International Statement Research Articles

International Social Law for an International Solidarity Community

Abstract: This paper aims to establish a common ground for solidarity requirements at the international level, in special between Brazil and the European Union. This essay departs from an initial international solidarity assumption, i.e., the common idea of human dignity both in international statements and in State constitutions, as well as from rules of Community law. As to restrictions, the paper is based on the European Community law and the Brazilian constitution, and thereby discusses a common element worthy of legislative protection, which is the human being rather than the citizen. Thus, both in Community and in Brazilian law, one's foreign, native or community condition should not interfere with the human being access to social rights. Therefore, by defending the respective regulatory scopes, such dimensions are committed to promoting human dignity in terms of social rights, in solidarity with the human condition itself, in whatever it requires. The study made use of the deductive method, once it is developed from general premises in order to find an answer to a specific situation, that of the international solidarity between Brazil and the European Union. The text included a literature review and consultation to legislative documents.

Lifestyle and Behavioral Management of Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a common condition with serious physiological and psychological health consequences. It affects women across their reproductive lifespan and is associated with pregnancy complications, including gestational diabetes, preeclampsia, and large gestational-age babies. PCOS is associated with excess weight gain, which, in turn, exacerbates the health burden of PCOS. Therefore, weight management, including a modest weight loss, maintenance of weight loss, prevention of weight gain, and prevention of excess gestational weight gain, is a first-line treatment for women with PCOS during and independent of pregnancy. Despite evidence-based guidelines, international position statements, and Cochrane reviews promoting lifestyle interventions for PCOS, the optimal complexity, intensity, and behavioral components of lifestyle interventions for women with PCOS are not well understood. The focus of this narrative review is the evidence supporting the use of behavioral strategies in weight management interventions for reproductive-aged women to apply to PCOS. Behavioral theories, behavior change strategies, and psychological correlates of weight management have been thoroughly explored in weight loss interventions in the general population, reproductive-aged women, and peri-natal women. This article uses this parallel body of research to inform suggestions regarding lifestyle interventions in women with PCOS. Outcomes of weight management programs in women with PCOS are likely to be improved with the inclusion of behavioral and psychological strategies, including goal setting, self-monitoring, cognitive restructuring, problem solving, and relapse prevention. Strategies targeting improved motivation, social support, and psychological well-being are also important. These can be applied to the clinical management of women with PCOS at different reproductive life stages.

Tensions in the New Millennium: Inclusion Ideology and Education Policy in the Finnish Comprehensive School

This article examines the discrepancy between the ideology of inclusive education and the national education policy in the Finnish comprehensive school education. The study covers twenty years and is based on observations that indicate that the change in comprehensive school education, grounded in inclusive education ideals, has been slow. This has been the case, even though Finnish education policy has, on principle, committed to many international statements that promote inclusion ideology. The data consists primarily of statistics indicating the number of students in special education and national and international research on the subject. It confirms our supposition, but also the fact that statistics are not merely challenging but also capable of distorting reality. While examining the changes in student quantities over the last twenty years, we came to the conclusion that the fluctuation does not result from any real growth in student numbers. Changes in statistical methods, terminology in the field of study, norms, education systems or even social phenomena can also cause distortion.

Coming to America: work visas, international diversity, and organizational attractiveness among highly skilled Asian immigrants

U.S. firms are increasingly seeking foreign workers to help satisfy growing demands for technical and highly skilled labor, and many immigrants continue to seek jobs in America. Despite this, few studies in the management discipline examine immigration issues as they relate to organizational attraction and recruitment. In an experimental study, we investigated the relationship between stated recruitment policies, perceived work-related expectancy, and organizational attractiveness among graduate students from Asia as potential job seekers to companies in the United States. We found a relationship between perceived work-related expectancy and either emphasizing international diversity or work visa sponsorship. However, emphasizing work visa sponsorship weakened the effect of international diversity on perceived work-related expectancy. Perceived work-related expectancy was also found to positively affect organizational attractiveness, resulting in a conditional indirect effect of international diversity statements on organizational attractiveness. Implications for organizations and directions for future research are discussed.

Surgical management of papillary thyroid carcinoma: an overview.

The surgical management of papillary thyroid carcinoma remains contentious and the optimal surgical strategy has not been yet established. The extent of thyroid resection has been the nub of this debate. Literature lacks prospective randomized controlled trials that could help put this debate to rest, and these have been labeled as being impractical. Consequently, large retrospective studies and expert opinion have constituted the basis of clinical practice guidelines. Recent American Thyroid Association and National Comprehensive Cancer Network guidelines consider a conservative approach in the form of a thyroid lobectomy sufficient for low-risk disease and that total thyroidectomy remains the standard of care in the presence of high-risk features. Nevertheless, many authorities still advocate more aggressive therapy for low-risk disease. The challenge in standardizing the surgical strategy to papillary thyroid carcinoma is mainly related to a major tumor characteristic: the high frequency of occult cancerous foci whether within the thyroid gland itself or within loco-regional lymph nodes as this tumor characteristic has been incriminated for a higher risk of recurrent disease and its adverse sequelae. The purpose of this article is to provide an overview of the surgical management of papillary thyroid carcinoma and the main arguments surrounding this hotly debated topic. All evidences for this review article were drawn from PubMed articles in English language mostly cross-referenced with international guideline statements.

The RENAPE observational registry: rationale and framework of the rare peritoneal tumors French patient registry

BackgroundRare peritoneal cancers represent complex clinical situations requiring a specific and multidisciplinary management. Because of their rarity, lack of awareness and knowledge often leads to diagnostic delays and misdiagnosis. And patients are not systematically referred to expert centers as they should be. Clinicians and researchers also face unique challenges with these rare cancers, because it is hard to conduct adequately powered, controlled trials in such small patient population. This is how an observational patient registry constitutes a key instrument for the development of epidemiological and clinical research in the field of these rare cancers. It is the appropriate tool to pool scarce data for epidemiological research and to assess the impact of diagnostic and therapeutic strategies. We aimed to provide the outlines and the framework of the RENAPE observational registry and share our experience in the establishment of a national patient registry.ResultsThe RENAPE observational registry has been launched in 2010 thanks to institutional supports. It concerns only patients with a histological diagnosis confirming a peritoneal surface malignancy. A web secured clinical database has been implemented based on data management procedures according to the principles of international recommendations and regulatory statements. A virtual tumor bank is linked in order to the conduct translational studies. Specialized working groups have been established to continuously upgrade and evolve the common clinical and histological data elements following the last classifications and clinical practices. They contribute also to standardize clinical assessment and homogenize practices.ConclusionsThe RENAPE Registry may improve awareness and understanding of the rare peritoneal tumors into the incidence, prevalence, recurrence, survival and mortality rates, as well as treatment practices thereby enabling therapeutic intervention to be evaluated and ultimately optimized.Trial registrationClinicalTrials.gov Identifier: NCT02834169

A Review of the Provision of Social and Emotional Learning in Australia, the United States, Poland, and Portugal

The aim of this research is to gather preliminary information from a range of countries to develop an international perspective on Social and Emotional Learning (SEL). Currently, there is no cohesive international statement on the minimum requirements to provide SEL in schools. By bringing together a range of international perspectives it is intended that clarity will be provided from which new approaches and initiatives can be developed and researched. International researchers familiar with SEL programs in their country were asked to answer five questions about the context and processes used to teach SEL in specific countries to begin an understanding and synthesis of best practice. These questions relate to: (1) sociocultural contexts of school systems, (2) the range of SEL programs presented in each country and what is common about these programs, (3) the effectiveness of prominent SEL programs, (4) the facilitators and barriers that exist to effectively present SEL programs within the country, and (5) recommendations for the future of SEL programs. A synthesis is followed by a discussion of the future of SEL and how the SEL Interest Group may make a contribution to the current state of the literature, curriculum, pedagogy, and research that informs SEL in schools.

Crossing the Rubicon: Death in 'The Year of the Transplant'.

How death should be measured was a subject of intense debate during the late 1960s, and one in which transplant surgeons had a particular interest. Legislation required a doctor to first pronounce ‘extinct’ the patients from whom ‘spare parts’ were sought for grafting. But transplant surgeons increasingly argued the moment of death was less important than was the moment of establishing that a patient was beyond the point of no return in dying, at which time she or he should be passed to the transplant team. This raised concerns that people identified as being a potential source of organs might not be adequately cared for in their own right. In 1968 the World Medical Association issued an international statement on death at its meeting in Sydney, Australia following a debate between delegates about how and by whom death should be assessed prior to organ removal. Soon afterwards Australian surgeons performed two of the one hundred and five heart transplants carried out around the world that year, dubbed by the New York Times to be one during which an ‘international epidemic’ of such grafts were carried out. This essay examines debates about death and transplanting, then analyses the pioneering Australian heart transplants, in the context of the Declaration of Sydney and continuing international discussions about whether these operations were moral and legal.

Clinical Course and Changes in High-Resolution Computed Tomography Findings in Patients with Idiopathic Pulmonary Fibrosis without Honeycombing.

Some patients with idiopathic pulmonary fibrosis (IPF) do not have honeycombing on high-resolution computed tomography (HRCT) at their initial evaluation. The clinical course and sequential changes in HRCT findings in these patients are not fully understood. We reviewed the cases of 43 patients with IPF without honeycombing on initial HRCT from institutions throughout Japan. All patients were diagnosed with IPF based on a surgical lung biopsy. Multidisciplinary discussions were held five times between 2011 and 2014, to exclude alternative etiologies. We evaluated the sequential changes in HRCT findings in 30 patients with IPF. We classified these 30 patients into three groups based on their HRCT patterns and clarified the clinical characteristics and prognosis among the groups. The patterns of all 30 patients on initial HRCT corresponded to a possible usual interstitial pneumonia (UIP) pattern which was described in the 2011 International Statement. On long-term follow-up (71.0±38.7 standard deviation [SD] months), honeycombing was seen in 16 patients (53%, the HoneyCo group); traction bronchiectasis or cysts without honeycombing was observed in 12 patients (40%, the NoHoneyCo group), and two patients showed no interval change (7%, the NoChange group) on HRCT. The mean survival periods of the HoneyCo and NoHoneyCo groups were 67.1 and 61.2 months, respectively (p = 0.76). There are some patients with IPF whose conditions chronically progress without honeycombing on HRCT. The appearance of honeycombing on HRCT during the follow-up might not be related to prognosis.

Spatial and temporal structure of the clinical research based on mesenchymal stromal cells: A network analysis

Background aimsUsing innovative tools derived from social network analysis, the aims of this study were (i) to decipher the spatial and temporal structure of the research centers network dedicated to the therapeutic uses of mesenchymal stromal cells (MSCs) and (ii) to measure the influence of fields of applications, cellular sources and industry funding on network topography. MethodsFrom each trial using MSCs reported on ClinicalTrials.gov, all research centers were extracted. Networks were generated using Cytoscape 3.2.2, where each center was assimilated to a node, and one trial to an edge connecting two nodes. ResultsThe analysis included 563 studies. An independent segregation was obvious between continents. Asian, South American and African centers were significantly more isolated than other centers. Isolated centers had fewer advanced phases (P < 0.001), completed studies (P = 0.01) and industry-supported studies (P < 0.001). Various thematic priorities among continents were identified: the cardiovascular, digestive and nervous system diseases were strongly studied by North America, Europe and Asia, respectively. The choice of cellular sources also affected the network topography; North America was primarily involved in bone-marrow–derived MSC research, whereas Europe and Asia dominated the use of adipose-derived MSCs. Industrial funding was the highest for North American centers (90.5%). ConclusionsStrengthening of international standards and statements with institutional, federal and industrial partners is necessary. More connections would facilitate the transfer of knowledge, sharing of resources, mobility of researchers and advancement of trials. Developing partnerships between industry and academic centers seems beneficial to the advancement of trials across different phases and would facilitate the translation of research discoveries.

Training Standards Statements of Family Medicine Postgraduate Training - A Review of Existing Documents Worldwide.

IntroductionFor the effective and safe management of complex care needs for patients in community settings, high quality family medicine (FM) training programmes are needed. In less primary care oriented countries, training standards statements for FM postgraduate training are less commonly found. The aim of this study was to review international training standards statements in FM postgraduate training and to catalogue these statements to be used as a best practice standard guide for FM training programs in Germany.Materials and MethodsA structured three-tiered search was performed: a systematic literature search in MEDLINE®; a search of international indicator databases; and a search in grey literature, consisting of a survey of international experts and a search in “Google (Scholar)”. From all identified documents, training standards statements were extracted, translated and summarized into categories referring to the same quality aspect.ResultsThe search strategy revealed 25 relevant documents (MEDLINE® n = 15, databases n = 2, experts n = 7, “Google” n = 1), containing 337 training standards statements. These were summarized into 80 statements. They covered structure quality (n = 35); process quality (n = 43); and two training standards statements referred to outcome quality (n = 2).ConclusionA broad range of internationally sourced training standards statements for FM postgraduate training could be identified from countries with well-established primary care systems. Only few statements internationally referred to outcome quality, expressing the difficulty in assessing outcome. The resulting inventory of training standards statements for FM postgraduate training can serve as a resource for institutions seeking to formalise and systematise FM training at regional or national levels.

Reporting quality and effect size comparison in randomized controlled trials of bo's abdominal acupuncture using CONSORT statement and STRICTA

ObjectiveTo evaluate the reporting quality of randomized controlled trials (RCT) that compared Bo's abdominal acupuncture with conventional body acupuncture, and compare the efficacy and safety between them by performing a Meta-analysis. MethodsAll RCTs comparing Bo's abdominal acupuncture with conventional body acupuncture were included. English and Chinese databases were searched from their respective inceptions to March 2014. The reporting quality was assessed according to the “Consolidated Standards of Reporting Trials” (CONSORT) checklist for parallel RCTs and the revised “Standards for Reporting Interventions in Clinical Trials of Acupuncture” (STRICTA). A Meta-analysis was conducted to synthesize the effect sizes, and publication bias was evaluated by the Egger linear regression test using Stata. ResultsNinety-seven studies were included, of which most lacked adequate reporting information, and 80.4% showed that the efficacy of abdominal acupuncture is superior to conventional body acupuncture, especially for the following diseases: lumbar disc herniation, cervical spondylosis, omarthritis and cervical vertigo, except simple obesity. Effect-sizes were controversial when evaluating different outcomes. ConclusionThe international standard CONSORT statement and STRICTA guidelines should be strictly applied when reporting acupuncture RCTs in the future. Abdominal acupuncture appears to be more effective compared with conventional body acupuncture for some diseases. However, further high quality blind RCTs using validated outcome indexes and standard reporting are warranted.

Medical Oaths and Their Educational Impact

Current health system put different tasks on physicians. Alongside with this change, medical education also becomes more sophisticated and the humanistic features of medicine undermined. However, it should be pointed out that the professional commitment of a physician and his/her primary duty is caring for the patients. Although changes in the health care system have affected the physician’s roles, this primal commitment mentioned as the primary task of the medicine as a profession. Besides, nowadays, physicians, patients, and members of the society have come to believe that medicine and especially its physician-patient relationship component is under threat, and virtually all have concluded that any action to address the issue must include a major educational initiative. (R L. Cruess, S R. Cruess &Yvonne Steinert eds. Teaching Medical Professionalism. 2009, Cambridge University Press) On the other hand, usually duties and responsibilities show themselves in the form of national and international codes and statements. Therefore a professional code could be seen as a set of ethical rules, values and standards that specify the jurisdiction and responsibilities of the members of that profession. That is why the professional code is also called rules governing the professional responsibilities. In the medical history since about four centuriesBC, emphasis on the obligations of a physician and his essential competencies was importantand has been discussed in philosophical and medical literature. For example, taking an oath based on the textof the Hippocratic Oath or the like, with its stresses on professional commitment and ethical responsibilitiesis still accepted as a part of the medical education or graduation process all over the world. Over the years, these ethical codes have been reviewed and revised and in each period have specified standards of the medical profession.

The transition of young adults with lifelong urological needs from pediatric to adult services: An international children's continence society position statement

Children with urinary tract disorders managed by teams, or individual pediatricians, urologists, nephrologists, gastroenterologists, neurologists, psychologists, and nurses at some point move from child-centered to adult-centered health systems. The actual physical change is referred to as the transfer whilst the process preceding this move constitutes transition of care. Our aims are twofold: to identify management and health-service problems related to children with congenital or acquired urological conditions who advance into adulthood and the clinical implications this has for long-term health and specialist care; and, to understand the issues facing both pediatric and adult-care clinicians and to develop a systems-approach model that meets the needs of young adults, their families and the clinicians working within adult services. Information was gleaned from presentations at an International Children's Continence Society meeting with collaboration from the International Continence Society, that discussed problems of transfer and transitioning such children. Several specialists attending this conference finalized this document identifying issues and highlighting ways to ease this transition and transfer of care for both patients and practitioners. The consensus was, urological patients with congenital or other lifelong care needs, are now entering adulthood in larger numbers than previously, necessitating new planning processes for tailored transfer of management. Adult teams must become familiar with new clinical problems in multiple organ systems and anticipate issues provoked by adolescence and physical growth. During this period of transitional care the clinician or team assists young patients to build attitudes, skills and understanding of processes needed to maximize function of their urinary tract-thus taking responsibility for their own healthcare needs. Preparation must also address, negotiating adult health care systems, psychosocial, educational or vocational issues, and mental wellbeing. Transitioning and transfer of children with major congenital anomalies to clinicians potentially unfamiliar with their conditions requires improved education both for receiving doctors and children's families. Early initiation of the transition process should allow the transference to take place at appropriate times based on the child's development, and environmental and financial factors. Neurourol. Urodynam. 36:811-819, 2017. © 2016 Wiley Periodicals, Inc.

Creative Commons Licenses: Empowering Open Access

Open access (OA) is a concept that in recent years has acquired popularity and widespread recognition. International statements and scholarly analysis converge on the following main characteristics of open access: free availability on the public Internet, permission for any users to read, download, copy, distribute, print, search, and link to the full texts of these articles, crawl them for indexing, pass them as data to software, and use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the Internet itself. The only legal constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited.

Post-treatment surveillance in locally advanced squamous cell carcinoma (SCCA) of the anal canal: A global subspecialist survey.

573 Background: Squamous cell carcinoma of the anal canal will be diagnosed in 28,000 individuals globally. Considered a rare cancer, the incidence of anal carcinoma continues to rise annually. Majority of patients present with locally advanced disease in which concurrent chemoradiation (CRT) will be provided with curative intent. The Anal Cancer IRCI Working Group was created to pursue novel approaches to the diagnosis, treatment, and surveillance of patients. Yet, surveillance following completion of CRT is not well established and varies as per NCCN (v2.2015) and ESMO guidelines. Methods: A 22-question survey provided to anonymous international GI subspecialists in various fields. Questions pertained to timing and type of diagnostic imaging, surveillance interval, approach to detection of complete response (CR), and prevention of sexual dysfunction. Results: Survey distribution was initiated in March 2015 and still ongoing. Thus far, 96 physicians responded. Conclusions: Carcinoma of the anal canal continues to rise in incidence annually. Surveillance following completion of CRT is warranted; however, global variability in practice patterns for surveillance exists. As such, the IRCI Anal Cancer Working Group intends to provide an international consensus surveillance statement. [Table: see text]

Environmental Conflict and Media Coverage of an Oil Spill in Trinidad

AbstractIn December 2013, local media reported an oil spill off the southwestern coast of Trinidad. Subsequent media reports generated local and international interest, statements, and commentary from company and government interests and members of the La Brea community (fisherfolk and residents directly affected by the oil spill), the national community, trade unionists, politicians, oil spill experts, and environmentalists. As the news coverage developed, various narrative themes emerged. Within these themes, various conflict issues, mainly pertaining to the nature and focus of communication, and differences over the prevention, mitigation and management of environmental disasters were manifested in the media coverage and corporate communications management of crisis and reputation. Using crisis communication theory, and content analysis of media and company texts, this study examined the extent of media coverage and organizational and corporate communications framing of the creation, escalation, and management of a significant environmental conflict situation.

Clinical Application of the Forced Oscillation Technique.

The forced oscillation technique (FOT) is a noninvasive method with which to measure respiratory system resistance and reactance during tidal breathing. Recently, its clinical application has spread worldwide with the expansion of commercially available broadband frequency FOT devices, including MostGraph and Impulse Oscillometry. An increasing number of reports have supported the usefulness of the FOT in the management of asthma and chronic obstructive pulmonary disease (COPD). However, the FOT is not a surrogate test for spirometry, but should be used complementarily. Furthermore, reference values are not necessarily available and the interpretation of some measured data is controversial. There is a need to update the international statement for not only technical aspects but also the clinical use of the FOT. In this review, we summarize the previously published studies and discuss how to use the FOT in a clinical setting.

Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy.

Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy.

La mesure de l’estime de soi à l’adolescence : proposition d’une nouvelle échelle multidimensionnelle (Emesa)

Drawing from the international statements about self-esteem's issues, this paper presents the development of a new French scale to assess it. With a multidimensional design, the tool aims to scrutiny the adolescents’ principal areas of life. The elements of validity showed that the factorial structure was satisfactory, the internal consistence of each dimension was good and the test-retest fidelity was quite high. The external validity was explored with the assistance of the MDI-C and showed that all dimensions of self-esteem were linked to depressive symptoms. The variations of the self-esteem, and of its components, depending on the gender and on the academic course have led us to build specific standardization for boys and girls and for apprentices and high school students.