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Current Practice (current + practice)
Selected AbstractsCurrent Practice, Demographics, and Trends of Critical Care Trained Emergency Physicians in the United StatesACADEMIC EMERGENCY MEDICINE, Issue 3 2010Julie A. Mayglothling MD Abstract Objectives:, Critical care medicine (CCM) is of growing interest among emergency physicians (EPs), but the number of CCM-trained EPs and their postfellowship practice is unknown. This study's purpose was to conduct a descriptive census survey of EPs who have completed or are currently in a CCM fellowship. Methods:, The authors created a Web-based survey, and requests to participate were sent to EPs who have completed or are currently in a CCM fellowship. Responses were collected over a 12-month period. Physicians were located via multiple whom electronic mailing lists, including the Emergency Medicine Section of the Society of Critical Care Medicine, Critical Care Section of the American College of Emergency Physicians, and the Emergency Medicine Residents' Association. The authors also contacted CCM fellowship coordinators and used informal networking. Data were collected on emergency medicine (EM) and other residency training; discipline, duration, and year of CCM fellowship; current practice setting; and board certification status, including the European Diploma in Intensive Care (EDIC). Results:, A total of 104 physicians completed the survey (97% response rate), of whom 73 had completed fellowship at the time of participation, and 31 of whom were in fellowship training. Of those who completed fellowship, 36/73 (49%) practice both EM and CCM, and 45/73 (62%) practice in academic institutions. Multiple disciplines of fellowship were represented: multidisciplinary (39), surgical (28), internal medicine (16), anesthesia (14), and other (4). Together, the CCM fellowships at the University of Maryland R Adams Cowley Shock Trauma Center and the University of Pittsburgh have trained 42% of all EM-CCM physicians, with 38 other institutions training from one to four fellows each. The number of EPs completing CCM fellowships has risen: from 1974 to 1989, 12 EPs; from 1990 to 1999, 15 EPs; and from 2000 to 2007, 43 EPs. Conclusions:, Emergency physicians are entering CCM fellowships in increasing numbers. Almost half of these EPs practice both EM and CCM. ACADAEMIC EMERGENCY MEDICINE 2010; 17:325,329 © 2010 by the Society for Academic Emergency Medicine [source] Forensic Risk Assessment in Intellectual Disabilities: The Evidence Base and Current Practice in One English RegionJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2000Stephen Turner The growing interest in forensic risk assessment in intellectual disability services reflects the perception that deinstitutionalization has exposed more people to a greater risk of offending. However, ,risk' and the related idea of ,dangerousness' are problematic concepts because of connotations of dichotomous definition, stability and predictability. Assessment instruments in mainstream forensic psychiatry often combine actuarial and clinical data, and increasingly stress the dynamic nature of risk as well as the importance of situational and accidental triggers. Despite this increasing sophistication of research in mainstream forensic psychiatry, the ability to predict future offending behaviour remains very limited. Furthermore, actuarial predictors developed in studies of psychiatric or prison populations may not be valid for individuals with intellectual disabilities. Offending behaviour among people with intellectual disabilities is also hard to circumscribe because it often does not invoke full legal process or even reporting to the police. In order to discover how such problems were reflected in practice, a survey of providers in the North-west Region of England was undertaken. Seventy out of 106 providers identified as possibly relevant to this inquiry responded to a short postal questionnaire. Twenty-nine (42%) respondents , mainly in the statutory sector , reported operating a risk assessment policy relating to offending. The number of risk assessments completed in the previous year varied from none to ,several hundred'. Providers reported three main kinds of problems: (1) resources or service configuration; (2) interagency or interdisciplinary cooperation or coordination; and (3) issues relating to the effectiveness, design and content of assessment. [source] A Survey of the Current Practice of Obstetric Anaesthesia and Analgesia in MalaysisJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2000Dr. Y. K. Chan Abstract Objective: A survey covering 30% of the deliveries in Malaysia was done to determine the practice of obstetric anaesthesia and analgesia for 1996. Results: From the survey, it was found that the regional anaesthesia rate for caesarean section was 46% in the government hospitals compared to 29.2% in the private hospitals, with spinal anaesthesia being the most common regional anaesthetic technique used in both types of hospitals. The epidural rate for labour analgesia was only 1.5% overall for the country. Epidural analgesia services were available in all private hospitals whereas 17.6% of government hospitals surveyed did not offer this service at all. Conclusions: Although the use of epidural analgesia for labour was low in Malaysia, the overall rate of regional anaesthesia for caesarean section (41.9%) is very much in keeping with the standards of safe practice recommended by the United Kingdom. [source] Current Practice for Imparting Carrier Status Detected by Newborn Screening for Sickle Cell Disorders and Cystic Fibrosis in EnglandNURSING & HEALTH SCIENCES, Issue 3 2007Hilda Parker [source] Forensic Issues in Pain: Review of Current PracticePAIN PRACTICE, Issue 2 2001Ronald J. Kulich PhD Ethical guidelines and recommendations for assessment, documentation, record review, and court testimony are discussed. Specific issues include the assessment of disability and impairment, malingering, and application of the Daubert standard in forensic pain practice. Examples of case law are reviewed for civil liability and CRPS, malpractice with opioid prescribing, and practice issues in a correctional setting. [source] Sleep-Disordered Breathing in Children: Survey of Current PracticeTHE LARYNGOSCOPE, Issue 6 2006Ron B. Mitchell MD Abstract Objectives: The American Academy of Pediatrics recommends objective testing with polysomnography (PSG) before adenotonsillectomy for sleep-disordered breathing (SDB) in children. Several studies have also shown that a clinical diagnosis correlates poorly with the presence or severity of SDB as confirmed by PSG. The purpose of this study was to examine surgical practice patterns among members of the American Society of Pediatric Otolaryngologists (ASPO). Methods: A questionnaire was sent electronically to all members of ASPO asking about demographics, PSG facilities, and pre- and postoperative management of children with SDB. Results: A total of 245 questionnaires were sent, and 105 (43%) were completed. The results of the survey show that up to 50% of pediatric visits in individual practices were for SDB. Only 10% of children who underwent adenotonsillectomy had PSG, and the most common reason to request it was doubt about diagnosis. The average wait for PSG was 3 to 6 weeks. Preoperative PSG was routinely requested in children under 1 year of age and children with morbid obesity, craniofacial abnormalities, or neuromuscular disease. The majority of pediatric otolaryngologists proceeded with an adenotonsillectomy in symptomatic children with normal PSG findings. Postoperative PSG was requested in less than 5% of children. Approximately 20% of children who underwent adenotonsillectomy for suspected SDB were observed overnight in hospital. Conclusions: A majority of respondents from this survey rely on a clinical diagnosis rather than PSG to recommend an adenotonsillectomy for SDB in children. PSG was generally used when the diagnosis was in doubt. [source] History and Current Practice of TonsillectomyTHE LARYNGOSCOPE, Issue S100 2002Ramzi T. Younis MD Abstract Objective To review important developments in the history of adenotonsillectomy and describe current methods and results for the operation. Study Design Review. Methods Tonsillectomy practices since antiquity were reviewed, with emphasis on introductions of new surgical tools and procedures, anesthesia methods, and patient care practices. Past and current indications for and complications associated with tonsillectomy were also reviewed. Results Devices used for adenotonsillectomy have included snares, forceps, guillotines, various kinds of scalpels, lasers, ultrasonic scalpels, powered microdebriders, and bipolar scissors. General anesthesia, the Crowe-Davis mouth gag, and methods for controlling bleeding have contributed greatly to success with the operation. Past and current indications for adenotonsillectomy are similar, although the relative importance of some indications has changed. The complication rate has declined, but the problems that do occur remain the same. Currently, cost-effectiveness is a principal concern. Conclusion The instruments and procedures used for adenotonsillectomy have evolved to render it a precise operation. Today, the procedure is a safe, effective method for treating breathing obstruction, throat infections, and recurrent childhood ear disease. [source] Analysing Texts in Context: Current Practices and New Protocols for Critical Discourse Analysis in Organization StudiesJOURNAL OF MANAGEMENT STUDIES, Issue 6 2010Shirley Leitch abstract Critical Discourse Analysis (CDA) in organization studies would be strengthened by an increased focus on a central CDA tenet that texts should be analysed in context. Context has, for the most part, been afforded a taken-for-granted status that is misplaced because of the diverse ways in which it may be defined and applied. These generally unacknowledged differences relate to whether context is treated as space, time, practice, change, or frame. The result is a confusing array of studies claiming some degree of CDA status without core agreement , or acknowledgement of disagreements , about what is meant by context or how it should be linked to texts. To remedy this situation we identify in this Point article nine methodological protocols related to conceptual definitions, data selection, and data analysis which we argue benefit the consistency and rigour with which CDA in organization studies is applied. Use of these protocols may also serve as criteria against which the rigour of CDA research papers may be assessed. [source] Current Practices in Microtia RepairTHE LARYNGOSCOPE, Issue S1 2009Michelle M. Roeser MD No abstract is available for this article. [source] Informed Consent for Research: Current Practices in Academic Emergency MedicineACADEMIC EMERGENCY MEDICINE, Issue 6 2008Edward Monico MD Abstract Background:, The emergency department (ED) environment presents unique barriers to the process of obtaining informed consent for research. Objectives:, The objective was to identify commonalities and differences in informed consent practices for research employed in academic EDs. Methods:, Between July 1, 2006, and June 30, 2007, an online survey was sent to the research directors of 142 academic emergency medicine (EM) residency training programs identified through the Accreditation Council for Graduate Medical Education (ACGME). Results:, Seventy-one (50%) responded. The average number of simultaneous clinical ED-based research projects reported was 7.3 (95% confidence interval [CI] = 5.53 to 9.07). Almost half (49.3%) of respondents reported that EM residents are responsible for obtaining consent. Twenty-nine (41.4%) participating institutions do not require documentation of an individual resident's knowledge of the specific research protocol and consent procedure before he or she is allowed to obtain consent from research subjects. Conclusions:, It is common practice in academic EDs for clinical investigators to rely on on-duty health care personnel to obtain research informed consent from potential research subjects. This practice raises questions regarding the sufficiency of the information received by research subjects, and further study is needed to determine the compliance of this consent process with federal guidelines. [source] Debriefing critical incidents in the paediatric emergency department: Current practice and perceived needs in Australia and New ZealandEMERGENCY MEDICINE AUSTRALASIA, Issue 6 2009Theane Theophilos Abstract Anecdotally critical incident debriefing (CID) is an important topic for staff in paediatric ED. The present study aimed to determine current baseline CID practices and perceived needs of ED staff. A questionnaire regarding CID practice was circulated to all 13 Paediatric Research in Emergency Departments International Collaborative (PREDICT) sites in Australia and New Zealand (including all tertiary paediatric ED), and completed by 1 senior doctor and 1 senior nurse. All PREDICT sites participated (13 nurses, 13 doctors). Seventy per cent did not currently have a hospital protocol on debriefing and 90% did not have ED-specific guidelines. The most commonly debriefed topics were death of a patient, multi-trauma and sudden infant death syndrome, also ranked highest in importance for debriefing. The median reported debriefs per department were 4 per year (range 0,12), all conducted within a week of the CI with half within 24 h. ED workers most likely to be invited to the CID session were doctors, nurses and social workers (96%). Debriefing was mostly conducted internally (62%) and most likely facilitated by a doctor (81%) or nurse (54%). Debriefing addressed both clinical and emotional issues (89%) within the same session (69%). Debriefing was rated as very important, median of 8/10 by doctors and 10/10 by nurses. Almost 90% of those surveyed indicated that they would like a CID programme and guidelines for their department. Debriefing is perceived as important by senior ED clinicians, yet few ED have formalized guidelines or programmes. Best-practice guidelines should be developed. [source] Diagnostic and therapeutic use of radioisotopes for bony disease in prostate cancer: Current practiceINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2007Nathan Lawrentschuk Abstract: Nuclear medicine techniques continue to be important non-invasive imaging tools assisting the diagnosis, monitoring and , in some cases , treatment of prostate cancer. Bone scintigraphy was the premier modality to have an extensive role in the staging of prostate cancer and has remained an integral tool for over three decades in the assessment of newly diagnosed disease or in follow-up staging. Therapeutic treatment and palliation of disseminated disease, particularly in the skeleton, has also been successful with several radioisotopes including strontium-89 chloride. Despite advances in nuclear medicine techniques and molecular imaging technology such as positron emission tomography and radioimmunoscintigraphy, bone scintigraphy still remains the gold standard in the assessment of osseous metastatic disease in prostate cancer. Thus, it is important to continually review the modalities that have remained important over time and not just to focus on newer technologies. This article summarizes the current diagnostic and therapeutic use of radioisotopes for bony disease in prostate cancer with particular reference to radionuclide bone scintigraphy and positron emission tomography. [source] The Effect of Changing Practice on Fall Prevention in a Rehabilitative Hospital: The Hospital Injury Prevention StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2004Michael Vassallo FRCP Objectives: To determine whether a change in practice to introduce a multidisciplinary fall-prevention program can reduce falls and injury in nonacute patients in a rehabilitation hospital. Design: A quasi-experimental study. Setting: Three geriatric wards with a similar design, equipment, staffing levels, and skill mix. Participants: Eight hundred twenty-five consecutive patients. Intervention: The patients' fall-risk status was assessed using the Downton Score. Current practice was maintained on the two control wards (n=550). On the experimental ward (n=275), a fall-prevention program was introduced. A multidisciplinary team met weekly specifically to discuss patients' fall risk and formulate a targeted plan. Patients at risk were identified using wristbands; risk factors were corrected or environmental changes made to enhance safety. Measurements: Primary outcomes were number of fallers, recurrent fallers, total falls, patients sustaining injury, and falls per occupied bed days. Secondary outcomes were place of discharge and mortality. Results: Patients were matched for age and risk status. Control wards had proportionally more fallers (20.2% vs 14.2%: P=.033), patients sustaining injury (8.2% vs 4%: P=.025), and total number of falls (170 vs 72: P=.045). These results did not remain significant after controlling for differing length of stay. There was no reduction in recurrent fallers (6.4% vs 4.7%: P=.43) and no effect on place of discharge (home discharges; 57.5% vs 60.7%: P=.41) or mortality (15.3% vs 13.8%: P=.60). Conclusion: This study shows that falls might be reduced in a multidisciplinary fall-prevention program, but the results are not definitive because of the borderline significance achieved and the variable length of stay. More research on fall prevention in hospital is required, particularly as to what interventions, if any, are effective at reducing falls in this group of patients. [source] Current practice compared with the international guidelines: endoscopic surveillance of Barrett's esophagusJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2007Nassira Amamra MPH Abstract Rationale, aims and objectives, To describe the current practice for the surveillance of patients with Barrett's esophagus, to compare this practice with the national guidelines published by the French Society of Digestive Endoscopy in 1998 and to identify the factors associated with the compliance to guidelines. Method, To determine the attitudes of French hepatogastroenterologists to screening for Barrett's oesophagus, a postal anonymous questionnaire survey was undertaken. It was sent to 246 hepatogastroenterologists in the Rhone-Alpes area. We defined eight criteria allowed to assess the conformity of practices with the guidelines. We created three topics composed of several criterion. The topics analysed were ,Biopsies', ,Surveillance' and the diagnosis of high grade dysplasia. We studied the factors which could be associated with the compliance with the guidelines. Results, The response rate was 81.3%. For 58.0% of the gastroenterologists, endoscopic biopsy sampling were made according to French guidelines (four-quadrant biopsies at 2 cm intervals). Agreement was 78.0% regarding the interval of surveillance for no dysplasia (every 2 or 3 years) and 78.5% regarding the low-grade dysplasia (every 6 or 12 months). For the management of high-grade dysplasia, 28.6% actually confirm the diagnosis by a second anatomopathologist and 42.0% treated by proton pump inhibitor during 2 months. Concerning the biopsies, the young gastroenterologists and gastroenterologists practising in university hospitals had a better adherence to the guidelines (Relative Risk: 2.22, 95% CI 1.25,3.95 and 3.74, 95% CI 1.04,13.47, respectively). The other factors of risk were not statistically significant. Conclusions, The endoscopic follow-up is mostly realized in accordance with the national guidelines. However, there is a wide variability in individual current practice. [source] Current practice in the management of children with cerebral palsy: a national survey of paediatric dietitiansJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2003Hilary Hartley Abstract Background Dietitians play a key role in the clinical management of children with cerebral palsy. This survey was conducted with the aim of establishing an overview of current dietetic practice in the management of these children. Method A questionnaire which asked for information on aspects of dietetic practice relating to children with cerebral palsy was circulated to members of the British Dietetic Association during May to October 2000. Results Many respondents had a small caseload size. However, a larger caseload was linked to membership of a multi-disciplinary team, a greater proportion of severely disabled children and use of a wider range of anthropometric measurements. Dietitians who were members of a multi-disciplinary team were more likely to visit children at home. Conclusions This survey provides an overview of current dietetic practice in the UK regarding the management of children with cerebral palsy. There is a potential shortfall in specialist dietitians and this survey highlights some of the gaps in service provision. Children with cerebral palsy benefit from dietetic input and there is an increasing need for specialist dietitians to be involved in their management. It will be necessary to continue to identify any gaps and find ways to overcome them. [source] Treatment of mild to moderate dehydration in children with oral rehydration therapyJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 8 2008Kristene C Diggins RN Abstract Purpose: To review current literature on the effectiveness of oral rehydration therapy (ORT) in the treatment of mild to moderate dehydration in children. Data sources: Recommendations from American Academy of Pediatrics (AAP), World Health Organization (WHO), selected research articles (2000,2006), and Internet sources. Conclusions: Dehydration is a common diagnosis in pediatric primary care. The literature indicates that dehydration is more often treated with intravenous (IV) therapy when ORT would be equally effective. ORT is an effective treatment for children with mild to moderate dehydration. ORT could be used more frequently rather than IV rehydration therapy. The use of ORT versus traditional methods of IV hydration matches the nursing philosophy of holistic care by enhancing client comfort and autonomy. Implications for practice: Current practice in the treatment of mild to moderate dehydration in children does not match both AAP and WHO guidelines, which are based on evidence supporting ORT effectiveness. Treatment with ORT allows children more flexibility to be treated at home and thus decreases hospital stay. Evidence shows that the time required to initiate ORT is actually quicker than IV therapy and allows for a less stressful therapy that can be performed in the home. [source] Current practice of antifungal prophylaxis and treatment in immunocompromised children and adults with malignancies: a single centre approachMYCOSES, Issue 2 2009Thomas Lehrnbecher Summary Although various guidelines on antifungal prophylaxis and treatment have been published, the practical approach in the individual clinical setting might considerably differ because of special local circumstances. In addition, there are major differences between paediatric and adult patients regarding antifungal strategies and the use of antifungal compounds. We here present the antifungal approach in the Departments of Hematology and Oncology of the University Hospital of Frankfurt, where per year approximately 350 children and adults are diagnosed with cancer and an additional 100 patients undergo haematopoietic stem cell transplantation. The differences in the approach between the paediatric and adult setting are highlighted. [source] Current practice of emergency vagotomy and Helicobacter pylori eradication for complicated peptic ulcer in the United KingdomBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 1 2003A. D. Gilliam Background The aim was to assess the current opinion of surgeons, by subspecialty, towards vagotomy and the practice of Helicobacter pylori testing, treatment and follow-up, in patients with bleeding or perforated duodenal ulcer. Methods A postal questionnaire was sent to 1073 Fellows of the Association of Surgeons of Great Britain and Ireland in 2001. Results Some 697 valid questionnaires were analysed (65·0 per cent). Most surgeons did not perform vagotomy for perforated or bleeding duodenal ulcer. There was no statistical difference between the responses of upper gastrointestinal surgeons and those of other specialists for perforated (P = 0·35) and bleeding (P = 0·45) ulcers. Respondents were more likely to perform a vagotomy for bleeding than for a perforated ulcer (P < 0·001). Although more than 80 per cent of surgeons prescribed H. pylori eradication treatment after operation, fewer than 60 per cent routinely tested patients for H. pylori eradication. Upper gastrointestinal surgeons were more likely to prescribe H. pylori treatment and test for eradication than other specialists (P < 0·01). Conclusion Most surgeons in the UK no longer perform vagotomy for duodenal ulcer complications. Copyright © 2002 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd [source] Current practice in the management of acute cholecystitisBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2000I. C. Cameron Aims: Several recent papers have advocated emergency cholecystectomy for patients with acute cholecystitis, stating that it is safe, cost effective and leads to less time off work. This study was designed to assess current practice in the management of acute cholecystitis in the UK. Methods: A postal questionnaire was sent to 357 consultant surgeons who were thought to be involved in a general surgical on-call rota, to ascertain their current management of patients with acute cholecystitis. Replies were received from 250 consultants (70 per cent) of whom 242 (68 per cent) were involved in a general surgical take. Sixteen of these consultants, however, handed their patients with acute cholecystitis on to a different team the following day for further management. Results: Twenty-seven consultants (12 per cent) routinely treat their patients by emergency cholecystectomy whenever possible, with 24 stating that they would do this within 72 h. Limiting factors to this practice were stated to be availability of surgical staff (15), theatre space (nine) and radiological investigations (four). The remaining consultants (n = 199) routinely manage their patients conservatively initially and providing they settle, either (1) book directly for cholecystectomy (n = 94, 47 per cent), (2) reassess as an outpatient (n = 65, 33 per cent), (3) either of above (n = 21; 11 per cent) or (4) refer on to a colleague (n = 19, 10 per cent). The commonest indications for acute cholecystectomy stated by consultants whose initial treatment policy is conservative are spreading peritonitis due to bile leak (93 per cent), empyema (89 per cent), unexpected space on a theatre list (28 per cent) and failure of an acute episode to settle (21 per cent). The laparoscopic method is the commonest for both elective and emergency cholecystectomy, but the percentage of consultants using an open method rises dramatically from 9 per cent in the elective situation to 48 per cent for emergency cholecystectomy. Conclusions: Despite evidence to support the increased use of emergency cholecystectomy, this practice is routinely carried out by only 12 per cent of consultants. However, of the consultants who treat their patients conservatively, 28 per cent are prepared to undertake emergency cholecystectomy if an unexpected space appears on the theatre list. © 2000 British Journal of Surgery Society Ltd [source] A Decision Support System Specification for Cost Escalation in Heavy Engineering IndustryCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 5 2002Nashwan N. Dawood The heavy civil engineering industry (railways, sewage-treatment, chemical and pharmaceutical facilities, oil and gas facilities, etc.) is one of the major contributors to the British economy and generally involves a high level of investment. Clients in this industry are demanding accurate cost estimates, proper analysis of out-turn cost and cost escalation, and a high quality risk analysis throughout the construction processes. Current practices in the industry have suggested that there is a lack of structured methodologies and systematic cost escalation approaches to achieve an appropriate cost analysis at the outset of projects and throughout the construction processes. In this context the prime objective of this research work is to develop a structured cost escalation methodology for improving estimating management and control in the heavy engineering industry construction processes. The methodology is composed of a forecasting model to predict cost indices of major items in industry and a risk knowledge-base model for identifying and quantifying causes of cost escalations. This paper reviews and discusses a knowledge-based model for applying a cost escalation factor. The cost escalation factor is made up of market variation, a risk element, and a component for bias. A knowledge elicitation strategy was employed to obtain the required knowledge for the model. The strategy included questionnaires, interviews, and workshops, and deliverables came in the form of influences and their effect on project cost escalation. From these deliverables, a decision support system and specifications for applying cost escalation to base estimates are presented. [source] Sampling within households in household surveysJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2007Robert G. Clark Summary., The number of people to select within selected households has significant consequences for the conduct and output of household surveys. The operational and data quality implications of this choice are carefully considered in many surveys, but the effect on statistical efficiency is not well understood. The usual approach is to select all people in each selected household, where operational and data quality concerns make this feasible. If not, one person is usually selected from each selected household. We find that this strategy is not always justified, and we develop intermediate designs between these two extremes. Current practices were developed when household survey field procedures needed to be simple and robust; however, more complex designs are now feasible owing to the increasing use of computer-assisted interviewing. We develop more flexible designs by optimizing survey cost, based on a simple cost model, subject to a required variance for an estimator of population total. The innovation lies in the fact that household sample sizes are small integers, which creates challenges in both design and estimation. The new methods are evaluated empirically by using census and health survey data, showing considerable improvement over existing methods in some cases. [source] Incorporating employee resourcing requirements into deployment decision makingPROJECT MANAGEMENT JOURNAL, Issue 2 2009Andrew R. J. Dainty Abstract Employee resourcing is the process of matching human resource capabilities to the strategic and operational needs of the organization. This is exceptionally problematic in project-based organizations due to the competing priorities of the project, the individual employee, and the wider succession needs of the organization. This article presents the findings of research examining the human resource management practices that form the key components of the resourcing process. These included, inter alia, human resource planning, recruitment and selection, team deployment, performance management, and human resource administration. Current practices were examined in seven leading construction firms, all of which faced dynamic resourcing priorities. Within an inductive methodology, semistructured interviews were carried out with senior executives, human resource management (HRM) specialists, senior operational managers, and project-based staff. Based on a synthesis of the promising practices extracted from the case-study organizations, an innovative approach to project resourcing was developed that aims to balance organizational, project, and individual employee requirements. Team deployment resides at the center of resourcing process for the project-based organization as it determines the success of the project, which in turn determines the competitiveness of the organization. Long-term planning and employee involvement enable team deployment to integrate with other elements of HRM effectively and thus help to balance the organizational strategic priorities, project requirements, and individual employee needs and preferences. [source] Standardization of lung function testing: Current practices in laboratories in Australia and New ZealandRESPIROLOGY, Issue 4 2006Graham L. HALL No abstract is available for this article. [source] Current practices in depression careTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue S1 2007Albert Yeung MD Abstract Despite improved awareness among the medical community concerning common mental health disorders, the high prevalence of depression in the United States remains unchanged1 and has been compounded by increasing evidence of gaps in mental health care for ethnic and racial minorities.1,2 Thus, there is a strong need for the timely creation of comprehensive educational initiatives aimed at improving the quality of care provided by mental health professionals and primary care physicians. Fundamental to this process is the examination of current treatment standards, as well as identification of practices that require improved physician education. Consistent use of appropriate screening tools, diagnostic accuracy and timeliness, continual assessment of illness severity, adherence to practice guidelines, and individualized patient care need heightened attention to improve outcomes. This article describes the most prevalent types of depression and summarizes current practices in depression care, with an emphasis on treatment standards and opportunities for improved performance. [source] BetweenIT: An Interactive Tool for Tight InbetweeningCOMPUTER GRAPHICS FORUM, Issue 2 2010Brian Whited Abstract The generation of inbetween frames that interpolate a given set of key frames is a major component in the production of a 2D feature animation. Our objective is to considerably reduce the cost of the inbetweening phase by offering an intuitive and effective interactive environment that automates inbetweening when possible while allowing the artist to guide, complement, or override the results. Tight inbetweens, which interpolate similar key frames, are particularly time-consuming and tedious to draw. Therefore, we focus on automating these high-precision and expensive portions of the process. We have designed a set of user-guided semi-automatic techniques that fit well with current practice and minimize the number of required artist-gestures. We present a novel technique for stroke interpolation from only two keys which combines a stroke motion constructed from logarithmic spiral vertex trajectories with a stroke deformation based on curvature averaging and twisting warps. We discuss our system in the context of a feature animation production environment and evaluate our approach with real production data. [source] Searching for Better Negotiation Agreement Based on Genetic AlgorithmCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 4 2005Ren-Jye Dzeng In current practice, contractors negotiate with suppliers according to negotiators' experiences instead of extensive exploration of negotiable options and negotiators' preferences. Consequently, negotiators often reach suboptimal agreements, and leave money on the table. This research intends to help negotiators explore negotiable options by developing a computer system, named C-Negotiator, using the genetic algorithm. This article also describes experiments conducted to determine how much money was left on the table on typical realistic construction procurements. The result shows that C-Negotiator's negotiation improved the joint payoff of the contractor and supplier from 1.5% to 9.8% compared with conventional human negotiation. The improvement may increase for more complex negotiation problems with more options and complicated preferences or for inexperienced negotiators. [source] Middleware benchmarking: approaches, results, experiences,CONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 15 2005Paul Brebner Abstract The report summarizes the results of the Workshop on Middleware Benchmarking held during OOPSLA 2003. The goal of the workshop was to help advance the current practice of gathering performance characteristics of middleware implementations through benchmarking. The participants of the workshop have focused on identifying requirements of and obstacles to middleware benchmarking and forming a position on the related issues. Selected requirements and obstacles are presented, together with guidelines to adhere to when benchmarking, open issues of current practice, and perspectives on further research. Copyright © 2005 John Wiley & Sons, Ltd. [source] UNDER THE BARRED UMBRELLA: IS THERE ROOM FOR A WOMEN-CENTERED SELF-INJURY POLICY IN CANADIAN CORRECTIONS?CRIMINOLOGY AND PUBLIC POLICY, Issue 1 2006JENNIFER M. KILTY Research Summary: This article examines a chain of policy directives concerning self-injury inside federal correctional facilities in Canada. Specific attention is paid to the impact of these policies on federally sentenced women. I argue that the Correctional Service of Canada's focus on risk assessment fails to address the needs of the women they confine. Instead, women's needs are reconceptualized as institutional risk factors. Policy Implications: Women who self-injure are still routinely disciplined for their behaviour in Federal Canadian prisons through admittance to administrative segregation. This policy challenges two sections of the Charter of Rights and Freedoms (s. 7 and s. 15) and must be changed. In this article, I will recommend a new women-centered approach to replace current practice. [source] Comparison of international and New Zealand guidelines for the care of pregnant women with diabetesDIABETIC MEDICINE, Issue 5 2006W. A. Cutchie Abstract Objective To compare international guidelines for the care of women with diabetes and pregnancy with reported current practice among New Zealand tertiary centres. Research design and methods A literature review of national and international guidelines for the care of women with diabetes in pregnancy was undertaken. Guideline activities were placed within nine facets of care, from preconception advice, through pregnancy from screening to follow-up. New Zealand tertiary centres guidelines were obtained and placed in the same framework. Results International guideline consensus was inconsistent across most facets of care. Those for the detection and diagnosis of gestational diabetes mellitus (GDM) were particularly discordant internationally, although intranational agreement has occurred. Conclusions International guidelines for the care of women with diabetes in pregnancy remain fragmented. The development of one set of guidelines based on the consensus of international best practice could overcome many of the misconceptions associated with diabetes in pregnancy. [source] Risk assessment for nonindigenous pests: 2.DIVERSITY AND DISTRIBUTIONS, Issue 5 2001Accounting for interyear climate variability Abstract The paper firstly discusses the importance of accounting for interyear variability when assessing the likelihood of establishment of an alien pest. The potential establishment of Colorado beetle (Leptinotarsa decemlineata) is used as an illustration within the geographical context of England and Wales. An aggregate risk index is introduced as a probabilistic representation of the likelihood that a pest might complete a single generation over a 30-year period (1961,90). Data for individual years were used to compute, objectively, the interyear distribution of risk across the landscape. The standard deviation in area at risk (26 800 km2) was high relative to the average proportion of the landscape potentially at risk (95 700 km2). In 40% of years, the area at risk was estimated to be higher than ,average'. Secondly, the paper demonstrates multiple indices of risk that reflect different aspects of pest risk assessment. Viewing risk from a variety of perspectives provides a means of gauging the consistency and therefore reliability of the results. This contrasts with current practice, where a single mapped output is commonly presented to decision makers. Modelling using a daily time step allowed the use of indices to investigate the long-term probabilities of biotic and abiotic events of short duration. These indices include estimates of pest activity and flight potential. [source] | ||||||||||||||||||||||||||||||||||||||||||||||