International consensus (ICON) on treatment of sudden sensorineural hearing loss

© 2018 Elsevier Masson SAS Sudden sensorineural hearing loss (SSNHL) is a common and alarming symptom that often prompts an urgent visit to an ENT specialist. Treatment of SSNHL remains one of the most problematic issues for contemporary otorhinolaryngology: although many meta-analyses and national guidelines have been issued, management is not standardized in terms of medical treatment, and duration and route of administration. We present several methodological suggestions for the study of treatments for SSNHL. These were developed from the existing level of evidence of the main treatments used in SSNHL by experts who convened at the IFOS 2017 ENT World Congress in Paris, France. All panelists agreed that one of the main limitations present in studies on SSNHL is related to the wide heterogeneity, which characterizes both the initial hearing deficit and the amount of hearing recovery. Although evidence of the efficacy of systemic steroids cannot be considered as strong enough to recommend their use, it is still the most widespread primary therapy and can be considered as the current standard of care. Therefore, systemic steroids stand as an adequate control for any innovative treatment. To reduce the number of subjects we suggest that the inclusion criteria should be restricted to moderate to profound levels of hearing loss. The efficacy of trans-tympanic steroids as a salvage therapy was suggested in several reports on small populations and needs to be confirmed with larger randomized controlled trials

Moderation and Mediation of an Effective HIV Risk-Reduction Intervention for South African Adolescents

Let Us Protect Our Future is a sexual risk-reduction intervention for sixth-grade adolescents in South Africa. Tested in a cluster-randomized controlled trial, the intervention significantly reduced self-reported intercourse and unprotected intercourse during a 12-month follow-up period. The present analyses were conducted to identify moderators of the intervention\u27s efficacy as well as, which theory-based variables mediated the intervention\u27s effects. Intervention efficacy over the 3-, 6-, and 12-month follow-up was tested using generalized estimating equation models. Living with their father in the home, parental strictness, and religiosity moderated the efficacy of the intervention in reducing unprotected intercourse. Self-efficacy to avoid risky situations and expected parental disapproval of their having intercourse, derived from Social Cognitive Theory, significantly mediated the intervention\u27s effect on abstinence. This is the first study to demonstrate that Social Cognitive variables mediate the efficacy of a sexual risk-reduction intervention among South African adolescents. --author-supplied descriptio

Civic Engagement: a Study of Changes in College

Using a mixed method longitudinal cohort design, the Tufts University study is examining student involvement in and attitudes towards civic engagement during the undergraduate years and beyond. It does this by using baseline data from students’ levels of community service in high school and then analyzes a variety of curricular and co-curricular experiences in college. This article focuses solely on the research design and some preliminary findings of students’ civic attitudes during their first two years of college

Treatment impact on recidivism of family only vs. generally violent partner violence perpetrators

Background/objective: The outcome of a treatment program for a large sample of male perpetrators on probation for intimate partner violence (IPV) was evaluated with particular reference to the differential impact on family only (FO) versus generally violent (GV) perpetrators. Method: Official rates of recidivism for three years post termination of treatment and probation were examined for 456 perpetrators after they were classified as FO and GV. Results: Both treatment completion and type of perpetrator were predictive of IPV recidivism and time to recidivism. However, analyses conducted separately for the two groups indicated that participation in the intervention predicted both recidivism and time to recidivism for the GV but not FO perpetrators who participated in treatment. Specifically, GV men were responsive to treatment whereas FO men were not. Results were somewhat different depending on who was included in the no treatment comparison group. Conclusions: Implications of these findings for one size fits all interventions in IPV are discussed with specific reference to the need to develop different interventions for GV and FO perpetrators

MIS Guidelines for Employment Law Programs in Poland

The guidelines presented in this report propose an efficient architecture for structuring the huge volume of information flow necessary to manage and administer the several labor market programs operated by the SOLO (System of Labor Offices). The proposal includes a recommendation for the sequence of events in developing the many parts of the system which exploits the latest technical and methodological possibilities, but recognizes the practical constraints of time and money. At the heart of the proposed automated management information system (MIS) to support planning, evaluation, and budgeting for labor market programs in Poland is a set of performance indicators. These performance indicators are the main instrument for monitoring the effectiveness of the several programs. The use of performance indicators will allow a standardized assessment of program performance across voivods, local offices, and programs which is not provided by other methods of evaluation

Developing and sustaining specialist and advanced practice roles in nursing and midwifery: A discourse on enablers and barriers

Aims and objectives To collate, synthesise and discuss published evidence and expert professional opinion on enablers and barriers to the development and sustainability of specialist and advanced practice roles in nursing and midwifery. Background Expanded practice is a response to population health needs, healthcare costs and practitioners’ willingness to expand their scope of practice through enhanced responsibility, accountability and professional autonomy. Design This discursive paper is based on a rapid review of literature on enablers and barriers to the development and sustainability of specialist and advanced practice roles and is part of a wider policy analysis. Methods We analysed and synthesised of 36 research articles, reviews and discussion papers on enablers and barriers in the development and sustainability of expanded practice roles. Results Several factors enable role expansion, including: role clarity; credentialing and endorsement; availability of education for expanded roles; individual practitioners’ dispositions towards role expansion; support from peers, other professionals and the work organisation; and costs. Where limited or absent, these same factors can constrain role expansion. Conclusions Enabling nurses and midwives to practice to their full scope of education and expertise is a global challenge for disciplinary leadership, a national challenge for professional regulation and a local challenge for employers and individual clinicians. These challenges need to be addressed through multistakeholder coordinated efforts at these four levels. Relevance to clinical practice This discursive paper synthesises empirical evidence and expert professional opinion on the factors that enable or hinder the development and sustainability of specialist and advanced practice roles. Providing a critical appraisal of current knowledge, it provides a reference source for disciplinary debate and policy development regarding the nursing and midwifery resource and informs clinicians of the myriad issues that can impact on their capacity to expand their scope of practice

These aren’t the loci you’re looking for: Principles of effective SNP filtering for molecular ecologists

Sequencing reduced‐representation libraries of restriction site‐associated DNA (RADseq) to identify single nucleotide polymorphisms (SNPs) is quickly becoming a standard methodology for molecular ecologists. Because of the scale of RADseq data sets, putative loci cannot be assessed individually, making the process of filtering noise and correctly identifying biologically meaningful signal more difficult. Artefacts introduced during library preparation and/or bioinformatic processing of SNP data can create patterns that are incorrectly interpreted as indicative of population structure or natural selection. Therefore, it is crucial to carefully consider types of errors that may be introduced during laboratory work and data processing, and how to minimize, detect and remove these errors. Here, we discuss issues inherent to RADseq methodologies that can result in artefacts during library preparation and locus reconstruction resulting in erroneous SNP calls and, ultimately, genotyping error. Further, we describe steps that can be implemented to create a rigorously filtered data set consisting of markers accurately representing independent loci and compare the effect of different combinations of filters on four RAD data sets. At last, we stress the importance of publishing raw sequence data along with final filtered data sets in addition to detailed documentation of filtering steps and quality control measures