scholarly journals Developing national guidelines for dredge disposal at sea

2020 ◽  
Author(s):  
G Lintern
Keyword(s):  
National Guidelines ◽  
Dredge Disposal

Attitudes, Beliefs, and Practices Regarding Asthma Care Among Providers and Adult Asthmatics in Imperial County

2003 ◽  
Vol 1 (2) ◽  
pp. 88-100
Author(s):  
Paula Kriner ◽  
Yolanda Bernal
Keyword(s):  
Focus Groups ◽  
Cultural Beliefs ◽  
National Guidelines ◽  
Medical Practitioners ◽  
Beliefs And Practices ◽  
Attitudes And Practices ◽  
Hospitalization Rates ◽  
Adult Asthmatic ◽  
Asthma Hospitalization ◽  
Survey Results

Asthma is a major cause of morbidity in children and adults. Imperial County has reported among the highest asthma hospitalization rates in the state. Factors such as poverty, access to care, poor selfmanagement skills, and ethnocultural beliefs may influence asthma exacerbations. Provider and adult asthmatic attitudes, beliefs, and practices regarding asthma were examined using a mixed-methods approach: a survey to evaluate provider conformance with national guidelines, and focus groups targeting medical practitioners and adult asthmatics. Half of all providers who treat asthmatics completed a self-administered survey about asthma diagnosis; clinical monitoring of patients; treatment; patient education; and practice guidelines. Provider focus groups further explored survey results. Adult asthmatics participated in Spanishlanguage focus groups exploring cultural beliefs, attitudes, and practices. El asma es la mayor causa de morbilidad entre niños y adultos. El Condado de Imperial ha reportado las tazas más altas de hospitalización a causa de asma en el estado. Factores como la pobreza, acceso a cuidado médico, falta de experiencia sobre como manejar la enfermedad, y creencias étnicas y culturales pueden tener una influencia en las exacerbaciones del asma. Las actitudes, creencias, y prácticas de proveedores de atención médica y adultos concerniente al asma fueron examinadas utilizando varios métodos: una encuesta con el fin de evaluar el nivel de conformidad de los proveedores según las pautas establecidas a nivel nacional, y grupos foco con médicos y adultos con asma. La mitad de los proveedores que proveen atención a asmáticos completaron una encuesta acerca del diagnosis de asma; el monitoreo clínico de los pacientes; administración de tratamiento; educación a los pacientes; y pautas establecidas para proveer atención a pacientes con asma. Los grupos foco con los proveedores exploraron aun más los resultados de las encuestas. Los adultos con asma participaron en grupos foco dirigidos en español para explorar más a fondo las creencias culturales, actitudes y prácticas.

INTRAUTERINE GROWTH RETARDATION - A REVIEW ARTICLE

2018 ◽  
pp. 184-195
Author(s):  
Minh Son Pham ◽  
Vu Quoc Huy Nguyen ◽  
Dinh Vinh Tran
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Growth Potential ◽  
National Guidelines ◽  
Intrauterine Growth ◽  
No Gold Standard

Small for gestational age (SGA) and fetal growth restriction (FGR) is difficult to define exactly. In this pregnancy condition, the fetus does not reach its biological growth potential as a consequence of impaired placental function, which may be because of a variety of factors. Fetuses with FGR are at risk for perinatal morbidity and mortality, and poor long-term health outcomes, such as impaired neurological and cognitive development, and cardiovascular and endocrine diseases in adulthood. At present no gold standard for the diagnosis of SGA/FGR exists. The first aim of this review is to: summarize areas of consensus and controversy between recently published national guidelines on small for gestational age or fetal growth restriction; highlight any recent evidence that should be incorporated into existing guidelines. Another aim to summary a number of interventions which are being developed or coming through to clinical trial in an attempt to improve fetal growth in placental insufficiency. Key words: fetal growth restriction (FGR), Small for gestational age (SGA)

СОХРАНЕНИЕ ПРИВЕРЖЕННОСТИ К ТЕРАПИИ КАК ГАРАНТИЯ ЭФФЕКТИВНОСТИ СЛИТ

2019 ◽  
Author(s):  
K.S. Pavlova ◽  
D.S. Mdinaradze
Keyword(s):  
Allergic Diseases ◽  
Atopic Asthma ◽  
National Guidelines ◽  
Allergen Specific Immunotherapy ◽  
Dose Dependent ◽  
Methods Of Treatment ◽  
Choice Of Therapy ◽  
Dose Dependent Effect ◽  
Reduced Adherence

По данным ВОЗ, рекомендации врача выполняют не более 50 пациентов. В конечном итоге это приводит к снижению или отсутствию эффекта от назначаемого лечения. В связи с этим во всех последних международных и национальных руководствах говорится о необходимости учета предпочтений пациента при выборе терапии. Аллерген-специфическая иммунотерапия (АСИТ) является одним из основных методов лечения аллергических заболеваний, таких как аллергический ринит, конъюнктивит и атопическая бронхиальная астма, обладает болезнь-модифицирующими свойствами и долгосрочным эффектом после окончания лечения. АСИТ относится к профилактическому и продолжительному методу (рекомендовано на протяжении не менее 3 лет), что часто является причиной снижения приверженности к терапии. В различных исследованиях подтвержден зависимый от дозы аллергена эффект АСИТ, а следовательно, изменение режимов или сокращение сроков терапии могут влиять на конечный результат. При недостаточной эффективности АСИТ необходимо в первую очередь рассматривать вероятность низкого комплаенса. Сублингвальная АСИТ (СЛИТ) требует от пациента высокой вовлеченности в процесс лечения. Задачей врача в данном случае становится повышение терапевтического сотрудничества как одного из важнейших факторов обеспечения эффективности СЛИТ. Основными способами в данном случае являются улучшение понимания пациентом цели терапии и регулярный контроль со стороны врача.According to WHO at last 50 of the patient dont follow doctors recommendations. Ultimately, this leads to a decrease or absence of the treatment effect. In this regard, all the latest international and national guidelines mention the need to take into account the patients preferences in the choice of therapy. Allergen-specific immunotherapy (AIT) is one of the main methods of treatment of allergic diseases such as allergic rhinitis, allergic conjunctivitis and atopic asthma, and has disease modifying properties and the long-term efficacy after stop treatment. AIT refers to a preventive and long-term method (recommended for at least 3 years), that is often the cause of reduced adherence to therapy. Various studies have confirmed the dose-dependent effect of AIT, and, consequently, changes in regimens or shortening of therapy may affect the end result. In case of insufficient effectiveness of AIT, the probability of low compliance should be considered first of all. Sublingual AIT (SLIT) requires the patient to be highly involved in the treatment process. The task of the doctor in this case is increasing therapeutic cooperation, as one of the most important factors to ensure the effectiveness of SLIT. The main methods in this case are to improve the patients understanding of the purpose of the therapy and regular monitoring by the doctor.

The Italian way to prevent groundwater contamination risk

2007 ◽  
Vol 2 (3) ◽  
Author(s):  
M. V. Civita ◽  
M. De Maio ◽  
A. Fiorucci
Keyword(s):  
Groundwater Contamination ◽  
Groundwater Vulnerability ◽  
Aquifer Vulnerability ◽  
National Council ◽  
National Guidelines ◽  
National Agency ◽  
Point Count ◽  
Italian Law ◽  
Special Project ◽  
Set Up

In the early 1980's the Italian scientific community, together with a number of institutional decision-makers, realized how urgent it was to protect natural and environmental resources. They agreed that an adequate level of scientifically organized knowledge allows the accurate planning and development of environmental systems through management and direction of the actual development process, without hindering it. Since the special project was first set up in 1984, as part of the GNDCI-CNR (National Group for the Defence against Hydrogeologic Disasters, of the Italian National Council of Research) scientific context, it has been the cardinal point of Research Line 4 “Assessment of Aquifer Vulnerability”. The problem of groundwater contamination was examined in this project for the very first time in Italy in an organic and extensive manner as a key for forecasting and prevention purposes. The Italian approaches to assessing and mapping groundwater vulnerability to contamination are essentially based on two main methodologies:- The GNDCI Basic Method a HCS (Hazard Contamination Source) type approach that can be used for any type of Italian hydrogeologic situation, even where there is a limited amount of data. A unified legend and symbols are also defined for each hydrogeologic level.- The SINTACS [Soggiacenza (depth to groundwater); Infiltrazione (effective infiltration); Non saturo (unsaturated zone attenuation capacity); Tipologia della copertura (soil/overburden attenuation capacity); Acquifero (saturated zone characteristics); Conducibilità (hydraulic conductivity); Superficie topografica (Slope)] method, a PCSM (Point Count System Model) developed for use prevalently in areas with good data base coverage. The methodological approaches described in this paper now make up the Italian standard which has been set in the recent very important Italian Law (152/99) and which has now been ratified in the national guidelines produced by ANPA, the Italian National Agency for Environment Protection. In this paper the structure of the Research Line, the progress obtained by the 21 Research units (over 100 researchers) in 20 years of activity, the results gained etc. are briefly highlighted.

scholarly journals Operationalizing the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations: A Standardized Scoring System (P13-034-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Marissa Shams-White ◽  
Alice Bender ◽  
Nigel Brockton ◽  
Susannah Brown ◽  
Lisa Kahle ◽  
...  
Keyword(s):  
Cancer Research ◽  
Cancer Prevention ◽  
Past Research ◽  
Healthy Weight ◽  
National Guidelines ◽  
Physically Active ◽  
Supplement Use ◽  
Funding Sources ◽  
Sweetened Beverages ◽  
Definition Of

Abstract Objectives To develop a standardized AICR/WCRF Score that measures adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and provide guidance for its application in research. Methods Each of the updated 2018 WCRF/AICR Cancer Prevention Recommendations and the associated goals and statements of advice were examined to inform the definition of a new Score. For each of the weight, physical activity, diet, and breastfeeding-specific recommendations, components and subcomponents were created. Standards for scoring each component were established based on quantitative guidance specified in the recommendations; however, if no specificity was provided, other guidelines (e.g., national guidelines), past research that operationalized 2007 WCRF/AICR recommendations, and expert panel advice were evaluated. Results The proposed AICR/WCRF Score includes eight of the ten WCRF/AICR 2018 recommendations: 1) Be a healthy weight, 2) Be physically active, 3) Eat a diet rich in whole grains, vegetables, fruits, and beans, 4) Limit consumption of fast foods and other processed foods high in fat, starches, or sugars, 5) Limit consumption of red and processed meats, 6) Limit consumption of sugar-sweetened beverages, 7) Limit alcohol consumption, and, optionally, 8) For mothers: breastfeed your baby, if you can. Each of the components are worth one point: 1, 0.5, and 0 points for fully, partially, and not meeting the recommendations, respectively (total Score: 0–7 or 8 points). Two recommendations were not included in the Score due to uncertain intent of supplement use (Do not use supplements for cancer prevention) and the redundancy of the dependent components in the final recommendation (After a cancer diagnosis: follow our Recommendations, if you can). Additional guidance will stress the importance of taking into account other risk factors, such as smoking, in relevant models using the new Score. Conclusions The AICR/WCRF Score is a practical tool operationalizing the 2018 recommendations. Future studies are needed to further examine how adherence to the Score relates to cancer risk and mortality in various populations. Funding Sources None.

scholarly journals Ethical Issues around Death and Withdrawal of Life Support in Neonatal Intensive Care

2021 ◽  
Author(s):  
Stuti Pant
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Life Support ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
Human Life ◽  
Traumatic Experiences ◽  
National Guidelines ◽  
Brain Injured ◽  
Discharge Against Medical Advice

AbstractAmongst all the traumatic experiences in a human life, death of child is considered the most painful, and has profound and lasting impact on the life of parents. The experience is even more complex when the death occurs within a neonatal intensive care unit, particularly in situations where there have been conflicts associated with decisions regarding the redirection of life-sustaining treatments. In the absence of national guidelines and legal backing, clinicians are faced with a dilemma of whether to prolong life-sustaining therapy even in the most brain-injured infants or allow a discharge against medical advice. Societal customs, vagaries, and lack of bereavement support further complicate the experience for parents belonging to lower socio-economic classes. The present review explores the ethical dilemmas around neonatal death faced by professionals in India, and suggests some ways forward.

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