WorldWideScience

Sample records for associations interim guidelines

  1. Assessment of cumulative evidence on genetic associations: Interim guidelines

    OpenAIRE

    Ioannidis, John; Boffetta, Paolo; Little, Julian; O'Brien, Thomas; Uitterlinden, André; Vineis, Paolo; Balding, David; Chokkalingam, Anand; Dolan, Siobhan; Flanders, Dana; Higgins, Julian; McCarthy, Mark; McDermott, David; Page, Grier; Rebbeck, Timothy

    2008-01-01

    textabstractEstablished guidelines for causal inference in epidemiological studies may be inappropriate for genetic associations. A consensus process was used to develop guidance criteria for assessing cumulative epidemiologic evidence in genetic associations. A proposed semi-quantitative index assigns three levels for the amount of evidence, extent of replication, and protection from bias, and also generates a composite assessment of 'strong', 'moderate' or 'weak' epidemiological credibility...

  2. Wind energy and aviation interests - interim guidelines

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    The impact on aviation of increasing the number of wind farms in the United Kingdom is discussed by the Wind Energy, Defence and Civil Aviation Interests Working Group, comprising the Department of Trade and Industry, the Civil Aviation Authority, the Ministry of Defence, and the British Wind Energy Association. The report offers guidance to wind farm developers, local authorities and statutory consultees within the aviation community: the main thrust of the guidelines is to support the UK Government's wind energy targets. Although the document does not contain in-depth technical discussions, it does provide references to such information.

  3. Record of Decision Colorado River Interim Surplus Guidelines Final Environmental Impact Statement

    OpenAIRE

    Secretary of the Department of the Interior

    2001-01-01

    This document constitutes the Record of Decision (ROD) of the Department of the Interior, regarding the preferred alternative for Colorado River Interim Surplus Guidelines (Guidelines). The Secretary of the Interior (Secretary) is vested with the responsibility of managing the mainstream waters of the lower Colorado River pursuant to federal law. This responsibility is carried out consistent with applicable federal law. Reclamation, as the agency that is designated to act on the Secretary’s b...

  4. 78 FR 56750 - Interim Staff Guidance on Environmental Issues Associated With New Reactors

    Science.gov (United States)

    2013-09-13

    ... COMMISSION Interim Staff Guidance on Environmental Issues Associated With New Reactors AGENCY: Nuclear... Notice: Draft Interim Staff Guidance on Environmental Issues Associated with New Reactors. ML12326A742 Interim Staff Guidance-026, Environmental Issues Associated with New Reactors. ML12326A811...

  5. Interim Guidelines for Pregnant Women During a Zika Virus Outbreak--United States, 2016.

    Science.gov (United States)

    Petersen, Emily E; Staples, J Erin; Meaney-Delman, Dana; Fischer, Marc; Ellington, Sascha R; Callaghan, William M; Jamieson, Denise J

    2016-01-22

    CDC has developed interim guidelines for health care providers in the United States caring for pregnant women during a Zika virus outbreak. These guidelines include recommendations for pregnant women considering travel to an area with Zika virus transmission and recommendations for screening, testing, and management of pregnant returning travelers. Updates on areas with ongoing Zika virus transmission are available online (http://wwwnc.cdc.gov/travel/notices/). Health care providers should ask all pregnant women about recent travel. Pregnant women with a history of travel to an area with Zika virus transmission and who report two or more symptoms consistent with Zika virus disease (acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis) during or within 2 weeks of travel, or who have ultrasound findings of fetal microcephaly or intracranial calcifications, should be tested for Zika virus infection in consultation with their state or local health department. Testing is not indicated for women without a travel history to an area with Zika virus transmission. In pregnant women with laboratory evidence of Zika virus infection, serial ultrasound examination should be considered to monitor fetal growth and anatomy and referral to a maternal-fetal medicine or infectious disease specialist with expertise in pregnancy management is recommended. There is no specific antiviral treatment for Zika virus; supportive care is recommended.

  6. Interim Guidelines for the Evaluation and Testing of Infants with Possible Congenital Zika Virus Infection - United States, 2016.

    Science.gov (United States)

    Staples, J Erin; Dziuban, Eric J; Fischer, Marc; Cragan, Janet D; Rasmussen, Sonja A; Cannon, Michael J; Frey, Meghan T; Renquist, Christina M; Lanciotti, Robert S; Muñoz, Jorge L; Powers, Ann M; Honein, Margaret A; Moore, Cynthia A

    2016-01-29

    CDC has developed interim guidelines for health care providers in the United States who are caring for infants born to mothers who traveled to or resided in an area with Zika virus transmission during pregnancy. These guidelines include recommendations for the testing and management of these infants. Guidance is subject to change as more information becomes available; the latest information, including answers to commonly asked questions, can be found online (http://www.cdc.gov/zika). Pediatric health care providers should work closely with obstetric providers to identify infants whose mothers were potentially infected with Zika virus during pregnancy (based on travel to or residence in an area with Zika virus transmission [http://wwwnc.cdc.gov/travel/notices]), and review fetal ultrasounds and maternal testing for Zika virus infection (see Interim Guidelines for Pregnant Women During a Zika Virus Outbreak*) (1). Zika virus testing is recommended for 1) infants with microcephaly or intracranial calcifications born to women who traveled to or resided in an area with Zika virus transmission while pregnant; or 2) infants born to mothers with positive or inconclusive test results for Zika virus infection. For infants with laboratory evidence of a possible congenital Zika virus infection, additional clinical evaluation and follow-up is recommended. Health care providers should contact their state or territorial health department to facilitate testing. As an arboviral disease, Zika virus disease is a nationally notifiable condition.

  7. Interim Guidelines for the Evaluation and Testing of Infants with Possible Congenital Zika Virus Infection - United States, 2016.

    Science.gov (United States)

    Staples, J Erin; Dziuban, Eric J; Fischer, Marc; Cragan, Janet D; Rasmussen, Sonja A; Cannon, Michael J; Frey, Meghan T; Renquist, Christina M; Lanciotti, Robert S; Muñoz, Jorge L; Powers, Ann M; Honein, Margaret A; Moore, Cynthia A

    2016-01-01

    CDC has developed interim guidelines for health care providers in the United States who are caring for infants born to mothers who traveled to or resided in an area with Zika virus transmission during pregnancy. These guidelines include recommendations for the testing and management of these infants. Guidance is subject to change as more information becomes available; the latest information, including answers to commonly asked questions, can be found online (http://www.cdc.gov/zika). Pediatric health care providers should work closely with obstetric providers to identify infants whose mothers were potentially infected with Zika virus during pregnancy (based on travel to or residence in an area with Zika virus transmission [http://wwwnc.cdc.gov/travel/notices]), and review fetal ultrasounds and maternal testing for Zika virus infection (see Interim Guidelines for Pregnant Women During a Zika Virus Outbreak*) (1). Zika virus testing is recommended for 1) infants with microcephaly or intracranial calcifications born to women who traveled to or resided in an area with Zika virus transmission while pregnant; or 2) infants born to mothers with positive or inconclusive test results for Zika virus infection. For infants with laboratory evidence of a possible congenital Zika virus infection, additional clinical evaluation and follow-up is recommended. Health care providers should contact their state or territorial health department to facilitate testing. As an arboviral disease, Zika virus disease is a nationally notifiable condition. PMID:26820387

  8. RANET technical guidelines: Interim technical guidelines for national assistance capabilities. Emergency preparedness and response. Date effective: 1 January 2007

    International Nuclear Information System (INIS)

    The publication is issued as an attachment to EPR-RANET (2006) and has the same status. It provides administrative and technical guidelines for National Assistance Capabilities and enters into effect on 1 January 2007. Additional technical guidelines are under development by assistance work group under international Action Plan for Strengthening the International Preparedness and Response System for Nuclear and Radiological Emergencies. As these are finalised they will be included in this document

  9. Update: Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure - United States, 2016.

    Science.gov (United States)

    Oduyebo, Titilope; Petersen, Emily E; Rasmussen, Sonja A; Mead, Paul S; Meaney-Delman, Dana; Renquist, Christina M; Ellington, Sascha R; Fischer, Marc; Staples, J Erin; Powers, Ann M; Villanueva, Julie; Galang, Romeo R; Dieke, Ada; Muñoz, Jorge L; Honein, Margaret A; Jamieson, Denise J

    2016-02-12

    CDC has updated its interim guidelines for U.S. health care providers caring for pregnant women during a Zika virus outbreak (1). Updated guidelines include a new recommendation to offer serologic testing to asymptomatic pregnant women (women who do not report clinical illness consistent with Zika virus disease) who have traveled to areas with ongoing Zika virus transmission. Testing can be offered 2-12 weeks after pregnant women return from travel. This update also expands guidance to women who reside in areas with ongoing Zika virus transmission, and includes recommendations for screening, testing, and management of pregnant women and recommendations for counseling women of reproductive age (15-44 years). Pregnant women who reside in areas with ongoing Zika virus transmission have an ongoing risk for infection throughout their pregnancy. For pregnant women with clinical illness consistent with Zika virus disease,* testing is recommended during the first week of illness. For asymptomatic pregnant women residing in areas with ongoing Zika virus transmission, testing is recommended at the initiation of prenatal care with follow-up testing mid-second trimester. Local health officials should determine when to implement testing of asymptomatic pregnant women based on information about levels of Zika virus transmission and laboratory capacity. Health care providers should discuss reproductive life plans, including pregnancy intention and timing, with women of reproductive age in the context of the potential risks associated with Zika virus infection.

  10. Guidelines on interim performance constraints for radioactive waste disposal in crystalline rock

    International Nuclear Information System (INIS)

    Interim performance constraints have been developed for preliminary design analyses of a radioactive waste repository in crystalline rock. The approach taken in defining these constraints was to consider the thermal, thermomechanical, and thermochemical beavior for three regions of the repository (very-near field, near field, and far field) during three time periods (operational, containment, and isolation). Physical, thermal, and mechanical limits are proposed. These may be required to support the repository performance objectives defined by the US Nuclear Regulatory Commission in 10 CFR Part 60, Disposal of High-Level Radioactive Wastes in Geologic Repositories, in particular those related to barrier performance after permanent closure (10 CFR 60.113). The performance constraints represent the informed judgment of a Working Group whose members are knowledgeable in matters relating to design of a repository in crystalline rock. The constraints are intended for use in early design studies and will be revised as analytical and experimental information to support revision becomes available

  11. Assessment report of research and development on 'the abolition measures of nuclear facilities and associated technology development' and 'radioactive waste treatment and disposal and associated technology development' (Interim report)

    International Nuclear Information System (INIS)

    Japan Atomic Energy Agency (JAEA) consulted the 'Evaluation Committee for Nuclear Cycle Backend Program Promotion' to perform the interim evaluation of 'the abolition measures of nuclear facilities and associated technology development' project and 'radioactive waste treatment and disposal and associated technology development' project in accordance with the 'Guideline for evaluation of government R and D activities', the 'Guideline for evaluation of R and D in Ministry of Education, Culture, Sports, Science and Technology (MEXT)' and the 'Operational rule for evaluation of R and D activities' by JAEA. In response to JAEA's request, the Committee decided the evaluation method and performed the interim evaluation of both projects from the viewpoints of purposes, plans, results and so on. As a result of review, the Committee concluded that both projects were proceeded adequately. (author)

  12. Interim Guidelines for Prevention of Sexual Transmission of Zika Virus - United States, 2016.

    Science.gov (United States)

    Oster, Alexandra M; Brooks, John T; Stryker, Jo Ellen; Kachur, Rachel E; Mead, Paul; Pesik, Nicki T; Petersen, Lyle R

    2016-02-12

    Zika virus is a mosquito-borne flavivirus primarily transmitted by Aedes aegypti mosquitoes (1,2). Infection with Zika virus is asymptomatic in an estimated 80% of cases (2,3), and when Zika virus does cause illness, symptoms are generally mild and self-limited. Recent evidence suggests a possible association between maternal Zika virus infection and adverse fetal outcomes, such as congenital microcephaly (4,5), as well as a possible association with Guillain-Barré syndrome. Currently, no vaccine or medication exists to prevent or treat Zika virus infection. Persons residing in or traveling to areas of active Zika virus transmission should take steps to prevent Zika virus infection through prevention of mosquito bites (http://www.cdc.gov/zika/prevention/).

  13. Interim Guidelines for Prevention of Sexual Transmission of Zika Virus - United States, 2016.

    Science.gov (United States)

    Oster, Alexandra M; Brooks, John T; Stryker, Jo Ellen; Kachur, Rachel E; Mead, Paul; Pesik, Nicki T; Petersen, Lyle R

    2016-02-12

    Zika virus is a mosquito-borne flavivirus primarily transmitted by Aedes aegypti mosquitoes (1,2). Infection with Zika virus is asymptomatic in an estimated 80% of cases (2,3), and when Zika virus does cause illness, symptoms are generally mild and self-limited. Recent evidence suggests a possible association between maternal Zika virus infection and adverse fetal outcomes, such as congenital microcephaly (4,5), as well as a possible association with Guillain-Barré syndrome. Currently, no vaccine or medication exists to prevent or treat Zika virus infection. Persons residing in or traveling to areas of active Zika virus transmission should take steps to prevent Zika virus infection through prevention of mosquito bites (http://www.cdc.gov/zika/prevention/). PMID:26866485

  14. American Association of Dental Schools Curricular Guidelines for Oral Radiology.

    Science.gov (United States)

    Journal of Dental Education, 1980

    1980-01-01

    Oral radiology curricular guidelines developed by the American Association of Dental Schools are provided. The guidelines describe minimal conditions under which a satisfactory educational experience can be offered. Principles of x-radiation, radiobiological concepts, radiological health, radiographic technique, radiographic quality, and darkroom…

  15. Past and future American Psychological Association guidelines for statistical practice

    NARCIS (Netherlands)

    Finch, S; Thomason, N; Cumming, G

    2002-01-01

    We review the publication guidelines of the American Psychological Association (APA) since 1929 and document their advice for authors about statistical practice. Although the advice has been extended with each revision of the guidelines, it has largely focused on null hypothesis significance testing

  16. Update: Interim Guidelines for Health Care Providers Caring for Infants and Children with Possible Zika Virus Infection--United States, February 2016.

    Science.gov (United States)

    Fleming-Dutra, Katherine E; Nelson, Jennifer M; Fischer, Marc; Staples, J Erin; Karwowski, Mateusz P; Mead, Paul; Villanueva, Julie; Renquist, Christina M; Minta, Anna A; Jamieson, Denise J; Honein, Margaret A; Moore, Cynthia A; Rasmussen, Sonja A

    2016-02-26

    CDC has updated its interim guidelines for U.S. health care providers caring for infants born to mothers who traveled to or resided in areas with Zika virus transmission during pregnancy and expanded guidelines to include infants and children with possible acute Zika virus disease. This update contains a new recommendation for routine care for infants born to mothers who traveled to or resided in areas with Zika virus transmission during pregnancy but did not receive Zika virus testing, when the infant has a normal head circumference, normal prenatal and postnatal ultrasounds (if performed), and normal physical examination. Acute Zika virus disease should be suspected in an infant or child aged notifiable. Health care providers should report suspected cases of Zika virus disease to their local, state, or territorial health departments to arrange testing and so that action can be taken to reduce the risk for local Zika virus transmission. As new information becomes available, these guidelines will be updated: http://www.cdc.gov/zika/. PMID:26914500

  17. Update: Interim Guidelines for Health Care Providers Caring for Infants and Children with Possible Zika Virus Infection--United States, February 2016.

    Science.gov (United States)

    Fleming-Dutra, Katherine E; Nelson, Jennifer M; Fischer, Marc; Staples, J Erin; Karwowski, Mateusz P; Mead, Paul; Villanueva, Julie; Renquist, Christina M; Minta, Anna A; Jamieson, Denise J; Honein, Margaret A; Moore, Cynthia A; Rasmussen, Sonja A

    2016-02-26

    CDC has updated its interim guidelines for U.S. health care providers caring for infants born to mothers who traveled to or resided in areas with Zika virus transmission during pregnancy and expanded guidelines to include infants and children with possible acute Zika virus disease. This update contains a new recommendation for routine care for infants born to mothers who traveled to or resided in areas with Zika virus transmission during pregnancy but did not receive Zika virus testing, when the infant has a normal head circumference, normal prenatal and postnatal ultrasounds (if performed), and normal physical examination. Acute Zika virus disease should be suspected in an infant or child aged Zika virus during delivery is possible, acute Zika virus disease should also be suspected in an infant during the first 2 weeks of life 1) whose mother traveled to or resided in an affected area within 2 weeks of delivery and 2) who has ≥2 of the following manifestations: fever, rash, conjunctivitis, or arthralgia. Evidence suggests that Zika virus illness in children is usually mild. As an arboviral disease, Zika virus disease is nationally notifiable. Health care providers should report suspected cases of Zika virus disease to their local, state, or territorial health departments to arrange testing and so that action can be taken to reduce the risk for local Zika virus transmission. As new information becomes available, these guidelines will be updated: http://www.cdc.gov/zika/.

  18. American Association of Dental Schools Curricular Guidelines for Orthodontics.

    Science.gov (United States)

    Journal of Dental Education, 1980

    1980-01-01

    Guidelines reviewed and approved by the American Association of Dental Schools and sent to the Council on Dental Education in June 1979 are outlined. Educational goals and objectives and sequence of instruction (including growth and development, preclinical orthodontics, and clinical experience) are discussed. (MLW)

  19. Workshop on problem areas associated with developing carcinogen guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1984-06-01

    A workshop was conducted to discuss problem areas associated with developing carcinogen guidelines. Session topics included (1) definition of a carcinogen for regulatory purposes; (2) potency; (3) risk assessment; (4) uncertainties; (5) de minimis quantity; and (6) legal and regulatory issues. Separate abstracts have been prepared for individual papers. (ACR)

  20. 78 FR 17679 - Implementation of the Updated American Veterinary Medical Association Guidelines for the...

    Science.gov (United States)

    2013-03-22

    ... Association Guidelines for the Euthanasia of Animals: 2013 Edition SUMMARY: The National Institutes of Health... the American Veterinary Medical Association (AVMA) Guidelines for the Euthanasia of Animals: 2013... updated Guidelines. DATES: Public concerns regarding the updated AVMA Guidelines for the Euthanasia...

  1. Interim safety basis for fuel supply shutdown facility

    International Nuclear Information System (INIS)

    This ISB in conjunction with the new TSRs, will provide the required basis for interim operation or restrictions on interim operations and administrative controls for the Facility until a SAR is prepared in accordance with the new requirements. It is concluded that the risk associated with the current operational mode of the Facility, uranium closure, clean up, and transition activities required for permanent closure, are within Risk Acceptance Guidelines. The Facility is classified as a Moderate Hazard Facility because of the potential for an unmitigated fire associated with the uranium storage buildings

  2. The Revised 2016 Korean Thyroid Association Guidelines for Thyroid Nodules and Cancers: Differences from the 2015 American Thyroid Association Guidelines

    Science.gov (United States)

    2016-01-01

    Increased detection of thyroid nodules using high-resolution ultrasonography has resulted in a world-wide increase in the incidence of differentiated thyroid cancer (DTC). Despite the steep increase in its incidence, the age-standardized mortality rate of thyroid cancer has remained stable, which leads toward a trend of more conservative treatment. The latest American Thyroid Association (ATA) guidelines for thyroid nodules and thyroid cancer revised in 2015 suggested that fine needle aspiration biopsy should be performed for thyroid nodules larger than 1 cm and lobectomy might be sufficient for 1 to 4 cm intrathyroidal DTC. In addition, active surveillance instead of immediate surgical treatment was also recommended as a treatment option for papillary thyroid microcarcinoma based on the results of a few observational studies from Japan. The Korean Thyroid Association (KTA) has organized a task force team to develop revised guidelines for thyroid nodules and DTC after an extensive review of articles and intense discussion on whether we should accept the changes in the 2015 ATA guidelines. This paper introduces and discusses the updated major issues and differences in the ATA and the KTA guidelines. PMID:27704738

  3. American Association of Dental Schools Curricular Guidelines for Practice Management and for Preventive Dentistry.

    Science.gov (United States)

    Journal of Dental Education, 1980

    1980-01-01

    Curricular guidelines developed by the American Association of Dental Schools for use by individual educational institutions as curriculum development aids are provided. The guidelines were developed by the Sections on Community and Preventive Dentistry and Practice Administration. (MLW)

  4. Hydrogen combustion in an MCO during interim storage (fauske and associates report 99-14)

    Energy Technology Data Exchange (ETDEWEB)

    PLYS, M.G.

    1999-05-12

    Flammable conditions are not expected to develop in an MCO during interim storage. This report considers potential phenomena which, although not expected t o occur, could lead t o flammable conditions. For example, reactions of hydrogen w i t h fuel over decades a r e postulated t o lead t o flammable atmospheric mixtures. For the extreme cases considered in this report, the highest attainable post-combustion pressure is about 13 atmospheres absolute, almost a factor of two and a half below the MCO design pressure of 31 atmospheres.

  5. Guidelines

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    <正>Editorial Office of Asian Agricultural Research Asian Agricultural Research, Agricultural Economist and Research Fellow, Shuhua Cao, Standing Director of Association of Agricultural Science Societies, 545 Pawtucket Ave. Suite300A, Pawtucket, RI 02860, USA Email : csh51888@yahoo. corn Tel : 4006762388-8991189058 Fax: 401-941-5829 Core members of Editorial Board of the Asian Agricultural Research Mark Xu, Professor, Foreign Agricultural Service of United States Department of Agriculture, Washington, DC 20250,

  6. American Association for Dental Schools Curricular Guidelines for Microscopic Anatomy (General and Oral).

    Science.gov (United States)

    Susi, Frank; Mundell, Robert

    1980-01-01

    Guidelines developed by the Section on Anatomical Sciences of the American Association for Dental Schools are presented. These guidelines were drawn up as an effort to provide a general criterion-referenced standard against which a school can measure its course content in histology. (MLW)

  7. Guideline on anterior cruciate ligament injury A multidisciplinary review by the Dutch Orthopaedic Association

    NARCIS (Netherlands)

    Meuffels, D.E.; Poldervaart, M.T.; Diercks, R.L.; Fievez, A.W.F.M.; Patt, T.W.; van der Hart, C.P.; Hammacher, E.R.; van der Meer, F.; Goedhart, E.A.; Lenssen, A.F.; Muller-Ploeger, S.B.; Pols, M.A.; Saris, D.B.F.

    2012-01-01

    The Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steer

  8. Guidelines

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    <正>Editorial Office of Asian Agricultural Research Asian Agricultural Research,Agricultural Economist and Research Fellow,Sharon,Standing Director of Association of Agricultural Science Societies,545 Pawtucket Ave.Suite 300A,Pawtucket,RI 02860,USA Email:csh51888@ yahoo.com Tel:4006762388-8991189058 Fax:401-941-5829 Journal Customer services For ordering information,claims and any enquiry concerning your journal subscription please go to contact your nearest office.America:Email:uschinamedia@yahoo.comm Tel:4006762388-8991189058 Fax:401-941-5829 Europe,Middle East,Africa and Asia Pacific:Email:asiaar@163.comm Tel:+86-551-5148112 Fax:86-551-5148869 Annual subscription rate(volume 3,12issues,2011):US $ 240

  9. Patient and hospital characteristics associated with variation in guideline adherence in intrauterine insemination care

    NARCIS (Netherlands)

    Hermens, R.P.M.G.; Haagen, E.C.; Nelen, W.L.D.M.; Tepe, E.M.; Akkermans, R.P.; Kremer, J.A.M.; Grol, R.P.T.M.

    2011-01-01

    OBJECTIVE: To assess the association of patient and hospital characteristics with adherence to guidelines for intrauterine insemination (IUI) care. DESIGN: Retrospective cohort study using multilevel regression analysis. Characteristics studied at the patient level were female age, type and duration

  10. Adherence to European Association of Urology Guidelines on Prophylactic Antibiotics

    DEFF Research Database (Denmark)

    Cai, Tommaso; Verze, Paolo; Brugnolli, Anna;

    2016-01-01

    Escherichia coli to piperacillin/tazobactam (9.1% vs. 5.4%; p=0.03), gentamicin (18.3% vs. 11.2%; p=0.02), and ciprofloxacin (32.3% vs. 19.1%; p=0.03) decreased significantly after protocol introduction. The defined daily dose (DDD) use of ciprofloxacin fell from 4.2 to 0.2 DDD per 100 patient-days after....... We found that adherence to the guidelines reduced the rate of bacterial resistance, in particular against piperacillin/tazobactam, gentamicin, and ciprofloxacin, and reduced costs without increasing the risk of postoperative infection after urologic procedures. We recommend adherence to the...

  11. Saudi Oncology Society and Saudi Urology Association combined clinical management guidelines for testicular germ cell tumors

    Directory of Open Access Journals (Sweden)

    Mohammed Alotaibi

    2016-01-01

    Full Text Available This is an update to the previously published Saudi guidelines for the evaluation, medical, and surgical management of patients diagnosed with testicular germ cell tumors. It is categorized according to the stage of the disease using the tumor-node-metastasis staging system 7th edition. The guidelines are presented with supporting evidence level, they are based on comprehensive literature review, several internationally recognized guidelines, and the collective expertise of the guidelines committee members (authors who were selected by the Saudi Oncology Society and Saudi Urological Association. Considerations to the local availability of drugs, technology and expertise have been regarded. These guidelines should serve as a roadmap for the urologists, oncologists, general physicians, support groups, and health care policy makers in the management of patients diagnosed with testicular germ cell tumors.

  12. Saudi oncology society and Saudi urology association combined clinical management guidelines for prostate cancer

    Directory of Open Access Journals (Sweden)

    Ashraf Abusamra

    2016-01-01

    Full Text Available This is an update to the previously published Saudi guidelines for the evaluation, medical, and surgical management of patients diagnosed with prostate cancer. It is categorized according to the stage of the disease using the tumor node metastasis staging system 7th edition. The guidelines are presented with supporting evidence level, they are based on comprehensive literature review, several internationally recognized guidelines, and the collective expertise of the guidelines committee members (authors who were selected by the Saudi oncology society and Saudi urological association. Considerations to the local availability of drugs, technology, and expertise have been regarded. These guidelines should serve as a roadmap for the urologists, oncologists, general physicians, support groups, and health care policy makers in the management of patients diagnosed with adenocarcinoma of the prostate to.

  13. The American Association for Thoracic Surgery Consensus Guidelines: Reasons and purpose.

    Science.gov (United States)

    Svensson, Lars G; Gillinov, A Marc; Weisel, Richard D; Keshavjee, Shaf; Bacha, Emile A; Moon, Marc R; Cameron, Duke E; Sugarbaker, David J; Adams, David H; Gaynor, J William; Coselli, Joseph S; Del Nido, Pedro J; Jones, David; Sundt, Thoralf M; Cohn, Lawrence H; Pomar, Jose L; Lytle, Bruce W; Schaff, Hartzell V

    2016-04-01

    The time interval for the doubling of medical knowledge continues to decline. Physicians, patients, administrators, government officials, and payors are struggling to keep up to date with the waves of new information and to integrate the knowledge into new patient treatment protocols, processes, and metrics. Guidelines, Consensus Guidelines, and Consensus Statements, moderated by seasoned content experts, offer one method to rapidly distribute new information in a timely manner and also guide minimal standards of treatment of clinical care pathways as they are developed as part of bundled care programs. These proposed Consensus Guidelines advance The American Association for Thoracic Surgery's mission of leading in cardiothoracic health care, education, innovation, and modeling excellence.

  14. Clinical practice guidelines on cancer-associated thrombosis: a review on scope and methodology.

    Science.gov (United States)

    Lee, Agnes Y Y; Peterson, Erica A; Wu, Cynthia

    2016-04-01

    Cancer-associated thrombosis is a well-recognized complication in patients with cancer. It imposes significant patient morbidity and anxiety, increases personal and societal financial burden, and is the second-leading cause of death in this population. There have been increasing research efforts to reduce the incidence of venous thromboembolism (VTE) and optimize its treatment but the quality of evidence is diverse. To assist clinicians in providing care based on best-available evidence, many international and national organizations have issued clinical practice guidelines. Among these, the most highly cited resources include those developed by the American College of Chest Physicians, the American Society of Clinical Oncology and the European Society of Medical Oncology. Nationally-based guidelines have also been published by various groups, including the Italian Association of Medical Oncology, the National Comprehensive Cancer Network, the French National Federation of the League of Centers Against Cancer, and the British Committee for Standards in Haematology. This review will cover fundamental aspects of clinical practice guideline development and evaluation, summarize the scope and methodology of published guidelines on the management of cancer-associated thrombosis and assess the quality of selected, international guidelines using the validated Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Areas of consensus and uncertainties will be briefly highlighted. PMID:27067964

  15. Methodology manual for European Association for Cardio-Thoracic Surgery (EACTS) clinical guidelines.

    Science.gov (United States)

    Sousa-Uva, Miguel; Head, Stuart J; Thielmann, Matthias; Cardillo, Giuseppe; Benedetto, Umberto; Czerny, Martin; Dunning, Joel; Castella, Manuel; Gudbjartsson, Tomas; Howell, Neil; Hazekamp, Mark; Kolh, Philippe; Beyersdorf, Friedhelm; Pagano, Domenico; Kappetein, A Pieter

    2015-12-01

    The goal of all clinical guidelines is to assist patients and practitioners in making healthcare decisions. However, clinical guidelines have been questioned about their quality, transparency and independence. Based on the revision of manuals by other scientific cardiothoracic organizations, this document provides instructions for the development of European Association for Cardio-Thoracic Surgery (EACTS) clinical guidelines and other types of evidence-based documents. Four key areas have been addressed: (i) selection of taskforce members and transparency of relations with the industry, (ii) methods for critical appraisal of medical evidence, (iii) rules for writing recommendations and (iv) review process. It is hoped that, by adopting this methodology, clinical guidelines produced by the EACTS will be well balanced, objective and, importantly, trusted by physicians and patients who benefit from their implementation.

  16. A Qualitative Study Exploring Factors Associated with Provider Adherence to Severe Pediatric Traumatic Brain Injury Guidelines.

    Science.gov (United States)

    Brolliar, Sarah M; Moore, Megan; Thompson, Hilaire J; Whiteside, Lauren K; Mink, Richard B; Wainwright, Mark S; Groner, Jonathan I; Bell, Michael J; Giza, Christopher C; Zatzick, Douglas F; Ellenbogen, Richard G; Ng Boyle, Linda; Mitchell, Pamela H; Rivara, Frederick P; Vavilala, Monica S

    2016-08-15

    Despite demonstrated improvement in patient outcomes with use of the Pediatric Traumatic Brain Injury (TBI) Guidelines (Guidelines), there are differential rates of adherence. Provider perspectives on barriers and facilitators to adherence have not been elucidated. This study aimed to identify and explore in depth the provider perspective on factors associated with adherence to the Guidelines using 19 focus groups with nurses and physicians who provided acute management for pediatric patients with TBI at five university-affiliated Level 1 trauma centers. Data were examined using deductive and inductive content analysis. Results indicated that three inter-related domains were associated with clinical adherence: 1) perceived guideline credibility and applicability to individual patients, 2) implementation, dissemination, and enforcement strategies, and 3) provider culture, communication styles, and attitudes towards protocols. Specifically, Guideline usefulness was determined by the perceived relevance to the individual patient given age, injury etiology, and severity and the strength of the evidence. Institutional methods to formally endorse, codify, and implement the Guidelines into the local culture were important. Providers wanted local protocols developed using interdisciplinary consensus. Finally, a culture of collaboration, including consistent, respectful communication and interdisciplinary cooperation, facilitated adherence. Provider training and experience, as well as attitudes towards other standardized care protocols, mirror the use and attitudes towards the Guidelines. Adherence was determined by the interaction of each of these guideline, institutional, and provider factors acting in concert. Incorporating provider perspectives on barriers and facilitators to adherence into hospital and team protocols is an important step toward improving adherence and ultimately patient outcomes. PMID:26760283

  17. Evaluating Clinical Practice Guidelines Based on Their Association with Return to Work in Administrative Claims Data

    DEFF Research Database (Denmark)

    Roberts, Eric T; DuGoff, Eva H; Heins, Sara E;

    2016-01-01

    OBJECTIVE: To examine the association between non-adherence to clinical practice guidelines (CPGs) and time to return to work (RTW) for patients with workplace injuries. DATA SOURCES/STUDY SETTING: Secondary analysis of medical billing and disability data for 148,199 for shoulder and back injuries...... from a workers' compensation insurer. STUDY DESIGN: Cox proportional hazard regression is used to estimate the association between time to RTW and receipt of guideline-discordant care. We test the robustness of our findings to an omitted confounding variable. DATA COLLECTION: Collected by the insurer...

  18. Walnut Creek National Wildlife Refuge : Interim hunting plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This interim hunting plan for Neal Smith National Wildlife Refuge (formerly Walnut Creek National Wildlife Refuge) outlines hunting guidelines for the Refuge....

  19. Reading and analysis on management guidelines for hyperthyroidism published in 2011 by American Thyroid Association and American Association of Clinical Endocrinologists

    International Nuclear Information System (INIS)

    Recently, the American Thyroid Association and American Association of Clinical Endocrinologists published 'Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists', and created 100 evidence-based recommendations. The guideline systematically introduced the diagnoses and therapies of hyperthyroidism, emphasizing the indications, contraindications, preparations, methodologies and follow-up strategies. The guideline also provided detailed management principles for hyperthyroidism in children and pregnancy, Graves' ophthalmopathy and some unusual causes of hyperthyroidism. (authors)

  20. Interim report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1985-06-01

    This Interim Report summarizes the research and development activities of the Superconducting Super Collider project carried out from the completion of the Reference Designs Study (May 1984) to June 1985. It was prepared by the SSC Central Design Group in draft form on the occasion of the DOE Annual Review, June 19--21, 1985. Now largely organized by CDG Divisions, the bulk of each chapter documents the progress and accomplishments to date, while the final section(s) describe plans for future work. Chapter 1, Introduction, provides a basic brief description of the SSC, its physics justification, its origins, and the R&D organization set up to carry out the work. Chapter 2 gives a summary of the main results of the R&D program, the tasks assigned to the four magnet R&D centers, and an overview of the future plans. The reader wishing a quick look at the SSC Phase I effort can skim Chapter 1 and read Chapter 2. Subsequent chapters discuss in more detail the activities on accelerator physics, accelerator systems, magnets and cryostats, injector, detector R&D, conventional facilities, and project planning and management. The magnet chapter (5) documents in text and photographs the impressive progress in successful construction of many model magnets, the development of cryostats with low heat leaks, and the improvement in current-carrying capacity of superconducting strand. Chapter 9 contains the budgets and schedules of the COG Divisions, the overall R&D program, including the laboratories, and also preliminary projections for construction. Appendices provide information on the various panels, task forces and workshops held by the CDG in FY 1985, a bibliography of COG and Laboratory reports on SSC and SSC-related work, and on private industrial involvement in the project.

  1. Clinical practice guidelines for hospital-acquired pneumonia and ventilator-associated pneumonia in adults

    OpenAIRE

    Coleman Rotstein; Gerald Evans; Abraham Born; Ronald Grossman; R Bruce Light; Sheldon Magder; Barrie McTaggart; Karl Weiss; Zhanel, George G

    2008-01-01

    Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are important causes of morbidity and mortality, with mortality rates approaching 62%. HAP and VAP are the second most common cause of nosocomial infection overall, but are the most common cause documented in the intensive care unit setting. In addition, HAP and VAP produce the highest mortality associated with nosocomial infection. As a result, evidence-based guidelines were prepared detailing the epidemiology, micro...

  2. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries

    DEFF Research Database (Denmark)

    Diangelis, Anthony J; Andreasen, Jens O; Ebeleseder, Kurt A;

    2012-01-01

    should assist dentists and patients in decision making and for providing the best care effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers......Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and followup are important for improving a favorable outcome. Guidelines...... goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented....

  3. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries. 1

    DEFF Research Database (Denmark)

    Diangelis, A J; Andreasen, J O; Ebeleseder, K A;

    2014-01-01

    should assist dentists and patients in decision making and for providing the best care effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers......Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and follow up are important for improving a favorable outcome. Guidelines...... goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented. The Hebrew Edition is part of the IADT global effort to provide accessibility...

  4. Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder

    Directory of Open Access Journals (Sweden)

    Michelle Nigri Levitan

    2013-12-01

    Full Text Available Objective: To present the most relevant findings regarding the Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder. Methods: We used the methodology proposed by the Brazilian Medical Association for the Diretrizes Project. The MEDLINE (PubMed, Scopus, Web of Science, and LILACS online databases were queried for articles published from 1980 to 2012. Searchable questions were structured using the PICO format (acronym for “patient” [or population], “intervention” [or exposure], “comparison” [or control], and “outcome”. Results: We present data on clinical manifestations and implications of panic disorder and its association with depression, drug abuse, dependence and anxiety disorders. In addition, discussions were held on the main psychiatric and clinical differential diagnoses. Conclusions: The guidelines are proposed to serve as a reference for the general practitioner and specialist to assist in and facilitate the diagnosis of panic disorder.

  5. Proposed Plan for Interim Remedial Action and Dangerous Waste Modified Closure of the Treatment, Storage, and Disposal Units and Associated Sites in the 100-NR-1 Operable Unit

    International Nuclear Information System (INIS)

    This Proposed Plan identifies the preferred alternatives for interim remedial action and dangerous waste unit modified closure and corrective action of the treatment, storage, and disposal (TSD) units and their associated sites in the 100-NR-1 Operable Unit, located at the Hanford Site (Figure S-1). The TSD units consist of contaminated soils, structures, and pipelines. There are four Resource Conservation and Recovery Act of 1976 (RCRA) TSD units: the 116-N-1 Crib and Trench, the 116-N-3 Crib and Trench, the 120-N-1 Percolation Pond, and the 120-N-2 Surface Impoundment. There are two associated sites: the UPR-100-N-31 unplanned release (UPR) spill site and the 100-N-58 South Settling Pond. This Proposed Plan also summarizes the other remedial alternatives analyzed for remedial action. The intent of the remedial action is to address contaminated areas that pose potential threats to human health and the environment

  6. Analysis of overall level of evidence behind the Institute of Healthcare Improvement ventilator-associated pneumonia guidelines

    Directory of Open Access Journals (Sweden)

    Iqbal M

    2011-08-01

    Full Text Available Background Clinical practice guidelines are developed to assist in patient care but the evidence basis for many guidelines has recently been called into question. Methods We conducted a literature review using PubMed and analyzed the overall quality of evidence and made strength of recommendation behind 6 Institute of Health Care (IHI guidelines for prevention of ventilator associated pneumonia (VAP. Quality of evidence was assessed by the American Thoracic Society levels of evidence (levels I through III with addition of level IV when evidence existed that the guideline increased VAP. We also examined our own intensive care units (ICUs for evidence of a correlation between guideline compliance and the development of VAP. Results None of the guidelines could be given more than a moderate recommendation. Only one of the guidelines (head of bed elevation was graded at level II and could be given a moderate recommendation. One was graded at level IV (stress ulcer disease prophylaxis. The remainder were graded level III and given weak recommendations. In our ICUs compliance with the guidelines did not correlate with a reduction in VAP (p<0.05. Conclusions Most of the IHI guidelines are based on level III evidence. Data from our ICUs did not support guideline compliance as a method of reducing VAP. Until more data from well-designed controlled clinical trials become available, physicians should remain cautious when using current IHI VAP guidelines to direct patient care decisions or as an assessment of the quality of care.

  7. Analysis of overall level of evidence behind the Institute of Healthcare Improvement ventilator-associated pneumonia guidelines

    OpenAIRE

    Iqbal M; Lee S; Singarajah CU; Robbins RA; Pattee JJ; Padrnos L; Bui T; Whitmore EJ

    2011-01-01

    Background Clinical practice guidelines are developed to assist in patient care but the evidence basis for many guidelines has recently been called into question. Methods We conducted a literature review using PubMed and analyzed the overall quality of evidence and made strength of recommendation behind 6 Institute of Health Care (IHI) guidelines for prevention of ventilator associated pneumonia (VAP). Quality of evidence was assessed by the American Thoracic Society levels of evidence (lev...

  8. The Association of Shelter Veterinarians' 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs.

    Science.gov (United States)

    Griffin, Brenda; Bushby, Philip A; McCobb, Emily; White, Sara C; Rigdon-Brestle, Y Karla; Appel, Leslie D; Makolinski, Kathleen V; Wilford, Christine L; Bohling, Mark W; Eddlestone, Susan M; Farrell, Kelly A; Ferguson, Nancy; Harrison, Kelly; Howe, Lisa M; Isaza, Natalie M; Levy, Julie K; Looney, Andrea; Moyer, Michael R; Robertson, Sheilah Ann; Tyson, Kathy

    2016-07-15

    As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs. PMID:27379593

  9. World marrow donor association crisis response, business continuity, and disaster recovery guidelines.

    Science.gov (United States)

    Pingel, Julia; Case, Cullen; Amer, Beth; Hornung, Raymond A; Schmidt, Alexander H

    2012-12-01

    Multiple institutions, such as donor registries, donor centers, transplantation centers, collection centers, and courier companies, are involved in the international exchange of hematopoietic stem cells. The ability to safely and efficiently ensure continued operation of a donor registry relies on an organization's resiliency in the face of an incident that could impede donor search, donor selection, stem cell collection, or transportation. The Quality Assurance Working Group of the World Marrow Donor Association has developed guidelines on how to establish an organizational resiliency program intended for donor registries initiating an emergency preparedness process. These guidelines cover the minimal requirements of preparedness in prevention and mitigation, crisis response, business continuity, and disaster recovery, and the need for continued maintenance and revision. Issues of international cooperation are addressed as well. PMID:22967871

  10. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries. 3

    DEFF Research Database (Denmark)

    Diangelis, A J; Andreasen, J O; Ebeleseder, K A;

    2014-01-01

    Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group...... discussions. Experienced researchers and clinicians from various specialities were included in the task group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their...... opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care for management of primary teeth injuries. The IADT cannot and does not guarantee favorable outcomes from strict adherence to the guidelines, but believe that their application can...

  11. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries

    DEFF Research Database (Denmark)

    Malmgren, Barbro; Andreasen, Jens O; Flores, Marie Therese;

    2012-01-01

    Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group...... discussions. Experienced researchers and clinicians from various specialities were included in the task group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their...... opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care for management of primary teeth injuries. The IADT cannot and does not guarantee favorable outcomes from strict adherence to the guidelines, but believe that their application can...

  12. Medical guidelines for space passengers. Aerospace Medical Association Task Force on Space Travel.

    Science.gov (United States)

    2001-10-01

    In the foreseeable future, private companies will manufacture space vehicles with a capacity of transporting tourists into low Earth orbit. Because of the stresses of spaceflight, the effects of microgravity, and limited medical care capability, a system of medical clearance is highly recommended for these space tourists. It is our purpose to establish guidelines for use by private businesses, medical providers, and those planning on being a space tourist. Consequently, a Task Force was organized by the Aerospace Medical Association (AsMA) for the purpose of facilitating safety of passengers, fellow passengers, crew, and flight operations. The guidelines are meant to serve only as a template with the full expectation that exceptions might be made with appropriate rationale. PMID:11601561

  13. Characterization of West African Jet Streams and Their Association to ENSO Events and Rainfall in ERA-Interim 1979–2011

    Directory of Open Access Journals (Sweden)

    Churchill Okonkwo

    2014-01-01

    Full Text Available The interannual variability of West African jet streams and their association with rainfall are reexamined using European Reanalysis ERA-Interim 1979–2011. The objective of the study is to characterize their climatology and role in rainfall variability in western Sahel. Wavelet analysis was used on wind speed data and implications to ENSO were discussed subsequently. Our results show that while the low-level African Westerly Jet (AWJ correlates well with rainfall south of the equator in boreal winter months, the Tropical Easterly Jet (TEJ and African Easterly Jet (AEJ correlate better with rainfall north of the equator in the boreal summer months. Results of interannual-to-decadal variability in 200 mb, 600 mb, and 850 mb of zonal wind reveal that there is enhanced variability in the 2–8 year band. Also, the TEJ, AEJ, and AWJ fluctuations are coupled with variations in southern oscillation. Further analysis suggests a statistically significant association between TEJ and the El Niño events of the 1980s that led to intense drought in the Sahel region of West Africa. The 2007 moderate La Niña shows a statistically significant coherence with the 500 mb, 600 mb, and 850 mb jets. These associations are also phase locked, suggesting that the association may be more than by chance.

  14. Comments to guidelines for the treatment of hypothyroidism prepared by the American thyroid association task force on thyroid hormone replacement

    Directory of Open Access Journals (Sweden)

    Valentin Viktorovich Fadeev

    2015-02-01

    Full Text Available The article is dedicated to the discussion about to guidelines for the treatment of hypothyroidism prepared by the American thyroid association task force on thyroid hormone replacement.

  15. The Association of Shelter Veterinarians veterinary medical care guidelines for spay-neuter programs.

    Science.gov (United States)

    Looney, Andrea L; Bohling, Mark W; Bushby, Philip A; Howe, Lisa M; Griffin, Brenda; Levy, Julie K; Eddlestone, Susan M; Weedon, James R; Appel, Leslie D; Rigdon-Brestle, Y Karla; Ferguson, Nancy J; Sweeney, David J; Tyson, Kathy A; Voors, Adriana H; White, Sara C; Wilford, Christine L; Farrell, Kelly A; Jefferson, Ellen P; Moyer, Michael R; Newbury, Sandra P; Saxton, Melissa A; Scarlett, Janet M

    2008-07-01

    As efforts to reduce the overpopulation and euthanasia of unwanted and unowned dogs and cats have increased, greater attention has been focused on spay-neuter programs throughout the United States. Because of the wide range of geographic and demographic needs, a wide variety of programs have been developed to increase delivery of spay-neuter services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, feral cat programs, and services provided through private practitioners. In an effort to ensure a consistent level of care, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. The guidelines consist of recommendations for preoperative care (eg, patient transport and housing, patient selection, client communication, record keeping, and medical considerations), anesthetic management (eg, equipment, monitoring, perioperative considerations, anesthetic protocols, and emergency preparedness), surgical care (eg, operating-area environment; surgical-pack preparation; patient preparation; surgeon preparation; surgical procedures for pediatric, juvenile, and adult patients; and identification of neutered animals), and postoperative care (eg, analgesia, recovery, and release). These guidelines are based on current principles of anesthesiology, critical care medicine, microbiology, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs. PMID:18593314

  16. Practice guidelines for perioperative transesophageal echocardiography: Recommendations of the Indian association of cardiovascular thoracic anesthesiologists

    Directory of Open Access Journals (Sweden)

    Kanchi Muralidhar

    2013-01-01

    Full Text Available Transoesophageal Echocardiography (TEE is now an integral part of practice of cardiac anaesthesiology. Advances in instrumentation and the information that can be obtained from the TEE examination has proceeded at a breath-taking pace since the introduction of this technology in the early 1980s. Recognizing the importance of TEE in the management of surgical patients, the American Societies of Anesthesiologists (ASA and the Society of Cardiac Anesthesiologists, USA (SCA published practice guidelines for the clinical application of perioperative TEE in 1996. On a similar pattern, Indian Association of Cardiac Anaesthesiologists (IACTA has taken the task of putting forth guidelines for transesophageal echocardiography (TEE to standardize practice across the country. This review assesses the risks and benefits of TEE for several indications or clinical scenarios. The indications for this review were drawn from common applications or anticipated uses as well as current clinical practice guidelines published by various society practicing Cardiac Anaesthesia and cardiology . Based on the input received, it was determined that the most important parts of the TEE examination could be displayed in a set of 20 cross sectional imaging planes. These 20 cross sections would provide also the format for digital acquisition and storage of a comprehensive TEE examination. Because variability exists in the precise anatomic orientation between the heart and the esophagus in individual patients, an attempt was made to provide specific criteria based on identifiable anatomic landmarks to improve the reproducibility and consistency of image acquisition for each of the standard cross sections.

  17. Correlation of compliance with central line associated blood stream infection guidelines and outcomes: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Gerkin R

    2012-05-01

    Full Text Available Background Clinical practice guidelines are developed to assist in patient care but the evidence basis for many guidelines has been called into question. Methods We conducted a literature review using PubMed and analyzed the overall quality of evidence and made strength of recommendation behind 8 Institute of Health Care (IHI guidelines for prevention of central line associated blood stream infection (CLABSI. Quality of evidence was assessed by the American Thoracic Society (ATS levels of evidence (levels I through III. We also examined data from our intensive care units (ICUs for evidence of a correlation between guideline compliance and the development of VAP.Results None of the guidelines was graded at level I. Two of the guidelines were graded at level II and the remaining 6 at level III. Despite the lack of evidence, 2 of the guidelines (hand hygiene, sterile gloves were given a strong recommendation. Chlorhexidine and use of nonfemoral sites were given a moderate recommendation. In our ICUs compliance with the use of chlorhexidine correlated with a reduction in CLABSI (p<0.02 but the remainder did not.Conclusions The IHI CLABSI guidelines are based on level II or III evidence. Data from our ICUs supported the use of chlorhexidine in reducing CLABSI. Until more data from well-designed controlled clinical trials become available, physicians should remain cautious when using current IHI guidelines to direct patient care decisions or as an assessment of the quality of care.

  18. Detection of mammaglobin mRNA in peripheral blood is associated with high grade breast cancer: Interim results of a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Schutte Del H

    2008-02-01

    Full Text Available Abstract Background We sought to examine the detection rate of cancer cells in peripheral blood (PBL and in bone marrow (BM using an established 7-gene marker panel and evaluated whether there were any definable associations of any individual gene with traditional predictors of prognosis. Methods Patients with T1-T3 primary breast cancer were enrolled into a prospective, multi-institutional cohort study. In this interim analysis 215 PBL and 177 BM samples were analyzed by multimarker, real-time RT-PCR analysis designed to detect circulating and disseminated breast cancer cells. Results At a threshold of three standard deviations from the mean expression level of normal controls, 63% (136/215 of PBL and 11% (19/177 of BM samples were positive for at least one cancer-associated marker. Marker positivity in PBL demonstrated a statistically significant association with grade II-III (vs. grade I; p = 0.0083. Overexpression of the mammaglobin (mam gene alone had a statistically significant association with high tumor grade (p = 0.0315, and showed a trend towards ER-negative tumors and a high risk category. There was no association between marker positivity in PBL and the pathologic (H&E and/or molecular (RT-PCR status of the axillary lymph nodes (ALN. Conclusion This study suggests that molecular detection of circulating cancer cells in PBL detected by RT-PCR is associated with high tumor grade and specifically that overexpression of the mam gene in PBL may be a poor prognostic indicator. There was no statistically significant association between overexpression of cancer-associated genes in PBL and ALN status, supporting the concept of two potentially separate metastatic pathways.

  19. Detection of mammaglobin mRNA in peripheral blood is associated with high grade breast cancer: Interim results of a prospective cohort study

    International Nuclear Information System (INIS)

    We sought to examine the detection rate of cancer cells in peripheral blood (PBL) and in bone marrow (BM) using an established 7-gene marker panel and evaluated whether there were any definable associations of any individual gene with traditional predictors of prognosis. Patients with T1-T3 primary breast cancer were enrolled into a prospective, multi-institutional cohort study. In this interim analysis 215 PBL and 177 BM samples were analyzed by multimarker, real-time RT-PCR analysis designed to detect circulating and disseminated breast cancer cells. At a threshold of three standard deviations from the mean expression level of normal controls, 63% (136/215) of PBL and 11% (19/177) of BM samples were positive for at least one cancer-associated marker. Marker positivity in PBL demonstrated a statistically significant association with grade II-III (vs. grade I; p = 0.0083). Overexpression of the mammaglobin (mam) gene alone had a statistically significant association with high tumor grade (p = 0.0315), and showed a trend towards ER-negative tumors and a high risk category. There was no association between marker positivity in PBL and the pathologic (H&E) and/or molecular (RT-PCR) status of the axillary lymph nodes (ALN). This study suggests that molecular detection of circulating cancer cells in PBL detected by RT-PCR is associated with high tumor grade and specifically that overexpression of the mam gene in PBL may be a poor prognostic indicator. There was no statistically significant association between overexpression of cancer-associated genes in PBL and ALN status, supporting the concept of two potentially separate metastatic pathways

  20. Evaluation of the American Heart Association 2015 revised Jones criteria versus existing guidelines

    Science.gov (United States)

    Kumar, Dinesh; Bhutia, Euden; Kumar, Pradeep; Shankar, Binoy; Juneja, Atul; Chandelia, Sudha

    2016-01-01

    Objectives To compare the diagnostic yield of acute rheumatic fever (ARF) by the American Heart Association/ American College of Cardiology (AHA/ACC) 2015 revised Jones criteria with the WHO 2004 and Australian guidelines 2012. Methods Retrospective observational study in 93 cases of suspected ARF admitted to the Division of Paediatric Cardiology between January 2012 and December 2014. WHO 2004, Australian guidelines and AHA/ACC 2015 Jones criteria were applied to assess definite and probable ARF. Results Of the 93 cases, 50 were diagnosed as the first episode of ARF and 43 as a recurrence of the condition. Subclinical carditis was a predominant presentation (38%) in the first episode group (p<0.01) whereas in the recurrence group carditis (88%) was the main presentation (p<0.01). Among the joint manifestations, the majority of patients in both the first episode group and the recurrence group presented with arthralgia. Of all the patients with suspected ARF (50), 34% of cases did not fulfil the standard Jones criteria 2004; however, 86% qualified as having ARF on applying the Australian and AHA/ACC 2015 criteria. Surprisingly in the recurrence group only 67% of the patients fulfilled AHA/ACC 2015 despite the modifications incorporated beyond WHO 2004; however, all the patients fulfilled the Australian guidelines either as definite (88.4%) or probable (11.6%). Inclusion of subclinical carditis, polyarthralgia and monoarthritis as major criteria influenced the diagnosis to definite ARF in 20%, 10% and 4% of patients, respectively. Conclusions The clinical manifestations of ARF, comprising subclinical carditis and arthralgia, are possibly milder in the Indian population; hence, inclusion of subclinical carditis, polyarthralgia and monoarthritis as major criteria in the newer guidelines has improved the diagnostic yield of ARF. In the absence of a gold standard for the diagnosis of ARF, it is not possible to comment on sensitivity and specificity. PMID:27326228

  1. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries. 2

    DEFF Research Database (Denmark)

    Diangelis, A J; Andreasen, J O; Ebeleseder, K A;

    2014-01-01

    Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and...... were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of avulsed permanent teeth. The Hebrew Edition is part of...

  2. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England.

    Science.gov (United States)

    Loveday, H P; Wilson, J A; Pratt, R J; Golsorkhi, M; Tingle, A; Bak, A; Browne, J; Prieto, J; Wilcox, M; UK Department of Health

    2014-01-01

    National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were originally commissioned by the Department of Health and developed during 1998-2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were first published in January 2001(1) and updated in 2007.(2) A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective for the prevention of HCAI, incorporated into amended guidelines. Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority. The Department of Health commissioned a review of new evidence and we have updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the epic2 guidelines published in 2007 remain robust, relevant and appropriate, but some guideline recommendations required adjustments to enhance clarity and a number of new recommendations were required. These have been clearly identified in the text. In addition, the synopses of evidence underpinning the guideline recommendations have been updated. These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence. National evidence-based guidelines are broad principles of best practice that need to be integrated into local practice guidelines and audited to reduce variation in practice and maintain patient safety. Clinically effective infection prevention and control practice is an essential feature of patient protection. By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and

  3. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules

    DEFF Research Database (Denmark)

    Gharib, H; Papini, E; Paschke, R;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes...

  4. AMERICAN COLLEGE OF CARDIOLOGY, AMERICAN HEART ASSOCIATION AND EUROPEAN SOCIETY OF CARDIOLOGY GUIDELINES (2006 FOR THE MANAGEMENT OF PATIENTS WITH ATRIAL FIBRILLATION (ENDING

    Directory of Open Access Journals (Sweden)

    V. Fuster

    2015-12-01

    Full Text Available A report of the American College of Cardiology, American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for practice guidelines.

  5. AMERICAN COLLEGE OF CARDIOLOGY, AMERICAN HEART ASSOCIATION AND EUROPEAN SOCIETY OF CARDIOLOGY GUIDELINES (2006 FOR THE MANAGEMENT OF PATIENTS WITH ATRIAL FIBRILLATION (ENDING

    Directory of Open Access Journals (Sweden)

    V. Fuster

    2007-01-01

    Full Text Available A report of the American College of Cardiology, American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for practice guidelines.

  6. Guideline-adherent initial intravenous antibiotic therapy for hospital-acquired/ventilator-associated pneumonia is clinically superior, saves lives and is cheaper than non guideline adherent therapy

    Directory of Open Access Journals (Sweden)

    Wilke MH

    2011-07-01

    Full Text Available Abstract Introduction Hospital-acquired pneumonia (HAP often occurring as ventilator-associated pneumonia (VAP is the most frequent hospital infection in intensive care units (ICU. Early adequate antimicrobial therapy is an essential determinant of clinical outcome. Organisations like the German PEG or ATS/IDSA provide guidelines for the initial calculated treatment in the absence of pathogen identification. We conducted a retrospective chart review for patients with HAP/VAP and assessed whether the initial intravenous antibiotic therapy (IIAT was adequate according to the PEG guidelines Materials and methods We collected data from 5 tertiary care hospitals. Electronic data filtering identified 895 patients with potential HAP/VAP. After chart review we finally identified 221 patients meeting the definition of HAP/VAP. Primary study endpoints were clinical improvement, survival and length of stay. Secondary endpoints included duration of mechanical ventilation, total costs, costs incurred on the intensive care unit (ICU, costs incurred on general wards and drug costs. Results We found that 107 patients received adequate initial intravenous antibiotic therapy (IIAT vs. 114 with inadequate IIAT according to the PEG guidelines. Baseline characteristics of both groups revealed no significant differences and good comparability. Clinical improvement was 64% over all patients and 82% (85/104 in the subpopulation with adequate IIAT while only 47% (48/103 inadequately treated patients improved (p Drug costs for the hospital stay were also lower (EUR 4,069 vs. EUR 4,833 yet not significant. The most frequent types of inadequate therapy were monotherapy instead of combination therapy, wrong type of penicillin and wrong type of cephalosporin. Discussion These findings are consistent with those from other studies analyzing the impact of guideline adherence on survival rates, clinical success, LOS and costs. However, inadequately treated patients had a higher

  7. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Kernan, Walter N; Ovbiagele, Bruce; Black, Henry R; Bravata, Dawn M; Chimowitz, Marc I; Ezekowitz, Michael D; Fang, Margaret C; Fisher, Marc; Furie, Karen L; Heck, Donald V; Johnston, S Claiborne Clay; Kasner, Scott E; Kittner, Steven J; Mitchell, Pamela H; Rich, Michael W; Richardson, DeJuran; Schwamm, Lee H; Wilson, John A

    2014-07-01

    The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines.

  8. Overview of the 2015 American Thyroid Association guidelines for managing thyroid nodules and differentiated thyroid cancer.

    Science.gov (United States)

    Matti, Bashar; Cohen-Hallaleh, Ruben

    2016-01-01

    The last few years have witnessed numerous publications addressing the management of thyroid nodules and differentiated thyroid cancers. The purpose of this review is to provide a simplified summary of the newly released guidelines by the American Thyroid Association. A systematic approach has been recommended to evaluate a thyroid nodule through clinical assessment, measurement of serum Thyroid Stimulating Hormone, neck ultrasonography and Fine Needle Aspiration where appropriate. This is followed by cytology analysis using the Bethesda scoring system to detect malignancy. Once diagnosed, thyroid cancers need to be staged and risk stratification needs to be applied to develop further treatment plans. Lastly, several recommendations have been presented to assure proper follow-up and support for thyroid cancer patients regardless of the treatment received. PMID:27607088

  9. Management of Differentiated Thyroid Cancer in Children: Focus on the American Thyroid Association Pediatric Guidelines.

    Science.gov (United States)

    Parisi, Marguerite T; Eslamy, Hedieh; Mankoff, David

    2016-03-01

    First introduced in 1946, radioactive iodine (I-131) produces short-range beta radiation with a half-life of 8 days. The physical properties of I-131 combined with the high degree of uptake in the differentiated thyroid cancers (DTCs) led to the use of I-131 as a therapeutic agent for DTC in adults. There are two indications for the potential use of I-131 therapy in pediatric thyroid disorders: nonsurgical treatment of hyperthyroidism owing to Graves' disease and the treatment of children with intermediate- and high-risk DTC. However, children are not just miniature adults. Not only are children and the pediatric thyroid gland more sensitive to radiation than adults but also the biologic behavior of DTC differs between children and adults as well. As opposed to adults, children with DTC typically present with advanced disease at diagnosis; yet, they respond rapidly to therapy and have an excellent prognosis that is significantly better than that in adult counterparts with advanced disease. Unfortunately, there are also higher rates of local and distant disease recurrence in children with DTC compared with adults, mandating lifelong surveillance. Further, children have a longer life expectancy during which the adverse effects of I-131 therapy may become manifest. Recognizing the differences between adults and children with DTC, the American Thyroid Association commissioned a task force of experts who developed and recently published a guideline to address the unique issues related to the management of thyroid nodules and DTC in children. This article reviews the epidemiology, diagnosis, staging, treatment, therapy-related effects, and suggestions for surveillance in children with DTC, focusing not only on the differences between adults and children with this disease but also on the latest recommendations from the inaugural pediatric management guidelines of the American Thyroid Association.

  10. New cholesterol guidelines for the management of atherosclerotic cardiovascular disease risk: a comparison of the 2013 American College of Cardiology/American Heart Association cholesterol guidelines with the 2014 National Lipid Association recommendations for patient-centered management of dyslipidemia.

    Science.gov (United States)

    Adhyaru, Bhavin B; Jacobson, Terry A

    2015-05-01

    This review discusses the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults and compares it with the 2014 National Lipid Association (NLA) Recommendations for Patient-Centered Management of Dyslipidemia. The review discusses some of the distinctions between the guidelines, including how to determine a patient's atherosclerotic cardiovascular disease risk, the role of lipoprotein treatment targets, the importance of moderate- and high-intensity statin therapy, and the use of nonstatin therapy in light of the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) trial.

  11. Factors Associated with Use of Guideline in Home Management of Malaria among Children in Rural South West Nigeria

    Directory of Open Access Journals (Sweden)

    Adekunle Akerele

    2011-01-01

    Full Text Available The dosage regimen for artemether-lumefantrine which is the standard of care for malaria in most of Sub-Saharan countries requires use of treatment guidelines and instructions to enhance caregivers' performance in the treatment of malaria. As part of a larger study evaluating its effectiveness in a rural local government area in southwestern Nigeria, 552 caregivers whose children had fever two weeks preceeding the survey were recruited. Information was collected with interviewer administered questionnaire. A multilevel logistic regression model was fitted using the gllamm approach in Stata to determine the factors associated with use of guideline. Age and educational background of caregiver were significantly associated with guideline use. Caregivers aged 26–30 years were 4 times more likely to use guideline than those aged >40 years. Caregivers with primary education were 4 times more likely to use guideline compared with caregivers with no formal education. Between-village variance was 0.00092 ± 0.3084. Guideline use reduced with increasing age and lower education.

  12. Factors Associated with Use of Guideline in Home Management of Malaria among Children in Rural South West Nigeria

    Science.gov (United States)

    Akerele, Adekunle; Yusuf, Oyindamola B.; Falade, Catherine O.; Ajayi, Ikeoluwapo O.; Pagnoni, Franco

    2011-01-01

    The dosage regimen for artemether-lumefantrine which is the standard of care for malaria in most of Sub-Saharan countries requires use of treatment guidelines and instructions to enhance caregivers' performance in the treatment of malaria. As part of a larger study evaluating its effectiveness in a rural local government area in southwestern Nigeria, 552 caregivers whose children had fever two weeks preceeding the survey were recruited. Information was collected with interviewer administered questionnaire. A multilevel logistic regression model was fitted using the gllamm approach in Stata to determine the factors associated with use of guideline. Age and educational background of caregiver were significantly associated with guideline use. Caregivers aged 26–30 years were 4 times more likely to use guideline than those aged >40 years. Caregivers with primary education were 4 times more likely to use guideline compared with caregivers with no formal education. Between-village variance was 0.00092 ± 0.3084. Guideline use reduced with increasing age and lower education. PMID:22312572

  13. Prognostic significance of interim 18F-FDG PET/CT SUV reduction associated with Ki67 in patients with diffuse large B-cell lymphoma

    International Nuclear Information System (INIS)

    To detect the prognostic significance of interim 18F-FDG PET/CT SUV (standard uptake value) reduction (ΔSUVmax) associated with Ki67 in patients with diffuse large B cell lymphoma (DLBCL). 47 DLBCL patients underwent PET/CT before initiation and after 2-4 cycles of chemotherapy were included. The SUVmax of the dominant lesions were calculated. Ki67 positive indices were provided by enzyme-labeled immunohistochemistry. SPSS17.0 was used for statistical analysis. ΔSUVmax of different groups were compared by t test. Receiver-operator characteristic analysis was performed to determine the optimal cutoff values. Kaplan- Meier analyses of PFS (Progression-free survival) were compared using log-rank test. The average of ΔSUVmax and ΔSUVmax% were 11.53 and 69.10%, respectively. The optimal cutoff values of ΔSUVmax and ΔSUVmax% were 11.45 and 82.92%, respectively. Higher ΔSUVmax and ΔSUVmax% indicated longer PFS (p<0.001). The optimal cutoff value of Ki67 was 55%. Ki67 ≥55% was revealed to be an indicator of shorter PFS (p=0.019). Either ΔSUVmax<11.45 or Ki67>55% was defined as an indicator to poor outcome and scored 1 point. The PFS rate was 100% in patients scored 0 point, yet 0% in patients scored 2 points. PFS tended to be shorter along with the score getting higher (p=0.006). ΔSUVmax and Ki67 positive index were both of significance in DLBCL prognosis. The prognostic value may be confirmed when ΔSUVmax was accordant with Ki67. (authors)

  14. Clinical Practice Guidelines for Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia in Adults

    Directory of Open Access Journals (Sweden)

    Coleman Rotstein

    2008-01-01

    Full Text Available Hospital-acquired pneumonia (HAP and ventilator-associated pneumonia (VAP are important causes of morbidity and mortality, with mortality rates approaching 62%. HAP and VAP are the second most common cause of nosocomial infection overall, but are the most common cause documented in the intensive care unit setting. In addition, HAP and VAP produce the highest mortality associated with nosocomial infection. As a result, evidence-based guidelines were prepared detailing the epidemiology, microbial etiology, risk factors and clinical manifestations of HAP and VAP. Furthermore, an approach based on the available data, expert opinion and current practice for the provision of care within the Canadian health care system was used to determine risk stratification schemas to enable appropriate diagnosis, antimicrobial management and nonantimicrobial management of HAP and VAP. Finally, prevention and risk-reduction strategies to reduce the risk of acquiring these infections were collated. Future initiatives to enhance more rapid diagnosis and to effect better treatment for resistant pathogens are necessary to reduce morbidity and improve survival.

  15. Evidence-based guidelines for the pharmacological treatment of anxiety disorders : recommendations from the British Association for Psychopharmacology

    NARCIS (Netherlands)

    Baldwin, DS; Anderson, IM; Nutt, DJ; Bandelow, B; Bond, A; Davidson, JRT; den Boer, JA; Fineberg, NA; Knapp, M; Scott, J; Wittchen, HU

    2005-01-01

    These British Association for Psychopharmacology guidelines cover the range and aims of treatment for anxiety disorders. They are based explicitly on the available evidence and are presented as recommendations to aid clinical decision making in primary and secondary medical care. They may also serve

  16. Guideline-recommended use of asthma medication by children is associated with parental information and knowledge : the PIAMA birth cohort

    NARCIS (Netherlands)

    Wijga, Alet H.; Zuidgeest, Mira G. P.; Kerkhof, Marjan; Koppelman, Gerard H.; Smit, Henriette A.; de Jongste, Johan C.

    2014-01-01

    PurposeWe investigated the use of asthma medication by children and the association of use as recommended by guidelines with modifiable risk factors: parental attitudes, knowledge of asthma medication and information provided by health care providers. MethodsQuestionnaire data were obtained from par

  17. Palliative sedation : not just normal medical practice. Ethical reflections on the Royal Dutch Medical Association's guideline on palliative sedation

    NARCIS (Netherlands)

    Janssens, Rien; van Delden, Johannes J. M.; Widdershoven, Guy A. M.

    2012-01-01

    The main premise of the Royal Dutch Medical Association's (RDMA) guideline on palliative sedation is that palliative sedation, contrary to euthanasia, is normal medical practice. Although we do not deny the ethical distinctions between euthanasia and palliative sedation, we will critically analyse t

  18. Phase 2 clinical trial of a recombinant adeno-associated viral vector expressing α1-antitrypsin: interim results.

    LENUS (Irish Health Repository)

    Flotte, Terence R

    2011-10-01

    Recombinant adeno-associated virus (rAAV) vectors offer promise for the gene therapy of α(1)-antitrypsin (AAT) deficiency. In our prior trial, an rAAV vector expressing human AAT (rAAV1-CB-hAAT) provided sustained, vector-derived AAT expression for >1 year. In the current phase 2 clinical trial, this same vector, produced by a herpes simplex virus complementation method, was administered to nine AAT-deficient individuals by intramuscular injection at doses of 6.0×10(11), 1.9×10(12), and 6.0×10(12) vector genomes\\/kg (n=3 subjects\\/dose). Vector-derived expression of normal (M-type) AAT in serum was dose dependent, peaked on day 30, and persisted for at least 90 days. Vector administration was well tolerated, with only mild injection site reactions and no serious adverse events. Serum creatine kinase was transiently elevated on day 30 in five of six subjects in the two higher dose groups and normalized by day 45. As expected, all subjects developed anti-AAV antibodies and interferon-γ enzyme-linked immunospot responses to AAV peptides, and no subjects developed antibodies to AAT. One subject in the mid-dose group developed T cell responses to a single AAT peptide unassociated with any clinical effects. Muscle biopsies obtained on day 90 showed strong immunostaining for AAT and moderate to marked inflammatory cell infiltrates composed primarily of CD3-reactive T lymphocytes that were primarily of the CD8(+) subtype. These results support the feasibility and safety of AAV gene therapy for AAT deficiency, and indicate that serum levels of vector-derived normal human AAT >20 μg\\/ml can be achieved. However, further improvements in the design or delivery of rAAV-AAT vectors will be required to achieve therapeutic target serum AAT concentrations.

  19. Reading and analysis on management guidelines for hypothyroidism published in 2012 by American thyroid association and American association of clinical endocrinologists

    International Nuclear Information System (INIS)

    Recently, American Thyroid Association and American Association of Clinical Endocrinologists published Clinical Guideline for Hypothyroidism. The authors took an evidence-based medicine approach, and created 52 recommendations on 15 issues. The guideline emphasized that serum thyrotropin is the single best screening test for primary thyroid dysfunction for the vast majority of outpatient clinical situations. The standard treatment for hypothyroidism is replacement with L-thyroxine. The decision to treat subclinical hypothyroidism when the serum thyrotropin is less than 10 mIU/L should be tailored to the individual patient. (authors)

  20. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules

    DEFF Research Database (Denmark)

    Gharib, Hossein; Papini, Enrico; Paschke, Ralf;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied.These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area...

  1. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of thyroid Nodules

    DEFF Research Database (Denmark)

    Gharib, Hossein; Papini, Enrico; Paschke, Ralf;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied.These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area...

  2. Association between the Adherence to the International Guidelines for Cancer Prevention and Mammographic Density.

    Directory of Open Access Journals (Sweden)

    Adela Castelló

    Full Text Available Mammographic density (MD is considered a strong predictor of Breast Cancer (BC. The objective of the present study is to explore the association between MD and the compliance with the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR recommendations for cancer prevention.Data of 3584 women attending screening from a population-based multicenter cross-sectional study (DDM-Spain collected from October 7, 2007 through July 14, 2008, was used to calculate a score that measures the level of compliance with the WCRF/AICR recommendations: R1Maintain adequate body weight; R2Be physically active; 3RLimit the intake of high density foods; R4Eat mostly plant foods; R5Limit the intake of animal foods; R6Limit alcohol intake; R7Limit salt and salt preserved food intake; R8Meet nutritional needs through diet. The association between the score and MD (assessed by a single radiologist using a semi-quantitative scale was evaluated using ordinal logistic models with random center-specific intercepts adjusted for the main determinants of MD. Stratified analyses by menopausal status and smoking status were also carried out.A higher compliance with the WCRF/AICR recommendations was associated with lower MD (OR1-unit increase = 0.93 95%CI:0.86;0.99. The association was stronger in postmenopausal women (OR = 0.91 95%CI:0.84;0.99 and nonsmokers (OR = 0.87;95%CI:0.80;0.96 for nonsmokers, OR = 1.01 95%CI:0.91;1.12 for smokers, P-interaction = 0.042. Among nonsmokers, maintaining adequate body weight (OR = 0.81 95%CI:0.65;1.01, practicing physical activity (OR = 0.68 95%CI:0.48;0.96 and moderating the intake of high-density foods (OR = 0.58 95%CI:0.40;0.86 and alcoholic beverages (OR = 0.76 95%CI:0.55;1.05 were the recommendations showing the strongest associations with MD.postmenopausal women and non-smokers with greater compliance with the WCRF/AICR guidelines have lower MD. These results may provide guidance to design specific

  3. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and other causes of Thyrotoxicosis

    DEFF Research Database (Denmark)

    Ross, Douglas S; Burch, Henry B; Cooper, David S;

    2016-01-01

    BACKGROUND: Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This article describes evidence-based clinical guidelines for the management...

  4. Guidelines for MIBG-scintigraphy in children; Empfehlungen zur Durchfuehrung der MIBG-Szintigraphie bei Kindern. Leitlinie uebernommen vom Paediatric Committee der European Association of Nuclear Medicine (EANM)

    Energy Technology Data Exchange (ETDEWEB)

    Olivier, P. [CHU Nancy (France); Colarinha, P. [Inst. Portugues de Oncologia, Lisbon (Portugal); Fettich, J. [Univ. Medical Centre Ljubljana (Slovenia); Fischer, S.; Hahn, K.; Porn, U. [Klinik fuer Nuklearmedizin, Univ. of Munich (Germany); Froekier, J. [Aarhus Univ. Hospital - Skejby (Denmark); Giammarile, F. [Centre Leon Berard, Lyon (France); Gordon, I. [Great Ormond Street Hospital for Children, London (United Kingdom); Kabasakal, L. [Cerraphasa Tipp Fakultesi, Nukleer Tipp Ana Bilim Dali, Aksaray (Turkey); Mann, M. [Red Cross Hospital Cape Town (South Africa); Mitjavila, M. [Hospital Universitario de Getafe, Madrid (Spain); Piepsz, A. [AZ VUB and CHU St Pierre, Brussels (Belgium); Sixt, R. [Sahlgrenska Univ. Hospital Oestra, Goeteborg (Sweden); Velzen, J. van [ARPES (Netherlands)

    2002-07-01

    These ''Empfehlungen'' are the german translation of the Guidelines on MIBG-Scintigraphy in Children, which were published by the Paediatric Committee of the European Association of Nuclear Medicine. (orig.) [German] Bei den vorliegenden Empfehlungen handelt es sich um die deutsche Uebersetzung der vom Paediatric Committee der European Association of Nuclear Medicine (EANM) publizierten Guidelines. (orig.)

  5. Guidelines for direct radionuclide cystography; Empfehlungen zur Durchfuehrung der direkten Radionuklid-Zystographie bei Kindern. Richtlinie uebernommen vom Paediatric Committee der European Association of Nuclear Medicine (EANM)

    Energy Technology Data Exchange (ETDEWEB)

    Fettich, J. [Univ. Medical Centre Ljubljana (Slovenia); Colarinha, P. [Inst. Portugues de Oncologia, Lisboa (Portugal); Fischer, S.; Hahn, K.; Porn, U. [Klinik fuer Nuklearmedizin, LMU Muenchen (Germany); Froekier, J. [Aarhus Univ. Hospital - Skejby (Denmark); Gordon, I. [Great Ormond Street Hospital for Children, London (United Kingdom); Kabasakal, L. [Cerraphasa Tip Fakultesi, Nukleer Tip Ana Bilim Dali, Aksaray (Turkey); Mann, M. [Inst. of Child Health, Rondebosh, Red Cross Hospital, Capetown (South Africa); Mitjavila, M. [Hospital Universitario de Getafe, Madrid (Spain); Olivier, P. [CHU Nancy (France); Piepsz, A. [CHU St Pierre (Belgium); Roca, I. [Hospital Vall d' Hebron, Barcelona (Spain); Sixt, R. [The Queen Silvia Children' s Hospital, Goeteborg (Sweden); Velzen, J. van [ARPES (Netherlands)

    2002-07-01

    These ''Empfehlungen'' are the german translation of the Guidelines on MIBG-Scintigraphy in Children, which were published by the Paediatric Committee of the European Association of Nuclear Medicine. (orig.) [German] Bei den vorliegenden Empfehlungen handelt es sich um die deutsche Uebersetzung der vom Paediatric Committee der European Association of Nuclear Medicine (EANM) publizierten Guidelines. (orig.)

  6. Guidelines for glomerular filtration rate determination in children; Empfehlungen zur Bestimmung der glomerulaeren Filtrationsrate bei Kindern. Leitlinie uebernommen vom Paediatric Committee der European Association of Nuclear Medicine (EANM)

    Energy Technology Data Exchange (ETDEWEB)

    Piepsz, A. [CHU St. Pierre, Brussels (Belgium); Colarinha, P. [Inst. Portuges de Oncologica, Lisbon (Portugal); Gordon, I. [Great Ormond Street Hospital for Children, London (United Kingdom); Hahn, K. [Dept. of Nuclear Medicine, Univ. of Munich (Germany); Olivier, P. [CHU Nancy (France); Sixt, R. [The Queen Silvia Children' s Hospital, Goeteborg (Sweden); Velzen, J. van [ARPES (Netherlands)

    2002-07-01

    These ''Empfehlungen'' are the german translation of the Guidelines on MIBG-Scintigraphy in Children, which were published by the Paediatric Committee of the European Association of Nuclear Medicine. (orig.) [German] Bei den vorliegenden Empfehlungen handelt es sich um die deutsche Uebersetzung der vom Paediatric Committee der European Association of Nuclear Medicine (EANM) publizierten Guidelines. (orig.)

  7. SARIS Guidelines. 2014 Ed

    International Nuclear Information System (INIS)

    The IAEA fundamental safety principles provide the basis for IAEA safety standards and IAEA related programmes. IAEA safety standards reflect an international consensus on what constitutes a high level of safety for protecting people and the environment, and therefore represent what all regulators should achieve. These standards, in particular IAEA Safety Standards Series No. GSR Part 1, Governmental, Legal and Regulatory Framework for Safety, provide the basics for establishing, maintaining and continuously improving the governmental, legal and regulatory framework for safety. Additional IAEA requirements and guidance, such as the IAEA Safety Standards Series No. GSR Part 3 (Interim), Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards, and IAEA Safety Standards Series No. GS-R-3, The Management System for Facilities and Activities, are also used to establish and develop the national infrastructure for safety and for establishing and implementing a management system. Assessment of the regulatory framework for safety with respect to the IAEA safety standards can be made either through an external review or through internal self-assessment. Self-assessment offers a mechanism by which an organization can assess its performance against established standards and models and thereby identify areas for improvement. The IAEA has developed a methodology and tool for Self-assessment of the Regulatory Infrastructure for Safety (SARIS), to assist States in undertaking self-assessment of their national safety framework in accordance with the requirements and recommendations of the IAEA safety standards, and to develop an action plan for improvement. The IAEA self-assessment methodology and the associated tools are fully compatible with the IAEA safety standards and are also used in the preparation for regulatory review missions, such as the Integrated Regulatory Review Service and advisory missions. These guidelines have been developed to

  8. 78 FR 53183 - Request for Public Comments Regarding the Interim Environmental Review of the Trans-Pacific...

    Science.gov (United States)

    2013-08-28

    ... interim environmental review of the proposed Trans-Pacific Partnership Agreement (TPP). The interim... with Executive Order 13141-Environmental Review of Trade Agreements (64 FR 63,169, Nov. 18, 1999) and its implementing guidelines (65 FR 79,442, Dec. 19, 2000) and report on such reviews to the...

  9. Adjuvant and Salvage Radiation Therapy After Prostatectomy: American Society for Radiation Oncology/American Urological Association Guidelines

    International Nuclear Information System (INIS)

    Purpose: The purpose of this guideline was to provide a clinical framework for the use of radiation therapy after radical prostatectomy as adjuvant or salvage therapy. Methods and Materials: A systematic literature review using PubMed, Embase, and Cochrane database was conducted to identify peer-reviewed publications relevant to the use of radiation therapy after prostatectomy. The review yielded 294 articles; these publications were used to create the evidence-based guideline statements. Additional guidance is provided as Clinical Principles when insufficient evidence existed. Results: Guideline statements are provided for patient counseling, use of radiation therapy in the adjuvant and salvage contexts, defining biochemical recurrence, and conducting a restaging evaluation. Conclusions: Physicians should offer adjuvant radiation therapy to patients with adverse pathologic findings at prostatectomy (ie, seminal vesicle invastion, positive surgical margins, extraprostatic extension) and salvage radiation therapy to patients with prostate-specific antigen (PSA) or local recurrence after prostatectomy in whom there is no evidence of distant metastatic disease. The offer of radiation therapy should be made in the context of a thoughtful discussion of possible short- and long-term side effects of radiation therapy as well as the potential benefits of preventing recurrence. The decision to administer radiation therapy should be made by the patient and the multidisciplinary treatment team with full consideration of the patient's history, values, preferences, quality of life, and functional status. The American Society for Radiation Oncology and American Urological Association websites show this guideline in its entirety, including the full literature review

  10. Adjuvant and Salvage Radiation Therapy After Prostatectomy: American Society for Radiation Oncology/American Urological Association Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Valicenti, Richard K., E-mail: Richard.valicenti@ucdmc.ucdavis.edu [Department of Radiation Oncology, University of California, Davis School of Medicine, Davis, California (United States); Thompson, Ian [Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas (United States); Albertsen, Peter [Division of Urology, University of Connecticut Health Center, Farmington, Connecticut (United States); Davis, Brian J. [Department of Radiation Oncology, Mayo Medical School, Rochester, Minnesota (United States); Goldenberg, S. Larry [Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia (Canada); Wolf, J. Stuart [Department of Urology, University of Michigan, Ann Arbor, Michigan (United States); Sartor, Oliver [Department of Medicine and Urology, Tulane Medical School, New Orleans, Louisiana (United States); Klein, Eric [Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, Ohio (United States); Hahn, Carol [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Roach, Mack [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Faraday, Martha M. [Four Oaks, Inc (United States)

    2013-08-01

    Purpose: The purpose of this guideline was to provide a clinical framework for the use of radiation therapy after radical prostatectomy as adjuvant or salvage therapy. Methods and Materials: A systematic literature review using PubMed, Embase, and Cochrane database was conducted to identify peer-reviewed publications relevant to the use of radiation therapy after prostatectomy. The review yielded 294 articles; these publications were used to create the evidence-based guideline statements. Additional guidance is provided as Clinical Principles when insufficient evidence existed. Results: Guideline statements are provided for patient counseling, use of radiation therapy in the adjuvant and salvage contexts, defining biochemical recurrence, and conducting a restaging evaluation. Conclusions: Physicians should offer adjuvant radiation therapy to patients with adverse pathologic findings at prostatectomy (ie, seminal vesicle invastion, positive surgical margins, extraprostatic extension) and salvage radiation therapy to patients with prostate-specific antigen (PSA) or local recurrence after prostatectomy in whom there is no evidence of distant metastatic disease. The offer of radiation therapy should be made in the context of a thoughtful discussion of possible short- and long-term side effects of radiation therapy as well as the potential benefits of preventing recurrence. The decision to administer radiation therapy should be made by the patient and the multidisciplinary treatment team with full consideration of the patient's history, values, preferences, quality of life, and functional status. The American Society for Radiation Oncology and American Urological Association websites show this guideline in its entirety, including the full literature review.

  11. Canadian Association of Gastroenterology Practice Guideline for Granting of Privileges to Perform Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    H Miller MacSween

    1997-01-01

    Full Text Available The purpose of this statement is to provide guidelines to assist hospital credentialling committees in their task of granting privileges to perform gastrointestinal endoscopy. Endoscopy of the gastrointestinal tract has evolved over the past 30 years as a potent tool to assist in the evaluation, diagnosis and therapy of patients with gastrointestinal tract disorders. Although gastrointestinal endoscopy was initially developed as a purely diagnostic tool, the development of therapeutic endoscopic techniques has dramatically expanded the role of gastrointestinal endoscopy, frequently to a therapeutic one. In setting guidelines for training and credentialling one must recognize that, excluding flexible sigmoidoscopy, endoscopists should be well trained in therapeutic endoscopy.

  12. CMM Interim Check (U)

    Energy Technology Data Exchange (ETDEWEB)

    Montano, Joshua Daniel [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-03-23

    Coordinate Measuring Machines (CMM) are widely used in industry, throughout the Nuclear Weapons Complex and at Los Alamos National Laboratory (LANL) to verify part conformance to design definition. Calibration cycles for CMMs at LANL are predominantly one year in length. Unfortunately, several nonconformance reports have been generated to document the discovery of a certified machine found out of tolerance during a calibration closeout. In an effort to reduce risk to product quality two solutions were proposed – shorten the calibration cycle which could be costly, or perform an interim check to monitor the machine’s performance between cycles. The CMM interim check discussed makes use of Renishaw’s Machine Checking Gauge. This off-the-shelf product simulates a large sphere within a CMM’s measurement volume and allows for error estimation. Data was gathered, analyzed, and simulated from seven machines in seventeen different configurations to create statistical process control run charts for on-the-floor monitoring.

  13. Clinical practice guidelines for the prevention and treatment of EGFR inhibitor-associated dermatologic toxicities

    NARCIS (Netherlands)

    M.E. Lacouture; M.J. Anadkat; R.J. Bensadoun; J. Bryce; A. Chan; J.B. Epstein; B. Eaby-Sandy; B.A. Murphy; A. Barasch; C. Beder; C.B. Boers-Doets; T. Doherty; J.E. Raber-Durlacher; D. Forstner; S. Langer; J. Lees; D. Mellor

    2011-01-01

    Background Epidermal growth factor receptor inhibitors (EGFRI) produce various dermatologic side effects in the majority of patients, and guidelines are crucial for the prevention and treatment of these untoward events. The purpose of this panel was to develop evidence-based recommendations for EGFR

  14. DRAFT: Russian Association of Endocrinologists Clinic Guidelines for Thyroid Nodules Diagnostic and Treatment

    Directory of Open Access Journals (Sweden)

    Vladimir Eduardovich Vanushko

    2015-05-01

    Full Text Available Russian guidelines for diagnostic of thyroid nodules gained some actual questions: necessity of ultrasound (US-screening of the thyroid cancer, indications for fine needle aspiration and exam of calcitonin, necessity of unification of US and cytopathology classification for signs of thyroid nodules. 

  15. Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology.

    Science.gov (United States)

    Barnes, Thomas R E

    2011-05-01

    These guidelines from the British Association for Psychopharmacology address the scope and targets of pharmacological treatment for schizophrenia. A consensus meeting, involving experts in schizophrenia and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from the participants and interested parties, and cover the pharmacological management and treatment of schizophrenia across the various stages of the illness, including first-episode, relapse prevention, and illness that has proved refractory to standard treatment. The practice recommendations presented are based on the available evidence to date, and seek to clarify which interventions are of proven benefit. It is hoped that the recommendations will help to inform clinical decision making for practitioners, and perhaps also serve as a source of information for patients and carers. They are accompanied by a more detailed qualitative review of the available evidence. The strength of supporting evidence for each recommendation is rated.

  16. American Bar Association Supplementary Guidelines for the Mitigation Function of Defense Teams in Death Penalty Cases: implications for social work.

    Science.gov (United States)

    Andrews, Arlene Bowers

    2012-04-01

    When a client faces a penalty of death, defense attorneys may call on social workers in many capacities: mitigation specialist, expert witness, consulting specialist, direct witness, or defense-initiated victim outreach worker. The American Bar Association set forth standards for capital defense attorneys, which led an interdisciplinary team to produce the "Supplementary Guidelines for the Mitigation Function of Defense Teams in Death Penalty Cases" to promote the exceptional competence and diligence required when the consequence is life or death. This article summarizes the "Supplementary Guidelines," with implications for social work practice--that is, professional responsibility, competence, interviewing skill, knowledge of behavioral and mental impairment, records review, life history compilation, data interpretation, witness support, law-related knowledge, and testimony. The social work, which is scrutinized in a court of law, requires cultural competence, diverse oral and written communication skills, diligence, and the highest ethical standards.

  17. An Evaluation of Web-Based Clinical Practice Guidelines for Managing Problems Associated with Cannabis Use

    OpenAIRE

    Norberg, Melissa M; Turner, Michael W; Rooke, Sally E; Langton, Julia M; Gates, Peter J

    2012-01-01

    Background Cannabis is the most widely used illicit substance, and multiple treatment options and avenues exist for managing its use. There has been an increase in the development of clinical practice guidelines (CPGs) to improve standards of care in this area, many of which are disseminated online. However, little is known about the quality and accessibility of these online CPGs. Objective The purpose of study 1 was to determine the extent to which cannabis-related CPGs disseminated online a...

  18. [Certification of an ambulatory gastroenterologic service fulfilling ISO Law 9001--criteria and national guidelines of the Gastroenterologic Association].

    Science.gov (United States)

    Birkner, B

    2000-09-01

    The objectives of certification and accreditation are the deployment and examination of quality improvement measures in health care services. The quality management system of the ISO 9001 is created to install measures and tools leading to assured and improved quality in health care. Only some experiences with certification fulfilling ISO 9001 criteria exist in the German health care system. Evidence-based clinical guidelines can serve as references for the development of standards in quality measurement. Only little data exists on the implementation strategy of guidelines and evaluation, respectively. A pilot quality management system in consistence with ISO 9001 criteria was developed for ambulatory, gastroenterological services. National guidelines of the German Society of Gastroenterology and Metabolism and the recommendations of the German Association of Physicians for quality assurance of gastrointestinal endoscopy were included in the documentation and internal auditing. This pilot quality management system is suitable for the first steps in the introduction of quality management in ambulatory health care. This system shows validity for accreditation and certification of gastrointestinal health care units as well.

  19. [Certification of an ambulatory gastroenterologic service fulfilling ISO Law 9001--criteria and national guidelines of the Gastroenterologic Association].

    Science.gov (United States)

    Birkner, B

    2000-09-01

    The objectives of certification and accreditation are the deployment and examination of quality improvement measures in health care services. The quality management system of the ISO 9001 is created to install measures and tools leading to assured and improved quality in health care. Only some experiences with certification fulfilling ISO 9001 criteria exist in the German health care system. Evidence-based clinical guidelines can serve as references for the development of standards in quality measurement. Only little data exists on the implementation strategy of guidelines and evaluation, respectively. A pilot quality management system in consistence with ISO 9001 criteria was developed for ambulatory, gastroenterological services. National guidelines of the German Society of Gastroenterology and Metabolism and the recommendations of the German Association of Physicians for quality assurance of gastrointestinal endoscopy were included in the documentation and internal auditing. This pilot quality management system is suitable for the first steps in the introduction of quality management in ambulatory health care. This system shows validity for accreditation and certification of gastrointestinal health care units as well. PMID:11084717

  20. Interim storage study report

    Energy Technology Data Exchange (ETDEWEB)

    Rawlins, J.K.

    1998-02-01

    High-level radioactive waste (HLW) stored at the Idaho Chemical Processing Plant (ICPP) in the form of calcine and liquid and liquid sodium-bearing waste (SBW) will be processed to provide a stable waste form and prepare the waste to be transported to a permanent repository. Because a permanent repository will not be available when the waste is processed, the waste must be stored at ICPP in an Interim Storage Facility (ISF). This report documents consideration of an ISF for each of the waste processing options under consideration.

  1. Interim Design Report

    OpenAIRE

    Abrams, R.; Agarwalla, S.; A. Alekou; Andreopoulos, C.; Ankenbrandt, C.; Antusch, S.; M. Apollonio(19, d); Aslaninejad, M.; J. Back; P. Ballett; Barker, G.; Beard, K.; Benedetto, E; Bennett, J.; Berg, J.

    2011-01-01

    The International Design Study for the Neutrino Factory (the IDS-NF) was established by the community at the ninth "International Workshop on Neutrino Factories, super-beams, and beta- beams" which was held in Okayama in August 2007. The IDS-NF mandate is to deliver the Reference Design Report (RDR) for the facility on the timescale of 2012/13. In addition, the mandate for the study [3] requires an Interim Design Report to be delivered midway through the project as a step on the way to the RD...

  2. Waste Encapsulation and Storage Facility interim operational safety requirements

    CERN Document Server

    Covey, L I

    2000-01-01

    The Interim Operational Safety Requirements (IOSRs) for the Waste Encapsulation and Storage Facility (WESF) define acceptable conditions, safe boundaries, bases thereof, and management or administrative controls required to ensure safe operation during receipt and inspection of cesium and strontium capsules from private irradiators; decontamination of the capsules and equipment; surveillance of the stored capsules; and maintenance activities. Controls required for public safety, significant defense-in-depth, significant worker safety, and for maintaining radiological consequences below risk evaluation guidelines (EGs) are included.

  3. Species management in aquatic habitats WRc RD Interim 1997

    OpenAIRE

    1997-01-01

    This is the Species management in aquatic Habitats WRc Interim 1997 document produced by the Environment Agency in 1997. This document reports progress on R&D Project 640, which aims to provide information on species of conservation value of particular relevance to the Environment Agency, in relation to its activities affecting aquatic environments. A range of stand-alone outputs is being produced, comprising Species Action Plans, practical management guidelines for Agency staff and third par...

  4. Practical Management of HIV-Associated Anemia in Resource-Limited Settings: Prospective Observational Evaluation of a New Mozambican Guideline.

    Science.gov (United States)

    Brentlinger, Paula E; Silva, Wilson P; Vermund, Sten H; Valverde, Emilio; Buene, Manuel; Moon, Troy D

    2016-01-01

    Mozambique's updated guideline for management of HIV-associated anemia prompts clinicians to consider opportunistic conditions, adverse drug reactions, and untreated immunosuppression in addition to iron deficiency, intestinal helminthes, and malaria. We prospectively evaluated this guideline in rural Zambézia Province. Likely cause(s) of anemia were determined through prespecified history, physical examination, and laboratory testing. Diagnoses were "etiologic" if laboratory confirmed (sputum microscopy, blood culture, Plasmodium falciparum malaria rapid test) or "syndromic" if not. To assess hemoglobin response, we used serial point-of-care measurements. We studied 324 ambulatory, anemic (hemoglobin diagnosis was achieved in 79 (24.4%). Of 169 (52.2%) subjects who improved (hemoglobin increase of ≥1 g/dl without indications for hospitalization), only 65 (38.5%) received conventional management (iron supplementation, deworming, and/or antimalarials) alone. Thirty (9.3%) died and/or were hospitalized, and 125 (38.6%) were lost to follow-up. Multivariable linear and logistic regression models described better hemoglobin responses and/or outcomes in subjects with higher CD4(+) T-lymphocyte counts, pre-enrollment antiretroviral therapy and/or co-trimoxazole prophylaxis, discontinuation of zidovudine for suspected adverse reaction, and smear-positive tuberculosis. Adverse outcomes were associated with fever, low body mass index, bacteremia, esophageal candidiasis, and low or missing CD4(+) T cell counts. In this severely resource-limited setting, successful anemia management often required interventions other than conventional presumptive treatment, thus supporting Mozambique's guideline revision. PMID:26178574

  5. Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Fonseca Andrade

    2016-01-01

    Full Text Available Objective to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. Method systematic review on literature based on data from CINAHL(r, Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r, Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. Results studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. Conclusion the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice.

  6. Clinical guidelines for male lower urinary tract symptoms associated with non-neurogenic overactive bladder

    Directory of Open Access Journals (Sweden)

    Chung-Cheng Wang

    2015-03-01

    Full Text Available The purpose of this guideline is to direct urologists and patients regarding how to identify overactive bladder (OAB in male patients with lower urinary tract symptoms (LUTS and to make an accurate diagnosis and establish treatment goals to improve the patients' quality of life (QoL. LUTS are commonly divided into storage, voiding, and postmicturition symptoms, and are highly prevalent in elderly men. LUTS can result from a complex interplay of pathophysiologic features that can include bladder dysfunction and bladder outlet dysfunction such as benign prostatic obstruction (BPO or poor relaxation of the urethral sphincter. Diagnosis of OAB in male LUTS leads to accurate diagnosis of pure OAB and bladder outlet-related OAB, and appropriate treatment in men with residual storage symptoms after treatment for LUTS.

  7. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association task force on practice guidelines

    Science.gov (United States)

    The goals of the American College of Cardiology (ACC) and the American Heart Association (AHA) are to prevent cardiovascular (CV) diseases, improve the management of people who have these diseases through professional education and research, and develop guidelines, standards and policies that promot...

  8. Guidelines from the Canadian Association of Pathologists for establishing a telepathology service for anatomic pathology using whole-slide imaging

    Directory of Open Access Journals (Sweden)

    Chantal Bernard

    2014-01-01

    Full Text Available The use of telepathology for clinical applications in Canada has steadily become more attractive over the last 10 years, driven largely by its potential to provide rapid pathology consulting services throughout the country regardless of the location of a particular institution. Based on this trend, the president of the Canadian Association of Pathologists asked a working group consisting of pathologists, technologists, and healthcare administrators from across Canada to oversee the development of guidelines to provide Canadian pathologists with basic information on how to implement and use this technology. The guidelines were systematically developed, based on available medical literature and the clinical experience of early adopters of telepathology in Canada. While there are many different modalities and applications of telepathology, this document focuses specifically on whole-slide imaging as applied to intraoperative pathology consultation (frozen section, primary diagnosis, expert or second opinions and quality assurance activities. Applications such as hematopathology, microbiology, tumour boards, education, research and technical and/or standard-related issues are not covered.

  9. Guidelines for glycerol use in hyperhydration and rehydration associated with exercise.

    Science.gov (United States)

    van Rosendal, Simon Piet; Osborne, Mark Andrew; Fassett, Robert Gordon; Coombes, Jeff Scott

    2010-02-01

    Dehydration in athletes alters cardiovascular and thermoregulatory function and may inhibit endurance exercise capacity if fluid loss exceeds 2% of bodyweight (BW). If this level of dehydration cannot be prevented when starting from a state of euhydration, then athletes may create a state of hyperhydration by consuming extra fluid prior to exercise. From this hyperhydrated situation, individuals have a greater capacity to tolerate fluid loss before becoming dehydrated. Furthermore, excess pre-exercise fluid intake enhances thermoregulatory ability, as well as increasing plasma volume to maintain cardiac output. However, hyperhydrating before exercise is difficult, because a large fluid intake is typically accompanied by diuresis. Glycerol-containing beverages create an osmotic gradient in the circulation favouring fluid retention, thereby facilitating hyperhydration and protecting against dehydration. Many studies have shown that increases in body water by 1 L or more are achievable through glycerol hyperhydration. This article analyses the evidence for glycerol use in facilitating hyperhydration and rehydration, and provides guidelines for athletes wishing to use this compound. An analysis of the studies in this area indicates that endurance athletes intending to hyperhydrate with glycerol should ingest glycerol 1.2 g/kg BW in 26 mL/kg BW of fluid over a period of 60 minutes, 30 minutes prior to exercise. The effects of glycerol on total body water when used during rehydration are less well defined, due to the limited studies conducted. However, ingesting glycerol 0.125 g/kg BW in a volume equal to 5 mL/kg BW during exercise will delay dehydration, while adding glycerol 1.0 g/kg BW to each 1.5 L of fluid consumed following exercise will accelerate the restoration of plasma volume. Side effects from glycerol ingestion are rare, but include nausea, gastrointestinal discomfort and light-headedness. In summary, glycerol ingestion before, during or following exercise

  10. Harmonization of immunotoxicology study guidelines

    Institute of Scientific and Technical Information of China (English)

    NakaK

    2002-01-01

    Guidance for immunotoxicology studies has been intensively discussed.The European Medicnes Evaluation Agency published the draft guidance on immunotoxicity on December 16,1999 and finalized it on July 27,2000.In the meantime,the US Food and Drug Administration (FDA) published the draft guidance on May 11,2001.The Japanese Ministry of Health,Labor and Welfare and the Japan Pharmaceutical Manufactures Association submitted their interim draft guidance to the International Conference of Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use(ICH) for discussion of Decemeber 20,2001.The approaches are taken in these(draft) guidance documents.A major difference among the guidance of the three regions is that only the EU guidance requires some immune function tests for all new medicinal products.The informal expert working proup meeting held in the ICH on February 7,2002 resched the conchusion that the guidelines should be eventually hamonized after collecting more data.A scientific session on immunotoxicity testing will be included in the ICH6,Osake,November 2003.

  11. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: Executive Summary of recommendations

    DEFF Research Database (Denmark)

    Gharib, H; Papini, E; Paschke, R;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes...

  12. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries

    DEFF Research Database (Denmark)

    Andersson, Lars; Andreasen, Jens O; Day, Peter;

    2012-01-01

    Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature...

  13. Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Pulmonary hypertension associated with hemolytic anemia

    Directory of Open Access Journals (Sweden)

    Sarfraz Saleemi

    2014-01-01

    Because of a unique pathophysiology, pulmonary hypertension associated with hemolytic disorders was moved from WHO group I to group V PH diseases. Treatment strategies are also unique and include blood transfusion, iron chelation, hydroxyurea, and oxygen therapy. The role of PH-specific agents has not been established.

  14. Association for Specialists in Group Work: Best Practice Guidelines 2007 Revisions

    Science.gov (United States)

    Thomas, R. Valorie; Pender, Debra A.

    2008-01-01

    The Association for Specialists in Group Work (ASGW) supports the practice of ethical and effective group work through the publication of guiding principles in planning, performing and processing group work. Originally prepared, approved and published in 1998 (ASGW; Rapin and Keel), the current revision addresses changes in the American Counseling…

  15. Interim Design Report

    CERN Document Server

    Abrams, R J; Alekou, A; Andreopoulos, C; Ankenbrandt, C M; Antusch, S; Apollonio, M; Aslaninejad, M; Back, J; Ballett, P; Barker, G; Beard, K B; Benedetto, E; Bennett, J R J; Berg, J S; Bhattacharya, S; Blackmore, V; Blennow, M; Blondel, A; Bogacz, A; Bonesini, M; Bontoiu, C; Booth, C; Bromberg, C; Brooks, S; Bross, A; Caretta, O; Cervera-Villanueva, A; Choubey, S; Cline, D; Cobb, J; Coloma, P; Coney, L; Cummings, M A C; Davenne, T; de Gouvea, A; Densham, C; Ding, X; Donini, A; Dornan, P; Dracos, M; Dufour, F; Eccleston, R; Edgecock, R; Efthymiopoulos, I; Ellis, M; Fernandez-Martinez, E; Fernow, R; Flanagan, G; Gallardo, J C; Gandhi, R; Garoby, R; Gavela, B; Geer, S; Gilardoni, S; Gomez-Cadenas, J J; Goswami, S; Graves, V B; Gupta, R; Hanson, G; Harrison, P; Hart, T; Hernandez, P; Huber, P; Indumathi, D; Johnson, R P; Johnstone, C; Karadzhov, Y; Kelliher, D; Kirk, H; Kopp, J; Kudenko, Y; Kuno, Y; Kurup, A; Kyberd, P; Laing, A; Li, T; Lindner, M; Long, K; Pavon, J Lopez; Loveridge, P; Machida, S; Majumdar, D; Maltoni, M; Martin-Albo, J; Martini, M; Matev, R; McDonald, K T; McFarland, A; Meloni, D; Mezzetto, M; Migliozzi, P; Mishra, S R; Mokhov, N; Mondal, N; Morfin, J; Mori, Y; Morozov, V; Neuffer, D; Ota, T; Palladino, V; Parke, S; Pascoli, S; Pasternak, J; Peltoniemi, J; Petti, R; Planche, T; Popovic, M; Pozimski, J; Prior, G; Prior, C; Rees, G; Rigolin, S; Roberts, T J; Roblin, Y; Rogers, C; Samulyak, R; Schwetz, T; Simos, N; Sinha, N; Skoro, G; Snopok, P; Soler, F J P; Souchlas, N; Strait, J; Stratakis, D; Striganov, S; Tang, J; Thomason, J W G; Tortora, L; Tsenov, R; Winter, W; Witte, H; Yasuda, O; Yoshikawa, C Y; Zisman, M

    2011-01-01

    The International Design Study for the Neutrino Factory (the IDS-NF) was established by the community at the ninth "International Workshop on Neutrino Factories, super-beams, and beta- beams" which was held in Okayama in August 2007. The IDS-NF mandate is to deliver the Reference Design Report (RDR) for the facility on the timescale of 2012/13. In addition, the mandate for the study [3] requires an Interim Design Report to be delivered midway through the project as a step on the way to the RDR. This document, the IDR, has two functions: it marks the point in the IDS-NF at which the emphasis turns to the engineering studies required to deliver the RDR and it documents baseline concepts for the accelerator complex, the neutrino detectors, and the instrumentation systems. The IDS-NF is, in essence, a site-independent study. Example sites, CERN, FNAL, and RAL, have been identified to allow site-specific issues to be addressed in the cost analysis that will be presented in the RDR. The choice of example sites shou...

  16. A hospital-site controlled intervention using audit and feedback to implement guidelines concerning inappropriate treatment of catheter-associated asymptomatic bacteriuria

    Directory of Open Access Journals (Sweden)

    Hysong Sylvia

    2011-04-01

    Full Text Available Abstract Background Catheter-associated urinary tract infection (CAUTI is one of the most common hospital-acquired infections. However, many cases treated as hospital-acquired CAUTI are actually asymptomatic bacteriuria (ABU. Evidence-based guidelines recommend that providers neither screen for nor treat ABU in most catheterized patients, but there is a significant gap between these guidelines and clinical practice. Our objectives are (1 to evaluate the effectiveness of an audit and feedback intervention for increasing guideline-concordant care concerning catheter-associated ABU and (2 to measure improvements in healthcare providers' knowledge of and attitudes toward the practice guidelines associated with the intervention. Methods/Design The study uses a controlled pre/post design to test an intervention using audit and feedback of healthcare providers to improve their compliance with ABU guidelines. The intervention and the control sites are two VA hospitals. For objective 1 we will review medical records to measure the clinical outcomes of inappropriate screening for and treatment of catheter-associated ABU. For objective 2 we will survey providers' knowledge and attitudes. Three phases of our protocol are proposed: the first 12-month phase will involve observation of the baseline incidence of inappropriate screening for and treatment of ABU at both sites. This surveillance for clinical outcomes will continue at both sites throughout the study. Phase 2 consists of 12 months of individualized audit and feedback at the intervention site and guidelines distribution at both sites. The third phase, also over 12 months, will provide unit-level feedback at the intervention site to assess sustainability. Healthcare providers at the intervention site during phase 2 and at both sites during phase 3 will complete pre/post surveys of awareness and familiarity (knowledge, as well as of acceptance and outcome expectancy (attitudes regarding the relevant

  17. [Antihypertensive therapy in diabetes mellitus: Guidelines of the Austrian Diabetes Association 2016].

    Science.gov (United States)

    Schernthaner, Guntram; Drexel, Heinz; Rosenkranz, Alexander; Schernthaner, Gerit-Holger; Watschinger, Bruno

    2016-04-01

    Blood pressure lowering is one of the most important interventions for reducing the vascular complications and mortality in patients with diabetes mellitus. Recent studies indicate that the optimal blood pressure level might be in the range between 130-140 mmHg systolic and 80‒90 mmHg diastolic. Lower blood pressure levels (e.g. 120/80 mmHg) can further reduce the risk for stroke and diabetic nephropathy, but are associated with increased cardiovascular mortality. In particular, very low blood pressure levels (ACE-inhibitors or Angiotensin-II receptor antagonists should be first line drugs. PMID:27052224

  18. Impact of Homeowner Association (HOA) landscaping guidelines on residential water use

    Science.gov (United States)

    Wentz, Elizabeth A.; Rode, Sandra; Li, Xiaoxiao; Tellman, Elizabeth M.; Turner, B. L., II

    2016-05-01

    The association between increasing water intensive land-cover, such as the use of turf grass and trees, and increasing water use is a growing concern for water-stressed arid cities. Appropriate regulatory measures addressing residential landscaping, such as those applied by Homeowner Associations (HOAs), may serve to reduce municipal water use, joining other water-use reducing measures under consideration by arid cities. This research assesses quantitatively the role that Covenants, Conditions, and Restrictions (CCRs) applied to landscaping by HOAs play on water consumption. Statistical comparisons and models of n=1973 parcels in Goodyear, Arizona, USA, reveal that: HOA yards have less vegetation cover and those households use less peak-season water (July) than those households in non-HOA neighborhoods. This hold true even though the HOA CCRs regulate only the minimum required front-yard vegetation and most residents maintain more than the minimum vegetation level. Furthermore, front-yard landscaping tends to be mimicked in the backyard such that total yard landscaping tracks best with total household water use. Results of the study suggest that HOA landscaping regulations have the potential to reduce peak-season water use by up to 24% if CCRs were to set maximum vegetation regulations rather than minimum and if compliance were enforced. Lowering residential water consumption in this way potentially involves tradeoffs with the cooling effects of vegetation and its consequences on the urban heat island effect, on energy use, and on home values.

  19. Ontario interim market

    International Nuclear Information System (INIS)

    Ontario's White Paper outlined the government's plan to restructure the electric power industry to an open market by the year 2000. Bill 35, when passed, will be the legislation required to start the process of electricity restructuring laid out in the White Paper. In the section dealing with the Independent Market Operator, the White Paper states that the Ontario government, as a transitional step to an open market, will introduce an element of competition into the industry by establishing an interim market for replacement power and impose a discipline on Ontario Hydro. Unfortunately, this transitional step did not live up to its billing and has had a minimal impact on both Ontario Hydro and the marketplace. Nevertheless, the experiment has provided a peek into the future of electricity and power pricing in Ontario, by making price information available and posted on the Internet. This paper examines how informative this experience has been and looks at the year just past in perspective. One of the notable developments was that the threat of a power shortage as a result of shutting down seven of Ontario Hydro's nuclear reactors, did not materialize. Ontario Hydro's fossil fuel generation plants were able to step into the breach and generate enough energy to make up for the reduction in nuclear production, and did so within the allowable limit for acid gas emissions. Some interesting developments in pricing electric power exported to the US in the summer of of 1998 are also reviewed for what they can teach us about the value of transparency and full price disclosure. 2 figs

  20. Permitting plan for the high-level waste interim storage

    International Nuclear Information System (INIS)

    This document addresses the environmental permitting requirements for the transportation and interim storage of solidified high-level waste (HLW) produced during Phase 1 of the Hanford Site privatization effort. Solidified HLW consists of canisters containing vitrified HLW (glass) and containers that hold cesium separated during low-level waste pretreatment. The glass canisters and cesium containers will be transported to the Canister Storage Building (CSB) in a U.S. Department of Energy (DOE)-provided transportation cask via diesel-powered tractor trailer. Tri-Party Agreement (TPA) Milestone M-90 establishes a new major milestone, and associated interim milestones and target dates, governing acquisition and/or modification of facilities necessary for: (1) interim storage of Tank Waste Remediation Systems (TWRS) immobilized HLW (IHLW) and other canistered high-level waste forms; and (2) interim storage and disposal of TWRS immobilized low-activity tank waste (ILAW). An environmental requirements checklist and narrative was developed to identify the permitting path forward for the HLW interim storage (HLWIS) project (See Appendix B). This permitting plan will follow the permitting logic developed in that checklist

  1. Radiation doses for pediatric nuclear medicine studies: comparing the North American consensus guidelines and the pediatric dosage card of the European Association of Nuclear Medicine

    Energy Technology Data Exchange (ETDEWEB)

    Grant, Frederick D.; Drubach, Laura A.; Treves, S. Ted; Fahey, Frederic H. [Boston Children' s Hospital, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Boston, MA (United States); Harvard Medical School, Joint Program in Nuclear Medicine, Department of Radiology, Boston, MA (United States); Gelfand, Michael J. [Cincinnati Children' s Hospital Medical Center, Section of Nuclear Medicine, Department of Radiology, Cincinnati, OH (United States)

    2015-05-01

    Estimated radiation dose is important for assessing and communicating the risks and benefits of pediatric nuclear medicine studies. Radiation dose depends on the radiopharmaceutical, the administered activity, and patient factors such as age and size. Most radiation dose estimates for pediatric nuclear medicine have not been based on administered activities of radiopharmaceuticals recommended by established practice guidelines. The dosage card of the European Association of Nuclear Medicine (EANM) and the North American consensus guidelines each provide recommendations of administered activities of radiopharmaceuticals in children, but there are substantial differences between these two guidelines. For 12 commonly performed pediatric nuclear medicine studies, two established pediatric radiopharmaceutical administration guidelines were used to calculate updated radiation dose estimates and to compare the radiation exposure resulting from the recommendations of each of the guidelines. Estimated radiation doses were calculated for 12 common procedures in pediatric nuclear medicine using administered activities recommended by the dosage card of the EANM (version 1.5.2008) and the 2010 North American consensus guidelines for radiopharmaceutical administered activities in pediatrics. Based on standard models and nominal age-based weights, radiation dose was estimated for typical patients at ages 1, 5, 10 and 15 years and adult. The resulting effective doses were compared, with differences greater than 20% considered significant. Following either the EANM dosage card or the 2010 North American guidelines, the highest effective doses occur with radiopharmaceuticals labeled with fluorine-18 and iodine-123. In 24% of cases, following the North American consensus guidelines would result in a substantially higher radiation dose. The guidelines of the EANM dosage card would lead to a substantially higher radiation dose in 39% of all cases, and in 62% of cases in which patients

  2. HIV-associated wasting in the HAART era: guidelines for assessment, diagnosis, and treatment.

    Science.gov (United States)

    Polsky, B; Kotler, D; Steinhart, C

    2001-08-01

    Wasting (malnutrition) and lipodystrophy are the two major nutritional alterations in human immunodeficiency virus (HIV)-infected individuals. Both wasting and lipodystrophy may involve a decrease in body fat content, while wasting-but not lipodystrophy-also includes the loss of lean body mass. Lipodystrophy has made the identification of wasting increasingly more difficult. The diagnosis of wasting depends on a definition of the condition that takes into account sex and cultural differences, as well as measurements of body cell mass. Patient management involves a concurrent, comprehensive approach designed to restore lost body cell mass and weight. The authors make recommendations for defining, diagnosing, and treating HIV-associated wasting. Specific therapies include testosterone replacement, other anabolic steroids, and recombinant human growth hormone. Other adjunctive measures, such as progressive resistance exercise and cytokine modulation, may also be utilized. Expected outcomes from effective treatment include restored body cell mass, improvement in quality of life, and reduced rates of hospitalization. Future directions for research should address the need for optimal treatment strategies. PMID:11522215

  3. Clarifications, guidelines and questions about the dental bleaching "associated" with orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Alberto Consolaro

    2013-10-01

    Full Text Available With regard to the best moment for carrying out or recommending dental bleaching to orthodontic patients, some explanations and orientations are given in order to answers the following questions: 1 Why orthodontic treatment completion is considered the best opportunity for carrying out the procedure? 2 Why dental bleaching should not be performed immediately before orthodontic treatment? 3 If that would be possible at any special case, what would that be? 4 Why dental bleaching should not be performed during orthodontic treatment? 5 If that would be possible at any special case, what would that be? This article highlights why it is essential to protect both the mucosa and the cervical region, regardless of the moment when dental bleaching is performed, whether associated with orthodontic treatment or not. The "how", "why" and "if" of whether or not it is convenient to perform dental bleaching before orthodontic treatment are still a matter of clinical suggestion, as it is a procedure that is under analysis, empirical knowledge waiting for scientific proof or disproof! Although tooth enamel has adamantine fluid flowing within it, providing a specific metabolism that is peculiar to its own and which could scientifically explain and base the option of carrying out teeth whitening before and during orthodontic treatment, we must still be very careful.

  4. An Interim President Sets the Stage

    Science.gov (United States)

    Guardo, Carol J.

    2006-01-01

    An interim president often plays a crucial role in leading a college or university. In some instances, the interim can address and resolve troublesome issues and thus clear the way for the new president to generate progress. In others, the interim stays the course so that the institution maintains its momentum and seizes strategic opportunities to…

  5. 32 CFR 776.82 - Interim suspension.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Interim suspension. 776.82 Section 776.82... Complaint Processing Procedures § 776.82 Interim suspension. (a) Where the Rules Counsel determines there is... interim suspension, pending completion of a professional responsibility investigation. The...

  6. 22 CFR 127.8 - Interim suspension.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Interim suspension. 127.8 Section 127.8 Foreign... Interim suspension. (a) The Managing Director of the Directorate of Defense Trade Controls or the Director of the Office of Defense Trade Controls Compliance is authorized to order the interim suspension...

  7. Minish Named Interim Head of Admissions at Virginia Tech

    OpenAIRE

    Virginia Tech News

    2004-01-01

    Roberta M.Minish, of Blacksburg, Va., associate dean emeritus of Virginia Tech's former College of Human Sciences and Education, has been named interim director of undergraduate admissions at the university, effective Jan. 19. She fills the position left vacant in December with the resignation of Karen Torgersen.

  8. EMCS Retrofit Analysis - Interim Report

    Energy Technology Data Exchange (ETDEWEB)

    Diamond, R.C.; Salsbury, T.I.; Bell, G.C.; Huang, Y.J.; Sezgen, A.O.; Mazzucchi, R.; Romberger, J.

    1999-03-01

    This report presents the interim results of analyses carried out in the Phillip Burton Federal Building in San Francisco from 1996 to 1998. The building is the site of a major demonstration of the BACnet communication protocol. The energy management and control systems (EMCS) in the building were retrofitted with BACnet compatible controllers in order to integrate certain existing systems on one common network. In this respect, the project has been a success. Interoperability of control equipment from different manufacturers has been demonstrated in a real world environment. Besides demonstrating interoperability, the retrofits carried out in the building were also intended to enhance control strategies and capabilities, and to produce energy savings. This report presents analyses of the energy usage of HVAC systems in the building, control performance, and the reaction of the building operators. The report does not present an evaluation of the performance capabilities of the BACnet protocol. A monitoring system was installed in the building that parallels many of the EMCS sensors and data were archived over a three-year period. The authors defined pre-retrofit and post-retrofit periods and analyzed the corresponding data to establish the changes in building performance resulting from the retrofit activities. The authors also used whole-building energy simulation (DOE-2) as a tool for evaluating the effect of the retrofit changes. The results of the simulation were compared with the monitored data. Changes in operator behavior were assessed qualitatively with questionnaires. The report summarizes the findings of the analyses and makes several recommendations as to how to achieve better performance. They maintain that the full potential of the EMCS and associated systems is not being realized. The reasons for this are discussed along with possible ways of addressing this problem. They also describe a number of new technologies that could benefit systems of the type

  9. Incontinence-associated dermatitis: consensus statements, evidence-based guidelines for prevention and treatment, and current challenges.

    Science.gov (United States)

    Doughty, Dorothy; Junkin, Joan; Kurz, Peter; Selekof, Joan; Gray, Mikel; Fader, Mandy; Bliss, Donna Z; Beeckman, Dimitri; Logan, Susan

    2012-01-01

    In 2010, an international consensus conference was held to review current evidence regarding the pathology, prevention, and management of incontinence-associated dermatitis (IAD). The results of this literature review were published in a previous issue of this Journal. This article summarizes key consensus statements agreed upon by the panelists, evidence-based guidelines for prevention and management of IAD, and a discussion of the major challenges currently faced by clinicians caring for these patients. The panelists concur that IAD is clinically and pathologically distinct from pressure ulcers and intertriginous dermatitis, and that a consistently applied, structured, or defined skin care program is effective for prevention and management of IAD. They also agreed that differential assessment of IAD versus pressure ulceration versus intertriginous dermatitis remains a major challenge. Panel members also concur that evidence is lacking concerning which products and protocols provide the best outcomes for IAD prevention and treatment in individual patients. Issues related to differential assessment, product labeling and utilization, staff education, and cost of care are the primary focus of this article. PMID:22572899

  10. A review of proposed Glen Canyon Dam interim operating criteria

    Energy Technology Data Exchange (ETDEWEB)

    LaGory, K.; Hlohowskyj, I.; Tomasko, D.; Hayse, J.; Durham, L.

    1992-04-01

    Three sets of interim operating criteria for Glen Canyon Dam on the Colorado River have been proposed for the period of November 1991, to the completion of the record of decision for the Glen Canyon Dam environmental impact statement (about 1993). These criteria set specific limits on dam releases, including maximum and minimum flows, up-ramp and down-ramp rates, and maximum daily fluctuation. Under the proposed interim criteria, all of these parameters would be reduced relative to historical operating criteria to protect downstream natural resources, including sediment deposits, threatened and endangered fishes, trout, the aquatic food base, and riparian plant communities. The scientific bases of the three sets of proposed operating criteria are evaluated in the present report:(1) criteria proposed by the Research/Scientific Group, associated with the Glen Canyon Environmental Studies (GCES); (2) criteria proposed state and federal officials charged with managing downstream resources; and (3) test criteria imposed from July 1991, to November 1991. Data from Phase 1 of the GCES and other sources established that the targeted natural resources are affected by dam operations, but the specific interim criteria chosen were not supported by any existing studies. It is unlikely that irreversible changes to any of the resources would occur over the interim period if historical operating criteria remained in place. It is likely that adoption of any of the sets of proposed interim operating criteria would reduce the levels of sediment transport and erosion below Glen Canyon Dam; however, these interim criteria could result in some adverse effects, including the accumulation of debris at tributary mouths, a shift of new high-water-zone vegetation into more flood-prone areas, and further declines in vegetation in the old high water zone.

  11. DQO Summary Report for 105-N/109-N Interim Safe Storage Project Waste Characterization

    International Nuclear Information System (INIS)

    The DQO summary report provides the results of the DQO process completed for waste characterization activities for the 105-N/109-N Reactor Interim Safe Storage Project including decommission, deactivate, decontaminate, and demolish activities for six associated buildings.

  12. DQO Summary Report for 105-N/109-N Interim Safe Storage Project Waste Characterization

    Energy Technology Data Exchange (ETDEWEB)

    T. A. Lee

    2005-09-15

    The DQO summary report provides the results of the DQO process completed for waste characterization activities for the 105-N/109-N Reactor Interim Safe Storage Project including decommission, deactivate, decontaminate, and demolish activities for six associated buildings.

  13. National NIF Diagnostic Program Interim Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    Warner, B

    2002-04-25

    , cost, and schedule. The NIF Director controls the NNDP Interim Management Plan. A Draft Program Execution Plan (PEP) for the National NIF Diagnostics Program has been also been prepared (NIF-0072083, Oct 2001, attached as Attachment 1) that describes the NNDP technical, cost, and schedule baselines, the method by which the NNDP will fund and monitor the work to be done by the participating laboratories; the process for controlling changes; and the associated reporting and review process. This plan is expected to be approved by the relevant stakeholders at the appropriate time; however, since October 2001, the NNDP has been operating according to the processes laid out in the draft PEP. Below is a summary of the most important aspects of the NNDP that are being applied during this interim period before approval of the full PEP.

  14. Final hazard classification and auditable safety analysis for the 105-C Reactor Interim Safe Storage Project

    International Nuclear Information System (INIS)

    This document summarizes the inventories of radioactive and hazardous materials present in the 105-C Reactor Facility and the operations associated with the Interim Safe Storage Project which includes decontamination and demolition and interim safe storage of the remaining facility. This document also establishes a final hazard classification and verifies that appropriate and adequate safety functions and controls are in place to reduce or mitigate the risk associated with those operations

  15. World association for the advancement of veterinary parasitology (WAAVP) guideline for testing the efficacy of ectoparasiticides for fish.

    Science.gov (United States)

    Sommerville, C; Endris, R; Bell, T A; Ogawa, K; Buchmann, K; Sweeney, D

    2016-03-30

    This guideline is intended to assist in the planning and execution of studies designed to assess the efficacy of ectoparasiticides for fish. It is the first ectoparasite-specific guideline to deal with studies set in the aquatic environment and therefore provides details for the maintenance of environmental standards for finfish. Information is included on a range of pre-clinical study designs as well as clinical studies in commercial/production sites, set within a regulatory framework. It provides information on the study animals, their welfare, husbandry and environmental requirements during the study. The most commonly pathogenic ectoparasites are presented with relevant points regarding life history, host challenge and numeric evaluation. Preparation and presentation of both topical and oral test treatments is provided, together with guidance on data collection and analysis. The guideline provides a quality standard or efficacy studies on finfish, which will assist researchers and regulatory authorities worldwide and contribute to the wider objective of harmonisation of procedures.

  16. Big Oaks National Wildlife Refuge : Interim Plans : 2000

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This interim plan for Big Oaks National Wildlife Refuge cover an interim comprehensive conservation plan, a hunting and fishing plan and an interim compatibility...

  17. Burn site groundwater interim measures work plan.

    Energy Technology Data Exchange (ETDEWEB)

    Witt, Jonathan L. (North Wind, Inc., Idaho Falls, ID); Hall, Kevin A. (North Wind, Inc., Idaho Falls, ID)

    2005-05-01

    This Work Plan identifies and outlines interim measures to address nitrate contamination in groundwater at the Burn Site, Sandia National Laboratories/New Mexico. The New Mexico Environment Department has required implementation of interim measures for nitrate-contaminated groundwater at the Burn Site. The purpose of interim measures is to prevent human or environmental exposure to nitrate-contaminated groundwater originating from the Burn Site. This Work Plan details a summary of current information about the Burn Site, interim measures activities for stabilization, and project management responsibilities to accomplish this purpose.

  18. Validation of the MEDFICTS dietary questionnaire: A clinical tool to assess adherence to American Heart Association dietary fat intake guidelines

    Directory of Open Access Journals (Sweden)

    Bindeman Jody

    2003-06-01

    Full Text Available Abstract Background Dietary assessment tools are often too long, difficult to quantify, expensive to process, and largely used for research purposes. A rapid and accurate assessment of dietary fat intake is critically important in clinical decision-making regarding dietary advice for coronary risk reduction. We assessed the validity of the MEDFICTS (MF questionnaire, a brief instrument developed to assess fat intake according to the American Heart Association (AHA dietary "steps". Methods We surveyed 164 active-duty US Army personnel without known coronary artery disease at their intake interview for a primary prevention cardiac intervention trial using the Block food frequency (FFQ and MF questionnaires. Both surveys were completed on the same intake visit and independently scored. Correlations between each tools' assessment of fat intake, the agreement in AHA step categorization of dietary quality with each tool, and the test characteristics of the MF using the FFQ as the gold standard were assessed. Results Subjects consumed a mean of 36.0 ± 13.0% of their total calories as fat, which included saturated fat consumption of 13.0 ± 0.4%. The majority of subjects (125/164; 76.2% had a high fat (worse than AHA Step 1 diet. There were significant correlations between the MF and the FFQ for the intake of total fat (r = 0.52, P 70 [high fat diet] was negligible (kappa statistic = 0.036. The MF was accurate at the extremes of fat intake, but could not reliably identify the 3 AHA dietary classifications. Alternative MF cutpoints of 50 (high fat diet were highly sensitive (96%, but had low specificity (46% for a high fat diet. ROC curve analysis identified that a MF score cutoff of 38 provided optimal sensitivity 75% and specificity 72%, and had modest agreement (kappa = 0.39, P Conclusions The MEDFICTS questionnaire is most suitable as a tool to identify high fat diets, rather than discriminate AHA Step 1 and Step 2 diets. Currently recommended

  19. Guideline of guidelines: thromboprophylaxis for urological surgery.

    Science.gov (United States)

    Violette, Philippe D; Cartwright, Rufus; Briel, Matthias; Tikkinen, Kari A O; Guyatt, Gordon H

    2016-09-01

    Decisions regarding thromboprophylaxis in urologic surgery involve a trade-off between decreased risk of venous thromboembolism (VTE) and increased risk of bleeding. Both patient- and procedure-specific factors are critical in making an informed decision on the use of thromboprophylaxis. Our systematic review of the literature revealed that existing guidelines in urology are limited. Recommendations from national and international guidelines often conflict and are largely based on indirect as opposed to procedure-specific evidence. These issues have likely contributed to large variation in the use of VTE prophylaxis within and between countries. The majority of existing guidelines typically suggest prolonged thromboprophylaxis for high-risk abdominal or pelvic surgery, without clear clarification of what these procedures are, for up to 4 weeks post-discharge. Existing guidance may result in the under-treatment of procedures with low risk of bleeding and the over-treatment of oncological procedures with low risk of VTE. Guidance for patients who are already anticoagulated are not specific to urological procedures but generally involve evaluating patient and surgical risks when deciding on bridging therapy. The European Association of Urology Guidelines Office has commissioned an ad hoc guideline panel that will present a formal thromboprophylaxis guideline for specific urological procedures and patient risk factors. PMID:27037846

  20. BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment.

    Science.gov (United States)

    Cooper, Stephen J; Reynolds, Gavin P; Barnes, Tre; England, E; Haddad, P M; Heald, A; Holt, Rig; Lingford-Hughes, A; Osborn, D; McGowan, O; Patel, M X; Paton, C; Reid, P; Shiers, D; Smith, J

    2016-08-01

    Excess deaths from cardiovascular disease are a major contributor to the significant reduction in life expectancy experienced by people with schizophrenia. Important risk factors in this are smoking, alcohol misuse, excessive weight gain and diabetes. Weight gain also reinforces service users' negative views of themselves and is a factor in poor adherence with treatment. Monitoring of relevant physical health risk factors is frequently inadequate, as is provision of interventions to modify these. These guidelines review issues surrounding monitoring of physical health risk factors and make recommendations about an appropriate approach. Overweight and obesity, partly driven by antipsychotic drug treatment, are important factors contributing to the development of diabetes and cardiovascular disease in people with schizophrenia. There have been clinical trials of many interventions for people experiencing weight gain when taking antipsychotic medications but there is a lack of clear consensus regarding which may be appropriate in usual clinical practice. These guidelines review these trials and make recommendations regarding appropriate interventions. Interventions for smoking and alcohol misuse are reviewed, but more briefly as these are similar to those recommended for the general population. The management of impaired fasting glycaemia and impaired glucose tolerance ('pre-diabetes'), diabetes and other cardiovascular risks, such as dyslipidaemia, are also reviewed with respect to other currently available guidelines.These guidelines were compiled following a consensus meeting of experts involved in various aspects of these problems. They reviewed key areas of evidence and their clinical implications. Wider issues relating to primary care/secondary care interfaces are discussed but cannot be resolved within guidelines such as these.

  1. BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment.

    Science.gov (United States)

    Cooper, Stephen J; Reynolds, Gavin P; Barnes, Tre; England, E; Haddad, P M; Heald, A; Holt, Rig; Lingford-Hughes, A; Osborn, D; McGowan, O; Patel, M X; Paton, C; Reid, P; Shiers, D; Smith, J

    2016-08-01

    Excess deaths from cardiovascular disease are a major contributor to the significant reduction in life expectancy experienced by people with schizophrenia. Important risk factors in this are smoking, alcohol misuse, excessive weight gain and diabetes. Weight gain also reinforces service users' negative views of themselves and is a factor in poor adherence with treatment. Monitoring of relevant physical health risk factors is frequently inadequate, as is provision of interventions to modify these. These guidelines review issues surrounding monitoring of physical health risk factors and make recommendations about an appropriate approach. Overweight and obesity, partly driven by antipsychotic drug treatment, are important factors contributing to the development of diabetes and cardiovascular disease in people with schizophrenia. There have been clinical trials of many interventions for people experiencing weight gain when taking antipsychotic medications but there is a lack of clear consensus regarding which may be appropriate in usual clinical practice. These guidelines review these trials and make recommendations regarding appropriate interventions. Interventions for smoking and alcohol misuse are reviewed, but more briefly as these are similar to those recommended for the general population. The management of impaired fasting glycaemia and impaired glucose tolerance ('pre-diabetes'), diabetes and other cardiovascular risks, such as dyslipidaemia, are also reviewed with respect to other currently available guidelines.These guidelines were compiled following a consensus meeting of experts involved in various aspects of these problems. They reviewed key areas of evidence and their clinical implications. Wider issues relating to primary care/secondary care interfaces are discussed but cannot be resolved within guidelines such as these. PMID:27147592

  2. Implementation of the American College of Cardiology/American Heart Association 2008 Guidelines for the Management of Adults With Congenital Heart Disease.

    Science.gov (United States)

    Goossens, Eva; Fernandes, Susan M; Landzberg, Michael J; Moons, Philip

    2015-08-01

    Although different guidelines on adult congenital heart disease (ACHD) care advocate for lifetime cardiac follow-up, a critical appraisal of the guideline implementation is lacking. We investigated the implementation of the American College of Cardiology/American Heart Association 2008 guidelines for ACHD follow-up by investigating the type of health care professional, care setting, and frequency of outpatient visits in young adults with CHD. Furthermore, correlates for care in line with the recommendations or untraceability were investigated. A cross-sectional observational study was conducted, including 306 patients with CHD who had a documented outpatient visit at pediatric cardiology before age 18 years. In all, 210 patients (68.6%) were in cardiac follow-up; 20 (6.5%) withdrew from follow-up and 76 (24.9%) were untraceable. Overall, 198 patients were followed up in tertiary care, 1/4 (n = 52) of which were seen at a formalized ACHD care program and 3/4 (n = 146) remained at pediatric cardiology. Of those followed in formalized ACHD and pediatric cardiology care, the recommended frequency was implemented in 94.2% and 89%, respectively (p = 0.412). No predictors for the implementation of the guidelines were identified. Risk factors for becoming untraceable were none or lower number of heart surgeries, health insurance issues, and nonwhite ethnicity. In conclusion, a significant number of adults continue to be cared for by pediatric cardiologists, indicating that transfer to adult-oriented care was not standard practice. Frequency of follow-up for most patients was in line with the ACC/AHA 2008 guidelines. A considerable proportion of young adults were untraceable in the system, which makes them vulnerable for discontinuation of care.

  3. PWR secondary water chemistry guidelines: Revision 3

    International Nuclear Information System (INIS)

    An effective, state-of-the art secondary water chemistry control program is essential to maximize the availability and operating life of major PWR components. Furthermore, the costs related to maintaining secondary water chemistry will likely be less than the repair or replacement of steam generators or large turbine rotors, with resulting outages taken into account. The revised PWR secondary water chemistry guidelines in this report represent the latest field and laboratory data on steam generator corrosion phenomena. This document supersedes Interim PWR Secondary Water Chemistry Recommendations for IGA/SCC Control (EPRI report TR-101230) as well as PWR Secondary Water Chemistry Guidelines--Revision 2 (NP-6239)

  4. Interim Hanford Waste Management Technology Plan

    International Nuclear Information System (INIS)

    The Interim Hanford Waste Management Technology Plan (HWMTP) is a companion document to the Interim Hanford Waste Management Plan (HWMP). A reference plan for management and disposal of all existing and certain projected future radioactive Hanford Site Defense Wastes (HSDW) is described and discussed in the HWMP. Implementation of the reference plan requires that various open technical issues be satisfactorily resolved. The principal purpose of the HWMTP is to present detailed descriptions of the technology which must be developed to close each of the technical issues associated with the reference plan identified in the HWMP. If alternative plans are followed, however, technology development efforts including costs and schedules must be changed accordingly. Technical issues addressed in the HWMTP and HWMP are those which relate to disposal of single-shell tank wastes, contaminated soil sites, solid waste burial sites, double-shell tank wastes, encapsulated 137CsCl and 90SrF2, stored and new solid transuranic (TRU) wastes, and miscellaneous wastes such as contaminated sodium metal. Among the high priority issues to be resolved are characterization of various wastes including early determination of the TRU content of future cladding removal wastes; completion of development of vitrification (Hanford Waste Vitrification Plant) and grout technology; control of subsidence in buried waste sites; and development of criteria and standards including performance assessments of systems proposed for disposal of HSDW. Estimates of the technology costs shown in this report are made on the basis that all identified tasks for all issues associated with the reference disposal plan must be performed. Elimination of, consolidation of, or reduction in the scope of individual tasks will, of course, be reflected in corresponding reduction of overall technology costs

  5. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.;

    2010-01-01

    ), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology....

  6. Developing Guidelines for HIV Antibody Testing among Victims of Pediatric Sexual Abuse.

    Science.gov (United States)

    Gellert, George A.; And Others

    1990-01-01

    An interim set of human immunodeficiency virus (HIV) testing guidelines for victims of pediatric sexual abuse (PSA) is proposed. Guidelines are based on responses of 63 practitioners of PSA assessment to 7 hypothetical clinical profiles with 12 testing criteria. (Author/DB)

  7. Electrical safety guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The Electrical Safety Guidelines prescribes the DOE safety standards for DOE field offices or facilities involved in the use of electrical energy. It has been prepared to provide a uniform set of electrical safety standards and guidance for DOE installations in order to affect a reduction or elimination of risks associated with the use of electrical energy. The objectives of these guidelines are to enhance electrical safety awareness and mitigate electrical hazards to employees, the public, and the environment.

  8. Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Pulmonary arterial hypertension associated with connective tissue diseases

    OpenAIRE

    Adel Boueiz; Hassoun, Paul M.

    2014-01-01

    The explosive growth of medical literature on pulmonary hypertension (PH) has led to a steady increase in awareness of this disease within the medical community during the past decade. The recent revision of the classification of PH is presented in in the main guidelines. Group 1 PH or pulmonary arterial hypertension (PAH) is a heterogeneous group and includes PH due to inheritable, drug-induced, and toxin-induced causes and to such underlying systemic causes as connective tissue diseases,...

  9. 45 CFR 1623.6 - Interim funding.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Interim funding. 1623.6 Section 1623.6 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION SUSPENSION PROCEDURES § 1623.6 Interim funding. (a) Pending the completion of suspension proceedings under this...

  10. 24 CFR 35.1330 - Interim controls.

    Science.gov (United States)

    2010-04-01

    ... controls are used for a soil area that is subject to erosion, measures shall be taken to contain the soil... specified in § 35.1320, dust control, and lead-contaminated soil control. As provided by § 35.155, interim... be removed. (f) Soil-lead hazards. (1) Interim control treatments used to control soil-lead......

  11. THESAURUS OF ERIC DESCRIPTORS (INTERIM) JANUARY 1967.

    Science.gov (United States)

    1967

    THE "THESAURUS OF ERIC DESCRIPTORS (INTERIM)" SUPERSEDES, AND REPRESENTS A REFINEMENT OF, THE "THESAURUS OF ERIC DESCRIPTORS." THE INTERIM ISSUE IS A PRELIMINARY ERIC SYSTEM TOOL AND IS NOT TO BE CONSIDERED A COMPLETE REPRESENTATION OF THE FINAL PRODUCT. THIS REFINEMENT IS THE RESULT OF TWO MAJOR PROJECTS--(1) THE INCORPORATION OF SUGGESTIONS…

  12. 15 CFR 904.322 - Interim action.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Interim action. 904.322 Section 904... Sanctions and Denials Permit Sanction for Violations § 904.322 Interim action. (a) To protect marine resources during the pendency of an action under this subpart, in cases of willfulness, or as...

  13. Fusion Breeder Program interim report

    International Nuclear Information System (INIS)

    This interim report for the FY82 Fusion Breeder Program covers work performed during the scoping phase of the study, December, 1981-February 1982. The goals for the FY82 study are the identification and development of a reference blanket concept using the fission suppression concept and the definition of a development plan to further the fusion breeder application. The context of the study is the tandem mirror reactor, but emphasis is placed upon blanket engineering. A tokamak driver and blanket concept will be selected and studied in more detail during FY83

  14. Periviable birth: Interim update.

    Science.gov (United States)

    Ecker, Jeffrey L; Kaimal, Anjali; Mercer, Brian M; Blackwell, Sean C; deRegnier, Raye Ann O; Farrell, Ruth M; Grobman, William A; Resnik, Jamie L; Sciscione, Anthony C

    2016-08-01

    Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth. These include, but are not limited to, nonmodifiable factors (eg, fetal sex, weight, plurality), potentially modifiable antepartum and intrapartum factors (eg, location of delivery, intent to intervene by cesarean delivery or induction for delivery, administration of antenatal corticosteroids and magnesium sulfate), and postnatal management (eg, starting or withholding and continuing or withdrawing intensive care after birth). Antepartum and intrapartum management options vary depending upon the specific circumstances but may include short-term tocolytic therapy for preterm labor to allow time for administration of antenatal steroids, antibiotics to prolong latency after preterm premature rupture of membranes or for intrapartum group B streptococci prophylaxis, and delivery, including cesarean delivery, for concern regarding fetal well-being or fetal malpresentation. Whenever possible, periviable births for which maternal or neonatal intervention is planned should occur in centers that offer expertise in maternal and neonatal care and the needed infrastructure, including intensive care units, to support such services. This document describes newborn outcomes after periviable birth, provides current evidence and recommendations regarding interventions in this setting, and provides an outline for family counseling with the goal of

  15. AGR-1 Data Qualification Interim Report

    Energy Technology Data Exchange (ETDEWEB)

    Machael Abbott

    2009-08-01

    Projects for the very-high-temperature reactor (VHTR) program provide data in support of Nuclear Regulatory Commission licensing of the VHTR. Fuel and materials to be used in the reactor are tested and characterized to quantify performance in high temperature and high fluence environments. The VHTR Program has established the NGNP Data Management and Analysis System (NDMAS) to ensure that VHTR data are (1) qualified for use, (2) stored in a readily accessible electronic form, and (3) analyzed to extract useful results. This document focuses on the first NDMAS objective. It describes the data streams associated with the first Advanced Gas Reactor (AGR-1) experiment, the processing of these data within NDMAS, and reports the interim FY09 qualification status of the AGR-1 data to date. Data qualification activities within NDMAS for specific types of data are determined by the data qualification category, which is assigned by the data generator, and include: (1) capture testing, to confirm that the data stored within NDMAS are identical to the raw data supplied, (2) accuracy testing, to confirm that the data are an accurate representation of the system or object being measured, and (3) documentation that the data were collected under an NQA-1 or equivalent QA program. The interim qualification status of the following four data streams is reported in this document: (1) fuel fabrication data, (2) fuel irradiation data, (3) fission product monitoring system (FPMS) data, and (4) Advanced Test Reactor (ATR) operating conditions data. A final report giving the NDMAS qualification status of all AGR-1 data (including cycle 145A) is planned for February 2010.

  16. Solid waste burial grounds interim safety analysis

    Energy Technology Data Exchange (ETDEWEB)

    Saito, G.H.

    1994-10-01

    This Interim Safety Analysis document supports the authorization basis for the interim operation and restrictions on interim operations for the near-surface land disposal of solid waste in the Solid Waste Burial Grounds. The Solid Waste Burial Grounds Interim Safety Basis supports the upgrade progress for the safety analysis report and the technical safety requirements for the operations in the Solid Waste Burial Grounds. Accident safety analysis scenarios have been analyzed based on the significant events identified in the preliminary hazards analysis. The interim safety analysis provides an evaluation of the operations in the Solid Waste Burial Grounds to determine if the radiological and hazardous material exposures will be acceptable from an overall health and safety standpoint to the worker, the onsite personnel, the public, and the environment.

  17. Solid waste burial grounds interim safety analysis

    International Nuclear Information System (INIS)

    This Interim Safety Analysis document supports the authorization basis for the interim operation and restrictions on interim operations for the near-surface land disposal of solid waste in the Solid Waste Burial Grounds. The Solid Waste Burial Grounds Interim Safety Basis supports the upgrade progress for the safety analysis report and the technical safety requirements for the operations in the Solid Waste Burial Grounds. Accident safety analysis scenarios have been analyzed based on the significant events identified in the preliminary hazards analysis. The interim safety analysis provides an evaluation of the operations in the Solid Waste Burial Grounds to determine if the radiological and hazardous material exposures will be acceptable from an overall health and safety standpoint to the worker, the onsite personnel, the public, and the environment

  18. German Guidelines.

    Science.gov (United States)

    Kruis, Wolfgang; Nguyen, Gia P; Leifeld, Ludger

    2016-10-01

    Because of its frequency, diverticular disease is a burden on health care systems. Only few formal guidelines covering all aspects of the disease exist. Here, some selected statements from the German guidelines are given. The guidelines include significant recommendations for the diagnosis and management of diverticular disease. Both diagnosis and management depend definitely on clear definitions of the situation of an individual patient. Therefore, a new classification is proposed that is based on earlier suggestions. An internationally established classification would not only enable better patient care but could also lead to studies with comparable results.

  19. 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.

  20. OSART guidelines

    International Nuclear Information System (INIS)

    The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the operational safety of nuclear power plants. These OSART Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Specific guidelines are provided as guide for the systematic review in the following areas important to operational safety: management, organization and administration, training and qualification, operations, maintenance, technical support, radiation protection, chemistry, emergency planning and preparedness

  1. Author Guidelines

    OpenAIRE

    Chief Editor

    2015-01-01

    Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts). Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s).SectionsEditorial:On issues of current public health needA...

  2. Rosiglitazone evaluated for cardiovascular outcomes--an interim analysis

    DEFF Research Database (Denmark)

    Home, Philip D; Pocock, Stuart J; Beck-Nielsen, Henning;

    2007-01-01

    group). The primary end point was hospitalization or death from cardiovascular causes. RESULTS: Because the mean follow-up was only 3.75 years, our interim analysis had limited statistical power to detect treatment differences. A total of 217 patients in the rosiglitazone group and 202 patients......BACKGROUND: A recent meta-analysis raised concern regarding an increased risk of myocardial infarction and death from cardiovascular causes associated with rosiglitazone treatment of type 2 diabetes. METHODS: We conducted an unplanned interim analysis of a randomized, multicenter, open...... in the control group had the adjudicated primary end point (hazard ratio, 1.08; 95% confidence interval [CI], 0.89 to 1.31). After the inclusion of end points pending adjudication, the hazard ratio was 1.11 (95% CI, 0.93 to 1.32). There were no statistically significant differences between the rosiglitazone...

  3. 2016 Laboratory guidelines for postvasectomy semen analysis: Association of Biomedical Andrologists, the British Andrology Society and the British Association of Urological Surgeons.

    Science.gov (United States)

    Hancock, P; Woodward, B J; Muneer, A; Kirkman-Brown, J C

    2016-07-01

    Post-vasectomy semen analysis (PVSA) is the procedure used to establish whether sperm are present in the semen following a vasectomy. PVSA is presently carried out by a wide variety of individuals, ranging from doctors and nurses in general practitioner (GP) surgeries to specialist scientists in andrology laboratories, with highly variable results.Key recommendations are that: (1) PVSA should take place a minimum of 12 weeks after surgery and after a minimum of 20 ejaculations. (2) Laboratories should routinely examine samples within 4 h of production if assessing for the presence of sperm. If non-motile sperm are observed, further samples must be examined within 1 h of production. (3) Assessment of a single sample is acceptable to confirm vasectomy success if all recommendations and laboratory methodology are met and no sperm are observed. Clearance can then be given. (4) The level for special clearance should be methods contained within these guidelines. Surgeons are responsible both preoperatively and postoperatively for the counselling of patients and their partners regarding complications and the possibility of late recanalisation after clearance. These 2016 guidelines replace the 2002 British Andrology Society (BAS) laboratory guidelines and should be regarded as definitive for the UK in the provision of a quality PVSA service, accredited to ISO 15189:2012, as overseen by the United Kingdom Accreditation Service (UKAS). PMID:27083211

  4. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.

    Science.gov (United States)

    Alberti, K G M M; Eckel, Robert H; Grundy, Scott M; Zimmet, Paul Z; Cleeman, James I; Donato, Karen A; Fruchart, Jean-Charles; James, W Philip T; Loria, Catherine M; Smith, Sidney C

    2009-10-20

    A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and central obesity. Various diagnostic criteria have been proposed by different organizations over the past decade. Most recently, these have come from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. The main difference concerns the measure for central obesity, with this being an obligatory component in the International Diabetes Federation definition, lower than in the American Heart Association/National Heart, Lung, and Blood Institute criteria, and ethnic specific. The present article represents the outcome of a meeting between several major organizations in an attempt to unify criteria. It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool. Three abnormal findings out of 5 would qualify a person for the metabolic syndrome. A single set of cut points would be used for all components except waist circumference, for which further work is required. In the interim, national or regional cut points for waist circumference can be used. PMID:19805654

  5. The 2013 American College of Cardiology/American Heart Association guidelines for the treatment of dyslipidemia: mind the gaps!

    Science.gov (United States)

    Athyros, Vasilios G; Katsiki, Niki; Karagiannis, Asterios; Mikhailidis, Dimitri P

    2014-09-01

    Abstract The ACC/AHA lipid guidelines need to be reconsidered before full implementation. A new cardiovascular disease (CVD) risk estimation, preferably based in interventional multiethnic studies, will be ideal. Specific LDL-C targets may also be necessary because there are data pointing out that they are useful and pragmatic. The risk/benefit ratio should be a key issue because medicine is all about this concept (Hippocrates 460 - c. 370 BC: "first do not harm"; and then in the Hippocratic Oath: "I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous"). PMID:24827374

  6. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American College of Cardiology/American Heart Association task force on practice guidelines

    Science.gov (United States)

    This guideline is based on the Full Panel Report which is provided as a data supplement to the guideline. The Full Panel Report contains background and additional material related to content, methodology, evidence synthesis, rationale and references and is supported by the NHLBI Systematic Evidence ...

  7. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-10-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education.To be considered for publication, the article should be presented in the following system:First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page.Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion.Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION1.1      Subheading of the Content 1.1.1   Subheading of the Content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table.For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure.The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press.Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www

  8. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-09-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education.To be considered for publication, the article should be presented in the following system:First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page.Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion.Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION1.1      Subheading of the content 1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table.For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure.The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press.Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www

  9. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the content 1.1.1 Subheading of the content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Back Matter| 79 80 | STUDIES IN ENGLISH LANGUAGE AND EDUCATION, Volume 1, Number 1, March 2014 Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v

  10. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2016-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second p age and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the Content 1.1.1 Subheading of the Content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www.teachingenglish.org

  11. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education.To be considered for publication, the article should be presented in the following system:First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page.Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion.Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION1.1      Subheading of the content 1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table.For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure.The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press.Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www

  12. Russian River Interim Action Management Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — An interim action plan is presented to guide the 1979 management of the Kenai National Moose Range's portion of the lower Russian River and its confluence with the...

  13. Interim and End States, Sellafield, United Kingdom

    International Nuclear Information System (INIS)

    The Sellafield PFSP is an uncovered external pond, currently in the pre-decommissioning waste retrieval phase. Further consideration is now being given to the next phases of decommissioning, including defining interim states and the end state for the facility

  14. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.;

    2010-01-01

    Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this...... evidence- and consensus-based set of guideline is to provide non-anesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE), the...... European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline....

  15. CANDU spent fuel dry storage interim technique

    International Nuclear Information System (INIS)

    CANDU heavy water reactor is developed by Atomic Energy of Canada (AECL) it has 40 years of design life. During operation, the reactor can discharge a lot of spent fuels by using natural uranium. The spent fuel interim storage should be considered because the spent fuel bay storage capacity is limited with 6 years inventory. Spent fuel wet interim storage technique was adopted by AECL before 1970s, but it is diseconomy and produced extra radiation waste. So based on CANDU smaller fuel bundle dimension, lighter weight, lower burn-up and no-critical risk, AECL developed spent fuel dry interim storage technique which was applied in many CANDU reactors. Spent fuel dry interim storage facility should be designed base on critical accident prevention, decay heat removal, radiation protection and fissionable material containment. According to this introduction, analysis spent fuel dry interim storage facility and equipment design feature, it can be concluded that spent fuel dry interim storage could be met with the design requirement. (author)

  16. Experience collecting interim data on mortality: an example from the RALES study

    Directory of Open Access Journals (Sweden)

    Kulbertus Henri

    2001-02-01

    Full Text Available Abstract Introduction The Randomized Aldactone Evaluation Study (RALES randomized 822 patients to receive 25 mg spironolactone daily and 841 to receive placebo. The primary endpoint was death from all causes. Randomization began on March 24, 1995; recruitment was completed on December 31, 1996; follow-up was scheduled to continue through December 31, 1999. Evidence of a sizeable benefit on mortality emerged early in the RALES. The RALES data safety monitoring board (DSMB, which met semiannually throughout the trial, used a prespecified statistical guideline to recommend stopping for efficacy. At the DSMB's request, its meetings were preceded by an 'endpoint sweep', that is, a census of all participants to confirm their vital status. Methods We used computer simulation to evaluate the effect of the sweeps. Results The sweeps led to an estimated 5 to 8% increase in the number of reported deaths at the fourth and fifth interim analyses. The data crossed the statistical boundary at the fifth interim analysis. If investigators had reported all deaths within the protocol-required 24-h window, the DSMB might have recommended stopping after the fourth interim analysis. Discussion Although endpoint sweeps can cause practical problems at the clinical centers, sweeps are very useful if the intervals between patient visits or contact are long or if endpoints require adjudication by committee, reading center, or central laboratory. Conclusion We recommend that trials with interim analyses institute active reporting of the primary endpoints and endpoint sweeps.

  17. Guideline on anterior cruciate ligament injury

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan); M.T. Poldervaart (Michelle T.); R.L. Diercks (Ron L.); A.W.F.M. Fievez (Alex W.F.M.); T.W. Patt (Thomas W.); C.P. van der Hart (Cor P.); E.R. Hammacher (Eric); F. van der Meer (Fred); E.A. Goedhart (Edwin A.); A.F. Lenssen (Anton F); S.B. Muller-Ploeger (Sabrina B); M.A. Pols (Margreet); D.B.F. Saris (Daniel)

    2012-01-01

    textabstractThe Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulate

  18. Curricular Guidelines for Endodontics.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

    Guidelines developed by the Section on Endodontics of the American Association of Dental Schools for use by educational institutions as curriculum development aids are provided. Endodontics is that branch of dentistry dealing with diagnosis and treatment of oral conditions that arise as a result of pathoses of dental pulp. (MLW)

  19. Record Keeping Guidelines

    Science.gov (United States)

    American Psychologist, 2007

    2007-01-01

    These guidelines are designed to educate psychologists and provide a framework for making decisions regarding professional record keeping. State and federal laws, as well as the American Psychological Association's "Ethical Principles of Psychologists and Code of Conduct," generally require maintenance of appropriate records of psychological…

  20. Methods Data Qualification Interim Report

    Energy Technology Data Exchange (ETDEWEB)

    R. Sam Alessi; Tami Grimmett; Leng Vang; Dave McGrath

    2010-09-01

    The overall goal of the Next Generation Nuclear Plant (NGNP) Data Management and Analysis System (NDMAS) is to maintain data provenance for all NGNP data including the Methods component of NGNP data. Multiple means are available to access data stored in NDMAS. A web portal environment allows users to access data, view the results of qualification tests and view graphs and charts of various attributes of the data. NDMAS also has methods for the management of the data output from VHTR simulation models and data generated from experiments designed to verify and validate the simulation codes. These simulation models represent the outcome of mathematical representation of VHTR components and systems. The methods data management approaches described herein will handle data that arise from experiment, simulation, and external sources for the main purpose of facilitating parameter estimation and model verification and validation (V&V). A model integration environment entitled ModelCenter is used to automate the storing of data from simulation model runs to the NDMAS repository. This approach does not adversely change the why computational scientists conduct their work. The method is to be used mainly to store the results of model runs that need to be preserved for auditing purposes or for display to the NDMAS web portal. This interim report demonstrates the currently development of NDMAS for Methods data and discusses data and its qualification that is currently part of NDMAS.

  1. Interim Hanford Waste Management Plan

    International Nuclear Information System (INIS)

    The September 1985 Interim Hanford Waste Management Plan (HWMP) is the third revision of this document. In the future, the HWMP will be updated on an annual basis or as major changes in disposal planning at Hanford Site require. The most significant changes in the program since the last release of this document in December 1984 include: (1) Based on studies done in support of the Hanford Defense Waste Environmental Impact Statement (HDW-EIS), the size of the protective barriers covering contaminated soil sites, solid waste burial sites, and single-shell tanks has been increased to provide a barrier that extends 30 m beyond the waste zone. (2) As a result of extensive laboratory development and plant testing, removal of transuranic (TRU) elements from PUREX cladding removal waste (CRW) has been initiated in PUREX. (3) The level of capital support in years beyond those for which specific budget projections have been prepared (i.e., fiscal year 1992 and later) has been increased to maintain Hanford Site capability to support potential future missions, such as the extension of N Reactor/PUREX operations. The costs for disposal of Hanford Site defense wastes are identified in four major areas in the HWMP: waste storage and surveillance, technology development, disposal operations, and capital expenditures

  2. [Diagnosis and treatment of gastroesophageal reflux disease in the mentally retarded: guidelines of a multidisciplinary consensus work group. Dutch Association of Physicians in Care of Mentally Handicapped].

    Science.gov (United States)

    Gimbel, H

    2000-06-10

    Gastroesophageal reflux disease (GORD) is more frequent among people with intellectual disability than among the intellectually normal population. Also GORD is more serious in this population. The diagnosis is often missed, because most intellectually disabled cannot express their complaints of GORD. For that reason a multidisciplinary working group of the Dutch Association of physicians active in the care of persons with a mental handicap has developed guidelines. The working group recommends endoscopy in case of a (alarm) symptoms: haematemesis, prolonged vomiting, irondeficiency anaemia e.c.i., and a 24 hour oesophageal pH test in case of b (aspecific) symptoms: recurrent pneumonia, refusal of food, regurgitation, rumination, dental erosions. In general most patients are cured with drug treatment (omeprazol or another proton pump inhibitor). If symptoms are not improved after 6 months of optimal treatment, surgical treatment may be considered. PMID:10876695

  3. Technical guidelines for head and neck cancer IMRT on behalf of the Italian association of radiation oncology - head and neck working group

    International Nuclear Information System (INIS)

    Performing intensity-modulated radiotherapy (IMRT) on head and neck cancer patients (HNCPs) requires robust training and experience. Thus, in 2011, the Head and Neck Cancer Working Group (HNCWG) of the Italian Association of Radiation Oncology (AIRO) organized a study group with the aim to run a literature review to outline clinical practice recommendations, to suggest technical solutions and to advise target volumes and doses selection for head and neck cancer IMRT. The main purpose was therefore to standardize the technical approach of radiation oncologists in this context. The following paper describes the results of this working group. Volumes, techniques/strategies and dosage were summarized for each head-and-neck site and subsite according to international guidelines or after reaching a consensus in case of weak literature evidence

  4. Problem drinking and exceeding guidelines for 'sensible' alcohol consumption in Scottish men: associations with life course socioeconomic disadvantage in a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Benzeval Michaela

    2008-09-01

    Full Text Available Abstract Background With surveys suggesting that exceeding guidelines for 'sensible' alcohol intake is commonplace, the health and social impact of modifying intake on a population level is potentially considerable. If public health interventions are to be successfully implemented, it is first important to identify correlates of such behaviours, including socioeconomic disadvantage. This was the aim of the present study. Methods Population-representative cohort study of 576 men from the West of Scotland. Data on life course socioeconomic position were collected in 1988 (at around 55 years of age. Alcohol consumption patterns (detailed seven day recall and problem drinking (CAGE questionnaire were ascertained in 1990/2 (at around 59 years of age. A relative index of inequality was computed to explore the comparative strength of different indicators of social circumstances from different periods of the life course. Results Socioeconomic adversity in both early life and in adulthood was related to an increased risk of exceeding the weekly and daily alcohol guidelines, with adult indicators of socioeconomic position revealing the strongest associations. Of these, material indicators of socioeconomic deprivation in adulthood – car ownership, housing tenure – were marginally more strongly related to heavy alcohol intake and problem drinking than education, income and occupational social class. A substantial proportion of the influence of early life deprivation on alcohol intake was mediated via adult socioeconomic position. Similar results were apparent when problem drinking was the outcome of interest. Conclusion In men in this cohort, exposure to disadvantaged social circumstances across the lifecourse, but particularly in adulthood, is associated with detrimental patterns of alcohol consumption and problem drinking in late middle age.

  5. Dietary guidelines

    DEFF Research Database (Denmark)

    Jelsøe, Erling

    2015-01-01

    in a number of countries have addressed the issue of making dietary guidelines that integrate health and sustainability, but in all cases they have been met with different kinds of resistance. This article reviews the development towards an integrated understanding of health and sustainability in...... relation to food and eating and the emergence of proposals for integrated guidelines. It explores the conflicts and controversies that have arisen in the wake of the various proposals and identifies a number of different types of conflicts. These relate to conflicts of interests between the various actors...... involved and political resistance against initiatives that are perceived as being in conflict with the values of a market economy and free trade. Furthermore, there are controversies that can be broadly characterised as relating to the politics of knowledge and have to do with the differentiation of...

  6. Methodological guidelines

    International Nuclear Information System (INIS)

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

  7. Dietary guidelines

    DEFF Research Database (Denmark)

    Jelsøe, Erling

    2015-01-01

    in a number of countries have addressed the issue of making dietary guidelines that integrate health and sustainability, but in all cases they have been met with different kinds of resistance. This article reviews the development towards an integrated understanding of health and sustainability in relation...... to food and eating and the emergence of proposals for integrated guidelines. It explores the conflicts and controversies that have arisen in the wake of the various proposals and identifies a number of different types of conflicts. These relate to conflicts of interests between the various actors involved...... and political resistance against initiatives that are perceived as being in conflict with the values of a market economy and free trade. Furthermore, there are controversies that can be broadly characterised as relating to the politics of knowledge and have to do with the differentiation of expertise...

  8. Methodological guidelines

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-04-01

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

  9. AUTHOR GUIDELINES

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2014-12-01

    Full Text Available AUTHOR GUIDELINESIndian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/loginOnline SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.SectionsEditorial:On issues of current public health needAbout 1000 – 1200 wordsReferences: 5 – 10 (PubMed - Citation preferredInvited Commentary:Brief, provocative, opinionated communicationsOn issues of current public health needMain Text: 750-1000 words excluding referencesReferences: 5 – 10 (PubMed - Citation preferredOriginal Article:Articles from Original ResearchStructured abstract: 250 wordsMain Text: 2500 - 3000 words, IMRD formatKey Words: 5 - 8References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4*Certificate of clearance from respective Institutional Ethical Committee (IECReview Article:On subject of public health relevanceAbstract: 250 wordsMain Text: 2500 - 3000 wordsKey Words: 3 - 4References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4Short Communication / Article:Short report of a research project / outbreakMain Text : 1000 – 1200 wordsReferences: 10 – 15 (PubMed - Citation preferredTable / Figure: 01*Certificate of clearance from respective Institutional Ethical Committee (IECReport from the field

  10. ASCOT guidelines

    International Nuclear Information System (INIS)

    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

  11. Author guidelines

    OpenAIRE

    Chief Editor

    2014-01-01

    AUTHOR GUIDELINESIndian Journal of Community Health (IJCH) accepts only online submission of manuscript(s) by using Open Journal software (OJS) at http://www.iapsmupuk.org/journal/index.php/IJCH/loginOnline SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH)? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly ad...

  12. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.;

    2010-01-01

    Propofol sedation by non-anaesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this...... evidence- and consensus-based set of guideline is to provide non-anaesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE), the...... European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology....

  13. Knowledge of Pediatric Critical Care Nurses Regarding Evidence Based Guidelines for Prevention of Ventilator Associated Pneumonia (VAP)

    Science.gov (United States)

    Ahmed, Gehan EL Nabawy; Abosamra, Omyma Mostafa

    2015-01-01

    Ventilator associated pneumonia (VAP) is a costly, preventable, and often fatal consequence of medical therapy that increases hospital and intensive care stays in mechanically ventilated patients. The prevention of VAP is primarily the responsibility of the bedside nurse whose knowledge, beliefs, and practices influence the health outcome of ICU…

  14. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2015-12-01

    Full Text Available Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.  http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionPAGE CONTENTSGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic-only material should be submitted and sent for peer review simultaneously with the primary manuscript.2. Reporting GuidelinesReporting guidelines have been developed for different study designs; examples include CONSORT for randomized trials, STROBE for observational studies, PRISMA for systematic reviews and meta-analyses, and STARD for studies of diagnostic accuracy. Journals are encouraged to ask authors to follow these guidelines because

  15. Hanford low-level tank waste interim performance assessment

    Energy Technology Data Exchange (ETDEWEB)

    Mann, F.M.

    1996-09-16

    The Hanford Low-Level Tank Waste Interim Performance Assessment examines the long-term environmental and human health effects associated with the disposal of the low-level fraction of the Hanford single- and double-shell tank waste in the Hanford Site 200 East Area. This report was prepared as a good management practice to provide needed information about the relationship between the disposal system design and its performance as early as possible in the project cycle. The calculations in this performance assessment show that the disposal of the low-level fraction can meet environmental and health performance objectives.

  16. Hanford low-level tank waste interim performance assessment

    Energy Technology Data Exchange (ETDEWEB)

    Mann, F.M.

    1997-09-12

    The Hanford Low-Level Tank Waste Interim Performance Assessment examines the long-term environmental and human health effects associated with the disposal of the low-level fraction of the Hanford single and double-shell tank waste in the Hanford Site 200 East Area. This report was prepared as a good management practice to provide needed information about the relationship between the disposal system design and performance early in the disposal system project cycle. The calculations in this performance assessment show that the disposal of the low-level fraction can meet environmental and health performance objectives.

  17. Hanford low-level tank waste interim performance assessment

    International Nuclear Information System (INIS)

    The Hanford Low-Level Tank Waste Interim Performance Assessment examines the long-term environmental and human health effects associated with the disposal of the low-level fraction of the Hanford single and double-shell tank waste in the Hanford Site 200 East Area. This report was prepared as a good management practice to provide needed information about the relationship between the disposal system design and performance early in the disposal system project cycle. The calculations in this performance assessment show that the disposal of the low-level fraction can meet environmental and health performance objectives

  18. Guidelines for direct radionuclide cystography

    International Nuclear Information System (INIS)

    These ''Empfehlungen'' are the german translation of the Guidelines on MIBG-Scintigraphy in Children, which were published by the Paediatric Committee of the European Association of Nuclear Medicine. (orig.)

  19. Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Pulmonary arterial hypertension associated with congenital heart disease

    Directory of Open Access Journals (Sweden)

    Antonio Lopes

    2014-01-01

    Full Text Available Congenital heart disease (CHD with intracardiac/extracardiac shunts is an important etiology of pulmonary arterial hypertension (PAH. The majority of children with congenital cardiac shunts do not develop advanced pulmonary vasculopathy, as surgical repair of the anomalies is now performed early in life. However, if not repaired early, some defects will inevitably lead to pulmonary vascular disease (truncus arteriosus, transposition of the great arteries associated with a ventricular septal defect (VSD, atrioventricular septal defects remarkably in Down syndrome, large, nonrestrictive VSDs, patent ductus arteriosus and related anomalies. The majority of patients are now assigned to surgery based on noninvasive evaluation only. PAH becomes a concern (requiring advanced diagnostic procedures in about 2-10% of them. In adults with CHD, the prevalence of advanced pulmonary vasculopathy (Eisenmenger syndrome is around 4-12%. [1] This article will discuss the diagnostic and management approach for PAH associated with CHD (PAH-CHD.

  20. Interim Storage of Spent Nuclear Fuel before Final Disposal in Germany - Regulator's view

    International Nuclear Information System (INIS)

    For spent nuclear fuel management in Germany the concept of dry interim storage in dual purpose casks before direct disposal is applied. The Federal Office for Radiation Protection (BfS) is the competent authority for licensing of interim storage facilities. The competent authority for surveillance of operation is the responsible authority of the respective federal state (Land). Currently operation licenses for storage facilities have been granted for a storage time of 40 years and are based on safety demonstrations for all safety issues as safe enclosure, shielding, sub-criticality and decay heat removal under consideration of operation conditions. In addition, transportability of the casks for the whole storage period has to be provided. Due to current delay in site selection and exploration of a disposal site, an extension of the storage time beyond 40 years could be needed. This will cause appropriate actions by the licensee and the competent authorities as well. A brief description of the regulatory base of licensing and surveillance of interim storage is given from the regulators view. Furthermore the current planning for final disposal of spent nuclear fuel and high level waste and its interconnections between storage and disposal concepts are shortly explained. Finally the relevant aspects for licensing of extended storage time beyond 40 years will be discussed. Current activities on this issue, which have been initiated by the Federal Government, will be addressed. On the regulatory side a review and amendment of the safety guideline for interim storage of spent fuel has been performed and the procedure of periodic safety review is being implemented. A guideline for implementing an ageing management programme is available in a draft version. Regarding safety of long term storage a study focussing on the identification and evaluation of long term effects as well as gaps of knowledge has been finished in 2010. A continuation and update is currently underway

  1. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum.

    Science.gov (United States)

    Gloviczki, Peter; Comerota, Anthony J; Dalsing, Michael C; Eklof, Bo G; Gillespie, David L; Gloviczki, Monika L; Lohr, Joann M; McLafferty, Robert B; Meissner, Mark H; Murad, M Hassan; Padberg, Frank T; Pappas, Peter J; Passman, Marc A; Raffetto, Joseph D; Vasquez, Michael A; Wakefield, Thomas W

    2011-05-01

    The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis. The document also includes recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases (CVDs), including edema, skin changes, or venous ulcers. Recommendations of the Venous Guideline Committee are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system as strong (GRADE 1) if the benefits clearly outweigh the risks, burden, and costs. The suggestions are weak (GRADE 2) if the benefits are closely balanced with risks and burden. The level of available evidence to support the evaluation or treatment can be of high (A), medium (B), or low or very low (C) quality. The key recommendations of these guidelines are: We recommend that in patients with varicose veins or more severe CVD, a complete history and detailed physical examination are complemented by duplex ultrasound scanning of the deep and superficial veins (GRADE 1A). We recommend that the CEAP classification is used for patients with CVD (GRADE 1A) and that the revised Venous Clinical Severity Score is used to assess treatment outcome (GRADE 1B). We suggest compression therapy for patients with symptomatic varicose veins (GRADE 2C) but recommend against compression therapy as the primary treatment if the patient is a candidate for saphenous vein ablation (GRADE 1B). We recommend compression therapy as the primary treatment to aid healing of venous ulceration (GRADE 1B). To decrease the recurrence of venous ulcers, we recommend ablation of the incompetent superficial veins in addition to compression therapy (GRADE 1A). For treatment of the incompetent great saphenous vein (GSV), we recommend endovenous thermal ablation (radiofrequency or laser) rather than high ligation and inversion stripping

  2. Interim Financial Reporting in Function of Proper Decision Makind

    OpenAIRE

    Kacanski, Slobodan; Tomašević, Stevan; Vlaović-Begović, Sanja

    2014-01-01

    This paper analyses the attributes of interim financial reporting, as well as performs overview and interpretation of International Accounting Standard 34 which deals with this issue. The paper emphasizes risk and effects of interim financial statements implementation in decision making process. Time and cost limitations significantly influence the level of reliability on interim repors since those reports were not audited. This paper analyses the attributes of interim financial reporting,...

  3. Interim-Management: A paradox for leadership research?

    OpenAIRE

    Bruns, Jürgen; Kabst, Rüdiger

    2005-01-01

    The study focuses on Interim-Management as a so far rarely discussed phenomenon of the flexible firm. Contradicting popular leadership perception, the authors argue that Interim-Management does not constitute a leadership paradox but can be explained by established organization theory. In particular, transaction cost economics as well as resource-based view help explain the utilization of Interim-Management. Furthermore, the authors show that Interim-Management constitutes a response to reduc...

  4. Use of Curriculum Guidelines by Dental Educators.

    Science.gov (United States)

    Susi, Frank R.

    1986-01-01

    A survey of dental school course directors concerning their knowledge and use of curriculum guidelines provided by the American Association of Dental Schools found that many are aware of the guidelines and find them useful. Further guideline dissemination efforts and determining priorities for curriculum elements are recommended. (MSE)

  5. National Athletic Trainers' Association Releases New Guidelines for Exertional Heat Illnesses: What School Nurses Need to Know.

    Science.gov (United States)

    VanScoy, Rachel M; DeMartini, Julie K; Casa, Douglas J

    2016-05-01

    Exertional heat illnesses (EHI) occur in various populations and settings. Within a school setting, there are student athletes who take part in physical activity where the risk of EHI is increased. The National Athletic Trainers' Association (NATA) released an updated position statement on EHI in September of 2015. This article is a summary of the position statement. The sports medicine team, including school nurses and athletic trainers, provides quality health care to these physically active individuals. Thus, it is important for school nurses to understand the prevention, recognition, and treatment of EHI.

  6. Design review report FFTF interim storage cask

    Energy Technology Data Exchange (ETDEWEB)

    Scott, P.L.

    1995-01-03

    Final Design Review Report for the FFTF Interim Storage Cask. The Interim Storage Cask (ISC) will be used for long term above ground dry storage of FFTF irradiated fuel in Core Component Containers (CCC)s. The CCC has been designed and will house assemblies that have been sodium washed in the IEM Cell. The Solid Waste Cask (SWC) will transfer a full CCC from the IEM Cell to the RSB Cask Loading Station where the ISC will be located to receive it. Once the loaded ISC has been sealed at the RSB Cask Loading Station, it will be transferred by facility crane to the DSWC Transporter. After the ISC has been transferred to the Interim Storage Area (ISA), which is yet to be designed, a mobile crane will be used to place the ISC in its final storage location.

  7. CMM Interim Check Design of Experiments (U)

    Energy Technology Data Exchange (ETDEWEB)

    Montano, Joshua Daniel [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-07-29

    Coordinate Measuring Machines (CMM) are widely used in industry, throughout the Nuclear Weapons Complex and at Los Alamos National Laboratory (LANL) to verify part conformance to design definition. Calibration cycles for CMMs at LANL are predominantly one year in length and include a weekly interim check to reduce risk. The CMM interim check makes use of Renishaw’s Machine Checking Gauge which is an off-the-shelf product simulates a large sphere within a CMM’s measurement volume and allows for error estimation. As verification on the interim check process a design of experiments investigation was proposed to test a couple of key factors (location and inspector). The results from the two-factor factorial experiment proved that location influenced results more than the inspector or interaction.

  8. 1987 Federal interim storage fee study: A technical and economic analysis

    International Nuclear Information System (INIS)

    This document is the latest in a series of reports that are published annually by Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE). This information in the report, which was prepared by E.R. Johnson Associates under subcontract to PNL, will be used by the DOE to establish a payment schedule for interim storage of spent nuclear fuel under the Federal Interim Storage (FIS) Program, which was mandated by the Nuclear Waste Policy Act of 1982. The information in this report will be used to establish the schedule of charges for FIS services for the year commencing January 1, 1988. 13 tabs

  9. Surgical Treatment Guidelines for Digital Deformity Associated With Intrinsic Muscle Spasticity (Intrinsic Plus Foot) in Adults With Cerebral Palsy.

    Science.gov (United States)

    Boffeli, Troy J; Collier, Rachel C

    2015-01-01

    Intrinsic plus foot deformity has primarily been associated with cerebral palsy and involves spastic contracture of the intrinsic musculature with resultant toe deformities. Digital deformity is caused by a dynamic imbalance between the intrinsic muscles in the foot and extrinsic muscles in the lower leg. Spastic contracture of the toes frequently involves curling under of the lesser digits or contracture of the hallux into valgus or plantarflexion deformity. Patients often present with associated pressure ulcers, deformed toenails, shoe or brace fitting challenges, and pain with ambulation or transfers. Four different patterns of intrinsic plus foot deformity have been observed by the authors that likely relate to the different patterns of muscle involvement. Case examples are provided of the 4 patterns of intrinsic plus foot deformity observed, including global intrinsic plus lesser toe deformity, isolated intrinsic plus lesser toe deformity, intrinsic plus hallux valgus deformity, and intrinsic plus hallux flexus deformity. These case examples are presented to demonstrate each type of deformity and our approach for surgical management according to the contracture pattern. The surgical approach has typically involved tenotomy, capsulotomy, or isolated joint fusion. The main goals of surgical treatment are to relieve pain and reduce pressure points through digital realignment in an effort to decrease the risk of pressure sores and allow more effective bracing to ultimately improve the patient's mobility. PMID:25154656

  10. Environmental assessment for 881 Hillside (High Priority Sites) interim remedial action

    International Nuclear Information System (INIS)

    This Environmental Assessment evaluates the impact of an interim remedial action proposed for the High Priority Sites (881 Hillside Area) at the Rocky Flats Plant (RFP). This interim action is to be conducted to minimize the release of hazardous substances from the 881 Hillside Area that pose a potential long-term threat to public health and the environment. This document integrates current site characterization data and environmental analyses required by the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) or ''Superfund'' process, into an environmental assessment pursuant to the National Environmental Policy Act (NEPA). Characterization of the 881 Hillside Area is continuing. Consequently, a final remedial action has not yet been proposed. Environmental impacts associated with the proposed interim remedial action and reasonable alternatives designed to remove organic and inorganic contaminants, including radionuclides, from alluvial groundwater in the 881 Hillside Area are addressed. 24 refs., 5 figs., 23 tabs

  11. FIS accreditation guidelines

    OpenAIRE

    Ojanen, Pinja

    2010-01-01

    The International Ski Federation (FIS) was founded to support and develop the sport of skiing 100 years ago. Since then skiing has grown in importance and has become more popular. Nowadays ski companies, athletes and family members, but also fan clubs, national ski associations, sponsors and local organizers get involved for a sporting event. The aim of this project-based thesis was to create guidelines and make the FIS accreditation system as user-friendly as possible. For the groups (ser...

  12. Interim sanitary landfill groundwater monitoring report. 1996 Annual report

    Energy Technology Data Exchange (ETDEWEB)

    Bagwell, L.A.

    1997-01-01

    Eight wells of the LFW series monitor groundwater quality in the Steed Pond Aquifer (Water Table) beneath the Interim Sanitary Landfill at the Savannah River Site. These wells are sampled semiannually to comply with the South Carolina Department of Health and Environmental Control Modified Municipal Solid Waste Permit 025500-1120 and as part of the SRS Groundwater Monitoring Program. Trichlorofluoromethane and 1,1,1-trichloroethane were elevated in one sidegradient well and one downgradient well during 1996. Zinc was elevated in three downgradient wells and also was detected in the associated laboratory blanks for two of those wells. Specific conductance was elevated in one background well and one sidegradient well. Barium and copper exceeded standards in one sidegradient well, and dichloromethane (a common laboratory contaminant) was elevated in another sidegradient well. Barium, copper, and dichloromethane were detected in the associated blanks for these wells, also. The groundwater flow direction in the Steed Pond Acquifer (Water Table) beneath the Interim Sanitary Landfill was to the southeast (universal transverse Mercator coordinates). The flow rate in this unit was approximately 210 ft/year during first quarter 1996 and 180 ft/yr during third quarter 1996.

  13. Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder : A revision of the 2005 guidelines from the British Association for Psychopharmacology

    NARCIS (Netherlands)

    Baldwin, David S.; Anderson, Ian M.; Nutt, David J.; Allgulander, Christer; Bandelow, Borwin; den Boer, Johan A.; Christmas, David M.; Davies, Simon; Fineberg, Naomi; Lidbetter, Nicky; Malizia, Andrea; McCrone, Paul; Nabarro, Daniel; O'Neill, Catherine; Scott, Jan; van der Wee, Nic; Wittchen, Hans-Ulrich

    2014-01-01

    This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treat

  14. 340 waste handling facility interim safety basis

    Energy Technology Data Exchange (ETDEWEB)

    VAIL, T.S.

    1999-04-01

    This document presents an interim safety basis for the 340 Waste Handling Facility classifying the 340 Facility as a Hazard Category 3 facility. The hazard analysis quantifies the operating safety envelop for this facility and demonstrates that the facility can be operated without a significant threat to onsite or offsite people.

  15. Disposal facility data for the interim performance

    International Nuclear Information System (INIS)

    The purpose of this report is to identify and provide information on the waste package and disposal facility concepts to be used for the low-level waste tank interim performance assessment. Current concepts for the low-level waste form, canister, and the disposal facility will be used for the interim performance assessment. The concept for the waste form consists of vitrified glass cullet in a sulfur polymer cement matrix material. The waste form will be contained in a 2 x 2 x 8 meter carbon steel container. Two disposal facility concepts will be used for the interim performance assessment. These facility concepts are based on a preliminary disposal facility concept developed for estimating costs for a disposal options configuration study. These disposal concepts are based on vault type structures. None of the concepts given in this report have been approved by a Tank Waste Remediation Systems (TWRS) decision board. These concepts will only be used in th interim performance assessment. Future performance assessments will be based on approved designs

  16. LANDFILL BIOREACTOR PERFORMANCE, SECOND INTERIM REPORT

    Science.gov (United States)

    A bioreactor landfill is a landfill that is operated in a manner that is expected to increase the rate and extent of waste decomposition, gas generation, and settlement compared to a traditional landfill. This Second Interim Report was prepared to provide an interpretation of fie...

  17. 12 CFR 268.505 - Interim relief.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Interim relief. 268.505 Section 268.505 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM RULES..., eligibility for a within-grade increase, or the completion of the service requirement for career tenure,...

  18. 33 CFR 385.38 - Interim goals.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Interim goals. 385.38 Section 385.38 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROGRAMMATIC REGULATIONS FOR THE COMPREHENSIVE EVERGLADES RESTORATION PLAN Ensuring Protection of the...

  19. 340 waste handling facility interim safety basis

    International Nuclear Information System (INIS)

    This document presents an interim safety basis for the 340 Waste Handling Facility classifying the 340 Facility as a Hazard Category 3 facility. The hazard analysis quantifies the operating safety envelop for this facility and demonstrates that the facility can be operated without a significant threat to onsite or offsite people

  20. An Interim Report on NASA's Draft Space Technology Roadmaps

    Science.gov (United States)

    2011-01-01

    NASA has developed a set of 14 draft roadmaps to guide the development of space technologies under the leadership of the NASA Office of the Chief Technologist (OCT). Each of these roadmaps focuses on a particular technology area (TA). The roadmaps are intended to foster the development of advanced technologies and concepts that address NASA's needs and contribute to other aerospace and national needs. OCT requested that the National Research Council conduct a study to review the draft roadmaps, gather and assess relevant community input, and make recommendations and suggest priorities to inform NASA's decisions as it finalizes its roadmaps. The statement of task states that "based on the results of the community input and its own deliberations, the steering committee will prepare a brief interim report that addresses high-level issues associated with the roadmaps, such as the advisability of modifying the number or technical focus of the draft NASA roadmaps." This interim report, which does not include formal recommendations, addresses that one element of the study charge. NASA requested this interim report so that it would have the opportunity to make an early start in modifying the draft roadmaps based on feedback from the panels and steering committee. The final report will address all other tasks in the statement of task. In particular, the final report will include a prioritization of technologies, will describe in detail the prioritization process and criteria, and will include specific recommendations on a variety of topics, including many of the topics mentioned in this interim report. In developing both this interim report and the final report to come, the steering committee draws on the work of six study panels organized by technical area, loosely following the organization of the 14 roadmaps, as follows: A Panel 1: Propulsion and Power TA01 Launch Propulsion Systems TA02 In-Space Propulsion Technologies TA03 Space Power and Energy Storage Systems TA13

  1. Hepatocellular carcinoma: illustrated guide to systematic radiologic diagnosis and staging according to guidelines of the American Association for the Study of Liver Diseases.

    LENUS (Irish Health Repository)

    McEvoy, Sinead H

    2013-10-01

    Hepatocellular carcinoma is a malignancy that predominantly occurs in the setting of cirrhosis. Its incidence is rising worldwide. Hepatocellular carcinoma differs from most malignancies because it is commonly diagnosed on the basis of imaging features alone, without histologic confirmation. The guidelines from the American Association for the Study of Liver Diseases (AASLD) are a leading statement for the diagnosis and staging of hepatocellular carcinoma, and they have recently been updated, incorporating several important changes. AASLD advocates the use of the Barcelona Clinic Liver Cancer (BCLC) staging system, which combines validated imaging and clinical predictors of survival to determine stage and which links staging with treatment options. Each stage of the BCLC system is outlined clearly, with emphasis on case examples. Focal liver lesions identified at ultrasonographic surveillance in patients with cirrhosis require further investigation. Lesions larger than 1 cm should be assessed with multiphasic computed tomography or magnetic resonance imaging. Use of proper equipment and protocols is essential. Lesions larger than 1 cm can be diagnosed as hepatocellular carcinoma from a single study if the characteristic dynamic perfusion pattern of arterial hyperenhancement and venous or delayed phase washout is demonstrated. If the imaging characteristics of hepatocellular carcinoma are not met, the alternate modality should be performed. Biopsy should be used if neither modality is diagnostic of hepatocellular carcinoma. Once the diagnosis has been made, the cancer should be assigned a BCLC stage, which will help determine suitable treatment options. Radiologists require a systematic approach to diagnose and stage hepatocellular carcinoma with appropriate accuracy and precision.

  2. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ASSOCIAZIONE MEDICI ENDOCRINOLOGI MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE DIAGNOSIS AND MANAGEMENT OF THYROID NODULES--2016 UPDATE.

    Science.gov (United States)

    Gharib, Hossein; Papini, Enrico; Garber, Jeffrey R; Duick, Daniel S; Harrell, R Mack; Hegedüs, Laszlo; Paschke, Ralf; Valcavi, Roberto; Vitti, Paolo

    2016-05-01

    malignant or suspicious nodules. The present document updates previous guidelines released in 2006 and 2010 by the American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE) and Associazione Medici Endocrinologi (AME). PMID:27167915

  3. Immunisation Guidelines for Ireland (2008)

    OpenAIRE

    Department of Health

    2008-01-01

    Immunisation Guidelines for Ireland (2008) This revised report on immunisation guidelines for Ireland has been prepared with the assistance of an active Committee from associated disciplines in Paediatrics, Infectious Diseases, General Practice, Public Health, Microbiology, Occupational Health, Travel Medicine and the Irish Medicines Board. The report itself continues to be simple and concise in design and of course does not claim to contain all information on any pharmacological material....

  4. Offshore waste treatment guidelines

    International Nuclear Information System (INIS)

    These guidelines were prepared to aid offshore oil and gas operators in the management of waste materials related to petroleum drilling and production operations in offshore areas regulated by the Canada-Newfoundland and Labrador Offshore Petroleum Board (CNLOPB) and the Canada-Nova Scotia Offshore Petroleum Board (CNSOPB). A description of the relevant sections of the regulatory regime applicable to Canada's offshore oil and gas operations was included. Offshore operators are expected to take all reasonable measures to minimize the volumes of waste materials generated by their operations. The guidelines included recommendations for identifying, monitoring, and reporting discharges; performance expectations for specific discharges; requirements for greenhouse gas (GHG) and other air emissions; methods of characterizing and monitoring produced water, drilling muds, and desalination brine. Operational discharges associated with the installation and maintenance of subsea systems were also reviewed, and qualifications of analytical laboratories were presented. 24 refs., 2 appendices.

  5. ASSET guidelines

    International Nuclear Information System (INIS)

    The IAEA Assessment of Safety Significant Events Team (ASSET) Service provides advice and assistance to Member States to enhance the overall level of plant safety while dealing with the policy of prevention of incidents at nuclear power plants. The ASSET programme, initiated in 1986, is not restricted to any particular group of Member States, whether developing or industrialized, but is available to all countries with nuclear power plants in operation or approaching commercial operation. The IAEA Safety Series publications form common basis for the ASSET reviews, including the Nuclear Safety Standards (NUSS) and the Basic Safety Principles (Recommendations of Safety Series No. 75-INSAG-3). The ASSET Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of their review of incident investigations. Additional guidance and reference material is provided by the IAEA to complement the expertise of the ASSET members. ASSET reviews accept different approaches that contribute to ensuring an effective prevention of incidents at plants. Suggestions are offered to enhance plant safety performance. Commendable good practices are identified and generic lessons are communicated to other plants, where relevant, for long term improvement

  6. Climate change : we are at risk : interim report

    International Nuclear Information System (INIS)

    Between November 2002 and May 2003 the Standing Senate Committee on Agriculture and Forestry travelled across Canada to hear the views of farmer organizations, rural associations, ecotourism groups and environmental organizations regarding concerns about climate change and the impact it may have on the agriculture and forestry sectors and rural communities. The Committee also examined potential adaptation strategies focusing on primary production, practices, technologies, ecosystems and other related areas. Farmers and forest operators are already facing changes in market conditions, domestic regulations, trade policies and technology. This interim report expressed the concerns of farmers and forest operators. It includes a review of the Saguenay flood of 1996, the Red River flood of 1997, the ice storm of 1998, and droughts since 1999. It also includes a discussion on climate change and its biophysical and economic effects on agriculture, forestry, water resources, rural communities, and Aboriginal communities. This interim report also briefly outlines the Kyoto Protocol, the emissions trading system, and the decarbonization of global energy systems. It emphasized the need for integrated research and government policies and programs that encourage adaptation to climate change. The final report will be released in October 2003 and will provide specific recommendations to ensure that Canada responds to the concerns of farmers and forest operators and to ensure continued prosperity in these sectors. refs., figs

  7. Climate change : we are at risk : interim report

    Energy Technology Data Exchange (ETDEWEB)

    Oliver, D.; Wiebe, J.

    2003-06-01

    Between November 2002 and May 2003 the Standing Senate Committee on Agriculture and Forestry travelled across Canada to hear the views of farmer organizations, rural associations, ecotourism groups and environmental organizations regarding concerns about climate change and the impact it may have on the agriculture and forestry sectors and rural communities. The Committee also examined potential adaptation strategies focusing on primary production, practices, technologies, ecosystems and other related areas. Farmers and forest operators are already facing changes in market conditions, domestic regulations, trade policies and technology. This interim report expressed the concerns of farmers and forest operators. It includes a review of the Saguenay flood of 1996, the Red River flood of 1997, the ice storm of 1998, and droughts since 1999. It also includes a discussion on climate change and its biophysical and economic effects on agriculture, forestry, water resources, rural communities, and Aboriginal communities. This interim report also briefly outlines the Kyoto Protocol, the emissions trading system, and the decarbonization of global energy systems. It emphasized the need for integrated research and government policies and programs that encourage adaptation to climate change. The final report will be released in October 2003 and will provide specific recommendations to ensure that Canada responds to the concerns of farmers and forest operators and to ensure continued prosperity in these sectors. refs., figs.

  8. ADHD Rehabilitation through Video Gaming: A Systematic Review Using PRISMA Guidelines of the Current Findings and the Associated Risk of Bias

    Science.gov (United States)

    Strahler Rivero, Thiago; Herrera Nuñez, Lina Maria; Uehara Pires, Emmy; Amodeo Bueno, Orlando Francisco

    2015-01-01

    Empirical research studies have highlighted the need to investigate whether video game can be useful as a tool within a neuropsychological rehabilitation program for attention deficit hyperactivity disorder (ADHD) patients. However, little is known about the possible gains that this kind of video game-based interventions can produce and even if these gains can be transferred to real life abilities. The present paper aims to uncover key information related to the use of video game in ADHD neuropsychological rehabilitation/intervention by focusing on its gains and its capability to transfer/generalize these gains to real life situation via a systematic review of the empirical literature. The PRISMA guidelines were adopted. Internet-based bibliographic searches were conducted via seven major electronic databases (i.e., PsycARTICLES, PsycINFO, Web of Science, Core Collection BIOSIS Citation Index, MEDLINE, SciELO Citation Index, and PubMed) to access studies examining the association between video game interventions in ADHD patients and behavioral and cognitive outcomes. A total of 14 empirical studies meeting the inclusion criteria were identified. The studies reported the attention, working memory, and the behavioral aspects as the main target of the intervention. Cognitive and behavioral gains were reported after the video game training (VGT). However, many bias related to the choice of outcome instruments, sampling and blindness of assessors, weaken the results power. Additional researches are important to clarify the effects and stability of the VGT programs, and an important effort should be made to construct better methods to assess improvements on everyday cognitive abilities and real world functioning. PMID:26557098

  9. ADHD rehabilitation through video gaming: A systematic review using PRISMA guidelines of the current findings and the associated risk of bias.

    Directory of Open Access Journals (Sweden)

    Thiago eStrahler Rivero

    2015-10-01

    Full Text Available Empirical research studies have highlighted the need to investigate whether video game can be useful as a tool within a neuropsychological rehabilitation program for Attention Deficit Hyperactivity Disorder patients. However, little is known about the possible gains that this kind of video game based interventions can produce and even if these gains can be transferred to real life abilities. The present paper aims to uncover key information related to the use of video game in ADHD neuropsychological rehabilitation/intervention by focusing on its gains and its capability to transfer/generalize these gains to real life situation via a systematic review of the empirical literature. The PRISMA guidelines were adopted. Internet-based bibliographic searches were conducted via seven major electronic databases (i.e., PsycARTICLES, PsycINFO, Web of Science, Core Collection BIOSIS Citation Index, MEDLINE, SciELO Citation Index, and PubMed to access studies examining the association between video game interventions in ADHD patients and behavioral and cognitive outcomes. A total of 14 empirical studies meeting the inclusion criteria were identified. The studies reported the attention, working memory and the behavioral aspects as the main target of the intervention. Cognitive and behavioral gains were reported after the video game training. However, many bias related to the choice of outcome instruments, sampling and blindness of assessors, weaken the results power. Additional researches are important to clarify the effects and stability of the video games training programs, and an important effort should be made to construct better methods to assess improvements on everyday cognitive abilities and real world functioning.

  10. Interim storage facility for spent fuel

    International Nuclear Information System (INIS)

    The spent fuel generated from the operation of a nuclear power plant is to be treated in the reprocessing plant in Rokkasho, Aomori. At present, spent fuel is stored in the nuclear power plant until it is reprocessed. However the amount of spent fuel generated exceeds the capacity of the reprocessing plant. Hence an additional spent fuel storage facility is needed for the nuclear fuel cycle. The spent fuel interim storage facility is the first institution in Japan that stores spent fuel outside of the nuclear power plant site. Our company has received an order for internal equipment for this facility. This paper introduces an overview of the interim storage facility for spent fuel. (author)

  11. Pathways to deep decarbonization - Interim 2014 Report

    International Nuclear Information System (INIS)

    The interim 2014 report by the Deep Decarbonization Pathways Project (DDPP), coordinated and published by IDDRI and the Sustainable Development Solutions Network (SDSN), presents preliminary findings of the pathways developed by the DDPP Country Research Teams with the objective of achieving emission reductions consistent with limiting global warming to less than 2 deg. C. The DDPP is a knowledge network comprising 15 Country Research Teams and several Partner Organizations who develop and share methods, assumptions, and findings related to deep decarbonization. Each DDPP Country Research Team has developed an illustrative road-map for the transition to a low-carbon economy, with the intent of taking into account national socio-economic conditions, development aspirations, infrastructure stocks, resource endowments, and other relevant factors. The interim 2014 report focuses on technically feasible pathways to deep decarbonization

  12. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

    Full Text Available AUTHOR GUIDELINES Indian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/login Online SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s. http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols 1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic

  13. Gaz de France interim financial report 2007

    International Nuclear Information System (INIS)

    This financial report contains the unaudited condensed financial statements of Gaz de France Group for the first half ended June 30, 2007, which were reviewed by the audit committee on August 27, 2007 and by the board of directors at its meeting on August 28, 2007. It includes forward-looking statements concerning the objectives, strategies, financial position, future operating results and the operations of Gaz de France Group. These statements reflect the Group's current perception of its activities and the markets in which it operates, as well as various estimates and assumptions considered to be reasonable. Content: interim management report (highlights of the first half of 2007, revenues and results for the period, financial structure, data on outstanding stock, outlook); interim consolidated financial statements (consolidated statements of income, consolidated balance sheets, consolidated statements of cash flows, recognized income and expenses, statements of changes in shareholders' equity, note to the consolidated financial statements); statement by the person responsible for the interim financial report; statutory auditors' report. (J.S.)

  14. Utility of interim and end-of-treatment PET/CT in peripheral T-cell lymphomas: A review of 124 patients.

    Science.gov (United States)

    El-Galaly, Tarec Christoffer; Pedersen, Martin Bjerregård; Hutchings, Martin; Mylam, Karen Juul; Madsen, Jakob; Gang, Anne Ortved; Bøgsted, Martin; de Nully Brown, Peter; Loft, Annika; Nielsen, Anne Lerberg; Hendel, Helle Westergreen; Iyer, Victor; Gormsen, Lars Christian

    2015-11-01

    According to the updated guidelines for imaging in lymphoma, 18F-FDG positron emission tomography/computed tomography (PET/CT) is recommended for staging and evaluation of treatment response in FDG-avid lymphomas. The purpose of the study was to evaluate the utility of PET/CT in nodal peripheral T-cell lymphomas (PTCL). Patients with newly diagnosed nodal PTCL (peripheral T-cell lymphoma NOS, anaplastic large-cell lymphoma, or angioimmunoblastic T-cell lymphoma) seen at five Danish hematology centers during the period 2006 to 2012 were included, if they had been pretherapeutically staged with PET/CT. Medical records were reviewed for baseline clinical and follow-up information. Staging, interim (I-PET), and end-of-treatment PET/CT (E-PET) studies were centrally reviewed, and reported using the Deauville 5-point score (DS). A total of 124 patients fulfilled the inclusion criteria. The median age was 58 years, and 88% received CHOP/CHOP-like therapy. Five years PFS and OS of the study population was 36.8% (95% CI 27.3-46.4) and 49.7% (95% CI 38.9-59.6), respectively. The presence of PET/CT-ascertained lung and/or liver involvement was associated with a worse outcome. The sensitivity of PET/CT for detecting biopsy-defined bone marrow involvement was only 18% (95% CI 4-43). An interim DS >3 was not prognostic for worse OS and PFS among CHOP/CHOP-like treated patients in uni- or multivariate analyses. A DS >3 after treatment predicted a worse prognosis. In conclusion, I-PET was not predictive of outcome in CHOP/CHOP-like treated PTCL patients when using the DS. Prospective studies are needed to determine the optimal use of PET/CT in PTCL including the role of quantitative PET/CT analysis.

  15. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.;

    2010-01-01

    Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this evi...... European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline....

  16. Operator licensing examination standards for power reactors. Interim revision 8

    International Nuclear Information System (INIS)

    These examination standards are intended to assist NRC examiners and facility licensees to better understand the processes associated with initial and requalification examinations. The standards also ensure the equitable and consistent administration of examinations for all applicants. These standards are for guidance purposes and are not a substitute for the operator licensing regulations (i.e., 10 CFR Part 55), and they are subject to revision or other changes in internal operator licensing policy. This interim revision permits facility licensees to prepare their initial operator licensing examinations on a voluntary basis pending an amendment to 10 CFR Part 55 that will require facility participation. The NRC intends to solicit comments on this revision during the rulemaking process and to issue a final Revision 8 in conjunction with the final rule

  17. Provisional materials: key components of interim fixed restorations.

    Science.gov (United States)

    Perry, Ronald D; Magnuson, Britta

    2012-01-01

    Clinicians have many choices of provisional materials from which to choose when fabricating interim fixed restorations. While traditional materials are still in use today, temporary materials are continuously being updated and improved upon. In addition to the functional necessities required of the provisional material, it must also provide esthetic value for the patient. This article provides an overview of provisional materials, including newer bis-acryls that have helped eliminate some of the challenges associated with traditional acrylic materials. Composite resin preformed crowns for single-unit provisional applications are also discussed, along with CAD/CAM-fabricated materials. Regardless of the material selected, a provisional restoration must maintain and protect the underlying tooth structure from ill effects. PMID:22432178

  18. Advanced nuclear reactor public opinion project. Interim report

    Energy Technology Data Exchange (ETDEWEB)

    Benson, B.

    1991-07-25

    This Interim Report summarizes the findings of our first twenty in-depth interviews in the Advanced Nuclear Reactor Public Opinion Project. We interviewed 6 industry trade association officials, 3 industry attorneys, 6 environmentalists/nuclear critics, 3 state officials, and 3 independent analysts. In addition, we have had numerous shorter discussions with various individuals concerned about nuclear power. The report is organized into the four categories proposed at our April, 1991, Advisory Group meeting: safety, cost-benefit analysis, science education, and communications. Within each category, some change of focus from that of the Advisory Group has been required, to reflect the findings of our interviews. This report limits itself to describing our findings. An accompanying memo draws some tentative conclusions.

  19. Early interim {sup 18}F-FDG PET in Hodgkin's lymphoma: evaluation on 304 patients

    Energy Technology Data Exchange (ETDEWEB)

    Zinzani, Pier Luigi; Stefoni, Vittorio; Broccoli, Alessandro; Argnani, Lisa; Baccarani, Michele [University of Bologna, Institute of Hematology and Medical Oncology ' ' L. e A. Seragnoli' ' , Policlinico ' ' Sant' Orsola-Malpighi' ' , Bologna (Italy); Rigacci, Luigi; Puccini, Benedetta [Azienda Ospedaliero Universitaria ' ' Careggi' ' , Hematology Department, Florence (Italy); Castagnoli, Antonio [Ospedale ' ' Misericordia e Dolce' ' , Nuclear Medicine, Prato (Italy); Vaggelli, Luca [Azienda Ospedaliero Universitaria ' ' Careggi' ' , Nuclear Medicine, Florence (Italy); Zanoni, Lucia; Fanti, Stefano [Policlinico ' ' Sant' Orsola-Malpighi' ' , Department of Nuclear Medicine, Bologna (Italy)

    2012-01-15

    The use of early (interim) PET restaging during first-line therapy of Hodgkin's lymphoma (HL) in clinical practice has considerably increased because of its ability to provide early recognition of treatment failure allowing patients to be transferred to more intensive treatment regimens. Between June 1997 and June 2009, 304 patients with newly diagnosed HL (147 early stage and 157 advanced stage) were treated with the ABVD regimen at two Italian institutions. Patients underwent PET staging and restaging at baseline, after two cycles of therapy and at the end of the treatment. Of the 304 patients, 53 showed a positive interim PET scan and of these only 13 (24.5%) achieved continuous complete remission (CCR), whereas 251 patients showed a negative PET scan and of these 231 (92%) achieved CCR. Comparison between interim PET-positive and interim PET-negative patients indicated a significant association between PET findings and 9-year progression-free survival and 9-year overall survival, with a median follow-up of 31 months. Among the early-stage patients, 19 had a positive interim PET scan and only 4 (21%) achieved CCR; among the 128 patients with a negative interim PET scan, 122 (97.6%) achieved CCR. Among the advanced-stage patients, 34 showed a persistently positive PET scan with only 9 (26.4%) achieving CCR, whereas 123 showed a negative interim PET scan with 109 (88.6%) achieving CCR. Our results demonstrate the role of an early PET scan as a significant step forward in the management of patients with early-stage or advanced-stage HL. (orig.)

  20. 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.

  1. Protecting rare, old-growth, forest-associated species under the Survey and Manage Program guidelines of the Northwest Forest Plan.

    Science.gov (United States)

    Molina, Randy; Marcot, Bruce G; Lesher, Robin

    2006-04-01

    The Survey and Manage Program of the Northwest Forest Plan (NWFP) represents an unparalleled attempt to protect rare, little-known species associated with late-successional and old-growth forests on more than 9.7 million ha of federal lands. Approximately 400 species of amphibians, bryophytes, fungi, lichens, mollusks, vascular plants, arthropod functional groups, and one mammal were listed under this program because viability evaluations indicated the plan's network of reserve land allocations might not sustain the species over time. The program's standards and guidelines used an adaptive approach, protecting known sites and collecting new information to address concerns for species persistence and to develop management strategies. Since implementation in 1994, approximately 68,000 known sites have been recorded at an expense of several tens of millions of dollars. New knowledge from surveys reduced concern for nearly 100 species, and they were removed from the protection list. Although successful in protecting hundreds of rare species not typically considered in most conservation programs, some of the enacted conservation measures created conflicts in meeting other management objectives of the plan, particularly timber harvest. The program accrued important gains in knowledge, reduced uncertainty about conservation of a number of species, and developed new methods of species inventory that will be useful in future management planning and implementation at many scales. The program, however was not completed because of changes in land-management philosophy. Ongoing litigation regarding its termination and potential changes to the plan cast further uncertainty on how the original goal of maintaining persistence of late-successional and old-growth species will be met and measured. The outcomes, controversies, and management frustrations of the program exemplify the inherent difficulties in balancing broad, regional conservation goals with social and economic goals of

  2. World association for the advancement of veterinary parasitology (WAAVP): Second edition of guidelines for evaluating the efficacy of anthelmintics in swine

    DEFF Research Database (Denmark)

    Hennessy, D.R.; Bauer, C.; Boray, J.C.;

    2006-01-01

    Guidelines are provided for evaluating the efficacy of anthelmintics in swine which, in conjunction with other sets of guidance such as those of the International Cooperation on Harmonization of Technical Requirements for Registration of Veterinary Medicinal Products (VICH GL7 and VICH GL16), sho...

  3. 47 CFR 51.715 - Interim transport and termination pricing.

    Science.gov (United States)

    2010-10-01

    ... has neither established transport and termination rates based on forward-looking economic cost studies... 47 Telecommunication 3 2010-10-01 2010-10-01 false Interim transport and termination pricing. 51... Telecommunications Traffic § 51.715 Interim transport and termination pricing. (a) Upon request from...

  4. Presidential Transition: The Experience of Two Community College Interim Presidents

    Science.gov (United States)

    Thompson, Matthew D.

    2010-01-01

    The purpose of this qualitative case study was to understand the experiences of two community college interim presidents, their characteristics, and how they led institutions following an abrupt presidential departure. There were two fundamental questions framing this research study, 1. How do two interim community college presidents lead…

  5. 50 CFR 660.720 - Interim protection for sea turtles.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Interim protection for sea turtles. 660.720 Section 660.720 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND... Migratory Fisheries § 660.720 Interim protection for sea turtles. (a) Until the effective date of §§...

  6. 47 CFR 73.404 - Interim hybrid IBOC DAB operation.

    Science.gov (United States)

    2010-10-01

    ... RADIO BROADCAST SERVICES Digital Audio Broadcasting § 73.404 Interim hybrid IBOC DAB operation. (a) The... test operation pursuant to § 73.1620, may commence interim hybrid IBOC DAB operation with digital... No. 99-325. FM stations are permitted to operate with hybrid digital effective radiated power...

  7. Site development interim removable dental prosthesis.

    Science.gov (United States)

    Pasquinelli, Kirk L; Sze, Alexander J; Matosian, Alex J

    2016-07-01

    Transitioning a patient with partial edentulism through hard and soft tissue grafting to an implant restoration with an interim removable dental prosthesis (IRDP) presents a challenge to the restorative dentist. The management of grafted sites requires care, and without the appropriate design, an IRDP may impede surgical outcomes and place the graft at risk for displacement or necrosis. A site development IRDP (SDIRDP) for a grafted site must fulfill restorative goals and promote the surgical objectives for site development. A technique is described for fabricating an SDIRDP that facilitates surgical procedures and maintains prosthetic goals. PMID:26831920

  8. Central waste complex interim safety basis

    Energy Technology Data Exchange (ETDEWEB)

    Cain, F.G.

    1995-05-15

    This interim safety basis provides the necessary information to conclude that hazards at the Central Waste Complex are controlled and that current and planned activities at the CWC can be conducted safely. CWC is a multi-facility complex within the Solid Waste Management Complex that receives and stores most of the solid wastes generated and received at the Hanford Site. The solid wastes that will be handled at CWC include both currently stored and newly generated low-level waste, low-level mixed waste, contact-handled transuranic, and contact-handled TRU mixed waste.

  9. Interim Reliability Evaluation Program procedures guide

    International Nuclear Information System (INIS)

    This document presents procedures for conducting analyses of a scope similar to those performed in Phase II of the Interim Reliability Evaluation Program (IREP). It documents the current state of the art in performing the plant systems analysis portion of a probabilistic risk assessment. Insights gained into managing such an analysis are discussed. Step-by-step procedures and methodological guidance constitute the major portion of the document. While not to be viewed as a cookbook, the procedures set forth the principal steps in performing an IREP analysis. Guidance for resolving the problems encountered in previous analyses is offered. Numerous examples and representative products from previous analyses clarify the discussion

  10. Guidelines on renal cell cancer

    NARCIS (Netherlands)

    Mickisch, G; Carballido, J; Hellsten, S; Schuize, H; Mensink, H

    2001-01-01

    Objectives., On behalf of the European Association of Urology (EAU), Guidelines for Diagnosis, Therapy and. Follow Up of Renal. Cell Carcinoma Patients were established. Criteria for recommendations were evidence based and included aspects of cost-effectiveness and clinical feasibility. Method: A sy

  11. Curriculum Guidelines on Forensic Dentistry.

    Science.gov (United States)

    Journal of Dental Education, 1990

    1990-01-01

    The American Association of Dental Schools' guidelines for curriculum design explain the scope of forensic dentistry and interrelationships with other fields, give an overview of the curriculum, and outline suggested primary educational goals, prerequisites, core content, specific behavioral objectives, sequencing, faculty and facility…

  12. Curriculum Guidelines for Operative Dentistry.

    Science.gov (United States)

    Journal of Dental Education, 1984

    1984-01-01

    The American Association of Dental Schools' guidelines for operative dentistry curricula include an overview of the scope and objectives of operative dentistry, notes on the interrelationship of the discipline and the total curriculum, and an outline of primary educational goals, core content, specific behavioral objectives, sequencing, faculty,…

  13. Teacher Certification/Preparation Guidelines.

    Science.gov (United States)

    Kotter, Rita

    1990-01-01

    Presents guidelines for general and theater specialist K-12 teacher certification developed by the American Alliance for Theatre Education and the Speech Communication Association. Advocates that all teachers have preparation in arts and communication and that theater and communication specialists continue to be trained. (SR)

  14. 29 CFR 2509.75-10 - Interpretive bulletin relating to the ERISA Guidelines and the Special Reliance Procedure.

    Science.gov (United States)

    2010-07-01

    ... Labor (the “Department”) and the Internal Revenue Service (the “Service”) announced the publication of a... recognition of the need to provide an immediate and complete set of interim guidelines to facilitate (1... rules govern the application of (1) the qualification requirements of the Internal Revenue Code of...

  15. An exploration of how guideline developer capacity and guideline implementability influence implementation and adoption: study protocol

    Directory of Open Access Journals (Sweden)

    Lemieux-Charles Louise

    2009-07-01

    Full Text Available Abstract Background Practice guidelines can improve health care delivery and outcomes but several issues challenge guideline adoption, including their intrinsic attributes, and whether and how they are implemented. It appears that guideline format may influence accessibility and ease of use, which may overcome attitudinal barriers of guideline adoption, and appear to be important to all stakeholders. Guideline content may facilitate various forms of decision making about guideline adoption relevant to different stakeholders. Knowledge and attitudes about, and incentives and capacity for implementation on the part of guideline sponsors may influence whether and how they develop guidelines containing these features, and undertake implementation. Examination of these issues may yield opportunities to improve guideline adoption. Methods The attributes hypothesized to facilitate adoption will be expanded by thematic analysis, and quantitative and qualitative summary of the content of international guidelines for two primary care (diabetes, hypertension and institutional care (chronic ulcer, chronic heart failure topics. Factors that influence whether and how guidelines are implemented will be explored by qualitative analysis of interviews with individuals affiliated with guideline sponsoring agencies. Discussion Previous research examined guideline implementation by measuring rates of compliance with recommendations or associated outcomes, but this produced little insight on how the products themselves, or their implementation, could be improved. This research will establish a theoretical basis upon which to conduct experimental studies to compare the cost-effectiveness of interventions that enhance guideline development and implementation capacity. Such studies could first examine short-term outcomes predictive of guideline utilization, such as recall, attitude toward, confidence in, and adoption intention. If successful, then long-term objective

  16. T Tank Farm Interim Cover Test - Design Plan

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Z. F.; Keller, Jason M.

    2006-07-01

    The Hanford Site has 149 underground single-shell tanks that store hazardous radioactive waste. Many of these tanks and their associated infrastructure (e.g., pipelines, diversion boxes) have leaked. Some of the leaked waste has entered the groundwater. The largest known leak occurred from the T-106 Tank in 1973. Many of the contaminants from that leak still reside within the vadose zone beneath the T Tank Farm. CH2M Hill Hanford Group, Inc. seeks to minimize movement of this residual contaminant plume by placing an interim cover on the surface. Such a cover is expected to prevent infiltrating water from reaching the plume and moving it further. Pacific Northwest National Laboratory has prepared a design plan to monitor and determine the effectiveness of the interim cover. A three-dimensional numerical simulation of water movement beneath a cover was conducted to guide the design of the plan. Soil water content, water pressure, and temperature will be monitored using off-the-shelf equipment that can be installed by the hydraulic hammer technique. In fiscal year 2006, two instrument nests will be installed, one inside and one outside of the proposed cover. In fiscal year 2007, two additional instrument nests, both inside the proposed cover, will be installed. Each instrument nest contains a neutron access tube and a capacitance probe (to measure water content), and four heat-dissipation units (to measure pressure head and temperature). A datalogger and a meteorological station will be installed outside of the fence. Two drain gauges will be installed in locations inside and outside the cover for the purpose of measuring soil water flux.

  17. Guideline on anterior cruciate ligament injury

    NARCIS (Netherlands)

    Meuffels, Duncan E; Poldervaart, Michelle T; Diercks, Ronald; Fievez, Alex W F M; Patt, Thomas W; Hart, Cor P van der; Hammacher, Eric R; Meer, Fred van der; Goedhart, Edwin A; Lenssen, Anton F; Muller-Ploeger, Sabrina B; Pols, Margreet A; Saris, Daniel B F

    2012-01-01

    The Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steer

  18. Efficacy and safety of abatacept for patients with Sjögren's syndrome associated with rheumatoid arthritis: rheumatoid arthritis with orencia trial toward Sjögren's syndrome Endocrinopathy (ROSE) trial-an open-label, one-year, prospective study-Interim analysis of 32 patients for 24 weeks.

    Science.gov (United States)

    Tsuboi, Hiroto; Matsumoto, Isao; Hagiwara, Shinya; Hirota, Tomoya; Takahashi, Hiroyuki; Ebe, Hiroshi; Yokosawa, Masahiro; Hagiya, Chihiro; Asashima, Hiromitsu; Takai, Chinatsu; Miki, Haruka; Umeda, Naoto; Kondo, Yuya; Ogishima, Hiroshi; Suzuki, Takeshi; Hirata, Shintaro; Saito, Kazuyoshi; Tanaka, Yoshiya; Horai, Yoshiro; Nakamura, Hideki; Kawakami, Atsushi; Sumida, Takayuki

    2015-03-01

    Abstract Objective. To assess the efficacy and safety of abatacept for secondary Sjögren's syndrome (SS) associated with rheumatoid arthritis (RA). Methods. The primary endpoint of this 1-year, open-labeled, prospective, observational multicenter study of RA-associated secondary SS was the rate of SDAI remission at 52 weeks after initiation of abatacept therapy. The secondary endpoints included that of Saxson's test and Schirmer's test. Adverse events during the study period were also analyzed. Results. Thirty-two patients (all females) were enrolled in this study. Interim analysis at 24 weeks included assessment of efficacy (n = 31) and safety (n = 32). The mean SDAI decreased from 19.8 ± 11.0 (± SD) at baseline to 9.9 ± 9.9 at 24 weeks (P < 0.05). Patients with clinical remission, as assessed by SDAI, increased from 0 patient (0 week) to 8 patients (25.8%) at 24 weeks. Saliva volume (assessed by Saxson's test) increased slightly from 2232 ± 1908 (0 week) to 2424 ± 2004 (24 weeks) mg/2 min (n = 29). In 11 patients with Greenspan grading 1/2 of labial salivary glands biopsy, saliva volume increased from 2945 ± 2090 (0 week) to 3419 ± 2121 (24 weeks) mg/2 min (P < 0.05). Schirmer's test for tear volume showed increase from 3.6 ± 4.6 (0 week) to 5.5 ± 7.1 (24 weeks) mm/5 min (n = 25; P < 0.05). Five adverse events occurred in five of 32 patients (15.6%), and three of these events were infections. Conclusion. Abatacept seems to be effective for both RA and RA-related secondary SS.

  19. Efficacy and safety of abatacept for patients with Sjögren's syndrome associated with rheumatoid arthritis: Rheumatoid Arthritis with Orencia Trial toward Sjögren's syndrome Endocrinopathy (ROSE) trial—an open-label, one-year, prospective study—Interim analysis of 32 patients for 24 weeks

    Science.gov (United States)

    Tsuboi, Hiroto; Matsumoto, Isao; Hagiwara, Shinya; Hirota, Tomoya; Takahashi, Hiroyuki; Ebe, Hiroshi; Yokosawa, Masahiro; Hagiya, Chihiro; Asashima, Hiromitsu; Takai, Chinatsu; Miki, Haruka; Umeda, Naoto; Kondo, Yuya; Ogishima, Hiroshi; Suzuki, Takeshi; Hirata, Shintaro; Saito, Kazuyoshi; Tanaka, Yoshiya; Horai, Yoshiro; Nakamura, Hideki; Kawakami, Atsushi

    2015-01-01

    Objective To assess the efficacy and safety of abatacept for secondary Sjögren's syndrome (SS) associated with rheumatoid arthritis (RA). Methods The primary endpoint of this 1-year, open-labeled, prospective, observational multicenter study of RA-associated secondary SS was the rate of SDAI remission at 52 weeks after initiation of abatacept therapy. The secondary endpoints included that of Saxson's test and Schirmer's test. Adverse events during the study period were also analyzed. Results Thirty-two patients (all females) were enrolled in this study. Interim analysis at 24 weeks included assessment of efficacy (n = 31) and safety (n = 32). The mean SDAI decreased from 19.8 ± 11.0 (± SD) at baseline to 9.9 ± 9.9 at 24 weeks (P < 0.05). Patients with clinical remission, as assessed by SDAI, increased from 0 patient (0 week) to 8 patients (25.8%) at 24 weeks. Saliva volume (assessed by Saxson's test) increased slightly from 2232 ± 1908 (0 week) to 2424 ± 2004 (24 weeks) mg/2 min (n = 29). In 11 patients with Greenspan grading 1/2 of labial salivary glands biopsy, saliva volume increased from 2945 ± 2090 (0 week) to 3419 ± 2121 (24 weeks) mg/2 min (P < 0.05). Schirmer's test for tear volume showed increase from 3.6 ± 4.6 (0 week) to 5.5 ± 7.1 (24 weeks) mm/5 min (n = 25; P < 0.05). Five adverse events occurred in five of 32 patients (15.6%), and three of these events were infections. Conclusion Abatacept seems to be effective for both RA and RA-related secondary SS. PMID:25211401

  20. Guidelines for vaccination of dogs and cats in Korea

    OpenAIRE

    Song, Woo-Jin; Kim, Hyun-Tae; Yoo, Han-Sang; Youn, Hwa-Young

    2014-01-01

    This guideline contains the recommended vaccination schedules of dogs and cats from World Small Animal Veterinary Association (WSAVA) and American Animal Hospital Association (AAHA). In 2010, WSAVA published guidelines for the vaccination of dogs and cats. And, in 2011, AAHA also published guidelines for vaccination of dogs. In Korea, there is no published guideline for vaccination of dogs and cats yet. Therefore, the plane of vaccination also reports the present situation of vaccination sche...

  1. 75 FR 16202 - Office of New Reactors; Interim Staff Guidance on Ensuring Hazard-Consistent Seismic Input for...

    Science.gov (United States)

    2010-03-31

    ...) DC/COL-ISG-017 titled ``Ensuring Hazard-Consistent Seismic Input for Site Response and Soil Structure..., and DC/COL-ISG-01, ``Interim Staff Guidance on Seismic Issues Associated with High Frequency Ground... No. ML081400293). The NRC staff issues DC/COL-ISGs to facilitate timely implementation of...

  2. World Association for the Advancement of Veterinary Parasitology (WAAVP): Guideline for the evaluation of drug efficacy against non-coccidial gastrointestinal protozoa in livestock and companion animals.

    Science.gov (United States)

    Geurden, T; Olson, M E; O'Handley, R M; Schetters, T; Bowman, D; Vercruysse, J

    2014-08-29

    The current guideline was written to aid in the design, implementation and interpretation of studies for the assessment of drug efficacy against non-coccidial gastrointestinal protozoan parasites, with Giardia spp. as the leading example. The information provided in this guideline deals with aspects of how to conduct controlled studies using experimental infection models (dose determination and dose confirmation) and efficacy studies in commercial facilities (field effectiveness studies). Furthermore, the selection of suitable animals, housing, infection procedure, choice of diagnostic technique and data analysis are discussed. This guideline is intended to assist investigators in conducting specific studies, to provide specific information for registration authorities involved in the decision-making process, to assist in the approval and registration of new drugs and to facilitate the worldwide adoption of uniform procedures. The primary parameter for drug efficacy is the reduction in either parasite excretion or parasite counts and a minimum efficacy of 90% is required against non-coccidial gastrointestinal protozoa. A supporting efficacy parameter is a significant difference in the proportion of infected animals between treated and non-treated groups. Persistent efficacy is considered as an additional claim to therapeutic efficacy.

  3. Functions and requirements document for interim store solidified high-level and transuranic waste

    Energy Technology Data Exchange (ETDEWEB)

    Smith-Fewell, M.A., Westinghouse Hanford

    1996-05-17

    The functions, requirements, interfaces, and architectures contained within the Functions and Requirements (F{ampersand}R) Document are based on the information currently contained within the TWRS Functions and Requirements database. The database also documents the set of technically defensible functions and requirements associated with the solidified waste interim storage mission.The F{ampersand}R Document provides a snapshot in time of the technical baseline for the project. The F{ampersand}R document is the product of functional analysis, requirements allocation and architectural structure definition. The technical baseline described in this document is traceable to the TWRS function 4.2.4.1, Interim Store Solidified Waste, and its related requirements, architecture, and interfaces.

  4. Enhancement pattern of small hepatocellular carcinoma (HCC) at contrast-enhanced US (CEUS), MDCT, and MRI: Intermodality agreement and comparison of diagnostic sensitivity between 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Furlan, Alessandro, E-mail: furlana@upmc.edu [Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 (United States); Marin, Daniele [Department of Radiology, Duke University Medical Center, Durham, NC 27710 (United States); Department of Radiological Sciences, University of Rome-La Sapienza, Rome, 00161 (Italy); Cabassa, Paolo [Department of Radiology, Brescia University, Brescia (Italy); Taibbi, Adele [Department of Radiology, University of Palermo, Palermo, 90127 (Italy); Brunelli, Elena [Department of Radiology, Brescia University, Brescia (Italy); Agnello, Francesco; Lagalla, Roberto; Brancatelli, Giuseppe [Department of Radiology, University of Palermo, Palermo, 90127 (Italy)

    2012-09-15

    Objective: To evaluate agreement between contrast-enhanced ultrasound (CEUS), multi-detector row computed tomography (MDCT) and magnetic resonance imaging (MRI) for the assessment of typical and atypical enhancement patterns of small hepatocellular carcinoma (HCC); and to compare diagnostic sensitivity of 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines. Materials and methods: Between January 2008 and December 2009, we included cirrhotic patients with newly diagnosed 10–20 mm HCC imaged at two contrast-enhanced imaging techniques among CEUS, MDCT, and MRI. Dynamic studies were reviewed by two radiologists to assess enhancement pattern. Percentage of cases with concordant findings and Cohen coefficient (k) were calculated. McNemar's test was used to compare sensitivity between 2005 and 2010 AASLD guidelines. Results: There were 91 patients (69 M; 22 F; mean age, 68 years) with 96 HCCs, studied with a combination of CEUS and MDCT (n = 59), CEUS and MRI (n = 26), or MDCT and MRI (n = 11). Intermodality agreement for assessment of tumor enhancement pattern was 67% (k = 0.294, P = 0.001). Typical enhancement pattern was detected coincidentally at two imaging modalities in 50 (52%) HCCs. Sensitivity for the diagnosis of HCC increased significantly using the 2010 AASLD (81/96 (84%) vs. 50/96 (52%), P < 0.001). Conclusions: Agreement between two imaging modalities for the detection of typical tumor enhancement pattern was reached in 52% of cases. The 2010 AASLD guidelines significantly increased the sensitivity for the diagnosis of HCC.

  5. Enhancement pattern of small hepatocellular carcinoma (HCC) at contrast-enhanced US (CEUS), MDCT, and MRI: Intermodality agreement and comparison of diagnostic sensitivity between 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines

    International Nuclear Information System (INIS)

    Objective: To evaluate agreement between contrast-enhanced ultrasound (CEUS), multi-detector row computed tomography (MDCT) and magnetic resonance imaging (MRI) for the assessment of typical and atypical enhancement patterns of small hepatocellular carcinoma (HCC); and to compare diagnostic sensitivity of 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines. Materials and methods: Between January 2008 and December 2009, we included cirrhotic patients with newly diagnosed 10–20 mm HCC imaged at two contrast-enhanced imaging techniques among CEUS, MDCT, and MRI. Dynamic studies were reviewed by two radiologists to assess enhancement pattern. Percentage of cases with concordant findings and Cohen coefficient (k) were calculated. McNemar's test was used to compare sensitivity between 2005 and 2010 AASLD guidelines. Results: There were 91 patients (69 M; 22 F; mean age, 68 years) with 96 HCCs, studied with a combination of CEUS and MDCT (n = 59), CEUS and MRI (n = 26), or MDCT and MRI (n = 11). Intermodality agreement for assessment of tumor enhancement pattern was 67% (k = 0.294, P = 0.001). Typical enhancement pattern was detected coincidentally at two imaging modalities in 50 (52%) HCCs. Sensitivity for the diagnosis of HCC increased significantly using the 2010 AASLD (81/96 (84%) vs. 50/96 (52%), P < 0.001). Conclusions: Agreement between two imaging modalities for the detection of typical tumor enhancement pattern was reached in 52% of cases. The 2010 AASLD guidelines significantly increased the sensitivity for the diagnosis of HCC

  6. What do the recent American Heart Association/American College of Cardiology Foundation Clinical Practice Guidelines tell us about the evolving management of coronary heart disease in older adults?

    Institute of Scientific and Technical Information of China (English)

    Daniel Forman; Nanette K Wenger

    2013-01-01

    Biological aging predisposes older adults to increased cardiovascular disease (CHD) and greater disease complexity. Given the high age-related prevalence of CHD and age-related compounding factors, the recently updated American Heart Association/American College of Cardiology Foundation CHD-related guidelines increased their focus on older patients. These guidelines are predominately evidence-based (using data from quality randomized clinical trials) and are organized to delineate medications and procedures that best treat particular cardiovascular diseases. While such rationale and thought work well in young and middle aged adults, they become problematic in patients who are very old. Data pertaining to adults aged ≥ 80 are virtually absent from most randomized clinical trials, and even in the instances when very old patients were included, eligibility criteria typically excluded candidates with co-morbidities and complexities of customary CHD patients. While medications and interventions yielding benefit in clinical trials should theoretically produce the greatest benefits for patients with high intrinsic risk, age-related cardiovascular complexities also increase iatrogenic risks. Navigating between the potential for high benefit and high risk in "evidence-based" cardiovascular management remains a key Geriatric Cardiology challenge. In this review we consider the expanded Geriatric Cardiology content of current guidelines, acknowledging both the progress that has been made, as well as the work that still needs to be accomplished to truly address the patient-centered priorities of older CHD patients.

  7. Guidelines for MIBG-scintigraphy in children

    International Nuclear Information System (INIS)

    These ''Empfehlungen'' are the german translation of the Guidelines on MIBG-Scintigraphy in Children, which were published by the Paediatric Committee of the European Association of Nuclear Medicine. (orig.)

  8. 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)

  9. LABORATORY GUIDELINES FOR ANALYSIS OF BIOTERRORISM SAMPLES

    Science.gov (United States)

    With advent of deaths associated with Bacillus anthracis spore contaminated mail, a worldwide need was apparent for increased laboratory capacity to safely analyze bioterrorism samples. The U.S. Department of Health and Human Services has furnished guidelines for microbiological...

  10. Curricular Guidelines for Teaching Dental Anatomy.

    Science.gov (United States)

    Okeson, Jeffrey; Buckman, James

    1981-01-01

    Guidelines developed by the Section on Dental Anatomy and Occlusion of the American Association of Dental Schools for use by individual educational institutions as curriculum development aids are provided. (MLW)

  11. Clinical Practice Guidelines and Industry

    Directory of Open Access Journals (Sweden)

    Ajai R. Singh

    2007-01-01

    Full Text Available In this section we shall see what Clinical Practice Guidelines (CPGs should be and what they are, the recent case of Xigris and a thriller-like manipulation by the concerned company to enter a performance 'bundle', CPG effectiveness/cost effectiveness and other considerations, how they serve Industry needs, and what methods can possibly assist them actualise their enormous potential.Introduction From the early nineties, a number of Clinical Practice Guidelines (CPGs have been created and published by many different associations and organizations at considerable expense. CPGs are supposed to serve an important purpose. They offer objective consensus of expert opinion on treatment and hence are trusted by hospitals and practicing physicians alike. They can reduce the possibility of inappropriate care being delivered, while helping introduce new knowledge into clinical practice (Grimshaw and Russell, 1993; Merritt et al. , 1997; Woolf et al. , 1999. They are a distillate of biomedical wisdom at a certain point of time applied to better and more efficient patient care. Hence, rigorously developed guidelines can translate complicated research findings into actionable recommendations of clinical care (Shiffman et al. , 2003; Haines and Jones, 1994. Clinical practice guidelines have generally been accepted as an objective consensus on evidence (Baird, 2003. Practice guidelines approved by expert panels are intended to standardize care in such a way as to improve health outcomes (Eichacker et al. , 2006. Major hospitals and knowledge updated physicians feel reassured they are doing the very best by following CPGs. State of the art, and such other fancy labels, can be justifiably applied to them.McMaster et al., (2007 have talked recently of getting guidelines to work in practice. In an effort to make CPGs more effective, developers of such guidelines have started grouping evidence-based interventions into what are called 'bundles'. The justification for

  12. Retention of long-term interim restorations with sodium fluoride enriched interim cement

    Science.gov (United States)

    Strash, Carolyn

    Purpose: Interim fixed dental prostheses, or "provisional restorations", are fabricated to restore teeth when definitive prostheses are made indirectly. Patients undergoing extensive prosthodontic treatment frequently require provisionalization for several months or years. The ideal interim cement would retain the restoration for as long as needed and still allow for ease of removal. It would also avoid recurrent caries by preventing demineralization of tooth structure. This study aims to determine if adding sodium fluoride varnish to interim cement may assist in the retention of interim restorations. Materials and methods: stainless steel dies representing a crown preparation were fabricated. Provisional crowns were milled for the dies using CAD/CAM technology. Crowns were provisionally cemented onto the dies using TempBond NE and NexTemp provisional cements as well as a mixture of TempBond NE and Duraphat fluoride varnish. Samples were stored for 24h then tested or thermocycled for 2500 or 5000 cycles before being tested. Retentive strength of each cement was recorded using a universal testing machine. Results: TempBond NE and NexTemp cements performed similarly when tested after 24h. The addition of Duraphat significantly decreased the retention when added to TempBond NE. NexTemp cement had high variability in retention over all tested time periods. Thermocycling for 2500 and 5000 cycles significantly decreased the retention of all cements. Conclusions: The addition of Duraphat fluoride varnish significantly decreased the retention of TempBond NE and is therefore not recommended for clinical use. Thermocycling significantly reduced the retention of TempBond NE and NexTemp. This may suggest that use of these cements for three months, as simulated in this study, is not recommended.

  13. Virtual reference service evaluation: Adherence to RUSA behavioral guidelines and IFLA digital reference guidelines

    OpenAIRE

    Shachaf, Pnina; Horowitz, Sarah M.

    2008-01-01

    This study evaluates the level of adherence to professional guidelines by virtual (e-mail) reference services. These professional guidelines are set up as standards to assure service quality; however, studies of virtual reference effectiveness rarely utilize these standards to measure reference success. This study evaluates and compares the level of adherence to two sets of professional guidelines that have been published by the International Federation of Library Associations and Institution...

  14. Project management plan for the 105-C Reactor interim safe storage project. Revision 1

    International Nuclear Information System (INIS)

    In 1942, the Hanford Site was commissioned by the US Government to produce plutonium. Between 1942 and 1955, eight water-cooled, graphite-moderated reactors were constructed along the Columbia River at the Hanford Site to support the production of plutonium. The reactors were deactivated from 1964 to 1971 and declared surplus. The Surplus Production Reactor Decommissioning Project (BHI 1994b) will decommission these reactors and has selected the 105-C Reactor to be used as a demonstration project for interim safe storage at the present location and final disposition of the entire reactor core in the 200 West Area. This project will result in lower costs, accelerated schedules, reduced worker exposure, and provide direct benefit to the US Department of Energy for decommissioning projects complex wide. This project sets forth plans, organizational responsibilities, control systems, and procedures to manage the execution of the Project Management Plan for the 105-C Reactor Interim Safe Storage Project (Project Management Plan) activities to meet programmatic requirements within authorized funding and approved schedules. The Project Management Plan is organized following the guidelines provided by US Department of Energy Order 4700.1, Project Management System and the Richland Environmental Restoration Project Plan (DOE-RL 1992b)

  15. Maywood Interim Storage Site: Annual environmental report for calendar year 1990, Maywood, New Jersey

    International Nuclear Information System (INIS)

    Environmental monitoring of the US Department of Energy's (DOE) Maywood Interim Storage Site (MISS) and surrounding area began in 1984. MISS is part of the Formerly Utilized Sites Remedial Action Program (FUSRAP), a DOE program to decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation's atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The MISS Environmental monitoring programs was established to accommodate facility characteristics, applicable regulations, hazard potential, quantities and concentrations of materials released, extent and use of affected land and water, and local public interest or concern. The environmental monitoring program at MISS includes sampling networks for radon concentrations in air; external gamma radiation exposure; and total uranium, radium-226, and thorium-232 concentrations in surface water, sediment, and groundwater. Additionally, several nonradiological parameters are measured in surface water, sediment, and groundwater. Monitoring results are compared with applicable Environmental Protection Agency (EPA) standards; federal, state, and local applicable or relevant and appropriate requirements (ARARs); and/or DOE derived concentration guidelines (DCGs). Environmental standards, ARARs, and DCGs are established to protect public health and the environment. Results from the 1990 environmental monitoring program show that concentrations of the contaminants of concern were all below applicable standards. Because the site is used only for interim storage and produces no processing effluents, all monitoring, except for radon and direct gamma radiation, was done on a quarterly basis. 18 refs., 17 figs., 28 tabs

  16. PROJECT W-551 INTERIM PRETREATMENT SYSTEM PRECONCEPTUAL CANDIDATE TECHNOLOGY DESCRIPTIONS

    Energy Technology Data Exchange (ETDEWEB)

    MAY TH

    2008-08-12

    The Office of River Protection (ORP) has authorized a study to recommend and select options for interim pretreatment of tank waste and support Waste Treatment Plant (WTP) low activity waste (LAW) operations prior to startup of all the WTP facilities. The Interim Pretreatment System (IPS) is to be a moderately sized system which separates entrained solids and 137Cs from tank waste for an interim time period while WTP high level waste vitrification and pretreatment facilities are completed. This study's objective is to prepare pre-conceptual technology descriptions that expand the technical detail for selected solid and cesium separation technologies. This revision includes information on additional feed tanks.

  17. Interim report and accounts 1993/94

    International Nuclear Information System (INIS)

    An interim set of accounts and reports is presented here for 1993/1994 for the health science company Amersham International. The company's research programs focus on developments in life science research, nuclear medicine and industrial quality and safety assurance, with particular expertise in the application of radioactivity to labelling and detection at the molecular level. This report which covers the half-year to 30 September 1993 shows promising financial results, with turnover, operating profits and earnings per share all having risen. All life science markets report growth although difficult trading conditions are being reported in Europe. Two products in the Healthcare business have achieved progress, a pain palliation agent for bone metastases has been launched in the United States, and European approval has been gained for a new technetium based heart imaging agent. Further growth is expected for the company. (UK)

  18. Spent Fuel Behaviour During Interim Storage

    International Nuclear Information System (INIS)

    Objective: Review of spent fuel data relevant for future storage in Spain Perform destructive and non-destructive examinations on irradiated and non-irradiated fuel rods relevant to Spanish spent fuel management. Research approach: Among the programmes initiated in the last years (finished or about to be finished) one may highlight the following ones: • Isotopic measurements on high burnup fuels: up to 75 GW·d·t(U)-1 PWR and 53 GW·d·t(U)-1 BWR peak values; • Mechanical tests on high burnup PWR (ZIRLO) cladding and BWR (Zry-2) cladding samples; • Mechanical tests on unirradiated ZIRLO rods. Influence of hydrides content; • Modelling of mechanical tests with unirradiated claddings; • Interim storage creep modelling; • Burnup measurement equipment; • Fuel database

  19. INTERIM ANALYSIS OF THE CONTRIBUTION OF HIGH-LEVEL EVIDENCE FOR DENGUE VECTOR CONTROL.

    Science.gov (United States)

    Horstick, Olaf; Ranzinger, Silvia Runge

    2015-01-01

    This interim analysis reviews the available systematic literature for dengue vector control on three levels: 1) single and combined vector control methods, with existing work on peridomestic space spraying and on Bacillus thuringiensis israelensis; further work is available soon on the use of Temephos, Copepods and larvivorous fish; 2) or for a specific purpose, like outbreak control, and 3) on a strategic level, as for example decentralization vs centralization, with a systematic review on vector control organization. Clear best practice guidelines for methodology of entomological studies are needed. There is a need to include measuring dengue transmission data. The following recommendations emerge: Although vector control can be effective, implementation remains an issue; Single interventions are probably not useful; Combinations of interventions have mixed results; Careful implementation of vector control measures may be most important; Outbreak interventions are often applied with questionable effectiveness. PMID:26506739

  20. Interim radiological safety standards and evaluation procedures for subseabed high-level waste disposal

    Energy Technology Data Exchange (ETDEWEB)

    Klett, R.D.

    1997-06-01

    The Seabed Disposal Project (SDP) was evaluating the technical feasibility of high-level nuclear waste disposal in deep ocean sediments. Working standards were needed for risk assessments, evaluation of alternative designs, sensitivity studies, and conceptual design guidelines. This report completes a three part program to develop radiological standards for the feasibility phase of the SDP. The characteristics of subseabed disposal and how they affect the selection of standards are discussed. General radiological protection standards are reviewed, along with some new methods, and a systematic approach to developing standards is presented. The selected interim radiological standards for the SDP and the reasons for their selection are given. These standards have no legal or regulatory status and will be replaced or modified by regulatory agencies if subseabed disposal is implemented. 56 refs., 29 figs., 15 tabs.

  1. Failure to Adhere to Protocol Specified Radiation Therapy Guidelines Was Associated With Decreased Survival in RTOG 9704 - A Phase III Trial of Adjuvant Chemotherapy and Chemoradiotherapy for Patients with Resected Adenocarcinoma of the Pancreas

    Science.gov (United States)

    Abrams, Ross A.; Winter, Kathryn A.; Regine, William F.; Safran, Howard; Hoffman, John P.; Lustig, Robert; Konski, Andre A.; Benson, Al B.; Macdonald, John S.; Rich, Tyvin A.; Willett, Christopher G.

    2011-01-01

    Purpose In RTOG 9704, as previously published, patients with resected pancreatic adenocarcinoma received continuous infusion 5-FU and concurrent radiotherapy (5FU-RT). 5FU-RT treatment was preceded and followed by randomly assigned chemotherapy, either 5-FU or gemcitabine. This analysis explored whether failure to adhere to specified RT guidelines influenced survival and/or toxicity. Methods and Materials RT requirements were protocol specified. Adherence was scored as per protocol (PP) or less than per protocol (associated with decreased risk of failure (p=0.016) and, for gemcitabine patients, a trend toward reduced grade 4/5 non-hematologic toxicity (p=0.065). Conclusions This is the first phase III, multi-center, adjuvant protocol for pancreatic adenocarcinoma to evaluate the impact of adherence to specified RT protocol guidelines on protocol outcomes. Failure to adhere to specified RT guidelines was associated with reduced survival and, for patients receiving gemcitabine, trend toward increased non-hematologic toxicity. PMID:21277694

  2. Failure to Adhere to Protocol Specified Radiation Therapy Guidelines Was Associated With Decreased Survival in RTOG 9704-A Phase III Trial of Adjuvant Chemotherapy and Chemoradiotherapy for Patients With Resected Adenocarcinoma of the Pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Abrams, Ross A., E-mail: Ross_a_abrams@rush.edu [Rush University Medical Center, Chicago, IL (United States); Winter, Kathryn A. [Radiation Therapy Oncology Group Statistical Center, Philadelphia, PA (United States); Regine, William F. [University of Maryland, Baltimore, MD (United States); Safran, Howard [Brown University, Providence, RI (United States); Hoffman, John P. [Fox Chase Cancer Center, Philadelphia, PA (United States); Lustig, Robert [Radiation Therapy Oncology Group Statistical Center, Philadelphia, PA (United States); Konski, Andre A. [Wayne State Medical Center, Detroit, MI (United States); Benson, Al B. [Northwestern University, Chicago, IL (United States); Macdonald, John S. [St. Vincent' s Cancer Care Center, New York, NY (United States); Rich, Tyvin A. [University of Virginia, Charlottesville, VA (United States); Willett, Christopher G. [Duke University, Durham, NC (United States)

    2012-02-01

    Purpose: In Radiation Therapy Oncology Group 9704, as previously published, patients with resected pancreatic adenocarcinoma received continuous infusion 5-FU and concurrent radiotherapy (5FU-RT). 5FU-RT treatment was preceded and followed by randomly assigned chemotherapy, either 5-FU or gemcitabine. This analysis explored whether failure to adhere to specified RT guidelines influenced survival and/or toxicity. Methods and Materials: RT requirements were protocol specified. Adherence was scored as per protocol (PP) or less than per protocol (associated with decreased risk of failure (p = 0.016) and, for gemcitabine patients, a trend toward reduced Grade 4/5 nonhematologic toxicity (p = 0.065). Conclusions: This is the first Phase III, multicenter, adjuvant protocol for pancreatic adenocarcinoma to evaluate the impact of adherence to specified RT protocol guidelines on protocol outcomes. Failure to adhere to specified RT guidelines was associated with reduced survival and, for patients receiving gemcitabine, trend toward increased nonhematologic toxicity.

  3. Failure to Adhere to Protocol Specified Radiation Therapy Guidelines Was Associated With Decreased Survival in RTOG 9704—A Phase III Trial of Adjuvant Chemotherapy and Chemoradiotherapy for Patients With Resected Adenocarcinoma of the Pancreas

    International Nuclear Information System (INIS)

    Purpose: In Radiation Therapy Oncology Group 9704, as previously published, patients with resected pancreatic adenocarcinoma received continuous infusion 5-FU and concurrent radiotherapy (5FU-RT). 5FU-RT treatment was preceded and followed by randomly assigned chemotherapy, either 5-FU or gemcitabine. This analysis explored whether failure to adhere to specified RT guidelines influenced survival and/or toxicity. Methods and Materials: RT requirements were protocol specified. Adherence was scored as per protocol (PP) or less than per protocol (< PP). Scoring occurred after therapy but before trial analysis and without knowledge of individual patient treatment outcomes. Scoring was done for all tumor locations and for the subset of pancreatic head location. Results: RT was scored for 416 patients: 216 PP and 200 < PP. For all pancreatic sites (head, body/tail) median survival (MS) for PP vs. < PP was 1.74 vs. 1.46 years (log–rank p = 0.0077). In multivariate analysis, PP vs. < PP score correlated more strongly with MS than assigned treatment arm (p = 0.014, p = NS, respectively); for patients with pancreatic head tumors, both PP score and gemcitabine treatment correlated with improved MS (p = 0.016, p = 0.043, respectively). For all tumor locations, PP score was associated with decreased risk of failure (p = 0.016) and, for gemcitabine patients, a trend toward reduced Grade 4/5 nonhematologic toxicity (p = 0.065). Conclusions: This is the first Phase III, multicenter, adjuvant protocol for pancreatic adenocarcinoma to evaluate the impact of adherence to specified RT protocol guidelines on protocol outcomes. Failure to adhere to specified RT guidelines was associated with reduced survival and, for patients receiving gemcitabine, trend toward increased nonhematologic toxicity.

  4. TANK FARM INTERIM SURFACE BARRIER MATERIALS AND RUNOFF ALTERNATIVES STUDY

    Energy Technology Data Exchange (ETDEWEB)

    HOLM MJ

    2009-06-25

    This report identifies candidate materials and concepts for interim surface barriers in the single-shell tank farms. An analysis of these materials for application to the TY tank farm is also provided.

  5. Big Oaks National Wildlife Refuge : Interim Public Access Plan : 2000

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This interim plan covers public access for Big Oaks National Wildlife Refuge. Sections include introduction, safety briefing protocols, entry procedure, types of...

  6. Strategic Review of Medical Training and Career Structure Interim Report

    OpenAIRE

    Department of Health

    2013-01-01

    Click here to download Strategic Review of Medical Training and Career Structure Interim Report PDF 44kb Click here to download Strategic Review of Medical Training and Career Structure Terms of Reference PDF 59KB

  7. Interim Land Use Plan : Muscatatuck National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Interim Land Use Plan for Muscatatuck NWR provides a brief history of the Refuge; summarizes present land conditions, needs, and habitat types; and provides an...

  8. Technical bases for interim storage of spent nuclear fuel

    International Nuclear Information System (INIS)

    The experience base for water storage of spent nuclear fuel has evolved since 1943. The technology base includes licensing documentation, standards, technology studies, pool operator experience, and documentation from public hearings. That base reflects a technology which is largely successful and mundane. It projects probable satisfactory water storage of spent water reactor fuel for several decades. Interim dry storage of spent water reactor fuel is not yet licensed in the US, but a data base and documentation have developed. There do not appear to be technological barriers to interim dry storage, based on demonstrations with irradiated fuel. Water storage will continue to be a part of spent fuel management at reactors. Whether dry storage becomes a prominent interim fuel management option depends on licensing and economic considerations. National policies will strongly influence how long the spent fuel remains in interim storage and what its final disposition will be

  9. Interim research assessment 2003-2005 - Computer Science

    OpenAIRE

    Mouthaan, A.J.; Hartel, P.H.

    2007-01-01

    This report primarily serves as a source of information for the 2007 Interim Research Assessment Committee for Computer Science at the three technical universities in the Netherlands. The report also provides information for others interested in our research activities.

  10. Security of radioactive sources: Interim guidance for comment

    International Nuclear Information System (INIS)

    The paper is a brief summary of the material contained in IAEA-TECDOC-1355, Security of Radioactive Sources: Interim Guidance for Comment, covering the topics of threat assessment, Security Groups and performance objectives, and security based categorization. (author)

  11. Variation in guideline adherence in intrauterine insemination care.

    Science.gov (United States)

    Haagen, Esther C; Nelen, Willianne L D M; Grol, Richard P T M; Braat, Didi D M; Hermens, Rosella P M G; Kremer, Jan A M

    2010-04-01

    Health-care delivery according to clinical practice guidelines is thought to be critical in achieving optimal outcomes. This study aimed to assess the extent to which practice performance in intrauterine insemination (IUI) care is consistent with guideline recommendations and to evaluate the association between guideline adherence and outcome of IUI care. In a retrospective cohort study, 1100 infertile couples who underwent IUI treatment at 10 Dutch hospitals were asked to grant access to their medical record for assessment of guideline adherence using 25 systematically developed guideline-based performance indicators. A total of 558 couples who started 2334 IUI cycles participated. Guideline adherence regarding 20 process and five structure aspects of IUI care was often substandard and varied considerably between hospitals. Out of 10 possible associations investigated, guideline adherence regarding sperm quality and guideline adherence regarding the total number of IUI cycles were associated with improved ongoing pregnancy rates after IUI. Thus, guideline adherence in IUI care is far from optimal and varies substantially between hospitals. As associations between guideline adherence and ongoing pregnancy after IUI were mainly non-significant, further research is needed to evaluate associations between guideline adherence and other outcomes of IUI care besides ongoing pregnancy, such as patient safety and cost effectiveness. PMID:20129823

  12. United States Guidelines for Diverticulitis Treatment.

    Science.gov (United States)

    Floch, Martin H; Longo, Walter E

    2016-10-01

    Guidelines for diverticular disease management were last supported and published by the American Gastroenterology Association and the American College of Gastroenterology 2 decades ago. Guidelines have been published in other countries and by some societies. These guidelines are suggested as United States of America guidelines. In reality, they are what is practiced in Connecticut at Yale New Haven hospitals. The epidemiology and pathophysiology is described. This is still considered a dietary fiber-deficiency disease that results in high intracolonic pressure with resultant outpocketing of diverticula in the weakest point of the colon at the sites of vascular penetration with developing elastin deposition in the colon wall. The age and gender distribution is described. They are most common in the sigmoid. The guidelines of management are described according to accepted classification of the disease at all stages from onset, to early formation, to mild disease, to complicated disease, to rare specific states. The outcomes and mortality are discussed. PMID:27622366

  13. K basins interim remedial action health and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    DAY, P.T.

    1999-09-14

    The K Basins Interim Remedial Action Health and Safety Plan addresses the requirements of the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), as they apply to the CERCLA work that will take place at the K East and K West Basins. The provisions of this plan become effective on the date the US Environmental Protection Agency issues the Record of Decision for the K Basins Interim Remedial Action, currently planned in late August 1999.

  14. RATIO BETWEEN ACCOUNTING PRINCIPLES AND INTERIM FINANCIAL REPORTING

    OpenAIRE

    Claudia-Elena GRIGORAS-ICHIM

    2010-01-01

    In economic and financial communication, the common language is represented by accounting rules which consent the process of converting the operations afferent to economic development in figures (the situation of the one which prepares the interim financial reports) and a process to convert figures in economic transactions (the situation of the one using the interim financial reports). Therefore arises necessarily the “accounting standardization process” involving a complex of rules capable t...

  15. Public informations guidelines

    International Nuclear Information System (INIS)

    The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities

  16. Public informations guidelines

    Energy Technology Data Exchange (ETDEWEB)

    None

    1986-06-01

    The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities.

  17. The Time Needed to Implement the Blue Ribbon Commission Recommendation on Interim Storage - 13124

    International Nuclear Information System (INIS)

    The report of the Blue Ribbon Commission on America's Nuclear Future [1] makes a number of important recommendations to be considered if Congress elects to redirect U.S. high-level radioactive waste disposal policy. Setting aside for the purposes of this discussion any issues related to political forces leading to stopping progress on the Yucca Mountain project and driving the creation of the Commission, an important recommendation of the Commission was to institute prompt efforts to develop one or more consolidated storage facilities. The Blue Ribbon Commission noted that this recommended strategy for future storage and disposal facilities and operations should be implemented regardless of what happens with Yucca Mountain. It is too easy, however, to focus on interim storage as an alternative to geologic disposal. The Blue Ribbon Commission report does not go far enough in addressing the magnitude of the contentious problems associated with reopening the issues of relative authorities of the states and federal government with which Congress wrestled in crafting the Nuclear Waste Policy Act [2]. The Blue Ribbon Commission recommendation for prompt adoption of an interim storage program does not appear to be fully informed about the actions that must be taken, the relative cost of the effort, or the realistic time line that would be involved. In essence, the recommendation leaves to others the details of the systems engineering analyses needed to understand the nature and details of all the operations required to reach an operational interim storage facility without derailing forever the true end goal of geologic disposal. The material presented identifies a number of impediments that must be overcome before the country could develop a centralized federal interim storage facility. In summary, and in the order presented, they are: 1. Change the law, HJR 87, PL 107-200, designating Yucca Mountain for the development of a repository. 2. Bring new nuclear waste

  18. Reading and analysis on management guidelines for hyperthyroidism published in 2011 by American Thyroid Association and American Association of Clinical Endocrinologists%解读美国甲状腺协会和临床内分泌医师协会2011年甲亢诊治指南

    Institute of Scientific and Technical Information of China (English)

    孟召伟; 谭建

    2011-01-01

    最近,美国甲状腺协会和临床内分泌医师协会联合发表了甲亢诊治指南,总共提出了100项指南性的参考建议.该指南系统介绍了甲亢的诊断和治疗,重点强调了131I治疗、抗甲状腺药物治疗和手术治疗的适应证、禁忌证、治疗准备、治疗方法和随诊策略,并详细介绍了儿童甲亢、妊娠期甲亢、甲亢突眼和一些少见甲亢的诊治原则.%Recently,the American Thyroid Association and American Association of Clinical Endocrinologists published"Hyperthyroidism and other causes of thyrotoxicosis:management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists",and created 100 evidencebased recommendations.The guideline systematically introduced the diagnoses and therapies of hyperthyroidism,emphasizing the indications,contraindications,preparations,methodologies and follow-up strategies.The guideline also provided detailed management principles for hyperthyroidism in children and pregnancy,Graves' ophthalmopathy and some unusual causes of hyperthyroidism.

  19. Interim measure work plan/design for Agra, Kansas.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2008-11-18

    This Interim Measure Work Plan/Design (IMWP/D) is supplemental to the Argonne document Interim Measure Conceptual Design for Remediation of Source Area Contamination at Agra, Kansas. The IMWP/D includes information required by Kansas Department of Health and Environment (KDHE) Policy BER-RS-029, Policy and Scope of Work for Interim Measures. Specific to Policy BER-RS-029 is the requirement for several documents that will ensure that an adequate amount and type of data are collected for implementation of the IMWP/D and that data quality and safe conditions are prevailed. Such information is included in the IMWP/D as follows: Appendix A: Data Acquisition Plan--Design Testing Requirements; Appendix B: Basis of Design; Appendix C: Permits; Appendix D: Quality Assurance Project Plan; Appendix E: Health and Safety Plan; and Appendix F: Operations, Maintenance, and Monitoring Schedule. The proposed remedial technology for this project is the installation of five large-diameter boreholes (LDBs) in a source area that has been identified on the property formerly used for grain storage by the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA). The goal of the LDB technology is the remediation of the source area by removal of mass quantities of contaminated soil from the vadose zone and treatment of any remaining contaminated soils that are adjacent to the source area to achieve a carbon tetrachloride concentration below 200 {micro}g/kg. Secondary to the soil remediation is the remediation of groundwater at and adjacent to the source areas. The LDB technology serves the following purposes: (1) The physical removal of contaminated soil from the identified source area. (2) Replacement of less permeable native materials (silty clay, clayey silt, and silty sand) with more permeable materials to facilitate the capture of volatilized contaminants in the vertical borehole. (3) Removal of contaminants volatilized by air sparging (AS) and extracted from the

  20. Adherence to asthma guidelines in general practices.

    Science.gov (United States)

    Roghmann, M C; Sexton, M

    1999-06-01

    Adherence to asthma practice guidelines is low. Improved compliance could potentially improve care of patients with asthma. The purpose of this study was to determine if patients managed in a general practice with an associated asthma clinic are more likely to use asthma medications according to clinical practice guidelines than patients managed in the general surgery of the practice. A cross-sectional study of adult asthmatics, aged 18-55 years, was conducted in six British general practices. Prescription data on all asthma medication was collected for a 6-month period. Information on asthma clinic attendance, age, sex, employment status, other medical illness, and how patients used their inhaled beta2-agonist was collected through questionnaire. The prescription data for asthma medication and patient use of inhaled beta2-agonist were compared to the British Thoracic Society's (BTS) Guidelines for Management of Asthma in Adults to determine if the patient's asthma medication regimen was appropriate. There was no significant association found between appropriate asthma medication and asthma clinic attendance or other patient characteristics. Adherence to the BTS guidelines was low. Fifty-eight percent of the asthma patients used asthma medication regimens that were not consistent with the BTS guidelines published 1 year earlier. Adherence to the BTS guidelines was low regardless of patient characteristics, including asthma clinic attendance, age, sex, employment status, other medical illness, or individual practice. These findings underscore the need to document the utility of clinical practice guidelines which may improve physician compliance.

  1. SWSA 6 interim corrective measures environmental monitoring: FY 1990 results

    Energy Technology Data Exchange (ETDEWEB)

    Ashwood, T.L.; Spalding, B.P.

    1991-07-01

    This report presents the results and conclusions from a multifaceted monitoring effort associated with the high-density polyethylene caps installed in Solid Waste Storage Area (SWSA) 6 at Oak Ridge National Laboratory (ORNL) as an interim corrective measure (ICM). The caps were installed between November 1988 and June 1989 to meet Resource Conservation and Recovery Act (RCRA) requirements for closure of those areas of SWSA 6 that had received RCRA-regulated wastes after November 1980. Three separate activities were undertaken to evaluate the performance of the caps: (1) wells were installed in trenches to be covered by the caps, and water levels in these intratrench wells were monitored periodically; (2) samples were taken of the leachate in the intratrench wells and were analyzed for a broad range of radiological and chemical contaminants; and (3) water levels in wells outside the trenches were monitored periodically. With the exception of the trench leachate sampling, each of these activities spanned the preconstruction, construction, and postconstruction periods. Findings of this study have important implications for the ongoing remedial investigation in SWSA 6 and for the design of other ICMs. 51 figs., 2 tabs.

  2. SWSA 6 interim corrective measures environmental monitoring: FY 1990 results

    International Nuclear Information System (INIS)

    This report presents the results and conclusions from a multifaceted monitoring effort associated with the high-density polyethylene caps installed in Solid Waste Storage Area (SWSA) 6 at Oak Ridge National Laboratory (ORNL) as an interim corrective measure (ICM). The caps were installed between November 1988 and June 1989 to meet Resource Conservation and Recovery Act (RCRA) requirements for closure of those areas of SWSA 6 that had received RCRA-regulated wastes after November 1980. Three separate activities were undertaken to evaluate the performance of the caps: (1) wells were installed in trenches to be covered by the caps, and water levels in these intratrench wells were monitored periodically; (2) samples were taken of the leachate in the intratrench wells and were analyzed for a broad range of radiological and chemical contaminants; and (3) water levels in wells outside the trenches were monitored periodically. With the exception of the trench leachate sampling, each of these activities spanned the preconstruction, construction, and postconstruction periods. Findings of this study have important implications for the ongoing remedial investigation in SWSA 6 and for the design of other ICMs. 51 figs., 2 tabs

  3. Guidelines for radioiodinated MIBG scintigraphy in children.

    Science.gov (United States)

    Olivier, Pierre; Colarinha, Paula; Fettich, Jure; Fischer, Sibylle; Frökier, Jörgen; Giammarile, Francesco; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Piepsz, Amy; Porn, Ute; Sixt, Rune; van Velzen, Jeannette

    2003-05-01

    These guidelines on the use of radioiodinated (99m)Tc-MIBG scintigraphy in children, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They have been influenced by the conclusions of the "Consensus Guidelines for MIBG Scintigraphy" (Paris, November 6, 1997) of the European Neuroblastoma Group and by those of the Oncological Committee of the French Society of Nuclear Medicine. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations.

  4. Guidelines for radioiodinated MIBG scintigraphy in children.

    Science.gov (United States)

    Olivier, Pierre; Colarinha, Paula; Fettich, Jure; Fischer, Sibylle; Frökier, Jörgen; Giammarile, Francesco; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Piepsz, Amy; Porn, Ute; Sixt, Rune; van Velzen, Jeannette

    2003-05-01

    These guidelines on the use of radioiodinated (99m)Tc-MIBG scintigraphy in children, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They have been influenced by the conclusions of the "Consensus Guidelines for MIBG Scintigraphy" (Paris, November 6, 1997) of the European Neuroblastoma Group and by those of the Oncological Committee of the French Society of Nuclear Medicine. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations. PMID:12658506

  5. Maintenance Trades Guidelines

    Science.gov (United States)

    Weidner, Theodore J.

    2008-01-01

    In 2002, APPA published "Maintenance Staffing Guidelines for Educational Facilities," the first building maintenance trades staffing guideline designed to assist educational facilities professionals with their staffing needs. addresses how facilities professionals can determine the appropriate size and mix of their organization. Contents include…

  6. Measure Guideline: Ventilation Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Springer, D.; Dakin, B.; German, A.

    2012-04-01

    The purpose of this measure guideline on ventilation cooling is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.

  7. Measure Guideline: Ventilation Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Springer, D. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); German, A. [Alliance for Residential Building Innovation (ARBI), David, CA (United States)

    2012-04-01

    The purpose of this measure guideline is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.

  8. D 59 Design Guidelines

    DEFF Research Database (Denmark)

    Burcharth, Hans F.; Lamberti, Alberto

    The present guidelines are specifically dedicated to Low Crested Structures on attempt to provide methodological tools both for the engineering design of structures and for prediction of performance and environmental impacts. It is anticipated that the guidelines will provide valuable inputs to c...

  9. Primary care guidelines

    DEFF Research Database (Denmark)

    Ijäs, Jarja; Alanen, Seija; Kaila, Minna;

    2009-01-01

    OBJECTIVE: To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres. DESIGN: A cross...

  10. Global Imaging referral guidelines

    International Nuclear Information System (INIS)

    The medical imaging specialists called for global referral guidelines which would be made available to referring doctors. These referral guidelines should be:- Applicable in different health care settings, including resource-poor settings; Inclusive in terms of the range of clinical conditions; User-friendly and accessible (format/media); Acceptable to stakeholders, in particular to the referrers as the main target audience. To conceive evidence-based medicine as an integration of best research evidence with clinical expertise and patient values. The Direct recipients of the Referral Guidelines would be:- Referrers: general practitioners / family doctors; paediatricians; emergency department doctors; other specialists and health workers. Providers (medical imaging practitioners): radiologists; nuclear medicine physicians; radiographers; other appropriately qualified practitioners providing diagnostic imaging services. For the Referral Guidelines to be effective there need to be: Credibility evidence-based Practicality end user involvement Context local resources, disease profiles Endorsement, opinion leaders Implementation- policy, education, CPOE - Monitoring of the use clinical audit, report feedback. The aim of the Referral Guidelines Project was to: Produce global referral guidelines that are evidence-based, cost effective and appropriate for the local setting, and include consideration of available equipment and expertise (RGWG; SIGs); Include supporting information about radiation doses, potential risks, protection of children and pregnant women (introductory chapter); Facilitate the implementation of the guidelines through guidance and tools (e.g. implementation guides, checklists, capacity building tools, guides on stakeholders engagement, audit support criteria); Conduct pilot testing in different clinical settings from each of the six WHO regions; Promote the inclusion of the referral guidelines in the curricula of medical schools; Develop and implement

  11. Guidelines for direct radionuclide cystography in children.

    Science.gov (United States)

    Fettich, Jure; Colarinha, Paula; Fischer, Sibylle; Frökier, Jörgen; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Olivier, Pierre; Piepsz, Amy; Porn, Ute; Roca, Isabel; Sixt, Rune; van Velzen, Jeannette

    2003-05-01

    These guidelines, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They contain information on the indications, acquisition, processing and interpretation of direct radioisotope cystography in children. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations.

  12. Clinical Practice Guidelines for Cardiogenic Shock.

    Directory of Open Access Journals (Sweden)

    Arelys Falcón Hernández

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Cardiogenic Shock. It has been defined as the persistence of tissue hypoperfusion, usually associated to blood hypotension as the result of heart pumping failure. This document includes a review of the main aspects as concepts, aetiology, diagnosis and treatment. It includes the concept, risk factors, clinical presentations, diagnosis, and therapy based on the possibilities of our environment. It includes assessment guidelines focused on the most important aspects to be accomplished.

  13. Guidelines for direct radionuclide cystography in children.

    Science.gov (United States)

    Fettich, Jure; Colarinha, Paula; Fischer, Sibylle; Frökier, Jörgen; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Olivier, Pierre; Piepsz, Amy; Porn, Ute; Roca, Isabel; Sixt, Rune; van Velzen, Jeannette

    2003-05-01

    These guidelines, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They contain information on the indications, acquisition, processing and interpretation of direct radioisotope cystography in children. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations. PMID:12692686

  14. [Implementation of Study Results in Guidelines and Adherence to Guidelines in Clinical Practice].

    Science.gov (United States)

    Waldfahrer, F

    2016-04-01

    Guidelines were introduced in hospital and practice-based otorhinolaryngology in the 1990s, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. The Society has cooperated in a further 34 guidelines. The quality of the guidelines has been continually improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany [Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.]. Since increasing digitalisation has made access to scientific publications quicker and more simple, relevant study results can be incorporated in guidelines more easily today than in the analogue world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines. PMID:27128403

  15. Preliminary report on operational guidelines developed for use in emergency preparedness and response to a radiological dispersal device incident.

    Energy Technology Data Exchange (ETDEWEB)

    Yu, C.; Cheng, J.-J.; Kamboj, S.; Domotor, S.; Wallo, A.; Environmental Science Division; DOE

    2006-12-15

    This report presents preliminary operational guidelines and supporting work products developed through the interagency Operational Guidelines Task Group (OGT). The report consolidates preliminary operational guidelines, all ancillary work products, and a companion software tool that facilitates their implementation into one reference source document. The report is intended for interim use and comment and provides the foundation for fostering future reviews of the operational guidelines and their implementation within emergency preparedness and response initiatives in the event of a radiological dispersal device (RDD) incident. The report principally focuses on the technical derivation and presentation of the operational guidelines. End-user guidance providing more details on how to apply these operational guidelines within planning and response settings is being considered and developed elsewhere. The preliminary operational guidelines are categorized into seven groups on the basis of their intended application within early, intermediate, and long-term recovery phases of emergency response. We anticipate that these operational guidelines will be updated and refined by interested government agencies in response to comments and lessons learned from their review, consideration, and trial application. This review, comment, and trial application process will facilitate the selection of a final set of operational guidelines that may be more or less inclusive of the preliminary operational guidelines presented in this report. These and updated versions of the operational guidelines will be made available through the OGT public Web site (http://ogcms.energy.gov) as they become finalized for public distribution and comment.

  16. Operable Unit 3: Proposed Plan/Environmental Assessment for interim remedial action

    International Nuclear Information System (INIS)

    This document presents a Proposed Plan and an Environmental Assessment for an interim remedial action to be undertaken by the US Department of Energy (DOE) within Operable Unit 3 (OU3) at the Fernald Environmental Management Project (FEMP). This proposed plan provides site background information, describes the remedial alternatives being considered, presents a comparative evaluation of the alternatives and a rationnale for the identification of DOE's preferred alternative, evaluates the potential environmental and public health effects associated with the alternatives, and outlines the public's role in helping DOE and the EPA to make the final decision on a remedy

  17. Department of Energy Plutonium ES ampersand H Vulnerability Assessment Savannah River Site interim compensatory measures

    International Nuclear Information System (INIS)

    The Savannah River Site (SRS) has recently completed a self-assessment of potential vulnerabilities associated with plutonium and other transuranic materials stored at the site. An independent Working Group Assessment Team (WGAT) appointed by DOE/ES ampersand H also performed an independent assessment, and reviewed and validated the site self-assessment. The purpose of this report is to provide a status of interim compensatory measures at SRS to address hazards in advance of any corrective actions. ES ampersand H has requested this status for all vulnerabilities ranked medium or higher with respect to potential consequences to workers, environment, and the public

  18. Assessment report of research and development activities. Activity: advanced science research' (Interim report)

    International Nuclear Information System (INIS)

    Japan Atomic Energy Agency (hereinafter referred to as 'JAEA') consults an assessment committee, 'Evaluation Committee of Research Activities for Advanced Science Research' (hereinafter referred to as 'Committee') for interim assessment of 'Advanced Science Research,' in accordance with General Guideline for the Evaluation of Government Research and Development (R and D) Activities' by Cabinet Office, Government of Japan, 'Guideline for Evaluation of R and D in Ministry of Education, Culture, Sports, Science and Technology' and 'Regulation on Conduct for Evaluation of R and D Activities' by JAEA. In response to the JAEA's request, the Committee assessed the research program of the Advanced Science Research Center (hereinafter referred to as 'ASRC') during the period of two years from October 2005 to September 2007. The Committee evaluated the management and research activities of the ASRC based on the explanatory documents prepared by the ASRC, the oral presentations with questions-and-answers by the Director and the research group leaders, and interviews from group members through on-site visits by the Committee members. One CD-ROM is attached as an appendix. (J.P.N.)

  19. Assessment report of research and development activities. Activity: Quantum Beam Science Research' (Interim report)

    International Nuclear Information System (INIS)

    Japan Atomic Energy Agency (hereinafter referred to as 'JAEA') consulted an assessment committee, 'Evaluation Committee of Research Activities for Quantum Beam Science Research (hereinafter referred to as 'Committee') for interim assessment of 'Quantum Beam Science Research', in accordance with General Guideline for Evaluation of Government Research and Development (R and D) Activities' by Cabinet Office, Government of Japan, 'Guideline for Evaluation of R and D in Ministry of Education, Culture, Sports, Science and Technology' and Regulation on Conduct for Evaluation of R and D Activities' by JAEA. In response to the JAEA's request, the Committee assessed the research program of the Quantum Beam Science Research, which includes the management of the Quantum Beam Science Directorate (hereinafter referred to as 'QuBS') and the research activities in the area of Quantum Beam Science during October, 2005 to September, 2007. The Committee evaluated the management and research activities in Quantum Beam Science based on the documents and oral presentations prepared by QuBS. This evaluation report presents the summary and the submitted by the Committee. (author)

  20. Sampling and analysis plan for Wayne Interim Storage Site (WISS), Wayne, New Jersey

    International Nuclear Information System (INIS)

    This field sampling plan describes the methodology to perform an independent radiological verification survey and chemical characterization of a remediated area of the subpile at the Wayne Interim Storage Site, Wayne, New Jersey.Data obtained from collection and analysis of systematic and biased soil samples will be used to assess the status of remediation at the site and verify the final radiological status. The objective of this plan is to describe the methods for obtaining sufficient and valid measurements and analytical data to supplement and verify a radiological profile already established by the Project Remediation Management Contractor (PMC). The plan describes the procedure for obtaining sufficient and valid analytical data on soil samples following remediation of the first layer of the subpile. Samples will be taken from an area of the subpile measuring approximately 30 m by 80 m from which soil has been excavated to a depth of approximately 20 feet to confirm that the soil beneath the excavated area does not exceed radiological guidelines established for the site or chemical regulatory limits for inorganic metals. After the WISS has been fully remediated, the Department of Energy will release it for industrial/commercial land use in accordance with the Record of Decision. This plan provides supplemental instructions to guidelines and procedures established for sampling and analysis activities. Procedures will be referenced throughout this plan as applicable, and are available for review if necessary

  1. Assessment report on research and development activities. Activity: 'Advanced science research' (Interim report)

    International Nuclear Information System (INIS)

    Japan Atomic Energy Agency (hereinafter referred to as “JAEA”) consulted an assessment committee, “Evaluation Committee of Research Activities for Advanced Science Research” (hereinafter referred to as “Committee”) for interim assessment of “Advanced Science Research,” in accordance with “General Guideline for the Evaluation of Government Research and Development (R and D) Activities” by Cabinet Office, Government of Japan, “Guideline for Evaluation of R and D in Ministry of Education, Culture, Sports, Science and Technology” and “Regulation on Conduct for Evaluation of R and D Activities” by JAEA. In response to the JAEA's request, the Committee assessed the research programs and activities of the Advanced Science Research Center (hereinafter referred to as “ASRC”) for the period of two years from April 2010. The Committee evaluated the management and the research programs of the ASRC based on the explanatory documents prepared by the ASRC and the oral presentations with questions-and-answers by the Director and the research group leaders. This report summarizes the result of the assessment by the Committee with the Committee report attached from page 7. (author)

  2. Evidence-based guidelines on the use of opioids in chronic non-cancer pain--a consensus statement by the Pain Association of Singapore Task Force

    NARCIS (Netherlands)

    Ho, K.Y.; Chua, N.H.; George, J.M.; Yeo, S.N.; Main, N.B.; Choo, C.Y.; Tan, J.W.; Tan, K.H.; Ng, B.Y.

    2013-01-01

    INTRODUCTION: While opioids are effective in carefully selected patients with chronic non-cancer pain (CNCP), they are associated with potential risks. Therefore, treatment recommendations for the safe and effective use of opioids in this patient population are needed. MATERIALS AND METHODS: A multi

  3. Are Healthy Diets that follow The 2005 Dietary Guidelines for Americans (DGA) associated with Bone Mineral Density (BMD) in men and women?

    Science.gov (United States)

    The 2005 DGA is a government promulgated healthy dietary pattern to reduce the risk of chronic diseases, including osteoporosis. We examined whether a diet consistent with the DGA was associated with higher BMD in men and women of the Framingham Offspring Study (FOS). We developed an index to measur...

  4. Diretrizes da Associação Médica Brasileira para o tratamento da depressão (versão integral Guidelines of the Brazilian Medical Association for the treatment of depression (complete version

    Directory of Open Access Journals (Sweden)

    Marcelo Pio de Almeida Fleck

    2003-06-01

    Full Text Available OBJETIVO: A depressão é uma condição freqüente e crônica associada a níveis altos de incapacitação funcional. A Associação Médica Brasileira, através de seu projeto "Diretrizes", buscou desenvolver guias para diagnóstico e tratamento das doenças mais comuns. O objetivo deste trabalho é o de apresentar o documento original que serviu de base a uma versão abreviada disponível no endereço eletrônico da Associação Médica Brasileira. MÉTODOS: A metodologia utilizada foi a proposta pela Associação Médica Brasileira para o projeto Diretrizes. Assim, o trabalho foi baseado em diretrizes desenvolvidas em outros países, aliados a artigos de revisão sistemáticos, ensaios clínicos randomizados e na ausência desses, estudos observacionais e recomendações de grupo de experts. RESULTADOS: São apresentados dados referentes à prevalência, demografia, incapacitação, diagnóstico e sub-diagnóstico de depressão. Em relação ao tratamento, são mostrados dados sobre a eficácia do tratamento medicamentoso e psicoterápico das depressões, além do perfil de custos e de efeitos colaterais das diferentes classes de medicamentos disponíveis no Brasil, como o planejamento das diferentes fases do tratamento. CONCLUSÕES: A Diretrizes se propõe a servir de base para uma atitude fundamentada em graus de evidências da literatura, auxiliando na tomada de decisões clínicas.OBJECTIVE: Depression is a frequent and chronic condition with high levels of functional disability. Brazilian Medical Association Guidelines project proposed guidelines for diagnosis and treatment of the most common medical disorders. The objective of this paper is to present the original document that originated the abbreviated version available at the electronic address of Brazilian Medical Association. METHODS: This paper was based on guidelines developed in other countries and systematic reviews, randomized clinical trials and when absent, observational

  5. Radioactive waste interim storage in Germany; Zwischenlagerung von radioaktiven Abfaellen in Deutschland

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-12-15

    The short summary on the radioactive waste interim storage in Germany covers the following issues: importance of interim storage in the frame of radioactive waste management, responsibilities and regulations, waste forms, storage containers, transport of vitrified high-level radioactive wastes from the reprocessing plants, central interim storage facilities (Gorleben, Ahaus, Nord/Lubmin), local interim storage facilities at nuclear power plant sites, federal state collecting facilities, safety, radiation exposure in Germany.

  6. London 2012 packaging guidelines

    OpenAIRE

    2013-01-01

    These guidelines are intended to provide supplemental advice to suppliers and licensees regarding the provisions of the LOCOG Sustainable Sourcing Code that relate to packaging design and materials selection.

  7. Guidelines for Crisis Management.

    Science.gov (United States)

    Wimberley, Lloyd

    1985-01-01

    The article offers guidelines for crisis prediction, preplanning, support team development, and post-crisis management that can handle aggressive behavior and convey to the child the existence of a legitimate system for enhancing positive self control. (CL)

  8. Transparent Guideline Methodology Needed

    DEFF Research Database (Denmark)

    Lidal, Ingeborg; Norén, Camilla; Mäkelä, Marjukka

    2013-01-01

    As part of learning at the Nordic Workshop of Evidence-based Medicine, we have read with interest the practice guidelines for central venous access, published in your Journal in 2012.1 We appraised the quality of this guideline using the checklist developed by The Evidence-Based Medicine Working ...... are based on best currently available evidence. Our concerns are in two main categories: the rigor of development, including methodology of searching, evaluating, and combining the evidence; and editorial independence, including funding and possible conflicts of interest....... Group.2 Similar criteria for guideline quality have been suggested elsewhere.3 Our conclusion was that this much needed guideline is currently unclear about several aspects of the methodology used in developing the recommendations. This means potential users cannot be certain that the recommendations...

  9. Epetra developers coding guidelines.

    Energy Technology Data Exchange (ETDEWEB)

    Heroux, Michael Allen; Sexton, Paul Michael

    2003-12-01

    Epetra is a package of classes for the construction and use of serial and distributed parallel linear algebra objects. It is one of the base packages in Trilinos. This document describes guidelines for Epetra coding style. The issues discussed here go beyond correct C++ syntax to address issues that make code more readable and self-consistent. The guidelines presented here are intended to aid current and future development of Epetra specifically. They reflect design decisions that were made in the early development stages of Epetra. Some of the guidelines are contrary to more commonly used conventions, but we choose to continue these practices for the purposes of self-consistency. These guidelines are intended to be complimentary to policies established in the Trilinos Developers Guide.

  10. 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)

  11. OSART guidelines. 1992 edition

    International Nuclear Information System (INIS)

    The IAEA Operational Safety Review Team (OSART) Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Specific guidelines are provided as a guide for the systematic review in the following areas important to operational safety: management, organization and administration, training and qualification, operations, maintenance, technical support, radiation protection, chemistry, emergency planning and preparedness. Additional guidance and reference material has been prepared by the IAEA to complement the expertise of the OSART members

  12. Dietary guidelines in singapore.

    Science.gov (United States)

    Lee, Benjamin Lc

    2011-01-01

    The 2011 Dietary Guidelines were developed with the aim of providing guidance on what dietary strategies can best address increasing rates of obesity and non-communicable chronic disease in Singapore. This set of dietary guidelines was developed with a local expert committee based on a review of scientific literature and data on current dietary patterns from the 2010 National Nutrition Survey. Projected nutrient intakes from a diet adhering to the 2011 Dietary Guidelines were calculated using a local food composition database (FOCOS) and validated against nutrient recommendations. Acknowledging that dietary requirements differ between age groups, different sets of dietary guidelines have been developed and customised for different segments of the population. To date, Singapore has produced dietary guidelines for children and adolescents (focusing on establishing healthy lifelong eating patterns), adults (focusing on preventing obesity and reinforcing healthy eating patterns), and most recently, guidelines for older adults (>50 years of age) that address the issue of potential dietary insufficiency caused by age-related increases in nutrient requirements combined with a reduction in energy requirements. In Singapore, dietary guidelines have been used to inform and direct public policy and promote dietary patterns that meet nutrient requirements while reducing the risk of non-communicable chronic diseases. Examples of public policy include: national guidelines on food advertising and standards for food served in nursing homes; examples of public health promotion programmes include: the Healthier Choice Symbol Programme for packaged food products and programmes encouraging provision of healthier meals in hawker centres, restaurants, and school or workplace canteens. PMID:21859669

  13. Web Accessibility and Guidelines

    Science.gov (United States)

    Harper, Simon; Yesilada, Yeliz

    Access to, and movement around, complex online environments, of which the World Wide Web (Web) is the most popular example, has long been considered an important and major issue in the Web design and usability field. The commonly used slang phrase ‘surfing the Web’ implies rapid and free access, pointing to its importance among designers and users alike. It has also been long established that this potentially complex and difficult access is further complicated, and becomes neither rapid nor free, if the user is disabled. There are millions of people who have disabilities that affect their use of the Web. Web accessibility aims to help these people to perceive, understand, navigate, and interact with, as well as contribute to, the Web, and thereby the society in general. This accessibility is, in part, facilitated by the Web Content Accessibility Guidelines (WCAG) currently moving from version one to two. These guidelines are intended to encourage designers to make sure their sites conform to specifications, and in that conformance enable the assistive technologies of disabled users to better interact with the page content. In this way, it was hoped that accessibility could be supported. While this is in part true, guidelines do not solve all problems and the new WCAG version two guidelines are surrounded by controversy and intrigue. This chapter aims to establish the published literature related to Web accessibility and Web accessibility guidelines, and discuss limitations of the current guidelines and future directions.

  14. Single-shell tank interim stabilization project plan

    Energy Technology Data Exchange (ETDEWEB)

    Ross, W.E.

    1998-03-27

    Solid and liquid radioactive waste continues to be stored in 149 single-shell tanks at the Hanford Site. To date, 119 tanks have had most of the pumpable liquid removed by interim stabilization. Thirty tanks remain to be stabilized. One of these tanks (C-106) will be stabilized by retrieval of the tank contents. The remaining 29 tanks will be interim stabilized by saltwell pumping. In the summer of 1997, the US Department of Energy (DOE) placed a moratorium on the startup of additional saltwell pumping systems because of funding constraints and proposed modifications to the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) milestones to the Washington State Department of Ecology (Ecology). In a letter dated February 10, 1998, Final Determination Pursuant to Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) in the Matter of the Disapproval of the DOE`s Change Control Form M-41-97-01 (Fitzsimmons 1998), Ecology disapproved the DOE Change Control Form M-41-97-01. In response, Fluor Daniel Hanford, Inc. (FDH) directed Lockheed Martin Hanford Corporation (LNMC) to initiate development of a project plan in a letter dated February 25, 1998, Direction for Development of an Aggressive Single-Shell Tank (SST) Interim Stabilization Completion Project Plan in Support of Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement). In a letter dated March 2, 1998, Request for an Aggressive Single-Shell Tank (SST) Interim Stabilization Completion Project Plan, the DOE reaffirmed the need for an aggressive SST interim stabilization completion project plan to support a finalized Tri-Party Agreement Milestone M-41 recovery plan. This project plan establishes the management framework for conduct of the TWRS Single-Shell Tank Interim Stabilization completion program. Specifically, this plan defines the mission needs and requirements; technical objectives and approach; organizational structure, roles, responsibilities

  15. Interim process report for the safety assessment SR-Can

    Energy Technology Data Exchange (ETDEWEB)

    Sellin, Patrick (ed.)

    2004-08-01

    This report is a documentation of buffer processes identified as relevant to the long-term safety of a KBS-3 repository. The report is part of the interim reporting of the safety assessment SR-Can, see further the Interim main report. The final SR-Can reporting will support SKB's application to build an Encapsulation plant for spent nuclear fuel and is to be produced in 2006. The purpose of this report is to document the scientific knowledge of the processes to a level required for an adequate treatment in the safety assessment. The documentation is thus from a scientific point of not exhaustive since such a treatment is neither necessary for the purposes of the safety assessment nor possible within the scope of an assessment. The purpose is further to determine the handling of each process in the safety assessment and to demonstrate how uncertainties are taken care of, given the suggested handling. The process documentation in the SR 97 version of the Process report is a starting point for this SR-Can interim version. As further described in the Interim main report, the list of relevant processes has been reviewed and slightly extended by comparison to other databases. Furthermore, the backfill has been included as a system part of its own, rather than being described together with the buffer as in SR 97. Apart from giving an interim account of the documentation and handling of buffer processes in SR-Can, this report is meant to serve as a template for the forthcoming documentation of processes occurring in other parts of the repository system. A complete list of processes can be found in the Interim FEP report for the safety assessment SR-Can. All material presented in this document is preliminary in nature and will possibly be updated as the SR-Can project progresses.

  16. Guidelines International Network: toward international standards for clinical practice guidelines.

    NARCIS (Netherlands)

    Qaseem, A.; Forland, F.; Macbeth, F.; Ollenschlager, G.; Phillips, S.; Wees, P.J. van der

    2012-01-01

    Guideline development processes vary substantially, and many guidelines do not meet basic quality criteria. Standards for guideline development can help organizations ensure that recommendations are evidence-based and can help users identify high-quality guidelines. Such organizations as the U.S. In

  17. Animal care guidelines and future directions.

    Science.gov (United States)

    Webster, A B

    2007-06-01

    Two notions broadly accepted in developed western societies have made animal care guidelines inevitable. These are that domestic animals are sentient and that humans are responsible to ensure the proper care of domestic animals. Despite these common views, people have differing moral understandings of the human-animal relationship, and there are sharp divisions over how these views should be applied to domestic animal care. Animal care guidelines have been developed by different nations at several organizational levels to represent a compromise that is acceptable to most people. These organizational levels include individual poultry companies, national poultry associations, individual customers of the poultry industry, national associations of customer companies, national governments, and international organizations. Animal care guideline development has typically included input from producers and scientists and, depending on the sponsoring organization, animal advocates and government representatives as well. Animal advocacy groups have also sought to influence domestic animal care by campaigning against animal production practices or by offering their preferred guidelines for producers to adopt in the hope that the endorsement of the welfare group would add value to the product. Originally, animal care guidelines were only recommended, with little or no requirement for compliance. In recent years, the need for retail companies to assure certain welfare standards has led to animal welfare auditing of production facilities. Animal care guidelines primarily have sought to establish standards for handling and husbandry in existing production systems. Future guidelines may put increasing emphasis on adoption of alternative management practices or housing systems. International animal care guidelines are being developed on 2 levels (i.e., among national governments to create a common standard for trade in animal products and within international retail companies to

  18. Corporate Risk Disclosure: A Content Analysis of Swedish Interim Reports

    OpenAIRE

    Khaledi, Soheila

    2014-01-01

    The aim of this research is to examine the determinants of the level of corporate risk disclosure (CRD) in the interim reports of Swedish non-financial companies. A quantitative research approach is used, the sample data of which consist of 166 firms with 4,849 interim reports over a 10-year period. By utilizing the notion of risk and its definition, I have distinguished three categories of risk, namely risk as uncertainty, risk as threat and risk as opportunity. A systematic content analysis...

  19. Pairing smoking-cessation services with lung cancer screening: A clinical guideline from the Association for the Treatment of Tobacco Use and Dependence and the Society for Research on Nicotine and Tobacco.

    Science.gov (United States)

    Fucito, Lisa M; Czabafy, Sharon; Hendricks, Peter S; Kotsen, Chris; Richardson, Donna; Toll, Benjamin A

    2016-04-15

    Smoking cessation is crucial for reducing cancer risk and premature mortality. The US Preventive Services Task Force (USPSTF) has recommended annual lung cancer screening with low-dose computed tomography (LDCT), and the Center for Medicare and Medicaid Services recently approved lung screening as a benefit for patients ages 55 to 77 years who have a 30 pack-year history. The Society for Research on Nicotine and Tobacco (SRNT) and the Association for the Treatment of Tobacco Use and Dependence (ATTUD) developed the guideline described in this commentary based on an illustrative literature review to present the evidence for smoking-cessation health benefits in this high-risk group and to provide clinical recommendations for integrating evidence-based smoking-cessation treatment with lung cancer screening. Unfortunately, extant data on lung cancer screening participants were scarce at the time this guideline was written. However, in this review, the authors summarize the sufficient evidence on the benefits of smoking cessation and the efficacy of smoking-cessation interventions for smokers ages 55 to 77 years to provide smoking-cessation interventions for smokers who seek lung cancer screening. It is concluded that smokers who present for lung cancer screening should be encouraged to quit smoking at each visit. Access to evidence-based smoking-cessation interventions should be provided to all smokers regardless of scan results, and motivation to quit should not be a necessary precondition for treatment. Follow-up contacts to support smoking-cessation efforts should be arranged for smokers. Evidence-based behavioral strategies should be used at each visit to motivate smokers who are unwilling to try quitting/reducing smoking or to try evidence-based treatments that may lead to eventual cessation.

  20. A comparative study of teaching clinical guideline for prevention of ventilator-associated pneumonia in two ways: face-to-face and workshop training on the knowledge and practice of nurses in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    MAJID YAZDANI

    2015-04-01

    Full Text Available Introduction: Ventilator-associated pneumonia (VAP is one of the most popular nosocomial infections in the intensive care units and the nurse’s role in preventing it is very important. The aim of this study was to compare the effect of two methods of face to face training and work- shop clinical guidelines in prevention of VAP. Methods: In this experimental randomized clinical trial, the knowledge and practice of nurses in ICUs were studied in two groups: face to face training (35 nurses and workshops (40 nurses by using clinical guidelines in prevention of VAP in one of the hospitals of Shiraz University of Medical Sciences. The level of knowledge and practice in each group was assessed by selfreport questionnaire, knowledge questionnaire and also direct observation of practice, before and after training. Data were analyzed with descriptive statistics, paired t-test, independent t-test, McNemar test, Fisher’s exact, sign and Chi-square test, using SPSS 14. Results: This study demonstrated that both methods of face to face training and workshop were very effective. The incidence of inappropriate pressure of cuff in the tracheal tubes and tracheostomy tubes was significantly reduced after training (p=0.001. But, by comparison of these two methods and the relationship between the variables revealed that no significant difference was found between the two groups of face to face training and workshop. Conclusion: Training the nurses is highly effective in preventing VAP, particularly for appropriate cuff pressure, suctioning and disinfecting hands.

  1. Pairing smoking-cessation services with lung cancer screening: A clinical guideline from the Association for the Treatment of Tobacco Use and Dependence and the Society for Research on Nicotine and Tobacco.

    Science.gov (United States)

    Fucito, Lisa M; Czabafy, Sharon; Hendricks, Peter S; Kotsen, Chris; Richardson, Donna; Toll, Benjamin A

    2016-04-15

    Smoking cessation is crucial for reducing cancer risk and premature mortality. The US Preventive Services Task Force (USPSTF) has recommended annual lung cancer screening with low-dose computed tomography (LDCT), and the Center for Medicare and Medicaid Services recently approved lung screening as a benefit for patients ages 55 to 77 years who have a 30 pack-year history. The Society for Research on Nicotine and Tobacco (SRNT) and the Association for the Treatment of Tobacco Use and Dependence (ATTUD) developed the guideline described in this commentary based on an illustrative literature review to present the evidence for smoking-cessation health benefits in this high-risk group and to provide clinical recommendations for integrating evidence-based smoking-cessation treatment with lung cancer screening. Unfortunately, extant data on lung cancer screening participants were scarce at the time this guideline was written. However, in this review, the authors summarize the sufficient evidence on the benefits of smoking cessation and the efficacy of smoking-cessation interventions for smokers ages 55 to 77 years to provide smoking-cessation interventions for smokers who seek lung cancer screening. It is concluded that smokers who present for lung cancer screening should be encouraged to quit smoking at each visit. Access to evidence-based smoking-cessation interventions should be provided to all smokers regardless of scan results, and motivation to quit should not be a necessary precondition for treatment. Follow-up contacts to support smoking-cessation efforts should be arranged for smokers. Evidence-based behavioral strategies should be used at each visit to motivate smokers who are unwilling to try quitting/reducing smoking or to try evidence-based treatments that may lead to eventual cessation. PMID:26916412

  2. Basis for Interim Operation for Fuel Supply Shutdown Facility

    International Nuclear Information System (INIS)

    This document establishes the Basis for Interim Operation (BIO) for the Fuel Supply Shutdown Facility (FSS) as managed by the 300 Area Deactivation Project (300 ADP) organization in accordance with the requirements of the Project Hanford Management Contract procedure (PHMC) HNF-PRO-700, ''Safety Analysis and Technical Safety Requirements''. A hazard classification (Benecke 2003a) has been prepared for the facility in accordance with DOE-STD-1027-92 resulting in the assignment of Hazard Category 3 for FSS Facility buildings that store N Reactor fuel materials (303-B, 3712, and 3716). All others are designated Industrial buildings. It is concluded that the risks associated with the current and planned operational mode of the FSS Facility (uranium storage, uranium repackaging and shipment, cleanup, and transition activities, etc.) are acceptable. The potential radiological dose and toxicological consequences for a range of credible uranium storage building have been analyzed using Hanford accepted methods. Risk Class designations are summarized for representative events in Table 1.6-1. Mitigation was not considered for any event except the random fire event that exceeds predicted consequences based on existing source and combustible loading because of an inadvertent increase in combustible loading. For that event, a housekeeping program to manage transient combustibles is credited to reduce the probability. An additional administrative control is established to protect assumptions regarding source term by limiting inventories of fuel and combustible materials. Another is established to maintain the criticality safety program. Additional defense-in-depth controls are established to perform fire protection system testing, inspection, and maintenance to ensure predicted availability of those systems, and to maintain the radiological control program. It is also concluded that because an accidental nuclear criticality is not credible based on the low uranium enrichment

  3. Hybrid specification, storage, retrieval and runtime application of clinical guidelines.

    Science.gov (United States)

    Shahar, Y

    2006-06-01

    Clinical guidelines are a major tool in improving the quality of medical care. However, most guidelines are in free text, are not machine-comprehensible and are not easily accessible to clinicians at the point of care. We have designed and implemented a web-based, modular, distributed architecture, the Digital Electronic Guideline Library (DeGeL), which facilitates gradual conversion of clinical guidelines from text to a formal representation in the chosen target guideline ontology. The architecture supports guideline classification, semantic markup, context-sensitive search, browsing, run-time application and retrospective quality assessment. The DeGeL hybrid meta-ontology includes elements common to all guideline ontologies, such as semantic classification and domain knowledge; it also includes four content-representation formats: free text, semi-structured text, semi-formal representation and a formal representation. These formats support increasingly sophisticated computational tasks. Guidelines can thus be in a hybrid representation in which guidelines, and even parts of the same guideline, might exist at different formalisation levels. We have also developed and rigorously evaluated a methodology and an associated web-based tool, Uruz, for gradually structuring and semi-formalising free-text clinical guidelines. Finally, we have designed, implemented and evaluated a new approach, the hybrid runtime application model, for supporting runtime application of clinical guidelines that are not necessarily in a machine-comprehensible format; in particular, when the guideline is in a semi-formal representation and the patient's data are either in an electronic medical record or in a paper format. The tool implementing this new approach, the Spock module, is customised at this point to the Asbru guideline specification language and exploits the hybrid structure of guidelines in DeGeL. The Spock module also exploits our temporal-abstraction mediator to the patient

  4. INTERIM BARRIER AT HANFORDS TY FARM TO PROTECT GROUNDWATER AT THE HANFORD SITE WASHINGTON USA

    Energy Technology Data Exchange (ETDEWEB)

    PARKER DL; HOLM MJ; HENDERSON JC; LOBER RW

    2011-01-13

    An innovative interim surface barrier was constructed as a demonstration project at the Hanford Site's TY Tank Farm. The purpose of the demonstration barrier is to stop rainwater and snowmelt from entering the soils within the tank farm and driving contamination from past leaks and spills toward the ground water. The interim barrier was constructed using a modified asphalt material with very low permeability developed by MatCon{reg_sign}. Approximately 2,400 cubic yards of fill material were added to the tank farm to create a sloped surface that will gravity drain precipitation to collection points where it will be routed through buried drain lines to an evapotranspiration basin adjacent to the farm. The evapotranspiration basin is a lined basin with a network of perforated drain lines covered with soil and planted with native grasses. The evapotranspiration concept was selected because it prevents the runoff from percolating into the soil column and also avoids potential monitoring and maintenance issues associated with standing water in a traditional evaporation pond. Because of issues associated with using standard excavation and earth moving equipment in the farm a number of alternate construction approaches were utilized to perform excavations and prepare the site for the modified asphalt.

  5. T-TY Tank Farm Interim Surface Barrier Demonstration—Vadose Zone Monitoring Plan

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Z. F.; Strickland, Christopher E.; Field, Jim G.; Parker, Danny L.

    2010-09-27

    The Hanford Site has 149 underground single-shell tanks that store hazardous radioactive waste. Many of these tanks and their associated infrastructure (e.g., pipelines, diversion boxes) have leaked. Some of the leaked waste has entered the groundwater. The largest known leak occurred from the T-106 Tank of the 241-T Tank Farm in 1973. Five tanks are assumed to have leaked in the TY Farm. Many of the contaminants from those leaks still reside within the vadose zone within the T and TY Tank Farms. The Department of Energy’s Office of River Protection seeks to minimize the movement of these contaminant plumes by placing interim barriers on the ground surface. Such barriers are expected to prevent infiltrating water from reaching the plumes and moving them further. The soil water regime is monitored to determine the effectiveness of the interim surface barriers. Soil-water content and water pressure are monitored using off-the-shelf equipment that can be installed by the hydraulic hammer technique. Four instrument nests were installed in the T Farm in fiscal year (FY) 2006 and FY2007; two nests were installed in the TY Farm in FY2010. Each instrument nest contains a neutron probe access tube, a capacitance probe, and four heat-dissipation units. A meteorological station has been installed at the north side of the fence of the T Farm. This document summarizes the monitoring methods, the instrument calibration and installation, and the vadose zone monitoring plan for interim barriers in T farm and TY Farm.

  6. [Guidelines on hand hygiene in health care institutions].

    Science.gov (United States)

    Kalenić, Smilja; Budimir, Ana; Bosnjak, Zrinka; Acketa, Lorena; Belina, Drazen; Benko, Ivan; Bosnjak, Danica; Culo, Marija; Jajić, Ines; Kis, Marina; Kos, Karmela; Koscák, Darko; Kuzman, Ilija; Lekić, Dusica; Prugovecki, Danijela; Juraga, Ana Tomić

    2011-01-01

    Healthcare associated infections (HCAI) are huge problem all over the world, and 5-10% of all hospitalized patients will develop infection during hospitalization. From the times of I. P. Semelweiss we know that clean hands are the most important single factor that can decrease the number of HCAI. World Health Organization (WHO) has recognised this problem and developed Guidelines for hand hygiene in healthcare institutions. This also was the reason of developing Croatian national Guidelines. The main goal of the Guidelines was to decrease number of HCAI associated with the hands of healthcare workers. These Guidelines are meant for all healthcare workers and other hospital staff who come to the direct contact with patients. An interdisciplinary team of experts developed these Guidelines using WHO Guidelines, other existing guidelines and literature reviews for hand hygiene. Grades of evidence for specific recommendations were determined using CDC/HICPAC grading system. Categorization is based on existing data, theoretical basis, applicability and economic impact. After a broad discussion in different professional societies, Guidelines were accepted. Guidelines include recommendations for hand hygiene indications, hand hygiene technique, surgical hand preparation, choosing hand hygiene preparations, skin care, nails, glove use, patients and visitors hand hygiene, role of education, as well as role of healthcare institution and role of government. Furthermore, in the Guidelines the concept of "Five moments for hand hygiene" is explained in detail, and main literature data are presented. PMID:21888080

  7. 40 CFR 266.103 - Interim status standards for burners.

    Science.gov (United States)

    2010-07-01

    ... during interim status to industrial furnaces (e.g., kilns, cupolas) that feed hazardous waste for a... HAZARDOUS WASTE MANAGEMENT FACILITIES Hazardous Waste Burned in Boilers and Industrial Furnaces § 266.103... and industrial furnaces that burn hazardous waste where such standards define the...

  8. 17 CFR 210.10-01 - Interim financial statements.

    Science.gov (United States)

    2010-04-01

    ... ACT OF 1934, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935, INVESTMENT COMPANY ACT OF 1940, INVESTMENT... registrants reporting under § 210.9 shall show investment securities gains or losses separately regardless of...)(11) of Regulation S-K, (17 CFR 229.601(b)(11)). (3) If, during the most recent interim...

  9. Single Shell Tank (SST) Interim Stabilization Project Plan

    Energy Technology Data Exchange (ETDEWEB)

    VLADIMIROFF, D.T.; BOYLES, V.C.

    2000-05-22

    This project plan establishes the management framework for the conduct of the CHG Single-Shell Tank Interim Stabilization completion program. Specifically, this plan defines the mission needs and requirements; technical objectives and approach; organization structure, roles, responsibilities, and interfaces; and operational methods. This plan serves as the project executional baseline.

  10. Effectiveness Monitoring Report, MWMF Tritium Phytoremediation Interim Measures.

    Energy Technology Data Exchange (ETDEWEB)

    Hitchcock, Dan; Blake, John, I.

    2003-02-10

    This report describes and presents the results of monitoring activities during irrigation operations for the calendar year 2001 of the MWMF Interim Measures Tritium Phytoremediation Project. The purpose of this effectiveness monitoring report is to provide the information on instrument performance, analysis of CY2001 measurements, and critical relationships needed to manage irrigation operations, estimate efficiency and validate the water and tritium balance model.

  11. 46 CFR 308.103 - Insured amounts under interim binder.

    Science.gov (United States)

    2010-10-01

    ... INSURANCE War Risk Hull and Disbursements Insurance § 308.103 Insured amounts under interim binder. (a... vessel had been requisitioned for title under section 902(a) of the Merchant Marine Act, 1936, as amended (46 App. U.S.C. 1242(a)) at the time of the attachment of the insurance under said policy:...

  12. Single-shell tank interim stabilization project plan

    Energy Technology Data Exchange (ETDEWEB)

    Ross, W.E.

    1998-05-11

    This project plan establishes the management framework for conduct of the TWRS Single-Shell Tank Interim Stabilization completion program. Specifically, this plan defines the mission needs and requirements; technical objectives and approach; organizational structure, roles, responsibilities, and interfaces; and operational methods. This plan serves as the project executional baseline.

  13. 40 CFR 80.141 - Interim detergent gasoline program.

    Science.gov (United States)

    2010-07-01

    ... registered by its manufacturer under 40 CFR part 79 according to the specifications in paragraphs (c) (1... hearing procedures shall be informal, and the hearing shall not be subject to or governed by 40 CFR part... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Interim detergent gasoline program....

  14. Interim analysis in long-term clinical trials

    NARCIS (Netherlands)

    G.A. van Es (Gerrit Anne)

    1990-01-01

    textabstractThe purpose of this dissertation is to evaluate the usefulness of both stopping rules and estimation methods in long-term clinical trials with interim analyses. The ASPECT trial, a long-term clinical trial to assess the effect of anticoagulant therapy on mortality in patients after myoca

  15. 42 CFR 417.808 - Interim per capita payments.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Interim per capita payments. 417.808 Section 417.808 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... efficiency and economy, and will not result in excessive adjustment at the end of the reporting period....

  16. ASPECTS CONCERNING INTERIM FINANCIAL REPORTING IN ROMANIA: STANDARDS AND REGULATIONS

    Directory of Open Access Journals (Sweden)

    Aristita Rotila

    2014-12-01

    Full Text Available The mechanisms employed for the communication of accounting information that is necessary for users in their economic decision-making process consist of the financial statements of an entity. All legal entities, no matter the domain of their activity, have the obligation to draw up annual financial statements for every completed financial year. For certain categories of entities, reporting obligations are also required for periods other than the annual reporting, throughout the financial year. It is the case of interim financial reporting. At the level of the international accounting framework, the aspects related to interim financial reporting are the subject of a separate standard, namely, IAS 34 Interim Financial Reporting. In Romania, the current system of accounting regulations concerning the annual financial statements comprises accounting regulations that comply with the European directives and which apply to the various categories of entities, on the one hand and, on the other, accounting regulations in line with the IFRS, which are applicable to other classes of entities from certain activity sectors. The accounting regulations that apply to each category refer to, among other things, the contents and the format of financial statements that have to be presented. Analysing the system of norms and regulations, this article identifies the requirements concerning interim financial reporting in Romania, with reference to the different types of entities.

  17. Penalty Inflation Adjustments for Civil Money Penalties. Interim Final Rule.

    Science.gov (United States)

    2016-06-27

    In accordance with the Federal Civil Penalties Inflation Adjustment Act of 1990, as amended by the Debt Collection Improvement Act of 1996, and further amended by the Bipartisan Budget Act of 2015, section 701: Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015, this interim final rule incorporates the penalty inflation adjustments for the civil money penalties contained in the Social Security Act

  18. An update on the management of chronic hepatitis C: Consensus guidelines from the Canadian Association for the Study of the Liver

    Science.gov (United States)

    Myers, Robert P; Ramji, Alnoor; Bilodeau, Marc; Wong, Stephen; Feld, Jordan J

    2012-01-01

    Chronic hepatitis C remains a significant medical and economic burden in Canada, affecting nearly 1% of the population. Since the last consensus conference on the management of chronic hepatitis C, major advances have warranted a review of recommended management approaches for these patients. Specifically, direct-acting antiviral agents with dramatically improved rates of virological clearance compared with standard therapy have been developed, and several single nucleotide polymorphisms associated with an increased probability of spontaneous and treatment-induced viral clearance have been identified. In light of this new evidence, a consensus development conference was held in November 2011; the present document highlights the results of the presentations and discussions surrounding these issues. It reviews the epidemiology of hepatitis C in Canada, preferred diagnostic testing approaches and recommendations for the treatment of chronically infected patients with the newly approved protease inhibitors (boceprevir and telaprevir), including those who have previously failed pegylated interferon and ribavirin therapy. In addition, recommendations are made regarding approaches to reducing the burden of hepatitis C in Canada. PMID:22720279

  19. Two Sudden and Unexpected Deaths of Patients with Schizophrenia Associated with Intramuscular Injections of Antipsychotics and Practice Guidelines to Limit the Use of High Doses of Intramuscular Antipsychotics.

    Science.gov (United States)

    Wahidi, Nasratullah; Johnson, Katie M; Brenzel, Allen; de Leon, Jose

    2016-01-01

    Intravenous haloperidol has been associated with torsades de pointes (TdP). These two sudden deaths were probable adverse drug reactions (ADRs) following intramuscular (IM) antipsychotics. The autopsies described lack of heart pathology and were highly compatible with the possibility of TdP in the absence of risk factors other than the accumulation of antipsychotics with a high serum peak after the last injection, leading to death within hours. The first case was a 27-year-old African-American male with schizophrenia but no medical issues. His death was probably caused by repeated IM haloperidol injections of 10 mg (totaling 35 mg in 2 days). The second case involves a 42-year-old African-American female with metabolic syndrome. Her probable cause of death was the last ziprasidone IM injection of 20 mg in addition to (1) three extra haloperidol doses (2 hours before the ziprasidone injection, 5 mg oral haloperidol; approximately 21 hours earlier, 5 mg oral haloperidol; and 2 days prior, one 10 mg IM haloperidol injection), (2) 10 mg/day of scheduled oral haloperidol for 6 days before death, and (3) a long-acting paliperidone injection of 156 mg 18 days before death. The study of haloperidol glucuronidation and its impairment in some African-Americans is urgently recommended. PMID:27597919

  20. What is the Asian Consensus Statement on NCCN clinical practice guidelines in oncology (NCCN-ACS)?

    Science.gov (United States)

    Akaza, Hideyuki

    2016-04-01

    Cancer treatment guidelines are compiled on the basis of established evidence. Such evidence is obtained from epidemiological, pathological and pharmacological study and, most importantly of all, the information gained from clinical trials. However, very little of the kind of evidence that is required for the compilation of treatment guidelines is actually obtained from Asian countries. When one considers the ethnic differences and disparities in medical care, coupled with the tremendous cultural diversity that characterize the Asian region, it would be difficult to conclude that there is currently sufficient evidence that could form the basis for the formulation of guidelines that would be relevant and applicable to all Asian countries. An urgent issue that needs to be addressed in order to achieve a breakthrough in this difficult situation is to build up a body of evidence at an advanced level that is specific to the Asian region and Asian ethnicities. For the interim, however, it is also necessary to efficiently incorporate evidence that has been obtained in Western countries. Furthermore, an effective method of utilizing guidelines that have already been compiled in Western countries is considered to be not by simply translating them into local languages, but rather to engage in a process of adaptation, whereby the guidelines are adjusted or modified to match the circumstances of a particular country or region. The NCCN Clinical Practice Guidelines-Asian Consensus Statement (NCCN-ACS) documents have been compiled with this intention in mind, utilizing the NCCN guidelines that are widely used internationally.

  1. Exercise in Pregnancy: Guidelines.

    Science.gov (United States)

    Artal, Raul

    2016-09-01

    In recent years it has been recognized that in all phases of life, including pregnancy, physical activity promotes health benefits and precludes comorbidities, the scientific evidence is indisputable. Several organizations around the world have updated in recent years the guidelines and recommendations for exercise in pregnancy. The December 2015, updated guidelines of the American College of Obstetricians and Gynecologists emphasize that physical activity in pregnancy has minimal risk. Although recommending exercise in pregnancy, the anatomic/physiological changes, absolute and relative contraindications should be considered. Women who exercised regularly before pregnancy, in the absence of contraindications, can continue and engage in moderate to strenuous activities, although information on strenuous activities in pregnancy is still limited. This review summarizes the most recent published and recommended guidelines. PMID:27398880

  2. OSART guidelines. 1994 edition

    International Nuclear Information System (INIS)

    These guidelines have been prepared to provide a basic structure and common reference both across the various areas covered by an OSART mission and across all the missions in the programme. As such, they are addressed, principally, to the team members of OSART missions but they will also provide guidance to a host nuclear plant preparing to receive a mission. The guidelines are intended to help each expert to formulate his review in the light of this own experience. They are not all inclusive and should not limit the expert's investigations, but are better considered as illustrating the adequate requirements for his review

  3. 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.

  4. 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.

  5. SLIGHTLY IRRADIATED FUEL (SIF) INTERIM DISPOSITION PROJECT

    International Nuclear Information System (INIS)

    CH2M HILL Plateau Remediation Company (CH2M HILL PRC) is proud to submit the Slightly Irradiated Fuel (SIF) Interim Disposition Project for consideration by the Project Management Institute as Project of the Year for 2010. The SIF Project was a set of six interrelated sub-projects that delivered unique stand-alone outcomes, which, when integrated, provided a comprehensive and compliant system for storing high risk special nuclear materials. The scope of the six sub-projects included the design, construction, testing, and turnover of the facilities and equipment, which would provide safe, secure, and compliant Special Nuclear Material (SNM) storage capabilities for the SIF material. The project encompassed a broad range of activities, including the following: Five buildings/structures removed, relocated, or built; Two buildings renovated; Structural barriers, fencing, and heavy gates installed; New roadways and parking lots built; Multiple detection and assessment systems installed; New and expanded communication systems developed; Multimedia recording devices added; and A new control room to monitor all materials and systems built. Project challenges were numerous and included the following: An aggressive 17-month schedule to support the high-profile Plutonium Finishing Plant (PFP) decommissioning; Company/contractor changeovers that affected each and every project team member; Project requirements that continually evolved during design and construction due to the performance- and outcome-based nature ofthe security objectives; and Restrictions imposed on all communications due to the sensitive nature of the projects In spite of the significant challenges, the project was delivered on schedule and $2 million under budget, which became a special source of pride that bonded the team. For years, the SIF had been stored at the central Hanford PFP. Because of the weapons-grade piutonium produced and stored there, the PFP had some of the tightest security on the Hanford

  6. SLIGHTLY IRRADIATED FUEL (SIF) INTERIM DISPOSITION PROJECT

    Energy Technology Data Exchange (ETDEWEB)

    NORTON SH

    2010-02-23

    CH2M HILL Plateau Remediation Company (CH2M HILL PRC) is proud to submit the Slightly Irradiated Fuel (SIF) Interim Disposition Project for consideration by the Project Management Institute as Project of the Year for 2010. The SIF Project was a set of six interrelated sub-projects that delivered unique stand-alone outcomes, which, when integrated, provided a comprehensive and compliant system for storing high risk special nuclear materials. The scope of the six sub-projects included the design, construction, testing, and turnover of the facilities and equipment, which would provide safe, secure, and compliant Special Nuclear Material (SNM) storage capabilities for the SIF material. The project encompassed a broad range of activities, including the following: Five buildings/structures removed, relocated, or built; Two buildings renovated; Structural barriers, fencing, and heavy gates installed; New roadways and parking lots built; Multiple detection and assessment systems installed; New and expanded communication systems developed; Multimedia recording devices added; and A new control room to monitor all materials and systems built. Project challenges were numerous and included the following: An aggressive 17-month schedule to support the high-profile Plutonium Finishing Plant (PFP) decommissioning; Company/contractor changeovers that affected each and every project team member; Project requirements that continually evolved during design and construction due to the performance- and outcome-based nature ofthe security objectives; and Restrictions imposed on all communications due to the sensitive nature of the projects In spite of the significant challenges, the project was delivered on schedule and $2 million under budget, which became a special source of pride that bonded the team. For years, the SIF had been stored at the central Hanford PFP. Because of the weapons-grade piutonium produced and stored there, the PFP had some of the tightest security on the Hanford

  7. Interim summary report of the safety case 2009

    International Nuclear Information System (INIS)

    Following the guidelines set forth by the Ministry of Trade and Industry (now Ministry of Employment and Economy), Posiva is preparing to submit a construction license application for the final disposal spent nuclear fuel at the Olkiluoto site, Finland, by the end of the year 2012. Disposal will take place in a geological repository implemented according to the KBS-3 method. The long-term safety section supporting the license application will be based on a safety case that, according to the internationally adopted definition, will be a compilation of the evidence, analyses and arguments that quantify and substantiate the safety and the level of expert confidence in the safety of the planned repository. The present Interim Summary Report represents a major contribution to the development of this safety case. The report has been compiled in accordance with Posiva's current plan for preparing this safety case. A full safety case for the KBS-3V variant will be developed to support the Preliminary Safety Assessment Report (PSAR) in 2012. The report outlines the current design and safety concept for the planned repository. It summarises the approach used to formulate scenarios for the evolution of the disposal system over time, describes these scenarios and presents the main models and computer codes used to analyse them. It also discusses compliance with Finnish regulatory requirements for long-term safety of a geological repository and gives the main evidence, arguments and analyses that lead to confidence, on the part of Posiva, in the long-term safety of the planned repository. Current understanding of the evolution of the disposal system indicates that, except a few unlikely circumstances affecting a small number of canisters, spent fuel will remain isolated, and the radionuclides contained within the canisters, for hundreds of thousands of years or more, in accordance with the base scenario. Confidence in this base scenario derives, in the first place, from the

  8. Subsurface Interim Measures/Interim Remedial Action Plan/Environmental Assessment and Decision Document, Operable Unit No. 2

    International Nuclear Information System (INIS)

    The subject Interim Measures/Interim Remedial Action plan/Environmental Assessment (IM/IRAP/EA) addresses residual free-phase volatile organic compound (VOC) contamination suspected in the subsurface within an area identified as Operable Unit No. 2 (OU2). This IM/IRAP/EA also addresses radionuclide contamination beneath the 903 Pad at OU2. Although subsurface VOC and radionuclide contamination on represent a source of OU2 ground-water contamination, they pose no immediate threat to public health or the environment. This IM/IRAP/EA identifies and evaluates interim remedial actions for removal of residual free-phase VOC contamination from three different subsurface environments at OU2. The term ''residual'' refers to the non-aqueous phase contamination remaining in the soil matrix (by capillary force) subsequent to the passage of non-aqueous or free-phase liquid through the subsurface. In addition to the proposed actions, this IM/IRAP/EA presents an assessment of the No Action Alternative. This document also considers an interim remedial action for the removal of radionuclides from beneath the 903 Pad

  9. Field Campaign Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Voyles, J. W. [DOE ARM Climate Research Facility, Washington, DC (United States); Chapman, L. A. [DOE ARM Climate Research Facility, Washington, DC (United States)

    2015-12-01

    This document establishes a common set of guidelines for the Atmospheric Radiation Measurement (ARM) Climate Research Facility for planning, executing, and closing out field campaigns. The steps that guide individual field campaigns are described in the Field Campaign Tracking System and are specifically tailored to meet the scope of each field campaign.

  10. Curriculum Guidelines for Pharmacology.

    Science.gov (United States)

    Shaw, David H.; And Others

    1990-01-01

    Pharmacology embraces the physical and chemical properties of drugs; the preparation of pharmaceutical agents; the absorption, fate, and excretion of drugs; and the effects of drugs on living systems. These guidelines represent a consensus on what would constitute a minimally acceptable pharmacology course for predoctoral dental students. (MLW)

  11. Measure Guideline: Evaporative Condensers

    Energy Technology Data Exchange (ETDEWEB)

    German, A [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Hoeschele, M. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States)

    2012-03-01

    This measure guideline on evaporative condensers provides information on properly designing, installing, and maintaining evaporative condenser systems as well as understanding the benefits, costs, and tradeoffs. This is a prescriptive approach that outlines selection criteria, design and installation procedures, and operation and maintenance best practices.

  12. Instructional Guidelines. Welding.

    Science.gov (United States)

    Fordyce, H. L.; Doshier, Dale

    Using the standards of the American Welding Society and the American Society of Mechanical Engineers, this welding instructional guidelines manual presents a course of study in accordance with the current practices in industry. Intended for use in welding programs now practiced within the Federal Prison System, the phases of the program are…

  13. 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…

  14. Postoperative pain treatment' practice guideline revised

    NARCIS (Netherlands)

    Houweling, P.L.; Molag, M.L.; Boekel, R.L.M. van; Verbrugge, S.J.; Haelst, I.M. van; Hollmann, M.W.

    2013-01-01

    - On the initiative of the Dutch Association of Anaesthesiologists, a multidisciplinary workgroup has revised the 2003 practice guideline on 'Postoperative pain treatment' for adults and children.- The main reason for revision was the availability of new drugs and new methods of administration. The

  15. CERCLA interim action at the Par Pond unit: A case study

    International Nuclear Information System (INIS)

    The Par Pond unit designated under CERCLA consists of sediments within a Savannah River Site (SRS) cooling water reservoir. The sediments are contaminated with radionuclides and nonradioactive constituents from nuclear production reactor operations. The mercury in Par Pond is believed to have originated from the Savannah River. Because of Par Pond Dam safety Issues, the water level of the reservoir was drawn down, exposing more than 1300 acres of contaminated sediments and triggering the need for CERCLA interim remedial action. This paper presents the interim action approach taken with Par Pond as a case study. The approach considered the complexity of the Par Pond ecosystem, the large size of Par Pond, the volume of contaminated sediments, and the institutional controls existing at SRS. The Environmental Protection Agency (EPA) considers units with large volumes of low-concentration wastes, as is the case with Par Pond, to be open-quotes special sites.close quotes Accordingly, EPA guidance establishes that the range of alternatives developed focus primarily on containment options and other remedial approaches that mitigate potential risks associated with the open-quotes special site.close quotes The remedial alternatives, according to EPA, are not to be prohibitively expensive or difficult to implement. This case study also is representative of the types of issues that will need to be addressed within the Department of Energy (DOE) complex as nuclear facilities are transitioned to inactive status and corrective/remedial actions are warranted

  16. T Tank Farm Interim Surface Barrier Demonstration--Vadose Zone Monitoring Plan

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Z. F.; Keller, Jason M.; Strickland, Christopher E.

    2007-04-01

    The Hanford Site has 149 underground single-shell tanks that store hazardous radioactive waste. Many of these tanks and their associated infrastructure (e.g., pipelines, diversion boxes) have leaked. Some of the leaked waste has entered the groundwater. The largest known leak occurred from the T-106 Tank in 1973. Many of the contaminants from that leak still reside within the vadose zone beneath the T Tank Farm. CH2M Hill Hanford Group, Inc. seeks to minimize movement of this residual contaminant plume by placing an interim barrier on the surface. Such a barrier is expected to prevent infiltrating water from reaching the plume and moving it further. A plan has been prepared to monitor and determine the effectiveness of the interim surface barrier. Soil water content and water pressure will be monitored using off-the-shelf equipment that can be installed by the hydraulic hammer technique. In fiscal year 2006, two instrument nests were installed. Each instrument nest contains a neutron probe access tube, a capacitance probe, four heat-dissipation units, and a drain gauge to measure soil water flux. A meteorological station has been installed outside of the fence. In fiscal year 2007, two additional instrument nests are planned to be installed beneath the proposed barrier.

  17. Inspector qualification guidelines

    International Nuclear Information System (INIS)

    The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied

  18. Guidelines for the management of contact dermatitis: an update.

    LENUS (Irish Health Repository)

    Bourke, J

    2012-02-01

    These guidelines for management of contact dermatitis have been prepared for dermatologists on behalf of the British Association of Dermatologists. They present evidence-based guidance for investigation and treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, including details of relevant epidemiological aspects, diagnosis and investigation.

  19. Guidelines for the management of contact dermatitis: an update.

    LENUS (Irish Health Repository)

    Bourke, J

    2009-05-01

    These guidelines for management of contact dermatitis have been prepared for dermatologists on behalf of the British Association of Dermatologists. They present evidence-based guidance for investigation and treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, including details of relevant epidemiological aspects, diagnosis and investigation.

  20. The New AASL Program Guidelines for School Library Programs

    Science.gov (United States)

    Boehm, Patricia

    2009-01-01

    In this article, the author provides an overview of and her reflections on the new American Association of School Librarians (AASL) program guidelines, "Empowering Learners: Guidelines for School Library Media Programs" (2009). At just sixty-four pages, this publication is easy to browse and ready for investigation. As to be expected from…

  1. Interim assessment of the VAL automated guideway transit system. Interim report

    Energy Technology Data Exchange (ETDEWEB)

    Anagnostopoulos, G.

    1981-11-01

    This report describes an interim assessment of the VAL (Vehicules Automatiques Legers or Light Automated Vehicle) AGT system which is currently under construction in Lille, France, and which is to become fully operational in December 1983. This report contains a technical description and performance data resulting from a demonstration test program performed concurrently in August 1980. VAL is the first driverless AGT urban system application in France. The system operates at grade, elevated, and in tunnels on an exclusive concrete dual-lane guideway that is 12.7 kilometers long. The configuration of the system is a push-pull loop operating between 17 on-line stations. The system is designed to provide scheduled operation at 60-second headways and a normal one-way capacity of 7440 passengers per hour per direction with 55 percent of the passengers seated. Two pneumatic-tired vehicles are coupled into a single vehicle capable of carrying 124 passengers at line speeds of 60 km/hr. During the course of the demonstration test program, VAL demonstrated that it could achieve high levels of dependability and availability and could perform safely under all perceivable conditions.

  2. Guidelines International Network: toward international standards for clinical practice guidelines.

    Science.gov (United States)

    Qaseem, Amir; Forland, Frode; Macbeth, Fergus; Ollenschläger, Günter; Phillips, Sue; van der Wees, Philip

    2012-04-01

    Guideline development processes vary substantially, and many guidelines do not meet basic quality criteria. Standards for guideline development can help organizations ensure that recommendations are evidence-based and can help users identify high-quality guidelines. Such organizations as the U.S. Institute of Medicine and the United Kingdom's National Institute for Health and Clinical Excellence have developed recommendations to define trustworthy guidelines within their locales. Many groups charged with guideline development find the lengthy list of standards developed by such organizations to be aspirational but infeasible to follow in entirety. Founded in 2002, the Guidelines International Network (G-I-N) is a network of guideline developers that includes 93 organizations and 89 individual members representing 46 countries. The G-I-N board of trustees recognized the importance of guideline development processes that are both rigorous and feasible even for modestly funded groups to implement and initiated an effort toward consensus about minimum standards for high-quality guidelines. In contrast to other existing standards for guideline development at national or local levels, the key components proposed by G-I-N will represent the consensus of an international, multidisciplinary group of active guideline developers. This article presents G-I-N's proposed set of key components for guideline development. These key components address panel composition, decision-making process, conflicts of interest, guideline objective, development methods, evidence review, basis of recommendations, ratings of evidence and recommendations, guideline review, updating processes, and funding. It is hoped that this article promotes discussion and eventual agreement on a set of international standards for guideline development.

  3. Medicare depreciation; useful life guidelines--HCFA. Proposed rule.

    Science.gov (United States)

    1982-09-30

    We are proposing to amend Medicare regulations to clarify which useful life guidelines providers of health care services may use to determine the useful life of a depreciable asset for Medicare reimbursement purposes. Current regulations state that providers must utilize HHS useful life guidelines or, if none have been published by HHS, the American Hospital Association (AHA) useful life guidelines of 1973 or IRS guidelines. We are proposing to eliminate the reference to IRS guidelines because those previously acceptable for Medicare purposes are outdated and have been made obsolete by the IRS or by statutory change. We would also delete the specific reference to the 1973 AHA guidelines. In addition, we intend this amendment to clarify that certain tax legislation on accelerated depreciation, recently passed by Congress, does not apply to the Medicare program.

  4. Clinical guidelines: Involvement of peers increases physician adherence

    Institute of Scientific and Technical Information of China (English)

    Pascal Vignally; Jean Charles Grimaud; Roland Sambuc; St(e)phanie Gentile

    2008-01-01

    The literature illustrates the important issue of physician adherence to guidelines in their daily practice. In a quantitative study, we asked a random sample of 100 hospital gastroenterologists to evaluate their knowledge of guidelines and awareness of promoters. The degree to which guidelines were considered reliable was not related to the scientific evidence but was significantly associated with the promoter. The French Society of Gastroenterology was considered to be a more reliable promoter than national health agencies and pharmaceutical industries. Gastroenterologists become aware of guidelines mainly through their specialty society (62%). Specialty societies appear to be a more important source of information on guidelines for physicians. National health agencies should involve the specialty societies in the guideline development process to achieve changes in clinical practice.

  5. Design requirements document for Project W-465, immobilized low-activity waste interim storage

    International Nuclear Information System (INIS)

    The scope of this Design Requirements Document (DRD) is to identify the functions and associated requirements that must be performed to accept, transport, handle, and store immobilized low-activity waste (ILAW) produced by the privatized Tank Waste Remediation System (TWRS) treatment contractors. The functional and performance requirements in this document provide the basis for the conceptual design of the TWRS ILAW Interim Storage facility project and provides traceability from the program level requirements to the project design activity. Technical and programmatic risk associated with the TWRS planning basis are discussed in the Tank Waste Remediation System Decisions and Risk Assessment (Johnson 1994). The design requirements provided in this document will be augmented by additional detailed design data documented by the project

  6. Verification of the new ECMWF ERA-Interim reanalysis over France

    Science.gov (United States)

    Szczypta, C.; Calvet, J.-C.; Albergel, C.; Balsamo, G.; Boussetta, S.; Carrer, D.; Lafont, S.; Meurey, C.

    2011-02-01

    An evaluation of the global ECMWF atmospheric reanalysis ERA-Interim (with a 0.5° grid) is performed over France, based on the high resolution (8 km) SAFRAN atmospheric reanalysis. The ERA-Interim precipitation, Incoming Solar Radiation (ISR), air temperature, air humidity, and wind speed, are compared with their SAFRAN counterparts. Also, interpolated in situ ISR observations are used in order to consolidate the evaluation of this variable. The daily precipitation estimates produced by ERA-Interim over France correlate very well with SAFRAN. However, the values are underestimated by 27%. A GPCP-corrected version of ERA-Interim is less biased (13%). The ERA-Interim estimates of ISR correlate very well with SAFRAN and with in situ observations on a daily basis. Whereas SAFRAN underestimates the ISR by 6 Wm-2, ERA-Interim overestimates the ISR by 10 Wm-2. In order to assess the impact of the ERA-Interim errors, simulations of the ISBA-A-gs land surface model are performed over the SMOSREX grassland site in southwestern France using ERA-Interim (with and without GPCP rescaling) and SAFRAN. Latent and sensible heat fluxes are simulated, together with carbon dioxide fluxes. The rescaled ERA-Interim performs better than the original ERA-Interim and permits to achieve flux scores similar to those obtained with SAFRAN.

  7. Verification of the new ECMWF ERA-Interim reanalysis over France

    Directory of Open Access Journals (Sweden)

    C. Szczypta

    2011-02-01

    Full Text Available An evaluation of the global ECMWF atmospheric reanalysis ERA-Interim (with a 0.5° grid is performed over France, based on the high resolution (8 km SAFRAN atmospheric reanalysis. The ERA-Interim precipitation, Incoming Solar Radiation (ISR, air temperature, air humidity, and wind speed, are compared with their SAFRAN counterparts. Also, interpolated in situ ISR observations are used in order to consolidate the evaluation of this variable. The daily precipitation estimates produced by ERA-Interim over France correlate very well with SAFRAN. However, the values are underestimated by 27%. A GPCP-corrected version of ERA-Interim is less biased (13%. The ERA-Interim estimates of ISR correlate very well with SAFRAN and with in situ observations on a daily basis. Whereas SAFRAN underestimates the ISR by 6 Wm−2, ERA-Interim overestimates the ISR by 10 Wm−2. In order to assess the impact of the ERA-Interim errors, simulations of the ISBA-A-gs land surface model are performed over the SMOSREX grassland site in southwestern France using ERA-Interim (with and without GPCP rescaling and SAFRAN. Latent and sensible heat fluxes are simulated, together with carbon dioxide fluxes. The rescaled ERA-Interim performs better than the original ERA-Interim and permits to achieve flux scores similar to those obtained with SAFRAN.

  8. Verification of the new ECMWF ERA-Interim reanalysis over France

    Directory of Open Access Journals (Sweden)

    C. Szczypta

    2010-09-01

    Full Text Available An evaluation of the global ECMWF atmospheric reanalysis ERA-Interim (with a 0.5° grid is performed over France, based on the high resolution (8 km SAFRAN atmospheric reanalysis. The ERA-Interim precipitation, Incoming Solar Radiation (ISR, air temperature, air humidity, and wind speed, are compared with their SAFRAN counterparts. Also, interpolated in situ ISR observations are used in order to consolidate the evaluation of this variable. The daily precipitation estimates produced by ERA-Interim over France correlate very well with SAFRAN. However, the values are underestimated by 26%. A GPCP-corrected version of ERA-Interim is less biased (10–15%. The ERA-Interim estimates of ISR correlate very well with SAFRAN and with in situ observations on a daily basis. Whereas SAFRAN underestimates the ISR by 6–8 W m−2, ERA-Interim overestimates the ISR by 9–10 W m−2. In order to assess the impact of the ERA-Interim errors, simulations of the ISBA-A-gs land surface model are performed over the SMOSREX grassland site in southwestern France using ERA-Interim (with and without GPCP rescaling and SAFRAN. Latent and sensible heat fluxes are simulated, together with carbon dioxide fluxes. The rescaled ERA-Interim performs better than the original ERA-Interim and permits to achieve flux scores similar to those obtained with SAFRAN.

  9. Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI

    Directory of Open Access Journals (Sweden)

    Reinhart, K.

    2010-01-01

    Full Text Available Practice guidelines are systematically developed statements and recommendations that assist the physicians and patients in making decisions about appropriate health care measures for specific clinical circumstances taking into account specific national health care structures. The 1st revision of the S-2k guideline of the German Sepsis Society in collaboration with 17 German medical scientific societies and one self-help group provides state-of-the-art information (results of controlled clinical trials and expert knowledge on the effective and appropriate medical care (prevention, diagnosis, therapy and follow-up care of critically ill patients with severe sepsis or septic shock. The guideline had been developed according to the “German Instrument for Methodological Guideline Appraisal” of the Association of the Scientific Medical Societies (AWMF. In view of the inevitable advancements in scientific knowledge and technical expertise, revisions, updates and amendments must be periodically initiated. The guideline recommendations may not be applied under all circumstances. It rests with the clinician to decide whether a certain recommendation should be adopted or not, taking into consideration the unique set of clinical facts presented in connection with each individual patient as well as the available resources.

  10. MedlinePlus: Quality Guidelines

    Science.gov (United States)

    ... this page: https://medlineplus.gov/criteria.html MedlinePlus Quality Guidelines To use the sharing features on this ... materials must also meet our existing quality guidelines. Quality, authority and accuracy of health content The organization's ...

  11. Guidelines for Home Energy Professionals

    Energy Technology Data Exchange (ETDEWEB)

    None

    2011-12-16

    The U.S. Department of Energy's (DOE's) Guidelines for Home Energy Professionals project (hereafter the Guidelines) fosters the growth of a high quality residential energy upgrade industry and a skilled and credentialed workforce.

  12. Guidelines for Direct Adhesive Composite Restoration.

    Science.gov (United States)

    Society Of Cariology And Endodontology, Chinese Stomatological Association Csa

    2015-01-01

    Direct adhesive composite restoration, a technique to restore tooth defects by bonding composite resin materials, has been widely used in the restoration of dental caries or other tooth defects. Retention of composite resin restoration mainly relies on bonding strength between the materials and dental tissue. The clinical outcomes rely greatly on the regulated clinical practice of dentists. In 2011, the Society of Cariology and Endodontology of Chinese Stomatological Association (CSA) published the 'Practices and evaluation criteria of composite resin bonded restoration (Discussion Version)'. Since then, opinions and comments regarding the 'Discussion Version' have been widely circulated within the Society. The final version of the guideline was based on systematic reviews of scientific literature and requirements for the edit of technical guidelines, and through several rounds of discussions, revisions and supplements. The society recommends this guideline for clinicians to use in their practices, when conducting direct composite restorations.

  13. Diretrizes da Associação Médica Brasileira para o tratamento do transtorno de ansiedade social Guidelines of the Brazilian Medical Association for the treatment of social anxiety disorder

    Directory of Open Access Journals (Sweden)

    Michelle N. Levitan

    2011-09-01

    functional and psychosocial impairment. The Brazilian Medical Association (BMA, with the project named Diretrizes (Guidelines, in English, seeks to develop consensus for the diagnosis and treatment of common diseases. The aim of this article is to present the most important findings of the guidelines on the treatment of SAD, serving as a reference for the general practitioner and specialist. METHOD: The method used was proposed by the BMA. The search was conducted in the databases of MEDLINE (PubMed, Scopus, Web of Science and LILACS, between 1980 and 2010. The strategy used was based on structured questions as PICO (acronym formed by the initials of "patient or population", "intervention, display or exhibition", "control or comparison" and "outcome". RESULTS: Studies show that the first-line pharmacological treatment for adults and children are serotonin selective reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors, whereas cognitive-behavioral therapy is considered the best psychotherapeutic treatment. Moreover, some psychiatric comorbidities were associated with a worse outcome of SAD. CONCLUSIONS: Despite its high prevalence, SAD does not receive adequate attention and treatment. The best choice for the treatment of adults is a combination of cognitive-behavioral psychotherapy with serotonin selective reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors. Other options as benzodiazepines or monoamine oxidase inhibitors must be used as second and third choices, respectively.

  14. Statins: Cholesterol guidelines and Indian perspective

    Directory of Open Access Journals (Sweden)

    Anil S Menon

    2015-01-01

    Full Text Available Statins have become an important drug in preventing the occurrence of atherosclerotic cardiovascular disease (ASCVD. The effectiveness of statins in reducing ASCVD has been established in large-scale clinical trials. The lipid management guidelines have been periodically modified due to accumulating evidence about the proportionate benefit achieved with a progressive reduction in cholesterol levels with higher doses of statins and even in those at low risk of development of ASCVD. The current American College of Cardiology/American Heart Association guidelines have based its recommendations from data gathered exclusively from randomized controlled trials. It has simplified the use of statins, but also raised questions regarding the validity of its cardiovascular event risk prediction tool. Epidemiology of cardiovascular disease in India differs from the western population; there is an increased the prevalence of metabolic syndrome and atherogenic dyslipidemia phenotype a group not addressed in the current guidelines. The guidelines are based on trials, which do not have a representative South Asian population. This article reviews the relevant literature, and examines the issues involved in adopting the guidelines to the Indian population.

  15. Guidelines or gospels?

    Science.gov (United States)

    Sundt, Thoralf M

    2016-06-01

    In the interest of advancing evidenced-based medicine, enthusiasm for clinical practice guidelines has skyrocketed. They have a genuine impact on clinical practice and are frequently referenced in the literature. Their construction is complex and labor intensive, and has significant limitations given the necessary process as well as the data available. There has been less focus on their appropriate clinical application as dictated by these inherent limitations. It is worthwhile taking a step back and considering how we know what we think we know based on statistical analysis of biomedical data sets and the real implications of those population data for making predictions about the individual patient we encounter in the clinic. These data as used to establish guidelines for care should be the foundation and starting point for our thoughtful recommendations and decision making, not the final word. The importance of nuance in clinical judgment remains even in this "evidence-based" world. PMID:26992602

  16. Plutonium Finishing Plant. Interim plutonium stabilization engineering study

    International Nuclear Information System (INIS)

    This report provides the results of an engineering study that evaluated the available technologies for stabilizing the plutonium stored at the Plutonium Finishing Plant located at the hanford Site in southeastern Washington. Further processing of the plutonium may be required to prepare the plutonium for interim (<50 years) storage. Specifically this document provides the current plutonium inventory and characterization, the initial screening process, and the process descriptions and flowsheets of the technologies that passed the initial screening. The conclusions and recommendations also are provided. The information contained in this report will be used to assist in the preparation of the environmental impact statement and to help decision makers determine which is the preferred technology to process the plutonium for interim storage

  17. Plutonium Finishing Plant. Interim plutonium stabilization engineering study

    Energy Technology Data Exchange (ETDEWEB)

    Sevigny, G.J.; Gallucci, R.H.; Garrett, S.M.K.; Geeting, J.G.H.; Goheen, R.S.; Molton, P.M.; Templeton, K.J.; Villegas, A.J. [Pacific Northwest Lab., Richland, WA (United States); Nass, R. [Nuclear Fuel Services, Inc. (United States)

    1995-08-01

    This report provides the results of an engineering study that evaluated the available technologies for stabilizing the plutonium stored at the Plutonium Finishing Plant located at the hanford Site in southeastern Washington. Further processing of the plutonium may be required to prepare the plutonium for interim (<50 years) storage. Specifically this document provides the current plutonium inventory and characterization, the initial screening process, and the process descriptions and flowsheets of the technologies that passed the initial screening. The conclusions and recommendations also are provided. The information contained in this report will be used to assist in the preparation of the environmental impact statement and to help decision makers determine which is the preferred technology to process the plutonium for interim storage.

  18. Measure Guideline: Evaporative Condensers

    Energy Technology Data Exchange (ETDEWEB)

    German, A.; Dakin, B.; Hoeschele, M.

    2012-03-01

    The purpose of this measure guideline on evaporative condensers is to provide information on a cost-effective solution for energy and demand savings in homes with cooling loads. This is a prescriptive approach that outlines selection criteria, design and installation procedures, and operation and maintenance best practices. This document has been prepared to provide a process for properly designing, installing, and maintaining evaporative condenser systems as well as understanding the benefits, costs, and tradeoffs.

  19. CIMP Internet Addiction Guideline

    OpenAIRE

    Azizah Zainudin; Marina Md Din; Marini Othman

    2013-01-01

    Nowadays, Internet addiction has become a major problem to the university students. The purpose of this study is to present a guideline to helps people to overcome their Internet addiction especially for students. There were 653 university students (341 females and 312 males) from five different universities in Malaysia have completed related survey. The survey questionnaires were taken from Young?s Addiction Scale (1996) and some questions were created by the researcher. In this paper, there...

  20. TORIS Data Preparation Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Guinn, H.; Remson, D.

    1999-03-11

    The objective of this manual is to present guidelines and procedures for the preparation of new data for the Tertiary Oil Recovery Information System (TORIS) data base. TORIS is an analytical system currently maintained by the Department of Energy's (DOE) Bartlesville Project Office. It uses an extensive field- and reservoir-level data base to evaluate the technical and economic recovery potential of specific crude oil reservoirs.

  1. Terrestrial gravity data analysis for interim gravity model improvement

    Science.gov (United States)

    1987-01-01

    This is the first status report for the Interim Gravity Model research effort that was started on June 30, 1986. The basic theme of this study is to develop appropriate models and adjustment procedures for estimating potential coefficients from terrestrial gravity data. The plan is to use the latest gravity data sets to produce coefficient estimates as well as to provide normal equations to NASA for use in the TOPEX/POSEIDON gravity field modeling program.

  2. 105-H Reactor Interim Safe Storage Project Final Report

    International Nuclear Information System (INIS)

    The following information documents the decontamination and decommissioning of the 105-H Reactor facility, and placement of the reactor core into interim safe storage. The D and D of the facility included characterization, engineering, removal of hazardous and radiologically contaminated materials, equipment removal, decontamination, demolition of the structure, and restoration of the site. The ISS work also included construction of the safe storage enclosure, which required the installation of a new roofing system, power and lighting, a remote monitoring system, and ventilation components.

  3. Report on interim storage of spent nuclear fuel

    Energy Technology Data Exchange (ETDEWEB)

    1993-04-01

    The report on interim storage of spent nuclear fuel discusses the technical, regulatory, and economic aspects of spent-fuel storage at nuclear reactors. The report is intended to provide legislators state officials and citizens in the Midwest with information on spent-fuel inventories, current and projected additional storage requirements, licensing, storage technologies, and actions taken by various utilities in the Midwest to augment their capacity to store spent nuclear fuel on site.

  4. Interim Sanitary Landfill Groundwater Monitoring Report. 1997 Annual Report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-01-01

    Eight wells of the LFW series monitor groundwater quality in the Steed Pond Aquifer (Water Table) beneath the Interim Sanitary Landfill at the Savannah River Site (SRS). These wells are sampled semiannually to comply with the South Carolina Department of Health and Environmental Control Modified Municipal Solid Waste Permit 025500-1120 (formerly dWP-087A) and as part of the SRS Groundwater Monitoring Program.

  5. Loss of approval for interim storage by time schedule

    International Nuclear Information System (INIS)

    The Act ''Gesetz zur Suche und Auswahl eines Standortes fuer ein Endlager fuer Waerme entwickelnde radioaktive Abfaelle'' on the search and selection of a site for a repository for heat-generating radioactive waste as also other acts insert a new topic for interim site storage. The operation should be restricted for 40 years. This part of the act is analysed with respect to future requirements for the storage of waste.

  6. Penalty Inflation Adjustments for Civil Money Penalties. Interim Final Rule.

    Science.gov (United States)

    2016-06-27

    In accordance with the Federal Civil Penalties Inflation Adjustment Act of 1990, as amended by the Debt Collection Improvement Act of 1996, and further amended by the Bipartisan Budget Act of 2015, section 701: Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015, this interim final rule incorporates the penalty inflation adjustments for the civil money penalties contained in the Social Security Act PMID:27373014

  7. 105-H Reactor Interim Safe Storage Project Final Report

    Energy Technology Data Exchange (ETDEWEB)

    E.G. Ison

    2008-11-08

    The following information documents the decontamination and decommissioning of the 105-H Reactor facility, and placement of the reactor core into interim safe storage. The D&D of the facility included characterization, engineering, removal of hazardous and radiologically contaminated materials, equipment removal, decontamination, demolition of the structure, and restoration of the site. The ISS work also included construction of the safe storage enclosure, which required the installation of a new roofing system, power and lighting, a remote monitoring system, and ventilation components.

  8. Improving the use of research evidence in guideline development: 1. Guidelines for guidelines

    Directory of Open Access Journals (Sweden)

    Oxman Andrew D

    2006-11-01

    Full Text Available Abstract Background The World Health Organization (WHO, like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the first of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this. Objectives We reviewed the literature on guidelines for the development of guidelines. Methods We searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments. Key questions and answers We found no experimental research that compared different formats of guidelines for guidelines or studies that compared different components of guidelines for guidelines. However, there are many examples, surveys and other observational studies that compared the impact of different guideline development documents on guideline quality. What have other organizations done to develop guidelines for guidelines from which WHO can learn? • Establish a credible, independent committee that evaluates existing methods for developing guidelines or that updates existing ones. • Obtain feedback and approval from various stakeholders during the development process of guidelines for guidelines. • Develop a detailed source document (manual that guideline developers can use as reference material. What should be the key components of WHO guidelines for guidelines? • Guidelines for guidelines should include information and instructions about the following components: 1 Priority setting; 2 Group composition and consultations; 3 Declaration and avoidance of conflicts of interest; 4 Group processes; 5

  9. Impact of WHO 2010 Guidelines on Antiretroviral Therapy Initiation among Patients with HIV-Associated Tuberculosis in Clinics with and without Onsite HIV Services in the Democratic Republic of Congo.

    Science.gov (United States)

    Yotebieng, Marcel; Tabala, Martine; Batumbula, Marie Louise; Wenzi, Landry; Basaki, Emmanuel; Mungoyo, Eugenie; Mangala, Richard; Behets, Frieda

    2016-01-01

    Background. We assessed the impact of WHO's 2010 guidelines that removed the requirement of CD4 count before ART, on timely initiation of ART among HIV/TB patients in the Democratic Republic of Congo (DRC). Methods. Data collected to monitor implementation of provider initiated HIV testing and counseling (PITC) and linkage to HIV care from 65 and 13 TB clinics in Kinshasa and Kisangani, respectively, between November 2010 and June 2013. Results. Prior to the WHO's 2010 guidelines, in Kinshasa, 79.1% (401/507) of HIV/TB patients referred for HIV services were initiated on ART in clinics with onsite ART services compared to 50.0% (63/123) in clinics without. Following the implementation of the new guidelines, 89.8% (714/795) and 93.0% (345/371) of HIV/TB patients referred for HIV services were initiated on ART, respectively, in clinics with onsite and without onsite ART services. Similarly, in Kisangani, 69.7% (53/120) and 36.4% (16/44) in clinics with and without onsite ART service, respectively, were initiated on ART prior to the 2010 guidelines and 88.8% (135/152) and 72.6% (106/146), respectively, after the new guidelines. Conclusion. Though implementation of the 2010 guidelines increased the proportion of HIV/TB patients initiated on ART substantially, it remained below the 100% target, particularly in clinics without onsite ART services. PMID:27595020

  10. Interim data report for the safety assessment SR-Can

    Energy Technology Data Exchange (ETDEWEB)

    Vahlund, Fredrik [Swedish Nuclear Fuel and Waste Management Co., Stockholm (Sweden); Andersson, Johan [JA Streamflow AB, Aelvsjoe (Sweden)

    2004-08-01

    This document is the interim data report in the project SR-Can. The purpose of the data report is to present input data, with uncertainty estimates, for the SR-Can assessment calculations. Besides input data, the report also describes the standardised procedures used when deriving the input data and the corresponding uncertainty estimates. However, in the present interim version of the report (written in the initial stage of the project when site characterisation has yet not been completed) the standardised procedures have not been possible to apply for most of the data and, in order to present a compilation of the data used in the assessment, much of the input data is presented without following the standardised procedures. This will however be changed for the final version of the SR-Can data report, in order to show the methodology that will be used in the final version one example of how input data will be presented is included (migration data for buffer) . The recommended input data for the assessment calculations are, for the interim version, mainly based on SR 97 Beberg data, these are merely presented without any background or uncertainty discussion (this is presented in the SR 97 data report)

  11. Interim Dry Storage of Spent Fuel in Casks

    International Nuclear Information System (INIS)

    French option for the back end of the fuel cycle is reprocessing of used fuel and recycling the fissile material, except some very specific fuel stored in vaults (dry conditions). Used fuel management solutions studied by AREVA for various countries allow for either direct transport to the reprocessing plant, or interim storage and transport after storage of used fuel. Interim storage solutions are wet storage or dry storage (DSC, metal casks or vault systems). When the decision on used fuel management has been postponed, some extension of interim storage duration is considered, therefore it becomes necessary to study used fuel and cask material behaviour and deterioration mechanisms. One objective of this R&D was to review research efforts on spent fuel behaviour and Dry storage experience in casks. Particularly we were interested in the assessment of retrievability of fuel after storage for further use. A review therefore, was made of the effect of storage time/ temperatures and of loading/ drying operation on used fuel integrity. R&D programmes were also carried out on the evaluation of cask materials in long term, especially materials susceptible to degradation

  12. The Interim Financial Reporting in the Spirit of the IAS 34 Norm

    OpenAIRE

    2008-01-01

    The role of an interim financial reporting is to allow the information users to acknowledge the activity of an entity on period shorter than financial exercise from the perspective of the available profits and cash flows generated as well as from the point of view of its financial position and liquidity. The interim financial reporting includes a complete or condensed set of financial statements which target to update the last financial reporting, usually the annual report. The interim financ...

  13. Immobilized high-level waste interim storage alternatives generation and analysis and decision report

    Energy Technology Data Exchange (ETDEWEB)

    CALMUS, R.B.

    1999-05-18

    This report presents a study of alternative system architectures to provide onsite interim storage for the immobilized high-level waste produced by the Tank Waste Remediation System (TWRS) privatization vendor. It examines the contract and program changes that have occurred and evaluates their impacts on the baseline immobilized high-level waste (IHLW) interim storage strategy. In addition, this report documents the recommended initial interim storage architecture and implementation path forward.

  14. Effect of polyester fiber reinforcement on the mechanical properties of interim fixed partial dentures

    OpenAIRE

    N. Gopichander; K.V. Halini Kumarai; Vasanthakumar, M

    2015-01-01

    Background: Different reinforcements currently available for interim fixed partial denture (FPD) materials do not provide the ideal strength for long-term use. Therefore, the aim of this investigation was to develop a more ideal provisional material for long-term use with better mechanical properties. This study evaluated the effectiveness of polyester fiber reinforcement on different interim FPD materials. Methods: Thirty resin-bonded FPDs were constructed from three provisional interim F...

  15. Healthy Brain Initiative Interim Progress Report

    Centers for Disease Control (CDC) Podcasts

    2016-02-25

    In 2013, CDC and the Alzheimer's Association released the second in a series of road maps. These are the accomplishments from the last two years.  Created: 2/25/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 2/25/2016.

  16. Radon Measurements in Schools: An Interim Report.

    Science.gov (United States)

    Environmental Protection Agency, Washington, DC. Office of Radiation Programs.

    Radon-222 is a colorless, odorless, tasteless, radioactive gas that occurs naturally in soil, rocks, underground water, and air. The United States Environmental Protection Agency (EPA) and other scientific organizations have identified an increased risk of lung cancer associated with exposure to elevated levels of radon in homes. Schools in many…

  17. US guidelines for treatment of schizophrenia expected next year.

    OpenAIRE

    Johnston, C

    1995-01-01

    The American Psychiatric Association (APA) is developing new guidelines for treating schizophrenia. The recommendations, which were previewed at the APA's annual meeting earlier this year, are expected to be released in 1996.

  18. VALIDATION GUIDELINES FOR LABORATORIES PERFORMING FORENSIC ANALYSIS OF CHEMICAL TERRORISM

    Science.gov (United States)

    The Scientific Working Group on Forensic Analysis of Chemical Terrorism (SWGFACT) has developed the following guidelines for laboratories engaged in the forensic analysis of chemical evidence associated with terrorism. This document provides a baseline framework and guidance for...

  19. Curriculum Guidelines on Predoctoral Oral and Maxillofacial Surgery.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    The American Association of Dental Schools' Curriculum Guidelines include an introduction to the discipline and its interrelationships with other disciplines, prerequisites, a core content outline, specific behavioral objectives, and notes on sequencing and faculty. (MSE)

  20. Bibliographic References for Numeric Social Science Data Files: Suggested Guidelines.

    Science.gov (United States)

    Dodd, Sue A.

    1979-01-01

    Some information components associated with social science numeric data bases are outlined, and guidelines, examples, and a uniform vocabulary for the creation of bibliograpic citations are included. (Author/MBR)

  1. Pharmacogenetics : From Bench to Byte-An Update of Guidelines

    NARCIS (Netherlands)

    Swen, J.J.; Nijenhuis, M.; De Boer, A.; Grandia, L.; Maitland-Van Der Zee, A.H.; Mulder, H.; Rongen, G.A.P.J.M.; Van Schaik, R.H.N.; Schalekamp, T.; Touw, D.J.; Van Der Weide, J.; Wilffert, B.; Deneer, V.H.M.; Guchelaar, H.-J.

    2011-01-01

    Currently, there are very few guidelines linking the results of pharmacogenetic tests to specific therapeutic recommendations. Therefore, the Royal Dutch Association for the Advancement of Pharmacy established the Pharmacogenetics Working Group with the objective of developing pharmacogenetics-based

  2. 2012版英国制药工业协会Ⅰ期临床试验指导原则介绍%Introduction of Association The British Pharmaceutical Industry ’ s guidelines for phase 1 clinical trials of 2012

    Institute of Scientific and Technical Information of China (English)

    况赟; 黄洁; 金承怀; 华烨; 阳国平

    2014-01-01

    Phase 1 clinical trials is a key step for new drugs from basic experiments to human verification.Developed countries have formulated the corresponding laws , regulations and policies and guiding principles.Association The British Pharmaceutical Industry ( ABPI ) released a 2012 version of guidelines for phase 1 clinical trials.It provided professional guidances for some important problems in phase 1 clinical trials ( such as risk assessment , contracts and agreements , confidentiality , subjects , in-vestigational medicinal products and so on ).This paper makes a brief in-troduction of guiding principles for phase 1 clinical trials on the 2012 ver-sion of the ABPI.%Ⅰ期临床试验是新药开发从临床前研究进入人体试验的关键一步。发达国家均制定了相应的法规政策和指导原则。英国制药工业协会( ABPI)发布了2012版Ⅰ期临床试验指导原则,其对Ⅰ期临床试验中重点关注的问题(如风险评估、合同和协议、保密、试验对象及试验用药品等)提供了专业的指导。本文就2012版ABPI Ⅰ期临床试验指导原则进行简要的介绍。

  3. A review of clinical guidelines.

    LENUS (Irish Health Repository)

    Andrews, E J

    2012-02-03

    BACKGROUND: Clinical guidelines are increasingly used in patient management but few clinicians are familiar with their origin or appropriate application. METHODS: A Medline search using the terms \\'clinical guidelines\\' and \\'practice guidelines\\' was conducted. Additional references were sourced by manual searching from the bibliographies of articles located. RESULTS AND CONCLUSION: Clinical guidelines originated in the USA in the early 1980s, initially as a cost containment exercise. Significant improvements in the process and outcomes of care have been demonstrated following their introduction, although the extent of improvement varies considerably. The principles for the development of guidelines are well established but many published guidelines fall short of these basic quality criteria. Guidelines are only one aspect of improving quality and should be used within a wider framework of promoting clinical effectiveness. Understanding their limitations as well as their potential benefits should enable clinicians to have a clearer view of their place in everyday practice.

  4. 78 FR 68101 - Environmental Issues Associated With New Reactors and Specific Environmental Guidance for...

    Science.gov (United States)

    2013-11-13

    ... (NRC) published a request for public comment on draft Interim Staff Guidance (ISG) ESP/COL-ISG 026, ``Interim Staff Guidance on Environmental Issues Associated with New Reactors'' and draft ISG ESP/ COL-ISG... NRC-2013-0212 for ESP/COL- ISG-026 or NRC-2013-0211 for ESP/COL-ISG-027. Address questions about...

  5. Comparing the 2010 North American and European atrial fibrillation guidelines.

    Science.gov (United States)

    Gillis, Anne M; Skanes, Allan C

    2011-01-01

    This article compares the important differences in the American College of Cardiology Foundation (ACCF)/American Heart Association (AHA)/Heart Rhythm Society (HRS), Canadian Cardiovascular Society (CCS), and European Society of Cardiology (ESC) 2010 guidelines on atrial fibrillation (AF). All guidelines recommend more lenient targets for ventricular rate control although the CCS guidelines recommend a target heart rate at rest drug for maintenance of sinus rhythm be based on the underlying cardiovascular disease state. However, the CCS guidelines do not recommend that the use of Class IC drugs or sotalol be restricted in the presence of left ventricular hypertrophy alone. All the guidelines have incorporated dronedarone into their recommendations of antiarrhythmic drug therapy for maintenance of sinus rhythm. However, the CCS guidelines do not make a specific recommendation that the use of dronedarone is reasonable to decrease the risk of hospitalization for cardiovascular causes in patients with AF. The ACCF/AHA/HRS update makes a strong recommendation for catheter ablation in patients with paroxysmal AF who have failed a single anti-arrhythmic drug whereas the CCS and ESC guidelines make this a conditional recommendation. The CCS guidelines are the only guidelines at present that recommend dabigitran for prevention of stroke in high risk patients and suggest that dabigatran is preferred to warfarin for stroke prevention in most patient groups.

  6. High level waste interim storge architecture selection - decision report

    Energy Technology Data Exchange (ETDEWEB)

    Calmus, R.B.

    1996-09-27

    The U.S. Department of Energy (DOE) has embarked upon a course to acquire Hanford Site tank waste treatment and immobilization services using privatized facilities (RL 1996a). This plan contains a two-phased approach. Phase I is a proof-of-principle/connnercial demonstration- scale effort and Phase II is a fiill-scale production effort. In accordance with the planned approach, interim storage and disposal of various products from privatized facilities are to be DOE fumished. The high-level waste (BLW) interim storage options, or alternative architectures, were identified and evaluated to provide the framework from which to select the most viable method of Phase I BLW interim storage (Calmus 1996). This evaluation, hereafter referred to as the Alternative Architecture Evaluation, was performed to established performance and risk criteria (technical merit, cost, schedule, etc.). Based on evaluation results, preliminary architectures and path forward reconunendations were provided for consideration in the architecture decision- maldng process. The decision-making process used for selection of a Phase I solidified BLW interim storage architecture was conducted in accordance with an approved Decision Plan (see the attachment). This decision process was based on TSEP-07,Decision Management Procedure (WHC 1995). The established decision process entailed a Decision Board, consisting of Westinghouse Hanford Company (VY`HC) management staff, and included appointment of a VTHC Decision Maker. The Alternative Architecture Evaluation results and preliminary recommendations were presented to the Decision Board members for their consideration in the decision-making process. The Alternative Architecture Evaluation was prepared and issued before issuance of @C-IP- 123 1, Alternatives Generation and Analysis Procedure (WI-IC 1996a), but was deemed by the Board to fully meet the intent of WHC-IP-1231. The Decision Board members concurred with the bulk of the Alternative Architecture

  7. Compliance with and knowledge about diabetes guidelines among physicians and nurses in Palestine.

    Science.gov (United States)

    Sharif, N El; Samara, I; Titi, I; Awartani, A

    2016-11-01

    Guidelines for the care of patients with diabetes mellitus are believed to improve clinical practice and patient care. This study aimed to analyse the pattern of diabetes care by physicians and nurses in primary care clinics in Palestine and their self-reported compliance with the local Palestinian guidelines. Questionnaires were used to collect data from 401 participants in 3 governorates in the West Bank. In total, 46.0% of participants knew about the existence of the Palestinian guidelines and about 60% believed these were partially used; 32.7% had received training on implementation of the guidelines. Multivariate analysis showed that training on the guidelines was the only factor significantly associated with self-reported compliance with guideline use. Respondents reported high commitment to the use of the guidelines, but their attitudes and behaviour varied with time constraints, availability of the guidelines, availability of laboratory tests and training on how to apply the guidelines. PMID:26857716

  8. Interim rules amending ERISA disclosure requirements for group health plans--DoL. Interim rules with request for comments.

    Science.gov (United States)

    1997-04-01

    This document contains interim rules governing the content of the summary plan description (SPD) for group health plans, the furnishing of summaries of material reductions in covered services or benefits by group health plans, and the disclosure of SPD and related information through electronic media. The rules contained in this document implement amendments to the disclosure provisions of the Employee Retirement Income Security Act of 1974 (ERISA) enacted as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Newborns' and Mothers' Health Protection Act of 1996 (NMHPA). Interested persons are invited to submit comments on the interim rules for consideration by the Department in developing final rules. The rules contained in this document are being adopted on an interim basis to accommodate statutorily established time frames intended to ensure that sponsors and administrators of group health plans, as well as participants and beneficiaries covered by such plans, have timely guidance concerning compliance with the recently enacted amendments to ERISA. PMID:10166825

  9. Rockwell International Hot Laboratory decontamination and dismantlement interim progress report 1987-1996

    Energy Technology Data Exchange (ETDEWEB)

    None

    1997-05-06

    OAK A271 Rockwell International Hot Laboratory decontamination and dismantlement interim progress report 1987-1996. The Rockwell International Hot Laboratory (RIHL) is one of a number of former nuclear facilities undergoing decontamination and decommissioning (D&D) at the Santa Susana Field Laboratory (SSFL). The RIHL facility is in the later stages of dismantlement, with the final objective of returning the site location to its original natural state. This report documents the decontamination and dismantlement activities performed at the facility over the time period 1988 through 1996. At this time, the support buildings, all equipment associated with the facility, and the entire above-ground structure of the primary facility building (Building 020) have been removed. The basement portion of this building and the outside yard areas (primarily asphalt and soil) are scheduled for D&D activities beginning in 1997.

  10. Tinnitus guidelines and treatment

    DEFF Research Database (Denmark)

    Larsen, Dalia Gustaityté; Ovesen, Therese

    2014-01-01

    In this study literature search was performed on tinnitus guidelines and treatment. Tinnitus can be described as the perception of sound in the absence of external acoustic stimulation, and validated questionnaires, oto-neurological examination, audiometry tests, MRI and angiography are necessary...... as diagnostic tools. Antidepressants, melatonin and cognitive behavioural therapy have no effect on tinnitus, whereas sound generators, hearing aids and tinnitus retraining therapy show some but limited improvement. National recommendations are required to ensure a homogenous and optimum offer for all patients....

  11. Climate friendly dietary guidelines

    OpenAIRE

    Trolle, Ellen; Mogensen, Lisbeth; Thorsen, Anne Vibeke; Jørgensen, Michael Søgaard

    2014-01-01

    The aim of this study was to investigate how the present Danish diet could be changed in a climate friendly direction that follows the recommendations of a healthy diet.The carbon footprint (CF) of an average Danish diet was calculated and compared to CF of a recommended healthy diet by 1) modifying the average diet according to the Danish food based dietary guidelines, 2) and adjusting to ensure an iso-energy content and a nutrient content according to the Nordic Nutrient Recommendations. Af...

  12. Guideline(s) For Planning A Gaming Event - Case Warhammer

    OpenAIRE

    Chan, Siu Yung

    2016-01-01

    The purpose of this thesis was to create a series of general guidelines for organizing a Warhammer 40,000 gaming event for Warhammer store in Helsinki owned by Games Workshop. The guidelines would help the store prepare a gaming event that attracts more participants and in the long term increases sales and customers. Event participants would have fun and enhance their friendship during the game. The guidelines would also be useful for new staff of Warhammer store in future. The theoretica...

  13. Attitudes toward guidelines in Finnish primary care nursing: a questionnaire survey

    DEFF Research Database (Denmark)

    Seija, Alanen; Kaila, Minna; Välimäki, Marita;

    2009-01-01

    BACKGROUND: Evidence-based clinical guidelines have attracted international interest as tools for improving the quality of health care. Attitudes toward these guidelines are of great importance because attitudes are proven to be important predictors of guideline use. Attitudes are also believed...... to be shaped by perceptions of others, which makes the role of organizational implementation interventions interesting. AIMS: This article describes primary care nurses' attitudes toward guidelines among Finnish primary care nurses and the associations between attitudes, implementation interventions...

  14. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application and comp......It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application...... and compliance with CPGs in most areas of clinical practice are deficient. Computerization of CPGs has been brought forward as a method to disseminate and to support application of CPGs. Until now, CPG-computerization has focused on development of formal expressions of CPGs. The developed systems have, however......, not gained any extensive application in clinical practice. The basic assumption in this thesis is that the scanty penetration is due to an inappropriate design process when designing computerized CPGs for clinical work practice. This thesis examines the application of guidance within areas where CPG...

  15. Postdoctoral program guidelines.

    Energy Technology Data Exchange (ETDEWEB)

    Teich-McGoldrick, Stephanie; Miller, Andrew W.; Sava, Dorina Florentina; Liu, Yanli; Ferreira, Summer Rhodes; Biedermann, Laura Butler; Cruz-Campa, Jose Luis; Hall, Lisa Michelle; Liu, Xiaohua H.; Ekoto, Isaac

    2012-04-01

    We, the Postdoc Professional Development Program (PD2P) leadership team, wrote these postdoc guidelines to be a starting point for communication between new postdocs, their staff mentors, and their managers. These guidelines detail expectations and responsibilities of the three parties, as well as list relevant contacts. The purpose of the Postdoc Program is to bring in talented, creative people who enrich Sandia's environment by performing innovative R&D, as well as by stimulating intellectual curiosity and learning. Postdocs are temporary employees who come to Sandia for career development and advancement reasons. In general, the postdoc term is 1 year, renewable up to five times for a total of six years. However, center practices may vary; check with your manager. At term, a postdoc may apply for a staff position at Sandia or choose to move to university, industry or another lab. It is our vision that those who leave become long-term collaborators and advocates whose relationships with Sandia have a positive effect upon our national constituency.

  16. PROJECT INTERIM ACTIVITY REPORT FOR SEMESTER 4

    CERN Document Server

    Koutchouk, J P

    2011-01-01

    The EuCARD project gathers 37 European partners engaged in state-of the-art technologies to upgrade major research accelerators. The main components and objectives of the project are: • Networks, focused on communication and dissemination, neutrino physics facilities, performance of hadron colliders and accelerators, and RF technologies, resulting in 40 leading laboratories worldwide being associated with EuCARD. • Transnational access facilities, offering precision beams and muon cooling setup, and pulsed irradiation for material testing. • Joint research: 21 R&D tasks grouped under the following themes: o Investigating the feasibility of new superconducting magnets and electrical links using Nb3Sn and/or High Temperature Superconductors. o Investigating the gradient limits for radiofrequency (RF) accelerating structures, whether normal or superconducting, together with specific issues of linear colliders such as extreme geometrical stabilization. o Developing more robust collimators for the protec...

  17. Guidelines for psychological practice with transgender and gender nonconforming people.

    Science.gov (United States)

    2015-12-01

    In 2015, the American Psychological Association adopted Guidelines for Psychological Practice with Transgender and Gender Nonconforming Clients in order to describe affirmative psychological practice with transgender and gender nonconforming (TGNC) clients. There are 16 guidelines in this document that guide TGNC-affirmative psychological practice across the lifespan, from TGNC children to older adults. The Guidelines are organized into five clusters: (a) foundational knowledge and awareness; (b) stigma, discrimination, and barriers to care; (c) lifespan development; (d) assessment, therapy, and intervention; and (e) research, education, and training. In addition, the guidelines provide attention to TGNC people across a range of gender and racial/ethnic identities. The psychological practice guidelines also attend to issues of research and how psychologists may address the many social inequities TGNC people experience. PMID:26653312

  18. Environmental survey of two interim dumpsites, Middle Atlantic Bight from 05 November 1973 to 10 November 1973 (NODC Accession 7501280)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — A second oceanographic survey cruise was made to an interim municipal sludge dumpsite and initially to an interim dumpsite for the disposal of industrial acid waste...

  19. Guidelines for Authors

    Directory of Open Access Journals (Sweden)

    Abdullah Demir

    2016-06-01

    Full Text Available Guidelines for Authors cumhuriyet theology journal  reguires writers to use the The Chicago Manual of Style “notes and bibliography” system of referencing.First citation: author(s first name and last name, title, (if applicable first and last name of translator or editor, place of publication, publisher, date of publication, page number.Subsequent citations: author’s last name, the short title, and the page number should be indicated in all subsequent citations. Footnote citations should conform to the following examples.References: References should be placed at the end of the text in alphabetical order. If a source has more than one author, the surname and name of the first author should be written, and the other authors should be indicated by et.al. The titles of books and journals should be italicized; article titles and book chapters should be placed in quotation marks. Translator’s and editor’s names (if there are any should follow the title of the work: BOOKa One Author: 
1. Michael Pollan, The Omnivore’s Dilemma: A Natural History of Four Meals (New York: Penguin, 2006, 99–100.2. Pollan, Omnivore’s Dilemma, 3.Bibliography: Pollan, Michael. The Omnivore’s Dilemma: A Natural History of Four Meals. New York: Penguin, 2006.  b Two Authors1. Geoffrey C. Ward and Ken Burns, The War: An Intimate History 1941–1945 (New York: Knopf, 2007, 52.2. Ward and Burns, War, 59–61. Bibliography: Ward, Geoffrey C., and Ken Burns. The War: An Intimate History 1941–1945. New York: Knopf, 2007.c Three or More Authors
For three or more authors, list all of the authors in the bibliography; in the note, list only the first author, followed by et al. (“and others”:1. Mitchell L. Eisen, Jodi A. Quas, and Gail S. Goodman, eds., Memory and Suggestibility in the Forensic Interview (Mahwah, NJ: L. Erlbaum Assoicates, 2002, 65.2. Eisen and et al., Memory and Suggestibility in the Forensic Interview, 67.Bibliography: Eisen, Mitchell

  20. Toward targeted hypertension screening guidelines

    OpenAIRE

    Buuren, S. van; Boshuizen, HC; Reijneveld, SA

    2006-01-01

    Background. guidelines for screening and subsequent treatment of hypertension vary widely between countries. Part Of this variation can be attributed to systematic differences between Populations, but little is known about the way in which guidelines should be targeted to the population of interest. Optimal guidelines should have high yield and low complexity. The goal is to fit procedures for screening and subsequent treatment of hypertension optimally to a specific population. Methods. Simu...

  1. Guidelines on Building Regulations 2008

    DEFF Research Database (Denmark)

    Thse guidelines clarify and intepret the provisions of the Building Regulations of 2008 (BR08). The Guidelines, which match BR08 in terms of organisation into Parts, are accompanied by the full text of the regulations and the explanatory notes issued by the Danish Enterprise and Construction...... climate, energy consumotion and services. The Guidelines are aimed at all professionals involved in building projects, particularly building design consultants, contractors and municipal application officers....

  2. Standard operating procedures for ESPEN guidelines and consensus papers.

    Science.gov (United States)

    Bischoff, Stephan C; Singer, Pierre; Koller, Michael; Barazzoni, Rocco; Cederholm, Tommy; van Gossum, André

    2015-12-01

    The ESPEN Guideline standard operating procedures (SOP) is based on the methodology provided by the Association of Scientific Medical Societies of Germany (AWMF), the Scottish Intercollegiate Guidelines Network (SIGN), and the Centre for Evidence-based Medicine at the University of Oxford. The SOP is valid and obligatory for all future ESPEN-sponsored guideline projects aiming to generate high-quality guidelines on a regular basis. The SOP aims to facilitate the preparation of guideline projects, to streamline the consensus process, to ensure quality and transparency, and to facilitate the dissemination and publication of ESPEN guidelines. To achieve this goal, the ESPEN Guidelines Editorial board (GEB) has been established headed by two chairmen. The GEB will support and supervise the guideline processes and is responsible for the strategic planning of ESPEN guideline activities. Key elements of the SOP are the generation of well-built clinical questions according to the PICO system, a systemic literature search, a classification of the selected literature according to the SIGN evidence levels providing an evidence table, and a clear and straight-forward consensus procedure consisting of online voting's and a consensus conference. Only experts who meet the obligation to disclosure any potential conflict of interests and who are not employed by the Industry can participate in the guideline process. All recommendations will be graded according to the SIGN grading and novel outcome models besides biomedical endpoints. This approach will further extent the leadership of ESPEN in creating up-to-date and suitable for implementation guidelines and in sharing knowledge on malnutrition and clinical nutrition. PMID:26254807

  3. Utility-Scale Parabolic Trough Solar Systems: Performance Acceptance Test Guidelines, April 2009 - December 2010

    Energy Technology Data Exchange (ETDEWEB)

    Kearney, D.

    2011-05-01

    Prior to commercial operation, large solar systems in utility-size power plants need to pass a performance acceptance test conducted by the engineering, procurement, and construction (EPC) contractor or owners. In lieu of the present absence of ASME or other international test codes developed for this purpose, the National Renewable Energy Laboratory has undertaken the development of interim guidelines to provide recommendations for test procedures that can yield results of a high level of accuracy consistent with good engineering knowledge and practice. The Guidelines contained here are specifically written for parabolic trough collector systems with a heat-transport system using a high-temperature synthetic oil, but the basic principles are relevant to other CSP systems.

  4. Measure Guideline: Internal Insulation of Masonry Walls

    Energy Technology Data Exchange (ETDEWEB)

    Straube, J. F.; Ueno, K.; Schumacher, C. J.

    2012-07-01

    This measure guideline provides recommendations for interior insulation assemblies that control interstitial condensation and durability risks; recommendations for acceptable thermal performance are also provided. An illustrated guide of high-risk exterior details (which concentrate bulk water), and recommended remediation details is provided. This is followed by a recommended methodology for risk assessment of a masonry interior insulation project: a series of steps are suggested to assess the risks associated with this retrofit, with greater certainty with added steps.

  5. Penile Cancer: Clinical Practice Guidelines in Oncology

    OpenAIRE

    Clark, Peter E.; Philippe E. Spiess; Agarwal, Neeraj; Biagioli, Matthew C.; Eisenberger, Mario A.; Greenberg, Richard E.; Herr, Harry W.; Inman, Brant A.; Kuban, Deborah A.; Kuzel, Timothy M.; Lele, Subodh M.; Michalski, Jeff; Pagliaro, Lance; Pal, Sumanta K.; Patterson, Anthony

    2013-01-01

    Squamous cell carcinoma of the penis represents approximately 0.5% of all cancers among men in the United States and other developed countries. Although rare, it is associated with significant disfigurement, and only half of the patients survive beyond 5 years. Proper evaluation of both the primary lesion and lymph nodes is critical, because nodal involvement is the most important factor of survival. The NCCN Clinical Practice Guidelines in Oncology for Penile Cancer provide recommendations o...

  6. Measure Guideline. Internal Insulation of Masonry Walls

    Energy Technology Data Exchange (ETDEWEB)

    Straube, J. F. [Building Science Corporation (BSC), Somerville, MA (United States); Ueno, K. [Building Science Corporation (BSC), Somerville, MA (United States); Schumacher, C. J. [Building Science Corporation (BSC), Somerville, MA (United States)

    2012-07-01

    This measure guideline provides recommendations for interior insulation assemblies that control interstitial condensation and durability risks; recommendations for acceptable thermal performance are also provided. An illustrated guide of high-risk exterior details (which concentrate bulk water), and recommended remediation details is provided. This is followed by a recommended methodology for risk assessment of a masonry interior insulation project: a series of steps are suggested to assess the risks associated with this retrofit, with greater certainty with added steps.

  7. Summary Interim Report on Findings and Interim Themes from Phase 1 of the review of Allied Health Professions (AHP) support for children/young people with a statement of special educational needs (SEN)

    OpenAIRE

    Public Health Agency

    2015-01-01

    Summary Interim Report on Findings and Interim Themes from Phase 1 of the review of Allied Health Professions (AHP) support for children/young people with a statement of special educational needs (SEN)This interim report is outlining the service principles agreed by the Project Board and the themes identified throughout engagement and information gathering.

  8. Physical Activity Design Guidelines for School Architecture.

    Directory of Open Access Journals (Sweden)

    Jeri Brittin

    Full Text Available Increasing children's physical activity at school is a national focus in the U.S. to address childhood obesity. While research has demonstrated associations between aspects of school environments and students' physical activity, the literature currently lacks a synthesis of evidence to serve as a practical, spatially-organized resource for school designers and decision-makers, as well as to point to pertinent research opportunities. This paper describes the development of a new practical tool: Physical Activity Design Guidelines for School Architecture. Its aims are to provide architects and designers, as well as school planners, educators, and public health professionals, with strategies for making K-12 school environments conducive to healthy physical activity, and to engage scientists in transdisciplinary perspectives toward improved knowledge of the school environment's impact. We used a qualitative review process to develop evidence-based and theory-driven school design guidelines that promote increased physical activity among students. The design guidelines include specific strategies in 10 school design domains. Implementation of the guidelines is expected to enable students to adopt healthier physical activity behaviors. The tool bridges a translational gap between research and environmental design practice, and may contribute to setting new industry and education standards.

  9. Physical Activity Design Guidelines for School Architecture.

    Science.gov (United States)

    Brittin, Jeri; Sorensen, Dina; Trowbridge, Matthew; Lee, Karen K; Breithecker, Dieter; Frerichs, Leah; Huang, Terry

    2015-01-01

    Increasing children's physical activity at school is a national focus in the U.S. to address childhood obesity. While research has demonstrated associations between aspects of school environments and students' physical activity, the literature currently lacks a synthesis of evidence to serve as a practical, spatially-organized resource for school designers and decision-makers, as well as to point to pertinent research opportunities. This paper describes the development of a new practical tool: Physical Activity Design Guidelines for School Architecture. Its aims are to provide architects and designers, as well as school planners, educators, and public health professionals, with strategies for making K-12 school environments conducive to healthy physical activity, and to engage scientists in transdisciplinary perspectives toward improved knowledge of the school environment's impact. We used a qualitative review process to develop evidence-based and theory-driven school design guidelines that promote increased physical activity among students. The design guidelines include specific strategies in 10 school design domains. Implementation of the guidelines is expected to enable students to adopt healthier physical activity behaviors. The tool bridges a translational gap between research and environmental design practice, and may contribute to setting new industry and education standards.

  10. Interim Financial Reporting in the Perspective of harmonization of the Romanian Accountancy with the International Financial Reporting Standards

    OpenAIRE

    Bunea-Bontas, Cristina Aurora

    2007-01-01

    The main objective of the interim financial reporting is to present, timely and regularly, information concerning the enterprise’s capacity to generate earnings and cash flows and its financial position and liquidity. International Accounting Standard 34 “Interim Financial Reporting” concerns the financial statements for an interim period. According to IAS 34, the interim financial report includes a complete or condensed set of financial statements, elaborated for a shorter period than a full...

  11. The Effect of Incorporation, Orientation and Silane Treatment of Glass Fibers on the Fracture Resistance of Interim Fixed Partial Dentures

    OpenAIRE

    Basant, Gupta; Reddy, Y G

    2011-01-01

    Fracture of interim fixed partial dentures (FPD) is of important concern to the dental surgeon, especially with long-span fixed partial dentures or areas of heavy occlusal stress. Polymers used in interim FPDs, reinforced with glass fibers have shown to have a positive effect on the fracture resistance of interim FPDs. Since little research has been done on the influence of silane treated glass fibers on the fracture resistance of interim FPDs, this study was conducted to evaluate the effect ...

  12. A new dietary strategy for long-term treatment of the metabolic syndrome is compared with the American Heart Association (AHA) guidelines: the MEtabolic Syndrome REduction in NAvarra (RESMENA) project.

    Science.gov (United States)

    de la Iglesia, Rocio; Lopez-Legarrea, Patricia; Abete, Itziar; Bondia-Pons, Isabel; Navas-Carretero, Santiago; Forga, Luis; Martinez, J Alfredo; Zulet, M Angeles

    2014-02-01

    The long-term effects of dietary strategies designed to combat the metabolic syndrome (MetS) remain unknown. The present study evaluated the effectiveness of a new dietary strategy based on macronutrient distribution, antioxidant capacity and meal frequency (MEtabolic Syndrome REduction in NAvarra (RESMENA) diet) for the treatment of the MetS when compared with the American Heart Association guidelines, used as Control. Subjects with the MetS (fifty-two men and forty-one women, age 49 (se 1) years, BMI 36·11 (se 0·5) kg/m²) were randomly assigned to one of two dietary groups. After a 2-month nutritional-learning intervention period, during which a nutritional assessment was made for the participants every 15 d, a 4-month self-control period began. No significant differences were found between the groups concerning anthropometry, but only the RESMENA group exhibited a significant decrease in body weight ( - 1·7%; P= 0·018), BMI ( - 1·7%; P= 0·019), waist circumference ( - 1·8%; P= 0·021), waist:hip ratio ( - 1·4%; P= 0·035) and android fat mass ( - 6·9%; P= 0·008). The RESMENA group exhibited a significant decrease in alanine aminotransferase and aspartate aminotransferase (AST) concentrations ( - 26·8%; P= 0·008 and - 14·0%; P= 0·018, respectively), while the Control group exhibited a significant increase in glucose (7·9%; P= 0·011), AST (11·3%; P= 0·045) and uric acid (9·0%; P< 0·001) concentrations. LDL-cholesterol (LDL-C) concentrations were increased (Control group: 34·4%; P< 0·001 and RESMENA group: 33·8%; P< 0·001), but interestingly so were the LDL-C:apoB ratio (Control group: 28·7%; P< 0·001, RESMENA group: 17·1%; P= 0·009) and HDL-cholesterol concentrations (Control group: 21·1%; P< 0·001, RESMENA group: 8·7; P= 0·001). Fibre was the dietary component that most contributed to the improvement of anthropometry, while body-weight loss explained changes in some biochemical markers. In conclusion, the RESMENA diet is a good

  13. 42 CFR 417.572 - Budget and enrollment forecast and interim reports.

    Science.gov (United States)

    2010-10-01

    ... of each contract period. The forecast must be based on financial and statistical data and records... 42 Public Health 3 2010-10-01 2010-10-01 false Budget and enrollment forecast and interim reports... forecast and interim reports. (a) Annual submittal. The HMO or CMP must submit an annual operating...

  14. Interim storage of wastes and refuse derived fuels; Zwischenlagerung von Abfaellen und Ersatzbrennstoffen

    Energy Technology Data Exchange (ETDEWEB)

    Thome-Kozmiensky, K.J.; Versteyl, A.; Beckmann, M. (eds.)

    2006-07-01

    Authors comment on interim storage of municipal wastes and refuse derived fuels. Topics of the 16 contributions are: Logistics and engineering, planning, estimation of storage time, cost and commitment, amend ment of the regulations, penal risks of interim storage, material flow management at waste incinerators, fire prevention, environmental risk, insurances. (uke)

  15. Interim format and content for a physical security plan for nuclear power plants

    International Nuclear Information System (INIS)

    The document serves as interim guidance to assist the licensee or applicant in the preparation of a physical security plan. It is to be used in conjunction with interim acceptance criteria for physical security programs, which will be distributed at a later date

  16. Conceptual design report for immobilized high-level waste interim storage facility (Phase 1)

    Energy Technology Data Exchange (ETDEWEB)

    Burgard, K.C.

    1998-06-02

    The Hanford Site Canister Storage Building (CSB Bldg. 212H) will be utilized to interim store Phase 1 HLW products. Project W-464, Immobilized High-Level Waste Interim Storage, will procure an onsite transportation system and retrofit the CSB to accommodate the Phase 1 HLW products. The Conceptual Design Report establishes the Project W-464 technical and cost basis.

  17. Conceptual design report for immobilized high-level waste interim storage facility (Phase 1)

    Energy Technology Data Exchange (ETDEWEB)

    Burgard, K.C.

    1998-04-09

    The Hanford Site Canister Storage Building (CSB Bldg. 212H) will be utilized to interim store Phase 1 HLW products. Project W-464, Immobilized High-Level Waste Interim Storage, will procure an onsite transportation system and retrofit the CSB to accommodate the Phase 1 HLW products. The Conceptual Design Report establishes the Project W-464 technical and cost basis.

  18. Conceptual design report for immobilized high-level waste interim storage facility (Phase 1)

    International Nuclear Information System (INIS)

    The Hanford Site Canister Storage Building (CSB Bldg. 212H) will be utilized to interim store Phase 1 HLW products. Project W-464, Immobilized High-Level Waste Interim Storage, will procure an onsite transportation system and retrofit the CSB to accommodate the Phase 1 HLW products. The Conceptual Design Report establishes the Project W-464 technical and cost basis

  19. 78 FR 40199 - Draft Spent Fuel Storage and Transportation Interim Staff Guidance

    Science.gov (United States)

    2013-07-03

    ... COMMISSION Draft Spent Fuel Storage and Transportation Interim Staff Guidance AGENCY: Nuclear Regulatory... Regulatory Commission (NRC) requests public comment on Draft Spent Fuel Storage and Transportation Interim... given in NUREG-1927 ``Standard Review Plan for Renewal of Spent Fuel Dry Cask Storage System...

  20. Effects of Interim Assessments across the Achievement Distribution: Evidence From an Experiment

    Science.gov (United States)

    Konstantopoulos, Spyros; Li, Wei; Miller, Shazia R.; van der Ploeg, Arie

    2016-01-01

    We use data from a large-scale experiment conducted in Indiana in 2009-2010 to examine the impact of two interim assessment programs (mCLASS and Acuity) across the mathematics and reading achievement distributions. Specifically, we focus on whether the use of interim assessments has a particularly strong effect on improving outcomes for low…

  1. 32 CFR 643.36 - Policy-Interim leasing of excess properties to facilitate economic readjustment.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Policy-Interim leasing of excess properties to facilitate economic readjustment. 643.36 Section 643.36 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE Policy § 643.36 Policy—Interim leasing of...

  2. Interim Action Proposed Plan for the Chemicals, Metals, and Pesticides (CMP) Pits Operable Unit; FINAL

    International Nuclear Information System (INIS)

    The purpose of this Interim Action Proposed Plan (IAPP) is to describe the preferred interim remedial action for addressing the Chemicals, Metals, and Pesticides (CMP) Pits Operable Unit and to provide an opportunity for public input into the remedial action selection process

  3. Performance of ERA-Interim wave data in the nearshore waters around India

    Digital Repository Service at National Institute of Oceanography (India)

    SanilKumar, V.; Naseef, T.M.

    the Interim European Centre for Medium-Range Weather Forecasts (ECMWF) Re-Analysis [ERA-Interim (ERA-I)] wave height and period data in the nearshore waters around India. The difference between the ERA-I significant wave height (SWH) and the buoy SWH varies...

  4. 76 FR 59394 - Energy Conservation Program for Consumer Products: Publication of the Extension of Interim Waiver...

    Science.gov (United States)

    2011-09-26

    ... multiple defrost cycles, and requested comments on Samsung's petition. 76 FR 16760 (March 25, 2011... comment period on its interim final rule for the refrigerator test procedure. 76 FR 57612 (Sept. 15, 2011...: Publication of the Extension of Interim Waiver Granted to Samsung Electronics America, Inc. From...

  5. PROJECT W-551 INTERIM PRETREATMENT SYSTEM TECHNOLOGY SELECTION SUMMARY DECISION REPORT AND RECOMMENDATION

    Energy Technology Data Exchange (ETDEWEB)

    CONRAD EA

    2008-08-12

    This report provides the conclusions of the tank farm interim pretreatment technology decision process. It documents the methodology, data, and results of the selection of cross-flow filtration and ion exchange technologies for implementation in project W-551, Interim Pretreatment System. This selection resulted from the evaluation of specific scope criteria using quantitative and qualitative analyses, group workshops, and technical expert personnel.

  6. A Blueprint for Telerehabilitation Guidelines

    Directory of Open Access Journals (Sweden)

    David Brennan

    2010-10-01

    Full Text Available Telerehabilitation refers to the delivery of rehabilitation services via information and communication technologies.  Clinically, this term encompasses a range of rehabilitation and habilitation services that include assessment, monitoring, prevention, intervention, supervision, education, consultation, and counseling.  Telerehabilitation has the capacity to provide service across the lifespan and across a continuum of care.  Just as the services and providers of telerehabilitation are broad, so are the points of service, which may include health care settings, clinics, homes, schools, or community-based worksites. This document was developed collaboratively by members of the Telerehabilitation SIG of the American Telemedicine Association, with input and guidance from other practitioners in the field, strategic stakeholders, and ATA staff.   Its purpose is to inform and assist practitioners in providing effective and safe services that are based on client needs, current empirical evidence, and available technologies.   Telerehabilitation professionals, in conjunction with professional associations and other organizations are encouraged to use this document as a template for developing discipline-specific standards, guidelines, and practice requirements.      

  7. Dosimetry at an interim storage for spent nuclear fuel.

    Science.gov (United States)

    Králík, M; Kulich, V; Studeny, J; Pokorny, P

    2007-01-01

    The Czech nuclear power plant Dukovany started its operation in 1985. All fuel spent from 1985 up to the end of 2005 is stored at a dry interim storage, which was designed for 60 CASTOR-440/84 casks. Each of these casks can accommodate 84 fuel assemblies from VVER 440 reactors. Neutron-photon mixed fields around the casks were characterized in terms of ambient dose equivalent measured by standard area dosemeters. Except this, neutron spectra were measured by means of a Bonner sphere spectrometer, and the measured spectra were used to derive the corresponding ambient dose equivalent due to neutrons. PMID:17526479

  8. Dosimetry at an interim storage for spent nuclear fuel.

    Science.gov (United States)

    Králík, M; Kulich, V; Studeny, J; Pokorny, P

    2007-01-01

    The Czech nuclear power plant Dukovany started its operation in 1985. All fuel spent from 1985 up to the end of 2005 is stored at a dry interim storage, which was designed for 60 CASTOR-440/84 casks. Each of these casks can accommodate 84 fuel assemblies from VVER 440 reactors. Neutron-photon mixed fields around the casks were characterized in terms of ambient dose equivalent measured by standard area dosemeters. Except this, neutron spectra were measured by means of a Bonner sphere spectrometer, and the measured spectra were used to derive the corresponding ambient dose equivalent due to neutrons.

  9. Haiti; Interim Poverty Reduction Strategy Paper: Joint Staff Advisory Note

    OpenAIRE

    International Monetary Fund

    2007-01-01

    This Joint Staff Advisory Note focuses on the Interim Poverty Reduction Strategy Paper (I-PRSP) for Haiti. The I-PRSP outlines the main areas of actions envisaged by the authorities to reduce poverty as well as the steps to be undertaken in the preparation of the full Poverty Reduction Strategy. The I-PRSP presents a good diagnostic of the current dimensions of poverty in Haiti. It also covers well the authorities’ macroeconomic objectives and the broad measures necessary to reach these obj...

  10. Republic of Congo; Interim Poverty Reduction Strategy Paper Progress Report

    OpenAIRE

    International Monetary Fund

    2005-01-01

    This paper examines Congo’s Interim Poverty Reduction Strategy Paper (I-PRSP). Congo’s I-PRSP explains the features and causes of poverty in Congo. It provides a short- and medium-term vision of development as well as a strategic orientation for a return to sustainable and equitable growth. The main objective is steady poverty reduction. The choice and implementation of strategic orientations and priority actions in the I-PRSP are consistent with the government’s commitment to rebuilding the ...

  11. World Association for the Advancement of Veterinary Parasitology (W.A.A.V.P.) second edition: guidelines for evaluating the efficacy of parasiticides for the treatment, prevention and control of flea and tick infestations on dogs and cats.

    Science.gov (United States)

    Marchiondo, A A; Holdsworth, P A; Fourie, L J; Rugg, D; Hellmann, K; Snyder, D E; Dryden, M W

    2013-05-01

    These second edition guidelines, updated from the 2007 version (Marchiondo et al., 2007), are intended to assist the planning and conduct of laboratory and clinical studies to assess the efficacy of ectoparasiticides applied to dogs or cats for the purpose of treating, preventing and controlling flea and tick infestations. Major revisions to this second edition include guidelines on the assessment of systemic flea and tick products, an update of the geographical distribution of the common fleas and ticks species on dogs and cats, determination of flea and tick efficacy based on geometric versus arithmetic means with respect to geographic regulatory agencies, modification of tick categorization in the assessment of efficacy, expanded guidelines on repellency and anti-feeding effects, enhanced practical field study guidance, and considerations on the ranges of flea and ticks for infestations in laboratory studies. The term ectoparasiticide includes insecticidal and acaricidal compounds, as well as insect growth regulators. The range of biological activities from animal treatment that are considered include: repellency and anti-feeding effects, knockdown, speed of kill, immediate and persistent lethal effects, and interference with egg fertility and subsequent development of off-host life cycle stages. Information is provided on the selection of animals, dose determination, dose confirmation and field studies, record keeping, interpretation of results and animal welfare. These guidelines are also intended to assist regulatory authorities involved in the approval and registration of new topical or systemic ectoparasiticides, and to facilitate the worldwide adoption of harmonized procedures.

  12. [Clinical guideline 'Turner syndrome'].

    Science.gov (United States)

    van den Akker, Erica L T; van Alfen, A A E M Janiëlle; Sas, Theo C J; Kerstens, Michiel N; Cools, Martine; Lambalk, Cornelis B

    2014-01-01

    Turner syndrome occurs in women who are missing one X chromosome. The most obvious symptoms are small stature and ovarian failure. Turner patients have an increased risk of a large number of disorders, and should therefore have lifelong medical supervision. Recent insights into patient management have been incorporated into the guidelines. Patients are increasingly involved in their own treatment. In patients with 45,X karyotype, Y-chromosomal material is actively sought in a larger number of cells and/or other tissues, using FISH. Pubertal induction therapy, if required, is initiated at an appropriate age. Egg donation or vitrification are new therapeutic options for fertility treatment. Monitoring for cardiac and vascular disease using cardiac ultrasound and MRI is performed more often, partly in connection with the risk of aortal dissection. The coordination of care of patients with Turner syndrome is concentrated in specialized centres in the Netherlands and Belgium.

  13. Guidelines for publication

    Science.gov (United States)

    Rapp, Richard H.

    The AGU Publications Committee and the Board of Journal Editors recently adopted standards for the conduct of the publications process of AGU. These standards articulate the way in which we believe most geophysicists behave when acting as author, editor, or reviewer. We do not perceive a problem with the ethical conduct in any phase of the AGU publications activity. Rather we are presenting what is common practice as a reminder to us all and as help to those who may be just embarking on their scientific careers.We wish to thank in particular our colleagues in the American Chemical Society. With their permission we borrowed heavily from “Ethical Guidelines to Publication of Chemical Research” in the document presented below.

  14. Rethinking guideline toxicity testing.

    Science.gov (United States)

    Saghir, Shakil Ahmed

    2015-07-01

    The guidelines for risk assessment of plant protection products (PPPs) and other non-pharmaceuticals were developed over three decades ago and have generally not been updated to incorporate advancements in toxicology and exposure sciences. These guidelines recommend using maximum-tolerated-dose (MTD) even when human relevance of such high doses is mostly limited due to orders of magnitude margin-of-exposure. Conducting animal studies at such high doses often requires further mode-of-action (MoA) studies elucidating human relevance. In order to improve data, ILSI/HESI-ACSA technical committee proposed a tiered approach with emphasis on determining systemic dose of parent and/or metabolite(s) in test animals as biological effects are reflective of systemic rather than administered dose. Any deviation from linearity in systemic dose (saturation of absorption or elimination) in animal studies may have profound toxic effect(s) not expected to occur in likely human exposure scenarios and should be avoided. Toxicity studies should ideally be conducted at kinetically linear doses or slightly above the point of departure from linearity or kinetically-derived maximum dose (KMD) as the systemic dose nonlinearity is a more sensitive parameter occurring much earlier than the MTD endpoints. Therefore, determining systemic dose, especially KMD, in study animals is an improvement to hazard assessment of PPPs and other non-pharmaceuticals allowing toxicologists to better understand findings in animals at systemically linear as well as nonlinear doses to likely human exposures which can easily be accomplished using core study animals as outlined below. Determining systemic dose in studies will also increase the understanding of initial potential MoA of a PPPs and other non-pharmaceuticals and reduce the use of animals by avoiding unnecessary additional MoA studies. PMID:25980640

  15. Interim data monitoring to enroll higher-risk participants in HIV prevention trials

    Directory of Open Access Journals (Sweden)

    Umo-Otong John

    2009-06-01

    Full Text Available Abstract Background Lower-than-expected incidence of HIV undermines sample size calculations and compromises the power of a HIV prevention trial. We evaluated the effectiveness of interim monitoring of HIV infection rates and on-going modification of recruitment strategies to enroll women at higher risk of HIV in the Cellulose Sulfate Phase III study in Nigeria. Methods We analyzed prevalence and incidence of HIV and other sexually transmitted infections, demographic and sexual behavior characteristics aggregated over the treatment groups on a quarterly basis. The site investigators were advised on their recruitment strategies based on the findings of the interim analyses. Results A total of 3619 women were screened and 1644 enrolled at the Ikeja and Apapa clinics in Lagos, and at the Central and Peripheral clinics in Port Harcourt. Twelve months after study initiation, the overall incidence of HIV was less than one-third of the pre-study assumption, with rates of HIV that varied substantially between clinics. Due to the low prevalence and incidence rates of HIV, it was decided to close the Ikeja clinic in Lagos and to find new catchment areas in Port Harcourt. This strategy was associated with an almost two-fold increase in observed HIV incidence during the second year of the study. Conclusion Given the difficulties in estimating HIV incidence, a close monitoring of HIV prevalence and incidence rates during a trial is warranted. The on-going modification of recruitment strategies based on the regular analysis of HIV rates appeared to be an efficient method for targeting populations at greatest risk of HIV infection and increasing study power in the Nigeria trial. Trial Registration The trial was registered with the ClinicalTrials.gov registry under #NCT00120770 http://clinicaltrials.gov/ct2/show/NCT00120770

  16. 77 FR 55232 - Japan Lessons-Learned Project Directorate Interim Staff Guidance JLD-ISG-2012-03; Compliance With...

    Science.gov (United States)

    2012-09-07

    ... COMMISSION Japan Lessons-Learned Project Directorate Interim Staff Guidance JLD-ISG-2012-03; Compliance With...: Nuclear Regulatory Commission (NRC). ACTION: Japan Lessons-Learned Project Directorate Interim Staff... Final Japan Lessons-Learned Project Directorate (JLD) Interim Staff Guidance (ISG),...

  17. 77 FR 55231 - Japan Lessons-Learned Project Directorate Interim Staff Guidance JLD-ISG-2012-02; Compliance With...

    Science.gov (United States)

    2012-09-07

    ... COMMISSION Japan Lessons-Learned Project Directorate Interim Staff Guidance JLD-ISG-2012-02; Compliance With...: Nuclear Regulatory Commission (NRC). ACTION: Japan Lessons-Learned Project Directorate interim staff... Final Japan Lessons-Learned Project Directorate Interim Staff Guidance (JLD-ISG),...

  18. Qualification guideline of the German X-ray association (DRG) und the German association for interventional radiology and minimal invasive therapy (DeGIR) for the performance of interventional-radiological minimal invasive procedures on arteries and veins; Qualifizierungsleitlinie der Deutschen Roentgengesellschaft (DRG) und der Deutschen Gesellschaft fuer Interventionelle Radiologie und minimalinvasive Therapie (DeGIR) zur Durchfuehrung interventionell-radiologischer minimalinvasiver Verfahren an Arterien und Venen

    Energy Technology Data Exchange (ETDEWEB)

    Buecker, A. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany); Gross-Fengels, W. [Asklepiosklinik, Hamburg-Harburg (Germany); Haage, P. [Helios-Kliniken, Wuppertal (Germany); Huppert, P. [Klinikum Darmstadt (Germany); Landwehr, P. [Henriettenstiftung, Hannover (Germany); Loose, R. [Klinikum Nuernberg-Nord (Germany); Reimer, P. [Klinikum Karlsruhe (Germany); Tacke, J. [Klinikum Passau (Germany); Vorwerk, D. [Klinikum Ingolstadt (Germany); Fischer, J.

    2012-06-15

    The topics covered in the qualification guideline of the German X-ray association (DRG) und the German association for interventional radiology and minimal invasive therapy (DeGIR) for the performance of interventional-radiological minimal invasive procedures on arteries and veins are the following: Practical qualification: aorta iliac vessels and vessels in the upper and lower extremities, kidney and visceral arteries, head and neck arteries, dialysis shunts, veins and pulmonary arteries, aorta aneurysms and peripheral artery aneurysms. Knowledge acquisition concerning radiation protection: legal fundamentals, education and training, knowledge actualization and quality control, definition of the user and the procedure, competence preservation.

  19. Toward targeted hypertension screening guidelines

    NARCIS (Netherlands)

    van Buuren, S; Boshuizen, HC; Reijneveld, SA

    2006-01-01

    Background. guidelines for screening and subsequent treatment of hypertension vary widely between countries. Part Of this variation can be attributed to systematic differences between Populations, but little is known about the way in which guidelines should be targeted to the population of interest.

  20. IT governance guidelines for directors

    CERN Document Server

    Calder, Alan

    2005-01-01

    This important new book – 'IT Governance: Guidelines for Directors' provides directors, executives, managers and professional advisers with clear, pragmatic guidelines for ensuring that IT and the business work together for the same strategic objectives. 

  1. Specialty Guidelines for Forensic Psychology

    Science.gov (United States)

    American Psychologist, 2013

    2013-01-01

    In the past 50 years forensic psychological practice has expanded dramatically. Because the practice of forensic psychology differs in important ways from more traditional practice areas (Monahan, 1980) the "Specialty Guidelines for Forensic Psychologists" were developed and published in 1991 (Committee on Ethical Guidelines for Forensic…

  2. ESUR prostate MR guidelines 2012

    DEFF Research Database (Denmark)

    Barentsz, Jelle O; Richenberg, Jonathan; Clements, Richard;

    2012-01-01

    The aim was to develop clinical guidelines for multi-parametric MRI of the prostate by a group of prostate MRI experts from the European Society of Urogenital Radiology (ESUR), based on literature evidence and consensus expert opinion. True evidence-based guidelines could not be formulated, but a...

  3. Advantages on dry interim storage for spent nuclear fuel

    Energy Technology Data Exchange (ETDEWEB)

    Romanato, L.S. [Centro Tecnologico da Marinha em Sao Paulo, Av. Professor Lineu Prestes 2468, 05508-900 Sao Paulo (Brazil); Rzyski, B.M. [IPEN/ CNEN-SP, 05508-000 Sao Paulo (Brazil)]. e-mail: romanato@ctmsp.mar.mil.br

    2006-07-01

    When the nuclear fuel lose its ability to efficiently create energy it is removed from the core reactor and moved to a storage unit waiting for a final destination. Generally, the spent nuclear fuel (SNF) remains inside concrete basins with water within the reactors facility for the radioactive activity decay. Water cools the generated heat and shields radioactivity emissions. After some period of time in water basins the SNF can be sent to a definitive deposition in a geological repository and handled as radioactive waste or to reprocessing installations, or still wait for a future solution. Meanwhile, SNF remains stored for a period of time in dry or wet installations, depending on the method adopted by the nuclear power plant or other plans of the country. In many SNF wet storage sites the capacity can be fulfilled very quickly. If so, additional area or other alternative storage system should be given. There are many options to provide capacity increase in the wet storage area, but dry storages are worldwide preferred since it reduces corrosion concerns. In the wet storage the temperature and water purity should be constantly controlled whereas in the dry storage the SNF stands protected in specially designed canisters. Dry interim storages are practical and approved in many countries especially that have the 'wait and see' philosophy (wait to see new technologies development). This paper shows the advantages of dry interim storages sites in comparison with the wet ones and the nowadays problems as terrorism. (Author)

  4. Glass packages in interim storage; Les verres dans les stockages

    Energy Technology Data Exchange (ETDEWEB)

    Jacquet-Francillon, N.

    1994-10-01

    This report summarize the current state of knowledge concerning the behavior of type C waste packages consisting of vitrified high-level solutions produced by reprocessing spent fuel. The composition and the physical and chemical properties of the feed solutions are reviewed, and the vitrification process is described. Sodium alumino-borosilicate glass compositions are generally employed - the glass used at la Hague for LWR fuel solutions, for example, contains 45 % SiO{sub 2}. The major physical, chemical, mechanical and thermal properties of the glass are reviewed. In order to allow their thermal power to diminish, the 3630 glass packages produced (as of January 1993) in the vitrification facilities at Marcoule and La Hague are placed in interim storage for several decades. The actual interim storage period has not been defined, as it is closely related to the concept and organization selected for the final destination of the packages: a geological repository. The glass behavior under irradiation is described. Considerable basic and applied research has been conducted to assess the aqueous leaching behavior of nuclear containment glass. The effects of various repository parameters (temperature, flow rate, nature of the environmental materials) have been investigated. The experimental findings have been used to specify a model describing the kinetics of aqueous corrosion of the glass. More generally all the ``source term`` models developed in France by the CEA or by ANDRA are summarized. (author). 152 refs., 33 figs.

  5. Nuclear waste: Is there a need for federal interim storage

    International Nuclear Information System (INIS)

    The Congress created the Monitored Retrievable Storage Review Commission to provide a report on the need for a Federal monitored retrievable storage facility (MRS) as part of the Nation's nuclear waste management system. The Commission concludes that the MRS as presently described in the law, which links the capacity and schedule of operation of the MRS to a permanent geologic repository, cannot be justified. The Commission finds, however, that while no single factor would favor an MRS over the No-MRS option, cumulatively the advantages of an MRS would justify the building of an MRS if: there were no linkages between the MRS and the repository; the MRS could be constructed at an early date; and the opening of the repository were delayed considerably beyond its presently scheduled date of operation. The Commission therefore recommends that the Congress take the following actions: Authorize construction of a Federal Emergency Storage facility with a capacity limit of 2,000 metric tons of uranium; Authorize construction of a User-Funded Interim Storage facility with a capacity limit of 5,000 metric tons of uranium; Reconsider the subject of interim storage by the year 2000

  6. Interim FEP report for the safety assessment SR-Can

    Energy Technology Data Exchange (ETDEWEB)

    Skagius, Kristina (ed.) [Kemakta Konsult AB, Stockholm (Sweden)

    2004-08-01

    This report describes the work with identification and structuring of features, events and processes (FEPs) that has been carried out within the scope of the SR-Can safety assessment up to the time of the interim reporting of the project. The overall objective of the work is to develop a database of features, events and processes in a format that would facilitate both a systematic analysis of FEPs and documentation of the FEP analysis as well as facilitate revisions and updates to be made in connection with new safety assessments. This overall objective also includes the development of procedures for a systematic FEP analysis as well as to apply these procedures in order to arrive at an SR-Can version of the FEP database. The work started by implementing the content of the SR 97 Process report into a database format suitable for import and processing of FEP information from other sources. The SR 97 version of the database was systematically audited against the NEA database with Project FEPs, version 1.2. In addition, an earlier audit of the SR 97 process report against the interaction matrices developed for a deep repository of the KBS-3 type was revisited and updated. Relevant FEPs from the audit were sorted into three main categories in the SR-Can database i) FEPs related to the initial states of the repository system, ii) FEPs related to internal processes of the repository system, and iii) FEPs related to external impacts on the repository system. These groups of FEPs were further processed for making decisions on how to handle these FEPs in the assessment. Biosphere processes were not included in the SR 97 Process report and there is thus not the same basis for updating these descriptions as for the engineered barriers and the geosphere. All biosphere FEPs from the audit have therefore been compiled in a single category in the database, but remain to be further handled. FEPs were also categorised as irrelevant or as being related to methodology on a general

  7. Colonie Interim Storage Site annual environmental report for calendar year 1991, Colonie, New York

    International Nuclear Information System (INIS)

    This document describes the environmental monitoring program at the Colonie Interim Storage Site (CISS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring at CISS began in 1984 when Congress added the site to the US Department of Energy's Formerly Utilized Sites Remedial Action Program. CISS property and surrounding areas were radioactively contaminated by operations conducted by National Lead Industries, which manufactured various components from uranium and thorium from 1958 to 1984. The environmental monitoring program at CISS includes sampling networks for external gamma radiation exposure and for radium-226, thorium-232, and total uranium concentrations in surface water, sediment, and groundwater. Additionally, several nonradiological parameters are measured in groundwater. In 1992 the program will also include sampling networks for radioactive and chemical contaminants in stormwater to meet permit application requirements under the Clean Water Act. Monitoring results are compared with applicable Environmental Protection Agency (EPA) standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE.orders. Environmental standards are established to protect public health and the environment. Results of environmental monitoring during 1991 indicate that average concentrations of radioactive contaminants of concern were well below applicable standards and DCGS. Concentrations of some chemical contaminants in groundwater were above-the New York State Department of Environmental Conservation (Class GA) and EPA guidelines for drinking water. The potential annual radiation exposure (excluding background) calculated for a hypothetical maximally exposed individual is 0.23 mrem (milliroentgen equivalent man), which is less than an individual would receive while traveling in an airplane at 12,000 meters (39,000 feet) for one hour

  8. Interim report on assessment of cable aging for nuclear power plants

    International Nuclear Information System (INIS)

    Research on assessment of cable aging for nuclear power plants (NPPs) started in 2002 in order to obtain data of safety-related cables affected by thermal aging, simultaneous thermal and radiation aging, and Loss-of-Coolant Accident (LOCA) equivalent test, which could contribute to draft guideline on comprehensive assessment of cable aging for NPPs while taking into consideration the latest knowledge. For the cable aging test, cross-linked polyethylene, flame-retardant cross-linked polyethylene, ethylene propylene rubber, flame-retardant ethylene propylene rubber, silicone rubber and special heat-resistant polyvinyl chloride insulators were selected from the safety-related cables used in the nuclear power plants. Furthermore, 2 to 3 kinds of cables with insulators of different manufacturers were added making a total of 14 kinds of cable specimens for the test. Aging period was selected as a basic parameter while three temperature conditions for thermal aging specimen and combined nine conditions of three temperatures with three dose rates for simultaneous aging specimens. Degradation of cable aging was characterized by elongation at break of tensile test. LOCA test for 9 kinds of cables was also conducted using the simultaneous aging specimens. Furthermore, the investigation of applicability of non-destructive degradation diagnostic technologies for aged cables was conducted to confirm the validity of cable aging evaluation at actual operating plants. Interim report was issued in 2006 and based on cable aging test until 21,000 hrs maximum; 1) a significant difference might be observed at times in the aging progress depending on the insulator manufacturer even if the insulator type was identical, 2) activation energy values calculated from the thermal aging test data were smaller than those currently used and principles of calculation and application of the activation energy were developed for evaluation and 3) superposition of time dependent data was applicable to

  9. Flow-based market coupling. A joint ETSO-EuroPEX proposal for cross-border congestion management and integration of electricity markets in Europe. Interim report

    International Nuclear Information System (INIS)

    , it does not attempt to put forward a prescriptive 'blueprint' for a particular market model, but rather to signal a general direction. It is assumed that implementation of changes in practice would proceed through a series of regional initiatives, governed where necessary by the EU Regulation on Cross-border Exchanges of Electricity, together with the associated Guidelines. The FMC model describes arrangements for day-ahead trading. This needs to be part of a broader set of arrangements including, on one side, effective opportunities for participants to hedge price risk and, on the other side, complementary adjustment and balancing arrangements. FMC is compatible with price risk being hedged via a variety of forward physical or financial markets. The minimum set of regulatory/contractual arrangements necessary to implement FMC has been identified. Some issues concerning the status of power exchanges in some Member States remain to be resolved, particularly regarding the designated nature of the proposed day-ahead market. The transmission modelling and market co-ordination processes remain to be specified in technical detail. Both should be as transparent as reasonably possible, and the latter is likely to be an iterative process, introducing the possibility of convergence issues. Subject to the response to this interim report from other parties, ETSO and EuroPEX agree that the FMC concept should be developed further. Eventual deliverables should include inputs for consideration under the EU Comitology procedure, and advice for consideration by local implementation projects

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Eccles Martin P

    2012-07-01

    Full Text Available Abstract 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.

  12. Comparative risk assessments for the production and interim storage of glass and ceramic waste forms: defense waste processing facility

    International Nuclear Information System (INIS)

    The Defense Waste Processing Facility (DWPF) for immobilizing nuclear high level waste (HLW) is scheduled to be built at the Savannah River Plant (SRP). High level waste is produced when SRP reactor components are subjected to chemical separation operations. Two candidates for immobilizing this HLW are borosilicate glass and crystalline ceramic, either being contained in weld-sealed stainless steel canisters. A number of technical analyses are being conducted to support a selection between these two waste forms. The present document compares the risks associated with the manufacture and interim storage of these two forms in the DWPF. Process information used in the risk analysis was taken primarily from a DWPF processibility analysis. The DWPF environmental analysis provided much of the necessary environmental information. To perform the comparative risk assessments, consequences of the postulated accidents are calculated in terms of: (1) the maximum dose to an off-site individual; and (2) the dose to off-site population within 80 kilometers of the DWPF, both taken in terms of the 50-year inhalation dose commitment. The consequences are then multiplied by the estimated accident probabilities to obtain the risks. The analyses indicate that the maximum exposure risk to an individual resulting from the accidents postulated for both the production and interim storage of either waste form represents only an insignificant fraction of the natural background radiation of about 90 mrem per year per person in the local area. They also show that there is no disaster potential to the off-site population. Therefore, the risks from abnormal events in the production and the interim storage of the DWPF waste forms should not be considered as a dominant factor in the selection of the final waste form

  13. Mortes evitáveis em pacientes de trauma associadas a não adesão às diretrizes de atendimento Preventable deaths in trauma patients associated with non adherence to management guidelines

    Directory of Open Access Journals (Sweden)

    Antonio Cesar Marson

    2010-09-01

    patients treated for traumatic injuries and to identify adherence to guidelines recommendations of treatment and association with death. The recommendations adopted were defined by the committee on trauma of the American College of Surgeons in advanced trauma life support. METHODS: Retrospective cohort study conducted at a teaching hospital. The study population was victims of trauma > 12 years of age with injury severity scores > 16 who were treated between January 1997 and December 2001. Data collection was divided into three phases: pre-hospital, in-hospital, and post-mortem. The data collected were analyzed using EPI INFO. RESULTS: We analyzed 207 patients, 147 blunt trauma victims (71% and 60 (29% penetrating trauma victims. Trauma victims had a 40.1% mortality rate. We identified 221 non adherence events that occurred in 137 patients. We found a mean of 1.61 non adherence per patient, and it occurred less frequently in survivors (1.4 than in non-survivors (1.9; p=0.033. According to the trauma score and injury severity score methodology, 54.2% of deaths were considered potentially preventable. Non adherence occurred 1.77 times more frequently in those considered potentially preventable deaths compared to other non-survivors (95% CI: 1.12-2.77; p=0.012, and 92.9% of the multiple non adherence occurred in the first group (p=0.029. CONCLUSIONS: Non adherence occurred more frequently in patients with potentially preventable deaths. Non adherence to guidelines recommendations can be considered a contributing factor to death in trauma victims and can lead to an increase in the number of potentially preventable deaths.

  14. Tropical fevers: Management guidelines

    Directory of Open Access Journals (Sweden)

    Sunit Singhi

    2014-01-01

    Full Text Available Tropical fevers were defined as infections that are prevalent in, or are unique to tropical and subtropical regions. Some of these occur throughout the year and some especially in rainy and post-rainy season. Concerned about high prevalence and morbidity and mortality caused by these infections, and overlapping clinical presentations, difficulties in arriving at specific diagnoses and need for early empiric treatment, Indian Society of Critical Care Medicine (ISCCM constituted an expert committee to develop a consensus statement and guidelines for management of these diseases in the emergency and critical care. The committee decided to focus on most common infections on the basis of available epidemiologic data from India and overall experience of the group. These included dengue hemorrhagic fever, rickettsial infections/scrub typhus, malaria (usually falciparum, typhoid, and leptospira bacterial sepsis and common viral infections like influenza. The committee recommends a ′syndromic approach′ to diagnosis and treatment of critical tropical infections and has identified five major clinical syndromes: undifferentiated fever, fever with rash / thrombocytopenia, fever with acute respiratory distress syndrome (ARDS, fever with encephalopathy and fever with multi organ dysfunction syndrome. Evidence based algorithms are presented to guide critical care specialists to choose reliable rapid diagnostic modalities and early empiric therapy based on clinical syndromes.

  15. Emergency Response Guideline Development

    Energy Technology Data Exchange (ETDEWEB)

    Gary D. Storrick

    2007-09-30

    Task 5 of the collaborative effort between ORNL, Brazil, and Westinghouse for the International Nuclear Energy Research Initiative entitled “Development of Advanced Instrumentation and Control for an Integrated Primary System Reactor” focuses on operator control and protection system interaction, with particular emphasis on developing emergency response guidelines (ERGs). As in the earlier tasks, we will use the IRIS plant as a specific example of an integrated primary system reactor (IPSR) design. The present state of the IRIS plant design – specifically, the lack of a detailed secondary system design – precludes establishing detailed emergency procedures at this time. However, we can create a structure for their eventual development. This report summarizes our progress to date. Section 1.2 describes the scope of this effort. Section 2 compares IPSR ERG development to the recent AP1000 effort, and identifies three key plant differences that affect the ERGs and control room designs. The next three sections investigate these differences in more detail. Section 3 reviews the IRIS Safety-by-Design™ philosophy and its impact on the ERGs. Section 4 looks at differences between the IRIS and traditional loop PWR I&C Systems, and considers their implications for both control room design and ERG development. Section 5 examines the implications of having one operating staff control multiple reactor units. Section 6 provides sample IRIS emergency operating procedures (EOPs). Section 7 summarizes our conclusions.

  16. Wind and tornado guidelines

    International Nuclear Information System (INIS)

    The objective of the Department of Energy Natural Phenomena Hazards Project is to provide guidance and criteria for design of new facilities and for evaluation of existing ones subjected to extreme winds, earthquakes, and floods. This paper describes the treatment of wind and tornado hazards. Four facility-use categories are defined which represent increasing levels of risk to personnel or the environment in the event of a high wind event. Facilities are assigned to a particular category, depending on their mission, value, or toxic material content. The assigned facility-use category determines the design and evaluation criteria. The criteria are based on probabilistic hazard assessment. Performance goals are also specified for each facility-use category. A uniform approach to design wind loads, based on the ANSI A58.1-1982 standard, allows treatment of high winds and hurricane and tornado winds in a similar manner. Based on the wind hazard models, some sites must account for the possibility of tornadoes while others do not. Atmospheric pressure changes and missiles must be taken into account when considering tornadoes. The design and evaluation guidelines are designed to establish consistent levels of risk for different natural phenomena hazards and for facilities at different geographical locations

  17. Get With The Guidelines Stroke Performance Indicators in a Brazilian Tertiary Hospital

    OpenAIRE

    de Carvalho, Flavio Augusto; Schwamm, Lee H.; Kuster, Gustavo W.; Bueno Alves, Monique; Cendoroglo Neto, Miguel; Sampaio Silva, Gisele

    2012-01-01

    Background Stroke is the fourth leading killer in the US, the first in Brazil and a leading cause of adult long-term disability in both countries. In spite of widespread recommendation, clinical practice guidelines have had limited effect on changing physician behavior. Recognizing that both knowledge and acceptance of guidelines do not necessarily imply guideline adherence, the American Heart Association/American Stroke Association (AHA/ASA) developed a national stroke quality improvement pr...

  18. Trastornos temporomandibulares: Perfil clínico, comorbilidad, asociaciones etiológicas y orientaciones terapéuticas Temporomandibular disorders: clinical profile, comorbility, etiological associations and therapeutical guidelines

    Directory of Open Access Journals (Sweden)

    W. Meeder Bella

    2010-08-01

    Full Text Available Objetivo: El propósito de la presente investigación fue dilucidar factores etiológicos y determinar la comorbilidad en enfermos con trastornos temporomandibulares (TTM y dolor orofacial (DOF, con el objetivo de definir orientaciones terapéuticas. Materiales y métodos: Se realizó un estudio clínico-anamnésico entre abril de 2004 y abril de 2008, en pacientes que concurrieron en forma espontánea a la clínica universitaria de la especialidad. Resultados: Se examinaron 263 pacientes, de los cuales 80,22% fueron mujeres. El motivo de consulta más prevalente fue dolor cráneo-cérvicofacial (84%. El 49,43% de los pacientes no reconoció la causa de inicio del problema, siendo "estrés/depresión" (24,71% la más referida. Los TTM representaron una condición eminentemente crónica: el 34,55% de los pacientes relataron un tiempo de evolución entre 1-5 años, solo un 17,58% tuvo una evolución menor de 6 meses. La frecuencia relativa de diagnósticos, no excluyentes, fue: dolor muscular local, 81,37%; capsulitis/sinovitis, 74,52%; y desórdenes psicosociales, 61,98%. Se observó alta comorbilidad con cefaleas, 55,89%; alteraciones psicosociales, 52,47%; disturbios del sueño, 39,54%, y alteraciones cervicales, 28,9% Discusión: Las características sociodemográficas y clínicas de los pacientes evaluados, se corresponden con los reportes de la literatura actual. Se encontraron asociaciones significativas entre: bruxismo y dolor muscular local (p=0,014; bruxismo y capsulitis/sinovitis (p=0,025, y depresión severa/moderada con dolor muscular local (p=0,006. Se concluye que para el tratamiento de pacientes con TTM es necesaria la autorregulación física, el control de parafunciones y la colaboración interdisciplinaria.Purpose: The aim of this study was to elucidate the etiologic factors and assess comorbidity in patients with temporomandibular disorders (TMD and orofacial pain (OFP, to define therapeutic guidelines. Materials and methods: A

  19. Guideline Implementation: Processing Flexible Endoscopes.

    Science.gov (United States)

    Bashaw, Marie A

    2016-09-01

    The updated AORN "Guideline for processing flexible endoscopes" provides guidance to perioperative, endoscopy, and sterile processing personnel for processing all types of reusable flexible endoscopes and accessories in all procedural settings. This article focuses on key points of the guideline to help perioperative personnel safely and effectively process flexible endoscopes to prevent infection transmission. The key points address verification of manual cleaning, mechanical cleaning and processing, storage in a drying cabinet, determination of maximum storage time before reprocessing is needed, and considerations for implementing a microbiologic surveillance program. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  20. Guideline Implementation: Processing Flexible Endoscopes.

    Science.gov (United States)

    Bashaw, Marie A

    2016-09-01

    The updated AORN "Guideline for processing flexible endoscopes" provides guidance to perioperative, endoscopy, and sterile processing personnel for processing all types of reusable flexible endoscopes and accessories in all procedural settings. This article focuses on key points of the guideline to help perioperative personnel safely and effectively process flexible endoscopes to prevent infection transmission. The key points address verification of manual cleaning, mechanical cleaning and processing, storage in a drying cabinet, determination of maximum storage time before reprocessing is needed, and considerations for implementing a microbiologic surveillance program. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. PMID:27568535