Supplementation Guidelines Research Articles

Guidelines for Supplements

Guidelines for Supplements

Impediments to Implementing Environmental Education

Abstract A case study of the implementation of a school's environmental education program revealed that planning ahead and teacher participation in decision making are imperative. The implementation of a sound environmental program requires that teachers understand the philosophical and pedagogical nature of environmental education in order to relate it to their subject areas. When guidelines for teachers, curicular supplements, and accessible materials are lacking, a school's ability to accomplish its goals is limited.

Developing Supplemental Guidelines for Music

Supplemental guidelines are an essential part of a regional conspectus of music collections sponsored by the New York Metropolitan Reference and Research Library Agency (METRO). In devising appropriate guide lines for this field of study, a task force of four music librarians determined that the four principal formats typical of music colleclions (books, periodicals, scores, and recordings) should be suitably individualized, both with respect to the Conspectus code definitions and to the recommended "benchmarks" (i.e., bibliographies and discographies that can be used to assess the quality of collections). Besides writing the guidelines, the task force is proposing changes to the Music Conspectus form in light of nearly a decade's experience since it was first developed by the Research Libraries Group (RLG).

Human Immunodeficiency Virus Infection and Indeterminate Western Blot Patterns

Interpretation of human immunodeficiency virus (HIV) antibody results that are "indeterminate" rather than clearly positive or negative is problematic for the person delivering the result as well as for the individual being tested. To improve counseling messages for these individuals, we evaluated data collected from a well-characterized cohort of 387 blood donors who had been monitored for up to 2 years. We sought to determine if persons with indeterminate Western blot patterns were infected with HIV, and whether information derived from follow-up monitoring would assist in the development of counseling messages for persons on whom no follow-up information was available. Donors were studied by laboratory assays, clinical evaluation, and assessment of risk for HIV. The absence of HIV infection in 97 of 98 donors with indeterminate Western blot patterns was confirmed by clinical follow-up, Western blot assays of sequential samples, and negative gene amplification results. We propose supplemental guidelines to be used as an adjunct to existing interpretive criteria for counseling individuals when they first present with an indeterminate Western blot finding.

Cardiopulmonary Resuscitation Training and Risk of Infection

To the Editor.— The American Heart Association has failed to address the key issue related to infection and cardiopulmonary resuscitation in the supplemental guidelines published in the November 17 issue ofThe Journal. 1 If good cardiopulmonary resuscitation training can be done without risk, there is no moral or ethical justification for exposing trainees to any risk. Adequate ventilation practice can be given during cardiopulmonary resuscitation courses using a bag-valve-mask apparatus. Practice and testing of this ventilation skill during cardiopulmonary resuscitation training combined with instruction about other more risky ventilation methods (mouth-to-mouth and mouth-to-mask) would provide a risk-free teaching situation. The students I teach would be willing to take the minuscule risk of contracting a serious infection to save a life. They are unwilling to take this risk to practice on a mannequin. The guidelines state that requests for individual mannequins should be honored, within reason. Since there is no

Risk of Infection During CPR Training and Rescue: Supplemental Guidelines

The American Heart Association and the American Red Cross used the findings from the 1985 National Conference on Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care to establish their policy on the risk of infection during cardiopulmonary resuscitation (CPR) training and rescue. Findings that support the safety of CPR training and rescue and appropriate risk reduction strategies are presented as an update to the 1985 article. The Emergency Cardiac Care Committee of the American Heart Association incorporated recent advisories from the Centers for Disease Control as well as other information into guidelines that augment earlier recommendations. (<i>JAMA</i>. 1989;262:2714-2715)

Risk of infection during CPR training and rescue: supplemental guidelines. The Emergency Cardiac Care Committee of the American Heart Association

The American Heart Association and the American Red Cross used the findings from the 1985 National Conference on Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care to establish their policy on the risk of infection during cardiopulmonary resuscitation (CPR) training and rescue. Findings that support the safety of CPR training and rescue and appropriate risk reduction strategies are presented as an update to the 1985 article. The Emergency Cardiac Care Committee of the American Heart Association incorporated recent advisories from the Centers for Disease Control as well as other information into guidelines that augment earlier recommendations.

Trace mineral supplementation of burn patients: A national survey

Much research effort has been devoted to determination of caloric and protein requirements in burn patients. Although it is generally accepted that trace mineral requirements increase concomitantly with caloric and protein needs, little research has been conducted to document that assumption. Our survey was undertaken to assess current practice and identify research needs. One hundred ninety-six survey questionnaires were sent to burn units in North America. Forty percent (78) were returned. Ninety percent of respondents prescribe or recommend trace mineral supplements in their facilities. "Higher risk" was the single criterion most often mentioned as a basis for supplementation (54 [77%] of 70 respondents), with 49 of them indicating that they provide trace mineral supplements to patients receiving total parenteral nutrition support. Fifty-six respondents provided detailed information concerning trace mineral supplementation. Of that group, 88% prescribe zinc supplements, 75% prescribe iron supplements, and 26% prescribe chromium supplements. Thirteen percent supplement selenium. Less than 2% supplement molybdenum or vanadium and do so only when administering total parenteral nutrition. Many respondents expressed concern about the lack of guidelines for trace mineral supplementation in the burn patient, leading to the conclusion that further research in that area would benefit burn-injured patients and the health care providers who care for them.

Very-low-protein diets in chronic renal failure: Nutrient content and guidelines for supplementation

The possibility that supplemented, very-low-protein diets may slow the progression of CRF increases the importance of that type of diet therapy (1). If the results are confirmed in large numbers of patients, it is likely that the supplements will become commercially available and will be used widely to treat patients with progressive renal failure. Adequate vitamin and mineral supplementation will be necessary in order to maintain good nutritional status. On the basis of previously reported data and the present results, supplemental thiamin, riboflavin, niacin, vitamin B-12, folic acid, pyridoxine, calcium, and possibly iron and zinc are recommended for patients treated with these very-low-protein diets. These recommendations are preliminary and may be altered as more long-term data are collected on the vitamin and mineral status of CRF patients.

Tissue selenium accretion in premature and full-term human infants and children

Development of supplementation guidelines for formulated diets and total parenteral nutrition requires knowledge of Se tissue accretion. To this end, the total organ Se content was calculated from the Se concentrations that were measured by neutron activation analysis in postmortem samples of liver (n=56), kidney (n=11), adrenal cortex (n=9), and pancreas (n=6) from infants and children from birth to 10 yr including 17 born prematurely. Hepatic Se concentrations were similar in full-term and premature newborns, decreased from birth to 1 yr, and then increased thereafter. The total hepatic Se content was significantly greater in full-term than in preterm newborns and increased with age and liver size after 1 yr. No significant differences were found between the concentrations of Se in kidney, pancreas, and adrenal tissues. Falling hepatic Se concentrations in the full-term infant concurrent with stable total organ Se content may indicate inadequate dietary intake or may reflect a normal redistribution of the nutrient. Premature infants are born with smaller stores than full-term infants and are at greater risk of developing a deficiency.

A STANDARDIZED NOMENCLATURE FOR RADIOGRAPHIC PROJECTIONS USED IN VETERINARY MEDICINE*

The objective of this report is to present a standardized nomenclature system for radiographic projections used in veterinary medicine that is anatomically accurate, easily understood, and easily communicated. The system is based on two simple rules: (1) radiographic projections should be named using only proper veterinary anatomic directional terms or their abbrecviations; (2) radiographic projections should be described by the direction that the central ray of the primary x‐ray beam penetrates the body part of interest, from point of entrance to point of exit. Additional recommendations are included that will result in further standardization of the nomenclature. These include supplemental guidelines for (1) combination of terms; (2) angles of obliquity; (3) positions of the body; and (4) orientation of the central ray relative to space. In addition, the position of joints and other body parts may require description. Selected examples of how the nomenclature system can be applied are included. It is recommended that this nomenclature be required by editors of veterinary journals and textbooks.