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Sample records for assessment guidelines overview

  1. Analysis and overview of the guidelines for assessing fitness to drive for commercial and private vehicle drivers.

    Science.gov (United States)

    Beran, R G

    2005-06-01

    interpretation. Some sections, such as that on sleep and epilepsy, are effectively analysed, while illnesses such as dementia are considered superficially. The guidelines are an attempt to assess fitness to drive, but contain serious flaws and provide limited information upon which to base decisions. Ambiguous language complicates application of the guidelines and places the health care professional at risk, despite a disclaimer protecting its authors.

  2. Risk Assessment Overview

    Science.gov (United States)

    Prassinos, Peter G.; Lyver, John W., IV; Bui, Chinh T.

    2011-01-01

    Risk assessment is used in many industries to identify and manage risks. Initially developed for use on aeronautical and nuclear systems, risk assessment has been applied to transportation, chemical, computer, financial, and security systems among others. It is used to gain an understanding of the weaknesses or vulnerabilities in a system so modification can be made to increase operability, efficiency, and safety and to reduce failure and down-time. Risk assessment results are primary inputs to risk-informed decision making; where risk information including uncertainty is used along with other pertinent information to assist management in the decision-making process. Therefore, to be useful, a risk assessment must be directed at specific objectives. As the world embraces the globalization of trade and manufacturing, understanding the associated risk become important to decision making. Applying risk assessment techniques to a global system of development, manufacturing, and transportation can provide insight into how the system can fail, the likelihood of system failure and the consequences of system failure. The risk assessment can identify those elements that contribute most to risk and identify measures to prevent and mitigate failures, disruptions, and damaging outcomes. In addition, risk associated with public and environment impact can be identified. The risk insights gained can be applied to making decisions concerning suitable development and manufacturing locations, supply chains, and transportation strategies. While risk assessment has been mostly applied to mechanical and electrical systems, the concepts and techniques can be applied across other systems and activities. This paper provides a basic overview of the development of a risk assessment.

  3. Regulatory guidelines for medical devices in India: An overview

    OpenAIRE

    Nadimpalli Radhadevi; Veeranna Balamuralidhara; Teggina Math Pramod Kumar; Valluru Ravi

    2012-01-01

    The objective of the present study offers an overview of regulatory guidelines for medical devices in India. Medical devices are now a pervasive part of modern medical care. They are in many cases associated with quality of care. In some cases, the use of devices has certainly improved quality. In other cases, devices have been associated with many problems. The approach to quality of devices has depended largely on regulation .Recently introduced guidelines and the amendment in the law will ...

  4. Overview of guidelines on breast screening

    DEFF Research Database (Denmark)

    Juhl Jørgensen, Karsten; Kalager, Mette; Barratt, Alexandra

    2017-01-01

    Updated guidelines on breast cancer screening have been published by several major organisations over the past five years. Recommendations vary regarding both age range, screening interval, and even on whether breast screening should be offered at all. The variation between recommendations reflects...... substantial differences in estimates of the major benefit (breast cancer mortality reduction) and the major harm (overdiagnosis). Estimates vary considerably among randomised trials, as well as observational studies: from no benefit to large reductions, and from no overdiagnosis to substantial levels......, such as small effects in absolute terms. There is a need for agreement on a hierarchy of observational study designs to quantify the major benefit and harm of cancer screening. This review provides a summary of recent guidelines on breast cancer screening and their major strengths and weaknesses, as well...

  5. Small Wind Site Assessment Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, Tim [Advanced Energy Systems LLC, Eugene, OR (United States); Preus, Robert [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-09-01

    Site assessment for small wind energy systems is one of the key factors in the successful installation, operation, and performance of a small wind turbine. A proper site assessment is a difficult process that includes wind resource assessment and the evaluation of site characteristics. These guidelines address many of the relevant parts of a site assessment with an emphasis on wind resource assessment, using methods other than on-site data collection and creating a small wind site assessment report.

  6. Societal assessment overview

    Science.gov (United States)

    Bloomquist, C. E.

    1980-01-01

    The decision to proceed with SPS depends on a political determination that commitment of the economic, institutional, and social energies required for its implementation is a worthwhile investment. This determination is national (and international) in scope and is based on knowledge of the environmental and societal impacts of the SPS, its projected economics and technological risks, expressed through the influence of contending segments of society. To assist the decision makers, an assessment of societal issues associated with the SPS was undertaken as part of the Concept Development and Evaluation Program. Results of the assessment are reported. The primary societal assessment objectives are to determine if the societal ramifications of an SPS might significantly impede its development, and to establish an information base regarding these issues. Estimates regarding SPS impacts commensurate with its stage of development and the needs of the decision makers are provided.

  7. Exercise stress testing. An overview of current guidelines.

    Science.gov (United States)

    Lear, S A; Brozic, A; Myers, J N; Ignaszewski, A

    1999-05-01

    Exercise stress testing (ET) is an inexpensive noninvasive tool that provides valuable cardiopulmonary information in healthy and diseased populations. It is most commonly used for diagnosing coronary artery disease (CAD) and developing appropriate exercise prescriptions (EP). With its widespread use and application, it is imperative that safe and appropriate guidelines and procedures are used, as there are a number of risks associated with testing in a population with or suspected of having CAD. The focus should be on the patient's safety: personnel must be properly trained and aware of all emergency procedures, contra-indications for ET and indications for test termination must be strictly adhered to. Three main types of testing are prevalent: submaximal, maximal and maximal utilising gas exchange. The maximal test is most commonly used, and the submaximal is appropriate for hospitalised patients. Gas exchange data is essential when assessing congestive heart failure and timing for heart transplantation. ET is commonly performed using a treadmill or a bicycle ergometer. The treadmill provides a more familiar exercise modality and has been shown to have greater diagnostic sensitivity than the bicycle ergometer; it is, however, more expensive and requires more space in the testing room. The bicycle ergometer is more appropriate for those individuals who are severely obese or have problems with extended periods of walking. Regardless of the modality used, an appropriate exercise protocol should be used. In North America, the Bruce protocol is the most common. However, the Bruce protocol, and others that estimate exercise capacity based on equations, tend to overestimate exercise capacity. They may be too demanding for those with limited exercise capacity, and too long for those with high exercise capacity. For these people, an exercise protocol that reaches maximal capacity in 8 to 12 minutes using smaller increments in workload should be considered. Once completed

  8. School nutrition guidelines: overview of the implementation and evaluation.

    Science.gov (United States)

    Gregorič, Matej; Pograjc, Larisa; Pavlovec, Alenka; Simčič, Marjan; Gabrijelčič Blenkuš, Mojca

    2015-06-01

    To holistically evaluate the extent of implementation of dietary guidelines in schools and present various monitoring systems. The study comprises three methods: (i) a cross-sectional survey (process evaluation); (ii) an indicator-based evaluation (menu quality); and (iii) a 5 d weighed food record of school lunches (output evaluation). Slovenian primary schools. A total 234 food-service managers from 488 schools completed a self-administrated questionnaire for process evaluation; 177 out of 194 randomly selected schools provided menus for menu quality evaluation; and 120 school lunches from twenty-four schools were measured and nutritionally analysed for output evaluation. The survey among food-service managers revealed high levels of implementation at almost all process evaluation areas of the guidelines. An even more successful implementation of these guidelines was found in relation to organization cultural issues as compared with technical issues. Differences found in some process evaluation areas were related to location, size and socio-economic characteristics of schools. Evaluation of school menu quality demonstrated that score values followed a normal distribution. Higher (better) nutrition scores were found in larger-sized schools and corresponding municipalities with higher socio-economic status. School lunches did not meet minimum recommendations for energy, carbohydrates or dietary fibre intake, nor for six vitamins and three (macro, micro and trace) elements. The implementation of the guidelines was achieved differently at distinct levels. The presented multilevel evaluation suggests that different success in implementation might be attributed to different characteristics of individual schools. System changes might also be needed to support and improve implementation of the guidelines.

  9. Overview of guidelines for the management of dyslipidemia: EU perspectives

    Directory of Open Access Journals (Sweden)

    Giner-Galvañ V

    2016-09-01

    Full Text Available Vicente Giner-Galvañ,1 María José Esteban-Giner,1 Vicente Pallarés-Carratalá2,3 1Department of General Internal Medicine, Unit of Hypertension and Cardiometabolic Risk, Hospital Mare de Déu dels Lliris, Alcoy, Alicante, 2Department of Health Surveillance, Unión de Mutuas, Castellón de la Plana, 3Department of Medicine, Universitat Jaume I, Castellón, Spain Abstract: Modern medicine is characterized by a continuous genesis of evidence making it very difficult to translate the latest findings into a better clinical practice. Clinical practice guidelines (CPG emerge to provide clinicians evidence-based recommendations for their daily clinical practice. However, the high number of existing CPG as well as the usual differences in the given recommendations usually increases the clinician’s confusion and doubts. It has apparently been the case for the 2013 American College of Cardiology/American Heart Association (ACC/AHA Guideline on the Treatment of Blood Cholesterol. These CPG proposed new and controversial concepts that have usually been considered an antagonist shift respective to European CPG. The most controversial published proposals are: 1 to consider evidence just from randomized clinical trials, 2 creation of a new cardiovascular (CV risk calculator, 3 to consider reducing CV risk instead of reducing low-density lipoprotein cholesterol (LDLc as the target of the treatment, and 4 consideration of statins as the only drugs for treatment. A deep analysis of the 2013 American College of Cardiology/American Heart Association CPG and comparison with the European ones show that from a practical and clinical point of view, there are more similarities than differences. To further help clinicians in their daily work, in the present globalized world, it is time to discuss and adopt a mutually agreed upon document created by both sides of the Atlantic. Probably it is not a short-term solution. Meanwhile, taking advantage of the similarities

  10. Bronchiectases in Children: Overview of Current Clinical Guidelines

    Directory of Open Access Journals (Sweden)

    A. A. Baranov

    2017-01-01

    Full Text Available The article is devoted to bronchiectases issue in children and reflects the most actual approaches to the diagnosis and management of patients with this pathology. Information on the true prevalence of bronchiectases both abroad and in Russia varies. Wherein, bronchiectases can be either an independent disease or a manifestation of another pathology, which necessitates an integrated multidisciplinary approach not only for diagnosis but also for patient management with this pathology. The material presented by the authors is based on clinical guidelines developed and approved by the profile association of the Union of Pediatricians of Russia and aimed at raising awareness of specialists providing medical care to children.

  11. Hierarchical aggregation for information visualization: overview, techniques, and design guidelines.

    Science.gov (United States)

    Elmqvist, Niklas; Fekete, Jean-Daniel

    2010-01-01

    We present a model for building, visualizing, and interacting with multiscale representations of information visualization techniques using hierarchical aggregation. The motivation for this work is to make visual representations more visually scalable and less cluttered. The model allows for augmenting existing techniques with multiscale functionality, as well as for designing new visualization and interaction techniques that conform to this new class of visual representations. We give some examples of how to use the model for standard information visualization techniques such as scatterplots, parallel coordinates, and node-link diagrams, and discuss existing techniques that are based on hierarchical aggregation. This yields a set of design guidelines for aggregated visualizations. We also present a basic vocabulary of interaction techniques suitable for navigating these multiscale visualizations.

  12. Assessment formats in dental medicine: An overview

    Directory of Open Access Journals (Sweden)

    Gerhard-Szep, Susanne

    2016-08-01

    Full Text Available Aim: At the annual meeting of German dentists in Frankfurt am Main in 2013, the Working Group for the Advancement of Dental Education (AKWLZ initiated an interdisciplinary working group to address assessments in dental education. This paper presents an overview of the current work being done by this working group, some of whose members are also actively involved in the German Association for Medical Education's (GMA working group for dental education. The aim is to present a summary of the current state of research on this topic for all those who participate in the design, administration and evaluation of university-specific assessments in dentistry.Method: Based on systematic literature research, the testing scenarios listed in the National Competency-based Catalogue of Learning Objectives (NKLZ have been compiled and presented in tables according to assessment value.Results: Different assessment scenarios are described briefly in table form addressing validity (V, reliability (R, acceptance (A, cost (C, feasibility (F, and the influence on teaching and learning (EI as presented in the current literature. Infoboxes were deliberately chosen to allow readers quick access to the information and to facilitate comparisons between the various assessment formats. Following each description is a list summarizing the uses in dental and medical education.Conclusion: This overview provides a summary of competency-based testing formats. It is meant to have a formative effect on dental and medical schools and provide support for developing workplace-based strategies in dental education for learning, teaching and testing in the future.

  13. Best Practices for Mental Health in Child Welfare: Screening, Assessment, and Treatment Guidelines

    Science.gov (United States)

    Romanelli, Lisa Hunter; Landsverk, John; Levitt, Jessica Mass; Leslie, Laurel K.; Hurley, Maia M.; Bellonci, Christopher; Gries, Leonard T.; Pecora, Peter J.; Jensen, Peter S.

    2009-01-01

    The Best Practices for Mental Health in Child Welfare Consensus Conference focused on developing guidelines in five key areas (screening and assessment, psychosocial interventions, psychopharmacologic treatment, parent engagement, and youth empowerment) related to children's mental health. This paper provides an overview of issues related to the…

  14. Praxis and guidelines for planned homebirths in the Nordic countries - an overview.

    Science.gov (United States)

    Lindgren, Helena; Kjaergaard, Hanne; Olafsdottir, Olof Asta; Blix, Ellen

    2014-03-01

    The objective of this overview was to investigate the current situation regarding guidelines and praxis for planned homebirths and also to investigate possibilities for comparative studies on planned homebirths in the Nordic countries (Denmark, Iceland, Norway, Finland and Sweden). National documents on homebirth and midwifery and recommendations regarding management and registration of planned homebirths in the included countries were investigated. Guidelines regarding planned home birth were found in four of the included countries. In Denmark any woman has the right to be attended by a midwife during a homebirth and each county council must present a plan for the organization of birth services, including homebirth services. In Norway and Iceland the service is fully or partly funded by taxes and national guidelines are available but access to a midwife attending the birth varies geographically. In the Stockholm County Council guidelines have been developed for publicly funding of planned home births; for the rest of Sweden no national guidelines have been formulated and the service is privately funded. Inconsistencies in the home birth services of the Nordic countries imply different opportunities for midwifery care to women with regard to their preferred place of birth. Uniform sociodemography, health care systems and cultural context in the Nordic countries are factors in favour of further research to compare and aggregate data on planned home births in this region. Additional data collection is needed since national registers do not sufficiently cover the planned place of birth. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Guidelines for guidelines: are they up to the task? A comparative assessment of clinical practice guideline development handbooks.

    Directory of Open Access Journals (Sweden)

    Shabnam Ansari

    . The findings help decision makers in identifying the necessary tasks for guideline development, provide an updated comparative list of guideline development handbooks, and provide a checklist to assess the comprehensiveness of guideline development processes.

  16. Guidelines for guidelines: are they up to the task? A comparative assessment of clinical practice guideline development handbooks.

    Science.gov (United States)

    Ansari, Shabnam; Rashidian, Arash

    2012-01-01

    necessary tasks for guideline development, provide an updated comparative list of guideline development handbooks, and provide a checklist to assess the comprehensiveness of guideline development processes.

  17. Final Accessibility Guidelines for Play Areas: Economic Assessment.

    Science.gov (United States)

    Architectural and Transportation Barriers Compliance Board, Washington, DC.

    This economic assessment informs the public about the implications of the final accessibility guidelines for play areas issued by the Access Board. The guidelines include scoping and technical provisions, which specify when and how access is to be provided to ground level and elevated play components. The guidelines also address soft contained…

  18. European Fissure Sealant Guidelines: assessment using AGREE II.

    Science.gov (United States)

    San Martin-Galindo, L; Rodríguez-Lozano, F J; Abalos-Labruzzi, C; Niederman, R

    2017-02-01

    Pit and fissure sealants are effective in reducing the incidence of occlusal caries, and multiple clinical practice guidelines (CPGs) have been developed for recommending their proper use. The usefulness of CPGs depends on their quality and on the rigour of the guideline development process. A study was made to assess the quality of current European CPGs based on the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument, which uses 23 key items rated on a 7-point scale to assess practice guideline development and the quality of reporting. A search was conducted for fissure sealant guidelines for preventing caries in children and adults at high and low risk published in the last 10 years. Calibration was carried out before scoring to assess agreement between the appraisers using the AGREE II instrument. The searches identified 19 relevant guidelines, and following application of the inclusion/exclusion criteria, three guidelines were retained for evaluation. The proportion of observed agreement was calculated, expressed by the agreement separately for positive and negative ratings (PA = 0.89, NA = 0-91). The results of the guideline assessments revealed the highest score for the Irish guideline, a moderate score for the French guideline and the lowest score for the European guideline. Based on the AGREE II instrument, the results obtained show significant variation in the quality assessment of the three European Fissure Sealant Guidelines. Future studies should be carried out both to develop quality dental CPGs and to investigate effective ways of adopting them. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Guidelines for rating Global Assessment of Functioning (GAF

    Directory of Open Access Journals (Sweden)

    Aas IH Monrad

    2011-01-01

    Full Text Available Abstract Background Global Assessment of Functioning (GAF is a scoring system for the severity of illness in psychiatry. It is used clinically in many countries, as well as in research, but studies have shown several problems with GAF, for example concerning its validity and reliability. Guidelines for rating are important. The present study aimed to identify the current status of guidelines for rating GAF, and relevant factors and gaps in knowledge for the development of improved guidelines. Methods A thorough literature search was conducted. Results Few studies of existing guidelines have been conducted; existing guidelines are short; and rating has a subjective element. Seven main categories were identified as being important in relation to further development of guidelines: (1 general points about guidelines for rating GAF; (2 introduction to guidelines, with ground rules; (3 starting scoring at the top, middle or bottom level of the scale; (4 scoring for different time periods and of different values (highest, lowest or average; (5 the finer grading of the scale; (6 different guidelines for different conditions; and (7 different languages and cultures. Little information is available about how rules for rating are understood by different raters: the final score may be affected by whether the rater starts at the top, middle or bottom of the scale; there is little data on which value/combination of GAF values to record; guidelines for scoring within 10-point intervals are limited; there is little empirical information concerning the suitability of existing guidelines for different conditions and patient characteristics; and little is known about the effects of translation into different languages or of different cultural understanding. Conclusions Few studies have dealt specifically with guidelines for rating GAF. Current guidelines for rating GAF are not comprehensive, and relevant points for new guidelines are presented. Theoretical and

  20. Overview of guidelines for the prevention and treatment of venous leg ulcers: a US perspective

    Directory of Open Access Journals (Sweden)

    White-Chu EF

    2014-02-01

    Full Text Available E Foy White-Chu,1 Teresa A Conner-Kerr2 1Oregon Health and Science University, Portland VA Medical Center, Portland, OR, 2Winston-Salem State University, Department of Physical Therapy, Winston Salem, NC, USA Abstract: Comprehensive care of chronic venous insufficiency and associated ulcers requires a multipronged and interprofessional approach to care. A comprehensive treatment approach includes exercise, nutritional assessment, compression therapy, vascular reconstruction, and advanced treatment modalities. National guidelines, meta-analyses, and original research studies provide evidence for the inclusion of these approaches in the patient plan of care. The purpose of this paper is to review present guidelines for prevention and treatment of venous leg ulcers as followed in the US. The paper further explores evidence-based yet pragmatic tools for the interprofessional team to use in the management of this complex disorder. Keywords: venous insufficiency, varicose ulcer, wound, compression bandages

  1. Facilitating pre-operative assessment guidelines representation using SNOMED CT.

    Science.gov (United States)

    Ahmadian, Leila; Cornet, Ronald; de Keizer, Nicolette F

    2010-12-01

    To investigate whether SNOMED CT covers the terms used in pre-operative assessment guidelines, and if necessary, how the measured content coverage can be improved. Pre-operative assessment guidelines were retrieved from the websites of (inter)national anesthesia-related societies. The recommendations in the guidelines were rewritten to "IF condition THEN action" statements to facilitate data extraction. Terms were extracted from the IF-THEN statements and mapped to SNOMED CT. Content coverage was measured by using three scores: no match, partial match and complete match. Non-covered concepts were evaluated against the SNOMED CT editorial documentation. From 6 guidelines, 133 terms were extracted, of which 71% (n=94) completely matched with SNOMED CT concepts. Disregarding the vague concepts in the included guidelines SNOMED CT's content coverage was 89%. Of the 39 non-completely covered concepts, 69% violated at least one of SNOMED CT's editorial principles or rules. These concepts were categorized based on four categories: non-reproducibility, classification-derived phrases, numeric ranges, and procedures categorized by complexity. Guidelines include vague terms that cannot be well supported by terminological systems thereby hampering guideline-based decision support systems. This vagueness reduces the content coverage of SNOMED CT in representing concepts used in the pre-operative assessment guidelines. Formalization of the guidelines using SNOMED CT is feasible but to optimize this, first the vagueness of some guideline concepts should be resolved and a few currently missing but relevant concepts should be added to SNOMED CT. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. Guidelines for Conducting Socially Valid Systematic Preference Assessments.

    Science.gov (United States)

    Lohrmann-O'Rourke, Sharon; Browder, Diane M.; Brown, Fredda

    2000-01-01

    This paper translates research findings on systematic preference assessment with individuals with nonsymbolic or limited symbolic communication skills into guidelines for planning such assessments to reduce the risk of missing or misinterpreting the person's preferences. It offers four questions for guiding the planning of preference assessments,…

  3. A Clinimetric Overview of Scar Assessment Scales

    NARCIS (Netherlands)

    van der Wal, M.B.A.; Verhaegen, P.D.H.M.; Middelkoop, E.; van Zuijlen, P.P.M.

    2012-01-01

    Standardized validated evaluation instruments are mandatory to increase the level of evidence in scar management. Scar assessment scales are potentially suitable for this purpose, but the most appropriate scale still needs to be determined. This review will elaborate on several clinically relevant

  4. An overview of approaches for assessing the impact of academic ...

    African Journals Online (AJOL)

    IT

    Towards impact measurement: An overview of approaches for assessing the impact of .... factors, such as cost-effectiveness and work satisfaction of teachers and lecturers. While evaluating the impact of a ... “academic literacy” as “being able to use, manipulate, and control language and cognitive abilities for specific ...

  5. Guidelines for a Scientific Approach to Critical Thinking Assessment

    Science.gov (United States)

    Bensley, D. Alan; Murtagh, Michael P.

    2012-01-01

    Assessment of student learning outcomes can be a powerful tool for improvement of instruction when a scientific approach is taken; unfortunately, many educators do not take full advantage of this approach. This article examines benefits of taking a scientific approach to critical thinking assessment and proposes guidelines for planning,…

  6. Assessing Visualization: An analysis of Chilean teachers’ guidelines

    DEFF Research Database (Denmark)

    Andrade-Molina, Melissa; Díaz, Leonora

    2017-01-01

    The aim of this paper is to argue on how visualization is recommended, by official curricular guidelines, to be assessed in schools. We contend that spatial abilities have been granted with the status of a key element to improve students’ performances by research and also by policy makers. Howeve...... do not help teachers while assessing visualization in schools; rather its focus is embedded in a tradition of training that leads to a reduction of space.......The aim of this paper is to argue on how visualization is recommended, by official curricular guidelines, to be assessed in schools. We contend that spatial abilities have been granted with the status of a key element to improve students’ performances by research and also by policy makers. However......, this importance seems to fade when it comes to assessing students while learning school mathematics and geometry. We conducted an analysis of the official guidelines for the assessment school mathematics in Chile. The analysis of two of those guides is considered here. The results revealed that these guidelines...

  7. Federal Radiological Monitoring and Assessment Center Overview of FRMAC Operations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    In the event of a major radiological emergency, 17 federal agencies with various statutory responsibilities have agreed to coordinate their efforts at the emergency scene under the umbrella of the Federal Radiological Emergency Response Plan. This cooperative effort will ensure that all federal radiological assistance fully supports their efforts to protect the public. the mandated federal cooperation ensures that each agency can obtain the data critical to its specific responsibilities. This Overview of Federal Radiological Monitoring and Assessment Center (FRMAC) describes the FRMAC response activities to a major radiological emergency. It also describes the federal assets and subsequent operational activities which provide federal radiological monitoring and assessment of the off-site areas.

  8. DYSLEXIA – AN OVERVIEW OF ASSESSMENT AND TREATMENT METHODS

    Directory of Open Access Journals (Sweden)

    Evelin Witruk

    2016-06-01

    Full Text Available This article will give an overview of the different methods of assessment and treatment currently used in the field of dyslexia with a special focus on genetic research. Based on the modification and extension of the multilevel model of Valtin (1989, modified by Witruk, 1993b, assessment and treatment methods will be discussed due to their primary objectives. These methods will be described regarding primary causes (biological risk factors, secondary causes (partial performance deficits, primary symptoms (reading and writing problems and secondary symptoms (emotional and behavioural disorders. Keywords: Multilevel model of dyslexia, genetics, magnocellular deficit, partial performance

  9. Assessing Clinical Microbiology Practice Guidelines: American Society for MicrobiologyAd HocCommittee on Evidence-Based Laboratory Medicine Practice Guidelines Assessment.

    Science.gov (United States)

    Nachamkin, Irving; Kirn, Thomas J; Westblade, Lars F; Humphries, Romney

    2017-11-01

    As part of the American Society for Microbiology (ASM) Evidence-Based Laboratory Medicine Practice Guidelines Committee of the Professional Practice Committee, an ad hoc committee was formed in 2014 to assess guidelines published by the committee using an assessment tool, Appraisal of Guidelines for Research Evaluation II (AGREE II). The AGREE II assessment helps reviewers determine whether published guidelines are robust, transparent, and clear in presenting practice recommendations in a standardized manner. Identifying strengths and weaknesses of practice guidelines by ad hoc assessments helps with improving future guidelines through the participation of key stakeholders. This minireview describes the development of the ad hoc committee and results from their review of several ASM best practices guidelines and a non-ASM practice guideline from the Emergency Nurses Association. Copyright © 2017 American Society for Microbiology.

  10. European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

    Science.gov (United States)

    von Karsa, L.; Patnick, J.; Segnan, N.; Atkin, W.; Halloran, S.; Lansdorp-Vogelaar, I.; Malila, N.; Minozzi, S.; Moss, S.; Quirke, P.; Steele, R. J.; Vieth, M.; Aabakken, L.; Altenhofen, L.; Ancelle-Park, R.; Antoljak, N.; Anttila, A.; Armaroli, P.; Arrossi, S.; Austoker, J.; Banzi, R.; Bellisario, C.; Blom, J.; Brenner, H.; Bretthauer, M.; Camargo Cancela, M.; Costamagna, G.; Cuzick, J.; Dai, M.; Daniel, J.; Dekker, E.; Delicata, N.; Ducarroz, S.; Erfkamp, H.; Espinàs, J. A.; Faivre, J.; Faulds Wood, L.; Flugelman, A.; Frkovic-Grazio, S.; Geller, B.; Giordano, L.; Grazzini, G.; Green, J.; Hamashima, C.; Herrmann, C.; Hewitson, P.; Hoff, G.; Holten, I.; Jover, R.; Kaminski, M. F.; Kuipers, E. J.; Kurtinaitis, J.; Lambert, R.; Launoy, G.; Lee, W.; Leicester, R.; Leja, M.; Lieberman, D.; Lignini, T.; Lucas, E.; Lynge, E.; Mádai, S.; Marinho, J.; Maučec Zakotnik, J.; Minoli, G.; Monk, C.; Morais, A.; Muwonge, R.; Nadel, M.; Neamtiu, L.; Peris Tuser, M.; Pignone, M.; Pox, C.; Primic-Zakelj, M.; Psaila, J.; Rabeneck, L.; Ransohoff, D.; Rasmussen, M.; Regula, J.; Ren, J.; Rennert, G.; Rey, J.; Riddell, R. H.; Risio, M.; Rodrigues, V.; Saito, H.; Sauvaget, C.; Scharpantgen, A.; Schmiegel, W.; Senore, C.; Siddiqi, M.; Sighoko, D.; Smith, R.; Smith, S.; Suchanek, S.; Suonio, E.; Tong, W.; Törnberg, S.; Van Cutsem, E.; Vignatelli, L.; Villain, P.; Voti, L.; Watanabe, H.; Watson, J.; Winawer, S.; Young, G.; Zaksas, V.; Zappa, M.; Valori, R.

    2015-01-01

    Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010.They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines. PMID:23212726

  11. Overview and comparative study of GPR international standards and guidelines - COST Action TU1208

    Science.gov (United States)

    Pajewski, Lara; Marciniak, Marian; Benedetto, Andrea; Tosti, Fabio

    2016-04-01

    Ground Penetrating Radar (GPR) can be effectively used for non-destructive testing of composite structures and diagnostics affecting the whole life-cycle of civil engineering works. Nevertheless, few recognised international standards exist in this field and inhomogeneous recommendations are present in different countries. Moreover, the levels of knowledge, awareness and experience regarding the use of GPR in civil engineering vary strongly across different European areas. The COST Action TU1208 is working hard on leveraging these differences, by sharing and disseminating knowledge and experience, as well as by developing guidelines and protocols for a safe and effective use of GPR in civil engineering. GPR users need to know which is the best way to conduct GPR measurements and what the quality level for the results should be. The TU1208 guidelines will ensure a higher efficiency and quality of GPR services and they will constitute a scientific basis for the introduction of European Standards on the application of GPR in civil engineering. The aim of this contribution is to present an in-depth overview and critical analysis of the existing GPR international and national standards and guidelines. The main documents considered in our work are listed and briefly described in the following. Three standards are provided by the American Society for Testing and Materials (ASTM), to guide the GPR use for subsurface investigation, evaluation of asphalt-covered concrete bridge decks, and determination of pavement-layer thickness: 1. ASTM D6432-11, Standard Guide for Using the Surface Ground Penetrating Radar Method for Subsurface Investigation, ASTM International, West Conshohocken, PA, 2011, www.astm.org, DOI: 10.1520/D6432-11. 2. ASTM D6087-08, Standard Test Method for Evaluating Asphalt-Covered Concrete Bridge Decks Using Ground Penetrating Radar, ASTM International, West Conshohocken, PA, 2008, www.astm.org, DOI: 10.1520/D6087-08. 3. ASTM D4748-10, Standard Test Method

  12. Assessing biocomputational modelling in transforming clinical guidelines for osteoporosis management.

    Science.gov (United States)

    Thiel, Rainer; Viceconti, Marco; Stroetmann, Karl

    2011-01-01

    Biocomputational modelling as developed by the European Virtual Physiological Human (VPH) Initiative is the area of ICT most likely to revolutionise in the longer term the practice of medicine. Using the example of osteoporosis management, a socio-economic assessment framework is presented that captures how the transformation of clinical guidelines through VPH models can be evaluated. Applied to the Osteoporotic Virtual Physiological Human Project, a consequent benefit-cost analysis delivers promising results, both methodologically and substantially.

  13. Lymphohematopoietic Cancers Induced by Chemicals and Other Agents: Overview and Implications for Risk Assessment (Final Report)

    Science.gov (United States)

    EPA announced the release of the final report, Lymphohematopoietic Cancers Induced by Chemicals and Other Agents: Overview and Implications for Risk Assessment . This report provides an overview of the types of mechanisms underlying the lymphohematopoietic cancers induc...

  14. Ecological risk assessment at the Idaho National Engineering Laboratory: Overview

    Energy Technology Data Exchange (ETDEWEB)

    VanHorn, R.; Bensen, T.; Green, T.; Hampton, N.; Staley, C. [Idaho National Engineering Lab., Idaho Falls, ID (United States); Morris, R.; Brewer, R.; Peterson, S.

    1994-12-31

    The paper will present an overview of the methods and results of the screening level ecological risk assessment (ERA) performed at the Idaho National Engineering Laboratory (INEL). The INEL is a site with some distinct characteristics. First it is a large Department of Energy (DOE) laboratory (2,300 km{sup 2}) having experienced 40 years of nuclear material production operations. Secondly, it is a relatively undisturbed cold desert ecosystem. Neither of these issues have been sufficiently addressed in previous ERAs. It was necessary in many instances to develop methods that differed from those used in other studies. This paper should provide useful methodologies for the ERAs performed at other similar sites.

  15. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches.

    Science.gov (United States)

    Melrose, Sherri

    2015-01-01

    Seasonal affective disorder or SAD is a recurrent major depressive disorder with a seasonal pattern usually beginning in fall and continuing into winter months. A subsyndromal type of SAD, or S-SAD, is commonly known as "winter blues." Less often, SAD causes depression in the spring or early summer. Symptoms center on sad mood and low energy. Those most at risk are female, are younger, live far from the equator, and have family histories of depression, bipolar disorder, or SAD. Screening instruments include the Seasonal Pattern Assessment Questionnaire (SPAQ). Typical treatment includes antidepressant medications, light therapy, Vitamin D, and counselling. This paper provides an overview of SAD.

  16. Cost-Effectiveness and Clinical Practice Guidelines: Have We Reached a Tipping Point?-An Overview.

    Science.gov (United States)

    Garrison, Louis P

    2016-01-01

    Given recent developments in the United States, where professional clinical societies have attempted to define "value" and consider it in their deliberations about appropriate care, this thematic article describes those recent specialty society efforts in the United States in cardiology and oncology and the multispecialty efforts in the United Kingdom for over 10 years. Despite our high levels of health spending, and our field's long and consistent approach to the basic tools of cost-effectiveness analysis (CEA), US private and public payers are not routinely or explicitly using CEAs in their reimbursement decisions. This is a puzzle that raises the following question: Why does the United States have so many skilled pharmacoeconomic practitioners and produce so many CEAs given this apparent lack of interest and trust? There are multiple reasons, but the lack of incentives to use the information certainly matters. This article identifies and discusses a number of key issues and challenges for incorporating CEA into US clinical guidelines development: potential bias in manufacturer-sponsored CEAs, the role of societal perspective, payer-subscriber and physician-patient agency relationships, the need for disease area CEA studies and modeling, patient heterogeneity, investigators' conflicts of interest, assessing the quality of economic studies, and aggregation of information using multicriteria decision analysis. These developments suggest that the application of CEA in health care decision making in the United States is evolving and may be approaching a tipping point. With increasing pressures on drug prices, perhaps reflecting challenges to industry sustainability, payers, providers, and patients are looking for value for money. CEA should be an important part of this process. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. EPA`s program for risk assessment guidelines: Quantification issues

    Energy Technology Data Exchange (ETDEWEB)

    Dourson, M.L. [Environmental Protection Agency, Washington, DC (United States)

    1990-12-31

    The quantitative procedures associated with noncancer risk assessment include reference dose (RfD), benchmark dose, and severity modeling. The RfD, which is part of the EPA risk assessment guidelines, is an estimation of a level that is likely to be without any health risk to sensitive individuals. The RfD requires two major judgments: the first is choice of a critical effect(s) and its No Observed Adverse Effect Level (NOAEL); the second judgment is choice of an uncertainty factor. This paper discusses major assumptions and limitations of the RfD model.

  18. A Review of School Readiness Practices in the States: Early Learning Guidelines and Assessments. Early Childhood Highlights. Volume 1, Issue 3

    Science.gov (United States)

    Daily, Sarah; Burkhauser, Mary; Halle, Tamara

    2010-01-01

    Research on the importance of the early childhood years has compelled states to support children's school readiness. This brief provides an overview of states' Early Learning Guidelines (ELGs) and school readiness assessments and outlines the following considerations: (1) School Readiness is more than Academics; (2) Align standards in appropriate…

  19. 77 FR 45350 - Notice of Availability of Microbial Risk Assessment Guideline: Pathogenic Microorganisms With...

    Science.gov (United States)

    2012-07-31

    ... to develop this guideline. Clear and credible microbial risk assessment methods will leverage limited... this guideline, agencies assessing a similar microbial medium or pathogen are able to more readily... for microbial risk assessment in a wide range of media and scenarios. The MRA Guideline applies to...

  20. Praxis and guidelines for planned homebirths in the Nordic countries - an overview

    DEFF Research Database (Denmark)

    Lindgren, Helena; Kjaergaard, Hanne; Olafsdottir, Olof Asta

    2014-01-01

    woman has the right to be attended by a midwife during a homebirth and each county council must present a plan for the organization of birth services, including homebirth services. In Norway and Iceland the service is fully or partly funded by taxes and national guidelines are available but access...

  1. [Drug therapy of fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles].

    Science.gov (United States)

    Sommer, C; Alten, R; Bär, K-J; Bernateck, M; Brückle, W; Friedel, E; Henningsen, P; Petzke, F; Tölle, T; Üçeyler, N; Winkelmann, A; Häuser, W

    2017-06-01

    The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A literature search for systematic reviews of randomized controlled drug trials from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences and applicability of available therapies were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. Amitriptyline and duloxetine are recommended in the case of comorbid depressive disorders or generalized anxiety disorder and pregabalin in the case of generalized anxiety disorder. Off-label use of duloxetine and pregabalin can be considered if there are no comorbid mental disorders or no generalized anxiety disorder. Strong opioids are not recommended.

  2. [Multimodal therapy of fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles].

    Science.gov (United States)

    Schiltenwolf, M; Eidmann, U; Köllner, V; Kühn, T; Offenbächer, M; Petzke, F; Sarholz, M; Weigl, M; Wolf, B; Häuser, W

    2017-06-01

    The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n = 8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A search of the literature for systematic reviews on randomized controlled trials of multimodal therapy from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences and applicability of available therapies were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. The use of multimodal therapy (combination of aerobic exercise with at least one psychological therapy) with a duration of at least 24 h is strongly recommended for patients with severe forms of fibromyalgia.

  3. [Psychotherapy and psychological procedures for fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles].

    Science.gov (United States)

    Köllner, V; Bernardy, K; Greiner, W; Krumbein, L; Lucius, H; Offenbächer, M; Sarholz, M; Settan, M; Häuser, W

    2017-06-01

    The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A systematic search of the literature for systematic reviews of randomized, controlled studies on psychological and psychotherapeutic procedures from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences and applicability of available therapies were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. Cognitive behavioral therapies received a strong recommendation but biofeedback, guided imagery and hypnosis received a weak recommendation.

  4. [Complementary and alternative procedures for fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles].

    Science.gov (United States)

    Langhorst, J; Heldmann, P; Henningsen, P; Kopke, K; Krumbein, L; Lucius, H; Winkelmann, A; Wolf, B; Häuser, W

    2017-06-01

    The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A search of the literature for systematic reviews of randomized controlled trials of complementary and alternative therapies from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was formed by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences and applicability of available therapies were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. Meditative movement therapies (e.g. qi gong, tai chi and yoga) are strongly recommended. Acupuncture and weight reduction in cases of obesity can be considered.

  5. Expert consensus panel guidelines on geriatric assessment in oncology.

    Science.gov (United States)

    O'Donovan, A; Mohile, S G; Leech, M

    2015-07-01

    Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. A four-round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations to gain consensus on a given topic. Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cut-off for assessment, represented a higher degree of disagreement. The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients. © 2015 John Wiley & Sons Ltd.

  6. Expert Consensus Panel Guidelines on Geriatric Assessment in Oncology

    Science.gov (United States)

    O'Donovan, A.; Mohile, S.G.; Leech, M.

    2015-01-01

    Introduction Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. Methods A four round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations in order to gain consensus on a given topic Results Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cutoff for assessment represented a higher degree of disagreement. Discussion The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients. PMID:25757457

  7. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches

    Directory of Open Access Journals (Sweden)

    Sherri Melrose

    2015-01-01

    Full Text Available Seasonal affective disorder or SAD is a recurrent major depressive disorder with a seasonal pattern usually beginning in fall and continuing into winter months. A subsyndromal type of SAD, or S-SAD, is commonly known as “winter blues.” Less often, SAD causes depression in the spring or early summer. Symptoms center on sad mood and low energy. Those most at risk are female, are younger, live far from the equator, and have family histories of depression, bipolar disorder, or SAD. Screening instruments include the Seasonal Pattern Assessment Questionnaire (SPAQ. Typical treatment includes antidepressant medications, light therapy, Vitamin D, and counselling. This paper provides an overview of SAD.

  8. An overview of data integration methods for regional assessment.

    Science.gov (United States)

    Locantore, Nicholas W; Tran, Liem T; O'Neill, Robert V; McKinnis, Peter W; Smith, Elizabeth R; O'Connell, Michael

    2004-06-01

    The U.S. Environmental Protections Agency's (U.S. EPA) Regional Vulnerability Assessment(ReVA) program has focused much of its research over the last five years on developing and evaluating integration methods for spatial data. An initial strategic priority was to use existing data from monitoring programs, model results, and other spatial data. Because most of these data were not collected with an intention of integrating into a regional assessment of conditions and vulnerabilities, issues exist that may preclude the use of some methods or require some sort of data preparation. Additionally, to support multi-criteria decision-making, methods need to be able to address a series of assessment questions that provide insights into where environmental risks are a priority. This paper provides an overview of twelve spatial integration methods that can be applied towards regional assessment, along with preliminary results as to how sensitive each method is to data issues that will likely be encountered with the use of existing data.

  9. A Topical Overview of Cumulative Risk Assessment Concepts ...

    Science.gov (United States)

    Cumulative risk assessments (CRAs) address combined risks from exposures to multiple chemical and nonchemical stressors and may focus on vulnerable communities or populations. Significant contributions have been made to the development of concepts, methods, and applications for CRA over the past decade. Work in both human health and ecological cumulative risk has advanced in two different contexts. First, in assessing the effects of chemical mixtures that share common modes of action, or that cause common adverse outcomes. In this context two primary models are used for predicting mixture effects, dose addition or response addition. The second context is evaluating the combined effects of chemical and nonchemical (e.g., radiation, biological, nutritional, economic, psychological, habitat alteration, land-use change, global climate change, and natural disasters) stressors. CRA can be adapted to address risk in many contexts, and this adaptability is reflected in the range in disciplinary perspectives in the published literature. This article presents the results of a literature search by presenting a range of selected work with the intention to give a broad overview of relevant topics and provide a starting point for researchers interested in CRA applications. This is a select literature review of topics in CRA. As a published article it will allow the citation of an analysis conducted on a rich and diverse set of CRA publications relevant to assessment methods

  10. Regulatory assessment of proposed accessibility guidelines for pedestrians in the public right-of-way

    Science.gov (United States)

    2011-06-30

    This report assesses the potential costs and benefits of proposed accessibility guidelines issued by the Access Board for pedestrian facilities in the public right-of-way. The report also analyzes the potential impacts of the proposed guidelines on s...

  11. Rapid assessment methods in eye care: An overview

    Directory of Open Access Journals (Sweden)

    Srinivas Marmamula

    2012-01-01

    Full Text Available Reliable information is required for the planning and management of eye care services. While classical research methods provide reliable estimates, they are prohibitively expensive and resource intensive. Rapid assessment (RA methods are indispensable tools in situations where data are needed quickly and where time- or cost-related factors prohibit the use of classical epidemiological surveys. These methods have been developed and field tested, and can be applied across almost the entire gamut of health care. The 1990s witnessed the emergence of RA methods in eye care for cataract, onchocerciasis, and trachoma and, more recently, the main causes of avoidable blindness and visual impairment. The important features of RA methods include the use of local resources, simplified sampling methodology, and a simple examination protocol/data collection method that can be performed by locally available personnel. The analysis is quick and easy to interpret. The entire process is inexpensive, so the survey may be repeated once every 5-10 years to assess the changing trends in disease burden. RA survey methods are typically linked with an intervention. This article provides an overview of the RA methods commonly used in eye care, and emphasizes the selection of appropriate methods based on the local need and context.

  12. Overview of the Environmental and Water Resources Institute's "Guidelines For Integrated Water Resources Management" Project

    Energy Technology Data Exchange (ETDEWEB)

    Gerald Sehlke

    2005-03-01

    Integrated Water Resources Management is a systematic approach to optimizing our understanding, control and management of water resources within a basin to meet multiple objectives. Recognition of the need for integrating water resources within basins is not unique to the Environmental and Water Resources Institute’s Integrated Water Resources Management Task Committee. Many individuals, governments and other organizations have attempted to develop holistic water resources management programs. In some cases, the results have been very effective and in other cases, valiant attempts have fallen far short of their initial goals. The intent of this Task Committee is to provide a set of guidelines that discusses the concepts, methods and tools necessary for integrating and optimizing the management of the physical resources and to optimize and integrate programs, organizations, infrastructure, and socioeconomic institutions into comprehensive water resources management programs.

  13. Biosimilars for psoriasis: worldwide overview of regulatory guidelines, uptake and implications for dermatology clinical practice.

    Science.gov (United States)

    Cohen, A D; Wu, J J; Puig, L; Chimenti, S; Vender, R; Rajagopalan, M; Romiti, R; de la Cruz, C; Skov, L; Zachariae, C; Young, H S; Foley, P; van der Walt, J M; Naldi, L; Prens, E P; Blauvelt, A

    2017-12-01

    The introduction of biological drugs for the treatment of patients with psoriasis has revolutionized treatment paradigms and enabled numerous patients to achieve disease control with an acceptable safety profile. However, the high cost of biologics limits access to these medications for the majority of patients worldwide. In recent years, the introduction of biosimilars for inflammatory diseases has become a fast evolving field. The future use of biosimilars offers the potential for decreased cost and increased access to biologics for patients with psoriasis. For approval of biosimilars, different regulatory agencies use highly variable methods for definition, production, approval, marketing and postmarketing surveillance. Due to potential interchangeability between biologics and biosimilars, traceability and pharmacovigilance are required to collect accurate data about adverse events in patients with psoriasis; spontaneous reporting, registries and use of 'big data' should facilitate this process on a global basis. The current article describes biosimilar regulatory guidelines and examples of biosimilar uptake in clinical practice in several countries around the world. As it is apparent that biological therapy treatment decisions may become more physician independent, the International Psoriasis Council recommends that dermatologists should take an active role in the development of biosimilar prescribing policies with their respective healthcare settings and government agencies. © 2017 British Association of Dermatologists.

  14. Assessing physicians' compliance with guidelines for Papanicolaou testing.

    Science.gov (United States)

    Cohen, M M; Roos, N P; MacWilliam, L; Wajda, A

    1992-06-01

    In this study, population-based data were used to examine the appropriateness of Papanicolaou (Pap) testing from the perspective of the women being tested and their physicians. The approach used is unique in its assessment of overtesting and undertesting in the primary care setting. From the data base of the province of Manitoba's universal health insurance plan, 4-year health histories (1981 to 1984) were constructed for each woman from a random sample of the population of women who, in 1982, were between the ages of 25 to 64 years (n = 22,287). At the last visit to a general practitioner, gynecologist, or general surgeon in 1984 (termed the current visit), the authors determined whether a Pap test was given for each woman. Using decision rules from a Canadian task force report on cervical screening and previous health history, the authors evaluated the appropriateness of screening by determining whether a Pap test was given and was needed, or whether a women who had not received a Pap test required one. Overall, 55.7% of women were tested appropriately. Of the 5352 women who received a Pap test at the current visit, 62.8% were overtested. Of the 16,935 women not tested at the current visit, 38.5% required screening (i.e. were undertested). Characteristics of a physician's practice that were significantly related to compliance with the guidelines included having a high proportion of patients visiting for obstetric or gynecologic reasons. Variables that were associated with negative compliance were 1) being a gynecologist; and 2) having a high proportion of patients who lived in inner city or rural areas. Because physicians are paid a fee for every Pap smear taken and the guidelines were well disseminated, these results should be reasonably representative of fee-for-service practice in North America, where preventive care is not subject to user charges. This study supports previous findings that a passive approach to dissemination of guidelines is insufficient to

  15. Overview and guidelines of off-label use of methotrexate in ectopic pregnancy: report by CNGOF.

    Science.gov (United States)

    Marret, Henri; Fauconnier, Arnaud; Dubernard, Gil; Misme, Hélène; Lagarce, Laurence; Lesavre, Magali; Fernandez, Hervé; Mimoun, Camille; Tourette, Claire; Curinier, Sandra; Rabishong, Benoit; Agostini, Aubert

    2016-10-01

    Our objective is to describe off-label use of methotrexate in ectopic pregnancy treatment using evidence based medicine. The patient group includes all women with a pregnancy outside the usual endometrium, or of unknown location. Method used was a Medline search on ectopic pregnancy managed using methotrexate treatment; evidence synthesis was done based on this current literature analysis. Level of evidence (LE) were given according to the centre for evidence base medicine rules. Grade was proposed for guidelines but no recommendation was possible as misoprostol is off label use for all the indications studied. In the absence of any contraindication, the protocol recommended for medical treatment of ectopic pregnancy is a single intramuscular injection of methotrexate (MTX) at a dosage of 1mg/kg or 50mg/m(2) (Grade A). It can be repeated once at the same dose should the hCG concentration not fall sufficiently. Pretreatment laboratory results must include a complete blood count and kidney and liver function tests (in accordance with its marketing authorization). MTX is an alternative to conservative treatment such as laparoscopic salpingotomy for uncomplicated tubal pregnancy (Grade A) with pretreatment hCG levels≤5000IU/l (Grade B). Expectant management is preferred for hCG levelspregnancies (Grade B). In situ MTX is an option for treating cervical, interstitial, or cesarean-scar pregnancies (Grade C). In pregnancies of unknown location persisting more than 10days in an asymptomatic woman who has an hCG level>2000IU/l, routine MTX treatment is an option. MTX is not indicated for combination with treatments such as mifepristone or potassium. Copyright © 2016. Published by Elsevier Ireland Ltd.

  16. An Overview of the Life Cycle Assessment Method-Past, Present, and Future

    NARCIS (Netherlands)

    Heijungs, Reinout; Guineév, Jeroen B.

    2012-01-01

    This chapter gives an overview of the mainstream method behind Life Cycle Assessment (LCA). It does so on the basis of the generally accepted principles, canonized by the International Organization for Standardization (ISO). The first part of the chapter is an overview devoted to the method itself

  17. Health technology assessment of medical devices: What is different? An overview of three European projects.

    Science.gov (United States)

    Schnell-Inderst, Petra; Mayer, Julia; Lauterberg, Jörg; Hunger, Theresa; Arvandi, Marjan; Conrads-Frank, Annette; Nachtnebel, Anna; Wild, Claudia; Siebert, Uwe

    2015-01-01

    With the growing use and importance of health technology assessment (HTA) in decision making during recent years, health technology assessors, decision makers and stakeholders are confronted with methodological challenges due to specific characteristics of health technologies (e. g., pharmaceuticals, diagnostic tests, screening programs), their developmental environment, and their regulation process. Being aware of the necessity to use HTA as a policy instrument for sustainable health care systems in a regulatory environment of decentralized Conformité Européenne (CE) marking, the European Union (EU) is increasingly supporting the development of methods for the assessment of medical devices (MD) on different levels: within the scope of European research projects and within joint assessment activities of the member states of the European network for Health Technology Assessment (EUnetHTA). First, this article describes three projects: MedtecHTA-Methods for Health Technology Assessment of Medical Devices, a European Perspective Work Package 3 (WP3), Comparative Effectiveness of Medical Devices led by the University for Health Sciences, Medical Informatics and Technology (UMIT). Second, we discuss the experiences of the Ludwig Boltzmann Institute Health Technology Assessment (LBI HTA) with the joint production of rapid assessments of medical devices by several European HTA agencies within EUnetHTA. Third, a brief outline is given of the framework of joint methodological guideline elaboration by the EUnetHTA partner organizations because a guideline for therapeutic MD is also being developed here. We will describe aims, methods and some preliminary results of MedtecHTA and EUnetHTA Joint Action 2 Work Package 5 Strand B (WP5B) applying the HTA Core Model for Rapid Assessment for national adaptation and reporting, and give an overview of the development process of methodological guidelines within WP 7 of EUnetHTA Joint Action 2. Based on a literature review in Medtec

  18. Guidelines for assessing the knowledge management maturity of organizations

    Directory of Open Access Journals (Sweden)

    C. J. Kruger

    2007-11-01

    Full Text Available In a recent article Kruger and Snyman hypothesized that progressions in knowledge management maturity (from a strategic perspective are directly related to an increased ability to speed up the strategic cycle of imitation, consolidation and innovation. The arguments proposed, however, neglected to supply the reader with a practical toolkit or even a roadmap (a time-related matrix, or questionnaire to successfully measure succession in knowledge management maturity. This article builds on the previous one and proposes a questionnaire consisting of six sections, containing 101 descriptive questions, to enable organizations to test and assess their knowledge management maturity empirically. The development of an instrument to measure knowledge management maturity required adhering to a research design that combined theoretical propositions with practical experimentation. As a point of departure, a knowledge management maturity matrix consisting of seven maturity levels was formulated. All questions contained within the matrix were benchmarked against a survey questionnaire developed by the public management service of the OECD (PUMA and were also pre-tested and validated. This process of refinement led to the formulation of the Knowledge Management Maturity Questionnaire. To avoid any taint of this research being based only on theoretical propositions, the questionnaire was tested by 178 master students of the University of Pretoria, South Africa, in nine different industries. The proposed questionnaire provides a bridge between theoretical propositions and practical usability, not only enabling knowledge management practitioners to assess the level of knowledge management maturity reached successfully but, more importantly, also serving as a guideline to institutionalize further and future knowledge management endeavours.

  19. Framing in mass communication research: an overview and assessment

    NARCIS (Netherlands)

    Vliegenthart, R.

    2012-01-01

    This article provides an overview of the use of the framing concept in mass communication research. It focuses on the questions what a frame is and how it is measured, how variation in framing can be explained and what the effects of media framing are. Specific attention will be paid to the

  20. 77 FR 3450 - Guidelines for Assessing Marine Mammal Stocks

    Science.gov (United States)

    2012-01-24

    ... electronic comments in Microsoft Word, Excel, WordPerfect, or Adobe PDF file formats only. FOR FURTHER... guidelines specify that when biological information is sufficient to identify the stock from which a dead or...

  1. Comparative assessment of bioanalytical method validation guidelines for pharmaceutical industry.

    Science.gov (United States)

    Kadian, Naveen; Raju, Kanumuri Siva Rama; Rashid, Mamunur; Malik, Mohd Yaseen; Taneja, Isha; Wahajuddin, Muhammad

    2016-07-15

    The concepts, importance, and application of bioanalytical method validation have been discussed for a long time and validation of bioanalytical methods is widely accepted as pivotal before they are taken into routine use. United States Food and Drug Administration (USFDA) guidelines issued in 2001 have been referred for every guideline released ever since; may it be European Medical Agency (EMA) Europe, National Health Surveillance Agency (ANVISA) Brazil, Ministry of Health and Labour Welfare (MHLW) Japan or any other guideline in reference to bioanalytical method validation. After 12 years, USFDA released its new draft guideline for comments in 2013, which covers the latest parameters or topics encountered in bioanalytical method validation and approached towards the harmonization of bioanalytical method validation across the globe. Even though the regulatory agencies have general agreement, significant variations exist in acceptance criteria and methodology. The present review highlights the variations, similarities and comparison between bioanalytical method validation guidelines issued by major regulatory authorities worldwide. Additionally, other evaluation parameters such as matrix effect, incurred sample reanalysis including other stability aspects have been discussed to provide an ease of access for designing a bioanalytical method and its validation complying with the majority of drug authority guidelines. Copyright © 2016. Published by Elsevier B.V.

  2. Methodological guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Halsnaes, K.; Callaway, J.M.; Meyer, H.J.

    1999-04-01

    The guideline document establishes a general overview of the main components of climate change mitigation assessment. This includes an outline of key economic concepts, scenario structure, common assumptions, modelling tools and country study assumptions. The guidelines are supported by Handbook Reports that contain more detailed specifications of calculation standards, input assumptions and available tools. The major objectives of the project have been provided a methodology, an implementing framework and a reporting system which countries can follow in meeting their future reporting obligations under the FCCC and for GEF enabling activities. The project builds upon the methodology development and application in the UNEP National Abatement Coasting Studies (UNEP, 1994a). The various elements provide countries with a road map for conducting climate change mitigation studies and submitting national reports as required by the FCCC. (au) 121 refs.

  3. Assessing adherence to the 2010 antiretroviral guidelines in the ...

    African Journals Online (AJOL)

    These clinical practice guidelines can be defined as systematically developed statements for both practitioners and patients, to assist with appropriate healthcare decisions for specific clinical circumstances.[2] Their intention is to improve healthcare processes, decrease practice variation and optimise use of resources.

  4. European clinical guidelines for Tourette Syndrome and other tic disorders. Part I : assessment

    NARCIS (Netherlands)

    Cath, Danielle C.; Hedderly, Tammy; Ludolph, Andrea G.; Stern, Jeremy S.; Murphy, Tara; Hartmann, Andreas; Czernecki, Virginie; Robertson, Mary May; Martino, Davide; Munchau, A.; Rizzo, R.

    A working group of the European Society for the Study of Tourette Syndrome (ESSTS) has developed the first European assessment guidelines of Tourette Syndrome (TS). The available literature including national guidelines was thoroughly screened and extensively discussed in the expert group of ESSTS

  5. New diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo guidelines

    NARCIS (Netherlands)

    Yokoe, Masamichi; Takada, Tadahiro; Strasberg, Steven M.; Solomkin, Joseph S.; Mayumi, Toshihiko; Gomi, Harumi; Pitt, Henry A.; Gouma, Dirk J.; Garden, O. James; Büchler, Markus W.; Kiriyama, Seiki; Kimura, Yasutoshi; Tsuyuguchi, Toshio; Itoi, Takao; Yoshida, Masahiro; Miura, Fumihiko; Yamashita, Yuichi; Okamoto, Kohji; Gabata, Toshifumi; Hata, Jiro; Higuchi, Ryota; Windsor, John A.; Bornman, Philippus C.; Fan, Sheung-Tat; Singh, Harijt; de Santibanes, Eduardo; Kusachi, Shinya; Murata, Atsuhiko; Chen, Xiao-Ping; Jagannath, Palepu; Lee, Sunggyu; Padbury, Robert; Chen, Miin-Fu

    2012-01-01

    Background The Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07) were published in 2007 as the world's first guidelines for acute cholangitis and cholecystitis. The diagnostic criteria and severity assessment of acute cholecystitis have since been widely used all over

  6. Qualitative assessment of agritourism safety guidelines: a demonstration project.

    Science.gov (United States)

    Tutor-Marcom, Robin; Greer, Annette; Clay, Maria; Ellis, Tammy; Thompson, Tami; Adam-Samura, Esther Seisay

    2013-01-01

    In 2007, the National Children's Center for Rural and Agricultural Health and Safety (NCCRAHS) published Agritourism Health and Safety Guidelines for Children to provide helpful recommendations for protecting the health and safety of children visiting agritourism farms. Supplement A: Policies and Procedures Guide and Supplement B: Worksite Guide were subsequently published in 2009 and provided agritourism farms with checklists to use in reviewing, planning, and implementing their own health and safety practices. In order to better understand what would be required of a farm wishing to implement the guidelines using Supplements A and B, the North Carolina Agromedicine Institute conducted a single-family farm demonstration project with support from the NCCRAHS. The aims of the project were to (1) determine child health and safety risks associated with an existing agritourism farm; (2) determine the cost of making improvements necessary to reduce risks; and (3) use project findings to motivate other agritourism farms, Cooperative Extension agents, and agritourism insurers to adopt or recommend Agritourism Health and Safety Guidelines for Children for their own farms or farms with which they work. At the conclusion of the study, the target farm was in compliance with an average of 86.9% of items in Supplements A and B. Furthermore, 89% of individuals self-identifying as farmers or farm workers and 100% of Cooperative Extension agents and agritourism insurers attending an end-of-project workshop indicated their intent to adopt or recommend Agritourism Health and Safety Guidelines for Children for their own farms or farms with which they work.

  7. European clinical guidelines for Tourette syndrome and other tic disorders. Part I: assessment

    DEFF Research Database (Denmark)

    Cath, Danielle C; Hedderly, Tammy; Ludolph, Andrea G

    2011-01-01

    members. Detailed clinical assessment guidelines of tic disorders and their comorbidities in both children and adults are presented. Screening methods that might be helpful and necessary for specialists' differential diagnosis process are suggested in order to further analyse cognitive abilities...

  8. Technical Review Guidelines for Environmental Impact Assessments in the Tourism, Energy and Mining Sectors

    Science.gov (United States)

    EPA coordinated a regional collaborative process with Central America and Dominican Republic Free Trade Agreement (CAFTA-DR) partners to develop Environmental Impact Assessment (EIA) Technical Review Guidelines for three sectors.

  9. [Etiology and pathophysiology of fibromyalgia syndrome : Updated guidelines 2017, overview of systematic review articles and overview of studies on small fiber neuropathy in FMS subgroups].

    Science.gov (United States)

    Üçeyler, N; Burgmer, M; Friedel, E; Greiner, W; Petzke, F; Sarholz, M; Schiltenwolf, M; Winkelmann, A; Sommer, C; Häuser, W

    2017-06-01

    The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was planned for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A systematic search of the literature from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Prospective population-based studies and systematic reviews with meta-analyses of case control studies were taken into consideration for the statements. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The statements were generated by multiple step formalized procedures. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. Current data do not enable identification of distinct factors in the etiology and pathophysiology of fibromyalgia syndrome. Fibromyalgia syndrome can be associated with inflammatory rheumatic diseases, gene polymorphisms, life style factors (e.g. smoking, obesity and lack of physical activity), depressive disorders as well as physical and sexual abuse in childhood and adulthood. Fibromyalgia syndrome is most probably the end result of various pathogenetic factors and pathophysiological mechanisms.

  10. Technical Overview of Ecological Risk Assessment - Analysis Phase: Exposure Characterization

    Science.gov (United States)

    Exposure Characterization is the second major component of the analysis phase of a risk assessment. For a pesticide risk assessment, the exposure characterization describes the potential or actual contact of a pesticide with a plant, animal, or media.

  11. [European Association of Urology guidelines on assessment and nonsurgical management of urinary incontinence].

    Science.gov (United States)

    Lucas, M G; Bosch, R J L; Burkhard, F C; Cruz, F; Madden, T B; Nambiar, A K; Neisius, A; de Ridder, D J M K; Tubaro, A; Turner, W H; Pickard, R S

    2013-04-01

    The previous European Association of Urology (EAU) guidelines on urinary incontinence comprised a summary of sections of the 2009 International Consultation on Incontinence. A decision was made in 2010 to rewrite these guidelines based on an independent systematic review carried out by the EAU guidelines panel, using a sustainable methodology. We present a short version of the full guidelines on assessment, diagnosis, and nonsurgical treatment of urinary incontinence, with the aim of increasing their dissemination. Evidence appraisal included a pragmatic review of existing systematic reviews and independent new literature searches, based on Population, Intervention, Comparator, Outcome questions. Appraisal of papers was carried out by an international panel of experts, who also collaborated on a series of consensus discussions, to develop concise structured evidence summaries and action-based recommendations using a modified Oxford system. The full version of the guidelines is available online (http://www.uroweb.org/guidelines/online-guidelines/). The guidelines include algorithms that refer the reader back to the supporting evidence, and they are more immediately useable in daily clinical practice. These new guidelines present an up-to-date summary of the available evidence, together with clear clinical algorithms and action-based recommendations based on the best available evidence. Where such evidence does not exist, they present a consensus of expert opinion. Copyright © 2012 AEU. Published by Elsevier España, S.L. All rights reserved.

  12. Measure Guideline: Wall Air Sealing and Insulation Methods in Existing Homes; An Overview of Opportunity and Process

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, S.; Stephenson, R.

    2012-09-01

    This guide provides renovators and retrofit contractors an overview of considerations when including wall air sealing and insulation in an energy retrofit project. It also outlines the potential project risks, various materials for insulating, possible field inspections needed, installation procedures, as well as the benefits and drawbacks. The purpose of this document is to provide the outline of the overview and process of insulating and air sealing walls so that home retrofit professionals can identify approaches to air sealing and insulation measures.

  13. RAVEN and Dynamic Probabilistic Risk Assessment: Software overview

    Energy Technology Data Exchange (ETDEWEB)

    Andrea Alfonsi; Cristian Rabiti; Diego Mandelli; Joshua Cogliati; Robert Kinoshita; Antonio Naviglio

    2014-09-01

    RAVEN is a generic software framework to perform parametric and probabilistic analysis based on the response of complex system codes. The initial development was aimed to provide dynamic risk analysis capabilities to the Thermo-Hydraulic code RELAP-7 [], currently under development at the Idaho National Laboratory. Although the initial goal has been fully accomplished, RAVEN is now a multi-purpose probabilistic and uncertainty quantification platform, capable to agnostically communicate with any system code. This agnosticism has been employed by providing Application Programming Interfaces (APIs). These interfaces are used to allow RAVEN to interact with any code as long as all the parameters that need to be perturbed are accessible by inputs files or via python interfaces. RAVEN is capable to investigate the system response, investigating the input space using Monte Carlo, Grid, or Latin Hyper Cube sampling schemes, but its strength is focused toward system feature discovery, such as limit surfaces, separating regions of the input space leading to system failure, using dynamic supervised learning techniques. The paper presents an overview of the software capabilities and their implementation schemes followed by some application examples.

  14. Overview and application of the AQEM assessment system

    NARCIS (Netherlands)

    Hering, D.; Moog, O.; Sandin, L.; Verdonschot, P.F.M.

    2004-01-01

    The main objective of the European Union (EU) funded project AQEM1was to develop a framework of an assessment system for streams in Europe based on benthic macroinvertebrates that fulfils the requirements of the EU Water Framework Directive. Initial assessment methods for 28 European stream types

  15. Historical overview of diet assessment and food consumption surveys in Spain: assessment methods and applications.

    Science.gov (United States)

    Morán Fagúndez, Luis Juan; Rivera Torres, Alejandra; González Sánchez, María Eugenia; de Torres Aured, Mari Lourdes; López-Pardo Martínez, Mercedes; Irles Rocamora, José Antonio

    2015-02-26

    The food consumption assessment methods are used in nutrition and health population surveys and are the basis for the development of guidelines, nutritional recommendations and health plans, The study of these issues is one of the major tasks of the research and health policy in developed countries. Major advances nationally in this area have been made since 1940, both in the reliability of the data and in the standardization of studies, which is a necessary condition to compare changes over time. In this article the history and application of different dietary surveys, dietary history and food frequency records are analyzed. Besides information from surveys conducted at a national level, the main data currently available for public health planning in nutrition comes from nutritional analysis of household budget surveys and food balance sheets, based on data provided by the Ministry of Agriculture. Copyright AULA MEDICA EDICIONES 2015. Published by AULA MEDICA. All rights reserved.

  16. Assessment in and of Serious Games: An Overview

    Directory of Open Access Journals (Sweden)

    Francesco Bellotti

    2013-01-01

    Full Text Available There is a consensus that serious games have a significant potential as a tool for instruction. However, their effectiveness in terms of learning outcomes is still understudied mainly due to the complexity involved in assessing intangible measures. A systematic approach—based on established principles and guidelines—is necessary to enhance the design of serious games, and many studies lack a rigorous assessment. An important aspect in the evaluation of serious games, like other educational tools, is user performance assessment. This is an important area of exploration because serious games are intended to evaluate the learning progress as well as the outcomes. This also emphasizes the importance of providing appropriate feedback to the player. Moreover, performance assessment enables adaptivity and personalization to meet individual needs in various aspects, such as learning styles, information provision rates, feedback, and so forth. This paper first reviews related literature regarding the educational effectiveness of serious games. It then discusses how to assess the learning impact of serious games and methods for competence and skill assessment. Finally, it suggests two major directions for future research: characterization of the player’s activity and better integration of assessment in games.

  17. Going DEEP: guidelines for building simulation-based team assessments.

    Science.gov (United States)

    Grand, James A; Pearce, Marina; Rench, Tara A; Chao, Georgia T; Fernandez, Rosemarie; Kozlowski, Steve W J

    2013-05-01

    Whether for team training, research or evaluation, making effective use of simulation-based technologies requires robust, reliable and accurate assessment tools. Extant literature on simulation-based assessment practices has primarily focused on scenario and instructional design; however, relatively little direct guidance has been provided regarding the challenging decisions and fundamental principles related to assessment development and implementation. The objective of this manuscript is to introduce a generalisable assessment framework supplemented by specific guidance on how to construct and ensure valid and reliable simulation-based team assessment tools. The recommendations reflect best practices in assessment and are designed to empower healthcare educators, professionals and researchers with the knowledge to design and employ valid and reliable simulation-based team assessments. Information and actionable recommendations associated with creating assessments of team processes (non-technical 'teamwork' activities) and performance (demonstration of technical proficiency) are presented which provide direct guidance on how to Distinguish the underlying competencies one aims to assess, Elaborate the measures used to capture team member behaviours during simulation activities, Establish the content validity of these measures and Proceduralise the measurement tools in a way that is systematically aligned with the goals of the simulation activity while maintaining methodological rigour (DEEP). The DEEP framework targets fundamental principles and critical activities that are important for effective assessment, and should benefit healthcare educators, professionals and researchers seeking to design or enhance any simulation-based assessment effort.

  18. Overview of the Building Assessment Survey and Evaluation Study

    Science.gov (United States)

    The Building Assessment Survey and Evaluation (BASE) study was conducted over a five-year period from 1994-1998, to characterize determinants of indoor air quality (IAQ) and occupant perceptions in representative public and commercial office buildings.

  19. Chemical Mixtures Health Risk Assessment: Overview of Exposure Assessment, Whole Mixtures Assessments; Basic Concepts

    Science.gov (United States)

    This problems-based, half-day, introductory workshop focuses on methods to assess health risks posed by exposures to chemical mixtures in the environment. Chemical mixtures health risk assessment methods continue to be developed and evolve to address concerns over health risks f...

  20. Overview of water resource assessment in South Africa: Current ...

    African Journals Online (AJOL)

    This paper reviews the progress made in the assessment of water resources in South Africa over the past 60 years by examining 5 major studies that were undertaken in this period. These studies illustrate how the exponential growth in computer power and the concomitant development of highly sophisticated tools have ...

  1. Assessment Tools' Indicators for Sustainability in Universities: An Analytical Overview

    Science.gov (United States)

    Alghamdi, Naif; den Heijer, Alexandra; de Jonge, Hans

    2017-01-01

    Purpose: The purpose of this paper is to analyse 12 assessment tools of sustainability in universities and develop the structure and the contents of these tools to be more intelligible. The configuration of the tools reviewed highlight indicators that clearly communicate only the essential information. This paper explores how the theoretical…

  2. Dual Sensory Loss: Overview of Problems, Visual Assessment, and Rehabilitation

    National Research Council Canada - National Science Library

    Brabyn, John A; Schneck, Marilyn E; Haegerstrom-Portnoy, Gunilla; Lott, Lori A

    2007-01-01

    .... The assessment and appropriate referral of patients with these combined deficits is discussed, including the interpretation of visual test results and the importance of factors other than standard visual acuity. Speculation is offered on potential strategies and solutions for rehabilitation as well as the need for future research and improvements in service delivery.

  3. Overview of Environmental Impact Assessment of Oil and Gas ...

    African Journals Online (AJOL)

    The environmental impact assessment (EIA) of oil and gas projects in Nigeria and the process of delivering it was examined with oil and gas projects. ... Analysis of data/sample and impact quantification; Drafting of EIA report of impact quantification through which the Environmental Management Plan (EMP) is obtained to ...

  4. Design guidelines for self-assessment support for adult academic distance learning

    DEFF Research Database (Denmark)

    Menendez Blanco, Maria; van der Veer, Gerrit; Benvenuti, Laura

    2011-01-01

    This contribution focuses on adult distance learning. Based on experiences at the Open University of the Netherlands we investigate specific problems that our students have with self-assessment and metacognition while studying. Starting from a literature review and complementing this with available...... student data from our teaching research center, we developed a conceptual framework that was iteratively adjusted and assessed by a questionnaire study and interviews. This allowed us to develop design guidelines for self-assessment support in distance learning environments. These guidelines were reviewed...

  5. The Army Selected Reserve Dental Readiness System (ASDRS): Historical Overview, Assessment and Recommendations

    Science.gov (United States)

    2012-05-28

    Department of Veterans Affairs ( DVA ). 15. SUBJECT TERMS Interoperability, Army Force Generation, Continuum of Care, Operationalization...and Department of Veterans Affairs ( DVA ). THE ARMY SELECTED RESERVE DENTAL READINESS SYSTEM (ASDRS): HISTORICAL OVERVIEW, ASSESSMENT AND...Affairs ( DVA ) could be groundbreaking. Army RC Dental Readiness Importance and Historical Context Dental Readiness is an important enabler for

  6. An overview of inventory and monitoring and the Role of FIA in National Assessments

    Science.gov (United States)

    W. Brad Smith

    2006-01-01

    This paper presents a brief conceptual overview of inventory and monitoring and the role of the Forest Inventory and Analysis (FIA) program in national assessments. FIA has become a focal point of national inventory and monitoring and kept national leadership as well as forest resource research and management professionals apprised, through periodic reports to Congress...

  7. Passivity-Based Stability Assessment of Grid-Connected VSCs - An Overview

    DEFF Research Database (Denmark)

    Harnefors, Lennart; Wang, Xiongfei; Yepes, Alejandro G.

    2016-01-01

    , then their destabilization is generally prevented. This paper presents an overview of passivity-based stability assessment, including techniques for space-vector modeling of VSCs whereby expressions for the input admittance can be derived. Design recommendations for minimizing the negative-real-part region are given as well....

  8. The diesel exhaust in miners study: I. Overview of the exposure assessment process.

    NARCIS (Netherlands)

    Stewart, P.A.; Coble, J.B.; Vermeulen, R.|info:eu-repo/dai/nl/216532620; Schleiff, P.; Blair, A.; Lubin, J.; Attfield, M.; Silverman, D.T.

    2010-01-01

    This report provides an overview of the exposure assessment process for an epidemiologic study that investigated mortality, with a special focus on lung cancer, associated with diesel exhaust (DE) exposure among miners. Details of several components are provided in four other reports. A major

  9. Design and Assessment for Hybrid Courses: Insights and Overviews

    OpenAIRE

    Hamza-Lup, Felix G; White, Stephen

    2015-01-01

    Technology is influencing education, providing new\\ud delivery and assessment models. A combination between online and traditional course, the hybrid (blended) course, may present a solution with many benefits as it provides a gradual transition towards technology enabled education. This research work provides a set of definitions for several course delivery approaches, and evaluates five years of data from a course that has been converted from traditional face-to-face delivery, to hybrid del...

  10. Measure Guideline. Wall Air Sealing and Insulation Methods in Existing Homes; An Overview of Opportunity and Process

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, S. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Stephenson, R. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States)

    2012-09-01

    This guide provides renovators and retrofit contractors an overview of considerations when including wall air sealing and insulation in an energy retrofit project. It also outlines the potential project risks, various materials for insulating, possible field inspections needed, installation procedures, as well as the benefits and drawbacks.

  11. A practical guideline for human error assessment: A causal model

    Science.gov (United States)

    Ayele, Y. Z.; Barabadi, A.

    2017-12-01

    To meet the availability target and reduce system downtime, effective maintenance have a great importance. However, maintenance performance is greatly affected in complex ways by human factors. Hence, to have an effective maintenance operation, these factors needs to be assessed and quantified. To avoid the inadequacies of traditional human error assessment (HEA) approaches, the application of Bayesian Networks (BN) is gaining popularity. The main purpose of this paper is to propose a HEA framework based on the BN for maintenance operation. The proposed framework aids for assessing the effects of human performance influencing factors on the likelihood of human error during maintenance activities. Further, the paper investigates how operational issues must be considered in system failure-rate analysis, maintenance planning, and prediction of human error in pre- and post-maintenance operations. The goal is to assess how performance monitoring and evaluation of human factors can effect better operation and maintenance.

  12. Reductions in Long-Term Suspensions Following Adoption of the Virginia Student Threat Assessment Guidelines

    Science.gov (United States)

    Cornell, Dewey G.; Gregory, Anne; Fan, Xitao

    2011-01-01

    This quasi-experimental study examined the adoption of the Virginia Student Threat Assessment Guidelines in 23 high schools. After training, school administrators and other staff members demonstrated substantial increases in knowledge of threat assessment principles and decreased commitment to zero tolerance approaches. Schools using the…

  13. Guidelines, Criteria, and Rules of Thumb for Evaluating Normed and Standardized Assessment Instruments in Psychology.

    Science.gov (United States)

    Cicchetti, Domenic V.

    1994-01-01

    In the context of developing assessment instruments in psychology, issues of standardization, norming procedures, and test reliability and validity are discussed. Criteria, guidelines, and rules of thumb are provided to help the clinician with instrument selection for a given psychological assessment. (SLD)

  14. Life Cycle Assessment of electricity generation: overview and methodological issues

    DEFF Research Database (Denmark)

    Turconi, Roberto; Boldrin, Alessio; Astrup, Thomas Fruergaard

    Electricity production is currently responsible for a large share of global Greenhouse Gas (GHG), NOx and SO2 emissions, and their related environmental impacts. This study provides a critical review of the status of research on life cycle assessment (LCA) of electricity generation. NREL [1...... of emissions, those were divided among three life cycle phases: fuel provision, operation of the plant and infrastructure. It was possible to estimate typical emission factors for all technologies except for biomass, where methodological and technical aspects result in very variable outcomes. Within...... these ranges, we identified direct emissions at the plant as the main contributor to the total GHG emissions for fossil fuels, with thermal efficiency being the most determining parameter. Nevertheless, with high thermal efficiency fuel provision becomes increasingly important (e.g. natural gas combined cycle...

  15. Performance assessment calculational exercises (PACE-90): Overview and summary

    Energy Technology Data Exchange (ETDEWEB)

    Barnard, R.W.; Dockery, H.A. [Sandia National Labs., Albuquerque, NM (United States)

    1991-12-31

    PACE-90 was undertaken by the Yucca Mountain Site Characterization Project in order to develop expertise in computational capabilities and to aid in identification of critical elements and processes necessary for performance assessment. One- and two-dimensional codes simulated groundwater flow and transport of selected radionuclides through Yucca Mountain for a period of 100,000 years. Using an groundwater percolation flux of 0.01 mm/yr and a new interpretation of the hydrostratigraphy, the calculations showed no contamination reaching the water table. However, these results should be interpreted with caution because the calculations were based on unvalidated conceptual models and parameters. In a separate part of the exercise, disturbed-condition problems (human intrusion, climate change, and volcanism) were developed as a basis for future calculations.

  16. Overview of DOE-NE Proliferation and Terrorism Risk Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Sadasivan, Pratap [Los Alamos National Laboratory

    2012-08-24

    Research objectives are: (1) Develop technologies and other solutions that can improve the reliability, sustain the safety, and extend the life of current reactors; (2) Develop improvements in the affordability of new reactors to enable nuclear energy; (3) Develop Sustainable Nuclear Fuel Cycles; and (4) Understand and minimize the risks of nuclear proliferation and terrorism. The goal is to enable the use of risk information to inform NE R&D program planning. The PTRA program supports DOE-NE's goal of using risk information to inform R&D program planning. The FY12 PTRA program is focused on terrorism risk. The program includes a mix of innovative methods that support the general practice of risk assessments, and selected applications.

  17. Overview of the National Water-Quality Assessment Program

    Science.gov (United States)

    Leahy, P.P.; Thompson, T.H.

    1994-01-01

    The Nation's water resources are the basis for life and our economic vitality. These resources support a complex web of human activities and fishery and wildlife needs that depend upon clean water. Demands for good-quality water for drinking, recreation, farming, and industry are rising, and as a result, the American public is concerned about the condition and sustainability of our water resources. The American public is asking: Is it safe to swim in and drink water from our rivers or lakes? Can we eat the fish that come from them? Is our ground water polluted? Is water quality degrading with time, and if so, why? Has all the money we've spent to clean up our waters, done any good? The U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program was designed to provide information that will help answer these questions. NAWQA is designed to assess historical, current, and future water-quality conditions in representative river basins and aquifers nationwide. One of the primary objectives of the program is to describe relations between natural factors, human activities, and water-quality conditions and to define those factors that most affect water quality in different parts of the Nation. The linkage of water quality to environmental processes is of fundamental importance to water-resource managers, planners, and policy makers. It provides a strong and unbiased basis for better decisionmaking by those responsible for making decisions that affect our water resources, including the United States Congress, Federal, State, and local agencies, environmental groups, and industry. Information from the NAWQA Program also will be useful for guiding research, monitoring, and regulatory activities in cost effective ways.

  18. Canada’s Guideline 9: improving SOGIE claims assessment?

    Directory of Open Access Journals (Sweden)

    Moira Dustin

    2017-10-01

    Full Text Available Asylum seekers making claims relating to their sexual orientation and gender identity often face unfair refusal. New guidance from the Immigration and Refugee Board of Canada takes admirable steps towards improving claims assessment, and offers a model for practitioners elsewhere.

  19. EPa`s program for risk assessment guidelines: Exposure issues

    Energy Technology Data Exchange (ETDEWEB)

    Callahan, M.A. [Environmental Protection Agency, Washington, DC (United States)

    1990-12-31

    Three major issues to be dealt with over the next ten years in the exposure assessment field are: consistency in terminology, the impact of computer technology on the choice of data and modeling, and conceptual issues such as the use of time-weighted averages.

  20. Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines

    NARCIS (Netherlands)

    Hirota, Masahiko; Takada, Tadahiro; Kawarada, Yoshifumi; Nimura, Yuji; Miura, Fumihiko; Hirata, Koichi; Mayumi, Toshihiko; Yoshida, Masahiro; Strasberg, Steven; Pitt, Henry; Gadacz, Thomas R.; de Santibanes, Eduardo; Gouma, Dirk J.; Solomkin, Joseph S.; Belghiti, Jacques; Neuhaus, Horst; Buechler, Markus W.; Fan, Sheung-Tat; Ker, Chen-Guo; Padbury, Robert T.; Liau, Kui-Hin; Hilvano, Serafin C.; Belli, Giulio; Windsor, John A.; Dervenis, Christos

    2007-01-01

    The aim of this article is to propose new criteria for the diagnosis and severity assessment of acute cholecystitis, based on a systematic review of the literature and a consensus of experts. A working group reviewed articles with regard to the diagnosis and treatment of acute cholecystitis and

  1. Assessing adherence to the 2010 antiretroviral guidelines in the ...

    African Journals Online (AJOL)

    what combinations of drugs to use when a change was indicated. • what laboratory ... 1 Infectious Disease Clinic,1 Military Hospital, Pretoria, South Africa. 2 Department of ... rollout clinic of the Infectious Diseases Clinic Pharmacy at 1 Military Hospital (1MH) over a period of 3 years to assess clinicians' adherence to the ...

  2. An overview of the revised 1996 IPCC guidelines for national greenhouses gas inventory methodology for nitrous oxide from agriculture

    NARCIS (Netherlands)

    Mosier, A.; Kroeze, C.; Nevison, C.; Oenema, O.; Seitzinger, S.; Cleemput, van O.

    1999-01-01

    The IPCC Guidelines for National Greenhouse Gas Inventories provide default methodologies for estimating emissions of the most important greenhouse gases at a national scale. The methodology for estimating emissions of nitrous oxide (N2O) from agriculture was revised in 1996 by an international

  3. [Physiotherapy, occupational therapy and physical therapy in fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles].

    Science.gov (United States)

    Winkelmann, A; Bork, H; Brückle, W; Dexl, C; Heldmann, P; Henningsen, P; Krumbein, L; Pullwitt, V; Schiltenwolf, M; Häuser, W

    2017-06-01

    The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A literature search for systematic reviews of randomized, controlled trials on physiotherapy, occupational therapy and physical therapy from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences and applicability of available therapies were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. Low to moderate intensity endurance and strength training are strongly recommended. Chiropractic, laser therapy, magnetic field therapy, massage and transcranial magnetic stimulation are not recommended.

  4. [Definition, classification, clinical diagnosis and prognosis of fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles].

    Science.gov (United States)

    Eich, W; Bär, K-J; Bernateck, M; Burgmer, M; Dexl, C; Petzke, F; Sommer, C; Winkelmann, A; Häuser, W

    2017-06-01

    The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A systematic search of the literature from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. The clinical diagnosis of fibromyalgia syndrome can be established by the American College of Rheumatology (ACR) 1990 classification criteria (with examination of tender points) or without the examination of tender points by the modified preliminary diagnostic ACR 2010 or 2011 criteria.

  5. DIET@NET: Best Practice Guidelines for dietary assessment in health research.

    Science.gov (United States)

    Cade, Janet E; Warthon-Medina, Marisol; Albar, Salwa; Alwan, Nisreen A; Ness, Andrew; Roe, Mark; Wark, Petra A; Greathead, Katharine; Burley, Victoria J; Finglas, Paul; Johnson, Laura; Page, Polly; Roberts, Katharine; Steer, Toni; Hooson, Jozef; Greenwood, Darren C; Robinson, Sian

    2017-11-15

    Dietary assessment is complex, and strategies to select the most appropriate dietary assessment tool (DAT) in epidemiological research are needed. The DIETary Assessment Tool NETwork (DIET@NET) aimed to establish expert consensus on Best Practice Guidelines (BPGs) for dietary assessment using self-report. The BPGs were developed using the Delphi technique. Two Delphi rounds were conducted. A total of 131 experts were invited, and of these 65 accepted, with 48 completing Delphi round I and 51 completing Delphi round II. In all, a total of 57 experts from North America, Europe, Asia and Australia commented on the 47 suggested guidelines. Forty-three guidelines were generated, grouped into the following four stages: Stage I. Define what is to be measured in terms of dietary intake (what? who? and when?); Stage II. Investigate different types of DATs; Stage III. Evaluate existing tools to select the most appropriate DAT by evaluating published validation studies; Stage IV. Think through the implementation of the chosen DAT and consider sources of potential biases. The Delphi technique consolidated expert views on best practice in assessing dietary intake. The BPGs provide a valuable guide for health researchers to choose the most appropriate dietary assessment method for their studies. These guidelines will be accessible through the Nutritools website, www.nutritools.org .

  6. Clinical assessment of chest pain and guidelines for imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gruettner, J., E-mail: joachim.gruettner@umm.de [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Henzler, T. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Sueselbeck, T. [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Fink, C. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Borggrefe, M.; Walter, T. [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany)

    2012-12-15

    For many emergency facilities, risk assessment of patients with diffuse chest pain still poses a major challenge. In their currently valid recommendations, the international cardiological societies have defined a standardized assessment of the prognostically relevant cardiac risk criteria. Here the classic sequence of basic cardiac diagnostics including case history (cardiac risk factors), physical examination (haemodynamic and respiratory vital parameters), ECG (ST segment analysis) and laboratory risk markers (troponin levels) is paramount. The focus is, on the one hand, on timely indication for percutaneous catheterization, especially in patients at high cardiac risk with or without ST-segment elevation in the ECG, and, on the other hand, on the possibility of safely discharging patients with intermediate or low cardiac risk after non-invasive exclusion of a coronary syndrome. For patients in the intermediate or low risk group, physical or pharmacological stress testing in combination with scintigraphy, echocardiography or magnetic resonance imaging is recommended in addition to basic diagnostics. Moreover, the importance of non-invasive coronary imaging, primarily cardiac CT angiography (CCTA), is increasing. Current data show that in intermediate or low risk patients this method is suitable to reliably rule out coronary heart disease. In addition, attention is paid to the major differential diagnoses of acute coronary syndrome, particularly pulmonary embolism and aortic dissection. Here the diagnostic method of choice is thoracic CT, possibly also in combination with CCTA aiming at a triple rule-out.

  7. Effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of cardiovascular disease: protocol for an overview of systematic reviews.

    Science.gov (United States)

    Studziński, Krzysztof; Tomasik, Tomasz; Krzyszton, Janusz; Jóźwiak, Jacek; Windak, Adam

    2017-03-08

    Major clinical practice guidelines recommend assessing risk of cardiovascular disease (CVD) using absolute/global/total CVD risk scores. However, the effectiveness of using them in clinical practice, despite publication of numerous randomised controlled trials (RCTs), is still poorly understood. To summarise and analyse current knowledge in this field, we will carry out an overview of existing systematic reviews (SRs). The objective of this overview will be to assess the effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of CVD compared with standard care. We will include SRs and meta-analyses which take into account RCTs and quasi-RCTs investigating the effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of CVD. SRs will be retrieved from 4 bibliographical databases and reference lists of identified reviews. Additionally, the PROSPERO database will be searched for unpublished, ongoing or recently completed SRs. 2 reviewers will assess the SRs independently for eligibility and bias. The data will be extracted to a special form. Any disagreement will be resolved by discussion. In case of lack of consensus, a third author will arbitrate. The overview of SRs will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Ethics approval is not required for overview of SRs. We will summarise evidence concerning whether use of the absolute/global/total CVD risk scoring tools in primary prevention of CVD is effective and supported with scientific data or not. If we face unsatisfactory confirmation, we will highlight a need for further research and advice on how to plan such a study. We will submit the results of our study for peer-review publication in a journal indexed in the international bibliographic database of biomedical information. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  8. Assessment of fires in chemical warehouses. An overview of the TOXFIRE project

    DEFF Research Database (Denmark)

    1999-01-01

    The report summarises the scientific outcome of the CEC Environment project "TOXFIRE. Guidelines for Management of Fires in Chemical Warehouses". The project was performed in the period 1994 - 1996 in a multi-national co-operation between partners fromUnited Kingdom, Sweden, Finland and Denmark...... performed. Also included were items as fire modelling, risk assessment to human health and the environment. Finally, the basis of guidelines for safetyengineers and fire brigades were established. The report describes the work done by each partner and the main results achieved. The references of all reports...

  9. Tumour assessment and staging: United Kingdom National Multidisciplinary Guidelines.

    Science.gov (United States)

    Roland, N; Porter, G; Fish, B; Makura, Z

    2016-05-01

    In general, the first decision to be made in a patient with a confirmed head and neck cancer is whether or not to treat the patient before deciding what form of management strategy is appropriate. There is no more important an aspect of head and neck cancer care than the initial evaluation of the patient and the patient's tumour. The practice requires specific expertise and judgement. The current tumour-node-metastasis system relies on morphology of the tumour (anatomical site and extent of disease) but the final decision on treatment hinges on a full assessment of the patient including physiological age and general condition. The aim of this paper is primarily to describe why and how we appraise a patient and their tumour. It addresses the general principles applicable to the topic of evaluation, classification and staging. In addition, the limitations and pitfalls of this process are described. Recommendations • All patients with head and neck cancer (HNC) should undergo tumour classification and staging prior to treatment. (R) • Pre-therapeutic clinical staging of HNCs should be based on at least a C2 factor (evidence obtained by special diagnostic means, e.g. radiographic imaging (e.g. computed tomography, magnetic resonance imaging or ultrasound scan), endoscopy, biopsy and cytology). (R) • Imaging to evaluate the primary site should be performed prior to biopsy to avoid the effect of upstaging from the oedema caused by biopsy trauma. (G) • Panendoscopy is only recommended for symptomatic patients or patients with primary tumours known to have a significant risk of a second (synchronous) primary tumour. (G).

  10. INTRODUCTION OF INNOVATIVE MEDICAL DEVICES AT FRENCH UNIVERSITY HOSPITALS: AN OVERVIEW OF HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT INITIATIVES.

    Science.gov (United States)

    Martelli, Nicolas; Billaux, Mathilde; Borget, Isabelle; Pineau, Judith; Prognon, Patrice; van den Brink, Helene

    2015-01-01

    Local health technology assessment (HTA) to determine whether new health technologies should be adopted is now a common practice in many healthcare organizations worldwide. However, little is known about hospital-based HTA activities in France. The objective of this study was to explore hospital-based HTA activities in French university hospitals and to provide a picture of organizational approaches to the assessment of new and innovative medical devices. Eighteen semi-structured interviews with hospital pharmacists were conducted from October 2012 to April 2013. Six topics were discussed in depth: (i) the nature of the institution concerned; (ii) activities relating to innovative medical devices; (iii) the technology assessment and decision-making process; (iv) the methodology for technology assessment; (v) factors likely to influence decisions and (vi) suggestions for improving the current process. The interview data were coded, collated and analyzed statistically. Three major types of hospital-based HTA processes were identified: medical device committees, innovation committees, and "pharmacy & management" processes. HTA units had been set up to support medical device and innovation committees for technology assessment. Slow decision making was the main limitation to both these committee-based approaches. As an alternative, "pharmacy & management" processes emerged as a means of rapidly obtaining a formal assessment. This study provides an overview of hospital-based HTA initiatives in France. We hope that it will help to promote hospital-based HTA activities in France and discussions about ways to improve and harmonize practices, through the development of national guidelines and/or a French mini-HTA tool, for example.

  11. Pressure Ulcers in Adults: Prediction and Prevention. Clinical Practice Guideline Number 3.

    Science.gov (United States)

    Agency for Health Care Policy and Research (DHHS/PHS), Rockville, MD.

    This package includes a clinical practice guideline, quick reference guide for clinicians, and patient's guide to predicting and preventing pressure ulcers in adults. The clinical practice guideline includes the following: overview of the incidence and prevalence of pressure ulcers; clinical practice guideline (introduction, risk assessment tools…

  12. The assessment of genetic risk of breast cancer : a set of GP guidelines

    NARCIS (Netherlands)

    de Bock, GH; Vlieland, TPMV; Hageman, GCHA; Oosterwijk, JC; Springer, MP; Kievit, J

    Background. Assessing a genetic risk for developing breast cancer is not an easy task for a GP. Current expert guidelines for referring and counselling women with a family history positive for breast cancer are complex and difficult to apply in general practice, and have only two strategies (to

  13. Multicentre evaluation of prescribing concurrence with anti-infective guidelines : epidemiological assessment of indicators

    NARCIS (Netherlands)

    Fijn, R; Chow, MC; Schuur, PMH; De Jong-Van den Berg, LTW; Brouwers, JRBJ

    2002-01-01

    Purpose To assess indicators for anti-infective prescribing not concurrent with regional pharmacotherapeutic treatment guidelines (PTGs) on infectious diseases. Methods A retrospective explorative cohort study based on hospital-wide anti-infective prescription data of a 2-month cross-sectional

  14. Guidelines for Preparing Psychological Specialists: An Entry-Level Course on Intellectual Assessment

    Science.gov (United States)

    Oakland, Thomas; Wechsler, Solange Muglia

    2016-01-01

    This article provides guidelines for an entry-level course that prepares psychology students and practitioners to acquire entry-level skills, abilities, knowledge, and attitudes important to the individual assessment of intellectual abilities of children and youth. The article reviews prominent international, regional, and national policies,…

  15. Early Intervention Evaluation Reports: Guidelines for Writing User-Friendly and Strength-Based Assessments

    Science.gov (United States)

    Towle, Patricia; Farrell, Anne F.; Vitalone-Raccaro, Nancy

    2008-01-01

    Assessment and evaluation activities are an integral part of early intervention services. These activities culminate in written evaluation reports that include information such as observations of skills and deficits, diagnosis, and recommendations for intervention. However, few guidelines exist to help guide early intervention providers in writing…

  16. Guidelines for the Design of Digital Closed Questions for Assessment and Learning in Higher Education

    Science.gov (United States)

    Draaijer, Silvester; Hartog, R. J. M.; Hofstee, J.

    2007-01-01

    Systems for computer based assessment as well as learning management systems offer a number of innovative closed question types, which are used more and more in higher education. These closed questions are used in computer based summative exams, in diagnostic tests, and in computer based activating learning material. Guidelines focusing on the…

  17. Food allergy guidelines and assessing allergic reaction risks: a regulatory perspective.

    Science.gov (United States)

    Luccioli, Stefano

    2012-06-01

    To review information in food allergy guidelines and the literature on assessing and understanding food allergic reaction risks. Current food allergy guidelines have focused on tools for better diagnosis of food allergy and treatment of reactions. These guidelines have not addressed the growing body of literature on risk assessment and diagnostic tools being used to assess dose-response relationships in relation to food-allergen exposures. The literature includes substantial data from food-allergen challenges performed in sensitive individuals, and probabilistic modeling of these data may help to elucidate the relationship between allergen dose exposures, including thresholds, and reaction risk in allergic individuals. Understanding this relationship has potential to improve the health-related quality of life of allergic consumers. Recent findings in the literature have highlighted improved diagnostic tools and other information that can be used to assess risks for allergic reaction to low-dose allergen exposures (thresholds) and reaction severity in food allergic consumers. Recommendations to better define and stratify allergic reaction risks for consumers could be adopted into guidelines for the diagnosis and clinical management of food allergy.

  18. Clinical Practice Guideline for Physical Therapy Assessment and Treatment in Patients With Nonspecific Neck Pain

    NARCIS (Netherlands)

    Bier, Jasper D; Scholten-Peeters, Wendy G M; Staal, J Bart; Pool, Jan; van Tulder, Maurits W; Beekman, Emmylou; Knoop, Jesper; Meerhoff, Guus; Verhagen, Arianne P

    2017-01-01

    The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice guideline for physical therapists that addresses the assessment and treatment of patients with nonspecific neck pain, including cervical radiculopathy, in Dutch primary care. Recommendations were based on a review of

  19. Guidelines for assessing favourable conservation status of Natura 2000 species and habitat types in Bulgaria

    NARCIS (Netherlands)

    Zingstra, H.L.; Kovachev, A.; Kitnaes, K.; Tzonev, R.; Dimova, D.; Tzvetkov, P.

    2009-01-01

    This executive summary describes the methodology for assessing the favourable conservation status of N2000 habitats and species on site level in Bulgaria and gives guidelines for its application. The methodology was developed in the frame of the BBI/Matra project 2006/014 “Favourable Conservation

  20. 49 CFR Appendix B to Part 209 - Federal Railroad Administration Guidelines for Initial Hazardous Materials Assessments

    Science.gov (United States)

    2010-10-01

    ... were International Maritime Dangerous Goods (IMDG) labels instead of 10″ placards. (Unit of violation... 49 Transportation 4 2010-10-01 2010-10-01 false Federal Railroad Administration Guidelines for Initial Hazardous Materials Assessments B Appendix B to Part 209 Transportation Other Regulations Relating...

  1. Guidelines for Assessing the Need for Adaptive Devices for Visually Impaired Pedestrians at Signalized Intersections.

    Science.gov (United States)

    Gallagher, Brian R.; de Oca, Patricia Montes

    1998-01-01

    Presents guidelines for orientation and mobility instructors and traffic engineers to assess the need for adaptive devices to make crosswalks at signalized intersections accessible to pedestrians with visual impairments. The discussions of audible and tactile pedestrian devices, along with case examples, distinguish when each device should be…

  2. Design guidelines for an umbilical cord blood stem cell therapy quality assessment model

    Science.gov (United States)

    Januszewski, Witold S.; Michałek, Krzysztof; Yagensky, Oleksandr; Wardzińska, Marta

    The paper enlists the pivotal guidelines for producing an empirical umbilical cord blood stem cell therapy quality assessment model. The methodology adapted was single equation linear model with domain knowledge derived from MEDAFAR classification. The resulting model is ready for therapeutical application.

  3. Harvesting forest biomass for energy in Minnesota: An assessment of guidelines, costs and logistics

    Science.gov (United States)

    Saleh, Dalia El Sayed Abbas Mohamed

    The emerging market for renewable energy in Minnesota has generated a growing interest in utilizing more forest biomass for energy. However, this growing interest is paralleled with limited knowledge of the environmental impacts and cost effectiveness of utilizing this resource. To address environmental and economic viability concerns, this dissertation has addressed three areas related to biomass harvest: First, existing biomass harvesting guidelines and sustainability considerations are examined. Second, the potential contribution of biomass energy production to reduce the costs of hazardous fuel reduction treatments in these trials is assessed. Third, the logistics of biomass production trials are analyzed. Findings show that: (1) Existing forest related guidelines are not sufficient to allow large-scale production of biomass energy from forest residue sustainably. Biomass energy guidelines need to be based on scientific assessments of how repeated and large scale biomass production is going to affect soil, water and habitat values, in an integrated and individual manner over time. Furthermore, such guidelines would need to recommend production logistics (planning, implementation, and coordination of operations) necessary for a potential supply with the least site and environmental impacts. (2) The costs of biomass production trials were assessed and compared with conventional treatment costs. In these trials, conventional mechanical treatment costs were lower than biomass energy production costs less income from biomass sale. However, a sensitivity analysis indicated that costs reductions are possible under certain site, prescriptions and distance conditions. (3) Semi-structured interviews with forest machine operators indicate that existing fuel reduction prescriptions need to be more realistic in making recommendations that can overcome operational barriers (technical and physical) and planning and coordination concerns (guidelines and communications

  4. True North: Building Imaginary Worlds with the Revised Canadian (CADTH Guidelines for Health Technology Assessment

    Directory of Open Access Journals (Sweden)

    Paul C Langley

    2017-05-01

    Full Text Available In March 2017 the Canadian Agency for Drugs and Technologies in Health (CADTH released the 4th edition of their Guidelines for the Economic Evaluation of Health Technologies: Canada. These guidelines, which were first published and revised for a 3rd edition in 2006 are intended to help decision makers, health systems leaders and policy makers make well-informed decisions. They are designed, apparently, to support best practice in conducting health technology assessments in Canada. The purpose of this commentary is to consider whether or not the evidence standards proposed and the consequent modeled claims for economic effectiveness meet the standards of normal science: are the CADTH standards capable of generating claims for competing products that are credible, evaluable and replicable? The review argues that the standards proposed by CADTH do not meet the standards expected in normal science. Technical sophistication in building reference case imaginary worlds is not a substitute for claims that are experimentally evaluable or capable of assessment through systematic observation. There is no way of judging whether imaginary claims are right or even if they are wrong. CADTH is not alone in setting standards that fail to meet the standards of normal science. Recent commentaries on formulary submission guidelines in a number of other countries, to include Ireland, the Netherlands, France, Australia, the UK and New Zealand conclude that they are subject to the same criticism. If the CADTH guidelines were never intended to support feedback to health system decision makers, then this should be made clear. If not, then consideration should be given to withdrawing the guidelines to ensure they conform to these standards. Hopefully, future versions of the CADTH guidelines will address this issue and focus on a rigorous research program of claims assessment and feedback and not the building of imaginary worlds.   Type:  Commentary

  5. Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.

    OpenAIRE

    Peter, W.F.H.; Jansen, M.J.; Hurkmans, E.J.; Bloo, H.; Dekker-Bakker, L.M.M.C.J.; Dilling, R.G.; Hilberdink, W.K.H.A.; Kersten-Smit, C.; Rooij, M. de; Veenhof, C.; Vermeulen, H.M.; Vos, R.J. de; Schoones, J.W.; Vliet Vlieland, T.P.M.

    2011-01-01

    BACKGROUND: An update of a Dutch physiotherapy practice guideline in Hip and Knee Osteoarthritis (HKOA) was made, based on current evidence and best practice. METHODS: A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters: initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and...

  6. Critical appraisal guidelines for assessing the quality and impact of user involvement in research.

    Science.gov (United States)

    Wright, David; Foster, Claire; Amir, Ziv; Elliott, Jim; Wilson, Roger

    2010-12-01

    The involvement of service users in the design and conduct of health research has developed significantly in the UK in recent years. Involving service users is now seen as a core component of good research practice for all forms of health research. Given the important role that users have in health research, it is necessary to develop guidelines for their effective involvement. Whilst guidelines are currently being formulated, there remain no criteria with which to assess user involvement in published studies and funding applications. This study offers guidelines for appraising the quality and impact of user involvement in published papers and grant applications. Appraisal guidelines for user involvement have been developed on the basis of available literature and experiences from studies involving cancer patients and carers in the design and conduct of research. Nine appraisal criteria have been developed. Criteria include issues such as 'Is the rationale for involving users clearly demonstrated?', 'Is the level of user involvement appropriate?', 'Is the recruitment strategy appropriate?', and 'Is the nature of training appropriate?' Generating and applying guidelines is vital if the impact of user involvement agenda in health research is to be understood. © 2010 University of Southampton. Health Expectations © 2010 Blackwell Publishing Ltd.

  7. Assessing the methodological quality of clinical guidelines for preventing falls of patients

    Directory of Open Access Journals (Sweden)

    Kamila Majkusová

    2016-12-01

    Full Text Available Aim: The study aimed to assess the methodological quality of selected clinical practice guidelines (CPGs for preventing risk of falling in adult patients in acute and long-term institutional care. Design: Descriptive study using qualitative research techniques. Methods: CPGs were systematically searched in databases of clinical guidelines, systematic reviews, electronic databases, and websites of organizations and professional societies, based on predefined criteria and keywords fo the period 2000-2015. After sorting and analysing 53 documents, the methodological quality of seven selected CPGs were assessed with the AGREE II generic instrument. Results: All CPGs obtained highest domain scores in the dimensions Clarity and Framework, and Purpose, while the lowest standardized scores were achieved by the Applicability and Editorial independence domains. The Rigor of development and Stakeholder Involvement domains achieved an average score. A total of three recommended guidelines showed high methodological quality: Falls. Assessment and prevention of falls in older people - 572 b., 84 % (NICE, 2013; Preventing Falls and Harm From Falls in Older People. Best Practice Guidelines for Australian Hospitals - 556 b., 84 % (ACSQHC, 2009; and Prevention of falls and fall injuries in the older adult - 559 b., 82 % (RNAO, 2005. Conclusion: Assessing the methodological quality of clinical guidelines using the AGREE instrument is one of the key steps in the process of their adaptation for other socio-cultural and organizational conditions. It would be possible to adapt and use all of the three most highly-rated CPGs to reduce risk of falling of inpatients in the Czech organizational and socio-cultural context.

  8. RELAP5/MOD2 Overview and Developmental. Assessment Results from TMl-1 Plant Transient Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lin, J. C.; Tsai, C. C.; Ransom, V. H.; Johnsen, G. W. [EGiG Idaho, Inc. Idaho National Engineering Laboratory, P.O. Box 1625, Idaho Falls, ID 83415 (United States)

    2013-02-01

    RELAP5/MOD2 is a new version of the RELAP5 thermal-hydraulic computer code containing improved modeling features that provide a generic capability for pressurized water reactor transient simulation. The objective of this paper is to provide code users with an overview of the code and to report developmental assessment results obtained from a Three Mile Island Unit One plant transient analysis. The assessment shows that the injection of highly sub-cooled water into a high-pressure primary coolant system does not cause unphysical results or pose a problem for RELAP5/MOD2. (author)

  9. Geothermal overview project: preliminary environmental assessments. Quarterly progress report, October 1, 1978--December 31, 1978

    Energy Technology Data Exchange (ETDEWEB)

    Phelps, P.L.

    1979-01-03

    The following are included: geothermal overview projects initiated in FY 1979, geothermal overview projects initiated in FY 1978, the agenda and participants in the overview planning meeting, the Oregon status reports, and the Hawaii status reports. (MHR)

  10. Hypertension Canada's 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults.

    Science.gov (United States)

    Leung, Alexander A; Daskalopoulou, Stella S; Dasgupta, Kaberi; McBrien, Kerry; Butalia, Sonia; Zarnke, Kelly B; Nerenberg, Kara; Harris, Kevin C; Nakhla, Meranda; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain; Bolli, Peter; Tremblay, Guy; McLean, Donna; Tobe, Sheldon W; Ruzicka, Marcel; Burns, Kevin D; Vallée, Michel; Prasad, G V Ramesh; Gryn, Steven E; Feldman, Ross D; Selby, Peter; Pipe, Andrew; Schiffrin, Ernesto L; McFarlane, Philip A; Oh, Paul; Hegele, Robert A; Khara, Milan; Wilson, Thomas W; Penner, S Brian; Burgess, Ellen; Sivapalan, Praveena; Herman, Robert J; Bacon, Simon L; Rabkin, Simon W; Gilbert, Richard E; Campbell, Tavis S; Grover, Steven; Honos, George; Lindsay, Patrice; Hill, Michael D; Coutts, Shelagh B; Gubitz, Gord; Campbell, Norman R C; Moe, Gordon W; Howlett, Jonathan G; Boulanger, Jean-Martin; Prebtani, Ally; Kline, Gregory; Leiter, Lawrence A; Jones, Charlotte; Côté, Anne-Marie; Woo, Vincent; Kaczorowski, Janusz; Trudeau, Luc; Tsuyuki, Ross T; Hiremath, Swapnil; Drouin, Denis; Lavoie, Kim L; Hamet, Pavel; Grégoire, Jean C; Lewanczuk, Richard; Dresser, George K; Sharma, Mukul; Reid, Debra; Lear, Scott A; Moullec, Gregory; Gupta, Milan; Magee, Laura A; Logan, Alexander G; Dionne, Janis; Fournier, Anne; Benoit, Geneviève; Feber, Janusz; Poirier, Luc; Padwal, Raj S; Rabi, Doreen M

    2017-05-01

    Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension. This year, we introduce 10 new guidelines. Three previous guidelines have been revised and 5 have been removed. Previous age and frailty distinctions have been removed as considerations for when to initiate antihypertensive therapy. In the presence of macrovascular target organ damage, or in those with independent cardiovascular risk factors, antihypertensive therapy should be considered for all individuals with elevated average systolic nonautomated office blood pressure (non-AOBP) readings ≥ 140 mm Hg. For individuals with diastolic hypertension (with or without systolic hypertension), fixed-dose single-pill combinations are now recommended as an initial treatment option. Preference is given to pills containing an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in combination with either a calcium channel blocker or diuretic. Whenever a diuretic is selected as monotherapy, longer-acting agents are preferred. In patients with established ischemic heart disease, caution should be exercised in lowering diastolic non-AOBP to ≤ 60 mm Hg, especially in the presence of left ventricular hypertrophy. After a hemorrhagic stroke, in the first 24 hours, systolic non-AOBP lowering to < 140 mm Hg is not recommended. Finally, guidance is now provided for screening, initial diagnosis, assessment, and treatment of renovascular hypertension arising from fibromuscular dysplasia. The specific evidence and rationale underlying each of these guidelines are discussed. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  11. A medication assessment tool to evaluate prescribers' adherence to evidence-based guidelines in bipolar disorder.

    Science.gov (United States)

    Al-Taweel, Dalal M; Alsuwaidan, Mohammad

    2017-08-01

    Background The goal of evidence-based clinical practice has led to an increased interest in the development of tools to measure adherence to national guidelines in different diseases. This aids in detecting and measuring inappropriate prescribing to specific patient groups by using quality standards extracted from evidence-based guidelines, and ultimately provide the basis of consistent standardized prescribing. Objective To design and validate a medication assessment tool to assess prescribers' adherence to international guideline recommendations in the management of bipolar disorder (MATBD). Setting Outpatient psychiatry clinic at a secondary healthcare setting in Kuwait. Method International guidelines concerned with the management of bipolar disorder were reviewed in order to develop MATBD. Face and content validity of the developed tool (MATBD) was performed with a research and expert group. A 4-point Likert scale was used to assess the expert group's level of agreement to individual criterion. Content validity ratio (CVR) was calculated for each criterion (n = 54) and the content validity index (CVI) was calculated for each section (n = 5) of the MATBD. Finally, feasibility testing was performed on 19 patient records to confirm the tool's fitness for purpose. Main Outcomes Measure Perceived relevance, utility, and clarity of individual criteria, and reliability of their application to clinical settings. Results Face validity and content validity were achieved with a research and expert group (n = 14). Content validity ratio (CVR) was demonstrated for 54 criteria; criteria with a negative CVR were removed. This resulted in a draft MATBD comprising of 52 criteria (CVI: 0.814). Feasibility testing on 19 patients' records resulted in a final MATBD comprising of 49 criteria divided into 3 sections: initial assessment, acute management and monitoring. Conclusion A medication assessment tool was developed and validated to be used as a means of profiling

  12. Mandibular advancement splint (MAS) therapy for obstructive sleep apnoea--an overview and quality assessment of systematic reviews.

    Science.gov (United States)

    Johal, Ama; Fleming, Padhraig S; Manek, Seema; Marinho, Valeria C C

    2015-09-01

    To conduct an overview of existing systematic reviews concerning management of obstructive sleep apnoea-hypopnoea syndrome (OSAHS) with mandibular advancement splint (MAS) and assess their methodological quality. PubMed and relevant Cochrane Library databases (CDSR, DARE, HTA) searches were performed (09.13) to identify systematic reviews investigating the response of adults with OSAHS to MAS therapy. The methodological quality of the included systematic reviews was assessed using AMSTAR, a validated tool for assessing quality. Eight systematic reviews, four incorporating meta-analyses, were identified evaluating both objective and subjective outcome measures. The effectiveness of MAS therapy was compared to no treatment (n = 1), non-active appliance (n = 6), continuous positive airway pressure (CPAP; n = 5), surgical intervention (n = 3) and a different MAS intervention (n = 4). The quality of the reviews was variable (median = 7, range = 3 to 11), with only two of higher quality (AMSTAR scores >10), one of them a Cochrane review. In this high quality and current review, the overall (pooled) effects for comparison of MAS therapy with inactive appliances, revealed significant benefits of MAS therapy in terms of both daytime sleepiness and objective apnoea-hypopnoea index (AHI) outcomes. In general, the results from the higher quality reviews concerning the effectiveness of MAS therapy for OSAHS highlight the ability of the intervention to improve OSAHS. Current reporting guidelines for systematic reviews (e.g. PRISMA) and sources of high-quality existing reviews should be closely followed to enhance the validity and relevance of future reviews.

  13. Technical Guidelines on Performing a Sediment Erosion and Deposition Assessment (SEDA) at Superfund Sites

    Science.gov (United States)

    2014-09-01

    ER D C TR -1 4- 9 Technical Guidelines on Performing a Sediment Erosion and Deposition Assessment (SEDA) at Superfund Sites En gi ne er... Superfund Sites Earl Hayter and Karl Gustavson Environmental Laboratory U.S. Army Engineer Research and Development Center 3909 Halls Ferry Road...Vicksburg, MS 39180-6199 Steve Ells Office of Superfund Remediation and Technology Innovation US Environmental Protection Agency, OSRTI 1200

  14. Assessing Palliative Care Content in Dementia Care Guidelines: A Systematic Review.

    Science.gov (United States)

    Durepos, Pamela; Wickson-Griffiths, Abigail; Hazzan, Afeez Abiola; Kaasalainen, Sharon; Vastis, Vasilia; Battistella, Lisa; Papaioannou, Alexandra

    2017-04-01

    Families of persons with dementia continue to report unmet needs during end of life (EOL). Strategies to improve care and quality of life for persons with dementia include development of clinical practice guidelines (CPGs) and an integrative palliative approach. We aimed to assess palliative care content in dementia CPGs to identify the presence or limitations of recommendations and discussion pertaining to common issues or domains affected by illness as described by the Canadian Hospice Palliative Care Association "Square of Care." A systematic review of databases and gray literature was conducted for recent CPGs. Guidelines meeting inclusion criteria were evaluated using the Appraisal of Guidelines for Research and Evaluation II instrument. Quality CPGs were analyzed through organizational template analysis using illness domains described by the "Canadian Hospice Palliative Care Association Model." The study protocol is registered at PROSPERO (CRD 42015025369). Eleven CPGs were selected and analyzed from 3779 citations. Nine guidelines demonstrated the maximum level of content regarding physical, psychological, and social care. Conversely, spiritual care was either absent (three) or minimal (three) in CPGs. Six CPGs did not address loss or grief, and seven CPGs did not address or had minimal content regarding EOL care. The lack of content surrounding grief represents a gap for this population at high risk for complicated grief and chronic sorrow. Results of this review require attention by CPG developers and researchers to develop evidence-based recommendations surrounding spiritual care, EOL, and grief. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  15. Ambiguity in guideline definitions introduces assessor bias and influences consistency in IUCN Red List status assessments

    Directory of Open Access Journals (Sweden)

    Matt W Hayward

    2015-07-01

    Full Text Available The IUCN Red List is the most widely used tool to measure extinction risk and report biodiversity trends. Accurate and standardised conservation status assessments for the IUCN Red List are limited by a lack of adequate information; and need consistent and unbiased interpretation of that information. Variable interpretation stems from a lack of quantified thresholds in certain areas of the Red List guidelines. Thus, even in situations with sufficient information to make a Red List assessment, inconsistency can occur when experts, especially from different regions, interpret the guidelines differently, thereby undermining the goals and credibility of the process. In such an information vacuum, assessors make assumptions depending on their level of Red List experience (subconscious bias and their personal values or agendas (conscious bias. We highlight two major issues where such bias influences assessments: relating to fenced subpopulations that require intensive management; and defining benchmark geographic distributions and thus the inclusion/exclusion of introduced subpopulations. We suggest assessor bias can be reduced by refining the Red List guidelines to include quantified thresholds for when to include fenced/intensively managed subpopulations or subpopulations outside the benchmark distribution; publishing case studies of difficult assessments to enhance cohesion between Specialist Groups; developing an online accreditation course on applying Red List criteria as a prerequisite for assessors; and ensuring that assessments of species subject to trade and utilisation are represented by all dissenting views (for example, both utilitarian and preservationist and reviewed by relevant Specialist Groups. We believe these interventions would ensure consistent, reliable assessments of threatened species between regions and across assessors with divergent views, and will thus improve comparisons between taxa and counteract the use of Red List

  16. Guideline appraisal with AGREE II: Systematic review of the current evidence on how users handle the 2 overall assessments.

    Directory of Open Access Journals (Sweden)

    Wiebke Hoffmann-Eßer

    Full Text Available The Appraisal of Guidelines for Research & Evaluation (AGREE II instrument is the most commonly used guideline appraisal tool. It includes 23 appraisal criteria (items organized within 6 domains and 2 overall assessments (1. overall guideline quality; 2. recommendation for use. The aim of this systematic review was twofold. Firstly, to investigate how often AGREE II users conduct the 2 overall assessments. Secondly, to investigate the influence of the 6 domain scores on each of the 2 overall assessments.A systematic bibliographic search was conducted for publications reporting guideline appraisals with AGREE II. The impact of the 6 domain scores on the overall assessment of guideline quality was examined using a multiple linear regression model. Their impact on the recommendation for use (possible answers: "yes", "yes, with modifications", "no" was examined using a multinomial regression model.118 relevant publications including 1453 guidelines were identified. 77.1% of the publications reported results for at least one overall assessment, but only 32.2% reported results for both overall assessments. The results of the regression analyses showed a statistically significant influence of all domains on overall guideline quality, with Domain 3 (rigour of development having the strongest influence. For the recommendation for use, the results showed a significant influence of Domains 3 to 5 ("yes" vs. "no" and Domains 3 and 5 ("yes, with modifications" vs. "no".The 2 overall assessments of AGREE II are underreported by guideline assessors. Domains 3 and 5 have the strongest influence on the results of the 2 overall assessments, while the other domains have a varying influence. Within a normative approach, our findings could be used as guidance for weighting individual domains in AGREE II to make the overall assessments more objective. Alternatively, a stronger content analysis of the individual domains could clarify their importance in terms of

  17. A pan-Canadian practice guideline and algorithm: screening, assessment, and supportive care of adults with cancer-related fatigue.

    Science.gov (United States)

    Howell, D; Keller-Olaman, S; Oliver, T K; Hack, T F; Broadfield, L; Biggs, K; Chung, J; Gravelle, D; Green, E; Hamel, M; Harth, T; Johnston, P; McLeod, D; Swinton, N; Syme, A; Olson, K

    2013-06-01

    The purpose of the present systematic review was to develop a practice guideline to inform health care providers about screening, assessment, and effective management of cancer-related fatigue (crf) in adults. The internationally endorsed adapte methodology was used to develop a practice guideline for pan-Canadian use. A systematic search of the literature identified a broad range of evidence: clinical practice guidelines, systematic reviews, and other guidance documents on the screening, assessment, and management of crf. The search included medline, embase, cinahl, the Cochrane Library, and other guideline and data sources to December 2009. Two clinical practice guidelines were identified for adaptation. Seven guidance documents and four systematic reviews also provided supplementary evidence to inform guideline recommendations. Health professionals across Canada provided expert feedback on the adapted recommendations in the practice guideline and algorithm through a participatory external review process. Practice guidelines can facilitate the adoption of evidence-based assessment and interventions for adult cancer patients experiencing fatigue. Development of an algorithm to guide decision-making in practice may also foster the uptake of a guideline into routine care.

  18. Needs, Effectiveness, and Gap Assessment for Key A-10C Missions: An Overview of Findings

    Science.gov (United States)

    2016-01-01

    C O R P O R A T I O N Needs, Effectiveness, and Gap Assessment for Key A-10C Missions An Overview of Findings Jeff Hagen, David Blancett, Michael...destroyed or countered by other means.5 We conducted detailed one-on-one modeling with U.S. Department of Defense (DoD) standard tools, where possible...the purposes of attacks against ground forces. As the U.S. Army becomes more dispersed , lighter, and more deployable, it is making many trade-offs

  19. EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines)

    NARCIS (Netherlands)

    Madersbacher, Stephan; Alivizatos, Gerasimos; Nordling, Jorgen; Sanz, Carlos Rioja; Emberton, Mark; de La Rosette, Jean J. M. C. H.

    2004-01-01

    Objective: To provide the first update of the EAU guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO). Methods: A systematic literature review was conducted based on the results of a MEDLINE(R) search

  20. Exposure Assessment Methods in Studies on Waste Management and Health Effects: An Overview

    Directory of Open Access Journals (Sweden)

    Andrea Spinazzè

    2017-02-01

    Full Text Available Concerns and uncertainties persist about potential environmental and health effects associated with exposure to emissions from widely adopted waste management facilities: despite a limited amount of evidence having been found for some exposure-effect associations, most of the available studies were characterized by limitations related to poor exposure assessment, which could introduce biases and weaknesses in the interpretation of results. This communication provides a brief overview of the exposure assessment methods used in studies on waste management and health effects: problems, key issues, priorities and challenges are briefly presented and discussed. The main conclusions refer to the need of newly developed and harmonized exposure assessment strategies and techniques, which represent an essential step in the study of waste-disposal facilities’ health impacts.

  1. Quality assessment of clinical practice guidelines on the treatment of hepatocellular carcinoma or metastatic liver cancer.

    Directory of Open Access Journals (Sweden)

    Yingqiang Wang

    Full Text Available OBJECTIVES: To assess the quality of the currently available clinical practice guidelines (CPGs for hepatocellular carcinoma, and provide a reference for clinicians in selecting the best available clinical protocols. METHODS: The databases of PubMed, MEDLINE, Web of Science, Chinese Biomedical Literature database (CBM, China National Knowledge Infrastructure (CNKI, WanFang, and relevant CPGs websites were systematically searched through March 2014. CPGs quality was appraised using the Appraisal of Guidelines for Research & Evaluation (AGREE II instrument, and data analysis was performed using SPSS 13.0 software. RESULTS: A total of 20 evidence-based and 20 expert consensus-based guidelines were included. The mean percentage of the domain scores were: scope and purpose 83% (95% confidence interval (CI, 81% to 86%, clarity of presentation 79% (95% CI, 73% to 86%, stakeholder involvement 39% (95% CI, 30% to 49%, editorial independence 58% (95% CI, 52% to 64%, rigor of development 39% (95% CI, 31% to 46%, and applicability 16% (95% CI, 10% to 23%. Evidence-based guidelines were superior to those established by consensus for the domains of rigor of development (p<0.001, clarity of presentation (p = 0.01 and applicability (p = 0.021. CONCLUSIONS: The overall methodological quality of CPGs for hepatocellular carcinoma and metastatic liver cancer is moderate, with poor applicability and potential conflict of interest issues. The evidence-based guidelines has become mainstream for high quality CPGs development; however, there is still need to further increase the transparency and quality of evidence rating, as well as the recommendation process, and to address potential conflict of interest.

  2. Systematic review of guidelines on cardiovascular risk assessment: Which recommendations should clinicians follow for a cardiovascular health check?

    NARCIS (Netherlands)

    Ferket, Bart S.; Colkesen, Ersen B.; Visser, Jacob J.; Spronk, Sandra; Kraaijenhagen, Roderik A.; Steyerberg, Ewout W.; Hunink, M. G. Myriam

    2010-01-01

    To appraise guidelines on cardiovascular risk assessment to guide selection of screening interventions for a health check. Guidelines in the English language published between January 1, 2003, and May 2, 2009, were retrieved using MEDLINE and CINAHL. This was supplemented by searching the National

  3. [Assessment and management of the risk for violence. An overview of the literature].

    Science.gov (United States)

    Tholen, A J

    2009-01-01

    In general psychiatry the risk of violence has to be assessed regularly, for instance in cases where civil commitment is under consideration. This article gives an overview of the actuarial instruments for risk assessment, discusses a model for the clinical assessment of risks of violence and for the compulsory management of such risks. The relevant literature was located via cross-references from key publications and via bibliographic references in specialized journals. The key words used in the search were violence, violent behaviour, dangerousness, risk assessment, risk prediction and risk management. Standardised actuarial assessment of the risk of violence is only of limited value in general psychiatric practice. Among certain high-risk groups standardised instruments targeted at the specific type of risk (acute, long-term) and at the type of decision (relating to security, treatment) can have added value within a broader clinical assessment. In general psychiatric practice a potential risk of violence should be assessed systematically in a structured manner. If there are risks of violence these can best be studied and assessed in specialised clinics or by specialized teams. Dynamic risk factors and protective factors should be evaluated systematically in cooperation with the various organizations concerned.

  4. Assessing Fidelity to Suicide Reporting Guidelines in Canadian News Media: The Death of Robin Williams.

    Science.gov (United States)

    Creed, Michael; Whitley, Rob

    2017-05-01

    Mindset is a short recently-published booklet funded by the Mental Health Commission of Canada outlining evidence-based guidelines and best practices for journalists writing about mental health and suicide. Our study aimed to assess fidelity to Mindset recommendations in Canadian newspaper reports of a recent celebrity suicide. A secondary aim is to identify common themes discussed in these newspaper articles. Articles about Robin Williams' suicide from major Canadian newspapers were gathered and coded for presence or absence of each of the 14 recommendations in the "Covering Suicide" section of Mindset. A threshold of 80% was set to test for high fidelity to the guidelines. A qualitative content analysis of the articles was also undertaken to discern common themes and social issues discussed in the articles. Fifty-five per cent of articles surpassed the 80% threshold for high fidelity, while 85% applied at least 70% of the recommendations. The recommendation most commonly overlooked was "Do tell others considering suicide how they can get help," which was absent in 73% of articles. The most common themes discussed were those of addictions and stigma. The news articles generally follow the evidence-based guidelines regarding the reporting of suicide set out in Mindset. This is a welcome development. Future research should continue to examine reporting of suicide to assess for further improvements, while also examining the wider impact of Mindset on the reporting of mental illness per se.

  5. APPLICATION OF SEDIMENT QUALITY GUIDELINES IN THE ASSESSMENT OF MANGROVE SURFACE SEDIMENT IN MENGKABONG LAGOON, SABAH, MALAYSIA

    Directory of Open Access Journals (Sweden)

    S. M. Praveena, M. Radojevic, M. H. Abdullah, A. Z. Aris

    2008-01-01

    Full Text Available There have been numerous sediment quality guidelines developed to monitor the sediments. Sediment quality guidelines are very useful to screen sediment contamination by comparing sediment contaminant concentration with the corresponding quality guideline, provide useful tools for screening sediment chemical data to identify pollutants of concern and prioritise problem sites and relatively good predictors of contaminations. However, these guidelines are chemical specific and do not include biological parameters. Aquatic ecosystems, including sediments, must be assessed in multiple components (biological data, toxicity, physicochemistry by using intregrated approaches in order to establish a complete and comprehensive set of sediment quality guidelines. Numerous sediment quality guidelines Washington Department of Ecology Sediment Quality Guideline, Australian and New Zealand Environment and Conservation Council, Swedish Environmental Sediment Quality, Screening Quick Reference Table, Portuguese Legislation on the Classification of Dredged Materials in Coastal Zones and Interim Sediment Quality Guideline for Hong Kong have been applied to the Mengkabong lagoon mangrove sediment and discussed. The most appropriate guideline that meets the prioritization criteria consistent with international initiatives and regulations is interim sediment quality values for Hong Kong. The guideline verifies that all the metals are below the Interim Sediment Quality Value-low. However, site-specific, biological testing and ecological analysis of exisiting benthics community structure related to sediment contamination are needed for final decision making in the case of Mengkabong lagoon.

  6. Preliminary Guideline for the High Temperature Structure Integrity Assessment Procedure Part I. High Temperature Structure Design Guide

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Han; Kim, J. B.; Lee, H. Y.; Park, C. G.; Joo, Y. S.; Koo, G. H.; Kim, S. H

    2007-02-15

    A preliminary guideline for the design and evaluation of LMR high temperature structure is presented based upon ASME B and PV Code, Section III, Subsection NH. The main contents of this guideline are the materials, general design, vessel, piping, core support structure, pumps, valves, fabrication, examination, and testing for the class 1 components. The ratcheting evaluation, enhanced creep assessment, welds design and evaluation, inelastic analysis approach, piping design alternatives, and bellows design method are described in appendices. A user of this guideline should follow the essential procedures and may refer to other pertinent codes, standards, laws, regulations, or other pertinent documents when this guideline does not lead to proper design of the structure. While this guideline adopts major procedures of Subsection NH, it refers to the RCC-MR and/or DDS in some amount for the items where these codes have excellency to improve this guideline.

  7. A systematic review of recent clinical practice guidelines on the diagnosis, assessment and management of hypertension.

    Directory of Open Access Journals (Sweden)

    Lubna A Al-Ansary

    Full Text Available BACKGROUND: Despite the availability of clinical practice guidelines (CPGs, optimal hypertension control is not achieved in many parts of the world; one of the challenges is the volume of guidelines on this topic and their variable quality. To systematically review the quality, methodology, and consistency of recommendations of recently-developed national CPGs on the diagnosis, assessment and the management of hypertension. METHODOLOGY/PRINCIPAL FINDINGS: MEDLINE, EMBASE, guidelines' websites and Google were searched for CPGs written in English on the general management of hypertension in any clinical setting published between January 2006 and September 2011. Four raters independently appraised each CPG using the AGREE-II instrument and 2 reviewers independently extracted the data. Conflicts were resolved by discussion or the involvement of an additional reviewer. Eleven CPGs were identified. The overall quality ranged from 2.5 to 6 out of 7 on the AGREE-II tool. The highest scores were for "clarity of presentation" (44.4%-88.9% and the lowest were for "rigour of development" (8.3%-30% for 9 CGPs. None of them clearly reported being newly developed or adapted. Only one reported having a patient representative in its development team. Systematic reviews were not consistently used and only 2 up-to-date Cochrane reviews were cited. Two CPGs graded some recommendations and related that to levels (but not quality of evidence. The CPGs' recommendations on assessment and non-pharmacological management were fairly consistent. Guidelines varied in the selection of first-line treatment, adjustment of therapy and drug combinations. Important specific aspects of care (e.g. resistant hypertension were ignored by 6/11 CPGs. The CPGs varied in methodological quality, suggesting that their implementation might not result in less variation of care or in better health-related outcomes. CONCLUSIONS/SIGNIFICANCE: More efforts are needed to promote the realistic

  8. Assessing the reliability of ecotoxicological studies: An overview of current needs and approaches.

    Science.gov (United States)

    Moermond, Caroline; Beasley, Amy; Breton, Roger; Junghans, Marion; Laskowski, Ryszard; Solomon, Keith; Zahner, Holly

    2017-07-01

    In general, reliable studies are well designed and well performed, and enough details on study design and performance are reported to assess the study. For hazard and risk assessment in various legal frameworks, many different types of ecotoxicity studies need to be evaluated for reliability. These studies vary in study design, methodology, quality, and level of detail reported (e.g., reviews, peer-reviewed research papers, or industry-sponsored studies documented under Good Laboratory Practice [GLP] guidelines). Regulators have the responsibility to make sound and verifiable decisions and should evaluate each study for reliability in accordance with scientific principles regardless of whether they were conducted in accordance with GLP and/or standardized methods. Thus, a systematic and transparent approach is needed to evaluate studies for reliability. In this paper, 8 different methods for reliability assessment were compared using a number of attributes: categorical versus numerical scoring methods, use of exclusion and critical criteria, weighting of criteria, whether methods are tested with case studies, domain of applicability, bias toward GLP studies, incorporation of standard guidelines in the evaluation method, number of criteria used, type of criteria considered, and availability of guidance material. Finally, some considerations are given on how to choose a suitable method for assessing reliability of ecotoxicity studies. Integr Environ Assess Manag 2017;13:640-651. © 2016 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2016 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

  9. Federal Radiological Monitoring and Assessment Center (FRMAC) overview of FRMAC operations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-02-01

    In the event of a major radiological emergency, 17 federal agencies with various statutory responsibilities have agreed to coordinate their efforts at the emergency scene under the umbrella of the Federal Radiological Emergency Response plan (FRERP). This cooperative effort will assure the designated Lead Federal Agency (LFA) and the state(s) that all federal radiological assistance fully supports their efforts to protect the public. The mandated federal cooperation ensures that each agency can obtain the data critical to its specific responsibilities. This Overview of the Federal Radiological Monitoring and Assessment Center (FRMAC) Operations describes the FRMAC response activities to a major radiological emergency. It also describes the federal assets and subsequent operational activities which provide federal radiological monitoring and assessment of the off-site areas. These off-site areas may include one or more affected states.

  10. Systematic review of guidelines for the assessment and management of high-grade anal intraepithelial neoplasia (AIN II/III).

    Science.gov (United States)

    Alam, N N; White, D A; Narang, S K; Daniels, I R; Smart, N J

    2016-02-01

    There is ambiguity with regard to the optimal management of anal intraepithelial neoplasia (AIN) III. The aim of this review was to assess and compare international/national society guidelines currently available in the literature on the management, treatment and surveillance of AIN III. We also aimed to assess the quality of the studies used to compile the guidelines and to clarify the terminology used in histological assessment. An electronic search of PubMed and Embase was performed using the search terms 'anal intraepithelial neoplasia', 'AIN', 'anal cancer', 'guidelines', 'surveillance' and 'management'. Literature reviews and guidelines or practice guidelines in peer reviewed journals from 1 January 2000 to 31 December 2014 assessing the treatment, surveillance or management of patients with AIN related to human papilloma virus were included. The guidelines identified by the search were assessed for the quality of evidence behind them using the Oxford Centre for Evidence-based Medicine 2011 Levels of Evidence. The database search identified 5159 articles and two further guidelines were sourced from official body guidelines. After inclusion criteria were applied, 28 full-text papers were reviewed. Twenty-five of these were excluded, leaving three guidelines for inclusion in the systematic review: those published by the Association of Coloproctology of Great Britain and Ireland, the American Society of Colon and Rectal Surgeons and the Italian Society of Colorectal Surgery. No guidelines were identified on the management of AIN III from human papilloma virus associations and societies. All three guidelines agree that a high index of clinical suspicion is essential for diagnosing AIN with a disease-specific history, physical examination, digital rectal examination and anal cytology. There is interchange of terminology from high-grade AIN (HGAIN) (which incorporates AIN II/III) and AIN III in the literature leading to confusion in therapy use. Treatment varies

  11. Reducing aquatic hazards of industrial chemicals: probabilistic assessment of sustainable molecular design guidelines.

    Science.gov (United States)

    Connors, Kristin A; Voutchkova-Kostal, Adelina M; Kostal, Jakub; Anastas, Paul; Zimmerman, Julie B; Brooks, Bryan W

    2014-08-01

    Basic toxicological information is lacking for the majority of industrial chemicals. In addition to increasing empirical toxicity data through additional testing, prospective computational approaches to drug development aim to serve as a rational basis for the design of chemicals with reduced toxicity. Recent work has resulted in the derivation of a "rule of 2," wherein chemicals with an octanol-water partition coefficient (log P) less than 2 and a difference between the lowest unoccupied molecular orbital and the highest occupied molecular orbital (ΔE) greater than 9 (log P9 eV) are predicted to be 4 to 5 times less likely to elicit acute or chronic toxicity to model aquatic organisms. The present study examines potential reduction of aquatic toxicity hazards from industrial chemicals if these 2 molecular design guidelines were employed. Probabilistic hazard assessment approaches were used to model the likelihood of encountering industrial chemicals exceeding toxicological categories of concern both with and without the rule of 2. Modeling predicted that utilization of these molecular design guidelines for log P and ΔE would appreciably decrease the number of chemicals that would be designated to be of "high" and "very high" concern for acute and chronic toxicity to standard model aquatic organisms and end points as defined by the US Environmental Protection Agency. For example, 14.5% of chemicals were categorized as having high and very high acute toxicity to the fathead minnow model, whereas only 3.3% of chemicals conforming to the design guidelines were predicted to be in these categories. Considerations of specific chemical classes (e.g., aldehydes), chemical attributes (e.g., ionization), and adverse outcome pathways in representative species (e.g., receptor-mediated responses) could be used to derive future property guidelines for broader classes of contaminants. © 2014 SETAC.

  12. Guidelines for hazard evaluation procedures

    National Research Council Canada - National Science Library

    2008-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxi 1 . Hazard Evaluation Procedures ... Management Overview ... ... Part I Preface 11 Introduction to the Guidelines 1.1 Background ... 1.2 Relationship...

  13. Appraisal of the Glasgow assessment and management of alcohol guideline: a comprehensive alcohol management protocol for use in general hospitals.

    Science.gov (United States)

    McPherson, A; Benson, G; Forrest, E H

    2012-07-01

    Guidelines exist for the management of alcohol withdrawal syndrome (AWS) but few have been assessed as to their suitability for general hospitals. The Glasgow Assessment and Management guideline for alcohol has been specifically developed for use in this context. To determine if this alcohol assessment guideline aids the management of AWS in general hospitals. The four components of the Glasgow Assessment and Management of Alcohol guideline were evaluated. This included the use of the Fast Alcohol Screening Test (FAST) to identify at risk patients, a risk stratification strategy to indicate fixed dose or symptom-triggered benzodiazepine treatment, the Glasgow Modified Alcohol Withdrawal Scale (GMAWS) for symptom-triggered treatment and a clear recommendation for vitamin prophylaxis of Wernicke's encephalopathy. FAST scores were assessed along with the CAGE (cut down, annoyed, guilty and eye-opener) screening tool to ascertain if a single screening tool could identify hazardous and dependent drinking. The GMAWS and Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) were compared between two medical units. A staff survey of the two AWS tools was also carried out. FAST was able to identify both probable hazardous and dependent drinking. The GMAWS was reliable and gauged both physical and cognitive aspects of AWS. Staff generally preferred the GMAWS-based treatment as opposed to CIWA-Ar management and welcomed the Guideline as a whole. The Glasgow Guideline aids the management of patients with AWS in an acute hospital setting. It allows early identification of at risk patients and directs effective therapeutic intervention.

  14. Guidelines for the assessment and acceptance of potential brain-dead organ donors.

    Science.gov (United States)

    Westphal, Glauco Adrieno; Garcia, Valter Duro; Souza, Rafael Lisboa de; Franke, Cristiano Augusto; Vieira, Kalinca Daberkow; Birckholz, Viviane Renata Zaclikevis; Machado, Miriam Cristine; Almeida, Eliana Régia Barbosa de; Machado, Fernando Osni; Sardinha, Luiz Antônio da Costa; Wanzuita, Raquel; Silvado, Carlos Eduardo Soares; Costa, Gerson; Braatz, Vera; Caldeira Filho, Milton; Furtado, Rodrigo; Tannous, Luana Alves; Albuquerque, André Gustavo Neves de; Abdala, Edson

    2016-09-01

    Organ transplantation is the only alternative for many patients with terminal diseases. The increasing disproportion between the high demand for organ transplants and the low rate of transplants actually performed is worrisome. Some of the causes of this disproportion are errors in the identification of potential organ donors and in the determination of contraindications by the attending staff. Therefore, the aim of the present document is to provide guidelines for intensive care multi-professional staffs for the recognition, assessment and acceptance of potential organ donors.

  15. Assessing the IADC Space Debris Mitigation Guidelines: A Case for Ontology-based Data Management

    Science.gov (United States)

    Walls, R.; Gaylor, D.; Reddy, V.; Furfaro, R.; Jah, M.

    2016-09-01

    As the population of man-made debris orbiting the Earth increases, so does the risk of damaging collisions. The Inter-Agency Space Debris Coordination Committee (IADC) has issued space debris mitigation guidelines including a key recommendation that before mission's end, spacecraft should move far enough from GEO so as not to be an operational hazard to other objects in active missions. It can be extremely difficult to determine if a spacecraft or operator is in compliance with this guideline, as it requires prediction of future actions based upon many data types. Furthermore, there has been no comprehensive assessment of the adequacy or validity of the IADC recommendations. The EU strives for a Code of Conduct in space, the United Nations-Committee On Peaceful Uses of Outer Space (UN-COPUOS) strives for guidelines to ensure the Long Term Sustainability of Space Activities (LTSSA), the FAA is concerned with Space Traffic Management (STM), etc. If rules, policies, guidelines, and laws are put in place, how can any entity know who and what is adhering to them, when we don't even know how to quantify and assess behavior of space objects? The University of Arizona aims to address this salient issue. As part of its new Space Object Behavioral Sciences (SOBS) initiative, the University of Arizona is developing an ontology-based system to support integration, use, and sharing of space domain data. As a first use-case, we will test the system's ability to assess compliance with the IADC recommendation to move beyond GEO at the end of a mission as well as the adequacy and validity of recommendations. We describe the relevant data types gathered for this use-case, present a prototype ontology, and outline methods for combining semantic analysis with astrodynamics modeling. Without loss of generality, we present this method as an approach that will form the foundation of SOBS and be used to address pressing challenges in Space Situational Awareness (SSA), Orbital Safety

  16. 78 FR 14510 - Notice of Availability of New Guidelines for Pest Risk Assessments of Imported Fruits and Vegetables

    Science.gov (United States)

    2013-03-06

    ... Assessments of Imported Fruits and Vegetables AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION... health pest risk assessments for imported fruit and vegetable commodities. These new guidelines are...-initiated, qualitative pest risk assessments (PRAs) for imports of fruits and vegetables. A PRA is defined...

  17. Overview of the need for modelling development in offshore QRA [Quantitative Risk Assessment] studies

    Energy Technology Data Exchange (ETDEWEB)

    Vinnem, J.E. [Preventor AS, Bryne (Norway); Pappas, J. [Norsk Hydro a.s., Stabekk (Norway); Cox, R.A. [SafetyCraft Ltd., Morden (United Kingdom)

    1997-12-31

    An overview of the use of QRA (Quantitative Risk Assessment) in the last 15-20 years for the North Sea offshore industry is presented, in addition to the most recent and current use of these studies. The objectives for the use of QRA studies are discussed in relation to regulatory compliance and active HSE management. The needs for further development of the QRA methodology is discussed in relation to the objectives, especially in relation to more cost effective management of HSE risks. The role that the ESRA QRA Work Group has defined for itself is briefly outlined, as well as the Group`s perspectives and current working objectives. It is concluded that there is still considerable potential for further improvement of the methodology, and the Work Group intends to assist in this development. (Author)

  18. Developing search strategies for clinical practice guidelines in SUMSearch and Google Scholar and assessing their retrieval performance

    Directory of Open Access Journals (Sweden)

    Kirchner Hanna

    2007-06-01

    Full Text Available Abstract Background Information overload, increasing time constraints, and inappropriate search strategies complicate the detection of clinical practice guidelines (CPGs. The aim of this study was to provide clinicians with recommendations for search strategies to efficiently identify relevant CPGs in SUMSearch and Google Scholar. Methods We compared the retrieval efficiency (retrieval performance of search strategies to identify CPGs in SUMSearch and Google Scholar. For this purpose, a two-term GLAD (GuideLine And Disease strategy was developed, combining a defined CPG term with a specific disease term (MeSH term. We used three different CPG terms and nine MeSH terms for nine selected diseases to identify the most efficient GLAD strategy for each search engine. The retrievals for the nine diseases were pooled. To compare GLAD strategies, we used a manual review of all retrievals as a reference standard. The CPGs detected had to fulfil predefined criteria, e.g., the inclusion of therapeutic recommendations. Retrieval performance was evaluated by calculating so-called diagnostic parameters (sensitivity, specificity, and "Number Needed to Read" [NNR] for search strategies. Results The search yielded a total of 2830 retrievals; 987 (34.9% in Google Scholar and 1843 (65.1% in SUMSearch. Altogether, we found 119 unique and relevant guidelines for nine diseases (reference standard. Overall, the GLAD strategies showed a better retrieval performance in SUMSearch than in Google Scholar. The performance pattern between search engines was similar: search strategies including the term "guideline" yielded the highest sensitivity (SUMSearch: 81.5%; Google Scholar: 31.9%, and search strategies including the term "practice guideline" yielded the highest specificity (SUMSearch: 89.5%; Google Scholar: 95.7%, and the lowest NNR (SUMSearch: 7.0; Google Scholar: 9.3. Conclusion SUMSearch is a useful tool to swiftly gain an overview of available CPGs. Its retrieval

  19. Basic overview towards the assessment of landslide and subsidence risks along a geothermal pipeline network

    Science.gov (United States)

    Astisiasari; Van Westen, Cees; Jetten, Victor; van der Meer, Freek; Rahmawati Hizbaron, Dyah

    2017-12-01

    An operating geothermal power plant consists of installation units that work systematically in a network. The pipeline network connects various engineering structures, e.g. well pads, separator, scrubber, and power station, in the process of transferring geothermal fluids to generate electricity. Besides, a pipeline infrastructure also delivers the brine back to earth, through the injection well-pads. Despite of its important functions, a geothermal pipeline may bear a threat to its vicinity through a pipeline failure. The pipeline can be impacted by perilous events like landslides, earthquakes, and subsidence. The pipeline failure itself may relate to physical deterioration over time, e.g. due to corrosion and fatigue. The geothermal reservoirs are usually located in mountainous areas that are associated with steep slopes, complex geology, and weathered soil. Geothermal areas record a noteworthy number of disasters, especially due to landslide and subsidence. Therefore, a proper multi-risk assessment along the geothermal pipeline is required, particularly for these two types of hazard. This is also to mention that the impact on human fatality and injury is not presently discussed here. This paper aims to give a basic overview on the existing approaches for the assessment of multi-risk assessment along geothermal pipelines. It delivers basic principles on the analysis of risks and its contributing variables, in order to model the loss consequences. By considering the loss consequences, as well as the alternatives for mitigation measures, the environmental safety in geothermal working area could be enforced.

  20. Performance assessment calculational exercises; PACE [Performance Assessment Calculational Exercises]-90: Overview and summary

    Energy Technology Data Exchange (ETDEWEB)

    Barnard, R.W.; Dockery, H.A.

    1990-10-01

    The Performance Assessment Calculational Exercises (PACE) are an ongoing effort coordinated by Yucca Mountain Project Office. The objectives of fiscal year 1990 work, termed PACE-90, as outlined in the Department of Energy Performance Assessment (PA) Implementation Plan were to develop PA capabilities among Yucca Mountain Project (YMP) participants by calculating performance of a Yucca Mountain (YM) repository under ``expected`` and also ``disturbed`` conditions, to identify critical elements and processes necessary to assess the performance of YM, and to perform sensitivity studies on key parameters. It was expected that the PACE problems would aid in development of conceptual models and eventual evaluation of site data. The PACE-90 participants calculated transport of a selected set of radionuclides through a portion of Yucca Mountain for a period of 100,000 years. Results include analyses of fluid-flow profiles, development of a source term for radionuclide release, and simulations of contaminant transport in the fluid-flow field. Later work included development of a problem definition for perturbations to the originally modeled conditions and for some parametric sensitivity studies. 3 refs.

  1. Methodology Guidelines on Life Cycle Assessment of Photovoltaic Electricity: 3rd Edition

    Energy Technology Data Exchange (ETDEWEB)

    Frischknecht, Rolf; Heath, Garvin; Raugei, Marco; Sinha, Parikhit; de Wild-Scholten, Mariska

    2016-01-01

    Life Cycle Assessment (LCA) is a structured, comprehensive method of quantifying material- and energy-flows and their associated emissions caused in the life cycle of goods and services. The ISO 14040 and 14044 standards provide the framework for LCA. However, this framework leaves the individual practitioner with a range of choices that can affect the results and thus the conclusions of an LCA study. The current IEA guidelines were developed to provide guidance on assuring consistency, balance, and quality to enhance the credibility and reliability of the results from LCAs on photovoltaic (PV) electricity generation systems. The guidelines represent a consensus among the authors - PV LCA experts in North America, Europe, and Asia - for assumptions made on PV performance, decisions on process input and emissions allocation, methods of analysis, and reporting of the results. Guidance is given on PV-specific parameters used as inputs in LCA and on choices and assumptions in life cycle inventory (LCI) data analysis and on implementation of modeling approaches. A consistent approach towards system modeling, the functional unit, the system boundaries, water use modeling and the allocation aspects enhances the credibility of PV electricity LCA studies and enables balanced LCA-based comparisons of different electricity producing technologies. The document discusses metrics like greenhouse gas emissions (GHG), cumulative energy demand (CED), acidification potential (AP), ozone depletion potential (ODP), human toxicity, ecotoxicity and ionizing radiation. Guidance is given for the definition of the energy payback time (EPBT), the nonrenewable energy payback time (NREPBT), and the impact mitigation potentials (IMP). The indicator energy return on investment (EROI) is described in a separate International Energy Agency (IEA) PV Power Systems (PVPS) Task 12 report (Raugei et al. 2015). The guidelines on the reporting and communication of the results serve the need for

  2. Hyperemesis gravidarum: a holistic overview and approach to clinical assessment and management.

    Science.gov (United States)

    Castillo, Melody J; Phillippi, Julia C

    2015-01-01

    Hyperemesis gravidarum (HG) is a rare and severe form of nausea and vomiting of pregnancy associated with significant costs and psychosocial impacts. The etiology of HG remains largely unknown, although maternal genetics and placental factors are suspected. Prompt recognition and treatment of HG are essential to minimize associated maternal and fetal morbidity. Diagnosis is made on the basis of typical presentation, with exclusion of other causes of severe nausea and vomiting of pregnancy. Validated clinical tools are available to assess severity of symptoms and guide plans of care. Evidence to guide management of HG is limited, but many nonpharmacologic and pharmacologic interventions are available with published guidelines to inform implementation. Care of the woman with HG requires compassion and acknowledgement of individual needs and responses to interventions.

  3. Guideline appraisal with AGREE II: Systematic review of the current evidence on how users handle the 2 overall assessments

    Science.gov (United States)

    Siering, Ulrich; Neugebauer, Edmund A. M.; Brockhaus, Anne Catharina; Lampert, Ulrike; Eikermann, Michaela

    2017-01-01

    Introduction The Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument is the most commonly used guideline appraisal tool. It includes 23 appraisal criteria (items) organized within 6 domains and 2 overall assessments (1. overall guideline quality; 2. recommendation for use). The aim of this systematic review was twofold. Firstly, to investigate how often AGREE II users conduct the 2 overall assessments. Secondly, to investigate the influence of the 6 domain scores on each of the 2 overall assessments. Materials and methods A systematic bibliographic search was conducted for publications reporting guideline appraisals with AGREE II. The impact of the 6 domain scores on the overall assessment of guideline quality was examined using a multiple linear regression model. Their impact on the recommendation for use (possible answers: “yes”, “yes, with modifications”, “no”) was examined using a multinomial regression model. Results 118 relevant publications including 1453 guidelines were identified. 77.1% of the publications reported results for at least one overall assessment, but only 32.2% reported results for both overall assessments. The results of the regression analyses showed a statistically significant influence of all domains on overall guideline quality, with Domain 3 (rigour of development) having the strongest influence. For the recommendation for use, the results showed a significant influence of Domains 3 to 5 (“yes” vs. “no”) and Domains 3 and 5 (“yes, with modifications” vs. “no”). Conclusions The 2 overall assessments of AGREE II are underreported by guideline assessors. Domains 3 and 5 have the strongest influence on the results of the 2 overall assessments, while the other domains have a varying influence. Within a normative approach, our findings could be used as guidance for weighting individual domains in AGREE II to make the overall assessments more objective. Alternatively, a stronger content analysis

  4. Assessment of medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Dilnasheen Sheikh

    2017-06-01

    Full Text Available The objective of the study is to assess the medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital. A prospective observational study was carried out for a period of 8 months from June 2015 to February 2016 at tertiary care hospital. At inpatient department regular chart review of patient case records was carried out to assess the medication errors. The observed medication errors were assessed for level of harm by using NCCMERP index. The outpatient prescriptions were screened for adherence to WHO prescription writing guidelines. Out of 200 patients, 40 patients developed medication errors. Most of the medication errors were observed in the age group above 61 years (40%. Majority of the medication errors were observed with drug class of antibiotics 9 (22.5% and bronchodilators 9 (22.5%. Most of the errors were under the NCCMERP index category C. Out of 545 outpatient prescriptions, 51 (9.37% prescriptions did not have prescriber’s name and all of the prescriptions lack prescriber’s personal contact number. Eighteen prescriptions did not have patient’s name and 426 (78.2% prescriptions did not have patient’s age. The prevalence of medication errors in this study was relatively low (20% without any fatal outcome. Omission error was the most frequently observed medication errors 31 (77.5%. In the present study, the patient’s age was missing in 78.2% of the prescriptions and none of the prescriptions had patient’s address and the drug names were not mentioned by their generic names.

  5. Guidelines for exposure assessment in health risk studies following a nuclear reactor accident.

    Science.gov (United States)

    Bouville, André; Linet, Martha S; Hatch, Maureen; Mabuchi, Kiyohiko; Simon, Steven L

    2014-01-01

    Worldwide concerns regarding health effects after the Chernobyl and Fukushima nuclear power plant accidents indicate a clear need to identify short- and long-term health impacts that might result from accidents in the future. Fundamental to addressing this problem are reliable and accurate radiation dose estimates for the affected populations. The available guidance for activities following nuclear accidents is limited with regard to strategies for dose assessment in health risk studies. Here we propose a comprehensive systematic approach to estimating radiation doses for the evaluation of health risks resulting from a nuclear power plant accident, reflected in a set of seven guidelines. Four major nuclear reactor accidents have occurred during the history of nuclear power production. The circumstances leading to these accidents were varied, as were the magnitude of the releases of radioactive materials, the pathways by which persons were exposed, the data collected afterward, and the lifestyle factors and dietary consumption that played an important role in the associated radiation exposure of the affected populations. Accidents involving nuclear reactors may occur in the future under a variety of conditions. The guidelines we recommend here are intended to facilitate obtaining reliable dose estimations for a range of different exposure conditions. We recognize that full implementation of the proposed approach may not always be feasible because of other priorities during the nuclear accident emergency and because of limited resources in manpower and equipment. The proposed approach can serve as a basis to optimize the value of radiation dose reconstruction following a nuclear reactor accident.

  6. Audit of a tertiary heart failure outpatient service to assess compliance with NICE guidelines.

    Science.gov (United States)

    Guha, Kaushik; Allen, Christopher J; Chawla, Sumir; Pryse-Hawkins, Hayley; Fallon, Laura; Chambers, Vicki; Vazir, Ali; Lyon, Alex R; Cowie, Martin R; Sharma, Rakesh

    2016-10-01

    The National Institute for Health and Care Excellence (NICE) updated its guidelines for chronic heart failure (HF) in 2010. This re-audit assessed interim improvement as compared with an audit in 2011. Patients with HF (preserved and reduced ejection fraction) attending a tertiary cardiac centre over a 2-year period (January 2013-December 2014) were audited. The data collected included demographics, HF aetiology, medications, clinical parameters and cardiac rehabilitation. In total, 513 patients were audited. Compared with 2011, male preponderance (71%) and age (68±14 years, (Mean ± SD)) were similar. 73% of patients lived outside of London. HF aetiologies included ischaemic heart disease (37% versus 40% in 2011), dilated cardiomyopathy (26% versus 20%) primary valve disease (13% versus 12%). For patients with left ventricular systolic dysfunction (n=434, 85% of patients audited) 89% were taking beta-blockers (compared with 77% in 2011), 91% an angiotensin converting enzyme inhibitor or angiotensin receptor blocker (86% in 2011) and 56% a mineralocorticoid receptor antagonist (44% in 2011); 6% were prescribed ivabradine. All patients were reviewed at least 6-monthly. Although 100% of patients were educated about exercise, only 21 (4%) enrolled in a supervised exercise programme. This audit demonstrated high rates of documentation, follow-up and compliance with guideline-based medical therapies. A consistent finding was poor access to cardiac rehabilitation. © Royal College of Physicians 2016. All rights reserved.

  7. The North American Regional Climate Change Assessment Program: Overview of Climate Change Results

    Science.gov (United States)

    Mearns, L. O.

    2012-12-01

    The North American Regional Climate Change Assessment Program (NARCCAP) is an international program that is serving the climate scenario needs of the United States, Canada, and northern Mexico. We are systematically investigating the uncertainties in regional scale projections of future climate and producing high resolution climate change scenarios using multiple regional climate models (RCMs) and multiple global model responses by nesting the RCMs within atmosphere ocean general circulation models (AOGCMs) forced with a medium-high emissions scenario, over a domain covering the conterminous US, northern Mexico, and most of Canada. The project also includes a validation component through nesting the participating RCMs within the NCEP reanalysis R2. The basic spatial resolution of the RCM simulations is 50 km. This program includes six different RCMs that have been used in various intercomparison programs in Europe and the United States. Four different AOGCMs provide boundary conditions to drive the RCMS for 30 years in the current climate and 30 years for the mid 21st century. The resulting climate model simulations form the basis for multiple high resolution climate scenarios that can be used in climate change impacts and adaptation assessments over North America. All 12 sets of current and future simulations have been completed. Measures of uncertainty across the multiple simulations are being developed by geophysical statisticians. In this overview talk, results from the various climate change experiments for various subregions, along with measures of uncertainty, will be presented

  8. Effectiveness of peer assessment for implementing a dutch physical therapy low back pain guideline: cluster randomized controlled trial

    NARCIS (Netherlands)

    Dulmen, S.A. van; Maas, Marjo; Staal, J.B.; Rutten, G.; Kiers, H.; Nijhuis-Van der Sanden, M.W.G.; Wees, P. van der

    2014-01-01

    BACKGROUND: Clinical practice guidelines are considered important instruments to improve quality of care. However, success is dependent on adherence, which may be improved using peer assessment, a strategy in which professionals assess performance of their peers in a simulated setting. OBJECTIVE:

  9. Factors controlling volume errors through 2D gully erosion assessment: guidelines for optimal survey design

    Science.gov (United States)

    Castillo, Carlos; Pérez, Rafael

    2017-04-01

    The assessment of gully erosion volumes is essential for the quantification of soil losses derived from this relevant degradation process. Traditionally, 2D and 3D approaches has been applied for this purpose (Casalí et al., 2006). Although innovative 3D approaches have recently been proposed for gully volume quantification, a renewed interest can be found in literature regarding the useful information that cross-section analysis still provides in gully erosion research. Moreover, the application of methods based on 2D approaches can be the most cost-effective approach in many situations such as preliminary studies with low accuracy requirements or surveys under time or budget constraints. The main aim of this work is to examine the key factors controlling volume error variability in 2D gully assessment by means of a stochastic experiment involving a Monte Carlo analysis over synthetic gully profiles in order to 1) contribute to a better understanding of the drivers and magnitude of gully erosion 2D-surveys uncertainty and 2) provide guidelines for optimal survey designs. Owing to the stochastic properties of error generation in 2D volume assessment, a statistical approach was followed to generate a large and significant set of gully reach configurations to evaluate quantitatively the influence of the main factors controlling the uncertainty of the volume assessment. For this purpose, a simulation algorithm in Matlab® code was written, involving the following stages: - Generation of synthetic gully area profiles with different degrees of complexity (characterized by the cross-section variability) - Simulation of field measurements characterised by a survey intensity and the precision of the measurement method - Quantification of the volume error uncertainty as a function of the key factors In this communication we will present the relationships between volume error and the studied factors and propose guidelines for 2D field surveys based on the minimal survey

  10. Comparison of test specific sediment effect concentrations with marine sediment quality assessment guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Carr, R.S.; Biedenbach, J.M. [National Biological Service, Corpus Christi, TX (United States). Marine Ecotoxicology Research Station; Long, E.R. [NOAA, Seattle, WA (United States); MacDonald, D.D. [MacDonald Environmental Sciences Ltd., Ladysmith, British Columbia (Canada)

    1995-12-31

    As part of NOAA`s National Status and Trends (NS and T) Bioeffects Assessment program and studies conducted by the National Biological Service, numerous sediment quality assessment surveys have recently been conducted along the Atlantic and Gulf coasts of the US using the sea urchin (Arbacia punctulata) fertilization and embryological development tests with pore water. Additional toxicity tests were also conducted in conjunction with most of these studies. The areas that have been sampled include Boston harbor, Massachusetts; Charleston Harbor, Winyah Bay, and Savannah River, South Carolina; St. Simon Sound, Georgia; Biscayne Bay, Tampa Bay, Choctawhatchee Bay, Apalachicola Bay, St. Andrew Bay, and Pensacola Bay, Florida; Galveston Bay, Lavaca Bay, and Sabine Lake, Texas, and 200 stations in the vicinity of offshore oil and gas production platforms in the Gulf of Mexico. Sufficient data are now available from this series of surveys to calculate test specific sediment effect concentrations (SECs). Based on these recent studies, SECs were developed for the sea urchin porewater and amphipod tests and compared with existing marine sediment quality assessment guidelines.

  11. HAS Should Not Be NICE: Rejecting Imaginary Worlds in the French Technology Assessment Guidelines

    Directory of Open Access Journals (Sweden)

    Paul C Langley

    2017-01-01

    Full Text Available Pricing decisions and access to pharmaceuticals should be evidence based. Unfortunately, the French guidelines for technology assessment, in their adoption of the National Institute for Health and Clinical Excellence (NICE reference case modeling standard ensure that this is not the case. Rather than requiring the submission of claims that are credible, evaluable and replicable, the Haute Autorité de Sante (HAS mandates the creation of imaginary worlds to support comparative effectiveness and cost-outcome claims. The purpose of this commentary is to make the case that HAS should reconsider this commitment to standards for health technology assessment that are more appropriately seen as pseudoscience. The recommendation is that HAS should put to one side mandating lifetime cost-per-quality adjusted life year (QALY or life years saved claims in favor of short-term claims that can be evaluated and reported to health system decision makers as part of a provisional assessment of new products as well as supporting ongoing disease area and therapeutic class reviews.   Type: Commentary

  12. The development and validation of the guidelines for stalking assessment and management.

    Science.gov (United States)

    Kropp, P Randall; Hart, Stephen D; Lyon, David R; Storey, Jennifer E

    2011-01-01

    International research has established that stalking is a prevalent problem with serious and often life-threatening consequences for victims. Stalking is also a unique form of violence due to its nature and diversity, making it difficult for criminal justice and health professionals to establish which perpetrators and victims have the greatest need for services and protection. Risk assessment is one way to address these problems but few tools exist. This article describes the development of the Guidelines for Stalking Assessment and Management (SAM), the first risk assessment instrument designed specifically for the stalking situation. Preliminary data are presented, indicating that the SAM has promise for use by professionals working with stalkers and their victims. Results indicated that interrater reliabilities for the SAM risk factors and total scores range from fair to good, and the structural reliability of the SAM is sound. Moreover, the SAM showed good concurrent validity when compared with two other measures of violence propensity: the Psychopathy Checklist Screening Version (PCL:SV) and the Violence Risk Appraisal Guide (VRAG). Limitations of the study are discussed, especially those related to the difficulties inherent in file-based research, and suggestions for future research are offered. Copyright © 2011 John Wiley & Sons, Ltd.

  13. [Absolute risk for fracture and WHO guideline. Fracture risk assessments recommended by World Health Organization and Japanese guidelines for prevention and treatment of osteoporosis 2006].

    Science.gov (United States)

    Nakamura, Toshitaka

    2007-07-01

    Bone mineral density (BMD) is a strong predictor of osteoporotic fractures. However, the increase in fracture risk is not steep, rather gentle, for the decline in BMD values. Postmenopausal women with osteopenia (T scores between - 2.5 and - 1.0) may also be at risk. Case finding strategies such as the combination of BMD and appropriate clinical risk factors for fracture are shown to identify subjects at high fracture risk. World Health Organization developed a fracture risk assessment tool, recommending its exploitation in the case findings. Under these circumstances, Japan guideline 2006 provided new criteria for the pharmacological intervention to prevent fragility fracture, besides the conventional criteria for diagnosing osteoporosis.

  14. A multiple-scenario assessment of the effect of a continuous-care, guideline-based decision support system on clinicians' compliance to clinical guidelines.

    Science.gov (United States)

    Shalom, Erez; Shahar, Yuval; Parmet, Yisrael; Lunenfeld, Eitan

    2015-04-01

    To quantify the effect of a new continuous-care guideline (GL)-application engine, the Picard decision support system (DSS) engine, on the correctness and completeness of clinicians' decisions relative to an established clinical GL, and to assess the clinicians' attitudes towards a specific DSS. Thirty-six clinicians, including residents at different training levels and board-certified specialists at an academic OB/GYN department that handles around 15,000 deliveries annually, agreed to evaluate our continuous-care guideline-based DSS and to perform a cross-over assessment of the effects of using our guideline-based DSS. We generated electronic patient records that realistically simulated the longitudinal course of six different clinical scenarios of the preeclampsia/eclampsia/toxemia (PET) GL, encompassing 60 different decision points in total. Each clinician managed three scenarios manually without the Picard DSS engine (Non-DSS mode) and three scenarios when assisted by the Picard DSS engine (DSS mode). The main measures in both modes were correctness and completeness of actions relative to the PET GL. Correctness was further decomposed into necessary and redundant actions, relative to the guideline and the actual patient data. At the end of the assessment, a questionnaire was administered to the clinicians to assess their perceptions regarding use of the DSS. With respect to completeness, the clinicians applied approximately 41% of the GL's recommended actions in the non-DSS mode. Completeness increased to the performance of approximately 93% of the guideline's recommended actions, when using the DSS mode. With respect to correctness, approximately 94.5% of the clinicians' decisions in the non-DSS mode were correct. However, these included 68% of the actions that were correct but redundant, given the patient's data (e.g., repeating tests that had been performed), and 27% of the actions, which were necessary in the context of the GL and of the given scenario

  15. An overview of the evolution of human reliability analysis in the context of probabilistic risk assessment.

    Energy Technology Data Exchange (ETDEWEB)

    Bley, Dennis C. (Buttonwood Consulting Inc., Oakton, VA); Lois, Erasmia (U.S. Nuclear Regulatory Commission, Washington, DC); Kolaczkowski, Alan M. (Science Applications International Corporation, Eugene, OR); Forester, John Alan; Wreathall, John (John Wreathall and Co., Dublin, OH); Cooper, Susan E. (U.S. Nuclear Regulatory Commission, Washington, DC)

    2009-01-01

    Since the Reactor Safety Study in the early 1970's, human reliability analysis (HRA) has been evolving towards a better ability to account for the factors and conditions that can lead humans to take unsafe actions and thereby provide better estimates of the likelihood of human error for probabilistic risk assessments (PRAs). The purpose of this paper is to provide an overview of recent reviews of operational events and advances in the behavioral sciences that have impacted the evolution of HRA methods and contributed to improvements. The paper discusses the importance of human errors in complex human-technical systems, examines why humans contribute to accidents and unsafe conditions, and discusses how lessons learned over the years have changed the perspective and approach for modeling human behavior in PRAs of complicated domains such as nuclear power plants. It is argued that it has become increasingly more important to understand and model the more cognitive aspects of human performance and to address the broader range of factors that have been shown to influence human performance in complex domains. The paper concludes by addressing the current ability of HRA to adequately predict human failure events and their likelihood.

  16. Wireless patient monitoring on shoe for the assessment of foot dysfunction: an overview

    Science.gov (United States)

    Abraham, Jose K.; Whitchurch, Ashwin K.; Varadan, Vijay K.; Sarukesi, Karunakaran

    2003-04-01

    This paper presents an overview of the wireless monitoring and quantitative assessment of joint dynamics of ankle which has suffered from soft tissue injury, immobilization or any dysfunction with special focus on the treatment and rehabilitation applications. The inadequacy of a reliable and easy method for continuous measurement and recording of ankle movement while doing physical therapy makes the monitoring of its progress difficult. Development of a wireless ankle motion monitoring system inside the shoe provides information on several aspects of activities associated with a dysfunctional foot. The system is based on continuous wireless monitoring of signals from accelerometers and gyroscopes fixed inside the shoe. From these signals, the duration, rate, and moment of occurrence of activities associated with mobility (e.g., lying, sitting, standing, walking up and down, running, cycling, wheelchair use and general movement) and transitions (changes in angle) can be detected. Information about the movement can be obtained by the acceleration sensors, which is related to the intensity of body-segment movement. Apart from monitoring accelerations, other signals due to turning and angular movements can be obtained using the miniature gyroscope attached to the shoe.

  17. Guideline development and impact assessment for registration of medical, dental and veterinary x-ray apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Colgan, P.; Harrison, D. [NSW Environment Protection Authority, Lidcombe, NSW, (Australia). Radiation Control Centre; Moore, W. [NSW Environmental Protection Authority, Chatswood, NSW, (Australia). Economics and Environmental Reporting Branch

    1996-10-01

    Under the NSW Radiation Control Act 1990, radiation apparatus used for diagnostic medical, dental and veterinary purposes will be required to become registered. The inspection required prior to registration will be conducted by a Consulting Radiation Expert who has been accredited by the Environment Protection Authority (EPA) as being competent in the field of quality assurance assessment of radiation apparatus used for diagnostic medical, dental and veterinary purposes. When regulating any activity in NSW, there is a requirement to undertake a regulatory impact statement of the proposed regulation. In addition, the introduction of any accompanying guideline requires a cost-benefit analysis. Costs may include enforcement, administrative and compliance activities. The calculation of benefit relies heavily on the improvement in apparatus performance (and hence dose reduction) that can be obtained with the introduction of a mandatory practice such as apparatus registration. This paper discusses the development of the registration guideline for NSW, including a summary of the public comments received. It further discusses the methodology and data used for the accompanying cost-benefit analysis. Information in this paper is presented in three parts: EPA field survey, cost analysis, and benefit analysis. For NSW it was estimated that the introduction of registration of these apparatus, over a two year period, would result in early replacement and repair costs (present values) to the medical industry of between $5.7 and $11.0 million, with an additional $2.5 million in EPA enforcement costs. The introduction of the proposed system of registration is expected to result in an estimated savings in quantifiable health detriment costs to NSW of between $11.8 and $17.7 million, and reduce the risk of radiation induced mortality. (authors). 4 refs., 11 tabs.

  18. An overview of measurement method tools available to communities for conducting exposure and cumulative risk assessments.

    Science.gov (United States)

    Medina-Vera, Myriam; Van Emon, Jeanette M; Melnyk, Lisa J; Bradham, Karen D; Harper, Sharon L; Morgan, Jeffrey N

    2010-06-01

    Community-based programs for assessing and mitigating environmental risks represent a challenge to participants because each brings a different level of understanding of the issues affecting the community. These programs often require the collaboration of several community sectors, such as community leaders, local governments and researchers. Once the primary concerns, community vulnerabilities and assets are identified, participants plan on how to address immediate actions, rank known risks, collect information to support decision making, set priorities and determine an evaluation process to assess the success of the actions taken. The evaluation process allows the community to develop new action plans based on the results obtained from earlier actions. Tracking the success of the community actions may be as simple as a visual/tangible result (e.g., cleaning a park) or as complex as the collection of specific measurements to track the reduction of toxic pollutants or to determine the presence of a specific contaminant. Recognizing that communities may need to perform measurements to meet their goals, this paper provides an overview of the available measurement methods for several chemicals and biologicals in relevant environmental samples to a community setting. The measurement methods are organized into several categories according to their level of complexity, estimated cost and sources. Community project technical advisors are encouraged to examine the objective(s) of the community to be addressed by a measurement collection effort and the level of confidence that needed for the data to make appropriate decisions. The tables provide a starting point for determining which measurement method may be appropriate for specific community needs.

  19. The U.S. Salinity Laboratory (USDA-ARS) guidelines for assessing multi-scale soil salinity with proximal and remote sensing

    Science.gov (United States)

    Scudiero, Elia; Skaggs, Todd; Corwin, Dennis

    2017-04-01

    Soil salinity is a major threat to sustainable agriculture, especially in arid and semi-arid regions. Updated and accurate inventories of salinity in agronomically and environmentally relevant ranges (i.e., essential for producers and decision-makers to assure long term food production. Over the past three decades, scientists at the U.S. Salinity Laboratory (USDA-ARS) in Riverside, CA have developed proximal sensor (i.e., electrical resistivity and electromagnetic induction) and remote imagery (e.g., MODIS, Landsat, WorldView) methodologies for assessing soil salinity at multiple scales: field (0.5 ha to 1 km2), landscape (1 to 10 km2), and regional (10 to 105 km2) scales. The purpose of this contribution is to provide an overview of these scale-dependent salinity assessment approaches. Guidelines, special considerations, and strengths and limitations of each scale-specific approach are presented for characterizing spatial and temporal variation in soil salinity. To support the discussion, we present a regional scale dataset comprising salinity surveys over 22 fields in California, USA. The dataset is used to provide practical examples of field-, landscape-, and regional-scale soil salinity assessment.

  20. Questionnaires used to assess barriers of clinical guideline use among physicians are not comprehensive, reliable, or valid: a scoping review.

    Science.gov (United States)

    Willson, Melina L; Vernooij, Robin W M; Gagliardi, Anna R

    2017-06-01

    This study described the number and characteristics of questionnaires used to assess barriers of guideline use among physicians. A scoping review was conducted. MEDLINE and EMBASE were searched from 2005 to June 2016. English-language studies that administered a questionnaire to assess barriers of guideline use among practicing physicians were eligible. Summary statistics were used to report study and questionnaire characteristics. Questionnaire content was assessed with a checklist of 57 known barriers. Each of the 178 included studies administered a unique questionnaire. The number of questionnaires increased yearly from 2005 to 2015. Few were pilot-tested (50, 28.1%) or tested for psychometric properties (3, 1.7%). Two were based on theory. None probed for the full range of known barriers. Ten included a free-text option. The majority assessed professional barriers (177, 99.4%) but few of the 14 factors within this domain. Questionnaire characteristics did not change over time. Organizations administered questionnaires that were not reliable or valid and did not comprehensively assess barriers and may have selected interventions unlikely to promote guideline use. Research is needed to construct a questionnaire that is practical, adaptable, and robust and leads to the selection of interventions that support guideline use. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Implementation of an Evidence Based Guideline for Assessment and Documentation of the Civil Commitment Process.

    Science.gov (United States)

    Perrigo, Tabitha L; Williams, Kimberly A

    2016-11-01

    The purpose of this quality improvement project was to implement an evidence-based practice guideline for assessment and documentation of the civil commitment process. Participants included six civil commitment examiners who conduct court ordered psychiatric evaluations at two crisis intervention centers in rural area of southeaster state. Data collection was conducted utilizing a chart audit tool both pre and post intervention of 100 civil commitment evaluations. The intervention included the development of an evidenced based form for documentation of civil commitment evaluations and a one on one educational training session was conducted for each participant. Descriptive statistics (t test) was utilized to analyze the data collected. The project demonstrated a significant increase as 25.5 % of evaluations contained the America Psychiatric Association's recommended 11 domains of assessment prior to implementation compared to 65.6 % (p value = 0.018) post implementation. Moreover, participants with family practice training showed an increase in commitment rates from 60 to 77.3 % (p value = 0.066). Whereas, psychiatric trained participants showed a decrease from 83.75 to 77.66 % (p value = 0.38). Demonstrating that court ordered evaluations guided by a standardized form based on evidence affected examiners recommendations for commitments.

  2. Summary guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Halsnaes, K.; Painuly, J.P.; Turkson, J.; Meyer, H.J.; Markandya, A.

    1999-09-01

    This document is a summary version of the methodological guidelines for climate change mitigation assessment developed as part of the Global Environment Facility (GEF) project Economics of Greenhouse Gas Limitations; Methodological Guidelines. The objectives of this project have been to develop a methodology, an implementing framework and a reporting system which countries can use in the construction of national climate change mitigation policies and in meeting their future reporting obligations under the FCCC. The methodological framework developed in the Methodological Guidelines covers key economic concepts, scenario building, modelling tools and common assumptions. It was used by several country studies included in the project. (au) 13 refs.

  3. The Diesel Exhaust in Miners Study: I. Overview of the Exposure Assessment Process

    Science.gov (United States)

    Stewart, Patricia A.; Coble, Joseph B.; Vermeulen, Roel; Schleiff, Patricia; Blair, Aaron; Lubin, Jay; Attfield, Michael; Silverman, Debra T.

    2010-01-01

    This report provides an overview of the exposure assessment process for an epidemiologic study that investigated mortality, with a special focus on lung cancer, associated with diesel exhaust (DE) exposure among miners. Details of several components are provided in four other reports. A major challenge for this study was the development of quantitative estimates of historical exposures to DE. There is no single standard method for assessing the totality of DE, so respirable elemental carbon (REC), a component of DE, was selected as the primary surrogate in this study. Air monitoring surveys at seven of the eight study mining facilities were conducted between 1998 and 2001 and provided reference personal REC exposure levels and measurements for other agents and DE components in the mining environment. (The eighth facility had closed permanently prior to the surveys.) Exposure estimates were developed for mining facility/department/job/year combinations. A hierarchical grouping strategy was developed for assigning exposure levels to underground jobs [based on job titles, on the amount of time spent in various areas of the underground mine, and on similar carbon monoxide (CO, another DE component) concentrations] and to surface jobs (based on the use of, or proximity to, diesel-powered equipment). Time trends in air concentrations for underground jobs were estimated from mining facility-specific prediction models using diesel equipment horsepower, total air flow rates exhausted from the underground mines, and, because there were no historical REC measurements, historical measurements of CO. Exposures to potentially confounding agents, i.e. respirable dust, silica, radon, asbestos, and non-diesel sources of polycyclic aromatic hydrocarbons, also were assessed. Accuracy and reliability of the estimated REC exposures levels were evaluated by comparison with several smaller datasets and by development of alternative time trend models. During 1998–2001, the average

  4. The diesel exhaust in miners study: I. Overview of the exposure assessment process.

    Science.gov (United States)

    Stewart, Patricia A; Coble, Joseph B; Vermeulen, Roel; Schleiff, Patricia; Blair, Aaron; Lubin, Jay; Attfield, Michael; Silverman, Debra T

    2010-10-01

    This report provides an overview of the exposure assessment process for an epidemiologic study that investigated mortality, with a special focus on lung cancer, associated with diesel exhaust (DE) exposure among miners. Details of several components are provided in four other reports. A major challenge for this study was the development of quantitative estimates of historical exposures to DE. There is no single standard method for assessing the totality of DE, so respirable elemental carbon (REC), a component of DE, was selected as the primary surrogate in this study. Air monitoring surveys at seven of the eight study mining facilities were conducted between 1998 and 2001 and provided reference personal REC exposure levels and measurements for other agents and DE components in the mining environment. (The eighth facility had closed permanently prior to the surveys.) Exposure estimates were developed for mining facility/department/job/year combinations. A hierarchical grouping strategy was developed for assigning exposure levels to underground jobs [based on job titles, on the amount of time spent in various areas of the underground mine, and on similar carbon monoxide (CO, another DE component) concentrations] and to surface jobs (based on the use of, or proximity to, diesel-powered equipment). Time trends in air concentrations for underground jobs were estimated from mining facility-specific prediction models using diesel equipment horsepower, total air flow rates exhausted from the underground mines, and, because there were no historical REC measurements, historical measurements of CO. Exposures to potentially confounding agents, i.e. respirable dust, silica, radon, asbestos, and non-diesel sources of polycyclic aromatic hydrocarbons, also were assessed. Accuracy and reliability of the estimated REC exposures levels were evaluated by comparison with several smaller datasets and by development of alternative time trend models. During 1998-2001, the average

  5. Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.

    Science.gov (United States)

    Peter, W F; Jansen, M J; Hurkmans, E J; Bloo, H; Dekker, J; Dilling, R G; Hilberdink, W; Kersten-Smit, C; de Rooij, M; Veenhof, C; Vermeulen, H M; de Vos, R J; Schoones, J W; Vliet Vlieland, T P

    2011-01-01

    An update of a Dutch physiotherapy practice guideline in Hip and Knee Osteoarthritis (HKOA) was made, based on current evidence and best practice. A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters: initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated. A first draft of the guideline was reviewed by 17 experts from different professional backgrounds. A second draft was field-tested by 45 physiotherapists. In total 11 topics were selected. For the initial assessment, three recommendations were formulated, pertaining to history taking, red flags, and formulating treatment goals. Concerning treatment, 7 recommendations were formulated; (supervised) exercise therapy, education and self management interventions, a combination of exercise and manual therapy, postoperative exercise therapy and taping of the patella were recommended. Balneotherapy and hydrotherapy in HKOA, and thermotherapy, TENS, and Continuous Passive Motion in knee OA were neither recommended nor discouraged. Massage therapy, ultrasound, electrotherapy, electromagnetic field, Low Level Laser Therapy, preoperative physiotherapy and education could not be recommended. For the evaluation of treatment goals the following measurement instruments were recommended: Lequesne index, Western Ontario and McMaster Universities osteoarthritis index, Hip disability and Osteoarthritis Outcome Score and Knee injury and Osteoarthritis Outcome Score, 6-minute walktest, Timed Up and Go test, Patient Specific Complaint list, Visual Analoge Scale for pain, Intermittent and Constant OsteoArthritis Pain Questionnaire, goniometry, Medical Research Council for strength, handheld

  6. Supplemental studies for cardiovascular risk assessment in safety pharmacology: a critical overview.

    Science.gov (United States)

    Picard, Sandra; Goineau, Sonia; Guillaume, Philippe; Henry, Joël; Hanouz, Jean-Luc; Rouet, René

    2011-12-01

    Safety Pharmacology studies for the cardiovascular risk assessment, as described in the ICH S7A and S7B guidelines, appear as being far from sufficient. The fact that almost all medicines withdrawn from the market because of life-threatening tachyarrhythmias (torsades-de-pointes) were shown as hERG blockers and QT interval delayers led the authorities to focus mainly on these markers. However, other surrogate biomarkers, e.g., TRIaD (triangulation, reverse-use-dependence, instability and dispersion of ventricular repolarization), have been identified to more accurately estimate the drug-related torsadogenic risk. In addition, more attention should be paid to other arrhythmias, not related to long QT and nevertheless severe and/or not self-extinguishing, e.g., atrial or ventricular fibrillation, resulting from altered electrical conduction or heterogeneous shortening of cardiac repolarization. Moreover, despite numerous clinical cases of drug-induced pulmonary hypertension, orthostatic hypotension, or heart valvular failure, few safety investigations are still conducted on drug interaction with cardiac and regional hemodynamics other than changes in aortic blood pressure evaluated in conscious large animals during the core battery mandatory studies. This critical review aims at discussing the usefulness, relevance, advantages, and limitations of some preclinical in vivo, in vitro, and in silico models, with high predictive values and currently used in supplemental safety studies.

  7. Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring

    Energy Technology Data Exchange (ETDEWEB)

    Velde, Joris van de [Ghent University, Department of Anatomy, Ghent (Belgium); Ghent University, Department of Radiotherapy, Ghent (Belgium); Vercauteren, Tom; Gersem, Werner de; Vandecasteele, Katrien; Vuye, Philippe; Vanpachtenbeke, Frank; Neve, Wilfried de [Ghent University, Department of Radiotherapy, Ghent (Belgium); Wouters, Johan; Herde, Katharina d' ; Kerckaert, Ingrid; Hoof, Tom van [Ghent University, Department of Anatomy, Ghent (Belgium)

    2014-07-15

    The goal of this work was to validate the Radiation Therapy Oncology Group (RTOG)-endorsed guidelines for brachial plexus (BP) contouring by determining the intra- and interobserver agreement. Accuracy of the delineation process was determined using anatomically validated imaging datasets as a gold standard. Five observers delineated the right BP on three cadaver computed tomography (CT) datasets. To assess intraobserver variation, every observer repeated each delineation three times with a time interval of 2 weeks. The BP contours were divided into four regions for detailed analysis. Inter- and intraobserver variation was verified using the Computerized Environment for Radiation Research (CERR) software. Accuracy was measured using anatomically validated fused CT-magnetic resonance imaging (MRI) datasets by measuring the BP inclusion of the delineations. The overall kappa (κ) values were rather low (mean interobserver overall κ: 0.29, mean intraobserver overall κ: 0.45), indicating poor inter- and intraobserver reliability. In general, the κ coefficient decreased gradually from the medial to lateral BP regions. The total agreement volume (TAV) was much smaller than the union volume (UV) for all delineations, resulting in a low Jaccard index (JI; interobserver agreement 0-0.124; intraobserver agreement 0.004-0.636). The overall accuracy was poor, with an average total BP inclusion of 38 %. Inclusions were insufficient for the most lateral regions (region 3: 21.5 %; region 4: 12.6 %). The inter- and intraobserver reliability of the RTOG-endorsed BP contouring guidelines was poor. BP inclusion worsened from the medial to lateral regions. Accuracy assessment of the contours showed an average BP inclusion of 38 %. For the first time, this was assessed using the original anatomically validated BP volume. The RTOG-endorsed BP guidelines have insufficient accuracy and reliability, especially for the lateral head-and-neck regions. (orig.) [German] Ziel der Studie war

  8. 76 FR 44586 - Notice of Availability of the External Review Draft of the Microbial Risk Assessment Guideline...

    Science.gov (United States)

    2011-07-26

    ... genetically modified microorganisms with the potential for environmental exposure. USDA/FSIS is charged with...: Pathogenic Microorganisms With Focus on Food and in Water AGENCY: Environmental Protection Agency (EPA... Risk Assessment Guideline: Pathogenic Microorganisms with Focus on Food and in Water.'' EPA developed...

  9. Assessment of the Policy Guidelines for the Teaching and Learning of Geography at the Senior High School Level in Ghana

    Science.gov (United States)

    Ababio, Bethel T.; Dumba, Hillary

    2014-01-01

    This article empirically assessed the extent to which geography teachers adhered to the Ghana Education Service policy guidelines on the teaching of geography at the Senior High School Level in Ghana. Census survey was used to collect data from seven geography teachers because of the researchers' objective of gaining a quick insight into the…

  10. GPs' adherence to guidelines for structured assessments of stroke survivors in the community and care homes.

    Science.gov (United States)

    Gonçalves-Bradley, Daniela C; Boylan, Anne-Marie; Koshiaris, Constantinos; Vazquez Montes, Maria; Ford, Gary A; Lasserson, Daniel S

    2015-12-01

    Clinical practice guidelines recommend that stroke survivors' needs be assessed at regular intervals after stroke. The extent to which GPs comply with national guidance particularly for patients in care homes who have greatest clinical complexity is unknown. This study aimed to establish the current clinical practice in the UK of needs assessment by GPs for stroke survivors after hospital discharge for acute stroke. Cross-sectional online survey of current practice of GPs, using the national doctors.net network. The survey was completed by 300 GPs who had on average been working for 14 years. The structured assessment of stroke survivors' needs was not offered by 31% of GPs, with no significant difference for level of provision in community or care home settings. The outputs of reviews were added to patients' notes by 89% of GPs and used to change management by 57%. Only half the GPs reported integrating the information obtained into care plans and only a quarter of GPs had a protocol for follow-up of identified needs. Analysis of free-text comments indicated that patients in some care homes may receive more regular and structured reviews. This survey suggests that at least one-third of GPs provide no formal review of the needs of stroke patients and that in only a minority are identified needs addressed in a structured way. Standardization is required for what is included in reviews and how needs are being identified and met. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. ICF linked Dutch physiotherapy guidelines concerning initial assessment, treatment and evaluation in hip and knee osteoarthritis.

    NARCIS (Netherlands)

    Peter, W.; Jansen, M.J.; Hurkmans, E.J.; Bloo, H.; Dekker-Bakker, L.M.M.C.J.; Dilling, R.G.; Hilberdink, W.K.H.A.; Kersten-Smit, C.; Rooij, M. de; Veenhof, C.; Vermeulen, E.M.; Vos, I. de; Schoones, J.W.; Vliet Vlieland, T.P.

    2011-01-01

    Purpose: In 2001 the Royal Dutch Society for Physical Therapy (KNGF) Guideline for hip and knee osteoarthritis (HKOA) was developed. Since then, many scientific papers on physical therapy interventions as well as national and international guidelines were published. Relevance: An update of the

  12. New diagnostic criteria and severity assessment of acute cholangitis in revised Tokyo guidelines

    NARCIS (Netherlands)

    Kiriyama, Seiki; Takada, Tadahiro; Strasberg, Steven M.; Solomkin, Joseph S.; Mayumi, Toshihiko; Pitt, Henry A.; Gouma, Dirk J.; Garden, O. James; Büchler, Markus W.; Yokoe, Masamichi; Kimura, Yasutoshi; Tsuyuguchi, Toshio; Itoi, Takao; Yoshida, Masahiro; Miura, Fumihiko; Yamashita, Yuichi; Okamoto, Kohji; Gabata, Toshifumi; Hata, Jiro; Higuchi, Ryota; Windsor, John A.; Bornman, Philippus C.; Fan, Sheung-Tat; Singh, Harijt; de Santibanes, Eduardo; Gomi, Harumi; Kusachi, Shinya; Murata, Atsuhiko; Chen, Xiao-Ping; Jagannath, Palepu; Lee, Sunggyu; Padbury, Robert; Chen, Miin-Fu

    2012-01-01

    Background The Tokyo Guidelines for the management of acute cholangitis and cholecystitis were published in 2007 (TG07) and have been widely cited in the world literature. Because of new information that has been published since 2007, we organized the Tokyo Guidelines Revision Committee to conduct a

  13. Multisite assessment of NIA-AA guidelines for the neuropathologic evaluation of Alzheimer's disease.

    Science.gov (United States)

    Montine, Thomas J; Monsell, Sarah E; Beach, Thomas G; Bigio, Eileen H; Bu, Yunqi; Cairns, Nigel J; Frosch, Matthew; Henriksen, Jonathan; Kofler, Julia; Kukull, Walter A; Lee, Edward B; Nelson, Peter T; Schantz, Aimee M; Schneider, Julie A; Sonnen, Joshua A; Trojanowski, John Q; Vinters, Harry V; Zhou, Xiao-Hua; Hyman, Bradley T

    2016-02-01

    Neuropathologic assessment is the current "gold standard" for evaluating the Alzheimer's disease (AD), but there is no consensus on the methods used. Fifteen unstained slides (8 brain regions) from each of the 14 cases were prepared and distributed to 10 different National Institute on Aging AD Centers for application of usual staining and evaluation following recently revised guidelines for AD neuropathologic change. Current practice used in the AD Centers Program achieved robustly excellent agreement for the severity score for AD neuropathologic change (average weighted κ = .88, 95% confidence interval: 0.77-0.95) and good-to-excellent agreement for the three supporting scores. Some improvement was observed with consensus evaluation but not with central staining of slides. Evaluation of glass slides and digitally prepared whole-slide images was comparable. AD neuropathologic evaluation as performed across AD Centers yields data that have high agreement with potential modifications for modest improvements. Copyright © 2016 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  14. The opportunity of tracking food waste in school canteens: Guidelines for self-assessment.

    Science.gov (United States)

    Derqui, Belén; Fernandez, Vicenc

    2017-11-01

    Reducing food waste is one of the key challenges of the food system and addressing it in the institutional catering industry can be a quick win. In particular, school canteens are a significant source of food waste and therefore embody a great opportunity to address food waste. The goal of our research is the development of guidelines for audit and self-assessment in measuring and managing food waste produced at school canteens. The purpose of the tool is to standardise food waste audits to be executed either by scholars, school staff or by catering companies with the objective of measuring and reducing food waste at schools. We performed a research among public and private schools and catering companies from which we obtained the key performance indicators to be measured and then pilot-tested the resulting tool in four schools with over 2900 pupil participants, measuring plate waste from over 10,000 trays. This tool will help managers in their efforts towards more sustainable organisations at the same time as the standardisation of food waste audits will provide researchers with comparable data. The study suggests that although there is low awareness on the amount of food wasted at school canteens, managers and staff are highly interested in the topic and would be willing to implement audits and reduction measures. The case study also showed that our tool is easy to implement and not disruptive. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. A novel means of assessing institutional adherence to blood transfusion guidelines.

    Science.gov (United States)

    Hicks, Caitlin W; Frank, Steven M; Wasey, Jack O; Efron, Jonathan; Gearhart, Susan; Fang, Sandy; Safar, Bashar; Makary, Martin A; Wick, Elizabeth C

    2015-01-01

    Risk-adjusted institutional transfusion rates are not currently available on a national level. A surrogate means of benchmarking transfusion practices to use for internal quality improvement was studied. Blood utilization was prospectively studied among all colorectal surgery patients at the study institution (July 2010-November 2012), and these data were benchmarked with transfusion data from the National Surgical Quality Improvement Program (NSQIP) database by hospital type and size. Using NSQIP, the study institution's colorectal surgery transfusion rate was 16.3% (150/920 cases), which was slightly higher than the 14.3% national mean transfusion rate (12 191/85 507 cases; P = .08). When broken down by hospital type and size, the study hospital had a similar rate of blood transfusion compared with academic hospitals (P = .35) but a significantly higher rate than community hospitals, regardless of patient volume (P = .03). Benchmarking blood utilization compared with similar-type hospitals using NSQIP may be a surrogate method to assess adherence to evidence-based transfusion guidelines and identify areas for structured quality improvement initiatives. © The Author(s) 2014.

  16. Guidelines for harmonized vulnerability and risk assessment for non-nuclear critical infrastructure: STREST Reference Report 3

    OpenAIRE

    Anastasiadis, Anastasios; Argyroudis, Sotiris; BABIČ Anže; Basco, Anna; CASOTTO Chiara; Crowley, Helen; Dolšek, Matjaž; FOTOPOULOU Stavroula; GALBUSERA LUCA; Giannopoulos, Georgios; Giardini, Domenico; KAKDERI Kalliopi; KARAFAGKA Stella; Matos, José Pedro; PITILAKIS Kyriazis

    2016-01-01

    Loss assessment of critical infrastructures (CIs) subject to natural hazards is fundamental to stress tests. The systemic approach that lifelines require for performance modelling is an open research topic, given their logical and physical complexity. The Work Package 4 (WP4) of STREST focused on the guidelines for the vulnerability assessment of critical infrastructures categorized as: A Individual, single-site infrastructures with high risk and potential for high local impact and regiona...

  17. [Suicide Risk Assessment in the Clinical Practice Guidelines for the Diagnosis and Management of Depression in Colombia].

    Science.gov (United States)

    Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana Patricia; Gil Lemus, Laura Marcela; Jaramillo, Luis Eduardo; García Valencia, Jenny; Bravo Narváez, Eliana; de la Hoz Bradford, Ana María; Palacio, Carlos

    2013-01-01

    Suicide is the most serious complications of depression. It has high associated health costs and causes millions of deaths worldwide per year. Given its implications, it is important to know the factors that increase the risk of its occurrence and the most useful tools for addressing it. To identify the signs and symptoms that indicate an increased risk of suicide, and factors that increase the risk in patients diagnosed with depression. To establish the tools best fitted to identify suicide risk in people with depression. Clinical practice guidelines were developed, following those of the methodmethodological guidelines of the Ministry of Social Protection, to collect evidence and to adjust recommendations. Recommendations from the NICE90 and CANMAT guidelines were adopted and updated for questions found in these guidelines, while new recommendations were developed for questions not found in them. Basic points and recommendations are presented from a chapter of the clinical practice guidelines on depressive episodes and recurrent depressive disorder related to suicide risk assessment. Their corresponding recommendation levels are included. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  18. Overview of eutrophication indicators to assess environmental status within the European Marine Strategy Framework Directive

    Science.gov (United States)

    Ferreira, João G.; Andersen, Jesper H.; Borja, Angel; Bricker, Suzanne B.; Camp, Jordi; Cardoso da Silva, Margarida; Garcés, Esther; Heiskanen, Anna-Stiina; Humborg, Christoph; Ignatiades, Lydia; Lancelot, Christiane; Menesguen, Alain; Tett, Paul; Hoepffner, Nicolas; Claussen, Ulrich

    2011-06-01

    In 2009, following approval of the European Marine Strategy Framework Directive (MSFD, 2008/56/EC), the European Commission (EC) created task groups to develop guidance for eleven quality descriptors that form the basis for evaluating ecosystem function. The objective was to provide European countries with practical guidelines for implementing the MSFD, and to produce a Commission Decision that encapsulated key points of the work in a legal framework. This paper presents a review of work carried out by the eutrophication task group, and reports our main findings to the scientific community. On the basis of an operational, management-oriented definition, we discuss the main methodologies that could be used for coastal and marine eutrophication assessment. Emphasis is placed on integrated approaches that account for physico-chemical and biological components, and combine both pelagic and benthic symptoms of eutrophication, in keeping with the holistic nature of the MSFD. We highlight general features that any marine eutrophication model should possess, rather than making specific recommendations. European seas range from highly eutrophic systems such as the Baltic to nutrient-poor environments such as the Aegean Sea. From a physical perspective, marine waters range from high energy environments of the north east Atlantic to the permanent vertical stratification of the Black Sea. This review aimed to encapsulate that variability, recognizing that meaningful guidance should be flexible enough to accommodate the widely differing characteristics of European seas, and that this information is potentially relevant in marine ecosystems worldwide. Given the spatial extent of the MSFD, innovative approaches are required to allow meaningful monitoring and assessment. Consequently, substantial logistic and financial challenges will drive research in areas such as remote sensing of harmful algal blooms, in situ sensor development, and mathematical models. Our review takes into

  19. Suitability Assessment of Printed Dietary Guidelines for Pregnant Women and Parents of Infants and Toddlers From 7 European Countries.

    Science.gov (United States)

    Garnweidner-Holme, Lisa Maria; Dolvik, Stina; Frisvold, Cathrine; Mosdøl, Annhild

    2016-02-01

    To evaluate selected European printed dietary guidelines for pregnant women and parents of infants and toddlers using the suitability assessment of materials (SAM) method. A descriptive study to determine the suitability of 14 printed dietary guidelines from 7 European countries based on deductive quantitative analyses. Materials varied greatly in format and content: 35.7% of materials were rated superior and 64.3% were rated adequate according to the overall SAM score for patient education material. None of the materials were scored not suitable. Among the categories, the highest average scores were for layout and typography and the lowest average scores were for cultural appropriateness and learning stimulation and motivation. Interrater reliability ranged from Cohen's kappa of 0.37 to 0.62 (mean, 0.41), indicating fair to moderate agreement among the 3 investigators. Overall, the suitability of the assessed printed dietary guidelines was adequate. Based on the SAM methodology, printed dietary guidelines may increase in suitability by emphasizing aspects related to health literacy and accommodating the needs of different food cultures within a population. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  20. Clinical Practice Guideline for Physical Therapy Assessment and Treatment in Patients With Nonspecific Neck Pain.

    Science.gov (United States)

    Bier, Jasper D; Scholten-Peeters, Wendy G M; Staal, J Bart; Pool, Jan; van Tulder, Maurits W; Beekman, Emmylou; Knoop, Jesper; Meerhoff, Guus; Verhagen, Arianne P

    2018-03-01

    The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice guideline for physical therapists that addresses the assessment and treatment of patients with nonspecific neck pain, including cervical radiculopathy, in Dutch primary care. Recommendations were based on a review of published systematic reviews.During the intake, the patient is screened for serious pathologies and corresponding patterns. Patients with cervical radiculopathy can be included or excluded through corresponding signs and symptoms and possibly diagnostic tests (Spurling test, traction/distraction test, and Upper Limb Tension Test). History taking is done to gather information about patients' limitations, course of pain, and prognostic factors (eg, coping style) and answers to health-related questions.In case of a normal recovery (treatment profile A), management should be hands-off, and patients should receive advice from the physical therapist and possibly some simple exercises to supplement "acting as usual."In case of a delayed/deviant recovery (treatment profile B), the physical therapist is advised to use, in addition to the recommendations for treatment profile A, forms of mobilization and/or manipulation in combination with exercise therapy. Other interventions may also be considered. The physical therapist is advised not to use dry needling, low-level laser, electrotherapy, ultrasound, traction, and/or a cervical collar.In case of a delayed/deviant recovery with clear and/or dominant psychosocial prognostic factors (treatment profile C), these factors should first be addressed by the physical therapist, when possible, or the patient should be referred to a specialist, when necessary.In case of neck pain grade III (treatment profile D), the therapy resembles that for profile B, but the use of a cervical collar for pain reduction may be considered. The advice is to use it sparingly: only for a short period per day and only for a few weeks.

  1. Incorporating patient perspectives in health technology assessments and clinical practice guidelines.

    Science.gov (United States)

    Hämeen-Anttila, K; Komulainen, J; Enlund, H; Mäkelä, M; Mäkinen, E; Rannanheimo, P; Sipilä, R

    Ensuring patient involvement in health technology assessments (HTAs) and clinical practice guidelines (CPGs) is important. However, the goals and methods of such involvement are not always clear. The aim of this study was to 1) discover ways to involve patients in HTA and CPG processes, 2) describe challenges, and 3) find ways of informing patients about HTAs and CPGs in Finland. As part of a one-day seminar targeted at representatives of patient organizations (POs), 3, 1-h focus group discussions were held (n = 20, with 14 PO representatives). PO representatives included real patients and health care professionals working in the organizations. The discussions were tape-recorded, transcribed, and thematically analyzed. Focus group participants highlighted the importance of gathering patient views from a group of patients, rather than individuals. Surveys through POs were the most frequently mentioned means of gathering patients' views. PO representatives reported interest in cooperating in HTA and CPG processes. The most often mentioned challenges were finding appropriate representatives for the target group and conveying information about HTAs and CPGs to patients. Multichannel communication was seen as essential. Furthermore the information should be readable, comprehensible, tailored, reliable, reusable, complementary, and timely. Possible strategies to involve patients in HTA and CPG processes were incorporating patient representatives in the CPG and HTA groups, offering timely possibility to participate, and ensuring reporting with clear and unambiguous language. The main identified challenge was finding appropriate representatives of the target group. The role of POs was seen as important particularly when informing the patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. [General treatment principles, coordination of care and patient education in fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles].

    Science.gov (United States)

    Petzke, F; Brückle, W; Eidmann, U; Heldmann, P; Köllner, V; Kühn, T; Kühn-Becker, H; Strunk-Richter, M; Schiltenwolf, M; Settan, M; von Wachter, M; Weigl, M; Häuser, W

    2017-06-01

    The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A search of the literature for systematic reviews on randomized, controlled trials on patient education and shared decision-making from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences, clinical and practical applicability of available therapies were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. The diagnosis of fibromyalgia syndrome should be explicitly communicated to the affected individual. Shared decision-making with the patient on the therapeutic options based on individual preferences of the patient, comorbidities and the success of previous treatment is recommended. A step-wise treatment approach depending on the severity of fibromyalgia syndrome and the response to therapeutic measures is recommended.

  3. Assessing the readiness of a school system to adopt food allergy management guidelines.

    Science.gov (United States)

    Eldredge, Christina; Patterson, Leslie; White, Brenda; Schellhase, Kenneth

    2014-08-01

    The prevalence of potentially fatal food allergies in school-aged children is rising. It is important for schools to have a food allergy management policy and an emergency action plan for each affected student. To examine the current status of food allergy guideline and/or policy implementation and adoption in a large school system in southeastern Wisconsin. A 24-item anonymous electronic survey was developed and completed by school principals and administrators in the Archdiocese of Milwaukee School System (approximately 125 schools) in southeastern Wisconsin. One in 4 responding schools reported no guidelines or policy. Schools that reported having students with special needs due to food allergy were more likely to have a local food allergy policy compared to schools that did not report having students with food allergy special needs (OR 6.3, 1.5-26, P = 0.01). Schools with food allergy guidelines/policies were 3.5 times more likely to require student individual action plans than schools with no guidelines or policies (OR 3.5, 1.00-12.2, P = 0.05). Gaps in evidence-based food allergy policy implementation were found in this school system. Schools with food-allergic children with special needs were more likely to have guidelines/policy, however, they were not more likely to require emergency action plans. The majority of schools (66, 90%) reported interest in receiving further information or training on food allergy management.

  4. Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions - a taskforce report

    OpenAIRE

    Svensson, P; Ettlin, Dominik A.; Matsuka, Y

    2011-01-01

    Summary  The goals of an international taskforce on somatosensory testing established by the Special Interest Group of Oro-facial Pain (SIG-OFP) under the International Association for the Study of Pain (IASP) were to (i) review the literature concerning assessment of somatosensory function in the oro-facial region in terms of techniques and test performance, (ii) provide guidelines for comprehensive and screening examination procedures, and (iii) give recommendations for future development o...

  5. Guidelines for Establishing Monitoring Programs to Assess the Success of Riparian Restoration Efforts in Arid and Semi-Arid Landscapes

    Science.gov (United States)

    2006-08-01

    ERDC TN-EMRRP-SR-50 1 Guidelines for Establishing Monitoring Programs to Assess the Success of Riparian Restoration Efforts in Arid and Semi ...Management and Restoration Research Program (EMRRP) work unit titled “Techniques for Reestablishing Riparian Hardwoods in Arid and Semi - arid ...Regions.” The objectives of this work are to provide technology to improve capabilities of restoring riparian areas in arid and semi - arid regions. The

  6. Assessment of structural integrity of Monju steel liner against sodium leakage and combustion. Overview

    Energy Technology Data Exchange (ETDEWEB)

    Okuda, E.; Kobayashi, T.; Ito, K. [Japan Nuclear Cycle Development Institute, Monju Construction Office, Fukui (Japan); Morishita, M.; Ichimiya, M.; Tsukimori, K.; Asayama, T.; Ueno, F. [Japan Nuclear Cycle Development Institute, Oarai Engineering Center, Ibaraki (Japan); Akatsu, M. [Kawasaki Heavy Industries, LTD, Tokyo (Japan)

    2001-07-01

    This report overviews the structural analyses and model tests to estimate the structural integrity of the lining structure of Monju under a postulated condition of sodium leakage and combustion. In these evaluations, both thinning of the liner due to molten salt type corrosion and thermal loading on the liner are conservatively assumed. Strain limits are determined and used to judge the structural integrity of the liner on basis of tensile and bending tests of the liner material. (author)

  7. Re-evaluation of the WHO (2010) formaldehyde indoor air quality guideline for cancer risk assessment.

    Science.gov (United States)

    Nielsen, Gunnar Damgård; Larsen, Søren Thor; Wolkoff, Peder

    2017-01-01

    In 2010, the World Health Organization (WHO) established an indoor air quality guideline for short- and long-term exposures to formaldehyde (FA) of 0.1 mg/m(3) (0.08 ppm) for all 30-min periods at lifelong exposure. This guideline was supported by studies from 2010 to 2013. Since 2013, new key studies have been published and key cancer cohorts have been updated, which we have evaluated and compared with the WHO guideline. FA is genotoxic, causing DNA adduct formation, and has a clastogenic effect; exposure-response relationships were nonlinear. Relevant genetic polymorphisms were not identified. Normal indoor air FA concentrations do not pass beyond the respiratory epithelium, and therefore FA's direct effects are limited to portal-of-entry effects. However, systemic effects have been observed in rats and mice, which may be due to secondary effects as airway inflammation and (sensory) irritation of eyes and the upper airways, which inter alia decreases respiratory ventilation. Both secondary effects are prevented at the guideline level. Nasopharyngeal cancer and leukaemia were observed inconsistently among studies; new updates of the US National Cancer Institute (NCI) cohort confirmed that the relative risk was not increased with mean FA exposures below 1 ppm and peak exposures below 4 ppm. Hodgkin's lymphoma, not observed in the other studies reviewed and not considered FA dependent, was increased in the NCI cohort at a mean concentration ≥0.6 mg/m(3) and at peak exposures ≥2.5 mg/m(3); both levels are above the WHO guideline. Overall, the credibility of the WHO guideline has not been challenged by new studies.

  8. Diet Assessment Methods in the Nurses' Health Studies and Contribution to Evidence-Based Nutritional Policies and Guidelines.

    Science.gov (United States)

    Hu, Frank B; Satija, Ambika; Rimm, Eric B; Spiegelman, Donna; Sampson, Laura; Rosner, Bernard; Camargo, Carlos A; Stampfer, Meir; Willett, Walter C

    2016-09-01

    To review the contribution of the Nurses' Health Studies (NHSs) to diet assessment methods and evidence-based nutritional policies and guidelines. We performed a narrative review of the publications of the NHS and NHS II between 1976 and 2016. Through periodic assessment of diet by validated dietary questionnaires over 40 years, the NHSs have identified dietary determinants of diseases such as breast and other cancers; obesity; type 2 diabetes; cardiovascular, respiratory, and eye diseases; and neurodegenerative and mental health disorders. Nutritional biomarkers were assessed using blood, urine, and toenail samples. Robust findings, from the NHSs, together with evidence from other large cohorts and randomized dietary intervention trials, have contributed to the evidence base for developing dietary guidelines and nutritional policies to reduce intakes of trans fat, saturated fat, sugar-sweetened beverages, red and processed meats, and refined carbohydrates while promoting higher intake of healthy fats and carbohydrates and overall healthful dietary patterns. The long-term, periodically collected dietary data in the NHSs, with documented reliability and validity, have contributed extensively to our understanding of the dietary determinants of various diseases, informing dietary guidelines and shaping nutritional policy.

  9. Theory and Practice: Examining PHAC's STI Assessment Guidelines Using Sexual Script Theory

    Directory of Open Access Journals (Sweden)

    JESSICA WATTS

    2010-10-01

    Full Text Available Across Canada, the rates of many sexually transmitted infections (STI, including HIV, continue to fluctuate, with the numbers of new infections increasing within many subpopulations. This warrants an evaluation of the Public Health Agency of Canada's clinical guidelines for STI management. To accomplish this, Gagnon and Simon's work on sexual scripts has been used to explore the structure of current STI clinical practice. This theoretical analysis reveals some of the shortcomings of PHAC's guidelines, and identifies how they reduce patients to vectors of illness and disease.

  10. 76 FR 67439 - External Peer Review Meeting for Draft Microbial Risk Assessment Guideline: Pathogenic...

    Science.gov (United States)

    2011-11-01

    ... Microorganisms With Focus on Food and Water AGENCY: Environmental Protection Agency (EPA). ACTION: Notice...: Pathogenic Microorganisms with Focus on Food and Water. EPA previously announced the release of the draft... Guideline: Pathogenic Microorganisms with Focus on Food and Water will be held on Monday, November 7, 2011...

  11. Guidelines for Assessment of Sex Bias and Sex Fairness in Career Interest Inventories.

    Science.gov (United States)

    National Inst. of Education (DHEW), Washington, DC.

    The draft guidelines are the outcome of a broadly representative three-day workshop and represent a more specific definition than previously available of the many aspects of sex fairness in career interest inventories and related interpretive, technical, and promotional materials. The diverse concerns of inventory users, respondents, authors, and…

  12. AN OVERVIEW AT MACROECONOMIC LEVEL THROUGH ACCOUNTING FIGURES PROVIDED BY THE ECB ASSESSMENT ON EUROZONE BANKING SYSTEM

    Directory of Open Access Journals (Sweden)

    Olivera Ecaterina OROS

    2014-05-01

    Full Text Available Along with the main macroeconomic indicators, the credit risk indicators became an important leverage in monitoring and evaluating the standard of living at a national level and the country’s economic evolution. These two types of indicators show a strong interconnection, and the correct assessment of the credit risk indicators becomes a must. As a consequence, the central banks and the main regulators in the Europe aria provided for a strict monitoring of such indicators and further on, for constant update of the banking supervisory regulations. In October 2013, the European Central bank (ECB issued the Note of Comprehensive Assessment that will be carried out during 2014, on the Euro-zone1 banking system. The outcome of the assessment will impact not only the accounting figures of the banking system, but also might change the macroeconomic overview of Euro-zone and the IASB's Conceptual Framework for Financial Reporting.

  13. Critical assessment of the European Association of Urology guideline indications for pelvic lymph node dissection at radical prostatectomy.

    Science.gov (United States)

    Abdollah, Firas; Sun, Maxine; Briganti, Alberto; Thuret, Rodolphe; Schmitges, Jan; Gallina, Andrea; Suardi, Nazareno; Capitanio, Umberto; Salonia, Andrea; Shariat, Shahrokh F; Perrotte, Paul; Rigatti, Patrizio; Montorsi, Francesco; Karakiewicz, Pierre I

    2011-12-01

    What's known on the subject? and What does the study add? Lymphadenectomy is the most accurate lymph node staging procedure in patients with prostate cancer. We presented the first formal validation of the 2010 European Association of Urology guidelines for lymphadenectomy in prostate cancer patients. • To assess the 2010 European Association of Urology (EAU) guidelines for prostate cancer, which recommend a pelvic lymph node dissection (PLND) at radical prostatectomy in all individuals with a nomogram-predicted lymph node invasion (LNI) risk of >7%. • We focused on 1520 patients treated with radical prostatectomy and PLND, between 2006 and 2010, at a single European institution. We examined the ability of the EAU proposed threshold to correctly predict histologically confirmed LNI. Moreover, we tested the ability of a range of nomogram thresholds between 1 and 14% to correctly predict histologically confirmed LNI. Finally, we externally validated the EAU PLND guideline nomogram. • Overall, 10.6% of patients had LNI. The use of the 7% limit would have allowed the avoidance of 49% of PLNDs, at the cost of missing 11% of patients with LNI. The use of thresholds of 6% and 8% would have allowed the avoidance of respectively 46% and 52% of PLNDs, at the cost of missing respectively 9% and 11% of patients with LNI. Overall, the accuracy of the EAU guideline nomogram according to the receiver operating characteristics derived area under curve was 81% • Our observations indicate that the EAU guideline nomogram is highly accurate. The recommended threshold of 7%, above which a PLND should be performed, is associated with a favourable compromise between avoidable PLNDs and potentially missed LNI cases. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

  14. Methadone Treatment: Overview and Bibliography.

    Science.gov (United States)

    Greenfield, Lawrence; Tang, Beth Archibald

    This overview focuses on methadone treatment. Briefly, it describes the clinical uses of methadone for substance abuse treatment, explores dosage guidelines, and discusses counseling components. This overview also reviews research data on the application of methadone treatment to special populations, such as pregnant women, polydrug users, and…

  15. [Medico-economic assessment of two methods for implementing thyroid testing guidelines].

    Science.gov (United States)

    Saillour-Glénisson, F; Michel, P; Daucourt, V

    2005-09-01

    To compare independent and combined effectiveness and cost-effectiveness of two implementation interventions of guidelines for ordering thyroid function tests. The two implementation interventions were a Memorandum Pocket Card (MPC) and a Test Request Form (TRF). Intervention groups were wards. The study used an experimental 2*2 factorial design with matching hospitals according to size and activity and wards according to pre-intervention appropriateness for test ordering. Four ward groups were established: the dual intervention group, the order form group, the pocket card group and the control group. Physicians in all groups received guidelines and were invited to a local information meeting. The main outcome measure of effectiveness was the Guideline Conformity Rate (GCR). The cost-effectiveness ratio was the cost difference between the tested intervention and the control intervention upon effectiveness difference between the tested intervention and the control intervention. Six hospitals participated in the study (two middle-sized hospitals, two small-sized hospitals and two psychiatric hospitals). A total of 1412 orders for thyroid function tests were collected. GCR was 78% in the dual intervention group, 83% in the order form group, 73% in the pocket card group and 62% in the control group. The interaction between TRF and MPC was not significant (B=-0.70, p=0.21). Compared to simple information, TRF was effective in increasing GCR (OR=2.65, 95% Confidence Interval [CI]: 1.52-4.62), unlike MPC (OR=1.28, CI: 0.75-2.19). TRF was the less expensive and the most effective intervention. Using a robust design, our study shows a greater effectiveness of TRF than MPC and their association in implementing thyroid function test guidelines. The development of clinical practice improvement projects through the second procedure of accreditation in France is a good opportunity to develop a guidelines implementation research project.

  16. Availability, content and quality of local guidelines for the assessment of suicide attempters in university and general hospitals in the Netherlands.

    NARCIS (Netherlands)

    Verwey, B.; Waarde, J.A. van; Rooij, I.A.L.M. van; Gerritsen, G.; Zitman, F.G.

    2006-01-01

    OBJECTIVE: This study was performed to investigate the availability, content and quality of local guidelines for the assessment of suicide attempters in the Netherlands. METHOD: All university and general hospitals in the Netherlands were asked to provide their local guidelines. Published national

  17. Development of the Stroke-unit Discharge Guideline: choice of assessment instruments for prediction in the subacute phase post-stroke

    NARCIS (Netherlands)

    Meijer, Ronald; van Limbeek, Jacques; de Haan, Rob

    2006-01-01

    The purpose of this paper is to present the design of an evidence-based dataset of assessment instruments for the prognostic factors of the Stroke-unit Discharge Guideline (SDG), a consensus based guideline for the decision of the discharge destination from the hospital stroke unit. In our

  18. In vitro models of the blood–brain barrier: An overview of commonly used brain endothelial cell culture models and guidelines for their use

    Science.gov (United States)

    Helms, Hans C; Abbott, N Joan; Burek, Malgorzata; Cecchelli, Romeo; Couraud, Pierre-Olivier; Deli, Maria A; Förster, Carola; Galla, Hans J; Romero, Ignacio A; Shusta, Eric V; Stebbins, Matthew J; Vandenhaute, Elodie; Weksler, Babette

    2016-01-01

    The endothelial cells lining the brain capillaries separate the blood from the brain parenchyma. The endothelial monolayer of the brain capillaries serves both as a crucial interface for exchange of nutrients, gases, and metabolites between blood and brain, and as a barrier for neurotoxic components of plasma and xenobiotics. This “blood-brain barrier” function is a major hindrance for drug uptake into the brain parenchyma. Cell culture models, based on either primary cells or immortalized brain endothelial cell lines, have been developed, in order to facilitate in vitro studies of drug transport to the brain and studies of endothelial cell biology and pathophysiology. In this review, we aim to give an overview of established in vitro blood–brain barrier models with a focus on their validation regarding a set of well-established blood–brain barrier characteristics. As an ideal cell culture model of the blood–brain barrier is yet to be developed, we also aim to give an overview of the advantages and drawbacks of the different models described. PMID:26868179

  19. Best practice guidelines for the use of the assessment centre method in South Africa (5th edition

    Directory of Open Access Journals (Sweden)

    Deon Meiring

    2016-04-01

    Full Text Available Orientation: Assessment Centres (ACs have a long and successful track record in South Africa when used for selection and development purposes. The popularity of the approach is mainly attributable to the ACs’ numerous strengths, which include the perceived fairness, practical utility and strong associations with on-the-job performance. To maintain the integrity of the AC, it is important for practitioners and decision makers to apply the method in a consistent and standardised manner.Research purpose: The purpose of the report is to provide practitioners and decision makers with practical guidelines and concrete procedures when using ACs as part of the organisation’s human resource management strategy. Motivation for the study: The past decade has seen significant advances in the science and practice of ACs. Now in its fifth edition, the revised Guidelines seek to provide important information to practitioners and decision makers on a number of factors when used in conjunction with the AC method, namely, technology, validation, legislation, ethics and culture.Main findings: The Guidelines provide specific suggestions and recommendations for using technology as part of the manner of delivery. Issues of culture, diversity and representation are also discussed. New features of the Guidelines include more concrete guidance on how to conduct a validation study as well as unpacking several ethical dilemmas that practitioners may encounter. Of critical importance is a position statement on the use of ACs in relation to new legislation (Employment Equity Amendment Act, Section 8, clause d pertaining to psychometric testing.Practical/managerial implications: The Guidelines serve as a benchmark of best practice for practitioners and decision makers who intend on, or are currently, using ACs in their organisations.Contribution/value-add: In the absence of formal standards governing the use of ACs in South Africa, the Guidelines provide an important

  20. ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I - Assessment and Management of Various Cardiovascular Risk Factors.

    Science.gov (United States)

    Wang, Angela Yee Moon; Brimble, K Scott; Brunier, Gillian; Holt, Stephen G; Jha, Vivekanand; Johnson, David W; Kang, Shin-Wook; Kooman, Jeroen P; Lambie, Mark; McIntyre, Chris; Mehrotra, Rajnish; Pecoits-Filho, Roberto

    2015-01-01

    Cardiovascular disease contributes significantly to the adverse clinical outcomes of peritoneal dialysis (PD) patients. Numerous cardiovascular risk factors play important roles in the development of various cardiovascular complications. Of these, loss of residual renal function is regarded as one of the key cardiovascular risk factors and is associated with an increased mortality and cardiovascular death. It is also recognized that PD solutions may incur significant adverse metabolic effects in PD patients. The International Society for Peritoneal Dialysis (ISPD) commissioned a global workgroup in 2012 to formulate a series of recommendations regarding lifestyle modification, assessment and management of various cardiovascular risk factors, as well as management of the various cardiovascular complications including coronary artery disease, heart failure, arrhythmia (specifically atrial fibrillation), cerebrovascular disease, peripheral arterial disease and sudden cardiac death, to be published in 2 guideline documents. This publication forms the first part of the guideline documents and includes recommendations on assessment and management of various cardiovascular risk factors. The documents are intended to serve as a global clinical practice guideline for clinicians who look after PD patients. The ISPD workgroup also identifies areas where evidence is lacking and further research is needed. Copyright © 2015 International Society for Peritoneal Dialysis.

  1. 75 FR 18171 - Overview Information; Race to the Top Fund Assessment Program; Notice Inviting Applications for...

    Science.gov (United States)

    2010-04-09

    ..., including English learners and students with disabilities. To be eligible for a High School Course..., technology and innovation in assessment, high school assessments, assessing English learners, assessing... development of the consortium's final high school summative assessments in mathematics and English language...

  2. [Guidelines for the fitness to drive assessment in people with obstructive sleep apnoea syndrome (OSAS) and narcolepsy].

    Science.gov (United States)

    Garbarino, S; Bonanni, E; Ingravallo, F; Mondini, S; Plazzi, G; Sanna, A

    2011-01-01

    Given the prevalence of sleep disorders and sleep deprivation in modern societies, and the correlation between sleepiness and work and driving accidents, the excessive daytime sleepiness is an important issue. Although many studies showed that patients with untreated Obstructive sleep apnoea syndrome (OSAS) and narcolepsy have an higher risk for driving accidents, neither the European Community regulation nor the Italian law of the driving licence mention restrictions for these disorders. In 2010 the scientific association COMLAS (Association of legal medicine professionals of the Italian National Health Service) published the Guidelines for the examination by the Local Medical Commissions. The author presented the guidelines to assess the fitness to drive of people with OSAS or narcolepsy. The proposed criteria, set up in collaboration with the Commission "Sleepiness, Safety and Transportation" of the Italian Association of Sleep Medicine (AIMS), can be considered among the most advanced internationally.

  3. Report from the ASCE task committee on chimney and stack examination and retrofit. Chimney and stack condition assessment guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Hertlein, B.H. [STS Consultants Ltd., Vernon Hills, IL (United States); Bochicchio, V. [ZBD Constructors Inc., Tampa, FL (United States)

    1999-11-01

    Industrial and Utility chimneys are typically exposed to severe environmental conditions, and sometimes subjected to changes in operating conditions. Extremes of weather and aggressive industrial atmospheres impose unavoidable stresses and can lead to rapid deterioration. Changes in fuel or the installation of flue gas scrubbers change the flue gas temperature and composition, and can create conditions unanticipated by the chimney designer. The purpose of the ASCE Task Committee for Chimney and Stack Examination and Retrofit was to develop a set of guidelines that would aid owners in understanding the issues involved in maintaining these structures, and at the same time ensure that owners, engineers, and contractors alike have a common frame of reference for the work involved. It is anticipated that, by using these guidelines, requests for chimney inspections or assessments can be answered with qualified responses that address the full scope of work required or expected by the owners.

  4. Caries risk assessment in young adults using Public Dental Service guidelines and the Cariogram-a comparative study

    DEFF Research Database (Denmark)

    Hänsel Petersson, Gunnel; Ericson, Ewa; Isberg, Per-Erik

    2012-01-01

    Abstract Objectives. To investigate the caries risk profiles in young adults and to compare the risk classification using the Public Dental Service (PDS) guidelines with a risk assessment program, the Cariogram. Materials and methods. All 19-year-old patients registered at eight public dental...... clinics were invited to participate (n = 1699). The study group who completed the baseline examination consisted of 1295 subjects representing 10% of all 19 year-olds attending dental care at the PDS in Skåne, Sweden. A risk classification of each patient was made by the patient's regular team according...... to the PDS guidelines. A research team collected whole saliva samples and information from a questionnaire and a structured interview in order to calculate risk according to the Cariogram model. Results. The mean DFS value was 4.9 and 23% of the patients were registered as caries-free (DFS = 0). The PDS risk...

  5. Assessment of the Adherence of Cardiologists to Guidelines for the Treatment of Atrial Fibrillation

    Science.gov (United States)

    van der Sand, Cézar R.; Leiria, Tiago Luiz Luz; Kalil, Renato Abdala Karam

    2013-01-01

    Background No local studies evaluating the knowledge of cardiologists on the management of atrial fibrillation (AF) and their adherence to these guidelines are available. Objective To evaluate the knowledge of cardiologists on the guidelines and clinical practices for the treatment of AF, correlating it to the time since medical graduation. Methods Cross-sectional study randomly including cardiologists affiliated to the Society of Cardiology of the State of Rio Grande do Sul (Sociedade de Cardiologia do Estado do Rio Grande do Sul - SOCERGS). The physicians were divided into two groups, according to time since graduation: those graduated for more (G1) or less (G2) than 25 years. Results Of the 859 SOCERGS members, 150 were interviewed, and six refused to participate in the study. G1 comprised 71 physicians, and G2, 73. Differences were observed in regard to the following variables: use of betablockers as the first-choice drug for the control of AF response in 59.2% (G1) vs 91.8% (G2) (p<0.0001); use of digoxin as the preferred drug for the control of AF response in 19.7% (G1) vs 0% (G2) (p< 0.0001); warfarin as the preferred anticoagulant in 71.8% (G1) vs 93.2% (G2) (p=0.009); application of a risk score for anticoagulation in 73.2% (G1) vs 87.7% (G2) (p=0.02). In questions regarding the knowledge about the Brazilian Society of Cardiology's guideline for AF, the overall percentage of right answers was 82.3%. Conclusion Most of the clinical measures regarding the management of AF comply with the guidelines, and the clinical practice differs according with the time since graduation. PMID:23877745

  6. Best Practices and Provisional Guidelines for Integrating Mobile, Virtual, and Videogame-Based Training and Assessments

    Science.gov (United States)

    2014-01-01

    Personnel Psychology , 59, 665-702. Knowles, M. (1980). The modern practice of adult education : From pedagogy to andragogy: Wilton, CT: Association...Review Sources. A literature search of online databases ( Education Resources Information Center, PsycINFO, PsycARTICLES, PsycEXTRA, Psychology ...interviewing. Personnel Journal, 72(6), 66. APA Task Force on Psychology in Education (1993). Learner-centered psychological principles: Guidelines for

  7. A framework of the desirable features of guideline implementation tools (GItools): Delphi survey and assessment of GItools

    NARCIS (Netherlands)

    Gagliardi, A.R.; Brouwers, M.C.; Bhattacharyya, O.K.; Wees, P.J. van der

    2014-01-01

    BACKGROUND: Guidelines are the foundation for healthcare planning, delivery and quality improvement but are not consistently implemented. Few guidelines are accompanied by guideline implementation tools (GItools). Users have requested GItools, and developers have requested guidance on how to develop

  8. Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.

    NARCIS (Netherlands)

    Peter, W.F.H.; Jansen, M.J.; Hurkmans, E.J.; Bloo, H.; Dekker-Bakker, L.M.M.C.J.; Dilling, R.G.; Hilberdink, W.K.H.A.; Kersten-Smit, C.; Rooij, M. de; Veenhof, C.; Vermeulen, H.M.; Vos, R.J. de; Schoones, J.W.; Vliet Vlieland, T.P.M.

    2011-01-01

    BACKGROUND: An update of a Dutch physiotherapy practice guideline in Hip and Knee Osteoarthritis (HKOA) was made, based on current evidence and best practice. METHODS: A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters: initial

  9. Assessment of heavy metals contamination in Mamut river sediments using sediment quality guidelines and geochemical indices.

    Science.gov (United States)

    Mohammad Ali, Bibi Noorarlijannah; Lin, Chin Yik; Cleophas, Fera; Abdullah, Mohd Harun; Musta, Baba

    2015-01-01

    This paper describes the concentration of selected heavy metals (Co, Cu, Ni, Pb, and Zn) in the Mamut river sediments and evaluate the degree of contamination of the river polluted by a disused copper mine. Based on the analytical results, copper showed the highest concentration in most of the river samples. A comparison with Interim Canadian Sediment Quality Guidelines (ICSQG) and Germany Sediment Quality Guidelines (GSQG) indicated that the sediment samples in all the sampling stations, except Mamut river control site (M1), exceeded the limit established for Cu, Ni, and Pb. On the contrary, Zn concentrations were reported well below the guidelines limit (ICSQG and GSQG). Mineralogical analysis indicated that the Mamut river sediments were primarily composed of quartz and accessory minerals such as chalcopyrite, pyrite, edenite, kaolinite, mica, and muscovite, reflected by the geological character of the study area. Enrichment factor (EF) and geoaccumulation index (Igeo) were calculated to evaluate the heavy metal pollution in river sediments. Igeo values indicated that all the sites were strongly polluted with the studied metals in most sampling stations, specifically those located along the Mamut main stream. The enrichment factor with value greater than 1.5 suggested that the source of heavy metals was mainly derived from anthropogenic activity such as mining. The degree of metal changes (δfold) revealed that Cu concentration in the river sediments has increased as much as 20 to 38 folds since the preliminary investigation conducted in year 2004.

  10. Cancer evaluation in the assessment of solid organ transplant candidates: A systematic review of clinical practice guidelines.

    Science.gov (United States)

    Acuna, Sergio A; Lam, Winnie; Daly, Corinne; Kim, S Joseph; Baxter, Nancy N

    2018-01-01

    Active malignancies are a contraindication to transplantation, as immunosuppression can lead to worse cancer outcomes; therefore, ensuring transplant candidates are free of malignancy before transplantation is essential. This systematic review assesses the availability, quality, and consistency of recommended cancer evaluation prior to transplantation in Clinical Practice Guidelines (CPGs) for the selection of solid organ transplant candidates. We systematically searched for CPGs for the assessment of transplant candidates. The characteristics of included CPGs, strength of recommendations and supporting evidence were extracted. A quality assessment of the CPGs was conducted using the AGREE II tool. We identified 52 CPG for the selection of solid organ transplant candidates. Only 13 (25%) included recommendations for cancer evaluation as part of the assessment of transplant candidates. Most recommended age and sex appropriate cancer screening as per the general population guidelines. Recommendations to evaluate for other malignancies and for high-risk candidates were variable. Most recommendations were based on expert opinion and only two CPGs provided an explicit link between the recommendations and supporting evidence. There is a lack of clear and consistent recommendations for pretransplant cancer evaluation in existing CPGs. Although there is some consensus regarding the indication to screen for cancer as per the recommendations for the general population, these recommendations are not an appropriate risk reduction strategy for transplant candidates. Standardized protocols to ensure transplant candidates are cancer free prior to transplantation are needed. Copyright © 2017. Published by Elsevier Inc.

  11. A review of multidisciplinary clinical practice guidelines in suicide prevention: toward an emerging standard in suicide risk assessment and management, training and practice.

    Science.gov (United States)

    Bernert, Rebecca A; Hom, Melanie A; Roberts, Laura Weiss

    2014-10-01

    The current paper aims to: (1) examine clinical practice guidelines in suicide prevention across fields, organizations, and clinical specialties and (2) inform emerging standards in clinical practice, research, and training. The authors conducted a systematic literature review to identify clinical practice guidelines and resource documents in suicide prevention and risk management. The authors used PubMed, Google Scholar, and Google Search, and keywords included: clinical practice guideline, practice guideline, practice parameters, suicide, suicidality, suicidal behaviors, assessment, and management. To assess for commonalities, the authors reviewed guidelines and resource documents across 13 key content categories and assessed whether each document suggested validated assessment measures. The search generated 101 source documents, which included N = 10 clinical practice guidelines and N = 12 additional resource documents (e.g., non-formalized guidelines, tool-kits). All guidelines (100 %) provided detailed recommendations for the use of evidence-based risk factors and protective factors, 80 % provided brief (but not detailed) recommendations for the assessment of suicidal intent, and 70 % recommended risk management strategies. By comparison, only 30 % discussed standardization of risk-level categorizations and other content areas considered central to best practices in suicide prevention (e.g., restricting access to means, ethical considerations, confidentiality/legal issues, training, and postvention practices). Resource documents were largely consistent with these findings. Current guidelines address similar aspects of suicide risk assessment and management, but significant discrepancies exist. A lack of consensus was evident in recommendations across core competencies, which may be improved by increased standardization in practice and training. Additional resources appear useful for supplemental use.

  12. RAVEN AS A TOOL FOR DYNAMIC PROBABILISTIC RISK ASSESSMENT: SOFTWARE OVERVIEW

    Energy Technology Data Exchange (ETDEWEB)

    Alfonsi Andrea; Mandelli Diego; Rabiti Cristian; Joshua Cogliati; Robert Kinoshita

    2013-05-01

    RAVEN is a software tool under development at the Idaho National Laboratory (INL) that acts as the control logic driver and post-processing tool for the newly developed Thermo-Hydraylic code RELAP- 7. The scope of this paper is to show the software structure of RAVEN and its utilization in connection with RELAP-7. A short overview of the mathematical framework behind the code is presented along with its main capabilities such as on-line controlling/monitoring and Monte-Carlo sampling. A demo of a Station Black Out PRA analysis of a simplified Pressurized Water Reactor (PWR) model is shown in order to demonstrate the Monte-Carlo and clustering capabilities.

  13. Assessment of environmental stresses for enhanced microalgal biofuel production-an overview

    Directory of Open Access Journals (Sweden)

    Dan eCheng

    2014-07-01

    Full Text Available Microalgal biofuels are currently considered to be the most promising alternative to future renewable energy source. Microalgae have great potential to produce various biofuels, including biodiesel, bioethanol, biomethane, and biohydrogen. Cultivation of biofuel-producing microalgae demands favorable environmental conditions, such as suitable light, temperature, nutrients, salinity, and pH. However, these conditions are not always compatible with the conditions beneficial to biofuel production, because biofuel-related compounds (such as lipids and carbohydrates tend to accumulate under environmental-stress conditions of light, temperature, nutrient, and salt. This paper presents a brief overview of the effects of environmental conditions on production of microalgal biomass and biofuel, with specific emphasis on how to utilize environmental stresses to improve biofuel productivity. The potential avenues of reaping the benefits of enhanced biofuel production by environmental stresses while maintaining high yields of biomass production have been discussed.

  14. Vehicle Technologies Program Overview

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2006-09-05

    Overview of the Vehicle Technologies Program including external assessment and market view; internal assessment, program history and progress; program justification and federal role; program vision, mission, approach, strategic goals, outputs, and outcomes; and performance goals.

  15. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis.

    Science.gov (United States)

    Eichenfield, Lawrence F; Tom, Wynnis L; Chamlin, Sarah L; Feldman, Steven R; Hanifin, Jon M; Simpson, Eric L; Berger, Timothy G; Bergman, James N; Cohen, David E; Cooper, Kevin D; Cordoro, Kelly M; Davis, Dawn M; Krol, Alfons; Margolis, David J; Paller, Amy S; Schwarzenberger, Kathryn; Silverman, Robert A; Williams, Hywel C; Elmets, Craig A; Block, Julie; Harrod, Christopher G; Smith Begolka, Wendy; Sidbury, Robert

    2014-02-01

    Atopic dermatitis (AD) is a chronic, pruritic, inflammatory dermatosis that affects up to 25% of children and 2% to 3% of adults. This guideline addresses important clinical questions that arise in the management and care of AD, providing updated and expanded recommendations based on the available evidence. In this first of 4 sections, methods for the diagnosis and monitoring of disease, outcomes measures for assessment, and common clinical associations that affect patients with AD are discussed. Known risk factors for the development of disease are also reviewed. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  16. Current status and guidelines for the assessment of tumour vascular support with dynamic contrast-enhanced computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Miles, K.A. [University of Sussex, Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Falmer (United Kingdom); Lee, T.Y. [Robarts Research Institute, Imaging Research Laboratories, London, Ontario (Canada); Goh, V. [St Thomas' Hospital, Division of Imaging Sciences and Biomedical Engineering, King' s College London, London (United Kingdom); Klotz, E. [Computed Tomography H IM CT PLM-E PA, Siemens Healthcare Sector, Forchheim (Germany); Cuenod, C. [INSERM U970 PARCC, Hopital Europeen Georges Pompidou (HEGP), Paris (France); Bisdas, S. [Eberhard Karls University, Department of Neuroradiology, Tuebingen (Germany); Groves, A.M. [University College London, University College Hospital, Institute of Nuclear Medicine, London (United Kingdom); Hayball, M.P. [Cambridge Computed Imaging Ltd, Cambridge (United Kingdom); Alonzi, R. [Mount Vernon Cancer Centre, Northwood (United Kingdom); Brunner, T. [Gray Institute for Radiation, Oncology and Biology, Oxford (United Kingdom)

    2012-07-15

    Dynamic contrast-enhanced computed tomography (DCE-CT) assesses the vascular support of tumours through analysis of temporal changes in attenuation in blood vessels and tissues during a rapid series of images acquired with intravenous administration of iodinated contrast material. Commercial software for DCE-CT analysis allows pixel-by-pixel calculation of a range of validated physiological parameters and depiction as parametric maps. Clinical studies support the use of DCE-CT parameters as surrogates for physiological and molecular processes underlying tumour angiogenesis. DCE-CT has been used to provide biomarkers of drug action in early phase trials for the treatment of a range of cancers. DCE-CT can be appended to current imaging assessments of tumour response with the benefits of wide availability and low cost. This paper sets out guidelines for the use of DCE-CT in assessing tumour vascular support that were developed using a Delphi process. Recommendations encompass CT system requirements and quality assurance, radiation dosimetry, patient preparation, administration of contrast material, CT acquisition parameters, terminology and units, data processing and reporting. DCE-CT has reached technical maturity for use in therapeutic trials in oncology. The development of these consensus guidelines may promote broader application of DCE-CT for the evaluation of tumour vascularity. (orig.)

  17. Assessing the diagnostic accuracy of the identification of hyperkinetic disorders following the introduction of government guidelines in England

    Directory of Open Access Journals (Sweden)

    Ford Tamsin

    2008-11-01

    Full Text Available Abstract Background Previous studies have suggested that both underdiagnosis and overdiagnosis routinely occur in ADHD and hyperkinesis (hyperkinetic disorders. England has introduced governmental guidelines for these disorders' detection and treatment, but there has been no study on clinical diagnostic accuracy under such a regime. Methods All open cases in three Child and Adolescent Mental Health Services (CAMHS in the South East of England were assessed for accuracy in the detection of hyperkinetic disorders, using a two-stage process employing the Strengths and Difficulties Questionnaire (SDQ for screening, with the cut-off between "unlikely" and "possible" as the threshold for identification, and the Development And Well-Being Assessment (DAWBA as a valid and reliable standard. Results 502 cases were collected. Their mean age 11 years (std dev 3 y; 59% were clinically diagnosed as having a hyperkinetic disorder including ADHD. Clinicians had missed two diagnoses of hyperkinesis and six of ADHD. The only 'false positive' case was one that had become asymptomatic on appropriate treatment. Conclusion The identification of children with hyperkinetic disorders by three ordinary English CAMHS teams appears now to be generally consistent with that of a validated, standardised assessment. It seems likely that this reflects the impact of Governmental guidelines, which could therefore be an appropriate tool to ensure consistent accurate diagnosis internationally.

  18. A Retrospective Performance Assessment of the Developmental Neurotoxicity Study in Support of OECD Test Guideline 426

    DEFF Research Database (Denmark)

    Makris, Susan L.; Raffaele, Kathleen; Allen, Sandra

    2009-01-01

    OBJECTIVE: We conducted a review of the history and performance of developmental neurotoxicity mic (DNT) testing in support of the finalization and implementation of Organisation of Economic Co-operation and Development (OECD) DNT test guideline 426 (TG 426). INFORMATION SOURCES AND ANALYSIS......: In this review we summarize extensive scientific efforts that form the foundation for this testing paradigm, including basic neurotoxicology research, interlaboratory collaborative studies, expert workshops, and validation studies, and we address the relevance, applicability, and use of the DNT study in risk...

  19. An Overview of a Programme of Research to Support the Assessment of Critical Thinking

    Science.gov (United States)

    Black, Beth

    2012-01-01

    Cambridge Assessment has more than 20 years experience in assessing Critical Thinking (CT) in a number of diverse tests and qualifications, unrivalled by any other body within the UK. In recent years, a number of research activities have been carried out in order to support these assessments, with a focus on the validity of measurement. This paper…

  20. Overview of methods used in cross-cultural comparisons of menopausal symptoms and their determinants: Guidelines for Strengthening the Reporting of Menopause and Aging (STROMA) studies.

    Science.gov (United States)

    Melby, Melissa K; Sievert, Lynnette Leidy; Anderson, Debra; Obermeyer, Carla Makhlouf

    2011-10-01

    This paper reviews the methods used in cross-cultural studies of menopausal symptoms with the goal of formulating recommendations to facilitate comparisons of menopausal symptoms across cultures. It provides an overview of existing approaches and serves to introduce four separate reviews of vasomotor, psychological, somatic, and sexual symptoms at midlife. Building on an earlier review of cross-cultural studies of menopause covering time periods until 2004, these reviews are based on searches of Medline, PsycINFO, CINAHL and Google Scholar for English-language articles published from 2004 to 2010 using the terms "cross cultural comparison" and "menopause." Two major criteria were used: a study had to include more than one culture, country, or ethnic group and to have asked about actual menopausal symptom experience. We found considerable variation across studies in age ranges, symptom lists, reference period for symptom recall, variables included in multivariate analyses, and the measurement of factors (e.g., menopausal status and hormonal factors, demographic, anthropometric, mental/physical health, and lifestyle measures) that influence vasomotor, psychological, somatic and sexual symptoms. Based on these reviews, we make recommendations for future research regarding age range, symptom lists, reference/recall periods, and measurement of menopausal status. Recommendations specific to the cross-cultural study of vasomotor, psychological, somatic, and sexual symptoms are found in the four reviews that follow this introduction. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  1. Trauma-related dissociative (conversion) disorders in children and adolescents--an overview of assessment tools and treatment principles.

    Science.gov (United States)

    Diseth, Trond H; Christie, Helen J

    2005-01-01

    A high proportion of patients in child and adolescent psychiatry with significant dissociative symptomatology after early childhood traumatization may go undiagnosed, be wrongly diagnosed and/or inappropriately treated. The diagnostics and treatment of dissociative disorders have been limited by lack of comprehensive, reliable and valid instruments and the ongoing polarization and fierce controversy regarding treatment. However, recent neurobiological findings of neurochemical, functional and structural cerebral consequences of early stressful childhood experiences point out a need for active, early and effective identification and treatment interventions. We present an update on assessment tools available in the Nordic countries, and an overview of different appropriate therapeutic intervention models for children and adolescents. A systematic overview of studies of dissociation in children and adolescent published over the last decade disclosed a total of 1019 references. The 465 papers describing aspects of assessment tools and/or treatment were studied in detail. Reliable and valid screening questionnaires and diagnostic interviews for children and adolescents now allow for effective early identification of dissociative disorders. A combination of individual psychotherapy, pharmacotherapy and family therapy are often required to handle dissociative disorders in children and adolescents. Cognitive-behavioural therapy, hypnotherapy, Eye-Movement Desensitization-Reprocessing (EMDR), psychodynamic therapy and an integrated approach are the main described psychotherapeutic approaches, but treatment of dissociation in children and adolescent does not require allegiance to any one particular treatment model. However, achievement of physical safety by providing a safe environment is a primary goal that supersedes any other therapeutic work. Assessments tools are now available, and appropriate therapeutic intervention models may hopefully contribute to reduce the risk

  2. e-PTSD: an overview on how new technologies can improve prediction and assessment of Posttraumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Bourla, Alexis; Mouchabac, Stephane; El Hage, Wissam; Ferreri, Florian

    2018-01-01

    Background : New technologies may profoundly change our way of understanding psychiatric disorders including posttraumatic stress disorder (PTSD). Imaging and biomarkers, along with technological and medical informatics developments, might provide an answer regarding at-risk patient's identification. Recent advances in the concept of 'digital phenotype', which refers to the capture of characteristics of a psychiatric disorder by computerized measurement tools, is one paradigmatic example. Objective : The impact of the new technologies on health professionals practice in PTSD care remains to be determined. The recent evolutions could disrupt the clinical practices and practitioners in their beliefs, ethics and representations, going as far as questioning their professional culture. In the present paper, we conducted an extensive search to highlight the articles which reflect the potential of these new technologies. Method : We conducted an overview by querying PubMed database with the terms [PTSD] [Posttraumatic stress disorder] AND [Computer] OR [Computerized] OR [Mobile] OR [Automatic] OR [Automated] OR [Machine learning] OR [Sensor] OR [Heart rate variability] OR [HRV] OR [actigraphy] OR [actimetry] OR [digital] OR [motion] OR [temperature] OR [virtual reality]. Results : We summarized the synthesized literature in two categories: prediction and assessment (including diagnostic, screening and monitoring). Two independent reviewers screened, extracted data and quality appraised the sources. Results were synthesized narratively. Conclusions : This overview shows that many studies are underway allowing researchers to start building a PTSD digital phenotype using passive data obtained by biometric sensors. Active data obtained from Ecological Momentary Assessment (EMA) could allow clinicians to assess PTSD patients. The place of connected objects, Artificial Intelligence and remote monitoring of patients with psychiatric pathology remains to be defined. These tools

  3. Guidelines for youth sports clubs to develop, implement, and assess health promotion within its activities.

    Science.gov (United States)

    Kokko, Sami

    2014-05-01

    The settings approach to health promotion is a world-known concept concerning settings like city, hospital, school, and workplace. The concept has also been used in some regionally specific settings, such as island, prison, or university. However, there are still many, often noninstitutional, settings that have a lot of potential but have not yet been recognized. One of the newcomers is the youth sports club, which has the potential to reach a lot of children and adolescents and is effective, via its casual educational nature based on voluntary participation. According to research, health is an important aim for most youth sports clubs, but it has not been converted into practical actions. Indeed, the clubs often recognize the importance of healthy lifestyles, but there is a lack of understanding of what to do to reinforce it within one's activities. That is why, on the basis of the results of the Health Promoting Sports Club survey in Finland, guidelines for clubs to enhance health promotion as a part of their activities were created. The aim of this article is to present the guidelines, theirs rationale, and practical examples.

  4. Levels and Patterns of Objectively Assessed Physical Activity and Compliance with Different Public Health Guidelines in University Students.

    Directory of Open Access Journals (Sweden)

    Natalia María Arias-Palencia

    Full Text Available Physical activity (PA is associated with health enhancement. The aim of this study was to assess: 1 levels and patterns of PA in university students by using accelerometers; and 2 the percentage of fulfilment of PA recommendations for adults, according to different public health guidelines.Observational cross-sectional study (Cuenca's Adults Study involving 296 (206 women healthy Spanish university students aged 18-25 years old. Participants wore the ActiGraph GT1M accelerometer for seven consecutive days. Total PA, steps and time spent in sedentary time, light, moderate, vigorous, and moderate to vigorous PA (MVPA was assessed, and the prevalence of sufficient PA was calculated according to various public health guidelines.No sex differences in total PA were found. University students were more sedentary during weekend days than weekdays (p<0.05. Only 30.3% of participants accumulated 30 min/day at least five days a week of MVPA. A total of 5.4% of students met the recommendation of 150 min/week of MVPA or 75 min/week of vigorous PA, in PA bouts of at least 10 min. using the same definition, but on five or more days a week, only 0.5% students were found to meet the recommendation. In addition, only 0.5% of students met the recommendation of 30 min/day of MVPA, at least five days a week and in bouts of at least 10 min. Finally, 28.1% of the students met the recommendation of 10,000 steps/day.Our study shows a high incidence of sedentary time in university students. The number of students meeting PA recommendations significantly differed depending on the recommendation proposed. Specific strategies to promote PA in this population are necessary as well as an agreement as to which PA guidelines should be used.

  5. The superworlds of SU(5) and SU(5) x U(1) a critical assessment and overview

    CERN Document Server

    López, J L; Zichichi, Antonino

    1993-01-01

    We present an overview of the simplest supergravity models which enforce radiative breaking of the electroweak symmetry, namely the minimal $SU(5)$ supergravity model and the class of string-inspired/derived supergravity models based on the flipped $SU(5)\\times U(1)$ structure supplemented by a minimal set of additional matter representations such that unification occurs at the string scale ($\\sim10^{18}\\GeV$). These models can be fully parametrized in terms of the top-quark mass, the ratio $\\tan\\beta=v_2/v_1$, and three supersymmetry breaking parameters ($m_{1/2},m_0,A$). The latter are chosen in the minimal $SU(5)$ model such that the stringent constraints from proton decay and cosmology are satisfied. In the flipped $SU(5)$ case we consider two string-inspired supersymmetry breaking scenaria: $SU(N,1)$ no-scale supergravity and a dilaton-induced supersymmetry breaking scenario. Both imply universal soft supersymmetry breaking parameters: $m_0=A=0$ and $m_0=\\coeff{1}{\\sqrt{3}}m_{1/2}, A=-m_{1/2}$ respective...

  6. T-H-M couplings in rock. Overview of results of importance to the SR-Can safety assessment

    Energy Technology Data Exchange (ETDEWEB)

    Hoekmark, Harald; Faelth, Billy [Clay Technology AB, Lund (Sweden); Wallroth, Thomas [BERGAB, Goeteborg (Sweden)

    2006-09-15

    hydraulic significance of the Excavation Damaged Zone (EDZ) is assessed from experiences and observations made during different tunnelling projects at the Aespoe Hard Rock laboratory and from conclusions of topical overviews. Previously, the general view was that an EDZ would form an independent and fast pathway along the drift. This is recognized to be an oversimplification. Rather, the EDZ is more likely to be discontinuous. In addition, it will be possible to reduce the damage by applying improved drill and blast procedures. The impacts of heat generation and glacial load on the hydraulic conditions in the far-field are analyzed using results from large-scale DEC thermo-mechanical models and preliminary results from on-going simulations of the ice-crust-mantle interaction during the most recent glaciation. Spalling in the walls of deposition holes as a result of excavation is concluded to be unlikely at all sites, but almost certain to occur after a few years of heating in dry deposition holes where the bentonite buffer has not taken up sufficient amounts of water to establish any support pressure. There are many uncertainties. The most important one is probably that of the development of stresses and pore pressures at repository depth during a glacial cycle. The ice-crust-mantle interaction analyses used to calculate the stresses assumed in this report are based on an earth model that appears to be too simplistic for this particular purpose. New analyses, with more realistic earth models and with updated ice load data, are underway and will be used to revise the results given here. Also some of the stress-transmissivity relations are uncertain, in particular when it comes to estimating effects of deformations of large fractures. Other uncertainties, for instance in site data such as the magnitudes and orientations of in situ stresses and rock properties data, are large but not larger than corresponding differences between the different sites, and do not appear to be of

  7. Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease.

    Science.gov (United States)

    Cameron, Daniel J; Johnson, Lorraine B; Maloney, Elizabeth L

    2014-09-01

    Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions - the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease. Healthcare providers who evaluate and manage patients with Lyme disease are the intended users of the new ILADS guidelines, which replace those issued in 2004 (Exp Rev Anti-infect Ther 2004;2:S1-13). These clinical practice guidelines are intended to assist clinicians by presenting evidence-based treatment recommendations, which follow the Grading of Recommendations Assessment, Development and Evaluation system. ILADS guidelines are not intended to be the sole source of guidance in managing Lyme disease and they should not be viewed as a substitute for clinical judgment nor used to establish treatment protocols.

  8. Humans and Ecosystems Over the Coming Millennia: Overview of a Biosphere Assessment of Radioactive Waste Disposal in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Kautsky, Ulrik; Lindborg, Tobias [Swedish Nuclear Fuel and Waste Management Co. (SKB), Stockholm (Sweden)], E-mail: ulrik.kautsky@skb.se; Valentin, Jack [Stockholm (Sweden)

    2013-05-15

    This is an overview of the strategy used to describe the effects of a potential release from a radioactive waste repository on human exposure and future environments. It introduces a special issue of AMBIO, in which 13 articles show ways of understanding and characterizing the future. The study relies mainly on research performed in the context of a recent safety report concerning a repository for spent nuclear fuel in Sweden (the so-called SR-Site project). The development of a good understanding of on-site processes and acquisition of site-specific data facilitated the development of new approaches for assessment of surface ecosystems. A systematic and scientifically coherent methodology utilizes the understanding of the current spatial and temporal dynamics as an analog for future conditions. We conclude that future ecosystem can be inferred from a few variables and that this multidisciplinary approach is relevant in a much wider context than radioactive waste.

  9. Nanotechnologies in agriculture and food - an overview of different fields of application, risk assessment and public perception.

    Science.gov (United States)

    Grobe, Antje; Rissanen, Mikko E

    2012-12-01

    Nanomaterials in agriculture and food are key issues of public and regulatory interest. Over the past ten years, patents for nanotechnological applications in the field of food and agriculture have become abundant. Uncertainty prevails however regarding their current development status and presence in the consumer market. Thus, the discussion on nanotechnologies in the food sector with its specific public perception of benefits and risks and the patterns of communication are becoming similar to the debate on genetically modified organisms. The food industry's silence in communication increased mistrust of consumer organisations and policy makers. The article discusses the background of the current regulatory debates, starting with the EU recommendation for defining nanomaterials, provides an overview of possible fields of application in agriculture and food industries and discusses risk assessment and the public debate on benefits and risks. Communicative recommendations are directed at researchers, the food industry and regulators in order to increase trust both in stakeholders, risk management and regulatory processes.

  10. Humans and ecosystems over the coming millennia: overview of a biosphere assessment of radioactive waste disposal in Sweden.

    Science.gov (United States)

    Kautsky, Ulrik; Lindborg, Tobias; Valentin, Jack

    2013-05-01

    This is an overview of the strategy used to describe the effects of a potential release from a radioactive waste repository on human exposure and future environments. It introduces a special issue of AMBIO, in which 13 articles show ways of understanding and characterizing the future. The study relies mainly on research performed in the context of a recent safety report concerning a repository for spent nuclear fuel in Sweden (the so-called SR-Site project). The development of a good understanding of on-site processes and acquisition of site-specific data facilitated the development of new approaches for assessment of surface ecosystems. A systematic and scientifically coherent methodology utilizes the understanding of the current spatial and temporal dynamics as an analog for future conditions. We conclude that future ecosystem can be inferred from a few variables and that this multidisciplinary approach is relevant in a much wider context than radioactive waste.

  11. Assessment of CPR-D skills of nursing students in two institutions: reality versus recommendations in the guidelines.

    Science.gov (United States)

    Mäkinen, Marja; Axelsson, Asa; Castrén, Maaret; Nurmi, Jouni; Lankinen, Iira; Niemi-Murola, Leila

    2010-08-01

    Significant differences in basic life support skills including cardiopulmonary resuscitation and defibrillation (CPR-D) were detected when nurses working in one Finnish and one Swedish hospital were tested using an Objective Structured Clinical Examination (OSCE). The purpose of this study was to use OSCE test in assessing guideline based CPR-D skills of newly qualified nurses. The CPR-D skills of newly qualified registered nurses studying in Halmstad University (n = 30), Sweden, Helsinki Metropolia University of Applied Sciences (n = 30), and Finland were assessed using an OSCE which was built up with a case of cardiac arrest with ventricular fibrillation as the initial rhythm. The Angoff average, 32.47, was calculated as cutoff point to pass the test. Forty-seven percent of the students in the Swedish group (mean score 32.47/49, range 26-39, SD 3.76) and 13% of the students in the Finnish group (mean score 23.80/49, range 13-35, SD 4.32) passed the OSCE (Pskills correlated with high grading of the clinical skills. In conclusion, CPR-D skills of the newly qualified nurses in both the institutes were clearly under par and were not adequate according to the resuscitation guidelines. Current style of teaching is unlikely to result in students being able to perform adequate CPR-D. Standardized testing would help in controlling the quality of learning.

  12. Evaluation of Chemical Warfare Agent Percutaneous Vapor Toxicity: Derivation of Toxicity Guidelines for Assessing Chemical Protective Ensembles.

    Energy Technology Data Exchange (ETDEWEB)

    Watson, A.P.

    2003-07-24

    Percutaneous vapor toxicity guidelines are provided for assessment and selection of chemical protective ensembles (CPEs) to be used by civilian and military first responders operating in a chemical warfare agent vapor environment. The agents evaluated include the G-series and VX nerve agents, the vesicant sulfur mustard (agent HD) and, to a lesser extent, the vesicant Lewisite (agent L). The focus of this evaluation is percutaneous vapor permeation of CPEs and the resulting skin absorption, as inhalation and ocular exposures are assumed to be largely eliminated through use of SCBA and full-face protective masks. Selection of appropriately protective CPE designs and materials incorporates a variety of test parameters to ensure operability, practicality, and adequacy. One aspect of adequacy assessment should be based on systems tests, which focus on effective protection of the most vulnerable body regions (e.g., the groin area), as identified in this analysis. The toxicity range of agent-specific cumulative exposures (Cts) derived in this analysis can be used as decision guidelines for CPE acceptance, in conjunction with weighting consideration towards more susceptible body regions. This toxicity range is bounded by the percutaneous vapor estimated minimal effect (EME{sub pv}) Ct (as the lower end) and the 1% population threshold effect (ECt{sub 01}) estimate. Assumptions of exposure duration used in CPE certification should consider that each agent-specific percutaneous vapor cumulative exposure Ct for a given endpoint is a constant for exposure durations between 30 min and 2 hours.

  13. General overview of the theories used in assessment: AMEE Guide No. 57.

    NARCIS (Netherlands)

    Schuwirth, L.W.; Vleuten, C.P.M. van der

    2011-01-01

    There are no scientific theories that are uniquely related to assessment in medical education. There are many theories in adjacent fields, however, that can be informative for assessment in medical education, and in the recent decades they have proven their value. In this AMEE Guide we discuss

  14. Overview: assessing the impacts of climate change on U.S. forests

    Science.gov (United States)

    Linda A. Joyce; Richard Birdsey

    2000-01-01

    The Forest Service conducts periodic assessments of the condition of forest and rangeland resources under the authority of the Renewable Resources Planning Act (RPA). The structure of these periodic assessments allows for the synthesis and integration of the current state of scientific knowledge (U.S. Department of Agriculture Forest Service 1989, 1994). As part of the...

  15. An Overview of CAS Standards: The Role in Self-Assessment and Evaluation

    Science.gov (United States)

    Hornak, Anne M.

    2014-01-01

    This chapter explores CAS as a tool for collecting assessment and evaluation data in community college student affairs offices. Details are provided about accessing the self-assessment modules, as well as the resources available to assist colleges with data collection. Finally, the chapter will explore how to use the data to advocate for…

  16. Two Decades of SIMCE: An Overview of the National Assessment System in Chile

    Science.gov (United States)

    Meckes, Lorena; Carrasco, Rafael

    2010-01-01

    The Chilean national learning outcome assessment system (Sistema de Medicion de Calidad de la Educacion, SIMCE) has carried out census-based assessments since 1988 and publishes the results at both the national and school levels. During its 20 years of existence, SIMCE has experienced changes in its institutional framework, objectives,…

  17. International guidelines for the in vivo assessment of skin properties in non-clinical settings

    DEFF Research Database (Denmark)

    Stefaniak, Aleksandr B; Plessis, Johan du; John, Swen M

    2013-01-01

    position, skin health, time of day), exogenous (hand washing, barrier creams, soaps and detergents, occlusion), environmental (seasonality), and measurement (atmospheric conditions) factors; (ii) report pH measurements results as a difference or percent change (not absolute values) using a measure......BACKGROUND: Skin surface pH is known to influence the dissolution and partitioning of chemicals and may influence exposures that lead to skin diseases. Non-clinical environments (e.g. workplaces) are highly variable, thereby presenting unique measurement challenges that are not typically...... encountered in clinical settings. Hence, guidelines are needed for consistent measurement of skin surface pH in environments that are difficult to control. METHODS: An expert workshop was convened at the 5th International Conference on Occupational and Environmental Exposure of Skin to Chemicals to review...

  18. Overview of integrative assessment of marine systems: the Ecosystem Approach in practice

    Directory of Open Access Journals (Sweden)

    Angel eBorja

    2016-03-01

    Full Text Available Traditional and emerging human activities are increasingly putting pressures on marine ecosystems and impacting their ability to sustain ecological and human communities. To evaluate the health status of marine ecosystems we need a science-based, integrated Ecosystem Approach, that incorporates knowledge of ecosystem function and services provided that can be used to track how management decisions change the health of marine ecosystems. Although many methods have been developed to assess the status of single components of the ecosystem, few exist for assessing multiple ecosystem components in a holistic way. To undertake such an integrative assessment, it is necessary to understand the response of marine systems to human pressures. Hence, innovative monitoring is needed to obtain data to determine the health of large marine areas, and in an holistic way. Here we review five existing methods that address both of these needs (monitoring and assessment: the Ecosystem Health Assessment Tool; a method for the Marine Strategy Framework Directive in the Bay of Biscay; the Ocean Health Index; the Marine Biodiversity Assessment Tool; and the Nested Environmental status Assessment Tool. We have highlighted their main characteristics and analyzing their commonalities and differences, in terms of: use of the Ecosystem Approach; inclusion of multiple components in the assessment; use of reference conditions; use of integrative assessments; use of a range of values to capture the status; weighting ecosystem components when integrating; determine the uncertainty; ensure spatial and temporal comparability; use of robust monitoring approaches; and address pressures and impacts. Ultimately, for any ecosystem assessment to be effective it needs to be: transparent and repeatable and, in order to inform marine management, the results should be easy to communicate to wide audiences, including scientists, managers and policymakers.

  19. Buckling-driven delamination growth in composite laminates: Guidelines for assessing the threat posed by interlaminar matrix delamination

    DEFF Research Database (Denmark)

    Bhushan, Karihaloo; Stang, Henrik

    2008-01-01

    This paper is concerned with development of a simple procedure to assess the threat posed by interlaminar matrix delaminations to the integrity of composite laminates when they are situated in a compressive stress field. Depending upon the size of the delamination, its location below the surface...... and on the level of the applied stress, it may or may not buckle away from the rest of the laminate. If it buckles, the post-buckling response will depend upon the applied compressive stress level, the thickness of the delaminated ply and the interlaminar critical energy release rate of the composite material...... for the mode mixity present at the delamination front. The pre- and post-buckling response is examined in its simplest form and guidelines provided for assessing whether or not a delamination detected during quality control or inspection poses a threat to the safe operation of the composite laminate....

  20. Environmental assessment of a territory: an overview of existing tools and methods.

    Science.gov (United States)

    Loiseau, Eléonore; Junqua, Guillaume; Roux, Philippe; Bellon-Maurel, Véronique

    2012-12-15

    In order to reduce our environmental impact, methods for environmental assessment of human activities are urgently needed. In particular in the case of assessment of land planning scenarios, there is presently no consensual and widely adopted method although it is strongly required by the European Directive (2001/42/EC) on Strategic Environmental Assessment. However, different kinds of tools and methods are available such as human and environmental risk assessment, the ecological footprint, material flow analysis, substance flow analysis, physical input-output table, ecological network analysis, exergy, emergy or life cycle assessment. This review proposes a discussion on these tools and methods specifically applied to territories. After the meaning of territory is clarified, these approaches are presented and analyzed based on "key features" such as formalization, system modeling, inventoried flows, indicators provided and usability. This comparison highlights the strengths and weaknesses of each tool. It also emphasizes that the approach of life cycle assessment could provide a relevant framework for the environmental assessment of territories as it is the only method which can avoid burden shifting between life cycle stages, environmental impacts and territories. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Solar Radiation Resource Assessment Project. Program overview of fiscal year 1993

    Energy Technology Data Exchange (ETDEWEB)

    1994-06-01

    The mission of the Solar Radiation Resource Assessment Project is to provide essential information about the solar radiation resource to users and planners of solar technologies so that they can make informed and timely decisions concerning applications of those technologies. The project team accomplishes this by producing and disseminating relevant and reliable information about solar radiation. Topics include: Variability of solar radiation, measurements of solar radiation, spectral distribution of solar radiation, and assessment of the solar resource. FY 1993 accomplishments are detailed.

  2. School-Based Mental Health Professionals' Bullying Assessment Practices: A Call for Evidence-Based Bullying Assessment Guidelines

    Science.gov (United States)

    Blake, Jamilia; Banks, Courtney S.; Patience, Brenda A.; Lund, Emily M.

    2014-01-01

    A sample of 483 school-based mental health professionals completed a survey about the training they have received related to conducting bullying assessments in schools, competence in conducting an assessment of bullying, and the bullying assessment methods they used. Results indicate that school counselors were usually informed about incidents of…

  3. Assessment of Coronary Artery Calcium Scoring for Statin Treatment Strategy according to ACC/AHA Guidelines in Asymptomatic Korean Adults.

    Science.gov (United States)

    Han, Donghee; Ó Hartaigh, Bríain; Lee, Ji Hyun; Rizvi, Asim; Park, Hyo Eun; Choi, Su Yeon; Sung, Jidong; Chang, Hyuk Jae

    2017-01-01

    The 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol management guidelines advocate the use of statin treatment for prevention of cardiovascular disease. We aimed to assess the usefulness of coronary artery calcium (CAC) for stratifying potential candidates of statin use among asymptomatic Korean individuals. A total of 31375 subjects who underwent CAC scoring as part of a general health examination were enrolled in the current study. Statin eligibility was categorized as statin recommended (SR), considered (SC), and not recommended (SN) according to ACC/AHA guidelines. Cox regression analysis was employed to estimate hazard ratios (HR) with 95% confidential intervals (CI) after stratifying the subjects according to CAC scores of 0, 1-100, and >100. Number needed to treat (NNT) to prevent one mortality event during study follow up was calculated for each group. Mean age was 54.4±7.5 years, and 76.3% were male. During a 5-year median follow-up (interquartile range; 3-7), there were 251 (0.8%) deaths from all-causes. A CAC >100 was independently associated with mortality across each statin group after adjusting for cardiac risk factors (e.g., SR: HR, 1.60; 95% CI, 1.07-2.38; SC: HR, 2.98; 95% CI, 1.09-8.13, and SN: HR, 3.14; 95% CI, 1.08-9.17). Notably, patients with CAC >100 displayed a lower NNT in comparison to the absence of CAC or CAC 1-100 in SC and SN groups. In Korean asymptomatic individuals, CAC scoring might prove useful for reclassifying patient eligibility for receiving statin therapy based on updated 2013 ACC/AHA guidelines.

  4. Assessing Risks to Wildlife Populations from Multiple Stressors: Overview of the Problem and Research Needs.

    Directory of Open Access Journals (Sweden)

    Wayne R. Munns, Jr.

    2006-06-01

    Full Text Available Wildlife populations are experiencing increasing pressure from human-induced changes in the landscape. Stressors including agricultural and urban land use, introduced invasive and exotic species, nutrient enrichment, direct human disturbance, and toxic chemicals directly or indirectly influence the quality and quantity of habitat used by terrestrial and aquatic wildlife. Governmental agencies such as the U.S. Environmental Protection Agency are required to assess risks to wildlife populations, in its broadest definition, that result from exposure to these stressors, yet considerable uncertainty exists with respect to how such assessments should be conducted. This uncertainty is compounded by questions concerning the interactive effects of co-occurring stressors, appropriate spatial scales of analysis, extrapolation of response data among species and from organisms to populations, and imperfect knowledge and use of limited data sets. Further, different risk problems require varying degrees of sophistication, methodological refinement, and data quality. These issues suggest a number of research needs to improve methods for wildlife risk assessments, including continued development of population dynamics models to evaluate the effects of multiple stressors at varying spatial scales, methods for extrapolating across endpoints and species with reasonable confidence, stressor-response relations and methods for combining them in predictive and diagnostic assessments, and accessible data sets describing the ecology of terrestrial and aquatic species. Case study application of models and methods for assessing wildlife risk will help to demonstrate their strengths and limitations for solving particular risk problems.

  5. Overview of Pain Management in Older Adults.

    Science.gov (United States)

    Savvas, Steven M; Gibson, Stephen J

    2016-11-01

    Epidemiological data suggests that the prevalence of musculoskeletal and neuropathic pain increases with age until at least late mid-life, though the pattern is somewhat unclear beyond this point. And though the prevalence of some types of pain may peak in late midlife, pain is still a substantial and common complaint even in the oldest age groups. This article provides an overview of later-life pain and includes a brief review of its epidemiology, describes commonly encountered barriers to its management, and discusses guidelines and recommended approaches to its assessment and management. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. International guidelines for the in vivo assessment of skin properties in non-clinical settings

    DEFF Research Database (Denmark)

    du Plessis, Johan; Stefaniak, Aleksandr; Eloff, Fritz

    2013-01-01

    There is an emerging perspective that it is not sufficient to just assess skin exposure to physical and chemical stressors in workplaces, but that it is also important to assess the condition, i.e. skin barrier function of the exposed skin at the time of exposure. The workplace environment, repre...

  7. 75 FR 15485 - Pipeline Safety: Workshop on Guidelines for Integrity Assessment of Cased Pipe

    Science.gov (United States)

    2010-03-29

    ... will be for the public, pipeline operators, trade associations, and others to address ideas and concerns with using External Corrosion Direct Assessment integrity evaluation methods and use of other... they were encountering technical challenges in conducting External Corrosion Direct Assessment (ECDA...

  8. EPA`s program for risk assessment guidelines: Cancer classification issues

    Energy Technology Data Exchange (ETDEWEB)

    Wiltse, J. [Environmental Protection Agency, Washington, DC (United States)

    1990-12-31

    Issues presented are related to classification of weight of evidence in cancer risk assessments. The focus in this paper is on lines of evidence used in constructing a conclusion about potential human carcinogenicity. The paper also discusses issues that are mistakenly addressed as classification issues but are really part of the risk assessment process. 2 figs.

  9. School-Based Assessment of ADHD: Purpose, Alignment with Best Practice Guidelines, and Training

    Science.gov (United States)

    Ogg, Julia; Fefer, Sarah; Sundman-Wheat, Ashley; McMahan, Melanie; Stewart, Tiffany; Chappel, Ashley; Bateman, Lisa

    2013-01-01

    Youth exhibiting symptoms of attention deficit hyperactivity disorder are frequently referred to school psychologists because of academic, social, and behavioral difficulties that they face. To address these difficulties, evidence-based assessment methods have been outlined for multiple purposes of assessment. The goals of this study were to…

  10. Overview of BioCreAtIvE: critical assessment of information extraction for biology

    Directory of Open Access Journals (Sweden)

    Hirschman Lynette

    2005-05-01

    Full Text Available Abstract Background The goal of the first BioCreAtIvE challenge (Critical Assessment of Information Extraction in Biology was to provide a set of common evaluation tasks to assess the state of the art for text mining applied to biological problems. The results were presented in a workshop held in Granada, Spain March 28–31, 2004. The articles collected in this BMC Bioinformatics supplement entitled "A critical assessment of text mining methods in molecular biology" describe the BioCreAtIvE tasks, systems, results and their independent evaluation. Results BioCreAtIvE focused on two tasks. The first dealt with extraction of gene or protein names from text, and their mapping into standardized gene identifiers for three model organism databases (fly, mouse, yeast. The second task addressed issues of functional annotation, requiring systems to identify specific text passages that supported Gene Ontology annotations for specific proteins, given full text articles. Conclusion The first BioCreAtIvE assessment achieved a high level of international participation (27 groups from 10 countries. The assessment provided state-of-the-art performance results for a basic task (gene name finding and normalization, where the best systems achieved a balanced 80% precision / recall or better, which potentially makes them suitable for real applications in biology. The results for the advanced task (functional annotation from free text were significantly lower, demonstrating the current limitations of text-mining approaches where knowledge extrapolation and interpretation are required. In addition, an important contribution of BioCreAtIvE has been the creation and release of training and test data sets for both tasks. There are 22 articles in this special issue, including six that provide analyses of results or data quality for the data sets, including a novel inter-annotator consistency assessment for the test set used in task 2.

  11. Assessment of in-vitro efficacy of 1% Virkon against bacteria, fungi, viruses and spores by means of AFNOR guidelines.

    Science.gov (United States)

    Herńndez, A; Martró, E; Matas, L; Martín, M; Ausina, V

    2000-11-01

    Peroxygenic acid, under the brand name Virkon, has unleashed great debate following contradictory reports of its efficacy and spectrum of activity. The aim of this study was to test the biocidal activity of the compound against 10 different micro-organisms, following standard in-vitro test procedures. Bactericidal, fungicidal and sporicidal activities were determined using quantitative suspension and germ carrier tests and virucidal activity was assessed using a simple dilution suspension test, following the Association Française de Normalisation (AFNOR) guidelines. One percent Virkon demonstrated bactericidal activity against Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Enterococcus hirae and Mycobacterium smegmatis in the suspension test and against P. aeruginosa, E. coli, S. aureus and E. hirae in the carrier test. One percent Virkon showed virucidal activity against poliovirus in the suspension test. However, this concentration did not comply with sporicidal and fungicidal activity guidelines. In conclusion, 1% Virkon is effective only against vegetative bacteria, yeasts and viruses, and should therefore be considered a low-level disinfectant. Copyright 2000 The Hospital Infection Society.

  12. The release of genetically modified crops into the environment - Part II. Overview of ecological risk assessment

    NARCIS (Netherlands)

    Conner, A.J.; Glare, T.R.; Nap, J.P.H.

    2003-01-01

    Despite numerous future promises, there is a multitude of concerns about the impact of GM crops on the environment. Key issues in the environmental assessment of GM crops are putative invasiveness, vertical or horizontal gene flow, other ecological impacts, effects on biodiversity and the impact of

  13. Workshop overview : Approaches to the assessment of the allergenic potential of food from genetically modified crops

    NARCIS (Netherlands)

    Ladics, G.S.; Holsapple, M.P.; Astwood, J.D.; Kimber, I.; Knippels, L.M.J.; Helm, R.M.; Dong, W.

    2003-01-01

    There is a need to assess the safety of foods deriving from genetically modified (GM) crops, including the allergenic potential of novel gene products. Presently, there is no single in vitro or in vivo model that has been validated for the identification or characterization of potential food

  14. MENTAL AND PSYCHOMOTOR RETARDATION IN EARLY CHILDHOOD: Overview and development of a protocol for neuropsychological assessment.

    Directory of Open Access Journals (Sweden)

    María del Mar Sánchez-Joya

    2010-12-01

    Full Text Available Introduction: The last decades have brought great advances in the understanding of child neurodevelopment and knowledge of cognitive processes that occur in the brain from an early age. As a result and thanks to the large number of standardized and scientifically guaranteed neuropsychological tests that are available today, we can assess and diagnose with high specificity, deficits or delays in the acquisition of cognitive functions. Besides, it allows knowing the strengths or normality points of children with various pathologies. Objective: To present the concepts and a neuropsychological assessment protocol for mental retardation, pervasive developmental disorder and psychomotor retardation. Development: First, the authors present a general model of neuropsychological assessment in childhood. Second, he concept, classification and aetiology of mental retardation is revised and it is proposed a neuropsychological profile. Finally, the paradigms of pervasive developmental disorder and psychomotor retardation are shown. Conclusion: Based on standardized and validated test for child neuropsychological assessment, children cognitive disorders can be accurately identified to plan each child's cognitive stimulation, and thus optimize the results of the therapy.

  15. Using Personal Cell Phones for Ecological Momentary Assessment An Overview of Current Developments

    NARCIS (Netherlands)

    Kuntsche, E.N.; Labhart, F.

    2013-01-01

    Ecological Momentary Assessment (EMA) is a way of collecting data in people's natural environments in real time and has become very popular in social and health sciences. The emergence of personal digital assistants has led to more complex and sophisticated EMA protocols but has also highlighted

  16. Value Added Teacher Preparation Assessment: Overview of 2007-08 Study

    Science.gov (United States)

    Noell, George; Burns, Jeanne M.

    2008-01-01

    The Louisiana Board of Regents is the first in the nation to publicly use a performance model based upon the achievement of students in grades 4-9 as one of several measures to examine the effectiveness of teacher preparation programs. The State has supported the development and implementation of a Value Added Teacher Preparation Assessment Model…

  17. Deliverable 4.3 Decision support guideline based on LCA and cost/efficiency assessment

    DEFF Research Database (Denmark)

    Larsen, Henrik Fred; Hansen, Peter Augusto; Boyer-Souchet, Florence

    2010-01-01

    The environmental sustainability assessments described in this report is based on life cycle assessments (LCA) of selected waste water treatment technology (WWTT) cases included in NEPTUNE. The basic approach in these assessments (avoided against induced impacts) is described in Deliverable 4...... into four clusters related to the main purpose of the treatment, e.g. nutrient removal or micropollutant removal. All are assessed within the cluster by comparing with the reference or by looking at induced versus avoided environmental impacts potentials originated from the various emissions and flows...... inventory of cluster 1 on micropollutant removal, tracks 22 organic micropollutants (pharmaceuticals) that have been sampled in different WWTTs by NEPTUNE partners. The resulting inventory is then modelled according to the EDIP97 methodology on the GaBi LCA modelling software, i.e. GaBi 4 (PE 2008...

  18. The state of school-based bilingual assessment: actual practice versus recommended guidelines.

    Science.gov (United States)

    Caesar, Lena G; Kohler, Paula D

    2007-07-01

    This study was designed to investigate the frequency with which school-based speech-language pathologists (SLPs) used recommended practices when assessing the language skills of bilingual students. The study also investigated the frequency with which SLPs used formal, standardized tests versus informal, alternative procedures with this population. A total of 596 surveys were mailed out to school-based SLPs in the state of Michigan who were members of the Michigan Speech, Language, and Hearing Association (MSHA) during the 2003-2004 academic year. Of the 409 usable surveys that were returned, 130 respondents indicated being involved in assessing bilingual children and comprised the sample used in this study. Results indicated that SLPs used formal, standardized English tests more frequently than informal assessment procedures when assessing bilingual students. Further in-depth analyses of SLPs' responses indicated that neither factors related to their years of experience or factors related to their academic preparation were significantly related to their use of recommended assessment practices. However, significant differences in use were noted based on respondents' employment settings. This study underscores the need for academic training programs and professional organizations to intentionally disseminate information regarding the expediency of alternative testing procedures. Implications for the adequate nonbiased assessment of bilingual children are discussed.

  19. Overview and Critical Assessment of the Tensile Properties of unirradiated and irradiated EUROFER97

    Energy Technology Data Exchange (ETDEWEB)

    Lucon, E.; Vandermeulen, W.

    2007-10-15

    Material research represents a crucial issue for the assessment of fusion as a future viable source of energy. Structural materials, in particular, need to show a superior mechanical and chemical behaviour to guarantee the safe operation of the reactor during its whole lifetime, while retaining low activation characteristics to minimise the environmental impact of the produced waste. In this context, specific efforts have been focused for the last twenty years in Europe, Japan and the US, on developing suitable Reduced Activation Ferritic Martensitic (RAFM) steels as candidate structural materials. EUROFER97 has recently emerged in Europe as the reference material for the DEMO design. In the framework of the Long-Term Programme of EFDA (European Fusion Development Agreement), a coordinated effort has been launched aimed at providing a critical assessment of the mechanical and microstructural properties of EUROFER97 in the unirradiated and irradiated conditions, based on the results accumulated since the late 90ies within numerous EFDA tasks.

  20. Life cycle assessment in green chemistry: overview of key parameters and methodological concerns

    DEFF Research Database (Denmark)

    Tufvesson, Linda M.; Tufvesson, Pär; Woodley, John

    2013-01-01

    Several articles within the area of green chemistry often promote new techniques or products as ‘green’ or ‘more environmentally benign’ than their conventional counterpart although these articles often do not quantitatively assess the environmental performance. In order to do this, life cycle...... with the purpose to reduce the time-consuming steps in LCA.In this review, several LCAs of so-called ‘green chemicals’ are analysed and key parameters and methodological concerns are identified. Further, some conclusions on the environmental performance of chemicals were drawn.For fossil-based platform chemicals......, for example eutrophication and the use of land.To assess the environmental performance of green chemicals, quantitative methods are needed. For this purpose, both simple metrics and more comprehensive methods have been developed, one recognised method being LCA. However, this method is often too time...

  1. EVIDENCE-BASED ASSESSMENT OF VOICE DISORDERS: A THEORETICAL OVERVIEW AND MODEL

    Directory of Open Access Journals (Sweden)

    Dobrinka GEORGIEVA

    2011-04-01

    Full Text Available This article deals with the current paradigm of evidence-based practices of the Speech Therapy (Speech language pathology, especially diagnosing based on evidences of voice disorders. One of the main goals of this article is to define voice disorders according to the World Health Organization’s ICF multidimensional concept. Using a comparative method, this study attempts to prove that traditionally, the assessment outcomes of voice disorders in the Speech Therapy have been largely based on the speech therapist’s point of view and never on the client’s position. The research insists on establishing and adopting definitive gold standards, with respect to voice assessment and therapy in Bulgaria.

  2. WP 2 Report: Integrated Status Quo and Trends Assessment in Wuxi. Overview of WP 2 Results

    Energy Technology Data Exchange (ETDEWEB)

    Dienst, Carmen; Hoeller, Samuel; Saurat, Mathieu; Schneider, Clemens; Xia-Bauer, Chun (Wuppertal Institute (Germany)); Oberheitmann, Andreas (China Environmental Research (China)); Fischer, Tom; Gemmer, Marco; Jiang Tong (China Meteorological Administration, National Climate Centre (China)); Wang Can; Wang Haoping (Tsinghua University, Research Centre for International Environmental Policy (China)); Ren Hongyan; Sui Xinying (Wuxi Low Carbon Development Research Centre (China))

    2013-04-01

    The overall project will scientifically explore the Low Carbon Future City (LCFC) concept in two case studies: the German region of Dusseldorf and the Chinese city of Wuxi, Jiangsu Province. The Wuppertal Institute together with a consortium of Chinese scientific institutes is developing integrated low carbon city strategies for the two pilot regions. The project is funded by the German Stiftung Mercator. Provided in this report, as part of the scientific analysis of the Chinese pilot region, is a comprehensive status quo and trends assessment of greenhouse gas emissions, climate change and resource use in Wuxi. It includes a GHG inventory, a business-as-usual scenario for GHG emissions, scenarios for future climate change and its impacts as well as an analysis of future resource use in the energy and buildings sector of Wuxi. Based on this assessment, the authors have selected key sectors for which low carbon scenarios as well as policy strategies will be finalised.

  3. Neuropathological assessment and validation of mouse models for Alzheimer's disease: applying NIA-AA guidelines

    Directory of Open Access Journals (Sweden)

    C. Dirk Keene

    2016-06-01

    Full Text Available Dozens of transgenic mouse models, generally based on mutations associated with familial Alzheimer's disease (AD, have been developed, in part, for preclinical testing of candidate AD therapies. However, none of these models has successfully predicted the clinical efficacy of drugs for treating AD patients. Therefore, development of more translationally relevant AD mouse models remains a critical unmet need in the field. A concept not previously implemented in AD preclinical drug testing is the use of mouse lines that have been validated for neuropathological features of human AD. Current thinking suggests that amyloid plaque and neurofibrillary tangle deposition is an essential component for accurate modeling of AD. Therefore, the AD translational paradigm would require pathologic Aβ and tau deposition, a disease-relevant distribution of plaques and tangles, and a pattern of disease progression of Aβ and tau isoforms similar to the neuropathological features found in the brains of AD patients. Additional parameters useful to evaluate parallels between AD and animal models would include 1 cerebrospinal fluid (CSF AD biomarker changes with reduced Aβ and increased phospho-tau/tau; 2 structural and functional neuroimaging patterns including MRI hippocampal atrophy, fluorodeoxyglucose (FDG, and amyloid/tau PET alterations in activity and/or patterns of pathologic peptide deposition and distribution; and 3 cognitive impairment with emphasis on spatial learning and memory to distinguish presymptomatic and symptomatic mice at specific ages. A validated AD mouse model for drug testing would likely show tau-related neurofibrillary degeneration following Aβ deposition and demonstrate changes in pathology, CSF analysis, and neuroimaging that mirror human AD. Development of the ideal model would revolutionize the ability to establish the translational value of AD mouse models and serve as a platform for discussions about national phenotyping guidelines

  4. Neuropathological assessment and validation of mouse models for Alzheimer's disease: applying NIA-AA guidelines.

    Science.gov (United States)

    Keene, C Dirk; Darvas, Martin; Kraemer, Brian; Liggitt, Denny; Sigurdson, Christina; Ladiges, Warren

    2016-01-01

    Dozens of transgenic mouse models, generally based on mutations associated with familial Alzheimer's disease (AD), have been developed, in part, for preclinical testing of candidate AD therapies. However, none of these models has successfully predicted the clinical efficacy of drugs for treating AD patients. Therefore, development of more translationally relevant AD mouse models remains a critical unmet need in the field. A concept not previously implemented in AD preclinical drug testing is the use of mouse lines that have been validated for neuropathological features of human AD. Current thinking suggests that amyloid plaque and neurofibrillary tangle deposition is an essential component for accurate modeling of AD. Therefore, the AD translational paradigm would require pathologic Aβ and tau deposition, a disease-relevant distribution of plaques and tangles, and a pattern of disease progression of Aβ and tau isoforms similar to the neuropathological features found in the brains of AD patients. Additional parameters useful to evaluate parallels between AD and animal models would include 1) cerebrospinal fluid (CSF) AD biomarker changes with reduced Aβ and increased phospho-tau/tau; 2) structural and functional neuroimaging patterns including MRI hippocampal atrophy, fluorodeoxyglucose (FDG), and amyloid/tau PET alterations in activity and/or patterns of pathologic peptide deposition and distribution; and 3) cognitive impairment with emphasis on spatial learning and memory to distinguish presymptomatic and symptomatic mice at specific ages. A validated AD mouse model for drug testing would likely show tau-related neurofibrillary degeneration following Aβ deposition and demonstrate changes in pathology, CSF analysis, and neuroimaging that mirror human AD. Development of the ideal model would revolutionize the ability to establish the translational value of AD mouse models and serve as a platform for discussions about national phenotyping guidelines and standards

  5. Program definition and assessment overview. [for thermal energy storage project management

    Science.gov (United States)

    Gordon, L. H.

    1980-01-01

    The implementation of a program level assessment of thermal energy storage technology thrusts for the near and far term to assure overall coherent energy storage program is considered. The identification and definition of potential thermal energy storage applications, definition of technology requirements, and appropriate market sectors are discussed along with the necessary coordination, planning, and preparation associated with program reviews, workshops, multi-year plans and annual operating plans for the major laboratory tasks.

  6. How valid and applicable are current diagnostic criteria and assessment methods for dentin hypersensitivity? An overview

    OpenAIRE

    Gernhardt, Christian R.

    2012-01-01

    Objectives Although dentin hypersensitivity is a common clinical condition and is generally reported by the patient after experiencing a sharp, short pain caused by one of several different external stimuli, it is often inadequately understood. The purpose of this paper is to discuss different available diagnostic approaches and assessment methods used in order to suggest a basis to diagnose, monitor, and measure these challenging painful conditions related to dentin hypersensitivity in daily...

  7. Assessment of physical activity and energy expenditure: an overview of objective measures

    Directory of Open Access Journals (Sweden)

    Andrew P Hills

    2014-06-01

    Full Text Available The ability to assess energy expenditure and estimate physical activity in free-living individuals is extremely important in the global context of non-communicable diseases including malnutrition, overnutrition (obesity and diabetes. It is also important to appreciate that physical activity and energy expenditure are different constructs with physical activity defined as any bodily movement that results in energy expenditure and accordingly, energy is expended as a result of physical activity. However, total energy expenditure, best assessed using the criterion doubly labelled water technique, includes components in addition to physical activity energy expenditure, namely resting energy expenditure and the thermic effect of food. Given the large number of assessment techniques currently used to estimate physical activity in humans, it is imperative to understand the relative merits of each. The goal of this review is to provide information on the utility and limitations of a range of objective measures of physical activity and their relationship with energy expenditure. The measures discussed include those based on energy expenditure or oxygen uptake including doubly labelled water, activity energy expenditure, physical activity level, and metabolic equivalent; those based on heart rate monitoring and motion sensors; and because of their widespread use, selected subjective measures.

  8. Transuranic and Low-Level Boxed Waste Form Nondestructive Assay Technology Overview and Assessment

    Energy Technology Data Exchange (ETDEWEB)

    G. Becker; M. Connolly; M. McIlwain

    1999-02-01

    The Mixed Waste Focus Area (MWFA) identified the need to perform an assessment of the functionality and performance of existing nondestructive assay (NDA) techniques relative to the low-level and transuranic waste inventory packaged in large-volume box-type containers. The primary objectives of this assessment were to: (1) determine the capability of existing boxed waste form NDA technology to comply with applicable waste radiological characterization requirements, (2) determine deficiencies associated with existing boxed waste assay technology implementation strategies, and (3) recommend a path forward for future technology development activities, if required. Based on this assessment, it is recommended that a boxed waste NDA development and demonstration project that expands the existing boxed waste NDA capability to accommodate the indicated deficiency set be implemented. To ensure that technology will be commercially available in a timely fashion, it is recommended this development and demonstration project be directed to the private sector. It is further recommended that the box NDA technology be of an innovative design incorporating sufficient NDA modalities, e.g., passive neutron, gamma, etc., to address the majority of the boxed waste inventory. The overall design should be modular such that subsets of the overall NDA system can be combined in optimal configurations tailored to differing waste types.

  9. Assessment of physical activity and energy expenditure: an overview of objective measures.

    Science.gov (United States)

    Hills, Andrew P; Mokhtar, Najat; Byrne, Nuala M

    2014-01-01

    The ability to assess energy expenditure (EE) and estimate physical activity (PA) in free-living individuals is extremely important in the global context of non-communicable diseases including malnutrition, overnutrition (obesity), and diabetes. It is also important to appreciate that PA and EE are different constructs with PA defined as any bodily movement that results in EE and accordingly, energy is expended as a result of PA. However, total energy expenditure, best assessed using the criterion doubly labeled water (DLW) technique, includes components in addition to physical activity energy expenditure, namely resting energy expenditure and the thermic effect of food. Given the large number of assessment techniques currently used to estimate PA in humans, it is imperative to understand the relative merits of each. The goal of this review is to provide information on the utility and limitations of a range of objective measures of PA and their relationship with EE. The measures discussed include those based on EE or oxygen uptake including DLW, activity energy expenditure, physical activity level, and metabolic equivalent; those based on heart rate monitoring and motion sensors; and because of their widespread use, selected subjective measures.

  10. Overview of the Quality and Completeness of Resource Assessment Data for the APEC Region

    Energy Technology Data Exchange (ETDEWEB)

    Renne, D. S.; Pilasky, S.

    1998-02-01

    The availability of information and data on the renewable energy resources (solar, wind, biomass, geothermal, and hydro) for renewable energy technologies is a critical element in the successful implementation of these technologies. This paper presents a comprehensive summary of published information on these resources for each of 1 8 Asia-Pacific Economic Cooperation (APEC) economies. In the introductory sections, a discussion of the quality and completeness of this information is presented, along with recommendations on steps that need to be taken to facilitate the further development and deployment of renewable energy technologies throughout the APEC region. These sections are then followed by economy-specific reviews, and a complete bibliography and summary description for each citation. The major results of this survey are that a basis for understanding renewable energy resources is currently available for essentially all the economies, although there is a significant need to apply improved and updated resource assessment techniques in most. For example, most wind resource assessments rely on data collected at national weather stations, which often results in underestimates of the true potential wind resource within an economy. As a second example, solar resource assessments in most economies rely on an analysis of very simple sunshine record data, which results in large uncertainties in accurately quantifying the resource. National surveys of biomass, geothermal, and hydro resources are often lacking; in most cases, resources for these technologies were discussed for site-specific studies only. Thus, the major recommendations in this paper are to: ( 1 ) upgrade current or install new wind and solar measurement systems at key 'benchmark' locations to provide accurate, representative information on these resources; (2) apply advanced wind and solar resource assessment tools that rely on data quality assessment procedures, the use of satellite data

  11. GUIDELINES FOR THE DESIGN OF INSTRUMENTS OF COMPETENCE ASSESSMENT FROM MEASURABLE LEARNING STANDARDS

    Directory of Open Access Journals (Sweden)

    Ignacio Polo Martínez

    2015-06-01

    Full Text Available The evaluation is not enough to improve education necessary but. There are no magic to educational problems through assessment solutions. However, the evaluation, in partnership with the methodology, should be treated as determinants of the quality and improving education. Surely, many teachers agree that it is not easy to design assessment tools that are consistent with the teaching-learning competence and, in turn, with rigorous curriculum standards and assessment of the Autonomous Community. However, this difficulty should not be considered as an impossibility. Through this article aims to contribute to building an improvement plan associated with the design of the evaluation instruments from different areas or subjects. Such a design should be based on at least the following: I want to evaluate (referring to assessment criteria and standards of assessable learning included in the instrument and I will evaluate (referencing jurisdictional situations linked to next and known student context, HOW I WILL QUALIFY (preserving the right of students to an objective evaluation and what consequences they will have the results for the different agents that make up the educational community.

  12. Strategy Guideline: Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Savage, C.; Hunt, A.

    2012-12-01

    This guideline will provide a general overview of the different kinds of demonstration home projects, a basic understanding of the different roles and responsibilities involved in the successful completion of a demonstration home, and an introduction into some of the lessons learned from actual demonstration home projects. Also, this guideline will specifically look at the communication methods employed during demonstration home projects. And lastly, we will focus on how to best create a communication plan for including an energy efficient message in a demonstration home project and carry that message to successful completion.

  13. Strategy Guideline. Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, A.; Savage, C.

    2012-12-01

    This guideline will provide a general overview of the different kinds of demonstration home projects, a basic understanding of the different roles and responsibilities involved in the successful completion of a demonstration home, and an introduction into some of the lessons learned from actual demonstration home projects. Also, this guideline will specifically look at the communication methods employed during demonstration home projects. And lastly, we will focus on how to best create a communication plan for including an energy efficient message in a demonstration home project and carry that message to successful completion.

  14. Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery.

    Science.gov (United States)

    Duceppe, Emmanuelle; Parlow, Joel; MacDonald, Paul; Lyons, Kristin; McMullen, Michael; Srinathan, Sadeesh; Graham, Michelle; Tandon, Vikas; Styles, Kim; Bessissow, Amal; Sessler, Daniel I; Bryson, Gregory; Devereaux, P J

    2017-01-01

    The Canadian Cardiovascular Society Guidelines Committee and key Canadian opinion leaders believed there was a need for up to date guidelines that used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of evidence assessment for patients who undergo noncardiac surgery. Strong recommendations included: 1) measuring brain natriuretic peptide (BNP) or N-terminal fragment of proBNP (NT-proBNP) before surgery to enhance perioperative cardiac risk estimation in patients who are 65 years of age or older, are 45-64 years of age with significant cardiovascular disease, or have a Revised Cardiac Risk Index score ≥ 1; 2) against performing preoperative resting echocardiography, coronary computed tomography angiography, exercise or cardiopulmonary exercise testing, or pharmacological stress echocardiography or radionuclide imaging to enhance perioperative cardiac risk estimation; 3) against the initiation or continuation of acetylsalicylic acid for the prevention of perioperative cardiac events, except in patients with a recent coronary artery stent or who will undergo carotid endarterectomy; 4) against α2 agonist or β-blocker initiation within 24 hours before surgery; 5) withholding angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker starting 24 hours before surgery; 6) facilitating smoking cessation before surgery; 7) measuring daily troponin for 48 to 72 hours after surgery in patients with an elevated NT-proBNP/BNP measurement before surgery or if there is no NT-proBNP/BNP measurement before surgery, in those who have a Revised Cardiac Risk Index score ≥1, age 45-64 years with significant cardiovascular disease, or age 65 years or older; and 8) initiating of long-term acetylsalicylic acid and statin therapy in patients who suffer myocardial injury/infarction after surgery. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  15. The quantity and quality of complementary and alternative medicine clinical practice guidelines on herbal medicines, acupuncture and spinal manipulation: systematic review and assessment using AGREE II.

    Science.gov (United States)

    Ng, Jeremy Y; Liang, Laurel; Gagliardi, Anna R

    2016-10-29

    Complementary and alternative medicine (CAM) use is often not disclosed by patients, and can be unfamiliar to health care professionals. This may lead to underuse of beneficial CAM therapies, and overuse of other CAM therapies with little proven benefit or known contraindications. No prior research has thoroughly evaluated the credibility of knowledge-based resources. The purpose of this research was to assess the quantity and quality of CAM guidelines. A systematic review was conducted to identify CAM guidelines. MEDLINE, EMBASE and CINAHL were searched in January 2016 from 2003 to 2015. The National Guideline Clearinghouse, National Center for Complementary and Integrative Health web site, and two CAM journals were also searched. Eligible guidelines published in English language by non-profit agencies on herbal medicine, acupuncture, or spinal manipulation for adults with any condition were assessed with the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. From 3,126 unique search results, 17 guidelines (two herbal medicine, three acupuncture, four spinal manipulation, eight mixed CAM therapies) published in 2003 or later and relevant to several clinical conditions were eligible. Scaled domain percentages from highest to lowest were clarity of presentation (85.3 %), scope and purpose (83.3 %), rigour of development (61.2 %), editorial independence (60.1 %), stakeholder involvement (52.0 %) and applicability (20.7 %). Quality varied within and across guidelines. None of the 17 guidelines were recommended by both appraisers; 14 were recommended as Yes or Yes with modifications. Guidelines that scored well could be used by patients and health care professionals as the basis for discussion about the use of these CAM therapies. In future updates, guidelines that achieved variable or lower scores could be improved according to specifications in the AGREE II instrument, and with insight from a large number of resources that are available

  16. Overview of integrative tools and methods in assessing ecological integrity in estuarine and coastal systems worldwide.

    Science.gov (United States)

    Borja, Angel; Bricker, Suzanne B; Dauer, Daniel M; Demetriades, Nicolette T; Ferreira, João G; Forbes, Anthony T; Hutchings, Pat; Jia, Xiaoping; Kenchington, Richard; Carlos Marques, João; Zhu, Changbo

    2008-09-01

    In recent years, several sets of legislation worldwide (Oceans Act in USA, Australia or Canada; Water Framework Directive or Marine Strategy in Europe, National Water Act in South Africa, etc.) have been developed in order to address ecological quality or integrity, within estuarine and coastal systems. Most such legislation seeks to define quality in an integrative way, by using several biological elements, together with physico-chemical and pollution elements. Such an approach allows assessment of ecological status at the ecosystem level ('ecosystem approach' or 'holistic approach' methodologies), rather than at species level (e.g. mussel biomonitoring or Mussel Watch) or just at chemical level (i.e. quality objectives) alone. Increasing attention has been paid to the development of tools for different physico-chemical or biological (phytoplankton, zooplankton, benthos, algae, phanerogams, fishes) elements of the ecosystems. However, few methodologies integrate all the elements into a single evaluation of a water body. The need for such integrative tools to assess ecosystem quality is very important, both from a scientific and stakeholder point of view. Politicians and managers need information from simple and pragmatic, but scientifically sound methodologies, in order to show to society the evolution of a zone (estuary, coastal area, etc.), taking into account human pressures or recovery processes. These approaches include: (i) multidisciplinarity, inherent in the teams involved in their implementation; (ii) integration of biotic and abiotic factors; (iii) accurate and validated methods in determining ecological integrity; and (iv) adequate indicators to follow the evolution of the monitored ecosystems. While some countries increasingly use the establishment of marine parks to conserve marine biodiversity and ecological integrity, there is awareness (e.g. in Australia) that conservation and management of marine ecosystems cannot be restricted to Marine Protected

  17. The North American Regional Climate Change Assessment Program: Overview of Phase I Results

    Energy Technology Data Exchange (ETDEWEB)

    Mearns, L. O.; Arritt, R.; Biner, S.; Bukovsky, Melissa; McGinnis, Seth; Sain, Steve; Caya, Daniel; Correia Jr., James; Flory, Dave; Gutowski, William; Takle, Gene; Jones, Richard; Leung, Lai-Yung R.; Moufouma-Okia, Wilfran; McDaniel, Larry; Nunes, A.; Qian, Yun; Roads, J.; Sloan, Lisa; Snyder, Mark A.

    2012-09-20

    The North American Regional Climate Change Assessment Program is an international effort designed to systematically investigate the uncertainties in regional scale projections of future climate and produce high resolution climate change scenarios using multiple regional climate models (RCMs) nested within atmosphere ocean general circulation models (AOGCMs) forced with the A2 SRES scenario, with a common domain covering the conterminous US, northern Mexico, and most of Canada. The program also includes an evaluation component (Phase I) wherein the participating RCMs are nested within 25 years of NCEP/DOE global reanalysis II. The grid spacing of the RCM simulations is 50 km.

  18. Yucca Mountain project total-system performance assessment preliminary analyses; Overview

    Energy Technology Data Exchange (ETDEWEB)

    Barnard, R.W.; Dockery, H.A. [Sandia National Labs., Albuquerque, NM (United States)

    1992-10-01

    This paper reports that Sandia National Laboratories and Pacific Northwest Laboratory have produced a coordinated initial total-system performance assessment analysis for the potential repository at Yucca Mountain. Analyses included radionuclide transport via groundwater and gas flow, human intrusion, tectonism, and basaltic igneous intrusion. Both abstracted and detailed calculations were used for the analyses. Probabilistic release distributions were calculated for the individual components, and a combined distribution for the overall behavior of the system was constructed. Results from the analyses using abstracted models indicate that this method produces reasonable outcomes based on the authors` current understanding of the site.

  19. Yucca Mountain Project total-system performance assessment preliminary analyses: Overview; Draft

    Energy Technology Data Exchange (ETDEWEB)

    Barnard, R.W.; Dockery, H.A.

    1991-12-19

    Sandia National Laboratories and Pacific Northwest Laboratory have produced a coordinated initial total-system performance assessment analysis for the potential repository at Yucca Mountain. Analyses included radionuclide transport via groundwater and gas flow, human intrusion, tectonism, and basaltic igneous intrusion. Both abstracted and detailed calculations were used for the analyses. Probabilistic release distributions were calculated for the individual components, and a combined distribution for the overall behavior of the system was constructed. Results from the analyses using abstracted models indicate that this method produces reasonable outcomes based on our current understanding of the site.

  20. How valid and applicable are current diagnostic criteria and assessment methods for dentin hypersensitivity? An overview.

    Science.gov (United States)

    Gernhardt, Christian R

    2013-03-01

    Although dentin hypersensitivity is a common clinical condition and is generally reported by the patient after experiencing a sharp, short pain caused by one of several different external stimuli, it is often inadequately understood. The purpose of this paper is to discuss different available diagnostic approaches and assessment methods used in order to suggest a basis to diagnose, monitor, and measure these challenging painful conditions related to dentin hypersensitivity in daily practice and scientific projects properly. A PubMed literature search strategy including the following MeSH terms were used as follows: "dentin sensitivity"[MeSH Terms] OR "dentin"[All Fields] AND "sensitivity"[All Fields] OR "dentin sensitivity"[All Fields] OR "dentin"[All Fields] AND "hypersensitivity"[All Fields] OR "dentin hypersensitivity"[All Fields] AND "diagnosis"[Subheading] OR "diagnosis"[All Fields] OR "diagnosis"[MeSH Terms] AND "assessment"[All Fields] AND ("methods"[Subheading] OR "methods"[All Fields] OR "methods"[MeSH Terms]. Furthermore, alternative terms such as "validity," "reliability," "root," "cervical," "diagnostic criteria," and "hypersensitivities" were additionally evaluated. The literature search, also including the alternative terms and journals, revealed only a small number of specific papers related to valid diagnosis, diagnostic criteria, and assessment methods of dentin hypersensitivity. Outcomes from these publications showed that the response to different stimuli varies substantially from one person to another and is, due to individual factors, often difficult to assess correctly. Furthermore, the cause of the reported pain can vary, and the patient's description of the history, symptoms, and discomfort might be different from one to another, not allowing a reliable and valid diagnosis. The dental practitioner, using a variety of diagnostic and measurement techniques each day, will often have difficulties in differentiating dentin hypersensitivity from

  1. Conceptual overview and preliminary risk assessment of cryogen use in deep underground mine production

    Science.gov (United States)

    Sivret, J.; Millar, D. L.; Lyle, G.

    2017-12-01

    This research conducts a formal risk assessment for cryogenic fueled equipment in underground environments. These include fans, load haul dump units, and trucks. The motivating advantage is zero-emissions production in the subsurface and simultaneous provision of cooling for ultra deep mine workings. The driving force of the engine is the expansion of the reboiled cryogen following flash evaporation using ambient temperature heat. The cold exhaust mixes with warm mine air and cools the latter further. The use of cryogens as ‘fuel’ leads to much increased fuel transport volumes and motivates special considerations for distribution infrastructure and process including: cryogenic storage, distribution, handling, and transfer systems. Detailed specification of parts and equipment, numerical modelling and preparation of design drawings are used to articulate the concept. The conceptual design process reveals new hazards and risks that the mining industry has not yet encountered, which may yet stymie execution. The major unwanted events include the potential for asphyxiation due to oxygen deficient atmospheres, or physical damage to workers due to exposure to sub-cooled liquids and cryogenic gases. The Global Minerals Industry Risk Management (GMIRM) framework incorporates WRAC and Bow-Tie techniques and is used to identify, assess and mitigate risks. These processes operate upon the competing conceptual designs to identify and eliminate high risk options and improve the safety of the lower risk designs.

  2. Enzymes in cleaning products: an overview of toxicological properties and risk assessment/management.

    Science.gov (United States)

    Basketter, David; Berg, Ninna; Broekhuizen, Cees; Fieldsend, Mark; Kirkwood, Sheila; Kluin, Cornelia; Mathieu, Sophie; Rodriguez, Carlos

    2012-10-01

    Enzymes used in cleaning products have an excellent safety profile, with little ability to cause adverse responses in humans. For acute toxicity, genotoxicity, sub-acute and repeated dose toxicity, enzymes are unremarkable. Reproductive toxicity and carcinogenicity are also not endpoints of concern. Exceptions are the ability of some proteases to produce irritating effects at high concentrations and more importantly, the intrinsic potential of these bacterial/fungal proteins to act as respiratory sensitizers. It is a reasonable assumption that the majority of enzyme proteins possess this hazard. However, methods for characterising the respiratory sensitisation hazard of enzymes are lacking and the information required for risk assessment and risk management, although sufficient, remains limited. Previously, most data was generated in animal models and in in vitro immunoassays that assess immunological cross-reactivity. Nevertheless, by the establishment of strict limits on airborne exposure (based on a defined minimal effect limit of 60ng active enzyme protein/m(3)) and air and health monitoring, occupational safety can be assured. Similarly, by ensuring that airborne exposure is kept similarly low, coupled with knowledge of the fate of these enzymes on skin and fabrics, it has proven possible to establish a long history of safe consumer use of enzyme containing products. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. An overview of methods for assessment of free radical activity in biology.

    Science.gov (United States)

    Jackson, M J

    1999-11-01

    Assays which purport to assess free radical activity in biological systems are multiple. However, despite numerous published descriptions of new methods and modifications of methods to assess free radical activity in biological materials, there is still a lack of reliable techniques for quantification of activity in vivo. Analysis of a number of related indicators and use of a variety of approaches appears the only reliable way to evaluate these processes in vivo. In studies of free radical generation by contracting skeletal muscle we have attempted to use a variety of indicators, including measurement of endogenous antioxidant levels, measurement of indirect indicators of free radical activity (e.g. products of lipid peroxidation, DNA oxidation or protein oxidation) and, where possible, measurement of direct indicators of free radical activity by electron spin resonance techniques. In view of the relative lack of specificity of many available techniques, caution should be exerted in evaluating the numerous examples of isolated single measures of free radical activity which are present in the scientific literature.

  4. Pediatric ophthalmology and childhood reading difficulties: Overview of reading development and assessments for the pediatric ophthalmologist.

    Science.gov (United States)

    Collins, Megan E; Mudie, Lucy I; Inns, Amanda J; Repka, Michael X

    2017-12-01

    Reading difficulties are common in the pediatric population, and large socioeconomic disparities exist. In the United States 46% of white children achieved expected reading proficiency by the end of fourth grade, while only 21% of Hispanic and 18% of African American children were reading at the expected level. Reading is an involved cognitive process with many subskills; likewise, development of reading proficiency is a complex and continuous process. Failure to achieve reading proficiency or even early difficulty with reading can affect a child's academic performance for years to come. Some studies suggest reading proficiency may be related to later success in life. Although many problems with reading are not related to vision, a vision assessment is recommended for children with reading difficulties and a suspected vision problem. The process of reading development as well as the varied educational assessments of reading are presented here for pediatric ophthalmologists. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  5. Health technology assessment in Catalonia: an overview of past and future perspectives.

    Science.gov (United States)

    de Solà-Morales, Oriol; Granados, Alicia

    2009-07-01

    The current and past situation of health technology assessment (HTA) in Catalonia is presented in this study. The approach used here is a historical review of facts and landmarks. Spain has undergone radical change in many aspects, but the changes in healthcare provision have been major indeed. Catalonia has had the ability to benefit from these changes and has been able to build upon professionals' experience and expertise to development a consistent HTA network and continuous evaluation paradigm. The early involvement of the Catalan Agency for Health Technology Assessment (CAHTA) in several relevant HTA international initiatives and the relationship of CAHTA and Research with other HTA agencies in Spain is also stressed. HTA is currently of common use in Catalonia for decision making at different levels. Now emphasis has to be put on the coming challenges that the HTA community will have to face in the coming years: uncontrolled demand, capacity scarcity, a rapidly evolving knowledge frontier, and insufficient input from the economic sphere into evaluations.

  6. Advanced lighting guidelines: 1993. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Eley, C.; Tolen, T.M. [Eley Associates, San Francisco, CA (United States); Benya, J.R. [Luminae Souter Lighting Design, San Francisco, CA (United States); Rubinstein, F.; Verderber, R. [Lawrence Berkeley Lab., CA (United States)

    1993-12-31

    The 1993 Advanced Lighting Guidelines document consists of twelve guidelines that provide an overview of specific lighting technologies and design application techniques utilizing energy-efficient lighting practice. Lighting Design Practice assesses energy-efficient lighting strategies, discusses lighting issues, and explains how to obtain quality lighting design and consulting services. Luminaires and Lighting Systems surveys luminaire equipment designed to take advantage of advanced technology lamp products and includes performance tables that allow for accurate estimation of luminaire light output and power input. The additional ten guidelines -- Computer-Aided Lighting Design, Energy-Efficient Fluorescent Ballasts, Full-Size Fluorescent Lamps, Compact Fluorescent Lamps, Tungsten-Halogen Lamps, Metal Halide and HPS Lamps, Daylighting and Lumen Maintenance, Occupant Sensors, Time Scheduling Systems, and Retrofit Control Technologies -- each provide a product technology overview, discuss current products on the lighting equipment market, and provide application techniques. This document is intended for use by electric utility personnel involved in lighting programs, lighting designers, electrical engineers, architects, lighting manufacturers` representatives, and other lighting professionals.

  7. 76 FR 57992 - Assessment Rate Adjustment Guidelines for Large and Highly Complex Institutions

    Science.gov (United States)

    2011-09-19

    ... total score will be made only if the comprehensive analysis of an institution's risk generally based on... bank methodology under the Amended Assessment Regulations and determine the relative risk ranking of... methodology regarding higher risk concentrations should include consideration of an institution's historical...

  8. Reprint of: Overview of avian toxicity studies for the Deepwater Horizon Natural Resource Damage Assessment.

    Science.gov (United States)

    Bursian, S J; Alexander, C R; Cacela, D; Cunningham, F L; Dean, K M; Dorr, B S; Ellis, C K; Godard-Codding, C A; Guglielmo, C G; Hanson-Dorr, K C; Harr, K E; Healy, K A; Hooper, M J; Horak, K E; Isanhart, J P; Kennedy, L V; Link, J E; Maggini, I; Moye, J K; Perez, C R; Pritsos, C A; Shriner, S A; Trust, K A; Tuttle, P L

    2017-12-01

    The Oil Pollution Act of 1990 establishes liability for injuries to natural resources because of the release or threat of release of oil. Assessment of injury to natural resources resulting from an oil spill and development and implementation of a plan for the restoration, rehabilitation, replacement or acquisition of natural resources to compensate for those injuries is accomplished through the Natural Resource Damage Assessment (NRDA) process. The NRDA process began within a week of the Deepwater Horizon oil spill, which occurred on April 20, 2010. During the spill, more than 8500 dead and impaired birds representing at least 93 avian species were collected. In addition, there were more than 3500 birds observed to be visibly oiled. While information in the literature at the time helped to identify some of the effects of oil on birds, it was not sufficient to fully characterize the nature and extent of the injuries to the thousands of live oiled birds, or to quantify those injuries in terms of effects on bird viability. As a result, the US Fish and Wildlife Service proposed various assessment activities to inform NRDA injury determination and quantification analyses associated with the Deepwater Horizon oil spill, including avian toxicity studies. The goal of these studies was to evaluate the effects of oral exposure to 1-20ml of artificially weathered Mississippi Canyon 252 oil kg bw-1 day-1 from one to 28 days or one to five applications of oil to 20% of the bird's surface area. It was thought that these exposure levels would not result in immediate or short-term mortality but might result in physiological effects that ultimately could affect avian survival, reproduction and health. These studies included oral dosing studies, an external dosing study, metabolic and flight performance studies and field-based flight studies. Results of these studies indicated changes in hematologic endpoints including formation of Heinz bodies and changes in cell counts. There

  9. Overview of avian toxicity studies for the Deepwater Horizon Natural Resource Damage Assessment.

    Science.gov (United States)

    Bursian, S J; Alexander, C R; Cacela, D; Cunningham, F L; Dean, K M; Dorr, B S; Ellis, C K; Godard-Codding, C A; Guglielmo, C G; Hanson-Dorr, K C; Harr, K E; Healy, K A; Hooper, M J; Horak, K E; Isanhart, J P; Kennedy, L V; Link, J E; Maggini, I; Moye, J K; Perez, C R; Pritsos, C A; Shriner, S A; Trust, K A; Tuttle, P L

    2017-04-01

    The Oil Pollution Act of 1990 establishes liability for injuries to natural resources because of the release or threat of release of oil. Assessment of injury to natural resources resulting from an oil spill and development and implementation of a plan for the restoration, rehabilitation, replacement or acquisition of natural resources to compensate for those injuries is accomplished through the Natural Resource Damage Assessment (NRDA) process. The NRDA process began within a week of the Deepwater Horizon oil spill, which occurred on April 20, 2010. During the spill, more than 8500 dead and impaired birds representing at least 93 avian species were collected. In addition, there were more than 3500 birds observed to be visibly oiled. While information in the literature at the time helped to identify some of the effects of oil on birds, it was not sufficient to fully characterize the nature and extent of the injuries to the thousands of live oiled birds, or to quantify those injuries in terms of effects on bird viability. As a result, the US Fish and Wildlife Service proposed various assessment activities to inform NRDA injury determination and quantification analyses associated with the Deepwater Horizon oil spill, including avian toxicity studies. The goal of these studies was to evaluate the effects of oral exposure to 1-20ml of artificially weathered Mississippi Canyon 252 oil kg bw-1 day-1 from one to 28 days or one to five applications of oil to 20% of the bird's surface area. It was thought that these exposure levels would not result in immediate or short-term mortality but might result in physiological effects that ultimately could affect avian survival, reproduction and health. These studies included oral dosing studies, an external dosing study, metabolic and flight performance studies and field-based flight studies. Results of these studies indicated changes in hematologic endpoints including formation of Heinz bodies and changes in cell counts. There

  10. Life cycle assessment (LCA) of electricity generation technologies: Overview, comparability and limitations

    DEFF Research Database (Denmark)

    Turconi, Roberto; Boldrin, Alessio; Astrup, Thomas Fruergaard

    2013-01-01

    Electricity generation is a key contributor to global emissions of greenhouse gases (GHG), NOx and SO2 and their related environmental impact. A critical review of 167 case studies involving the life cycle assessment (LCA) of electricity generation based on hard coal, lignite, natural gas, oil...... identified as follows: the energy recovery efficiency and the flue gas cleaning system for fossil fuel technologies; the electricity mix used during both the manufacturing and the construction phases for nuclear and renewable technologies; and the type, quality and origin of feedstock, as well as the amount...... and type of co-products, for biomass-based systems. This review demonstrates that the variability of existing LCA results for electricity generation can give rise to conflicting decisions regarding the environmental consequences of implementing new technologies....

  11. Foreign Language Testing and Assessment in Greece: An overview and appraisal

    Directory of Open Access Journals (Sweden)

    Sophia Papaefthymiou-Lytra

    2012-02-01

    Full Text Available The aim of this paper is twofold. First, I will briefly review practices in testing and assessment in Greece; I will refer to current practices, their prospects and long term influence inside and outside school contexts. In particular, I will make brief reference to foreign language (FL demands outside the school context, namely, the job market and appraise the consequences of the choices made so far for FL education in the primary and secondary school context. Second, I will advocate a way forward by advancing the principle ‘learn a foreign language(s for lifelong use’ rather than ‘get-trained to get a certificate as early in life as possible’.

  12. Overview of MELCOR 1.8.4: Modeling advances and assessment

    Energy Technology Data Exchange (ETDEWEB)

    Gauntt, R.O.; Cole, R.K.; Rodriguez, S.B.; Young, M.F.; Gasser, R.D. [Sandia National Labs., Albuquerque, NM (United States). Modeling and Analysis Dept.; Leonard, M.T.; Ashbaugh, S. [Innovative Technology Solutions, Albuquerque, NM (United States)

    1998-03-01

    The newly released MELCOR 1.8.4 reactor accident analysis code contains many new modeling features as well as improvements to existing models. New model additions to the MELCOR code include a model for predicting enhanced depletion rates for hygroscopic aerosols and a model for predicting the chemisorption of Cesium to the surfaces of piping. Improvements to existing models include: upgrading the core module (COR) to handle flow redistribution resulting from the formation of core blockages, improving the thermal hydraulics (CVH) coupling with COR to handle flow reversal situations, and upgrading the fission product scrubbing model to incorporate the SPARC90 code. Significant upgrading of the COR package core degradation modeling was also included in the new code release version. New and improved models are described in the following paper. In addition, a number of assessment analyses were recently performed, focusing on demonstrating the new and improved capabilities in the code. Results of assessment calculations demonstrating code performance for aerosol (pool) scrubbing, hygroscopic aerosol behavior, and core degradation and hydrogen production are presented. Finally, ongoing code developments activities beyond MELCOR 1.8.4 are described. These include models for treating iodine behavior in containment sumps, pools, and atmosphere, and plans for implementing reflood models and the attendant effects on accident progression. Further improvements and additions to the core degradation modeling in MELCOR are described, including the implementation of enhanced clad failure models to treat clad ballooning and eutectic interaction with grid spacers, and expansion of the COR package to allow for improved representation of UO{sub 2}-Zr eutectic behavior, improved melt relocation treatment, greater detail in describing aspects of BWR core degradation (fuel channel, bypass, and lower plenum), and more flexibility in modeling other structures in the core such as core plate

  13. Disease Risk Assessments Involving Companion Animals: an Overview for 15 Selected Pathogens Taking a European Perspective.

    Science.gov (United States)

    Rijks, J M; Cito, F; Cunningham, A A; Rantsios, A T; Giovannini, A

    2016-07-01

    Prioritization of companion animal transmissible diseases was performed by the Companion Animals multisectoriaL interprofessionaL Interdisciplinary Strategic Think tank On zoonoses (CALLISTO) project. The project considered diseases occurring in domesticated species commonly kept as pets, such as dogs and cats, but also included diseases occurring in captive wild animals and production animal species. The prioritization process led to the selection of 15 diseases of prime public health relevance, agricultural economic importance, or both. An analysis was made of the current knowledge on the risk of occurrence and transmission of these diseases among companion animals, and from companion animals to man (zoonoses) or to livestock. The literature was scanned for risk assessments for these diseases. Studies were classified as import risk assessments (IRAs) or risk factor analyses (RFAs) in endemic areas. For those pathogens that are absent from Europe, only IRAs were considered; for pathogens present throughout Europe, only RFAs were considered. IRAs were identified for seven of the eight diseases totally or partially absent from Europe. IRAs for classical rabies and alveolar echinococcosis found an increased risk for introduction of the pathogen into officially disease-free areas as a consequence of abandoning national rules and adopting the harmonized EU rules for pet travel. IRAs for leishmaniosis focused on risk associated with the presence of persistently infected dogs in new geographical areas, taking into consideration the risk of disease establishment should a competent vector arise. IRAs for Crimean-Congo haemorrhagic fever and West Nile fever indicated that the likelihood of introduction via companion animals was low. IRAs for bluetongue paid no attention to the risk of introduction via companion animals, which was also the case for IRAs for foot-and-mouth disease, the only disease considered to be absent from Europe. RFAs dealing with the risk factors for

  14. A study on current risk assessments and guidelines on the use of food animal products derived from cloned animals.

    Science.gov (United States)

    Hur, Sun Jin

    2017-10-01

    The author widely surveyed and analyzed the food safety issues, ethical issues, permits, and approval of animal products from animals cloned by somatic cell nuclear transfer worldwide. As a result of a 2-year survey, the author found that there is no evidence that meat and milk derived from cloned animals or their progeny pose a risk to food safety in terms of genotoxicity, adverse reproductive effects, or allergic reactions. Most countries have not approved meat and milk derived from cloned animals, and their progeny are entering the food supply. To establish the guidelines, the author suggests four principles of safety assessment for meat and milk derived from cloned animals. The four main principles for safety assessment are similarities of chemical composition, adverse reproductive effects, genotoxicity, and allergic reactions under the influence of meat and milk from cloned animals and noncloned counterparts. This principle means that meat and milk derived from a cloned animal are safe if there are no differences in the four safety assessments of meat and milk between cloned animal's progeny and noncloned counterparts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Personalized, assessment-based, and tiered medical education curriculum integrating treatment guidelines for atrial fibrillation.

    Science.gov (United States)

    Lee, Brian C; Ruiz-Cordell, Karyn D; Haimowitz, Steven M; Williams, Cara; Stambler, Bruce S; Mandarakas, Anthia

    2017-07-01

    This continuing medical education (CME) curriculum utilizes the Learner Assessment Platform (LAP), providing learners with personalized educational pathways related to atrial fibrillation treatment. There are improvements in knowledge among physician learners after CME, especially among LAP learners. In this LAP-based curriculum, an evaluation of learner deficits on designated learning objectives was conducted in tier 1 and used to direct learners to individualized tier 2 activities. Performance was assessed across learner tracks from baseline to learners' final intervention. Retention data were measured by the postcurriculum assessment, completed 8 weeks after the learners last intervention. Additionally, each activity included a unique matched set of pretest and post-test questions assessing the 4 learner domains: knowledge, competence, confidence, and practice patterns. Significant learner improvement was measured across the curriculum over all 4 learner-domains: 48% (P < 0.0005), 78% (P < 0.0005), 21% (P < 0.0005), and 20% (P < 0.0005) improvements for knowledge, competence, confidence, and practice, respectively. Significant gains in participant performance scores (28% increase, P < 0.0005) by the final activity was observed. Learners who participated in the LAP (N = 989) demonstrated greater improvement in performance from baseline compared to non-LAP learners (41% increase for LAP vs 23% and 26% increase for non-LAP learners who completed 1 (N = 1899) or ≥2 (N = 533) activities, respectively, P = 0.003). The participant population (N = 3421) achieved statistically significant improvement across the curriculum, with LAP learners showing greater performance gains compared to non-LAP learners. These findings support the value of the LAP methodology in providing a cumulative and individualized CME experience. © 2017 Wiley Periodicals, Inc.

  16. Guidelines for Exposure Assessment in Health Risk Studies Following a Nuclear Reactor Accident

    OpenAIRE

    Bouville, André; Linet, Martha S.; Hatch, Maureen; Mabuchi, Kiyohiko; Simon, Steven L.

    2013-01-01

    Background: Worldwide concerns regarding health effects after the Chernobyl and Fukushima nuclear power plant accidents indicate a clear need to identify short- and long-term health impacts that might result from accidents in the future. Fundamental to addressing this problem are reliable and accurate radiation dose estimates for the affected populations. The available guidance for activities following nuclear accidents is limited with regard to strategies for dose assessment in health risk s...

  17. Tri-Service Procedural Guidelines for Ecological Risk Assessments. Volume 1.

    Science.gov (United States)

    1996-05-01

    Acheta domesticus to acridine. Environ. Entomol. 9:18-20. B-93 Technique Name: Terrestrial Arthropods (non-insect) and isopods...US EPA 1982). Crickets and harvester ants have been used on a limited basis within an ecological effects assessment. Adult house crickets ( Acheta ... domesticus ) were exposed to acridine via the diet, and following 18-day exposures lethality and sublethal effects were determined. House crickets and

  18. Ethically sound technology? Guidelines for interactive ethical assessment of personal health monitoring.

    Science.gov (United States)

    Palm, Elin; Nordgren, Anders; Verweij, Marcel; Collste, Göran

    2013-01-01

    Novel care-technologies possess a transformational potential. Future care and support may be provided via monitoring technologies such as smart devices, sensors, actors (robots) and Information and Communication Technologies. Such technologies enable care provision outside traditional care institutions, for instance in the homes of patients. Health monitoring may become "personalized" i.e. tailored to the needs of individual care recipients' but may also alter relations between care providers and care recipents, shape and form the care environment and influence values central to health-care. Starting out from a social constructivist theory of technology, an interactive ethical assessment-model is offered. The suggested model supplements a traditional analysis based on normative ethical theory (top-down approach) with interviews including relevant stakeholders (a bottom-up approach). This method has been piloted by small-scale interviews encircling stakeholder perspectives on three emerging technologies: (1) Careousel, a smart medicine-management device, (2) Robot Giraff, an interactive and mobile communication-device and (3) I-Care, a care-software that combines alarm and register system. By incorporating stakeholder perspectives into the analysis, the interactive ethical assessment model provides a richer understanding of the impact of PHM-technologies on ethical values than a traditional top-down model. If the assessment is conducted before the technology has reached the market - preferably in close interaction with developers and users - ethically sound technologies may be obtained.

  19. Guidelines for Composing and Assessing a Paper on Treatment of Pain.

    Science.gov (United States)

    Bogduk, Nikolai; Kennedy, David J; Vorobeychik, Yakov; Engel, Andrew

    2017-11-01

    Authors, readers, and editors share a common focus. Authors want to publish their work. Readers want to see high-quality, new information. Referees and editors serve to ensure that authors provide valid conclusions based on the quality of information that readers want.Common to each of these roles are instructions to authors. However, these are typically written in an uninspiring, legalistic style, as if they are a set of rules that authors must obey if they expect to get published. This renders the instructions boring and oppressive, if not forbidding. Yet they need not be so, if they are set in context.Instructions to authors can be cast in a way as to reflect common purpose. They can remind authors what perceptive readers want to see in a paper and, thereby, prompt authors to include all necessary information. If cast in this way, instructions to authors are not a set of rules by which to satisfy publishers; they become guidelines for the etiquette of communication between authors and their readers.Against this background, the present article has been composed to serve several purposes. Foremost, it amplifies instructions to authors beyond the conventional technicalities such as headings, layout, font size, and line spacing. It prescribes the type of information that should be communicated and explains the reasons for those recommendations. Doing so not only informs authors about what to write, but also informs readers and referees about what to look for in a good paper. Secondarily, the article publicizes examples of errors and deficiencies of manuscripts submitted to the Journal in the past that have delayed their acceptance and publication, which could have been avoided had the forthcoming recommendations been followed. The recommendations also reprise the elements taught in courses conducted by the Spine Intervention Society in their extended program on evidence-based medicine. Doing so underscores that instructions for authors are not a procedural

  20. Posttraumatic Stress Disorder: Overview of Evidence-Based Assessment and Treatment

    Directory of Open Access Journals (Sweden)

    Cynthia L. Lancaster

    2016-11-01

    Full Text Available Posttraumatic stress disorder (PTSD is a chronic psychological disorder that can develop after exposure to a traumatic event. This review summarizes the literature on the epidemiology, assessment, and treatment of PTSD. We provide a review of the characteristics of PTSD along with associated risk factors, and describe brief, evidence-based measures that can be used to screen for PTSD and monitor symptom changes over time. In regard to treatment, we highlight commonly used, evidence-based psychotherapies and pharmacotherapies for PTSD. Among psychotherapeutic approaches, evidence-based approaches include cognitive-behavioral therapies (e.g., Prolonged Exposure and Cognitive Processing Therapy and Eye Movement Desensitization and Reprocessing. A wide variety of pharmacotherapies have received some level of research support for PTSD symptom alleviation, although selective serotonin reuptake inhibitors have the largest evidence base to date. However, relapse may occur after the discontinuation of pharmacotherapy, whereas PTSD symptoms typically remain stable or continue to improve after completion of evidence-based psychotherapy. After reviewing treatment recommendations, we conclude by describing critical areas for future research.

  1. Genetically Modified Foods: A Brief Overview of the Risk Assessment Process.

    Science.gov (United States)

    Finkelstein, Paige E

    2016-02-18

    Billions of people worldwide are unable to meet their daily micro nutritional needs. Genetically modified (GM) foods, while initially developed to tolerate herbicides and resist disease and insects, have the potential to help alleviate this issue that is currently posing a serious public health concern. However, there is a negative public perception surrounding GM foods, calling for more research regarding the risks that GM foods could pose to the public, specifically on the topics of allergenicity and gene transfer. The risk assessments of GM foods should be performed on a case-by-case basis, by a process outlined by the WHO. The goal of determining food safety is to obtain reasonable certainty that under normal levels of consumption, there will be no harm to people. Current research has shown that GM foods do not cause increased allergenicity or have a meaningful risk of gene transfer to people. GM foods should become publicly accepted products that can bring significant benefit to people at risk of under nutrition.

  2. An overview of colorimetric assay methods used to assess survival or proliferation of mammalian cells.

    Science.gov (United States)

    Vega-Avila, Elisa; Pugsley, Michael K

    2011-01-01

    The aim of this review is to briefly describe some colorimetric methods that are commonly used to evaluate a new chemical entity (NCE) on cell cultures in non-clinical oncology discovery research. These methods have the distinct advantage over other techniques in that they can be applied and used in a cell monolayer or a suspension culture. Both protein assay determination and cell viability assays may be conducted using these culture systems. The viability of cell cultures is routinely assessed by utilizing the metabolic capacity of cells which biochemically convert chemicals (usually color dyes) which can then be conveniently measured at specific wavelengths using a multi-well plate reader. Resazurin (Alamar Blue) is an example of one of these metabolically active compounds. Resazurin is a nontoxic dye that can also be used to measure migration and cellular invasion without resorting to sacrifice of the cells during the test procedure. Another is 5-bromo-2-deoxyuridine (bromodeoxyuridine or BrdU) which is a thymidine analog that incorporates into the DNA of dividing cells during the S-phase of the cell cycle. We will also discuss the colorimetric version of the traditional 3H-thymidine incorporation and immunoenzymatic assay used to measure DNA synthesis and its application to discovery research.

  3. Cryogenic Safety Rules and Guidelines at CERN

    CERN Multimedia

    CERN. Geneva

    2016-01-01

    CERN defines and implements a Safety Policy that sets out the general principles governing safety at CERN. As an intergovernmental organisation, CERN further establishes its own Safety Rules as necessary for its proper functioning. In this process, it takes into account the laws and regulation of the Host States (France and Switzerland), EU regulations and directives, as well as international regulations, standards and directives. For the safety of cryogenic equipment, this is primarily covered by the Safety Regulation for Mechanical Equipment and the General Safety Instruction for Cryogenic Equipment. In addition, CERN has also developed Safety Guidelines to support the implementation of these safety rules, covering cryogenic equipment and oxygen deficiency hazard assessment and mitigation. An overview of the cryogenic safety rules and these safety guidelines will be presented.

  4. An overview assessment of the effectiveness and global popularity of some methods used in measuring riverbank filtration

    Science.gov (United States)

    Umar, Da'u. Abba; Ramli, Mohammad Firuz; Aris, Ahmad Zaharin; Sulaiman, Wan Nor Azmin; Kura, Nura Umar; Tukur, Abubakar Ibrahim

    2017-07-01

    This paper presents an overview assessment of the effectiveness and popularity of some methods adopted in measuring river bank filtration (RBF). The review is aim at understanding some of the appropriate methods used in measuring riverbank filtration, their frequencies of use, and their spatial applications worldwide. The most commonly used methods and techniques in riverbank filtration studies are: Geographical Information System (GIS) (site suitability/surface characterization), Geophysical, Pumping Test and borehole logging (sub-surface), Hydrochemical, Geochemical, and Statistical techniques (hydrochemistry of water), Numerical modelling, Tracer techniques and Stable Isotope Approaches (degradation and contaminants attenuation processes). From the summary in Table 1, hydrochemical, numerical modelling and pumping test are the frequently used and popular methods, while geophysical, GIS and statistical techniques are the less attractive. However, many researchers prefer integrated approach especially that riverbank filtration studies involve diverse and interrelated components. In term of spatial popularity and successful implementation of riverbank filtration, it is explicitly clear that the popularity and success of the technology is more pronounced in developed countries like U.S. and most European countries. However, it is gradually gaining ground in Asia and Africa, although it is not far from its infancy state in Africa, where the technology could be more important considering the economic status of the region and its peculiarity when it comes to water resources predicaments.

  5. An Overview of Literature Topics Related to Current Concepts, Methods, Tools, and Applications for Cumulative Risk Assessment (2007–2016)

    Science.gov (United States)

    Fox, Mary A.; Brewer, L. Elizabeth; Martin, Lawrence

    2017-01-01

    Cumulative risk assessments (CRAs) address combined risks from exposures to multiple chemical and nonchemical stressors and may focus on vulnerable communities or populations. Significant contributions have been made to the development of concepts, methods, and applications for CRA over the past decade. Work in both human health and ecological cumulative risk has advanced in two different contexts. The first context is the effects of chemical mixtures that share common modes of action, or that cause common adverse outcomes. In this context two primary models are used for predicting mixture effects, dose addition or response addition. The second context is evaluating the combined effects of chemical and nonchemical (e.g., radiation, biological, nutritional, economic, psychological, habitat alteration, land-use change, global climate change, and natural disasters) stressors. CRA can be adapted to address risk in many contexts, and this adaptability is reflected in the range in disciplinary perspectives in the published literature. This article presents the results of a literature search and discusses a range of selected work with the intention to give a broad overview of relevant topics and provide a starting point for researchers interested in CRA applications. PMID:28387705

  6. Can life-cycle assessment produce reliable policy guidelines in the building sector?

    Science.gov (United States)

    Säynäjoki, Antti; Heinonen, Jukka; Junnila, Seppo; Horvath, Arpad

    2017-01-01

    Life-cycle assessment (LCA) is an established methodology that can provide decision-makers with comprehensive data on the environmental impacts of products and processes during the entire life cycle. However, the literature on building LCAs consists of highly varying results between the studies, even when the assessed buildings are very similar. This makes it doubtful if LCA can actually produce reliable data for supporting policy-making in the building sector. However, no prior reviews looking into this issue in the building sector exist. This study includes an extensive literature review of LCA studies on the pre-use phase of buildings. The purpose of this study is to analyze the variation between the results of different studies and find out whether the differences can be explained by the contextual differences or if it is actually the methodological choices that cause the extremely high variation. We present 116 cases from 47 scientific articles and reports that used process LCA, input-output (IO) LCA or hybrid LCA to study the construction-phase GHG emissions of buildings. The results of the reviewed studies vary between 0.03 and 2.00 tons of GHG emissions per gross area. The lowest was assessed with process LCA and highest with IO LCA, and in general the lower end was found to be dominated by process LCA studies and the higher end by IO LCA studies, hybrid LCAs being placed in between. In general, it is the methodological issues and subjective choices of the LCA practitioner that cause the vast majority of the huge variance in the results. It thus seems that currently the published building LCAs do not offer solid background information for policy-making without deep understanding of the premises of a certain study and good methodological knowledge.

  7. Environmental ethics: an overview, assessing the place of bioscientists in society, supplemented with selected Australian perspectives.

    Science.gov (United States)

    Buckeridge, John

    2014-01-01

    Ethics deals with moral behavior in a professional context; ideally, it leads to a set of governing principles through which the appropriateness of any activity may be determined or assessed. Environmental ethics specifically deals with how humans interact with the biosphere. It is clear, however, that, as a species, we are failing in our duty of environmental stewardship. The encroachment of human activity into the natural environment is inexorable, and almost always deleterious. Any response to mitigate loss of taxa or ecosystems will have economic implications, and these are often considerable. In finding effective solutions, a process soon becomes political. In light of this we must reflect upon the leadership role that biologists have, especially our impact on policy development that pertains to natural resource management. Although our track record is no worse than any other professional group, biologists by way of training usually have a greater understanding of natural processes and must be prepared to articulate these publically. We have an ethical mandate to question decisions, policies and legislation that impact negatively upon biological systems: a mandate guided through logic, grounded in empirical science, and hopefully coupled with a deep understanding of the true value of both the living world and the physical world which sustains it. This paper uses Australian examples to demonstrate the frequent clashes between economics and biology, in anticipation that we should strive to achieve the underlying principles of sustainability, environmental stewardship and resource management in both daily decision-making and in long-term planning. © 2012 Wiley Publishing Asia Pty Ltd, ISZS and IOZ/CAS.

  8. Assessing Heart Rate in Physical Education. Assessment Series: K-12 Physical Education.

    Science.gov (United States)

    Buck, Marilyn M.

    This guide discusses the assessment of heart rate and, in particular, the assessment of heart rate using a heart monitor. Part 1, "Foundation for the Use of Heart Rate," reviews literature about heart rate assessment and heart rate monitors, offering an overview of national guidelines for physical activity. It focuses on the importance…

  9. Non-Communicable Disease Clinical Practice Guidelines in Brazil: A Systematic Assessment of Methodological Quality and Transparency.

    Directory of Open Access Journals (Sweden)

    Caroline de Godoi Rezende Costa Molino

    Full Text Available Annually, non-communicable diseases (NCDs kill 38 million people worldwide, with low and middle-income countries accounting for three-quarters of these deaths. High-quality clinical practice guidelines (CPGs are fundamental to improving NCD management. The present study evaluated the methodological rigor and transparency of Brazilian CPGs that recommend pharmacological treatment for the most prevalent NCDs.We conducted a systematic search for CPGs of the following NCDs: asthma, atrial fibrillation, benign prostatic hyperplasia, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease and/or stable angina, dementia, depression, diabetes, gastroesophageal reflux disease, hypercholesterolemia, hypertension, osteoarthritis, and osteoporosis. CPGs comprising pharmacological treatment recommendations were included. No language or year restrictions were applied. CPGs were excluded if they were merely for local use and referred to NCDs not listed above. CPG quality was independently assessed by two reviewers using the Appraisal of Guidelines Research and Evaluation instrument, version II (AGREE II."Scope and purpose" and "clarity and presentation" domains received the highest scores. Sixteen of 26 CPGs were classified as low quality, and none were classified as high overall quality. No CPG was recommended without modification (77% were not recommended at all. After 2009, 2 domain scores ("rigor of development" and "clarity and presentation" increased (61% and 73%, respectively. However, "rigor of development" was still rated < 30%.Brazilian healthcare professionals should be concerned with CPG quality for the treatment of selected NCDs. Features that undermined AGREE II scores included the lack of a multidisciplinary team for the development group, no consideration of patients' preferences, insufficient information regarding literature searches, lack of selection criteria, formulating recommendations, authors' conflict of

  10. Assessing the economic impact of Rx-to-OTC switches: systematic review and guidelines for future development.

    Science.gov (United States)

    Cohen, J; Millier, A; Karray, S; Toumi, M

    2013-01-01

    Switching drugs from prescription to non-prescription status (Rx-to-OTC) presents a unique set of challenges and opportunities to policy-makers and the industry in terms of managing health outcomes, pharmaceutical spending, and steering of consumer choices of therapy. Decision-analytic models are used to address uncertainty and produce reasonable estimates of the economic impact of switches for payers. This article presents a critical literature review of existing models which assess the economic impact of Rx-to-OTC switches, and provides guidelines in which future economic evaluations of Rx-to-OTC switches could be improved. A comprehensive search strategy was implemented in Medline and Embase, to retrieve published economic evaluations on Rx-to-OTC switches from 1995-2010. The research digest of the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) was reviewed for potentially relevant abstracts for the past 3 years. Each model used was critically evaluated in terms of structure, relevance of inputs, methodology used, and robustness of results. Worldwide, the economic impact of Rx-to-OTC switches has only been evaluated in a total of 12 peer-reviewed publications. Ten out of 12 studies were US-based, and two European-based. The models covered various disease categories, including allergy, hypercholesterolemia, gastroenterology, contraception, pulmonology, and virology. Seventy-five per cent of the models predicted cost savings for payers and patients. Limitations of the models mainly included use of strong assumptions and non-inclusion of specific populations due to lack of data. Guidelines were developed to help future model development. They cover structural issues on decision context, health states, and clinical outcomes, and other considerations for model specifications. Although reviewed studies lacked quality, this review of economic evidence of Rx-to-OTC switches suggests that switches may produce cost savings to public and private

  11. Parasites as biological tags to assess host population structure: Guidelines, recent genetic advances and comments on a holistic approach☆

    Science.gov (United States)

    Catalano, Sarah R.; Whittington, Ian D.; Donnellan, Stephen C.; Gillanders, Bronwyn M.

    2013-01-01

    We review the use of parasites as biological tags of marine fishes and cephalopods in host population structure studies. The majority of the work published has focused on marine fish and either single parasite species or more recently, whole parasite assemblages, as biological tags. There is representation of host organisms and parasites from a diverse range of taxonomic groups, although focus has primarily been on host species of commercial importance. In contrast, few studies have used parasites as tags to assess cephalopod population structure, even though records of parasites infecting cephalopods are well-documented. Squid species are the only cephalopod hosts for which parasites as biological tags have been applied, with anisakid nematode larvae and metacestodes being the parasite taxa most frequently used. Following a brief insight into the importance of accurate parasite identification, the population studies that have used parasites as biological tags for marine fishes and cephalopods are reviewed, including comments on the dicyemid mesozoans. The advancement of molecular genetic techniques is discussed in regards to the new ways parasite genetic data can be incorporated into population structure studies, alongside host population genetic analyses, followed by an update on the guidelines for selecting a parasite species as a reliable tag candidate. As multiple techniques and methods can be used to assess the population structure of marine organisms (e.g. artificial tags, phenotypic characters, biometrics, life history, genetics, otolith microchemistry and parasitological data), we conclude by commenting on a holistic approach to allow for a deeper insight into population structuring. PMID:25197624

  12. Diagnosis and assessment of dilated cardiomyopathy: a guideline protocol from the British Society of Echocardiography

    Directory of Open Access Journals (Sweden)

    Thomas Mathew

    2017-06-01

    Full Text Available Heart failure (HF is a debilitating and life-threatening condition, with 5-year survival rate lower than breast or prostate cancer. It is the leading cause of hospital admission in over 65s, and these admissions are projected to rise by more than 50% over the next 25 years. Transthoracic echocardiography (TTE is the first-line step in diagnosis in acute and chronic HF and provides immediate information on chamber volumes, ventricular systolic and diastolic function, wall thickness, valve function and the presence of pericardial effusion, while contributing to information on aetiology. Dilated cardiomyopathy (DCM is the third most common cause of HF and is the most common cardiomyopathy. It is defined by the presence of left ventricular dilatation and left ventricular systolic dysfunction in the absence of abnormal loading conditions (hypertension and valve disease or coronary artery disease sufficient to cause global systolic impairment. This document provides a practical approach to diagnosis and assessment of dilated cardiomyopathy that is aimed at the practising sonographer.

  13. Guidelines for Hosted Payloads Integration Product Overview

    Science.gov (United States)

    2014-05-08

    Aerojet Carlo Abesamis abesamis@jpl.nasa.gov NASA Andrew Adams andrew.c.adams@boeing.com Boeing David Adcock adcock.david@orbital.com Orbital Robert...ULA Launch Shawn Cullen shawn.cullen@jdsu.com JDSU Louis D’Angelo louis.a.d’angelo@lmco.com Lockheed Martin David Davis David.Davis.3@us.af.mil SMC

  14. Critical features of peer assessment of clinical performance to enhance adherence to a low back pain guideline for physical therapists: a mixed methods design

    NARCIS (Netherlands)

    Maas, M.J.M.; Dulmen, S.A. van; Sagasser, M.H.; Heerkens, Y.F.; Vleuten, C.P.M. van der; Nijhuis, M.W.; Wees, P.J. van der

    2015-01-01

    BACKGROUND: Clinical practice guidelines are intended to improve the process and outcomes of patient care. However, their implementation remains a challenge. We designed an implementation strategy, based on peer assessment (PA) focusing on barriers to change in physical therapy care. A previously

  15. The Crisis of Qualified Manpower for Criminal Justice: An Analytic Assessment with Guidelines for New Policy. Volume 1, Probation/Parole.

    Science.gov (United States)

    Piven, Herman; Alcabes, Abraham

    This study analyzed data on manpower problems and solutions in criminal justice with special reference to probation and parole. It provides guidelines for the development of a national policy regarding probation and parole manpower and training, which were established through systematic assessment of manpower shortages and standards, and of…

  16. Validation of the MEDFICTS dietary questionnaire: A clinical tool to assess adherence to American Heart Association dietary fat intake guidelines

    Directory of Open Access Journals (Sweden)

    Bindeman Jody

    2003-06-01

    Full Text Available Abstract Background Dietary assessment tools are often too long, difficult to quantify, expensive to process, and largely used for research purposes. A rapid and accurate assessment of dietary fat intake is critically important in clinical decision-making regarding dietary advice for coronary risk reduction. We assessed the validity of the MEDFICTS (MF questionnaire, a brief instrument developed to assess fat intake according to the American Heart Association (AHA dietary "steps". Methods We surveyed 164 active-duty US Army personnel without known coronary artery disease at their intake interview for a primary prevention cardiac intervention trial using the Block food frequency (FFQ and MF questionnaires. Both surveys were completed on the same intake visit and independently scored. Correlations between each tools' assessment of fat intake, the agreement in AHA step categorization of dietary quality with each tool, and the test characteristics of the MF using the FFQ as the gold standard were assessed. Results Subjects consumed a mean of 36.0 ± 13.0% of their total calories as fat, which included saturated fat consumption of 13.0 ± 0.4%. The majority of subjects (125/164; 76.2% had a high fat (worse than AHA Step 1 diet. There were significant correlations between the MF and the FFQ for the intake of total fat (r = 0.52, P 70 [high fat diet] was negligible (kappa statistic = 0.036. The MF was accurate at the extremes of fat intake, but could not reliably identify the 3 AHA dietary classifications. Alternative MF cutpoints of 50 (high fat diet were highly sensitive (96%, but had low specificity (46% for a high fat diet. ROC curve analysis identified that a MF score cutoff of 38 provided optimal sensitivity 75% and specificity 72%, and had modest agreement (kappa = 0.39, P Conclusions The MEDFICTS questionnaire is most suitable as a tool to identify high fat diets, rather than discriminate AHA Step 1 and Step 2 diets. Currently recommended

  17. Assessment of possible allergenicity of hypothetical ORFs in common food crops using current bioinformatic guidelines and its implications for the safety assessment of GM crops.

    Science.gov (United States)

    Young, Gregory J; Zhang, Shiping; Mirsky, Henry P; Cressman, Robert F; Cong, Bin; Ladics, Gregory S; Zhong, Cathy X

    2012-10-01

    Before a genetically modified (GM) crop can be commercialized it must pass through a rigorous regulatory process to verify that it is safe for human and animal consumption, and to the environment. One particular area of focus is the potential introduction of a known or cross-reactive allergen not previously present within the crop. The assessment of possible allergenicity uses the guidelines outlined by the Food and Agriculture Organization (FAO) and World Health Organization's (WHO) Codex Alimentarius Commission (Codex) to evaluate all newly expressed proteins. Some regulatory authorities have broadened the scope of the assessment to include all DNA reading frames between stop codons across the insert and spanning the insert/genomic DNA junctions. To investigate the utility of this bioinformatic assessment, all naturally occurring stop-to-stop frames in the non-transgenic genomes of maize, rice, and soybean, as well as the human genome, were compared against the AllergenOnline (www.allergenonline.org) database using the Codex criteria. We discovered thousands of frames that exceeded the Codex defined threshold for potential cross-reactivity suggesting that evaluating hypothetical ORFs (stop-to-stop frames) has questionable value for making decisions on the safety of GM crops. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Tobacco cessation Clinical Practice Guideline use by rural and urban hospital nurses: a pre-implementation needs assessment

    Directory of Open Access Journals (Sweden)

    Smith Patricia M

    2012-04-01

    Full Text Available Abstract Background This study was a pre-program evaluation of hospital-based nurses' tobacco intervention beliefs, confidence, training, practice, and perceived intervention barriers and facilitators. It was designed to identify relevant information prior to implementing tobacco cessation guidelines across a large northern rural region, home to 1 urban and 12 rural hospitals. Methods This cross-sectional survey was distributed by nurse managers to nurses in the 13 hospitals and returned by nurses (N = 269 via mail to the researchers. Results Nurses were somewhat confident providing cessation interventions, agreed they should educate patients about tobacco, and 94% perceived tobacco counselling as part of their role. Although only 11% had received cessation training, the majority reported intervening, even if seldom--91% asked about tobacco-use, 96% advised quitting, 89% assessed readiness to quit, 88% assisted with quitting, and 61% arranged post-discharge follow-up. Few performed any of these steps frequently, and among those who intervened, the majority spent Conclusions The findings showed nurses' willingness to engage in tobacco interventions. What the majority were doing maps onto the recommended minimum of 1-3 minutes but intervention frequency and follow-up were suboptimal. The rural-urban differences suggest a need for more research to explore the strengths of rural practice which could potentially inform approaches to smoking cessation in urban hospitals.

  19. OVERVIEW OF THE U.S. DEPARTMENT OF ENERGY AND NUCLEAR REGULATORY COMMISSION PERFORMANCE ASSESSMENT APPROACHES: CEMENTITIOUS BARRIERS PARTNERSHIP

    Energy Technology Data Exchange (ETDEWEB)

    Langton, C.; Burns, H.

    2009-05-29

    ) spent fuel pools. These examples were selected to provide a perspective on the various needs, capabilities to model cementitious barriers, and use of sensitivity and uncertainty analysis and were not intended to include all cementitious barriers used in all low-level waste related PAs. The summary section in each report/chapter provides an overview of important considerations for the examples and compares and contrasts the different approaches that have been used. For example, specific time dependent physical processes (changes in hydraulic conductivity) and chemical processes (partitioning coefficients, and solubility coefficients) are identified and compared. The summary section also identifies key needs for future assessments. The Cementitious Barriers Partnership was established to address the key needs related to the use of cementitious barriers - waste forms, containment structures, physical stabilization fill materials.

  20. French good practice guidelines for management of the risk of low back pain among workers exposed to manual material handling: Hierarchical strategy of risk assessment of work situations.

    Science.gov (United States)

    Petit, Audrey; Mairiaux, Philippe; Desarmenien, Arnaud; Meyer, Jean-Pierre; Roquelaure, Yves

    2016-02-15

    Manual material handling remains a major cause of occupational accidents and diseases in various sectors and occupations. This paper summarizes the main recommendations of the good practice guidelines of the French Society of Occupational Medicine for the risk assessment for back disorders in workers exposed to manual handling of loads. The guidelines were written by a multidisciplinary working group of 24 experts, according to the Clinical Practice Guidelines method proposed by French National Health Authority, and reviewed by a multidisciplinary peer review committee of 50 experts. Recommendations were based on a large systematic review of the international literature carried out from 1990 to March 2012 and classified (Grade A, B, C or expert consensus) according to their level of evidence. The main recommendations are a three-level hierarchical method of risk assessment based on participatory ergonomics and suggested assessment tools that can be used routinely by professionals of occupational health, workers themselves and their supervisors. These French guidelines are intended for professionals of occupational health in charge of the prevention of low back disorders. The recommended methods are applicable to other countries than France.

  1. Unexplained developmental delay/learning disability: guidelines for best practice protocol for first line assessment and genetic/metabolic/radiological investigations.

    Science.gov (United States)

    O'Byrne, J J; Lynch, S A; Treacy, E P; King, M D; Betts, D R; Mayne, P D; Sharif, F

    2016-02-01

    Investigation of patients, particularly children, with unexplained global developmental delay (GDD)/learning disability (LD) has been challenging due to a lack of clear guidance from specialised centres. Limited knowledge of rare diseases and a poor understanding of the purpose or limitations of appropriate investigations have been some of the principal reasons for this difficulty. A guideline development group was formed to recommend on appropriate, first line metabolic, genetic and radiological investigations for children and adults with unexplained GDD/ID. A comprehensive literature search was conducted, evaluated and reviewed by the guideline committee and a best practice protocol for first line assessment and genetic, metabolic and radiological investigations was decided upon after considering diagnostic yield, practicality, treatability and costs. It is hoped that these recommendations will become national guidelines for the first line metabolic, genetic and radiological investigation of patients presenting with unexplained GDD/ID.

  2. Curriculum Guidelines on Forensic Dentistry.

    Science.gov (United States)

    Journal of Dental Education, 1990

    1990-01-01

    The American Association of Dental Schools' guidelines for curriculum design explain the scope of forensic dentistry and interrelationships with other fields, give an overview of the curriculum, and outline suggested primary educational goals, prerequisites, core content, specific behavioral objectives, sequencing, faculty and facility…

  3. Curriculum Guidelines for Microscopic Anatomy.

    Science.gov (United States)

    Journal of Dental Education, 1993

    1993-01-01

    The American Association of Dental Schools' guidelines for curricula in microscopic anatomy offer an overview of the histology curriculum, note primary educational goals, outline specific content for general and oral histology, suggest prerequisites, and make recommendations for sequencing. Appropriate faculty and facilities are also suggested.…

  4. Predoctoral Curriculum Guidelines for Biomaterials.

    Science.gov (United States)

    Journal of Dental Education, 1986

    1986-01-01

    The American Association of Dental Schools' predoctoral guidelines for biomaterials curricula includes notes on interrelationships between this and other fields, a curriculum overview, primary educational goals, prerequisites, a core content outline, specific behavioral objectives for each content area, and information on sequencing, faculty and…

  5. [Guidelines for the sociomedical assessment of performance in patients suffering from chronic non-malignant diseases of the liver and the bile ducts--for the Medical Assessment Services of the German Pension Fund].

    Science.gov (United States)

    Horn, S; Irle, H; Knorr, I; Pottins, I; Rohwetter, M; Schuhknecht, P; Timner, K; Becker, E

    2009-06-01

    The following guidelines were developed for the medical assessment services of the German pension fund. Starting from day-to-day practice, criteria and attributes to guide decisions for a systematisation of the sociomedical assessment of performance in diseases of the liver and the bile ducts were compiled. The guidelines aim at standardising the sociomedical assessment of performance and help to make the decision-making process more transparent, e. g., for the assessment of applications for decreased earning capacity benefits. The guidelines summarise the typical manifestations of diseases of the liver and the bile ducts and describe the necessary medical information for the sociomedical assessment of performance. Relevant assessment criteria for the medical history, clinical examination, and for diagnostic tests are illustrated. The assessment of the individual's capacity is outlined, taking occupational factors into account. Following the determination of dysfunctions, the remaining abilities and disabilities, respectively, are deduced and compared with occupational demands. Finally, inferences are drawn regarding the occupational capacity of the individual. The guidelines followed from an extended procedure to attain a wide consensus in the setting of the German Pension Fund and an upgraded evidence base.

  6. Assessment of Adaptive Reuse of Heritage Shop Houses for Sleep Lodging in Malaysia: Fulfilment of Conservation Guidelines

    National Research Council Canada - National Science Library

    Othuman Mydin, M.A; Keling, N.A; Sani, N. Md; Abas, N.F

    2014-01-01

    This study focuses on the compliance of adaptive reuse of historic shop houses for sleep lodging with reference to the Guidelines for Conservation Areas and Heritage Buildings by Majlis Perbandaran Pulau Pinang (MPPP...

  7. Performance of a Condensed Protocol That Reduces Effort and Cost of NIA-AA Guidelines for Neuropathologic Assessment of Alzheimer Disease.

    Science.gov (United States)

    Flanagan, Margaret E; Marshall, Desiree A; Shofer, Jane B; Montine, Kathleen S; Nelson, Peter T; Montine, Thomas J; Keene, C Dirk

    2017-01-01

    Concerns regarding resource expenditures have been expressed about the 2012 NIA-AA Sponsored Guidelines for neuropathologic assessment of Alzheimer disease (AD) and related dementias. Here, we investigated a cost-reducing Condensed Protocol and its effectiveness in maintaining the diagnostic performance of Guidelines in assessing AD, Lewy body disease (LBD), microvascular brain injury, hippocampal sclerosis (HS), and congophilic amyloid angiopathy (CAA). The Condensed Protocol consolidates the same 20 regions into 5 tissue cassettes at ∼75% lower cost. A 28 autopsy brain-retrospective cohort was selected for varying levels of neuropathologic features in the Guidelines (Original Protocol), as well as an 18 consecutive autopsy brain prospective cohort. Three neuropathologists at 2 sites performed blinded evaluations of these cases. Lesion specificity was similar between Original and Condensed Protocols. Sensitivities for AD neuropathologic change, LBD, HS, and CAA were not substantially impacted by the Condensed Protocol, whereas sensitivity for microvascular lesions (MVLs) was decreased. Specificity for CAA was decreased using the Condensed Protocol when compared with the Original Protocol. Our results show that the Condensed Protocol is a viable alternative to the NIA-AA guidelines for AD neuropathologic change, LBD, and HS, but not MVLs or CAA, and may be a practical alternative in some practice settings. © 2017 American Association of Neuropathologists, Inc. All rights reserved.

  8. Overview of U.S. nuclear launch safety approval process, supporting launch vehicle databook and probabilistic risk assessment methods

    Science.gov (United States)

    Reinhart, L. E.

    2001-01-01

    This paper provides an overview of the U.S. space nuclear power system launch approval process as defined by the two separate requirements of the National Environmental Policy Act (NEPA) and Presidential Directive/National Security Council Memorandum No. 25 (PD/NSC-25).

  9. Avoidance of large biases and large random errors in the assessment of moderate treatment effects: the need for systematic overviews.

    Science.gov (United States)

    Collins, R; Gray, R; Godwin, J; Peto, R

    1987-01-01

    In order to avoid selective biases and to minimize random errors, inference about the effects of treatment on serious endpoints needs to be based not on one, or a few, of the available trial results, but on a systematic overview of the totality of the evidence from all the relevant unconfounded randomized trials. But, only where coverage of all, or nearly all, randomized patients in all relevant trials (or a reasonably unbiased sample of such trials) can be assured, is a systematic overview of trials reasonably trustworthy, for then any selective biases are likely to be small in comparison with any moderate effects of treatment. Checks for the existence of such biases can best be conducted if reasonably detailed data are available from each trial. Future trials should take into account the results of any relevant overviews in their design, and should plan to obtain sufficient numbers of events to contribute substantially to such overviews. In many cases, this implies the need for randomized trials that are much larger than is currently standard.

  10. Lymphohematopoietic Cancers Induced by Chemicals and Other Agents: Overview and Implications for Risk Assessment (External Review Draft)

    Science.gov (United States)

    This draft report provides an overview of the types of mechanisms underlying the lymphohematopoietic cancers induced by chemical agents and radiation in humans, with a primary emphasis on leukemia and leukemia-inducing agents. It focuses on how mechanistic information on human l...

  11. Tobacco cessation Clinical Practice Guideline use by rural and urban hospital nurses: a pre-implementation needs assessment.

    Science.gov (United States)

    Smith, Patricia M; Sellick, Scott M; Spadoni, Michelle M

    2012-04-30

    This study was a pre-program evaluation of hospital-based nurses' tobacco intervention beliefs, confidence, training, practice, and perceived intervention barriers and facilitators. It was designed to identify relevant information prior to implementing tobacco cessation guidelines across a large northern rural region, home to 1 urban and 12 rural hospitals. This cross-sectional survey was distributed by nurse managers to nurses in the 13 hospitals and returned by nurses (N = 269) via mail to the researchers. Nurses were somewhat confident providing cessation interventions, agreed they should educate patients about tobacco, and 94% perceived tobacco counselling as part of their role. Although only 11% had received cessation training, the majority reported intervening, even if seldom--91% asked about tobacco-use, 96% advised quitting, 89% assessed readiness to quit, 88% assisted with quitting, and 61% arranged post-discharge follow-up. Few performed any of these steps frequently, and among those who intervened, the majority spent benefits and motivation) encouraged nurses to intervene and work-related factors discouraged them (time and workloads). There were significant rural-urban differences--more rural nurses perceived intervening as part of their role, reported having more systems in place to support cessation, reported higher confidence for intervening, and more frequently assisted patients with quitting and arranged follow-up. The findings showed nurses' willingness to engage in tobacco interventions. What the majority were doing maps onto the recommended minimum of 1-3 minutes but intervention frequency and follow-up were suboptimal. The rural-urban differences suggest a need for more research to explore the strengths of rural practice which could potentially inform approaches to smoking cessation in urban hospitals.

  12. Utility of routine data sources for feedback on the quality of cancer care: an assessment based on clinical practice guidelines

    Directory of Open Access Journals (Sweden)

    Baade Peter

    2009-05-01

    Full Text Available Abstract Background Not all cancer patients receive state-of-the-art care and providing regular feedback to clinicians might reduce this problem. The purpose of this study was to assess the utility of various data sources in providing feedback on the quality of cancer care. Methods Published clinical practice guidelines were used to obtain a list of processes-of-care of interest to clinicians. These were assigned to one of four data categories according to their availability and the marginal cost of using them for feedback. Results Only 8 (3% of 243 processes-of-care could be measured using population-based registry or administrative inpatient data (lowest cost. A further 119 (49% could be measured using a core clinical registry, which contains information on important prognostic factors (e.g., clinical stage, physiological reserve, hormone-receptor status. Another 88 (36% required an expanded clinical registry or medical record review; mainly because they concerned long-term management of disease progression (recurrences and metastases and 28 (11.5% required patient interview or audio-taping of consultations because they involved information sharing between clinician and patient. Conclusion The advantages of population-based cancer registries and administrative inpatient data are wide coverage and low cost. The disadvantage is that they currently contain information on only a few processes-of-care. In most jurisdictions, clinical cancer registries, which can be used to report on many more processes-of-care, do not cover smaller hospitals. If we are to provide feedback about all patients, not just those in larger academic hospitals with the most developed data systems, then we need to develop sustainable population-based data systems that capture information on prognostic factors at the time of initial diagnosis and information on management of disease progression.

  13. Asthma control assessment in a pediatric population: comparison between GINA/NAEPP guidelines, Childhood Asthma Control Test (C-ACT), and physician's rating.

    Science.gov (United States)

    Deschildre, A; Pin, I; El Abd, K; Belmin-Larrar, S; El Mourad, S; Thumerelle, C; Le Roux, P; Langlois, C; de Blic, J

    2014-06-01

    Guidelines recommend regular assessment of asthma control. The Childhood Asthma Control Test (C-ACT) is a clinically validated tool. To evaluate asthma control according to GINA2006, NAEPP, pediatrician's assessment (PA), and C-ACT in asthmatic children visiting their ambulatory pediatrician or tertiary care pediatric pulmonologist. Demographic data, treatment, and number of severe exacerbations during the previous year were collected. Control was assessed using (i) strict GINA 2006 criteria, (ii) GINA without taking into account the exacerbation item, (iii) NAEPP criteria, and (iv) PA. Children and parents filled out the C-ACT. Five hundred and twenty-five children completed the survey (mean age: 7.7 years; 28% ≤ 6 years). 78% had a controller treatment. 58% reported ≥ 1 severe exacerbation. C-ACT was ≤ 19 in 29.5%. Control was not achieved in 76.5%, 55%, 40%, and 34% according to GINA 2006 guidelines, NAEPP guidelines, GINA 2006 without exacerbation criteria, and PA, respectively. C-ACT was significantly lower in children ≤ 6 years old (P = 0.002) or with severe exacerbations (P 21 were controlled and 85% of patients with a C-ACT < 17 not controlled. We observed discrepancies between the different tools applied to assess asthma control in children, and the impact of age and exacerbations. Cutoff point of 19 of C-ACT was not associated with the best performance compared to PA. Assessment of control should take into account symptoms and lung function as suggested by the latest GINA guidelines as well as exacerbation over a long period. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Assessing racial/ethnic disparities in chemotherapy treatment among breast cancer patients in context of changing treatment guidelines.

    Science.gov (United States)

    Silva, Abigail; Rauscher, Garth H; Hoskins, Kent; Rao, Ruta; Ferrans, Carol Estwing

    2013-12-01

    Conflicting study results with regards to racial/ethnic disparities in chemotherapy use among breast cancer patients may be due to the different sample populations, treatment data sources, and treatment eligibility definitions used. This study examined chemotherapy disparity in the context of changing treatment guidelines and explored factors that may help explain treatment differences observed. The data come from a population-based study that included interview and medical record data (including state cancer registry) from non-Hispanic (nH) White, nH Black, and Hispanic breast cancer patients diagnosed in 2005-2008. Logistic regression using model-based standardization was used to estimate age-adjusted risk differences and multivariate analysis was conducted to identify explanatory factors of the differences. Per the 2005/2006 National Comprehensive Cancer Network (NCCN) guidelines, minority patients appeared more likely than nH White patients to receive a chemotherapy recommendation (0.87 vs 0.75, p = 0.003). When eligibility was determined per the 2007 guidelines, there was no disparity because under these guidelines, nH White patients were more likely than minority patients to have tumors that no longer required chemotherapy. There was evidence that chemotherapy advances for breast cancer patients are implemented in the clinical setting well ahead of NCCN guidelines. Finally, among eligible patients, chemotherapy recommendation was very high and virtually always accepted and received, with no disparities found at these points of clinical care. The findings suggest that an evaluation of guideline-adherent chemotherapy treatment patterns must carefully consider the definition of treatment eligibility, given ongoing changes in treatment guidelines and early uptake of new diagnostic tools and treatments.

  15. Predictive value of early weight loss in obesity management with orlistat: an evidence-based assessment of prescribing guidelines.

    Science.gov (United States)

    Rissanen, A; Lean, M; Rössner, S; Segal, K R; Sjöström, L

    2003-01-01

    To assess the clinical usefulness of published guidelines for the use of orlistat, by studying whether weight loss >/=2.5 kg during a 4 week dietary lead-in period, and weight losses of >/=5% after 12 weeks and >/=10% after 6 months of drug therapy predict weight loss and risk factor changes after 2 years. A retrospective analysis of pooled data from 2 multicentre, randomised, placebo-controlled clinical trials with similar design. Twenty-nine centres throughout Europe. Two hundred and twenty men and women (BMI 28-43 kg/m(2)) who completed 2 years of treatment. After a 4 week hypocaloric diet plus placebo, 2 years of treatment with orlistat 120 mg tid, plus a hypocaloric diet for the first year and a weight maintenance diet in year two. Weight loss and obesity-related risk factor changes. Weight loss >/=5% body weight after 12 weeks of diet plus orlistat therapy was a good indicator of 2 year weight loss, whereas weight loss of >/=2.5 kg during the 4 week lead-in and >/=10% after 6 months did not add significantly to the prediction of 2 year outcomes. Patients who lost >/=5% of their weight at 12 weeks (n=104, 47.3%) lost significantly more weight after 2 years than others: -11.9% (95% confidence interval (CI) -13.4% to -10.3%) vs -4.7% (-5.7% to -3.7%) (P=0.0001), and had significantly greater reductions in total cholesterol, LDL-cholesterol, triglycerides, glucose, insulin, and blood pressure. Among those who achieved >/=5% weight loss at 12 weeks, the overall health benefits were not significantly greater in patients who went on to lose >/=10% body weight at 6 months compared with those who did not achieve >/=10% weight loss by month 6. Of the criteria currently suggested for assessing response to orlistat treatment, weight loss of >/=5% at 12 weeks accurately predicts sustained improvements in weight and major risk factors at 2 years, while other suggested criteria are less useful.

  16. A critical review of recent clinical practice guidelines on the diagnosis and treatment of non-neurogenic male lower urinary tract symptoms

    Science.gov (United States)

    Chua, Michael Erlano; Mendoza, Jonathan; See, Manuel; Esmena, Ednalyn; Aguila, Dean; Silangcruz, Jan Michael; Reyes, Buenaventura Jose; Luna, Saturnino; Morales, Marcelino

    2015-01-01

    Introduction: We provide an overview of the quality of recent clinical clinical practice guidelines (CPGs) for non-neurogenic male lower urinary tract symptoms (LUTS) and summarize the recommendations for their diagnosis, assessment, and treatment. Methods: We systematically searched recent (2008–2013) CPGs for non-neurogenic male LUTS. Eligible CPGs were assessed and appraised using Appraisal of Guidelines, Research and Evaluation II (AGREE II) tool by a CPG-appraisal group. The appraisal scores for each guideline were summarized according to each domain and in total. A recommendation summary was made across the guidelines for diagnostics, conservative management, medical, minimally invasive therapy, and surgical management. Results: A total of 8 guidelines were considered. According to AGREE II appraisal of guidelines, the National Institute for Health and Clinical Excellence (NICE), American Urological Association (AUA) and European Association of Urology (EAU) consistently scored high on the guideline domains assessed. Recommendations on diagnostics, conservative management, medical, and surgical management were consistent among the top 3 guidelines. However, we noted a discrepancy in recommending minimally invasive therapy as an alternative management of moderate to severe or bothersome non-neurogenic male LUTS secondary to benign prostatic enlargement (BPE); the NICE guideline, in particular, does not recommend using minimally invasive therapy. Conclusion: The quality of recent CPGs on non-neurogenic male LUTS was appraised and summarized. The guidelines from NICE, AUA and EAU were considered highly compliant to the AGREE II proposition for guideline formation and development. PMID:26279717

  17. Assessing the impact of the U.S. Endangered Species Act recovery planning guidelines on managing threats for listed species.

    Science.gov (United States)

    Troyer, Caitlin M; Gerber, Leah R

    2015-10-01

    The Endangered Species Act (ESA) of the United States was enacted in 1973 to prevent the extinction of species. Recovery plans, required by 1988 amendments to the ESA, play an important role in organizing these efforts to protect and recover species. To improve the use of science in the recovery planning process, the Society for Conservation Biology (SCB) commissioned an independent review of endangered species recovery planning in 1999. From these findings, the SCB made key recommendations for how management agencies could improve the recovery planning process, after which the U.S. Fish and Wildlife Service and the National Marine Fisheries Service redrafted their recovery planning guidelines. One important recommendation called for recovery plans to make threats a primary focus, including organizing and prioritizing recovery tasks for threat abatement. We sought to determine the extent to which results from the SCB study were incorporated into these new guidelines and whether the SCB recommendations regarding threats manifested in recovery plans written under the new guidelines. Recovery planning guidelines generally incorporated the SCB recommendations, including those for managing threats. However, although recent recovery plans have improved in their treatment of threats, many fail to adequately incorporate threat monitoring. This failure suggests that developing clear guidelines for monitoring should be an important priority in improving ESA recovery planning. © 2015 Society for Conservation Biology.

  18. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review.

    Science.gov (United States)

    Zeng, Xiantao; Zhang, Yonggang; Kwong, Joey S W; Zhang, Chao; Li, Sheng; Sun, Feng; Niu, Yuming; Du, Liang

    2015-02-01

    To systematically review the methodological assessment tools for pre-clinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline. We searched PubMed, the Cochrane Handbook for Systematic Reviews of Interventions, Joanna Briggs Institute (JBI) Reviewers Manual, Centre for Reviews and Dissemination, Critical Appraisal Skills Programme (CASP), Scottish Intercollegiate Guidelines Network (SIGN), and the National Institute for Clinical Excellence (NICE) up to May 20th, 2014. Two authors selected studies and extracted data; quantitative analysis was performed to summarize the characteristics of included tools. We included a total of 21 assessment tools for analysis. A number of tools were developed by academic organizations, and some were developed by only a small group of researchers. The JBI developed the highest number of methodological assessment tools, with CASP coming second. Tools for assessing the methodological quality of randomized controlled studies were most abundant. The Cochrane Collaboration's tool for assessing risk of bias is the best available tool for assessing RCTs. For cohort and case-control studies, we recommend the use of the Newcastle-Ottawa Scale. The Methodological Index for Non-Randomized Studies (MINORS) is an excellent tool for assessing non-randomized interventional studies, and the Agency for Healthcare Research and Quality (ARHQ) methodology checklist is applicable for cross-sectional studies. For diagnostic accuracy test studies, the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool is recommended; the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) risk of bias tool is available for assessing animal studies; Assessment of Multiple Systematic Reviews (AMSTAR) is a measurement tool for systematic reviews/meta-analyses; an 18-item tool has been developed for appraising case series studies, and the Appraisal of Guidelines, Research and Evaluation (AGREE

  19. The fish sexual development test: an OECD test guideline proposal with possible relevance for environmental risk assessment. Results from the validation programme

    DEFF Research Database (Denmark)

    Holbech, Henrik; Brande-Lavridsen, Nanna; Kinnberg, Karin Lund

    2010-01-01

    The Fish Sexual Development Test (FSDT) has gone through two validations as an OECD test guideline for the detection of endocrine active chemicals with different modes of action. The validation has been finalized on four species: Zebrafish (Danio rerio), Japanese medaka (Oryzias latipes), three...... as a population relevant endpoint and the results of the two validation rounds will be discussed in relation to environmental risk assessment and species selection....

  20. Physics Survey Overview

    Energy Technology Data Exchange (ETDEWEB)

    None

    2002-12-30

    An overview of a series of assignments of the branches of physics carried out by the Board on Physics and Astronomy of the National Research Council. It identifies further theories in physics and makes recommendations on preventive priorities. The Board on Physics and Astronomy (BPA) has conducted a new decadal survey of physics entitled ''Physics in a New Era''. The survey includes assessments of the main branches of physics as well as certain selected emerging areas. The various elements of the survey were prepared by separately-appointed National Research Council (NRC) committees. The BPA formed the Physics Survey Overview Committee (PSOVC) to complete the survey by preparing an overview of the field of physics to summarize and synthesize the results of the various assessments and to address cross-cutting issues that concern physics as a whole.

  1. ASVCP quality assurance guidelines: external quality assessment and comparative testing for reference and in-clinic laboratories.

    Science.gov (United States)

    Camus, Melinda S; Flatland, Bente; Freeman, Kathleen P; Cruz Cardona, Janice A

    2015-12-01

    The purpose of this document is to educate providers of veterinary laboratory diagnostic testing in any setting about comparative testing. These guidelines will define, explain, and illustrate the importance of a multi-faceted laboratory quality management program which includes comparative testing. The guidelines will provide suggestions for implementation of such testing, including which samples should be tested, frequency of testing, and recommendations for result interpretation. Examples and a list of vendors and manufacturers supplying control materials and services to veterinary laboratories are also included. © 2015 American Society for Veterinary Clinical Pathology.

  2. A Systematic Review of Ebola Treatment Trials to Assess the Extent to Which They Adhere to Ethical Guidelines.

    Science.gov (United States)

    Richardson, Thomas; Johnston, Andrew McDonald; Draper, Heather

    2017-01-01

    base for its effectiveness against Ebola is speculative. Some limited and appropriate deviation from standard research expectations in disaster situations is increasingly accepted. However, this is not an excuse for poor ethics oversight and international regulations are in place which should not be ignored. New guidelines are needed that better define the boundaries between using medicines for compassionate use and conducting a clinical trial. Greater support should be offered for local research ethics committees in affected areas so that they can provide robust ethical review. Further systematic reviews should be carried out in epidemics of any novel infectious diseases to assess if comparable findings arise.

  3. A Systematic Review of Ebola Treatment Trials to Assess the Extent to Which They Adhere to Ethical Guidelines.

    Directory of Open Access Journals (Sweden)

    Thomas Richardson

    pre-trial evidence base for its effectiveness against Ebola is speculative.Some limited and appropriate deviation from standard research expectations in disaster situations is increasingly accepted. However, this is not an excuse for poor ethics oversight and international regulations are in place which should not be ignored. New guidelines are needed that better define the boundaries between using medicines for compassionate use and conducting a clinical trial. Greater support should be offered for local research ethics committees in affected areas so that they can provide robust ethical review. Further systematic reviews should be carried out in epidemics of any novel infectious diseases to assess if comparable findings arise.

  4. The Parenting to Reduce Adolescent Depression and Anxiety Scale: Assessing parental concordance with parenting guidelines for the prevention of adolescent depression and anxiety disorders

    Directory of Open Access Journals (Sweden)

    Mairead C. Cardamone-Breen

    2017-09-01

    Full Text Available Background Despite substantial evidence demonstrating numerous parental risk and protective factors for the development of adolescent depression and anxiety disorders, there is currently no single measure that assesses these parenting factors. To address this gap, we developed the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS as a criterion-referenced measure of parental concordance with a set of evidence-based parenting guidelines for the prevention of adolescent depression and anxiety disorders. In this paper, we used a sample of Australian parents of adolescents to: (1 validate the PRADAS as a criterion-referenced measure; (2 examine parental concordance with the guidelines in the sample; and (3 examine correlates of parental concordance with the guidelines. Methods Seven hundred eleven parents completed the PRADAS, as well as two established parenting measures, and parent-report measures of adolescent depression and anxiety symptoms. Six hundred sixty adolescent participants (aged 12–15 also completed the symptom measures. Concordance with the guidelines was assessed via nine subscale scores and a total score. Reliability of the scores was assessed with an estimate of the agreement coefficient, as well as 1-month test-retest reliability. Convergent validity was examined via correlations between the scale and two established parenting measures. Results One proposed subscale was removed from the final version of the scale, resulting in a total of eight subscales. Reliability was high for the total score, and acceptable to high for seven of the eight subscales. One-month test-retest reliability was acceptable to high for the total score. Convergent validity was supported by moderate to high correlations with two established measures of parenting. Overall, rates of parental concordance with the guidelines were low in our sample. Higher scores were associated with being female and higher levels of parental education

  5. The Parenting to Reduce Adolescent Depression and Anxiety Scale: Assessing parental concordance with parenting guidelines for the prevention of adolescent depression and anxiety disorders.

    Science.gov (United States)

    Cardamone-Breen, Mairead C; Jorm, Anthony F; Lawrence, Katherine A; Mackinnon, Andrew J; Yap, Marie B H

    2017-01-01

    Despite substantial evidence demonstrating numerous parental risk and protective factors for the development of adolescent depression and anxiety disorders, there is currently no single measure that assesses these parenting factors. To address this gap, we developed the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS) as a criterion-referenced measure of parental concordance with a set of evidence-based parenting guidelines for the prevention of adolescent depression and anxiety disorders. In this paper, we used a sample of Australian parents of adolescents to: (1) validate the PRADAS as a criterion-referenced measure; (2) examine parental concordance with the guidelines in the sample; and (3) examine correlates of parental concordance with the guidelines. Seven hundred eleven parents completed the PRADAS, as well as two established parenting measures, and parent-report measures of adolescent depression and anxiety symptoms. Six hundred sixty adolescent participants (aged 12-15) also completed the symptom measures. Concordance with the guidelines was assessed via nine subscale scores and a total score. Reliability of the scores was assessed with an estimate of the agreement coefficient, as well as 1-month test-retest reliability. Convergent validity was examined via correlations between the scale and two established parenting measures. One proposed subscale was removed from the final version of the scale, resulting in a total of eight subscales. Reliability was high for the total score, and acceptable to high for seven of the eight subscales. One-month test-retest reliability was acceptable to high for the total score. Convergent validity was supported by moderate to high correlations with two established measures of parenting. Overall, rates of parental concordance with the guidelines were low in our sample. Higher scores were associated with being female and higher levels of parental education. Greater parental concordance with the guidelines

  6. International guidelines for the in vivo assessment of skin properties in non-clinical settings: part 1. pH

    Science.gov (United States)

    Stefaniak, Aleksandr B; du Plessis, Johan; John, Swen M; Eloff, Fritz; Agner, Tove; Chou, Tzu-Chieh; Nixon, Rosemary; Steiner, Markus F C; Kudla, Irena; Holness, D Linn

    2013-01-01

    Background Skin surface pH is known to influence the dissolution and partitioning of chemicals and may influence exposures that lead to skin diseases. Non-clinical environments (e.g. workplaces) are highly variable, thereby presenting unique measurement challenges that are not typically encountered in clinical settings. Hence, guidelines are needed for consistent measurement of skin surface pH in environments that are difficult to control. Methods An expert workshop was convened at the 5th International Conference on Occupational and Environmental Exposure of Skin to Chemicals to review available data on factors that could influence the determination of skin surface pH in non-clinical settings with emphasis on the workplace as a worst case scenario. Results The key elements of the guidelines are: (i) minimize, to the extent feasible, the influences of relevant endogenous (anatomical position, skin health, time of day), exogenous (hand washing, barrier creams, soaps and detergents, occlusion), environmental (seasonality), and measurement (atmospheric conditions) factors; (ii) report pH measurements results as a difference or percent change (not absolute values) using a measure of central tendency and variability; and (iii) report notable deviations from these guidelines and other relevant factors that may influence measurements. Conclusion Guidelines on the measurement and reporting of skin surface pH in non-clinical settings should promote consistency in data reporting, facilitate inter-comparison of study results, and aid in understanding and preventing occupational skin diseases. PMID:23279097

  7. A proposed approach for quantitative benefit-risk assessment in diagnostic radiology guideline development: the American College of Radiology Appropriateness Criteria Example.

    Science.gov (United States)

    Agapova, Maria; Bresnahan, Brian B; Higashi, Mitchell; Kessler, Larry; Garrison, Louis P; Devine, Beth

    2017-02-01

    The American College of Radiology develops evidence-based practice guidelines to aid appropriate utilization of radiological procedures. Panel members use expert opinion to weight trade-offs and consensus methods to rate appropriateness of imaging tests. These ratings include an equivocal range, assigned when there is disagreement about a technology's appropriateness and the evidence base is weak or for special circumstances. It is not clear how expert consensus merges with the evidence base to arrive at an equivocal rating. Quantitative benefit-risk assessment (QBRA) methods may assist decision makers in this capacity. However, many methods exist and it is not clear which methods are best suited for this application. We perform a critical appraisal of QBRA methods and propose several steps that may aid in making transparent areas of weak evidence and barriers to consensus in guideline development. We identify QBRA methods with potential to facilitate decision making in guideline development and build a decision aid for selecting among these methods. This study identified 2 families of QBRA methods suited to guideline development when expert opinion is expected to contribute substantially to decision making. Key steps to deciding among QBRA methods involve identifying specific benefit-risk criteria and developing a state-of-evidence matrix. For equivocal ratings assigned for reasons other than disagreement or weak evidence base, QBRA may not be needed. In the presence of disagreement but the absence of a weak evidence base, multicriteria decision analysis approaches are recommended; and in the presence of weak evidence base and the absence of disagreement, incremental net health benefit alone or combined with multicriteria decision analysis is recommended. Our critical appraisal further extends investigation of the strengths and limitations of select QBRA methods in facilitating diagnostic radiology clinical guideline development. The process of using the decision

  8. Overview of the AVT-191 Project to Assess Sensitivity Analysis and Uncertainty Quantification Methods for Military Vehicle Design

    Science.gov (United States)

    Benek, John A.; Luckring, James M.

    2017-01-01

    A NATO symposium held in 2008 identified many promising sensitivity analysis and un-certainty quantification technologies, but the maturity and suitability of these methods for realistic applications was not known. The STO Task Group AVT-191 was established to evaluate the maturity and suitability of various sensitivity analysis and uncertainty quantification methods for application to realistic problems of interest to NATO. The program ran from 2011 to 2015, and the work was organized into four discipline-centric teams: external aerodynamics, internal aerodynamics, aeroelasticity, and hydrodynamics. This paper presents an overview of the AVT-191 program content.

  9. UK clinical guideline for the prevention and treatment of osteoporosis.

    Science.gov (United States)

    Compston, J; Cooper, A; Cooper, C; Gittoes, N; Gregson, C; Harvey, N; Hope, S; Kanis, J A; McCloskey, E V; Poole, K E S; Reid, D M; Selby, P; Thompson, F; Thurston, A; Vine, N

    2017-12-01

    In 2008, the UK National Osteoporosis Guideline Group (NOGG) produced a guideline on the prevention and treatment of osteoporosis, with an update in 2013. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women and men age 50 years or over. Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base. Conclusions and recommendations were systematically graded according to the strength of the available evidence. Review of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment, lifestyle measures and pharmacological interventions, duration and monitoring of bisphosphonate therapy, glucocorticoid-induced osteoporosis, osteoporosis in men, postfracture care and intervention thresholds. The guideline, which has received accreditation from the National Institute of Health and Care Excellence (NICE), provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals who are involved in its management.

  10. Tobacco cessation Clinical Practice Guideline use by rural and urban hospital nurses: a pre-implementation needs assessment

    OpenAIRE

    Smith Patricia M; Sellick Scott M; Spadoni Michelle M

    2012-01-01

    Abstract Background This study was a pre-program evaluation of hospital-based nurses' tobacco intervention beliefs, confidence, training, practice, and perceived intervention barriers and facilitators. It was designed to identify relevant information prior to implementing tobacco cessation guidelines across a large northern rural region, home to 1 urban and 12 rural hospitals. Methods This cross-sectional survey was distributed by nurse managers to nurses in the 13 hospitals and returned by n...

  11. Water-quality assessment of the Central Arizona Basins, Arizona and northern Mexico; environmental setting and overview of water quality

    Science.gov (United States)

    Cordy, Gail E.; Rees, Julie A.; Edmonds, Robert J.; Gebler, Joseph B.; Wirt, Laurie; Gellenbeck, Dorinda J.; Anning, David W.

    1998-01-01

    The Central Arizona Basins study area in central and southern Arizona and northern Mexico is one of 60 study units that are part of the U.S. Geological Survey's National Water-Quality Assessment program. The purpose of this report is to describe the physical, chemical, and environmental characteristics that may affect water quality in the Central Arizona Basins study area and present an overview of water quality. Covering 34,700 square miles, the study area is characterized by generally north to northwestward-trending mountain ranges separated by broad, gently sloping alluvial valleys. Most of the perennial rivers and streams are in the northern part of the study area. Rivers and streams in the south are predominantly intermittent or ephemeral and flow in response to precipitation such as summer thunderstorms. Effluent-dependent streams do provide perennial flow in some reaches. The major aquifers in the study area are in the basin-fill deposits that may be as much as 12,000 feet thick. The 1990 population in the study area was about 3.45 million, and about 61 percent of the total was in Maricopa County (Phoenix and surrounding cities). Extensive population growth over the past decade has resulted in a twofold increase in urban land areas and increased municipal water use; however, agriculture remains the major water use. Seventy-three percent of all water with drawn in the study area during 1990 was used for agricultural purposes. The largest rivers in the study area-the Gila, Salt, and Verde-are perennial near their headwaters but become intermittent downstream because of impoundments and artificial diversions. As a result, the Central Arizona Basins study area is unique compared to less arid basins because the mean surface-water outflow is only 528 cubic feet per second from a total drainage area of 49,650 square miles. Peak flows in the northern part of the study area are the result of snowmelt runoff; whereas, summer thunderstorms account for the peak flows in

  12. Cross-talk between available guidelines for the management of patients with beta-thalassemia major.

    Science.gov (United States)

    Musallam, Khaled M; Angastiniotis, Michael; Eleftheriou, Androulla; Porter, John B

    2013-01-01

    Efforts to optimize the management of patients with β-thalassemia major (TM) continue to expand. Evidence from biomedical research evaluating safe and careful processing measures of blood products, the efficacy and safety of oral iron chelators, and noninvasive techniques for the assessment of iron overload are translated into better patient outcomes. The construction of TM management guidelines facilitated the incorporation of such evidence into practice. However, as several aspects of the management of TM remain controversial or governed by resource availability, a concern regarding potential variations in recommendations made by the different guidelines becomes rational, especially for physicians treating TM patients outside countries where the guidelines were constructed. In this work, we overview currently available guidelines for the management of TM and explore apparent similarities and differences between them. The evaluated guidelines included the Thalassaemia International Federation, US, Canadian, UK, Italian and Australian guidelines. We noted a general consensus for most aspects of management, although some guidelines provided more comprehensive and contemporary recommendations than others. We did not identify differences warranting concern, although minor differences in iron overload assessment strategy and more notable variations in the recommendations for iron chelation therapy were observed. Copyright © 2013 S. Karger AG, Basel.

  13. Design Guidelines for Low Crested Structures

    DEFF Research Database (Denmark)

    Burcharth, H. F.; Lamberti, Alberto

    2004-01-01

    The paper presents an overview of the design guidelines for low crested structures (LCS's) to be applied in coastal protection schemes. The design guidelines are formulated as a part of the research project: Environmental Design of Low Crested Coastal Defence Structures (DELOS) within the EC 5FP...... 1998-2002. The Guidelines comprise engineering aspects related to morphological impact and structure stability, biological aspects related to ecological impact, and socio-economical aspects related to the implementation of LCS-schemes. The guidelines are limited to submerged and regularly overtopped...

  14. Guideline of guidelines: kidney stones.

    Science.gov (United States)

    Ziemba, Justin B; Matlaga, Brian R

    2015-08-01

    Several professional organizations have developed evidence-based guidelines for the initial evaluation, diagnostic imaging selection, symptomatic management, surgical treatment, medical therapy, and prevention of recurrence for both ureteric and renal stones. The purpose of this article is to summarize these guidelines with reference to the strength of evidence. All guidelines endorse an initial evaluation to exclude concomitant infection, imaging with a non-contrast computed tomography scan, and consideration of medical expulsive therapy or surgical intervention depending on stone size and location. Recommends for metabolic evaluation vary by guideline, but all endorse increasing fluid intake to reduce the risk of recurrence. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

  15. Assessment of Practice Patterns Following Publication of the SSO–ASTRO Consensus Guideline on Margins for Breast-Conserving Therapy in Stage I and II Invasive Breast Cancer

    Science.gov (United States)

    DeSnyder, Sarah M.; Hunt, Kelly K.; Smith, Benjamin D.; Moran, Meena S.; Klimberg, Suzanne; Lucci, Anthony

    2015-01-01

    Background The recently published SSO–ASTRO consensus guideline on margins concluded “no ink on tumor” is the standard for an adequate margin. This study was conducted to determine how this guideline is aligned with current clinical practice. Methods A survey was sent to 3057 members of the American Society of Breast Surgeons. Questions assessed respondents’ clinical practice type and duration, familiarity with the guideline, and preferences for margin re-excision. Results Of those surveyed, 777 (25 %) responded. Most (92 %) indicated familiarity with the guideline. Of these respondents, the majority (n = 678, or 94.7 %) would re-excise all or most of the time when tumor extended to the inked margin. Very few (n = 9, or 1.3 %) would re-excise all or most of the time when tumor was within 2 mm of the margin. Over 12 % (n = 90) would re-excise all or most of the time for a triple-negative tumor within 1 mm of the margin, whereas 353 (49.6 %) would re-excise all or most of the time when imaging and pathology were discordant, and tumor was within 1 mm of multiple margins. Finally, 330 (45.8 %) would re-excise all or most of the time when multiple foci of ductal carcinoma in situ extended to within 1 mm of multiple inked margins. Conclusions Surgeons are in agreement to re-excise margins when tumor touches ink and generally not to perform re-excisions when tumor is close to (but not touching) the inked margin. For more complex scenarios, surgeons are utilizing their individual clinical judgment to determine the need for re-excision. PMID:26202554

  16. Assessment of Practice Patterns Following Publication of the SSO-ASTRO Consensus Guideline on Margins for Breast-Conserving Therapy in Stage I and II Invasive Breast Cancer.

    Science.gov (United States)

    DeSnyder, Sarah M; Hunt, Kelly K; Smith, Benjamin D; Moran, Meena S; Klimberg, Suzanne; Lucci, Anthony

    2015-10-01

    The recently published SSO-ASTRO consensus guideline on margins concluded "no ink on tumor" is the standard for an adequate margin. This study was conducted to determine how this guideline is aligned with current clinical practice. A survey was sent to 3057 members of the American Society of Breast Surgeons. Questions assessed respondents' clinical practice type and duration, familiarity with the guideline, and preferences for margin re-excision. Of those surveyed, 777 (25%) responded. Most (92%) indicated familiarity with the guideline. Of these respondents, the majority (n = 678, or 94.7%) would re-excise all or most of the time when tumor extended to the inked margin. Very few (n = 9, or 1.3%) would re-excise all or most of the time when tumor was within 2 mm of the margin. Over 12 % (n = 90) would re-excise all or most of the time for a triple-negative tumor within 1 mm of the margin, whereas 353 (49.6%) would re-excise all or most of the time when imaging and pathology were discordant, and tumor was within 1 mm of multiple margins. Finally, 330 (45.8%) would re-excise all or most of the time when multiple foci of ductal carcinoma in situ extended to within 1 mm of multiple inked margins. Surgeons are in agreement to re-excise margins when tumor touches ink and generally not to perform re-excisions when tumor is close to (but not touching) the inked margin. For more complex scenarios, surgeons are utilizing their individual clinical judgment to determine the need for re-excision.

  17. Critical features of peer assessment of clinical performance to enhance adherence to a low back pain guideline for physical therapists: a mixed methods design.

    Science.gov (United States)

    Maas, Marjo J M; van Dulmen, Simone A; Sagasser, Margaretha H; Heerkens, Yvonne F; van der Vleuten, Cees P M; Nijhuis-van der Sanden, Maria W G; van der Wees, Philip J

    2015-11-12

    Clinical practice guidelines are intended to improve the process and outcomes of patient care. However, their implementation remains a challenge. We designed an implementation strategy, based on peer assessment (PA) focusing on barriers to change in physical therapy care. A previously published randomized controlled trial showed that PA was more effective than the usual strategy "case discussion" in improving adherence to a low back pain guideline. Peer assessment aims to enhance knowledge, communication, and hands-on clinical skills consistent with guideline recommendations. Participants observed and evaluated clinical performance on the spot in a role-play simulating clinical practice. Participants performed three roles: physical therapist, assessor, and patient. This study explored the critical features of the PA program that contributed to improved guideline adherence in the perception of participants. Dutch physical therapists working in primary care (n = 49) organized in communities of practice (n = 6) participated in the PA program. By unpacking the program we identified three main tasks and eleven subtasks. After the program was finished, a questionnaire was administered in which participants were asked to rank the program tasks from high to low learning value and to describe their impact on performance improvement. Overall ranking results were calculated. Additional semi-structured interviews were conducted to elaborate on the questionnaires results and were transcribed verbatim. Questionnaires comments and interview transcripts were analyzed using template analysis. Program tasks related to performance in the therapist role were perceived to have the highest impact on learning, although task perceptions varied from challenging to threatening. Perceptions were affected by the role-play format and the time schedule. Learning outcomes were awareness of performance, improved attitudes towards the guideline, and increased self-efficacy beliefs in

  18. Application of sediment quality guidelines in the assessment and management of contaminated surficial sediments in Port Jackson (Sydney Harbour), Australia.

    Science.gov (United States)

    Birch, Gavin F; Taylor, Stuart E

    2002-06-01

    Sediments in the Port Jackson estuary are polluted by a wide range of toxicants and concentrations are among the highest reported for any major harbor in the world. Sediment quality guidelines (SQGs), developed by the National Oceanographic and Atmospheric Administration (NOAA) in the United States are used to estimate possible adverse biological effects of sedimentary contaminants in Port Jackson to benthic animals. The NOAA guidelines indicate that Pb, Zn, DDD, and DDE are the most likely contaminants to cause adverse biological effects in Port Jackson. On an individual chemical basis, the detrimental effects due to these toxicants may occur over extensive areas of the harbor, i.e., about 40%, 30%, 15% and 50%, respectively. The NOAA SQGs can also be used to estimate the probability of sediment toxicity for contaminant mixtures by determining the number of contaminants exceeding an upper guideline value (effects range medium, or ERM), which predicts probable adverse biological effects. The exceedence approach is used in the current study to estimate the probability of sediment toxicity and to prioritize the harbour in terms of possible adverse effects on sediment-dwelling animals. Approximately 1% of the harbor is mantled with sediment containing more than ten contaminants exceeding their respective ERM concentrations and, based on NOAA data, these sediments have an 80% probability of being toxic. Sediment with six to ten contaminants exceeding their respective ERM guidelines extend over approximately 4% of the harbor and have a 57% probability of toxicity. These areas are located in the landward reaches of embayments in the upper and central harbor in proximity to the most industrialised and urbanized part of the catchment. Sediment in a further 17% of the harbor has between one and five exceedences and has a 32% probability of being toxic. The application of SQGs developed by NOAA has not been tested outside North America, and the validity of using them in Port

  19. Practice implications for peristomal skin assessment and care from the 2014 world council of enterostomal therapists international ostomy guideline.

    Science.gov (United States)

    Stelton, Susan; Zulkowski, Karen; Ayello, Elizabeth A

    2015-06-01

    All persons with an ostomy are at risk for development of peristomal skin problems. This is true regardless of the person's nation of residence, type of stoma, or supplies available for stoma care. There are measures that can be taken to lessen the potential for peristomal skin problems. These measures include preoperative stoma site marking, preoperative education, appropriate pouch/barrier fitting, and pouch maintenance. The 2014 World Council of Enterostomal Therapists International Ostomy Guideline includes recommendations that can be implemented to prevent situations that may lead to peristomal skin complications.

  20. Managing Ulcerative Colitis – The Guidelines and Beyond

    Directory of Open Access Journals (Sweden)

    Mitchell RKL Lie

    2013-11-01

    Full Text Available Management guidelines offer clinicians clear, evidence-based and often succinct treatment advice. For ulcerative colitis these guidelines describe the use of 5-ASA, corticosteroids, thiopurines, cyclosporine, and anti-TNFα therapies. However, guidelines do have some drawbacks, mainly a lack of concrete advice concerning patients resistant to these aforementioned therapies. This review gives a short overview of current guidelines and addresses treatment alternatives for conventional therapies.

  1. Dietary guidelines

    DEFF Research Database (Denmark)

    Jelsøe, Erling

    2015-01-01

    Dietary guidelines are issued regularly in most developed countries. In almost all cases they are concerned solely with the nutritional aspects of food and eating and are based on an understanding of food exclusively as a source of nutrients. In recent years, however, a growing number of proposals...... in a number of countries have addressed the issue of making dietary guidelines that integrate health and sustainability, but in all cases they have been met with different kinds of resistance. This article reviews the development towards an integrated understanding of health and sustainability in relation...... to food and eating and the emergence of proposals for integrated guidelines. It explores the conflicts and controversies that have arisen in the wake of the various proposals and identifies a number of different types of conflicts. These relate to conflicts of interests between the various actors involved...

  2. An Overview of Smart Shoes in the Internet of Health Things: Gait and Mobility Assessment in Health Promotion and Disease Monitoring

    Directory of Open Access Journals (Sweden)

    Bjoern M. Eskofier

    2017-09-01

    Full Text Available New smart technologies and the internet of things increasingly play a key role in healthcare and wellness, contributing to the development of novel healthcare concepts. These technologies enable a comprehensive view of an individual’s movement and mobility, potentially supporting healthy living as well as complementing medical diagnostics and the monitoring of therapeutic outcomes. This overview article specifically addresses smart shoes, which are becoming one such smart technology within the future internet of health things, since the ability to walk defines large aspects of quality of life in a wide range of health and disease conditions. Smart shoes offer the possibility to support prevention, diagnostic work-up, therapeutic decisions, and individual disease monitoring with a continuous assessment of gait and mobility. This overview article provides the technological as well as medical aspects of smart shoes within this rising area of digital health applications, and is designed especially for the novel reader in this specific field. It also stresses the need for closer interdisciplinary interactions between technological and medical experts to bridge the gap between research and practice. Smart shoes can be envisioned to serve as pervasive wearable computing systems that enable innovative solutions and services for the promotion of healthy living and the transformation of health care.

  3. Pregnancy and melanoma: a European-wide survey to assess current management and a critical literature overview.

    Science.gov (United States)

    Ribero, S; Longo, C; Dika, E; Fortes, C; Pasquali, S; Nagore, E; Glass, D; Robert, C; Eggermont, A M; Testori, A; Quaglino, P; Nathan, P; Argenziano, G; Puig, S; Bataille, V

    2017-01-01

    Management of melanoma during pregnancy can be extremely challenging. The reported incidence of melanoma in pregnancy ranges from 2.8 to 5.0 per 100 000 pregnancies. There are no guidelines for the management of melanoma during pregnancy. The survey was designed to investigate the opinions of melanoma physicians on decision making in relation to pregnancy and melanoma. A clinical scenario-based survey on management of pregnancy in melanoma was distributed all over Europe via the membership of the EORTC and other European melanoma societies. A total of 290 questionnaires were returned with a larger participation from southern Europe. A large heterogeneity was found for the answers given in the different clinical scenarios with 50% of the answers showing discordance, especially regarding sentinel lymph node biopsy during pregnancy. Discordant answers were also found for the counselling of women about a potential delay in getting pregnant after a high-risk melanoma (35% for a 2 year wait minimum vs. 57% no waiting needed), while for thin melanomas, as expected, there was more concordance with 70% of the physicians recommending no delay. Fifteen per cent of physicians recommended an abortion in stage II melanoma during the third month of pregnancy. Twenty per cent of the responders advised against hormonal replacement therapy in melanoma patients. The management of melanoma during pregnancy varies widely in Europe. At present, there is a lack of consensus in Europe, which may lead to very important decisions in women with melanoma, and guidelines are needed. © 2016 European Academy of Dermatology and Venereology.

  4. Assessment of Iranian Nurses and Emergency Medical Personnel in Terms of Cardiopulmonary Resuscitation Knowledge Based on the 2010 Guideline.

    Science.gov (United States)

    Kalhori, Reza Pourmirza; Jalali, Amir; Naderipour, Arsalan; Almasi, Afshin; Khavasi, Mohammad; Rezaei, Masoud; Abbasi, Mohammad

    2017-01-01

    The aim of this study was to compare the cardiopulmonary resuscitation (CPR) knowledge of hospital nurses and emergency medical personnel in Kermanshah, Iran. This descriptive cross-sectional study was conducted on 330 hospital nurses and 159 emergency medical personnel working in educational hospitals and emergency medical centers in Kermanshah. Data were collected using a validated and reliable (r = 0.74) researcher-made questionnaire consisting of a demographic characteristics questionnaire and the 2010 CPR knowledge questionnaire. Based on the most recent CPR guidelines, the knowledge of 19.5%, 78.6%, and 1.9% of the emergency medical staff was excellent, good, and moderate, respectively. None of the participants had poor knowledge. In addition, the knowledge of 20.2%, 65.4%, 14%, and 0.4% of the nurses in this study was excellent, good, moderate, and poor, respectively. There was no significant difference in CPR knowledge between hospital nurses and emergency medical staff. Moreover, no significant association was found between CPR knowledge and gender, age, work experience, field of study, previous occupation, and advanced resuscitation courses. However, CPR knowledge of individuals with training in basic CPR courses was higher than participants without training in these courses (P nurses and emergency medical personnel was in an acceptable range. Nevertheless, it is strongly recommended that nurses and emergency staff receive training according to the most recent CPR guidelines.

  5. Childhood and adolescent attention-deficit hyperactivity disorder: diagnosis, clinical practice guidelines, and social implications.

    Science.gov (United States)

    Salmeron, Patricia A

    2009-09-01

    To review the diagnostic criteria for attention-deficit hyperactivity disorder (ADHD), present an overview of the effects that ADHD has on family dynamics, school performance, and substance abuse, and provide an overview of the American Academy of Pediatrics (AAP) clinical practice and treatment guidelines. An extensive health science literature review was carried out using PubMed and Cumulative Index to Nursing and Allied Health Literature. Other information was collected by searching reference lists of published reports. The diagnostic criteria and guidelines are important to make an accurate clinical assessment and manage a child with ADHD. Early diagnosis and treatment of ADHD decreases academic failure, family conflict, social isolation, substance abuse, and occupational adversity in later years for these children. Often primary care nurse practitioners are the first healthcare provider a child with ADHD will see. Awareness of the diagnostic criteria and treatment for children with ADHD can assist with early identification and perhaps eliminate much impairment that accompanies this chronic disorder.

  6. 2014 Guideline for Management of Wounds in Patients With Lower-Extremity Arterial Disease (LEAD): An Executive Summary.

    Science.gov (United States)

    Bonham, Phyllis A; Flemister, Bonny G; Droste, Linda R; Johnson, Jan J; Kelechi, Teresa; Ratliff, Catherine R; Varnado, Myra F

    2016-01-01

    The purpose of this article is to provide a summary of the recommendations from the 2014 Guideline for Management of Wounds in Patients With Lower-Extremity Arterial Disease (LEAD), published by the Wound, Ostomy and Continence Nurses Society (WOCN). This article provides an overview of the process used to update and develop the guideline, and specific recommendations from the guideline for assessment, referral for further evaluation, interventions (ie, debridement, dressings, infection, antibiotics, nutrition, pain management, compression issues, medications, surgical options, and adjunctive therapies), and patient education and risk-reduction strategies. The LEAD guideline is a resource for physicians, nurses, therapists, and other healthcare professionals who work with adults who have/or are at risk for wounds due to LEAD. The full text of the published guideline, which includes the available evidence supporting the recommendations and a complete reference list, is available from the WOCN Society, 1120 Rt. 73, Suite 200, Mount Laurel, NJ, 08054; Web site: www.wocn.org. Refer to the Supplemental Digital Content (Supplement Digital Content 1, http://links.lww.com/JWOCN/A31) associated with this article for the complete reference list for the guideline. The guideline has been accepted for publication by the National Guideline Clearinghouse (www.guideline.gov/).

  7. Safety assessment of a novel active ingredient, acetyl aspartic acid, according to the EU Cosmetics Regulation and the Scientific Committee on Consumer Safety guidelines.

    Science.gov (United States)

    Daly, P; Moran, G

    2015-10-01

    Acetyl aspartic acid (A-A-A) was proposed as a new novel active ingredient for use in cosmetics. The safety of A-A-A was assessed by following an in-house-developed 'New Ingredient Testing Strategy', which was designed in accordance with the Scientific Committee on Consumer Safety (SCCS) notes of guidance and the requirements of Annex I of the EU Cosmetics Regulation. The aim of the project was to determine whether A-A-A was safe for use in cosmetics and to determine a maximum permitted safe level in the formulations. A literature review was conducted, consulting over 40 different information sources. This highlighted a number of gaps which required testing data. A-A-A was tested for phototoxicity according to OECD test guideline 432, skin irritation according to OECD test guideline 439 and eye irritation according to OECD test guideline 437. Dermal absorption of A-A-A was measured according to OECD test guideline 428 and was used to calculate the margin of safety (MoS). Finally, A-A-A was tested in a human repeat insult patch test (HRIPT) and a 14-day in-use tolerance study. A-A-A was non-phototoxic and was non-irritating to skin and eyes in in vitro testing. Dermal absorption was calculated to be 5%. The MoS for A-A-A was 351, at a level of 5%, for all cosmetic product types, indicating no systemic safety toxicity concern. A-A-A at 5% under occlusive patch on a panel of 50 adult volunteers induced no skin irritation or allergic reaction in the HRIPT study. Finally, repeated application of A-A-A to the periocular area, twice per day for 14 days, in 21 female volunteers, demonstrated that 1% A-A-A was well tolerated following dermatological and ophthalmological assessment in a cosmetic formulation. A-A-A was assessed as safe by the cosmetic safety assessor for use in cosmetics at a level of 5% in all cosmetic product types, in line with the requirements of the EU Cosmetics Regulation and in accordance with the SCCS notes of guidance. © 2015 Society of Cosmetic

  8. Assessment of the chemical contamination in home-produced eggs in Belgium: General overview of the CONTEGG study

    Energy Technology Data Exchange (ETDEWEB)

    Van Overmeire, I., E-mail: ilse.vanovermeire@iph.fgov.be [Scientific Institute of Public Health. J. Wytsmanstraat 14, B-1050, Brussels (Belgium); Pussemier, L.; Waegeneers, N. [Veterinary and Agrochemical Research Centre (VAR-CODA-CERVA), Leuvensesteenweg 17, B-3080 Tervuren (Belgium); Hanot, V.; Windal, I.; Boxus, L. [Scientific Institute of Public Health. J. Wytsmanstraat 14, B-1050, Brussels (Belgium); Covaci, A. [Toxicological Center, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk (Belgium); Eppe, G. [CART Mass Spectrometry Laboratory, Chemistry Department, University of Liege, Allee de la Chimie 3, B-6c Sart-Tilman, B-4000 Liege (Belgium); Scippo, M.L. [Laboratory of food analysis, faculty of veterinary medicine, CART (Centre of Analysis of Residue in Traces), University of Liege, B43b, bld de Colonster 20, Sart-Tilman, B-4000 Liege (Belgium); Sioen, I.; Bilau, M. [Department of Public Health, Ghent University, UZ 2 Blok A, De Pintelaan 185, B-9000 (Belgium); Gellynck, X.; De Steur, H. [Department of Agricultural Economics, Division Agro-Food marketing, Ghent University (Belgium); Tangni, E.K. [Veterinary and Agrochemical Research Centre (VAR-CODA-CERVA), Leuvensesteenweg 17, B-3080 Tervuren (Belgium); Goeyens, L. [Scientific Institute of Public Health. J. Wytsmanstraat 14, B-1050, Brussels (Belgium)

    2009-07-15

    This overview paper describes a study conducted for the Belgian Federal Public Service of Health, Food Chain Safety and Environment during 2006-2007. Home-produced eggs from Belgian private owners of hens were included in a large study aiming to determine concentration levels of various environmental contaminants. By means of the analyses of soil samples and of kitchen waste samples, obtained from the same locations, an investigation towards the possible sources of contaminants was possible. Eggs, soils, faeces and kitchen waste samples were checked for the presence of dioxins, PCBs (including dioxin-like PCBs), organochlorine pesticides, trace elements, PAHs, brominated flame retardants and mycotoxins. The study design, sampling methodology and primary conclusions of the study are given. It was found that in some cases dioxin-like compounds were present at levels that are of concern for the health of the egg consumers. Therefore, measures to limit their contamination in eggs, produced by hens of private owners, were proposed and deserve further attention.

  9. Assessing compliance of cardiologists with the national cholesterol education program (NCEP III guidelines in an ambulatory care setting

    Directory of Open Access Journals (Sweden)

    Salihu Hamisu M

    2004-05-01

    Full Text Available Abstract Introduction The NCEP III -ATP guidelines provide clear clinical directives for lipid management especially statins therapy in appropriate patient groups. Compliance of primary care physicians with these guidelines especially in ambulatory care settings has been shown to be poor. The compliance of cardiologist to these guidelines is less documented. Methods A retrospective chart review of 386 patients managed in a large urban cardiology practice was undertaken. Patients with documented contraindications to use of statins were excluded from the study. Only patients with two or more years of follow-up in the practice were included. Demographic variables and medical history including CAD or its equivalent and its major risk factors were identified. The proportion of patients on statins and adequacy of statins therapy were recorded. The lipid profiles of all patients were also analyzed. Results Fifteen patients with documented contraindications to statins therapy including persistent/severe LFT abnormalities, allergies, and gastrointestinal intolerance were excluded. A total of 371 patients were included in the analysis. The mean age for patients in the study was 65 years (range: 42–84. 236 (64% were males while 141 (36% were females. 161 (43% patients were on statins while 210 (57% weren't. 88 (62% of females were on stain compared to 116 (49% of males (p = 0.001. 68% of patients below the age of 50 yrs were not on statins compared with 55% of those greater than 50 yrs (p = 0.01. 38% of patients on statins therapy had sub-optimal lipid profile despite greater than two years of therapy. No statistically significant differences in race and use of satins were noted. Conclusion This study demonstrates a higher than expected prevalence of sub-optimal management of dyslipidemia among patients with established coronary heart disease without contraindications to statins managed by cardiologists. Cardiology and primary care practices require

  10. Guidelines for selecting codes for ground-water transport modeling of low-level waste burial sites. Volume 1. Guideline approach

    Energy Technology Data Exchange (ETDEWEB)

    Simmons, C.S.; Cole, C.R.

    1985-05-01

    This document was written for the National Low-Level Waste Management Program to provide guidance for managers and site operators who need to select ground-water transport codes for assessing shallow-land burial site performance. The guidance given in this report also serves the needs of applications-oriented users who work under the direction of a manager or site operator. The guidelines are published in two volumes designed to support the needs of users having different technical backgrounds. An executive summary, published separately, gives managers and site operators an overview of the main guideline report. This volume includes specific recommendations for decision-making managers and site operators on how to use these guidelines. The more detailed discussions about the code selection approach are provided. 242 refs., 6 figs.

  11. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology.

    Science.gov (United States)

    Kozek-Langenecker, Sibylle A; Afshari, Arash; Albaladejo, Pierre; Santullano, Cesar Aldecoa Alvarez; De Robertis, Edoardo; Filipescu, Daniela C; Fries, Dietmar; Görlinger, Klaus; Haas, Thorsten; Imberger, Georgina; Jacob, Matthias; Lancé, Marcus; Llau, Juan; Mallett, Sue; Meier, Jens; Rahe-Meyer, Niels; Samama, Charles Marc; Smith, Andrew; Solomon, Cristina; Van der Linden, Philippe; Wikkelsø, Anne Juul; Wouters, Patrick; Wyffels, Piet

    2013-06-01

    The aims of severe perioperative bleeding management are three-fold. First, preoperative identification by anamesis and laboratory testing of those patients for whom the perioperative bleeding risk may be increased. Second, implementation of strategies for correcting preoperative anaemia and stabilisation of the macro- and microcirculations in order to optimise the patient's tolerance to bleeding. Third, targeted procoagulant interventions to reduce the amount of bleeding, morbidity, mortality and costs. The purpose of these guidelines is to provide an overview of current knowledge on the subject with an assessment of the quality of the evidence in order to allow anaesthetists throughout Europe to integrate this knowledge into daily patient care wherever possible. The Guidelines Committee of the European Society of Anaesthesiology (ESA) formed a task force with members of scientific subcommittees and individual expert members of the ESA. Electronic databases were searched without language restrictions from the year 2000 until 2012. These searches produced 20 664 abstracts. Relevant systematic reviews with meta-analyses, randomised controlled trials, cohort studies, case-control studies and cross-sectional surveys were selected. At the suggestion of the ESA Guideline Committee, the Scottish Intercollegiate Guidelines Network (SIGN) grading system was initially used to assess the level of evidence and to grade recommendations. During the process of guideline development, the official position of the ESA changed to favour the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. This report includes general recommendations as well as specific recommendations in various fields of surgical interventions. The final draft guideline was posted on the ESA website for four weeks and the link was sent to all ESA members. Comments were collated and the guidelines amended as appropriate. When the final draft was complete, the Guidelines Committee and

  12. GRADE Equity Guidelines 3

    DEFF Research Database (Denmark)

    Welch, Vivian A; Akl, Elie A; Pottie, Kevin

    2017-01-01

    OBJECTIVE: The aim of this paper is to describe a conceptual framework for how to consider health equity in the GRADE (Grading Recommendations Assessment and Development Evidence) guideline development process. STUDY DESIGN AND SETTING: Consensus-based guidance developed by the GRADE working grou...

  13. Evidence-based guidelines

    DEFF Research Database (Denmark)

    Wattjes, Mike P; Rovira, Àlex; Miller, David

    2015-01-01

    . This use of MRI can help predict treatment response and assess the efficacy and safety of new therapies. In the second part of the MAGNIMS (Magnetic Resonance Imaging in MS) network's guidelines on the use of MRI in MS, we focus on the implementation of this technique in prognostic and monitoring tasks. We...

  14. Impact of 2013 ASCO/CAP HER2 reporting guidelines in breast cancer: An assessment study from Indian oncology centre that primarily performs HER2 IHC testing with special emphasis on IHC equivocal category.

    Science.gov (United States)

    Pasricha, Sunil; Gupta, Gurudutt; Garg, Ritu; Sharma, Anila; Gandhi, Jatin S; Durga, Garima; Kamboj, Meenakshi; Grover, Shrruti; Mehta, Anurag

    2017-12-18

    The ASCO/CAP guidelines for HER2 reporting in breast cancer published in 2007 and were updated in 2013 to assure that the right patient receives the targeted therapy. The updated guidelines have lowered the threshold for HER2 positivity criteria and altered the equivocal category for both IHC and FISH. This first study from India addresses the impact of these updated guidelines in the various reporting categories at a tertiary care centre. We compared the trend of HER2 IHC reporting 1 year before (Period A) and 1 year after (Period B) the implementation of updated 2013 ASCO/CAP guidelines. All HER2 equivocal IHC cases of post 2013 guidelines were reclassified as per 2007 guidelines to detect additional number of cases that have been put into equivocal category. Reflex FISH correlation was also assessed to detect any additional cases eligible for anti HER2 therapy with implementation of these updated guidelines. With implementation of updated 2013 guidelines, there was significant decrease in the number of cases scored as 1+ (from 30.7% to 20.6%; P value: .0001) while significant increase in number of 2+ cases (from 20.2% to 27.3%; P value: .004). Post 2013 guidelines, 39% (64 cases) of tumors were additionally put into the equivocal category which would have been considered as negative (score 1+) as per 2007 guidelines. The reflex FISH testing in these equivocal cases resulted in detection of only 1.5% of additional cases eligible for anti HER2 therapy. With implementation of updated 2013 guidelines, there is no significant increase in HER2 positivity trend. However, there is appreciable increase in IHC equivocal cases which subsequently led to increased reflex FISH testing without significantly contributing to the detection of additional eligible cases for anti HER2 therapy, but resulted in delaying of definite HER2 status along with financial implications. © 2017 Wiley Periodicals, Inc.

  15. The First National Assessment of Career and Occupational Development: An Overview. Career and Occupational Development Report No. 05-COD-00.

    Science.gov (United States)

    Education Commission of the States, Denver, CO. National Assessment of Educational Progress.

    Summary findings gathered by the National Assessment of Educational Progress (NAEP) in the 1973-74 national assessment of career and occupational development (COD) are reported. (NAEP is an information-gathering project that surveys the educational attainment of 9-year-olds, 13-year-olds, 17-year-olds, and adults (ages 26-35) in ten learning…

  16. Chapter 4: Overview of the vegetation management treatment economic analysis module in the integrated landscape assessment project

    Science.gov (United States)

    Xiaoping Zhou; Miles A. Hemstrom

    2014-01-01

    Forest land provides various ecosystem services, including timber, biomass, and carbon sequestration. Estimating trends in these ecosystem services is essential for assessing potential outcomes of landscape management scenarios. However, the state-and transition models used in the Integrated Landscape Assessment Project for simulating landscape changes over time do not...

  17. The WHO injury surveillance guidelines: a systematic review of the non-fatal guidelines' utilization, efficacy and effectiveness.

    Science.gov (United States)

    Kipsaina, C; Ozanne-Smith, J; Routley, V

    2015-10-01

    To systematically assess the utilization, efficacy and effectiveness of the WHO Injury Surveillance Guidelines. A systematic review of the literature. A comprehensive systematic search of peer reviewed and grey literature was conducted for relevant studies published between Jan 2002 and May 2013 reporting utilization of the Injury Surveillance Guidelines. Injury experts and government departments from low- and middle-income countries were contacted. Forty-nine studies met the inclusion criteria. These were conducted in health facilities in five WHO regions, African Region (28%): Eastern Mediterranean and Western Pacific Regions, both 22%. The Guidelines were mostly used selectively: the minimum data set as a survey tool; process and system environment evaluation; categorizing injuries for data analysis; measuring injury severity and for data quality assessment or comparisons. Twenty-six studies used the Guidelines to collect overview injury data prospectively and/or retrospectively, or for Injury Surveillance System (ISS) feasibility studies, with four actually establishing an ISS or informing the establishment process. Few reported effects on injury policies and programs. Most studies used only the minimum dataset, limiting the level of detail for injury prevention. Other ISSs may have been established using the Guidelines, though no English language publications referencing this were found. This review provides encouraging results that the Guidelines continue to be used, albeit mainly for short-term studies predominantly in low- and middle-income countries with very limited sustained ISS establishment and local injury prevention capacity building. It highlights the need to improve and expand the minimum dataset to at least include a meaningful narrative text and potentially to expand the mechanism codes to a second level of detail, as well as building local injury prevention capacity. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier

  18. Assessing the Quality of Mobile Exercise Apps Based on the American College of Sports Medicine Guidelines: A Reliable and Valid Scoring Instrument.

    Science.gov (United States)

    Guo, Yi; Bian, Jiang; Leavitt, Trevor; Vincent, Heather K; Vander Zalm, Lindsey; Teurlings, Tyler L; Smith, Megan D; Modave, François

    2017-03-07

    Regular physical activity can not only help with weight management, but also lower cardiovascular risks, cancer rates, and chronic disease burden. Yet, only approximately 20% of Americans currently meet the physical activity guidelines recommended by the US Department of Health and Human Services. With the rapid development of mobile technologies, mobile apps have the potential to improve participation rates in exercise programs, particularly if they are evidence-based and are of sufficient content quality. The goal of this study was to develop and test an instrument, which was designed to score the content quality of exercise program apps with respect to the exercise guidelines set forth by the American College of Sports Medicine (ACSM). We conducted two focus groups (N=14) to elicit input for developing a preliminary 27-item scoring instruments based on the ACSM exercise prescription guidelines. Three reviewers who were no sports medicine experts independently scored 28 exercise program apps using the instrument. Inter- and intra-rater reliability was assessed among the 3 reviewers. An expert reviewer, a Fellow of the ACSM, also scored the 28 apps to create criterion scores. Criterion validity was assessed by comparing nonexpert reviewers' scores to the criterion scores. Overall, inter- and intra-rater reliability was high with most coefficients being greater than .7. Inter-rater reliability coefficients ranged from .59 to .99, and intra-rater reliability coefficients ranged from .47 to 1.00. All reliability coefficients were statistically significant. Criterion validity was found to be excellent, with the weighted kappa statistics ranging from .67 to .99, indicating a substantial agreement between the scores of expert and nonexpert reviewers. Finally, all apps scored poorly against the ACSM exercise prescription guidelines. None of the apps received a score greater than 35, out of a possible maximal score of 70. We have developed and presented valid and reliable

  19. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

    Full Text Available AUTHOR GUIDELINES Indian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/login Online SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s. http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols 1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic

  20. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2015-12-01

    Full Text Available Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.  http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionPAGE CONTENTSGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic-only material should be submitted and sent for peer review simultaneously with the primary manuscript.2. Reporting GuidelinesReporting guidelines have been developed for different study designs; examples include CONSORT for randomized trials, STROBE for observational studies, PRISMA for systematic reviews and meta-analyses, and STARD for studies of diagnostic accuracy. Journals are encouraged to ask authors to follow these guidelines because

  1. Non-Chemical Stressors and Cumulative Risk Assessment: An Overview of Current Initiatives and Potential Air Pollutant Interactions

    Science.gov (United States)

    Lewis, Ari S.; Sax, Sonja N.; Wason, Susan C.; Campleman, Sharan L.

    2011-01-01

    Regulatory agencies are under increased pressure to consider broader public health concerns that extend to multiple pollutant exposures, multiple exposure pathways, and vulnerable populations. Specifically, cumulative risk assessment initiatives have stressed the importance of considering both chemical and non-chemical stressors, such as socioeconomic status (SES) and related psychosocial stress, in evaluating health risks. The integration of non-chemical stressors into a cumulative risk assessment framework has been largely driven by evidence of health disparities across different segments of society that may also bear a disproportionate risk from chemical exposures. This review will discuss current efforts to advance the field of cumulative risk assessment, highlighting some of the major challenges, discussed within the construct of the traditional risk assessment paradigm. Additionally, we present a summary of studies of potential interactions between social stressors and air pollutants on health as an example of current research that supports the incorporation of non-chemical stressors into risk assessment. The results from these studies, while suggestive of possible interactions, are mixed and hindered by inconsistent application of social stress indicators. Overall, while there have been significant advances, further developments across all of the risk assessment stages (i.e., hazard identification, exposure assessment, dose-response, and risk characterization) are necessary to provide a scientific basis for regulatory actions and effective community interventions, particularly when considering non-chemical stressors. A better understanding of the biological underpinnings of social stress on disease and implications for chemical-based dose-response relationships is needed. Furthermore, when considering non-chemical stressors, an appropriate metric, or series of metrics, for risk characterization is also needed. Cumulative risk assessment research will benefit

  2. Environmental risk assessment for new human pharmaceuticals in the European Union according to the draft guideline/discussion paper of January 2001.

    Science.gov (United States)

    Straub, Jürg Oliver

    2002-10-05

    Since 1993, an environmental risk assessment (ERA) for a new drug application has been stipulated by EU Directive 93/39/EEC amending Directive 65/65/EEC. In early 2001, after several unpublished draft versions for an ERA guideline, a draft guideline/discussion paper for an ERA for non-GMO-containing drugs was published by the European Medicines Evaluation Agency (EMEA). The draft guideline describes a step-wise, tiered procedure for the ERA. The first tier consists of deriving a crude predicted environmental concentration (PEC) in the aquatic compartment for the active pharmaceutical ingredient (API) or its major metabolites, based on predicted amounts used and specific removal rates in sewage treatment or surface waters. If this crude PEC is concerns are apparent, no further assessment is deemed necessary. Else, in the second tier, a crude predicted no-effect level (PNEC) for the aquatic compartment is to be extrapolated by dividing the lowest 50% effect concentration from acute ecotoxicity tests with algae, daphnia or fish (EC(50), LC(50)) by an assessment factor (usually 1000). If the ratio PEC/PNEC is <1, no further assessment is deemed necessary. Lastly, in the third tier, further considerations on a case-by-case basis are needed. This may encompass refining the environmental fate information and thereby the PEC, considering further environmental compartments and their respective PECs (up to and including field studies), but also refining the PNEC. While the ERA addresses mainly the API, excipients of the formulated drug should be considered as well. In the ease of medicinal products, the benefit for patients has relative precedence over environmental risks, meaning that even in the ease of an unacceptable residual risk for new drugs after third tier considerations, prohibition of a new API is not taken into consideration. Instead, possible mitigating or precautionary safety measures may consist of specific product labelling (i.e. package leaflets for the

  3. The role of skin conductivity in a low frequency exposure assessment for peripheral nerve tissue according to the ICNIRP 2010 guidelines

    Science.gov (United States)

    Schmid, Gernot; Cecil, Stefan; Überbacher, Richard

    2013-07-01

    Based on numerical computations using commercially available finite difference time domain code and a state-of-the art anatomical model of a 5-year old child, the influence of skin conductivity on the induced electric field strength inside the tissue for homogeneous front-to-back magnetic field exposure and homogeneous vertical electric field exposure was computed. Both ungrounded as well as grounded conditions of the body model were considered. For electric field strengths induced inside CNS tissue the impact of skin conductivity was found to be less than 15%. However, the results demonstrated that the use of skin conductivity values as obtainable from the most widely used data base of dielectric tissue properties and recommended by safety standards are not suitable for exposure assessment with respect to peripheral nerve tissue according to the ICNIRP 2010 guidelines in which the use of the induced electric field strengths inside the skin is suggested as a conservative surrogate for peripheral nerve exposure. This is due to the fact that the skin conductivity values derived from these data bases refer to the stratum corneum, the uppermost layer of the skin, which does not contain any nerve or receptor cells to be protected from stimulation effects. Using these skin conductivity values which are approximately a factor 250-500 lower than skin conductivity values used in studies on which the ICNIRP 2010 guidelines are based on, may lead to overestimations of the induced electric field strengths inside the skin by substantially more than a factor of 10. However, reliable conductivity data of deeper skin layers where nerve and preceptor cells are located is very limited. It is therefore recommended to include appropriate background information in the ICNIRP guidelines and the dielectric tissue property databases, and to put some emphasis on a detailed layer-specific characterization of skin conductivity in near future.

  4. Guideline for safe and eco-friendly biomass gasification

    Energy Technology Data Exchange (ETDEWEB)

    Vos, J.; Knoef, H. (BTG biomass technology group, Enschede (Netherlands)); Hauth, M. (Graz Univ. of Technology. Institute of Thermal Engineering, Graz (Austria)) (and others)

    2009-11-15

    The objective of the Gasification Guide project is to accelerate the market penetration of small-scale biomass gasification systems (< 5 MW fuel power) by the development of a Guideline and Software Tool to facilitate risk assessment of HSE aspects. The Guideline may also be applied in retrofitting or converting old thermal plants in the Eastern European countries - with rich biomass recourses - to new gasification plants. The objective of this document is to guide key target groups identifying potential hazards and make a proper risk assessment. The software tool is an additional aid in the risk assessment. This guideline is intended to be a training tool and a resource for workers and employers to safely design, fabricate, construct, operate and maintain small-scale biomass gasification facilities. The Guideline is applicable with the following constraints: 1) The maximum scale of the gasification plant was agreed to be about 1 MW{sub e}. The reason is that large companies do have normally their safety rules in place; 2) This means in principle only fixed bed gasifier designs. However, most parts are also valid to other designs and even other thermal conversion processes; 3) The use of contaminated biomass is beyond the scope of this Guideline. The Guideline contains five major chapters; Chapter 2 briefly describes the gasification technology in general. Chapter 3 gives an overview of major legal framework issues on plant permission and operation. The legal frame is changing and the description is based on the situation by the end of 2007. Chapter 4 explains the theory behind the risk assessment method and risk reduction measures. Chapter 5 is the heart of the Guideline and gives practical examples of good design, operation and maintenance principles. The practical examples and feedback have been received throughout the project and the description is based on mid-2009. Chapter 6 describes the best techniques currently available for emission abatement which are

  5. States' Participation Guidelines for Alternate Assessments Based on Modified Academic Achievement Standards (AA-MAS) in 2010. Synthesis Report 82

    Science.gov (United States)

    Lazarus, Sheryl S.; Hodgson, Jennifer R.; Price, Lynn M.; Thurlow, Martha L.

    2011-01-01

    Federal legislation requires that all students participate in state accountability systems. Most students with disabilities participate in the regular assessment, with or without accommodations. Students with more significant cognitive disabilities participate in the Alternate Assessment based on Alternate Achievement Standards (AA-AAS). A few…

  6. Overviews in Education Research: A Systematic Review and Analysis

    Science.gov (United States)

    Polanin, Joshua R.; Maynard, Brandy R.; Dell, Nathaniel A.

    2017-01-01

    Overviews, or syntheses of research syntheses, have become a popular approach to synthesizing the rapidly expanding body of research and systematic reviews. Despite their popularity, few guidelines exist and the state of the field in education is unclear. The purpose of this study is to describe the prevalence and current state of overviews of…

  7. Implementation of World Health Organization Integrated Management of Childhood Illnesses (IMCI Guidelines for the Assessment of Pneumonia in the Under 5s in Rural Malawi.

    Directory of Open Access Journals (Sweden)

    Ngozi Kalu

    Full Text Available The Cooking and Pneumonia Study (CAPS is a pragmatic cluster-level randomized controlled trial of the effect of an advanced cookstove intervention on pneumonia in children under the age of 5 years (under 5s in Malawi (www.capstudy.org. The primary outcome of the trial is the incidence of pneumonia during a two-year follow-up period, as diagnosed by healthcare providers who are using the World Health Organization (WHO integrated management of childhood illnesses (IMCI pneumonia assessment protocol and who are blinded to the trial arms. We evaluated the quality of pneumonia assessment in under 5s in this setting via a cross-sectional study of provider-patient encounters at nine outpatient clinics located within the catchment area of 150 village-level clusters enrolled in the trial across the two study locations of Chikhwawa and Karonga, Malawi, between May and June 2015 using the IMCI guidelines as a benchmark. Data were collected using a key equipment checklist, an IMCI pneumonia knowledge test, and a clinical evaluation checklist. The median number of key equipment items available was 6 (range 4 to 7 out of a possible 7. The median score on the IMCI pneumonia knowledge test among 23 clinicians was 75% (range 60% to 89%. Among a total of 176 consultations performed by 15 clinicians, a median of 9 (range 3 to 13 out of 13 clinical evaluation tasks were performed. Overall, the clinicians were adequately equipped for the assessment of sick children, had good knowledge of the IMCI guidelines, and conducted largely thorough clinical evaluations. We recommend the simple pragmatic approach to quality assurance described herein for similar studies conducted in challenging research settings.

  8. Modelling Overview

    DEFF Research Database (Denmark)

    Larsen, Lars Bjørn; Vesterager, Johan

    This report provides an overview of the existing models of global manufacturing, describes the required modelling views and associated methods and identifies tools, which can provide support for this modelling activity.The model adopted for global manufacturing is that of an extended enterprise....... One or more units from beyond the network may complement the extended enterprise. The common reference model for this extended enterprise will utilise GERAM (Generalised Enterprise Reference Architecture and Methodology) to provide an architectural framework for the modelling carried out within...... sharing many of the characteristics of a virtual enterprise. This extended enterprise will have the following characteristics: The extended enterprise is focused on satisfying the current customer requirement so that it has a limited life expectancy, but should be capable of being recreated to deal...

  9. Practical Application of the Revised Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: A Case Study Approach.

    Science.gov (United States)

    Warren, Malissa; McCarthy, Mary S; Roberts, Pamela R

    2016-06-01

    Nutrition therapy is an essential component of the care plan for critically ill and injured patients. There is consensus that critically ill patients are at risk for malnutrition, and the associated consequences of increased infectious morbidity, multiorgan dysfunction, prolonged hospitalization, and disproportionate mortality can be minimized with specialized enteral and/or parenteral nutrition therapy. In this article, we describe 2 case studies that are intended to introduce the nutrition support clinician to key updates in the recently released Guidelines for Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). The case studies demonstrate a pragmatic approach to nutrition therapy in the intensive care unit (ICU) and are intended to elicit dialogue for timely, appropriate nutrition care at policy meetings, professional conferences, and ICU daily rounds. While explicitly stated in the formal document, it is worth repeating that the guidelines are directed toward generalized patient populations, but as with any therapeutic intervention in the ICU, nutrition therapy should be tailored to the individual patient. In addition, protocols and procedures should reflect the local institutional culture and meet with approval of critical care clinicians. © 2016 American Society for Parenteral and Enteral Nutrition.

  10. Application of the condensed protocol for the NIA-AA guidelines for the neuropathological assessment of Alzheimer's disease in an academic clinical practice.

    Science.gov (United States)

    Bharadwaj, Rajnish; Cimino, Patrick J; Flanagan, Margaret E; Latimer, Caitlin S; Gonzalez-Cuyar, Luis F; Juric-Sekhar, Gordana; Montine, Thomas J; Marshall, Desiree A; Keene, C Dirk

    2018-02-01

    In response to concerns regarding resource expenditures required to implement fully the 2012 National Institute on Aging and the Alzheimer's Association (NIA-AA) Sponsored Guidelines for the neuropathological assessment of Alzheimer's disease (AD), we previously developed a sensitive and cost-reducing condensed protocol (CP) at the University of Washington (UW) Alzheimer's Disease Research Center (ADRC) that consolidated the recommended NIA-AA protocol into fewer cassettes requiring fewer immunohistochemical stains. The CP was not designed to replace NIA-AA protocols, but instead to make the NIA-AA criteria accessible to clinical and forensic neuropathology practices where resources limit full implementation of NIA-AA guidelines. In this regard, we developed practical criteria to instigate CP sampling and immunostaining, and applied these criteria in an academic clinical neuropathological practice. During the course of 1 year, 73 cases were sampled using the CP; of those, 53 (72.6%) contained histological features that prompted CP work-up. We found that the CP resulted in increased identification of AD and Lewy body disease neuropathological changes from what was expected using a clinical history-driven work-up alone, while saving approximately $900 per case. This study demonstrates the feasibility and cost-savings of the CP applied to a clinical autopsy practice, and highlights potentially unrecognised neurodegenerative disease processes in the general ageing community. © 2017 John Wiley & Sons Ltd.

  11. A practical approach for linearity assessment of calibration curves under the International Union of Pure and Applied Chemistry (IUPAC) guidelines for an in-house validation of method of analysis.

    Science.gov (United States)

    Sanagi, M Marsin; Nasir, Zalilah; Ling, Susie Lu; Hermawan, Dadan; Ibrahim, Wan Aini Wan; Naim, Ahmedy Abu

    2010-01-01

    Linearity assessment as required in method validation has always been subject to different interpretations and definitions by various guidelines and protocols. However, there are very limited applicable implementation procedures that can be followed by a laboratory chemist in assessing linearity. Thus, this work proposes a simple method for linearity assessment in method validation by a regression analysis that covers experimental design, estimation of the parameters, outlier treatment, and evaluation of the assumptions according to the International Union of Pure and Applied Chemistry guidelines. The suitability of this procedure was demonstrated by its application to an in-house validation for the determination of plasticizers in plastic food packaging by GC.

  12. Assessing clinical significance in measuring oncology patient quality of life: Introduction to the symposium, content overview, and definition of terms

    NARCIS (Netherlands)

    Sloan, Jeff A.; Cella, David; Frost, Marlene; Guyatt, Gordon H.; Sprangers, Mirjam; Symonds, Tara

    2002-01-01

    The Clinical Significance Consensus Meeting Group of the Symposium on the Clinical Significance of Quality-of-Life Measures in Cancer Patients produced 6 articles regarding the clinical significance of quality of life (QOL) assessments in oncology. The 6 articles deal with the methods used to date:

  13. Workplace Basic Skills from Beginning to End (Overview, Needs Analysis, Marketing/Recruitment, Workforce Assessment, Curriculum, Instruction, Evaluation).

    Science.gov (United States)

    Jones, Douglas; And Others

    The materials, visuals to accompany a presentation on development of workplace literacy programs, include: a definition of workplace literacy; flow chart for basic skills program development; definition of workplace education needs assessment; list of topics for interviewing trainers, supervisors, management personnel/HR, safety, union/labor…

  14. Overview of the Taxonomy of Environmental Types and the Factor Structure of the Salter Environmental Type Assessment.

    Science.gov (United States)

    Salter, Daniel W.; Vandiver, Beverly J.

    2002-01-01

    The Salter Environmental Type Assessment (SETA) was created to be a commensurate measure for the Myers-Briggs Type Indicator and to improve the efficacy of the person-environmental interaction paradigm to student affairs. A confirmatory factor analysis of SETA profiles supported the four dimensions in environmental type theory. The utility of this…

  15. ACC/AHA Special Report: Clinical Practice Guideline Implementation Strategies: A Summary of Systematic Reviews by the NHLBI Implementation Science Work Group: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

    Science.gov (United States)

    Chan, Wiley V; Pearson, Thomas A; Bennett, Glen C; Cushman, William C; Gaziano, Thomas A; Gorman, Paul N; Handler, Joel; Krumholz, Harlan M; Kushner, Robert F; MacKenzie, Thomas D; Sacco, Ralph L; Smith, Sidney C; Stevens, Victor J; Wells, Barbara L; Castillo, Graciela; Heil, Susan K R; Stephens, Jennifer; Vann, Julie C Jacobson

    2017-02-28

    In 2008, the National Heart, Lung, and Blood Institute convened an Implementation Science Work Group to assess evidence-based strategies for effectively implementing clinical practice guidelines. This was part of a larger effort to update existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity. Review evidence from the published implementation science literature and identify effective or promising strategies to enhance the adoption and implementation of clinical practice guidelines. This systematic review was conducted on 4 critical questions, each focusing on the adoption and effectiveness of 4 intervention strategies: (1) reminders, (2) educational outreach visits, (3) audit and feedback, and (4) provider incentives. A scoping review of the Rx for Change database of systematic reviews was used to identify promising guideline implementation interventions aimed at providers. Inclusion and exclusion criteria were developed a priori for each question, and the published literature was initially searched up to 2012, and then updated with a supplemental search to 2015. Two independent reviewers screened the returned citations to identify relevant reviews and rated the quality of each included review. Audit and feedback and educational outreach visits were generally effective in improving both process of care (15 of 21 reviews and 12 of 13 reviews, respectively) and clinical outcomes (7 of 12 reviews and 3 of 5 reviews, respectively). Provider incentives showed mixed effectiveness for improving both process of care (3 of 4 reviews) and clinical outcomes (3 reviews equally distributed between generally effective, mixed, and generally ineffective). Reminders showed mixed effectiveness for improving process of care outcomes (27 reviews with 11 mixed and 3 generally ineffective results) and were generally ineffective for clinical outcomes (18 reviews with 6 mixed and 9 generally ineffective results). Educational outreach visits (2 of 2

  16. European guidelines on upper tract urothelial carcinomas: 2013 update.

    Science.gov (United States)

    Rouprêt, Morgan; Babjuk, Marko; Compérat, Eva; Zigeuner, Richard; Sylvester, Richard; Burger, Max; Cowan, Nigel; Böhle, Andreas; Van Rhijn, Bas W G; Kaasinen, Eero; Palou, Joan; Shariat, Shahrokh F

    2013-06-01

    The European Association of Urology (EAU) guideline group for upper tract urothelial carcinoma (UTUC) has prepared updated guidelines to aid clinicians in assessing the current evidence-based management of UTUC and to incorporate present recommendations into daily clinical practice. To provide a brief overview of the EAU guidelines on UTUC as an aid to clinicians in their daily clinical practice. The recommendations provided in the current guidelines are based on a thorough review of available UTUC guidelines and articles identified using a systematic search of Medline. Data on urothelial malignancies and UTUCs in the literature were searched using Medline with the following keywords: urinary tract cancer; urothelial carcinomas; upper urinary tract, carcinoma; renal pelvis; ureter; bladder cancer; chemotherapy; nephroureterectomy; adjuvant treatment; instillation; neoadjuvant treatment; recurrence; risk factors; nomogram; and survival. References were weighted by a panel of experts. There is a lack of data in the current literature to provide strong recommendations (ie, grade A) due to the rarity of the disease. A number of recent multicentre studies are now available, and there is a growing interest in UTUC in the recent literature. Overall, 135 references have been included here, but most of these studies are still retrospective analyses. The TNM 2009 classification is recommended. Recommendations are given for diagnosis as well as radical and conservative treatment (ie, imperative and elective cases); additionally, prognostic factors are discussed. Recommendations are also provided for patient follow-up after different therapeutic options. These guidelines contain information for the management of individual patients according to a current standardised approach. Physicians must take into account the specific clinical characteristics of each individual patient when determining the optimal treatment regimen including tumour location, grade, and stage; renal

  17. Guidelines for assessing the valorization of a waste into cementitious material: dredged sediment for production of self compacting concrete

    Directory of Open Access Journals (Sweden)

    Rozas, F.

    2015-09-01

    Full Text Available This article presents some guidelines in order to analyse the feasibility of including a waste material in the production of a structural cementitious material. First of all, the compatibility of the waste with a cementitious material has to be assured; then, if necessary, a decontamination step will be carried out; after, decision on the type of material has to be taken based on different aspects, with special emphasis on the granulometry. As a last step, mechanical, environmental and durability properties have to be evaluated. Then the procedure is illustrated with a full example, obtaining a self compacting concrete (SCC including dredged sediment taken from a Spanish harbour.Este artículo presenta algunas directrices con el fin de analizar la posibilidad de incluir un material de desecho en la producción de un material base cemento estructural. En primer lugar, debe asegurarse la compatibilidad de los residuos con el material base cemento. Tras ello, si es necesario, se llevará a cabo la etapa de descontaminación del residuo. Después debe tomarse la decisión sobre el tipo de material a utilizar en base a diferentes aspectos, haciendo especial énfasis en la granulometría. Como último paso, deben evaluarse las propiedades mecánicas, ambientales y de durabilidad del producto final. El procedimiento a seguir se ilustra con un ejemplo concreto basado en la obtención de un hormigón autocompactante (SCC incluyendo en su fabricación sedimentos dragados tomados de un puerto español.

  18. Adherence to the integrated management of childhood illness guidelines in Namibia, Kenya, Tanzania and Uganda: evidence from the national service provision assessment surveys.

    Science.gov (United States)

    Krüger, Carsten; Heinzel-Gutenbrunner, Monika; Ali, Mohammed

    2017-12-13

    Integrated Management of Childhood Illness (IMCI) is regarded as a standard public health approach to lowering child mortality in developing countries. However, little is known about how health workers adhere to the guidelines at the national level in sub-Saharan African countries. Data from the Service Provision Assessment surveys of Namibia (NA) (survey year: 2009), Kenya (KE) (2010), Tanzania (TZ) (2006) and Uganda (UG) (2007) were analysed for adherence to the IMCI guidelines by health workers. Potential influencing factors included the survey country, patient's age, the different levels of the national health system, the training level of the health care provider (physician, non-physician clinician, nurse-midwife, auxiliary staff), and the status of re-training in IMCI. In total, 6856 children (NA: 1495; KE: 1890; TZ: 2469; UG: 1002 / male 51.2-53.5%) aged 2-73 months (2-24 months, 65.3%; median NA: 19 months; KE: 18 months; TZ: 16 months; UG: 15 months) were clinically assessed by 2006 health workers during the surveys. Less than 33% of the workers carried out assessment of all three IMCI danger signs, namely inability to eat/drink, vomiting everything, and febrile convulsions (NA: 11%; KE: 11%; TZ: 14%; UG: 31%) while the rate for assessing all three of the IMCI main symptoms of cough/difficult breathing, diarrhoea, and fever was < 60% (NA: 48%; KE: 34%; TZ: 50%; UG: 57%). Physical examination rates for fever (temperature) (NA: 97%; KE: 87%; TZ: 73%; UG: 90%), pneumonia (respiration rate/auscultation) (NA: 43%; KE: 24%; TZ: 25%; UG: 20%) and diarrhoea (dehydration status) (NA: 29%; KE: 19%; TZ: 20%; UG: 39%) varied widely and were highest when assessing children with the actual diagnosis of pneumonia and diarrhoea. Adherence rates tended to be higher in children ≤ 24 months, at hospitals, among higher-qualified staff (physician/non-physician clinician) and among those with recent IMCI re-training. Despite nationwide training in IMCI the adherence

  19. An Overview of GIS-Based Modeling and Assessment of Mining-Induced Hazards: Soil, Water, and Forest.

    Science.gov (United States)

    Suh, Jangwon; Kim, Sung-Min; Yi, Huiuk; Choi, Yosoon

    2017-11-27

    In this study, current geographic information system (GIS)-based methods and their application for the modeling and assessment of mining-induced hazards were reviewed. Various types of mining-induced hazard, including soil contamination, soil erosion, water pollution, and deforestation were considered in the discussion of the strength and role of GIS as a viable problem-solving tool in relation to mining-induced hazards. The various types of mining-induced hazard were classified into two or three subtopics according to the steps involved in the reclamation procedure, or elements of the hazard of interest. Because GIS is appropriated for the handling of geospatial data in relation to mining-induced hazards, the application and feasibility of exploiting GIS-based modeling and assessment of mining-induced hazards within the mining industry could be expanded further.

  20. Advantages and Limitations of Focal Liver Lesion Assessment with Ultrasound Contrast Agents: Comments on the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines.

    Science.gov (United States)

    Chiorean, Liliana; Tana, Claudio; Braden, Barbara; Caraiani, Cosmin; Sparchez, Zeno; Cui, Xin-Wu; Baum, Ulrich; Dietrich, Christoph F

    Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in sonography. Due to US contrast agents (UCAs) and contrast-specific techniques, sonography offers the potential to show enhancement of liver lesions in a similar way as contrast-enhanced cross-sectional imaging techniques. The real-time assessment of liver perfusion throughout the vascular phases, without any risk of nephrotoxicity, represents one of the major advantages that this technique offers. CEUS has led to a dramatic improvement in the diagnostic accuracy of US and subsequently has been included in current guidelines as an important step in the diagnostic workup of focal liver lesions (FLLs), resulting in a better patient management and cost-effective therapy. The purpose of this review was to provide a detailed description of contrast agents used in different cross-sectional imaging procedures for the study of FLLs, focusing on characteristics, indications and advantages of UCAs in clinical practice. © 2016 S. Karger AG, Basel.

  1. Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: nutritional assessment.

    Science.gov (United States)

    Ruiz-Santana, S; Arboleda Sánchez, J A; Abilés, J

    2011-11-01

    Current parameters to assess nutritional status in critically-ill patients are useful to evaluate nutritional status prior to admission to the intensive care unit. However, these parameters are of little utility once the patient's nutritional status has been altered by the acute process and its treatment. Changes in water distribution affect anthropometric variables and biochemical biomarkers, which in turn are affected by synthesis and degradation processes. Increased plasma levels of prealbumin and retinol -proteins with a short half-life- can indicate adequate response to nutritional support, while reduced levels of these proteins indicate further metabolic stress. The parameters used in functional assessment, such as those employed to assess muscular or immune function, are often altered by drugs or the presence of infection or polyneuropathy. However, some parameters can be used to monitor metabolic response and refeeding or can aid prognostic evaluation.

  2. Quality assessment of recent evidence-based clinical practice guidelines for management of type 2 diabetes mellitus in adults using the AGREE II instrument.

    Science.gov (United States)

    Anwer, Muhammad A; Al-Fahed, Ousama B; Arif, Samir I; Amer, Yasser S; Titi, Maher A; Al-Rukban, Mohammed O

    2017-09-25

    Type 2 diabetes mellitus (T2DM) is a worldwide and national public health problem that has a great impact on the population in Saudi Arabia. High-quality clinical practice guidelines (CPGs) are cornerstones in improving the health care provided for patients with diabetes. This study evaluated the methodological rigour, transparency, and applicability of recently published CPGs. Our group conducted a systematic search for recently published CPGs for T2DM. The searching and screening for Source CPGs were guided by tools from the ADAPTE methods with specific inclusion/exclusion criteria. Five reviewers using the second version of the Appraisal of Guidelines for Research and Evaluation (AGREE II) Instrument independently assessed the quality of the retrieved Source CPGs. Domains of Scope and purpose and Clarity of presentation received the highest scores in all CPGs. Most of the assessed CPGs (86%) were considered with high overall quality and were recommended for use. Rigour of development and applicability domains were together highest in 3 CPGs (43%). The overall high quality of DM CPGs published in the last 3 years demonstrated the continuous development and improvement in CPG methodologies and standards. Health care professionals should consider the quality of any CPG for T2DM before deciding to use it in their daily clinical practice. Three CPGs have been identified, using the AGREE criteria, as high-quality and trustworthy. Ideally, the resources provided by the AGREE trust including the AGREE II Instrument should be used by a clinician to scan through the large number of published T2DM CPGs to identify the CPGs with high methodological quality and applicability. © 2017 John Wiley & Sons, Ltd.

  3. Curriculum Guidelines for Predoctoral Oral Radiology.

    Science.gov (United States)

    Journal of Dental Education, 1987

    1987-01-01

    The American Association of Dental Schools' guidelines for oral radiology curricula give an overview of the field and its interrelationships with other fields and outline the primary educational objectives, prerequisites, core content, specific behavioral objectives, sequencing, faculty, facilities, and occupational hazards to be considered in…

  4. Curriculum Guidelines for Predoctoral Pediatric Dentistry.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    Guidelines for development of a pedodontics curriculum describe the interrelationships of this and other dental fields, give an overview of the curriculum and its primary educational objectives, and outline the suggested prerequisites, core content, specific behavioral objectives, sequencing, and faculty requirements. (MSE)

  5. An Overview on Human Umbilical Cord Blood Stem Cell-Based Alternative In Vitro Models for Developmental Neurotoxicity Assessment.

    Science.gov (United States)

    Singh, Abhishek Kumar; Kashyap, Mahendra Pratap

    2016-07-01

    The developing brain is found highly vulnerable towards the exposure of different environmental chemicals/drugs, even at concentrations, those are generally considered safe in mature brain. The brain development is a very complex phenomenon which involves several processes running in parallel such as cell proliferation, migration, differentiation, maturation and synaptogenesis. If any step of these cellular processes hampered due to exposure of any xenobiotic/drug, there is almost no chance of recovery which could finally result in a life-long disability. Therefore, the developmental neurotoxicity (DNT) assessment of newly discovered drugs/molecules is a very serious concern among the neurologists. Animal-based DNT models have their own limitations such as ethical concerns and lower sensitivity with less predictive values in humans. Furthermore, non-availability of human foetal brain tissues/cells makes job more difficult to understand about mechanisms involve in DNT in human beings. Although, the use of cell culture have been proven as a powerful tool for DNT assessment, but many in vitro models are currently utilizing genetically unstable cell lines. The interpretation of data generated using such terminally differentiated cells is hard to extrapolate with in vivo situations. However, human umbilical cord blood stem cells (hUCBSCs) have been proposed as an excellent tool for alternative DNT testing because neuronal development from undifferentiated state could exactly mimic the original pattern of neuronal development in foetus when hUCBSCs differentiated into neuronal cells. Additionally, less ethical concern, easy availability and high plasticity make them an attractive source for establishing in vitro model of DNT assessment. In this review, we are focusing towards recent advancements on hUCBSCs-based in vitro model to understand DNTs.

  6. A cocktail approach for assessing the in vitro activity of human cytochrome P450s: an overview of current methodologies.

    Science.gov (United States)

    Spaggiari, Dany; Geiser, Laurent; Daali, Youssef; Rudaz, Serge

    2014-12-01

    An assessment of cytochrome P450 (CYP) enzyme activity is essential for characterizing the phase I metabolism of biological systems or to evaluate the inhibition/induction properties of xenobiotics. CYPs have generally been investigated individually by single probes, and metabolite formation has been monitored by liquid chromatography-mass spectrometry (LC-MS). To increase the throughput, many probes have been applied to assess multiple CYP activities simultaneously within a single experiment. This strategy is called the cocktail approach, and it has already been reviewed for in vivo applications, but never for in vitro ones. This review focuses for the first time on an in vitro cocktail approach, and it references the most notable articles on this topic. The advantages and limitations of applying cocktails for the in vitro activity assessment of major human CYPs, namely, CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1 and subfamily CYP3A, are discussed. This article considers the probe reaction selections for each CYP according to regulatory recommendations, probe metabolic properties (i.e., specificity and turnover), probe concentrations and analytical sensitivity, but it also highlights a challenge specific to cocktail design, which is probe-probe interaction. The last part of the review reports some methodologies for incubating these cocktails and discusses some important issues regarding the incubation time, enzyme concentrations and sample preparation. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Assessing emergency obstetric care provision in low- and middle-income countries: a systematic review of the application of global guidelines

    Directory of Open Access Journals (Sweden)

    Aduragbemi Banke-Thomas

    2016-08-01

    Full Text Available Background: Lack of timely and quality emergency obstetric care (EmOC has contributed significantly to maternal morbidity and mortality, particularly in low- and middle-income countries (LMICs. Since 2009, the global guideline, referred to as the ‘handbook’, has been used to monitor availability, utilization, and quality of EmOC. Objective: To assess application and explore experiences of researchers in LMICs in assessing EmOC. Design: Multiple databases of peer-reviewed literature were systematically reviewed on EmOC assessments in LMICs, since 2009. Following set criteria, we included articles, assessed for quality based on a newly developed checklist, and extracted data using a pre-designed extraction tool. We used thematic summaries to condense our findings and mapped patterns that we observed. To analyze experiences and recommendations for improved EmOC assessments, we took a deductive approach for the framework synthesis. Results: Twenty-seven studies met our inclusion criteria, with 17 judged as high quality. The highest publication frequency was observed in 2015. Most assessments were conducted in Nigeria and Tanzania (four studies each and Bangladesh and Ghana (three each. Most studies (17 were done at subnational levels with 23 studies using the ‘handbook’ alone, whereas the others combined the ‘handbook’ with other frameworks. Seventeen studies conducted facility-based surveys, whereas others used mixed methods. For different reasons, intrapartum and very early neonatal death rate and proportion of deaths due to indirect causes in EmOC facilities were the least reported indicators. Key emerging themes indicate that data quality for EmOC assessments can be improved, indicators should be refined, a holistic approach is required for EmOC assessments, and assessments should be conducted as routine processes. Conclusions: There is clear justification to review how EmOC assessments are being conducted. Synergy between

  8. 6,220 institutionalised people with intellectual disability referred for visual assessment between 1993 and 2003: overview and trends.

    Science.gov (United States)

    van Isterdael, C E D; Stilma, J S; Bezemer, P D; Tijmes, N T

    2006-10-01

    To summarise the results of visual performance tests and other data of institutionalised people with intellectual disability referred to a visual advisory centre (VAC) between 1993 and 2003, and to determine trends in these data. A retrospective medical record review was undertaken of 6,220 consecutive people examined ophthalmologically according to a standard protocol by one VAC that specialised in visual assessment and treatment of people with intellectual disability, between 1993 and 2003. chi2 test for linear trend was used and linear regression coefficients were calculated. The proportion of people aged > or =50 years increased from 19.3% to 34.2% between 1995 and 2003 (pdisability decreased from 80.0% to 52.6% (pvisual impairment or blindness decreased from 70.9% to 22.9% (pvisual disorders decreased from 89.6% to 75.3% (pdisability were identified in 58.4% people; 20.8% had Down's syndrome. Many ocular diagnoses were found, indicating the need for ophthalmological monitoring. Specialised centres are helpful, because assessment and treatment of people with intellectual disability is complicated and time consuming. Protocols for efficient referral will have to be developed. A major task lies ahead to improve the treatment rates of refractive errors, cataract and strabismus, and to find specific causes of intellectual disability.

  9. ER/LA Opioid Analgesics REMS: Overview of Ongoing Assessments of Its Progress and Its Impact on Health Outcomes.

    Science.gov (United States)

    Cepeda, M Soledad; Coplan, Paul M; Kopper, Nathan W; Maziere, Jean-Yves; Wedin, Gregory P; Wallace, Laura E

    2017-01-01

    Opioid abuse is a serious public health concern. In response, the Food and Drug Administration (FDA) determined that a risk evaluation and mitigation strategy (REMS) for extended-release and long-acting (ER/LA) opioids was necessary to ensure that the benefits of these analgesics continue to outweigh the risks. Key components of the REMS are training for prescribers through accredited continuing education (CE), and providing patient educational materials. The impact of this REMS has been assessed using diverse metrics including evaluation of prescriber and patient understanding of the risks associated with opioids; patient receipt and comprehension of the medication guide and patient counseling document; patient satisfaction with access to opioids; drug utilization and changes in prescribing patterns; and surveillance of ER/LA opioid misuse, abuse, overdose, addiction, and death. The results of these assessments indicate that the increasing rates of opioid abuse, addiction, overdose, and death observed prior to implementation of the REMS have since leveled off or started to decline. However, these benefits cannot be attributed solely to the ER/LA opioid analgesics REMS since many other initiatives to prevent abuse occurred contemporaneously. These improvements occurred while preserving patient access to opioids as a large majority of patients surveyed expressed satisfaction with their access to opioids.

  10. Critical Overview of HER2 Assessement in Bladder Cancer: What Is Missing for a Better Therapeutic Approach?

    Science.gov (United States)

    Cimpean, Anca Maria; Tarlui, Valeria; Cumpănaş, Alin Adrian; Bolintineanu, Sorin; Cumpănaş, Andrei; Raica, Marius

    2017-09-01

    To assess the concordance between IHC and FISH and its influence on tumor type, grade and lympho-vascular invasion (LVI). HER2 immunohistochemistry (IHC) to 45 cases of bladder carcinoma, followed by fluorescent in situ hybridization (FISH) were applied. 31.12% cases were IHC positive. Less than 35% of HER2-negative cases presented LVI and this percent increased to 54.54% for +1 HER2 cases. LVI increases up to 57.14% for +2 HER2 cases and slightly decreased for +3 HER2 cases to 42.85%. IHC/FISH concordance was found for 73.34% cases but 31.57% were previously negative and 36.36% scored as +1 by IHC had gene amplification as shown by FISH analysis. T3 was correlated with HER2-IHC (p=0.05) and HER2-FISH (p=0.01). Improved HER2 assessement is needed for urothelial carcinomas. HER2-IHC scored as 0-2 should be validated by and reclassified according to FISH analysis. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  11. Substituting environmentally relevant flame retardants: assessment fundamentals. Vol. 1: results and summary overview; Erarbeitung von Bewertungsgrundlagen zur Substitution umweltrelevanter Flammschutzmittel. Bd. 1: Ergebnisse und zusammenfassende Uebersicht

    Energy Technology Data Exchange (ETDEWEB)

    Leisewitz, A.; Kruse, H.; Schramm, E.

    2001-04-01

    The study examines the status, trends and alternatives (substitution and reduction potentials) in the use of flame retardants in selected product sectors: construction; electronics and electrical engineering; rail vehicles; textiles/upholstery. In addition, the study characterises thirteen flame retardants in terms of material flows, applications and toxicology/ecotoxicology. Vol. I: Summary overview of flame retardant applications in Germany in 1999/2000; characterisation of 13 flame retardants in terms of substance properties and application-specific characteristics, range of applications and quantities; derivation of assessment fundamentals for flame retardants, focussing on toxicology/ecotoxicology, suitability for closed-loop substance management, and potential for substitution and reduction; summary assessment of 13 flame retardants; summary overview of flame retardant applications. Vol. II: Analysis of flame retardant applications (state of the art, trends, alternatives) in: unsaturated polyester (UP) resins (rail vehicles); polyurethane (PU) insulating foams and one component foams (OCF) (construction sector); plastics for generic uses in electronic and electrical equipment, in casings for electronic and electrical equipment and in printed circuit boards (electronics/electrical engineering); and in upholstery and mattresses (textile applications). Vol. III: Toxicological/ecotoxicological profiles of substances: Decabromodiphenyl oxide; Tetrabromobisphenol A; Bis[pentabromophenyl]ethane; Hexabromocyclodo-decane, Tris[chloropropyl]phosphate, Resorcinol-bis-diphenylphosphate; N-Hydroxymethyl-3-dimethylphosphonopropionamide, Red phosphorus, Ammonium polyphosphate, Melamin cyanurate, Aluminiumtrihydroxide, Sodium borate decahydrate, Antimony trioxide. (orig.) [German] Untersucht werden Stand, Trends und Alternativen (Substitutions- und Minderungspotentiale) beim Einsatz von Flammschutzmitteln (FSM) in ausgewaehlten Produkten aus: Baubereich, Elektrotechnik

  12. Evaluation of pediatric dentistry guidelines using the AGREE instrument.

    Science.gov (United States)

    Shah, Purvi; Moles, David R; Parekh, Susan; Ashley, Paul; Siddik, Dania

    2011-01-01

    Guidelines are used to inform clinical practice and improve the quality of health care. Poorly developed guidelines may emphasize the incorrect intervention. The purpose of this paper was to evaluate the quality of pediatric dentistry guidelines using the AGREE instrument. A search was carried out to identify pediatric dentistry guidelines up to November 2007. Three independent assessors evaluated the guidelines using the AGREE tool. Fifty-seven guidelines produced by 11 organisations were evaluated. Most guidelines assessed were of poor quality, as determined by the AGREE instrument. Consideration should be given to using the AGREE instrument in the development of new guidelines and review of existing guidelines.

  13. Overview of new GNSS tropospheric products for GNSS-meteorology and their assessment at Geodetic Observatory Pecny (CZ)

    Science.gov (United States)

    Dousa, J.; Vaclavovic, P.; Gyori, G.

    2012-12-01

    Geodetic Observatory Pecný (GOP) has a long-term experience in the estimation of precise tropospheric parameters from GNSS permanent stations, in particular under the limited timelines of near real time. More than a decade, the GOP zenith total delays (ZTD) contributed to various projects in Europe (COST-716, TOUGH, E-GVAP, E-GVAP II) and the operational ZTD hourly updated product flows via the meteorological observation exchange network - GTS - to the end users worldwide. Currently, the GOP regional ZTD product is operationally assimilated in Météo France and UK MetOffice at least and further exploited in various ways at many other meteorological institutions. New developments at GOP over last three years consist of a) implementation and assessment of the global hourly ZTD product of about 170 stations, b) implementation of routine multi-GNSS (GPS+GLONASS) ZTD European product, and c) implementation of ultra-fast/real-time ZTD product. The GOP global ZTD product has been implemented on request of the meteorological institutions running global numerical weather forecasting models. The global ZTD product was seriously evaluated over ten months (Oct 2009 - Aug 2011) when compared to reprocessed EUREF and IGS ZTDs, radiosondes and ZTDs derived from UK MetOffice's global numerical weather model. After the evaluation (and on special request of UK MetOffice) the product has been switched from testing to operational status within the framework of the EUMETNET EIG GPS Water Vapour Programme (E-GVAP) and officially disseminated via the GTS network. The GOP multi-GNSS ZTD solution has been tested since 2009 shortly after developing GOP ultra-rapid GPS+GLONASS orbits for the International GNSS Service (IGS). A specific bias of mean value 1.5 mm was identified between GPS- and GLONASS-only ZTD at that time, and relation to the IGS05 antenna phase centre offset and variation models (PCO+PCV) identified. Consequently, the implementation of a routine operation has been done

  14. Surface-water-quality assessment of the Yakima River Basin in Washington: Overview of major findings, 1987-91

    Science.gov (United States)

    Morace, Jennifer L.; Fuhrer, Gregory J.; Rinella, Joseph F.; McKenzie, Stuart W.; Gannett, Marshall W.; Bramblett, Karen L.; Pogue, Ted R.; Skach, Kenneth A.; Embrey, Sandra S.; Cuffney, Thomas F.; Meador, Michael R.; Porter, Stephen D.; Gurtz, Martin E.

    1999-01-01

    Surface-water-quality conditions were assessed in the Yakima River Basin, which drains 6,155 square miles of mostly forested, range, and agricultural land in Washington. The Yakima River Basin is one of the most intensively farmed and irrigated areas in the United States, and is often referred to as the “Nation’s Fruitbowl.” Natural and anthropogenic sources of contaminants and flow regulation control water-quality conditions throughout the basin. This report summarizes the spatial and temporal distribution, sources, and implications of the dissolved oxygen, water temperature, pH, suspended sediment, nutrient, organic compound (pesticide), trace element, fecal indicator bacteria, radionuclide, and aquatic ecology data collected during the 1987–91 water years.

  15. Assessing Cost-Effectiveness in Obesity (ACE-Obesity: an overview of the ACE approach, economic methods and cost results

    Directory of Open Access Journals (Sweden)

    Swinburn Boyd

    2009-11-01

    Full Text Available Abstract Background The aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. We have reported elsewhere on the modelled effectiveness of 13 obesity prevention interventions in children. In this paper, we report on the cost results and associated methods together with the innovative approach to priority setting that underpins the ACE-Obesity study. Methods The Assessing Cost Effectiveness (ACE approach combines technical rigour with 'due process' to facilitate evidence-based policy analysis. Technical rigour was achieved through use of standardised evaluation methods, a research team that assembles best available evidence and extensive uncertainty analysis. Cost estimates were based on pathway analysis, with resource usage estimated for the interventions and their 'current practice' comparator, as well as associated cost offsets. Due process was achieved through involvement of stakeholders, consensus decisions informed by briefing papers and 2nd stage filter analysis that captures broader factors that influence policy judgements in addition to cost-effectiveness results. The 2nd stage filters agreed by stakeholders were 'equity', 'strength of the evidence', 'feasibility of implementation', 'acceptability to stakeholders', 'sustainability' and 'potential for side-effects'. Results The intervention costs varied considerably, both in absolute terms (from cost saving [6 interventions] to in excess of AUD50m per annum and when expressed as a 'cost per child' estimate (from Conclusion The use of consistent methods enables valid comparison of potential intervention costs and cost-offsets for each of the interventions. ACE-Obesity informs policy-makers about cost-effectiveness, health impact, affordability and 2nd stage filters for important options for preventing unhealthy weight gain in children. In related articles cost-effectiveness results and

  16. Assessment of quality of life in advanced, metastatic prostate cancer: an overview of randomized phase III trials.

    Science.gov (United States)

    Adamowicz, Krzysztof

    2017-04-01

    The chief therapeutic goal in metastatic prostate cancer is prolongation of survival with good quality of life . Quality of life (health-related) is often used as an endpoint parameter in phase III trials in metastatic prostate cancer, but the value of using HRQOL in this context has not been assessed to date. In order to evaluate the role of HRQOL assessment in contemporary phase III trials in prostate cancer, we searched the PubMed database to identify publications presenting the results of these trials on systemic therapies for prostate cancer published between January 2000 and December 2015. The analysis was separately presented in ten leading journals. We searched for companion papers reporting on QOL separately. We identified 84 studies which included a total of 57,193 patients in ten leading journals and 27 studies (7270 patients) in other journals. HRQOL parameters were described or mentioned in the main publication in 25 publications and four companions in total. There was no obvious trend in quality of life reported over two 8-year periods . The explicit statistical comparisons were reported in 22/25 cases (88 %), with significant difference in only 10/25 (40 %) studies and in eight cases (80 %) was conducive to the examined arm. There was no significant association between improvements in HRQOL and improvements in overall survival (OS) or any other primary endpoint in the analyzed studies. Only one study was found which presented the difference in quality of life with no difference in the primary endpoint. HRQOL is an indicator of benefit during treatment of patients with metastatic prostate cancer, but it is unlikely that HRQOL results can help clinicians choose between treatments given that they are not correlated with changes in OS or at other primary endpoints.

  17. Assessing cost-effectiveness in obesity (ACE-obesity): an overview of the ACE approach, economic methods and cost results.

    Science.gov (United States)

    Carter, Rob; Moodie, Marj; Markwick, Alison; Magnus, Anne; Vos, Theo; Swinburn, Boyd; Haby, Michele M

    2009-11-18

    The aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. We have reported elsewhere on the modelled effectiveness of 13 obesity prevention interventions in children. In this paper, we report on the cost results and associated methods together with the innovative approach to priority setting that underpins the ACE-Obesity study. The Assessing Cost Effectiveness (ACE) approach combines technical rigour with 'due process' to facilitate evidence-based policy analysis. Technical rigour was achieved through use of standardised evaluation methods, a research team that assembles best available evidence and extensive uncertainty analysis. Cost estimates were based on pathway analysis, with resource usage estimated for the interventions and their 'current practice' comparator, as well as associated cost offsets. Due process was achieved through involvement of stakeholders, consensus decisions informed by briefing papers and 2nd stage filter analysis that captures broader factors that influence policy judgements in addition to cost-effectiveness results. The 2nd stage filters agreed by stakeholders were 'equity', 'strength of the evidence', 'feasibility of implementation', 'acceptability to stakeholders', 'sustainability' and 'potential for side-effects'. The intervention costs varied considerably, both in absolute terms (from cost saving [6 interventions] to in excess of AUD50m per annum) and when expressed as a 'cost per child' estimate (from costs per child reflected cost structure, target population and/or under-utilisation. The use of consistent methods enables valid comparison of potential intervention costs and cost-offsets for each of the interventions. ACE-Obesity informs policy-makers about cost-effectiveness, health impact, affordability and 2nd stage filters for important options for preventing unhealthy weight gain in children. In related articles cost

  18. [National External Quality Assessment for medical biology laboratories in Burkina Faso: an overview of three years of activity].

    Science.gov (United States)

    Sakande, Jean; Nikièma, Abdoulaye; Kabré, Elie; Nacoulma, Eric; Sawadogo, Charles; Lingani, Virginie; Traoré, Lady Kady; Kouanda, Abdoulaye; Kientéga, Youssouf; Somda, Joseph; Kagambéga, Faustin; Sanou, Mahamoudou; Sangaré, Lassana; Traoré-Ouédraogo, Rasmata

    2010-01-01

    We report results of the National External Quality Assessment for (NEQA) laboratories in Burkina Faso, a country with limited resources located in West Africa whose epidemiology is dominated by infectious diseases. The national laboratory network consists of 160 laboratories including 40 private. The Government of Burkina Faso has adopted a national laboratory policy. One of the objectives of this policy is to improve the quality of laboratory results. One of the strategies to achieve this objective is the establishment of a NEQA. The NEQA is a panel testing also called proficiency testing. It is mandatory for all laboratories to participate to the NEQA. The NEQA is organized twice a year and covers all areas of laboratories (bacteriology-virology, biochemistry, hematology, parasitology and immunology). The review of three years of activity (2006-2008) shows the following results: (1) for microscopic examination of bacteria after Gram staining, the error rate decreased from 24.7% in 2006 to 13.1% in 2007 and 13% in 2008; (2) errors rate in reading slides for the microscopic diagnosis of malaria were 23.4%, 14.6% and 10.2% respectively in 2006, 2007 and 2008; (3) for biochemistry, the percentages of unsatisfactory results were respectively 12.5%, 14.8% and 13.8% in 2006, 2007 and 2008 for the overall parameters assessed. The analysis of the results generated by the laboratories during these three years shows a quality improvement. However, the NEQA should be strengthened through ongoing training and quality control of reagents and equipment.

  19. Guidelines for Assessment of Gait and Reference Values for Spatiotemporal Gait Parameters in Older Adults: The Biomathics and Canadian Gait Consortiums Initiative.

    Science.gov (United States)

    Beauchet, Olivier; Allali, Gilles; Sekhon, Harmehr; Verghese, Joe; Guilain, Sylvie; Steinmetz, Jean-Paul; Kressig, Reto W; Barden, John M; Szturm, Tony; Launay, Cyrille P; Grenier, Sébastien; Bherer, Louis; Liu-Ambrose, Teresa; Chester, Vicky L; Callisaya, Michele L; Srikanth, Velandai; Léonard, Guillaume; De Cock, Anne-Marie; Sawa, Ryuichi; Duque, Gustavo; Camicioli, Richard; Helbostad, Jorunn L

    2017-01-01

    Background: Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims (1) to give consensus guidance for clinical and spatiotemporal gait analysis based on the recorded footfalls in older adults aged 65 years and over, and (2) to provide reference values for spatiotemporal gait parameters based on the recorded footfalls in healthy older adults free of cognitive impairment and multi-morbidities. Methods: International experts working in a network of two different consortiums (i.e., Biomathics and Canadian Gait Consortium) participated in this initiative. First, they identified items of standardized information following the usual procedure of formulation of consensus findings. Second, they merged databases including spatiotemporal gait assessments with GAITRite® system and clinical information from the "Gait, cOgnitiOn & Decline" (GOOD) initiative and the Generation 100 (Gen 100) study. Only healthy-free of cognitive impairment and multi-morbidities (i.e., ≤ 3 therapeutics taken daily)-participants aged 65 and older were selected. Age, sex, body mass index, mean values, and coefficients of variation (CoV) of gait parameters were used for the analyses. Results: Standardized systematic assessment of three categories of items, which were demographics and clinical information, and gait characteristics (clinical and spatiotemporal gait analysis based on the recorded footfalls), were selected for the proposed guidelines. Two complementary sets of items were distinguished: a minimal data set and a full data set. In addition, a total of 954 participants (mean age 72.8 ± 4.8 years, 45.8% women) were recruited to establish the reference values. Performance of spatiotemporal gait parameters based on the recorded footfalls

  20. Guidelines for Assessment of Gait and Reference Values for Spatiotemporal Gait Parameters in Older Adults: The Biomathics and Canadian Gait Consortiums Initiative

    Directory of Open Access Journals (Sweden)

    Olivier Beauchet

    2017-08-01

    Full Text Available Background: Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims (1 to give consensus guidance for clinical and spatiotemporal gait analysis based on the recorded footfalls in older adults aged 65 years and over, and (2 to provide reference values for spatiotemporal gait parameters based on the recorded footfalls in healthy older adults free of cognitive impairment and multi-morbidities.Methods: International experts working in a network of two different consortiums (i.e., Biomathics and Canadian Gait Consortium participated in this initiative. First, they identified items of standardized information following the usual procedure of formulation of consensus findings. Second, they merged databases including spatiotemporal gait assessments with GAITRite® system and clinical information from the “Gait, cOgnitiOn & Decline” (GOOD initiative and the Generation 100 (Gen 100 study. Only healthy—free of cognitive impairment and multi-morbidities (i.e., ≤ 3 therapeutics taken daily—participants aged 65 and older were selected. Age, sex, body mass index, mean values, and coefficients of variation (CoV of gait parameters were used for the analyses.Results: Standardized systematic assessment of three categories of items, which were demographics and clinical information, and gait characteristics (clinical and spatiotemporal gait analysis based on the recorded footfalls, were selected for the proposed guidelines. Two complementary sets of items were distinguished: a minimal data set and a full data set. In addition, a total of 954 participants (mean age 72.8 ± 4.8 years, 45.8% women were recruited to establish the reference values. Performance of spatiotemporal gait parameters based on the recorded

  1. Quality and methods of developing practice guidelines

    Directory of Open Access Journals (Sweden)

    Clark Otavio

    2002-01-01

    Full Text Available Abstract Background It is not known whether there are differences in the quality and recommendations between evidence-based (EB and consensus-based (CB guidelines. We used breast cancer guidelines as a case study to assess for these differences. Methods Five different instruments to evaluate the quality of guidelines were identified by a literature search. We also searched MEDLINE and the Internet to locate 8 breast cancer guidelines. These guidelines were classified in three categories: evidence based, consensus based and consensus based with no explicit consideration of evidence (CB-EB. Each guideline was evaluated by three of the authors using each of the instruments. For each guideline we assessed the agreement among 14 decision points which were selected from the NCCN (National Cancer Comprehensive Network guidelines algorithm. For each decision point we recorded the level of the quality of the information used to support it. A regression analysis was performed to assess if the percentage of high quality evidence used in the guidelines development was related to the overall quality of the guidelines. Results Three guidelines were classified as EB, three as CB-EB and two as CB. The EB guidelines scored better than CB, with the CB-EB scoring in the middle among all instruments for guidelines quality assessment. No major disagreement in recommendations was detected among the guidelines regardless of the method used for development, but the EB guidelines had a better agreement with the benchmark guideline for any decision point. When the source of evidence used to support decision were of high quality, we found a higher level of full agreement among the guidelines' recommendations. Up to 94% of variation in the quality score among guidelines could be explained by the quality of evidence used for guidelines development. Conclusion EB guidelines have a better quality than CB guidelines and CB-EB guidelines. Explicit use of high quality evidence

  2. Slurry pipeline technology: an overview

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Jay P. [Pipeline Systems Incorporated (PSI), Belo Horizonte, MG (Brazil); Lima, Rafael; Pinto, Daniel; Vidal, Alisson [Ausenco do Brasil Engenharia Ltda., Nova Lima, MG (Brazil). PSI Div.

    2009-12-19

    Slurry pipelines represent an economical and environmentally friendly transportation means for many solid materials. This paper provides an over-view of the technology, its evolution and current Brazilian activity. Mineral resources are increasingly moving farther away from ports, processing plants and end use points, and slurry pipelines are an important mode of solids transport. Application guidelines are discussed. State-of-the-Art technical solutions such as pipeline system simulation, pipe materials, pumps, valves, automation, telecommunications, and construction techniques that have made the technology successful are presented. A discussion of where long distant slurry pipelines fit in a picture that also includes thickened and paste materials pipe lining is included. (author)

  3. The Water Footprint Assessment of Electricity Production: An Overview of the Economic-Water-Energy Nexus in Italy

    Directory of Open Access Journals (Sweden)

    Pier Paolo Miglietta

    2018-01-01

    Full Text Available The term “water-energy nexus” has remarkable implications in the sustainable management of water resources. The aim of this paper is to analyse the production of electricity, from an economic and technical perspective, using the water footprint and economic water productivity approaches. After comparing the percentage of contribution of fossil and renewable sources to the production of the electricity sector, the study then compares the percentage of contribution of fossil and renewable sources to the consumptive water footprint of Italian electricity production for each year analysed. Furthermore, distinguishing between renewable and fossil sources, the paper proceeds to assess the total consumptive water footprint generated by each energy source for the electricity production in Italy during the period 2007–2016. The study represents an original contribution for the identification of policies and managerial implications in the context of the energy sector, serving as a practical guide. The results, in fact, confirm the need for scientific and practical efforts to manage electricity production in an integrated perspective and provide a first glance at addressing the optimal design of energy source mix in the Italian regulation context, contributing to reducing the water footprint, without ignoring the economic aspects.

  4. Systematic review on tuberculosis transmission on aircraft and update of the European Centre for Disease Prevention and Control risk assessment guidelines for tuberculosis transmitted on aircraft (RAGIDA-TB).

    Science.gov (United States)

    Kotila, Saara M; Payne Hallström, Lara; Jansen, Niesje; Helbling, Peter; Abubakar, Ibrahim

    2016-01-01

    As a setting for potential tuberculosis (TB) transmission and contact tracing, aircraft pose specific challenges. Evidence-based guidelines are needed to support the related-risk assessment and contact-tracing efforts. In this study evidence of TB transmission on aircraft was identified to update the Risk Assessment Guidelines for TB Transmitted on Aircraft (RAGIDA-TB) of the European Centre for Disease Prevention and Control (ECDC). Electronic searches were undertaken from Medline (Pubmed), Embase and Cochrane Library until 19 July 2013. Eligible records were identified by a two-stage screening process and data on flight and index case characteristics as well as contact tracing strategies extracted. The systematic literature review retrieved 21 records. Ten of these records were available only after the previous version of the RAGIDA guidelines (2009) and World Health Organization guidelines on TB and air travel (2008) were published. Seven of the 21 records presented some evidence of possible in-flight transmission, but only one record provided substantial evidence of TB transmission on an aircraft. The data indicate that overall risk of TB transmission on aircraft is very low. The updated ECDC guidelines for TB transmission on aircraft have global implications due to inevitable need for international collaboration in contract tracing and risk assessment.

  5. GRADE guidelines

    DEFF Research Database (Denmark)

    Guyatt, Gordon H; Thorlund, Kristian; Oxman, Andrew D

    2013-01-01

    , calculating summary measures requires converting to the same units of measurement for each study. The longest standing and most widely used approach is to divide the difference in means in each study by its standard deviation and present pooled results in standard deviation units (standardized mean difference...... in means is usually desirable. When the natural units of the outcome measure are not easily interpretable, choosing a threshold to create a binary outcome and presenting relative and absolute effects become a more attractive alternative. When studies use different measures of the same construct...... and absolute effects, presenting the ratio of the means of intervention and control groups, and presenting the results in minimally important difference units. We outline the merits and limitations of each alternative and provide guidance for meta-analysts and guideline developers....

  6. Field assessment of semi-aerobic condition and the methane correction factor for the semi-aerobic landfills provided by IPCC guidelines.

    Science.gov (United States)

    Jeong, Sangjae; Nam, Anwoo; Yi, Seung-Muk; Kim, Jae Young

    2015-02-01

    According to IPCC guidelines, a semi-aerobic landfill site produces one-half of the amount of CH4 produced by an equally-sized anaerobic landfill site. Therefore categorizing the landfill type is important on greenhouse gas inventories. In order to assess semi-aerobic condition in the sites and the MCF value for semi-aerobic landfill, landfill gas has been measured from vent pipes in five semi-aerobically designed landfills in South Korea. All of the five sites satisfied requirements of semi-aerobic landfills in 2006 IPCC guidelines. However, the ends of leachate collection pipes which are main entrance of air in the semi-aerobic landfill were closed in all five sites. The CH4/CO2 ratio in landfill gas, indicator of aerobic and anaerobic decomposition, ranged from 1.08 to 1.46 which is higher than the values (0.3-1.0) reported for semi-aerobic landfill sites and is rather close to those (1.0-2.0) for anaerobic landfill sites. The low CH4+CO2% in landfill gas implied air intrusion into the landfill. However, there was no evidence that air intrusion has caused by semi-aerobic design and operation. Therefore, the landfills investigated in this study are difficult to be classified as semi-aerobic landfills. Also MCF of 0.5 may significantly underestimate methane emissions compared to other researches. According to the carbon mass balance analyses, the higher MCF needs to be proposed for semi-aerobic landfills. Consequently, methane emission estimate should be based on field evaluation for the semi-aerobically designed landfills. Copyright © 2015. Published by Elsevier Ltd.

  7. Importance of Genetic Diversity Assessment in Crop Plants and Its Recent Advances: An Overview of Its Analytical Perspectives

    Directory of Open Access Journals (Sweden)

    M. Govindaraj

    2015-01-01

    Full Text Available The importance of plant genetic diversity (PGD is now being recognized as a specific area since exploding population with urbanization and decreasing cultivable lands are the critical factors contributing to food insecurity in developing world. Agricultural scientists realized that PGD can be captured and stored in the form of plant genetic resources (PGR such as gene bank, DNA library, and so forth, in the biorepository which preserve genetic material for long period. However, conserved PGR must be utilized for crop improvement in order to meet future global challenges in relation to food and nutritional security. This paper comprehensively reviews four important areas; (i the significance of plant genetic diversity (PGD and PGR especially on agriculturally important crops (mostly field crops; (ii risk associated with narrowing the genetic base of current commercial cultivars and climate change; (iii analysis of existing PGD analytical methods in pregenomic and genomic era; and (iv modern tools available for PGD analysis in postgenomic era. This discussion benefits the plant scientist community in order to use the new methods and technology for better and rapid assessment, for utilization of germplasm from gene banks to their applied breeding programs. With the advent of new biotechnological techniques, this process of genetic manipulation is now being accelerated and carried out with more precision (neglecting environmental effects and fast-track manner than the classical breeding techniques. It is also to note that gene banks look into several issues in order to improve levels of germplasm distribution and its utilization, duplication of plant identity, and access to database, for prebreeding activities. Since plant breeding research and cultivar development are integral components of improving food production, therefore, availability of and access to diverse genetic sources will ensure that the global food production network becomes more

  8. Assessment of fraction-specific toxicity and derivation of recommended soil quality guidelines for crude oil in agricultural/grassland soils

    Energy Technology Data Exchange (ETDEWEB)

    Leggett, S. [Matrix Solutions Inc., Jackson, MS (United States); Stephenson, G. [ESG International, Guelph, ON (Canada); Visser, S. [Calgary Univ., AB (Canada); Lee, K.; Bolton, A. [Anderson Exploration Ltd., Calgary, AB (Canada)

    2000-06-01

    A project was initiated in 1998 to collect scientific data through a combination of laboratory and field studies to help determine risk-based soil quality guidelines for petroleum hydrocarbons (PHC) in agricultural soils. The data obtained will provide useful information for the Alberta Tier I Criteria for Contaminated Soil Assessment and Remediation (CCSA) regarding the source and nature of ecotoxicity associated with PHC contaminated sites. The first phase of the project involved the collection of ecotoxicological data for specific hydrocarbon fractions to develop an approach to support ecologically relevant, risk-based, soil quality criteria for the protection of human health. The second phase involved the evaluation of short- and long-term risks associated with high concentrations of residual hydrocarbons in soils. Although the project is not scheduled to be completed until 2001, preliminary results are available regarding the toxicity of a crude oil mixture and two hydrocarbon fractions on terrestrial plant and animal species in topsoil. Data from both phases will be integrated to better understand the risk associated with hydrocarbon residuals in soil. The results will help regulators to establish relevant clean up standards for PHCs. They will also help industry to establish risk based clean-up standards for PHCs during site-specific risk assessments. 4 refs.

  9. THE WAY OF ASSESSING THE ADHERENCE TO MODERN DRUG THERAPY CLINICAL GUIDELINES AIMED AT REDUCING THE RISK OF RECURRENT STROKE (ACCORDING TO THE LIS-2 REGISTER

    Directory of Open Access Journals (Sweden)

    A. Yu. Suvorov

    2015-09-01

    Full Text Available Aim. To develop a method for the assessment of quality of medical prevention of recurrent stroke and its’ testing using the results of the LIS-2 register (Lyubertsy study of mortality in patients after stroke.Material and methods. The scale evaluation of the quality of therapy for the prevention of recurrent stroke developed in accordance with the modern clinical practice guidelines, as well as the recurrent stroke prevention index (RSPI for this assessment were elaborated. The analysis of the therapy was performed in patients after stroke in LIS-2 registers (n=219. The assessment of the quality of treatment was performed using RSPI, the influence of the index results on the in-hospital mortality was studied.Results. Two groups of patients [with RSPI=0 (n=137 and RSPI>0 (n=82] were formed on the basis of the results evaluation via RSPI. Significant differences between groups were not found. At the same time higher in-hospital mortality (p=0.014; χ2 Pearson was detected in patients with RSPI=0; relative risk of in-hospital death (after adjustment for sex and age was 2.04 [1.07-3.91] (p=0.031. Analysis of the length of survival and duration of hospital stay was performed in both groups using the Kaplan-Meier method. In-hospital mortality was significantly higher in patients with RSPI=0, which was confirmed by the log-rank test (p=0.032.Conclusion. The results of the quality of medical care assessment in accordance with the developed method are significantly related to the outcomes during the stay in a hospital. The developed method, based on current clinical recommendations, can serve as an example of the implementation of evidence-based medicine in actual practice.

  10. Effective doses, guidelines & regulations.

    Science.gov (United States)

    Burch, Michael D

    2008-01-01

    categories usually required to satisfy comprehensive risk assessment process for the major toxins to currently adopt any of the international guidelines as regulations in the US. The major limitations that need to be overcome include: the capacity to deal with multiple toxin congeners, the absence of robust analytical methods for compliance monitoring, and the absence of certified toxin standards to support analyses. However, the current WHO provisional guideline for microcystin-LR, or the other national guideline variants that are based upon it, (e.g., Canadian, Australian) may be appropriate to adopt as a health advisory in the short-term, while regulations are developed. The bathing and recreationa water guidelines developed in other countries could also be translated fo use as recreational water guidelines situation in the US.

  11. An assessment of resuscitation quality in the television drama Emergency Room: guideline non-compliance and low-quality cardiopulmonary resuscitation lead to a favorable outcome?

    Science.gov (United States)

    Hinkelbein, Jochen; Spelten, Oliver; Marks, Jörg; Hellmich, Martin; Böttiger, Bernd W; Wetsch, Wolfgang A

    2014-08-01

    Two earlier studies found that outcome after cardiopulmonary resuscitation (CPR) in the television medical drama Emergency Room (ER) is not realistic. No study has yet evaluated CPR quality in ER. Retrospective analysis of CPR quality in episodes of ER. Three independent board-certified emergency physicians trained in CPR and the American Heart Association (AHA) guidelines reviewed ER episodes in two 5-year time-frames (2001-2005 and 2005-2009). Congruency with the corresponding 2000 and 2005 AHA guidelines was determined for each CPR scene. None. None. To evaluate whether CPR is in agreement with the specific algorithms of the AHA guidelines. Fisher's exact test and Mann-Whitney-U-test were used to evaluate statistical significance (PCPR scene was in agreement with the published AHA guidelines. However, low-quality CPR and non-compliance with the guidelines resulted in favorable outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools.

    Science.gov (United States)

    Perry, Rachel; Leach, Verity; Davies, Philippa; Penfold, Chris; Ness, Andy; Churchill, Rachel

    2017-05-15

    Fibromyalgia (FM) is a chronic, debilitating pain disorder. Dissatisfaction with conventional medicine can lead people with FM to turn to complementary and alternative medicine (CAM). Two previous overviews of systematic reviews of CAM for FM have been published, but they did not assessed for risk of bias in the review process. Five databases Medline, Embase, AMED (via OVID), Web of Science and Central were searched from their inception to December 2015. Reference lists were hand-searched. We had two aims: the first was to provide an up-to-date and rigorously conducted synthesis of systematic reviews of CAM literature on FM; the second was to evaluate the quality of the available systematic review evidence using two different tools: AMSTAR (Shea et al. BMC Med Res Methodol 15; 7:10, 2007) and a more recently developed tool ROBIS (Whiting et al. J Clin Epidemiol 69:225-34, 2016) specifically designed to assess risk of bias in systematic reviews. Any review that assessed one of eight CAM therapies for participants diagnosed with FM was considered. The individual studies had to be randomised controlled trials where the intervention was compared to placebo, treatment as usual or waitlist controls to be included. The primary outcome measure was pain, and the secondary outcome measure was adverse events. We identified 15 reviews that met inclusion criteria. There was low-quality evidence that acupuncture improves pain compared to no treatment or standard treatment, but good evidence that it is no better than sham acupuncture. The evidence for homoeopathy, spinal manipulation and herbal medicine was limited. Overall, five reviews scored 6 or above using the AMSTAR scale and the inter-rater agreement was good (83.6%), whereas seven reviews achieved a low risk of bias rating using ROBIS and the inter-rater agreement was fair (60.0%). No firm conclusions were drawn for efficacy of either spinal manipulation or homoeopathy for FM. There is limited evidence for topical

  13. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-03-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the content  1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  14. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-10-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the Content  1.1.1   Subheading of the Content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  15. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2016-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second p age and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the Content 1.1.1 Subheading of the Content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www.teachingenglish.org

  16. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the content 1.1.1 Subheading of the content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Back Matter| 79 80 | STUDIES IN ENGLISH LANGUAGE AND EDUCATION, Volume 1, Number 1, March 2014 Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v

  17. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-09-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the content  1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  18. Clinical trial design for systemic agents in patients with brain metastases from solid tumours: a guideline by the Response Assessment in Neuro-Oncology Brain Metastases working group.

    Science.gov (United States)

    Camidge, D Ross; Lee, Eudocia Q; Lin, Nancy U; Margolin, Kim; Ahluwalia, Manmeet S; Bendszus, Martin; Chang, Susan M; Dancey, Janet; de Vries, Elisabeth G E; Harris, Gordon J; Hodi, F Stephen; Lassman, Andrew B; Macdonald, David R; Peereboom, David M; Schiff, David; Soffietti, Ricardo; van den Bent, Martin J; Wefel, Jeffrey S; Wen, Patrick Y

    2018-01-01

    Patients with active CNS disease are often excluded from clinical trials, and data regarding the CNS efficacy of systemic agents are usually obtained late in the drug development process or not at all. In this guideline from the Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) working group, we provide detailed recommendations on when patients with brain metastases from solid tumours should be included or excluded in clinical trials of systemic agents. We also discuss the limitations of retrospective studies in determining the CNS efficacy of systemic drugs. Inclusion of patients with brain metastases early on in the clinical development of a drug or a regimen is needed to generate appropriate CNS efficacy or non-efficacy signals. We consider how to optimally incorporate or exclude such patients in systemic therapy trials depending on the likelihood of CNS activity of the agent by considering three scenarios: drugs that are considered very unlikely to have CNS antitumour activity or efficacy; drugs that are considered very likely to have CNS activity or efficacy; and drugs with minimal baseline information on CNS activity or efficacy. We also address trial design issues unique to patients with brain metastases, including the selection of appropriate CNS endpoints in systemic therapy trials. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Development of a diagnostic test set to assess agreement in breast pathology: practical application of the Guidelines for Reporting Reliability and Agreement Studies (GRRAS).

    Science.gov (United States)

    Oster, Natalia V; Carney, Patricia A; Allison, Kimberly H; Weaver, Donald L; Reisch, Lisa M; Longton, Gary; Onega, Tracy; Pepe, Margaret; Geller, Berta M; Nelson, Heidi D; Ross, Tyler R; Tosteson, Aanna N A; Elmore, Joann G

    2013-02-05

    Diagnostic test sets are a valuable research tool that contributes importantly to the validity and reliability of studies that assess agreement in breast pathology. In order to fully understand the strengths and weaknesses of any agreement and reliability study, however, the methods should be fully reported. In this paper we provide a step-by-step description of the methods used to create four complex test sets for a study of diagnostic agreement among pathologists interpreting breast biopsy specimens. We use the newly developed Guidelines for Reporting Reliability and Agreement Studies (GRRAS) as a basis to report these methods. Breast tissue biopsies were selected from the National Cancer Institute-funded Breast Cancer Surveillance Consortium sites. We used a random sampling stratified according to woman's age (40-49 vs. ≥50), parenchymal breast density (low vs. high) and interpretation of the original pathologist. A 3-member panel of expert breast pathologists first independently interpreted each case using five primary diagnostic categories (non-proliferative changes, proliferative changes without atypia, atypical ductal hyperplasia, ductal carcinoma in situ, and invasive carcinoma). When the experts did not unanimously agree on a case diagnosis a modified Delphi method was used to determine the reference standard consensus diagnosis. The final test cases were stratified and randomly assigned into one of four unique test sets. We found GRRAS recommendations to be very useful in reporting diagnostic test set development and recommend inclusion of two additional criteria: 1) characterizing the study population and 2) describing the methods for reference diagnosis, when applicable.

  20. Session Overview

    Science.gov (United States)

    Spencer, Cherrill

    2010-02-01

    High-school teachers are amongst the most important contributors to the development of the science and technology workforce of the future. Many of the more than 23,000 US high-school physics teachers are not adequately prepared to teach the subject. Only one-third of them, for example, majored in physics or physics education. Can inadequate teacher preparation be a factor in the poor performance of US students on international assessments of their achievements in science and physics? Since 1995 the Trends in International Mathematics and Science Study (TIMSS) has been administered four times to many hundreds of thousands of students in over 60 countries. TIMSS is used to measure trends in the mathematics and science knowledge and skills of fourth- and eighth-graders. The Program for International Student Assessment (PISA) has been administered three times since 2000, it focuses on 15-year-olds' capabilities in reading literacy, mathematics literacy, and science literacy. TIMSS Advanced (1995) assessed school-leaving students who have had special preparation in advanced mathematics and physics. In all these studies the US students, including the Advanced Placement physics students, scored below the international average, sometimes in the bottom third of countries! Three speakers have been invited to talk about the physics K-12 education systems in other countries, one that consistently scores at the top of the PISA (Finland) or score much higher than the USA on TIMSS ( various Northern European countries) and significantly better on recent bi-lateral comparisons (China). What can we learn from the physics teaching systems in these high-scoring countries that might be applied in the USA? There will be a panel discussion following the 3 invited talks, audience participation will be encouraged. )

  1. Conducting a Community Audit: Assessing the Workforce Development Needs and Resources of Your Community.

    Science.gov (United States)

    2000

    This document details the purposes and principles of community audits and presents guidelines for designing and conducting a community audit to assess a local community's workforce development needs and resources. Section 1 presents an overview of the U.S. Department of Labor's Community Audit Project and explains the following key steps in…

  2. An ontology-aware integration of clinical models, terminologies and guidelines: an exploratory study of the Scale for the Assessment and Rating of Ataxia (SARA).

    Science.gov (United States)

    Maarouf, Haitham; Taboada, María; Rodriguez, Hadriana; Arias, Manuel; Sesar, Ángel; Sobrido, María Jesús

    2017-12-06

    Electronic rating scales represent an important resource for standardized data collection. However, the ability to exploit reasoning on rating scale data is still limited. The objective of this work is to facilitate the integration of the semantics required to automatically interpret collections of standardized clinical data. We developed an electronic prototype for the Scale of the Assessment and Rating of Ataxia (SARA), broadly used in neurology. In order to address the modeling challenges of the SARA, we propose to combine the best performances from OpenEHR clinical archetypes, guidelines and ontologies. A scaled-down version of the Human Phenotype Ontology (HPO) was built, extracting the terms that describe the SARA tests from free-text sources. This version of the HPO was then used as backbone to normalize the content of the SARA through clinical archetypes. The knowledge required to exploit reasoning on the SARA data was modeled as separate information-processing units interconnected via the defined archetypes. Each unit used the most appropriate technology to formally represent the required knowledge. Based on this approach, we implemented a prototype named SARA Management System, to be used for both the assessment of cerebellar syndrome and the production of a clinical synopsis. For validation purposes, we used recorded SARA data from 28 anonymous subjects affected by Spinocerebellar Ataxia Type 36 (SCA36). When comparing the performance of our prototype with that of two independent experts, weighted kappa scores ranged from 0.62 to 0.86. The combination of archetypes, phenotype ontologies and electronic information-processing rules can be used to automate the extraction of relevant clinical knowledge from plain scores of rating scales. Our results reveal a substantial degree of agreement between the results achieved by an ontology-aware system and the human experts.

  3. Perceived barriers to guideline adherence: a survey among general practitioners

    NARCIS (Netherlands)

    Lugtenberg, M.; Burgers, J.S.; Besters, C.F.; Han, D.; Westert, G.P.

    2011-01-01

    BACKGROUND: Despite considerable efforts to promote and support guideline use, adherence is often suboptimal. Barriers to adherence vary not only across guidelines but also across recommendations within guidelines. The aim of this study was to assess the perceived barriers to guideline adherence

  4. Validation of evidence-based clinical practice guideline: Nursing ...

    African Journals Online (AJOL)

    The overall assessment of the guideline revealed that two-thirds of academic appraisers strongly recommended the guideline to be used in practice and most of practitioner nurses and practitioner physicians recommended the guideline to be in practice. Conclusion: The development of this guideline was based on the ...

  5. AUTHOR GUIDELINES

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2014-12-01

    Full Text Available AUTHOR GUIDELINESIndian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/loginOnline SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.SectionsEditorial:On issues of current public health needAbout 1000 – 1200 wordsReferences: 5 – 10 (PubMed - Citation preferredInvited Commentary:Brief, provocative, opinionated communicationsOn issues of current public health needMain Text: 750-1000 words excluding referencesReferences: 5 – 10 (PubMed - Citation preferredOriginal Article:Articles from Original ResearchStructured abstract: 250 wordsMain Text: 2500 - 3000 words, IMRD formatKey Words: 5 - 8References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4*Certificate of clearance from respective Institutional Ethical Committee (IECReview Article:On subject of public health relevanceAbstract: 250 wordsMain Text: 2500 - 3000 wordsKey Words: 3 - 4References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4Short Communication / Article:Short report of a research project / outbreakMain Text : 1000 – 1200 wordsReferences: 10 – 15 (PubMed - Citation preferredTable / Figure: 01*Certificate of clearance from respective Institutional Ethical Committee (IECReport from the field

  6. Methodological quality of guidelines in gastroenterology.

    Science.gov (United States)

    Malheiro, Rui; de Monteiro-Soares, Matilde; Hassan, Cesare; Dinis-Ribeiro, Mário

    2014-06-01

    Clinical guidelines are a common feature in modern endoscopy practice and they are being produced faster than ever. However, their methodological quality is rarely assessed. This study evaluated the methodological quality of current clinical guidelines in the field of gastroenterology, with an emphasis on endoscopy. Practice guidelines published by the American College of Gastroenterology (ACG), American Gastroenterological Association (AGA), American Society for Gastrointestinal Endoscopy (ASGE), European Society of Gastrointestinal Endoscopy (ESGE), British Society of Gastroenterology (BSG), National Institute for Health and Care Excellence (NICE), and the Scottish Intercollegiate Guidelines Network (SIGN) were searched between September and October 2012 and evaluated using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument (23 items, scores 1 - 7 for each item; higher scores mean better quality). A total of 100 guidelines were assessed. The mean number of items scoring 6 or 7 per guideline was 9.2 (out of 23 items). Overall, 99 % of guidelines failed to include the target population in the development process, and 96 % did not report facilitators and barriers to guideline application. In addition, 86 % did not include advice or tools, and 94 % did not present monitoring or auditing criteria. The global methodological quality of clinical guidelines in the field of gastroenterology is poor, particularly regarding involvement of the target population in the development of guidelines and in the provision of clear suggestions to practitioners. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Overview of Alcohol Consumption

    Science.gov (United States)

    ... form Search Alcohol & Your Health Overview of Alcohol Consumption Alcohol's Effects on the Body Alcohol Use Disorder Fetal ... A Standard Drink? Drinking Levels Defined Overview of Alcohol Consumption People drink to socialize, celebrate, and relax. Alcohol ...

  8. Exploring Clinical Overview

    DEFF Research Database (Denmark)

    Fleron, Benedicte

    Clinical overview is explored at four emergency departments (EDs) during the introduction of a new IT system to support hereof. Important aspects of clinical overview are described for the clinical practice and for the further development of the IT system.......Clinical overview is explored at four emergency departments (EDs) during the introduction of a new IT system to support hereof. Important aspects of clinical overview are described for the clinical practice and for the further development of the IT system....

  9. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America.

    Science.gov (United States)

    Wormser, Gary P; Dattwyler, Raymond J; Shapiro, Eugene D; Halperin, John J; Steere, Allen C; Klempner, Mark S; Krause, Peter J; Bakken, Johan S; Strle, Franc; Stanek, Gerold; Bockenstedt, Linda; Fish, Durland; Dumler, J Stephen; Nadelman, Robert B

    2006-11-01

    Evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis were prepared by an expert panel of the Infectious Diseases Society of America. These updated guidelines replace the previous treatment guidelines published in 2000 (Clin Infect Dis 2000; 31[Suppl 1]:1-14). The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them. For each of these Ixodes tickborne infections, information is provided about prevention, epidemiology, clinical manifestations, diagnosis, and treatment. Tables list the doses and durations of antimicrobial therapy recommended for treatment and prevention of Lyme disease and provide a partial list of therapies to be avoided. A definition of post-Lyme disease syndrome is proposed.

  10. Using field data to assess the effects of pesticides on crustacea in freshwater aquatic ecosystems and verifying the level of protection provided by water quality guidelines.

    Science.gov (United States)

    Guy, Martha; Singh, Lucina; Mineau, Pierre

    2011-07-01

    The purpose of this study was to investigate how well single-species laboratory data predict real-world pesticide toxicity effects on Crustacea. Data from field pesticide exposures from experimental mesocosm and small pond studies were converted into toxicity units (TUs) by dividing measured pesticide concentrations by the L(E)C50 for Daphnia or acute 5% hazard concentration for Crustacea (HC5-C). The proportion of crustacean taxa significantly affected by the pesticide treatment, called the count ratio of effect, was used in logistic regression models. Of 200 possible logistic model combinations of the TUs, fate, physicochemical variables, and structural variables versus the count ratio of effect for the mesocosm data, the best model was found to incorporate log(TU HC5-C). This model was used to convert pesticide water quality guidelines from around the world into estimates of the proportion of crustacean taxa predicted to be impacted by exposure to a pesticide at the water quality guideline concentration. This analysis suggests 64% of long-term water quality guidelines and 88% of short-term pesticide water quality guidelines are not protective of the aquatic life they are designed to protect. We conclude that empirically derived data from mesocosm studies should be incorporated into water quality guideline derivation for pesticides where available. Also, interspecific differences in susceptibility should be accounted for more accurately to ensure water quality guidelines are adequately protective against the adverse effects of pesticide exposure. Copyright © 2011 SETAC.

  11. The 1988 VGB guideline for boiler feedwater, boiler water, and steam of steam generators with a permissible operating pressure of > 68 bar - is this guideline still up-to-date?

    Energy Technology Data Exchange (ETDEWEB)

    Bursik, A. [PowerPlant Chemistry GmbH, Neulussheim (Germany)

    2003-12-01

    An evaluation of any guideline requires consideration of the historical development of the guideline and the guideline-issuing organization. This is particularly important for overseas readers who are not familiar with either the VGB organization or the VGB Guideline for Boiler Feedwater, Boiler Water, and Steam of Steam Generators. Therefore, a brief historic overview precedes the actual evaluation. Of the many possible evaluation criteria, the applicability of the guideline in utility units with all-ferrous and mixed metallurgy, in units with drum boilers, and in typical ''non-utility'' (industrial) steam-generating installations is considered. In addition, the appropriateness of the guideline for combined cycles with multipressure heat recovery steam generators (and for a combination of once-through and drum boilers in one combined cycle unit), the utilization of state-of-the-art knowledge of power cycle and steam chemistry, and the suitability for advanced training of chemistry and operation staff in power plants are also subjects of this assessment. (orig.)

  12. Development and Preliminary Validation of a Comprehensive Questionnaire to Assess Women’s Knowledge and Perception of the Current Weight Gain Guidelines during Pregnancy

    Directory of Open Access Journals (Sweden)

    Holly Ockenden

    2016-11-01

    Full Text Available The aim of this study was to develop and validate an electronic questionnaire, the Electronic Maternal Health Survey (EMat Health Survey, related to women’s knowledge and perceptions of the current gestational weight gain guidelines (GWG, as well as pregnancy-related health behaviours. Constructs addressed within the questionnaire include self-efficacy, locus of control, perceived barriers, and facilitators of physical activity and diet, outcome expectations, social environment and health practices. Content validity was examined using an expert panel (n = 7 and pilot testing items in a small sample (n = 5 of pregnant women and recent mothers (target population. Test re-test reliability was assessed among a sample (n = 71 of the target population. Reliability scores were calculated for all constructs (r and intra-class correlation coefficients (ICC, those with a score of >0.5 were considered acceptable. The content validity of the questionnaire reflects the degree to which all relevant components of excessive GWG risk in women are included. Strong test-retest reliability was found in the current study, indicating that responses to the questionnaire were reliable in this population. The EMat Health Survey adds to the growing body of literature on maternal health and gestational weight gain by providing the first comprehensive questionnaire that can be self-administered and remotely accessed. The questionnaire can be completed in 15–25 min and collects useful data on various social determinants of health and GWG as well as associated health behaviours. This online tool may assist researchers by providing them with a platform to collect useful information in developing and tailoring interventions to better support women in achieving recommended weight gain targets in pregnancy.

  13. Water-quality assessment of southern Florida; an overview of available information on surface-and ground-water quality and ecology

    Science.gov (United States)

    Haag, K.H.; Miller, R.L.; Bradner, L.A.; McCulloch, D.S.

    1996-01-01

    This report summarizes water-quality conditions, issues of concern, and management efforts underway in southern Florida. The report is designed to provide a conceptual framework for the Southern Florida National Water Quality Assessment (NAWQA) study that began in 1994. The report makes reference to the most important water-quality literature pertaining to southern Florida, to water-quality studies that are underway or planned, and to topics which are of high priority in the study unit. These topics include: the availability and suit ability of water for competing demands; nutrient enrichment of the Everglades; transport, degradation, and effects of pesticides; and the sources and cycling of mercury in the ecosystem. The report also includes a retrospective analysis and conceptual presentation of nutrient loading, which is a high priority for the national NAWQA Program and for regional water-quality managers. Nutrient contributions from point and nonpoint sources are estimated for nine basins in the study area and are discussed in relation to land use. Fertilizer is the dominant source of phosphorus in eight basins and the dominant source of nitrogen in at least five basins. Atmospheric sources of nitrogen contribute more than 20 percent of the total nitrogen input to all basins and are the dominant source of nitrogen input to Lake Okeechobee and the Everglades. Nutrient loads are also estimated in selected canal and river outflows in southern Florida to provide a spatial overview of the magnitude of nutrient loading to coastal waters. Annual phosphorus loads from the Peace River are the highest in the study unit; annual phosphorus loads from the Caloosahatchee River and the major Palm Beach canals are also high, compared to other parts of southern Florida. Estimated annual loads of phosphorus from parts of the Big Cypress Basin and the S-12 water-control structures of the Tamiami Canal are low compared with estimated phosphorus loads in outflows in the northern

  14. Diversity, dynamics and biogeography of Chilean benthic nearshore ecosystems: an overview and guidelines for conservation Diversidad, dinámica y biogeografía del ecosistema costero bentónico de Chile: revisión y bases para conservación marina

    Directory of Open Access Journals (Sweden)

    MIRIAM FERNANDEZ

    2000-12-01

    Full Text Available Despite Chile has been one of the pioneering countries in studies of human impact on marine communities, and despite the enormous economic and social significance that the marine environment has for the country, the development of marine conservation programs and the scientific basis for sustainability has not kept pace, with the exploitation rate of marine fisheries and the increasing use of the coast for other purposes. Although we think that the establishment of any conservation policies along the vast coastline of Chile must be based on a multitude of approaches and considerations, scientific, biological, and ecological principles should guide much of these efforts. In this paper, we attempt to present a general overview of the current knowledge about the ecology and biogeography of nearshore systems in Chile. Based on the most relevant existing information, our goals are to: 1 Identify major biogeographic and ecological features of nearshore ecosystems, and the obvious gaps in information, 2 identify the most harmful human activities impacting the structure and dynamics of these systems, and 3 suggest the possible use of indicators to assess the conservational status of different environments along the coast. This overview shows, on one side, the geographic areas of deficitary knowledge on nearshore environments that are critical for future marine conservation and management plans, and on the other, the availability of high quality information for other geographic areas along the coast. Regarding the taxonomy and large-scale patterns of species distribution, important gaps in information were detected, however no big changes in the total number of species are expected in the future. There are few large-scale patterns of species distribution are reported in the literature, and in this contribution, but more work needs to be done, particularly for some taxa, to identify areas of high species diversity as well as areas which possess unique

  15. [Undescended testis: current treatment guidelines].

    Science.gov (United States)

    Haid, B

    2016-01-01

    Cryptorchidism is the most common genital malformation in male newborns. In recent years, guidelines concerning diagnosis and therapy have undergone considerable evolution with the implementation of recent knowledge in pathophysiology, diagnosis, and therapy. The aim of this publication is to provide an overview of the current national and international guideline recommendations concerning diagnosis and treatment of cryptorchidism. Critical points are discussed in light of current scientific literature. The current guidelines of the European Association of Urology (EAU)/European Society for Pediatric Urology (ESPU), the American Association of Urology (AUA), the pediatric urologic task force of the Austrian Society of Urology (ÖGU), the international consultation on urological disease (ICUD) and the German Society of Urology (DGU)/German Association of Pediatric Surgery (DGKCh) have been analyzed concerning the most important aspects of treatment and diagnosis. There is broad consensus concerning most steps and decisions for the treatment of cryptorchidism. However, some aspects of diagnostic imaging, the use of hormonal therapy, and surgical access in nonpalpable testis warrant further discussion and are the fields of considerable changes.

  16. Assisted reproductive technology: an overview of Cochrane Reviews.

    Science.gov (United States)

    Farquhar, Cindy; Rishworth, Josephine R; Brown, Julie; Nelen, Willianne L D M; Marjoribanks, Jane

    2015-07-15

    As many as one in six couples will encounter problems with fertility, defined as failure to achieve a clinical pregnancy after regular intercourse for 12 months. Increasingly, couples are turning to assisted reproductive technology (ART) for help with conceiving and ultimately giving birth to a healthy live baby of their own. Fertility treatments are complex, and each ART cycle consists of several steps. If one of the steps is incorrectly applied, the stakes are high as conception may not occur. With this in mind, it is important that each step of the ART cycle is supported by good evidence from well-designed studies. To summarise the evidence from Cochrane systematic reviews on procedures and treatment options available to couples with subfertility undergoing assisted reproductive technology (ART). Published Cochrane systematic reviews of couples undergoing ART (in vitro fertilisation or intracytoplasmic sperm injection) were eligible for inclusion in the overview. We also identified Cochrane reviews in preparation, for future inclusion.The outcomes of the overview were live birth (primary outcome), clinical pregnancy, multiple pregnancy, miscarriage and ovarian hyperstimulation syndrome (secondary outcomes). Studies of intrauterine insemination and ovulation induction were excluded.Selection of systematic reviews, data extraction and quality assessment were undertaken in duplicate. Review quality was assessed by using the AMSTAR tool. Reviews were organised by their relevance to specific stages in the ART cycle. Their findings were summarised in the text and data for each outcome were reported in 'Additional tables'. Fifty-nine systematic reviews published in The Cochrane Library up to July 2015 were included. All were high quality. Thirty-two reviews identified interventions that were effective (n = 19) or promising (n = 13), 14 reviews identified interventions that were either ineffective (n = 2) or possibly ineffective (n = 12), and 13 reviews were unable to

  17. ACC/AHA Special Report: Clinical Practice Guideline Implementation Strategies: A Summary of Systematic Reviews by the NHLBI Implementation Science Work Group: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

    Science.gov (United States)

    Chan, Wiley V; Pearson, Thomas A; Bennett, Glen C; Cushman, William C; Gaziano, Thomas A; Gorman, Paul N; Handler, Joel; Krumholz, Harlan M; Kushner, Robert F; MacKenzie, Thomas D; Sacco, Ralph L; Smith, Sidney C; Stevens, Victor J; Wells, Barbara L

    2017-02-28

    In 2008, the National Heart, Lung, and Blood Institute convened an Implementation Science Work Group to assess evidence-based strategies for effectively implementing clinical practice guidelines. This was part of a larger effort to update existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity. Review evidence from the published implementation science literature and identify effective or promising strategies to enhance the adoption and implementation of clinical practice guidelines. This systematic review was conducted on 4 critical questions, each focusing on the adoption and effectiveness of 4 intervention strategies: (1) reminders, (2) educational outreach visits, (3) audit and feedback, and (4) provider incentives. A scoping review of the Rx for Change database of systematic reviews was used to identify promising guideline implementation interventions aimed at providers. Inclusion and exclusion criteria were developed a priori for each question, and the published literature was initially searched up to 2012, and then updated with a supplemental search to 2015. Two independent reviewers screened the returned citations to identify relevant reviews and rated the quality of each included review. Audit and feedback and educational outreach visits were generally effective in improving both process of care (15 of 21 reviews and 12 of 13 reviews, respectively) and clinical outcomes (7 of 12 reviews and 3 of 5 reviews, respectively). Provider incentives showed mixed effectiveness for improving both process of care (3 of 4 reviews) and clinical outcomes (3 reviews equally distributed between generally effective, mixed, and generally ineffective). Reminders showed mixed effectiveness for improving process of care outcomes (27 reviews with 11 mixed and 3 generally ineffective results) and were generally ineffective for clinical outcomes (18 reviews with 6 mixed and 9 generally ineffective results). Educational outreach visits (2 of 2

  18. Assessment of near visual acuity in 0-13 year olds with normal and low vision: a systematic review

    NARCIS (Netherlands)

    Huurneman, B.; Boonstra, F.N.

    2016-01-01

    BACKGROUND: The inclusion for rehabilitation of visually impaired children is partly based on the measurement of near vision, but guidelines for near visual acuity assessment are currently lacking. The twofold purpose of this systematic review was to: (i) provide an overview of the impact of the

  19. A practical approach to programmatic assessment design.

    Science.gov (United States)

    Timmerman, A A; Dijkstra, J

    2017-12-01

    Assessment of complex tasks integrating several competencies calls for a programmatic design approach. As single instruments do not provide the information required to reach a robust judgment of integral performance, 73 guidelines for programmatic assessment design were developed. When simultaneously applying these interrelated guidelines, it is challenging to keep a clear overview of all assessment activities. The goal of this study was to provide practical support for applying a programmatic approach to assessment design, not bound to any specific educational paradigm. The guidelines were first applied in a postgraduate medical training setting, and a process analysis was conducted. This resulted in the identification of four steps for programmatic assessment design: evaluation, contextualisation, prioritisation and justification. Firstly, the (re)design process starts with sufficiently detailing the assessment environment and formulating the principal purpose. Key stakeholders with sufficient (assessment) expertise need to be involved in the analysis of strengths and weaknesses and identification of developmental needs. Central governance is essential to balance efforts and stakes with the principal purpose and decide on prioritisation of design decisions and selection of relevant guidelines. Finally, justification of assessment design decisions, quality assurance and external accountability close the loop, to ensure sound underpinning and continuous improvement of the assessment programme.

  20. A practice guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: referral indications for cancer predisposition assessment.

    Science.gov (United States)

    Hampel, Heather; Bennett, Robin L; Buchanan, Adam; Pearlman, Rachel; Wiesner, Georgia L

    2015-01-01

    The practice guidelines of the American College of Medical Genetics and Genomics (ACMG) and the National Society of Genetic Counselors (NSGC) are developed by members of the ACMG and NSGC to assist medical geneticists, genetic counselors, and other health-care providers in making decisions about appropriate management of genetic concerns, including access to and/or delivery of services. Each practice guideline focuses on a clinical or practice-based issue and is the result of a review and analysis of current professional literature believed to be reliable. As such, information and recommendations within the ACMG and NSGC joint practice guidelines reflect the current scientific and clinical knowledge at the time of publication, are current only as of their publication date, and are subject to change without notice as advances emerge. In addition, variations in practice, which take into account the needs of the individual patient and the resources and limitations unique to the institution or type of practice, may warrant approaches, treatments, and/or procedures that differ from the recommendations outlined in this guideline. Therefore, these recommendations should not be construed as dictating an exclusive course of management, nor does the use of such recommendations guarantee a particular outcome. Genetic counseling practice guidelines are never intended to displace a health-care provider's best medical judgment based on the clinical circumstances of a particular patient or patient population. Practice guidelines are published by the ACMG or the NSGC for educational and informational purposes only, and neither the ACMG nor the NSGC "approve" or "endorse" any specific methods, practices, or sources of information.Cancer genetic consultation is an important aspect of the care of individuals at increased risk of a hereditary cancer syndrome. Yet several patient, clinician, and system-level barriers hinder identification of individuals appropriate for cancer genetics

  1. Epidemiological and clinical assessment of a shared territorial malaria guideline in the 10 years of its implementation (Barcelona, North Metropolitan Area, Catalonia, Spain, 2007-2016).

    Science.gov (United States)

    Mòdol, Josep M; Roure, Sílvia; Smithson, Àlex; Fernández-Rivas, Gema; Esquerrà, Anna; Robert, Neus; Méndez, María; Ramos, Javier; Carreres, Anna; Valerio, Lluís

    2017-09-11

    Malaria remains a major source of morbi-mortality among travellers. In 2007, a consensual multicenter Primary Care-Hospital shared guideline on travel-prior chemoprophylaxis, diagnosis and clinical management of imported malaria was set up in the Barcelona North Metropolitan area. The aim of the study is to assess the evolution of malaria cases in the area as well as its clinical management over the 10 years of its implementation. A total of 190 malaria cases, all them imported, have been recorded. The overall estimated malaria crude incidence was of 0.47 cases per 10,000 population/year (95% CI 0.34-0.59) with a slight significant positive slope especially at the expense of an increase in Indian sub-continent Plasmodium vivax cases. The number of patients who attended the pre-travel consultation was low (13.7%) as well as those with prescribed chemoprophylaxis (10%). Severe malaria was diagnosed in 34 (17.9%) patients and ICU admittance was required in 2.6% of them. Organ sequelae (two renal failures and one post-acute distress respiratory syndrome) were recorded in 3 patients at hospital discharge, although all three were recovered at 30 days. None of the patients died. Patients complying with severity criteria were significantly males (p = 0.04), came from Africa (p = 0.02), were mainly non-immigrant travellers (p = 0.01) and were attended in a hospital setting (p < 0.001). The most frequently identified species was Plasmodium falciparum (64.2%), P. vivax (23.2%), Plasmodium malariae (1.6%) and Plasmodium ovale (1.1%). Those patients diagnosed with P. falciparum malaria came more often from sub-Saharan Africa (p < 0.001) and those with P. vivax came largely from the Indian sub-continent (p = 0.003). Among the 126 patients in whom an immunochromatographic antigenic test was performed, the result was interpreted as falsely negative in 12.1% of them. False negative results can be related to cases with <1% parasitaemia. After 10 years of surveillance

  2. EAU Guidelines on Chronic Pelvic Pain

    NARCIS (Netherlands)

    Fall, Magnus; Baranowski, Andrew P.; Elneil, Sohier; Engeler, Daniel; Hughes, John; Messelink, Embert J.; Oberpenning, Frank; Williams, Amanda C. de C.

    Context: These guidelines were prepared on behalf of the European Association of Urology (EAU) to help urologists assess the evidence-based management of chronic pelvic pain (CPP) and to incorporate the recommendations into their clinical practice. Objective: To revise guidelines for the diagnosis,

  3. Development of environmental guidelines for electronic appliances

    DEFF Research Database (Denmark)

    Legarth, Jens Brøbech; Alting, Leo; Erichsen, Hanne K. Linnet

    1994-01-01

    This paper presents a general method for the development of environmental guidelines for complex products. The method is based on the life cycle concept. The application of life cycle assessment methods reveals the peak environmental impacts, and their source resulting in environmental guidelines...

  4. Switchgrass Ukraine : overview of switchgrass research and guidelines

    NARCIS (Netherlands)

    Elbersen, H.W.; Kulyk, M.; Poppens, R.P.; Lesschen, J.P.; Kraisvitnii, P.; Galytska, M.; Rii, O.; Roik, M.V.; Kurylo, V.L.; Morozov, O.V.; Smirnykh, V.M.; Gorobets, A.M.; Gerasymenko, O.V.

    2013-01-01

    Between 2008 and 2013 switchgrass experiments have been conducted in Ukraine which have showed what varieties are locally adapted, how switchgrass can be established, what yields may be expected, what row space should be used, what seeding rate is optimal, etc. In the experiments the Ukrainian

  5. Indication criteria for total hip or knee arthroplasty in osteoarthritis: a state-of-the-science overview.

    Science.gov (United States)

    Gademan, Maaike G J; Hofstede, Stefanie N; Vliet Vlieland, Thea P M; Nelissen, Rob G H H; Marang-van de Mheen, Perla J

    2016-11-09

    This systematic review gives an overview of guidelines and original publications as well as the evidence on which the currently proposed indication criteria are based. Until now such a state-of-the-science overview was lacking. Websites of orthopaedic and arthritis organizations (English/Dutch language) were independently searched by two authors for THA/TKA guidelines for OA. Furthermore, a systematic search strategy in several databases through August 2014 was performed. Quality of the guidelines was assessed with the AGREE II instrument, which consists of 6 domains (maximum summed score of 6 indicating high quality). Also, the level of evidence of all included studies was assessed. We found 6 guidelines and 18 papers, out of 3065 references. The quality of the guidelines summed across 6 domains ranged from 0.46 to 4.78. In total, 12 THA, 10 TKA and 2 THA/TKA indication sets were found. Four studies stated that no evidence-based indication criteria are available. Indication criteria concerning THA/TKA consisted of the following domains: pain (in respectively 11 and 10 sets), function (12 and 7 sets), radiological changes (10 and 9 sets), failed conservative therapy (8 and 4 sets) and other indications (6 and 7 sets). Specific cut-off values or ranges were often not stated and the level of evidence was low. The indication criteria for THA/TKA are based on limited evidence. Empirical research is needed, especially regarding domain specific cut-off values or ranges at which the best postoperative outcomes are achieved for patients, taking into account the limited lifespan of a prosthesis.

  6. Assessing the effect of a guideline change on drug use prevalence by including the birth cohort dimension : the case of benzodiazepines

    NARCIS (Netherlands)

    Bijlsma, Maarten J.; Hak, Eelko; Bos, Jens; De Jong-van den Berg, Lolkje T. W.; Janssen, Fanny

    Purpose The aim of this study was to investigate whether including the birth cohort dimension in time series analysis leads to a more accurate estimation of the (long-term) effect of a guideline change on the trend of benzodiazepine use. Methods We calculated age-specific (20-84years) and

  7. Evidence at a glance: error matrix approach for overviewing available evidence

    DEFF Research Database (Denmark)

    Keus, Frederik; Wetterslev, Jørn; Gluud, Christian

    2010-01-01

    Clinical evidence continues to expand and is increasingly difficult to overview. We aimed at conceptualizing a visual assessment tool, i.e., a matrix for overviewing studies and their data in order to assess the clinical evidence at a glance....

  8. How to develop guidelines for clinical practice.

    Science.gov (United States)

    Jaeschke, R; Jankowski, M; Brozek, J; Antonelli, M

    2009-09-01

    Recent decades have seen an explosion of clinical practice guidelines documents developed to inform clinicians about the best options for managing treatment, with the explicit intent to influence behaviour. As our exposure to guidelines has increased it has become clear that the process of guideline development should follow specific rules in order to avoid disagreement, misunderstanding, misleading recommendations, and confusion. In this article, we review the approach to developing clinical practice guidelines suggested by an international Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) workgroup. This approach suggests several steps for guideline development: 1. determine the purpose, scope, and intended audience; 2. select the panel of guideline authors; 3. specify the main focused clinical questions that the recommendations will address; 4. decide on the relative importance of outcomes; 5. find and summarize the evidence supporting each recommendation; 6. determine the quality of the available evidence; 7. evaluate the balance of desirable and undesirable consequences for a particular course of action; 8. formulate recommendations, including their strenght; and 9. consider a system for subsequent guideline implementation and evaluation. We aim to help the readers of practice guidelines asses those guidelines' quality and validity, as well as to assist the authors of future guidelines in systematically generating clinical recommendations.

  9. Overview of the Esophagus

    Science.gov (United States)

    ... Esophagitis Esophageal Pouches (Diverticula) Esophageal Spasm Gastroesophageal Reflux Disease (GERD) Hiatus Hernia Infection of the Esophagus Propulsion Disorders of the Throat Overview of Injuries ...

  10. Case-based educational intervention to assess change in providers' knowledge and attitudes towards the 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline.

    Science.gov (United States)

    Pokharel, Yashashwi; Steinberg, Lynne; Chan, Winston; Akeroyd, Julia M; Jones, Peter H; Nambi, Vijay; Nasir, Khurram; Petersen, Laura; Ballantyne, Christie M; Virani, Salim S

    2016-03-01

    Prior studies have shown provider-level knowledge gaps regarding the 2013 American College of Cardiology/American Heart Association guideline on the treatment of cholesterol and concerns about 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation. The effect of an educational intervention to mitigate knowledge gaps is unknown. We developed a questionnaire and administered it to providers before (pre-training) and after (post-training) a case-based educational intervention across 6 sites in Texas. The intervention highlighted the key recommendations of the 2013 guideline and the differences from the prior guideline mainly using clinical-vignettes. Several practice pertinent items were also discussed. Most participants were providers-in-training (78%) in internal medicine (68%). Compared to pre-training, the post-training metrics were: 43% vs. 82% for providers' ability to identify 4 statin benefit groups; 47% vs. 97% for their awareness of the ASCVD risk threshold of ≥ 7.5% to initiate discussion about risks/benefits of statin therapy; 9% vs. 40% for awareness of differences between the Framingham and the ASCVD risk estimator; 26% vs. 78% for awareness of the definition of statin intensity; 35% vs. 62% for using a repeat lipid panel to document treatment response and adherence; and 46% vs. 81% for confidence in using the ASCVD risk estimator, respectively. A case-based educational intervention was associated with significant increase in providers' knowledge towards the 2013 cholesterol guideline, which could be related to the engaging nature of our intervention, using practice pertinent information and clinical vignettes. Such interventions could be useful in effective dissemination of the cholesterol guideline. Published by Elsevier Ireland Ltd.

  11. Case-based Educational Intervention to Assess Change in Providers’ Knowledge and Attitudes Towards the 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline

    Science.gov (United States)

    Pokharel, Yashashwi; Steinberg, Lynne; Chan, Winston; Akeroyd, Julia M.; Jones, Peter H.; Nambi, Vijay; Nasir, Khurram; Petersen, Laura; Ballantyne, Christie M.; Virani, Salim S.

    2017-01-01

    Objective Prior studies have shown provider-level knowledge gaps regarding the 2013 American College of Cardiology/American Heart Association guideline on the treatment of cholesterol and concerns about 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation. The effect of an educational intervention to mitigate knowledge gaps is unknown. Methods We developed a questionnaire and administered it to providers before (pre-training) and after (post-training) a case-based educational intervention across 6 sites in Texas. The intervention highlighted the key recommendations of the 2013 guideline and the differences from the prior guideline mainly using clinical-vignettes. Several practice pertinent items were also discussed. Results Most participants were providers-in-training (78%) in internal medicine (68%). Compared to pre-training, the post-training metrics were: 43% vs. 82% for providers’ ability to identify 4 statin benefit groups; 47% vs. 97% for their awareness of the ASCVD risk threshold of ≥7.5% to initiate discussion about risks/benefits of statin therapy; 9% vs. 40% for awareness of differences between the Framingham and the ASCVD risk estimator; 26% vs. 78% for awareness of the definition of statin intensity; 35% vs. 62% for using a repeat lipid panel to document treatment response and adherence; and 46% vs. 81% for confidence in using the ASCVD risk estimator, respectively. Conclusions A case-based educational intervention was associated with significant improvements in providers’ knowledge and attitudes towards the 2013 cholesterol guideline, which could be related to the engaging nature of our intervention, using practice pertinent information and clinical vignettes. Such interventions could be useful in effective dissemination of the cholesterol guideline. PMID:26773472

  12. Biosimilars in Developed and Developing East and Southeast Asian Countries: Japan, South Korea, and Malaysia—Overview, Evolution, and Regulations Assessment

    Science.gov (United States)

    Bas, Tomas Gabriel; Oliu Castillo, Carolina

    2016-01-01

    The development of biological products has experienced continuous growth over the past three decades. The expiration of patent protection for many biological medicines has led to the development of biosimilars in many countries around the world. This paper reviews the literature on biosimilar drugs and covers their therapeutic status, clinical trials, approved biosimilars, and regulatory guidelines in Japan, South Korea, and Malaysia. The literature suggests that biosimilars are comparable but not identical to the reference product. They are not a generic version of an innovative product and do not ensure therapeutic equivalence. Biosimilars present more challenges than conventional generics and their marketing approval is also much more complicated. Guidelines for biosimilars were published in Japan in July 2009 by the Ministry of Health, Labour and Welfare (MHLW), in South Korea in March 2009 by the Ministry of Food and Drug Safety (MFDS), and in Malaysia in July 2008 by the National Pharmaceutical Control Bureau (NPCB). PMID:27213153

  13. Biosimilars in Developed and Developing East and Southeast Asian Countries: Japan, South Korea, and Malaysia—Overview, Evolution, and Regulations Assessment

    Directory of Open Access Journals (Sweden)

    Tomas Gabriel Bas

    2016-01-01

    Full Text Available The development of biological products has experienced continuous growth over the past three decades. The expiration of patent protection for many biological medicines has led to the development of biosimilars in many countries around the world. This paper reviews the literature on biosimilar drugs and covers their therapeutic status, clinical trials, approved biosimilars, and regulatory guidelines in Japan, South Korea, and Malaysia. The literature suggests that biosimilars are comparable but not identical to the reference product. They are not a generic version of an innovative product and do not ensure therapeutic equivalence. Biosimilars present more challenges than conventional generics and their marketing approval is also much more complicated. Guidelines for biosimilars were published in Japan in July 2009 by the Ministry of Health, Labour and Welfare (MHLW, in South Korea in March 2009 by the Ministry of Food and Drug Safety (MFDS, and in Malaysia in July 2008 by the National Pharmaceutical Control Bureau (NPCB.

  14. Physical Activity Guidelines

    Science.gov (United States)

    ... use this site. health.gov Physical Activity Guidelines Physical Activity Physical activity is key to improving the health of the Nation. Based on the latest science, the Physical Activity Guidelines for Americans is an essential resource for ...

  15. Interpreting procedures from descriptive guidelines.

    Science.gov (United States)

    Peleg, Mor; Gutnik, Lily A; Snow, Vincenza; Patel, Vimla L

    2006-04-01

    Errors in clinical practice guidelines may translate into errors in real-world clinical practice. The best way to eliminate these errors is to understand how they are generated, thus enabling the future development of methods to catch errors made in creating the guideline before publication. We examined the process by which a medical expert from the American College of Physicians (ACP) created clinical algorithms from narrative guidelines, as a case study. We studied this process by looking at intermediate versions produced during the algorithm creation. We identified and analyzed errors that were generated at each stage, categorized them using Knuth's classification scheme, and studied patterns of errors that were made over the set of algorithm versions that were created. We then assessed possible explanations for the sources of these errors and provided recommendations for reducing the number of errors, based on cognitive theory and on experience drawn from software engineering methodologies.

  16. Integrated Medical Model Overview

    Science.gov (United States)

    Myers, J.; Boley, L.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.; Saile, L.; hide

    2015-01-01

    The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project.

  17. Nonmedical interventions for children with ASD: recommended guidelines and further research needs.

    Science.gov (United States)

    Maglione, Margaret A; Gans, Daphna; Das, Lopamudra; Timbie, Justin; Kasari, Connie

    2012-11-01

    To use the findings of a systematic review of scientific evidence to develop consensus guidelines on nonmedical interventions that address cognitive function and core deficits in children with autism spectrum disorders (ASDs) and to recommend priorities for future research. The guidelines were developed by a Technical Expert Panel (TEP) consisting of practitioners, researchers, and parents. A systematic overview of research findings was presented to the TEP; guideline statements were drafted, discussed, debated, edited, reassessed, and presented for formal voting. The strength of evidence of efficacy varied by intervention type from insufficient to moderate. There was some evidence that greater intensity of treatment (hours per week) and greater duration (in months) led to better outcomes. The TEP agreed that children with ASD should have access to at least 25 hours per week of comprehensive intervention to address social communication, language, play skills, and maladaptive behavior. They agreed that applied behavioral analysis, integrated behavioral/developmental programs, the Picture Exchange Communication System, and various social skills interventions have shown efficacy. Based on identified gaps, they recommend that future research focus on assessment and monitoring of outcomes, addressing the needs of pre/nonverbal children and adolescents, and identifying the most effective strategies, dose, and duration to improve specific core deficits. The creation of treatment guidelines and recommendations for future research represents an effort by leading experts to improve access to services for children with ASDs while acknowledging that the research evidence has many gaps.

  18. Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach.

    Science.gov (United States)

    Zhang, Yuan; Coello, Pablo Alonso; Brożek, Jan; Wiercioch, Wojtek; Etxeandia-Ikobaltzeta, Itziar; Akl, Elie A; Meerpohl, Joerg J; Alhazzani, Waleed; Carrasco-Labra, Alonso; Morgan, Rebecca L; Mustafa, Reem A; Riva, John J; Moore, Ainsley; Yepes-Nuñez, Juan José; Cuello-Garcia, Carlos; AlRayees, Zulfa; Manja, Veena; Falavigna, Maicon; Neumann, Ignacio; Brignardello-Petersen, Romina; Santesso, Nancy; Rochwerg, Bram; Darzi, Andrea; Rojas, Maria Ximena; Adi, Yaser; Bollig, Claudia; Waziry, Reem; Schünemann, Holger J

    2017-05-02

    There are diverse opinions and confusion about defining and including patient values and preferences (i.e. the importance people place on the health outcomes) in the guideline development processes. This article aims to provide an overview of a process for systematically incorporating values and preferences in guideline development. In 2013 and 2014, we followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to adopt, adapt and develop 226 recommendations in 22 guidelines for the Ministry of Health of the Kingdom of Saudi Arabia. To collect context-specific values and preferences for each recommendation, we performed systematic reviews, asked clinical experts to provide feedback according to their clinical experience, and consulted patient representatives. We found several types of studies addressing the importance of outcomes, including those reporting utilities, non-utility measures of health states based on structured questionnaires or scales, and qualitative studies. Guideline panels used the relative importance of outcomes based on values and preferences to weigh the balance of desirable and undesirable consequences of alternative intervention options. However, we found few studies addressing local values and preferences. Currently there are different but no firmly established processes for integrating patient values and preferences in healthcare decision-making of practice guideline development. With GRADE Evidence-to-Decision (EtD) frameworks, we provide an empirical strategy to find and incorporate values and preferences in guidelines by performing systematic reviews and eliciting information from guideline panel members and patient representatives. However, more research and practical guidance are needed on how to search for relevant studies and grey literature, assess the certainty of this evidence, and best summarize and present the findings.

  19. An Overview of Dental Radiology. NCHCT Monograph Series.

    Science.gov (United States)

    Manny, Edward F.; And Others

    This overview of dental radiology contains sections on demographics, equipment, dental radiology quality assurance, efficacy, dental radiology education curricula, professional organizations' guidelines for training and use, and state activities. In section 1 dental personnel, population of dental personnel, employment and earning prospects,…