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Background and purpose: Patient and public involvement in clinical practice guideline development is recommended to increase guideline trustworthiness and relevance. The aim was to engage multiple sclerosis (MS) patients and caregivers in the definition of the key questions to be answered in the European Academy of Neurology guideline on palliative care of people with severe MS. Methods: A mixed methods approach was used: an international online survey launched by the national MS societies of eight countries, after pilot testing/debriefing on 20 MS patients and 18 caregivers, focus group meetings of Italian and German MS patients and caregivers. Results: Of 1199 participants, 951 (79%) completed the whole online survey and 934 from seven countries were analysed: 751 (80%) were MS patients (74% women, mean age 46.1) and 183 (20%) were caregivers (36% spouses/partners, 72% women, mean age 47.4). Participants agreed/strongly agreed on inclusion of the nine pre‐specified topics (from 89% for 'advance care planning' to 98% for 'multidisciplinary rehabilitation'), and <5% replied 'I prefer not to answer' to any topic. There were 569 free comments: 182 (32%) on the pre‐specified topics, 227 (40%) on additional topics (16 guideline‐pertinent) and 160 (28%) on outcomes. Five focus group meetings (three of MS patients, two of caregivers, and overall 35 participants) corroborated the survey findings. In addition, they allowed an explanation of the guideline production process and the exploration of patient‐important outcomes and of taxing issues. Conclusions: Multiple sclerosis patient and caregiver involvement was resource and time intensive, but rewarding. It was the key for the formulation of the 10 guideline questions and for the identification of patient‐important outcomes. [ABSTRACT FROM AUTHOR]

The article examines effective teacher evaluations that hold teachers accountable, encourage them to remain current in their fields, and note their contributions to the community. Teacher observation, supervision, and evaluation sharpen the quality and character of the educational process. Effective schools are thought of as learning communities and should embrace the promotion of professional excellence, the improvement of teaching staff, the improvement of student learning and growth, and the provision of a basis for reviewing the performance of teachers. The authors outline a plan for observation and evaluation.

Binding energies, excitation energies and spectroscopic factors have been calculated forNi andCu in an unrestricted (2p, l f,2p) shell-model space. The effective two-body matrix elements are obtained from the modified surface delta interaction (MSDI) and from a least-squares fit to experimental binding and excitation energies (ASDI). The average deviation between about 100 experimental and calculated energies is 0.14MeV for MSDI and 0.08 MeV for ASDI. Excitation energies of high-spin states are given also. Spectroscopic factors have been calculated for all single-nucleon transfer reactions on stable Ni or Cu targets leading to Ni or Cu isotopes. For spectroscopic factors larger than 0.4 the average deviation between theory and experiment is about 30%. The experimentally observed and calculated spectroscopic strengths are compared by using sum rules and are found to be consistent. An extensive compilation has been made of experimental data on energies, J assignments and spectroscopic factors. [ABSTRACT FROM AUTHOR]

Urine patches are considered to be important sites for nitrous oxide(N2O) production through nitrification and denitrification due to their high concentration of nitrogen (N). The aim of the present study was to determine the microbial source and size of production of N2O in different zones of a urine patch on grasslandon peat soil. Artificial urine was applied in elongated patches of 4.5 m. Four lateral zones were distinguished and sampled for four weeks using an intact soil core incubation method. Incubation of soil cores took place without any additions to the headspace to determine total N2O production, with acetylene addition to determine total denitrification (N2O +N2), and with methyl fluoride to determine the N2O produced through denitrification. Nitrous oxide production was largest in the centre and decreased towards the edge of the patch. Maximum N2O production was about 50 mg N m-2 d-1 and maximum denitrification activity was 70 mg N m-2 d- 1. Nitrification was the main N2O producing process. Nitrous oxide production through denitrification was only of significance when denitrification activity was high. Total N loss through nitrification and denitrification over 31 days was 4.1 g N per patch which was 2.2% of the total applied urine-N. [ABSTRACT FROM AUTHOR]