774 resultados para Best-selling books


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Vegeu el resum a l'inici del document de l'arxiu adjunt

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El projecte COIM-BEST ha investigat com, per mitjà de la formació, es pot millorar la coordinació entre múltiples agències per fer front a les situacions crítiques que es produeixen en les grans emergències. Entre les conclusions de l’estudi COIM-BEST, que ja ha rebut bones valoracions per part de la comissió europea, es destaca la necessitat d’una bona coordinació entre els cossos i agents que participen en la gestió de les grans crisis, generar una confiança entre aquests actors, harmonitzar la formació i una bona articulació de les categories de comandament que es fan càrrec de la direcció de la gestió de l’emergència. El projecte COIM-BEST s'emmarca en el Programa per a la prevenció, preparació i gestió de les conseqüències del terrorisme i altres riscos relacionats amb la seguretat (CIPS) de la Direcció General de Justícia, Llibertat i Seguretat de la Comissió Europea i compta amb la col·laboració de l‘Institut de Seguretat Pública de Catalunya, la Fondazione per la Ricerca sulle Migrazione e Integrazione delle Tecnologie (FORMIT), el Global Law Enforcement Institute i la Universitat Politècnica de Catalunya

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A workshop was convened to discuss best practices for the assessment of drug-induced liver injury (DILI) in clinical trials. In a breakout session, workshop attendees discussed necessary data elements and standards for the accurate measurement of DILI risk associated with new therapeutic agents in clinical trials. There was agreement that in order to achieve this goal the systematic acquisition of protocol-specified clinical measures and lab specimens from all study subjects is crucial. In addition, standard DILI terms that address the diverse clinical and pathologic signatures of DILI were considered essential. There was a strong consensus that clinical and lab analyses necessary for the evaluation of cases of acute liver injury should be consistent with the US Food and Drug Administration (FDA) guidance on pre-marketing risk assessment of DILI in clinical trials issued in 2009. A recommendation that liver injury case review and management be guided by clinicians with hepatologic expertise was made. Of note, there was agreement that emerging DILI signals should prompt the systematic collection of candidate pharmacogenomic, proteomic and/or metabonomic biomarkers from all study subjects. The use of emerging standardized clinical terminology, CRFs and graphic tools for data review to enable harmonization across clinical trials was strongly encouraged. Many of the recommendations made in the breakout session are in alignment with those made in the other parallel sessions on methodology to assess clinical liver safety data, causality assessment for suspected DILI, and liver safety assessment in special populations (hepatitis B, C, and oncology trials). Nonetheless, a few outstanding issues remain for future consideration.

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BACKGROUND Most textbooks contains messages relating to health. This profuse information requires analysis with regards to the quality of such information. The objective was to identify the scientific evidence on which the health messages in textbooks are based. METHODS The degree of evidence on which such messages are based was identified and the messages were subsequently classified into three categories: Messages with high, medium or low levels of evidence; Messages with an unknown level of evidence; and Messages with no known evidence. RESULTS 844 messages were studied. Of this total, 61% were classified as messages with an unknown level of evidence. Less than 15% fell into the category where the level of evidence was known and less than 6% were classified as possessing high levels of evidence. More than 70% of the messages relating to "Balanced Diets and Malnutrition", "Food Hygiene", "Tobacco", "Sexual behaviour and AIDS" and "Rest and ergonomics" are based on an unknown level of evidence. "Oral health" registered the highest percentage of messages based on a high level of evidence (37.5%), followed by "Pregnancy and newly born infants" (35%). Of the total, 24.6% are not based on any known evidence. Two of the messages appeared to contravene known evidence. CONCLUSION Many of the messages included in school textbooks are not based on scientific evidence. Standards must be established to facilitate the production of texts that include messages that are based on the best available evidence and which can improve children's health more effectively.

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[Vente (Livres). 1897-11-11. Londres]

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Recent clinical trials with type 2 diabetic patients and the quest of normal glyceamic values, have revealed difficulties and limitations. These too normal glyceamic targets corresponding to the physiological standards are associated with very high rate of hypoglycemia and an increase of mortality. A too simplistic view of treatment: "the lowest, the better is in the diabetes" is no longer defensible. The knowledge from complex systems behavior invites us to search targets adapted to a new state of equilibrium due to loss of self-regulation. These targets should not aim the physiological standards but to be adapted to patient's situation. Shared decision-making and consensus are the two pillars of this new strategy supported by the new ADA-EASD guidelines.

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BACKGROUND: The goals of our study are to determine the most appropriate model for alcohol consumption as an exposure for burden of disease, to analyze the effect of the chosen alcohol consumption distribution on the estimation of the alcohol Population- Attributable Fractions (PAFs), and to characterize the chosen alcohol consumption distribution by exploring if there is a global relationship within the distribution. METHODS: To identify the best model, the Log-Normal, Gamma, and Weibull prevalence distributions were examined using data from 41 surveys from Gender, Alcohol and Culture: An International Study (GENACIS) and from the European Comparative Alcohol Study. To assess the effect of these distributions on the estimated alcohol PAFs, we calculated the alcohol PAF for diabetes, breast cancer, and pancreatitis using the three above-named distributions and using the more traditional approach based on categories. The relationship between the mean and the standard deviation from the Gamma distribution was estimated using data from 851 datasets for 66 countries from GENACIS and from the STEPwise approach to Surveillance from the World Health Organization. RESULTS: The Log-Normal distribution provided a poor fit for the survey data, with Gamma and Weibull distributions providing better fits. Additionally, our analyses showed that there were no marked differences for the alcohol PAF estimates based on the Gamma or Weibull distributions compared to PAFs based on categorical alcohol consumption estimates. The standard deviation of the alcohol distribution was highly dependent on the mean, with a unit increase in alcohol consumption associated with a unit increase in the mean of 1.258 (95% CI: 1.223 to 1.293) (R2 = 0.9207) for women and 1.171 (95% CI: 1.144 to 1.197) (R2 = 0. 9474) for men. CONCLUSIONS: Although the Gamma distribution and the Weibull distribution provided similar results, the Gamma distribution is recommended to model alcohol consumption from population surveys due to its fit, flexibility, and the ease with which it can be modified. The results showed that a large degree of variance of the standard deviation of the alcohol consumption Gamma distribution was explained by the mean alcohol consumption, allowing for alcohol consumption to be modeled through a Gamma distribution using only average consumption.

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The purpose of this research project is to study current practices in enhancing visibility and protection of highway maintenance vehicles involved in moving operations such as snow removal and shoulder operations, crack sealing, and pothole patching. The results will enable the maintenance staff to adequately assess the applicability and impact of each strategy to their use and budget. The report’s literature review chapter examines the use of maintenance vehicle warning lights, retroreflective tapes, shadow vehicles and truck-mounted attenuators, and advanced vehicle control systems, as well as other practices to improve visibility for both snowplow operators and vehicles. The chapter concludes that the Manual on Uniform Traffic Control Devices does not specify what color or kind of warning lights to use. Thus, a wide variety of lights are being used on maintenance vehicles. The study of the relevant literatures also suggests that there are no clear guidelines for moving work zones at this time. Two types of surveys were conducted to determine current practices to improve visibility and safety in moving work zones across the country and in the state of Iowa. In the first survey of state departments of transportation, most indicated using amber warning lights on their maintenance vehicles. Almost all the responding states indicated using some form of reflective material on their vehicles to make them more visible. Most participating states indicated that the color of their vehicles is orange. Most states indicated using more warning lights on snow removal vehicles than their other maintenance vehicles. All responding state agencies indicated using shadow vehicles and/or truck-mounted attenuators during their moving operations. In the second survey of Iowa counties, most indicated using very similar traffic control and warning devices during their granular road maintenance and snow removal operations. Mounting warning signs and rotating or strobe lights on the rear of maintenance vehicles is common for Iowa counties. The most common warning devices used during the counties’ snow removal operations are reflective tapes, warning flags, strobe lights, and auxiliary headlamps.

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Bridge approach settlement and the formation of the bump is a common problem in Iowa that draws upon considerable resources for maintenance and creates a negative perception in the minds of transportation users. This research study was undertaken to investigate bridge approach problems and develop new concepts for design, construction, and maintenance that will reduce this costly problem. As a result of the research described in this report, the following changes are suggested for implementation on a pilot test basis: • Use porous backfill behind the abutment and/or geocomposite drainage systems to improve drainage capacity and reduce erosion around the abutment. • On a pilot basis, connect the approach slab to the bridge abutment. Change the expansion joint at the bridge to a construction joint of 2 inch. Use a more effective joint sealing system at the CF joint. Change the abutment wall rebar from #5 to #7 for non-integral abutments. • For bridges with soft foundation or embankment soils, implement practices of better compaction, preloading, ground improvement, soil removal and replacement, or soil reinforcement that reduce time-dependent post construction settlements.

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NovoTTF-100A (TTF) is a portable device delivering low-intensity, intermediate-frequency, alternating electric fields using noninvasive, disposable scalp electrodes. TTF interferes with tumor cell division, and it has been approved by the US Food and Drug Administration (FDA) for the treatment of recurrent glioblastoma (rGBM) based on data from a phase III trial. This presentation describes the updated survival data 2 years after completing recruitment. Adults with rGBM (KPS ≥ 70) were randomized (stratified by surgery and center) to either continuous TTF (20-24 h/day, 7 days/week) or efficacious chemotherapy based on best physician choice (BPC). The primary endpoint was overall survival (OS), and secondary endpoints were PFS6, 1-year survival, and QOL. Patients were randomized (28 US and European centers) to either TTF alone (n ¼ 120) or BPC (n ¼ 117). Patient characteristics were balanced, median age was 54 years (range, 23-80 years), and median KPS was 80 (range, 50-100). One quarter of the patients had debulking surgery, and over half of the patients were at their second or later recurrence. OS in the intent-to-treat (ITT) population was equivalent in TTF versus BPC patients (median OS, 6.6vs. 6.0 months; n ¼ 237; p ¼ 0.26; HR ¼ 0.86). With a median follow-up of 33.6 months, long-term survival in the TTF group was higher than that in the BPC group at 2, 3, and 4 years of follow-up (9.3% vs. 6.6%; 8.4% vs. 1.4%; 8.4% vs. 0.0%, respectively). Analysis of patients who received at least one treatment course demonstrated a survival benefit for TTF patients compared to BPC patients (median OS, 7.8 vs. 6.0 months; n ¼ 93 vs. n ¼ 117; p ¼ 0.012; HR ¼ 0.69). In this group, 1-year survival was 28% vs. 20%, and PFS6 was 26.2% vs. 15.2% (p ¼ 0.034). TTF, a noninvasive, novel cancer treatment modality shows significant therapeutic efficacy with promising long-term survival results. The impact of TTF was more pronounced when comparing only patients who received the minimal treatment course. A large-scale phase III trial in newly diagnosed GBM is ongoing.

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Designs of CSCL (Computer Supported Collaborative Learning)activities should be flexible, effective and customizable toparticular learning situations. On the other hand, structureddesigns aim to create favourable conditions for learning. Thus,this paper proposes the collection of representative and broadlyaccepted (best practices) structuring techniques in collaborative learning. With the aim of establishing a conceptual common ground among collaborative learning practitioners and softwaredevelopers, and reusing the expertise that best practicesrepresent, the paper also proposes the formulation of these techniques as patterns: the so-called CLFPs (CollaborativeLearning Flow Patterns). To formalize these patterns, we havechosen the educational modelling language IMS Learning Design (IMS-LD). IMS-LD has the capability to specify many of the collaborative characteristics of the CLFPs. Nevertheless, the language bears limited capability for describing the services that mediate interactions within a learning activity and the specification of temporal or rotated roles. This analysis isdiscussed in the paper, as well as our approaches towards thedevelopment of a system capable of integrating tools using IMSLDscripts and a CLFP-based Learning Design authoring tool.

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This guidebook has been published by the University of Northern Iowa New Iowans Program to assist employers, managers and supervisors with the unique challenges associated with hiring, training and integrating immigrant and refugee workers. Its purpose is to promote proactive engagement of newcomer workers to assure the vitality of Iowa businesses. Successful integration of immigrants and refugees in our workplaces and communities is essential to insure Iowa’s long-term economic and social health. This book provides essential information for human resource directors, trainers, supervisors and others as they meet the challenges and rewards of hiring immigrants and refugees. Of course, no guidebook can provide simple solutions to complex issues in a great variety if workplaces. This is not a “cookbook” with recipes that provide easy answers to challenges facing every company and worker. All employers are unique and approach problems differently. What works in one company might not work as well in another.

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Bridge approach settlement and the formation of the bump is a common problem in Iowa that draws upon considerable resources for maintenance and creates a negative perception in the minds of transportation users. This research study was undertaken to investigate bridge approach problems and develop new concepts for design, construction, and maintenance that will reduce this costly problem. As a result of the research described in this report, the following changes are suggested for implementation on a pilot test basis: • Use porous backfill behind the abutment and/or geocomposite drainage systems to improve drainage capacity and reduce erosion around the abutment. • On a pilot basis, connect the approach slab to the bridge abutment. Change the expansion joint at the bridge to a construction joint of 2 inch. Use a more effective joint sealing system at the CF joint. Change the abutment wall rebar from #5 to #7 for non-integral abutments. • For bridges with soft foundation or embankment soils, implement practices of better compaction, preloading, ground improvement, soil removal and replacement, or soil reinforcement that reduce time-dependent post construction settlements.