The ARCH Projects: design and rationale (IAASSG 001).

OBJECTIVE A number of factors limit the effectiveness of current aortic arch studies in assessing optimal neuroprotection strategies, including insufficient patient numbers, heterogenous definitions of clinical variables, multiple technical strategies, inadequate reporting of surgical outcomes and a lack of collaborative effort. We have formed an international coalition of centres to provide more robust investigations into this topic. METHODS High-volume aortic arch centres were identified from the literature and contacted for recruitment. A Research Steering Committee of expert arch surgeons was convened to oversee the direction of the research. RESULTS The International Aortic Arch Surgery Study Group has been formed by 41 arch surgeons from 10 countries to better evaluate patient outcomes after aortic arch surgery. Several projects, including the establishment of a multi-institutional retrospective database, randomized controlled trials and a prospectively collected database, are currently underway. CONCLUSIONS Such a collaborative effort will herald a turning point in the surgical management of aortic arch pathologies and will provide better powered analyses to assess the impact of varying surgical techniques on mortality and morbidity, identify predictors for neurological and operative risk, formulate and validate risk predictor models and review long-term survival outcomes and quality-of-life after arch surgery.

Monitoring disease activity and progression in Crohn's disease. A Swiss perspective on the IBD ahead 'optimised monitoring' recommendations.

BACKGROUND AND AIMS The structured IBD Ahead 'Optimised Monitoring' programme was designed to obtain the opinion, insight and advice of gastroenterologists on optimising the monitoring of Crohn's disease activity in four settings: (1) assessment at diagnosis, (2) monitoring in symptomatic patients, (3) monitoring in asymptomatic patients, and (4) the postoperative follow-up. For each of these settings, four monitoring methods were discussed: (a) symptom assessment, (b) endoscopy, (c) laboratory markers, and (d) imaging. Based on literature search and expert opinion compiled during an international consensus meeting, recommendations were given to answer the question 'which diagnostic method, when, and how often'. The International IBD Ahead Expert Panel advised to tailor this guidance to the healthcare system and the special prerequisites of each country. The IBD Ahead Swiss National Steering Committee proposes best-practice recommendations adapted for Switzerland. METHODS The IBD Ahead Steering Committee identified key questions and provided the Swiss Expert Panel with a structured literature research. The expert panel agreed on a set of statements. During an international expert meeting the consolidated outcome of the national meetings was merged into final statements agreed by the participating International and National Steering Committee members - the IBD Ahead 'Optimized Monitoring' Consensus. RESULTS A systematic assessment of symptoms, endoscopy findings, and laboratory markers with special emphasis on faecal calprotectin is deemed necessary even in symptom-free patients. The choice of recommended imaging methods is adapted to the specific situation in Switzerland and highlights the importance of ultrasonography and magnetic resonance imaging besides endoscopy. CONCLUSION The recommendations stress the importance of monitoring disease activity on a regular basis and by objective parameters, such as faecal calprotectin and endoscopy with detailed documentation of findings. Physicians should not rely on symptoms only and adapt the monitoring schedule and choice of options to individual situations.

Sutureless Aortic Valve Replacement International Registry (SU-AVR-IR): design and rationale from the International Valvular Surgery Study Group (IVSSG).

BACKGROUND Sutureless aortic valve replacement (SU-AVR) is an innovative approach which shortens cardiopulmonary bypass and cross-clamp durations and may facilitate minimally invasive approach. Evidence outlining its safety, efficacy, hemodynamic profile and potential complications is replete with small-volume observational studies and few comparative publications. METHODS Minimally invasive aortic valve surgery and high-volume SU-AVR replacement centers were contacted for recruitment into a global collaborative coalition dedicated to sutureless valve research. A Research Steering Committee was formulated to direct research and support the mission of providing registry evidence warranted for SU-AVR. RESULTS The International Valvular Surgery Study Group (IVSSG) was formed under the auspices of the Research Steering Committee, comprised of 36 expert valvular surgeons from 27 major centers across the globe. IVSSG Sutureless Projects currently proceeding include the Retrospective and Prospective Phases of the SU-AVR International Registry (SU-AVR-IR). CONCLUSIONS The global pooling of data by the IVSSG Sutureless Projects will provide required robust clinical evidence on the safety, efficacy and hemodynamic outcomes of SU-AVR.

Use of empowerment evaluation to determine a sustainability plan for a community-based preconception care program

Women With IMPACT (WWI) is a community-based preconception care educational intervention. WWI is being implemented by the Impacting Maternal and Prenatal Care Together (IMPACT) Collaborative and targets zip codes in Harris County, Texas at high risk for infant mortality, low birthweight, and preterm birth. WWI started March 2012 and continues through August 2013. Three workshop series are planned. This study was conducted with participants and facilitators from the first workshop series. This study aimed to 1) evaluate the WWI program using empowerment evaluation, 2) engage all WWI stakeholders in an empowerment evaluation so the method could be adopted as a participatory evaluation process for future IMPACT activities, and 3) develop recommendations for sustainability of the WWI intervention, based on empowerment evaluation findings and results from the pre/post program evaluation completed by WWI participants. Study participants included WWI participants and facilitators and IMPACT Collaborative Steering Committee members. WWI participants were female, 18-35 year-old, non-pregnant residents of zip codes at high risk of adverse birth outcomes. All other study participants were 18 years or older. A two-phased empowerment evaluation (EE) was utilized in this study. Sessions 1-4 were conducted independently of one another – 3 with participants at different sites and one with the facilitators. The fifth session included WWI participant and facilitator representatives, and IMPACT Steering Committee members. Session 5 built upon the work of the other sessions. Observation notes were recorded during each session. Thematic content analysis was conducted on all EE tables and observation notes. Mission statements drafted by each group focused on improvement of physical and mental health through behavior change and empowerment of all participants. The top 5 overall program components were: physical activity, nutrition, self-worth, in-class communication, and stress. Goals for program improvement were set by EE participants for each of these components. Through thematic content analysis of the tables and observation notes, social support emerged as an important theme of the program among all participant groups. Change to a healthy lifestyle emerged as an important theme in terms of program improvement. Two-phased EE provided an opportunity for all program stakeholders to provide feedback regarding important program components and provide suggestions for program improvement. EE, thematic content analysis, pre/post evaluation results, and inherent program knowledge were triangulated to make recommendations to sustain the program once the initial funding ends. ^

El cambio en la designación general de material (DGM) de las AACR a las RDA : Definición de los atributos tipo de contenido, tipo de medio y tipo de soporte

Se aborda el estudio de los atributos tipo de contenido, tipo de medio y tipo de soporte definidos por el código de catalogación Resource Description and Access (RDA) para solucionar los problemas que presentaba la lista de términos utilizadas para registrar la designación general de material (DGM) en las Anglo American Cataloging Rules (AACR). Los términos eran ambiguos combinando aspectos referidos al contenido y clase de material del recurso. Se parte de una exhaustiva revisión bibliográfica y del estudio de los documentos que se generaron en el proceso de elaboración del nuevo código. Se menciona el trabajo conjunto entre el Joint Steering Committee (JSC) y el estándar ONIX para el establecimiento de criterios que permitieron definir estos tres atributos, así como el aporte del modelo FRBR en la definición de los mismos. Se presentan ejemplos de registros bibliográficos donde se utilizan estos tres atributos en formato MARC21, ISBD consolidada a partir de la definición del área 0 y en el esquema de metadatos Dublin Core. Se finaliza destacando la necesidad de continuar con investigaciones que permitan concluir sobre la adecuación de estos tres atributos a las necesidades de los catalogadores, usuarios y a la realidad tecnológica

El cambio en la designación general de material (DGM) de las AACR a las RDA : Definición de los atributos tipo de contenido, tipo de medio y tipo de soporte

Se aborda el estudio de los atributos tipo de contenido, tipo de medio y tipo de soporte definidos por el código de catalogación Resource Description and Access (RDA) para solucionar los problemas que presentaba la lista de términos utilizadas para registrar la designación general de material (DGM) en las Anglo American Cataloging Rules (AACR). Los términos eran ambiguos combinando aspectos referidos al contenido y clase de material del recurso. Se parte de una exhaustiva revisión bibliográfica y del estudio de los documentos que se generaron en el proceso de elaboración del nuevo código. Se menciona el trabajo conjunto entre el Joint Steering Committee (JSC) y el estándar ONIX para el establecimiento de criterios que permitieron definir estos tres atributos, así como el aporte del modelo FRBR en la definición de los mismos. Se presentan ejemplos de registros bibliográficos donde se utilizan estos tres atributos en formato MARC21, ISBD consolidada a partir de la definición del área 0 y en el esquema de metadatos Dublin Core. Se finaliza destacando la necesidad de continuar con investigaciones que permitan concluir sobre la adecuación de estos tres atributos a las necesidades de los catalogadores, usuarios y a la realidad tecnológica

El cambio en la designación general de material (DGM) de las AACR a las RDA : Definición de los atributos tipo de contenido, tipo de medio y tipo de soporte

Se aborda el estudio de los atributos tipo de contenido, tipo de medio y tipo de soporte definidos por el código de catalogación Resource Description and Access (RDA) para solucionar los problemas que presentaba la lista de términos utilizadas para registrar la designación general de material (DGM) en las Anglo American Cataloging Rules (AACR). Los términos eran ambiguos combinando aspectos referidos al contenido y clase de material del recurso. Se parte de una exhaustiva revisión bibliográfica y del estudio de los documentos que se generaron en el proceso de elaboración del nuevo código. Se menciona el trabajo conjunto entre el Joint Steering Committee (JSC) y el estándar ONIX para el establecimiento de criterios que permitieron definir estos tres atributos, así como el aporte del modelo FRBR en la definición de los mismos. Se presentan ejemplos de registros bibliográficos donde se utilizan estos tres atributos en formato MARC21, ISBD consolidada a partir de la definición del área 0 y en el esquema de metadatos Dublin Core. Se finaliza destacando la necesidad de continuar con investigaciones que permitan concluir sobre la adecuación de estos tres atributos a las necesidades de los catalogadores, usuarios y a la realidad tecnológica

Epidemiological characteristics and diagnostic approach in patients admitted to the emergency room for transient loos of consciousness: Group for Syncope Study in the Emergency Room (GESINUR) study

Aims: To assess the clinical presentation and acute management of patients with transient loss of consciousness (T-LOC) in the emergency department (ED). Methods and results: A multi-centre prospective observational study was carried out in 19 Spanish hospitals over 1 month. The patients included were 14 years old and were admitted to the ED because of an episode of T-LOC. Questionnaires and corresponding electrocardiograms (ECGs) were reviewed by a Steering Committee (SC) to unify diagnostic criteria, evaluate adherence to guidelines, and diagnose correctly the ECGs. We included 1419 patients (prevalence, 1.14%).ECG was performed in 1335 patients (94%) in the ED: 498 (37.3%) ECGs were classified as abnormal. The positive diagnostic yield ranged from 0% for the chest X-ray to 12% for the orthostatic test. In the ED, 1217 (86%) patients received a final diagnosis of syncope, whereas the remaining 202 (14%) were diagnosed of non-syncopal transient lossof consciousness (NST-LOC). After final review by the SC, 1080 patients (76%) were diagnosed of syncope, whereas 339 (24%) were diagnosed of NST-LOC (P , 0.001). Syncope was diagnosed correctly in 84% of patients. Only 25% of patients with T-LOC were admitted to hospitals. Conclusion Adherence to clinical guidelines for syncope management was low; many diagnostic tests were performed with low diagnostic yield. Important differences were observed between syncope diagnoses at the ED and by SC decision.

The Civil Society Forum of the Eastern Partnership four years on: Progress, challenges and prospects. CEPS Special Report, January 2014

Established in 2009, during the Eastern Partnership Summit in Prague, the Eastern Partnership Civil Society Forum supports the development of civil society organisations from the EU-28 and the six Partnership countries, namely Armenia, Azerbaijan, Belarus, Georgia, Moldova and Ukraine. After four years of operation, the Secretariat of the Forum’s Steering Committee commissioned CEPS to conduct a comprehensive evaluation of its programme. This report singles out the institutionalisation and socialisation inculcated among its members as the Forum’s greatest accomplishment. In contrast to its internal developments, it argues that the external policy successes of the Forum remain modest. This report is the first attempt to conduct an in-depth assessment of the Forum's Annual Assembly, the Steering Committee and its Secretariat, the Working Groups and National Platforms. Ten actionable recommendations are put forward aimed at improving the Civil Society Forum’s standing and performance.

The twenty-first century needs a better G20 and a new G7+. Bruegel Policy Contribution 2014/13, 14 November 2014

During the 2008 financial crisis, the G20 was hastily elevated to ‘global economic steering committee’. In the early stages of the crisis, the G20 was an effective forum for crisis containment. As the crisis has eased, however, the G20 has lost both direction and momentum. Governments and policymakers have felt less need to act in unison and have rather refocused on their national agendas, as is their duty and primary function. However, effective global governance is needed permanently, not just in crisis times. It is desirable to have more representative and effective global governance that, among other things, is equipped to prevent crises rather than just react to them. In an environment of rapid change in global patterns of trade and wealth creation, a new revamped (but highly representative) grouping should be created within the G20, to provide leadership on key economic policy matters. Euro-area members should give up their individual seats in this G7+, allowing room for China and other large emerging economies. Without euro-area countries taking such a step, it would be impossible to reconcile effectiveness and representation in this new G7+, which would take charge of decision making on global economic imbalances, financial and monetary issues. All existing G20 countries, including individual euro-area countries, would however remain in the G20, which could potentially expand and would remain the prime forum for discussion on all remaining matters at global level.

Selected major elements and trace elements of ferrar dolerite clasts from sediment core CRP-1 (Table 1,2)

One of the objectives of the Cape Roberts Project is to study the tectonic history of the western Ross Sea region. Timing of the uplift of the Transantarctic Mountains, which are adjacent to the drillsite, will be a component of the tectonic studies (International Steering Committee, 1994; Cale Roberts Science Team, 1998a). The study of the clast samples from the core will be an important means of providing insight into the timing of uplift of the Transantarctic Mountains. Tholeiitic igneous rocks of the Jurassic (180 Ma) Ferrar large igneous province (FLIP) are widespreaded along the Transantarctic Mountains and have the potential to provide distinct indicators of erosion during uplift of the mountains. In the Transantarctic Mountains adjacent to the Cape Roberts drill site the FLIP is represented by lavas and pyroclastic of the Kirkpatrick basalts and by thick Ferrar dolerite sills which intrude the Beacon Supergroup sediments and, occasionally, the granitic basement rocks. In the Prince Albert Mountains, the youngest Kirkpatrick basalt lava is over 150 m thick, and has a very distinct high TiO2 chemical composition which is unique in the FLIP. If such rocks can be identified in the core they may provide precise timing of the initiation of uplift and denudation of the Transantarctic Mountains. Here we report on an examination of 20 Ferrar dolerite clasts. This brief report is intended as a pilot study to the examination of FLIP clasts from older drillcore.

Report of Machine Workshop on the 6-GeV Synchrotron Radiation Source : National Bureau Standards, Gaithersburg, Maryland, March 28-30, 1985.

"Sponsored by the US Department of Energy through the Advanced Photon Source Steering Committee"--Pref.

Wisconsin Library network plan report : recommendations for network development at the area level /

WI docs. no: Ed.3/2:2250

"Streamlined auditing and monitoring of community based services: first steps toward a more efficient system for providers, state government, and the community" : report to the Illinois General Assembly as required by PA 96-1141 /

The Steering Committee recognizes that the Departments may need to implement reviews necessary to address specific Federal requirements and that while consolidated reporting should be used when possible, the review and reporting processes should facilitate the ability to garner Federal funding. However, the analysis thus far confirms the need for change and a significant potential to reduce redundant monitoring and reporting. At the end of this Executive Summary, there is a summary presentation, including a timeline and progress indicators, that gives more details on these recommendations.

Some proposals to management : a suggested approach to sound industrial and public relations /

Mode of access: Internet.