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

African Journals Online (AJOL)

guidelines for treatment of HIV exist,[1] which integrate scientific ... Ordinarily, subjective approaches such as interviews and selfreport ... for assessing adherence to these guidelines using objective evidence ..... HIV InSite Knowledge Base.

The new hypertension guidelines.

Science.gov (United States)

Stern, Ralph H

2013-10-01

The Canadian Hypertension Education Program (CHEP) has published guidelines annually since 2000. The CHEP guidelines are a model of concise, comprehensive, up-to-date, evidence-rated guidelines for physicians who diagnose and treat hypertension. The guidelines address measurement of blood pressure and the definition of hypertension, secondary hypertension evaluation and treatment, and blood pressure targets and medication choices in patients with and without compelling indications. This review describes CHEP's process for developing guidelines and provides an overview of the 2013 recommendations. ©2013 Wiley Periodicals, Inc.

Evaluation process of global environmental impact: assessment guidelines

International Nuclear Information System (INIS)

Memon, A.R.; Mahar, R.B.

2001-01-01

In developed and developing countries, the EIA (Environmental Impact Assessment) is becoming mandatory for the approval of Industrial projects and projects of Environmental hazards. The approving authority of each country has its own guidelines to get projects approved and make project proponents responsible to submit Environmental Impact Statement for the its detailed assessment. In this paper authors have studied an existing EIA Global guidelines and its evaluation process of altogether 40 countries from four continents, Asia, Pacific/Middle East, Europe, Australia and America/Canada. This evaluation process is recorded in the tabulation form and it has been formulated stage wise in which stage one highlights the inception of EIA guidelines of each country and stage two and three gives implementation process. The inception stage of guidelines gives an idea that when EIA was started and an implementation stages provide all information that when EIA become a part of legislation that provide an opportunity to the reader to understand the decision making process for project approvals. The main objective of writing EIA guidelines is to monitor the sustain ability of various types of the projects under different sectoral guidelines, therefore Projects related with different Sectors have been chosen and a detailed record in tabulation form gives an idea to understand the interaction of these guidelines. To make this paper more comprehensive, authors have gone thorough the sectoral guidelines of altogether 64 countries and studied 21 sector oriented project fields. These are of Agriculture/Irrigation, Biodiversity, Coastal/Marine, Community Participation, Extractive industries, Fisheries, Forestry, Hazard Risk, Health, Human settlement, Industry, Multi sectorial, Ports and Harbors, Power, refugees/resettlement, Social, Strategies/Planning, Tourism/Recreational, transportation, Waste Pollution and Wetlands/Water resources. (author)

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.

Guidelines for Camouflage Assessment Using Observers

NARCIS (Netherlands)

Ronconi, P.; Jacobs, P.A.M.; Mauer, E.; Huebner, G.; Dotoli, P.; Peak, J.E.; Hepfinger, L.; Balma, R.; Christopher, G.; Fleuriet, J.; Honke, T.

2007-01-01

The objective of SCI-095 was to advance alternative techniques for determining the camouflage effectiveness of military systems reliably at reduced cost. SCI-095 produced “Guidelines for Camouflage Assessment Using Observers” which is a standardized methodology for observerbased tests and

Radioactive waste disposal assessment - overview of biosphere processes and models

International Nuclear Information System (INIS)

Coughtrey, P.J.

1992-09-01

This report provides an overview of biosphere processes and models in the general context of the radiological assessment of radioactive waste disposal as a basis for HMIP's response to biosphere aspects of Nirex's submissions for disposal of radioactive wastes in a purpose-built repository at Sellafield, Cumbria. The overview takes into account published information from the UK as available from Nirex's safety and assessment research programme and HMIP's disposal assessment programme, as well as that available from studies in the UK and elsewhere. (Author)

An overview of the DOE high-level waste storage tank structural integrity assessment guidelines

International Nuclear Information System (INIS)

Bandyopadhyay, K.; Bush, S.; Kassir, M.; Mather, B.; Shewmon, P.; Streicher, M.; Thompson, B.; van Rooyen, D.; Weeks, J.

1995-01-01

The basic elements of a structural integrity program for high-level waste storage tanks include identifying significant aging degradation mechanisms, developing programs to monitor and control these degradation processes, and developing management options and procedures to minimize impact on the environment should tank leakage develop. A Waste Tank Structural Integrity Panel (TSIP) was established by Brookhaven National Laboratory at the request of the DOE Office of Environmental Restoration and Waste Management to review these elements and prepare a set of guidelines that could be used by DOE and its contractors to manage the structural integrity of these tanks. These guidelines emphasize the identification of significant degradation mechanisms for both the steel and concrete components of the tanks, the recommended monitoring and inspection programs, and the indicated management options

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.

Guidelines for selecting codes for ground-water transport modeling of low-level waste burial sites. Volume 1. Guideline approach

International Nuclear Information System (INIS)

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

[Development of "assessment guideline of family power for healthy life"].

Science.gov (United States)

Fukushima, M; Shimanouchi, S; Kamei, T; Takagai, E; Hoshino, Y; Sugiyama, I

1997-12-01

The purpose of this study is to develop "assessment guideline of family power for healthy life" aiming at expanding self-care power of family in community nursing practice. The subjects of this study covered those families in one hundred and fifty six instances that we had seized as subject for nursing care and study. The method of this study had constructed assessment guideline inductively out of each case, and modified it by applying to cases of families with health problems and others. As a result, we had formed nine items of "family power for healthy life" and three items of "conditions influencing family power for healthy life" for "assessment guideline of family power for healthy life".

Overview and status of Department of Energy siting guidelines

International Nuclear Information System (INIS)

Hanlon, C.

1984-01-01

One of the initial requirements of the Nuclear Waste Policy Act of 1982 was the development of siting guidelines for use in the selection of repository sites. The key issues raised during the consultation process are summarized as follows: the use of NRC and EPA regulations; the application of the guidelines in the siting process; the structure and specificity of the guidelines; the relationship between system and technical guidelines; the use of the systems approach in evaluating the overall performance of the repository system; the relative importance of individual guidelines; the degree of reliance placed on engineered barriers; impacts on the local population; impacts on the environment; protection of ground-water resources; and transportation. All of these issues were considered in revising the guidelines, and the responses to them are summarized in general terms

Functional-Based Assessment of Social Behavior: Introduction and Overview.

Science.gov (United States)

Lewis, Timothy J.; Sugai, George

1994-01-01

This introduction to and overview of a special issue on social behavior assessment within schools discusses the impact of function-based methodologies on assessment and intervention practices in identification and remediation of challenging social behaviors. (JDD)

Measure Guideline. Steam System Balancing and Tuning for Multifamily Residential Buildings

Energy Technology Data Exchange (ETDEWEB)

Choi, Jayne [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States); Ludwig, Peter [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States); Brand, Larry [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States)

2013-04-01

This guideline provides building owners, professionals involved in multifamily audits, and contractors insights for improving the balance and tuning of steam systems. It provides readers an overview of one-pipe steam heating systems, guidelines for evaluating steam systems, typical costs and savings, and guidelines for ensuring quality installations. It also directs readers to additional resources for details not included here. Measures for balancing a distribution system that are covered include replacing main line vents and upgrading radiator vents. Also included is a discussion on upgrading boiler controls and the importance of tuning the settings on new or existing boiler controls. The guideline focuses on one-pipe steam systems, though many of the assessment methods can be generalized to two-pipe steam systems.

[Brief overview of the guidelines for the use of 24 hour ambulatory blood pressure monitoring (ABPM)].

Science.gov (United States)

Shimada, Kazuyuki

2014-08-01

The guidelines for the use of ambulatory blood pressure monitoring published from Japanese Circulation Society in 2010 was briefly overviewed. The accuracy of devices now used in clinical practice in Japan is of sufficient grade. The thresholds for hypertension diagnosis based on ABPM have been determined with international concensus. The evaluation of ABPM data and the clinical indications for ABPM are suggested. Particularly, white-coat hypertension, masked hypertension, nocturnal hypertension, morning hypertension and diurnal blood pressure variation are conditions for which ABPM is very useful for the detection, treatment decision and follow-up. Hypertension treatment would be very much improved by the introduction of ABPM into clinical practice.

An overview of performance assessment methodology

International Nuclear Information System (INIS)

Hongnian Jow

2010-01-01

The definition of performance assessment (PA) within the context of a geologic repository program is a post-closure safety assessment; a system analysis of hazards associated with the facility and the ability of the site and the design of the facility to provide for the safety functions. For the last few decades, PA methodology bas been developed and applied to different waste disposal programs around the world. PA has been used in the safety analyses for waste disposal repositories for low-level waste, intermediate level waste, and high-level waste including spent nuclear fuels. This paper provides an overview of the performance assessment methodology and gives examples of its applications for the Yucca Mountain Project. (authors)

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

Probiotic guidelines and physician practice: a cross-sectional survey and overview of the literature.

Science.gov (United States)

Draper, K; Ley, C; Parsonnet, J

2017-08-24

Probiotic use by patients and physicians has dramatically increased over the last decade, although definitive evidence is often lacking for their use. We examined probiotic-prescribing practices among health care providers (HCP) at a tertiary medical centre and compared these practices to clinical guidelines. HCP at the Stanford Medical Center received a survey on probiotic prescribing practices including choice of probiotic and primary indications. A broad overview of the literature was performed. Among 2,331 HCP surveyed, 632 responded. Of the 582 of these who routinely prescribed medications, 61% had recommended probiotic foods or supplements to their patients. Women and gastroenterologists were more likely to prescribe probiotics (odds ratio (OR): 1.5, 95% confidence interval (CI): 1.0-2.1; OR: 3.9, 95% CI: 1.5-10.1, respectively). Among probiotic prescribers, 50% prescribed inconsistently or upon patient request, and 40% left probiotic choice to the patient. Common indications for probiotics, particularly Lactobacillus GG, were prevention and treatment of antibiotic-associated diarrhoea (79 and 66%, respectively). Probiotics were often prescribed for 'general bowel health' or at patient request (27 and 39% of responders, respectively). Most respondents (63%) thought an electronic medical record (EMR) pop-up would change probiotic prescribing patterns. However, a review of published guidelines and large trials found inconsistencies in probiotic indications, dosages and strain selection. Probiotic prescribing is common but lacks consistency, with choice of probiotic frequently left to the patient, even for indications with some strain-specific evidence. Implementation of EMR pop-ups/pocket guides may increase consistency in probiotic prescribing, although the lack of clear and consistent guidelines must first be addressed with large, well-designed clinical trials.

Guidelines for pressure vessel safety assessment

Science.gov (United States)

Yukawa, S.

1990-04-01

A technical overview and information on metallic pressure containment vessels and tanks is given. The intent is to provide Occupational Safety and Health Administration (OSHA) personnel and other persons with information to assist in the evaluation of the safety of operating pressure vessels and low pressure storage tanks. The scope is limited to general industrial application vessels and tanks constructed of carbon or low alloy steels and used at temperatures between -75 and 315 C (-100 and 600 F). Information on design codes, materials, fabrication processes, inspection and testing applicable to the vessels and tanks are presented. The majority of the vessels and tanks are made to the rules and requirements of ASME Code Section VIII or API Standard 620. The causes of deterioration and damage in operation are described and methods and capabilities of detecting serious damage and cracking are discussed. Guidelines and recommendations formulated by various groups to inspect for the damages being found and to mitigate the causes and effects of the problems are presented.

[The German Program for Disease Management Guidelines: COPD Guideline 2006. Short review].

Science.gov (United States)

Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika

2007-01-15

In Germany, the first national consensus on evidence-based recommendations for COPD prevention and disease management was reached in spring 2006. After a development period of 9 months, the National Disease Management Guideline COPD was finalized by nominal group process under the authorship of the scientific societies for pneumology (DGP and Atemwegsliga), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the NICE COPD Guideline 2004, the GOLD Recommendations as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline COPD 2006 (www.copd.versorgungsleitlinien.de).

Health impact assessment: A comparison of 45 local, national, and international guidelines

International Nuclear Information System (INIS)

Hebert, Katherine A.; Wendel, Arthur M.; Kennedy, Sarah K.; Dannenberg, Andrew L.

2012-01-01

This article provides a comparison of health impact assessment (HIA) guidelines from around the world and for multiple geographic scales. We identify commonalities and differences within HIA guides to discuss the plausibility of consensus guidelines and to inform guideline development. The practice of HIA has grown over the last two decades with a concurrent growth of HIA guides. This study expands on earlier review work and includes guides published since 2007 (Mindell, Boltong and Forde, 2008). From April 2010 to October 2011, 45 HIA guides were identified through an internet search and review of previous research. Common characteristics, key features, and the HIA process were analyzed. The 45 documents recommended similar but not identical processes for conducting HIAs. These analyses suggest that guidelines for HIAs are similar in many areas of the world and that new HIA practitioners can use these findings to inform their approach. Further discussion is needed to determine if the approaches established in these guidelines are followed and if one set of common guidelines could be written for use in numerous countries and regions. - Highlights: ► We analyze 45 health impact assessment (HIA) guidelines worldwide. ► We examine similarities and unique attributes of each guideline. ► We discuss the advantages and disadvantages of developing consensus guidelines. ► Identifying additional guidelines aides in future HIA work and evaluation.

AN OVERVIEW OF SWEDISH RESEARCH ON IMPACT ASSESSMENT

OpenAIRE

CHARLOTTA FAITH-ELL

2015-01-01

This statement aims at giving an overview of the research on impact assessment in Sweden. It takes a point of departure at the introduction of impact assessment in 1991 describing the Swedish research until today. Since the introduction of EIA in the Swedish legislation in the 1990s, a large number of PhD dissertations have been dealing with various aspects of impact assessment. An estimation based on the literature search is that about 20 PhD theses, in which the core of the research is rela...

Optimal Pain Assessment in Pediatric Rehabilitation: Implementation of a Nursing Guideline.

Science.gov (United States)

Kingsnorth, Shauna; Joachimides, Nick; Krog, Kim; Davies, Barbara; Higuchi, Kathryn Smith

2015-12-01

In Ontario, Canada, the Registered Nurses' Association promotes a Best Practice Spotlight Organization initiative to enhance evidence-based practice. Qualifying organizations are required to implement strategies, evaluate outcomes, and sustain practices aligned with nursing clinical practice guidelines. This study reports on the development and evaluation of a multifaceted implementation strategy to support adoption of a nursing clinical practice guideline on the assessment and management of acute pain in a pediatric rehabilitation and complex continuing care hospital. Multiple approaches were employed to influence behavior, attitudes, and awareness around optimal pain practice (e.g., instructional resources, electronic reminders, audits, and feedback). Four measures were introduced to assess pain in communicating and noncommunicating children as part of a campaign to treat pain as the fifth vital sign. A prospective repeated measures design examined survey and audit data to assess practice aligned with the guideline. The Knowledge and Attitudes Survey (KNAS) was adapted to ensure relevance to the local practice setting and was assessed before and after nurses' participation in three education modules. Audit data included client demographics and pain scores assessed annually over a 3-year window. A final sample of 69 nurses (78% response rate) provided pre-/post-survey data. A total of 108 pediatric surgical clients (younger than 19 years) contributed audit data across the three collection cycles. Significant improvements in nurses' knowledge, attitudes, and behaviors related to optimal pain care for children with disabilities were noted following adoption of the pain clinical practice guideline. Targeted guideline implementation strategies are central to supporting optimal pain practice. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Design Guidelines for Low Crested Structures

DEFF Research Database (Denmark)

Burcharth, H. F.; Lamberti, Alberto

2004-01-01

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......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...

Curriculum Guidelines for Periodontics.

Science.gov (United States)

Journal of Dental Education, 1985

1985-01-01

Guidelines 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)

An overview of clinical guidelines for the management of vertebral compression fracture: a systematic review.

Science.gov (United States)

Parreira, Patrícia C S; Maher, Chris G; Megale, Rodrigo Z; March, Lyn; Ferreira, Manuela L

2017-12-01

Vertebral compression fractures (VCFs) are the most common type of osteoporotic fracture comprising approximately 1.4 million cases worldwide. Clinical practice guidelines can be powerful tools for promoting evidence-based practice as they integrate research findings to support decision making. However, currently available clinical guidelines and recommendations, established by different medical societies, are sometimes contradictory. The aim of this study was to appraise the recommendations and the methodological quality of international clinical guidelines for the management of VCFs. This is a systematic review of clinical guidelines for the management of VCF. Guidelines were selected by searching MEDLINE and PubMed, PEDro, CINAHL, and EMBASE electronic databases between 2010 and 2016. We also searched clinical practice guideline databases, including the National Guideline Clearinghouse and the Canadian Medical Association InfoBase. The methodological quality of the guidelines was assessed by two authors independently using the Appraisal of Guidelines, Research and Evaluation (AGREE) II Instrument. We also classified the strength of each recommendation as either strong (ie, based on high-quality studies with consistent findings for recommending for or against the intervention), weak (ie, based on a lack of compelling evidence resulting in uncertainty for benefit or potential harm), or expert consensus (ie, based on expert opinion of the working group rather than on scientific evidence). Guideline recommendations were grouped into diagnostic, conservative care, interventional care, and osteoporosis treatment and prevention of future fractures. Our study was prospectively registered on PROSPERO. Four guidelines from three countries, published in the period 2010-2013, were included. In general, the quality was not satisfactory (50% or less of the maximum possible score). The domains scoring 50% or less of the maximum possible score were rigor of development, clarity

Clinical practice guidelines and consensus statements in oncology--an assessment of their methodological quality.

Directory of Open Access Journals (Sweden)

Carmel Jacobs

Full Text Available Consensus statements and clinical practice guidelines are widely available for enhancing the care of cancer patients. Despite subtle differences in their definition and purpose, these terms are often used interchangeably. We systematically assessed the methodological quality of consensus statements and clinical practice guidelines published in three commonly read, geographically diverse, cancer-specific journals. Methods Consensus statements and clinical practice guidelines published between January 2005 and September 2013 in Current Oncology, European Journal of Cancer and Journal of Clinical Oncology were evaluated. Each publication was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II rigour of development and editorial independence domains. For assessment of transparency of document development, 7 additional items were taken from the Institute of Medicine's standards for practice guidelines and the Journal of Clinical Oncology guidelines for authors of guidance documents.Consensus statements and clinical practice guidelines published between January 2005 and September 2013 in Current Oncology, European Journal of Cancer and Journal of Clinical Oncology were evaluated. Each publication was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II rigour of development and editorial independence domains. For assessment of transparency of document development, 7 additional items were taken from the Institute of Medicine's standards for practice guidelines and the Journal of Clinical Oncology guidelines for authors of guidance documents.Thirty-four consensus statements and 67 clinical practice guidelines were evaluated. The rigour of development score for consensus statements over the three journals was 32% lower than that of clinical practice guidelines. The editorial independence score was 15% lower for consensus statements than clinical practice guidelines. One journal scored

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.

Guidelines for international plutonium management: Overview and implications

International Nuclear Information System (INIS)

Bryson, M.C.; Fitzgerald, C.P.; Kincaid, C.

1998-01-01

In September, 1997, nine of the world's plutonium-using countries agreed to a set of guidelines for international plutonium management, with acceptances to be submitted to the International Atomic Energy Agency on December 1. Following three years of discussion, the guidelines provide a unified package of accepted rules for the storage, handling, and transportation of civil plutonium as well as military plutonium that has been declared as no longer required for defense purposes. New requirements include a formal declaration of national plutonium strategies, which will recognize the environmental, economic, and proliferation concerns and the consequent importance of balancing plutonium supply and demand. Nations will also make annual declaration of their non-military stockpiles of unirradiated plutonium, together with estimates of the plutonium content in spent reactor fuel. These guidelines represent the first formally accepted recognition of the need for plutonium management of this scope and could thus provide a partial basis for future monitoring and policy regimes

Empirical evaluation of the Process Overview Measure for assessing situation awareness in process plants.

Science.gov (United States)

Lau, Nathan; Jamieson, Greg A; Skraaning, Gyrd

2016-03-01

The Process Overview Measure is a query-based measure developed to assess operator situation awareness (SA) from monitoring process plants. A companion paper describes how the measure has been developed according to process plant properties and operator cognitive work. The Process Overview Measure demonstrated practicality, sensitivity, validity and reliability in two full-scope simulator experiments investigating dramatically different operational concepts. Practicality was assessed based on qualitative feedback of participants and researchers. The Process Overview Measure demonstrated sensitivity and validity by revealing significant effects of experimental manipulations that corroborated with other empirical results. The measure also demonstrated adequate inter-rater reliability and practicality for measuring SA in full-scope simulator settings based on data collected on process experts. Thus, full-scope simulator studies can employ the Process Overview Measure to reveal the impact of new control room technology and operational concepts on monitoring process plants. Practitioner Summary: The Process Overview Measure is a query-based measure that demonstrated practicality, sensitivity, validity and reliability for assessing operator situation awareness (SA) from monitoring process plants in representative settings.

Assessment of EPRI water chemistry guidelines for new nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Kim, K.; Fruzzetti, K.; Garcia, S. [Electric Power Research Inst., Palo Alto, California (United States); Eaker, R. [Richard W. Eaker, LLC, Matthews, North Carolina (United States); Giannelli, J.; Tangen, J. [Finetech, Inc., Parsippany, New Jersey (United States); Gorman, J.; Marks, C. [Dominion Engineering, Inc., Reston, Virginia (United States); Sawochka, S. [NWT Corp., San Jose, California (United States)

2010-07-01

Water chemistry control technologies for nuclear power plants have been significantly enhanced over the past few decades to improve material and equipment reliability and fuel performance, and to minimize radionuclide production and transport. Chemistry Guidelines have been developed by the Electric Power Research Institute (EPRI) for current operating plants and have been intermittently revised over the past twenty-five years for the protection of systems and components and for radiation management. As new plants are being designed for improved safety and increased power production, it is important to ensure that the designs consider implementation of industry approved water chemistry controls. In parallel, the industry will need to consider and develop updated water chemistry guidelines as well as plant startup and operational strategies based on the advanced plant designs. In 2010, EPRI began to assess chemistry control strategies at advanced plants, based on the Design Control Documents (DCDs), Combined Construction and Operating License Applications (COLA), and operating experiences (where they exist) against current Water Chemistry Guidelines. Based on this assessment, differences between planned chemistry operations at new plants and the current Guidelines will be identified. This assessment will form the basis of future activities to address these differences. The project will also assess and provide, as feasible, water chemistry guidance for startup and hot functional testing of the new plants. EPRI will initially assess the GE-Hitachi/Toshiba ABWR and the Westinghouse AP1000 designs. EPRI subsequently plans to assess other plant designs such as the AREVA U.S. EPR, Mitsubishi Heavy Industries (MHI) U.S. APWR, and GE-Hitachi (GE-H) ESBWR. This paper discusses the 2010 assessments of the ABWR and AP1000. (author)

Assessment of EPRI water chemistry guidelines for new nuclear power plants

International Nuclear Information System (INIS)

Kim, K.; Fruzzetti, K.; Garcia, S.; Eaker, R.; Giannelli, J.; Tangen, J.; Gorman, J.; Marks, C.; Sawochka, S.

2010-01-01

Water chemistry control technologies for nuclear power plants have been significantly enhanced over the past few decades to improve material and equipment reliability and fuel performance, and to minimize radionuclide production and transport. Chemistry Guidelines have been developed by the Electric Power Research Institute (EPRI) for current operating plants and have been intermittently revised over the past twenty-five years for the protection of systems and components and for radiation management. As new plants are being designed for improved safety and increased power production, it is important to ensure that the designs consider implementation of industry approved water chemistry controls. In parallel, the industry will need to consider and develop updated water chemistry guidelines as well as plant startup and operational strategies based on the advanced plant designs. In 2010, EPRI began to assess chemistry control strategies at advanced plants, based on the Design Control Documents (DCDs), Combined Construction and Operating License Applications (COLA), and operating experiences (where they exist) against current Water Chemistry Guidelines. Based on this assessment, differences between planned chemistry operations at new plants and the current Guidelines will be identified. This assessment will form the basis of future activities to address these differences. The project will also assess and provide, as feasible, water chemistry guidance for startup and hot functional testing of the new plants. EPRI will initially assess the GE-Hitachi/Toshiba ABWR and the Westinghouse AP1000 designs. EPRI subsequently plans to assess other plant designs such as the AREVA U.S. EPR, Mitsubishi Heavy Industries (MHI) U.S. APWR, and GE-Hitachi (GE-H) ESBWR. This paper discusses the 2010 assessments of the ABWR and AP1000. (author)

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.

Training Requirements in OSHA Standards and Training Guidelines. Revised.

Science.gov (United States)

Occupational Safety and Health Administration, Washington, DC.

This guide provides an overview of Occupational Safety and Health Act (OSHA) standards and training guidelines for various industries. The first section introduces the concept of voluntary training guidelines, explaining that the guidelines are designed to help employers determine whether a worksite problem can be solved by training, what training…

[The German program for disease management guidelines: type 2 diabetes--diabetic retinopathy/maculopathy guideline 2006. Short review].

Science.gov (United States)

Ollenschläger, Günter; Kopp, Ina; Thole, Henning; Lelgemann, Monika

2007-02-15

In Germany, the first national consensus between six medical scientific associations on evidence-based recommendations for prevention and therapy of retinopathy/maculopathy in type 2 diabetes was reached in fall 2006. The recommendations' main sources are the NICE Retinopathy Guideline 2002, and existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Type 2 Diabetes-Retinopathy/Maculopathy 2006 (www.diabetes.versorgungsleitlinien.de).

Human engineering guidelines for the evaluation and assessment of Video Display Units

International Nuclear Information System (INIS)

Gilmore, W.E.

1985-07-01

This report provides the Nuclear Regulatory Commission with a single source that documents known guidelines for conducting formal Human Factors evaluations of Video Display Units (VDUs). The handbook is a ''cookbook'' of acceptance guidelines for the reviewer faced with the task of evaluating VDUs already designed or planned for service in the control room. The areas addressed are video displays, controls, control/display integration, and workplace layout. Guidelines relevant to each of those areas are presented. The existence of supporting research is also indicated for each guideline. A Comment section and Method for Assessment section are provided for each set of guidelines

[The German Program for Disease Management Guidelines: CHD Guideline 2006. Short review].

Science.gov (United States)

Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

2006-12-15

In Germany, the first national consensus on evidence-based recommendations for disease management in patients with chronic coronary heart disease was reached in summer 2006. After a development period of 4 years, the National Disease Management Guideline Chronic Coronary Heart Disease was finalized by nominal group process under the authorship of the scientific associations for cardiac rehabilitation (DGPR), cardiac surgery (DGTHG), cardiology (DGK), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the ACC/AHA guidelines 2002 updates as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Chronic Coronary Heart Disease 2006 (www.khk.versorgungsleitlinie.de).

Comparing guidelines for adjuvant endocrine therapy in postmenopausal women with breast cancer: a coming of age.

Science.gov (United States)

Verma, Sunil; Jackisch, Christian

2011-02-01

Following surgery for early breast cancer, the standard of care for postmenopausal women is adjuvant therapy with any combination of radiation therapy, endocrine therapy, chemotherapy and/or targeted therapy. Clinicians rely on many tools, including guidelines, to make these treatment decisions. Such guidelines include the St Gallen consensus statement, the American Society of Clinical Oncology guidelines and the National Comprehensive Cancer Network guidelines, as well as various regional and national guidelines. Recommendations may vary, because different methods and criteria were used to assess the strength of supporting data. This article provides an overview of global guidelines for the adjuvant treatment of breast cancer and points out the major differences. Ongoing changes are highlighted, particularly those regarding the adjuvant endocrine treatment of postmenopausal women with breast cancer. While previous guidelines recommended tamoxifen alone, all major guidelines now recommend using third-generation aromatase inhibitors either in sequence with tamoxifen or as upfront treatment.

An overview of environment Canada's National Incinerator Testing and Evaluation Program (NITEP)

International Nuclear Information System (INIS)

Finkelstein, A.

1991-01-01

In response to the many concerns associated with incineration, Environment Canada established the National Incineration Testing and evaluation Program (NITEP) in 1984. It's mission was to assess the incineration process as a means for disposal of MSW in Canada. The program primarily focused on the environment and health impacts of MSW incinerators by determining how design and operating conditions can be modified to reduce emissions of concern. In addition to developing better measuring and monitoring methods, supporting ash residue management research programs, NITEP established four major field projects to develop the data base necessary for national guidelines. This paper presents a brief overview of the most significant field program findings over the past six years and the rationale for the Canadian Council of Ministers of the Environment (CCME) Operating and Emissions Guidelines for MSW Incinerators published in June of 1989. In addition an overview of the ash work completed to date, and work still underway, will be presented

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

Science.gov (United States)

2012-07-31

... ENVIRONMENTAL PROTECTION AGENCY Notice of Availability of Microbial Risk Assessment Guideline: Pathogenic Microorganisms With Focus on Food and Water AGENCY: Environmental Protection Agency (EPA). ACTION... risk assessment and also promote consistency in approaches and methods. The MRA Guideline can be...

Guidelines for the Assessment Process (GAP): A proposal for discussion

NARCIS (Netherlands)

Ferná ndez-Ballesteros, R.; Bruyn, E.E.J. De; Gody, A.; Hornke, L.F.; Laak, J. ter; Vizcarro, C.; Westhoff, K.; Westmeyer, H.; Zaccagnini, J.L.

2001-01-01

Current existing or proposed standards and guidelines in the field of psychological assessment are confined to psychological tests and psychological testing. But tests constitute only one category of psychological assessment procedures, and testing is only one of many available strategies or classes

WOCN 2016 Guideline for Prevention and Management of Pressure Injuries (Ulcers): An Executive Summary.

Science.gov (United States)

This article provides an executive summary of recommendations from the 2016 Guideline for Prevention and Management of Pressure Ulcers (Injuries) published by the Wound, Ostomy and Continence Nurses Society (WOCN). It presents an overview of the process used to update and develop the guideline, and lists the specific recommendations from the guideline for assessment, prevention, and treatment of pressure injuries. The guideline is a resource for physicians, nurses, therapists, and other healthcare professionals who work with adults who have/or are at risk for pressure injuries. The full text of the published guideline, which includes the available evidence supporting the recommendations and a complete reference list, is available from the Wound, Ostomy and Continence Nurses Society, 1120 Rt 73, Ste 200, Mount Laurel, NJ 08054; Web site: www.wocn.org. Refer to the Supplemental Digital Content (http://links.lww.com/JWOCN/A38) associated with this article for a complete reference list for the guideline. The guideline has been accepted for inclusion in the National Guideline Clearinghouse (www.guideline.gov/).

Reliability of assessment of adherence to an antimicrobial treatment guideline

NARCIS (Netherlands)

Mol, PGM; Gans, ROB; Panday, PVN; Degener, JE; Laseur, M; Haaijer-Ruskamp, FM

Assessment procedures for adherence to a guideline must be reliable and credible. The aim of this study was to explore the reliability of assessment of adherence, taking account of the professional backgrounds of the observers. A secondary analysis explored the impact of case characteristics on

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

African Journals Online (AJOL)

Overview of water resource assessment in South Africa: Current state and future challenges. ... These studies illustrate how the exponential growth in computer power and the concomitant development of highly sophisticated tools have changed the manner in which our water resources have been appraised, allowing us to ...

32 CFR 806b.2 - Basic guidelines.

Science.gov (United States)

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Basic guidelines. 806b.2 Section 806b.2 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE ADMINISTRATION PRIVACY ACT PROGRAM Overview of the Privacy Act Program § 806b.2 Basic guidelines. This part implements the Privacy Act of 1974...

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.

Guidelines for the on-site assessment of historic timber structures

NARCIS (Netherlands)

Cruz, H.; Yeomans, D.; Tsakanika, E.; Macchioni, N.; Jorissen, A.J.M.; Touza, M.; Mannucci, M.; Lourenco, P.B.

2014-01-01

In the scope of COST IE0601-WoodCulther (http://www.woodculther.org) it was agreed to produce Guidelines for the Assessment of Historic Timber Structures, covering the principles and possible approaches for the safety assessment of old timber structures of historical relevance, that could be used as

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

Assessment and diffusion of medical innovations in France: an overview.

Science.gov (United States)

Dubromel, Amélie; Geffroy, Loïc; Aulagner, Gilles; Dussart, Claude

2018-01-01

Background: In France, a significant part of health expenditure is publicly funding. This put a heavy burden on society. In an economic context requiring tight control of public spending, it seems relevant to control the diffusion of medical innovations. That is why health technology assessment is subject to an increasing interest at national level for management and approval decisions. This article provides an overview of the assessment and diffusion of medical innovation in France. Method: The data are extracted from French authorities or organisations websites and documents and from French legislative texts. In addition, regarding discussion, a search in MEDLINE database was carried out. Results: An overview of the assessment and diffusion of medical innovation in France is given by presenting the different types of medical innovations according to French health system definition (I); introducing French authorities participating to health technology assessment and describe assessment procedures of medical innovations (II); and giving details about market access process of innovative health product in France (III). Key opportunities and challenges of medical innovation assessment and diffusion in France are discussed at the end of this article. Conclusion: In France, medical innovation is considered as a crucial component for quality of care and performance of healthcare system. The aim of health technology assessment is to promote a secure and timely access to innovation for patients. Nevertheless, it appears necessary to improve regulatory mechanisms.

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

African Journals Online (AJOL)

Overview of water resource assessment in South Africa: Current state and future challenges. ... a helpful Frequently Asked Questions about PDFs. Alternatively, you can download the PDF file directly to your computer, from where it can be opened using a PDF reader. To download the PDF, click the Download link above.

Preliminary Guideline for the High Temperature Structure Integrity Assessment Procedure Part II. High Temperature Structural Integrity Assessment

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 high temperature structural integrity assessment belongs to the Part II of a whole preliminary guideline for the high temperature structure. The main contents of this guideline are the evaluation procedures of the creep-fatigue crack initiation and growth in high temperature condition, the high temperature LBB evaluation procedure, and the inelastic evaluations of the welded joints in SFR structures. The methodologies for the proper inelastic analysis of an SFR structures in high temperatures are explained and the guidelines of inelastic analysis options using ANSYS and ABAQUS are suggested. In addition, user guidelines for the developed NONSTA code are included. This guidelines need to be continuously revised to improve the applicability to the design and analysis of the SFR structures.

Portfolio assessment and evaluation: implications and guidelines for clinical nursing education.

Science.gov (United States)

Chabeli, M M

2002-08-01

With the advent of Outcomes-Based Education in South Africa, the quality of nursing education is debatable, especially with regard to the assessment and evaluation of clinical nursing education, which is complex and renders the validity and reliability of the methods used questionable. This paper seeks to explore and describe the use of portfolio assessment and evaluation, its implications and guidelines for its effective use in nursing education. Firstly, the concepts of assessment, evaluation, portfolio and alternative methods of evaluation are defined. Secondly, a comparison of the characteristics of the old (traditional) methods and the new alternative methods of evaluation is made. Thirdly, through deductive analysis, synthesis and inference, implications and guidelines for the effective use of portfolio assessment and evaluation are described. In view of the qualitative, descriptive and exploratory nature of the study, a focus group interview with twenty students following a post-basic degree at a university in Gauteng regarding their perceptions on the use of portfolio assessment and evaluation method in clinical nursing education was used. A descriptive method of qualitative data analysis of open coding in accordance with Tesch's protocol (in Creswell 1994:155) was used. Resultant implications and guidelines were conceptualised and described within the existing theoretical framework. Principles of trustworthiness were maintained as described by (Lincoln & Guba 1985:290-327). Ethical considerations were in accordance with DENOSA's standards of research (1998:7).

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.

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.

RELAP5 assessment: conclusions and user guidelines

International Nuclear Information System (INIS)

Kmetyk, L.N.

1984-10-01

The RELAP5 independent assessment project at Sandia National Laboratories is part of an overall effort funded by the NRC to determine the ability of various systems codes to predict the detailed thermal/hydraulic response of LWRs during accident and off-normal conditions. The RELAP5/MOD1 code has been assessed at Sandia against a variety of test data from both integral and separate effects test facilities. All these analyses have been documented in detail in individual topical reports; in this paper we attempt to evaluate the overall code performance by comparing results from many different calculations, and to offer other users some guidelines based on our experience to date

[How to assess clinical practice guidelines with AGREE II: The example of neonatal jaundice].

Science.gov (United States)

Renesme, L; Bedu, A; Tourneux, P; Truffert, P

2016-03-01

Neonatal jaundice is a very frequent condition that occurs in approximately 50-70% of term or near-term (>35 GA) babies in the 1st week of life. In some cases, a high bilirubin blood level can lead to kernicterus. There is no consensus for the management of neonatal jaundice and few countries have published national clinical practice guidelines for the management of neonatal jaundice. The aim of this study was to assess the quality of these guidelines. We conducted a systematic review of the literature for national clinical practice guidelines for the management of neonatal jaundice in term or near-term babies. Four independent reviewers assessed the quality of each guideline using the AGREE II evaluation. For each of the clinical practice guidelines, the management modalities were analyzed (screening, treatment, follow-up, etc.). Seven national clinical practice guidelines were found (South Africa, USA AAP, UK NICE, Canada, Norway, Switzerland, and Israel). The AGREE II score showed widespread variation regarding the quality of these national guidelines. There was no major difference between the guidelines concerning the clinical management of these babies. The NICE guideline is the most valuable guideline regarding the AGREE II score. NICE showed that, despite a strong and rigorous methodology, there is no evidenced-based recommended code of practice (RCP). Comparing RCPs, we found no major differences. The NICE guideline showed the best quality. The AGREE II instrument should be used as a framework when developing clinical practice guidelines to improve the quality of the future guideline. In France, a national guideline is needed for a more standardized management of neonatal jaundice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

OSART Independent Safety Culture Assessment (ISCA) Guidelines

International Nuclear Information System (INIS)

2016-01-01

Safety culture is understood as an important part of nuclear safety performance. This has been demonstrated by the analysis of significant events such as Chernobyl, Davis Besse, Vandellos II, Asco, Paks, Mihamma and Forsmark, among others. In order to enhance safety culture, one essential activity is to perform assessments. IAEA Safety Standard Series No. GS-R-3, The Management System for Facilitites and Activities, states requirements for continuous improvement of safety culture, of which self, peer and independent safety culture assessments constitute an essential part. In line with this requirement, the Independent Safety Culture Assessment (ISCA) module is offered as an add-on module to the IAEA Operational Safety Review Team (OSART) programme. The OSART programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. By including the ISCA module in an OSART mission, the receiving organization benefits from the synergy between the technical and the safety culture aspects of the safety review. The joint operational safety and safety culture assessment provides the organization with the opportunity to better understand the interactions between technical, human, organizational and cultural aspects, helping the organization to take a systemic approach to safety through identifying actions that fully address the root causes of any identified issue. Safety culture assessments provide insight into the fundamental drivers that shape organizational patterns of behaviour, safety consciousness and safety performance. The complex nature of safety culture means that the analysis of the results of such assessments is not as straightforward as for other types of assessment. The benefits of the results of nuclear safety culture assessments are maximized only if appropriate tools and guidance for these assessments is used; hence, this comprehensive guideline has been developed. The methodology explained

Medication and monitoring in palliative sedation therapy: a systematic review and quality assessment of published guidelines.

Science.gov (United States)

Schildmann, Eva Katharina; Schildmann, Jan; Kiesewetter, Isabel

2015-04-01

Palliative sedation therapy (PST) is increasingly used in patients at the end of life. However, consensus about medications and monitoring is lacking. To assess published PST guidelines with regard to quality and recommendations on drugs and monitoring. We searched CINAHL, the Cochrane Library, Embase, PsycINFO, PubMed, and references of included articles until July 2014. Search terms included "palliative sedation" or "sedation" and "guideline" or "policy" or "framework." Guideline selection was based on English or German publications that included a PST guideline. Two investigators independently assessed the quality of the guidelines according to the Appraisal of Guidelines for Research and Evaluation II instrument (AGREE II) and extracted information on drug selection and monitoring. Nine guidelines were eligible. Eight guidelines received high quality scores for the domain "scope and purpose" (median 69%, range 28-83%), whereas in the other domains the guidelines' quality differed considerably. The majority of guidelines suggest midazolam as drug of first choice. Recommendations on dosage and alternatives vary. The guidelines' recommendations regarding monitoring of PST show wide variation in the number and details of outcome parameters and methods of assessment. The published guidelines on PST vary considerably regarding their quality and content on drugs and monitoring. Given the need for clear guidance regarding PST in patients at the end of life, this comparative analysis may serve as a starting point for further improvement. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Guidelines for Providing Accommodations Using CASAS Assessment for Learners with Disabilities

Science.gov (United States)

CASAS - Comprehensive Adult Student Assessment Systems (NJ1), 2005

2005-01-01

These guidelines address methods for administering Comprehensive Adult Student Assessment System (CASAS) assessments using accommodations for learners with documented disabilities. The suggested accommodations for disability categories include provisions for: (1) Accommodations in test administration procedures; and (2) Use of appropriate CASAS…

Guideline appraisal with AGREE II: online survey of the potential influence of AGREE II items on overall assessment of guideline quality and recommendation for use.

Science.gov (United States)

Hoffmann-Eßer, Wiebke; Siering, Ulrich; Neugebauer, Edmund A M; Brockhaus, Anne Catharina; McGauran, Natalie; Eikermann, Michaela

2018-02-27

The AGREE II instrument is the most commonly used guideline appraisal tool. It includes 23 appraisal criteria (items) organized within six domains. AGREE II also includes two overall assessments (overall guideline quality, recommendation for use). Our aim was to investigate how strongly the 23 AGREE II items influence the two overall assessments. An online survey of authors of publications on guideline appraisals with AGREE II and guideline users from a German scientific network was conducted between 10th February 2015 and 30th March 2015. Participants were asked to rate the influence of the AGREE II items on a Likert scale (0 = no influence to 5 = very strong influence). The frequencies of responses and their dispersion were presented descriptively. Fifty-eight of the 376 persons contacted (15.4%) participated in the survey and the data of the 51 respondents with prior knowledge of AGREE II were analysed. Items 7-12 of Domain 3 (rigour of development) and both items of Domain 6 (editorial independence) had the strongest influence on the two overall assessments. In addition, Items 15-17 (clarity of presentation) had a strong influence on the recommendation for use. Great variations were shown for the other items. The main limitation of the survey is the low response rate. In guideline appraisals using AGREE II, items representing rigour of guideline development and editorial independence seem to have the strongest influence on the two overall assessments. In order to ensure a transparent approach to reaching the overall assessments, we suggest the inclusion of a recommendation in the AGREE II user manual on how to consider item and domain scores. For instance, the manual could include an a-priori weighting of those items and domains that should have the strongest influence on the two overall assessments. The relevance of these assessments within AGREE II could thereby be further specified.

Insights from Guideline for Performance of Internal Flooding Probabilistic Risk Assessment (IFPRA)

International Nuclear Information System (INIS)

Choi, Sun Yeong; Yang, Joo Eon

2009-01-01

An internal flooding (IF) risk assessment refers to the quantitative probabilistic safety assessment (PSA) treatment of flooding as a result of pipe and tank breaks inside the plants, as well as from other recognized flood sources. The industry consensus standard for Internal Events Probabilistic Risk Assessment (ASME-RA-Sb-2005) includes high-level and supporting technical requirements for developing internal flooding probabilistic risk assessment (IFPRA). This industry standard is endorsed in Regulatory Guide 1.200, Revision 1 as an acceptable approach for addressing the risk contribution from IF events for risk informed applications that require U.S. Nuclear Regulatory commission (NRC) approval. In 2006, EPRI published a draft report for IFPRA that addresses the requirements of the ASME PRA consensus standard and have made efforts to refine and update the final EPRI IFPRA guideline. Westinghouse has performed an IFPRA analysis for several nuclear power plants (NPPs), such as Watts Bar and Fort Calhoun, using the draft EPRI guidelines for development of an IFPRA. Proprietary methodologies have been developed to apply the EPRI guidelines. The objectives of the draft report for IFPRA guideline are to: · Provide guidance for PSA practitioners in the performance of the elements of a PRA associated with internal flooding events consistent with the current state of the art for internal flooding PRA · Provide guidance regarding acceptable approaches that is sufficient to meeting the requirements of the ASME PRA Standard associated with internal flooding · Incorporate lessons learned in the performance of internal flooding PRAs including those identified as pilot applications of earlier drafts of this procedures guide The purpose of this paper is to present a vision for domestic nuclear power plants' IFPRA by comparing the method of the draft EPRI guidelines with the existing IFPRA method for domestic NPPs

Insights from Guideline for Performance of Internal Flooding Probabilistic Risk Assessment (IFPRA)

Energy Technology Data Exchange (ETDEWEB)

Choi, Sun Yeong; Yang, Joo Eon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2009-10-15

An internal flooding (IF) risk assessment refers to the quantitative probabilistic safety assessment (PSA) treatment of flooding as a result of pipe and tank breaks inside the plants, as well as from other recognized flood sources. The industry consensus standard for Internal Events Probabilistic Risk Assessment (ASME-RA-Sb-2005) includes high-level and supporting technical requirements for developing internal flooding probabilistic risk assessment (IFPRA). This industry standard is endorsed in Regulatory Guide 1.200, Revision 1 as an acceptable approach for addressing the risk contribution from IF events for risk informed applications that require U.S. Nuclear Regulatory commission (NRC) approval. In 2006, EPRI published a draft report for IFPRA that addresses the requirements of the ASME PRA consensus standard and have made efforts to refine and update the final EPRI IFPRA guideline. Westinghouse has performed an IFPRA analysis for several nuclear power plants (NPPs), such as Watts Bar and Fort Calhoun, using the draft EPRI guidelines for development of an IFPRA. Proprietary methodologies have been developed to apply the EPRI guidelines. The objectives of the draft report for IFPRA guideline are to: {center_dot} Provide guidance for PSA practitioners in the performance of the elements of a PRA associated with internal flooding events consistent with the current state of the art for internal flooding PRA {center_dot} Provide guidance regarding acceptable approaches that is sufficient to meeting the requirements of the ASME PRA Standard associated with internal flooding {center_dot} Incorporate lessons learned in the performance of internal flooding PRAs including those identified as pilot applications of earlier drafts of this procedures guide The purpose of this paper is to present a vision for domestic nuclear power plants' IFPRA by comparing the method of the draft EPRI guidelines with the existing IFPRA method for domestic NPPs.

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

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…

Operational safety review programmes for nuclear power plants. Guidelines for assessment

International Nuclear Information System (INIS)

2002-01-01

The IAEA has been offering the Operational Safety Review Team (OSART) programme to provide advice and assistance to Member States in enhancing the operational safety of nuclear power plants (NPPs). Simultaneously, the IAEA has encouraged self-assessment and review by Member States of their own nuclear power plants to continuously improve nuclear safety. Currently, some utilities have been implementing safety review programmes to independently review their own plants. Corporate or national operational safety review programmes may be compliance or performance based. Successful utilities have found that both techniques are necessary to provide assurance that (i) as a minimum the NPP meets specific corporate and legal requirements and (ii) management at the NPP is encouraged to pursue continuous improvement principles. These programmes can bring nuclear safety benefits to the plants and utilities. The IAEA has conducted two pilot missions to assess the effectiveness of the operational review programme. Based on these missions and on the experience gained during OSART missions, this document has been developed to provide guidance on and broaden national/corporate safety review programmes in Member States, and to assist in maximizing their benefits. These guidelines are intended primarily for the IAEA team to conduct assessment of a national/corporate safety review programme. However, this report may also be used by a country or utility to establish its own national/corporate safety review programme. The guidelines may likewise be used for self-assessment or for establishing a baseline when benchmarking other safety review programmes. This report consists of four parts. Section 2 addresses the planning and preparation of an IAEA assessment mission and Sections 3 and 4 deal with specific guidelines for conducting the assessment mission itself

Curriculum Guidelines for Clinical Dental Hygiene.

Science.gov (United States)

Journal of Dental Education, 1985

1985-01-01

The American Association of Dental Schools curriculum guidelines for clinical dental hygiene include definitions, notes on the interrelationship of courses, an overview of course objectives, and suggested primary educational goals, prerequisites, core content, specific objectives, sequencing, faculty, and facilities. (MSE)

ISRIA statement: ten-point guidelines for an effective process of research impact assessment.

Science.gov (United States)

Adam, Paula; Ovseiko, Pavel V; Grant, Jonathan; Graham, Kathryn E A; Boukhris, Omar F; Dowd, Anne-Maree; Balling, Gert V; Christensen, Rikke N; Pollitt, Alexandra; Taylor, Mark; Sued, Omar; Hinrichs-Krapels, Saba; Solans-Domènech, Maite; Chorzempa, Heidi

2018-02-08

As governments, funding agencies and research organisations worldwide seek to maximise both the financial and non-financial returns on investment in research, the way the research process is organised and funded is becoming increasingly under scrutiny. There are growing demands and aspirations to measure research impact (beyond academic publications), to understand how science works, and to optimise its societal and economic impact. In response, a multidisciplinary practice called research impact assessment is rapidly developing. Given that the practice is still in its formative stage, systematised recommendations or accepted standards for practitioners (such as funders and those responsible for managing research projects) across countries or disciplines to guide research impact assessment are not yet available.In this statement, we propose initial guidelines for a rigorous and effective process of research impact assessment applicable to all research disciplines and oriented towards practice. This statement systematises expert knowledge and practitioner experience from designing and delivering the International School on Research Impact Assessment (ISRIA). It brings together insights from over 450 experts and practitioners from 34 countries, who participated in the school during its 5-year run (from 2013 to 2017) and shares a set of core values from the school's learning programme. These insights are distilled into ten-point guidelines, which relate to (1) context, (2) purpose, (3) stakeholders' needs, (4) stakeholder engagement, (5) conceptual frameworks, (6) methods and data sources, (7) indicators and metrics, (8) ethics and conflicts of interest, (9) communication, and (10) community of practice.The guidelines can help practitioners improve and standardise the process of research impact assessment, but they are by no means exhaustive and require evaluation and continuous improvement. The prima facie effectiveness of the guidelines is based on the systematised

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...

Guidelines for indoor air hygiene in school buildings

Energy Technology Data Exchange (ETDEWEB)

Moriske, Heinz-Joern; Szewzyk, Regine (eds.)

2008-08-15

The new guidelines for indoor air hygiene in school buildings are intended as a response to current requirements in school practice. The recommendations aim to help to avoid mistakes in modernising school buildings and to provide hygiene-specific support in planning of new school buildings. The guidelines are laid out as follows: (a) In the general section the targets of the guidelines and the target groups are addressed. The current indoor hygiene situation in German schools is described, followed by the parameters with regard to peripheral issues which will not be dealt with further; (b) Part A deals with the hygiene requirements in the practical running of schools. Besides general requirements for maintenance and operation the important issues of cleaning and ventilation are considered, as well as minor building works; (c) Part B provides an overview of important chemical and biological contaminants in schools; (d) Part C looks at building and air conditioning requirements. The important issues of acoustic requirements is also addressed; (e) Part D shows how to deal practically with problem cases and list case studies with 'typical' procedures; (f) Part E provides a brief overview of existing renovation guidelines.

Guidelines for indoor air hygiene in school buildings

Energy Technology Data Exchange (ETDEWEB)

Moriske, Heinz-Joern; Szewzyk, Regine [eds.

2008-08-15

The new guidelines for indoor air hygiene in school buildings are intended as a response to current requirements in school practice. The recommendations aim to help to avoid mistakes in modernising school buildings and to provide hygiene-specific support in planning of new school buildings. The guidelines are laid out as follows: (a) In the general section the targets of the guidelines and the target groups are addressed. The current indoor hygiene situation in German schools is described, followed by the parameters with regard to peripheral issues which will not be dealt with further; (b) Part A deals with the hygiene requirements in the practical running of schools. Besides general requirements for maintenance and operation the important issues of cleaning and ventilation are considered, as well as minor building works; (c) Part B provides an overview of important chemical and biological contaminants in schools; (d) Part C looks at building and air conditioning requirements. The important issues of acoustic requirements is also addressed; (e) Part D shows how to deal practically with problem cases and list case studies with 'typical' procedures; (f) Part E provides a brief overview of existing renovation guidelines.

Overview of a performance assessment methodology for low-level radioactive waste disposal facilities

International Nuclear Information System (INIS)

Kozak, M.W.; Chu, M.S.Y.

1991-01-01

A performance assessment methodology has been developed for use by the US Nuclear Regulatory Commission in evaluating license applications for low-level waste disposal facilities. This paper provides a summary and an overview of the modeling approaches selected for the methodology. The overview includes discussions of the philosophy and structure of the methodology. This performance assessment methodology is designed to provide the NRC with a tool for performing confirmatory analyses in support of license reviews related to postclosure performance. The methodology allows analyses of dose to individuals from off-site releases under normal conditions as well as on-site doses to inadvertent intruders. 24 refs., 1 tab

Conceptual Models and Guidelines for Clinical Assessment of Financial Capacity.

Science.gov (United States)

Marson, Daniel

2016-09-01

The ability to manage financial affairs is a life skill of critical importance, and neuropsychologists are increasingly asked to assess financial capacity across a variety of settings. Sound clinical assessment of financial capacity requires knowledge and appreciation of applicable clinical conceptual models and principles. However, the literature has presented relatively little conceptual guidance for clinicians concerning financial capacity and its assessment. This article seeks to address this gap. The article presents six clinical models of financial capacity : (1) the early gerontological IADL model of Lawton, (2) the clinical skills model and (3) related cognitive psychological model developed by Marson and colleagues, (4) a financial decision-making model adapting earlier decisional capacity work of Appelbaum and Grisso, (5) a person-centered model of financial decision-making developed by Lichtenberg and colleagues, and (6) a recent model of financial capacity in the real world developed through the Institute of Medicine. Accompanying presentation of the models is discussion of conceptual and practical perspectives they represent for clinician assessment. Based on the models, the article concludes by presenting a series of conceptually oriented guidelines for clinical assessment of financial capacity. In summary, sound assessment of financial capacity requires knowledge and appreciation of clinical conceptual models and principles. Awareness of such models, principles and guidelines will strengthen and advance clinical assessment of financial capacity. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

ASCOT guidelines revised 1996 edition. Guidelines for organizational self-assessment of safety culture and for reviews by the assessment of safety culture in organizations team

International Nuclear Information System (INIS)

1996-01-01

In order to properly assess safety culture, it is necessary to consider the contribution of all organizations which have an impact on it. Therefore, while assessing the safety culture in an operating organization it is necessary to address at least its interfaces with the local regulatory agency, utility corporate headquarters and supporting organizations. These guidelines are primarily intended for use by any organization wishing to conduct a self-assessment of safety culture. They should also serve as a basis for conducting an international peer review of the organization's self-assessment carried out by an ASCOT (Assessment of Safety Culture in Organizations Team) mission

Integrated assessment models of climate change. An incomplete overview

International Nuclear Information System (INIS)

Dowlatabadi, H.

1995-01-01

Integrated assessment is a trendy phrase that has recently entered the vocabulary of folks in Washington, DC and elsewhere. The novelty of the term in policy analysis and policy making circles belies the longevity of this approach in the sciences and past attempts at their application to policy issues. This paper is an attempt at providing an overview of integrated assessment with a special focus on policy motivated integrated assessments of climate change. The first section provides an introduction to integrated assessments in general, followed by a discussion of the bounds to the climate change issue. The next section is devoted to a taxonomy of the policy motivated models. Then the integrated assessment effort at Carnegie Mellon is described briefly. A perspective on the challenges ahead in successful representation of natural and social dynamics in integrated assessments of global climate change is presented in the final section. (Author)

Advice for acute low back pain: a comparison of what research supports and what guidelines recommend.

Science.gov (United States)

Stevens, Matthew L; Lin, Chung-Wei C; de Carvalho, Flavia A; Phan, Kevin; Koes, Bart; Maher, Chris G

2017-10-01

Advice is widely considered an effective treatment for acute low back pain (LBP); however, details on what and how to deliver this intervention is less clear. We assessed and compared clinical trials that test advice for acute LBP with practice guidelines for their completeness of reporting and concordance on the content, method of delivery, and treatment regimen of advice interventions. Systematic review. Advice randomized controlled trials were identified through a systematic search. Guidelines were taken from recent overviews of guidelines for LBP. Completeness of reporting was assessed using the Template for Intervention Description and Replication checklist. Thematic analysis was used to characterize advice interventions into topics across the aspects of content, method of delivery, and regimen. Concordance between clinical trials and guidelines was assessed by comparing the number of trials that found a statistically significant treatment effect for an intervention that included a specific advice topic with the number of guidelines recommending that topic. The median (interquartile range) completeness of reporting for clinical trials and guidelines was 8 (7-9) and 3 (2-4) out of nine items on the Template for Intervention Description and Replication checklist, respectively. Guideline recommendations were discordant with clinical trials for 50% of the advice topics identified. Completeness of reporting was less than ideal for randomized controlled trials and extremely poor for guidelines. The recommendations made in guidelines of advice for acute LBP were often not concordant with the results of clinical trials. Taken together, these findings mean that the potential clinical value of advice interventions for patients with acute LBP is probably not being realized. Copyright © 2017 Elsevier Inc. All rights reserved.

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…

Guidelines for psychosocial interventions in addictive disorders in India: An introduction and overview.

Science.gov (United States)

Murthy, Pratima

2018-02-01

While guidelines for psychosocial interventions in addictive disorders in India were earlier rooted in clinical experience and global empirical evidence, recently there have been efforts to develop guidelines for intervention based on the local needs assessments of specific populations and more appreciably, a testing of the effectiveness of the interventions. This supplement on psychosocial interventions for addictive disorders covers some of the important aspects of psychosocial interventions in five sections. Section I covers the general principles of management and specific assessment approaches, screening for cognitive dysfunction and assessment of co-morbidities. Section II focuses on specific psychosocial interventions including brief interventions, relapse prevention, cognitive behavioural interventions, psychoanalytical interventions, cognitive rehabilitation, interventions in dual disorders, marital and family therapy, psychosocial interventions for sexual dysfunction and sexual addictions. Section III describes innovative approaches including third wave therapies, video-based relapse prevention, digital technology as a tool for psychosocial interventions as well as psychosocial interventions in technological addictions. The latter part of this section also deals with psychosocial interventions in special populations including children and adolescents, women, sexual minorities and the elderly. Section IV pans into community based psychosocial interventions including community camps and workplace prevention. The need to develop task sharing through the involvement of trained health workers to deliver community and home-based interventions is highlighted. Section V underscores the ethical issues in different aspects of psychosocial intervention and the need for research in this area. Although there is a tendency to formulate addiction in either biomedical or psychosocial terms and to view interventions either as pharmacological or psychosocial, these

American National Standard: criteria and guidelines for assessing capability for surface faulting at nuclear power plant sites

International Nuclear Information System (INIS)

Anon.

1982-01-01

This standard provides applicants and consultants with criteria and guidelines for investigations directed toward the assessment of the capability for surface faulting at nuclear power plant sites. Assessment of vibratory ground motion resulting from faulting is not treated in these guidelines

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.

Assessment of EPRI water chemistry guidelines for new nuclear power plants

International Nuclear Information System (INIS)

Reid Richard; Kim Karen; McCree, Anisa; Eaker, Richard; Sawochka, Steve; Giannelli, Joe

2012-09-01

Water chemistry control technologies for nuclear power plants have been significantly enhanced over the past few decades to improve material and equipment reliability and fuel performance, and to minimize radionuclide production and transport. Chemistry Guidelines have been developed by the Electric Power Research Institute (EPRI) for currently operating plants and have been intermittently revised over the past twenty-five years for the protection of systems and components and for radiation management. As new plants are being designed for improved safety and increased power production, it is important to ensure that the designs consider implementation of state-of-the-art, industry developed water chemistry controls. In parallel, the industry will need to consider and update water chemistry guidelines as well as plant startup and operational strategies based on the advanced plant designs. EPRI has performed assessments of water chemistry control guidance or assumptions provided in design and licensing documents for several advanced plant designs. These designs include: Westinghouse AP1000 Pressurized Water Reactor AREVA US-EPR Pressurized Water Reactor Mitsubishi Nuclear Energy Systems/Mitsubishi Heavy Industries Advanced Pressurized Water Reactor Korea Hydro and Nuclear Power APR1400 Pressurized Water Reactor Toshiba Advanced Boiling Water Reactor (ABWR) General Electric-Hitachi Economic Simplified Boiling Water Reactor (ESBWR) The intent of these assessments was to identify key design differences in each of the new plant designs relative to the current operating fleet and to identify differences in water chemistry specifications or design assumptions provided in design and licensing documents for the plants in comparison to current EPRI Water Chemistry Guidelines. This paper provides a summary of the key results of these assessments. The fundamental design and operation of the advanced plants is similar to the currently operating fleet. As such, the new plants are

Draft guidelines for an environmental impact assessment small scale hydroelectric plant redevelopment

International Nuclear Information System (INIS)

1992-01-01

A pulp and paper company in St. George, New Brunswick, is proposing to redevelop an existing hydroelectric plant built around 1900. The redevelopment proposal consists of decommissioning the existing powerhouse, constructing a new powerhouse containing a 12-MW Kaplan turbine, excavating a tailrace channel, and installing a new penstock. Other design considerations include improvements to gates in the main dam for improved flood control and modifications to the trash racks to prevent potential fish mortality. The provincial environment ministry has determined that an environmental impact assessment of the potential impacts of the redevelopment was required. Guidelines to be used in the assessment process are presented, including definition of the study boundaries, prediction of environmental effects, description of methods of mitigating and compensating for anticipated impacts, a commitment to monitoring and public consultation, and submittal of terms of reference in response to final assessment guidelines. Requirements for conducting the assessment study and content of the report are also listed. 1 fig

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.

High integrity software for nuclear power plants: Candidate guidelines, technical basis and research needs. Executive summary: Volume 1

International Nuclear Information System (INIS)

Seth, S.; Bail, W.; Cleaves, D.; Cohen, H.; Hybertson, D.; Schaefer, C.; Stark, G.; Ta, A.; Ulery, B.

1995-06-01

The work documented in this report was performed in support of the US Nuclear Regulatory Commission to examine the technical basis for candidate guidelines that could be considered in reviewing and evaluating high integrity computer software used in the safety systems of nuclear power plants. The framework for the work consisted of the following software development and assurance activities: requirements specification; design; coding; verification and validation, including static analysis and dynamic testing; safety analysis; operation and maintenance; configuration management; quality assurance; and planning and management. Each activity (framework element) was subdivided into technical areas (framework subelements). The report describes the development of approximately 200 candidate guidelines that span the entire range of software life-cycle activities; the assessment of the technical basis for those candidate guidelines; and the identification, categorization and prioritization of research needs for improving the technical basis. The report has two volumes: Volume 1, Executive Summary, includes an overview of the framework and of each framework element, the complete set of candidate guidelines, the results of the assessment of the technical basis for each candidate guideline, and a discussion of research needs that support the regulatory function; Volume 2 is the main report

Development, Evaluation, and Future Directions of the Virginia Student Threat Assessment Guidelines

Science.gov (United States)

Cornell, Dewey; Allen, Korrie

2011-01-01

The Virginia Student Threat Assessment Guidelines were developed in response to studies of school shootings conducted by the U.S. Federal Bureau of Investigation, U.S. Secret Service, and U.S. Department of Education that recommended schools should adopt a threat assessment approach to prevent targeted violence. This article reviews the…

Methodology in use for the assessment of carcinogenic risk. II. Radiation. Oncology overview

International Nuclear Information System (INIS)

1983-04-01

Oncology Overviews are a service of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute, intended to facilitate and promote the exchange of information between cancer scientists by keeping them aware of literature related to their research being published by other laboratories throughout the world. Each Oncology Overview represents a survey of the literature associated with a selected area of cancer research. It contains abstracts of articles which have been selected and organized by researchers associated with the field. Contents: Assessment of carcinogenic risk from environmental and occupational exposures to ionizing radiation; Assessment of carcinogenic risk from exposure to ionizing radiation used for medical diagnosis or treatment; Assessment of carcinogenic risk from exposure to ionizing radiation following nuclear bomb explosions; Comparison of risk from radiation sources with risk from nonradiation sources; Experimental studies to assess risk of carcinogenesis following exposure to ionizing radiation; Theoretical aspects of dose-response relationships in the assessment of carcinogenic risk from exposure to ionizing radiation; Public policy and standards for acceptable risk from exposure to ionizing radiation; General reviews on the assessment of risk from exposure to ionizing radiation

Assessment of clinical guidelines for continuation treatment in major depression.

Science.gov (United States)

Nuijten, M J

2001-01-01

The primary objective of this study was to assess the appropriateness of the existing Dutch clinical guidelines for the treatment of depression from a health-economic perspective. The existing guidelines recommend continuation treatment for a period up to 9 months. The assessment was based on a Markov model using decision-analytic techniques. For this analysis we defined six mutually exclusive states defined by the existence of depression and type of treatment. The outcomes for the model were defined as: time without depression (TWD), quality-adjusted life years (QALYs), direct medical costs, and cost of lost productivity. The primary perspective of the study was that of the third-party payer, while the secondary perspective was that of the society in 1999. The probabilities of clinical events and therapeutic choices as well as the utilities were based on published literature. The medical resource use related to each state was abstracted from published literature and expert opinion. The associated 1999 unit costs of the used medical resources were derived from official Dutch tariff lists of allowable reimbursements. Indirect costs in this model were based on lost productivity only. The results of the primary analysis showed that the use of the guidelines is not cost-effective. Continuation treatment for a period of 9 months increases the total direct medical costs (NLG 1276 vs. NLG 474), decreases the costs resulting from lost productivity (NLG 304 vs. NLG 909), increases total costs (NLG 1580 vs. NLG 1383) and increases TWD (96.9% vs. 86.4%). However, continuation treatment does not change the utility outcomes (0.60 vs. 0.61 QALYs) for both treatment strategies. Hence continuation treatment is not cost-effective from either a third-party payer perspective or a societal perspective. A scenario analysis showed that an extension of the continuation treatment to maintenance treatment might result in a favorable cost-effectiveness outcome of the treatment guideline. In

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

NARCIS (Netherlands)

Menendez Blanco, Maria; Van der Veer, Gerrit; Benvenuti, Laura; Kirschner, Paul A.

2011-01-01

Menendez Blanco, M., Van der Veer, G., Benvenuti, L., & Kirschner, P. A. (2011). Design guidelines for self-assessment support for adult academic distance learning. In H-J Shalin (Ed.), Constructing self-discovery learning spaces online: scaffolding and decision making technologies (pp. 169-198).

Assessment of external costs for transport project evaluation: Guidelines in some European countries

Energy Technology Data Exchange (ETDEWEB)

Petruccelli, Umberto, E-mail: umberto.petruccelli@unibas.it

2015-09-15

Many studies about the external costs generated by the transport system have been developed in the last twenty years. To standardize methodologies and assessment procedures to be used in the evaluation of the projects, some European countries recently have adopted specific guidelines that differ from each other in some aspects even sensibly. This paper presents a critical analysis of the British, Italian and German guidelines and is aimed at cataloguing the external cost types regarded and the assessment methods indicated as well as to highlight the differences of the results, in terms of applicability and reliability. The goal is to contribute to a European standardization process that would lead to the drafting of guidelines suited for all EU countries. - Highlights: • The analyzed guidelines agree on the methods to evaluate costs from air pollution, greenhouse gases and accidents. • They recommend respectively: dose-resp. approach; costs to reduce/permit emissions; whole direct, indirect and social costs. • For noise, DE guide indicates defensive expenditure or SP methods; IT guide, SP method; UK guide, the hedonic prices one. • For on territory impact, DE guide regards only the barrier effect; the IT one, also the soil consumption and system effects. • British guide proposes a qualitative methodology to estimate the impact on various landscapes and environments.

Overview of the European Medicines Agency's Development of Product-Specific Bioequivalence Guidelines.

Science.gov (United States)

Sullivan, Jane O'; Blake, Kevin; Berntgen, Michael; Salmonson, Tomas; Welink, Jan

2017-12-05

The European Medicines Agency's (EMA) product-specific bioequivalence guidelines outline harmonized regulatory requirements for studies to demonstrate bioequivalence for products that may have particular needs due to their pharmacokinetics, in addition to those outlined in general guidance. As such they are potentially very useful to the pharmaceutical industry in the development of generic medicinal products and to regulatory authorities for harmonized decision-making. Since their introduction in 2013, EMA product-specific bioequivalence guidelines continue to increase in number, and as of June 2017, encompass a number of different pharmacotherapeutic groups and pharmaceutical forms. This article further elucidates the processes involved for stakeholders and reviews the Agency's experience with the development of these guidelines, including the scientific issues witnessed with their advancement. A comparison with the United States Food and Drug Administration approach to similar guidelines is also provided. © 2017 The Authors Clinical Pharmacology & Therapeutics published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.

Symptom relief in patients with pneumonia and dementia: implementation of a practice guideline.

Science.gov (United States)

van der Maaden, Tessa; van der Steen, Jenny T; Koopmans, Raymond T C M; Doncker, Sarah M M M; Anema, Johannes R; Hertogh, Cees M P M; de Vet, Henrica C W

2017-08-01

This study aimed to assess the degree of implementation and barriers encountered in the use of a practice guideline for optimal symptom relief for patients with dementia and pneumonia in Dutch nursing homes. A process evaluation included assessment of reach, fidelity, and dose delivered using researcher's observations, and dose received was addressed in a question "use of the practice guideline," which the physicians completed for each patient included in the study. Perceived barriers were assessed with a structured questionnaire (response 69%) and semi-structured interviews (n = 14), which were subject to qualitative content analysis. Of the 55 physicians involved in the intervention phase, 87% attended an implementation meeting; 20 physicians joined the study later (reach). The intervention was implemented as planned, and all intervention components were delivered by the researchers (fidelity and dose delivered). Thirty-six physicians included 109 patients. For 81% of the patients, the treating physician stated to have used the guideline (dose received). The guideline was perceived as providing a good overview of current practice, but some physicians had expected a more directive protocol or algorithm. Further, recommended regular observations of symptoms were rarely performed. Physician's often felt that "this is not different from what we usually do," and with the acute illness, there was not always enough time to (re)familiarize with the contents. The physicians used the practice guideline frequently despite important barriers. Future implementation may involve strategies such as multiple interactive meetings. Further, the greatest potential to alter usual practice should be emphasized, such as using observational instruments. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project.

Science.gov (United States)

2003-02-01

International interest in clinical practice guidelines has never been greater but many published guidelines do not meet the basic quality requirements. There have been renewed calls for validated criteria to assess the quality of guidelines. To develop and validate an international instrument for assessing the quality of the process and reporting of clinical practice guideline development. The instrument was developed through a multi-staged process of item generation, selection and scaling, field testing, and refinement procedures. 100 guidelines selected from 11 participating countries were evaluated independently by 194 appraisers with the instrument. Following refinement the instrument was further field tested on three guidelines per country by a new set of 70 appraisers. The final version of the instrument contained 23 items grouped into six quality domains with a 4 point Likert scale to score each item (scope and purpose, stakeholder involvement, rigour of development, clarity and presentation, applicability, editorial independence). 95% of appraisers found the instrument useful for assessing guidelines. Reliability was acceptable for most domains (Cronbach's alpha 0.64-0.88). Guidelines produced as part of an established guideline programme had significantly higher scores on editorial independence and, after the publication of a national policy, had significantly higher quality scores on rigour of development (pinternationally. The instrument is sensitive to differences in important aspects of guidelines and can be used consistently and easily by a wide range of professionals from different backgrounds. The adoption of common standards should improve the consistency and quality of the reporting of guideline development worldwide and provide a framework to encourage international comparison of clinical practice guidelines.

Guidelines for Assessment and Abatement of Asbestos-Containing Materials in Buildings.

Science.gov (United States)

Pielert, James H.; Mathey, Robert G.

This report presents guidelines, based on available information, for the assessment and abatement of asbestos-containing materials in buildings. Section 1 provides background information on the history and use of asbestos-containing products in buildings, the characteristics of asbestos fibers, products and materials containing asbestos, and…

Assessing biodiversity in arable farmland by means of indicators: an overview

Directory of Open Access Journals (Sweden)

Bockstaller Christian

2011-05-01

Full Text Available Maintaining biodiversity is one of the key issues of sustainable agriculture. It is now stated that innovation to enhance biodiversity in arable land requires operational assessment tools like indicators. The goal of the article is to provide an overview of available indicators. Besides measured indicators and simple indicators based on management data, we focus on predictive indicators derived from operational models and adapted to ex ante assessment in innovative cropping design. The possibility of use for each indicator type is discussed.

An Overview of Recent Developments in Cognitive Diagnostic Computer Adaptive Assessments

Directory of Open Access Journals (Sweden)

Alan Huebner

2010-01-01

Full Text Available Cognitive diagnostic modeling has become an exciting new field of psychometric research. These models aim to diagnose examinees' mastery status of a group of discretely defined skills, or attributes, thereby providing them with detailed information regarding their specific strengths and weaknesses. Combining cognitive diagnosis with computer adaptive assessments has emerged as an important part of this new field. This article aims to provide practitioners and researchers with an introduction to and overview of recent developments in cognitive diagnostic computer adaptive assessments.

Guidelines for interim storage of low level waste

International Nuclear Information System (INIS)

Hornibrook, C.; Castagnacci, A.; Clymer, G.; Kelly, J.; Naughton, M.; Saunders, P.; Stoner, P.; Walker, N.; Cazzolli, R.; Dettenmeier, R.; Loucks, L.; Rigsby, M.; Spall, M.; Strum, M.

1992-12-01

This report presents an overview of on-site storage of Low Level Waste while providing guidelines for using the complete Interim On-Site Storage of Low Level Waste report series. Overall, this report provides a methodology for planning and implementing on-site storage

2009 Space Shuttle Probabilistic Risk Assessment Overview

Science.gov (United States)

Hamlin, Teri L.; Canga, Michael A.; Boyer, Roger L.; Thigpen, Eric B.

2010-01-01

Loss of a Space Shuttle during flight has severe consequences, including loss of a significant national asset; loss of national confidence and pride; and, most importantly, loss of human life. The Shuttle Probabilistic Risk Assessment (SPRA) is used to identify risk contributors and their significance; thus, assisting management in determining how to reduce risk. In 2006, an overview of the SPRA Iteration 2.1 was presented at PSAM 8 [1]. Like all successful PRAs, the SPRA is a living PRA and has undergone revisions since PSAM 8. The latest revision to the SPRA is Iteration 3. 1, and it will not be the last as the Shuttle program progresses and more is learned. This paper discusses the SPRA scope, overall methodology, and results, as well as provides risk insights. The scope, assumptions, uncertainties, and limitations of this assessment provide risk-informed perspective to aid management s decision-making process. In addition, this paper compares the Iteration 3.1 analysis and results to the Iteration 2.1 analysis and results presented at PSAM 8.

ARN Training on Advance Methods for Internal Dose Assessment: Application of Ideas Guidelines

International Nuclear Information System (INIS)

Rojo, A.M.; Gomez Parada, I.; Puerta Yepes, N.; Gossio, S.

2010-01-01

Dose assessment in case of internal exposure involves the estimation of committed effective dose based on the interpretation of bioassay measurement, and the assumptions of hypotheses on the characteristics of the radioactive material and the time pattern and the pathway of intake. The IDEAS Guidelines provide a method to harmonize dose evaluations using criteria and flow chart procedures to be followed step by step. The EURADOS Working Group 7 'Internal Dosimetry', in collaboration with IAEA and Czech Technical University (CTU) in Prague, promoted the 'EURADOS/IAEA Regional Training Course on Advanced Methods for Internal Dose Assessment: Application of IDEAS Guidelines' to broaden and encourage the use of IDEAS Guidelines, which took place in Prague (Czech Republic) from 2-6 February 2009. The ARN identified the relevance of this training and asked for a place for participating on this activity. After that, the first training course in Argentina took place from 24-28 August for training local internal dosimetry experts. This paper resumes the main characteristics of this activity. (authors) [es

Baby steps in the prevention of childhood obesity: IOM guidelines for pediatric practice.

Science.gov (United States)

Gaffney, Kathleen F; Kitsantas, Panagiota; Brito, Albert; Kastello, Jennifer

2014-01-01

The aim of this paper is to present an overview of the infancy-related guidelines from the Institute of Medicine (IOM, 2011) report “Early Childhood Obesity Prevention Policies” and highlight research studies that support their implementation in pediatric practice. Findings from recent studies of infant growth monitoring, feeding, sleep, and physical activity are presented. Research strategies that may be applied to today's clinical assessments and interventions are specified. Participation by pediatric nurses in the development of future multi-component interventions to prevent rapid infant weight gain is recommended.

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,…

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

Guideline for load and resistance assessment of existing european railway bridges

OpenAIRE

JENSEN, Jens S; CASAS, Joan R; KAROUMI, Raid; PLOS, Mario; CREMONA, Christian; MELBOURNE, Clive

2008-01-01

Many of the European railway bridges are getting close to the end of their service life. At the same time the railway operators demand higher axle loads for freight trains and higher speeds for passenger trains. This requires new and better approaches for assessing both the railway loads and the resistance of railway bridges. The main objective of the "Guideline for Load and Resistance Assessment of Existing European Railway Bridges", developed within EU founded project "Sustainable Bridge...

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

ARN Training Course on Advance Methods for Internal Dose Assessment: Application of Ideas Guidelines

International Nuclear Information System (INIS)

Rojo, A.M.; Gomez Parada, I.; Puerta Yepes, N.; Gossio, S.

2010-01-01

Dose assessment in case of internal exposure involves the estimation of committed effective dose based on the interpretation of bioassay measurement, and the assumptions of hypotheses on the characteristics of the radioactive material and the time pattern and the pathway of intake. The IDEAS Guidelines provide a method to harmonize dose evaluations using criteria and flow chart procedures to be followed step by step. The EURADOS Working Group 7 'Internal Dosimetry', in collaboration with IAEA and Czech Technical University (CTU) in Prague, promoted the 'EURADOS/IAEA Regional Training Course on Advanced Methods for Internal Dose Assessment: Application of IDEAS Guidelines' to broaden and encourage the use of IDEAS Guidelines, which took place in Prague (Czech Republic) from 2-6 February 2009. The ARN identified the relevance of this training and asked for a place for participating on this activity. After that, the first training course in Argentina took place from 24-28 August for training local internal dosimetry experts. (authors)

Framework for technical assessment in JR Maglev

Energy Technology Data Exchange (ETDEWEB)

Seki, Akio [Central Japan Railway Co., Tokyo (Japan); Akahoshi, Toru [Central Japan Railway Co., Tokyo (Japan); Furuki, Tsutomu [Railway Technical Research Inst., Tokyo (Japan)

1995-12-31

In the course of development of JR Maglev, various technical assessments are carried out at each stage of development by a system management group of a project team in order to achieve goals of development. For the purpose, guidelines for practicality assessment were prepared at design stage. It is now striven to make test plans necessary for the practicality assessment. This assessment will serve for those to be ultimately implemented by Ministry of Transport (MOT). This paper presents an overview of concepts, methods and procedures of the technical assessments especially focused on the practicality assessment in the development of JR Maglev. (orig.)

Using ecosystem modelling techniques in exposure assessments of radionuclides - an overview

International Nuclear Information System (INIS)

Kumblad, L.

2005-01-01

The risk to humans from potential releases from nuclear facilities is evaluated in safety assessments. Essential components of these assessments are exposure models, which estimate the transport of radionuclides in the environment, the uptake in biota, and transfer to humans. Recently, there has been a growing concern for radiological protection of the whole environment, not only humans, and a first attempt has been to employ model approaches based on stylized environments and transfer functions to biota based exclusively on bioconcentration factors (BCF). They are generally of a non-mechanistic nature and involve no knowledge of the actual processes involved, which is a severe limitation when assessing real ecosystems. in this paper, the possibility of using an ecological modelling approach as a complement or an alternative to the use of BCF-based models is discussed. The paper gives an overview of ecological and ecosystem modelling and examples of studies where ecosystem models have been used in association to ecological risk assessment studies for other pollutants than radionuclides. It also discusses the potential to use this technique in exposure assessments of radionuclides with a few examples from the safety assessment work performed by the Swedish nuclear fuel and waste management company (SKB). Finally there is a comparison of the characteristics of ecosystem models and traditionally exposure models for radionuclides used to estimate the radionuclide exposure of biota. The evaluation of ecosystem models already applied in safety assessments has shown that the ecosystem approach is possible to use to assess exposure to biota, and that it can handle many of the modelling problems identified related to BCF-models. The findings in this paper suggest that both national and international assessment frameworks for protection of the environment from ionising radiation would benefit from striving to adopt methodologies based on ecologically sound principles and

PROSPER guidelines: Guidelines for peer review and for plant self-assessment of operational experience feedback process

International Nuclear Information System (INIS)

2003-01-01

Effective use of operational performance information is an important element in any plant operator's arrangements for enhancing the operational safety of a nuclear power plant (NPP). This has been recognized in the IAEA Safety Fundamental, The Safety of Nuclear Installations (Safety Series No. 110). Under the technical aspects of safety, one of the principles of operation and maintenance is that the operating organization and the regulatory body shall establish complementary programmes to analyse operating experience to ensure that lessons are learned and acted upon. Such experience shall be shared with relevant national and international bodies. The Convention on Nuclear Safety, which entered into force in July 1996, also recognized the importance of operational experience feedback as a tool of high importance for the safety of nuclear plant operation and its further enhancement. It follows that the arrangements and results achieved under the operation experience feedback process in Member States will be covered by the national report under the Convention and will be subject to periodical review. These principles are further expanded in the IAEA Safety Standards Safety of Nuclear Power Plants: Operation (Safety Standard Series No. NS-R-2, year 2000) under the Feedback of The IAEA-led Peer Review of the effectiveness of the Operational Safety Performance Experience Review process (PROSPER) and associated guidelines have been developed to provide advice and assistance to utilities or individual power plants to strengthen and enhance the effectiveness of operational experience programmes in achieving these fundamental objectives. The objectives of the former IAEA Assessment of Significant Safety Events Team (ASSET) service have been expanded to include an evaluation of the effective use of all operating performance information available to the plant (e.g. external operating experience, internal low-level and near miss event reports and other relevant operating

Risk assessment for civil engineering facilities: critical overview and discussion

International Nuclear Information System (INIS)

Faber, M.H.; Stewart, M.G.

2003-01-01

The present paper should be seen as a basis for discussion of important aspects of risk analysis and assessment, as well as attempting to describe risk assessment in accordance with the present state of the art. Risk assessment is thus presented in an overview form from the viewpoint of being a means for decision-making and thus within the formal framework of decision theory. First the motivation for risk analysis is given and the theoretical basis together with the practical aspects, methodologies and techniques for the implementation of risk assessment in civil engineering applications are explained and discussed. The paper furthermore addresses the problems associated with risk acceptance criteria, risk aversion and value of human life and attempts to provide suggestions for the rational treatment of these aspects. Finally a number of problem areas are highlighted and the needs for further education, research and dissemination are stressed

High integrity software for nuclear power plants: Candidate guidelines, technical basis and research needs. Main report, Volume 2

International Nuclear Information System (INIS)

Seth, S.; Bail, W.; Cleaves, D.; Cohen, H.; Hybertson, D.; Schaefer, C.; Stark, G.; Ta, A.; Ulery, B.

1995-06-01

The work documented in this report was performed in support of the US Nuclear Regulatory Commission to examine the technical basis for candidate guidelines that could be considered in reviewing and evaluating high integrity computer e following software development and assurance activities: Requirements specification; design; coding; verification and validation, inclukding static analysis and dynamic testing; safety analysis; operation and maintenance; configuration management; quality assurance; and planning and management. Each activity (framework element) was subdivided into technical areas (framework subelements). The report describes the development of approximately 200 candidate guidelines that span the entire ran e identification, categorization and prioritization of technical basis for those candidate guidelines; and the identification, categorization and prioritization of research needs for improving the technical basis. The report has two volumes: Volume 1, Executive Summary includes an overview of the framwork and of each framework element, the complete set of candidate guidelines, the results of the assessment of the technical basis for each candidate guideline, and a discussion of research needs that support the regulatory function; this document, Volume 2, is the main report

High integrity software for nuclear power plants: Candidate guidelines, technical basis and research needs. Main report, Volume 2

Energy Technology Data Exchange (ETDEWEB)

Seth, S.; Bail, W.; Cleaves, D.; Cohen, H.; Hybertson, D.; Schaefer, C.; Stark, G.; Ta, A.; Ulery, B. [Mitre Corp., McLean, VA (United States)

1995-06-01

The work documented in this report was performed in support of the US Nuclear Regulatory Commission to examine the technical basis for candidate guidelines that could be considered in reviewing and evaluating high integrity computer e following software development and assurance activities: Requirements specification; design; coding; verification and validation, inclukding static analysis and dynamic testing; safety analysis; operation and maintenance; configuration management; quality assurance; and planning and management. Each activity (framework element) was subdivided into technical areas (framework subelements). The report describes the development of approximately 200 candidate guidelines that span the entire ran e identification, categorization and prioritization of technical basis for those candidate guidelines; and the identification, categorization and prioritization of research needs for improving the technical basis. The report has two volumes: Volume 1, Executive Summary includes an overview of the framwork and of each framework element, the complete set of candidate guidelines, the results of the assessment of the technical basis for each candidate guideline, and a discussion of research needs that support the regulatory function; this document, Volume 2, is the main report.

Curriculum Guidelines for Periodontics for Dental Hygiene Programs.

Science.gov (United States)

Journal of Dental Education, 1986

1986-01-01

American Association of Dental Schools guidelines consist of an introduction to the field and its interrelationships with other fields of dental hygiene; an overview of the curriculum; outlines of primary educational goals, prerequisites, and specific content-related and clinical behavioral objectives; and recommendations concerning sequencing,…

Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project.

NARCIS (Netherlands)

Cluzeau, F.A.; Burgers, J.S.; Brouwers, M.M.; Grol, R.P.T.M.; et al.,

2003-01-01

BACKGROUND: International interest in clinical practice guidelines has never been greater but many published guidelines do not meet the basic quality requirements. There have been renewed calls for validated criteria to assess the quality of guidelines. OBJECTIVE: To develop and validate an

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

NARCIS (Netherlands)

Stewart, P.A.; Coble, J.B.; Vermeulen, R.; 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

Federal Radiological Monitoring and Assessment Center Overview of FRMAC Operations

International Nuclear Information System (INIS)

1998-01-01

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

Guidelines for health technology assessment in Thailand (second edition)--the development process.

Science.gov (United States)

Chaikledkaew, Usa; Kittrongsiri, Kankamon

2014-05-01

The first Thai-specific HTA guidelines were completed in 2008 with the aim of ensuring that all HTA data was accurate, of high quality, and relevant for making decisions pertaining to healthcare resource allocation. Based on a quality assessment of 89 economic evaluation studies in the Thai context published in international academic journals between 1982 and 2012, the analysis revealed a significant increase in quality of data sources and result reporting in studies published after the dissemination of the first Thai HTA guidelines. As the first Thai HTA guidelines were developed in 2008, a number of areas for improvement have been identified. Therefore, the objective of this chapter is to describe the development process of this second edition of HTA guidelines for Thailand which builds on the success of the first edition, while attempting to address some of the identified limitations of the first edition and reflect the changes that the health care and policy contexts have undergone in the intervening years. It is hoped that this second edition will continue to build on these successes so that policy decision making becomes increasingly evidence-based.

General guidelines for the Assessment of Internal Dose from Monitoring Data (Project IDEAS)

International Nuclear Information System (INIS)

Doerfel, H.; Andrasi, A.; Bailey, M.; Blanchardon, E.; Berkovski, V.; Castellani, C. M.; Hurtgen, C.; Jourdain, J. R.; LeGuen, B.; Puncher, M.

2004-01-01

In recent major international intercomparison exercises on intake and internal dose assessments from monitoring data the results calculated by different participants varied significantly. This was mainly due to the broad variety of methods and assumptions applied in the assessment procedure. Based on these experiences the need for harmonisation of the procedures has been formulated within an EU research project under the 5th Framework Programme. The aim of the project, IDEAS, is to develop general guidelines for standardising assessments of intakes and internal doses. The IDEAS project started in October 2001 and will end in March 2005. Eight institutions from seven European countries are participating. Inputs from internal dosimetry professionals from across Europe are also being used to ensure a broad consensus in the outcome of the project. The IDEAS project is closely related to some goals of the work of Committee 2 of the ICRP and since 2003 there has been close cooperation between the two groups. To ensure that the guidelines are applicable to a wide range of practical situations, the first step has been to compile a database of well-documented cases of internal contamination. In parallel, an improved version of an existing software package has been developed and distributed to the partners for further use. A large number of cases from the database have been evaluated independently by partners in the project using the same software and the results have been reviewed. Based on these evaluations guidelines are being drafted and will be discussed with dosimetry professionals from around the world by means of a virtual workshop on the Internet early in 2004. The guidelines will be revised and refined on the basis of the experiences and discussions of this virtual workshop and the outcome of an intercomparison exercise organised as part of the project. This will be open to all internal dosimetry professionals. (Author) 10 refs

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

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. KEY CONCLUSION: 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...... 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...

Adherence to guidelines and protocols in the prehospital and emergency department setting : A systematic review

NARCIS (Netherlands)

Theo van Achterberg; S. Meijer; M. Verhofstad; Joke Mintjes; Lilian Vloet

2011-01-01

A gap between guidelines or protocols and clinical practice often exists, which may result in patients not receiving appropriate care. Therefore, the objectives of this systematic review were (1) to give an overview of professionals’ adherence to (inter)national guidelines and protocols in the

Adherence to guidelines and protocols in the prehospital and emergency care setting: a systematic review

NARCIS (Netherlands)

Ebben, R.H.A.; Vloet, L.C.M.; Verhofstad, M.H.J.; Meijer, S.; Groot, J. de; Achterberg, T. van

2013-01-01

A gap between guidelines or protocols and clinical practice often exists, which may result in patients not receiving appropriate care. Therefore, the objectives of this systematic review were (1) to give an overview of professionals' adherence to (inter)national guidelines and protocols in the

Curricular Guidelines for Dental Hygiene Care for the Handicapped.

Science.gov (United States)

Journal of Dental Education, 1984

1984-01-01

The American Association of Dental Schools' guidelines for dental hygiene curriculum cover the scope and definitions of care for the handicapped, interrelationships between disciplines and courses, a curriculum overview, primary educational goals, prerequisites, a core content outline, specific behavioral objectives, sequencing, faculty, and…

Euthanasia: an overview and the jewish perspective.

Science.gov (United States)

Gesundheit, Benjamin; Steinberg, Avraham; Glick, Shimon; Or, Reuven; Jotkovitz, Alan

2006-10-01

End-of-life care poses fundamental ethical problems to clinicians. Defining euthanasia is a difficult and complex task, which causes confusion in its practical clinical application. Over the course of history, abuse of the term has led to medical atrocities. Familiarity with the relevant bioethical issues and the development of practical guidelines might improve clinical performance. To define philosophical concepts, to present historical events, to discuss the relevant attitudes in modern bioethics and law that may be helpful in elaborating practical guidelines for clinicians regarding euthanasia and end-of-life care. Concepts found in the classic sources of Jewish tradition might shed additional light on the issue and help clinicians in their decision-making process. An historical overview defines the concepts of active versus passive euthanasia, physician-assisted suicide and related terms. Positions found in classical Jewish literature are presented and analyzed with their later interpretations. The relevance and application in modern clinical medicine of both the general and Jewish approaches are discussed. The overview of current bioethical concepts demonstrates the variety of approaches in western culture and legal systems. Philosophically and conceptually, there is a crucial distinction between active and passive euthanasia. The legitimacy of active euthanasia has been the subject of major controversy in recent times in various countries and religious traditions. The historical overview and the literature review demonstrate the need to provide clearer definitions of the concepts relating to euthanasia, for in the past the term has led to major confusion and uncontrolled abuse. Bioethical topics should, therefore, be included in medical training and continuing education. There are major debates and controversies regarding the current clinical and legal approaches. We trust that classical Jewish sources might contribute to the establishment of clinical

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

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,…

NASA Safety Standard: Guidelines and Assessment Procedures for Limiting Orbital Debris

Science.gov (United States)

1995-01-01

Collision with orbital debris is a hazard of growing concern as historically accepted practices and procedures have allowed man-made objects to accumulate in orbit. To limit future debris generation, NASA Management Instruction (NMI) 1700.8, 'Policy to Limit Orbital Debris Generation,' was issued in April of 1993. The NMI requires each program to conduct a formal assessment of the potential to generate orbital debris. This document serves as a companion to NMI 1700.08 and provides each NASA program with specific guidelines and assessment methods to assure compliance with the NMI. Each main debris assessment issue (e.g., Post Mission Disposal) is developed in a separate chapter.

The development of assessment and remediation guidelines for contaminated soils, a review of the science

International Nuclear Information System (INIS)

Sheppard, S.C.; Gaudet, C.; Sheppard, M.I.; Cureton, P.M.; Wong, M.P.

1992-01-01

Soil contamination is no longer restricted to isolated incidents and locations; it is a general and contentious problem. However, the problem is complex, starting with the very definition of what level and type of contamination is unacceptable. A myriad of regulatory and de facto guidelines have emerged, and they are extremely fragmented, inconsistent and incomplete. This review attempts to summarize the historical development of assessment and remediation guidelines, to highlight the unique difficulties of the problem, and then to discuss the scientific information that exists and that is needed to improve guidelines. This is an unlimited scope for research on this subject. (author)

Air quality model guideline

International Nuclear Information System (INIS)

Idriss, A.; Spurrell, F.

2009-06-01

Alberta Environment has developed a guidelines for operations and proposed operations that require approvals under the province's Environmental Protection and Enhancement Act or that operate under a code of practice for emissions to the atmosphere. In an effort to ensure consistency in the use of dispersion models for regulatory applications in Alberta, this document provided detailed guidance on suitable methods and approaches that should be employed to assess air quality from emission sources, specifically, information required to demonstrate that a source meets the Alberta ambient air quality objectives. The document outlined the statutory authority and provided an overview of the approach. It provided detailed advice on the types and uses of dispersion models with particular reference to the modelling protocol, input data, and output interpretation. Guidance on the application of regulatory models were also presented. Various models were described and their intended uses were explained. Internet addresses for different modelling resources were also offered. Last, some information about regional modelling in the province of Alberta was discussed. 40 refs., 4 tabs., 7 figs., 3 appendices.

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.

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.

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)

Terrain assessment guidelines : CAGC best practice. Version 3

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-07-01

This terrain classification assessment guideline discussed the steps required for personnel to understand terrain hazards present during seismic operations. Maps and other sources must be used to classify terrain steepness and surface conditions using geographical information systems (GIS), LIDAR, or satellite photographs. The impact of managing steep terrain within projects must also be considered when class 3, 4, 5, or 6 terrain has been identified. Terrains must also be classified according to colours. Secondary terrain assessments must be conducted when class 3, 4, 5, or 6 terrain has been identified. Terrain management plans should included methods of keeping untrained workers out of areas with classes greater than 3. Methods of entering and exiting steep terrain must be identified. Workers must be trained to work in areas with steep terrains. Methods of rescue and evacuation must also be established. Procedures were outlined for all terrain classes. Footwear, head protection and general safety requirements were outlined. 14 figs.

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...

Non-melanoma Skin Cancer in Canada Chapter 1: Introduction to the Guidelines.

Science.gov (United States)

Guenther, Lyn C; Barber, Kirk; Searles, Gordon E; Lynde, Charles W; Janiszewski, Peter; Ashkenas, John

2015-01-01

Non-melanoma skin cancer (NMSC), including basal and squamous cell carcinoma, represents the most common malignancy. The aim of this document is to provide guidance to Canadian health care practitioners on NMSC management. After conducting a literature review, the group developed recommendations for prevention, management, and treatment of basal cell carcinomas, squamous cell carcinomas, and actinic keratoses. These tumour types are considered separately in the accompanying articles. The Grading of Recommendations Assessment, Development and Evaluation system was used to assign strength to each recommendation. This introduction describes the scope and structure of the guidelines and the methods used to develop them. The epidemiology of NMSC is reviewed, as are the pathophysiologic changes occurring with damage to the skin, which lead to the formation of actinic keratoses and invasive squamous or basal cell carcinomas. This introduction describes the need for primary prevention and offers an overview of treatment options that are discussed in later chapters of the guidelines. © The Author(s) 2015.

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.

Overview, comparative assessment and recommendations of forecasting models for short-term water demand prediction

CSIR Research Space (South Africa)

Anele, AO

2017-11-01

Full Text Available -term water demand (STWD) forecasts. In view of this, an overview of forecasting methods for STWD prediction is presented. Based on that, a comparative assessment of the performance of alternative forecasting models from the different methods is studied. Times...

2002 GUIDELINES FOR ADVANCEMENT AND PROMOTION

CERN Document Server

Human Resources Division

2002-01-01

1. General Following the various Weekly Bulletin announcements concerning the new Merit Advancement and Promotion Scheme (MAPS), the Director-General has now fixed the guidelines and schedule for the 2002 annual advancement review as summarised below. The full details have been presented to the Management Board and to the Standing Concertation Committee. The guidelines correspond to the information given in the document 'An overview of the Merit Advancement and Promotion Scheme (MAPS) and implementation measures' dated 11 July 2001. The procedures will follow those given in the recently published Administrative Circular 26 (Rev. 3) except that the annual interview programme is extended to the completion date of 31 March 2002. As in previous years, decisions will be made, where possible, by 1 July 2002 except for career path changes for staff in Career Paths A to D which will be made by 31 October 2002 and applied retroactively to 1 July 2002. 2. Budget guidelines The budget allocation for the annual part of a...

The Perinatal Guidelines Evaluation Project HIV and Pregnancy Study: overview and cohort description.

Science.gov (United States)

Ethier, Kathleen A.; Ickovics, Jeannette R.; Fernandez, M. Isabel; Wilson, Tracey E.; Royce, Rachel A.; Koenig, Linda J.

2002-01-01

OBJECTIVE: The HIV and Pregnancy Study of the Perinatal Guidelines Evaluation Project is a prospective, longitudinal, multisite study established to: (a) assess the implementation of Public Health Service guidelines regarding the prevention of perinatal HIV transmission and (b) evaluate the psychosocial consequences of HIV infection among pregnant women. A distinctive aspect of the study is the use of an HIV-negative comparison group. This article describes the methodology of the study and baseline characteristics of the study sample. Methods and Results. HIV-infected (n = 336) and uninfected (n = 298) pregnant women were enrolled from four geographic areas: Connecticut, North Carolina, Brooklyn, NY, and Miami, FL. The study included three structured face-to-face interviews from late pregnancy to six months postpartum for HIV-infected and uninfected women. Additional self-reports of medication adherence were collected for the HIV-infected participants, and the medical records of infected mothers and their infants were reviewed. Electronic monitoring of medication adherence was conducted for a subset of the infected women. The groups were successfully matched on self-reported characteristics, including HIV-risk behaviors. More than half of the uninfected women reported a high-risk sexual partner. Baseline comparisons indicated that both the HIV-infected and uninfected women had high levels of depressive symptoms, stress, and recent negative life events. CONCLUSIONS: This study provides a unique description of the psychosocial and behavioral characteristics of a population of low-income women. The results of this study suggest that HIV infection is one of many stressors faced by the women in this study. PMID:12356998

Williston Reservoir raising - environmental overview

Energy Technology Data Exchange (ETDEWEB)

1988-07-01

This preliminary environmental overview report was prepared by B.C. Hydro in June 1987 and revised in July 1988 as an initial assessment of a possible 1.5 m (5 ft.) raise in the Williston Reservoir maximum normal level. The enviromental overview study and the associated engineering and property studies were undertaken to provide information for a decision on whether to initiate more detailed studies. Overview studies are based mainly on available reports, mapping and field data, supplemented by limited site reconnaissance and, in this case, input from key agencies and groups. The lack of adequate mapping of areas which could be affected by reservoir raising did not permit definitive conclusion to be reached. This mapping will be done over the next year to complete the overview assessment. This document covers the impact assessment of socio-economic factors, forestry, reservoir clearing, heritage, recreation, aquatic resources, and wilflife. Further studies in each of these areas are also included. 54 refs., 11 figs., 8 tabs.

Physics Survey Overview

International Nuclear Information System (INIS)

2002-01-01

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

Guideline for the management of wounds in patients with lower-extremity venous disease: an executive summary.

Science.gov (United States)

Kelechi, Teresa J; Johnson, Jan J

2012-01-01

This article provides an executive summary of the lower extremity venous disease (LEVD) evidence-based guideline produced by the WOCN Wound Guidelines Task Force. The target audience for this guideline is health care professionals who specialize in, direct, or provide wound care for patients at risk for or with lower-extremity venous disease. The full guideline opens with an overview of definitions of LEVD, its prevalence, clinical relevance, etiology, related physiology and pathophysiology, and overall management goals for patients at risk for developing venous leg ulcers. A detailed assessment section describes how to conduct a full clinical history and physical examination. Two approaches to interventions are provided: one addresses prevention strategies to reduce the risk of developing LEVD with ulcers. Methods to prevent ulcer recurrence are summarized including compression therapy, adjunctive therapies, medications, and patient education. A second approach presents treatment interventions including wound cleansing, debridement, infection control, antibiotic use, along with management of the periwound skin, nutrition, pain, and edema. This section also discusses limb elevation, surgical options, adjunctive therapies, patient education, and health care provider follow-up. A comprehensive reference list, glossary of terms, and appendices on cellulitis and venous eczema, types of edema, and compression therapy are available at the end of the guideline. This article provides an executive summary of the essential features of the guideline.

Radiological risk comparison guidelines

International Nuclear Information System (INIS)

Hallinan, E.J.; Muhlestein, L.D.; Brown, L.F.; Yoder, R.E.

1992-01-01

An important aspect of DOE safety analyses is estimating potential accident risk. The estimates are used to: determine if additional controls are needed, identify Safety Class Items, and demonstrate adequate risk reduction. Thus, guidelines are needed to measure comparative risks. The Westinghouse M ampersand O Nuclear Facility Safety Committee and the Safety Envelope Working Group have developed radiological risk guidelines for comparing the risks from individual accident analyses. These guidelines were prepared under contract with the US Department of Energy. These guidelines are based on historical DOE guidelines and current requirements, and satisfy DOE and technical community proposals. for goals that demonstrate acceptable risk. The guidelines consist of a frequency versus consequence curve for credible accidents. Offsite and onsite guidelines are presented. The offsite risk acceptance guidelines are presented in Figure 1. The guidelines are nearly isorisk for anticipated events where impacts are chronic, and provide additional reduction for unlikely events where impacts may be acute and risk uncertainties may be significant. The guidelines are applied to individual release accident scenarios where a discrete frequency and consequence has been estimated. The guideline curves are not to be used for total risk assessments. Common cause events are taken into consideration only for an individual facility. Frequencies outside the guideline range are considered to be local site option (analyst judgement) as far as assessments of risk acceptance are concerned. If the curve is exceeded, then options include either a more detailed analysis or imposing additional preventive or mitigative features. Another presentation discusses implementation in detail. Additional work is needed to provide risk comparison guidelines for releases from multiple facilities and for toxic releases

Overview of IAEA guidelines for fire safety inspection and operation in nuclear power plants

International Nuclear Information System (INIS)

Mowrer, D.S.

1998-01-01

In 1992, the International Atomic Energy Agency began an ambitious project on fire safety in nuclear power plants. The purpose of this ongoing project is to provide specific guidance on compliance with the requirements set forth through the IAEA Nuclear Safety Standards program established in 1974. The scope of the Fire Safety project encompasses several tasks, including the development of new standards and guidelines to assist Member States in assessing the level of fire safety in existing plants. Five new Safety Practices, one new Safety Guide and a Technical Document have been developed for use by the fire safety community. The primary intent of these new documents is to provide detailed guidance and a consistent format for the assessment of the overall level of fire safety being provided in existing nuclear power plants around the world and especially in developing countries. Sufficient detail is provided in the Safety Guide and Safety Practices to allow technically knowledgeable plant personnel, outside consultants or other technical experts to assess the adequacy of fire safety within the plant facilities. This paper describes topics addressed by each of the IAEA Fire Safety documents and discussed the relationship of each document to others in the series. (author)

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

Science.gov (United States)

2010-03-29

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket ID...: Pipeline and Hazardous Materials Safety Administration (PHMSA), DOT. ACTION: Notice of workshop. SUMMARY... ``Guidelines for Integrity Assessment of Cased Pipe in Gas Transmission Pipelines'' and related Frequently...

[Guideline on brain metastases: not a cookbook].

Science.gov (United States)

Reijneveld, Jaap C

2011-01-01

The guideline 'Brain Metastases', which was revised on behalf of the Dutch Society for Neuro-Oncology (LWNO), provides an excellent overview of levels of scientific evidence on diagnosis and treatment of patients with parenchymal brain metastases of solid tumours. I would like to emphasize, however, that this guideline is not a cookbook for facilitating individual physicians to treat patients on their own. It is important that every patient suffering from brain metastases is discussed by a multidisciplinary tumour board consisting of at least a neurologist, a neurosurgeon, a medical oncologist, a radiation oncologist, a pathologist and a radiologist, and that several crucial questions need to be explicitly asked and answered about every single patient.

Statin eligibility and cardiovascular risk burden assessed by coronary artery calcium score: comparing the two guidelines in a large Korean cohort.

Science.gov (United States)

Rhee, Eun-Jung; Park, Se Eun; Oh, Hyung Geun; Park, Cheol-Young; Oh, Ki-Won; Park, Sung-Woo; Blankstein, Ron; Plutzky, Jorge; Lee, Won-Young

2015-05-01

To investigate the statin eligibility and the predictabilities for cardiovascular disease between AHA/ACC and ATPIII guidelines, comparing those results to concomitant coronary artery calcium scores (CACS) in a large cohort of Korean individuals who met statin-eligibility criteria. Among 19,920 participants in a health screening program, eligibility for statin treatment was assessed by the two guidelines. The presence and extent of coronary artery calcification (CAC) was measured by multi-detector computed tomography and compared among the various groups defined by the two guidelines. Applying the new ACC/AHA guideline to the health screening cohort increased the statin-eligible population from 18.7% (as defined by ATP III) to 21.7%. Statin-eligible subjects as defined only by ACC/AHA guideline manifested a higher proportion of subjects with CAC compared with those meeting only ATP-III criteria even after adjustment for age and sex (47.1 vs. 33.8%, pguideline showed higher odds ratio for the presence of CACS>0 compared with those meeting ATP-III criteria {3.493 (3.245∼3.759) vs. 2.865 (2.653∼3.094)}, which was attenuated after adjusted for age and sex. In this large Korean cohort, more subjects would have qualified for statin initiation under the new ACC/AHA guideline as compared with the proportion recommended for statin treatment by ATP III guideline. Among statin-eligible Korean health screening subjects, the new ACC/AHA guideline identified a greater extent of atherosclerosis as assessed by CACS as compared to ATP III guideline assessment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Guidelines for Affective Signal Processing (ASP): From lab to life

NARCIS (Netherlands)

van den Broek, Egon; Janssen, Joris H.; Westerink, Joyce H.D.M.; Cohn, J.; Nijholt, Antinus; Pantic, Maja

2009-01-01

This article presents the rationale behind ACII2009’s special session: Guidelines for Affective Signal Processing (ASP): From lab to life. Although affect is embraced by both science and engineering, its recognition has not reached a satisfying level. Through a concise overview of ASP and the

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

Guidelines for selecting codes for ground-water transport modeling of low-level waste burial sites. Volume 2. Special test cases

International Nuclear Information System (INIS)

Simmons, C.S.; Cole, C.R.

1985-08-01

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. Volume 1, titled ''Guideline Approach,'' consists of Chapters 1 through 5 and a glossary. Chapters 2 through 5 provide the more detailed discussions about the code selection approach. This volume, Volume 2, consists of four appendices reporting on the technical evaluation test cases designed to help verify the accuracy of ground-water transport codes. 20 refs

Public safety around dams guidelines

Energy Technology Data Exchange (ETDEWEB)

Bennett, T [Canadian Dam Association, Edmonton, AB (Canada)

2010-07-01

This presentation discussed Canadian and international initiatives for improving dam safety and described some of the drivers for the development of new Canadian Dam Association (CDA) public safety guidelines for dams. The CDA guidelines were divided into the following 3 principal sections: (1) managed system elements, (2) risk assessment and management, and (3) technical bulletins. Public and media responses to the drownings have called for improved safety guidelines. While the public remains unaware of the hazards of dams, public interaction with dams is increasing as a result of interest in extreme sports and perceived rights of access. Guidelines are needed for dam owners in order to provide due diligence. Various organizations in Canada are preparing technical and public safety dam guidelines. CDA guidelines have also been prepared for signage, booms and buoys, and audible and visual alerts bulletins. Working groups are also discussing recommended practices for spill procedures, spillways and the role of professional engineers in ensuring public safety. Methods of assessing risk were also reviewed. Managed system elements for risk assessment and public interactions were also discussed, and stepped control measures were presented. tabs., figs.

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.

An overview of performance assessment for the Waste Isolation Pilot Plant

International Nuclear Information System (INIS)

Jow, Hong-Nian; Anderson, D.R.; Marietta, M.

1997-01-01

This paper presents an overview of the methodology used in the recent performance assessment (PA) to support the U.S. Department of Energy (DOE) Carlsbad Area Office's (CAO's) Waste Isolation Pilot Plant (WIPP) Compliance Certification Application (CCA). The results of this recently completed WIPP PA will be presented. Major release modes contributing to the total radionuclide release to the accessible environment will be discussed. Comparison of the mean complementary cumulative distribution function (CCDF) curve against the Environmental Protection Agency (EPA) radionuclide release limits will be presented

Practice insights on patient care-management overview for chemoradiation toxic mucositis-guidelines, guideline-supported therapies and high potency polymerized cross-linked sucralfate (ProThelial).

Science.gov (United States)

McCullough, Ricky W

2018-01-01

Aim To offer a practice insight for the management of chemoradiation toxic mucositis. Method Review chemoradiation toxic mucositis, its pathobiology and breadth of symptom presentation. Review mucositis guidelines and guideline-supported anti-mucositis therapies. Offer guidance on guidelines and an abbreviated review of high potency cross-linked sucralfate for management of chemoradiation toxic mucositis. Result There are six major mucositis guidelines but only one that is current and regularly updated. Guidelines from the Multinational Association Supportive Cancer Care suggest 14 interventions gleaned from controlled trials, 12 of which are off-label uses of therapies that offer statistically significant but incrementally beneficial outcomes. Several evidence-based limitations of guidelines are discussed. Data on high potency polymerized cross-linked sucralfate confirming complete prevention and rapid (2-3 days) elimination, sustained throughout cancer treatment is verified as high quality evidence in accordance to standards adopted by Agency for Healthcare Research and Quality. A 96-97% reduction in mucositis duration qualifies as a positive Glasziou treatment effect, which is discussed as an additional measure of evidence-based medicine. Conclusion Statistically significant but fractional treatment effects of guideline-supported interventions are not likely to substantially alter the course of mucositis when it occurs nor completely prevent its onset. Complete prevention and rapid sustained elimination should be the goal, therefore high potency polymerized cross-linked sucralfate may be useful. Where guidelines fail, institution-based protocols led by oncology pharmacists could succeed. In an effort to eliminate toxic mucositis, enhance compliance to chemoradiation regimens, and improve survival, such protocols for practice may verify pharmacoeconomic benefits, if any, in using high potency polymerized cross-linked sucralfate to manage toxic mucositis.

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.

The application of national and international guidelines in the assessment of the radiological quality of drinking water

International Nuclear Information System (INIS)

Cooper, M.B.

1998-01-01

Full text: The World Health Organisation has developed international guidelines for drinking water quality which define acceptable levels of contaminants including radionuclides. These guidelines were the basis for the recent Australian water quality guidelines developed by the National Health and Medical Research Council in conjunction with the Agriculture and Resource Management Council of Australia and New Zealand. This paper highlights some of the practical problems in applying the guidelines in the assessment of groundwater supplies in Australia where the radium content of the water may be significant and the presence of other dissolved minerals can create difficulties in the analytical procedures. Generally, screening methods are based on the determination of gross alpha and beta radioactivity and the limitations of these techniques are discussed. The issue is also addressed as to the appropriate actions in the event of guideline values for specific radionuclides being exceeded

Data on the descriptive overview and the quality assessment details of 12 qualitative research papers.

Science.gov (United States)

Barnabishvili, Maia; Ulrichs, Timo; Waldherr, Ruth

2016-09-01

This data article presents the supplementary material for the review paper "Role of acceptability barriers in delayed diagnosis of Tuberculosis: Literature review from high burden countries" (Barnabishvili et al., in press) [1]. General overview of 12 qualitative papers, including the details about authors, years of publication, data source locations, study objectives, overview of methods, study population characteristics, as well as the details of intervention and the outcome parameters of the papers are summarized in the first two tables included to the article. Quality assessment process of the methodological strength of 12 papers and the results of the critical appraisal are further described and summarized in the second part of the article.

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...

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.

Ecological risk assessment at the Idaho National Engineering Laboratory: Overview

International Nuclear Information System (INIS)

VanHorn, R.; Bensen, T.; Green, T.; Hampton, N.; Staley, C.; Morris, R.; Brewer, R.; Peterson, S.

1994-01-01

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 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

Effects of energy development on ground water quality: an overview and preliminary assessment

International Nuclear Information System (INIS)

Parker, W.M. III; Yin, S.C.L.; Davis, M.J.; Kutz, W.J.

1981-07-01

A preliminary national overview of the various effects on ground water quality likely to result from energy development. Based on estimates of present and projected energy-development activities, those regions of the country are identified where ground water quality has the potential for being adversely affected. The general causes of change in ground water quality are reviewed. Specific effects on ground water quality of selected energy technologies are discussed, and some case-history material is provided. A brief overview of pertinent legislation relating to the protection and management of ground water quality is presented. Six methodologies that have some value for assessing the potential effects on ground water quality of energy development activities are reviewed. A method of identifying regions in the 48 contiguous states where there is a potential for ground water quality problems is described and then applied

General guidelines for the assessment of internal dose from monitoring data: Progress of the IDEAS project

International Nuclear Information System (INIS)

Doerfel, H.; Andrasi, A.; Bailey, M.; Blanchardon, E.; Cruz-Suarez, R.; Berkovski, V.; Castellani, C. M.; Hurtgenv, C.; Leguen, B.; Malatova, I.; Marsh, J.; Stather, J.; Zeger, J.

2007-01-01

In recent major international intercomparison exercises on intake and internal dose assessments from monitoring data, the results calculated by different participants varied significantly. Based on this experience the need for harmonisation of the procedures has been formulated within an EU 5. Framework Programme research project. The aim of the project, IDEAS, is to develop general guidelines for standardising assessments of intakes and internal doses. The IDEAS project started in October 2001 and ended in June 2005. The project is closely related to some goals of the work of Committee 2 of the ICRP and since 2003 there has been close cooperation between the two groups. To ensure that the guidelines are applicable to a wide range of practical situations, the first step was to compile a database of well-documented cases of internal contamination. In parallel, an improved version of an existing software package was developed and distributed to the partners for further use. A large number of cases from the database was evaluated independently by the partners and the results reviewed. Based on these evaluations, guidelines were drafted and discussed with dosimetry professionals from around the world by means of a virtual workshop on the Internet early in 2004. The guidelines have been revised and refined on the basis of the experiences and discussions in this virtual workshop. The general philosophy of the Guidelines is presented here, focusing on the principles of harmonisation, optimisation and proportionality. Finally, the proposed Levels of Task to structure the approach of internal dose evaluation are reported. (authors)

Multilevel and multi-user sustainability assessment of farming systems

Energy Technology Data Exchange (ETDEWEB)

Van Passel, Steven, E-mail: Steven.vanpassel@uhasselt.be [Hasselt University, Faculty of Business Economics, Centre for Environmental Sciences, Agoralaan, Building D, 3590, Diepenbeek (Belgium); University of Antwerp, Department Bioscience Engineering, Groenenborgerlaan 171, 2020 Antwerp (Belgium); Meul, Marijke [University College Ghent, Department of Biosciences and Landscape Architecture, Campus Schoonmeersen, Building C, Schoonmeersstraat 52, 9000, Gent (Belgium)

2012-01-15

Sustainability assessment is needed to build sustainable farming systems. A broad range of sustainability concepts, methodologies and applications already exists. They differ in level, focus, orientation, measurement, scale, presentation and intended end-users. In this paper we illustrate that a smart combination of existing methods with different levels of application can make sustainability assessment more profound, and that it can broaden the insights of different end-user groups. An overview of sustainability assessment tools on different levels and for different end-users shows the complementarities and the opportunities of using different methods. In a case-study, a combination of the sustainable value approach (SVA) and MOTIFS is used to perform a sustainability evaluation of farming systems in Flanders. SVA is used to evaluate sustainability at sector level, and is especially useful to support policy makers, while MOTIFS is used to support and guide farmers towards sustainability at farm level. The combined use of the two methods with complementary goals can widen the insights of both farmers and policy makers, without losing the particularities of the different approaches. To stimulate and support further research and applications, we propose guidelines for multilevel and multi-user sustainability assessments. - Highlights: Black-Right-Pointing-Pointer We give an overview of sustainability assessment tools for agricultural systems. Black-Right-Pointing-Pointer SVA and MOTIFS are used to evaluate the sustainability of dairy farming in Flanders. Black-Right-Pointing-Pointer Combination of methods with different levels broadens the insights of different end-user groups. Black-Right-Pointing-Pointer We propose guidelines for multilevel and multi-user sustainability assessments.

Multilevel and multi-user sustainability assessment of farming systems

International Nuclear Information System (INIS)

Van Passel, Steven; Meul, Marijke

2012-01-01

Sustainability assessment is needed to build sustainable farming systems. A broad range of sustainability concepts, methodologies and applications already exists. They differ in level, focus, orientation, measurement, scale, presentation and intended end-users. In this paper we illustrate that a smart combination of existing methods with different levels of application can make sustainability assessment more profound, and that it can broaden the insights of different end-user groups. An overview of sustainability assessment tools on different levels and for different end-users shows the complementarities and the opportunities of using different methods. In a case-study, a combination of the sustainable value approach (SVA) and MOTIFS is used to perform a sustainability evaluation of farming systems in Flanders. SVA is used to evaluate sustainability at sector level, and is especially useful to support policy makers, while MOTIFS is used to support and guide farmers towards sustainability at farm level. The combined use of the two methods with complementary goals can widen the insights of both farmers and policy makers, without losing the particularities of the different approaches. To stimulate and support further research and applications, we propose guidelines for multilevel and multi-user sustainability assessments. - Highlights: ► We give an overview of sustainability assessment tools for agricultural systems. ► SVA and MOTIFS are used to evaluate the sustainability of dairy farming in Flanders. ► Combination of methods with different levels broadens the insights of different end-user groups. ► We propose guidelines for multilevel and multi-user sustainability assessments.

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.

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

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

NARCIS (Netherlands)

Meijer, R.; Limbeek, J. van; Haan, R. de

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

Quality Assessment of Clinical Practice Guidelines for Respiratory Diseases in China: A Systematic Appraisal.

Science.gov (United States)

Jiang, Mei; Liao, Li-Yue; Liu, Xiao-Qing; He, Wei-Qun; Guan, Wei-Jie; Chen, Hao; Li, Yi-Min

2015-09-01

There has been a significant increase in the publication of clinical practice guidelines (CPGs) for respiratory diseases in China. However, little is known about the quality and potential impacts of these CPGs. Our objective was to critically evaluate the quality of Chinese CPGs for respiratory diseases that were published in peer-reviewed medical journals. A systematic search of scientific literature published between 1979 and 2013 was undertaken to identify and select CPGs that were related to respiratory diseases. Four Chinese databases (the Chinese Biomedical Literature database [CBM], the China National Knowledge Infrastructure [CNKI], the VIP database, and the WANFANG database) were used. The quality of eligible guidelines was assessed independently by four reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. The overall agreement among reviewers was evaluated using an intraclass correlation coefficient. A total of 109 guidelines published in 27 medical journals from 1979 to 2013 were evaluated. The overall agreement among reviewers was considered good (intraclass correlation coefficient, 0.838; 95% CI, 0.812-0.862). The scores of the six AGREE domains were low: 57.3% for scope and purpose (range, 4.2%-80.5%), 23.8% for stakeholder involvement (range, 2.8%-54.2%), 7.7% for rigor of development (range, 0%-27.1%), 59.8% for clarity and presentation (range, 22.2%-80.6%), 10.9% for applicability (range, 0%-22.9%), and 0.6% for editorial independence (range, 0%-16.7%). Scores for all guidelines were below 60%, and only three guidelines (2.8%) were recommended for clinical practice with modifications. The quality of the guidelines was low, and stakeholder involvement, rigor of development, applicability, and editorial independence should be considered in the future development of CPGs for respiratory diseases in China.

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

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....... The project included micro, small, medium, and two types of large scale combustion experiments. The experiments focused on the characterization of the combustion products and scaling effects are described.Additional, a few experiments on the effects of packaging and water on the fire products have been...... 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...

[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.

Overview of the NRC/EPRI common cause analysis framework

International Nuclear Information System (INIS)

Rasmuson, D.M.; Worledge, D.H.; Mosleh, A.; Fleming, K.; Parry, G.W.; Paula, H.

1988-01-01

This paper presents an overview of a framework for the inclusion of the impact of common cause failures in risk and reliability evaluations. Common cause failures are defined as that subset of dependent failures whose causes are not explicitly included in the logic model as basic events. The emphasis here is on providing guidelines for a practical, systematic approach that can be used to perform and clearly document the analysis. The framework comprises four major stages: (1) Logic Model Development, (2) Identification of Common Cause Component Groups, (3) Common Cause Modeling and Data Analysis, and (4) Quantification and Interpretation of Results. The framework and the methods discussed for performing the different stages of the analysis integrate insights obtained from engineering assessments of the system and the historical evidence from multiple failure events into a systematic, reproducible, and defensible analysis. 25 references

Process Control System Cyber Security Standards - An Overview

Energy Technology Data Exchange (ETDEWEB)

Robert P. Evans

2006-05-01

The use of cyber security standards can greatly assist in the protection of process control systems by providing guidelines and requirements for the implementation of computer-controlled systems. These standards are most effective when the engineers and operators, using the standards, understand what each standard addresses. This paper provides an overview of several standards that deal with the cyber security of process measurements and control systems.

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.

European trauma guideline compliance assessment: the ETRAUSS study.

Science.gov (United States)

Hamada, Sophie Rym; Gauss, Tobias; Pann, Jakob; Dünser, Martin; Leone, Marc; Duranteau, Jacques

2015-12-08

Haemorrhagic shock is the leading cause of preventable death in trauma patients. The 2013 European trauma guidelines emphasise a comprehensive, multidisciplinary, protocol-based approach to trauma care. The aim of the present Europe-wide survey was to compare 2015 practice with the 2013 guidelines. A group of members of the Trauma and Emergency Medicine section of the European Society of Intensive Care Medicine developed a 50-item questionnaire based upon the core recommendations of the 2013 guidelines, employing a multistep approach. The questionnaire covered five fields: care structure and organisation, haemodynamic resuscitation targets, fluid management, transfusion and coagulopathy, and haemorrhage control. The sampling used a two-step approach comprising initial purposive sampling of eminent trauma care providers in each European country, followed by snowball sampling of a maximum number of trauma care providers. A total of 296 responses were collected, 243 (81 %) from European countries. Those from outside the European Union were excluded from the analysis. Approximately three-fourths (74 %) of responders were working in a designated trauma centre. Blunt trauma predominated, accounting for more than 90 % of trauma cases. Considerable heterogeneity was observed in all five core aspects of trauma care, along with frequent deviations from the 2013 guidelines. Only 92 (38 %) of responders claimed to comply with the recommended systolic blood pressure target, and only 81 (33 %) responded that they complied with the target pressure in patients with traumatic brain injury. Crystalloid use was predominant (n = 209; 86 %), and vasopressor use was frequent (n = 171, 76 %) but remained controversial. Only 160 respondents (66 %) declared that they used tranexamic acid always or often. This is the first European trauma survey, to our knowledge. Heterogeneity is significant across centres with regard to the clinical protocols for trauma patients and as to locally

[The practice guideline 'Sore throat' (second revision) from the Dutch College of General Practitioners; a response from the perspective of otorhinolaryngology

NARCIS (Netherlands)

Marres, H.A.M.

2008-01-01

In this comment, the practice guideline 'Sore throat' (second revision) is discussed. This guideline, composed by the Dutch College of General Practitioners, offers general practitioners a well-appreciated overview of the common practices regarding diagnostic tests and treatment of pharyngitis and

Quality of evidence-based pediatric guidelines

NARCIS (Netherlands)

Boluyt, Nicole; Lincke, Carsten R.; Offringa, Martin

2005-01-01

Objective. To identify evidence-based pediatric guidelines and to assess their quality. Methods. We searched Medline, Embase, and relevant Web sites of guideline development programs and national pediatric societies to identify evidence-based pediatric guidelines. A list with titles of identified

77 FR 45329 - Availability of Microbial Risk Assessment Guideline: Pathogenic Microorganisms With Focus on Food...

Science.gov (United States)

2012-07-31

... impact the risk assessment and facilitates reproducible risk evaluation. Using the guidelines, agencies.... Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation...

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

Science.gov (United States)

2014-01-01

videogame -based platforms, 2) role of assessments and how they can be implemented within these platforms, or 3) benefits or challenges of the...Technical Report 1334 Best Practices and Provisional Guidelines for Integrating Mobile, Virtual, and Videogame -Based Training and...Virtual, and Videogame -Based Training and Assessments 5a. CONTRACT OR GRANT NUMBER W5J9CQ-11-D-0002 5b. PROGRAM ELEMENT NUMBER 622785

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.

German guidelines for the diagnosis and therapy of localized scleroderma.

Science.gov (United States)

Kreuter, Alexander; Krieg, Thomas; Worm, Margitta; Wenzel, Jörg; Moinzadeh, Pia; Kuhn, Annegret; Aberer, Elisabeth; Scharffetter-Kochanek, Karin; Horneff, Gerd; Reil, Emma; Weberschock, Tobias; Hunzelmann, Nicolas

2016-02-01

Localized scleroderma designates a heterogeneous group of sclerotic skin disorders. Depending on the subtype, severity, and site affected, adjacent structures such as adipose tissue, muscles, joints, and bones may be involved. This is an update of the existing German AWMF (Association of the Scientific Medical Societies in Germany) guidelines (classification: S2k). These guidelines provide an overview of the definition, epidemiology, classification, pathogenesis, laboratory workup, histopathology, clinical scoring systems, as well as imaging and device-based workup of localized scleroderma. Moreover, consensus-based recommendations are given on the management of localized scleroderma depending on its clinical subtype. Treatment recommendations are presented in a therapeutic algorithm. No financial support was given by any pharmaceutical company. The guidelines are valid until July 2019. © 2016 The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.

Frailty Assessment in Heart Failure: an Overview of the Multi-domain Approach.

Science.gov (United States)

McDonagh, Julee; Ferguson, Caleb; Newton, Phillip J

2018-02-01

The study aims (1) to provide a contemporary description of frailty assessment in heart failure and (2) to provide an overview of multi-domain frailty assessment in heart failure. Frailty assessment is an important predictive measure for mortality and hospitalisation in individuals with heart failure. To date, there are no frailty assessment instruments validated for use in heart failure. This has resulted in significant heterogeneity between studies regarding the assessment of frailty. The most common frailty assessment instrument used in heart failure is the Frailty Phenotype which focuses on five physical domains of frailty; the appropriateness a purely physical measure of frailty in individuals with heart failure who frequently experience decreased exercise tolerance and shortness of breath is yet to be determined. A limited number of studies have approached frailty assessment using a multi-domain view which may be more clinically relevant in heart failure. There remains a lack of consensus regarding frailty assessment and an absence of a validated instrument in heart failure. Despite this, frailty continues to be assessed frequently, primarily for research purposes, using predominantly physical frailty measures. A more multidimensional view of frailty assessment using a multi-domain approach will likely be more sensitive to identifying at risk patients.

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

International Nuclear Information System (INIS)

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

Assessment of space plasma effectsfor satellite applications:Working Group 2 overview

Directory of Open Access Journals (Sweden)

N. Jakowski

2004-06-01

Full Text Available An important part of the tasks of Working Group 2 of the COST Action 271 «Assessment of space plasma effect for satellites applications» is the assessment of novel data sources for information about the state of ionisation of the ionosphere. This report deals with those aspects which are not represented adequately in the scientific papers in this issue. Here emphasis is given to the product aspect (data and model collections, descriptions of methods and algorithms, availability of products, expected future developments and the links between the past COST Actions 238 and 251 with the present Action 271 and with possible future cooperations. Working Group 2 was leading in the transionospheric propagation aspects of possible products for the International Telecommunication Union?s Radiocommunication (ITU-R Study Group 3. This report gives a short overview emphasizing future developments.

ASSET guidelines. Revised 1991 Edition

International Nuclear Information System (INIS)

1991-12-01

The present publication is an updated version of the IAEA Assessment of Safety Significant Events Team (ASSET) Guidelines, IAEA-TECDOC-573, published in 1990. Sections 5 and 6 include revised definitions and investigation guidelines for identification of both direct and root causes. These revisions were recommended by a Consultants Meeting held in Vienna on 3-7 December 1990. This guidance is not intended to infringe an expert's prerogative to investigate additional items. Its main purpose is to provide a basic structure and ensure consistency in the assessments. Use of the ASSET guidelines should also facilitate comparison between the observations made in different nuclear power plants and harmonize the reporting of generic ASSET results. The guidelines should always be used with a critical attitude and a view to possible improvements

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

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.

2018-01-01

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

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.

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

Analysis on the Compliance with GRI Guidelines and the Information Disclosed by Japanese Companies

OpenAIRE

Kawahara, Naoko; Irie, Noriko

2015-01-01

[Abstract] Japanese companies do not comply with the Global Reporting Initiatives （GRI）'s Sustainability Guidelines as much as other developed countries, and their compliance levels are lower among developed countries. This study overviewed the characteristics of Japanese GRI compliance and analysed 15 Japanese listed companies on the information of their corporate sustainability reports in which they comply with the GRI version 3.1 Guidelines. The possible correlation between GRI compliance ...

Assessment of clinical practice guideline methodology for the treatment of knee osteoarthritis with intra-articular hyaluronic acid.

Science.gov (United States)

Altman, Roy D; Schemitsch, Emil; Bedi, Asheesh

2015-10-01

Clinical practice guidelines are of increasing importance in the decision making for the treatment of knee osteoarthritis. Inconsistent recommendations regarding the use of intra-articular hyaluronic acid for the treatment of knee osteoarthritis have led to confusion among treating physicians. Literature search to identify clinical practice guidelines that provide recommendations regarding the use of intra-articular hyaluronic acid treatment for knee osteoarthritis was conducted. Included guidelines were appraised using the AGREE II instrument. Guideline development methodologies, how the results were assessed, the recommendation formation, and work group composition were summarized. Overall, 10 clinical practice guidelines were identified that met our inclusion criteria. AGREE II domain scores were variable across the included guidelines. The methodology utilized across the guidelines was heterogeneous regarding the evidence inclusion criteria, analysis of evidence results, formulation of clinical practice recommendations, and work group composition. The recommendations provided by the guidelines for intra-articular hyaluronic acid treatment for knee osteoarthritis are highly inconsistent as a result of the variability in guideline methodology. Overall, 30% of the included guidelines recommended against the use of intra-articular hyaluronic acid in the treatment of knee osteoarthritis, while 30% deemed the treatment an appropriate intervention under certain scenarios. The remaining 40% of the guidelines provided either an uncertain recommendation or no recommendation at all, based on the high variability in reviewed evidence regarding efficacy and trial quality. There is a need for a standard "appropriate methodology" that is agreed upon for osteoarthritis clinical practice guidelines in order to prevent the development of conflicting recommendations for intra-articular hyaluronic acid treatment for knee osteoarthritis, and to assure that treating physicians who

Reliability tests and guidelines for B-mode ultrasound assessment of central adiposity.

Science.gov (United States)

Stoner, Lee; Chinn, Victoria; Cornwall, Jon; Meikle, Grant; Page, Rachel; Lambrick, Danielle; Faulkner, James

2015-11-01

Ultrasound represents a validated and relatively inexpensive diagnostic device for assessing central adiposity; however, widespread adoption has been impeded by the lack of reliable standard operating procedures. To examine the reliability of, and describe guidelines for, ultrasound-derived recording of intra-abdominal fat thickness (IAT) and maximal preperitoneal fat thickness (PFT). Ultrasound scans were obtained from 20 adults (50% female, 26 ± 7 years, 24·5 kg/m(2) ) on three different mornings. IAT was assessed 2 cm above the umbilicus (transverse plane) measuring from linea alba to: (i) anterior aorta, (ii) posterior aorta and (iii) anterior aspect of the vertebral column. PFT was measured from linea alba to visceral peritoneum in (i) sagittal and (ii) transverse planes, immediately over and inferior to the xiphi-sternum, respectively. For IAT, the criterion intraclass correlation coefficient (ICC) of 0·75 was exceeded for measurements to anterior aorta (0·95), posterior aorta (0·94) and vertebra (0·96). The reliability coefficient expressed as a percentage of the mean (RC%) was lowest (better) for measurement to vertebrae (9·8%). For PFT, mean thickness was comparable for sagittal (1·74 cm) and transverse (1·76 cm) planes; ICC values were also comparable for both planes (0·98 vs. 0·98, respectively), as were RC% (7·5% vs. 7·1%, respectively). IAT assessments to the vertebra were marginally more reliable than those to other structures. While PFT assessments were equally reliable for both measurements planes, precise probe placement was easier for the sagittal plane. Based on these findings, guidelines for the reliable measurement of central adiposity using ultrasound are presented. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

Non-ionizing radiations : physical characteristics, biological effects and health hazard assessment

International Nuclear Information System (INIS)

Repacholi, M.H.

1988-01-01

The Workshop was a project of the International Non-Ionizing Radiation Committee of IRPA and comprised a series of educational lectures and demonstrations intended to give a comprehensive overview of non-ionizing electromagnetic radiation: physical characteristics, sources of concern, levels of exposure, mechanisms of interaction and reported effects of these fields and radiations with biological tissues, human studies, health risk assessment, national and international standards and guidelines, and protective measures

Guidelines for radiological interventions

International Nuclear Information System (INIS)

Kauffmann, G.W.

1998-01-01

The German Radiological Society, in cooperation with other German professional bodies, set up draft Guidelines for Radiological Interventions and submitted them to the professional community for discussion. The Guidelines are meant to assess the potential of radiological interventions as treatment alternatives to surgery or aggressive therapy such as chemotherapy. In fact, technical practicability on its own is insufficient to warrant intervention. The Guidelines are systematically compiled notions and recommendations whose aim it is to provide support to physicians and patients in choosing suitable medical care provisions (prevention, diagnosis, therapy, aftertreatment) in specific circumstances. A complete Czech translation of the Guidelines is given. (P.A.)

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.

Life Cycle Assessment of electricity generation: overview and methodological issues

DEFF Research Database (Denmark)

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

study focuses on the comparability between different technologies, identifying and quantifying the possible mistakes that can occur when comparing two technologies whose environmental assessments have been performed with conflicting assumptions. Nine different power generation technologies were examined......: hard coal, lignite, natural gas, oil, nuclear, biomass, hydroelectric, solar photovoltaic and wind. More than 150 published studies were selected and analyzed to investigate whether "typical" GHG, NOx and SO2 emission factors for each technology could be identified. For a better overview of the sources...... 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...

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

Measure Guideline. Air Sealing Attics in Multifamily Buildings

Energy Technology Data Exchange (ETDEWEB)

Otis, Casey [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Maxwell, Sean [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

2012-06-01

This Building America Measure Guideline is intended for owners, builders, contractors, homeowners, and other stakeholders in the multifamily building industry, and focuses on challenges found in existing buildings for a variety of housing types. It explains why air sealing is desirable, explores related health and safety issues, and identifies common air leakage points in multifamily building attics. In addition, it also gives an overview of materials and techniques typically used to perform air sealing work.

A Pathway to National Guidelines for Laboratory Diagnostics of Chronic Kidney Disease – Examples from Diverse European Countries

Science.gov (United States)

Aakre, Kristin Moberg; Yucel, Dogan; Bargnoux, Anne-Sophie; Cristol, Jean-Paul; Piéroni, Laurence

2017-01-01

The principal benefit of guidelines is to improve the quality of care received by patients. In the 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (KDIGO) was released and it is designed to provide information and assist decision making. This review gives a brief overview of a various national CKD guidelines that rely on the newly released KDIGO guidelines. All of the included countries (France, Turkey, Norway and Croatia) are non-English speaking countries and they differ in population and socio economic aspects. Examples shown in this review may provide valuable experience for countries that are in process of creating their national CKD guidelines. PMID:29333148

Guidelines for evaluating the environmental performance of Product/Service-Systems through life cycle assessment

DEFF Research Database (Denmark)

Kjær, Louise Laumann; Pigosso, Daniela C. A.; McAloone, Tim C.

2018-01-01

Product/Service-Systems (PSS) such as integrated solutions, performance-based contracts or sharing systems are often proposed as means to enable improved environmental sustainability. However, PSS are not necessarily environmentally benign compared to conventional systems. Quantitative environmen......Product/Service-Systems (PSS) such as integrated solutions, performance-based contracts or sharing systems are often proposed as means to enable improved environmental sustainability. However, PSS are not necessarily environmentally benign compared to conventional systems. Quantitative....... In this article, we propose a set of guidelines consisting of six steps, which elaborates the LCA process with respect to the specific consideration for PSS assessment. The guidelines were developed based on identified challenges for the application of LCA on PSS, a review of existing LCAs on PSS case studies...

Overview of renewable energies in Lorraine - Assessment: Year 2013. Situation note on renewable energies in Lorraine - Assessment: first half 2014, 2nd half 2014. Overview of renewable energies in the Grand East region - Assessment year 2015-release 2016. Overview of renewable and recovery energies in the Grand East region - Assessment year 2016-release 2017

International Nuclear Information System (INIS)

2015-02-01

A first document proposes an overview of the development of renewable energies in Lorraine with respect to regional as well as European and national objectives defined for each renewable energy type. Annual data for 2013 are herein presented. Graphs indicate values for the share of renewable energies, the energy mix in Lorraine, locations, evolutions and levels of production for the different renewable sources (wind, photovoltaic, hydroelectricity, methanization, wood energy, geothermal and heat pumps, solar thermal, waste valorisation, bio-fuels). The second and third documents propose assessments and comments of situations and evolutions of productions and development (actions, regulatory and legal context, projects) for the different sources, an assessment of the implementation progress of the regional scheme of connection of renewable energies. Annual publications are then proposed which give the same kind of assessments, and comparisons with other French regions

Computer system validation: an overview of official requirements and standards.

Science.gov (United States)

Hoffmann, A; Kähny-Simonius, J; Plattner, M; Schmidli-Vckovski, V; Kronseder, C

1998-02-01

A brief overview of the relevant documents for companies in the pharmaceutical industry, which are to be taken into consideration to fulfil computer system validation requirements, is presented. We concentrate on official requirements and valid standards in the USA, European Community and Switzerland. There are basically three GMP-guidelines. their interpretations by the associations of interests like APV and PDA as well as the GAMP Suppliers Guide. However, the three GMP-guidelines imply the same philosophy about computer system validation. They describe more a what-to-do approach for validation, whereas the GAMP Suppliers Guide describes a how-to-do validation. Nevertheless, they do not contain major discrepancies.

Updating contextualized clinical practice guidelines on stroke rehabilitation and low back pain management using a novel assessment framework that standardizes decisions.

Science.gov (United States)

Gambito, Ephraim D V; Gonzalez-Suarez, Consuelo B; Grimmer, Karen A; Valdecañas, Carolina M; Dizon, Janine Margarita R; Beredo, Ma Eulalia J; Zamora, Marcelle Theresa G

2015-11-04

Clinical practice guidelines need to be regularly updated with current literature in order to remain relevant. This paper reports on the approach taken by the Philippine Academy of Rehabilitation Medicine (PARM). This dovetails with its writing guide, which underpinned its foundational work in contextualizing guidelines for stroke and low back pain (LBP) in 2011. Working groups of Filipino rehabilitation physicians and allied health practitioners met to reconsider and modify, where indicated, the 'typical' Filipino patient care pathways established in the foundation guidelines. New clinical guidelines on stroke and low back pain which had been published internationally in the last 3 years were identified using a search of electronic databases. The methodological quality of each guideline was assessed using the iCAHE Guideline Quality Checklist, and only those guidelines which provided full text references, evidence hierarchy and quality appraisal of the included literature, were included in the PARM update. Each of the PARM-endorsed recommendations was then reviewed, in light of new literature presented in the included clinical guidelines. A novel standard updating approach was developed based on the criteria reported by Johnston et al. (Int J Technol Assess Health Care 19(4):646-655, 2003) and then modified to incorporate wording from the foundational PARM writing guide. The new updating tool was debated, pilot-tested and agreed upon by the PARM working groups, before being applied to the guideline updating process. Ten new guidelines on stroke and eleven for low back pain were identified. Guideline quality scores were moderate to good, however not all guidelines comprehensively linked the evidence body underpinning recommendations with the literature. Consequently only five stroke and four low back pain guidelines were included. The modified PARM updating guide was applied by all working groups to ensure standardization of the wording of updated recommendations

Alternate Assessments for Students with Significant Cognitive Disabilities: Participation Guidelines and Definitions. NCEO Report 406

Science.gov (United States)

Thurlow, Martha L.; Lazarus, Sheryl S.; Larson, Erik D.; Albus, Deb A.; Liu, Kristi K.; Kwong, Elena

2017-01-01

With the reauthorization of the Elementary and Secondary Education Act (ESEA) in 2015, renewed attention was paid to the importance of guidelines for participation in alternate assessments based on alternate achievement standards (AA-AAS) and to understanding of who the students are who have significant cognitive disabilities. The analyses…

The development of oncology treatment guidelines: an analysis of the National Guidelines Clearinghouse.

Science.gov (United States)

Palta, Manisha; Lee, W Robert

2011-01-01

In the last 2 decades, guidelines have been developed to improve quality of patient care. A recent editorial of guideline development procedures suggested the process has significant limitations that affect their scientific validity.(1) This prompted us to review oncology treatment guidelines to determine if such limitations are widespread. We performed a review of oncology treatment guidelines registered at the National Guidelines Clearinghouse (www.guideline.gov). Each guideline was independently reviewed by 2 authors and the following criteria were assessed: coordinating organization, guideline panel composition, reporting conflict of interest, peer review, dissent, expiration date, PubMed citation, and evidence-based scoring and grading of recommendations. Disagreements were resolved by consensus in subsequent discussions. Sixty-four guidelines were reviewed (39 [61%] were developed by a medical specialty society and 25 [39%] were developed by government agencies). Fifty (78%) guideline panels were multidisciplinary and 44 (69%) included individuals with epidemiologic and health services research expertise. Potential conflicts of interest were disclosed in 43 (67%) guidelines. Sixty (94%) guidelines underwent peer review, with external review in 31 (48%). Seventeen (27%) guidelines are indexed by PubMed. Fifty-one (80%) guidelines included evidence-based methodologies and 46 (72%) used evidence-based scoring of recommendations. Significant differences were observed according to coordinating organization (eg, disclosure of conflict of interest in 46% of guidelines developed by medical specialty societies versus 100% authored by government agencies [P <.0001]). The majority of oncology-related treatment guidelines registered at the National Guidelines Clearinghouse satisfy most of the criteria for sound guideline development. Significant differences in these criteria were observed according to the coordinating organization that developed the guideline. Copyright

Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR): Part 1, Overview of NUCLARR data retrieval: User's guide

International Nuclear Information System (INIS)

Gilmore, W.E.; Gentillon, C.D.; Gertman, D.I.; Beers, G.H.; Galyean, W.J.; Gilbert, B.G.

1988-06-01

The Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR) is an automated data base management system for processing and storing human error probability and hardware component failure data. The NUCLARR system software resides on an IBM (or compatible) personal micro-computer. NUCLARR can be used by the end user to furnish data inputs for both human and hardware reliability analysis in support of a variety of risk assessment activities. The NUCLARR system is documented in a five-volume series of reports. Volume IV of this series is the User's Guide for operating the NUCLARR software and is presented in three parts. This document, Part 1: Overview of NUCLARR Data Retrieval provides an introductory overview to the system's capabilities and procedures for data retrieval. The methods and criteria for selection of data sources and entering them into the NUCLARR system are also described in this document

European project for developing general guidelines for harmonising internal dose assessment procedures (IDEAS)

International Nuclear Information System (INIS)

Andrasi, A.; Bailey, M.; Puncher, M.; Berkovski, V.; Eric Blanchardon, E.; Jourdain, J.-R.; Carlo-Maria Castellani, C.-M.; Doerfel, H.; Christian Hurtgen, Ch.; Le Guen, B.

2003-01-01

Several international intercomparison exercises on intake and internal dose assessments from monitoring data led to the conclusion that the results calculated by different participants varied significantly mainly because of the wide variety of methods and assumptions applied in the assessment procedure. Based on these experiences the need for harmonisation of the procedures has been formulated as an EU research project under the 5 th Framework Programme (2001-2005), with the aim of developing general guidelines for standardising assessments of intakes and internal doses. In the IDEAS project eight institutions from seven European countries are participating using inputs also from internal dosimetry professionals from across Europe to ensure broad consensus in the outcome of the project. The IDEAS project is explained

Perceptions and Challenges of Using Emergency Triage Assessment Treatment Guideline in Emergency Department at Muhimbili National Hospital, Tanzania

OpenAIRE

Safari, Sixtus Ruyumbu

2012-01-01

Triage is the process of determining the priority of patients' treatments based on the severity of their conditions. This helps treating patients efficiently when resources are insufficient for all to be treated immediately. Health care providers use ETAT guideline during triaging patients to improve quality of care and reduce morbidity and mortality rates. But the adherence to the guidelines protocol has been a challenge in triage rooms. This paper assessed perspective of HCWs and challenges...

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.

[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.

Best practice guidelines for stroke in Cameroon: An innovative and participatory knowledge translation project

Directory of Open Access Journals (Sweden)

Lynn Cockburn

2014-11-01

Objectives: The purpose of this article is to describe how a group of front-line practitioners collaborated with academics and students to develop best practice guidelines (BPG for the management and rehabilitation of stroke in adult patients in Cameroon. Method: A working group was established and adapted internationally recognised processes for the development of best practice guidelines. The group determined the scope of the guidelines, documented current practices, and critically appraised evidence to develop guidelines relevant to the Cameroon context. Results: The primary result of this project is best practice guidelines which provided an overview of the provision of stroke rehabilitation services in the region, and made 83 practice recommendations to improve these services. We also report on the successes and challenges encountered during the process, and the working group’s recommendations aimed at encouraging others to consider similar projects. Conclusion: This project demonstrated that there is interest and capacity for improving stroke rehabilitation practices and for stroke guideline development in Africa.

Trend of glycated hemoglobin testing in diabetic patients: to assess compliance with clinical practice guidelines

International Nuclear Information System (INIS)

Ghayur, S.; Tariq, H.

2013-01-01

Objective: To determine appropriate use of glycated hemoglobin (HbA1c) testing in accordance with current recommended guidelines. Study Design: Descriptive study. Place and Duration of Study: Chemical Pathology Department Shifa International Hospital, Islamabad from Oct 2011 to Oct 2012. Material and Methods: We randomly selected 170 known diabetic patients' data from our Laboratory Information System (LIS) who were retrospective analyzed for HbA1c to check for intervals and test frequency for each patient in one year. Patients with follow-up for at least one year at Shifa International Hospital, Islamabad and having their routine investigations in our chemical pathology laboratory were included. The concentrations of HbA1c for all the specimens were measured immunoturbidimetrically using a microparticle agglutination inhibition method. Four guidelines namely World Health Organization (WHO), American Diabetic Association (ADA), Canadian Diabetic Association (CDA) and National Institute for Health and Clinical Excellence (NICE) about HbA1c testing were utilized for data interpretation. All tests ordered within a 2 months period or more than 6 months following the previous order were labeled as inappropriate. Results: Only 35.8% of the patients were being properly monitored as per guidelines. Out of 64% patients who were inappropriately monitored, 12.9% had repeat orders within 2 months while 51.1% of patients were being monitored at longer interval against recommended guidelines. Conclusions: Glycated hemoglobin is a useful tool to objectively assess the prior glycemic control of patients with type 1 and type 2 diabetes. The study highlights that in large proportion of diabetic patients, HbA1c is not utilized properly as a tool to assess the risk of diabetic complications but in a small proportion is also tested unnecessarily which adds to avoidable health expenditure. (author)

Compliance with practice guidelines: clinical autonomy revisited

NARCIS (Netherlands)

Klazinga, N.

1994-01-01

The development of practice guidelines is gaining popularity in both North America and Europe. This review article explores the different reasons behind guideline development, the methodologies used and the effects assessed so far. Experience since 1982 with a guideline development programme at CBO

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

Science.gov (United States)

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

2013-01-01

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. 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. The mean DFS value was 4.9 and 23% of the patients were registered as caries-free (DFS = 0). The PDS risk classification was predominantly based on past caries and/or present caries activity. The majority was classified as 'some risk', while 16.7% were assessed as being of 'high' or 'very high risk'. The corresponding value for the two highest risk groups in the Cariogram model was 17.4%. The agreement between the two models was found acceptable (77.5%) for those assessed as low risk, while discrepancies were disclosed among those classified with higher risks. Although the proportion of subjects assessed with high or very high risk was similar using the PDS guidelines and the Cariogram model, the agreement between the models was fair. An acceptable agreement was only disclosed for the low risk category.

Federal Radiological Monitoring and Assessment Center (FRMAC): Overview of FRMAC operations

International Nuclear Information System (INIS)

1993-09-01

The purpose of this Management Overview of the Federal Radiological Monitoring and Assessment Center (FRMAC) is to explain the federal preparation for a radiological accident and to describe the subsequent response activities which provide radiological monitoring and assessment outside the boundaries of the monitoring which support the radiological accident site. In the event of a radiological accident, federal agencies with various statutory responsibilities have agreed to coordinate their efforts at the accident scene under the umbrella of the Federal Radiological Emergency Response Plan (FRERP). This cooperative effort will assure the state(s) and the Lead Federal Agency (LFA) that all federal technical assistance is fully supporting their efforts to protect the public and will provide these monitoring results in a working data center for immediate use by the state(s) and LFA decision makers. The federal agencies do not relinquish their statutory responsibilities. However, the mandated federal cooperation ensures that each agency can obtain the data critical to its specific responsibility

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

Science.gov (United States)

Westphal, Glauco Adrieno; Garcia, Valter Duro; de Souza, Rafael Lisboa; Franke, Cristiano Augusto; Vieira, Kalinca Daberkow; Birckholz, Viviane Renata Zaclikevis; Machado, Miriam Cristine; de Almeida, Eliana Régia Barbosa; 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; de Albuquerque, André Gustavo Neves; Abdala, Edson; Gonçalves, Anderson Ricardo Roman; Pacheco-Moreira, Lúcio Filgueiras; Dias, Fernando Suparregui; Fernandes, Rogério; Giovanni, Frederico Di; de Carvalho, Frederico Bruzzi; Fiorelli, Alfredo; Teixeira, Cassiano; Feijó, Cristiano; Camargo, Spencer Marcantonio; de Oliveira, Neymar Elias; David, André Ibrahim; Prinz, Rafael Augusto Dantas; Herranz, Laura Brasil; de Andrade, Joel

2016-01-01

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. PMID:27737418

Programmer's manual for CAMCON: Compliance Assessment Methodology CONtroller

International Nuclear Information System (INIS)

Rechard, R.P.; Gilkey, A.P.; Rudeen, D.K.; Byle, K.A.; Iuzzolino, H.J.

1993-05-01

CAMCON, the Compliance Assessment Methodology CONtroller, is an analysis system that assists in assessing the compliance of the Waste Isolation Pilot Plant (WIPP) with applicable long-term regulations of the US Environmental Protection Agency, including Subpart B of the Environmental Standards for the Management and Disposal of spent Nuclear Fuel, High-Level and Transuranic Radioactive Wastes, 40 CFR 191 and 40CFR268.6, which is the portion of the Land Disposal Restrictions implementing the Resource, Conservative, and Recovery Act of 1976, as amended that states the conditions for disposal of hazardous chemical wastes. This manual provides an architectural overview of the CAMCON system. Furthermore this manual presents guidelines and presents suggestions for programmers developing the many different types of software necessary to investigate various events and physical processes of the WIPP. These guidelines include user interface requirements, minimum quality assurance requirements, coding style suggestions, and the use of numerous software libraries developed specifically for or adapted for the CAMCON system

Guidelines for the evaluation and assessment of the sustainable use of resources and of wastes management at healthcare facilities.

Science.gov (United States)

Townend, William K; Cheeseman, Christopher R

2005-10-01

This paper presents guidelines that can be used by managers of healthcare facilities to evaluate and assess the quality of resources and waste management at their facilities and enabling the principles of sustainable development to be addressed. The guidelines include the following key aspects which need to be considered when completing an assessment. They are: (a) general management; (b) social issues; (c) health and safety; (d) energy and water use; (e) purchasing and supply; (f) waste management (responsibility, segregation, storage and packaging); (g) waste transport; (h) recycling and re-use; (i) waste treatment; and (j) final disposal. They identify actions required to achieve a higher level of performance which can readily be applied to any healthcare facility, irrespective of the local level of social, economic and environmental development. The guidelines are presented, and the characteristics of facilities associated with sustainable (level 4) and unsustainable (level 0) healthcare resource and wastes management are outlined. They have been used to assess a major London hospital, and this highlighted a number of deficiencies in current practice, including a lack of control over purchasing and supply, and very low rates of segregation of municipal solid waste from hazardous healthcare waste.

PIAAC Technical Standards and Guidelines

Science.gov (United States)

OECD Publishing, 2014

2014-01-01

The Programme for International Assessment of Adult Competencies (PIAAC) will establish technical standards and guidelines to ensure that the survey design and implementation processes of PIAAC yield high-quality and internationally comparable data. This document provides a revised version of the technical standards and guidelines originally…

An evaluation of contaminated estuarine sites using sediment quality guidelines and ecological assessment methodologies.

Science.gov (United States)

Fulton, M; Key, P; Wirth, E; Leight, A K; Daugomah, J; Bearden, D; Sivertsen, S; Scott, G

2006-10-01

Toxic contaminants may enter estuarine ecosystems through a variety of pathways. When sediment contaminant levels become sufficiently high, they may impact resident biota. One approach to predict sediment-associated toxicity in estuarine ecosystems involves the use of sediment quality guidelines (ERMs, ERLs) and site-specific contaminant chemistry while a second approach utilizes site-specific ecological sampling to assess impacts at the population or community level. The goal of this study was to utilize an integrated approach including chemical contaminant analysis, sediment quality guidelines and grass shrimp population monitoring to evaluate the impact of contaminants from industrial sources. Three impacted sites and one reference site were selected for study. Grass shrimp populations were sampled using a push-netting approach. Sediment samples were collected at each site and analyzed for metals, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and pesticides. Contaminant levels were then compared to sediment quality guidelines. In general, grass shrimp population densities at the sites decreased as the ERM quotients increased. Grass shrimp densities were significantly reduced at the impacted site that had an ERM exceedance for chromium and the highest Mean ERM quotient. Regression analysis indicated that sediment chromium concentrations were negatively correlated with grass shrimp density. Grass shrimp size was reduced at two sites with intermediate levels of contamination. These findings support the use of both sediment quality guidelines and site-specific population monitoring to evaluate the impacts of sediment-associated contaminants in estuarine systems.

Assessment of available evidence in the management of gallbladder and bile duct stones: a systematic review of international guidelines

NARCIS (Netherlands)

Reuver, P.R.; Besselink, M.G.; Laarhoven, K.J. van; Harrison, E.M.; Wigmore, S.J.; Hugh, T.J.; Boermeester, M.A.

2017-01-01

BACKGROUND: Gallstone disease is a frequent disorder in the Western world with a prevalence of 10-20%. Recommendations for the assessment and management of gallstones vary internationally. The aim of this systematic review was to assess quality of guideline recommendations for treatment of

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.

Overview of fourth generation reactors. Assessment in terms of safety and radiation protection

International Nuclear Information System (INIS)

Couturier, J.; Baudrand, O.; Blanc, D.; Bourgois, T.; Hache, G.; Ivanov, E.; Bonneville, H.; Meignen, R.; Nicaise, G.; Bruna, G.; Clement, B.; Kissane, M.; Monhardt, B.

2012-01-01

Based on a systematic analysis of the different concepts of fourth generation nuclear reactors, this report gives an overview of specific aspects regarding safety and radiation protection for six concepts: sodium fast reactors (SFR), gas fast reactors (GFR), lead fast reactors (LFR), molten salt reactors (MSR), very high or high temperature reactors (V/HTR) and supercritical water reactors (SCWR). This assessment is based on different studies and researches performed by the IRSN at an international level. For each reactor concept, the report proposes a presentation of the current status of development and its perspectives, describes the safety aspects which are specific to this concept, identifies and discusses elements for safety analysis, and assesses the concept with respect to the Fukushima accident and IAEA recommendations and predefined themes

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)

Ergonomics standards and guidelines for computer workstation design and the impact on users' health - a review.

Science.gov (United States)

Woo, E H C; White, P; Lai, C W K

2016-03-01

This paper presents an overview of global ergonomics standards and guidelines for design of computer workstations, with particular focus on their inconsistency and associated health risk impact. Overall, considerable disagreements were found in the design specifications of computer workstations globally, particularly in relation to the results from previous ergonomics research and the outcomes from current ergonomics standards and guidelines. To cope with the rapid advancement in computer technology, this article provides justifications and suggestions for modifications in the current ergonomics standards and guidelines for the design of computer workstations. Practitioner Summary: A research gap exists in ergonomics standards and guidelines for computer workstations. We explore the validity and generalisability of ergonomics recommendations by comparing previous ergonomics research through to recommendations and outcomes from current ergonomics standards and guidelines.

Advanced control room design review guidelines: Integration of the NUREG-0700 guidelines and development of new human-system interface guidelines

Energy Technology Data Exchange (ETDEWEB)

Carter, R.J.

1997-07-01

This report documents the work conducted in four tasks of the Nuclear Regulatory Commission (NRC) project entitled Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation. The purpose of the first task was to integrate the applicable sections of NUREG-0700 into the advanced control room design review (ACRDR) guidelines to ensure that all applicable guidelines are together in one document and conveniently accessible to users. The primary objective of the second task was to formulate a strategy for the development of new ACRDR guidelines that have not otherwise been identified. The main focus of the third task was to modify the individual ACRDR guidelines generated to date to ensure that they are suitable for the intended nuclear power plant (NPP) control station system application. The goal of the fourth task was to develop human factors guidelines for two human-system interface categories that are missing from the current ACRDR guidelines document. During the first task those areas in NUREG-0700 that are not addressed by the ACRDR guidelines document were identified, the areas were subsequently reviewed against six recent industry human factors engineering review guidelines, and the NUREG-0700 guidelines were updated as necessary. In the second task 13 general categories of human-system interface guidelines that are either missing from or not adequately addressed by the ACRDR document were discovered. An approach was derived for the development of new ACRDR guidelines, a preliminary assessment of the available sources that may be useful in the creation of new guidelines and their applicability to the identified human-system interface categories was performed, and an estimate was made of the amount of time and level of effort required to complete the development of needed new ACRDR guidelines. During the third task those NPP control station systems to which the NUREG-0700 and ACRDR guidelines apply were identified, matrices of such

Advanced control room design review guidelines: Integration of the NUREG-0700 guidelines and development of new human-system interface guidelines

International Nuclear Information System (INIS)

Carter, R.J.

1997-07-01

This report documents the work conducted in four tasks of the Nuclear Regulatory Commission (NRC) project entitled Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation. The purpose of the first task was to integrate the applicable sections of NUREG-0700 into the advanced control room design review (ACRDR) guidelines to ensure that all applicable guidelines are together in one document and conveniently accessible to users. The primary objective of the second task was to formulate a strategy for the development of new ACRDR guidelines that have not otherwise been identified. The main focus of the third task was to modify the individual ACRDR guidelines generated to date to ensure that they are suitable for the intended nuclear power plant (NPP) control station system application. The goal of the fourth task was to develop human factors guidelines for two human-system interface categories that are missing from the current ACRDR guidelines document. During the first task those areas in NUREG-0700 that are not addressed by the ACRDR guidelines document were identified, the areas were subsequently reviewed against six recent industry human factors engineering review guidelines, and the NUREG-0700 guidelines were updated as necessary. In the second task 13 general categories of human-system interface guidelines that are either missing from or not adequately addressed by the ACRDR document were discovered. An approach was derived for the development of new ACRDR guidelines, a preliminary assessment of the available sources that may be useful in the creation of new guidelines and their applicability to the identified human-system interface categories was performed, and an estimate was made of the amount of time and level of effort required to complete the development of needed new ACRDR guidelines. During the third task those NPP control station systems to which the NUREG-0700 and ACRDR guidelines apply were identified, matrices of such

Managing the nation's nuclear waste. Overview: Nuclear Waste Policy Act

International Nuclear Information System (INIS)

1985-10-01

Signed into law by the President on January 7, 1983, the Nuclear Waste Policy Act established a national policy for safely storing, transporting, and disposing of spent nuclear fuel and high-level radioactive waste. This overview presents the following information on the Nuclear Waste Policy Act: (1) background; (2) permanent repository; (3) siting guidelines and mission plan; (4) monitored retrievable storage; and (5) nuclear waste funds. (DT)

Historical overview of radiation exposure guidance on radioactive consumer products

International Nuclear Information System (INIS)

Tapert, A.C.

1978-01-01

This paper is an historical overview of radiation exposure recommendations suggested by several commissions, committees, and agencies. Guidelines issued by the International Commission of Radiological Protection, International Atomic Energy Agency, Federal Radiation Council, Nuclear Energy Agency (formerly the European Nuclear Energy Agency), National Council on Radiation Protection and Measurements, Food and Drug Administration, Conference of Radiation Control Program Directors, and the US Nuclear Regulatory Commission are discussed

Environmental assessment overview: Richton Dome site, Mississippi

International Nuclear Information System (INIS)

1986-05-01

In February 1983, the US Department of Energy (DOE) identified the Richton Dome site in Mississippi as one of the nine potentially acceptable sites for a mined geologic repository for spent nuclear fuel and high-level radioactive waste. To determine their suitability, the Richton Dome site and the eight other potentially acceptable sites have been evaluated in accordance with the DOE's General Guidelines for the Recommendation of Sites for the Nuclear Waste Repositories. The site is in the Gulf interior region, which is one of five distinct geohydrologic settings considered for the first repository. On the basis of the evaluations reported in this EA, the DOE has found that the Richton Dome site is not disqualified under the guidelines. On the basis of these findings, the DOE is nominating the Richton Dome site as one of five sites suitable for characterization. 3 figs

The era of 3Rs implementation in developmental and reproductive toxicity (DART) testing: Current overview and future perspectives.

Science.gov (United States)

Beekhuijzen, Manon

2017-09-01

Since adoption of the first globally implemented guidelines for developmental and reproductive toxicity (DART) testing for pharmaceuticals, industrial chemicals and agrochemicals, many years passed without major updates. However in recent years, significant changes in these guidelines have been made or are being implemented. These changes have been guided by the ethical drive to reduce, refine and replace (3R) animal testing, as well as the addition of endocrine disruptor relevant endpoints. Recent applied improvements have focused on reduction and refinement. Ongoing scientific and technical innovations will provide the means for replacement of animal testing in the future and will improve predictivity in humans. The aim of this review is to provide an overview of ongoing global DART endeavors in respect to the 3Rs, with an outlook towards future advances in DART testing aspiring to reduce animal testing to a minimum and the supreme ambition towards animal-free hazard and risk assessment. Copyright © 2017 Elsevier Inc. All rights reserved.

The CARE guidelines: consensus-based clinical case report guideline development.

Science.gov (United States)

Gagnier, Joel J; Kienle, Gunver; Altman, Douglas G; Moher, David; Sox, Harold; Riley, David

2014-01-01

A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design. Develop, disseminate, and implement systematic reporting guidelines for case reports. We used a three-phase consensus process consisting of (1) pre-meeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines, and (3) post-meeting feedback, review, and pilot testing, followed by finalization of the case report guidelines. This consensus process involved 27 participants and resulted in a 13-item checklist-a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent. We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery. Copyright © 2014 Reproduced with permission of Global Advances in Health and Medicine. Published by Elsevier Inc. All rights reserved.

Current Guidelines Have Limited Applicability to Patients with Comorbid Conditions: A Systematic Analysis of Evidence-Based Guidelines

Science.gov (United States)

Lugtenberg, Marjolein; Burgers, Jako S.; Clancy, Carolyn; Westert, Gert P.; Schneider, Eric C.

2011-01-01

Background Guidelines traditionally focus on the diagnosis and treatment of single diseases. As almost half of the patients with a chronic disease have more than one disease, the applicability of guidelines may be limited. The aim of this study was to assess the extent that guidelines address comorbidity and to assess the supporting evidence of recommendations related to comorbidity. Methodology/Principal Findings We conducted a systematic analysis of evidence-based guidelines focusing on four highly prevalent chronic conditions with a high impact on quality of life: chronic obstructive pulmonary disease, depressive disorder, diabetes mellitus type 2, and osteoarthritis. Data were abstracted from each guideline on the extent that comorbidity was addressed (general comments, specific recommendations), the type of comorbidity discussed (concordant, discordant), and the supporting evidence of the comorbidity-related recommendations (level of evidence, translation of evidence). Of the 20 guidelines, 17 (85%) addressed the issue of comorbidity and 14 (70%) provided specific recommendations on comorbidity. In general, the guidelines included few recommendations on patients with comorbidity (mean 3 recommendations per guideline, range 0 to 26). Of the 59 comorbidity-related recommendations provided, 46 (78%) addressed concordant comorbidities, 8 (14%) discordant comorbidities, and for 5 (8%) the type of comorbidity was not specified. The strength of the supporting evidence was moderate for 25% (15/59) and low for 37% (22/59) of the recommendations. In addition, for 73% (43/59) of the recommendations the evidence was not adequately translated into the guidelines. Conclusions/Significance Our study showed that the applicability of current evidence-based guidelines to patients with comorbid conditions is limited. Most guidelines do not provide explicit guidance on treatment of patients with comorbidity, particularly for discordant combinations. Guidelines should be more

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

International Nuclear Information System (INIS)

Lin, J. C.; Tsai, C. C.; Ransom, V. H.; Johnsen, G. W.

2013-01-01

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)

Guidelines for radiological performance assessment of DOE low-level radioactive waste disposal sites

International Nuclear Information System (INIS)

Case, M.J.; Otis, M.D.

1988-07-01

This document provides guidance for conducting radiological performance assessments of Department of Energy (DOE) low-level radioactive waste (LLW) disposal facilities. The guidance is specifically intended to provide the fundamental approach necessary to meet the performance assessment requirements. The document is written for LLW facility operators or other personnel who will manage the performance assessment task. The document is meant to provide guidance for conducting performance assessments in a generally consistent manner at all DOE LLW disposal facilities. The guidance includes a summary of performance objectives to be met by LLW disposal facilities (these objectives are derived from current DOE and other applicable federal regulatory guidelines); specific criteria for an adequate performance assessment and from which a minimum set of required calculations may be determined; recommendations of methods for screening critical components of the analysis system so that these components can be addressed in detail; recommendations for the selection of existing models and the development of site-specific models; recommendations of techniques for comparison of assessment results with performance objectives; and a summary of reporting requirements

ASCOT guidelines

International Nuclear Information System (INIS)

1994-05-01

These guidelines describe an approach used in conducting an Assessment of Safety Culture in Organizations Team (ASCOT) review. They are intended to assist the team members in conducting their reviews and at the same time provide guidance to hosts preparing to receive an ASCOT review. They may also be used by any organization wishing to conduct their own self-assessment of safety culture, independent of an ASCOT review

VGB primary and secondary side water chemistry guidelines for PWR plants

International Nuclear Information System (INIS)

Neder, H.; Wolter, D.; Staudt, U.

2007-01-01

The recent revision of the VGB Water Chemistry Guidelines was issued in 2005 and published in the second half of 2006. These guidelines are based on the primary and secondary side operating chemistry experience with all Siemens designed pressurized water reactors gained since the beginning of the 1980s. These guidelines cover For the primary side chemistry Modified lithium boron chemistry, Zinc chemistry for dose rate reduction, Enriched boric acid (EBA) chemistry for high duty core design For the secondary side chemistry High all-volatile treatment (AVT) chemistry (high pH operation) Oxygen injection in the secondary side Especially for the secondary side chemistry, compared with the water chemistry guidelines of other organizations worldwide, these Guidelines are less stringent, providing more operational flexibility to the plant operation, and can be applied for all new designs of steam generators with egg-crates or broached hole tube supports and with I 690TT or I 800 tubing materials. This paper gives an overview of the 2006 revision of the VGB Water Chemistry Guidelines for PWR plants and describes the fundamental goals of water chemistry operation strategies. In addition, the reasons for the selected control parameters and action levels, to achieve an adequate plant performance, are presented based on the operating experience. (orig.)

Programmer`s manual for CAMCON: Compliance Assessment Methodology CONtroller

Energy Technology Data Exchange (ETDEWEB)

Rechard, R.P. [Sandia National Labs., Albuquerque, NM (United States); Gilkey, A.P.; Rudeen, D.K.; Byle, K.A. [New Mexico Engineering Research Inst., Albuquerque, NM (United States); Iuzzolino, H.J. [Geo-Centers, Inc., Albuquerque, NM (United States)

1993-05-01

CAMCON, the Compliance Assessment Methodology CONtroller, is an analysis system that assists in assessing the compliance of the Waste Isolation Pilot Plant (WIPP) with applicable long-term regulations of the US Environmental Protection Agency, including Subpart B of the Environmental Standards for the Management and Disposal of spent Nuclear Fuel, High-Level and Transuranic Radioactive Wastes, 40 CFR 191 and 40CFR268.6, which is the portion of the Land Disposal Restrictions implementing the Resource, Conservative, and Recovery Act of 1976, as amended that states the conditions for disposal of hazardous chemical wastes. This manual provides an architectural overview of the CAMCON system. Furthermore this manual presents guidelines and presents suggestions for programmers developing the many different types of software necessary to investigate various events and physical processes of the WIPP. These guidelines include user interface requirements, minimum quality assurance requirements, coding style suggestions, and the use of numerous software libraries developed specifically for or adapted for the CAMCON system.

Prospective systematic review registration: perspective from the Guidelines International Network (G-I-N).

Science.gov (United States)

Van der Wees, Philip; Qaseem, Amir; Kaila, Minna; Ollenschlaeger, Guenter; Rosenfeld, Richard

2012-02-09

Clinical practice and public health guidelines are important tools for translating research findings into practice with the aim of assisting health practitioners as well as patients and consumers in health behavior and healthcare decision-making. Numerous programs for guideline development exist around the world, with growing international collaboration to improve their quality. One of the key features in developing trustworthy guidelines is that recommendations should be based on high-quality systematic reviews of the best available evidence. The review process used by guideline developers to identify and grade relevant evidence for developing recommendations should be systematic, transparent and unbiased. In this paper, we provide an overview of current international developments in the field of practice guidelines and methods to develop guidelines, with a specific focus on the role of systematic reviews. The Guidelines International Network (G-I-N) aims to stimulate collaboration between guideline developers and systematic reviewers to optimize the use of available evidence in guideline development and to increase efficiency in the guideline development process. Considering the significant benefit of systematic reviews for the guideline community, the G-I-N Board of Trustees supports the international prospective register of systematic reviews (PROSPERO) initiative. G-I-N also recently launched a Data Extraction Resource (GINDER) to present and share data extracted from individual studies in a standardized template. PROSPERO and GINDER are complementary tools to enhance collaboration between guideline developers and systematic reviewers to allow for alignment of activities and a reduction in duplication of effort.

Environmental assessment overview, Davis Canyon site, Utah

International Nuclear Information System (INIS)

1986-05-01

In February 1983, the US Department of Energy (DOE) identified the Davis Canyon site in Utah as one of the nine potentially acceptable sites for a mined geologic repository for spent nuclear fuel and high-level radioactive waste. To determine their suitability, the Davis Canyon site and the eight other potentially acceptable sites have been evaluated in accordance with the DOE's General Guidelines for the Recommendation of Sites for the Nuclear Waste Repositories. The Davis Canyon site is in the Paradox Basin, which is one of five distinct geohydrologic settings considered for the first repository. On the basis of the evaluations reported in this EA, the DOE has found that the Davis Canyon site is not disqualified under the guidelines. On the basis of these findings, the DOE is nominating the Davis Canyon site as one of five sites suitable for characterization. 3 figs

Systematic evaluation of clinical practice guidelines for pharmacogenomics.

Science.gov (United States)

Beckett, Robert D; Kisor, David F; Smith, Thomas; Vonada, Brooke

2018-06-01

To systematically assess methodological quality of pharmacogenomics clinical practice guidelines. Guidelines published through 2017 were reviewed by at least three independent reviewers using the AGREE II instrument, which consists of 23 items grouped into 6 domains and 2 items representing an overall assessment. Items were assessed on a seven-point rating scale, and aggregate quality scores were calculated. 31 articles were included. All guidelines were published as peer-reviewed articles and 90% (n = 28) were endorsed by professional organizations. Mean AGREE II domain scores (maximum score 100%) ranged from 46.6 ± 11.5% ('applicability') to 78.9 ± 11.4% ('clarity of presentation'). Median overall quality score was 72.2% (IQR: 61.1-77.8%). Quality of pharmacogenomics guidelines was generally high, but variable, for most AGREE II domains.

USING EXPERT OPINION IN HEALTH TECHNOLOGY ASSESSMENT: A GUIDELINE REVIEW.

Science.gov (United States)

Hunger, Theresa; Schnell-Inderst, Petra; Sahakyan, Narine; Siebert, Uwe

2016-01-01

External experts can be consulted at different stages of an HTA. When using vague information sources, it is particularly important to plan, analyze, and report the information processing in a standardized and transparent way. Our objective was to search and analyze recommendations regarding where and how to include expert data in HTA. We performed a systematic database search and screened the Internet pages of seventy-seven HTA organizations for guidelines, recommendations, and methods papers that address the inclusion of experts in HTA. Relevant documents were downloaded, and information was extracted in a standard form. Results were merged in tables and narrative evidence synthesis. From twenty-two HTA organizations, we included forty-two documents that consider the use of expert opinion in HTA. Nearly all documents mention experts in the step of preparation of the evidence report. Six documents address their role for priority setting of topics, fifteen for scoping, twelve for the appraisal of evidence and results, another twelve documents mention experts when considering the dissemination of HTA results. During the assessment step, experts are most often asked to amend the literature search or to provide expertise for special data analyses. Another issue for external experts is to appraise the HTA results and refer them back to a clinical and social context. Little is reported on methods of expert elicitation when their input substitutes study data. Despite existing recommendations on the use of expert opinion in HTA, common standards for elicitation are scarce in HTA guidelines.

Industry guidelines for the calibration of maximum anemometers

Energy Technology Data Exchange (ETDEWEB)

Bailey, B.H. [AWS Scientific, Inc., Albany, NY (United States)

1996-12-31

The purpose of this paper is to report on a framework of guidelines for the calibration of the Maximum Type 40 anemometer. This anemometer model is the wind speed sensor of choice in the majority of wind resource assessment programs in the U.S. These guidelines were established by the Utility Wind Resource Assessment Program. In addition to providing guidelines for anemometers, the appropriate use of non-calibrated anemometers is also discussed. 14 refs., 1 tab.

Introduction to special section on Uncertainty Assessment in Surface and Subsurface Hydrology : An overview of issues and challenges

NARCIS (Netherlands)

Montanari, A.; Shoemaker, C.A.; Van de Giesen, N.C.

This paper introduces the Water Resources Research special section on Uncertainty Assessment in Surface and Subsurface Hydrology. Over the past years, hydrological literature has seen a large increase in the number of papers dealing with uncertainty. In this article, we present an overview of the

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.

Index-TB Guidelines: Guidelines on extrapulmonary tuberculosis for India

Science.gov (United States)

Sharma, Surendra K.; Ryan, H.; Khaparde, Sunil; Sachdeva, K. S.; Singh, Achintya D.; Mohan, Alladi; Sarin, Rohit; Paramasivan, C N; Kumar, Prahlad; Nischal, Neeraj; Khatiwada, Saurav; Garner, Paul; Tharyan, Prathap

2017-01-01

Extrapulmonary tuberculosis (EPTB) is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i) use of Xpert MTB/RIF in diagnosis, (ii) use of adjunct corticosteroids in treatment, and (iii) duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research. PMID:28862176

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

OpenAIRE

Matt W Hayward; Matt W Hayward; Matt W Hayward; Matthew F Child; Graham I. H. Kerley; Peter A. Lindsey; Peter A. Lindsey; Michael John Somers; Bruce eBurns

2015-01-01

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,...

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

OpenAIRE

Hayward, Matt W.; Child, Matthew F.; Kerley, Graham I. H.; Lindsey, Peter A.; Somers, Michael J.; Burns, Bruce

2015-01-01

The IUCN Red List is the most widely used tool to measure extinction risk and report biodiversity trends. Accurate and standardized 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,...

e-Addictology: An Overview of New Technologies for Assessing and Intervening in Addictive Behaviors.

Science.gov (United States)

Ferreri, Florian; Bourla, Alexis; Mouchabac, Stephane; Karila, Laurent

2018-01-01

New technologies can profoundly change the way we understand psychiatric pathologies and addictive disorders. New concepts are emerging with the development of more accurate means of collecting live data, computerized questionnaires, and the use of passive data. Digital phenotyping , a paradigmatic example, refers to the use of computerized measurement tools to capture the characteristics of different psychiatric disorders. Similarly, machine learning-a form of artificial intelligence-can improve the classification of patients based on patterns that clinicians have not always considered in the past. Remote or automated interventions (web-based or smartphone-based apps), as well as virtual reality and neurofeedback, are already available or under development. These recent changes have the potential to disrupt practices, as well as practitioners' beliefs, ethics and representations, and may even call into question their professional culture. However, the impact of new technologies on health professionals' practice in addictive disorder care has yet to be determined. In the present paper, we therefore present an overview of new technology in the field of addiction medicine. Using the keywords [e-health], [m-health], [computer], [mobile], [smartphone], [wearable], [digital], [machine learning], [ecological momentary assessment], [biofeedback] and [virtual reality], we searched the PubMed database for the most representative articles in the field of assessment and interventions in substance use disorders. We screened 595 abstracts and analyzed 92 articles, dividing them into seven categories: e-health program and web-based interventions, machine learning, computerized adaptive testing, wearable devices and digital phenotyping, ecological momentary assessment, biofeedback, and virtual reality. This overview shows that new technologies can improve assessment and interventions in the field of addictive disorders. The precise role of connected devices, artificial

e-Addictology: An Overview of New Technologies for Assessing and Intervening in Addictive Behaviors

Directory of Open Access Journals (Sweden)

Florian Ferreri

2018-03-01

Full Text Available BackgroundNew technologies can profoundly change the way we understand psychiatric pathologies and addictive disorders. New concepts are emerging with the development of more accurate means of collecting live data, computerized questionnaires, and the use of passive data. Digital phenotyping, a paradigmatic example, refers to the use of computerized measurement tools to capture the characteristics of different psychiatric disorders. Similarly, machine learning–a form of artificial intelligence–can improve the classification of patients based on patterns that clinicians have not always considered in the past. Remote or automated interventions (web-based or smartphone-based apps, as well as virtual reality and neurofeedback, are already available or under development.ObjectiveThese recent changes have the potential to disrupt practices, as well as practitioners’ beliefs, ethics and representations, and may even call into question their professional culture. However, the impact of new technologies on health professionals’ practice in addictive disorder care has yet to be determined. In the present paper, we therefore present an overview of new technology in the field of addiction medicine.MethodUsing the keywords [e-health], [m-health], [computer], [mobile], [smartphone], [wearable], [digital], [machine learning], [ecological momentary assessment], [biofeedback] and [virtual reality], we searched the PubMed database for the most representative articles in the field of assessment and interventions in substance use disorders.ResultsWe screened 595 abstracts and analyzed 92 articles, dividing them into seven categories: e-health program and web-based interventions, machine learning, computerized adaptive testing, wearable devices and digital phenotyping, ecological momentary assessment, biofeedback, and virtual reality.ConclusionThis overview shows that new technologies can improve assessment and interventions in the field of addictive

Misguided guidelines for managing labor.

Science.gov (United States)

Cohen, Wayne R; Friedman, Emanuel A

2015-06-01

In a recent review we expressed concerns about new guidelines for the assessment and management of labor recommended jointly by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM). These guidelines are based heavily on a new concept of how cervical dilatation and fetal descent progress, derived from the work of Zhang et al. In their Viewpoint article they have addressed, but not allayed, the concerns we described in our review. We assert that the dilatation curve promulgated by Zhang et al cannot be reconciled with direct clinical observation. Even if they were correct, however, it still does not follow that the ACOG/SMFM guidelines should recommend replacing the coherent system of identifying and managing labor aberrations described by Friedman. That system is grounded in well-established clinical principles based on decades of use and the objectively documented association of some labor abnormalities with poor fetal and maternal outcomes. Recommendations for new clinical management protocols should require the demonstration of superior outcomes through extensive, preferably prospective, assessment. Using untested guidelines for the management of labor may adversely affect women and children. Even if those guidelines were to reduce the currently excessive cesarean delivery rate, the price of that benefit is likely to be a trade-off in harm to parturients and their offspring. The nature and degree of that harm needs to be documented before considering adoption of the guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

Sample preparation guidelines for two-dimensional electrophoresis.

Science.gov (United States)

Posch, Anton

2014-12-01

Sample preparation is one of the key technologies for successful two-dimensional electrophoresis (2DE). Due to the great diversity of protein sample types and sources, no single sample preparation method works with all proteins; for any sample the optimum procedure must be determined empirically. This review is meant to provide a broad overview of the most important principles in sample preparation in order to avoid a multitude of possible pitfalls. Sample preparation protocols from the expert in the field were screened and evaluated. On the basis of these protocols and my own comprehensive practical experience important guidelines are given in this review. The presented guidelines will facilitate straightforward protocol development for researchers new to gel-based proteomics. In addition the available choices are rationalized in order to successfully prepare a protein sample for 2DE separations. The strategies described here are not limited to 2DE and can also be applied to other protein separation techniques.

Internal dose assessments: Uncertainty studies and update of ideas guidelines and databases within CONRAD project

International Nuclear Information System (INIS)

Marsh, J. W.; Castellani, C. M.; Hurtgen, C.; Lopez, M. A.; Andrasi, A.; Bailey, M. R.; Birchall, A.; Blanchardon, E.; Desai, A. D.; Dorrian, M. D.; Doerfel, H.; Koukouliou, V.; Luciani, A.; Malatova, I.; Molokanov, A.; Puncher, M.; Vrba, T.

2008-01-01

The work of Task Group 5.1 (uncertainty studies and revision of IDEAS guidelines) and Task Group 5.5 (update of IDEAS databases) of the CONRAD project is described. Scattering factor (SF) values (i.e. measurement uncertainties) have been calculated for different radionuclides and types of monitoring data using real data contained in the IDEAS Internal Contamination Database. Based upon this work and other published values, default SF values are suggested. Uncertainty studies have been carried out using both a Bayesian approach as well as a frequentist (classical) approach. The IDEAS guidelines have been revised in areas relating to the evaluation of an effective AMAD, guidance is given on evaluating wound cases with the NCRP wound model and suggestions made on the number and type of measurements required for dose assessment. (authors)

Scandinavian Clinical Practice Guidelines on the diagnosis, management and follow-up of anaphylaxis during anaesthesia

DEFF Research Database (Denmark)

Kroigaard, M; Garvey, L H; Gillberg, L

2007-01-01

to the rare and unforeseeable nature of anaphylaxis, mainly includes case series and expert opinion (grade of evidence IV and V). These guidelines include an overview of the epidemiology of anaphylactic reactions during anaesthesia. A treatment algorithm is suggested, with emphasis on the incremental...... advice concerning follow-up procedures is provided. In addition, an algorithm is included with advice on how to manage patients with previous suspected anaphylaxis during anaesthesia. Lastly, Appendix 2 provides an overview of the incidence, mechanisms and possibilities for follow-up for some common drug...

Molecular and Serological Assessment of Chronic HBV Carriers and Additional Burden of Applying Updated Guidelines in Pakistan

International Nuclear Information System (INIS)

Hussain, A. B.; Ghani, E.; Rathore, M. A.; Khan, F. A.; Ali, N.

2014-01-01

Objective: To assess the additional burden of the patients eligible for treatment, based on recommendations on viral load, in the light of 2009 version of AASLD guidelines, as compared to 2004 guidelines and to determine the frequency of HBeAg in chronic HBV carriers. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Virology Department, Armed Forces Institute of Pathology, Rawalpindi, from November 2010 to January 2012. Methodology: Persons with chronic HBV infection, reporting for HBV DNA PCR test, were included in the study and blood samples were collected. HBV DNA load was determined by Real Time PCR. HBsAg and HBeAg were tested by ELISA. Results: Out of the 801 subjects positive for HBsAg, 74 (9.24%) were positive for HBeAg. Out of them, 113 (14.1%) had HBV DNA load > 100,000 copies/ml and were eligible for treatment according to AASLD 2004 guidelines. Forty one (5.1%) had HBV load between 10,000 and 100,000 copies/ml, and were additionally eligible for treatment as per AASLD 2009 guidelines. The 5.1% of 4.5 million estimated HBV carries in Pakistan comes to 229500. Conclusion: There was a low HBeAg positivity and HBV DNA positivity in our chronic HBV infected persons. Moreover, there is an increase of 229500 potential candidates for HBV treatment in Pakistan based on viral load testing, according to the AASLD 2009 guidelines when compared with 2004 guidelines. The increase in the number of candidates for treatment may require an additional expenditure of tens of billions of rupees. (author)

Guidelines on the scope, content, and use of comprehensive risk assessment in the management of high-level nuclear waste transportation

International Nuclear Information System (INIS)

Golding, D.; White, A.

1990-12-01

This report discusses the scope of risk assessment strategies in the management of the transport of high-level radioactive wastes. In spite of the shortcomings of probabilistic risk assessment(PRA), the Transportation Needs Assessment recommended this as the preferred methodology to assess the risks of high level nuclear waste (HLNW) transportation. A PRA also will need to heed the lessons learned from the development and application of PRA elsewhere, such as in the nuclear power industry. A set of guidelines will aid this endeavor by outlining the appropriate scope, content, and use of a risk assessment which is more responsive to the uncertainties, human-technical interactions, social forces, and iterative relationship with risk management strategies, than traditional PRAS. This more expansive definition, which encompasses but is not totally reliant on rigorous data requirements and quantitative probability estimates, we term Comprehensive Risk Assessment (CRA) Guidelines will be developed in three areas: the limitations of existing methodologies and suggested modifications; CRA as part of a flexible, effective, adaptive risk management system for HLNW transportation; and, the use of CRA in risk communication

Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.

Science.gov (United States)

Jauch, Edward C; Saver, Jeffrey L; Adams, Harold P; Bruno, Askiel; Connors, J J Buddy; Demaerschalk, Bart M; Khatri, Pooja; McMullan, Paul W; Qureshi, Adnan I; Rosenfield, Kenneth; Scott, Phillip A; Summers, Debbie R; Wang, David Z; Wintermark, Max; Yonas, Howard

2013-03-01

The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators responsible for the care of acute ischemic stroke patients within the first 48 hours from stroke onset. These guidelines supersede the prior 2007 guidelines and 2009 updates. Members of the writing committee were appointed by the American Stroke Association Stroke Council's Scientific Statement Oversight Committee, representing various areas of medical expertise. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Panel members were assigned topics relevant to their areas of expertise, reviewed the stroke literature with emphasis on publications since the prior guidelines, and drafted recommendations in accordance with the American Heart Association Stroke Council's Level of Evidence grading algorithm. The goal of these guidelines is to limit the morbidity and mortality associated with stroke. The guidelines support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit. The guideline discusses early stroke evaluation and general medical care, as well as ischemic stroke, specific interventions such as reperfusion strategies, and general physiological optimization for cerebral resuscitation. Because many of the recommendations are based on limited data, additional research on treatment of acute ischemic stroke remains urgently needed.

[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.

Alpha contamination assessment for D ampersand D activities: Technology overview

International Nuclear Information System (INIS)

Conaway, J.G.; Rawool-Sullivan, M.W.; MacArthur, D.W.

1996-02-01

Instruments based on the principle of Long-Range Alpha Detection (LRAD) detect the ions created in ambient air by Ionizing radiation, particularly alpha radiation, interacting with air molecules. Using either an electrostatic field or forced convection, these ions can be transported to a detection grid where the ions produce a small current that is measured with a sensitive electrometer. LRAD-based instruments can give separate, simultaneous measurements of alpha-emitting solids and inert radioactive gases such as radon. LRAD-based instruments assess surface contamination on an entire object or large surface area in a single, rapid measurement, including relatively inaccessible areas such as interior surfaces of pipes and process equipment. The LRAD concept is well proven and has been developed into a range of different radiation detection devices. This paper presents an overview of the technology, while several associated papers explore specific applications in greater detail

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2010 on the treatment of acute bipolar depression

DEFF Research Database (Denmark)

Grunze, Heinz; Vieta, Eduard; Goodwin, Guy M

2010-01-01

OBJECTIVES: These guidelines are based on a first edition that was published in 2002, and have been edited and updated with the available scientific evidence until September 2009. Their purpose is to supply a systematic overview of all scientific evidence pertaining to the treatment of acute bipo...... edition of this guideline in 2002, there are many areas which still need more intense research to optimize treatment. The majority of treatment recommendations is still based on limited data and leaves considerable areas of uncertainty.......OBJECTIVES: These guidelines are based on a first edition that was published in 2002, and have been edited and updated with the available scientific evidence until September 2009. Their purpose is to supply a systematic overview of all scientific evidence pertaining to the treatment of acute...... bipolar depression in adults. METHODS: The data used for these guidelines have been extracted from a MEDLINE and EMBASE search, from the clinical trial database clinicaltrials.gov, from recent proceedings of key conferences, and from various national and international treatment guidelines...

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.

Prospective systematic review registration: perspective from the Guidelines International Network (G-I-N

Directory of Open Access Journals (Sweden)

Van der Wees Philip

2012-02-01

Full Text Available Abstract Clinical practice and public health guidelines are important tools for translating research findings into practice with the aim of assisting health practitioners as well as patients and consumers in health behavior and healthcare decision-making. Numerous programs for guideline development exist around the world, with growing international collaboration to improve their quality. One of the key features in developing trustworthy guidelines is that recommendations should be based on high-quality systematic reviews of the best available evidence. The review process used by guideline developers to identify and grade relevant evidence for developing recommendations should be systematic, transparent and unbiased. In this paper, we provide an overview of current international developments in the field of practice guidelines and methods to develop guidelines, with a specific focus on the role of systematic reviews. The Guidelines International Network (G-I-N aims to stimulate collaboration between guideline developers and systematic reviewers to optimize the use of available evidence in guideline development and to increase efficiency in the guideline development process. Considering the significant benefit of systematic reviews for the guideline community, the G-I-N Board of Trustees supports the international prospective register of systematic reviews (PROSPERO initiative. G-I-N also recently launched a Data Extraction Resource (GINDER to present and share data extracted from individual studies in a standardized template. PROSPERO and GINDER are complementary tools to enhance collaboration between guideline developers and systematic reviewers to allow for alignment of activities and a reduction in duplication of effort.

Inconsistencies in clinical guidelines for obstetric anaesthesia for Caesarean section

DEFF Research Database (Denmark)

Winther, Lars; Mitchell, A U; Møller, Ann

2013-01-01

Anaesthetists need evidence-based clinical guidelines, also in obstetric anaesthesia. We compared the Danish, English, American, and German national guidelines for anaesthesia for Caesarean section. We focused on assessing the quality of guideline development and evaluation of the guidelines...

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....

Index-TB guidelines: Guidelines on extrapulmonary tuberculosis for India

Directory of Open Access Journals (Sweden)

Surendra K Sharma

2017-01-01

Full Text Available Extrapulmonary tuberculosis (EPTB is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i use of Xpert MTB/RIF in diagnosis, (ii use of adjunct corticosteroids in treatment, and (iii duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research.

Analyzing the "CareGap": assessing gaps in adherence to clinical guidelines in adult soft tissue sarcoma.

Science.gov (United States)

Waks, Zeev; Goldbraich, Esther; Farkash, Ariel; Torresani, Michele; Bertulli, Rossella; Restifo, Nicola; Locatelli, Paolo; Casali, Paolo; Carmeli, Boaz

2013-01-01

Clinical decision support systems (CDSSs) are gaining popularity as tools that assist physicians in optimizing medical care. These systems typically comply with evidence-based medicine and are designed with input from domain experts. Nonetheless, deviations from CDSS recommendations are abundant across a broad spectrum of disorders, raising the question as to why this phenomenon exists. Here, we analyze this gap in adherence to a clinical guidelines-based CDSS by examining the physician treatment decisions for 1329 adult soft tissue sarcoma patients in northern Italy using patient-specific parameters. Dubbing this analysis "CareGap", we find that deviations correlate strongly with certain disease features such as local versus metastatic clinical presentation. We also notice that deviations from the guideline-based CDSS suggestions occur more frequently for patients with shorter survival time. Such observations can direct physicians' attention to distinct patient cohorts that are prone to higher deviation levels from clinical practice guidelines. This illustrates the value of CareGap analysis in assessing quality of care for subsets of patients within a larger pathology.

A review of quality assessment of the methodology used in guidelines and systematic reviews on oral mucositis.

NARCIS (Netherlands)

Potting, C.; Mistiaen, P.; Poot, E.; Blijlevens, N.; Donnelly, P.; Achterberg, T. van

2009-01-01

Aims and objectives: The objective of this study was to identify and to assess the quality of evidence-based guidelines and systematic reviews we used in the case of oral mucositis, to apply general quality criteria for the prevention and treatment of oral mucositis in patients receiving

Matrix vaccination guidelines : 2015 ABCD recommendations for indoor/outdoor cats, rescue shelter cats and breeding catteries

NARCIS (Netherlands)

Hosie, Margaret J; Addie, Diane D; Boucraut-Baralon, Corine; Egberink, Herman; Frymus, Tadeusz; Gruffydd-Jones, Tim; Hartmann, Katrin; Horzinek, Marian C; Lloret, Albert; Lutz, Hans; Marsilio, Fulvio; Pennisi, Maria Grazia; Radford, Alan D; Thiry, Etienne; Truyen, Uwe; Möstl, Karin

OVERVIEW: In 2013, the ABCD published 'Matrix vaccination guidelines: ABCD recommendations for indoor/outdoor cats, rescue shelter cats and breeding catteries' in a Special Issue of the Journal of Feline Medicine and Surgery (Volume 15, Issue 7, pages 540-544). The ABCD's vaccination recommendations

Operational research on implementation of tuberculosis guidelines in Mozambique

NARCIS (Netherlands)

Brouwer, M.A.

2015-01-01

The overall objective of this thesis is to assess how guideline implementation and evaluation contribute to health care decision-making and to assess what critical factors contribute to successful or unsuccessful implementation of TB control guidelines through case studies mainly conducted in

The appraisal of clinical guidelines in dentistry.

Science.gov (United States)

Glenny, Anne-Marie; Worthington, Helen V; Clarkson, Jan E; Esposito, Marco

2009-01-01

To appraise the reported processes involved in the development of published dental guidelines. Electronic databases were searched to identify guidelines making recommendations for any health professional within dentistry. All included guidelines were appraised using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. A total of 105 guidelines met the inclusion criteria. The appraised guidelines showed lack of rigour in their development (median score 14.3%; range 0% to 100%). Only 10 (9.5%) were coded as 'strongly recommend' by at least two assessors. If recommendations within clinical guidelines are to be relied upon, the methods used in their development must be explicit and free from bias. When using the AGREE checklist to make decisions on whether or not to implement individual sets of guidelines, the findings of the present assessment reinforce the need for more than two assessors to be included in the appraisal of each set of guidelines.

Overview of Provisional Peer-Reviewed Toxicity Values (PPRTVs), Alternative Methods in Human Health Risk Assessment, and the RapidTox Dashboard

Science.gov (United States)

This poster provides an overview of three key lines of ongoing work at EPA/ORD/NCEA-CIN: Provisional Peer-Reviewed Toxicity Values (PPRTVs), Alternative Methods in Human Health Risk Assessment, and the RapidTox Dashboard collaboration.

An Overview of the Current Status of Talent Care and Talent Support in Hungary

Science.gov (United States)

Fuszek, Csilla

2014-01-01

After a short historical introduction, the article provides an overview of the current talent support trends in Hungary. It gives an insight into the legislation, guidelines and institutional system associated with the national talent support strategy, and presents the main NGO initiatives present in the early 21st century, in particular the…

Adolescent brain cognitive development (ABCD study: Overview of substance use assessment methods

Directory of Open Access Journals (Sweden)

Krista M. Lisdahl

2018-08-01

Full Text Available One of the objectives of the Adolescent Brain Cognitive Development (ABCD Study (https://abcdstudy.org/ is to establish a national longitudinal cohort of 9 and 10 year olds that will be followed for 10 years in order to prospectively study the risk and protective factors influencing substance use and its consequences, examine the impact of substance use on neurocognitive, health and psychosocial outcomes, and to understand the relationship between substance use and psychopathology. This article provides an overview of the ABCD Study Substance Use Workgroup, provides the goals for the workgroup, rationale for the substance use battery, and includes details on the substance use module methods and measurement tools used during baseline, 6-month and 1-year follow-up assessment time-points. Prospective, longitudinal assessment of these substance use domains over a period of ten years in a nationwide sample of youth presents an unprecedented opportunity to further understand the timing and interactive relationships between substance use and neurocognitive, health, and psychopathology outcomes in youth living in the United States. Keywords: Adolescent Brain Cognitive Development Study, Adolescent, Child, Substance use, Alcohol, Cannabis, Marijuana, Nicotine, Longitudinal, Methods, Assessment, Drug use, Prescription drug use, Inhalants

Steam generator tube fitness-for-service guidelines

International Nuclear Information System (INIS)

Gorman, J.A.; Harris, J.E.; Lowenstein, D.B.

1995-07-01

The objectives of this project were to characterize defect mechanisms which could affect the integrity of steam generator tubes, to review and critique state-of-the-art Canadian and international steam generator tube fitness-for-service criteria and guidelines, and to obtain recommendations for criteria that could be used to assess fitness-for service guidelines for steam generator tubes containing defects in Canadian power plant service. Degradation mechanisms, that could affect CANDU steam generator tubes in Canada, have been characterized. The design standards and safety criteria that apply to steam generator tubing in nuclear power plant service in Canada and in Belgium, France, Japan, Spain, Sweden, and the USA have been reviewed and described. The fitness-for-service guidelines used for a variety of specific defect types in Canada and internationally have been evaluated and described in detail in order to highlight the considerations involved in developing such defect specific guidelines. Existing procedures for defect assessment and disposition have been identified, including inspection and examination practices. The approaches used in Canada and in Belgium, France, Japan, Spain, Sweden, and the USA for fitness-for-service guidelines were compared and contrasted for a variety of defect mechanisms. The strengths and weaknesses of the various approaches have been assessed. The report presents recommendations on approaches that may be adopted in the development of fitness-for-service guidelines for use in the dispositioning of steam generator tubing defects in Canada. (author). 175 refs., 2 tabs., 28 figs

Assessment of global guidelines for preventive chemotherapy against schistosomiasis and soil-transmitted helminthiasis: a cost-effectiveness modelling study.

Science.gov (United States)

Lo, Nathan C; Lai, Ying-Si; Karagiannis-Voules, Dimitrios-Alexios; Bogoch, Isaac I; Coulibaly, Jean T; Bendavid, Eran; Utzinger, Jürg; Vounatsou, Penelope; Andrews, Jason R

2016-09-01

WHO guidelines recommend annual treatment for schistosomiasis or soil-transmitted helminthiasis when prevalence in school-aged children is at or above a threshold of 50% and 20%, respectively. Separate treatment guidelines are used for these two helminthiases, and integrated community-wide treatment is not recommended. We assessed the cost-effectiveness of changing prevalence thresholds and treatment guidelines under an integrated delivery framework. We developed a dynamic, age-structured transmission and cost-effectiveness model that simulates integrated preventive chemotherapy programmes against schistosomiasis and soil-transmitted helminthiasis. We assessed a 5-year treatment programme with praziquantel (40 mg/kg per treatment) against schistosomiasis and albendazole (400 mg per treatment) against soil-transmitted helminthiasis at 75% coverage. We defined strategies as highly cost-effective if the incremental cost-effectiveness ratio was less than the World Bank classification for a low-income country (gross domestic product of US$1045 per capita). We calculated the prevalence thresholds for cost-effective preventive chemotherapy of various strategies, and estimated treatment needs for sub-Saharan Africa. Annual preventive chemotherapy against schistosomiasis was highly cost-effective in treatment of school-aged children at a prevalence threshold of 5% (95% uncertainty interval [UI] 1·7-5·2; current guidelines recommend treatment at 50% prevalence) and for community-wide treatment at a prevalence of 15% (7·3-18·5; current recommendation is unclear, some community treatment recommended at 50% prevalence). Annual preventive chemotherapy against soil-transmitted helminthiasis was highly cost-effective in treatment of school-aged children at a prevalence of 20% (95% UI 5·4-30·5; current guidelines recommend treatment at 20% prevalence) and the entire community at 60% (35·3-85·1; no guidelines available). When both helminthiases were co-endemic, prevalence

Physiotherapy in rheumatoid arthritis: development of a practice guideline.

Science.gov (United States)

Hurkmans, E J; van der Giesen, F J; Bloo, H; Boonman, D C; van der Esch, M; Fluit, M; Hilberdink, W K; Peter, W F; van der Stegen, H P; Veerman, E A; Verhoef, J; Vermeulen, H M; Hendriks, H M; Schoones, J W; Vliet Vlieland, T P

2011-01-01

To improve the quality of the physiotherapy management in patients with rheumatoid arthritis (RA) a Dutch practice guideline, based on current scientific evidence and best practice, was developed. This guideline comprised all elements of a structured approach (assessment, treatment and evaluation) and was based on the Internatio-nal Classification of Functioning, disability and Health (ICF) and the ICF core sets for RA. 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 10 experts from different professional backgrounds resulting in the final guideline. In total 7 topics were selected. For the initial assessment, three recommendations were made. Based on the ICF core sets for RA a list of health problems relevant for the physiotherapist was made and completed with red flags and points of attention. Concerning treatment, three recommendations were formulated; both exercise therapy and education on physiotherapy were recommended, whereas passive interventions (delivery of heat or cold, mechanical, electric and electromagnetic energy, massage, passive mobilization/manipulation and balneotherapy) were neither recommended nor discouraged. For treatment evaluation at the level of activities and participation, the Health Assessment Questionnaire was recommended. For evaluating specific body structures and functions the handheld dynamometer, 6-minute walk test or Ästrand bicycle test (including Borg-scale for rating the perceived exertion), Escola Paulista de Medicina Range of Motion Scale and a Visual Analog Scale for pain and

Transport properties site descriptive model. Guidelines for evaluation and modelling

International Nuclear Information System (INIS)

Berglund, Sten; Selroos, Jan-Olof

2004-04-01

This report describes a strategy for the development of Transport Properties Site Descriptive Models within the SKB Site Investigation programme. Similar reports have been produced for the other disciplines in the site descriptive modelling (Geology, Hydrogeology, Hydrogeochemistry, Rock mechanics, Thermal properties, and Surface ecosystems). These reports are intended to guide the site descriptive modelling, but also to provide the authorities with an overview of modelling work that will be performed. The site descriptive modelling of transport properties is presented in this report and in the associated 'Strategy for the use of laboratory methods in the site investigations programme for the transport properties of the rock', which describes laboratory measurements and data evaluations. Specifically, the objectives of the present report are to: Present a description that gives an overview of the strategy for developing Site Descriptive Models, and which sets the transport modelling into this general context. Provide a structure for developing Transport Properties Site Descriptive Models that facilitates efficient modelling and comparisons between different sites. Provide guidelines on specific modelling issues where methodological consistency is judged to be of special importance, or where there is no general consensus on the modelling approach. The objectives of the site descriptive modelling process and the resulting Transport Properties Site Descriptive Models are to: Provide transport parameters for Safety Assessment. Describe the geoscientific basis for the transport model, including the qualitative and quantitative data that are of importance for the assessment of uncertainties and confidence in the transport description, and for the understanding of the processes at the sites. Provide transport parameters for use within other discipline-specific programmes. Contribute to the integrated evaluation of the investigated sites. The site descriptive modelling of

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

2014-01-01

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. PMID:25077519

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.

AMAT guidelines. Reference document for the IAEA Ageing Management Assessment Teams (AMATs)

International Nuclear Information System (INIS)

1999-01-01

Effective ageing management is an important element for ensuring the safety of nuclear power plant. The IAEA Ageing Management Assessment Team (AMAT) programme provides advice and assistance to utilities or individual NPPs to strengthen and enhance the effectiveness of ageing management programs (AMPs). Such AMPs are required by an increasing number of safety utilities and implemented by an increasing number of utilities, often as a part of NPP life or life cycle management programs that involve the integration of ageing management and economic planning. The guidelines in this report are primarily intended for IAEA-led AMAT team members as a basic structure and common reference for peer reviews of AMPs

Labour management guidelines for a Tanzanian referral hospital

DEFF Research Database (Denmark)

Maaløe, Nanna; Housseine, Natasha; van Roosmalen, Jos

2017-01-01

hospital, this paper describes the development process of locally achievable, partograph-associated, and peer-reviewed labour management guidelines, and it presents an assessment of professional birth attendants’ perceptions. Methods: Part 1: Modification of evidence-based international guidelines through...... by staff and two external peer-review cycles, there were no major concerns with the guidelines internally nor externally. Thereby, international recommendations were condensed to the eight-paged ‘PartoMa guidelines ©’. This pocket booklet includes routine assessments, supportive care, and management......, locally achievable, and acceptable support for intrapartum surveillance, triage, and management. This is a crucial example of adapting evidence-based international recommendations to local reality. Trial registration: This paper describes the intervention of the PartoMa trial, which is registered...

The development of evidence-based guidelines in dentistry.

Science.gov (United States)

Faggion, C M

2013-02-01

Use of guidelines is an important means of reducing the gap between research and clinical practice. Sound and unbiased information should be available to enable dental professionals to provide better clinical treatment for their patients. The development of clinical guidelines in dentistry should follow standard and transparent methodology. The purpose of this article is to propose important steps for developing evidence-based clinical recommendations in dentistry. Initially, dental guidelines should be extensively sought and assessed to answer focused clinical questions. If there is a paucity of guidelines or if existing guidelines are not of good methodological quality, systematic reviews should be searched or conducted to serve as a basis for the development of evidence-based guidelines. When systematic reviews are produced, they should be rigorous in order to provide the best evidence possible. In the last phase of the process, the overall quality of evidence should be scrutinized and assessed, together with other factors (balance between treatment effects and side effects, patients' values, and cost-effectiveness of therapy) to determine the strength of recommendations. It is expected this approach will result in the development of sound clinical guidelines and consequent improvement of dental treatment.

Increasing Language Awareness and Self-Efficacy of FL Students Using Self-Assessment and the ACTFL Proficiency Guidelines

Science.gov (United States)

Kissling, Elizabeth M.; O'Donnell, Mary E.

2015-01-01

This study describes how oral language was assessed in an advanced-level college foreign language (FL) conversation course. Learners used the American Council on the Teaching of Foreign Languages Proficiency Guidelines to guide self-analyses of their oral production at intervals throughout the course. The intent was to provide opportunities for…

A Critical Review of Low Back Pain Guidelines.

Science.gov (United States)

Chetty, Laran

2017-09-01

Low back pain (LBP) remains one of the most common and challenging musculoskeletal conditions encountered by health care professionals and is a leading cause of absenteeism. Clinical guidelines are often considered best evidence in health care. The aim of this critical review was to assess the quality and recommendations of LBP guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Electronic databases were used to identify LBP guidelines published between 2000 and 2015. Nine guidelines were selected for review from a total of 17. Only five guidelines effectively addressed the AGREE scoring. On the basis of the appraisal and domain scores, only four guidelines were strongly recommended. Improved translation of research evidence from guidelines to clinical practice is needed.

[Graphic synopsis of implementation of German guideline clearing reports in national disease management guidelines].

Science.gov (United States)

Thole, Henning

2011-01-01

While methods for the production of guidelines (evidence analysis, assessment, adaptation) have been continually refined throughout the past years, there is a lack of instruments for the production of easily understandable synopses. Definition of a methodological approach to encompass synopses by Spidernet diagrams. Tables of synopses can be generated with distinct information to bring down the main results in one Spidernet diagram. This is possible for both the entire synopsis and parts of it. Guideline comparisons require detailed analyses on the one hand and easily understandable presentations of their results on the other. Guideline synopses can be substantially supported by graphic presentation of the results of synopsis. Graphic synopsis is also helpful in other cases; it may be used, for example, to summarise HTA reports, systematic reviews or guidelines. Copyright © 2011. Published by Elsevier GmbH.

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...

International guidelines for the in vivo assessment of skin properties in non-clinical settings: Part 2. transepidermal water loss and skin hydration

Science.gov (United States)

du Plessis, Johan; Stefaniak, Aleksandr; Eloff, Fritz; John, Swen; Agner, Tove; Chou, Tzu-Chieh; Nixon, Rosemary; Steiner, Markus; Franken, Anja; Kudla, Irena; Holness, Linn

2015-01-01

Background 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, representing a non-clinical environment, can be highly variable and difficult to control, thereby presenting unique measurement challenges not typically encountered in clinical settings. Methods An expert working group convened a workshop as part of the 5th International Conference on Occupational and Environmental Exposure of Skin to Chemicals (OEESC) to develop basic guidelines and best practices (based on existing clinical guidelines, published data, and own experiences) for the in vivo measurement of transepidermal water loss (TEWL) and skin hydration in non-clinical settings with specific reference to the workplace as a worst-case scenario. Results Key elements of these guidelines are: (i) to minimize or recognize, to the extent feasible, the influences of relevant endogenous-, exogenous-, environmental- and measurement/instrumentation-related factors; (ii) to measure TEWL with a closed-chamber type instrument; (iii) report results as a difference or percent change (rather than absolute values); and (iv) accurately report any notable deviations from this guidelines. Conclusion It is anticipated that these guidelines will promote consistent data reporting, which will facilitate inter-comparison of study results. PMID:23331328

Revised guideline for the approval procedure of package designs in Germany

International Nuclear Information System (INIS)

Nitsche, F.; Roedel, R.

2004-01-01

The IAEA Regulations for the Safe Transport of Radioactive Material, TS-R-1 are applied in Germany through the implementation of the Dangerous Goods Transport Regulations for class 7 of the International Modal Organisations (ADR, RID, IMDG-Code, ICAO-TI). Based on this the approval procedures for packages designs applied in Germany are in compliance with the provisions of TS-R-1. The Guideline R 003 issued by the Ministry of Transport, Building and Housing (BMVBW) in 1991 is the basis for the package design approval procedures in Germany. This Guideline has been reviewed and revised to reflect latest developments in the regulations as well as in the regulatory practice. In particular it has been extended to the approval procedures of Type C packages, packages subject to transitional arrangements, special form and low dispersible radioactive material and provides more detailed information to the applicant about the requested documentation. Publication of this revised guideline has been delayed but it is expected to take place in October 2004. The paper gives an overview about the main parts and provisions of this revised Guideline R 003 with the focus on package design approval procedures

Diagnosis and management of idiopathic pulmonary fibrosis: French practical guidelines

Directory of Open Access Journals (Sweden)

Bruno Crestani

2014-06-01

Full Text Available Idiopathic pulmonary fibrosis (IPF is the most frequent chronic idiopathic interstitial pneumonia in adults. The management of rare diseases in France has been organised by a national plan for rare diseases, which endorsed a network of expert centres for rare diseases throughout France. This article is an overview of the executive summary of the French guidelines for the management of IPF, an initiative that emanated from the French National Reference Centre and the Network of Regional Competence Centres for Rare Lung Diseases. This review aims at providing pulmonologists with a document that: 1 combines the current available evidence; 2 reviews practical modalities of diagnosis and management of IPF; and 3 is adapted to everyday medical practice. The French practical guidelines result from the combined efforts of a coordination committee, a writing committee and a multidisciplinary review panel, following recommendations from the Haute Autorité de Santé. All recommendations included in this article received at least 90% agreement by the reviewing panel. Herein, we summarise the main conclusions and practical recommendations of the French guidelines.

Preoperative assessment of lung cancer patients: evaluating guideline compliance (re-audit).

Science.gov (United States)

Jayia, Parminderjit Kaur; Mishra, Pankaj Kumar; Shah, Raajul R; Panayiotou, Andrew; Yiu, Patrick; Luckraz, Heyman

2015-03-01

Guidelines have been issued for the management of lung cancer patients in the United Kingdom. However, compliance with these national guidelines varies in different thoracic units in the country. We set out to evaluate our thoracic surgery practice and compliance with the national guidelines. An initial audit in 2011 showed deficiencies in practice, thus another audit was conducted to check for improvements in guideline compliance. A retrospective study was carried out over a 12-month period from January 2013 to January 2014 and included all patients who underwent radical surgical resection for lung cancer. Data were collected from computerized records. Sixty-eight patients had radical surgery for lung cancer between January 2013 and January 2014. Four patients were excluded from the analysis due to incomplete records. Our results showed improvements in our practice compared to our initial audit. More patients underwent surgery within 4 weeks of computed tomography and positron-emission tomography scanning. An improvement was noticed in carbon monoxide transfer factor measurements. Areas for improvement include measurement of carbon monoxide transfer factor in all patients, a cardiology referral in patients at risk of cardiac complications, and the use of a global risk stratification model such as Thoracoscore. Guideline-directed service delivery provision for lung cancer patients leads to improved outcomes. Our results show improvement in our practice compared to our initial audit. We aim to liaise with other thoracic surgery units to get feedback about their practice and any audits regarding adherence to the British Thoracic Society and National Institute for Health and Care Excellence guidelines. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

British Columbia water quality guidelines (criteria): 1998 edition

Energy Technology Data Exchange (ETDEWEB)

Nagpal, N.K.; Pommen, L.W.; Swain, L.G.

1998-08-01

British Columbia has developed water quality guidelines in order that water quality data can be assessed and site-specific water quality objectives can be prepared. The guidelines provide benchmarks for the assessment of water quality and setting water quality objectives. Guidelines are provided to protect the following six major water uses: drinking water, aquatic life, wildlife, recreation/aesthetics, agriculture, and industrial. Water quality encompasses the physical, chemical and biological quality of the water, sediment and biota. Among other quality criteria the guide provides maximum approved concentrations for nitrogen, aluminum, copper, cyanide, lead, mercury, and molybdenum. 30 tabs.

Appraising and comparing pressure ulcer guidelines.

Science.gov (United States)

Wimpenny, Peter; van Zelm, Ruben

2007-01-01

Whilst considerable activity has been related to guideline development for nurses regarding pressure ulcer prevention and management, no attempt has been made to comparatively evaluate these guidelines against some form of quality indicators. To compare and contrast four national pressure ulcer guidelines, and identify similarities and differences in their quality and content. An international comparative appraisal method, using the AGREE (Appraisal of Guidelines Research and Evaluation) instrument, was undertaken to appraise four published pressure ulcer guidelines. Two further domains were added to the AGREE instrument to assess comparability of the guidelines and their perceived contribution to practice. An international group undertook the comparative appraisal. The domain scores for each guideline show some but not total agreement among reviewers. One particular set of guidelines was identified as scoring highest in a majority of AGREE domains. Overall, evidence of variability exists between pressure ulcer guidelines and common areas of development to consider for all guidelines. The results raise many questions concerning the "best" pressure ulcer guideline to use, particularly related to the AGREE scoring. Some notable shortcomings exist in all the pressure ulcer guidelines reviewed and these shortcomings need to be addressed from a quality perspective. However, other issues such as style of reporting and potential contribution to practice might more fully affect choice by practitioners as opposed to guideline developers. Notable differences exist among the four guidelines that are possibly explained by different approaches to development and also because of different cultural factors and intentions for use. Whilst the AGREE tool identifies the quality of the guideline development process it still requires local engagement with practitioners to determine which guideline should be implemented.

An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part II: prescription of systemic antibiotics.

Science.gov (United States)

Hinckfuss, Susan Elisabeth; Messer, Louise Brearley

2009-04-01

Current clinical guidelines recommend prescribing systemic antibiotic therapy (SAT) for patients having an avulsed permanent tooth replanted. The principles of evidence-based dentistry can be used to assess whether this is the best approach based on currently-available evidence. The objective of this study was to use the principles of evidence-based dentistry to answer the PICO question: (P) for a replanted avulsed permanent tooth, (I) is prescribing SAT, (C) compared with not prescribing SAT, (O) associated with an increased likelihood of successful periodontal healing after tooth replantation? A literature search was performed across four internet databases (Ovid Medline, Cochrane Library, PubMed, ISI Web of Science), for relevant citations (n = 35 702). Limiting citations to those in English and removing duplicates produced a set of titles (n = 14 742) that were sieved according to evidence-based dentistry principles. Relevant titles were selected for abstract assessment (n = 782), identifying papers for examination (n = 74). Inclusion criteria were applied and three papers (326 total teeth) met the final criteria for meta-analysis. Meta-analyses found no statistically significant difference between prescribing or not prescribing antibiotics for acceptable periodontal healing without progressive root resorption (common odds ratio = 0.90, SE = 0.29, 95% confidence intervals = 0.51-1.58). The evidence for an association between prescribing SAT and an increased likelihood of acceptable periodontal healing outcome is inconclusive. This investigation of antibiotic use as defined in the clinical guidelines indicates there is inconclusive clinical evidence from studies of replanted avulsed human teeth to either contradict or support the guideline. Pending future research to the contrary, dentists are recommended to follow current guidelines in prescribing SAT when replanting avulsed teeth.

Methods used in adaptation of health-related guidelines: A systematic survey.

Science.gov (United States)

Abdul-Khalek, Rima A; Darzi, Andrea J; Godah, Mohammad W; Kilzar, Lama; Lakis, Chantal; Agarwal, Arnav; Abou-Jaoude, Elias; Meerpohl, Joerg J; Wiercioch, Wojtek; Santesso, Nancy; Brax, Hneine; Schünemann, Holger; Akl, Elie A

2017-12-01

Adaptation refers to the systematic approach for considering the endorsement or modification of recommendations produced in one setting for application in another as an alternative to de novo development. To describe and assess the methods used for adapting health-related guidelines published in peer-reviewed journals, and to assess the quality of the resulting adapted guidelines. We searched Medline and Embase up to June 2015. We assessed the method of adaptation, and the quality of included guidelines. Seventy-two papers were eligible. Most adapted guidelines and their source guidelines were published by professional societies (71% and 68% respectively), and in high-income countries (83% and 85% respectively). Of the 57 adapted guidelines that reported any detail about adaptation method, 34 (60%) did not use a published adaptation method. The number (and percentage) of adapted guidelines fulfilling each of the ADAPTE steps ranged between 2 (4%) and 57 (100%). The quality of adapted guidelines was highest for the "scope and purpose" domain and lowest for the "editorial independence" domain (respective mean percentages of the maximum possible scores were 93% and 43%). The mean score for "rigor of development" was 57%. Most adapted guidelines published in peer-reviewed journals do not report using a published adaptation method, and their adaptation quality was variable.

Developing International Guidelines on Volcanic Hazard Assessments for Nuclear Facilities

Science.gov (United States)

Connor, Charles

2014-05-01

Worldwide, tremendous progress has been made in recent decades in forecasting volcanic events, such as episodes of volcanic unrest, eruptions, and the potential impacts of eruptions. Generally these forecasts are divided into two categories. Short-term forecasts are prepared in response to unrest at volcanoes, rely on geophysical monitoring and related observations, and have the goal of forecasting events on timescales of hours to weeks to provide time for evacuation of people, shutdown of facilities, and implementation of related safety measures. Long-term forecasts are prepared to better understand the potential impacts of volcanism in the future and to plan for potential volcanic activity. Long-term forecasts are particularly useful to better understand and communicate the potential consequences of volcanic events for populated areas around volcanoes and for siting critical infrastructure, such as nuclear facilities. Recent work by an international team, through the auspices of the International Atomic Energy Agency, has focused on developing guidelines for long-term volcanic hazard assessments. These guidelines have now been implemented for hazard assessment for nuclear facilities in nations including Indonesia, the Philippines, Armenia, Chile, and the United States. One any time scale, all volcanic hazard assessments rely on a geologically reasonable conceptual model of volcanism. Such conceptual models are usually built upon years or decades of geological studies of specific volcanic systems, analogous systems, and development of a process-level understanding of volcanic activity. Conceptual models are used to bound potential rates of volcanic activity, potential magnitudes of eruptions, and to understand temporal and spatial trends in volcanic activity. It is these conceptual models that provide essential justification for assumptions made in statistical model development and the application of numerical models to generate quantitative forecasts. It is a

Environmental assessment overview, Deaf Smith County site, Texas

International Nuclear Information System (INIS)

1986-05-01

In February 1983, the US Department of Energy (DOE) identified a location in Deaf Smith County, Texas, as one of nine potentially acceptable sites for mined geologic repository for spent nuclear fuel and high-level radioactive waste. To determine their suitability, the Deaf Smith County site and eight other potentially acceptable sites have been evaluated in accordance with the DOE's General Guidelines for the Recommendation of Sites for the Nuclear Waste Repositories. The Deaf Smith County site is in the Permian Basin, which is one of five distinct geohydrologic settings considered for the first repository. On the basis of the evaluations reported in this EA, the DOE has found that the Deaf Smith County site is not disqualified under the guidelines. On the basis of these findings, the DOE is nominating the Deaf Smith County site as one of five sites suitable for characterization. 3 figs

Systematic review of guidelines on peripheral artery disease screening.

Science.gov (United States)

Ferket, Bart S; Spronk, Sandra; Colkesen, Ersen B; Hunink, M G Myriam

2012-02-01

Peripheral artery disease (PAD) screening may be performed to prevent progression of PAD or future cardiovascular disease in general. Recommendations for PAD screening have to be derived indirectly because no randomized trials comparing screening versus no screening have been performed. We performed a systematic review of guidelines to evaluate the value of PAD screening in asymptomatic adults. Guidelines in English published between January 1, 2003 and January 20, 2011 were retrieved using MEDLINE, CINAHL, the National Guideline Clearinghouse, the National Library for Health, the Canadian Medication Association Infobase, and the G-I-N International Guideline Library. Guidelines developed by national and international medical societies from Western countries, containing recommendations on PAD screening, were included. Two reviewers independently assessed rigor of guideline development using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. One reviewer performed full extraction of recommendations, which was validated by a second reviewer. Of 2779 titles identified, 8 guidelines were included. AGREE scores varied from 33% to 81%. Five guidelines advocated PAD screening, others found insufficient evidence for PAD screening or were against it. Measurement of the ankle-brachial index (ABI) was generally recommended for middle-aged populations with elevated cardiovascular risk levels. Those identified as having PAD are reclassified as high risk, warranting intensive preventive interventions to reduce their risk of a cardiovascular event. The underlying evidence mainly consisted of studies performed in patients with established PAD. A meta-analysis that evaluated ABI testing in the context of traditional cardiovascular risk assessment was interpreted differently. Recommendations on PAD screening vary across current guidelines, making the value of PAD screening uncertain. The variation seems to reflect lack of studies that show added value of

Design and evaluation of new overview screens for the LABIHS simulator

International Nuclear Information System (INIS)

Oliveira, Mauro V.; Almeida, Jose C.S.; Jaime, Guilherme D.G.; Augusto, Silas C.

2015-01-01

The development and evaluation of Human-System Interfaces (HSIs) for control rooms is a research area at the Human-System Interface Laboratory (LABIHS). The main objective of this laboratory is to develop and evaluate projects of HSIs for industrial plants using different methodology construction. The evaluation of the interfaces is carried out in the LABIHS simulator at the Nuclear Engineering Institute (IEN). Previous evaluation of the overview screen of the nuclear power plant (NPP) simulator of the LABIHS showed the necessity of additional information to reduce the operator workload. To overcome this issue, a set of three 52-inch LCD TV was acquired to replace the projector in the task of showing the overview screen to the simulator operators. A new set of screens was developed to gather information in the three LCD screens. The approach used on the development of the new screens was based on human factors guidelines and recommendations. The objective of this work is present the design of these new overview screens and to evaluate their contribution to reduce the operators mental workload in this new scenario. (author)

Bridging the gap between academic research and regulatory health risk assessment of Endocrine Disrupting Chemicals.

Science.gov (United States)

Beronius, Anna; Hanberg, Annika; Zilliacus, Johanna; Rudén, Christina

2014-12-01

Regulatory risk assessment is traditionally based primarily on toxicity studies conducted according to standardized and internationally validated test guidelines. However, health risk assessment of endocrine disrupting chemicals (EDCs) is argued to rely on the efficient integration of findings from academic research. The aim of this review was to provide an overview of current developments to facilitate the use of academic research in regulatory risk assessment of chemicals and how certain aspects of study design and reporting are particularly important for the risk assessment process. By bridging the gap between academic research and regulatory health risk assessment of EDCs, scientific uncertainty in risk assessment conclusions can be reduced, allowing for better targeted policy decisions for chemical risk reduction. Copyright © 2014. Published by Elsevier Ltd.

Guidelines for prediction of CO{sub 2} corrosion in oil and gas production systems

Energy Technology Data Exchange (ETDEWEB)

Nyborg, Rolf

2009-09-15

A group of corrosion experts from different oil companies has prepared guidelines for use of CO{sub 2} corrosion prediction tools. The guidelines are intended for use in design and engineering practice applied by companies operating oil and gas production facilities. This document attempts to set minimum guidelines that should be common to most companies. The document is sufficiently flexible to allow individual companies to adapt the information set forth in this document to their own environment and requirements. A methodology for defining the Iikelihood of corrosion and the impact on CO{sub 2} prediction is developed. The CO{sub 2} prediction is based on existing tools. An overview of available CO{sub 2} corrosion prediction models evaluated by the participants is given. It is the responsibility of the operator to select which model to use. (Author)

Glaucoma-service provision in Scotland: introduction and need for Scottish Intercollegiate Guidelines Network guidelines.

Science.gov (United States)

Syrogiannis, Andreas; Rotchford, Alan P; Agarwal, Pankaj Kumar; Kumarasamy, Manjula; Montgomery, Donald; Burr, Jennifer; Sanders, Roshini

2015-01-01

To describe the pattern of glaucoma-service delivery in Scotland and identify areas for improvement, taking into account Scottish General Ophthalmic Services (GOS) arrangements and the Eye Care Integration project, and to design Scottish Intercollegiate Guidelines Network (SIGN) guidelines to refine the primary and secondary interface of glaucoma care. A glaucoma-survey questionnaire was sent to all consultant glaucomatologists in Scotland. The design of SIGN guidelines was based on the results of the questionnaire using SIGN methodology. Over 90% of Scottish glaucoma care is triaged and delivered within hospital services. Despite GOS referral, information is variable. There are no consistent discharge practices to the community. These results led to defined research questions that were answered, thus formulating the content of the SIGN guidelines. The guideline covers the assessment of patients in primary care, referral criteria to hospital, discharge criteria from hospital to community, and monitoring of patients at risk of glaucoma. With increasing age and limitations to hospital resources, refining glaucoma pathways between primary and secondary care has become a necessity. Scotland has unique eye care arrangements with both the GOS and Eye Care Integration project. It is hoped that implementation of SIGN guidelines will identify glaucoma at the earliest opportunity and reduce the rate of false-positive referrals to hospital.

A critical appraisal of guidelines for the management of knee osteoarthritis using Appraisal of Guidelines Research and Evaluation criteria

Science.gov (United States)

Poitras, Stéphane; Avouac, Jérôme; Rossignol, Michel; Avouac, Bernard; Cedraschi, Christine; Nordin, Margareta; Rousseaux, Chantal; Rozenberg, Sylvie; Savarieau, Bernard; Thoumie, Philippe; Valat, Jean-Pierre; Vignon, Éric; Hilliquin, Pascal

2007-01-01

Clinical practice guidelines have been elaborated to summarize evidence related to the management of knee osteoarthritis and to facilitate uptake of evidence-based knowledge by clinicians. The objectives of the present review were summarizing the recommendations of existing guidelines on knee osteoarthritis, and assessing the quality of the guidelines using a standardized and validated instrument – the Appraisal of Guidelines Research and Evaluation (AGREE) tool. Internet medical literature databases from 2001 to 2006 were searched for guidelines, with six guidelines being identified. Thirteen clinician researchers participated in the review. Each reviewer was trained in the AGREE instrument. The guidelines were distributed to four groups of three or four reviewers, each group reviewing one guideline with the exception of one group that reviewed two guidelines. One independent evaluator reviewed all guidelines. All guidelines effectively addressed only a minority of AGREE domains. Clarity/presentation was effectively addressed in three out of six guidelines, scope/purpose and rigour of development in two guidelines, editorial independence in one guideline, and stakeholder involvement and applicability in none. The clinical management recommendation tended to be similar among guidelines, although interventions addressed varied. Acetaminophen was recommended for initial pain treatment, combined with exercise and education. Nonsteroidal anti-inflammatory drugs were recommended if acetaminophen failed to control pain, but cautiously because of gastrointestinal risks. Surgery was recommended in the presence of persistent pain and disability. Education and activity management interventions were superficially addressed in most guidelines. Guideline creators should use the AGREE criteria when developing guidelines. Innovative and effective methods of knowledge translation to health professionals are needed. PMID:18062805

Incorporating a gender perspective into the development of clinical guidelines: a training course for guideline developers

Directory of Open Access Journals (Sweden)

Burgers Jako S

2007-11-01

Full Text Available Abstract Background Dutch guideline-developing organizations do not focus systematically on differences between men and women when developing guidelines, even though there is increasing evidence that being male or female may have an effect on health and health outcomes. In collaboration with two prominent Dutch guideline-developing organizations, we designed a training course to encourage systematic attention to sex differences in guideline development procedures. Methods The course is targeted towards guideline developers. Its aims are to improve awareness concerning the relevance of considering sex differences in the guideline development process, as well as the competence and skills necessary for putting this into practice. The design and teaching methods of the course are based on adult learning styles and principles of changing provider behaviour. It was adjusted to the working methods of guideline organizations. The course was taught to, and evaluated by, a group of staff members from two guideline organizations in the Netherlands. Results The course consists of five modules, each of which corresponds to a key step in the guideline development process. The participants rated the training course positively on content, programme, and trainers. Their written comments suggest that the course met its objectives. Conclusion The training course is the first to address sex differences in guideline development. Results from the pilot test suggest that the course achieved its objectives. Because its modules and teaching methods of the course are widely transferable, the course could be useful for many organizations that are involved in developing guidelines. Follow-up studies are needed to assess the long-term effect of the course on the actions of guideline developers and its utility in other settings.

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

International Nuclear Information System (INIS)

Carr, R.S.; Biedenbach, J.M.; MacDonald, D.D.

1995-01-01

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

Guidelines for personal exposure monitoring of chemicals: Part III.

Science.gov (United States)

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2018-01-25

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part IV.

Science.gov (United States)

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2018-03-27

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part II.

Science.gov (United States)

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2017-11-25

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part I.

Science.gov (United States)

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2017-09-28

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided later in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part V.

Science.gov (United States)

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2018-05-25

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

How nurses seek and evaluate clinical guidelines on the Internet

NARCIS (Netherlands)

Verhoeven, F.; Steehouder, M.F.; Hendrix, Ron M.G.; van Gemert-Pijnen, Julia E.W.C.

2010-01-01

Aim: This paper is a report of a study conducted to assess nurses’ information-seeking strategies and problems encountered when seeking clinical guidelines on the Internet, and to investigate the criteria they apply when evaluating the guidelines and the websites communicating the guidelines. -

Screening for non-alcoholic fatty liver disease in children: do guidelines provide enough guidance?

Science.gov (United States)

Koot, B G P; Nobili, V

2017-09-01

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the industrialized world in children. Its high prevalence and important health risks make NAFLD highly suitable for screening. In practice, screening is widely, albeit not consistently, performed. To review the recommendations on screening for NAFLD in children. Recommendations on screening were reviewed from major paediatric obesity guidelines and NAFLD guidelines. A literature overview is provided on open questions and controversies. Screening for NAFLD is advocated in all obesity and most NAFLD guidelines. Guidelines are not uniform in whom to screen, and most guidelines do not specify how screening should be performed in practice. Screening for NAFLD remains controversial, due to lack of a highly accurate screening tool, limited knowledge to predict the natural course of NAFLD and limited data on its cost effectiveness. Guidelines provide little guidance on how screening should be performed. Screening for NAFLD remains controversial because not all conditions for screening are fully met. Consensus is needed on the optimal use of currently available screening tools. Research should focus on new accurate screening tool, the natural history of NAFLD and the cost effectiveness of different screening strategies in children. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

[Quality indicators for National Disease Management Guidelines using the example of the National Disease Management Guideline for "Chronic Heart Failure"].

Science.gov (United States)

Nothacker, Monika Judith; Langer, Thomas; Weinbrenner, Susanne

2011-01-01

Together with an expert committee a structured approach to determining quality indicators for National Disease Management Guidelines has been developed. The key steps of this approach include: introducing guideline authors to the methodology at an early stage of the process of guideline development, pre-selecting recommendations of the guideline which are potentially measurable by means of quality indicators, assessing the potentially measurable quality indicators in written form using five criteria (including their importance for the health care system and clarity of definitions) and approving them in a formal consensus process. For lack of a database these quality indicators must be regarded as preliminary. For the National Disease Management Guideline "Chronic Heart Failure" nine rate-based indicators have been chosen. The indicators correspond to important strong recommendations (grade of recommendation: A) from the fields of diagnosis (two), general therapeutic strategy (two), specific treatment (three), clinical monitoring (one) and co-ordination of care (one). In a second step, the quality indicators have to be validated within a pilot project. The determination and assessment of the potential quality indicators have revealed room for improvement of guideline development. In particular, there is a need for more health care data and for specification of recommendations.

Guidelines in electrodiagnostic medicine. American Association of Electrodiagnostic Medicine.

Science.gov (United States)

1992-02-01

The American Association of Electrodiagnostic Medicine (AAEM) is committed to the development of sound and clinically relevant guidelines through review of literature, expert opinion and consensus. In 1979, with the assistance of its Professional Practice Committee and association leaders, the association published its initial guidelines, Guidelines in Electrodiagnostic Medicine, covering the practice of electrodiagnostic medicine. The committee is charged with ongoing revision of the document, as needed, and the current version includes standards of practice in clinical electromyography, risks in electrodiagnostic medicine, basic equipment requirements, and the role of paramedical support. In 1988, Educational Guidelines for Electrodiagnostic Training Programs (Appendix A) was prepared by the AAEM Training Program Committee and added to aid training program directors in establishing new training programs or in reviewing the current status of the educational aspects of existing programs. In 1986, the AAEM charged its Quality Assurance Committee with the responsibility for the development of guidelines pertinent to electrodiagnostic medical consultations. The impetus for the charge was the requests received from members of the AAEM and other interested parties for educational material on indications for and conduct of electrodiagnostic medical consultations. As a result of the committee's efforts, Suggested Guidelines for Electrodiagnostic Medical Consultations (Appendix D), was published in 1989 and additional sections added subsequently. The current document includes (1) general indications for an electrodiagnostic medical consultation for patients with suspected myopathies, neuromuscular junction disorders, polyneuropathies, mononeuropathies, plexopathies, radiculopathies, neuronopathies and central nervous system disorders, (2) specific indications for patients with suspected lumbosacral or cervical radiculopathies, (3) general principles of electrodiagnostic

Effects of ambient vibrations on heritage buildings: overview and wireless dynamic monitoring application

International Nuclear Information System (INIS)

Monti, G.; Quaranta, G.; Fumagalli, F.; Marano, G.C.; Rea, R.; Nazzaro, B.

2015-01-01

Growing awareness of the negative effects due to ambient vibrations caused by transportations infrastructures in Historical centres is attributable to the high vulnerability of heritage buildings as a consequence of deterioration phenomena and damages that reduced the structural capacity of such valuable constructions over the past centuries. As the mobility demand increases, several cities hosting heritage buildings are subjected to raising traffic loadings, so that constructions of new infrastructures is often required. Hence, assessing the effects of short-term vibrations due to construction activities or the consequences of the long-term vibrations caused by traffic is very important for the preservation of cultural heritage. An operative approach for evaluating the effects of ambient vibrations based on experimental measurements is a useful tool when a new infrastructure is being built, and can support strategic decisions for the elaboration of transportation plans at the urban level. Therefore, an overview is here presented of existing studies, guidelines and codes that provide pertinent information on this topic. Of special importance is the analysis of existing proposed thresholds, i.e. limit values that, if compiled with, damage due to ambient vibrations is not likely to occur. On the basis of such overview, the selection of threshold values for the Flavian Amphitheater is discussed, along with current efforts towards a wireless dynamic monitoring of its dynamic response.

Comments from the Developmental Neurotoxicology Committee of the Japanese Teratology Society on the OECD Guideline for the Testing of Chemicals, Proposal for a New Guideline 426, Developmental Neurotoxicity Study, Draft Document (October 2006 version), and on the Draft Document of the Retrospective Performance Assessment of the Draft Test Guideline 426 on Developmental Neurotoxicity.

Science.gov (United States)

Ema, Makoto; Fukui, Yoshihiro; Aoyama, Hiroaki; Fujiwara, Michio; Fuji, Junichiro; Inouye, Minoru; Iwase, Takayuki; Kihara, Takahide; Oi, Akihide; Otani, Hiroki; Shinomiya, Mitsuhiro; Sugioka, Kozo; Yamano, Tsunekazu; Yamashita, Keisuke H; Tanimura, Takashi

2007-06-01

In October 2006, a new revision of the draft guideline (OECD Guideline for the Testing of Chemicals, Proposal for a New Guideline 426. Developmental Neurotoxicity Study) and Draft Document of the Retrospective Performance Assessment (RPA) of the Draft Test Guideline 426 on Developmental Neurotoxicity were distributed following incorporation of the results of the Expert Consultation Meeting in Tokyo on May 24-26, 2005. The draft guideline consists of 50 paragraphs and an appendix with 102 references; and the draft RPA consists of 37 paragraphs with 109 references. National coordinators were requested to arrange for national expert reviews of these draft documents in their member countries. Members of the Developmental Neurotoxicology (DNT) Committee of the Japanese Teratology Society (JTS) reviewed, discussed, and commented on the draft Test Guideline Proposal. The DNT Committee of the JTS also commented on the draft document of the RPA. These comments were sent to the OECD Secretariat. The DNT Committee of the JTS expects the comments to be useful for the finalization of these draft documents.

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.

Computerization of guidelines: towards a "guideline markup language".

Science.gov (United States)

Dart, T; Xu, Y; Chatellier, G; Degoulet, P

2001-01-01

Medical decision making is one of the most difficult daily tasks for physicians. Guidelines have been designed to reduce variance between physicians in daily practice, to improve patient outcomes and to control costs. In fact, few physicians use guidelines in daily practice. A way to ease the use of guidelines is to implement computerised guidelines (computer reminders). We present in this paper a method of computerising guidelines. Our objectives were: 1) to propose a generic model that can be instantiated for any specific guidelines; 2) to use eXtensible Markup Language (XML) as a guideline representation language to instantiate the generic model for a specific guideline. Our model is an object representation of a clinical algorithm, it has been validated by running two different guidelines issued by a French official Agency. In spite of some limitations, we found that this model is expressive enough to represent complex guidelines devoted to diabetes and hypertension management. We conclude that XML can be used as a description format to structure guidelines and as an interface between paper-based guidelines and computer applications.

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

Guidelines and workbook for assessment of organization and administration of utilities seeking operating license for a nuclear power plant. Guidelines for utility organization and administration plan. Volume 1, Revision 1

International Nuclear Information System (INIS)

Thurber, J.A.; Olson, J.; Osborn, R.N.; Sommers, P.; Widrig, R.D.

1986-09-01

Volumes 1 and 2 of this report are a partial response to the requirements of Item I.B.1.1 of the ''NRC Action Plan Developed as a Result of the TMI-2 Accident,'' NUREG-0660, and are designed to serve as a basis for replacing the earlier NUREG-0731, ''Guidelines for Utility Management Structure and Technical Resources.'' These Guidelines are intended to provide guidance to the user in preparing a written plan for a proposed nuclear organization and administration. The purpose of the Workbook (Vol. 2) is to guide the NRC reviewer through a systematic review and assessment of a proposed organization and administration. It is the NRC's intention to incorporate these Guidelines and Workbook into a future revision of the Standard Review Plan (SRP), NUREG-0800. However, at this time the report is being published so that the material may be used on a voluntary basis by industry to systematically prepare or evaluate their organization or administration plans. Use of the report by the NRC would not occur until after it has been incorpoarted in the SRP

Adherence to cardiac practice guidelines in the management of Non-ST-Elevation Acute Coronary Syndromes: a systematic literature review.

NARCIS (Netherlands)

Engel, J.; Damen, N.L.; Wulp, I. van der; Bruijne, M.C. de; Wagner, C.

2017-01-01

Background: In the management of non-ST-elevation acute coronary syndrome (NSTACS) a gap between guideline-recommended care and actual practice has been reported. A systematic overview of the actual extent of this gap, its potential impact on patient-outcomes, and influential factors is lacking.

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...

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.

Radiological assessment of paediatric cervical spine injury in blunt trauma: the potential impact of new NICE guidelines on the use of CT

International Nuclear Information System (INIS)

Davies, J.; Cross, S.; Evanson, J.

2016-01-01

Aim: To determine the potential effect of changes to the National Institute for Health and Care Excellence (NICE) guidelines to the use of computed tomography (CT) in the assessment of suspected paediatric cervical spine (c-spine) injury. Material and methods: A 5 year retrospective study was conducted of c-spine imaging in paediatric (<10 years) patients presenting following blunt trauma at a Level 1 trauma centre in London. All patients under the age of 10 years who underwent any imaging of the c-spine following blunt trauma were included. Clinical data relating to the presenting signs and symptoms were obtained from the retrospective review of electronic records and paper notes. This was then applied to the previous NICE guideline (CG56) and to the new NICE guideline (CG176). Patients with incomplete data were excluded. Results: Two hundred and seventy-eight patients <10 years underwent imaging of the c-spine following blunt trauma. Two hundred and seventy (97.12%) examinations had complete data and were included in further analysis. One hundred and forty-nine (55.19%) met the criteria for a CT of the c-spine under NICE CG56, whereas 252 (93.33%) met the updated NICE CG176 criteria for c-spine CT. Five (1.85%) patients had a c-spine injury and met the criteria under both CG56 and CG176 NICE guidelines. Conclusion: Recent changes to NICE Head Injury Guidelines relating to radiological assessment of paediatric c-spine following blunt trauma are likely to result in an increased usage of CT as the initial radiological investigation over plain radiographs, without an apparent increase in specificity in the present series. - Highlights: • Paediatric CSI is a rare but serious consequence of blunt trauma. • New NICE 176 criteria broadened the criteria for c-spine CT following trauma. • 69% more patients may be eligible for assessment with CT under new guidelines. • 5 cases of CSI occurred in this series of 278 paediatric trauma cases. • All 5 cases met CG176

Japanese guidelines for allergic rhinitis 2017

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Kimihiro Okubo

2017-04-01

To incorporate evidence based medicine (EBM introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2016. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA, this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline.

[Physical activity guidelines for Canadians: strategies for dissemination of the message, expectations for change and evaluation].

Science.gov (United States)

Brawley, Lawrence R; Latimer, Amy E

2007-01-01

Physical activity guidelines offer evidence-based behavioural benchmarks that relate to reduced risk of morbidity and mortality if people adhere to them. Essentially, the guidelines tell people what to do, but not why and how they should do it. Thus, to motivate adherence, messages that translate guidelines should convey not only how much physical activity one should attempt and why it is recommended, but also how to achieve such a recommendation. Canada's physical activity guides exemplify how guidelines can be translated. This paper (i) provides a brief overview of the challenges encountered in creating the existing guides and (ii) highlights important practical issues and empirical evidence that should be considered in the future when translating guidelines into messages and disseminating these messages. We draw on the successes of past efforts to translate the goals of physical activity guidelines and on recent literature on messages and media campaigns to make recommendations. Information to motivate people to move toward the goals in physical activity guidelines should be translated into a set of messages that are informative, thought provoking, and persuasive. These messages should be disseminated to the public via a multi-phase social-marketing campaign that is carefully planned and thoroughly evaluated.

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...

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

Predictive analytics in mental health: applications, guidelines, challenges and perspectives.

Science.gov (United States)

Hahn, T; Nierenberg, A A; Whitfield-Gabrieli, S

2017-01-01

The emerging field of 'predictive analytics in mental health' has recently generated tremendous interest with the bold promise to revolutionize clinical practice in psychiatry paralleling similar developments in personalized and precision medicine. Here, we provide an overview of the key questions and challenges in the field, aiming to (1) propose general guidelines for predictive analytics projects in psychiatry, (2) provide a conceptual introduction to core aspects of predictive modeling technology, and (3) foster a broad and informed discussion involving all stakeholders including researchers, clinicians, patients, funding bodies and policymakers.

15 CFR 990.12 - Overview.

Science.gov (United States)

2010-01-01

... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OIL POLLUTION ACT REGULATIONS NATURAL RESOURCE DAMAGE ASSESSMENTS Introduction § 990.12 Overview. This part describes three phases of a natural resource..., is described in subpart D of this part. The Restoration Planning Phase, during which trustees...

Appraisal tools for clinical practice guidelines: a systematic review.

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Ulrich Siering

Full Text Available Clinical practice guidelines can improve healthcare processes and patient outcomes, but are often of low quality. Guideline appraisal tools aim to help potential guideline users in assessing guideline quality. We conducted a systematic review of publications describing guideline appraisal tools in order to identify and compare existing tools.Among others we searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews from 1995 to May 2011 for relevant primary and secondary publications. We also handsearched the reference lists of relevant publications. On the basis of the available literature we firstly generated 34 items to be used in the comparison of appraisal tools and grouped them into thirteen quality dimensions. We then extracted formal characteristics as well as questions and statements of the appraisal tools and assigned them to the items.We identified 40 different appraisal tools. They covered between three and thirteen of the thirteen possible quality dimensions and between three and 29 of the possible 34 items. The main focus of the appraisal tools were the quality dimensions "evaluation of evidence" (mentioned in 35 tools; 88%, "presentation of guideline content" (34 tools; 85%, "transferability" (33 tools; 83%, "independence" (32 tools; 80%, "scope" (30 tools; 75%, and "information retrieval" (29 tools; 73%. The quality dimensions "consideration of different perspectives" and "dissemination, implementation and evaluation of the guideline" were covered by only twenty (50% and eighteen tools (45% respectively.Most guideline appraisal tools assess whether the literature search and the evaluation, synthesis and presentation of the evidence in guidelines follow the principles of evidence-based medicine. Although conflicts of interest and norms and values of guideline developers, as well as patient involvement, affect the trustworthiness of guidelines, they are currently insufficiently considered. Greater focus should be

Quality and consistency of guidelines for the management of mild traumatic brain injury in the emergency department.

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Tavender, Emma J; Bosch, Marije; Green, Sally; O'Connor, Denise; Pitt, Veronica; Phillips, Kate; Bragge, Peter; Gruen, Russell L

2011-08-01

The objective was to provide an overview of the recommendations and quality of evidence-based clinical practice guidelines (CPGs) for the emergency management of mild traumatic brain injury (mTBI), with a view to informing best practice and improving the consistency of recommendations. Electronic searches of health databases (MEDLINE, EMBASE, The Cochrane Library, PsycINFO), CPG clearinghouse websites, CPG developer websites, and Internet search engines up to January 2010 were conducted. CPGs were included if 1) they were published in English and freely accessible, 2) their scope included the management of mTBI in the emergency department (ED), 3) the date of last search was within the past 10 years (2000 onward), 4) systematic methods were used to search for evidence, and 5) there was an explicit link between the recommendations and the supporting evidence. Four authors independently assessed the quality of the included CPGs using the Appraisal of Guidelines, Research and Evaluation (AGREE) Instrument. The authors extracted and categorized recommendations according to initial clinical assessment, imaging, management, observation, discharge planning, and patient information and follow-up. The search identified 18 potential CPGs, of which six met the inclusion criteria. The included CPGs varied in scope, target population, size, and guideline development processes. Four CPGs were assessed as "strongly recommended." The majority of CPGs did not provide information about the level of stakeholder involvement (mean AGREE standardized domain score = 57%, range = 25% to 81%), nor did they address the organizational/cost implications of applying the recommendations or provide criteria for monitoring and review of recommendations in practice (mean AGREE standardized domain score = 46.6%, range = 19% to 94%). Recommendations were mostly consistent in terms of the use of the Glasgow Coma Scale (GCS) score (adult and pediatric) to assess the level of consciousness, initial

A comparative review of pharmacoeconomic guidelines.

Science.gov (United States)

Jacobs, P; Bachynsky, J; Baladi, J F

1995-09-01

We have reviewed 4 international sets of guidelines for the economic evaluation of pharmaceutical products-those of the Australian Pharmaceutical Benefits Advisory Committee, the Canadian Coordinating Office for Health Technology Assessment, the Ontario Ministry of Health, and the England and Wales Department of Health. Comparison of these guidelines reveals that there are a number of differences between them, including disparities in outcome selection, costs and perspectives. These observations were attributed to differences in study purpose, conceptual approach, measurement techniques and value judgements. Uniformity can be achieved only in conceptual approach and measurement technique. Guidelines should be flexible to accommodate differences in the study purposes and value judgements of the analysts.

[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.

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.

Cochrane Qualitative and Implementation Methods Group guidance series-paper 6: reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses.

Science.gov (United States)

Flemming, Kate; Booth, Andrew; Hannes, Karin; Cargo, Margaret; Noyes, Jane

2018-05-01

To outline contemporary and novel developments for the presentation and reporting of syntheses of qualitative, implementation, and process evaluation evidence and provide recommendations for the use of reporting guidelines. An overview of reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses drawing on current international literature and the collective expert knowledge of the Cochrane Qualitative and Implementation Methods Group. Several reporting guidelines exist that can be used or adapted to report syntheses of qualitative, implementation, and process evaluation evidence. Methods to develop individual guidance varied. The use of a relevant reporting guideline can enhance the transparency, consistency, and quality of reporting. Guidelines that exist are generic, method specific, and for particular aspects of the reviewing process, searching. Caution is expressed over the potential for reporting guidelines to produce a mechanistic approach moving the focus away from the content and toward the procedural aspects of the review. The use of a reporting guideline is recommended and a five-step decision flowchart to guide the choice of reporting guideline is provided. Gaps remain in method-specific reporting guidelines such as mixed-study, implementation, and process evaluation evidence syntheses. Copyright © 2017 Elsevier Inc. All rights reserved.

A brief overview on radon measurements in drinking water.

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Jobbágy, Viktor; Altzitzoglou, Timotheos; Malo, Petya; Tanner, Vesa; Hult, Mikael

2017-07-01

The aim of this paper is to present information about currently used standard and routine methods for radon analysis in drinking waters. An overview is given about the current situation and the performance of different measurement methods based on literature data. The following parameters are compared and discussed: initial sample volume and sample preparation, detection systems, minimum detectable activity, counting efficiency, interferences, measurement uncertainty, sample capacity and overall turnaround time. Moreover, the parametric levels for radon in drinking water from the different legislations and directives/guidelines on radon are presented. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Environmental impact assessment of quarries under water table: state of the art

International Nuclear Information System (INIS)

Menatti, M.; Vismara, R.

2009-01-01

After an overview of environmental problems concerning pits under water table, data and results showed in a few examples of literature and in some Environmental Impact Study are summarized. A close examination about sector normative instruments, in the field of E.I.A. (Environmental Impact Assessment) and S.E.A. (Strategic Environmental Assessment) is showed, through some key elements obtained from a few guidelines expressed by control and authorization governmental authority.In addition, the paper deals with a specific problem about wash water management and, in particular, silt material management; the possible impacts derived from the directly wash water introduction in the pit lake and from the use of settling lagoon are analyzed. [it

Environmental assessment overview, Reference repository location, Hanford site, Washington

International Nuclear Information System (INIS)

1986-05-01

In February 1983, the US Department of Energy (DOE) identified a reference repository location at the Hanford Site in Washington as one of the nine potentially acceptable sites for a mined geologic repository for spent nuclear fuel and high-level radioactive waste. The site is in the Columbia Plateau, which is one of five distinct geohydrologic settings considered for the first repository. To determine their suitability, the Hanford site and the eight other potentially acceptable sites have been evaluated in accordance with the DOE's General Guidelines for the Recommendation of Sites for the Nuclear Waste Repositories. On the basis of the evaluations reported in this EA, the DOE has found that the Hanford site is not disqualified under the guidelines. On the basis of these findings, the DOE is nominating the Hanford site as one of five sites suitable for characterization. 3 figs

78 FR 11059 - Examination Guidelines for Implementing the First Inventor To File Provisions of the Leahy-Smith...

Science.gov (United States)

2013-02-14

...] Examination Guidelines for Implementing the First Inventor To File Provisions of the Leahy-Smith America... concerning the first inventor to file provisions of the Leahy-Smith America Invents Act (AIA). The AIA amends... Inventor To File Provisions of the Leahy-Smith America Invents Act I. Overview of the Changes to 35 U.S.C...

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.

Asia Oceania Guidelines for the Implementation of Programs for Cervical Cancer Prevention and Control

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Hextan Y. S. Ngan

2011-01-01

The primary purpose of these guidelines is to provide information on scientific evidence on the different modalities and approaches of cervical cancer prevention programs, for high resource and low resource settings. The secondary purpose is to provide an overview of the current situation of cervical cancer control and prevention in various Asian Oceania countries: their views of an ideal program, identified obstacles, and suggestions to overcome them are discussed.

Peak load arrangements : Assessment of Nordel guidelines

Energy Technology Data Exchange (ETDEWEB)

2009-07-01

Two Nordic countries, Sweden and Finland, have legislation that empowers the TSO to acquire designated peak load resources to mitigate the risk for shortage situations during the winter. In Denmark, the system operator procures resources to maintain a satisfactory level of security of supply. In Norway the TSO has set up a Regulation Power Option Market (RKOM) to secure a satisfactory level of operational reserves at all times, also in winter with high load demand. Only the arrangements in Finland and Sweden fall under the heading of Peak Load Arrangements defined in Nordel Guidelines. NordREG has been invited by the Electricity Market Group (EMG) to evaluate Nordel's proposal for 'Guidelines for transitional Peak Load Arrangements'. The EMG has also financed a study made by EC Group to support NordREG in the evaluation of the proposal. The study has been taken into account in NordREG's evaluation. In parallel to the EMG task, the Swedish regulator, the Energy Markets Inspectorate, has been given the task by the Swedish government to investigate a long term solution of the peak load issue. The Swedish and Finnish TSOs have together with Nord Pool Spot worked on finding a harmonized solution for activation of the peak load reserves in the market. An agreement accepted by the relevant authorities was reached in early January 2009, and the arrangement has been implemented since 19th January 2009. NordREG views that the proposed Nordel guidelines have served as a starting point for the presently agreed procedure. However, NordREG does not see any need to further develop the Nordel guidelines for peak load arrangements. NordREG agrees with Nordel that the market should be designed to solve peak load problems through proper incentives to market players. NordREG presumes that the relevant authorities in each country will take decisions on the need for any peak load arrangement to ensure security of supply. NordREG proposes that such decisions should be

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

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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

Clinical algorithms to aid osteoarthritis guideline dissemination

DEFF Research Database (Denmark)

Meneses, S. R. F.; Goode, A. P.; Nelson, A. E

2016-01-01

Background: Numerous scientific organisations have developed evidence-based recommendations aiming to optimise the management of osteoarthritis (OA). Uptake, however, has been suboptimal. The purpose of this exercise was to harmonize the recent recommendations and develop a user-friendly treatment...... algorithm to facilitate translation of evidence into practice. Methods: We updated a previous systematic review on clinical practice guidelines (CPGs) for OA management. The guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation for quality and the standards for developing...... to facilitate the implementation of guidelines in clinical practice are necessary. The algorithms proposed are examples of how to apply recommendations in the clinical context, helping the clinician to visualise the patient flow and timing of different treatment modalities. (C) 2016 Osteoarthritis Research...

Addressing implementation challenges during guideline development - a case study of Swedish national guidelines for methods of preventing disease.

Science.gov (United States)

Richter-Sundberg, Linda; Kardakis, Therese; Weinehall, Lars; Garvare, Rickard; Nyström, Monica E

2015-01-22

provides examples of how guideline developers perceive and approach the issue of implementation during the development and early launch of prevention guidelines. Models for guideline development could benefit from an initial assessment of how the guideline topic, its target context and stakeholders will affect the upcoming implementation.

Using Qualitative Research to Inform Development of Professional Guidelines: A Case Study of the Society of Critical Care Medicine Family-Centered Care Guidelines.

Science.gov (United States)

Coombs, Maureen A; Davidson, Judy E; Nunnally, Mark E; Wickline, Mary A; Curtis, J Randall

2017-08-01

To explore the importance, challenges, and opportunities using qualitative research to enhance development of clinical practice guidelines, using recent guidelines for family-centered care in the ICU as an example. In developing the Society of Critical Care Medicine guidelines for family-centered care in the neonatal ICU, PICU, and adult ICU, we developed an innovative adaptation of the Grading of Recommendations, Assessments, Development and Evaluations approach to explicitly incorporate qualitative research. Using Grading of Recommendations, Assessments, Development and Evaluations and the Council of Medical Specialty Societies principles, we conducted a systematic review of qualitative research to establish family-centered domains and outcomes. Thematic analyses were undertaken on study findings and used to support Population, Intervention, Comparison, Outcome question development. We identified and employed three approaches using qualitative research in these guidelines. First, previously published qualitative research was used to identify important domains for the Population, Intervention, Comparison, Outcome questions. Second, this qualitative research was used to identify and prioritize key outcomes to be evaluated. Finally, we used qualitative methods, member checking with patients and families, to validate the process and outcome of the guideline development. In this, a novel report, we provide direction for standardizing the use of qualitative evidence in future guidelines. Recommendations are made to incorporate qualitative literature review and appraisal, include qualitative methodologists in guideline taskforce teams, and develop training for evaluation of qualitative research into guideline development procedures. Effective methods of involving patients and families as members of guideline development represent opportunities for future work.

Implementing New Reform Guidelines in Teaching Introductory College Statistics Courses

Science.gov (United States)

Everson, Michelle; Zieffler, Andrew; Garfield, Joan

2008-01-01

This article introduces the recently adopted Guidelines for the Assessment and Instruction in Statistics Education (GAISE) and provides two examples of introductory statistics courses that have been redesigned to better align with these guidelines.

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

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...

Guidelines and Value-Based Decision Making: An Evolving Role for Payers.

Science.gov (United States)

McCauley, Janet L

2015-01-01

Payers use evidence-based guidelines to promote effective health diagnoses and treatments for their members and to ensure that members are not subject to harmful or wasteful care. Payer guidelines inform coverage, but the content of these guidelines relies on the same evidentiary base as clinical treatment guidelines. Recent strategies to foster value through benefit design and alternative reimbursement methodologies illustrate emerging applications for evidence-based guidelines. The current focus on cost effectiveness within health technology assessment, comparative effectiveness research in collaboration with payers, and transparency around payer evidence assessment could better align payers' interests in evidence-based care with those of other stakeholders. The move to value in health care will depend upon credible clinical evidence to enable informed decision making. ©2015 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

The clinical development process for a novel preventive vaccine: An overview

Directory of Open Access Journals (Sweden)

K Singh

2016-01-01

Full Text Available Each novel vaccine candidate needs to be evaluated for safety, immunogenicity, and protective efficacy in humans before it is licensed for use. After initial safety evaluation in healthy adults, each vaccine candidate follows a unique development path. This article on clinical development gives an overview on the development path based on the expectations of various guidelines issued by the World Health Organization (WHO, the European Medicines Agency (EMA, and the United States Food and Drug Administration (USFDA. The manuscript describes the objectives, study populations, study designs, study site, and outcome(s of each phase (Phase I-III of a clinical trial. Examples from the clinical development of a malaria vaccine candidate, a rotavirus vaccine, and two vaccines approved for human papillomavirus (HPV have also been discussed. The article also tabulates relevant guidelines, which can be referred to while drafting the development path of a novel vaccine candidate.

Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology.

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Smith, Ian; Kranke, Peter; Murat, Isabelle; Smith, Andrew; O'Sullivan, Geraldine; Søreide, Eldar; Spies, Claudia; in't Veld, Bas

2011-08-01

This guideline aims to provide an overview of the present knowledge on aspects of perioperative fasting with assessment of the quality of the evidence. A systematic search was conducted in electronic databases to identify trials published between 1950 and late 2009 concerned with preoperative fasting, early resumption of oral intake and the effects of oral carbohydrate mixtures on gastric emptying and postoperative recovery. One study on preoperative fasting which had not been included in previous reviews and a further 13 studies published since the most recent review were identified. The searches also identified 20 potentially relevant studies of oral carbohydrates and 53 on early resumption of oral intake. Publications were classified in terms of their evidence level, scientific validity and clinical relevance. The Scottish Intercollegiate Guidelines Network scoring system for assessing level of evidence and grade of recommendations was used. The key recommendations are that adults and children should be encouraged to drink clear fluids up to 2 h before elective surgery (including caesarean section) and all but one member of the guidelines group consider that tea or coffee with milk added (up to about one fifth of the total volume) are still clear fluids. Solid food should be prohibited for 6 h before elective surgery in adults and children, although patients should not have their operation cancelled or delayed just because they are chewing gum, sucking a boiled sweet or smoking immediately prior to induction of anaesthesia. These recommendations also apply to patients with obesity, gastro-oesophageal reflux and diabetes and pregnant women not in labour. There is insufficient evidence to recommend the routine use of antacids, metoclopramide or H2-receptor antagonists before elective surgery in non-obstetric patients, but an H2-receptor antagonist should be given before elective caesarean section, with an intravenous H2-receptor antagonist given prior to emergency

[Needs assessment to improve the applicability and methodological quality of a German S3 guideline].

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Burckhardt, Marion; Hoffmann, Cristina; Nink-Grebe, Brigitte; Sänger, Sylvia

2018-04-01

Clinical practice guidelines can change the practice in healthcare only if their recommendations are implemented in a comprehensive way. The German S3 guideline "Local Therapy of Chronic Wounds in Patients with Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes" will be updated in 2017. The emphasis here is on the guideline's validity, user-friendliness and implementation into practice. Therefore, the aim was to identify the improvements required in regard to the guideline's methods and content presentation. The methodological approach used was the critical appraisal of the guideline according to established quality criteria and an additional stakeholder survey. Both were conducted between August and November 2016. The guideline and its related documents were reviewed independently by two researchers according to the criteria of the "Appraisal of Guidelines for Research and Evaluation" (AGREE-II). Published reviews and peer reviews by external experts and organisations were also taken into account. For the stakeholder survey, a questionnaire with open questions was distributed by e-mail and via the Internet to health professionals and organisations involved in the care of patients with leg ulcers in Germany. The questions were aimed at amendments and new topics based on the stakeholders' experience in inpatient and outpatient care. In addition, the survey focused on gathering suggestions to improve the applicability of the guideline. Suggested new topics and amendments were summarised thematically. The stakeholders' suggestions to improve the applicability, the results of the critical appraisal and the relevant aspects of the external reviews were then summarised according to the AGREE-II domains and presented in a cause and effect diagram. 17 questionnaires (out of 864 sent out by e-mail) were returned. Due to high practice relevance, the stakeholders suggested an expansion of the inclusion criteria to patients with infected wounds and

Climate Change and Coastal Zones. An Overview of the State-of-the-Art on Regional and Local Vulnerability Assessment

International Nuclear Information System (INIS)

Sterr, H.; Klein, R.J.T.; Reese, S.

2000-06-01

This paper provides an overview of the latest developments in methodologies for assessing the vulnerability of coastal zones to climate change at regional and local scales. The focus of vulnerability assessment in coastal zones used to be on erosion and land loss due to sea-level rise. Methodologies now increasingly consider the wide range of climate and impact variables that play a part in determining coastal vulnerability, as well as non-climatic developments. The paper presents a conceptual framework for vulnerability assessment that identifies a number of system components that can be considered determinants of vulnerability. It then goes on to outline a number of steps that are required for the actual assessment of coastal vulnerability, such as scenario development, data collection and impact assessment. The approach is illustrated using a regional and local case study in Germany

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

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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

WOCN Society Clinical Guideline: Management of the Adult Patient With a Fecal or Urinary Ostomy-An Executive Summary.

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This article provides an executive summary of the recommendations from the Clinical Guideline: Management of the Adult Patient With a Fecal or Urinary Ostomy, published by the Wound, Ostomy and Continence Nurses Society (WOCN Society). It presents an overview of the process used to update and develop the guideline and lists specific recommendations from the guideline. We provide recommendations that include the following topics: stoma construction, preoperative education, stoma site marking, selection of an ostomy pouching system, postoperative education, postoperative management issues, follow-up care after discharge from the acute care setting, health-related quality of life, and stomal and peristomal complications. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patient outcomes. The full text of the published guideline, which includes available evidence supporting the recommendations and a complete reference list, is available in print and as a mobile application from the WOCN Society's online bookstore (http://www.wocn.org). Refer to Supplemental Digital Content 1 (available at: http://links.lww.com/JWOCN/A40) associated with this article for a complete reference list for the guideline.

[Clinical application evaluation of Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine].

Science.gov (United States)

Liu, Yu-Qi; Liu, Meng-Yu; Li, Chun; Shi, Nan-Nan; Wang, Yue-Xi; Wang, Li-Ying; Zhao, Xue-Yao; Kou, Shuang; Han, Xue-Jie; Wang, Yan-Ping

2017-09-01

This study is to assess the Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine in clinical application and provide evidence for further guideline revision. The assessment was divided into applicability assessment and practicability assessment. The applicability assessment based on questionnaire survey and the traditional Chinese medicine (TCM) practitioners were asked to independently fill the Questionnaire for Applicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The practicability assessment was based on prospective case investigation and analysis method and the TCM practitioners-in-charge filled the Case Investigation Questionnaire for Practicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The data were analyzed in descriptive statistics. 151 questionnaires were investigated for applicability assessment and 1 016 patients were included for practicability assessment. The results showed that 88.74% of them were familiar with the guidelines and 45.70% used them. The guidelines quality and related items were similar in applicability assessment and practicability assessment, and scored highly as more than 85.00% except the "recuperating and prevention". The results suggested that the quality of Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine was high and could better guide the clinical practice. The "recuperating and prevention" part should be improved and the evidence data should be included in future guideline revision, so that the clinical utilization rate could be increased. Copyright© by the Chinese Pharmaceutical Association.

The challenge of developing ethical guidelines for a research infrastructure

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Kutsch, Werner Leo

2016-04-01

The mission of the Integrated Carbon Observation System (ICOS RI) is to enable research to understand the greenhouse gas (GHG) budgets and perturbations. The ICOS RI provides the long-term observations required to understand the present state and predict future behaviour of the global carbon cycle and GHG emissions. Technological developments and implementations, related to GHGs, will be promoted by the linking of research, education and innovation. In order to provide this data ICOS RI is a distributed research infrastructure. The backbones of ICOS RI are the national measurement stations such as ICOS atmosphere, ecosystem and ocean stations. ICOS Central Facilities are the European level ICOS RI Centres, which have the specific tasks in collecting and processing the data and samples received from the national measurement networks. During the establishment of ICOS RI ethical guidelines were developed. These guidelines describe principles of ethics in the research activities that should be applied within ICOS RI. They should be acknowledged and followed by all researchers affiliated to ICOS RI and should be supported by all participating institutions. The presentation describes (1) the general challenge to develop ethical guidelines in a complex international infrastructure and (2) gives an overview about the content that includes different kinds of conflicts of interests, data ethics and social responsibility.

Assessment of radiological referral practice and effect of computer-based guidelines on radiological requests in two emergency departments

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Carton, Matthieu; Auvert, Bertran; Guerini, Henri; Boulard, Jean-Christophe; Heautot, Jean-Francois; Landre, Marie-France; Beauchet, Alain; Sznajderi, Marc; Brun-Ney, Dominique; Chagnon, Sophie

2002-02-01

AIM: To assess medical emergency radiology referral practice compared with a set of French guidelines and to measure the efficiency of computer-based guidelines on unnecessary medical imaging. MATERIALS AND METHODS: All radiological requests were computerized in the medical emergency departments of two French teaching hospitals. During control periods, radiological requests were recorded but no action was taken. During intervention periods, reminder displays on screen indicated the appropriate recommendations. Three control and three intervention periods of 1 month each were conducted. The percentage of requests that did not conform to the guidelines and variation related to periods of control and intervention were measured. RESULTS: The proportion of requests that did not conform to the guidelines was 33{center_dot}2% when the guidelines were inactive and decreased to 26{center_dot}9% when the recommendations were active (P < 0{center_dot}0001). The three imaging examinations (chest radiographs, abdominal plain radiographs and CT of the brain) accounted for more than 80% of all requests; more than 50% of abdominal plain radiographs requests did not conform with recommendations while this percentage was respectively 24{center_dot}9% and 15{center_dot}8% for chest radiographs and computed tomography (CT) of the brain. Seven situations accounted for 70% of non-conforming radiological referrals; in these situations, junior practitioners' knowledge was inadequate. CONCLUSION: While the computer provided advice that was tailored to the needs of individual patients, concurrent with care, the effect of our intervention was weak. However, our study identified the few situations that were responsible for the majority of unnecessary radiological requests; we expect that this result could help clinicians and radiologists to develop more specific actions for these situations. Carton, M. et al. (2002). Clinical Radiology (2002)

Assessment of radiological referral practice and effect of computer-based guidelines on radiological requests in two emergency departments

International Nuclear Information System (INIS)

Carton, Matthieu; Auvert, Bertran; Guerini, Henri; Boulard, Jean-Christophe; Heautot, Jean-Francois; Landre, Marie-France; Beauchet, Alain; Sznajderi, Marc; Brun-Ney, Dominique; Chagnon, Sophie

2002-01-01

AIM: To assess medical emergency radiology referral practice compared with a set of French guidelines and to measure the efficiency of computer-based guidelines on unnecessary medical imaging. MATERIALS AND METHODS: All radiological requests were computerized in the medical emergency departments of two French teaching hospitals. During control periods, radiological requests were recorded but no action was taken. During intervention periods, reminder displays on screen indicated the appropriate recommendations. Three control and three intervention periods of 1 month each were conducted. The percentage of requests that did not conform to the guidelines and variation related to periods of control and intervention were measured. RESULTS: The proportion of requests that did not conform to the guidelines was 33·2% when the guidelines were inactive and decreased to 26·9% when the recommendations were active (P < 0·0001). The three imaging examinations (chest radiographs, abdominal plain radiographs and CT of the brain) accounted for more than 80% of all requests; more than 50% of abdominal plain radiographs requests did not conform with recommendations while this percentage was respectively 24·9% and 15·8% for chest radiographs and computed tomography (CT) of the brain. Seven situations accounted for 70% of non-conforming radiological referrals; in these situations, junior practitioners' knowledge was inadequate. CONCLUSION: While the computer provided advice that was tailored to the needs of individual patients, concurrent with care, the effect of our intervention was weak. However, our study identified the few situations that were responsible for the majority of unnecessary radiological requests; we expect that this result could help clinicians and radiologists to develop more specific actions for these situations. Carton, M. et al. (2002). Clinical Radiology (2002)

[Gender dysphoria in children and adolescents - treatment guidelines and follow-up study].

Science.gov (United States)

Meyenburg, Bernd; Kröger, Anne; Neugebauer, Rebecca

2015-01-01

Treatment guidelines for transidentity in children and adolescents are presently under discussion. We present an overview of the various treatment modalities. Further, follow-up data on children and adolescents referred for gender-identity problems are presented. Of the 84 patients seen for the first time more than 3 years before follow-up, 37 mailed in the completed questionnaires. In addition, 33 patients agreed to answer some short follow-up questions. We assessed steps of treatment, gender role, psychopathology, and psychotherapy. We compared differences in psychopathology in patients with vs. without gender role change and in patients with intense vs. less intense psychotherapy. A total of 22 patients had completely changed gender role, and some had started hormonal treatment und sex reassignment surgery. Most patients were satisfied with the treatment results. All patients showed less psychopathology on follow-up, independent of role change or intensity of psychotherapy. In general, the patients reported little psychopathology. Our follow-up results support the present treatment approach. In patients with little psychopathology, low-frequency supportive treatment appears sufficient to obtain safe judgement on hormonal of surgical treatment.

National planning guidelines for environment ally sustainable development in Scotland and lessons learnt for Pakistan

International Nuclear Information System (INIS)

Qamar-ul-Islam; Anjum, G.A.; Shahzad, M.

2005-01-01

This piece of research work reflects the researcher's academic as well as the practical experiences of Scottish planning about the concept, issues and policy formulations. It is in the context of National Planning Policy Guidelines, originated in Scotland with particular reference to it's Fife Region. The first part reflects the general overview of Scotland followed by brief description of the region. Another part deals with the existing strategic issues in the region which are related to land and the environment notably rural planning priorities, agricultural scarce land, conservation of recreational and tourist areas, forest land potentials, landscape resources, national scenic areas, petro-chemical, industrial zones, river pollution and future land use for housing. This study has suggested National Planning Policy Guidelines to these issues. Last section deals with the lessons learnt from Scotland and appropriate application of these guidelines in case of Pakistan. The establishment of the relevant National Planning Guidelines according to our local environmental and socio-economic conditions can also play a significant role to safe guard our rural and urban landscapes and their respective environments. These broad guidelines must therefore be recommended in the broader spectrum in spatial linkage. Moreover these guidelines must therefore synthesize and articulated specifically at structure plans, master plans at district, sub district or local plans and planning processes which can lead Pakistan towards environmentally sustainable development. (author)

Efficient clinical evaluation of guideline quality: development and testing of a new tool

Science.gov (United States)

2014-01-01

Background Evaluating the methodological quality of clinical practice guidelines is essential before deciding which ones which could best inform policy or practice. One current method of evaluating clinical guideline quality is the research-focused AGREE II instrument. This uses 23 questions scored 1–7, arranged in six domains, which requires at least two independent testers, and uses a formulaic weighted domain scoring system. Following feedback from time-poor clinicians, policy-makers and managers that this instrument did not suit clinical need, we developed and tested a simpler, shorter, binary scored instrument (the iCAHE Guideline Quality Checklist) designed for single users. Methods Content and construct validity, inter-tester reliability and clinical utility were tested by comparing the new iCAHE Guideline Quality Checklist with the AGREE II instrument. Firstly the questions and domains in both instruments were compared. Six randomly-selected guidelines on a similar theme were then assessed by three independent testers with different experience in guideline quality assessment, using both instruments. Per guideline, weighted domain and total AGREE II scores were calculated, using the scoring rubric for three testers. Total iCAHE scores were calculated per guideline, per tester. The linear relationship between iCAHE and AGREE II scores was assessed using Pearson r correlation coefficients. Score differences between testers were assessed for the iCAHE Guideline Quality Checklist. Results There were congruent questions in each instrument in four domains (Scope & Purpose, Stakeholder involvement, Underlying evidence/Rigour, Clarity). The iCAHE and AGREE II scores were moderate to strongly correlated for the six guidelines. There was generally good agreement between testers for iCAHE scores, irrespective of their experience. The iCAHE instrument was preferred by all testers, and took significantly less time to administer than the AGREE II instrument. However

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

Science.gov (United States)

Arias-Palencia, Natalia María; Solera-Martínez, Monserrat; Gracia-Marco, Luis; Silva, Pedro; Martínez-Vizcaíno, Vicente; Cañete-García-Prieto, Jorge; Sánchez-López, Mairena

2015-01-01

Background 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. Methods 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. Results No sex differences in total PA were found. University students were more sedentary during weekend days than weekdays (pstudents 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. Conclusions 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. PMID:26536605

Reporting of financial conflicts of interest in clinical practice guidelines: a case study analysis of guidelines from the Canadian Medical Association Infobase.

Science.gov (United States)

Shnier, Adrienne; Lexchin, Joel; Romero, Mirna; Brown, Kevin

2016-08-15

Clinical practice guidelines are widely distributed by medical associations and relied upon by physicians for the best available clinical evidence. International findings report that financial conflicts of interest (FCOI) with drug companies may influence drug recommendations and are common among guideline authors. There is no comparable study on exclusively Canadian guidelines; therefore, we provide a case study of authors' FCOI declarations in guidelines from the Canadian Medical Association (CMA) Infobase. We also assess the financial relationships between guideline-affiliated organizations and drug companies. Using a population approach, we extracted first-line drug recommendations and authors' FCOI disclosures in guidelines from the CMA Infobase. We contacted the corresponding authors on guidelines when FCOI disclosures were missing for some or all authors. We also extracted guideline-affiliated organizations and searched each of their websites to determine if they had financial relationships with drug companies. We analyzed 350 authors from 28 guidelines. Authors were named on one, two, or three guidelines, yielding 400 FCOI statements. In 75.0 % of guidelines at least one author, and in 21.4 % of guidelines all authors, disclosed FCOI with drug companies. In 54.0 % of guidelines at least one author, and in 28.6 % of guidelines over half of the authors, disclosed FCOI with manufacturers of drugs that they recommended. Twenty of 48 authors on multiple guidelines reported different FCOI in their disclosures. Eight guidelines identified affiliated organizations with financial relationships with manufacturers of drugs recommended in those guidelines. This is the first study to systematically describe FCOI disclosures by authors of Canadian guidelines and financial relationships between guideline-affiliated organizations and pharmaceutical companies. These financial relationships are common. Because authoritative value is assigned to guidelines distributed by

Use of Standard Guidelines for Department of Medicine Summary Letters.

Science.gov (United States)

Fitz, Matthew; La Rochelle, Jeffrey; Lang, Valerie; DeWaay, Deborah; Adams, William; Nasraty, Farah

2018-04-12

Phenomenon: Fourth-year medical students obtain Department of Medicine (DOM) letters ("Chair" letters) to support their residency applications. Writing and interpreting DOM letters are challenging. There is heterogeneity in the letters that makes it difficult to both write and read these letters. The purpose of this study is to determine the value of new guidelines developed by a task force of clerkship directors and program directors in internal medicine and assess the implementation of these guidelines. The Clerkship Directors in Internal Medicine performed a cross-sectional survey of internal medicine clerkship directors at U.S. and Canadian medical schools in 2014. In addition, the primary author's institution reviewed 1,347 DOM letters between 2012 and 2014 to assess the implementation of these guidelines. The survey response rate was 78%. DOM letter writers reported the guidelines were better, easier to implement, and more compatible with the purpose of DOM letters than previously. Most letter readers reported that letters using the guidelines were more credible. Writers of DOM letters in lower academic ranks rated the letters with guidelines higher in several domains than those in higher academic ranks. Readers of DOM letters in higher academic ranks rated the letters with guidelines higher in several domains than those in lower academic ranks. In the DOM letters examined, the odds of meeting each guideline increased with each additional year. However, for 3 guidelines there was an initial decline in adherence from 2012 to 2013 before increasing again in 2014-the recommended length, clerkship description, and detailed narrative guidelines. Letters solely written by a chair were less likely to incorporate the guidelines. Insights: Clerkship directors often write the DOM letters and identify with the purpose of the guidelines. As writers, lower ranking academic faculty value the guidelines more than higher ranking academic faculty. As readers of DOM letters

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.

European Guidelines for Quality Assurance in Cervical Cancer Screening. Second edition--summary document.

Science.gov (United States)

Arbyn, M; Anttila, A; Jordan, J; Ronco, G; Schenck, U; Segnan, N; Wiener, H; Herbert, A; von Karsa, L

2010-03-01

European Guidelines for Quality Assurance in Cervical Cancer Screening have been initiated in the Europe Against Cancer Programme. The first edition established the principles of organised population-based screening and stimulated numerous pilot projects. The second multidisciplinary edition was published in 2008 and comprises approximately 250 pages divided into seven chapters prepared by 48 authors and contributors. Considerable attention has been devoted to organised, population-based programme policies which minimise adverse effects and maximise benefits of screening. It is hoped that this expanded guidelines edition will have a greater impact on countries in which screening programmes are still lacking and in which opportunistic screening has been preferred in the past. Other methodological aspects such as future prospects of human papillomavirus testing and vaccination in cervical cancer control have also been examined in the second edition; recommendations for integration of the latter technologies into European guidelines are currently under development in a related project supported by the European Union Health Programme. An overview of the fundamental points and principles that should support any quality-assured screening programme and key performance indicators are presented here in a summary document of the second guidelines edition in order to make these principles and standards known to a wider scientific community.

Strength of recommendations in WHO guidelines using GRADE was associated with uptake in national policy.

Science.gov (United States)

Nasser, Syed Muhammad Umar; Cooke, Graham; Kranzer, Katharina; Norris, Susan L; Olliaro, Piero; Ford, Nathan

2015-06-01

This study assesses the extent to which the strength of a recommendation in a World Health Organization (WHO) guideline affects uptake of the recommendation in national guidelines. The uptake of recommendations included in HIV and TB guidelines issued by WHO from 2009 to 2013 was assessed across guidelines from 20 low- and middle-income countries in Africa and Southeast Asia. Associations between characteristics of recommendations (strength, quality of the evidence, type) and uptake were assessed using logistic regression. Eight WHO guidelines consisting of 109 strong recommendations and 49 conditional recommendations were included, and uptake assessed across 44 national guidelines (1,255 recommendations) from 20 countries. Uptake of WHO recommendations in national guidelines was 82% for strong recommendations and 61% for conditional recommendations. The odds of uptake comparing strong recommendations and conditional recommendations was 1.9 (95% confidence interval: 1.4, 2.7), after adjustment for quality of evidence. Higher levels of evidence quality were associated with greater uptake, independent of recommendation strength. Guideline developers should be confident that conditional recommendations are frequently adopted. The fact that strong recommendations are more frequently adopted than conditional recommendations underscores the importance of ensuring that such recommendations are justified. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical algorithms to aid osteoarthritis guideline dissemination.

Science.gov (United States)

Meneses, S R F; Goode, A P; Nelson, A E; Lin, J; Jordan, J M; Allen, K D; Bennell, K L; Lohmander, L S; Fernandes, L; Hochberg, M C; Underwood, M; Conaghan, P G; Liu, S; McAlindon, T E; Golightly, Y M; Hunter, D J

2016-09-01

Numerous scientific organisations have developed evidence-based recommendations aiming to optimise the management of osteoarthritis (OA). Uptake, however, has been suboptimal. The purpose of this exercise was to harmonize the recent recommendations and develop a user-friendly treatment algorithm to facilitate translation of evidence into practice. We updated a previous systematic review on clinical practice guidelines (CPGs) for OA management. The guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation for quality and the standards for developing trustworthy CPGs as established by the National Academy of Medicine (NAM). Four case scenarios and algorithms were developed by consensus of a multidisciplinary panel. Sixteen guidelines were included in the systematic review. Most recommendations were directed toward physicians and allied health professionals, and most had multi-disciplinary input. Analysis for trustworthiness suggests that many guidelines still present a lack of transparency. A treatment algorithm was developed for each case scenario advised by recommendations from guidelines and based on panel consensus. Strategies to facilitate the implementation of guidelines in clinical practice are necessary. The algorithms proposed are examples of how to apply recommendations in the clinical context, helping the clinician to visualise the patient flow and timing of different treatment modalities. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

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

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.

Overview of risk assessment

International Nuclear Information System (INIS)

Rimington, J.D.

1992-01-01

The paper begins by defining some terms, and then refer to a number of technical and other difficulties. Finally it attempts to set out why risk assessment is important and what its purposes are. 2) First, risk and risk assessment - what are they?. 3) Risk is a subject of universal significance. Life is very uncertain, and we can achieve no object or benefit in it except by approaching nearer to particular hazards which lie between us and our objects. That approach represents acceptance of risk. 4) Risk assessment is a way of systematising our approach to hazard with a view to determining what is more and what is less risky. It helps us in the end to diminish our exposure while obtaining whatever benefits we have in mind, or to optimise the risks and the benefits

Overview of risk assessment

Energy Technology Data Exchange (ETDEWEB)

Rimington, J D [Health and Safety Executive (United Kingdom)

1992-07-01

The paper begins by defining some terms, and then refer to a number of technical and other difficulties. Finally it attempts to set out why risk assessment is important and what its purposes are. 2) First, risk and risk assessment - what are they?. 3) Risk is a subject of universal significance. Life is very uncertain, and we can achieve no object or benefit in it except by approaching nearer to particular hazards which lie between us and our objects. That approach represents acceptance of risk. 4) Risk assessment is a way of systematising our approach to hazard with a view to determining what is more and what is less risky. It helps us in the end to diminish our exposure while obtaining whatever benefits we have in mind, or to optimise the risks and the benefits.

An International Approach to Enhancing a National Guideline on Driving and Dementia.

Science.gov (United States)

Rapoport, Mark J; Chee, Justin N; Carr, David B; Molnar, Frank; Naglie, Gary; Dow, Jamie; Marottoli, Richard; Mitchell, Sara; Tant, Mark; Herrmann, Nathan; Lanctôt, Krista L; Taylor, John-Paul; Donaghy, Paul C; Classen, Sherrilene; O'Neill, Desmond

2018-03-12

The purpose of this study was to update a national guideline on assessing drivers with dementia, addressing limitations of previous versions which included a lack of developmental rigor and stakeholder involvement. An international multidisciplinary team reviewed 104 different recommendations from 12 previous guidelines on assessing drivers with dementia in light of a recent review of the literature. Revised guideline recommendations were drafted by consensus. A preliminary draft was sent to specialist physician and occupational therapy groups for feedback, using an a priori definition of 90% agreement as consensus. The research team drafted 23 guideline recommendations, and responses were received from 145 stakeholders. No recommendation was endorsed by less than 80% of respondents, and 14 (61%) of the recommendations were endorsed by more than 90%.The recommendations are presented in the manuscript. The revised guideline incorporates the perspectives of consensus of an expert group as well as front-line clinicians who regularly assess drivers with dementia. The majority of the recommendations were based on evidence at the level of expert opinion, revealing gaps in the evidence and future directions for research.

Using mixed methods research in medical education: basic guidelines for researchers.

Science.gov (United States)

Schifferdecker, Karen E; Reed, Virginia A

2009-07-01

Mixed methods research involves the collection, analysis and integration of both qualitative and quantitative data in a single study. The benefits of a mixed methods approach are particularly evident when studying new questions or complex initiatives and interactions, which is often the case in medical education research. Basic guidelines for when to use mixed methods research and how to design a mixed methods study in medical education research are not readily available. The purpose of this paper is to remedy that situation by providing an overview of mixed methods research, research design models relevant for medical education research, examples of each research design model in medical education research, and basic guidelines for medical education researchers interested in mixed methods research. Mixed methods may prove superior in increasing the integrity and applicability of findings when studying new or complex initiatives and interactions in medical education research. They deserve an increased presence and recognition in medical education research.

[Guidelines for diagnosis, treatment and prevention of infections in cancer patients 2013].

Science.gov (United States)

2014-01-01

Cancer patients pose an increased risk of infectious complications due to their underlying disease and its treatment. The present guidelines, developed by the Commission of Infections in the Immunocompromised Host of the Argentine Society of Infectious Diseases are an updated version of those published in 2008. For the elaboration of these guidelines, both the scientific evidence and the local experience were thoroughly evaluated. This Consensus includes an overview of the risk factors and the epidemiology of infections in both adult and pediatric cancer patients. It deals with the management of the febrile neutropenic patient, the risk categorization, the initial empirical therapy in the multiresistant era and its subsequent management. It includes a section dedicated to the antifungal empirical and directed therapy as well as the diagnosis and treatment of the most frequent fungal infections. Prevention strategies, both general and for high-risk patients, including those receiving biologic response modifiers, are herein shown. These guidelines should be applied in conjunction with a careful clinical evaluation and taking into account local epidemiological factors. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Guidelines for the Gamification of Self-Management of Chronic Illnesses: Multimethod Study.

Science.gov (United States)

AlMarshedi, Alaa; Wills, Gary; Ranchhod, Ashok

2017-05-12

Gamification is the use of game elements and techniques in nongaming contexts. The use of gamification in health care is receiving a great deal of attention in both academic research and the industry. However, it can be noticed that many gamification apps in health care do not follow any standardized guidelines. This research aims to (1) present a set of guidelines based on the validated framework the Wheel of Sukr and (2) assess the guidelines through expert interviews and focus group sessions with developers. Expert interviews (N=6) were conducted to assess the content of the guidelines and that they reflect the Wheel of Sukr. In addition, the guidelines were assessed by developers (N=15) in 5 focus group sessions, where each group had an average of 3 developers. The guidelines received support from the experts. By the end of the sixth interview, it was determined that a saturation point was reached. Experts agreed that the guidelines accurately reflect the framework the Wheel of Sukr and that developers can potentially use them to create gamified self-management apps for chronic illnesses. Moreover, the guidelines were welcomed by developers who participated in the focus group sessions. They found the guidelines to be clear, useful, and implementable. Also, they were able to suggest many ways of gamifying a nongamified self-management app when they were presented with one. The findings suggest that the guidelines introduced in this research are clear, useful, and ready to be implemented for the creation of self-management apps that use the notion of gamification as described in the Wheel of Sukr framework. The guidelines are now ready to be practically tested. Further practical studies of the effectiveness of each element in the guidelines are to be carried out. ©Alaa AlMarshedi, Gary Wills, Ashok Ranchhod. Originally published in JMIR Serious Games (http://games.jmir.org), 12.05.2017.

Opioid Therapy for Chronic Pain: Overview of the 2017 US Department of Veterans Affairs and US Department of Defense Clinical Practice Guideline.

Science.gov (United States)

Rosenberg, Jack M; Bilka, Brandon M; Wilson, Sara M; Spevak, Christopher

2018-05-01

The US Department of Veterans Affairs (VA) and US Department of Defense (DoD) revised the 2010 clinical practice guideline (CPG) for the management of opioid therapy for chronic pain, considering the specific needs of the VA and DoD and new evidence regarding prescribing opioid medication for non-end-of-life-related chronic pain. This paper summarizes the major recommendations and compares them with the US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids. This Opioid Therapy CPG was developed for VA-DoD service members, veterans, and their families. The VA/DoD Evidence-Based Practice Work Group convened a VA/DoD guideline renewal development effort and conformed to the guidelines established by the VA/DoD Joint Executive Council (JEC) and VA/DoD Health Executive Council (HEC). The panel developed questions, searched and evaluated the literature, developed recommendations using GRADE methodology, and developed algorithms. Passage of the CARA Act by Congress compelled consideration and comparison with the CDC opioid therapy guideline mid-development. There were 18 recommendations made. This article focuses on guideline development and key recommendations with CDC comparisons taken from four major areas, including: initiation and continuation of opioids;type, dose, follow-up, and taper of opioids;risk mitigation;acute pain. Guideline development and recommendations are presented. There was substantial overlap with the CDC opioid guideline. Additionally, there were items particularly relevant to the VA-DoD, including risk mitigation, suicide prevention, and preventing opioid use disorder in young patients. Our guideline highlights avoiding opioid therapy longer than 90 days as a critical juncture.

The Use of SNOMED CT for Representing Concepts Used in Preoperative Guidelines

NARCIS (Netherlands)

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

2009-01-01

The use of guidelines to improve quality of care depends on presenting them in a standard machine-interpretable form and using common terms in guidelines as well as in patient records. In this study, the use of SNOMED CT for representing concepts used in preoperative assessment guidelines was

Overview of the NASA Environmentally Responsible Aviation Project's Propulsion Technology Portfolio

Science.gov (United States)

Suder, Kenneth L.

2012-01-01

The NASA Environmentally Responsible Aviation (ERA) Project is focused on developing and demonstrating integrated systems technologies to TRL 4-6 by 2020 that enable reduced fuel burn, emissions, and noise for futuristic air vehicles. The specific goals aim to simultaneously reduce fuel burn by 50%, reduce Landing and Take-off Nitrous Oxides emissions by 75% relative to the CAEP 6 guidelines, and reduce cumulative noise by 42 Decibels relative to the Stage 4 guidelines. These goals apply to the integrated vehicle and propulsion system and are based on a reference mission of 3000nm flight of a Boeing 777-200 with GE90 engines. This paper will focus primarily on the ERA propulsion technology portfolio, which consists of advanced combustion, propulsor, and core technologies to enable these integrated air vehicle systems goals. An overview of the ERA propulsion technologies will be described and the status and results to date will be presented.

Improved guidelines for RELAP4/MOD6 reflood calculations

International Nuclear Information System (INIS)

Chen, T.H.; Fletcher, C.D.

1980-01-01

Computer simulations were performed for an extensive selection of forced- and gravity-feed reflood experiments. This effort was a portion of the assessment procedure for the RELAP4/MOD6 thermal hydraulic computer code. A common set of guidelines, based on recommendations from the code developers, was used in determining the model and user-selected input options for each calculation. The comparison of code-calculated and experimental data was then used to assess the capability of the RELAP4/MOD6 code to model the reflood phenomena. As a result of the assessment, the guidelines for determining the user-selected input options were improved

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…

Comparison of Quality And Content of Violence Guidelines For The Health Care Sector

Directory of Open Access Journals (Sweden)

Rabia Kahveci

2018-03-01

Full Text Available More than 50% of the employees in health sector are exposed to violence at any time. This study investigated international workplace violence guidelines for the health care sector to compare their quality and content and explore whether these guidelines could be used in different settings. We ran a broad review to identify international guidelines for violence in health care. After identification of the guidelines, the quality of the guidelines was assessed by personal experience and views of the authors, also taking AGREE domains into consideration as a guidance. The identified guidelines were later qualitatively analyzed for the content by two researchers and compared to each other. Canada, New Zealand, USA, UK and Turkey’s guidelines were involved in the study. Definitions of workplace violence, risk factors, objectives of the guideline, legal requirements, responsible stakeholders, target population, strategies recommended, physical environment, training and staffing were assessed in the content of the violence guidelines. It was found that current guidelines need improvement in both quality and content, but it is possible to have an international guidance that could be applicable in different settings. The development of violence guidelines should be the first and most strategic step for better protection of the health care workers. We expect our results to be useful in preparation of new guidelines for different settings.

Poland - Electricity and gas marked development study and practical guidelines for using EU funds. Practical guidelines for using EU funds for energy projects

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-12-01

The present report is prepared as part of the project 'Poland - Electricity and gas market development study and practical guidelines for using EU - funds'. The EU structural and cohesion funds are presently considered the most relevant funds concerning support to energy projects. In general, the Polish administration of the EU structural funds is strongly decentralized. The eligible project types to be supported from the various structural funds are described in a number of sector programmes. The sector programmes are described in vertical view, meaning that it is difficult to assess what kind of energy projects are eligible for support and, if eligible, then under which programme. This report presents a horizontal view of the various programmes in order to give an overview of the possibilities of support to energy related projects. The background for this report is a study of the following sector programmes: 1. Improvement of the competitiveness of enterprises. 2. Human resources development. 3. Restructuring and modernization of food sector and rural development. 4. Fisheries and fish processing. 5. Transport - maritime economy. 6. Integrated regional operational programme. 7. Technical assistance. Based on this review, it can be stated that energy projects in general have a low priority but can be supported under various measures within the programmes. (BA)

Developing clinical practice guidelines: target audiences, identifying topics for guidelines, guideline group composition and functioning and conflicts of interest.

Science.gov (United States)

Eccles, Martin P; Grimshaw, Jeremy M; Shekelle, Paul; Schünemann, Holger J; Woolf, Steven

2012-07-04

Clinical practice guidelines are one of the foundations of efforts to improve health care. In 1999, we authored a paper about methods to develop guidelines. Since it was published, the methods of guideline development have progressed both in terms of methods and necessary procedures and the context for guideline development has changed with the emergence of guideline clearing houses and large scale guideline production organisations (such as the UK National Institute for Health and Clinical Excellence). It therefore seems timely to, in a series of three articles, update and extend our earlier paper. In this first paper we discuss: the target audience(s) for guidelines and their use of guidelines; identifying topics for guidelines; guideline group composition (including consumer involvement) and the processes by which guideline groups function and the important procedural issue of managing conflicts of interest in guideline development.

Guideline of guidelines: asymptomatic microscopic haematuria.

Science.gov (United States)

Linder, Brian J; Bass, Edward J; Mostafid, Hugh; Boorjian, Stephen A

2018-02-01

The aim of the present study was to review major organizational guidelines on the evaluation and management of asymptomatic microscopic haematuria (AMH). We reviewed the haematuria guidelines from: the American Urological Association; the consensus statement by the Canadian Urological Association, Canadian Urologic Oncology Group and Bladder Cancer Canada; the American College of Physicians; the Joint Consensus Statement of the Renal Association and British Association of Urological Surgeons; and the National Institute for Health and Care Excellence. All guidelines reviewed recommend evaluation for AMH in the absence of potential benign aetiologies, with the evaluation including cystoscopy and upper urinary tract imaging. Existing guidelines vary in their definition of AMH (role of urine dipstick vs urine microscopy), the age threshold for recommending evaluation, and the optimal imaging method (computed tomography vs ultrasonography). Of the reviewed guidelines, none recommended the use of urine cytology or urine markers during the initial AMH evaluation. Patients should have ongoing follow-up after a negative initial AMH evaluation. Significant variation exists among current guidelines for AMH with respect to who should be evaluated and in what manner. Given the patient and health system implications of balancing appropriately focused and effective diagnostic evaluation, AMH represents a valuable future research opportunity. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Impact of a clinical guideline for prescribing antibiotics to inpatients reporting penicillin or cephalosporin allergy.

Science.gov (United States)

Blumenthal, Kimberly G; Shenoy, Erica S; Varughese, Christy A; Hurwitz, Shelley; Hooper, David C; Banerji, Aleena

2015-10-01

Self-reported penicillin allergy infrequently reflects an inability to tolerate penicillins. Inpatients reporting penicillin allergy receive alternative antibiotics that might be broader spectrum, more toxic, or less effective. To develop and assess a clinical guideline for the general inpatient provider that directs taking a history and prescribing antibiotics for patients with penicillin or cephalosporin allergy. A guideline was implemented to assist providers with assessing allergy history and prescribing antibiotics for patients with reported penicillin or cephalosporin allergy. The guideline used a standard 2-step graded challenge or test dose. A quasi-experimental study was performed to assess safety, feasibility, and impact on antibiotic use by comparing treatment 21 months before guideline implementation with 12 months after guideline implementation. Significantly more test doses to β-lactam antibiotics were performed monthly after vs before guideline implementation (median 14.5, interquartile range 13-16.25, vs 2, interquartile range 1-3.25, P  .5) between periods. Guideline-driven test doses decreased alternative antimicrobial therapy after the test dose, including vancomycin (68.3% vs 37.2%, P penicillin or cephalosporin allergy was associated with an almost 7-fold increase in the number of test doses to β-lactams without increased adverse drug reactions. Patients assessed with guideline-driven test doses were observed to have significantly decreased alternative antibiotic exposure. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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.

Actinic Keratosis Clinical Practice Guidelines: An Appraisal of Quality

Directory of Open Access Journals (Sweden)

Joslyn S. Kirby

2015-01-01

Full Text Available Actinic keratosis (AK is a common precancerous skin lesion and many AK management guidelines exist, but there has been limited investigation into the quality of these documents. The objective of this study was to assess the strengths and weaknesses of guidelines that address AK management. A systematic search for guidelines with recommendations for AK was performed. The Appraisal of Guidelines for Research and Evaluation (AGREE II was used to appraise the quality of guidelines. Multiple raters independently reviewed each of the guidelines and applied the AGREE II tool and scores were calculated. Overall, 2,307 citations were identified and 7 fulfilled the study criteria. The Cancer Council of Australia/Australian Cancer Network guideline had the highest mean scores and was the only guideline to include a systematic review, include an evidence rating for recommendations, and report conflicts of interest and funding sources. High-quality, effective guidelines are evidence-based with recommendations that are concise and organized, so practical application is facilitated. Features such as concise tables, pictorial diagrams, and explicit links to evidence are helpful. However, the rigor and validity of some guidelines were weak. So, it is important for providers to be aware of the features that contribute to a high-quality, practical document.

Poly Cystic Ovarian Syndrome: An Updated Overview

Science.gov (United States)

El Hayek, Samer; Bitar, Lynn; Hamdar, Layal H.; Mirza, Fadi G.; Daoud, Georges

2016-01-01

Poly Cystic Ovarian Syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. Women suffering from PCOS present with a constellation of symptoms associated with menstrual dysfunction and androgen excess, which significantly impacts their quality of life. They may be at increased risk of multiple morbidities, including obesity, insulin resistance, type II diabetes mellitus, cardiovascular disease (CVD), infertility, cancer, and psychological disorders. This review summarizes what the literature has so far provided from guidelines to diagnosis of PCOS. It will also present a general overview about the morbidities associated with this disease, specifically with its more severe classic form. Finally, the review will stress on the various aspects of treatment and screening recommendations currently used in the management of this condition. PMID:27092084

Poly Cystic Ovarian Syndrome: an updated overview

Directory of Open Access Journals (Sweden)

Samer eEl Hayek

2016-04-01

Full Text Available 1.AbstractPoly Cystic Ovarian Syndrome (PCOS is one of the most common metabolic and reproductive disorders among women of reproductive age. Women suffering from PCOS present with a constellation of symptoms associated with menstrual dysfunction and androgen excess, which significantly impacts their quality of life. They may be at increased risk of multiple morbidities, including obesity, insulin resistance, type II diabetes mellitus, cardiovascular disease, infertility, cancer, and psychological disorders. This review summarizes what the literature has so far provided from guidelines to diagnosis of PCOS. It will also present a general overview about the morbidities associated with this disease, specifically with its more severe classic form. Finally, the review will stress on the various aspects of treatment and screening recommendations currently used in the management of this condition.

Reliability Based Calibration of Fatigue Design Guidelines for Ship Structures

DEFF Research Database (Denmark)

Folsø, Rasmus; Otto, S.; Parmentier, G.

2002-01-01

A simple reliability based framework is applied to calibrate a new set of fatigue design guidelines. This new guideline considers two different approaches for the assessment of both loads, stresses and local stress raising effects, and partial safety factors must be given for any combination...

The Relationship between Waiting Times and "Adherence" to the Scottish Intercollegiate Guidelines Network 98 Guideline in Autism Spectrum Disorder Diagnostic Services in Scotland

Science.gov (United States)

McKenzie, Karen; Forsyth, Kirsty; O'Hare, Anne; McClure, Iain; Rutherford, Marion; Murray, Aja; Irvine, Linda

2016-01-01

The aim of this study was to explore the extent to which the Scottish Intercollegiate Guidelines Network 98 guidelines on the assessment and diagnosis of autism spectrum disorder were adhered to in child autism spectrum disorder diagnostic services in Scotland and whether there was a significant relationship between routine practice which more…

Aligning guidelines and medical practice: Literature review on pediatric palliative care guidelines.

Science.gov (United States)

De Clercq, Eva; Rost, Michael; Pacurari, Nadia; Elger, Bernice S; Wangmo, Tenzin

2017-08-01

Palliative care for children is becoming an important subspecialty of healthcare. Although concurrent administration of curative and palliative care is recommended, timely referral to pediatric palliative care (PPC) services remains problematic. This literature review aims to identify barriers and recommendations for proper implementation of palliative care for children through the looking glass of PPC guidelines. To identify studies on PPC guidelines, five databases were searched systematically between 1960 and 2015: Scopus, PubMed, PsycINFO, the Web of Science, and CINAHL. No restrictions were placed on the type of methodology employed in the studies. Concerning barriers, most of the papers focused on gaps within medical practice and the lack of evidence-based research. Common recommendations therefore included: training and education of healthcare staff, formation of a multidisciplinary PPC team, research on the benefits of PPC, and raising awareness about PPC. A small number of publications reported on the absence of clear guidance in PPC documents regarding bereavement care, as well as on the difficulties and challenges involved in multidisciplinary care teams. Our results indicate that a critical assessment of both the research guidelines and medical practice is required in order to promote timely implementation of PPC for pediatric patients.

Record High US Measles Cases: Patient Vaccination, Clinical Assessment and Management

Centers for Disease Control (CDC) Podcasts

This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Record High US Measles Cases: Patient Vaccination, Clinical Assessment and Management. In May 2014, the United States recorded the largest number of reported measles cases since 1994 and the number continues to rise. Most cases reported have been acquired in the U.S. and are associated with importations from countries where measles is still common. This highly contagious, acute viral illness spreads quickly in unvaccinated populations once reaching the U.S. The recent measles outbreaks highlight the importance of maintaining high vaccination coverage in the U.S. and ensuring age-appropriate vaccination for international travelers. During this COCA call, clinicians will learn the status of measles in the U.S. and CDC vaccination recommendations and guidelines for patient assessment and management.

Guidelines for the undergraduate psychology major: Version 2.0.

Science.gov (United States)

2016-01-01

The APA Guidelines for the Undergraduate Psychology Major: Version 2.0 (henceforth Guidelines 2.0; APA, 2013) represents a national effort to describe and develop high-quality undergraduate programs in psychology. The task force charged with the revision of the original guidelines for the undergraduate major examined the success of the document's implementation and made changes to reflect emerging best practices and to integrate psychology's work with benchmarking scholarship in higher education. Guidelines 2.0 abandoned the original distinction drawn between psychology-focused skills and psychology skills that enhance liberal arts development. Instead, Guidelines 2.0 describes five inclusive goals for the undergraduate psychology major and two developmental levels of student learning outcomes. Suggestions for assessment planning are provided for each of the five learning goals. (c) 2016 APA, all rights reserved).

Adapting a Natura 2000 field guideline for a remote sensing-based assessment of heathland conservation status

Science.gov (United States)

Schmidt, Johannes; Fassnacht, Fabian Ewald; Neff, Christophe; Lausch, Angela; Kleinschmit, Birgit; Förster, Michael; Schmidtlein, Sebastian

2017-08-01

Remote sensing can be a valuable tool for supporting nature conservation monitoring systems. However, for many areas of conservation interest, there is still a considerable gap between field-based operational monitoring guidelines and the current remote sensing-based approaches. This hampers application in practice of the latter. Here, we propose a remote sensing approach for mapping the conservation status of Calluna-dominated Natura 2000 dwarf shrub habitats that is closely related to field mapping schemes. We transferred the evaluation criteria of the field guidelines to three related variables that can be captured by remote sensing: (1) coverage of the key species, (2) stand structural diversity, and (3) co-occurring species. Continuous information on these variables was obtained by regressing ground reference data from field surveys and UAV flights against airborne hyperspectral imagery. Merging the three resulting quality layers in an RGB representation allowed for illustrating the habitat quality in a continuous way. User-defined thresholds can be applied to this stack of quality layers to derive an overall assessment of habitat quality in terms of nature conservation, i.e. the conservation status. In our study, we found good accordance of the remotely sensed data with field-based information for the three variables key species, stand structural diversity and co-occurring vegetation (R2 of 0.79, 0.69, and 0.71, respectively) and it was possible to derive meaningful habitat quality maps. The conservation status could be derived with an accuracy of 65%. In interpreting these results it should be considered that the remote sensing based layers are independent estimates of habitat quality in their own right and not a mere replacement of the criteria used in the field guidelines. The approach is thought to be transferable to similar regions with minor adaptions. Our results refer to Calluna heathland which we consider a comparably easy target for remote sensing

Best practice in forensic entomology--standards and guidelines.

Science.gov (United States)

Amendt, Jens; Campobasso, Carlo P; Gaudry, Emmanuel; Reiter, Christian; LeBlanc, Hélène N; Hall, Martin J R

2007-03-01

Forensic entomology, the use of insects and other arthropods in forensic investigations, is becoming increasingly more important in such investigations. To ensure its optimal use by a diverse group of professionals including pathologists, entomologists and police officers, a common frame of guidelines and standards is essential. Therefore, the European Association for Forensic Entomology has developed a protocol document for best practice in forensic entomology, which includes an overview of equipment used for collection of entomological evidence and a detailed description of the methods applied. Together with the definitions of key terms and a short introduction to the most important methods for the estimation of the minimum postmortem interval, the present paper aims to encourage a high level of competency in the field of forensic entomology.

Guidance for the application of an assessment methodology for innovative nuclear energy systems. INPRO manual - Overview of the methodology. Vol. 1 of 9 of the final report of phase 1 of the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO) including a CD-ROM comprising all volumes

International Nuclear Information System (INIS)

2008-11-01

The International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO) was initiated in the year 2000, based on a resolution of the IAEA General Conference (GC(44)/RES/21). The main objectives of INPRO are (1) to help to ensure that nuclear energy is available to contribute in fulfilling energy needs in the 21st century in a sustainable manner, (2) to bring together both technology holders and technology users to consider jointly the international and national actions required to achieve desired innovations in nuclear reactors and fuel cycles; and (3) to create a forum to involve all relevant stakeholders that will have an impact on, draw from, and complement the activities of existing institutions, as well as ongoing initiatives at the national and international level. This document follows the guidelines of the INPRO report 'Methodology for the assessment of innovative nuclear reactors and fuel cycles, Report of Phase 1B (first part) of the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO)', IAEA-TECDOC-1434 (2004), together with its previous report Guidance for the evaluation for innovative nuclear reactors and fuel cycles, Report of Phase 1A of the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO), IAEA-TECDOC-1362 (2003). This INPRO manual is comprised of an overview volume (laid out in this report), and eight additional volumes (available on a CD-ROM attached to the inside back cover of this report) covering the areas of economics (Volume 2), infrastructure (Volume 3), waste management (Volume 4), proliferation resistance (Volume 5), physical protection (Volume 6), environment (Volume 7), safety of reactors (Volume 8), and safety of nuclear fuel cycle facilities (Volume 9). The overview volume sets out the philosophy of INPRO and a general discussion of the INPRO methodology. This overview volume discusses the relationship of INPRO with the UN concept of sustainability to demonstrate how the

Inclusion of ethical issues in dementia guidelines: a thematic text analysis.

Science.gov (United States)

Knüppel, Hannes; Mertz, Marcel; Schmidhuber, Martina; Neitzke, Gerald; Strech, Daniel

2013-08-01

Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care. To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained. Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors

Australian Football League concussion guidelines: what do community players think?

Science.gov (United States)

White, Peta E; Donaldson, Alex; Sullivan, S John; Newton, Joshua

2016-01-01

Background Preventing concussion in sport is a global challenge. To assess community-level adult male Australian Football players’ views on following the Australian Football League's (AFL) concussion guidelines. Methods 3 focus groups, each comprising 6 players from 1 regional league, were conducted until saturation of issues raised. Discussions followed a semistructured script and were audio-recorded and transcribed verbatim. Thematic analysis was conducted by 2 coders independently. Results Identified advantages of the guidelines included highlighting the seriousness of concussion; changing the culture around playing with concussion and shifting return-to-play decision responsibility from players to others. Disadvantages included players being removed from play unnecessarily; removal of players’ rights to decide if they are fit to play and players changing their behaviours to avoid being removed from play. Identified facilitators to guideline use included local league enforcement; broad information dissemination and impartial medically trained staff to assess concussion. Identified barriers to guideline use included players’ desire to play at all costs; external pressure that encouraged players to return to play prematurely; and inconvenience and cost. Conclusions Players generally understand that the AFL concussion guidelines protect their long-term welfare. However, their desire to play at all costs and help their team win is a common barrier to reporting concussion and adhering to guidelines. Leagues should take a lead role by mandating and enforcing the use of the guidelines and educating coaches, game day medical providers and players. The return-to-play component of the guidelines is complex and needs further consideration in the context of community sport. PMID:28890801

Comparing an Unstructured Risk Stratification to Published Guidelines in Acute Coronary Syndromes.

Science.gov (United States)

Beck, Ann-Jean C C; Hagemeijer, Anouk; Tortolani, Bess; Byrd, Bethany A; Parekh, Amisha; Datillo, Paris; Birkhahn, Robert

2015-09-01

Guidelines are designed to encompass the needs of the majority of patients with a particular condition. The American Heart Association (AHA) in conjunction with the American College of Cardiology (ACC) and the American College of Emergency Physicians (ACEP) developed risk stratification guidelines to aid physicians with accurate and efficient diagnosis and management of patients with acute coronary syndrome (ACS). While useful in a primary care setting, in the unique environment of an emergency department (ED), the feasibility of incorporating guidelines into clinical workflow remains in question. We aim to compare emergency physicians' (EP) clinical risk stratification ability to AHA/ACC/ACEP guidelines for ACS, and assessed each for accuracy in predicting ACS. We conducted a prospective observational cohort study in an urban teaching hospital ED. All patients presenting to the ED with chest pain who were evaluated for ACS had two risk stratification scores assigned: one by the treating physician based on clinical evaluation and the other by the AHA/ACC/ACEP guideline aforementioned. The patient's ACS risk stratification classified by the EP was compared to AHA/ACC/ACEP guidelines. Patients were contacted at 30 days following the index ED visit to determine all cause mortality, unscheduled hospital/ED revisits, and objective cardiac testing performed. We enrolled 641 patients presenting for evaluation by 21 different EPs. There was a difference between the physician's clinical assessment used in the ED, and the AHA/ACC/ACEP task force guidelines. EPs were more likely to assess patients as low risk (40%), while AHA/ACC/ACEP guidelines were more likely to classify patients as intermediate (45%) or high (45%) risk. Of the 119 (19%) patients deemed high risk by EP evaluation, 38 (32%) were diagnosed with ACS. AHA/ACC/ACEP guidelines classified only 57 (9%) patients low risk with 56 (98%) of those patients diagnosed with no ACS. In the ED, physicians are more efficient

Guidelines for an environmental code of ethics for research institutions

International Nuclear Information System (INIS)

Gardusi, Claudia; Aquino, Afonso Rodrigues de

2009-01-01

The purpose of this work is to reflect about actions that may contribute to the creation of mechanisms to protect the environment in the development of research projects at research institutions, specifically the Nuclear and Energy Research Institute - IPEN. A brief review of part of the ethical values applied to the process of scientific development during the old, medieval and modern periods is presented, showing the split of the nature ethical principles. It is also reported an overview of the creation of codes of ethics applied to research institutions. Moreover, criteria are presented to settle guidelines to protect the environment during the development of research projects. (author)

Correlates of Achieving the Guidelines of Four Forms of Physical Activity, and the Relationship between Guidelines Achievement and Academic Performance: Undergraduate Students in Finland.

Science.gov (United States)

El Ansari, Walid; Suominen, Sakari; Draper, Steve

2017-06-01

We surveyed and compared, by gender, the levels and correlates of achieving the international guidelines of four forms of physical activity (PA): moderate PA (MPA), vigorous PA (VPA), moderate or vigorous PA (MVPA), and muscle strengthening PA (MSPA). The study assessed the associations between achieving the guidelines of the four PA forms and a range of socio-demographic, health and academic performance variables. Data was collected across the seven faculties of the University of Turku (2013-2014 from a representative sample of 1,189 undergraduates). An English language online self-administered questionnaire assessed frequency and duration of PA/week for each form of PA. We employed cut-offs for the guidelines in accordance with the American Heart Association. Chi-square statistic tested the differences in PA, socio-demographic variables and academic performance between males and females. Binary logistic regression examined the factors associated with achieving the four PA guidelines and linear regression examined the association between the frequency of PA and academic performance. Achievement of PA guidelines was relatively low across the sample. Female students were less likely to achieve the VPA or MSPA guidelines, but were more health conscious and in generally exhibited better academic performace than males. High health awareness and excellent/very good self-rated health were the strongest predictors of achieving all forms of PA. Parents' education level was positively related to likelihood of achieving the VPA, MVPA and MSPA guidelines. Achieving the MPA guidelines (but not VPA or MSPA) was positively associated with subjective perceptions of better academic performance. Achievement of PA guidelines was generally low for this sample of Finnish students, and was associated with positive health status and high health awareness. Universities need a holistic approach to improve awareness of health and promote PA in students' lifestyles. Copyright© by the

Guidelines for endoscopic management of non-variceal upper gastrointestinal bleeding.

Science.gov (United States)

Fujishiro, Mitsuhiro; Iguchi, Mikitaka; Kakushima, Naomi; Kato, Motohiko; Sakata, Yasuhisa; Hoteya, Shu; Kataoka, Mikinori; Shimaoka, Shunji; Yahagi, Naohisa; Fujimoto, Kazuma

2016-05-01

Japan Gastroenterological Endoscopy Society (JGES) has compiled a set of guidelines for endoscopic management of non-variceal upper gastrointestinal bleeding using evidence-based methods. The major cause of non-variceal upper gastrointestinal bleeding is peptic gastroduodenal ulcer bleeding. As a result, these guidelines mainly focus on peptic gastroduodenal ulcer bleeding, although bleeding from other causes is also overviewed. From the epidemiological aspect, in recent years in Japan, bleeding from drug-related ulcers has become predominant in comparison with bleeding from Helicobacter pylori (HP)-related ulcers, owing to an increase in the aging population and coverage of HP eradication therapy by national health insurance. As for treatment, endoscopic hemostasis, in which there are a variety of methods, is considered to be the first-line treatment for bleeding from almost all causes. It is very important to precisely evaluate the severity of the patient's condition and stabilize the patient's vital signs with intensive care for successful endoscopic hemostasis. Additionally, use of antisecretory agents is recommended to prevent rebleeding after endoscopic hemostasis, especially for gastroduodenal ulcer bleeding. Eighteen statements with evidence and recommendation levels have been made by the JGES committee of these guidelines according to evidence obtained from clinical research studies. However, some of the statements that are supported by a low level of evidence must be confirmed by further clinical research. © 2016 Japan Gastroenterological Endoscopy Society.

Human-system interface design review guideline -- Process and guidelines: Final report. Revision 1, Volume 1

International Nuclear Information System (INIS)

1996-06-01

NUREG-0700, Revision 1, provides human factors engineering (HFE) guidance to the US Nuclear Regulatory Commission staff for its: (1) review of the human system interface (HSI) design submittals prepared by licensees or applications for a license or design certification of commercial nuclear power plants, and (2) performance of HSI reviews that could be undertaken as part of an inspection or other type of regulatory review involving HSI design or incidents involving human performance. The guidance consists of a review process and HFE guidelines. The document describes those aspects of the HSI design review process that are important to the identification and resolution of human engineering discrepancies that could adversely affect plant safety. Guidance is provided that could be used by the staff to review an applicant's HSI design review process or to guide the development of an HSI design review plan, e.g., as part of an inspection activity. The document also provides detailed HFE guidelines for the assessment of HSI design implementations. NUREG-0700, Revision 1, consists of three stand-alone volumes. Volume 1 consists of two major parts. Part 1 describes those aspects of the review process of the HSI design that are important to identifying and resolving human engineering discrepancies. Part 2 contains detailed guidelines for a human factors engineering review which identify criteria for assessing the implementation of an applicant's or licensee's HSI design

UK national guidelines on the management of syphilis 2015.

Science.gov (United States)

Kingston, M; French, P; Higgins, S; McQuillan, O; Sukthankar, A; Stott, C; McBrien, B; Tipple, C; Turner, A; Sullivan, A K; Radcliffe, Keith; Cousins, Darren; FitzGerald, Mark; Fisher, Martin; Grover, Deepa; Higgins, Stephen; Kingston, Margaret; Rayment, Michael; Sullivan, Ann

2016-05-01

These guidelines are an update for 2015 of the 2008 UK guidelines for the management of syphilis. The writing group have piloted the new BASHH guideline methodology, notably using the GRADE system for assessing evidence and making recommendations. We have made significant changes to the recommendations for screening infants born to mothers with positive syphilis serology and to facilitate accurate and timely communication between the teams caring for mother and baby we have developed a birth plan. Procaine penicillin is now an alternative, not preferred treatment, for all stages of syphilis except neurosyphilis, but the length of treatment for this is shortened. Other changes are summarised at the start of the guideline. © The Author(s) 2016.

REVIEW OF QUANTITATIVE STANDARDS AND GUIDELINES FOR FUNGI IN INDOOR AIR

Science.gov (United States)

Exposure to fungal aerosols clearly causes human disease. However, methods for assessing exposure remain poorly understood, and guidelines for interpreting data are often contradictory. The purposes of this paper are to review and compare existing guidelines for indoor airborne...

Integrated building (and) airflow simulation: an overview

NARCIS (Netherlands)

Hensen, J.L.M.

2002-01-01

This paper aims to give a broad overview of building airflow simulation, and advocates that the essential ingredients for quality assurance are: domain knowledge; selection of appropriate level of resolution; calibration and validation; and a correct performance assessment methodology. Directions

Spanish guideline for the definition and assessment of risk-informed inservice inspection programs for piping

International Nuclear Information System (INIS)

Figueras, J.M.; Olivar, F.; Mendoza, C.; Vazquez, T.; Morales, L.; Bros, J.; Mach, I.; Gutierrez, E.

2001-01-01

The recent emphasis on risk-informed in-service inspection has been taken on by the Spanish Utilities and the Spanish Regulatory Body in their proposal for a co-operation project for defining a Risk-Informed In-Service Inspection Guideline for Piping. This paper describes first the main features of this Spanish guideline and then the results of the pilot applications developed in order to check the consistency of the guideline. (authors)

Spanish guideline for the definition and assessment of risk-informed inservice inspection programs for piping

Energy Technology Data Exchange (ETDEWEB)

Figueras, J.M.; Olivar, F.; Mendoza, C.; Vazquez, T. [CSN, Madrid (Spain); Morales, L. [UNESA, Madrid (Spain); Bros, J.; Mach, I. [Tecnatom, Madrid (Spain); Gutierrez, E. [Iberinco, Madrid (Spain)

2001-07-01

The recent emphasis on risk-informed in-service inspection has been taken on by the Spanish Utilities and the Spanish Regulatory Body in their proposal for a co-operation project for defining a Risk-Informed In-Service Inspection Guideline for Piping. This paper describes first the main features of this Spanish guideline and then the results of the pilot applications developed in order to check the consistency of the guideline. (authors)

Adherence to dietary guidelines and cardiovascular disease risk in the EPIC-NL cohort

NARCIS (Netherlands)

Struijk, E.A.; May, A.M.; Wezenbeek, N.L.W.J.; Fransen, H.; Soedamah-Muthu, S.S.; Geelen, A.; Boer, J.; Schouw, van der Y.T.; Bueno de Mesquita, H.B.; Beulens, J.W.J.

2014-01-01

Background Global and national dietary guidelines have been created to lower chronic disease risk. The aim of this study was to assess whether greater adherence to the WHO guidelines (Healthy Diet Indicator (HDI)); the Dutch guidelines for a healthy diet (Dutch Healthy Diet-index (DHD-index)); and

Risk management guidelines for petroleum storage tank sites

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-10-01

These guidelines provide a site management process designed particularly for soil and groundwater pollution originating from existing or former petroleum storage tank (PST) facilities and provide uniform standards for the remediation of polluted PST sites in Alberta. The numerical criteria, risk management objectives and technical information described in this document were compiled from four documents including Remediation Guidelines for Petroleum Storage Tank Sites 1994, the Canada-Wide Standards for Petroleum Hydrocarbons in Soil, Alberta Soil and Water Quality Guidelines for Hydrocarbons at Upstream Oil and Gas Facilities, and Guidelines for Managing Risks at Contaminated Sites in Alberta. The changes in these updated guidelines reflect new remediation criteria and provide a process for determining alternate site-specific management objectives for more petroleum storage tank sites. The guidelines were developed using a risk-based approach that ensures the protection of human health, safety and the environment. The guidelines apply to aboveground and underground storage tank facilities that contain gasoline, diesel, heating oil, and aviation fuel. The guidelines specify requirements by Alberta Environment and the Alberta Fire Code. The chapter on risk management process included information on site investigation, determination of soil type, pollution source removal, land use assessment, selection of exposure pathways, depth of remediation, human inhalation and groundwater protection pathways, and verification of remediation. figs, 4 tabs., 2 appendices.

Guidelines for the environmental impact statement for the proposed Great Whale River Hydroelectric Project

International Nuclear Information System (INIS)

1992-01-01

The guidelines presented on the preparation of the environmental impact statement for the Great Whale hydroelectric project by Hydro-Quebec stipulated a project justification, description of the biophysical and social environments, a project description, and that the assessment must address project impacts, mitigative and compensatory measures, environmental surveillance, monitoring, and long-term management programs. Background information presented in this document provides technical notes on the guidelines and the environmental assessment process, a glossary of terms, and biographical notes. The technical notes address guideline structure, project justification, native knowledge, evaluation issues, cumulative impacts, and the assessment and review process

Conflict of Interest Policies and Industry Relationships of Guideline Development Group Members: A Cross-Sectional Study of Clinical Practice Guidelines for Depression.

Science.gov (United States)

Cosgrove, Lisa; Krimsky, Sheldon; Wheeler, Emily E; Peters, Shannon M; Brodt, Madeline; Shaughnessy, Allen F

2017-01-01

Because of increased attention to the issue of trustworthiness of clinical practice guidelines, it may be that both transparency and management of industry associations of guideline development groups (GDGs) have improved. The purpose of the present study was to assess a) the disclosure requirements of GDGs in a cross-section of guidelines for major depression; and, b) the extent and type of conflicts of panel members. Treatment guidelines for major depression were identified and searched for conflict of interest policies and disclosure statements. Multi-modal screens for undeclared conflicts were also conducted. Fourteen guidelines with a total of 172 panel members were included in the analysis. Eleven of the 14 guidelines (78%) had a stated conflict of interest policy or disclosure statement, although the policies varied widely. Most (57%) of the guidelines were developed by panels that had members with industry financial ties to drug companies that manufacture antidepressant medication. However, only a minority of total panel members (18%) had such conflicts of interest. Drug company speakers bureau participation was the most common type of conflict. Although some progress has been made, organizations that develop guidelines should continue to work toward greater transparency and minimization of financial conflicts of interest.

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.

Content and quality of workplace guidelines developed to prevent mental health problems

DEFF Research Database (Denmark)

Nexø, Mette Andersen; Kristensen, Josefine Vejlby; Grønvad, Majbritt Thorhauge

2018-01-01

Objectives A wide range of guidelines have been developed to prevent work-related mental health problems (MHP), but little is known about the quality of such guidelines. We systematically reviewed the content and quality of workplace guidelines aiming to prevent, detect, and/or manage work......-related MHP. Methods We conducted systematic online and database searches (MEDLINE; Web of Science; PsychNET; occupational safety and health databases) to identify guidelines. Eligibility criteria included guidelines recommending primary, secondary, or tertiary preventive interventions to be implemented...... at the workplace by employers, employees or organizational staff. A minimum of minimum three independent reviewers assessed the quality of guidelines using the Guidelines for Research and Evaluation (AGREE II). Guidelines rated ≥65% with regards to domain I, II, and III were considered to be of good developmental...

Overview of human health in the Arctic: conclusions and recommendations.

Science.gov (United States)

Donaldson, Shawn; Adlard, Bryan; Odland, Jon Øyvind

2016-01-01

This article is intended to provide an overview of the key conclusions, knowledge gaps and key recommendations based on the recent 2015 Arctic human health assessment under the Arctic Monitoring and Assessment Program. This assessment was based primarily on data from human health monitoring and research studies and peer-reviewed literature published since the last assessment in 2009.

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.

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

OVERVIEW ON BNL ASSESSMENT OF SEISMIC ANALYSIS METHODS FOR DEEPLY EMBEDDED NPP STRUCTURES