WorldWideScience

Sample records for recommended practices overview

  1. International short-term medical missions: a systematic review of recommended practices.

    Science.gov (United States)

    Roche, Stephanie D; Ketheeswaran, Pavinarmatha; Wirtz, Veronika J

    2017-01-01

    To identify practices for conducting international short-term medical missions (STMMs) recommended in the literature and examine how these link STMMs to recipient countries' existing health systems. Systematic review of PubMed-indexed articles on STMMs and their bibliographies using preferred reporting items for systematic reviews and meta-analyses guidelines. Recommendations were organized using the World Health Organization Health Systems Framework. In 92 publications, 67 % offered at least one recommendation that would link STMMs to the recipient country's health system. Among these recommendations, most focused on service delivery and few on health financing and governance. There is a lack of consensus around a proper standard of care, patient selection, and trip duration. Comprehensive global standards are needed for STMM work to ensure that services are beneficial both to patients and to the broader healthcare systems of recipient countries. By providing an overview of the current recommendations and important gaps where practice recommendations are needed, this study can provide relevant input into the development of global standards for STMMs.

  2. Conducting research in clinical psychology practice: Barriers, facilitators, and recommendations.

    Science.gov (United States)

    Smith, Kirsten V; Thew, Graham R

    2017-09-01

    The combination of clinical psychologists' therapeutic expertise and research training means that they are in an ideal position to be conducting high-quality research projects. However, despite these skills and the documented benefits of research to services and service users, research activity in practice remains low. This article aims to give an overview of the advantages of, and difficulties in conducting research in clinical practice. We reviewed the relevant literature on barriers to research and reflected on our clinical and research experiences in a range of contexts to offer practical recommendations. We considered factors involved in the planning, sourcing support, implementation, and dissemination phases of research, and outline suggestions to improve the feasibility of research projects in post-qualification roles. We suggest that research leadership is particularly important within clinical psychology to ensure the profession's continued visibility and influence within health settings. Clinical implications Emerging evidence suggests that clinical settings that foster research are associated with better patient outcomes. Suggestions to increase the feasibility of research projects in clinical settings are detailed. Limitations The present recommendations are drawn from the authors' practical experience and may need adaptation to individual practitioners' settings. This study does not attempt to assess the efficacy of the strategies suggested. © 2017 The Authors. British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

  3. TU-E-BRB-03: Overview of Proposed TG-132 Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Brock, K. [University of Michigan (United States)

    2015-06-15

    Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.

  4. Overview of human health in the Arctic: conclusions and recommendations.

    Science.gov (United States)

    Donaldson, Shawn; Adlard, Bryan; Odland, Jon Øyvind

    2016-01-01

    This article is intended to provide an overview of the key conclusions, knowledge gaps and key recommendations based on the recent 2015 Arctic human health assessment under the Arctic Monitoring and Assessment Program. This assessment was based primarily on data from human health monitoring and research studies and peer-reviewed literature published since the last assessment in 2009.

  5. Clinical practice recommendations for depression.

    Science.gov (United States)

    Malhi, G S; Adams, D; Porter, R; Wignall, A; Lampe, L; O'Connor, N; Paton, M; Newton, L A; Walter, G; Taylor, A; Berk, M; Mulder, R T

    2009-01-01

    To provide clinically relevant evidence-based recommendations for the management of depression in adults that are informative, easy to assimilate and facilitate clinical decision making. A comprehensive literature review of over 500 articles was undertaken using electronic database search engines (e.g. MEDLINE, PsychINFO and Cochrane reviews). In addition articles, book chapters and other literature known to the authors were reviewed. The findings were then formulated into a set of recommendations that were developed by a multidisciplinary team of clinicians who routinely deal with mood disorders. The recommendations then underwent consultative review by a broader advisory panel that included experts in the field, clinical staff and patient representatives. The clinical practice recommendations for depression (Depression CPR) summarize evidence-based treatments and provide a synopsis of recommendations relating to each phase of the illness. They are designed for clinical use and have therefore been presented succinctly in an innovative and engaging manner that is clear and informative. These up-to-date recommendations provide an evidence-based framework that incorporates clinical wisdom and consideration of individual factors in the management of depression. Further, the novel style and practical approach should promote uptake and implementation.

  6. Modeling good research practices--overview: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force-1.

    Science.gov (United States)

    Caro, J Jaime; Briggs, Andrew H; Siebert, Uwe; Kuntz, Karen M

    2012-01-01

    Models-mathematical frameworks that facilitate estimation of the consequences of health care decisions-have become essential tools for health technology assessment. Evolution of the methods since the first ISPOR modeling task force reported in 2003 has led to a new task force, jointly convened with the Society for Medical Decision Making, and this series of seven papers presents the updated recommendations for best practices in conceptualizing models; implementing state-transition approaches, discrete event simulations, or dynamic transmission models; dealing with uncertainty; and validating and reporting models transparently. This overview introduces the work of the task force, provides all the recommendations, and discusses some quandaries that require further elucidation. The audience for these papers includes those who build models, stakeholders who utilize their results, and, indeed, anyone concerned with the use of models to support decision making.

  7. Energy efficiency in Europe. Overview of policies and good practices

    International Nuclear Information System (INIS)

    Sebi, Carine; Mairet, Nicolas; Pollier, Karine; Lapillonne, Bruno; Dyevre, Nicolas; Bolinches, Christine

    2014-01-01

    As part of its Presidency of the Club EnR, a network of 24 national energy management agencies in Europe, ADEME drew up a brochure in 2014 on policies and best practices for energy efficiency in the countries of the European Union. An overview of the actions and programmes of 'neighbouring countries' is also given in this brochure. This action is a concrete part of the knowledge-sharing approach that encourages wide dissemination of proven or particularly promising policies. After an introductory chapter on the key figures and general objectives of the EU, the document is structured into 10 consumer industries and supplemented by a chapter on cross-industry measures. The conclusion draws lessons and makes recommendations to improve the results of future actions

  8. Clinical practice recommendations for bipolar disorder.

    Science.gov (United States)

    Malhi, G S; Adams, D; Lampe, L; Paton, M; O'Connor, N; Newton, L A; Walter, G; Taylor, A; Porter, R; Mulder, R T; Berk, M

    2009-01-01

    To provide clinically relevant evidence-based recommendations for the management of bipolar disorder in adults that are informative, easy to assimilate and facilitate clinical decision-making. A comprehensive literature review of over 500 articles was undertaken using electronic database search engines (e.g. MEDLINE, PsychINFO and Cochrane reviews). In addition articles, book chapters and other literature known to the authors were reviewed. The findings were then formulated into a set of recommendations that were developed by a multidisciplinary team of clinicians who routinely deal with mood disorders. These preliminary recommendations underwent extensive consultative review by a broader advisory panel that included experts in the field, clinical staff and patient representatives. The clinical practice recommendations for bipolar disorder (bipolar CPR) summarise evidence-based treatments and provide a synopsis of recommendations relating to each phase of the illness. They are designed for clinical use and have therefore been presented succinctly in an innovative and engaging manner that is clear and informative. These up-to-date recommendations provide an evidence-based framework that incorporates clinical wisdom and consideration of individual factors in the management of bipolar disorder. Further, the novel style and practical approach should promote their uptake and implementation.

  9. Surgery for constipation : systematic review and practice recommendations : Graded practice and future research recommendations

    OpenAIRE

    Knowles, C. H.; Grossi, U.; Horrocks, E. J.; Pares, D.; Vollebregt, P. F.; Chapman, M.; Brown, S.; Mercer-Jones, M.; Williams, A. B.; Yiannakou, Y.; Hooper, R. J.; Stevens, N.; Mason, James; HASH(0x55897e1f8d68); HASH(0x55897e16c5e8)

    2017-01-01

    Aim\\ud \\ud This manuscript forms the final of seven that address the surgical management of chronic constipation (CC) in adults. The content coalesces results from the five systematic reviews that precede it and of the European Consensus process to derive graded practice recommendations (GPR).\\ud Methods\\ud \\ud Summary of review data, development of GPR and future research recommendations as outlined in detail in the ‘introduction and methods’ paper.\\ud Results\\ud \\ud The overall quality of d...

  10. The Practice of Campus-Based Threat Assessment: An Overview

    Science.gov (United States)

    Pollard, Jeffrey W.; Nolan, Jeffrey J.; Deisinger, Eugene R. D.

    2012-01-01

    This article provides an overview of threat assessment and management as implemented on campuses of higher education. Standards of practice and state calls for implementation are cited. An overview of some of the basic principles for threat assessment and management implementation is accompanied by examples of how they are utilized. Pitfalls…

  11. Modeling good research practices--overview: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force--1.

    Science.gov (United States)

    Caro, J Jaime; Briggs, Andrew H; Siebert, Uwe; Kuntz, Karen M

    2012-01-01

    Models--mathematical frameworks that facilitate estimation of the consequences of health care decisions--have become essential tools for health technology assessment. Evolution of the methods since the first ISPOR Modeling Task Force reported in 2003 has led to a new Task Force, jointly convened with the Society for Medical Decision Making, and this series of seven articles presents the updated recommendations for best practices in conceptualizing models; implementing state-transition approaches, discrete event simulations, or dynamic transmission models; and dealing with uncertainty and validating and reporting models transparently. This overview article introduces the work of the Task Force, provides all the recommendations, and discusses some quandaries that require further elucidation. The audience for these articles includes those who build models, stakeholders who utilize their results, and, indeed, anyone concerned with the use of models to support decision making. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  12. Training Research: Practical Recommendations for Maximum Impact

    Science.gov (United States)

    Beidas, Rinad S.; Koerner, Kelly; Weingardt, Kenneth R.; Kendall, Philip C.

    2011-01-01

    This review offers practical recommendations regarding research on training in evidence-based practices for mental health and substance abuse treatment. When designing training research, we recommend: (a) aligning with the larger dissemination and implementation literature to consider contextual variables and clearly defining terminology, (b) critically examining the implicit assumptions underlying the stage model of psychotherapy development, (c) incorporating research methods from other disciplines that embrace the principles of formative evaluation and iterative review, and (d) thinking about how technology can be used to take training to scale throughout all stages of a training research project. An example demonstrates the implementation of these recommendations. PMID:21380792

  13. Recommended practice for process sampling for partial pressure analysis

    International Nuclear Information System (INIS)

    Blessing, James E.; Ellefson, Robert E.; Raby, Bruce A.; Brucker, Gerardo A.; Waits, Robert K.

    2007-01-01

    This Recommended Practice describes and recommends various procedures and types of apparatus for obtaining representative samples of process gases from >10 -2 Pa (10 -4 Torr) for partial pressure analysis using a mass spectrometer. The document was prepared by a subcommittee of the Recommended Practices Committee of the American Vacuum Society. The subcommittee was comprised of vacuum users and manufacturers of mass spectrometer partial pressure analyzers who have practical experience in the sampling of process gas atmospheres

  14. Overview of nuclear power plant equipment qualification issues and practices

    International Nuclear Information System (INIS)

    Torr, K.G.

    1989-01-01

    This report presents a view of and commentary on the current status of equipment qualification (EQ) in nuclear industries of the major western nations. The introductory chapters discuss the concepts of EQ, the elements of EQ process and highlight some of the key issues in EQ. A brief review of industry practices and some of the prevalent industrial standards is presented, followed by an overview of current regulatory positions in the USA, France, Germany and Sweden. A summary and commentary on the latest research findings on issues relating to accident simulation, to aging simulation and some special topics related to EQ, has been contributed by Franklin Research Centre of Philadelphia. The last part of the report deals with equipment qualification in Canada and gives recommendations on EQ for new plants as well as currently operational CANDU nuclear power plants

  15. Allergy-immunology practice parameters and strength of recommendation data: an evolutionary perspective.

    Science.gov (United States)

    Park, Matthew H; Banks, Taylor A; Nelson, Michael R

    2016-03-01

    The practice parameters for allergy and immunology (A/I) are a valuable tool guiding practitioners' clinical practice. The A/I practice parameters have evolved over time in the context of evidence-based medicine milestones. To identify evolutionary trends in the character, scope, and evidence underlying recommendations in the A/I practice parameters. Practice parameters that have guided A/I from 1995 through 2014 were analyzed. Statements and recommendations with strength of recommendation categories A and B were considered to have a basis in evidence from controlled trials. Forty-three publications and updates covering 25 unique topics were identified. There was great variability in the number of recommendations made and the proportion of statements with controlled trial evidence. The mean number of recommendations made per practice parameter has decreased significantly, from 95.8 to a mean of 38.3. There also is a trend toward an increased proportion of recommendations based on controlled trial evidence in practice parameters with fewer recommendations, with a mean of 30.7% in practice parameters with at least 100 recommendations based on controlled trial evidence compared with 48.3% in practice parameters with 30 to 100 recommendations and 51.0% in those with fewer than 30 recommendations. The A/I practice parameters have evolved significantly over time. Encouragingly, greater controlled trial evidence is associated with updated practice parameters and a recent trend of more narrowly focused topics. These findings should only bolster and inspire confidence in the utility of the A/I practice parameters in assisting practitioners to navigate through the uncertainty that is intrinsic to medicine in making informed decisions with patients. Published by Elsevier Inc.

  16. Four simple recommendations to encourage best practices in research software.

    Science.gov (United States)

    Jiménez, Rafael C; Kuzak, Mateusz; Alhamdoosh, Monther; Barker, Michelle; Batut, Bérénice; Borg, Mikael; Capella-Gutierrez, Salvador; Chue Hong, Neil; Cook, Martin; Corpas, Manuel; Flannery, Madison; Garcia, Leyla; Gelpí, Josep Ll; Gladman, Simon; Goble, Carole; González Ferreiro, Montserrat; Gonzalez-Beltran, Alejandra; Griffin, Philippa C; Grüning, Björn; Hagberg, Jonas; Holub, Petr; Hooft, Rob; Ison, Jon; Katz, Daniel S; Leskošek, Brane; López Gómez, Federico; Oliveira, Luis J; Mellor, David; Mosbergen, Rowland; Mulder, Nicola; Perez-Riverol, Yasset; Pergl, Robert; Pichler, Horst; Pope, Bernard; Sanz, Ferran; Schneider, Maria V; Stodden, Victoria; Suchecki, Radosław; Svobodová Vařeková, Radka; Talvik, Harry-Anton; Todorov, Ilian; Treloar, Andrew; Tyagi, Sonika; van Gompel, Maarten; Vaughan, Daniel; Via, Allegra; Wang, Xiaochuan; Watson-Haigh, Nathan S; Crouch, Steve

    2017-01-01

    Scientific research relies on computer software, yet software is not always developed following practices that ensure its quality and sustainability. This manuscript does not aim to propose new software development best practices, but rather to provide simple recommendations that encourage the adoption of existing best practices. Software development best practices promote better quality software, and better quality software improves the reproducibility and reusability of research. These recommendations are designed around Open Source values, and provide practical suggestions that contribute to making research software and its source code more discoverable, reusable and transparent. This manuscript is aimed at developers, but also at organisations, projects, journals and funders that can increase the quality and sustainability of research software by encouraging the adoption of these recommendations.

  17. Recommended practice for the neutron radiography of nuclear fuels

    International Nuclear Information System (INIS)

    Matfield, R.S.

    1983-01-01

    The document is part of a Neutron Radiography Handbook being prepared by a Neutron Radiography Working Party of the European Community. It commences with a description of the information that should be provided by a user of neutron radiography services and then gives recommendations on the equipment to be used. This is followed by two sections on the techniques to be used for detecting discontinuities and the making of measurements on nuclear fuel. This is then followed by recommended safety practices and then sections on film handling, film processing, viewing of radiographs, references, radiographs, storage and records. Recommendations on training and certification are being prepared. It does not include any technical justification for the practices which are recommended. (Auth.)

  18. Ambulatory Blood Pressure Monitoring – Clinical Practice Recommendations

    Directory of Open Access Journals (Sweden)

    Katalin Mako

    2016-09-01

    Full Text Available Ambulatory blood pressure monitoring (ABPM became a subject of considerable scientific interest. Due to the increasing use of the ABPM in everyday clinical practice it is important that all the users have a correct knowledge on the clinical indications, the methodology of using the device including some technical issues and the interpretation of results. In the last years several guidelines and position papers have been published with recommendations for the monitoring process, reference values, for clinical practice and research. This paper represents a summary of the most important aspects related to the use of ABPM in daily practice, being a synthesis of recommendations from the recent published guidelines and position papers. This reference article presents the practical and technical issues of ABPM, the use of this method in special situations, the clinical interpretation of measured values including the presentation of different ABPM patterns, derived parameters, the prognostic significance and the limitations of this method.

  19. Radiation protection: Philosophy, recommendations and practice

    International Nuclear Information System (INIS)

    Woodhead, D.S.

    1997-01-01

    The philosophy developed by the International Commission on Radiological Protection for the control of human radiation exposure will be described. The application of the ICRP recommendations to the authorization and control of the disposal of radioactive wastes to the sea will be discussed in the context of the practice in the United Kingdom. (author)

  20. Rehabilitation for post-stroke cognitive impairment: an overview of recommendations arising from systematic reviews of current evidence.

    Science.gov (United States)

    Gillespie, David C; Bowen, Audrey; Chung, Charlie S; Cockburn, Janet; Knapp, Peter; Pollock, Alex

    2015-02-01

    Although cognitive impairments are common following stroke, there is considerable uncertainty about the types of interventions that can reduce activity restrictions and improve quality of life. Indeed, a recent project to identify priorities for research into life after stroke determined that the top priority for patients, carers and health professionals was how to improve cognitive impairments. To provide an overview of the evidence for the effectiveness of cognitive rehabilitation for patients with stroke and to determine the main gaps in the current evidence base. Evidence was synthesised for the six Cochrane reviews relating to rehabilitation for post-stroke cognitive impairment and any subsequently published randomized controlled trials to February 2012. Data arising from 44 trials involving over 1500 patients was identified. Though there was support for the effectiveness of cognitive rehabilitation for some cognitive impairments, significant gaps were found in the current evidence base. All of the Cochrane reviews identified major limitations within the evidence they identified. There is currently insufficient research evidence, or evidence of insufficient quality, to support clear recommendations for clinical practice. Recommendations are made as to the research required to strengthen the evidence base, and so facilitate the delivery of effective interventions to individuals with cognitive impairment after stroke. © The Author(s) 2014.

  1. Personalized Approach to Nutrition of Children Athletes: Practical Recommendations

    Directory of Open Access Journals (Sweden)

    S. G. Makarova

    2016-01-01

    Full Text Available Adequate nutrition is the most important factor of children’s health, affecting not only his/her state of health, but also physical activity indicators. Children athletes, for compensating the energy cost, anabolic processes activation, and operability recovery, need an optimum diet with adequate protein, fats, carbohydrates, minerals and vitamins to cover the development and growth needs, as well as to recover from the physical and neuro-psychological stress. There are also certain requirements to food and drinking regime, especially during periods of intense training and competitions. Recommendations for the composition of diets for children athletes are developed and presented in a number of guidelines; however, studies show that the actual nutrition of almost half of the specialized children and youth Olympic reserve schools’ students does not meet the recommended standards. The article presents an overview of modern approaches to young athletes’ nutrition organization, and gives recommendations for personified diet correction and nutritive support depending on sports specialization, nature of physical activity, stage of training process, and individual features of a child.

  2. Four simple recommendations to encourage best practices in research software

    DEFF Research Database (Denmark)

    Jiménez, Rafael C.; Kuzak, Mateusz; Alhamdoosh, Monther

    2017-01-01

    Scientific research relies on computer software, yet software is not always developed following practices that ensure its quality and sustainability. This manuscript does not aim to propose new software development best practices, but rather to provide simple recommendations that encourage...... the adoption of existing best practices. Software development best practices promote better quality software, and better quality software improves the reproducibility and reusability of research. These recommendations are designed around Open Source values, and provide practical suggestions that contribute...... to making research software and its source code more discoverable, reusable and transparent. This manuscript is aimed at developers, but also at organisations, projects, journals and funders that can increase the quality and sustainability of research software by encouraging the adoption...

  3. First aid in the dental practice: an overview.

    Science.gov (United States)

    Jevon, P

    2016-06-24

    First aid encompasses a wide range of scenarios ranging from simple reassurance following a minor mishap to dealing with a life-threatening emergency. Dentists may need to provide first aid in their dental practice to a patient, relative or member of staff. This article provides an overview to first aid in the dental practice, including priorities, responsibilities when providing first aid, assessment of the environment and the casualty (primary survey &secondary survey). The new A3 'First Aid in the Workplace' poster is now available and is included as an insert in this issue (BDJ Vol. 220, Issue 12).

  4. Surgery for constipation: systematic review and practice recommendations: Graded practice and future research recommendations.

    Science.gov (United States)

    Knowles, C H; Grossi, U; Horrocks, E J; Pares, D; Vollebregt, P F; Chapman, M; Brown, S; Mercer-Jones, M; Williams, A B; Yiannakou, Y; Hooper, R J; Stevens, N; Mason, J

    2017-09-01

    This manuscript forms the final of seven that address the surgical management of chronic constipation (CC) in adults. The content coalesces results from the five systematic reviews that precede it and of the European Consensus process to derive graded practice recommendations (GPR). Summary of review data, development of GPR and future research recommendations as outlined in detail in the 'introduction and methods' paper. The overall quality of data in the five reviews was poor with 113/156(72.4%) of included studies providing only level IV evidence and only four included level I RCTs. Coalescence of data from the five procedural classes revealed that few firm conclusions could be drawn regarding procedural choice or patient selection: no single procedure dominated in addressing dynamic structural abnormalities of the anorectum and pelvic floor with each having similar overall efficacy. Of one hundred 'prototype' GPRs developed by the clinical guideline group, 85/100 were deemed 'appropriate' based on the independent scoring of a panel of 18 European experts and use of RAND-UCLA consensus methodology. The remaining 15 were all deemed uncertain. Future research recommendations included some potential RCTs but also a strong emphasis on delivery of large multinational high-quality prospective cohort studies. While the evidence base for surgery in CC is poor, the widespread European consensus for GPRs is encouraging. Professional bodies have the opportunity to build on this work by supporting the efforts of their membership to help convert the documented recommendations into clinical guidelines. © 2017 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.

  5. Medical Physics Practice Guidelines - the AAPM's minimum practice recommendations for medical physicists.

    Science.gov (United States)

    Mills, Michael D; Chan, Maria F; Prisciandaro, Joann I; Shepard, Jeff; Halvorsen, Per H

    2013-11-04

    The AAPM has long advocated a consistent level of medical physics practice, and has published many recommendations and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physics practice. Despite these concerted and enduring efforts, the profession does not have clear and concise statements of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. To this end, the AAPM has recently endorsed the development of MPPGs, which may be generated in collaboration with other professional societies. The MPPGs are intended to be freely available to the general public. Accrediting organizations, regulatory agencies, and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider prudent in clinical practice settings. Support includes, but is not limited to, staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This article has described the purpose, scope, and process for the development of MPPGs.

  6. [Nutrition recommendations for children who practice sports].

    Science.gov (United States)

    Sánchez-Valverde Visus, F; Moráis López, A; Ibáñez, J; Dalmau Serra, J

    2014-08-01

    Several health benefits have been attributed to sports practice, and an adequate nutrition status helps to maintain an optimal performance. Children most frequently practice non-competitive and non-endurance activities in a school setting. The dietary intake of children who practice sports should be similar to the general population, properly meeting their energy and nutrient requirements. During the activity performance, correct hydration should be aimed for, with water appearing to be an adequate source in most cases. General calorie and micronutrient supplementation should not be commonly recommended in children. Paediatricians must control nutritional status and dietary habits of children who practice sports, especially in those cases when weight-loss is aimed for, as well as take into account the psychological implications of competitive sports practice. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  7. Compliance With Recommended Food Safety Practices in Television Cooking Shows.

    Science.gov (United States)

    Cohen, Nancy L; Olson, Rita Brennan

    Examine compliance with recommended food safety practices in television cooking shows. Using a tool based on the Massachusetts Food Establishment Inspection Report, raters examined 39 episodes from 10 television cooking shows. Chefs demonstrated conformance with good retail practices for proper use and storage of utensils in 78% of episodes; preventing contamination (62%), and fingernail care (82%). However, 50% to 88% of episodes were found to be out of compliance with other personal hygiene practices, proper use of gloves and barriers (85% to 100%), and maintaining proper time and temperature controls (93%). Over 90% failed to conform to recommendations regarding preventing contamination through wiping cloths and washing produce. In only 13% of episodes were food safety practices mentioned. There appears to be little attention to food safety during most cooking shows. Celebrity and competing chefs have the opportunity to model and teach good food safety practices for millions of viewers. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  8. Subsea leak detection systems - recommended practice

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Kristin Nergaard

    2010-07-01

    It is known in the industry that occasional leakages occur in subsea production systems. In spite of efforts to apply subsea leak detectors, the experience is that most leakages are either detected by ROV during routine inspections or interventions or as oil slicks on the surface . Operators and authority awareness towards the environmental impact of oil and gas production is increasing. The regulatory bodies in Norway, EU and USA specify requirements for detection of acute pollution. This paper presents the development of a Recommended Practice (RP) sponsored by OLF (The Norwegian Oil Industry Association). The JIP includes several major oil and gas operators. The objective of the RP is to serve as a technical and practical reference in the field of subsea leak detection. (Author)

  9. Effective implementation of research into practice: an overview of systematic reviews of the health literature.

    Science.gov (United States)

    Boaz, Annette; Baeza, Juan; Fraser, Alec

    2011-06-22

    The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice. A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing 313 primary studies were included. Four strategy types are identified: audit and feedback; computerised decision support; opinion leaders; and multifaceted interventions. Nine of the reviews reported on multifaceted interventions. This review highlights the small effects of single interventions such as audit and feedback, computerised decision support and opinion leaders. Systematic reviews of multifaceted interventions claim an improvement in effectiveness over single interventions, with effect sizes ranging from small to moderate. This review found that a number of published systematic reviews fail to state whether the recommended practice change is based on the best available research evidence. This overview of systematic reviews updates the body of knowledge relating to the effectiveness of key mechanisms for improving clinical practice and service development. Multifaceted interventions are more likely to improve practice than single interventions such as audit and feedback. This review identified a small literature focusing explicitly on getting research evidence into clinical practice. It emphasizes the importance of ensuring that primary studies and systematic reviews are precise about the extent to which the reported interventions focus on changing practice based on research evidence (as opposed to other information codified in guidelines and education materials).

  10. Adoption Level of IFAD Project Recommended Farming Practices ...

    African Journals Online (AJOL)

    E M IGBOKWE

    the respondents respectively identified low counterpart funding, untimely disbursement of funds and inadequate mobility of extension staff as the major constraints to the effective implementation of the programme. Generally, there was a high level of adoption of the recommended farming practices among the participating.

  11. Recommended programming practices to facilitate the portability of science computer programs

    International Nuclear Information System (INIS)

    Anon.

    1983-01-01

    This standard recommends programming practices to facilitate the portability of computer programs prepared for scientific and engineering computations. These practices are intended to simplify implementation, conversion, and modification of computer programs

  12. Treatment Recommendations for Single-Unit Crowns: Findings from The National Dental Practice-Based Research Network

    Science.gov (United States)

    McCracken, Michael S.; Louis, David R.; Litaker, Mark S.; Minyé, Helena M.; Mungia, Rahma; Gordan, Valeria V.; Marshall, Don G.; Gilbert, Gregg H.

    2016-01-01

    Background Objectives were to: (1) quantify practitioner variation in likelihood to recommend a crown; and (2) test whether certain dentist, practice, and clinical factors are significantly associated with this likelihood. Methods Dentists in the National Dental Practice-Based Research Network completed a questionnaire about indications for single-unit crowns. In four clinical scenarios, practitioners ranked their likelihood of recommending a single-unit crown. These responses were used to calculate a dentist-specific “Crown Factor” (CF; range 0–12). A higher score implies a higher likelihood to recommend a crown. Certain characteristics were tested for statistically significant associations with the CF. Results 1,777 of 2,132 eligible dentists responded (83%). Practitioners were most likely to recommend crowns for teeth that were fractured, cracked, endodontically-treated, or had a broken restoration. Practitioners overwhelmingly recommended crowns for posterior teeth treated endodontically (94%). Practice owners, Southwest practitioners, and practitioners with a balanced work load were more likely to recommend crowns, as were practitioners who use optical scanners for digital impressions. Conclusions There is substantial variation in the likelihood of recommending a crown. While consensus exists in some areas (posterior endodontic treatment), variation dominates in others (size of an existing restoration). Recommendations varied by type of practice, network region, practice busyness, patient insurance status, and use of optical scanners. Practical Implications Recommendations for crowns may be influenced by factors unrelated to tooth and patient variables. A concern for tooth fracture -- whether from endodontic treatment, fractured teeth, or large restorations -- prompted many clinicians to recommend crowns. PMID:27492046

  13. Effective implementation of research into practice: an overview of systematic reviews of the health literature

    Directory of Open Access Journals (Sweden)

    Fraser Alec

    2011-06-01

    Full Text Available Abstract Background The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice. Findings A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing 313 primary studies were included. Four strategy types are identified: audit and feedback; computerised decision support; opinion leaders; and multifaceted interventions. Nine of the reviews reported on multifaceted interventions. This review highlights the small effects of single interventions such as audit and feedback, computerised decision support and opinion leaders. Systematic reviews of multifaceted interventions claim an improvement in effectiveness over single interventions, with effect sizes ranging from small to moderate. This review found that a number of published systematic reviews fail to state whether the recommended practice change is based on the best available research evidence. Conclusions This overview of systematic reviews updates the body of knowledge relating to the effectiveness of key mechanisms for improving clinical practice and service development. Multifaceted interventions are more likely to improve practice than single interventions such as audit and feedback. This review identified a small literature focusing explicitly on getting research evidence into clinical practice. It emphasizes the importance of ensuring that primary studies and systematic reviews are precise about the extent to which the reported interventions focus on changing practice based on research evidence (as opposed to other information codified in guidelines and education materials.

  14. Parenting Coordinators' Practices Recommendations: A Qualitative Study

    OpenAIRE

    Hirsch, Barbara Phyllis

    2016-01-01

    This qualitative study used a phenomenological approach to understand the experiences of seven parenting coordinators in using parenting coordination practices that they have found to be effective and would recommend to other parenting coordinators to achieve the following goals: educating parents, increasing the quality of parenting and co-parenting, managing conflict, and involving children and other family members in the process of parenting coordination. Data were collected with semi-str...

  15. Recommended Practices Guide Securing WLANs using 802.11i

    Energy Technology Data Exchange (ETDEWEB)

    Masica, K

    2006-10-16

    This paper addresses design principles and best practices regarding the implementation and operation of Wireless LAN (WLAN) communication networks based on the 802.11i security standard. First, a general overview of WLAN technology and standards is provided in order to ground the discussion in the evolution of WLAN standards and security approaches. This is followed by a detailed explanation of the 802.11i standard for securing WLAN networks. Principles for designing secure WLAN networks are then presented, followed by a list of specific best practices that can be used as a guideline for organizations considering the deployment of WLAN networks for non-critical control and monitoring applications. Finally, a section on technical issues and considerations for deploying WLAN networks in critical environments is presented.

  16. Practical Recommendations for the Preliminary Design Analysis of ...

    African Journals Online (AJOL)

    Interior-to-exterior shear ratios for equal and unequal bay frames, as well as column inflection points were obtained to serve as practical aids for preliminary analysis/design of fixed-feet multistory sway frames. Equal and unequal bay five story frames were analysed to show the validity of the recommended design ...

  17. Contact Dermatitis for the Practicing Allergist.

    Science.gov (United States)

    Bernstein, David I

    2015-01-01

    This article provides an overview of important practice recommendations from the recently updated Contact Dermatitis Practice Parameter. This updated parameter provides essential recommendations pertaining to clinical history, physical examination, and patch testing evaluation of patients suspected of allergic contact dermatitis. In addition to providing guidance for performing and interpreting closed patch testing, the updated parameter provides concrete recommendations for assessing metal hypersensitivity in patients receiving prosthetic devices, for evaluating workers with occupational contact dermatitis, and also for addressing allergic contact dermatitis in children. Finally, the document provides practical recommendations useful for educating patients regarding avoidance of exposure to known contact sensitizers in the home and at work. The Contact Dermatitis Parameter is designed as a practical, evidence-based clinical tool to be used by allergists and dermatologists who routinely are called upon to evaluate patients with skin disorders. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. Four simple recommendations to encourage best practices in research software [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Rafael C. Jiménez

    2017-06-01

    Full Text Available Scientific research relies on computer software, yet software is not always developed following practices that ensure its quality and sustainability. This manuscript does not aim to propose new software development best practices, but rather to provide simple recommendations that encourage the adoption of existing best practices. Software development best practices promote better quality software, and better quality software improves the reproducibility and reusability of research. These recommendations are designed around Open Source values, and provide practical suggestions that contribute to making research software and its source code more discoverable, reusable and transparent. This manuscript is aimed at developers, but also at organisations, projects, journals and funders that can increase the quality and sustainability of research software by encouraging the adoption of these recommendations.

  19. Recommended practices in elevated temperature design: A compendium of breeder reactor experiences (1970-1986): An overview

    International Nuclear Information System (INIS)

    Wei, B.C.; Cooper, W.L. Jr.; Dhalla, A.K.

    1987-09-01

    Significant experiences have been accumulated in the establishment of design methods and criteria applicable to the design of Liquid Metal Fast Breeder Reactor (LMFBR) components. The Subcommittee of the Elevated Temperature Design under the Pressure Vessel Research Council (PVRC) has undertaken to collect, on an international basis, design experience gained, and the lessons learned, to provide guidelines for next generation advanced reactor designs. This paper shall present an overview and describe the highlights of the work

  20. Recommended Feeding and Dietary Practices To Improve Infant and Maternal Nutrition.

    Science.gov (United States)

    Academy for Educational Development, Washington, DC.

    The LINKAGES Project is intended to improve breastfeeding and related complementary feeding and maternal dietary practices. The project, in consultation with technical experts and program managers, identified a set of recommended feeding and dietary practices intended to break the cycle of poor health and nutrition that passes from generation to…

  1. Recommendations on practice of conditioned pain modulation (CPM) testing.

    Science.gov (United States)

    Yarnitsky, D; Bouhassira, D; Drewes, A M; Fillingim, R B; Granot, M; Hansson, P; Landau, R; Marchand, S; Matre, D; Nilsen, K B; Stubhaug, A; Treede, R D; Wilder-Smith, O H G

    2015-07-01

    Protocols for testing conditioned pain modulation (CPM) vary between different labs/clinics. In order to promote research and clinical application of this tool, we summarize the recommendations of interested researchers consensus meeting regarding the practice of CPM and report of its results. © 2014 European Pain Federation - EFIC®

  2. Practical recommendations for radium-223 treatment of metastatic castration-resistant prostate cancer

    International Nuclear Information System (INIS)

    Du, Yong; Carrio, Ignasi; De Vincentis, Giuseppe; Fanti, Stefano; Ilhan, Harun; Mommsen, Caroline; Nitzsche, Egbert; Sundram, Francis; Vogel, Wouter; Oyen, Wim; Lewington, Val

    2017-01-01

    Radium Ra 223 dichloride (radium-223, Xofigo registered) is the first targeted alpha therapy for patients with castration-resistant prostate cancer and symptomatic bone metastases. Radium-223 provides a new treatment option for this setting, but also necessitates a new treatment management approach. We provide straightforward and practical recommendations for European nuclear medicine centres to optimize radium-223 service provision. An independent research consultancy agency observed radium-223 procedures and conducted interviews with all key staff members involved in radium-223 treatment delivery in 11 nuclear medicine centres across six countries (Germany, Italy, the Netherlands, Spain, Switzerland and the UK) experienced in administering radium-223. The findings were collated and discussed at a meeting of experts from these centres, during which key consensus recommendations were defined. The recommendations cover centre organization and preparation; patient referral; radium-223 ordering, preparation and disposal; radium-223 treatment delivery/administration; and patient experience. Guidance includes structured coordination and communication within centres and multidisciplinary teams, focusing on sharing best practice to provide high-quality, patient-centred care throughout the treatment pathway. These expert recommendations are intended to complement existing management guidelines. Sharing best practice and experience will help nuclear medicine centres to optimize radium-223 service provision and improve patient care. (orig.)

  3. Practical recommendations for radium-223 treatment of metastatic castration-resistant prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Du, Yong [The Royal Marsden NHS Foundation Trust, Department of Nuclear Medicine and PET/CT, London (United Kingdom); Carrio, Ignasi [Hospital Sant Pau, Barcelona (Spain); De Vincentis, Giuseppe [Policlinico Umberto I University Hospital Rome, Rome (Italy); Fanti, Stefano [University Hospital Bologna, Bologna (Italy); Ilhan, Harun [Ludwig-Maximilians-University Hospital, Munich (Germany); Mommsen, Caroline [Praxis fuer diagnostische und therapeutische Nuklearmedizin Berlin, Berlin (Germany); Nitzsche, Egbert [Canton Hospital Aarau, Aarau (Switzerland); Sundram, Francis [University Hospital Southampton NHS Foundation Trust, Southampton (United Kingdom); Vogel, Wouter [The Netherlands Cancer Institute, Amsterdam (Netherlands); Oyen, Wim [The Royal Marsden NHS Foundation Trust, Department of Nuclear Medicine and PET/CT, London (United Kingdom); The Institute of Cancer Research, London (United Kingdom); Lewington, Val [Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom)

    2017-09-15

    Radium Ra 223 dichloride (radium-223, Xofigo registered) is the first targeted alpha therapy for patients with castration-resistant prostate cancer and symptomatic bone metastases. Radium-223 provides a new treatment option for this setting, but also necessitates a new treatment management approach. We provide straightforward and practical recommendations for European nuclear medicine centres to optimize radium-223 service provision. An independent research consultancy agency observed radium-223 procedures and conducted interviews with all key staff members involved in radium-223 treatment delivery in 11 nuclear medicine centres across six countries (Germany, Italy, the Netherlands, Spain, Switzerland and the UK) experienced in administering radium-223. The findings were collated and discussed at a meeting of experts from these centres, during which key consensus recommendations were defined. The recommendations cover centre organization and preparation; patient referral; radium-223 ordering, preparation and disposal; radium-223 treatment delivery/administration; and patient experience. Guidance includes structured coordination and communication within centres and multidisciplinary teams, focusing on sharing best practice to provide high-quality, patient-centred care throughout the treatment pathway. These expert recommendations are intended to complement existing management guidelines. Sharing best practice and experience will help nuclear medicine centres to optimize radium-223 service provision and improve patient care. (orig.)

  4. Doctors’ Knowledge of Hypertension Guidelines Recommendations Reflected in Their Practice

    Directory of Open Access Journals (Sweden)

    Nafees Ahmad

    2018-01-01

    Full Text Available Aim. To evaluate doctors’ knowledge, attitude, and practices and predictors of adherence to Malaysian hypertension guidelines (CPG 2008. Methods. Twenty-six doctors involved in hypertension management at Penang General Hospital were enrolled in a cross-sectional study. Doctors’ knowledge and attitudes towards guidelines were evaluated through a self-administered questionnaire. Their practices were evaluated by noting their prescriptions written to 520 established hypertensive outpatients (20 prescriptions/doctor. SPSS 17 was used for data analysis. Results. Nineteen doctors (73.07% had adequate knowledge of guidelines. Specialists and consultants had significantly better knowledge about guidelines’ recommendations. Doctors were positive towards guidelines with mean attitude score of 23.15±1.34 points on a 30-point scale. The median number of guidelines compliant prescriptions was 13 (range 5–20. Statistically significant correlation (rs = 0.635, P<0.001 was observed between doctors’ knowledge and practice scores. A total of 349 (67.1% prescriptions written were guidelines compliant. In multivariate analysis hypertension clinic (OR = 0.398, P=0.008, left ventricular hypertrophy (OR = 0.091, P=0.001 and heart failure (OR = 1.923, P=0.039 were significantly associated with guidelines adherence. Conclusion. Doctors’ knowledge of guidelines is reflected in their practice. The gap between guidelines recommendations and practice was seen in the pharmacotherapy of uncomplicated hypertension and hypertension with left ventricular hypertrophy, renal disease, and diabetes mellitus.

  5. A methodology for practical implementation of ICRP recommendations for optimization

    International Nuclear Information System (INIS)

    Webb, G.A.M.; Clarke, R.H.

    1979-01-01

    The system of dose limitation recommended by the Commission has been restated in its most recent recommendations with the requirements implying cost benefit analysis elevated to pride of place. The main subject of this paper is discussion of the problems involved in carrying out differential cost benefit analysis (optimization) studies. The various quantities such as Effective Dose Equivalent and Collective Effective Dose Equivalent Commitment needed to carry out these studies are discussed, their strengths and weaknesses identified and suggestions made as to how they should be used in practice. In particular the implications underlying the use of the collective quantities as the independent variable in these studies are clarified and examined. The need for the maximum realism in calculational models and parameters used in the calculation of collective quantities for optimization studies is stressed, with the corollary of conservative calculations for comparison with dose limits. The methods for calculating costs are examined, both for the plant or equipment installed to reduce doses and for the cost associated with the consequent reduction in health detriment. Some practical problems are cited in both the theory and practice of optimization. It is concluded that optimization is not yet sufficiently developed in either basic formalism or practical application. Some areas are identified where further work is needed. (author)

  6. Infection control practices across Canada: do dentists follow the recommendations?

    Science.gov (United States)

    McCarthy, G M; Koval, J J; John, M A; MacDonald, J K

    1999-10-01

    This study investigated provincial and territorial differences in dentists' compliance with recommended infection control practices in Canada (1995). Questionnaires were mailed to a stratified random sample of 6,444 dentists, of whom 66.4% responded. Weighted analyses included Pearson's chi-square test and multiple logistic regression. Significant provincial and territorial differences included testing for immune response after hepatitis B virus (HBV) vaccination, HBV vaccination for all clinical staff, use of infection control manuals and post-exposure protocols, biological monitoring of heat sterilizers, handwashing before treating patients, using gloves and changing them after each patient, heat-sterilizing handpieces between patients, and using masks and uniforms to protect against splatter of blood and saliva. Excellent compliance (compliance with a combination of 18 recommended infection control procedures) ranged from 0% to 10%; the best predictors were more hours of continuing education on infection control in the last two years, practice location in larger cities (> 500,000) and sex (female). Clearly, improvements in infection control are desirable for dentists in all provinces and territories. Extending mandatory continuing education initiatives to include infection control may promote better compliance with current recommendations.

  7. Practical recommendations for breathing-adapted radiotherapy

    International Nuclear Information System (INIS)

    Simon, L.; Giraud, P.; Rosenwald, J.C.; Dumas, J.L.; Lorchel, F.; Marre, D.; Dupont, S.; Varmenot, N.; Ginestet, C.; Caron, J.; Marchesi, V.; Ferreira, I.; Garcia, R.

    2007-01-01

    Respiration-gated radiotherapy offers a significant potential for improvement in the irradiation of tumor sites affected by respiratory motion such as lung, breast and liver tumors. An increased conformality of irradiation fields leading to decreased complications rates of organs at risk (lung, heart) is expected. Respiratory gating is in line with the need for improved precision required by radiotherapy techniques such as 3D conformal radiotherapy or intensity modulated radiotherapy. Reduction of respiratory motion can be achieved by using either breath-hold techniques or respiration synchronized gating techniques. Breath-hold techniques can be achieved with active techniques, in which airflow of the patient is temporarily blocked by a valve, or passive techniques, in which the patient voluntarily holds his/her breath. Synchronized gating techniques use external devices to predict the phase of the respiration cycle while the patient breaths freely. This work summarizes the different experiences of the centers of the STIC 2003 project. It describes the different techniques, gives an overview of the literature and proposes a practice based on our experience. (authors)

  8. Good practices in Local Government - A first overview of Portuguese reality

    Science.gov (United States)

    Carvalhosa, P.; Portela, F.; Machado, J.; Santos, M. F.; Abelha, A.

    2017-03-01

    Good practices in eGov are being increasingly used by Local Governments being that it is considered by them as an advantage. The main goal is providing to the town hall a differentiation point and approximate their services to the citizens. For this, it is necessary to define and apply innovative strategies in order to increase the use of services by the citizens. This paper is framed in a research work and it presents a first overview of the existing good practices in eGov, taking in consideration the Portuguese’s reality. The good practices identified were distinguished with many awards and with a positive response from the target audience. The use of digital marketing strategies aims to increase their membership and coming closer the municipalities of its citizens through the dissemination of the good practices. At this moment the data collected are almost exclusively of good practice in Portugal, however some international practices were also identified. As a result of this study the community has a list of good practices that can be applied in their municipalities.

  9. Action to Support Practices Implement Research Evidence (ASPIRE): protocol for a cluster-randomised evaluation of adaptable implementation packages targeting 'high impact' clinical practice recommendations in general practice.

    Science.gov (United States)

    Willis, Thomas A; Hartley, Suzanne; Glidewell, Liz; Farrin, Amanda J; Lawton, Rebecca; McEachan, Rosemary R C; Ingleson, Emma; Heudtlass, Peter; Collinson, Michelle; Clamp, Susan; Hunter, Cheryl; Ward, Vicky; Hulme, Claire; Meads, David; Bregantini, Daniele; Carder, Paul; Foy, Robbie

    2016-02-29

    There are recognised gaps between evidence and practice in general practice, a setting which provides particular challenges for implementation. We earlier screened clinical guideline recommendations to derive a set of 'high impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. We aim to evaluate the effectiveness and cost-effectiveness of a multifaceted, adaptable intervention package to implement four targeted, high impact recommendations in general practice. The research programme Action to Support Practice Implement Research Evidence (ASPIRE) includes a pair of pragmatic cluster-randomised trials which use a balanced incomplete block design. Clusters are general practices in West Yorkshire, United Kingdom (UK), recruited using an 'opt-out' recruitment process. The intervention package adapted to each recommendation includes combinations of audit and feedback, educational outreach visits and computerised prompts with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. In trial 1, practices are randomised to adapted interventions targeting either diabetes control or risky prescribing and those in trial 2 to adapted interventions targeting either blood pressure control in patients at risk of cardiovascular events or anticoagulation in atrial fibrillation. The respective primary endpoints comprise achievement of all recommended target levels of haemoglobin A1c (HbA1c), blood pressure and cholesterol in patients with type 2 diabetes, a composite indicator of risky prescribing, achievement of recommended blood pressure targets for specific patient groups and anticoagulation prescribing in patients with atrial fibrillation. We are also randomising practices to a fifth, non-intervention control group to further assess Hawthorne effects. Outcomes will be assessed using routinely collected data

  10. Good practice recommendations - medical-professional control of internal exposure to radionuclides in nuclear base installations

    International Nuclear Information System (INIS)

    Berard, Philippe; Blanchin, Nicolas; Fottorino, Robert; Gonin, Michele; Quesne, Benoit; Agrinier, Anne-Laure; Bourgaut, Laurent; Blanchardon, Eric; Challeton de Vathaire, Cecile; Franck, Didier; Piechowski, Jean; Fritsch, Paul; Poncy, Jean-Luc

    2011-07-01

    The first part of this voluminous report presents the context and method of definition of recommendations for a clinical practice and comprises a literature review of national, European and international recommendations, standards and work-group reports. The second part develops recommendations under four main themes: assessment of the committed effective dose (objectives, implementation, communication, traceability and archiving), control programs, dosimetric estimation based on results, and health risk and taking into care by the occupational physician. The authors adopted the same structure for each sub-theme or issue: target extract of regulatory and standard requirements and international recommendations, analysis of literature and of data from professional practices, opinion of the work-group, and graded recommendations with respect to the proof level

  11. Barriers to implementing the "2008 Mexican Clinical Practice Guideline recommendations for the management of hip and knee osteoarthritis" in primary healthcare practice.

    Science.gov (United States)

    Loyola-Sanchez, Adalberto; Richardson, Julie; Pelaez-Ballestas, Ingris; Sánchez, José Guadalupe; González, Martha Alicia; Sánchez-Cruz, Juan; Jiménez-Baez, María Valeria; Nolasco-Alonso, Nancy; Alvarado, Idolina; Rodríguez-Amado, Jacqueline; Alvarez-Nemegyei, José; Wilson, Mike G

    2014-01-01

    To evaluate the implementability of the "2008 Mexican Clinical Practice Guideline for the management of hip and knee osteoarthritis at the primary level of care" within primary healthcare of three Mexican regions using the Guideline Implementability Appraisal methodology version 2 (GLIA.v2). Six family physicians, representing the South, North, and Central Mexico, and one Mexican physiatrist evaluated the 45 recommendations stated by the Mexican guideline. The GLIA.v2 methodology includes the execution of qualitative and semi-quantitative techniques. Reviewers' agreement was between moderate to near complete in most cases. Sixty-nine percent of the recommendations were considered difficult to implement within clinical practice. Eight recommendations did not have an appropriate format. Only 6 recommendations were judged as able to be consistently applied to clinical practice. Barriers related to the context of one or more institutions/regions were identified in 25 recommendations. These barriers are related to health providers/patients' beliefs, processes of care within each institution, and availability of some treatments recommended by the guideline. The guideline presented problems of conciseness and clarity that negatively affect its application within the Mexican primary healthcare context. We identified individual, organizational and system characteristics, which are common to the 3 institutions/regions studied and constitute barriers for implementing the guideline to clinical practice. It is recommended that the 2008-Mexican-CPG-OA be thoroughly revised and restructured to improve the clarity of the actions implied by each recommendation. We propose some strategies to accomplish this and to overcome some of the identified regional/institutional barriers. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  12. Grading quality of evidence and strength of recommendations in clinical practice guidelines part 3 of 3. The GRADE approach to developing recommendations

    NARCIS (Netherlands)

    Brożek, J. L.; Akl, E. A.; Compalati, E.; Kreis, J.; Terracciano, L.; Fiocchi, A.; Ueffing, E.; Andrews, J.; Alonso-Coello, P.; Meerpohl, J. J.; Lang, D. M.; Jaeschke, R.; Williams, J. W.; Phillips, B.; Lethaby, A.; Bossuyt, P.; Glasziou, P.; Helfand, M.; Watine, J.; Afilalo, M.; Welch, V.; Montedori, A.; Abraha, I.; Horvath, A. R.; Bousquet, J.; Guyatt, G. H.; Schünemann, H. J.

    2011-01-01

    This is the third and last article in the series about the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to grading the quality of evidence and the strength of recommendations in clinical practice guidelines and its application in the field of allergy. We

  13. Probiotic guidelines and physician practice: a cross-sectional survey and overview of the literature.

    Science.gov (United States)

    Draper, K; Ley, C; Parsonnet, J

    2017-08-24

    Probiotic use by patients and physicians has dramatically increased over the last decade, although definitive evidence is often lacking for their use. We examined probiotic-prescribing practices among health care providers (HCP) at a tertiary medical centre and compared these practices to clinical guidelines. HCP at the Stanford Medical Center received a survey on probiotic prescribing practices including choice of probiotic and primary indications. A broad overview of the literature was performed. Among 2,331 HCP surveyed, 632 responded. Of the 582 of these who routinely prescribed medications, 61% had recommended probiotic foods or supplements to their patients. Women and gastroenterologists were more likely to prescribe probiotics (odds ratio (OR): 1.5, 95% confidence interval (CI): 1.0-2.1; OR: 3.9, 95% CI: 1.5-10.1, respectively). Among probiotic prescribers, 50% prescribed inconsistently or upon patient request, and 40% left probiotic choice to the patient. Common indications for probiotics, particularly Lactobacillus GG, were prevention and treatment of antibiotic-associated diarrhoea (79 and 66%, respectively). Probiotics were often prescribed for 'general bowel health' or at patient request (27 and 39% of responders, respectively). Most respondents (63%) thought an electronic medical record (EMR) pop-up would change probiotic prescribing patterns. However, a review of published guidelines and large trials found inconsistencies in probiotic indications, dosages and strain selection. Probiotic prescribing is common but lacks consistency, with choice of probiotic frequently left to the patient, even for indications with some strain-specific evidence. Implementation of EMR pop-ups/pocket guides may increase consistency in probiotic prescribing, although the lack of clear and consistent guidelines must first be addressed with large, well-designed clinical trials.

  14. How to define 'best practice' for use in Knowledge Translation research: a practical, stepped and interactive process.

    Science.gov (United States)

    Bosch, Marije; Tavender, Emma; Bragge, Peter; Gruen, Russell; Green, Sally

    2013-10-01

    Defining 'best practice' is one of the first and crucial steps in any Knowledge Translation (KT) research project. Without a sound understanding of what exactly should happen in practice, it is impossible to measure the extent of existing gaps between 'desired' and 'actual' care, set implementation goals, and monitor performance. The aim of this paper is to present a practical, stepped and interactive process to develop best practice recommendations that are actionable, locally applicable and in line with the best available research-based evidence, with a view to adapt these into process measures (quality indicators) for KT research purposes. Our process encompasses the following steps: (1) identify current, high-quality clinical practice guidelines (CPGs) and extract recommendations; (2) select strong recommendations in key clinical management areas; (3) update evidence and create evidence overviews; (4) discuss evidence and produce agreed 'evidence statements'; (5) discuss the relevance of the evidence with local stakeholders; and (6) develop locally applicable actionable best practice recommendations, suitable for use as the basis of quality indicators. Actionable definitions of local best practice are a prerequisite for doing KT research. As substantial resources go into rigorously synthesizing evidence and developing CPGs, it is important to make best use of such available resources. We developed a process for efficiently developing locally applicable actionable best practice recommendations from existing high-quality CPGs that are in line with current research evidence. © 2012 John Wiley & Sons Ltd.

  15. Integration of health technology assessment recommendations into organizational and clinical practice: A case study in Catalonia.

    Science.gov (United States)

    Gagnon, Marie-Pierre; Sánchez, Emília; Pons, Joan M V

    2006-01-01

    Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy makers. This research sought to understand factors affecting the uptake of HTA recommendations to support decision making with respect to the introduction of three health technologies. Using a multidimensional framework, based upon a combination of theoretical models, a case study was conducted. A total of twenty-eight semistructured interviews were done with physicians from fifteen hospitals and other stakeholders in Catalonia. Interview content was analyzed iteratively and classified according to theoretical dimensions and contextual factors. At the sociopolitical level, factors related to the organization and financing of the health system were found to affect the utilization of HTA recommendations. At the healthcare organization level, existing collaborations between the hospital and the HTA agency favored the integration of recommendations into practices. Formalism in the organization also influenced the utilization of HTA recommendations. At the professional level, the high degree of autonomy of specialists, the importance of peers and collegial control, and the definition of professional roles and responsibilities influenced physicians' willingness to integrate HTA recommendations into their practice. This study offers a comprehensive framework to understand the complex dynamics that affect adoption of health technologies in organizational and professional practices. The findings suggest some avenues to promote the integration of HTA recommendations into practices and, thus, increase the utilization of scientific evidence to support decision making in health care.

  16. Practice-based Research Network Research Good Practices (PRGPs): Summary of Recommendations.

    Science.gov (United States)

    Dolor, Rowena J; Campbell-Voytal, Kimberly; Daly, Jeanette; Nagykaldi, Zsolt J; O'Beirne, Maeve; Sterling, Pamela; Fagnan, Lyle J; Levy, Barcey; Michaels, LeAnn; Louks, Hannah A; Smith, Paul; Aspy, Cheryl B; Patterson, V Beth; Kano, Miria; Sussman, Andrew L; Williams, Robert; Neale, Anne Victoria

    2015-12-01

    Practice-based research networks (PBRNs) conduct research in community settings, which poses quality control challenges to the integrity of research, such as study implementation and data collection. A foundation for improving research processes within PBRNs is needed to ensure research integrity. Network directors and coordinators from seven U.S.-based PBRNs worked with a professional team facilitator during semiannual in-person meetings and monthly conference calls to produce content for a compendium of recommended research practices specific to the context of PBRNs. Participants were assigned to contribute content congruent with their expertise. Feedback on the draft document was obtained from attendees at the preconference workshop at the annual PBRN meeting in 2013. A revised document was circulated to additional PBRN peers prior to finalization. The PBRN Research Good Practices (PRGPs) document is organized into four chapters: (1) Building PBRN Infrastructure; (2) Study Development and Implementation; (3) Data Management, and (4) Dissemination Policies. Each chapter contains an introduction, detailed procedures for each section, and example resources with information links. The PRGPs is a PBRN-specific resource to facilitate PBRN management and staff training, to promote adherence to study protocols, and to increase validity and generalizability of study findings. © 2015 Wiley Periodicals, Inc.

  17. Best Practices in Hiring: Addressing Unconscious Bias

    Science.gov (United States)

    Simpson, Caroline E.

    2012-01-01

    Research has shown that implementing certain hiring practices will increase diversity in the workplace while enhancing academic quality. All of these practices rely on addressing the issue of 'unconscious bias.' A brief overview of unconscious bias--what it is, how it works, and simple measures to counter it--will be presented. Successful strategies, actions, and recommendations for implementing best recruiting and hiring practices, which have been proven to enhance academic excellence by ensuring a deep and diverse applicant pool, will also be presented.

  18. Using exploratory factor analysis in personality research: Best-practice recommendations

    Directory of Open Access Journals (Sweden)

    Sumaya Laher

    2010-11-01

    Research purpose: This article presents more objective methods to determine the number of factors, most notably parallel analysis and Velicer’s minimum average partial (MAP. The benefits of rotation are also discussed. The article argues for more consistent use of Procrustes rotation and congruence coefficients in factor analytic studies. Motivation for the study: Exploratory factor analysis is often criticised for not being rigorous and objective enough in terms of the methods used to determine the number of factors, the rotations to be used and ultimately the validity of the factor structure. Research design, approach and method: The article adopts a theoretical stance to discuss the best-practice recommendations for factor analytic research in the field of psychology. Following this, an example located within personality assessment and using the NEO-PI-R specifically is presented. A total of 425 students at the University of the Witwatersrand completed the NEO-PI-R. These responses were subjected to a principal components analysis using varimax rotation. The rotated solution was subjected to a Procrustes rotation with Costa and McCrae’s (1992 matrix as the target matrix. Congruence coefficients were also computed. Main findings: The example indicates the use of the methods recommended in the article and demonstrates an objective way of determining the number of factors. It also provides an example of Procrustes rotation with coefficients of agreement as an indication of how factor analytic results may be presented more rigorously in local research. Practical/managerial implications: It is hoped that the recommendations in this article will have best-practice implications for both researchers and practitioners in the field who employ factor analysis regularly. Contribution/value-add: This article will prove useful to all researchers employing factor analysis and has the potential to set the trend for better use of factor analysis in the South African context.

  19. Are nutrition messages lost in transmission? Assessing the quality and consistency of diabetes guideline recommendations on the delivery of nutrition therapy.

    Science.gov (United States)

    Hale, Kelli; Capra, Sandra; Bauer, Judy

    2016-12-01

    To provide an overview of (1) the consistency of Type 2 Diabetes Clinical Practice Guidelines recommendations on the delivery of nutrition therapy and (2) Clinical Practice Guideline quality. Large international clinical practice guideline repositories, diabetes organisation websites, and electronic databases (Pubmed, Scopus), were searched to identify Clinical Practice Guidelines for adults with type 2 diabetes published 2005 to August 2014. Recommendations on the delivery of nutrition therapy were extracted and inductive content analysis was used to analyse consistency. Two researchers independently assessed guideline quality using the AGREE II tool. Nine topics were identified from the recommendations. Overall the consistency of the recommendations was related to guideline type. Compared with nutrition-specific guidelines, the broad ones had a broader focus and included more patient-focused recommendations. The ten Clinical Practice Guidelines assessed included six broad guidelines and four nutrition specific guidelines. Based on AGREE II analysis, the broad guidelines were higher quality than nutrition-specific ones. Broad Clinical Practice Guidelines were higher quality and included more patient-focused recommendations than nutrition-specific ones. Our findings suggest a need for nutrition-specific guidelines to be modified to include greater patient-focus, or for practitioners delivering nutrition therapy to adopt broad Clinical Practice Guidelines. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. CE: Tuberculosis: A New Screening Recommendation and an Expanded Approach to Elimination in the United States.

    Science.gov (United States)

    Parmer, John; Allen, Leeanna; Walton, Wanda

    2017-08-01

    : Nurses play a critical role in the diagnosis and treatment of tuberculosis and in the prevention of tuberculosis transmission through infection control practices. To eliminate tuberculosis in the United States, however, an expanded approach to testing and treating people with latent tuberculosis infection must be implemented. Recently, the U.S. Preventive Services Task Force (USPSTF) issued a new recommendation statement on latent tuberculosis infection testing that expands nurses' opportunities to identify at-risk populations for tuberculosis prevention. In combination with newer testing methodologies and shorter treatment regimens, implementation of the USPSTF recommendation has the potential to remove previously existing barriers to screening and treatment of both patients and health care providers. This article provides a general overview of tuberculosis transmission, pathogenesis, and epidemiology; presents preventive care recommendations for targeted testing among high-risk groups; and discusses the USPSTF recommendation's applicability to public health and primary care practice in the United States.

  1. Application of Recommended Design Practices for Conceptual Nuclear Fusion Space Propulsion Systems

    Science.gov (United States)

    Williams, Craig H.

    2004-01-01

    An AIAA Special Project Report was recently produced by AIAA's Nuclear and Future Flight Propulsion Technical Committee and is currently in peer review. The Report provides recommended design practices for conceptual engineering studies of nuclear fusion space propulsion systems. Discussion and recommendations are made on key topics including design reference missions, degree of technological extrapolation and concomitant risk, thoroughness in calculating mass properties (nominal mass properties, weight-growth contingency and propellant margins, and specific impulse), and thoroughness in calculating power generation and usage (power-flow, power contingencies, specific power). The report represents a general consensus of the nuclear fusion space propulsion system conceptual design community and proposes 15 recommendations. This paper expands on the Report by providing specific examples illustrating how to apply each of the recommendations.

  2. Practical recommendations for performing ultrasound scanning in the urological and andrological fields

    Directory of Open Access Journals (Sweden)

    Pasquale Martino

    2014-03-01

    Full Text Available Aim: US scanning has been defined as the urologist’s stethoscope. These recommendations have been drawn up with the aim of ensuring minimum standards of excellence for ultrasound imaging in urological and andrological practice. A series of essential recommendations are made, to be followed during ultrasound investigations in kidney, prostate, bladder, scrotal and penile diseases. Methods: Members of the Imaging Working Group of the Italian Society of Urology (SIU in collaboration with the Italian Society of Ultrasound in Urology, Andrology and Nephrology (SIEUN identified expert Urologists, Andrologists, Nephrologists and Radiologists. The recommendations are based on review of the literature, previously published recommendations, books and the opinions of the experts. The final document was reviewed by national experts, including members of the Italian Society of Radiology. Results: Recommendations are listed in 5 chapters, focused on: kidney, bladder, prostate and seminal vesicles, scrotum and testis, penis, including penile echo-doppler. In each chapter clear definitions are made of: indications, technological standards of the devices, the method of performance of the investigation. The findings to be reported are described and discussed, and examples of final reports for each organ are included. In the tables, the ultrasound features of the principal male uro-genital diseases are summarized. Diagnostic accuracy and second level investigations are considered. Conclusions: Ultrasound is an integral part of the diagnosis and follow-up of diseases of the urinary system and male genitals in patients of all ages, in both the hospital and outpatient setting. These recommendations are dedicated to enhancing communication and evidence-based medicine in an inter- and multi-disciplinary approach. The ability to perform and interpret ultrasound imaging correctly has become an integral part of clinical practice in uro-andrology, but intra and inter

  3. Practical recommendations for performing ultrasound scanning in the urological and andrological fields.

    Science.gov (United States)

    Martino, Pasquale; Galosi, Andrea Benedetto; Bitelli, Marco; Consonni, Paolo; Fiorini, Fulvio; Granata, Antonio; Gunelli, Roberta; Liguori, Giovanni; Palazzo, Silvano; Pavan, Nicola; Scattoni, Vincenzo; Virgili, Guido

    2014-03-28

    US scanning has been defined as the urologist's stethoscope. These recommendations have been drawn up with the aim of ensuring minimum standards of excellence for ultrasound imaging in urological and andrological practice. A series of essential recommendations are made, to be followed during ultrasound investigations in kidney, prostate, bladder, scrotal and penile diseases. Members of the Imaging Working Group of the Italian Society of Urology (SIU) in collaboration with the Italian Society of Ultrasound in Urology, Andrology and Nephrology (SIEUN) identified expert Urologists, Andrologists, Nephrologists and Radiologists. The recommendations are based on review of the literature, previously published recommendations, books and the opinions of the experts. The final document was reviewed by national experts, including members of the Italian Society of Radiology. Recommendations are listed in 5 chapters, focused on: kidney, bladder, prostate and seminal vesicles, scrotum and testis, penis, including penile echo-doppler. In each chapter clear definitions are made of: indications, technological standards of the devices, the method of performance of the investigation. The findings to be reported are described and discussed, and examples of final reports for each organ are included. In the tables, the ultrasound features of the principal male uro-genital diseases are summarized. Diagnostic accuracy and second level investigations are considered. Ultrasound is an integral part of the diagnosis and follow-up of diseases of the urinary system and male genitals in patients of all ages, in both the hospital and outpatient setting. These recommendations are dedicated to enhancing communication and evidence-based medicine in an inter- and multi-disciplinary approach. The ability to perform and interpret ultrasound imaging correctly has become an integral part of clinical practice in uro-andrology, but intra and inter-observer variability is a well known limitation. These

  4. Recommendable Practices for Effective Nuclear Crisis Communication

    International Nuclear Information System (INIS)

    Lee, Chang Ju; Hah, Yeon Hee

    2011-01-01

    'Crisis communication' refers one of the activities done by the Nuclear Regulatory Organizations (NROs) in order to protect the public and the environment from the possible harmful effects. As denoted by the BMU, German NRO, crisis communication is not only 'public information' or 'information for the public', but also communication between authorities in order to guarantee that public information is consistent. This study proposes some recommendable practices for developing a guideline of well-prepared nuclear crisis communication system, including its management framework, and for introducing good insights, based on the study of international aspects provided by relevant OECD/NEA WPGC (Working Group on Public Communication for Nuclear Regulatory Organizations)i working group

  5. Internal Quality Control Practices in Coagulation Laboratories: recommendations based on a patterns-of-practice survey.

    Science.gov (United States)

    McFarlane, A; Aslan, B; Raby, A; Moffat, K A; Selby, R; Padmore, R

    2015-12-01

    Internal quality control (IQC) procedures are crucial for ensuring accurate patient test results. The IQMH Centre for Proficiency Testing conducted a web-based survey to gather information on the current IQC practices in coagulation testing. A questionnaire was distributed to 174 Ontario laboratories licensed to perform prothrombin time (PT) and activated partial thromboplastin time (APTT). All laboratories reported using two levels of commercial QC (CQC); 12% incorporate pooled patient plasma into their IQC program; >68% run CQC at the beginning of each shift; 56% following maintenance, with reagent changes, during a shift, or with every repeat sample; 6% only run CQC at the beginning of the day and 25% when the instruments have been idle for a defined period of time. IQC run frequency was determined by manufacturer recommendations (71%) but also influenced by the stability of test (27%), clinical impact of an incorrect test result (25%), and sample's batch number (10%). IQC was monitored using preset limits based on standard deviation (66%), precision goals (46%), or allowable performance limits (36%). 95% use multirules. Failure actions include repeating the IQC (90%) and reporting patient results; if repeat passes, 42% perform repeat analysis of all patient samples from last acceptable IQC. Variability exists in coagulation IQC practices among Ontario clinical laboratories. The recommendations presented here would be useful in encouraging standardized IQC practices. © 2015 John Wiley & Sons Ltd.

  6. MANAGERIAL AND COST ACCOUNTING PRACTICES - A ROMANIAN OVERVIEW

    Directory of Open Access Journals (Sweden)

    CARDOS ILDIKO REKA

    2011-12-01

    for management in the decision making process but these information are produced using traditional managerial accounting practices, tools and techniques are preferred by Romanian organizations in the detriment of modern practices like activity based-costing or target costing. Implications - The results of our study represents a reference point for both researchers and practitioners who are willing to carry on future research in the field of managerial accounting. Originality/Value - This paper tries to fill a gap in the literature related to the Romanian managerial accounting systems and practices. Moreover, it present an overview of managerial accounting practices within Romanian companies giving the possibility to formulate suggestions and proposals for its future development and evolution.

  7. MOST COMMON TACTICAL ERRORS IN CHRONIC SYSTOLIC HEART FAILURE PATIENTS MANAGEMENT: PRACTICAL RECOMMENDATIONS

    Directory of Open Access Journals (Sweden)

    A. S. Poskrebysheva

    2012-01-01

    Full Text Available Treatment of chronic heart failure (CHF often can be a rather difficult task. Proper selection of therapy and strict adherence to the recommendations is vital in these patients. Unfortunately, in practice we often encounter with free interpretation of the recommendations, which leads to tactical errors and reduce the effectiveness of treatment. This article deals with the most common tactical errors, and contains recommendations for the management of patients with CHF, which can be very useful to the practitioner.

  8. MOST COMMON TACTICAL ERRORS IN CHRONIC SYSTOLIC HEART FAILURE PATIENTS MANAGEMENT: PRACTICAL RECOMMENDATIONS

    Directory of Open Access Journals (Sweden)

    A. S. Poskrebysheva

    2014-07-01

    Full Text Available Treatment of chronic heart failure (CHF often can be a rather difficult task. Proper selection of therapy and strict adherence to the recommendations is vital in these patients. Unfortunately, in practice we often encounter with free interpretation of the recommendations, which leads to tactical errors and reduce the effectiveness of treatment. This article deals with the most common tactical errors, and contains recommendations for the management of patients with CHF, which can be very useful to the practitioner.

  9. Exercise recommendations for childhood cancer survivors exposed to cardiotoxic therapies: an institutional clinical practice initiative.

    Science.gov (United States)

    Okada, Maki; Meeske, Kathleen A; Menteer, Jondavid; Freyer, David R

    2012-01-01

    Childhood cancer survivors who have received treatment with anthracyclines are at risk for developing cardiomyopathy in dose-dependent fashion. Historically, restrictions on certain types of physical activity that were intended to preserve cardiac function have been recommended, based on a mixture of evidence-based and consensus-based recommendations. In the LIFE Cancer Survivorship & Transition Program at Children's Hospital Los Angeles, the authors reevaluated their recommendations for exercise in survivors who were exposed to anthracyclines, with or without irradiation in proximity to the myocardium. The primary goal was to develop consistent, specific, practical, safe, and (where possible) evidence-based recommendations for at-risk survivors in the program. To accomplish this, the authors referred to current exercise guidelines for childhood cancer survivors, consulted recent literature for relevant populations, and obtained input from the program's pediatric cardiology consultant. The resulting risk-based exercise recommendations are designed to complement current published guidelines, maximize safe exercise, and help childhood cancer survivors return to a normal life that emphasizes overall wellness and physical activity. This article describes a single institution's experience in modifying exercise recommendations for at-risk childhood survivors and includes the methods, findings, and current institutional practice recommendations along with sample education materials.

  10. Improving the dependability of research in personality and social psychology: recommendations for research and educational practice.

    Science.gov (United States)

    Funder, David C; Levine, John M; Mackie, Diane M; Morf, Carolyn C; Sansone, Carol; Vazire, Simine; West, Stephen G

    2014-02-01

    In this article, the Society for Personality and Social Psychology (SPSP) Task Force on Publication and Research Practices offers a brief statistical primer and recommendations for improving the dependability of research. Recommendations for research practice include (a) describing and addressing the choice of N (sample size) and consequent issues of statistical power, (b) reporting effect sizes and 95% confidence intervals (CIs), (c) avoiding "questionable research practices" that can inflate the probability of Type I error, (d) making available research materials necessary to replicate reported results, (e) adhering to SPSP's data sharing policy, (f) encouraging publication of high-quality replication studies, and (g) maintaining flexibility and openness to alternative standards and methods. Recommendations for educational practice include (a) encouraging a culture of "getting it right," (b) teaching and encouraging transparency of data reporting, (c) improving methodological instruction, and (d) modeling sound science and supporting junior researchers who seek to "get it right."

  11. Are Adults Diagnosed with Diabetes achieving the American Diabetes Association Clinical Practice Recommendations?

    Science.gov (United States)

    Pérez, Cynthia M.; Febo-Vázquez, Isaedmarie; Guzmán, Manuel; Ortiz, Ana Patricia; Suárez, Erick

    2012-01-01

    Objective This study assessed the proportion of adults with previously diagnosed diabetes mellitus (DM) who met selected preventive practices and treatment goals according to the American Diabetes Association (ADA) standards of medical care. Methods A secondary analysis of data collected for a previous epidemiologic study that used a probability cluster design to select 859 persons aged 21–79 years in the San Juan metropolitan area was undertaken. This study focused on 136 (15.8%) adults who self-reported DM. The Standards of Medical Care in Diabetes published by the ADA in 2011 were used to determine the proportion of adults achieving selected clinical practice recommendations. Results Less than half of adults achieved recommended treatment goals for LDL-cholesterol (47.8%), HDL-cholesterol (44.1%), blood pressure (41.2%) and HbA1c (28.7%). The percentage of adults achieving recommended levels of HbA1c, blood pressure and LDL-cholesterol simultaneously was 6.6%; the percentage achieving HbA1c, blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides and albumin-to-creatinine ratio target levels was only 2.2%. More than half (60.2%) reported daily self-monitoring of foot ulcers and HbA1c testing at least twice over the past year (52.3%). However, less than half reported annual dilated eye examination (49.2%), annual comprehensive foot examination (43.8%), daily self-monitoring blood glucose (37.5%), moderate or vigorous physical activity (33.8%), and self-management DM education (28.9%). Conclusion This study showed that a substantial proportion of adults with DM did not achieve ADA recommendations on selected preventive practices and treatment goals. Strategies to improve DM medical care and surveillance of preventive-care practices and treatment goals among affected individuals are essential for planning further initiatives that contribute to reduce the burden of DM complications. PMID:22432404

  12. A manual of recommended practices for hydrogen energy systems

    Energy Technology Data Exchange (ETDEWEB)

    Hoagland, W.; Leach, S. [W. Hoagland and Associates, Boulder, CO (United States)

    1997-12-31

    Technologies for the production, distribution, and use of hydrogen are rapidly maturing and the number and size of demonstration programs designed to showcase emerging hydrogen energy systems is expanding. The success of these programs is key to hydrogen commercialization. Currently there is no comprehensive set of widely-accepted codes or standards covering the installation and operation of hydrogen energy systems. This lack of codes or standards is a major obstacle to future hydrogen demonstrations in obtaining the requisite licenses, permits, insurance, and public acceptance. In a project begun in late 1996 to address this problem, W. Hoagland and Associates has been developing a Manual of Recommended Practices for Hydrogen Systems intended to serve as an interim document for the design and operation of hydrogen demonstration projects. It will also serve as a starting point for some of the needed standard-setting processes. The Manual will include design guidelines for hydrogen procedures, case studies of experience at existing hydrogen demonstration projects, a bibliography of information sources, and a compilation of suppliers of hydrogen equipment and hardware. Following extensive professional review, final publication will occur later in 1997. The primary goal is to develop a draft document in the shortest possible time frame. To accomplish this, the input and guidance of technology developers, industrial organizations, government R and D and regulatory organizations and others will be sought to define the organization and content of the draft Manual, gather and evaluate available information, develop a draft document, coordinate reviews and revisions, and develop recommendations for publication, distribution, and update of the final document. The workshop, Development of a Manual of Recommended Practices for Hydrogen Energy Systems, conducted on March 11, 1997 in Alexandria, Virginia, was a first step.

  13. Recommended practices for wind farm data collection and reliability assessment for O&M optimization

    DEFF Research Database (Denmark)

    Hahn, Berthold; Welte, Thomas; Faulstich, Stefan

    2017-01-01

    . The complete results of IEA Wind Task 33 are described in the expert group report on recommended practices for "Wind farm data collection and reliability assessment for O&M optimization" which will be published by IEA Wind in 2017. This paper briefly presents the background of the work, the recommended process...

  14. Feeding practices of low-income mothers: how do they compare to current recommendations?

    OpenAIRE

    Power, Thomas G; Hughes, Sheryl O; Goodell, L Suzanne; Johnson, Susan L; Duran, J Andrea Jaramillo; Williams, Kimberly; Beck, Ashley D; Frankel, Leslie A

    2015-01-01

    Background Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Methods Eighty low-income mothers and their preschool children were videotaped a...

  15. Recommendation Report: EJournals/EBooks A-Z Management System

    KAUST Repository

    Ramli, Rindra M.

    2014-01-01

    This is a recommendation report for KAUST Library on the Ejournals / EBooks AZ Management systems project. It briefly described the issues faced by the ERM Team, project plan overview and the project findings as well as the recommendation(s).

  16. Scrum in practice: an overview of Scrum adaptations

    DEFF Research Database (Denmark)

    Hron, Michal; Obwegeser, Nikolaus

    2018-01-01

    Agile software development practices have gained widespread acceptance and application across all industries. Scrum, as one of the most widely used agile methods, has been adopted in countless organizations. However, while there is an understanding that practitioners rarely apply Scrum “by the book......”, only little research addresses the actual adaptations and modifications that are made to fit Scrum to real world requirements: whether it is to solve methodological drawbacks, to fit the method to specific contextual constraints, or to add additional value to the method by augmentation or combination...... with other tools and methods. To get an overview of the proposed adaptations and their implications, this study presents a systematic review of literature reporting on challenges and motivations that lead to modifications of the Scrum method. Based on 31 relevant studies we extract seven distinct motivations...

  17. Chemical Emergencies Overview

    Science.gov (United States)

    ... Address What's this? Submit What's this? Submit Button Chemical Emergencies Overview Recommend on Facebook Tweet Share Compartir ... themselves during and after such an event. What chemical emergencies are A chemical emergency occurs when a ...

  18. MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

    Science.gov (United States)

    Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

    2017-07-01

    The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  19. Best practices in business process redesign: an overview and qualitative evaluation of successful redesign heuristics

    NARCIS (Netherlands)

    Reijers, H.A.; Limam Mansar, S.

    2005-01-01

    To implement business process redesign several best practices can be distinguished. This paper gives an overview of heuristic rules that can support practitioners to develop a business process design that is a radical improvement of a current design. The emphasis is on the mechanics of the process,

  20. Investigation of barriers to clinical practice guideline-recommended pharmacotherapy in the treatment of COPD.

    Directory of Open Access Journals (Sweden)

    Price L

    2007-06-01

    Full Text Available Background: The adoption of clinical practice guideline recommendations for COPD is suboptimal. Determining the barriers to the implementation of these practice guidelines may help improve patient care.Objective: To determine whether barriers to the use of pharmacotherapy according to practice guidelines are related primarily to patient or prescriber factors.Methods: Retrospective cohort study. Members of a health maintenance organization identified as having spirometry-defined COPD ranging from stage II to IV. Electronic medical records were reviewed for documentation of the following: 1 patient affordability issues, 2 history of an adverse drug reaction, 3 history of inefficacy to therapy, and 4 prescription history.Results: A total of 111 medical records were reviewed. There were 51% of patients who had not filled medications that had been prescribed in accordance with guidelines and 43% did not have the guideline recommended medications prescribed in the previous year. Only 4% and 2% of patients had documented inefficacy and affordability issues, respectively. There were no reported cases of adverse drug reactions. Conclusions: This study provides insight to the acceptance of COPD treatment recommendations by patients and providers. Further research is needed to design interventions to reduce barriers and optimize COPD treatment.

  1. The unusual practices within some Neo-Pentecostal churches in South Africa: Reflections and recommendations

    Directory of Open Access Journals (Sweden)

    Mookgo S. Kgatle

    2017-09-01

    Full Text Available This article reflects and makes recommendations on the recent unusual practices within some Neo-Pentecostal churches in South Africa. Neo-Pentecostal churches in South Africa refer to churches that have crossed denominational boundaries. These churches idolise the miraculous, healing, deliverance and enactment of bizarre church performances often performed by charismatic and highly influential spiritual leaders. There have been unusual practices within some Neo-Pentecostal churches that include, among others, the eating of grass, eating of snakes, drinking of petrol, spraying of Doom on the congregants and other experiences. There are many possible theological, psychological and socio-economic explanations for these unusual practices. Given the facts that many South Africans experience various socio-economic challenges, it is argued here that the socio-economic factor is the main explanation for the support of these unusual practices. The unusual practices within some Neo-Pentecostal churches in South Africa are critically unpacked by looking at various churches where the incidents happened. The possible theological, psychological and socio-economic explanations for such practices are outlined in detail. Recommendations are made based on the scientific findings on the unusual practices.

  2. Increasing Glencore's sustainable management performance: recommendation and risks, statements based on literature and best practices

    OpenAIRE

    Gottschall, Arnaud; Maeder, Eric

    2014-01-01

    The main purpose of this report is to provide Glencore with applicable recommendations so that it can improve its sustainable reputation. The second purpose of the work is to present all risks incurred by Glencore’s non-application of sustainable recommendations. Recommendations and risks have been developed based on literature, interviews and companies’ good practices. Sustainability reports of mining companies publicly quoted have been intensively used to grasp the different sustainability ...

  3. Implementation of pressure ulcer prevention best practice recommendations in acute care: an observational study.

    Science.gov (United States)

    Barker, Anna Lucia; Kamar, Jeannette; Tyndall, Tamara Jane; White, Lyn; Hutchinson, Anastasia; Klopfer, Nicole; Weller, Carolina

    2013-06-01

    Pressure ulcers are a common but preventable problem in hospitals. Implementation of best practice guideline recommendations can prevent ulcers from occurring. This 9-year cohort study reports prevalence data from point prevalence surveys during the observation period, and three practice metrics to assess implementation of best practice guideline recommendations: (i) nurse compliance with use of a validated pressure ulcer risk assessment and intervention checklist; (ii) accuracy of risk assessment scoring in usual-care nurses and experienced injury prevention nurses; and (iii) use of pressure ulcer prevention strategies. The prevalence of hospital-acquired pressure ulcers decreased following implementation of an evidence-based prevention programme from 12·6% (2 years preprogramme implementation) to 2·6% (6 years postprogramme implementation) (P pressure ulcer prevention documentation according to best practice guidelines was high (>84%). A sample of 270 patients formed the sample for the study of risk assessment scoring accuracy and use of prevention strategies. It was found usual-care nurses under-estimated patients' risk of pressure ulcer development and under-utilised prevention strategies compared with experienced injury prevention nurses. Despite a significant reduction in prevalence of hospital-acquired pressure ulcers and high documentation compliance, use of prevention strategies could further be improved to achieve better patient outcomes. Barriers to the use of prevention strategies by nurses in the acute hospital setting require further examination. This study provides important insights into the knowledge translation of pressure ulcer prevention best practice guideline recommendations at The Northern Hospital. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

  4. Practice implications and recommendations for managing codeine misuse and dependence

    Directory of Open Access Journals (Sweden)

    Bergin Michael

    2015-12-01

    Full Text Available Codeine, a weak opiate, requires increased pharmacovigilance relating to availability, heterogeneous nature of misuse, dependence and associated harm. A scoping review of literature on codeine was conducted using Arksey & O’Malley’s framework (1. Databases searched included PubMed, EBSCO Host, Science Direct, EMBASE, PsycINFO, Cochrane library and Medline from 1994 to 2014. Follow-up search strategies involved hand searching and searching of pharmaceutical, health, medical and drug related websites. Initial zscreening identified 3,105 articles with 475 meeting the inclusion criteria. Eight broad categories organised the literature, data charting and qualitative synthesis. This paper presents implications for practice and makes recommendations to address these issues. Themes identified relate to raising public and practitioner awareness, risk management, dispensing practices and monitoring and surveillance of codeine. Evidence to inform law enforcement, drug surveillance, public health initiatives, harm reduction approaches, pharmacy, clinical and treatment practices is warranted.

  5. Recommended Screening Practices for Launch Collision Aviodance

    Science.gov (United States)

    Beaver, Brian A.; Hametz, Mark E.; Ollivierre, Jarmaine C.; Newman, Lauri K.; Hejduk, Matthew D.

    2015-01-01

    The objective of this document is to assess the value of launch collision avoidance (COLA) practices and provide recommendations regarding its implementation for NASA robotic missions. The scope of this effort is limited to launch COLA screens against catalog objects that are either spacecraft or debris. No modifications to manned safety COLA practices are considered in this effort. An assessment of the value of launch COLA can be broken down into two fundamental questions: 1) Does collision during launch represent a significant risk to either the payload being launched or the space environment? 2) Can launch collision mitigation be performed in a manner that provides meaningful risk reduction at an acceptable level of operational impact? While it has been possible to piece together partial answers to these questions for some time, the first attempt to comprehensively address them is documented in reference (a), Launch COLA Operations: an Examination of Data Products, Procedures, and Thresholds, Revision A. This report is the product of an extensive study that addressed fundamental technical questions surrounding launch collision avoidance analysis and practice. The results provided in reference (a) will be cited throughout this document as these two questions are addressed. The premise of this assessment is that in order to conclude that launch COLA is a value-added activity, the answer to both of these questions must be affirmative. A "no" answer to either of these questions points toward the conclusion that launch COLA provides little or no risk mitigation benefit. The remainder of this assessment will focus on addressing these two questions.

  6. Breastfeeding and Postpartum Depression: An Overview and Methodological Recommendations for Future Research

    Science.gov (United States)

    Pope, Carley J.; Mazmanian, Dwight

    2016-01-01

    Emerging research suggests that a relationship exists between breastfeeding and postpartum depression; however, the direction and precise nature of this relationship are not yet clear. The purpose of this paper is to provide an overview of the relationship between breastfeeding and postpartum depression as it has been examined in the empirical literature. Also, the potential mechanisms of action that have been implicated in this relationship are also explored. PubMed and PsycINFO were searched using the keywords: breastfeeding with postpartum depression, perinatal depression, postnatal depression. Results of this search showed that researchers have examined this relationship in diverse ways using diverse methodology. In particular, researchers have examined the relationships between postpartum depression and breastfeeding intention, initiation, duration, and dose. Due to a number of methodological differences among past studies we make some recommendations for future research that will better facilitate an integration of findings. Future research should (1) use standardized assessment protocols; (2) confirm diagnosis through established clinical interview when possible; (3) provide a clear operationalized definition for breastfeeding variables; (4) clearly define the postpartum period interval assessed and time frame for onset of symptoms; (5) be prospective or longitudinal in nature; and (6) take into consideration other potential risk factors identified in the empirical literature. PMID:27148457

  7. Breastfeeding and Postpartum Depression: An Overview and Methodological Recommendations for Future Research

    Directory of Open Access Journals (Sweden)

    Carley J. Pope

    2016-01-01

    Full Text Available Emerging research suggests that a relationship exists between breastfeeding and postpartum depression; however, the direction and precise nature of this relationship are not yet clear. The purpose of this paper is to provide an overview of the relationship between breastfeeding and postpartum depression as it has been examined in the empirical literature. Also, the potential mechanisms of action that have been implicated in this relationship are also explored. PubMed and PsycINFO were searched using the keywords: breastfeeding with postpartum depression, perinatal depression, postnatal depression. Results of this search showed that researchers have examined this relationship in diverse ways using diverse methodology. In particular, researchers have examined the relationships between postpartum depression and breastfeeding intention, initiation, duration, and dose. Due to a number of methodological differences among past studies we make some recommendations for future research that will better facilitate an integration of findings. Future research should (1 use standardized assessment protocols; (2 confirm diagnosis through established clinical interview when possible; (3 provide a clear operationalized definition for breastfeeding variables; (4 clearly define the postpartum period interval assessed and time frame for onset of symptoms; (5 be prospective or longitudinal in nature; and (6 take into consideration other potential risk factors identified in the empirical literature.

  8. Antibiotic prophylaxis in veterinary cancer chemotherapy: A review and recommendations.

    Science.gov (United States)

    Bisson, J L; Argyle, D J; Argyle, S A

    2018-06-12

    Bacterial infection following cancer chemotherapy-induced neutropenia is a serious cause of morbidity and mortality in human and veterinary patients. Antimicrobial prophylaxis is controversial in the human oncology field, as any decreased incidence in bacterial infections is countered by patient adverse effects and increased antimicrobial resistance. Comprehensive guidelines exist to aid human oncologists in prescribing antimicrobial prophylaxis but similar recommendations are not available in veterinary literature. As the veterinarian's role in antimicrobial stewardship is increasingly emphasized, it is vital that veterinary oncologists implement appropriate antimicrobial use. By considering the available human and veterinary literature we present an overview of current clinical practices and are able to suggest recommendations for prophylactic antimicrobial use in veterinary cancer chemotherapy patients. © 2018 The Authors. Veterinary and Comparative Oncology published by John Wiley & Sons Ltd.

  9. Dosimetry of clinical neutron and proton beams: An overview of recommendations

    International Nuclear Information System (INIS)

    Vynckier, S.

    2004-01-01

    Neutron therapy beams are obtained by accelerating protons or deuterons on Beryllium. These neutron therapy beams present comparable dosimetric characteristics as those for photon beams obtained with linear accelerators; for instance, the penetration of a p(65) + Be neutron beam is comparable with the penetration of an 8 MV photon beam. In order to be competitive with conventional photon beam therapy, the dosimetric characteristics of the neutron beam should therefore not deviate too much from the photon beam characteristics. This paper presents a brief summary of the neutron beams used in radiotherapy. The dosimetry of the clinical neutron beams is described. Finally, recent and future developments in the field of physics for neutron therapy is mentioned. In the last two decades, a considerable number of centres have established radiotherapy treatment facilities using proton beams with energies between 50 and 250 MeV. Clinical applications require a relatively uniform dose to be delivered to the volume to be treated, and for this purpose the proton beam has to be spread out, both laterally and in depth. The technique is called 'beam modulation' and creates a region of high dose uniformity referred to as the 'spread-out Bragg peak'. Meanwhile, reference dosimetry in these beams had to catch up with photon and electron beams for which a much longer tradition of dosimetry exists. Proton beam dosimetry can be performed using different types of dosemeters, such as calorimeters, Faraday cups, track detectors and ionisation chambers. National standard dosimetry laboratories will, however, not provide a standard for the dosimetry of proton beams. To achieve uniformity on an international level, the use of an ionisation chamber should be considered. This paper reviews and summarises the basic principles and recommendations for the absorbed dose determination in a proton beam, utilising ionisation chambers calibrated in terms of absorbed dose to water. These recommendations

  10. Understanding the Organizational Nature of Student Persistence: Empirically-based Recommendations for Practice.

    Science.gov (United States)

    Berger, Joseph B.

    2002-01-01

    Builds on the assumption that colleges and universities are organizations and subsequently that the organizational perspective provides important insights for improving retention on campuses. A review of existing organizational studies of undergraduate persistence serves as the basis for ten empirically-based recommendations for practice that are…

  11. Knowledge translation: an overview and recommendations in relation to the Fourth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia

    Science.gov (United States)

    2013-01-01

    The growing population of persons with dementia in Canada and the provision of quality care for this population is an issue that no healthcare authority will escape. Physicians often view dementia as a difficult and time-consuming condition to diagnose and manage. Current evidence must be effectively transformed into usable recommendations for physicians; however, we know that use of evidence-based practice recommendations is a challenge in all realms of medical care, and failure to utilize these leads to less than optimal care for patients. Despite this expanding need for readily available resources, knowledge translation (KT) is often seen as a daunting, if not confusing, undertaking for researchers. Here we offer a brief introduction to the processes around KT, including terms and definitions, and outline some common KT frameworks including the knowledge to action cycle, the Promoting Action on Research Implementation in Health Services framework and the Consolidated Framework for Implementation Research. We also outline practical steps for planning and executing a KT strategy particularly around the implementation of recommendations for practice, and offer recommendations for KT planning in relation to the Fourth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia. PMID:24565407

  12. Psychosocial care for cancer: a framework to guide practice, and actionable recommendations for Ontario

    Science.gov (United States)

    Turnbull Macdonald, G.C.; Baldassarre, F.; Brown, P.; Hatton–Bauer, J.; Li, M.; Green, E.; Lebel, S.

    2012-01-01

    Objectives We set out to create a psychosocial oncology care framework and a set of relevant recommendations that can be used to improve the quality of comprehensive cancer care for Ontario patients and their families.meet the psychosocial health care needs of cancer patients and their families at both the provider and system levels. Data Sources and Methods The adapte process and the practice guideline development cycle were used to adapt the 10 recommendations from the 2008 U.S. Institute of Medicine standard Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs into the psychosocial oncology care framework. In addition, the evidence contained in the original document was used, in combination with the expertise of the working group, to create a set of actionable recommendations. Refinement after formal external review was conducted. Data Extraction and Synthesis The new framework consists of 8 defining domains. Of those 8 domains, 7 were adapted from recommendations in the source document; 1 new domain, to raise awareness about the need for psychosocial support of cancer patients and their families, was added. To ensure high-quality psychosocial care and services, 31 actionable recommendations were created. The document was submitted to an external review process. More than 70% of practitioners rated the quality of the advice document as high and reported that they would recommend its use. Conclusions This advice document advocates for a multidisciplinary approach to cancer care in response to the distress experienced by cancer patients and their families. The recommendations will be useful in future to measure performance, quality of practice, and access to psychosocial services. PMID:22876147

  13. How to Measure Motivational Interviewing Fidelity in Randomized Controlled Trials: Practical Recommendations.

    Science.gov (United States)

    Jelsma, Judith G M; Mertens, Vera-Christina; Forsberg, Lisa; Forsberg, Lars

    2015-07-01

    Many randomized controlled trials in which motivational interviewing (MI) is a key intervention make no provision for the assessment of treatment fidelity. This methodological shortcoming makes it impossible to distinguish between high- and low-quality MI interventions, and, consequently, to know whether MI provision has contributed to any intervention effects. This article makes some practical recommendations for the collection, selection, coding and reporting of MI fidelity data, as measured using the Motivational Interviewing Treatment Integrity Code. We hope that researchers will consider these recommendations and include MI fidelity measures in future studies. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Best practice recommendations for the development, implementation, and evaluation of online knowledge translation resources in rehabilitation.

    Science.gov (United States)

    Levac, Danielle; Glegg, Stephanie M N; Camden, Chantal; Rivard, Lisa M; Missiuna, Cheryl

    2015-04-01

    The knowledge-to-practice gap in rehabilitation has spurred knowledge translation (KT) initiatives aimed at promoting clinician behavior change and improving patient care. Online KT resources for physical therapists and other rehabilitation clinicians are appealing because of their potential to reach large numbers of individuals through self-paced, self-directed learning. This article proposes best practice recommendations for developing online KT resources that are designed to translate evidence into practice. Four recommendations are proposed with specific steps in the development, implementation, and evaluation process: (1) develop evidence-based, user-centered content; (2) tailor content to online format; (3) evaluate impact; and (4) share results and disseminate knowledge. Based on KT evidence and instructional design principles, concrete examples are provided along with insights gained from experiences in creating and evaluating online KT resources for physical therapists. In proposing these recommendations, the next steps for research are suggested, and others are invited to contribute to the discussion. © 2015 American Physical Therapy Association.

  15. 1251 seed calibration using afterloading equipment SeedSelectron. Practical solution to meet the recommendations of the AAPM

    International Nuclear Information System (INIS)

    Perez-Calatayud, J.; Richart, J.; Perez-Garcia, J.; Guirado, D.; Ballester, F.; Rodriguez, S.; Santos, M.; Depiaggio, M.; Carmona, V.; Lliso, F.; Camacho, C.; Pujades, M. C.

    2011-01-01

    SeedSelectron is a system used in the afterloader permanent implant brachytherapy seeds 1-125 interstitial prostate. Two aspects are critical when you can meet the recommendations of the AAPM: a practical difficulty to check the quantity of seed required, and the great uncertainty of all measured diodes. The purpose of this paper is to present a practical solution that has been adopted to implement the recommendations of the AAPM

  16. Diversity in smallholder farms growing coffee and their use of recommended coffee management practices in Uganda

    NARCIS (Netherlands)

    Bongers, G.; Fleskens, L.; Ven, van de G.W.J.; Mukasa, D.; Giller, K.E.; Asten, van P.

    2015-01-01

    Many smallholder farm systems in Uganda produce coffee as an important cash crop. Yet coffee yields are poor. To increase farmers’ production, a range of agronomic practices have been recommended by national and international agencies. Yet the adoption potential of recommendations differs between

  17. Scientific Software - the role of best practices and recommendations

    Science.gov (United States)

    Fritzsch, Bernadette; Bernstein, Erik; Castell, Wolfgang zu; Diesmann, Markus; Haas, Holger; Hammitzsch, Martin; Konrad, Uwe; Lähnemann, David; McHardy, Alice; Pampel, Heinz; Scheliga, Kaja; Schreiber, Andreas; Steglich, Dirk

    2017-04-01

    In Geosciences - like in most other communities - scientific work strongly depends on software. For big data analysis, existing (closed or open source) program packages are often mixed with newly developed codes. Different versions of software components and varying configurations can influence the result of data analysis. This often makes reproducibility of results and reuse of codes very difficult. Policies for publication and documentation of used and newly developed software, along with best practices, can help tackle this problem. Within the Helmholtz Association a Task Group "Access to and Re-use of scientific software" was implemented by the Open Science Working Group in 2016. The aim of the Task Group is to foster the discussion about scientific software in the Open Science context and to formulate recommendations for the production and publication of scientific software, ensuring open access to it. As a first step, a workshop gathered interested scientists from institutions across Germany. The workshop brought together various existing initiatives from different scientific communities to analyse current problems, share established best practices and come up with possible solutions. The subjects in the working groups covered a broad range of themes, including technical infrastructures, standards and quality assurance, citation of software and reproducibility. Initial recommendations are presented and discussed in the talk. They are the foundation for further discussions in the Helmholtz Association and the Priority Initiative "Digital Information" of the Alliance of Science Organisations in Germany. The talk aims to inform about the activities and to link with other initiatives on the national or international level.

  18. On the verge of shared decision making in Israel: Overview and future directions.

    Science.gov (United States)

    Karnieli-Miller, Orit; Miron-Shatz, Talya; Siegal, Gil; Zisman-Ilani, Yaara

    2017-06-01

    Israel has a universal-national healthcare system and a progressive health policy legislation which, together, provide its residents with high-level healthcare services and either free or highly subsidized coverage without any pre-existing conditions. However, it is surprising that shared decision making (SDM) practices and policy are not an integral part of Israel's healthcare system. The purpose of this overview is to describe the gap between the organizational-infrastructure compatibility of Israel's universal healthcare policy and the efforts needed to advance SDM as part of routine healthcare practice. Review of recent research and education initiatives will be described as well as recommendations for policy and clinical practice. Copyright © 2017. Published by Elsevier GmbH.

  19. Recommendations to bridge rural/urban drug-use(r) research and practice.

    Science.gov (United States)

    Leukefeld, C G; Edwards, R W

    1999-01-01

    This article presents recommendations developed by a group of United States drug-use(r) researchers interested in rural and urban research and practice who met in Lexington, Kentucky, in October 1996. Overall, there was consensus about the importance of better understanding the urban/rural drug and alcohol use/dependency continuum. It was emphasized that drug and alcohol use/dependency are chronic and relapsing disorders. Definitions of rural and urban are most important, and different definitions may be associated with factors that are masked by population density. Specific recommendations are presented in the following areas: Rural Factors, Epidemiology, HIV/AIDS, Treatment and Other Services, Migration, Youth, Protective Factors, Systems Perspective, Measurement, Confidentiality, Criminal Justice, Research, Policy Research, Economic Factors, Service Providers, and Managed Care.

  20. The CanPain SCI Clinical Practice Guidelines for Rehabilitation Management of Neuropathic Pain after Spinal Cord: screening and diagnosis recommendations.

    Science.gov (United States)

    Mehta, S; Guy, S D; Bryce, T N; Craven, B C; Finnerup, N B; Hitzig, S L; Orenczuk, S; Siddall, P J; Widerström-Noga, E; Casalino, A; Côté, I; Harvey, D; Kras-Dupuis, A; Lau, B; Middleton, J W; Moulin, D E; O'Connell, C; Parrent, A G; Potter, P; Short, C; Teasell, R; Townson, A; Truchon, C; Wolfe, D; Bradbury, C L; Loh, E

    2016-08-01

    Clinical practice guidelines. To develop the first Canadian clinical practice guidelines for screening and diagnosis of neuropathic pain in people with spinal cord injury (SCI). The guidelines are relevant for inpatient and outpatient SCI rehabilitation settings in Canada. The CanPainSCI Working Group reviewed evidence to address clinical questions regarding screening and diagnosis of neuropathic pain after SCI. A consensus process was followed to achieve agreement on recommendations and clinical considerations. Twelve recommendations, based on expert consensus, were developed for the screening and diagnosis of neuropathic pain after SCI. The recommendations address methods for assessment, documentation tools, team member accountability, frequency of screening and considerations for diagnostic investigation. Important clinical considerations accompany each recommendation. The expert Working Group developed recommendations for the screening and diagnosis of neuropathic pain after SCI that should be used to inform practice.

  1. Obesity prevention, screening, and treatment: practices of pediatric providers since the 2007 expert committee recommendations.

    Science.gov (United States)

    Rausch, John Conrad; Perito, Emily Rothbaum; Hametz, Patricia

    2011-05-01

    This study surveyed pediatric primary care providers at a major academic center regarding their attitudes and practices of obesity screening, prevention, and treatment. The authors compared the care providers' reported practices to the 2007 American Medical Association and Centers for Disease Control and Prevention Expert Committee Recommendations to evaluate their adherence to the guidelines and differences based on level of training and specialty. Of 96 providers surveyed, less than half used the currently recommended criteria for identifying children who are overweight (24.7%) and obese (34.4%), with attendings more likely to use the correct criteria than residents (P obesity, the majority felt their counseling was not effective. There was considerable variability in reported practices of lab screening and referral patterns of overweight and obese children. More efforts are needed to standardize providers' approach to overweight and obese children.

  2. Practical consensus recommendations on management of HR + ve early breast cancer with specific reference to genomic profiling

    Directory of Open Access Journals (Sweden)

    S Aggarwal

    2018-01-01

    Full Text Available Breast cancer is a heterogeneous disease and patients are managed clinically based on ER, PR, HER2 expression, and key risk factors. The use of gene expression assays for early stage disease is already common practice. These tests have found a place in risk stratifying the heterogeneous group of stage I–II breast cancers for recurrence, for predicting chemotherapy response, and for predicting breast cancer-related mortality. Most guidelines for hormone receptor (HR–positive early breast cancer recommend addition of adjuvant chemotherapy for most women, leading to overtreatment, which causes considerable morbidity and cost. Expert oncologist discussed about strategies of gene expression assays and aid in chemotherapy recommendations for treatment of HR + ve EBC and the expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.

  3. Need for intraoperative ultrasound and surgical recommendation for partial nephrectomy: correlation with tumor imaging features and urologist practice patterns.

    Science.gov (United States)

    Sun, Maryellen R M; Wagner, Andrew A; San Francisco, Ignacio F; Brook, Alexander; Kavoussi, Louis; Russo, Paul; Steele, Graeme; Viterbo, Rosalia; Pedrosa, Ivan

    2012-03-01

    This study aimed to evaluate the need for intraoperative ultrasound (IOUS) and recommendation for surgical approach in the resection of renal tumors through a survey of practicing urologists, with correlation to tumor imaging features and urologist practice pattern. An institutional review board-approved retrospective review, compliant with the Health Insurance Portability and Accountability Act, of 44 renal tumors that underwent laparoscopic partial nephrectomy at the study institution was performed. The numeric component of the RENAL nephrometry score (radius [diameter], % exophytic, nearness [to collecting system/renal sinus], location) was calculated for each case using preoperative computed tomography/magnetic resonance imaging. Five anonymized images of each tumor were presented to 4 academic urologists with varying practice patterns. Reviewers independently scored each case for its need for IOUS, for recommendation of a surgical technique, and for the difficulty of the proposed surgery. The RENAL scores were as follows: RENAL 1 (low complexity, score 4-6; n = 19); RENAL 2 (moderate complexity, score 7-9; n = 23); RENAL 3 (high complexity, score 10-12; n = 2). The only RENAL score component significantly influencing need for IOUS was percentage exophytic (P = 0.00002). There was an inverse relationship between normalized and averaged need for IOUS and percentage exophytic (P recommendation of surgical method was the reviewer him/herself, with each reviewer's recommendations closely matching his/her practice pattern. Size and percentage exophytic represented the only tumor features significantly (P = 0.03) influencing surgical recommendation. There was a significant difference in the perceived need for IOUS and surgical recommendation when 4 academic urologists reviewed a series of renal masses requiring resection. Percentage exophytic correlated inversely with need for IOUS. Urologist's practice pattern and tumor size and percentage exophytic were most

  4. Practical consensus recommendations on fertility preservation in patients with breast cancer

    Directory of Open Access Journals (Sweden)

    Jyoti Bajpai

    2018-01-01

    Full Text Available Young women diagnosed with cancer today have a greater chance of long-term survival than ever before. Successful survivorship for this group of patients includes maintaining a high quality of life after a cancer diagnosis and treatment; however, lifesaving treatments such as chemotherapy, radiation, and surgery can impact survivors by impairing reproductive and endocrine health. Expert oncologists along with reproductive medicine specialists discuss fertility preservation options in this chapter since fertility preservation is becoming a priority for young women with breast cancer. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations for the benefit of community oncologists.

  5. Climate change and mountain water resources: overview and recommendations for research, management and policy

    Directory of Open Access Journals (Sweden)

    D. Viviroli

    2011-02-01

    Full Text Available Mountains are essential sources of freshwater for our world, but their role in global water resources could well be significantly altered by climate change. How well do we understand these potential changes today, and what are implications for water resources management, climate change adaptation, and evolving water policy? To answer above questions, we have examined 11 case study regions with the goal of providing a global overview, identifying research gaps and formulating recommendations for research, management and policy.

    After setting the scene regarding water stress, water management capacity and scientific capacity in our case study regions, we examine the state of knowledge in water resources from a highland-lowland viewpoint, focusing on mountain areas on the one hand and the adjacent lowland areas on the other hand. Based on this review, research priorities are identified, including precipitation, snow water equivalent, soil parameters, evapotranspiration and sublimation, groundwater as well as enhanced warming and feedback mechanisms. In addition, the importance of environmental monitoring at high altitudes is highlighted. We then make recommendations how advancements in the management of mountain water resources under climate change could be achieved in the fields of research, water resources management and policy as well as through better interaction between these fields.

    We conclude that effective management of mountain water resources urgently requires more detailed regional studies and more reliable scenario projections, and that research on mountain water resources must become more integrative by linking relevant disciplines. In addition, the knowledge exchange between managers and researchers must be improved and oriented towards long-term continuous interaction.

  6. Diagnosis and management of idiopathic pulmonary fibrosis: French practical guidelines

    Directory of Open Access Journals (Sweden)

    Bruno Crestani

    2014-06-01

    Full Text Available Idiopathic pulmonary fibrosis (IPF is the most frequent chronic idiopathic interstitial pneumonia in adults. The management of rare diseases in France has been organised by a national plan for rare diseases, which endorsed a network of expert centres for rare diseases throughout France. This article is an overview of the executive summary of the French guidelines for the management of IPF, an initiative that emanated from the French National Reference Centre and the Network of Regional Competence Centres for Rare Lung Diseases. This review aims at providing pulmonologists with a document that: 1 combines the current available evidence; 2 reviews practical modalities of diagnosis and management of IPF; and 3 is adapted to everyday medical practice. The French practical guidelines result from the combined efforts of a coordination committee, a writing committee and a multidisciplinary review panel, following recommendations from the Haute Autorité de Santé. All recommendations included in this article received at least 90% agreement by the reviewing panel. Herein, we summarise the main conclusions and practical recommendations of the French guidelines.

  7. Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice.

    Science.gov (United States)

    Anderson, Jaclyn; Caplan, Liron; Yazdany, Jinoos; Robbins, Mark L; Neogi, Tuhina; Michaud, Kaleb; Saag, Kenneth G; O'Dell, James R; Kazi, Salahuddin

    2012-05-01

    Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Group (WG) to comprehensively evaluate the validity, feasibility, and acceptability of available RA disease activity measures and derive recommendations for their use in clinical practice. The Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures. Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created. A survey was administered to rheumatologists soliciting input. The WG used these survey results in conjunction with the psychometric analyses to derive final recommendations. Systematic review of the literature resulted in identification of 63 RA disease activity measures. Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation. Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible. From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of ACR-recommended RA disease activity measures. We recommend the Clinical Disease Activity Index, Disease Activity Score with 28-joint counts (erythrocyte sedimentation rate or C-reactive protein), Patient Activity Scale (PAS), PAS-II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings. Copyright © 2012 by the American College of Rheumatology.

  8. Estimating the harms and benefits of prostate cancer screening as used in common practice versus recommended good practice: A microsimulation screening analysis.

    Science.gov (United States)

    Carlsson, Sigrid V; de Carvalho, Tiago M; Roobol, Monique J; Hugosson, Jonas; Auvinen, Anssi; Kwiatkowski, Maciej; Villers, Arnauld; Zappa, Marco; Nelen, Vera; Páez, Alvaro; Eastham, James A; Lilja, Hans; de Koning, Harry J; Vickers, Andrew J; Heijnsdijk, Eveline A M

    2016-11-15

    Prostate-specific antigen (PSA) screening and concomitant treatment can be implemented in several ways. The authors investigated how the net benefit of PSA screening varies between common practice versus "good practice." Microsimulation screening analysis (MISCAN) was used to evaluate the effect on quality-adjusted life-years (QALYs) if 4 recommendations were followed: limited screening in older men, selective biopsy in men with elevated PSA, active surveillance for low-risk tumors, and treatment preferentially delivered at high-volume centers. Outcomes were compared with a base model in which annual screening started at ages 55 to 69 years and were simulated using data from the European Randomized Study of Screening for Prostate Cancer. In terms of QALYs gained compared with no screening, for 1000 screened men who were followed over their lifetime, recommended good practice led to 73 life-years (LYs) and 74 QALYs gained compared with 73 LYs and 56 QALYs for the base model. In contrast, common practice led to 78 LYs gained but only 19 QALYs gained, for a greater than 75% relative reduction in QALYs gained from unadjusted LYs gained. The poor outcomes for common practice were influenced predominantly by the use of aggressive treatment for men with low-risk disease, and PSA testing in older men also strongly reduced potential QALY gains. Commonly used PSA screening and treatment practices are associated with little net benefit. Following a few straightforward clinical recommendations, particularly greater use of active surveillance for low-risk disease and reducing screening in older men, would lead to an almost 4-fold increase in the net benefit of prostate cancer screening. Cancer 2016;122:3386-3393. © 2016 American Cancer Society. © 2016 American Cancer Society.

  9. [Treatment with psychotropic agents in patients with dementia and delirium : Gap between guideline recommendations and treatment practice].

    Science.gov (United States)

    Hewer, Walter; Thomas, Christine

    2017-02-01

    Psychiatric symptoms in dementia and delirium are associated with a substantially reduced quality of life of patients and their families and often challenging for professionals. Pharmacoepidemiological surveys have shown that, in particular, patients living in nursing homes receive prescriptions of psychotropic agents in significant higher frequency than recommended by current guidelines. This article focuses on a critical appraisal of this gap from the point of view of German healthcare services. Narrative review with special reference to the German dementia guideline from 2016 and recently published practice guidelines for delirium in old age in German and English language. The indications for use of psychotropic agents, especially antipsychotics, are defined narrowly in the German dementia guideline. According to this guideline for several psychopathological symptoms evidence based recommendations cannot be given, currently. For delirium several practice guidelines related to different treatment settings have been published recently. Comparable to the German dementia guideline they recommend general medical interventions and nonpharmacological treatment as first line measures and the use of psychotropic agents only under certain conditions. These guidelines differ to some extent regarding the strength of recommendation for psychopharmacological treatment. The guidelines discussed here advocate well-founded a cautious prescription of psychotropic agents in patients with dementia and delirium. This contrasts to everyday practice which is characterized by significantly higher prescription rates. This gap may explained partially by a lack of evidence-based recommendations regarding certain psychopathological symptoms. Most notably, however, epidemiological data disclose an unacceptable rate of hazardous overtreatment with psychotropic agents, especially in long-term care of persons with dementia. In this situation counteractive measures by consequent implementation

  10. Practical Dietary Recommendations for the Prevention and Management of Nonalcoholic Fatty Liver Disease in Adults.

    Science.gov (United States)

    George, Elena S; Forsyth, Adrienne; Itsiopoulos, Catherine; Nicoll, Amanda J; Ryan, Marno; Sood, Siddharth; Roberts, Stuart K; Tierney, Audrey C

    2018-01-01

    Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. In the absence of effective pharmacotherapies, clinical guidelines focus primarily on weight loss to treat this condition. Established consensus, evidence-based, and clinical dietary recommendations for NAFLD are currently lacking. The aim of this paper is to provide evidence-based practical dietary recommendations for the prevention and management of NAFLD in adults. A literature review focusing on established principles for the development of clinical practice recommendations was employed using the following criteria: based on substantial evidence, ensures risk minimization, is flexible for an individual patient approach, and is open to further modification as evidence emerges. The Practice-based Evidence in Nutrition classification system was used to grade these principles. Five key dietary recommendations were developed: 1) follow traditional dietary patterns, such as the Mediterranean diet; 2) limit excess fructose consumption and avoid processed foods and beverages with added fructose; 3) PUFAs, especially long-chain omega-3 rich foods and MUFAs, should replace SFAs in the diet; 4) replace processed food, fast food, commercial bakery goods, and sweets with unprocessed foods high in fiber, including whole grains, vegetables, fruits, legumes, nuts, and seeds; and 5) avoid excess alcohol consumption. Improving diet quality may reduce the incidence and progression of NAFLD and associated risk factors. Many of the benefits are likely to result from the collective effect of dietary patterns. High-quality research-in particular, randomized clinical trials assessing dietary interventions that focus on liver-specific endpoints-are needed as a priority. © 2018 American Society for Nutrition. All rights reserved.

  11. Physics Survey Overview

    International Nuclear Information System (INIS)

    2002-01-01

    An overview of a series of assignments of the branches of physics carried out by the Board on Physics and Astronomy of the National Research Council. It identifies further theories in physics and makes recommendations on preventive priorities. The Board on Physics and Astronomy (BPA) has conducted a new decadal survey of physics entitled ''Physics in a New Era''. The survey includes assessments of the main branches of physics as well as certain selected emerging areas. The various elements of the survey were prepared by separately-appointed National Research Council (NRC) committees. The BPA formed the Physics Survey Overview Committee (PSOVC) to complete the survey by preparing an overview of the field of physics to summarize and synthesize the results of the various assessments and to address cross-cutting issues that concern physics as a whole

  12. Yellow Fever Vaccine Booster Doses: Recommendations of the Advisory Committee on Immunization Practices, 2015.

    Science.gov (United States)

    Staples, J Erin; Bocchini, Joseph A; Rubin, Lorry; Fischer, Marc

    2015-06-19

    On February 26, 2015, the Advisory Committee on Immunization Practices (ACIP) voted that a single primary dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers. ACIP also approved recommendations for at-risk laboratory personnel and certain travelers to receive additional doses of yellow fever vaccine (Box). The ACIP Japanese Encephalitis and Yellow Fever Vaccines Workgroup evaluated published and unpublished data on yellow fever vaccine immunogenicity and safety. The evidence for benefits and risks associated with yellow fever vaccine booster doses was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. This report summarizes the evidence considered by ACIP and provides the updated recommendations for yellow fever vaccine booster doses.

  13. Practical evaluation of robots for elderly in Denmark — an overview

    DEFF Research Database (Denmark)

    Hansen, Søren Tranberg; Andersen, Hans Jørgen; Bak, Thomas

    2010-01-01

    Robots for elderly have drawn a great deal of attention as it is a controversial topic being pushed forward by the fact that there will be a dramatic increase of elderly in most western countries. Within the field of HRI, much research has been conducted on robots interacting with elderly and also...... a number of commercial products have been introduced to the market. Since 2006, a number of projects have been launched in Denmark in order to evaluate robot technology in practice in elder care. This paper gives an brief overview of a selected number of projects and outlines the characteristics...... and results. Finally it is discussed how HRI can benefit from these....

  14. What the recommended practice for setpoint determination methodologies does or does not do. Part 2

    International Nuclear Information System (INIS)

    Beuchel, B.E.; Annon, M.C.

    1991-01-01

    The long-awaited Recommended Practice (RP) to complement ISA S67.04-1987 Setpoints for Nuclear Safety-Related Instrumentation is very close to publication. The RP, entitled Methodologies for the Determination of Setpoints for Nuclear Safety-Related Instrumentation, has been prepared through the efforts of over 50 persons representing over 20 utilities, all four LWR NSSS vendors, three instrument manufacturers, several architectural engineering firms, numerous consulting firms and other individuals. Throughout the period during which the RP was being prepared, it became apparent to the RP Committee members that the scope and approaches outlined in the RP were not fully understood by the general nuclear community. Therefore, the goals of this paper are to enhance the understanding of the RP and facilitate the utilization of the RP by potential users. The primary objective of the paper is to provide a broad overview of the purpose and scope of the RP. This will be achieved by describing the general organization of the RP as well as a brief explanation of the contents of each section. The paper will also discuss the role of the RP in the development of actual setpoint calculations, i.e., and explanation of the need for a user's specific methodology document to customize the RP for a specific user. In addition, the paper identifies, and attempts to clarify, several potential misconceptions by users, as to what the RP does not do

  15. Practical recommendations for the evaluation of improvement initiatives

    Science.gov (United States)

    Parry, Gareth; Coly, Astou; Goldmann, Don; Rowe, Alexander K; Chattu, Vijay; Logiudice, Deneil; Rabrenovic, Mihajlo; Nambiar, Bejoy

    2018-01-01

    Abstract A lack of clear guidance for funders, evaluators and improvers on what to include in evaluation proposals can lead to evaluation designs that do not answer the questions stakeholders want to know. These evaluation designs may not match the iterative nature of improvement and may be imposed onto an initiative in a way that is impractical from the perspective of improvers and the communities with whom they work. Consequently, the results of evaluations are often controversial, and attribution remains poorly understood. Improvement initiatives are iterative, adaptive and context-specific. Evaluation approaches and designs must align with these features, specifically in their ability to consider complexity, to evolve as the initiative adapts over time and to understand the interaction with local context. Improvement initiatives often identify broadly defined change concepts and provide tools for care teams to tailor these in more detail to local conditions. Correspondingly, recommendations for evaluation are best provided as broad guidance, to be tailored to the specifics of the initiative. In this paper, we provide practical guidance and recommendations that funders and evaluators can use when developing an evaluation plan for improvement initiatives that seeks to: identify the questions stakeholders want to address; develop the initial program theory of the initiative; identify high-priority areas to measure progress over time; describe the context the initiative will be applied within; and identify experimental or observational designs that will address attribution. PMID:29447410

  16. The use of lithium for the treatment of bipolar disorder: Recommendations from clinical practice guidelines.

    Science.gov (United States)

    Malhi, Gin S; Gessler, Danielle; Outhred, Tim

    2017-08-01

    Lithium is an effective mood stabilizer that is used principally for the management of bipolar disorder (BD). Its administration is complex and often requires sophisticated management and assiduous monitoring. When considering the use of lithium therapy for bipolar disorder, clinicians are advised to refer to recommendations outlined in clinical practice guidelines (CPGs); but because of varying emphases placed by different international CPGs, recommendations addressing the practical use of lithium lack consistency. In order to inform clinicians of optimal lithium therapy for bipolar disorder, we compared and synthesized recommendations for the treatment of bipolar disorder made by recognized CPGs internationally. We conducted a search of the literature and extracted guidance across multiple clinical issues, including clinical indications, disorder subtypes, additional uses, special populations, practical aspects, and side effects. Collectively, CPGs consider lithium most robustly as a first-line intervention for maintenance treatment of bipolar disorder and strongly for the treatment of mania, with relatively modest support for the management of acute bipolar depression. Additionally, there is consensus across the CPGs that lithium tangibly reduces the risk of suicide. Generally, CPGs provide guidance on the many facets of initiating and maintaining patients on lithium therapy, but individually the CPGs varied in terms of depth and practical guidance they provide across these areas. However, consensus was established across many key areas of practice such as the ideal lithium plasma concentration for maintenance and monitoring (0.6-0.8mmol/L), along with the need for regular monitoring of renal and endocrine function. However, with more complex aspects (e.g., atypical presentations) and in special populations (e.g., youth; pregnancy and post-partum; older adults), guidance varied considerably and clear consensus recommendations were more difficult to achieve. In

  17. Subjective memory impairment in general practice : Short overview and design of a mixed methods study.

    Science.gov (United States)

    Pentzek, Michael; Leve, Verena; Leucht, Verena

    2017-05-01

    Public awareness for dementia is rising and patients with concerns about forgetfulness are not uncommon in general practice. For the general practitioner (GP) subjectively perceived memory impairment (SMI) also offers a chance to broach the issue of cognitive function with the patient. This may support GPs' patient-centered care in terms of a broader frailty concept. What is SMI (definition, operationalization, prevalence and burden)? Which conceptions and approaches do GPs have regarding SMI? Narrative overview of recent SMI criteria and results, selective utilization of results from a systematic literature search on GP dementia care, non-systematic search regarding SMI in general practice, deduction of a study design from the overview and development according to international standards. Studies revealed that approximately 60% of GP patients aged >74 reported a declining memory, every sixth person had concerns about this aspect and only relatively few seek medical advice. Concerns about SMI are considered a risk factor for future dementia. Specific general practice conceptions about SMI could not be identified in the literature. Using guidelines for mixed methods research, the design of an exploratory sequential mixed methods study is presented, which should reveal different attitudes of GPs towards SMI. Subjective memory impairment (SMI) is a common feature and troubles a considerable proportion of patients. Neuropsychiatric research is progressing, but for the transfer of the SMI concept into routine practice, involvement of GP research is necessary. A new study aims to make a contribution to this.

  18. Compliance with NAGCAT work practices recommendations for youth cleaning service alleys in stall barns.

    Science.gov (United States)

    Canan, B D; Asti, L; Heaney, C; Ashida, S; Renick, K; Xiang, H; Stallones, L; Jepsen, S D; Crawford, J M; Wilkins, J R

    2011-04-01

    Unintentional injury is the leading cause of death in the U.S. among persons 1 to 44 years of age. Over one million children and adolescents in the U.S. live, work, and/or play on farms, where injury risk is relatively high compared to other settings. In an attempt to reduce the number of childhood agricultural injuries occurring on farms, the North American Guidelines for Children's Agricultural Tasks (NAGCAT) was developed to assist parents or other caregivers in assigning developmentally appropriate chores to youth exposed to agricultural hazards. The results presented here are from a longitudinal study in which we obtained (self-reported) daily chore, injury, and safety behavior data from children and adolescents. We focused on one NAGCAT chore, cleaning a service alley in a stall barn, in order to estimate the extent of compliance with specific work practice recommendations contained in the NAGCAT. Our results indicated that among the four NAGCAT-recommended safety practices for cleaning service alleys in stall barns (wearing nonskid shoes, leather gloves, a respirator, and eye protection), wearing non-skid shoes was the only safety practice reported with any degree of regularity. Overall, boys were more likely to wear non-skid shoes compared to girls. In addition, older youth were generally more likely to report higher work practice compliance compared to younger youth.

  19. Corruption in Education Systems: A Review of Practices, Causes, Effects and Recommendations

    Directory of Open Access Journals (Sweden)

    Sergio Cárdenas Denham

    2012-11-01

    Full Text Available Achieving higher levels of transparency and accountability in education systems is essential for attaining an adequate distribution of educational opportunities. Studies of corruption in education systems are important since they can contribute to increasing public awareness of the harmful effects of corruption and promote political support for the implementation of anti-corruption initiatives in education. This paper describes a typology of corrupt practices and develops a classification for the findings reported in the literature on corruption in education, such as causes, consequences and recommendations, as well as a classification of the methodologies applied to the study of corrupt practices. Finally, it describes the possible implications of these findings for policymakers.

  20. Recommended Practice for Patch Management of Control Systems

    Energy Technology Data Exchange (ETDEWEB)

    Steven Tom; Dale Christiansen; Dan Berrett

    2008-12-01

    A key component in protecting a nation’s critical infrastructure and key resources is the security of control systems. The term industrial control system refers to supervisory control and data acquisition, process control, distributed control, and any other systems that control, monitor, and manage the nation’s critical infrastructure. Critical Infrastructure and Key Resources (CIKR) consists of electric power generators, transmission systems, transportation systems, dam and water systems, communication systems, chemical and petroleum systems, and other critical systems that cannot tolerate sudden interruptions in service. Simply stated, a control system gathers information and then performs a function based on its established parameters and the information it receives. The patch management of industrial control systems software used in CIKR is inconsistent at best and nonexistent at worst. Patches are important to resolve security vulnerabilities and functional issues. This report recommends patch management practices for consideration and deployment by industrial control systems owners.

  1. Nutritional Practices of National Female Soccer Players: Analysis and Recommendations

    Science.gov (United States)

    Martin, Louise; Lambeth, Anneliese; Scott, Dawn

    2006-01-01

    The aim of the study was to establish the nutritional practices and activity patterns of elite female soccer players. The nutritional intake of 16 female England Soccer players was self-reported over a seven-day period. Participants were provided with written and verbal guidelines for the completion of the diaries. Training details were also recorded, and used in combination with BMR predictions to calculate daily energy expenditure. Energy, macronutrient and micronutrient intakes were determined using DietMaster 4.0 software. Results suggest that energy intake was low (1904 ± 366.3 kcal) in relation to previous recommendations for soccer players. Energy expenditure (2153.5 ± 596.2 kcal) was not significantly different (p > 0.05) from intake, suggesting energy balance was achieved. Carbohydrate (53.8 ± 6.8%), protein (16.8 ± 2.1%) and fat (28.8 ± 6.6%) intakes were in line with recommendations. Fluid intake (2466 ± 1350.5ml·day-1) was sufficient to meet baseline recommendations, but would need to be higher to meet the additional requirement of training and competition. With the exception of vitamin A and iron, all micronutrient intakes were higher than the DRI. In conclusion, recommendations for female soccer players are to encourage consumption of carbohydrate-electrolyte beverages to enhance carbohydrate intake and increase fluid intake, and ensure sufficient iron rich foods are included in the diet to meet the DRI. Key points Female soccer players demonstrate a low energy intake in relation to predicted requirements, but were in energy balance in this study. Increased carbohydrate intake may be beneficial to both training and competition performance of elite female soccer players Fluid requirements should be addressed on an individual basis and matched to player requirements. The iron status of female soccer players may be compromised due to insufficient dietary intake to meet the DRV. PMID:24198690

  2. Nutritional practices of national female soccer players: analysis and recommendations.

    Science.gov (United States)

    Martin, Louise; Lambeth, Anneliese; Scott, Dawn

    2006-01-01

    The aim of the study was to establish the nutritional practices and activity patterns of elite female soccer players. The nutritional intake of 16 female England Soccer players was self-reported over a seven-day period. Participants were provided with written and verbal guidelines for the completion of the diaries. Training details were also recorded, and used in combination with BMR predictions to calculate daily energy expenditure. Energy, macronutrient and micronutrient intakes were determined using DietMaster 4.0 software. Results suggest that energy intake was low (1904 ± 366.3 kcal) in relation to previous recommendations for soccer players. Energy expenditure (2153.5 ± 596.2 kcal) was not significantly different (p > 0.05) from intake, suggesting energy balance was achieved. Carbohydrate (53.8 ± 6.8%), protein (16.8 ± 2.1%) and fat (28.8 ± 6.6%) intakes were in line with recommendations. Fluid intake (2466 ± 1350.5ml·day(-1)) was sufficient to meet baseline recommendations, but would need to be higher to meet the additional requirement of training and competition. With the exception of vitamin A and iron, all micronutrient intakes were higher than the DRI. In conclusion, recommendations for female soccer players are to encourage consumption of carbohydrate-electrolyte beverages to enhance carbohydrate intake and increase fluid intake, and ensure sufficient iron rich foods are included in the diet to meet the DRI. Key pointsFemale soccer players demonstrate a low energy intake in relation to predicted requirements, but were in energy balance in this study.Increased carbohydrate intake may be beneficial to both training and competition performance of elite female soccer playersFluid requirements should be addressed on an individual basis and matched to player requirements.The iron status of female soccer players may be compromised due to insufficient dietary intake to meet the DRV.

  3. Feeding practices of low-income mothers: how do they compare to current recommendations?

    Science.gov (United States)

    Power, Thomas G; Hughes, Sheryl O; Goodell, L Suzanne; Johnson, Susan L; Duran, J Andrea Jaramillo; Williams, Kimberly; Beck, Ashley D; Frankel, Leslie A

    2015-03-07

    Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Eighty low-income mothers and their preschool children were videotaped at dinner in their homes. Mothers were chosen from a larger study to create a 2 X 2 X 2 design: maternal ethnicity (African American vs. Latina) by child gender by child weight status (healthy weight vs. overweight/obese). Observers coded videotapes for a range of maternal feeding strategies and other behaviors. Many mothers spent considerable time encouraging eating--often in spite of the child's insistence that he or she was finished. Mothers talked little about food characteristics, rarely referred to feelings of hunger and fullness, and made more attempts to enforce table manners than to teach eating skills. Latina mothers showed higher levels of teaching eating skills and encouraging their children to eat; African American mothers showed higher levels of enforcing table manners and getting children to clear their plates. Mothers of boys used more unelaborated commands and less questions/suggestions than mothers of girls. Finally, compared to mothers of overweight/obese children, mothers of healthy weight children showed higher levels of encouraging eating and lower levels of discouraging eating. Most of the mothers in this study did not engage in feeding practices that are consistent with current recommendations. They did this, despite the fact that they knew they were being observed. These results should be used to inform future research about the motivations behind mothers' feeding practices and the development of interventions by helping identify areas in greatest need of change.

  4. Practical consensus recommendations on management of triple-negative metastatic breast cancer

    Directory of Open Access Journals (Sweden)

    R Rangarao

    2018-01-01

    Full Text Available Patients with breast cancer along with metastatic estrogen and progesterone receptor (ER/PR- and human epidermal growth factor receptor 2 (HER2-negative tumors are referred to as having metastatic triple-negative breast cancer (mTNBC disease. Resistance to current standard therapies such as anthracyclines or taxanes limits the available options for previously treated patients with metastatic TNBC to a small number of non-cross-resistant regimens, and there is currently no preferred standard chemotherapy. Clinical experience suggests that many women with triple-negative metastatic breast cancer (MBC relapse quickly. Expert oncologist discussed about new chemotherapeutic strategies and agents used in treatment of mTNBC and the expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.

  5. Electronic Resources Management System: Recommendation Report 2017

    KAUST Repository

    Ramli, Rindra M.

    2017-01-01

    This recommendation report provides an overview of the selection process for the new Electronic Resources Management System. The library has decided to move away from Innovative Interfaces Millennium ERM module. The library reviewed 3 system

  6. Recommendations From the International Consortium on Professional Nursing Practice in Long-Term Care Homes.

    Science.gov (United States)

    McGilton, Katherine S; Bowers, Barbara J; Heath, Hazel; Shannon, Kay; Dellefield, Mary Ellen; Prentice, Dawn; Siegel, Elena O; Meyer, Julienne; Chu, Charlene H; Ploeg, Jenny; Boscart, Veronique M; Corazzini, Kirsten N; Anderson, Ruth A; Mueller, Christine A

    2016-02-01

    In response to the International Association of Gerontology and Geriatrics' global agenda for clinical research and quality of care in long-term care homes (LTCHs), the International Consortium on Professional Nursing Practice in Long Term Care Homes (the Consortium) was formed to develop nursing leadership capacity and address the concerns regarding the current state of professional nursing practice in LTCHs. At its invitational, 2-day inaugural meeting, the Consortium brought together international nurse experts to explore the potential of registered nurses (RNs) who work as supervisors or charge nurses within the LTCHs and the value of their contribution in nursing homes, consider what RN competencies might be needed, discuss effective educational (curriculum and practice) experiences, health care policy, and human resources planning requirements, and to identify what sustainable nurse leadership strategies and models might enhance the effectiveness of RNs in improving resident, family, and staff outcomes. The Consortium made recommendations about the following priority issues for action: (1) define the competencies of RNs required to care for older adults in LTCHs; (2) create an LTCH environment in which the RN role is differentiated from other team members and RNs can practice to their full scope; and (3) prepare RN leaders to operate effectively in person-centered care LTCH environments. In addition to clear recommendations for practice, the Consortium identified several areas in which further research is needed. The Consortium advocated for a research agenda that emphasizes an international coordination of research efforts to explore similar issues, the pursuit of examining the impact of nursing and organizational models, and the showcasing of excellence in nursing practice in care homes, so that others might learn from what works. Several studies already under way are also described. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care

  7. Predicting abuse potential of stimulants and other dopaminergic drugs: overview and recommendations.

    Science.gov (United States)

    Huskinson, Sally L; Naylor, Jennifer E; Rowlett, James K; Freeman, Kevin B

    2014-12-01

    Examination of a drug's abuse potential at multiple levels of analysis (molecular/cellular action, whole-organism behavior, epidemiological data) is an essential component to regulating controlled substances under the Controlled Substances Act (CSA). We reviewed studies that examined several central nervous system (CNS) stimulants, focusing on those with primarily dopaminergic actions, in drug self-administration, drug discrimination, and physical dependence. For drug self-administration and drug discrimination, we distinguished between experiments conducted with rats and nonhuman primates (NHP) to highlight the common and unique attributes of each model in the assessment of abuse potential. Our review of drug self-administration studies suggests that this procedure is important in predicting abuse potential of dopaminergic compounds, but there were many false positives. We recommended that tests to determine how reinforcing a drug is relative to a known drug of abuse may be more predictive of abuse potential than tests that yield a binary, yes-or-no classification. Several false positives also occurred with drug discrimination. With this procedure, we recommended that future research follow a standard decision-tree approach that may require examining the drug being tested for abuse potential as the training stimulus. This approach would also allow several known drugs of abuse to be tested for substitution, and this may reduce false positives. Finally, we reviewed evidence of physical dependence with stimulants and discussed the feasibility of modeling these phenomena in nonhuman animals in a rational and practical fashion. This article is part of the Special Issue entitled 'CNS Stimulants'. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. An overview of age estimation in forensic anthropology: perspectives and practical considerations.

    Science.gov (United States)

    Márquez-Grant, Nicholas

    2015-01-01

    Information on methods of age estimation in physical anthropology, in particular with regard to age-at-death from human skeletal remains, is widely available in the literature. However, the practicalities and real challenges faced in forensic casework are not always highlighted. To provide a practitioner's perspective, regarding age estimation in forensic anthropology (both in the living as well as the dead), with an emphasis on the types of cases, the value of such work and its challenges and limitations. The paper reviews the current literature on age estimation with a focus on forensic anthropology, but it also brings the author's personal perspective derived from a number of forensic cases. Although much is known about what methods to use, but not always how to apply them, little attention has been given in the literature to the real practicalities faced by forensic anthropologists, for example: the challenges in different types of scenarios; how to report age estimations; responsibilities; and ethical concerns. This paper gathers some of these aspects into one overview which includes the value of such work and the practical challenges, not necessarily with the methods themselves, but also with regard to how these are applied in the different cases where age estimation is required.

  9. Preventive dentistry: practitioners' recommendations for low-risk patients compared with scientific evidence and practice guidelines.

    Science.gov (United States)

    Frame, P S; Sawai, R; Bowen, W H; Meyerowitz, C

    2000-02-01

    The purpose of this article is to compare published evidence supporting procedures to prevent dental caries and periodontal disease, in low-risk patients, with the actual preventive recommendations of practicing dentists. Methods included (1) a survey questionnaire of general dentists practicing in western New York State concerning the preventive procedures they would recommend and at what intervals for low-risk children, young adults, and older adults; and (2) review of the published, English-language literature for evidence supporting preventive dental interventions. The majority of dentists surveyed recommended semiannual visits for visual examination and probing to detect caries (73% to 79%), and scaling and polishing to prevent periodontal disease (83% to 86%) for low-risk patients of all ages. Bite-wing radiographs were recommended for all age groups at annual or semiannual intervals. In-office fluoride applications were recommended for low-risk children at intervals of 6 to 12 months by 73% of dentists but were recommended for low-risk older persons by only 22% of dentists. Application of sealants to prevent pit and fissure caries was recommended for low-risk children by 22% of dentists. Literature review found no studies comparing different frequencies of dental examinations and bite-wing radiographs to determine the optimal screening interval in low-risk patients. Two studies of the effect of scaling and polishing on the prevention of periodontal disease found no benefit from more frequent than annual treatments. Although fluoride is clearly a major reason for the decline in the prevalence of dental caries, there are no studies of the incremental benefit of in-office fluoride treatments for low-risk patients exposed to fluoridated water and using fluoridated toothpaste. Comparative studies using outcome end points are needed to determine the optimal frequency of dental examinations and bite-wing radiographs for the early detection of caries, and of scaling

  10. Is there a gap between recommended and ‘real world’ practice in the management of depression in young people? A medical file audit of practice

    Directory of Open Access Journals (Sweden)

    Hetrick Sarah E

    2012-06-01

    Full Text Available Abstract Background Literature has shown that dissemination of guidelines alone is insufficient to ensure that guideline recommendations are incorporated into every day clinical practice. Methods We aimed to investigate the gaps between guideline recommendations and clinical practice in the management of young people with depression by undertaking an audit of medical files in a catchment area public mental health service for 15 to 25 year olds in Melbourne, Australia. Results The results showed that the assessment and recording of depression severity to ensure appropriate treatment planning was not systematic nor consistent; that the majority of young people (74.5% were prescribed an antidepressant before an adequate trial of psychotherapy was undertaken and that less than 50% were monitored for depression symptom improvement and antidepressant treatment emergent suicide related behaviours (35% and 30% respectively. Encouragingly 92% of first line prescriptions for those aged 18 years or under who were previously antidepressant-naïve was for fluoxetine as recommended. Conclusions This research has highlighted the need for targeted strategies to ensure effective implementation. These strategies might include practice system tools that allow for systematic monitoring of depression symptoms and adverse side effects, particularly suicide related behaviours. Additionally, youth specific psychotherapy that incorporates the most effective components for this age group, delivered in a youth friendly way would likely aid effective implementation of guideline recommendations for engagement in an adequate trial of psychotherapy before medication is initiated.

  11. Best practice guidelines for stroke in Cameroon: An innovative and participatory knowledge translation project

    Directory of Open Access Journals (Sweden)

    Lynn Cockburn

    2014-11-01

    Objectives: The purpose of this article is to describe how a group of front-line practitioners collaborated with academics and students to develop best practice guidelines (BPG for the management and rehabilitation of stroke in adult patients in Cameroon. Method: A working group was established and adapted internationally recognised processes for the development of best practice guidelines. The group determined the scope of the guidelines, documented current practices, and critically appraised evidence to develop guidelines relevant to the Cameroon context. Results: The primary result of this project is best practice guidelines which provided an overview of the provision of stroke rehabilitation services in the region, and made 83 practice recommendations to improve these services. We also report on the successes and challenges encountered during the process, and the working group’s recommendations aimed at encouraging others to consider similar projects. Conclusion: This project demonstrated that there is interest and capacity for improving stroke rehabilitation practices and for stroke guideline development in Africa.

  12. Adherence to cardiac practice guidelines in the management of Non-ST-Elevation Acute Coronary Syndromes: a systematic literature review.

    NARCIS (Netherlands)

    Engel, J.; Damen, N.L.; Wulp, I. van der; Bruijne, M.C. de; Wagner, C.

    2017-01-01

    Background: In the management of non-ST-elevation acute coronary syndrome (NSTACS) a gap between guideline-recommended care and actual practice has been reported. A systematic overview of the actual extent of this gap, its potential impact on patient-outcomes, and influential factors is lacking.

  13. Practical Recommendations on Supplemental Feeding Introduction

    Directory of Open Access Journals (Sweden)

    S. G. Makarova

    2015-01-01

    Full Text Available Despite the availability of a national consensus document describing in detail modern approaches to feeding infants, pediatricians keep on giving most diverse recommendations on the time of supplemental feeding introduction. The article presents a brief historical review, as well the modern view on the issue of introduction of supplemental feeding to children. In the previous century, it was common both in Russia and most European countries to introduce supplemental feeding to children at the age of 2 or even 1.5 months. In 2002, the World Health Organization put forward an initiative in support of breastfeeding and recommended not to introduce supplemental feeding before the age of 6 months. A certain “golden mean” has apparently been achieved on the basis of results of studies and a longterm discussion among the specialists in feeding from different countries — all scientific communities and national recommendations of most countries define the optimal age for supplemental feeding introduction as “from 4 (completed months to 6 (completed months” with certain individual approach. 

  14. Interventions for sustained healthcare professional behaviour change: a protocol for an overview of reviews.

    Science.gov (United States)

    Dombrowski, Stephan U; Campbell, Pauline; Frost, Helen; Pollock, Alex; McLellan, Julie; MacGillivray, Steve; Gavine, Anna; Maxwell, Margaret; O'Carroll, Ronan; Cheyne, Helen; Presseau, Justin; Williams, Brian

    2016-10-13

    quality of evidence used to determine implications for clinical practice and make recommendations for future research. This overview will bring together the best available evidence relating to the sustainability of health professional behaviour change, thus supporting policy makers with decision-making in this field.

  15. RECOMMENDER SYSTEMS IN E-COMMERCE APPLICATIONS

    Directory of Open Access Journals (Sweden)

    Gyöngyvér KOVÁCS

    2016-12-01

    Full Text Available One of the major problem with online shopping is finingd the right product, because finding the right product presumes that we know its name, but in most cases it is not so. For this reason the users need help in the process of online searching/shopping. Recommender systems have became a popular technique and strategy for helping users to select desirable products or services. In the past few years the recommender systems have changed from novelties used by a few big e-commerce sites, to serious business tools that are re-shaping the world of e-commerce. In this paper, we provide a brief overview of the classification of recommendation systems based on technology used to create recommendations, and inputs they need from the customers. Furthermore we analyze a few algorithms used by recommender systems and we will also present some marketing recommender systems and their comparative analysis.

  16. New radiation quantities recommended by ICRU for practical use in radiological protection: their implementation in the United Kingdom

    International Nuclear Information System (INIS)

    1986-06-01

    This report considers the practical application of both the ICRU Report No. 39 and the ICRP Statement of 1985 and recommends the implementation of the ICRU operational quantities in the United Kingdom but, at this stage, the increase in the Q values for neutrons is not recommended. No other changes in Q are expected for some years. (author)

  17. Teaching reading comprehension to learners with autism spectrum disorder: Discrepancies between teacher and research-recommended practices.

    Science.gov (United States)

    Accardo, Amy L; Finnegan, Elizabeth G

    2017-11-01

    Students with autism spectrum disorder have been found to experience difficulty with reading comprehension despite intact decoding and word recognition. This identified need for targeted reading comprehension remediation results in a need for teachers to utilize research-based practices and to individualize instruction for students with autism spectrum disorder; however, teachers report a lack of access to such practices. This study utilized survey methodology to gather perceptions and experiences of teachers and to compare teacher preparedness to use effective instructional practices emerging from the extant research to teacher-reported effective practices in the classroom. Study findings, based on 112 participants, reveal a discrepancy between teacher-reported effective practices, and the practices identified as effective through research, indicating a research to practice gap. Implications for practice include professional development recommendations, and the need for increased communication between researchers and teachers.

  18. Korean older intimate partner violence survivors in North America: cultural considerations and practice recommendations.

    Science.gov (United States)

    Shim, Woochan S; Nelson-Becker, Holly

    2009-01-01

    While literature on elder abuse has expanded, elder abuse by intimate partners has been less investigated. Even less is known about intimate partner violence among older Koreans living in North America. This article identifies important cultural considerations for individuals helping the Korean older adult community, beginning with the definition of intimate partner violence in this community and barriers to leaving that include traditional views of the East Asian self. Current practice interventions are discussed and recommendations for future practice such as healing han, the accumulated suffering from years of abuse, are suggested. The ultimate goal of this paper is to expand awareness in order to develop the best culturally competent prevention and intervention practice for Korean older intimate partner violence survivors in North America.

  19. Clinical Orofacial Examination in Juvenile Idiopathic Arthritis: International Consensus-based Recommendations for Monitoring Patients in Clinical Practice and Research Studies.

    Science.gov (United States)

    Stoustrup, Peter; Twilt, Marinka; Spiegel, Lynn; Kristensen, Kasper Dahl; Koos, Bernd; Pedersen, Thomas Klit; Küseler, Annelise; Cron, Randy Q; Abramowicz, Shelly; Verna, Carlalberta; Peltomäki, Timo; Alstergren, Per; Petty, Ross; Ringold, Sarah; Nørholt, Sven Erik; Saurenmann, Rotraud K; Herlin, Troels

    2017-03-01

    To develop international consensus-based recommendations for the orofacial examination of patients with juvenile idiopathic arthritis (JIA), for use in clinical practice and research. Using a sequential phased approach, a multidisciplinary task force developed and evaluated a set of recommendations for the orofacial examination of patients with JIA. Phase 1: A Delphi survey was conducted among 40 expert physicians and dentists with the aim of identifying and ranking the importance of items for inclusion. Phase 2: The task force developed consensus about the domains and items to be included in the recommendations. Phase 3: A systematic literature review was performed to assess the evidence supporting the consensus-based recommendations. Phase 4: An independent group of orofacial and JIA experts were invited to assess the content validity of the task force's recommendations. Five recommendations were developed to assess the following 5 domains: medical history, orofacial symptoms, muscle and temporomandibular joint function, orofacial function, and dentofacial growth. After application of data search criteria, 56 articles were included in the systematic review. The level of evidence for the 5 recommendations was derived primarily from descriptive studies, such as cross-sectional and case-control studies. Five recommendations are proposed for the orofacial examination of patients with JIA to improve the clinical practice and aid standardized data collection for future studies. The task force has formulated a future research program based on the proposed recommendations.

  20. Welfare issues of horses: an overview and practical recommendations

    Directory of Open Access Journals (Sweden)

    Elisabetta Canali

    2010-01-01

    Full Text Available The largest proportion of the world’s horses are still used for work in agriculture and traction, however in the western countries they are increasingly kept for recreational and social purposes, breeding, sport and competition. It is often assumed that horses enjoys better farming conditions than other species, yet they have specific needs which should be fulfilled in order to have a proper welfare. This paper will review the main welfare issues of horses and the following aspects will be considered: nutrition, housing and management, clinical problems, behaviour problems, training and riding, transportation, measuring welfare. Horses are social animals that live in groups in close contact with conspecifics. They spend most of their waking hours moving at walk, grazing and eating grass. Some of the constraints imposed on horses during the last centuries conflict to their naturally evolved behaviour. Effective and humane handling of horses positively affects many important aspects like the safety of man, the performance level and the welfare of horses. It is an essential condition for keeping horses that handlers, riders, trainers, farriers and veterinarians have proper knowledge of the behaviour of the horse in order to fulfil their natural needs and guarantee their welfare.

  1. Practical Recommendations to Improve the Quality of Training and Methodical Support of Professional Teacher Education

    Science.gov (United States)

    Grebennikov, Valery V.; Grudtsina, Ludmila Yu.; Marchuk, Nikolay N.; Sangadgiev, Badma V.; Kudyashev, Nail K.

    2016-01-01

    The research urgency is caused by the transition to the knowledge society and new demands for training and methodical provision of professional pedagogical education. The purpose of this paper is to develop practical recommendations to improve the quality of training and methodical support of professional pedagogical education. The leading…

  2. Recommended industry best management practices for the prevention of Phytophthora ramorum introduction in nursery operations

    Science.gov (United States)

    Karen Suslow

    2008-01-01

    The following industry recommended best management practices (BMPs), designed for growers and/or interstate shippers of host and associated host plants of Phytophthora ramorum, consists of biosecurity guidelines created by and for nursery growers in order to reduce the risks associated with P. ramorum. The control of P....

  3. Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the International Society of Urological Pathology consensus conference.

    Science.gov (United States)

    Amin, Mahul B; Epstein, Jonathan I; Ulbright, Thomas M; Humphrey, Peter A; Egevad, Lars; Montironi, Rodolfo; Grignon, David; Trpkov, Kiril; Lopez-Beltran, Antonio; Zhou, Ming; Argani, Pedram; Delahunt, Brett; Berney, Daniel M; Srigley, John R; Tickoo, Satish K; Reuter, Victor E

    2014-08-01

    Members of the International Society of Urological Pathology (ISUP) participated in a half-day consensus conference to discuss guidelines and recommendations regarding best practice approaches to use of immunohistochemistry (IHC) in differential diagnostic situations in urologic pathology, including bladder, prostate, testis and, kidney lesions. Four working groups, selected by the ISUP leadership, identified several high-interest topics based on common or relevant challenging diagnostic situations and proposed best practice recommendations, which were discussed by the membership. The overall summary of the discussions and the consensus opinion forms the basis of a series of articles, one for each organ site. This Special Article summarizes the overall recommendations made by the four working groups. It is anticipated that this ISUP effort will be valuable to the entire practicing community in the appropriate use of IHC in diagnostic urologic pathology.

  4. [Infant food diversification. Assessment of practices in relation to French recommendations in pediatricians and pediatric residents in southern France].

    Science.gov (United States)

    Banti, T; Carsin, A; Chabrol, B; Reynaud, R; Fabre, A

    2016-10-01

    Infant food diversification has undergone a rapid succession of good practice recommendations in France, but there has been no assessment of pediatrician practices on food diversification. To assess the practices of pediatricians in relation to current recommendations of the French Society of Pediatrics on infant food diversification. This was an observational study conducted from 1 November 2014 to 31 March 2015. The study population consisted of 97 pediatricians in the Var department and 84 pediatric residents assigned to the University of Aix-Marseille in France. A questionnaire was sent by email or post to determine physician characteristics, food diversification methods in healthy children and those at atopic risk, and how the pediatric consultation was conducted. The expected answers were based on the most recent recommendations of the French Society of Pediatrics published in 2008, updated from 2003. In summary, breastfeeding is recommended up to 6 months. Food diversification can be started between 4 and 6 months in children with no allergy risk. Gluten, honey, legumes and cow's milk are introduced between 4 and 7 months, after 12 months and after 36 months, respectively. In atopic children, food diversification is delayed until after 6 months and the most allergenic foods (nuts, exotic fruits, peanuts, and shellfish) are introduced after the age of 12 months. Eighty-four responses were obtained (51%): 50 pediatricians and 34 pediatric residents. Sixteen items were classified depending on whether or not an update after 2003 existed. Over 80% of the physicians responded as recommended for the recently updated items for the age of introduction of "solid food in healthy children", "gluten", "cow's milk protein hydrolysates", and "the time until introduction of cow's milk in the atopic child". At best, 65% of physicians responded in accordance with recommendations for items without a recent update, age of introduction of "cow's milk", "milk desserts

  5. Treatment Recommendation Actions, Contingencies, and Responses: An Introduction.

    Science.gov (United States)

    Stivers, Tanya; Barnes, Rebecca K

    2017-08-21

    In the era of patient participation in health care decision making, we know surprisingly little about the ways in which treatment recommendations are made, the contexts that shape their formulation, and the consequences of these formulations. In this article, we introduce a systematic collective investigation of how recommendations for medications are responded to and made in primary versus secondary care, in the US versus the UK, and in contexts where the medication was over the counter versus by prescription. This article provides an overview of the coding system that was used in this project including describing what constitutes a recommendation, the primary action types clinicians use for recommendations, and the types of responses provided by patients to recommendations.

  6. Data Mining Methods for Recommender Systems

    Science.gov (United States)

    Amatriain, Xavier; Jaimes*, Alejandro; Oliver, Nuria; Pujol, Josep M.

    In this chapter, we give an overview of the main Data Mining techniques used in the context of Recommender Systems. We first describe common preprocessing methods such as sampling or dimensionality reduction. Next, we review the most important classification techniques, including Bayesian Networks and Support Vector Machines. We describe the k-means clustering algorithm and discuss several alternatives. We also present association rules and related algorithms for an efficient training process. In addition to introducing these techniques, we survey their uses in Recommender Systems and present cases where they have been successfully applied.

  7. Practical consensus recommendations regarding the management of hormone receptor positive early breast cancer in elderly women

    Directory of Open Access Journals (Sweden)

    Govind Babu

    2018-01-01

    Full Text Available Breast cancer is a leading cause of death among women, and its incidence increases with age. Currently the treatment of breast cancer in older patients is almost identical to their younger counterparts. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations for the benefit of community oncologists regarding the management of early breast cancer specifically in elderly women.

  8. A well-started beginning elementary teacher's beliefs and practices in relation to reform recommendations about inquiry-based science

    Science.gov (United States)

    Avraamidou, Lucy

    2017-06-01

    Given reform recommendations emphasizing scientific inquiry and empirical evidence pointing to the difficulties beginning teachers face in enacting inquiry-based science, this study explores a well-started beginning elementary teacher's (Sofia) beliefs about inquiry-based science and related instructional practices. In order to explore Sofia's beliefs and instructional practices, several kinds of data were collected in a period of 9 months: a self-portrait and an accompanying narrative, a personal philosophy assignment, three interviews, three journal entries, ten lesson plans, and ten videotaped classroom observations. The analysis of these data showed that Sofia's beliefs and instructional practices were reform-minded. She articulated contemporary beliefs about scientific inquiry and how children learn science and was able to translate these beliefs into practice. Central to Sofia's beliefs about science teaching were scientific inquiry and engaging students in investigations with authentic data, with a prevalent emphasis on the role of evidence in the construction of scientific claims. These findings are important to research aiming at supporting teachers, especially beginning ones, to embrace reform recommendations.

  9. New developments in technology-assisted supervision and training: a practical overview.

    Science.gov (United States)

    Rousmaniere, Tony; Abbass, Allan; Frederickson, Jon

    2014-11-01

    Clinical supervision and training are now widely available online. In this article, three of the most accessible and widely adopted new developments in clinical supervision and training technology are described: Videoconference supervision, cloud-based file sharing software, and clinical outcome tracking software. Partial transcripts from two online supervision sessions are provided as examples of videoconference-based supervision. The benefits and limitations of technology in supervision and training are discussed, with an emphasis on supervision process, ethics, privacy, and security. Recommendations for supervision practice are made, including methods to enhance experiential learning, the supervisory working alliance, and online security. © 2014 Wiley Periodicals, Inc.

  10. Recommender systems

    OpenAIRE

    Lu L.; Medo M.; Yeung C.H.; Zhang Y.-C.; Zhang Z.-K.; Zhou T.

    2012-01-01

    The ongoing rapid expansion of the Internet greatly increases the necessity of effective recommender systems for filtering the abundant information. Extensive research for recommender systems is conducted by a broad range of communities including social and computer scientists, physicists, and interdisciplinary researchers. Despite substantial theoretical and practical achievements, unification and comparison of different approaches are lacking, which impedes further advances. In this article...

  11. A Heart-Healthy Diet: Recent Insights and Practical Recommendations.

    Science.gov (United States)

    Dinu, Monica; Pagliai, Giuditta; Sofi, Francesco

    2017-08-24

    The purpose of this study is to review the current evidence on the relationship between diet and heart, giving practical recommendations for cardiovascular prevention. A heart-healthy diet should maximize the consumption of whole grains, vegetables, fruit, and legumes and discourage the consumption of meat and meat products as well as refined and processed foods. Plant-based diets fully meet these criteria, and the evidence supporting the protective effect of these dietary patterns evolved rapidly in recent years. Among plant-based diets, the Mediterranean and vegetarian diets gained the greater interest, having been associated with numerous health benefits such as reduced levels of traditional and novel risk factors and lower risk of cardiovascular disease. These positive effects may be explained by their high content of dietary fiber, complex carbohydrate, vitamins, minerals, polyunsaturated fatty acids, and phytochemicals. Current evidence suggests that both Mediterranean and vegetarian diets are consistently beneficial with respect to cardiovascular disease.

  12. [Nutrition in pregnancy - Practice recommendations of the Network "Healthy Start - Young Family Network"].

    Science.gov (United States)

    Koletzko, B; Bauer, C-P; Bung, P; Cremer, M; Flothkötter, M; Hellmers, C; Kersting, M; Krawinkel, M; Przyrembel, H; Rasenack, R; Schäfer, T; Vetter, K; Wahn, U; Weißenborn, A; Wöckel, A

    2012-06-01

    Nutrition, physical activity and lifestyle in pregnancy influence maternal and child health. The "Healthy start - Young Family Network" supported by the German Government with the national action plan IN FORM developed recommendations on nutrition in pregnancy. Folic acid supplements (400 µg/day) should be started before pregnancy and continue for at least the first trimester. Iodine rich foods and salt and an iodine supplement (100-150 µg/day) are recommended. Long-chain omega-3 fatty acids should be provided with ≥ 1 weekly portion of oily sea fish, or a DHA-supplement if regular fish consumption is avoided. Vitamin D supplementation is advisable unless there is regular exposure to sunlight. Iron supplements should be used based on medical history and blood testing. Vegetarian diets with nutritional supplements can provide adequate nutrition, but counselling is recommended. In contrast, a vegan diet is inadequate and requires additional micronutrient supplementation. For risk reduction of listeriosis and toxoplasmosis, raw animal foods, soft cheeses and packed fresh salads should be avoided; fresh fruit, vegetables and salad should be washed well and consumed promptly. Pregnant women should remain physically active and perform sports with moderate intensity. They should avoid alcohol, active and passive smoking. Up to 3 daily cups of coffee are considered harmless, but energy drinks should be avoided. Childhood allergy is not reduced by avoiding certain foods in pregnancy whereas oily sea fish is recommended. Health care professions should lead parents to health-promoting lifestyles. Subjects of part 1 of the article are practice recommendations on nutrition, on energy needs, micronutrient needs and body weight/weight gain in pregnancy. © Georg Thieme Verlag KG Stuttgart · New York.

  13. From recommendation to action: psychosocial factors influencing physician intention to use Health Technology Assessment (HTA recommendations

    Directory of Open Access Journals (Sweden)

    Sánchez Emília

    2006-03-01

    technology assessment into professional practice. Results identify determinant factors that should be considered in the elaboration of strategies to support the implementation of evidence-based practice, with respect to emerging health technologies and modalities of practice. However, it is important to emphasise that behavioural determinants of evidence-based practice vary according to the specific technology considered. Evidence-based implementation of HTA recommendations, as well as other evidence-based practices, should build on a theoretical understanding of the complex forces that shape the practice of healthcare professionals.

  14. Screening test recommendations for methicillin-resistant Staphylococcus aureus surveillance practices: A cost-minimization analysis.

    Science.gov (United States)

    Whittington, Melanie D; Curtis, Donna J; Atherly, Adam J; Bradley, Cathy J; Lindrooth, Richard C; Campbell, Jonathan D

    2017-07-01

    To mitigate methicillin-resistant Staphylococcus aureus (MRSA) infections, intensive care units (ICUs) conduct surveillance through screening patients upon admission followed by adhering to isolation precautions. Two surveillance approaches commonly implemented are universal preemptive isolation and targeted isolation of only MRSA-positive patients. Decision analysis was used to calculate the total cost of universal preemptive isolation and targeted isolation. The screening test used as part of the surveillance practice was varied to identify which screening test minimized inappropriate and total costs. A probabilistic sensitivity analysis was conducted to evaluate the range of total costs resulting from variation in inputs. The total cost of the universal preemptive isolation surveillance practice was minimized when a polymerase chain reaction screening test was used ($82.51 per patient). Costs were $207.60 more per patient when a conventional culture was used due to the longer turnaround time and thus higher isolation costs. The total cost of the targeted isolation surveillance practice was minimized when chromogenic agar 24-hour testing was used ($8.54 per patient). Costs were $22.41 more per patient when polymerase chain reaction was used. For ICUs that preemptively isolate all patients, the use of a polymerase chain reaction screening test is recommended because it can minimize total costs by reducing inappropriate isolation costs. For ICUs that only isolate MRSA-positive patients, the use of chromogenic agar 24-hour testing is recommended to minimize total costs. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  15. WE-AB-201-04: The Recommendations of MPPG #5 and Practical Implementation Strategies

    International Nuclear Information System (INIS)

    Smilowitz, J.

    2015-01-01

    . The recommendations of MPPG #5 and practical implementation strategies (Jennifer Smilowitz) The recently published recommendations from Task Group No. 244, Medical Physics Practice Guideline on Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams will be presented. The recommendations focus on the validation of commissioning data and dose calculations. Tolerance values for non-IMRT beam configurations are summarized based on established criteria and data collected by the IROC. More stringent evaluation criteria for IMRT dose calculations are suggested to test the limitations of the TPS dose algorithms for advanced delivery conditions. The MPPG encourages users to create a suite of validation tests for dose calculation for various conditions for static photon beams, heterogeneities, IMRT/VMAT and electron beams. This test suite is intended to be used for subsequent testing, including TPS software upgrades. In the past, the recommendations of some reports have not been widely implemented due to practical limitations. Implementation strategies, tools and processes developed by multiple centers for efficient and “do-able” MPPG #5 testing will be presented, as well as a discussion on the overall validation experience. Learning Objectives: Identify some of the key documents relevant for TPS commissioning and QA Understand strategies for testing TPS software Gain a practical knowledge of the Gamma test criteria Increase familiarity with the process of commissioning a TPS Learn about the use of Control Charts for TPS QA Review the role of the TPS in the overall planning process Increase awareness of the link between TPS QA and chart checking Gain an increased appreciation for the importance of interdisciplinary communication Understand the new recommendations from MPPG #5 on TPS Dose Algorithm Commissioning and QC/QA Learn practical implementation processes and tools for MPPG #5 validation recommendations

  16. WE-AB-201-04: The Recommendations of MPPG #5 and Practical Implementation Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Smilowitz, J. [University of Wisconsin (United States)

    2015-06-15

    . The recommendations of MPPG #5 and practical implementation strategies (Jennifer Smilowitz) The recently published recommendations from Task Group No. 244, Medical Physics Practice Guideline on Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams will be presented. The recommendations focus on the validation of commissioning data and dose calculations. Tolerance values for non-IMRT beam configurations are summarized based on established criteria and data collected by the IROC. More stringent evaluation criteria for IMRT dose calculations are suggested to test the limitations of the TPS dose algorithms for advanced delivery conditions. The MPPG encourages users to create a suite of validation tests for dose calculation for various conditions for static photon beams, heterogeneities, IMRT/VMAT and electron beams. This test suite is intended to be used for subsequent testing, including TPS software upgrades. In the past, the recommendations of some reports have not been widely implemented due to practical limitations. Implementation strategies, tools and processes developed by multiple centers for efficient and “do-able” MPPG #5 testing will be presented, as well as a discussion on the overall validation experience. Learning Objectives: Identify some of the key documents relevant for TPS commissioning and QA Understand strategies for testing TPS software Gain a practical knowledge of the Gamma test criteria Increase familiarity with the process of commissioning a TPS Learn about the use of Control Charts for TPS QA Review the role of the TPS in the overall planning process Increase awareness of the link between TPS QA and chart checking Gain an increased appreciation for the importance of interdisciplinary communication Understand the new recommendations from MPPG #5 on TPS Dose Algorithm Commissioning and QC/QA Learn practical implementation processes and tools for MPPG #5 validation recommendations.

  17. Guideline recommendations for post-acute postoperative physiotherapy in total hip and knee arthroplasty: are they used in daily clinical practice?

    Science.gov (United States)

    Peter, W F; Nelissen, R G H H; Vlieland, T P M Vliet

    2014-09-01

    In a Dutch guideline on physiotherapy (PT) in hip and knee osteoarthritis, a number of recommendations on post-acute (i.e. after discharge from hospital) PT following total hip (THA) and total knee (TKA) arthroplasty were included. Little is known about the uptake of these recommendations in daily clinical practice. The aim of the present study was to determine the extent to which the guideline recommendations regarding post-acute PT after THA and TKA are followed in daily clinical practice. An online pilot survey on the delivery of post-acute, postoperative PT was sent to a random sample of 957 Dutch physiotherapists. The survey included questions on the application of recommended, neither recommended nor advised against, and advised against treatment modalities and various treatment modalities for which there were no formulated recommendations. A total of 219 physiotherapists completed the questionnaire, with a mean age of 40 years (standard deviation 12.6), 55% female and 95% working in primary care. The vast majority reported the use of the recommended exercise modalities (muscle strengthening exercises (96%), and functional exercises (99%). Continuous passive motion, which was neither recommended nor advised against, and electrical muscle stimulation, which was not recommended, were provided by 1%. Reported treatment modalities for which there were no formulated recommendations included patient education (99%), gait training (95%), active range of motion (ROM) exercises (93%), balance exercises (86%), passive ROM exercises (58%), aerobic exercises (50%), massage (18%) and cold therapy (11%). The vast majority of physiotherapists reported adhering to recommendations on post-acute postoperative PT in THA and TKA patients after discharge from hospital. Although yet to be confirmed in a larger nationwide survey, the relatively high frequency of use of many other treatment modalities, for which there were no formulated recommendations, suggests the need to extend

  18. Efficacy of microbial sampling recommendations and practices in sub-Saharan Africa.

    Science.gov (United States)

    Taylor, David D J; Khush, Ranjiv; Peletz, Rachel; Kumpel, Emily

    2018-05-01

    Current guidelines for testing drinking water quality recommend that the sampling rate, which is the number of samples tested for fecal indicator bacteria (FIB) per year, increases as the population served by the drinking water system increases. However, in low-resource settings, prevalence of contamination tends to be higher, potentially requiring higher sampling rates and different statistical methods not addressed by current sampling recommendations. We analyzed 27,930 tests for FIB collected from 351 piped water systems in eight countries in sub-Saharan Africa to assess current sampling rates, observed contamination prevalences, and the ability of monitoring agencies to complete two common objectives of sampling programs: determine regulatory compliance and detect a change over time. Although FIB were never detected in samples from 75% of piped water systems, only 14% were sampled often enough to conclude with 90% confidence that the true contamination prevalence met an example guideline (≤5% chance of any sample positive for FIB). Similarly, after observing a ten percentage point increase in contaminated samples, 43% of PWS would still require more than a year before their monitoring agency could be confident that contamination had actually increased. We conclude that current sampling practices in these settings may provide insufficient information because they collect too few samples. We also conclude that current guidelines could be improved by specifying how to increase sampling after contamination has been detected. Our results suggest that future recommendations should explicitly consider the regulatory limit and desired confidence in results, and adapt when FIB is detected. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  19. The optimisation principle and the new ICRP recommendations: practical implications on operational radiation protection

    International Nuclear Information System (INIS)

    Lochard, J.

    1992-01-01

    The formulation of the optimisation principle proposed by the International Commission of Radiological Protection in its new recommendations is largely oriented towards better control of individual doses. In this perspective, the concept of doe constraint and the reference to equity in dose distributions are becoming key elements within the optimisation process. This paper discusses some first reflexions regarding this new orientation and outlines the main impacts that must be forwarded to the practical level. (author)

  20. The translation of the new ICRP recommendations into practice: a new challenge for International Co-operation

    International Nuclear Information System (INIS)

    Ilari, O.; Gonzalez, A.; Boutrif, E.; Hanson, G.; Borras, C.

    1992-01-01

    The new ICRP recommendations have introduced several elements of novelty which may have a significant impact on the requirements and costs of radiation protection in Member countries. There is now a need for a conversion of the ICRP guidance into terms that are sufficiently practical and straightforward to facilitate their transfer into regulatory texts and operational practices at the national level. The paper discusses the strategy adopted for the revision of the Basic Safety Standards for Radiation Protection and highlights the main issues to be considered in this work.(author)

  1. Portal imaging practice patterns of children's oncology group institutions: Dosimetric assessment and recommendations for minimizing unnecessary exposure

    International Nuclear Information System (INIS)

    Olch, Arthur J.; Geurts, Mark; Thomadsen, Bruce; Famiglietti, Robin; Chang, Eric L.

    2007-01-01

    Purpose: To determine and analyze the dosimetric consequences of current portal imaging practices for pediatric patients, and make specific recommendations for reducing exposure from portal imaging procedures. Methods and Materials: A survey was sent to approximately 250 Children's Oncology Group (COG) member institutions asking a series of questions about their portal imaging practices. Three case studies are presented with dosimetric analysis to illustrate the magnitude of unintended dose received by nontarget tissues using the most common techniques from the survey. Results: The vast majority of centers use double-exposure portal image techniques with a variety of open field margins. Only 17% of portal images were obtained during treatment, and for other imaging methods, few centers subtract monitor units from the treatment delivery. The number of monitor units used was nearly the same regardless of imager type, including electronic portal imaging devices. Eighty-six percent imaged all fields the first week and 17% imaged all fields every week. An additional 1,112 cm 3 of nontarget tissue received 1 Gy in one of the example cases. Eight new recommendations are made, which will lower nontarget radiation doses with minimal impact on treatment verification accuracy. Conclusion: Based on the survey, changes can be made in portal imaging practices that will lower nontarget doses. It is anticipated that treatment verification accuracy will be minimally affected. Specific recommendations made to decrease the imaging dose and help lower the rate of radiation-induced secondary cancers in children are proposed for inclusion in future COG protocols using radiation therapy

  2. Neuromuscular Electrical Stimulation for Treatment of Muscle Impairment: Critical Review and Recommendations for Clinical Practice

    Science.gov (United States)

    Houghton, Pamela; Anthony, Joseph; Rennie, Sandy; Shay, Barbara L.; Hoens, Alison M.

    2017-01-01

    Purpose: In response to requests from physiotherapists for guidance on optimal stimulation of muscle using neuromuscular electrical stimulation (NMES), a review, synthesis, and extraction of key data from the literature was undertaken by six Canadian physical therapy (PT) educators, clinicians, and researchers in the field of electrophysical agents. The objective was to identify commonly treated conditions for which there was a substantial body of literature from which to draw conclusions regarding the effectiveness of NMES. Included studies had to apply NMES with visible and tetanic muscle contractions. Method: Four electronic databases (CINAHL, Embase, PUBMED, and SCOPUS) were searched for relevant literature published between database inceptions until May 2015. Additional articles were identified from bibliographies of the systematic reviews and from personal collections. Results: The extracted data were synthesized using a consensus process among the authors to provide recommendations for optimal stimulation parameters and application techniques to address muscle impairments associated with the following conditions: stroke (upper or lower extremity; both acute and chronic), anterior cruciate ligament reconstruction, patellofemoral pain syndrome, knee osteoarthritis, and total knee arthroplasty as well as critical illness and advanced disease states. Summaries of key details from each study incorporated into the review were also developed. The final sections of the article outline the recommended terminology for describing practice using electrical currents and provide tips for safe and effective clinical practice using NMES. Conclusion: This article provides physiotherapists with a resource to enable evidence-informed, effective use of NMES for PT practice. PMID:29162949

  3. Implementing portfolio in postgraduate general practice training. Benefits and recommendations.

    Science.gov (United States)

    Alotaibi, Fawaz S

    2012-10-01

    This paper presents a review to explore the literature focusing on portfolio in postgraduate general practice (GP) training, and to examine the impact of implementation of portfolio on learning process, as well as proposing recommendations for its implementation in postgraduate GP training. An electronic search was carried out on several databases for studies addressing portfolio in postgraduate GP training. Six articles were included to address specifically the effectiveness of portfolio in postgraduate GP training. Five of them described successful experiences of portfolio-based learning implementation. Only one article addressed portfolio-based assessment in postgraduate GP training. The existing evidence provides various benefits of professional portfolio-based learning. It does appear to have advantages of stimulating reflective learning, promoting proactive learning, and bridging the hospital experiences of the learners to GP. Moreover, the challenges to implementation of portfolio-based learning are often based on orientation and training of stakeholders.

  4. Recommendations for improved and coherent acquisition and processing of backscatter data from seafloor-mapping sonars

    Science.gov (United States)

    Lamarche, Geoffroy; Lurton, Xavier

    2018-06-01

    Multibeam echosounders are becoming widespread for the purposes of seafloor bathymetry mapping, but the acquisition and the use of seafloor backscatter measurements, acquired simultaneously with the bathymetric data, are still insufficiently understood, controlled and standardized. This presents an obstacle to well-accepted, standardized analysis and application by end users. The Marine Geological and Biological Habitat Mapping group (Geohab.org) has long recognized the need for better coherence and common agreement on acquisition, processing and interpretation of seafloor backscatter data, and established the Backscatter Working Group (BSWG) in May 2013. This paper presents an overview of this initiative, the mandate, structure and program of the working group, and a synopsis of the BSWG Guidelines and Recommendations to date. The paper includes (1) an overview of the current status in sensors and techniques available in seafloor backscatter data from multibeam sonars; (2) the presentation of the BSWG structure and results; (3) recommendations to operators, end-users, sonar manufacturers, and software developers using sonar backscatter for seafloor-mapping applications, for best practice methods and approaches for data acquisition and processing; and (4) a discussion on the development needs for future systems and data processing. We propose for the first time a nomenclature of backscatter processing levels that affords a means to accurately and efficiently describe the data processing status, and to facilitate comparisons of final products from various origins.

  5. Practical consensus recommendations on Her2 +ve breast cancer with solitary brain mets

    Directory of Open Access Journals (Sweden)

    Nitesh Rohatgi

    2018-01-01

    Full Text Available Breast cancer is a common cause of brain metastases, with metastases occurring in at least 10–16% of patients. Longer survival of patients with metastatic breast cancer and the use of better imaging techniques are associated with an increased incidence of brain metastases. Current therapies include surgery, whole-brain radiation therapy, stereotactic radiosurgery, chemotherapy and targeted therapies. However, the timing and appropriate use of these therapies is controversial and careful patient selection by using available prognostic tools is extremely important. Expert oncologist discussed on the mode of treatment to extend the OS and improve the quality of life ofHER2-positivebreast cancer patients with Solitary brain metastases. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.

  6. Practical recommendations for the implementation of health technologies to enhance physical fitness of students in extracurricular classes during non-traditional gymnastics

    Directory of Open Access Journals (Sweden)

    E.V. Fomenko

    2014-07-01

    Full Text Available Purpose : to develop practical recommendations for extracurricular classes nontraditional kinds of gymnastics to improve the organization of physical education teachers in schools. Material : in the experiment involved 358 students. Analyzed the available literature data. Results : a comparative analysis of physical fitness of students and practical recommendations for the non-traditional occupations gymnastics. Been a significant interest in physical education classes. Found that the main ways of improving physical education students may be the formation of the need for strengthening health facilities fitness aerobics, shaping, pilates. Conclusions : highlights the need to structure the problems they need and develop appropriate solutions.

  7. Implementation intention and planning interventions in Health Psychology : Recommendations from the Synergy Expert Group for research and practice

    NARCIS (Netherlands)

    Hagger, M.S.; Luszczynska, A.; de Wit, J.; Benyamini, Y.; Burkert, S.; Chamberland, P.-E.; Chater, A.; Dombrowski, S.U.; van Dongen, A.; French, D.P.; Gauchet, A.; Hankonen, N.; Karekla, M.; Kinney, A.Y.; Kwasnicka, D.; Lo, S.H.; López-Roig, S.; Meslot, C.; Marques, M.M.; Neter, E.; Plass, A.M.; Potthoff, S.; Rennie, L.; Scholz, U.; Stadler, G.; Stolte, E.; ten Hoor, G.; Verhoeven, A.A.C.; Wagner, M.; Oettingen, G.; Sheeran, P.; Gollwitzer, P.M.

    2016-01-01

    The current article details a position statement and recommendations for future research and practice on planning and implementation intentions in health contexts endorsed by the Synergy Expert Group. The group comprised world-leading researchers in health and social psychology and behavioural

  8. Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice

    NARCIS (Netherlands)

    Hagger, M.S.; Luszczynska, A.; de Wit, J.; Benyamini, Y.; Burkert, S.; Chamberland, P.E.; Chater, A.; Dombrowski, S.U.; van Dongen, A.; French, D.P.; Gauchet, A.; Hankonen, N.; Karekla, M.; Kinney, A.Y.; Kwasnicka, D.; Lo, S.H.; López-Roig, S.; Meslot, C.; Marques, M.M.; Neter, E.; Plass, A.M.; Potthoff, S.; Rennie, L.; Scholz, U; Stadler, G.; Stolte, E.; Ten Hoor, G.; Verhoeven, A.; Wagner, M.; Oettingen, G.; Sheeran, P.; Gollwitzer, P.M.

    2016-01-01

    The current article details a position statement and recommendations for future research and practice on planning and implementation intentions in health contexts endorsed by the Synergy Expert Group. The group comprised world-leading researchers in health and social psychology and behavioural

  9. Imaging Techniques in Endodontics: An Overview

    Science.gov (United States)

    Deepak, B. S.; Subash, T. S.; Narmatha, V. J.; Anamika, T.; Snehil, T. K.; Nandini, D. B.

    2012-01-01

    This review provides an overview of the relevance of imaging techniques such as, computed tomography, cone beam computed tomography, and ultrasound, to endodontic practice. Many limitations of the conventional radiographic techniques have been overcome by the newer methods. Advantages and disadvantages of various imaging techniques in endodontic practice are also discussed. PMID:22530184

  10. Overview of religions.

    Science.gov (United States)

    Brooks, Nicky

    2004-01-01

    This article provides a brief overview of 9 religions: Christianity, Judaism, Jehovah's Witnesses, The Church of Jesus Christ of Latter-Day Saints, Christian Science, Islam, Hinduism, Sikhism, and Buddhism. Basic information on the origins, language, naming practices, diet, personal hygiene, and dress requirements is provided. For additional information, Web sites for each of these religions are also provided.

  11. PROSPECT: a practical method for formulating evidence-based expert recommendations for the management of postoperative pain.

    Science.gov (United States)

    Neugebauer, E A M; Wilkinson, R C; Kehlet, H; Schug, S A

    2007-07-01

    Many patients still suffer severe acute pain in the postoperative period. Although guidelines for treating acute pain are widely published and promoted, most do not consider procedure-specific differences in pain experienced or in techniques that may be most effective and appropriate for different surgical settings. The procedure-specific postoperative pain management (PROSPECT) Working Group provides procedure-specific recommendations for postoperative pain management together with supporting evidence from systematic literature reviews and related procedures at http://www.postoppain.org The methodology for PROSPECT reviews was developed and refined by discussion of the Working Group, and it adapts existing methods for formulation of consensus recommendations to the specific requirements of PROSPECT. To formulate PROSPECT recommendations, we use a methodology that takes into account study quality and source and level of evidence, and we use recognized methods for achieving group consensus, thus reducing potential bias. The new methodology is first applied in full for the 2006 update of the PROSPECT review of postoperative pain management for laparoscopic cholecystectomy. Transparency in PROSPECT processes allows the users to be fully aware of any limitations of the evidence and recommendations, thereby allowing for appropriate decisions in their own practice setting.

  12. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older - United States, 2018.

    Science.gov (United States)

    Kim, David K; Riley, Laura E; Hunter, Paul

    2018-02-09

    In October 2017, the Advisory Committee on Immunization Practices (ACIP) voted to approve the Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2018. The 2018 adult immunization schedule summarizes ACIP recommendations in two figures and a table of contraindications and precautions for vaccines recommended for adults, and is intended is to assist health care providers in implementing the current ACIP recommendations for vaccinating adults. The schedule can be found at https://www.cdc.gov/vaccines/schedules.* The full ACIP recommendations for each vaccine are available at https://www.cdc.gov/vaccines/hcp/acip-recs/index.html. The 2018 adult immunization schedule has also been approved by the American College of Physicians (https://www.acponline.org), the American Academy of Family Physicians (https://www.aafp.org), the American College of Obstetricians and Gynecologists (https://www.acog.org), and the American College of Nurse-Midwives (http://www.midwife.org). The ACIP-recommended use of each vaccine is developed after an in-depth review of vaccine-related data, including data on disease epidemiology, vaccine efficacy and effectiveness, vaccine safety, feasibility of program implementation, and economic aspects of immunization policy (1).

  13. Control of doses delivered to patients in medical imagery. Progress report of the program of actions recommended by the ASN. January 2015

    International Nuclear Information System (INIS)

    2015-01-01

    This report proposes an overview and an assessment of the various actions recommended by the ASN (the French Nuclear Safety Authority) for a better management of doses delivered to patients in the case of medical imagery. It indicates and discusses the progress noticed: actions which have been already performed, actions which are currently in progress, and actions which are still to be launched. These actions concern various aspects: the practice quality and safety (quality and safety management), the organisation, human resources and training, equipment and installation safety, radio-vigilance practices, relationships with patients, knowledge of practices and of exposures of patients and workers. Some highlights are outlined: some persistent lacks in human resources, some encouraging initiatives in the field of training, some progresses in the field of practice quality and safety, and some limited results regarding equipment (notably MRI) and installation safety

  14. [Clinical recommendations for sport practice in diabetic patients (RECORD Guide). Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN)].

    Science.gov (United States)

    Gargallo-Fernández, Manuel; Escalada San Martín, Javier; Gómez-Peralta, Fernando; Rozas Moreno, Pedro; Marco Martínez, Amparo; Botella-Serrano, Marta; Tejera Pérez, Cristina; López Fernández, Judith

    2015-01-01

    Sporting activity is becoming a common practice in patients with diabetes mellitus (DM). This situation requires both a preliminary medical assessment and a wide range of changes in treatment which have scarcely been addressed in medical literature. To prepare a clinical guideline on the medical approach to patients with diabetes who practice sport regularly. An expert panel from the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN) reviewed the most relevant literature in each of the sections. Based both on this review and on data from the experience of a number of athletes with DM, a number of recommendations were agreed within each section. Finally, the Working Group and representatives of the SEEN jointly discussed all these recommendations. The guideline provides recommendations ranging from medical assessment before patients with DM start to practice sport to actions during and after physical activity. Recommendations are also given on aspects such as the impact of sport on blood glucose control, training schemes, or special risk situations. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  15. Standard recommended practice for examination of fuel element cladding including the determination of the mechanical properties

    International Nuclear Information System (INIS)

    Anon.

    1975-01-01

    Guidelines are provided for the post-irradiation examination of fuel cladding and to achieve better correlation and interpretation of the data in the field of radiation effects. The recommended practice is applicable to metal cladding of all types of fuel elements. The tests cited are suitable for determining mechanical properties of the fuel elements cladding. Various ASTM standards and test methods are cited

  16. Revision of the recommended international general standard for irradiated foods and of the recommended international code of practice for the operation of radiation facilities used for the treatment of foods

    International Nuclear Information System (INIS)

    1981-11-01

    In view of the findings and statements of the Joint FAO/IAEA/WHO Expert Committee on the Wholesomeness of Irradiated Food, convened in Geneva from 27 October to 3 November 1980, a Consultation Group, convened in Geneva from 1 to 3 July 1981 suggested the revision of the Recommended International General Standard for Irradiated Foods and of the Recommended International Code of Practice for the Operation of Radiation Facilities. The proposed changes are given and justified and the revised wording of the documents presented

  17. [The school doctorand suspected child abuse : towards good practice recommendations in the child's interest].

    Science.gov (United States)

    Noirhomme-Renard, F; Blavier, A; Lachaussée, S; Monville, C; Nihoul, C; Gosset, C

    2016-10-01

    Child maltreatment, including all forms of mal¬treatment, remains a major public health problem in high-income countries. Healthcare professionals only contribute to a small proportion of reports. In French-speaking Belgium, almost 100 % of school-aged children are regularly submitted to periodical school health visits. The school health doctor is well placed to recognize neglected or abused children. Based on international good practice recommendations, this paper proposes means for the detection and management of child abuse in the context of school medicine.

  18. Creating and connecting recommended practices for reproducible research through collaborative culture and consensus in the Research Data Alliance

    Science.gov (United States)

    Parsons, M. A.; Yarmey, L.; Dillo, I.

    2017-12-01

    Data are the foundation of a robust, efficient, and reproducible scientific enterprise. The Research Data Alliance (RDA) is a community-driven, action-oriented, virtual organization committed to enabling open sharing and reuse of data by building social and technical bridges. The international RDA community includes almost 6000 members bringing diverse perspectives, domain knowledge, and expertise to a common table for identification of common challenges and holistic solutions. RDA members work together to identify common interests and form exploratory Interest Groups and outcome-oriented Working Groups. Participants exchange knowledge, share discoveries, discuss barriers and potential solutions, articulate policies, and align standards to enhance and facilitate global data sharing within and across domains and communities. With activities defined and led by members, RDA groups have organically been addressing issues across the full research cycle with community-ratified Recommendations and other outputs that begin to create the components of a global, data-sharing infrastructure. This paper examines how multiple RDA Recommendations can be implemented together to improve data and information discoverability, accessibility, and interconnection by both people and machines. For instance, the Persistent Identifier Types can support moving data across platforms through the Data Description Registry Interoperability framework following the RDA/WDS Publishing Data Workflows model. The Scholix initiative connects scholarly literature and data across numerous stakeholders can draw on the Practical Policy best practices for machine-actionable data policies. Where appropriate, we use a case study approach built around several flagship data sets from the Deep Carbon Observatory to examine how multiple RDA Recommendations can be implemented in actual practice.

  19. Evidence utilisation project: Management of inadvertent perioperative hypothermia. The challenges of implementing best practice recommendations in the perioperative environment.

    Science.gov (United States)

    Munday, Judy; Hines, Sonia Jane; Chang, Anne M

    2013-12-01

    The prevention of inadvertent perioperative hypothermia (IPH) remains an important issue in perioperative healthcare. The aims of this project were to: (i) assess current clinical practice in the management of IPH and (ii) promote best practice in the management of IPH in adult operating theatres. This project from August 2010 to March 2012 utilised a system of audit and feedback to implement best practice recommendations. Data were collected via chart audits against criteria developed from best practice recommendations for managing IPH. Evidence-based best practices, such as consistent temperature monitoring and patient warming, were implemented using multifaceted interventions. Perioperative records for 73 patients (baseline) and 72 patients (post-implementation) were audited. Post-implementation audit showed an increase in patients with temperatures >36°C admitted to the post-anaesthetic care unit (PACU) (8%) and discharged from PACU (28%). The percentage of patients receiving preoperative temperature monitoring increased (38%); however, low levels of intraoperative monitoring remained (31% of patients with surgery of 30 min or longer duration). Small increases were found in patient warming of 5% intraoperatively and 8% postoperatively. Preoperative warming was not successfully implemented during this phase of the project. Temperature monitoring, warming and rates of normothermia improved; however, barriers to best practice of IPH management were experienced, which negatively impacted on the project. Further stages of implementation and audit were added to further address IPH management in this department. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

  20. Sonic branding: a framework for understanding sound branding and an overview of its most noticeable practices across industries

    OpenAIRE

    Bollue, Sebastien

    2015-01-01

    This thesis presents the importance and relevance of sound in branding, as very few studies on sonic branding have been conducted so far. The aim of this thesis is to lay out a framework for understanding sonic branding as a phenomenon and for getting an overview of the most notable practices of sonic branding across various industries. The study is commissioned by the advertising agency Wondergarden for who a workshop was also created. Additionally this thesis hopefully can inspire other...

  1. The practices, challenges and recommendations of South African audiologists regarding managing children with auditory processing disorders

    Directory of Open Access Journals (Sweden)

    Claire Fouché-Copley

    2016-06-01

    Full Text Available Audiologists managing children with auditory processing disorders (APD encounter challenges that include conflicting definitions, several classification profiles, problems with differential diagnosis and a lack of standardised guidelines. The heterogeneity of the disorder and its concomitant childhood disorders makes diagnosis difficult. Linguistic and cultural issues are additional challenges faced by South African audiologists. The study aimed to describe the practices, challenges and recommendations of South African audiologists managing children with APD. A quantitative, non-experimental descriptive survey was used to obtain data from 156 audiologists registered with the Health Professions of South Africa. Findings revealed that 67% screened for APD, 42% assessed while 43% provided intervention. A variety of screening and assessment procedures were being administered, with no standard test battery identified. A range of intervention strategies being used are discussed. When the relationship between the number of years of experience and the audiologists’ level of preparedness to practice in the field of APD was compared, a statistically significant difference (p = 0.049 was seen in that participants with more than 10 years of experience were more prepared to practice in this area. Those participants having qualified as speech-language therapists and audiologists were significantly more prepared (p = 0.03 to practice than the audiologists who comprised the sample. Challenges experienced by the participants included the lack of linguistically and culturally appropriate screening and assessment tools and limited normative data. Recommendations included reviewing the undergraduate audiology training programmes, reinstituting the South African APD Taskforce, developing linguistically and culturally appropriate normative data, creating awareness among educators and involving them in the multidisciplinary team. Keywords: Screening; assessment

  2. Farmers' Characteristics and Adoption' of Recommended Practices ...

    African Journals Online (AJOL)

    into cooperatives and increased agricultural extension education to enhance communication were recommended. ,. Key words: ... I Further actions by the Federal government to fully utilize the ... by constructing tube wells, wash bore, purchase.

  3. Are ECG monitoring recommendations before prescription of QT-prolonging drugs applied in daily practice?

    DEFF Research Database (Denmark)

    Warnier, Miriam Jacoba; Rutten, Frans Hendrik; Souverein, Patrick Cyriel

    2015-01-01

    PURPOSE: Monitoring of the QT duration by electrocardiography (ECG) prior to treatment is frequently recommended in the label of QT-prolonging drugs. It is, however, unknown how often general practitioners in daily clinical practice are adhering to these risk-minimization measures. We assessed...... the frequency of ECG measurements in patients where haloperidol was initiated in primary care. METHODS: Patients (≥18 years) with a first prescription of haloperidol in the UK Clinical Practice Research Datalink (2009-2013) were included. The proportion of ECGs made was determined in two blocks of 4 weeks......: during the exposure period when haloperidol was initiated, and during the control period, 1 year before. Conditional logistic regression analysis was applied to calculate the relative risk of having an ECG in the exposure period compared with the control period. Subgroup analyses were performed to assess...

  4. Empirical evaluation of the Process Overview Measure for assessing situation awareness in process plants.

    Science.gov (United States)

    Lau, Nathan; Jamieson, Greg A; Skraaning, Gyrd

    2016-03-01

    The Process Overview Measure is a query-based measure developed to assess operator situation awareness (SA) from monitoring process plants. A companion paper describes how the measure has been developed according to process plant properties and operator cognitive work. The Process Overview Measure demonstrated practicality, sensitivity, validity and reliability in two full-scope simulator experiments investigating dramatically different operational concepts. Practicality was assessed based on qualitative feedback of participants and researchers. The Process Overview Measure demonstrated sensitivity and validity by revealing significant effects of experimental manipulations that corroborated with other empirical results. The measure also demonstrated adequate inter-rater reliability and practicality for measuring SA in full-scope simulator settings based on data collected on process experts. Thus, full-scope simulator studies can employ the Process Overview Measure to reveal the impact of new control room technology and operational concepts on monitoring process plants. Practitioner Summary: The Process Overview Measure is a query-based measure that demonstrated practicality, sensitivity, validity and reliability for assessing operator situation awareness (SA) from monitoring process plants in representative settings.

  5. Precision of commercial soil testing practice for phosphorus fertilizer recommendations in Finland

    Directory of Open Access Journals (Sweden)

    T. PELTOVUORI

    2008-12-01

    Full Text Available Implementation of the Agri-Environmental Program in 1995 has emphasized the role of advisory soil testing in phosphorus (P input planning and markedly expanded the market for commercial soil testing in Finland. A small precision experiment (5 laboratories and a simulation study on soil sampling were conducted to evaluate the current precision of the soil testing practice for P. The observed values of reproducibility (95% probability of soil P determination were 42-61% of the mean P concentration for three soils. This approximately corresponds to a maximum error of one P class in a seven-step classification system. Soil texture and organic matter content are used as secondary variables in P fertilization planning. In commercial soil testing these are both determined by finger assessment and the results have significant errors in most laboratories. Erroneous texture determinations are more likely to lead to errors in P fertilizer recommendations than soil P analysis itself. In this study the largest deviation from a correct P fertilization recommendation was +10 kg ha-1. In soil sampling simulation, stratified random sampling in areas of differing texture gave the most consistent results with geostatistical analysis of the soil test data, as compared with random, systematic, and judgment sampling strategies.;

  6. Verbal and numerical consumer recommendations: switching between recommendation formats leads to preference inconsistencies.

    Science.gov (United States)

    Maciejovsky, Boris; Budescu, David V

    2013-06-01

    Many Web sites provide consumers with product recommendations, which are typically presented by a sequence of verbal reviews and numerical ratings. In three experiments, we demonstrate that when participants switch between formats (e.g., from verbal to numerical), they are more prone to preference inconsistencies than when they aggregate the recommendations within the same format (e.g., verbal). When evaluating recommendations, participants rely primarily on central-location measures (e.g., mean) and less on other distribution characteristics (e.g., variance). We explain our findings within the theoretical framework of stimulus-response compatibility and we make practical recommendations for the design of recommendation systems and Web portals.

  7. An overview of longitudinal data analysis methods for neurological research.

    Science.gov (United States)

    Locascio, Joseph J; Atri, Alireza

    2011-01-01

    The purpose of this article is to provide a concise, broad and readily accessible overview of longitudinal data analysis methods, aimed to be a practical guide for clinical investigators in neurology. In general, we advise that older, traditional methods, including (1) simple regression of the dependent variable on a time measure, (2) analyzing a single summary subject level number that indexes changes for each subject and (3) a general linear model approach with a fixed-subject effect, should be reserved for quick, simple or preliminary analyses. We advocate the general use of mixed-random and fixed-effect regression models for analyses of most longitudinal clinical studies. Under restrictive situations or to provide validation, we recommend: (1) repeated-measure analysis of covariance (ANCOVA), (2) ANCOVA for two time points, (3) generalized estimating equations and (4) latent growth curve/structural equation models.

  8. An Overview of Longitudinal Data Analysis Methods for Neurological Research

    Directory of Open Access Journals (Sweden)

    Joseph J. Locascio

    2011-10-01

    Full Text Available The purpose of this article is to provide a concise, broad and readily accessible overview of longitudinal data analysis methods, aimed to be a practical guide for clinical investigators in neurology. In general, we advise that older, traditional methods, including (1 simple regression of the dependent variable on a time measure, (2 analyzing a single summary subject level number that indexes changes for each subject and (3 a general linear model approach with a fixed-subject effect, should be reserved for quick, simple or preliminary analyses. We advocate the general use of mixed-random and fixed-effect regression models for analyses of most longitudinal clinical studies. Under restrictive situations or to provide validation, we recommend: (1 repeated-measure analysis of covariance (ANCOVA, (2 ANCOVA for two time points, (3 generalized estimating equations and (4 latent growth curve/structural equation models.

  9. Recommender systems in knowledge-mining

    Science.gov (United States)

    Volna, Eva

    2017-07-01

    The subject of the paper is to analyse the possibilities of application of recommender systems in the field of data mining. The work focuses on three basic types of recommender systems (collaborative, content-based and hybrid). The goal of the article is to evaluate which of these three concepts of recommender systems provides forecast with the lowest error rate in the domain of recommending movies. This target is fulfilled by the practical part of the work - at first, the own recommender system was designed and created, capable of obtaining movies recommendation from the database based on the user's preferences. Next, we verified experimentally which recommender system produces more accurate results.

  10. British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases.

    Science.gov (United States)

    Schelenz, Silke; Barnes, Rosemary A; Barton, Richard C; Cleverley, Joanne R; Lucas, Sebastian B; Kibbler, Christopher C; Denning, David W

    2015-04-01

    Invasive fungal diseases are an important cause of morbidity and mortality in a wide range of patients, and early diagnosis and management are a challenge. We therefore did a review of the scientific literature to generate a series of key recommendations for the appropriate use of microbiological, histological, and radiological diagnostic methods for diagnosis of invasive fungal diseases. The recommendations emphasise the role of microscopy in rapid diagnosis and identification of clinically significant isolates to species level, and the need for susceptibility testing of all Aspergillus spp, if treatment is to be given. In this Review, we provide information to improve understanding of the importance of antigen detection for cryptococcal disease and invasive aspergillosis, the use of molecular (PCR) diagnostics for aspergillosis, and the crucial role of antibody detection for chronic and allergic aspergillosis. Furthermore, we consider the importance of histopathology reporting with a panel of special stains, and emphasise the need for urgent (<48 hours) and optimised imaging for patients with suspected invasive fungal infection. All 43 recommendations are auditable and should be used to ensure best diagnostic practice and improved outcomes for patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Operationalising UN security council resolution 1540: an overview of select practical activities in the chemical and biological weapon-related areas

    International Nuclear Information System (INIS)

    Hart, J.

    2009-01-01

    The UN member states are continuing to take measures to inter alia establish and effectively implement controls to prevent the proliferation of nuclear, biological and chemical weapons and their means of delivery in accordance with United Nations Security Council Resolution 1540 (2004). The resolution also encourages enhanced international cooperation on such efforts, including by working through the 1540 Committee. Most analyses on the implementation of the resolution have focused on nuclear issues. This presentation provides an overview of select practical activities in the chemical and biological weapon-related areas, including chemical product classification and identification, biosafety and biosecurity practices and criminal prosecutions for unauthorised chemical transfers.(author)

  12. 16 CFR 1.43 - Recommendations.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Recommendations. 1.43 Section 1.43 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL... investigation. If, after investigation, it concludes that the law has been violated, it may make to such...

  13. STP Position Paper: Recommended Practices for Sampling and Processing the Nervous System (Brain, Spinal Cord, Nerve, and Eye) during Nonclinical General Toxicity Studies

    Science.gov (United States)

    The Society of Toxicologic Pathology charged a Nervous System Sampling Working Group with devising recommended practices to routinely screen the central and peripheral nervous systems in Good Laboratory Practice-type nonclinical general toxicity studies. Brains should be trimmed ...

  14. Overview, comparative assessment and recommendations of forecasting models for short-term water demand prediction

    CSIR Research Space (South Africa)

    Anele, AO

    2017-11-01

    Full Text Available -term water demand (STWD) forecasts. In view of this, an overview of forecasting methods for STWD prediction is presented. Based on that, a comparative assessment of the performance of alternative forecasting models from the different methods is studied. Times...

  15. SIMULATION AS PART OF INDUSTRIAL PRACTICE

    Directory of Open Access Journals (Sweden)

    Miriam Pekarčíková

    2015-06-01

    Full Text Available Article discusses the simulation as an efficient scientific method of problem solving in industrial practice. It creates an overview of the simulation program means used in industrial practice and creates an overview of tools for discrete, continuous, and combined.

  16. Expert Consensus Group report on the use of apomorphine in the treatment of Parkinson's disease - Clinical practice recommendations

    DEFF Research Database (Denmark)

    Trenkwalder, Claudia; Chaudhuri, K Ray; García Ruiz, Pedro J

    2015-01-01

    practice. This document outlines best-practice recommendations for selecting appropriate candidates for apomorphine intermittent injection (the pen-injection formulation) or apomorphine continuous infusion (the pump formulation), for initiating patients onto therapy and for managing their ongoing treatment...... and predictable 'off' periods, those who require reliable and fast relief when anticipating an 'off', those with levodopa absorption or gastric emptying problems resulting in delayed or failed 'on', or for rapid relief of early morning dystonia or akinesia. Apomorphine infusion(1) is suited for patients whose...

  17. Electronic Resources Management System: Recommendation Report 2017

    KAUST Repository

    Ramli, Rindra M.

    2017-05-01

    This recommendation report provides an overview of the selection process for the new Electronic Resources Management System. The library has decided to move away from Innovative Interfaces Millennium ERM module. The library reviewed 3 system as potential replacements namely: Proquest 360 Resource Manager, Ex Libris Alma and Open Source CORAL ERMS. After comparing and trialling the systems, it was decided to go for Proquest 360 Resource Manager.

  18. The Application of Standards and Recommendations to Clinical Ethics Consultation in Practice: An Evaluation at German Hospitals.

    Science.gov (United States)

    Schochow, Maximilian; Rubeis, Giovanni; Steger, Florian

    2017-06-01

    The executive board of the Academy for Ethics in Medicine (AEM) and two AEM working groups formulated standards and recommendations for clinical ethics consultation in 2010, 2011, and 2013. These guidelines comply with the international standards like those set by the American Society for Bioethics and Humanities. There is no empirical data available yet that could indicate whether these standards and recommendations have been implemented in German hospitals. This desideratum is addressed in the present study. We contacted 1.858 German hospitals between September 2013 and January 2014. A follow-up survey was conducted between October 2014 and January 2015. The data of the initial survey and the follow-up survey were merged and evaluated. The statements of the participants were compared with the standards and recommendations. The standards of the AEM concerning the tasks of clinical ethics consultation (including ethics consultation, ethics training and the establishment of policy guidelines) are employed by a majority of participants of the study. Almost all of these participants document their consultation activities by means of protocols or entries in the patient file. There are deviations from the recommendations of the AEM working groups regarding the drafting of statutes, activity reports, and financial support. The activities of clinical ethics consultation predominantly comply with the standards of the AEM and recommendations for the documentation. The recommendations for evaluation should be improved in practice. This applies particularly for activity reports in order to evaluate the activities. Internal evaluation could take place accordingly.

  19. Overview of Performance Based Practical Design

    Science.gov (United States)

    2018-03-01

    DOI: https://doi.org/10.13023/KTC.RR.2018.03 State transportation agencies (STAs) have increasingly turned to practical design and performance based practical design(PBPD) to inform project development and implementation and to reduce project cos...

  20. Introduction of Situation, Background, Assessment, Recommendation into Nursing Practice: A Prospective Study.

    Science.gov (United States)

    Achrekar, Meera S; Murthy, Vedang; Kanan, Sadhana; Shetty, Rani; Nair, Mini; Khattry, Navin

    2016-01-01

    The aim of the study was to introduce and evaluate the compliance to documentation of situation, background, assessment, recommendation (SBAR) form. Twenty nurses involved in active bedside care were selected by simple random sampling. Use of SBAR was illustrated thru self-instructional module (SIM). Content validity and reliability were established. The situation, background, assessment, recommendation (SBAR) form was disseminated for use in a clinical setting during shift handover. A retrospective audit was undertaken at 1 st week (A1) and 16 th week (A2), post introduction of SIM. Nurse's opinion about the SBAR form was also captured. Majority of nurses were females (65%) in the age group 21-30 years (80%). There was a significant association ( P = 0.019) between overall audit scores and graduate nurses. Significant improvement ( P = 0.043) seen in overall scores between A1 (mean: 23.20) and A2 (mean: 24.26) and also in "Situation" domain ( P = 0.045) as compared to other domains. There was only a marginal improvement in documentation related to patient's allergies and relevant past history (7%) while identifying comorbidities decreased by 40%. Only 70% of nurses had documented plan of care. Most (76%) of nurses expressed that SBAR form was useful, but 24% nurses felt SBAR documentation was time-consuming. The assessment was easy (53%) to document while recommendation was the difficult (53%) part. SBAR technique has helped nurses to have a focused and easy communication during transition of care during handover. Importance and relevance of capturing information need to be reinforced. An audit to look for reduced number of incidents related to communication failures is essential for long-term evaluation of patient outcomes. Use of standardized SBAR in nursing practice for bedside shift handover will improve communication between nurses and thus ensure patient safety.

  1. Introduction of Situation, Background, Assessment, Recommendation into Nursing Practice: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Meera S Achrekar

    2016-01-01

    Full Text Available Objective: The aim of the study was to introduce and evaluate the compliance to documentation of situation, background, assessment, recommendation (SBAR form. Methods: Twenty nurses involved in active bedside care were selected by simple random sampling. Use of SBAR was illustrated thru self-instructional module (SIM. Content validity and reliability were established. The situation, background, assessment, recommendation (SBAR form was disseminated for use in a clinical setting during shift handover. A retrospective audit was undertaken at 1 st week (A1 and 16 th week (A2, post introduction of SIM. Nurse′s opinion about the SBAR form was also captured. Results : Majority of nurses were females (65% in the age group 21-30 years (80%. There was a significant association (P = 0.019 between overall audit scores and graduate nurses. Significant improvement (P = 0.043 seen in overall scores between A1 (mean: 23.20 and A2 (mean: 24.26 and also in "Situation" domain (P = 0.045 as compared to other domains. There was only a marginal improvement in documentation related to patient′s allergies and relevant past history (7% while identifying comorbidities decreased by 40%. Only 70% of nurses had documented plan of care. Most (76% of nurses expressed that SBAR form was useful, but 24% nurses felt SBAR documentation was time-consuming. The assessment was easy (53% to document while recommendation was the difficult (53% part. Conclusions: SBAR technique has helped nurses to have a focused and easy communication during transition of care during handover. Importance and relevance of capturing information need to be reinforced. An audit to look for reduced number of incidents related to communication failures is essential for long-term evaluation of patient outcomes. Use of standardized SBAR in nursing practice for bedside shift handover will improve communication between nurses and thus ensure patient safety.

  2. Dysphagia in Duchenne muscular dystrophy: practical recommendations to guide management.

    Science.gov (United States)

    Toussaint, Michel; Davidson, Zoe; Bouvoie, Veronique; Evenepoel, Nathalie; Haan, Jurn; Soudon, Philippe

    2016-10-01

    Duchenne muscular dystrophy (DMD) is a rapidly progressive neuromuscular disorder causing weakness of the skeletal, respiratory, cardiac and oropharyngeal muscles with up to one third of young men reporting difficulty swallowing (dysphagia). Recent studies on dysphagia in DMD clarify the pathophysiology of swallowing disorders and offer new tools for its assessment but little guidance is available for its management. This paper aims to provide a step-by-step algorithm to facilitate clinical decisions regarding dysphagia management in this patient population. This algorithm is based on 30 years of clinical experience with DMD in a specialised Centre for Neuromuscular Disorders (Inkendaal Rehabilitation Hospital, Belgium) and is supported by literature where available. Dysphagia can worsen the condition of ageing patients with DMD. Apart from the difficulties of chewing and oral fragmentation of the food bolus, dysphagia is rather a consequence of an impairment in the pharyngeal phase of swallowing. By contrast with central neurologic disorders, dysphagia in DMD accompanies solid rather than liquid intake. Symptoms of dysphagia may not be clinically evident; however laryngeal food penetration, accumulation of food residue in the pharynx and/or true laryngeal food aspiration may occur. The prevalence of these issues in DMD is likely underestimated. There is little guidance available for clinicians to manage dysphagia and improve feeding for young men with DMD. This report aims to provide a clinical algorithm to facilitate the diagnosis of dysphagia, to identify the symptoms and to propose practical recommendations to treat dysphagia in the adult DMD population. Implications for Rehabilitation Little guidance is available for the management of dysphagia in Duchenne dystrophy. Food can penetrate the vestibule, accumulate as residue or cause aspiration. We propose recommendations and an algorithm to guide management of dysphagia. Penetration/residue accumulation

  3. DNV launches new recommended practice for design of subsea equipment

    Energy Technology Data Exchange (ETDEWEB)

    Toerstad, Elisabeth Heggelund

    2005-07-01

    The application of modern corrosion-resistant alloys to subsea pipelines and components has led to serious problems of hydrogen embrittlement from the corrosion protection system, resulting in cracks and leaks. The most commonly known incidents of this kind are the duplex hubs on Voinhaven, UK and Garn West and the 13% Cr pipelines on Tune and Aasgard, all at the Norwegian shelf. Understanding the nature of this problem has called for a broad multidisciplinary approach, involving expertise on corrosion and metallurgy as well as structural design and integrity. Competence in probabilistic analyses and risk assessments has also been necessary in order to set acceptance criteria and evaluate probability of failure for existing installations. (Det Norske Veritas (DNV) is now about to issues a Recommended Practise (RP) for design of subsea equipment in duplex steels under Cathodic Protection. The RP is based on knowledge gained through failure investigations, qualification pr grams and research work, and a broad industry consortium has contributed with experience and knowledge. Hydrogen Induced Stress Cracking (HISC) due to hydrogen from the Cathodic Protection (CP) system has been one of the most frequent and costly failure modes for subsea equipment and pipelines in the North Sea over the recent years. Today, the international oil business is looking to Norway for assistance in establishing detailed knowledge about and preventive measures against this failure mode. A significant research work is currently being carried out jointly by DNV, SINTEF and TWI (The Welding Institute), supported by a broad industry consortium - aiming at a better understanding of the HISC (Hydrogen Induced Stress Cracking) mechanism and establishment of test methods which reflect the sensitivity to cracking. DNV has also established a Recommended Practice, which will be issued late 2005. It reflects the experience gained from the failure examinations, fitness for purpose evaluations, research

  4. An Overview of the Challenges and Opportunities for Globalization ...

    African Journals Online (AJOL)

    The paper is an overview of the existing challenges and opportunities of globalization of Nigerian libraries. It examine the challenges and opportunities for the establishment of viable information and communication. Technologies (ICTs) and recommends the way forward for interconnectivity of Nigerian libraries to facilitate ...

  5. Overview of ICRP Committee 4: application of the Commission's recommendations.

    Science.gov (United States)

    Cool, D A

    2016-06-01

    Committee 4 develops principles and recommendations on radiological protection of people in all exposure situations. The committee meeting in 2014 was hosted by GE Healthcare in Arlington Heights, IL, USA on 27 July-1 August 2014. The programme of work of Committee 4 encompasses several broad areas, including a series of reports covering various aspects of existing exposure situations, leading the efforts of the International Commission on Radiological Protection (ICRP) to update and elaborate recommendations in light of the accident at Fukushima Daiichi nuclear power plant for emergencies and living in contaminated areas, elaborating the underpinnings of the system of radiological protection, and developing focussed reports on specific topic areas in consultation with ICRP's special liaison organisations. Committee 4 has six active Task Groups working on naturally occurring radioactive material; cosmic radiation in aviation; updates of ICRP Publications 109 and 111; ethics of radiological protection; surface and near-surface disposal of solid radioactive waste; and exposures resulting from contaminated sites from past industrial, military, and nuclear activities. In addition, there is a Working Party on tolerability of risk, and ongoing work with the various special liaison organisations of ICRP. © The International Society for Prosthetics and Orthotics.

  6. A Study of Business Incubators: Models, Best Practices, and Recommendations for NASA and Florida

    Science.gov (United States)

    1997-01-01

    This study was conducted to provide NASA-Kennedy Space Center with information and recommendations to support establishing one or more technology-based business incubators In Florida. The study involved assembling information about incubators: why they succeed, why they fail, how they are organized, and what services they provide. Consequently, this study focuses on widely-recognized "best practices," needed to establish successful technology- based business incubators. The findings are used to optimize the design and implementation of one or more technology-based business incubators to be established in Florida. Recommendations reflect both the essential characteristics of successful incubators and the optimal business demographics in Florida. Appendix A provides a fuller description of the objectives of the study. Technology-based business incubators are an increasing catalyst of new business development across the USi Incubators focus on providing entrepreneurs and small start-up firms with a wide array of support services necessary to bring forth new products and processes based on technologies developed in the nation's federal and private laboratories and universities. Appendix B provides extensive discussion of findings relative to technology- based business incubators.

  7. Farmers\\' Characteristics And Adoption Of Recommended Practices ...

    African Journals Online (AJOL)

    The study focused on farmers under the fadama project scheme in Edo State, Nigeria with emphasis on the relationship between farmers\\' characteristics and adoption of recommended technologies. Analyses of data obtained from a random sample of 80 respondents reveals that fadama farming was dominated by females ...

  8. The VCU Pressure Ulcer Summit: Collaboration to Operationalize Hospital-Acquired Pressure Ulcer Prevention Best Practice Recommendations.

    Science.gov (United States)

    Brindle, C Tod; Creehan, Sue; Black, Joyce; Zimmermann, Deb

    2015-01-01

    This executive summary reports outcomes of an interprofessional collaboration between experts in pressure ulcer prevention, bedside clinicians, regulatory agencies, quality improvement, informatics experts, and professional nursing organizations. The goal of the collaboration was to develop a framework to assist facilities to operationalize best practice recommendations to sustain organizational culture change in hospital-acquired pressure ulcer prevention, to develop a hospital-acquired pressure ulcer severity score, and to address topics related to the unavoidable pressure ulcer.

  9. Matrix vaccination guidelines : 2015 ABCD recommendations for indoor/outdoor cats, rescue shelter cats and breeding catteries

    NARCIS (Netherlands)

    Hosie, Margaret J; Addie, Diane D; Boucraut-Baralon, Corine; Egberink, Herman; Frymus, Tadeusz; Gruffydd-Jones, Tim; Hartmann, Katrin; Horzinek, Marian C; Lloret, Albert; Lutz, Hans; Marsilio, Fulvio; Pennisi, Maria Grazia; Radford, Alan D; Thiry, Etienne; Truyen, Uwe; Möstl, Karin

    OVERVIEW: In 2013, the ABCD published 'Matrix vaccination guidelines: ABCD recommendations for indoor/outdoor cats, rescue shelter cats and breeding catteries' in a Special Issue of the Journal of Feline Medicine and Surgery (Volume 15, Issue 7, pages 540-544). The ABCD's vaccination recommendations

  10. 12 CFR 13.4 - Recommendations to customers.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Recommendations to customers. 13.4 Section 13.4... PRACTICES § 13.4 Recommendations to customers. In recommending to a customer the purchase, sale or exchange... reasonable grounds for believing that the recommendation is suitable for the customer upon the basis of the...

  11. Ethical Issues Raised by Private Practice Physiotherapy Are More Diverse than First Meets the Eye: Recommendations from a Literature Review

    Science.gov (United States)

    Drolet, Marie-Josée; Williams-Jones, Bryn

    2015-01-01

    ABSTRACT Purpose: Physiotherapy in private practice differs from physiotherapy practised in a public setting in several ways, the most evident of which is the for-profit nature of private physiotherapy clinics; these differences can generate distinct and challenging ethical issues. The objectives of this article are to identify ethical issues encountered by physiotherapists in private practice settings and to identify potential solutions and recommendations to address these issues. Method: After a literature search of eight databases, 39 studies addressing ethical issues in a private practice context were analyzed. Results: A total of 25 ethical issues emerging from the included studies were classified into three main categories: (1) business and economic issues (e.g., conflicts of interests, inequity in a managed care context, lack of time affecting quality of care); (2) professional issues (e.g., professional autonomy, clinical judgment, treatment effectiveness, professional conduct); and (3) patients' rights and welfare issues (e.g., confidentiality, power asymmetries, paternalism vs. patient autonomy, informed consent). Recommendations as to how physiotherapists could better manage these issues were then identified and categorized. Conclusions: The physiotherapy community should reflect on the challenges raised by private practice so that professionals can be supported—through education, research, and good governance—in providing the best possible care for their patients. PMID:25931663

  12. Ethical issues raised by private practice physiotherapy are more diverse than first meets the eye: recommendations from a literature review.

    Science.gov (United States)

    Hudon, Anne; Drolet, Marie-Josée; Williams-Jones, Bryn

    2015-01-01

    Physiotherapy in private practice differs from physiotherapy practised in a public setting in several ways, the most evident of which is the for-profit nature of private physiotherapy clinics; these differences can generate distinct and challenging ethical issues. The objectives of this article are to identify ethical issues encountered by physiotherapists in private practice settings and to identify potential solutions and recommendations to address these issues. After a literature search of eight databases, 39 studies addressing ethical issues in a private practice context were analyzed. A total of 25 ethical issues emerging from the included studies were classified into three main categories: (1) business and economic issues (e.g., conflicts of interests, inequity in a managed care context, lack of time affecting quality of care); (2) professional issues (e.g., professional autonomy, clinical judgment, treatment effectiveness, professional conduct); and (3) patients' rights and welfare issues (e.g., confidentiality, power asymmetries, paternalism vs. patient autonomy, informed consent). Recommendations as to how physiotherapists could better manage these issues were then identified and categorized. The physiotherapy community should reflect on the challenges raised by private practice so that professionals can be supported-through education, research, and good governance-in providing the best possible care for their patients.

  13. Hit Identification and Optimization in Virtual Screening: Practical Recommendations Based Upon a Critical Literature Analysis

    Science.gov (United States)

    Zhu, Tian; Cao, Shuyi; Su, Pin-Chih; Patel, Ram; Shah, Darshan; Chokshi, Heta B.; Szukala, Richard; Johnson, Michael E.; Hevener, Kirk E.

    2013-01-01

    A critical analysis of virtual screening results published between 2007 and 2011 was performed. The activity of reported hit compounds from over 400 studies was compared to their hit identification criteria. Hit rates and ligand efficiencies were calculated to assist in these analyses and the results were compared with factors such as the size of the virtual library and the number of compounds tested. A series of promiscuity, drug-like, and ADMET filters were applied to the reported hits to assess the quality of compounds reported and a careful analysis of a subset of the studies which presented hit optimization was performed. This data allowed us to make several practical recommendations with respect to selection of compounds for experimental testing, defining hit identification criteria, and general virtual screening hit criteria to allow for realistic hit optimization. A key recommendation is the use of size-targeted ligand efficiency values as hit identification criteria. PMID:23688234

  14. Hit identification and optimization in virtual screening: practical recommendations based on a critical literature analysis.

    Science.gov (United States)

    Zhu, Tian; Cao, Shuyi; Su, Pin-Chih; Patel, Ram; Shah, Darshan; Chokshi, Heta B; Szukala, Richard; Johnson, Michael E; Hevener, Kirk E

    2013-09-12

    A critical analysis of virtual screening results published between 2007 and 2011 was performed. The activity of reported hit compounds from over 400 studies was compared to their hit identification criteria. Hit rates and ligand efficiencies were calculated to assist in these analyses, and the results were compared with factors such as the size of the virtual library and the number of compounds tested. A series of promiscuity, druglike, and ADMET filters were applied to the reported hits to assess the quality of compounds reported, and a careful analysis of a subset of the studies that presented hit optimization was performed. These data allowed us to make several practical recommendations with respect to selection of compounds for experimental testing, definition of hit identification criteria, and general virtual screening hit criteria to allow for realistic hit optimization. A key recommendation is the use of size-targeted ligand efficiency values as hit identification criteria.

  15. Investing in Youth: A Compilation of Recommended Policies and Practices. National Conference (New Orleans, Louisiana, December 9-11, 1992).

    Science.gov (United States)

    National Governors' Association, Washington, DC.

    These proceedings include 13 "perspectives from the field" and 9 selected papers (with abstracts) from a national conference on recommended policies and practices for investing in youth. The 13 perspectives papers are as follows: "Saving the Next Generation" (Berlin); "Effective Strategies for Investing in Youth"…

  16. Materiality in a Practice-Based Approach

    Science.gov (United States)

    Svabo, Connie

    2009-01-01

    Purpose: The paper aims to provide an overview of the vocabulary for materiality which is used by practice-based approaches to organizational knowing. Design/methodology/approach: The overview is theoretically generated and is based on the anthology Knowing in Organizations: A Practice-based Approach edited by Nicolini, Gherardi and Yanow. The…

  17. Parents of preschoolers: expert media recommendations and ratings knowledge, media-effects beliefs, and monitoring practices.

    Science.gov (United States)

    Funk, Jeanne B; Brouwer, Jason; Curtiss, Kathleen; McBroom, Evan

    2009-03-01

    Given the increase in screen media targeted at the very young, the purpose of this study was to examine preschooler parents' knowledge about expert recommendations for young children's screen media experience, their knowledge of specific screen media ratings, their beliefs about screen media effects, and actual monitoring practices. Parents of 94 children education, age and gender of child, and parents' perceptions of their child's favorite television show and favorite video or computer game. Eleven multiple-choice questions assessed the respondent's knowledge of expert recommendations for screen media for preschoolers and the meaning of television and video game content ratings. Fourteen questions addressed the typical amount of their preschooler's screen media exposure, parental rules regarding screen media use, and parents' beliefs about appropriate use of screen media for preschoolers. Preschoolers were exposed to an average of approximately 12 hours of screen media in a typical week. Parents believe that media do have either short- or long-term effects on preschoolers. Performance on factual questions was poor (mean score: 2.83 of 11). In particular, only 34% of the parents correctly identified the expert recommendation for children >2 years of age. Parents should continue to be educated about the need for preschoolers to participate in activities that promote language development, socialization, imagination, and physical activity. Although professionals should work to improve the ratings, and ultimately to implement a universal ratings system for all screen media, parents need to be encouraged to improve their understanding of current recommendations for screen media exposure and television and video game ratings.

  18. Overview of battery technology for HEV

    NARCIS (Netherlands)

    Smets, S.; Debal, P.; Conte, V.; Alaküla, M.; Santini, D.; Duvall, M.; Winkel, R.; Badin, F.

    2006-01-01

    Several electric energy storage systems exist with different principles and characteristics. On the other hand, there are also various hybrid electric vehicles with specific requirements. This paper gives an overview of the advantages/disadvantages and practical aspects of battery technologies and

  19. Upper limb robotics applied to neurorehabilitation: An overview of clinical practice.

    Science.gov (United States)

    Duret, Christophe; Mazzoleni, Stefano

    2017-01-01

    During the last two decades, extensive interaction between clinicians and engineers has led to the development of systems that stimulate neural plasticity to optimize motor recovery after neurological lesions. This has resulted in the expansion of the field of robotics for rehabilitation. Studies in patients with stroke-related upper-limb paresis have shown that robotic rehabilitation can improve motor capacity. However, few other applications have been evaluated (e.g. tremor, peripheral nerve injuries or other neurological diseases). This paper presents an overview of the current use of upper limb robotic systems for neurorehabilitation, and highlights the rationale behind their use for the assessment and treatment of common neurological disorders. Rehabilitation robots are little integrated in clinical practice, except after stroke. Although few studies have been carried out to evaluate their effectiveness, evidence from the neurosciences and indications from pilot studies suggests that upper limb robotic rehabilitation can be applied safely in various other neurological conditions. Rehabilitation robots provide an intensity, quality and dose of treatment that exceeds therapist-mediated rehabilitation. Moreover, the use of force fields, multi-sensory environments, feedback etc. renders such rehabilitation engaging and motivating. Future studies should evaluate the effectiveness of rehabilitation robots in neurological pathologies other than stroke.

  20. Implementing AORN recommended practices for a safe environment of care, part II.

    Science.gov (United States)

    Kennedy, Lynne

    2014-09-01

    Construction in and around a working perioperative suite is a challenge beyond merely managing traffic patterns and maintaining the sterile field. The AORN "Recommended practices for a safe environment of care, part II" provides guidance on building design; movement of patients, personnel, supplies, and equipment; environmental controls; safety and security; and control of noise and distractions. Whether the OR suite evolves through construction, reconstruction, or remodeling, a multidisciplinary team of construction experts and health care professionals should create a functional plan and communicate at every stage of the project to maintain a safe environment and achieve a well-designed outcome. Emergency preparedness, a facility-wide security plan, and minimization of noise and distractions in the OR also help enhance the safety of the perioperative environment. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  1. Overview, practical tips and potential pitfalls of using automatic exposure control in CT: Siemens care dose 4D

    International Nuclear Information System (INIS)

    Soederberg, Marcus

    2016-01-01

    Today, computed tomography (CT) systems routinely use automatic exposure control (AEC), which modulates the tube current. However, for optimal use, there are several aspects of an AEC system that need to be considered. The purpose of this study was to provide an overview of the Siemens CARE Dose 4D AEC system, discuss practical tips and demonstrate potential pitfalls. Two adult anthropomorphic phantoms were examined using two different Siemens CT systems. When optimising the CT radiation dose and image quality, the projection angle of the localiser, patient centring, protocol selection, scanning direction and the use of protective devices requires special attention. (authors)

  2. Radiosterilization of Medical Products and Recommended Code of Practice. Proceedings of a Symposium

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1967-09-15

    Proceedings of a Symposium organized by the IAEA and held in Budapest, 5-9 June 1967, together with the IAEA recommended 'Code of Practice for Radiosterilization of Medical Products' resulting from a panel meeting held in Vienna, December 1966, and considered at the Symposium. The meeting was attended by 160 participants from 25 Member States and 3 international organizations. The commercial use of ionizing radiation for sterilizing medical supplies extends back to the early 1960s. The ability of the process to sterilize products made of materials such as plastics, which are destroyed by traditional sterilization procedures, has promoted much new thinking in product design. Most important is the ability of the radiation to sterilize items finally sealed and packed for dispatch, eliminating risk of recontamination. Some new fields of research are discussed in the Proceedings. The Code of Practice, drawn up by experts at several meetings, is aimed at producing uniform, safe procedures throughout the world, facilitating international trade in radiosterilized products. Contents: Introductory lecture; Radiosterilization of pharmaceuticals and bioproducts (12 papers); Radiosterilization of biological tissues (6 papers); Vaccine production by ionizing radiation (5 papers); Radiosterilization of medical devices and supplies (4 papers); Radiosensitivity of micro-organisms and microbiological testing (4 papers); Technical and economic aspects of radiosterilization (6 papers); Code of practice for radiosterilization (full code and 1 review paper). The Code of Practice is in English. Each paper is in its original language (29 English, 5 French, 4 Russian and 1 Spanish) and is preceded by an abstract in English with one in the original language if this is not English. Discussions are in English. (author)

  3. Radiosterilization of Medical Products and Recommended Code of Practice. Proceedings of a Symposium

    International Nuclear Information System (INIS)

    1967-01-01

    Proceedings of a Symposium organized by the IAEA and held in Budapest, 5-9 June 1967, together with the IAEA recommended 'Code of Practice for Radiosterilization of Medical Products' resulting from a panel meeting held in Vienna, December 1966, and considered at the Symposium. The meeting was attended by 160 participants from 25 Member States and 3 international organizations. The commercial use of ionizing radiation for sterilizing medical supplies extends back to the early 1960s. The ability of the process to sterilize products made of materials such as plastics, which are destroyed by traditional sterilization procedures, has promoted much new thinking in product design. Most important is the ability of the radiation to sterilize items finally sealed and packed for dispatch, eliminating risk of recontamination. Some new fields of research are discussed in the Proceedings. The Code of Practice, drawn up by experts at several meetings, is aimed at producing uniform, safe procedures throughout the world, facilitating international trade in radiosterilized products. Contents: Introductory lecture; Radiosterilization of pharmaceuticals and bioproducts (12 papers); Radiosterilization of biological tissues (6 papers); Vaccine production by ionizing radiation (5 papers); Radiosterilization of medical devices and supplies (4 papers); Radiosensitivity of micro-organisms and microbiological testing (4 papers); Technical and economic aspects of radiosterilization (6 papers); Code of practice for radiosterilization (full code and 1 review paper). The Code of Practice is in English. Each paper is in its original language (29 English, 5 French, 4 Russian and 1 Spanish) and is preceded by an abstract in English with one in the original language if this is not English. Discussions are in English. (author)

  4. Power Testing in Basketball: Current Practice and Future Recommendations.

    Science.gov (United States)

    Wen, Neal; Dalbo, Vincent J; Burgos, Bill; Pyne, David B; Scanlan, Aaron T

    2018-02-01

    Numerous foundational movements performed during basketball are predicated on underlying power-related attributes, including speed, change-of-direction, and jumping. Accordingly, fitness testing batteries for basketball have incorporated an assortment of linear speed tests, change-of-direction tests, and jump tests. However, due to the wide variety of testing options it is difficult for basketball practitioners to select appropriate testing protocols for the assessment of power-related attributes. As a result, there is a need to review the relevant literature to identify game-specific, power-related attributes important in basketball and the most appropriate tests available to assess power-related attributes for basketball practitioners. Therefore, the aims of this review were to: (1) identify essential power-related attributes important in basketball; (2) discuss the suitability of common and novel power-related tests; and (3) provide recommendations for future research and best practice approaches for basketball coaching staff. In this review, we propose a series of novel tests that are more targeted and specific to basketball movements including: (1) 5-m and 10-m linear sprints, (2) Modified Agility T-Test, (3) Change-of-Direction Deficit, (4) lateral bound, (5) Sargent jump, (6) one-step jump, and (7) isometric midthigh pull test. Improved testing of power-related attributes should enable basketball practitioners to develop targeted training plans for enhancing player performance.

  5. Physics through the 1990s: An overview

    International Nuclear Information System (INIS)

    1986-01-01

    This Overview summarizes and addresses issues that broadly concern physics. The role of physics in society is discussed. Highlights of the progress and the opportunities in each subfield, plus the future needs and recommended action are described. In addition, there are three supplements on issues that cut across the individual fields: international aspects of physics, education and supply of physicists, and organization and support of physics

  6. Coal waste management practices in the USA:an overview

    Institute of Scientific and Technical Information of China (English)

    Yoginder P. Chugh; Paul T. Behum

    2014-01-01

    This paper provides an overview of coal waste management practices with two case studies and an estimate of management cost in 2010 US dollars. Processing of as-mined coal typically results in considerable amount of coarse and fine coal processing wastes because of in-seam and out-of-seam dilution mining. Processing plant clean coal recovery values run typically 50%–80%. Trace metals and sulfur may be present in waste materials that may result in leachate water with corrosive charac-teristics. Water discharges may require special measures such as liner and collection systems, and treatment to neutralize acid drainage and/or water quality for trace elements. The potential for variations in coal waste production and quality depends upon mining or processing, plus the long-term methods of waste placement. The changes in waste generation rates and engineering properties of the coal waste during the life of the facility must be considered. Safe, economical and environmentally acceptable management of coal waste involves consideration of geology, soil and rock mechanics, hydrology, hydraulics, geochemistry, soil science, agronomy and environmental sciences. These support all aspects of the regulatory environment including the design and construction of earth and rock embankments and dams, as well as a wide variety of waste disposal structures. Development of impoundments is critical and require considerations of typical water-impounding dams and additional requirements of coal waste disposal impoundments. The primary purpose of a coal waste disposal facility is to dispose of unusable waste materials from mining. However, at some sites coal waste impoundments serve to provide water storage capacity for processing and flood attenuation.

  7. Critical overview of the development of the optimization requirement and its implementation

    International Nuclear Information System (INIS)

    Gonzalez, A.J.

    1988-01-01

    This paper is intended to provide a critical overview of the development of the optimization requirement of the system of dose limitation recommended by the International Commission on Radiological Protection (ICRP), as well as of its implementation. The concept of optimization began to evolve in the mid-1950s and was formally introduced as a requirement for radiation protection in 1978. Recommendations on its practical implementation have been available for five years. After such a long evolution, it seems reasonable to make a critical assessment of the development of the optimization concept, and this summary paper is intended to provide such an assessment. It does not include a description of the requirement or of any method for implementing it, since it is assumed that optimization is familiar by now. The paper concentrates rather on misunderstandings of and achievements owed to optimization and explores some of their underlying causes, the intention being to draw lessons from past experience and to apply them to future developments in this area. The paper presents an outlook on some remaining policy issues that still pending solution as well as some suggestions on prioritization of implementation of optimization and on standardizing the optimization protection

  8. Recommender Systems for Learning

    CERN Document Server

    Manouselis, Nikos; Verbert, Katrien; Duval, Erik

    2013-01-01

    Technology enhanced learning (TEL) aims to design, develop and test sociotechnical innovations that will support and enhance learning practices of both individuals and organisations. It is therefore an application domain that generally covers technologies that support all forms of teaching and learning activities. Since information retrieval (in terms of searching for relevant learning resources to support teachers or learners) is a pivotal activity in TEL, the deployment of recommender systems has attracted increased interest. This brief attempts to provide an introduction to recommender systems for TEL settings, as well as to highlight their particularities compared to recommender systems for other application domains.

  9. Treatment of asthma: Identification of the practice behavior and the deviation from the guideline recommendations

    Directory of Open Access Journals (Sweden)

    Bhattacharyya Parthasarathi

    2010-01-01

    Full Text Available Background: Despite an exponential development of the understanding of the disease with availability of good therapy and feasibility of good control along with availability of globally accepted guidelines, there remains a significant gap between the guidelines and prevailing practice behavior for treating asthma all over the globe. This perhaps stands as the single most deterrent factor for good asthma care worldwide. The objective of the study is to analyze the asthma prescriptions to find out the available status of the practice behaviour and the deviations from the guideline in asthma practice. Materials and Methods: The asthma prescriptions of the referred patients presenting to the OPD services of the IPCR, Kolkata were photocopied and collected. They were further analyzed based on the available information upon a format being prepared on four major areas as qualifications, clinical recording habit, practice of evaluating patients, and treatment habit that stands apparent from the prescribed medications. The doctors were divided into three categories as a MBBS, b MD/DNB (medicine and respiratory medicine, and c DM (non respiratory sub-specialities and statistical analysis has been performed comparing the three groups as per the performance in the four pre-decided areas. Results: All the groups fall short of any guideline or text of asthma care in all the areas involved. Conclusion: The practice behaviour of our doctors for asthma care appears deficient in several areas and seems far from guideline recommendations. This needs further evaluation and adoption of appropriate interventions.

  10. Baby steps in the prevention of childhood obesity: IOM guidelines for pediatric practice.

    Science.gov (United States)

    Gaffney, Kathleen F; Kitsantas, Panagiota; Brito, Albert; Kastello, Jennifer

    2014-01-01

    The aim of this paper is to present an overview of the infancy-related guidelines from the Institute of Medicine (IOM, 2011) report “Early Childhood Obesity Prevention Policies” and highlight research studies that support their implementation in pediatric practice. Findings from recent studies of infant growth monitoring, feeding, sleep, and physical activity are presented. Research strategies that may be applied to today's clinical assessments and interventions are specified. Participation by pediatric nurses in the development of future multi-component interventions to prevent rapid infant weight gain is recommended.

  11. Discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia: Recommendations for clinical practice from the French Chronic Myeloid Leukemia Study Group.

    Science.gov (United States)

    Rea, Delphine; Ame, Shanti; Berger, Marc; Cayuela, Jean-Michel; Charbonnier, Aude; Coiteux, Valérie; Cony-Makhoul, Pascale; Dubruille, Viviane; Dulucq, Stéphanie; Etienne, Gabriel; Legros, Laurence; Nicolini, Franck; Roche-Lestienne, Catherine; Escoffre-Barbe, Martine; Gardembas, Martine; Guerci-Bresler, Agnès; Johnson-Ansah, Hyacinthe; Rigal-Huguet, Françoise; Rousselot, Philippe; Mahon, François-Xavier

    2018-05-03

    The ultimate goal of chronic myeloid leukemia management in the tyrosine kinase inhibitor (TKI) era for patients who obtain deep molecular responses is maintaining a durable off-treatment response after treatment discontinuation; this situation is called treatment-free remission (TFR). Knowledge accumulated during the last 10 years justifies moving TFR strategies from research to clinical practice. Twenty experts from the French Chronic Myeloid Leukemia Study Group (France Intergroupe des Leucémies Myéloïdes Chroniques), including 17 hematologists, 2 molecular biologists, and 1 cytogeneticist, critically reviewed published data with the goal of developing evidence-based recommendations for TKI discontinuation in clinical practice. Clinically relevant questions were addressed, including the selection of candidate patients (with known prognostic factors for outcomes taken into account), detailed monitoring procedures during the treatment-free phase, a definition of relapse requiring therapy resumption, and monitoring after treatment reintroduction. This work presents consensus statements with the aim of guiding physicians and biologists by means of pragmatic recommendations for safe TKI discontinuation in daily practice. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  12. 12 CFR 368.4 - Recommendations to customers.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Recommendations to customers. 368.4 Section 368... POLICY GOVERNMENT SECURITIES SALES PRACTICES § 368.4 Recommendations to customers. In recommending to a customer the purchase, sale or exchange of a government security, a bank that is a government securities...

  13. Overview of the critical disaster management challenges faced during Van 2011 earthquakes.

    Science.gov (United States)

    Tolon, Mert; Yazgan, Ufuk; Ural, Derin N; Goss, Kay C

    2014-01-01

    On October 23, 2011, a M7.2 earthquake caused damage in a widespread area in the Van province located in eastern Turkey. This strong earthquake was followed by a M5.7 earthquake on November 9, 2011. This sequence of damaging earthquakes led to 644 fatalities. The management during and after these earthquake disaster imposed many critical challenges. In this article, an overview of these challenges is presented based on the observations by the authors in the aftermath of this disaster. This article presents the characteristics of 2011 Van earthquakes. Afterward, the key information related to the four main phases (ie, preparedness, mitigation, response, and recovery) of the disaster in Van is presented. The potential strategies that can be taken to improve the disaster management practice are identified, and a set of recommendations are proposed to improve the existing situation.

  14. The Practice of Health Program Evaluation.

    Science.gov (United States)

    Lewis, Sarah R

    2017-11-01

    The Practice of Health Program Evaluation provides an overview of the evaluation process for public health programs while diving deeper to address select advanced concepts and techniques. The book unfolds evaluation as a three-phased process consisting of identification of evaluation questions, data collection and analysis, and dissemination of results and recommendations. The text covers research design, sampling methods, as well as quantitative and qualitative approaches. Types of evaluation are also discussed, including economic assessment and systems research as relative newcomers. Aspects critical to conducting a successful evaluation regardless of type or research design are emphasized, such as stakeholder engagement, validity and reliability, and adoption of sound recommendations. The book encourages evaluators to document their approach by developing an evaluation plan, a data analysis plan, and a dissemination plan, in order to help build consensus throughout the process. The evaluative text offers a good bird's-eye view of the evaluation process, while offering guidance for evaluation experts on how to navigate political waters and advocate for their findings to help affect change.

  15. Systematic tailoring for the implementation of guideline recommendations for anxiety and depressive disorders in general practice: perceived usefulness of tailored interventions

    NARCIS (Netherlands)

    Sinnema, H.; Terluin, B.; Wensing, M.; Volker, D.; Franx, G.; van Balkom, A.J.L.M.; de Lange, J.

    2013-01-01

    Background: The uptake of guideline recommendations in general practice can potentially be improved by designing implementation interventions that are tailored to prospectively identify barriers. However, there is insufficient evidence regarding the most effective and efficient approaches to

  16. Systematic tailoring for the implementation of guideline recommendations for anxiety and depressive disorders in general practice: perceived usefulness of tailored interventions

    NARCIS (Netherlands)

    Sinnema, H.; Terluin, B.; Wensing, M.; Volker, D.; Franx, G.; Balkom, A. van; Lange, J.

    2013-01-01

    BACKGROUND: The uptake of guideline recommendations in general practice can potentially be improved by designing implementation interventions that are tailored to prospectively identify barriers. However, there is insufficient evidence regarding the most effective and efficient approaches to

  17. Nebraska family practitioners' infant feeding recommendations.

    Science.gov (United States)

    Auerbach, K G; Walburn, J

    1987-01-01

    The authors conducted an anonymous survey of 220 Nebraska family and general practitioners' attitudes and practice recommendations for infant feeding. Most practitioners' attitudes reflect published American Academy of Pediatrics (AAP) guidelines regarding using commercial formula for bottle-feeding babies rather than evaporated milk-based formulations. Ninety-two per cent agreed with recommendations relating to the need for fluoride supplementation when fluoride was unavailable in the water supply and 93% agreed that whole cow's milk was inappropriate in the infant's first year. Another 68% felt similarly about evaporated milk formulas. However, 32% of board certified and 53% of nonboard certified physicians continue to believe that early solid foods will reduce night waking. In 80% of the cases, practice recommendations disagreed with AAP guidelines by prescribing vitamin supplements for bottle-feeding babies receiving proprietary infant formulas. Additionally, two-thirds of the practitioners recommended unnecessary water complements and 62% suggested formula supplementation for breastfeeding babies. Solid foods and whole cow's milk for both breastfeeding and bottle-feeding babies often were recommended earlier than the second half of the first year.

  18. Overview of interatomic potentials

    International Nuclear Information System (INIS)

    Bonny, G.; Malerba, L.

    2005-12-01

    In this report an overview on interatomic potentials is given. This overview is by no means complete and it has merely the intention to give the reader an idea of where interatomic potentials come from, as well as to provide the basic ideas behind some commonly used methods for deriving interatomic potentials for molecular dynamics applications. We start by giving a short introduction about the concept of interatomic potential in the framework of quantum mechanics, followed by a short description of commonly used methods for deriving semi-empirical interatomic potentials. After some short theoretical notions on each method, some practical parameterizations of commonly used potentials are given, including very recent ones. An effort has been made to classify existing approaches within a rational and consequent scheme, which is believed to be of use for a thorough comprehension of the topic. Although these approaches can be used in a variety of different materials, we will only discuss the practical cases of metals. Following this, some widespread ad hoc modification of the general methods are discussed. The report is concluded by a generalization of the methods to multi-component materials, in particular metallic alloys. (author)

  19. Systematic review of clinical practice guidelines to identify recommendations for rehabilitation after stroke and other acquired brain injuries

    Science.gov (United States)

    Lannin, Natasha A; Hoffmann, Tammy

    2018-01-01

    Objectives Rehabilitation clinical practice guidelines (CPGs) contain recommendation statements aimed at optimising care for adults with stroke and other brain injury. The aim of this study was to determine the quality, scope and consistency of CPG recommendations for rehabilitation covering the acquired brain injury populations. Design Systematic review. Interventions Included CPGs contained recommendations for inpatient rehabilitation or community rehabilitation for adults with an acquired brain injury diagnosis (stroke, traumatic or other non-progressive acquired brain impairments). Electronic databases (n=2), guideline organisations (n=4) and websites of professional societies (n=17) were searched up to November 2017. Two independent reviewers used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, and textual syntheses were used to appraise and compare recommendations. Results From 427 papers screened, 20 guidelines met the inclusion criteria. Only three guidelines were rated high (>75%) across all domains of AGREE-II; highest rated domains were ‘scope and purpose’ (85.1, SD 18.3) and ‘clarity’ (76.2%, SD 20.5). Recommendations for assessment and for motor therapies were most commonly reported, however, varied in the level of detail across guidelines. Conclusion Rehabilitation CPGs were consistent in scope, suggesting little difference in rehabilitation approaches between vascular and traumatic brain injury. There was, however, variability in included studies and methodological quality. PROSPERO registration number CRD42016026936. PMID:29490958

  20. The Five-Factor Model: General Overview

    Directory of Open Access Journals (Sweden)

    A A Vorobyeva

    2011-12-01

    Full Text Available The article describes the five-factor model (FFM, giving an overview of its history, basic dimensions, cross-cultural research conducted on the model and highlights some practical studies based on the FFM, including the studies on job performance, leader performance and daily social interactions. An overview of the recent five-factor theory is also provided. According to the theory, the five factors are encoded in human genes, therefore it is almost impossible to change the basic factors themselves, but a person's behavior might be changed due to characteristic adaptations which do not alter personality dimensions, only a person's behavior.

  1. Male Body Practices.

    Science.gov (United States)

    Lefkowich, Maya; Oliffe, John L; Hurd Clarke, Laura; Hannan-Leith, Madeline

    2017-03-01

    The pressure on boys and men to engage in extensive body practices (e.g., closely monitored eating and exercise habits) and achieve ideal male bodies has grown significantly over the past 20 years. Central to the depiction of ideal male bodies and body practices are both the pursuit and achievement of lean and well-defined muscles. The labels "pitches," "purchases," and "performativities" were inductively derived from the literature, and used to describe the multifaceted connections between masculinities, muscularity, and idealized male body practices. "Pitches" distil how popular culture posture norms of masculinity, and manly bodies and behaviors attainable and necessary. "Purchases" refer to men's diverse buy-in to dominant discourses about acceptable male bodies and practices. "Performativities" chronicle how men embody and navigate gender norms as they evaluate their own bodies, behaviors, and eating habits and those of their peers. Based on findings from the current scoping review, future research could benefit from fully linking masculinities with the drive for muscularity to address health and social risks associated with the pursuit of the idealized male body. In highlighting the plurality of masculinities and the complexity of men's diverse identities, health care providers can better reach and support men. Focusing on, and celebrating, a wider range of male bodies could help recenter dominant discourses about how and whose bodies and experiences are idealized. The current scoping review article offers an overview of how masculinities and muscularity have been linked to male body practices, and recommendations to advance this emergent field.

  2. Best practice governance principles in the sports industry: an overview

    African Journals Online (AJOL)

    This overview examines the British and Australian models and codes of corporate governance since South African Company Law as well as Australian Company Law have their roots in British Company Law. From the literature seven pillars of good governance emerged and their applicability to sports governing bodies is ...

  3. An Overview of Interrater Agreement on Likert Scales for Researchers and Practitioners

    Directory of Open Access Journals (Sweden)

    Thomas A. O'Neill

    2017-05-01

    Full Text Available Applications of interrater agreement (IRA statistics for Likert scales are plentiful in research and practice. IRA may be implicated in job analysis, performance appraisal, panel interviews, and any other approach to gathering systematic observations. Any rating system involving subject-matter experts can also benefit from IRA as a measure of consensus. Further, IRA is fundamental to aggregation in multilevel research, which is becoming increasingly common in order to address nesting. Although, several technical descriptions of a few specific IRA statistics exist, this paper aims to provide a tractable orientation to common IRA indices to support application. The introductory overview is written with the intent of facilitating contrasts among IRA statistics by critically reviewing equations, interpretations, strengths, and weaknesses. Statistics considered include rwg, rwg*, r′wg, rwg(p, average deviation (AD, awg, standard deviation (Swg, and the coefficient of variation (CVwg. Equations support quick calculation and contrasting of different agreement indices. The article also includes a “quick reference” table and three figures in order to help readers identify how IRA statistics differ and how interpretations of IRA will depend strongly on the statistic employed. A brief consideration of recommended practices involving statistical and practical cutoff standards is presented, and conclusions are offered in light of the current literature.

  4. COMPETENCE ASSESSMENT: BEST PRACTICES IN EUROPEAN COUNTRIES

    Directory of Open Access Journals (Sweden)

    Magdalena VELCIU

    2014-04-01

    Full Text Available In the current changing environment of work, the process of competence assessment is increasingly relevant as workers gain knowledge and practical skills through fulfilling different and new working tasks and through self-education. In this context, innovative tools for competence assessment and validation are very useful for encouraging movement of individuals between jobs and from unemployment or inactivity to employment and for increasing the capacity of companies to respond and adapt to changing and challenging environments. This article presents an overview of best practices for competence assessment and validation in order to identify and select methods that have been effective in various European countries including Romania. The article concludes with a set of „learned lessons” and short recommendations in order to improve the framework of competence assessment in Romanian context. Our findings are useful for the new human resources management that aims toward efficiently usage of the workforce, inside companies and in a global labour market, encouraging flexibility and adaptability.

  5. Overview of village scale, renewable energy powered desalination

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, K.E.

    1997-04-01

    An overview of desalination technologies is presented, focusing on those technologies appropriate for use in remote villages, and how they can be powered using renewable energy. Technologies are compared on the basis of capital cost, lifecycle cost, operations and maintenance complexity, and energy requirements. Conclusions on the appropriateness of different technologies are drawn, and recommendations for future research are given.

  6. New Insulin Delivery Recommendations.

    Science.gov (United States)

    Frid, Anders H; Kreugel, Gillian; Grassi, Giorgio; Halimi, Serge; Hicks, Debbie; Hirsch, Laurence J; Smith, Mike J; Wellhoener, Regine; Bode, Bruce W; Hirsch, Irl B; Kalra, Sanjay; Ji, Linong; Strauss, Kenneth W

    2016-09-01

    Many primary care professionals manage injection or infusion therapies in patients with diabetes. Few published guidelines have been available to help such professionals and their patients manage these therapies. Herein, we present new, practical, and comprehensive recommendations for diabetes injections and infusions. These recommendations were informed by a large international survey of current practice and were written and vetted by 183 diabetes experts from 54 countries at the Forum for Injection Technique and Therapy: Expert Recommendations (FITTER) workshop held in Rome, Italy, in 2015. Recommendations are organized around the themes of anatomy, physiology, pathology, psychology, and technology. Key among the recommendations are that the shortest needles (currently the 4-mm pen and 6-mm syringe needles) are safe, effective, and less painful and should be the first-line choice in all patient categories; intramuscular injections should be avoided, especially with long-acting insulins, because severe hypoglycemia may result; lipohypertrophy is a frequent complication of therapy that distorts insulin absorption, and, therefore, injections and infusions should not be given into these lesions and correct site rotation will help prevent them; effective long-term therapy with insulin is critically dependent on addressing psychological hurdles upstream, even before insulin has been started; inappropriate disposal of used sharps poses a risk of infection with blood-borne pathogens; and mitigation is possible with proper training, effective disposal strategies, and the use of safety devices. Adherence to these new recommendations should lead to more effective therapies, improved outcomes, and lower costs for patients with diabetes. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  7. Monitoring program design recommendations for uranium mining communities

    International Nuclear Information System (INIS)

    1978-10-01

    Environmental radiological monitoring requirements and their rationale have been developed for operating uranium mine/mill sites including the pre-operational phase, and for non-operating tailings areas, in order to assess the radiological impact on the environment and follow long-term trends. These recommendations have been based on a review of regulatory standards, sources and nature of releases from mines, mills and tailings, and environmental pathway analysis. Media and measurements considered in the routine on-going programs include airborne radon, airborne particulates, external radiation, terrestrial biota, surface water, drinking water, ground water, fish and sediment. Program implementation guides are provided. An overview of sampling and field technique and specific recommendations have been made. (auth)

  8. The Practice Environment Scale of the Nursing Work Index: An updated review and recommendations for use.

    Science.gov (United States)

    Swiger, Pauline A; Patrician, Patricia A; Miltner, Rebecca S Susie; Raju, Dheeraj; Breckenridge-Sproat, Sara; Loan, Lori A

    2017-09-01

    The Practice Environment Scale of the Nursing Work Index (PES-NWI) is an instrument, which measures the nursing practice environment - defined as factors that enhance or attenuate a nurse's ability to practice nursing skillfully and deliver high quality care. The purpose of this paper is to provide an updated review of the Practice Environment Scale of the Nursing Work Index's use to date and provide recommendations that may be helpful to nursing leaders and researchers who plan to use this instrument. A narrative review of quantitative studies. PubMed, EMBASE, and the Cumulative Index to Nursing & Allied Health Literature were searched to identify relevant literature using the search terms, Practice Environment Scale of the Nursing Work Index and PES-NWI. Studies were included if they were published in English between 2010 and 2016 and focused on the relationship between the Practice Environment Scale of the Nursing Work Index and patient, nurse, or organizational outcomes. Data extraction focused on the reported survey scores and the significance and strength of the reported associations. Forty-six articles, from 28 countries, were included in this review. The majority reported significant findings between the nursing practice environment and outcomes. Although some modifications have been made, the instrument has remained primarily unchanged since its development. Most often, the scores regarding staffing and resource adequacy remained the lowest. The frequency of use of this instrument has remained high. Many researchers advocate for a move beyond the study of the connection between the Practice Environment Scale and nurse, patient, and organizational outcomes. Research should shift toward identifying interventions that improve the environment in which nurses practice and determining if changing the environment results in improved care quality. Published by Elsevier Ltd.

  9. Implementing falls prevention research into policy and practice: an overview of a new National Health and Medical Research Council Partnership Grant.

    Science.gov (United States)

    Lord, Stephen R; Delbaere, Kim; Tiedemann, Anne; Smith, Stuart T; Sturnieks, Daina L

    2011-06-01

    Preventing falls and fall-related injuries among older people is an urgent public health challenge. This paper provides an overview of the background to and research planned for a 5-year National Health and Medical Research Council Partnership Grant on implementing falls prevention research findings into policy and practice. This program represents a partnership between key Australian falls prevention researchers, policy makers and information technology companies which aims to: (1) fill gaps in evidence relating to the prevention of falls in older people, involving new research studies of risk factor assessment and interventions for falls prevention; (2) translate evidence into policy and practice, examining the usefulness of new risk-identification tools in clinical practice; and (3) disseminate evidence to health professionals working with older people, via presentations, new evidence-based guidelines, improved resources and learning tools, to improve the workforce capacity to prevent falls and associated injuries in the future.

  10. Clearing Hurdles: The Challenges of Implementation of Mental Health Evidence-Based Practices in Under-resourced Schools.

    Science.gov (United States)

    Eiraldi, Ricardo; Wolk, Courtney Benjamin; Locke, Jill; Beidas, Rinad

    Schools have become the main provider of services to children with mental health needs. Although there is substantial literature on barriers to implementation of evidence-based practices (EBPs) in under-resourced school districts, less has been written on how to overcome those barriers. Providing mental health services in the school setting presents a tremendous opportunity to increase access to quality mental health care for underserved youth. This review provides a brief overview of the barriers to successful implementation and sustainment of EBPs in under-resourced public schools and provides recommendations for overcoming them. The discussion is organized around an established conceptual framework adapted for the delivery of services in under-resourced schools that focuses on interdependent factors that exist at the individual-, team, school-, and macro-levels. This manuscript explores some recommendations and strategies for effectively addressing challenges related to implementation of EBPs. Research ideas are offered to bridge the research-to-practice gap that impacts many under-resourced public school districts.

  11. Clearing Hurdles: The Challenges of Implementation of Mental Health Evidence-Based Practices in Under-resourced Schools

    Science.gov (United States)

    Eiraldi, Ricardo; Wolk, Courtney Benjamin; Locke, Jill; Beidas, Rinad

    2015-01-01

    Schools have become the main provider of services to children with mental health needs. Although there is substantial literature on barriers to implementation of evidence-based practices (EBPs) in under-resourced school districts, less has been written on how to overcome those barriers. Providing mental health services in the school setting presents a tremendous opportunity to increase access to quality mental health care for underserved youth. This review provides a brief overview of the barriers to successful implementation and sustainment of EBPs in under-resourced public schools and provides recommendations for overcoming them. The discussion is organized around an established conceptual framework adapted for the delivery of services in under-resourced schools that focuses on interdependent factors that exist at the individual-, team, school-, and macro-levels. This manuscript explores some recommendations and strategies for effectively addressing challenges related to implementation of EBPs. Research ideas are offered to bridge the research-to-practice gap that impacts many under-resourced public school districts. PMID:26336512

  12. Woodfuel supply business in Canada: An overview

    Energy Technology Data Exchange (ETDEWEB)

    1980-01-01

    An overview of wood fuel supply in Canada is presented in order to increase awareness about the need for and the operation of woodfuel supply businesses. Background is provided on the residential heating and woodfuel situation from a national perspective. In 1979, under 2% of Canadian households got their primary heat from wood and 7% supplemented their heat from wood, coke, or coal. The implications of increasing this percentage are discussed. Typical characteristics of woodfuel suppliers are outlined; it is seen that 98% of the slightly more than 1,000 woodfuel dealers in Canada are part-time operators. Demand for wood, types of wood fuels (including wood chips and pellets), the role of wood fuel in local economic development, and forest management considerations are also reviewed. Case studies of representative wood-fuel businesses are presented to show the variation in practices across Canada. Finally, a manual on setting up, running, and planning woodfuel operations is included. Recommendations are made on business structure, personnel and management, marketing and pricing, scheduling, cost estimation, wood procurement, harvesting, processing, delivery, and safety. 90 refs., 12 figs., 7 tabs.

  13. Mental Health and Mental Disorder Recommendation Programs.

    Science.gov (United States)

    Ruchiwit, Manyat

    2017-12-01

    The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and target groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

  14. An overview of Smorn V-Munich

    International Nuclear Information System (INIS)

    Kryter, R.C.; La Wanda, E. Klobe; Hendrix, S.P.

    1988-03-01

    At the recent fifth Symposium on Reactor Noise (SMORN V), over half the participants represented power utilities, and thirteen out of ninety papers covered practical experience of plant monitoring by noise analysis. In 1986 the Nuclear Energy Agency published a State of the Art Report on Reactor Noise Analysis providing an assessment of the applicability of noise techniques to power reactor operations, which was drawn up by a working group of the NEA Committee on Reactor Physics in the aftermath of the 1984 SMORN IV symposium in Dijon. Since that time, the practical applications of noise analysis techniques to plant surveillance have become more widespread, in particular in the areas of loose part detection and vibration monitoring. Theoretical understanding of the methods has continued to improve. These advances were presented at the SMORN V symposium, held in Munich from 12th - 16th October 1987. The meeting also recommended that the 1986 State of the Art report should be updated, and the present overview is intended, like its predecessor, for a wide audience including national safety authorities and managers in the nuclear industry. The full proceedings of the symposium, to be published in 1988 by Pergamon Press, will include all the papers presented at the meeting. This document was assembled and edited at Oak Ridge National Laboratory from the summaries of each session provided by the session chairmen. Topics which were divided into multiple sessions for the purpose of the conference have been regrouped into single chapters. A complete list of the papers presented at the conference is included in the appendix

  15. Genetic drift. Overview of German, Nazi, and Holocaust medicine.

    Science.gov (United States)

    Cohen, M Michael

    2010-03-01

    An overview of German, Nazi, and Holocaust medicine brings together a group of subjects discussed separately elsewhere. Topics considered include German medicine before and during the Nazi era, such as advanced concepts in epidemiology, preventive medicine, public health policy, screening programs, occupational health laws, compensation for certain medical conditions, and two remarkable guidelines for informed consent for medical procedures; also considered are the Nuremberg Code; American models for early Nazi programs, including compulsory sterilization, abusive medical experiments on prison inmates, and discrimination against black people; two ironies in US and Nazi laws; social Darwinism and racial hygiene; complicity of Nazi physicians, including the acts of sterilization, human experimentation, and genocide; Nazi persecution of Jewish physicians; eponyms of unethical German physicians with particular emphasis on Reiter, Hallervorden, and Pernkopf; eponyms of famous physicians who were Nazi victims, including Pick and van Creveld; and finally, a recommendation for convening an international committee of physicians and ethicists to deal with five issues: (a) to propose alternative names for eponyms of physicians who exhibited complicity during the Nazi era; (b) to honor the eponyms and stories of physicians who were victims of Nazi atrocities and genocide; (c) to apply vigorous pressure to those German and Austrian Institutes that have not yet undertaken investigations to determine if the bodies of Nazi victims remain in their collections; (d) to recommend holding annual commemorations in medical schools and research institutes worldwide to remember and to reflect on the victims of compromised medical practice, particularly, but not exclusively, during the Nazi era because atrocities and acts of genocide have occurred elsewhere; and (e) to examine the influence of any political ideology that compromises the practice of medicine. (c) 2010 Wiley-Liss, Inc

  16. The Institute for Safe Medication Practices and Poison Control Centers: Collaborating to Prevent Medication Errors and Unintentional Poisonings.

    Science.gov (United States)

    Vaida, Allen J

    2015-06-01

    This article provides an overview on the Institute for Safe Medication Practices (ISMP), the only independent nonprofit organization in the USA devoted to the prevention of medication errors. ISMP developed the national Medication Errors Reporting Program (MERP) and investigates and analyzes errors in order to formulate recommendations to prevent further occurrences. ISMP works closely with the US Food and Drug Administration (FDA), drug manufacturers, professional organizations, and others to promote changes in package design, practice standards, and healthcare practitioner and consumer education. By collaborating with ISMP to share and disseminate information, Poison Control centers, emergency departments, and toxicologists can help decrease unintentional and accidental poisonings.

  17. A Systematic Review of Marine-Based Species Distribution Models (SDMs with Recommendations for Best Practice

    Directory of Open Access Journals (Sweden)

    Néstor M. Robinson

    2017-12-01

    Full Text Available In the marine environment Species Distribution Models (SDMs have been used in hundreds of papers for predicting the present and future geographic range and environmental niche of species. We have analyzed ways in which SDMs are being applied to marine species in order to recommend best practice in future studies. This systematic review was registered as a protocol on the Open Science Framework: https://osf.io/tngs6/. The literature reviewed (236 papers was published between 1992 and July 2016. The number of papers significantly increased through time (R2 = 0.92, p < 0.05. The studies were predominantly carried out in the Temperate Northern Atlantic (45% followed by studies of global scale (11% and studies in Temperate Australasia (10%. The majority of studies reviewed focused on theoretical ecology (37% including investigations of biological invasions by non-native organisms, conservation planning (19%, and climate change predictions (17%. Most of the studies were published in ecological, multidisciplinary, or biodiversity conservation journals. Most of the studies (94% failed to report the amount of uncertainty derived from data deficiencies and model parameters. Best practice recommendations are proposed here to ensure that novice and advanced SDM users can (a understand the main elements of SDMs, (b reproduce standard methods and analysis, and (c identify potential limitations with their data. We suggest that in the future, studies of marine SDMs should report on key features of the approaches employed, data deficiencies, the selection of the best explanatory model, and the approach taken to validate the SDM results. In addition, based on the literature reviewed, we suggest that future marine SDMs should account for uncertainty levels as part of the modeling process.

  18. ACPSEM brachytherapy working group recommendations for quality assurance in brachytherapy

    International Nuclear Information System (INIS)

    Dempsey, Claire; Smith, Ryan; Nyathi, Thulani; Ceylan, Abdurrahman; Howard, Lisa; Patel, Virendra; Dam, Ras; Haworth, Annette

    2013-01-01

    The Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) Radiation Oncology Specialty Group (ROSG) formed a series of working groups in 2011 to develop recommendation papers for guidance of radiation oncology medical physics practice within the Australasian setting. These recommendations are intended to provide guidance for safe work practices and a suitable level of quality control without detailed work instructions. It is the responsibility of the medical physicist to ensure that locally available equipment and procedures are sufficiently sensitive to establish compliance to these recommendations. The recommendations are endorsed by the ROSG, have been subject to independent expert reviews and have also been approved by the ACPSEM Council. For the Australian audience, these recommendations should be read in conjunction with the Tripartite Radiation Oncology Practice Standards. This publication presents the recommendations of the ACPSEM Brachytherapy Working Group (BTWG) and has been developed in alignment with other international associations. However, these recommendations should be read in conjunction with relevant national, state or territory legislation and local requirements, which take precedence over the ACPSEM recommendation papers. It is hoped that the users of this and other ACPSEM recommendation papers will contribute to the development of future versions through the Radiation Oncology Specialty Group of the ACPSEM.

  19. Recommendations of the German Commission on Radiological Protection on information to authorities and public

    International Nuclear Information System (INIS)

    Hille, R.

    1997-01-01

    Information to the authorities and the public in nuclear emergency situations is a very sensitive point in accident prevention and emergency response. The German Commission on Radiological Protection has made several recommendations on this and defined the necessary measures. Thus, the Commission has had a crucial influence on the German information system for nuclear accidents. It therefore seems wortwhile to give an overview of all these recommendations. (orig.) [de

  20. Ethical Issues in Designing Internet-Based Research: Recommendations for Good Practice

    Science.gov (United States)

    Gupta, Shikha

    2017-01-01

    This article presents an overview of internet-based research, highlighting the absence of a standard terminology to define and classify such research. The label internet-based research or online research can cover a diverse range of research designs and methods, involving different degrees of ethical concern regarding privacy, transparency,…

  1. A Systematic Review of Clinical Practice Guidelines' Recommendations on Levothyroxine Therapy Alone versus Combination Therapy (LT4 plus LT3) for Hypothyroidism.

    Science.gov (United States)

    Kraut, Eyal; Farahani, Pendar

    2015-12-04

    Patients with hypothyroidism are increasingly enquiring about the benefit of using combination therapy of levothyroxine (LT4) and liothyronine (LT3) as a potential treatment for hypothyroidism. Combination therapy, however, remains controversial. The purpose of this study was to systematically review available hypothyroidism treatment recommendations from clinical practice guidelines from around the world to identify the consensus regarding combination therapy. Clinical practice guidelines were obtained from searches of PubMed, EMBASE, and MEDLINE, using several combinations of MeSH terms. The search was limited to clinical guidelines in English-language publications, published between January 1, 1990 and May 1, 2015. A quantitative approach was utilized for data synthesis. Thirteen guidelines were identified, including three regarding pregnancy, two regarding pediatric populations and eight regarding adult populations. There were six guidelines from North America, four guidelines from Europe and three guidelines from South America. Twelve of the guidelines were published after 2010. Nine guidelines addressed combination therapy of LT4 plus LT3, and all nine concluded that LT4 therapy alone is the standard of care, with insufficient evidence to recommend widespread combination therapy. Only the 2012 ETA Guidelines and the 2015 BTA Guidelines concluded that combination therapy could be used, although only in certain circumstances and as an experimental treatment. This systematic review illustrates that clinical practice guidelines worldwide do not recommend and do not support routine use of combination LT4 and LT3 therapy to treat hypothyroidism.

  2. Euthanasia: an overview and the jewish perspective.

    Science.gov (United States)

    Gesundheit, Benjamin; Steinberg, Avraham; Glick, Shimon; Or, Reuven; Jotkovitz, Alan

    2006-10-01

    End-of-life care poses fundamental ethical problems to clinicians. Defining euthanasia is a difficult and complex task, which causes confusion in its practical clinical application. Over the course of history, abuse of the term has led to medical atrocities. Familiarity with the relevant bioethical issues and the development of practical guidelines might improve clinical performance. To define philosophical concepts, to present historical events, to discuss the relevant attitudes in modern bioethics and law that may be helpful in elaborating practical guidelines for clinicians regarding euthanasia and end-of-life care. Concepts found in the classic sources of Jewish tradition might shed additional light on the issue and help clinicians in their decision-making process. An historical overview defines the concepts of active versus passive euthanasia, physician-assisted suicide and related terms. Positions found in classical Jewish literature are presented and analyzed with their later interpretations. The relevance and application in modern clinical medicine of both the general and Jewish approaches are discussed. The overview of current bioethical concepts demonstrates the variety of approaches in western culture and legal systems. Philosophically and conceptually, there is a crucial distinction between active and passive euthanasia. The legitimacy of active euthanasia has been the subject of major controversy in recent times in various countries and religious traditions. The historical overview and the literature review demonstrate the need to provide clearer definitions of the concepts relating to euthanasia, for in the past the term has led to major confusion and uncontrolled abuse. Bioethical topics should, therefore, be included in medical training and continuing education. There are major debates and controversies regarding the current clinical and legal approaches. We trust that classical Jewish sources might contribute to the establishment of clinical

  3. Smart Mirror: Intelligent Makeup Recommendation and Synthesis

    OpenAIRE

    Nguyen, Tam V.; Liu, Luoqi

    2017-01-01

    The female facial image beautification usually requires professional editing softwares, which are relatively difficult for common users. In this demo, we introduce a practical system for automatic and personalized facial makeup recommendation and synthesis. First, a model describing the relations among facial features, facial attributes and makeup attributes is learned as the makeup recommendation model for suggesting the most suitable makeup attributes. Then the recommended makeup attributes...

  4. Agile Software Development: An Introduction and Overview

    Science.gov (United States)

    Dingsøyr, Torgeir; Dybå, Tore; Moe, Nils Brede

    Agile software development is an important topic in software engineering and information systems. This chapter provides a characterization and definition of agile software development, an overview of research through a summary of existing overview studies, an analysis of the research literature so far, and an introduction to the main themes of this book. The first part of the book provides foundations and background of agile development. The second part describes findings from studies of agile methods in practice. The third part identifies principal challenges and discusses new frontiers that agile development methods will meet in the future.

  5. Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice12

    Science.gov (United States)

    Sherf Dagan, Shiri; Goldenshluger, Ariela; Globus, Inbal; Schweiger, Chaya; Kessler, Yafit; Kowen Sandbank, Galit; Ben-Porat, Tair; Sinai, Tali

    2017-01-01

    Bariatric surgery is currently the most effective treatment for morbid obesity and its associated metabolic complications. To ensure long-term postoperative success, patients must be prepared to adopt comprehensive lifestyle changes. This review summarizes the current evidence and expert opinions with regard to nutritional care in the perioperative and long-term postoperative periods. A literature search was performed with the use of different lines of searches for narrative reviews. Nutritional recommendations are divided into 3 main sections: 1) presurgery nutritional evaluation and presurgery diet and supplementation; 2) postsurgery diet progression, eating-related behaviors, and nutritional therapy for common gastrointestinal symptoms; and 3) recommendations for lifelong supplementation and advice for nutritional follow-up. We recognize the need for uniform, evidence-based nutritional guidelines for bariatric patients and summarize recommendations with the aim of optimizing long-term success and preventing complications. PMID:28298280

  6. The final recommendations of the ASIEPI project

    DEFF Research Database (Denmark)

    Thomsen, Kirsten Engelund; Rose, Jørgen; Aggerholm, Søren

    requirements; • impact, compliance and control of legislation; • effective handling of thermal bridges; • stimulation of good building and ductwork airtightness; • support for the market uptake for innovative systems; • stimulation of better summer comfort and efficient cooling. This report compiles the major...... findings and recommendations for each of these 6 topics. It also gives an overview of all other project materials, and thus helps the reader to quickly pinpoint the material most relevant to his/her question at any given time....

  7. A scalable and practical one-pass clustering algorithm for recommender system

    Science.gov (United States)

    Khalid, Asra; Ghazanfar, Mustansar Ali; Azam, Awais; Alahmari, Saad Ali

    2015-12-01

    KMeans clustering-based recommendation algorithms have been proposed claiming to increase the scalability of recommender systems. One potential drawback of these algorithms is that they perform training offline and hence cannot accommodate the incremental updates with the arrival of new data, making them unsuitable for the dynamic environments. From this line of research, a new clustering algorithm called One-Pass is proposed, which is a simple, fast, and accurate. We show empirically that the proposed algorithm outperforms K-Means in terms of recommendation and training time while maintaining a good level of accuracy.

  8. Presentation: Overview of Water Reuse Challenges and Opportunities

    Science.gov (United States)

    This presentation, Overview of Water Reuse Challenges and Opportunities, was given at the STAR Human and Ecological Health Impacts Associated with Water Reuse and Conservation Practices Kick-off Meeting and Webinar held on Oct. 26-27, 2016.

  9. International Good Practice on Practical Implementation of Characterisation in Decommissioning. Radiological Characterization in Decommissioning of Nuclear Facilities: International Good Practice on Practical Implementation

    International Nuclear Information System (INIS)

    Larsson, A.; Empdage, M.; Weber, I.; )

    2017-01-01

    Within the Nuclear Energy Agency (NEA), the Working Party on Decommissioning and Dismantling (WPDD) operates under the umbrella of the Radioactive Waste Management Committee (RWMC). The WPDD provides a focus for the analysis of decommissioning policy, strategy and regulation, including the related issues of waste management, release of buildings and sites from regulatory control and associated cost estimation and funding. WPDD also convenes task groups comprised of experts from the NEA member countries to review related topics such as characterisation techniques which support decommissioning and associated waste management. The Task Group on Radiological Characterisation and Decommissioning was established in 2011 to identify and present characterisation good practice at different stages of decommissioning and to identify areas that could, or should, be developed further through international cooperation and coordination. By the end of 2016 two phases of work will be complete. The first phase developed strategic guidance for decision makers on the selection and tailoring of strategies for radiological characterisation, which gives an overview of good practice for radiological characterisation at different phases of the life cycle of a nuclear installation. The second phase has focused on strategies for practical implementation of radiological characterisation from a waste and materials end-state perspective. This paper provides a summary of the phase 2 findings, covering: -) a major international survey (questionnaire) to elicit the views of characterisation experts regarding good practice; -) Learning drawn from recent international case studies; -) The collation and analysis of regulations, standards and guidance documents; -) Learning distilled from an international conference on characterisation co-organised by the task group; and -) Overall conclusions regarding characterisation good practice, recommendations and identified areas for further international

  10. Clinical practice guidelines: 2004 standards, options and recommendations for the management of patient with adenocarcinoma of the stomach - radiotherapy

    International Nuclear Information System (INIS)

    Ychou, M.; Duffour, J.; Lemanski, C.; Masson, B.; Gory-Delabaere, G.; Bosquet, L.; Blanc, P.; Giovannini, M.; Monge, G.; Guillemin, F.; Marchal, F.; Conroy, T.; Merrouche, Y.; Adenis, A.; Bosset, J.F.; Bouche, O.; Pezet, D.; Triboulet, J.P.

    2004-01-01

    Context. - The 'Standards, Options and Recommendations' (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centers (FNCLCC), the 20 French regional cancer centers, and specialists from French Public Universities, General Hospitals and Private Clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. Objectives. - To elaborate clinical practice guidelines for patients with stomach adenocarcinoma. These recommendations cover the diagnosis, treatment and follow-up of these tumors. Methods. - The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. The Standards, Options and Recommendations are thus based on the best available evidence and expert agreement. Results. - Adjuvant radiation therapy alone is not a standard treatment for patients with stomach adenocarcinoma. Adjuvant concomitant chemoradiotherapy is not a standard treatment for patients with stage II or III stomach adenocarcinoma R0, with D1 or D2 lymphadenectomy who have undergone surgery. Following surgical resection, adjuvant concomitant chemoradiotherapy should be proposed to patients without de-nutrition with a lymphadenectomy < D1 (fewer than 15 lymph nodes examined) and those with T3 and/or N+ tumours following the protocol used in the MacDonald trials (SWOG-9008) (Level of evidence B1). Adjuvant concomitant chemoradiotherapy can be administered to patients without de-nutrition with D1 or D2 lymphadenectomy and with involvement of regional lymph nodes (N2 or N3). (authors)

  11. Energy Therapies in Advanced Practice Oncology: An Evidence-Informed Practice Approach

    Science.gov (United States)

    Potter, Pamela J.

    2013-01-01

    Advanced practitioners in oncology want patients to receive state-of-the-art care and support for their healing process. Evidence-informed practice (EIP), an approach to evaluating evidence for clinical practice, considers the varieties of evidence in the context of patient preference and condition as well as practitioner knowledge and experience. This article offers an EIP approach to energy therapies, namely, Therapeutic Touch (TT), Healing Touch (HT), and Reiki, as supportive interventions in cancer care; a description of the author’s professional experience with TT, HT, and Reiki in practice and research; an overview of the three energy healing modalities; a review of nine clinical studies related to oncology; and recommendations for EIP. These studies demonstrate a response to previous research design critiques. Findings indicate a positive benefit for oncology patients in the realms of pain, quality of life, fatigue, health function, and mood. Directionality of healing in immune response and cell line studies affirms the usual explanation that these therapies bring harmony and balance to the system in the direction of health. Foremost, the research literature demonstrates the safety of these therapies. In order to consider the varieties of evidence for TT, HT, and Reiki, EIP requires a qualitative examination of patient experiences with these modalities, exploration of where these modalities have been integrated into cancer care and how the practice works in the oncology setting, and discovery of the impact of implementation on provider practice and self-care. Next steps toward EIP require fleshing out the experience of these modalities by patients and health-care providers in the oncology care setting. PMID:25031994

  12. Systematic and transparent inclusion of ethical issues and recommendations in clinical practice guidelines: a six-step approach.

    Science.gov (United States)

    Mertz, Marcel; Strech, Daniel

    2014-12-04

    Clinical practice guidelines (CPGs), a core tool to foster medical professionalism, differ widely in whether and how they address disease-specific ethical issues (DSEIs), and current manuals for CPG development are silent on this issue. The implementation of an explicit method faces two core challenges: first, it adds further complexity to CPG development and requires human and financial resources. Second, in contrast to the in-depth treatment of ethical issues that is standard in bioethics, the inclusion of DSEIs in CPGs need to be more pragmatic, reductive, and simplistic, but without rendering the resulting recommendations useless or insufficiently justified. This paper outlines a six-step approach, EthicsGuide, for the systematic and transparent inclusion of ethical issues and recommendations in CPGs. The development of EthicsGuide is based on (a) methodological standards in evidence-based CPG development, (b) principles of bioethics, (c) research findings on how DSEIs are currently addressed in CPGs, and (d) findings from two proof-of-concept analyses of the EthicsGuide approach. The six steps are 1) determine the DSEI spectrum and the need for ethical recommendations; 2) develop statements on which to base ethical recommendations; 3) categorize, classify, condense, and paraphrase the statements; 4) write recommendations in a standard form; 5) validate and justify recommendations, making any necessary modifications; and 6) address consent. All six steps necessarily come into play when including DSEIs in CPGs. If DSEIs are not explicitly addressed, they are unavoidably dealt with implicitly. We believe that as ethicists gain greater involvement in decision-making about health, personal rights, or economic issues, they should make their methods transparent and replicable by other researchers; and as ethical issues become more widely reflected in CPGs, CPG developers have to learn how to address them in a methodologically adequate way. The approach proposed

  13. Economic Sanctions Overview

    Directory of Open Access Journals (Sweden)

    Marian Dent

    2015-01-01

    Full Text Available The Sanctions Seminar held on November 19 was organized by LexisNexis Russia in cooperation with ANO Pericles.The Seminar theme was ‘Economic Sanctions Overview: Due Diligence and AML Procedures.’ In the course of the seminar, practicing lawyers, compliance and AML professionals had the opportunity to interact on the scope of US A and EU Sanctions and their impact on global business transaction, as well as get a better understanding of the due diligence procedures necessary in order to comply with a such complex environment.

  14. Recommendations for palliative and bereavement care in the NICU: a family-centered integrative approach.

    Science.gov (United States)

    Kenner, C; Press, J; Ryan, D

    2015-12-01

    Technological advances have increased our ability to detect a life-threatening, life-limiting or lethal problem early in pregnancy, leaving parents months to anticipate a death or a prematurely born infant. Babies can also be born with unanticipated problems that could lead to death. In either scenario, perinatal palliative care should be offered as a strategy for family support. Since the preponderance of professional training focuses on saving lives, many health professionals are uncomfortable with palliative care. This article's purpose is to define best practices for the provision of family-centered perinatal and neonatal palliative care and provision of support to bereaved families experiencing anticipated and unanticipated life-limiting conditions or death of their infant. An overview of core concepts and values is presented, followed by intervention strategies to promote an integrated family-centered approach to palliative and bereavement care. The concluding section presents evidence-based recommendations.

  15. TU-E-BRB-01: Overview of DIR Advantages/Challenges and Workflow

    International Nuclear Information System (INIS)

    Geneser, S.

    2015-01-01

    Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations

  16. TU-E-BRB-01: Overview of DIR Advantages/Challenges and Workflow

    Energy Technology Data Exchange (ETDEWEB)

    Geneser, S. [University of California San Francisco (United States)

    2015-06-15

    Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.

  17. InterTechnology Corporation proposed criteria and recommendations for selection of PON non-residential demonstration sites

    Energy Technology Data Exchange (ETDEWEB)

    None

    1976-12-01

    This report has been prepared with the objective of providing ERDA with recommended procedures for implementing the strategies set forth in the Systems Level Plan which are considered essential to the success of the National Demonstration Program. In order to logically develop these recommendations, this report is divided into three sections: A. Overview of the Demonstration Program to date. B. Essential Overall Program Strategies. C. Candidate Screening and Selection Criteria. (WDM)

  18. Toward Privacy-Preserving Personalized Recommendation Services

    Directory of Open Access Journals (Sweden)

    Cong Wang

    2018-02-01

    Full Text Available Recommendation systems are crucially important for the delivery of personalized services to users. With personalized recommendation services, users can enjoy a variety of targeted recommendations such as movies, books, ads, restaurants, and more. In addition, personalized recommendation services have become extremely effective revenue drivers for online business. Despite the great benefits, deploying personalized recommendation services typically requires the collection of users’ personal data for processing and analytics, which undesirably makes users susceptible to serious privacy violation issues. Therefore, it is of paramount importance to develop practical privacy-preserving techniques to maintain the intelligence of personalized recommendation services while respecting user privacy. In this paper, we provide a comprehensive survey of the literature related to personalized recommendation services with privacy protection. We present the general architecture of personalized recommendation systems, the privacy issues therein, and existing works that focus on privacy-preserving personalized recommendation services. We classify the existing works according to their underlying techniques for personalized recommendation and privacy protection, and thoroughly discuss and compare their merits and demerits, especially in terms of privacy and recommendation accuracy. We also identity some future research directions. Keywords: Privacy protection, Personalized recommendation services, Targeted delivery, Collaborative filtering, Machine learning

  19. Compliance with recommended care at trauma centers: association with patient outcomes.

    Science.gov (United States)

    Shafi, Shahid; Barnes, Sunni A; Rayan, Nadine; Kudyakov, Rustam; Foreman, Michael; Cryer, H Gil; Alam, Hasan B; Hoff, William; Holcomb, John

    2014-08-01

    State health departments and the American College of Surgeons focus on the availability of optimal resources to designate hospitals as trauma centers, with little emphasis on actual delivery of care. There is no systematic information on clinical practices at designated trauma centers. The objective of this study was to measure compliance with 22 commonly recommended clinical practices at trauma centers and its association with in-hospital mortality. This retrospective observational study was conducted at 5 Level I trauma centers across the country. Participants were adult patients with moderate to severe injuries (n = 3,867). The association between compliance with 22 commonly recommended clinical practices and in-hospital mortality was measured after adjusting for patient demographics and injuries and their severity. Compliance with individual clinical practices ranged from as low as 12% to as high as 94%. After adjusting for patient demographics and injury severity, each 10% increase in compliance with recommended care was associated with a 14% reduction in the risk of death. Patients who received all recommended care were 58% less likely to die (odds ratio = 0.42; 95% CI, 0.28-0.62) compared with those who did not. Compliance with commonly recommended clinical practices remains suboptimal at designated trauma centers. Improved adoption of these practices can reduce mortality. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Launch and recovery of ROV: Investigation of operational limit from DNV Recommended Practices and time domain simulations in SIMO

    OpenAIRE

    Valen, Magnus

    2010-01-01

    Offshore contractors seek to operate their remotely operated vehicles for the widest range of sea conditions where particularly launch and recovery through splash zone are critical phases in the offshore operation. The analytical methods for calculation of operational limit proposed by guidelines from DNV Recommended Practices may lead to an over-estimation of the hydrodynamic forces and consequently to an unduly restrictive operational limit. Accurate predictions of the hydrodynamic forces a...

  1. Practical recommendations for breathing-adapted radiotherapy; Bonnes pratiques pour la radiotherapie asservie a la respiration

    Energy Technology Data Exchange (ETDEWEB)

    Simon, L.; Giraud, P.; Rosenwald, J.C. [Institut Curie, Dept. d' Oncologie-radiotherapie, 75 - Paris (France); Dumas, J.L.; Lorchel, F. [CHU de Besancon, Hopital Jean-Minjoz, Service Radiotherapie, 25 - Besancon (France); Marre, D. [Institut Claudius-Regaud, Dept. des Radiations, 31 - Toulouse (France); Dupont, S. [Hopital Europeen Georges-Pompidou, Service d' Oncoradiotherapie, 75 - Paris (France); Varmenot, N. [Centre Henri-Becquerel, UnitE de Physique Medicale, 76 - Rouen (France); Ginestet, C. [Centre Leon-Berard, Dept. de Radiotherapie, 69 - Lyon (France); Caron, J. [Institut Bergonie, Dept. de Radiotherapie, 33 - Bordeaux (France); Marchesi, V. [Centre Alexis-Vautrin, Dept. de Radiotherapie, 54 - Vandoeuvre-les-Nancy (France); Ferreira, I. [Institut Gustave-Roussy, Dept. d' Oncologie Radiotherapie, 94 - Villejuif (France); Garcia, R. [Institut Sainte-Catherine, Service de Radiotherapie, 84 - Avignon (France)

    2007-06-15

    Respiration-gated radiotherapy offers a significant potential for improvement in the irradiation of tumor sites affected by respiratory motion such as lung, breast and liver tumors. An increased conformality of irradiation fields leading to decreased complications rates of organs at risk (lung, heart) is expected. Respiratory gating is in line with the need for improved precision required by radiotherapy techniques such as 3D conformal radiotherapy or intensity modulated radiotherapy. Reduction of respiratory motion can be achieved by using either breath-hold techniques or respiration synchronized gating techniques. Breath-hold techniques can be achieved with active techniques, in which airflow of the patient is temporarily blocked by a valve, or passive techniques, in which the patient voluntarily holds his/her breath. Synchronized gating techniques use external devices to predict the phase of the respiration cycle while the patient breaths freely. This work summarizes the different experiences of the centers of the STIC 2003 project. It describes the different techniques, gives an overview of the literature and proposes a practice based on our experience. (authors)

  2. Adherence to recommendations for primary prevention of atopic disease in neonatology clinical practice.

    Science.gov (United States)

    Passariello, Annalisa; Terrin, Gianluca; Baldassarre, Maria E; Bisceglia, Massimo; Ruotolo, Serena; Berni Canani, Roberto

    2010-08-01

    The prevalence and severity of atopic manifestations in children are increasing in western countries in the last decades. Specific nutritional intervention may prevent or delay the onset of atopic diseases in infants at high risk of developing allergy. These nutritional interventions should be applied early in the perinatal period to have a chance of success. Thus, we assessed adherence to the dietary management recommendations of the Committee on Nutrition and Section on Allergy and Immunology of the American Academy of Pediatrics (AAP) for the prevention of atopic diseases in neonatal age through an audit study. Questionnaire was administered to the chiefs of 30 maternity units (MU) with more than 1500 live births/yr to report the policy applied in their MU. Twenty-two MU returned the questionnaire. Identification of high-risk newborns was routinely performed only in 7/22 MU (31.8%). High-risk newborns were identified by the presence of at least two or one first-degree relative (parent or sibling) with documented allergic disease by 18.2% and 45.5% of MU, respectively. Specific maternal dietary restrictions during lactation were adopted in 7/22 MU (31.8%). Extensively or partially hydrolyzed formula was prescribed for bottle-fed high-risk infants in 22.7% of MU. Only 2/22 MU have a policy in complete agreement with the nutritional intervention proposed by the AAP. Our study suggest a poor adherence to dietary recommendations for primary prevention of atopic disease in neonatology clinical practice. Further efforts should be planned to improve the knowledge and the application of these preventive strategies.

  3. [Practice marketing. Data analysis of a urological group practice].

    Science.gov (United States)

    Schneider, T; Schneider, B; Eisenhardt, A; Sperling, H

    2009-07-01

    The urological practice setting in Germany has changed tremendously over the last years. Group practices with two or more urologists working together are becoming more and more popular. At the same time, marketing has become essential even for urologists. To evaluate the patient flow to our group practice, we asked all new patients to fill out a questionnaire (n=2112). We also evaluated the efficacy of our recall system. The analysis showed that patients were 18-93 years old (mean 57 years), 68% being male and 32% female. The largest age group consisted of 41-50-year-olds. The most important reasons for choosing our practice were recommendations by general practitioners in 38%, recommendations by specialists in 11%, and recommendations by friends and relatives in 27%. Five percent of the patients chose the practice because of the Internet home page and 10% because of entries in various phone books. Three percent of the patients came because of newspaper articles about the practice owners, and advertising for a urological practice. Phone books are increasingly becoming less important, and the Internet is increasingly attractive to the younger population. Recall systems can also be useful for urological practices.

  4. Deployment of Wind Turbines in the Built Environment: Risks, Lessons, and Recommended Practices

    Energy Technology Data Exchange (ETDEWEB)

    Fields, Jason [National Renewable Energy Lab. (NREL), Golden, CO (United States); Oteri, Frank [National Renewable Energy Lab. (NREL), Golden, CO (United States); Preus, Robert [National Renewable Energy Lab. (NREL), Golden, CO (United States); Baring-Gould, Ian [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-06-01

    Built-environment wind turbine (BEWT) projects are wind energy projects that are constructed on, in, or near buildings. These projects present an opportunity for distributed, low-carbon generation combined with highly visible statements on sustainability, but the BEWT niche of the wind industry is still developing and is relatively less mature than the utility-scale wind or traditional distributed wind sectors. The findings from this report cannot be extended to wind energy deployments in general because of the large difference in application and technology maturity. This paper investigates the current state of the BEWT industry by reviewing available literature on BEWT projects as well as interviewing project owners on their experiences deploying and operating the technology. The authors generated a series of case studies that outline the pertinent project details, project outcomes, and lessons learned. This paper integrates those information sources into recommended practices that can be utilized by future stakeholders to evaluate the feasibility of BEWTs for their unique applications and sites.

  5. A critical overview of safety-related and technological criteria for nuclear fuel

    International Nuclear Information System (INIS)

    Lahodova, M.; Valach, M.

    2000-10-01

    A detailed overview of the safety criteria, methods of analysis and computer codes used in OECD countries is presented. A critical analysis of the validity of criteria in the high burnup domain was performed, and recommendations for testing their validity based on available experimental data are put forth. (author)

  6. Functional-Based Assessment of Social Behavior: Introduction and Overview.

    Science.gov (United States)

    Lewis, Timothy J.; Sugai, George

    1994-01-01

    This introduction to and overview of a special issue on social behavior assessment within schools discusses the impact of function-based methodologies on assessment and intervention practices in identification and remediation of challenging social behaviors. (JDD)

  7. Recommendation System for Adaptive Learning.

    Science.gov (United States)

    Chen, Yunxiao; Li, Xiaoou; Liu, Jingchen; Ying, Zhiliang

    2018-01-01

    An adaptive learning system aims at providing instruction tailored to the current status of a learner, differing from the traditional classroom experience. The latest advances in technology make adaptive learning possible, which has the potential to provide students with high-quality learning benefit at a low cost. A key component of an adaptive learning system is a recommendation system, which recommends the next material (video lectures, practices, and so on, on different skills) to the learner, based on the psychometric assessment results and possibly other individual characteristics. An important question then follows: How should recommendations be made? To answer this question, a mathematical framework is proposed that characterizes the recommendation process as a Markov decision problem, for which decisions are made based on the current knowledge of the learner and that of the learning materials. In particular, two plain vanilla systems are introduced, for which the optimal recommendation at each stage can be obtained analytically.

  8. Implementing digital preservation in repositories: Knowledge and practices

    Directory of Open Access Journals (Sweden)

    Caterina Groposo Pavão

    2016-09-01

    Full Text Available Digital preservation has to be undertaken by institutional repositories, which are responsible for the preservation of the scientific output from academic institutions. However, due to the constant evolution of the field, to gain domain knowledge and recognise best practices is a complex task for people responsible for digital preservation in those institutions. Digital preservation research, practices and solutions address specific problems, such as formats, curation, reference models, authenticity, policies and preservation plans, tools, etc., while stakeholders need an integrated, contextualized and applicable overview. This paper focuses on the implementation of digital preservation in repositories, from the perspective of the team responsible for the project, regarding the necessary knowledge and best practices. Initially, it defines and contextualizes digital preservation repositories. The following section presents a conceptual model of digital preservation, synthesized from conceptual models developed in influential projects in the field, which allows us to identify the domain knowledge in digital preservation. Finally, aspects represented in the model are discussed in the light of the performance of teams implementing digital preservation repositories. It provides recommendations, guides and examples that may be useful for the implementation of digital preservation. It points to the need to strengthen the relationship between domain knowledge in digital preservation repositories with practices developed in numerous projects developed worldwide.

  9. A lexicographic approach to language policy and recommendations for future dictionaries

    DEFF Research Database (Denmark)

    Tarp, Sven; Gouws, Rufus H.

    2008-01-01

    Language policy prevails at different levels and its formulation typically results in a prescriptive presentation of data. In their dictionaries, lexicographers have to respond to the deci­sions of language policy makers. In this regard dictionaries can adhere to a strict prescriptive policy...... by including only the prescribed forms. Dictionaries can also give a descriptive account of lan­guage use without making any recommendations or claims of correctness. Thirdly, dictionaries can be proscriptive by recommending certain forms, even if such a recommendation goes against the prescribed forms....... This article offers an overview of different levels of language policy and the prin­ciples of prescription, description and proscription. Examples are given to illustrate certain lexico­graphic applications of prescription. It is emphasised that access to relevant data is important to dictionary users...

  10. Conservative sharp wound debridement: an overview of Canadian education, practice, risk, and policy.

    Science.gov (United States)

    Rodd-Nielsen, Elise; Harris, Connie L

    2013-01-01

    The purpose of this study was to describe the education, policy, practice, and risk management strategies of nurses performing conservative sharp wound debridement (CSWD) in Canada, prior to the release of the Canadian Association for Enterostomal Therapy Evidence-Based Recommendations for Conservative Sharp Wound Debridement. Data collection was based on a nonrandomized, nonexperimental study design and reported using descriptive statistics. Invitations for health care professionals to participate in a CSWD scan were sent to 4315 people via e-mail through the membership lists of 2 Canadian voluntary professional wound care associations. Skip logic screened out respondents who had no experience in CSWD (n = 57). The total number of professionals who participated was 487. A 26-question electronic scan addressed demographics, education, policy, practice, and risk/quality issues related to CSWD. A comment section was included for some questions. A selected subsample of 397 nurses was chosen from the original total of 487 respondents. Nonnurse respondents were excluded due to the low total number of participants in each of these other professional categories. Nurses perform CSWD in all types of care settings in Canada from outpost nursing stations to hospital wards, homes, and long-term care facilities. The wound education preparation reported varied. The most frequently reported formal wound care education was a 2-day course (59%; n = 220), followed by an enterostomal therapy course (42%; n = 155) and the International Interdisciplinary Wound Care Course (26%; n = 98), with overlapping preparation evident. Eleven percent of respondents (n = 47) reported having taken no formal wound course, and 7% (n = 27) taught themselves to perform CSWD. Twenty-eight percent of nurses (n = 112) were unclear about whether CSWD was within their scope of practice or replied that it was not, and 69% (n = 273) did not know if there was provincial legislation that restricted their

  11. Privacy in Recommender Systems

    NARCIS (Netherlands)

    Jeckmans, Arjan; Beye, Michael; Erkin, Zekeriya; Erkin, Zekeriya; Hartel, Pieter H.; Lagendijk, Reginald; Tang, Qiang; Ramzan, Naeem; van Zwol, Roelof; Lee, Jong-Seok; Clüver, Kai; Hua, Xian-Sheng

    In many online applications, the range of content that is offered to users is so wide that a need for automated recommender systems arises. Such systems can provide a personalized selection of relevant items to users. In practice, this can help people find entertaining movies, boost sales through

  12. Summary of Federal Aviation Administration Responses to National Transportation Safety Board Safety Recommendations.

    Science.gov (United States)

    1982-01-01

    agency shall respond to each such recommendation formally and in writing not later than 90 days after receipt thereof. The Act also requires that the...34 which provides an overview of the current IELT situation. The study was prompted by the large number of false ELT signals and failures to activate

  13. ISSN exercise & sport nutrition review: research & recommendations

    Science.gov (United States)

    2010-01-01

    Sports nutrition is a constantly evolving field with hundreds of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper is a five year update of the sports nutrition review article published as the lead paper to launch the JISSN in 2004 and presents a well-referenced overview of the current state of the science related to how to optimize training and athletic performance through nutrition. More specifically, this paper provides an overview of: 1.) The definitional category of ergogenic aids and dietary supplements; 2.) How dietary supplements are legally regulated; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of the ergogenic value of nutrition and dietary supplementation in regards to weight gain, weight loss, and performance enhancement. Our hope is that ISSN members and individuals interested in sports nutrition find this review useful in their daily practice and consultation with their clients.

  14. ISSN exercise & sport nutrition review: research & recommendations

    Directory of Open Access Journals (Sweden)

    Mendel Ron

    2010-02-01

    Full Text Available Abstract Sports nutrition is a constantly evolving field with hundreds of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper is a five year update of the sports nutrition review article published as the lead paper to launch the JISSN in 2004 and presents a well-referenced overview of the current state of the science related to how to optimize training and athletic performance through nutrition. More specifically, this paper provides an overview of: 1. The definitional category of ergogenic aids and dietary supplements; 2. How dietary supplements are legally regulated; 3. How to evaluate the scientific merit of nutritional supplements; 4. General nutritional strategies to optimize performance and enhance recovery; and, 5. An overview of our current understanding of the ergogenic value of nutrition and dietary supplementation in regards to weight gain, weight loss, and performance enhancement. Our hope is that ISSN members and individuals interested in sports nutrition find this review useful in their daily practice and consultation with their clients.

  15. Do health workers’ preferences influence their practices? Assessment of providers’ attitude and personal use of new treatment recommendations for management of uncomplicated malaria, Tanzania

    Directory of Open Access Journals (Sweden)

    Masanja Irene M

    2012-11-01

    Full Text Available Abstract Background Due to growing antimalarial drug resistance, Tanzania changed malaria treatment policies twice within a decade. First in 2001 chloroquine (CQ was replaced by sulfadoxine-pyrimethamine (SP for management of uncomplicated malaria and by late 2006, SP was replaced by artemether-lumefantrine (AL. We assessed health workers’ attitudes and personal practices following the first treatment policy change, at six months post-change and two years later. Methods Two cross-sectional surveys were conducted in 2002 and 2004 among healthcare workers in three districts in South-East Tanzania using semi-structured questionnaires. Attitudes were assessed by enquiring which antimalarial was considered most suitable for the management of uncomplicated malaria for the three patient categories: i children below 5; ii older children and adults; and iii pregnant women. Practice was ascertained by asking which antimalarial was used in the last malaria episode by the health worker him/herself and/or dependants. Univariate and multivariate logistic regression was used to identify factors associated with reported attitudes and practices towards the new treatment recommendations. Results A total of 400 health workers were interviewed; 254 and 146 in the first and second surveys, respectively. SP was less preferred antimalarial in hospitals and private health facilities (p Conclusion Following changes in malaria treatment recommendations, most health workers did not prefer the new antimalarial drug, and their preferences worsened over time. However, many of them still used the newly recommended drug for management of their own or family members’ malaria episode. This indicates that, other factors than providers’ attitude may have more influence in their personal treatment practices.

  16. Practical Phonetics and Phonology

    DEFF Research Database (Denmark)

    Collins, Beverley; Mees, Inger M.

    This wide-ranging introduction to practical aspects of English phonetics and phonology offers an accessible overview of the subject, with activities, study questions, sample analyses, commentaries and key readings. The flexible "two-dimensional" structure is built around four sections - introduct......This wide-ranging introduction to practical aspects of English phonetics and phonology offers an accessible overview of the subject, with activities, study questions, sample analyses, commentaries and key readings. The flexible "two-dimensional" structure is built around four sections...... - introduction, development, exploration and extension - which offer self-contained stages for study. Each topic can also be read across these sections, enabling the reader to build gradually on the knowledge gained....

  17. Nuclear Security Recommendations on Nuclear and Other Radioactive Material out of Regulatory Control: Recommendations

    International Nuclear Information System (INIS)

    2011-01-01

    This publication presents recommendations for the nuclear security of nuclear and other radioactive material that is out of regulatory control. It is based on national experiences and practices and guidance publications in the field of security as well as the nuclear security related international instruments. The recommendations include guidance for States with regard to the nuclear security of nuclear and other radioactive material that has been reported as being out of regulatory control as well as for material that is lost, missing or stolen but has not been reported as such, or has been otherwise discovered. In addition, these recommendations adhere to the detection and assessment of alarms and alerts and to a graded response to criminal or unauthorized acts with nuclear security implications

  18. Re-examining the Evidence in Radiation Dermatitis Management Literature: An Overview and a Critical Appraisal of Systematic Reviews

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Raymond Javan, E-mail: email.rchan@gmail.com [Cancer Care Services, Royal Brisbane and Women' s Hospital (Australia); School of Nursing and Midwifery, University of Queensland, and Research Centre for Clinical and Community Practice Innovation, Griffith University (Australia); Larsen, Emily; Chan, Philip [Cancer Care Services, Royal Brisbane and Women' s Hospital (Australia)

    2012-11-01

    Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for 'assessment of multiple systematic reviews'). Results: Of 1837 potential titles, 6 SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.

  19. Re-examining the Evidence in Radiation Dermatitis Management Literature: An Overview and a Critical Appraisal of Systematic Reviews

    International Nuclear Information System (INIS)

    Chan, Raymond Javan; Larsen, Emily; Chan, Philip

    2012-01-01

    Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for “assessment of multiple systematic reviews”). Results: Of 1837 potential titles, 6 SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.

  20. Online Student Services: Current Practices and Recommendations for Implementation

    Science.gov (United States)

    Bailey, Tabitha L.; Brown, Abbie

    2016-01-01

    Recommendations for planning and development of online student services based on a review of the literature on research conducted in a variety of college settings. Focus topics include the institutional website, help desks and information centers, student orientation, academic support, and library services.

  1. Evaluation of an inpatient psychiatric hospital physician education program and adherence to American Diabetes Association practice recommendations.

    Science.gov (United States)

    Koffarnus, Robin L; Mican, Lisa M; Lopez, Debra A; Barner, Jamie C

    2016-03-01

    This study evaluated adherence to American Diabetes Association (ADA) recommendations for diabetes monitoring following an educational intervention for physicians in an inpatient psychiatric hospital. This retrospective chart review was conducted in an inpatient psychiatric institution from July 1, 2010-January 15, 2011. A total of 120 subjects (60 subjects each in the pre- and post-intervention groups) meeting the inclusion criteria served as the study sample. Included subjects were admitted and discharged from an inpatient psychiatric institution within 90 days prior to (pre-intervention) and following (post-intervention) the physician education program. The medical staff was presented an educational program intervention, consisting of a 30 minute overview of the ADA 2010 Standards of Care recommendations and distribution of laminated treatment reminders. Electronic grouped order sets for patients with diabetes were also created and implemented. The primary outcome was change (pre-intervention to post-intervention) in frequency of hemoglobin A1c documentation on admission following the intervention. Secondary outcomes included the change in frequency of documentation of fasting plasma glucose, serum creatinine, urine creatinine/microalbumin ratio (UMA), fasting lipid profile (FLP), and change in days on sliding scale insulin. Regarding change in frequency of documentation of A1c values on admission, chi-square analysis revealed a significant increase from pre-intervention to post-intervention period of 30% (n = 18) to 61.7% (n = 37), respectively (p = 0.0005). Documentation of FLP also significantly increased [73.3% vs. 91.7% (p = 0.0082)]. There were no significant differences in the documentation of fasting plasma glucose, serum creatinine, and UMA or days treated with sliding scale insulin. The physician education program was successful in increasing the assessment of A1c values and lipid profiles for patients with diabetes mellitus in a psychiatric

  2. Education System Reform in China after 1978: Some Practical Implications

    Science.gov (United States)

    Sun, Miantao

    2010-01-01

    Purpose: This paper aims to provide an overview of education system reform in China since 1978, and its practical implications. Design/methodology/approach: Data were collected from literature review and interview. An overview of education system reform and its practical implications was found through data analysis. Findings: There has been two…

  3. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2018.

    Science.gov (United States)

    Robinson, Candice L; Romero, José R; Kempe, Allison; Pellegrini, Cynthia; Szilagyi, Peter

    2018-02-09

    In October 2017, the Advisory Committee on Immunization Practices (ACIP) approved the Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2018. The 2018 child and adolescent immunization schedule summarizes ACIP recommendations, including several changes from the 2017 immunization schedules, in three figures and footnotes to the figures. These documents can be found on the CDC immunization schedule website (https://www.cdc.gov/vaccines/schedules/index.html). These immunization schedules are approved by ACIP (https://www.cdc.gov/vaccines/acip/index.html), the American Academy of Pediatrics (https://www.aap.org), the American Academy of Family Physicians (https://www.aafp.org), and the American College of Obstetricians and Gynecologists (https://www.acog.org). Health care providers are advised to use the figures and the footnotes together. The full ACIP recommendations for each vaccine, including contraindications and precautions, can be found at https://www.cdc.gov/vaccines/hcp/acip-recs/index.html. Providers should be aware that changes in recommendations for specific vaccines can occur between annual updates to the childhood/adolescent immunization schedules. If errors or omissions are discovered within the child and adolescent schedule, CDC posts revised versions on the CDC immunization schedule website.

  4. Pathological gambling: An overview

    Directory of Open Access Journals (Sweden)

    Shalini Singh

    2017-01-01

    Full Text Available Gambling activities are popular as a form of recreation and have been a source of income for many people worldwide. Although gambling has been common across continents and time, and a subset of individuals experience problems with gambling. This review attempts to provide an overview of problem gambling for clinicians who are likely to encounter such patients in their practice. The review discusses the relevance, nosology, and epidemiology of gambling. We also discuss the associated comorbidities and principles of management of pathological gambling.

  5. Glenohumeral osteoarthritis: overview, therapy, and rehabilitation.

    Science.gov (United States)

    Macías-Hernández, Salvador Israel; Morones-Alba, Juan Daniel; Miranda-Duarte, Antonio; Coronado-Zarco, Roberto; Soria-Bastida, María de Los Angeles; Nava-Bringas, Tania; Cruz-Medina, Eva; Olascoaga-Gómez, Andrea; Tallabs-Almazan, Laura Verónica; Palencia, Chanell

    2017-08-01

    Glenohumeral osteoarthritis (GHOA) is a common cause of pain and functional disability of the shoulder. Despite the limited evidence, there are several options for the treatment of this pathology. The aim of this article is to provide current information on the characteristics of the disease and the pathophysiology, evidence based on medical and surgical treatments with emphasis on the rehabilitation process. It was performed with an extensive literature review, mainly clinical practice guidelines, randomized controlled trials, reviews, focusing on the rehabilitation management. There are few clinical practice guidelines that address GHOA as a pathology with unique characteristics. Evidence based treatment recommendations are mostly supported by low-quality evidence and experts' opinions, with few high levels of evidence studies guiding treatment decisions. Despite the lack of good quality evidence, rehabilitation programs have proven to be efficient and reliable, and this revision provides information and recommendations in this field. Implication of Rehabilitation Glenohumeral osteoarthritis is a common cause of pain and functional disability of the shoulder There are few clinical practice guidelines that address Glenohumeral Osteoarthritis as a pathology with unique characteristics, and recommendations for rehabilitation and therapeutic exercise are poor The paper provides current information on the characteristics of the disease, its rehabilitation process, and could be of interest for rehabilitation professionals to direct their practices in this field.

  6. Practical nutritional recommendations for the athlete.

    Science.gov (United States)

    Maughan, Ronald J; Burke, Louise M

    2011-01-01

    The aim of training is to achieve optimum performance on the day of competition via three processes or paradigms; training hard to create the required training stimulus, training smart to maximize adaptations to the training stimulus, and training specifically to fine- turn the behaviors or physiology needed for competition strategies. Dietary strategies for competition must target the factors that would otherwise cause fatigue during the event, promoting an enhancement of performance by reducing or delaying the onset of these factors. In some cases, the nutritional strategies needed to achieve these various paradigms are different, and even opposite to each other, so athletes need to periodize their nutrition, just as they periodize their training program. The evolution of new knowledge from sports nutrition research, such as presented in this book, usually starts with a stark concept that must be further refined; to move from individual nutrients to food, from 'one size fits all' to the individual needs and practices of different athletes, and from single issues to an integrated picture of sports nutrition. The translation from science to practice usually requires a large body of follow-up studies as well as experimentation in the field. Copyright © 2011 S. Karger AG, Basel.

  7. Prevention of Backover Fatalities in Highway Work Zones: A Synthesis of Current Practices and Recommendations

    Directory of Open Access Journals (Sweden)

    Wei Fan

    2014-12-01

    Full Text Available The purpose of this paper is to synthesize current practices and procedures on the prevention of backing fatalities in highway work zones. First, general work zone safety hazards are reviewed, particularly blind areas are identified. Second, engineering controls currently in use are examined and explained to help understand what steps can be taken to prevent future backing fatalities. Third, administrative controls (including signalers, drivers, and workers-on-foot training are also discussed. Fourth, existing technology controls are reviewed for use in aiding equipment operators in identifying when pedestrian personnel are in dangerous areas around their equipment (i.e., back-up camera, radar. Fifth, recommendations are made based on the comprehensive review of the backover fatality prevention techniques in construction work zones and the conducted testing results of several commercially available systems. Recommendations on engineering and technology controls are discussed, with detailed information such as improving internal traffic control plans, and integrating technology with traffic control plans. Information and drawings are provided to illustrate how to design work zones, and the internal traffic flow diagrams are created using the integrated technology available, and site specific characteristics. The drawings represent examples of using different types of technology, in different scenarios using the proper legend, as well as using the proper general and technology notes to help explain the traffic control plan, ensuring that full comprehension is made. Recommendations on administrative controls are also given such as how to conduct safety meetings, electing safety officers, how to set regulations and guidelines for workers, and how to handle training. Training should be used as a backover fatality prevention method for pedestrian workers, flaggers, spotters, and equipment operators. Finally, a summary and discussion of future research

  8. Global dietary patterns and diets in childhood: implications for health outcomes

    Science.gov (United States)

    This article provides an overview of child feeding recommendations and how these relate to actual practice and dietary adequacy, primarily in developing countries. From birth to 6 months, recommendations focus on optimal breastfeeding practices, although these are still suboptimal in about one third...

  9. Good Practices for Real-World Data Studies of Treatment and/or Comparative Effectiveness: Recommendations from the Joint ISPOR-ISPE Special Task Force on Real-World Evidence in Health Care Decision Making.

    Science.gov (United States)

    Berger, Marc L; Sox, Harold; Willke, Richard J; Brixner, Diana L; Eichler, Hans-Georg; Goettsch, Wim; Madigan, David; Makady, Amr; Schneeweiss, Sebastian; Tarricone, Rosanna; Wang, Shirley V; Watkins, John; Mullins, C Daniel

    2017-09-01

    Real-world evidence (RWE) includes data from retrospective or prospective observational studies and observational registries and provides insights beyond those addressed by randomized controlled trials. RWE studies aim to improve health care decision making. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and the International Society for Pharmacoepidemiology (ISPE) created a task force to make recommendations regarding good procedural practices that would enhance decision makers' confidence in evidence derived from RWD studies. Peer review by ISPOR/ISPE members and task force participants provided a consensus-building iterative process for the topics and framing of recommendations. The ISPOR/ISPE Task Force recommendations cover seven topics such as study registration, replicability, and stakeholder involvement in RWE studies. These recommendations, in concert with earlier recommendations about study methodology, provide a trustworthy foundation for the expanded use of RWE in health care decision making. The focus of these recommendations is good procedural practices for studies that test a specific hypothesis in a specific population. We recognize that some of the recommendations in this report may not be widely adopted without appropriate incentives from decision makers, journal editors, and other key stakeholders. Copyright © 2017. Published by Elsevier Inc.

  10. Could we do better? Behavioural tracking on recommended consumer health websites.

    Science.gov (United States)

    Burkell, Jacquelyn; Fortier, Alexandre

    2015-09-01

    This study examines behavioural tracking practices on consumer health websites, contrasting tracking on sites recommended by information professionals with tracking on sites returned by Google. Two lists of consumer health websites were constructed: sites recommended by information professionals and sites returned by Google searches. Sites were divided into three groups according to source (Recommended-Only, Google-Only or both) and type (Government, Not-for-Profit or Commercial). Behavioural tracking practices on each website were documented using a protocol that detected cookies, Web beacons and Flash cookies. The presence and the number of trackers that collect personal information were contrasted across source and type of site; a second set of analyses specifically examined Advertising trackers. Recommended-Only sites show lower levels of tracking - especially tracking by advertisers - than do Google-Only sites or sites found through both sources. Government and Not-for-Profit sites have fewer trackers, particularly from advertisers, than do Commercial sites. Recommended sites, especially those from Government or Not-for-Profit organisations, present a lower privacy threat than sites returned by Google searches. Nonetheless, most recommended websites include some trackers, and half include at least one Advertising tracker. To protect patron privacy, information professionals should examine the tracking practices of the websites they recommend. © 2015 Health Libraries Group.

  11. Human Papillomavirus vaccination in general practice in France, three years after the implementation of a targeted vaccine recommendation based on age and sexual history : Targeted HPV vaccine recommendation in France

    OpenAIRE

    Thierry , Pascale; Lasserre , Andrea; Rossignol , Louise; Kernéis , Solen; Blaizeau , Fanette; Stheneur , Chantal; Blanchon , Thierry; Levy-Bruhl , Daniel; Hanslik , Thomas

    2015-01-01

    International audience; IntroductionIn France, vaccination against human papilloma virus (HPV) was recommended in 2007 for all 14-year-old girls as well as “catch-up” vaccination for girls between 15-23 years of age either before or within one year of becoming sexually active. We evaluated the vaccine coverage according to the eligibility for vaccination in a sample of young girls aged 14 to 23 years, who were seen in general practices. Patients and methodsA survey was proposed to 706 general...

  12. Review of refugee mental health interventions following resettlement: best practices and recommendations.

    Science.gov (United States)

    Murray, Kate E; Davidson, Graham R; Schweitzer, Robert D

    2010-10-01

    There are increasing numbers of refugees worldwide, with approximately 16 million refugees in 2007 and over 2.5 million refugees resettled in the United States since the start of its humanitarian program. Psychologists and other health professionals who deliver mental health services for individuals from refugee backgrounds need to have confidence that the therapeutic interventions they employ are appropriate and effective for the clients with whom they work. The current review briefly surveys refugee research, examines empirical evaluations of therapeutic interventions in resettlement contexts, and provides recommendations for best practices and future directions in resettlement countries. The resettlement interventions found to be most effective typically target culturally homogeneous client samples and demonstrate moderate to large outcome effects on aspects of traumatic stress and anxiety reduction. Further evaluations of the array of psychotherapeutic, psychosocial, pharmacological, and other therapeutic approaches, including psychoeducational and community-based interventions that facilitate personal and community growth and change, are encouraged. There is a need for increased awareness, training and funding to implement longitudinal interventions that work collaboratively with clients from refugee backgrounds through the stages of resettlement. © 2010 American Orthopsychiatric Association.

  13. The Role of Lean Process Improvement in Implementation of Evidence-Based Practices in Behavioral Health Care.

    Science.gov (United States)

    Steinfeld, Bradley; Scott, Jennifer; Vilander, Gavin; Marx, Larry; Quirk, Michael; Lindberg, Julie; Koerner, Kelly

    2015-10-01

    To effectively implement evidence-based practices (EBP) in behavioral health care, an organization needs to have operating structures and processes that can address core EBP implementation factors and stages. Lean, a widely used quality improvement process, can potentially address the factors crucial to successful implementation of EBP. This article provides an overview of Lean and the relationship between Lean process improvement steps, and EBP implementation models. Examples of how Lean process improvement methodologies can be used to help plan and carry out implementation of EBP in mental health delivery systems are presented along with limitations and recommendations for future research and clinical application.

  14. An overview of curriculum development in the different periods of ...

    African Journals Online (AJOL)

    2005. ... The objective of this article is to overview the practices of elementary and secondary schools curriculum development in the different periods. ... Public and professional engagement in curriculum development is little or non-existent.

  15. Historical overview of radiation exposure guidance on radioactive consumer products

    International Nuclear Information System (INIS)

    Tapert, A.C.

    1978-01-01

    This paper is an historical overview of radiation exposure recommendations suggested by several commissions, committees, and agencies. Guidelines issued by the International Commission of Radiological Protection, International Atomic Energy Agency, Federal Radiation Council, Nuclear Energy Agency (formerly the European Nuclear Energy Agency), National Council on Radiation Protection and Measurements, Food and Drug Administration, Conference of Radiation Control Program Directors, and the US Nuclear Regulatory Commission are discussed

  16. farmer's characteristics and adoption of recommended practices ...

    African Journals Online (AJOL)

    Prof. Ekwueme

    80 respondents reveals that fadama farming was dominated by females ... determinants of respondents' adoption of fadama-related technologies, accounting for about 39% of .... of male adoption of improved practices could be related to the.

  17. Opioid Therapy for Chronic Pain: Overview of the 2017 US Department of Veterans Affairs and US Department of Defense Clinical Practice Guideline.

    Science.gov (United States)

    Rosenberg, Jack M; Bilka, Brandon M; Wilson, Sara M; Spevak, Christopher

    2018-05-01

    The US Department of Veterans Affairs (VA) and US Department of Defense (DoD) revised the 2010 clinical practice guideline (CPG) for the management of opioid therapy for chronic pain, considering the specific needs of the VA and DoD and new evidence regarding prescribing opioid medication for non-end-of-life-related chronic pain. This paper summarizes the major recommendations and compares them with the US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids. This Opioid Therapy CPG was developed for VA-DoD service members, veterans, and their families. The VA/DoD Evidence-Based Practice Work Group convened a VA/DoD guideline renewal development effort and conformed to the guidelines established by the VA/DoD Joint Executive Council (JEC) and VA/DoD Health Executive Council (HEC). The panel developed questions, searched and evaluated the literature, developed recommendations using GRADE methodology, and developed algorithms. Passage of the CARA Act by Congress compelled consideration and comparison with the CDC opioid therapy guideline mid-development. There were 18 recommendations made. This article focuses on guideline development and key recommendations with CDC comparisons taken from four major areas, including: initiation and continuation of opioids;type, dose, follow-up, and taper of opioids;risk mitigation;acute pain. Guideline development and recommendations are presented. There was substantial overlap with the CDC opioid guideline. Additionally, there were items particularly relevant to the VA-DoD, including risk mitigation, suicide prevention, and preventing opioid use disorder in young patients. Our guideline highlights avoiding opioid therapy longer than 90 days as a critical juncture.

  18. weHelp: A Reference Architecture for Social Recommender Systems.

    Science.gov (United States)

    Sheth, Swapneel; Arora, Nipun; Murphy, Christian; Kaiser, Gail

    2010-01-01

    Recommender systems have become increasingly popular. Most of the research on recommender systems has focused on recommendation algorithms. There has been relatively little research, however, in the area of generalized system architectures for recommendation systems. In this paper, we introduce weHelp : a reference architecture for social recommender systems - systems where recommendations are derived automatically from the aggregate of logged activities conducted by the system's users. Our architecture is designed to be application and domain agnostic. We feel that a good reference architecture will make designing a recommendation system easier; in particular, weHelp aims to provide a practical design template to help developers design their own well-modularized systems.

  19. Best Practices in Intellectual Disability Identification

    Science.gov (United States)

    Fiorello, Catherine A.; Jenkins, Tiffany K.

    2018-01-01

    This article is an overview of identification of intellectual disabilities (ID), with a focus on meeting legal and ethical requirements when assessing children from culturally and linguistically diverse backgrounds and those living in poverty. Specific procedures and recommended instruments will be reviewed.

  20. Modern wiring practice

    CERN Document Server

    Steward, W E

    2012-01-01

    Continuously in print since 1952, Modern Wiring Practice has now been fully revised to provide an up-to-date source of reference to building services design and installation in the 21st century. This compact and practical guide addresses wiring systems design and electrical installation together in one volume, creating a comprehensive overview of the whole process for contractors and architects, as well as electricians and other installation engineers. Best practice is incorporated throughout, combining theory and practice with clear and accessible explanation, all

  1. Benchmark study on glyphosate-resistant cropping systems in the United States. Part 7: Effects of weed management strategy (grower practices versus academic recommendations) on the weed soil seedbank over 6 years.

    Science.gov (United States)

    Gibson, David J; Young, Bryan G; Owen, Micheal D K; Gage, Karla L; Matthews, Joseph L; Jordan, David L; Shaw, David R; Weller, Stephen C; Wilson, Robert G

    2016-04-01

    Shifts in weed species composition and richness resulting from near-exclusive reliance on herbicides in glyphosate-resistant (GR) cropping systems has necessitated the implementation of alternative weed management tactics to reduce selection pressures of herbicides. We contrasted the response of the weed soil seedbank to effects of weed management strategy, comparing grower practices with academic recommendations for best management practices (BMPs) over 6 years and across five weed hardiness zones in the US Midwest at sites subject to GR cropping systems. Total weed population density and species richness varied according to cropping system, location and prior year's crop, but less so to weed management strategy. The seedbank population density for 11 of the 14 most frequent weed species was affected by weed management strategy either alone or in an interaction with hardiness zone or year, or both. In only 29% of comparisons was weed population density lower following academic recommendations, and this depended upon prior crop and cropping system. The population density of high-risk weed species was reduced by academic recommendations, but only in two of six years and under continuous GR maize. Overall, the weed population density was decreasing in field halves subject to the BMPs in the academic recommendations relative to grower practices. The soil seedbank is slow to respond to academic recommendations to mitigate glyphosate-resistant weeds, but represents a biological legacy that growers need to keep in mind even when management practices reduce emerged field weed population densities. © 2015 Society of Chemical Industry.

  2. Improving end-of-life care: Recommendations from the IOM.

    Science.gov (United States)

    Dobbins, Elizabeth H

    2016-09-22

    A 2014 consensus report by the Institute of Medicine offers recommendations for healthcare providers to decrease unwanted care and improve the quality of life at the end of life. This article discusses the recommendations of interest to advanced practice registered nurses.

  3. Introduction and Overview: Prevention Services--From Optimistic Promise to Widespread, Effective Practice.

    Science.gov (United States)

    Weissberg, Roger P.; Kuster, Carol Bartels; Gullotta, Thomas P.

    This opening chapter provides an overview of the book, "Healthy Children 2010: Establishing Preventive Services." The article describes the purpose of the work, which is to provide strategies to establish and successfully implement effective prevention services in key socializing settings that powerfully affect the growth an development…

  4. 16 CFR 1021.4 - Overview of environmental review process for CPSC actions.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Overview of environmental review process for CPSC actions. 1021.4 Section 1021.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL... detailed fashion. (See § 1021.10(a), below.) It contains sufficient information to form a basis for...

  5. Remote control systems for space heating. Product overview 2010 and recommendations - Final report; Fernsteuerungen fuer Raumheizungen. Produktuebersicht 2010 und Empfehlungen - Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Geilinger, E.; Bush, E. [Bush Energie GmbH, Felsberg (Switzerland); Venzin, T. [Hochschule fuer Technik und Wirtschaft (HTW) Chur, Chur (Switzerland); Nipkow, J. [Arena, Zuerich (Switzerland)

    2010-09-15

    indicate that remote-controlled heating systems are not promoted actively enough in consulting, sales and heating service. This report not only gives an overview of the current market situation and recommendations on remote controls for heating, but also serves as the basis for communication. The key target groups need to be better informed and motivated. (authors)

  6. Who controls the uses of organs after death? Law in the books, law in practice and the view of the people.

    Science.gov (United States)

    Naffine, Ngaire; Richards, Bernadette; de Lacey, Sheryl; Braunack-Mayer, Annette; Rogers, Wendy

    2012-12-01

    The conventional wisdom is that we are free to dispose of our organs at death and that they will be employed according to our wishes. However, this reflects neither the formal law nor medical practice. This article explores the theory underlying the principle of self-determination after death. It presents an overview of Australian law and the way that the law is interpreted in clinical practice. It then presents the results of a community survey on organ disposition, and identifies a gap between community expectations and the current operation of Australian law. It concludes with some specific recommendations for development of the law to align it more closely with contemporary community views.

  7. Good practice recommendations for paediatric outpatient parenteral antibiotic therapy (p-OPAT) in the UK: a consensus statement.

    Science.gov (United States)

    Patel, Sanjay; Abrahamson, Ed; Goldring, Stephen; Green, Helen; Wickens, Hayley; Laundy, Matt

    2015-02-01

    There is compelling evidence to support the rationale for managing children on intravenous antimicrobial therapy at home whenever possible, including parent and patient satisfaction, psychological well-being, return to school/employment, reductions in healthcare-associated infection and cost savings. As a joint collaboration between the BSAC and the British Paediatric Allergy, Immunity and Infection Group, we have developed good practice recommendations to highlight good clinical practice and governance within paediatric outpatient parenteral antibiotic therapy (p-OPAT) services across the UK. These guidelines provide a practical approach for safely delivering a p-OPAT service in both secondary care and tertiary care settings, in terms of the roles and responsibilities of members of the p-OPAT team, the structure required to deliver the service, identifying patients and pathologies that are suitable for p-OPAT, ensuring appropriate vascular access, antimicrobial choice and delivery and the clinical governance aspects of delivering a p-OPAT service. The process of writing a business case to support the introduction of a p-OPAT service is also addressed. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  8. A review of the effects of martial arts practice on health.

    Science.gov (United States)

    Woodward, Thomas W

    2009-02-01

    Martial arts are ancient forms of combat, modified for modern sport and exercise. Participation in the martial arts is increasing, particularly for youth. Martial arts provide health-promoting and meaningful exercise for millions of practitioners. Benefits from this practice include better overall health and balance, as well as an improved sense of psychological well being. They do not promote aggression and may be used as a treatment modality for youth who are at-risk for violence. This article provides an overview of martial arts for physicians who may evaluate such injuries in their practice. Physicians may wish to consider recommending martial arts to patients as a beneficial form of exercise. They are relatively safe compared to many other sports, and most martial arts injuries are comparatively minor. Risks can possibly be reduced by limiting exposure of inexperienced students, as well as using protective equipment, including mouthguards, eye/face protection, headgear, and padding.

  9. Existing Default Values and Recommendations for Exposure Assessment - A Nordic Exposure Group Project 2011

    DEFF Research Database (Denmark)

    Höglund, Lena; Räisänen, Jouni; Hämäläinen, Anne-Maija

    range of more or less well-documented values originating from many different sources. The purpose of this report is to give an overview and to evaluate exposure factors that are currently used by the authorities and industry in the exposure assessments for both adults (occupational and consumer exposure......) and children in relation to REACH. Another important purpose of the report is to contribute towards a further harmonisation of exposure factors by giving recommendations of most valid and representative defaults. These recommendations can be used besides REACH also in biocide's and plant protection product...

  10. An Overview of Iron in Term Breast-Fed Infants

    Directory of Open Access Journals (Sweden)

    Wafaa A. Qasem

    2015-01-01

    Full Text Available Background Iron is an essential nutrient for normal growth and neurodevelopment of infants. Iron deficiency (ID remains the most common micronutrient deficiency worldwide. There are convincing data that ID is associated with negative effects on neurological and psychomotor development. Objectives In this review, we provide an overview of current knowledge of the importance of iron in normal term breast-fed infants with a focus on recommendations, metabolism, and iron requirements. Conclusions Health organizations around the world recommend the introduction of iron-rich foods or iron supplements for growing infants to prevent ID. However, there is no routine screening for ID in infancy. Multicenter trials with long-term follow-up are needed to investigate the association between iron fortification/supplementation and various health outcomes.

  11. Prevention and treatment of pressure ulcers by newest recommendations from European Pressure Ulcer Advisory Panel (EPUAP: practical reference guide for GPs

    Directory of Open Access Journals (Sweden)

    Jakub Taradaj

    2017-03-01

    Full Text Available The guideline titled “Prevention and treatment of pressure ulcers: clinical practice guideline” is the result of a collaborative effort between the National Pressure Ulcer Advisory Panel (NPUAP, European Pressure Ulcer Advisory Panel (EPUAP and Pan Pacific Pressure Injury Alliance (PPPIA. A comprehensive literature review was conducted on pressure ulcer prevention and treatment. Rigorous scientific methodology was used to appraise available research and make evidence-based recommendations for the prevention and treatment of pressure ulcers. Draft guidelines were made available to 986 invited individual stakeholders and organizations or societies, and the feedback of the stakeholders was taken under consideration by the developers of the guideline. The guideline includes 575 explicit recommendations and/or research summaries for multidisciplinary pressure ulcer topics.

  12. Solar and artificial radiation: health effects and protective measures -- position statement and overview. (RSU 118/OT0799)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-08-16

    Sunburn is the skin's visible reaction to acute overexposure to ultraviolet radiation (UVR). It is estimated that in any given year there are about 3,150 new cases of malignant melanoma, the deadliest kind of skin cancer, and 64,000 new cases of non-melanoma skin cancers in Canada. Between 1986 and 1995 the age-standardized mortality of malignant melanoma increased by an annual average of 2.7 per cent among men and 1.7 per cent among women, the largest increase in mortality of all cancers in men and the second largest among women. This report provides a brief overview of the main characteristics, sources and health effects of ultraviolet radiation, along with a description of general protective measures and recommendations for specific settings. The expectation is that the document will help to promote sound UVR exposure reduction practices, and by so doing, help to reduce the negative health effects of overexposure to UVR among Canadians. The recommended protective measures include minimizing sun exposure (including exposure to sunlamps which are not considered a safe way to get a tan); seeking shade, especially from 11.00 AM to 4.00 PM; covering up; using a sunscreen with SPF 15 or higher that has both UV and UVB protection; and using lip and eye protection. Practising regular skin self-examination is also recommended.

  13. IMPLEMENTING HEALTH TECHNOLOGY ASSESSMENT-BASED RECOMMENDATIONS IN FINLAND

    DEFF Research Database (Denmark)

    Sihvo, Sinikka; Ikonen, Tuija; Mäkelä, Marjukka

    2017-01-01

    Objectives: The Managed Uptake of Medical Methods Program (MUMM) started 10 years ago as a joint venture of the Finnish Office for Health Technology Assessment (Finohta) and the twenty hospital districts in Finland. The aim is to offer information on the effectiveness, safety, organizational...... in decision making. Conclusions: HTA-based MUMM recommendations were well received by physicians but in practice they are less used than clinical practice guidelines. Short-form electronic surveys were a useful way of gathering information about awareness and implementation. The surveys also functioned...... as another method of informing key physicians about the recommendations....

  14. [Normocalcemic primary hyperparathyroidism: recommendations for management and follow-up].

    Science.gov (United States)

    Martínez Díaz-Guerra, Guillermo; Jódar Gimeno, Esteban; Reyes García, Rebeca; Gómez Sáez, José Manuel; Muñoz-Torres, Manuel

    2013-10-01

    To provide practical recommendations for evaluation and follow-up of patients with normocalcemic primary hyperparathyroidism. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. A systematic search was made in MEDLINE (PubMed), using the terms normocalcemic primary hyperparathyroidism and primary hyperparathyroidism, for articles in English published before 22 November 2012. Literature was reviewed by 2 members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology, and after development of recommendations, the manuscript was reviewed by all other members of the Group, and their suggestions were incorporated. The document provides practical recommendations for evaluation and follow-up of patients with normocalcemic primary hyperparathyroidism. There is however little evidence available about different aspects of this disease, mainly progression rate and clinical impact. More data are therefore needed before definite recommendations may be made. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  15. Auditor recommendations resulting from three clinical audit rounds in Finnish radiology units.

    Science.gov (United States)

    Miettunen, Kirsi; Metsälä, Eija

    2017-06-01

    Background The purpose of clinical audits performed in radiology units is to reduce the radiation dose of patients and staff and to implement evidence-based best practices. Purpose To describe auditor recommendations in three Finnish clinical audit rounds performed in 2002-2014, and to determine if auditor recommendations have had any impact on improving medical imaging practice. Material and Methods The retrospective observational study was performed in radiology units holding a radiation safety license issued by the Finnish Radiation and Nuclear Safety Authority. The data comprised a systematic sample (n = 120) of auditor reports produced in three auditing rounds in these units during the years 2002-2014. The data were analyzed by descriptive methods and by using the Friedman two-way ANOVA test. Results The number of auditor recommendations given varied between clinical audit rounds and according to the type of imaging unit, as well as according to calculation method. Proportionally, the most recommendations in all three clinical audit rounds were given about defining and using quality assurance functions and about guidelines and practices for carrying out procedures involving radiation exposure. Demanding radiology units improved their practices more than basic imaging units towards the third round. Conclusion Auditor recommendations help to address the deficiencies in imaging practices. There is a need to develop uniform guidelines and to provide tutoring for clinical auditors in order to produce comparable clinical audit results.

  16. Policies for biosimilar uptake in Europe: An overview.

    Science.gov (United States)

    Moorkens, Evelien; Vulto, Arnold G; Huys, Isabelle; Dylst, Pieter; Godman, Brian; Keuerleber, Simon; Claus, Barbara; Dimitrova, Maria; Petrova, Guenka; Sović-Brkičić, Ljiljana; Slabý, Juraj; Šebesta, Robin; Laius, Ott; Karr, Allan; Beck, Morgane; Martikainen, Jaana E; Selke, Gisbert W; Spillane, Susan; McCullagh, Laura; Trifirò, Gianluca; Vella Bonanno, Patricia; Mack, Asbjørn; Fogele, Antra; Viksna, Anita; Władysiuk, Magdalena; Mota-Filipe, Helder; Meshkov, Dmitry; Kalaba, Marija; Mencej Bedrač, Simona; Fürst, Jurij; Zara, Corrine; Skiöld, Peter; Magnússon, Einar; Simoens, Steven

    2017-01-01

    Across European countries, differences exist in biosimilar policies, leading to variations in uptake of biosimilars and divergences in savings all over Europe. The aim of this article is to provide an overview of different initiatives and policies that may influence the uptake of biosimilars in different European countries. Recommendations will be formulated on how to create sustainable uptake. An overview of policies on biosimilars was obtained via a questionnaire, supplemented with relevant articles. Topics were organized in five themes: availability, pricing, reimbursement, demand-side policies, and recommendations to enhance uptake. In all countries studied, biological medicines are available. Restrictions are mainly dependent on local organization of the healthcare system. Countries are willing to include biosimilars for reimbursement, but for commercial reasons they are not always marketed. In two thirds of countries, originator and biosimilar products may be subjected to internal reference pricing systems. Few countries have implemented specific incentives targeting physicians. Several countries are implementing pharmacist substitution; however, the scope and rules governing such substitution tend to vary between these countries. Reported educational policies tend to target primarily physicians, whereas fewer initiatives were reported for patients. Recommendations as proposed by the different country experts ranged from the need for information and communication on biosimilars to competitive pricing, more support for switching and guidance on substitution. Most countries have put in place specific supply-side policies for promoting access to biosimilars. To supplement these measures, we propose that investments should be made to clearly communicate on biosimilars and educate stakeholders. Especially physicians need to be informed on the entry and use of biosimilars in order to create trust. When physicians are well-informed on the treatment options, further

  17. Best practices and recommendations on policy packaging

    DEFF Research Database (Denmark)

    Fearnley, Nils; Longva, Frode; Ramjerdi, Farideh

    2011-01-01

    . This report gives practical and general advice for each of these stages: 1. Define objectives and targets 2. Create an inventory of measures, identify potential primary measures and detect causal relationships 3. Assess policy package 4. Modify package 5. Package implementation 6. Evaluate effects, introduce...

  18. Variation in adult vaccination policies across Europe: an overview from VENICE network on vaccine recommendations, funding and coverage.

    Science.gov (United States)

    Kanitz, Elisabeth E; Wu, Lauren A; Giambi, Cristina; Strikas, Raymond A; Levy-Bruhl, Daniel; Stefanoff, Pawel; Mereckiene, Jolita; Appelgren, Eva; D'Ancona, Fortunato

    2012-07-27

    In 2010-2011, in the framework of the VENICE project, we surveyed European Union (EU) and Economic Area (EEA) countries to fill the gap of information regarding vaccination policies in adults. This project was carried out in collaboration with the United States National Vaccine Program Office, who conducted a similar survey in all developed countries. VENICE representatives of all 29 EU/EEA-countries received an online questionnaire including vaccination schedule, recommendations, funding and coverage in adults for 17 vaccine-preventable diseases. The response rate was 100%. The definition of age threshold for adulthood for the purpose of vaccination ranged from 15 to 19 years (median=18 years). EU/EEA-countries recommend between 4 and 16 vaccines for adults (median=11 vaccines). Tetanus and diphtheria vaccines are recommended to all adults in 22 and 21 countries respectively. The other vaccines are mostly recommended to specific risk groups; recommendations for seasonal influenza and hepatitis B exist in all surveyed countries. Six countries have a comprehensive summary document or schedule describing all vaccines which are recommended for adults. None of the surveyed countries was able to provide coverage estimates for all the recommended adult vaccines. Vaccination policies for adults are not consistent across Europe, including the meaning of "recommended vaccine" which is not comparable among countries. Coverage data for adults should be collected routinely like for children vaccination. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. ACPSEM ROSG TBI working group recommendations for quality assurance in total body irradiation

    International Nuclear Information System (INIS)

    Nelligan, Raelene; Bailey, Michael; Tran, Thu; Baldwin, Zoe

    2015-01-01

    The Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) radiation oncology specialty group (ROSG) formed a series of working groups in 2011 to develop recommendations for guidance of radiation oncology medical physics practice within the Australasian setting. These recommendations are intended to provide guidance for safe work practices and a suitable level of quality control without detailed work instructions. It is the responsibility of the medical physicist to ensure that locally available equipment and procedures are sufficiently sensitive to establish compliance to these recommendations. The recommendations are endorsed by the ROSG, and have been subject to independent expert reviews. For the Australian audience, these recommendations should be read in conjunction with the tripartite radiation oncology practice standards [1, 2]. This publication presents the recommendations of the ACPSEM total body irradiation working group (TBIWG) and has been developed in alignment with other international associations. However, these recommendations should be read in conjunction with relevant national, state or territory legislation and local requirements, which take precedence over the ACPSEM recommendations. It is hoped that the users of this and other ACPSEM recommendations will contribute to the development of future versions through the ROSG of the ACPSEM. This document serves as a guideline for calibration and quality assurance of equipment used for TBI in Australasia.

  20. Energy taxes in practice. Energy tax - electricity tax - biofuel quota - energy tax compliance. 3. upd. and rev. ed.

    International Nuclear Information System (INIS)

    Stein, Roland M.; Thoms, Anahita

    2016-01-01

    You need a quick and easy overview of the legal provisions of the energy tax law? You would like to understand the relationship between the European and national regulations and their impact on the daily practice? This manual prepares the energy tax, electricity tax and biofuel quota law for you clearly on and illustrated by examples, what to look in practice in order to avoid pitfalls. It picks up especially contentious issues and problems, discusses the relevant case law and the relevant regulations and finally gives precise recommendations for daily practice. Based on practice notes, examples and diagrams you can easily identify how to transfer the legal requirements on the own workspaces or optionally can use tax breaks. This includes information on both simplified - and thus less subject to error - methods and to tax exemptions and credits. The manual is complemented by forms, extracts from the Combined Nomenclature and an online material collection with regulatory and legal texts. [de

  1. Gaps in the prevention of perinatal transmission of hepatitis B virus between recommendations and routine practices in a highly endemic region: a provincial population-based study in China

    Directory of Open Access Journals (Sweden)

    Hu Yali

    2012-09-01

    Full Text Available Abstract Background Hepatitis B virus (HBV infection is endemic in China; perinatal transmission is the main source of chronic HBV infection. Simultaneous administration of hepatitis B immune globulin (HBIG and hepatitis B vaccine is highly effective to prevent perinatal transmission of HBV; however, the effectiveness also depends on full adherence to the recommended protocols in daily practice. In the present investigation, we aimed to identify gaps in immunoprophylaxis of perinatal transmission of HBV between recommendations and routine practices in Jiangsu Province, China. Methods Totally 626 children from 6 cities and 8 rural areas across Jiangsu Province, China, born from February 2003 to December 2004, were enrolled; 298 were born to mothers with positive hepatitis B surface antigen (HBsAg and 328 were born to HBsAg-negative mothers. Immunoprophylactic measures against hepatitis B were retrospectively reviewed for about half of the children by checking medical records or vaccination cards and the vaccine status was validated for most of children. Results Of 298 children born to HBV carrier mothers, 11 (3.7% were HBsAg positive, while none of 328 children born to non-carrier mothers was HBsAg positive (P  Conclusions There are substantial gaps in the prevention of perinatal HBV infection between the recommendations and routine practices in China, which highlights the importance of full adherence to the recommendations to eliminate perinatal HBV infection in the endemic regions.

  2. A Reflection upon the "Getting Practical" Programme: Rethinking How We Teach Practical Science

    Science.gov (United States)

    Brennan, Nikki

    2010-01-01

    In this article, the author provides an overview of the "Getting Practical" training programme of professional development for all those involved with teaching practical science at primary, secondary, and post-16 levels. The programme is being led by the ASE, working with its co-ordinating partners: the Centre for Science Education,…

  3. The ICRP 2007 recommendations

    International Nuclear Information System (INIS)

    Streffer, C.

    2007-01-01

    Protection). These documents are: - Committee 1: Low-Dose Extrapolation of Radiation-Related Cancer Risks, ICRP Publication 99(2); - Committee 1: Biological and Epidemiological Information on Health Risks Attributable to Ionising Radiation (FD-C-1); (Annex A) - Committee 2: Quantities used in Radiological Protection (FD-C-2); (Annex B) - Committee 3: Radiological Protection in Medicine; - Committee 4: Optimisation of Radiological Protection; - Committee 4: Assessing Dose to the Representative Person. Drafts have been presented on the web-site of ICRP (www.icrp.org). Many constructive comments have been made which have been evaluated and considered for possible changes. In this publication it is focussed on the chapters with data from physics and biology and only a rough overview of the later parts of the recommendations are given. (author)

  4. The ICRP 2007 recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Streffer, C. [Chairman of ICRP Committee 2, Institute of Science and Ethics, University Duisburg-Essen, 45117 Essen (Germany)

    2007-07-01

    Protection). These documents are: - Committee 1: Low-Dose Extrapolation of Radiation-Related Cancer Risks, ICRP Publication 99(2); - Committee 1: Biological and Epidemiological Information on Health Risks Attributable to Ionising Radiation (FD-C-1); (Annex A) - Committee 2: Quantities used in Radiological Protection (FD-C-2); (Annex B) - Committee 3: Radiological Protection in Medicine; - Committee 4: Optimisation of Radiological Protection; - Committee 4: Assessing Dose to the Representative Person. Drafts have been presented on the web-site of ICRP (www.icrp.org). Many constructive comments have been made which have been evaluated and considered for possible changes. In this publication it is focussed on the chapters with data from physics and biology and only a rough overview of the later parts of the recommendations are given. (author)

  5. Radiation in dental practice: awareness, protection and recommendations.

    Science.gov (United States)

    Praveen, B N; Shubhasini, A R; Bhanushree, R; Sumsum, P S; Sushma, C N

    2013-01-01

    Radiation is the transmission of energy through space and matter. There are several forms of radiation, including ionizing and nonionizing. X-rays are the ionizing radiation used extensively in medical and dental practice. Even though they provide useful information and aid in diagnosis, they also have the potential to cause harmful effects. In dentistry, it is mainly used for diagnostic purposes and in a dental set-up usually the practicing dentist exposes, processes and interprets the radiograph. Even though such exposure is less, it is critical to reduce the exposure to the dental personnel and patients in order to prevent the harmful effects of radiation. Several radiation protection measures have been advocated to ameliorate these effects. A survey conducted in the Bengaluru among practicing dentists revealed that radiation protection awareness was very low and the necessary measures taken to reduce the exposure were not adequate. The aim of the article is to review important parameters that must be taken into consideration in the clinical set-up to reduce radiation exposure to patients and dental personnel.

  6. Adoption of Recommended Rice Production Practices among ...

    African Journals Online (AJOL)

    User

    rice production practices by women farmers in Nasarawa State. A total of 203 women rice farmers were selected for the study using multi- ... RRPPs were unavailability of credit facilities, poor marketing system and ... economy which provides employment opportunity for about 70-80 percent of the total ..... shown in Table 1.

  7. ACPSEM ROSG TBE working group recommendations for quality assurance in total body electron irradiation

    International Nuclear Information System (INIS)

    Nelligan, Raelene; Baldwin, Zoe; Ostwald, Trish; Tran, Thi; Bailey, Michael

    2015-01-01

    The Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) Radiation Oncology Specialty Group (ROSG) formed a series of working groups in 2011 to develop recommendations for guidance of radiation oncology medical physics practice within the Australasian setting. These recommendations are intended to provide guidance for safe work practices and a suitable level of quality control without detailed work instructions. It is the responsibility of the medical physicist to ensure that locally available equipment and procedures are sufficiently sensitive to establish compliance to these recommendations. The recommendations are endorsed by the ROSG, and have been subject to independent expert reviews. For the Australian readers, these recommendations should be read in conjunction with the Tripartite Radiation Oncology Reform Implementation Committee Quality Working Group: Radiation Oncology Practice Standards (2011), and Radiation Oncology Practice Standards Supplementary Guide (2011). This publication presents the recommendations of the ACPSEM ROSG Total Body Electron Irradiation Working Group and has been developed in alignment with other international associations. However, these recommendations should be read in conjunction with relevant national, state or territory legislation and local requirements, which take precedence over the ACPSEM recommendations. It is hoped that the users of this and other ACPSEM recommendations will contribute to the development of future versions through the Radiation Oncology Specialty Group of the ACPSEM. This document serves as a guideline for calibration and quality assurance of equipment used for TBE in Australasia.

  8. 2016 Updates to US Medical Eligibility Criteria for Contraceptive Use and Selected Practice Recommendations for Contraceptive Use: Highlights for Adolescent Patients.

    Science.gov (United States)

    Hoopes, Andrea J; Simmons, Katharine B; Godfrey, Emily M; Sucato, Gina S

    2017-04-01

    The US Medical Eligibility Criteria for Contraceptive Use (MEC) and US Selected Practice Recommendations for Contraceptive Use (SPR) provide evidence-based guidance to safely provide contraception counseling and services. Both documents were updated in 2016 and are endorsed by the North American Society for Pediatric and Adolescent Gynecology. The purpose of this mini-review is to highlight updates to the US MEC and US SPR that are most relevant to health care providers of adolescents to support dissemination and implementation of these evidence-based best practices. This document is intended to highlight these changes and to complement, not replace, the detailed practice guidance within the US MEC and US SPR. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  9. Recommender systems for technology enhanced learning research trends and applications

    CERN Document Server

    Manouselis, Nikos; Verbert, Katrien

    2014-01-01

    Presents cutting edge research from leading experts in the growing field of Recommender Systems for Technology Enhanced Learning (RecSys TEL) International contributions are included to demonstrate the merging of various efforts and communities Topics include: Linked Data and the Social Web as Facilitators for TEL Recommender Systems in Research and Practice, Personalised Learning-Plan Recommendations in Game-Based Learning and Recommendations from Heterogeneous Sources in a Technology Enhanced Learning Ecosystem

  10. Nuclear Security Recommendations on Nuclear and other Radioactive Material out of Regulatory Control: Recommendations (Spanish Edition)

    International Nuclear Information System (INIS)

    2012-01-01

    This publication presents recommendations for the nuclear security of nuclear and other radioactive material that is out of regulatory control. It is based on national experiences and practices and guidance publications in the field of security as well as the nuclear security related international instruments. The recommendations include guidance for States with regard to the nuclear security of nuclear and other radioactive material that has been reported as being out of regulatory control as well as for material that is lost, missing or stolen but has not been reported as such, or has been otherwise discovered. In addition, these recommendations adhere to the detection and assessment of alarms and alerts and to a graded response to criminal or unauthorized acts with nuclear security implications.

  11. Nuclear Security Recommendations on Nuclear and Other Radioactive Material out of Regulatory Control: Recommendations (Arabic Edition)

    International Nuclear Information System (INIS)

    2012-01-01

    This publication presents recommendations for the nuclear security of nuclear and other radioactive material that is out of regulatory control. It is based on national experiences and practices and guidance publications in the ? field of security as well as the nuclear security related international instruments. The recommendations include guidance for States with regard to the nuclear security of nuclear and other radioactive material that has been reported as being out of regulatory control as well as for material that is lost, missing or stolen but has not been reported as such, or has been otherwise discovered. In addition, these recommendations adhere to the detection and assessment of alarms and alerts and to a graded response to criminal or unauthorized acts with nuclear security implications.

  12. Nuclear Security Recommendations on Nuclear and Other Radioactive Material out of Regulatory Control: Recommendations (Russian Edition)

    International Nuclear Information System (INIS)

    2011-01-01

    This publication presents recommendations for the nuclear security of nuclear and other radioactive material that is out of regulatory control. It is based on national experiences and practices and guidance publications in the field of security as well as the nuclear security related international instruments. The recommendations include guidance for States with regard to the nuclear security of nuclear and other radioactive material that has been reported as being out of regulatory control as well as for material that is lost, missing or stolen but has not been reported as such, or has been otherwise discovered. In addition, these recommendations adhere to the detection and assessment of alarms and alerts and to a graded response to criminal or unauthorized acts with nuclear security implications.

  13. Recommendation for measuring clinical outcome in distal radius fractures: a core set of domains for standardized reporting in clinical practice and research.

    Science.gov (United States)

    Goldhahn, Jörg; Beaton, Dorcas; Ladd, Amy; Macdermid, Joy; Hoang-Kim, Amy

    2014-02-01

    Lack of standardization of outcome measurement has hampered an evidence-based approach to clinical practice and research. We adopted a process of reviewing evidence on current use of measures and appropriate theoretical frameworks for health and disability to inform a consensus process that was focused on deriving the minimal set of core domains in distal radius fracture. We agreed on the following seven core recommendations: (1) pain and function were regarded as the primary domains, (2) very brief measures were needed for routine administration in clinical practice, (3) these brief measures could be augmented by additional measures that provide more detail or address additional domains for clinical research, (4) measurement of pain should include measures of both intensity and frequency as core attributes, (5) a numeric pain scale, e.g. visual analogue scale or visual numeric scale or the pain subscale of the patient-reported wrist evaluation (PRWE) questionnaires were identified as reliable, valid and feasible measures to measure these concepts, (6) for function, either the Quick Disability of the arm, shoulder and hand questionnaire or PRWE-function subscale was identified as reliable, valid and feasible measures, and (7) a measure of participation and treatment complications should be considered core outcomes for both clinical practice and research. We used a sound methodological approach to form a comprehensive foundation of content for outcomes in the area of distal radius fractures. We recommend the use of symptom and function as separate domains in the ICF core set in clinical research or practice for patients with wrist fracture. Further research is needed to provide more definitive measurement properties of measures across all domains.

  14. A Classification-based Review Recommender

    Science.gov (United States)

    O'Mahony, Michael P.; Smyth, Barry

    Many online stores encourage their users to submit product/service reviews in order to guide future purchasing decisions. These reviews are often listed alongside product recommendations but, to date, limited attention has been paid as to how best to present these reviews to the end-user. In this paper, we describe a supervised classification approach that is designed to identify and recommend the most helpful product reviews. Using the TripAdvisor service as a case study, we compare the performance of several classification techniques using a range of features derived from hotel reviews. We then describe how these classifiers can be used as the basis for a practical recommender that automatically suggests the mosthelpful contrasting reviews to end-users. We present an empirical evaluation which shows that our approach achieves a statistically significant improvement over alternative review ranking schemes.

  15. Recommendations of ICRP for radiation protection in 2005

    International Nuclear Information System (INIS)

    Holm, L. E.

    2004-01-01

    The present recommendations of the International Commission on Radiological Protection (ICRP) were published in 1991, and since then, the ICRP has provided additional recommendations. The system of protection has become increasingly co plex with time, and the Commission has decided to adopt a new set of recommendations in 2005- These should be seen as a consolidation of earlier recommendations. The new recommendations will recognize where the responsibility for justifying the introduction of a new practice lies, maintain the existing dose limits for individuals, develop the concept of dose constraints, require optimisation of protection from any source to ensure that exposures are as law as reasonably achievable, include of a policy for protection of non-human species, and clarify the dramatics quantities. The Commission intends to adopt the new recommendations in 2005, and this will be 15 years after the current recommendations were adopted. (Author) 13 refs

  16. [Consensus clinical practice guidelines of the Andalusian Epilepsy Society: therapeutic recommendations when dealing with a first epileptic seizure and in epileptic status].

    Science.gov (United States)

    Mercadé-Cerda, J M; Sánchez-Alvarez, J C; Galán-Barranco, J M; Moreno-Alegre, V; Serrano-Castro, P J; Cañadillas-Hidalgo, F M

    Most epileptic seizures are brief and self-limiting, but sometimes they can last longer than expected and this entails (in the case of generalised seizures) a high risk of morbidity and mortality, which increases as they get longer. This severity justifies the need to draw up a set of consensus-based practice guidelines based on implicit evidence, to use Liberati's nomenclature, concerning aspects related to the recommended therapeutic management of a patient with prolonged seizures who is being attended in an emergency department. A selective search was conducted on PubMed-Medline for scientific information related to the subject using scientific evidence filters. This search was completed in other scientific evidence search engines, such as Tripdatabase, Biblioteca Cochrane Plus or DARE. The selected references were analysed and discussed by the authors, and the available evidence and any recommendations that could be drawn from it were collected. The search revealed the existence of 33 primary documents and six practice guidelines or protocols related with the topic under study. The recommendations were inserted in the text explicitly. The therapeutic protocol must be started when faced with any seizures that last more than five minutes. First, steps must be taken to ensure proper respiratory and cardiocirculatory functioning, and then fast-acting antiepileptic drugs are administered intravenously and in high doses until the cause is identified and controlled. Due to their lower level of morbidity and mortality, prolonged non-convulsive seizures do not generally require therapy that is so vigorous and with such a high risk of complications.

  17. Task 9 recommended practice guides - Executive summaries. Financing mechanisms for solar home systems in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-09-15

    This Practice Guide issued by the Photovoltaic Power Systems (PVPS) group of the International Energy Agency (IEA) summarises how insufficient financing, the low incomes of the potential clients in remote rural areas and the high initial investment costs for the Solar Home System (SHS) are the factors responsible for insufficient progress in this area. The findings of the study such as access to finance, subsidies, formal and informal intermediaries and alternative financing solutions are discussed. SHS operating costs, possible higher priorities for other commodities and other market-driven factors are discussed. The report notes that most other reports concentrate more on technical and institutional rather than on the underlying financing schemes and associated data. Recommendations made deal with political aspects as well as technical, financial and awareness issues.

  18. Amikacin Dosing and Monitoring in Spinal Cord Injury Patients: Variation in Clinical Practice Between Spinal Injury Units and Differences in Experts' Recommendations

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2006-01-01

    Full Text Available The objective of this article was to determine the current practice on amikacin dosing and monitoring in spinal cord injury patients from spinal cord physicians and experts. Physicians from spinal units and clinical pharmacologists were asked to provide protocol for dosing and monitoring of amikacin therapy in spinal cord injury patients. In a spinal unit in Poland, amikacin is administered usually 0.5 g twice daily. A once-daily regimen of amikacin is never used and amikacin concentrations are not determined. In Belgium, Southport (U.K., Spain, and the VA McGuire Medical Center (Richmond, Virginia, amikacin is given once daily. Whereas peak and trough concentrations are determined in Belgium, only trough concentration is measured in Southport. In both these spinal units, modification of the dose is not routinely done with a nomogram. In Spain and the VA McGuire Medical Center, monitoring of serum amikacin concentration is not done unless a patient has renal impairment. In contrast, the dose/interval of amikacin is adjusted according to pharmacokinetic parameters at the Edward Hines VA Hospital (Hines, Illinois, where amikacin is administered q24h or q48h, depending on creatinine clearance. Spinal cord physicians from Denmark, Germany, and the Kessler Institute for Rehabilitation (West Orange, New Jersey state that they do not use amikacin in spinal injury patients. An expert from Canada does not recommend determining serum concentrations of amikacin, but emphasizes the value of monitoring ototoxicity and nephrotoxicity. Experts from New Zealand recommend amikacin in conventional twice- or thrice-daily dosing because of the theoretical increased risk of neuromuscular blockade and apnea with larger daily doses in spinal cord injury patients. On the contrary, experts from Greece, Israel, and the U.S. recommend once-daily dosing and determining amikacin pharmacokinetic parameters for each patient. As there is considerable variation in clinical

  19. Design and evaluation of new overview screens for the LABIHS simulator

    International Nuclear Information System (INIS)

    Oliveira, Mauro V.; Almeida, Jose C.S.; Jaime, Guilherme D.G.; Augusto, Silas C.

    2015-01-01

    The development and evaluation of Human-System Interfaces (HSIs) for control rooms is a research area at the Human-System Interface Laboratory (LABIHS). The main objective of this laboratory is to develop and evaluate projects of HSIs for industrial plants using different methodology construction. The evaluation of the interfaces is carried out in the LABIHS simulator at the Nuclear Engineering Institute (IEN). Previous evaluation of the overview screen of the nuclear power plant (NPP) simulator of the LABIHS showed the necessity of additional information to reduce the operator workload. To overcome this issue, a set of three 52-inch LCD TV was acquired to replace the projector in the task of showing the overview screen to the simulator operators. A new set of screens was developed to gather information in the three LCD screens. The approach used on the development of the new screens was based on human factors guidelines and recommendations. The objective of this work is present the design of these new overview screens and to evaluate their contribution to reduce the operators mental workload in this new scenario. (author)

  20. EANM-EORTC general recommendations for sentinel node diagnostics in melanoma

    DEFF Research Database (Denmark)

    Chakera, Annette H; Hesse, Birger; Burak, Zeynep

    2009-01-01

    -draining sentinel lymph nodes. If specific recommendations given cannot be based on evidence from original, scientific studies, referral is given to "general consensus" and similar expressions. The recommendations are designed to assist in the practice of referral to, performance, interpretation and reporting...

  1. Body dysmorphic disorder and orthodontics--an overview for clinicians.

    Science.gov (United States)

    Anthony, Marshneil Trista; Farella, Mauro

    2014-11-01

    Patients with body dysmorphic disorder (BDD) often seek aesthetic medical treatment including orthodontics to correct their perceived physical defects. When the disorder pertains to the dentofacial region, it is important for orthodontists to be familiar with this condition. The purpose of this article is to provide an overview of the current knowledge on BDD and its relationship to orthodontics. PubMed, Scopus, Science Direct, and Google Scholar databases were searched for publications relating to BDD and orthodontics. Further articles were sourced from the reference lists of the articles identified through the search. The literature recommends that orthodontic patients suspected of having BDD should be referred to a psychiatrist for a definitive diagnosis and subsequent management. However, this may be difficult to implement in clinical practice. Management by a psychiatrist could include pharmacotherapy and cognitive behavioural therapy. There is still debate as to whether orthodontic treatment should be provided for these patients. As health care workers providing aesthetic treatment to patients, orthodontists should be aware of BDD and its implications. Risks include repeated requests for unnecessary treatment, dissatisfaction with the result and thus potential for litigation. BDD still remains a challenge to diagnose, and further research is needed to determine the appropriate management of orthodontic patients suffering from the disorder.

  2. Recommended Practice: Creating Cyber Forensics Plans for Control Systems

    Energy Technology Data Exchange (ETDEWEB)

    Eric Cornelius; Mark Fabro

    2008-08-01

    issues and to accommodate for the diversity in both system and architecture types, a framework based in recommended practices to address forensics in the control systems domain is required. This framework must be fully flexible to allow for deployment into any control systems environment regardless of technologies used. Moreover, the framework and practices must provide for direction on the integration of modern network security technologies with traditionally closed systems, the result being a true defense-in-depth strategy for control systems architectures. This document takes the traditional concepts of cyber forensics and forensics engineering and provides direction regarding augmentation for control systems operational environments. The goal is to provide guidance to the reader with specifics relating to the complexity of cyber forensics for control systems, guidance to allow organizations to create a self-sustaining cyber forensics program, and guidance to support the maintenance and evolution of such programs. As the current control systems cyber security community of interest is without any specific direction on how to proceed with forensics in control systems environments, this information product is intended to be a first step.

  3. Practical considerations for obtaining high quality quantitative computed tomography data of the skeletal system.

    Science.gov (United States)

    Troy, Karen L; Edwards, W Brent

    2018-05-01

    Quantitative CT (QCT) analysis involves the calculation of specific parameters such as bone volume and density from CT image data, and can be a powerful tool for understanding bone quality and quantity. However, without careful attention to detail during all steps of the acquisition and analysis process, data can be of poor- to unusable-quality. Good quality QCT for research requires meticulous attention to detail and standardization of all aspects of data collection and analysis to a degree that is uncommon in a clinical setting. Here, we review the literature to summarize practical and technical considerations for obtaining high quality QCT data, and provide examples of how each recommendation affects calculated variables. We also provide an overview of the QCT analysis technique to illustrate additional opportunities to improve data reproducibility and reliability. Key recommendations include: standardizing the scanner and data acquisition settings, minimizing image artifacts, selecting an appropriate reconstruction algorithm, and maximizing repeatability and objectivity during QCT analysis. The goal of the recommendations is to reduce potential sources of error throughout the analysis, from scan acquisition to the interpretation of results. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Recommendations for pneumococcal immunization outside routine childhood immunization programs in Western Europe.

    Science.gov (United States)

    Castiglia, Paolo

    2014-10-01

    The global burden of pneumococcal diseases is high, with young children and adults≥50 years of age at highest risk of infection. Two types of vaccine are available for the prevention of pneumococcal diseases caused by specific Streptococcus pneumoniae serotypes: the pneumococcal polysaccharide vaccine (PPV23) and the pneumococcal conjugate vaccine (PCV7, PCV10, and PCV13). Despite pneumococcal immunization programs in adults and children, the burden in adults has remained high. Most European countries have national or local/regional vaccination recommendations. The objective of this review was to provide an overview of the government recommendations for pneumococcal vaccination outside routine childhood vaccination programs for 16 Western European countries as of August 2014. We found that recommendations for pneumococcal immunization across Europe are complex and vary greatly among countries in terms of age groups and risk groups recommended for vaccination, as well as which vaccine should be administered. Clarifying or simplifying these recommendations and improving their dissemination could help to increase pneumococcal vaccine uptake and decrease the high burden of pneumococcal diseases in adults, both through a direct effect of the vaccine and via a herd effect in unvaccinated individuals.

  5. Energy efficiency in the European Union: overview of policies and good practices

    International Nuclear Information System (INIS)

    2008-01-01

    The world is facing increasing energy prospects and stakes, in terms of energy supply security and safety, environmental impact as well as economic and social costs. In Europe, these fast-growing concerns have led to the adoption of new energy efficiency policies at national and European levels: legislation, regulations, institutional measures, awareness-raising and training campaigns, financial incentives, investment schemes, etc. As in other sectors and at each stage of European development, knowledge and experience feedback drive the Member States towards a growing harmonization of national policies: the most encouraging national measures may be adopted by other countries and even implemented at a European level. The valorization and exchange of best practices therefore contributes to the fulfilment of European commitments on energy efficiency and greenhouse gas emissions reduction. All these schemes are integrally part of a common European energy policy to be applied to energy production, transportation and distribution - the supply side - as well as to all social and economic activities which make up the demand side, and which is the subject of this document. The presentation hereafter provides an overview of energy efficiency policies and programs implemented in the European Union and in the Member States. It shows the diversity of available means of action and strategic choices within the different countries whilst highlighting the most innovative and significant measures. The various tools available are of course used in different ways in each country depending on their characteristics. Economic structure, for example, can explain the differences in the implementation of certain measures as it results in concentrating on the sectors which produce the most greenhouse gases - and which differ from one country to another. Energy balances -energy-producing countries or energy-dependent countries - and political contexts - with more or less liberal governments

  6. An overview of systematic review.

    Science.gov (United States)

    Baker, Kathy A; Weeks, Susan Mace

    2014-12-01

    Systematic review is an invaluable tool for the practicing clinician. A well-designed systematic review represents the latest and most complete information available on a particular topic or intervention. This article highlights the key elements of systematic review, what it is and is not, and provides an overview of several reputable organizations supporting the methodological development and conduct of systematic review. Important aspects for evaluating the quality of a systematic review are also included. Copyright © 2014 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  7. Listening to parents to improve health visiting practice.

    Science.gov (United States)

    Morton, Alison; Hargreaves, Sharon; Taylor, Liz

    2015-05-01

    Listening to the "voice" of the service user is now widely accepted as central to the delivery of high quality healthcare. This paper presents an overview of the importance of service user engagement and personalised care in health visiting with a brief review of recent policy and research. A personalised approach to health visiting practice is recommended to improve service user experience and uptake of the health visiting service offer and this is considered most significant when engaging "hard to reach" groups. A project report on a service user experience strategy within the 0-19 service of a NHS Trust in England is presented which describes initiatives to develop a health visiting and school nursing service that listens to service users. A cyclical service user engagement model which incorporates continuous reviews and service reconfiguration is described with examples of service changes in response to expressed local needs.

  8. Interim report of the JHPS expert committee on radiation protection of the lens of the eye (1). Overview of the lens, radiogenic cataract, and equivalent dose limit for the lens newly recommended by the ICRP

    International Nuclear Information System (INIS)

    Akahane, Keiichi; Tatsuzaki, Hideo; Iimoto, Takeshi; Ichiji, Takeshi; Hamada, Nobuyuki; Fujimichi, Yuki; Iwai, Satoshi; Ohguchi, Hiroyuki; Ohno, Kazuko; Yamauchi, Chiyo; Tsujimura, Norio; Hotta, Yutaka; Yamasaki, Tadashi; Yokoyama, Sumi

    2014-01-01

    In April 2011, the International Commission on Radiological Protection (ICRP) issued the statement on tissue reactions. This stimulated interest in many countries. The Expert Committee on Radiation Protection of the Lens of the Eye was established in the Japanese Health Physics Society, and in April 2013, started discussion about the international developments and recent studies related to the dosimetry of the lens of the eye. This committee now publishes the interim report consisting of parts I-VI. Of these, this Part I overviews the structure of the eye and lens, cataract types and the scientific evidence of its new dose threshold and equivalent dose limit newly recommended by the ICRP. (author)

  9. Remote control systems for space heating. Product overview 2010 and recommendations - Final report; Fernsteuerungen fuer Raumheizungen. Produktuebersicht 2010 und Empfehlungen - Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Geilinger, E.; Bush, E. [Bush Energie GmbH, Felsberg (Switzerland); Venzin, T. [Hochschule fuer Technik und Wirtschaft (HTW) Chur, Chur (Switzerland); Nipkow, J. [Arena, Zuerich (Switzerland)

    2010-09-15

    . Their responses indicate that remote-controlled heating systems are not promoted actively enough in consulting, sales and heating service. This report not only gives an overview of the current market situation and recommendations on remote controls for heating, but also serves as the basis for communication. The key target groups need to be better informed and motivated. (authors)

  10. Stakeholders' Recommendations to Improve Patient-centered "LGBTQ" Primary Care in Rural and Multicultural Practices.

    Science.gov (United States)

    Kano, Miria; Silva-Bañuelos, Alma Rosa; Sturm, Robert; Willging, Cathleen E

    2016-01-01

    Individuals among gender/sexual minorities share experiences of stigma and discrimination, yet have distinctive health care needs influenced by ethnic/racial minority and rural realities. We collected qualitative data from lesbian/gay/bisexual/transgender (LGBT) and queer persons across the largely rural, multicultural state of New Mexico, particularly those from understudied ethnic groups, regarding factors facilitating or impeding patient-centered primary care. The themes identified formed the basis for a statewide summit on LGBT health care guidelines and strategies for decreasing treatment gaps. Three to 15 individuals, ages 18 to 75 years, volunteered for 1 of 4 town hall dialogues (n = 32), and 175 people took part in the summit. Participants acknowledged health care gaps pertinent to LGBT youth, elders, American Indians, and Latinos/Latinas, expressing specific concern for rural residents. This preliminary research emphasizes the need to improve primary care practices that treat rural and ethnic-minority LGBT people and offers patient-driven recommendations to enhance care delivery while clinic-level transformations are implemented. © Copyright 2016 by the American Board of Family Medicine.

  11. Work-based physiological assessment of physically-demanding trades: a methodological overview.

    Science.gov (United States)

    Taylor, Nigel A S; Groeller, Herb

    2003-03-01

    Technological advances, modified work practices, altered employment strategies, work-related injuries, and the rise in work-related litigation and compensation claims necessitate ongoing trade analysis research. Such research enables the identification and development of gender- and age-neutral skills, physiological attributes and employment standards required to satisfactorily perform critical trade tasks. This paper overviews a methodological approach which may be adopted when seeking to establish trade-specific physiological competencies for physically-demanding trades (occupations). A general template is presented for conducting a trade analyses within physically-demanding trades, such as those encountered within military or emergency service occupations. Two streams of analysis are recommended: the trade analysis and the task analysis. The former involves a progressive dissection of activities and skills into a series of specific tasks (elements), and results in a broad approximation of the types of trade duties, and the links between trade tasks. The latter, will lead to the determination of how a task is performed within a trade, and the physiological attributes required to satisfactorily perform that task. The approach described within this paper is designed to provide research outcomes which have high content, criterion-related and construct validities.

  12. A Novel Mobile Personalized Recommended Method Based on Money Flow Model for Stock Exchange

    Directory of Open Access Journals (Sweden)

    Qingzhen Xu

    2014-01-01

    Full Text Available Personalized recommended method is widely used to recommend commodities for target customers in e-commerce sector. The core idea of merchandise personalized recommendation can be applied to financial field, which can also achieve stock personalized recommendation. This paper proposes a new recommended method using collaborative filtering based on user fuzzy clustering and predicts the trend of those stocks based on money flow. We use M/G/1 queue system with multiple vacations and server close-down time to measure practical money flow. Based on the indicated results of money flow, we can select the more valued stock to recommend to investors. The experimental results show that the proposed method provides investors with reliable practical investment guidance and receiving more returns.

  13. Online Fan Practices and CALL

    Science.gov (United States)

    Sauro, Shannon

    2017-01-01

    This article provides a narrative overview of research on online fan practices for language and literacy learning, use, and identity work. I begin with an introduction to online fan communities and common fan practices found in these online affinity spaces, the best known of which is fan fiction, fictional writing that reinterprets and remixes the…

  14. Physiotherapy co-management of rheumatoid arthritis: identification of red flags, significance to clinical practice and management pathways.

    Science.gov (United States)

    Briggs, Andrew M; Fary, Robyn E; Slater, Helen; Ranelli, Sonia; Chan, Madelynn

    2013-12-01

    Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune disease. Physiotherapy interventions for people with RA are predominantly targeted at ameliorating disability resulting from articular and peri-articular manifestations of the disease and providing advice and education to improve functional capacity and quality of life. To ensure safe and effective care, it is critical that physiotherapists are able to identify potentially serious articular and peri-articular manifestations of RA, such as instability of the cervical spine. Additionally, as primary contact professionals, it is essential that physiotherapists are aware of the potentially serious extra-articular manifestations of RA. This paper provides an overview of the practice-relevant manifestations associated with RA that might warrant further investigation by a medical practitioner (red flags), their relevance to physiotherapy practice, and recommended management pathways. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Experimental Assessment of Flow Fields Associated with Heart Valve Prostheses Using Particle Image Velocimetry (PIV): Recommendations for Best Practices.

    Science.gov (United States)

    Raghav, Vrishank; Sastry, Sudeep; Saikrishnan, Neelakantan

    2018-03-12

    Experimental flow field characterization is a critical component of the assessment of the hemolytic and thrombogenic potential of heart valve substitutes, thus it is important to identify best practices for these experimental techniques. This paper presents a brief review of commonly used flow assessment techniques such as Particle image velocimetry (PIV), Laser doppler velocimetry, and Phase contrast magnetic resonance imaging and a comparison of these methodologies. In particular, recommendations for setting up planar PIV experiments such as recommended imaging instrumentation, acquisition and data processing are discussed in the context of heart valve flows. Multiple metrics such as residence time, local velocity and shear stress that have been identified in the literature as being relevant to hemolysis and thrombosis in heart valves are discussed. Additionally, a framework for uncertainty analysis and data reporting for PIV studies of heart valves is presented in this paper. It is anticipated that this paper will provide useful information for heart valve device manufacturers and researchers to assess heart valve flow fields for the potential for hemolysis and thrombosis.

  16. Overview of PADC nuclear track readers. Recent trends and solutions

    International Nuclear Information System (INIS)

    Hulber, E.

    2009-01-01

    The development of automated track readers dates back to the first routine dosimetry applications of solid state nuclear track detectors. Many research-laboratory track readers and a few commercial systems were introduced in the past 25 years. The traditional application area for high-throughput track readers is radon testing in buildings and fast neutron dosimetry. The latter application, in particular, has considerably increased the need for efficient polyallyldiglycol carbonate (PADC) track reader systems with high throughput. The paper provides an overview of recent trends in the development of high-throughput PADC track readers and it gives a glimpse into the practice of designing this category of devices. A general overview is provided of the technical aspects relating to the optics, the hardware and the track recognition approaches. Ultimate theoretical limits in the performance as well as promising new approaches are addressed. Requirements and practical solutions are illustrated with reference to a commercially available system.

  17. eHealth in Wound Care,- overview and key issues to consider before implementation

    DEFF Research Database (Denmark)

    Moore, Zena; Angel, Donna; Bjerregaard, Julie

    2015-01-01

    Purpose This document aims to provide wound care clinicians with a rapid and structured overview of the key issues related to use of eHealth applications (telemedicine and telehealth) within wound care. This includes: • An overview of terminology and available literature • Guidance on the methodo......Purpose This document aims to provide wound care clinicians with a rapid and structured overview of the key issues related to use of eHealth applications (telemedicine and telehealth) within wound care. This includes: • An overview of terminology and available literature • Guidance...... on the methodology for evaluation of eHealth solutions • An introduction to and discussion of the potential benefits of eHealth technologies in wound care, and the possible barriers to their implementation • Recommendations for ensuring a good implementation process and supporting involvement of wound care...... professionals in safeguarding that eHealth solutions meet the needs of the patients. Methodology The document sections lean on the structure and focus areas of the Model for ASsessment of Telemedicine (MAST) which defines crucial items to evaluate an eHealth application. The content of the document is developed...

  18. Allergic Rhinitis in Children: Principles of Early Diagnosis and Effective Therapy. Overview of Clinical Recommendations

    Directory of Open Access Journals (Sweden)

    Alexander A. Baranov

    2017-01-01

    Full Text Available The article briefly summarizes the key provisions of the clinical recommendations on medical care delivery for children with allergic rhinitis: modern approaches to diagnosis and therapy. The current document was developed by the professional association of pediatric specialists —the Union of Pediatricians of Russia — together with the leading experts of the Russian Association of Allergists and Clinical Immunologists. The recommendations are regularly updated due to the latest evidence-based results of effectiveness and safety of various medical interventions. The article presents information on the epidemiology of allergic rhinitis in children, specific diagnostic features which provide the opportunity for the timely and correct diagnosis and an effective therapy with personal approach.

  19. Recommendations of the French academy of medicine

    International Nuclear Information System (INIS)

    The, G. de; Tubiana, M.

    2002-01-01

    Recently the French academy of medicine (FAM) decided to make a point concerning radiological protection and issued the 6 following recommendations and statements: 1) FAM recommends the global reduction of the radiation dose received by patients during medical examination; 2) FAM recommends to promote and develop the research work concerning the biological effects of doses lower than 100 mSv; 3) FAM recommends to reject the linear-non threshold model for low dose radiation; 4) FAM agrees with the UNSCEAR report about the consequences of the Chernobyl accident, apart from the early fatalities in rescue workers, the main health effect is an increase risk of thyroid cancer in children, in particular, there has been no evidence of increase in other cancer incidence or in congenital malformation; 5) FAM recommends the introduction of the dari as a practical dose sub-unit, 1 dari represents the dose received by the whole body for 1 year due to natural radioactivity; and 6) FAM recommends that the European directive concerning the annual limit dose, maintains its value to 100 mSv a year. (A.C.)

  20. Clustering of unhealthy lifestyle behaviors is associated with a low adherence to recommended preventive practices among COPD patients in Spain.

    Science.gov (United States)

    de Miguel-Díez, Javier; Jiménez-García, Rodrigo; Hernández-Barrera, Valentín; Maestu, Luis Puente; Aparicio, Irene Jarana; Ramos, Alicia Oliva; López de Andrés, Ana; Carrasco-Garrido, Pilar

    2014-08-01

    To analyze clustering of unhealthy lifestyle behavior and its relationship with non-adherence to recommended clinical preventive care services among Spanish COPD patients. Cross-sectional study including 2,575 COPD subjects from the 2006 Spanish National Health Survey (NHS) and 2009 European Health Survey for Spain (EHISS). Subjects were asked about the following recommended preventive practices: uptake of blood pressure (BP) measurement, lipid profile, influenza vaccination and dental examination. Lifestyle behaviors included: smoking status, physical activity, alcohol consumption and obesity. Logistic regression models were built to assess the association between clustering of unhealthy lifestyle and the uptake of preventive activities. Blood pressure measurement in the previous 6 months and a blood lipid test in the last year had not been taken by 11.74% and 23.26% of the subjects, respectively, in 2006 NHS and by 11.16% and 16.33% of the subjects, respectively, in EHISS 2009. Then, 36.36% percent had not been vaccinated and 70.61% had not received dental examination in 2006 NHS and these percentages decreased to 27.33% and 66.22%, respectively, in 2009 EHISS. A higher number of unhealthy lifestyle behaviors increased the probability of not being vaccinated and not having a dental examination. Clustering of unhealthy lifestyle behaviors is linearly associated with a greater number of preventive measures unfulfilled. Compliance with healthy lifestyles and adherence to recommended clinical preventive services is under desirable levels among Spanish COPD patients. Patients with lifestyles considered as "worse" are those who also have lower uptake of recommended preventive activities.

  1. Somatosensory evoked potentials in the assessment of peripheral neuropathies: Commented results of a survey among French-speaking practitioners and recommendations for practice.

    Science.gov (United States)

    Morizot-Koutlidis, R; André-Obadia, N; Antoine, J-C; Attarian, S; Ayache, S S; Azabou, E; Benaderette, S; Camdessanché, J-P; Cassereau, J; Convers, P; d'Anglejean, J; Delval, A; Durand, M-C; Etard, O; Fayet, G; Fournier, E; Franques, J; Gavaret, M; Guehl, D; Guerit, J-M; Krim, E; Kubis, N; Lacour, A; Lozeron, P; Mauguière, F; Merle, P-E; Mesrati, F; Mutschler, V; Nicolas, G; Nordine, T; Pautot, V; Péréon, Y; Petiot, P; Pouget, J; Praline, J; Salhi, H; Trébuchon, A; Tyvaert, L; Vial, C; Zola, J-M; Zyss, J; Lefaucheur, J-P

    2015-05-01

    Somatosensory evoked potentials (SSEPs) are increasingly performed for the assessment of peripheral neuropathies, but no practical guidelines have yet been established in this specific application. To determine the relevant indication criteria and optimal technical parameters for SSEP recording in peripheral neuropathy investigation. A survey was conducted among the French-speaking practitioners with experience of SSEP recording in the context of peripheral neuropathies. The results of the survey were analyzed and discussed to provide recommendations for practice. SSEPs appear to be a second-line test when electroneuromyographic investigation is not sufficiently conclusive, providing complementary and valuable information on central and proximal peripheral conduction in the somatosensory pathways. Guidelines for a standardized recording protocol, including the various parameters to be measured, are proposed. We hope that these proposals will help to recognize the value of this technique in peripheral neuropathy assessment in clinical practice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Recommended well drilling and testing program

    International Nuclear Information System (INIS)

    Long, J.; Wilson, C.

    1978-07-01

    A well drilling and testing program is recommended by Lawrence Berkeley Laboratory to identify the hydrology of deep basalts in the Pasco Basin. The ultimate objective of this program is to assist in determining the feasibility of locating a nuclear waste repository on the Hanford Reservation. The recommended program has been staged for maximum effectiveness. In the first stage, six wells have been identified for drilling and testing which, when coupled with existing wells, will provide sufficient data for a preliminary overview of basin hydrology and a preliminary determination of the hydrologic suitability of the deep basalt for a repository site. The rate at which the first stage wells are drilled and tested will depend upon the date at which a preliminary determination of site suitability is required. It was assumed that a preliminary determination of suitability would be required in 1980, in which case all six first stage wells would be drilled in FY 1979. If the results of the first stage analysis are favorable for repository siting, tentative repository sites can be identified and a second stage hydrology program can be implemented to provide the necessary details of the flow system. To accomplish this stage, a number of deep wells would be required at locations both inside and outside the basin, with specific sites to be identified as the work progresses to obtain maximum utility of existing data. A program is recommended for testing in each new well and for completion of testing in each existing well. Recommended tests include borehole geophysics, pressure and permeability testing, geochemical sampling, tracer testing, hydrofracturing and borehole fracture logging. The entire data collection program is oriented toward providing the information required to establish and verify an accurate numerical model of the Pasco Basin

  3. Curricular priorities for business ethics in medical practice and research: recommendations from Delphi consensus panels.

    Science.gov (United States)

    DuBois, James M; Kraus, Elena M; Gursahani, Kamal; Mikulec, Anthony; Bakanas, Erin

    2014-11-15

    No published curricula in the area of medical business ethics exist. This is surprising given that physicians wrestle daily with business decisions and that professional associations, the Institute of Medicine, Health and Human Services, Congress, and industry have issued related guidelines over the past 5 years. To fill this gap, the authors aimed (1) to identify the full range of medical business ethics topics that experts consider important to teach, and (2) to establish curricular priorities through expert consensus. In spring 2012, the authors conducted an online Delphi survey with two heterogeneous panels of experts recruited in the United States. One panel focused on business ethics in medical practice (n = 14), and 1 focused on business ethics in medical research (n = 12). Panel 1 generated an initial list of 14 major topics related to business ethics in medical practice, and subsequently rated 6 topics as very important or essential to teach. Panel 2 generated an initial list of 10 major topics related to business ethics in medical research, and subsequently rated 5 as very important or essential. In both domains, the panel strongly recommended addressing problems that conflicts of interest can cause, legal guidelines, and the goals or ideals of the profession. The Bander Center for Medical Business Ethics at Saint Louis University will use the results of the Delphi panel to develop online curricular resources for each of the highest rated topics.

  4. Recommended Practices for the Safe Design and Operation of Flywheels

    Energy Technology Data Exchange (ETDEWEB)

    Bender, Donald Arthur [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-12-01

    Flywheel energy storage systems are in use globally in increasing numbers . No codes pertaining specifically to flywheel energy storage exist. A number of industrial incidents have occurred. This protocol recommends a technical basis for safe flywheel de sign and operation for consideration by flywheel developers, users of flywheel systems and standards setting organizations.

  5. Weed management practices in natural ecosystems: a critical overview

    Directory of Open Access Journals (Sweden)

    C.F. Reinhardt

    2000-07-01

    Full Text Available Increasing public pressure against the use of pesticides and other agricultural inputs has placed increased emphasis on the development of ecologically based pest management. One distinct reaction of the Weed Science discipline has been the swing away from herbicide research to increased research on the basic biology and ecology of weeds in hopes of reduced reliance on "technological crutches" such as herbicides and other practices that are potentially harmful to the environment. Biological control is the long-standing alternative to the use of herbicides and interest in the former practice has been boosted by the realization that the use of herbicides may lead to the development of herbicide resistance in weed populations, and that herbicide residues occur in surface and groundwater. Supporters of herbicide use would point out that biological control is generally not effective in crop production systems, and is basically slow-acting. Debates between protagonists for the exclusive use of one or the other weed management practice tend to obscure the benefits that integration of different techniques are likely to have. For natural ecosystems it is proposed that integration of the more subtle practice of biological control with the use of herbicides, which relatively quickly overwhelm a biological system with mortality, is likely to be the most effective weed management tool. Different weed management practices that could be considered in natural ecosystems are discussed in terms of three key performance rating criteria, viz. activity, selec- tivity and persistence In this concise review, general discussion is focussed on the fundamentals of weed management practices, with the view to promote concept-based approaches that are critical for the development of effective weed management strate- gies.

  6. Current Hitachi knowledge engineering systems: an overview

    Energy Technology Data Exchange (ETDEWEB)

    Masui, S; Maeda, A; Masuishi, T [Hitachi, Ltd., Tokyo (Japan)

    1992-02-01

    In order to bring the knowledge engineering technology up to the practical phase, Hitachi has provided several knowledge engineering system products, including expert system building tools, knowledge acquisition tools, and many kinds of stand-alone and build-in expert systems in both the business and process control fields. In this review article, an overview of Hitachi{prime}s recent knowledge systems is described, which includes a trend analysis on recent market recognition. In addition, to introduce the Hitachi{prime}s current activities, a new product, a user interface building tool, and a new method of tuning fuzzy membership functions using a neuro-computing algorithm are also described. Furthermore, it is pointed out that not only practical tools and methodologies, but also a practical development team, including a planning section, a cooperating expert, a user section, and experienced knowledge engineers, is needed to achieve practical expert systems. 20 refs., 10 figs., 1 tab.

  7. Policies for biosimilar uptake in Europe: An overview

    Science.gov (United States)

    Vulto, Arnold G.; Huys, Isabelle; Dylst, Pieter; Godman, Brian; Keuerleber, Simon; Claus, Barbara; Dimitrova, Maria; Petrova, Guenka; Sović-Brkičić, Ljiljana; Slabý, Juraj; Šebesta, Robin; Laius, Ott; Karr, Allan; Beck, Morgane; Martikainen, Jaana E.; Selke, Gisbert W.; Spillane, Susan; McCullagh, Laura; Trifirò, Gianluca; Vella Bonanno, Patricia; Mack, Asbjørn; Fogele, Antra; Viksna, Anita; Władysiuk, Magdalena; Mota-Filipe, Helder; Meshkov, Dmitry; Kalaba, Marija; Mencej Bedrač, Simona; Fürst, Jurij; Zara, Corrine; Skiöld, Peter; Magnússon, Einar; Simoens, Steven

    2017-01-01

    Background Across European countries, differences exist in biosimilar policies, leading to variations in uptake of biosimilars and divergences in savings all over Europe. Objectives The aim of this article is to provide an overview of different initiatives and policies that may influence the uptake of biosimilars in different European countries. Recommendations will be formulated on how to create sustainable uptake. Methods An overview of policies on biosimilars was obtained via a questionnaire, supplemented with relevant articles. Topics were organized in five themes: availability, pricing, reimbursement, demand-side policies, and recommendations to enhance uptake. Results In all countries studied, biological medicines are available. Restrictions are mainly dependent on local organization of the healthcare system. Countries are willing to include biosimilars for reimbursement, but for commercial reasons they are not always marketed. In two thirds of countries, originator and biosimilar products may be subjected to internal reference pricing systems. Few countries have implemented specific incentives targeting physicians. Several countries are implementing pharmacist substitution; however, the scope and rules governing such substitution tend to vary between these countries. Reported educational policies tend to target primarily physicians, whereas fewer initiatives were reported for patients. Recommendations as proposed by the different country experts ranged from the need for information and communication on biosimilars to competitive pricing, more support for switching and guidance on substitution. Conclusions Most countries have put in place specific supply-side policies for promoting access to biosimilars. To supplement these measures, we propose that investments should be made to clearly communicate on biosimilars and educate stakeholders. Especially physicians need to be informed on the entry and use of biosimilars in order to create trust. When physicians

  8. Policies for biosimilar uptake in Europe: An overview.

    Directory of Open Access Journals (Sweden)

    Evelien Moorkens

    Full Text Available Across European countries, differences exist in biosimilar policies, leading to variations in uptake of biosimilars and divergences in savings all over Europe.The aim of this article is to provide an overview of different initiatives and policies that may influence the uptake of biosimilars in different European countries. Recommendations will be formulated on how to create sustainable uptake.An overview of policies on biosimilars was obtained via a questionnaire, supplemented with relevant articles. Topics were organized in five themes: availability, pricing, reimbursement, demand-side policies, and recommendations to enhance uptake.In all countries studied, biological medicines are available. Restrictions are mainly dependent on local organization of the healthcare system. Countries are willing to include biosimilars for reimbursement, but for commercial reasons they are not always marketed. In two thirds of countries, originator and biosimilar products may be subjected to internal reference pricing systems. Few countries have implemented specific incentives targeting physicians. Several countries are implementing pharmacist substitution; however, the scope and rules governing such substitution tend to vary between these countries. Reported educational policies tend to target primarily physicians, whereas fewer initiatives were reported for patients. Recommendations as proposed by the different country experts ranged from the need for information and communication on biosimilars to competitive pricing, more support for switching and guidance on substitution.Most countries have put in place specific supply-side policies for promoting access to biosimilars. To supplement these measures, we propose that investments should be made to clearly communicate on biosimilars and educate stakeholders. Especially physicians need to be informed on the entry and use of biosimilars in order to create trust. When physicians are well-informed on the treatment

  9. Identifying patient-centred recommendations for improving patient safety in General Practices in England: a qualitative content analysis of free-text responses using the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire.

    Science.gov (United States)

    Ricci-Cabello, Ignacio; Saletti-Cuesta, Lorena; Slight, Sarah P; Valderas, Jose M

    2017-10-01

    There is a growing interest in identifying strategies to achieve safer primary health-care provision. However, most of the research conducted so far in this area relies on information supplied by health-care providers, and limited attention has been paid to patients' perspectives. To explore patients' experiences and perceptions of patient safety in English general practices with the aim of eliciting patient-centred recommendations for improving patient safety. The Patient Reported Experiences and Outcomes of Safety in Primary Care questionnaire was sent to a random sample of 6736 primary care users registered in 45 English practices. We conducted a qualitative content analysis of responses to seven open-ended items addressing patients' experiences of safety problems, lessons learnt as a result of such experiences and recommendations for safer health care. A total of 1244 (18.4%) participants returned completed questionnaires. Of those, 678 (54.5%) responded to at least one open-ended question. Two main themes emerged as follows: (i) experiences of safety problems and (ii) good practices and recommendations to improve patient safety in primary care. Most frequent experiences of safety problems were related to appointments, coordination between providers, tests, medication and diagnosis. Patients' responses to these problems included increased patient activation (eg speaking up about concerns with their health care) and avoidance of unnecessary health care. Recommendations for safer health care included improvements in patient-centred communication, continuity of care, timely appointments, technical quality of care, active monitoring, teamwork, health records and practice environment. This study identified a number of patient-centred recommendations for improving patient safety in English general practices. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  10. Good practices according to WHO's recommendation for normal labor and birth and women's assessment of the care received: the "birth in Brazil" national research study, 2011/2012.

    Science.gov (United States)

    Baldisserotto, Marcia Leonardi; Theme Filha, Mariza Miranda; da Gama, Silvana Granado Nogueira

    2016-10-17

    The World Health Organization recommends good practices for the conduct of uncomplicated labor and birth, with the aim of improving the quality of and assessment by women of childbirth care. The aim of this study was to evaluate the association between adoption of good practices according to WHO's recommendation for normal labor and birth and assessment by women of the care received. Birth in Brazil is a national hospital-based study with countrywide representation consisting of 23,894 mothers and their newborns, conducted between February 2011 and October 2012. The present study analysed a subsample of this national survey. Postpartum women classified as low risk during pregnancy who had experienced either spontaneous or induced labor were included in this study, totalling 4102 mothers. To estimate the association between assessment by women of the childbirth care received (dependent variable) and good practices according to WHO's recommendation during normal labor and birth (independent variables), a multinomial logistic regression analysis was used and crude and adjusted odds ratios calculated with their 95 % confidence intervals. The good practices associated with positive assessment of the care received by women during labor and birth included the partner's presence, privacy in the birthing place, time available to ask questions, clarity of information received, and empathic support from caregivers during labor and birth. Freedom of movement, free nutrition offered, choice of companions, nonpharmacological analgesia, skin-to-skin contact and breastfeeding in the childbirth room were not associated with the assessment by women of the care received. Our findings reveal the importance to mothers of their relationship with the team of caregivers during labor and birth. Therefore, caregiver teams must be qualified within a more humanistic vision of childbirth health care.

  11. Transgender women, hormonal therapy and HIV treatment: a comprehensive review of the literature and recommendations for best practices.

    Science.gov (United States)

    Radix, Asa; Sevelius, Jae; Deutsch, Madeline B

    2016-01-01

    Studies have shown that transgender women (TGW) are disproportionately affected by HIV, with an estimated HIV prevalence of 19.1% among TGW worldwide. After receiving a diagnosis, HIV-positive TGW have challenges accessing effective HIV treatment, as demonstrated by lower rates of virologic suppression and higher HIV-related mortality. These adverse HIV outcomes have been attributed to the multiple sociocultural and structural barriers that negatively affect their engagement within the HIV care continuum. Guidelines for feminizing hormonal therapy among TGW recommend combinations of oestrogens and androgen blockers. Pharmacokinetic studies have shown that certain antiretroviral therapy (ART) agents, such as protease inhibitors (PIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and cobicistat, interact with ethinyl estradiol, the key oestrogen component of oral contraceptives (OCPs). The goal of this article is to provide an overview of hormonal regimens used by TGW, to summarize the known drug-drug interactions (DDIs) between feminizing hormonal regimens and ART, and to provide clinical care recommendations. The authors identified English language articles examining DDIs between oestrogen therapy, androgen blockers and ART published between 1995 and 2015 using PubMed, Cumulative Index to Nursing and Allied Health Literature and EBSCOhost. Published articles predominantly addressed interactions between ethinyl estradiol and NNRTIs and PIs. No studies examined interactions between ART and the types and doses of oestrogens found in feminizing regimens. DDIs that may have the potential to result in loss of virologic suppression included ethinyl estradiol and amprenavir, unboosted fosamprenavir and stavudine. No clinically significant DDIs were noted with other anti-retroviral agents or androgen blockers. There are insufficient data to address DDIs between ART and feminizing hormone regimens used by TGW. There is an urgent need for further research in this

  12. An exploratory qualitative assessment of factors influencing childhood vaccine providers' intention to recommend immunization in the Netherlands

    Directory of Open Access Journals (Sweden)

    Mollema Liesbeth

    2012-02-01

    Full Text Available Abstract Background Under the Dutch national immunization program (NIP, childhood vaccination is not mandatory, but its recommendation by childhood vaccine providers (CVP is important for maintaining high vaccination coverage. We therefore examined factors related to providers' intentions to recommend vaccinations to parents of young children. Methods We conducted four focus group discussions with nurses and physicians who provide vaccines to children 0-4 years old in diverse regions of the Netherlands. Three groups represented CVPs at child welfare centers (CWCs serving the general population, with the fourth representing anthroposophical CWCs. Elements of the Theory of Planned Behaviour (TPB were used to design the groups; thematic analysis was used to structure and analyze the dataset. Results Four main themes emerged, including 1 perceived responsibility: to promote vaccines and discuss pros and cons with parents (although this was usually not done if parents readily accepted the vaccination; 2 attitudes toward the NIP: mainly positive, but doubts as to NIP plans to vaccinate against diseases with a low perceived burden; 3 organizational factors: limited time and information can hamper discussions with parents; 4 relationship with parents: crucial and based mainly on communication to establish trust. Compared to CVPs at standard CWCs, the anthroposophical CWCs spent more time communicating and were more willing to adapt the NIP to individual cases. Conclusions Our qualitative assessment provides an overview of beliefs associated with providers' intention to recommend vaccinations. They were motivated to support the NIP, but their intentions to recommend vaccinations were affected by the perceived relevance of the vaccines, practical issues like limited time and by certain types of resistant parents. These results will inform future studies to test the magnitude and relative impact of these factors.

  13. Recommendations for physical and occupational therapy practice from the perspective of clients undergoing therapy for breast cancer-related impairments.

    Science.gov (United States)

    Lattanzi, Jill B; Giuliano, Susan; Meehan, Caitlin; Sander, Beth; Wootten, Rachel; Zimmerman, Amanda

    2010-01-01

    Evidence points to the efficacy of physical and occupational therapy intervention for the management of impairments and functional limitations related to the treatment of breast cancer. However, few studies give voice to the women participating in the physical rehabilitation programs intended to ameliorate their deficits. The purpose of this qualitative investigation was to explore the experience of physical rehabilitation as well as to identify recommendations for physical and occupational therapy practice from the perspective of the client undergoing therapy for breast cancer-related impairments. A phenomenological design was chosen and included a purposive sample of women (n = 10) undergoing physical rehabilitation for impairments related to breast cancer treatment. Data included semistructured interviews and artifact examination. Ten semistructured interviews were conducted at a setting of the participants' choice. Data collection continued until saturation was reached. Data analysis was cyclical and ongoing and involved all six researchers in analyzing and triangulating all pieces of data. Member checks and a peer review were conducted to confirm relevance and validity. Five themes emerged: 1) challenges with obtaining referrals, 2) challenges with patient education, 3) improvements in functional impairments, 4) emotional support, and 5) benefits of a specialized clinic environment. Consideration of the five themes led to four recommendations for physical and occupational therapist practice from the perspective of the client: 1) advocate for presurgical therapy consultations, 2) be competent in the management of all impairments and functional limitations associated with breast cancer treatment, 3) be aware of the emotional support the therapist has the capacity to provide or not provide, and 4) as much as possible, create an inviting, nonclinical environment.

  14. Applying a Social Justice Lens to Youth Mentoring: A Review of the Literature and Recommendations for Practice.

    Science.gov (United States)

    Albright, Jamie N; Hurd, Noelle M; Hussain, Saida B

    2017-06-01

    Youth mentoring interventions are often designed with the intention of promoting improved outcomes among marginalized youth. Despite their promise to reduce inequality through the provision of novel opportunities and increased social capital to marginalized youth, youth mentoring interventions hold the potential to reproduce rather than reduce inequality. In the current review, we explore literature on youth mentoring that has incorporated a social justice lens. We conclude that there is a need for greater attention to principles of social justice in the design, implementation, and evaluation of youth mentoring interventions. After reviewing the literature, we make recommendations for research and practice based on a social justice perspective and explore alternatives to traditional youth mentoring that may allow for better alignment with social justice principles. © Society for Community Research and Action 2017.

  15. Fertility preservation in women--a practical guide to preservation techniques and therapeutic strategies in breast cancer, Hodgkin's lymphoma and borderline ovarian tumours by the fertility preservation network FertiPROTEKT.

    Science.gov (United States)

    von Wolff, Michael; Montag, Markus; Dittrich, Ralf; Denschlag, Dominik; Nawroth, Frank; Lawrenz, Barbara

    2011-08-01

    Fertility preservation methods are playing an increasing role in women up to the age of 40 years because of rising survival rates in those affected by cancer. However, balanced practical recommendations concerning all relevant fertility preservation, to support doctors in counselling and treating patients, are still rare. These recommendations were prepared by the network FertiPROTEKT ( http://www.fertiprotect.eu ), a collaboration of around 70 centres in Germany, Switzerland and Austria. The recommendations were developed by specialists in reproductive medicine, reproductive biology and oncology, which gave a comprehensive overview of all named techniques as well as their benefits and risks. Furthermore, practice-orientated recommendations for the individual use of fertility preservation methods for various indications such as breast cancer, Hodgkin's lymphoma and borderline ovarian tumours are given. Various options such as ovarian stimulation and cryopreservation of unfertilised or fertilised oocytes, cryopreservation and transplantation of ovarian tissue, GnRH-agonist administration and transposition of the ovaries can be offered. All the techniques can be performed alone or in combination within a maximum of 2 weeks with low risk and different success rates. Fertility preservation in women has become an option with realistic chances to become pregnant after cytotoxic therapies. The information provided allows a well balanced and realistic counselling and treatment.

  16. Conducting a Discrete-Choice Experiment Study Following Recommendations for Good Research Practices: An Application for Eliciting Patient Preferences for Diabetes Treatments.

    Science.gov (United States)

    Janssen, Ellen M; Hauber, A Brett; Bridges, John F P

    2018-01-01

    To consolidate and illustrate good research practices in health care to the application and reporting of a study measuring patient preferences for type 2 diabetes mellitus medications, given recent methodological advances in stated-preference methods. The International Society for Pharmacoeconomics and Outcomes Research good research practices and other recommendations were used to conduct a discrete-choice experiment. Members of a US online panel with type 2 diabetes mellitus completed a Web-enabled, self-administered survey that elicited choices between treatment pairs with six attributes at three possible levels each. A D-efficient experimental design blocked 48 choice tasks into three 16-task surveys. Preference estimates were obtained using mixed logit estimation and were used to calculate choice probabilities. A total of 552 participants (51% males) completed the survey. Avoiding 90 minutes of nausea was valued the highest (mean -10.00; 95% confidence interval [CI] -10.53 to -9.47). Participants wanted to avoid low blood glucose during the day and/or night (mean -3.87; 95% CI -4.32 to -3.42) or one pill and one injection per day (mean -7.04; 95% CI -7.63 to -6.45). Participants preferred stable blood glucose 6 d/wk (mean 4.63; 95% CI 4.15 to 5.12) and a 1% decrease in glycated hemoglobin (mean 5.74; 95% CI 5.22 to 6.25). If cost increased by $1, the probability that a treatment profile would be chosen decreased by 1%. These results are consistent with the idea that people have strong preferences for immediate consequences of medication. Despite efforts to produce recommendations, ambiguity surrounding good practices remains and various judgments need to be made when conducting stated-preference studies. To ensure transparency, these judgments should be described and justified. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. Global asessment of manure management policies and practices

    NARCIS (Netherlands)

    Teenstra, E.D.; Vellinga, Th.V.; Aktasaeng, N.; Amatayaku, W.; Ndambi, A.; Pelster, D.; Germer, L.; Jenet, A.; Opio, C.; Andeweg, K.

    2014-01-01

    The Livestock and Manure Management Component (LMMC) of the CCAC Agriculture Initiative supports integrated manure management practices by increasing knowledge and awareness, removing barriers to action and enhancing practice change. This Global Assessment report provides an overview of manure

  18. Overview of Court Practice Relating to the Right of the Limited Use of Someone Else's Property in an English Law

    Directory of Open Access Journals (Sweden)

    Viktoria S. Arhipova

    2016-09-01

    Full Text Available In this article author carries out the detailed overview of the court practice concerning the right of limited use of someone else's property in system of a common law. In it definition the concept "servitude", servitude signs of an English law is given, each of them is in detail described and additional requirements which are necessary for existence of the servitude are described. In the conclusion the author emphasizes that the case law, unfortunately, has for the judge certainly no binding force. In certain cases the judge has the right to deviate from precedents and to pass the decision, new on the content. This fact proves flexibility of case law, but at the same time and some uncertainty, the choice of one of a set of the available precedents and its interpretation at discretion depends on the judge.

  19. On the new recommendation of the International Commission on Radiological Protection. Publication 60

    International Nuclear Information System (INIS)

    Chukhin, S.G.

    1994-01-01

    The International Commission on Radioligical Protection (ICRP) published in 1990 new main recommendations (Publication 60), in which the recommendations of 1977 (Publication 26) were revised and noticeable changes were introduced. The main changes in ICRP recommendations important for practical personnel are discussed. These important changes include introduction of two protection systems, which are the protection system in practice and that during intervention, conception of potential irradiation, dose and risk limits, changes in dose limits and risk coefficients, determination of the effective dose and its numerical values by changing the weighting coefficients. The problems open to arguments are formulated

  20. Good Practice Chaplaincy: An Exploratory Study Identifying the Appropriate Skills, Attitudes and Practices for the Selection, Training and Utilisation of Chaplains.

    Science.gov (United States)

    Carey, Lindsay B; Rumbold, Bruce

    2015-08-01

    This article presents an overview of exploratory research regarding the skills, knowledge, attitudes and practices considered necessary for chaplains to be highly competent in providing holistic care to clients and staff. Utilising a qualitative methodology, two focus groups comprising Salvation Army chaplains and their managers provided data about their expectations of chaplaincy personnel and about the pastoral care interventions undertaken by chaplains. The results indicated that while there were some differences in opinion, nevertheless, in overall terms, there was general agreement between chaplains and their managers about particular personal and professional qualities necessary for chaplains to be considered appropriate and proficient. Evidence was also obtained indicating a need for change with regard to the organisational attitude and culture of The Salvation Army towards chaplaincy. Recommendations are presented concerning (1) the selection criteria for chaplaincy, (2) training and utilisation of chaplains plus (3) issues relating to organizational cultural change necessary to develop a future-ready chaplaincy more suitable for the twenty-first century.

  1. Nuclear knowledge management overview at EDF

    International Nuclear Information System (INIS)

    Ballay, J.; Vannieuwenhuyse, J.; Nups, A.

    2004-01-01

    This paper gives an overview of knowledge management practices within the French nuclear generation park. The study was initially partnered by one of the 19 Nuclear Power-plants, located at Golfech near Toulouse, and then extended to a more general overview. Golfech is a 650 people unit, from which 25 of them were interviewed to carry out the study. This staff was made of managers, experts, seniors and juniors, all of them being working at Golfech in the different skills for nuclear generation needs: driving, engineering, maintenance, safety, environment, etc. They were questioned about their practices, tools and organisations concerning creating, sharing, transferring, and renewing knowledge. A general knowledge management model was derived from this study. It shows that the professional knowledge, in any industrial sector, is the result of four learning processes: an education-oriented process, a codified and normative learning process, a context-based collective learning process and an experience-based individual learning process. These learning processes inter-operate through any kind of activity, and they induce four knowledge structures: the basic knowledge, the technical knowledge, the know-how and the experiential knowledge. In conclusion, the model explains how the firm learns and, in the same time, how everybody as a single individual learns. It is a crucial point to understand how the knowledge-based economy runs, as a constant interconnection between two opposite but complementary forces: the collective and the individual ones. (author)

  2. An Overview of the Legal framework of Advanced Fee Fraud and Cybercrime in Nigeria

    Directory of Open Access Journals (Sweden)

    Mu’azu Abdullahi Saulawa

    2016-08-01

    Full Text Available The paper seeks to discuss an overview on the advanced fee fraud offences as well as cybercrime in Nigerian. The aims of the paper focus on discussing the advanced fee fraud under the related provisions of Advanced Fee Fraud Act 2006 on the success of the law in addressing the practices of crimes in relation to information technology. The paper also discusses the cybercrimes in Nigeria with a brief look out on the Cybercrime (Prohibition and Prevention Act 2015. Further, it also aims at examining the application of the law in the fraud offences which raises an issue of the regulatory framework of the cybercrime. The methodology adopted by the paper is doctrinal approach method wherein both primary and secondary sources of data were analysed, particularly the local laws and other relevant documents. The finding of the paper reveals that the relevant section of the in the Advanced Fee Fraud Act that deals with electronic communication has not been invoked. This is because the discussed relevant law under the advanced fee fraud did not in any away deal with cases concerning electronic communication under section 13. The paper recommends that there is a need to strengthen the adequacy of the legal framework on the Cybercrimes so as to checkmate such practices in Nigeria.

  3. Adolescent bariatric surgery: a systematic review of recommendation documents.

    Science.gov (United States)

    Childerhose, Janet E; Alsamawi, Amal; Mehta, Tanvi; Smith, Judith E; Woolford, Susan; Tarini, Beth A

    2017-10-01

    Bariatric surgery has been performed on adolescents since the 1970s, but little is known about the guidance offered to providers in recommendation documents published in the United States. A systematic review was conducted to generate a complete record of all US recommendation documents and describe variability across the documents. This study had 3 aims: to identify the developers, examine selection criteria, and document reasons why developers have recommended this intervention for adolescents. Four databases (MEDLINE, National Guidelines Clearinghouse, Trip, and Embase) ertr searched, followed by a hand search. Documents were eligible for inclusion if they satisfied 5 criteria: written in the English language; developed and published by a US organization; comprised a clinical practice guideline, position statement, or consensus statement; offered a minimum 1-sentence recommendation on bariatric surgery for the treatment of obesity or related co-morbidities; and offered a minimum 1-sentence recommendation on bariatric surgery for children, adolescents, or both. No date limits were applied. Sixteen recommendation documents published between 1991 and 2013 met our inclusion criteria: 10 clinical practice guidelines, 4 position statements, and 2 consensus statements. Nine were produced by medical organizations, 3 by surgical organizations, and 4 by public health/governmental bodies. One document recommended against bariatric surgery for minors, and 15 endorsed the intervention for this population. Body mass index (a measure of obesity calculated by dividing weight in kilograms by the square of height in meters) thresholds were the selection criteria most often provided. Minimum age varied widely. Of the 15 endorsing documents, 10 provided a reason for performing bariatric surgery on minors, most often to treat obesity-related co-morbidities that threaten the health of the adolescent. We make 3 suggestions to improve the quality of future recommendation documents

  4. Advice for acute low back pain: a comparison of what research supports and what guidelines recommend.

    Science.gov (United States)

    Stevens, Matthew L; Lin, Chung-Wei C; de Carvalho, Flavia A; Phan, Kevin; Koes, Bart; Maher, Chris G

    2017-10-01

    Advice is widely considered an effective treatment for acute low back pain (LBP); however, details on what and how to deliver this intervention is less clear. We assessed and compared clinical trials that test advice for acute LBP with practice guidelines for their completeness of reporting and concordance on the content, method of delivery, and treatment regimen of advice interventions. Systematic review. Advice randomized controlled trials were identified through a systematic search. Guidelines were taken from recent overviews of guidelines for LBP. Completeness of reporting was assessed using the Template for Intervention Description and Replication checklist. Thematic analysis was used to characterize advice interventions into topics across the aspects of content, method of delivery, and regimen. Concordance between clinical trials and guidelines was assessed by comparing the number of trials that found a statistically significant treatment effect for an intervention that included a specific advice topic with the number of guidelines recommending that topic. The median (interquartile range) completeness of reporting for clinical trials and guidelines was 8 (7-9) and 3 (2-4) out of nine items on the Template for Intervention Description and Replication checklist, respectively. Guideline recommendations were discordant with clinical trials for 50% of the advice topics identified. Completeness of reporting was less than ideal for randomized controlled trials and extremely poor for guidelines. The recommendations made in guidelines of advice for acute LBP were often not concordant with the results of clinical trials. Taken together, these findings mean that the potential clinical value of advice interventions for patients with acute LBP is probably not being realized. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. IRCAD recommendation on safe laparoscopic cholecystectomy.

    Science.gov (United States)

    Conrad, Claudius; Wakabayashi, Go; Asbun, Horacio J; Dallemagne, Bernard; Demartines, Nicolas; Diana, Michele; Fuks, David; Giménez, Mariano Eduardo; Goumard, Claire; Kaneko, Hironori; Memeo, Riccardo; Resende, Alexandre; Scatton, Olivier; Schneck, Anne-Sophie; Soubrane, Olivier; Tanabe, Minoru; van den Bos, Jacqueline; Weiss, Helmut; Yamamoto, Masakazu; Marescaux, Jacques; Pessaux, Patrick

    2017-11-01

    An expert recommendation conference was conducted to identify factors associated with adverse events during laparoscopic cholecystectomy (LC) with the goal of deriving expert recommendations for the reduction of biliary and vascular injury. Nineteen hepato-pancreato-biliary (HPB) surgeons from high-volume surgery centers in six countries comprised the Research Institute Against Cancer of the Digestive System (IRCAD) Recommendations Group. Systematic search of PubMed, Cochrane, and Embase was conducted. Using nominal group technique, structured group meetings were held to identify key items for safer LC. Consensus was achieved when 80% of respondents ranked an item as 1 or 2 (Likert scale 1-4). Seventy-one IRCAD HPB course participants assessed the expert recommendations which were compared to responses of 37 general surgery course participants. The IRCAD recommendations were structured in seven statements. The key topics included exposure of the operative field, appropriate use of energy device and establishment of the critical view of safety (CVS), systematic preoperative imaging, cholangiogram and alternative techniques, role of partial and dome-down (fundus-first) cholecystectomy. Highest consensus was achieved on the importance of the CVS as well as dome-down technique and partial cholecystectomy as alternative techniques. The put forward IRCAD recommendations may help to promote safe surgical practice of LC and initiate specific training to avoid adverse events. © 2017 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  6. Perioperative Management of Patients with Inflammatory Rheumatic Diseases Undergoing Major Orthopaedic Surgery: A Practical Overview.

    Science.gov (United States)

    Gualtierotti, Roberta; Parisi, Marco; Ingegnoli, Francesca

    2018-04-01

    Patients with inflammatory rheumatic diseases often need orthopaedic surgery due to joint involvement. Total hip replacement and total knee replacement are frequent surgical procedures in these patients. Due to the complexity of the inflammatory rheumatic diseases, the perioperative management of these patients must envisage a multidisciplinary approach. The frequent association with extraarticular comorbidities must be considered when evaluating perioperative risk of the patient and should guide the clinician in the decision-making process. However, guidelines of different medical societies may vary and are sometimes contradictory. Orthopaedics should collaborate with rheumatologists, anaesthesiologists and, when needed, cardiologists and haematologists with the common aim of minimising perioperative risk in patients with inflammatory rheumatic diseases. The aim of this review is to provide the reader with simple practical recommendations regarding perioperative management of drugs such as disease-modifying anti-rheumatic drugs, corticosteroids, non-steroidal anti-inflammatory drugs and tools for a risk stratification for cardiovascular and thromboembolic risk based on current evidence for patients with inflammatory rheumatic diseases.

  7. 16 CFR 1207.4 - Recommended standards for materials of manufacture.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Recommended standards for materials of manufacture. 1207.4 Section 1207.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT... materials of manufacture. (a) General. The materials used in swimming pool slides should be compatible with...

  8. PRS: PERSONNEL RECOMMENDATION SYSTEM FOR HUGE DATA ANALYSIS USING PORTER STEMMER

    OpenAIRE

    T N Chiranjeevi; R H Vishwanath

    2016-01-01

    Personal recommendation system is one which gives better and preferential recommendation to the users to satisfy their personalized requirements such as practical applications like Webpage Preferences, Sport Videos preferences, Stock selection based on price, TV preferences, Hotel preferences, books, Mobile phones, CDs and various other products now use recommender systems. The existing Pearson Correlation Coefficient (PCC) and item-based algorithm using PCC, are called as UPCC and IPCC respe...

  9. Twenty years of staffing, practice environment, and outcomes research in military nursing.

    Science.gov (United States)

    Patrician, Patricia A; Loan, Lori A; McCarthy, Mary S; Swiger, Pauline; Breckenridge-Sproat, Sara; Brosch, Laura Ruse; Jennings, Bonnie Mowinski

    Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research. The MilNOD, in combination with evidence from other health care studies, provides nurses and leaders with information about the associations between staffing, patient outcomes, and the professional practice environment of nursing in the military. Leaders, therefore, have useful empirical evidence to make data-driven decisions. The MilNOD studies are the basis for the current Army nursing dashboard, and care delivery framework, called the Patent CaringTouch System. Future research is needed to identify ideal staffing based on workload demands, and provide leaders with factors to consider when operationalizing staffing recommendations. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Recommendations for the ethical use and design of artificial intelligent care providers.

    Science.gov (United States)

    Luxton, David D

    2014-09-01

    This paper identifies and reviews ethical issues associated with artificial intelligent care providers (AICPs) in mental health care and other helping professions. Specific recommendations are made for the development of ethical codes, guidelines, and the design of AICPs. Current developments in the application of AICPs and associated technologies are reviewed and a foundational overview of applicable ethical principles in mental health care is provided. Emerging ethical issues regarding the use of AICPs are then reviewed in detail. Recommendations for ethical codes and guidelines as well as for the development of semi-autonomous and autonomous AICP systems are described. The benefits of AICPs and implications for the helping professions are discussed in order to weigh the pros and cons of their use. Existing ethics codes and practice guidelines do not presently consider the current or the future use of interactive artificial intelligent agents to assist and to potentially replace mental health care professionals. AICPs present new ethical issues that will have significant ramifications for the mental health care and other helping professions. Primary issues involve the therapeutic relationship, competence, liability, trust, privacy, and patient safety. Many of the same ethical and philosophical considerations are applicable to use and design of AICPs in medicine, nursing, social work, education, and ministry. The ethical and moral aspects regarding the use of AICP systems must be well thought-out today as this will help to guide the use and development of these systems in the future. Topics presented are relevant to end users, AI developers, and researchers, as well as policy makers and regulatory boards. Published by Elsevier B.V.

  11. Academic English Socialization through Individual Networks of Practice

    Science.gov (United States)

    Zappa-Hollman, Sandra; Duff, Patricia A.

    2015-01-01

    This article introduces the notion of individual network of practice (INoP) as a viable construct for analyzing academic (discourse) socialization in second language (L2) contexts. The authors provide an overview of social practice theories that have informed the development of INoP--community of practice (CoP; Lave & Wenger, 1991; Wenger,…

  12. Recommendations for the clinical practice: Standards, options and recommendations 2003 for the use of recombinant erythropoietin (alpha and beta epoetine, alpha darbepoetine, EPO) in the taking charge of anemia in oncology for the patients treated by radiotherapy, update

    International Nuclear Information System (INIS)

    Marchal, Ch.; Spaeth, C.; Casadevall, N.; Daouphars, M.; Marec-Berard, P.; Fabre, N.; Haugh, M.

    2004-01-01

    Standards, Options and Recommendations for the use of recombinant erythropoietin (epoietin alpha and beta darbepoietin alpha, EPO) in the management of anaemia in oncology for patient undergoing radiotherapy - UPDATE 2003. Context. - 'The Standards, Options and Recommendations' (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the twenty French cancer centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. Objectives. - To update the Standards, Options and Recommendations clinical practice guidelines for the use of recombinant erythropoietin (epoietin alpha and beta darbepoietin-alpha, EPO) in the management of anaemia in oncology for patient undergoing radiotherapy. Methods. - The working group identified the questions requiring up-dating from the previous guideline. Medline and Embase were searched using specific search strategies from January 1999 to October 2002. Literature monitoring was performed to identify randomized clinical trials published between October 2002 to November 2003. In addition several Internet sites were searched in October 2002. Results. - There is no standard attitude for use of rHuEPO in patients undergoing radiotherapy. There is no evidence to support use of rHuEPO in patients with ENT cancer receiving radiotherapy alone. In patients undergoing curative radiotherapy, it is recommended to correct anaemia under 10 g/dL using transfusion rather than rHuEPO. When the haemoglobin concentration is between 12 g/dL and 14 g/dL initial use of rHuEPO can be an option under certain conditions for radio-chemotherapy if the risk of anaemia is

  13. Technology transfer through a network of standard methods and recommended practices - The case of petrochemicals

    Science.gov (United States)

    Batzias, Dimitris F.; Karvounis, Sotirios

    2012-12-01

    Technology transfer may take place in parallel with cooperative action between companies participating in the same organizational scheme or using one another as subcontractor (outsourcing). In this case, cooperation should be realized by means of Standard Methods and Recommended Practices (SRPs) to achieve (i) quality of intermediate/final products according to specifications and (ii) industrial process control as required to guarantee such quality with minimum deviation (corresponding to maximum reliability) from preset mean values of representative quality parameters. This work deals with the design of the network of SRPs needed in each case for successful cooperation, implying also the corresponding technology transfer, effectuated through a methodological framework developed in the form of an algorithmic procedure with 20 activity stages and 8 decision nodes. The functionality of this methodology is proved by presenting the path leading from (and relating) a standard test method for toluene, as petrochemical feedstock in the toluene diisocyanate production, to the (6 generations distance upstream) performance evaluation of industrial process control systems (ie., from ASTM D5606 to BS EN 61003-1:2004 in the SRPs network).

  14. Restaurant food cooling practices.

    Science.gov (United States)

    Brown, Laura Green; Ripley, Danny; Blade, Henry; Reimann, Dave; Everstine, Karen; Nicholas, Dave; Egan, Jessica; Koktavy, Nicole; Quilliam, Daniela N

    2012-12-01

    Improper food cooling practices are a significant cause of foodborne illness, yet little is known about restaurant food cooling practices. This study was conducted to examine food cooling practices in restaurants. Specifically, the study assesses the frequency with which restaurants meet U.S. Food and Drug Administration (FDA) recommendations aimed at reducing pathogen proliferation during food cooling. Members of the Centers for Disease Control and Prevention's Environmental Health Specialists Network collected data on food cooling practices in 420 restaurants. The data collected indicate that many restaurants are not meeting FDA recommendations concerning cooling. Although most restaurant kitchen managers report that they have formal cooling processes (86%) and provide training to food workers on proper cooling (91%), many managers said that they do not have tested and verified cooling processes (39%), do not monitor time or temperature during cooling processes (41%), or do not calibrate thermometers used for monitoring temperatures (15%). Indeed, 86% of managers reported cooling processes that did not incorporate all FDA-recommended components. Additionally, restaurants do not always follow recommendations concerning specific cooling methods, such as refrigerating cooling food at shallow depths, ventilating cooling food, providing open-air space around the tops and sides of cooling food containers, and refraining from stacking cooling food containers on top of each other. Data from this study could be used by food safety programs and the restaurant industry to target training and intervention efforts concerning cooling practices. These efforts should focus on the most frequent poor cooling practices, as identified by this study.

  15. [Organizational recommendations for day surgery].

    Science.gov (United States)

    Bontemps, Gilles

    2014-03-01

    In France, the delayed development of day surgery compared to other countries led the ANAP and the HAS in 2011 to enter into a joint work program to provide some reference guide for hospitals to change their practices to outpatient. In this context, organizational guidelines and operational tools were published in May 2013. The method of construction of the recommendations resulting from an original work that combined a three-fold approach: field vision by identifying the highlights of 15 hospitals selected for their representative performance and analyzing the risks of five voluntary hospitals, mobilization organizational theories from the social sciences, using 53 professional experts. The work concluded on 16 organizational recommendations under four forms (basic principles, strategic elements, operational elements and perspectives). These recommendations are accompanied by tools and guides diagnosis and implementation, as well as productions for further reflection. These organizational recommendations confirmed the specificity of day surgery, which is not related to the act, but to the organization, management and optimization of different flows of a hospital (patient flow, professional flows, logistical, informational…). The performance of a day surgery organization is linked to its ability to control its flow and anticipation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. The use of EORTC measures in daily clinical practice-A synopsis of a newly developed manual.

    Science.gov (United States)

    Wintner, Lisa M; Sztankay, Monika; Aaronson, Neil; Bottomley, Andrew; Giesinger, Johannes M; Groenvold, Mogens; Petersen, Morten Aa; van de Poll-Franse, Lonneke; Velikova, Galina; Verdonck-de Leeuw, Irma; Holzner, Bernhard

    2016-11-01

    Cancer has increasingly become a chronic condition and the routine collection of patient-reported outcomes (PROs) like quality of life is widely recommended for clinical practice. Nonetheless, the successful implementation of PROs is still a major challenge, although common barriers to and facilitators of their beneficial use are well known. To support health care professionals and other stakeholders in the implementation of the EORTC PRO measures, the EORTC Quality of Life Group provides guidance on issues considered important for their use in daily clinical practice. Herein, we present an outline of the newly developed "'Manual for the use of EORTC measures in daily clinical practice", covering the following issues: * a rationale for using EORTC measures in routine care *selection of EORTC measures, timing of assessments, scoring and presentation of results * aspects of a strategic implementation * electronic data assessment and telemonitoring, and * further use of EORTC measures and ethical considerations. Next to an extensive overview of currently available literature, the manual specifically focuses on knowledge about EORTC measures to give evidence-based recommendations whenever possible and to encourage readers and end-users of EORTC measures to contribute to further needed high-quality research. The manual will be accessible on the EORTC Quality of Life Group website's homepage and will be periodically updated to take into account any new knowledge due to medical, technical, regulatory and scientific advances. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Automated recommendation for cervical cancer screening and surveillance.

    Science.gov (United States)

    Wagholikar, Kavishwar B; MacLaughlin, Kathy L; Casey, Petra M; Kastner, Thomas M; Henry, Michael R; Hankey, Ronald A; Peters, Steve G; Greenes, Robert A; Chute, Christopher G; Liu, Hongfang; Chaudhry, Rajeev

    2014-01-01

    Because of the complexity of cervical cancer prevention guidelines, clinicians often fail to follow best-practice recommendations. Moreover, existing clinical decision support (CDS) systems generally recommend a cervical cytology every three years for all female patients, which is inappropriate for patients with abnormal findings that require surveillance at shorter intervals. To address this problem, we developed a decision tree-based CDS system that integrates national guidelines to provide comprehensive guidance to clinicians. Validation was performed in several iterations by comparing recommendations generated by the system with those of clinicians for 333 patients. The CDS system extracted relevant patient information from the electronic health record and applied the guideline model with an overall accuracy of 87%. Providers without CDS assistance needed an average of 1 minute 39 seconds to decide on recommendations for management of abnormal findings. Overall, our work demonstrates the feasibility and potential utility of automated recommendation system for cervical cancer screening and surveillance.

  18. Clinical practice guideline: 2006 update of recommendations for the radiotherapeutic management of patients with soft tissue sarcoma (sarcoma of the extremity, uterine sarcoma and retroperitoneal sarcoma)

    International Nuclear Information System (INIS)

    Le Pechoux, C.; Pautier, P.; Le Cesne, A.; Delannes, M.; Bui, B.N.; Blay, J.Y.; Bonichon, F.; Bonvalot, S.; Morice, P.; Chevalier-Place, A.; Taieb, S.; Coindre, J.M.; Ray-Coquard, I.; Stoeckle, E.

    2006-01-01

    Context. - The National French Federation of Comprehensive Cancer Centres (FNCLCC) initiated the update of clinical practice guideline for the management of patients with soft tissue sarcoma in collaboration with the French Sarcoma Group (GSF-GETO), specialists from French public universities, general hospitals and private clinics and with the French National Cancer Institute. This work is based on the methodology developed in the 'Standards, Options and Recommendations' (SOR) project. Objectives - To update SOR guidelines for the management of patients with oft tissue sarcoma previously validated in 1995. Methods. -The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts who define the CPGs according to the definitions of the Standards, Options and Recommendations project. Once the guidelines have been developed, they are reviewed by independent reviewers. Results. - This article presents the updated recommendations for radiotherapeutic management. The main recommendations are: 1) irradiation before or after surgical treatment is the standard for soft tissue sarcoma of the extremity and uterine sarcoma; 2) no systematic irradiation should be done in case of retroperitoneal sarcoma. (author)

  19. Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in adults aged 65 years and older - Advisory Committee on Immunization Practices (ACIP), 2012.

    Science.gov (United States)

    2012-06-29

    Since 2005, the Advisory Committee on Immunization Practices (ACIP) has recommended a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine booster dose for all adolescents aged 11 through 18 years (preferred at 11 through 12 years) and for those adults aged 19 through 64 years who have not yet received a dose. In October 2010, despite the lack of an approved Tdap vaccine for adults aged 65 years and older, ACIP recommended that unvaccinated adults aged 65 years and older be vaccinated with Tdap if in close contact with an infant, and that other adults aged 65 years and older may receive Tdap. In July 2011, the Food and Drug Administration (FDA) approved expanding the age indication for Boostrix (GlaxoSmithKline Biologicals, Rixensart, Belgium) to aged 65 years and older. In February 2012, ACIP recommended Tdap for all adults aged 65 years and older. This recommendation supersedes previous Tdap recommendations regarding adults aged 65 years and older.

  20. PRACTICAL RECOMMENDATIONS OF DATA PREPROCESSING AND GEOSPATIAL MEASURES FOR OPTIMIZING THE NEUROLOGICAL AND OTHER PEDIATRIC EMERGENCIES MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Ionela MANIU

    2017-08-01

    Full Text Available Time management, optimal and timed determination of emergency severity as well as optimizing the use of available human and material resources are crucial areas of emergency services. A starting point for achieving these optimizations can be considered the analysis and preprocess of real data from the emergency services. The benefits of performing this method consist in exposing more useful structures to data modelling algorithms which consequently will reduce overfitting and improves accuracy. This paper aims to offer practical recommendations for data preprocessing measures including feature selection and discretization of numeric attributes regarding age, duration of the case, season, period, week period (workday, weekend and geospatial location of neurological and other pediatric emergencies. An analytical, retrospective study was conducted on a sample consisting of 933 pediatric cases, from UPU-SMURD Sibiu, 01.01.2014 – 27.02.2017 period.

  1. The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo.

    Science.gov (United States)

    Mohammad, Tasneem F; Al-Jamal, Mohammed; Hamzavi, Iltefat H; Harris, John E; Leone, Giovanni; Cabrera, Raúl; Lim, Henry W; Pandya, Amit G; Esmat, Samia M

    2017-05-01

    Treatment of vitiligo with narrowband ultraviolet B light (NBUVB) is an important component of the current standard of care. However, there are no consistent guidelines regarding the dosing and administration of NBUVB in vitiligo, reflected by varied treatment practices around the world. To create phototherapy recommendations to facilitate clinical management and identify areas requiring future research. The Vitiligo Working Group (VWG) Phototherapy Committee addressed 19 questions regarding the administration of phototherapy over 3 conference calls. Members of the Photomedicine Society and a group of phototherapy experts were surveyed regarding their phototherapy practices. Based on comparison and analysis of survey results, expert opinion, and discussion held during conference calls, expert recommendations for the administration of NBUVB phototherapy in vitiligo were created. There were several areas that required further research before final recommendations could be made. In addition, no standardized methodology was used during literature review and to assess the strength of evidence during the development of these recommendations. This set of expert recommendations by the VWG is based on the prescribing practices of phototherapy experts from around the world to create a unified, broadly applicable set of recommendations on the use of NBUVB in vitiligo. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Termination of resuscitation in the prehospital setting: A comparison of decisions in clinical practice vs. recommendations of a termination rule.

    Science.gov (United States)

    Verhaert, Dominique V M; Bonnes, Judith L; Nas, Joris; Keuper, Wessel; van Grunsven, Pierre M; Smeets, Joep L R M; de Boer, Menko Jan; Brouwer, Marc A

    2016-03-01

    Of the proposed algorithms that provide guidance for in-field termination of resuscitation (TOR) decisions, the guidelines for cardiopulmonary resuscitation (CPR) refer to the basic and advanced life support (ALS)-TOR rules. To assess the potential consequences of implementation of the ALS-TOR rule, we performed a case-by-case evaluation of our in-field termination decisions and assessed the corresponding recommendations of the ALS-TOR rule. Cohort of non-traumatic out-of-hospital cardiac arrest (OHCA)-patients who were resuscitated by the ALS-practising emergency medical service (EMS) in the Nijmegen area (2008-2011). The ALS-TOR rule recommends termination in case all following criteria are met: unwitnessed arrest, no bystander CPR, no shock delivery, no return of spontaneous circulation (ROSC). Of the 598 cases reviewed, resuscitative efforts were terminated in the field in 46% and 15% survived to discharge. The ALS-TOR rule would have recommended in-field termination in only 6% of patients, due to high percentages of witnessed arrests (73%) and bystander CPR (54%). In current practice, absence of ROSC was the most important determinant of termination [aOR 35.6 (95% CI 18.3-69.3)]. Weaker associations were found for: unwitnessed and non-public arrests, non-shockable initial rhythms and longer EMS-response times. While designed to optimise hospital transportations, application of the ALS-TOR rule would almost double our hospital transportation rate to over 90% of OHCA-cases due to the favourable arrest circumstances in our region. Prior to implementation of the ALS-TOR rule, local evaluation of the potential consequences for the efficiency of triage is to be recommended and initiatives to improve field-triage for ALS-based EMS-systems are eagerly awaited. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. An overview of practice and regulations concerning aircraft noise protection in Serbia

    Directory of Open Access Journals (Sweden)

    Mirković Bojana D.

    2015-01-01

    Full Text Available This paper gives an overview of studies and regulation concerning the issue of aircraft noise protection in Republic of Serbia. After crossing the limit of 50.000 operations in 2014, Airport 'Nikola Tesla' is classified as major airport, and with that urged to fulfill various requirements related to nose protection. Major airports are obliged to monitor noise, as well as to prepare strategic noise maps and action plans aiming to decrease number of people exposed to aircraft noise above acceptable level.

  4. Useful and usable alarm systems : recommended properties

    International Nuclear Information System (INIS)

    Veland, Oeystein; Kaarstad, Magnhild; Seim, Lars Aage; Foerdestroemmen, Nils T.

    2001-01-01

    This document describes the result of a study on alarm systems conducted by IFE in Halden. The study was initiated by the Norwegian Petroleum Directorate. The objective was to identify and formulate a set of important properties for useful and usable alarm systems. The study is mainly based on review of the latest international recognised guidelines and standards on alarm systems available at the time of writing, with focus on realistic solutions from research and best practice from different industries. In addition, IFE experiences gathered through specification and design of alarm systems and experimental activities in HAMMLAB and bilateral projects, have been utilized where relevant. The document presents a total of 43 recommendations divided into a number of general recommendations and more detailed recommendations on alarm generation, structuring, prioritisation, presentation and handling. (Author)

  5. Barriers and enablers to implementing multiple stroke guideline recommendations: a qualitative study.

    Science.gov (United States)

    McCluskey, Annie; Vratsistas-Curto, Angela; Schurr, Karl

    2013-08-19

    Translating evidence into practice is an important final step in the process of evidence-based practice. Medical record audits can be used to examine how well practice compares with published evidence, and identify evidence-practice gaps. After providing audit feedback to professionals, local barriers to practice change can be identified and targetted with focussed behaviour change interventions. This study aimed to identify barriers and enablers to implementing multiple stroke guideline recommendations at one Australian stroke unit. A qualitative methodology was used. A sample of 28 allied health, nursing and medical professionals participated in a group or individual interview. These interviews occurred after staff had received audit feedback and identified areas for practice change. Questions focused on barriers and enablers to implementing guideline recommendations about management of: upper limb sensory impairments, mobility including sitting balance; vision; anxiety and depression; neglect; swallowing; communication; education for stroke survivors and carers; advice about return to work and driving. Qualitative data were analysed for themes using theoretical domains described by Michie and colleagues (2005). Six group and two individual interviews were conducted, involving six disciplines. Barriers were different across disciplines. The six key barriers identified were: (1) Beliefs about capabilities of individual professionals and their discipline, and about patient capabilities (2) Beliefs about the consequences, positive and negative, of implementing the recommendations (3) Memory of, and attention to, best practices (4) Knowledge and skills required to implement best practice; (5) Intention and motivation to implement best practice, and (6) Resources. Some barriers were also enablers to change. For example, occupational therapists required new knowledge and skills (a barrier), to better manage sensation and neglect impairments while physiotherapists

  6. Protecting multi-party privacy in location-aware social point-of-interest recommendation

    KAUST Repository

    Wang, Weiqi; Liu, An; Li, Zhixu; Zhang, Xiangliang; Li, Qing; Zhou, Xiaofang

    2018-01-01

    Point-of-interest (POI) recommendation has attracted much interest recently because of its significant business potential. Data used in POI recommendation (e.g., user-location check-in matrix) are much more sparse than that used in traditional item (e.g., book and movie) recommendation, which leads to more serious cold start problem. Social POI recommendation has proved to be an effective solution, but most existing works assume that recommenders have access to all required data. This is very rare in practice because these data are generally owned by different entities who are not willing to share their data with others due to privacy and legal concerns. In this paper, we first propose PLAS, a protocol which enables effective POI recommendation without disclosing the sensitive data of every party getting involved in the recommendation. We formally show PLAS is secure in the semi-honest adversary model. To improve its performance. We then adopt the technique of cloaking area by which expensive distance computation over encrypted data is replaced by cheap operation over plaintext. In addition, we utilize the sparsity of check-ins to selectively publish data, thus reducing encryption cost and avoiding unnecessary computation over ciphertext. Experiments on two real datasets show that our protocol is feasible and can scale to large POI recommendation problems in practice.

  7. Protecting multi-party privacy in location-aware social point-of-interest recommendation

    KAUST Repository

    Wang, Weiqi

    2018-04-04

    Point-of-interest (POI) recommendation has attracted much interest recently because of its significant business potential. Data used in POI recommendation (e.g., user-location check-in matrix) are much more sparse than that used in traditional item (e.g., book and movie) recommendation, which leads to more serious cold start problem. Social POI recommendation has proved to be an effective solution, but most existing works assume that recommenders have access to all required data. This is very rare in practice because these data are generally owned by different entities who are not willing to share their data with others due to privacy and legal concerns. In this paper, we first propose PLAS, a protocol which enables effective POI recommendation without disclosing the sensitive data of every party getting involved in the recommendation. We formally show PLAS is secure in the semi-honest adversary model. To improve its performance. We then adopt the technique of cloaking area by which expensive distance computation over encrypted data is replaced by cheap operation over plaintext. In addition, we utilize the sparsity of check-ins to selectively publish data, thus reducing encryption cost and avoiding unnecessary computation over ciphertext. Experiments on two real datasets show that our protocol is feasible and can scale to large POI recommendation problems in practice.

  8. Communication in healthcare: a narrative review of the literature and practical recommendations.

    Science.gov (United States)

    Vermeir, P; Vandijck, D; Degroote, S; Peleman, R; Verhaeghe, R; Mortier, E; Hallaert, G; Van Daele, S; Buylaert, W; Vogelaers, D

    2015-11-01

    Effective and efficient communication is crucial in healthcare. Written communication remains the most prevalent form of communication between specialised and primary care. We aimed at reviewing the literature on the quality of written communication, the impact of communication inefficiencies and recommendations to improve written communication in healthcare. Narrative literature review. A search was carried out on the databases PubMed, Web of Science and The Cochrane Library by means of the (MeSH)terms 'communication', 'primary health care', 'correspondence', 'patient safety', 'patient handoff' and 'continuity of patient care'. Reviewers screened 4609 records and 462 full texts were checked according following inclusion criteria: (1) publication between January 1985 and March 2014, (2) availability as full text in English, (3) categorisation as original research, reviews, meta-analyses or letters to the editor. A total of 69 articles were included in this review. It was found that poor communication can lead to various negative outcomes: discontinuity of care, compromise of patient safety, patient dissatisfaction and inefficient use of valuable resources, both in unnecessary investigations and physician worktime as well as economic consequences. There is room for improvement of both content and timeliness of written communication. The delineation of ownership of the communication process should be clear. Peer review, process indicators and follow-up tools are required to measure the impact of quality improvement initiatives. Communication between caregivers should feature more prominently in graduate and postgraduate training, to become engraved as an essential skill and quality characteristic of each caregiver. © 2015 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

  9. TH-A-BRC-00: New Task Groups for External Beam QA: An Overview

    International Nuclear Information System (INIS)

    2016-01-01

    AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance - Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline

  10. TH-A-BRC-00: New Task Groups for External Beam QA: An Overview

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance - Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline

  11. Medical Informatics in Clinical Practice: An Overview. | Okoromah ...

    African Journals Online (AJOL)

    Providing a high-quality service to patients involves having the right information at the ... Knowledge and practice and application of computer technology in both ... informatics and to stimulate interest in computer support in health care in our ...

  12. Energy and architecture — An overview

    Science.gov (United States)

    Sonetti, G.

    2013-06-01

    This paper aims to provide a short overview on the complex aspects and growing concern about energy in architecture by gradually zooming into it, starting from a macro-scale analysis of building contribution in the total EU energy consumption, related policies, user behaviour's impacts and vernacular architecture techniques; then looking at the meso scale of building energy performance during its use, dynamic simulations of heat transfer and insights from a whole life cycle analysis of the energy involved during construction and disposal phases; finally, at the building element micro-scale, describing local heat transfer and human thermal comfort measurements. Conclusions gather recommendations and further scenarios where different stakeholders and techniques can play their part for a wiser and more sustainable energy use, and a better built environment for us and those to come.

  13. Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

    Directory of Open Access Journals (Sweden)

    Luca Busetto

    2017-12-01

    Full Text Available Bariatric surgery is today the most effective long-term therapy for the management of patients with severe obesity, and its use is recommended by the relevant guidelines of the management of obesity in adults. Bariatric surgery is in general safe and effective, but it can cause new clinical problems and is associated with specific diagnostic, preventive and therapeutic needs. For clinicians, the acquisition of special knowledge and skills is required in order to deliver appropriate and effective care to the post-bariatric patient. In the present recommendations, the basic notions needed to provide first-level adequate medical care to post-bariatric patients are summarised. Basic information about nutrition, management of co-morbidities, pregnancy, psychological issues as well as weight regain prevention and management is derived from current evidences and existing guidelines. A short list of clinical practical recommendations is included for each item. It remains clear that referral to a bariatric multidisciplinary centre, preferably the one performing the original procedure, should be considered in case of more complex clinical situations.

  14. Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

    Science.gov (United States)

    Busetto, Luca; Dicker, Dror; Azran, Carmil; Batterham, Rachel L.; Farpour-Lambert, Nathalie; Fried, Martin; Hjelmesæth, Jøran; Kinzl, Johann; Leitner, Deborah R.; Makaronidis, Janine M.; Schindler, Karin; Toplak, Hermann; Yumuk, Volkan

    2018-01-01

    Bariatric surgery is today the most effective long-term therapy for the management of patients with severe obesity, and its use is recommended by the relevant guidelines of the management of obesity in adults. Bariatric surgery is in general safe and effective, but it can cause new clinical problems and is associated with specific diagnostic, preventive and therapeutic needs. For clinicians, the acquisition of special knowledge and skills is required in order to deliver appropriate and effective care to the post-bariatric patient. In the present recommendations, the basic notions needed to provide first-level adequate medical care to post-bariatric patients are summarised. Basic information about nutrition, management of co-morbidities, pregnancy, psychological issues as well as weight regain prevention and management is derived from current evidences and existing guidelines. A short list of clinical practical recommendations is included for each item. It remains clear that referral to a bariatric multidisciplinary centre, preferably the one performing the original procedure, should be considered in case of more complex clinical situations. PMID:29207379

  15. Islamic Cultures: Health Care Beliefs and Practices.

    Science.gov (United States)

    Kemp, Charles

    1996-01-01

    Presents an overview of Islamic health care beliefs and practices, noting health-related social and spiritual issues, fundamental beliefs and themes in Islam, health care beliefs and practices common among Muslims, and health-affecting social roles among Muslims. Cultural, religious, and social barriers to health care and ways to reduce them are…

  16. Contemporaneous International Asthma Guidelines Present Differing Recommendations: An Analysis

    Directory of Open Access Journals (Sweden)

    Samir Gupta

    2016-01-01

    Full Text Available Background. Several international groups develop asthma guidelines. Conflicting recommendations across guidelines have been described in several disease areas and may contribute to practice variability. Accordingly, we compared the latest Canadian Thoracic Society (CTS asthma guideline with contemporaneous international asthma guidelines to evaluate conflicting recommendations and their causes. Methods. We identified the latest CTS asthma guideline update (2012 and the following societies which also updated their guidelines in 2012: the British Thoracic Society and Scottish Intercollegiate Guidelines Network and the Global Initiative for Asthma. We compared these three guidelines on (1 key methodological factors and (2 adult pharmacotherapy recommendations. Results. Methods used and documentation provided for literature search strategy and dates, evidence synthesis, outcomes considered, evidence appraisal, and recommendation formulation varied between guidelines. Criteria used to define suboptimal asthma control varied widely between guidelines. Inhaled corticosteroid dosing recommendations diverged, as did recommendations surrounding use of budesonide/formoterol as a reliever and controller and recommendations in the subsequent step. Conclusions. There are important differences between recommendations provided in contemporaneous asthma guidelines. Causes include differences in methods used for interpreting evidence and formulating recommendations. Adopting a common set of valid and explicit methods across international societies could harmonize recommendations and facilitate guideline implementation.

  17. A nurse-led clinic for patients consulting with osteoarthritis in general practice: development and impact of training in a cluster randomised controlled trial.

    Science.gov (United States)

    Healey, Emma L; Main, Chris J; Ryan, Sarah; McHugh, Gretl A; Porcheret, Mark; Finney, Andrew G; Morden, Andrew; Dziedzic, Krysia S

    2016-12-21

    Despite a lack of service provision for people with osteoarthritis (OA), each year 1 in 5 of the general population consults a GP about a musculoskeletal condition such as OA. Consequently this may provide an opportunity for practice nurses to take an active role in helping patients manage their condition. A nurse led clinic for supporting patients with OA was developed for the MOSAICS study investigating how to implement the NICE 2014 OA Guideline core recommendations. This paper has two main objectives, firstly to provide an overview of the nurse-led OA clinic, and secondly to describe the development, key learning objectives, content and impact of the training to support its delivery. A training programme was developed and delivered to provide practice nurses with the knowledge and skill set needed to run the nurse-led OA clinic. The impact of the training programme on knowledge, confidence and OA management was evaluated using case report forms and pre and post training questionnaires. The pre-training questionnaire identified a gap between what practice nurses feel they can do and what they should be doing in line with NICE OA guidelines. Evaluation of the training suggests that it enabled practice nurses to feel more knowledgeable and confident in supporting patients to manage their OA and this was reflected in the clinical management patients received in the nurse-led OA clinics. A significant gap between what is recommended and what practice nurses feel they can currently provide in terms of OA management was evident. The development of a nurse training programme goes some way to develop a system in primary care for delivering the core recommendations by NICE. The cluster trial linked to this training was conducted from May 2012 through February 2014 by the Arthritis Research UK Primary Care Centre, Keele University, UK (Trial registration number ISRCTN06984617 ).

  18. A modified Delphi method toward multidisciplinary consensus on functional convalescence recommendations after abdominal surgery.

    Science.gov (United States)

    van Vliet, Daphne C R; van der Meij, Eva; Bouwsma, Esther V A; Vonk Noordegraaf, Antonie; van den Heuvel, Baukje; Meijerink, Wilhelmus J H J; van Baal, W Marchien; Huirne, Judith A F; Anema, Johannes R

    2016-12-01

    Evidence-based information on the resumption of daily activities following uncomplicated abdominal surgery is scarce and not yet standardized in medical guidelines. As a consequence, convalescence recommendations are generally not provided after surgery, leading to patients' insecurity, needlessly delayed recovery and prolonged sick leave. The aim of this study was to generate consensus-based multidisciplinary convalescence recommendations, including advice on return to work, applicable for both patients and physicians. Using a modified Delphi method among a multidisciplinary panel of 13 experts consisting of surgeons, occupational physicians and general practitioners, detailed recommendations were developed for graded resumption of 34 activities after uncomplicated laparoscopic cholecystectomy, laparoscopic and open appendectomy, laparoscopic and open colectomy and laparoscopic and open inguinal hernia repair. A sample of occupational physicians, general practitioners and surgeons assessed the recommendations on feasibility in daily practice. The response of this group of care providers was discussed with the experts in the final Delphi questionnaire round. Out of initially 56 activities, the expert panel selected 34 relevant activities for which convalescence recommendations were developed. After four Delphi rounds, consensus was reached for all of the 34 activities for all the surgical procedures. A sample of occupational physicians, general practitioners and surgeons regarded the recommendations as feasible in daily practice. Multidisciplinary convalescence recommendations regarding uncomplicated laparoscopic cholecystectomy, appendectomy (laparoscopic, open), colectomy (laparoscopic, open) and inguinal hernia repair (laparoscopic, open) were developed by a modified Delphi procedure. Further research is required to evaluate whether these recommendations are realistic and effective in daily practice.

  19. Recommendations for citizen-oriented risk communication

    International Nuclear Information System (INIS)

    Fertmann, R.

    2005-01-01

    The purpose of recommendations for citizen-oriented risk communication should be to provide ''banisters'' which leave the players their freedom of action and allow them to adapt communicative structures to the situation at hand. Uncertainty and controversial issues at the levels of information, participation and assessment are identified as potential stumbling blocks in risk communication. The experiences gained in Hamburg shed a light on a diversity of processes in risk communication, which the present paper proceeds to evaluate. One of its essential recommendations is to have dialogic processes develop into forms of participation. A guide on risk communication which was formulated in the USA has been adapted to conditions as they prevail in Germany. The adapted version is more practically oriented than the rules of the EPA or the more recent CDC recommendations. Suitable success criteria include a fair procedure, a common baseline of what is known and not known, the acceptance of different assessment criteria, and the exchange of the pros and cons of different options

  20. Cutaneous epidermoid carcinoma (spinocellular carcinoma): clinical practice recommendations for diagnosis and therapy. Full report

    International Nuclear Information System (INIS)

    Martin, Ludovic; Bonerandi, Jean-Jacques; Brugneaux, Julie; Beauvillain, Claude; Chassagne, Jean-Francois; Clavere, Pierre; Grolleau, Jean-Louis; Grossin, Maggy; Sei, Jean-Francois; Caquant, Ludovic; Chaussade, Veronique; Desouches, Christophe; Garnier, Francois; Jourdain, Alain; Lemonnier, Jean-Yves; Maillard, Herve; Ortonne, Nicolas; Rio, Emmanuel; Simon, Etienne

    2009-01-01

    This guide aims at providing practitioners taking into care patients presenting a cutaneous cancer with recommendations based on scientific evidences or expert agreements. More precisely, the objectives are to clarify the terminology used to describe the different forms of cutaneous epidermoid carcinoma (CEC) and of their precursors (actinic keratosis, Bowen's disease), to propose a prognosis classification of CECs adapted to the previously identified prognosis factors, to optimise the diagnosis and therapy of actinic keratosis and Bowen's disease according to recent publications, and to recall the principles of a primary prevention of CECs and of their precursors, and of screening of high risk individuals. Thus, the different parts of this report address the following issues: anatomic-clinical forms and epidemiology of CECs and of their precursors, prognosis factors of CECs, means of treatment of CECs and of their precursors (medical, physical, surgical, radiation-based, and chemical treatments). Radiotherapy notably comprises external radiotherapy and interstitial brachytherapy. Indications for radiotherapy are discussed with respect to existing guides and to the clinical situation. The authors address the care of CECs and of their precursors (prevention, screening and clinical diagnosis, care of invasive CECs, keratoacanthoma treatment). They finally discuss quality criteria aimed at practice improvement, and perspectives regarding the evolution of this guide and studies to be performed

  1. Exercise recommendations in patients with newly diagnosed fibromyalgia.

    Science.gov (United States)

    Wilson, Brad; Spencer, Horace; Kortebein, Patrick

    2012-04-01

    To evaluate exercise recommendations in patients newly diagnosed with fibromyalgia. A retrospective chart review. A public university rheumatology clinic. Patients newly diagnosed with fibromyalgia (N = 122). Frequency and type of exercise recommendations. The mean (standard deviation) age of these patients with fibromyalgia was 45 ± 12 years; 91% were women. Exercise was recommended as part of the documented treatment plan in 47% of these patients (57/122); only 3 patients had a documented contraindication for exercise. Aquatic exercise was most frequently recommended (56% [32/57]), followed by combined aquatic-aerobic exercise (26% [15/57]), and, infrequently, aerobic exercise only (5% [3/57]); only 7% of these patients (4/57) were referred for physical therapy. The primary method of communication was verbal discussion (94% [54/57]). Although there is well-documented evidence that exercise is beneficial for patients with fibromyalgia, we found that less than half of patients with newly diagnosed fibromyalgia in our study were provided recommendations to initiate an exercise program as part of their treatment plan. Further investigation of these findings are warranted, including evaluation of other university and community rheumatology practices as well as that of other physicians caring for patients with fibromyalgia. However, our findings indicate that there appears to be an opportunity to provide more specific and practical education regarding the implementation of an exercise regimen for patients with newly diagnosed fibromyalgia. Physiatrists may be particularly well suited to manage the exercise component of patients with fibromyalgia because of their specialized training in exercise prescription. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  2. A historical overview of traditional medicine practices and policy in ...

    African Journals Online (AJOL)

    Background: Although traditional medicine plays an important role in Ethiopian society, knowledge about the extent and characteristics of traditional healing practices and practitioners is limited and has frequently been ignored in the national health system. Objective: To review history of practices and policies on traditional ...

  3. A Global Assessment on Climate Research Engaging Indigenous Knowledge Systems and Recommendations for Quality Standards of Research Practice in Indigenous Communities

    Science.gov (United States)

    Davíd-Chavez, D. M.; Gavin, M. C.

    2017-12-01

    . This study also draws from the researcher's experiences as an Indigenous scientist and includes recommendations for quality research practice. This global assessment provides an evidence base to inform our understanding of broader impacts related to research design.

  4. Survey of independent inventors: An overview

    Energy Technology Data Exchange (ETDEWEB)

    Whalley, P.

    1992-12-01

    Independent inventors are important but little-researched members of the US technical community. The survey reported on here is the first in modern times to attempt to provide a profile of the US independent inventor that goes beyond a single geographical or organizational locale. The report that follows provides an overview of the demographics, practices and concerns of the modern US inventor as represented by the members of leading US inventor organizations. It is by no means comprehensive but seeks to be indicative of the issues raised in the survey each which will be dealt with more comprehensively in future publications.

  5. An overview of the national immunization policy making process: the role of the Korea expert committee on immunization practices

    Science.gov (United States)

    2012-01-01

    The need for evidence-based decision making in immunization programs has increased due to the presence of multiple health priorities, limited human resources, expensive vaccines, and limited funds. Countries should establish a group of national experts to advise their Ministries of Health. So far, many nations have formed their own National Immunization Technical Advisory Groups (NITAGs). In the Republic of Korea, the Korea Expert Committee on Immunization Practices (KECIP), established by law in the early 1990s, has made many important technical recommendations to contribute to the decline in vaccine preventable diseases and currently functions as a NITAG. It includes 13 core members and 2 non-core members, including a chairperson. Core members usually come from affiliated organizations in internal medicine, pediatrics, obstetrics, microbiology, preventive medicine, nursing and a representative from a consumer group, all of whom serve two year terms. Non-core members comprise two government officials belonging to the Korea Centers for Disease Control and Prevention (KCDC) and the Korea Food and Drug Administration. Meetings are held as needed, but at least twice a year, and sub-committees are formed as a resource for gathering, analyzing, and preparing information for the KECIP meetings. Once the sub-committees or the KCDC review the available data, the KECIP members discuss each issue in depth and develop recommendations, usually by a consensus in the meeting. The KECIP publishes national guidelines and immunization schedules that are updated regularly. KECIP's role is essentially consultative and the implementation of their recommendations may depend on the budget or current laws. PMID:22359523

  6. An overview of the national immunization policy making process: the role of the Korea expert committee on immunization practices

    Directory of Open Access Journals (Sweden)

    Hee Yeon Cho

    2012-01-01

    Full Text Available The need for evidence-based decision making in immunization programs has increased due to the presence of multiple health priorities, limited human resources, expensive vaccines, and limited funds. Countries should establish a group of national experts to advise their Ministries of Health. So far, many nations have formed their own National Immunization Technical Advisory Groups (NITAGs. In the Republic of Korea, the Korea Expert Committee on Immunization Practices (KECIP, established by law in the early 1990s, has made many important technical recommendations to contribute to the decline in vaccine preventable diseases and currently functions as a NITAG. It includes 13 core members and 2 non-core members, including a chairperson. Core members usually come from affiliated organizations in internal medicine, pediatrics, obstetrics, microbiology, preventive medicine, nursing and a representative from a consumer group, all of whom serve two year terms. Non-core members comprise two government officials belonging to the Korea Centers for Disease Control and Prevention (KCDC and the Korea Food and Drug Administration. Meetings are held as needed, but at least twice a year, and sub-committees are formed as a resource for gathering, analyzing, and preparing information for the KECIP meetings. Once the sub-committees or the KCDC review the available data, the KECIP members discuss each issue in depth and develop recommendations, usually by a consensus in the meeting. The KECIP publishes national guidelines and immunization schedules that are updated regularly. KECIP’s role is essentially consultative and the implementation of their recommendations may depend on the budget or current laws.

  7. New method of assigning uncertainty in volume calibration

    International Nuclear Information System (INIS)

    Lechner, J.A.; Reeve, C.P.; Spiegelman, C.H.

    1980-12-01

    This paper presents a practical statistical overview of the pressure-volume calibration curve for large nuclear materials processing tanks. It explains the appropriateness of applying splines (piecewise polynomials) to this curve, and it presents an overview of the associated statistical uncertainties. In order to implement these procedures, a practical and portable FORTRAN IV program is provided along with its users' manual. Finally, the recommended procedure is demonstrated on actual tank data collected by NBS

  8. Solar Ready: An Overview of Implementation Practices

    Energy Technology Data Exchange (ETDEWEB)

    Watson, A.; Guidice, L.; Lisell, L.; Doris, L.; Busche, S.

    2012-01-01

    This report explores three mechanisms for encouraging solar ready building design and construction: solar ready legislation, certification programs for solar ready design and construction, and stakeholder education. These methods are not mutually exclusive, and all, if implemented well, could contribute to more solar ready construction. Solar ready itself does not reduce energy use or create clean energy. Nevertheless, solar ready building practices are needed to reach the full potential of solar deployment. Without forethought on incorporating solar into design, buildings may be incompatible with solar due to roof structure or excessive shading. In these cases, retrofitting the roof or removing shading elements is cost prohibitive. Furthermore, higher up-front costs due to structural adaptations and production losses caused by less than optimal roof orientation, roof equipment, or shading will lengthen payback periods, making solar more expensive. With millions of new buildings constructed each year in the United States, solar ready can remove installation barriers and increase the potential for widespread solar adoption. There are many approaches to promoting solar ready, including solar ready legislation, certification programs, and education of stakeholders. Federal, state, and local governments have the potential to implement programs that encourage solar ready and in turn reduce barriers to solar deployment. With the guidance in this document and the examples of jurisdictions and organizations already working to promote solar ready building practices, federal, state, and local governments can guide the market toward solar ready implementation.

  9. Feasability study for waterway infrastructure: International overview and methodological recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Santos Fontes Pereira, L. dos; Brandão, R.; Yamashita, Y.; Guilherme de Aragão, J.J.

    2016-07-01

    The context in which the waterway transportation is in Brazil makes clear the development need of specific methodologies for the sector planning. This paper aims to compare the methods of analysis of technical, economic and environmental viability, adopted in Europe, United States and Brazil, listing the best practices and possible improvements of the method adopted in Brazil. The analysis of the documents was based on comparative method, seeking the common elements from its attributes. Each document was analysed in terms of: its structure; type of impacts; required indicators on each impact analysis; reference values for classification of indicators; and the form of integrated analysis of different impacts. The study suggests the inclusion of certain changes in the methodology of calculation and in its combination of tools and parameters used in the measurement of fiscal impacts on the comparative analysis of standard models usually adopted in the United States, Europe and the World Bank. (Author)

  10. Recommended general safety requirements for nuclear power plants

    International Nuclear Information System (INIS)

    1983-06-01

    This report presents recommendations for a set of general safety requirements that could form the basis for the licensing of nuclear power plants by the Atomic Energy Control Board. In addition to a number of recommended deterministic requirements the report includes criteria for the acceptability of the design of such plants based upon the calculated probability and consequence (in terms of predicted radiation dose to members of the public) of potential fault sequences. The report also contains a historical review of nuclear safety principles and practices in Canada

  11. Islamic Beliefs and Practices.

    Science.gov (United States)

    Sefein, Naim A.

    1981-01-01

    To help social studies classroom teachers present a realistic picture of the Middle Eastern religion of Islam, this article presents an overview of major beliefs and religious practices of Moslems. Information is presented on religious fundamentals, Islam's relationship to Judaism and Christianity, the development of Islam, the role of women, and…

  12. Association between patients' recommendation of their GP and their evaluation of the GP.

    Science.gov (United States)

    Vedsted, Peter; Heje, Hanne N

    2008-01-01

    Patient priorities and patient evaluations indicate that accessibility should receive more attention to increase quality in general practice. The definition of family medicine emphasizes the patient-centred approach, communication skills, continuity, and clinical skills. We aimed to explore the associations between the 23 items in the Europep questionnaire measuring patient evaluation of general practice and the patients' recommendation of their general practitioner (GP) to friends and to study the relationship of these items with the core competences of family medicine. Cross-sectional study where patients aged 18 years and over attending the practice were included. Patients completed the Danish version of the 23 item Europep questionnaire and an additional item about the degree to which they could recommend their GP to friends. Danish general practice (the DanPEP study). A total of 50 191 patients and 690 GPs were included in the analyses. For each item, associations were calculated between a positive answer and the degree to which the patient could recommend the GP. Analyses were made at patient and GP levels. We found 12 items that covered the 10 most strongly associated items from both analyses: four of six items from the "doctor-patient relationship", two of five items from "medical care", and all items from "information and support" and "organization of services". No items from "accessibility" were among the 12 items. Recommending the GP to others was most strongly associated with the "emphatic", "patient-oriented", "informative and coordinating", and "competent/skilled" GP and to a lesser degree with accessibility to general practice.

  13. Overview of Substance Use and Mental Health Among the "Baby Boomers" Generation.

    Science.gov (United States)

    Cleary, Michelle; Sayers, Jan; Bramble, Marguerite; Jackson, Debra; Lopez, Violeta

    2017-01-01

    As the population ages, risk factors commonly shared by chronic degenerative disease can be exacerbated by behaviours and lifestyle choices. There is increasing evidence that those affected by chronic disease (and associated symptoms such as pain), depression and adverse behavioural and lifestyle patterns are at risk of substance misuse. This paper overviews substance use in Baby Boomers, which are defined as people aged between 52-70 years old, and the implications this may have on their mental health and well-being. We provide an overview of the characteristics of the Baby Boomer generation, their health status and what is currently known about their substance use and misuse. A strengthening of older adult mental health outpatient services is recommended to prevent and address substance use among older adults. Further research examining factors that influence substance use among this group could better inform health promotion programs targeting Baby Boomers.

  14. Evidence-based practice of periodontics.

    Science.gov (United States)

    Cobb, Charles M; MacNeill, Simon R; Satheesh, Keerthana

    2010-01-01

    Evidence-based practice involves complex and conscientious decision making based not only on the available evidence but also on patient characteristics, situations, and preferences. It recognizes that care is individualized and ever-changing and involves uncertainties and probabilities. The specialty of periodontics has abundant high-level evidence upon which treatment decisions can be determined. This paper offers a brief commentary and overview of the available evidence commonly used in the private practice of periodontics.

  15. Nursing-led management of side effects of radiation: evidence-based recommendations for practice

    Directory of Open Access Journals (Sweden)

    Poirier P

    2013-03-01

    Full Text Available Patricia PoirierUniversity of Maine School of Nursing, Orono, ME, USAAbstract: It has been estimated that 50%–60% of patients diagnosed with cancer will receive radiation therapy at some point in their treatment. Although radiation therapy can play a significant role in the cure or control of cancer, and the palliation of symptoms, it also has side effects. Side effects of radiation therapy can interfere with patient quality of life and daily functioning. Severe side effects can lead to delays in treatment, potentially affecting the outcome of treatment. All patients receiving radiation therapy are at risk of fatigue and skin reactions in the area of the body being treated. Other side effects of radiation therapy are specific to the part of the body being treated. Radiation therapy to the head and neck area may cause oral mucositis, dryness, and nutritional deficiencies. Radiation therapy to the chest or lung area may lead to difficulty in swallowing and eating. Radiation therapy to the pelvis frequently causes diarrhea. There are many nursing interventions available to manage the side effects of treatment based on best available evidence and expert opinion. Nurses in all settings are essential in helping patients manage the side effects of treatment and maintain their quality of life. The purpose of this review is to provide nurses with evidence-based recommendations and suggestions for managing common acute side effects of radiation therapy.Keywords: evidence-based practice, radiation therapy, side effects, nursing management

  16. An overview of exhaust emissions regulatory requirements and control technology for stationary natural gas engines

    International Nuclear Information System (INIS)

    Ballard, H.N.; Hay, S.C.; Shade, W.N. Jr.

    1992-01-01

    In this paper a practical overview of stationary natural gas engine exhaust emissions control technology and trends in emissions regulatory requirements is presented. Selective and non-selective catalytic reduction and lean burn technologies are compared. Particular emphasis is focussed on implications of the Clean Air Act of 1990. Recent emissions reduction conversion kit developments and a practical approach to continuous monitoring are discussed

  17. Practical implications of the ICRP recommendations (1977) and the revised IAEA basic safety standards for radiation protection

    International Nuclear Information System (INIS)

    1979-01-01

    Full text: The Seminar provided a forum for exchange of views concerning the practical problems associated with the implementation of the recommendations published in ICRP report No. 26 The papers presented and the discussions which followed will greatly help the IAEA, WHO, ILO and OECD/NEA to finalize the draft of the Basic Safety Standards for Radiation Protection. The papers and discussions centered mainly on three items - risk assessments and the associated detriment which might result from exposure to ionizing radiation as encountered in radiation work, optimization of protection; and some practical difficulties associated with the implementation of the recommendations Examples of the application of optimization were presented which helped clarify the methodology of optimizing protection. General and panel discussions helped to clarify the question of intuitive versus quantitative optimization. The consensus was that optimization of protection is mainly an intuitive operation, the quantitative tools being an aid to the process. These tools are more important in optimizing the design of installations and equipment, while the process is less quantitative in the case of optimization of operations. The value of the man-rem was discussed in a few papers and in panel and other discussions. It became clear that its value can be different in different cases of justification and different again in justification and optimization assessments. Therefore a range of values is needed rather than a single universal value. However, for optimization assessments where parts of the collective dose occur in different countries, the principal of geographical equity was advocated, implying the same value to the man-rem in all countries. Some papers and discussions centered around the identification and evaluation of detriment. Two types of detriment were identified, namely 'objective' detriment (composed of stochastic effects which could be assessed f r om knowledge of the

  18. Australian health professionals' health website recommendation trends.

    Science.gov (United States)

    Usher, Wayne T

    2011-08-01

    This study was concerned with indentifying motivations and trends associated with a health website recommendation from eight of Australia's major health professions to the health consumer. Health professions included in this study are: psychiatrists, general practitioners, social workers, dietitians, chiropractors, physiotherapists, optometrists and pharmacists. An online survey (www.limesurvey.org) was developed from a common set of questions negotiated between all eight health professions. Survey questions were constructed in an attempt to identify participants' reasons for or against recommending a health website to a patient. A 5-point scale (not, slightly, neutral, moderately, strongly) to measure influence was used throughout the question set. This study indicates that Australian general practitioners (GPs) were the highest Australian health professionals to undertake a health website recommendation (86%), followed by psychiatrists (80%), with the lowest being physiotherapists (42%) and optometrists (33%). A profile of the Australian health professional who recommends a health website is identified as male, aged above 50 years, has had more than 10 years experience, works in a major city, is in private practice and has patient numbers exceeding 500 in a 12-month period (2009). Recommendations from this study include the need to develop mechanisms that identify high-quality online medical information and the development and implementation of Continuing Professional Development (CPD) courses which up-skill health professionals concerning the recommendation of health websites for health care delivery.

  19. Evaluation of training effectiveness- overview of principles, problems and practices in Sweden

    International Nuclear Information System (INIS)

    Andersson, Haakan

    2003-01-01

    Evaluation of training is a complex concept that involves many interrelated activities. Successful evaluation studies require a basic understanding of this complexity. Evaluation of training and training effects is therefore a part of the basic instructor-training program at KSU, The Swedish nuclear training and safety centre. Complex evaluation studies require, however, preconditions that far from always can be met. It is therefore also important to learn from successful evaluation studies and try to extrapolate the conclusions to other similar situations. A short overview of one such study at a Swedish nuclear power plant is presented. (author)

  20. An overview of dental radiology: a primer on dental radiology

    International Nuclear Information System (INIS)

    Manny, E.F.; Carlson, K.C.; McClean, P.M.; Rachlin, J.A.; Segal, P.

    1980-01-01

    To provide medical and scientific background on certain selected technologies generally considered to be of particular significance, the National Center for Health Care Technology (NCHCT) has commissioned a series of overview papers. This is one of several projects entered into jointly by the Bureau of Radiological Health (BRH) and NCHCT relating to the use of radiation for health care. Dental radiation protection has been a long-time interest of BRH. Both past and on-going efforts to minimize population radiation exposure from electronic products have included specific action programs directed at minimizing unnecessary radiation exposure to the population from dental radiology. Current efforts in quality assurance and referral criteria are two aspects of NCHCT's own assessment of this technology which are described within the larger picture presented in this overview. The issues considered in this document go beyond the radiation exposure aspects of dental x-ray procedures. To be responsive to the informational needs of NCHCT, the assessment includes various other factors that influence the practice of dental radiology. It is hoped this analysis will serve as the basis for planning and conducting future programs to improve the practice of dental radiology

  1. Radiological protection of paediatric patients: An overview

    International Nuclear Information System (INIS)

    Ringertz, H.G.; Bremmer, S.

    2001-01-01

    Paediatric patients require special attention with respect to radiation protection, for various reasons. The difference between a 1 kg premature baby and a 100 kg teenager puts special demands on the radiographic techniques used, and the increased radiosensitivity of growing tissue and the patients' longer life expectancy put greater demands on the justification of the procedures to be carried out. The optimization procedure involves practical aspects such as immobilization, body build specific exposure parameters and body build specific anatomical knowledge. These and other aspects of paediatric radiological protection are discussed in this overview. (author)

  2. Energy and architecture — An overview

    Directory of Open Access Journals (Sweden)

    Sonetti G.

    2013-06-01

    Full Text Available This paper aims to provide a short overview on the complex aspects and growing concern about energy in architecture by gradually zooming into it, starting from a macro-scale analysis of building contribution in the total EU energy consumption, related policies, user behaviour’s impacts and vernacular architecture techniques; then looking at the meso scale of building energy performance during its use, dynamic simulations of heat transfer and insights from a whole life cycle analysis of the energy involved during construction and disposal phases; finally, at the building element micro-scale, describing local heat transfer and human thermal comfort measurements. Conclusions gather recommendations and further scenarios where different stakeholders and techniques can play their part for a wiser and more sustainable energy use, and a better built environment for us and those to come.

  3. Assessing quality of life in the treatment of patients with age-related macular degeneration: clinical research findings and recommendations for clinical practice.

    Science.gov (United States)

    Yuzawa, Mitsuko; Fujita, Kyoko; Tanaka, Erika; Wang, Edward C Y

    2013-01-01

    The importance of incorporating quality-of-life (QoL) assessments into medical practice is growing as health care practice shifts from a "disease-based" to a "patient-centered" model. The prevalence of age-related macular degeneration (AMD) is increasing in today's aging population. The purpose of this paper is: (1) to discuss, by reviewing the current literature, the impact of AMD on patients' QoL and the utility of QoL assessments in evaluating the impact of AMD and its treatment; and (2) to make a recommendation for incorporating QoL into clinical practice. We conducted a PubMed and an open Internet search to identify publications on the measurement of QoL in AMD, as well as the impact of AMD and the effect of treatment on QoL. A total of 28 articles were selected. AMD has been found to cause a severity-dependent decrement in QoL that is comparable to systemic diseases such as cancer, ischemic heart disease, and stroke. QoL impairment manifests as greater social dependence, difficulty with daily living, higher rates of clinical depression, increased risk of falls, premature admission to nursing homes, and suicide. The National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) is the most widely used eye disease-specific QoL instrument in AMD. It has been shown to correlate significantly with visual acuity (VA). QoL reflects aspects of AMD including psychological well-being, functional capacity, and the ability to perform patients' valued activities, which are not captured by a single, numerical VA score. The literature shows that the adverse impact of AMD on QoL is comparable to serious systemic disease. Eye disease-specific instruments for measuring QoL, such as the NEI VFQ-25, have shown a significant correlation of QoL decrement with measures of disease severity, as well as significant QoL improvement with treatment. The NEI VFQ-25 and other validated instruments provide a wide-ranging assessment of vision-related functioning that is important to

  4. IMPACT 2002+, ReCiPe 2008 and ILCD’s recommended practice for characterization modelling in life cycle impact assessment: a case study-based comparison

    DEFF Research Database (Denmark)

    Owsianiak, Mikolaj; Laurent, Alexis; Bjørn, Anders

    2014-01-01

    Purpose The European Commission has launched a recommended set of characterization models and factors for application in life cycle impact assessment (LCIA). However, it is not known how this recommended practice, referred to as the ILCD 2009, performs relative to some of the most frequently used...... and ecosystems, all studied methodologies consistently identify the same window option as having the lowest and the highest environmental impact. This is mainly because few processes, associated with production of heat, dominate the total impacts, and there is a large difference in demand for heat between...... categories. The differences are somewhat smaller (within 1 order of magnitude) for the impact categories respiratory inorganics and photochemical ozone formation, and are within a factor of 3 for the remaining impact categories. The differences in impact scores in our case study are brought about...

  5. The implications of the 1990 recommendations of ICRP for occupational exposure

    International Nuclear Information System (INIS)

    Clarke, R.H.

    1991-01-01

    In November 1990 the International Commission on Radiological Protection agreed to a new set of recommendations. In this Paper those aspects of the recommendations which are relevant to occupational exposure are described and their implications examined. First the new estimates of carcinogenic risk are presented and the way in which they are used to provide a measure of detriment is explained. The Paper then shows how the attributes of radiation detriment are used to set dose limits. Finally, the practical implementation of the recommendations is considered. (Author)

  6. 77 FR 71796 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Science.gov (United States)

    2012-12-04

    ... been limited in laboratory medicine. No single- evidence-based model for recommending practices in... of laboratory tests available certainly warrant such a model. The Laboratory Medicine Best Practices..., 2012. Ron A. Otten, Director, Office of Scientific Integrity (OSI), Office of the Associate Director...

  7. Interest of seeing Precision Viticulture through two distributed competences: Determination of resources and schemes allowing some practical recommendations

    Directory of Open Access Journals (Sweden)

    Moreiro Leslie B.

    2017-01-01

    Full Text Available The aim of this article is to better understand resources needed and constraints to avoid in implementation of Precision Viticulture technologies. In this view, we adapt distributed cognition theory to multilevel model of competence in management sciences. We use a qualitative methodology based on semi-structured interviews in 7 cases study. The main results allow us to distinguish the two aspects of Precision Viticulture, artifacts, providers of resources, and their utilization scheme. Furthermore, Precision Viticulture is decomposed here in two tasks. The first task is characterization of heterogeneity. The second is modulation of technical itineraries. These two tasks are complementary. In addition, we present ours results by highlighting resources used by firm using these technologies and constraints that they face. Finally, with these results, we can do some practical recommendations to designers and users of these technologies.

  8. Definition and specification for PACS. A checklist based on the standard ''IEEE Recommended Practice for Software Requirements Specifications''

    International Nuclear Information System (INIS)

    Koenig, H.; Klose, K.J.

    1999-01-01

    Problem: The formulation of requirements is necessary to control the goals of a PACS project. Furthermore, in this way, the scope of functionality necessary to support radiological working processes becomes clear. Method: Definitions of requirements and specification are formulated independently of systems according to the IEEE standard 'Recommended Practice for Software Requirements Specifications'. Definitions are given in the Request for Information, specifications in the Request for Proposal. Functional and non-functional requirements are distinguished. The solutions are rated with respect to scope, appropriateness and quality of implementation. Results: A PACS checklist was created according to the methods described above. It is published on the homepage of the 'Arbeitsgemeinschaft Informationstechnologie' (AGIT) within the 'Deutsche Roentgengesellschaft' (DRG) (http://www.uni-marburg.de/mzr.agit). Conclusion: The checklist provides a discussion forum which should contribute to an agreement on accepted basic PACS functionalities. (orig.) [de

  9. [Problem areas and examples of best practice in intersectoral medication treatment--a literature review].

    Science.gov (United States)

    Mehrmann, Lena; Ollenschläger, Günter

    2014-01-01

    Transitions between the outpatient and inpatient sector are a critical phase in medication treatment. This article provides an overview of published problem areas and examples of best practice in the intersectoral medication treatment. Data with regard to related problem areas and examples of best practice was collected in August 2011 by a systematic literature research. The relevant literature was identified using the following databases and search engines: MEDLINE, The Cochrane Library, EMBASE, Google, and Google Scholar. Additionally, a hand search was done on the websites of SpringerLink and Thieme Connect. The initial search yielded a total of 4,409 records which were further selected in two screening steps and analysed according to their relevance. Of the remaining 63 records, 3 exclusively described problem areas, 11 of them examples of best practice, and 49 provided information on both problem areas and examples of best practice with regard to intersectoral medication treatment. Among other things, problem areas include varying legal regulations in inpatient and outpatient medication treatment, drug therapy interruptions after hospital discharge, or deficits in communication and continuity of care. Examples of best practice are projects, programmes, initiatives, recommendations, and points to consider with respect to medication reconciliation, pharmaceutical support, or transitions of care. Problem areas as well as examples of best practice are mainly focused on the transition from inpatient to outpatient care. Copyright © 2013. Published by Elsevier GmbH.

  10. [Schools meals in French secondary state schools: compliance to national recommendations and schools catering patterns].

    Science.gov (United States)

    Bertin, M; Lafay, L; Calamassi-Tran, G; Volatier, J-L; Dubuisson, C

    2011-02-01

    Recent reports on the lack of nutritional quality of meals served in schools have led public authorities to draft, in 1999, recommendations for restoring a balanced food supply. Following the survey carried out by the French food safety Agency in 2005-2006, which highlighted gaps in the implementation of these recommendations, a law passed in July 2010 plans to make these recommendations mandatory, as their 2007 revised version. Thus, the objective of this study was to assess initial school compliance with regard to this last revised version of the recommendations and to identify school patterns through their catering management and implication in a dietary project. Seven hundred and seven secondary state schools were questioned (570 were administrated by the Ministry of Education and 137 by the Ministry of Agriculture) on their catering practices. Twenty consecutive menus from each school were also analyzed with a specific coding system to establish its nutritional composition for comparison with the 2007 recommendations. On average, schools complied with half of the recommendations. Good compliance was observed with the 2007 recommendations concerning fried products, starchy foods, fruits, and dairy products whereas very few schools were in compliance with recommendations concerning fish, cheeses and sweetened desserts containing less than 15 % fat and more than 20 g of sugar per portion. Furthermore, compliance with recommendations was significantly better for lunch meals, and even better for agricultural establishments. A 5-component meal was also associated with greater compliance with the recommendations. In addition, four school patterns were identified based on catering management practices. The first two categories of establishments had knowledge of the recommendations but exhibited different levels of application. The last two types of establishments had no knowledge of the recommendations and differed in their catering management practices. Compliance

  11. Practice Theory and Research: Exploring the Dynamics of Social Life

    NARCIS (Netherlands)

    Spaargaren, G.; Weenink, D.; Lamers, M.

    2016-01-01

    There has been an upsurge in scholarship concerned with theories of social practices in various fields including sociology, geography and management studies. This book provides a systematic introduction and overview of recent formulations of practice theory organised around three important themes:

  12. Mentoring advanced practice nurses in research: recommendations from a pilot program.

    Science.gov (United States)

    Leung, Doris; Widger, Kimberley; Howell, Doris; Nelson, Sioban; Molassiotis, Alex

    2012-01-01

    Advanced Practice Nurses (APNs) need research skills to develop and advance their practice and, yet, many have limited access to research training and support following completion of their advanced degree. In this paper we report on the development, delivery, and evaluation of an innovative pilot program that combined research training and one-to-one mentorship for nine APNs in conducting research relevant to their practice. The program was organized within an academic institution and its affiliated hospitals in Toronto, Canada. Our experience with this program may assist those in other organizations to plan and deliver a similar program for APN research mentorship.

  13. The impact of fear appeals on processing and acceptance of action recommendations.

    Science.gov (United States)

    de Hoog, Natascha; Stroebe, Wolfgang; de Wit, John B F

    2005-01-01

    A stage model of processing of fear-arousing communications was tested in an experiment that examined the impact of vulnerability to a severe health risk, the quality of the arguments supporting a protective action recommendation, and the source to which the recommendation was attributed, on processing and acceptance of the recommendation. Argument quality influenced attitudes toward the recommendation (but not intention to act), and this effect was mediated by negative thoughts about the recommendation. Vulnerability influenced intention to act (but not attitudes), and this effect was mediated by perceived threat and positive thoughts about the recommendation. The pattern of findings suggests that although vulnerability to a severe health risk induces biased processing of the recommendation, biased processing is restricted to intentions and does not compromise the evaluation of the recommendation. The theoretical and practical implications of these findings are discussed.

  14. The joint industry development of a recommended practice for the site specific assessment of mobile jackup units

    International Nuclear Information System (INIS)

    Jones, D.E.; Bennett, W.T.; Hoyle, M.J.R.

    1993-01-01

    The mobile self-elevating (drilling) unit, or jack-up, has been central to the exploration and development of offshore oil and gas reserves. In recent years there has been an increased desire to benefit from the potential economics of using these units in longer term production roles either in association with a fixed platform or as a stand-alone facility. However, until recently there had been no concerted effort to develop a consistent and commonly accepted standard for general industry use in site specific assessment of jack-ups. This paper describes the background and work carried out to develop such a standard. The project is nearing completion and has resulted in the publication of a Guideline document. A Recommended Practice and associated Commentary are (at the time of writing) in the final stage of drafting for release to the project sponsors for trial and comment prior to issuing the first Edition early in 1994

  15. Heterogeneity of Rabies Vaccination Recommendations across Asia

    Directory of Open Access Journals (Sweden)

    Philippe Buchy

    2017-07-01

    Full Text Available Asian countries bear the greatest burden of the disease, with a majority (59% of rabies-related deaths occurring in Asia. In order to promote best practices, we summarized national human vaccination guidelines across this region, to highlight differences and similarities and to discuss the aspects that would benefit from updates. National management guidelines for rabies were retrieved from various sources to extract information on rabies pre- and post-exposure prophylaxis (PrEP, and PEP, booster vaccination, and route of administration. Rabies guidelines recommendations for wound management and PrEP across Asia are broadly aligned to the World Health Organization (WHO guidelines. For PEP, the 5-dose Essen, and the 4-dose Zagreb are the regimens of choice for intramuscular (IM, and the Thai Red Cross regimen for intradermal (ID, administration. Several national guidelines have yet to endorse ID vaccine administration. Most guidelines recommend rabies immunoglobulin in category III exposures. Booster recommendations are not included in all guidelines, with limited clarity on booster requirement across the spectrum of risk of rabies exposure. In conclusion, national recommendations across Asian countries differ and while some guidelines are closely aligned to the WHO recommendations, resource-saving ID administration and use of rational abbreviated schedules have yet to be endorsed.

  16. Good practices according to WHO’s recommendation for normal labor and birth and women’s assessment of the care received: the “birth in Brazil” national research study, 2011/2012

    Directory of Open Access Journals (Sweden)

    Marcia Leonardi Baldisserotto

    2016-10-01

    Full Text Available Abstract Background The World Health Organization recommends good practices for the conduct of uncomplicated labor and birth, with the aim of improving the quality of and assessment by women of childbirth care. The aim of this study was to evaluate the association between adoption of good practices according to WHO’s recommendation for normal labor and birth and assessment by women of the care received. Methods Birth in Brazil is a national hospital-based study with countrywide representation consisting of 23,894 mothers and their newborns, conducted between February 2011 and October 2012. The present study analysed a subsample of this national survey. Postpartum women classified as low risk during pregnancy who had experienced either spontaneous or induced labor were included in this study, totalling 4102 mothers. To estimate the association between assessment by women of the childbirth care received (dependent variable and good practices according to WHO’s recommendation during normal labor and birth (independent variables, a multinomial logistic regression analysis was used and crude and adjusted odds ratios calculated with their 95 % confidence intervals. Results The good practices associated with positive assessment of the care received by women during labor and birth included the partner’s presence, privacy in the birthing place, time available to ask questions, clarity of information received, and empathic support from caregivers during labor and birth. Freedom of movement, free nutrition offered, choice of companions, nonpharmacological analgesia, skin-to-skin contact and breastfeeding in the childbirth room were not associated with the assessment by women of the care received. Conclusions Our findings reveal the importance to mothers of their relationship with the team of caregivers during labor and birth. Therefore, caregiver teams must be qualified within a more humanistic vision of childbirth health care.

  17. Recommendations for data monitoring committees from the Clinical Trials Transformation Initiative.

    Science.gov (United States)

    Calis, Karim A; Archdeacon, Patrick; Bain, Raymond; DeMets, David; Donohue, Miriam; Elzarrad, M Khair; Forrest, Annemarie; McEachern, John; Pencina, Michael J; Perlmutter, Jane; Lewis, Roger J

    2017-08-01

    Background/aims Use of data monitoring committees to oversee clinical trials was first proposed nearly 50 years ago. Since then, data monitoring committee use in clinical trials has increased and evolved. Nonetheless, there are no well-defined criteria for determining the need for a data monitoring committee, and considerable variability exists in data monitoring committee composition and conduct. To understand and describe the role and function of data monitoring committees, and establish best practices for data monitoring committee trial oversight, the Clinical Trials Transformation Initiative-a public-private partnership to improve clinical trials-launched a multi-stakeholder project. Methods The data monitoring committee project team included 16 individuals charged with (1) clarifying the purpose of data monitoring committees, (2) identifying best practices for independent data monitoring committee conduct, (3) describing effective communication practices, and (4) developing strategies for training data monitoring committee members. Evidence gathering included a survey, a series of focus group discussions, and a 2-day expert meeting aimed at achieving consensus opinions that form the foundation of our data monitoring committee recommendations. Results We define the role of the data monitoring committee as an advisor to the research sponsor on whether to continue, modify, or terminate a trial based on periodic assessment of trial data. Data monitoring committees should remain independent from the sponsor and be composed of members with no relevant conflicts of interest. Representation on a data monitoring committee generally should include at least one clinician with expertise in the therapeutic area being studied, a biostatistician, and a designated chairperson who has experience with clinical trials and data monitoring. Data monitoring committee meetings are held periodically to evaluate the unmasked data from ongoing trials, but the content and conduct of

  18. A practical guide to cardiovascular 3D printing in clinical practice: Overview and examples.

    Science.gov (United States)

    Abudayyeh, Islam; Gordon, Brent; Ansari, Mohammad M; Jutzy, Kenneth; Stoletniy, Liset; Hilliard, Anthony

    2018-06-01

    The advent of more advanced 3D image processing, reconstruction, and a variety of three-dimensional (3D) printing technologies using different materials has made rapid and fairly affordable anatomically accurate models much more achievable. These models show great promise in facilitating procedural and surgical planning for complex congenital and structural heart disease. Refinements in 3D printing technology lend itself to advanced applications in the fields of bio-printing, hemodynamic modeling, and implantable devices. As a novel technology with a large variability in software, processing tools and printing techniques, there is not a standardized method by which a clinician can go from an imaging data-set to a complete model. Furthermore, anatomy of interest and how the model is used can determine the most appropriate technology. In this over-view we discuss, from the standpoint of a clinical professional, image acquisition, processing, and segmentation by which a printable file is created. We then review the various printing technologies, advantages and disadvantages when printing the completed model file, and describe clinical scenarios where 3D printing can be utilized to address therapeutic challenges. © 2017, Wiley Periodicals, Inc.

  19. Non-musical sound branding – a conceptualization and research overview

    DEFF Research Database (Denmark)

    Graakjær, Nicolai J.; Bonde, Anders

    2018-01-01

    Purpose The purpose of this paper is to advance the understanding of sound branding by developing a new conceptual framework and providing an overview of the research literature on non-musical sound. Design/methodology/approach Using four mutually exclusive and collectively exhaustive types of non......-musical sound, the paper assesses and synthesizes 99 significant studies across various scholarly fields. Findings The overview reveals two areas in which more research may be warranted, that is, non-musical atmospherics and non-musical sonic logos. Moreover, future sound-branding research should examine...... in further detail the potentials of developed versus annexed object sounds, and mediated versus unmediated brand sounds. Research limitations/implications The paper provides important insights into critical issues that suggest directions for further research on non-musical sound branding. Practical...

  20. [Management of breast nipple discharge: Recommendations].

    Science.gov (United States)

    Ouldamer, L; Kellal, I; Legendre, G; Ngô, C; Chopier, J; Body, G

    2015-12-01

    To investigate diagnostic value of imaging procedures and management strategies of the patients with nipple discharge (ND) to establish management recommendations. Bibliographical search in French and English languages by consultation of PubMed, Cochrane and Embase databases. Although, all ND require an systematic evaluation guided by clinical data, bloody ND could be a predictor of breast cancer risk among different colors of discharge particularly in patients of more than 50 years (LE2). The mammography and breast ultrasography are the imaging procedures to realize in first intention (grade C) but they turn out useful only when they detect radiological abnormalities (LE4). Galactography has only a localizing value of possible ductal abnormalities (when standard imaging procedures is not contributive) (LE4). Thus, in the diagnostic investigation of a suspicious ND, galactography it is not recommended in standard practice (grade C). The breast Magnetic Resonance Imaging (MRI) is recommended when breast standard imaging procedures are not contributive (grade C). The ND cytology is useful only if it is positive (i.e. reveal cancer cells). There is no proof on the diagnostic performance of the cytological analysis of the ND to allow a recommendation on its realization or not. In front of a suspicious ND, when breast-imaging procedures reveals an associated radiological lesion, an adapted percutaneous biopsy is recommended by percutaneous way (grade C). Vacuum-assisted breast biopsies is a diagnostic tool but can also be therapeutic allowing to avoid surgery in case of benign lesion but current literature data do not allow recommendations on the therapeutic aspect of vacuum-assisted breast biopsy (LE4). In the absence of associated radiological signal, and in case of reproducible bloody persistent ND, a pyramidectomy is recommended (grade C). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  1. A Hybrid Recommender System Based on User-Recommender Interaction

    OpenAIRE

    Zhang, Heng-Ru; Min, Fan; He, Xu; Xu, Yuan-Yuan

    2015-01-01

    Recommender systems are used to make recommendations about products, information, or services for users. Most existing recommender systems implicitly assume one particular type of user behavior. However, they seldom consider user-recommender interactive scenarios in real-world environments. In this paper, we propose a hybrid recommender system based on user-recommender interaction and evaluate its performance with recall and diversity metrics. First, we define the user-recommender interaction...

  2. School-community learning partnerships for sustainability: Recommended best practice and reality

    Science.gov (United States)

    Wheeler, Leone; Guevara, Jose Roberto; Smith, Jodi-Anne

    2018-05-01

    Effective partnerships across different stakeholders are essential to the collaboration required for learning cities to contribute to sustainable development. Through partnerships, formal educational institutions, such as schools and universities, play a vital role in establishing and sustaining learning cities, often by facilitating the meaningful participation of different local community members. The research presented in this article examines the characteristics of effective school-community partnerships in the literature and compares it to the results of a three-year research study which examined 16 case studies of school-community partnerships in the state of Victoria in Australia. Using participatory action research, the researchers identified four approaches to implementing partnerships for sustainability, explored challenges to achieving an idealised partnership, and made recommendations for establishing successful partnership networks. The researchers propose that partnerships be viewed as a dynamic resource rather than merely a transactional arrangement that addresses the identified challenges of time, funding, skills and personnel. Furthermore, the use of "partnership brokers", such as local government or non-government organisations, is recommended to expand the current school-centred approach to partnerships. These insights aim to contribute to providing quality education and lifelong learning through partnerships - outcomes crucial for establishing and sustaining learning cities.

  3. Primary HPV testing recommendations of US providers, 2015.

    Science.gov (United States)

    Cooper, Crystale Purvis; Saraiya, Mona

    2017-12-01

    To investigate the HPV testing recommendations of US physicians who perform cervical cancer screening. Data from the 2015 DocStyles survey of U.S. health care providers were analyzed using multivariate logistic regression to identify provider characteristics associated with routine recommendation of primary HPV testing for average-risk, asymptomatic women ≥30years old. The analysis was limited to primary care physicians and obstetrician-gynecologists who performed cervical cancer screening (N=843). Primary HPV testing for average-risk, asymptomatic women ≥30years old was recommended by 40.8% of physicians who performed cervical cancer screening, and 90.1% of these providers recommended primary HPV testing for women of all ages. The screening intervals most commonly recommended for primary HPV testing with average-risk, asymptomatic women ≥30years old were every 3years (35.5%) and annually (30.2%). Physicians who reported that patient HPV vaccination status influenced their cervical cancer screening practices were almost four times more likely to recommend primary HPV testing for average-risk, asymptomatic women ≥30years old than other providers (Adj OR=3.96, 95% CI=2.82-5.57). Many US physicians recommended primary HPV testing for women of all ages, contrary to guidelines which limit this screening approach to women ≥25years old. The association between provider recommendation of primary HPV testing and patient HPV vaccination status may be due to anticipated reductions in the most oncogenic HPV types among vaccinated women. Published by Elsevier Inc.

  4. PMP practice makes perfect over 1000 PMP practice questions and answers

    CERN Document Server

    Estrella, John A; Zahran, Sami

    2011-01-01

    A unique learning resource to prepare for the PMP certification exam Without sufficient practice and preparation for taking the Project Management Institute's (PMI's) PMP certification exam, you won't be able to actually put your skills into practice in the real world! To help you achieve your goal of passing the exam, this two-part prep book covers all elements of the brand-new Project Management Professional exam. A team of experts presents you with a solid overview of the exam as well as hundreds of questions, detailed answers, and explanations. In addition, each question is accompa

  5. Commercial Buildings Partnerships - Overview of Higher education projects

    Energy Technology Data Exchange (ETDEWEB)

    Parrish, Kristen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Robinson, Alastair [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Regnier, Cindy [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-02-01

    The Commercial Building Partnership (CBP), a public/private, cost-shared program sponsored by the U.S. Department of Energy (DOE), paired selected commercial building owners and operators with representatives of DOE, its national laboratories, and private-sector technical experts. These teams explored energy-saving measures across building systems – including some considered too costly or technologically challenging – and used advanced energy modeling to achieve peak whole-building performance. Modeling results were then included in new construction or retrofit designs to achieve significant energy reductions. CBP design goals aimed to achieve 50 percent energy savings compared to ANSI/ASHRAE/IES Standard 90.1-2004 for new construction, while retrofits are designed to consume at least 30 percent less energy than either Standard 90.1-2004 or current consumption. After construction and commissioning of the project, laboratory staff continued to work with partners to collect and analyze data for verification of the actual energy reduction. CBP projects represent diverse building types in commercial real estate, including lodging, grocery, retail, higher education, office, and warehouse/storage facilities. Partners also commit to replicating low-energy technologies and strategies from their CBP projects throughout their building portfolios. As a result of CBP projects, five sector overviews (Lodging, Food Sales, General Merchandise, Higher Education, Offices) were created to capture successful strategies and recommended energy efficiency measures that could broadly be applied across these sectors. These overviews are supplemented with individual case studies providing specific details on the decision criteria, modeling results, and lessons learned on specific projects. Sector overviews and CBP case studies will also be updated to reflect verified data and replication strategies as they become available.

  6. [Concordance between hospital prescriptions and recommendations in the treatment of mania].

    Science.gov (United States)

    Laforgue, Edouard-Jules; Bulteau, Samuel; Cholet, Jennyfer; Victorri-Vigneau, Caroline; Guitteny, Marie; Mauduit, Nicolas; Vanelle, Jean-Marie; Sauvaget, Anne

    2017-06-01

    There are differences between recommendations and practice in the pharmacological treatment of acute mania. The objective was to assess conformity of the anti-manic prescription between national recommendations (Haute Autorité de santé [French health authority, HAS] and "résumé des caractéristiques du produit" [product characteristics, RCP]) and clinical practice. We observed the drug prescriptions of in-patients for a manic episode. The main outcome measure was the concordance rate with the recommendations of the drugs prescriptions at the 48th hour. The secondary outcome repeated the same process with the hospital discharge statement of switches, associations, the presence of symptomatic and antidepressant treatments. Sixty-six episodes were included, 40 patients (60%) had a prescription complies with RCP recommendations H48 and 46 patients (70%) to HAS. These rates fall at hospital discharge. Off-label prescriptions, drug combinations and choices of not listed molecules are the most common reasons for non-conformity. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  7. Recommended management practices for operation and closure of shallow injection wells at DOE facilities

    International Nuclear Information System (INIS)

    1993-07-01

    The Safe Drinking Water Act established the Underground Injection Control (UIC) program to ensure that underground injection of wastes does not endanger an underground source of drinking water. Under UIC regulations, an injection well is a hole in the ground, deeper than it is wide, that receives wastes or other fluid substances. Types of injection wells range from deep cased wells to shallow sumps, drywells, and drainfields. The report describes the five classes of UIC wells and summarizes relevant regulations for each class of wells and for the UIC program. The main focus of the report is Class IV and V shallow injection wells. Class IV wells are prohibited and should be closed when they are identified. Class V wells are generally authorized by rule, but EPA or a delegated state may require a permit for a Class V well. This report provides recommendations on sound operating and closure practices for shallow injection wells. In addition the report contains copies of several relevant EPA documents that provide additional information on well operation and closure. Another appendix contains information on the UIC programs in 21 states in which there are DOE facilities discharging to injection wells. The appendix includes the name of the responsible regulatory agency and contact person, a summary of differences between the state's regulations and Federal regulations, and any closure guidelines for Class IV and V wells

  8. The male reproductive system - An overview of common problems.

    Science.gov (United States)

    Wijesinha, Sanjiva; Piterman, Leon; Kirby, Catherine N

    2013-05-01

    Many male reproductive system problems could be perceived as being embarrassing, which may be one of the reasons that they are often not identified in general practice. This article provides an overview of some common problems affecting the male reproductive system, and outlines current treatment options. Erectile dysfunction, premature ejaculation, loss of libido, testicular cancer and prostate disease may cause embarrassment to the patient and, occasionally, the general practitioner. We describe how patients affected by these conditions may present to general practice, and discuss the reasons why they may not present. We also discuss how GPs can overcome difficulties in identifying and dealing with their male patients suffering from male reproductive system issues.

  9. Poly Cystic Ovarian Syndrome: An Updated Overview

    Science.gov (United States)

    El Hayek, Samer; Bitar, Lynn; Hamdar, Layal H.; Mirza, Fadi G.; Daoud, Georges

    2016-01-01

    Poly Cystic Ovarian Syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. Women suffering from PCOS present with a constellation of symptoms associated with menstrual dysfunction and androgen excess, which significantly impacts their quality of life. They may be at increased risk of multiple morbidities, including obesity, insulin resistance, type II diabetes mellitus, cardiovascular disease (CVD), infertility, cancer, and psychological disorders. This review summarizes what the literature has so far provided from guidelines to diagnosis of PCOS. It will also present a general overview about the morbidities associated with this disease, specifically with its more severe classic form. Finally, the review will stress on the various aspects of treatment and screening recommendations currently used in the management of this condition. PMID:27092084

  10. Poly Cystic Ovarian Syndrome: an updated overview

    Directory of Open Access Journals (Sweden)

    Samer eEl Hayek

    2016-04-01

    Full Text Available 1.AbstractPoly Cystic Ovarian Syndrome (PCOS is one of the most common metabolic and reproductive disorders among women of reproductive age. Women suffering from PCOS present with a constellation of symptoms associated with menstrual dysfunction and androgen excess, which significantly impacts their quality of life. They may be at increased risk of multiple morbidities, including obesity, insulin resistance, type II diabetes mellitus, cardiovascular disease, infertility, cancer, and psychological disorders. This review summarizes what the literature has so far provided from guidelines to diagnosis of PCOS. It will also present a general overview about the morbidities associated with this disease, specifically with its more severe classic form. Finally, the review will stress on the various aspects of treatment and screening recommendations currently used in the management of this condition.

  11. EULAR RECOMMENDATIONS FOR THE USE OF IMAGING IN SPONDYLOARTHRITIS IN CLINICAL PRACTICE

    DEFF Research Database (Denmark)

    Mandl, P; Navarro-Compán, V; Terslev, L

    2014-01-01

    , tenosynovitis, bursitis and particularly peripheral enthesitis, which may support the diagnosis of SpA. MRI of the SIJ and/or spine may be used to assess and monitor disease activity, while CR of the SIJ and/or spine may be used for long-term monitoring of structural damage, particularly new bone formation...... of the included studies was performed using the QUADAS-2 tool. Results: A total of 7550 references were identified in the search process, from which 157 studies were included in the systematic review. Ten recommendations were produced encompassing the role of imaging in making a diagnosis of axial Sp...... in axial SpA. In patients with AS (not nonradiographic axial SpA), initial CRs of the lumbar and cervical spine are recommended to detect syndesmophytes, which are predictive of development of new syndesmophytes. MRI (vertebral corner inflammatory lesion) may also be used to predict development of new...

  12. Recommendations for the use of PET and PET-CT for radiotherapy planning in research projects.

    Science.gov (United States)

    Somer, E J; Pike, L C; Marsden, P K

    2012-08-01

    With the increasing use of positron emission tomography (PET) for disease staging, follow-up and therapy monitoring in a number of oncological indications there is growing interest in the use of PET and PET-CT for radiation treatment planning. In order to create a strong clinical evidence base for this, it is important to ensure that research data are clinically relevant and of a high quality. Therefore the National Cancer Research Institute PET Research Network make these recommendations to assist investigators in the development of radiotherapy clinical trials involving the use of PET and PET-CT. These recommendations provide an overview of the current literature in this rapidly evolving field, including standards for PET in clinical trials, disease staging, volume delineation, intensity modulated radiotherapy and PET-augmented planning techniques, and are targeted at a general audience. We conclude with specific recommendations for the use of PET in radiotherapy planning in research projects.

  13. Renal cystic disease: A practical overview

    International Nuclear Information System (INIS)

    Hartman, D.S.

    1987-01-01

    Renal cystic disease includes a group of lesions with extremely diverse clinical, radiographic, and pathologic findings. The recent development of multiple imaging systems to study renal cystic disease has resulted in considerable interest in correlating the images obtained by different modalities with each other and with the underlying gross pathology. A thorough knowledge of the disturbed morphology and natural history of these diseases will lead to a better understanding of their appearance on radiologic imaging. This refresher course correlates disturbed morphology with appearances on diagnostic imaging, urography, US, angiography, CT, and MR imaging. The advantages and limitations of each imaging method are detailed. A practical classification emphasizing differential features is presented. The presentation is divided into two parts. In the first part typical and atypical cystic masses, including acquired cystic disease (from dialysis), Von Hippel-Lindau disease, and the cystic disease of tuberous sclerosis are discussed. In the second part, polycystic kidney disease (dominant and recessive), medullary cystic disease, medullary sponge kidney, multicycle-dysplastic kidney, renal sinus cysts (peripelvic), and pluricystic kidney disease are discussed

  14. The new ICRP recommendations

    International Nuclear Information System (INIS)

    Schlesinger, T.

    1977-01-01

    The new ICRP recommendations are based on the concept of risk. The doses received by workers have to be justified and kept as low as practically achievable. The acceptable annual occupational risk is of the order of 10 -4 . This corresponds to an average annual dose equivalent of about 5 mSv(0.5 Rem). The annual dose equivalent limit for whole body irradiation will remain 50 mSv/year (5 Rem/year) provided that the average is about 1/10th of this value. The concept of the critical organ is abandoned and is replaced by the concept of equidetriment. (author)

  15. Permissible dose from external sources of ionizing radiation. Recommendations of the National Committee on Radiation Protection. Handbook 59

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1954-09-24

    The Advisory Committee on X-ray and Radium Protection was formed in 1929 upon the recommendation of the International Commission on Radiological Protection, under the sponsorship of the National Bureau of Standards, and with the cooperation of the leading radiological organizations. The small committee functioned effectively until the advent of atomic energy, which introduced a large number of new and serious problems in the field of radiation protection. The present report deals primarily with the protection of persons occupationally exposed to ionizing radiation from external sources. An attempt has been made to cover most of the situations encountered in practice. However, it has not always been possible to make recommendations in quantitative terms. In such cases the recommendations are intended to serve as practical guides. The recommendations are based on presently available information and cannot be regarded as permanent. For this reason and on general grounds it is strongly recommended that exposure to radiation be kept at the lowest practicable level in all cases.

  16. Permissible dose from external sources of ionizing radiation. Recommendations of the National Committee on Radiation Protection. Handbook 59

    International Nuclear Information System (INIS)

    1954-01-01

    The Advisory Committee on X-ray and Radium Protection was formed in 1929 upon the recommendation of the International Commission on Radiological Protection, under the sponsorship of the National Bureau of Standards, and with the cooperation of the leading radiological organizations. The small committee functioned effectively until the advent of atomic energy, which introduced a large number of new and serious problems in the field of radiation protection. The present report deals primarily with the protection of persons occupationally exposed to ionizing radiation from external sources. An attempt has been made to cover most of the situations encountered in practice. However, it has not always been possible to make recommendations in quantitative terms. In such cases the recommendations are intended to serve as practical guides. The recommendations are based on presently available information and cannot be regarded as permanent. For this reason and on general grounds it is strongly recommended that exposure to radiation be kept at the lowest practicable level in all cases

  17. Knowledge and Attitudes Regarding Category B ACIP Recommendations among Primary Care Providers for Children.

    Science.gov (United States)

    Kempe, Allison; Allison, Mandy A; MacNeil, Jessica R; O'Leary, Sean T; Crane, Lori A; Beaty, Brenda L; Hurley, Laura P; Brtnikova, Michaela; Lindley, Megan C; Liang, Jennifer L; Albert, Alison P; Smith, Jean C

    2018-04-17

    In 2015, the Advisory Committee on Immunization Practices (ACIP) made a category B recommendation for use of serogroup B meningococcal (MenB) vaccines, meaning individual clinical decision-making should guide recommendations. This was the first use of a category B recommendation pertaining to a large population and the first such recommendation for adolescents. As part of a survey regarding MenB vaccine, our objectives were to assess among pediatricians (Peds) and family physicians (FPs) nationally: 1) knowledge of the meaning of category A versus B recommendations and insurance coverage implications; and 2) attitudes about category A and B recommendations. We surveyed a nationally representative sample of Peds and FPs by e-mail and mail from 10-12/2016. The response rate was 72% (660/916). Although >80% correctly identified the definition of a category A recommendation, only 24% were correct about the definition for category B. Fifty-five percent didn't know that private insurance would pay for vaccines recommended as category B, and 51% didn't know that category B-recommended vaccines would be covered by the Vaccines for Children program. Fifty-nine percent found it difficult to explain category B recommendations to patients; 22% thought ACIP should not make category B recommendations; and 39% were in favor of category B recommendations because they provide leeway in decision-making. For category B recommendations to be useful in guiding practice, primary care clinicians will need to have a better understanding of their meaning, their implications for insurance payment and guidance on how to discuss them with parents and patients. Copyright © 2018. Published by Elsevier Inc.

  18. 1251 seed calibration using afterloading equipment Seed Selectron. Practical solution to meet the recommendations of the AAPM; Calibracion de semillas de {sup 1}25I usando el equipo de carga difereida SeedSelectron. Solucion practica para cumplir las recomendaciones de la AAPM

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Calatayud, J.; Richart, J.; Perez-Garcia, J.; Guirado, D.; Ballester, F.; Rodriguez, S.; Santos, M.; Depiaggio, M.; Carmona, V.; Lliso, F.; Camacho, C.; Pujades, M. C.

    2011-07-01

    Seed Selectron is a system used in the after loader permanent implant brachytherapy seeds 1-125 interstitial prostate. Two aspects are critical when you can meet the recommendations of the AAPM: a practical difficulty to check the quantity of seed required, and the great uncertainty of all measured diodes. The purpose of this paper is to present a practical solution that has been adopted to implement the recommendations of the AAPM.

  19. Safe Re-use Practices in Wastewater-Irrigated Urban Vegetable Farming in Ghana

    DEFF Research Database (Denmark)

    Keraita, Bernard; Abaidoo, R.C; Beernaerts, I.

    2012-01-01

    of stakeholders at different levels along the food chain. This paper presents an overview of safe re-use practices including farm-based water treatment methods, water application techniques, post-harvest handling practices, and washing methods. The overview is based on a comprehensive analysis of the literature......Irrigation using untreated wastewater poses health risks to farmers and consumers of crop products, especially vegetables. With hardly any wastewater treatment in Ghana, a multiple-barrier approach was adopted and safe re-use practices were developed through action research involving a number...... and our own specific studies, which used data from a broad range of research methods and approaches. Identifying, testing, and assessment of safe practices were done with the active participation of key actors using observations, extensive microbiological laboratory assessments, and field...

  20. 12 CFR 208.37 - Government securities sales practices.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 2 2010-01-01 2010-01-01 false Government securities sales practices. 208.37... Securities-Related Activities § 208.37 Government securities sales practices. (a) Scope. This subpart is... dealer. (d) Recommendations to customers. In recommending to a customer the purchase, sale or exchange of...