Knowledge management training manual examples,life inspiring books to read ya,esther und jerry hicks in deutsch - Test Out

The ICH Steering Committee (SC) will meet in Fukuoka, Japan from 6 to 11 June to discuss ongoing harmonisation activities. The IPEC Federation (International Pharmaceutical Excipients Council) has published a three-page position paper concerning the risk-based approach of the EU Guidelines following the principles of Quality Risk Management according to ICH Q9.
For many years now, discussions have been ongoing as to whether it is possible to include non-distillation technologies as a method for the production of Water for Injections (WFI). The currently valid version of the EU GMP Guide  Annex 15 “Qualification and Validation” from 2001 will finally be replaced by 1 October 2015. With this GMP MANUAL UPDATE you have direct access to all prime regulatory changes and to our GMP expert interpretations. In a highly acclaimed talk held during our GMP Symposium, Richard Denk elucidated the risk factors for contamination and the influence of highly active substances.
The European Medicines Agency (EMA) has released a Concept Paper on the Revision of Annex 1 of the Guidelines on Good Manufacturing Practice – Manufacture of Sterile Medicinal Products which addresses the need to update Annex 1 of the European GMP Guide. New versions of Chapter 3 (Premises and Equipment) and Chapter 5 (Production) have been published providing transitional arrangements for toxicological evaluation. FDA Center for Drug Evaluation and Research (CDER) launched an Office of Pharmaceutical Quality (OPQ) as part of its ongoing Quality Initiative. The ICH Q3D Guideline on Elemental Impurities reached Step 4 of the ICH Process in December 2014 and now enters the implementation period (Step 5).
The US Food and Drug Administration (FDA) has just released a list of all new and revised draft guidances it plans to release in 2015.
The ICH Steering Committee (SC) and its Expert Working Groups (EWGs) met in Lisbon, Portugal on November 8–13, 2014. Before the end of the year the European Commission has published the “Commission Delegated Regulation (EU) No.
The EMA has published the final version of the „Guideline on setting health based exposure limits for use in risk identification in the manufacture of different medicinal products in shared facilities”. A biosimilar is a biological medicinal product that contains a version of the active substance of an already authorised original biological medicinal product (reference medicinal product) in the EEA. Officials of Australia and New Zealand have confirmed the plan to stop the development of the joint regulatory authority ANZTPA. This month representatives of the FDA have met with their cross-agency team from the EMA, the European Commission and GMP experts form European Union Member States in London, in order to make progress on mutual reliance on GMP inspections. ISPE released its Drug Shortages Prevention Plan during the 2014 Annual Meeting in Las Vegas, Nevada. This month the EMA released a “Reflection paper in the requirements for selection and justification of starting materials for the manufacture of chemical active substances”. On 21 October 2014, the FDA released the final version of its Guidance for Industry entitled „Circumstances that constitute delaying, limiting, or refusing a drug inspection”.
The ICH Steering Committee has endorsed the final concept paper Q12 “Technical and Regulatory Considerations for Pharmaceutical Product Lifecycle Management”.
The use of products with non-declared pharmacological activity or “other illegal medicines”, often from uncontrolled sources but also purchased from the legal market, is still a major problem within Europe.
From 10-11 September 2014, the second symposium on combating counterfeits and other illegal medicines took place at EDQM. The Active Pharmaceutical Ingredients Committee, APIC, has recently published a comprehensive How to do Document regarding electronic Common Technical Documents. The European Commission has published a revised version of Part II of the EU GMP Guide – Basic Requirements for Active Substances used as Starting Materials. The EU’s decentralised procedure is being used as a model to accelerate the assessment of applications for generic medicines as part of the International Generic Drug Regulators PilotExternal link icon (IGDRP). The ICH M7 Guideline on Assessment and Control of DNA Reactive (Mutagenic) Impurities in Pharmaceuticals to Limit Potential Carcinogenic Risk has reached Step 4 of the ICH process and is now entering the implementation period (Step 5).
FDAs Center for Drug Evaluation and Reseach (CDER) has published its yearly list of guidance documents and a list of new, revised and withdrawn guidances.
Last week the FDA issued several policy documents regarding compounded drug products for human use, as part of the agency’s effort to implement the compounding provisions of the Drug Quality and Security Act (DQSA), enacted in November 2013. EU regulators have unveiled a new logo which will appear on the websites of all authorised online pharmacies known to provide authentic medicines.
The Australian Therapeutic Goods Administration (TGA) is set to strengthen its collaboration with the European Directorate for the Quality of Medicines and HealthCare (EDQM). EMA has published the long awaited Qualified Person (QP) declaration template and accompanying guidance concerning GMP compliance of API manufacture. The FDA, in partnership with other federal and international agencies, took action last week against websites that sell potentially dangerous, unapproved prescription drugs to U.S. As previously reported, the FDA is working on a system that will help to identify and trace dangerous drugs that are counterfeit, stolen or tainted throughout the whole supply chain. This month, the WHO has published a proposal for the revision of the supplementary guidelines on GMP: Validation, namely Appendix 7 – non-sterile process validation. The European Commission has published the final version of Chapter 6 Quality Control of the EU Guidelines for Good Manufacturing Practice for Medicinal Products for Human and Veterinary Use on April 3, 2014.
The EMA has published the final version of the long awaited Guideline on Process Validation “Guideline on process validation for finished products – information and data to be provided in regulatory submissions” on February 24, 2014. The FDA has published a Draft Guideline for Industry entitled Analytical Procedures and Methods Validation for Drugs and Biologics. The FDA initiates the Secure Supply Chain Pilot Program to enhance the security of imported drugs. The CFDA has announced the adoption of the draft amendment to the Regulations for the Supervision and Administration of Medical Devices at the executive meeting of the State Council on February 12, 2014.
As announced by the Swiss Regulatory Authority Swissmedic, a Memorandum of Understanding in the area of therapeutic products was signed with the Korean Ministry for Food and Drug Safety (MFDS).
Shortly after the FDA notified Ranbaxy Laboratories, Ltd., that it is prohibited from manufacturing and distributing active pharmaceutical ingredients (APIs) from its facility in Toansa, India, for FDA-regulated drug products due to particularly serious GMP deficiencies, health agencies in Europe are evaluating the FDA inspection findings to assess if these deviations from GMP have any implication on medicines on the European market.
The Health Ministry of India has constituted a sub-committee to prepare guidelines regulating the transportation of drugs in the country. Early this month, the China Food and Drug Administration (CFDA) issued an announcement on the implementation of the Good Manufacturing Practice for Drugs (2010 Revision) for sterile pharmaceutical products. According to pharmabiz, the government of India is planning a revision of its GMP guidelines – Schedule M – and considers making them on par with the WHO-GMP standards. The International Conference on Harmonisation (ICH) Steering Committee (SC) and its Expert Working Groups (EWGs) published the results of their last meeting in Osaka: ICH Reviews Future ICH Topics and Its Organisation Towards Increased Engagement Globally.
Manual of Glaucoma is a comprehensive reference guide to the basics, diagnosis and new surgical possibilities for the treatment of glaucoma.
The first of its kind to cover the cutting edge technique of glued IOLs in eyes with deficient capsules, A Video Textbook of Glued IOLs combines the practical explanation of written text with the dynamic demonstration of a surgical video website.
A Video Textbook of Glued IOLs offers state-of-the-art instruction from the innovators of the technique themselves and its step-by-step approach makes it simple to understand and easy to reproduce for anterior segment surgeons, junior ophthalmologists, specialists, and post-graduates alike. Diabetes mellitus is a complex, multifactorial disease that is often associated with progressive retinopathy and visual loss. New Trends in Basic and Clinical Research of Glaucoma: A Neurodegenerative Disease of the Visual System is the latest volume from Progress in Brain Research focusing on new trends in basic and clinical research of glaucoma.
The report was developed during a Member State Meeting on SSFFC in October 2014 in Geneva, Switzerland. Food and Drug Administration (FDA) has published their yearly list of new and revised draft guidances CDER is planning to publish in 2015.
Food and Drug Administration (FDA) issued five draft documents related to drug compounding and repackaging to help entities in complying with important health provisions. The EMA has published a revised version of the guideline "Guideline on similar biological medicinal products".
The report has been presented in a revised format, following comments from a stakeholder focus group. Delaying, refusing, denying – FDA inspectors often see themselves confronted with cooperation problems.
Representatives from forensic and customs laboratories, national medicines and food authorities, enforcement groups and the European Commission were invited to shed light on the problem of falsification of medicines.
According to the EC this became necessary due to changes in various Annexes of the GMP Guide. FDA and the EMA (European Medicines Agency) announced the launch of a joint initiative to share information on inspections of bioequivalence studies submitted in support of generic drug approvals. Homeopathic individualized medicines versus fluoxetine for moderate to severe depression: double-blind, randomized non-inferiority trial.
This book is divided into 44 chapters across six sections covering fundamentals, diagnosis, open angle glaucoma, angle closure glaucoma, childhood glaucoma, and a final section on new techniques for managing glaucoma.
With this unique combination, the narrated videos are able to demonstrate all the challenging surgical situations, while the textbook will provide more in-depth step-by-step details for each technique.
Ahmed>Ophthalmologic surgery has seen ever-evolving advancements in treatment methodologies. The book covers anatomy, pathology and signs and symptoms, plus visual field defects associated with specific parts of the visual pathway. This new title gives a comprehensive review of modern optical technologies alongside their clinical deployment. This established international series examines major areas of basic and clinical research within neuroscience, as well as emerging subfields. The draft documents apply to outsourcing facilities, federal facilities, pharmacies and physicians. The regulation was issued on 25 November 2014 in the Official Journal of the European Union and has entered into force on 15 December 2014. Ubiratan Cardinalli Adler, UNIFESP (Federal University of SA?o Paulo, Brazil), Av Rouxinol, 1041 cj.
Beginning with the anatomy of the optic nerve head, and the pathophysiology and classification of glaucoma, subsequent chapters cover methods of diagnosis such as Gonioscopy and OCT, variations of glaucoma such as pigmentary glaucoma and malignant glaucoma, and congenital and developmental glaucoma in children.
An expanding choice of intraocular lenses and implantation approaches has contributed to improved quality of life in people with vision impairments. It bridges the technology and clinical domains and will be suitable in both technical and clinical environments.
Cree>Discusses the Effect of Automated Assessment Programs on Health Care Provision Diabetes is approaching pandemic numbers, and as an associated complication, diabetic retinopathy is also on the rise. Scott, Flynn, and Smiddy have compiled the current basic science and clinical information from leading authorities on diabetic eye disease.
Not only the new principles of ICH Q8, Q9, Q10 and Q11 constituted a new regulatory environment but also a continuous updating of Chapters of Part I of the EU GMP Guide or Annex 11 (computerised systems).
Manual of Glaucoma also includes a separate chapter on complementary and alternative therapies, as well as new surgical modalities, wound healing techniques and postoperative care. Although cataract surgery has a very high success rate, unexpected complications can occur. This new edition includes updated methods of visual field assessment, additional descriptions of how individual visual field results should be interpreted, an updated review of the pros and cons of the various available test programs, and recent research advances and recommendations on baseline assessment, diagnosis, and re-assessment options to promote good clinical practice decisions. It introduces and develops basic physical methods (in optics, photonics, and metrology) and their applications in the design of optical systems for use in medical technology with a special focus on ophthalmology. Much about the computer-based diagnosis of this intricate illness has been discovered and proven effective in research labs. They have also included the results of clinical trials in patients with diabetic retinopathy, as well as the guidelines established by collaborative studies and the concepts of disease mechanisms and clinical management that have subsequently evolved from those guidelines. Here, in one concise handbook, is every major clinical procedure used in ocular examinations. Another important document to be mentioned in connection with the new Annex 15 is the EMA guidance on process validation. There is a need for large-scale longitudinal data on treatment utilization and outcomes, stress, emotion, and pain. Enhanced by 236 full colour images and illustrations, Manual of Glaucoma is an essential source of reference for ophthalmologists and ophthalmology residents. Medical applications described in detail demonstrate the advantage of utilizing optical-photonic methods. The summary is accompanied by brief discussion of the relevance (or irrelevance) of the paper to practicing ophthalmologists. But, unfortunately, many of these advances have subsequently failed during transition from the lab to the clinic. This monograph will provide practitioners with a concise, up-to-date, practical reference for the diagnosis and management of ocular disease in diabetic patients. Offering ideal preparation for clinical eye exams, the book features detailed, systematic guidance on how to confidently perform all major examination techniques, which are described by purpose, indication, equipment, set-up, recording, and examples. Throughout three major sections and 28 chapters, top experts share many years of combined wisdom, firsthand tips, and extensive skills acquired from utilizing and refining IOL techniques.
Exercises and solutions for each chapter help understand and apply basic principles and methods. Each procedure is accompanied by precise illustrations and photographs, designed to enhance your knowledge and comfort level with the full spectrum of techniques. Randomized long-term trial of camel milk as an adjunct to insulin therapy in type-1 diabetes.
The comprehensive, richly illustrated text and accompanying surgical videos provide invaluable training on how to handle even the most complex cases, including strategies for overcoming obstacles such as compromised capsular support. Expert commentaries evaluate the clinical importance of each article and discuss its application to your practice.
Automated Image Detection of Retinal Pathology discusses the epidemiology of the disease, proper screening protocols, algorithm development, image processing, and feature analysis applied to the retina. Chapters include numerous illustrations of visual field results, colour plates of associated fundus images, and neuroimaging scans.



Conveys the Need for Widely Implemented Risk-Reduction Programs Offering an array of informative examples, this book analyzes the use of automated computer techniques, such as pattern recognition, in analyzing retinal images and detecting diabetic retinopathy and its progression as well as other retinal-based diseases. References and further reading lists are also provided with key articles and up-to-date literature.
It also addresses the benefits and challenges of automated health care in the field of ophthalmology. Patients are recruited from web sites for patient advocacy and health enhancement programs. The book then details the increasing practice of telemedicine screening and other advanced applications including arteriolar-venous ratio, which has been shown to be an early indicator of cardiovascular, diabetes, and cerebrovascular risk. Therefore this long-term study was undertaken to assess the efficacy, safety and acceptability of camel milk as an adjunct to insulin therapy in type 1 diabetic patients. Although tremendous advances have been made in this complex field, there are still many questions that remain unanswered. Methods: In this 2-year randomized clinical parallel design study, 24 patients with type 1 diabetes were enrolled and divided in 2 groups. This book is a valuable resource for researchers looking to take retinal pathology to that next level of discovery as well as for clinicians and primary health care professionals that aim to utilize automated diagnostics as part of their health care program. Group I (n=12) received usual care (ie, diet, exercise, and insulin), and group II (n=12) received 500 mL camel milk in addition to diet, exercise, and insulin. Previous studies have found that between 30% and 60% of pediatric neurology patients have used CAM at some point in their lives. Whereas, the effect of vitamin C on conventional photodynamic therapy (PDT) of tumor cells has been documented, the mechanism of vitamin C induced increase in tumor cell response to PDT is unclear. In this report we demonstrate the presence of vitamin C during photo-oxidation of MC540 significantly increases its apoptotic activity in tumor cells. Interestingly, we observed that the presence of vitamin C during photo-oxidation of MC540 only and not its addition to a prior photo-exposed mixture to MC540 is critical for its enhanced sensitivity. These findings provide impetus to the approach in developing ROS generating small molecule compounds with potent apoptosis inducing activity. These data could have implications in the use of vitamin C in photo-sensitizer-mediated reactions with the view to favorably tailoring the cancer cell milieu for efficient apoptotic execution. Many patients are still not discussing their CAM use with their doctors and are using CAM alongside their conventional medicines, thereby increasing the likelihood for potential interactions. One limitation of this study is that our ability to determine between-site differences is limited by the difference in sample size. Electrodermal measures as clinical markers: Jing-point electrical impedance in adolescent women with chronic pelvic pain. Consequently, skin electrical measures at Jing points are commonly obtained and interpreted for diagnostic purposes. Denise Adams, University of Alberta, 1047 RTF Building, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
The objective of this study is to determine whether electrodermal measures at Jing-points are associated with clinical outcomes in adolescents with chronic pelvic pain in a randomized, sham-controlled acupuncture trial. Methods: We recruited 18 adolescent women aged 13 to 22 years of age suffering from chronic pelvic pain and laparoscopically diagnosed with Stage I-III endometriosis. Using a Hibiki-7 device, normalized electrical impedance values were obtained at all 24 Jing-points for each treatment session. Phase II: CAM research networks in Canada and the US will notify CAM providers of this study, so they may alert patients.
Left-right asymmetry and measures for statistical dispersion (standard deviation and Gini coefficient) of Jing-point impedance values were calculated.
Parents or legal guardians may self-identify and reply on behalf of patients under 18 year of age if they meet the criteria for Phase I.
With a generalized estimating equation method, we evaluated the association between the electrodermal-derived measures and clinical outcomes while accounting for treatment designation and time. Phase III: The methods for phase II were utilized but CAM associations and training organizations were substituted for CAM research networks. The majority of the cases involved the use of Traditional Chinese Medicine to improve quality of life. Preliminary analyses indicate that, over time, subjects in the active acupuncture arm were more likely to have reduced left-right asymmetry and statistical dispersion of Jing-point measures compared to subjects in the sham-control arm.
Further analyses with multivariable models will be performed to assess whether this difference is statistically significant for each electrodermal measure. The chiropractic care of children with otitis media: a systematic review of the literature utilizing whole systems research evaluation and meta-synthesis. Joel Alcantara, International Chiropractic Pediatric Association, 327 N Middletown Rd, Media, PA 19063. Key words were otitis media and related words (ie, acute otitis media, otitis media with effusion, ear infections, etc) AND chiropractic. A narrative review of the literature was performed and augmented with a meta-synthesis of the literature with a focus on chiropractic management and the application of a whole systems research (WSR) evaluation.
Results: Our systematic review revealed 20 articles consisting of 6 case reports, 5 case series, 1 retrospective cohort, 2 prospective cohorts, 2 reviews of the literature, 2 commentaries, 1 survey study and 1 prospective, parallel-group, observer-blinded, randomized feasibility study. Due to the lack of higher-level research design, a meta-analysis of the literature was not possible. This included the use of otoscopy and tympanogram to provide objective pretreatment and comparative outcome measures. Eighty-nine percent of respondents reported treating pediatric patients; patients under the age of 17 made up 12% of chiropractic and 20% of both naturopathic and osteopathic patients.
Activator, Gonstead, Toftness, Chiropractic Biophysics, and Diversified Techniques were utilized with an emphasis on the upper cervical spine (the C1 or C2 vertebral bodies).
Approximately two-thirds of both osteopaths and naturopaths disagree or strongly disagree that immunizations are safe compared to one-third of chiropractors. One paper described utilization of cranial technique, 2 papers described a dietary intervention, and 2 papers utilized soft-tissue massage to augment spinal manipulative therapy. Fifteen studies were amenable to the WSR evaluation resulting in a score of 7.06 from a maximum of 11.
The immunizations of most concern to the 3 professions included MMR, varicella, influenza, DPTP, and hepatitis.
The most common reasons for concern were related to safety, including that vaccines may contain dangerous ingredients, may produce side effects, and may be linked to future problems such as neurological damage. Conclusion: This systematic review highlights the need for more higher-level research designs in addition to incorporating new methodologies (ie, whole systems research) reflective of the holistic and vitalistic clinical and theoretical framework of chiropractic.
The chiropractic care of children with enuresis: a systematic review of the literature utilizing whole systems research evaluation. Significantly more naturopaths advised parents against vaccinations (27%), compared to 10% of chiropractors, and 12% of osteopaths (P=.0002).
Joel Alcantara, International Chiropractic Pediatric Association, 327 North Middletown Rd, Media, PA 19063.
There was no significant difference between groups for those advising parents in favor of vaccinations (15% C, 14% N, 6% O) (P=.1143). Key words were enuresis, nocturnal enuresis, bedwetting as well as related words AND chiropractic. A narrative review of the literature was performed and augmented with an evaluation using WSR evaluation.
Results: Our systematic review revealed 7 articles meeting the eligibility criteria for review. Four of the 7 papers involve case reports describing the care of children aged 8 to 14 years with primary complaints of nocturnal enuresis. Spinal manipulative therapy involved the use of Toggle recoil, Sacro-Occipital Technique, Activator Methods, Gonstead Technique, and Diversified Technique to address primarily segmental dysfunctions in the lumbosacral spine. We conducted a systematic review to assess the nature and severity of adverse events associated with pediatric acupuncture.
A large prospective cohort study (N=171) demonstrated improvement in wet nights per week from baseline following 2 weeks of care. In a randomized clinical trial, within-group comparison of pretreatment and comparative rates of enuresis subjects demonstrated an improvement. However, the study was fraught with research design issues such as randomization and biostatistics.
Six of the 7 studies were amenable to WSR evaluation and resulted in a scoring of 7.33 from a maximum possible score of 11 points. One reviewer screened all articles, while the second reviewed all excluded articles to ensure that no article was inappropriately excluded. Full articles of potentially relevant references were retrieved and assessed by two independent reviewers. The use of Whole Systems Research provides promise in contributing to evidence-based practice and reflects the holistic and vitalistic chiropractic approach to patient care.
Results: Seven thousand, two hundred sixty-two potentially relevant articles were identified. Eleven of these studies included adults as the majority of patients; for these studies the age of the patient experiencing the adverse event was never reported. Most of the adverse events that have been identified in children were mild and included pain, bruising, and worsening of symptoms. The few adverse events rated as moderate or serious included one pneumothorax, 2 infections, and 2 cases of complications from needles left in the body.
Methods: This study was approved by the Institutional Review Board of Life University (Atlanta, Georgia). A 26-item questionnaire was sent to 9000 subscribers of an online newsletter from Midwifery Today Magazine.
The first domain identified demographics (midwife credentials, age, years in practice, and place of practice). The second domain queried participants regarding their formal and postgraduate training on the subject of chiropractic. The third domain attempted to identify their experience (ie, positive or negative experience) with chiropractic personally and professionally as it pertains to pregnancy and infant care.
The fourth domain asked their opinion about the safety of chiropractic care for pregnant and pediatric patients.
The fifth domain surveyed their knowledge regarding the scope of practice of chiropractic for pregnant and pediatric patients.
The respondent ranged in age from 41 to 50 years with practice experience ranging from 6 to 10 years. With respect to their training on chiropractic, 31% (n=57) reported receiving formal education (ie, during midwifery education) on the subject of chiropractic.
Fifty-five of the 157 who did not indicated receiving some education on chiropractic through continuing education seminars. With respect to the midwife responders’ experience with chiropractic, 95% (n=176) admitted to making a professional referral to a chiropractor with 73% (n=137) having referred an infant to a chiropractor. Ninety-two percent (n=171) reported being chiropractic patients with another 58% (n=124) presenting their child for chiropractic care. Over 90% indicated experiencing a positive experience as patients and with their child’s care. All of the respondents perceived chiropractic was safe for pregnant patients, while only 97% considered chiropractic safe for children. An overwhelming majority of the responders (98%) indicated that chiropractors work with birth professionals, while 92% indicated that they were knowledgeable about the role of chiropractic in prenatal care. Lastly, 75% indicated interest in learning more about chiropractic, with 86% wanting more evidence-based practice chiropractic. From the 809 articles reviewed, 18 articles met the full inclusion criteria and proceeded to data extraction.
Identified adverse events include local pain or soreness, swelling, mild fevers, and skin rashes. Thus far, the majority of adverse events reported have been mild with few moderate or serious adverse events occurring in pediatric patients. Total weight and body composition changes in response to weight reduction diets of varied protein content in midlife women. Age-related changes in body composition for women include loss of lean mass and gains in total weight, fat mass and central fat deposition. There is growing evidence that diets with low-to-moderate carbohydrate and fat content and increased levels of high-quality protein are effective for weight loss. Greater subjective satiety is reported by subjects following test meals containing whey protein compared to other protein sources.
The beneficial effects of whey protein on satiety, thermogenesis, and lean body mass protection suggest that whey may be a preferred protein source for weight loss treatment. The specific aims of this study are to assess weight loss in subjects receiving energy-reduced dietary regimens and to evaluate parameters of weight and body mass change between the 3 treatment groups. Study Design: We are conducting a randomized, controlled pilot feeding study to evaluate the effect of different dietary protein sources on weight loss.
Endpoint measures include body weight and body composition data obtained at baseline and at 8 weeks for dietary treatment. The HP diet and the WP diet produced greater total fat loss and less total lean tissue loss than the CD.
Conclusions: Preliminary data shows that across treatment groups, the high-protein diets conserved lean tissue and promoted reduction of fat tissue. Trials investigating TCM must be conducted with increased methodological rigor to be of value in evaluations. The single included study suggesting that acupuncture may be safe and efficacious in CFS is limited in applicability by the use of sham acupuncture as the control.


Integration and interface between naturopaths and conventional rural care: empirical findings from a grass-roots research project. The worsening epidemic of DM in the United States, along with the increasing prevalence of obesity, insulin resistance, and IGT, render the identification of promising interventions for these states a matter of some urgency.
Jon Adams, University of Queensland, School of Population Health ,University of Qld, Herston, Queensland, 4006, Australia. While lifestyle interventions based on dietary pattern and physical activity can delay or prevent the onset of diabetes and reduce cardiovascular risk, adherence at the population level is severely limiting. Pharmacotherapy offers promise for diabetes prevention, but with associated high costs, unacceptability to many patients, and potential toxicity. In this context, the potential role of chromium (Cr), an insulin cofactor, in IGT is of great interest. Proposed, therefore, is a randomized, double-blind, placebo-controlled pilot trial conducted at the Yale Prevention Research Center to investigate the effects of daily Cr for 6 months at 2 dose levels on serum measures of glucose tolerance and on endothelial function in adults with IGT, IFG, and IR. The study is powered to detect a clinically meaningful effect of Cr supplementation at either dose on glucose control, and to compare the two doses for equivalence. The study will investigate effects of Cr on both measures of glucose tolerance (glucose, insulin, OGTT) and brachial artery endothelial function, thus combining serum measures with a physiologic test of Cr effects on the vasculature.
The proposed study will generate much needed data regarding the efficacy of Cr in those at risk for type 2 diabetes and offers the promise of guiding practice, as well as directing future study. By contributing to knowledge related to potential diabetes prevention strategies, this study addresses one of the more pressing public health issues in the United States today. Risk to human subjects in this study is a minor increment over minimal due to the administration of nitroglycerin as a control in BARS testing. Secondary outcomes: (4) It will show improved well-being, as measured by elevated melatonin and DHEA.
Unlike many relaxation therapies, energy healing requires no participation by the patient, a feature that makes it particularly attractive in the hospital setting, where patients are often anxious, depressed, in pain, or sedated.
Despite the increasing use of energy healing, few studies have looked at its benefits and even fewer at its underlying mechanisms of action.
In this pilot study, we examined the effects of an energy healing modality known as Reiki on the autonomic nervous system (ANS) and the hypothalamus-pituitary-adrenal (HPA) axis, both of which participate in the stress response and stress-induced pain and disease progression. Subjects rested for 10 min before baseline heart rate and blood pressure were measured and blood was drawn to determine cortisol, ACTH, and DHEA levels, using commercial immunoassay kits. Subjects then received a 30- to 45-min Reiki or Pretend Reiki session followed immediately by post-session heart rate and blood pressure measurements and at 2h by blood draws.
When asked whether they thought they were in the Reiki or Pretend Reiki group, about 70% of the participants reported that they believed that they had received a true Reiki session. This suggests that the beneficial effects of Reiki on physiology, as compared to the Pretend Reiki, cannot be explained solely by the placebo effect. Issac Amponsah, Faculty of Pharmacy Kwame Nkrumah University of SC, Knust, Kumasi, 233, Ghana.
Effects of ultra-low dilutions of sabal serrulata on human prostate cancer growth: mechanistic studies.
Hakima Amri, Georgetown University, Basic Science Bldg, 3900 Reservoir Rd NW, Washington, DC 20007. Finally, serum protein differential expression was carried out using 2-dimensional gel electrophoresis followed by mass spectrometry analysis.
Effect of mind-body medicine skills on elements of emotional intelligence in medical students.
Yet studies have reported that traits such as altruism and empathy tend to decline throughout medical school training. In an effort to foster medical student self-awareness and mindfulness, which may improve their EI, Georgetown University School of Medicine (GUSOM) offers an experiential course to undergraduate medical students in mind-body medicine skills. The purpose is to expose students to a variety of mind-body approaches including meditation, imagery, as well as group sharing and listening generously for self-awareness and reflection. The aim of this study was to assess the impact of the Mind Body Medicine Skills (MBS) course on perceived stress, mindfulness, and elements of EI including intrapersonal capacities (attention to feelings, mood repair, clarity of feelings) and interpersonal capacities (perspective-taking, empathetic concern, and personal distress in response to distress in others).
The intervention group (n=30) was comprised of first year medical students who self-selected to participate in this elective. The control group (n=36) included students from the first year class who completed the surveys but did not take the MBS course. Four questionnaires were completed at the start and end of the spring semester by all study participants: the Perceived Stress Scale (PSS), the Mindful Attention Awareness Scale (MAAS), and a survey of EI developed by Stratton et al (2005) comprised of the Trait Meta-Mood Scale and the Interpersonal Reactivity Index. ANCOVA was used to compare the MBS and the control groups at the end of the semester, controlling for beginning scores.
Patient perspectives of integrative and primary care management of back and neck paina€”qualitative findings from a randomized clinical trial.
These conditions are additionally some of the most common reasons why patients use complementary therapies, often without dialogue with conventional care providers.
The focus groups were conducted separately for those in the integrative vs the conventional treatment groups. The interview data were transcribed ad verbatim and analyzed utilizing inductive content analysis technique. Eliane Angst, UCLA Center for Excellence in Pancreatic Diseases, 675 Charles E Young Drive South, Los Angeles, CA 90095. A significant reduction in cell numbers was seen with quercetin concentrations of ~30 AµM and a maximum effect at ~75 AµM. In MIA PaCa-2 cells a ~65% reduction in cell number was seen with 75 AµM of quercetin after 48 hours.
Starved BxPC-3 cells treated with 75 AµM quercetin showed a ~95% reduction in cell number after 48 hours.
Conclusion: These results suggest that quercetin has a potent growth-inhibitory effect in pancreatic cancer cells in vitro. Additional experiments to investigate the underlying mechanism of growth inhibition and animal studies are underway. Flovanoids may reveal to be potent anticancer drugs found in our daily food, leading to specific diet recommendations. These can be taken together to qualify as an academic minor in many of the conventional MA or PhD programs, often forming the basis of a thesis or dissertation required for the terminal degree. In the fall of 2009, the university will launch a doctorate of nursing practice with a focus in integrative health and healing. Georgetown University developed a concentration of CAM within its Masters in Physiology program in 2003. We address the multicultural perspective, comparing data collected in Canada and Europe to those in the United States. The reason for this is that results on the health-promoting effects of spirituality and religiosity cannot easily be transferred from the United States to countries with different cultural and religious backgrounds.
Thus, one has to recognize different concepts of spirituality, different attitudes towards its utilization, and objections against the implementation of it in a particular medical system.
In Germany, 3 colleagues have founded the Transdisciplinary Working Group on Spirituality and Health, and in Canada the Canadian Research Network on Spirituality and Health has been active for a couple of years. Data and approaches from these different networks will be combined into this symposium.Dr BA?ssing is an associate professor at the University of Witten, Herdeckea€™s Faculty of Medicine, where he directs the research group Spirituality and Health. The effect of a€?acupuncture for losing weighta€? on the level of blood sugar: a survey on the mechanism. Hoda Azizi, Beijing University of Chinese Medicine, 11 Bei San Huan Dong Lu, Beijing, Beijing, 100029, China.
Material and Methods: In this clinical trial study, 66 patients were included in case and control groups.
Blood sugar was examined just before inserting needles and immediately after withdrawal of needles. Conclusion: Our results suggest that the mechanism of acupuncture in losing weight is significantly related to making an increase in BS.
John Balletto, Center for Muscular Therapy, Inc, 545 Pawtucket Avenue, Mailbox 304, Pawtucket, RI 02860-6046. As with business startups that begin informally and successfully mature into larger enterprises, growth brings new organizational challenges, together with greater visibility and opportunity. The maturation of massage as a healthcare profession increases the need for a process to formalize the synthesis of massage therapy knowledge from clinical experience and research—to collect what we know and to make such baseline knowledge widely available to practitioners, consumers, and other healthcare stakeholders. The present paper lays out the motivations and framework for creating massage therapy guidelines that are informed both by research and by clinical experience. It also acts as a report to the massage therapy profession and to other stakeholders about the work of the Best Practices Committee of the Massage Therapy Foundation since 2006. And it has the additional goal of providing a healthcare literature basis for future academic discussions of massage. The discussion here is based on a definition from the Institute of Medicine and on research into the nature of expertise. Topics addressed include guideline creation, credentialing of complementary and alternative medicine practitioners, definition of competence, and the increasing role of technology (that is, informatics) in managing training and task-necessary competencies. The roles of transparency and a wide and open peer review are emphasized as essential to the usability and credibility of guidelines. Health Canada issues consumer advisories regarding the safety of marketed health products, yet the criteria for issuing advisories have not been evaluated for consistency or objectivity. The Causality Algorithm used by Health Canada was used to rate degree of association between the adverse events (AEs) and the products.
The Severity of Adverse Events Scale, developed by the National Cancer Institute, was used to determine the severity of the AEs. Most NHP AWRs were issued based on potential AEs from contamination and adulteration, whereas most of the AWRs for therapeutic drugs were issued due to actual AEs. Of the 6 NHP AWRs issued for actual AEs, 3 (50%) were unassessable for severity, whereas of the 28 AWRs issued for actual therapeutic drug AEs, 1 (3%) was unassessable for severity.
The origin of reports for NHPs tended to be from foreign sources or Health Canada, whereas reports for therapeutic drugs were mostly issued by Health Canada in conjunction with drug manufacturers.
The potential of a mistletoe (Viscum album L) extract to alleviate adverse effects of cancer chemotherapy: an in vitro study. Stephan Baumgartner, University of Bern, Institute of Complementary Medicine KIKOM, Inselspital, Bern, BE, 3010, Switzerland.
We investigated the effect of a mistletoe extract on PBMC with and without concomitant treatment with cyclophosphamide and compared viability and replication of normal PBMC with that of a T-cell leukemia cell line.
The results motivate further preclinical and clinical investigations of mistletoe extracts as an adjuvant medication in cancer therapy to alleviate side effects of conventional therapy. Stephan Baumgartner, Institute of Complementary Medicine KIKOM, University of Bern, Inselspital, Imhoof-Pavillon, Bern, BE, 3010, Switzerland. We investigated the potential of a commonly used plant pathogen–system, Arabidopsis thaliana infected with the virulent bacteria Pseudomonas syringae (pv tomato strain DC3000), regarding its response towards a homeopathic treatment. Compared to Bion (a common SAR inducer used as positive control), the magnitude of the treatment effect of Biplantol was about 50%. None of the other tested preparations yielded significant effects in the overall evaluation. The purpose of this study was to determine remedy effects on a common quantitative measure of complexity, the correlation dimension (D2), of human sleep electroencephalography (EEG). High Hostile subjects increased complexity at C3 and Pz, but decreased complexity at O2 during stage 3 sleep on CC. In the high Anxiety-Sensitive subjects, CC caused significant increases in complexity at Pz and O1 during stage 3 sleep and at C3, C4, and Pz during stage 4 sleep. CC increased complexity significantly at Cz, C4, and O2 during REM sleep in only the high Anxiety-Sensitive subjects. The purpose of the present study was to determine whether or not the objective measure of polysomnographically-recorded all-night sleep recordings can distinguish verum homeopathic remedies from placebo in human subjects.
NV produced more marked effects on increased shifts in sleep stages, with a growth in effects from night 22 to 23. This study examined the effects of olfactory administration of a polycrest homeopathic remedy Sulphur on heart rate variability (HRV). The Sulphur was given at dilution factors used for preparing 6c, 12c, and 30c potencies (1 potency per session, with potency order randomized), but for each potency, the test solutions were succussed to different degrees (stirred without shaking, 10, 20, or 100 succussions). Homeopathic remedies increase spectral electroencephalographic power during sleep in healthy young adults. The purpose of the present study was to assess the effects of verum vs placebo homeopathic remedies on spectral qEEG measures of polysomnographically-recorded all-night sleep recordings. Evaluating a nonlinear dynamical model for human flourishing: Relationship of PANAS positive-to-negative-affect ratio and global health and well-being.
The purpose of the present study was to compare global physical health (GPH) and well-being ratings of young adults whose P:N mood ratios fell above vs below the Losada line. Despite higher (MCSD) scores in PF, a small sex and age difference between groups, ANCOVAs controlling for MCSD, sex, and age still showed statistical significance of the above PF vs PL group differences. Gurjeet Birdee, Osher Research Center Harvard Medical School, 401 Park Drive, Suite 22-A West, Boston, MA 02215. We identified the prevalence of CAM modalities used and the characteristics of users among the pediatric population.



Training manager certification jobs
Management workshops in malaysia



Comments to «Knowledge management training manual examples»

  1. Thoughts, but you happen to be not.
  2. Member of AWNY and participating in the 2011 collaborative.
  3. Ability to exert work for a purpose of living a life you want for knew that a lot of of his book.