suggests that appropriate medical care for interscholastic athletes is frequently lacking. However, few investigators have examined factors related to care. Objective: To examine medical care provided by interscholastic athletics programs and to identify factors associated with variations in provision of care. Design: Cross-sectional study. Setting: Mailed and e-mailed survey. Patients or Other Participants: One hundred sixty-six South Carolina high schools. Intervention(s): The 132-item Appropriate Medical Care Assessment Tool (AMCAT) was developed and pilot tested. It included 119 items assessing medical care based on the Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement and Monograph (test-retest reliability: r  =  0.89). Also included were items assessing potential influences on medical care. Presence, source, and number of athletic trainers; school size; distance to nearest medical center; public or private status; sports medicine supply budget; and varsity football regional championships served as explanatory variables, whereas the school setting, region of state, and rate of free or reduced lunch qualifiers served as control variables. Main Outcome Measure(s): The Appropriate Care Index (ACI) score from the AMCAT provided a quantitative measure of medical care and served as the response variable. The ACI score was determined based on a school's response to items relating to AMCSSAA guidelines. Results: Regression analysis revealed associations with ACI score for athletic training services and sports medicine supply budget (both P sports medicine supply budget. Conclusions: The AMCAT offers an evaluation of medical care provided by interscholastic athletics programs. In South Carolina schools, athletic training services and the sports medicine supply budget were associated with higher levels of medical care. These results offer guidance for improving the medical care provided for

  9. Key factors for providing appropriate medical care in secondary school athletics: athletic training services and budget.

    Science.gov (United States)

    Wham, George S; Saunders, Ruth; Mensch, James

    2010-01-01

    Research suggests that appropriate medical care for interscholastic athletes is frequently lacking. However, few investigators have examined factors related to care. To examine medical care provided by interscholastic athletics programs and to identify factors associated with variations in provision of care. Cross-sectional study. Mailed and e-mailed survey. One hundred sixty-six South Carolina high schools. The 132-item Appropriate Medical Care Assessment Tool (AMCAT) was developed and pilot tested. It included 119 items assessing medical care based on the Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement and Monograph (test-retest reliability: r = 0.89). Also included were items assessing potential influences on medical care. Presence, source, and number of athletic trainers; school size; distance to nearest medical center; public or private status; sports medicine supply budget; and varsity football regional championships served as explanatory variables, whereas the school setting, region of state, and rate of free or reduced lunch qualifiers served as control variables. The Appropriate Care Index (ACI) score from the AMCAT provided a quantitative measure of medical care and served as the response variable. The ACI score was determined based on a school's response to items relating to AMCSSAA guidelines. Regression analysis revealed associations with ACI score for athletic training services and sports medicine supply budget (both P athletic trainer and the size of the sports medicine supply budget. The AMCAT offers an evaluation of medical care provided by interscholastic athletics programs. In South Carolina schools, athletic training services and the sports medicine supply budget were associated with higher levels of medical care. These results offer guidance for improving the medical care provided for interscholastic athletes.

  10. 75 FR 71448 - Notice of Intent To Provide Supplemental Funding

    Science.gov (United States)

    2010-11-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND...). The goal of this supplemental is a program expansion for one award to include direct Medicare fraud... fraud, error and abuse. The Centers for Medicare & Medicaid Services data has revealed that Medicare...

  11. Complex Dietary Supplements from Raw Plants Provide Nutrition for Athletes

    Directory of Open Access Journals (Sweden)

    Dmitriy M. Uvarov

    2017-03-01

    Full Text Available The aim of this study was to investigate the effectiveness of mechanically activated complexes from plant substances to enhance athletes’ adaptability to intense physical activity. Methods: The object of the study was the dietary supplement Kladorod, which is based on the reindeer lichen Cladonia rangiferina and Rhodiola rosea in weight ratio of 10:1. To test the dietary supplement, we developed a special scheme for the experiment and selected 10 elite athletes (boxers and mixfighters. Athletes were divided into 2 groups and were under the same conditions (nutrition, medical monitoring, living conditions and training process. Athletes of the experimental group were given the dietary supplement Kladorod (capsule of 0.4 g by mouth between meals 4 times a day for 28 days. The control group was given placebo (Ringer-Locke powder capsules in the same terms in a similar way. During the experiment, the athletes were medically examined 3 times: at the beginning, in the middle, and after the course of intervention. We measured muscle performance, fat mass, muscle mass, and serum concentrations of cortisol and total testosterone. Results: It was established that during the intensive training of boxers and mixfighters for rating fights, administration of the dietary supplement Kladorod for 28 days stabilized the absolute and relative muscle mass, preventing its reduction, in comparison with the placebo group. At the same time, indicators of fat mass decreased significantly in the experimental group. After administering the course of Kladorod, we did not observe a significant decrease in testosterone/cortisol ratio, compared to the control group Thus, the use of biologically active supplements based on lichen raw materials and complexes of lichen raw materials with different plant substances enables the body to increase its adaptive potential and physical capacity.

  12. Do water quality criteria based on nonnative species provide appropriate protection for native species?

    Science.gov (United States)

    Jin, Xiaowei; Wang, Zijian; Wang, Yeyao; Lv, Yibing; Rao, Kaifeng; Jin, Wei; Giesy, John P; Leung, Kenneth M Y

    2015-08-01

    The potential use of toxicity data for nonnative species to derive water quality criteria is controversial because it is sometimes questioned whether criteria based on species from one geographical region provide appropriate protection for species in a different region. However, this is an important concept for the development of Chinese water quality criteria or standards. Data were assembled on 38 chemicals for which values were available for both native and nonnative species. Sensitivities of these organisms were compared based on the 5% hazardous concentration values and the species sensitivity distribution from a literature review. Results of the present study's analysis showed that there is approximately 74% certainty that use of nonnative species to generate water quality criteria would be sufficiently protective of aquatic ecosystems in China. Without applying any assessment factor to the water quality criteria generated from nonnative species, the uncertainty would be 26% when the native Chinese species might be under protection. Applying an assessment factor of 10 would offer adequate protection to native Chinese species for approximately 90% of tested chemicals and thus reduce the uncertainty from 26% to 10%. © 2015 SETAC.

  13. Supplementing energy demand of rural households in Bangladesh through appropriate biogas technology

    DEFF Research Database (Denmark)

    Ashekuzzaman, S.M.; Badruzzaman, A.B.M.; Rafiqul Hoque, A.T.M.

    2010-01-01

    This paper has sought to show the potential of energy recovery from rurally available agro and household organic wastes and thus, the possible impact on supplementing energy demand, reducing deforestation, and replacing fossil fuel as well as avoided greenhouse gases. Results show that co...... of sustainable waste management, reducing deforestation as well as replacing fossil fuels....

  14. Supplemental Educational Services: An Action Science Research Study of Achieving State Standards for Provider Effectiveness

    Science.gov (United States)

    McClintock, Cynthia Collette

    2012-01-01

    Supplemental educational services are designed to contribute tremendous support to local school districts and communities through state-approved provider programs. The state, however, prior to approving supplemental educational services provider programs, must utilize all available resources to assist in the process of screening and approving…

  15. Herbal and dietary supplement disclosure to health care providers by individuals with chronic conditions.

    Science.gov (United States)

    Mehta, Darshan H; Gardiner, Paula M; Phillips, Russell S; McCarthy, Ellen P

    2008-12-01

    Very little is known about herbal and dietary supplement disclosure in adults with chronic medical conditions, especially on a national level. To examine herbal and dietary supplement disclosure to conventional health care providers by adults with chronic medical conditions. Data on herbal and dietary supplement use (N = 5456 users) in the previous year were used from the 2002 National Health Interview Survey. Bi-variable analyses compared characteristics between herbal and dietary supplement disclosers and nondisclosers. Multivariable logistic regression identified independent correlates of herbal and dietary supplement disclosure. Overall, only 33% of herbal and dietary supplement users reported disclosing use of herbal and dietary supplements to their conventional health care provider. Among herbal and dietary supplement users with chronic conditions, less than 51% disclosed use to their conventional health care provider. Hispanic (adjusted odds ratio and 95% confidence interval = 0.70 [0.52, 0.94]) and Asian American (adjusted odds ratio and 95% confidence interval = 0.54 [0.33, 0.89]) adults were much less likely than non-Hispanic white Americans to disclose herbal and dietary supplement use. Having less than a high school education (adjusted odds ratio and 95% confidence interval = 0.61 [0.45, 0.82]) and not having insurance (adjusted odds ratio and 95% confidence interval = 0.77 [0.59, 1.00]) were associated with being less likely to disclose herbal and dietary supplement use. Herbal and dietary supplement disclosure rates are low, even among adults with chronic conditions. These findings raise concerns about the safety of herbal and dietary supplements in combination with allopathic care. Future studies should focus on educating physicians about crosscultural care as well as eliciting information about herbal and dietary supplement use.

  16. Providing Supplemental Counseling Experiences: Alternatives to Role-Playing.

    Science.gov (United States)

    Hazler, Richard J.; Singer, Mark J.

    This paper offers a rationale and introduction to three innovative techniques which provide initial counseling experiences to trainees in the helping professions. The development of a cooperative program with the drama department to train and utilize drama students as coached clients is described as the first technique. The second technique is…

  17. FY2005 Supplemental Appropriations for Iraq and Afghanistan, Tsunami Relief, and Other Activities

    National Research Council Canada - National Science Library

    Belasco, Amy; Nowels, Larry

    2005-01-01

    ... (subsequently amended to total $82.04 billion) to provide funds for ongoing military operations in Iraq and Afghanistan, the global war on terror, reconstruction in Afghanistan, Tsunami relief and rehabilitation, and other activities...

  18. FY2005 Supplemental Appropriations for Iraq and Afghanistan, Tsunami Relief, and Other Activities

    Science.gov (United States)

    2005-05-12

    biodiversity of the Galapagos. (p. 3881) Approved (UC) Kohl (No. 380) Increases from $150 million to $470 million food aid. (p. S3966-68; S3970...control aid for Morocco , a close U.S. ally; poverty-focused assistance for El Salvador, a country that has deployed troops to Iraq; judicial reform...Senate-reported bill provided $40 million for the Partners Fund, urging support for Yemen, the Krygyz Republic, Morocco , El Salvador, Mongolia, and

  19. Pollination services provided by bees in pumpkin fields supplemented with either Apis mellifera or Bombus impatiens or not supplemented.

    Science.gov (United States)

    Petersen, Jessica D; Reiners, Stephen; Nault, Brian A

    2013-01-01

    Pollinators provide an important service in many crops. Managed honey bees (Apis mellifera L.) are used to supplement pollination services provided by wild bees with the assumption that they will enhance pollination, fruit set and crop yield beyond the levels provided by the wild bees. Recent declines in managed honey bee populations have stimulated interest in finding alternative managed pollinators to service crops. In the eastern U.S., managed hives of the native common eastern bumble bee (Bombus impatiens Cresson) may be an excellent choice. To examine this issue, a comprehensive 2-yr study was conducted to compare fruit yield and bee visits to flowers in pumpkin (Cucurbita pepo L.) fields that were either supplemented with A. mellifera hives, B. impatiens hives or were not supplemented. We compared pumpkin yield, A. mellifera flower visitation frequency and B. impatiens flower visitation frequency between treatments. Results indicated that supplementing pumpkin fields with either A. mellifera or B. impatiens hives did not increase their visitation to pumpkin flowers or fruit yield compared with those that were not supplemented. Next, the relationship between frequency of pumpkin flower visitation by the most prominent bee species (Peponapis pruinosa (Say), B. impatiens and A. mellifera) and fruit yield was determined across all pumpkin fields sampled. Fruit yield increased as the frequency of flower visits by A. mellifera and B. impatiens increased in 2011 and 2012, respectively. These results suggest that supplementation with managed bees may not improve pumpkin production and that A. mellifera and B. impatiens are important pollinators of pumpkin in our system.

  20. Providing appropriate genetic information to healthy multi-ethnic carriers of hemoglobinopathy in The Netherlands

    Directory of Open Access Journals (Sweden)

    Piero C. Giordano

    2014-09-01

    Full Text Available The aims of this study are: i to enquire whether informing healthy hemoglobinopathy carriers about their condition is a welcome initiative in The Netherlands; ii to study whether using information letters and thorough explanation is associated with presence or absence of undesired feelings or emotions. We have approached 100 multi-ethnic carriers previously diagnosed in our lab. All subjects had previously received our information letter through their physician who was supposed to have provided an explanation of the letter if required. We have enquired whether the subjects had experienced negative or positive emotions after receiving our diagnosis and explanation and to which degree, if they were sufficiently informed and satisfied and if they would have considered prevention in case of risk. The rate negative versus positive feelings was calculated using a numerical distribution. We have registered negative feelings in a rate that was directly proportional to the lack of information. While the number of registered negative feelings in well-informed carriers was very low it was more present in badly informed. Nevertheless, all participants found carrier information a welcome initiative and over 80% of them declared to be in favor of prenatal diagnosis in case of risk.

  1. Old age and chronic disease: is the emergency medical system the appropriate provider for the elderly?

    Science.gov (United States)

    Mochmann, Hans-Christian; Arntz, Hans-Richard; Dincklage, Falk V; Rauch, Ursula; Schultheiss, Heinz P; Bobbert, Peter

    2014-04-01

    The use of emergency medical services increases with the age of patients. Some care providers hold on to the prejudice that these alarms are unnecessary or of a lower importance. We assessed the relation of age and age-dependent emergency characteristics, taking into consideration the ratings of emergency physicians on whether or not emergency cases were considered truly in need of emergency physician attendance. Emergency physicians dispatched by the Berlin Fire Department evaluated for each case the necessity of emergency physician attendance. Case characteristics such as the day of the week and location of the emergency as well as patient characteristics such as age, sex, prior status, and care dependency were recorded. In addition, whether or not the physician accompanied the patient to the hospital was recorded as a parameter for emergency severity. Analysis was performed using multiple logistic regression modeling. During the 6-month prospective study period, 2702 cases were evaluated. Emergency medical services are used more frequently by older individuals, especially octogenarians. Emergency cases in older individuals were significantly more often rated as in need of emergency physician attendance; however, the rate of patients accompanied by the emergency physician to the hospital did not differ between the age groups. The age of patients, the primary diagnosis, the day and location of the emergency, and the presence of pre-existing dementia showed a significant impact on the necessity of physician-attended emergency missions. Despite common prejudices, emergency cases in elder patients are rated more often as in need of emergency physician attendance compared with those involving younger patients.

  2. Effectiveness of interventions to provide culturally appropriate maternity care in increasing uptake of skilled maternity care: a systematic review

    OpenAIRE

    Coast, Ernestina; Jones, Eleri; Lattof, Samantha R; Portela, Anayda

    2016-01-01

    Addressing cultural factors that affect uptake of skilled maternity care is recognized as an important step in improving maternal and newborn health. This article describes a systematic review to examine the evidence available on the effects of interventions to provide culturally appropriate maternity care on the use of skilled maternity care during pregnancy, for birth or in the postpartum period. Items published in English, French and/or Spanish between 1 January 1990 and 31 March 2014 were...

  3. Whole or ground millet grain provided in two supplementation frequencies for grazing beef cattle: nutritional parameters

    Directory of Open Access Journals (Sweden)

    João Marcos Beltrame Benatti

    2014-05-01

    Full Text Available The objective of this study was to evaluate the processing of millet grain provided at two supplementation frequencies for grazing beef cattle during the dry season on nutritional parameters. Five rumen-cannulated crossbred steers, with 24 to 26 months of age and average body weight of 428.6±26.06 kg, were assigned to a Latin square design (5 × 5 in a 2 × 2 + 1 factorial arrangement, as follows: two forms of millet grain (whole grains - or ground; WG - GG, two strategies of concentrate supplementation (daily distribution - 7X; or three times a week - 3X and a control treatment (mineral mixture - MM. Animals were kept in five paddocks of 0.24 ha each with Marandu grass pastures. Concentrate supplements were supplied at 2.00 and 4.66 kg/animal/day for treatments 7X and 3X, respectively. The concentrate supplementation enhanced the intake of total dry matter (DM and organic matter (OM and nutrients compared with mineral supplementation. No differences were found between dry matter intake and forage organic matter intake. The values of digestibility coefficients of DM, OM, ether extract, total carbohydrates and non-fiber carbohydrates were increased by concentrate supplementation. Regarding concentrations of rumen ammonia nitrogen, the interactions among time × treatment × day and day × treatment had effects on the measurements of ruminal pH. Plasma urea nitrogen, urinary urea excretion and urinary urea N excretion differed only between MM treatment and the others, with no interference of grain physical form and supplementation frequency on those variables. The millet grain processing does not alter forage intake, but improves digestibility. Daily supplementation increases digestibility of dry matter and neutral detergent fiber.

  4. Control of antioxidant supplementation through interview is not appropriate in oxidative-stress sport studies: Analytical confirmation should be required.

    Science.gov (United States)

    Barranco-Ruiz, Yaira; Aragón-Vela, Jeronimo; Casals, Cristina; Martínez-Amat, Antonio; Casuso, Rafael A; Huertas, Jesus R

    2017-01-01

    Controlling antioxidant supplementation in athletes involved in studies related to oxidative stress and muscle damage is the key to ensure results. The aim of this study was to confirm through high-performance liquid chromatography (HPLC) analysis whether well-trained individuals lied during a personal interview when asked if they were taking supplements with antioxidants, and how this could affect oxidative stress, muscle damage, and antioxidant response. A total of 94 men, well trained in endurance sports, volunteered in this study. They denied taking any antioxidant supplementation at initial interview. After a HPLC analysis, abnormal α-tocopherol concentrations were detected, probably due to a hidden antioxidant supplementation. Participants were classified into two groups: no evidence of antioxidant supplementation (NS group = α-tocopherol values antioxidant supplementation (S group = α-tocopherol values >80 nmol/mL; n = 19). Lipid peroxidation, muscle damage, antioxidant enzyme activity, and nonenzymatic antioxidant content were analyzed according to this classification. Statistical comparisons were performed using Student's t test. The α-tocopherol concentrations were significantly higher in the S group than in the NS group (MD = 725.01 ± 39.01 nmol/mL; P = 0.001). The S group showed a trend toward lower hydroperoxides than the NS group (MD = 1.19 ± 0.72 nmol/mL; P = 0.071). The S group showed significantly lower catalase activity than the NS group (MD = 0.10 ± 0.02-seg-1 mg-1; P antioxidant supplementation in a personal interview, as they showed high plasmatic α-tocopherol concentrations after HPLC verification. Catalase activity seems to be affected by high α-tocopherol plasma levels. Therefore, we strongly recommend the HPLC analysis as a necessary tool to verify the antioxidant intake and preserve results in studies linking oxidative stress and sport. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Effectiveness of interventions to provide culturally appropriate maternity care in increasing uptake of skilled maternity care: a systematic review.

    Science.gov (United States)

    Coast, Ernestina; Jones, Eleri; Lattof, Samantha R; Portela, Anayda

    2016-12-01

    Addressing cultural factors that affect uptake of skilled maternity care is recognized as an important step in improving maternal and newborn health. This article describes a systematic review to examine the evidence available on the effects of interventions to provide culturally appropriate maternity care on the use of skilled maternity care during pregnancy, for birth or in the postpartum period. Items published in English, French and/or Spanish between 1 January 1990 and 31 March 2014 were considered. Fifteen studies describing a range of interventions met the inclusion criteria. Data were extracted on population and intervention characteristics; study design; definitions and data for relevant outcomes; and the contexts and conditions in which interventions occurred. Because most of the included studies focus on antenatal care outcomes, evidence of impact is particularly limited for care seeking for birth and after birth. Evidence in this review is clustered within a small number of countries, and evidence from low- and middle-income countries is notably lacking. Interventions largely had positive effects on uptake of skilled maternity care. Cultural factors are often not the sole factor affecting populations' use of maternity care services. Broader social, economic, geographical and political factors interacted with cultural factors to affect targeted populations' access to services in included studies. Programmes and policies should seek to establish an enabling environment and support respectful dialogue with communities to improve use of skilled maternity care. Whilst issues of culture are being recognized by programmes and researchers as being important, interventions that explicitly incorporate issues of culture are rarely evaluated. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  6. Pilot study evaluating the effects of an intervention to enhance culturally appropriate hypertension education among healthcare providers in a primary care setting

    NARCIS (Netherlands)

    Beune, E.J.A.J.; Bindels, P.J.E.; Mohrs, J.; Stronks, K.; Haafkens, J.A.

    2010-01-01

    ABSTRACT: BACKGROUND: To improve hypertension care for ethnic minority patients of African descent in the Netherlands, we developed a provider intervention to facilitate the delivery of culturally appropriate hypertension education. This pilot study evaluates how the intervention affected the

  7. Pilot study evaluating the effects of an intervention to enhance culturally appropriate hypertension education among healthcare providers in a primary care setting

    NARCIS (Netherlands)

    E.J.A.J. Beune (Erik Jaj); P.J.E. Bindels (Patrick); J. Mohrs (Jacob); K. Stronks (Karien); J.A. Haafkens (Joke)

    2010-01-01

    textabstractBackground: To improve hypertension care for ethnic minority patients of African descent in the Netherlands, we developed a provider intervention to facilitate the delivery of culturally appropriate hypertension education. This pilot study evaluates how the intervention affected the

  8. Providing lipid-based nutrient supplements does not affect developmental milestones among Malawian children.

    Science.gov (United States)

    Mangani, Charles; Cheung, Yin Bun; Maleta, Kenneth; Phuka, John; Thakwalakwa, Chrissie; Dewey, Kathryn; Manary, Mark; Puumalainen, Taneli; Ashorn, Per

    2014-01-01

    To assess whether using lipid-based nutrient supplements (LNS) to complement the diets of infants and young children affected when they achieved selected developmental milestones. In rural Malawi, 840 6-month-old healthy infants were enrolled to a randomised trial. Control participants received no supplements, others were provided with milk-containing LNS, soy-containing LNS or corn-soy blend (CSB) for 12 months. Outcomes were the age at which they achieved key milestone: motor (walking with assistance, standing and walking alone, running), social (drinking from a cup and eating by themselves) and language (saying single comprehensible words and waving goodbye). The mean age at which the subjects walked with assistance was 42.5, 42.3, 42.7 and 43.2 weeks in the control, milk-LNS, soy-LNS and CSB groups, respectively (p = 0.748). There were also no significant differences in the mean age at standing alone (45.0, 44.9, 45.1 and 46.3 weeks), walking alone (54.6, 55.1, 55.3, 56.5 weeks), running (64.6, 63.7, 64.8, 65.9 weeks) or any other social or language milestones (each p > 0.10). The findings do not support a hypothesis that providing tested formulations and doses of micronutrient-fortified LNS or CSB would have an impact on when young children in rural Malawi achieved selected developmental milestones. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  9. Online Professional Development for Child Care Providers: Do They Have Appropriate Access to and Comfort with the Internet?

    Directory of Open Access Journals (Sweden)

    Lindsay E. Wright

    2014-10-01

    Full Text Available With the expansion of online trainings today, Extension professionals have an opportunity to reach child care providers in more convenient ways. However, having convenient, reliable Internet access can be a barrier to online training for some child care providers, especially those with limited financial resources. This study investigated child care providers’ ability to access online training through convenient, reliable Internet access by asking 494 child care providers in Georgia about their access to and comfort with the Internet. Participants completed a brief 12-question survey that included questions about their Internet access and use for both personal and professional purposes (i.e., whether or not they have Internet access, where they have access, how often they use it, and how comfortable they feel using it. The majority of child care providers reported having Internet access (89.68% and feeling comfortable using the Internet (68.62%, and therefore, have the technological resources to participate in online professional development.

  10. Estimating the effect of plant-provided food supplements on pest consumption by omnivorous predators: lessons from two coccinellid beetles.

    Science.gov (United States)

    Schuldiner-Harpaz, Tarryn; Coll, Moshe

    2017-05-01

    Plant-provided food supplements can influence biological pest control by omnivorous predators in two counteracting ways: they can (i) enhance predator populations, but (ii) reduce pest consumption by individual predators. Yet the majority of studies address only one of these aspects. Here, we first tested the influence of canola (Brassica napus L.) pollen supplements on the life history of two ladybeetle species: Hoppodamia variegata (Goeze) and Coccinella septempunctata (L.). We then developed a theoretical model to simulate total pest consumption in the presence and absence of pollen supplements. Supplementing a prey diet with canola pollen increased H. variegata larval survival from 50 to 82%, and C. septempunctata female oviposition by 1.6-fold. Model simulations revealed a greater benefit of pollen supplements when relying on C. septempunctata for pest suppression than on H. variegata. For these two predators, the tested pollen serves as an essential supplement to a diet of prey. However, the benefit of a mixed prey-pollen diet was not always sufficient to overcome individual decrease in pest consumption. Taken together, our study highlights the importance of addressing both positive and negative roles of plant-provided food supplements in considering the outcome for biological control efforts that rely on omnivorous predators. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  11. Docosahexaenoic acid (DHA, essentiality and requirements: why and how to provide supplementation

    Directory of Open Access Journals (Sweden)

    Nieto, Susana

    2006-06-01

    Full Text Available Lipids comprize from 50-60% of the structural matter of the brain and docosahexaenoic acid (C22:6, DHA is the most  important omega-3 long-chain polyunsaturated fatty acid in the brain phospholipids comprizing 25% of the total fatty acids of the grey matter. The majority of the DHA present in the human brain is incorporated during the brain growth spurt which starts at week 26 of gestation and imposes a high demand for the fatty acid until about 2 years of age. DHA is required during brain development when neuronal and glial differentiation and migration, and active myelination and synaptogenesis take place. The fatty acid must be incorporated into the brain lipids as preformed DHA because less than 5% of its precursor (alpha linolenic acid, LNA is converted to DHA. The human foetus has a limited ability to synthesize DHA from LNA, and therefore it must be largely supplied from maternal sources. Maternal DHA available for foetal nutrition can be provided from three main sources: adipose tissue, which is the main reservoir for the fatty acid; through biosynthesis from the precursor LNA, which occurs mainly in the liver; and as preformed DHA from dietary sources. In the postnatal period DHA is provided by the mother to the newborn through milk secretion. Western nutrition provides low LNA and DHA and Expert Nutrition Committees suggest that mothers should receive DHA supplementation during pregnancy and lactation. At present DHA supplementation can be provided from different sources: as purified free DHA, as an ethyl ester derivative, extracted from single-cell algae oils, from egg yolk phospholipids, or in the form of sn-2 DHA monoacylglycerol. In this review we revise and discuss the evidence of DHA requirements for the newborn, the need for maternal supplementation during pregnancy and nursing, and the alternatives at present for providing DHA supplementation.Los lípidos comprenden entre el 50-60% de la estructura del cerebro, y el

  12. NIH Study Provides Clarity on Supplements for Protection Against Blinding Eye Disease

    Science.gov (United States)

    ... vision. Before the AREDS2 study finished, manufacturers began marketing supplements based on the study design. In AREDS2, ... Health, leads the federal government's research on the visual system and eye diseases. NEI supports basic and ...

  13. Nutritional Supplement of Hatchery Eggshell Membrane Improves Poultry Performance and Provides Resistance against Endotoxin Stress.

    Directory of Open Access Journals (Sweden)

    S K Makkar

    Full Text Available Eggshells are significant part of hatchery waste which consist of calcium carbonate crust, membranes, and proteins and peptides of embryonic origins along with other entrapped contaminants including microbes. We hypothesized that using this product as a nutritional additive in poultry diet may confer better immunity to the chickens in the paradigm of mammalian milk that enhances immunity. Therefore, we investigated the effect of hatchery eggshell membranes (HESM as a short term feed supplement on growth performance and immunity of chickens under bacterial lipopolysaccharide (LPS challenged condition. Three studies were conducted to find the effect of HESM supplement on post hatch chickens. In the first study, the chickens were fed either a control diet or diets containing 0.5% whey protein or HESM as supplement and evaluated at 5 weeks of age using growth, hematology, clinical chemistry, plasma immunoglobulins, and corticosterone as variables. The second and third studies were done to compare the effects of LPS on control and HESM fed birds at 5 weeks of age following at 4 and 24 h of treatment where the HESM was also sterilized with ethanol to deplete bacterial factors. HESM supplement caused weight gain in 2 experiments and decreased blood corticosterone concentrations. While LPS caused a significant loss in body weight at 24 h following its administration, the HESM supplemented birds showed significantly less body weight loss compared with the control fed birds. The WBC, heterophil/lymphocyte ratio, and the levels of IgG were low in chickens fed diets with HESM supplement compared with control diet group. LPS challenge increased the expression of pro-inflammatory cytokine gene IL-6 but the HESM fed birds showed its effect curtailed, also, which also, favored the up-regulation of anti-inflammatory genes compared with control diet fed chickens. Post hatch supplementation of HESM appears to improve performance, modulate immunity, and increase

  14. Nutritional Supplement of Hatchery Eggshell Membrane Improves Poultry Performance and Provides Resistance against Endotoxin Stress.

    Science.gov (United States)

    Makkar, S K; Rath, N C; Packialakshmi, B; Zhou, Z Y; Huff, G R; Donoghue, A M

    2016-01-01

    Eggshells are significant part of hatchery waste which consist of calcium carbonate crust, membranes, and proteins and peptides of embryonic origins along with other entrapped contaminants including microbes. We hypothesized that using this product as a nutritional additive in poultry diet may confer better immunity to the chickens in the paradigm of mammalian milk that enhances immunity. Therefore, we investigated the effect of hatchery eggshell membranes (HESM) as a short term feed supplement on growth performance and immunity of chickens under bacterial lipopolysaccharide (LPS) challenged condition. Three studies were conducted to find the effect of HESM supplement on post hatch chickens. In the first study, the chickens were fed either a control diet or diets containing 0.5% whey protein or HESM as supplement and evaluated at 5 weeks of age using growth, hematology, clinical chemistry, plasma immunoglobulins, and corticosterone as variables. The second and third studies were done to compare the effects of LPS on control and HESM fed birds at 5 weeks of age following at 4 and 24 h of treatment where the HESM was also sterilized with ethanol to deplete bacterial factors. HESM supplement caused weight gain in 2 experiments and decreased blood corticosterone concentrations. While LPS caused a significant loss in body weight at 24 h following its administration, the HESM supplemented birds showed significantly less body weight loss compared with the control fed birds. The WBC, heterophil/lymphocyte ratio, and the levels of IgG were low in chickens fed diets with HESM supplement compared with control diet group. LPS challenge increased the expression of pro-inflammatory cytokine gene IL-6 but the HESM fed birds showed its effect curtailed, also, which also, favored the up-regulation of anti-inflammatory genes compared with control diet fed chickens. Post hatch supplementation of HESM appears to improve performance, modulate immunity, and increase resistance of

  15. Providing nutrition supplements to institutionalized seniors with probable Alzheimer's disease is least beneficial to those with low body weight status.

    Science.gov (United States)

    Young, Karen W H; Greenwood, Carol E; van Reekum, Robert; Binns, Malcolm A

    2004-08-01

    To examine whether providing a midmorning nutrition supplement increases habitual energy intake in seniors with probable Alzheimer's disease (AD) and to investigate the effects of body weight status and cognitive and behavioral function on the response to the intervention. Randomized, crossover, nonblinded clinical trial. A fully accredited geriatric teaching facility affiliated with the University of Toronto's Medical School with a home for the aged. Thirty-four institutionalized seniors with probable AD who ate independently. Nutrition supplements were provided between breakfast and lunch for 21 consecutive days and compared with 21 consecutive days of habitual intake. Investigator-weighed food intake, body weight, cognitive function (Severe Impairment Battery and Global Deterioration Scale), behavioral disturbances (Neuropsychiatric Inventory-Nursing Home Version), and behavioral function (London Psychogeriatric Rating Scale). Relative to habitual intake, group mean analyses showed increased 24-hour energy, protein, and carbohydrate intake during the supplement phase, but five of 31 subjects who finished all study phases completely compensated for the energy provided by the supplement by reducing lunch intake, and 24-hour energy intake was enhanced in only 21 of 31 subjects. Compensation at lunch was more likely in subjects with lower body mass indices, increased aberrant motor behavior, poorer attention, and increased mental disorganization/confusion. Nutrition supplements were least likely to enhance habitual energy intake in subjects who would normally be targeted for nutrition intervention-those with low body weight status. Those likely to benefit include those with higher body mass indices, less aberrant motor problems, less mental disorganization, and increased attention.

  16. Suppression of cuelure attraction in male Queensland fruit flies provided raspberry ketone supplements as immature adults.

    Directory of Open Access Journals (Sweden)

    Humayra Akter

    Full Text Available Tephritid fruit flies are amongst the most damaging insect pests of horticulture globally. Some of the key fruit fly species are managed using the sterile insect technique (SIT, whereby millions of sterile males are released to suppress reproduction of pest populations. Male annihilation technique (MAT, whereby sex specific lures are used to attract and kill males, is often used to reduce wild male numbers before SIT programs commence, providing released sterile males an increased numerical advantage. Overall program efficacy might be improved if MAT could be deployed simultaneously with SIT, continuously depleting fertile males from pest populations and replacing them with sterile males. However, such 'male replacement' requires a means of suppressing attraction of released sterile males to lures used in MAT. Previous studies have found that exposure of some fruit flies to lure compounds as mature adults can suppress subsequent response to those lures, raising the possibility of pre-release treatments. However, this approach requires holding flies until after maturation for treatment and then release. The present study takes a novel approach of exposing immature adult male Queensland fruit flies (Bactrocera tryoni, or 'Qfly' to raspberry ketone (RK mixed in food, forcing these flies to ingest RK at ages far younger than they would naturally. After feeding on RK-supplemented food for two days after emergence, male Qflies exhibited a reduction in attraction to cuelure traps that lasted more than 20 days. This approach to RK exposure is compatible with current practises, in which Qflies are released as immature adults, and also yields advantages of accelerated reproductive development and increased mating propensity at young ages.

  17. Suppression of cuelure attraction in male Queensland fruit flies provided raspberry ketone supplements as immature adults.

    Science.gov (United States)

    Akter, Humayra; Adnan, Saleh; Morelli, Renata; Rempoulakis, Polychronis; Taylor, Phillip W

    2017-01-01

    Tephritid fruit flies are amongst the most damaging insect pests of horticulture globally. Some of the key fruit fly species are managed using the sterile insect technique (SIT), whereby millions of sterile males are released to suppress reproduction of pest populations. Male annihilation technique (MAT), whereby sex specific lures are used to attract and kill males, is often used to reduce wild male numbers before SIT programs commence, providing released sterile males an increased numerical advantage. Overall program efficacy might be improved if MAT could be deployed simultaneously with SIT, continuously depleting fertile males from pest populations and replacing them with sterile males. However, such 'male replacement' requires a means of suppressing attraction of released sterile males to lures used in MAT. Previous studies have found that exposure of some fruit flies to lure compounds as mature adults can suppress subsequent response to those lures, raising the possibility of pre-release treatments. However, this approach requires holding flies until after maturation for treatment and then release. The present study takes a novel approach of exposing immature adult male Queensland fruit flies (Bactrocera tryoni, or 'Qfly') to raspberry ketone (RK) mixed in food, forcing these flies to ingest RK at ages far younger than they would naturally. After feeding on RK-supplemented food for two days after emergence, male Qflies exhibited a reduction in attraction to cuelure traps that lasted more than 20 days. This approach to RK exposure is compatible with current practises, in which Qflies are released as immature adults, and also yields advantages of accelerated reproductive development and increased mating propensity at young ages.

  18. The influence of nutritional supplement drinks on providing adequate calorie and protein intake in older adults with dementia.

    Science.gov (United States)

    Allen, V; Methven, L; Gosney, M

    2013-09-01

    Investigate the impact of the provision of ONS on protein and energy intake from food and ability to meet protein and calorie requirements in people with dementia. After consent by proxy was obtained, participants took part in a cross over study comparing oral intake on an intervention day to an adjacent control day. The study occurred in Nursing homes and hospitalised settings. Older adults with dementia over the age of 65 were recruited. 26 participants (aged 83.9+/-8.4years, MMSE 13.08+/-8.13) took part. Intervention (if any): On the intervention day nutritional supplement drinks were provided three times. Each drink provided 283.3+/-41.8 Kcal of energy and 13.8+/-4.7g of protein. Supplements were removed approximately 1 hour before meals were served and weighed waste (g) was obtained. Intake of food consumed was determined on intervention and control days using the quartile method (none, quarter, half, three quarters, all) for each meal component. More people achieved their energy and protein requirements with the supplement drink intervention with no sufficient impact on habitual food consumption. Findings from these 26 participants with dementia indicate that supplement drinks may be beneficial in reducing the prevalence of malnutrition within the group as more people meet their nutritional requirements. As the provision of supplement drinks is also demonstrated to have an additive effect to consumption of habitual foods these can be used alongside other measures to also improve oral intake.

  19. 76 FR 51381 - Supplemental Awards to Seven Unaccompanied Alien Shelter Care Providers

    Science.gov (United States)

    2011-08-18

    ... HUMAN SERVICES Office of Refugee Resettlement Supplemental Awards to Seven Unaccompanied Alien Shelter...)(5)(C); 235(d); of the Trafficking Victims Protection Reauthorization Act of 2008, (8 U.S.C. 1232). Project Period: October 1, 2010--September 30, 2011. ] Summary: The Administration for Children and...

  20. Dietary Supplements and Young Teens: Misinformation and Access Provided by Retailers.

    Science.gov (United States)

    Herriman, Maguire; Fletcher, Laura; Tchaconas, Alexis; Adesman, Andrew; Milanaik, Ruth

    2017-02-01

    Despite the American Academy of Pediatrics' recommendations against pediatric use of creatine and testosterone boosters, research suggests that many young teenagers take these dietary supplements. Our objective was to determine to what extent health food stores would recommend and/or sell creatine and testosterone boosters to a 15-year-old boy customer. Research personnel posing as 15-year-old high school athletes seeking to increase muscle strength contacted 244 health food stores in the United States via telephone. Researchers asked the sales attendant what supplements he/she would recommend. If a sales attendant did not mention creatine or testosterone boosters initially, each of these supplements was then specifically asked about. Supplement recommendations were recorded. Sales attendants were also asked if a 15-year-old could purchase these products on his own in the store. A total of 67.2% (164/244) of sales attendants recommended creatine: 38.5% (94/244) recommended creatine without prompting, and an additional 28.7% (70/244) recommended creatine after being asked specifically about it. A total of 9.8% (24/244) of sales attendants recommended a testosterone booster. Regarding availability for sale, 74.2% (181/244) of sales attendants stated a 15-year-old was allowed to purchase creatine, whereas 41.4% (101/244) stated one could purchase a testosterone booster. Health food store employees frequently recommend creatine and testosterone boosters for boy high school athletes. In response to these findings, pediatricians should inform their teenage patients, especially athletes, about safe, healthy methods to improve athletic performance and discourage them from using creatine or testosterone boosters. Retailers and state legislatures should also consider banning the sale of these products to minors. Copyright © 2017 by the American Academy of Pediatrics.

  1. Providing supplemental milk to piglets preweaning improves the growth but not survival of gilt progeny compared with sow progeny.

    Science.gov (United States)

    Miller, Y J; Collins, A M; Smits, R J; Thomson, P C; Holyoake, P K

    2012-12-01

    Gilt progeny have lighter weaning weights and greater postweaning medication and mortality rates compared with the progeny of older parity sows. Because weaning weight has been positively correlated with postweaning survival, this study aimed to determine whether the provision of supplemental milk preweaning could improve weaning weight and subsequent weights as well as postweaning survival of gilt progeny. The study was replicated in summer and winter as the effects of supplemental milk were expected to vary with season. The progeny of 80 gilts (parity 0) and 80 sows (parity 2 to 5) were allocated to both treatments: with or without supplemental milk in these 2 seasons with 5 sheds/season. Litter size was standardized (10 to 11 piglets) and each piglet was weighed at birth, d 21, weaning (4 wk), and 10 wk of age. Medications and mortalities were recorded both preweaning and postweaning. Pigs were housed within treatment groups postweaning, and ADFI and G:F were measured. Gilt progeny were 200 g lighter at birth in both replicates (P gilt and sow progeny by 800 g in summer (P gilts or sows (P > 0.05). Supplemental milk disappearance (the daily difference between the volume of milk provided and the residue left in the drinker) was greater in summer than winter (by 130 mL/piglet d(-1); P gilt progeny reached or exceeded that of nonsupplemented sow progeny. Gilt progeny had greater postweaning mortality (2.6%) and medication rates (6.2%) than sow progeny (1 and 2.2%, respectively; both P Gilt progeny also had less postweaning ADFI than sow progeny in winter (528 and 636 g, respectively; P 0.05). The hypothesis that supplemental milk provision did increase gilt progeny weaning weight was supported (especially in summer) but the supplementation had no effect on postweaning weights and survival. Efforts to improve gilt progeny postweaning growth and survival need to be aimed at improving health and immunity, not just weaning weight.

  2. Impact of supplemental training programs on improving medical students' confidence in providing diabetes self-management education and support.

    Science.gov (United States)

    Fazel, Maryam T; Fazel, Mohammad; Bedrossian, Nora L; Picazo, Fernando; Sobel, Julia D; Fazel, Mahdieh; Te, Charisse; Pendergrass, Merri L

    2017-01-01

    The purpose of this study was to evaluate the effectiveness of supplemental diabetes-related training modalities and volunteer activities in increasing first-year medical students' knowledge/comfort in providing diabetes self-management education and support (DSMES) to patients. A group of medical students developed supplemental diabetes-related training/volunteer programs. The training modalities included an optional 7-session interprofessionally taught Diabetes Enrichment Elective and a 3-hour endocrinologist-led training session intended to prepare students for involvement in an inpatient DSMES volunteer program. The volunteer program provided the students with the opportunity to provide DSMES to patients with diabetes admitted to an academic medical center. Those participating in any of the stated programs were compared to those with no such training regarding confidence in providing DSMES using an optional online survey. The results were analyzed by using Mann-Whitney U test and descriptive analyses. A total of 18 first-year medical students responded to the optional survey with a response rate of ~30% (10 of 33) among participants in any training/volunteer program. First-year medical students who attended any of the offered optional programs had statistically significant higher comfort level in 4 of the 6 areas assessed regarding providing DSMES compared with those with no such training (ptraining modalities/volunteer programs can provide benefit in providing medical students with practical knowledge while improving their confidence in providing DSMES to patients with diabetes.

  3. Appropriate use of endoscopy in the diagnosis and treatment of gastrointestinal diseases: up-to-date indications for primary care providers

    Directory of Open Access Journals (Sweden)

    Vien X Nguyen

    2010-11-01

    Full Text Available Vien X Nguyen1, Vi Thuy Le Nguyen2, Cuong C Nguyen11Department of Gastroenterology, Mayo Clinic, Scottsdale, AZ, USA; 2Department of Pharmacy, Banner Baywood Medical Center, Mesa, AZ, USAAbstract: The field of endoscopy has revolutionized the diagnosis and treatment of ­gastrointestinal (GI diseases in recent years. Besides the ‘traditional’ endoscopic ­procedures (esophagogastroduodenoscopy, colonoscopy, flexible sigmoidoscopy, and endoscopic retrograde cholangiopancreatography, advances in imaging technology (endoscopic ultrasonography, ­wireless capsule endoscopy, and double balloon enteroscopy have allowed GI specialists to detect and manage disorders throughout the digestive system. This article reviews various ­endoscopic procedures and provides up-to-date endoscopic indications based on the ­recommendations of American Society for Gastrointestinal Endoscopy and American Cancer Society for primary care providers in order to achieve high-quality and cost-effective care.Keywords: endoscopy, endoscopic indications, endoscopic procedures, imaging, primary care, gastrointestinal disorders, appropriate use

  4. Dietary supplementation of propionylated starch to domestic cats provides propionic acid as gluconeogenic substrate potentially sparing the amino acid valine.

    Science.gov (United States)

    Rochus, Kristel; Cools, An; Janssens, Geert P J; Vanhaecke, Lynn; Wuyts, Birgitte; Lockett, Trevor; Clarke, Julie M; Fievez, Veerle; Hesta, Myriam

    2014-01-01

    In strict carnivorous domestic cats, a metabolic competition arises between the need to use amino acids for gluconeogenesis and for protein synthesis both in health and disease. The present study investigated the amino acid-sparing potential of propionic acid in cats using dietary propionylated starch (HAMSP) supplementation. A total of thirty cats were fed a homemade diet, supplemented with either HAMSP, acetylated starch (HAMSA) or celite (Control) for three adaptation weeks. Propionylated starch was hypothesised to provide propionic acid as an alternative gluconeogenic substrate to amino acids, whereas acetic acid from HAMSA would not provide any gluconeogenic benefit. Post-adaptation, a 5-d total faecal collection was carried out to calculate apparent protein digestibility coefficients. Fresh faecal and blood samples were collected to analyse fermentation endproducts and metabolites. The apparent protein digestibility coefficients did not differ between supplements (P = 0·372) and were not affected by the protein intake level (P = 0·808). Faecal propionic acid concentrations were higher in HAMSP than in HAMSA (P = 0·018) and Control (P = 0·003) groups, whereas concentrations of ammonia (P = 0·007) were higher in HAMSA than in HAMSP cats. Tendencies for or higher propionylcarnitine concentrations were observed in HAMSP compared with HAMSA (P = 0·090) and Control (P = 0·037) groups, and for tiglyl- + 3-methylcrotonylcarnitine concentrations in HAMSP as compared with Control (P = 0·028) cats. Methylmalonylcarnitine concentrations did not differ between groups (P = 0·740), but were negatively correlated with the protein intake level (r -0·459, P = 0·016). These results suggest that HAMSP cats showed more saccharolytic fermentation patterns than those supplemented with HAMSA, as well as signs of sparing of valine in cats with a sufficient protein intake.

  5. Parallel experimental design and multivariate analysis provides efficient screening of cell culture media supplements to improve biosimilar product quality.

    Science.gov (United States)

    Brühlmann, David; Sokolov, Michael; Butté, Alessandro; Sauer, Markus; Hemberger, Jürgen; Souquet, Jonathan; Broly, Hervé; Jordan, Martin

    2017-07-01

    Rational and high-throughput optimization of mammalian cell culture media has a great potential to modulate recombinant protein product quality. We present a process design method based on parallel design-of-experiment (DoE) of CHO fed-batch cultures in 96-deepwell plates to modulate monoclonal antibody (mAb) glycosylation using medium supplements. To reduce the risk of losing valuable information in an intricate joint screening, 17 compounds were separated into five different groups, considering their mode of biological action. The concentration ranges of the medium supplements were defined according to information encountered in the literature and in-house experience. The screening experiments produced wide glycosylation pattern ranges. Multivariate analysis including principal component analysis and decision trees was used to select the best performing glycosylation modulators. Subsequent D-optimal quadratic design with four factors (three promising compounds and temperature shift) in shake tubes confirmed the outcome of the selection process and provided a solid basis for sequential process development at a larger scale. The glycosylation profile with respect to the specifications for biosimilarity was greatly improved in shake tube experiments: 75% of the conditions were equally close or closer to the specifications for biosimilarity than the best 25% in 96-deepwell plates. Biotechnol. Bioeng. 2017;114: 1448-1458. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. Bodybuilding supplementation and tooth decay.

    Science.gov (United States)

    Ali, M S; Batley, H; Ahmed, F

    2015-07-10

    Supplementation is a key component in bodybuilding and is increasingly being used by amateur weight lifters and enthusiasts to build their ideal bodies. Bodybuilding supplements are advertised to provide nutrients needed to help optimise muscle building but they can contain high amounts of sugar. Supplement users are consuming these products, while not being aware of their high sugar content, putting them at a higher risk of developing dental caries. It is important for dental professionals to recognise the increased risk for supplement users and to raise awareness, provide appropriate preventative advice and be knowledgeable of alternative products to help bodybuilders reach their goals, without increasing the risk of dental caries.

  7. Collaborative Appropriation

    DEFF Research Database (Denmark)

    Muller, Michael; Neureiter, Katja; Verdezoto, Nervo

    2016-01-01

    Previous workshops and papers have examined how individual users adopt and adapt technologies to meet their own local needs, by “completing design through use.” However, there has been little systematic study of how groups of people engage collaboratively in these activities. This workshop opens...... a discussion for these under-studied forms of collaborative appropriation, using a broad range of perspectives including empirical data, design explorations, research, and critique....

  8. Sandy PMO Disaster Relief Appropriations Act of 2013 Financial Data

    Data.gov (United States)

    Department of Homeland Security — Sandy PMO: Disaster Relief Appropriations Act of 2013 (Sandy Supplemental Bill) Financial Data. This is the Sandy Supplemental Quarterly Financial Datasets that are...

  9. Effects of supplemental protein provided to postpartum beef cows in liquid or cube form on metabolic, endocrine and reproductive functions

    National Research Council Canada - National Science Library

    Kane, K.K; Schafer, T.P; Harris, J.M; Hallford, D.M; Remmenga, M.D; Hawkins, D.E

    2001-01-01

    Metabolic, endocrine and reproductive functions in postpartum beef cows, supplemented with protein supplied as range cubes or liquid, were evaluated. Angus cows (n = 60; 2 to 8 yr; mean BCS 4.6 [+ or -] 0.1...

  10. Surgical education at Weill Bugando Medical Centre: supplementing surgical training and investing in local health care providers.

    Science.gov (United States)

    Mitchell, Katrina B; Giiti, Geofrey; Kotecha, Vihar; Chandika, Alphonce; Pryor, Kane O; Härtl, Roger; Gilyoma, Japhet

    2013-06-01

    Global surgery initiatives increasingly are focused on strengthening education and local health care systems to build surgical capacity. The goal of this education project was to support local health care providers in augmenting the surgical curriculum at a new medical school, thus promoting long-term local goals and involvement. Working with local surgeons, residents, and medical and assistant medical officer students, we identified the most common surgical conditions presenting to Weill Bugando Medical Centre in Mwanza, Tanzania, and the areas of greatest need in surgical education. We developed an 8-week teaching schedule for undergraduate students and an electronic database of clinical surgery topics. In addition, we started teaching basic surgical skills in the operating theatre, bridging to an official and recurring workshop through a supporting international surgery organization. The medical and assistant medical officer students reported increased satisfaction with their clinical surgery rotations and mastery of key educational subjects. The initiation of an Essential Surgical Skills workshop through the Canadian Network for International Surgery showed students had improved comfort with basic surgical techniques. Short-term surgical missions may appear to fill a void in the shortage of health care in the developing world. However, we conclude that global health resources are more appropriately used through projects giving ownership to local providers and promoting education as a foundation of development. This results in better coordination among local and visiting providers and greater impact on education and long-term growth of health care capacity.

  11. Effects of protein and omega-3 supplementation, provided during regular dialysis sessions, on nutritional and inflammatory indices in hemodialysis patients.

    Science.gov (United States)

    Daud, Zulfitri A Mat; Tubie, Boniface; Adams, Judy; Quainton, Tracey; Osia, Robert; Tubie, Sharon; Kaur, Deepinder; Khosla, Pramod; Sheyman, Marina

    2012-01-01

    Malnutrition and chronic inflammation in dialysis patients negatively impacts prognosis. However, intervening to correct this problem (through nutritional supplementation) is often hampered by poor compliance due to both medical and socioeconomic barriers. We have therefore performed a pilot study to investigate the technical feasibility of "directly observed treatment" of nutritional supplementation (protein and omega-3 fatty acids), administered during regular dialysis sessions. Secondary end points included observation of nutritional and inflammatory status of hypoalbuminemic patients undergoing hemodialysis. Main inclusion criteria were serum albumin ≤ 3.9 g/dL (3 months prior to the study). Sixty-three eligible patients agreed to participate. Two intervention groups received 30 mL of a liquid protein supplement plus either 2.4 g omega-3 (1800 mg eicosapentaenoic acid + 600 mg docosahexaenoic acid) or a placebo, three times per week after their routine dialysis session for 6 months. Serum albumin, plasma lipids, and other indicators of nutritional and inflammatory status were measured. Directly observed nutritional supplementation resulted in a significant improvement in the low density lipoprotein cholesterol/high density lipoprotein cholesterol ratio in the omega-3 group as compared to the placebo group (P = 0.043). For the omega-3 group, serum albumin was also marginally higher after 6 months as compared to baseline (P = 0.07). The observed increase in C-reactive protein in the placebo group over 6 months was not apparent in the omega-3 group, although there was no significant difference between groups. Nuclear factor kappa B, malnutrition-inflammation score, normalized protein nitrogen appearance, body mass index, and hemoglobin were unaffected by the intervention. "Directly observed treatment" with an omega-3 based supplement (as opposed to a pure protein supplement) showed beneficial effects on the lipid profile, and C-reactive protein levels. Further

  12. Cost-effectiveness in orthopedics: providing essential information to both physicians and health care policy makers for appropriate allocation of medical resources.

    Science.gov (United States)

    Dougherty, Christopher P; Howard, Timothy

    2013-09-01

    Cost-effective analysis has become an important tool in helping determine what procedures are both cost-effective and appropriate in today's cost control health care. The quality-adjusted life-year (QALY) is a standard measure for health-related quality-of-life in medical cost-effectiveness research. It can be used to compare different interventions to determine the cost-effectiveness of each procedure. Use of QALY to compare health care interventions has become the new gold standard. The key words arthroscopy, cost-effectiveness analysis, QALY, shoulder, hip, knee, ankle, elbow, wrist, and pubic symphysis were searched utilizing PubMed and an internet search engine. Cost/QALY ratios were determined and compared with other surgical procedures using techniques other than arthroscopy. Cost/QALYs were found for the shoulder, hip, knee, and elbow. The QALY for the shoulder was $13,092, for a simple knee was $5783, for a hip $21,700, and for an elbow $2031. General costs were found for the ankle, wrist, and pubic symphysis, that could be used to estimate QALYs without the complex formal calculation. On the basis of our findings, arthroscopy is an extremely cost-effective allocation of health care resources.

  13. Effects of protein and omega-3 supplementation, provided during regular dialysis sessions, on nutritional and inflammatory indices in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Mat Daud ZA

    2012-03-01

    Full Text Available Zulfitri A Mat Daud1, Boniface Tubie2, Judy Adams2, Tracey Quainton2, Robert Osia2, Sharon Tubie2, Deepinder Kaur1, Pramod Khosla1, Marina Sheyman21Department of Nutrition and Food Science, Wayne State University, 2Great Lake Dialysis, LLC, Detroit, MI, USAPurpose: Malnutrition and chronic inflammation in dialysis patients negatively impacts prognosis. However, intervening to correct this problem (through nutritional supplementation is often hampered by poor compliance due to both medical and socioeconomic barriers. We have therefore performed a pilot study to investigate the technical feasibility of “directly observed treatment” of nutritional supplementation (protein and omega-3 fatty acids, administered during regular dialysis sessions. Secondary end points included observation of nutritional and inflammatory status of hypoalbuminemic patients undergoing hemodialysis.Methods: Main inclusion criteria were serum albumin ≤ 3.9 g/dL (3 months prior to the study. Sixty-three eligible patients agreed to participate. Two intervention groups received 30 mL of a liquid protein supplement plus either 2.4 g omega-3 (1800 mg eicosapentaenoic acid + 600 mg docosahexaenoic acid or a placebo, three times per week after their routine dialysis session for 6 months. Serum albumin, plasma lipids, and other indicators of nutritional and inflammatory status were measured.Results: Directly observed nutritional supplementation resulted in a significant improvement in the low density lipoprotein cholesterol/high density lipoprotein cholesterol ratio in the omega-3 group as compared to the placebo group (P = 0.043. For the omega-3 group, serum albumin was also marginally higher after 6 months as compared to baseline (P = 0.07. The observed increase in C-reactive protein in the placebo group over 6 months was not apparent in the omega-3 group, although there was no significant difference between groups. Nuclear factor kappa B, malnutrition-inflammation score

  14. South African medical students’ perceptions and knowledge about antibiotic resistance and appropriate prescribing: Are we providing adequate training to future prescribers?

    Directory of Open Access Journals (Sweden)

    Sean Wasserman,

    2017-05-01

    Full Text Available Background. Education of medical students has been identified by the World Health Organization as an important aspect of antibiotic resistance (ABR containment. Surveys from high-income countries consistently reveal that medical students recognise the importance of antibiotic prescribing knowledge, but feel inadequately prepared and require more education on how to make antibiotic choices. The attitudes and knowledge of South African (SA medical students regarding ABR and antibiotic prescribing have never been evaluated. Objective. To evaluate SA medical students’ perceptions, attitudes and knowledge about antibiotic use and resistance, and the perceived quality of education relating to antibiotics and infection. Methods. This was a cross-sectional survey of final-year students at three medical schools, using a 26-item self-administered questionnaire. The questionnaires recorded basic demographic information, perceptions about antibiotic use and ABR, sources, quality, and usefulness of current education about antibiotic use, and questions to evaluate knowledge. Hard-copy surveys were administered during whole-class lectures. Results. A total of 289 of 567 (51% students completed the survey. Ninety-two percent agreed that antibiotics are overused and 87% agreed that resistance is a significant problem in SA – higher proportions than those who thought that antibiotic overuse (63% and resistance (61% are problems in the hospitals where they had worked (p<0.001. Most reported that they would appreciate more education on appropriate use of antibiotics (95%. Only 33% felt confident to prescribe antibiotics, with similar proportions across institutions. Overall, prescribing confidence was associated with the use of antibiotic prescribing guidelines (p=0.003, familiarity with antibiotic stewardship (p=0.012, and more frequent contact with infectious diseases specialists (p<0.001. There was an overall mean correct score of 50% on the knowledge

  15. PPD-QALY-an index for cost-effectiveness in orthopedics: providing essential information to both physicians and health care policy makers for appropriate allocation of medical resources.

    Science.gov (United States)

    Dougherty, Christopher P; Howard, Timothy

    2013-09-01

    Because of the increasing health care costs and the need for proper allocation of resources, it is important to ensure the best use of health benefits for sick and injured people of the population. An index or indicator is needed to help us quantify what is being spent so that comparisons with other options can be implemented. Cost-effective analysis seems to be well suited to provide this essential information to health care policy makers and those charged with distributing disability funds so that the proper allocation of resources can be achieved. There is currently no such index to show whether the benefits paid out are the most cost-effective. By comparing the quality-adjusted life year (QALY) of a treatment method to the disability an individual would experience, on the basis of lost wages as measure of disability, we provide decision makers more information for the basis of cost allocation in health care. To accomplish this, we describe a new term, the PPD-QALY (permanent partial disability-quality of life year). This term was developed to establish an index to which musculoskeletal care can be compared, to evaluate the cost-effectiveness of a treatment on the basis of the monetary value of the disability. This term serves to standardize the monetary value of an injury. Cost-effective analysis in arthroscopic surgery may prove to be a valuable asset in this role and to provide decision makers the information needed to determine the societal benefit from new arthroscopic procedures as they are developed and implemented.

  16. Distinct difference in absorption pattern in pigs of betaine provided as a supplement or present naturally in cereal dietary fiber.

    Science.gov (United States)

    Hedemann, Mette Skou; Theil, Peter Kappel; Lærke, Helle Nygaard; Bach Knudsen, Knud Erik

    2015-03-18

    The net absorption of betaine and choline was determined for 4 h after the first meal of the day in three experiments with porto-arterial catheterized pigs in which betaine was added as a supplement to a low-betaine diet (n=4 pigs) and compared to the net absorption of betaine and choline from high-fiber breads differing in amount and source of dietary fiber (two experiments, n=6 pigs each). Plasma betaine peaked after 30 min when betaine was fed as a supplement, whereas it peaked after 120-180 min when high-fiber breads were fed. Plasma betaine showed no diet×time interaction after feeding with high-fiber breads, indicating that the absorption kinetic did not differ between fiber sources. The net absorption of choline was not affected by the experimental diets. In conclusion, betaine in cereal sources has to be liberated from the matrix prior to absorption, causing delayed absorption.

  17. A point-of-sale communications campaign to provide consumers safety information on drug-dietary supplement interactions: a pilot study.

    Science.gov (United States)

    Perlman, Adam I; Lebow, David G; Raphael, Karen; Ali, Ather; Simmons, Leigh Ann

    2013-01-01

    Concurrent use of dietary supplements with over-the-counter and prescription pharmaceuticals has become increasingly common, and with this trend, so has the incidence of adverse drug-supplement interactions. In the current market, consumers have no way to distinguish between safe and potentially harmful supplements. Thus, the primary objective of this study was to test the hypothesis that messages designed to increase consumers' awareness of potential health risks of concurrent use of dietary supplements with over-the-counter and prescription pharmaceuticals would promote further consideration and action, as evidenced by (a) seeking additional information from an authoritative source or qualified health care professional and (b) changing dietary supplement usage patterns. To test this hypothesis, an innovative consumer information delivery system, referred to as the Buyer Information Network (BuyIN), was utilized. BuyIN uses currently available, Web-enabled point-of-sale (POS) technology to provide up-to-date, evidence-based, health- and safety-related messages to consumers at the retail checkout counter. Results showed that more than one-fourth (27.1%) of consumers (n = 199) who purchased targeted items reported they were aware of the messages. Of this subgroup of aware consumers, 11.2% reported that they sought additional information from a physician or pharmacist, 11.5% reported that they visited the website listed on the coupon, and 10.5% indicated that they changed their dietary supplement usage patterns as a result of the messages. Future research should include a large-scale study of a fully implemented and capable system at multiple test sites around the country, including investigating the utility of BuyIN in different retail settings.

  18. Distinct Difference in Absorption Pattern in Pigs of Betaine Provided as a Supplement or Present Naturally in Cereal Dietary Fiber

    DEFF Research Database (Denmark)

    Hedemann, Mette Skou; Theil, Peter Kappel; Lærke, Helle Nygaard

    2015-01-01

    high-fiber breads differing in amount and source of dietary fiber (two experiments, n = 6 pigs each). Plasma betaine peaked after 30 min when betaine was fed as a supplement, whereas it peaked after 120–180 min when high-fiber breads were fed. Plasma betaine showed no diet × time interaction after...... feeding with high-fiber breads, indicating that the absorption kinetic did not differ between fiber sources. The net absorption of choline was not affected by the experimental diets. In conclusion, betaine in cereal sources has to be liberated from the matrix prior to absorption, causing delayed...

  19. Calcium and Vitamin D Supplement Prescribing Practices among Providers Caring for Children with Autism Spectrum Disorders: Are We Addressing Bone Health?

    Directory of Open Access Journals (Sweden)

    Shylaja Srinivasan

    2016-01-01

    Full Text Available Children with autism spectrum disorders (ASD have several risk factors for low bone mineral density. The gluten-free, casein-free (GFCF diet is a complementary therapy sometimes used in ASD that raises concerns for the adequacy of calcium and vitamin D intake. This study evaluated the prescribing practices of calcium and vitamin D supplements and the practice of checking 25-hydroxy vitamin D (25(OHD levels by providers in 100 children with ASD, 50 of whom were on the GFCF diet. Fifty-two percent and 46% of children on the GFCF diet were on some form of vitamin D and calcium supplements, respectively, compared to 18% and 14% of those not on this diet. Twenty-four percent of children in the GFCF group had a documented 25(OHD level compared to none in the non-GFCF group. The data highlight a gap in calcium and vitamin D supplement prescribing practices among providers caring for children with ASD as well as a gap in the practice of checking 25(OHD levels.

  20. Calcium and cholecalciferol supplementation provides no added benefit to nutritional counseling to improve bone mineral density in survivors of childhood acute lymphoblastic leukemia (ALL).

    Science.gov (United States)

    Kaste, S C; Qi, A; Smith, K; Surprise, H; Lovorn, E; Boyett, J; Ferry, R J; Relling, M V; Shurtleff, S A; Pui, C H; Carbone, L; Hudson, M M; Ness, K K

    2014-05-01

    We sought to improve lumbar spine bone mineral density (LS-BMD) in long-term survivors of childhood acute lymphoblastic leukemia (ALL) using calcium and cholecalciferol supplementation. This double-blind, placebo-controlled trial randomized 275 participants (median age, 17 [9-36.1] years) with age- and gender-specific LS-BMD Z-scores <0 to receive nutritional counseling with supplementation of 1,000 mg/day calcium and 800 International Unit cholecalciferol or placebo for 2 years. The primary outcome was change in LS-BMD assessed by quantitative computerized tomography (QCT) at 24 months. Linear regression models were employed to identify the baseline risk factors for low LS-BMD and to compare LS-BMD outcomes. Pre-randomization LS-BMD below the mean was associated with male gender (P = 0.0024), White race (P = 0.0003), lower body mass index (P < 0.0001), and cumulative glucocorticoid doses of ≥ 5,000 mg (P = 0.0012). One hundred eighty-eight (68%) participants completed the study; 77% adhered to the intervention. Mean LS-BMD change did not differ between survivors randomized to supplements (0.33 ± 0.57) or placebo (0.28 ± 0.56). Participants aged 9-13 years and those 22-35 years had the greatest mean increases in LS-BMD (0.50 ± 0.66 and 0.37 ± 0.23, respectively). Vitamin D insufficiency (serum 25[OH]D <30 ng/ml) found in 296 (75%), was not associated with LS-BMD outcomes (P = 0.78). Cholecalciferol and calcium supplementation provides no added benefit to nutritional counseling for improving LS-BMD among adolescent and young adult survivors of ALL (93% of whom had LS-BMD Z-scores above the mean at study entry). © 2014 Wiley Periodicals, Inc.

  1. 75 FR 26747 - U.S. Gas & Electric, Inc., Energy Services Providers, Inc., ESPI New England, Inc; Supplemental...

    Science.gov (United States)

    2010-05-12

    ... No: 2010-11240] DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Docket Nos. ER10-1129-000; ER10-1130-000; ER10-1131-000] U.S. Gas & Electric, Inc., Energy Services Providers, Inc., ESPI New... U.S. Gas & Electric, Inc., Energy Services Providers, Inc., and ESPI New England, Inc.'s application...

  2. Special Appropriation Act Projects

    Science.gov (United States)

    EPA is sometimes directed to provide funding to a specific entity for study, purpose, or activity.This information will be of interest to a community or other entity that has been identified in one of EPA's appropriations acts to receive such funding.

  3. Lipid-Based Nutrient Supplements Providing Approximately the Recommended Daily Intake of Vitamin A Do Not Increase Breast Milk Retinol Concentrations among Ghanaian Women.

    Science.gov (United States)

    Klevor, Moses K; Haskell, Marjorie J; Lartey, Anna; Adu-Afarwuah, Seth; Zeilani, Mamane; Dewey, Kathryn G

    2016-02-01

    Vitamin A deficiency remains a global public health problem. Daily supplementation with a lipid-based nutrient supplement (LNS) has potential for increasing milk vitamin A concentrations. The objective of this study was to determine whether daily supplementation with approximately the recommended daily intake of vitamin A in an LNS or a multiple-micronutrient supplement (MMN) during pregnancy and the first 6 mo postpartum has an effect on breast milk retinol concentration at 6 mo postpartum. Women ≤20 wk pregnant (n = 1320) were randomly assigned to receive either the MMN providing 18 micronutrients, including 800 μg retinol equivalents of vitamin A, or the LNS with the same nutrients as the MMN group, plus 4 minerals and macronutrients, until 6 mo postpartum; a control group received iron and folic acid during pregnancy and a placebo (calcium tablet) during the first 6 mo postpartum. Breast milk samples collected at 6 mo postpartum were analyzed for retinol and fat concentrations by HPLC and creamatocrit, respectively, in a subsample of 756 women. The breast milk retinol concentration was (mean ± SD) 56.3 ± 2.1 nmol/g fat, with no significant differences between groups [iron and folic acid (n = 243): 59.1 ± 2.8; MMN (n = 260): 55.4 ± 2.5; LNS (n = 253): 54.7 ± 2.5 nmol/g fat; P = 0.45], regardless of whether the woman had or had not received a high-dose vitamin A supplement (200,000 IU) soon after childbirth. Around 17% of participants had low milk retinol (≤28 nmol/g fat). We estimated that 41% of infants were potentially receiving vitamin A at amounts above the Tolerable Upper Intake Level (600 μg retinol activity equivalents/d), with no group differences in percentages with low or high milk retinol concentration. Daily consumption of approximately the recommended intake of vitamin A did not increase breast milk retinol concentrations in this sample of Ghanaian women. This trial was registered at clinicaltrials.gov as NCT00970866. © 2016 American

  4. Value Appropriation in Business Exchange

    DEFF Research Database (Denmark)

    Ellegaard, Chris; Medlin, Christopher J.; Geersbro, Jens

    2014-01-01

    master the difficult balance between value creation and appropriation. This review has provided an overview of the many managerial options for value appropriation and created knowledge on the effects of the various appropriation mechanisms enabling managers to secure company rents while not jeopardizing......Purpose – Value appropriation is a central, yet neglected aspect in business exchange research. The purpose of the paper is to generate an overview of research on active value appropriation in business exchange and provide the foundation for further research into value appropriation, as well...... as some initial guidance for managers. Design/methodology/approach – Literatures investigating value appropriation were identified by the means of a systematic review of the overall management literature. Findings – The authors provide an overview and comparison of the literatures and find that they apply...

  5. Dietary Supplements

    Science.gov (United States)

    ... keeping bones strong. Pregnant women can take the vitamin folic acid to prevent certain birth defects in their babies. To take a supplement as safely as possible Tell your health care provider about any dietary supplements you use Do not take a bigger dose ...

  6. Bilateral posterior cervical cages provide biomechanical stability: assessment of stand-alone and supplemental fixation for anterior cervical discectomy and fusion

    Directory of Open Access Journals (Sweden)

    Voronov LI

    2016-07-01

    single- and multilevel constructs (P<0.05.Conclusion: The biomechanical effectiveness of bilateral posterior cages in limiting cervical segmental motion is comparable to single-level plated ACDF. Furthermore, supplementation of single- and multilevel ACDF with posterior cervical cages provided a significant increase in stability and therefore may be a potential, minimally disruptive option for supplemental fixation for improving ACDF fusion rates. Keywords: cervical spine, posterior fusion, biomechanics, cervical facets, DTRAX Posterior Cervical Cage

  7. Appropriation and dispossession by space

    DEFF Research Database (Denmark)

    Larsen, Troels Schultz

    in and around the given neglected housing estate. Based on this analysis it is discussed how we should supplement Bourdieu’s discussions of the 'appropriation of space' and Wacquant’s concept of territorial stigmatization with a perspective on how social groups unable to appropriate a space of their own any......In his analysis of contemporary social suffering Bourdieu explicitly summarizes his comprehension of the relations between social-, symbolic- and physical space in his analysis of site effects. He briefly outlines a model of the relations between these spaces by making a distinction between place...... of the people occupying the given site that situates them in social space vis-a-vis other positions. This way any site also becomes a more or less spontaneous fuzzy dual reading or symbolization of both its physicality and the people occupying the given site. Based on his relational thinking and the above...

  8. Conceptualization and Appropriation

    DEFF Research Database (Denmark)

    Bossen, Claus; Dalsgård, Peter

    2005-01-01

    and system development. Second, we argue that the process of design extends far into the process of use and that much can be learned by looking at the process of appropriation of a new system. The problems of conceptualisation and appropriation point towards the need to critically examine the mangle...

  9. Appropriability, services and reputation

    NARCIS (Netherlands)

    Dolfsma, W.A.

    2011-01-01

    The appropriability regime (Teece 1986) that innovating service firms face is generally weaker than what firms in manufacturing sectors face. An important means to appropriate benefits from innovation that service firms can use is their reputation. This conceptual paper offers insights into how a

  10. Narrative self-appropriation

    DEFF Research Database (Denmark)

    Køster, Allan

    2017-01-01

    role in processes of appropriating such embodied self-alienness. Importantly, the notion of narrative used is that of a scalar conception of narrativity as a variable quality of experience that comes in degrees. From this perspective, narrative appropriation is a process of gradually attributing...... the quality of narrativity to experiences, thereby familiarising the moods, affects, and responses that otherwise govern “from behind”. Finally, I propose that the idea of a narrative appropriation of embodied self-alienness is also relevant to the much-debated question of personal responsibility in BPD......; particularly as this question plays out in psychotherapeutic contexts where a narrative self-appropriation may facilitate an increase in sense of autonomy and reduce emotions of guilt and shame....

  11. Appropriation of Information Systems

    DEFF Research Database (Denmark)

    Kjærgaard, Annemette Leonhardt; Jensen, Tina Blegind

    2008-01-01

    This paper explores the use of cognitive mapping for eliciting users' sensemaking during information system (IS) appropriation. Despite the potential usefulness of sensemaking, few studies in IS research use it as a theoretical lens to address IS appropriation. A possible reason for this may...... be that sensemaking does not easily lend itself to be used in practice. We introduce cognitive mapping as a way to elicit users' sensemaking and illustrate its value by reporting on findings from an empirical study of the introduction of an Electronic Patient Record (EPR) system. The contribution of the paper...

  12. ACR Appropriateness Criteria Myelopathy.

    Science.gov (United States)

    Roth, Christopher J; Angevine, Peter D; Aulino, Joseph M; Berger, Kevin L; Choudhri, Asim F; Fries, Ian Blair; Holly, Langston T; Kendi, Ayse Tuba Karaqulle; Kessler, Marcus M; Kirsch, Claudia F; Luttrull, Michael D; Mechtler, Laszlo L; O'Toole, John E; Sharma, Aseem; Shetty, Vilaas S; West, O Clark; Cornelius, Rebecca S; Bykowski, Julie

    2016-01-01

    Patients presenting with myelopathic symptoms may have a number of causative intradural and extradural etiologies, including disc degenerative diseases, spinal masses, infectious or inflammatory processes, vascular compromise, and vertebral fracture. Patients may present acutely or insidiously and may progress toward long-term paralysis if not treated promptly and effectively. Noncontrast CT is the most appropriate first examination in acute trauma cases to diagnose vertebral fracture as the cause of acute myelopathy. In most nontraumatic cases, MRI is the modality of choice to evaluate the location, severity, and causative etiology of spinal cord myelopathy, and predicts which patients may benefit from surgery. Myelopathy from spinal stenosis and spinal osteoarthritis is best confirmed without MRI intravenous contrast. Many other myelopathic conditions are more easily visualized after contrast administration. Imaging performed should be limited to the appropriate spinal levels, based on history, physical examination, and clinical judgment. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals, and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  13. Synbiotic supplementation promotes improvement of chronic diarrhea of unknown etiology in patient with chronic kidney disease and provides better outcomes in dialysis

    Science.gov (United States)

    Alvarenga Borges, Natalia; Elias Farage, Najla; Faria Barros, Amanda; Carvalho Ferreira, Dennis; Fouque, Denis; Mafra, Denise

    2016-02-16

    Chronic kidney disease (CKD) patients often have gastrointestinal symptoms which may result in malnutrition and a negative impact on their quality of life. Modulation of the gut microbiota can be a strategy to promote host health and homeostasis. The authors present a case of chronic diarrhea in a hemodialysis (HD) patient with an unknown etiology. After about one year and several failed interventions, synbiotic therapy was performed. The diarrhea episodes ceased after three months of daily supplementation and both biochemical and nutritional parameters improved. Synbyotic therapy promoted clinical benefits in this patient. Therefore, this simple therapy may be a promising alternative in CKD and it should be tested in larger studies.

  14. Workspace appropriation and attachment

    Directory of Open Access Journals (Sweden)

    M. PAVALACHE-ILIE

    2016-11-01

    Full Text Available This literature synthesis presents a short history of the evolution of the concepts of space appropriation and place attachment, highlighting the difficulty of their operationalisation from a cultural point of view. The next subject brought into discussion is the relation between the affective dimension of the connection between a person and the work place and the behaviours which are prone to insure the proper functioning of organizations, such as the organizational civism and the organizational commitment.

  15. Crowding as appropriation

    DEFF Research Database (Denmark)

    Thelle, Mikkel

    2016-01-01

    ofbodies, it is assessed how the agency of the crowd works on animmediate level and in its more lasting effects on urban space.The notion of appropriation is related to the crowd’s claim,formal and informal, as resulting from a negotiation of this,mostly public, space, and articulated in empirical cases...... such aselections, political activism or pickpocketing. Thus, the articlesuggests terms for a bodily focused and historically situatedcrowd theory....

  16. ACR appropriateness criteria jaundice.

    Science.gov (United States)

    Lalani, Tasneem; Couto, Corey A; Rosen, Max P; Baker, Mark E; Blake, Michael A; Cash, Brooks D; Fidler, Jeff L; Greene, Frederick L; Hindman, Nicole M; Katz, Douglas S; Kaur, Harmeet; Miller, Frank H; Qayyum, Aliya; Small, William C; Sudakoff, Gary S; Yaghmai, Vahid; Yarmish, Gail M; Yee, Judy

    2013-06-01

    A fundamental consideration in the workup of a jaundiced patient is the pretest probability of mechanical obstruction. Ultrasound is the first-line modality to exclude biliary tract obstruction. When mechanical obstruction is present, additional imaging with CT or MRI can clarify etiology, define level of obstruction, stage disease, and guide intervention. When mechanical obstruction is absent, additional imaging can evaluate liver parenchyma for fat and iron deposition and help direct biopsy in cases where underlying parenchymal disease or mass is found. Imaging techniques are reviewed for the following clinical scenarios: (1) the patient with painful jaundice, (2) the patient with painless jaundice, and (3) the patient with a nonmechanical cause for jaundice. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Narrative self-appropriation

    DEFF Research Database (Denmark)

    Køster, Allan

    2017-01-01

    It is often emphasised that persons diagnosed with Borderline Personality Disorder [BPD] show difficulties in understanding their own psychological states. In this article, I argue that from a phenomenological perspective BPD can be understood as an existential modality where the embodied self...... is profoundly saturated by an alienness regarding the person’s own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through e.g. psychotherapy. Following this line of thought, I present the idea that narrativising experiences can play an important...... the quality of narrativity to experiences, thereby familiarising the moods, affects, and responses that otherwise govern “from behind”. Finally, I propose that the idea of a narrative appropriation of embodied self-alienness is also relevant to the much-debated question of personal responsibility in BPD...

  18. Providing An Appropriate Education Programme For Children With ...

    African Journals Online (AJOL)

    ... special school, integrated school, special unit in regular schools and the new emphasis on inclusive education. The paper then emphasized the danger inherent in wrong education programme for the children with mental retardation. International Journal of Emotional psychology and sport ethics (IJEPSE) Vol. 7 2005: pp.

  19. Providing Appropriate Exploratory Programs for Students in the Middle Grades.

    Science.gov (United States)

    Barnhart, Edward A.

    1987-01-01

    Describes a middle school program in Washington State that offers 20-day activity minicourses (ranging from aerobic dancing to weightlifting) and seven-week "unified arts" courses (computer lab, wood shop, cooking, art, and dramatics) designed to help emerging adolescents explore various vocational and avocational interests. Includes six…

  20. Antiretroviral therapy provided to HIV-infected Malawian women in a randomized trial diminishes the positive effects of lipid-based nutrient supplements on breast-milk B vitamins.

    Science.gov (United States)

    Allen, Lindsay H; Hampel, Daniela; Shahab-Ferdows, Setareh; York, Emily R; Adair, Linda S; Flax, Valerie L; Tegha, Gerald; Chasela, Charles S; Kamwendo, Debbie; Jamieson, Denise J; Bentley, Margaret E

    2015-12-01

    Little information is available on B vitamin concentrations in human milk or on how they are affected by maternal B vitamin deficiencies, antiretroviral therapy, or maternal supplementation. The objective was to evaluate the effects of antiretroviral therapy and/or lipid-based nutrient supplements (LNSs) on B vitamin concentrations in breast milk from HIV-infected women in Malawi. Breast milk was collected from 537 women recruited within the Breastfeeding, Antiretrovirals, and Nutrition study at 2 or 6 wk and 24 wk postpartum. Women were assigned to receive antiretrovirals and LNSs, antiretrovirals only, LNSs only, or a control. Antiretrovirals and LNSs were given to the mothers from weeks 0 to 28. The antiretrovirals were zidovudine/lamivudine and nelfinavir or lopinavir/ritonavir. LNSs provided 93-118% of the Recommended Dietary Allowances of thiamin, riboflavin, niacin, pyridoxine, and vitamin B-12. Infants were exclusively breastfed. LNSs increased milk concentrations of all vitamins except thiamin, whereas antiretrovirals lowered concentrations of nicotinamide, pyridoxal, and vitamin B-12. Although antiretrovirals alone had no significant effect on riboflavin concentrations, they negatively affected the LNS-induced increase in this vitamin. Thiamin was not influenced by the study interventions. Concentrations of all B vitamins were much lower than usually accepted values. All B vitamins were low in milk, and all but thiamin were increased by maternal supplementation with LNSs. Antiretrovirals alone decreased concentrations of some B vitamins in milk. When LNS was given in addition to antiretrovirals, the negative effect of antiretrovirals offset the positive effect of LNSs for all vitamins except thiamin. This trial was registered at clinicaltrials.gov as NCT00164762. © 2015 American Society for Nutrition.

  1. Calcium supplements

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007477.htm Calcium supplements To use the sharing features on this page, please enable JavaScript. WHO SHOULD TAKE CALCIUM SUPPLEMENTS? Calcium is an important mineral for the ...

  2. Unauthorized Appropriations and Expiring Authorizations

    Science.gov (United States)

    1996-01-11

    regarding optometry) health care for rural areas) re- search on health professions issues) chiropractic demonstration projects and residency training...socially disadvantaged individuals FY 1995 Appropriations Authorized: $ 2,500,000 Unauthorized FY 1996 Appropriations: $ 1,000,000 * State agricultural...Reconciliation Act of 1990 * Grants to states to improve their child care licensing and registration requirements and procedures FY 1994 Appropriations Authorized

  3. Volume-Based F-18 FDG PET/CT Imaging Markers Provide Supplemental Prognostic Information to Histologic Grading in Patients With High-Grade Bone or Soft Tissue Sarcoma

    DEFF Research Database (Denmark)

    Andersen, Kim Francis; Fuglo, Hanna Maria; Rasmussen, Sine Hvid

    2015-01-01

    to 2012 including 92 patients with histologically verified high-grade BS (N = 37) or STS (N = 55). All patients underwent a pretreatment F-18 FDG PET/CT scan. Clinical data were registered. Measurements of the accuracy of metabolic tumor volume with a preset threshold of 40% of the maximum standardized...... analysis. Kaplan-Meier survival estimates and log-rank test were used to compare the degree of equality of survival distributions. Prognostic variables with related hazard ratios (HR) were assessed using Cox proportional hazards regression analysis.Forty-one of 92 patients died during follow-up (45%; 12 BS.......05, HR 3.37 [95% CI 1.02-11.11]). No significant results were demonstrated for MTV40%.Volume-based F-18 FDG PET/CT imaging markers in terms of pretreatment estimation of TLG provide supplemental prognostic information to histologic grading, with significant independent properties for prediction...

  4. Understanding motivations for dietary supplementation during pregnancy: A focus group study.

    Science.gov (United States)

    Malek PhD, Lenka; Umberger PhD, Wendy J; Makrides PhD, Maria; Collins PhD, Carmel T; Zhou PhD, Shao Jia

    2018-02-01

    to increase understanding of psychosocial factors (behavioural, normative and control beliefs) motivating vitamin and mineral supplement use during pregnancy. ten focus group discussions and two in-depth interviews were conducted using a script comprising questions based on study objectives. All discussions were recorded, transcribed verbatim and analysed using a framework approach. South Australia, Australia. 40 women aged 21-45 years who were either pregnant orachieve peace of mind knowing that nutrient requirements were 'definitely' being met. Other common factors motivating supplement use were the beliefs that supplementation: benefits maternal and fetal health; corrects known nutritional deficiencies; and is a more efficient method of obtaining required nutrients relative to food. Advice received from healthcare providers and marketing of supplements also motivated supplementation, while forgetting to take supplements was the most common barrier to use. Cost was only a barrier when considering whether or not to continue supplementation post-birth. women believe that supplements are an easier and more reliable source of nutrients than food intake alone, and rely on dietary supplementation as an insurance policy during pregnancy. Further studies are needed in larger and more representative samples to validate these findings and to test the effectiveness of information and intervention strategies targeting appropriate supplement use during pregnancy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Supplemental Colleges

    Data.gov (United States)

    Department of Homeland Security — The Supplemental Colleges layer attempts to capture additional Post Secondary Education campuses of colleges and universities associated with a single campus listed...

  6. Antiretroviral therapy provided to HIV-infected Malawian women in a randomized trial diminishes the posiitive effect of lipid-based nutrient supplements on breast milk B-vitamins

    Science.gov (United States)

    Background: There is little information on B-vitamin concentrations in human milk or how they are affected by maternal B-vitamin deficiencies, antiretroviral (ARV) therapy or maternal supplementation. Objective: To evaluate effects of ARV therapy and/or lipid-based nutrient supplements (LNS) on B-v...

  7. Legislative Branch: FY2014 Appropriations

    Science.gov (United States)

    2013-11-25

    Authorizations Since 1999, by Matthew E. Glassman . Legislative Branch: FY2014 Appropriations Congressional Research Service 10 The FY2012 level of...Congresses, by Matthew E. Glassman . Legislative Branch: FY2014 Appropriations Congressional Research Service 11 Members’ Representational...vehicles; communications equipment; security equipment and its installation; dignitary protection; intelligence analysis; hazardous material response

  8. Dietary supplements for aquatic sports.

    Science.gov (United States)

    Derave, Wim; Tipton, Kevin D

    2014-08-01

    Many athletes use dietary supplements, with use more prevalent among those competing at the highest level. Supplements are often self-prescribed, and their use is likely to be based on an inadequate understanding of the issues at stake. Supplementation with essential micronutrients may be useful when a diagnosed deficiency cannot be promptly and effectively corrected with food-based dietary solutions. When used in high doses, some supplements may do more harm than good: Iron supplementation, for example, is potentially harmful. There is good evidence from laboratory studies and some evidence from field studies to support health or performance benefits from appropriate use of a few supplements. The available evidence from studies of aquatic sports is small and is often contradictory. Evidence from elite performers is almost entirely absent, but some athletes may benefit from informed use of creatine, caffeine, and buffering agents. Poor quality assurance in some parts of the dietary supplements industry raises concerns about the safety of some products. Some do not contain the active ingredients listed on the label, and some contain toxic substances, including prescription drugs, that can cause health problems. Some supplements contain compounds that will cause an athlete to fail a doping test. Supplement quality assurance programs can reduce, but not entirely eliminate, this risk.

  9. decolonising sustainability: subverting and appropriating ...

    African Journals Online (AJOL)

    DECOLONISING SUSTAINABILITY: SUBVERTING AND APPROPRIATING. MYTHOLOGIES OF SOCIAL CHANGE. Noel Gough. This essay explores some possibilities for decolonising the concept of sustainability in southern African dis- courses of ..... stories include commonplace features of green stories. (such as ...

  10. Appropriate roads for rural access

    CSIR Research Space (South Africa)

    Paige-Green, P

    2006-03-01

    Full Text Available be reduced, the result remains environmentally unsustainable. Low cost but appropriate techniques for upgrading these roads cost-effectively to sealed standards have been implemented in many countries recently. These techniques optimize the use of local...

  11. Effects of a Vitamin D and Leucine-Enriched Whey Protein Nutritional Supplement on Measures of Sarcopenia in Older Adults, the PROVIDE Study: A Randomized, Double-Blind, Placebo-Controlled Trial

    NARCIS (Netherlands)

    Bauer, J.M.; Verlaan, S.; Bautmans, I.; Brandt, K.; Donini, L.M.; Maggio, M.; McMurdo, M.E.T.; Mets, T.; Seal, C.; Wijers, S.L.; Ceda, G.P.; De Vito, G.; Donders, G.; Drey, M.; Greig, C.; Holmback, U.; Narici, M.; McPhee, J.; Poggiogalle, E.; Power, D.; Scafoglieri, A.; Schultz, R.; Sieber, C.C.; Cederholm, T.

    2015-01-01

    Background: Age-related losses of muscle mass, strength, and function (sarcopenia) pose significant threats to physical performance, independence, and quality of life. Nutritional supplementation could positively influence aspects of sarcopenia and thereby prevent mobility disability. Objective: To

  12. Unauthorized Appropriations and Expiring Authorizations

    Science.gov (United States)

    2015-01-15

    in general, pediatric , and public health dentistry , and for a loan repayment program (sec. 5302, 42 U.S.C. 293k-2) 39 FY 2015 Appropriations...Appropriations: Not Available Emergency medicine research and pediatric emergency medicine research through National Institutes of Health, Agency for...Committee Patient Protection and Affordable Care ActP.L. 111-148 (Continued) Health care workforce loan repayment program: pediatric medical and surgical

  13. Appropriateness: analysis of outpatient radiology requests.

    Science.gov (United States)

    Cristofaro, M; Busi Rizzi, E; Schininà, V; Chiappetta, D; Angeletti, C; Bibbolino, C

    2012-03-01

    This study assessed radiology requests and the influence of previous radiological procedures on their specificity and appropriateness, evaluated diagnostic outcomes and recorded the economic impact of inappropriate examinations. We prospectively analysed 4,018 outpatient requests, the appropriateness of which was assessed using an evaluation form. Economic analysis was based on costs listed in the Italian National Health Services (NHS) national tariff as established by the Ministerial Decree of 22 July 1996. Statistical analysis was carried out using Pearson's test and univariate and multivariate logistic regression models. Of 4,018 outpatient requests, 57% were not included in a follow-up protocol and 56% were found to be appropriate. The diagnostic question was confirmed in 66% of cases considered appropriate (prequests was 257,317 euro, with inappropriate requests accounting for 94,012 euro (36.5%). We found a 56% rate of appropriate requests and demonstrated that appropriate prescriptions provided with a specific clinical question led to significantly higher confirmation rates of the diagnostic hypothesis. In addition, inappropriate requests had a major negative economic impact.

  14. Nutritional supplements

    DEFF Research Database (Denmark)

    Petersen, Gry Bjerg; Andersen, Jens Rikardt

    2015-01-01

    Background: Several studies have indicated that cancer patients have significantly altered taste sensitivity without specifying the preferences. One of the related problems is low compliance to nutritional therapy with oral nutritional supplements (ONS) in patients suffering severe weight loss...

  15. Supplemental information

    Data.gov (United States)

    U.S. Environmental Protection Agency — Supplemental information showing results of inter-comparison between C-PORT, AERMOD and R-LINE dispersion algorithms. This dataset is associated with the following...

  16. The Appropriateness of Hierarchies (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2010-09-01

    evidence’. He proposes two alternatives to evidence hierarchies, signal-to-noise ratios and evidence typologies. I personally favour the latter, in which ‚a typology of evidence stresses the need to consider which type of studies are most appropriate for answering different types of questions‛ (p.87. But whether we can find a way to create such a typology within LIS that would be more than a token is questionable. Where it could be helpful is in providing practitioners with ideas of the types of research they may consider for different types of questions, and the reasons why these methods are appropriate. Why bog ourselves down in a context of one research method being better than another? This is simply divisive and does not contribute solutions. Let's stop talking in terms of research hierarchies and inherent worth of particular methods and instead talk about appropriateness and good research design. Even better, let’s get on with doing studies that are appropriate, rigorous, and relevant to practice.

  17. 18 CFR 740.13 - Supplemental instructions.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Supplemental instructions. 740.13 Section 740.13 Conservation of Power and Water Resources WATER RESOURCES COUNCIL STATE WATER MANAGEMENT PLANNING PROGRAM § 740.13 Supplemental instructions. As deemed appropriate, the Council...

  18. Choosing a primary care provider

    Science.gov (United States)

    ... Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Choosing a primary care provider URL of this page: //medlineplus.gov/ency/article/001939.htm Choosing a primary care provider To ...

  19. Types of health care providers

    Science.gov (United States)

    ... Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Types of health care providers URL of this page: //medlineplus.gov/ency/article/001933.htm Types of health care providers To ...

  20. 'Appropriate' medical treatment: what's in a word?

    Science.gov (United States)

    Phull, Jaspreet; Bartlett, Peter

    2012-04-01

    Following the amendments in the 2007 Act, there were several revisions made focusing largely on community treatment orders and deprivation of liberty of persons lacking capacity. One of the amendments included a requirement that 'appropriate treatment' be 'available' for compulsion to be imposed in a variety of contexts, most notably admission for treatment under section 3. The definition of appropriate medical treatment within the Act appears largely circular, and therefore of little assistance. The Code of Practice provides some guidance but does little to add to the statutory language. In terms of jurisprudence, there are three reported cases concerning the provision. These cases are analysed and their significance is discussed in an attempt to formulate a clearer definition for appropriate medical treatment.

  1. ICT APPROPRIATION: A KNOWLEDGE CREATION PERSPECTIVE

    DEFF Research Database (Denmark)

    Akther, Farzana

    This thesis investigates information and communication tools (ICTs) as instruments of community development processes in the context of a case study conducted in collaboration with a community empowerment program (CEP) of the non-government organization (NGO) BRAC in Bangladesh by conceptualizing...... a learning theory-based model for ICT appropriation. The aim of this research is to understand the conditions of ICT appropriation as a collective knowledge creation process within rural community development projects—and, thus, to provide tools for perceiving and constructing local ICT development...... in organizations. The study claims that ICT capacity building through a collective resource approach (participatory design) may sustain a knowledge-creation process based on hands-on participation and interaction among individuals, communities, and the sharing of artifacts and thereby offers an ICT appropriation...

  2. Cultural Backgrounds and Textual Appropriation

    Science.gov (United States)

    Shi, Ling

    2006-01-01

    This study examines interviews with 46 undergraduates to explore if participants with differing language and cultural backgrounds view plagiarism or textual appropriation primarily as a) a language problem because of a lack of words of one's own, or b) a cultural challenge as a result of either some first language (L1) cultural training to…

  3. TECHNICAL COMPARISON OF CANDIDATE ION EXCHANGE MEDIA FOR SMALL COLUMN ION EXCHANGE (SCIX) APPLICATIONS IN SUPPORT OF SUPPLEMENTAL LAW PRETREATMENT

    Energy Technology Data Exchange (ETDEWEB)

    RAMSEY AA; THORSON MR

    2010-12-28

    At-tank supplemental pretreatment including both filtration and small column ion exchange is currently under evaluation to facilitate salt waste retrieval and processing in the Hanford tank farms. Spherical resorcinol formaldehyde (sRF) resin is the baseline ion exchange resin for use in the Waste Treatment and Immobilization Plant (WTP). This document provides background and technical rationale to assist in determining whether spherical resorcinol formaldehyde (sRF) is also the appropriate ion exchange resin for supplemental LAW pretreatment processes and compares sRF with crystalline silicotitanate (CST) as potential supplemental pretreatment ion exchange media.

  4. Three-month nutritional supplementation in Indonesian infants and toddlers benefits memory function 8 y later.

    Science.gov (United States)

    Pollitt, E; Watkins, W E; Husaini, M A

    1997-12-01

    Does short-term supplementary feeding during infancy and childhood have long-lasting effects? In 1986, 334 children aged 6-60 mo living on rural tea plantations in West Java, Indonesia, participated in a 3-mo randomized trial to test the effects of a dietary supplement providing approximately 1672 kJ (400 kcal) energy/d, with about the same nutrient density as local foods. We returned to the same communities in 1994 and enrolled 231 (125 supplemented, 106 control) of the original subjects in a follow-up study of the long-term effects of supplementation. We assessed these subjects by using several measures: anthropometry, iron status, information processing, Peabody Picture Vocabulary Test, word fluency, and an arithmetic test. The supplemented group showed no differences from those in the control group. However, when the analysis was limited to subjects who had received the supplement before the age of 18 mo (n = 73), the supplemented children performed better than control children on the Sternberg test of working memory (decision time intercept: probe absent, P = 0.002; probe present, P = 0.053). After considering possible confounders, we concluded that the supplementation during infancy was responsible for the difference. This finding shows that supplementation can have long-lasting effects on a specific domain if the child receives it at the appropriate stage of development.

  5. Innovation Determinants and Barriers: A Tri-Perspective Analysis of IT Appropriation within an Early Childhood Education and Care Organisation

    Directory of Open Access Journals (Sweden)

    Melinda Plumb

    2015-11-01

    Full Text Available Empirical studies on information technology (IT in early childhood education and care organisations are scant, despite an increasing number of these organisations choosing to innovate with IT. This paper presents a framework to understand the appropriation of IT as an innovation within such an organisation. The framework consists of three perspectives on innovation: an individualist, a structuralist and an interactive process perspective. While the first focuses on concepts such as leadership, IT champions, previous IT exposure, the second focuses on organisation size, parents as stakeholders, competitors, government compliance and regulatory requirements. The third perspective views the innovation as a dynamic phenomenon of change, produced by the continuous interaction of the innovation content, its context, and the appropriation process as related in an interactive process. We demonstrate the framework’s applicability and determine that the three perspectives supplement each other and together provide a deeper understanding of the IT appropriation process in terms of innovation determinants and barriers.

  6. ACR Appropriateness Criteria® Pretreatment Staging of Colorectal Cancer.

    Science.gov (United States)

    Fowler, Kathryn J; Kaur, Harmeet; Cash, Brooks D; Feig, Barry W; Gage, Kenneth L; Garcia, Evelyn M; Hara, Amy K; Herman, Joseph M; Kim, David H; Lambert, Drew L; Levy, Angela D; Peterson, Christine M; Scheirey, Christopher D; Small, William; Smith, Martin P; Lalani, Tasneem; Carucci, Laura R

    2017-05-01

    Colorectal cancers are common tumors in the United States and appropriate imaging is essential to direct appropriate care. Staging and treatment differs between tumors arising in the colon versus the rectum. Local staging for colon cancer is less integral to directing therapy given radical resection is often standard. Surgical options for rectal carcinoma are more varied and rely on accurate assessment of the sphincter, circumferential resection margins, and peritoneal reflection. These important anatomic landmarks are best appreciated on high-resolution imaging with transrectal ultrasound or MRI. When metastatic disease is suspected, imaging modalities that provide a global view of the body, such as CT with contrast or PET/CT may be indicated. Rectal cancer often metastasizes to the liver and so MRI of the liver with and without contrast provides accurate staging for liver metastases. This article focuses on local and distant staging and reviews the appropriateness of different imaging for both variants. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. Coordinating Supplemental Reading Instruction

    Science.gov (United States)

    Deeney, Theresa A.

    2008-01-01

    Although supplemental reading services are meant to improve reading achievement of struggling readers and students with reading disabilities, without concerted effort to ensure communication and coordination with in-school instruction, they may fall short of their desired mark. To promote learning, it is critical that any services provided outside…

  8. Nutritional Supplements for Strength Power Athletes

    Science.gov (United States)

    Wilborn, Colin

    Over the last decade research involving nutritional supplementation and sport performance has increased substantially. Strength and power athletes have specific needs to optimize their performance. Nutritional supplementation cannot be viewed as a replacement for a balanced diet but as an important addition to it. However, diet and supplementation are not mutually exclusive, nor does one depend on the other. Strength and power athletes have four general areas of supplementation needs. First, strength athletes need supplements that have a direct effect on performance. The second group of supplements includes those that promote recovery. The third group comprises the supplements that enhance immune function. The last group of supplements includes those that provide energy or have a direct effect on the workout. This chapter reviews the key supplements needed to optimize the performance and training of the strength athlete.

  9. Ergogenic Aids and Supplements.

    Science.gov (United States)

    Porrini, Marisa; Del Boʼ, Cristian

    2016-01-01

    Great interest is currently shown for the contribution of nutrition to optimize training and athletic performance, and a considerable debate exists about the potential ergogenic value of several dietary supplements. However, most of the products used by athletes do not provide sufficient scientific evidence regarding their efficacy in enhancing physical performance as well as their specificity of action and safety. For this reason, sport nutrition professionals need skills in evaluating the scientific value of papers and advertisements on ergogenic aids and supplements in order to support athletes in their choice. In the present chapter, the efficacy of some of the most popular supplements used by athletes and sport practitioners will be discussed. Particular attention will be devoted to amino acids and derivatives, caffeine and caffeinated energy drinks, and some antioxidants. © 2016 S. Karger AG, Basel.

  10. Supplements of interest for sport-related injury and sources of supplement information among college athletes.

    Science.gov (United States)

    Malinauskas, B M; Overton, R F; Carraway, V G; Cash, B C

    2007-01-01

    This study examined incidence of sport-related injury, interest in supplements to treat injury, and sources of supplement information among 145 college athletes (89 males, 56 females). A survey was used to assess sport-related injuries, interest in three categories of supplements to treat injury, and sources of supplement information among college athletes who used athletic training room and weight training facilities. Pearson chi2 was used to evaluate differences in frequency distribution of responses by sex. Sport-related injuries were experienced by 91% of athletes (93% males, 88% females). Overall, 17% of participants were interested in supplements to improve circulation, 34% for joint and soft tissue repair, and 22% to reduce inflammation. Significant sex differences were not found for any supplements in any categories evaluated. Males were more likely than females to rely on strength coaches (37%, 20%) for supplement information. Athletic trainers (71% of athletes), coaches (60%), and physicians (41%) were the primary professionals, and the internet (79%), magazines (68%), and television (52%) the most popular sources of media for supplement information. The majority of athletes experience injury during their college athletic career and 17% to 34% express an interest in supplements for injury treatment. Athletes would benefit from scientifically sound guidance to identify appropriate supplements for injury treatment and internet sites for supplement information. Future research should identify if athletes are more likely to increase supplement use when they are injured or if supplement use is more prevalent among athletes who are prone to injury.

  11. ACR Appropriateness Criteria Crohn Disease.

    Science.gov (United States)

    Kim, David H; Carucci, Laura R; Baker, Mark E; Cash, Brooks D; Dillman, Jonathan R; Feig, Barry W; Fowler, Kathryn J; Gage, Kenneth L; Noto, Richard B; Smith, Martin P; Yaghmai, Vahid; Yee, Judy; Lalani, Tasneem

    2015-10-01

    Crohn disease is a chronic inflammatory disorder involving the gastrointestinal tract, characterized by episodic flares and times of remission. Underlying structural damage occurs progressively, with recurrent bouts of inflammation. The diagnosis and management of this disease process is dependent on several clinical, laboratory, imaging, endoscopic, and histologic factors. In recent years, with the maturation of CT enterography, and MR enterography, imaging has played an increasingly important role in relation to Crohn Disease. In addition to these specialized examination modalities, ultrasound and routine CT have potential uses. Fluoroscopy, radiography, and nuclear medicine may be less beneficial depending on the clinical scenario. The imaging modality best suited to evaluating this disease may change, depending on the target population, severity of presentation, and specific clinical situation. This document presents seven clinical scenarios (variants) in both the adult and pediatric populations and rates the appropriateness of the available imaging options. They are summarized in a consolidated table, and the underlying rationale and supporting literature are presented in the accompanying narrative. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. MICROBIOLOGICAL QUALITY OF FOOD SUPPLEMENTS.

    Science.gov (United States)

    Ratajczak, Magdalena; Kubicka, Marcelina M; Kamińska, Dorota; Długaszewska, Jolanta

    2015-01-01

    Many specialists note that the food offered today - as a result of very complex technological processing - is devoid of many components that are important for the organism and the shortages have to be supplemented. The simplest for it is to consume diet supplements that provide the missing element in a concentrated form. In accordance with the applicable law, medicinal products include all substances or mixtures of substances that are attributed with properties of preventing or treating diseases with humans or animals. Permits to admit supplements to the market are issued by the Chief Sanitary Inspector and the related authorities; permits for medicines are issued by the Chief Pharmaceutical Inspector and the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products. Therefore, admittance of a supplement to the market is less costly and time consuming_than admittance of a medicine. Supplements and medicines may contain the same component but medicines will have a larger concentration than supplements. Sale of supplements at drug stores and in the form of tablets, capsules, liquids or powders makes consumer often confusing supplements with medicines. Now there are no normative documents specifying limits of microbiological impurities in diet supplements. In Polish legislation, diet supplements are subject to legal acts concerning food. Medicines have to comply with microbiological purity requirements specified in the Polish Pharmacopeia. As evidenced with the completed tests, the proportion of diet supplement samples with microbiological impurities is 6.5%. Sales of diet supplements have been growing each year, they are consumed by healthy people but also people with immunology deficiencies and by children and therefore consumers must be certain that they buy safe products.

  13. Herbs, Supplements and Alternative Medicines

    Science.gov (United States)

    ... of Events Wellness Lives Here Awareness Programs Hispanic Heritage Month African American Programs Latino Programs Asian Americans, ... to Your Health Care Provider Stay Educated, Make Smart Decisions Labels and Contents for Dietary Supplements Independent ...

  14. Medicare and Medicaid Statistical Supplement

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Office of Enterprise Data and Analytics (OEDA) produced an annual Medicare and Medicaid Statistical Supplement report providing detailed statistical...

  15. Nonlinear mechanics a supplement to theoretical mechanics of particles and continua

    CERN Document Server

    Fetter, Alexander L

    2006-01-01

    In their prior Dover book, Theoretical Mechanics of Particles and Continua, Alexander L. Fetter and John Dirk Walecka provided a lucid and self-contained account of classical mechanics, together with appropriate mathematical methods. This supplement-an update of that volume-offers a bridge to contemporary mechanics.The original book's focus on continuum mechanics-with chapters on sound waves in fluids, surface waves on fluids, heat conduction, and viscous fluids-forms the basis for this supplement's discussion of nonlinear continuous systems. Topics include linearized stability analysis; a det

  16. Phytochemical Assays of Commercial Botanical Dietary Supplements

    Directory of Open Access Journals (Sweden)

    Robert Krochmal

    2004-01-01

    Full Text Available The growing popularity of botanical dietary supplements (BDS has been accompanied by concerns regarding the quality of commercial products. Health care providers, in particular, have an interest in knowing about product quality, in view of the issues related to herb-drug interactions and potential side effects. This study assessed whether commercial formulations of saw palmetto, kava kava, echinacea, ginseng and St. John's wort had consistent labeling and whether quantities of marker compounds agreed with the amounts stated on the label. We purchased six bottles each of two lots of supplements from nine manufacturers and analyzed the contents using established commercial methodologies at an independent laboratory. Product labels were found to vary in the information provided, such as serving recommendations and information about the herb itself (species, part of the plant, marker compound, etc. With regard to marker compound content, little variability was observed between different lots of the same brand, while the content did vary widely between brands (e.g. total phenolic compounds in Echinacea ranged from 3.9–15.3 mg per serving; total ginsenosides in ginseng ranged from 5.3–18.2 mg per serving. Further, the amounts recommended for daily use also differed between brands, increasing the potential range of a consumer's daily dose. Echinacea and ginseng were the most variable, while St. John's wort and saw palmetto were the least variable. This study highlights some of the key issues in the botanical supplement market, including the importance of standardized manufacturing practices and reliable labeling information. In addition, health care providers should keep themselves informed regarding product quality in order to be able to appropriately advise patients utilizing both conventional and herbal medicines.

  17. ACR Appropriateness Criteria® Suspected Liver Metastases.

    Science.gov (United States)

    Kaur, Harmeet; Hindman, Nicole M; Al-Refaie, Waddah B; Arif-Tiwari, Hina; Cash, Brooks D; Chernyak, Victoria; Farrell, James; Grajo, Joseph R; Horowitz, Jeanne M; McNamara, Michelle M; Noto, Richard B; Qayyum, Aliya; Lalani, Tasneem; Kamel, Ihab R

    2017-05-01

    Liver metastases are the most common malignant liver tumors. The accurate and early detection and characterization of liver lesions is the key to successful treatment strategies. Increasingly, surgical resection in combination with chemotherapy is effective in significantly improving survival if all metastases are successfully resected. MRI and multiphase CT are the primary imaging modalities in the assessment of liver metastasis, with the relative preference toward multiphase CT or MRI depending upon the clinical setting (ie, surveillance or presurgical planning). The optimization of imaging parameters is a vital factor in the success of either modality. PET/CT, intraoperative ultrasound are used to supplement CT and MRI. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. Budget and Appropriations - Congressional Justification

    Science.gov (United States)

    The Congressional Justification is prepared when the President submits an annual budget to Congress, to justify the President's request by explaining NCI's mission, objectives for the coming fiscal year, and providing comparative budget data and analysis.

  19. Introduction to tobacco control supplement.

    Science.gov (United States)

    Chen, Ii-Lun; Husten, Corinne G

    2014-05-01

    Electronic cigarettes (e-cigarettes) have recently gained significant attention in the marketplace and in the media. However, limited information is available about the worldwide impact of e-cigarettes; most public health officials are calling for more data so they can more fully understand the potential risks and benefits of e-cigarettes in order to inform regulatory action. In the USA, e-cigarettes that are marketed as tobacco products are not currently regulated by the Food and Drug Administration (FDA). However, having a continuum of nicotine-containing products that cross jurisdictional lines within the FDA in the future would create the potential (and the need) for a comprehensive nicotine strategy at the FDA. As part of developing the most appropriate approach to e-cigarette regulation, FDA Center for Tobacco Products scientists have been reviewing the available literature to determine the state of e-cigarette knowledge and have identified research areas that could be addressed. This supplement provides a summary of the current knowledge and research gaps pertaining to e-cigarettes with regards to product design, chemistry and toxicology of e-liquid and aerosol constituents, human factor-based risk factors, abuse liability, clinical pharmacology and human health effects, paediatric issues, and environmental issues.

  20. Lessons learned from the scaling-up of a weekly multimicronutrient supplementation program in the integrated food security program (PISA).

    Science.gov (United States)

    Lechtig, Aarón; Gross, Rainer; Vivanco, Oscar Aquino; Gross, Ursula; López de Romaña, Daniel

    2006-01-01

    Weekly multimicronutrient supplementation was initiated as an appropriate intervention to protect poor urban populations from anemia. To identify the lessons learned from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]) weekly multimicronutrient supplementation program implemented in poor urban populations of Chiclayo, Peru. Data were collected from a 12-week program in which multimicronutrient supplements were provided weekly to women and adolescent girls 12 through 44 years of age and children under 5 years of age. A baseline survey was first conducted. Within the weekly multimicronutrient supplementation program, information was collected on supplement distribution, compliance, biological effectiveness, and cost. Supplementation, fortification, and dietary strategies can be integrated synergistically within a micronutrient intervention program. To ensure high cost-effectiveness of a weekly multimicronutrient supplementation program, the following conditions need to be met: the program should be implemented twice a year for 4 months; the program should be simultaneously implemented at the household (micro), community (meso), and national (macro) levels; there should be governmental participation from health and other sectors; and there should be community and private sector participation. Weekly multimicronutrient supplementation programs are cost effective options in urban areas with populations at low risk of energy deficiency and high risk of micronutrient deficiencies.

  1. International energy: Subject thesaurus supplement

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    This is a supplement to International Energy: Subject Thesaurus (ETDE/PUB--2(Rev.1)), which replaced DOE/TIC-7000--the EDB Subject Thesaurus. This supplement is provided periodically to keep International Energy: Subject Thesaurus recipients up-to-date on valid vocabulary terms (descriptors) used in building and maintaining several international energy information databases. Each issue contains all new terms added since the publication of the Thesaurus. Each supplement is a cumulative listing of the new terms, so that each issue replaces the previous one.

  2. 16 CFR 614.1 - Appropriate proof of identity.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Appropriate proof of identity. 614.1 Section... IDENTITY § 614.1 Appropriate proof of identity. (a) Consumer reporting agencies shall develop and implement reasonable requirements for what information consumers shall provide to constitute proof of identity for...

  3. Weight Loss Nutritional Supplements

    Science.gov (United States)

    Eckerson, Joan M.

    Obesity has reached what may be considered epidemic proportions in the United States, not only for adults but for children. Because of the medical implications and health care costs associated with obesity, as well as the negative social and psychological impacts, many individuals turn to nonprescription nutritional weight loss supplements hoping for a quick fix, and the weight loss industry has responded by offering a variety of products that generates billions of dollars each year in sales. Most nutritional weight loss supplements are purported to work by increasing energy expenditure, modulating carbohydrate or fat metabolism, increasing satiety, inducing diuresis, or blocking fat absorption. To review the literally hundreds of nutritional weight loss supplements available on the market today is well beyond the scope of this chapter. Therefore, several of the most commonly used supplements were selected for critical review, and practical recommendations are provided based on the findings of well controlled, randomized clinical trials that examined their efficacy. In most cases, the nutritional supplements reviewed either elicited no meaningful effect or resulted in changes in body weight and composition that are similar to what occurs through a restricted diet and exercise program. Although there is some evidence to suggest that herbal forms of ephedrine, such as ma huang, combined with caffeine or caffeine and aspirin (i.e., ECA stack) is effective for inducing moderate weight loss in overweight adults, because of the recent ban on ephedra manufacturers must now use ephedra-free ingredients, such as bitter orange, which do not appear to be as effective. The dietary fiber, glucomannan, also appears to hold some promise as a possible treatment for weight loss, but other related forms of dietary fiber, including guar gum and psyllium, are ineffective.

  4. Diabetes and Dietary Supplements

    Science.gov (United States)

    ... R S T U V W X Y Z Diabetes and Dietary Supplements: In Depth Share: On This ... much do we know about dietary supplements for diabetes? Many studies have investigated dietary supplements, including vitamins, ...

  5. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  6. Annual Statistical Supplement, 2002

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2002 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  7. Annual Statistical Supplement, 2003

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2003 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  8. Annual Statistical Supplement, 2001

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2001 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  9. Annual Statistical Supplement, 2010

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2010 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  10. Annual Statistical Supplement, 2007

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2007 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  11. Annual Statistical Supplement, 2016

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2016 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  12. Annual Statistical Supplement, 2000

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2000 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  13. Annual Statistical Supplement, 2008

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2008 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  14. Annual Statistical Supplement, 2006

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2006 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  15. Annual Statistical Supplement, 2005

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2005 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  16. Annual Statistical Supplement, 2015

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2015 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  17. Annual Statistical Supplement, 2004

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2004 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  18. Annual Statistical Supplement, 2014

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2014 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  19. Annual Statistical Supplement, 2009

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2009 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  20. Annual Statistical Supplement, 2011

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2011 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  1. Increasing Coverage of Appropriate Vaccinations

    Science.gov (United States)

    Jacob, Verughese; Chattopadhyay, Sajal K.; Hopkins, David P.; Morgan, Jennifer Murphy; Pitan, Adesola A.; Clymer, John

    2016-01-01

    Context Population-level coverage for immunization against many vaccine-preventable diseases remains below optimal rates in the U.S. The Community Preventive Services Task Force recently recommended several interventions to increase vaccination coverage based on systematic reviews of the evaluation literature. The present study provides the economic results from those reviews. Evidence acquisition A systematic review was conducted (search period, January 1980 through February 2012) to identify economic evaluations of 12 interventions recommended by the Task Force. Evidence was drawn from included studies; estimates were constructed for the population reach of each strategy, cost of implementation, and cost per additional vaccinated person because of the intervention. Analyses were conducted in 2014. Evidence synthesis Reminder systems, whether for clients or providers, were among the lowest-cost strategies to implement and the most cost effective in terms of additional people vaccinated. Strategies involving home visits and combination strategies in community settings were both costly and less cost effective. Strategies based in settings such as schools and managed care organizations that reached the target population achieved additional vaccinations in the middle range of cost effectiveness. Conclusions The interventions recommended by the Task Force differed in reach, cost, and cost effectiveness. This systematic review presents the economic information for 12 effective strategies to increase vaccination coverage that can guide implementers in their choice of interventions to fit their local needs, available resources, and budget. PMID:26847663

  2. Effective Nutritional Supplement Combinations

    Science.gov (United States)

    Cooke, Matt; Cribb, Paul J.

    Few supplement combinations that are marketed to athletes are supported by scientific evidence of their effectiveness. Quite often, under the rigor of scientific investigation, the patented combination fails to provide any greater benefit than a group given the active (generic) ingredient. The focus of this chapter is supplement combinations and dosing strategies that are effective at promoting an acute physiological response that may improve/enhance exercise performance or influence chronic adaptations desired from training. In recent years, there has been a particular focus on two nutritional ergogenic aids—creatine monohydrate and protein/amino acids—in combination with specific nutrients in an effort to augment or add to their already established independent ergogenic effects. These combinations and others are discussed in this chapter.

  3. Developing appropriate criteria for Benign Prostatic Hyperplasia Surgery Using RAND Appropriateness Method (RAM

    Directory of Open Access Journals (Sweden)

    R Ostovar

    2009-07-01

    .5% were considered as inappropriate. Also 22 cases (7.8% were considered as appropriate indications for drug therapy and none were found to be suitable for waiting and watching. There were 94 scenarios related to surgery that 75 scenarios (80% were grouped in appropriate and 8 scenarios (8.5% identified inappropriate. Conclusion: At the present time, due to the lack of scientific evidence for suitable decision-making in providing health services, methods based upon agreement, including the one used in the present study, and the use of treatment standards derived from similar studies, are amongst the most important measures taken to improve the standard of health, provide suitable health services, and to reduce unnecessary costs. In addition, RAM appropriateness method could be an ideal method in determining the appropriateness of health care and in reducing the rate of inappropriate services provided. The similarity of results derived from other studies performed by the RAND method in determining the appropriateness of benign prostatic hyperplasia treatment with the current study shows the validity and reliability of this method. Keywords: Appropriate criteria, Benign Prostatic Hyperplasia (BPH, Appraisal of Guidelines for Research and Evaluation (AGREE.

  4. Juvenile Justice, Runaway Youth, and Missing Children's Act Amendments of 1984. Hearing before the Subcommittee on Human Resources of the Committee on Education and Labor. House of Representatives, Ninety-Eighth Congress, Second Session on H.R. 4971 to Amend the Juvenile Justice and Delinquency Prevention Act of 1974 to Authorize Appropriations for Fiscal Years 1985 through 1989, and for Other Purposes.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. House Committee on Education and Labor.

    Provided in this document are the text of H.R. 4971, a record of testimony offered in a congressional hearing, and a wide variety of supplemental materials. H.R. 4971 is a bill to amend the Juvenile Justice and Delinquency Prevention (JJDP) Act of 1974 to authorize appropriations for fiscal years 1985 through 1989 and for other purposes. Numerous…

  5. Criteria and instruments of appropriateness in primary care

    Directory of Open Access Journals (Sweden)

    Andrea Pizzini

    2008-06-01

    Full Text Available The World Health Organization describes three particular features to assess the appropriateness of most medical services provided by clinicians during typical primary care visits: equity, efficacy and effectiveness. But many others aspects are involved and primary care physicians provide a wide range of services, most of which have not been studied sufficiently to develop explicit criteria for appropriateness. This articles describes meaning and characteristics of appropriateness in primary care and underlines the most important difficulties met by general practitioners, from the so called “disease mongering” to the application of the results of trials into the real clinical practice.

  6. Food appropriation through large scale land acquisitions

    Science.gov (United States)

    Rulli, Maria Cristina; D'Odorico, Paolo

    2014-05-01

    The increasing demand for agricultural products and the uncertainty of international food markets has recently drawn the attention of governments and agribusiness firms toward investments in productive agricultural land, mostly in the developing world. The targeted countries are typically located in regions that have remained only marginally utilized because of lack of modern technology. It is expected that in the long run large scale land acquisitions (LSLAs) for commercial farming will bring the technology required to close the existing crops yield gaps. While the extent of the acquired land and the associated appropriation of freshwater resources have been investigated in detail, the amount of food this land can produce and the number of people it could feed still need to be quantified. Here we use a unique dataset of land deals to provide a global quantitative assessment of the rates of crop and food appropriation potentially associated with LSLAs. We show how up to 300-550 million people could be fed by crops grown in the acquired land, should these investments in agriculture improve crop production and close the yield gap. In contrast, about 190-370 million people could be supported by this land without closing of the yield gap. These numbers raise some concern because the food produced in the acquired land is typically exported to other regions, while the target countries exhibit high levels of malnourishment. Conversely, if used for domestic consumption, the crops harvested in the acquired land could ensure food security to the local populations.

  7. Sharing Status and Appropriating Identity

    DEFF Research Database (Denmark)

    de Oliveira, Sandi Michele

    2013-01-01

    On 26 December 2012 President Cavaco Silva announced the creation of the Conselho da Diápora Portuguesa, an association of 300 “notable” (notáveis) Portuguese to be individually invited by the Council’s Board. Their function will be to service as lobbyists working to improve the country’s image...... in the world. In other words, and according to the Council’s President Filipe de Botton, the Conselho da Diáspora Portuguesa will be able to “take advantage of the best that Portugal has to offer outside Portugal.” Through remittances, Portuguese emigrants have long been a source of economic benefit...... to their relatives in Portugal as well as to the needs of the Portuguese Government. This initiative, however, is different; here, in addition to direct economic benefits that the Council’s members may provide, their identity itself as successful Portuguese is put into play. Using tools from discourse analysis...

  8. Iron Supplementation and Altitude: Decision Making Using a Regression Tree

    Directory of Open Access Journals (Sweden)

    Laura A. Garvican-Lewis, Andrew D. Govus, Peter Peeling, Chris R. Abbiss, Christopher J. Gore

    2016-03-01

    not increase in the 8 athletes with Ferritin-Pre <35 µg.L-1 who were supplemented with 105 mg.d-1, it is possible that in these athletes this dose was insufficient to support erythropoiesis. Furthermore, athletes with higher Ferritin-Pre, but large daily iron requirements, may also benefit from supplementation at altitude. The lack of improvement in Hbmass in non-supplemented athletes, may be related to reduced iron availability and mobility, despite plentiful iron stores, perhaps due to an increase in hepcidin post-exercise (Peeling, 2010. In summary, our regression tree suggests if sufficient iron is made available (via supplementation, even ID athletes can improve Hbmass in response to altitude. Some athletes with otherwise normal ferritin may also require supplementation to maintain an iron balance capable of supporting both the haematological and non-haematological adaptations to altitude. We recommend an individualised approach when deciding whether iron supplementation is appropriate, particularly concerning the dose provided.

  9. Cybernetic appropriateness review. Does it change physician hospital utilization patterns?

    Science.gov (United States)

    Studnicki, J; Stevens, C E

    1985-01-01

    All hospital care can be characterized as either appropriate (i.e., efficatious and necessary) or inappropriate (i.e., services without benefit or services that could be provided in a less costly setting). A demonstration project combining an appropriateness determination methodology with a cybernetic control system was implemented in a study area that included six hospitals and approximately 400 practicing physicians. Project results to date indicate substantial improvements in the ratio of appropriate to inappropriate care for both hospitals and individual physicians. Evaluation research design problems and areas of future research are also discussed.

  10. The Association between Provider Practice and Knowledge of ORS and Zinc Supplementation for the Treatment of Childhood Diarrhea in Bihar, Gujarat and Uttar Pradesh, India: A Multi-Site Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Laura M Lamberti

    Full Text Available Programs aimed at reducing the burden of diarrhea among children under-five in low-resource settings typically allocate resources to training community-level health workers, but studies have suggested that provider knowledge does not necessarily translate into adequate practice. A diarrhea management program implemented in Bihar, Gujarat and Uttar Pradesh, India trained private sector rural medical practitioners (RMPs and public sector Accredited Social Health Activists (ASHAs and Anganwadi workers (AWWs in adequate treatment of childhood diarrhea with oral rehydration salts (ORS and zinc. We used cross-sectional program evaluation data to determine the association between observed diarrhea treatment practices and reported knowledge of ORS and zinc among each provider cadre.We conducted principal components analysis on providers' responses to diarrhea treatment questions in order to generate a novel scale assessing ORS/zinc knowledge. We subsequently regressed a binary indicator of whether ORS/zinc was prescribed during direct observation onto the resulting knowledge scores, controlling for other relevant knowledge predictors.There was a positive association between ORS/zinc knowledge score and prescribing ORS and zinc to young children with diarrhea among private sector RMPs (aOR: 2.32; 95% CI: 1.29-4.17 and public sector ASHAs and AWWs (aOR 2.48; 95% CI: 1.90-3.24. Controlling for knowledge score, receipt of training in the preceding 6 months was a good predictor of adequate prescribing in the public but not the private sector. In the public sector, direct access to ORS and zinc supplies was also highly associated with prescribing.To enhance the management of childhood diarrhea in India, programmatic activities should center on increasing knowledge of ORS and zinc among public and private sector providers through biannual trainings but should also focus on ensuring sustained access to an adequate supply chain.

  11. Environmental Report 2000 Data Supplement

    Energy Technology Data Exchange (ETDEWEB)

    Biermann, A H; Althouse, P E; Bertoldo, N A; Blake, R G; Brigdon, S L; Brown, R A; Campbell, C G; Christofferson, E; Clark, L M; Folks, K J; Gallegos, G M; Grayson, A R; Harrach, R J; Larson, J M; MacQueen, D H; Mathews, S; Nisbet, B; Ring Peterson, S; Taffet, M J; Tate, P J; Vellinger, R J; Williams, R A

    2001-09-01

    This Data Supplement to the Lawrence Livermore National Laboratory's (LLNL's) annual ''Environmental Report 2000'' was prepared for the U.S. Department of Energy. The main volume is intended to provide all information on LLNL's environmental impact and compliance activities that is of interest to most readers. The Data Supplement supports main volume summary data and is essentially a detailed data report that provides individual data points, where applicable. Some summary data are also included in the Data Supplement, and more detailed accounts are given of sample collection and analytical methods. The two volumes are organized in a parallel fashion to aid the reader in cross-referencing between them. This supplement includes more detailed information to support the nine chapters in the main volume that cover monitoring of air surveillance, air effluent, sewerable water, surface water, groundwater, soil and sediment, vegetation and foodstuff, environmental radiation, and quality assurance. The other five chapters in the main volume have no supporting information in the Data Supplement. As in our previous annual reports, data are presented in Systeme International (SI) units. In particular, the primary units used for radiological results are becquerels and sieverts for activity and dose, with curies and rem used secondarily (1 Bq = 2.7 x 10{sup -11} Ci; 1 Sv = 100 rem).

  12. Environmental Report 1999 Data Supplement

    Energy Technology Data Exchange (ETDEWEB)

    Larson, J M; Biermann, A H; Harrach, R J; Althouse, P E; Bertoldo, N A; Blake, R G; Brandstetter, E R; Brigdon, S L; Brown, R A; Christofferson, E; Folks, K J; Gallegos, G M; Garcia, L M; Giesing, T A; Grayson, A R; Hall, L C; MacQueen, D H; Mathews, S; Peterson, S R; Taffet, M J; Tate, P J; Vellinger, R J; Ward, R J; Williams, R A

    2000-09-01

    This Data Supplement to the Lawrence Livermore National Laboratory's (LLNL's) annual ''Environmental Report 1999'' was prepared for the U.S. Department of Energy. The main volume is intended to provide all information on LLNL's environmental impact and compliance activities that is of interest to most readers. The Data Supplement supports main volume summary data and is essentially a detailed data report that provides individual data points, where applicable. Some summary data are also included in the Data Supplement, and more detailed accounts are given of sample collection and analytical methods. The two volumes are organized in a parallel fashion to aid the reader in cross-referencing between them. This supplement includes more detailed information to support the nine chapters in the main volume that cover monitoring of air, air effluent, sewerable water, surface water, ground water, soil and sediment, vegetation and foodstuff, environmental radiation, and quality assurance. The other five chapters in the main volume have no supporting information in the Data Supplement. As in our previous annual reports, data are presented in Systeme International (SI) units. In particular, the primary units used for radiological results are becquerels and sieverts for activity and dose, with curies and rem used secondarily (1 Bq = 2.7 x 10{sup -11} Ci; 1 Sv = 100 rem).

  13. 16 CFR 1.86 - Supplemental statements.

    Science.gov (United States)

    2010-01-01

    ... PROCEDURES Procedures for Implementation of the National Environmental Policy Act of 1969 § 1.86 Supplemental statements. Except for proposals for legislation, as provided in CEQ Regulation (40 CFR 1502.9(c)), the Commission shall publish supplements to either draft or final environmental statements if: (a) The Commission...

  14. Enhanced Nutrition Education Instead of Consuming Supplements

    Science.gov (United States)

    Crowder, Todd; Kidd, Kellie; Jensen, Nancy; Jensen, Laura

    2008-01-01

    Fueled by the internet, instantaneous videos, and the emphasis to look "right" or always win athletic competitions, many students are seeking information on nutrition and dietary supplements. Classroom observations reveal student interest and discussions are among the highest when the topic is dietary supplements. Teachers and coaches provide an…

  15. 32 CFR 3.5 - Appropriate use.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Appropriate use. 3.5 Section 3.5 National... CONTRACTS, GRANTS, OR COOPERATIVE AGREEMENTS FOR PROTOTYPE PROJECTS § 3.5 Appropriate use. In accordance... Executive for the agency determines in writing that exceptional circumstances justify the use of a...

  16. Reactive arthritis--the appropriate name.

    Science.gov (United States)

    Keynan, Yoav; Rimar, Doron

    2008-04-01

    Reiter's syndrome is an eponym used to denote the triad of arthritis, urethritis and conjunctivitis. This syndrome is named after Hans Conrad Julius Reiter, who was involved in the activities of the Nazi Racial Hygiene Program related to involuntary sterilization, euthanasia and criminal research projects. Reiter defamed the entire medical profession and it was therefore suggested that the term Reiter's syndrome be changed to reactive arthritis. We undertook to investigate the use of the eponym Reiter syndrome in medical literature, medical schools in Israel and medical textbooks, compared to the term reactive arthritis, by searching Medline between the years 2003 and 2007, 14 current medical textbooks, curricula of the four medical schools in Israel, and computerized patient file systems in Israel. We found a decline in the use of the eponym in articles published between 2003 (18%) and 2007 (9%); however, most textbooks (13/14) still use it. Two of the four medical schools in Israel continue to use the eponym. The eponym appears in the computerized patient files of all four healthcare providers in Israel. We hold that the continued use of the eponym Reiter syndrome in medical textbooks, medical schools and computerized patients files in Israel is honoring an abomination and is inconsistent with medical principles. Awareness is still lacking and we suggest deleting the Reiter syndrome eponym from use, and replacing it with the more appropriate term--reactive arthritis.

  17. Determining appropriate nutritional interventions for South African ...

    African Journals Online (AJOL)

    values were determined: vitamins A and E, calcium, magnesium, phosphorus, albumin, haemoglobin, serum iron and ferritin and percentage of transferrin saturation. Malnutrition was evident in 13% of the ..... impact of a targeted food supplementation programme in Bangladeshi urban slum children. Ann Trap Paediatr 1992 ...

  18. CHILD DEVELOPMENT BIBLIOGRAPHY. SUPPLEMENT I.

    Science.gov (United States)

    Harvard Univ., Cambridge, MA. Graduate School of Education.

    THIS BIBLIOGRAPHY SUPPLEMENT LISTS MATERIAL ON VARIOUS ASPECTS OF CHILD DEVELOPMENT. APPROXIMATELY 90 UNANNOTATED REFERENCES ARE PROVIDED TO DOCUMENTS DATING FROM 1956 TO 1966. JOURNALS, BOOKS, AND REPORT MATERIALS ARE LISTED. SUBJECT AREAS INCLUDED ARE BEHAVIOR TESTS, CONDITIONING, MATERNAL REACTIONS, GRADE PREDICTABILITY, EXPERIMENTAL STUDIES,…

  19. Benefits of antioxidant supplements for knee osteoarthritis: rationale and reality.

    Science.gov (United States)

    Grover, Ashok Kumar; Samson, Sue E

    2016-01-05

    Arthritis causes disability due to pain and inflammation in joints. There are many forms of arthritis, one of which is osteoarthritis whose prevalence increases with age. It occurs in various joints including hip, knee and hand with knee osteoarthritis being more prevalent. There is no cure for it. The management strategies include exercise, glucosamine plus chondroitin sulfate and NSAIDs. In vitro and animal studies provide a rationale for the use of antioxidant supplements for its management. This review assesses the reality of the benefits of antioxidant supplements in the management of knee osteoarthritis. Several difficulties were encountered in examining this issue: poorly conducted studies, a lack of uniformity in disease definition and diagnosis, and muddling of conclusions from attempts to isolate the efficacious molecules. The antioxidant supplements with most evidence for benefit for pain relief and function in knee osteoarthritis were based on curcumin and avocado-soya bean unsaponifiables. Boswellia and some herbs used in Ayurvedic and Chinese medicine may also be useful. The benefits of cuisines with the appropriate antioxidants should be assessed because they may be more economical and easier to incorporate into the lifestyle.

  20. Emerging Supplements in Sports

    OpenAIRE

    Mason, Bryan C.; Lavallee, Mark E.

    2012-01-01

    Context: Nutritional supplements advertised as ergogenic are commonly used by athletes at all levels. Health care professionals have an opportunity and responsibility to counsel athletes concerning the safety and efficacy of supplements on the market. Evidence Acquisition: An Internet search of common fitness and bodybuilding sites was performed to identify supplement promotions. A search of MEDLINE (2000?August, 2011) was performed using the most commonly identified supplements, including gl...

  1. The efficacy of protein supplementation during recovery from muscle-damaging concurrent exercise.

    Science.gov (United States)

    Eddens, Lee; Browne, Sarah; Stevenson, Emma J; Sanderson, Brad; van Someren, Ken; Howatson, Glyn

    2017-07-01

    This study investigated the effect of protein supplementation on recovery following muscle-damaging exercise, which was induced with a concurrent exercise design. Twenty-four well-trained male cyclists were randomised to 3 independent groups receiving 20 g protein hydrolysate, iso-caloric carbohydrate, or low-calorific placebo supplementation, per serve. Supplement serves were provided twice daily, from the onset of the muscle-damaging exercise, for a total of 4 days and in addition to a controlled diet (6 g·kg-1·day-1 carbohydrate, 1.2 g·kg-1·day-1 protein, remainder from fat). Following the concurrent exercise session at time-point 0 h, comprising a simulated high-intensity road cycling trial and 100 drop-jumps, recovery of outcome measures was assessed at 24, 48, and 72 h. The concurrent exercise protocol was deemed to have caused exercise-induced muscle damage (EIMD), owing to time effects (p 0.05) were observed for any of the outcome measures. The present results indicate that protein supplementation does not attenuate any of the indirect indices of EIMD imposed by concurrent exercise, when employing great rigour around the provision of a quality habitual diet and the provision of appropriate supplemental controls.

  2. Nutritional supplements for people being treated for active tuberculosis.

    Science.gov (United States)

    Grobler, Liesl; Nagpal, Sukrti; Sudarsanam, Thambu D; Sinclair, David

    2016-06-29

    Tuberculosis and malnutrition are linked in a complex relationship. Tuberculosis may cause undernutrition through increased metabolic demands and decreased intake, and nutritional deficiencies may worsen the disease, or delay recovery by depressing important immune functions. At present, there is no evidence-based nutritional guidance for adults and children being treated for tuberculosis. To assess the effects of oral nutritional supplements in people being treated with antituberculous drug therapy for active tuberculosis. We searched the Cochrane Infectious Disease Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2016), MEDLINE (from 1946 to 4 February 2016), EMBASE (from 1980 to 4 February 2016), LILACS (from 1982 to 4 February 2016), the metaRegister of Controlled Trials (mRCT), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and the Indian Journal of Tuberculosis up to 4 February 2016, and checked the reference lists of all included studies. Randomized controlled trials that compared any oral nutritional supplement given for at least four weeks with no nutritional intervention, placebo, or dietary advice only for people being treated for active tuberculosis. The primary outcomes of interest were all-cause death, and cure at six and 12 months. Two review authors independently selected trials for inclusion, and extracted data and assessed the risk of bias in the included trials. We presented the results as risk ratios (RR) for dichotomous variables, and mean differences (MD) for continuous variables, with 95% confidence intervals (CIs). Where appropriate, we pooled data from trials with similar interventions and outcomes. We assessed the quality of the evidence using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Thirty-five trials, including 8283 participants, met the inclusion criteria of this review. Macronutrient supplementation

  3. Style as Supplement - Supplement as Style

    DEFF Research Database (Denmark)

    Sørensen, Bent

    , and to aim for an almost Brechtian Verfremdung-effect, but the film also uses this device as a stylistic trait to characterize something ‘essential' about Derrida and his style. Derrida strikes the same chord by insisting on drawing attention to the artificiality of the making of the film, where questions...... and deferrals. This is of course another link in the infinite Derridean chain of supplements to supplements of supplements - in his writings, his persona and the legacy of images of him left behind in the archives. How does this perpetual deferral reflect itself in Derrida's visual and verbal style...

  4. Chautauqua notebook: appropriate technology on radio

    Energy Technology Data Exchange (ETDEWEB)

    Renz, B.

    1981-01-01

    Experiences in establishing and maintaining a regional call-in information-exchange radio show (Chautauqua) on energy conservation, appropriate technology, renewable energy sources, and self-reliance are discussed. Information is presented on: appropriate technology; the Chautauquaa concept; topics discussed; research performed; guests; interviewing tips; types of listeners; program features; where to find help; promotion and publicity; the technical and engineering aspects; the budget and funding; and station policies. (MCW)

  5. Ways of art appropriation by the advertising

    Directory of Open Access Journals (Sweden)

    Roberta Fernandes Esteves

    2013-09-01

    Full Text Available Based on the different ways of appropriation of the artistic visualrepresentations by the advertising communication, proposed by Lucia Santaella (2005 – imitation of the ways of composing and incorporation of the artistic image – this article presents, as of the examination of advertisements broadcast in different countries, seven new categories outlined on the basis of partial or total use of the appropriated image and the interference performed in them.

  6. Preparing Financial Reports for Marine Corps Appropriations

    Science.gov (United States)

    2001-04-12

    PREPARING FINANCIAL REPORTS FOR MARINE CORPS APPROPRIATIONS Report No. D-2001-097 April 12, 2001...to) ("DD MON YYYY") Title and Subtitle Preparing Financial Reports for Marine Corps Appropriations Contract or Grant Number Program Element...Act of 1990, as amended by the Federal Financial Management Act of 1994. This is the third report on our audit of the FY 2000 Department of the Navy

  7. Indications, Utility and Appropriateness of Echocardiography in Outpatient Cardiology

    Science.gov (United States)

    Orsini, Enrico; Antoncecchi, Ettore; Carbone, Vincenzo; Dato, Achille; Monducci, Igor; Nistri, Stefano; Zito, Giovanni Battista

    2013-01-01

    Objective: Respect of “appropriateness” is considered an essential requirement, both on the clinical and the economic profile, and also as it helps to shorten the waiting list. However, only a few studies have dealt with the control of appropriateness in clinical practice, and most of them have focused only on hospital admissions and invasive procedures. Materials and Methods: INDICARD-out is a prospective, multicenter study carried out by A.R.C.A. (Associazioni Regionali Cardiologi Ambulatoriali) cardiologists from 13 Italian Regions, providing information on indications, utility and appropriateness of echocardiography in outpatient cardiology. Results: A total of 2110 prescriptions for echocardiogram were evaluated. Hypertension (23%) and the screening of asymptomatic subjects (17%) by far were the most frequent indications to echocardiography. Overall, 54% of the tests resulted appropriate, 30% were of uncertain appropriateness and 16% were inappropriate. Besides, 31% of the echocardiograms were not useful, and 28% were non pertinent for patient management. The vast majority of prescriptions (72%) came from non-cardiologist physicians (54% from general practitioners). The echocardiograms prescribed by cardiologists were significantly more appropriate, more useful and more pertinent than the tests prescribed by non-cardiologists. Conclusions: The appropriateness, utility and pertinence of the echocardiography are still suboptimal in practice cardiology, especially when indicated by non-cardiologists. The cardiologist, from mere executor of tests prescribed and managed by other physicians, should gain the role of the clinician who takes care of all the cardiologic needs of the patient community. PMID:28465880

  8. Korean guidelines for the appropriate use of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Jin [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul(Korea, Republic of); Yong, Hwan Seok [Dept. of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul(Korea, Republic of); Kim, Sung Mok [Dept. of Radiology, amsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jung A [Dept. of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of); Hong, Yoo Jin [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2015-04-15

    The development of cardiac CT has provided a non-invasive alternative to echocardiography, exercise electrocardiogram, and invasive angiography and cardiac CT continues to develop at an exponential speed even now. The appropriate use of cardiac CT may lead to improvements in the medical performances of physicians and can reduce medical costs which eventually contribute to better public health. However, until now, there has been no guideline regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist clinicians and other health professionals in the use of cardiac CT for diagnosis and treatment of heart diseases, especially in patients at high risk or suspected of heart disease.

  9. An audit tool for assessing the appropriateness of carotid endarterectomy

    Directory of Open Access Journals (Sweden)

    Feasby Thomas E

    2004-07-01

    Full Text Available Abstract Background To update appropriateness ratings for carotid endarterectomy using the best clinical evidence and to develop a tool to audit the procedure's use. Methods A nine-member expert panel drawn from all the Canadian Specialist societies that are involved in the care of patients with carotid artery disease, used the RAND Appropriateness Methodology to rate scenarios where carotid endarterectomy may be performed. A 9-point rating scale was used that permits the categorization of the use of carotid endarterectomy as appropriate, uncertain, or inappropriate. A descriptive analysis was undertaken of the final results of the panel meeting. A database and code were then developed to rate all carotid endarterectomies performed in a Western Canadian Health region from 1997 to 2001. Results All scenarios for severe symptomatic stenosis (70–99% were determined to be appropriate. The ratings for moderate symptomatic stenosis (50–69% ranged from appropriate to inappropriate. It was never considered appropriate to perform endarterectomy for mild stenosis (0–49% or for chronic occlusions. Endarterectomy for asymptomatic carotid disease was thought to be of uncertain benefit at best. The majority of indications for the combination of endarterectomy either prior to, or at time of coronary artery bypass grafting were inappropriate. The audit tool classified 98.0% of all cases. Conclusions These expert panel ratings, based on the best evidence currently available, provide a comprehensive and updated guide to appropriate use of carotid endarterectomy. The resulting audit tool can be downloaded by readers from the Internet and immediately used for hospital audits of carotid endarterectomy appropriateness.

  10. Particle Suspension Mechanisms - Supplemental Material

    Energy Technology Data Exchange (ETDEWEB)

    Dillon, M B

    2011-03-03

    This supplemental material provides a brief introduction to particle suspension mechanisms that cause exfoliated skin cells to become and remain airborne. The material presented here provides additional context to the primary manuscript and serves as background for designing possible future studies to assess the impact of skin cells as a source of infectious aerosols. This introduction is not intended to be comprehensive and interested readers are encouraged to consult the references cited.

  11. Dietary supplements containing prohibited substances: A review ...

    African Journals Online (AJOL)

    not yet) prohibited designer steroids and other performance-enhancing newer chemical entities will increase. Athletes, coaches and sports doctors should therefore be provided with information regarding dietary supplements and be advised to ...

  12. Probiotic Supplements Failed to Prevent Babies' Infections

    Science.gov (United States)

    ... functions. Probiotic supplements provide some of those same organisms. Most often, products contain strains of the bacteria ... the bottom line for parents is this: "Breast milk is best." "Breast milk contains human milk oligosaccharides, ...

  13. FY 2015 Supplement to the Presidents Budget

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — The annual Supplement to the Presidents Budget for the NITRD Program provides a technical summary of the research activities planned and coordinated through NITRD in...

  14. FY 2014 Supplement to the Presidents Budget

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — The annual Supplement to the Presidents Budget for the NITRD Program provides a technical summary of the research activities planned and coordinated through NITRD in...

  15. FY 2016 Supplement to the Presidents Budget

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — The annual Supplement to the Presidents Budget for the NITRD Program provides a technical summary of the research activities planned and coordinated through NITRD in...

  16. (Mis)Appropriations of Gadamer in Qualitative Research: A ...

    African Journals Online (AJOL)

    Christopher R Stones

    qualitative lines. The first article in this two-part discussion provides a Husserlian investigation of the meaning of 'method' for psychology as a human science. This investigation is undertaken in the light of some researchers' appropriations of Gadamer's philosophical hermeneutics in the service of non-methodical praxes.

  17. In search of an appropriate contemporary approach in Christian ...

    African Journals Online (AJOL)

    The article addresses the question: 'To what extent can Max Weber's ethic of responsibility be a helpful resource in the search of Christian Social Ethics for an appropriate contemporary approach'? This question is addressed by, first of all, providing a summary of Weber's famous speech Politics as a Vocation in which he ...

  18. Developmentally Appropriate Technology Use and Early Childhood Teacher Education

    Science.gov (United States)

    Rosen, Dina B.; Jaruszewicz, Candace

    2009-01-01

    Early childhood teacher education methods classes often emphasize the application of developmentally appropriate practices (DAP). In today's digital age, it is important for teacher educators and their students to think about how to extend DAP to technology use. In this article, two contrasting classroom scenarios are provided to illustrate…

  19. A guide to appropriate use of Correlation coefficient in medical ...

    African Journals Online (AJOL)

    However, misuse of correlation is so common among researchers that some statisticians have wished that the method had never been devised at all. The aim of this article is to provide a guide to appropriate use of correlation in medical research and to highlight some misuse. Examples of the applications of the correlation ...

  20. ACR Appropriateness Criteria® Chronic Liver Disease.

    Science.gov (United States)

    Horowitz, Jeanne M; Kamel, Ihab R; Arif-Tiwari, Hina; Asrani, Sumeet K; Hindman, Nicole M; Kaur, Harmeet; McNamara, Michelle M; Noto, Richard B; Qayyum, Aliya; Lalani, Tasneem

    2017-11-01

    Because liver fibrosis can be treated, it is important to diagnose liver fibrosis noninvasively and monitor response to treatment. Although ultrasound (grayscale and Doppler) can diagnose cirrhosis, it does so unreliably using morphologic and sonographic features and cannot diagnose the earlier, treatable stages of hepatic fibrosis. Transient elastography, ultrasound elastography with acoustic radiation force impulse, and MR elastography are modalities that can assess for hepatic fibrosis. Although all international organizations recommend ultrasound for screening for hepatocellular carcinoma, ultrasound is particularly limited for identifying hepatocellular carcinoma in patients with obesity, nonalcoholic fatty liver disease, and nodular cirrhotic livers. In these patient groups as well as patients who are on the liver transplant wait list, ultrasound is so limited that consideration can be made for screening for hepatocellular carcinoma with either MRI or multiphase CT. Additionally, patients who have been previously diagnosed with and treated for hepatocellular carcinoma require continued surveillance for recurrent hepatocellular carcinoma. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. ACR Appropriateness Criteria® Staging of Pancreatic Ductal Adenocarcinoma.

    Science.gov (United States)

    Qayyum, Aliya; Tamm, Eric P; Kamel, Ihab R; Allen, Peter J; Arif-Tiwari, Hina; Chernyak, Victoria; Gonda, Tamas A; Grajo, Joseph R; Hindman, Nicole M; Horowitz, Jeanne M; Kaur, Harmeet; McNamara, Michelle M; Noto, Richard B; Srivastava, Pavan K; Lalani, Tasneem

    2017-11-01

    Pancreatic adenocarcinoma is associated with poor overall prognosis. Complete surgical resection is the only possible option for cure. As such, increasingly complex surgical techniques including sophisticated vascular reconstruction are being used. Continued advances in surgical techniques, in conjunction with use of combination systemic therapies, and radiation therapy have been suggested to improve outcomes. A key aspect to surgical success is reporting of pivotal findings beyond absence of distant metastases, such as tumor size, location, and degree of tumor involvement of specific vessels associated with potential perineural tumor spread. Multiphase contrast-enhanced multidetector CT and MRI are the imaging modalities of choice for pretreatment staging and presurgical determination of resectability. Imaging modalities such as endoscopic ultrasound and fluorine-18-2-fluoro-2-deoxy-D-glucose imaging with PET/CT are indicated for specific scenarios such as biopsy guidance and confirmation of distant metastases, respectively. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  2. Metabolomic perfusate analysis during kidney machine perfusion: the pig provides an appropriate model for human studies.

    Directory of Open Access Journals (Sweden)

    Jay Nath

    Full Text Available Hypothermic machine perfusion offers great promise in kidney transplantation and experimental studies are needed to establish the optimal conditions for this to occur. Pig kidneys are considered to be a good model for this purpose and share many properties with human organs. However it is not established whether the metabolism of pig kidneys in such hypothermic hypoxic conditions is comparable to human organs.Standard criteria human (n = 12 and porcine (n = 10 kidneys underwent HMP using the LifePort Kidney Transporter 1.0 (Organ Recovery Systems using KPS-1 solution. Perfusate was sampled at 45 minutes and 4 hours of perfusion and metabolomic analysis performed using 1-D 1H-NMR spectroscopy.There was no inter-species difference in the number of metabolites identified. Of the 30 metabolites analysed, 16 (53.3% were present in comparable concentrations in the pig and human kidney perfusates. The rate of change of concentration for 3-Hydroxybutyrate was greater for human kidneys (p<0.001. For the other 29 metabolites (96.7%, there was no difference in the rate of change of concentration between pig and human samples.Whilst there are some differences between pig and human kidneys during HMP they appear to be metabolically similar and the pig seems to be a valid model for human studies.

  3. Can pay-for-performance to primary care providers stimulate appropriate use of antibiotics?

    DEFF Research Database (Denmark)

    Dietrichson, Jens; Maria Ellegård, Lina; Anell, Anders

    2018-01-01

    Antibiotic resistance is a major threat to public health worldwide. As the health care sector's use of antibiotics is an important contributor to the development of resistance, it is crucial that physicians only prescribe antibiotics when needed and that they choose narrow-spectrum antibiotics, w...

  4. Selecting Culturally and Linguistically Appropriate Materials: Suggestions for Service Providers. ERIC Digest.

    Science.gov (United States)

    Santos, Rosa Milagros; Reese, Debbie

    The population of the United States is growing more culturally diverse each year, and this diversity is clearly evident among families with young children; however, individuals who work in early childhood programs are not as diverse as those they serve. Moreover, many early childhood professionals have little preparation for working with families…

  5. Regional Assessment of Supplementation Project. Status report

    Energy Technology Data Exchange (ETDEWEB)

    1991-10-01

    The Fish and Wildlife Program of the Northwest Power Planning Council (NPPC) prescribes several approaches to achieve its goal of doubling the salmon and steelhead runs of the Columbia River. Among those approaches are habitat restoration, improvements in adult and juvenile passage at dams and artificial propagation. Supplementation will be a major part of the new hatchery programs. The purpose of the Regional Assessment of Supplementation Project (RASP) is to provide an overview of ongoing and planned supplementation activities, to construct a conceptual framework and model for evaluating the potential benefits and risks of supplementation and to develop a plan for better regional coordination of research and monitoring and evaluation of supplementation. RASP has completed its first year of work. Progress toward meeting the first year`s objectives and recommendations for future tasks are contained in this report.

  6. Regional Assessment of Supplementation Project : Status Report.

    Energy Technology Data Exchange (ETDEWEB)

    Unknown author

    1991-10-01

    The Fish and Wildlife Program of the Northwest Power Planning Council (NPPC) prescribes several approaches to achieve its goal of doubling the salmon and steelhead runs of the Columbia River. Among those approaches are habitat restoration, improvements in adult and juvenile passage at dams and artificial propagation. Supplementation will be a major part of the new hatchery programs. The purpose of the Regional Assessment of Supplementation Project (RASP) is to provide an overview of ongoing and planned supplementation activities, to construct a conceptual framework and model for evaluating the potential benefits and risks of supplementation and to develop a plan for better regional coordination of research and monitoring and evaluation of supplementation. RASP has completed its first year of work. Progress toward meeting the first year's objectives and recommendations for future tasks are contained in this report.

  7. Patient-provider conversations about sterilization: A qualitative analysis.

    Science.gov (United States)

    Kimport, Katrina; Dehlendorf, Christine; Borrero, Sonya

    2017-03-01

    Although female sterilization is the second most commonly used contraceptive method in the US, research suggests that providers may serve as barriers to desired sterilization. We conducted a modified grounded theory analysis of audio-recorded contraceptive counseling visits with 52 women who specified on a previsit survey that they wanted no future children and a supplemental analysis of visits with 14 women who wanted or were unsure about future children in which sterilization was mentioned. Sterilization was discussed in only 19 of the 52 visits, primarily with patients who were older women with children. Although some framed sterilization positively, many clinicians discouraged patients from pursuing sterilization, encouraging them instead to use long-acting reversible methods and framing the permanence of sterilization as undesirable. In the 33 remaining sessions, sterilization was not mentioned, and clinicians largely failed to solicit patients' future reproductive intentions. We found no clear patterns regarding discussion of sterilization in the 14 supplemental cases. Clinicians did not discuss sterilization with all patients for whom it might have been appropriate and thus missed opportunities to discuss sterilization as part of the full range of appropriate methods. When they did discuss sterilization, they only infrequently presented the method in positive ways and more commonly encouraged patients to choose a long-acting reversible method instead. Clinicians may want to reflect on their counseling practices around sterilization to ensure that counseling is centered on patient preferences, rather than driven by their own assumptions about the desirability of reversibility. Clinicians often fail to discuss sterilization as a contraceptive option with potentially appropriate candidates and, when they do, often discourage its selection. Clinicians should consider assessing reproductive intentions to ensure that potentially relevant methods are included in

  8. Nutritional supplements for people being treated for active tuberculosis

    Science.gov (United States)

    Grobler, Liesl; Nagpal, Sukrti; Sudarsanam, Thambu D; Sinclair, David

    2016-01-01

    Background Tuberculosis and malnutrition are linked in a complex relationship. Tuberculosis may cause undernutrition through increased metabolic demands and decreased intake, and nutritional deficiencies may worsen the disease, or delay recovery by depressing important immune functions. At present, there is no evidence-based nutritional guidance for adults and children being treated for tuberculosis. Objectives To assess the effects of oral nutritional supplements in people being treated with antituberculous drug therapy for active tuberculosis. Search methods We searched the Cochrane Infectious Disease Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2016), MEDLINE (from 1946 to 4 February 2016), EMBASE (from 1980 to 4 February 2016), LILACS (from 1982 to 4 February 2016), the metaRegister of Controlled Trials (mRCT), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and the Indian Journal of Tuberculosis up to 4 February 2016, and checked the reference lists of all included studies. Selection criteria Randomized controlled trials that compared any oral nutritional supplement given for at least four weeks with no nutritional intervention, placebo, or dietary advice only for people being treated for active tuberculosis. The primary outcomes of interest were all-cause death, and cure at six and 12 months. Data collection and analysis Two review authors independently selected trials for inclusion, and extracted data and assessed the risk of bias in the included trials. We presented the results as risk ratios (RR) for dichotomous variables, and mean differences (MD) for continuous variables, with 95% confidence intervals (CIs). Where appropriate, we pooled data from trials with similar interventions and outcomes. We assessed the quality of the evidence using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Main results Thirty-five trials

  9. Long-Term Military Contingency Operations: Identifying the Factors Affecting Budgeting in Annual or Supplemental Appropriations

    National Research Council Canada - National Science Library

    Evans, Amanda B

    2006-01-01

    .... The results show that planning, timing, accountability, visibility, politics and policy, stakeholder influence, military objectives, and fear of change are the most important factors. These findings can help stakeholders shape funding strategy.

  10. FY2007 Supplemental Appropriations for Defense, Foreign Affairs, and Other Purposes

    National Research Council Canada - National Science Library

    Daggett, Stephen; Belasco, Amy; Towell, Pat; Epstein, Susan B; Veillette, Connie; Tarnoff, Curt; Margesson, Rhoda; Elias, Bart

    2007-01-01

    ... of S. 965, and subsequent debate in the Senate has proceeded using the House number, H.R. 1591. The House-passed bill includes a Democratic leadership plan that sets three alternative timetables for withdrawal from Iraq...

  11. Appropriate antibiotic therapy in critically ill patients

    Directory of Open Access Journals (Sweden)

    Filippo Pieralli

    2016-12-01

    Full Text Available Severe sepsis and septic shock are leading causes of morbidity and mortality in critically ill patients in and outside Intensive Care Units. Early hemodynamic and respiratory support, along with prompt appropriate antimicrobial therapy and source control of the infectious process are cornerstone management strategies to improve survival. Antimicrobial therapy should be as much appropriate as possible, since inappropriate initial antimicrobial therapy is associated with poorer outcome in different clinical settings. When prescribing antibiotic therapy, drug’s characteristics, along with dosing, pharmacokinetics, and pharmacodynamic properties related to the drug and to the clinical scenario should be well kept in mind in order to achieve maximal success.

  12. Long-chain polyunsaturated fatty acid supplementation in infants born at term.

    Science.gov (United States)

    Simmer, Karen; Patole, Sanjay K; Rao, Shripada C

    2011-12-07

    The n-3 and n-6 fatty acids linolenic acid and linoleic acid are precursors of the n-3 and n-6 long chain fatty acids (LCPUFA). Infant formula has historically only contained the precursor fatty acids. Over the last few years, some manufacturers have added LCPUFA to formulae and marketed them as providing an advantage for the development of term infants. To assess whether supplementation of formula with LCPUFA is safe and of benefit to term infants. We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, April, 2011), MEDLINE (1966 to April 2011), EMBASE (1980 to April 2011), CINAHL (December 1982 to April 2011) and abstracts of the Society for Pediatric Research (1980 to 2010). No language restrictions were applied. Randomised and quasi randomised trials comparing LCPUFA supplemented vs. non-supplemented formula milk and with clinical endpoints were reviewed. Methodological quality of studies was assessed using the guidelines of Cochrane neonatal review group. Data were sought regarding effects on visual acuity, neurodevelopmental outcomes and physical growth. When appropriate, meta-analysis was conducted to provide a pooled estimate of effect. Twenty-five randomised studies were identified; fifteen were included (n = 1889) and ten excluded.Visual acuity was assessed by nine studies. Visual evoked potential was used in six studies, two used Teller cards and one used both. Four studies reported beneficial effects while the remaining five did not.Neurodevelopmental outcome was measured by eleven studies. Bayley scales of infant development (BSID) was used in nine studies; only two showed beneficial effects. Meta-analysis did not show significant benefits of supplementation. One study followed the infants up to nine years of age and did not find benefit of supplementation. One study reported better novelty preference measured by Fagan Infant test at nine months. Another study reported better problem solving at 10 months. One study used

  13. Rediscovering Enterprise: Developing Appropriate University Entrepreneurship Education

    Science.gov (United States)

    Bridge, Simon; Hegarty, Cecilia; Porter, Sharon

    2010-01-01

    Purpose: Entrepreneurship can refer to business start-up, but now sometimes has wider connotations. This paper aims to explore what entrepreneurship means for the promoters of entrepreneurship education and what might be appropriate for the students who consume it. Design/methodology/approach: The paper assesses the work of NICENT (The Northern…

  14. Appropriateness and Diagnostic Yield of Referrals for ...

    African Journals Online (AJOL)

    Appropriate referrals constituted 221(58.9%). Inappropriate referral rate was similar for endoscopists and non-endoscopists. Positive yield was 62.7%. Male sex, age > 45 years, haematemesis, persistent vomiting, gastroenterologists' referrals and epigastric tenderness were the best predictors of positive yield. Gastritis, 121 ...

  15. Perspectives on Conceptualizing Developmentally Appropriate Sexuality Education

    Science.gov (United States)

    Silvério Marques, Sara; Goldfarb, Eva S.; Deardorff, Julianna; Constantine, Norman A.

    2017-01-01

    Despite recognition of the importance of a developmentally appropriate approach to sexuality education, there is little direct guidance on how to do this. This study employed in-depth interviews with experienced sexuality educators and developers of sexuality education materials to identify how this concept is understood and applied in the field.…

  16. Among the Periodicals: Developmentally Appropriate Practice

    Science.gov (United States)

    Kohler, Maxie; Christensen, Lois; Kilgo, Jennifer

    2012-01-01

    This article contains a review of eight refereed publications that addressed the topic of developmentally appropriate practice (DAP), as that is a topic presently being discussed widely both nationally and internationally. According to the most recent 2009 NAEYC publication on DAP, recommended practices are those "that result from the process of…

  17. Education and Human Capital Development through Appropriate ...

    African Journals Online (AJOL)

    First Lady

    Abstract. The study examines education and human capital development through appropriate utilisation of information services. The paper is essentially a descriptive analysis of the state of education and human development in. Delta state and assesses the readiness of Delta state government on the development of ...

  18. Teaching Rhythmic Gymnastics: A Developmentally Appropriate Approach.

    Science.gov (United States)

    Palmer, Heather C.

    This book is designed to guide teachers through the process of creating a developmentally appropriate rhythmic gymnastics program for children age 5-11. Rhythmic gymnastics programs develop fitness, inspire creativity, and allow all children to work at their own level. The book features 10 chapters in two parts. Part 1, "Getting Started on a…

  19. What Makes a Game Developmentally Appropriate?

    Science.gov (United States)

    Pica, Rae

    2009-01-01

    It is important for teachers to make the activities they present, including games, opportunities to promote children's development in one or more domains. Teachers need to select games that are developmentally appropriate. It is relatively simple to modify traditional games, such as Musical Chairs or Simon Says, to be cooperative instead of…

  20. Addressing Development Vision 2025: Appropriate Training Models ...

    African Journals Online (AJOL)

    Appropriately trained Human Resources for Health (HRH) are key inputs in the realisation of high quality livelihood, the first attribute of Tanzania‟s Development Vision 2025. Within this attribute elements related to HRH include: access to quality primary health care for all, reduction in infant and maternal mortality rates by ...

  1. Teaching Learners to Appropriately Mitigate Requests

    Science.gov (United States)

    Uso-Juan, Esther; Martinez-Flor, Alicia

    2008-01-01

    It is commonly recognized that, for lecturers of English as a Foreign Language (EFL) in a university setting, the goal of their teaching is to develop learners' ability to communicate appropriately in this language. This means that teaching practices should pay attention not only to the key features of the linguistic system of English, but also to…

  2. Veterans Medical Care: FY2011 Appropriations

    Science.gov (United States)

    2011-03-21

    services to veterans who meet certain eligibility rules including hospital and medical care , disability compensation and pensions,3 education ,4...prosthetic and orthotic devices, including eyeglasses and hearing aids; home health services, hospice care , palliative care , and institutional respite care ...CRS Report for Congress Prepared for Members and Committees of Congress Veterans Medical Care : FY2011 Appropriations Sidath Viranga

  3. Quantitative determination of vinpocetine in dietary supplements

    Science.gov (United States)

    French, John M. T.; King, Matthew D.

    2017-01-01

    Current United States regulatory policies allow for the addition of pharmacologically active substances in dietary supplements if derived from a botanical source. The inclusion of certain nootropic drugs, such as vinpocetine, in dietary supplements has recently come under scrutiny due to the lack of defined dosage parameters and yet unproven short- and long-term benefits and risks to human health. This study quantified the concentration of vinpocetine in several commercially available dietary supplements and found that a highly variable range of 0.6–5.1 mg/serving was present across the tested products, with most products providing no specification of vinpocetine concentrations. PMID:27319129

  4. Dietary Supplements for Toddlers

    Science.gov (United States)

    ... Teen Young Adult Healthy Children > Ages & Stages > Toddler > Nutrition > Dietary Supplements for Toddlers Ages & Stages Listen Español Text Size ... variety of iron-rich foods so that, eventually, supplementation won't be necessary. Additional Information ... & Nutrition Tips: Your 2-Year-Old Vitamin D Deficiency ...

  5. Using Dietary Supplements Wisely

    Science.gov (United States)

    ... or pills (15.9 percent), and ginseng (14.1 percent). National Health and Nutrition Examination Survey (NHANES) data ... 53 percent of American adults took at least one dietary supplement, most commonly multivitamin/multimineral supplements (taken by 39 percent of all adults). Women were more likely than ...

  6. Supplementation in Rats

    African Journals Online (AJOL)

    Erah

    Purpose: The use of L-arginine and potassium chloride separately as supplements has been reported to result in altered vascular reactivity. The concentration of either agent used has varied widely and there has been no report on the outcome of combined supplementation with both agents on vascular reactivity.

  7. Explanatory supplement to the astronomical almanac

    CERN Document Server

    Urban, Sean E

    2013-01-01

    The Explanatory Supplement to the Astronomical Almanac offers explanatory material, supplemental information and detailed descriptions of the computational models and algorithms used to produce The Astronomical Almanac, which is an annual publication prepared jointly by the US Naval Observatory and Her Majesty's Nautical Almanac Office in the UK. Like The Astronomical Almanac, The Explanatory Supplement provides detailed coverage of modern positional astronomy. Chapters are devoted to the celestial and terrestrial reference frames, orbital ephemerides, precession, nutation, Earth rotation, and coordinate transformations. These topics have undergone substantial revisions since the last edition was published. Astronomical positions are intertwined with timescales and relativity in The Astronomical Almanac, so related chapters are provided in The Explanatory Supplement. The Astronomical Almanac also includes information on lunar and solar eclipses, physical ephemerides of solar system bodies, and calendars, so T...

  8. Idaho Supplementation Studies, 1991-1992 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Leitzinger, Eric J.; Bowles, Edward C.; Plaster, Kurtis (Idaho Department of Fish and Game, Boise, ID)

    1993-10-01

    Idaho Supplementation Studies (ISS) will help determine the utility of supplementation as a potential recovery tool for decimated stocks of spring and summer chinook salmon Oncorhynchus tshawytscha in Idaho. The objectives are to monitor and evaluate the effects of supplementation on presmolt and smolt numbers and spawning escapements of naturally produced salmon; monitor and evaluate changes in natural productivity and genetic composition of target and adjacent populations following supplementation and; determine which supplementation strategies (broodstock and release stage) provide the quickest effects on and highest response in natural production without adverse productivity.

  9. Defense: FY2009 Authorization and Appropriations

    Science.gov (United States)

    2009-02-25

    replace the Army’s current fleet of combat vehicles, including M-1 Abrams tanks and M-2 Bradley infantry vehicles, beginning in 2015. The Army has...Army Abrams tanks or Bradley fighting vehicles, which some observers argue are more appropriately considered in the baseline budget as part of ongoing...other unanticipated needs. This may indicate that congressional scepticism about war-related procurement funding requests may be growing.38 Although

  10. Defense: FY2014 Authorization and Appropriations

    Science.gov (United States)

    2013-12-16

    Defense Programs (Appropriations) ........................................................................... 58 Afghanistan Security Forces Fund...Fiscal Cliff” and the American Taxpayer Relief Act of 2012, coordinated by Mindy R. Levit . 15 Last spring when DOD was still under a CR and also faced...enough force to win a major conventional war in one region while, concurrently, being able to inflict enough damage on an aggressor in a second region to

  11. Supplemental instruction in chemistry

    Science.gov (United States)

    Lundeberg, Mary A.

    This study was designed to measure some effects of supplemental instruction in chemistry. Supplemental instruction is a peer-led cooperative learning program that encourages students to develop conceptual understanding by articulating both understandings and misconceptions in a think-aloud fashion. Supplemental instruction was offered three hours weekly outside of class and lab time for students in four classes of General Organic and Biological Chemistry. Over a two-year period 108 students volunteered to participate in this program; 45 students did not participate. As measured by final grades in chemistry and responses to a questionnaire, supplemental instruction was effective in increasing students' achievement in chemistry. Further research is needed to determine the in-depth effects of supplemental instruction on students' learning, problem solving, and self-esteem.

  12. Resveratrol food supplements

    DEFF Research Database (Denmark)

    Aschemann-Witzel, Jessica; Grunert, Klaus G

    2015-01-01

    Background: Consumers increasingly choose food supplements in addition to their diet. Research on supplement users finds they are likely to be female, older and well-educated; Furthermore, supplement users are often characterised as being especially health-oriented, an observation which is termed...... the ‘inverse supplement hypothesis’. However, results are dependent on the substance in question. Little is known so far about botanicals in general, and more specifically, little is known about resveratrol. The psychographic variables of food supplement users are yet relatively underexplored. By comparing US...... and Danish respondents, we aimed to identify whether sociodemographic variables, health status, health beliefs and behaviour and interest in food aspects specifically relevant to resveratrol (e.g., naturalness, indulgence, and Mediterranean food) explain favourable attitudes and adoption intentions toward...

  13. 26 CFR 1.501(c)(17)-1 - Supplemental unemployment benefit trusts.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Supplemental unemployment benefit trusts. 1.501(c... Supplemental unemployment benefit trusts. (a) Requirements for qualification. (1) A supplemental unemployment... the purpose of providing supplemental unemployment compensation benefits (as defined in section 501(c...

  14. Myocardial perfusion imaging determination using an appropriate use smartphone application.

    Science.gov (United States)

    Mahajan, Ashish; Bal, Susan; Hahn, Harvey

    2015-02-01

    Inappropriate cardiac imaging has been a significant cost concern and cause of radiation burden to patients. To assess if a smartphone application (app) based on 2009 Appropriate Use Criteria (AUC) for Cardiac Radionuclide Imaging published by American College of Cardiology would be feasible at the point of order. We evaluated stress myocardial perfusion imaging (MPI) (N = 403) (mean age = 62.23 years; 47.89% males) over a 4 month period using a smartphone app to determine whether the study ordered was Appropriate, Inappropriate, or Uncertain per 2009 AUC. We also monitored the time needed to use the app to determine the level of appropriateness of each stress MPI. The results of the stress MPI were noted. Of the 403 stress MPIs evaluated, 267 (66.25%) were noted to be Appropriate, 118 (29.28%) were Inappropriate, and 13 (3.23%) were Uncertain, per AUC; 5 (1.25%) remained unclassified. Average time needed to use the app to assess each stress MPI for appropriateness was noted to be 44 (±9) seconds. Non-teaching physicians ordered 70 (38.89%) inappropriate stress MPIs as compared to 20 (23.53%) ordered by physicians on resident teaching service, and 28 (23.33%) by cardiologists (P = .0045). Among inappropriately ordered stress MPIs, 87 (42.65%) were ordered in females as compared to 31 (17.13%) in males (P smartphone app provides an easy-to-use tool to assist physicians in determining the level of appropriateness of stress MPI in a time- and cost-effective manner at the point of order. The smartphone app may have potential to promote the usage of the AUC and possibly aid reduction of healthcare cost and ionizing radiation burden.

  15. Assessment of the Authenticity of Herbal Dietary Supplements: Comparison of Chemical and DNA Barcoding Methods.

    Science.gov (United States)

    Pawar, Rahul S; Handy, Sara M; Cheng, Raymond; Shyong, Nicole; Grundel, Erich

    2017-07-01

    About 7 % of the U. S. population reports using botanical dietary supplements. Increased use of such supplements has led to discussions related to their authenticity and quality. Reports of adulteration with substandard materials or pharmaceuticals are of concern because such substitutions, whether inadvertent or deliberate, may reduce the efficacy of specific botanicals or lead to adverse events. Methods for verifying the identity of botanicals include macroscopic and microscopic examinations, chemical analysis, and DNA-based methods including DNA barcoding. Macroscopic and microscopic examinations may fail when a supplement consists of botanicals that have been processed beyond the ability to provide morphological characterizations. Chemical analysis of specific marker compounds encounters problems when these compounds are not distinct to a given species or when purified reference standards are not available. Recent investigations describing DNA barcoding analysis of botanical dietary supplements have raised concerns about the authenticity of the supplements themselves as well as the appropriateness of using DNA barcoding techniques with finished botanical products. We collected 112 market samples of frequently consumed botanical dietary supplements of ginkgo, soy, valerian, yohimbe, and St. John's wort and analyzed each for specific chemical markers (i.e., flavonol glycosides, total isoflavones, total valerenic acids, yohimbine, and hypericins, respectively). We used traditional DNA barcoding techniques targeting the nuclear ITS2 gene and the chloroplast gene psbA-trnH on the same samples to determine the presence of DNA of the labelled ingredient. We compared the results obtained by both methods to assess the contribution of each in determining the identity of the samples. Georg Thieme Verlag KG Stuttgart · New York.

  16. Micronutrient intakes from food and supplements in Australian adolescents.

    Science.gov (United States)

    Gallagher, Caroline M; Black, Lucinda J; Oddy, Wendy H

    2014-01-14

    Low micronutrient intakes in adolescents are frequently reported. We assessed micronutrient intakes in adolescents to determine whether supplement use optimises intakes. Dietary intake was assessed using a food frequency questionnaire in 17 year old participating in the Western Australian Pregnancy Cohort (Raine) Study (n=991). We calculated median daily micronutrient intakes in supplement users and non-users (from food sources only and from food and supplements), along with the percentage of adolescents meeting the Estimated Average Requirements (EAR) or Adequate Intake (AI) where appropriate. Intakes of calcium, magnesium, folate and vitamins D and E from food only were low. Although supplements significantly increased micronutrient intakes in supplement users, more than half of supplement users failed to meet the EAR or AI for some key micronutrients. Compared with non-users, supplement users had higher micronutrient intakes from food sources with the exception of vitamins D and B12 and were more likely to achieve the EAR or AI for many micronutrients from food only. Intakes of some key micronutrients were low in this population, even among supplement users. Those facing the greatest risk of micronutrient deficiencies were less likely to use supplements.

  17. Iron Supplementation Consumption in High School Students: A Cross- Sectional Study

    Directory of Open Access Journals (Sweden)

    Mohammad Khammarnia

    2016-07-01

    Full Text Available Background: Girls are one of the high risk groups for iron deficiency anemia. Iron supplementation program is a preventive strategy for female students in high schools in Iran. This study aimed to estimate the prevalence of iron supplements consumption among high school students in the southeast of Iran. Methods: A quantitative study was conducted in Zahedan (the capital of Sistan and Balochestan province in the southeast of Iran in 2015. The sample size was 400 high school students from different areas of Zahedan who were randomly selected. A standard questionnaire was used for data collection. The data were analyzed using SPSS statistical software through descriptive statistics, one way ANOVA and Chi-square. Results: In total, 68.2% of the students did not administer any tablets whether regularly or irregularly during the past 16 weeks. About 41 third grade students did not take any tablets in 16 weeks. There were a statistically significant correlation between lack of taking tablet and their grade point average of the last year (P=0.003, F=1.078; also, it had a significant association with school grade of students (P=0.009. Conclusion: Most of the students did not use iron supplementation in Zahedan high schools. Measures should be taken to increase the culture of consuming iron tablets by providing appropriate environmental conditions; it seems that iron supplementation programs will have positive impacts on the students.

  18. The feminist appropriation of pregnancy testing in 1970s Britain

    OpenAIRE

    Olszynko-Gryn, Jesse

    2017-01-01

    This article restores pregnancy testing to its significant position in the history of the women’s liberation movement in 1970s Britain. It shows how feminists appropriated the pregnancy test kit, a medical technology which then resembled a small chemistry set, and used it as a political tool for demystifying medicine, empowering women and providing a more accessible, less judgmental alternative to the NHS. While the majority of testees were young women hoping for a negative result, many other...

  19. Technical noise supplement : TeNS : a technical supplement to the Traffic Noise Analysis Protocol.

    Science.gov (United States)

    1998-10-01

    The purpose of this Technical Noise Supplement (TeNS) is to provide technical background : information on transportation-related noise in general and highway traffic noise in : particular. It is designed to elaborate on technical concepts and procedu...

  20. Providing Culturally Sensitive Care for Transgender Patients

    Science.gov (United States)

    Maguen, Shira; Shipherd, Jillian C.; Harris, Holly N.

    2005-01-01

    Culturally sensitive information is crucial for providing appropriate care to any minority population. This article provides an overview of important issues to consider when working with transgender patients, including clarification of transgender terminology, diagnosis issues, identity development, and appropriate pronoun use. We also review…

  1. Providing Continuing Education for International Nurses.

    Science.gov (United States)

    Case, Debra L

    2015-10-01

    In an increasingly globalized world, providing continuing education (CE) for nurses is becoming a more common opportunity for U.S. educators. It is important for educators to provide CE programs in a culturally competent and sensitive environment. The challenges involved include effective communication, appropriate teaching methodologies, contextually appropriate content, and awareness of cultural-specific needs and customs. Copyright 2015, SLACK Incorporated.

  2. Supplementation in the Columbia Basin : Summary Report Series : Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    1992-12-01

    This progress report broadly defines the scope of supplementation plans and activities in the Columbia Basin. It provides the foundation for more detailed analysis of supplementation in subsequent reports in this series. Topics included in this report are: definition of supplementation, project diversity, objectives and performance standards, uncertainties and theory. Since this is a progress report, the content is subject to modification with new information. The supplementation theory will continue to evolve throughout the duration of RASP and beyond. The other topics in this report are essentially complete and are not expected to change significantly. This is the first of a series of four reports which will summarize information contained in the larger, RASP progress and completion reports. Our goal is to make the findings of RASP more accessible by grouping related topics into smaller but complete narratives on important aspects of supplementation. We are planning to publish the following reports under the general title Supplementation in the Columbia River Basin: Part 1, Background, Description, Performance Measures, Uncertainty and Theory; Part 2, Theoretical Framework and Models; Part 3, Planning Guidelines; and Part 4, Regional Coordination of Research and Monitoring. Supplementation is expected to be a major contributor to the planned increase in salmon and steelhead production in the Columbia Basin. The Fish and Wildlife Program of the Northwest Power Planning Council (NPPC) uses three approaches to protect and enhance salmon and steelhead in the Columbia Basin: (1) enhance fish production; (2) improve passage in the mainstem rivers; and (3) revise harvest management to support the rebuilding of fish runs (NPPC 1987). The fish production segment calls for a three-part approach focused on natural production, hatchery production, and supplementation. Supplementation is planned to provide over half of the total production increases. The Regional Assessment

  3. Supplements for exotic pets.

    Science.gov (United States)

    Mejia-Fava, Johanna; Colitz, Carmen M H

    2014-09-01

    The use of supplements has become commonplace in an effort to complement traditional therapy and as part of long-term preventive health plans. This article discusses historical and present uses of antioxidants, vitamins, and herbs. By complementing traditional medicine with holistic and alternative nutrition and supplements, the overall health and wellness of exotic pets can be enhanced and balanced. Further research is needed for understanding the strengths and uses of supplements in exotic species. Going back to the animals' origin and roots bring clinicians closer to nature and its healing powers. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Position Statement: “Functionally Appropriate Nonhuman Primate Environments” as an Alternative to the Term “Ethologically Appropriate Environments”

    Science.gov (United States)

    Bloomsmith, Mollie A; Hasenau, John; Bohm, Rudolf P

    2017-01-01

    The American Society of Primatologists (ASP), the Association of Primate Veterinarians (APV), and the American College of Laboratory Animal Medicine (ACLAM) have come together to develop this position statement in which the term “functionally appropriate nonhuman primate environments” is proposed as a better descriptor and as an alternative to the previously used term, “ethologically appropriate environments” to describe environments that are suitable for nonhuman primates involved in biomedical research. In 2015, the United States Department of Agriculture requested comments on a petition which called for amending the Animal Welfare Act so that all research primates would be housed in “ethologically appropriate physical and social environments.” We are critical of this term because: (1) it does not provide clarification beyond that in current regulatory language; (2) it does not provide for balance between animal welfare goals and the reasons why the primates are housed in captivity; (3) it discounts the adaptability that is inherent in the behavior of primates; (4) it conveys that duplication of features of the natural environment are required for suitable holding environments; (5) objective studies reveal that environments that appear to be more ethologically appropriate do not necessarily better meet the needs of animals; and (6) using the term “ethology” is inherently confusing. We propose that the term “functionally appropriate nonhuman primate environments” be used instead, as it emphasizes how environments work for nonhuman primates, it better describes current activities underway to improve nonhuman primate welfare, and the balance that is achieved between meeting the needs of the animals and the requirements of the research in which they are involved. PMID:28905724

  5. Dietary nitrate supplementation and exercise performance.

    Science.gov (United States)

    Jones, Andrew M

    2014-05-01

    Dietary nitrate is growing in popularity as a sports nutrition supplement. This article reviews the evidence base for the potential of inorganic nitrate to enhance sports and exercise performance. Inorganic nitrate is present in numerous foodstuffs and is abundant in green leafy vegetables and beetroot. Following ingestion, nitrate is converted in the body to nitrite and stored and circulated in the blood. In conditions of low oxygen availability, nitrite can be converted into nitric oxide, which is known to play a number of important roles in vascular and metabolic control. Dietary nitrate supplementation increases plasma nitrite concentration and reduces resting blood pressure. Intriguingly, nitrate supplementation also reduces the oxygen cost of submaximal exercise and can, in some circumstances, enhance exercise tolerance and performance. The mechanisms that may be responsible for these effects are reviewed and practical guidelines for safe and efficacious dietary nitrate supplementation are provided.

  6. The Appropriated Racial Oppression Scale: Development and preliminary validation.

    Science.gov (United States)

    Campón, Rebecca Rangel; Carter, Robert T

    2015-10-01

    The aim of the present study was to develop an instrument to measure "internalized racism" called appropriated racial oppression for people of Color. Generated items were reviewed by experts in the areas of multicultural psychology and scale construction. A total sample of 656 adults was collected in 2 phases: The first phase consisted of 341 adults (Age: M = 35, SD = 12.05). Of these, 99 were Black, 70 multiracial, 61 Asian, 61 Latino, 37 Native American, 10 identified as "other," and 3 participants did not answer. Most were female (n = 256), and heterosexual (n = 277). In the second phase, there were 315 adults (Age: M = 35; SD = 12.05). Eighty were Black, 68 Multiracial, 56 Asian, 54 Latino, 40 Native American, 16 were other and 1 participant did not answer. Two-thirds were female (n = 216) and heterosexual (n = 251). The 341 adult participants' responses were used to run exploratory factor analysis that revealed a 32-item, 4-factor structure for the construct of appropriated racial oppression. The 315 adult participants' data were used in a confirmatory factor analysis that resulted in a 4-factor, 24-item model fit. To test for both predictive and criterion-related validity, a path analysis was conducted. Results of the path analysis demonstrated significant relationships between appropriated racial oppression and anxiety and depression. It has been found that there is preliminary evidence for the validity of the newly developed Appropriated Racial Oppression Scale. Moreover, results of this study provide critical information in assisting clinicians treating individuals with appropriated racial oppression. (c) 2015 APA, all rights reserved).

  7. Iron supplements (image)

    Science.gov (United States)

    The mineral iron is an essential nutrient for humans because it is part of blood cells, which carry oxygen to all body cells. There is no conclusive evidence that iron supplements contribute to heart attacks.

  8. Multivitamin/Mineral Supplements

    Science.gov (United States)

    ... Submit Search NIH Office of Dietary Supplements Consumer Datos en español Health Professional Other Resources Multivitamin/mineral ... Vitamin K lowers the drug's effectiveness and doctors base the medicine dose partly on the amount of ...

  9. Breastfeeding: Vitamin D Supplementation

    Science.gov (United States)

    ... International Lactation Consultant Association About Us Division Information Nutrition Physical Activity Overweight & Obesity Healthy Weight Breastfeeding Micronutrient Malnutrition State and Local Programs Vitamin D Supplementation Recommend on Facebook Tweet Share Compartir While breastfeeding ...

  10. FDA 101: Dietary Supplements

    Science.gov (United States)

    ... Joint FDA/WebMD resource Fortify Your Knowledge About Vitamins More in Consumer Updates Animal & Veterinary Children's Health Cosmetics Dietary Supplements Drugs Food Medical Devices Nutrition Radiation-Emitting Products Tobacco Products Vaccines, Blood & Biologics ...

  11. Dietary Supplement Ingredient Database

    Science.gov (United States)

    ... and US Department of Agriculture Dietary Supplement Ingredient Database Toggle navigation Menu Home About DSID Mission Current ... values can be saved to build a small database or add to an existing database for national, ...

  12. Vitamin Supplement - Editorial

    OpenAIRE

    Jakobsen, Jette; Bysted, Anette

    2012-01-01

    This Vitamin Supplement presents some of the main information presented at The First International Vitamin Conference in Copenhagen, May, 2010. The theme of the conference was ‘Vitamins in foods and supplements: Analytical possibilities versus nutritional needs in human research, food databases, and labeling’. All 13 vitamins were represented. Although vitamin D and folate that in recent years have been heavily debated, also were the one in focus and is represented in 8 of the 17 papers inclu...

  13. Antioxidant supplements and mortality

    DEFF Research Database (Denmark)

    Bjelakovic, Goran; Nikolova, Dimitrinka; Gluud, Christian

    2014-01-01

    Oxidative damage to cells and tissues is considered involved in the aging process and in the development of chronic diseases in humans, including cancer and cardiovascular diseases, the leading causes of death in high-income countries. This has stimulated interest in the preventive potential of a...... of antioxidant supplements. Today, more than one half of adults in high-income countries ingest antioxidant supplements hoping to improve their health, oppose unhealthy behaviors, and counteract the ravages of aging....

  14. Protecting military personnel from high risk dietary supplements.

    Science.gov (United States)

    Deuster, Patricia A; Lieberman, Harris R

    2016-01-01

    It is legal tomarketmost naturally occurring substances as dietary supplements in the USA without manufacturers demonstrating they are safe or effective, and an endless variety of ingredients, from esoteric botanicals to unapproved pharmaceuticals, can be found in dietary supplements. Use of certain supplements can pose a risk, but since a robust reporting systemdoes not exist in the USA it is difficult to know which are problematic and the number of adverse events (AE) resulting from their use. Certain populations, includingmilitary personnel, aremore likely to use dietary supplements than the general population. Approximately 70% of military personnel take dietary supplements while about 50% of civilians do. Service members prefer supplements purported to enhance physical performance such as supposedly natural stimulants, protein and amino acids, and combination products. Since some of thesemay be problematic, Servicemembers are probably at higher risk of injury than the general population. Ten percent of military populations appear to be taking potentially risky supplements, and the US Department of Defense (DoD) has taken variousmeasures to protect uniformed personnel including education, policy changes, and restricting sales. Actions taken include launching Operation Supplement Safety (OPSS), introducing a High Risk Supplement list, educating health care professionals on reporting AE thatmight be associated with dietary supplements, recommending policy for reporting AE, and developing an online AE reporting system. OPSS is a DoD-wide effort to educate service members, leaders, health care providers, military families, and retirees on how to safely select supplements

  15. Vitamin and Mineral Supplement Fact Sheets

    Science.gov (United States)

    ... website Submit Search NIH Office of Dietary Supplements Vitamin and Mineral Supplement Fact Sheets Search the list ... Supplements: Background Information Botanical Dietary Supplements: Background Information Vitamin and Mineral Fact Sheets Botanical Supplement Fact Sheets ...

  16. Methods of achieving and maintaining an appropriate caesarean section rate.

    LENUS (Irish Health Repository)

    Robson, Michael

    2013-04-01

    Caesarean section rates continue to increase worldwide. The appropriate caesarean section rate remains a topic of debate among women and professionals. Evidence-based medicine has not provided an answer and depends on interpretation of the literature. Overall caesarean section rates are unhelpful, and caesarean section rates should not be judged in isolation from other outcomes and epidemiological characteristics. Better understanding of caesarean section rates, their consequences and their benefits will improve care, and enable learning between delivery units nationally and internationally. To achieve and maintain an appropriate caesarean section rate requires a Multidisciplinary Quality Assurance Programme in each delivery unit, recognising caesarean section rates as one of many factors that determine quality. Women will always choose the type of delivery that seems safest to them and their babies. Professionals need to monitor the quality of their practice continuously in a standardised way to ensure that women can make the right choice.

  17. Appropriation and the uses of comics in information science literature

    Directory of Open Access Journals (Sweden)

    Valdir José Morigi

    2016-04-01

    Full Text Available Introduction: This article realizes the bibliographic mapping in the studies of Information Science, to demonstrate the development of comics in this area. Objective: Mapping studies about comics made in Information Science, showing their uses and appropriations in the dissemination's process of the collected results in this research. Methodology: Bibliographical research with qualitative-quantitative approach. Results: The comics are subject of research in Information Science from the perspective of the dissemination and interpretation of informatiom. Its use helps in the learning of the users and scholars shows its benefits. The studies demonstrate that the comics provide a mental effort because the visuals also allow learning. Studies also show that they can be used for research, where are showed the knowledge acquired in reading of comics, in other words, the knowledge without scientific basis. Conclusions: Concludes that some studies of Information Science determine which purposes the comics are appropriated by users.

  18. DEVELOPING CULTURALLY- APPROPRIATE SPEAKING MATERIALS FOR BEGINNING MUSLIM STUDENTS

    Directory of Open Access Journals (Sweden)

    Dana Yudha Kristiawan

    2017-04-01

    Full Text Available Current practice in teaching Muslim students who are beginners in English does not maximize effective participation. Beginners tend to be reluctant to speak if the materials and activities are incompatible with their level of ability. Moreover, teachers find it difficult to provide material which is suitable for beginning Muslim students. To address these problems, this article highlights the suggestions for appropriate extra class activities and how to integrate Muslim culture in the design of materials. What follows, the article discusses the implementation of incorporating Muslim cultures into classroom materials design. And lastly, it fleshes out step-by-step guidelines for Muslim culture oriented material. The presenter contends that culturally appropriate Muslim material will help beginners practice their speaking by means of extra class activity.

  19. Introduction: minimally invasive spine surgery video supplement.

    Science.gov (United States)

    Mummaneni, Praveen V

    2013-07-01

    This video supplement of Neurosurgery Focus is devoted to minimally invasive spine surgery. Minimally invasive spine surgery has gained popularity amongst patients and physicians over the past decade because it has been shown in select instances to lower blood loss and reduce length of hospital stay for appropriately selected candidates. This supplement includes videos from many of the leaders in the field. Pioneers like Frank LaMarca, Paul Park, Cheerag Upadhyaya, Juan Uribe, and Mike Wang have all sent in videos depicting minimally invasive spinal deformity surgery options. The supplement also includes videos from several different countries, demonstrating how widespread and nuanced minimally invasive spinal procedures have become. Drs. Barbagallo, Certo, Sciacca, and Albanese from Italy; Drs. Gragnaniello and Seex from Australia; and Drs. Liao, Wu, Huang, Wang, Chang, Cheng, and Shih from Taiwan have all sent in nuanced surgical videos that will be of interest to many viewers. I personally enjoyed viewing videos on lumbar degenerative disease surgery depicting unique surgical nuances to treat common problems. Dr. Beejal Amin, Dr. Harel Deutsch, Dr. Daniel Lu, and Dr. Adam Kanter have each submitted videos depicting lumbar decompression and/or fusion for lumbar degenerative stenosis and spondylosis. This supplement also included videos depicting the minimally invasive treatment of uncommon spinal pathologies as well. Videos from Dr. Fred Geisler, Dr. John O'Toole, and Dr. Noel Perin covered topics as varied as sacroiliac joint dysfunction, spinal arteriovenous malformations, and sympathetic chain surgery. I hope that you enjoy this issue of Neurosurgical Focus devoted to videos depicting the surgical nuances of minimally invasive spinal surgery. This video supplement has international appeal, and it has been an honor to be a guest editor on this superb supplement.

  20. Active components in food supplements

    NARCIS (Netherlands)

    Siemelink M; Jansen EHJM; Piersma AH; Opperhuizen A; LEO

    2000-01-01

    The growing food supplement market, where supplements are both more diverse and more easily available (e.g. through Internet) formed the backdrop to the inventory of the active components in food supplements. The safety of an increased intake of food components via supplements was also at issue

  1. Comparing food limitation among three stages of nesting: supplementation experiments with the burrowing owl.

    Science.gov (United States)

    Wellicome, Troy I; Danielle Todd, L; Poulin, Ray G; Holroyd, Geoffrey L; Fisher, Ryan J

    2013-08-01

    Food availability is an important limiting factor for avian reproduction. In altricial birds, food limitation is assumed to be more severe during the nestling stage than during laying or incubation, but this has yet to be adequately tested. Using food-supplementation experiments over a 5-year period, we determined the degree and timing of food limitation for burrowing owls (Athene cunicularia) breeding in Canada. Burrowing owls are an endangered species and food limitation during the nestling stage could influence reproductive performance of this species at the northern extent of their range. Supplemented pairs fledged on average 47% more owlets than unfed pairs, except during a year when natural food was not limiting (i.e., a prey irruption year). The difference in fledgling production resulted from high nestling mortality in unfed broods, with 96% of all nestling deaths being attributed to food shortage. Supplemental feeding during the nestling period also increased fledgling structural size. Pairs fed from the start of laying produced the same number of hatchlings as pairs that received no supplemental food before hatch. Furthermore, pairs supplemented from egg laying to fledging and pairs supplemented during the nestling period alone had the same patterns of nestling survival, equal numbers of fledglings, and similar fledgling mass and structural size. Our results provide empirical support for the hypothesis that the nestling period is the most food-limited phase of the breeding cycle. The experimental design we introduce here could be used with other altricial species to examine how the timing of food limitation differs among birds with a variety of life-history strategies. For burrowing owls, and other species with similar life histories, long-term, large-scale, and appropriately timed habitat management increasing prey abundance or availability is critical for conservation. Our results provide empirical support for the hypothesis that the nestling period is

  2. Designing appropriate blended courses: a students' perspective.

    Science.gov (United States)

    Tsai, Chia-Wen

    2010-10-01

    The computing education in Taiwan's vocational schools usually focuses on how to help students enhance their professional skills and pass certified examinations. In addition, due to national education policy and universities' regulations, pure online courses are not permitted in Taiwan. In order to design appropriate blended learning (BL) courses, the author explored the effects of web-mediated self-regulated learning (SRL) with variations in online class frequency on enhancing students' computing skills and their perspective of the blended courses. A total of 172 students, divided into four groups, participated in the experiment. The results showed that students in the SRL and BL group with five online classes had the highest scores for using a database management system (DBMS), and the highest pass rate on certified examinations. Students in this group also expressed their positive perspective on the arrangement of their blended course with the intervention of web-mediated SRL.

  3. Wound dressings: selecting the most appropriate type.

    Science.gov (United States)

    Broussard, Karen C; Powers, Jennifer Gloeckner

    2013-12-01

    Appropriate wound dressing selection is guided by an understanding of wound dressing properties and an ability to match the level of drainage and depth of a wound. Wounds should be assessed for necrosis and infection, which need to be addressed prior to selecting an ideal dressing. Moisture-retentive dressings include films, hydrogels, hydrocolloids, foams, alginates, and hydrofibers and are useful in a variety of clinical settings. Antimicrobial-impregnated dressings can be useful in wounds that are superficially infected or are at higher risk for infection. For refractory wounds that need more growth stimulation, tissue-engineered dressings have become a viable option in the past few decades, especially those that have been approved for burns, venous ulcers, and diabetic ulcers. As wounds heal, the ideal dressing type may change, depending on the amount of exudate and depth of the wound; thus success in wound dressing selection hinges on recognition of the changing healing environment.

  4. Shoosing the appropriate size wind turbine

    Energy Technology Data Exchange (ETDEWEB)

    Lynette, R. [FloWind Corp., San Rafael, CA (United States)

    1996-12-31

    Within the past several years, wind turbines rated at 400 kW and higher have been introduced into the market, and some manufacturers are developing machines rated at 750 - 1,000+ kW. This raises the question: What is the appropriate size for utility-grade wind turbines today? The answer depends upon the site where the machines will be used and the local conditions. The issues discussed in the paper are: (1) Site-Related (a) Visual, noise, erosion, television interference, interference with aviation (b) Siting efficiency (2) Logistics (a) Adequacy of roads and bridges to accept large vehicles (b) Availability and cost of cranes for erection and maintenance (c) Capability of local repair/overhauls (3) Cost Effectiveness (a) Capital costs (1) Wind Turbine (2) Infrastructure costs (b) Maintenance costs (4) Technical/Financial Risk. 1 fig., 1 tab.

  5. ACR Appropriateness Criteria Osteonecrosis of the Hip.

    Science.gov (United States)

    Murphey, Mark D; Roberts, Catherine C; Bencardino, Jenny T; Appel, Marc; Arnold, Erin; Chang, Eric Y; Dempsey, Molly E; Fox, Michael G; Fries, Ian Blair; Greenspan, Bennett S; Hochman, Mary G; Jacobson, Jon A; Mintz, Douglas N; Newman, Joel S; Rosenberg, Zehava S; Rubin, David A; Small, Kirstin M; Weissman, Barbara N

    2016-02-01

    Osteonecrosis of the hip (Legg-Calvé-Perthes) is a common disease, with 10,000-20,000 symptomatic cases annually in the United States. The disorder affects both adults and children and is most frequently associated with trauma and corticosteroid usage. The initial imaging evaluation of suspected hip osteonecrosis is done using radiography. MRI is the most sensitive and specific imaging modality for diagnosis of osteonecrosis of the hip. The clinical significance of hip osteonecrosis is dependent on its potential for articular collapse. The likelihood of articular collapse is significantly increased with involvement of greater than 30%-50% of the femoral head area, which is optimally evaluated by MRI, often in the sagittal plane. Contrast-enhanced MRI may be needed to detect early osteonecrosis of the hip in pediatric patients, revealing hypoperfusion. In patients with a contraindication for MRI, use of either CT or bone scintigraphy with SPECT (single-photon emission CT) are alternative radiologic methods of assessment. Imaging helps guide treatment, which may include core decompression, osteotomy, and ultimately, need for joint replacement. The ACR Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  6. Evidence for Policy Making: Clinical Appropriateness Study of Lumbar Spine MRI Prescriptions Using RAND Appropriateness Method

    Directory of Open Access Journals (Sweden)

    Hossein Yousefi Manesh

    2013-01-01

    Full Text Available MRI is a new and expensive diagnostic technology, which has been used increasingly all over the world. Low back pain is a worldwide prevalent disorder and MRI technique is one of the several ways to diagnose it. This paper aims to identify the appropriateness of lumbar spine MRI prescriptions in Shiraz teaching hospitals using standardized RAND Appropriateness Method (RAM criteria. Methods This study consisted of two phases. The first phase involved a qualitative enquiry and the second phase had a quantitative cross-sectional nature. In the first phase RAM was used for developing lumbar spine MRI indications and scenarios. In the second phase, the finalized scenarios were compared with the history and physical examination of 300 patients with low back pain. The rate of appropriateness of lumbar spine MRI prescription was then calculated. Results Of 300 cases of lumbar spine MRI prescriptions, approximately 167 (56% were considered inappropriate, 72 (24% were uncertain, and 61 (20% were deemed to be appropriate. The economic burden of inappropriate prescriptions was calculated at 88,009,000 Rials. In addition, the types of expertise and physical examination were considered as related factors to appropriateness of prescriptions. Conclusion In conclusion, a large proportion of lumbar spine MRI prescriptions, which result in financial burden on the insurance companies and the patients alike is unnecessary. This study suggests that policy makers consider this evidence while decision-making. Our findings highlight the imperative role of Health Technology Assessment (HTA and Clinical Practice Guidelines (CPGs. As a result, developing local clinical guidelines may create the commitment needed in physicians in prescribing appropriate prescriptions within the health sector. The study further recommends that appropriate scenarios should be considered as a criterion for payment and reimbursement.

  7. Exploring voices, exploring appropriate education. A practitioners’ discourse'

    NARCIS (Netherlands)

    Grol, C.E.J.

    2012-01-01

    My thesis describes an exploratory process into a practitioners’ discourse on appropriate education. Chapter one: Appropriate Education is about the Dutch educational policy called Passend onderwijs. The chapter positions the appropriate education in national and international educational and

  8. Supplement use by Young Athletes

    OpenAIRE

    Jill Anne McDowall

    2007-01-01

    This paper reviews studies of supplement use among child and adolescent athletes, focusing on prevalence and type of supplement use, as well as gender comparisons. Supplement use among adult athletes has been well documented however there are a limited number of studies investigating supplement use by child and adolescent athletes. A trend in the current literature revealed that the most frequently used supplements are in the form of vitamin and minerals. While health and illness prevention a...

  9. Supplemental irrigation as an initiative to support water and food security: A global evaluation of the potential to support and increase precipitation-fed wheat production

    Science.gov (United States)

    Smilovic, M.; Gleeson, T. P.; Adamowski, J. F.; Langhorn, C.; Kienzle, S. W.

    2016-12-01

    Supplemental irrigation is the practice of supporting precipitation-fed agriculture with limited irrigation. Precipitation-fed agriculture dominates the agricultural landscape, but is vulnerable to intraseasonal and interannual variability in precipitation and climate. The interplay between food security, water resources, ecosystem health, energy, and livelihoods necessitates evaluating and integrating initiatives that increase agricultural production while reducing demands on water resources. Supplemental irrigation is the practice of minimally irrigating in an effort to stabilize and increase agricultural production, as well as increase water productivity - the amount of crop produced per unit of water. The potential of supplemental irrigation to support both water and food security has yet to be evaluated at regional and global scales. We evaluate whether supplemental irrigation could stabilize and increase agricultural production of wheat by determining locally-calibrated water use-crop yield relationships, known as crop-water production functions. Crop-water production functions are functions of seasonal water use and crop yield, and previous efforts have largely ignored the effects of the temporal distribution of water use throughout the growing season. We significantly improve upon these efforts and provide an opportunity to evaluate supplemental irrigation that appropriately acknowledges the effects of irrigation scheduling. Integrating agroclimatic and crop data with the crop-water model Aquacrop, we determine the increases in wheat production achieved by maximizing water productivity, sharing limited water between different years, and other irrigation scenarios. The methodology presented and evaluation of supplemental irrigation provides water mangers, policy makers, governments, and non-governmental organizations the tools to appropriately understand and determine the potential of this initiative to support precipitation-fed agriculture.

  10. [Association between periconceptional folic acid supplementation and small for gestational age birth based on pre-pregnancy body mass index].

    Science.gov (United States)

    Guo, L L; Shen, J X; Ru, S H; Wang, Y; Li, M; Feng, Y L; Zhang, P; Wu, W W; Wang, S P; Zhang, Y W; Yang, H L

    2017-09-10

    Objective: To investigate the association between periconceptional folic acid supplementation and small for gestational age (SGA) birth based on maternal pre-pregnancy body mass index (BMI) and provide evidence for the development of comprehensive prevention programs on SGA birth. Methods: Between March, 2012 and September, 2016, a total of 8 523 pregnant women delivering in the First Affiliated Hospital of Shanxi Medical University were surveyed to collect the information about their demographic characteristics, folic acid supplementation before and during pregnancy and about their infants. Among their infants, 1 066 were small for gestational age (case group), 7 457 were appropriate for gestational age (AGA) (control group). Unconditional logistic regression model was used to evaluate the association between periconceptional folic acid supplementation and SGA birth in the context of different pre-pregnancy BMI. Results: The overall incidence of SGA birth was 12.51 % (1 066/8 523). After adjusting the confounding factors, pre-pregnancy BMIbirth ( OR =1.22, 95 %CI : 1.01-1.47), pre-pregnancy BMI≥24.0 kg/m(2) was associated with a reduced risk of SGA birth ( OR =0.81, 95 %CI :0.68-0.97). After adjusting confounding factors, periconceptional folic acid supplementation was a protective factor for SGA birth ( OR =0.82, 95 %CI : 0.68-0.98). After stratified by pre-pregnancy BMI, periconceptional folic acid supplementation was associated with the reduced risk of SGA birth in overweight group (24.0 kg/m(2)≤BMIsupplement type, periconceptional single folic acid supplementation (400 μg per tablet) was a protective factor for SGA birth ( OR =0.82, 95 %CI : 0.69-0.99). After stratified by pre-pregnancy BMI, periconceptional single folic acid supplementation (400 μg per tablet) was associated with the reduced risk of SGA birth in overweight groups ( OR =0.56, 95 %CI : 0.36-0.86). No association was observed between periconceptional folic acid containing multivitamin

  11. Nutritional supplements usage by Portuguese athletes.

    Science.gov (United States)

    Sousa, Mónica; Fernandes, Maria João; Moreira, Pedro; Teixeira, Vítor Hugo

    2013-01-01

    In this study, we determined the prevalence of nutritional supplements (NS) usage, the type of supplements used, the reasons for usage, and the source of nutritional advice among Portuguese athletes. Two hundred ninety-two athletes (68 % male, 12 - 37 years old) from 13 national sports federations completed a questionnaire that sought information on socio-demographics, sports data, and NS usage. Most athletes (66 %) consumed NS, with a median consumption of 4 supplements per athlete. The most popular supplements included multivitamins/minerals (67 %), sport drinks (62 %), and magnesium (53 %). Significant differences for the type of NS consumed were found between gender and age groups and the number of weekly training hours. Most athletes used NS to accelerate recovery (63 %), improve sports performance (62 %), and have more energy/reduce fatigue (60 %). Athletes sought advice on supplementation mainly from physicians (56 %) and coaches (46 %). Age and gender were found to influence reasons for use and the source of information. Reasons for NS usage were supported scientifically in some cases (e. g., muscle gain upon protein supplementation), but others did not have a scientific basis (e. g., use of glutamine and magnesium). Given the high percentage of NS users, there is an urgent need to provide athletes with education and access to scientific and unbiased information, so that athletes can make assertive and rational choices about the utilization of these products.

  12. Idaho Supplementation Studies : 1993 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Leitzinger, Eric J.; Plaster, Kurtis; Hassemer, Peter

    1996-12-01

    Idaho Supplementation Studies (ISS) will help determine the utility of supplementation as a potential recovery tool for decimated stocks of spring and summer chinook salmon, Oncorhynchus tshawytscha, in Idaho as part of a program to protect, mitigate, and enhance fish and wildlife affected by the development and operation of hydroelectric power plants on the Columbia River. The objectives are to: (1) monitor and evaluate the effects of supplementation on presmolt and smolt numbers and spawning escapements of naturally produced salmon; (2) monitor and evaluate changes in natural productivity and genetic composition of target and adjacent populations following supplementation; and (3) determine which supplementation strategies provide the quickest and highest response in natural production without adverse effects on productivity. Field work began in 1991 with the collection of baseline data from treatment and some control streams. Full implementation began in 1992 with baseline data collection on treatment and control streams and releases of supplementation fish into several treatment streams. Field methods included snorkeling to estimate chinook salmon parr populations, PIT tagging summer parr to estimate parr-to-smolt survival, multiple redd counts to estimate spawning escapement and collect carcass information. Screw traps were used to trap and PIT tag outmigrating chinook salmon during the spring and fall outmigration. Weirs were used to trap and enumerate returning adult salmon in select drainages.

  13. Lectin staining and Western blot data showing differential sialylation of nutrient-deprived cancer cells to sialic acid supplementation

    Directory of Open Access Journals (Sweden)

    Haitham A. Badr

    2015-12-01

    Full Text Available This report provides data that are specifically related to the differential sialylation of nutrient deprived breast cancer cells to sialic acid supplementation in support of the research article entitled, “Nutrient-deprived cancer cells preferentially use sialic acid to maintain cell surface glycosylation" [1]. Particularly, breast cancer cells, when supplemented with sialic acid under nutrient deprivation, display sialylated glycans at the cell surface, but non-malignant mammary cells show sialylated glycans intracellularly. The impact of sialic acid supplementation under nutrient deprivation was demonstrated by measuring levels of expression and sialylation of two markers, EGFR1 and MUC1. This Data in Brief article complements the main manuscript by providing detailed instructions and representative results for cell-level imaging and Western blot analyses of changes in sialylation during nutrient deprivation and sialic acid supplementation. These methods can be readily generalized for the study of many types of glycosylation and various glycoprotein markers through the appropriate selection of fluorescently-labeled lectins.

  14. Irrigation infrastructure and water appropriation rules for food security

    Science.gov (United States)

    Gohar, Abdelaziz A.; Amer, Saud A.; Ward, Frank A.

    2015-01-01

    In the developing world's irrigated areas, water management and planning is often motivated by the need for lasting food security. Two important policy measures to address this need are improving the flexibility of water appropriation rules and developing irrigation storage infrastructure. Little research to date has investigated the performance of these two policy measures in a single analysis while maintaining a basin wide water balance. This paper examines impacts of storage capacity and water appropriation rules on total economic welfare in irrigated agriculture, while maintaining a water balance. The application is to a river basin in northern Afghanistan. A constrained optimization framework is developed to examine economic consequences on food security and farm income resulting from each policy measure. Results show that significant improvements in both policy aims can be achieved through expanding existing storage capacity to capture up to 150 percent of long-term average annual water supplies when added capacity is combined with either a proportional sharing of water shortages or unrestricted water trading. An important contribution of the paper is to show how the benefits of storage and a changed water appropriation system operate under a variable climate. Results show that the hardship of droughts can be substantially lessened, with the largest rewards taking place in the most difficult periods. Findings provide a comprehensive framework for addressing future water scarcity, rural livelihoods, and food security in the developing world's irrigated regions.

  15. Textual appropriation in engineering master's theses: a preliminary study.

    Science.gov (United States)

    Eckel, Edward J

    2011-09-01

    In the thesis literature review, an engineering graduate student is expected to place original research in the context of previous work by other researchers. However, for some students, particularly those for whom English is a second language, the literature review may be a mixture of original writing and verbatim source text appropriated without quotations. Such problematic use of source material leaves students vulnerable to an accusation of plagiarism, which carries severe consequences. Is such textual appropriation common in engineering master's writing? Furthermore, what, if anything, can be concluded when two texts have been found to have textual material in common? Do existing definitions of plagiarism provide a sufficient framework for determining if an instance of copying is transgressive or not? In a preliminary attempt to answer these questions, text strings from a random sample of 100 engineering master's theses from the ProQuest Dissertations and Theses database were searched for appropriated verbatim source text using the Google search engine. The results suggest that textual borrowing may indeed be a common feature of the master's engineering literature review, raising questions about the ability of graduate students to synthesize the literature. The study also illustrates the difficulties of making a determination of plagiarism based on simple textual similarity. A context-specific approach is recommended when dealing with any instance of apparent copying.

  16. Searching for an Appropriate Exchange Rate Regime

    Directory of Open Access Journals (Sweden)

    Yunjong Wang

    2001-06-01

    Full Text Available This paper attempts to survey current debates on the choice of exchange rate regime in emerging market economies. The issue of choosing an appropriate exchange rate regime is being actively discussed since the recent Asian crisis. As a lesson from the recent crises, one widely shared conclusion is that soft peg exchange rate regimes are extremely vulnerable in a world of volatile capital movements. Consequently, new orthodoxy based on the impossible trinity hypothesis favours two corner solutions ― greater flexibility or credible institutional assurance, like a currency board system or dollarization. Nevertheless, questions whether such corner solutions are adequate for developing countries are rising of late. "Fear of floating" is still conspicuous in many developing countries having adopted nominally a free-floating exchange rate regime. Developing countries are sensitive to exchange rate fluctuations because the cost of exchange rate volatility is greater than the benefit when compared to developed countries. Monitoring bands is a compromise solution, but it still needs further enhancement of estimation techniques for fundamental equilibrium exchange rates in order to make those estimation results more workable in practice. Other alternatives include the creation of soft peg of the G-3 currencies. Despite counterarguments, the stability of G-3 currencies could prove to be beneficial to emerging market economies.

  17. Iodine Supplementation in the Newborn

    Directory of Open Access Journals (Sweden)

    Paolo Ghirri

    2014-01-01

    Full Text Available Iodine deficiency can be defined as the world’s greatest single cause of preventable brain damage. Fetal and neonatal hypothyroidism, caused by iodine deficiency can be prevented prior to conception and then during pregnancy and lactation when an adequate iodine supplementation is ensured. Extremely low birth weight preterm babies risk having a negative iodine balance status in the first weeks of life, exacerbating the hypothyroxinaemia of the prematurity. It is important to ensure that these babies are provided with an adequate iodine intake from the first days of life. Mothers and newborns should avoid environmental iodine excess during pregnancy or lactation.

  18. Does supplemental feeding affect behaviour and foraging of ...

    African Journals Online (AJOL)

    The western giant eland (Tragelaphus derbianus derbianus) needs appropriate management for its survival. We measured the effects of supplemental food on activity and browsing patterns during seasons of scarce natural food resources in 2008 and 2009 for a herd of six animals in the Fathala Reserve (Senegal).

  19. Design and Construction for Community Health Service Precision Fund Appropriation System Based on Performance Management.

    Science.gov (United States)

    Gao, Xing; He, Yao; Hu, Hongpu

    2017-01-01

    Allowing for the differences in economy development, informatization degree and characteristic of population served and so on among different community health service organizations, community health service precision fund appropriation system based on performance management is designed, which can provide support for the government to appropriate financial funds scientifically and rationally for primary care. The system has the characteristic of flexibility and practicability, in which there are five subsystems including data acquisition, parameter setting, fund appropriation, statistical analysis system and user management.

  20. Zinc supplements for preventing otitis media.

    Science.gov (United States)

    Gulani, Anjana; Sachdev, Harshpal S

    2014-06-29

    Otitis media is inflammation of the middle ear and is usually caused by infection. It affects people of all ages but is particularly common in young children. Around 164 million people worldwide have long-term hearing loss caused by this condition, 90% of them in low-income countries. As zinc supplements prevent pneumonia in disadvantaged children, we wanted to investigate whether zinc supplements could also prevent otitis media. To evaluate whether zinc supplements prevent otitis media in adults and children of different ages. We searched CENTRAL (2014, Issue 1), MEDLINE (1950 to February week 4, 2014) and EMBASE (1974 to March 2014). Randomised, placebo-controlled trials of zinc supplements given at least once a week for at least a month for preventing otitis media. Two review authors independently assessed the eligibility and methodological quality of the included trials and extracted and analysed data. We summarised results using risk ratios (RRs) or rate ratios for dichotomous data and mean differences (MDs) for continuous data. We combined trial results where appropriate. No new trials were identified for inclusion in this update. We identified 12 trials for inclusion, 10 of which contributed outcomes data. There were a total of 6820 participants. In trials of healthy children living in low-income communities, two trials did not demonstrate a significant difference between the zinc-supplemented and placebo groups in the numbers of participants experiencing an episode of definite otitis media during follow-up (3191 participants); another trial showed a significantly lower incidence rate of otitis media in the zinc group (rate ratio 0.69, 95% confidence interval (CI) 0.61 to 0.79, n = 1621). A small trial of 39 infants undergoing treatment for severe malnutrition suggested a benefit of zinc for the mean number of episodes of otitis media (mean difference (MD) -1.12 episodes, 95% CI -2.21 to -0.03). Zinc supplements did not seem to cause any serious adverse

  1. Vitamin K supplementation for cystic fibrosis.

    Science.gov (United States)

    Jagannath, Vanitha A; Thaker, Vidhu; Chang, Anne B; Price, Amy I

    2017-08-22

    Cystic fibrosis is a genetic disorder which can lead to multiorgan dysfunction. Malabsorption of fat and fat-soluble vitamins (A, D, E, K) may occur and can cause subclinical deficiencies of some of these vitamins. Vitamin K is known to play an important role in both blood coagulation and bone formation. Supplementation with vitamin K appears to be one way of addressing the deficiency, but there is very limited agreement on the appropriate dose and frequency of use of these supplements. This is an updated version of the review. To assess the effects of vitamin K supplementation in people with cystic fibrosis and to determine the optimal dose and route of administration of vitamin K for both routine and therapeutic use. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Most recent search: 30 January 2017. Randomised and quasi-randomised controlled trials of all preparations of vitamin K used as a supplement compared to either no supplementation (or placebo) at any dose or route and for any duration, in children or adults diagnosed with cystic fibrosis (by sweat test or genetic testing). Two authors independently screened papers, extracted trial details and assessed their risk of bias. Two trials (total of 32 participants) each lasting one month were included in the review and were assessed as having a moderate risk of bias. One was a dose-ranging parallel group trial in children (aged 8 to 18 years); and the other (with an older cohort) had a cross-over design comparing supplements to no treatment, but no separate data were reported for the first intervention period. Neither of the trials addressed any of the primary outcomes (coagulation, bone formation and quality of life). Both trials reported the restoration of serum vitamin K and undercarboxylated osteocalcin

  2. Culturally and Linguistically Appropriate Services Cnty Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — PHS Act section 2719 requires non-grandfathered group health plans and health insurance issuers offering non-grandfathered health insurance coverage to provide...

  3. Supplements and sports.

    Science.gov (United States)

    Jenkinson, David M; Harbert, Allison J

    2008-11-01

    Use of performance-enhancing supplements occurs at all levels of sports, from professional athletes to junior high school students. Although some supplements do enhance athletic performance, many have no proven benefits and have serious adverse effects. Anabolic steroids and ephedrine have life-threatening adverse effects and are prohibited by the International Olympic Committee and the National Collegiate Athletic Association for use in competition. Blood transfusions, androstenedione, and dehydroepiandrosterone are also prohibited in competition. Caffeine, creatine, and sodium bicarbonate have been shown to enhance performance in certain contexts and have few adverse effects. No performance benefit has been shown with amino acids, beta-hydroxy-beta-methylbutyrate, chromium, human growth hormone, and iron. Carbohydrate-electrolyte beverages have no serious adverse effects and can aid performance when used for fluid replacement. Given the widespread use of performance-enhancing supplements, physicians should be prepared to counsel athletes of all ages about their effectiveness, safety, and legality.

  4. On the Way to Appropriate Model Complexity

    Science.gov (United States)

    Höge, M.

    2016-12-01

    When statistical models are used to represent natural phenomena they are often too simple or too complex - this is known. But what exactly is model complexity? Among many other definitions, the complexity of a model can be conceptualized as a measure of statistical dependence between observations and parameters (Van der Linde, 2014). However, several issues remain when working with model complexity: A unique definition for model complexity is missing. Assuming a definition is accepted, how can model complexity be quantified? How can we use a quantified complexity to the better of modeling? Generally defined, "complexity is a measure of the information needed to specify the relationships between the elements of organized systems" (Bawden & Robinson, 2015). The complexity of a system changes as the knowledge about the system changes. For models this means that complexity is not a static concept: With more data or higher spatio-temporal resolution of parameters, the complexity of a model changes. There are essentially three categories into which all commonly used complexity measures can be classified: (1) An explicit representation of model complexity as "Degrees of freedom" of a model, e.g. effective number of parameters. (2) Model complexity as code length, a.k.a. "Kolmogorov complexity": The longer the shortest model code, the higher its complexity (e.g. in bits). (3) Complexity defined via information entropy of parametric or predictive uncertainty. Preliminary results show that Bayes theorem allows for incorporating all parts of the non-static concept of model complexity like data quality and quantity or parametric uncertainty. Therefore, we test how different approaches for measuring model complexity perform in comparison to a fully Bayesian model selection procedure. Ultimately, we want to find a measure that helps to assess the most appropriate model.

  5. Legislation should support optimal breastfeeding practices and access to low-cost, high-quality complementary foods: Indonesia provides a case study.

    Science.gov (United States)

    Soekarjo, Damayanti; Zehner, Elizabeth

    2011-10-01

    It is important to support women to exclusively breastfeed for 6 months and continue breastfeeding for 24 months and beyond. It is also necessary to provide the poor with access to affordable ways to improve the quality of complementary foods. Currently, many countries do not have the legal and policy environment necessary to support exclusive and continued breastfeeding. Legislative and policy changes are also necessary for introducing complementary food supplements, allowing them to be marketed to those who need them, and ensuring that marketing remains appropriate and in full compliance with the International Code of Marketing of Breastmilk Substitutes. This paper aims to illustrate the above with examples from Indonesia and to identify legislative requirements for supporting breastfeeding and enabling appropriate access to high-quality complementary food supplements for children 6-24 months of age. Requirements include improved information, training, monitoring and enforcement systems for the International Code of Marketing of Breastmilk Substitutes; implementation and monitoring of the Baby-Friendly Hospital Initiative; establishment of a registration category for complementary food supplements to enhance availability of high-quality, low-cost fortified products to help improve young child feeding; clear identification and marketing of these products as complementary food supplements for 6-24-month-olds so as to promote proper use and not interfere with breastfeeding. © 2011 Blackwell Publishing Ltd.

  6. Is selenium supplementation in autoimmune thyroid diseases justified?

    DEFF Research Database (Denmark)

    Winther, Kristian H.; Bonnema, Steen; Hegedüs, Laszlo

    2017-01-01

    PURPOSE OF REVIEW: This review provides an appraisal of recent evidence for or against selenium supplementation in patients with autoimmune thyroid diseases, and discusses possible effect mechanisms. RECENT FINDINGS: Epidemiological data suggest an increased prevalence of autoimmune thyroid...... diseases under conditions of low dietary selenium intake. Two systematic reviews have evaluated controlled trials among patients with autoimmune thyroiditis and report that selenium supplementation decreases circulating thyroid autoantibodies. The immunomodulatory effects of selenium might involve reducing...... proinflammatory cytokine release. However, clinically relevant effects of selenium supplementation, including improvement in quality of life, are more elusive. In Graves’ disease, some, but not all, trials indicate that adjuvant selenium supplementation enhances the restoration of biochemical euthyroidism...

  7. Iodine Supplementation in Pregnancy and the Dilemma of Ambiguous Recommendations

    DEFF Research Database (Denmark)

    Andersen, Stine Linding; Laurberg, Peter

    2016-01-01

    question is at what level of iodine intake pregnant women should be advised to take iodine-containing supplements. The consensus reached by the WHO/UNICEF/ICCIDD in 2007 was that pregnant women should not be recommended to take iodine-containing supplements if the population in general had been iodine...... sufficient for at least 2 years. However, guidance on this differs between scientific societies. This review discusses iodine supplementation in pregnancy. Based on current evidence, the recommendations given by WHO/UNICEF/ICCIDD in 2007 provide a valid guidance on the use of iodine supplements in pregnant...

  8. Determinants of dietary supplement use - healthy individuals use dietary supplements

    DEFF Research Database (Denmark)

    Kofoed, Christina L F; Christensen, Jane; Dragsted, Lars Ove

    2015-01-01

    The prevalence of dietary supplement use varies largely among populations, and previous studies have indicated that it is high in the Danish population compared with other European countries. The diversity in supplement use across countries indicates that cultural and environmental factors could...... influence the use of dietary supplements. Only few studies investigating the use of dietary supplements have been conducted in the Danish population. The present cross-sectional study is based on 54 948 Danes, aged 50-64 years, who completed self-administrated questionnaires on diet, dietary supplements...... to the intake of dietary supplements. We found that 71 % of the participants were dietary supplement users; female sex, older age groups and higher educated participants were more likely to be users of any dietary supplements. One additional point in the health index was associated with 19, 16 and 9 % higher...

  9. 76 FR 45208 - Agency Use of Appropriated Funds for Child Care Costs for Lower Income Employees

    Science.gov (United States)

    2011-07-28

    ... entering into a Federally recognized marriage. That is because child care subsidies are currently available... MANAGEMENT 5 CFR Part 792 RIN 3206-AL36 Agency Use of Appropriated Funds for Child Care Costs for Lower... agencies' use of appropriated funds to provide child care subsidies for lower-income civilian employees, to...

  10. Toward an Appropriate Technology Model of Communicative Course Design: Issues and Definitions.

    Science.gov (United States)

    Markee, Numa

    1986-01-01

    Provides a rationale for considering English for specific purposes in terms of "appropriate technology"; surveys the philosophical and intellectual underpinnings of the appropriate technology movement; defines key terms and clarifies them with language teaching examples; and briefly considers some objections to the notion of appropriate…

  11. Essays on Firm Valuation and Value Appropriation

    NARCIS (Netherlands)

    W. de Maeseneire (Wouter)

    2005-01-01

    textabstractSophisticated valuation techniques such as adjusted present value and real options, attract ever-increasing attention from theory and practice. A huge number of papers in the academic field provide various applications of these advanced tools, for instance valuing research and

  12. some thoughts on an appropriate theoretical framework

    African Journals Online (AJOL)

    10332324

    Disabilities was adopted at a diplomatic conference on 28 June 2013.3 .... This section does not purport to provide a comprehensive theory of IP because this is a nearly insurmountable task that is both inappropriate and unnecessary for present purposes. Not even a leading text on the theory and philosophy of IP30.

  13. An international study on dietary supplementation use in dancers

    NARCIS (Netherlands)

    Brown, D.D.; Wyon, M.

    2014-01-01

    Little is known of the prevalence and motives of dietary supplement use amongst dancers from different cultures. Investigating supplement use, presumed effects, and other factors may be crucial for improving educational and nutritional advice provided for this cohort. Therefore, this study

  14. Protein supplement users among high school athletes have misconceptions about effectiveness.

    Science.gov (United States)

    Duellman, Margaret C; Lukaszuk, Judith M; Prawitz, Aimee D; Brandenburg, Jason P

    2008-07-01

    Protein supplements commonly are ingested by athletes to improve strength, agility, and speed. While athletes require a higher amount of protein (g.kg body weight) than nonathletes do to support protein synthesis, they do not necessarily need to consume protein from supplemental sources. To date, no studies have shown an advantage of ingesting protein supplements over natural, protein-containing foods; therefore, dietary sources of protein may be just as effective as protein supplemental sources in the regulation of muscle protein synthesis. Misconceptions regarding protein supplement effectiveness may originate from athletes' nutrition information sources. A survey questionnaire queried high school football players about sources of information and measured protein supplement misconceptions by using scores on a Protein Supplement Misconceptions Index. Sixty-one high school football players participated in the study; 39 were protein supplementers, and 22 were non-protein supplementers. There was a significant difference between index scores of protein supplementers and non-protein supplementers (t = -3.4, p = 0.001), indicating that protein supplementers had a greater level of misconceptions than non-protein supplementers did. Bonferroni post hoc procedures used with individual index items revealed that protein supplementers were more likely than non-protein supplementers to agree that "athletes should take protein supplements" (p = 0.001) and needed them "to gain as much muscle as possible" (p = 0.001). Greater misconceptions for protein supplementers may have resulted from the sources chosen for information and advice. Since coaches, parents, and friends were the primary sources of advice about protein supplements for protein supplementers, it would be valuable to provide nutrition education to these groups concurrently with educating young athletes to dispel ongoing misconceptions regarding the need for and effectiveness of protein supplements.

  15. Oral Supplementation of Myoinositol

    DEFF Research Database (Denmark)

    Gregersen, G.; Bertelsen, B.; Harbo, H.

    1983-01-01

    28 young diabetics with short disease duration participated in a double-blind study by taking 6 g of myoinositol or placebo daily for 2 months. The aim was to demonstrate a possible beneficial effect of this compound on subclinical diabetic neuropathy. Measurement of vibratory perception threshol...... of myoinositol in their muscle tissue remained uninfluenced by oral supplementation of myoinositol....

  16. Challenging obesity: Patient, provider, and expert perspectives on the roles of available and emerging nonsurgical therapies.

    Science.gov (United States)

    Apovian, Caroline M; Garvey, W Timothy; Ryan, Donna H

    2015-07-01

    Adult obesity is recognized as a chronic disease. According to principles of chronic disease management, healthcare professionals should work collaboratively with patients to determine appropriate therapeutic strategies that address overweight and obesity, specifically considering a patient's disease status in addition to their individual needs, preferences, and attitudes regarding treatment. A central role and responsibility of healthcare professionals in this process is to inform and educate patients about their treatment options. Although current recommendations for the management of adult obesity provide general guidance regarding safe and proper implementation of lifestyle, pharmacological, and surgical interventions, healthcare professionals need awareness of specific evidence-based information that supports individualized clinical application of these therapies. More specifically, healthcare professionals should be up-to-date on approaches that promote successful lifestyle management and be knowledgeable about newer weight loss pharmacotherapies, so they can offer patients with obesity a wide range of options to personalize their treatment. Accordingly, this educational activity has been developed to provide participants with the latest information on treatment recommendations and therapeutic advances in lifestyle intervention and pharmacotherapy for adult obesity management. This supplement is based on the content presented at a live CME symposium held in conjunction with ObesityWeek 2014. This supplement provides an expert summary of current treatment recommendations and recent advances in nonsurgical therapies for the management of adult obesity. Patient and provider perspectives on obesity management are highlighted in embedded video clips available via QR codes, and new evidence will be applied using clinically relevant case studies. This supplement provides a topical update of obesity management, including clinical practice examples, for healthcare

  17. Challenging Obesity: Patient, Provider, and Expert Perspectives on the Roles of Available and Emerging Nonsurgical Therapies

    Science.gov (United States)

    Apovian, Caroline M.; Garvey, W. Timothy; Ryan, Donna H.

    2015-01-01

    Objective Adult obesity is recognized as a chronic disease. According to principles of chronic disease management, healthcare professionals should work collaboratively with patients to determine appropriate therapeutic strategies that address overweight and obesity, specifically considering a patient’s disease status in addition to their individual needs, preferences, and attitudes regarding treatment. A central role and responsibility of healthcare professionals in this process is to inform and educate patients about their treatment options. Although current recommendations for the management of adult obesity provide general guidance regarding safe and proper implementation of lifestyle, pharmacological, and surgical interventions, healthcare professionals need awareness of specific evidence-based information that supports individualized clinical application of these therapies. More specifically, healthcare professionals should be up-to-date on approaches that promote successful lifestyle management and be knowledgeable about newer weight loss pharmacotherapies, so they can offer patients with obesity a wide range of options to personalize their treatment. Accordingly, this educational activity has been developed to provide participants with the latest information on treatment recommendations and therapeutic advances in lifestyle intervention and pharmacotherapy for adult obesity management. Design and Methods This supplement is based on the content presented at a live CME symposium held in conjunction with ObesityWeek 2014. Results This supplement provides an expert summary of current treatment recommendations and recent advances in nonsurgical therapies for the management of adult obesity. Patient and provider perspectives on obesity management are highlighted in embedded video clips available via QR codes, and new evidence will be applied using clinically relevant case studies. Conclusions This supplement provides a topical update of obesity management

  18. Omega-3 Supplements: An Introduction

    Science.gov (United States)

    ... 3 Supplements in the United States What the Science Says If You Are Considering Omega-3 Supplements NCCIH-Funded Research For More Information Key References ©Thinkstock Introduction Omega-3 fatty acids (omega-3s) are a ...

  19. Vitamin Supplements: Healthy or Hoax?

    Science.gov (United States)

    ... It Works Healthy Workplace Food and Beverage Toolkit Vitamin Supplements: Healthy or Hoax? Updated:Jun 12,2015 Can ... Don’t do this: Don’t take antioxidant vitamin supplements such as A, C and E . Scientific evidence ...

  20. Herbal Supplements: Considerations for the Athletic Trainer.

    Science.gov (United States)

    Winterstein, Andrew P.; Storrs, Cordial M.

    2001-01-01

    Examines common herbal supplements, exploring potential risks associated with herbal use and providing recommendations to athletic trainers regarding patient care issues. Data from searches of the MEDLINE, SPORT Discus, CINAHL, and Academic Search Elite databases indicate that athletes must understand that natural does not equal safe, and most…

  1. A Note on Evaluating Supplemental Instruction

    Science.gov (United States)

    Paloyo, Alfredo R.

    2015-01-01

    Selection bias pervades the evaluation of supplemental instruction (SI) in non-experimental settings. This brief note provides a formal framework to understand this issue. The objective is to contribute to the accumulation of credible evidence on the impact of SI.

  2. Food Service Worker. Supplemental Individualized Student Modules.

    Science.gov (United States)

    Hasty, Liswa E.; Bridwell, Terry B.

    Developed to supplement the food service worker modules published in 1977, this handbook provides fourteen additional individualized student modules. The topics included are as follow: (1) personal grooming; (2) safe handling of food and eating utensils; (3) setting up tables; (4) handling customers; (5) menus; (6) taking and placing the order;…

  3. Should nutritional supplements and sports drinks companies sponsor sport? A short review of the ethical concerns.

    Science.gov (United States)

    Outram, Simon M; Stewart, Bob

    2015-06-01

    This paper proposes that the sponsorship of sport by nutritional supplements and sport drinks companies should be re-examined in the light of ethical concerns about the closeness of this relationship. A short overview is provided of the sponsorship of sport, arguing that ethical concerns about its appropriateness remain despite the imposition of severe restrictions on tobacco sponsorship. Further, the paper examines the main concerns about supplement use and sports drinks with respect to efficacy, health and the risks of doping. Particular consideration is given to the health implications of these concerns. It is suggested that they, of themselves, do not warrant the restriction of sponsorship by companies producing supplements and sports drinks. Nevertheless, it is argued that sports sponsorship does warrant further ethical examination--above and beyond that afforded to other sponsors of sport--as sport sponsorship is integral to the perceived need for such products. In conclusion, it is argued that sport may have found itself lending unwarranted credibility to products which would otherwise not necessarily be seen as beneficial for participation in sports and exercise or as inherently healthy products. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Guidelines for vitamin supplements in chronic kidney disease patients: what is the evidence?

    Science.gov (United States)

    Handelman, Garry J; Levin, Nathan W

    2011-01-01

    Wide discrepancies exist in the use of vitamins in kidney disease, and evidence-based recommendations are sparse. Water-soluble vitamin levels may be inadequate in patients not receiving supplements and this may be associated with increased mortality, which deserves further attention to increase strength of evidence. Supplements should be administered cautiously as renal mechanisms to prevent hypervitaminosis are no longer functional. The most reliable assays for vitamin status examine tissue mechanisms that rely on vitamins as cofactors. Vitamin A levels are generally quite high, vitamin D is low and requires supplementation, and the benefits of vitamin E may be linked to its usage in a modified dialysis membrane. Because of restricted diets that provide limited vitamin intake from food, many renal patients can benefit from a tablet that adds an amount equal to one recommended daily allowance of water-soluble vitamins, but larger amounts are not appropriate or beneficial. Vitamin status is influenced by interaction of many variables, and individual attention to each patient is warranted to achieve optimal vitamin status. Copyright © 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  5. Defense: FY2014 Authorization and Appropriations

    Science.gov (United States)

    2014-01-08

    that would provide defense funding up to that level: Defense (H.R. 2397, passed July 24, 315-109), Energy and Water (H.R. 2609, passed July 10, 227...pay—to the National Health Expenditure index, which is a federal government barometer of changes in health care costs; and • Introduce enrollment...attack boats in “littoral”—that is, “near to shore”— waters . All three versions of the bill also authorize $143.1 million, as requested, to continue

  6. [Bariatric surgery: how and why to supplement].

    Science.gov (United States)

    Bordalo, Livia Azevedo; Teixeira, Tatiana Fiche Sales; Bressan, Josefina; Mourão, Denise Machado

    2011-01-01

    Patients who have undergone bariatric surgery are at increased risk of developing nutritional deficiencies from limited food intake and absorption of different nutrients. A systematic review of several database websites (PubMed and ISI Web of Science) was conducted from September 1983 to April 2010 to identify literature related to micronutrient deficiencies occurring after bariatric surgery. Keywords used individually or in various combinations in the search were bariatric surgery, obesity, vitamin/mineral deficiencies, protein deficiency, nutrient absorption and nutrient supplementation. Literature suggests that to prevent or treat nutritional deficiencies resulting from anatomical changes due to surgical techniques nutritional supplementation is usually necessary. The success of oral nutritional supplementation to correct or prevent nutritional deficiencies depends on several factors. Thus, to understand how nutrients can be administered is very important for clinical practice. This review aims to provide help for the best selection of nutrients to ensure an adequate replacement of nutrients in patients who have undergone bariatric surgery.

  7. Dietary Supplements: What You Need to Know

    Science.gov (United States)

    ... Office of Dietary Supplements Dietary Supplements: What You Need to Know The majority of adults in the United States take one or more dietary supplements either every day or occasionally. Today's dietary supplements include vitamins, minerals, herbals and botanicals, ...

  8. Midwives' views on of appropriate antenatal counselling for congenital anomaly tests: do they match clients' preferences?

    NARCIS (Netherlands)

    Martin, L.; Hutton, E.K.; Spelten, E.R.; Gitsels-van der Wal, J.T.; Dulmen, S. van

    2014-01-01

    Objective: this study aims to provide insight into: (a) midwives' views on appropriate antenatal counselling for congenital anomaly tests, and (b) whether these views match clients' preferences regarding antenatal counselling. Design: a comparative (midwives versus clients) questionnaire survey.

  9. Midwives' views on appropriate antenatal counselling for congenital anomaly tests: Do they match clients' preferences?

    NARCIS (Netherlands)

    Martin, L.; Hutton, E.K.; Spelten, E.R.; Gitsels-van der Wal, J.T.; Dulmen, S. van

    2014-01-01

    OBJECTIVE: this study aims to provide insight into: (a) midwives' views on appropriate antenatal counselling for congenital anomaly tests, and (b) whether these views match clients' preferences regarding antenatal counselling. DESIGN: a comparative (midwives versus clients) questionnaire survey.

  10. The Palatability of Cereal Based Nutritional Supplements in Cancer Patients

    Science.gov (United States)

    Baik, Hyun Wook; Lee, Yu Sun; Song, Min-Kyung

    2014-01-01

    Recently, it is reported that intervention of oral nutritional supplement improves the nutritional status of cancer patients, and the effectiveness is affected by the sensory preference of cancer patients on the oral nutritional supplement. However, the variety of oral nutritional supplement is extremely limited and the number of patient's benefits from using the products are restricted mostly due to sensory dislikes. The objective of this study was to provide sensory preference score of trial manufactured products with different accessory ingredients to maximize the use of oral nutritional supplements. Cancer patients (n = 30) and age, sex-matched healthy volunteers (n = 30) participated in the sensory assessments (taste, flavor, viscosity, color and overall preference) of three types of oral supplements (cereal base, cereal base+herb and cereal base+fruit) and a control supplement product with scorched cereal flavor, a top seller in current Korean market. Results indicate that the cancer patients' overall preference was significantly higher for the control supplement, and fruit added supplement was preferred over plain cereal and herb added products, although the difference was insignificant. However, there was no significant preference difference for the supplements among the control group for all sensory factors. These results suggest that cancer patients are more sensitive to sensory preferences compared to the control group, and the patients prefer the flavor of cooked cereal which is a staple food in Korea. PMID:24527420

  11. Vitamin/mineral supplement use among high school athletes.

    Science.gov (United States)

    Sobal, J; Marquart, L F

    1994-01-01

    Vitamin/mineral supplements are consumed by adolescent athletes motivated both by general health concerns and a desire for improved athletic performance. Supplement use by high school athletes was examined using a questionnaire administered to 742 athletes at all nine schools in one rural county. A total of 38% used supplements, with supplement use not differing by gender or grade in school. Athletes with aspirations to participate in college sports more often consumed supplements. Healthy growth, treating illness, and sports performance were the most important reasons for supplement use, with parents, doctors, and coaches being the greatest influences on use. Most athletes (62%), especially boys, believed supplement consumption improved athletic performance. Supplement use by these adolescents appears to be motivated more by health reasons than sports performance. It is suggested that it may be useful to assess vitamin/mineral supplement use by adolescents and to provide education and counseling about diet, nutrition, and exercise for those who use them as ergogenic aids to improve athletic performance.

  12. Intermittent oral iron supplementation during pregnancy.

    Science.gov (United States)

    Peña-Rosas, Juan Pablo; De-Regil, Luz Maria; Gomez Malave, Heber; Flores-Urrutia, Monica C; Dowswell, Therese

    2015-10-19

    Anaemia is a frequent condition during pregnancy, particularly among women in low- and middle-income countries. Traditionally, gestational anaemia has been prevented with daily iron supplements throughout pregnancy, but adherence to this regimen due to side effects, interrupted supply of the supplements, and concerns about safety among women with an adequate iron intake, have limited the use of this intervention. Intermittent (i.e. two or three times a week on non-consecutive days) supplementation has been proposed as an alternative to daily supplementation. To assess the benefits and harms of intermittent supplementation with iron alone or in combination with folic acid or other vitamins and minerals to pregnant women on neonatal and pregnancy outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2015), the WHO International Clinical Trials Registry Platform (ICTRP) (31 July 2015) and contacted relevant organisations for the identification of ongoing and unpublished studies (31 July 2015). Randomised or quasi-randomised trials. We assessed the methodological quality of trials using standard Cochrane criteria. Two review authors independently assessed trial eligibility, extracted data and conducted checks for accuracy. This review includes 27 trials from 15 countries, but only 21 trials (with 5490 women) contributed data to the review. All studies compared daily versus intermittent iron supplementation. The methodological quality of included studies was mixed and most had high levels of attrition.The overall assessment of the quality of the evidence for primary infant outcomes was low and for maternal outcomes very low.Of the 21 trials contributing data, three studies provided intermittent iron alone, 14 intermittent iron + folic acid and four intermittent iron plus multiple vitamins and minerals in comparison with the same composition of supplements provided in a daily regimen.Overall, for women receiving any intermittent

  13. Detection of Cyanotoxins in Algae Dietary Supplements.

    Science.gov (United States)

    Roy-Lachapelle, Audrey; Solliec, Morgan; Bouchard, Maryse F; Sauvé, Sébastien

    2017-02-25

    Algae dietary supplements are marketed worldwide as natural health products. Although their proprieties have been claimed as beneficial to improve overall health, there have been several previous reports of contamination by cyanotoxins. These products generally contain non-toxic cyanobacteria, but the methods of cultivation in natural waters without appropriate quality controls allow contamination by toxin producer species present in the natural environment. In this study, we investigated the presence of total microcystins, seven individual microcystins (RR, YR, LR, LA, LY, LW, LF), anatoxin-a, dihydroanatoxin-a, epoxyanatoxin-a, cylindrospermopsin, saxitoxin, and β-methylamino-l-alanine in 18 different commercially available products containing Spirulina or Aphanizomenon flos-aquae . Total microcystins analysis was accomplished using a Lemieux oxidation and a chemical derivatization using dansyl chloride was needed for the simultaneous analysis of cylindrospermopsin, saxitoxin, and β-methylamino-l-alanine. Moreover, the use of laser diode thermal desorption (LDTD) and ultra-high performance liquid chromatography (UHPLC) both coupled to high resolution mass spectrometry (HRMS) enabled high performance detection and quantitation. Out of the 18 products analyzed, 8 contained some cyanotoxins at levels exceeding the tolerable daily intake values. The presence of cyanotoxins in these algal dietary supplements reinforces the need for a better quality control as well as consumer's awareness on the potential risks associated with the consumption of these supplements.

  14. Detection of Cyanotoxins in Algae Dietary Supplements

    Directory of Open Access Journals (Sweden)

    Audrey Roy-Lachapelle

    2017-02-01

    Full Text Available Algae dietary supplements are marketed worldwide as natural health products. Although their proprieties have been claimed as beneficial to improve overall health, there have been several previous reports of contamination by cyanotoxins. These products generally contain non-toxic cyanobacteria, but the methods of cultivation in natural waters without appropriate quality controls allow contamination by toxin producer species present in the natural environment. In this study, we investigated the presence of total microcystins, seven individual microcystins (RR, YR, LR, LA, LY, LW, LF, anatoxin-a, dihydroanatoxin-a, epoxyanatoxin-a, cylindrospermopsin, saxitoxin, and β-methylamino-l-alanine in 18 different commercially available products containing Spirulina or Aphanizomenon flos-aquae. Total microcystins analysis was accomplished using a Lemieux oxidation and a chemical derivatization using dansyl chloride was needed for the simultaneous analysis of cylindrospermopsin, saxitoxin, and β-methylamino-l-alanine. Moreover, the use of laser diode thermal desorption (LDTD and ultra-high performance liquid chromatography (UHPLC both coupled to high resolution mass spectrometry (HRMS enabled high performance detection and quantitation. Out of the 18 products analyzed, 8 contained some cyanotoxins at levels exceeding the tolerable daily intake values. The presence of cyanotoxins in these algal dietary supplements reinforces the need for a better quality control as well as consumer’s awareness on the potential risks associated with the consumption of these supplements.

  15. Public Opinion Regarding Whether Speaking With Patients About Firearms Is Appropriate: Results of a National Survey.

    Science.gov (United States)

    Betz, Marian E; Azrael, Deborah; Barber, Catherine; Miller, Matthew

    2016-10-18

    Health care providers have been encouraged to discuss firearms with patients; whether patients view these discussions as appropriate is unclear. To estimate, in a national sample, the perceived appropriateness of provider discussions about firearms. Probability-based online survey conducted in April 2015. Analyses used survey weights to generate nationally representative estimates. U.S. adults. 3914 English-speaking adults (55% participation rate). Participants were asked, "In general, would you think it is never, sometimes, usually, or always appropriate for physicians and other health professionals to talk to their patients about firearms?" A majority (66% [95% CI, 63% to 69%]) of participants said that it is at least sometimes appropriate for providers to talk to patients about firearms. Specifically, 23% (CI, 20% to 25%) said that provider discussions about firearms were always appropriate, 14% (CI, 11% to 16%) said that they were usually appropriate, and 30% (CI, 27% to 33%) thought they were sometimes appropriate; 34% (CI, 31% to 37%) felt that such discussions were never appropriate. Views varied by firearm ownership: 54% (CI, 52% to 57%) of gun owners said that provider discussions are at least sometimes appropriate, compared with 67% (CI, 62% to 71%) of nonowners living with an owner and 70% (CI, 66% to 74%) of nonowners not living with an owner. Firearm owners who were more likely to think that firearm discussions are at least sometimes appropriate included those with children at home (62% [CI, 57% to 67%]), those who thought that having a gun at home increases suicide risk (75% [CI, 67% to 83%), and those who thought that provider discussions of seat belts are at least sometimes appropriate (73% [CI, 70% to 75%]). The provider discussion question did not specify clinical context. Two thirds of non-firearm owners and over one half of firearm owners in the United States believe that health care provider discussions about firearms are at least sometimes

  16. [ERGOGENIC SPORT SUPPLEMENTS FOR ATHLETES].

    Science.gov (United States)

    Arieli, Rakefet; Lahav, Yair

    2016-06-01

    Use of performance-enhancing supplements occurs at all levels of sports, from recreational athletes to professional athletes. Although some supplements do enhance athletic performance, many have no proven benefits and have adverse effects. Nutritional supplements are categorized into the following categories: I. Apparently Effective. II. Possibly Effective. III. Too Early To Tell. IV. Apparently Ineffective. This article will review 4 ergogenic supplements which are categorized in the first category--"Apparently Effective"--1) Buffer agents 2) Creatine 3) Caffeine and 4 Nitric Oxide. Given the widespread use of performance enhancing supplements, physicians, and dietitians should be prepared to counsel athletes about their effectiveness, safety and legality.

  17. Design Methodology for Appropriate Technology: Engineering as if People Mattered

    Directory of Open Access Journals (Sweden)

    Akbar Adhiutama

    2013-08-01

    Full Text Available Since the emerging of its idea circa four decades ago, Appropriate Technology (AT had been proven as a comprehensive solution in a limited condition. However, practitioners & academia have different opinions with engineers on how an AT must be designed. Researchers had noted the crucial factors in the issue as such, and they gave a notion of the urgency for a dedicated design methodology for AT. This study, therefore, aims to provide it. Such methodology is developed by incorporating AT characteristics, fundamental issues in community empowerment, and the principles of existing design methodologies. The methodology emphasizes combination between bottom-up and top-down design approaches. It means that an AT must be started purely from local conditions rather than given technical specifications, and be given back to local people to be seamlessly integrated into their routines. It also underlines the crucial importance of community involvement throughout design stages. By looking at previous design methodologies that were developed based on pure Engineering Problem Solving (EPS, this study delivers a fresh and comprehensive one that covers surrounding issues and concepts to produce an AT based on the real meaning of technological appropriateness.

  18. The role of laboratory in ensuring appropriate test requests.

    Science.gov (United States)

    Ferraro, Simona; Panteghini, Mauro

    2017-07-01

    This review highlights the role of laboratory professionals and the strategies to be promoted in strict cooperation with clinicians for auditing, monitoring and improving the appropriateness of test request. The introduction of local pathways and care maps in agreement with international and national guidelines as well as the implementation of reflex testing and algorithms have a central role in guiding test request and in correcting the overuse/misuse of tests. Furthermore, removing obsolete tests from laboratory menu and vetting of restricted tests is recommended to increase cost-effectiveness. This saves costs and permits to introduce new biomarkers with increased diagnostic accuracy with a better impact on patient outcome. An additional issue is concerning the periodicity of (re)testing, accounting that only a minority of tests may be ordered as often as necessary. In the majority of cases, a minimum retesting interval should be introduced. The availability of effective computerised order entry systems is relevant in ensuring appropriate test requests and in providing an aid by automated rules that may stop inappropriate requests before they reach the laboratory. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  19. Drama: an appropriate tool in development support communication.

    Science.gov (United States)

    Moyo, F F

    1997-01-01

    Because it supports progress, drama embodies development and, thus, can be used to support development communication. In fact, drama is the most appropriate medium for effecting change for development because it 1) involves interpersonal communication; 2) broadens the meaning of development; 3) challenges assumptions, demands accountability, suggests remedies, and evaluates the totality of performance; 4) exploits the politics of possibility; 5) is inherently dialogue; 6) allows the target community to participation during the exposition, the conflict, and the resolution; 7) is easy to assimilate; and 8) provides access to any medium. Drama is especially appropriate in South Africa because children carry on a tradition of play-acting, South Africans exhibit politeness to strangers that makes them passively aggressive in resisting change, it allows the temporary removal of cultural barriers among members of households, and it resembles the oral tradition that was pervasive in the culture. Drama can impart greater legitimacy to topics originating from the community or fuse a totally new concept with local culture. It can be used as a tool to criticize political mismanagement, comment on social problems, question culture, debate religious matters, examine economic society, assist educational programs, assist health efforts, raise people's awareness about conservation, and help spread technological advancements. Drama allows more to be done than said and allows communities to be involved in development efforts.

  20. Mental Health First Aid in Rural Communities: Appropriateness and Outcomes.

    Science.gov (United States)

    Talbot, Jean A; Ziller, Erika C; Szlosek, Donald A

    2017-01-01

    Mental Health First Aid (MHFA), an early intervention training program for general audiences, has been promoted as a means for improving population-level behavioral health (BH) in rural communities by encouraging treatment-seeking. This study examined MHFA's appropriateness and impacts in rural contexts. We used a mixed-methods approach to study MHFA trainings conducted from November 2012 through September 2013 in rural communities across the country. (a) posttraining questionnaires completed by 44,273 MHFA participants at 2,651 rural and urban trainings in 50 US states; (b) administrative data on these trainings; and (c) interviews with 16 key informants who had taught, sponsored, or participated in rural MHFA. Measure of Rurality: Rural-Urban Commuting Area Codes. Chi-square tests were conducted on questionnaire data. Structural, descriptive, and pattern coding techniques were used to analyze interview data. MHFA appears aligned with some key rural needs. MHFA may help to reduce unmet need for BH treatment in rural communities by raising awareness of BH issues and mitigating stigma, thereby promoting appropriate treatment-seeking. However, rural infrastructure deficits may limit some communities' ability to meet new demand generated by MHFA. MHFA may help motivate rural communities to develop initiatives for strengthening infrastructure, but additional tools and consultation may be needed. This study provides preliminary evidence that MHFA holds promise for improving rural BH. MHFA alone cannot compensate for weaknesses in rural BH infrastructure. © 2016 National Rural Health Association.

  1. Dietary supplements for dysmenorrhoea.

    Science.gov (United States)

    Pattanittum, Porjai; Kunyanone, Naowarat; Brown, Julie; Sangkomkamhang, Ussanee S; Barnes, Joanne; Seyfoddin, Vahid; Marjoribanks, Jane

    2016-03-22

    Dysmenorrhoea refers to painful menstrual cramps and is a common gynaecological complaint. Conventional treatments include non-steroidal anti-inflammatory drugs (NSAIDs) and oral contraceptive pills (OCPs), which both reduce myometrial activity (contractions of the uterus). A suggested alternative approach is dietary supplements. We used the term 'dietary supplement' to include herbs or other botanical, vitamins, minerals, enzymes, and amino acids. We excluded traditional Chinese medicines. To determine the efficacy and safety of dietary supplements for treating dysmenorrhoea. We searched sources including the Cochrane Gynaecology and Fertility Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, PsycINFO (all from inception to 23 March 2015), trial registries, and the reference lists of relevant articles. We included randomised controlled trials (RCTs) of dietary supplements for moderate or severe primary or secondary dysmenorrhoea. We excluded studies of women with an intrauterine device. Eligible comparators were other dietary supplements, placebo, no treatment, or conventional analgesia. Two review authors independently performed study selection, performed data extraction and assessed the risk of bias in the included trials. The primary outcomes were pain intensity and adverse effects. We used a fixed-effect model to calculate odds ratios (ORs) for dichotomous data, and mean differences (MDs) or standardised mean differences (SMDs) for continuous data, with 95% confidence intervals (CIs). We presented data that were unsuitable for analysis either descriptively or in additional tables. We assessed the quality of the evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods. We included 27 RCTs (3101 women). Most included studies were conducted amongst cohorts of students with primary dysmenorrhoea in their late teens or early twenties. Twenty-two studies were

  2. Supplement to the Annual Energy Outlook 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-02-17

    The Supplement to the Annual Energy Outlook 1993 is a companion document to the Energy Information Administration`s (EIA) Annual Energy Outlook 1993 (AEO). Supplement tables provide the regional projections underlying the national data and projections in the AEO. The domestic coal, electric power, commercial nuclear power, end-use consumption, and end-use price tables present AEO forecasts at the 10 Federal Region level. World coal tables provide data and projections on international flows of steam coal and metallurgical coal, and the oil and gas tables provide the AEO oil and gas supply forecasts by Oil and Gas Supply Regions and by source of supply. All tables refer to cases presented in the AEO, which provides a range of projections for energy markets through 2010.

  3. Defense Authorization and Appropriations Bills: FY1970-FY2017

    Science.gov (United States)

    2017-01-18

    authority were made available in: (1) the Agriculture , Rural Development , Food and Drug Administration, and Related Agencies Appropriations Act, 2010...2) the Energy and Water Development and Related Agencies Appropriations Act, 2010; (3) the Department of Homeland Security Appropriations Act, 2010...addresses guaranteed loans in the rural housing insurance fund. CRS-25 w. Consolidated Appropriations Act, 2012. The measure was the vehicle for making

  4. Comparative performance of the Geenius™ HIV-1/HIV-2 supplemental test in Florida's public health testing population.

    Science.gov (United States)

    Fordan, Sally; Bennett, Berry; Lee, Meghan; Crowe, Susanne

    2017-06-01

    The Centers for Disease Control and Prevention (CDC) published updated guidelines in 2014 for the laboratory diagnosis of HIV in the United States, which recommend use of a supplemental immunoassay (IA) that differentiates HIV-1 from HIV-2 after a repeatedly reactive HIV-1/2 antigen/antibody "Combo" screening test. In October 2014, Bio-Rad Laboratories introduced the FDA-cleared Geenius HIV-1/HIV-2 Supplemental assay and in July 2016, it replaced the Multispot HIV-1/HIV-2 differentiation rapid test as the second test in the HIV diagnostic algorithm. To compare performance of the new FDA-cleared Bio-Rad Geenius HIV-1/HIV-2 Supplemental assay and the Bio-Rad Multispot HIV-1/HIV-2 differentiation assay for use as the primary supplemental test in the 2014 CDC/APHL HIV Diagnostic Algorithm. Two sets of specimens were used to assess the performance of Geenius; 340 select retrospective specimens, obtained through routine clinical submissions from individuals seeking HIV serostatus determinations and 10 known HIV-2 antibody reactive specimens provided by Bio-Rad Laboratories. Panels were created and characterized solely by in-house laboratory results. The panels consisted of: algorithm-defined "established HIV-1 infections" (n=250), "acute HIV-1 infections" (n=20), "early HIV-1 infections" (n=10) and "false positive Combo specimens" (n=60). CONCLUSIONS: The Geenius assay provides significant advantages over Multispot as an appropriate replacement for the primary supplemental test in the HIV Diagnostic Algorithm. In this retrospective study, Geenius was highly concordant with Multispot, reclassified some acute and early algorithm-defined HIV-1 positive specimens and demonstrated a potential decrease in the number HIV-1 RNA nucleic acid amplification tests needed to complete the diagnostic algorithm. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality

    DEFF Research Database (Denmark)

    Smith, Emily R; Shankar, Anuraj H; Wu, Lee S-F

    2017-01-01

    . Multiple micronutrient supplements also had a greater effect on preterm births among underweight pregnant women (BMI ... to multiple micronutrient supplements also provided greater overall benefits. Studies should now aim to elucidate the mechanisms accounting for differences in the effect of antenatal multiple micronutrient supplements on infant health by maternal nutrition status and sex. FUNDING: None....

  6. 43 CFR 20.506 - Appropriations, legislation and lobbying.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Appropriations, legislation and lobbying... RESPONSIBILITIES AND CONDUCT Other Employee Conduct Provisions § 20.506 Appropriations, legislation and lobbying... manner a Member of Congress, to favor or oppose, by vote or otherwise, any legislation or appropriation...

  7. Variables Affecting the Appropriateness of Self-Disclosure

    Science.gov (United States)

    Chaikin, Alan L.; Derlega, Valerian J.

    1974-01-01

    Intimate self-disclosure to a stranger or an acquaintance was seen as less appropriate than nondisclosure. Disclosure to someone of a different age was seen as less appropriate than nondisclosure. Disclosure or nondisclosure to a person of the same age or to a friend was perceived as appropriate. (Author)

  8. Understanding the Concept of Nationally Appropriate Mitigation Action

    DEFF Research Database (Denmark)

    Sharma, Sudhir; Desgain, Denis DR

    and enhance the understanding of NAMAs by explaining the underlying decisions of the Conference of the Parties in layman’s terms. The first chapter describes how the concept of NAMA emerged in the context of the negotiations on climate change. The chapter gives an overview of how the concepts of NAMA......This publication is intended to enable national policy makers and other stakeholders, such as the private sector and technical experts, to acquaint themselves with the concept of NAMA. It aims to provide a comprehensive overview of the Nationally Appropriate Mitigation Action (NAMA) concept...... by developing countries to the UNFCCC, and ends by proposing a structure for formal submission of a NAMA. The third chapter specifically addresses the concept of measurement, reporting and verification (MRV), and describes the implications for countries implementing the MRV requirements. The last chapter...

  9. The Impact on Athletes of the Current Regulatory Scheme for Dietary Supplements

    OpenAIRE

    Kruzer, Lyndsey

    2009-01-01

    This paper uses the popularity of dietary supplements among athletes and the possibility that such athletes may unknowingly fail drug tests because of said supplements as a lens for examining some of the weaknesses caused by the FDA’s current limited authority over the supplement industry. After providing an outline of both the current state of the law with respect to dietary supplements and the regulations and liability to which athletes are subject, I emphasize the impact and potential con...

  10. An international consensus on the appropriate evaluation and treatment for adults with spinal deformity.

    Science.gov (United States)

    Berven, Sigurd H; Kamper, Steven J; Germscheid, Niccole M; Dahl, Benny; Shaffrey, Christopher I; Lenke, Lawrence G; Lewis, Stephen J; Cheung, Kenneth M; Alanay, Ahmet; Ito, Manabu; Polly, David W; Qiu, Yong; de Kleuver, Marinus

    2017-08-05

    Evaluation and surgical management for adult spinal deformity (ASD) patients varies between health care providers. The purpose of this study is to identify appropriateness of specific approaches and management strategies for the treatment of ASD. From January to July 2015, the AOSpine Knowledge Deformity Forum performed a modified Delphi survey where 53 experienced deformity surgeons from 24 countries, rated the appropriateness of management strategies for multiple ASD clinical scenarios. Four rounds were performed: three surveys and a face-to-face meeting. Consensus was achieved with ≥70% agreement. Appropriate surgical goals are improvement of function, pain, and neural symptoms. Appropriate preoperative patient evaluation includes recording information on history and comorbidities, and radiographic workup, including long standing films and MRI for all patients. Preoperative pulmonary and cardiac testing and DEXA scan is appropriate for at-risk patients. Intraoperatively, appropriate surgical strategies include long fusions with deformity correction for patients with large deformity and sagittal imbalance, and pelvic fixation for multilevel fusions with large curves, sagittal imbalance, and osteoporosis. Decompression alone is inappropriate in patients with large curves, sagittal imbalance, and progressive deformity. It is inappropriate to fuse to L5 in patients with symptomatic disk degeneration at L5-S1. These results provide guidance for informed decision-making in the evaluation and management of ASD. Appropriate care for ASD, a very diverse spectrum of disease, must be responsive to patient preference and values, and considerations of the care provider, and the healthcare system. A monolithic approach to care should be avoided.

  11. Performance enhancement with supplements: incongruence between rationale and practice

    Directory of Open Access Journals (Sweden)

    Mazanov Jason

    2007-11-01

    Full Text Available Abstract Background Athletes are expected to consider multiple factors when making informed decision about nutritional supplement use. Besides rules, regulations and potential health hazards, the efficacy of different nutritional supplements in performance enhancement is a key issue. The aim of this paper was to find evidence for informed decision making by investigating the relationship between specific performance-related reasons for supplement use and the reported use of nutritional supplements. Methods The 'UK Sport 2005 Drug Free Survey' data (n = 874 were re-analysed using association [χ2] and 'strength of association' tests [ϕ] to show the proportion of informed choices and to unveil incongruencies between self-reported supplement use and the underlying motives. Results Participants (n = 520 reported supplement use in the pattern of: vitamin C (70.4%, creatine (36.1%, whey protein (30.6%, iron (29.8%, caffeine (23.8%, and ginseng (8.3% for the following reasons: strength maintenance (38.1%, doctors' advice (24.2%, enhancing endurance (20.0%, ability to train longer (13.3%, and provided by the governing body (3.8%. Of thirty possible associations between the above supplements and reasons, 11 were predictable from literature precedents and only 8 were evidenced and these were not strong (ϕ 2 = 49.14, p 2 = 97.08, p 2 = 97.82, p Conclusion This study provided a platform for assessing congruence between athletes' reasons for supplement use and their actual use. These results suggest that a lack of understanding exists in supplement use. There is an urgent need to provide accurate information which will help athletes make informed choices about the use of supplements.

  12. FY 2009 Supplement to the President`s Budget

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — Published: February 2008 Pages: 37 This Supplement to the President`s Fiscal Year FY 2009 Budget provides a technical summary of the budget request for the...

  13. FY 2010 Supplement to the President`s Budget

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — This Supplement to the President`s Fiscal Year FY 2010 Budget provides a technical summary of the budget request for the Networking and Information Technology...

  14. FY 2007 Supplement to the President`s Budget

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — This Supplement to the President`s Fiscal Year FY 2007 Budget provides a technical summary of the budget request for the Networking and Information Technology...

  15. FY 2011 Supplement to the President`s Budget

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — This Supplement to the President`s Fiscal Year FY 2011 Budget provides a technical summary of the budget request for the Networking and Information Technology...

  16. FY 2008 Supplement to the President`s Budget

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — This Supplement to the President`s Fiscal Year FY 2008 Budget provides a technical summary of the budget request for the Networking and Information Technology...

  17. Recommended nutritional supplements for bariatric surgery patients.

    Science.gov (United States)

    Malone, Margaret

    2008-12-01

    To review nutritional supplements commonly required after bariatric surgery to provide a practical guide and reference source for generalist healthcare providers. A PubMed literature search (1988-July 2008) was conducted, using the search term nutritional deficiency after bariatric surgery, and was limited to English-language literature on adult (aged >19 y) human subjects. Additional references from the selected literature were also included. Data were extracted from large clinical series and practice guidelines whenever possible. Case reports were used only when they were the sole information source. Nutritional deficiencies that occur after bariatric surgery depend significantly on the type of surgery performed. Restrictive procedures such as gastric banding are the least likely to cause nutritional deficits, since none of the intestine is bypassed. Malabsorptive procedures such as biliopancreatic diversion or mixed restrictive/malabsorptive procedures (eg, Roux-en-Y gastric bypass) can result in serious nutritional problems when patients do not take required supplements after surgery. Vitamins and minerals that are commonly deficient in this circumstance include vitamin B(12), calcium, vitamin D, thiamine, folic acid, iron, zinc, and magnesium. Rare ocular complications have been reported with hypovitaminosis A. Healthcare professionals, especially those who practice outside large bariatric centers, must be aware of the supplements required by patients who have had bariatric surgery. Many patients fail to follow up with the surgery centers and are managed by their primary care teams and community pharmacists, especially in the selection of multivitamin and nutritional supplements.

  18. Dietary supplement research portfolio at the NIH, 2009-2011.

    Science.gov (United States)

    Garcia-Cazarin, Mary L; Wambogo, Edwina A; Regan, Karen S; Davis, Cindy D

    2014-04-01

    The U.S. dietary supplement market increased by 7.5% in 2012 compared with 2011, reaching $32.5 billion in sales. Therefore, federally supported research on dietary supplements is important to determine their health effects, safety, and efficacy. A portfolio analysis was performed across the NIH and the Office of Dietary Supplements (ODS) for fiscal years (FYs) 2009-2011 by using the databases Human Nutrition Research Information Management (HNRIM) and Computer Access to Research on Dietary Supplements (CARDS). The results indicated that total NIH dietary supplement-related funding for FYs 2009-2011 was $855 million ($295 million in 2009, $311 million in 2010, and $249 million in 2011). The institutes and centers with the highest investment in dietary supplement research were as follows: the National Heart, Lung, and Blood Institute ($135 million); the National Cancer Institute ($188 million); the National Center for Complementary and Alternative Medicine ($99 million); the National Institute of Diabetes and Digestive and Kidney Diseases ($68 million); the National Institute of Environmental Health Sciences ($58 million); and the ODS ($32 million). The dietary supplement ingredients receiving the most funding were botanicals (22%), vitamins (20%), lipids (14%), and minerals and trace elements (10%). The top 3 outcome research areas were cancer (61% of total dietary supplement investment), cardiovascular disease (47%), and women's reproductive health (38%). In FYs 2009, 2010, and 2011, the ODS provided 3.5%, 3.6%, and 4.1%, respectively, of the NIH investment in dietary supplement research. ODS funding focused on cellular, enzymatic, or molecular mechanisms (64% of total ODS funding). This portfolio analysis demonstrates that the NIH has committed substantial funding to dietary supplement research in an effort to expand the scientific knowledge base on the efficacy and safety of dietary supplements.

  19. Appropriateness and utilization of cardiac CT: implications for development of future criteria.

    Science.gov (United States)

    Murphy, Meagan K; Brady, Thomas J; Nasir, Khurram; Gazelle, G Scott; Bamberg, Fabian; Truong, Quynh A; Mamuya, Wilfred S; Abbara, Suhny; Lee, Thomas H; Blankstein, Ron

    2010-10-01

    The cardiac CT (CCT) appropriateness criteria (AC) were jointly published by multiple societies to ensure effective utilization of CCT. We sought to determine how these criteria apply to CCT scans performed at a tertiary-care hospital. Data were collected from medical records and interviews of 267 consecutive patients referred for CCT. Two physicians designated exam indication as appropriate, inappropriate, or uncertain as per AC, or "not known" if not listed in AC. CCT exam indication was appropriate in 47%, inappropriate in 9%, uncertain in 15%, and not known in 29%. The most common appropriate indication was evaluation of CAD in symptomatic patients with equivocal stress test, whereas the most common inappropriate referral was evaluation of asymptomatic patients with low pretest probability of CAD. Most exams (69%) were for evaluation of CAD, with the remaining exams performed to evaluate other elements of cardiac structure or function. Exams for these non-CAD indications were more likely to be appropriate and less likely to have an undetermined (uncertain or not known) level of appropriateness than those for CAD indications. There was no difference in exam appropriateness whether ordered by cardiologists or internists, but providers who completed training >25 years ago ordered fewer appropriate and more inappropriate exams than younger providers. In applying the AC to a large academic medical center, few CCT exams were inappropriate; however, many patients referred for CCT, particularly for evaluation of CAD, had an indication for which the level of appropriateness remained undetermined. Given the rapid adoption of CCT, these results emphasize the need to refine current criteria for appropriate utilization.

  20. 77 FR 13591 - Imperial Valley Solar Company (IVSC) 1, LLC; Supplemental Notice That Initial Market-Based Rate...

    Science.gov (United States)

    2012-03-07

    ...Library system by clicking on the appropriate link in the above list. They are also available for review... Energy Regulatory Commission Imperial Valley Solar Company (IVSC) 1, LLC; Supplemental Notice That... supplemental notice in the above-referenced proceeding of Imperial Valley Solar Company (IVSC) 1, LLC's...

  1. Daily versus intermittent iron supplementation in pregnant women

    Directory of Open Access Journals (Sweden)

    Cherati Shahla

    2011-10-01

    Full Text Available Abstract Background The purpose of this study was compare of daily iron supplementation in three time frames- daily, weekly and three time weekly supplementation in preventing anemia in healthy pregnant women. Method The present study was a prospective simply randomized clinical trial. During January 2006- January 2008, 150 healthy pregnant women without anemia, in their 16th week of pregnancy were randomly allocated into three equal groups. The first group (n = 50 received a 50 mg-ferrous sulfate tablet daily, second group (n = 50 received a 50 mg-ferrous sulfate tablet three times a week, and the third group (n = 50 received two 50 mg-ferrous sulfate tablets (100 mg weekly, respectively for 12 consecutive weeks. Serum hemoglobin, ferritin, and iron were measured before and after the supplementation. Paired t and ANOVA tests were used as appropriated. Results There were no significant differences between the pre- and post-treatment hemoglobin levels with iron supplementation in the three group (P = 0.518, P = 0.276, respectively. The mean serum iron level before and after treatment with iron supplementation in the three groups was not statistically significant (P = 0.962, P = 0.970, respectively. Although the mean serum ferritin level before and after treatment with iron supplementation was statistically significant in the three groups, no significant differences were found comparing the three groups (P = 0.827, P = 0.635 respectively. Conclusions This results suggested, three times a week or weekly iron supplementation is as effective as daily supplementation for healthy pregnant women without anemia. Trial Registration ISRCTN: IRCT201101093820N1

  2. Supplementing National Menu Labeling

    Science.gov (United States)

    White, Lexi C.

    2012-01-01

    The US Food and Drug Administration’s forthcoming national menu labeling regulations are designed to help curb the national obesity epidemic by requiring calorie counts on restaurants’ menus. However, posted calories can be easily ignored or misunderstood by consumers and fail to accurately describe the healthiness of foods. We propose supplemental models that include nutritional information (e.g., fat, salt, sugar) or specific guidance (e.g., “heart-healthy” graphics). The goal is to empower restaurant patrons with better data to make healthier choices, and ultimately to reduce obesity prevalence. PMID:23078494

  3. Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel.

    Science.gov (United States)

    Keller, H H; Vesnaver, E; Davidson, B; Allard, J; Laporte, M; Bernier, P; Payette, H; Jeejeebhoy, K; Duerksen, D; Gramlich, L

    2014-04-01

    Malnutrition is common in acute care hospitals worldwide and nutritional status can deteriorate during hospitalisation. The aim of the present qualitative study was to identify enablers and challenges and, specifically, the activities, processes and resources, from the perspective of nutrition care personnel, required to provide quality nutrition care. Eight hospitals participating in the Nutrition Care in Canadian Hospitals study provided focus group data (n = 8 focus groups; 91 participants; dietitians, dietetic interns, diet technicians and menu clerks), which were analysed thematically. Five themes emerged from the data: (i) developing a nutrition culture, where nutrition practice is considered important to recovery of patients and teams work together to achieve nutrition goals; (ii) using effective tools, such as screening, evidence-based protocols, quality, timely and accurate patient information, and appropriate and quality food; (iii) creating effective systems to support delivery of care, such as communications, food production and delivery; (iv) being responsive to care needs, via flexible food systems, appropriate menus and meal supplements, up to date clinical care and including patient and family in the care processes; and (v) uniting the right person with the right task, by delineating roles, training staff, providing sufficient time to undertake these important tasks and holding staff accountable for their care. The findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed. © 2013 The British Dietetic Association Ltd.

  4. Heterologous expression of membrane proteins: choosing the appropriate host.

    Directory of Open Access Journals (Sweden)

    Florent Bernaudat

    Full Text Available BACKGROUND: Membrane proteins are the targets of 50% of drugs, although they only represent 1% of total cellular proteins. The first major bottleneck on the route to their functional and structural characterisation is their overexpression; and simply choosing the right system can involve many months of trial and error. This work is intended as a guide to where to start when faced with heterologous expression of a membrane protein. METHODOLOGY/PRINCIPAL FINDINGS: The expression of 20 membrane proteins, both peripheral and integral, in three prokaryotic (E. coli, L. lactis, R. sphaeroides and three eukaryotic (A. thaliana, N. benthamiana, Sf9 insect cells hosts was tested. The proteins tested were of various origins (bacteria, plants and mammals, functions (transporters, receptors, enzymes and topologies (between 0 and 13 transmembrane segments. The Gateway system was used to clone all 20 genes into appropriate vectors for the hosts to be tested. Culture conditions were optimised for each host, and specific strategies were tested, such as the use of Mistic fusions in E. coli. 17 of the 20 proteins were produced at adequate yields for functional and, in some cases, structural studies. We have formulated general recommendations to assist with choosing an appropriate system based on our observations of protein behaviour in the different hosts. CONCLUSIONS/SIGNIFICANCE: Most of the methods presented here can be quite easily implemented in other laboratories. The results highlight certain factors that should be considered when selecting an expression host. The decision aide provided should help both newcomers and old-hands to select the best system for their favourite membrane protein.

  5. Guidebook for the Development of a Nationally Appropriate Mitigation Action for Solar Water Heaters

    DEFF Research Database (Denmark)

    Haselip, James Arthur; Lütken, Søren E.; Sharma, Sudhir

    This guidebook provides an introduction to designing government-led interventions to scale up investment in solar water heater (SWH) markets, showing how these interventions can be packaged as Nationally Appropriate Mitigation Actions (NAMAS). Reflecting the changing balance in global greenhouse...... gas emissions, NAMAs embody the principle of common but differentiated responsibilities. In addition to developed countries’ commitments to make quantitative reductions of greenhouse gas emissions, developing countries are invited to contribute with voluntary actions that are ‘nationally appropriate...

  6. Understanding the concept of nationally appropriate mitigation action

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, S.; Desgain, D.

    2013-05-15

    This publication is intended to enable national policy makers and other stakeholders, such as the private sector and technical experts, to acquaint themselves with the concept of NAMA. It aims to provide a comprehensive overview of the Nationally Appropriate Mitigation Action (NAMA) concept and enhance the understanding of NAMAs by explaining the underlying decisions of the Conference of the Parties in layman's terms. The first chapter describes how the concept of NAMA emerged in the context of the negotiations on climate change. The chapter gives an overview of how the concepts of NAMA and related MRV and financing issues have evolved through the different COPs. The second chapter clarifies the understanding of NAMAs in the context of the global temperature goal, and moves on to discuss the legal nature and scope of NAMAs. The chapter subsequently analyses the diversity of NAMAs submitted by developing countries to the UNFCCC, and ends by proposing a structure for formal submission of a NAMA. The third chapter specifically addresses the concept of measurement, reporting and verification (MRV), and describes the implications for countries implementing the MRV requirements. The last chapter discusses institutional arrangements, under the Convention, for providing financing to develop and implement NAMAs. The chapter also briefly discusses the different financial sources for implementing NAMAs, and concludes by explaining the concept of incremental cost in this specific context. (Author)

  7. ACR Appropriateness Criteria(®) Thoracic Aorta Interventional Planning and Follow-Up.

    Science.gov (United States)

    Bonci, Gregory; Steigner, Michael L; Hanley, Michael; Braun, Aaron R; Desjardins, Benoit; Gaba, Ron C; Gage, Kenneth L; Matsumura, Jon S; Roselli, Eric E; Sella, David M; Strax, Richard; Verma, Nupur; Weiss, Clifford R; Dill, Karin E

    2017-11-01

    Thoracic endovascular aortic repair (TEVAR) has undergone rapid evolution and is now applied to a range of aortic pathologies. Imaging plays a vital role in the pre- and postintervention assessment of TEVAR patients. Accurate characterization of pathology and evaluation for high-risk anatomic features are necessary in the planning phase, and careful assessment for graft stability, aortic lumen diameter, and presence of endoleak are paramount in the follow-up period. CTA is the imaging modality of choice for pre- and postintervention assessment, and MRA is an acceptable alternative depending on patient stability and graft composition. Lifelong imaging follow-up is necessary in TEVAR patients because endoleaks may develop at any time. The exact surveillance interval is unclear and may be procedure and patient specific. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  8. 75 FR 29531 - Frequency Regulation Compensation in the Organized Wholesale Power Markets; Supplemental Notice...

    Science.gov (United States)

    2010-05-26

    ...] Frequency Regulation Compensation in the Organized Wholesale Power Markets; Supplemental Notice of Technical... conference will provide a forum to consider issues related to frequency regulation compensation in organized...

  9. Digestive Enzyme Supplementation in Gastrointestinal Diseases

    OpenAIRE

    Ianiro, Gianluca; Pecere, Silvia; Giorgio, Valentina; Gasbarrini, Antonio; Cammarota, Giovanni

    2016-01-01

    Background: Digestive enzymes are able to break down proteins and carbohydrates and lipids, and their supplementation may play a role in the management of digestive disorders, from lactose intolerance to cystic fibrosis. To date, several formulations of digestive enzymes are available on the market, being different each other in terms of enzyme type, source and origin, and dosage. Methods: This review, performed through a non-systematic search of the available literature, will provide an over...

  10. Micronutrient supplementation in adults with HIV infection

    Science.gov (United States)

    Visser, Marianne E; Durao, Solange; Sinclair, David; Irlam, James H; Siegfried, Nandi

    2017-01-01

    a review of the effects of micronutrient supplements for people living with HIV. This is an update of a Cochrane Review previously published in 2010. After searching for relevant trials up to 18 November 2016, the review authors included 33 trials. Thirteen of these trials included people not on HIV treatment and were conducted in Thailand, Peru, and eight African countries. Nineteen trials included people on HIV treatment and were conducted in North America, Europe, Brazil, Singapore, Thailand, Botswana, and Uganda. One trial from China did not state whether people living with HIV were on treatment or not. Some trials looked at the effects of taking supplements with multiple micronutrients whereas others looked at supplementation with single vitamins or minerals. What are micronutrient supplements and how might they help people living with HIV? Micronutrient supplements contain vitamins or minerals, or both, that are essential to good health. Many of these vitamins play important roles in maintaining the human immune system, which helps to fight off infections. Infection with HIV causes a progressive destruction of the immune system, which leaves people vulnerable to frequent infections. Many people living with HIV, especially in low-income countries, are also undernourished and many consume diets deficient that these essential micronutrients. Supplementation could therefore help people living with HIV to stay healthy for longer by strengthening their immune system or assisting recovery from infections. What the research says Multiple micronutrients Providing a daily supplement that contains multiple vitamins and minerals may have little or no effect on reducing deaths in people living with HIV, whether they are taking antiretroviral drugs or not (low certainty evidence). Daily supplements may have little or no effect on HIV disease progression as measured by CD4 cell count (low certainty evidence) or HIV viral load (low or moderate certainty evidence). Single or

  11. Quantifying the Assessment Loads of Students and Staff: The Challenge of Selecting Appropriate Metrics

    Science.gov (United States)

    Scott, Shirley V.

    2015-01-01

    Assessment is central to learning. It is also central to the cost of providing higher education. Choosing how much and what forms of assessment are questions not only of good teaching but of good policy. Measuring the amount of assessment set in each course provides a basis on which to determine equitable and appropriate workloads for students and…

  12. Vitamin D supplementation for women during pregnancy

    Directory of Open Access Journals (Sweden)

    Luz Maria De-Regil

    0.83; four trials, 638 women. Vitamin D and calcium versus no supplementation or a placebo Women who received vitamin D with calcium had a lower risk of pre-eclampsia than those not receiving any intervention (RR 0.51; 95% CI 0.32 to 0.80; three trials; 1114 women, moderate quality, but also an increased risk of preterm birth (RR 1.57; 95% CI 1.02 to 2.43, three studies, 798 women, moderate quality. Maternal vitamin D concentration at term, gestational diabetes, adverse effects and low birthweight were not reported in any trial or reported only by one study. AUTHORS CONCLUSIONS: New studies have provided more evidence on the effects of supplementing pregnant women with vitamin D alone or with calcium on pregnancy outcomes. Supplementing pregnant women with vitamin D in a single or continued dose increases serum 25-hydroxyvitamin D at term and may reduce the risk of pre-eclampsia, low birthweight and preterm birth. However, when vitamin D and calcium are combined, the risk of preterm birth is increased. The clinical significance of the increased serum 25-hydroxyvitamin D concentrations is still unclear. In light of this, these results need to be interpreted with caution. Data on adverse effects were lacking in all studies. The evidence on whether vitamin D supplementation should be given as a part of routine antenatal care to all women to improve maternal and infant outcomes remains unclear. While there is some indication that vitamin D supplementation could reduce the risk of pre-eclampsia and increase length and head circumference at birth, further rigorous randomized trials are required to confirm these effects.

  13. Food Components and Supplements

    DEFF Research Database (Denmark)

    Parlesak, Alexandr

    2012-01-01

    the growth of these bacteria (prebiotics) are added to food to achieve health effects exceeding its pure nutritional function. Several of these effects are mediated by enzyme systems involved in xenobiotic and drug metabolism, and in some cases this might lead to undesired interactions with medication.......g., secondary plant metabolites such as flavonoids), or as contaminants that enter the food chain at different stages or during the food production process. For these components, a wide spectrum of biological effects was observed that ranges from health-threatening impacts (e.g., polycyclic aromatic amines...... cases, nutrients, food contaminants, and secondary plant metabolites can themselves become substrates for xenobiotic-metabolizing enzymes, resulting in health-promoting or health-threatening products. This chapter focuses on how important components of our daily nutrition and supplements can interfere...

  14. Therapy Provider Phase Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Therapy Provider Phase Information dataset is a tool for providers to search by their National Provider Identifier (NPI) number to determine their phase for...

  15. Appropriate spatial sampling of rainfall for flow simulation

    NARCIS (Netherlands)

    Dong, Xiaohua; Dohmen-Janssen, Catarine M.; Booij, Martijn J.

    2005-01-01

    The objective of this study is to find the appropriate number and location of raingauges for a river basin for flow simulation by using statistical analyses and hydrological modelling. First, a statistical method is used to identify the appropriate number of raingauges. Herein the effect of the

  16. 14 CFR 1261.403 - Consultation with appropriate officials; negotiation.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Consultation with appropriate officials; negotiation. 1261.403 Section 1261.403 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION... appropriate officials; negotiation. (a) The authority pursuant to § 1261.402 to determine to forego collection...

  17. Indigenous Thought, Appropriation, and Non-Aboriginal People

    Science.gov (United States)

    Haig-Brown, Celia

    2010-01-01

    In this article, I explore the question, "What is the relationship between appropriation of Indigenous thought and what might be called "deep learning" based in years of education in Indigenous contexts." Beginning with an examination of meanings ascribed to cultural appropriation, I bring texts from Gee on secondary…

  18. 34 CFR 104.33 - Free appropriate public education.

    Science.gov (United States)

    2010-07-01

    ... FEDERAL FINANCIAL ASSISTANCE Preschool, Elementary, and Secondary Education § 104.33 Free appropriate... 34 Education 1 2010-07-01 2010-07-01 false Free appropriate public education. 104.33 Section 104.33 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS...

  19. Evaluation of the appropriate perioperative antibiotic prophylaxis in Italy.

    Directory of Open Access Journals (Sweden)

    Francesco Napolitano

    Full Text Available BACKGROUND: The appropriate use of antibiotics prophylaxis in the prevention and reduction in the incidence of surgical site infection is widespread. This study evaluates the appropriateness of the prescription of antibiotics prophylaxis prior to surgery amongst hospitalized patients in the geographic area of Avellino, Caserta, and Naples (Italy and the factors associated with a poor adherence. METHODS: A sample of 382 patients admitted to 23 surgical wards and undergoing surgery in five hospitals were randomly selected. RESULTS: Perioperative antibiotic prophylaxis was appropriate in 18.1% of cases. The multivariate logistic regression analysis showed that patients with hypoalbuminemia, with a clinical infection, with a wound clean were more likely to receive an appropriate antibiotic prophylaxis. Compared with patients with an American Society of Anesthesiologists (ASA score ≥4, those with a score of 2 were correlated with a 64% reduction in the odds of having an appropriate prophylaxis. The appropriateness of the timing of prophylactic antibiotic administration was observed in 53.4% of the procedures. Multivariate logistic regression model showed that such appropriateness was more frequent in older patients, in those admitted in general surgery wards, in those not having been underwent an endoscopic surgery, in those with a higher length of surgery, and in patients with ASA score 1 when a score ≥4 was chosen as the reference category. The most common antibiotics used inappropriately were ceftazidime, sultamicillin, levofloxacin, and teicoplanin. CONCLUSIONS: Educational interventions are needed to improve perioperative appropriate antibiotic prophylaxis.

  20. Young Adults Perception of Appropriateness of some Domestic ...

    African Journals Online (AJOL)

    The process of acquisition of appropriate gender role is both developmental and cultural. The study examined perception of appropriate gender role in the family and the actual participation in family work. The participants were 545 freshmen of a Federal university and a State University within Lagos, Nigeria.

  1. Army Corps of Engineers: Water Resource Authorizations, Appropriations, and Activities

    Science.gov (United States)

    2017-02-27

    Army Corps of Engineers: Water Resource Authorizations, Appropriations, and Activities Nicole T. Carter Specialist in Natural Resources Policy...of Engineers: Water Resource Authorizations, Appropriations, and Activities Congressional Research Service Summary The U.S. Army Corps of...congressional attention because its water resource projects can have significant local and regional economic benefits and environmental effects

  2. Undoing Appropriateness: Raciolinguistic Ideologies and Language Diversity in Education

    Science.gov (United States)

    Flores, Nelson; Rosa, Jonathan

    2015-01-01

    In this article, Nelson Flores and Jonathan Rosa critique appropriateness-based approaches to language diversity in education. Those who subscribe to these approaches conceptualize standardized linguistic practices as an objective set of linguistic forms that are appropriate for an academic setting. In contrast, Flores and Rosa highlight the…

  3. Quality indicators to measure appropriate antibiotic use in hospitalized adults

    NARCIS (Netherlands)

    Bosch, C.M.A. van den; Geerlings, S.E.; Natsch, S.S.; Prins, J.M.; Hulscher, M.

    2015-01-01

    BACKGROUND: An important requirement for an effective antibiotic stewardship program is the ability to measure appropriateness of antibiotic use. The aim of this study was to develop quality indicators (QIs) that can be used to measure appropriateness of antibiotic use in the treatment of all

  4. Quality indicators to measure appropriate antibiotic use in hospitalized adults

    NARCIS (Netherlands)

    van den Bosch, Caroline M. A.; Geerlings, Suzanne E.; Natsch, Stephanie; Prins, Jan M.; Hulscher, Marlies E. J. L.

    2015-01-01

    An important requirement for an effective antibiotic stewardship program is the ability to measure appropriateness of antibiotic use. The aim of this study was to develop quality indicators (QIs) that can be used to measure appropriateness of antibiotic use in the treatment of all bacterial

  5. Model appropriateness for simulation of climate change and river flooding

    NARCIS (Netherlands)

    Booij, Martijn J.; Bentley, L.R.

    2000-01-01

    An important question in water resources and related subjects is how an appropriate model should look given a specific research area and objective. This question is dealt with by developing a model appropriateness procedure based on model uncertainties. The procedure has been applied to a river

  6. An appropriateness framework for the Dutch Meuse decision support system

    NARCIS (Netherlands)

    Xu, YuePing; Xu, Yue-Ping; Booij, Martijn J.; Mynett, Arthur; Mynett, Arthur E.

    2007-01-01

    Models are essential in a decision support system for river basin management. In a decision support system for integrated planning and management, the use of appropriate models is important to avoid models being either too simple or too complex. In this paper, appropriate models refer to models that

  7. Glutamine supplementation in sick children: is it beneficial?

    Science.gov (United States)

    Mok, Elise; Hankard, Régis

    2011-01-01

    The purpose of this review is to provide a critical appraisal of the literature on Glutamine (Gln) supplementation in various conditions or illnesses that affect children, from neonates to adolescents. First, a general overview of the proposed mechanisms for the beneficial effects of Gln is provided, and subsequently clinical studies are discussed. Despite safety, studies are conflicting, partly due to different effects of enteral and parenteral Gln supplementation. Further insufficient evidence is available on the benefits of Gln supplementation in pediatric patients. This includes premature infants, infants with gastrointestinal disease, children with Crohn's disease, short bowel syndrome, malnutrition/diarrhea, cancer, severe burns/trauma, Duchenne muscular dystrophy, sickle cell anemia, cystic fibrosis, and type 1 diabetes. Moreover, methodological issues have been noted in some studies. Further mechanistic data is needed along with large randomized controlled trials in select populations of sick children, who may eventually benefit from supplemental Gln.

  8. Glutamine Supplementation in Sick Children: Is It Beneficial?

    Directory of Open Access Journals (Sweden)

    Elise Mok

    2011-01-01

    Full Text Available The purpose of this review is to provide a critical appraisal of the literature on Glutamine (Gln supplementation in various conditions or illnesses that affect children, from neonates to adolescents. First, a general overview of the proposed mechanisms for the beneficial effects of Gln is provided, and subsequently clinical studies are discussed. Despite safety, studies are conflicting, partly due to different effects of enteral and parenteral Gln supplementation. Further insufficient evidence is available on the benefits of Gln supplementation in pediatric patients. This includes premature infants, infants with gastrointestinal disease, children with Crohn's disease, short bowel syndrome, malnutrition/diarrhea, cancer, severe burns/trauma, Duchenne muscular dystrophy, sickle cell anemia, cystic fibrosis, and type 1 diabetes. Moreover, methodological issues have been noted in some studies. Further mechanistic data is needed along with large randomized controlled trials in select populations of sick children, who may eventually benefit from supplemental Gln.

  9. Nutritional Supplements for Endurance Athletes

    Science.gov (United States)

    Rasmussen, Christopher J.

    Athletes engaged in heavy endurance training often seek additional nutritional strategies to help maximize performance. Specific nutritional supplements exist to combat certain factors that limit performance beginning with a sound everyday diet. Research has further demonstrated that safe, effective, legal supplements are in fact available for today's endurance athletes. Several of these supplements are marketed not only to aid performance but also to combat the immunosuppressive effects of intense endurance training. It is imperative for each athlete to research the legality of certain supplements for their specific sport or event. Once the legality has been established, it is often up to each individual athlete to decipher the ethics involved with ingesting nutritional supplements with the sole intent of improving performance.

  10. Creative Commons and Appropriation: Implicit Collaboration in Digital Works

    Directory of Open Access Journals (Sweden)

    R. Lyle Skains

    2016-03-01

    Full Text Available Appropriation is a common practice in art and literature; electronic literature in particular lends itself readily to appropriation and collaboration, due to its multimodal and born-digital nature. This paper presents practice-based research examining the effects of digital appropriation on two works of digital fiction (a hyperfiction and an interactive fiction, demonstrating how it alters the creative writer’s typical process, as well as the resulting narrative itself. This practice of appropriation results in “implicit collaboration” between the digital creative writer and those whose work is appropriated, an arguable form of shared authorship. Questions regarding the ethics of this practice, including copyright concerns and authorship, are discussed.

  11. APPROPRIATING CREATIVE WORKS PROTECTED BY INTELLECTUAL PROPERTY RIGHTS

    Directory of Open Access Journals (Sweden)

    Cornelia DUMITRU

    2015-07-01

    Full Text Available The ownership, either public or private, is an expression for appropriating goods. Consequently, the appropriation takes the form of private (i.e. private property and common forms (i.e. public property. The common law property defines appropriation as „a deliberate act of acquisition of something, often without the permission of the owner”, but the intellectual property rights do not protect goods. Particularly in this case „the object” of appropriation does not represent a „res nullius” simply because the intellectual property right arises from the act of creation, therefore the appropriation of somebody else’s creation becomes equivalent with stealing (plagiarism. Consequently, if we are to admit that the authors have a right of ownership over them, then ownership in intellectual property law has (it must have other manifestations than those known and accepted in the common law of property.

  12. Lessons Learned in Engineering. Supplement

    Science.gov (United States)

    Blair, James C.; Ryan, Robert S.; Schultzenhofer, Luke A.

    2011-01-01

    This Contractor Report (CR) is a compilation of Lessons Learned in approximately 55 years of engineering experience by each James C. Blair, Robert S. Ryan, and Luke A. Schutzenhofer. The lessons are the basis of a course on Lessons Learned that has been taught at Marshall Space Flight Center. The lessons are drawn from NASA space projects and are characterized in terms of generic lessons learned from the project experience, which are further distilled into overarching principles that can be applied to future projects. Included are discussions of the overarching principles followed by a listing of the lessons associated with that principle. The lesson with sub-lessons are stated along with a listing of the project problems the lesson is drawn from, then each problem is illustrated and discussed, with conclusions drawn in terms of Lessons Learned. The purpose of this CR is to provide principles learned from past aerospace experience to help achieve greater success in future programs, and identify application of these principles to space systems design. The problems experienced provide insight into the engineering process and are examples of the subtleties one experiences performing engineering design, manufacturing, and operations. The supplemental CD contains accompanying PowerPoint presentations.

  13. Proposal of a Nutritional Quality Index (NQI) to Evaluate the Nutritional Supplementation of Sportspeople.

    Science.gov (United States)

    Palacin-Arce, Alba; Monteagudo, Celia; Beas-Jimenez, Juan de Dios; Olea-Serrano, Fatima; Mariscal-Arcas, Miguel

    2015-01-01

    Numerous supplements are used by sportspeople. They are not always appropriate for the individual or the sports activity and may do more harm than good. Vitamin and mineral supplements are unnecessary if the energy intake is sufficient to maintain body weight and derives from a diet with an adequate variety of foods. The study objectives were to evaluate the main nutrients used as supplements in sports and to propose a nutritional quality index (NQI) that enables sportspeople to optimize their use of supplements and detect and remedy possible nutritional deficits. A nutritional study was performed in 485 sportspeople recruited from Centros Andaluces de Medicina del Deporte, (CAMD). All completed socio-demographic, food frequency, and lifestyle questionnaires. The nutritional quality of their diet and need for supplementation were evaluated by scoring their dietary intake with and without supplementation, yielding two NQI scores (scales of 0-21 points) for each participant. A superior mean NQI score was obtained when the supplements taken by participants were not included (16. 28 (SD of 3.52)) than when they were included (15.47 (SD: 3.08)), attributable to an excessive intake of some nutrients through supplementation. These results indicate that sportspeople with a varied and balanced diet do not need supplements, which appear to offer no performance benefits and may pose a health risk.

  14. Probiotic supplements and debridement of peri-implant mucositis

    DEFF Research Database (Denmark)

    Hallström, Hadar; Lindgren, Susann; Widén, Cecilia

    2016-01-01

    OBJECTIVE: The aim of this double-blind randomized placebo-controlled trial was to evaluate the effects of probiotic supplements in adjunct to conventional management of peri-implant mucositis. MATERIALS AND METHODS: Forty-nine adult patients with peri-implant mucositis were consecutively recruited...... debridement and oral hygiene reinforcement resulted in clinical improvement of peri-implant mucositis and a reduction in cytokine levels. Probiotic supplements did not provide added benefit to placebo....

  15. A Promising Approach to Provide Appropriate Colon Target Drug Delivery Systems of Vancomycin HCL: Pharmaceutical and Microbiological Studies

    Directory of Open Access Journals (Sweden)

    Kadria A. Elkhodairy

    2014-01-01

    Full Text Available Vancomycin HCl was prepared as orally administered colon target drug delivery tablets for systemic therapy. Tablet matrices containing 10–60% of tablet weight of guar gum (F1–F6 were prepared by direct compression and subjected to in vitro release studies to explore their sustained release in the colon. Various synthetic and natural polymers were incorporated to F6 to modify the drug release rate. Different 15 matrix tablet formulations (F6–F20 were enteric coated with hydroxypropyl methyl cellulose phthalate. F6, F13 and F20 showed promising sustained release results having median dissolution time (MDT values: 8.25, 7.97, and 7.64, respectively. Microbiological assay was performed to test the efficacy of F6, F13, and F20 to inhibit clinical Staphylococcus aureus (SA isolates. Bactericidal activity of F6 was reached after 2, 4, and 24 hours of incubation against MSSA 18, MRSA 29, and MRSA 11 strains, respectively, while it was reached within 6–8 hours in case of F13, and F20 against all strains tested. F13 enhanced log microbial reduction by 1.74, 0.65 and 2.4 CFU/mL compared to F6 while it was 1, 2.57 and 1.57 compared to F20 against MSSA18, MRSA11 and MRSA29, respectively. Vancomycin HCl tablets displayed a promising sustained release in vitro and microbiological inhibitory action on all isolates tested.

  16. Evaluating the Appropriateness and Use of Domain Critical Errors

    Directory of Open Access Journals (Sweden)

    Chad W. Buckendahl

    2012-10-01

    Full Text Available The consequences associated with the uses and interpretations of scores for many credentialing testing programs have important implications for a range of stakeholders. Within licensure settings specifically, results from examination programs are often one of the final steps in the process of assessing whether individuals will be allowed to enter practice. This article focuses on the concept of domain critical errors and suggests a framework for considering their use in practice. Domain critical errors are defined here as knowledge, skills, abilities, or judgments that are essential to the definition of minimum qualifications in a testing program's pass-'fail decision-making process. Using domain critical errors has psychometric and policy implications, particularly for licensure programs that are mandatory for entry-level practice. Because these errors greatly influence pass-'fail decisions, the measurement community faces an ongoing challenge to promote defensible practices while concurrently providing assessment literacy development about the appropriate design and use of testing methods like domain critical errors.

  17. An appropriate role for ethics in teaching contemporary issues.

    Science.gov (United States)

    Schillo, K K

    1999-01-01

    There seems to be general agreement among animal scientists that training in contemporary issues is an appropriate goal of animal science curricula. One approach is based on the view that public policy issues embody moral dilemmas that arise when the moral perspectives (values) of opposing groups are incompatible. Based on this view, an understanding of such issues requires some training in ethics. More specifically, knowledge of major moral theories and the nature of values is necessary to identify and analyze the moral components of issues. An appreciation for ethics also provides insight into addressing issues in a morally responsible manner. The plurality of values and the contextual nature of policy issues precludes solutions based on application of universal moral principles. Nevertheless, informed judgments, based on the collective wisdom of individuals, frequently offer solutions that address opposing values. Such judgments can be attained when those affected by issues form communities, attempt to achieve a collective understanding of the problem, and, if possible, construct a common set of values that facilitates consensus. Based on this analysis, issues courses should facilitate the development of learning communities wherein students and teachers critically analyze (i.e., deconstruct) and reconstruct issues in ways that enhance understanding and instill a respect for diverse moral perspectives. An expression of such understanding and respect is the ability to distinguish between situations when consensus offers fair solutions and when it subjects minority groups to the tyranny of the majority.

  18. Culturally appropriate vegetables and economic development. A contextual analysis.

    Science.gov (United States)

    Adekunle, Bamidele; Filson, Glen; Sethuratnam, Sridharan

    2012-08-01

    This paper examines the implications of the demand for ethno-cultural vegetables (ECV) by South-Asians, the largest cultural group in the Greater Toronto Area (GTA), on their potential for Ontario agricultural economic development and significant consumer health benefits. A conceptual framework is presented to explain the relationship among factors such as change in demographics, demand for locally produced ECV and both the potential agricultural and health benefits. Analysis of cross-sectional data collected in 2009 also indicates that the respondents have certain characteristics that are pertinent to understanding why they shop in particular stores and their perceptions about what constitutes quality. In sum, household size and percentage spent on vegetables predict their expenditure on ECV, an indication that South-Asians resident in the GTA will continue to demand their ECV. It is thus a niche market that farmers can explore if its potential economic value to them is clarified and the government can provide sufficient support by increasing awareness and creating appropriate economic incentives for farmers willing to grow these vegetables. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Bibliometrics: tracking research impact by selecting the appropriate metrics

    Science.gov (United States)

    Agarwal, Ashok; Durairajanayagam, Damayanthi; Tatagari, Sindhuja; Esteves, Sandro C; Harlev, Avi; Henkel, Ralf; Roychoudhury, Shubhadeep; Homa, Sheryl; Puchalt, Nicolás Garrido; Ramasamy, Ranjith; Majzoub, Ahmad; Ly, Kim Dao; Tvrda, Eva; Assidi, Mourad; Kesari, Kavindra; Sharma, Reecha; Banihani, Saleem; Ko, Edmund; Abu-Elmagd, Muhammad; Gosalvez, Jaime; Bashiri, Asher

    2016-01-01

    Traditionally, the success of a researcher is assessed by the number of publications he or she publishes in peer-reviewed, indexed, high impact journals. This essential yardstick, often referred to as the impact of a specific researcher, is assessed through the use of various metrics. While researchers may be acquainted with such matrices, many do not know how to use them to enhance their careers. In addition to these metrics, a number of other factors should be taken into consideration to objectively evaluate a scientist's profile as a researcher and academician. Moreover, each metric has its own limitations that need to be considered when selecting an appropriate metric for evaluation. This paper provides a broad overview of the wide array of metrics currently in use in academia and research. Popular metrics are discussed and defined, including traditional metrics and article-level metrics, some of which are applied to researchers for a greater understanding of a particular concept, including varicocele that is the thematic area of this Special Issue of Asian Journal of Andrology. We recommend the combined use of quantitative and qualitative evaluation using judiciously selected metrics for a more objective assessment of scholarly output and research impact. PMID:26806079

  20. PATTERNS FOR IDENTIFYING APPROPRIATE KNOWLEDGE MANAGEMENT STRATEGIES IN ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Khadijeh Salmani

    2012-06-01

    Full Text Available Nowadays, striving to find an efficient way for developing or identifying appropriate knowledge management strategies in organizations has become so critical. Researchers and practitioners have attached great importance to information pyramids in organizations and have highlighted the lack of trained and skilled staff as a serious problem. On the other hand, having more flexibility at workplace, offering better service, and fulfilling customers' demands require a strategy for managing knowledge and its consequence. Knowledge management provides a wide range of different strategies and methods for identifying, creating, and sharing knowledge in organizations. This deep insight which consists of individual, organization’s experience, knowledge, and understanding helps organization respond to both internal and external stimuli and act in harmony. One fact which has seemingly achieved a consensus is the need for different strategies of knowledge management. Among the wide range of various and often unclear knowledge management strategies one can choose a strategy in a specific situation. The aim of this paper is to respond to strategic questions which emphasize competitive intelligence and internal knowledge retrieval system. The implications are discussed in detail.

  1. Bibliometrics: tracking research impact by selecting the appropriate metrics.

    Science.gov (United States)

    Agarwal, Ashok; Durairajanayagam, Damayanthi; Tatagari, Sindhuja; Esteves, Sandro C; Harlev, Avi; Henkel, Ralf; Roychoudhury, Shubhadeep; Homa, Sheryl; Puchalt, Nicolás Garrido; Ramasamy, Ranjith; Majzoub, Ahmad; Ly, Kim Dao; Tvrda, Eva; Assidi, Mourad; Kesari, Kavindra; Sharma, Reecha; Banihani, Saleem; Ko, Edmund; Abu-Elmagd, Muhammad; Gosalvez, Jaime; Bashiri, Asher

    2016-01-01

    Traditionally, the success of a researcher is assessed by the number of publications he or she publishes in peer-reviewed, indexed, high impact journals. This essential yardstick, often referred to as the impact of a specific researcher, is assessed through the use of various metrics. While researchers may be acquainted with such matrices, many do not know how to use them to enhance their careers. In addition to these metrics, a number of other factors should be taken into consideration to objectively evaluate a scientist's profile as a researcher and academician. Moreover, each metric has its own limitations that need to be considered when selecting an appropriate metric for evaluation. This paper provides a broad overview of the wide array of metrics currently in use in academia and research. Popular metrics are discussed and defined, including traditional metrics and article-level metrics, some of which are applied to researchers for a greater understanding of a particular concept, including varicocele that is the thematic area of this Special Issue of Asian Journal of Andrology. We recommend the combined use of quantitative and qualitative evaluation using judiciously selected metrics for a more objective assessment of scholarly output and research impact.

  2. Bibliometrics: tracking research impact by selecting the appropriate metrics

    Directory of Open Access Journals (Sweden)

    Ashok Agarwal

    2016-01-01

    Full Text Available Traditionally, the success of a researcher is assessed by the number of publications he or she publishes in peer-reviewed, indexed, high impact journals. This essential yardstick, often referred to as the impact of a specific researcher, is assessed through the use of various metrics. While researchers may be acquainted with such matrices, many do not know how to use them to enhance their careers. In addition to these metrics, a number of other factors should be taken into consideration to objectively evaluate a scientist′s profile as a researcher and academician. Moreover, each metric has its own limitations that need to be considered when selecting an appropriate metric for evaluation. This paper provides a broad overview of the wide array of metrics currently in use in academia and research. Popular metrics are discussed and defined, including traditional metrics and article-level metrics, some of which are applied to researchers for a greater understanding of a particular concept, including varicocele that is the thematic area of this Special Issue of Asian Journal of Andrology. We recommend the combined use of quantitative and qualitative evaluation using judiciously selected metrics for a more objective assessment of scholarly output and research impact.

  3. Please Touch the Children: Appropriate Touch in the Primary Classroom

    Science.gov (United States)

    Owen, Pamela M.; Gillentine, Jonathan

    2011-01-01

    This study proposes to shift the current theoretical framework in which teachers practise a guarded approach regarding the touching of children in early childhood settings, towards a practice of acceptance. A brief historical context of touching is presented and supplemented with a survey of 63 currently practising K-3rd grade teachers. The survey…

  4. Intermittent oral iron supplementation during pregnancy (Review)

    Science.gov (United States)

    Peña-Rosas, Juan Pablo; De-Regil, Luz Maria; Dowswell, Therese; Viteri, Fernando E

    2014-01-01

    Background Anaemia is a frequent condition during pregnancy, particularly among women from developing countries who have insufficient iron intake to meet increased iron needs of both the mother and the fetus. Traditionally, gestational anaemia has been prevented with the provision of daily iron supplements throughout pregnancy, but adherence to this regimen due to side effects, interrupted supply of the supplements, and concerns about safety among women with an adequate iron intake, have limited the use of this intervention. Intermittent (i.e. one, two or three times a week on non-consecutive days) supplementation with iron alone or in combination with folic acid or other vitamins and minerals has recently been proposed as an alternative to daily supplementation. Objectives To assess the benefits and harms of intermittent supplementation with iron alone or in combination with folic acid or other vitamins and minerals to pregnant women on neonatal and pregnancy outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (23 March 2012). We also searched the WHO International Clinical Trials Registry Platform (ICTRP) for ongoing studies and contacted relevant organisations for the identification of ongoing and unpublished studies (23 March 2012). Selection criteria Randomised or quasi-randomised trials. Data collection and analysis We assessed the methodological quality of trials using standard Cochrane criteria. Two review authors independently assessed trial eligibility, extracted data and conducted checks for accuracy. Main results This review includes 21 trials from 13 different countries, but only 18 trials (with 4072 women) reported on our outcomes of interest and contributed data to the review. All of these studies compared daily versus intermittent iron supplementation. Three studies provided iron alone, 12 iron+folic acid and three more iron plus multiple vitamins and minerals. Their methodological quality was mixed

  5. Lead content in 70 brands of dietary calcium supplements.

    Science.gov (United States)

    Bourgoin, B P; Evans, D R; Cornett, J R; Lingard, S M; Quattrone, A J

    1993-01-01

    OBJECTIVES. Elevated lead levels in calcium supplements may pose a health risk, particularly to children with milk intolerance who rely on these products to meet their calcium requirement. Earlier reports chiefly focused on the lead content in supplements derived from bonemeal and dolomite. This study undertook to determine the lead levels in the major forms of calcium supplements currently available. METHODS. The lead content was measured in 70 brands of calcium supplements grouped in the following five categories: dolomite, bonemeal, refined and natural source calcium carbonate, and calcium chelates. RESULTS. The lead levels measured in the supplements ranged from 0.03 microgram/g to 8.83 micrograms/g. Daily lead ingestion rates revealed that about 25% of the products exceeded the US Food and Drug Administration's "provisional" total tolerable daily intake of lead for children aged 6 years and under. Less than 20% of the supplements had "normalized" lead levels comparable to or lower than that reported for cow's milk. CONCLUSIONS. Children are the most sensitive to the low-level effects of lead. If calcium supplements are to provide an alternate source of calcium to some of these individuals, they should also deliver concomitant lead dosages no greater than those obtained from milk products themselves. PMID:8342726

  6. Dietary supplements for athletes: emerging trends and recurring themes.

    Science.gov (United States)

    Maughan, R J; Greenhaff, P L; Hespel, P

    2011-01-01

    Dietary supplements are widely used at all levels of sport. Changes in patterns of supplement use are taking place against a background of changes in the regulatory framework that governs the manufacture and distribution of supplements in the major markets. Market regulation is complicated by the increasing popularity of Internet sales. The need for quality control of products to ensure they contain the listed ingredients in the stated amount and to ensure the absence of potentially harmful substances is recognized. This latter category includes compounds prohibited under anti-doping regulations. Several certification programmes now provide testing facilities for manufacturers of both raw ingredients and end products to ensure the absence of prohibited substances. Athletes should carry out a cost-benefit analysis for any supplement they propose to use. For most supplements, the evidence is weak, or even completely absent. A few supplements, including caffeine, creatine, and bicarbonate, are supported by a strong research base. Difficulties arise when new evidence appears to support novel supplements: in recent years, β-alanine has become popular, and the use of nitrate and arginine is growing. Athletes seldom wait until there is convincing evidence of efficacy or of safety, but caution is necessary to minimize risk.

  7. Supplements for Diabetes Mellitus: A Review of the Literature.

    Science.gov (United States)

    Yilmaz, Zera; Piracha, Fawad; Anderson, Leeann; Mazzola, Nissa

    2017-12-01

    The primary approach to controlling diabetes involves diet and lifestyle modification combined with pharmacologic interventions. Patients who are interested in exploring dietary supplements in the management of diabetes may have questions about which supplement to choose and whether any issues will arise with their current medication regimen. After reading this review, the pharmacist should be able to identify supplements that may provide benefit to improve diabetes management, understand what potential harm to the patient may occur, and be able to assist the patient in choosing high-quality supplements. This review will focus on the safety and efficacy data surrounding nicotinamide, ginseng, fenugreek, vitamin D, chromium, and cinnamon. These supplements are commonly listed in general circulation periodicals with claims to improve blood sugar management. Efficacy data showed a modest decrease in fasting plasma glucose of -0.96 mmol/dL (-17.29 mg/dL) for fenugreek and -24.59 mg/dL for cinnamon. It remains to be seen whether supplementation with these products can affect outcomes such as morbidity and mortality. Despite many studies being available, the majority lack uniformity across multiple dimensions, including varying participant characteristics, inconsistent formulations of supplement and dose, and differing study durations. This, coupled with variation in quality and purity of commercially available products, prevents universal recommendation for use in diabetes management.

  8. Assessing appropriateness of parenteral nutrition usage in an acute hospital.

    Science.gov (United States)

    Smyth, Niamh D; Neary, Elaine; Power, Siobhan; Feehan, Sinead; Duggan, Sinead N

    2013-04-01

    Although parenteral nutrition (PN) has become an integral component of patient care, the risks and costs associated with this therapy must be weighed against the benefits. The Department of Nutrition and Dietetics at our tertiary referral, university-affiliated hospital has audited the use of enteral nutrition and PN based on criteria devised from guidelines developed by the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). We aimed to examine the use of PN over time and in particular to investigate the appropriate and inappropriate use of this feeding method. Each patient referred for PN was assessed by a dietitian and need for PN evaluated. The appropriateness of the PN was categorized according to predefined criteria. A total of 1191 patients had 1409 episodes of PN during the study period. According to the predefined criteria, 82% of PN episodes were considered "appropriate." PN was "appropriate but avoidable" in 13% of cases. In 5% of episodes, the commencement of PN was considered "inappropriate." The use of appropriate PN increased significantly over the study period (P = .018). Most PN episodes were deemed appropriate. We saw 5% inappropriate usage, which is lower than reported in comparable studies. This study underlines the importance of continuous audit and evaluation of practice to maintain appropriate and evidence-based practice in nutrition support.

  9. Supplement to the annual energy outlook 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-03-01

    This report is a companion document to the Annual Energy Outlook 1994 (AEO94), (DOE/EIA-0383(94)), released in Jan. 1994. Part I of the Supplement presents the key quantitative assumptions underlying the AEO94 projections, responding to requests by energy analysts for additional information on the forecasts. In Part II, the Supplement provides regional projections and other underlying details of the reference case projections in the AEO94. The AEO94 presents national forecasts of energy production, demand and prices through 2010 for five scenarios, including a reference case and four additional cases that assume higher and lower economic growth and higher and lower world oil prices. These forecasts are used by Federal, State, and local governments, trade associations, and other planners and decisionmakers in the public and private sectors.

  10. Appropriateness of hospitalization for CAP-affected pediatric patients: report from a Southern Italy General Hospital

    Directory of Open Access Journals (Sweden)

    Antonelli Fabio

    2009-09-01

    Full Text Available Abstract Background Community-acquired pneumonia (CAP is a common disease, responsible for significant healthcare expenditures, mostly because of hospitalization. Many practice guidelines on CAP have been developed, including admission criteria, but a few on appropriate hospitalization in children. The aim of this study was to evaluate appropriate hospital admission for CAP in a pediatric population. Methods We evaluated appropriate admission to a Pediatric Unit performing a retrospective analysis on CAP admitted pediatric patients from a Southern Italy area. Diagnosis was made based on clinical and radiological signs. Appropriate hospital admission was evaluated following clinical and non-clinical international criteria. Family ability to care children was assessed by evaluating social deprivation status. Results In 2 winter seasons 120 pediatric patients aged 1-129 months were admitted because of CAP. Median age was 28.7 months. Raised body temperature was scored in 68.3% of patients, cough was present in 100% of cases, and abdominal pain was rarely evidenced. Inflammatory indices (ESR and CRP were found elevated in 33.3% of cases. Anti-Mycoplasma pneumoniae antibodies were found positive in 20.4%. Trans-cutaneous (TC SaO2 was found lower than 92% in 14.6%. Dyspnoea was present in 43.3%. Dehydration requiring i.v. fluid supplementation was scored in 13.3%. Evaluation of familial ability to care their children revealed that 76% of families (derived from socially depressed areas were "at social risk", thus not able to appropriately care their children. Furthermore, analysis of CAP patients revealed that "at social risk" people accessed E.D. and were hospitalized more frequently than "not at risk" patients (odds ratio = 3.59, 95% CI: 1,15 to 11,12; p = 0.01, and that admitted "at social risk" people presented without clinical signs of severity (namely dyspnoea, and/or SaO2 ≤ 92%, and/or dehydration more frequently than "not at risk" population

  11. Reputational concerns with altruistic providers.

    Science.gov (United States)

    Olivella, Pau; Siciliani, Luigi

    2017-09-01

    We study a model of reputational concerns when doctors differ in their degree of altruism and they can signal their altruism by their (observable) quality. When reputational concerns are high, following the introduction or enhancement of public reporting, the less altruistic (bad) doctor mimics the more altruistic (good) doctor. Otherwise, either a separating or a semi-separating equilibrium arises: the bad doctor mimics the good doctor with probability less than one. Pay-for-performance incentive schemes are unlikely to induce crowding out, unless some dimensions of quality are unobservable. Under the pooling equilibrium a purchaser can implement the first-best quality by appropriately choosing a simple payment scheme with a fixed price per unit of quality provided. This is not the case under the separating equilibrium. Therefore, policies that enhance public reporting complement pay-for-performance schemes. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Appropriate HIV and AIDS Interventions drawn from Baseline ...

    African Journals Online (AJOL)

    Appropriate HIV and AIDS Interventions drawn from Baseline Knowledge Attitude and Behaviour Surveys of University Students. MPS Ngoma, JA Menon, J Malungo, S Siziya, T Nkumbula, M Musepa, L Zgambo, C Lwatula ...

  13. The application of appropriate technologies and systems for sustainable sanitation

    CSIR Research Space (South Africa)

    Duncker, Louiza C

    2014-11-01

    Full Text Available Sustainable development, which encompasses sustainable sanitation, is defined as development that is appropriate, has the specific objectives of accelerated growth, targeted interventions and community mobilisation to eradicate poverty and focuses...

  14. Appropriateness of Parenteral Nutrition Usage in Cancer Patients.

    Science.gov (United States)

    Feng, Yu-Lin; Lee, Chun-Sung; Chiu, Chong-Chi; Chao, Chien-Ming; Lai, Chih-Cheng

    2015-01-01

    This study is to investigate the indication appropriateness of parenteral nutrition (PN) administration in cancer patients. Between December 2013 and August 2014, all cancer patients who received PN (including total PN and Kabiven) in a regional hospital of Southern Taiwan were included in this retrospective study. A total of 107 cancer patients received PN. Among them, colorectal cancer was the most common type of cancer (n = 45, 42.1%), followed by gastric cancer, head and neck cancer, and esophageal cancer. After evaluation of the appropriateness of PN administration, 88 (82.2%) PN episodes were considered appropriate and unavoidable, 4 (3.7%) as appropriate and avoidable but 15 (14.1%) as inappropriate. In conclusion, PN could be inappropriately used by some oncologic physicians. Physicians and nutrition support team specialists should carefully evaluate the indication of PN administration for cancer patients to obey the generally acknowledged usage rule.

  15. Interior, Environment, and Related Agencies: FY2007 Appropriations

    National Research Council Canada - National Science Library

    Vincent, Carol H; Bearden, David M; Corn, M. L; Gorte, Ross W; Humphries, Marc; Sheikh, Pervaze A; Whiteman, David L; Boren, Susan; Walke, Roger; Bea, Keith

    2007-01-01

    ... of Health and Human Services. It also includes funding for arts and cultural agencies; the Environmental Protection Agency, which was recently transferred to the appropriations subcommittees that deal with Interior and Related Agencies...

  16. Appropriate models for estimating stresses and strains in asphalt layers

    CSIR Research Space (South Africa)

    Jooste, FJ

    1998-09-01

    Full Text Available The broad objective is to make recommendations for appropriate modelling procedures to be used in the structural design of asphalt layers. Findings of this investigation are intended to be used in refining and validating existing asphalt pavement...

  17. The Senate Electoral Cycle and Bicameral Appropriations Politics.

    Science.gov (United States)

    Shepsle, Kenneth A; Van Houweling, Robert P; Abrams, Samuel J; Hanson, Peter C

    2009-01-01

    We consider the consequences of the Senate electoral cycle and bicameralism for distributive politics, introducing the concept of contested credit claiming, i.e. that members of a state's House and Senate delegations must share the credit for appropriations that originate in their chamber with delegation members in the other chamber. Using data that isolates appropriations of each chamber, we test a model of the strategic incentives contested credit claiming creates. Our empirical analysis indicates that the Senate electoral cycle induces a back-loading of benefits to the end of senatorial terms, but that the House blunts this tendency with countercyclical appropriations. Our analysis informs our understanding of appropriations earmarking, and points a way forward in studying the larger consequences of bicameral legislatures.

  18. The Senate Electoral Cycle and Bicameral Appropriations Politics1

    Science.gov (United States)

    Shepsle, Kenneth A.; Van Houweling, Robert P.; Abrams, Samuel J.; Hanson, Peter C.

    2009-01-01

    We consider the consequences of the Senate electoral cycle and bicameralism for distributive politics, introducing the concept of contested credit claiming, i.e. that members of a state’s House and Senate delegations must share the credit for appropriations that originate in their chamber with delegation members in the other chamber. Using data that isolates appropriations of each chamber, we test a model of the strategic incentives contested credit claiming creates. Our empirical analysis indicates that the Senate electoral cycle induces a back-loading of benefits to the end of senatorial terms, but that the House blunts this tendency with countercyclical appropriations. Our analysis informs our understanding of appropriations earmarking, and points a way forward in studying the larger consequences of bicameral legislatures. PMID:19543433

  19. Choosing Appropriate Hazards Analysis Techniques For Your Process

    Science.gov (United States)

    1996-08-21

    Study ( HAZOP ); (v) Failure Mode and Effects Analysis (FMEA); (vi ) Fault Tree Analysis; or (vii) An appropriate equivalent methodology.” The safety...CFR 1910.119: ! Checklist ! What-if ! What-if Checklist ! Hazards and Operability Study ( HAZOP ) ! Fault Tree / Logic Diagram ! Failure Modes and...than the other methods and are more appropriate for a simple process. The HAZOP has found much use in the petroleum and chemical industries and the

  20. Food supplementation does not increase demographic rates in a passerine species of conservation concern

    Directory of Open Access Journals (Sweden)

    Innes M.W. Sim

    2015-05-01

    Full Text Available Numerous studies have examined the effects of the provision of supplementary food on aspects of avian reproductive success, but far fewer have gone on to examine the potential positive effects of food supplementation on the demographic rates which are key for population growth rate. Testing for potential effects of food shortage on vital rates is likely to be particularly important in species of high conservation concern, where populations are particularly small, isolated or decreasing rapidly. Here we test the effects of the provision of supplementary food on reproductive success, body condition at fledging and post-fledging survival of ring ouzels (Turdus torquatus, a species of high conservation concern in the UK. However, food supplementation had no detectable effect on any of these parameters. There was no significant difference in return rates of fed and unfed fledglings in the year following hatching, and most post-fledging mortality was apparently caused by predation by raptors and mustelids. We conclude that the supply of invertebrate food sources for nestlings was not a major limiting factor in our study area, at least during this two-year study. Further studies are required to quantify the precise mix of habitats used by ring ouzels, at the appropriate scale, which provide concealment from predators and access to food supplies throughout the spring and summer months.

  1. Federal Buildings Supplemental Survey 1993

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-11-01

    The Energy Information Administration (EIA) of the US Department of Energy (DOE) is mandated by Congress to be the agency that collects, analyzes, and disseminates impartial, comprehensive data about energy including the volume consumed, its customers, and the purposes for which it is used. The Federal Buildings Supplemental Survey (FBSS) was conducted by EIA in conjunction with DOE`s Office of Federal Energy Management Programs (OFEMP) to gain a better understanding of how Federal buildings use energy. This report presents the data from 881 completed telephone interviews with Federal buildings in three Federal regions. These buildings were systematically selected using OFEMP`s specifications; therefore, these data do not statistically represent all Federal buildings in the country. The purpose of the FBSS was threefold: (1) to understand the characteristics of Federal buildings and their energy use; (2) to provide a baseline in these three Federal regions to measure future energy use in Federal buildings as required in EPACT; and (3) to compare building characteristics and energy use with the data collected in the CBECS.

  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. Investigating the use of appropriation in the writing of a child with autism: A case study.

    Science.gov (United States)

    Maxwell, Jamie; Weill, Christine; Damico, Jack

    This case study investigated how a 10year old child with ASD (Autism Spectrum Disorder), Kameron (pseudonym), utilized appropriation as a writing strategy in the context of group therapy. Using the same questions as Lensmire and Beals (1994) in their study of a typically developing third-grader, written products were collected over the course of one semester and analyzed, along with video, audio, and participant observation data, to consider the following questions: 1) Where did the material come from? 2) What was taken? and 3) How was it used? Analysis of the process of Kameron's writing revealed utilization of appropriation as a strategy for 2 of the 4 written products. Material was appropriated from both adult authored texts performed via read alouds and from topics and values located in the local peer culture. Kameron's appropriation of shared experiences provided substance to initiate and engage in a shared peer culture. Increased engagement in the writing process and fewer off task behaviors were noted when appropriations were evidenced compared to the writing pieces where no appropriation occurred. The results demonstrate the powerful implications of both a process oriented and strength-based approach to writing and greater social awareness than expected in children with ASD. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. No impact of fish oil supplements on bleeding risk

    DEFF Research Database (Denmark)

    Begtrup, Katrine Munk; Krag, Andreas Engel; Hvas, Anne-Mette

    2017-01-01

    Abstract Introduction: Fish oil supplementation may inhibit platelet aggregation and can potentially increase the risk of bleeding. The aim of the present systematic review was to evaluate the effect of fish oil supplements on haemostasis and bleeding risk, and to provide recommendations on whether...... it is necessary to discontinue fish oil supplementation prior to surgery. Methods: Studies were identified through PubMed and Embase searches and by reviewing the reference lists of the included papers. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Included...... of the included studies were randomised controlled trials or included a control group. Overall, fish oil supplements reduced platelet aggregation in healthy subjects. Fish oil exposure in surgical patients did not increase bleeding or blood transfusions either during or after surgery. Conclusion: Fish oil...

  5. Appropriateness of colonoscopy requests according to EPAGE-II in the Spanish region of Catalonia.

    Science.gov (United States)

    Marzo-Castillejo, M; Almeda, J; Mascort, J J; Cunillera, O; Saladich, R; Nieto, R; Piñeiro, P; Llagostera, M; Cantero, Fx; Segarra, M; Puente, D

    2015-10-26

    In a context of increasing demand and pressure on the public health expenditure, appropriateness of colonoscopy indications is a topic of discussion. The objective of this study is to evaluate the appropriateness of colonoscopy requests performed in a primary care (PC) setting in Catalonia. Cross-sectional descriptive study. Out-patients >14 years of age, referred by their reference physicians from PC or hospital care settings to the endoscopy units in their reference hospitals, to undergo a colonoscopy. Evaluation of the appropriateness of 1440 colonoscopy requests issued from January to July 2011, according to the EPAGE-II guidelines (European Panel on the Appropriateness of Gastrointestinal Endoscopy). The most frequent indications of diagnostic suspicion requests were: rectal bleeding (37.46 %), abdominal pain (26.54 %), and anaemia study (16.78 %). The most frequent indications of disease follow-up were adenomas (58.1 %), and CRC (31.16 %). Colonoscopy was appropriate in 73.68 % of the cases, uncertain in 16.57 %, and inappropriate in 9.74 %. In multivariate analysis, performed colonoscopies reached an OR of 9.9 (CI 95 % 1.16-84.08) for qualifying as appropriate for colorectal cancer (CRC) diagnosis, 1.49 (CI 95 % 1.1-2.02) when requested by a general practitioner, and 1.09 (CI 95 % 1.07-1.1) when performed on women. Appropriateness of colonoscopy requests in our setting shows a suitable situation in accordance with recognized standards. General practitioners contribute positively to this appropriateness level. It is necessary to provide physicians with simple and updated guidelines, which stress recommendations for avoiding colonoscopy requests in the most prevalent conditions in PC.

  6. Dietary Supplements for Weight Loss

    Science.gov (United States)

    ... 2 • WEIGHT-LOSS SUPPLEMENTS FACT SHEET FOR CONSUMERS Bitter orange Bitter orange contains synephrine (a stimulant), and is claimed to ... breakdown of fat, and decrease appetite. Products with bitter orange usually also contain caffeine and other ingredients. Bitter ...

  7. Added Value via SPI supplement

    Data.gov (United States)

    U.S. Environmental Protection Agency — Supplement that indicates where to find the source data sets on the EPA system. This dataset is associated with the following publication: Bowden, J., K.D. Talgo, T....

  8. Herbal Supplements: Cause for Concern?

    OpenAIRE

    Borrione, Paolo; Luigi, Luigi Di; Maffulli, Nicola; Pigozzi, Fabio

    2008-01-01

    More than 1400 herbal products or herbal-derived compounds are commonly commercialised for health uses worldwide (Tyler, 1996). Herbs are considered dietary supplements, and therefore are subjected to a very limited form of regulation, and advertisements normally highlight their potential activities without mentioning any side effect. Also, herbs are generally believed to be 'natural', and hence safe. Many nutritional supplements contains herb compounds usually not present in the diet (e.g. G...

  9. Preferred provider organizations.

    Science.gov (United States)

    Davy, J D

    1984-05-01

    The 1980s has marked the beginning of a new alternative health care delivery system: the preferred provider organization ( PPO ). This system has developed from the health maintenance organization model and is predominant in California and Colorado. A PPO is a group of providers, usually hospitals and doctors, who agree to provide health care to subscribers for a negotiated fee that is usually discounted. Preferred provider organizations are subject to peer review and strict use controls in exchange for a consistent volume of patients and speedy turnaround on claims payments. This article describes the factors leading to the development of PPOs and the implications for occupational therapy.

  10. 42 CFR 457.495 - State assurance of access to care and procedures to assure quality and appropriateness of care.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false State assurance of access to care and procedures to... State assurance of access to care and procedures to assure quality and appropriateness of care. A State... appropriateness of care provided under the plan, including how the State will assure: (a) Access to well-baby care...

  11. Cardiovascular Effects of Calcium Supplements

    Directory of Open Access Journals (Sweden)

    Ian R. Reid

    2013-07-01

    Full Text Available Calcium supplements reduce bone turnover and slow the rate of bone loss. However, few studies have demonstrated reduced fracture incidence with calcium supplements, and meta-analyses show only a 10% decrease in fractures, which is of borderline statistical and clinical significance. Trials in normal older women and in patients with renal impairment suggest that calcium supplements increase the risk of cardiovascular disease. To further assess their safety, we recently conducted a meta-analysis of trials of calcium supplements, and found a 27%–31% increase in risk of myocardial infarction, and a 12%–20% increase in risk of stroke. These findings are robust because they are based on pre-specified analyses of randomized, placebo-controlled trials and are consistent across the trials. Co-administration of vitamin D with calcium does not lessen these adverse effects. The increased cardiovascular risk with calcium supplements is consistent with epidemiological data relating higher circulating calcium concentrations to cardiovascular disease in normal populations. There are several possible pathophysiological mechanisms for these effects, including effects on vascular calcification, vascular cells, blood coagulation and calcium-sensing receptors. Thus, the non-skeletal risks of calcium supplements appear to outweigh any skeletal benefits, and are they appear to be unnecessary for the efficacy of other osteoporosis treatments.

  12. Vitamin D supplementation guidelines.

    Science.gov (United States)

    Pludowski, Pawel; Holick, Michael F; Grant, William B; Konstantynowicz, Jerzy; Mascarenhas, Mario R; Haq, Afrozul; Povoroznyuk, Vladyslav; Balatska, Nataliya; Barbosa, Ana Paula; Karonova, Tatiana; Rudenka, Ema; Misiorowski, Waldemar; Zakharova, Irina; Rudenka, Alena; Łukaszkiewicz, Jacek; Marcinowska-Suchowierska, Ewa; Łaszcz, Natalia; Abramowicz, Pawel; Bhattoa, Harjit P; Wimalawansa, Sunil J

    2018-01-01

    Research carried out during the past two-decades extended the understanding of actions of vitamin D, from regulating calcium and phosphate absorption and bone metabolism to many pleiotropic actions in organs and tissues in the body. Most observational and ecological studies report association of higher serum 25-hydroxyvitamin D [25(OH)D] concentrations with improved outcomes for several chronic, communicable and non-communicable diseases. Consequently, numerous agencies and scientific organizations have developed recommendations for vitamin D supplementation and guidance on optimal serum 25(OH)D concentrations. The bone-centric guidelines recommend a target 25(OH)D concentration of 20ng/mL (50nmol/L), and age-dependent daily vitamin D doses of 400-800IU. The guidelines focused on pleiotropic effects of vitamin D recommend a target 25(OH)D concentration of 30ng/mL (75nmol/L), and age-, body weight-, disease-status, and ethnicity dependent vitamin D doses ranging between 400 and 2000IU/day. The wise and balanced choice of the recommendations to follow depends on one's individual health outcome concerns, age, body weight, latitude of residence, dietary and cultural habits, making the regional or nationwide guidelines more applicable in clinical practice. While natural sources of vitamin D can raise 25(OH)D concentrations, relative to dietary preferences and latitude of residence, in the context of general population, these sources are regarded ineffective to maintain the year-round 25(OH)D concentrations in the range of 30-50ng/mL (75-125nmol/L). Vitamin D self-administration related adverse effects, such as hypercalcemia and hypercalciuria are rare, and usually result from taking extremely high doses of vitamin D for a prolonged time. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Translation of a Tobacco Survey into Spanish and Asian Languages: The Tobacco Use Supplement to the Current Population Survey

    Science.gov (United States)

    Willis, Gordon; Lawrence, Deirdre; Hartman, Anne; Kudela, Martha Stapleton; Levin, Kerry; Forsyth, Barbara

    2013-01-01

    Because of the vital need to attain cross-cultural comparability of estimates of tobacco use across subgroups of the U.S. population that differ in primary language use, the NCI Tobacco Use Special Cessation Supplement to the Current Population Survey (TUSCS-CPS) was translated into Spanish, Chinese (Mandarin and Cantonese), Korean, Vietnamese, and Khmer (Cambodian). The questionnaire translations were extensively tested using an eight-step process that focused on both translation procedures and empirical pretesting. The resulting translations are available on the Internet (at http://riskfactor.cancer.gov/studies/tus-cps/translation/questionnaires.html) for tobacco researchers to use in their own surveys, either in full, or as material to be selected as appropriate. This manuscript provides information to guide researchers in accessing and using the translations, and describes the empirical procedures used to develop and pretest them (cognitive interviewing and behavior coding). We also provide recommendations concerning the further development of questionnaire translations. PMID:18584471

  14. Analysis of databases appropriation in the academic staffs of Iranian Universities of Medical Sciences according to the social appropriation approach.

    Science.gov (United States)

    Keyvanara, Mahmoud; Sohrabi, Mozaffar Cheshmeh; Zare, Firoozeh; Hassnazadeh, Akbar; Malekahmadi, Parisa

    2014-01-01

    Numerous researches conducted on about the quality of perception of media messages shows that the people are not passive receivers but they have the ability of understanding, interpreting and accepting or rejecting messages. In order to make clear the relationship of information and communication technologies with social changes and to gain a broader vision from this scope, sociological theories about information and communication technologies' usage, especially appropriation approach can be very useful. So, keeping in mind the important role of Databases in the qualitative expansion of education, research, diagnosis, remedy and medical services presentation, this research was carried out with the aim of status determination of databases appropriation in the academic staffs of Iranian Universities of Medical Sciences according to the social appropriation approach in 2012. This is an applicative research of an analytical-descriptive type, which was carried out by measurement approach. The statistical society of this research was composed of the academic staffs of the Iranian Universities of Medical Sciences in 2012 and finally 390 academic staffs were selected according to the Cochran's formula were selected. The research tool are searcher's made questionnaire, which was composed of nine separate parts. Its validity was accepted by the specialists and its reliability was calculated and found to be 0.961 by Cronbakh's alpha. Database appropriation score in the academic staffs of Iranian Universities of Medical Sciences with 65.020% was in a good status and data bases dis appropriation score with 71.484 was in a high status. According to the findings of this research, Librarians and politicians in this scope-with determination of the academic staff's positive and negative points in usage and appropriation would be capable of accurately diagnozing and analyzing the chances and challenges of the academic staffs members in using databases and would also be capable of

  15. Vitamin D status and supplementation in elite Irish athletes.

    Science.gov (United States)

    Magee, Pamela J; Pourshahidi, L Kirsty; Wallace, Julie M W; Cleary, John; Conway, Joe; Harney, Edward; Madigan, Sharon M

    2013-10-01

    A high prevalence of vitamin D insufficiency/deficiency, which may impact on health and training ability, is evident among athletes worldwide. This observational study investigated the vitamin D status of elite Irish athletes and determined the effect of wintertime supplementation on status. Serum 25-hydroxyvitamin D [25(OH)D], calcium, and plasma parathyroid hormone were analyzed in elite athletes in November 2010 (17 boxers, 33 paralympians) or March 2011 (34 Gaelic Athletic Association [GAA] players). A subset of boxers and paralympians (n = 27) were supplemented during the winter months with either 5,000 IU vitamin D3/d for 10-12 weeks or 50,000 IU on one or two occasions. Biochemical analysis was repeated following supplementation. Median 25(OH)D of all athletes at baseline was 48.4 nmol/L. Vitamin D insufficiency/deficiency (serum 25(OH)D supplementation (all doses) significantly increased 25(OH)D (median 62.8 nmol/L at baseline vs. 71.1 nmol/L in April or May; p = .001) and corrected any insufficiencies/deficiencies in this subset of athletes. In contrast, 25(OH)D significantly decreased in those that did not receive a vitamin D supplement, with 74% of athletes classed as vitamin D insufficient/deficient after winter, compared with only 35% at baseline. This study has highlighted a high prevalence of vitamin D insufficiency/ deficiency among elite Irish athletes and demonstrated that wintertime vitamin D3 supplementation is an appropriate regimen to ensure vitamin D sufficiency in athletes during winter and early spring.

  16. Grande Ronde Basin Supplementation Program; Lostine River, 2001 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Onjukka, Sam T. (Oregon Department of Fish and Wildlife, Portland, OR); Harbeck, Jim (Nez Perce Tribe, Department of Fisheries Resource Management, Enterprise, OR)

    2003-03-01

    The Northwest Power Planning Council (NPPC) identified supplementation as a high priority to achieve its goal of increasing runs of anadromous fish in the Columbia Basin. Supplementation activities in the Lostine River and associated monitoring and evaluation conducted by the Nez Perce Tribe relate directly to the needs addressed in the Columbia River Basin Fish and Wildlife Program (NPPC 1994). Measure 7.4L.1 of the Program mandates that appropriate research accompany any proposed supplementation. In addition, measure 7.3B.2 of the Program stresses the need for evaluating supplementation projects to assess their ability to increase production. Finally, Section 7.4D.3 encourages the study of hatchery rearing and release strategies to improve survival and adaptation of cultured fish. In 1997, Oregon Department of Fisheries and Wildlife (ODFW) requested a modification of Permit 1011 to allow the take of adult spring chinook salmon. In 1998, the Nez Perce Tribe also requested a permit specific to activities on Lostine River. The permit was issued in 2000. A special condition in the permits required the development of a long term management plan for the spring chinook salmon of the Grande Ronde Basin. The Nez Perce Tribe, ODFW, and the Confederated Tribes of the Umatilla Indian Reservation (CTUIR) completed a formal long range plan entitled ''Grande Ronde Basin Endemic Spring Chinook Salmon Supplementation Program''. The program proposes to increase the survival of spring chinook salmon in the Grand Ronde Basin through hatchery intervention. Adult salmon from the Lostine River, Catherine Creek, and the Upper Grande Ronde River are used for a conventional supplementation program in the basin. The Nez Perce program currently operates under the ESA Section 10 Permit 1149.

  17. Grande Ronde Basin Supplementation Program; Lostine River, 2000 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Onjukka, Sam T. (Oregon Department of Fish and Wildlife, Portland, OR); Harbeck, Jim (Nez Perce Tribe, Department of Fisheries Resource Management, Enterprise, OR)

    2003-03-01

    The Northwest Power Planning Council (NPPC) identified supplementation as a high priority to achieve its goal of increasing runs of anadromous fish in the Columbia Basin. Supplementation activities in the Lostine River and associated monitoring and evaluation conducted by the Nez Perce Tribe relate directly to the needs addressed in the Columbia River Basin Fish and Wildlife Program (NPPC 1994). Measure 7.4L.1 of the Program mandates that appropriate research accompany any proposed supplementation. In addition, measure 7.3B.2 of the Program stresses the need for evaluating supplementation projects to assess their ability to increase production. Finally, Section 7.4D.3 encourages the study of hatchery rearing and release strategies to improve survival and adaptation of cultured fish. In 1997, Oregon Department of Fisheries and Wildlife (ODFW) requested a modification of Permit 1011 to allow the take of adult spring chinook salmon. In 1998, the Nez Perce Tribe also requested a permit specific to activities on Lostine River. The permit was issued in 2000. A special condition in the permits required the development of a long term management plan for the spring chinook salmon of the Grande Ronde Basin. The Nez Perce Tribe, ODFW, and the Confederated Tribes of the Umatilla Indian Reservation (CTUIR) completed a formal long range plan entitled ''Grande Ronde Basin Endemic Spring Chinook Salmon Supplementation Program''. The program proposes to increase the survival of spring chinook salmon in the Grand Ronde Basin through hatchery intervention. Adult salmon from the Lostine River, Catherine Creek, and the Upper Grande Ronde River are used for a conventional supplementation program in the basin. The Nez Perce program currently operates under the ESA Section 10 Permit 1149.

  18. 20 CFR 416.1062 - What support we will provide.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What support we will provide. 416.1062 Section 416.1062 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... What support we will provide. Performance support may include, but is not limited to, any or all of the...

  19. Molecular Approaches for Optimizing Vitamin D Supplementation.

    Science.gov (United States)

    Carlberg, Carsten

    2016-01-01

    Vitamin D can be synthesized endogenously within UV-B exposed human skin. However, avoidance of sufficient sun exposure via predominant indoor activities, textile coverage, dark skin at higher latitude, and seasonal variations makes the intake of vitamin D fortified food or direct vitamin D supplementation necessary. Vitamin D has via its biologically most active metabolite 1α,25-dihydroxyvitamin D and the transcription factor vitamin D receptor a direct effect on the epigenome and transcriptome of many human tissues and cell types. Different interpretation of results from observational studies with vitamin D led to some dispute in the field on the desired optimal vitamin D level and the recommended daily supplementation. This chapter will provide background on the epigenome- and transcriptome-wide functions of vitamin D and will outline how this insight may be used for determining of the optimal vitamin D status of human individuals. These reflections will lead to the concept of a personal vitamin D index that may be a better guideline for an optimized vitamin D supplementation than population-based recommendations. © 2016 Elsevier Inc. All rights reserved.

  20. Tips for Older Dietary Supplement Users

    Science.gov (United States)

    ... Administration, DHHS, Center for Food Safety and Applied Nutrition: Dietary Supplements Tips for the Savvy Supplement User: Making Informed ... that supplements include botanical/herbal as well as vitamin/mineral ... may see sold as dietary supplements. It is not possible to list them all ...

  1. Food Supplement Usage by Adolescent Males.

    Science.gov (United States)

    Fleischer, Barbara; Read, Marsha

    1982-01-01

    Adolescent males (N=568) responded to a questionnaire examining their food supplement usage, types of food supplements consumed, reasons for use and non-use, relationship of use to concern for health, and demographic and external factors influencing supplement use. Presents factors related to food supplement usage. (RC)

  2. [Vitamin-mineral supplements in nutrition of adults].

    Science.gov (United States)

    Kodentsova, V M; Pogozheva, A V; Gromova, O A; Shikh, E V

    2015-01-01

    The diet of population consisting of natural products is quite adequate and even excessive of energy consumption, but is not able to meet fully the need of organism in a number of micronutrients. Due to lack of sun exposure and long presence indoors endogenous synthesis of vitamin D in the skin by ultraviolet radiation does not provide the body’s need for this vitamin. Intake of vitaminmineral supplements (VMS) is appropriate because combined deficiency of vitamins and minerals takes place in population. Prophylactic doses (equal to physiological needs) provide a diet completeness and reduce the risk of vitamin deficiency and its consequences. The high incidence of combined deficiency of vitamins among population and the existence of vitamin interactions are the basis for the application of the multivitamins. The simultaneous intake of vitamins is more physiological, their combination is more effective than a separate or isolated destination of each of them. Efficacy of the VMS has been shown in the treatment and prevention of some diseases. The main requirements for the VMS are full list of vitamins and minerals, the lack of which is detected most frequently, in doses covering the needs of organism. For the health of the pregnant woman and her unborn child preference should be given for complexes, containing DHA and/or probiotics along with vitamins. The principles of the selection of the composition and vitamin doses in the VMS for using patients suffering from various pathologies should be based on data on the patient’s sufficiency with vitamins, the understanding of the role of vitamin deficiency in the pathogenesis of the disease, as well as on the composition of the diet and its modifications.

  3. Building Service Provider Capabilities

    DEFF Research Database (Denmark)

    Brandl, Kristin; Jaura, Manya; Ørberg Jensen, Peter D.

    In this paper we study whether and how the interaction between clients and the service providers contributes to the development of capabilities in service provider firms. In situations where such a contribution occurs, we analyze how different types of activities in the production process...

  4. Providing free autopoweroff plugs

    DEFF Research Database (Denmark)

    Jensen, Carsten Lynge; Hansen, Lars Gårn; Fjordbak, Troels

    2012-01-01

    Experimental evidence of the effect of providing households with cheap energy saving technology is sparse. We present results from a field experiment in which autopoweroff plugs were provided free of charge to randomly selected households. We use propensity score matching to find treatment effects...

  5. DOD and VA Health Care: Actions Needed to Help Ensure Appropriate Medication Continuation and Prescribing Practices

    Science.gov (United States)

    2016-01-01

    guideline further recommends that providers prescribe low doses of opioids or other centrally acting pain medications (which reduce the transmission of...41In 2010, DOD and VHA jointly developed a clinical practice guideline for the use of opioids to treat...chronic pain conditions. It includes recommendations for determining the appropriateness of opioid therapy, starting and adjusting dosages, assessing

  6. Selecting appropriate gastroenteric contrast media for diagnostic fluoroscopic imaging in infants and children: a practical approach.

    Science.gov (United States)

    Callahan, Michael J; Talmadge, Jennifer M; MacDougall, Robert D; Kleinman, Patricia L; Taylor, George A; Buonomo, Carlo

    2017-04-01

    In our experience, questions about the appropriate use of enteric contrast media for pediatric fluoroscopic studies are common. The purpose of this article is to provide a comprehensive review of enteric contrast media used for pediatric fluoroscopy, highlighting the routine use of these media at a large tertiary care pediatric teaching hospital.

  7. Japanese Nursery and Kindergarten Teachers' Beliefs and Practices Regarding Developmentally Appropriate Practices

    Science.gov (United States)

    Hegde, Archana V.; Sugita, Chisato; Crane-Mitchell, Linda; Averett, Paige

    2014-01-01

    This study explored Japanese day nursery and kindergarten teachers' beliefs and practices regarding developmentally appropriate practices. Data were collected using in-depth interviews. Teacher interviews provided insights into the merger of the childcare and education systems of Japan. Six themes emerged from the analysis of the day nursery and…

  8. Wiffle Ball: Turning a Backyard Favorite into an Appropriate Physical Education Unit

    Science.gov (United States)

    Layne, Todd E.

    2017-01-01

    Wiffle ball is a game that has been played for many years (Santora, 2003). Unfortunately, implementation in physical education has been inconsistent at best. The sport education model outlined in this article provides an appropriate method for teaching skills associated with wiffle ball for a variety of ages. Students can develop appropriate…

  9. Teaching Young Children about the Civil Rights Movement: Applying Effective & Developmentally Appropriate Strategies

    Science.gov (United States)

    Foster, Janet E.; Root, Tonja L.; Lee, Seungyoun

    2015-01-01

    Considering the importance of the Civil Rights Movement, children need to be introduced to the related concepts early in their school experiences, and teachers need to consider students' developmental needs and curriculum standards in order to provide appropriate content and methods of instruction. The purpose of this article is to introduce a…

  10. Systematic review of the effects of iodised salt and iodine supplements on prenatal and postnatal growth: study protocol.

    Science.gov (United States)

    Farebrother, Jessica; Naude, Celeste E; Nicol, Liesl; Sang, Zhongna; Yang, Zhenyu; Andersson, Maria; Jooste, Pieter L; Zimmermann, Michael B

    2015-04-23

    Iodine is an essential micronutrient and component of the thyroid hormones. Sufficient ingestion of iodine is necessary for normal growth and development. If iodine requirements are not met, growth can be impaired. Salt iodisation and supplementation with iodine can prevent iodine deficiency disorders and stunted growth. No systematic review has yet collated the evidence linking iodine to growth. With an increased emphasis on stunting within the WHO Global Nutrition Targets for 2025, we propose a systematic review to address this question. We will undertake a systematic review, and if appropriate, meta-analyses, evaluating the effects of iodised salt or iodine supplements on prenatal and postnatal somatic growth, until age 18. We will search a number of databases, including MEDLINE, EMBASE, Web of Science, CINAHL, PsychINFO, the Cochrane Library, including the CENTRAL register of Controlled Trials and also the WHO library and ICTRP (International Clinical Trials Registry Platform), which includes the Clinicaltrials.gov repository. We will also search Wanfang Data and the China Knowledge Resource Integrated Database. Included studies must have compared exposure to iodised salt, iodine supplements or iodised oil, to placebo, non-iodised salt or no intervention. Primary outcomes will be continuous and categorical markers of prenatal and postnatal somatic growth. Secondary outcomes will cover further measures of growth, including growth rates and indirect markers of growth such as insulin-like growth factor-1 (IGF-1). The systematic review will be published in a peer-reviewed journal, and will be sent directly to the WHO, United Nations Children's Fund, International Council for the Control of Iodine Deficiency Disorders and other stakeholders. The results generated from this systematic review will provide evidence to support future programme recommendations regarding iodine fortification or supplementation and child growth. PROSPERO CRD42014012940. Published by the

  11. Making appropriation 'stick': stabilizing politics in an 'inherently feminist' tool.

    Science.gov (United States)

    Hasson, Katie Ann

    2012-10-01

    This article examines how feminist politics are made to 'stick' to appropriated technologies in the context of a contemporary feminist women's health clinic in the US. Feminist clinics such as 'FemHealth', founded as part of 1970s women's health movements, put medical tools and knowledge into lay women's hands, making the appropriation of medical technologies a centerpiece of their political project. In the process, they rejected the authority of physicians and gave new politicized meanings to the tools they claimed as their own. As lay healthworkers at FemHealth continued the project of appropriation, they also continued to negotiate their dependence on physicians to perform tasks that required a medical license. Drawing on participant observation and interviews with healthworkers, I argue that struggles over the role and authority of physicians in this clinic play out through debates over two similar and competing tools used in the abortion procedure: the single-tooth tenaculum and the cervical stabilizer. Many healthworkers invested in the stabilizer as 'inherently feminist' in hopes that it would maintain its politics even when passed into physicians' hands. While appropriation depends on the ability of users to alter a technology's meanings, actors may feel invested in the new politics taken on by appropriated tools and work towards making those meanings persist, or 'stick'.

  12. Appropriate working hours for surgical training according to Australasian trainees.

    Science.gov (United States)

    O'Grady, Gregory; Harper, Simon; Loveday, Benjamin; Adams, Brandon; Civil, Ian D; Peters, Matthew

    2012-04-01

    The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees. All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly 'sleep loss hours' (hours to be appropriate for 'technical' and 'non-technical' training needs compared with 55 h/week (interquartile range: 50-60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly 'sleep loss hours', was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work-life balance worked median 55 h/week. Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  13. Supplemental knowledge acquisition through external product interface for CLIPS

    Science.gov (United States)

    Saito, Tim; Ebaud, Stephen; Loftin, Bowen R.

    1990-01-01

    Traditionally, the acquisition of knowledge for expert systems consisted of the interview process with the domain or subject matter expert (SME), observation of domain environment, and information gathering and research which constituted a direct form of knowledge acquisition (KA). The knowledge engineer would be responsible for accumulating pertinent information and/or knowledge from the SME(s) for input into the appropriate expert system development tool. The direct KA process may (or may not) have included forms of data or documentation to incorporate from the SME's surroundings. The differentiation between direct KA and supplemental KA (indirect) would be the difference in the use of data. In acquiring supplemental knowledge, the knowledge engineer would access other types of evidence (manuals, documents, data files, spreadsheets, etc.) that would support the reasoning or premises of the SME. When an expert makes a decision in a particular task, one tool that may have been used to justify a recommendation, would have been a spreadsheet total or column figure. Locating specific decision points from that data within the SME's framework would constitute supplemental KA. Data used for a specific purpose in one system or environment would be used as supplemental knowledge for another, specifically a CLIPS project.

  14. Investigation of Appropriate Refractory Material for Laboratory Electritic Resistrance Furnance

    Directory of Open Access Journals (Sweden)

    J.B Agboola

    2009-07-01

    Full Text Available There have been numerous efforts to increase the local content of furnaces; hence the choice of appropriate refractory material for lining of locally manufactured furnaces has remained a major concern. This research work investigates the choice of appropriate local refractory material for the lining of laboratory electric resistance furnace.Electric resistance furnaces are extensively used in the laboratory for heat treatment of metals and alloys. Refractory binders such as silicon carbide were experimented upon for strength and resistance to high temperature.The results obtained showed that Kankara fireclay containing 15% SiC ( 5.70 % linear shrinkage , 46.2% apparent porosity, 1.77gkm³ Bulk density, 18 cycles of spalling tests at 1300°C, 5.253KN/m² of cold strength has appropriate properties for producing grooved bricks for lining of laboratory electric resistance Furnace.

  15. Appropriate technology: the challenge of the second generation.

    Science.gov (United States)

    Jéquier, N

    1980-07-28

    Appropriate technology, defined here as a low-cost technology aimed at helping to meet the most basic needs of the world's poorest people, can only be a viable proposition if its proponents succeed in making the transition from the first to the second generation, i.e. from the small-scale experiments and pilot innovations of today, to the massive application of new devices (hardware) and new forms of organization (software). The main agents in this second generation are national planning institutions, government ministries, established research centres, development agencies, financial institutions and industral corporations. Some of the ways in which this transition can be facilitated are examined, as well as a number of specific issues such as intelligence policies in appropriate technology, the structure of decision-making mechanisms and the linkage between appropriate technology and overall development strategies.

  16. Use of supplements by Japanese elite athletes for the 2012 Olympic Games in London.

    Science.gov (United States)

    Sato, Akiko; Kamei, Akiko; Kamihigashi, Etsuko; Dohi, Michiko; Akama, Takao; Kawahara, Takashi

    2015-05-01

    To investigate supplement use among Japanese elite athletes. We conducted a cross-sectional survey study using individual interviews during athletes' medical evaluations. One to 5 months before the Olympic Games in 2012, London, United Kingdom. Five hundred fifty-two Japanese athletes for the London Games, including candidates. Sex, sports, supplement category, and participation. Whether athletes used supplements, what products were used, the frequency and purposes of use, and from what sources athletes received information on supplements. All 552 athletes were interviewed by pharmacists regarding supplement use and agreed to the survey. Of them, 452 (81.9%) used 1 or more supplement products in the year before the study; a total of 952 different products (mean = 1.7, SD = 1.4) were used. The most commonly used supplement was amino acids (310 athletes; 56.2%), and 358 (38.7%) of the total products were amino acids. Of the athletes, 241 (43.7%) took at least 1 supplement daily, and of the supplements, 457 (49.4%) were taken daily. The most common purpose for supplement use was recovery from fatigue-327 (59.2%) athletes chose this answer, and 486 (52.5%) products were used for this purpose. Finally, regarding athletes' information sources on supplements, coaches, managers, and trainers were the most frequent advisors (275 athletes, 49.8%; 466 products, 50.4%). The results revealed widespread supplement use among Japanese elite athletes for the London Olympic Games. Education system was required not only for athletes but also for athletes' entourage, such as coaches, managers, trainers, and supplement companies. This study will provide basic data for establishing an education system that would better guide athletes' use of supplements.

  17. Quality of Bread Supplemented with Antrodia salmonea-Fermented Grains

    Directory of Open Access Journals (Sweden)

    Rao-Chi Chien

    2016-01-01

    Full Text Available Fermented grains of buckwheat, oat, embryo rice and wheat, which were prepared by solid-state fermentation with Antrodia salmonea, and the mycelium was used to substitute 7 % of wheat flour to make bread. No difference in proximate composition, texture profile and contents of non-volatile taste components was observed among bread samples. White bread and bread supplemented with mycelium and fermented grains looked different. Bread supplemented with fermented grains had similar thermal properties, which differed from those of white bread and bread supplemented with mycelium. Bread supplemented with fermented grains contained substantial mass fractions (on dry mass basis of adenosine (0.92–1.96 μg/g, ergosterol (24.53–30.12 μg/g, ergothioneine (2.16–3.18 μg/g and γ-aminobutyric acid (2.20–2.45 μg/g. In addition, bread supplemented with mycelium contained lovastatin (0.43 μg/g. White bread and bread supplemented with fermented grains had similar sensory results. Overall, fermented grains could be incorporated into bread to provide beneficial effects.

  18. Multiple supplements for beef heifers on pasture in dry season

    Directory of Open Access Journals (Sweden)

    Renata Pereira da Silva-Marques

    2015-02-01

    Full Text Available The objective was to evaluate levels of multiple supplement for beef heifers in restricted grazing on average daily gain (ADG, economic analysis and intakes of total dry matter (TDMI, forage dry matter (FDMI, crude protein (CPI and total digestible nutrients (TDNI. For evaluation of performance and economic analysis, twenty Nellore heifers (328.45 kg were used. The following supplements were evaluated as fed to the animals: control (mineral supplement and supplementation levels of 2, 4 and 6 kg/animal/day, composing the following percentages of average body weight (ABW: 0.55, 1.11 and 1.66%, respectively. To evaluate the nutrient intake, additional five Nellore heifers with 344 kg, were used, which were submitted to same supplements previously mentioned, in addition to the level of 2.22% of ABW (8 kg/animal/day. Average daily gain showed quadratic behavior; TDMI, CPI and TDNI had increasing linear behavior; and FDMI showed decreasing linear behavior in function of the supplementation levels. The strategy of supplying 0.55, 1.11 and 1.66% of the ABW to heifers on restricted grazing provides additional weight gains of 608, 762 and 943 g/day, respectively, which are effective in promoting similar productive and economic performance to those obtained in grazing systems in the rainy period.

  19. Quality of Bread Supplemented with Antrodia
salmonea-Fermented Grains

    Science.gov (United States)

    Chien, Rao-Chi; Ulziijargal, Enkhjargal

    2016-01-01

    Summary Fermented grains of buckwheat, oat, embryo rice and wheat, which were prepared by solid-state fermentation with Antrodia salmonea, and the mycelium was used to substitute 7% of wheat flour to make bread. No difference in proximate composition, texture profile and contents of non-volatile taste components was observed among bread samples. White bread and bread supplemented with mycelium and fermented grains looked different. Bread supplemented with fermented grains had similar thermal properties, which differed from those of white bread and bread supplemented with mycelium. Bread supplemented with fermented grains contained substantial mass fractions (on dry mass basis) of adenosine (0.92–1.96 µg/g), ergosterol (24.53–30.12 µg/g), ergothioneine (2.16–3.18 µg/g) and γ-aminobutyric acid (2.20–2.45 µg/g). In addition, bread supplemented with mycelium contained lovastatin (0.43 µg/g). White bread and bread supplemented with fermented grains had similar sensory results. Overall, fermented grains could be incorporated into bread to provide beneficial effects. PMID:27904408

  20. Is selenium supplementation in autoimmune thyroid diseases justified?

    Science.gov (United States)

    Winther, Kristian H; Bonnema, Steen J; Hegedüs, Laszlo

    2017-10-01

    This review provides an appraisal of recent evidence for or against selenium supplementation in patients with autoimmune thyroid diseases, and discusses possible effect mechanisms. Epidemiological data suggest an increased prevalence of autoimmune thyroid diseases under conditions of low dietary selenium intake. Two systematic reviews have evaluated controlled trials among patients with autoimmune thyroiditis and report that selenium supplementation decreases circulating thyroid autoantibodies. The immunomodulatory effects of selenium might involve reducing proinflammatory cytokine release. However, clinically relevant effects of selenium supplementation, including improvement in quality of life, are more elusive. In Graves' disease, some, but not all, trials indicate that adjuvant selenium supplementation enhances the restoration of biochemical euthyroidism, and might benefit patients with mild Graves' orbitopathy. The use of selenium supplementation as adjuvant therapy to standard thyroid medication may be widespread, but a growing body of evidence yields equivocal results. The available evidence from trials does not support routine selenium supplementation in the standard treatment of patients with autoimmune thyroiditis or Graves' disease. However, correction of moderate to severe selenium deficiency may offer benefits in preventing, as well as treating, these disorders. Molecular mechanisms have been proposed, but further studies are needed.

  1. Selecting appropriate absorbent products to treat urinary incontinence.

    Science.gov (United States)

    Payne, Drew

    2015-11-01

    Urinary incontinence can have a significant negative effect on a person's life, especially if left unmanaged and untreated. Continence assessment, often carried out by community nurses, is an important element in the management of a person's urinary incontinence, and so is the selection of appropriate absorbent incontinence pads. This article reviews: the causes and effects of urinary incontinence; how to derive the most appropriate information from a continence assessment; strategies for selecting incontinence pads for a person, on the basis of the results of the continence assessment; and some of the problems and risks associated with the use of incontinence pads.

  2. Appropriate Use Criteria for Hyaluronic Acid in the Treatment of Knee Osteoarthritis in the United States

    Science.gov (United States)

    Bhadra, Arup K.; Altman, Roy; Dasa, Vinod; Myrick, Karen; Rosen, Jeffrey; Vad, Vijay; Vitanzo, Peter; Bruno, Michelle; Kleiner, Hillary; Just, Caryn

    2016-01-01

    Objective: A workgroup of clinical experts has developed an Appropriate Use Criteria (AUC) for the use of hyaluronic acid (HA) in the treatment of osteoarthritis (OA) of the knee. The increasingly broad and varied use of HA injections, lack of published clinical guidance, and limited coverage for their use has created the imperative to establish appropriateness criteria. Methods: The experts of this workgroup represent rheumatology, orthopedic surgery, physiatry, sports medicine, and nursing clinicians with substantive knowledge of intra-articular HA therapy. This workgroup utilized the results of a systematic review of evidence, expert clinical opinion, and current evidence-based clinical practice guidelines to develop appropriateness criteria for the use of intra-articular HA for knee OA in 17 real-world clinical scenarios. Results: The workgroup scored the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as appropriate (7-9), uncertain (4-6), or inappropriate (1-3). Six scenarios were scored as appropriate, 10 scenarios were scored as uncertain, and 1 scenario was scored as inappropriate. Conclusion: This article can assist clinicians in shared decision-making by providing best practices in considering HA injections for knee OA treatment. Moreover, this AUC article can aid payers and policy makers in determining reimbursement and preauthorization policies and more appropriately managing health care resources. It is clear that further research is still necessary—particularly in patient populations differentiated by OA severity—that may benefit the greatest from the use of HA injections for the treatment of knee OA. PMID:28618868

  3. Safety evaluation report related to the operation of Watts Bar Nuclear Plant, Units 1 and 2 (Docket Nos. 50-390 and 50-391). Supplement No. 15

    Energy Technology Data Exchange (ETDEWEB)

    Tam, P.S.

    1995-06-01

    This report supplements the Safety Evaluation Report (SER), NUREG-0847 (June 1982), Supplement No. 1 (September 1982), Supplement No. 2 (January 1984), Supplement No. 3 (January 1985), Supplement No. 4 (March 1985), Supplement No. 5 (November 1990), Supplement No. 6 (April 1991), Supplement No. 7 (September 1991), Supplement No. 8 (January 1992), Supplement No. 9 (June 1992), Supplement No. 10 (October 1992), Supplement No. 11 (April 1993), Supplement No. 12 (October 1993), Supplement No. 13 (April 1994), and Supplement No. 14 (December 1994) issued by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission with respect to the application filed by the Tennessee Valley Authority, as applicant and owner, for licenses to operate the Watts Bar Nuclear Plant, Units 1 and 2 (Docket Nos. 50-390 and 50-391). The facility is located in Rhea County, Tennessee, near the Watts Bar Dam on the Tennessee River. This supplement provides recent information regarding resolution of some of the outstanding and confirmatory items, and proposed license conditions identified in the SER.

  4. Oral creatine supplementation: separating fact from hype.

    Science.gov (United States)

    Juhn, M S

    1999-05-01

    Many athletes-especially those participating in sports that emphasize strength-are taking oral creatine. Creatine supplements appear to enhance performance in repeated short bursts of stationary cycling and weight lifting, but the data on running, swimming, and single cycle sprints are not convincing of an ergogenic effect. Commonly reported side effects include muscle cramping, GI disturbances, and renal dysfunction, but creatine's effect on the heart, brain, reproductive organs, and other organs has yet to be determined. Comprehensive studies with larger samples and crossover design are needed. If patients decide to take oral creatine, physicians need to provide guidance for proper dosing as well as education about potential harmful effects.

  5. Vitamin C supplementation in pregnancy.

    Science.gov (United States)

    Rumbold, Alice; Ota, Erika; Nagata, Chie; Shahrook, Sadequa; Crowther, Caroline A

    2015-09-29

    Vitamin C supplementation may help reduce the risk of pregnancy complications such as pre-eclampsia, intrauterine growth restriction and maternal anaemia. There is a need to evaluate the efficacy and safety of vitamin C supplementation in pregnancy. To evaluate the effects of vitamin C supplementation, alone or in combination with other separate supplements on pregnancy outcomes, adverse events, side effects and use of health resources. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2015) and reference lists of retrieved studies. All randomised or quasi-randomised controlled trials evaluating vitamin C supplementation in pregnant women. Interventions using a multivitamin supplement containing vitamin C or where the primary supplement was iron were excluded. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Twenty-nine trials involving 24,300 women are included in this review. Overall, 11 trials were judged to be of low risk of bias, eight were high risk of bias and for 10 trials it was unclear. No clear differences were seen between women supplemented with vitamin C alone or in combination with other supplements compared with placebo or no control for the risk of stillbirth (risk ratio (RR) 1.15, 95% confidence intervals (CI) 0.89 to 1.49; 20,038 participants; 11 studies; I² = 0%; moderate quality evidence), neonatal death (RR 0.79, 95% CI 0.58 to 1.08; 19,575 participants; 11 studies; I² = 0%), perinatal death (average RR 1.07, 95% CI 0.77 to 1.49; 17,105 participants; seven studies; I² = 35%), birthweight (mean difference (MD) 26.88 g, 95% CI -18.81 to 72.58; 17,326 participants; 13 studies; I² = 69%), intrauterine growth restriction (RR 0.98, 95% CI 0.91 to 1.06; 20,361 participants; 12 studies; I² = 15%; high quality evidence), preterm birth (average RR 0.99, 95% CI 0.90 to 1.10; 22,250 participants; 16 studies; I² = 49%; high quality evidence

  6. Boron supplementation in broiler diets

    Directory of Open Access Journals (Sweden)

    EJ Fassani

    2004-12-01

    Full Text Available Boron supplementation in broiler feed is not a routine practice. However, some reports suggest a positive effect of boron on performance. This study assessed the effects of boron supplementation on broiler performance. Diets were based on maize and soybean meal, using boric acid P.A. as boron source. Six supplementation levels (0, 30, 60, 90, 120 and 150 ppm were evaluated using 1,440 one-day old males housed at a density of 30 chickens in each of 48 experimental plots of 3m². A completely randomized block design was used with 8 replicates. Feed intake, weight gain and feed conversion were assessed in the periods from 1 to 7 days, 1 to 21 days and 1 to 42 days of age, and viability was evaluated for the total 42-day rearing period. No performance variable was affected by boron supplementation (p>0.05 in the period from 1 to 7 days. The regression analysis indicated an ideal level of 37.4 ppm of boron for weight gain from 1 to 21 days (p0.05, although feed intake was reduced linearly with increased boron levels (p0.05. Ash and calcium percentages in the tibias of broilers and viability in the total rearing period were not affected by boron supplementation (p>0.05.

  7. An 8-year experience with routine SL mix patch testing supplemented with Compositae mix in Denmark

    DEFF Research Database (Denmark)

    Paulsen, E; Andersen, Klaus Ejner; Hausen, B M

    2001-01-01

    Routine patch testing with sesquiterpene lactone (SL) mix, supplemented with Compositae mix (CM) and other Compositae extracts and allergens where appropriate, was evaluated over an 8-year period. 190 of 4386 patients tested (4.3%) were Compositae-sensitive, 143 females (mean age 51.5 years) and 47...

  8. Fault Detection of a Wheelset Bearing Based on Appropriately Sparse Impulse Extraction

    Directory of Open Access Journals (Sweden)

    Jianming Ding

    2017-01-01

    Full Text Available Convolution sparse representation (CSR is a novel compressive sensing technique proposed in 2016 and provides an excellent framework for extracting the impulses induced by bearing faults and the unevenness of wheel tread. However, its sparsity performance on extracting impulses is sensitive to the improper penalty parameter. So, a novel fault detection method, appropriately sparse impulse extraction, is proposed based on the combination of CSR, estimating the number of atom types (ENA, and crest factor. The type of atoms embedded in vibration signals is estimated by ENA. Aiming at the different types of atoms, the impulses with different sparse characteristic are spanned by CSR with different penalty parameters. The appropriately sparse impulses are selected for fault detection based on the maximal crest factor. The simulation validation, experiment verification, and practical application are conducted to validate the effectiveness of the proposed appropriately sparse impulses extraction. These results show that the proposed appropriately sparse impulse extraction not only can obtain fault-characteristic frequency and its harmonics for fault judgment but also describes the dynamic behaviour between elementary defects and their matching surfaces. In addition, the proposed appropriately sparse impulse extraction can isolate the impulses with different types of atoms and is very suitable for detecting the wheelset bearing faults.

  9. Adoption, adaptation, and abandonment: Appropriation of science education professional development learning

    Science.gov (United States)

    Longhurst, Max L.

    Understanding factors that impact teacher utilization of learning from professional development is critical in order maximize the educational and financial investment in teacher professional learning. This study used a multicase mixed quantitative and qualitative methodology to investigate the factors that influence teacher adoption, adaption, or abandonment of learning from science teacher professional development. The theoretical framework of activity theory was identified as a useful way to investigate the phenomenon of teacher appropriation of pedagogical practices from professional development. This framework has the capacity to account for a multitude of elements in the context of a learning experience. In this study educational appropriation is understood through a continuum of how an educator acquires and implements both practical and conceptual aspects of learning from professional development within localized context. The variability associated with instructional changes made from professional development drives this inquiry to search for better understandings of the appropriation of pedagogical practices. Purposeful sampling was used to identify two participants from a group of eighth-grade science teachers engaged in professional development designed to investigate how cyber-enabled technologies might enhance instruction and learning in integrated science classrooms. The data from this investigation add to the literature of appropriation of instructional practices by connecting eight factors that influence conceptual and practical tools with the development of ownership of pedagogical practices in the appropriation hierarchy. Recommendations are shared with professional development developers, providers, and participants in anticipation that future science teaching experiences might be informed by findings from this study.

  10. Early Postnatal Growth Of Preterm Low Birth Weight, Appropriately ...

    African Journals Online (AJOL)

    Background: Postnatal growth monitoring is useful in assessing the health of preterm babies but their growth patterns have not been sufficiently studied in Africans. Aim: To describe the growth achievements of preterm, low birth weight, appropriately-sized, Nigerian infants. Study design: The subjects were prospectively ...

  11. 34 CFR 300.17 - Free appropriate public education.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Free appropriate public education. 300.17 Section 300.17 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF...

  12. Even Sewage Is a Resource...for "Appropriate Technology."

    Science.gov (United States)

    Hand, Marge

    1980-01-01

    Recounts highlights of a 1980 weekend course at Queens College Environmental Center (New York) focusing on lessons from history and other cultures in using overlooked resources to develop "Appropriate Technology." Practical and innovative energy alternatives discussed include solar energy, wind power, indoor hydroponic farming, shellfish…

  13. Selection of an Appropriate Interpolation Method for Rainfall Data In ...

    African Journals Online (AJOL)

    Interpolation technique can be used to establish the rainfall data at the location of interest from available data. There are many interpolation methods in use with various limitations and likelihood of errors. This study applied five interpolation methods to existing rainfall data in central Nigeria to determine the most appropriate ...

  14. Developing criteria for Cesarean Section using the RAND appropriateness method

    Directory of Open Access Journals (Sweden)

    Rashidi Batool

    2010-09-01

    Full Text Available Abstract Background Cesarean section rates are increasing worldwide, and a rapid increase has been observed in Iran. Disagreement exists between clinicians about when to use cesarean section. We aimed to identify the appropriateness criteria for the use of cesarean section in Iran. Method A consensus development study using a modified version of the RAND Appropriateness Method (RAM. We generated scenarios from valid clinical guidelines and expert opinions. A panel of experts participated in consensus development: first round via mail (12 members, second round face-to-face (9 members. We followed the RAM recommendations for the development of the scenario lists, rating scales, and statistical analyses. Results 294 scenarios relevant to cesarean section were identified. 191 scenarios were considered appropriate, of which 125 scenarios were agreed upon. The panel found cesarean inappropriate for 21% of scenarios, and 'equivocal' for 14% of scenarios. Conclusion RAM is useful for identifying stakeholder views in settings with limited resources. The participants' views on appropriateness of certain indications differed with available evidence. A large number of scenarios without agreement may partly explain why it has been difficult to curb the growth in cesarean section rate.

  15. 24 CFR 100.143 - Appropriate corrective action.

    Science.gov (United States)

    2010-04-01

    ... FAIR HOUSING DISCRIMINATORY CONDUCT UNDER THE FAIR HOUSING ACT Discrimination in Residential Real... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Appropriate corrective action. 100.143 Section 100.143 Housing and Urban Development Regulations Relating to Housing and Urban...

  16. Appropriate selection for omalizumab treatment in patients with severe asthma?

    DEFF Research Database (Denmark)

    Nygaard, Leo; Henriksen, Daniel Pilsgaard; Madsen, Hanne

    2017-01-01

    .3-11.1, p = 0.0005), respectively. Conclusion: Only 42% of the omalizumab-treated patients were appropriately selected according to current guidelines. Still, as omalizumab showed significant improvement in asthma control over time, it is important to keep this drug in mind as an add-on to asthma therapy...

  17. Selecting appropriate methods of knowledge synthesis to inform biodiversity policy

    NARCIS (Netherlands)

    Pullin, Andrew; Frampton, Geoff; Jongman, Rob; Kohl, Christian; Livoreil, Barbara; Lux, Alexandra; Pataki, György; Petrokofsky, Gillian; Podhora, Aranka; Saarikoski, Heli; Santamaria, Luis; Schindler, Stefan; Sousa-pinto, Isabel; Vandewalle, Marie; Wittmer, Heidi

    2016-01-01

    Responding to different questions generated by biodiversity and ecosystem services policy or management requires different forms of knowledge (e.g. scientific, experiential) and knowledge synthesis. Additionally, synthesis methods need to be appropriate to policy context (e.g. question types,

  18. Training L2 Learners to Use Facebook Appropriately and Effectively

    Science.gov (United States)

    Prichard, Caleb

    2013-01-01

    Recognizing how essential communication technologies have become to language learners, the TESOL Technology Standards Task Force set three goals for learners (Healey et al., 2011): 1) demonstrating skills in technology for a multilingual world, 2) using technology appropriately and ethically, and 3) using and evaluating technology for language…

  19. Kangaroo Mother Care: Using Appropriate Technology for the Care ...

    African Journals Online (AJOL)

    Kangaroo Mother Care: Using Appropriate Technology for the Care of Premature and Low Birth Weight Infants - A review. ... Currently, this method of care consists of three components: (a) Kangaroo position (skin-to-skin contact between a mother's bare breast and her nearly naked infant – except for a diaper, and woollen ...

  20. Developmentally Appropriate Music Practice: Children Learn What They Live.

    Science.gov (United States)

    Neelly, Linda Page

    2001-01-01

    Discusses how adults can infuse music in young children's routines to nurture powerful learning connections. Includes discussion of musical development, its impact on other developmental domains, and brain development and music. Highlights four music activities to illustrate developmentally appropriate music experiences, asserting that…

  1. Counselling as a psychological approach to fostering appropriate ...

    African Journals Online (AJOL)

    The focus of this paper is on counselling as a psychological approach to fostering appropriate learning behaviour in Nigerian secondary school students. The paper drew attention to the confrontation, mentoring, behavioural, appraisal, and standards blending models to appeal to the consciences of students with ...

  2. Appropriation des technologies de l'information et de la ...

    African Journals Online (AJOL)

    ... de nos entreprises; et 2) les effets des TIC sur ces modes sont explicables et mesurables. Ces hypothèses Sont confirmées par le travail de hiérarchisation des variables stratégiques explicatives retenues à cet effet. Mots clés: TIC, entreprise algérienne, organisation et management, utilisation et appropriation des TIC ...

  3. Cultural Appropriation, Performance, and Agency in Mexicana Parent Involvement

    Science.gov (United States)

    Galindo, Rene; Medina, Christina

    2009-01-01

    Parental agency is examined in the creation of a dance performance by a group of Mexican immigrant mothers that combined a mixture of genres into an educational message. The "folklorico" performance resulted from a process of cultural appropriation involving linguistic, cultural, and experiential "translations." This process was concerned with…

  4. The anaerobic baffled reactor (ABR): An appropriate technology for ...

    African Journals Online (AJOL)

    This project has studied the appropriateness of the ABR for on-site primary sanitation in low-income communities. The baffled design of the ABR ensures high solids retention resulting in high treatment rates, while the overall sludge production is characteristically low. Effluent COD values measured from a 3 000 l pilot ABR ...

  5. (Mis)Appropriations of Gadamer in Qualitative Research: A ...

    African Journals Online (AJOL)

    However, teaching the practice of phenomenological psychological research requires careful articulation of the differences between a descriptive and an ... This investigation is undertaken in the light of some researchers' appropriations of Gadamer's philosophical hermeneutics in the service of non-methodical praxes.

  6. Defense: FY2017 Budget Request, Authorization, and Appropriations

    Science.gov (United States)

    2016-04-12

    planes , combat vehicles, and associated equipment. This is a $2.0 billion increase from the amount appropriated for depot maintenance in FY2016. Since...attempts to relieve some of that budget pressure by deferring planned acquisitions. The request includes $4.4 billion for 43 F-35A Lightning II

  7. Identification of appropriate tools of information and communication ...

    African Journals Online (AJOL)

    Access to sufficient and desirable food is one of the principles of any developing and healthy society. One of the important means for attainment of food security is information and communication technologies (ICT). The purpose of the research was to identify appropriate tools of ICT in improving food security of Iran's rural ...

  8. Towards a more situation appropriate and responsive extension ...

    African Journals Online (AJOL)

    Towards a more situation appropriate and responsive extension approach for Ethiopia. ... In the analysis of data the ordinary least squares (OLS) regression methods were employed to identify the most important determinants associated with behavioural change. The results indicate that, in general, the intervening variables ...

  9. Small-Sided Games: Developmentally Appropriate Applications in Traditional Activities.

    Science.gov (United States)

    Petersen, Susan; Cruz, Luz

    This paper presents a systematic progression of small-sided games within two traditional sports units (soccer and volleyball). Developmentally appropriate guidelines encourage teachers at all levels to incorporate small-sided games (2v2, 3v3, and 4v4). Advantages of small-sided games include: allowing students numerous practice opportunities;…

  10. Relations between the technological standards and technological appropriation

    Directory of Open Access Journals (Sweden)

    Carlos Alberto PRADO GUERRERO

    2010-06-01

    Full Text Available The objective of this study is to analyze the educational practices of using Blackboard in blended learning environments with students of higher education to understand the relationship between technological appropriation and standards of educational technology. To achieve that goal, the following research question was raised: ¿To what extent are the standards of education technology with the appropriation of technology in blended learning environments in higher educa­tion related? The contextual framework of this work includes the following topics: the institution, teaching, teachers and students. The design methodology that was used is of a correlation type. Correlations were carried out to determine the frequency and level in the technological standards as well as the appropriation of technology. In the comparison of the results obtained by the students, the teachers and the platform; we found that students in the school study showed a high degree of technology ownership and this was the same for the performance shown on the technological standards. It was established that teachers play a key role in developing the techno­logical appropriation of students and performance in technology standards.

  11. Valid, Reliable, and Appropriate Assessments for Adult English Language Learners

    Science.gov (United States)

    Kenyon, Dorry; Van Duzer, Carol

    2003-01-01

    Ensuring that language tests for adult English language learners are appropriate, valid, and reliable is a challenge. Performance-based assessments are complex to develop and implement. Yet, because the focus of assessment, both in the National Reporting System for Adult Education (NRS) descriptors and in the Department of Education's definition…

  12. Need for appropriate specimen for microbiology diagnosis of chronic osteomyelitis

    Directory of Open Access Journals (Sweden)

    Lakshmi Vemu

    2018-01-01

    CONCLUSION: As per our data, the culture yield from wound swabs was low or contaminated with normal skin flora, as compared to the biopsy or tissue specimen. Hence, an appropriate sampling of the infected bone using recommended protocols is highly essential for improving microbiological yield and the outcome of COM.

  13. Appropriate tools and methods for tropical microepidemiology: a ...

    African Journals Online (AJOL)

    Whilst the Global Positioning System (GPS) allows accurate and easy determination of latitude and longitude, sophisticated Geographical Information Systems (GIS) that can process the data may not be available and accessible where they are most needed. Objective: To describe an appropriate procedure for interpreting ...

  14. Choosing appropriate temporal and spatial scales for ecological ...

    Indian Academy of Sciences (India)

    ... post-settlement human disturbances have exceeded the limits of such scales, settlement conditions can be justified scientifically as appropriate targets of restoration efforts without recourse to obsolete teleological concepts of equilibria and without ignoring the presence and ecological influence of indigenous peoples.

  15. A case study of culturally appropriate conservation education

    Science.gov (United States)

    David N. Bengston; Michele. Schermann

    2016-01-01

    Create culturally appropriate conservation education materials for Hmong Americans, including new refugees and elders with little proficiency in English, as well as the broader, multigenerational Hmong community. This case study discusses an organizational response from the USDA Forest Service, in partnership with others, to better serve the Hmong American community....

  16. Appropriations, Congress & Budget Execution Color of Money 101

    Science.gov (United States)

    2011-08-29

    Appropriation Bill • Grants the Budget Authority for the Program • Budget Authority May Be Above or Below What was Authorized Mother , may I...PERMISSION Dad, can I have some dough to ….. FUNDING Congressional Enactment Timetable JAN FEB MAR APR MAY JUN JUL

  17. Appropriate and non-medical use of methylphenidate by residence ...

    African Journals Online (AJOL)

    The purpose was to determine to what degree residence students from a tertiary academic institution use methylphenidate in both non-medical and appropriate manners in the South African context. Reasons for use, doses consumed and side effects experienced were investigated. The study followed a quantitative ...

  18. Judgments of Social Appropriateness by Children and Adolescents with Autism.

    Science.gov (United States)

    Loveland, Katherine A.; Pearson, Deborah A.; Tunali-Kotoski, Belgin; Ortegon, Juliana; Gibbs, M. Cullen

    2001-01-01

    This study compared judgments of social appropriateness to videotaped scenes by children and adolescents with (n=19) and without (n=19) autism. The non-autism group detected inappropriate behaviors significantly more often than the autism group for verbal but not nonverbal scenes. Groups also differed in the reasons given for their judgments in…

  19. evaluation of the appropriateness of certain grain production ...

    African Journals Online (AJOL)

    p2333147

    developing sector in South Africa call for a balanced and context based strategy. A combination of both paradigms ... scorecard was designed to help assess the appropriateness of the individual technologies based on ... criteria for the assessment of the technologies on the scorecard. The criteria are: i). Felt need – Do the ...

  20. Improving Library and Information Services: use of appropriate ...

    African Journals Online (AJOL)

    The focus of this paper is on how to improve services in libraries and information centers in Nigeria by the use of appropriate Information Communication Technology (ICT). Nigerian Libraries as reviewed in this paper are still not fully ICT compliant. Five sub-topics were discussed in order to articulate the focus of the paper.

  1. Developing Students' Thought Processes for Choosing Appropriate Statistical Methods

    Science.gov (United States)

    Murray, James; Knowles, Elizabeth

    2014-01-01

    Students often struggle to select appropriate statistical tests when investigating research questions. The authors present a lesson study designed to make students' thought processes visible while considering this choice. The authors taught their students a way to organize knowledge about statistical tests and observed its impact in the classroom…

  2. The Appropriation of Fine Art into Contemporary Narrative Picturebooks

    Science.gov (United States)

    Serafini, Frank

    2015-01-01

    Many picturebook artists have been formally trained in specific artistic styles, movements, and techniques. These artists appropriate and transform works of fine art to varying degrees to fit the themes and designs of the stories they illustrate and publish, and to increase the significance and impact of their illustrations. The…

  3. Developing an Appropriate Goalball Unit for Secondary Physical Education

    Science.gov (United States)

    Laughlin, Michael K.; Happel, Kathleen

    2016-01-01

    Goalball, a sport designed for those with visual impairments, is a competitive and recreational sport enjoyed by athletes around the world. Students with and without visual impairments can experience positive outcomes when teachers appropriately include a goalball unit as part of their inclusive secondary physical education curriculum. This…

  4. Reliability and validity of the Chinese version Appropriateness Evaluation Protocol

    NARCIS (Netherlands)

    Liu, W. (Wenwei); Yuan, S. (Suwei); Wei, F. (Fengqing); Yang, J. (Jing); Zhang, Z. (Zhe); C. Zhu (Changbin); Ma, J. (Jin)

    2015-01-01

    textabstractObjective: To adapt the Appropriateness Evaluation Protocol (AEP) to the specific settings of health care in China and to validate the Chinese version AEP (C-AEP). Methods: Forward and backward translations were carried out to the original criteria. Twenty experts participated in the

  5. MySQL based selection of appropriate indexing technique in ...

    African Journals Online (AJOL)

    This paper deals with selection of appropriate indexing technique applied on MySQL Database for a health care system and related performance issues using multiclass support vector machine (SVM). The patient database is generally huge and contains lot of variations. For the quick search or fast retrieval of the desired ...

  6. Reading Disability: The Genetics Connection and Appropriate Action.

    Science.gov (United States)

    Fielding-Barnsley, Ruth

    This paper presents an overview of recent findings relating to the influence of genetics on reading disability. The paper questions the appropriateness of the etiology of reading disability and its possible relevance to remediation. It finds that early identification of children who are at risk of reading failure due to a genetic cause could help…

  7. Is English Language Really the Appropriate Language for Health ...

    African Journals Online (AJOL)

    The research instruments used for this work were questionnaire, interview and general observation. Since one of the targets of the Millennium Development Goals is the attainment of health for all by the year 2015, it is therefore important that health issues are communicated appropriately through the choice of a language ...

  8. Open Source as Appropriate Technology for Global Education

    Science.gov (United States)

    Carmichael, Patrick; Honour, Leslie

    2002-01-01

    Economic arguments for the adoption of "open source" software in business have been widely discussed. In this paper we draw on personal experience in the UK, South Africa and Southeast Asia to forward compelling reasons why open source software should be considered as an appropriate and affordable alternative to the currently prevailing…

  9. 16PF in screening for appropriateness of mentors.

    Science.gov (United States)

    Garner, Curtis M; Byars, Allyn; Greenwood, Michael; Garner, Karen A

    2003-02-01

    The utility of the Sixteen Personality Factor Questionnaire, Fifth Edition (16PF) as an indicator of mentor effectiveness was examined. A random sample of the 16PF scores of 74 mentors was drawn from a population of 837 mentors from Big Brothers Big Sisters. Caseworkers rated mentor's effectiveness using a rubric developed for this purpose. The rubric showed good interrater agreement. Caseworkers' ratings of mentor's effectiveness was used to rate mentors systematically as appropriate or inappropriate. The 16PF scores of mentors were compared at an alpha level of .05 for appropriate and inappropriate groups using independent t tests and multivariate analyses of variance, which reflected significant differences between male and female mentors on Factors E and Q3. Significant differences were also found between "appropriate" and "inappropriate" mentors on Factors L and Q4. These differences reflected only moderate effect sizes and lacked practical significance or meaning. The results suggest that, while the 16PF discriminates statistically between "appropriate" and "inappropriate" mentors, in terms of practical significance, the questionnaire is not particularly useful as an initial screening tool.

  10. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Anderson de [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Comissão Nacional de Energia Nuclear - CNEN (Brazil); Rezende, Maria Fernanda [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Corrêa, Renato; Mousinho, Rodrigo [Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Azevedo, Jader Cunha [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Miranda, Sandra Marina; Oliveira, Aline Ribeiro [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Gutterres, Ricardo Fraga [Comissão Nacional de Energia Nuclear - CNEN (Brazil); Mesquita, Evandro Tinoco; Mesquita, Cláudio Tinoco [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil)

    2014-11-15

    Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

  11. Assessing Students' Perceptions of Inappropriate and Appropriate Teacher Humor

    Science.gov (United States)

    Frymier, Ann Bainbridge; Wanzer, Melissa Bekelja; Wojtaszczyk, Ann M.

    2008-01-01

    This study replicated and extended a preliminary typology of appropriate and inappropriate teacher humor and advanced three explanations for differences in interpretations of teacher humor. Students were more likely to view teacher humor as inappropriate when it was perceived as offensive and when it demeaned students as a group or individually.…

  12. Provider of Services File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The POS file consists of two data files, one for CLIA labs and one for 18 other provider types. The file names are CLIA and OTHER. If downloading the file, note it...

  13. The Provident Principal.

    Science.gov (United States)

    McCall, John R.

    This monograph offers leadership approaches for school principals. Discussion applies the business leadership theory of Warren Bennis and Burt Nanus to the role of the principal. Each of the booklet's three parts concludes with discussion questions. Part 1, "Visions and Values for the Provident Principal," demonstrates the importance of…

  14. What HERA may provide?

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hannes [DESY, Hamburg (Germany); De Roeck, Albert [CERN, Genf (Switzerland); Bartles, Jochen [Univ. Hamburg (DE). Institut fuer Theoretische Physik II] (and others)

    2008-09-15

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. (orig.)

  15. care Providers in Ibadan

    African Journals Online (AJOL)

    Three hundred and eighty six respondents (77.7%) were aware of intermittent preventive treatment (IPT). Awareness ... Key Words: malaria in pregnancy, intermittent preventive treatment, malaria control, health care providers. Department of Obstetrics .... Auxiliary nurses do not have formal training prior to employment.

  16. Working with culture: culturally appropriate mental health care for Asian Americans.

    Science.gov (United States)

    Park, Mijung; Chesla, Catherine A; Rehm, Roberta S; Chun, Kevin M

    2011-11-01

    The aim of this study is to describe how mental healthcare providers adapted their practice to meet the unique needs of Asian Americans. As the number of ethnic minorities and multicultural patients and families rapidly increases, cultural competency becomes an essential skill for all healthcare providers. The lack of knowledge about how healthcare providers grapple with diverse cultures and cultural competency limits the ability of others to deliver patient-centred care across cultural lines. Interpretive phenomenology guided the design and conduct of this study. Twenty mental healthcare providers who treated Asian Americans were recruited. Narrative data were collected through face-to-face, in-depth interviews between 2006 and 2007. Three characteristics of culturally appropriate care for Asian Americans were identified. Cultural brokering: providers addressed issues stemming from cultural differences via bicultural skills education. Asian American patients generally received broader education than current literature recommended. Supporting families in transition: providers assisted Asian American families during transition from and to professional care. Using cultural knowledge to enhance competent care: providers' knowledge of Asian culture and flexible attitudes affected the care that they provided. Culturally competent providers were able to identify cultural issues that were relevant to the specific situation, and incorporated cultural solutions into the care provided. Culturally appropriate care is nuanced and context specific. Thus, more sophisticated and broader conceptualizations are necessary to prepare nurses for such complex practice. © 2011 Blackwell Publishing Ltd.

  17. Usefulness of Hand-Held Ultrasonography as a Gatekeeper to Standard Echocardiography for "Rarely Appropriate" Echocardiography Requests.

    Science.gov (United States)

    Pathan, Faraz; Fonseca, Ricardo; Marwick, Thomas H

    2016-11-15

    Adoption of appropriate use criteria has not had a major impact on the frequency of "rarely appropriate" tests, with the rarely appropriate tests rate remaining at ∼20% in most institutions. We sought whether access to hand-held ultrasound (HHU) could be an alternative means of reducing rarely appropriate requests. We compared 2 approaches to rarely appropriate requests; "standard transthoracic echocardiography" (SE) as requested (control) and HHU as a gatekeeper (HHU). Patients were followed up for 6 months and assessed for end points including time until scan, repeat echocardiography/cost of either strategy, new major pathology, and change in management. The most common rarely appropriate requests in both groups were assessment of infective endocarditis without positive blood cultures and precordial murmur evaluation in absence of any other signs or symptoms of cardiovascular disease. The groups had comparable age, gender, requesting physician, and inpatient versus outpatient distribution. HHU led to a 59% reduction in rarely appropriate requests requiring SE. HHU significantly reduced time to decision for inpatients (0 [interquartile range 0, 1] vs 2 days [interquartile range 1, 4], p change in management. In conclusion, HHU can be an effective gatekeeper to SE for rarely appropriate echocardiograms, reducing time to echocardiography and cost while satisfying the referring physician and avoiding repeat requests for SE. HHU provides a safety net that identifies potential important findings in rarely appropriate requests. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Internet Medline providers.

    Science.gov (United States)

    Vine, D L; Coady, T R

    1998-01-01

    Each database in this review has features that will appeal to some users. Each provides a credible interface to information available within the Medline database. The major differences are pricing and interface design. In this context, features that cost more and might seem trivial to the occasional searcher may actually save time and money when used by the professional. Internet Grateful Med is free, but Ms. Coady and I agree the availability of only three ANDable search fields is a major functional limitation. PubMed is also free but much more powerful. The command line interface that permits very sophisticated searches requires a commitment that casual users will find intimidating. Ms. Coady did not believe the feedback currently provided during a search was sufficient for sustained professional use. Paper Chase and Knowledge Finder are mature, modestly priced Medline search services. Paper Chase provides a menu-driven interface that is very easy to use, yet permits the user to search virtually all of Medline's data fields. Knowledge Finder emphasizes the use of natural language queries but fully supports more traditional search strategies. The impact of the tradeoff between fuzzy and Boolean strategies offered by Knowledge Finder is unclear and beyond the scope of this review. Additional software must be downloaded to use all of Knowledge Finders' features. Other providers required no software beyond the basic Internet browser, and this requirement prevented Ms. Coady from evaluating Knowledge Finder. Ovid and Silver Platter offer well-designed interfaces that simplify the construction of complex queries. These are clearly services designed for professional users. While pricing eliminates these for casual use, it should be emphasized that Medline citation access is only a portion of the service provided by these high-end vendors. Finally, we should comment that each of the vendors and government-sponsored services provided prompt and useful feedback to e

  19. Vitamin D supplementation for cystic fibrosis.

    Science.gov (United States)

    Ferguson, Janet H; Chang, Anne B

    2014-05-14

    Cystic fibrosis (CF) is a genetic disorder with multiorgan effects. In a subgroup with pancreatic insufficiency malabsorption of the fat soluble vitamins (A, D, E, K) may occur. Vitamin D is involved in calcium homeostasis and bone mineralisation and may have extraskeletal effects. This review examines the evidence for vitamin D supplementation in cystic fibrosis. To assess the effects of vitamin D supplementation on the frequency of vitamin D deficiency, respiratory outcomes and vitamin D toxicity in the cystic fibrosis population. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Date of the most recent search: 08 July 2013. Randomised and quasi-randomised controlled studies of vitamin D supplementation compared to placebo in the cystic fibrosis population regardless of exocrine pancreatic function. Both authors independently assessed the risk of bias of each included study and extracted outcome data (from published study information) for assessment of bone mineralization, growth and nutritional status, frequency of vitamin D deficiency, respiratory status, quality of life and adverse events. Six studies (239 participants) are included, although only three studies provided data from 69 adults and children with cystic fibrosis for analysis. One study compared a single high dose of vitamin D (250,000 IU) to placebo at the time of hospital admission with a respiratory exacerbation in 30 pancreatic insufficient adults with cystic fibrosis. The second study compared supplemental 800 international units (IU) vitamin D and placebo for 12 months in 30 osteopenic pancreatic insufficient adults; both groups continued 900 IU vitamin D daily. The third study compared supplemental 1 g calcium alone, 1600 IU vitamin D alone, 1600 IU vitamin D and 1 g calcium and placebo in a double

  20. Providing plastic zone extrusion

    Science.gov (United States)

    Manchiraju, Venkata Kiran; Feng, Zhili; David, Stan A.; Yu, Zhenzhen

    2017-04-11

    Plastic zone extrusion may be provided. First, a compressor may generate frictional heat in stock to place the stock in a plastic zone of the stock. Then, a conveyer may receive the stock in its plastic zone from the compressor and transport the stock in its plastic zone from the compressor. Next, a die may receive the stock in its plastic zone from the conveyer and extrude the stock to form a wire.

  1. The effect of supplementing untreated, urea-supplemented and urea ...

    African Journals Online (AJOL)

    ammoniated wheat-straw with maize-meal and/or .... experiment, in order to investigate the effects of straw treatment (untreated, supplemented with 2% urea or ..... High levels of soy bean meal and maize gluten meal were, however, found to suppress the ...

  2. Taking iron supplements

    Science.gov (United States)

    ... your health care provider tell you how many pills you should take each day and when you should take them. Taking more iron than your body needs can cause serious medical problems. Blood counts return to normal after 2 months of iron therapy for most people. ...

  3. E-mail as the Appropriate Method of Communication for the Decision-Maker When Soliciting Advice for an Intellective Decision Task.

    Science.gov (United States)

    Prahl, Andrew; Dexter, Franklin; Swol, Lyn Van; Braun, Michael T; Epstein, Richard H

    2015-09-01

    For many problems in operating room and anesthesia group management, there are tasks with optimal decisions, and yet experienced personnel tend to make decisions that are worse or no better than random chance. Such decisions include staff scheduling, case scheduling, moving cases among operating rooms, and choosing patient arrival times. In such settings, operating room management leadership decision-making should typically be autocratic rather than participative. Autocratic-style decision-making calls for managers to solicit and consider feedback from stakeholders in the decision outcome but to make the decision themselves using their expert knowledge and the facts received. For this to be effective, often the manager will obtain expert advice from outside the organization (e.g., health system). In this narrative review, we evaluate the advantages and disadvantages of using prompt asynchronous written communication (i.e., e-mail) as a communication channel for such interaction between a decision-maker (manager) and advisor. A detailed Appendix (Supplemental Digital Content, http://links.lww.com/AA/B72) lists each observational and experimental result. We find that the current ubiquitous role of e-mail for such communication is appropriate. Its benefits include improved time management via asynchronicity, low cognitive load (e.g., relative to Web conferencing), the ability to hide undesirable and irrelevant cues (e.g., physical appearance), the appropriateness of adding desirable cues (e.g., titles and degrees), the opportunity to provide written expression of confidence, and the ability for the advisor to demonstrate the answer for the decision-maker. Given that the manager is e-mailing an advisor whose competence the manager trusts, it is unnecessary to use a richer communication channel to develop trust. Finally, many of the limitations of e-mail can be rectified through training. We expect that decades from now, e-mail (i.e., asynchronous writing) between an

  4. Textual appropriation: totalitarian violence in Shakespeare’s Macbeth and Textual appropriation: totalitarian violence in Shakespeare’s Macbeth and

    Directory of Open Access Journals (Sweden)

    Anna Stegh Camati

    2008-04-01

    Full Text Available Adaptations and vernacular appropriations on page and stage offer alternative readings of Shakespeare’s plays, mediated by heterogeneous forces of race, language and culture Appropriation can take multiple forms, as each generation attempts to redefine Shakespeare in contemporary terms in an ongoing process of mutation (Marsden 9. In an essay entitled “The Postcolonial/Postmodern Shakespeare”, Jyotsna Singh states that the postmodernist tendency to pluralize and decenter all totalizing assumptions of the centre has altered traditional values: “the Shakespearean text is no longer sacrosanct: instead it is invaded by heteroglossia, or multiplicity of styles and forms in the Bakhtinian sense, that disrupt the cultural authority of the official English Shakespeare” (Kerr et alii 39. Adaptations and vernacular appropriations on page and stage offer alternative readings of Shakespeare’s plays, mediated by heterogeneous forces of race, language and culture Appropriation can take multiple forms, as each generation attempts to redefine Shakespeare in contemporary terms in an ongoing process of mutation (Marsden 9. In an essay entitled “The Postcolonial/Postmodern Shakespeare”, Jyotsna Singh states that the postmodernist tendency to pluralize and decenter all totalizing assumptions of the centre has altered traditional values: “the Shakespearean text is no longer sacrosanct: instead it is invaded by heteroglossia, or multiplicity of styles and forms in the Bakhtinian sense, that disrupt the cultural authority of the official English Shakespeare” (Kerr et alii 39.

  5. Nurses' opinions on appropriate administration of PRN range opioid analgesic orders for acute pain.

    Science.gov (United States)

    Gordon, Debra B; Pellino, Teresa A; Higgins, Gerry Ann; Pasero, Chris; Murphy-Ende, Kathleen

    2008-09-01

    The use of "as needed" or "pro re nata" (PRN) range opioid analgesic orders is a common clinical practice in the management of acute pain, designed to provide flexibility in dosing to meet an individual's unique needs. Range orders enable necessary adjustments in doses based on individual response to treatment. However, PRN range opioid orders have recently come under scrutiny as a source of confusion and as a medication management safety issue. How nurses administer range orders may vary based on their interpretation of the intent of an order, inadequate knowledge of analgesic titration, or exaggerated concerns about opioid safety. The purpose of this study was to investigate nurses' opinions of the appropriate implementation of range orders. Six hundred two nurses from one large academic medical center and one multihospital system completed an online survey using theoretic clinical vignettes to examine their opinions of appropriate analgesic administration practices. The majority of participants chose appropriate responses to the vignettes; however, there was a great deal of variability in responses. Those who had attended pain management courses were more likely to have a higher percentage of appropriate responses than those who had not attended courses. Years in practice and educational level were not significantly related to percentage of appropriate responses; however, there was a trend for nurses with a master's degree to have a higher percentage than nurses with other educational preparation. Consideration of opioid pharmacokinetics can provide logic to develop a new paradigm where range orders are replaced with orders that provide more explicit instructions to titrate an opioid to the most effective dose.

  6. An Evidence-Based Review of Fat Modifying Supplemental Weight Loss Products

    Directory of Open Access Journals (Sweden)

    Amy M. Egras

    2011-01-01

    Full Text Available Objective. To review the literature on fat modifying dietary supplements commonly used for weight loss. Methods. Recently published randomized, placebo-controlled trials were identified in PubMed, MEDLINE, International Pharmaceutical Abstracts, Cochrane Database, and Google Scholar using the search terms dietary supplement, herbal, weight loss, obesity, and individual supplement names. Discussion. Data for conjugated linoleic acid (CLA, Garcinia cambogia, chitosan, pyruvate, Irvingia gabonensis, and chia seed for weight loss were identified. CLA, chitosan, pyruvate, and Irvingia gabonensis appeared to be effective in weight loss via fat modifying mechanisms. However, the data on the use of these products is limited. Conclusion. Many obese people use dietary supplements for weight loss. To date, there is little clinical evidence to support their use. More data is necessary to determine the efficacy and safety of these supplements. Healthcare providers should assist patients in weighing the risks and benefits of dietary supplement use for weight loss.

  7. Providing Compassion through Flow

    Directory of Open Access Journals (Sweden)

    Lydia Royeen

    2015-07-01

    Full Text Available Meg Kral, MS, OTR/L, CLT, is the cover artist for the Summer 2015 issue of The Open Journal of Occupational Therapy. Her untitled piece of art is an oil painting and is a re-creation of a photograph taken while on vacation. Meg is currently supervisor of outpatient services at Rush University Medical Center. She is lymphedema certified and has a specific interest in breast cancer lymphedema. Art and occupational therapy serve similar purposes for Meg: both provide a sense of flow. She values the outcomes, whether it is a piece of art or improved functional status

  8. Providing Contraception to Adolescents.

    Science.gov (United States)

    Raidoo, Shandhini; Kaneshiro, Bliss

    2015-12-01

    Adolescents have high rates of unintended pregnancy and face unique reproductive health challenges. Providing confidential contraceptive services to adolescents is important in reducing the rate of unintended pregnancy. Long-acting contraception such as the intrauterine device and contraceptive implant are recommended as first-line contraceptives for adolescents because they are highly effective with few side effects. The use of barrier methods to prevent sexually transmitted infections should be encouraged. Adolescents have limited knowledge of reproductive health and contraceptive options, and their sources of information are often unreliable. Access to contraception is available through a variety of resources that continue to expand. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Ysla S. Catalina & Providence

    OpenAIRE

    Diazgranados, Carlos Nicolás; Torres Carreño, Guillermo Andrés; Castell, Edmon; Moreno, Santiago; Ramirez, Natalia

    2010-01-01

    Esta Hoja de Mano pertenece a la exposición temporal "Ysla S. Catalina & Providence". Contiene un resumen histórico de las Islas de Santa Catalina y Providencia en los idiomas inglés y español y un mapa del siglo VI que lo hace más didáctico apoyado por figuras recortables. Esta muestra hace parte del proyecto IDA y VUELTA del Sistema de Patrimonio Cultural y Museos SPM que gestiona la descentralización del patrimonio cultural de la Universidad Nacional de Colombia a otras ciudades del pa...

  10. Intake of Nutritional Supplements among People Exercising in Gyms in Beirut City

    Science.gov (United States)

    El Khoury, D.; Antoine-Jonville, S.

    2012-01-01

    The use of nutritional supplements among exercisers in gyms has been never investigated in the Middle East. The aim of the current study was to assess the prevalence intake of nutritional supplements and the potential influencing factors among people exercising in gyms in Beirut city. In this cross-sectional study, 512 exercisers, aged between 20 and 50 years, were randomly selected from gyms. The intake of nutritional supplements was reported among 36.3% (95% confidence interval 32.2–40.5) of participants, with a weak presence of medical supervision. Patterns of supplement use differed by gender and age. Men and younger exercisers were found to focus on supplements associated with performance enhancement and muscle building, while women and older exercisers were more concerned with health-promoting products such as vitamins, minerals, and herbal supplements. An appropriate dissemination of accurate and scientifically sound information regarding the benefits and side effects of nutritional supplements is highly recommended in the sports environment in Beirut city. PMID:22506105

  11. US Dietary Supplement Labeling Rules and the Possibility of Medical Cost Reduction.

    Science.gov (United States)

    Amagase, Harunobu

    2015-01-01

    US dietary supplements classified as foods are regulated under the Dietary Supplement Health and Education Act (DSHEA) and other rules. After the DSHEA established in 1994, the supplement market grew by about 4 times and reached $32 billion as of 2012. One of the major reasons for this market expansion is that consumers can recognize functions of the supplements by the structure/function (S/F) claims. S/F claims must not be false or misleading, and must be based upon reliable scientific evidence, especially clinical studies. At the same time, disclaimers must be shown on the package, which are "These statements have not been evaluated by the Food and Drug Administration (FDA). These products are not intended to diagnose, treat, cure or prevent any disease." Both the FDA and Federal Trade Commission (FTC) are responsible for label claims and advertisement of dietary supplements. S/F claims are not medical claims, but these may have impact on people's mindset to be healthier. Recent research shows utilizing dietary supplements in 4 major areas with 10 popular ingredients could hypothetically reduce medical costs by over $50 billion in the US in the period of 2013-2020. Predicted fewer health problems and reduced medical cost information will further increase awareness of supplement usage and thus may raise quality of life. These may reduce the medical cost significantly, if the products are used appropriately with sufficient consumer education.

  12. Supplements and inadvertent doping - how big is the risk to athletes.

    Science.gov (United States)

    Judkins, Catherine; Prock, Peter

    2012-01-01

    Despite ongoing improvements to regulatory and manufacturing guidelines, the potential for contaminated nutritional supplements to cause a failed doping test for an athlete remains a concern. Several surveys of supplements available through the internet and at retail have confirmed that many are contaminated with steroids and stimulants that are prohibited for use in elite sport. Suggested responses to this issue include the complete avoidance of all supplements. However, this approach seems to be unrealistic as many athletes use nutritional supplements for very different reasons. In addition, the number of publications describing trials that demonstrate the benefit of certain nutritional products has also increased over the last decade or so. This ensures that for many sports the use of supplements will remain a common practice. In response to the issue of contamination in nutritional supplements, many reputable manufacturers have their products rigorously tested by sports anti-doping laboratories to help ensure as far as possible that the risks to an athlete remain minimal. In this chapter we review the issue of supplements and contamination, and look at how this might be addressed through effective quality control procedures at the manufacturing facility and through the highly sensitive testing of finished products using appropriately accredited tests. Copyright © 2012 S. Karger AG, Basel.

  13. Probiotic supplement use among young children in Taiwan: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Yi-Chun Chen

    Full Text Available The objective of this study is to provide details on probiotic supplement use among young children in Taiwan.This study is based on the Taiwan Birth Cohort Study database. We used questionnaires to collect information on probiotic supplement use among young children from birth to 18 months of age, while also considering their demographic characteristics and other covariates. Low-birth-weight infants, preterm infants, those with birth defects, and those with caregivers who returned incomplete questionnaires were excluded. The final valid sample comprised 16,991 cases.Approximately half the children received probiotic supplements before the age of 18 months. Only 6.3% of the children received probiotic supplements during the two periods of birth to 6 months and 7 to 18 months. Firstborn children, native mothers, mothers with higher educational levels, higher family income, and parents who lead healthy lifestyles were positively related to probiotic supplement use among children. Young children who were breastfed, with eczema, or with gastrointestinal tract problems were significantly positively associated with probiotic supplement use.The findings show that probiotic supplement usage among young children is associated with a more socially advantaged circumstance and certain child health factors, such as eczema, diarrhea, and constipation. Parents might use probiotic supplements for prevention or treatment of child diseases. The findings of this research could serve as a baseline for future studies, and provide insight into probiotic supplement use behavior for health professionals caring for infants and young children.

  14. Use of dietary supplements by female seniors in a large Northern California health plan

    Directory of Open Access Journals (Sweden)

    Schaffer Donna M

    2005-02-01

    Full Text Available Abstract Background Women aged ≥ 65 years are high utilizers of prescription and over-the-counter medications, and many of these women are also taking dietary supplements. Dietary supplement use by older women is a concern because of possible side effects and drug-supplement interactions. The primary aim of this study was to provide a comprehensive picture of dietary supplement use among older women in a large health plan in Northern California, USA, to raise awareness among health care providers and pharmacists about the need for implementing structural and educational interventions to minimize adverse consequences of self-directed supplement use. A secondary aim was to raise awareness about how the focus on use of herbals and megavitamins that has occurred in most surveys of complementary and alternative therapy use results in a significant underestimate of the proportion of older women who are using all types of dietary supplements for the same purposes. Methods We used data about use of different vitamin/mineral (VM supplements and nonvitamin, nonmineral (NVNM supplements, including herbals, from a 1999 general health survey mailed to a random sample of adult members of a large Northern California health plan to estimate prevalence of and characteristics associated with supplement use among women aged 65–84 (n = 3,109. Results Based on weighted data, 84% had in the past 12 months used >1 dietary supplement, 82% a VM, 59% a supplement other than just multivitamin or calcium, 32% an NVNM, and 25% an herbal. Compared to white, nonHispanic women, African-Americans and Latinas were significantly less likely to use VM and NVNM supplements and Asian/Pacific Islanders were less likely to use NVNM supplements. Higher education was strongly associated with use of an NVNM supplement. Prevalence did not differ by number of prescription medications taken. Among white, nonHispanic women, multiple logistic regression models showed that college

  15. Social Appropriateness in EU Counter-Terrorism Law and Policy

    DEFF Research Database (Denmark)

    Martins, Bruno Oliveira

    2015-01-01

    institutionalist theory with insights from the New Haven school, namely its societal and process-oriented conceptions of law, it crosses legal and political science traditions to explore the ways in which EU counter-terrorism law and policy acquire and maintain social appropriateness....... versus justice equation, on the issues of privacy and data protection, and on the broader respect for fundamental rights more generally. In this process, the legitimacy and the social appropriateness of some of these measures have been questioned, both at the societal level and before or by European...... institutions such as the European Parliament or the Court of Justice of the EU. In this chapter it is argued that the constitutional foundations of the EU play a decisive role in granting legitimacy to EU counter-terrorism law and policy and to ensuring its social acceptability. Combining sociological...

  16. Development planning and appropriate technology: a dilemma and a proposal

    Energy Technology Data Exchange (ETDEWEB)

    Ellis, G.

    1981-03-01

    This paper examines the present system of project paper preparation and project planning used by the US Agency for International Development and many donor agencies. Three approaches for meeting the evident weaknesses of the system - a holistic approach to the planning problem, an operant-conditioning approach to implementation, and a process approach to planning and implementation - are presented and critiqued. On the basis of the critique, an approach grounded in a search for an approximately appropriate technology is supported; and a proposal for an appropriate-technology evaluation system which would analyze alternative technologies, deliver information to the field level, supply needed information on technologies and implementation, constrain donor planners, reduce lag time, incorporate evaluations into future planning, and reduce dependence upon planners is presented. 66 references.

  17. Fan (Fiction Acting on Media and the Politics of Appropriation

    Directory of Open Access Journals (Sweden)

    Wolfgang Reißmann

    2017-09-01

    Full Text Available Fanfiction is the creative appropriation and transformation of existing popular media texts by fans who take stories, worlds and/or characters as starting points and create their own stories based on them. As a cultural field of practice, fanfiction questions prevalent concepts of individual authorship and proprietary of cultural goods. At the same time, fanfiction itself is challenged. Through processes of mediatization, fanfiction grew and became increasingly visible. Third parties, ranging from the media industry (e.g., film studios and copyright holders to journalism and academia, are interested in fanfiction and are following its development. We regard fanfiction communities and fan acting as fields for experimentation and as discursive arenas which can help understand what appropriating, writing and publishing in a digital culture and the future of writing might look like. In this paper, we outline important debates on the legitimacy and nature of fanfiction and present preliminary results of current research within Germany.

  18. Multivitamin-mineral supplements in the Older Americans Act Nutrition Program: not a one-size-fits-all quick fix.

    Science.gov (United States)

    Marra, Melissa Ventura; Wellman, Nancy S

    2008-07-01

    We challenge the suggestion of Congress that the Older Americans Act (OAA) Nutrition Program should provide multivitamin-mineral supplements (MVMs) in addition to meals. MVMs are not a quick fix for poor diets. They do not contain calories, protein, essential fatty acids, or fiber, nor do they adequately address nutritional gaps of some vitamins and minerals. Older adults with chronic health conditions who take multiple medications are at greater risk than the general healthy population for nutrient-drug interactions and toxicity. The OAA Nutrition Program is not an appropriate venue to indiscriminately distribute MVMs, because there is insufficient evidence of their benefits and safety. The program's limited funds and efforts should instead be directed to nutrient-dense healthy meals, quality food service, and greater accessibility to individualized nutrition services.

  19. Diligence in determining the appropriate form of stationarity

    Directory of Open Access Journals (Sweden)

    André Heymans

    2014-02-01

    Full Text Available Orientation: One of the most vexing problems of modelling time series data is determining the appropriate form of stationarity, as it can have a significant influence on the model’s explanatory properties, which makes interpreting the results problematic.Research purpose: This article challenged the assumption that most financial time series are first differenced stationary. The common difference first, ask questions later approach was revisited by taking a more systematic approach when analysing the statistical properties of financial time series data.Motivation for the study: Since Nelson and Plosser’s (1982 argued that many macroeconomic time series are difference stationary, many econometricians simply differenced data in order to achieve stationarity. However, the inherent properties of time series data have changed over the past 30 years. This necessitates a proper evaluation of the properties of data before deciding on the appropriate course of action, in order to avoid over-differencing which causes variables to lose their explanatory ability that leads to spurious results.Research approach, design and method: This article introduced a rigorous process that enables econometricians to determine the most appropriate form of stationarity, which is led by the underlying statistical properties of several financial and economic variables.Main findings: The results highlighted the importance of consulting the d parameter to makea more informed decision, rather than only assuming that the data are I(1. Evidence also suggested that the appropriate form of stationarity can vary, but emphasises the importance to consider a series to be fractionally differenced.Practical/managerial implications: Only when data are correctly classified and transformed accordingly will the data be neither under- nor over-differenced, thus enhancing the validity of the results generated by statistical models.Contribution/value-add: By utilising this rigorous

  20. Pseudomonas aeruginosa Bloodstream Infection: Importance of Appropriate Initial Antimicrobial Treatment

    OpenAIRE

    Micek, Scott T; Lloyd, Ann E.; David J. Ritchie; Reichley, Richard M.; Fraser, Victoria J.; Kollef, Marin H

    2005-01-01

    Pseudomonas aeruginosa bloodstream infection is a serious infection with significant patient mortality and health-care costs. Nevertheless, the relationship between initial appropriate antimicrobial treatment and clinical outcomes is not well established. This study was a retrospective cohort analysis employing automated patient medical records and the pharmacy database at Barnes-Jewish Hospital. Three hundred five patients with P. aeruginosa bloodstream infection were identified over a 6-yea...